Ormeloxifene in the management of abnormal uterine bleeding in tertiary care centre South Kerala

Background: AUB is the most common presentation in the reproductive age group. Many females suffer from AUB and its related effects. A study on the effectiveness of an easily available drug (ormeloxifene) with an easy dosing schedule was done and its wonderful role in controlling the symptoms and improvement of quality of life of a female with no financial burdens and surgical morbidity was studied.Methods: A hospital based prospective observational study was conducted among women attending the outpatient clinic of OBG department at Dr Somervell Memorial CSI Medical College, Karakonam, Trivandrum district.Results: Total 50 women with AUB took part in the study. 62% had menstrual duration of <7 days with regular cycles (84%). 86% of them had history of passage of clots. 48% of them had dysmenorrhea. Efficacy of ormeloxifene was assessed by using PBAC score and haemoglobin level measurement. A repeated measures ANOVA with a Greenhouse-Geisser correction determined mean PBAC score differed significantly between months. Post hoc analysis with a Bonferroni adjustment revealed PBAC score was statistically significantly decreased from pre-intervention to 3 months to 6 months. There is statistically significant difference with respect to haemoglobin level improvement.Conclusions: Ormeloxifene is an excellent drug in controlling AUB as evidenced by the PBAC score and haemoglobin levels. Ormeloxifene has better compliance and acceptability. It is cost effective with a simple dosage schedule. A significant decrease in the menstrual blood loss and marked improvement in the hemoglobin concentration.

Epidemiology of female infertility in Sonepat district of Haryana: a community based cross-sectional study

Background: Infertility is a global reproductive health problem and the prevalence rate increased by 0.37% per year for females. There are many such risk factors which are avoidable. Thus the purpose of the study is to identify and quantify the burden of infertility and associated risk factors for infertility. Methods: This observational community based cross-sectional study was conducted among 444 reproductive age group (18-49 years) women residing in district Sonepat, from August 2021 to May 2022. Simple random sampling technique was used to select the study subjects. The categorical data were analyzed statistically using Chi-Square test and Odds ratio with 95% confidence interval. Continuous variables were analyzed using independent t-test. Results: Out of 444 study population majority of women were fertile (88.7%), while 6.3% of women were secondary infertile and 5% women were primary infertile. Most women were aged between 30-39 years. The difference of occurrence of infertility in relation to time since marriage, male age at marriage, number of family members, thyroid, PCOD, tuberculosis and height were statistically significant. Conclusions: Almost all the factors came out to be responsible for infertility were modifiable. Awareness generation and provision of infertility care services at primary health care facilities will be of use in addressing infertility in Haryana.

Volumetric Assessment of the Insula in a Normally Functioning Human Brain Using Magnetic Resonance Imaging / Evaluación Volumétrica de la Ínsula en un Cerebro Humano que Funciona Normalmente Utilizando Imágenes de Resonancia Magnética

SUMMARY: Volumetric assessment of brain structures is an important tool in neuroscience research and clinical practice. The volumetric measurement of normally functioning human brain helps detect age-related changes in some regions, which can be observed at varying degrees. This study aims to estimate the insular volume in the normally functioning human brain in both genders, different age groups, and side variations. A cross-sectional retrospective study was conducted on 42 adult Sudanese participants in Al-Amal Hospital, Sudan, between May to August 2022, using magnetic resonance imaging (MRI) and automatic brain segmentation through a software program (BrainSuite). The statistical difference in total insular volume on both sides of the cerebral hemisphere was small. The insular volume on the right side was greater in males, while the left side showed no difference between both genders. A statistically significant difference between males and females was found (p > 0.05), and no statistical difference in different age groups was found according to the one-way ANOVA test (p>0.05). Adult Sudanese males showed a larger insular volume than females. MRI can be used to morphometrically assess the insula to detect any pathological variations based on volume changes.

La evaluación volumétrica de las estructuras cerebrales es una herramienta importante en la investigación y la práctica clínica de la neurociencia. La medición volumétrica del cerebro humano, que funciona normalmente, ayuda a detectar cambios relacionados con la edad en algunas regiones, las cuales se pueden observar en diversos grados. Este estudio tuvo como objetivo estimar el volumen insular en el cerebro humano que funciona normalmente, en ambos sexos, de diferentes grupos de edad y sus variaciones laterales. Se realizó un estudio retrospectivo transversal en 42 participantes sudaneses adultos en el Hospital Al-Amal, Sudán, entre mayo y agosto de 2022, utilizando imágenes de resonancia magnética y segmentación automática del cerebro a través de un software (BrainSuite). Fue pequeña la diferencia estadística en el volumen insular total, en los hemisferios cerebrales. El volumen insular del lado derecho fue mayor en los hombres, mientras que el lado izquierdo no mostró diferencia entre ambos sexos. Se encontró una diferencia estadísticamente significativa entre hombres y mujeres (p > 0,05), y no se encontró diferencia estadística en los diferentes grupos de edad, según la prueba de ANOVA de una vía (p> 0,05). Los hombres sudaneses adultos mostraron un mayor volumen insular que las mujeres. La resonancia magnética se puede utilizar para evaluar morfométricamente la ínsula y para detectar cualquier variación patológica basada en cambios de volumen.

