Ultrasound is the initial imaging modality in evaluating ovarian pathology in women in a fertile state, establishing the diagnosis in most cases and without exposing them to large doses of ionizing radiation. In this article, we will describe the imaging findings of the main ovarian pathologies that generate pelvic pain and that are a reason for admission to the emergency room, as well as a brief review of each topic.

Secondary and primar neoplasms of the appendix are rare tumors found in approximately 1% of appendectomy specimens, with epithelial and neuroendocrine tumors being more frequent. (1). Epithelial adenocarcinoma is the most common malignancy with mucinous (37%) and non-mucinous (27%) histological subtypes. We present a clinical case.

Introduction: Procyanidins are a class of flavonoids found in many fruits and plants and have been used as traditional medicine or other homemade remedies, particularly for wound healing. This study systematically reviews the available literature on the potential benefits of procyanidins for wound healing in human cells. Materials/Methods: Relevant keywords consisting of "Procyanidin" AND "Wound healing" was explored in databases including PubMed, Google Scholar, Nature, and Science Direct. This is a systematic review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Seven (7) articles met the established inclusion and exclusion criteria. Procyanidins presented a potential benefit in cellular proliferation and migration, antibacterial, anti-inflammatory, and antioxidant activity in wound healing. Conclusion: Procyanidins are beneficial for developing therapies in wound healing, and our review provides a scientific basis for future research.

Introduction: Necrotizing fasciitis (NF) is an infection of the soft tissues (skin, subcutaneous tissue and fascia) that implies a rapidly and progressive evolution. In general, the treatment consists of stabilizing the patient, as well as the use of antibiotics that cover the most common agents, however, in most cases this is not useful without definitive management that consists of cleaning and surgical debridement. In addition to surgical lavage, adjunctive measures are often used in the treatment of complex wounds, such as vacuum-assisted closure (VAC) systems, also known as microdeformation wound therapy (MDWT) or negative pressure wound therapy (NPWT). Objective: The objective is to present a successful case in the treatment of necrotizing fasciitis by negative pressure therapy with subsequent placement of grafts. Case report: We present the case of a 50-year-old male patient with an extensive area of ??necrosis in the anterior, posterior and external surface of the left pelvic limb secondary to a fall. Treatment consists of antibiotic and debridement of devitalized tissues, followed by VAC therapy to promote granulation of the tissues and prepare them for reconstruction. For its reconstruction, partial thickness grafts were used in the entire exposed area, with 100% integration of the tissues without functional limitation during its follow-up in the outpatient clinic. Conclusion: The use of negative pressure therapy accelerates the wound granulation process, making it an option for patients with large areas of devitalized tissue, thus reducing their hospital stay and improving their quality of life.

Background: Foreign substance injections into the penile subcutaneous tissue to enlarge the penis frequently produce disastrous complications, such as penile granulomas. Here we reported a case of penile granuloma along with our reconstruction technique. Method: This report presents a 57-year-old male with a 4-year-old granuloma with recurrent ulcers. A penile reconstruction was conducted using unilateral inguinal full-thickness skin graft. Patient was discharged after one week and followed with regular visits to the outpatient clinic for 6 months. Results: No complication was reported post-surgery and wounds recovered well. However, the patient complained on reduced sensation and pain on the penile tip, and inability to erect after 6 weeks post-surgery. After 6 months post-surgery, the patient can retain erection with remaining sexual dissatisfaction. Conclusion: Inguinal full-thickness skin grafts provide adequate coverage for penile reconstruction in granuloma excision. Eventually, regaining sexual function and satisfaction remain an intricate challenge to face.

