Research progress on the relationship between intestinal flora and thyroid diseases / 公共卫生与预防医学

Intestinal flora plays an important role in maintaining the body's immune balance, digestion, and nutrient absorption. Thyroid function mainly includes the synthesis and secretion of thyroid hormones and the regulation of metabolic balance in the body. When the body’s thyroid hormone synthesis and secretion are too little or too much, it will lead to thyroid diseases. Studies have shown that intestinal flora may affect the occurrence and development of thyroid diseases by participating in thyroid metabolism, immune regulation, cross immunoreaction, and interaction with thyroid-related predisposing factors. Understanding the structural changes and functional mechanisms of intestinal flora during the occurrence and development of thyroid diseases can provide a new basis for the diagnosis and treatment of thyroid diseases and improvement of clinical prognosis.

Pattern of Refractive Errors in a Tertiary Hospital in South East, Nigeria

Background: Uncorrected refractive errors (RE) are a major cause of visual impairment. They affect a large proportion of the population globally and have psychological and socio-economic effects on the individual, family and society. They could lead to poor quality of life.Aim: To determine the pattern and predisposing factors of refractive errors among patients seen in the outpatient clinic.Methodology: A cross-sectional, descriptive study involving patients with refractive error that presented to the eye clinic in the year 2017. Data were obtained from patients’ records, entered into and analysed using IBM SPSS version 25.Results: A total of 300 patients with refractive errors were seen in the period of study. This comprised of 93 males and 207 females with mean age of 40.13±17.6 years. The commonest presenting complaint was blurring of both far & near vision (24%), other presenting complaints in decreasing order of frequency were blurring of distant vision, itching, blurring of near vision, eye pain, headache and red eyes in 18%,15%, 9.6%, 5.6%, and 3.2% respectively. Presbyopia was noted in 55.3% while myopia, anisometropia, astigmatism and hypermetropia were noted in 20.7%, 19.3%, 7.0% and 1.3% respectively. Nuclear sclerosis was the commonest co-existing ocular pathology or morbidity.Statistically significant association was found between age of the patients and presence of ocular disease existing with RE (p=0.016).Conclusion: Fifty-one percent of the study population had refractive errors. The commonest refractive error was myopia while hypermetropia was the least common refractive error in this environment.

Factores predisponentes asociados a la fractura de cadera en la región noroeste de la provincia de Villa Clara / Predisposing Factors Associated With Hip Fracture in the Northwest Region of Villa Clara Province

Introducción: La fractura de cadera es la causa más común de hospitalización en los servicios de urgencias de ortopedia. Objetivo: Describir los factores predisponentes asociados a la fractura de cadera en la región noroeste de la provincia de Villa Clara. Métodos: Se realizó un estudio descriptivo transversal en el período de noviembre de 2017 a diciembre de 2019, en la la región noroeste de la provincia de Villa Clara. La población en estudio estuvo integrada por 227 pacientes atendidos en el Hospital General Universitario Mártires del 9 de abril, del municipio Sagua la Grande, los cuales fueron ingresados en el servicio de Ortopedia y Traumatología por fractura de cadera. La muestra fue seleccionada mediante un muestreo no probabilístico y se tuvieron en cuenta los criterios de la investigación. Resultados: Según grupos de edad, predominaron las edades comprendidas entre 80-89 años en ambos sexos (42,7 por ciento), con mayor frecuencia entre las mujeres (45,3 por ciento) con respecto a los hombres (36,4 por ciento). Conclusiones: La caída de sus pies resultó ser el factor predominante asociado a la fractura de cadera en la región noroeste de la provincia de Villa Clara, con predominio en el sexo femenino. Esto sugiere la necesidad de desarrollar campañas de comunicación social para la población, dirigidas a la prevenciónde la fractura de cadera con un enfoque de género(AU)

Introduction: Hip fracture is the most common cause of hospitalization in orthopedic emergency services. Objective: To describe the predisposing factors associated with hip fracture in the northwestern region of the province of Villa Clara. Methods: A cross-sectional descriptive study was carried out from November 2017 to December 2019, in the northwestern region of Villa Clara province. A total of 227 patients participated; they were admitted to Mártires del 9 de abril General University Hospital, in Sagua la Grande municipality, and were treated in the Orthopedics and Traumatology service for hip fracture. Non-probabilistic sampling and the research criteria were taken into account for the selection. Results: According to age groups, the ages between 80-89 years prevailed in both sexes (42.7 percent), with higher frequency among women (45.3 percent) compared to men (36.4 percent). Conclusions: The fall from their feet"turned out to be the predominant factor associated with hip fracture in the northwest region of Villa Clara province, where the female sex predominated. This suggests the need to develop social communication campaigns for the population, aimed at the prevention of hip fracture with a gender approach(AU)

