Introduction: Urgent medical care and specific therapy are needed for illnesses like acute appendicitis and hostile abdomen. A frequent condition that affects people of all ages, acute appendicitis is more prevalent in young people of European descent. The major factor causing acute appendix inflammation is obstruction of the appendixs lumen. Abdominal infection, acute appendicitis, acute pancreatitis, and peritonitis are just a few of the dangerous conditions that might be indicated by a hostile abdomen. Theoretically, acute appendicitis is an immediate inflammation of the appendix that causes abdominal discomfort and, if untreated, can lead to significant consequences. Acute appendicitis is often treated with surgery to remove the appendix. Abdominal discomfort, nausea, vomiting, fever, and chills are among the symptoms. Although it can afflict persons of various ages, acute appendicitis is most frequently experienced by young people of European descent. With a frequency of about 7% worldwide, acute appendicitis epidemiology is a subject of much research. A hostile abdomen is a condition that can be a symptom of a number of dangerous illnesses, including abdominal sepsis, acute appendicitis, acute pancreatitis, and peritonitis. Abdominal discomfort, stiffness, bloating, and inflammation-related symptoms are some of the symptoms. It takes a thorough analysis, including physical exams and imaging tests, to diagnose a hostile abdomen. Depending on the underlying reason, the hostile abdomen may be treated with surgery, antibiotics, or other medical procedures. Discussion: If left untreated, illnesses like acute appendicitis and hostile abdomen can lead to major problems. In order to appropriately detect and diagnose their patients, clinicians must be knowledgeable about these disorders. Although acute appendicitis cannot be prevented, major complications can be avoided with early management. For optimal care of the hostile abdomen and diagnosis of the underlying etiology, a multidisciplinary approach is also required. Abdominal hostility and acute appendicitis are two significant illnesses that need prompt medical care, a precise diagnosis, and effective treatment. A frequent condition that affects people of all ages, acute appendicitis is more prevalent in young people of European descent. An hostile abdomen is a symptom indicating a wide range of dangerous illnesses.

Postcholecystectomy bilioma is an uncommon but potentially dangerous complication that can happen after gallbladder surgery. This disorder is characterized by the buildup of bile in the peritoneal cavity as a result of bile duct damage following surgery or bile duct leaking. The development of a postcholecystectomy bilioma may be asymptomatic or manifest as nausea, fever, and abdominal discomfort. Imaging studies such as computed tomography, magnetic resonance imaging, and ultrasound are used to make the diagnosis. The size, location, and presence or absence of complications all affect how postcholecystectomy bilioma is treated. Small, asymptomatic biliomas can be treated conservatively, while larger, more difficult biliomas may need invasive procedures like surgery or image-guided percutaneous drainage. The prevention of postcholecystectomy bilioma requires meticulous surgical technique and meticulous postoperative monitoring.

Skin conditions known as keloid scars can afflict people of all ages and ethnicities. The description, features, and potential risk factors for this ailment are covered in the introduction. I provide a thorough analysis of the etiology, administration, mitigation, and therapy of keloid scars. The distinctions between keloid scars and hypertrophic scars, the causes of keloid scar development, and the surgical and non-surgical therapies that are available are all discussed. The discussion focuses on the main issues and factors in the management of keloid scars. The necessity of prevention and the need for a customized and interdisciplinary approach are explored, along with the current therapy techniques and their individual limitations. The conclusion reviews the material covered in the earlier parts and highlights the value of prevention, selecting a therapy that is tailored to the patients particular needs, and the necessity for more study into the pathophysiology of keloid scars.

The patients life and capacity to carry out everyday tasks may be significantly impacted by traumatic phalange amputation. Motor vehicle collisions and occupational exposure are risk factors for traumatic phalange amputation. To maximize the preservation of the severed component and reduce complications, proper care and treatment of traumatic phalange amputation are essential. The successful reimplantation of the severed component using the PA approach has been demonstrated. Traumatic phalange amputation treatment options include surgical repair and reperfusion therapy. Yet, time is of the importance for a successful course of therapy, therefore prompt medical attention is essential. For the sake of patient safety and occupational health care, traumatic phalange amputation prevention is crucial. Traumatic injuries can be prevented through the use of personal protective equipment and training in occupational safety. As traumatic phalange amputation can have a significant impact on the function and appearance of the affected limb, which can affect the patients ability to perform daily activities and self-esteem, it is important to provide a comprehensive approach to the patients care that includes psychological and emotional support. In general, traumatic phalange amputation may be effectively managed and treated, which can greatly enhance the patients quality of life and lessen the effects of the injury.

Introduction: If left untreated, acute cholecystitis, a common illness that can develop during pregnancy, can cause major consequences for both the mother and fetus. It might be difficult to diagnose acute cholecystitis during pregnancy since its symptoms can resemble those of other abdominal disorders. For the first time in the history of the United States, the first time in the history of the United States. The production of gallstones and consequent inflammation are thought to be caused by hormonal changes, altered gallbladder function, and reduced gallbladder motility, which are all factors in the pathophysiology of acute cholecystitis during pregnancy. The clinical history, symptoms, physical examination, and diagnostic procedures, such as abdominal ultrasonography and assessment of bilirubin and liver enzyme levels, are used to make the diagnosis of acute cholecystitis during pregnancy. The severity of the symptoms and the womans gestational age determine how to treat acute cholecystitis during pregnancy. Cholecystectomy, a laparoscopic procedure to remove the gallbladder, is typically the most successful therapy for acute cholecystitis during pregnancy. Yet, because of the physiological and structural changes in the pregnant womans body, surgery may be more difficult. As a result, each patiens therapy should be customized, and the risks and benefits of surgery should be carefully weighed. The prognosis of acute cholecystitis during pregnancy is favourable if appropriately detected and treated. Pregnant women should be aware of symptoms and seek medical assistance right away if they think they may have acute cholecystitis. Most pregnant women may have a safe pregnancy and birth with prompt diagnosis and treatment.