Bis-(benzidinedioxime) nickel(II) acetate complex was synthesizedby reacting the metal ions with benzidinedioxime in 1:1 mole ratio.The nickel(II) complex was characterized by elemental analysis, NMR, and powder X-ray diffraction. The result obtained from CHN Elemental analysis and 1H nuclear magnetic resonance confirmed that the nickel(II) complex is synthesized by reacting benzidinedioxime with nickel(II) acetate in a 1:1 mole ratio. The powder XRD showed that two Ni(II) coordinated to two benzidinedioxime ligands via the nitrogen atoms of both oxime groups and the two azomethine nitrogen atoms. Powder X-ray diffraction (PXRD) indicated that the nickel(II) complex has little distorted tetrahedral geometry. Nickel(II) complex has a higher antimicrobial activist against K. pneumonia, B. subtilis, and Candida than kanamycin. In addition, the B. subtilis shows resistance against kanamycin (inhibition zone 0) while it shows high sensitivity against bis-benzidinedioxime nickel(II) acetate complex (inhibition zone 33.3 ± 0.82 mm, MIC 18.5 µg/mL). The average MICs of bis-benzidinedioxime nickel(II) acetate are found to be for inhibition of each of the five organisms in the range of 6.2–55.65 µg/mL. The molecular docking studies investigations confirmed that the bis-benzidinedioxime nickel(II) acetate is the most potent aminoglycoside enzymes bacterial inhibitors. The bis-benzidinedioxime nickel(II) acetate exhibited high binding energy with the receptor aminoglycoside-3-phosphotransferase enzyme than receptors of other aminoglycoside enzymes families.

Introduction: Coronary artery dissection and myocardial infarction happen rarely after BCT (3). In the following, a rare case of acute myocardial infarction (AMI) caused by the dissection of left anterior descending (LAD) artery following BCT due to suffering a blow in boxing is presented. Case presentation: A 22-year-old professional boxing athlete presented with chest pain and dyspnea from a week ago to our center. A week before the visit, the patient referred to the general hospital complaining from chest pain and nausea after suffering a blow during boxing. According to the ECG and normal cardiac troponin, the patient was discharged with diagnosis of Prinzmetal Angina (without coronary angiography). When referring our center, lead electrocardiogram (ECG) was done and showed ST segment elevation on V1-V4 leads and T inversion on aVL and I leads. According to wchocardiography, (LVEF) was calculated to be 45%. Angiography was performed due to the lack of definitive diagnosis and suspicion of coronary artery disease. Results of angiography showed coronary artery dissection on LAD. Finally, the patient was diagnosed with AMI due to LAD dissection and was subjected to angioplasty intervention Discussion: In our case, BCT resulted in LAD dissection after a less common cause of trauma. Not having a serious risk factor, the presence of atypical symptoms of the disease, as well as evidence of ST segment elevation without increasing the cardiac enzyme led to dilemma and delayed diagnosis, and the diagnosis of Prinzmetal angina was mistaken for the patient. So due to failure of improvement and further investigation, the diagnosis of AMI due to LAD dissection after BCT reached certainty

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Several risk factors are described for gastric cancer. Helicobacter pylori infection and a family history of gastric cancer are the two main risk factors for gastric cancer. Gastric cancer has significant geographic, ethnic, and socioeconomic differences in distribution. This review article will discuss risk factors for gastric cancer. The molecular cascade of events underlying colonic-type gastric cancer and its distinct precursor lesions is not fully understood. In contrast, much more is known about the molecular pathogenesis of diffuse gastric cancer, which has prominent molecular abnormalities in the cell adhesion protein E-cadherin. Today, gastric cancer remains a major clinical challenge because of its prevalence, poor prognosis, and limited treatment options. Therefore, one of the main goals of the World Health Organization and researchers is to organize a GC prevention programme

Pregnancy is a state associated with an increased risk of lithogenesis on the gallbladder. Cholelithiasis during pregnancy has an incidence of 12%, with pregnancy being an important risk factor for gallstones. The delayed endoscopic intervention has been associated with an increased risk of adverse events. Using the resource of ERCP in pregnancy is valuable in diseases of the biliary tract. The use of measures to reduce exposure to radiation should be the norm and the delay of this procedure should not be carried out when there are precise indications for it.

