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Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

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Background: Generalised peritonitis secondary to Ileal Perforation is a common surgical emergency in tropical countries. It has become the fifth most common cause of abdominal emergency due to high incidence of enteric fever, tuberculosis, non-specific enteritis in these regions. To compare the management approaches by evaluatingObjective: the morbidity & mortality outcome of primary repair and ileostomy in non-traumatic ileal perforation with respect to pre- operative parameters, intra-operative findings & post-operative complications and mortality. Study is aMethods: randomized retrospective and prospective comparative observational study done from April 2022 to March 2023, 70 cases of ileal perforation fulfilling the inclusion & exclusion criteria and subdivided them into two groups. Patients who underwent primary repair & ileostomy into group 1 & 11 respectively. In our study the median age groupResults: affected were 36-50 years, males preponderance was there. Surgical site infection is the most common complications associated with both the procedures. Leak & Burst abdomen were the most devastating complication among primary repair. In our study increased rate of Post-operative complications were observed more in group 1 than group 11, Though Cosmetic acceptance & cost effectiveness was better to be in group 1 patients. In ileal perforation,Conclusion: Exteriorization procedure, temporary de-functioning ileostomy plays an important role is more appropriate compared to primary repair in terms of post-operative complications & mortality. Yet the primary determinant to choose the procedure remains to be general condition of the patient & intra-operative findings.

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Introducción. El tratamiento del cáncer de esófago ha evolucionado notablemente en los últimos años. Los nuevos abordajes permiten preservar el esófago en tumores tempranos, mediante técnicas endoscópicas, y en aquellos localmente avanzados, es posible realizar resecciones mínimamente invasivas en combinación con tratamiento oncológico. La innovación quirúrgica es necesaria para aumentar la eficacia terapéutica, sin embargo, ésta requiere un aprendizaje cuya curva impacta en los resultados obtenidos. El objetivo de este trabajo fue mostrar cómo incide la curva de aprendizaje en la morbimortalidad asociada al procedimiento. Métodos. Se tomó una cohorte de 128 pacientes con esofagectomía mínimamente invasiva por cáncer de esófago, realizadas entre enero de 2014 y diciembre de 2023. Se agruparon en dos etapas de manera cronológica, creando dos grupos de 64 pacientes cada uno. Se evaluaron variables demográficas, tipo de anastomosis realizada, tasa de complicaciones, anatomía patológica, días de internación y seguimiento. Resultados. No hubo una diferencia significativa entre los dos grupos en factores demográficos, como edad y sexo, tipos histológicos o sitio de la anastomosis. La morbilidad (complicaciones tipo III y IV de Clavien-Dindo) fue del 43,7 % en la primera etapa y del 23 % en la segunda, con una diferencia significativa (p=0,02). Conclusiones. En nuestra cohorte mostramos una diferencia estadísticamente significativa en cuanto a la morbilidad entre la primera y la segunda etapa, sin embargo, no hubo diferencias en la mortalidad. Los hallazgos sugieren así que la curva de aprendizaje de un procedimiento tiene un impacto negativo transitorio sobre los resultados.

Introduction. The treatment of esophageal cancer has evolved significantly in recent years. New approaches allow preserving the esophagus in early tumors, using endoscopic techniques, and in locally advanced tumors, it is possible to perform minimally invasive resections in combination with an oncological treatment. Surgical innovation is necessary to increase therapeutic efficacy; however, it requires learning curve whose impacts the results obtained. The objective of this work was to show how the learning curve affects the morbidity and mortality associated with the procedure. Methods. A cohort of 128 patients with minimally invasive esophagectomy due to esophageal cancer was included, performed between January 2014 and December 2023. They were grouped into two stages chronologically, creating two groups of 64 patients each. Demographic variables, type of anastomosis performed, complication rate, pathology types, hospital stay and follow-up were analyzed. Results. There was no significant difference between both groups in demographic variables, such as age and sex, histological types, or anastomosis site. Morbidity (Dindo-Clavien types III and IV complications) was 43.7% on the first stage and 23% in the second one, with a significant difference (p=0.02). Conclusions. In our cohort, we showed a statistically significant difference in morbidity between the first and second stages; however, there were no differences in mortality. The findings thus suggest that the learning curve of a procedure has a temporary negative impact on the results.