Causas de muerte en pacientes adultos con insuficiencia cardíaca internados Hospital Nacional en el periodo 2017 - 2021

RESUMEN Introducción: la insuficiencia cardíaca presenta una elevada mortalidad intrahospitalaria y tras el alta, siendo una causa frecuente de reingreso hospitalario por descompensación cardíaca. Objetivos: determinar las causas de muerte en pacientes adultos con insuficiencia cardíaca internados Hospital Nacional, Itauguá, Paraguay, en el periodo 2017 - 2021 Metodología: estudio observacional descriptivo retrospectivo de corte trasverso, que incluyó a 103 adultos, de ambos sexos, con insuficiencia cardíaca. Resultados: la edad media fue 60 ± 14 años (27 - 92 años), la mayoría de los pacientes eran varones (54,37%), de procedencia urbana (57,28 %), con estudios primarios (65,05%), secundarios (31,07%) y con comorbilidades (99,03%). La principal comorbilidad fue la hipertensión arterial (28,16%). Las principales patologías intercurrentes fueron las patologías de causa infecciosa (56,25%). La media de la fracción de eyección fue 43 ± 11% (17 - 68%). La patología cardiaca más frecuente fue la cardiopatía hipertensiva (53,40%) seguida de la isquémica (35,92%). La media del BNP fue 1823 pg/dL. La mayoría de los pacientes tenían una fracción de eyección disminuida (70,87%) seguida de la conservada (29,13%). La mortalidad fue 41,7%. La principal causa de muerte fue la causa extracardiaca (62,79%) con las patologías infecciosas como la más común (44,44%). Al analizar los factores relacionados con la mortalidad se constató que la edad ≥ 60 años y el presentar patología intercurrente estuvo relacionado con la mortalidad (p< 0,05). Conclusiones: la mortalidad fue 42% y la principal causa de muerte fue de causa extra cardiaca (62,7%), siendo las patologías intercurrentes de causa infecciona las más frecuentes. Los predictores de mortalidad fueron la edad igual o mayor a 60 años y la presencia de patologías intercurrentes (p <0.05).

ABSTRACT Introduction: Heart failure presents a high in-hospital and after discharge mortality, being a frequent cause of hospital readmission due to cardiac decompensation. Objectives: To determine the causes of death in adult patients with heart failure admitted to the National Hospital, Itauguá, Paraguay, in the period 2017 - 2021. Methodology: Retrospective descriptive observational cross-sectional study, which included 103 adult men and women with heart failure. Results: The mean age was 60±14 years (27-92 years), most of the patients were men (54.37%), of urban origin (57.28%), with primary studies (65.05%), secondary (31.07%) and with comorbidities (99.03%). The main comorbidity was arterial hypertension (28.16%). The main intercurrent pathologies were pathologies of infectious cause (56.25%). The mean ejection fraction was 43±11% (17-68%). The most frequent cardiac pathology was hypertensive heart disease (53.40%) followed by ischemic heart disease (35.92%). The mean BNP was 1823 pg/dL. Most of the patients had a decreased ejection fraction (70.87%) followed by a preserved one (29.13%). Mortality was 41.7% and the main cause of death was extracardiac (62.79%) with infectious pathologies as the most common (44.44%). When analyzing the factors related to mortality, it was found that age ≥ 60 years and presenting intercurrent pathology was related to mortality (p<0.05). Conclusions: Mortality was 42% and the main cause of death was non-cardiac (62.7%), with intercurrent pathologies caused by infection being the most frequent. The predictors of mortality were age equal to or greater than 60 years and the presence of intercurrent pathologies (p <0.05).

Análisis de factores predictivos en la aparición de fístulas faringocutáneas poslaringectomía total / Analysis or predictive factors associated with pharingocutaneous fistulas after total laryngectomy