Procyanidin is an oligomeric compound composed of catechin and epicatechin. Procyanidin can be found in many foods that can be found easily in Indonesia. In contrast, many people might not know that procyanidin can be found innatural plantations like fruits and cultivation crops. It can be found in grapes, apples, cranberries, cherries, strawberries, kiwis, apricots, and mangoes. Also in barley, sorghum, red rice, soybeans, and cocoa. Even nuts like almonds, hazelnuts, and peanuts. Many studies found that it has medicinal properties. Famous for its antioxidant and anti-inflammatory properties, procyanidin also has many other benefits. Aging is a definite process. It cannot be stopped. Lately, researchers have been trying to slow the process of aging. This literature review discusses the benefits of procyanidin for aging.

Background: Oral mucosal lesions (OMLs) are precursors of oral cancer which affect the quality of life, such as difficulty swallowing, pain, and mastication. These lesions were found related to tobacco consumption. In Indonesia, almost half of the fishers were active tobacco smokers Objectives: This study aims to find the prevalence and factors related to oral mucosal lesions among fishers in Jember, Indonesia. Methods: In this cross-sectional study, oral examination for mucosal lesions and interviews were conducted among 301 fishers. Kruskall Wallis test was run to seek the association of respondent’s demographic, character-smoking habits, and prevalence of oral mucosal lesions. Chi-squre test was conducted for every lesion to find the correlation between demographic characteristics and smoking habits. Result: One or more mucosal lesions were found in 97,7% of the population. Melanosis was observed the most frequently (88.4%), followed by frictional keratosis (33.9%), candidiasis (32.6%), black hairy tongue (6%), nicotine stomatitis (5.3%), leukoplakia (2%). This study found that a majority of fishers use filter cigarettes (73.1%), and they use > 20 cigarettes per day (70.1%). The number of oral mucosal lesions was higher among the older age group, lower education status, and more frequent smokers. Conclusion: The prevalence of oral mucosal lesions among smokers in the fishers community was high and related to sociodemographic factors and a smoking habit.

Aducanumab (brand name Aduhelm) is the first FDA-approved, pharmacologic treatment for Alzheimer’s disease (AD) but many uncertainties remain regarding both efficacy and safety. Of paramount concern are associated adverse effects including cerebral edema and hemorrhage which prompted a post-approval study. Aside from safety concerns, withdrawal from the market may occur if it fails to demonstrate efficacy as described in pre-approval reports.

Accidents are inadvertent untoward events that lead to injuries or diseases. In the healthcare setting, both patients and healthcare workers are at risk of being victims. By virtue of children’s evolving developmental maturity, caring for them puts all parties more at risk. Having a comprehensive framework to prevent accidents in paediatric practice is therefore crucial. This paper aims to utilize the primordial, primary, secondary and tertiary levels of prevention to detail the strategies for preventing needle stick injury, exposure to blood-borne infections, post-injection traumatic neuropathy, post injection abscess, Nicolau syndrome, fluid overload, and drug overdose in paediatric healthcare settings. Preventing the selected injuries and disorders involves a multidisciplinary team of paediatricians, paediatric surgeons, orthopaedic surgeons, burns and plastic surgeons, neurosurgeons, toxicologists, pharmacists, microbiologists, infectious disease physicians, anaesthetists, and public health physicians.

A massive loss of dermis layer such as in deep burn wounds brings several important consequences and complications which contribute to major problems, personally and economically, for the burn patients and their families. Ideal burn wound treatment should not focus merely on removing devitalized tissue, controlling bacterial growth, and promoting healing, but also on accelerating the healing process and preventing scar-related complications. The evolution of biomaterial science for burn wounds has provided physicians with novel dressing materials based on natural and also synthetic polymers, and the latest development introduces the use of hyaluronic acid (HA) as a potential burn wound dressing. HA has been studied to have involvement in many phases of the wound healing process, such as inflammation, granulation, and re-epithelialization. Dealing with the unfavorable physical properties of the native polymer such as solubility and rapid degradation, modification and improvement are designed to produce insoluble molecules to facilitate hyaluronic acid-based (HA-based) wound dressing products as a valuable option for the treatment of deep burns. Our literature review shares the development and the outcome of the use of these products in burns. The currently available clinical experience suggests that these HA-based wound dressing products provide a safe therapeutic method useful for the treatment of acute burns and minimize scar-related complications, although further improvements are still required to make an ideal HA-based wound dressing product for standard burn wound treatment.

