Abstract Introduction: Google Trends is a data tool that measures the volume of online searches and has been proven to be associated with changes in the search for medical care. This study aims to identify a possible increase in searches about flu vaccination during COVID-19. Methods: We performed an analysis of the “flu vaccine” (2016-2020). Relative search volume (0 to 100, highest interest in the query) was studied for two groups of countries, according to the incidence rate of COVID-19 (highest: Belgium, Czech Republic, Spain, Portugal, Denmark; lowest: Poland, Sweden, Norway, Finland, Greece). Results: Median search volume before COVID-19 varied between 0 (Czech Republic and Portugal) and 4 (Belgium and Poland) outside the flu vaccination season and between 0 (Czech Republic) and 31 (Greece) during the vaccination season. As COVID-19 settled, the online search increased outside vaccination season in every country (p<0.05), except in the Czech Republic (p=0.22). During vaccination season, the search also increased in every country (p<0.05) except Finland (p=0.21). As to the percentage of increase in search during vaccination season during COVID-19, the top 5 countries were: Czech Republic (5200%), Spain (484,6%), Poland (400,0%), Denmark (311,8%) and Portugal (280%). Conclusion: Flu vaccination is one of the most acknowledged public health measures and its online search peaks annually in most of the studied countries. The COVID-19 pandemic increased its search, predominantly in countries with higher incidence.

We report an otherwise normal, apparently healthy 9-year-old boy having no past or family history of bleeding who presented with persistent bleeding after a cultural circumcision. The patient had a history of consanguinity, a normal physical examination, and all the initial blood tests, including complete blood count {CBC} and first-line coagulation screens assay, were normal. Postoperatively, the bleeding time and peripheral smear studies were abnormal, suggesting qualitative platelet disorder. The patient did not respond to a combination of hemostatic agents, including local measures such as fibrin sealants, topical thrombin, and oral tranexamic acid therapy. A second-line coagulation assay was normal, but for the peripheral blood film for a qualitative study of the platelets, a Platelet Function Analyzer (PFA-100) and Light Transmission Aggregometry {LTA) tests suspected Glanzmann’s thrombasthenia, which was confirmed by Flow cytometry {FC} showing the absence of aIIbß3. Treatment recommendations were made with recombinant activated factor VII, good control of persistent post-circumcision bleeding was achieved, and CBC remained stable; at follow, the patient is doing well.

Antibacterial agents, commonly known as antibiotics, are among the most widely prescribed and utilized medications in healthcare settings worldwide. However, the widespread and often indiscriminate use of antibiotics has led to concerning patterns of use, contributing to the emergence and spread of antimicrobial resistance (AMR), a significant global public health threat. This study aimed to investigate the pattern of use of antibacterial agents in a private hospital in Yenagoa, Bayelsa State, Nigeria. The objectives of the study were to determine the most frequently used class of antibiotics, identify the percentage of antibiotics prescribed by route of administration, and identify the percentage of antibiotics prescribed as generics. The study employed a retrospective approach, utilizing a carefully designed data collection form to assess the pattern of antibiotic use in the selected private hospital. Patient folders with prescriptions containing antibiotics between January and December 2019 were reviewed. Convenience sampling was used to select the study facility, time frame, and folders. Descriptive statistics were employed for data analysis using Microsoft Excel 2021. The demographic data revealed a slightly higher prescription rate for female patients (52.59%) and a significant portion of prescriptions for outpatients (64.31%). The age group with the highest prescription rate was 26-30 years (13.18%). Penicillins emerged as the most frequently prescribed class of antibiotics (38.19%), followed by Nitroimidazoles (21.43%) and Cephalosporins (15.08%). Oral administration was predominant (70%), and a substantial majority of prescriptions were for generic antibiotics (88.31%). The pattern of antibacterial use in this private hospital reflects a pragmatic approach focused on widely used antibiotic classes, convenient administration routes, and cost-effective generic options. The findings suggest a reliance on Penicillins, Nitroimidazoles, and Cephalosporins for treating infections, with a preference for oral administration due to its convenience and suitability for outpatient treatment. The high prescription rate for generic antibiotics highlights a focus on cost-effective treatment options without compromising therapeutic efficacy. The study provides insights into the pattern of antibacterial agent use in a private hospital in Yenagoa, Bayelsa State, Nigeria, identifying the most commonly prescribed antibiotic classes, routes of administration, and the predominance of generic prescriptions. Future research could explore the clinical outcomes associated with these patterns to ensure optimal patient care and adherence to antimicrobial stewardship principles. Additionally, implementing comprehensive antibiotic stewardship programs and continuous monitoring of antibiotic use patterns in private healthcare facilities could contribute to combating the global threat of antimicrobial resistance.

