Cost analysis study of price variation among the various brands of proton pump inhibitors available in Benghazi-Libya

Background: A large proportion of patients in developing countries have to pay out of pocket for their medications. The prices of different brands of the same medications vary considerably and may vary from one community pharmacy to another. This study was undertaken to evaluate the variation in costs of proton pump inhibitors (PPI) and histamine H2-receptor antagonists available in Libya. Methods: Prices of various brands of PPI and various formulations were collected from four community pharmacies in the city of Benghazi. Both cost ratio and percentage variation were calculated and compared for various brands of the same strength and number of tablets, capsules, injections, or syrups. Results: The highest cost ratio and percentage price variation were found with omeprazole 20 mg, followed by omeprazole 40 mg. Other significant cost variations (>100%) were seen with pantoprazole 40 mg, Downoprazol (omeprazole + sodium bicarbonate) 40 mg, and esomeprazole 40 mg. Ampoules of omeprazole, cimetidine, and ranitidine had cost ratios of 1:1.7, 1:1.7, and 1:1.8, and cost variation ratios of 71.4, 66.7, and 75, respectively. Variations in prices of PPI and histamine H2 antagonists from the same manufacturer between different community pharmacies were common. The highest percentage cost variation (100) was seen with omeprazole 20 mg. Conclusions: Due to political instability, the prices of all drugs are controlled by importing private companies and the owners of community pharmacies instead of governmental authorities, that leads to cost variations. Therefore, the health authorities exert strict control on pricing of medications.

Non obstructive versus obstructive coronary artery disease documented by coronary angiography: prevalence, diagnostic features in a single center experience

Background: Coronary angiography often detects NOCAD. Stable angina or MI patients may have NOCAD, defined as less than 50% luminal diameter decrease by visual assessment on coronary angiography. The study was to determine the frequency of non-obstructive coronary artery disease in Al Hussain cardiac centre patients who underwent CAG and the differences in clinical presentation and associated morbidity between the two groups. Methods: Cross-sectional research was done at Karbala's al-Hussaini cardiac centre. CAG data from 167 IHD-like patients between January and May 2021. NOCAD 42 individuals (stenosis <50%) were compared to 125 obstructive CAD patients (?50% stenosis). Results: Between January and May 2021, 167 individuals received CAG for diagnostic, therapeutic, elective, or emergency purposes. The study included 113 (67.7%) men and 54 (32.3%) women. Patients had an average age of 56.52�.09 years, with a median of 58 years. Overall, 25.1% (n=42) of research participants had NOCAD. The frequency of INOCA was 29.4% and MINOCA 19.1%. Patients with NOCAD were younger than those with obstructive CAD (p<0.05). no significant gender, co morbidity, or clinical differences across groups. Conclusions: We believe this is the first report of prevalence, risk factors, and clinical aspects in karbalai patients' cardiac care centre in Iraq. NOCAD patients are younger and their medical history, clinical features, ECG, and serum troponin are difficult to distinguish from OCAD.

Reverse dorsal metacarpal artery flap: a review

Deep soft tissue injuries around the thumb can significantly impair hand function if not managed appropriately. Various surgical options exist for treating these complex lesions, including microsurgical flaps, local flaps, and distant pedicled flaps. The dorsal metacarpal artery (DMCA) family of flaps belongs to the latter category. These versatile flaps can be designed as racquet-shaped, island, or bilobed flaps, utilizing the first DMCA alone or in combination with the second DMCA. In this review, we explore the surgical anatomy, techniques, and clinical applications of reversal DMCA flap (RDMA).

Delayed splenic rupture following abdominal trauma: a case report

We present the case of a 20-year-old male who presents multiple traumas of the abdomen 26 days prior to his return to the emergency room. Going again to evaluation with frank data of peritoneal irritation, since there is no hemodynamic commitment, a contrasted abdomen computed tomography (CT) scan is requested, finding a grade III splenic lesion, which is why he is admitted for emergency splenectomy. This case reports a splenic injury with the need for delayed splenectomy.

