Current Medical Problems Research Articles

Treatment of Ruptured Infected Abdominal Aortic Aneurysm Caused by Salmonella spp.: A Case Report.

Despite significant advances in diagnostic methods, sepsis is still a current medical problem, and its complications contribute to increased mortality among different age groups. The article presents the case of a 71-year-old man who developed an inflammatory aneurysm of the abdominal aorta in the course of sepsis of Salmonella spp. etiology, followed by its rupture. The case confirms that we must not forget about rare, especially unusual complications, which may depend on the type of microorganism. Properly quick diagnosis allowed for the implementation of appropriate treatment and survival of the patient.

Preoperative and Intraoperative Blood Pressure Variability Independently Correlate with Outcomes

BackgroundBlood pressure variability (BPV) describes visit-to-visit blood pressure (BP) changes independent of hypertension. Preoperative BPV and intraoperative BPV are associated with increased postoperative outcomes. We investigated the impact of both preoperative BPV and intraoperative BPV on elective surgical outcomes, specifically whether preoperative BPV and intraoperative BPV were independent risk factors for surgical complications. Materials and MethodsWe investigated 600 patients undergoing elective surgery lasting more than two h and who had ≥8 outpatient BP recordings over three preoperative years. Age, sex, ethnicity, BMI, current medical problems, and medications at time of surgery were recorded.BPV was calculated as the standard deviation (SD) of systolic or diastolic BP for the 369 valid patients. Average BPV were compared between adverse outcomes of readmission, wound infection, acute kidney injury, death, myocardial infarction, and cerebral vascular accident. ResultsThree-hundred-sixty-nine (52.6% male, 47.4% female, 98.1% non–Hispanic) patients (mean age 62.5) were included in the study. Preoperative systolic (P = 0.043) and diastolic (P = 0.009) BPV were higher for patients with the combined endpoint of all adverse events. Preoperative systolic BPV was correlated with intraoperative BPV (P = 0.010). Both systolic and diastolic preoperative BPV was found to be independent from intraoperative BPV. Otolaryngology procedures were associated with less adverse outcomes (P = 0.034), whil antimicrobials (P = 0.022), autonomic drugs (P < 0.001), or respiratory drugs (P = 0.032) was associated with an increased likelihood of adverse outcome. ConclusionPreoperative DBPV is associated with increased risk of readmission, wound infection and the combined endpoint of all adverse events. Intraoperative systolic blood pressure variability (SPBV) is associated with increased risk of acute kidney injury and the combined endpoint of all adverse events. Preoperative DBPV and intraoperative SBPV are independent risk factors for ninety-d postoperative outcomes. BPV should be considered in individualized risk assessment when assessing patient eligibility for elective procedures.

Basic Evaluation of Urinary Incontinence.

Urinary incontinence is a significant, quality of life health condition affecting millions of women. Incontinence is increasingly common as the population ages, and women present with varying degrees of bother. With basic in-office evaluation, most subtypes of urinary incontinence can be defined, evaluated, and treated. Basic in-office evaluation involves a detailed history with a review of current medical problems and medications, a physical examination, and selective in-office testing.

A patient expectations questionnaire for determining criteria for entrustment decisions

Introduction To train health professionals for patient-centered care, patient engagement in medical curriculum development and assessment is widely recommended. But there are few published methods on how to consult with patients effectively, particularly when creating entrustable professional activities (EPAs). In this mixed-method study, we developed a questionnaire for facilitating patient input when developing EPA assessment criteria. Methods We developed a questionnaire for documenting patient expectations of their doctors which included: patient interviews to identify questionnaire items, expert validation, cognitive interviews with respondents, and finally, pilot testing. For the pilot testing, 87 participants with a variety of health problems from medical/surgical wards and outpatient clinics at a tertiary hospital were recruited. The final questionnaire included open-ended and ranking-style questions. Results Using the questionnaire, patients could identify their key expectations of their doctors when managing their current medical problem. Most patients wrote clear, brief free-text responses directly applicable to EPA descriptors that were time-efficient to analyze. Conclusions The questionnaire is a feasible method of recording patient expectations, enabling educators to consult with and include patient perspectives when developing criteria for entrustment decisions in a diverse range of clinical contexts.