Buschke-Lowenstein tumor is a benign lesion of the skin and mucosa that occurs most commonly in the genital and perianal region of sexually active men and women. It is associated with human papillomavirus (HPV) and is treated with surgery in most cases. In addition, patients with immunodeficiency have a higher incidence of TBL. The initial clinical evaluation should include a detailed history, a careful physical examination, and an assessment of risk factors, including sexual activity, immunosuppression, and HPV exposure. The diagnosis of TBL is based on clinical presentation, histopathology and HPV detection. Histopathologic examination is necessary to confirm the diagnosis of TBL and to rule out other similar conditions. In addition, HPV detection is important to establish the risk of progression to malignant lesions and guide the management of TBL. Article

Wegeners disease, also known as Granulomatosis with Polyangiitis (GPA), is a rare autoimmune disorder that affects small- to medium-sized blood vessels, causing inflammation and damage to various organs. The disease commonly involves the respiratory tract, kidneys, and the skin. In terms of dermatological symptoms, patients may develop purpura, which are small red or purple spots on the skin caused by bleeding under the skin, or nodules or ulcers that may be painful or non-painful. These lesions can occur anywhere on the body but are often found on the lower legs. Vascular involvement can lead to necrotizing vasculitis, which can be life-threatening if not treated promptly. Early diagnosis and treatment with immunosuppressive therapy can help manage the symptoms and prevent organ damage.

Lipomas of the large intestine are less frequently encountered with a frequency ranging from 0.2 to 4.4 %. Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 17571. We here describe a case of a 72-year-old female with complaints of colicky right abdominal pain for a 1-month duration. Contrast enhance CT imaging revealed a non- uniform wall thickness with irregular narrowing of lumen of intestine. She underwent right hemicolectomy in view of obstruction. Gross examination revealed a large polypoidal mass arising from the mucosa at the ileocaecal junction. Histopathological examination revealed it to be a submucosal lipoma.

Background: Pain is a subjective, emotional experience which is the most common symptom in cancer patient and its intensity increases as disease advances. Unrelieved pain affects quality of life in all direction. Therefore, assessment of patients experience of pain is an important factor in providing effective pain management. Assessment of patient satisfaction can help to identify appropriate treatment modalities and can further help in its effectiveness. Methods: A descriptive cross-sectional study was conducted among 158 cancer patients in Cancer Care Center using consecutive sampling technique. Face to face interview (semi-structured) was conducted by using a validated questionnaire "APS- POQ". Data analysis was done in SPSS version 20 using descriptive statistics. Inferential statistics such as Chi square test was used to determine association. Result: Out of total 158 respondents, 48.1% of respondents had mild pain followed by moderate pain 25.9% and 25.9% of them had severe pain. Majority of respondents 87.3% were satisfied with pain management. Out of total respondents, 94.9% were satisfied with nurses response and 93.0% were satisfied with doctors response regarding pain management. Out of total respondents 82.3% received medication in less than or equal to 10 minutes. More than half 53.2% respondents verbalized that health care personnel explained on importance and reporting of pain management. Oral pain medication, relaxation and massage were top ranked approaches. Respondents with mild to moderate pain intensity were more satisfied compared to severe pain intensity. There was association between waiting time for pain medication and patient satisfaction. Conclusion: The study concludes that majority of respondents were satisfied with overall pain management. Among total respondents, 94.9% were satisfied with nurses response regarding pain management. It was found that respondents with mild and moderate pain were more satisfied than with severe pain. It also revealed that there was significant inverse relationship between waiting time for pain medication and patient satisfaction.

Atopic dermatitis is a chronic inflammatory skin disease that affects a large number of pediatric patients between 2 and 17 years of age. Typical symptoms include intense itching, erythema, and scaling of the skin. Atopic dermatitis has been found to be associated with decreased quality of life for patients and their families. Diagnosis is made by clinical evaluation and differential diagnosis with other dermatologic diseases. Treatment is based on the severity of the disease and the age of the patient. Topical treatments are the first line of treatment, while systemic treatments are reserved for patients with severe atopic dermatitis who do not respond to topical treatments. In addition, other treatments, such as light therapy, biological therapy and allergen-specific immunotherapy, have been evaluated in patients with atopic dermatitis. A multidisciplinary approach and appropriate patient and family education are critical to the successful management of atopic dermatitis in pediatric patients.

Objective: Ovarian cancer is a global problem and is the eighth most common type of cancer in women. The proinflammatory IL-8 cytokine has been established as an immunoregulatory cytokine. Ovarian cancer cells continuously secrete this cytokine which increases its tumorigenicity Methods: Observational study with cross-sectional design. The sample of this study were ovarian neoplasm patients who underwent surgery at Dr. Wahidin Sudirohusodo hospital and the networking hospitals. The sampling was done by consecutive random sampling. Measurement of serum IL-8 was conducted using the ELISA method. Data were analyzed by chi-square test. Result: Serum IL-8 levels were found to be associated with staging and histopathological results in ovarian neoplasms with a significant elevation of IL-8 levels at a mean value of 146.10 pg/mL (p <0.05) in advanced stage ovarian neoplasm and at a mean value of 152.43 pg/mL (p <0.05) in ovarian neoplasm with epithelial histopathology results. Although an increase in serum IL-8 levels was also observed in the ovarian neoplasm group with an abnormal CA-125 result with a mean value of 124.16 pg/mL (p > 0.05), malignant RMI with a mean value of 148.91 pg/mL (p > 0.05), and cytology containing malignant cells with a mean value of 167.68 pg/mL (p > 0.05), these findings were not statistically significant. Conclusion: In this study, it was concluded that IL-8 levels were significantly increased in ovarian neoplasms with advanced stage and histopathological results of epithelial type.