RESUMEN Antecedentes: la fístula faringocutánea es la complicación más común luego de una laringectomía total. Los factores implicados en su aparición son estudiados por numerosos autores sin obtener resultados concluyentes. Objetivo: Evaluar las causas de aparición de fístula faringocutánea y describir los factores de riesgo implicados en la aparición de fístulas faringocutáneas en la población estudiada. Material y métodos: estudio retrospectivo, observacional, con análisis estadístico de variables. Se consideraron 55 pacientes a quienes se les realizó una laringectomía total inicialmente o como rescate, desde enero de 2000 hasta diciembre de 2019, con una proporción hombre/mujer de 48/7. La edad media fue de 61,3 años. El 96,36% con diagnóstico anatomopatológico de carcinoma epidermoide. Análisis estadístico (prueba de chi cuadrado-prueba de Mann-Whitney) de variables relacionadas con la aparición de fístula faringocutánea. Resultados: la incidencia de fístulas alcanzó el 20% de los pacientes laringectomizados. Cerraron espontáneamente el 72,73% de las fístulas y requirieron el uso de colgajos, 3 (27,27%) pacientes. De los pacientes fistulizados, el 63,64% tenían radioterapia previa. El uso de sonda nasogástrica para alimentación se prolongó en dichos pacientes por más de 15 días. El tiempo de internación promedio de los pacientes fistulizados fue de 23 días. Conclusión: en nuestro medio, el factor más asociado a la aparición de fístulas tras laringectomía fue el uso de radioterapia previa. La fístula en estos pacientes tardó más tiempo en cerrarse y requirió en algunos casos reconstrucciones más complejas.

ABSTRACT Background: Pharyngocutaneous fistula is the most common complication after total laryngectomy. The factors associated with its development have been studied by several authors without conclusive results. Objective: To evaluate the causes for the development of PCF and to describe the risk factors associated with PCF in the population studied. Material and methods: We conducted a retrospective and observational study with statistical analysis of the variables. A total of 55 patients undergoing initial or salvage total laryngectomy from January 2000 to December 2019 were included. Male-to-female ratio was 48/7. Mean age was 61.3 years. The pathological diagnosis was epidermoid carcinoma in 96.36% of the cases. Statistical analysis: (chi square test and Mann-Whitney test) of the variables related with the development of pharyngocutaneous fistula. Results: The incidence of fistula in patients with laryngectomy was 20%. Spontaneous closure occurred in 72.73% and 3 patients (27.27%) required the use of flaps. In patients with fistula, 63.64% had previous radiotherapy. In these patients, the use of nasogastric tube feeding lasted > 15 days. Mean length of hospital stay in patients with fistula with 23 days. Conclusion: In our environment, previous radiotherapy was the most significant factor associated with the development of fistula. In these patients, fistula took longer to close and required more complex reconstructions in some cases.

Predisposição a formas graves de COVID-19 e adesão às medidas de prevenção: o papel do apoio social / Predisposition to severe forms of COVID-19 and adherence to preventive measures: the role of social support

Resumo Objetivou-se verificar a adesão às medidas de prevenção em idosos com maior predisposição a formas graves de COVID-19 e sua associação e interação com o apoio social. Trata-se de um estudo transversal realizado em amostra de 3.477 participantes do inquérito telefônico do Estudo Longitudinal da Saúde dos Idosos Brasileiros (iniciativa ELSI-COVID-19), que informaram ter saído de casa na semana anterior à realização do inquérito. A adesão foi aferida pela frequência com que saiu de casa, necessidade de sair de casa, uso de máscara e higienização das mãos. As análises basearam-se no modelo Poisson com variância robusta. Idade ≥ 65 anos, hipertensão, diabetes e obesidade foram considerados fatores predisponentes para formas graves de COVID-19. O apoio social incluiu o arranjo domiciliar e a conexão social na pandemia. Aproximadamente 46% apresentaram melhor adesão, que foi associada positivamente ao número de fatores predisponentes para formas graves. O apoio social não foi associado à adesão e não modificou essa associação, após ajustamentos. Conclui-se que a adesão às medidas de prevenção, que deveria ser estendida a todos, está concentrada nos idosos com maior predisposição a formas graves de COVID-19, independentemente do apoio social.

Abstract This study sought to assess the adherence to preventive measures among the elderly more prone to severe forms of COVID-19, and the association and interaction with social support. It is a cross-sectional study conducted with a sample of 3,477 participants of the telephone survey of the Brazilian Longitudinal Study of Aging (ELSI-COVID-19 initiative), who reported going out of the home in the past week. The adherence was based on the frequency of leaving the house, the need to venture outside the home, use of masks, and sanitization of hands. Statistical analysis was based on the Poisson model with robust variance. Predisposing factors for severe forms of COVID-19 included age ≥65 years, hypertension, diabetes, and obesity. Social support included living arrangements and social distancing during the pandemic. Approximately 46% of the participants showed higher adherence, which was positively associated with the number of predisposing factors for severe forms of COVID-19. Social support was not associated with adherence, nor was this association modified after adjustments. The conclusion drawn is that higher adherence is concentrated among the elderly with greater predisposition to severe forms of COVID-19, irrespective of social support, albeit preventive measures should be adopted by all.

