Hepatic herniation through an abdominal incisional hernia is an extremely rare phenomenon that has been reported in the medical literature in few case reports. It is associated with complications such as hepatic encephalopathy and Budd-Chiari syndrome. Most cases can be managed conservatively through observation, but many cases require surgical intervention to preserve liver function. Our case is a 61-year-old female who presented with herniation of the left hepatic lobe through an abdominal incisional hernia which was managed surgically.

ECMO (Extracorporeal Membrane Oxygenation) is an extracorporeal oxygenation technique that involves the use of a specialized membrane to oxygenate the blood and remove carbon dioxide out of the body. It is commonly used in critically ill patients with severe respiratory or cardiac failure to provide life support while waiting for organs to recover normal function.1

Aortic valve replacement (AVR) is a surgical procedure in which the defective valve is surgically removed and a new valve is implanted. The surgical technique is used when the aortic valve becomes stenotic or regurgitant, leading to decreased cardiac output and other life-threatening complications. AVR is performed under general anesthesia.

Surgery is a medical discipline that has advanced significantly in recent decades thanks to advances in technology and medical research. Surgical drains are devices used to evacuate excess fluids that accumulate in the surgical wound. There are different types of drains that can be used depending on the area intervened and the type of fluid to be evacuated. Each type of drainage has specific advantages and disadvantages, and their choice will depend on the characteristics of the patient and the procedure.

Reconstructive surgery is a surgical technique used to restore the function and appearance of tissues that have been damaged or removed due to previous illnesses, injuries, or surgeries. Complications of reconstructive surgery are a major concern for patients and surgeons. Complications can affect patients quality of life, increase healthcare costs, and prolong recovery time. It is important that patients are fully informed about the risks and benefits of reconstructive surgery, and that surgeons take steps to minimize the risk of complications.

Bile duct iatrogenies are adverse events that occur in patients undergoing surgical, endoscopic or radiological procedures in the bile duct region. Bile duct iatrogenies are serious complications that can have a significant impact on a patients quality of life. The prevention of these complications is essential and depends on the experience of the professional who performs the procedure, knowledge of the anatomy of the bile duct and the proper use of available technology. Proper repair of biliary lesions is critical to reducing long-term complications

Abdominal diastasis is a condition that occurs when the rectus abdominis muscles separate, leading to weakness in the abdominal wall and can manifest as a bulge in the middle abdomen. Abdominal diastasis is a common condition that can generate annoying symptoms and affect the quality of life of those who suffer from it. Management of abdominal diastasis can include a variety of therapeutic approaches, from conservative management with specific exercises and manual therapy, to surgery in more severe cases.

Breast reduction is a surgical procedure used to reduce the size of the breasts and improve the shape and proportion of the body. This procedure can relieve back, neck, and shoulder pain, as well as improve the confidence and quality of life of patients suffering from large, heavy breasts. Breast reduction is an effective and safe surgical intervention to decrease the size of the breasts and improve the quality of life of patients.

Wound healing is critical to prevent complications, such as infections, delayed healing, and misshapen scars, and to promote optimal recovery of damaged tissue. Proper wound evaluation, proper cleaning, debridement, use of proper dressings, proper nutrition and hydration, infection prevention and treatment, inflammation control, and use of advanced therapies are all important measures to consider in wound care.

Sepsis in surgery is a common complication that can be life-threatening. It is defined as a systemic inflammatory response to an infection and can progress to septic shock and multiple organ failure. Sepsis in surgery is a serious complication that affects many surgical patients. Early prevention, identification and treatment are essential to improve patient outcomes.

Persistent pulmonary air leak affects between 10-15% of pulmonary surgical procedures, generally requiring management through the use of conventional chest drainage systems (water-sealed pleural chamber) of subjective interpretation due to poor detection sensitivity. of leaks, resulting in increased morbidity, hospital stay, and costs.

Healthcare workers (HCWs) are vital in providing guidance and recommendations to patients and the wider community about vaccination, which includes giving correct information on the risks and benefits of the vaccine. As they are crucial players in vaccine delivery and have a large impact on vaccine acceptability in the community, it is important to know their attitudes towards vaccination. In this study we aimed to assess acceptance rate and identify factors associated with vaccine hesitancy among Libyan healthcare staff in west region cities. We use questionnaire to the healthcare staff workers in the western district in Libya. A total of 150 respondents completed the questionnaire. This study showed that 60.66% of healthcare workers accepted the COVID-19 vaccine, 39.33% workers were hesitant. 42% of respondents were believed that origin of corona is man-made virus. 38.66 % stated that Pfizer-Biontech vaccine is the most accepted vaccine. 82% of participants in this current study were willing to encourage people for vaccination and only 18% were not encouraged.

Cholangiocarcinoma (CCA) is the primary malignant tumor of bile ducts which originates from the cholangiocytes. It accounts for 10-15% of all Hepato-biliary malignancies. Hilar Cholangiocarcinoma (Klatskin tumor) is a type of extrahepatic CCA. We present a case of 37-year-old female patient diagnosed with Hilar Cholangiocarcinoma who presented with complaints of loss of appetite since 2 months associated with generalized itching and yellowish discoloration of sclera & skin with palpable firm mass in right hypochondriac region. The patient underwent Percutaneous Transhepatic Biliary Drainage (PTBD) followed by internalization to relieve the biliary obstruction along with Intra Luminal Brachytherapy (ILBT) of 20Gy (4 fractions of 5Gy each). The patient was symptomatically better for 6 months with much alleviation of pain, jaundice and was able to continue with her daily activities. Therefore, it can be concluded by saying that ILBT is an effective modality of treatment in HCCA for alleviation of pain and maintaining patency post PTBD procedure.

