Introduction: This study focuses on the Malaria endemic in the Thar Desert- The most populated desert in the world. Malarial endemicity in a desert environment is a unique and rare geographical presentation, as malaria is usually common in areas where there is rainfall and water stagnation - like ponds, fields, etc. In this study, we want to highlight the unique clinical presentation, lab findings, and reason behind the existence of malaria in the desert. Most importantly we also would like to share our innovative idea to eliminate breeding sites using Quadcopters and drones. Materials and methods: Study type – Prospective observation study, Study duration – October 2020 to December 2020, Sample size-103 cases, Inclusion criteria – all smear-positive Malaria cases, Exclusion criteria – Cases Referred to higher centers because of complications.Tools used for breeding site identification – Quadcopters and Drones with HD cameras. Since the area to be surveyed was vast (>30km), it was very difficult to do a manual survey in the harsh desert climate. The patients’ demographics, Clinical Presentations, and laboratory parameters were collected systematically in a predesigned format and entered into an excel sheet. The finding of our study was compared with the malaria cases from different parts of the country. Results: All malaria was identified as Plasmodium vivax. The mean age group was 36 years (min-21 and max-56). Clinical features- out of 103 cases, 78% of the patients presented with all 4 symptoms of fever, chills, headache, and bodyache.22% presented with atypical isolated symptoms of abdominal pain, vomiting, myalgia, severe joint pain. 77% of patients had mild hepatosplenomegaly, 7 patients presented with hypotension, and 2 were in sepsis. Lab parameters – 88% of the patients had anemia, of which 5% had severe anemia, 40% had leucopenia while 6% had leucocytosis.87%had thrombocytopenia, out of which 56% had a platelet count less than 50,000/ml. 2% had mild AKI, bilirubin levels were elevated in 53%, and 36% had transaminitis. Using technology, the survey of the entire area was done in 1 week and all the breeding sites were eliminated on the same day of identification and a drastic drop in malaria cases was noted. Conclusion: We conclude that desert malarial presentation of Plasmodium vivax is unique in clinical presentation and lab derangements compared to other malarial cases. Usage of technology like quadcopters and drones for breeding site identification played a major role in curtailing cases drastically in a very short period in an effective way.
Background: The incidence of congenital diaphragmatic hernia (CDH) has been reported to be 1 in 2000-5000 newborns. The late presentation can occur in 5-30% of all cases and it can be harder to diagnose, as symptoms are usually vague and non-specific. Methods: We performed a retrospective review of chart files of all patients admitted to our hospital with the diagnosis of congenital diaphragmatic hernia between 2010 and 2021. Result: Of the ninety-two cases of CDH treated in our hospital between 2010 and 2021, twenty-six (28%) were late presenting. In the late-presenting CDH group, we found a slight female preponderance, with fifteen female patients (58%) and eleven male patients. A posterolateral left defect in the diaphragm was noted in fifteen cases (58%), a right defect was noted in just one case (4%) and ten patients (38%) were diagnosed with an anterior diaphragmatic hernia. The age at diagnosis varied from 2 months to 14 years. Associated anomalies were noted in just four cases. In all cases, a thoracoabdominal radiograph was performed and ten patients also had a CT scan. Primary repair was performed in 25 of the 26 patients. The mortality rate in our study population was 11%, we reported 3 cases with unfavorable evolution. Conclusion: CDH presenting beyond the neonatal period is a usual finding and it represents a true diagnostic challenge.
