Aim: The aim of this work is to study the diseases of the human circulatory system in Cyprus and their relationship to smoking and air pollution. Methods: The statistical methods were used to derive the results of this work are Mann-Whitney U test in order to check the statistical significance of cardiovascular diseases in relation to gender, One-Way ANOVA test in order to check the statistical significance of human circulatory diseases in relation to age and the Pearson correlation coefficient for the relationship between the diseases of both predisposing factors of smoking and air pollution. Results: The results showed that there is no statistically significant difference in the number of cardiovascular diseases in relation to gender, there is a statistically significant relationship between circulatory system diseases and age, and in particular they occur mainly at ages 65 and over. An exception is the disease of varicose veins of lower extremities, which occurs most often in ages 45-64. Finally, there is a statistically significant relationship between the numbers of incidents of circulatory diseases with air pollution and there is no statistically significant relationship with smoking. Conclusions: This work has shown that diseases of the circulatory system vary with age, while air pollution is an important predisposing factor.
Objective: Using orthopedic splint and cast is a basic orthopedic treatment method after orthopedic fracture, dislocation and soft tissue injury. We want to examine the sharing of these orthopedic practices in social media areas and their results. Method: in a single-centered study; we asked about face-to-face questions at the controls of the patients who suffered from cast and splint. Patients were asked questions before we prepared. Results: 105 patients who participated in the study 61 were male (58.1%) and 44 were female (41.9%). The mean age of patients was 14.5 ± 42.2 years.35 patients had distal radius fracture and had short arm cast,42 patient had ankle soft tissue injury and had short leg splint,6 patient had ankle fracture and had short leg cast,20 patient had boxer fracture and had short arm splint,2 patient had humerus shaft fracture and had long arm cast.56(53.3%) patients had social media account. Thirty-two (57.1%) of the 56 patients shared cast and splint in the official social media. Conclusion: increasing use of social media and orthopedic treatments such as cast, and splint are shared in social media, unnecessary splint application is requested from patients. Some of the patients comes in control in a later date late due to social media sharing.
Introduction: The gradual deterioration of sperm parameters, observed over the years, is attributed to environmental factors such as tobacco. Smoking has already been incriminated in erectile dysfunction as well as in alterations in sperm quality. This study aims to determine the spermatic abnormalities associated with active and/or passive exposure to smoking. Methods: A cross-sectional analytical study was conducted over a period of 8 months (September 2016 - April 2017) at the Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction. All men with spermatic abnormalities who agreed to give informed consent were included consecutively. The mode of exposure to smoking and spermatic abnormalities were sought. The statistical analysis was done using the software Epi info version 3.5.4. using the Chi-square test with a value of p <0.05 considered as statistically significant. Results: A total of 228 men with a spermatic anomaly were included in the study, of whom 82 (36.0%) were exposed to smoking. The proportion of men with oligozoospermia was higher among smokers (49, 59.8%) than among non-smokers (62, 42.5%), similarly for those with oligoasthenozoospermia (smokers: 25, 30.5% vs. no smokers 37, 25.3%). These differences were statistically significant for oligozoospermia (p = 0.012) and oligoasthenozoospermia (p = 0.028). Conclusion: Spermatic abnormalities found in passive and/or active tobacco exposure were oligozoospermia and oligoasthenozoospermia.
Cervical cancer is a huge health concern. It is the second most common female tumor worldwide. It is consider a professionalchallenge for gynecologist. 90% of newly diagnosed cases are in the countries with a low socio-economic growth. Lack of health care infrastructure, accessibility, low level of education, lack of hygienic habits are all the factors contributing to this figure. Cervical cancer occurs mainly in low-resource, underserved regions as part of a complex of diseases linked to poverty, race/ethnicity, and/or other health disparities. It has been shown that only 5% of women living in under developed countries, are having regular yearly screening. Under given circumstances regular cervical cancer screening using cervical cytology (Papanicolaou [Pap] smears) is the best cost-effective option gynecologist have.The goal of this scientific paper is to present the results of screening test done in Clinical Center Pristina Gracanica Kosovo, Serbia.Screening was done retrospectively in the period of 2011-2015. The total number of screened women was 2871. Pap smear test and colposcopy were performed. In 6.3% of the cases Pap test was positive, including 96% Papa III, and 12 cases of cervical cancer were diagnosed.
