Validity and reliability of the brief version of the Symptom Checklist SA-45

Given the prevalence of mental disorders and elevated psychological symptoms, there has been a call for action to scale up health services. To provide optimal care, detecting symptoms early and evaluating the psychological state is essential. Self-report measures are useful to evaluate specific diagnoses and explore psychological symptoms. The present study aimed to provide new psychometric evidence of the Argentine version of the Brief Symptoms Checklist. Through non-probabilistic and intentional sampling, 760 individuals aged 18 to 63 (M = 28.1; SD = 8.61) were selected. Confirmatory factor analysis showed that the nine correlated factors model exhibited the best-fit indices and yielded full configural, metric and scalar invariance across gender and region. The factors mainly showed adequate reliability values similar to previous research. T values are provided as population-based norms. The results showed that the instrument is valid and reliable, and could be a valuable tool in various contexts, particularly in primary care, where the evaluation requires a very short time and useful information.

Dada la prevalencia de los trastornos mentales y los síntomas psicológicos elevados, ha habido un llamado a la acción para ampliar los servicios de salud. Para brindar una atención óptima, es fundamental la detección temprana de los síntomas y la evaluación del estado psicológico. Las medidas de autoinforme tienen una amplia utilidad para evaluar diagnósticos específicos y explorar síntomas psicológicos. El objetivo de este estudio fue aportar nuevas evidencias psicométricas de la versión argentina de la versión breve del Inventario de Síntomas Psicológicos. Mediante un muestreo no probabilístico e intencional, se seleccionaron 760 individuos de 18 a 63 años (M = 28.1; DE = 8.61). A través de análisis factoriales confirmatorios se halló que el modelo de nueve factores correlacionados mostró un mejor ajuste y se encontraron evidencias acerca de su invariancia escalar, métrica y configural según género y región. Los factores mostraron mayormente valores de confiabilidad adecuados, concordantes con investigaciones previas. Se proporcionaron puntajes normativos T. Los resultados mostraron que el instrumento es válido y confiable, y podría ser una herramienta valiosa en diversos contextos, particularmente en la atención primaria, donde la evaluación exige tiempos muy breves e información de utilidad.

Dada a prevalência dos transtornos mentais e sintomas psicológicos elevados, houve um apelo à ação para ampliar os serviços de saúde. A detecção precoce dos sintomas e a avaliação do estado psicológico são fundamentais para oferecer cuidados ideais. As medidas de autorrelato têm ampla utilidade para avaliar diagnósticos específicos e explorar sintomas psicológicos. O objetivo deste estudo foi gerar novas evidências psicométricas da adaptação argentina da versão curta do Inventário de Sintomas Psicológicos. Por meio de amostragem não probabilística e intencional, foram selecionados 760 indivíduos de 18 a 63 anos (M = 28,1; DP = 8,61). Por meio de análises fatoriais confirmatórias, constatou-se que o modelo de nove fatores correlacionados apresentou melhor ajuste e foram encontradas evidências sobre sua invariância escalar, métrica e configuracional segundo gênero e região. Os fatores apresentaram majoritariamente valores de confiabilidade adequados, condizentes com pesquisas anteriores. São fornecidos escores normativos T. Os resultados mostraram que o instrumento é válido e confiável, podendo ser uma ferramenta valiosa em vários contextos, particularmente na atenção primária, onde a avaliação requer tempos muito curtos e informações úteis.