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El trauma es una causa significativa de muerte y discapacidad a nivel mundial, afecta principalmente a la población económicamente activa y representa el 9% de las muertes globales. En Chile, existen pocos estudios relacionados al tema, uno de los pocos destaca una tasa de mortalidad de 8.45 por cada 100.000 habitantes. Objetivo: Describir epidemiológicamente la mortalidad por traumatismos en Chile durante los años 2021 y 2023. Materiales y métodos: Estudio de carácter observacional, descriptivo, ecológico y longitudinal, retrospectivo. Se realizó un análisis de los datos obtenidos por el Departamento de Estadísticas de Información de Salud (DEIS) correspondientes a defunciones en la población chilena durante los años 2021 y 2023 causadas por traumatismos. Resultados: Durante el periodo analizado de 2021 a 2023, se registraron un total de 4741 defunciones asociadas a politraumatismo en Chile, con tasas de mortalidad de 8.12, 8.5, y 7.43 por 100 mil habitantes para los años 2021, 2022 y 2023 respectivamente. La mayoría de estas defunciones fueron en hombres, manteniendo una proporción hombre: mujer de 4:1. Las edades entre 15 y 65 años mostraron la mayor tasa de mortalidad, seguidas por las edades menores a 14 años con tasas significativamente más bajas. La mayoría de las defunciones fueron por accidentes de tránsito, seguidas por exposición a factores no especificados, caídas, y otras causas específicas de trauma. Conclusión: Se observan patrones claros. Se estima una tasa de mortalidad de 8,016 por 100 mil habitantes en el periodo analizado. De igual forma por género, se estima que es 4 veces más frecuente en hombres. La población laboral es la más perjudicada, mientras que la causa más frecuente sigue siendo los accidentes vehiculares, lo que sugiere la importancia de futuros estudios en este campo, siendo necesario estudios posteriores para profundizar en causas especificas y mecanismos de trauma.

Trauma is a significant cause of death and disability worldwide, primarily affecting the economically active population and accounting for 9% of global deaths. In Chile, there are few studies related to this topic, with one of the few highlighting a mortality rate of 8.45 per 100,000 inhabitants. Objective: To describe the epidemiology of mortality due to trauma in Chile during the years 2021 and 2023. Materials and Methods: This is an observational, descriptive, ecological, and longitudinal retrospective study. An analysis was conducted using data obtained from the Department of Health Statistics and Information (DEIS) concerning deaths in the Chilean population during the years 2021 and 2023 caused by trauma. Results: During the analyzed period from 2021 to 2023, a total of 4,741 deaths associated with polytrauma were recorded in Chile, with mortality rates of 8.12, 8.5, and 7.43 per 100,000 inhabitants for the years 2021, 2022, and 2023, respectively. The majority of these deaths were in men, maintaining a male-to-female ratio of 4:1. Ages between 15 and 65 years showed the highest mortality rate, followed by ages under 14 years with significantly lower rates. Most of the deaths were due to traffic accidents, followed by exposure to unspecified factors, falls, and other specific causes of trauma. Conclusion: Clear patterns are observed. An estimated mortality rate of 8.016 per 100,000 inhabitants is observed during the analyzed period. Similarly, by gender, it is estimated to be four times more frequent in men. The working population is the most affected, while the most frequent cause remains vehicular accidents, suggesting the importance of future studies in this field. Further studies are necessary to delve into specific causes and mechanisms of trauma.

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Background: Although there has been significant economic progress and development globally over the past few decades, countries in the South-East Asia region continue to face a substantial burden of infectious diseases. In contrast to other low- and middle-income nations, where non-communicable diseases (NCDs) are replacing infectious diseases, India is seeing a situation where infectious diseases persist alongside the growth of non-communicable diseases. This dual burden places additional strain on households in the country. Methods: A record-based cross-sectional study was conducted in a tertiary care hospital in, the Konkan region. A complete enumeration of one-year data of all critically ill indoor patients was collected from HMIS software and the IDSP Portal and compiled in Microsoft Excel. Results: Of 957 admitted patients, 61% were males and 39% were females. Around 36% of patients admitted in the most productive age group (15-45 years). The peak in admission was seen in the monsoon season (July to October). Maximum patients were of respiratory illness followed by bacterial cellulitis. Conclusion: The study will help to formulate policies to control infectious diseases based on their variability according to age, gender, and season. Understanding the prevalence of diseases will also aid health officials in efficiently allocating resources and implementing preventative initiatives.