Introduction: In Mexico it affects approximately 2 million people, with a significant impact on quality of life and difficult to manage. Theoretical framework: The lesion it causes is round, salmon-pink papules and plaques, located on knees, elbows and scalp. The diagnosis is mainly clinical and the treatment will depend on the affected body surface and the location. The drugs considered first line are topical and second line drugs are used systemically, which in many occasions have adverse effects that make attachment difficult. Guselkumab, a drug approved in 2017, is an IgG1 that blocks the p19 subunit of IL-23. Discussion: Guselkumab, which is a monoclonal antibody, provides better patient outcomes compared to the drugs used in current therapeutics. There is little information currently available on Guselkumab since it has only recently been approved, but in all studies it has shown to be superior to other monoclonal antibodies, the main disadvantage being that it is not currently available in Mexico and the long administration time. Conclusion:Researching new drugs helps us to provide the patient with a treatment with the least amount of adverse effects, achieving greater adherence and better control of the disease.

The COVID-19 pandemic has been severe in the past situation. It affects everyones physical and mental health. Economic, social, living conditions, and the education system that need to be adjusted to the way students learn. Changing the teaching methods of teachers and parents in order to supervise their children to overcome such a turning situation, and as a result of the situation, the research team was interested in taking the lessons learned on parental care in cognitive issues. Attitude, prevention, and adaptation in the above situations. The majority of respondents were female parents aged 41 years and over, with bachelors degrees, employed or private sector employees, and parents with two children aged 6-7 years. Have the highest level of protective behavior for your child. They are well adapted physically, mentally, academically, socially, and environmentally, and are well prepared to prevent coronavirus infection.

Tilapia skin is an attractive and viable option for the treatment of second and third degree burns in patients. Several studies have shown that tilapia skin has antibacterial and anti-inflammatory properties that promote wound healing and reduce pain and inflammation in burn patients. In addition, tilapia skin is readily available, inexpensive and has a low probability of disease transmission. Compared to other treatment options, such as skin grafts, tilapia skin has a high success rate in promoting wound healing. More research is needed to fully establish the efficacy and safety of tilapia skin in the treatment of burns, but the current results are promising and suggest that tilapia skin may be a viable and cost-effective option for burn treatment.

Introduction: Tumors of the sheath of the peripheral nerves, also known as schwannomas, mainly benign. The malignancy of these is very rare and there are few cases reported in the literature. Clinical case: A 62-year-old male with a diagnosis of ulcerated malignant schwannoma in the distal third of the posterior aspect of the right thoracic limb who attended the oncosurgery service. The CT scan reported a large solid tumor, predominantly hypodense, with a probable origin dependent on the poorly defined triceps brachii muscle. Surgical removal was performed with two centimeters of perilesional margins, performing primary closure with drain placement. Conclusion: Surgical treatment of total surgical removal with adequate margin coverage is the treatment of choice as a protective factor in survival in this type of tumor..

SGLT2 inhibitors are a class of drugs commonly used in the treatment of type 2 diabetes. Although these drugs are effective in controlling blood sugar, they also have significant systemic side effects that must be considered. The most common side effects of SGLT2 inhibitors include urinary tract infections, euglycemic ketoacidosis, orthostatic hypotension, dehydration, and cardiovascular adverse events. In addition, an increased incidence of bone fractures and decreased bone mineral density has been observed in patients taking these drugs. It is important that physicians consider these side effects when prescribing SGLT2 inhibitors and monitor patients regularly for any complications. Individual benefit-risk assessment is critical before deciding to prescribe these drugs. In summary, although SGLT2 inhibitors are an effective treatment option for type 2 diabetes, their use should be carefully evaluated and monitored to minimize systemic side effects.

Weber-Christian disease is an inflammatory disease, of the lobular panniculitis group, affecting the skin, subcutaneous adipose tissue and other organs. It is characterized by recurrent episodes of inflammation, pain and subcutaneous nodules, often associated with fever and systemic symptoms. The pathogenesis of the disease remains poorly understood, but it has been suggested that it may be related to an autoimmune response or an exaggerated inflammatory response to infections or other triggers. Diagnosis is based on clinical presentation, histologic findings and exclusion of other causes of inflammation and subcutaneous nodules. Treatment includes steroids, immunomodulatory therapies and surgery in severe cases. Weber-Christian disease can be a debilitating and potentially fatal disease if it affects internal organs. Understanding this disease and early identification are important for proper treatment and a better prognosis for affected patients.

