Concordance of acid-fast stain result and histopathologic vs clinical diagnosis of leprosy: A three-year retrospective study in a Tertiary Government Hospital and Sanitarium in the Philippines

Objectives@#In the Philippines, there has been a lack of information on the concordance between classifications of Hansen’s disease or leprosy clinically, histopathologically, and with AFS results. The study ultimately aimed to determine the concordance between the clinical diagnosis, histopathological results, and AFS results of patients with leprosy seen at the Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium (DJNRMHS). @*Methods@#This is a descriptive, retrospective, single-center study conducted at the DJNRMHS, a tertiary government hospital and one of the last remaining sanitaria in the country located in northern Metro Manila in the Philippines. The study reviewed and included all the patient records from the years 2017-2019 which included skin biopsy results and slit-skin smear with AFS. Leprosy patients were then classified based on the following classifications: World Health Organization (WHO) and Ridley-Jopling classifications; and the concordance of clinical diagnosis vs the histopathologic findings and clinical diagnosis vs AFS results were determined using kappa testing.

Provision and use of physical rehabilitation services for adults with disabilities in Rwanda: A descriptive study

Physical rehabilitation interventions address functional deficits caused by impairments that affect someone's performance. Whilst rehabilitation is important, it is assumed that these services are either minimal or nonexistent in low-resource settings. Our data expand on the data from the Situation Assessment of Rehabilitation in the Republic of Rwanda report to describe rehabilitation services and who access them at public and semiprivate facilities (primarily funded by the private sector).Objectives: This article describes the use of the outpatient physical rehabilitation services across nine health facilities, the characteristics of adults attending these health facilities and some of the facilitators and barriers they encounter when attending rehabilitation. Method: Data were collected between September and December 2018 from the heads of departments and adult patients attending outpatient rehabilitation services funded by the government, international nongovernmental organizations or faith-based organizations. Results: Two hundred and thirteen adults were recruited from nine facilities. There is a sixfold difference in the number of rehabilitation personnel between public and semiprivate hospitals in these facilities' catchment areas. However, most participants were recruited at public facilities (186 [87%]), primarily with physical disorders. Patients reported that family support (94%) was the most crucial facilitator for attending rehabilitation, whilst transportation cost (96%) was a significant barrier. Conclusion: Rehabilitation service availability for Rwandan adults with disabilities is limited. Whilst family support helps patients attend rehabilitation, transportation costs remain a significant barrier to people attending rehabilitation. Strategies to address these issues include developing triage protocols, training community health workers and families. Contribution: Data on rehabilitation service provision in Rwanda and most African countries are either non-existent or very limited. These data contain important information regarding the services provided and the people who used them across different health facilities (public versus private) and urban versus rural settings). To improve rehabilitation service provision, we first need to understand the current situation. These data are an important step to better understanding rehabilitation in Rwanda

Malaria in Haiti: A descriptive study on spatial and temporal profile from 2009 to 2018

ABSTRACT Background: Haiti is one of the Caribbean countries where malaria persists. More than 99% of malaria cases are caused by Plasmodium falciparum, the main vector being the mosquito Anopheles albimanus. In this paper, we describe the epidemiological profile of malaria in Haiti between 2009 and 2018. Methods We analyzed information on cases reported by the Ministry of Health of Haiti and the World Health Organization (WHO). Results: Between 2009 and 2018, 232,479 malaria cases were reported by the Ministry of Public Health and Population (MSPP); an increase in the incidence of malaria in the country in 2010, followed by a decrease in 2011, was primarily observed. Due to recent efforts to reduce malaria by 2020, its incidence declined from 60,130 cases in 2010 to 8,978 cases in 2018. Controversially, in terms of the number of reported cases, the MSPP and WHO report conflicting data. However, the results from both datasets present the same trend in Haiti from 2009 to 2018. The results also illustrate the endemicity of the disease throughout Haiti, both in rural and urban areas, especially along the coast. Conclusions: This study emphasizes the need to promote official data collection and analyses, as well as the application of epidemiological surveillance of malaria at the municipal level, for a better understanding of the real impact of malaria on the Haitian population and to create more appropriate interventions.

Etiology, treatment and outcome of children diagnosed with Secondary Hemophagocytic Lymphohistiocytosis in a tertiary hospital