Abstract In the early 1980s, extracorporeal shock wave lithotripsy (ESWL) was introduced not only in research but also in clinical practice, by Chaussy and associates. [1-3] It has been a popular technique for non-surgical treatment for most upper ureteric and renal calculi since then. This study aimed to identify and analyze the characteristics of the highly cited articles in extracorporeal shock wave lithotripsy (ESWL) related to urological publications in the Science Citation Index (SCI) between 1991 and 2013. The analyzed aspects covered the distribution of annual production and its citations per publication, journals, countries, institutions, authors, and the top cited articles. Results There were 1722 publications found with the keywords ‘extracorporeal shock wave lithotripsy’ in the titles, abstracts, or keywords from the SCI from 1991 to 2013. In total, 1147 publications related to stones in the genitourinary system were analyzed in this study. Of total publications, 50% had 3 or 4 authors. The highest percentage of published documents were journal articles (81%), followed distantly by letters (5.4%). The core journal is the Journal of Urology (US). Articles were primarily written in English (93%). Authors from the US (30%) ranked highest in publication activity, followed by those from Germany (8.0%) and Turkey (7.1%). The publication rate of ESWL articles decreased steadily during the period of this study. In addition, a simulation model was applied to describe the relationship between the cumulative number of publications and year. Conclusions The largest number of publications originates from the US, and the journal with the greatest influence is the Journal of Urology. The annual number of publications decreased each year.

Abstract Sjögrens syndrome is diagnosed on the basis of specific changes in the eyes, mouth, and salivary glands, along with the finding of autoantibodies and histological changes. Sjögrens syndrome usually affects the eyes and mouth. Dry eyes are irritated and sensitive to light, the cornea is eroded in more severe cases, and bits of epithelium hang from its surface, resulting in impaired vision. Decreased salivation makes chewing and swallowing difficult and favors secondary candidiasis, loose teeth, and the formation of stones in the salivary ducts. Weak sense of taste and smell. Drying damages the skin and mucous membranes of the nose, pharynx, larynx, trachea, and vagina. Cough and respiratory infections occur, sometimes alopecia. In 1/3 of patients, the parotid glands are enlarged, usually harder, smooth, and slightly sensitive. A promising field of research is the cap potential healing function of mesenchymal stem cells (MSC) inside the remedy of primary Sjögrens syndrome. To date, proof has been collected that transfusion of MSCs can suppress autoimmunity and repair salivary gland secretory features in each mouse model and in sufferers with primary Sjögrens syndrome. This impact is mediated with the aid of inducing regulatory T cells, suppressing Th1, Th17, and T follicular helper cell responses. The prognosis of Sjögrens syndrome is easy, while the medical presentation is florid and can then be primarily based totally on records and the outcomes of bodily exams alone. However, several investigations are required in maximum sufferers with suspected Sjögrens syndrome, in whom there are only some early signs. Many investigations are possible; however, most effective, the minimal required to make the prognosis wishes to be performed. A choice is commonly important due to the fact each look might be negative in a small percentage of sufferers, and none is absolutely unique.