Efectos de la COVID-19 en la calidad de la atención de los servicios de salud en Colombia: Revisión de literatura / Effects of COVID-19 on the quality of health care services in Colombia: a literature review / Efeitos da covid-19 na qualidade dos serviços de saúde na colômbia: revisão da literatura

Introducción: La pandemia por COVID-19 ha afectado significativamente la calidad de los servicios de cuidado de la salud. Objetivo: Analizar los efectos en los atributos de la calidad en salud de los servicios de atención de enfermedades diferentes a la COVID-19 en Colombia, durante el periodo 2020-2022. Materiales y métodos: Se analizaron 24 artículos de alcance nacional y otros específicos de departamentos como Antioquia, Córdoba, Santander y Cundinamarca. Resultados: La pandemia por COVID-19 impactó la calidad de los servicios en la atención de enfermedades como cáncer, accidentes cerebrovasculares y de eventos como la interrupción voluntaria del embarazo. Conclusión: La calidad de la salud se vio afectada en todas sus dimensiones durante las fases de la pandemia, especialmente en la población con enfermedades crónicas y relacionadas con la salud infantil y materna. Además, se destacaron respuestas como el uso de la telemedicina y de la atención domiciliaria para contribuir a la calidad de la salud en Colombia.

Introduction: The COVID-19 pandemic has significantly affected the quality of health care services. Objective: To analyze the effects of COVID-19 on the quality of health care services focused on treating diseases other than COVID-19 in Colombia during the 2020-2022 period. Materials and methods: 24 articles were analyzed, which included some studies focused on national issues and others specific to the departments of Antioquia, Cordoba, Santander, and Cundinamarca. Results: The COVID-19 pandemic affected the quality of health services caring for diseases such as cancer, strokes, and critical circumstances like voluntary termination of pregnancy. Conclusion: All dimensions of health care were affected during the pandemic, especially impacting populations with chronic diseases and diseases related to child and maternal health. It is important to highlight that telemedicine and home care contributed to improving the quality of health in Colombia.

Introdução: A pandemia de COVID-19 afetou significativamente a qualidade dos serviços de saúde. Objetivo: Analisar os efeitos da COVID-19 nos atributos de qualidade em saúde dos serviços de atenção a outras doenças além da COVID-19 na Colômbia, durante o período 2020-2022. Materiais e métodos: foram analisados 24 artigos de âmbito nacional e outros específicos de departamentos como Antioquia, Córdoba, Santander e Cundinamarca. Resultados: A pandemia da COVID-19 impactou a qualidade dos serviços no cuidado de doenças como câncer, acidente vascular cerebral e eventos como a interrupção voluntária da gravidez. Conclusão: A qualidade da saúde foi afetada em todas as suas dimensões durante as fases da pandemia, especialmente na população com doenças crônicas e doenças relacionadas à saúde infantil e materna. Além disso, foram destacadas respostas como o uso da telemedicina e do atendimento domiciliar para contribuir para a qualidade da saúde na Colômbia.

Impact of Kinesiotherapy Rehabilitation on Quadriceps Femoris Muscle Strength and Functionality in Total Hip Arthroplasty Patients / Impacto de la Rehabilitación con Kinesioterapia en la Fuerza y Funcionalidad del Músculo Cuádriceps Femoral en Pacientes con Artroplastía Total de Cadera

SUMMARY: The objective was measure quadricep strength after Total Hip Arthroplasty (THA) and kinetic treatment and then determine its impact on the functional recovery of patients with hip osteoarthritis. A total of 79 (25 were male and 54 were female) patients with THA. Exclusion criteria were previous extra-system kinetic treatment, operated on for hip fracture, not completing the treatment. Maximum Isometric Strength (MIS), Time Up and Go (TUG), Modified Harris Hip Score. There was a significant increase in the MIS of the post-treatment operated knee extension in both men and women (p < 0.0001 SE = 0.43; p < 0.0001 SE = 1.22, respectively). In the TUG, the execution time was significantly lower post-treatment in both men and women (p < 0.0001 SE = 0.77; p < 0.0001 SE = 0.94, respectively). The final Harris score increased significantly post-treatment in male and female (p < 0.0001 SE = 2.90; p < 0.0001 SE = 1.96, respectively). the association between MIS and the Harris score, it was noted that, for a 1 kg increase in this measure compared to the initial assessment, the Harris score, after 12 weeks of treatment, increased by 0.179 points (β = 0.179; p = 0.050). The conclusions were Indicate an increase in knee extension MIS of the operated hip after treatment in both sexes. At the same time, functionality increased post-treatment in both male and female.