Background@#Hemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome that is associated with a variety of underlying conditions leading to the same characteristic hyperinflammatory phenotype. @*Objectives@#To describe the clinical profile of patients diagnosed with HLH admitted between January 1, 2010 to September 30, 2019 in a tertiary care hospital. @*Methods@#Retrospective descriptive study of pediatric patients diagnosed with HLH in a tertiary care hospital. @*Results@#Eleven subjects were included in the study. Age distribution showed a bimodal pattern: < 5 years old (5, 46%) and 10-15 years old (4, 36%). Male to female ratio is 4.5:1. All patients presented with fever (100%) followed by hepatomegaly (5, 45%) and splenomegaly (4, 36%) on physical examination. All eleven subjects fulfilled the following criteria for HLH such as fever, splenomegaly, and hyperferritinemia. Six out of eleven showed hypofibrinogemia (55%) and hypertriglyceridemia (55%). Among the eleven with two cell cytopenia, five presented with anemia (46%), six with neutropenia (55%), while all of them had thrombocytopenia (100%). Other laboratory findings noted were elevated ALT (5, 46%), CRP (4, 36%), AST (3, 27%), alkaline phosphatase (3, 27%), and hyponatremia (3, 27%). EBV and dengue (3, 27%) were the most common etiologies. Pneumonia (3, 27%) was the most common complication, followed by sepsis (2, 18%). All but one patient were responsive to either dexamethasone (7, 64%) and or IVIG (5, 45%) and chemotherapy (1, 9%). The antibiotic most commonly used was piperacillin tazobactam (3, 27%). The median hospital stay was 17 days. There was one mortality (9%). @*Conclusion@#HLH should be considered in children presenting with prolonged fever, hepatomegaly, and or splenomegaly, with hyperferritinemia, thrombocytopenia, anemia and neutropenia.

Analysis of the epidemiological characteristics and response to public health emergencies in Putuo District of Shanghai from 2004 to 2019 / 上海预防医学

ObjectiveTo analyze the epidemiological characteristics of public health emergencies in Putuo District and provide scientific evidence to effectively respond to public health emergencies in the future. MethodsDescriptive epidemiological methods were used to analyze the data of public health emergencies reported by the national online system in Putuo District from 2004 to 2019. ResultsA total of 59 public health emergencies were reported from 2004 to 2019， during which 1 252 patients and 6 death cases were involved. From 2004 to 2019， the number of public health emergencies in Putuo District first increased and then decreased， fluctuating at a low level yearly. Most of the emergencies were general events （72.88%， 43/59）. 69.49 percent （41/59） of the events were infectious diseases， and 67.80 percent （40/59） occurred in schools and child care institutes， with primary schools with the highest number of events. The peaks of infectious disease events occurred in June and November， while the majority of occupational poisoning and heat stoke events occurred in July and August， with 4 patients dead from heat stroke. The medians of events detection， verification， reporting and controlling timelines were 10.81， 3.00， 1.70 and 307.40 h； different categories of events varied in their detection and controlling time interval （all P<0.01）. Multiple linear regression analysis showed that events detection and verification timelines were correlated with controlling timelines （b=0.766， 0.758， F=3.84， 5.65， all P<0.01）. ConclusionsThe majority of public health emergencies in Putuo District are caused by infectious diseases， especially chicken pox. The prevention and control measures should be strengthened in schools. For occupational poisoning and heat stoke events， attention should be paid to different occupational groups. The capacity of emergency detection and verification should be enhanced to improve the efficiency of incident control.

Analysis of the epidemiological characteristics and response to public health emergencies in Putuo District of Shanghai from 2004 to 2019 / 上海预防医学

ObjectiveTo analyze the epidemiological characteristics of public health emergencies in Putuo District and provide scientific evidence to effectively respond to public health emergencies in the future. MethodsDescriptive epidemiological methods were used to analyze the data of public health emergencies reported by the national online system in Putuo District from 2004 to 2019. ResultsA total of 59 public health emergencies were reported from 2004 to 2019， during which 1 252 patients and 6 death cases were involved. From 2004 to 2019， the number of public health emergencies in Putuo District first increased and then decreased， fluctuating at a low level yearly. Most of the emergencies were general events （72.88%， 43/59）. 69.49 percent （41/59） of the events were infectious diseases， and 67.80 percent （40/59） occurred in schools and child care institutes， with primary schools with the highest number of events. The peaks of infectious disease events occurred in June and November， while the majority of occupational poisoning and heat stoke events occurred in July and August， with 4 patients dead from heat stroke. The medians of events detection， verification， reporting and controlling timelines were 10.81， 3.00， 1.70 and 307.40 h； different categories of events varied in their detection and controlling time interval （all P<0.01）. Multiple linear regression analysis showed that events detection and verification timelines were correlated with controlling timelines （b=0.766， 0.758， F=3.84， 5.65， all P<0.01）. ConclusionsThe majority of public health emergencies in Putuo District are caused by infectious diseases， especially chicken pox. The prevention and control measures should be strengthened in schools. For occupational poisoning and heat stoke events， attention should be paid to different occupational groups. The capacity of emergency detection and verification should be enhanced to improve the efficiency of incident control.

Promoción de la educación inclusiva e intercultural: estudio de caso en un colegio rural colombiano / Promotion of Inclusive and Intercultural Education: Case study in a Colombian rural School / Promoção da Educação Inclusiva e Intercultural: Estudo de caso em una escola rural colombiana

