International Journal of Medical Science and Clinical Research Studies

Considerations in Dressler Syndrome: A Comprehensive Review

Mon, 01 Apr 2024 00:00:00 +0000

Dressler Syndrome, also known as post-myocardial infarction syndrome, is a rare but potentially serious complication that occurs following myocardial infarction or cardiac surgery. It is characterized by pericarditis, pleuritis, and fever, typically presenting weeks to months after the initial event. This article provides a comprehensive review of Dressler Syndrome, including its pathophysiology, clinical presentation, diagnosis, and management. Additionally, it discusses the importance of early recognition and appropriate treatment to prevent complications and improve outcomes.

Role of Physician in Fitness before Surgery

Raghavi Abhilesh Bembey, Dr. Ram Babu — Tue, 02 Apr 2024 00:00:00 +0000

A preoperative checkup is necessary for every patient undergoing surgery. A physician's opinion is vital in deciding the suitability of major or minor surgeries by assessing the health status of the patients. Multiple parameters must be monitored and recorded, including a proper history, thorough clinical examination, and an appropriate laboratory checkup. By assessing pre and perioperative risks, the physician can optimize the patient's medical conditions to reduce morbidity and mortality, improving outcomes and quality of life. This chapter discusses these topics at length and provides recommendations for fellow practitioners.

Forehead Flap in Nasal Tip Reconstruction

Tue, 02 Apr 2024 00:00:00 +0000

The forehead flap is a long-standing surgical technique used for nasal restoration. The forehead flap is considered the most reliable method for reconstructing nasal soft tissue. It offers a reconstructive surgeon a strong pedicle and a significant volume of tissue, making it suitable for repairing nearly any lesion. The modifications made by experts such as Burget and Menick have significantly enhanced the functionality of this outstanding flap. The guiding principles for reconstructing the nose with a forehead flap involve maintaining a straight line along the axis, using the pedicle on the same side as the defect, expanding the flap at a right angle when additional length is required, employing a small pedicle, and performing early subperiosteal dissection. Furthermore, the issue of lining abnormalities can be effectively and dependably resolved through the utilization of a folded forehead flap.

Updates in Diagnosis and Management of Forearm Compartment Syndrome

Tue, 02 Apr 2024 00:00:00 +0000

In children, compartment syndrome of the forearm often arises from supracondylar fractures, whereas in adults, distal radius fractures are the predominant cause. In 48% of instances, diagnosis was based exclusively on clinical assessment, while in the remaining 52% of cases, a combination of intracompartmental pressure measurement and clinical assessment was used. Several methods, including wick catheters, slit catheters, the Whitesides method, and the Stryker compartment pressure measurement device, were employed to measure intracompartmental pressure. The treatment approach of choice was fasciotomy, with a preference rate of 73%. Out of all the patients that needed wound management, postfasciotomy skin grafting was essential in 61% of them, while secondary closure was done in 39% of cases. The most prevalent consequence, observed in 21% of patients, was neurological impairment.

What a Day in Medicine!!

Dr Gauri — Wed, 03 Apr 2024 00:00:00 +0000

Science amazes us every day, whether it’s a call from your beloved from thousands of miles away , your favorite program on TV aired from faraway places , your coffee machine that makes your delicious cup of coffee, your car, your laptop, internet, wireless connectivity , Alexa/Google/Siri ,Social media, AI applications and what not! We are so much used to these luxuries that we fail to stop for a second to realize how awesome they are.

High Decibels as Causing Deconcentration and Hearing Damage in Pilots, Crew Members and Passengers Passengers: Experimental Study in the Brazilian Air Force

Wed, 03 Apr 2024 00:00:00 +0000

Hearing is one of the main senses for aeronautical activities and plays a key role in the intelligibility of communications between pilots. Noise is a factor that impairs good hearing and can lead to various health problems, as well as impairing the performance of aviation cadets when they perform multiple tasks during flight. It is important to educate airmen about how noise can negatively affect instructional flights and the conditions that expose them to too much of a drop in concentration during flights. The sound pressure levels to which cadet airmen are exposed during their training is an aggravating factor for their communication and safety. The aim of this study was to determine whether there is a relationship between noise and loss of concentration during instruction in the Neiva T-25 aircraft, with the aim of collecting and analyzing data in order to improve air mission instruction in terms of health and flight safety by highlighting the harmful nature of noise in the Second Air Instruction Squadron (2º EIA). A questionnaire with eight questions about the influence of noise on the performance of aerial mission practices was administered to a sample of 20 Cadet Aviators from the Second Squadron who were taking part in the aerial instruction course in the Neiva T-25. The results of the questionnaires showed the importance of raising awareness about the harmful effects of noise in military activity, as it is a matter of flight safety.