STUDY OF ADNEXAL MASS IN REPRODUCTIVE AGE GROUP WOMEN AND THEIR OUTCOME

BACKGROUND: Adnexal masses is a significant condition commonly seen in women’sreproductive age. Most common masses arise from ovaries due to their complexembryologic & histologic origin. For diagnosis, ultrasonography is the gold standard.Laproscopy is the gold standard surgical intervention.METHODS: This study was a prospective study that was conducted at a tertiary carehospital in the obstetrics and gynecology department from October 2021 to December2021.RESULTS: In this study, No. 31% of the patients were between the ages of 26 and 35.Of the patients, 12.90% came from the upper socioeconomic class, 72.58% from themiddle, and 14.51% from the lower socioeconomic class. The most common complaintwas abdominal pain (41.93%) followed by menstrual irregularities (25.80%). 46.77% ofpatients were managed medically. In 32.25% of patients, laparoscopy was performed andin 20.96% of patients, laparotomy was performed.CONCLUSION: Adnexal masses are a very common gynecological problem, Presentwith abdominal pain / other symptoms /an incidental finding on ultrasonography done forother purposes. So, the basic approach should be early diagnosis and appropriate medicalor surgical treatment, to minimize morbidity and avoid mortality.

Prevalence and pattern of alcohol consumption among women of reproductive age group in urban settings of Sikkim: a cross sectional study

Background: Alcohol consumption by women of reproductive age group not only affects their health but can also cause multiple adverse birth outcomes. The objectives of the study were to assess the prevalence and pattern of alcohol consumption among women of reproductive age group in urban field practice areas of Sikkim Manipal Institute of Medical Sciences (SMIMS) by using a structured questionnaire and WHO tool, AUDIT (Alcohol Use Disorder Identification Test). Methods: The study was a cross sectional study. A total of 284 women of reproductive age group (15-49 years) were interviewed using a structured questionnaire and AUDIT. Results: The overall prevalence of alcohol consumption was 36.6%. Proportion of alcohol users was more among women of 25-34 years. Almost 95% of the women are current users (alcohol use in past 12 months). Beer was mostly preferred over other types of alcoholic beverages. Social customs (36.5%) and stress (25%) were the main reasons for consumption of alcohol. Based on AUDIT score, low risk drinking 68.6% was the predominant drinking pattern reported. However, one fourth of the women fall into hazardous pattern of drinking and 3 out of every 100 women had harmful and dependent pattern of drinking respectively. Conclusions: The present study highlights the prevalence of alcohol consumption among women of reproductive age group in urban field practice areas of SMIMS. Socio-cultural factors and stressful life plays an influential role in consumption of alcohol. Although low risk drinking is the predominant pattern of alcohol use, an alarming 31% of women consuming alcohol are at risk of developing alcohol related harm.

Study of Deliberate Self-Poisoning Among Adult Females in A Tertiary Care Hospital

Background: Poisoning is a common medico-social problem in our country causing around 300,000 episodes and around 2000 deaths per year. Attempted suicide among adult females are a major public health problem. The number of self-poisoning in females are increasing in our country day by day. The incidence, nature, etiology, age group affected and the outcome of self-poisoning in females of our country is different from that of the western world. Objective: The objective of the study was to analysis the socio-demographic profile & pattern of deliberate self-poisoning among adult females admitted in the Medicine Department, Dhaka Medical College Hospital. Material and Methods: This was a descriptive cross sectional study conducted in the Department of Medicine, Dhaka Medical College Hospital from January 2016 to June 2016. 100 admitted female participants were enrolled in this study as study population. A purposive sampling method was applied for sampling from study population. Results: The age of the participants were from 18 to 55 years with the mean age of 28.19 (± 9.84) years. Most number of the participants were in 21-29 year’s age group (42%) followed by ?20 year’s (29%). House wife (30%) was the most common occupation followed by student (25%). Most of the participants were from lower economic class (51%), followed by middle class (41%). 48% participants were in primary level, 24% in secondary level and 22% were illiterate. Most of the participants were married (51%), followed by unmarried (35%), divorced (9%) and widow (5%). 62% participants from rural and 38% from urban area. 75% were Muslim and 25% were Hindu. 55% were from the joint family and 45% were from the nuclear family. Most of the self-poisoning occurred between 6 am to 12 pm (42%), followed by 6 pm to 12 am (30%), 12 pm to 6 pm (20%) and 12 am to 6 am (8%). Insecticide was the most common poison materials (43%), followed by drug ingestion (30%), household detergent (13%), rodenticide (6%) and others (8%). Maximum participants reported the reason for self-poisoning was family disharmony (35%) followed by romantic disappointment (27%). 17% participants reported previous suicidal attempt and 11% had previous psychiatric disorder. Nearly half of the participants (43%) sought medical care within 2 hours and one fourth participants (31%) within 4 hours. About two-thirds of the participants (66%) received primary medical care from different govt. hospitals. Most of the female participants with self-poisoning were recovered completely (71%), while 20% participants recovered with complications and 9% participants died. In the study, fatality rate was found 33.3% in rodenticide and 16.3% in insecticide poisoning. Conclusions: As evident from the study, by intervene these problems by various measures might be helpful to prevent many of deliberate self-harm. Early diagnosis and prompt institution of appropriate treatment can make a favorable outcome in deliberate self-poisoning of female participants.

