Introduction: Child malnutrition is a major public health problem in low- and middle-income countries. Mali, like its Sahelian neighbors, is structurally exposed to food and nutrition crises, aggravated by the security crisis.

Introduction: Forearm fractures are common in young adults after direct trauma, such as traffic accidents, falls from height, and sports activities. Septic nonunion is defined as the failure of fracture consolidation and persistence of infection for 6-8 months. Factors contributing to its development include inadequate initial reduction, unstable fixation, early limb mobilization. In septic nonunions, influencing factors also include open fractures, extensive soft tissue damage, highly comminuted fractures, and patient-specific characteristics such as comorbidities.

Background: Chronic gingivitis is highly prevalent across all animals. Traditional methods for managing it have proven ineffective, prompting exploration into natural products as adjuncts to mechanical treatment due to their long-term safety profile. Coriandrum sativum, a member of the Apiaceae family, is recognized for its anti-inflammatory, analgesic, antibacterial, and antioxidant qualities. Previous studies have shown that applying extracts of C. sativum alongside non-surgical periodontal therapy (NSPT) effectively reduced periodontal clinical parameters in treating chronic periodontitis. Methodology: Participants were randomly assigned to two groups: group A (control group) received a placebo gel, and group B (test group) received coriander sativum gel. They were instructed to apply the gel twice daily for two weeks. Before and after the two-week period, gingival index and gingival bleeding index were measured. Results: Both the placebo gel and Coriandrum sativum gel significantly reduced gingival indices and gingival bleeding indices (P < 0.001). The placebo gel exhibited greater effectiveness in decreasing both gingival bleeding and gingival indices compared to Coriandrum sativum, although this difference did not reach statistical significance (P > 0.05). Conclusion: Based On This Study, Coriandrum Sativum Gel Shows Promise In Reducing gingival indices and may be recommended to patients for managing chronic gingivitis.

The aim of this study; It is the determination of the satisfaction of the basic needs of university students. Research; The research was carried out with the participation of 1st year students studying in the first and emergency aid department of a foundation university and 93 students (Female: 75, Male 18) between 30.11.2022 and 10.04.2023. The "Personal Information Form" prepared by the researchers in the collection of the research data was collected with the "Basic Needs Satisfaction of University Students Scale". Analyses were performed with SPSS 25.0 program. In the analysis, the significance level was determined as 5%. Number, percentage, mean, standard deviation, median, minimum and maximum values were used as descriptive statistics. Histogram graphs were examined to check the normal distribution assumption. In addition, attention was paid to the fact that the skewness and kurtosis coefficients were between -1 and +1. In the comparison of the means of the two independent groups, if the normal distribution assumption is satisfied, the independent samples t-test; When normal distribution could not be achieved, Mann Whitney U test was used. Correlation analyses were performed to determine the relationships between quantitative variables. Since the normal distribution assumption could not be satisfied, Spearman correlation analysis was applied. In this study, the majority of the participants in the study were women, single, did not have children, studied in normal education, whose income was equal to their expenses, lived with their families, did not smoke or drink alcohol, and were able to meet the basic needs of the majority. Within the scope of "competence, autonomy and relationship", which are the scale sub-dimension scores of the participants participating in the study; There was no significant difference between gender, type of education, cohabitation status with family, and smoking and alcohol use. While there was no significant relationship between the ages of the participants and the "competence and autonomy" sub-dimension, a negative, weak and significant relationship was found between the age and the "relationship" sub-dimension, and it was determined that as the age of the participants increased, their satisfaction with their relations with the people at the university decreased. In this study, it was determined that meeting the basic needs satisfaction of the students studying in the first and emergency aid program has an important place.

Anxiety in children can significantly impact the dental treatment process, making it essential to understand the factors contributing to this anxiety and its effects on treatment outcomes. This study explores the relationship between the level of anxiety in pediatric patients during dental care and the success of treatment at the Nala Husada Dental and Oral Health Teaching Hospital (RSGM-P). The study employed an observational analytic design with a cross-sectional approach, involving 35 children aged 6-12 years who underwent dental treatment at RSGM-P Nala Husada. Anxiety levels were measured using the CFSS-DS method, with scores ranging from 15 to 45, categorized into three levels: very anxious, anxious, and not anxious. Data analysis was conducted using the Spearman correlation test to examine the relationship between anxiety levels and treatment success. The results showed that the majority of pediatric patients had low levels of anxiety (54.3% not anxious), and the treatment success rate was 71.4%. The correlation analysis revealed a significant relationship between anxiety levels and treatment success (Sig. (2-tailed) < 0.05), indicating that lower anxiety levels are associated with higher success rates in pediatric dental care. This study underscores the importance of managing anxiety in children to improve dental treatment outcomes, as well as the crucial role of effective communication between dentists and pediatric patients in reducing anxiety.