The Use of Negative Pressure Wound Therapy (NPWT) as a Dressing for Split Thickness Skin Graft for Bilateral Chronic Venous Leg Ulcer

Vikas Indru Moorjani, Metaudina Chandra Pratiwi, Brevitra Janesa Bismedi — Thu, 04 Apr 2024 00:00:00 +0000

Background: Chronic ulcer is a type of wound, which persists for at least 3 months. One of the causes of chronic ulcer is deep vein thrombosis (DVT). Chronic ulcers require very high maintenance costs and can negatively impact the patient’s quality of life and mental health.

Case Illustration: A 40-year-old man came to the hospital with a history of chronic ulcer on both legs, which first appeared 3 years ago. The Patient had undergone treatment at a public outpatient clinic and hospital, unfortunately the wound did not heal. The patient continued to change the bandage independently and did not go to the doctor for wound control. Upon doppler ultrasound, a sign of deep vein thrombosis (DVT) was observed. Negative Pressure Wound therapy (NPWT) was used for wound bed preparation, Split Thickness Skin Graft (STSG) on the left foot was used as a dressing, while conventional dressing was chosen for the right foot. The graft take on the left foot with NPWT was 95%, while the one on the right foot with conventional dressing was 90%.

Discussion: Negative pressure wound therapy (NPWT) is a closed system that applies negative pressure through continuous or intermittent suction. NPWT can be used in wound bed preparation to reduce biofilm. NNPWT helps in the removal of exudates from the wound, thus preventing the build-up of serous fluids and blood, reducing the growth of bacteria at the base of the wound, which helps tissue growth after split thickness skin graft (STSG).

Conclusion: NPWT stimulates better healing after surgery. The left leg, which used NPWT after STSG had faster healing time and better aesthetic result by promoting graft take. The graft take on the left leg (with NPWT) was higher compared to the right leg.

Successful Treatment of Cerebral Tuberculoma in Acquired Immune Deficiency Syndrome Patient a Case Report

Rachmad Aji Saksana, Ika Trisnawati, Eko Budiono — Fri, 05 Apr 2024 00:00:00 +0000

Introduction: Tuberculosis (TB) remains a leading problem in developing and endemic countries. Cerebral tuberculosis is a rare but dangerous complication of tuberculosis infection in the central nervous system. The immunosuppressive condition in human immunodeficiency virus infection is a risk factor for severe tuberculosis.

Case Report: An Indonesian man, 32 years old, married, came with complaints of headaches, dizziness, delirium, nausea and vomiting since 1 month before the examination. He had a history of TB treatment 1 year before the examination. The results of the neurological examination were within normal limits, the HIV test was reactive and there was a decrease in CD4. Head MRI examination with contrast showed multiple solid nodules in the thalamus with the largest size 2.3×2.7 cm, indicating cerebral tuberculoma. Chest x-ray was normal, GeneXpert MTB sputum was not detected. Next, primary treatment is given with anti-tuberculosis drugs, Highly Active Antiretroviral Therapy (HAART), co-trimoxazole, and dexamethasone. There was clinical, laboratory and radiological improvement after 12 months of treatment. Viral load is undetectable, CD4 is elevated. A head CT scan did not show tuberculoma. He became healthy and was able to return to work

Discussion: Cerebral tuberculoma is a condition characterized by the presence of intracranial tuberculoma. The clinical manifestations are non-specific, such as headaches or seizures. This is caused by space occupying lesions and increase intracranial pressure. In this case, the diagnosis of cerebral tuberculoma was made through head MRI with contrast. TB therapy and co-trimoxazole are given as soon as the diagnosis is made, while antiretrovirals are given 2 weeks after he has tolerated the TB medication. The minimum duration of therapy for cerebral tuberculosis is 12 months. He require lifelong antiretroviral medication.

Conclusion: Tuberculoma should be considered as differential diagnosis of space-occupying lesions in patients HIV/AIDS. Early diagnosis, adequate therapy, patient adherence and family support can cure severe tuberculosis.

Immunopathogenesis and Therapeutic Insights into Cicatricial Pemphigoid: A Comprehensive Review

Mon, 08 Apr 2024 00:00:00 +0000

Cicatricial Pemphigoid (CP), also known as mucous membrane pemphigoid, is a rare autoimmune blistering disorder characterized by subepithelial blistering and scarring of mucous membranes. The hallmark of CP is the formation of autoantibodies against structural proteins within the basement membrane zone, leading to an array of clinical manifestations affecting oral, ocular, and other mucosal surfaces. This review aims to elucidate the complex immunopathogenic mechanisms underlying CP, exploring the role of autoantigens such as BP180 and BP230, as well as the involvement of inflammatory mediators and immune cells. Additionally, the article provides a comprehensive overview of current diagnostic modalities and therapeutic approaches, ranging from systemic corticosteroids to novel immunomodulatory agents and biological therapies. The challenges in managing CP, including potential side effects of immunosuppressive treatments, are discussed alongside emerging strategies to enhance treatment efficacy and minimize adverse effects. A deeper understanding of the molecular pathways involved in CP pathogenesis is crucial for the development of targeted therapies, fostering improved patient outcomes and quality of life