The impact of Flexner's report on medical education in Sub-Saharan Africa Sudan as an example

Flexner’s Report 1910 is one of the most important and influential events in the history of medicine worldwide that led to the emergence of modern medical education. reforms of medical education took places as results of this report leading to the establishment of the biomedical model as the gold standard of medical training. Objectives: to identify the impact of Flexner's Report on Medical Education in Sub-Saharan Africa taking Sudan as an example more than 100 years after the report. The health system and medical education in Sub-Saharan Africa during the colonial era and after independence were studied. Conclusion: Medical education in Sub-Saharan Africa has not yet received a holistic review, reforms, and standardization and the health system needs more educational strategic planning. Multiple factors play a role in preventing the modernization of medical education in Sub-Saharan Africa, such as the poor economic status of these countries, inadequate infrastructure, equipment, and educational standards, large annual students intake, and lack of appropriately qualified teaching staff.

Prevalence of hypertension and associated anthropometric indices among the non-medical employees working in medical college Thiruvananthapuram: a cross-sectional study

Background: Hypertension is a major public health problem. Globally 1.28 billion adults aged 30-79 years have hypertension and among this 46% were undiagnosed. Kerala is one state undergoing epidemiological transition and having high prevalence of hypertension. So, we did this study to estimate the proportion of hypertension among non-medical employees of Medical College Thiruvananthapuram. Methods: A cross-sectional study was conducted among 202 non-medical employees of medical college Thiruvananthapuram. Data was collected using an investigator administered questionnaire. Anthropometric indices were measured and recorded. Blood pressure (BP) was recorded twice in a gap of 15 min for each participant in sitting position using mercury sphygmomanometer. Mean systolic BP (SBP) and diastolic BP (DBP) was calculated to confirm hypertension. Participants those who were already detected as hypertensive and on treatment were also noted. Data was analysed using SPSS software version 27. Results: Prevalence of hypertension in the study population was 61/202 (30.19%). Among the hypertensive 39 (63.9%) were already detected and on treatment and 22 (36.1%) were undiagnosed. Among already detected hypertensive 13 (33.3%) were found to be inadequately treated. Hypertension was found to be associated with waist circumference and BMI. Conclusions: The study population was found to have high prevalence of hypertension and having association with waist circumference and BMI. The rule of halves for depicting the trend of hypertension in study population can be used as a tool to deduce various interventions in the community.

Morbidity profiling of patients treated at Ayothidoss Pandithar Hospital of the National Institute of Siddha from 2004 to 2023 in Tamil Nadu, India

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.

Prevalence of chronic kidney disease among the hypertensive patients in Wajir county, Kenya

Background: Chronic kidney disease (CKD) is public health burden and rising rapidly in prevalence in developing countries especially in Sub-Saharan Africa. CKD increases with advancing age and comorbidities like hypertension, diabetes and obesity. However, there is no data on CKD the prevalence and risk factors associated among the hypertensive adult patients in Wajir county. This study aimed at estimating the prevalence and establishing risk factors associated with CKD among hypertensive patients in Wajir county and sought to recommend viable preventive measures. Methods: Analytical cross-sectional study design utilized, non-probability consecutive sampling was adopted to obtain sample size of 293 respondent attending medical outpatient clinic at Wajir county referral hospital between September to December 2023. The study utilised primary data that were collected using structured questionnaires and secondary data from the laboratory result. Results: Key findings revealed majority of hypertensive patients have CKD (45.40%), highlighting a critical health concern in the region. The study found most CKD cases were in early stages (stages 1 and 2), some had progressed to severe stages (stages 4 and 5). Regression analysis identified several demographic and clinical factors associated with CKD development, including age, gender, and education, and employment status, family history of CKD and difficulty in medication compliance. Conclusions: there is high prevalence of chronic kidney disease among hypertensive adults in Wajir county. With nearly half of hypertensive patients also suffering from CKD, there is an undeniable public health crisis at hand in Wajir county. Study recommended initiation of targeted screening programs.

