The aim of our work was to identify the indications and to assess complications of tracheostomy in the intensive care setting. This work to retrospectively analyze the files of patients with tracheostomies in the multipurpose intensive care unit of the Gabriel Toure university Hospital in Bamako over 4 years from January 2016 to December 2020, including all patients with tracheostomies in intensive care or in operating room by surgical teams. The parameters taken into account were: the reasons for admission to intensive care unit, the history, the duration of intubation and ventilation before tracheostomy, the duration of total cannulation, the complications that arose during the performance of the procedure, immediately postoperatively and late. The mean age of our patients was 31.97 ± 19.03 years with extremes of 0.25 and 79 years. The sex ratio was 2.25 in favour of the male. The circumstances of hospitalization in intensive care are dominated which are neither respiratory nor neurological. The tracheotomy was performed in 52 patients, 21 patients in the operating room by an otolaryngologist including 2 in trans-isthmic and 31 times in the intensive care unit (intensive care) by an otolaryngologist team including 11 case in trans-isthmic. Tracheostomy was performed on average 2.6 ± 5.03 days after MV initiation (Median = 2 days), with extremes ranging from 0 to 45 days. Among the 52 patients included in our study, 27 patients (51.9%) underwent a tracheostomy during the first two days of MV (early tracheostomy group) and 25 patients (48.08%) underwent a tracheostomy beyond the second day of VM (Late tracheostomy group). During our study, no decanulation was carried out in the intensive care unit, the number of places reduced, does not allow hospitalized patients of which tracheostomies remain there after a slight improvement. The postoperative consequences were simple in 12 patients, or 23.1%.
Introduction: Vallecular cyst is a mucous retention cyst that forms between the base of the tongue and the lingual surface of the epiglottis. Our objective was the diagnostic, therapeutic and progressive aspects. Case report: This was a 6-year-old female patient, a student, residing in Kayes with no medical or surgical history, who was admitted for progressive pharyngeal discomfort that had been developing for 3 months. At the nasofibroscopy we highlighted a soft, oval, transluminal mass, with regular contours, non-painful, non-bleeding on contact, measuring approximately 5 cm in diameter at the level of the right vallecula. The rest of the examination of the other devices was normal. We concluded that it was a vallecula cyst. A coordinated airway management plan was established by the anesthesiologist-surgeon before the procedure. Excisional surgery was performed under general anesthesia with orotracheal intubation. The histological result of the surgical specimen concluded that there was fibrous and inflammatory squamous tissue. After six months of follow-up, we have not noted any recurrence. Conclusion: Vallecular cyst is a rare and potentially fatal condition in children due to narrowness of the laryngeal passage. vallecular cyst can be discovered at any age. Laryngeal endoscopy allows diagnosis to be made and treatment is surgical either by endoscopic route or by external cervical route
Cirrhosis is a serious, progressive disease and constitutes a public health problem. The objective of this study was to examine the role of ultrasound in the diagnosis of cirrhosis at the Hospital of Mali. This was a prospective cross-sectional study conducted from February 2024 to February 2025. The study included all patients admitted to the department for abdominal ultrasound as part of the diagnosis of liver cirrhosis. Data were analyzed using SPSS version 21.0. Patient participation was voluntary. Patient confidentiality and anonymity were guaranteed. We identified 121 cases of cirrhosis diagnosed among 3,142 abdominal ultrasounds performed, representing a prevalence of 3.85%. Male patients accounted for 70% of cases. The mean age was 51.34 ± 13.86 years. The predominant clinical symptom was abdominal pain in 89.3% of cases. Hepatomegaly with a sharp lower border was recorded in 80.88% of cases. On ultrasound, hepatomegaly was present in 55% of patients. The echogenicity of the liver was heterogeneous in 96.7% of cases. The liver margins were irregular in 73% of cases. Hepatic dysmorphism was present in 74% of cases. Nodules were present in 60% of patients, and portal vein dilation in 58.7% of patients. Cirrhosis remains a common and serious condition. Ultrasound is an essential tool for screening and diagnosis.