The study was conducted on (90) blood samples, 60 samples from patients with (PCOS) and 30 of them were healthy women. Blood samples were collected from women attending outpatient clinics in Kirkuk Governorate, after their diagnosis. By obstetrics and gynecologists for the period from 11/20/2021 to 25/2/2022, as their ages ranged between (17-42) years, and they were divided into three groups depending on the body mass index (BMI), the first group (30) samples for patients with (PCOS) who are obese with BMI of more than 30 kg/m2 , and second group (30) samples for ladies without obesity who have polycystic ovary syndrome with a BMI of less than 25 kg / m2 and the third group (30) samples of non-infected women with a BMI of more than 30 kg / m2 as a control group. The study included the measurement of antioxidants, including non-enzymatic antioxidants It includes (glutathione, uric acid, and bilirubin), as well as measuring the concentration of malondialdehyde in obese, and without obesity (PCOS). The findings of this researh show following: * Increase that is statistically significant (P =0.01) in the concentration malondialdehyde when comparing obese women with PCOS with control, and increase that is statistically significant (P =0.05) when comparing between PCOS-afflicted obese and non-obese women * A notable reduction in the p-valu (P=0.01) in the (bilirubin and glutathione) of concentration when comparing obese PCOS patients with control, a notable reduction and at the level of probability (P=0.01) in the concentration of bilirubin and (P=0.05) in the concentration of glutathione at Comparing obese women with PCOS to non-obese patients. * A notable reduction (P=0.05) in the total capacity of antioxidants in obese women with PCOS compared with the control group, the results showed decrease that is statistically significant (P =0.01) when comparing the concentration of the total capacity of antioxidants between women Obese and non-obese patients. * A non-significant differences in uric acid concentration when comparing women with PCOS with control, and the results showed a increase that is statistically significant (P =0.05) when comparing women with PCOS who are obese with those who are not obese.

Background: Obstruction of the bile duct, whether caused by a tumor or a surgical injury, will cause: jaundice, elevated liver enzymes, and eventually, liver failure. The primary goal of percutaneous management is draining bile into the small intestine and achieving a drainage that is the most similar to the normal physiologic drainage, maintaining normal enterohepatic circulation. The present study aims to make a correlation between percutaneous biliary diversion and the decrease in serum bilirubin in pre- and post-procedure studies (24 hours). Methods: We did a retrospective review of the database of the Interventional Radiology service of Hospital Regional 11º de Octubre, México. The time study was between years 2017 and 2022. We analyzed 75 patient’s clinical records who underwent percutaneous management with a diagnosis of bile duct dilation due to an obstructive origin. The population was divided in three groups benign, malignant and post-surgical based on the ethiology of the bile duct obstruction. Total serum bilirubins, liver enzymes, coagulation tests and platelets of each patient were obtained from the clinical record prior to percutaneous biliary diversion and 24 hours after procedure. Results: 75 patient records were explored, of which 26 (34.7%) were men and 49 (65.3%) were women The mean age was 62.3 years. A statistically significant decrease in total serum bilirubin was observed 24 hr after the procedure with a p value of 0.009. A statistically significant decrease after the procedure was also observed in liver enzymes with a value of: GGT with p: 0.002, GOT with p: 0.003 and LDH with p: 0.005 Discussion: There was a decrease in total serum bilirubin and liver enzymes after an effective biliary diversion, regardless of the cause of obstruction.

Background: Dental age estimation plays a vital role in todays medical world. There are various methods for determining the approximate age of a person. Dental age estimation seen from the growth of the teeth can be measured by looking at the clinical condition of the individuals oral cavity or through panoramic photos. There are many studies related to the estimation of individual age through the teeth but not yet in children with Down Syndrome. Purpose: The purpose of this study was to analyze the differences in the dental estimated ages of Down syndrome children using the Schour-Massler and the Blenkin-Taylor method in Jember Region. Material and Methods: The research was cross-sectional. The research subjects were people with Down Syndrome 10-17 years old and taking panoramic photos. Calculating dental age using the method of Schour- Massler and Blenkin-Taylor by 3 observers. Data analysis using Kolmogorov Smirnov and Paired T-Test. Results: The mean difference between the age of the sample and the age of the teeth in the Schour -Massler method is 2.0-3.1 years and the difference between the age of the sample and the age of the teeth in the Blenkin-Taylor method is 1.6-3.2 years. Conclusion: There was a delay in the teeth age, especially in Down Syndrome children using both the Schour-Massler measurement method and the Blenkin-Taylor method.

The fatality rate for pediatric population with complex congenital cardiac disease has decreased as a result of improvements in surgical techniques and conservative management [1]. Therefore, more patients are presenting for non-cardiac surgeries as adults with congenital cardiac history [2]. For individuals with complex congenital cardiac disease and single ventricle physiology, the fontan procedure is a palliative operation that reroutes the systemic venous return to the pulmonary artery [3]. Despite improvements in outcomes, this aberrant circulation has a number of co-morbidities, including cardiac dysfunction, arrhythmias, shunt abnormalities, limited exercise ability, and other systemic manifestations [4]. These patients raise various anaesthetic concerns, such as understanding underlying cardiac morphology and mechanics and being conversant with the complexities of fontan physiology for efficient intra-operative management. In this report, we present a case of a 17-year-old male, with complex congenital heart disease with fontan physiology, posted electively for left tibia nailing under sequential combined spinal epidural anaesthesia.

Background: The Infection Prevention and Control is an effort to ensure the protection for everyone toward the possibility of being infected by infection from sources to the community while receiving health services at various health facilities. It is hoped that the implementation of infection prevention and control at the health centers can be carried out efficiently and effectively by following the established policies and standard procedures. How is the implementation of Infection Prevention and Control in public health center. Materials/Methods: This study is a quantitative study with a cross-sectional approach which was carried out to determine the effect of knowledge and support on the implementation of infection prevention and control in in public health center in Bengkulu Province. The population in this study is the health center staffs who carry out the service. The samples taken were 131 respondents. Data analysis was carried out through linear and multiple regression using SPSS 22 which aims to analyze the effect of knowledge and support on the implementation of infection prevention and control in public health center. Result: From the results of the Chi-square test analysis, it can be seen that the effect of knowledge on the infection prevention and control application obtains a p-value of 1.0>0.5. From these results, it can be concluded that there is no effect of knowledge on the application of infection prevention and control. The attitude variable affects the infection prevention and control application which obtains 100% good results. The support variable has an effect on the infection prevention and control application which obtains a p-value of 0.021 <0.5. From these results it can be concluded that there is an effect of support variable on the implementation of infection prevention and control. The officers’ knowledge has not had an effect on the implementation of infection prevention and control at the health centers. Several factors that can affect the compliance and non-compliance of health workers with infection prevention and control steps are: knowledge, education and training, experience, and lack of equipment and materials supplies. Conclusion: Officers need to increase their knowledge of IPC and be trained in firmness of attitude, maintaining support from the environment in order to maintain and improve their ability to apply IPC.