RETRACTED ARTICLE: Design of a data management system for medical Internet of Things based on mobile platform

With the development of various applications of the Internet of Things, the use of wireless sensor networks as a collection and transmission of data has become a research priority. The method of collecting and uploading data varies by application field. The application in the field of medical monitoring is an important aspect, and the detailed research and analysis of sensor networks in the fields of medical monitoring system architecture, data collection, data storage tables, and data upload methods have important practical value. At the same time, it also provides technical solutions to meet people’s high-quality needs for medical services. The current hospital information system is independent and private. In addition to the normal registration, payment and printing of payment slips, patients cannot know more about the medical information that has been generated about themselves. When a patient sees a doctor in a different hospital or even another place, there is no past medical history as a reference. Patients cannot have a comprehensive grasp of the information retained in the medical information system, and at the same time they have concerns about privacy and security. Based on this, this paper proposes the concept of a distributed medical information system based on a mobile platform. As a combination of mobile platform and medical information, emerging technologies provide a solution to the current medical system problems and further enhance the circulation of information. Security allows users to have stronger control over their own information.

СВЧ - технологии в медико-экологической практике.

This article discusses three current medical and environmental problems that use microwave technologies to solve. The first task was related to the influence of the magnetic field on the human body. At the same time, special attention was paid to its deficiency, which leads to undesirable consequences and the need for correction. The second task was related to the diagnosis and therapy of brain tumors. The results of studies of the possibility of virtual microwave diagnostics of cerebral edema using the CST MS 2013 software component on a computer phantom of the human head with physically accurate electrodynamic parameters of biological tissues are presented and its effectiveness is shown, including in the early stages of the disease. In addition, the possibility of local hyperthermia of neoplasms in the brain using a focused electromagnetic field is considered. The third task was related with assessment of the electromagnetic situation in the urban area in order to identify areas with field levels exceeding sanitary norms. Electrodynamic calculation of the field distribution in the urban development zone, represented by a three-dimensional computer model, was carried out on the base of the FEKO program.

Therapeutic effect of thiocetam on the manifestations of ischemia-reperfusion complicated by massive blood loss and mechanical trauma

Among the current medical and social problems, injuries and blood loss occupy a prominent place, causing stress on the antioxidant defenses. Hypoxia, which underlies the pathogenesis of the post-traumatic period of both diseases, leads to a significant imbalance in the work of internal organs. Scientists are increasingly attracted by the need to use a tourniquet or intraoperative ligatures, as reperfusion local and systemic damage develops. Antioxidants are considered a promising means of correction.The aim of the study was to investigate the features of metabolic disorders in the liver in the early post-traumatic period on the background of the use of a tourniquet and the effectiveness of thiocetam correction.Materials and methods. The experiment was perfomed on 130 white male rats (200-250 g), which were divided into 4 groups: control – the CG, the EG-1 – combination of limb ischemia-reperfusion (IR) with blood loss, the EG-2 – combination of limb IR with blood loss and mechanical trauma of the thigh; the EG-3 combination of limb IR, blood loss, mechanical injury and thiocetam administration. The Malonic dialdehide level catalase activity were estimated in the liver.Results. The use of thiocetam, which is able to struggle against of ischemia and lipid peroxidation by reactivating antiradical enzymes: superoxide dismutase, catalase and glutathione peroxidase, had a positive effect on the state of antioxidant and prooxidant units in the organ, located far from the place of primary ischemia-reperfusion. If in the group of untrated animals (the EG-2, where massive blood loss was combined with a thigh fracture and the use of hemostatic tourniquet) in the early period, the MDA level exceeded the CG data in 5,4 times, and on the 7th and 14th days remained high – being higher on 2,1 times and on 2,7 times, then in the EG-3 (group of treated animals) on the 1st day the level of MDA exceeded the CG data in 4,3 times, but on the 7th and 14th days was higher by 90,5 % and 64 % respectively. The supportive effect of thiocetam on the activity of catalase in the liver was also noted. Thus, in EG-2 the level of antioxidant enzyme on the 1st day decreased by 71,7 %, and remained almost at this level throughout the all post-experimental period. As for the group of treated animals, the level of activity on the 1st day after the intervention decreased by 44,7%, and was so for almost the entire period. On the 14th day, it remained reduced compared to the CG by 35,1 %, while in EG-2 this index was lower compared to the CG by 70,5 %.Conclusion. Having the positive effect of the introduction of thiocetam in the ischemic area, we can eventually add new complex, given the world experience, which would affect the development of the inflammatory response and the rheological properties of blood.

Application of Artificial Intelligence Technology in Oncology: Towards the Establishment of Precision Medicine.