Jejunal diverticular bleeding is a rare but potentially life-threatening condition, particularly in elderly patients with underlying comorbidities such as cardiovascular disease. It can be challenging to diagnose and treat, which can delay diagnosis and lead to unsatisfactory clinical outcomes. Even with the advancements in endoscopic technology, conventional surgical intervention remains the standard for the treatment of jejunal diverticular bleeding. We report a case of a 70-year-old woman with underlying coronary artery disease on anticoagulant and antiplatelet therapy and underlying hypertension, presenting with recurrent melena and painless hematochezia, accompanied by hypovolemic shock. Despite conservative management and extensive diagnostic workup, the bleeding source remained unidentified until surgical intervention. This case highlights the challenges in diagnosing jejunal diverticular bleeding and the effectiveness of laparotomy with enterotomy and retrograde intraoperative endoscopy in its management.

Objective: The aim of this study is to report a rare triplane fracture of the proximal tibia. Clinical case: a seven-year-old overweight boy suffered a low-speed traffic accident causing an indirect trauma to his left knee. A displaced triplane fracture of the proximal tibia was diagnosed. It was treated with external fixators and an epiphyseal Kirschner wire (KW). After a month, the fixators and KW were removed, and an above-knee cast was applied until two months post-injury. Four years after the lesion, the patient is now 11-years-old, asymptomatic, achieved fracture union, has a medial collateral ligament (MCL) injury, and a proximal tibia angular deformity consisting of varus and recurvatum.

Clinical education is an essential component in the training of health professionals, since it will serve for the development of clinical and professional competencies of future specialists. The object of study in which this publication is framed is to know the different models of clinical education and how they can be approached from a formative evaluation by competences. The methodology used for its realization has been through a literature review of the existing clinical and educational models to subsequently conclude with those benefits that can be provided by a correct formative competency assessment for its implementation in the classroom, as well as those that in turn can be provided to students for their professional development throughout their careers.

Situs inversus is a rare congenital condition in which the thoracic and abdominal organs are located in a mirror image of their normal position. This anomaly affects approximately 1 in 10,000 people and can occur completely (situs inversus totalis) or partial (situs inversus incompletetus). The condition may be discovered incidentally during radiological or surgical studies. Acute cholecystitis is a diagnostic challenge in patients with situs invesus totalis. A review of a clinical case of a patient with acute cholecystitis and situs invesus totalis will be carried out, with timely diagnosis and treatment of acute and incidental cholecystitis for situs invesus totalis.

Frozen abdomen is a condition characterized by the loss of natural free spaces between intra-abdominal organs and compartmental structures, leading to pathological changes out of normal anatomical proportion. This condition is often caused by surgical procedures, such as peritonitis, severe acute pancreatitis, anastomotic leakage, ostomies, phased care of abdominal injuries, decompressive laparostomy, Crohns disease, peritoneal carcinomatosis, or radiation. Aggressive abdomens are often a nightmare for surgical procedures, presenting with symptoms such as abdominal discomfort, infection, anastomotic leakage, and impaired intestinal transit. Diagnosis of a hostile abdomen is often made during the operation itself, with surgeons decision-making heavily influenced by the situation being examined. Post-diagnosis, it is crucial to delay any surgical intervention as much as possible, as the diseases nature makes operative management difficult and puts the patient at a high risk of inadvertent injuries, intestinal resections, trans-operative bleeding, and other complications. The ideal surgical management for a hostile abdomen is "no management." Surgeons are the leading cause of short bowel syndrome worldwide, characterized by needless intestine resections due to accidental damage or insufficient dissection during abdominal surgery in the context of an aggressive abdomen. In these cases, intestinal anastomosis is not indicated due to the patients insufficient local circumstances for the repair of the intestinal wall and systemic factors that do not conducive to optimal tissue healing.