Introduction: One of the cornerstones and common causes of kidney stone formation is the volume of fluid consumed during a 24- hour that influences on forming that by several mechanisms. Since fluid intake decreases during Ramadan, one of the common questions posed is whether Ramadan fasting is associated with the precipitating of stone formation. The present study was aimed to investigate the effect of Ramadan fasting on precipitating and Inhibitors of stone formation in patients with a history of renal kidney disease. Methods: The study population included all of the patients with kidney stone diseases who were seen at the Clinic of Urology and Nephrology affiliated with Baqiyatallah hospital during the month of Ramadan in 2014 and 2015. The number of 66 patients was chosen and included in the study through randomized simple sampling. All subjects underwent blood tests like serum uric acid, serum phosphate, serum calcium, and serum sodium. Samples were tested in terms of volume, magnesium, uric acid, Calcium, Phosphate, Sodium, citrate, oxalate, Calcium oxalate supersaturation, Calcium Phosphate supersaturation, Uric acid supersaturation. Results: Sixty-six eligible patients were included that the mean age was 48.35±12.10 years. Fourteen men and 52 women were included. There were no significant differences in the mean pH of urine, urinary sodium, urinary oxalate, super- saturated levels of calcium oxalate in the urine, urinary phosphate levels, and super-saturated levels of urinary calcium phosphate between the two groups (P>0.05). The average volume of urine, urinary magnesium, urinary calcium, urinary citrate, the uric acid level in the non-fasting group was higher than the fasting group (P0.05). There was no difference in the mean super-saturated level of uric acid between the two groups (P=0.035). Conclusion: There was controversial evidence on the effect of Ramadan fasting on kidney stone formation and there is not enough evidence in the present study that Ramadan fasting precipitates risk factors associated with calculus formation
Ulcerative colitis is one of the idiopathic inflammatory diseases of the large intestine with an unknown cause, which occurs in recurrent attacks of inflammation in the lining of the mucosa and below the intestinal mucosa. Impaired mucosal immune responses, the involvement of inflammatory cytokines such as IL-1, TNF-α, and IL-6, and other inflammatory mediators such as arachidonic acid metabolites play an important role in the immunopathogenesis of ulcerative colitis. Based on medical findings on the pathogenesis of the disease, new therapies have focused on the responses of the intestinal immune system and the inflammatory process. However, the widespread use of treatments such as aminosalicylates and corticosteroids continues. Most of these drugs have severe side effects. Some patients do not respond well to these treatments and sometimes have to undergo surgery and colectomy. Therefore, extensive studies are being conducted to control and prevent disease to use natural treatment methods such as the use of antioxidants with the approach of removing free radicals that prevent the destruction of cells and tissues in the body. Today, various studies have pointed to the effects of herbal medicines as a complementary treatment in inflammatory diseases. Their low cost and high effectiveness have attracted the attention of researchers in this field. The aim of the present study is a comprehensive review of modern and traditional treatments based on herbal medicines in the field of ulcerative colitis.
Mercury is a chemical element that has been known since prehistoric times and has been used over time as a component of paints, in the treatment of various diseases, and later in various industrial compounds. Mercury enters the body transcutaneously, by inhaling or by ingesting food contaminated with mercury. The most common cause of mercury poisoning is eating seafood, but people can get mercury poisoning from industrial processing, thermometers, dental work, and old paints. The most vulnerable are people at occupational risk due to chronic exposure, as well as fetuses in the intrauterine period. Mercury poisoning produces extremely serious effects on the nervous, renal, and gastrointestinal systems. The nature and extent of mercury poisoning depend on factors such as the route of exposure, the rate of exposure, the distribution and biotransformation of mercury in the body, the chemical form of mercury or the mercury compound. Both mercury in the blood and the urine should not exceed 10 μg/L. The critical values of mercury in the blood are >150 μg/L and the lethal ones exceed 800 μg/L. New diagnostic methods allow the rapid and accurate identification of the concentration of mercury in biological products. Treatment is based on the use of chelating agents. However, the prognosis of mercury poisoning is extremely variable, due to the potentially irreversible nature of the lesions.
Family Medicine has always been regarded as an interdisciplinary specialty, but lately, in most Eastern-European countries, such as Romania, it has been supported by many laws and regulations. The outcome of this prolific background has brought both advantages and disadvantages. Some advantages relate to a sustainable structure, and, at the same time, Family Medicine has been recognized as being the gate-keeper in almost any health care system. Further, due to the privatization of most family practice offices, in Romania, appeared a modern organizational approach, in the shape of a consortium of family physician practices. Some family physicians consider providing their services in a private office as a benefit, but for others the freedom and autonomy to become responsible of their own practice is considered to be a drawback because, apart from the clinical activity, many family physicians have to deal with managerial and marketing issues. In Romania, a consortium of family practice offices has to overcome a very competitive environment and some Marketing specific trends. The aim of this paper is to investigate the usefulness of marketing strategies in the Romanian family physician practice.