Background: Vaccination can help children boost their immunity which is good for their growth and development. Children, specifically school-age children, are usually getting vaccination program in school, known as Bulan Imunisasi Anak Sekolah (BIAS) or school children immunization month. However, a lot of children are usually reluctant to attend the program because of the anxiety to get vaccinated. Therefore, this study aimed to help children getting over through their anxiety by giving them visual animation to distract them during vaccination as well as studying the impact of animation on children’s knowledge and anxiety during BIAS. Methods: The methods employed in this study was quasi-experiment with pre and post test design. The data was collected usin a modified questionnaire adopted from Zung Self Rating Anxiety Scale (ZSRAS) and Tailor Manifest Anxiety Scale (T-MAS). The data were analyzed using univariate analysis to acquired frequency distribution, while bivariate analysis was also used to acquired results of dependent and independent t-test. 76 respondents were selected for this study which was divided into two groups: control and intervention groups. Results: The results show statistically significant between respondents’ level of anxiety in intervention group during BIAS (p value 0,000). There was also statistically significance on the level of anxiety after the intervention between intervention and control groups. (p value 0,002). Conclusion: From the results, in can be concluded that dictraction, specifically animation, during vaccination for children can be an alternative in nursing intervention to lower the anxiety on children.

Introduction: Hypoparathyroidism is the most frequent complication of thyroidectomy, which is influenced by multiple factors, mainly unintentional resection, due to its location, size and difficulty in identification, leading to post-surgical hypocalcemia in 20 to 30% of which 1 to 3% of cases, hypocalcemia may be permanent; due to this techniques have been described for its identification, Benmiloud et al. conducted a case-control study where they compared the efficacy of near-infrared light in detecting parathyroid glands. Parathyroid identification rates were higher in the near-infrared light group compared to the control group (76.3% vs 65.7%). Material and Methods: Cross-sectional, prospective, comparative and analytical study in a third-level hospital in Mexico City, in 20 patients diagnosed with primary and secondary hyperparathyroidism undergoing partial or total parathyroid surgery, with the aim of determining the concordance of near-infrared autofluorescence in these glands and the resultatwhich final histopathological, statistical analysis was performed in SPSS 24, with the Kappa and ji-square coefficient, Results:A total of 20 patients undergoing parathyroid surgery, the most common histopathological finding with 44.2% was parathyroid hyperplasia, with a sensitivity for autofluorescence with the result of histopathology of 82.4% and specificity of 88.9% with PPV of 93.3% and NPV 72.7% and a Kappa coefficient with a value of 0.67 with a p <0.005. Conclusions: The concordance of near-infrared autofluorescence in parathyroid glands with the result of histopathology is considerable, with a good overall performance for timely detection of parathyroid tissue

Born at 28 weeks of gestation and weighing 800g at birth, her father preferred a public health facility where the cost of neonatal intensive care is less prohibitive. At the same time, her mother suffered wound dehiscence and was re-admitted for a prolonged period. Incidentally, resident doctors in public hospitals were three weeks into a nationwide industrial action at the time. With no one available to help out with household chores, the father had to combine the care of two children, and the logistics of two hospitals. The kids at home soon dropped out of school when the financial burden became unbearable. Even though the family’s long and onerous journey eventually ended, its impact is a large ‘wound’ that may take a while to heal.

Introduction: The COVID 19 pandemic has come to change paradigms in terms of ventilatory support measures worldwide, prone ventilation was shown to decrease mortality in patients with ARDS. Objective:To identify the difference in days of mechanical ventilation of patients with respiratory failure by COVID-19 In the Intensive Care Unit with prone position for £48 hours compared to >48 hours. Material and methods: We evaluated all patients admitted to the Intensive Care Unit of UMAE Hospital No. 1 de Especialidades del Bajío, who required mechanical ventilation and prone position for refractory acute respiratory failure due to SARS-CoV-2 infection, we identified those in prone position for £48 hours versus > 48 hours (h), and we evaluated the difference in days of mechanical ventilation between the two groups, concluding who maintained more days of mechanical ventilation. Results: Statistical significance was found only for the following variables: days of mechanical ventilation (p=<0.001), days of ICU stay (p=0.04), time in prone position (p=0.001) and PaO2/FiO2 ratio after maintaining prone position (p=<0.001). Conclusion: The improvement in the oxygenation index in prone position >48 h is greater compared to those who remained £48 h, however, the time (days) under mechanical ventilation was less in the £48 h group; complications had no impact on the time in prone position.