The skins primary response to any type of aggression is scarring, a physiological process that aims to restore the skins integrity. The bodys defensive mechanisms against tissue injury include the recovery, regeneration, and healing of tissues with the goal of returning the tissue to its regular anatomical and functional state. The main processes that control the amount and functioning of cell populations in normal tissues are cell proliferation, differentiation, and death. Based on their capacity for cell division, tissues are categorised into three groups, each of which has unique cell characteristics. In order to maintain tissue homeostasis and stop the organ from collapsing as a result of cell loss or absence, guide cells or stem cells are essential. Polypeptide growth factors are an example of a chemical mediator that is crucial in regulating cell differentiation and development.

Objective: The purpose of this study was to translate, adjust and evaluate the validity and reliability of the Champions Health Belief Model scale, so as to measure the beliefs of self-examination practices of Vietnamese women. Material and Methods: The adaptation and psychometric characteristics test of the Vietnamese HBM scale was performed, with 40 participants, from October 2021 to June 2022. Of these, 10 women were initially randomized to adjust the translation version, and 30 women were to evaluate the reliability of the scale. The content value of the scale is measured by the opinion of 5 experts. Reliability was measured by Cronbachs alpha, while An estimation of stability is commonly assessed by a test–retest reliability analysis (ICC). Result: The Vietnamese version of the Health Belief Model scale (V-HBMS) demonstrated good content validity, with the Items content validity index (I-CVI) score for all 42 items> 0.79. Internal consistency with Cronbachs alpha ranges from .715 to .954 and the reliability of the ICC re-test ranged from .954-.000 (p-value = 0.000) determined with good results. Conclusion: The Vietnamese version of the Health Belief Model scale can be considered a valid tool to survey the belief of Vietnamese women in the implementation of breast self-examination behavior.

Neuroendocrine tumors rarely occur in the urinary bladder, relatively less than 1% of occurrence, as the tumor is very rare, pathogenesis is uncertain some authors showed that it is from urothelial origin. It can be carcinomatous, subdivided into small cell and large cell pathology. Small cell carcinoma of the bladder is a rarity that may present at an advanced pathologic stage. No treatment regimens have been standardized for local or metastatic disease. Many publications showed that the disease is treated with combined chemotherapy or with radical cystectomy, here we are presenting a case of a 78 years old male, who underwent transurethral resection of bladder 1 month ago and the biopsy report was suggestive of neuroendocrine tumor of bladder, after that patient underwent radical cystectomy with neobladder reconstruction surgery.

Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global epidemic. The rates of obesity have been rising in many countries, including the United States, Australia, China, and also in our country Indonesia. Bariatric surgery has seen a rise in rates worldwide in tandem with rising obesity rates in the world. Our literature review highlights the number of bariatric surgeries performed and the various procedures like gastric sleeve, Roux-en-Y gastric bypass, and gastric banding, available for patients. Furthermore, our review provides insights how combining bariatric surgery with body contouring procedures such as abdominoplasties, thighplasties, mastopexies, and brachyoplasties improves quality of life.

Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global epidemic. The rates of obesity have been rising in many countries, including the United States, Australia, China, and also in our country Indonesia. Bariatric surgery has seen a rise in rates worldwide in tandem with rising obesity rates in the world. Our literature review highlights the number of bariatric surgeries performed and the various procedures like gastric sleeve, Roux-en-Y gastric bypass, and gastric banding, available for patients. Furthermore, our review provides insights how combining bariatric surgery with body contouring procedures such as abdominoplasties, thighplasties, mastopexies, and brachyoplasties improves quality of life.

Background: Gourami scales contain antibacterial compounds, e.g., catechins, chitin, calcium, omega 3, omega 6, and flavonoids. Our previous studies have shown that millimicrons-sized gourami fish scales powder (GFSP) added to Glass ionomer cement (GIC) acts as an immunomodulator against Streptococcus mutans both in vitro and in vivo. However, the antibacterial activity of the material was affected by the particle size, and the effects of smaller GFSP, which is nano-sized (nGFSP), on oral biofilms are largely unknown. Materials and Methods: This study analyzed the potential of nGFSP added to conventional GIC in inhibiting the growth of Streptococcus sanguinis, Streptococcus mutans, and Staphylococcus aureus. nGFSP were divided into five groups, 0% (control), 0.5%, 1.5%, 2.5%, and 3.5% (4 samples for each group). The antibacterial activity was evaluated using the agar diffusion method. Then, the diameter of the inhibition zone was measured and analyzed using ANOVA followed by the LSD test. Results: Antibacterial activity against S. sanguinis, S. aureus, and S. mutans significantly increased with nGFSP. The largest zone of inhibition was measured at a concentration of 3.5%, that is, 4.02 mm (S. sanguinis) and 2.29 mm (S. aureus). Meanwhile, nGFSP is more effective in inhibiting the growth of S. mutans in an optimum concentration of 0.5% with a zone of inhibition is 3.54 mm. Conclusion: The addition of nGFSP improved the antibacterial activity of GIC against gram-positive pathogenic bacteria, such as S. sanguinis, S. aureus, and S. mutans.

Understanding the strategies of bacterial infections requires an extensive knowledge of the essential role virulence factors play in bacterial pathogenicity. These components are essential in spreading of the infection, the capacity of the bacteria to avoid host defenses and the start of disease. The absence or presence of certain virulence factors has significant influence on the rate of infection dissemination. Virulence factors are divided into four groups: adhesion factors, invasion factors, toxin factors and immune evasion factors. The review here, addresses how virulence parameters affect host cells and tissues, how they may influence disease development and how they may be utilized to identify and treat bacterial infections. Controlling virulence parameters is also an important aspect of this. Virulence parameters expression can be influenced by variety of genetic and environmental variables, including quorum sensing which is not always present. Finally developing efficient prevention and therapeutic techniques for bacterial infections requires detailed understanding of the control of virulence parameters. Indicating the important role of virulence factors in bacterial pathogenicity is vital in the development of powerful treatment methods.