Atención médica de body packers en un territorio colombiano / Medical care for body packers in a Colombian territory

Introducción. El número de capturas a los body packers, que son aquellas personas que ingieren paquetes con estupefacientes para tráfico ilegal, ha aumentado paulatinamente. El objetivo de este estudio fue presentar los casos de body packers atendidos en dos instituciones de salud de Florencia, un territorio al sur de Colombia, entre 2003 y 2017. Métodos. Este es un estudio retrospectivo descriptivo. Se hizo un análisis univariado en RStudio y Microsoft Excel® de variables sociodemográficas y clínicas. Se emplearon medidas de tendencia central y dispersión para las variables continuas, frecuencias y proporciones para las variables categóricas. Resultados. Se incluyeron 72 pacientes. La mayoría de los casos fueron reportados entre 2007 y 2012 (77,5 %). La relación entre hombres y mujeres fue de 4,9:1. La edad media fue de 29,1 años. El principal motivo de admisión fue para chequeo médico tras captura por parte de los organismos de seguridad nacional (76,4 %). En 9 de cada 10 admitidos se realizaron estudios de imagen (94,4 %); la principal ayuda diagnóstica fue la radiografía de abdomen simple (84,7 %), con una sensibilidad del 91,6 %. Se realizó manejo expectante en tres de cada cuatro pacientes (74,6 %). El 6,9 % presentaron complicaciones, con una mortalidad (1,4 %). Conclusiones. La radiografía de abdomen simple es una ayuda diagnóstica adecuada para el tamizaje de los body packers. El manejo conservador es aceptable, teniendo en cuenta el porcentaje bajo de complicaciones.

Introduction. The number of arrests of body packers, who are those people who ingest packages with narcotics for illegal trafficking, has gradually increased. The objective of this study was to present the cases of body packers treated in two health institutions in Florencia, a territory in southern Colombia, between 2003 and 2017. Methods. This is a descriptive retrospective study. A univariate analysis was performed in RStudio and Microsoft Excel® of sociodemographic and clinical variables. Measures of central tendency and dispersion were used for continuous variables, frequencies and proportions for categorical variables. Results. 72 patients were included. Most cases were reported between 2007 and 2012 (77.5%). The ratio between men and women was 4.9:1. The mean age was 29.1 years. The main reason for admission was for medical check-up after capture by national security agencies (76.4%). In nine out of ten admitted patients, imaging studies were performed (94.4%); the main diagnostic imaging was simple abdominal X-ray (84.7%), with a sensitivity of 91.6%. Expectant management was performed in three out of four patients (74.6%). 6.9% presented complications, with one mortality (1.4%). Conclusions. Simple abdominal x-ray is an adequate diagnostic tool for screening body packers. Conservative management is acceptable, taking into account the low percentage of complications.

Association of male lower urinary tract symptoms with metabolic syndrome: a prospective study from tertiary care centre

Background: The exact nature of the association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) is still not completely understood. There appears to be support for the hypothesis that metabolic and pathological derangements characterizing MetS can promote the development and progression of Benign Prostatic Enlargement and LUTS. Methods: A total of 212 patients were included in the study, of whom 106 (50%) had LUTS and metabolic syndrome and 106 (50%) had LUTS without metabolic syndrome. The severity of the patient抯 lower urinary tract symptoms was assessed by the International Prostate Symptom Score (IPSS). Erectile function was assessed by a 5 question International Index of Erectile Function (IIEF) Questionnaire. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). Results: The study showed a statistically significant association between prostate volume, IPSS score, and each individual component of metabolic syndrome. There is a significant association between metabolic syndrome and sexual dysfunction in men, and the severity of lower urinary tract symptoms is correlated with the severity of erectile dysfunction in the age group in the department of urology. Conclusions: Patients with MetS, characterized by increased waist circumference, BMI, triglycerides, and decreased HDL levels, exhibited more severe Lower urinary tract symptoms, along with heightened sexual dysfunction, particularly erectile and ejaculatory dysfunction.

