ABSTRACT
INTRODUCTION@#Doppler scrotal ultrasonography (US) is the modality of choice in diagnosing testicular torsion. We aimed to evaluate the performance of scrotal US in diagnosing testicular torsion over the past 18 years in our institution and determine the factors contributing to the length of wait times for it.@*METHODS@#A retrospective review was conducted of boys who presented with acute scrotal pain from 2014 to 2015. US reports, operative findings, final diagnosis and key time points of the patients' journey (time to emergency department consultation, time to admission, time to US and time to operating theatre [OT]) were collected. US performance results were compared with those observed in a historical cohort from 1998 to 2004. Wait times were compared between operated and non-operated patients.@*RESULTS@#Data from 519 boys with a mean age of 9.15 years was collected. Of these, 438 (84.4%) boys had undergone initial scrotal US; of these scrotal US cases, 28 were surgically explored, with 23 confirmed to have torsion. Another five cases were explored without prior US, and all were confirmed to have torsion. Performance analysis of US showed a sensitivity of 100% and a specificity of 98.8%. There was no significant difference between wait times of operated and non-operated patients. Time to US (P < 0.0001, r = 0.96) and time to OT (P < 0.0001, r = 0.64) correlated significantly with the total time from presentation to surgery.@*CONCLUSION@#There has been an improvement in the diagnostic performance of scrotal US for testicular torsion over the past 18 years. Quality improvement programmes targeted at reducing wait times for patients presenting with acute scrotum should target time to US and time to OT.
Subject(s)
Male , Child , Humans , Female , Scrotum/surgery , Spermatic Cord Torsion/surgery , Acute Pain/diagnostic imaging , Ultrasonography , Retrospective StudiesABSTRACT
@#Introduction: In circumstances where the ante mortem list is unknown, gender determination would exclude onehalf of the population, aid in a more precise search of the ante mortem records. This study aims to formulate gender prediction models in the Pakhtun Pakistani population using digital dental arch dimensions. Methods: Data collection and analysis of the dental casts were conducted on 128 subjects, 64 males and 64 females from the Pakistani population. The mean age of the subjects was 19.2 years old. Several linear dental arch dimensions were measured and recorded for both upper and lower arches. Results: It was found that gender differences in linear arch dimensions were statistically significant for both males and females (p<0.05); in which the arch dimensions for the males were larger than the arch dimensions for the females. Stepwise discriminant function analysis found that the highest discriminant power of the variables was present within the inter-second premolar width for the upper arch and inter-molar width for the lower arch. These variables significantly contributed to gender variance. Moreover, the prediction of 67.2% of original grouped cases for the upper arch and 66.4% of cross-validated group cases was correct. Similarly, the correct prediction was made on 64.8% of original grouped cases for the lower arch and 64.1% of cross-validated group cases. Conclusion: The dental arch dimensions were larger among the males compared to the females. Prediction models obtained in this study were moderately strong predictors which may be used as an adjunct to predict gender.
ABSTRACT
We report a case of pyrexia of unknown origin (PUO) in a 19-year-old male, who was admitted with a history of pyrexia for 2 weeks. The diagnosis remained uncertain despite multiple investigations and the patient subsequently had various clinical manifestations similar to those seen in coronavirus disease 2019 (COVID-19). Since it was initially presumed to be pyrexia due to viral origin or enteric fever, patient was started on empirical treatment. The diagnosis of COVID-19 was confirmed by corroborating various biochemical markers that had a greater association with COVID-19. Patient was discharged after 21 days with empirical antibiotics, anticoagulants and other supportive medications. He required no further hospital admissions and has been on regular follow-up.