Background: Post-surgical motor deficits are a frequent complication in neuro-oncologic patients and can significantly affect functional recovery. Transcranial magnetic stimulation (TMS) has emerged as a potential therapeutic modality to facilitate motor rehabilitation. This systematic review examined the effectiveness and safety of TMS in promoting motor recovery following brain tumor surgery. Methods: A systematic review of four studies evaluating TMS for postoperative motor rehabilitation in patients with brain tumors was performed. Outcome measures included motor function assessments using the British Medical Research Council (BMRC) scale, Fugl-Meyer Assessment (FMA), and Karnofsky Performance Status (KPS), as well as the incidence of adverse events. Results: The effects of TMS on motor recovery were inconsistent across studies, with some demonstrating improvements in BMRC and FMA scores, while others reported limited therapeutic benefit. Overall, TMS was generally well tolerated, with only minimal adverse events documented. Conclusions: TMS may represent a safe and promising adjunctive intervention for postoperative motor recovery in brain tumor patients; however, the current evidence remains insufficient to establish definitive clinical benefit. Further large-scale prospective studies using standardized treatment protocols are necessary to clarify its therapeutic efficacy and long-term safety profile.
Introduction: Acute kidney injury (AKI) and chronic kidney disease (CKD) represent a growing burden in sub-Saharan Africa, where local hospital-based data remain scarce. In the Democratic Republic of the Congo (DRC), no published study had previously described this profile at the Charite Maternelle University Hospital in Goma. Objective: To describe the epidemiological, clinical, therapeutic, outcome, and prognostic profile of kidney diseases in the Internal Medicine Department of the Charite Maternelle University Hospital in Goma between January 2016 and January 2020. Methods: This was a retrospective descriptive study including 60 hospitalized patients with a confirmed diagnosis of AKI or CKD, selected from 2,675 admissions to the Internal Medicine Department. Data were collected using a standardized form entered KoboCollect and analyzed with SPSS version 20. Qualitative variables were expressed as frequencies and percentages, while quantitative variables were presented as mean ± standard deviation or median [interquartile range], depending on their distribution. Results: Among 2,675 patients, 60 (2.24%) had kidney disease: 41 AKI (68.3%) and 19 CKD (31.7%). There was a male predominance (sex ratio 1.31; 56.7%). AKI occurred more frequently in patients under 40 years (46.3%), whereas CKD predominated in those aged 40–65 years (57.9%). Sepsis was the leading cause of AKI (51.2%), followed by hypovolemia (34.1%) and drug-induced nephrotoxicity (14.6%). Diabetes (57.9%) and hypertension (36.8%) were the main causes of CKD. Renal ultrasound abnormalities were found in 46.7% of cases. Only 26.3% of CKD patients received dialysis. Overall mortality in CKD was 21.1%. Conclusion: This study highlights the predominance of sepsis in AKI and the diabetes–hypertension combination in CKD, in a resource-limited setting with very restricted access to renal replacement therapy. It underscores the urgent need to improve early detection and management of cardiovascular and infectious risk factors.
Objectives: To evaluate the effects of MI combined with PNI on the quality of life, self-efficacy, psychological state, and sleep quality of patients with GERD. Methods: 60 GERD patients were enrolled based on inclusion and exclusion criteria and randomly assigned to the observation (30 cases) or control groups (30 cases). The observation group underwent MI combined with PNI, while control group received conventional nursing interventions. The changes in inflammatory response-related indicators were compared between two groups. The reflux disease questionnaire (RDQ), symptom self-rating scale (SCL-90), self-efficacy scale (GSES), simple SF-36 scale and Pittsburgh sleep quality index scale (PSQI) were employed to assess the patient's conditions before, three months following and after nursing. Results: Baseline inflammatory markers and scale scores showed no significant between-group differences. After 3 months, the observation group demonstrated significant reductions in these inflammatory markers compared with baseline and the control group. At the same time point, SCL-90 scores decreased across multiple domains, GSES scores improved, and SF-36 scores increased in several dimensions. PSQI scores were also significantly lower in the observation group, indicating better sleep quality. Conclusion: MI combined with PNI may reduce inflammation, relieve negative emotions, and enhance self-efficacy, quality of life, and sleep in GERD patients.