Meckel's Diverticulum: A Literature Review of Basic Concepts, Diagnosis and Treatment Options

Tue, 09 Apr 2024 00:00:00 +0000

Meckel's diverticulum (MD) is a common congenital anomaly of the gastrointestinal tract, characterized by an outpouching in the terminal ileum. It can be symptomatic in various ways, most commonly causing ulcers and gastrointestinal bleeding. Complications such as bleeding, perforation, diverticulitis, or intestinal obstruction may develop in approximately 4% of patients. Diagnosis can be challenging, but a CT scan is often the tool of choice, particularly for identifying complications. Surgical procedures like laparoscopy or laparotomy provide a more accurate diagnosis. Treatment typically involves surgical removal of the diverticulum, with laparoscopy being a safe and effective method. Risk factors for acute complications in adults include age under 50, male sex, MD length over 2 centimeters, and intradiverticular tissue abnormalities.

Pediatric Considerations in Pompe Disease: A Comprehensive Review

Fri, 12 Apr 2024 00:00:00 +0000

Pompe disease, also known as glycogen storage disease type II, is a rare inherited disorder caused by a deficiency of the enzyme acid alpha-glucosidase (GAA), leading to the accumulation of glycogen in various tissues, particularly muscles. While Pompe disease can affect individuals of all ages, its presentation and management in pediatric patients present unique challenges. This review aims to provide a comprehensive overview of the clinical manifestations, diagnosis, and management of Pompe disease in pediatric populations. Special considerations in the areas of respiratory support, nutrition, physical therapy, and long-term outcomes will be discussed. Understanding these aspects is crucial for optimizing the care and quality of life for children with Pompe disease

Effectivity of Beetroot in Increasing Pregnant Women Hemoglobin

Intan Renata Silitonga, Nina Nur Hayati — Sat, 13 Apr 2024 00:00:00 +0000

The background is that anemia is a major problem in pregnancy women. According to Riskesdas 2019 there are 20.1 % of anemia in West Java. In Cimenyan Public Health Center area there are 37% pregnant women with anemia at 2022. The government has done efforts to reduce this condition by giving the iron tablets to pregnant women. Food supplementation that are rich of iron nutrition such as beetroot consumption can increase the hemoglobin. From the prelimary studies founded that 6 from 10 pregnant women never exprerience consuming beetroot and doesnt know the benefits of consuming beetroot.

The aim of the study is to know the effectivity of consuming beetroot in increasing hemoglobin of pregnant women with anemia.

The methode is quasy experiment with one group pretest and post-test design, with purposive sampling technique, with 34 subjects. This research use the standard procedure of processing and consuming beetroot. Respondent’s hemoglobin are measure with hemoglobinometer before and after beetroot comsumption. The statistic use bivariate analysis with Wilcoxon test.

The result is that the hemoglobin median value from 34 subjects before consuming beetroot juice is 9.75 gr/dl, and after consuming beetroot juice is 10.7 gr/dl. From the statistic test is Sig value (0,000) that means the beetroot juice consumption effectivity increases hemoglobin level in pregnant women with anemia.

The conclusion is that the consuming beetroot is effective in increasing pregnant women hemoglobin with anemia.

Importance of Renal Graft Reperfusion Thermoregulation in Living Donor Kidney Transplant Patients: Gasometrical and Hemodynamical Study

Sat, 13 Apr 2024 00:00:00 +0000

INTRODUCTION: Hypothermia, defined as a decrease in core body temperature below 36°C, has a notable influence on hemodynamic variables during anesthesia, which is of great interest in perioperative medicine. Temperature regulation is crucial in anesthetic management because hypothermia can significantly impact the patient's cardiovascular functioning. Accidental (uncontrolled) hypothermia during anesthetic and surgical procedures carries considerable risks such as: Increases the incidence of surgical site infections, prolongs the effects of drugs administered during anesthesia, and disrupts normal coagulation, potentially increasing the risk of bleeding. For these reasons, body temperature regulation is a critical aspect to monitor and control during anesthesia.