ABSTRACT
Tuberculosis (TB) is infectious diseases were the lungs are mostly affected. It is caused by the Mycobacterium tuberculosisbacteria and is spread when a person already affected with TB coughs, sneezes, spits,laughs, or talk. Even though it’s is contagious does not easily catch i.e. chances of catching TB are much higher with someone you live with or work than from a stranger. Multidrug-Resistant TB (MDR-TB) arises when the antibiotic fails to kill bacteria. MDR-TB can be treatable and curable with specific anti-TB drugs but unfortunately, these are limited in quantities or not readily available. As per WHO around 4,50,000 people developed MDR-TB in the year 2012. People with a weak immune system are at maximumrisk of active TB development. For instance, HIV conquers the immune system, making it harder for the body to control TB bacteria. People infected with both HIV and TB are 20-30% more probable to develop active TB than those who do not have HIV. Besides, WHO estimates, every year 9 million people get sick with TB and 3 million with these are “missed” by health systems. Among the top 3 causes of death in women between 15-44 TB is one the major cause. The symptoms of TB may be mild for many months and can infect 10-15 other people through close contact. This study involves a comparative evaluation of the presence of Tuberculosis concerning factors such as socioeconomic status, sex ratio, age, addiction of nicotine or alcohol, etc. All the screenings were based upon various methods of diagnosis used in pulmonary tuberculosis such as Ziehl Neelsen staining, culture on L.J media, Petroff’s concentration method, and DNA PCR method
ABSTRACT
Introduction: Urinary tract infection in pregnancy isassociated with significant morbidity for both the motherand the baby. The aim of this study was to determine thebacterial profile and antibiotic resistance pattern of the urinarypathogens isolated from pregnant women at Mata GujriMemorial Medical College and Hospital, Kishanganj.Material and methods: A total of 267 pregnant womenwith and without symptoms of urinary tract infection wereenrolled as a study subject from October 2016to october2017.Organisms were identified from mid-stream clean catch urinesamples and antibiotic susceptibility was performed usingbacteriological standard tests. Data were collected usingstructured questionnaires and were processed and analyzedusing SPSS for Windows version 16.Results: Out of 267 pregnant women, 37 were symptomaticand the rest 230 asymptomatic. Bacteriological screening ofurine samples revealed growth of bacteria in 8.5% (7/37) and18.9% (28/230) for symptomatic and asymptomatic pregnantwomen respectively with overall prevalence of 9.5%.The most common isolates detected were E.coli (45.7%)followed by coagulase negative Staphylococcus (17.1%).Gram-negative bacteria showed resistance rates in the rangeof 56.5%-82.6% against trimethoprim/sulfamethoxazole,amoxicillin and ampicillin. Gram positive isolates showedresistant rate ranging from 50-100% against trimethoprimsulphamethoxazole, amoxicillin and ampicillin. Both Grampositive and gram negative bacteria showed high sensitivityagainst Nitrofurantoin with a rate of 82.3% and 87%,respectively. All isolated Gram positive bacterial uropathogenswere sensitive for Amoxicillin-clauvlanic acid.Conclusion: The isolation of bacterial pathogens both fromsymptomatic and asymptomatic pregnant women that areresistance to the commonly prescribed drug calls for an earlyscreening of all pregnant women to urinary tract infection.
ABSTRACT
Zika virus (ZIKV) that was less known for decades suddenly became a global health emergency at the beginning of 2016. The virus was first discovered in the Zikaforest of Uganda in 1947, and the first confirmed human infection was reported in Uganda between19621963. From its origin in East Africa, ZIKV then spread to West and Central Africa with a limited occurrence in North Africa. ZIKV has been circulating in Africa for over 60 years, but less attention had been given, not until its recent outbreaks outside Africa and its discovered association with adverse congenital disabilities. ZIKV is known to cause several debilitating neurological complications, including microcephaly in newborns and GuillainBarré Syndrome (GBS) in adults. This review thus aims to highlight the epidemiological evidence and distribution of ZIKV in Africa with a focus on determinants, complications as well as management. We used literature searched from key databases such as Google Scholar, Web of Science, among others, to collect relevant current information about ZIKV in Africa. Climate, sociodemographic factors, and increasing human density impact the spread of ZIKV in Africa, as in other areas. Furthermore, ZIKV transmission is affected by several unique factors, including the potential risk of sexual transmission, as well as vast numbers of refugees and other travellers from ZIKA endemic areas across Africa, and all over the world. The review identifies the need to improve surveillance mechanisms and focusing on vector control as critical steps to enable prompt detection and avert potential outbreaks of the disease in the continent.