Dural arteriovenous fistula (DAVF), is an abnormal connection of vessels in the tissues around the brain or spinal cord in which one or more arteries are directly connected to one or more veins or venous spaces called sinuses, which may or may not be asymptomatic for years. The case presented is about an osteodural arteriovenous fistula which is not a common location for DAVFs and reported through its clinical and pharmacotherapeutic management during and after the patient’s diagnosis. The patient interviewed is a 39-year old Asian male his symptoms were non-aggressive as manifested by severe headaches and tinnitus. He is already hyperlipidemic and hypertensive prior to the admission with history of asthma attacks.
Introduction: Malunion is a common complication of distal radius fractures. The incidence after conservative treatment is 25% and after surgery is 10% (1). After distal radius malunion, different surgical procedures have been described, such as fixation with K wire, plate, use of external fixator and frequent locking plate application (2-3). Case Report: In our case 32 year old patient who was operated by neurosurgery after traffic accident. Two months after the operation, the patient came to the orthopedics clinic. Distal radius dorsal angle malunion was detected after x-ray control.we choose dorsal aproach and using only k wire in surgery. Conclusion: In this case we understand that ,in distal radius extra articular malunion surgery, prefering dorsal approach and using only k wire can be good results like the other syrgery procedures.
Background: Surgical Site Infection (SSI) poses a burden to patients and the healthcare system by increasing cost and hospital stay as well as causing significant morbidity and mortality. The incidence of SSI in sub-Sahara Africa is approximately 10% and 60% for clean wounds and dirty wounds respectively. We determined bacterial etiology and antimicrobial susceptibility of surgical site infections at Moi Teaching and Referral Hospital, Eldoret-Kenya. Methods: We conducted a cross sectional study among 57 cases of SSI. Data was collected on sociodemographic and clinical characteristics using a structured questionnaire. Pus swab was collected from the cases for culture and antimicrobial sensitivity. Blood culture was done for participants who presented with systemic features of infection including fever of 37.50C and above. Frequencies and proportions were determined for bacterial etiology and antimicrobial susceptibility. Results: A total of 55 bacterial organisms were isolated from 46 patients. The most common isolate was Staphylococcus aureus - 22 (40.0%) followed by Escherichia coli- 11 (20.0%), Acinetobacter baumannii- 6 (10.9%), Klebsiella pneumoniae -5 (9.1%), Pseudomonas aeruginosa-4(7.3%), Proteus mirabilis 2(3.6%) and Streptococcus pyogenes 1 (1.8%). Methicillin Resistant Staphylococcus Aureus (MRSA) comprised 59% (13) of all Staphylococcus aureus. Gram positive bacteria had over 50% resistance to Ceftriaxone, Cotrimoxazole, Ciprofloxacin, Azithromycin, Erythromycin, Cefuroxime and Levofloxacin. Gram negatives had more than 50% resistance to Ceftriaxone, Cefotaxime, Ceftazidime, Cefepime and Levofloxacin. MRSA and Acinetobacter baumannii showed multidrug resistance. Conclusion: Staphylococcus aureus was the commonest causative agent for SSI with MRSA constituting 59% of Staph aureus infection. Organisms causing SSI were resistant to most commonly used antimicrobial agents at MTRH. Recommendations: Active surveillance for SSI causing organisms and their susceptibility patterns should be instituted at MTRH. Antimicrobial use should be rationalized according to local susceptibility patterns.
Background: Diabetes mellitus is one of the most prevalent chronic diseases, its proper management is important for better prognosis. poor control is not uncommon and factors associated with uncontrolled state vary between communities. No previous published researches focused on estimating uncontrolled cases in Jeddah, nor exploring its associated factors. Objectives of the study: To estimate prevalence of uncontrolled type 2 diabetic cases and explore its associated factors in patients attending primary heal care centers, Jeddah, KSA. Subjects and methods: Through a cross section study, with nested case control design, 400 diabetic patients were selected randomly from primary health care centers in Jeddah. They responded to a predesigned valid questionnaire enclosing information about glycemic level, and demographic and clinical variables possibly associated with poor glycemic control. Chi square test and Odds ratio were used to identify factors significantly associated and predicting uncontrolled diabetes. Results: Out of all patients (n=400), more than one half (54%) aged 60 years or older, with marked dominance of females (65.5%). almost three quarters (72.5%) were considered as being “uncontrolled cases”. The most significant factors associated with poor glycemic control included being a female (OR=1.456, 95% CI: 1.065-2.706)), older patients as it reached up to 80.4% in patients aged 60-79 years, widowed (87.1%), obese patients (73.6%) and hypertensive patients (OR=3.126, 95% CI:1.867-5.233). Poor control was less frequentr in those who had positive history of hyperglycemic crisis (OR=0.578, 95% CI:0.497-0.673) and those who had positive family history of diabetes mellitus (OR=0.822, 95% CI:0.728-0.928) p<0.05. Conclusion and recommendations: Poor glycemic control is markedly prevalent among diabetic patients attending PHC in Jeddah. Associated factors included being female, old age, obesity, hypertension and positive family history of diabetes. Tailored care should be planned for diabetic patients with the predictors of poor glycemic explored in the current study.