MATERIAL AND METHODS: A descriptive, observational, single-center, and retrospective study was carried out in patients undergoing a related living donor kidney transplant between June 2022-2023 at the Juarez Hospital in Mexico. All data were collected from the demographic sheets, laboratories and trans anesthetic sheets of the patient's file. The data was integrated into an Excel database and statistical processing was performed in SPSS or STATSm software. The statistical analysis was tested for normality according to Kolmogorov-Smirnov with Lilliefors correction, where it was found that the population has a normal or non-normal distribution. The Mann-Whitney U test was performed to compare the difference of the means between the two groups. A correlation was made with Kendall´s Tau coefficient; All statistical analyzes were performed with a value of p<0.05, considering these significantly.

RESULTS: Of the 65 transplanted patients between Jun 2023 and June 2024 only 28 have appropriate inclusion criteria. Of the remaining 28, 16 were female (57.14%) and 12 were male (42.8%) with an average age of recipients of 30.2430.46 ±11.45 years with a weight of 58.23 ±10.47 kg, height 154.20 ±15.32 cm.

Gasometrical and Hemodynamic Values upon Reperfusion with a Forced Air Turbine. The gasometrical variables before reperfusion were: Venous pH 7.41±0.05 (p=0.046); Arterial pH 7.40±0.04 (p=0.015); Venous Oxygen Saturation 68.2±9.74% (p = 0.039). Hemodynamic variables before reperfusion were: IC 3.67±1.77 lt/min/m2 (p=0.001); Stroke Volume 79.5±39.6 ml/beat (p=0.022), Oxygen Extraction 25.1±9.95% (p=0.001) and Myocardial Efficiency 0.28±0.06 (p=0.024); The gasometrical variables after reperfusion were: Venous pH 7.40±0.03; Arterial pH 7.380±0.04; Venous Oxygen Saturation 60.03±4.37%; The hemodynamic variables after reperfusion were: IC 2.88±0.48 liter/min/m2; Stroke Volume 65.4±16.01 ml/beat; Oxygen Extraction Rate 36.9±4.31% (p = 0.039) and Myocardial Efficiency 0.32±0.06

Gasometrical and Hemodynamic Values upon Reperfusion without Forced Air Turbine. The gasometrical variables before reperfusion were: Venous pH 7.32±0.04 (p=0.012); Arterial pH 7.30±0.04 (p=0.019); Venous Oxygen Saturation 64.7±8.27% (p = 0.026). Hemodynamic variables before reperfusion were Cardiac Index 3.28±1.66 lt/min/m2 (p=0.006); Stroke Volume 72.39±45.44 ml/beat (p=0.029); Oxygen Extraction 29.11±9.65% (p=0.001) and Myocardial Efficiency 0.268±0.08 (p=0.022). The gasometrical variables after reperfusion were: Venous pH 7.33±0.04; Arterial pH 7.320±0.05; Venous Oxygen Saturation 58.593±5.41%. The hemodynamic variables after reperfusion were: Cardiac Index 2.75±0.69 liter/min/m2, Stroke Volume 59.05±18.81 ml/beat, Oxygen Extraction Rate 38.47±6.17% and Myocardial Efficiency 0.31±0.05.

CONCLUSIONS: Understanding the behavior of blood gas and hemodynamic variables upon reperfusion in transplant patients is essential for adequate kidney graft survival. In these patients, the use of a hot forced air turbine improves the conditions under which said reperfusion is performed, impacting not only at the blood gas level (venous pH, arterial pH and venous oxygen saturation) but also at the hemodynamic level (cardiac index, stroke volume, myocardial efficiency The limitations of the study are heterogeneity of the etiologies of CKD, sample size, and volume status prior to the procedure. To date the published works are consistent with the literature.

Lemmel Syndrome as a Cause of Obstructive Jaundice: Case Report

Mon, 15 Apr 2024 00:00:00 +0000

Lemmel syndrome is a rare cause of obstructive jaundice, it was first described in 1934 by Dr. Gerhard Lemmel. It is caused by a periampullary duodenal diverticulum and only 5% are symptomatic. The diagnosis of this entity should be considered in a patient with obstructive jaundice and in the absence of choledocholithiasis or neoplasia. Here we present an 83-year-old male case successfully treated with ERCP.

Validation of Thermography for the Diagnosis of Compartment Syndrome in the Upper Extremities Due To Electrical Burns in Patients with Altered Alertness

Wed, 17 Apr 2024 00:00:00 +0000

Background: Compartment syndrome in the extremities is a surgical emergency that requires decompression to avoid complications, the diagnosis is made through the clinic, if there is doubt it is confirmed with the measurement of intracompartmental pressure by means of an invasive device, it is imperative for the diagnosis to measure it in patients with altered alertness.

Objective: To determine the sensitivity and specificity of thermography compared to the measurement of intracompartmental pressure with the Whiteside method as a diagnosis of upper extremity compartment syndrome in patients with electrical burns with impaired alertness. Thus achieving faster, more accessible, cheaper, reliable and non-invasive detection. It can be used by the first contact physician and/or paramedics, nurses, students for timely diagnosis and treatment, reducing the rate of sequelae and complications.