Caracterización de los factores predisponentes de la conducta sexual en parejas infértiles. Guisa. Enero - Diciembre. 2018 / Characterization of predisposing factors of sexual behavior in infertile couples. Guise. January December. 2018 / Caracterização dos fatores predisponentes do comportamento sexual em casais inférteis. Guise. Janeiro dezembro. 2018

RESUMEN Introducción: la infertilidad ha aumentado al nivel mundial como consecuencia del incremento de las infecciones de transmisión sexual y la enfermedad inflamatoria pélvica, que dejan como secuelas la obstrucción de las trompas uterinas, además de otros factores asociados como las infecciones vaginales, el aborto provocado y sus complicaciones infecciosas. Objetivo: caracterizar factores predisponentes de la conducta sexual en las parejas infértiles en Guisa. Métodos: se realizó un estudio observacional, retrospectivo. Las variables utilizadas en el estudio fueron edad de las mujeres, número de abortos, antecedentes de infección vaginal (por tricomonas, cándidas, clamidias y vaginosis bacteriana). Para la realización de la investigación se revisaron las historias clínicas de todas las pacientes que acudieron a consulta de infertilidad durante el periodo de estudio y se confeccionó una planilla de recogida de datos. El universo estuvo constituido por las 105 pacientes atendidas en consulta de infertilidad y la muestra se conformó con 92 pacientes que cumplieron los criterios de inclusión. Resultados: predominaron las pacientes con edad promedio entre 25-29 años, los factores predisponentes como los abortos provocados, la infección vaginal por clamidia y la salpingitis como causa más frecuente de infertilidad. Conclusiones: la prevalencia de la infertilidad en Guisa es alta, puede ser prevenible si se manejan de forma integral los factores que la originan. Su abordaje integral y precoz puede disminuir su incidencia.

ABSTRACT Introduction: infertility has increased worldwide as a consequence of the increase in sexually transmitted infections and pelvic inflammatory disease, which leave as sequelae the obstruction of the uterine tubes, in addition to other associated factors such as vaginal infections, induced abortion and its infectious complications. Objective: to characterize predisposing factors of sexual behavior in infertile couples in Guisa. Methods: an observational, retrospective study was carried out. The variables used in the study were age of the women, number of abortions, history of vaginal infection (due to trichomonas, candida, chlamydia and bacterial vaginosis). To carry out the research, the medical records of all the patients who attended the infertility consultation during the study period were reviewed and a data collection sheet was prepared. The universe consisted of 105 patients seen in infertility consultation and the sample was made up of 92 patients who met the inclusion criteria. Results: patients with an average age between 25-29 years prevailed, predisposing factors such as induced abortions, vaginal chlamydial infection and salpingitis as the most frequent cause of infertility. Conclusions: the prevalence of infertility in Guisa is high, it can be preventable if the factors that originate it are managed in an integral way. Its comprehensive and early approach can reduce its incidence.

RESUMO Introdução: a infertilidade tem aumentado mundialmente como consequência do aumento das infecções sexualmente transmissíveis e doenças inflamatórias pélvicas, que deixam como sequelas a obstrução das tubas uterinas, além de outros fatores associados como infecções vaginais, aborto induzido e suas complicações infecciosas. Objetivo: caracterizar os fatores predisponentes do comportamento sexual em casais inférteis da Guisa. Métodos: foi realizado um estudo observacional retrospectivo. As variáveis ​​utilizadas no estudo foram idade das mulheres, número de abortos, história de infecção vaginal (por tricomonas, candida, clamídia e vaginose bacteriana). Para a realização da pesquisa, foram revisados ​​os prontuários de todas as pacientes que compareceram à consulta de infertilidade no período do estudo e elaborada uma ficha de coleta de dados. O universo foi constituído por 105 pacientes atendidos em consulta de infertilidade e a amostra foi composta por 92 pacientes que atenderam aos critérios de inclusão. Resultados: prevaleceram pacientes com idade média entre 25-29 anos, fatores predisponentes como aborto induzido, infecção vaginal por clamídia e salpingite como a causa mais frequente de infertilidade. Conclusões: a prevalência de infertilidade na Guisa é elevada, podendo ser evitada se os fatores que a originam forem geridos de forma integral. Sua abordagem abrangente e precoce pode reduzir sua incidência.