Background: Sexual way of acquiring the HIV virus continues to predominate in 95% of reported cases in Albania. Nowadays, sexual risk behaviors of people living with HIV still remain big public health concern for spread of HIV virus from infected persons to another uninfected one; no date is available regarding risk behaviors of people living with HIV in Albania. Objectives: This study was undertaken to improve the understating about sexual behaviors of people living with HIV in Albania over the past 12 months and during the last episode of sexual intercourse. Material and Methods: A descriptive cross sectional study was conducted in outpatient clinic of people living with HIV in Albania. Two hundred sixty four patients were interviewed about their sexual identity, sexual orientation, sexual attraction, sexual practices, and their sexual partners using AMIS questionnaire (Emory University Instrument) to measure their sexual risk behaviors. The data collected was analyzed using SPSS software. Results: Overall two hundred sixty four (264) participants of the study, 70 (26.5%) were females and 194 (73.5%) were males. In the study’ sample prevail age group 35- 44 years old (28.8%). The mean age of the sample was 43.41 years old. The most predominat marital status were married 48.1%. The mean of education is 3.63. It reveals that the average of the sample has completed 8 to 12 years of school. The median monthly income was between 100 $-150$. 76.1 % of sample resided in urban region; of which 45.8% lives in the capital city (Tirana). 93.9% were Albanian by ethnic background. Based to their sexual orientation the participants are grouped into heterosexual, bisexual and homosexual. For all variables includes to sexual activity over the last 12 months and last intercourse and also to their assertions we have found a strong association for p value < 0.01. Conclusion: Over the past 12 months, never used condom 61.9% of heterosexual male; 86.3% of female; 57.15% of homo/bisexual male. The last sexual intercourse was unprotected 57.8% of heterosexual male; 80.4% of female and 59.3% of homo/bisexual. There is no information regarding their last HIV partners 48.3% for heterosexual male; 37.25 of female and 89.6% of homo/bisexual male.
OBJECTIVE: The aim of our study is to evaluate aerosol therapy with two different types of corticosteroids (budesonide and beclomethasone) in patients suffering from acute rhinitis. METHODS: 96 patients with acute rhinosinusitis (ARS) were enrolled. The population was divided randomly into two groups: 48 patients treated with aerosol budesonide vial 0.5mg / ml (group A), the other 48 treated with beclomethasone vial 0.8mg / 2ml (group B). All patients underwent control after 20 days of treatment. Data about, olfactory function (Visual Analog Scale), Sino-Nasal Outcomes Test (SNOT-22) and total nasal resistance (rhinomanometry) were collected and analyzed. RESULTS: Group A evidenced a reduction of total nasal resistance (p = 0.007) and of nasal symptomatology (p = 0,008). The olfactory function did not show statistically significant differences between the two groups. CONCLUSION: patients who have performed aerosol therapy with budesonide, compared to those who have used beclomethasone, have an improvement in nasal airflow and a reduction in obstructive symptoms statistically valid.
Aim: To determine the prevalence of disomy 21 in sperm samples from fathers of children with Down syndrome in order to identify cases with a high likelihood of paternal origin. Materials and Methods: FISH analysis has been carried out in the sperm samples of 10 normal males and 13 fathers of children with trisomy 21, totally 23 males. in this study the hybridization efficiency and segregation frequencies were detected by using locus-specific probes of chromosome 21 and 13. SPSS software and t-test were used for statistical analysis. Results: 13 420 nuclei of our case group in this study the hybridization efficiency and segregation frequencies were detected by using locus-specific probes of chromosome 21 and 13. have been examined and the percentage of cells were determined as follows, 92.57 %; haploid , 1.6 %; disomic for chromosome 21, 0.6%; dizomic for chromosome 13, 1.3 %; diploid cells. As the control group, a total of 10 000 nuclei were analyzed and 95.28 %; haploid , 0.49 %; disomic for chromosome 21, 0.3 %; disomic for chromosome 13, 1.26 %; diploid cells were determined. Conclusions: The results of our small-scale case-control study were similar to the rate of paternal origin in the literature. In conclusion, FISH may be considered a reliable method in sperm aneuploidy screening.