Background: Placental abruption also known as abruptio placentae or accidental haemorrhage, is the second most common cause of antepartum haemorrhage after placenta praevia. The study was aimed at reviewing cases of placental abruption managed at the Rivers State University Teaching Hospital (RSUTH) over a 6-year period, to determine the prevalence, trend, and sociodemographic/obstetrics factors. Methods: This was a cross-sectional study of all recorded cases of placental abruption managed at the Rivers State University Teaching Hospital (RSUTH) from 1st January 2016 to 31st December 2021. Descriptive statistics were derived using IBM, Statistical Product and Service Solutions (SPSS) version 25.0 Armonk, New York. Results: There were 14,195 deliveries and 68 cases of placental abruption; giving a prevalence of 0.48% or 4.8 per 1000 or 1 in 208 deliveries. The rate of placental abruption per 1000 deliveries increased from 2.0 in 2016 to 8.7 in 2018 and then decreased to 6.2 in 2021. The mean (SD) age and gestational age of the participants were 32.7±4.8, (95%CI: 31.5, 33.9) years and 35.6 ±3.2 (95%CI: 34.8,36.4) weeks. The modal parity was para 1. Over 90% of the participants had emergency caesarean sections. The majority 65(95.6%) of the participants were Christians, 56(82.4%) booked and more than half 37(54.4%) were multipara. Conclusion: The prevalence of placental abruption in RSUTH is 0.48%; with a declining pattern of occurrence. It occurred more among booked multiparous women. This Knowledge will be helpful to Clinicians in management of Placental Abruption.

Background: The tibial plateau fracture rates among the top 10 intra-articular fractures in terms of frequency. Due to the extreme displacement of the bony fragments, the accompanying depression and impaction of the cancellous subchondral bone, and the unavoidable cartilage injury, the fracture patterns are extremely complex and difficult to manage. Objective: The study amid to figure out the distribution of Radiological measurement of Schatzker type II Tibial Plateau Fracture by Proximal Tibial Metaphyseal. Methodology: This was a prospective observational study, carried out at NITOR, Dhaka, Bangladesh from July 2019 to June 2021. Purposive sampling technique was used. Results: The mean duration of radiological union was 13.3±1.6 weeks. The mean angular depression was 0.68±1.1 mm, condylar widening was 0.26± 0.68 mm, and the angulation was 0.480 ±1.50 mm. 64.5% cases were excellent and 35.5% were good at the most recent follow-up. Normal coronal alignments were observed in 87.1% instances upon final follow-up. Conclusion: Schatzker type II tibial plateau fracture by proximal tibial metaphyseal plate gives excellent to good functional outcome with minimal complications, so this is an effective and safe method.

Introduction: Chemical burns are an uncommon form of burn injury, accounting for 2.1% to 6.5% of all burn centre admissions. We presented one rare case of a second degree chemical burn due to successive contacts of acidic wart removal solution and paint mixture solution. Case: A 38-year-old male with chemical burn on both feet due to reckless usage of a self-purchased wart removal solution, and accidental contact with paint mixture solution. Our surgeon author diagnosed a superficial partial thickness (second-degree) chemical burn on this patient, and performed surgical debridement followed by hyaluronic-enhanced silver sulfadiazine topical dressing to provide antimicrobial protection to the wound and topical petrolatum-based ointment to maintain moist environment for the wound and the periwound. Our team also gave Ceftaroline, a cephalosporin for serious infections of the skin and tissues below the skin, intravenously. Result: One day after the surgical procedure, the wound dimensions were slightly more extensive than the initial size due to extensive debridement and necrotomy. All wounds produced no or minimal exudate, showed no slough nor pus inside the granulation area, and no swelling nor maceration in the periwound area. The fifth day after the surgical procedure, the wound on the lateral side of patient’s right foot was almost completely covered by epithelialization. The wound on the sole of patient’s right foot was about 70-80% covered by epithelialization, and the wound on the sole of patient’s left foot was also about 70% covered by epithelialization. Discussion: Topical solution for wart removal consists of many chemicals agents (i.e. salicylic acid and acetic acid) and its application should strongly be under guidance and monitoring by physician due to its potential to harm human bodies and trigger chemical burn injury in varying degrees. Paint mixture is usually safe, risks no or minimal harms when in contact with skin, however it can provide a more difficult scenario and consequently a more extensive cleansing during the wound debridement procedure. Immediate decontamination and adequate dilution through massive irrigation is a major determinant of burn severity after chemical injury. Application of 1% silver sulfadiazine topical antibiotics enhanced with 0.2% hyaluronic acid for moisturizer displayed significant improvement for the burn wound healing. Conclusion: Knowing exactly what type of chemical substance in contact with the skin and tissues that caused the chemical burn injury is as equally important as the comprehensive management itself. For acidic burn injuries, a proper and sometimes extensive necrotomy procedure is mandatory to provide a good tissue regeneration.

Objective: Describe the profile of Multidrug Resistance (MDR), Extended Resistance (XDR) and Pan-Resistance (PDR) to antibacterials and identify the associated clinical factors in a hospital in Chihuahua, Mexico. Materials and methods: An observational, analytical, case-control study was carried out during the period from January 2018 to December 2020. From 308 clinical records, 506 bacteria were isolated, the variables included previous admission and treatment, days of hospital stay, site of infection, days of antibiotic use, use of 2 or more antibiotics, relationship with nosocomial infection, coinfection, admission service, and reason for admission. Descriptive analysis, Xi2 and logistic regression were performed to search for association with bacterial resistance. Results: 56 and 44% of the isolates were gram negative and positive. Significant risk factors were days of hospital stay, previous antibiotic use, nosocomial infection, antibiotic use for more than 10 days, use of two or more antibiotics, and coinfection; the latter four being an independent risk factor for bacterial multiresistance. Conclusion: The surgery, internal medicine and pediatric services deserve special attention due to the high proportion of multi-resistant isolates and the presence of pan-resistance, in the same way, previous admission, previous treatment and days of antibiotic use were identified as risk factors for multi-resistance. derived from the prescription and therefore, subject to modification.

Pyloromyotomy is a surgical procedure used to treat infants with pyloric stenosis. Pyloric stenosis is a relatively common condition in which the muscle at the bottom of the stomach (the pylorus) becomes thickened, leading to obstruction of the passage of food into the small intestine. Pyloromyotomy is a surgical procedure that involves making a small incision in the infants abdomen and cutting through the thickened muscle fibers of the pylorus to create a wider opening for food to pass through. This article reviews the indications, technique, outcomes, and potential complications of pyloromyotomy, with a particular focus on the pediatric population. The success rate of the procedure is over 95%, and most infants are able to resume feeding within a day or two after the procedure. Pyloromyotomy is a safe and effective treatment for pyloric stenosis, but as with any surgical procedure, there are risks involved, including bleeding, infection, and damage to surrounding organs. The article discusses the preoperative preparation, intraoperative techniques, and postoperative care of infants undergoing pyloromyotomy, as well as the long-term outcomes and potential complications of the procedure. The importance of careful patient selection, accurate diagnosis, and multidisciplinary management is emphasized, along with the need for close monitoring and follow-up after surgery.