Erysipelas is an acute dermo-hypodermic (non-necrotizing) infection of bacterial origin, mainly group A beta-hemolytic streptococcus. The lower limbs are affected in more than 80% of cases and the risk factors identified are skin barrier breakdown, lymphedema and obesity. Diagnosis is clinical and is based on the association of an acute inflammatory plaque with fever, lymphangitis, lymphadenopathy and leukocytosis. Bacteriology is generally not useful due to low sensitivity or late positivity. In atypical forms, erysipelas should be distinguished from necrotizing fasciitis and acute venous thrombosis. Penicillin remains the gold standard treatment, although new drugs may be used, given their pharmacodynamic profile. Recurrence is the main complication, being crucial the correct treatment of risk factors1.

Holmium laser enucleation of the prostate (HOLEP) is a surgical technique increasingly used in transurethral resection of the prostate. This procedure has been shown to be safe and effective in the treatment of benign prostatic hyperplasia, offering a higher success rate in the removal of prostate tissue and a lower rate of complications compared to other methods of transurethral prostate resection. In addition, HOLEP has been used successfully in patients with large prostates and those with coagulation disorders, making it a safe and effective treatment option for a wide variety of patients. In summary, HOLEP is an effective and safe surgical technique in transurethral resection of the prostate, and may be an attractive treatment option for patients seeking a rapid recovery and reduced complication rate.

Erysipelas is an acute dermo-hypodermic (non-necrotizing) infection of bacterial origin, mainly group A beta-hemolytic streptococcus. The lower limbs are affected in more than 80% of cases and the risk factors identified are skin barrier breakdown, lymphedema and obesity. Diagnosis is clinical and is based on the association of an acute inflammatory plaque with fever, lymphangitis, lymphadenopathy and leukocytosis. Bacteriology is generally not useful due to low sensitivity or late positivity. In atypical forms, erysipelas should be distinguished from necrotizing fasciitis and acute venous thrombosis. Penicillin remains the gold standard treatment, although new drugs may be used, given their pharmacodynamic profile. Recurrence is the main complication, being crucial the correct treatment of risk factors1.

Breast implant rupture is a rare event that can occur at any time after breast augmentation surgery. The most common causes of rupture are natural aging of the implant, traumatic injury, and failure of the implant material. Symptoms of breast implant rupture can range from mild discomfort to total loss of breast shape and size. Diagnosing a ruptured breast implant can be challenging, as the condition can be asymptomatic in some cases. However, imaging tests such as MRI and ultrasound can help detect the presence of ruptured implants. Treatment options for ruptured breast implants vary depending on the type of implant, the duration of rupture and the presence of symptoms. In general, treatment involves surgical removal of the ruptured implant and replacement with a new one or complete removal of the implant and surrounding silicone material. Regular checkups with a board-certified plastic surgeon and being aware of any changes in the shape or feel of the breasts are crucial for early detection and treatment of breast implant rupture. Women considering breast augmentation surgery should carefully weigh the potential risks and benefits of the procedure before undergoing surgery. Breast implant rupture is a rare but important complication that requires prompt diagnosis and treatment to avoid potential complications. Understanding the causes, symptoms, diagnosis and treatment options for breast implant rupture can help women make informed decisions about breast augmentation surgery and maintain the health of their breasts.

Cardiopulmonary resuscitation is the main stay of treatment to revive patient who are in cardiac arrest and traditionally it was conducted under the supervision of emergency, critical care and anesthesia department. Knowledge of CPR and preparedness towards CPR among other specialty remains questionable. It has been observed through there are ample of data from developed countries but there is a paucity of work in developing countries regarding the same. OBJECTIVE: To assess the knowledge and level of preparedness and to assess the perception towards cardiopulmonary resuscitation among physicians and to determine factors influencing the same and the recommendation for further improvement. METHODOLOGY: This cross-sectional questionnaire-based study was conducted using a sample of 41 physicians employed in different specialties of Medica super specialty hospital using a pre validated questionnaire for a period of 12 months. Fischer exact test or Chi Kolmogorove -Smirnov analysis has been used to check if data is following the normal distribution. Pearson’s correlation analysis or Spearman’s rank correlation analysis has been used to assess correlation between two variables. RESULT : 41 physicians responded among 80 contacted (n=41,response rate= 51.25%).In our study The mean age of the participants was 39.46 (±9.01) years with a median of 38 years. The age ranged from 2564 years. 75.6% of the respondents were males. Major group of participants are belonged to emergency medicine (29.3% ) followed by non-interventional cardiology.43.9% of study populations are holding doctor level medical degree.39% of study population is holding ACLS /BLS certification. 100% of physician of study population are being aware of importance of CPR and 73.2% are keen to take part in CPR awareness programme. Most of the physicians (75.6%) believe teaching and mastering CPR intervention should be made mandatory to all medical undergraduates. There was no significant association of specialty, highest qualification, years of experience or presence of ATLS certification with score on question regarding main purpose of CPR. There was a significant association of score on this question with presence of ACLS/BLS Certification, with all respondents who possessed ACLS/BLS certification answering all options correctly. CONCLUSION :The study showed variable level of perception of knowledge and level of preparedness towards cardiopulmonary resuscitation among physicians and there are no single variable or determined factor for above. Though the study indicates there is correlation between the ACLS/BLS/ALS certification and knowledge of CPR further study and evaluation is needed in context of developing countries. It is also recommended a refresher course intending towards last years of medical school would be beneficial regarding knowledge of CPR

Porcelain gallbladder is a rare and potentially serious condition characterized by calcification of the gallbladder wall. Chronic inflammation and bile flow obstruction are thought to be important factors in its pathogenesis. The clinical presentation of this condition can range from asymptomatic to severe complications such as bile duct obstruction and acute cholecystitis. Diagnosis is made by a combination of clinical, radiological and biopsy findings. Treatment is controversial due to the rarity of the condition and the lack of clinical studies. In most cases, cholecystectomy is recommended as definitive treatment to prevent serious complications. Careful evaluation and an individualized approach to the management of this potentially serious condition is needed.