Targetoid haemosiderotic haemangioma is a benign, solitary vascular tumor that usually occurs at young or middle aged women. It may be either on extremities, or on the trunk. A 32-year old woman presented with a 5 mm papul with a violaceous center surrounded by an annular pale part and an ecchymotic ring located outermost. The lesion was present for 1 month, but the patient reported that it has recurred 5 times in 2 years at the same location. The lesion was excised totally and it did not relapse during one year’s follow up. A diagnosis of recurrent targetoid hemosiderotic hemangioma was made both clinically and histopathologically.
Objectives: This study aimed to examine the relationship between caregiving for autistic children and their mothers' social participation. It also evaluated the effects of three factors; time, finances and stigma attached to the disability upon social participation. Methods: Purposive sampling technique was used to recruit mothers of autistic children living in Saudi Arabia. A survey was conducted to collect data from 42 mothers of children with autism. Ordinal regression was used to examine the relationship between the social participation of the mothers of autistic children and caregiving and the other factors. Descriptive statistics were used to analyse demographic data. Results: We found that caregiving for autistic children had a negative relationship with the amount of mothers' social participation (significant at p<0.05). Moreover, social participation was affected negatively by factors such as time, finance and stigma. The most significant amongst them was time followed by financial constraints. Stigma was the least momentous factor. Conclusions: The social participation of mothers of autistic children in Saudi Arabia is negatively influenced by multidimensional and high care demands. This is further complicated by additional financial pressures, time constraints, and stigma associated with this disabling condition. Provision of a variety of social support programs and training, such as effective time management, adequate coping skills, and counseling services may help in overcoming these obstacles. This, in turn, may aid not only in improving social participation but also occupational balance, psychological well-being and quality of life of the affected mothers
Background: Systemic lupus erythematosus (SLE) is a multisystemic disease, caused by a variety of factors, which lead to immunological abnormalities. Osteopontin (OPN) is a pleiotropic protein, important in bone remodeling and immune system signaling. It produced by various cells, including immune cells, and played a key role in regulating T-helper 1/T-helper 2 balances, stimulating B lymphocytes to produce antibodies, regulating macrophages, neutrophils and inducing dendritic cells. Over expression of OPN has been associated with the pathogenesis of immune-mediated diseases. Objectives: To investigate the role of osteopontin in SLE and to assess its relation to disease activity and subclinical atherosclerosis. Subjects and Methods: This cross sectional case control study was conducted on 30 SLE patients fulfilling SLICCA /ACR criteria for SLE classification and 30 subjects sex- and age-matched apparently healthy as control group. All patients were assessed for SLE disease activity by the systemic lupus activity Index (SLEDAI). Serum OSP and Doppler ultrasound for carotid artery media thickness (CIMT) were measured in all patients and control. Results: Plasma OPN levels were significantly higher in SLE patients than in control group (P<0.001) and had significant positive correlation with disease activity (r 0,595, P<0.05) and CIMT (r = 0.400, P <0.001), but there was no significant correlation between CIMT and disease activity. Conclusion: serum level of OPN was higher in SLE patients and correlated with disease activity and CIMT, and can be used as a marker of subclinical atherosclerosis.
We present a case of an 18-year-old boy habitual consumer of alcohol, initially followed by a leukoplakia of the vocal cords and subsequently undergoing a Multiple Organ Dysfunction Syndrome (MODS) with hepatic, renal and nervous system involvement. We find a mutation of alcohol dehydrogenase 4.
The aim of this paper is to review all current knowledge about the best way to manage this important problem including a prioritized list of steps taken to avoid hematuria apparition or its worsening, to assess whether a catheter is blocked and the actions are taken to restore catheter patency for continuous bladder irrigation.
BACKGROUND: Malignant triton tumor (MTT) is a variant of the typical malignant peripheral nerve sheath tumors with rhabdomyoblastic differentiation what mostly occur in the context of neurofibromatosis type 1. CASE PRESENTATION: Here, we report on a case of a 15-year-old male with a clinical history of neurofibromatosis type 1 who presented to the pediatric emergency department with an intraperitoneal tumor of about 20 cm of diameter. The biopsy of this tumor confirmed histology of rhabdomyosarcoma. The patient received six cycles of chemotherapy. After that, resection of the tumor was performed. Histological findings revealed a malignant peripheral nerve sheath tumors (MPNST) of Triton type. Then he received 28 sessions of radiation therapy. The child died 11 months after radiation therapy. CONCLUSION: Malignant triton tumor is a very aggressive tumor. A multidisciplinary approach is required for diagnosis and treatment of this rare pediatric tumor.