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Introdução: As queimaduras são um desafio da saúde pública devido à alta morbimortalidade e prejuízo na qualidade de vida da vítima. Elas afetam desproporcionalmente as populações de menor nível socioeconômico, resultando em elevados custos para saúde. Método: Estudo ecológico, retrospectivo, observacional, com abordagem quantitativa e análise de tendência temporal da morbimortalidade por queimadura em Santa Catarina, com dados obtidos dos Sistemas de Informações Hospitalar e de mortalidade disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. Análise temporal pelo Teste de Correlação de Spearman. Resultados: Verificada tendência de crescimento na taxa geral de internação (Spearman=0,806; p<0,005) por queimaduras no estado no período analisado. Maior prevalência no sexo masculino (RP 1,68), na população de 0 a 4 anos (RP 3,08) e na região da Grande Florianópolis (taxa média 23,22%). Predominou o grupo classificado como médio queimado (taxa média 25,67%) e as internações de 0 a 3 dias (taxa média 50,25%). Queimaduras em cabeça, pescoço e tronco (taxa média 32,25%) foram as mais prevalentes. Conclusão: Identificada tendência de crescimento na taxa de internação por queimaduras em crianças no estado. Maior prevalência de internação no sexo masculino, em crianças de 0 a 4 anos e na região da Grande Florianópolis. Predomínio de médio queimados e de queimaduras em cabeça, pescoço e tronco, com maior taxa de internações de curta duração.

Introduction: Burns is a public health challenge due to high morbidity and mortality and impairment of the victim's quality of life. They disproportionately affect populations of lower socioeconomic status, resulting in high health costs. Method: Ecological, retrospective, observational study, with a quantitative approach and temporal trend analysis of morbidity and mortality due to burns in Santa Catarina, with data obtained from the Hospital and Mortality Information Systems made available by the Information Technology Department of the Unified Health System. Temporal analysis by Spearman Correlation Test. Results: There was a growing trend in the general hospitalization rate (Spearman=0.806; p<0.005) for burns in the state in the period analyzed. Higher prevalence in males (RP 1.68), in the population aged 0 to 4 years (RP 3.08), and in the Greater Florianópolis region (mean rate 23.22%). The group classified as medium burn predominated (mean rate 25.67%) and hospitalizations of 0 to 3 days (mean rate 50.25%). Burns to the head, neck, and trunk (mean rate 32.25%) were the most prevalent. Conclusion: A growth trend was identified in the hospitalization rate for burns in children in the state. Higher prevalence of hospitalization in males, in children aged 0 to 4 years, and in the Greater Florianópolis region. Predominance of moderate burns and burns to the head, neck, and trunk, with a higher rate of short-term hospitalizations.

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Introducción. Las complicaciones quirúrgicas son un tema relevante, difícil de abordar e inmerso en una cultura punitiva y vergonzosa hacia el médico. La ausencia de una medición sistemática, confiable y socializada es un desafío para los servicios quirúrgicos. El desconocimiento de las medidas de frecuencia y el impacto de las complicaciones quirúrgicas en las instituciones, y a su vez, dentro de los servicios quirúrgicos, evidencia la necesidad de abordar el tema desde una perspectiva de mejoramiento continuo. Métodos. Se hizo un análisis crítico y reflexivo sobre la conceptualización de las complicaciones quirúrgicas, los avances en su proceso de evaluación y su utilidad como indicador de calidad en los servicios quirúrgicos. Se ilustraron las metodologías con ejemplos clínicos que facilitan su entendimiento y aplicabilidad. Resultados. El trabajo inicial de los doctores Clavien & Dindo se ha fortalecido al considerar integralmente el proceso de atención quirúrgica como un indicador de calidad de la atención en salud. El desarrollo del Índice Integral de Complicaciones (CCI), para los eventos en el período posoperatorio, representa un paso adicional en el abordaje del problema. Su potencialidad en el análisis de los eventos ofrece una oportunidad para la implementación y la investigación en el tema. Conclusiones. Las complicaciones quirúrgicas representan un indicador robusto que permite evaluar el desempeño individual y grupal en un servicio quirúrgico. Hay metodologías recientes que deben ser incorporadas en la actividad asistencial de los cirujanos. Representan un insumo en la educación médica a todo nivel e, igualmente, un elemento de crecimiento personal y académico para todo cirujano.