Encefalitis por dengue en Argentina / Dengue encephalitis in Argentina

Resumen El virus dengue es un virus endémico en Argentina que, si bien inicialmente se consideró que no era neu rotrópico, actualmente se reconoce que tiene neuroinva sión, condicionando así una prevalencia de manifesta ciones neurológicas de hasta el 15% entre los enfermos. Aun siendo considerados síntomas de gravedad, existe subdiagnóstico de encefalitis por dengue debido a su variada forma de presentación clínica. Las manifesta ciones neurológicas de la encefalitis por dengue pueden abarcar desde fiebre y cefalea hasta alteraciones del nivel de conciencia y convulsiones. Si bien el líquido cefalorraquídeo (LCR) puede hallarse normal en hasta un tercio de los casos, lo habitual es que presente aumento de concentración de proteínas y pleocitosis. En cuanto a los métodos de neuroimagen, los hallazgos suelen ser variados e inespecíficos, e incluso pueden ser normales hasta en 40-50% de los casos. Se presentan 3 casos de encefalitis por dengue diag nosticados en un hospital universitario de Buenos Ai res, Argentina, en donde la presentación clínica varió desde desorientación témporo-espacial hasta estatus convulsivo refractario con diferentes presentaciones en el LCR pero todos con PCR positivo para dengue y con neuroimágenes sin alteraciones.

Abstract Dengue virus is an endemic virus in Argentina that, although it was initially considered to be non-neuro tropic, it is currently recognized to be neuroinvasive; thus conditioning a prevalence of neurological mani festations of up to 15% among patients. Even being considered severe symptoms, there is underdiagnoses of dengue encephalitis due to its varied clinical presenta tion. Neurological manifestations of dengue encephalitis can range from fever and headache to altered levels of consciousness and seizures. Although the cerebrospinal fluid may be normal in up to a third of cases, it usually presents increased protein concentration and pleocyto sis. Regarding neuroimaging methods, the findings are usually varied and nonspecific, and can even be normal in up to 40-50% of cases. We present three cases of dengue encephalitis di agnosed in a university hospital in Buenos Aires, Ar gentina, where the clinical presentation varied from temporal-spatial disorientation to refractory convulsive status with different presentations in the cerebrospinal fluid but all with positive PCR for dengue in it and with normal neuroimaging.

Uma abordagem qualitativa sobre o uso do cateter urinário de longo prazo no contexto ambulatorial / A qualitative approach on long-term indwelling catheter use in an outpatient setting

Resumo O cateter vesical de longa permanência pode ser indicado em situações clínicas, como nas doenças crônicas do sistema genitourinário ou neurológico. Além dos riscos de infecção, traumas e sangramentos, a permanência do cateter pode afetar dimensões psicoemocionais e socioeconômicas. Objetivamos compreender como a necessidade de uso do cateter urinário por um longo prazo afeta a autopercepção, as interrelações e o autocuidado deste paciente. Realizamos um estudo qualitativo, descritivo, a partir da entrevista de 17 pacientes, e aplicamos a análise temática e o pensamento complexo. Os diferentes prognósticos e as expectativas em relação ao cateter influenciaram a autopercepção, a adaptação, sua aceitação ou negação. A presença do cateter, seja como medida curativa ou para conforto, pode afetar a autoimagem e a sexualidade, gerar inseguranças e incertezas, que requerem compreensão da multidimensionalidade das situações, que sofrem interferências do meio pessoal, familiar e social, bem como da capacidade dos sistemas de saúde para o seu enfrentamento. Apesar dos desafios, a maioria dos participantes relatou disposição favorável para o autocuidado, seja para viabilizar retirada do cateter, ou para prevenir agravos em indicações vitalícias.

Abstract A long-term indwelling catheter may be indicated in clinical situations, such as chronic diseases of the genitourinary or neurological systems. In addition to the risks of infection, trauma, and bleeding, a catheter's permanence can affect psycho-emotional and socioeconomic dimensions. We aimed to understand how the need to use a long-term indwelling catheter affects this patient's self-perception, interrelationships, and self-care. We carried out a qualitative, descriptive study based on interviews with 17 patients, and applied thematic analysis and complex thinking. The different prognoses and expectations regarding the catheter influenced self-perception, adaptation, acceptance, or denial. The presence of a catheter, whether as a curative measure or for comfort, can affect self-image and sexuality, and generate insecurities and uncertainties, which require understanding the multidimensionality of situations that suffer interference from the personal, family, and social environment, as well as health systems' capacity to deal with it. Despite the challenges, the majority of participants reported a favorable disposition towards self-care, whether to enable catheter removal or to prevent injuries in lifelong indications.