Resumen Introducción: debido al fenómeno de globalización actual, cada vez es más necesario aportar una visión inclusiva e intercultural al ámbito educativo. No responder adecuadamente a esta demanda puede provocar situaciones de exclusión, segregación y discriminación del alumnado. El gobierno colombiano ha planteado diferentes acciones para fortalecer este enfoque y evitar dichas problemáticas. No obstante, estas acciones deben ser analizadas en profundidad para evidenciar la promoción de la educación inclusiva e intercultural en las instituciones educativas. Objetivo: el propósito de la investigación es determinar el nivel de conocimiento y ejecución de las prácticas inclusivas e interculturales en el Colegio Llano de Palmas (Colombia). Materiales y métodos: el diseño de investigación se acomete mediante un estudio de caso. La metodología utilizada es cuantitativa descriptiva (Hernández, Fernández & Baptista, 2010), implementando el cuestionario sobre el reconocimiento y aplicabilidad de la competencia inclusiva e intercultural. Resultados: el análisis de datos revela que la educación inclusiva e intercultural apenas se fomenta de forma regular en el centro educativo (10 %), siendo mayoritaria su promoción inadecuada (90 %) mediante una implementación esporádica (49 %), no aplicándose en absoluto (36 %) o desconociendo por completo su estado de desarrollo (5 %). Conclusiones: los resultados obtenidos indican que el conocimiento y la ejecución de prácticas inclusivas e interculturales en el Colegio Llano de Palmas es notablemente mejorable. Esta situación demanda el diseño y aplicación de estrategias específicas de promoción más efectivas, así como el análisis de distintos entornos educativos para determinar la situación actual del país en este sentido.

Abstract Introduction. Due to the current phenomenon of globalization, it is increasingly necessary to provide an inclusive and intercultural vision to the education. Not responding adequately to this demand can lead to situations of exclusion, segregation, and discrimination for students. The Colombian government has proposed several actions to strengthen this approach and avoid those problems. However, these actions must be analyzed in depth to demonstrate the promotion of inclusive and intercultural education in institutions. Objective: the purpose of this research is to determine the level of knowledge and execution of inclusive and intercultural practices at Llano de Palmas School (Colombia). Materials and methods: this research applies a case study design. The methodology used is descriptive quantitative (Hernández et al., 2010), implementing the questionnaire on the recognition and applicability of inclusive and intercultural competency. Results: the data analysis reveals that inclusive and intercultural education is hardly encouraged on a regular basis in the school (10 %), with a widely inadequate promotion (90 %) through sporadic implementations (49 %), not being applied at all (36 %), or being completely unaware of their development status (5 %). Conclusions: the results obtained indicate that the knowledge and execution of inclusive and intercultural practices at Llano de Palmas School is remarkably low. This situation demands the design and application of specific strategies for more effective promotion, as well as the analysis of different educational contexts to determine the current situation of the country in this regard.

Resumo Introdução: devido ao atual fenômeno da globalização, é cada vez mais necessário fornecer uma visão inclusiva e intercultural ao campo educacional. Não responder adequadamente a essa demanda pode levar a situações de exclusão, segregação e discriminação de estudantes. O governo colombiano propôs diferentes ações para fortalecer essa abordagem e evitar esses problemas. No entanto, essas ações devem ser analisadas em profundidade para demonstrar a promoção da educação inclusiva e intercultural nas instituições de ensino. Objetivo: o objetivo da pesquisa é determinar o nível de conhecimento e execução de práticas inclusivas e interculturais na Escola Llano de Palmas (Colombia). Materiais e métodos: o desenho da pesquisa é realizado através de um estudo de caso. A metodologia utilizada é quantitativa descritiva (Hernández et al., 2010), implementando o questionário sobre o reconhecimento e aplicabilidade da competência inclusiva e intercultural. Resultados: a análise dos dados revela que a educação inclusiva e intercultural dificilmente é incentivada regularmente no centro educacional (10 %), sendo sua promoção inadequada a maioria (90 %) através de implementação esporádica (49 %), não sendo aplicada de forma alguma (36 %) ou desconhecem completamente o seu estado de desenvolvimento (5 %). Conclusões: os resultados obtidos indicam que o conhecimento e na execução de práticas inclusivas e interculturais na Escola Llano de Palmas são notavelmente melhorados. Essa situação exige o desenho e aplicação de estratégias específicas para promoção mais efetiva, bem como a análise de diferentes ambientes educacionais para determinar a situação atual do país nesse quesito.

Awareness and Practices of Minimal Invasive Dentistry amongst Dental Interns - A Descriptive Analysis.

The current approach to management of caries has evolved towards minimal invasive dentistry comprising of early diagnosis of incipient lesions, remineralization and conservative dental treatment with minimal intervention if required. Despite the focus of the dental curriculum on minimal invasive dentistry, not much of it is adopted into practice by the students. We wanted to assess the knowledge, attitude, and skills of minimal invasive dentistry amongst the dental interns of Dakshina Kannada district. MethodsThe data was gathered through an online questionnaire developed and validated by experts. ResultsA total of 244 dental interns responded to the online questionnaire survey. Majority was aware of the principles of minimal invasive dentistry mainly through lectures, although not many had practiced it. Fluoride treatment was the most recommended treatment for the prevention of caries. Although most of them agreed that caries risk assessment was effective, nearly half of them had never practiced it. A greater part of the respondents agreed upon the effectiveness of preventive measures and conservative modalities of treatment in the current day practice. ConclusionsDespite the awareness and knowledge of minimal invasive dentistry amongst the interns of Dakshina Kannada population, the practice of minimal invasive dentistry should be taught to the students and should be implemented in routine dental practice.