Background: Severe postoperative pain is common after haemorrhoidectomy and can delay recovery and discharge. While spinal anaesthesia provides good intraoperative analgesia, its postoperative effect is short-lived. This study aimed to compare the efficacy of an adjuvant perineal block combined with spinal anaesthesia versus spinal anaesthesia alone for postoperative pain control. Methods: In this randomized, double-blind controlled trial, 68 patients (ASA I–III) scheduled for elective open haemorrhoidectomy were assigned into two groups: Group A (Block Group): spinal anaesthesia with 0.5% hyperbaric bupivacaine followed by posterior perineal block using 20 ml of 0.25% bupivacaine; Group B (Control Group): spinal anaesthesia alone. Postoperative pain was assessed using the Visual Analogue Scale (VAS) at 2, 12, 24 and 48 hours. Secondary outcomes included time to first rescue analgesic, total opioid consumption, urinary retention, nausea/vomiting, and patient satisfaction. Results: Patients in Group A had significantly lower mean VAS scores at all postoperative intervals, with the greatest difference at 6 hours (3.1 ± 1.2 vs 5.2 ± 1.4; p < 0.001). The mean time to first analgesic request was prolonged in the Block Group (312 ± 56 min) compared to Control (182 ± 48 min). Total 24-hour opioid requirement was reduced by approximately 40%. Incidence of urinary retention and nausea/vomiting was similar between groups. No local anaesthetic toxicity or block-related complications occurred. Conclusion: Adding a perineal block to spinal anaesthesia significantly enhances postoperative pain control, delays the need for rescue analgesia, and lowers opioid consumption without added risk. This combined approach may be recommended as an effective, safe analgesic technique after haemorrhoidectomy.
Background: White-Sutton Syndrome (WSS) is a rare autosomal dominant neurodevelopmental disorder caused by pathogenic variants in the POGZ gene, which is essential for chromatin remodeling and neuronal development. Because of its broad phenotypic heterogeneity and lack of disease-specific features, early diagnosis and management remain challenging. Timely genetic testing can significantly aid in early diagnosis and intervention, improving patient outcomes. Objective: To describe the clinical and genetic findings of a Chinese pediatric patient with a novel POGZ mutation, summarize the diagnostic approach, and underscore the importance of early genetic testing and multidisciplinary management for the diagnosis and management of WSS. Method: A 4-month-old male infant presented with developmental delay and abnormal liver function. Comprehensive clinical, imaging, auditory, and ophthalmologic evaluations were performed. Whole-genome sequencing and Sanger validation were conducted, followed by multidisciplinary management including nutritional therapy and early rehabilitation. Result: The patient exhibited microcephaly, hypotonia, distinctive facial dysmorphism, auditory impairment, and retinitis pigmentosa. Brain MRI revealed hypoplasia of the corpus callosum. A novel heterozygous frameshift mutation c.2699_2700dup (p.Leu901TyrfsTer2) in POGZ was identified and classified as pathogenic according to ACMG criteria (PVS1 + PS2 + PM2 + PP4). The variant was not reported in existing genetic databases, representing a novel pathogenic mutation expanding the POGZ mutational spectrum. Despite multidisciplinary rehabilitation, neurodevelopmental progress remained limited. Conclusion: This report documents the first Chinese case of White-Sutton Syndrome caused by a novel POGZ frameshift mutation, emphasizing the importance of early genetic testing for accurate diagnosis and timely intervention. Genetic diagnosis combined with personalized rehabilitation may improve long-term neurodevelopmental outcomes for patients with WSS. This case study expands the mutation spectrum of the POGZ gene and provides valuable reference for the diagnosis, treatment, prognosis assessment, and genetic counseling of WSS patients.
Objective This study seeks to explore the association between common clinical indicators and pregnancy outcomes in patients with polycystic ovary syndrome (PCOS). Methods A cohort of 52 women with PCOS, 22 with isolated polycystic ovarian morphology (PCOM), 13 with isolated hyperandrogenism (HA), and 59 healthy controls was recruited from the Department of Reproductive Medicine, First Affiliated Hospital, Zhejiang University School of Medicine, between June 2021 and September 2022. Clinical parameters including age and body mass index (BMI) were recorded, while levels of D-dimer (DD), alanine aminotransferase (ALT), aspartate transaminase (AST), creatinine (Cr), urea nitrogen (UN), fasting plasma glucose (Glu), fasting insulin (Fins), and thyroid-stimulating hormone (TSH), embryo availability rate, fertilization Rate were measured. Differences across PCOS, PCOM, and HA groups were analyzed using analysis of variance and non-parametric tests. Results (1) In the PCOS group, significant differences were observed for embryo availability rate, age, WBC, TSH, ALT, AST, MAFLD, and BARD scores (P < 0.05). (2) Embryo availability was inversely associated with age, MAFLD, BARD, Fins, TSH, and WBC, and positively associated with AST (P < 0.05). (3) Fertilization rate was negatively correlated with V-PH, CA125, granulocyte percentage, BMI, Cr, and UN/Cr (P < 0.05). (4) ROC analysis of pregnancy outcomes in PCOS patients demonstrated that age, ALT, AST, AST/ALT, Cr, UN/Cr, DD, TSH, and CA125 had areas, sensitivities, and specificities above the moving average threshold. Conclusion Endocrine profiles differ significantly among PCOS, PCOM, and HA groups, and markers such as Age, ALT, AST, AST/ALT ratio, Cr, UN/Cr, DD, TSH, and CA125 can serve as potential predictors of pregnancy outcomes in patients with PCOS.
Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by variants in the GBA gene. This study reports a novel pathogenic large deletion in the GBA gene identified in a 70-day-old male infant presenting with cholestasis and hepatosplenomegaly, leading to a diagnosis of GD. Comprehensive genetic analysis using whole-exome sequencing (WES) revealed compound heterozygous variants, a maternally inherited c.1448T>C (p.Leu483Pro) missense variant and a paternally derived large deletion encompassing both the GBAP1 pseudogene and the functional GBA gene. The paternal origin of the deletion was confirmed by quantitative PCR (qPCR), and long-range PCR with subsequent sequencing precisely mapped the breakpoints, characterizing the deletion as 20,627 bp in length. A critical diagnostic finding was that standard Sanger sequencing initially failed to detect this deletion, misleadingly suggesting the infant was homozygous for the missense variant. This case highlights a significant limitation of Sanger sequencing, which can misinterpret large heterozygous deletions as false homozygosity due to allele dropout. Consequently, this report underscores the necessity of employing comprehensive genomic methods like WES as a first-line diagnostic test for lysosomal storage disorders such as GD, ensuring accurate detection of complex variants including large structural variants.
Hypertension is extremely prevalent in patients with diabetes. Limited data exist on whether patterns of drug therapy among diabetic hypertensive patients are consistent with evidence-based practice guidelines. There are many variations in prescribing patterns of diabetic hypertensive patients needs much care while choosing drugs. We have very limited research-based information regarding the patterns of drug therapy among diabetic hypertensive patients. The aim of this study was to assess the patterns of drug therapy among diabetic hypertensive patients. This retrospective study was conducted in the Department of Pharmacology, Uttara Adhunik Medical College and Hospital, Dhaka, Bangladesh during the period from January 2000 to December 2020. In total 78 diabetic hypertensive patients treated in the mentioned hospital were enrolled in this study as study subjects. As per the inclusion criteria of this study, only those patients who got at least one anti-diabetic and one anti-hypertensive drug in treatment were included. Proper written consents were taken from all the participants before data collection. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. In this study, the male-female ratio of the participants was 1.3:1. The mean ±SD age (Year) and BMI (Body Mass Index) (Kg/m2) of our participants were 53.2 ±6.82 and 32.41 ±2.49 respectively. For our patients, 87% and 13% drugs were used through oral and parenteral routes respectively. In this study, among all of our participants, as antihypertensive drug therapy, in 49%, 36% and 15% cases mono, duel and triple antihypertensive drugs were used respectively. In this study, among all of our participants, as anti-diabetic drug therapy, in majority of the patients, mono-therapy was used whereas, in 24% cases double and in 10% cases triple drug therapy was used. Majority of the diabetic hypertensive patients are treated by mono antihypertensive and mono antidiabetic therapy. The treatment cost of insulin receiving patients are higher than that of other diabetic hypertensive patients.
Retinopathy of prematurity (ROP) is increasingly treated with intravitreal bevacizumab (IVB) but consensus on the optimal dose remains to be determined. Peripheral avascular retina (PAR) and fluorescein leakage are recognised sequelae following anti-vascular endothelial growth factor (VEGF) therapy. The impact of IVB dose on the frequency of these outcomes requires further investigation. This study aimed to compare the prevalence of these two findings on fundus fluorescein angiography (FFA) in infants post treatment of ROP with either 0.625 mg or 0.3125 mg IVB. This was a retrospective study of 74 eyes to compare the prevalence of PAR, fluorescein leak and length of temporal retinal vascularisation (LTRV) after receiving IVB as primary therapy for severe ROP. PAR was observed in almost all eyes treated with IVB (P=1). The number of eyes demonstrating fluorescein leak was double in those receiving 0.3125 mg (6 out of 34) compared to 0.625 mg (3 out of 40) though this difference was not statistically significant (OR 2.61, 95% CI 0.50-17.53, P=0.286). Eyes treated with 0.625 mg IVB had a non-significantly greater mean LTRV by 0.37 disc diameters (P=0.573). Despite lacking statistical significance, the doubled fluorescein leakage rate and trend towards lower LTRV in patients receiving 0.3125 mg may warrant caution in high-risk cases.