Pregnancy Malaria: Predisposing Factors, Burden and Management in Agrarian Settlements Southeast Nigeria

Aim:To evaluate predisposing factors, burden and management of malaria amongst pregnant women in some agrariansettlements southeast Nigeria.Study Design:Cross-sectional survey conducted in 4 randomly selected agrarian communities was conducted Place and Duration of Study:Isi-Uzo Local Government Area (Eha-Amufu, Ikem, Mbu, Neke and Umualor). The study lasted six months.Methodology: A total of 385 respondents participated. A cross-sectional survey was conducted in 4 randomly selected agrarian communities was conducted. Data were collected using a structured questionnaire.Results: Obstetric and socio-demographic characteristics of the participants showed that majority were age-bracket 25-34 (42.6%), 1sttrimester (56.4%) and multigravidae (52.8%), primary education group (32.2%), secondary education group (55.6%), farmers (73.1%) and Christians (93.5%). All the respondents (100%) agreed to the presence of overgrown bushes in their environs, many farming activities which is the main source of income and staying out late at night for relaxation. A high percentage of the women experienced fever (57.9), headache (61.6), cough & catarrh (54.5) and anorexia (53.8) monthly reflecting high malaria frequency in the locale. 20.3% had experienced stillbirth, 82.6% neonatal death and 65.5% infant mortality once, twice or more. And according to (58.7%) and (38.7%) of respondents, malaria moderately and highly affects their productivity during pregnancy respectively. Respondents that seek health/treatment in hospitals (50.9) differ insignificantly from those that seek health through traditional remedies (49.1). Cost of treatment was reported to be high and moderate by 31.9% and 65.5% respondents respectively. Poor healthcare delivery was implicated as major dissatisfaction with treatment by 76.4% of respondents.Conclusion:Malaria is a major health problem encountered by pregnant women in agrarian locales. Hence, girls should be exposed to malaria awareness programs an earlier stage of life

Factores asociados a mortalidad en pacientes Covid-19 en un Hospital del norte de Perú / Factors associated with mortality in Covid-19 patients in a Hospital in northern Peru

Objetivo. Determinar los factores de riesgo sociodemográficos y clínicos relacionados con la mortalidad en pacientes COVID-19 en un Hospital del norte de Perú. Material y Métodos: la investigación se llevó a cabo en un Hospital del norte de Perú. La población la constituyeron 208 Historias Clínicas de pacientes COVID-19 atendidos entre Marzo a Julio del 2020. La variable independiente fueron los factores sociodemográficos tales como la edad, sexo y el estado civil y los factores clínicos como antecedentes epidemiológicos, los factores de riesgo (co-morbilidades) y el estado de salud y la variable dependiente fue la mortalidad Covid-19. Resultados: La mortalidad COVID-19 alcanzó al 46,20 % en pacientes mayores 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %), con antecedentes epidemiológicos (37,5%), y factores de riesgo (comorbilidad) un 74,50 %, principalmente asociados con hipertensión arterial (8,2%), obesidad (3,4%) y diabetes mellitus II (1,9%), y comorbilidades indeterminadas (Otras) un 6,7%. No se presentó mortalidad en los pacientes cuyo estado de salud era Estable, mientras que los pacientes con estado de salud reservado y fallecieron representaron un 46,2%. Conclusión: La mortalidad por COVID-19 alcanzó un 46,20%; mayores de 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %). Se encontró relación significativa entre factores sociodemográficos como la edad, factores clínicos (comorbilidad), en su mayoría hipertensión arterial, obesidad y diabetes mellitus II, y pacientes con estado de salud reservado con la mortalidad del COVID-19.

Objetive. To determine the sociodemographic and clinical risk factors related to mortality in COVID-19 patients in a Hospital in northern Peru. Material and Methods: the research was carried out in a Hospital in the north of Peru. The population was made up of 208 Clinical Histories of COVID-19 patients seen between March and July 2020. The independent variable was sociodemographic factors such as age, sex and marital status, and clinical factors such as epidemiological history, risk factors (co-morbidities) and health status and the dependent variable was Covid-19 mortality. Results: COVID-19 mortality reached 46.20% in patients older than 65 years (51.90%), male (60.40%) and married (65.40%), with an epidemiological history (37.5%) , and risk factors (comorbidity) 74.50%, mainly associated with arterial hypertension (8.2%), obesity (3.4%) and diabetes mellitus II (1.9%), and indeterminate comorbidities (Others) 6.7%. There was no mortality in patients whose health status was Stable, while patients with reserved health status and who died represented 46.2%. Conclusion: mortality from COVID-19 reached 46.20%; older than 65 years (51.90%),male(60.40%) and married (65.40%). A significant relationship was found between sociodemographic factors such as age, clinical factors (comorbidity), mostly arterial hypertension, obesity and diabetes mellitus II, and patients with a reserved health status with the mortality of COVID-19.