Material and methods: All patients with a presumptive diagnosis of compartment syndrome in the upper extremities secondary to electrical burn with altered alertness who were admitted to the Adolfo López Mateos Medical Center were included®.Results: In the present study, a sensitivity of 58% and a specificity of 100% were obtained, with a positive predictive value of 100% and a negative predictive value of 50%, as well as a prevalence of 70.58% and an incidence of 7 out of 10 patients.

Conclusion: We can conclude that the study has a good specificity and when analyzing the values present we notice that it can have a good sensitivity which is altered by the amount of the sample of the patients.

Tendinopathies Associated with Statin Therapy in Patients with Dyslipidemia: Case Study

Denisse Eugenia Aguilar Domínguez, Erika Palacios Rosas, Jorge Luis León Álvarez — Thu, 18 Apr 2024 00:00:00 +0000

Statins are considered the initial and first-line treatment in cardiovascular and atherosclerotic diseases, characterized by inhibiting HMG-CoA reductase. Some adverse effects associated with these drugs are injuries to the tendon structure including tenosynovitis, tendon and tendon rupture.

The aim of this article is to evaluate the tendon structure by musculoskeletal ultrasound and to raise the question of whether chronic statin consumption in this patient with dyslipidemia is related to the appearance of tendinopathies.

Methodology A cross-sectional descriptive observational study was carried out, focused on the evaluation of the incidence of tendinopathies in patients who have been using statins chronically. A case study approach was used, analysing in detail a female patient selected according to the established inclusion and exclusion criteria.

The sample consisted of a patient who met the inclusion criteria: age between 45-60 years, chronic use of statins for more than 12 months, presentation of symptoms suggestive of tendinopathy.

Patients with a history of musculoskeletal diseases prior to the start of treatment were excluded, and anyone with arthritis, chronic septic inflammatory processes, athletes, young patients, and those who did not want to participate in the study and did not agree to give informed consent were excluded.

For data collection, 7 patients were selected, of which 1 only met the inclusion and acceptance criteria for the study, a clinical history was taken with exhaustive clinical evaluations of the selected patients, focused on the identification of tendinopathy symptoms and other possible risk factors, at the end a musculoskeletal ultrasound was carried out where possible tendon injuries were identified and characterized. evaluating tendon structure and its relationship to statin use. This methodology provides a detailed and structured approach to conducting research on the incidence of tendinopathies associated with statin use.

Results During the clinical evaluation of this patient, symptoms associated with tendinopathy of the long portion of the biceps brachii on the right side were identified. The results of the musculoskeletal ultrasound confirmed the alterations in the structure of the tendon, finding tenosynovitis, significant peritendinous effusion and microruptures of the long portion of the biceps brachii not only on the affected side, but also on the contralateral side, which was asymptomatic for tendon pathology. In addition, not only was the biceps tendon modified, micro ruptures in the supraspinatus tendon and subacromial bursitis were observed. This patient had been taking atorvastatin 20mg every 24 hours in the mornings for 9 years and was not attributed with any mechanism of overuse injury that triggered multiple tendinopathies at the rotator cuff level.

Fat Embolism Syndrome: A Rare Case Report

Nurul Fadiyah, Khrisnanto Nugroho, Tendi Novara — Tue, 02 Apr 2024 00:00:00 +0000

Background: Fat embolism syndrome (FES) is a life-threatening complication in patients with orthopedic trauma, especially long bone fractures. The diagnosis of fat embolism is made by clinical features alone with no specific laboratory findings. FES has no specific treatment and requires supportive care, although it can be prevented by early fixation of bone fractures. Here, we report a case of FES in a patient with a right closed femoral fractrure severe comminutive, which was diagnosed initially by Gurd’s criteria and subsequently confirmed by typical appearances on Magnetic Resonance Imaging (MRI) of the brain. The most important for fat embolism syndrome management is divided two-fold: preventative and supportive.

Patient: A 43-year-old male fell from a high-rise building approximately 3 days before admission. A deformity was observed on the right thigh and the patient felt intense pain. After a few hours, the patient became weak and experienced a loss of consciousness. He was diagnosed with Fat Embolism Syndrome (FES) by using Gurd’s criteria. The diagnosis was confirmed after excluding other diagnoses with similar clinical presentation.