Plagio en artículos de investigación en revistas biomédicas cubanas. 2016 / Plagiarism in Cuban biomedical research articles. 2016

Introducción: El plagio junto a la fabricación y falsificación de resultados constituyen las formas más graves de mala conducta científica. Sin embargo, la escasez de estudios concretos sobre esta mala práctica, motivó realizar la presente investigación. Objetivo: Caracterizar los artículos que incurren en plagio publicado en revistas biomédicas cubanas indizadas en SciELO, durante 2016. Material y métodos: Estudio descriptivo, transversal, con una muestra probabilística de 50 artículos originales, obtenida por muestreo aleatorio simple de 786 investigaciones publicadas en 32 revistas biomédicas cubanas indizadas en SciELO. Se realizó un análisis textual a través de Google Scholar, para identificar textos idénticos. Luego se cotejaron los artículos con similitudes, y se seleccionó como original el de fecha de publicación más antigua. Para el análisis se utilizó el Software RStudio 1.0.136. No se revelan títulos de artículos, autores, instituciones ni revistas en que se publicaron. Resultados: Más de la mitad de los artículos (52 por ciento) cumplía el criterio de plagio. Los hallazgos se encontraron en todas las secciones del artículo, fundamentalmente en introducción (52 por ciento), discusión (18 por ciento) y material y métodos (10 por ciento). El patrón de plagio más frecuente fue "en mosaico" (sustitución, adición, sustracción), seguido por "plagio directo" (copia exacta de bloques de texto). Conclusiones: La frecuencia de plagio en los artículos revisados es alta, con predominio hacia las estructuras teóricas del artículo (introducción y discusión), y fundamentalmente a partir del uso de sinónimos, cambios de verbos, adición y/o sustracción de texto, correspondiente al plagio en mosaico(AU)

Introduction: Plagiarism and the fabrication and falsification of results constitute the most serious forms of scientific misconduct. However, there is a lack of solid studies on this malpractice which motivated us to carry out this research work. Objective: To characterize the articles engaged in plagiarism published in Cuban biomedical journals indexed in SciELO in 2016. Material and Methods: A descriptive cross-sectional study was conducted using a probabilistic sample of 50 original articles obtained by simple random sampling of 786 research studies published in 32 Cuban biomedical journals indexed in SciELO. A textual analysis was performed using Google Scholar to identify identical texts. After that, similar articles were compared and the oldest data of publication was taken into account to determine the original article. R Studio Software 1.0.136 was used for the analysis. The titles of the articles, authors, institutions and journals were not shown. Results: More than half of the articles (52 percent) met the criteria of plagiarism. Similarities were found in all sections of the article, mainly in the introduction (52 percent), discussion (18 percent) and material and methods (10 percent). The most frequent pattern of plagiarism was in "mosaic" (substitution, addiction, subtraction), followed by "direct plagiarism" (exact copy of sections of text). Conclusions: The frequency of plagiarism in the articles reviewed is high, predominating in the theoretical structures of the article (introduction and discussion), where synonyms, changes in verbs, addition or omission of parts of the text were identified, corresponding to plagiarism in mosaic.

Nurse’s knowledge regarding importance of human milk and milk banking

Background: Breast milk is the complete nutrition for the babies during first 6 months of life. It is very important to feed the baby with breast milk during that crucial period of growth. Unavailability of breast milk can put the baby in life threatening conditions. In order to resolve the problem and to improve the mortality rate of neonates, nurses should have up to date information regarding the breast milk and its storage. Aim of this study was to assess the knowledge of nurses regarding importance of human milk and milk banking.Methods: Quantitative, descriptive research approach was used to assess the knowledge of 150 purposively selected nurses working in obstetric, gynae and pediatric wards in selected hospitals of Punjab by using socio-demographic sheet and self-structured questionnaire. Both descriptive and inferential statistical methods were used for the analysis of data.Results: Study findings revealed that majority of nurses 66% have adequate knowledge regarding importance of human milk and milk banking. Knowledge of nurses regarding importance of human milk and milk banking is significantly associated with working department.Conclusions: Study concluded that knowledge of nurses regarding importance of human milk and milk banking is satisfactory. But for the further improvement in knowledge of nurse’s in-service programs should be provided to them after regular intervals of time. So that they perform their work efficiently.

The Pattern of Neonatal Admission and Outcome in Special Care Newborn Unit of A Medical College Hospital in Northern Bangladesh

Background: Among the causes of under-five mortalityneonatal mortality contributes the highest. This indicatorpossesses a great impact towards achieving SDG forBangladesh. This study will help in understanding theindicators and to plan allowance of proper resource andplanning to the proper field.Objective: To describe the pattern of neonatal admission andoutcome in a level II SCANU in a medical college hospital innorthern part of Bangladesh.Method: A retrospective descriptive study of neonataladmissions in SCANU of Rangpur Medical College Hospitalfrom January 2017 to December 2019 total 2 years.Results: A total 6583 babies were admitted in this period.Among them 1808 (27.4%) was inborn and 4775(72.5%) outborn. Male 4103(62.3%) Female 2480(37.6%), male femaleratio 1.6:1. Major causes of admission was prematurity lowbirth weight 2786(42.3%), birth asphyxia 2100(31.9%),neonatal jaundice721 (10.9%), neonatal sepsis 710(10.8%),others 266(4.04%). Common Diseases contributing to deathwere prematurity low birth weight 246(39.6%), Birth asphyxia240 (38.6%), neonatal sepsis 86 (13.8%).Overall mortality ratewas 9.43%.Conclusion: Preterm low birth weight and its complicationswas the major cause of mortality while perinatal asphyxia wasthe important cause of admission among the outborn neonates.Most of the cases were preventable if we ensure properantenatal care and counselling for hospital delivery, properresuscitation practice and timely referral to facility.Improvement in neonatal care at different levels will furtherreduce the neonatal mortality.