Hypothermia is defined as a so-called central vital sign below 35°C (95°F). Impaired thermoregulation may contribute to accidental hypothermia. Hypothermia is evaluated as mild, moderate, or severe central blood warmth and clinical features ranging from shivering to progressive bradycardia, coma, and circulatory collapse. During the diagnostic evaluation, the patients core temperature should first be determined, followed by an ECG. Additional tests evaluate comorbidities and complications. Treatment consists of rewarming and supportive care. Cardiac arrhythmias are the main common explanation for death from hypothermia.

Local and regional anesthesia, in discrepancy to systemic, general anesthesia, involves the reversible deadening of a specific region of the body to help any sensation of pain. Pain may be blocked on different situations of its signal transduction pathway,e.g., at the point of origin, along the jitters, or in the brain. Consequently, local and regional anesthesia can be divided into local topical and infiltration anesthesia, regional supplemental whim-whams blocks( PNB), and neuraxial anesthesia(e.g., spinal and epidural). Local anesthesia can be combined with general anesthesia, allowing the boluses of anesthetic and analgesic medicines to be reduced during surgery, and may exclude the need for other measures to achieve sufficient anesthesia( depending on the timeframe of surgery, threat profile, cases concurrence). In general, local anesthesia carries lower threat than general anesthesia, as essential body functions(e.g.respiration) arent affected.

Background: Hypertrophic scar is a problem of wound healing process. Salmon DNA (Polydeoxyribonucleotide/PDRN) is a mixture of deoxyribonucleotide gonads derivate of Oncorhynchus mykiss (Rainbow Salmon) that helps wound healing process and preventing the formation of scars. Methods: A diabetic 30-year-old man with 5x3 cm hypertrophic scar on his dorsal hand since 10 months. The hypertrophic scar had been treated with ointments and Triamcinolone 10mg/ml every 2 weeks for 2 months. The patient was treated with intradermal injection 2% Polydeoxyribonucleotide (PDRN) in 2.7 ml (PDRN Bellavita®) and topical therapy containing Allium cepa extract and Vitamin E (Lanakeloid®) every 12 hours. PDRN was injected intradermal into the whole area of the scar using a 30-G Needle at a dose of 0.05 ml at each injection site with a distance of about 0.5-1.0 cm. PDRN was given every 2 weeks for 3 months. Vancouver Scar Scale was used to asses hypertrophic scar treatment progress. Results: The Vancouver Scar Scale was downgrading from 10 to 3 in 3 months. Conclusion: The combination of PDRN injection with topical administration of Allium cepa and vitamin E, is effective for hypertrophic scar treatment.

Introduction: Bone marrow aspiration (BMA) is an important tool in diagnosis of many haematological and non-haematological diseases. BMA usually done together with complete blood cell count (CBC) and peripheral blood picture. BMA needed for diagnosis of hypersplinsm. BMA alone is sufficient for diagnosis of megaloblastic anaemia, microcytic anaemia, acute leukaemia, chronic myeloid leukaemia, chronic lymphocytic leukaemia and immune thrombocytopenic purpura (ITP). The objective of this study was to determine the indication of bone Aspiration (BMA) in Kassala state eastern Sudan. Identify the important of BMA in diagnosis of hyperslenism and other diseases in the area. Methodology: All cases for BMA referred from different hospitals and health centres in Kassala state. Seventy-one cases of bone marrow aspiration conducted at the Department of Pathology Faculty of Medicine, Kassala University from October 2016 to October 2017. Blood cell count and peripheral blood picture done for all patients subjected for bone marrow aspiration. Clinical information, physical examination, BMA results and other investigations recorded in specially designed form. Data entered on SPSS version 15 and statistically analyse. Results: In 71 of patients underwent BMA, 46 (64.8%) of them with splenomegaly. Twenty (44%) of patients with splenomegaly was due to bilharzia, 18 (39%) due to malaria, two due to malignancy (4%), two (4%) due Visceral Leishmaniosis and two unrevealed causes. Out of the cases with splenomegaly 34 (73.9%) showed features of hypersplenism. Non-splenomegaly cases, 8(32%), 3(12%), 2(8%), iron deficiency, haemolytic, aplastic, and megaloblastic anaemia respectively. 4 cases diagnosed as Idiopathic Thrombocytopenia (ITP). Two cases diagnosed as acute leukaemia. Conclusion: Bone marrow aspiration was very important tool for diagnosis of hypersplenism, endemic diseases in the area and other haematological disorders.