Introduction: Songgon Health Center is an area with the highest incidence of stunting in Banyuwangi Regency. Several factors can influence the occurrence of stunting in children. This study aims to determine the influence of household and family factors, inadequate complementary feeding, breastfeeding, and infections on the occurrence of stunting in toddlers years in the working area of Songgon Health Center, Banyuwangi Regency.

Small bowel obstruction (SBO) is a common surgical emergency that can result from various causes, including adhesions, hernias, tumors, and foreign bodies. SBO caused by food bolus impaction is a rare but important clinical condition, particularly in patients with a history of gastrointestinal surgery. This case report presents a 56-year-old male with a history of gastrojejunostomy and bypass surgery in 2010, performed for benign duodenal stenosis, who presented with a small bowel obstruction due to food bolus impaction. The patient complained of a two-day history of constipation, colicky abdominal pain, nausea, vomiting, and reduced urine output. Despite initial conservative management for suspected adhesive intestinal obstruction, exploratory laparotomy revealed food bolus impaction without adhesions. Bowel decompression and food bolus removal were performed, and the patient recovered uneventfully. This case report highlights the challenges in managing SBO due to food bolus impaction in a patient with prior gastrointestinal surgery and discusses the importance of long-term dietary adjustments in preventing recurrence.

Summary Traumatic osteochondral fractures in pediatric patients are associated with patellofemoral dislocations in a high percentage (18–75%). Clinical presentation is variable, so maintaining a high index of clinical suspicion is important for better diagnosis, treatment, and outcomes. Accordingly, we present the case of a 12-year-old patient with an osteochondral fracture of the patella associated with a patellofemoral dislocation. The treatment was surgical, involving osteosynthesis with HCS screws, resulting in an excellent functional outcome at 3 years of follow-up.

Breast cancer treatment involves a multidisciplinary approach, including oncologic surgery, adjuvant therapy, and psychosocial therapies. Breast reconstruction has evolved over time, with early beliefs preventing its use. Early techniques included autologous breast reconstruction, local myocutaneous flaps, tubed pedicle flaps, prosthetic implant-based reconstructions, and silicone implants. Modern procedures began with the free flap in 1973, which allowed for more precise matching of normal breast tissue. Advancements in abdominal-based free flaps, transverse rectus abdominis myocutaneous (TRAM) flaps, and the DIEP flap have contributed to its popularity. Advancements in breast reconstructive surgery have been significantly influenced by advancements in microsurgery, including the discovery of the free flap and the development of perforator-based flaps. The introduction of preoperative imaging methods, such as computed tomography angiography (CT), has made breast reconstruction more efficient. The use of operating microscopes and microvascular anastomotic coupler devices has also improved surgical procedures. However, flap perfusion remains a challenge, and new approaches like fluorescence imaging and laser Doppler imaging can help diagnose flap impairment. Despite the early stages of breast surgery research, advances in pre-operative planning and imaging remain significant. The combination of virtual reality and robotic surgery could further enhance the capabilities of doctors in breast reconstruction.

Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disorder associated with underlying malignancies, most commonly lymphoproliferative diseases. The condition is characterized by a complex interplay of immunological mechanisms that lead to a distinctive clinical presentation, including severe mucocutaneous lesions and a polymorphic skin eruption. The pathophysiology of PNP involves autoantibodies targeting desmosomal and hemidesmosomal proteins, as well as other epithelial adhesion molecules, resulting in widespread acantholysis and inflammation. Diagnosing PNP poses significant challenges due to its overlapping features with other pemphigus variants and autoimmune blistering diseases, necessitating a combination of clinical, histopathological, immunofluorescence, and serological evaluations. Therapeutic strategies for PNP are equally complex, requiring a multidisciplinary approach that addresses both the underlying malignancy and the severe autoimmune response. Despite advances in understanding the molecular underpinnings of PNP, the prognosis remains poor, with high mortality rates attributed to complications such as infections, respiratory failure, and the progression of the associated neoplasm. This review provides an in-depth analysis of the current knowledge on the pathophysiology, clinical manifestations, diagnostic challenges, and therapeutic approaches in paraneoplastic pemphigus, highlighting the need for early recognition and tailored treatment strategies to improve patient outcomes.