Introduction. Surgical complications are a relevant topic, difficult to address and immersed in a punitive and shameful culture towards the doctor. The absence of systematic, reliable, and socialized measurement is a challenge for surgical services. The lack of knowledge of frequency measurements and the impact of surgical complications in institutions, and in turn, within surgical services, shows the need to address the issue from a perspective of continuous improvement. Methods. A critical and reflective analysis was carried out on the conceptualization of surgical complications, the advances in their evaluation process and their usefulness as an indicator of quality in surgical services. The methodologies were illustrated with clinical examples that facilitate their understanding and applicability. Results. The initial work of doctors Clavien & Dindo has been strengthened by comprehensively considering the surgical care process as an indicator of quality of health care. The development of the Comprehensive Complication Index (CCI), for events in the postoperative period, represents an additional step in addressing the problem. Its potential in the analysis of events offers an opportunity for implementation and research on the topic. Conclusions. Surgical complications represent a robust indicator that allows evaluating individual and group performance in a surgical service. There are recent methodologies that must be incorporated into the care activity of surgeons. They represent an input in medical education at all levels and equally, an element of personal and academic growth for every surgeon.

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Introducción. El trasplante hepático es el tratamiento indicado en aquellas enfermedades del hígado en las cuales ya se han agotado otras medidas terapéuticas, y es un procedimiento complejo. Las complicaciones postquirúrgicas se relacionan con alta morbimortalidad y pueden llevar a desenlaces fatales; las complicaciones vasculares son las de mayor mortalidad, por lo que es crucial la detección temprana y el tratamiento oportuno. El objetivo de este estudio fue caracterizar los pacientes que presentaron complicaciones vasculares posterior a trasplante hepático. Métodos. Estudio descriptivo, retrospectivo, con seguimiento a los pacientes sometidos a trasplante hepático en la Fundación Cardiovascular, entre los años 2013 y 2023, que presentaron complicaciones vasculares. Se evaluó el tipo de complicación, los factores de riesgo y los desenlaces postquirúrgicos. Resultados. Se incluyeron en total 82 pacientes trasplantados, con un predominio del sexo masculino 59,8 % (n=49); la principal indicación del trasplante fue el alcoholismo (21,9 %). Veinte pacientes presentaron complicaciones vasculares; la más frecuente fue trombosis de arteria hepática, en el 45 % (n=9). En tres de estos casos se requirió nuevo trasplante. Conclusión. Las complicaciones vasculares empeoran la evolución clínica postoperatoria de los pacientes y están relacionadas con alta morbimortalidad, por lo cual es crucial la valoración multidisciplinaria, el diagnóstico oportuno y la intervención temprana para disminuir los desenlaces fatales.

Introduction. Liver transplant is the treatment indicated for those liver diseases in which other therapeutic measures have already been exhausted, and it is a complex procedure. Post-surgical complications are related to high morbidity and mortality and can lead to fatal outcomes. Vascular complications are the ones with the highest mortality, so early detection and timely treatment are crucial. The objective of this study was to characterize patients who presented vascular complications after liver transplantation. Methods. Descriptive, retrospective study, with follow-up of patients undergoing liver transplant at the Fundación Cardiovascular, between 2013 and 2023, who presented vascular complications. The type of complication, risk factors and postsurgical outcomes were evaluated. Results. A total of 82 transplant patients were included, with a predominance of males with 59.8% (n=49); the main indication for transplant was alcoholism (21.9%). Twenty patients presented vascular complications; the most frequent was hepatic artery thrombosis 45% (n=9). In three of these cases a new transplant was required. Conclusion. Vascular complications worsen the postoperative clinical course of patients and are associated with high morbidity and mortality, which is why multidisciplinary assessment, diagnosis and early intervention are crucial to reduce fatal outcomes.