ABSTRACT
Few epidemiological studies have been undertaken of measles disease among Sudanese, although measles is the third leading cause of death since 1995among childhood diseases that can be prevented by immunization. The measles vaccine was introduced into the EPI programin 1985. In the run-up to the introduction of the vaccine, the country suffered from measles epidemics periodically and extensively, ranging from 50,000 to 75,000 cases and from 15,000 to 30,000 deaths per year. Simple actions can save a million livesof children throughimmunizationcoverage, eye care programs, maternal and child health education, maintaining and improving the general nutritional status of Sudanesechildren. Continuous surveillance and monitoring systems and evaluation are essential tasks at all levels to improve performance, identify and address problems throughout establishing and increasingthe surveillance system. This review highlights a brief overview of measles epidemiology in Sudan and determinants of a measles outbreak, clinical symptoms, complications, and surveillance sites and the ways for prevention and control of measles disease. The review established that it is crucial to enforce coordination between governmental and non-governmental agencies for an effective disease surveillancesystem in the area, especially in those affected by civil wars
ABSTRACT
Sickle cell disease (SCD) is one of the most common life-threatening monogenic disorders affecting millions of people worldwide. The disease has a high prevalence in malaria-endemic tropics, especially in sub-Saharan Africa. Although sickle-cell trait (SCT) offers protective advantage against malaria, it does not apply to homozygous individuals with sickle cell anemia but instead makes them more susceptible to not only malaria but to also other infections, causing a great deal of under-five mortality. Despite the fatal risks and high incidence rates of SCD, little attention is given, in terms of funding, management and surveillance, especially among East African countries. In addition, few works of literature exist, and less has been documented about the disease. This minireview aimed to report the current situation in terms of prevalence, mortality, diagnosis and management of SCD among East African countries; Uganda, Kenya, Tanzania, Rwanda and Burundi SCD is characterised by retarded growth, chronic pain attacks and severe organ damage leading to fatal complications. This, coupled with limited resources in East African countries, reduces the survival of SCD patients and most die before five years. SCD is detected through a blood test usually by Haemoglobin electrophoresis, and Hydroxyurea therapy, antibiotics and blood transfusion are used to prevent complications. Early childhood detection through comprehensive newborn screening programmes has been implementedin some countries and is key in the management of the disease.
ABSTRACT
Background: Liver is the most important organ performing more than 500 functions in the body. In addition, the human cell has a natural antioxidants system which maintains the production of antioxidants and reactive oxygen species (ROS) during the metabolic process of the cell. Objective: This particular research study is basically conducted for the purpose to assess the impact of low-intensity exercise on liver enzymes and antioxidants systems of the body. Methods and materials: Total 40 subjects (20 from low-intensity exercise as an experimental group and 20 subjects as a control group) were included as the participants of the study. For assessment of liver functions and redox state of the body, 5 ml blood was collected from all subjects. Liver functions tests (LFTs) were performed for the assessment of liver enzymes and ferric reducing assay protocols (FRAP) was performed for the assessment of the redox state of the body. The data obtained about liver functions and redox state were processed through statistical package for social sciences (SPSS) version 23 and thus different statistical tools i.e. mean, standard deviation and T-score were used for the analysis of data. Results: Data analysis reveals that; no significant effect was found on liver enzymes as well as on antioxidants system of the body. Conclusion: On the basis of findings the researcher concluded that low-intensity exercise has no significant effects on liver enzymes. In addition, it was also concluded that low-intensity exercise helps in the improvement of blood life quality by reducing various health problems related to oxidative damages of cells and muscles fatigue.
ABSTRACT
Promotion, as well as maintenance of health, is directly associated with exercise and good dietary habits. Lack of exercise and good dietary habits adversely affect health, therefore this study was conducted to assess the perception of patients regarding the effectiveness of exercise and medicine in the maintenance of health. Total of 30 patients of different diseases (heart diseases, hypertension, and obesity) was voluntarily taken as a sample of the study. For the collection of data, a questionnaire was developed; collected data were analyzed by applying Student’s t-test using SPSS version 21.0. Heart problems, hypertension, and obesity all are the chronic health problems and the majority of the respondents opined that the impact of performing various kinds of exercise along with medicine for reducing these chronic health problems was significant (p=0.004). On the basis of findings, the researcher concluded that exercise is the sister art of medicine which plays a significant role in preventing different health problems such as heart diseases, hypertension, and obesity.
