Obesity is a critical universal well-being challenge. Obesity is influencing various chronic conditions like high blood pressure, diabetic illnesses, strokes, cardiovascular ailments, and different kinds of cancer. Treatment of obesity becomes subject to high healthcare costs and lifestyle modifications. However, the most worrying aspect in Saudi Arabia is the intensifying obese-related cases among kids and teenagers. Progression of the condition becomes complex to manage. Again, the vital or severity of health consequences of childhood obesity underscores the disorder as a community health issue in the country. Kids’ and teenagers’ obesity cases have adverse effects on life quality and expectancy and lead to substantial healthcare expenses. Evaluation of various research underscores a relation between obesity, socio-economic status, and lifestyle changes. According to Al-Hussaini et al. (2019), economic success and subsequent lifestyle shifts incorporating sedentary lifestyles and dietary mannerisms continue to influence child and adolescent obesity in Saudi. The evaluation of literature on obesity-related cases in the country offers a better comprehension of the link between child or adolescent obesity and lifestyle factors, which enables one to understand how to prevent and manage the condition effectively.
Linezolid (LZD) is an antimicrobial agent with a broad spectrum of activity against virtually all clinically important Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCoNS) and vancomycin-resistant enterococci (VRE). Thrombocytopenia (TP) is a common adverse effect of Linezolid (LZD). Prolonged treatment duration, renal insufficiency, chronic liver disease, malignancy, previous vancomycin use, baseline platelet count, and lower body weight have been reported as possible risk factors for LZD-associated TP. Here, we illustrate a case of a 51-year-old male patient diagnosed with pancreatitis and urinary tract infection and was prescribed several antibiotics including Linezolid. In this case, platelets count which were initially normal started declining from day 7 of initiating Linezolid. Linezolid was withdrawn from treatment from day 9. Platelet count gradually came back to normal on day 16. This suggests reversible type of thrombocytopenia by Linezolid. This case illustrates need for careful observation of platelet count during the treatment with Linezolid. Keywords: Linezolid, Thrombocytopenia, Dechallenge
Acute upper limb ischemia in neonates is extremely rare and oftenassociated with disastrous outcomes including digital gangrene, chroniclimb ischemia, sepsis and limb loss. It is usually seen in the contextof intra-arterial catheters in the preterm neonates but it can be alsoseen in cases of difficult or traumatic deliveries as well as in infantswith coagulation deficits but can also be spontaneous with no obviousaetiology. Treatment options include topical vasodilators, systemicanticoagulation and in some instances, surgical intervention. We reportthree cases of acute limb ischemia in preterm neonates in which anew treatment option was introduced. The neonates responded to acombination of topical nitro-glycerine cream, systemic anticoagulationwith heparin and physical light massaging of the area just proximalto the site of reduced flow in the vessel assuming some degree ofvasospasm of the vessel occurs with or without thrombosis.Keywords: neonatal ischemia, management of neonatal ischemia, topicalvasodilators, systemic anticoagulation, massage therapy, surgicalintervention
The analysis of literature data and our published results of examination of patients with a wide range of pathological processes was carried out. It has been established that polar changes in reactivity provoke the development of immune-dependent ones, which include primary and secondary immunodeficiencies, auto-aggressive and immunocomplex diseases, or immunoassociated purulent-inflammatory, nonspecific inflammatory lung diseases, cerebrovascular diseases, in which suppression and stimulation of reactivity is a pathogenetic mechanism for normalizing homeostasis, depending on the links of the immune system, doses of antigens, the initial state of protective functions, phases of the immune response, etc. Keywords: Stimulation. Suppression. Immunodeficiency
Background: Nursing documentation is a record of care planned and provided by qualified nurses under the guidance of a competent nurse for each patient as well as the clients. Objective: to provide published studies about accuracy of nursing documentation. Methods: Searches were conducted using the following electronic databases: PUBMED, MEDLIN, CINAHAL, SAUDI DIGETAL LIBRALY and GOOGLE SCOLAR as gray data base. Search was limited to English-Language publication. And include study over 10year period. Result: nursing documentations is inaccurate, lacking precision, and low in quality. Factors that influence nursing documentation differ but are also interrelated with each other. Shortage of employees, insufficient knowledge about the significance of documentation, patient load, lack of hospital education, and lack of support from nurse leaders are the reported challenges to documentation. Conclusion: Most of the lecture revel the necessary need of nursing documentation practice. Affected factor and with several recommendations for improvement noted. Keywords: ''nursing care plan," "nursing documentation,'' "accuracy of documentation" and ''nursing report.''