Clinical features of children with coronavirus disease 2019 in different age groups during the epidemic of Omicron variant / 中国当代儿科杂志

OBJECTIVES@#To study the differences in the clinical features of children with coronavirus disease 2019 (COVID-19) in different age groups during the epidemic of Omicron variant.@*METHODS@#A retrospective analysis was performed on the clinical data of 211 children with COVID-19 who were admitted to the Department of General Pediatrics, Zhongshan People's Hospital, from December 9, 2022 to January 8, 2023. According to their age, they were divided into 4 groups: 1 month-<1 year (n=84), 1-<3 years group (n=64), 3-<5 years (n=29), and ≥5 years (n=34). The above groups were compared in terms of general status, clinical features, ancillary examination results, treatment, and outcome.@*RESULTS@#The children aged <3 years accounted for 70.1% (148/211) of all hospitalized children with COVID-19, and the 3-<5 years group and the ≥5 years group had a significantly higher proportion of children with underlying diseases than the 1 month-<1 year group and the 1-<3 years group (P<0.05). Compared with the other three groups, the 1 month-<1 year group had significantly higher incidence rates of dyspnea, nasal congestion/nasal discharge, diarrhea and significantly lower incidence rates of convulsion and nervous system involvement (P<0.05). Moreover, compared with the other three groups, the 1 month-<1 year group had significantly higher incidence rates of increases in bile acid and creatine kinase isoenzyme and significantly lower incidence rates of decreased platelet count, increased neutrophil percentage, and decreased lymphocyte percentage (P<0.05). The 1 month-<1 year group had a significantly higher incidence rate of mild COVID-19 than the 1-<3 years group and a significantly lower incidence rate of severe/critical COVID-19 than the other three groups (P<0.05). Compared with the other three groups, the 1 month-<1 year group had a significantly higher proportion of children receiving oxygen inhalation therapy (P<0.05).@*CONCLUSIONS@#Children with COVID-19 in different age groups have different clinical features during the epidemic of Omicron variant, especially between the children aged 1 month to <1 year and those aged ≥1 year.

Life cycle phases: Literature review and new classification proposal for application in healthcare

ABSTRACT Introduction: Although uncommon in dentistry, the concept of the life cycle holds great importance for dental professionals in identifying crucial intervention opportunities and determining the optimal timing for treatments and procedures. Objective: To carry out a review of the literature on life cycle classifications and their distinct phases, evaluating their applicability in healthcare. Methods: A literature review was performed, searching for articles in PubMed, SciELO, National Health Library (BvB), and Google Scholar databases, as well as relevant books. The keywords "life cycle," "life stages," "human development," "age groups," and "biological age" were used. Relevant articles were selected by analyzing their titles and abstracts, and read in full to confirm their inclusion in the research. Results: Nine distinct life cycle classifications were found, each with unique criteria. Conclusion: Based on the comprehensive literature review, a novel classification was proposed (The 10-phase Life Cycle), which encompasses dental, growth, physiological aging, sociocultural, and behavioral characteristics, aiming to enhance communication among healthcare professionals, particularly those engaged in the growth, development, and aging processes of human beings.