Epidemiology of Gallbladder Cancer in North India - a Radiological Descriptive Study

Introduction: Gallbladder cancer (GBC) is one of thecommonest cancers in North India. Despite the high incidence,very little data is available of the staging distribution ofGBC in this region. We aimed at getting a snapshot of thedistribution of GBC at a single high volume centre.Material and Methods: One hundred and forty sevenpatients who were evaluated between 1st July 2017 and 31stOctober 2018 for staging of GBC, were included in this study.Radiological staging was done according to the AJCC TNM8th edition using a standardized reporting format.Results: Majority of patients were females (70%). Fundus ofGB was the most common site of tumor (39.4%) and liver(76.8%) was the most common adjacent organ involved aswell as the most common site of metastatic disease (36%).Only 42 (28.5%) patients had non-metastatic disease.Biliary obstruction was present in 63 (42.8%) patients, withmajority being type 2 hilar blocks (65%). Loco-regional nodalinvolvement was present in 87.1% patients, station 12 nodalinvolvement being most common (76.1%).Conclusion: This is the first study to describe the distributionof GBC stages in the high incidence region of North India.This should provide information for future research andfunding for GBC related research.

Supervivencia en mujeres con cáncer de mama. Hospital "José Ramón López Tabranes". Provincia Matanzas. 2010-2015 / Survival in women with breast cancer. Hospital "Jose Ramon Lopez Tabrane".Province of Matanzas. 2010-2015

RESUMEN Introducción: en el último trienio la mortalidad por cáncer mamario en el sexo femenino en Cuba disminuyó ligeramente sus tasas, sin embargo no se han realizado estudios de supervivencia por esta enfermedad en la provincia Matanzas. Objetivo: evaluar el comportamiento del tiempo de supervivencia global a los 5 años en esta serie y valorar la sobrevida en función de variables seleccionadas. Materiales y métodos: se realizó un estudio observacional descriptivo, longitudinal y retrospectivo, en el que participaron 288 mujeres diagnosticadas con cáncer de mama en la consulta de mastología del Hospital "José Ramón López Tabranes" de la provincia Matanzas, desde el 1 de Enero del 2010 hasta el 31 de Diciembre del 2015. Se utilizó el método de Kaplan Meier para determinar el tiempo de supervivencia global a los 5 años y en función de variables seleccionadas. La comparación de las diferentes curvas para las variables de exposición se realizó con la prueba de Rangos Logarítmicos (Log Rank). Se consideró estadísticamente significativo el valor del estadígrafo mayor de 1 y p < 0.05. Resultados: la supervivencia global a los 5 años fue de un 66 %. Se registran supervivencias muy por debajo de los estándares internacionales para las pacientes en estadios III (37 %) y IV (0). La supervivencia global disminuye de manera significativa en la medida en que se incrementan el número de ganglios afectados y el tamaño del tumor al momento del diagnóstico. Conclusiones: la supervivencia global a los 5 años resultó inferior a la registrada en la mayoría de los estudios internacionales consultados. Se muestra una disminución marcada de la sobrevida en pacientes con estadios clínicos avanzados de la enfermedad: (III y IV).

ABSTRACT Introduction: in the last three years, mortality rates due to breast cancer in the female sex in Cuba slightly decreased, but studies of this disease survival have not been carried out in the province of Matanzas. Objective: to evaluate the behavior of the global survival time of this series at the 5th year and to assess survival according to chosen variables. Material and method: a retrospective, longitudinal, observational descriptive study was carried out; 288 women diagnosed with breast cancer took part on it; they were diagnosed in the mastology consultation of the hospital "Jose Ramon Lopez Tabrane", province of Matanzas during the period January 1st 2010- December 31st 2015. The Kaplan-Meier method was used to determine the global survival time at the 5th year according to chosen variables. The comparison of the different curves for the exposition variables was made using the Log Rank test. The test value higher than 1 and p < 0.05 was considered statistically significant. Results: global survival at the 5th year was 66 %. There are survival rates well below the international standards for the stage III (37 %) and stage IV (0) patients. Global survival significantly decreases insofar as the number of affected ganglia and the size of the tumor at the moment of the diagnosis increase. Conclusions: global survival at the 5th year was lower than the one recorded in most of the consulted international studies. There is a remarkable decrease of survival in patients with disease advanced clinical stages: III and IV.