The aim of this study was to determine the sensitivity level of IgA and NS1 serological tests in early diagnosis of dengue infection in febris patients 3–5 days in Cimahi. Next is to find out which of the two serological tests is the most effective for early diagnosis of dengue infection in febris patients for 3-5 days. The incidence and death rate due to dengue virus infection is still quite high, especially in several areas in Indonesia. The clinical manifestations of dengue virus infection are very diverse and the outcome of dengue infection (prognosis) is difficult to predict. An efficient and accurate diagnosis of dengue is the most important part of the patient care process. Serological examination is a laboratory diagnostic method that is often used to confirm the presence of dengue virus infection. NS1 and IgA anti-dengue are serologic tests that are often used, especially in the acute phase of the disease. This study aims to determine differences in the sensitivity of NS1 and IgA in patients with dengue infection with a fever of 3–5 days. This study was a prospective analytic observational study with a cross-sectional design. The subjects of this study were patients with dengue infection with a duration of 3-5 days. The number of samples that met the inclusion criteria was 69 people. The results of this study showed differences in the sensitivity of NS1 and IgA to antidengue in patients with dengue infection with a fever of 3-5 days. NS1 examination had the highest sensitivity value on the 3rd day of 75.0% and the lowest on the 5th day of 52.4%. Anti-dengue IgA examination had the lowest sensitivity value on the 3rd day of 10.0% and the highest on the 5th day of 42.9%. Keywords : S1, IgA Antidengue, Dengue infection, sensitivity.
Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a study to enroll all patients aged 18 years and over who were admitted to Emergency Department during March to May 2019 for hypertensive crises (systolic blood pressure ?220 mmHg and/or diastolic blood pressure ?120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Out of these 6614 patients admitted from ED during 3 months 462 patients admitted with uncontrolled hypertension, Out of these 114 patients with Hypertensive crisis. Men had higher frequency then women. Most of the patients had one or more Risk factors present. Almost half of patients were presented with Neurological deficit (43.8%), Dyspnoea (28.2%), Chest pain (19.2%), Headache (14.9%), Giddiness (13.1%). Per orally Calcium channel blocker most commonly used while intravenous Labetalol most commonly used.
Background: India is experiencing a transitional shift with more of new cases of Non Communicable Disease observed specially in young adults. One of the major reasons of this upsurge is faulty dietary habits, resulting in overweight and obesity and further rise in NCDs. The purpose of this study is to assess eating habits and nutritional risk factors for NCDs in a medical student of Medical college of Delhi. Methods: After explaining the purpose of the study in individual classroom explained questionnaire was mailed to all 300 medical college undergraduate students currently studying in this medical college. The form consists of questions on sociodemographic details including information about weights, height and eating habits including, drinking and smoking habits. Results: Filled forms were returned by 220 students out of which 204 were found to be complete and were considered for further analysis. Of total 204 students, 72 (35.3%) were females and 132 (64.7%) were males in our study. Regarding meals only 154 (75.5%) were found to be taking meals regularly i.e. more than 3 times a day and 82.4% (168) were having breakfast on regularly basis. Daily consumption of vegetable and legumes against recommended two times were found only in 41.2 (84) students, similarly daily fruit consumption against recommended two times was found only in 30.4% (62) students only. However fast-food consumption on daily basis was as high as 23.5% (48).Smoking was absent in students and alcohol intake was present in 3% of males (06) and reportedly absent in females. About 22.5% (46) was reported of doing some sort of exercise in a week but only 20 (9.8 %) were found to be doing exercise on daily basis. 156 (76.5%) sought some sort of information regarding balanced diet and 120 (58.8%) had reported to have adequate information about balance diet. Conclusion: Eating habits were found to be irregular among undergraduate medical students with regard to meals and daily intake of fruits and vegetables was found to be less than recommended norms. More efforts are required for improving eating practices of the students and also for adequate nutrition and its implication on health. Keywords: Eating Practices, MBBS students, Balanced diet, Junk food, Regular meals, Non comunicable diseases.