Peripheral Arterial Insufficiency: A Comprehensive Review of Revascularization Surgery Benefits

Thu, 18 Apr 2024 00:00:00 +0000

Peripheral Arterial Insufficiency (PAI) is a common condition characterized by reduced blood flow to the extremities, leading to symptoms such as claudication, pain, and non-healing wounds. Revascularization surgery, including procedures like angioplasty and bypass grafting, has emerged as a cornerstone in the management of PAI, offering significant improvements in symptoms, quality of life, and limb salvage rates. This review aims to provide a comprehensive overview of PAI, including its pathophysiology, diagnostic modalities, and medical management. Additionally, the review highlights the various revascularization techniques available, their indications, outcomes, and the evolving role of endovascular interventions. Understanding the benefits and limitations of revascularization surgery is crucial for optimizing the care of patients with PAI and reducing the burden of this debilitating disease.

A Systematic Review of Microvascular Reconstruction Techniques in Head and Neck Surgery: Accessing Advancements in Surgical Methods and Functional Outcomes

Thu, 18 Apr 2024 00:00:00 +0000

In recent years, microvascular reconstruction in head and neck surgery has gained significant advancements. With advent of latest technological innovations in microvascular reconstruction techniques, now surgeons have better and more safe option of critical surgeries such as neck and head. Scientists now have a deeper understanding of anatomical complexities because of the latest knowledge and tools. In this systematic review, we aim to discuss the latest technological advancements in head and neck surgery and what kind of microvascular reconstruction techniques are performed with novel surgical methods. Innovations like Augmented Reality (AR) integration, patient-specific implants, and 3D-printed surgical guides have improved surgical outcomes. This review discusses dynamic microvascular reconstruction techniques for facial paralysis. We have emphasised the success of immediate functional gracilis transfer and chimeric flaps. We will discuss novel strategies such as microvascular alternative donor site technology and the adoption of immediate dental implants, which have also contributed to improved aesthetic and functional outcomes.

A Comprehensive Review of Couvelaire Uterus: Diagnosis, and Management

Thu, 18 Apr 2024 00:00:00 +0000

Couvelaire uterus, also known as uteroplacental apoplexy or Couvelaire syndrome, is a rare and serious complication of pregnancy characterized by the extravasation of blood into the myometrium and the formation of a hematoma between the myometrium and the placenta. This review aims to provide a comprehensive overview of the pathophysiology, clinical manifestations, diagnosis, and management of Couvelaire uterus. We discuss the etiology and risk factors associated with the condition, as well as its potential complications and outcomes. Additionally, we outline the various diagnostic modalities available, including ultrasound and magnetic resonance imaging, and describe the current management strategies, which often involve close monitoring and, in severe cases, surgical intervention. By highlighting the key aspects of Couvelaire uterus, this review seeks to enhance clinicians' understanding of this rare condition and improve patient outcomes.

The Interplay between Chagas Disease and Cardiovascular Disorders: A Comprehensive Review

Thu, 18 Apr 2024 00:00:00 +0000

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a neglected tropical disease prevalent in Latin America. While traditionally known for its acute and chronic manifestations, recent research has shed light on its association with cardiovascular disorders. This review aims to explore the intricate relationship between Chagas disease and cardiovascular diseases, including cardiomyopathy, arrhythmias, and thromboembolic events. We delve into the epidemiology, pathophysiology, clinical manifestations, diagnostic challenges, and management strategies of these coexisting conditions. Additionally, we discuss the impact of Chagas disease on the cardiovascular system in the context of global health and highlight the importance of integrated care approaches for affected individuals.

Managing Acne in Individuals with Polycystic Ovarian Syndrome

Daniela Guerrero Carrillo, Jorge Eduardo González Barajas — Thu, 18 Apr 2024 00:00:00 +0000

Acne vulgaris is a prevalent, long-lasting skin condition that affects individuals aged 15 to 40. It appears to be a common ailment that occurs during adolescence. Nevertheless, it frequently impacts adults as well. Polycystic ovarian syndrome (PCOS) is a prevalent cause of acne vulgaris in adult women. The presence of hyperandrogenism and metabolic problems in this condition may lead to the development of comedones, papules, and nodules on the face, chest, and back. This article specifically examines the current therapies for acne that are linked to polycystic ovarian syndrome.

Burden and Epidemiology of Snakebite Envenoming in Tanzania

Fri, 19 Apr 2024 00:00:00 +0000

Background: Snakebite envenoming (SBE) is a pressing public health issue in tropical countries. However, there is a paucity of data regarding the burden and epidemiology of SBE in Tanzania, undermining advocacy and the implementation of necessary prevention and control measures.

Methods: From June to September 2022, both health facility-based and community-based survey was conducted to collect data of the snakebite incidents that occurred between 2017 and 2021 in five regions of Tanzania; Pwani, Manyara, Tabora, Katavi, and Ruvuma. Data were analysed using STATA and summarized by tables and narrative descriptions.