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most commonly performed minimally invasive procedures for the diagnosis and treatment of biliary and pancreatic diseases. Hepatic hematoma secondary to ERCP is a rare and potentially serious complication with few cases described in the literature. Objective: The objective is to present a case of a giant hepatic subcapsular hematoma (HSH) secondary to ERCP, surgically resolved by laparotomy due to its recurrence and significant growth. Case report: We present the case of a 55-year-old female patient with a history of laparoscopic cholecystectomy and subsequent ERCP due to residual choledocholithiasis. The patient presented intense abdominal pain and fever after being discharged home, so she was admitted to the general surgery service where a HSH was diagnosed. Initially, conservative treatment with imaging follow-up is indicated, however, due to growth of the hematoma and recurrence, surgical treatment is indicated. Conclusion: Most patients respond to conservative treatment, however there will be patients who require surgical treatment, so suspecting this pathology will help provide timely treatment.

A new type of coronavirus called BA.5 is causing a stir because it is more evolved than other Omicron variants. However, BA.5 strategically circumvents the accumulated defenses against previous versions of the virus. All this means that cases of reinfection are on the rise, including among newly vaccinated and infected people. The most common symptoms of the original Omicron strain include runny nose, sneezing and sore throat. Headache, muscle aches, coughing, sneezing, high temperature, pressure in the ears and face, and loss of taste and smell, especially in vaccinated persons. Diarrhea and anorexia are likely linked to Covid-19, but the two lists of symptoms are nearly identical. , now seems to be lurking everywhere and infecting everyone, whether they already have a vaccine, have booster shots, or have a recent bout of COVID-19. “If you have BA.1, you are not adequately protected against BA.4/5”.The purpose of this short descriptive review in General Is to To shed light on the occurrence and implications of various mutations in SARS-CoV-2 to date.

Coronavirus disease (COVID-19) is an infectious disease caused by a new strain of coronavirus. While most people infected with COVID-19 will have mild to moderate respiratory illness and recover without needing special treatment, the elderly are more likely to develop serious illness. With the ongoing mutation of the emerging coronavirus and the growing list of its symptoms, it is becoming increasingly necessary to remain vigilant about the signs of COVID-19. COVID-19 symptoms are different in the elderly compared to others. Some of these symptoms may be missing in the elderly and the aging of the immune system may play a role in your guide. The aim of this descriptive minireview, generally, is to shed light on The immune aging in elderly and the potential impact on the immune response against SARS-CoV-2 in Covid -19 patients.

Corona virus is not a single virus, but rather a large family of coronaviruses that cause disease in humans and animals. The severity of symptoms of infection with one of the types of coronavirus in humans ranges from the common cold to severe acute respiratory infection (SARS). The Middle East Respiratory Syndrome Corona virus (MERS-CoV) was first discovered in April 2012, when it was not known to humans, and it was causing severe illness in people with it and the death of half of the cases of infection. With the emerging corona virus (19-COVID), which has led to the death of a large number of people and confused life in all countries of the world nearly 6 million people have died all over the world. The aim of this descriptive minireview, generally, is to shed light on the SARS-CoV-2 family : Characteristics and Clinical manifestation and presentation of Covid – 19