Significant increase in the smart phone use had been associated with various effect on the health. Various theories have proposed for sleep, circadian rhythm disturbances and studies have shown effect on melatonin levels and mental health. The objective of this study was to evaluate the effect of smart phone on sleep time, sleep duration and serum melatonin levels. To determine academic and non-academic usage and its correlation with academic performance. Effect of smart phone usage on the mental health i.e. anxiety and depression in young adult first year medical students. Sample size was 100 , 3 were absent. A brief questionaries’ was asked to all the study group regarding usage of mobile phone and sleep hours in night. 9 A.M Morning fasting blood samples were taken and serum melatonin was estimated by ELISA kit. Hamilton’s anxiety scale and Hamilton’s depression scale was applied to the study group. Study had shown the smart phone usage was having an impact on sleep. Study have shown late bedtime, long sleep duration in the students with high user group. This may be result of sleep displacement and circadian rhythm disturbances. Low levels of melatonin in high users as compared to low users, which may be due to exposure EMF leading to circadian rhythm disturbance. The academic and the non- academic usage was significantly high in high users, but with no significant difference in the academic performance. High academic usage of smart phone may lead to better academic performance despite of late bedtime. Non-academic usage of smart phone may cause emotional arousal leading to anxiety. Anxiety and depression score was high in high users group, but the difference was not statistically significant. But it is not clearly understood whether the smart usage is responsible for anxiety and depression or anxiety and depression causes high smart phone usage. Smartphones affect the academic lives of the undergraduate medical students. This study can conclude with the fact that using smartphones made an impact on students both positively and negatively. KEYWORDS: - Smart phone, sleep, Melatonin, Anxiety, Depression
The present study shows an association of Prevalence of Subclinical Hypothyrodism (SCH) with Myocardial Infarction (MI). 200 patients with Acute MI of Adult (age > 18 years) males and females were selected. We observed that female Patients belonging to Age group of 51-60(15.5%) were more prone to MI. Study depicts SCH were observed in 16% of MI patients and Euthyroid was observed in 84% Patients. No gender difference was noted in abnormal thyroid hormone profile in male and female group. A higher prevalence of MI was seen in age group 51-60 years in both male and female accounting for 26% and 15.5%respectively. A statistically higher prevalence of STEMI was seen in SCH and Euthyroid Patients (77.5%) as compared to NSTEMI in SCH and Euthyroid Patients (22.5%). Physicians should be encouraged to educate the people about the risks of diabetes, hypertension and smoking. Furthermore, abnormal thyroid status increases risk of coronary artery disease and cardiovascular mortality affecting ventricular function, serum cholesterol levels, and heart rate and rhythm.