Wasit city, Iraq provided a total of twenty-four different samples of urine for the researchers to examine. The samples were first cultured onto Ma-Cconkey agar and Blood agar, and placed into brain heart infusion broth. Microscopic inspection, cultural characteristics, biochemical assays, and the Api20 E system were all utilized to independently verify the isolates identities. Only two out of twenty-four human samples (8.3%) included Providencia species, with P. rettgeri being the most prevalent of those species. Using the disc diffusion technique, tests of antimicrobial susceptibility were carried out against 10 different antibiotics. All of the Providencia isolates had evidence of multidrug resistance (MDR), and the level of absolute resistance to cefoxitin, methicillin, vancomycin, doxycycline, clarithromycin, and trimethoprim/sulfamethoxazole was 100%. They exhibited a high degree of sensitivity to ofloxacin, chloramphenicol, cefixime, and teimethoprim, with a percentage of 100%.

Vitamin D is a lipid-soluble substance that has two forms, vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). UV light is the main source of vitamin D that induces the conversion of 7-dehydrcholestrol to vitamin D in the skin. Food sources that contain a high amount of vitamin D are egg yolk, fish, and liver. Several studies revealed the wide prevalence of deficiency in Vit. D among the healthy population, in addition, different diseases have a relation with their inadequacy in the body. This review study summarized the results recorded by published articles in different regions in Iraq regarding vitamin D deficiency. The review concluded that there is a high prevalence of Vit. D deficiency among the population in different regions of Iraq.

AIM: It was aimed to investigate the effect of local anesthetic application on the Pfannenstiel incision line on patient comfort. METHODS: The study was carried out between 2021 and 2022. It was performed on 240 patients. The patients were categorized as Group 1 in which a local anesthetic was administered and Group 2, which was not administered a local anesthetic. It was performed on 120 hysterectomy cases operated under general anesthesia. 5 mg 0.5% bupivacaine was used as a local anesthetic. The patients were evaluated in terms of postoperative pain score, gas-gaita release time, postoperative mobilization, narcotic analgesic requirement, post-operative home comfort, daily return to basic work, and feeling like they used to be. For statistical analysis, SPSS Version 28.0.1 program was used. RESULTS: A statistically significant decrease was observed in postoperative 2nd-hour pain scores in Group 1 patients compared to Group 2 (p=0.007). A statistically significant decrease was found in the need for narcotic analgesics in Group 1 patients (p=0.04). Gas-stool release time was shorter in Group 1 patients compared to Group 2, and it was statistically significant (p=0.038). Mobilization was easier in the 1st group of patients and it was found to be statistically significant compared to the 2nd group (p=0.004). In other parameters, there was no difference between the two groups. CONCLUSION: Applying local anesthesia to the incision site reduces pain in the first 2 hours postoperatively, earlier gas-gaita output, comfortable mobilization, and a decrease in the need for narcotic analgesics.

Purpose:To evaluate diagnosis of Trichilemmal carcinoma scalp with clinico-radiological and pathological correlation.Introduction:Trichilemmal carcinoma is a rare slow growing malignant adnexal tumour that originates from the external hair sheath of hair follicle accounting for <0.005% of adnexal carcinoma1. It mimics squamous cell carcinoma, basal cell carcinoma, sebaceous carcinoma. Rarity, indolent clinical course inspite of local aggressiveness and a good survival rate post excision further undermine the importance of this unique entity.Herewith, we are reporting a case of recurrent trichilemmal carcinoma of scalp presented to the outpatient department of Radiation Oncology at our institute.

Burn is one of the most common injuries which leading to high morbidity and mortality. Inflammation and infection involve in burn pathophysiology. Inflammation occurs in burn mainly due to release of inflammatory cytokines, while infection occurs when skin barrier damage and immune system is compromised due to suppression of neutrophils and T cells. In previous studies, silver nanoparticles (AgNPs) exhibit antimicrobial and anti-inflammatory properties through several mechanism. Antimicrobial mechanism of AgNPs including the damage of cell wall and alteration inner part of cell, while anti-inflammatory mechanism of AgNPs is by reducing pro-inflammatory cytokines. Therefore, silver nanoparticles can be reasonable treatment for burn.

Summary: Burn is one of the most common injuries which leading to high morbidity and mortality. Inflammation and infection involve in burn pathophysiology. Inflammation occurs in burn mainly due to release of inflammatory cytokines, while infection occurs when skin barrier damage and immune system is compromised due to suppression of neutrophils and T cells. In previous studies, silver nanoparticles (AgNPs) exhibit antimicrobial and anti- inflammatory properties through several mechanism. Antimicrobial mechanism of AgNPs including the damage of cell wall and alteration inner part of cell, while anti-inflammatory mechanism of AgNPs is by reducing pro-inflammatory cytokines. Therefore, silver nanoparticles can be reasonable treatment for burn. Background: Lax abdominal muscles cause laxity or bulging. This is generally a consequence of age or post-pregnancy, causing the abdominal rectus muscles and fascia that overlies and divides them to weaken. Abdominoplasty, a popular cosmetic surgery, has improved in recent years. helped minimize abdominal fat and skin. Medical institutions are diagnosing and treating obesity at an increasing pace. Objective: The purpose of the study was reduce the excess abdominal skin,subcutaneous tissue and anterior abdominal wall laxity. Methods: The duration of this prospective observational research was from July 2014 to April 2015. The research population consisted of patients hospitalized to the Plastic Surgery Department of Dhaka Medical College Hospital and numerous private hospitals in Dhaka with extra abdominal skin and abdominal wall laxity owing to various causes, such as past pregnancy or severe weight loss. From the study population, 30 instances that satisfied the enrollment requirements were chosen. Results: The majority of patients (26, or 86.67 %) were female, and 76 % were married. At the time of surgery, the average age was 41.3 years. The total complication rate was 40%, with just four serious complications (13.33%) and the most being mild (9, 30 %). Seroma (3, 10%), infection (2, 6.67%), hematoma (2, 6.67%), wound dehiscence (1, 3.33%), partial flap loss (2, 6.67%), umbilical stenosis (1, 3.33%), epidermolysis (1, 3.33%), DVT (1, 3.33%) were the most prevalent complications (1, 3.33 %). Very excellent (19, 66.3%), good (9, 30%), and adequate were patients\ratings of satisfaction (2, 6 %). No patient reported low or extremely bad satisfaction. Conclusion: Abdominoplasty may be done with little risk and provides excellent results. Patients reported relief from their symptoms and satisfaction with the result. However, there was a high rate of mild problems, most of which involved wound healing. At most cases, problems were mild and quickly treated in a doctor\s office.