Haematological Indices and Predisposing Factors Associated with Tuberculosis at Federal Medical Center Owerri, Imo State, Nigeria

Introduction:Tuberculosis(TB)is a chronic infectious disease caused by bacterium “Mycobacterium tuberculosis”.It is a systemic infection and has deleterious effect on both circulatory and respiratory systems, and thrives more in a society with little knowledge of its predisposing factors.Aim of the Study:This study was carried out to identify the predisposing factors of tuberculosis and itseffects on haematological indices of thepositivepatients at the Federal Medical Center, Owerri, Imo state, Nigeria.Materials and Methods:The blood samples wereanalyzed manuallyfor the indices whilepredisposing factors of Tuberculosis were obtained with the aid of a structured self-administered questionnair,these were administered simultaneously while the blood samples were been collected.Results and Discussion: Results were considered to be statistically signifificant (P<0.05), (OR>1).Simple frequencies were also computed. Theresults revealed that Haemoglobin(P=0.001); Erythrocyte sedimentation rate(P=0.020); Neutrophils(P=0.002); Eosinophils(P=0.000); Monocytes(P=0.000); Platelets(P=0.001) of the Tuberculosis positive patients when compared with the controls, showed, statistically (P<0.05) significant haematological abnormalities. History of Tuberculosis in family(Odd ratio=9.3) and Alcoholism(OR=6.0) were significant predisposing factors of Tuberculosis. Other predisposing factors; smoking habits(OR=2.7), Educationalstatus(OR=2.2), marital status(OR=1.3) were also associated with Tuberculosis infection, while employment status(OR=1.0) and socio-economic status(OR=0.1) were not.Tuberculosis infection in this study adversely affected Haemoglobin, Platelets, Erythrocyte sedimentation rate, Neutrophil, Eosinophil and Monocyte values, while family history of Tuberculosis and Alcoholism were significantly associated with the infection.Conclusion: Quarrantine of Tuberculosis patients and creating more awareness on the predisposing factors of tuberculosis will help towards preventing, reducing and eliminating the disease

Emergency obstetric hysterectomy: experience at a tertiary care centre in Central India

Background: Obstetric hysterectomy is an important procedure in modern obstetrics and its proper indications, risks and complications need to be studied for judicious usage and improvement in outcome.Methods: A retrospective, record-based study was carried out over one and a half years at a tertiary care government hospital. All the patients who underwent emergency obstetric hysterectomy at the study centre during study period were studied. Labour room register, operation room register for emergency and elective cases, case records, referral slips and mortality register data were reviewed for the same and outcomes analysed.Results: Total 33 patients underwent emergency obstetric hysterectomy, with the incidence observed at 0.21%. The most common indications were atonic post-partum hemorrhage (42.4%), uterine rupture (33.3%) and morbidly adherent placenta (18.1%). Prior cesarean section (36.4%) and placenta previa (15.1%) were the commonest predisposing factors associated with PPH and uterine rupture. Subtotal hysterectomy (66.7%) was observed to be the preferred type of surgery. Out of total 7 maternal deaths that occurred, 4 (57%) were because of disseminated intravascular coagulation.Conclusions: There is increasing trend in the rate of obstetric hysterectomy along with rise in rate of previous LSCS, emphasizing the importance of the mode of delivery. Measures to reduce the rate of primary cesarean section are advisable.

Factores del estilo de vida predisponentes a displasia cervical en mujeres atendidas en el hospital María Auxiliadora, 2013-2017 / Lifestyle factors predisposing to cervical dysplasia in women attended in the hospital María Auxiliadora, 2013-2017

Introduccion: La displasia cervical es la lesión precursora del cáncer de cuello uterino, en el que se observan alteraciones de las células cervicales sin llegar a adoptar características de malignidad. Objetivo: Identificar los factores predisponentes para displasia cervical en las pacientes atendidas en el hospital María Auxiliadora durante el 2013 al 2017. Métodos: Estudio de diseño casos y controles, analítico y observacional. Se analizaron 216 historias clínicas de pacientes, dividiéndose en 72 casos y 144 controles. Resultados: En el análisis bivariado, resultaron significativos la menarquia temprana (OR=2,071;p=0.024), el inicio temprano de relaciones sexuales (OR=2,213;p=0.017), el tener múltiples parejas sexuales (OR=3,036;p=0.001) y la multiparidad (OR=2,316;p=0.005). En el análisis multivariado las variables independientes fueron el tener múltiples parejas sexuales (OR=2,626; p=0.003) y la multiparidad (OR=2,759;p=0.045) las cuales resultaron significativas. Conclusión: Se concluye que los factores del estilo de vida predisponentes a displasia cervical fueron tener múltiples parejas sexuales y la multiparidad.