El objetivo del estudio fue medir la fuerza del músculo cuádriceps femoral después de la artroplastia total de cadera (THA, por sus siglas en inglés) y el tratamiento kinésico, para determinar su impacto en la recuperación funcional de pacientes con osteoartritis de cadera. En el estudio participaron 79 pacientes con THA (25 hombres y 54 mujeres). Se excluyeron quienes tuvieron tratamiento Kinésico previo fuera del hospital, operación por fractura de cadera y no completar el tratamiento. Las principales medidas tomadas fueron: Fuerza Máxima Isométrica (MIS), Time UP and GO (TUG), Puntuación Modificada de Harris de Cadera. Hubo un aumento significativo en la MIS de la extensión de rodilla del lado operado después del tratamiento tanto en hombres (p<0,0001, EE=0,43) como en mujeres (p<0,0001, EE=1,22). En el TUG, el tiempo de ejecución fue significativamente menor después del tratamiento en hombres (p<0,0001, EE=0,77) y mujeres (p<0,0001, EE=0,94). La puntuación final de Harris aumentó significativamente después del tratamiento en hombres (p<0,0001, EE=2,90) y mujeres (p<0,0001, EE=1,96). En cuanto a la asociación entre MIS y la puntuación de Harris, se observó que por cada aumento de 1 kg en esta medida en comparación con la evaluación inicial, la puntuación de Harris aumentó en 0,179 puntos después de 12 semanas de tratamiento (β=0,179; p=0,050). En conclusión se observó un aumento en la MIS de la extensión de rodilla del lado operado después del tratamiento en ambos sexos. Al mismo tiempo, la funcionalidad aumentó después del tratamiento tanto en hombres como en mujeres.

Comparison of blood loss in total knee replacement surgery with and without tranexamic acid: a prospective, time framed and observational analytical study

Background: Total knee replacement is one of the common orthopaedic procedures performed worldwide. Blood transfusion is one of the major requirements in TKR procedure due to the amount of blood loss during and after the procedure. We carried out a prospective study to determine the efficacy of tranexamic acid in controlling blood loss during TKR procedure. Methods: Study was conducted at a tertiary care centre, involving cases operated by a single surgeon. Study included 140 patients undergoing primary TKR for advance degenerative disease of knee and were divided into two groups of 70 each, one group that received tranexamic acid before surgery and another group that did not receive tranexamic acid before surgery. Patient with allergy to the drug, hepato/renal dysfunction, DVT, abnormal PT and INR were not included. Tranexamic acid was given intravenously as well as intra-articular. Results: Pre-operative haemoglobin ranged from 10.2 gm% to 14.4 gm% in the group getting tranexamic acid and from 10% to 14 % in the group not getting tranexamic acid. Post operatively haemoglobin varied from 8.4 gm% to 12.8 gm% in Group 1 and from 7.8 gm% to 12 gm% in Group 2. Difference of mean post-operative Hb (p=0.0045) and PCV (p=0.0024) in two groups was statistically significant. Conclusions: We concluded that administration of tranexamic acid reduces the blood loss as well as need of blood transfusion in a patient undergoing total knee replacement.

Evaluación de la calidad del agua envasada para consumo humano en la ciudad de Villavicencio (Colombia) / Assessment of quality of sachet water for human consumption in Villavicencio (Colombia)

RESUMEN En Colombia, las empresas de acueducto deben garantizar que el agua que suministran se pueda consumir directamente; sin embargo, la percepción de la población es que su calidad no es la adecuada para su ingesta directa. Esta situación es más notoria en algunas ciudades, como es el caso de Villavicencio, Meta, donde la mayoría de la población consume agua envasada en diferentes presentaciones, debido a la poca confianza en el agua que suministra la empresa de acueducto, por lo tanto, este producto se ha convertido en un artículo de primera necesidad en la canasta familiar de los hogares de Villavicencio. El objetivo de este trabajo fue evaluar la calidad del agua envasada de diez empresas, por un periodo de 8 meses. La calidad se evaluó mediante el análisis de los siguientes parámetros fisicoquímicos: cloruro, dureza total, hierro, manganeso, nitrato, nitrito, pH, sodio, sólidos totales y turbiedad y los siguientes parámetros microbiológicos: bacterias coliformes totales, bacterias coliformes fecales y Pseudomonas aeruginosa. Los parámetros fisicoquímicos estuvieron dentro de los valores admisibles, de acuerdo con la norma de referencia; no obstante, se evidenció la presencia de microorganismos en el 33 % de las muestras analizadas, por lo que su consumo representa un riesgo para la salud humana.

ABSTRACT In Colombia, water companies must guarantee that the water they supply can be consumed directly. However, the population's perception is that the quality of this water is not adequate for direct consumption. This situation is more noticeable in some cities, such as Villavicencio, Meta, where most of the population consumes packaged water in different presentations due to little confidence in the water supplied by the water company. Therefore, this product has become a staple item of Villavicencio households. The aim of this work was to assess the quality of packaged water from ten companies for a period of 8 months. Quality was assessed by analyzing the following physicochemical parameters: chlorides, total hardness, iron, manganese, nitrate, nitrite, pH, sodium, total solids, and turbidity; and the following microbiological parameters: total coliform bacteria, fecal coliform bacteria, and Pseudomonas aeruginosa. The physicochemical parameters were within the admissible values in accordance with the reference standard. However, the presence of microorganisms was evident in 33 % of the samples analyzed, so its consumption represents a risk to human health.