Quality of life in menopausal women attending gynaecology OPD in a tertiary care hospital

Background: The longevity of women due to increase in life expectancy makes them spend almost one third of life after menopause. Menopause is a transitional event that can profoundly affect quality of life. It is an adaptation process accompanied by many biological, psychological changes. Aim of the study was to study menopause related symptoms, their severity and impact on quality of life.Methods: The longevity of women due to increase in life expectancy makes them spend almost one third of life after menopause. Menopause is a transitional event that can profoundly affect quality of life. It is an adaptation process accompanied by many biological, psychological changes. Aim of the study was to study menopause related symptoms, their severity and impact on quality of life.Results: The present study showed that the most severe symptoms of vasomotor, psychological, physical and sexual domains were hot flushes, night sweats, feeling of wanting to be alone, feeling depressed, low backache, change in sexual desire. In group 1 there were more vasomotor symptoms as compared to group 2. Severity of psychological, physical, sexual symptoms increased in group 2. In local gynaecological examination more abnormalities were found in group 2 (34%) as compared to group 1 (14%). Also, there was an increased percentage of diabetes (18.96%), hypercholesterolemia (31.03%), hypertriglyceridemia (31.03%) in group 2.Conclusions: Our study concluded that by identifying characteristics associated with poor quality of life of menopausal women would help them in making strategies that are required for improving their health and quality of life.

Genitourinary syndrome of menopause exploring the history, updates and treatment

The biological factors and physiological functions fundamental to the female anatomy delineate the complexity of reproductive phenomenon in this population. When women experience menopausal transition, genital, sexual, and urinary signs and symptoms materialize often. These longstanding signs and symptoms, presently referred to as the genitourinary syndrome (GUS) of menopause, a relatively new term, impact their quality of life and sexual health with the emergence of vulvovaginal and urogenital atrophy, typical of irritation, soreness, dryness, dyspareunia, and itching. Despite its prevalence, GUS of menopause often goes unreported due to embarrassment, leading to underdiagnoses, diminished intervention, and under-treatment. Moreover, the rising life expectancy is also emerging as a contributing factor to the increasing prevalence of GUS of menopause, directly affecting women's health. While there are notable awareness, education, and healthcare frameworks in place aimed at addressing the unique needs of menopausal women, there is a need to explore further GUS� prevalence, pathophysiology, risk factors, clinical features, diagnosis, and treatment to understand, diagnose, and effectively manage this condition.

A comparative study of morbidity and symptom severity among double-J stented patients with and without tamsulosin administration

Background: The insertion of a double-J (DJ) stent is considered a routine and necessary urological procedure. The symptoms produced by the stent are predominantly irritative in nature and the use of alpha blockers like tamsulosin have shown considerable in treating the stent associated symptom. Aim of the study was to assess tamsulosin's impact on ureteral stent-associated morbidity. Methods: A comparative cross-sectional study. All the patients with ureteric calculi admitted in the department of urology, Narayana Hospital, Nellore, Andhra Pradesh. Results: A total of 80 patients who met the inclusion criteria, were divided into two groups. Group A receiving placebo and group B receiving tamsulosin 0.4 mg. Among the study population, there was statistically significant difference between the means of parameters between the groups during the stent removal. The means of group B were significantly lower than the means of group A which shows that tamsulosin is very effective in managing the pain and also the stent related morbidity. Conclusions: Tamsulosin is very effective in managing the pain and also the stent related morbidity, which was measured by international prostate symptom score (IPSS) score – both obstructive and irritative. The quality of life was suggestively better in tamsulosin group.