RESUMO Introdução: Embora incomum na Odontologia, o conceito de ciclo vital é de grande importância para ajudar os profissionais dessa área a identificar oportunidades cruciais para intervenções e para determinar o momento ideal para tratamentos e procedimentos. Objetivo: Realizar uma revisão da literatura sobre as classificações do ciclo vital e suas distintas fases, avaliando sua aplicabilidade na área da saúde. Métodos: Foi realizada uma revisão da literatura, buscando artigos nas bases de dados PubMed, SciELO, Biblioteca Nacional de Saúde (BvB) e Google Acadêmico; além de livros relevantes. Foram utilizadas as palavras-chave "ciclo vital", "estágios de vida", "desenvolvimento humano", "faixas etárias" e "idade biológica". Os artigos relevantes foram selecionados por meio da análise de seus títulos e resumos e lidos na íntegra para confirmar sua inclusão na pesquisa. Resultados: Nove classificações distintas de ciclo vital foram encontradas, cada uma com critérios únicos. Conclusão: Com base nessa revisão abrangente da literatura, é proposta uma nova classificação (o ciclo vital de 10 fases) que engloba características dentárias, de crescimento, envelhecimento fisiológico, socioculturais e comportamentais, com o objetivo de melhorar a comunicação entre os profissionais da área de saúde, particularmente aqueles envolvidos nos processos de crescimento, desenvolvimento e envelhecimento do ser humano.

Conjunctivitis epidemiological profile in an ophthalmological service in the metropolitan region of Fortaleza - Ceará ­ Brazil / Perfil epidemiológico da conjuntivite em um serviço oftalmológico na região metropolitana de Fortaleza - Ceará ­ Brasil

Objective: to evaluate the seasonal and endemic characteristics of conjunctivitis at the ophthalmology service of the Leiria de Andrade Foundation (FLA) in the last ten years to trace the epidemiological profile of conjunctivitis in Fortaleza - CE. Methods: this was a descriptive and epidemiological study based on quantitative and qualitative analysis, retrospectively, from January to December 2012 to 2019, with a projection for the years 2020 and 2021. Results: 107,778 medical records were analysed, with endemic and seasonal fluctuation, being the months of October to December more frequent in the intervals of the highest incidence of the disease. Two peaks were notorious, one with epidemic characteristics, from July 2013 to November 2014, and the other with outbreak characteristics, probably due to a national-level epidemic, between January and April 2018. The most affected age group was between 19 and 59 years, covering about 72% of cases, with no statistical difference between genders. Conclusion: according to the study data, it was possible to infer that the epidemiological scenario of Fortaleza - CE is in line with the literature regarding age range and sex. The endemicity of the disease reinforces its relevance in the scenario of the Unified Health System (SUS) of the region.

Objetivo: avaliar as características sazonais e endêmicas da conjuntivite no serviço de oftalmologia da Fundação Leiria de Andrade (FLA) nos últimos 10 anos, a fim de traçar o perfil epidemiológico da conjuntivite em Fortaleza - CE. Métodos: estudo descritivo e epidemiológico, com base em análise quantitativa e qualitativa, retrospectivamente, de janeiro a dezembro de 2012 a 2019, com projeção para os anos de 2020 e 2021. Resultados: foram analisados 107.778 prontuários, com variação endêmica e sazonal, estando os meses de outubro a dezembro com maior frequência dentro dos intervalos de maior incidência da doença. Notaram-se dois picos, um com características epidêmicas, de julho de 2013 a novembro de 2014, e outro com características de surto, provavelmente decorrente de uma epidemia de nível nacional entre janeiro e abril de 2018. A faixa etária mais afetada foi entre 19 e 59 anos, compreendendo cerca de 72% dos casos, sem diferença estatística entre os gêneros. Conclusão: de acordo com os dados do estudo, foi possível inferir que o cenário epidemiológico de Fortaleza - CE está de acordo com a literatura quanto à faixa etária e ao sexo. A endemicidade da doença reforça sua pesquisa no cenário do Sistema Único de Saúde (SUS) da região

Bilateral multifocal choroiditis with disc edema in a 15-year-old girl following COVID-19 vaccination

A few cases of posterior uveitis following COVID-19 vaccination have been reported but none in the pediatric age group. A 15-year-old girl presented with history of headache and bilateral blurred vision of five days duration. The symptoms developed five days after vaccination with the first dose of Covaxin (inactivated SARS-CoV-2 vaccine). Her anterior segment was normal in both eyes (BE), whereas the posterior segment showed mild vitritis with disc edema and multiple yellowish lesions at the level of choroid clustered at the macula and associated with multiple serous detachments. BE uveitis resolved, and the vision was completely recovered three weeks after treatment with steroids. Hence, ophthalmologists should be aware of uveitis following vaccination—a condition that is usually benign, transient, and results in excellent outcomes with timely diagnosis and early treatment with steroids.