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Background: Magnesium sulphate (MgSO4) is the most popular anti-convulsant drug for treatment of eclampsia. Pritchard regimen is the most widely used regime worldwide where maintenance dose of MgSO4 is administered for 24-hour after delivery or last fit (whichever is later). As the duration of MgSO4 therapy increases, the incidence of adverse effects also increases. Therefore, the present study has been conducted to compare the maternal outcome with decreased duration of MgSO4 therapy for 12-hour with that of 24 hours for patients with eclampsia. Methods: It was an experimental study which was performed as a single centered, open labelled hospital based randomized control trial. It was conducted for 2 years (December 2019 to November 2021) among the patients of eclampsia admitted at department of obstetrics and gynaecology, AGMC and GBPH. Results: No cases of recurrent seizures in either group with additional benefit of lesser adverse effect of toxicity of MgSO4 in the 12-hour group. Conclusions: In the present study, it has been seen that 12-hour MgSO4 maintenance therapy is as efficacious as standard 24 hours therapy in controlling seizure as there was no case of recurrent seizure in either group.

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Background: Most of the cases of diarrhoea recover with rehydration only and do not require antibiotic therapy. Oral Rehydration Solution (ORS), introduced by WHO, is the single most important measure in the management of acute diarrhoea due to all aetiologies and in all age groups across the globe. To determine the Knowledge and Practices of ORS usage among mothers of children less than 6 years of age. Methods: A cross-sectional study was conducted among all mothers of children <6 years of age registered at Anganwadi centres of a village which is a rural field practice area for a government medical college (n=300). A pretested questionnaire was used. House-to-house visits were conducted to gather information through face-to-face interviews after getting informed consent. Results: Most of the mothers (60.9%) were educated up to 8th standard. More than half of them (58.2%) had heard about ORS. Among all study subjects only 11.9% knew that ORS should be given to children suffering from diarrhoea, whereas few were practicing it. Among those who had heard about ORS, a very high majority (87.2%) knew about its role in treating diarrhoea, and only 2.6% knew about its shelf life. Out of those who have heard about ORS, 38.5% were collecting it from Anganwadis, whereas >25% were purchasing it themselves. Conclusion: Poor knowledge and practices regarding ORS use is a matter of concern. IEC activities and behavioural change communication are strongly advocated regarding ORS use.

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Background: Elderly primigravida is a common problem in present days, due to a rise in educational levels, efficient birth control measures and a larger number of women in the workforce. Low birth weight, antepartum and intrapartum foetal loss, neonatal mortality, and several pregnancy and labour issues requiring surgical delivery are all associated with advanced maternal age. Methods: An observational study was undertaken in the Department of Obstetrics and Gynecology, S.C.B Medical College and Hospital, Cuttack from March 2021 to February 2022 on elderly primigravida. All the sociodemographic details were obtained from the study subjects. The intranatal, antenatal, postnatal and neonatal parameters were observed. Results: A total of 100 cases were selected for the study. The majority were literate and from urban areas, belonging to 31-35 years age group and middle socioeconomic status. Major complications noticed were anemia, fibroid, and hypothyroidism with the occurrence of hypertensive disorders of pregnancy, felt growth restriction, and antepartum hemorrhage. Major labor complications were fetal distress, premature rupture of membrane, and cephalopelvic disproportion. The majority of patients delivered low birth weight babies with low APGAR scores (<7 at 5 min) and increased incidence of neonatal morbidities. Early neonatal death and stillbirth were high showing an increased perinatal mortality. Conclusion: This study concluded that an elderly primigravida is a high-risk group that encounters complications during pregnancy and labor. The newborns are also low birth weight with a high risk of neonatal morbidities. Pre-conceptional counselling, supervision during antenatal and intrapartum periods and scheduled obstetric intervention are necessary for optimum outcomes.