Premenstrual syndrome among budding medical professionals at medical college in a metro city: a cross sectional study

Background: Premenstrual syndrome (PMS) is a group of menstrual disorder constituting various physical, emotional and behavioral symptoms occurring in the luteal phase usually a week before menstruation. It is a very common condition affecting many young girls and severity can have a negative impact on the quality of life. Our study was done to estimate the prevalence of this condition among the medical undergraduate students.Methods: This cross-sectional study was conducted at Lady Hardinge medical college, New Delhi, India among medical undergraduates after ethical clearance. A convenient sample size of 228 was taken. The participants were selected by random sampling technique and informed consent was obtained. The data was collected as per PMSS scale and analyzed by frequencies and percentages using SPSS version 21.Results: The prevalence of PMS among our enrolled participants was 100%. Majority about 61% belonged to age group of 21-25 years. About 40.8% of students had mild symptoms, 35.1% moderate, 18.0% severe and 6.1% very severe form of PMS. However, no significant difference was found in the severity between 2 age groups.Conclusions: Our study highlights 100% prevalence of PMS with varied severity of presentation. The very high prevalence of PMS among medical undergraduates calls for an urgent need to priorities the health care by creating awareness and provide necessary medical, social and psychological support to our budding professionals.

A study of knowledge, attitude and perception of perimenopausal changes in women aged 40-45 years in Gurugram district of Haryana, India

Background: Menopause, defined as cessation of menstruation for at least one year duration, due to exhaustion of the ovarian functions. 'Perimenopause' or 'climacteric' is the period of transition in which the woman's body makes the changes for menopause.Methods: A cross- sectional study by recruiting 100 female participants between 40-45 years.Results: 56% women have not heard about the term menopause or perimenopause. 50% thought that stoppage of menstrual cycle was a natural phenomenon and 70% had no idea about the risk factors of perimenopause or menopause. 68% females did not know about hormone replacement therapy.Conclusions: More spread of awareness and health education is needed regarding the same so as to clarify the doubts and bust the many myths existing so as to help women have a smooth transition to menopause and have a healthy and productive post-menopausal life.

Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers

Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.

Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.

Estructura de los síntomas de depresión según el CES-D y la ZDS en pacientes ambulatorios de un hospital general de Lima, Perú / The Structure of Depressive Symptoms Using CES-D and ZDS in Outpatients in a General Hospital in Lima, Peru

RESUMEN Introducción: La depresión es una de las principales causas de discapacidad por enfermedad en el mundo. Estudios previos han demostrado la gran heterogeneidad del diagnóstico de depresión, por lo que es necesario desarrollar nuevas aproximaciones diagnósticas. El análisis de redes es una perspectiva que considera los síntomas como constituyentes del trastorno psiquiátrico. El objetivo es determinarla estructura de síntomas depresivos a partir de las escalas para depresión CES-D y ZDS. Métodos: Estudio transversal de análisis secundario de 194 pacientes mediante las escalas CES-D y ZDS. A partir de la base de datos se elaboraron matrices de correlaciones y redes de correlaciones parciales regularizadas, se estimaron medidas de centralidad y se realizó un análisis de estabilidad de la red. Resultados: En la escala CES-D, el ítem más central fue «Triste¼, mientras que en la escala ZDS lo fueron «Triste¼ y «Vivir¼. En la escala CES-D, la conexión entre «Disfrutar¼ y «Contento¼ fue la más fuerte. En la escala ZDS, fue entre los ítems «Vivir¼ y «Útil¼. El ítem «Marianas¼ fue el menos conectado de la red ZDS. Conclusiones: El síntoma más central de la escala CES-D fue la tristeza, mientras que en la ZDS fueron la tristeza y la anhedonia.