Background: Peripheral vascular calcification (PVC) commonly develop in patients on hemodialysis (HD) and associated with increase risk of morbidity and mortality. Aim of study: To study risk factors of developing peripheral vascular calcification in patients on hemodialysis especially in relation to parathyroid hormone abnormalities. Patients and Methods: Cross sectional (observational) study on 54 patients on regular hemodialysis and divided into 2 groups according to abdominal X-Ray. Results: 54 patient: 32 female, 22 male; mean age = 51.59 +/- 17.61, mean duration of HD = 44.83 +/- 38. 4 months Peripheral vascular calcification by lateral lumbar X-Ray is 12 patients i.e 22.22% We studied effects of many risk factors and appeared significant effects of age, duration of HD and use of calcium containing oral phosphate binders. Also there is some effects of increased serum calcium and phosphate, hypertension and DM but statistically not significant. PTH abnormalities also affect on PVC especially in low level of PTH (a dynamic bone disease) but statistically not significant. In this study, no apparent effect of inflammation on calcification. Conclusion: Peripheral vascular calcification, commonly present in patients on hemodialysis and associated with increase risk of morbidity and mortality, with many risk factors causing increase peripheral vascular calcification which can be prevented and treated
Congenital anomalies are one of the main causes of physical disabilities, stillbirths and neonatal deaths. It Can contribute to long-term disability, which may have significant impacts on individuals, families, health-care systems and societies. Diagnosis of a child who presents with multiple congenital anomalies both prenatal and postnatal is still a complex issue. We present a complex case of a newborn with multiple congenital anomalies (MCAs) including hydrocephalus, Down syndrome, phocomelia, ectrodactyl and ambiguous genitalia. This is the first case to be reported in Tanzania and among the few cases in World’s English literatures. Key words: Congenital, Hydrocephalus, Down syndrome, Phocomelia, Ectrodactyl ,Ambiguous genitalia
Introduction The number of abortions when classified into facility based , medical abortions outside facilities and other type of abortions constituted a medium of 3375252, 14837497 and 807251 cases respectively, when adjusted for various parameters for India. The present study was conducted to include abortions outside medical facilities including methods of abortion, clinical complaints, complications and their management. Material and methods The hospital records for patients who underwent abortions were accessed for a four year period from 2016-2020. The number of patients undergoing supervised abortions and patients presenting with incomplete abortions or related complications were recorded. The presenting complaints for spontaneous abortions and abortions done outside medical health facility along with the therapeutic interventions for such unsafe abortions including complications were assessed. Results The total numbers of abortions were 4316, out of which hospital supervised termination of pregnancies constituted 59.8% where as abortions or related complications outside a medical facility were 40.2 %. The modes of abortion, presenting features and complications of abortions performed outside medical facilities (total number=1824) and the treatment were recorded. Out of these patients with spontaneous abortions were 36.8% whereas those presenting with complications constituted 63.2%. The commonest method for such abortions was use of abortions pills but other abortifacients and crude instrumentation were also recorded. The commonest clinical feature was discharge per vagina, with retained products of conception causing most complications. The main therapeutic procedure done was dilatation and curettage. Conclusion The rural population needs a robust health facility for abortion related care. The sale of abortion pills needs to be tightly regulated . Similarly, crude instrumentation which is a significant cause of morbidity, in unsupervised abortions can be eliminated by awareness and strengthening the health care system making it more approachable for women in rural population.
Highly active anti-retroviral therapy (HAART) has now transformed HIV pandemic from “virtual death sentence” to a “chronic manageable disease”. An adherence rate of 95% to ART decreases viral suppression to nearly 78% and is thus ear marked as an optimum therapy for viral suppression. The objectives are to estimate the level and associated factors of adherence (with respect to the five WHO dimensions) to ART among HIV positive patients. It was a cross-sectional study carried out at the ART center of a tertiary care teaching hospital. Simple random sampling was done from the new enrollment list of the previous 6 months. A total of 120 respondents were interviewed by a pre-designed semi structured questionnaire and analyzed using SPSS. Majority of the participants (55.1%) aged 26 to 40 years and 57% of them were found to be adherent. Patients aged more than 40 years (OR 11.55), distance < 100 kms from the ART Centre (OR 2.75), dissatisfied with family support (OR 3.42), and those with decreased CD4 count from the previous count (OR 6.56) were found to be highly significantly associated with the probability of being adherent to ART. Adherence to ART was found among 57% among the study subjects. Elderly patients residing nearer to service delivery centre and those at higher risk of morbidity due to lower CD4 count were found to be some of the major determinants of adherence to ART. Link ART centres and LAC Plus Centres with community level awareness programs are recommended.