Background: Cardiovascular diseases (CVD) are the leading cause of mortality in China, accounting for 40% of annual deaths and affecting over 290 million individuals. Rapid urbanization, lifestyle changes, and an aging population have exacerbated CVD risk factors such as hypertension, diabetes, and obesity. Artificial Intelligence (AI) technologies, including machine learning (ML) and deep learning (DL), offer transformative potential to address these challenges by enhancing diagnostic accuracy, risk stratification, and patient management. Objectives: This systematic review evaluates the effectiveness of AI in improving CVD diagnosis and treatment outcomes within the Chinese healthcare system. Secondary aims include assessing AI’s role in risk prediction, identifying implementation barriers, and exploring future directions. Methods: Following PRISMA guidelines, we conducted a comprehensive literature search (2021-2025) across PubMed, CNKI, IEEE Xplore, Scopus, and Web of Science. Inclusion criteria focused on peer-reviewed studies involving AI applications (ML/DL) in adult CVD care, while excluding non-empirical research or studies outside China. Results: Preliminary findings demonstrate that AI significantly enhances diagnostic precision (e.g., CNNs for ECG interpretation, DL for imaging analysis) and enables personalized treatment plans. Challenges include infrastructural limitations, data privacy concerns, and clinician resistance due to inadequate training. AI-driven predictive analytics show promise in early intervention but require robust validation and ethical oversight. Conclusion: AI holds immense potential to revolutionize CVD care in China, though its integration demands addressing technological, educational, and ethical barriers. Future research should prioritize longitudinal studies and standardized frameworks to ensure equitable, transparent AI deployment in cardiology.
Background: Rural China experiences a disproportionately high burden of atrial fibrillation (AF) among the elderly, facing three major challenges in AF management: (1) inequitable distribution of medical resources, (2) limited access to healthcare, and (3) significant variability in clinical competency among village doctors. Objective: To evaluate current realities, systemic challenges, and evidence-based solutions for AF management in rural elderly populations, focusing on village doctors' roles and telemedicine integration. Method: A narrative review was conducted using PubMed, CNKI, and Wanfang Data (2000-2025), focusing on studies related to AF management, rural healthcare, and village doctors in China. Evidence was synthesized from epidemiological surveys, policy analyses, and intervention trials, including the MIRACLE-AF cluster-randomized trial which evaluated a telemedicine-assisted model involving remote monitoring, specialist consultations, and village doctor education. Result: Rural China exhibits low AF detection rates (4.3% in high-risk elderly) and suboptimal care due to limited resources, poor patient awareness, and significant knowledge gaps among village doctors (89.6% lacking formal medical training). The MIRACLE-AF trial demonstrated significant improvements in the intervention group: higher anticoagulation adherence (85.2% vs. 20.8%) and reduced annual cardiovascular event incidence (6.2% vs. 9.6%). Rural AF prevalence (5.4% in ≥75-year-olds) correlates with aging, lifestyle factors, and healthcare disparities. Persistent urban-rural gaps exist in AF awareness (78.3% vs. 35.3%) and risk factor control. Conclusion: Enhancing village doctors' capabilities through telemedicine-supported training, coupled with policy reforms and infrastructure investment, is essential for equitable AF management. Integrating digital health platforms with traditional care offers a feasible approach to reduce rural-urban disparities, improve outcomes, and establish sustainable chronic disease management in resource-limited settings.