Study of profile of cases and complications of ileal perforation at KMCH, Katihar

Background: Bowel perforation is an important cause of acute abdomen. It carries high morbidity and mortality. Materials and methods: The present descriptive study included 48 patients with ileal perforation admitted at the department of surgery. Data regarding clinical features, management and complications was noted. Results: Mean age of the patients was 34.4 ± 8.8 years with male preponderance. Abdominal pain and distension (100%) and constipation (87.5%) were the common symptoms seen. Single perforation was commoner (64.6%) than multiple perforations. It was caused by typhoid in 39.6% cases, due to tuberculosis in 16.7%, due to injury in 10.4% and other causes in 33.3% cases. Surgical site infection was the commonest complication. Conclusion: Ileal perforation is caused by typhoid or tuberculosis in majority of the cases and presents with pain abdomen and distension. Rates of infection are high in these cases.

Pelvic Inflammatory Disease (pid): A Cross Sectional Prospective Study At A Tertiary Care Centre

Introduction : Pelvic inflammatory disease (PID) is aninfectionof the upper part of thefemale reproductive sys-temnamely theuterus,fallopian tubes, andovaries, and inside of thepelvis. Objective: to find out the clinical profile of PID in a tertiary care centre. Methods:This was a cross sectional, descriptive study conducted at the Department of Obstetrics and Gynaecology, during period from January to December2016. Total 200 patients complaining of low-er abdominal pain, vaginal discharge & having adnexal as well as cervical motion tenderness on bimanual examina-tion between the age group of 18 -45 years were randomly selected for study. Parameters like age, parity, socio-economic status, age of marriage, sexual behavior, Presenting complaints and use of contraceptive were recorded. Results:Most common age group was 20-24 years (29.5%).Maximum number of cases was seen in parity between 2-5 (58%).PID was commonest amongst illiterate women (36%). Maximum number of cases was seen in women from lower socioeconomic class (74%).Out of 200 cases, 79% patients were married, 14 % were remarried.Presenting complaints were pain in abdomen (93.5%), per vaginal discharge (66%), fever (51%).Abdominal tenderness was seen in 95 % of cases. Palpable mass was present in 11 % of cases. Forniceal & cervical motion tenderness were the com-monest Per Vaginal examination findings seen in 89% & 84% cases respectively.Conclusion:Incidence of PID was higher in age group between 20-29 years, multipara, women from lower socioeconomic class & illiterate women. Pain in lower abdomen, per vaginal discharge & fever were the commonest complaints. Most of the patients on ex-amination had forniceal & cervical motion tenderness.

Clinical characteristic and management of Peters anomaly / 中华实验眼科杂志

Background Peters anomaly is a rare eye disease.Understanding the clinical features of Peters anomaly is helpful for us to correctly manage this disease.Objective This study was to investigate the clinical characteristics and treatment methods of Peters anomaly and provide available basis for the diagnosis and individualized treatment of Peters abnormal.Methods A descriptive study was performed.The clinical data from 8 eyes of 4 patients with Peters anomaly who were diagnosed and treated in Beijing Children's Hospital from January 1,2014 to March 30,2016 were retrospectively analyzed.The clinical manifestations of the anterior ocular segment were examined by handheld slit-lamp microscope,and corneal curvature,corneal thickness,axial length and intraocular pressure were measured.The therapy and outcomes of the patients were evaluated.Results Peters anomaly was classified into type Ⅰ,type Ⅱ and Peters plus syndrome based on the findings and literature'criteria.Regarding to the clinical findings,the adhesion of peripheral angle with cornea,shallow or disappeared anterior chamber were found in all the eyes,and these manifestations were type Ⅰ Peters anomaly and occurred in 2 eyes of 2 patients.The opacity and adhesion of the central lens capsula to corneal endothelium was seen in 6 eyes which belonged to type Ⅱ Peters anomaly.The mean corneal thickness was (680± 127) μm in 4 measured eyes,which was thicker than normal eyes;the mean corneal curvature was (37.40±1.79)D in 4 measured eyes;the mean axial length was (21.06±0.19)mm and the mean diameter of cornea was (9.4 ± 0.5) mm in 4 measured eyes.Iridocoloboma was found in 4 eyes and congenital aniridia was in 4 eyes.In addition,esotropia appeared in 1 patient,and nystagmus occurred in 3 patients.The 3 patients of type Ⅱ in this study were found to have the disorders associated with systemic neurogenic developmental abnormalities and diagnosed as Peters plus syndrome.Trabeculectomy with anterior vitrectomy was performed in 2 eyes with the intraocular pressure ＞30 mmHg(1 mmHg =0.133k Pa) and the introcular pressure reduced to below 21 mmHg after operation.Penetrating corneal transplantation was carried out on 1 eye with central opacity.However,rejection of graft occurred at 1 month and became complete cloudy at 3 months after surgery.Cataract extraction surgery was performed on 4 eyes with lens opacity and intraocular lens were implanted in 2 eyes or iridectomy was carried out in another 2 eyes,and the visual quality was evidently improved after operation.Conclusions The clinical characteristics of Peters anomaly include leukoma,shallow anterior chamber,peripheral iris adhesion with cornea and lens opacity due to adhesion of lens anterior capsule to corneal endothelium.Personalized operative regimen should be determined based on the clinical findings of the eyes with Peters anomaly.