ABSTRACT Background: Depression represents one of the leading causes of disability due to illness worldwide. Previous studies have demonstrated the significant heterogeneity of the diagnosis of depression, making it necessary to develop new diagnostic approaches. Network analysis is a perspective that considers symptoms as constituents of the psychiatric disorder itself. The objective was to determine the structure of depressive symptoms using the CES-D and ZDS depression scales. Methods: Cross-sectional study of secondary analysis of 194 patients using the CES-D and ZDS scales. Correlation matrices and regularised partial correlation networks were constructed from the database. Centrality measures were estimated, and a network stability analysis was performed. Results: On the CES-D scale, the most central item was "Sad"; while on the ZDS scale, the most central items were "Sad" and "Live". On the CES-D scale, the connection between "Enjoy" and "Happy" was the strongest. On the ZDS scale, the strongest connection was between the items "Live" with "Useful". The item "Morning" was the least connected on the ZDS. Conclusions: The most central symptom from the CES-D scale was sadness, while from the ZDS scale, was sadness and anhedonia.

Clinical usefulness of urinary symptoms and urinalysis in diagnosis of Schistosoma haematobium infection in an endemic area in Southern Nigeria: descriptive study

Background: Schistosoma haematobium infection occurs worldwide with the largest number of cases seen in sub-Saharan Africa. Most of the infections are acquired during childhood and are linked to urogenital diseases which contributes significantly to morbidity and mortality. A study on the use of urinary symptoms, signs and urinalysis in the diagnosis of S. haematobium infection might aid in providing early, prompt and rapid intervention that will limit associated complications.Methods: The study was a descriptive cross-sectional of 421 children aged 6-12 years in Ohaukwu LGA, Ebonyi State, recruited from four public primary schools using multistage sampling method. Urinary symptoms and signs were obtained using a questionnaire; urine samples were collected for urinalysis and urine microscopy. Simple proportions and odds ratio (CI) were used to analyze the data. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for various symptoms and signs. The data was analyzed with IBM-SPSS 20. Significance was set at p<0.05.Results: The prevalence of S. haematobium infection among school children in Ohaukwu LGA was 30.17%. Visible blood in urine 71.77% and dysuria 70.16% were the predominant symptoms while liver tenderness 8.87% was the most common sign. The sensitivity vs specificity of visible blood in urine and microscopic haematuria were 71.77% vs 94.43% and 100.00% vs 97.21% respectively.Conclusions: Microscopic haematuria alone was highly sensitive and specific and can be a reliable alternative to the gold standard in making diagnosis of S. haematobium infection in children living in this endemic region.

Comparison of stent-related symptoms, passive ureter dilatation and stone clearance rate using 4.5 French versus 6 French double J stenting of unfavourable ureter: a prospective randomized controlled trial in a tertiary care centre

Background: Retrograde intrarenal surgery (RIRS) is the standard of care for renal stones of less than 1.5 cm and less than 1000 Hounsfield units (HU). Most virgin ureters do not allow the flexible ureteroscope in the first setting. Placement of a D-J stent in the ureter dilates the ureter. Therefore, our study aimed to compare stone clearance rates and symptom complex of passive ureteral dilation following 4.5 French/Fr versus 6 French/Fr double J (DJ) stent placement. Methods: After obtaining ethics approval and written informed consent, 100 patients satisfying the inclusion and exclusion criteria were included and data recorded. patients were randomized into group A (4.5 Fr) and group B (6 Fr). Stent was placed. After 4 weeks, symptoms were assessed by the ureteral stent symptom questionnaire (USSQ). Following retrograde intrarenal surgery (RIRS) successful passage of ureteric access sheath (UAS) and stone clearance rates were assessed. Results: The surgical success rate, stone clearance rate was similar in the two groups (p value: more than 0.05). The USSQ score was significantly lower in group A (p value: 0.001). Conclusions: Stent of smaller diameter (4.5 Fr) is associated with less patient discomfort with similar surgical completion rates and stone clearance.