Patient satisfaction is a key indicator of healthcare service quality and an important component in evaluating health system performance, particularly within referral hospitals in low-resource settings like Tanzania. This interdisciplinary study was conducted at Kilimanjaro Christian Medical Centre (KCMC) Referral Hospital to assess outpatient satisfaction using the SERVQUAL framework. A stratified random sampling technique was employed to ensure proportional representation of patients across various outpatient clinics. Within each clinic stratum, participants were selected using simple random sampling. Outpatients were evaluated across five service quality dimensions: tangibility, reliability, responsiveness, assurance, and empathy. Modified Poisson regression analysis was applied to examine associations between patient satisfaction and selected demographic and service-related variables. The results revealed that effective communication with healthcare providers (RR = 1.246, p = 0.008) and the availability of prescribed medications (RR = 1.093, p = 0.009) were significantly associated with higher satisfaction. Conversely, patients aged 46 years and above reported lower satisfaction levels (RR = 0.903, p = 0.002). Additionally, more than half of the respondents expressed dissatisfaction with the waiting time for services. While overall satisfaction with outpatient services was generally positive, the findings underscore the need for targeted improvements, particularly in reducing waiting times. This study highlights the value of integrating robust statistical modeling and service quality frameworks to generate actionable insights for enhancing patient-centered care in sub-Saharan African referral hospitals.
The genodermatoses is genetic diseases that affect to the skin and their old ones, in those which alone they influence hereditary mechanisms linked to the genes. The neurofibromatosis type 1 are a genodermatoses that belongs to the group of the Rasophaties, with brown formation of stains with milk and tumours in skin and nervous system. This diseases can be diagnose clinically with the presence of two clinical approaches. In the year 2001 a Rasophatie was described that previously it was considered a clinical form of the neurofibromatosis, but it was demonstrated by means of molecular studies that it is a different diseases and it was designated as Legius syndrome. This syndrome completes two of the current diagnostic approaches of the neurofibromatosis type 1, when presenting coffee with milk macula and axillary or inguinal ephelides, being difficult to differentiate them. Although at the moment molecular studies of sequence exist for the diagnosis of both rasopatías, in some countries it is a non-available technology. In Cuba, like part of a methodology for the attention to patient with genodermatoses, the proposal of modification of diagnostic approaches of neurofibromatosis type 1 were included, unifying in one single approach the presence of coffee with milk macula and axillary or inguinal ephelides. The presentation is made with the purpose of standing out the importance of modifying the diagnostic approaches of neurofibromatosis type 1, proposed in the methodology. An adolescent is described that presented coffee with milk macula, axillary ephelides and overturn for deficit of attention with hyperactivity, assisted in specialized consultation of genodermatoses in the Pediatric Hospital “Martyrs of Tunas” with diagnostic presumptive of neurofibromatosis type 1. In the presented case the proposed approaches and the molecular study of neurofibromatosis type 1 negative, they guided toward the diagnosis of Legius syndrome. This case demonstrates the importance of the modification of the diagnostic approaches of neurofibromatosis type 1, proposed in the methodology for the attention to patient with genodermatoses that avoids the diagnostic error.
Irregular red blood cell antibodies may occur in blood donors and can cause serious complications to the point of endangering patient life if transfused. The rate of detection of irregular red blood cell antibodies among people ranges approximately from 0.2% to 2%. Despite the efforts, donated blood is still not screened for irregular red cell antibodies in many local community hospitals, and there is a scarcity of information about irregular red blood cell antibodies in Tanzania. The present study was carried out to determine the prevalence and factors associated with irregular red blood cell antibodies among voluntary blood donors at the Northern Zone Blood Transfusion Service Centre, Moshi, Kilimanjaro. It was an analytical cross-sectional study conducted in the northern zone blood transfusion center from May to June 2023. The study population was all voluntary blood donors attending the Northern Zone Blood Transfusion Center. Interview-administered questionnaires were used to collect information from study participants. Blood samples were screened for irregular RBC using a fully automated immunohematology system (NEO IRIS, Immucor Inc., Norcross, GA, USA). Data was entered and analyzed using SPSS. Logistic regression analysis determined the factors associated with irregular red blood cell antibodies among voluntary blood donors. Odds ratios and their 95% confidence intervals were reported. The mean age of participants was 29.72 (SD 8.958) years. In rural areas, the prevalence of irregular red cell antibodies was 14.3% while in urban areas it was 2.4%. Among participants with a transfusion history, the prevalence of irregular red cell antibodies was 14.3% compared to 2.4% for those who had never been transfused. We recommend including antibody screening tests in the routine pretransfusion testing protocol, especially for those requiring frequent transfusions and having the risk of alloimmunization.