ABSTRACT
Use of animals in experimentation and research has always been a topic of great debate. Some express their strong support while others are against animal research practices and want their complete abolition.1 At present, there is a pill for every ill. Rapid advancement in the field of science and technology contributed in discovering cure and medications even for the rarest of the rare diseases. Most of the present day discoveries in medical science lay their foundation on animal experimentation. The use of drugs in clinical practice have been possible only after going through successful animal studies for safety, efficacy and toxicity.
ABSTRACT
Background: There were 4.1% of all new cases and 19% of previously treated patients were diagnosed with either multidrug resistant or rifampicin resistant tuberculosis in 2016. In the state of Uttar Pradesh, there were 2.16 new cases and 44,531 previously treated cases. The objectives of the study were to assess the predisposing factors, causality assessment, severity grading and avoidability of the adverse drug reactions (ADRs) of the antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This prospective observational study was conducted for 12 months at a tertiary care hospital. The patients with MDR tuberculosis on treatment with DOTS Plus regimen under RNTCP and who met the inclusion exclusion criteria were recruited after informed consent. ADRs were monitored daily till the patients remained admitted and thereafter monthly. Predisposing factors were recorded. Causality assessment was performed by Naranjo scale and WHO UMC scale, severity by Hartwig’s scale and avoidability by Halla’s scale.Results: There were 115 patients were recruited, 70 developed at least one ADR. 98 ADRs were reported. The commonest ADR reported were – gastrointestinal (38.76%), neurological (21.24%) and hepatobiliary (8.16%). Diabetes and HIV predisposed to development of ADRs. 58.18% ADRs were classified as possible and 37.5% as probable by Naranjo’s scale. 51.02% ADRs were classified as probable and 42.83% as possible by WHO-UMC. 56% were classified as mild, 36% moderate, and 6% severe via Hartwig’s scale. 51 ADRs were classified as avoidable and 40 ADRs were possibly avoidable.Conclusions: Monitoring and assessment of ADRs is necessary to promote awareness, curb resistance and maintain adherence.
ABSTRACT
Background: Between 2006 and 2015, the prevalence of MDR-TB has been found to be as high as 39.9% in some states. Approximately 35.8% of all previously treated patients developed MDR-TB. The objective of the present study was to identify demographic and health characteristics of patients as well as incidence and pattern of the adverse drug reactions caused by antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This 12 months study of observational study was conducted at a DOTS centre. MDR-TB diagnosed patients treated with DOTS Plus regimen were enrolled after getting informed consent. Patient information was recorded. Patient follow-up was conducted to identify the incidence and pattern of ADRs.Results: A total of 115 patients were enrolled. Maximum number of cases were in the 31-40 age group (25.21%) followed by the 41-50 age group (20.86%). 76 (66.08%) were males and 39 (33.91%) were females. 52 patients (45.21%) had concomitant diseases, out of which 15 (13.04%) were HIV positive and 21 (18.26%) were diabetic. 70 patients (60.86%) developed ADRs. The adverse drug reaction that were seen are -38 (38.76%) cases of gastrointestinal adverse drug reactions, 8 (8.16%) jaundice/hepatitis, 7 (7.14%) impaired hearing/vertigo, 21 (21.24%) central nervous system adverse drug reaction, 6 (6.12%) peripheral neuropathy, 6 (6.12%) rash and itching, 5 (5.10%) arthralgia, 3 (3.06%) renal impairment, 2 (2.04%) hypothyroidism and 2 (2.04%) blurred vision.Conclusions: Determining which population groups are affected most by ADRs can help physicians to better monitor and make an early diagnosis to reduce ADR-related morbidity and mortality.
ABSTRACT
Background: Greek Physician Aretaeus (30-90CE) observed a disease with symptoms such as constant thirst (polydipsia), excessive urination (polyuria) and loss of weight. Based on these findings, he named the condition ‘diabetes’, meaning ‘a flowing through. Diabetes mellitus is a serious public health concern, not just because of its high prevalence or the chronicity, but more importantly because of its life-threatening micro vascular and macro vascular complications which are often silent and undetected until the advanced and irreversible stage has developed, and they may even appear years before the diagnosis of diabetes.Methods: A cross-sectional study was carried out on elderly (60 years and above). This study was intended to measure prevalence of diabetes mellitus and associated risk factors.Results: In present study, the prevalence of diabetes was found to be higher among female participants at 41.98% compared to males at 25.90%. Prevalence of diabetes was highest in the age group of 60-70 years. Mean BMI (28.05) of female participants was higher compared to the BMI of the male participants which was 25.52. It was observed that the prevalence of diabetes increases with increase in BMI.Conclusions: Early detection and treatment of these chronic morbidities should be done with regular health check- ups and screening of these diseases before they can cause permanent damage to health of individual or death. People should also be educated and counselled about monitoring their health parameters to ensure early detection and treatment.