Simple SummaryArtificial intelligence (AI) technology has been advancing rapidly in recent years and is being implemented in society. The medical field is no exception, and the clinical implementation of AI-equipped medical devices is steadily progressing. In particular, AI is expected to play an important role in realizing the current global trend of precision medicine. In this review, we introduce the history of AI as well as the state of the art of medical AI, focusing on the field of oncology. We also describe the current status of the use of AI for drug discovery in the oncology field. Furthermore, while AI has great potential, there are still many issues that need to be resolved; therefore, we would provide details on current medical AI problems and potential solutions.In recent years, advances in artificial intelligence (AI) technology have led to the rapid clinical implementation of devices with AI technology in the medical field. More than 60 AI-equipped medical devices have already been approved by the Food and Drug Administration (FDA) in the United States, and the active introduction of AI technology is considered to be an inevitable trend in the future of medicine. In the field of oncology, clinical applications of medical devices using AI technology are already underway, mainly in radiology, and AI technology is expected to be positioned as an important core technology. In particular, “precision medicine,” a medical treatment that selects the most appropriate treatment for each patient based on a vast amount of medical data such as genome information, has become a worldwide trend; AI technology is expected to be utilized in the process of extracting truly useful information from a large amount of medical data and applying it to diagnosis and treatment. In this review, we would like to introduce the history of AI technology and the current state of medical AI, especially in the oncology field, as well as discuss the possibilities and challenges of AI technology in the medical field.

How accurate is telephone triage in out-of-hours care? An observational trial in real patients

ABSTRACT Objectives Patients in Belgium needing out-of-hours medical care have two options: the emergency department (ED) or a general practitioner (GP) on call. Currently, there is no triage system in Belgium, so patients do not know where they should go. However, patients who could be managed by a GP frequently present themselves at an ED without referral. GPs often organise themselves in a General Practitioners Cooperative (GPC). This study assesses the accuracy of a newly developed telephone triage guideline. Methods Observational real-time simulation: all walk-in patients at two GPCs and three EDs were asked to call a triage telephone number with their current medical problem. The operator handling this call registered an urgency level and a resource (ED, GP or ambulance) to deploy. The treating physician's opinion was used a the gold standard for correct triage. Patients were not informed about the outcome of the triage and continued the standard care path they had chosen. Results The overall sensitivity of the telephone triage for detecting patients who could be managed by a GP was 82% with a specificity of 53%. The correctness of the advice given by the operator according to the physicians was 71%, with 12% underestimation of urgency and 17% overestimation. At the GPC, the sensitivity for detecting patients requiring GP management/care was 91% with a specificity of 36%. At the ED, the sensitivity for detecting GP patients was 67% with a specificity of 48%. Conclusion This study evaluates a new guideline for telephone triage, showing potential overtriage for patients wanting to attend the GPC, with possible inefficiency, and potential undertriage for patients wanting to attend the ED, with possible safety issues.

Koronawirus – aktualny problem medyczny i społeczny

Coronaviruses can be divided into two groups due to pathogenicity The first group causes mild upper respiratory tract infections The second group includes highly pathogenic coronaviruses, which are the cause of severe pneumonia In December 2019, the emergence of a new 2019-nCoV coronavirus was reported in the human population, which caused a pandemic Cases of pneumonia have been reported in patients Complications included: acute respiratory distress syndrome, anaemia, acute myocardial injury, secondary infections and in severe cases - death of patients Viral factors and host immune responses were important in the development of infection The course of the disease also depended on: initial viral load in the respiratory tract, comorbidities and the age of patients Younger people experienced milder symptoms, and older people had more severe disease Diabetes, hypertension, cardiovascular disease and renal failure were the most frequently mentioned comorbidities The therapeutic problems concerned the need to develop effective CoV treatment regimens Late diagnosis is often the cause of a complex situation that requires intervention in intensive care units There are still no approved antiviral drugs and vaccines to prevent SARS-CoV infection One of the therapeutic solutions is to change the purpose of various approved medicines used in other diseases Another problem is the transmission of infection, which occurs between people as a result in close and direct contact Rules for protection against infection have been introduced Personal protective equipment has been used: gloves, aprons, protective masks and glasses In addition, the transmission of the infection in indirect contact with contaminated objects is of great importance Monitoring the epidemiological situation and providing timely information is very important to ensure the safety of the public during and after the pandemic The purpose of this article is to present the characteristics of the new 2019-nCoV coronavirus and its ability to multiply in the human body Pathogenic types of coronaviruses, current infection, symptoms, diagnostic methods, treatment and infection transmission, and psychological effects of quarantine are discussed