SARS-CoV19 is spreading all over the world starting from China in the end of 2019. This important emergency involved every single aspect of ordinary life. Even hospitals have undergone changes with the aim of ensuring the best care and preventing the spread of the virus. This is a personal contribution to illustrate all the measures put in place to avoid contagion. Although in an ENT unit you have strictly to do with the airway, none of the staff so far has been positive. Keyword: SARS-CoV19, safety, prevention, ENT, contagion.
Background: The Arab Spring, a wave of demonstrations and protests that hadtaken place in the Arab world since December 18, 2010, had also affected Syria. Thenumber of Syrian refugees who have migrated to Turkey is over 3.5 million.Objective: The aim of this study was to evaluate the demography, clinical featuresand invoice amounts of Syrian refugee patients who were operated in an orthopedicand traumatology clinic of a healthcare institution far from the Syria district region.Materials and Methods: For this purpose, 329 Syrian patients who underwentsurgery in the field of orthopedics and Traumatology between June 2011 and 2018were enrolled in the study. The records of Syrian refugees have been retrospectivelyexamined.Results: Male applicants (76.3%) were more than females (23.7%).%). It was observedthat the highest number of applications were in the field of microsurgery (21.3%),followed by trauma (20.7%) and pediatric orthopedics (14.6%), respectively. Includingthe non-emergency trauma patients, 90% of the patients underwent elective surgerieswhile 10% underwent emergency surgeries. It was determined that the average invoiceamount was 4987 TL (min: 207 TL, max: 87541 TL) and the highest cost was in thefield of vertebral surgery (average 19384 TL). The rate of emergency applications hasshown a significant increase in 2016 and later (2016-2017-2018) compared to 2015 andbefore .Conclusion : The main Syrian refugees patient profile of the health centers far fromthe war zone is composed of elective cases and their costs.Key words: Health Services Accessibility–Hospital Costs–Orthopedic Procedures–Refugees–Syria
Background Attenuating pain in severe acute pancreatitis (SAP) remains a challenge for clinicians specially in first 48-72 hours. Randomized trials are difficult to plan and execute as the pain is very severe and management is frustrating. Moreover, most of the have on comparison of two drugs rather than comparing the pain regimens as multi-modality treatment. Objectives The objective of the study was to compare step-up versus step-down approach of pain management in SAP patients admitted in surgical critical care unit. Methods Retrospective analysis of data related to control of pain in SAP was carried out. Patients of acute pancreatitis classified as severe or critical as per Atlanta or determinant based classification were included in the study. Chronic pancreatitis, Etiology other than or alcoholic pancreatitis (BP and AP) and incomplete data entry were the major exclusions. Patients’ files were reviewed, and they were re-classified as SAP. VAS and analgesia requirement were tabulated and . Patients of and alcoholic pancreatitis were divided into two subgroups viz step-up ( started later) and step-down ( started from the beginning). Data of 84 patients was calculated and . Mean age of BP patients was significantly less than AP. Males were the major sufferers in AP and females in BP. The mean VAS on arrival was not significantly different between BP and AP. The difference in mean VAS remains insignificant for up to 8 hours of admission, after which, patients with AP started having relief at a faster rate compared to patients with BP. From 4th hour , the fall in VAS was more and significant in step down approach. The time when the difference in mean VAS between the step-up and step-down groups of patients with AP was found significant was 10th hour from admission. The difference persisted till 72 hours of observation. Patients of AP responded more to routine analgesics or when the were added later compared to patients of BP. The difference in mean VAS between step down sub-groups of BP and AP did not show significance. An overall comparison of step-up and step-down sub-groups of both BP and AP patients revealed a significant difference in mean VAS from 4th hour . Conclusion Patients who followed step-down approach of pain management significantly better compared to those who followed step-up approach.