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Background: Children face the greatest risk of disease and death in their first 28 days. Improvements in basic neonatal care such as thermoregulation and breastfeeding have substantially reduced neonatal mortality and morbidity. There is still a need to strengthen the provision of advanced care for neonates. Identifying factors impacting neonatal mortality and morbidity and addressing them through a package of evidence-based interventions are essential to avoiding preventable deaths. Methods: The current study analyses data from a cross-sectional study in the rural outreach area of a tertiary hospital in Hyderabad, India to assess clinical and socio-demographic factors affecting neonatal morbidity. One hundred and fifty neonates admitted in neonatal intensive care unit and their mothers were included. A semi-structured questionnaire was used to obtain responses through face-to-face interview. Descriptive and inferential analyses were performed using R Statistical Software (version 4.3.2). Results: Among the 150 neonates, 99 (66%) neonates were admitted for respiratory distress. 39 (26%) males were low birth weight and 28 (18.67%) females were low birth weight. There was no significant association between low birth weight, high risk pregnancy and gender of the neonate. A significant association was obtained between low socio-economic status and low birth weight. Conclusions: Neonatal mortality and morbidity can be attributed to several factors including neonatal characteristics, maternal characteristics, health infrastructure and health manpower. However, prevalence of socio-demographic risk factors affecting neonates is disproportionately higher in low- and middle-income countries. A multi-pronged approach is required to address the multimodal causation of low birth weight and morbidity in neonates.

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Background: Old age is associated with diminished physiological reserve; so any physical illness, metabolically derangement or pharmacological challenge can worsen cognitive and physical function. The only way to minimize or avoid these will be to be on the lookout and have a proactive approach and assessment in every older patient irrespective of the presenting complaint. This study aimed to assess the socio-demographic profile and self reported morbidity pattern of the elderly population and to estimate the prevalence of depression among the elderly population using the geriatric depression scale. Methods: A pre-designed, pretested and semi-structured questionnaire was used in the study. The data collection technique is by personal interview of the study subjects. A pre-designed, pretested and semi-structured questionnaire was used in the study. The data collection technique is by personal interview of the study subjects. Results: In our study more women were under depression than the men. The most common physical morbidity among the elderly population was cataract (59.7%), followed by arthritis (57.1%), non- specific body pains (40.1%) and hypertension (39%). Conclusions: Prevalence of depression among the elderly population is reported to be high (84.3%) in this study. Multi morbidity, socio economic factors and financial dependence were factors associated with depression in elderly.

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Background: Understanding the patient flow for health-seeking patterns and utilization of AYUSH care in India has been considered essential for a greater emphasis on mainstreaming and blending into the existing healthcare systems. This study examines the morbidity profiling of patients reporting to Ayothidoss Pandithar Hospital (APH) of the National Institute of Siddha (NIS), Chennai. Methods: The study included new and old/revisit patients who attended the APH, Outpatient Department (OPD), special OPD, and Inpatient Department (IPD) from October 2004 to December 2023. Results: Through OPD and IPD, APH has treated 98,94,373 cases and 7,61,754 cases, respectively. The average number of cases treated per day at OPD was 1484, and 115 in IPD. Men were higher in OPD and IPD. The more common diseases treated during 2012-2023 at OPD were Madhumegam (diabetes mellitus) 13% and Azhal keelvayu (osteoarthritis) 12% whereas, in IPD, it was Thandagavatham (lumbar spondylosis) 9.5% and Pakkavatham (hemiplegia) 9.4%. At APH, 9 X-ray investigations, 44 Varmam therapies, 37 Thokkanam therapies, 497 pathological, 433 biochemical investigations, and 38 microbiological tests were performed each day. Conclusions: This study reveals the scope of the Siddha system of Medicine in managing Musculoskeletal disorders. The patient data generated at APH would enhance the National Health Policy (NHP) objective of strengthening and prioritizing health services' importance, promoting good health, and creating guidelines for high-quality care.

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Background: Despite the significance of late preterm and early term neonates in neonatal health, comprehensive data on their prevalence, morbidity, mortality, and associated maternal sociodemographic and economic characteristics is grossly lacking in Garissa County, Kenya. This study aimed to determine the prevalence, morbidity, and mortality of late preterm (LPN) and early term neonates (ETN) born at Garissa County Referral Hospital (GCRH), relative to full-term neonates (FTN). Methods: Singleton live neonates in the three groups were enrolled. Prevalence was computed as percentages of births in each category relative to total singleton live births during the study period. Ordinal logistic regression analysis was used to assess morbidity patterns, with statistical significance set at p<0.05. Mortality rates were presented as total deaths per 1,000 live births within the first 28 days. Results: The LPN, ETN, and FTN had a prevalence of 8.47%, 11.86%, and 9.2%, respectively. Maternal age was significantly associated with gestational age (p=0.014; ?c=0.263), while other sociodemographic and economic characteristics were comparable across groups (p>0.05). LPNs had lower odds of respiratory distress diagnosis on day 1 compared to ETNs (OR=-1.68896; 95% CI: -3.012335 to -0.365593; p=0.012). Mortality rates were comparable among gestational age categories (p=0.649). Conclusions: Overall, the study shows that LPN and ETN are considerably prevalent in Garissa County and that, only maternal age impacts on gestational age. Targeted interventions, particularly for younger mothers, should be implemented to mitigate associated risks and improve neonatal outcomes.