Unveiling the complexity of cardiac amyloidosis: a comprehensive case report

This case report documents a woman in her sixties who initially presented with cardiac symptoms such as heart palpitations, shortness of breath, and fluctuating blood pressure. Following her hospital admission, she received a diagnosis of paroxysmal atrial fibrillation and underwent successful electrical cardioversion. Despite this intervention, her symptoms persisted, necessitating radiofrequency ablation of the Cavo-tricuspid isthmus, which proved to be highly effective. Subsequent diagnostic testing revealed the presence of coronary artery disease, atherosclerotic cardiosclerosis, and mitral valve abnormalities, all of which were managed appropriately. Upon discharge, the patient was prescribed a medication regimen comprising anticoagulants, hypotensive therapy, and statins, which she tolerated well. However, her symptoms deteriorated, leading to a referral to a specialized center where she was promptly diagnosed with cardiac amyloidosis (CA) and received appropriate treatment. Adjustments to her treatment plan were made based on this diagnosis, and a cardiac MRI confirmed the presence of amyloidosis. A biopsy of the buccal mucosa further confirmed the presence of AL-amyloidosis based on immunohistochemistry test results. The patient commenced chemotherapy, which unfortunately led to kidney damage but ultimately resulted in significant improvement in her condition. Recurrent atrial fibrillation episodes necessitated further interventions, which were performed swiftly and effectively. Multi-organ assessments revealed numerous abnormalities, guiding tailored management strategies. A multidisciplinary team comprising cardiology, hematology, and general practice specialists coordinated the patient's care, focusing on pharmacotherapy and lifestyle modifications, which were found to be highly effective. Emphasis was placed on continuous monitoring and adherence to treatment plans for long-term management, resulting in positive outcomes.

Implementing dietary counselling in family practice for diabetes control and prevention

The importance of dietary counselling in family practice for managing and preventing diabetes is the focal point of this review, highlighting its integral role in chronic disease management. With diabetes increasingly prevalent worldwide, there is a critical need for effective management strategies, with dietary interventions playing a key role. Family practitioners, often the initial point of contact for patients, have a unique opportunity to implement these dietary changes, which are pivotal in influencing diabetes outcomes and averting long-term complications. Despite facing challenges such as limited time and the need for specialized knowledge, dietary counselling in family practice stands as a proactive measure focused on prevention and early intervention. It adopts a patient-centered approach, where dietary habits and preferences are assessed, and personalized, evidence-based advice is provided. The inclusion of dietitians in primary care teams, utilization of technology for support, and advocacy for policy reforms are recommended to enhance the effectiveness of dietary counselling. Despite various obstacles, integrating dietary counselling into routine care remains a significant advantage, promoting healthier lifestyle choices and effectively managing the increasing burden of chronic diseases.

A peak into metastatic Leydig cell tumor: a rare case report

Testicle tumors are a rare entity among men population, comprising 1-1.5% of all cancers. The Sex cord Stromal tumors contribute just 4% of all testicular cancers, only 10% of them are malignant. Most common sex cord-stromal tumors are the Leydig cell tumor, comprising of 75 to 80% of the total. Incidence is bimodal involving children and adults between 30 and 60 years. The commonest metastatic sites are regional lymph nodes, lung, liver, and bones. Here, we report a case of late metastatic relapsed Leydig cell tumor in a 38-year-old male. Patients with metastatic Leydig cell tumors have poor prognosis and standard treatment recommendations are unclear.

Pineal parenchymal tumour of intermediate differentiation: a rare case report

Pineal parenchymal tumours are erratic, accounting for <1% of all primary central nervous system tumours. It was first categorised by the WHO in 2000 as a pineal parenchymal tumour with an intermediate prognosis between pineocytoma and pineoblastoma. We reported a case of 38-year-old gentle man presented with chief complaints of headache and vomiting since 1 day. MRI brain showed a relatively well defined lesion epicentered at posterior aspect of third ventricle, extending and blocking Aqueduct of Sylvius leading to upstream dilatation of both lateral and third ventricles with periventricular ooze was observed. Excision of lesion was performed, histopathological diagnosis of pineal parenchymal tumours of intermediate differentiation (PPTID) was made, which was further confirmed on IHC. PPTID are enormously erratic tumour, and restricted data are available concerning their pathologic features and biologic behaviours causing interruption in making proper diagnosis and deciding an optimal treatment approach.