Ectopic pregnancies at a tertiary care centre: a five-year retrospective study

Background: Ectopic Pregnancy results in significant morbidity. Our aim during present study was to understand age wise, parity wise distribution of cases, risk factors, clinical presentation and management of ectopic pregnancy which may be useful in lowering morbidity and mortality.Methods: A five-year retrospective study was done from 2019 to 2023; comprising detailed medical records of detected cases of ectopic pregnancies admitted to the tertiary care centre.Results: Incidence of ectopic pregnancy during present study was 0.40%. 65.48% of ectopic pregnancy cases recorded in the age group of 21-30 years. Majority of parity wise cases were multipara (63.95%). There were no risk factors noted in 34.01% cases. Majority of the cases (65.95%) had one or the other distinguishable risk factor. 21.68% cases had history of Tubectomy, while 19.38% ectopic gestation had history of abortion. Most of the patients presented with clinical presentation of amenorrhoea 59.89%. 55.83% cases had bleeding per vaginum, while 47.71% had pain in abdomen. Most common ectopic pregnancy site was ampulla, with 63.95% cases. Ultrasonic findings showed ruptured ectopic pregnancy in 59.39% cases and unruptured in 30.45%. Regarding mode of management in the cases, surgical management with unilateral total salpingectomy (56.79%) was most commonly performed, followed by salpingoopherectomy (14.81%).Conclusions: Ectopic pregnancy is a common obstetric emergency leading to first trimester morbidity and mortality. Diagnosis of these cases requires a high index of clinical suspicion and early intervention often is lifesaving. Hence, knowledge of the disease related trends and timely management is the key for successful outcomes in such cases.

Combination of purple sweet potato (Ipomoea batatas L.) leaf extract with metformin on blood glucose and total cholesterol levels of albino rats induced by high-fat diet and streptozotocin

Background: Diabetes mellitus is a metabolic disease characterized by hyperglycemia due to impaired insulin secretion, often accompanied by hypercholesterolemia. Metformin is a first-line antihyperglycemic drug that is often combined with other antihyperglycemic drugs. Purple sweet potato leaves have been widely studied to reduce glucose and cholesterol levels. Methods: This study was an experimental study using rats induced with a high-fat diet and streptozotocin, which were divided into 8 treatment groups, namely groups given CMC Na 0.5%, Metformin 45 mg/kg BW, Purple Sweet Potato Leaf Extract (SPLE) 200 mg/kg BW, SPLE 400 mg/kg BW, SPLE 800 mg/kg BW, SPLE 200 mg/kg BW with metformin 45 mg/kg BW, SPLE 400 mg/kg BW with metformin 45 mg/kg BW, and SPLE 800 mg/kg BW with metformin 45 mg/kg BW. Results: After treatment for 28 days with SPLE doses of 200 mg, 400 mg, and 800 mg/kg BW, both single doses and combinations with metformin showed a decrease in fasting blood glucose levels and total cholesterol, which were statistically significantly different (p<0.05) between treatment groups using the one-way ANOVA. The combination of SPLE 800 mg/kg BW with metformin normalized blood glucose levels of 93.50±4.93 mg/dl. Conclusion: The combination of purple sweet potato leaf extract with metformin is more effective in reducing blood glucose and total cholesterol levels compared to the single administration of metformin and SPLE.

Total cholesterol and triglycerides status in autistic spectrum disorder children: a case-control study on Bangladeshi children

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by challenges in social interaction, communication, and repetitive behaviors. The association between lipid profiles, particularly total cholesterol and triglycerides, and ASD in children is a growing focus in pediatric health research. This study aimed to assess the total cholesterol and triglycerides status in autistic spectrum disorder children. Methods: This cross-sectional study was conducted in the department of physiology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2014 to January 2015 with 100 male children, half in a healthy control group (group A) and the other half diagnosed with autism spectrum disorder (group B). Results: In this study, no significant correlation was found between the groups for age (p=0.94) or BMI (p=0.29). The mean (盨E) serum total cholesterol levels were 146�70 mg/dl in group A and 145.00�77 mg/dl in group B, showing no significant difference between the two groups (p=0.885). But, the mean (盨E) serum triglyceride levels were 86.14�28 mg/dl in group A and 107.74�91 mg/dl in group B, with significantly higher levels compared to group A (p<0.01). Conclusions: Although there is no significant difference in serum total cholesterol levels between healthy children and those with autistic spectrum disorder, there is a significant difference in serum triglyceride levels. Therefore, further studies are needed to provide a clearer understanding of the lipid profile comparison.

Study to analyse the intraoperative and post-operative complications of total abdominal hysterectomy and total laparoscopic hysterectomy

Background: Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p<0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p<0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p<0.05).Conclusions: TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.

Complicaciones de la laringectomía total: experiencia de 7 años en un hospital universitario de Paraguay / Complications of total laryngectomy: a 7-year experience in a university hospital in Paraguay