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Background: Surgical site infections (SSIs) are responsible for increased morbidity and mortality among post-operative patients worldwide. They also increase healthcare costs and prolong the duration of hospital stay. This study aims to determine the incidence of SSIs in elective and emergency general surgery and its association with various risk factors. Methods: A retrospective cohort study was carried out using the case sheets of 200 patients who underwent general surgery in a tertiary public hospital of South India. The patients were selected from two cohorts- emergency and elective (100 from each). The data retrieved from the hospital抯 electronic medical records were analyzed using STATA version 14.0. Results: Of the 200 patients included in the study, 57% were men and the mean (range) age was 49.3 (18-88) years; 122 patients (61%) had contaminated wounds, 68 patients (34%) had a pre-existing comorbidity and the average duration of hospital stay was 6.98 days. The overall surgical site infection rate was 11%; 13% in emergency surgery and 9% in elective surgery. Staphylococcus aureus was isolated from 36% of the patients with surgical site infections. Conclusions: Emergency surgery reported a higher infection rate than elective surgery. Old age, pre-existing medical illnesses, wound contamination and prolonged hospital stay were also found to increase the risks for developing SSIs.

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Background: Aging, longevity, advanced health care, and demographic transition have altered the quality of life (QOL) among the elderly. This study was planned to assess the QOL among the elderly and the associated factors in rural Bihar. Methods: This community-based cross-sectional study among 395 elderlies residing in rural Bihar adopted a multistage sampling technique and a standard WHO-QOL BREF tool to assess the QOL. A multivariable linear regression analysis was performed and an adjusted beta-coefficient was reported to determine the factors determining the QOL. Results: A total of 33 [8.4% (95% CI: 6-11.5%)] out of 395 elderlies had poor QOL. Age [adjusted B= -0.19 (-0.3 to -0.07)], Females [adjusted B= -1.89 (-3.5 to -0.25)], No. of drugs consumed [adjusted B=1.7 (0.4 to 2.99)], presence of any of the comorbidity [adjusted B=-5.9 (-10.8 to -1.1)], presence of Polymorbidity [adjusted B=-3.5 (-6.6 to -0.4)] were found to be independent correlates of QOL scores among elderly. Conclusion: Almost one in ten elderlies had poor QOL. The physical domain of QOL was affected the most among all the domains. Increasing age, female gender, presence of any co-morbidity, presence of poly-morbidity, and more drug consumption were associated with decreasing QOL scores among the elderly.

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Introduction: : A high-risk pregnancy is a condition in which the mother, fetus, or both are at risk for morbidity or mortality before or after delivery. Moreover, most maternal deaths could be prevented if women had timely approached appropriate health care during pregnancy, childbirth, and immediately afterward. Objective: 1. To estimate the prevalence of high-risk pregnancies among antenatal women. 2. To determine the sociodemographic factors inluencing high-risk pregnancy among the study population. Method: A hospital-based cross-sectional study included 858 antenatal women attending tertiary health care center. Convenience sampling was used, data was collected using pre- tested proforma and statistical analysis was performed using SPSS version 23, employing the chi-square test/Fisher's Exact test to explore associations. Results: The study found a 28.6% prevalence of high-risk pregnancies. Rural women had a 2.87 times higher risk (p-value: <0.001, OR: 2.87, 95% CI: 2.118 � 3.898) compared to urban women. Similarly, women in joint families had a 3.58 times higher risk (P-value: <0.001, OR: 3.58, 95% CI: 2.478- 5.182) compared to those in nuclear families. Conclusion: The current study found that place of residence, type of family, and occupation had a signiicant association with high-risk pregnancies. The most common risk conditions for high-risk pregnancies were a Previous history of cesarean section followed by preeclampsia.

