From Contraception to Calculus: An Unusual Case of Intrauterine Contraceptive Device (IUCD) Migration to the Bladder, Recovering Nine Years Post-insertion.

Uterine perforations caused by intrauterine contraceptive devices (IUCDs) have been rarely documented in medical literature. However, the migration of these devices into the bladder (intravesical migration), resulting in calculus formation, is an exceptionally uncommon occurrence. When intravesical migration happens, the IUCD may be found lodged in the bladder. In this particular case, the presence of the IUCD was detected within the bladder in the form of calculus, notably without adhering or embedding in the bladder walls. Despite being inserted nine years prior, the patient underwent seven normal deliveries without complications and remained asymptomatic concerning urinary issues until the last two years before presentation. The calculus was successfully removed from the urinary bladder via a laparotomy performed by gynecologists. This case underscores the essential role of radiological investigations and regular follow-ups in patients who report conception after IUCD insertion, as they aid in confirming the potential migration of the device and facilitate timely intervention for removal.

Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review.

Bacterial bloodstream infections (BSI) are the leading cause of mortality and morbidity in pediatric solid organ transplant recipients. This systematic review aimed to pool global data from leading transplant institutions and identify the overall incidence, risk factors, and causative organisms of BSI in pediatric liver transplant recipients. A systematic review of the PubMed and OVID databases was conducted from 2000 to 2022. The initial search yielded 252 unique articles, which were independently reviewed by 2 authors. Articles that reported pediatric-specific data on BSI in isolated liver transplant patients were included, including the incidence of BSI, isolated organisms, and involved risk factors involved. This systematic review was registered with PROSPERO (ID: CRD42023403206). Fourteen articles from the United States, France, Iran, Japan, Korea, South Africa, Thailand, and Turkey were included. A total of 4,812 liver transplants were included in the final analysis. The mean patient age was 25 months (age range, 0-18 years), and 50.9% were male. The overall incidence of BSI was 23.5% (range, 14.7%-55%). The most commonly reported organisms were Staphylococcus epidermidis, Enterococcus, Klebsiella spp., and Escherichia coli. Among the risk factors studied, postoperative biliary complications, a medical history of biliary atresia, and younger age were the risk factors most commonly associated with BSI. Bacterial BSI after pediatric liver transplantation occur at a high incidence, with a unique organism profile notable for a higher percentage of gram-negative organisms. Further studies are required to determine the most appropriate prophylactic and empirical antibiotic management strategies for this population.

Unveiling Lethal Risks Lurking in Hot Tub Baths: A Review of Tragic Consequences.

Heat therapy, including saunas, jacuzzi, and hot tub bathing, has gained global popularity. However, the escalating incidents of injuries and fatalities associated with hot tub activities are a significant public health concern. This study aims to comprehensively review and analyze the pathophysiological factors contributing to hot tub-related deaths, addressing the need for awareness and mitigation strategies. A comprehensive search of electronic databases, PubMed and Science Direct, was conducted to identify articles relevant to bath-related deaths. Eligible studies were exported to the Rayyan (Qatar Computing Research Institute, Qatar) software for data analysis. The data extracted from the 18 studies were compiled to elucidate the mechanisms underlying hot tub bath-related deaths and to advocate for the adoption of potential mitigation strategies and future directions to prevent such incidents in the future. The review revealed insights into the current trend of fatalities linked to hot tub bathing. A detailed analysis of pathophysiological aspects, encompassing hemodynamics, electrolyte disturbances, serum glucagon alterations, and the impact of alcohol and substance abuse during hot tub use, was conducted. Furthermore, we explored the effects of temperature and conducted a thorough discussion of postmortem evidence analysis concerning deaths related to bathtub usage. Finally, the paper discusses mitigation strategies to prevent fatalities attributed to hot tub bathing. In conclusion, our review highlights growing public health concerns surrounding injuries and fatalities related to hot tub activities. Through an examination of the incidence rates, pathophysiological factors, and proposed mitigation strategies, we provide crucial insights for enhancing safety and addressing the escalating risks associated with hot tub bathing.

Social media use among adolescents with eating disorders: a double-edged sword.

Eating disorders are on the rise with a significant impact on mental health. Misuse of social media platforms is likely a significant contributing factor. This trend is especially pronounced among adolescents, who are increasingly using social media platforms for communications, building relationships, learning and entertainment. The unsupervised sharing of social media content can have drastic consequences on the physical and psychological wellbeing of youth, which often takes the form of "thinspiration" or "fitspiration". This probably serves as a trigger for those already struggling with eating disorders. In addition, there is a lack of awareness among youth and adults on ideal knowledge-sharing practices related to an eating disorder. By addressing the unique challenges that social media presents for youth with eating disorders, communities can work towards creating a safer and more supportive online environment on a global scale. At this junction, this article aims to share the current challenges of social media use among adolescents with eating disorders and put forth recommendations for how social media could be used as a tool for positive impact in this population.

Empowering Women's Health: A Global Perspective on Artificial Intelligence and Robotics.