This study aimed to develop and validate a nomogram for predicting ICU mortality risk in patients with spinal fractures to improve prognostic accuracy. Using data from 1,146 patients in the eICU Collaborative Research Database, independent risk factors—including age, BMI, APACHE IV score, admission source, mechanical ventilation, spinal cord injury, sepsis, oxygen saturation, white blood cell count, hemoglobin, and glucose—were identified via forward stepwise logistic regression and incorporated into the nomogram. The model demonstrated excellent performance, with AUCs of 0.902 (0.857–0.938) in the training cohort and 0.903 (0.825–0.953) in the validation cohort, significantly outperforming APACHE IV according to the DeLong test. Further validation via Hosmer-Lemeshow test, calibration curves, NRI, IDI, and DCA confirmed the nomogram’s superior calibration and clinical utility. As the first comprehensive predictive tool of its kind for spinal fracture patients, this nomogram offers improved mortality risk estimation and supports clinical decision-making.
Introduction: Erectile dysfunction (ED) refers to inability to achieve and sustain erection sufficient for satisfactory penetrative sexual experience. Lower Urinary Tract Symptoms (LUTS) includes storage, voiding and post-micturition symptoms due to bladder outlet obstruction. LUTS may be a risk factor for ED. Objectively, international prostate symptoms score (IPSS) is an essential tool for assessing the bothersome nature of lower urinary tract symptoms while the abridged version of international index of erectile function (IIEF-5) is objectively useful in assessing ED. This study is focused on establishing the relationship between severity of ED and IPSS in patients with bladder outlet obstruction (BOO) caused by prostate enlargement. Methodology: By simple random sampling, patients presenting in clinic with bladder outlet obstruction not due to urethral stricture were evaluated for ED. Two questionnaires (IIEF-5 and IPSS) and a specially designed proforma were administered to all the patients who met the criteria for inclusion. The questionnaires objectively evaluated the ED and severity of LUTS respectively. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. P-value of < 0.05 was seen as statistically significant. Results: One hundred and seventeen male patients with bladder outlet obstruction were enrolled in this study. Ninety patients (77%) varying severity of IIEF-5 score while twenty-seven patients (23%) normal IIEF-5 score. Mean age of patients with severe IIEF-5 score was 64 while the mean age of patients with moderate IIEF-5 score, mild to moderate IIEF-5 score, mild IIEF-5 score and normal IIEF-5 score were 64, 65, 60 and 58 respectively. Over seventy one percent (71.4%) of patients between 41-50 years had varying degree of ED based on IIEF-5 score. 65% of patients between the age range of 51-60 abnormal IIEF-5 score while 89% and 94% of patients between the age range of 61-70 and 71-80 respectively varying degree of ED. Patients with severe IIEF-5 score had the highest mean IPSS of 23 while patients with normal IIEF-5 score had the lowest mean IPSS. The P-value (0.21) was not significant. Conclusion: This study shows that IIEF-5/ED has a direct relationship with IPSS. There was a positive link between ED/IIEF-5 and IPSS/LUTS. This may also be part of the rationale for administering low dose tadalafil to improve sexual performance in patients with bladder outlet obstruction.
Background: Smart anatomy is an emerging interdisciplinary field that utilizes digital technology, information technology, artificial intelligence (AI), and other modern technological means to study, display, and apply human anatomy. The emergence of smart anatomy as a discipline is not accidental; it is a response to the actual needs of modern, information - based anatomy teaching and the development of modern medical science. It is equipped with digital and information technology and is an inevitable product of the AI era. Objective: The use of smart anatomy laboratories for anatomy teaching is conducive to opening up new fields of research in anatomy education, changing the traditional expression and teaching modes of human anatomy, re - evaluating the relationship between anatomy and other disciplines, and utilizing more extensive and detailed anatomical atlases for teaching. This approach aims to completely transform the traditional, cumbersome laboratory settings. Results: Currently, there are no reports on the use of smart anatomy laboratories for anatomy teaching research. Existing reports on smart anatomy teaching only cover certain aspects, such as creating smart classrooms for human anatomy using "Rain Classroom." Conclusion: This paper introduces the resource allocation, application scope, and management of newly - established smart anatomy laboratories. It also analyzes the characteristics and advantages of using smart anatomy laboratories for anatomy teaching, providing new insights and references for the development and teaching research of smart anatomy.