Estudo descritivo dos exames de manometria anorretal realizados no laboratório de motilidade digestiva da Santa Casa de Misericórdia, Porto Alegre, Brasil / A descriptive study of anorectal manometry tests performed in the laboratory of digestive motility of Santa Casa de Misericórdia in Porto Alegre, Brazil

Introdução: A manometria anorretal é, atualmente, o padrão ouro, como método de diagnóstico laboratorial dos distúrbios evacuatórios. O objetivo do presente estudo é descrever uma experiência brasileira, da realização da manometria anorretal, valorizando-a como meio diagnóstico. Métodos: Estudo retrospectivo, com revisão dos laudos dos exames, no Laboratório de Motilidade Digestiva da Santa Casa de Misericórdia de Porto Alegre, Brasil. Foram incluídos os pacientes consecutivos, acima de 12 anos de idade, submetidos à manometria anorretal, entre março de 2003 e outubro de 2015. Resultados: No período, foram realizados 1319 exames, em pacientes com média de idade de 53,4±19,4 anos, sendo 70,7% do sexo feminino. A incontinência anal, com 62,4% dos exames, foi a principal indicação da manometria anorretal, a segunda foi constipação com 29,4% e por outros motivos em 8,2% dos pacientes. No período entre 2011 e 2015, houve um aumento significativo dos exames realizados por incontinência anal, em relação ao de 2003 até 2010. Conclusões: As duas principais indicações da manometria anorretal, no presente estudo e na literatura, são constipação e incontinência anal. O aumento significativo dos exames por incontinência anal, após 2011, sugere uma maior consciência dos médicos e pacientes em relação às possibilidades de diagnóstico e tratamento das disfunções evacuatórias. Este é o primeiro estudo brasileiro, que discute as indicações da manometria anorretal e as características dos pacientes encaminhados para o exame. Os autores sugerem a valorização da manometria anorretal como ferramenta de diagnóstico nas disfunções evacuatórias AU)

Introduction: Anorectal manometry is currently the gold standard for laboratory diagnosis of bowel disorders. The aim of the present study is to describe a Brazilian experience in performing anorectal manometry, valuing it as a diagnostic tool. Methods: A retrospective study, with review of test reports, in the Digestive Motility Laboratory of Santa Casa de Misericórdia, Porto Alegre, Brazil. We included consecutive patients, over 12 years of age, undergoing anorectal manometry from March 2003 to October 2015. Results: 1319 tests were performed in the studied period in patients with mean age of 53.4 ± 19.4, 70.7% of whom females. Anal incontinence, accounting for 62.4% of the tests, was the main indication for anorectal manometry, the second was constipation with 29.4%, and other reasons in 8.2% of the patients. In the 2011-2015 period there was a significant increase in the number of tests due to anal incontinence as compared to the 2003-2010 period. Conclusions: The two main indications for anorectal manometry in this study and in the literature are constipation and anal incontinence. The significant increase in the number of tests performed due to anal incontinence after 2011 suggests clinicians' and patients' greater awareness of the possibilities for diagnosis and treatment of bowel dysfunction. This is the first Brazilian study discussing the indications of anorectal manometry and the characteristics of the patients referred to the test. The authors suggest the use of anorectal manometry as a diagnostic tool in evacuation dysfunctions (AU)

Device-associated healthcare-associated infection in intensive care unit of a university hospital in China:a descriptive study / 中国感染控制杂志

Objective To identify the occurrence and microorganism profile of device-associated healthcare-associa-ted infections (DA-HAIs)in the intensive care unit (ICU)of a university hospital in China.Methods From Janua-ry 1 to November 30,2015,patients admitted to the ICU of a university hospital in China for more than 48 hours were performed prospective descriptive study. DA-HAIs were defined according to the criteria of the Centers for Disease Control and Prevention (CDC)of U.S.,descriptive statistical analysis was performed.Results Of 254 pa-tients admitted to ICU,the overall incidence of DA-HAIs was 15.35% ,with 10.23 cases of DA-HAIs per 1 000 ICU-days;the incidence of ventilator-associated pneumonia (VAP ),catheter-associated urinary tract infection (CAUTI),and central line-associated bloodstream infection (CLABSI)were 7.05 per 1 000 ventilator-days,4.91 per 1 000 urinary catheter-days,and 3.22 per 1 000 central line-days,respectively. The main infection site was lower respiratory tract,accounting for 48. 27% ,followed by bloodstream system (27. 59% ),urinary tract (22.99% ),and gastrointestinal tract(1.15% ). The major isolated microorganism was Acinetobacterbaumannii (21 .52% ).Conclusion The surveillance system can identify the epidemiological status of DA-HAIs and make effec-tive control measures to ensure the healthcare safety.