Comparison of eyecare utilization at two service delivery levels during the COVID-19 pandemic as a measure of their impact: A multicentric retrospective analysis across four North Indian high-volume eyecare organizations

Purpose: The purpose of this study was to assess the performance of the tertiary centers (TCS) and vision centers (VCs) of the four organizations participating in this research, once the lockdown was lifted, and to compare it with the performance during the same period of the previous year. Methods: This was a cross?sectional study assessing eyecare utilization in the first 2 months after resumption of services post the lockdown in 2020 and comparing that across the same time period in 2019. Anonymized data containing basic demographic details, proportions of patient visits and their reasons, as well as referral information was collected. The drop percentage method was used, and P values were calculated using paired t?tests. Results: Four TCs and 60 VCs were included. Overall, outpatient attendance dipped 51.2% at TCs and 27.5% at VCs, across the 2 years. At both levels of care delivery, the percentage drop in females was more than that in males; however, the overall drop at VCs was less than that at TCs, for both sexes. Eyecare utilization in pediatric populations dropped significantly more than in adult populations, across the overall sample. There was no significant change in referrals for refractive error as a proportion of total outpatients, although there was a significant decline in the same for cataract and specialty treatment. Conclusion: VCs are valuable and successful model for eyecare delivery especially in the continued aftermath of the COVID?19 pandemic

Association of sex, sexual maturation, age group, economic class, and nutritional status with the different cutoff points of screen time in adolescents / Associação entre sexo, maturação sexual, faixa etária, classe econômica e estado nutricional com os diferentes pontos de corte do tempo de tela em adolescentes

Abstract Objectives: to estimate the prevalence of adolescents' screen time in three different scenarios and possible associations with gender, sexual maturation, age group, economic class, and nutritional status. Methods: a cross-sectional study conducted with a representative sample of 3,979 adolescents from Greater Curitiba. Screen time (television, computer, and video game) was self-reported and categorized as ≤2h/day, >2 to ≤4h/day, and >4h/day. Ordinal logistic regression tested the associations. Results: the sample consisted of adolescents of 14.60±1.88 years old, most girls (51.2%). The prevalence of screen time >4h/day was 89.3%. Girls (OR=0.61; CI95%=0.49-0.76) and the older age groups ("14 to 16 years" OR=0.29; CI95%=0.22-0.39, and "17 to 19 years" OR=0.11; CI95%=0.08-0.16) were less likely to be in the groups of higher screen time. Conclusions: screen time above four hours seems to be the most prevalent among adolescents. Older girls and teens are less likely to have higher screen time.

Resumo Objetivos: estimar a prevalência de tempo de tela de adolescentes em três diferentes cenários e possíveis associações com sexo, maturação sexual, faixa etária, classe econômica e estado nutricional. Métodos: estudo transversal realizado com amostra representativa de 3.979 adolescentes da Grande Curitiba. O tempo de tela (televisão, computador e videogame) foi autorrelatado e categorizado em ≤2h/dia, >2 a ≤4h/dia e >4h/dia. A regressão logística ordinal testou as associações. Resultados: amostra com idade média de 14,60±1,88 anos, formada por 51,2% de meninas.A prevalência de tempo de tela >4h/dia foi de 89,3%. Meninas (OR=0,61; IC95%=0,49-0,76) e os grupos de idade mais velhos ("14 a 16 anos" OR=0,29; IC95%=0,22-0,39 e "17 a 19 anos" OR=0,11; IC95%=0,08-0,16) eram menos propensos a estar nos grupos de maior tempo de tela. Conclusões: o tempo de tela acima de quatro horas parece ser o mais prevalente entre os adolescentes. Meninas e adolescentes mais velhos são menos propensos ao maior tempo de tela.

Orexin-A levels in reproductive age group women and its association with body mass index

Objectives: Orexins are hypothalamic neuropeptides, which are involved in feeding behaviour, sleep-wakefulness, and neuroendocrine homeostasis in the body. The study was conducted with the aim to estimate the serum orexin levels in reproductive age group (RAG) women and to determine the association of serum orexin levels with body mass index (BMI) in females of RAG. Materials and Methods: One hundred and forty apparently healthy women of RAG (20–40 years) were randomly selected. Fasting serum orexin levels were measured using ELISA and BMI was calculated in women based on their height and weight. Results: Serum orexin levels were significantly higher in women with BMI ? 25 kg/m2 (P = 0.035) as compared to women with BMI < 25 kg/m2 . Conclusion: In the present study, BMI correlated significantly with mean serum orexin levels. However, serum orexin levels did not correlate with the age of women.