ABSTRACT
Globally, one of the major causes of mortality and morbidity is ischemic heart disease (IHD). It has been established that in cardiac disorders, there exists a synergistic correlation between the oxidative stress and inflammatory cytokines. The stabilization and regulation of the oxidative stress and inflammatory cytokines in these patients is essential for the better management of the disease. Hence, the aim of this study was to study the effect of natural antioxidant, resveratrol, on the oxidative stress and inflammatory biomarkers in cultures of monocytes isolated from peripheral blood mononuclear cells (PBMCs) from the patients with myocardial infarction. Monocytes isolated from peripheral blood mononuclear cells (PBMC’s) of patients with myocardial infarction (MI) and healthy controls were employed in culture studies (with and without resveratrol). The 24 h cultures were subjected to evaluation of cytokine/ interleukins levels i.e. TNF-α, IL-1 and IL-6 as well as oxidative stress markers like MDA and Glutathione. The patient’s samples exhibited a significantly decreased level of intramonocyte glutathione as compared to samples of healthy subjects. On the other hand, significantly increased levels of MDA were observed in culture supernatants of monocytes isolated from PBMC’s of patients with MI in comparison to those of healthy controls. A significant degree of amelioration in intramonocyte glutathione levels coupled with decreased MDA levels (culture supernatants) were observed in cultures treated with resveratrol (20 ug/mL). Furthermore, 24 h culture supernatants of untreated patients cells exhibited augmented levels of IL-1, IL-6, and TNF-α. However, co-culturing with resveratrol exhibited a significant decrease in the levels of all the IL-1, IL-6 and TNF-α. Resveratrol—a potent polyphenol from grapes and also a natural antioxidant regulates the oxidative stress and inflammatory biomarkers and may be used as a prophylactic antioxidant in high risk patients.
ABSTRACT
Objective: To find out frequency of obesity in female University students in Faisalabad and to investigate its association with blood groups of ABO system
Methods: A cross sectional study was conducted with a sample size of 200 female University students, recruited from the Faisalabad based institutes from May 2017 to July 2017. Relevant information was taken by administering questionnaire. Height in meters and weight in kg were taken by stadiometer. BMI was calculated using formula BMI=weight in kg/height m2. Blood groups were determined by classic [antigen-antibody agglutination test].The data was analyzed through SPSS 20. Descriptive were presented as mean+/- SD and association of BMI with blood groups was assessed by regression analysis. P value
Results: Out of students, 192 attempted the questionnaire and participated in study [96% response rate], 30% of the 192 females were obese, distribution of ABO blood group showed 43%, followed by O, A and AB. 90% were Rh positive and 10% were Rh negative. Blood group O showed a trend towards obesity and blood group AB showed a trend towards lean body
Conclusion: The blood group O showed the significant positive association with obesity. Population with blood group O showed greatest susceptibility to be overweight and obese
ABSTRACT
Chitosan was extracted from the oriental hornet, Vespa orientalis [L.], Vespinae, Order; Hymenoptera, as a new source of insect chitosan, using chemical methods. We assessed the physical properties of the wasp's chitosan using different approaches including: preliminary color-change identification, Fourier Transform Infrared spectroscopy [FTIR], X-ray diffraction and Nuclear Magnetic Resonance spectroscopy [1H-NMR]. The results showed that it gave a
higher purity, solubility and Degree of Deacetylation [DD] compared to crustacean chitosan. Also, it is soluble in a very low concentration of acetic acid from 0.25% to 0.5% while that of Crustacea was soluble in more than 1% acetic acid, so the oriental hornet could be a novel alternative source of higher pure and more soluble chitosan
ABSTRACT
Objective: A health risk behavior like physical inactivity, unhealthy diet, tobacco use, drug abuse, unprotected sexual practices or harmful use of alcohol is linked with serious ailments like liver cirrhosis, hypertension, abnormal lipid profile and number of cardiovascular diseases. Our study is aimed to explore perception of students about health risk behaviors; eating routines, life style and stress handling practices and compare amongst medical students of first and second year