The impact of COVID-19 pandemic on diet and lifestyle of undergraduate medical students of South India-a cross sectional study

Background: COVID-19, infectious disease caused by the Corona virus, caused economic and social disruptions all over the World. In order to contain this pandemic, complete/partial lock down was declared in different parts and thus restricting all human activities. Lifestyle behaviours, especially eating habits, physical activity and sleep patterns changed causing complications such as obesity, diabetes and cardiovascular disorders. The prevalence of depression, anxiety and stress increased among the public. Methods: The study is conducted among medical students to find out the extent of after effects of COVID pandemic on the diet and life style of medical students. Online questionnaire was used to access the lifestyle and exercise patterns of medical students across South India. Results: The study reveals that the pandemic has led to notable shifts in the daily routines, eating habits, and overall well-being of this demographic. Factors such as increased stress, remote learning, and limited social interactions have played a crucial role in these changes. Significant change in hours of sleep, and change in sitting and screen time has been observed. Slight increase in the daily intake of fruits and vegetables, intake of balanced diet and immunity-boosting food, consumption of junk food/fast food and fried food has been observed. The consumption of unhealthy food when bored or stressed is also slightly increased. There is also slight change in quality of sleep and participation in exercise.

Relação entre meditação, regulação emocional e expressão vocal: estudo de intervenção / Relación entre meditación, regulación emocional y expresión vocal: estudio de intervención / The relationship between meditation, emotional regulation and vocal expression: interventional study

Introdução: A voz é um indicador de estados emocionais, influenciada por fatores como o tônus vagal, a respiração e a variabilidade da frequência cardíaca. O estudo explora esses fatores e a relação com a regulação emocional e a prática meditativa como técnica de autorregulação. Objetivo: Investigar a diferença nas características vocais e na variação da frequência cardíaca em meditadores experientes (EM) e novatos (NM) antes e depois de uma prática meditativa e em não praticantes de meditação ­ grupo controle (CG), antes e depois de um teste controle. Métodos: Estudo quase-fatorial 3 x 2. Três grupos foram avaliados (meditadores experientes EM; meditadores novatos NM; e grupo controle CG, não praticantes de meditação) em dois momentos da manipulação experimental ­ antes e depois de uma sessão meditativa para praticantes de meditação, e antes e depois de uma tarefa de busca de palavras para o grupo controle. A frequência fundamental, jitter, shimmer, relação harmônico-ruído e o primeiro (F1), o segundo (F2) e terceiro (F3) formantes da vogal [a]; a variação da frequência cardíaca (SDNN, RMSSD, LF/HF, SD1 and SD2); estado de ansiedade e autopercepção vocal, foram investigados, antes e após a intervenção. Resultados: O grupo EM alcançou ótimo relaxamento do trato vocal. Os grupos NM e CG apresentaram mudanças em F1. Prática meditativa, de longa duração, está associado com grande diferença em F3, SDNN e SD2 na variação da frequência cardíaca. Conclusão: Os resultados sugerem que prática meditativa influencia a expressão vocal e reação emocional, e que a experiência em prática meditativa favorece esta relação. (AU)

Introduction: The voice is an indicator of emotional states, influenced by factors such as vagal tone, breathing and heart rate variability. This study explores these factors and their relationship with emotional regulation and meditative practice as a self-regulation technique. Purpose: To investigate the difference in vocal characteristics and heart rate variability in experienced (EM) and novice (NM) meditators before and after a meditation practice and in non-meditators - control group (CG), before and after a control test. Methods: 3 x 2 quasi-factorial study. Three groups were evaluated (experienced meditators EM; novice meditators NM; and control group CG, non-meditators) at two points in the experimental manipulation - before and after a meditation session for meditators, and before and after a word search task for the control group. The fundamental frequency, jitter, shimmer, harmonic-to-noise ratio and the first (F1), second (F2) and third (F3) formants of the vowel [a]; heart rate variation (SDNN, RMSSD, LF/HF, SD1 and SD2); anxiety state and vocal self-perception, were investigated, before and after the intervention. Results: The EM group achieved optimal vocal tract relaxation. The NM and CG groups showed changes in F1. Long-term meditative practice was associated with a large difference in F3, SDNN and SD2 in heart rate variation. Conclusion: The results suggest that meditation practice influences vocal expression and emotional reaction, and that experience in meditation practice favors this relationship. (AU)