In our rapidly evolving world, technology stands at the forefront, driving remarkable advancements across various sectors. One of the most notable changes is the use of Artificial Intelligence (AI) and robotics in healthcare, starting a revolution that has the power to change women's health all over the world. Developed nations are already witnessing the benefits. However, a significant portion of the global population in underdeveloped regions is lagging behind, resulting in a noticeable disparity. This is particularly evident in women's healthcare, an area already facing global inequities. As we witness a digital revolution, we examine the progressive steps taken in women's healthcare. AI and robotics are key to this transformation. The services range from using data to predict cancer trends to tailor-made medicine and technologies in reproduction. This editorial addresses the existing gaps and the digital divide, exploring the necessity for an inclusive approach in technology design and implementation to ensure equitable healthcare access.  Furthermore, it highlights the imperative role of multi-sectoral collaborations to foster innovation while mitigating risks. The clear goal is to build a future where all women, no matter where they live, can get good healthcare, helped by AI and robotics, bringing in a time of healthcare for all. It's crucial for everyone involved to come together to make a healthcare system that everyone can use, helping women everywhere with the help of new technology.

Understanding the reasons for refusal of polio vaccine by families in Quetta Block, Pakistan.

Background: Global polio eradication is a goal yet to be achieved in countries like Pakistan. In recent years, the Polio Eradication Initiative has been making steady progress with good campaign coverage and low numbers of polio cases. However, in 2019 Pakistan reported 146 cases compared to 12 in 2018. A major factor cited for this regression was a surge in vaccine refusals by parents and caretakers. Aims: To assess the reasons for the refusal of polio vaccination in Quetta Block, Balochistan. Methods: The study was conducted using data acquired from 2 polio vaccination campaigns over 3 months in 2019. The data were collected in Quetta Block, a highly endemic zone having continuous transmission of the polio virus over several years. The data were analysed using the statistical software, SPSS, version 20. We used descriptive statistics to demonstrate the characteristics of the study population. Categorical variables were measured as frequencies and percentages. Results: Refusal rates were almost 8.6% for the polio campaign of April and 8.1% for June 2019. Misconceptions about vaccines made up 56.4% of reasons for refusals, followed by religion 16%. Conclusion: Misconceptions about the vaccine are the main driving force behind vaccine refusals in the study setting. Efficient strategies are required to address misconceptions in this red zone of poliovirus transmission in Balochistan.

Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey.

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.

Relationship Between Villous Atrophy and tTGA Levels in Dyspeptic Patients: A Case Series.

Aim The objective of the study was to observe the association of villous atrophy with anti-tissue transglutaminase levels in the identified subjects that met our addressed inclusion criteria. Methods A case series study was conducted among 40 patients presenting with dyspepsia along with signs and symptoms of celiac disease at the Bolan Medical Complex Hospital, Quetta over a period of five months from 25/5/17 to 25/10/17. The patients were referred to undergo tissue transglutaminase antibody serum test. The positive ones underwent biopsies to assess pathological entities including villous atrophy, blunting (focal or total), crypts, Intestinal layers and the number of Intraepithelial lymphocytes. The results collected were analyzed by using IBM SPSS version 20 (IBM Corp., Armonk, NY). Results There was a weak, negative correlation between tTGA and focal villous blunting (r = -0.345, p = 0.029) showing that high levels of tTGA are associated with lower risk of focal villous blunting. Correlation of tTGA and total villous blunting was a weak positive correlation (r = 0.282, p = 0.07) showing that high levels of tTGA are associated with increased risk of total villous blunting. There was a weak, negative correlation between tTGG and focal villous blunting (r = 0.409, p = 0.009) showing thathigh levels of tTGG are associated with a greater risk of focal villous blunting (p < 0.01) while tTGG and total villous blunting was a weak negative correlation (r = -0.330, p = 0.03) showing that high levels of tTGG are associated with lower risk of total villous blunting. Conclusion The study concludes by providing evidence of the absence of tissue transglutaminase antibodies in patients with histology-proven celiac disease. It implies that serology tests may be negative in some of the patients with typical chronic symptoms. Therefore, in such cases, histopathology may be conclusive in defining the status of celiac disease.

Breast cancer knowledge and perception among healthcare professionals and senior medical students at Bolan Medical Complex Hospital Quetta, Pakistan.

OBJECTIVE: To assess knowledge and perception about different aspects of Breast Cancer among health care professionals at Bolan Medical Complex Hospital Quetta, Pakistan. METHODS: This cross-sectional study was carried out at Bolan Medical Complex Hospital Quetta from October to December 2017. A total of 312 health care workers including consultants (42), residents (85), medical officers (52), interns (45), nurses (48) and final year medical students (40) took part in the study. The study tool was a self-designed questionnaire with separate sections to assess the knowledge about risk factors, signs and symptoms, screening tools, breast self-examination (BSE), treatment and barriers in seeking medical advice. RESULTS: Participants had satisfactory knowledge about risk factors and signs of breast cancer but poor knowledge about association of breast cancer with menarche status, oral contraceptive pills and smoking. Majority was aware of mammography benefits and believed that breast cancer is curable with therapy. All perceived that cultural and socioeconomic barriers are the cause of late stage presentation. The nurses particularly were having misconceptions in knowledge about breast cancer risk factors and screening tools. CONCLUSIONS: The current study demonstrated that knowledge related to breast cancer was average and highlighted the need for provision of continuing medical education programmes to improve health practitioners' practice on cancer screening tools. Knowledge was particularly deficient regarding screening modalities and BSE method and timing. Special emphasis is needed to train nurses, so they could play an expanded role in breast cancer care.