Piper guineense, Xylopiaaethiopica and Monodoramyristica seeds are among the plant parts commonly used as spices and studied evaluating the proximate composition while mineral parameters were evaluated using Atomic Absorption Spectrophotometer (AAS) methods. Antibacterial activity was assessed using the agar well diffusion method while gas chromatography and mass spectrometry were used for the phytochemical analysis. Results of the study showed that X. aethiopica seeds were high in percentage moisture content (9.60%), crude fiber (9.97%) and crude protein (28.67%) compare to P. guineense and M. myristica while P. guineense was high in percentage lipid (26.00%) and carbohydrate (63.05%). The differences in the moisture content, lipid, crude fibre, crude protein and carbohydrate were statistically significant (P<0-05). M. myristica seeds had a higher amount of copper (49.885mg/kg), potassium (2.835%), calcium (1.570%) and sodium (1.730%) than P. guineense and X. aethiopica seeds, while X. aethiopica seeds had a higher amount of zinc (33.675mg/kg) than M. myristica and P.guineense seeds. P. guineense seeds had a higher amount of iron (655.455mg/kg) than M. myristica and X.aethiopica seeds. The differences in the calcium, potassium, sodium, copper, iron, and zinc were statistically significant (P<0.05). Ethanol extract of X. aethiopica showed higher inhibitory effect (P<0.05) against Staphylococcus aureus with MIC of 3.125mg/ml and MBC 25mg/ml. Among the thirty five compounds detected in piper guineense, thirty two compounds in xylopiaaethiopica and thirty one compounds in Monodoramyristica, the common ones were Lauric anhydride, Dodecanoic acid and Octadecanoic acid. The present study had pontentials for microbial control with Xylopiaaethiopica showing the most inhibitory action.

Partial or complete nipple areolar complex (NAC) necrosis following breast reduction mammaplasties is an overwhelming complication for both the plastic surgeon and the patient. Its reported incidence vary from 2% for full-thickness necrosis to 11% for superficial epidermolysis. Early identification and management of NAC vascular insufficiency is important in order to avoid total NAC loss. The Total Posterior Pedicle breast reduction technique described by Richard Moufarrege in 1982 consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its preservation of the breastfeeding function, for its conservation of the nipple erogenous sensation, and for its low rate of long-term complications such as pseudoptosis. In this article, we demonstrate that the Moufarrege Total Posterior Pedicle has an absolute secure blood supply to the NAC and no risk of NAC necrosis.

Background: Lax abdominal muscles cause laxity or bulging. This is generally a consequence of age or post-pregnancy, causing the abdominal rectus muscles and fascia that overlies and divides them to weaken. Abdominoplasty, a popular cosmetic surgery, has improved in recent years. helped minimize abdominal fat and skin. Medical institutions are diagnosing and treating obesity at an increasing pace. Objective: The purpose of the study was reduce the excess abdominal skin,subcutaneous tissue and anterior abdominal wall laxity. Methods: The duration of this prospective observational research was from July 2014 to April 2015. The research population consisted of patients hospitalized to the Plastic Surgery Department of Dhaka Medical College Hospital and numerous private hospitals in Dhaka with extra abdominal skin and abdominal wall laxity owing to various causes, such as past pregnancy or severe weight loss. From the study population, 30 instances that satisfied the enrollment requirements were chosen. Results: The majority of patients (26, or 86.67 %) were female, and 76 % were married. At the time of surgery, the average age was 41.3 years. The total complication rate was 40%, with just four serious complications (13.33%) and the most being mild (9, 30 % ). Seroma (3, 10%), infection (2, 6.67%), hematoma (2, 6.67%), wound dehiscence (1, 3.33%), partial flap loss (2, 6.67%), umbilical stenosis (1, 3.33%), epidermolysis (1, 3.33%), DVT (1, 3.33%) were the most prevalent complications (1, 3.33 % ). Very excellent (19, 66.3%), good (9, 30%), and adequate were patients ratings of satisfaction (2, 6 % ). No patient reported low or extremely bad satisfaction. Conclusion: Abdominoplasty may be done with little risk and provides excellent results. Patients reported relief from their symptoms and satisfaction with the result. However, there was a high rate of mild problems, most of which involved wound healing. At most cases, problems were mild and quickly treated in a doctors office.

Objective: This study aims to compare the effects of vaginal delivery (VD) and cesarean section (CS) on anxiety experienced in the subsequent pregnancy. Methods: It was held in Aydin Adnan Menderes University Hospital between 01.06.2013-01.06.2014. Our study is a case-control study. 172 pregnant women were included in the study. The patients were divided into two groups CS and VD, according to the type of delivery that occurred in their previous pregnancy. The Beck Anxiety Inventory (BAI) was applied to each patient. The data of the research were evaluated in SPSS v.15 and Minitab v.13.0 package programs. Results: A total of 172 patients were included in our study, including 86 pregnant women who gave birth with CS in their previous pregnancy and 86 pregnant women who had VD. The average age of pregnant women is 28.23. According to BAI results, 50 (29.1%) of 172 patients had mild anxiety, 40 (23.3%) had moderate anxiety, and 14 (8.1%) had severe anxiety. The number of those who did not show any symptoms is 68. According to BAI, the most common finding in patients was irritability (1.0412) and a sense of bad things will happen (1.0765). When examining whether there is a significant relationship between the previous delivery method and BAI scores, a statistically significant relationship was not found in the relationship study performed with the T-Test (p>0.05). Conclusion: Giving birth with a VD or CS does not affect current pregnancy and birth anxiety.