Hospital length of stay (LOS) is a quality metric health systems use as a proxy of efficient hospital management (1). Many strategies to reduce ICU length of stay (LOS) have been implemented, but few studies have evaluated the role of ICU design in reduction of LOS and outcome. This study was informed by the need to compare ICU performance in terms of length of stay and outcome before the upgrade of the ICU facilities and organizational structure (January 2018 – December 2019) and after upgrade of the ICU facilities (January 2020 – December 2021). Finally we demonstrate the impact of ICU design in reducing costs of ICU patients.

Adenocarcinoma no otherwise specified (NOS) and polymorphous low-grade adenocarcinoma (PLGA), are malignant tumors of the salivary glands. Both types of malignant tumors have the potential for recurrence and distant metastases. Rare cases of recurrence and metastases lead to the absence of standardized systemic therapy for salivary gland cancer. This case report aims to expand the literature regarding recurrence and distant metastases of parotid gland adenocarcinoma. We report the case of a 54-year-old woman who complained of a recurrent lump in the right mandibular area who had previously undergone chemoradiotherapy, right parothyrodectomy, and left mastectomy. Histopathological examination of the biopsies that were performed gave different results, namely adenocarcinoma and PLGA.

Fitz-Hugh-Curtis syndrome (FHCFS) is a chronic inflammatory disease that affects the peritoneal and hepatic surfaces, causing the formation of adhesions and fibrous bands between these structures. This condition occurs as a result of prior infection by sexually transmitted pathogens, such as Chlamydia trachomatis or Neisseria gonorrhoeae, which provoke an inflammatory response at the peritoneal level and subsequently affect the hepatic surface.1

Hand reconstructive surgery has become an increasingly important specialty due to the increasing incidence of hand injuries in the general population. According to the World Health Organization, hand injuries are responsible for about 10% of all emergency department visits. The hand is a complex structure consisting of many bones, muscles, tendons, nerves, and blood vessels. Hand function is essential for performing everyday activities, such as eating, dressing, working, and participating in recreational activities. Hand injuries can have a significant impact on a patients quality of life and can limit their ability to perform daily activities and work. Hand reconstructive surgery aims to restore hand function and improve the patients quality of life. The choice of surgical technique should be based on the cause and severity of the injury, as well as the preferences of the patient and surgeon.

Reconstructive breast surgery can significantly improve patients quality of life after a mastectomy, which can have a positive impact on their psychological well-being. Patients who undergo breast reconstructive surgery have greater satisfaction with their body image, an improvement in their self-esteem, and a decrease in anxiety and depression. In short, the aesthetic analysis of breast reconstructive surgery is an essential aspect in the practice of plastic and reconstructive surgery, since it allows optimal results and significantly improves the quality of life of patients. Therefore, it is necessary to continue researching and improving the techniques and methodologies used in this field to ensure quality and personalized care to patients.

Breast reconstruction is an important procedure for women who have had a mastectomy due to breast cancer or other diseases. Breast reconstruction can improve self-esteem, body image, and quality of life for women who have experienced breast loss. Breast reconstruction with implants is an effective and popular technique for breast reconstruction after mastectomy. However, it also has its limitations and complications, so it is important for patients and surgeons to work together to select the right technique and minimize the risk of post-operative complications. The choice of implant type, surgical technique and prevention of complications such as capsular contracture and implant rupture are important factors to consider in breast reconstruction with implants. Continued research and development in this field may further improve the efficacy and safety of this technique in the future.

Although cases have been reported in women with smooth surface implants as well, textured surface implants have seen the majority of breast implant-associated lymphoma cases. The most typical signs and symptoms are breast lumps, discomfort, and swelling. Clinical, radiographic, and pathological findings are used to make a diagnosis. The basic course of treatment is still removal of the implant and capsule, however in some circumstances stem cell transplantation, chemotherapy, and radiation therapy may be required. Patients with breast implants who exhibit symptoms should be evaluated by doctors for lymphoma. Long-term monitoring is necessary to identify illness recurrence early and guarantee effective therapy. In conclusion, lymphomas connected to breast implants provide a diagnostic and therapeutic challenge that has to be handled collaboratively and with a full understanding of the patient. Article Details

Cancer-related wounds are still one of the healing challenges that are still faced by various health practitioners, where these wounds are often unsightly and associated with foul odor, drainage, and bleeding. Wounds caused by malignant tumors have a wide range of symptoms and severity, thus there is no treatment that has been demonstrated to be able to relieve them effectively. The use of wound dressings, which have antibacterial advantages and are helpful for treating wound infections as well as preventing wound contamination, is one method of wound care. Natural substances known as polyphenols, which are often created by plants, have potential antibacterial and antioxidant properties. G-90 is a mixed macromolecular substance with glyco-lipoprotein properties that aids in tissue regeneration in vivo, particularly when it comes to wound healing. Plenty of flavonoids are present in the polyphenolic chemicals produced by necklace worms (Pheretima aspergillum). Flavonoids contribute to the formation of cross-links with collagen, which can have the impact of accelerating wound healing and the decline in inflammatory cells like macrophages. In this situation, Pheretima aspergillum, which has G-90 glyco-lipoproteins and polyphenols, may be useful for healing malignant wounds.