Results: A total of 869 snakebite incidents were registered, resulting in 18 deaths. The estimated annual incidence, and mortality rates were 105.6, and 2.2 per 100,000 people, respectively. Pwani and Tabora regions exhibited a higher proportion of cases, accounting for 26% (226) and 23.4% (203) respectively. Males constituted the majority of cases, representing 52.5% (456), and individuals aged 10 to 59 years were most affected, accounting for approximately 85% of cases. The incidents commonly occurred during agricultural activities (31.5% or 219 cases) and while walking on rural roads (32% or 221 cases). Furthermore, snakebites were more prevalent during the dry season (34% or 295 cases) and the rainy season (25% or 218 cases). Factors such as time of day, season, circumstances/activities, occupation, age, and education level were found to be significantly associated with snakebite incidents.

Conclusion: This study underscore the significant impact of SBE in Tanzania, affecting individuals of all age groups, particularly farmers. Urgent collaborative efforts are required to address and mitigate the consequences of SBE in the country.

A Multifaceted Intervention Program for Improving Heart Health in Elderly Care Homes: A Clinical Trial

Mr. Pritam Dhalla, Mr. Abhilash Chakraverty — Fri, 19 Apr 2024 00:00:00 +0000

This clinical research addresses the critical need for enhanced healthcare practices in geriatric care facilities, where cardiovascular diseases (CVDs) constitute a major risk to the aging population. With CVDs being the primary cause of death among people over 65, the study sought to assess the cardiovascular and pulmonary health of senior residents in care facilities. A pilot study with 7 patients over the age of 65 was undertaken using non-invasive monitoring devices, specifically Cardiomate and WREN. The entire method comprised participant recruiting, medical history gathering, and physiological evaluations.

Notably, the trial revealed a substantial lack of regular monitoring and health checkups in elderly care homes, exacerbated by concerns related to invasive procedures. The participants' restricted willingness to undergo ECG procedures (1:3 ratio) highlighted the importance of patient-friendly monitoring systems. Uncovering hidden health concerns and diseases underlined the significance of complete health evaluations, emphasizing the supposedly asymptomatic character of some ailments.

The study found a significant frequency of cardiovascular and respiratory disorders in geriatric care facilities, highlighting the need for specialized healthcare interventions. Mobility constraints and limited access to routine hospital visits emphasized the need for novel solutions. As a result, the paper calls for the integration of real-time monitoring technologies to bridge existing healthcare gaps in aged care, ensuring continuous surveillance and timely interventions.

The statistical study included descriptive statistics, correlation analyses, and frequency distributions. These studies shed light on physiological parameters, medical history, and diseases, providing important insights for personalized healthcare solutions. Overall, the findings highlight the critical need for multimodal healthcare measures to improve the quality of life and health outcomes for the most vulnerable elderly people in care facilities.

Psoriasis. Definition and Classification of A Complex Entity

Daniela Guerrero Carrillo — Mon, 22 Apr 2024 00:00:00 +0000

Psoriasis, a chronic inflammatory skin condition influenced by hereditary factors and immune system response, exhibits diverse clinical manifestations. While its global incidence is around 2%, prevalence varies across geographical regions and ethnicities. The most common form, psoriasis vulgaris, presents as red, itchy patches with silver-colored scales, predominantly affecting the trunk, limbs, and scalp. Other clinical subtypes include inverse psoriasis, guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis, each with distinct features and impacts. Beyond skin manifestations, psoriasis is associated with various co-occurring medical conditions, including hyperlipidemia, hypertension, coronary artery disease, type 2 diabetes, and obesity. Psoriasis patients have an increased risk of cardiovascular disease, with severity correlating with the incidence of diabetes and cardiovascular events. Additionally, psoriatic arthritis affects around 40% of patients and is often accompanied by nail involvement. Recent studies utilizing imaging techniques like 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) and nuclear magnetic resonance spectroscopy have shed light on systemic inflammation and cardiovascular risk in psoriasis patients. Treatments targeting IL-23 and IL-17 have shown promising results, though long-term efficacy and drug survival remain areas of concern. Psoriasis profoundly impacts patients' quality of life, with psychological distress comparable to cancer and depression. However, treatment can significantly alleviate symptoms and improve overall well-being. Ongoing research aims to expand treatment options, particularly targeting novel molecular pathways. In conclusion, while significant progress has been made in understanding and treating psoriasis, challenges remain in optimizing therapy selection and long-term management. Further research is warranted to elucidate the complex genetic and immunological underpinnings of the disease and to enhance treatment outcomes for affected individuals

Ozenoxacin: A Review of Clinical Efficacy on Impetigo Treatment

Daniela Guerrero Carrillo, Alejandra Guerrero Carrillo — Mon, 22 Apr 2024 00:00:00 +0000