Introducción: El cáncer de laringe es la neoplasia maligna más común de las vías aerodigestivas superiores. La laringectomía total es el tratamiento de elección en casos avanzados, pero se asocia a una alta tasa de complicaciones. Objetivos: Conocer la prevalencia de las complicaciones posquirúrgicas de la laringectomía total y los factores asociados en pacientes con cáncer de laringe. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo, de corte transversal, revisando el comportamiento de la laringectomía total y sus principales complicaciones en la Cátedra y Servicio de Otorrinolaringología del Hospital de Clínicas de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción, Paraguay, de 2015 a 2022. Se incluyeron pacientes mayores de 18 años, de ambos sexos, postoperados de laringectomía total, con diagnóstico anatomopatológico de neoplasia de laringe. Se excluyeron pacientes no operados, con fichas incompletas o que abandonaron el tratamiento. Se analizaron variables demográficas, clínicas, quirúrgicas y anatomopatológicas. Resultados: Se incluyeron 10 pacientes, todos varones, con edad media de 56,3 ± 10,2 años. El 90% presentaba hábitos tóxicos. La complicación más frecuente fue la fístula faringocutánea (70%), seguida por infección del sitio quirúrgico (10%) y sangrado posoperatorio (10%). El 71,4% de las fístulas se resolvieron con medidas conservadoras. El 30% tenía afectación supraglótica y el 57,1% de los que presentaron complicaciones recibieron radioterapia previa. Conclusión: Las complicaciones de la laringectomía total son frecuentes, principalmente la fístula faringocutánea. La afectación supraglótica y la radioterapia previa se asociaron a mayor tasa de complicaciones. Se requieren estudios prospectivos con muestras más grandes para confirmar estos hallazgos.

Introduction: Laryngeal cancer is the most common malignant neoplasm of the upper aerodigestive tract. Total laryngectomy is the treatment of choice in advanced cases, but it is associated with a high rate of complications. Objectives: To determine the prevalence of postoperative complications of total laryngectomy and associated factors in patients with laryngeal cancer. Materials and methods: Observational, descriptive, retrospective, cross-sectional study, reviewing the behavior of total laryngectomy and its main complications in the Department of Otorhinolaryngology of the Hospital de Clínicas, Faculty of Medical Sciences, National University of Asunción, Paraguay, from 2015 to 2022. Patients over 18 years of age, of both sexes, who underwent total laryngectomy, with anatomopathological diagnosis of laryngeal neoplasm were included. Non-operated patients, those with incomplete records or who abandoned treatment were excluded. Demographic, clinical, surgical and anatomopathological variables were analyzed. Results: Ten patients were included, all male, with a mean age of 56.3 ± 10.2 years. Ninety percent had toxic habits. The most frequent complication was pharyngocutaneous fistula (70%), followed by surgical site infection (10%) and postoperative bleeding (10%). Conservative measures resolved 71.4% of the fistulas. Thirty percent had supraglottic involvement and 57.1% of those who presented complications received previous radiotherapy. Conclusion: Complications of total laryngectomy are frequent, mainly pharyngocutaneous fistula. Supraglottic involvement and previous radiotherapy were associated with a higher rate of complications. Prospective studies with larger samples are required to confirm these findings.

Tendencias en la cirugía de artroplastía total de rodilla en Chile. ¿Cómo las estamos operando? / Trends in total knee replacement surgery in Chile. How are we operating them?

INTRODUCCION La artroplastía total de rodilla (ATR), que ha tenido un aumento importante en la población en las últimas décadas, presenta una gran variación en su estudio y técnica entre los distintos países. En la actualidad no hay datos nacionales registrados que evalúen la forma de su implementación. Objetivo Registrar las tendencias respecto de la ATR en distintos aspectos en Chile y compararlas con los registros de otros países. MATERIALES y METODOS Se realizó una encuesta vía email a cirujanos de rodilla en Chile considerando cuatro aspectos: generalidades, estudio preoperatorio, técnica quirúrgica y técnica de cementación. Se excluyeron las encuestas que no rellenadas por completo. Se analizaron los datos generales y separados según años de experiencia (ADE). Se compararon los datos con los obtenidos en estudios internacionales. RESULTADOS Se obtuvieron 87 encuestas completas. La mayoría de los encuestados realizaba entre 25 y 50 ATR en 1 año (44%), y el 16%, más de 75. Sólo un 20% utilizaba la modalidad ambulatoria, y un 43% creía que siempre deben ser hospitalizadas (mayor frecuencia en los cirujanos con más de 10 ADE). Un 18% utilizaba algún sistema robótico, con mayor frecuencia en cirujanos con más de 10 ADE; los sistemas más usados fueron ROSA y CORI. El 90% creía que la ATR debería ser parte del programa de Garantías Explícitas de Salud (GES), sin diferencias según ADE. El 81% usaba sistema estabilizado posterior (posterior-estabilized, PS, en inglés), 96% realizaba un abordaje parapatelar medial, 82% usaba guía extramedular tibial, 41% tendía a recambiar la patela, y un 35% no usaba torniquete (ninguna de las variables mostró diferencias según ADE). Sólo un 31% utilizaba cementación al vacío (mayor frecuencia en el grupo con menos de 10 ADE), 95% colocaba el cemento en componentes y en hueso, 75% colocaba en la quilla, y 56% utilizaba el dedo para colocarlo (sólo 22% con pistola). La secuencia más frecuente de cementación fue tibia-fémur-patela. En la mayoría de los aspectos evaluados, se observaron diferencias importantes con estudios de otros países. CONCLUSION Existe una gran variabilidad en la realización de ATR en Chile, con tendencias distintas a las de otros países. En general, en relación con los distintos ADE, no hay grandes diferencias en la técnica quirúrgica, sí habiendo diferencias en la técnica de cementación y en el uso de sistemas robóticos