Introducción: La voz es un indicador de los estados emocionales, influida por factores como el tono vagal, la respiración y la variabilidad de la frecuencia cardiaca. Este estudio explora estos factores y su relación con la regulación emocional y la práctica de la meditación. Objetivo: Investigar la diferencia en las características vocales y variabilidad de la frecuencia cardiaca en meditadores experimentados (EM) y novatos (NM) antes y después de una práctica de meditación y en no meditadores - grupo control (GC), antes y después de una prueba control. Métodos: Estudio cuasi-factorial 3 x 2. Se evaluaron tres grupos (meditadores experimentados EM; meditadores novatos NM; y grupo control CG, no meditadores) en dos momentos - antes y después de una sesión de meditación para los meditadores, y antes y después de una tarea de búsqueda de palabras para el grupo control. Se investigaron la frecuencia fundamental, jitter, shimmer, relación armónico-ruido y los formantes primero (F1), segundo (F2) y tercero (F3) de la vocal [a]; la variación de la frecuencia cardiaca (SDNN, RMSSD, LF/HF, SD1 y SD2); el estado de ansiedad y autopercepción vocal, antes y después de la intervención. Resultados: El grupo EM consiguió una relajación óptima del tracto vocal. Los grupos NM y CG mostraron cambios en F1. La práctica de meditación a largo plazo se asocia con una gran diferencia en F3, SDNN y SD2 en la variación de la frecuencia cardiaca. Conclusión: Los resultados sugieren que la práctica de meditación influye en la expresión vocal y reacción emocional. (AU)

Anal mucosal melanoma presenting as per rectal bleed: a case report

Anorectal mucosal melanoma is a rare, malignant and aggressive tumor that usually presents late. It primarily arises from the melanocytes but can also arise from the mucosal surface. It also carries poor survival rates. Early diagnosis of the disease and prompt treatment is necessary. Overall 5-year survival rate for anal melanoma is below 10%. We present a case of a 77 years old male patient who presented with chief complaints of per rectal bleeding and decreased appetite. Patient’s symptoms were initially confused for benign conditions like hemorrhoids. He was diagnosed with anal mucosal melanoma on per rectal biopsy. Patient’s radiological investigations including PET scan and MRCP were suggestive of liver and lung metastasis. In view of the advanced stage of the disease, the decision was taken to treat the patient conservatively. He was started on imatinib therapy and a regular follow up was kept and palliative care was provided.

CT findings of a patient with Hay-Wells syndrome: a case report

Hay-Wells syndrome is a rare genetic disorder caused by a heterozygous mutation in the TP63 gene that affects the development of ectodermal derivatives. While the exact prevalence of hearing loss in this condition is not well established, it has been suggested that approximately 50% of patients may present with varying degrees of hearing impairment. Here we present a case of a 6-year-old female patient diagnosed with Hay-Wells syndrome since birth who has been developing hearing loss predominantly on the right side for the past year. Considering the embryological origin of the external ear, an associated abnormality with the syndrome cannot be disregarded. Early recognition and diagnosis of this syndrome are crucial for appropriate management and potential interventions for hearing loss. Utilizing imaging methods can aid in demonstrating the characteristic alterations of the syndrome, which is important given its low incidence in the general population. This case report emphasizes the significance of prompt diagnosis, which is critical for implementing genetic counseling and effective disease prevention measures. We should be well-versed in the characteristic imaging findings that aid in early identification and genetic diagnosis of the disorder.

