A-prospective-study-of-role-of-bacteria-in-gall-stone-disease

Aim: To know organism most commonly found in bile, to study and compare the incidence of gall stone in culture negative versus culture positive bile. bile will be collected from removed gall bladder after the patientMethod: undergoes cholecystectomy and subjected to culture and sensitivity, and the result of the organism found will be tabulated and incidence of which organism is highest will be known in the study and which antibiotic was it most sensitive to will be noted. A total of 29 patients were included in the study. Out of 29 calculous cholelithiasisResults: patients only 10 of them had positive bile culture. More than 50 percent of patients had growth belonging to the Enterobacter family, and highest sensitivity was for imipenem antibiotic.

Antibiotic Prophylaxis Before Invasive Dental Procedures for Patients atHigh Risk of Infective Endocarditis - A Systematic Review

Background: Clinical use of antibiotics prophylaxis (AP) for preventing infective endocarditis (IE) after invasive dental procedures is controversial. Expert consensus guidelines are inconsistent, either restricting its use to high?risk individuals or advising its use again. Objectives: To determine whether there is a genuine need for AP to prevent IE in high?risk patients undergoing invasive dental procedures. Methods: Online search was performed on PubMed, Science Direct, British Dental Journal and Cochrane Register of Controlled Trials. The methodological quality of each study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen (17) clinical trials were included in the final analysis recruiting 2,410 patients (AP = 1,366; placebo = 1,044). Bacteraemia was detected in 302 AP patients (22.1%) and 362 placebo patients (34.7%). AP reduced the risk of bacteraemia by 49% (risk ratio: 0.51; 95% CI; 0.45 to 0.58; P = 0.0001). Conclusion: Although using AP for IE may be pragmatic and justified for high?risk patients undergoing invasive dental procedures, the evidence is inconclusive because post?procedural bacteraemia may not be a good surrogate marker for IE. Moreover, trials investigating the direct association between AP and IE are lacking due to low disease prevalence and high?cost challenges

Assessment of immunization status and barriers to vaccination among the university students of Pakistan

A cross-sectional study was conducted to determine the vaccination status and barriers to vaccination among the university students by utilizing a simple random sampling technique in the largest public sector university of Southern Punjab, Pakistan. The participants comprised 380 university students. Data was collected by a self-designed questionnaire. Statistical Package for Social Sciences (SPSS) was used for data analysis. Chi-square Test and Fischer Exact test were applied to assess the impact of demographics on vaccination status, and barriers to vaccination. Out of 380 participants, 328 (86.31 pewrcent) were males and 52 (13.68) females. The immunization status of university students against various diseases was variable: 97.10 percent (n=369) were vaccinated against poliomyelitis, 58.68 percent (n=223) against BCG, 44.21 percent (n=168) against hepatitis B, 49.21 percent (n=187) against diphtheria, pertussis and tetanus and 55.26 percent (n=210) against measles vaccine. The barriers to vaccination were unwillingness 15.0 percent (n=57), inaccessibility 17.10 percent (n=65), financial issues 4.47 percent (n=17) and unawareness 63.42 percent (n=241). Moreover, 31 percent (n=118) of the participants considered that the use of vaccines is unsafe. The vaccination status of the university students in Southern Punjab, Pakistan is alarming as most of the students were unvaccinated. The unawareness and perception of the unsafety of vaccines were the biggest barriers to vaccination(AU)