INTRODUCTION Total knee replacement (TKR) significantly increased among the population in recent decades, and it shows great variation in its study and technique in different countries. There is no registered Chilean data to assess TKR implementation. Objective To record the trends in TKR in different aspects within Chile and compare them with records from other countries. MATERIALS AND METHODS We conducted an email survey among knee surgeons in Chile considering four aspects: general features, preoperative study, surgical technique, and cementation technique. We excluded surveys not completed in full. The analyses included overall data and data per years of experience (YOEs), and we compared the results with those of international studies. RESULTS We obtained 87 complete surveys. Most respondents performed 25 to 50 TKRs each year (44%), with only 16% performing over 75 TKRs. Only 20% used the ambulatory modality, while 43% believed patients always require hospitalization (especially surgeons with more than 10 YOEs). Robotic systems were used by 18% of the surgeons, especially those with more than 10 YOEs; the most used systems were ROSA and CORI. In total 90% of the respondents believed TKR should be part of the Explicit Health Guarantees (Garantías Explícitas de Salud, GES, in Spanish) program, with no differences in terms of YOEs. A total of 81% used the posterior-stabilized (PS) system, 96% performed a medial parapatellar approach, 82% used an extramedullary tibial guide, 41% tended to replace the patella, and 35% did not use a tourniquet (none of the variables showed differences according to YOEs). Only 31% used vacuum cementation (with a higher frequency in the group with fewer than 10 YOEs), 95% placed cement on components and bone, 75% placed it in the keel, and 56% used finger packing (only 22% with a gun). The most common cementation sequence was tibia femur-patella. In most aspects evaluated, we observed important differences compared with studies from other countries. CONCLUSION There is a high variability in the performance of TKR in Chile, with different trends compared with those of other countries. Overall, there are no major differences in the surgical technique concerning YOEs, although there is variation in the cementation technique and the use of robotic systems

Laparoscopic surgical correction of endometriosis improves fertility rates in infertile patients: a retrospective analysis of 119 cases

Background: Endometriosis is a common cause of infertility, affecting up to 50% of women with infertility. Surgery is a widely used treatment option for endometriosis, and the removal of endometriomas, nodules, and total posterior compartment peritonectomy has been shown to improve fertility rates in affected patients. The aim of the present study was to evaluate the role of laparoscopic surgical correction of endometriosis by removal of endometriomas, nodules, and total posterior compartment peritonectomy in improving rates of fertility in patients with endometriosis.Methods: A retrospective analysis of 119 patients who underwent laparoscopic surgical correction of endometriosis for infertility between May 2021 and April 2023 at Venus Women’s Hospital and IVF Center, Rajkot, India, was conducted. Inclusion criteria were documented endometriosis confirmed on Ultrasound and/or laparoscopy or accidentally detected during laparoscopy. All patients underwent laparoscopy for diagnosis confirmation. The primary outcome was pregnancy.Results: A total of 119 patients with endometriosis-related infertility were included in the study. Of the 119 patients who underwent laparoscopic surgical correction of endometriosis, 11 were lost to follow-up, leaving 108 patients for analysis. Of these, 76 patients (70.4%) conceived within one year of surgery. Of those who conceived, 34 (44.7%) did so spontaneously, without any medical treatments. A total of 42 patients (55.3%) conceived with ovulation induction only or ovulation induction with intrauterine insemination (IUI). Twenty-two patients (28.9%) underwent in vitro fertilization (IVF) and conceived, while 10 (13.2%) did not conceive with the first cycle of IVF and were still undergoing infertility treatment. The majority of patients (95%) reported relief of dysmenorrhea and dyspareunia after surgery.Conclusions: Study suggests that laparoscopic surgical correction of endometriosis by removal of endometriomas, nodules, and posterior peritonectomy can improve rates of fertility in patients with endometriosis-related infertility. The procedure was also found to be effective in relieving pain symptoms in most patients.

Mediação de saberes na sobrevivência ao câncer de laringe: a experiência de pessoas Laringectomizadas Totais / Mediation of knowledge in surviving laryngeal cancer: the experience of Total Laryngectomized persons / Mediación del conocimiento en la supervivencia al cáncer de laringe: la experiencia de las personas sometidas a Laringectomía Total

O presente estudo parte de reflexões acerca da sobrevivência ao câncer e da experiência estigmatizante vivenciada por pessoas diagnosticadas com câncer de laringe no Hospital Nacional do Câncer/Instituto Nacional do Câncer, submetidas à cirurgia de Laringectomia Total e participantes do Grupo de Laringec-tomizados Totais. O objetivo foi compreender as mediações de saberes e de informações produzidas pelos participantes do grupo na interface com os profissionais de saúde, considerando a sua dupla condição de estigma: o câncer e a deficiência. Parte-se de uma abordagem socioantropológica de caráter qualitativo e ex-ploratório que empregou os métodos de entrevista narrativa com cinco participantes. A análise foi realizada pelo método hermenêutico-dialético. Nos resultados destacam-se a busca pelo reconhecimento individual e social e a valorização da experiência frente aos saberes oficiais e o quanto as mediações extrapolam o espaço institucional. A mediação de saberes faz emergirem elementos significativos para o enfrentamento de uma cultura informacional dominante.