Efficacy and compliance of e-aid cognitive behavioral therapy in patients with situational insomnia among different age groups / 中华行为医学与脑科学杂志

Objective:To explore the efficacy and compliance of e-aid cognitive behavioral therapy (eCBTI) in patients with situational insomnia among different age groups.Methods:A total of 194 patients with situational insomnia were recruited via a campaign of the " Prevention and Protection Handbook Against Epidemic" from March to April 2020 in Guangzhou, China.Participants were divided into two groups according to age: under 35 years old ( n=87) and 35 years old and above ( n=107). They all received one-week eCBTI intervention.Insomnia severity index (ISI), Pre-sleep arousal scale (PSAS) and Hospital anxiety and depression scale (HADS) were used to evaluate the severity of insomnia for all participants pre- and post-intervention.The change of each scale within the group and the reduction rate of each scale between groups were compared using t test and one-way ANOVA. Results:(1) Intervention efficacy: in the <35-year-old group, compared with baseline, the scores of ISI scale ((9.2±4.1), (14.8±5.1)), PSAS cognitive arousal subscale ((18.5±8.4), (23.5±6.6)), PSAS((34.3±15.8), (40.3±10.7)), HADS depression subscale ((5.8±3.6), (8.5±4.6)) and HADS anxiety subscale((7.1±3.9), (9.5±4.5) )were statistically significant after eCBTI intervention ( t= 2.88-8.80, all P<0.01), but there was no significant difference in score of PSAS body subscale ((15.8±7.8), (16.8±5.7)). In ≥35-year-old group, compared with baseline, the scores of ISI scale ((9.7±4.2), (14.4±4.3)), HADS depression subscale ((4.6±2.2), (6.6±3.5))and PSAS cognitive arousal subscale ((16.9 ±8.5), (20.0±5.8))were significantly different after intervention ( t= 2.90-6.86, all P<0.01), meanwhile the scores of PSAS body subscale ((14.3±8.0), (13.9±5.2)), PSAS((32.2±16.5), (33.9±9.2)), HADS anxiety subscale((6.1±3.2), (7.0±3.5)) were not statistically significant (all P>0.05). There was no significant difference in the score reduction rate between the two groups before and after intervention (all P>0.05). (2) Compliance: 86 cases dropped out, and the dropout rate was 61.3%.Totally 75 cases (38.7%) completed the 7-day treatment, and 119 cases (61.3%) completed the treatment within 1-6 days.Further study found that there was statistically significant difference in the reduction rate of ISI total score among the three groups with excellent, good and poor compliance ( F=5.655, P=0.004). Conclusion:eCBTI has a good effect on situational insomnia in different age groups, and there is no difference in treatment compliance.

Cáncer de próstata: análisis de tasa de mortalidad, periodo 2017-2021 en Chile / Prostatic Cancer: analysis of the mortality rate in Chile between 2017-2021

Introducción: El cáncer de próstata (CP) es una neoplasia dependiente de hormonas de la próstata. Presenta una mortalidad mundial en descenso, disminuyendo de 39 a 19 por cada 100.000 personas; En Chile no existen datos recientes. Objetivos: Describir la tasa de mortalidad (TM) por cáncer de próstata en el periodo 2017-2021 en Chile. Materiales y métodos: Estudio ecológico sobre defunciones por CP en el periodo 2017-2021 en Chile (n=10.783), según grupo etario y región. Utilizando datos obtenidos por el Departamento de Estadística e Información de Salud para realizar la estadística descriptiva y cálculo de TM. No se requirió comité de ética. Resultados: Se evidenció una TM del período de 34,84/100.000 hombres, presentando una disminución de 7,90% entre los años 2017 y 2021. El grupo etario de 65 a 79 años presentó la mayor cantidad de defunciones con 139,95% (4308). La región metropolitana presentó la mayor cantidad de defunciones con 32,96% (3.555). Conclusión: La disminución de la TM durante la pandemia por COVID-19 puede deberse a que posiblemente pacientes fueron mal clasificados como defunciones por COVID-19. Respecto al grupo etario con mayor cantidad de defunciones, se condice con la literatura. La región con mayor cantidad de defunciones fue la región más poblada de Chile, la cual puede presentar mayor cantidad de pacientes con CP. En conclusión, el CP presenta altas TM en grupos de avanzada edad, es importante realizar los diagnósticos de manera oportuna, ya que es una patología detectable que acarrea gastos en salud.

Introduction: Prostate cancer (PC) is a hormone-dependent neoplasm of the prostate. It presents a global mortality in decline, decreasing from 39 to 19 per 100,000 people; In Chile, there is no recent data. Objective: To describe the mortality rate (MR) of prostate cancer in the years between 2017-2021 in Chile. Materials and methods: An ecological study on deaths from PC in the period 2017-2021 in Chile (n=10,783), according to age group and region. Using data obtained by the Departamento de Estadística e Información de Salud, to perform descriptive statistics and calculate MR. No ethics committee was required. Results: A MR of 34.84/100,000 men in the period studied was evidenced, presenting a decrease of 7.90%. The age group of 65 to 79 years old presented a greater number of deaths with 139.95% (4308). The metropolitan region presented the largest number of deaths with 32.96% (3,555). Conclusion: The decrease in MR during the COVID-19 pandemic may be due to the fact that patients were possibly misclassified as COVID-19 deaths. Regarding the age group with the highest number of deaths, it is consistent with the literature. The region with the highest number of deaths was the most populated region of Chile, which may have the highest number of patients with PC. In conclusion, PC presents high MR in older age groups; it is important to make diagnoses in a timely manner, as it is a detectable pathology that entails health costs.