Burnout en estudiantes de pregrado de medicina y su relación con variables de personalidad / Burnout in undergraduate medical students and its relationship with personality variables

El objetivo de esta investigación fue analizar la asociación entre autoeficacia percibida, personalidad resistente, locus de control, percepción de estrés y síndrome de Burnout en 40 estudiantes de medicina de pregrado. El análisis de los datos se efectuó considerando estadística descriptiva y técnicas exploratorias multivariadas. Los resultados muestran la pertinencia que puede tener la personalidad resistente en la atenuación del estrés crónico al asociarse negativamente con el síndrome de Burnout y agruparse dentro de los componentes que explicaban mayor variación en la combinación lineal de variables en comparación con la autoeficacia y el locus de control. Se confirma la necesidad de reforzar la formación de los estudiantes de medicina a través del establecimiento de recursos de afrontamiento ante el estrés y formación de una personalidad resistente, ya que los datos muestran niveles altos en percepción de estrés y síndrome de Burnout a seis meses de estar realizando el internado.

The objective of this research was to analyze the association between perceived self-efficacy, hardiness, locus of control, perceived stress and Burnout syndrome in 40 undergraduate medical students. The data analysis was performed considering descriptive statistics and multivariate exploratory techniques. The results show the relevance that may have the hardiness in the attenuation of chronic stress negatively associated with Burnout and grouped within components that explained more variation in the linear combination of variables compared to self-efficacy and locus of control. The need to strengthen the training of medical students through the establishment of resources Coping Stress and formation of a strong personality is confirmed as the data show high levels of perceived stress and Burnout six months of doing the internship.

Características epidemiológicas, clínicas y bioquímicas de los pacientes pediátricos con cetoacidosis diabética. Hospital de Especialidades Pediátrica Omar Torrijos Herrera 2003-2011

Introducción. La cetoacidosis diabética (CAD) es una complicación importante de la diabetes mellitus tipo 1 (DM1) que se presenta de novo o en pacientes ya diagnosticados, sin datos publicados en la literatura nacional. Objetivos. Describir las características epidemiológicas, clínicas y bioquímicas de los pacientes admitidos al Hospital de Especialidades Pediátricas "Omar Torrijos Herrera" (HEPOTH) con diagnóstico de CAD. Métodos. Se realizó una revisión retrospectiva de los expedientes clínicos de los pacientes con diagnóstico de CAD admitidos a las salas de hospitalización del HEPOTH para describir las variables edad, sexo, glicemia, gravedad de la CAD, tiempo de resolución, complicaciones y uso de bicarbonato. Se utilizó estadística descriptiva (frecuencias, media y desviación estándar) y analítica con α=0.05 para cada comparación. Resultados. Encontramos 58 casos de CAD (28 masculinos, 30 femeninos). Observamos un pico bimodal de frecuencias entre los 8 y 11 años para ambos sexos. En el 62% de los casos no se encontró un factor evidente para la descompensación. Las variables metabólicas de todos los casos fueron evaluadas y se establecieron las medias (desviación estándar) de glicemia (530.9 [144.9]), bicarbonato (8.16 [3.58]) y pH (7.12 [0.12]). Se observó que, a mayor gravedad, menor valor de bicarbonato y de pH sanguíneo; además de una relación inversa, estadísticamente significativa (p<0.001) entre el pH al inicio del tratamiento con el tiempo requerido hasta alcanzar el pH de 7.30. La complicación más frecuente fue la hipokaliemia (44.8%). El edema cerebral ocurrió en 9% de los casos, de los cuales se registró una muerte (tasa de letalidad cruda = 1.7%). Conclusiones. La CAD es más frecuente entre los 8 y 11 años de edad y usualmente se presenta con criterios de gravedad. La hipokaliemia es la complicación más frecuente y el factor predisponente es difícil de detectar. A pesar de la baja letalidad encontrada, se debe vigilar por edema cerebral.

Background Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus, presenting either de novo or in patients already diagnosed, without data published in the national literature. Aims To describe the epidemiological, clinical, and biochemical characteristics of patients admitted to the "Omar Torrijos Herrera" Pediatric Specialties with diagnosis of DKA. Methods We performed a restrospective review of clinical records of patients diagnosed with DKA admitted to the wards of the Hospital to describe the variables age, sex, glycemia, DKA severity, time to resolution, complications, and use of bicarbonate. Descriptive (frequencies, mean, standard deviation [SD]) and analysitcal statistics were used with α=0.05 for each comparison. Results We found 58 cases of DKA (28 males, 30 females). We observed a bimodal peak of frequencies between ages 8 and 11 for both genders. In 62% of the cases there was no evident factor for the descompensation. Metabolica variables in all of the cases were assessed and mean (SD) of glycemia (530.9 [144.9]), bicarbonate (8.16 [3.58]) and blood pH (7.12 [0.12]) were established. The higher the severity, the lower bicarbonate and blood pH value; besides an inverse and statistically significant relationship (p<0.001) between pH at the beginning of the treatment and the time required to reach a blood pH value of 7.30. The most frequent complication was hypokalemia (44.8%). Cerebral edema occurred in 9% of the cases, among which one decease was registered (crude lethality rate = 1.7%). Conclusions Diabetic ketoacidosis is more frequent between 8 and 11 years of age and usually presents with severity criteria. Hypokalemia is the most frequent complication and the predisposing factor is difficult to detect. Even though we found a low lethality rate secondary to cerebral edema, this complication must be always beared in mind.