The multiple mutations of the Covid 19 virus worry people around the world, and the reason for this is very clear, as the last century witnessed four pandemics of influenza viruses, which are: H1N1 in 1918, H2N2 in 1957, H3N2 in 1968, and H1N1 in 2009 - which came in a second deadly wave In the fall and the beginning of winter. Covid-19 may behave in the same way, and the dangerous mutants of Covid have already seemed to sweep the world like the Indian strain. The worry that we might get a double overwhelming infection from the flu and the coronavirus is justified and could be very dangerous to humanity. That the effect of this double overwhelming infection may be dangerous is more closely related to human behavior than to virology: as there are many similar characteristics common to the two viruses in virus transmission, spread, symptoms, and so on. Where both Covid-19 and influenza are transmitted - in most cases - through respiratory droplets, so the same prevention strategies used to limit the spread of the first will also work to limit the spread of the second and the speed of dealing with the first for sure from the second and so on. The aim of this descriptive minireview, generally, is to shed light on the SARS-CoV-2 induced Covid 19 and Influenza Dual overwhelming infection and the Rising attention to Similarities between them.

Objective: evaluate the improvement of Patient – Care provider interactions by implementing a person – center proposal daily round ensured by trained non-medical staff for patients admitted in wards. Design: prospective comparative study, using check list extracted from person center care and data was collected from a third-party survey approved in Saudi Arabia health care since 2019. Setting: Wadi Al Dawasir region, Saudi Arabia. Population: The study period (July 2020 to July 2021). The person center proposal daily round was started as a proactive measure to improve the patient-care provider interaction after the decrease of patient satisfaction in the third-party survey data. We include all admitted inpatient wards (231 patients) except critical area and COVID – 19 units after pandemic. Main outcome measures: we compare Patient satisfaction about sleeping, level of noise in and around room, pain controlled, Promptness in responding to the call button, Instruction given about how to care at home and Staff effort to include the patient in decisions about his treatment before and during the person center proposal round. Results: the overall trajectory of patient satisfaction is increased according to the third-party survey upon implementation of the round. In the third quarter 2020 we remark increase of satisfaction about sleep from (85%) to (92.85%) in the third quarter 2021.the same improvement is seen in the others parameters as pain-controlled satisfaction (from 81.25% to 87.5%), promptness in responding to the caPropsal Person Center Daily Round, shortage of staff, patient –care provider interactions. ll button (from 79.54% to86), instruction given about how to care at home (from 88% to 89.86%) and staff effort to include patient in decision about his treatment (from 80.81% to 88% of the third quarter 2021) Conclusion: When proposal round happens well it considered as incredible tool to improve communication between nurses’ staff who are in shortage at the unit and admitted patients

This study was conducted in western Hospital and research centre Nepalgunj from 2007 to 2010. It was a prospective non randomized study consisting 250 patient of both sex and aged between 18 and 67 years with ASA (American Society of Anaesthesiologist) grade I and II scheduled for upper arm surgery. The subjects were given brachial plexus block on sitting position with their head tilted to opposite side of the block. In this technique 3 cm long 23 gauge needle was inserted from the point above clavicle to the lateral to subclavian artery pulsation, direction of needle was towards spinous process of 7th cervical vertebra. This procedure was done in 250 patients. Out of 250 patients 246 patients experienced paresthesia and pain relief after 20 ml solution (mixture of 5 ml 0.5% bupivacaine, 5 ml 2% xylocaine with adrenalin and 10ml normal saline). The onset of sensory block onset was observed to be 6.32±0.94 minutes and duration of sensory block was 2.5 to 4.2 hours. Similarly, the onset of motor block was 10.72±1.0 minutes and duration of action was 0.5 to 2.5 hours

An abnormal communication is a connection between two epithelial surfaces such as between hollow organs, skin or vessels. In onco-radiological practice they may occur in association with malignancy due to the primary or recurrent tumor, or in due course of treatment of the tumor by surgery, chemotherapy and radiotherapy. Looking for these abnormal communications and their causes are necessary for further planning, management and follow up of these cases. Computed tomography (CT) is sensitive in detecting , assessing the fistulous tract with positive contrast effect and contrast leak at abnormal sites, changes in the adjacent soft tissue and identification of air foci within the tract. Now, we report a case series of 8 rare, unusual and abnormal communications such as esophago-mediastinal, tracheo-mediastinal, entero-enteric, entero-cutaneous seen in different cancers on CT in our oncoradiological practice in MNJ Institute of Oncology and Regional Cancer Center.