A systematic review of clinical applications and diagnostic efficacy of intravascular optical coherence tomography in cardiology

Intravascular Optical Coherence Tomography (OCT) has emerged advanced imaging modality in cardiology, offering high-resolution visualization of coronary artery structures. Since its inception in the late 1990s, OCT has undergone significant advancements, transitioning from time-domain to frequency-domain systems, thereby enhancing its clinical viability and diagnostic efficacy. We aimed to comprehensively assess the clinical applications and diagnostic efficacy of intravascular OCT in cardiology, particularly in guiding percutaneous coronary interventions (PCI) and evaluating coronary artery diseases. In methodology, A systematic search was conducted in PubMed and Google Scholar databases for studies published between 2013 and 2023, comparing OCT with intravascular ultrasound (IVUS) and conventional angiography (C.A.) in guiding PCI procedures. Studies were selected based on predefined inclusion and exclusion criteria, focusing on major adverse cardiovascular events (MACE), cardiac death, and revascularizations as outcomes. In results we included 28 studies from databased and 3 manuals, highlighting OCT's superior resolution in identifying thin-capped fibroatheromas (TCFAs), optimizing stent placement, and assessing plaque composition. Comparative analyses revealed no significant differences in clinical efficacy between OCT and IVUS, with both modalities showing superiority over C.A. in reducing cardiovascular events. The OCTIVUS trial further confirmed the non-inferiority of OCT-guided PCI compared to IVUS-guided PCI, with lower procedural complications reported in the OCT group. In conclusion, Intravascular OCT has revolutionized the diagnostic and interventional landscape in cardiology, offering unparalleled insights into coronary artery pathology. Its high-resolution imaging capabilities facilitate accurate plaque characterization, stent optimization, and real-time intervention guidance, thereby improving clinical outcomes in PCI procedures. Future research should focus on expanding OCT's applications and further validating its efficacy in diverse clinical settings.

Morbidity pattern of communicable diseases in a tertiary care hospital in metropolitan city of western Maharashtra

Background: In India, infectious diseases continue to be predominant with emerging non-communicable diseases, imposing a double burden of diseases on health care system. Hence, the tertiary health care hospital-based study was done to compare the morbidity pattern of communicable diseases with respect to non-communicable diseases. Methods: A 2 years’ record-based data of admitted patients was collected in a tertiary health care hospital. The data was analysed using Microsoft Excel version 365. Significance of association and difference in proportions has been checked with chi-square test and Z test for SEDP respectively at significance level of 0.05. Results: During the study period of two years, 6818 patients were admitted in the hospital, of which 74.51% suffered from communicable diseases while 25.49% suffered from other types of disease including non-communicable diseases. Of the 5080, patients with communicable diseases, 57.74% were males and 42.26% were females. Communicable diseases and non-communicable diseases had male predominance (p<0.05) and was higher amongst age group 0-15 years (p<0.05). Hospital stay was prolonged in patients suffering from communicable disease (p<0.05). Significant increased difference was found in AFI, Malaria, Dengue and in Leptospirosis prevalence and significant decreased difference was found in acute gastroenteritis, IV, Covid-19, Respiratory infections and enteric fever (p<0.05). Conclusions: Communicable diseases continue to be a major threat to public health system in India. Through effective surveillance programmes, any change in trends of disease can be identified and suitable measures can be adapted to control and prevent it.

Knowledge, attitude and practice about menstruation and menstrual hygiene among adolescent school girls of rural field practice area of tertiary care hospital, Nandyal, Andhra Pradesh: a cross-sectional study

Background: As the reproduction starts from the puberty and in which most of the girls will be not aware of menstruation and they will lack the knowledge as most of the girls will be in school age group. This study is done to understand their knowledge, attitude and practice on menstruation and menstrual hygiene in school going girls. Methods: A school based cross sectional study was conducted after getting ethics committee clearance during August-September 2023 (2 months) in RHTC field area of Santhiram medical college, Nandyal among high school girls of 8th, 9th and 10th classes by simple random sampling method with sample size 230, study tool was pre-designed, pre-tested, semi structured questionnaire by interview method collected data and analysed by SPSS 25 version. Results: In this study out of 230 participants about 43% were under the age group 13 years, 57.8% were have knowledge on menstruation and 60% were not aware of origin of blood and 76.1% are attending school during the menses, 31% of girls Still feels embarrassing buying pads, 40% don’t attend to perform house activities and sitting at the corner. Only 51.7% are using dustbins for disposal. Conclusions: This study results shows that girls have a poor knowledge, attitudes and practices regarding menstruation and menstrual hygiene. There is a gap between knowledge and menstrual hygiene and usage of proper sanitation, school administration and health facilities should conduct awareness programmes on menstrual hygiene.