Diagnosis delay and factors associated with delay among tuberculosis patients in Mombasa County, Kenya

Background: Most tuberculosis (TB) transmissions occur between the onset of symptoms and treatment initiation. Early case identification and treatment initiation is an effective method to control the spread of TB, but the lack of a clear understanding about the extent of TB diagnostic delay and the factors contributing to delay continue to derail progress in combating the disease. The purpose of this study was to determine the extent of diagnostic delay and factors associated with delay among TB patients. Methods: An analytic cross-sectional survey of 302 TB patients on the intensive phase of treatment was carried out to determine the diagnostic delay period among TB patients. Data were collected using a semi-structured questionnaire. The mean patient delay and associations between the length of patient delay and the various independent variables were determined. Results: The mean diagnostic delay was 47 days, patient delay was 34 days and health system delay was 13 days. Patients with extrapulmonary TB had lengthy diagnostic delay of 81 days. Prolonged delay was associated with low TB awareness. Conclusions: The study findings underscore the need to improve the quality of TB awareness in the community; campaigns should go beyond providing general information about TB to emphasize on early care-seeking.

Lower urinary tract symptoms evaluation with uroflowmetry in patients with benign prostatic hyperplasia

Background: Uroflowmetry, a non-invasive urodynamic technique, is commonly employed in evaluating patients with potential lower urinary tract dysfunction. Accurate assessment of the severity of lower urinary tract symptoms (LUTS) can be achieved through the utilization of various validated questionnaires, such as the International Prostate Symptom Score (IPSS). The objective of this study was to investigate the correlation between uroflowmetry parameters and the severity of symptoms. Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation from May 2022 to December 2023. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Significant statistical correlations were identified between the IPSS and uroflowmetry outcomes, including peak flow rate, average flow rate, and post-void residual urine. However, no correlation was observed between the IPSS and measurements of prostate volume. Conclusions: A positive correlation was observed between the measured peak flow rate through uroflowmetry and the severity of lower urinary tract symptoms.

Evaluation of current physical symptoms and psychological sufferings of patients during attending department of palliative medicine in a tertiary care hospital

Background: Empirical evidence indicates that anxiety and depression in cancer patients are often overlooked, leading to insufficient assistance for their psychosocial needs. Distinguishing between clinical anxiety and depression and the typical emotional distress post-cancer diagnosis can be challenging but holds significant implications for coping strategies and outcomes. The aim of this study was to assess current physical symptoms and psychological sufferings of patients� during attending in a Palliative care department of a tertiary care hospital. Methods: This cross?sectional study was conducted among 191 patients with cancer attending the department of palliative medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from November 2021 and March 2022. Data was collected by face?to?face interview using a structured questionnaire. Depression and anxiety were evaluated using a modified version of the primary care evaluation of mental disorders guide. Results: 47 participants (20.7% prevalence of depressive disorders and 13.9% prevalence of anxiety disorders) met the diagnostic criteria for at least one anxiety or depressive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The 95% confidence interval for these results was between 20.2 and 29.0. Conclusions: In summary, depression and anxiety disorders are prevalent among patients in palliative care, significantly reducing the quality of life for those facing cancer-related mortality.

Female pelvic floor myofascial syndrome and its relationship with lower urinary tract storage symptoms

Background: Pelvic floor myofascial syndrome is defined as non-articular skeletal muscle pain, characterized by the presence of trigger points. Present in 14-23% of patients with chronic pelvic pain. It has an impact on urinary function. The prevalence of lower urinary tract symptoms is 15-67%, with storage symptoms predominating in patients with PFMS. Objective was to determine the relationship between female pelvic floor myofascial syndrome and lower urinary tract storage symptoms.Methods: This was a retrospective, observational, descriptive, cross-sectional, homodemic and single-center study at University Hospital Doctor José Eleuterio González, Monterrey, Nuevo Leon, Mexico from period one from April 1st to June 30th, 2022. Type of non-probabilistic convenience sampling. Database in Excel 2016, Pearson's ?² statistical test in the SPSS V25® program.Results: 136 patients with PFMS and LUTS storage were evaluated. The most frequent age group was 46-55 years with 33.1% (N=45); the marital status was married with 74.3% (N=101). In relation to education 55.9% (N=76) with a bachelor's degree. The most frequent storage symptoms were nocturia 67.6% (N=92) p<0.05, frequency 60.3% (N=82) p=0.512, urgency 57.4% p<0.005.Conclusions: Knowing the correlation between PFMS and storage LUTS can guide specific pain treatment with review of urinary symptoms. In patients with nocturia, frequency, urgency, SUI and UUI, a physical examination should be performed and included trigger points in the pelvic floor. Nocturia is the most prevalent storage LUTS in PFMS.