Introduction: The cervical clearance is the precursor lesion of cancer of the cervix, in which alterations of the cervical cells are observed. Objective: To identify the predisposing factors for the cervical dispute in the patients treated at the María Auxiliadora Hospital during 2013 to 2017. Methods: Design study, cases, controls, analytical and observational. 216 clinical records of patients will be analyzed, divided into 72 cases and 144 controls. Results: In the bivariate analysis, significant results in early menarche (OR = 2.071, p = 0.024), early onset of sexual relations (OR = 2.213, p = 0.017), having multiple sexual partners (OR = 3.036; = 0.001) and multiparity (OR = 2.316, p = 0.005). In the multivariate analysis, the independent variables were multiple sexual partners (OR = 2.626, p = 0.003) and multiparity (OR = 2.759, p = 0.045). Conclusion: It is concluded that lifestyle factors predispose a cervical dispute.

A Over View to Diagnosis of Oral Lichen Planus: A Hospital Based Clinical Study

Objective: To evaluate the clinical characteristics,predisposing/aggravating factors and malignant potential oforal lichen planus (OLP).Study design: This study was conducted at department ofSkin & V.D., S. P. Medical College Bikaner at outpatient basis.Results: Reticular form was the most common clinical typeseen in 64 patients (54.7%), followed by erosive in 37 (32.6%)and erythematous types in 15 (12.6%) patients. The diseasecaused pain, burning and other symptoms in 72 (75.7%)patients. Buccal mucosa was the chief site of involvement(n=29). Other sites involved were tongue (n=8), lips (n=21),palate (n=3) and floor of mouth (n=0). Stress, spicy foods andpoor oral hygiene aggravated disease in most (n=77) of thepatients. A malignant transformation rate of 0.07% wasobserved.

Recurrent Kaposi Varicelliform Eruption: Investigation of Clinical Characteristics and Predisposing Factors / 대한피부과학회지

BACKGROUND: Kaposi varicelliform eruption (KVE) is a disseminated viral infection primarily caused by the herpes simplex virus in the setting of an underlying chronic skin disease. Few studies have reported the clinical characteristics and predisposing factors for recurrent KVE.OBJECTIVES: To characterize the clinical features and predisposing factors for recurrent KVE.METHODS: This retrospective comparative study of recurrent vs. single-episode KVE was performed at the Pusan National University Hospital between 2004 and 2017.RESULTS: A total of 84 episodes occurred in 60 patients, and of these, 13 patients developed recurrence (21.7%). No statistically significant intergroup difference was observed in the mean age and sex distribution. The face was the most common site of involvement in both groups, followed by the trunk and the upper and lower extremities. Atopic dermatitis was the most common pre-existing disease in both groups; however, Darier's disease was more common in the recurrent KVE group, and this difference was statistically significant. Most patients with KVE (66.7%) showed aggravation of the underlying skin disease within 3 months of KVE onset. This finding was more prominent in patients with recurrent episodes (91.7%) than in those with single-episode KVE (58.3%), (p=0.040).CONCLUSION: This study can contribute to a better understanding of recurrent KVE and guide clinicians in treating patients with conditions predisposing to KVE.

The 4Ps of Formulation & Intervention

@#The next step after the biopsychosocial information is collected from the extended history, extended examination, and extended investigation is the formulation of the 4P factors related to the patient’s problems (Predisposing, Perpetuating, Precipitating, and Protective factors). In this 4P formulation, attention is paid to the genogram, time-line, ROADS of the family, and the patient’s readiness to change. In certain situations, SBAR tool (Situation, Background, Assessment, Recommendation) may be needed to help get a better clarity of the situation and issues. Formulation helps us to be strategic in our psychosocial management.

Factores predisponentes de trauma dental en escolares del municipio Rafael Freyre / Predisposing Factors for Dental Trauma in Students from Rafael Freyre Municipality

Introducción: los traumatismos dentales representan uno de los más serios problemas de salud pública de los niños y adolescentes. Objetivo: identificar los factores predisponentes de trauma dentario en escolares de la escuela primaria. Método: se realizó un estudio descriptivo transversal, en escolares de 5 a 12 años de la escuela primaria "28 de septiembre" del Municipio Rafael Freyre, en el período de enero a junio de 2016. El universo de estudio y la muestra estuvo constituido por 236 niños. Se estudiaron algunas variables como edad, sexo, hábitos bucales deformantes, competencia labial y resalte. Resultados: las edades de 9 y 10 años fueron las más afectadas representadas por 47 escolares para el 19,9%. Predominó el sexo masculino (68,1%) en escolares con lesión traumática. El hábito bucal deformante más frecuente fue la succión digital en el 82,9%. El 65,9% de los pacientes que sufrieron lesiones traumáticas tenían una relación labial incompetente. El 80,9% de los escolares con trauma dental presentaban resalte aumentado. Conclusiones: los factores predisponentes más frecuentes fueron el resalte aumentado, el perfil convexo y la presencia de hábitos bucales deformantes entre los cuales la succión digital y la respiración bucal fueron los más representativos.