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Back ground: Long-coronavirus disease is the long-term consequences of COVID-19 infection experienced by individuals who are infected with the virus. Signs, symptoms, and problems that persist or worsen following an acute COVID-19 infection are collectively referred to as long COVID. This study tries to determine the correlation between vaccination status and the post-COVID long-term effects in vaccinated versus non-vaccinated infected individuals. Methodology: It was a cross-sectional descriptive design, encompassing 416 individuals. Study cases represented vaccinated individuals who were infected and were suffering from the long-term consequences of COVID-19, as opposed to non-vaccinated infected individuals. Individuals who were neither infected, vaccinated, or unvaccinated considered as a reference group for estimating the correlation utilizing Odds ratio (OR). Result: This study revealed that vaccinated individuals were more commonly affected by weakness (OR= 0.93; 95% CI 0.49-1.7), joint pain (OR= 0.7; 95% CI 0.41-1.4), and concentration problems (OR= 0.87; 95% CI 0.44-1.7) so that present study didn’t notify significant statistical findings for post-COVID conditions risks regarding to vaccination status. Conclusion: The correlation between vaccinated and non-vaccinated individuals who develop post-COVID-19 conditions showed that risk factors for developing these conditions were independently associated with vaccination status among infected participants.

ABSTRACT

Fundamento: los síndromes coronarios agudos constituyen un problema de salud debido a su alta morbilidad y mortalidad. Sería razonable asumir que los trabajadores de la salud cuidan y controlan sus propios factores de riesgo coronario, no obstante, los resultados obtenidos en investigaciones muestran que no siempre es así. Objetivo: caracterizar los factores de riesgo coronario en trabajadores del Hospital General Docente Guillermo Domínguez López de Las Tunas. Método: se realizó un estudio descriptivo de corte transversal en el Hospital General Docente Guillermo Domínguez López de Las Tunas entre diciembre de 2019 y diciembre de 2022. La población de estudio fue de 912 trabajadores y la muestra de 200. Fue un muestreo probabilístico, aleatorio simple, dividido en dos grupos: A (con síndrome coronario agudo) y B (sin síndrome coronario agudo). Se analizaron las siguientes variables: edad, sexo, factores de riesgo coronario. La información se obtuvo de expedientes clínicos y se analizó en porcentaje, media, desviación estándar y el estadígrafo z para obtener la influencia de los factores de riesgo en la enfermedad. Resultados: la media de edad del grupo A: 56,5 (±5,03), grupo B: 46,4 (±11,33) años con predominio del sexo masculino (54,5 %). Los factores de riesgo que predominaron fueron: sedentarismo (57 %), tabaquismo (36,5 %) e hipertensión arterial (34 %). Los de mayor influencia fueron: los antecedentes de cardiopatía isquémica, la enfermedad vascular, la obesidad abdominal (z: 0,99), la diabetes mellitus (z: 0,92) y la hipertensión arterial (z: 0,70). Conclusiones: el síndrome coronario predomina en la quinta década de la vida y con mayor frecuencia en el sexo masculino.

Foundation: acute coronary syndromes constitute a health problem due to their high morbidity and mortality. It would be reasonable to assume that health workers take care of and control their own coronary risk factors, however, research results show that this is not always the case. Objective: to characterize coronary risk factors in workers at the Guillermo Domínguez López General Teaching Hospital in Las Tunas. Method: a descriptive cross-sectional study was carried out at the Guillermo Domínguez López General Teaching Hospital in Las Tunas between December 2019 and December 2022. The study population was 912 workers and the sample was 200. It was a probabilistic, simple random sampling divided into two groups: A (with acute coronary syndrome) and B (without acute coronary syndrome). The following variables were analyzed: age, sex, coronary risk factors. The information was obtained from clinical records and analyzed in percentage, mean, standard deviation and the z statistic to obtain the influence of risk factors on the disease. Results: the average age of group A: 56.5 (±5.03), group B: 46.4 (±11.33) years with a predominance of the male sex (54.5 %). The predominant risk factors were: sedentary lifestyle (57 %), smoking (36.5 %) and high blood pressure (34 %). Those with the greatest influence were: a history of ischemic heart disease, vascular disease, abdominal obesity (z: 0.99), diabetes mellitus (z: 0.92) and arterial hypertension (z: 0.70). Conclusions: coronary syndrome predominates in the fifth decade of life and is more common in males.