Artículo original / Characterization of patients with COVID -19 according to clinical groups

RESUMEN Fundamento: la incidencia de casos positivos a la COVID-19 en edades pediátricas y adultos ha ido en aumento, lo que genera colapsos en los servicios sanitarios por las cifras elevadas de contagios en todo el mundo. Objetivo: caracterizar los pacientes de edades pediátricas y adultas, positivas a la COVID-19 de las provincias Camagüey y Ciego de Ávila, según grupos clínicos. Métodos: se realizó un estudio descriptivo de corte transversal en el Hospital Militar Clínico-Quirúrgico Docente Dr. Octavio de la Concepción y de la Pedraja, desde de marzo de 2020 a julio de 2020. El universo estuvo constituido por los 90 pacientes diagnosticados con la COVID-19. La información recogida en los expedientes clínicos se incluyó en un formulario y se consideró como variable dependiente grupos clínicos positivos a la COVID-19: asintomáticos y sintomáticos y como variables independientes: grupos de edades, sexo, comorbilidades, fuente de infección, complicaciones y los grupos según sintomatología de acuerdo a la clasificación del Colegio del Rey de Londres. Resultados: los pacientes sintomáticos fueron más frecuentes, el grupo etario más afectado fue el de 27 a 59 años en ambas formas clínicas, se contagiaron de forma similar ambos sexos. Las complicaciones fueron más frecuentes en el grupo sintomático, donde la neumonía y la bronconeumonía fueron las más representativas. Conclusiones : los pacientes sintomáticos y la fuente de infección autóctona fueron más frecuentes en edad pediátrica y adultos. Las complicaciones fueron poco frecuentes en estos grupos de edades y la neumonía y la bronconeumonía las más habituales.

ABSTRACT Background: the incidence of positive cases to COVID-19 in pediatric and adult ages has been increasing, generating collapses in health services due to the high numbers of infections around the world. Objective: to characterize patients of pediatric and adult ages; positive for COVID-19 in the Camagüey and Ciego de Ávila provinces, according to clinical groups. Methods: a descriptive cross-sectional study was carried out at the Dr. Octavio de la Concepción y de la Pedraja Teaching Clinical Surgical Military Hospital, during the period from March 2020 to July 2020. The universe consisted of 90 diagnosed patients with Covid-19. The information collected in the clinical records was included in a form and clinical groups positive for COVID-19 were considered as dependent variables: asymptomatic and symptomatic, and as independent variables: age groups, sex, comorbidities, source of infection, complications and the groups according to symptoms according to the classification of the London King's College. Results: symptomatic patients were more frequent, the age group most affected was that of 27 to 59 years in both clinical forms, both sexes were infected in a similar way. Complications were more frequent in the symptomatic group, where pneumonia and bronchopneumonia were the most representative. Conclusions: symptomatic patients and the source of autochthonous infection were more frequent in pediatric and adult ages. Complications were rare in these age groups and pneumonia and bronchopneumonia the most common.

A study of causes, investigation and management of structural causes of abnormal uterine bleeding in reproductive age group

Background: Abnormal uterine bleeding (AUB) is debilitating condition affecting 14-25% of women of reproductive age. It has significant impact on women’s personal, social, physical and quality of life. Present study is planned to study causes, investigation along with management of structural causes of abnormal uterine bleeding in reproductive age group.Methods: Consecutive type of non-probability sampling was used for selection of study subjects. A total of 100 gynaecology OPD women diagnosed with menorrhagia of 15-45 years age group were enrolled in study.Results: Mean age of the study subjects was between 26-35 years (47%). 67% were from low socio-economic class while 33% were from middle class. Maximum number of women (66%) had symptoms for less than 6 months. 47% presented with Menorrhagia. 89% were Multiparous, and 11% were Nulliparous. Most common structural causes of AUB was leiomyoma (41%) followed by polyps (23%), adenomyosis (17%), endometrial hyperplasia (15%) and endometrial carcinoma (4%). Prevalence of anemia was 73% in present study. Maximum leiomyoma were treated medically while higher percentage of polyps and hyperplasia was treated surgically. Most commonly performed surgery was polypectomy (20%) followed by dilatation and curettage (17%) and myomectomy (15%). Total abdominal hysterectomy was done in 8% cases while radical hysterectomy was done in 2% cases.Conclusions: Benign lesions of endometrium account for majority of cases presenting with AUB in reproductive age group. Other premalignant and malignant causes should also be considered. High prevalence of anemia was observed in these cases. A comparative clinicopathological study will help in arriving at the cause and correct diagnosis. Histopathological examination is one of the major tools in evaluation of abnormal uterine bleeding and helps us in proper management and treatment of cases.