Introduction: dental trauma is one of the one of the most serious problems of public health in children and adolescents. Objective: identify the predisposing factors of dental trauma in children of the elementary school. Method: a descriptive cross-sectional study was conducted with students aged 5-12 from "28 de September" elementary school in the municipality of Rafael Freyre from January to June 2016.The universe and the sample of study was constituted for 236 children. The variables studied were age, sex, type of deforming oral habit, labial competence and overbite. Results: the ages between 9-10 were the most affected ones represented with 47 children (19.9%). There was a predominance of the male sex (68.1%) among students with traumatic injuries. Thumb sucking was the most common deforming oral habit (82.9%). Bilabial incompetence was found in 65.9% of the children with history of traumatic injuries. Increased overbite was found in 80.9% of the children with dental trauma. Conclusions: the most common predisposing factors were increased overjet, bilabial incompetence, and deforming oral habits. Thumb sucking and the buccal respiration were the prevailing ones.

Identification of predominant prevailing nontuberculosis mycobacteria in Hangzhou and analysis of their predisposing factors and drug resistance / 中国人兽共患病学报

This study is aim to determine the predominant prevailing nontuberculosis mycobacteria (NTM) in Hangzhou and to understand the predisposing factors and drug resistance of NTM.PNB/TCH growth tests were used to preliminarily identify the NTM in the mycobacterium-positive culture samples from 1 972 patients.The species of NTM isolates were con firmed using mycobacterium molecular linear probe method and sequencing of PCR product of 16S rRNA gene.The influence of sex and age on predisposing factors of NTM was subsequently analyzed.Concentration proportional method was applied to de tect the susceptibility of NTM isolates to armazide,rifampicin,streptomycin,ethambutol,ofloxacin and kanamycin.Results of PNB/TCH growth tests showed that 9.8％ (193/1 972) of the 1 972 mycobacterium-positive culture samples were positive.The mycobacterium molecular linear probe hybridization and PCR product sequencing confirmed that in the 193 samples with positive results of PNB/TCH growth tests,66.3％,18.1％,8.3％ and 7.3％ were infected with NTM alone,two mycobacteria,Mycobacterium tuberculosis and bacteria that not belonging to the genus of Mycobacteria,respectively.In the 173 NTM isolates (128 with single infection and 45 with mixed infection),57.8％ were identified as Mycobacterium intracellulare,followed by Mycobacterium abscessus (12.1％),Mycobacterium kansasi i (9.8％),Mycobacterium chelonei (9.8％) and Mycobacterium avium (5.8％).In the 35 mixed infection samples,28.5％ and 20.0％ were the co-infection of M.intracellulare and M.chelonei with M.tuberculosis,respectively.Male patients infected with NTM were more than female patients (1.67 ∶ 1) and the infection rate (80.4％) of populations with age over 50 years old was significantly high than that with lower than 50 years old (P＜0.01).Pulmonary infection proportion (95.1 ％) of NTM was significantly higher than other positions of body (P＜0.01).100％ of NTM isolates were resistant to armazide while the resistance rates of the isolates against the other 5 antituberculosis drugs were as high as 70.3 ％ 90.6 ％.As the conclusion of this study,M.intracellulare is the predominant prevailing NTM species in the recent years in Hangzhou,NTM mainly causes pulmonary infection and middle-aged and old people are easily infected by NTM.Moreover,NTM isolates have high resistance against commonly used antituberculosis drugs.

Progress of telomere and telomerase in hematological diseases / 白血病·淋巴瘤

Telomere and telomerase play important roles in protecting and maintaining the stability and integrity of chromosomes. Telomere and telomerase are closely related with multiple diseases, and their relationship with aging and tumors has become a hot topic in recent years. Relevant reports in the American Society of Hematology Annual Meeting in 2016 will be reviewed together with advances of telomere and telomerase in hematological diseases.

Association Between IL-31 Serum Levels And Other Predisposing Factors With Allergic Diseases In HRPZ II and HUSM, Kelantan, Malaysia

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzyme-linked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.