Cancer-related wounds are still one of the healing challenges that are still faced by various health practitioners, where these wounds are often unsightly and associated with foul odor, drainage, and bleeding. Wounds caused by malignant tumors have a wide range of symptoms and severity, thus there is no treatment that has been demonstrated to be able to relieve them effectively. The use of wound dressings, which have antibacterial advantages and are helpful for treating wound infections as well as preventing wound contamination, is one method of wound care. Natural substances known as polyphenols, which are often created by plants, have potential antibacterial and antioxidant properties. G-90 is a mixed macromolecular substance with glyco-lipoprotein properties that aids in tissue regeneration in vivo, particularly when it comes to wound healing. Plenty of flavonoids are present in the polyphenolic chemicals produced by necklace worms (Pheretima aspergillum). Flavonoids contribute to the formation of cross-links with collagen, which can have the impact of accelerating wound healing and the decline in inflammatory cells like macrophages. In this situation, Pheretima aspergillum, which has G-90 glyco-lipoproteins and polyphenols, may be useful for healing malignant wounds.

Neuroendocrine tumors represent approximately 20% of lung cancers; most are small cell lung cancer. The WHO classification system is used to classify lung tumors. In cases where there are clinical manifestations, these will depend on the location, size and perilesional edema generated by the metastases. A 78-year-old male who presented sudden right hemiplegia and bradylalia. A simple tomography of the skull was performed where hyperdense lesions were identified in two different regions, with well-defined borders and perilesional edema, for which a simple chest tomography was performed where a left lung tumor was evidenced, through bronchoscopy bronchoalveolar lavage was performed, which reported small cells. with data suggestive of small cell carcinoma with metastasis to the central nervous system. Small cell lung cancer is the most aggressive form of lung cancer. Although characterized by rapid responses to chemotherapy and sensitivity to radiation therapy, due to early resistance to treatment, the 5-year overall survival is <10%. Clinical suspicion from the second level of care allows us to focus on a more effective diagnostic protocol.

Background: The most commonly used indicator for dental caries level is the DMF-T index. The DMF-T index is the index for assessing dental health status due to caries in permanent teeth. The DMF-T index was first used by Henry Klein et al. is the sum of the D/decay (dental caries), M/missing (missing teeth), and F/filling (caved teeth). Physical and cognitive changes in the elderly resulted in the assessment of the DMF-T index corresponding. Materials and Methods: This is an analytic observational study, using a cross-sectional approach to four elderly communities. The elderly community selected in Jember were Karangrejo Village, Karangharjo Village, Karangsono Village, and Mojosari Village. This research used 2 DMF-T indexes: the DMF-T Klein index and the real DMF-T index. Research subjects were the young elderly (45-59 years old), middle elderly (60-74 years old), and old elderly (75 years and over). Data were collected in February-March 2021. The data were compared between the DMF-T Klein index and the real DMF-T index. Data then analyzed using Wilcoxon Signed Rank test Results: This study found that there was a significant difference in the DMFT Index in the middle and old elderly. Whilst, in the young elderly, there is no significant difference in their DMFT index. This result indicates that the Klein DMF-T index can still be used at the age of 45-59 years old.Conclusion: DMF-T Klein index is still appropriate for young elderly (45-59 years), but not for middle elderly (60-74 years) and old elderly (75 years and over).

Purpose of the research: Patient safety is a very needed system, considering that currently, many patients are very concerned about their management. With this system, it is hoped to minimize errors in patient handling. Almost every medical action has potential risks. A large number of drugs, examinations, and procedures, as well as many patients and hospital staff, is a potential for medical error to occur. Errors that occur in the medical care process will result in or potentially result in injury to the patient. Situation awareness (SA) is often essential for making good decisions, especially in complex and dynamic situations. SA is more than just being aware of an events current state but also placing the event in the expected context. SA is categorized as a non-technical skill whose unit of analysis is not only health service providers but also interactions between various health service providers in a service unit. Method: observational analytic research with a cross-sectional approach. The research population was all paramedics at Nala Husada Dental Hospital, with a sample of 17 people. Result: Paramedics at Nala Husada Dental Hospital have a high level of knowledge but still feel insecure and need to feel better about doing it. A high level of expertise does not guarantee that a person has strong self-confidence or belief in acting. Conclusion: All respondents have a high level of knowledge regarding patient safety and have under-confident characteristics in implementing patient safety. There is no relationship between knowledge level and actual accuracy and between knowledge level and perceived accuracy.

Trigger finger, or stenosing tenosynovitis, is a common pathology of the hand, but a low incidence of this condition has been reported in children. Its pathophysiology is poorly understood and genetic association studies are lacking. There are conservative management such as immobilization with a splint, corticosteroid injection, physical rehabilitation therapy, but the definitive treatment is usually surgical, including percutaneous release of the A1 pulley and open release of the A1 pulley.