Absorbable versus Non-Absorbable Sutures in Paediatric Facial Trauma - A Cosmetic Assessment

Paediatric age group is most vulnerable to trauma. Children often suffer facial injuries. Though many topical skin adhesives and strips are available in the market which have given excellent cosmetic results, deeper injuries especially along the lines of high tension need suturing both with buried and skin sutures. Different variety of sutures are available in the market which are used as per the choice of the surgeon. Children are more apprehensive when it comes to suture removal. So use of absorbable sutures in place of non-absorbable sutures in skin can save the children from this fear factor. MethodsA prospective study was done in the department of plastic surgery from May 2012 to Dec. 2013 with an objective of studying the outcome of plain catgut suture as skin sutures versus non-absorbable skin suture Nylon in facial trauma in the paediatric age group. Chromic catgut was used as buried suture in both groups. All the patients presenting in emergency department with facial trauma with age 10 years or less were included in the study. Skin sutures, where needed removal, were removed on 5th post-operative day followed by follow up on 7th post-operative day, 3rd month and 8th month during which cosmetic assessment of scar was done. 25 patients who presented first in emergency and fulfilled the study criteria were sutured with 5 - 0 chromic catgut buried sutures and skin suture used was 6 - 0 Nylon and this group was labelled group A. Next 25 patients who presented in emergency for suturing were sutured with 5 - 0 chromic catgut as buried and plain catgut as skin suture. This group was labelled as Group B. Cosmetic outcome was assessed on 7th post-operative day, 3rd month and 8th month by using Beusang E cosmetic scar assessment scale based on two parameters which included colour and texture of scar.1 Statistical analysis was done with continuous variables expressed as Mean ± S.D. and categorical variables were expressed as count (percentage). Chi-square was used to compare the categorical variables between groups or Fisher exact test was used. ResultsOn 7th post-operative day follow up, out of 50 patients, 25 patients (50 %) in whom nylon was used as skin suture, 4 patients (16 %) had mismatch of colour. All scars were smooth in texture. In rest 25 patients (50 %) in whom plain catgut was used as a skin suture, 1 (4 %) patient had mismatch of the colour. None of the patients had frank pus in both groups & hypertrophic scar was seen in one patient. On 3rd month follow up, Group A patients with nylon as skin suture, 1 (4 %) patient showed hypertrophic scar whereas in Group B (8 %) patients had hypertrophic scar. On 8th month follow up, both group A & B had colour mismatch of 12% with firm texture of scar in 8% patients. ConclusionsThere is no long-term differences in cosmetic outcomes and complication rates between absorbable catgut suture and commonly used nylon sutures in the repair of facial trauma in paediatric age groups. So, absorbable sutures are acceptable alternative to non-absorbable suture especially in paediatric age group, keeping in mind their apprehensive nature and fear of suture removal.

A study to determine socio demographic corelates of reproductive tract infection amongst women of reproductive age group

Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.

Clinical correlation of cardiac functions and troponin I and CPK-MB in dengue fever in children

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the World. The spectrum of manifestations includes mild fever to severe and life-threatening disease, though uncommon complications such as myocarditis have also been reported in many cases. We conducted this study to analyze association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever. Aims and objectives of the study was the association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever.Methods: This was a prospective observational study in which 80 paediatric patients who were hospitalized anddiagnosed to be having Dengue fever were included. All patients were stratified into either of the 3 groups- Dengue without warning signs, Dengue with warning signs and severe Dengue. A detailed history and thorough clinical examination were done for all patients. A complete blood count, electrolytes, hepatic and renal function tests were done in all children. Cardiac function was assessed by 2D Echo, CPK-MB and Troponin-I, p value less than 0.05 was taken as statistically significant.Results: Of the 80 studied cases there were 53 (66.25%) males and 27 (33.75%) females with a M:F ratio of 1.9:1. Dengue with and without warning signs was seen in 27.5% and 60% cases respectively whereas severe dengue was seen in 12.5% cases. The ejection fraction was comparable across the 3 groups. On 2D echo ejection fraction was 62.95%, 63.21% and 65.1% in cases with warning signs, without warning signs and severe dengue respectively. Additionally, ECG abnormalities were seen in 8.75% patients. All 80 patients had a normal CPK-MB and Troponin-I levels.Conclusions: Cardiac markers (CPK-MB and Troponin-I) remain unaffected during Dengue illness and do not have significant correlation between Dengue without warning signs, Dengue with warning signs and severe Dengue.