A case of recurrent achalasia cardia with sigmoid esophagus managed laparoscopically

Recurrences of symptoms after the surgery for achalasia cardia are not uncommon. There are several causes of recurrences but the early recurrences are thought to be secondary either to incomplete myotomy or late recurrences due to fibrosis after the myotomy or megaesophagus. A laparoscopic approach is a standard method because of the obvious benefits for the patients. The extent of the myotomy and addition of fundoplication are debatable issue in the management of achalasia cardia but evidence suggests that some kind of fundoplication would be necessary after the complete division of lower esophageal sphincter. We present our experience in a case of recurrent achalasia, secondary to incomplete myotomy managed laparoscopically by extended myotomy and a Dors fundoplication.

Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms / Exposición a la violencia y discapacidad en mujeres colombianas sobrevivientes de violencia de pareja íntima: el papel mediador de los síntomas depresivos

ABSTRACT Background: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. Methods: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. Results: The direct effect of IPV severity on the level of disability was not statistically significant ((3 = 0.09; P = 0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was ((3 = 0.39; P <0.01). The total effect of IPV severity on the level of disability was even greater ((3 = 0.48; P = 0.01). Conclusions: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

RESUMEN Introducción: La violencia es un importante problema de salud pública y una de las principales causas de muerte en todo el mundo. Las consecuencias para la salud mental de sobrevivir a la violencia de la pareja íntima incluyen depresión, ansiedad y trastorno de estrés postraumático. Estudios previos han identificado que existe una relación entre la depresión y el nivel de discapacidad en mujeres sobrevivientes a violencia de pareja íntima. La estimación del efecto directo, indirecto o total de una exposición en un resultado permite identificar efectos mediadores en un grupo de variables. La detección de los efectos de la mediación es útil para identificar vías causales que generan un resultado final y proporciona una justificación para diseñar intervenciones dirigidas al mediador, lo que a su vez afecta positivamente al resultado. El objetivo es identificar el efecto mediador de los síntomas de depresión en la relación entre gravedad de la violencia y el nivel de discapacidad de las mujeres víctimas de violencia de pareja. Métodos: Estudio transversal que incluyó a 94 mujeres de 18 o más años víctimas de violencia de pareja, identificadas en 2 instituciones públicas de salud de Cali y Tuluá, en el suroccidente de Colombia. Se realizó un análisis de rutas causales mediante un modelo de ecuaciones estructurales (SEM), en Stata® 14. Resultados: El efecto directo de la gravedad de la violencia en la discapacidad no es significativo ((3 = 0,09; p = 0,63); sin embargo, el efecto indirecto mediado por los síntomas de depresión incrementa su magnitud y es significativo (3 = 0,39; p <0,01). El efecto total es mayor y significativo (3 = 0,48; p = 0,01). Conclusiones: Existe un papel mediador de los síntomas depresivos entre la exposición a violencia de pareja y el nivel de discapacidad en las mujeres del suroccidente colombiano. Así, tratar los síntomas de depresión es fundamental para mejorar la funcionalidad de las mujeres víctimas de la violencia de pareja. Los resultados de esta investigación contribuyen a definir estrategias para prevenir y abordar la violencia de pareja, los síntomas depresivos y la discapacidad en esta población.