Hospital as a health service unit that provides services in general and special fields, one of which is operating room services. The biggest issue in this installation is surgical wound infection, where many factors influence this condition. Education to patients and families regarding information on surgical wound infections can be given starting from before rehabilitation, during surgery and after the rehabilitation process. Education can provide an overview of surgical wound infections so that patients or families can do things according to existing guidelines so that surgical wound infections can be prevented. A new innovation regarding guidelines in patient education in preventing surgical wound infections called BeSSIC (Bendan Surgical Site Infection Control) with the PIP-ED (Pre, Intra, and Post- Operative Education) guideline provides an overview of educational checklists that must be given before, when and after the operation took place.

The hand is one of the most important parts of the human body and its ability to perform everyday tasks is fundamental to the performance of daily life. The epidemiology of catastrophic hand injuries is varied, depending on the type of injury. These can be caused by car accidents, sports accidents, industrial accidents, and in some cases, acts of violence. Catastrophic hand injuries can also result from diseases, such as osteomyelitis or hand cancer. Advances in medical technology and surgical procedures have allowed surgeons to improve precision and control in repairing injuries to nerves, blood vessels, bones, tendons and skin.

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis that is easily transmitted. These bacteria can attack any organ in the body, but they most commonly attack the lungs. According to some research findings, there is a link between a persons level of knowledge about disease prevention and management, including pulmonary tuberculosis. Many government efforts have been made to eradicate tuberculosis cases. These efforts include health centers and hospitals promotional, preventive, and curative efforts. Counseling is a comprehensive process of communication and behavior modification through education. The purpose of this study is to determine the relationship between age and TB treatment knowledge in the community of District Kaliwates, Jember Regency. This analytic observational study with a cross-sectional design was carried out online with a sample size of 123 people. Using the Google application form, conduct a survey. The researcher explained the researchs goals and objectives before distributing questionnaires via the Google form application, collecting questionnaire data, and verifying data respondent answers. The collected data will be made available automatically via spreadsheet or excel. IBM SPSS Statistics 23 was used for data analysis. The chi-square test was used to analyze the data. The chi-square test results revealed that there was no relationship between age and knowledge of TB treatment. Conclusion: there is no significant relationship between age and medical knowledge TB in the community of Kaliwates District, Jember.

Background: Poststroke seizures occur in 6-8% of the adult population that suffer an ischaemic stroke. This pathological process increases metabolic stress and cell death, the extent of vascular obstruction in the brain, the mortality rate and long term morbidity. Poststroke seizures represent one of the most important complications of stroke that must be recognised and treated in a timely fashion. These are classified as either early or late depending on the time of onset after stroke. Case Report: A 51 year old woman presented to the Emergency Department of RSUD Dr Murjani following a generalised tonic-clonic seizure 3 hours prior that had lasted for two minutes. On arrival the patient subsequently had two further generalised tonic-clonic seizures with a one hour interval between. Whole body stiffness and a fixed upward gaze were observed. A non-contrast CT Head displayed a diffuse infarct of the left frontotemporoparietooccipital lobes. The patient had a history of stroke one year previously and a second stroke one month ago with resultant persistent weakness of the right upper and lower limbs. This patient was diagnosed with poststroke seizure of late onset and treated in hospital with diazepam 10mg and phenytoin 100mg three times per day. Discussion: Poststroke seizure is described as either early-onset (occurring in the first week after a stroke) or late-onset (occurring after the first week). Based on the International League Against Epilepsy (ILAE) definition, a single unprovoked late-onset poststroke seizure occurring more than seven days after a stroke is considered as epilepsy with a high risk (>60%) of recurrent seizures that may occur for up to ten years thereafter. Hence this risk factor must be identified and treated correctly to prevent significantly increased morbidity for the patient

The present study reports for the first time, the effects of soot exposure on peripheral capillary oxygen saturation and pulmonary functions among residents of Yenagoa, Bayelsa State. In the present study, peripheral capillary oxygen saturation level and respiratory indices ie pulmonary functions were evaluated among soot exposed residents in Yenagoa, Nigeria and the values compared with apparently healthy residents of a less polluted region in the same city. A total of 300 subjects within the ages of 18 to 65 consisting of 200 subjects living within soot exposed areas and 100 subjects who live 2km away from the polluted environment. Using questionnaires, personal data of each participant were collected. The questionnaire focused on sex, age, height and weight, duration of stay in Yenagoa, oxygen saturation level, respiratory indices, pulse rate, smoking habit, pregnancy and lung conditions. Hospital scale balance and calibrated metre rule were used to collect their anthropometric data while oxygen saturation, pulse rate and respiratory indices were measured using Sp-10 pocket spirometer and Pulse oximeter.The results from the study population shows a significant decrease in PEFR, FEF and pulse rates of exposed subjects compared with the control. Meanwhile no statistical differences were observed in BMI, FVC, FEV1and oxygen saturation level between the exposed and the control subjects except the BMI of the exposed subjects across their various age groups. There was a negative correlation observed in the plot against age and BMI versus respiratory indices. This study shows that the subjects living within soot polluted environment possess lower lung function indices compared with those living two kilometres away from the polluted environment, in Yenagoa, Nigeria.