This study is based on reflections on surviving cancer and the stigmatizing experience of people diagnosed with laryngeal cancer at the Hospital Nacional do Câncer/Instituto Nacional do Câncer, who underwent Total Laryngectomy surgery and participated in the Total Laryngectomy Group. The goal was to understand the mediations of knowledge and information produced by the group participants, in the interface with health professionals, considering their double condition of stigma: cancer and disability. It is based on a socio-anthropological approach, of qualitative and exploratory nature that employed the narrative interview method with five participants. The analysis was carried out through the hermeneutic-dialectic method. The results highlight the search for individual and social recognition and the appreciation of experience in relation to official knowledge, and how the mediations go beyond the institutional space. The mediation of knowledge brings out significant elements to confront a dominant informational culture.

El presente estudio se basa en las reflexiones sobre la supervivencia al cáncer y la experiencia estigmatiza-dora de personas diagnosticadas de cáncer de laringe en el Hospital Nacional do Câncer/Instituto Nacional do Câncer, que se sometieron a una Laringectomía Total y participaron en el Grupo de Laringectomía Total. Objetivo: comprender las mediaciones de conocimiento e información producidas por los participantes del grupo, en la interfaz con los profesionales de salud, considerando su doble estigma: cáncer y discapacidad. Se basa en un abordaje socioantropológico, cualitativo y exploratorio, que utilizó métodos de entrevista narrativa con cinco participantes. El análisis ocurrió a través del método hermenéutico-dialéctico. Los resultados destacan la búsqueda de reconocimiento individual y social y la valorización de la experiencia en relación con el conocimiento oficial y la medida en que las mediaciones van más allá del espacio insti-tucional. La mediación del conocimiento pone de manifiesto elementos significativos sobre una cultura informacional dominante.

Effect of omega 3 fatty acid in infertile males with oligozoospermia

Background: Oligozoospermia is the cause of male infertility in 33.3% of cases. Omega-3 fatty acid has been utilized in infertility because of its widespread availability, low cost, and high safety profile. We intended to conduct a study to evaluate the efficacy of omega-3 fatty acid in oligozoospermia.Methods: A prospective comparative study was conducted in the outdoor of the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to August 2023. A total of 70 Infertile males with oligozoospermia, were enrolled in the study. The participants were assigned to the omega-3 fatty acid group who was treated with omega-3 fatty acid 1 gm orally twice daily for 12 weeks. The other group was treated with placebo orally twice daily for 12 weeks. Sixty patients completed the 12 weeks of treatment. The changes in sperm count were determined.Results: The mean age of the participants was 35.6±4.59 years. Following treatment with omega-3 fatty acid significant improvement was observed in sperm count from 11.10±2.81 million/ml to 34.2±31.36 million/ml. Significant improvement in total motile sperm count was also observed. At the end of 12 weeks of treatment 76.7% of participants in the omega 3 fatty acid group and 10.0% in the placebo group had normozoospermia.Conclusions: Supplementation with omega-3 fatty acid results in improvement of sperm concentration and total motile sperm count in infertile men with oligozoospermia.

Role of Bougainvillea glabra Stem Extract on Paracetamol and Alcohol-Induced Hepatotoxicity in Rats

The current study investigates the in-vivo hepatoprotective effectiveness of Bougainvillea glabra stem extract against alcohol and paracetamol-induced hepatotoxicity in animal models. The alterations in liver enzymes including serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP), and total bilirubin are studied in rats given B. glabra extract with paracetamol or alcohol to produce hepatotoxicity. The levels of glutathione and lipid peroxidation were also examined, and the outcomes were contrasted with silymarin as the reference. The acute toxicity studies presented the plant extract under category 5 of GHS system, which further motivated the studies for hepatoprotective activity. The induction of hepatotoxicity was confirmed with the elevated levels of serum and tissue biochemical by the administration of paracetamol and alcohol. Under paracetamol as a hepatotoxin, the animals with 200 and 400 mg/kg p.o demonstrated near figures for SGPT and SGOT of the group treated with silymarin with significance. The results were still more appreciative under alcohol as a hepatotoxin. In both cases, the group with 400 mg/kg p.o gave a promising result with the reduced inflammatory cells under histopathological studies.

Quality of Life of Patients submitted to Total Knee Arthroplasty / Qualidade de vida de pacientes submetidos à artroplastia total do joelho

Objective: the aim of this study was to evaluate the quality of life between patients who have already undergone the TKA surgery and those who have not. Methodology: 118 patients [60 undergoing TKA (G1) and the remaining 58 awaiting the procedure (G2)] answered questions about QoL using the WOMAC and SF-36 protocols. The comparison was performed using the chi-square test and Student's t-test, with a significance level of 0.05. Results: with regard to clinical aspects, there was a higher level of pain in Group G2, as well as greater frequency in the use of medications, especially for pain relief. In the QoL evaluation, significant difference was observed in all the domains of the generic questionnaire SF-36 and in WOMAC, estando a capacidade functional do G2 reduzida e abaixo do nível observado nos pacientes do G1. Conclusion: patients with advanced knee arthrosis who underwent TKA, compared to those who did not undergo the procedure, had better quality of life in all domains assessed by both the general SF-36 questionnaire and the WOMAC questionnaire.