Diarrhea is a complication in critically ill patients, contributing to increased morbidity and healthcare costs. It is often multifactorial in origin, arising from infections, enteral nutrition, medications (especially antibiotics), and altered immunity and gastrointestinal function due to critical illness. Diarrhea in these patients can exacerbate fluid and electrolyte imbalances, increase the risk of skin breakdown, and contribute to malnutrition. Identifying the underlying etiology is essential for targeted management. Diagnostic approaches typically include stool cultures, assessments for Clostridium difficile infection, and evaluation of medication-related causes. Treatment involves supportive care, such as fluid and electrolyte replacement, modifying enteral nutrition, and judicious use of anti-diarrheal agents when appropriate. Preventative strategies, such as the careful use of antibiotics and probiotics, may reduce the incidence of diarrhea in critically ill patients. Addressing diarrhea effectively requires a multidisciplinary approach to reduce complications and improve patient outcomes in the critical care setting.

Postpartum haemorrhage (PPH) is a major cause of maternal mortality worldwide. This study aimed to evaluate the efficacy of tranexamic acid (TXA) in reducing blood loss following vaginal delivery in an Indian setting. Method: A double-blind, randomized controlled trial was conducted at SMS Medical College, Jaipur, from April 2023 to October 2023. A total of 130 women undergoing vaginal delivery were randomly assigned to receive either 1g of TXA (Group A) or placebo (Group B) intravenously within 2 minutes of delivery. Blood loss was measured using graduated drapes and weighed swabs. Secondary outcomes included estimation of change in hemoglobin and hematocrit levels, need for additional uterotonics, and blood transfusions. Statistical analysis was performed using IBM SPSS version 23.0.0.

The objective of this work is to develop Van Nes rotationplasty as a therapeutic option in osteoarticular tumorsof the lower limbs surrounding the knee and to present the first case in which this technique was used inUruguay. Clinical case: this is an 8-year-old boy, who consulted for a pathological diaphyseal fracture of theright femur. He was diagnosed with undifferentiated osteosarcoma of the non-metastatic femur, whoseresponse to neoadjuvant chemotherapy was doubtful. Finally, it was decided to perform a Van Nes plasty aftera Winkelmann resection type AI. Conclusion: Van Nes plasty is a procedure that should be considered as avalid therapeutic option in tumors surrounding the knee, mainly in children. It is a unique biologicalreconstruction procedure with excellent functional results.

The treatment of burn patients poses unique challenges, both in the acute and delayed setting. Although partial-thickness skin grafting and, to a lesser extent, local tissue rearrangement form the mainstay of burn wound management, the literature suggests that free tissue transfer can be used successfully in select cases (either in the acute or delayed setting). The most common indication for early free tissue transfer in burn surgery is to salvage an extremity when the injury exposes vital structures (neurovascular bundles, tendons, joint spaces, bones). Most free flap reconstructions are used in the delayed setting, often to release scar contracture and optimize return to function.

Rectal prolapse is an invagination of the rectum that causes it to protrude through the anus. Irreducible rectal prolapse is an unusual condition; in most cases, the prolapse reduces spontaneously. Non-surgical treatment alternatives have been noted, such as the use of sugar, which reduces rectal prolapse. The results have not yet been compared against surgical treatment, so they cannot yet be considered the preferred option. Given the many techniques and procedures, it should be considered that the best procedure must be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patients lifetime. The Delorme procedure is a transanal technique that addresses complete rectal prolapse with a low surgical risk and minimal morbidity (less damage to pelvic and hypogastric nerves compared to abdominal procedures). It is associated with a significant improvement in anal continence, low recurrence rates, short hospital stays, and patient comfort.

First described in 1922, Steven Johnson Syndrome (SJS) is an acute mucocutaneous disease with conjunctivitis, stomatitis, purple macules and skin necrosis in which an acute inflammatory process followed by the action of immune complexes has been identified. In the middle hypersensitivity, it should involve less than 10% of the total body surface. Its annual incidence in the world is unknown, it is estimated 1-2 cases per million in a year of which 20% will be pediatric patients; this can be triggered by drugs, infectious agents and biological agents. It manifests as lesions in the skin and mucous membranes of which it can involve ocular conjunctiva, oral, nasal, vaginal, urethral and perianal mucosa