Perioperative bleeding is a common complication of surgery that can increase patient morbidity and mortality. Careful patient assessment and early identification of risk factors are critical in preoperative management. In addition, the patients history of blood transfusion, optimization of hemostasis, and discontinuation of anticoagulants and antiplatelets prior to surgery should be considered

Stevens-Johnson syndrome is a rare but serious medical condition, which is classified within the blistering diseases of the skin and mucous membranes. It is characterized by a severe and generalized immune-mediated inflammatory reaction, predominantly affecting the skin and mucous membranes, such as the eyes, mouth and genitalia.

Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the interaction between the innate and adaptive immune systems. The release of antimicrobial peptides (AMPs) by keratinocytes, particularly LL-37 peptides, plays a crucial role in the initiation of psoriatic inflammation. The activation of dendritic cells and distinct T-cell subsets, particularly Th1 and Th17, leads to the formation of scaly plaques in psoriasis. Although most cases are treated with topical or systemic medications, severe forms such as pustular psoriasis and psoriatic arthritis may require surgical management. Surgical procedures aim to relieve symptoms, improve function, and minimize scarring and cosmetic deformities. However, psoriatic patients are at higher risk of post-surgical infections and surgical stress may trigger psoriatic flare-ups. Thus, meticulous post-surgical wound care and psychological support are essential for optimal outcomes.

Most of the pediatric surgical conditions or major congenital malformations are diagnosed on spot or with simple radiological imaging just like Tracheoesophageal Fistula (TEF), e.g., Inability to pass NG tube with coiling of NG tube on chest X-ray. But a few of them are still challenging to diagnose, just like ‘H’ type TEF because of delayed presentation as well as absent classical symptoms. (1) And even in today’s era where radiological accuracy has reached to a new level, this diagnosis is missed many times and only confirmed on table. Here we are reporting a case of ‘H’ type TEF, a 17 days old male child, whom we diagnosed on single attempt with virtual bronchoscopy.

Background: COVID-19 is an acute respiratory condition caused by a virus and it is declared at pandemic condition. Health sector faced challenged and medical technologists are direct contact of infected patients and sample. Objective: The study was to assess the knowledge and practice of medical technologists on COVID-19 infection prevention in laboratory in tertiary level hospital and institute Dhaka city. Methodology: A descriptive cross-sectional study was conducted among purposive selected 221 medical technologists working in six hospital and institute (public hospital & public institute) in Bangladesh. Data were collected by self-administrated structure questionnaire. Results: The study n-221 revealed that 100% respondents had knowledge about doing and doffing of PPE, 100% of the respondents had known that RT-PCR was confirm test for COVID-19 infection, 100% of the respondents had known about caused of COVID-19 by virus, 75.1% of the respondents were not getting training about COVID-19 sample packaging and 64.3% of the respondents were not getting training in laboratory safety against COVID-19 infection. Around 99.5% of respondents use color code bin for waste disposal, around 99.5% of the respondents were used respiratory safety cabinet and highest 96.8% of the respondents were used PPE during samples processing. Conclusion: Through periodic training and motivation, adequate supply of resources and infection prevention materials, quarantine facility for medical technologists should be available in hospital and institute that can improve overall knowledge and practice on COVID-19 infection prevention of medical technologists.

Breast implants are devices used in cosmetic and reconstructive surgery to increase the volume and improve the shape of the breasts. In this study, the different types of breast implants available in clinical practice were investigated. Four main types were identified: saline implants, silicone gel implants, highly cohesive silicone gel implants, and double lumen implants. Saline implants consist of a silicone shell filled with sterile saline. They have advantages such as the ability to adjust volume during surgery, easy rupture detection and lower cost. However, they may have a less natural feel and a higher risk of wrinkling and rippling. Silicone gel implants are widely used because of their more natural look and feel. Silicone gel is cohesive and offers a consistency similar to breast tissue. They have a lower incidence of wrinkling and rippling, greater durability and less sensitivity to cold. However, detection of ruptures can be more difficult and there is a potential risk of capsular contracture. Highly cohesive silicone gel implants, also known as anatomical implants, are designed to mimic the natural shape and projection of the breast. They have predictable aesthetic results, a lower incidence of capsular contracture and greater resistance to displacement. However, they may require longer incisions and have a higher cost. Double lumen implants have two separate shell layers, one internal with cohesive silicone gel and the other external with saline solution. They offer an additional layer of security in case of rupture of the inner shell and allow volume adjustment during surgery. However, they may have a less natural feel and greater technical complexity.