Objetivo: o objetivo deste estudo foi avaliar a qualidade de vida entre pacientes que já se submeteram à cirurgia de ATJ e aqueles que ainda não passaram pelo procedimento. Metodologia: 118 pacientes [60 submetidos à ATJ (G1) e os 58 restantes aguardando o procedimento (G2)] responderam perguntas sobre QV usando os protocolos WOMAC e SF-36. A comparação foi realizada usando o teste qui-quadrado e o teste t de Student, com um nível de significância de 0,05. Resultados: em relação aos aspectos clínicos, houve um maior nível de dor no Grupo G2, bem como maior frequência no uso de medicamentos, especialmente para alívio da dor. Na avaliação da QV, foi observada diferença significativa em todos os domínios do questionário genérico SF-36 e no WOMAC, estando a capacidade funcional do G2 reduzida e abaixo do nível observado nos pacientes do G1. Conclusão: pacientes com artrose avançada de joelho que se submeteram à ATJ, em comparação com aqueles que não passaram pelo procedimento, apresentaram melhor qualidade de vida em todos os domínios avaliados tanto pelo questionário geral SF-36 quanto pelo questionário WOMAC.

Total leucocyte count and platelet indices: novel, early diagnostic markers of acute appendicitis

Background: Among the plethora of causes for patients presenting with an acute abdomen, appendicitis is the most common conclusive diagnosis. Known being controversial for its etiology and pathogenesis, diagnosis of acute appendicitis has been challenging despite the development of various clinical and laboratory studies. Inflammatory markers of hematological origin-total leucocyte count (TLC), platelet indices viz. mean platelet count (MPV), plateletcrit (PCT), and platelet distribution width (PDW), have long been preferred as rudimentary diagnostic parameters for acute appendicitis despite being contentious. Methods: An analytical and cross-sectional study among 100 individuals. Statistical evaluation of TLC, MPV, PCT and PDW of 21 appendicitis cases and 70 healthy individuals were complied. Results: Compared to the control group, cases showed significantly higher values of TLC and MPV while the PCT and PDW were normally distributed and showed no significant statistics. The sensitivity of TLC and MPV was determined to be 95.2%, 71.4%, and specificity 100%, 73.8% respectively. Conclusions: With equitable results, the routine and cost-effective TLC and MPV play a novel role in the early diagnosis of acute appendicitis.

Sigma metrics as quality indicators in guiding and tracking laboratory process improvement

Background: To demonstrate the utility of sigma metrics towards assessing the quality of processes, and optimization of statistical quality control rules in a high-volume clinical laboratory, in a two-phase quality improvement project. Methods: In the 損re� period, the sigma score was assessed across 25 routine high-volume assay parameters in our laboratory, comprising of 20 clinical chemistry and 5 immunoassay methods. Measures were taken to improve the analytical quality of low sigma score parameters within a 6-month period. Another sigma metric analysis was then performed in the 損ost� period to examine any measurable improvement. Results: The average sigma metric increased from 6.4? to 9.2?. Out of 25 analytes, 17 showed a significant improvement, defined as an increase in the sigma metric by greater than 1.0. Conclusions: The changes in sigma metric had a significant positive impact on the DPMO and reinforced the reliability of our test results. It showed that our quality control processes can be streamlined and simplified further, to optimize the frequency of internal quality control, while still maintaining the same level of error detection and analytical quality assurance. The analysis also provided additional benefits of achieving lesser errors, fewer sample reruns and troubleshooting, and improved turnaround time, for better clinician and patient satisfaction

Effect and Mechanism of Total Saponins from Panax Japonicus on White Adipose Tissue Browning/Brown Adipose Tissue Activation in High-fat Diet-induced Mice / 中国实验方剂学杂志

ObjectiveTo investigate the effect and mechanism of total saponins from Panax japonicus （TSPJ） on white adipose tissue （WAT） browning/brown adipose tissue （BAT） activation in C57BL6/J male mice fed on a high-fat diet （HFD）. MethodThirty-two C57BL6/J male mice （8-week-old） were randomly divided into a normal group， a model group， a low-dose TSPJ group， and a high-dose TSPJ group. The mice in the low-dose and high-dose TSPJ groups were given TSPJ for four months by gavage at 25， 75 mg·kg-1·d-1， respectively， and those in the other groups were given 0.5% sodium carboxymethyl cellulose （CMC-Na） accordingly. After four months of feeding， all mice were placed at 4 ℃ for acute cold exposure， and the core body temperature was monitored. Subsequently， all mice were sacrificed， and BAT and inguinal WAT （iWAT） were separated rapidly to detect the corresponding indexes. Hematoxylin-eosin （HE） staining was used to observe the morphological changes in each group. The effect of TSPJ on the mRNA expression of uncoupling protein 1 （UCP1）， fatty acid-binding protein 4 （FABP4）， cytochrome C （CytC）， PR domain-containing protein 16 （PRDM16）， elongation of very long chain fatty acids protein 3 （ELOVL3）， peroxisome proliferator-activated receptor γ （PPARγ）， and peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α） in iWAT and BAT was detected by Real-time polymerase chain reaction （Real-time PCR）. Western blot was also used to detect the protein expression of UCP1， PRDM16， PPARγ， and PGC-1α in BAT and iWAT of each group. The effect of TSPJ on UCP1 expression in BAT and iWAT was detected by immunohistochemistry. Result① Compared with the model group， TSPJ could decrease the body weight and proportions of iWAT and BAT in the HFD-induced mice （P<0.05， P<0.01）. ② The body temperature of mice in the model group decreased compared with that in the normal group in the acute cold exposure tolerance test （P<0.05）. The body temperature in the high-dose TSPJ group increased compared with that in the model group （P<0.01）. ③ Compared with the normal group， the model group showed increased adipocyte diameter in iWAT and BAT and decreased number of adipocytes per unit area. Compared with the model group， the TSPJ groups showed significantly reduced cell diameter and increased number of cells per unit area， especially in the high-dose TSPJ group. ④ Compared with the normal group， the model group showed decreased mRNA expression of FABP4， UCP1， CytC， PRDM16， ELOVL3， PGC-1α， and PPARγ in adipose tissues of mice （P<0.05， P<0.01）. Compared with the model group， after intervention with TSPJ， the mRNA expression was significantly up-regulated （P<0.05， P<0.01）. ⑤ Compared with the normal group， the model group showed decreased protein expression of UCP1， PRDM16， PPARγ， and PGC-1α in adipose tissues of mice （P<0.05， P<0.01）. Compared with the model group， after intervention with TSPJ， the protein expression increased significantly （P<0.05， P<0.01）. ConclusionTSPJ could induce the browning of iWAT/BAT activation and enhance adaptive thermogenesis in obese mice induced by HFD. The underlying mechanism may be attributed to the activation of the PPARγ/PGC-1α signaling pathway.