Mandibular Incisive Canal Morphometry: A Cone-Beam Computed Tomography Study in Jordan / Morfometría del Canal Incisivo Mandibular: Un Estudio de Tomografía Computarizada de Haz Cónico en Jordania

SUMMARY: Mandibular incisive canal (MIC) and related mental foramen (MF) and anterior loop (AL) morphometrics are important landmarks in medical and dental clinical applications. The main aim of this retrospective study to determine the morphometry of the mandibular incisive canal (MIC) in a Jordanian population and to propose a new shape-pattern classification of the MIC. In addition, MF and AL morphometrics were determined. Carestream 3D imaging software was used on 100 Cone-Beam Computed Tomography (CBCT) of a Jordanian population to determine the MF, AL and MIC morphometrics. The detection prevalence of the MIC was 96 %. The right and left MIC showed four distinct line patterns, proposed for the first time in this paper. The line-patterns were angular (L-line), straight (I-line), curved (V-line) and wavy (W-line), with a prevalence of 41 %, 19 %, 25.5 %, and 10.5 %, respectively. MF was detected in all mandibles with a round shape in 58 % of the images. The most common horizontal and vertical positions of the MF were H4 and H3 (73.5 %) and V3 and V2 (95 %), respectively. An accessory MF was detected in 14.5 % of the samples and was more prevalent in males and on the right side. AL was detected in 92.5 % of the samples and exhibited a pattern prevalence of 25.5 %, 40 % and 27 % for types I, II and III, respectively. Results revealed that asymmetry and gender differences between right and left MIC, MF, AL and AMF was seen in patient's mandibles. In conclusion, this is the first study to propose and show that Mandibular incisive canal exhibits four potential line patterns (L, I, V and W lines patterns). Gender and ethnic variations of the mandibular canal landmarks morphometrics of both right and left hemi-mandible are important to be acknowledged in learning anatomy and when planning or performing dental and medical procedures.

Las relaciones de la morfometría del canal incisivo mandibular (MCI), del foramen mentoniano (FM) y del asa anterior (AA) son hitos importantes en las aplicaciones clínicas médicas y dentales. El objetivo principal de este estudio retrospectivo fue determinar la morfometría del MCI en una población jordana y proponer una nueva clasificación de patrón de forma del MCI. Además, se determinaron la morfometría de FM y AA. Se utilizó el software de imágenes 3D Carestream en 100 tomografías computarizadas de haz cónico (CBCT) de una población jordana para determinar la morfometría de FM, MCI y AA. La prevalencia de detección de MCI fue del 96 %. El MCI derecho e izquierdo mostraron cuatro patrones de líneas distintas, propuestas por primera vez en este artículo. Los patrones de líneas fueron angulares (línea L), rectos (línea I), curvos (línea V) y ondulados (línea W), con una prevalencia del 41 %, 19 %, 25,5 % y 10,5 % respectivamente. Se detectó el FM en todas las mandíbulas y con forma redonda en el 58 % de las imágenes. Las posiciones horizontal y vertical más comunes del FM fueron H4 y H3 (73,5 %) y V3 y V2 (95 %), respectivamente. Se detectó FM accesorio en el 14,5 % de las muestras y fue más prevalente en el sexo masculino y en el lado derecho. AA se detectó en el 92,5 % de las muestras y exhibió un patrón de prevalencia del 25,5 %, 40 % y 27 % para los tipos I, II y III, respectivamente. Los resultados revelaron asimetría y diferencias en el sexo entre MCI, FM, AA derecha e izquierda en las mandíbulas de los pacientes. En conclusión, este es el primer estudio que propone y muestra que el canal incisivo mandibular exhibe cuatro patrones de líneas potenciales (patrones de líneas L, I, V y W). Es importante reconocer las variaciones étnicas y de sexo de la morfometría de los puntos de referencia del canal mandibular de la hemimandíbula derecha e izquierda al estudiar y aprender anatomía y al planificar o realizar procedimientos médicos y dentales.