Background: Personal hygiene is deemed a necessary precautionary measure against different communicable diseases. Its importance is further reiterated during the current COVID-19 global pandemic. Method: A descriptive cross-sectional study was conducted among 309 day-laborer using convenient sampling technique. The study was conducted from 1st January 2021 to 31st December 2021. An interviewer-guided semi structured questionnaire with questions on knowledge, practices and barriers to personal hygiene was used in data collection. The chi-squire test was applied to evaluate the correlations among the respondents between knowledge and practices. A 95% confidence interval was used and statistical significance was P<0.001. Result: Research findings showed that most the respondents had good knowledge regarding COVID-19 in term source, transmission, wearing mask, hand wash, social distance, coughing etiquette, avoiding touching of face and nose. Additionally, most of the respondents having moderate practices on personal hygiene during COVID-19 was 58.9%. Furthermore, most of the respondents were wear face mask while going to outside or meet with someone. Only 1.9% respondents wearing mask all time. 83.8% noted lack of soap and water in their workplace as a barrier to maintain personal hygiene. Conclusion: The study revealed that overall maximum proportion of respondents with good knowledge but having moderate practices with some barrier. Findings indicates there is need for optimizing personal hygiene practices through the addressing barriers and promoting public health education.

High fidelity simulation (HFS) has emerged as a crucial tool in healthcare education due to its ability to facilitate the implementation of realistic clinical scenarios. Proficiency in Cardiopulmonary Resuscitation (CPR) is imperative for nursing professionals. This study aims to explore previous literature

Background: The SARS-CoV-2 COVID-19 pandemic has triggered the need to develop rapidly effective and safe vaccines that are the most important public health measures and most effective strategy to protect the population from coronavirus diseases (COVID-19). The slum people are deprived of advanced medical facilities due to low socio-economic conditions. Objectives: The present study was conducted to assess slum dwellers’ knowledge and perceptions towards COVID-19 vaccination. Methods: A descriptive cross-sectional survey was conducted among 305 adult slum people using convince sampling technique. An interviewer guided by face-to-face interviewing using semi-structured. The chi-square test was applied to evaluate the correlations among the respondents between knowledge and perception of the COVID-19 vaccine. A 95% confidence interval was used and statistical significance was p ?0.01. Results: Overall, the mean ± SD age of the respondents was 35.39 ± 11.62 years. Only 35.7% of respondents believed vaccines to be effective in controlling COVID-19. Among the respondents, 71.8% received the COVID-19 vaccine. Nearly 83.3% of respondents believed that the COVID-19 vaccine has side effects. Though over half of the respondents, about 60% had the trust that the vaccines were safe for them, still a significant number as 40% of respondents had concern the vaccine safety. Conclusion: The study revealed that about two-thirds received vaccination while others had not good conception regarding COVID-19 vaccination because of slum dwellers had a low literacy level, low adherence to health safety regulations and low confidence in the healthcare system.

Acute respiratory tract infections (ARI) in children have a high prevalence that can be caused by bacteria or viruses. Antibiotics are prescribed more often than recommendations in the guidelines. This study aims to evaluate the rationality of antibiotic use and the occurrence of drug interactions in pediatric patients diagnosed with ARI at one of the hospitals in Pontianak based on some parameters such as right drug, right dose, and right duration as well as the incidence of drug interactions. Data collection was carried out based on medical record data which was carried out with a total sampling technique, namely taking all data that met the inclusion criteria.This research is a descriptive cross sectional design and retrospective data collection using patient medical records. Samples were taken by total sampling method. The results obtained from 131 patients consisting of 172 visits, right drug (131), right dose (93), and right duration (77).

Aging has had and will have a considerable relevance in the population for millions of years. Various ways have been explored to prevent or prolong it, since aging is often accompanied by chronic degenerative diseases. Although not much information has been discovered about this, the participation of telomeres in aging has been studied. Telomeres are the ends of DNA that protect and prevent its degradation, however, the relationship of the presence of long telomeres to a long life has been contemplated in conjunction with the reduction of chronic degenerative diseases, so that these individuals have a more desirable quality of life than individuals who have shortened telomeres

Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. hominid. Having scabies infestation coexisting in the same human body with a wound potentially lead to delayed wound healing. We constituted this literature review discussing wound healing in relation woth immunological state and oxidative stress in scabies infestation using information from literatures obtained from Google Scholar and PubMed. The immune response to scabies infection involves multiple layers of defense mechanisms, including the skins defense mechanisms, T-cells, keratinocytes, and cytokines. Scabies mites can trigger upregulation of pro-inflammatory cytokines interleukins-1a (IL-1a) and interleukins-1ß (IL-1ß), which play a critical role in the early phases of wound healing by promoting the recruitment of immune cells and stimulating the production of growth factors and extracellular matrix proteins. Scabies mite infestation also triggers a sustained release of reactive oxygen species (ROS) from neutrophils which later becomes an oxidative stress leading to delayed healing and chronic inflammation. Topical treatment for scabies usually involves pesticide substances which, despite its therapeutic effect, have side effect of triggering ROS production. Comprehending the immunological state and oxidative stress in scabies infestation is essential in planning proper management for every wound with scabies comorbidity.

This is a case report of a 60-year-old patient with renal disease of 21 years of evolu5on without renal replacement therapy, as well as systemic arterial hypertension with poor adherence to treatment, began his condi5on with indifference to the environment, drowsiness, admiDed to the emergency room where, thrombocytopenia and in cabinet studies take computed tomography of the skull with report of subarachnoid hemorrhage. The patient presents with thrombocytopenia due to consump5on secondary to hemorrhage and platelet dysfunc5on due to chronic kidney disease stage V, this patent required transfusion support of 5 platelet units and two globular packs, who laboratorially reflected an increase in platelet levels and clinical improvement evaluated with the Glasgow Coma Scale