Correlation between Content of Active Ingredients of Aurantii Fructus and Soil Factor / 中国实验方剂学杂志

ObjectiveTo study the correlation between the content of active ingredients of Aurantii Fructus in different main production areas and soil factors， so as to provide a theoretical basis for implementing ecological regulation of soil， improving the quality of Aurantii Fructus， and revealing the origin of genuine medicinal materials. MethodThe content of naringin， neohesperidin， total flavonoids， volatile oil， total nitrogen， total phosphorus， total potassium， and 17 soil factor-related indicators in 25 batches of Aurantii Fructus from different production areas were determined. The main soil factors affecting the content of active ingredients of Aurantii Fructus were analyzed by Pearson correlation analysis， principal component analysis， and grey correlation analysis. ResultThe pH value of the soil is between 4.83 and 8.21， and the soil is weakly acidic and neutral in general. Soil fertility exceeds the average. Pearson correlation analysis shows that the soil factors most related to the four active ingredients of Aurantii Fructus are total phosphorus， available copper， available zinc， exchangeable magnesium， available sulfur， available phosphorus， and available molybdenum. Principal component analysis shows that total nitrogen， alkali-hydrolyzable nitrogen， organic matter， available phosphorus， and available zinc are the main characteristic factors in soil. Grey correlation analysis shows that the main soil factors affecting the active ingredients of Aurantii Fructus are total phosphorus， total nitrogen， available zinc， available copper， exchangeable magnesium， and pH. ConclusionIn the cultivation of Aurantii Fructus， the medicinal material quality of Aurantii Fructus could be improved by adjusting the level of beneficial factors in the soil and improving the soil texture.

Research on Material Basis of Homologous and Heterogeneous Effect of Aurantii Fructus Immaturus and Aurantii Fructus Based on Total Statistical Moment Analysis and Molecular Connectivity Index / 中国实验方剂学杂志

ObjectiveTo investigate the material basis of homologous and heterogeneous effect of Aurantii Fructus Immaturus（AFI） and Aurantii Fructus（AF） based on the total statistical moment analysis and molecular connectivity index（MCI）. MethodRelevant literature at home and abroad and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP） were consulted to establish the chemical composition database of AFI and AF， and set up their fingerprints by ultra-high performance liquid chromatography（UPLC）， and the total statistical moments and similarity parameters of the fingerprint were calculated. According to MCI， all components of AFI and AF were divided into different component groups， the average values of 0-8th order（0χ-8χ） MCI of the common component groups of AFI and AF were calculated. ResultThe values of total zero-order moment（AUCT） of AFI and AF were （10.57±2.45）×106， （5.09±0.89）×106 μV·s， the values of total first-order moment（MCRTT） were （11.57±1.58）， （12.10±1.29） min， the values of total second-order moments（VCRTT） were（24.49±2.30）， （26.49±2.54） min2， respectively. It showed that qualitative and quantitative parameters of AFI and AF were significantly different. The components with high similarity such as neohesperidin， hesperidin and narirutin were screened as the common potential pharmacodynamic components of AFI and AF. The non-common components of AFI， such as alysifolinone and imperatorin， and the non-common components of AF， such as neoeriocitrin and isosakuranin， with high similarity were screened out as potential heterogeneous components of AFI and AF. The composition groups of AFI and AF were classified into six categories， and the similarities between the composition groups of AFI and AF and the total constituents were 0.872-0.979 and 0.918-0.997， the average values of 0χ-8χ MCI of alkaloids in AFI and AF were 3.65 and 3.14， the average values of 0χ-8χ MCI of flavonoids were 8.47 and 8.47， the average values of 0χ-8χ MCI of volatile oils were 2.71 and 3.48， respectively. It showed that there were some differences in MCI of chemical constituents（groups） between AFI and AF. ConclusionThe chemical constituents（groups） of AFI and AF not only differ in content and species， but also in structural characteristics and structure-activity relationship， which can provide a basis for further explaining the scientific connotation of homologous and heterogeneous effect of AFI and AF.