Se realizó un estudio transversal para determinar el estado de vacunación y las barreras a la vacunación entre los estudiantes universitarios, mediante la utilización de una técnica de muestreo aleatorio simple, en la universidad más grande del sector público del sur de Punjab, Pakistán. Los participantes fueron 380 estudiantes universitarios. Los datos se recopilaron mediante un cuestionario de diseño propio. Se utilizó el Paquete Estadístico para Ciencias Sociales (SPSS) para el análisis de datos. Se aplicaron la prueba de chi-cuadrado y la prueba exacta de Fischer para evaluar el impacto de la demografía en el estado de vacunación y las barreras para la vacunación. De 380 participantes, 328 (86,31por ciento) fueron hombres y 52 (13,68 por ciento) mujeres. El estado de inmunización de los estudiantes universitarios frente a diversas enfermedades fue variable: 97,10 por ciento (n = 369) fueron vacunados contra poliomielitis, 58,68 por ciento (n = 223) contra BCG, 44,21por ciento (n = 168) contra hepatitis B, 49,21 por ciento (n = 187) contra la difteria, tos ferina y tétanos y 55,26 por ciento (n = 210) contra la vacuna contra el sarampión. Las barreras para la vacunación fueron la falta de voluntad 15,0 por ciento (n = 57); la inaccesibilidad 17,10 por ciento (n = 65); los problemas económicos 4,47 por ciento (n = 17) y el desconocimiento 63,42 por ciento (n = 241). Además, el 31por ciento (n = 118) de los participantes consideró que el uso de vacunas no es seguro. El estado de vacunación de los estudiantes universitarios en el sur de Punjab, Pakistán, es alarmante ya que la mayoría de los estudiantes no estaban vacunados. El desconocimiento y la percepción de la inseguridad de las vacunas fueron las mayores barreras para la vacunación(AU)

Congenital chylous ascites: a case report

Due to the rarity of congenital chylous ascites and the lack of standards in diagnosis and therapy, this disease constitutes a medical challenge and individual therapy seems to be extremely important. A late preterm newborn with antenatally diagnosed ascites was born and chylous ascites was diagnosed after feeds were started. The baby was managed initially with nil per oral, parenteral nutrition and octreotide, followed by adding MCT formula feeds. Considering the rarity of neonatal chylous ascites and the non-uniformity in management plans and follow up, more case reports need to be published. Also, MCT formula, the main stay of management has to be discontinued as soon as possible with gradual introduction into breast feeds or normal newborn formula milk as long chain fatty acids are essential for optimal brain growth in newborns.

​Concurrent Hyperfractionated Chemoradiation Versus Conventional Fractionated Chemoradiation With Low-Dose Weekly Paclitaxel In Locally Advanced Non–Small-Cell Lung Cancer In A Tertiary Cancer Center In Kashmir: A Prospective Study

Introduction: Lung cancer is the most common cancer worldwide and has a poor prognosis but integration of chemoradiationhas led to an increase in overall survival time and percentage of cured patients with acceptable toxicity.Purpose: The purpose of this study was to compare the efficacy of hyperfractionated (HFX) radiotherapy with conventionalradiotherapy and weekly concurrent paclitaxel in stage IIB/III non-small-cell lung cancer (NSCLC).Materials and Methods: A total of 60 patients were enrolled, of which 30 patients were given twice daily radiotherapy(1.2 Gy each) to a total of 72 Gy over 5–6 weeks and 30 patients were given single daily fraction (2 Gy) to a total of 66 Gy forthe same duration to achieve a comparable biological effective dose. Both groups received weekly 50 mg/m2 paclitaxel.Results: An overall response of 83.3% versus 56.6% with a partial response of 70% versus 53.3% and complete response(CR) of 13.3% versus 3% was seen in HFX radiotherapy versus conventional radiotherapy which was statistically significant(P = 0.04). 10 of 25 patients and 11 of 17 patients who achieved response in study and control groups, respectively, progressed.The median survival of patients in HFX radiotherapy arm was 18 months, compared to 9 months in conventional radiotherapyarm. The median time to local recurrence was 19 versus 11 months with local recurrence-free survival of 72% versus 66% at1 year follow-up. The 1 and 2 year survival rates were 76% and 40% in study arm and 50% and 26% in control arm (P - 0.005).Esophagitis (70% vs. 63.3%), skin reaction (70% vs. 63.3%), and radiation-induced pneumonitis (50% vs. 43.3%) were thecommon toxicities with no statistical significance between the two groups. Overall, there was mild chemotherapy-related toxicity.Conclusions: The combination of HFX radiation with weekly paclitaxel is effective treatment with a moderate degree of toxicityin stage IIB/III NSCLC. An average response to treatment and the use of lesser drugs have made us to consider this therapyin locally advanced NSCLC.