Background and Objectives: Pregnancy is considered a sensitive period in womens life, which is associated with many physical and psychological changes, and each person deals with it differently. Countless studies have confirmed the relationship between stress and anxiety during pregnancy and the mental and physical health of the child. The effectiveness of yoga –based mindfulness on quality of life in pregnant women. Methods and Materials: The present study was semi-experimental design with pre-test and post-test with control group. The statistical population of this study included all pregnant women referred to Iranian maternal health midwifery clinic in 1401, 30 of these subjects, were selected and randomly assigned (Each has equal chance of being elected) to two groups. Both groups were pre-test and post-test before and after the intervention. The experimental group received 16 sessions of 75 minutes (weekly 3 sessions) under yoga practice. Data collection tools include demographic characteristics and Short form 36 (SF-36) quality of life questionnaire. The collected data were analyzed by covariance analysis using spss-24. Results: The findings showed that the effectiveness of yoga-based mindfulness treatment had a greater impact on quality of life (P=0/002? F=5/969) in pregnant women. Conclusion: Therefore, it can be concluded that yoga can be used as a convenient, affordable and low-cost treatment for improving the quality of life of pregnant women.

Pneumomediastinum is the presence of air in the mediastinum, located around the heart, and structures in the middle of the thorax, while pneumothorax is the presence of air in the pleural space and pneumoperitoneum is nothing more than air in the peritoneum, these spaces in conditions normal does not contain the presence of air, so its existence should alert the clinician to an abnormality, some of the structures present in these compartments may be affected, in this context, these three entities are closely related to open or closed thoracic or abdominal trauma, break of viscera hollow , esophageal perforation , asthmatic patients with severe crisis , or with COPD due to bull rupture , some athletes with extreme efforts such as lifting weights , others as maneuver valsalva , labor etc. Endometriosis and alpha 1 deficiency antitrypsin Or as a consequence of barotrauma due to invasive or non-invasive mechanical ventilation. In patients with severe covid 19 it seems to be a marker of severe pneumonitis since some studies have reported pneumomediastinum in patients who were not receiving mechanical ventilation at the time of diagnosis, in a study multicenter 377 cases half of the patients with Pneumomediastinum. In this study, 377 cases of 58,484 hospitalized patients with Covid-19 were identified, in 53 hospitals in the United Kingdom, reporting an incidence of 0.64% of these 195/377 deaths (57.7%). Pneumomediastinum was associated with high rates of mechanical ventilation 172/377 (45.6%), mechanical ventilation was the most important predictor at the time of diagnosis (p<0.001), along with age (p<0.01) and age. diabetes (p=0.08). (2) Infrequent complications related to Covid-19 have been described, such as pneumopericardium, this is defined as the presence of air in the pericardial space. Generally, the most frequent cause is iatrogenesis due to procedures and open or closed chest trauma, its pathophysiology is closely related to Pneumomediastinum, pneumothorax and subcutaneous emphysema, 3 basic mechanisms are needed, such as: increased pressure between the alveoli and the perivascular interstitial space, loss of integrity of the alveolar wall (alveolar damage and air entry doors, all this entails that the alveolar air leak, dissects the perivascular interstitial space and travels centripetally towards the mediastinum (in the first place) and from here it can continue to other spaces such as the pericardial space, pleural space or subcutaneous tissue, the examination by Excellence for the diagnosis of pneumopericardium and differentiating it from Pneumomediastinum is computed tomography, this also allows confirming other complications such as pneumothorax and subcutaneous emphysema(1) Below we present a retrospective observational study, in which 400 chest CT scans of patients admitted with a diagnosis of severe covid-19 were reviewed and analyzed in a covid-19 sentinel hospital, Coro, Falcón, Venezuela. The objective was to determine the incidence of Pneumomediastinum, pneumothorax and pneumoperitoneum in patients admitted with severe covid-19, evaluate their signs and symptoms, comorbidities, periods of hospital stay, mortality. The investigation is justified since many of the admitted patients came with deteriorating respiratory status, which was generally attributed to lung parenchymal damage, and the diagnosis of these entities could go unnoticed with fatal consequences for the survival of patients.

Optic disc pit is a rare congenital abnormality. This disorder can be associated with serous maculopathy which results on a visual deterioration. Pathophysiology of this maculopathy remains unknown and it appears in the third or fourth decade. There is no consensus in treatment of optic disc pit-associated maculopathy. In this article, we will report a case of an optic disc pit maculopathy in a 31 years old Moroccan patient treated with PPV.

Inguinal Bladder Hernia (IBH) is a common disorder requiring adequate surgical management. Association with multiple organs is prevalent but bladder involvement is rare, with 1-3% of inguinal hernias. Patients are generally asymptomatic and difficult to diagnose thus presenting as an incidental finding or diagnosed during surgery. Most literature advocate surgical repair as a standard, an open surgical approach is preferred more than laparoscopic.

Neuroendocrine tumors rarely occur in the urinary bladder, relatively less than 1% of occurrence, as the tumor is very rare, pathogenesis is uncertain some authors showed that it is from urothelial origin. It can be carcinomatous, subdivided into small cell and large cell pathology. Small cell carcinoma of the bladder is a rarity that may present at an advanced pathologic stage. No treatment regimens have been standardized for local or metastatic disease. Many publications showed that the disease is treated with combined chemotherapy or with radical cystectomy, here we are presenting a case of a 78 years old male, who underwent transurethral resection of bladder 1 month ago and the biopsy report was suggestive of neuroendocrine tumor of bladder, after that patient underwent radical cystectomy with neobladder reconstruction surgery.

This paper provides an overview of euglycemic diabetic ketoacidosis (euDKA) associated with the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors. euDKA is a rare but potentially life-threatening complication that can occur in patients taking SGLT2 inhibitors, and its clinical presentation differs from traditional diabetic ketoacidosis. This paper discusses the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of euDKA. Prompt recognition and appropriate treatment are critical to prevent morbidity and mortality. Healthcare providers should be aware of the potential risk of euDKA in patients taking SGLT2 inhibitors and educate them on the signs and symptoms of this serious complication. Further research is needed to better understand the pathophysiology of euDKA and identify strategies for its prevention and treatment.