Secondary mammary cancers are rare tumors and represent only 0.3% of all malignant breast tumors. Mammary metastases of ovarian origin are rarely reported in the literature. We report the case of a 48-year-old woman with antecedent peritoneal tuberculosis treated 2 years ago. She had chronic pelvic and lower back pain associated with weight loss and general impairment. Pelvic examination showed a bilateral mobile and painful latero-uterine mass. Serum CA 125 levels were elevated. Abdomino-pelvic ultrasound and CT scans showed the presence of a bilateral para-uterine pelvic liquid mass evoking a hydrosalpinx. The patient received a laparoscopy with an ovarian biopsy. The morphological and immunohistochemical aspect points to an invasive and sparsely differentiated primary ovarian adenocarcinoma. The patient benefited from 4 chemo treatments with a good radiological and biological response. Two years after the onset of symptoms, the patient presented a solitary 3-cm nodule in the left breast without associated axillary adenopathies. At mammography, the tumor was classified as ACR 4 and biopsies were performed. The histological study showed malignant tumor proliferation with the same morphological and immunohistochemical characteristics as an ovarian tumor. The patient was lost to follow-up after the diagnosis of breast metastasis.
Facial skeletal changes associated with hyperparathyroidism assume three radiographic patterns: osteitis fibrosa cystica, fibrous dysplasia, and leontiasis ossea. The 3rd pattern is unique to renal osteodystrophy. Renal osteodystrophy frequently affects the spine, ribs, long bones, and skull. Findings of renal osteodystrophy in facial and cranial bones are rare. However, it’s most severe osseous complication is characterized by massive thickening of the cranial vault and facial bones, called uremic leontiasis ossea (ULO), with only few cases reported in the literature. The uremic leontiasis ossea causes significant aesthetic and functional changes. It is important to recognize features of leontiasis ossea, as it may result in life threatening upper airway obstruction and compressive cranial neuropathy while after parathyroidectomy, facial changes can be stabilized or improved mildly. We report a case of uremic leontiasis ossea with a history of gradual enlargement of the facial bones over a period of one year. Significant hypertrophy of the maxilla and clavarial bone is most significant CT finding with serpiginous tunneling within the bone and poor visualization of the cortical bone. Nuclear medicine scans are also useful for demonstrating parathyroid adenoma. Ultimately, the diagnosis of uremic leontiasis ossea can be made non-invasively through a combination of clinical parameters and imaging findings, as described in this article.
Purpose. To determines the incidence of complications of acute symptomatic posterior vitreous detachment (PVD) and its impact on ophthalmic emergency setup. Design. A retrospective study of 172 patients presented in one years’ time, with acute symptomatic posterior vitreous detachment. Methods. A retrospective record of 172 patients (n=172) was reviewed who were seen in one years’ time period at local hospital’s eye departments as emergency referrals. Referrals were made by primary care physicians and optometrists. Only patients with acute symptomatic PVD were taken into account. Their symptomatology, visual acuity, fundus examination findings, follow up appointments and outcomes were checked. Results. Mean age at presentation was 62.76 years. Acute Symptomatic Posterior vitreous detachment was detected without complications in 126 (73.25%). Retinal breaks were found on initial presentation in 33 patients (19.18%). Out of these, 18 had rhegmatogenous retinal detachment on initial presentation (10.46%), while one patient who also had vitreous haemorrhage developed it later. PVD was seen with vitreous haemorrhage in 4 patients (2.32%). Seven patients presented with PVD and associated retinal haemorrhages (4.06%). Demographically 96 patients were females (55.81%) as compared to 76 males (44.186%). The highest incidence was between 51 to 75 years of age (84.29%). Posterior vitreous detachments accounted for 7.50% of total eye emergencies in one year. Conclusions. Patients with flashes and floaters should be seen urgently. Priority should be given to patients with cells in vitreous (shafer’s sign) as well as retinal or vitreous haemorrhages. These patients should be seen by experienced ophthalmologist to rule out any break with 360 degree indirect ophthalmoscopic examinations. Junior doctors should have extensive training with indirect ophthalmoscopy with scleral indentation and should not miss shafer’s sign in all patients with acute symptomatic PVD.