Today Neurofibromatosis type 1 belongs to a genetic disorder in which there is a mutation of a gene that is on chromosome 17 which will cause at some point in the patients life the development and growth of tumors in the central nervous system or even outside it. Epidemiologically it is known that there is no predilection for sex or person, but it is known and common, that the onset of presentation of symptoms is given after birth, for this reason, it is a disorder that occurs more frequently in children, it is important to recognize the disorder to be able to attend to the complications that occur with the evolution of the disease, remembering that a specific treatment is not known exactly. It is considered necessary the integral attention to the multiple complications that could come present, which mentions some of the most serious are: Musculoskeletal disorders, as well as presenting skin problems, being frequent presentation in the first year of life. Eye problems, learning problems at school age and even worse prognosis can reach a degree of mental retardation.

This study examines the characteristics and composition of macro and micronutrients in kenyang diet in obesity therapy compared with a regular obesity diet, a low-energy diet. The approach is qualitative, Diet Quality Index (DQI-I) instruments is used for kenyang diet and low-energy diet consumers. Kenyang diet and the low energy diet have different characteristics from qualitative and quantitative aspects. Kenyang diet has the principle of natural food ingredients without processing and elimination of food additives. In comparison, the low-energy diet focuses on consuming foods low in energy, high in protein, sufficient in fat, and high in fiber. The composition of the kenyang diet obtained was 22% protein, 45% fat, and 35% carbohydrates from the total energy intake. Compared to kenyang diet, low-energy diet meets a balanced nutritional composition. Processing the menu in kenyang diet and low-energy diet has differences in frying technique. Kenyang diet as a qualitative diet has advantages and disadvantages in terms of nutrition and health. Consumption of natural foods and avoiding processed foods is a good health approach. Kenyang diet uses mindful techniques as the initial stage of the diet by giving full attention to what is eaten. However, kenyang diet has a risk of iodine and potassium deficiency due to the absence of consumption of table salt and milk in the long term.

Background: Critical thinking in present times is a profoundly esteemed instructive outcome after an educational course or program particularly corresponding to higher level of professional training. The main aim of the study was to compare the method of instruction and to enhance critical thinking among nursing students. Methodology: Quasi-experimental study was conducted to assess the effectiveness of concept mapping versus traditional method of instruction as a tool to enhance critical thinking among nursing students in medical surgical nursing (cardiovascular system). Pre-test and post-test control group design was used. B.Sc Nursing III year students were included as experimental group (n=97) and comparison group(n=94). The experimental group was initially given a session on concept mapping and its uses in nursing education. For both the groups instruction on cardiovascular conditions using concept mapping and traditional method was administered respectively. The experimental group and comparison group were assessed for the critical thinking ability using structured questionnaire. The concept maps were evaluated using McMurray’s method scoring criteria. Findings: The findings of the study suggest that the difference between pre-test and post-test mean knowledge scores in Concept mapping (variables- analysis, synthesis and evaluation) was found to be significantly higher than the traditional group at 0.05 level. There was significant improvement in construction of concept maps in criteria related to breadth, interconnectivity, and linkage. Majority of students coined the opinion which indicates high level of acceptance that ranges between 90 to 100%. Conclusion: It was concluded that concept mapping is an innovative strategy for enhancing critical thinking ability in nursing students.

A 55yr old diabetic, hypertensive male with prior history of coronary stenting presented to the emergency department with complaints of abdominal pain and distension of duration 4 days. The abdomen was grossly distended with diffuse tenderness and guarding The Patient was evaluated resuscitated, investigated, and found to be Hollow viscous perforation with peritonitis. The Patient was subjected to emergency laparotomy. The surprise finding in the Operating room was mass arising from jejunum with perforation. The Resected specimen histopathology revealed GIST jejunum which was an unusual cause of acute abdomen.