Impetigo, a common bacterial skin infection primarily affecting children, presents a global prevalence of 11.2%, with higher rates among children aged 2-5 years. Caused mainly by Staphylococcus aureus and Streptococcus pyogenes, impetigo lesions typically appear on the face, neck, and hands, spreading easily through scratching and close contact. Effective disease control is essential to alleviate symptoms, prevent complications such as rheumatic heart disease, and reduce transmission rates. Treatment with antimicrobial agents, especially topical antibiotics, is recommended for localized impetigo. Oral antibiotics are reserved for extensive or systemic infections and outbreaks. However, the emergence of antibiotic-resistant strains, including methicillin-resistant S. aureus (MRSA), poses a significant challenge. There is a pressing need for alternative antimicrobial agents effective against resistant strains. Ozenoxacin, a new topical quinolone, inhibits DNA gyrase and topoisomerase IV, essential enzymes for bacterial DNA replication. Unlike other quinolones, ozenoxacin effectively inhibits both enzymes at low concentrations, penetrating bacterial cells rapidly and achieving high intrabacterial concentrations. In tests against S. aureus and S. pyogenes, ozenoxacin exhibited superior bactericidal activity compared to mupirocin and fusidic acid, achieving a 3-log reduction in colony-forming units within 4 hours. Clinical studies have demonstrated the efficacy and safety of ozenoxacin 1% cream in treating impetigo, with placebo-controlled trials confirming its therapeutic effectiveness. Ozenoxacin holds promise as a valuable addition to the armamentarium against impetigo, particularly in the face of rising antibiotic resistance.impetigo, therapy, ozenoxacin

Enhancing Postpartum Health and Behavior: Evaluating The Impact of Postpartum Counselling in Eraviperoor Grama Panchayath

Surya Soman, Bevan Abraham , Jomol Mathew, Riya Thomas, Dr. Philip Jacob — Mon, 22 Apr 2024 00:00:00 +0000

This study aims to assess the effectiveness of patient counseling in improving postpartum health and behavior in the context of Eraviperoor Grama Panchayath. Postpartum health is a critical period in a woman's life, and proper care and behavior during this phase significantly influence maternal and neonatal outcomes. This research employs a mixed-methods approach, combining quantitative surveys and qualitative interviews to comprehensively evaluate the impact of patient counseling on postpartum health and behavior. Objective: Effectiveness of patient counseling on postpartum health & behavior.

The quantitative aspect involves administering structured questionnaires to a sample of postpartum women who have received counseling. These surveys will focus on aspects such as maternal physical health, mental well-being, infant care practices, and adherence to recommended postpartum behaviors. The qualitative component comprises in-depth interviews and postpartum women to gain insights into their perceptions, experiences, and the challenges faced in implementing counseling interventions. It provides a deeper understanding of the nuances surrounding patient counseling in Eraviperoor Grama Panchayath. Results: The PPD was found to be 40% mild /moderate and 4% severe. Baby blues was found to be 77% prevalent. The effectiveness of counseling on overall maternal problems was found to be 96%.

Subcapsular Intrahepatic Hematoma As A Rare Complication of ERCP Secondary to Choledocholithiasis Case Report

Tue, 23 Apr 2024 00:00:00 +0000

Subcapsular Intrahepatic Hematoma represents a challenging clinical entity in the field of endoscopy. We present an interesting and rare case report and a bibliographic review to provide a comprehensive overview of this condition. The article delves into this condition, including its definition, risk factors, incidence, and management strategies. The discussion section highlights emerging approaches and future directions in managing subcapsular liver hematoma. In conclusion, the importance of evidence-based practices in addressing this rare complication of ERCP.

The Relationship between Parenting Pattern of Parents who Work Outside the Home to the Oral Hygiene of Preschool Children in Bobbin Area of Jember

Fri, 26 Apr 2024 00:00:00 +0000

Objective: To examine the overview and relationship of parenting styles of working parents on the oral hygiene of preschool children in the Bobbin Area of Jember.

Metode: Parenting styles applied by each parent vary depending on their perspective. Various parenting styles applied by parents to their children include democratic or authoritative, authoritarian, permissive, and uninvolved parenting styles. One form of parental concern for their child is maintaining oral hygiene. Preschool children are one of the most vulnerable groups to dental and oral health problems. This study is an analytical observational study with a cross-sectional approach and using purposive sampling technique. The study used 79 respondents who filled out a questionnaire.

Results: The average parenting style applied by parents is authoritative and the status of oral hygiene of preschool children is fair.

Conclusion: There is a difference in the value of the Oral Hygiene Index (OHI) of children in each application of parenting styles by parents, and there is a relationship between the parenting styles of working parents and the oral hygiene of preschool children in the Bobbin Area of Jember.

Keywords : Parenting styles, Parents, Children, Oral hygiene, Oral Hygiene Index