Background: The number of studies with the application of scales, such as Attitudes Toward Obese Persons Scale (ATOP), on morbid obese patients are limited. Therefore, we wanted to examine the attitudes toward obese people through the eyes of morbid obese patients. Methods: Between October 2019 - April 2020, 70 female and 20 male, morbid obese patients, who were admitted to the general surgery department to be evaluated for bariatric surgery were included in this study. These 90 morbid obese patients were asked to fill out ATOP, which included 20 statements. Results: The mean ATOP score of all morbid obese patients was 63.44±18.58 (range:19-116). The mean ATOP score of female patients was 63.47±20.34 (range:19-116), whereas the mean ATOP score of male patients was 63.35±10.69 (range:43-80) (p=0.98). The frequency of the responses given by the male and female patients to the third statement, which was “Most obese people are more self-conscious than other people” pointed out a statistically significant difference (p=0.02). Conclusions: Based on ATOP scores gained from morbid obese patients, 60% of morbid obese patients did not feel as happy as non-obese people, whereas 74.4% of the morbid obese patients thought that obese people were not as healthy as non- obese people. Moreover, ATOP scores which were slightly higher than 60 points in both female and male morbid obese patients indicated that morbid obese patients had neither negative nor highly positive attitudes toward obese people.
Background: The most frequently encountered complication of anastomotic surgery is fistula. In addition to the medical history of the patient, local conditions, the operative moment and surgical technique that were chosen, a series of some other factors can interfere, leading to suture disunity. Aim: The aim of the study was to analyze the existence of a relationship between the use of cecostomy (as a mechanism of temporary diversion) and the frequency of anastomotic fistulas. Materials and methods: We conducted a retrospective study, over a period of 7 years, between 2011-2018 taking into consideration 194 patients who benefited from resections completed with anastomoses in the transverse colon, descending colon, sigmoid and rectum. They were divided into two categories: patients who benefited from cecostomy and patients for whom we did not use this technique. The frequency of fistulas was analyzed for the two main groups and in association with each type of surgery. Results: It was observed the existence of a relationship between the appearance of fistulas and the use of a decompression mechanism such as cecostomy in the sense of a lower number of fistulas for the first situation (2.66%) compared to 11.76% for cases without cecostomy (p=0.034). The duration of hospitalization in the group with cecostomy was shorter than in those without this derivative stoma and the postoperative recovery was good. Conclusions: Cecostomy is a useful protection for the anastomosis line, with the advantage that, when the tube is suppressed, the stoma will spontaneously close.
The individual values of combatants determine life goals, how to achieve them, and perform an important adaptive and protective function under conditions of combat stress. Understanding them enables mental health professionals to create an effective system of Combat and Operational Stress Control for military personnel. The purpose of this research was to determine the personal value sphere typology of individual values of combatants of the War in Eastern Ukraine, and, on its basis, to predict the vector of PTSD development. The value sphere (Rokeach Value Scale) and peculiarities of mental status (“Traumatic Stress Questionnaire”) of nine hundred forty three Ukrainian combatants were investigated. Cluster analysis made it possible to create a typology of combatants' values, consisting of five types: “Passionary”, “The one who does not leave the comfort zone”, “Romantic”, “Formal military man”, “Routine”. The most resistant to combat stress are combatants who are aimed at interiorizing values, expanding the boundaries of existing norms, and public recognition (“Passionary” (2.19%), “Romantic” (3.82%)), and the most vulnerable are those who are “Routine” (15.30%) and “Formal military man” (4.37%). The majority of Ukrainian combatants have a defined type of “The one who does not leave the comfort zone” type (74.32%). For them, safety and well-to-do life are the main priorities.
The field of nursing has a lot of responsibilities and workload and is considered as a hard job. If a person does not have the spirit of being responsible for work or interest in service, he cannot survive in the difficult conditions that exist in the field of nursing, such as fatigue, work shifts, stress. Occupational concerns such as insufficient staff, high workload, long working hours and work pressure make nurses unable to play their role in front of their families. On the other hand, nurses are usually unable to perform their duties in the workplace due to family problems. In this study, related articles from the years 2000-2020 were reviewed. The results of studies showed that due to the importance of work-life balance in nurses, it is recommended that managers create the conditions for creating effective methods and techniques for job flexibility for nurses and help nurses to better perform these approaches with the necessary training. Taking care of nurses living conditions, question and answer sessions and interviews with nurses, establishing kindergartens with long working hours can also be effective in creating balance.