Subjects and Methods: In this cross-sectional study, 233 female students between 1 8-25 years of age, from first two years of medical college were administered a self-structured questionnaire Response of each item was rated on five-point Likert scale. Maximum points in the scale were five and the minimum was one for each item. Mean score was obtained by adding points of all responses. Degree of health awareness was categorized into low, medium and high on the basis of mean cumulative scores. Independent sample t test was used to compare means between study groups based on academic level [Year I and II medical students]
Results: The overall results of the study revealed positive health behaviors among medical students. Year I MBBS had superior acquaintance on healthy eating routines [p-value = 0.001], lifestyle patterns [p-value = 0.002], and stress handling practices [p-value < 0.001] as compared to senior class. Tendency to have anxiety attacks was more in 1st year students [p-value=0.002] while capability to withstand stress was better in senior class [p-value=0.004]
Conclusion: Majority of medical students practiced positive health behaviors. These attitudes in terms of selection of life style choices; healthy food and physical activity with avoidance of health risk behaviors and supportive practices was better in Year I students
ABSTRACT
Background: breastfeeding is considered to be beneficial for both babies and mothers
Objective: this study aimed to assess the knowledge and attitude of breastfeeding among women in Al-Madina Al-Munawwarah, Saudi Arabia
Methods: this was an analyticalcross-sectional study and it was carried out in Al- Madina, Kingdom of Saudi Arabia during the year 2017. Data were collected by electronic self-administered semi-structured questionnaire
Results: data were collected from 388 female. The majority of the respondents were above 36 years old [48.2%]. More than half of our respondents 225 [58.0%] were unemployed and 277 [71.4%] had a college-level education or higher. 138 [35.6%] of the women were exclusively feeding their baby by breastfeeding, while the majority of the respondents 220 [56.7%] chose a mix of both breast and formula feeding. The percentage of women who received hospital education regarding breastfeeding was equal to the women who had not received the hospital education 194 [50.0%]. 175 [45.1%] of the respondents reported that health problem is the most reason that preventing them from breastfeeding their babies. Mothers believed that breastfeeding helped them by preventing breast and ovarian cancer 308 [79.4%] and the majority of the respondents 334 [86.1%] believed that breastfeeding improved the immunity and protect from different illness
Conclusion: in spite of the low percentage of exclusive breastfeeding, all the mothers were certain about the importance of breastfeeding to them and to their babies. There is a significant opportunity to improve awareness among women regarding the importance of exclusive breastfeeding
ABSTRACT
Background: recent studies have shown the effectiveness of bariatric surgery in improving severe obesity, it's associated with co-morbidities and the level of mortality
Objective: this study aimed to determine the motives of bariatric surgeries among Saudi adults in Al-Madinah and to assess their beliefs and knowledge toward surgical intervention in treating obesity
Methods: this was an observational analytical cross-sectional study and it was carried out in Al- Madinah, Kingdom of Saudi Arabia during 2018
Results: the data were collected from 406 participants. 61.8% of them were female. The mean age was 33.5 +/- 9.12 and the mean of BMI of the participants was 29.89 +/-8.22. The majority of the participants were married [62.6%]. More than half of our respondents [80.3%] had a college-level education or higher. 51.5% were employed. 79.6% of participants tried to lose weight by traditional methods. The majority of the participants [77.6%] did not undergo weight loss surgery. 75% of the respondents who did the surgery reported that health problem was the most reason motivated them to do the surgery. 364 [90.8%] of the participants believed that bariatric surgeries were effective in treating of obesity. However, 67.8% of the participants didn't prefer the surgery over traditional methods to lose weight. The majority of the respondents [77.6%] believed that bariatric surgery was not the best choice to lose weight and 95% of the participants believed that bariatric surgeries had complications
Conclusion: health problem is the major motive for our population to do bariatric surgery