Background: Pilonidal sinus disease is a common condition usually affecting young individuals and has been conventionally treated by open excision technique. Rhomboid Limberg is a transposition flap that has been pleaded for treatment of this condition. Aim: To study the outcome of Rhomboid excision with Limberg flap closure for the treatment of Sacrococcygeal Pilonidal sinus. Material and Methods: The study was conducted prospectively in the department of surgery Skims Medical College Srinagar from March 2014 to February 2019 and total of 55 patients with primary or recurrent pilonidal sinus disease were studied. Results: The average operative time was 60 minutes (range 50-80 minutes) Postoperative stay of patients in the hospital was 3-4 days.The complications were seen in total of four patients which included Seroma and mild gaping of the wound in one patient each and dehiscence in two patients. None of the patients had recurrence till date.Conclusions: Rhomboid excision with Limberg flap transposition is an effective surgical technique for management of pilonidal sinus. Keywords: Pilonidal sinus, Limberg flap, rhomboid transposition flap, fasciocutaneous flap,
Context: Cumulative appraisal of tumor size, lymph node involvementand metastasis is essential for evaluating the prognosis of any cancer.Oral cancer being no exception to this rule also shows lymph nodemetastasis in advanced stages. Oral cancer boasts of certain peculiarmicroscopic features, among which nuclear morphometric changesform a key component. Accuracy in identifying these nuclear changeswill help in better prediction of the prognosis of oral cancer.Fractal measurement is an offshoot of the computer aided image analysiswhich aids in the accurate analysis of the structural properties ofhistopathology specimens.Aims: To evaluate the use of nuclear fractal dimensions (NFD) topredict lymph node metastasis in oral squamous cell carcinoma.Settings and Design: A cross-sectional comparative study was carriedout using archived histopathological tissue specimens of oral squamouscell carcinoma which were then subjected to morphometric analysis.Methods and Material: 30 H&E stained sections of OSCC with andwithout lymph node metastasis were taken for the analysis. The microscopicimages were captured from five representative high power fieldsfrom infiltrated dysplastic epithelial islands in the connective tissue andsubjected to image analysis using Image Pro Premiere software. Wellstained,well-defined and non-overlapping neoplastic nuclei were semimanuallyselected and subjected to fractal analysis.Statistical analysis used: Statistical analysis was done by applyingstudent’s unpaired t-test and ‘p’ value below 0.005 was consideredstatistically significant.Results: A mean Nuclear Fractal Dimension of 1.099 0.0068 forOSCCs with nodal metastasis as opposed to NFD of 1.0550.0047 forOSCCs devoid of lymph node involvement was observedConclusions: Nuclear fractal dimensions may prove to be a valuableindicator in the assessment of prognosis oral squamous cell carcinoma.Keywords: nuclear fractal dimensions, image analysis, nuclear morphometry
Objective: To identify the level of organizational citizenship behavior and its relation tojob satisfaction in the nursing field.Methodology: One step search strategy includes an extended search in various databases:Cumulative Index Nursing and Allied Health Literature (CINAHL), MEDLINE, ProQuest,and google scholar. Twenty published studied between January 2015 and April 2020 wereincluded in the review.Results: Two themes emerged from the present review, which are nurses' organizationalcitizenship behavior level and effect of nurses’ job satisfaction on organizationalcitizenship behavior. In the theme of nurses' organizational citizenship behavior level;seven studies found most nurses had a high level of OCB, three studies found they hadhigher than average, five studies demonstrated that they had a moderate level while onlyone study found their OCB on a low level. Regarding the other theme, three studies did notfind a correlation between job satisfaction and OCB, whereas three studies displayed thatjob satisfaction had a positive effect on OCB.Conclusion: Most of the studies found that nurses had a high-level regard OCB.However, the result of studies regards the influence of job satisfaction on OCB wereambivalent.Keywords: organizational citizenship behavior, organizational behavior, job satisfaction,work satisfaction, nurses.