Paradoxical Vocal Cord Motion in a Pair of Twin Preterm Infants

Background: Intractable obstructive apneas requiring multiple intubations are rare innewborns. Case characteristics: We report a pair of twins born at 29 weeks gestationwho had severe obstructive apneas due to Paradoxical Vocal Cord Motion (PVCM).Outcome: The symptoms resolved promptly with ipratropium nebulization. Follow-up at12 months of age revealed normal development. Message: PVCM should be consideredin the differential diagnosis of intractable obstructive apneas in very low birth weightpreterm infants

effectiveness of using children songs in social adjustment among children with mild mental disability

Aims: The study aimed at identifying effectiveness extent of children songs usage in social adjustment for children with moderate mental retardation

Method: Experimental methodology

Sample: Sample consists of 22 subjects of children with moderate mental retardation who are exposed to integration in Sanan primary school and El-Tabary primary school, Cairo governorate, their age ranges between [7-12] years

Tools: A form of data collection, prepared by the researcher, scale of social adjustment behavior [Abd El-Aziz Al-Shakhs]

Results: there are statistically significant differences between pre and post measure on social adjustment scale and its five dimensions on experimental group in favor of post measure at abstract level that is less than 0.05, as a result, the previous hypothesis is rejected, there are no statistically significant differences between degrees averages of children between experimental group and control group in level of linguistic development on social abstract level 0.445 that is more than 0.05. meaning that there are no differences as a result the previous hypothesis is rejected, there are statistically significant differences between degrees averages of children between experimental group and control group in level of independent occupational performance on scale of social adjustment after applying the program at abstract level of 0.045 as a result the previous hypothesis was rejected in favor of experimental group after post measure, there are statistically significant differences between degrees averages of children between experimental group and control group in level of family roles performance development on scale of social adjustment after applying the program, at abstract level of 0.021, as a result the previous hypothesis was rejected in favor of experimental group after measuring by arithmetic mean 19.6 for 14.7 in favor of control group, there are no statistically significant differences between degrees averages of children between experimental group and control group in level of economical scale after applying the program at abstract level of 0.167, that is more than 0.05, there are statistically significant differences between degrees averages scale of social adjustment after applying the program ay abstract level of 0.02

How predictive are the signs and symptoms of small bowel obstruction

The present study aims to determine the diagnostic significance of signs and symptoms of Small Bowel Obstruction [SBO] and to ascertain if there was any delay in presentation of the patients to the hospital. This retrospective case study spanning 3 years was conducted at Riyadh Medical Complex, Saudi Arabia. All adult patients admitted from the ER with a diagnosis of SBO were included in the study. The medical records of the patients with International Classification of Diseases [ICD] 9 codes 552.8, 560, 560.8, 560.81 and 560.9 were searched and retrieved. A total of 195 patients were included in the study out of which 174 patients had a definitive diagnosis of SBO. The study group was composed of 76.4% males and 71.8% were aged between 20 years to 60 years. The mean duration of symptoms was 4.8 days, ranging from 6 hours to 17 days. The cardinal signs and symptoms of obstruction had low sensitivity [Range: 56-75], and specificity [Range: 28-61], but relatively high positive predictive value [PPV] [Range: 86-93]. The morbidity was 13.8% while mortality was 3.4%.The cardinal features of SBO are neither specific nor sensitive, and though they may have an acceptable PPV, the predicted rate of false positive diagnosis is unacceptable. Therefore, the clinician may not rely on the clinical picture alone for the diagnosis of SBO. The presentation of the studied patients was delayed compared to the literature and it may be an important factor in increasing morbidity and mortality, but this aspect needs to be studied further

Wandering Spleen

Wandering spleen is a rare clinical entity, characterized by splenic hypermobility that results from elongation or maldevelopment of its suspensary ligaments. The wandering spleen is in constant danger of torsion and infarction. This condition poses a great diagnostic challenge due oto lack of awareness and paucity of symptoms. Among adults, it usually occurs in females of childbearing age, the children below ten years of age are other sufferers. The clinical presentation may be acute or chronic, such as asymptomatic abdominal mass, an acute abdomen, or, most commonly, a mass associated with vague abdominal symptoms. Computed tomography and duplex ultrasonography are best diagnostic modalities. The traditional conservative approach carries high risk of infarction leading to splenectomy and postsplenectomy sepsis. Splenopexy is the treatment of choice for all noninfarcted wandering spleens. Splenectomy should only be performed when there is no evidence of splenic blood flow after detorsion of the spleen. The present study, reviews the presentation, course, diagnostic modalities and management options of wandering spleen