RESEARCH ON THE INCIDENCE OF MALIGNANT TESTICULAR TUMORS IN UKRAINE AND SUMY REGION

The oncological incidence of testicular cancer is the current medical and social problem in Ukraine and in the world. Despite the relatively low incidence rate for this pathology, it is of fundamental importance for clinicians, since it is the most common type of malignant tumors in young men of working age (15–45 years). In particular, the incidence of testicular cancer in the Sumy region slightly differs from the national average. That is why the objective of our study was to analyze the level of testicular neoplasia among the population of the Sumy region and Ukraine in 2011–2019, as well as to compare them. Based on the obtained data, the Sumy region is included in the group of regions of Ukraine with an over-threshold incidence of testicular cancer. Statistical data analysis showed a tendency to decrease of the overall incidence of testicular cancer among the adult population in Ukraine during the study period (on average, 2.55 per 100,000 population). At the same time, in the Sumy region, there was a gradual increase in the frequency of cases of this sociopathology in men with the highest indicators reached in 2017 (4.33 per 100,000 population). Consequently, in Ukraine, this pathology affected men mainly at the age of 35–39. However, it is should be noted that the age range of morbidity in the Sumy region was somewhat broader and mainly affected the population aged 30–39, and, in some years –men at the age of 20–29. It was established that testicular cancer affects the pediatric population, although it is extremely rare. Considering that seminoma is the most common type of testicular tumor, we focused on an in-depth study of its morphological features. Statistical data analysis revealed a link between the incidence of testicular cancer and the age of the male population. An important element of the research is the study of etiopathological factors that affect the growth of the degree of involvement, caused by this pathology.

Analysis of factors of pulmonary fungal infection in mice in respiratory medicine department based on logistic regression analysis model and Progranulin.

The objective of this research is to solve the current medical problems of a high incidence of fungal infections in the lungs, high misdiagnosis rate, and high mortality. In this study, firstly, the logistic regression model was used to conduct. Risk factors of pulmonary fungal infection in respiratory department were analyzed. Then a model of pulmonary fungal infection in mice was constructed, and the expression difference of Progranulin (PGRN) in serum was detected by enzyme-linked immuno sorbent assay (ELISA). The expression of PGRN in lung tissues of mice infected by pulmonary fungi was detected by Western bolt method and quantitative polymerase chain reaction (PCR). The PGRN protein and mRNA expression in the lung epithelial cells of mice were detected after the infection. Results logistic regression model was used to analyze the main risk factors affecting pulmonary infection in mice. The risk factors of pulmonary fungal infection were indent catheter, hypoproteinemia, long-term use of glucocorticoid and long-term use of antibiotics. The PGRN content in serum was obviously higher than that before pulmonary fungal infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissue was obviously higher than that before infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissues of the infected group was obviously higher than that of the non-infected group (P < 0.01). The expression of PGRN protein in the lung epithelial cells of mice was obviously higher at 24 h after infection than before infection (P < 0.01), and the expression of PGRN mRNA was obviously higher at 12 h after infection than before infection (P < 0.01), indicating that PGRN is highly expressed in fungal pulmonary infection and is involved in disease progression. Therefore, this study provides a new idea for the diagnosis and treatment of fungal pulmonary infection in the later stage and has a good guiding significance for the diagnosis and treatment of fungal pulmonary infection.

Teaching by Induction:Project-Based Learning for Silicon Valley

It is well known that there continues to be a shortage of women in technology jobs. The teaching methods and gender bias in K-12 education continue to favour boys progressing to engineering and technology positions. The project initiated by Ravi Krishnan Jagannathan in Silicon Valley, California, sought to prepare middle school and high school girls for success in high tech. The strategy used was to teach math and science inductively. The use of computers for teaching the girls both fundamental science and math in the middle school laid the foundation for teaching high school girls to apply Artificial Intelligence (AI) to develop solutions to current medical and ergonomic problems. This paper will discuss the inductive teaching strategy with the aim of motivating both parents and teachers to adopt a similar project that can help address the shortfall of women in tech.

Community's Perception and Attitude towards People with Epilepsy in Ethiopia.

Introduction Most people with epilepsy suffer from a dual burden. In one hand, they struggle with the symptoms and disabilities on the other hand from misconceptions and stigma associated with it. But there are no recent studies which assess the community's perception and attitude. Objective To assess the perception and attitude of the community towards people with epilepsy and identify associated factors. Methods A community-based cross-sectional study was conducted in South Ethiopia from a total of 701 participants. Data were collected with face to face interview using a structured questionnaire developed based on the Health Belief Model (HBM). Data were presented with frequencies, tables, and figures. Univariate and multivariable logistic regression was done to identify significantly important variables. The presence of association was presented by odds ratio and 95% confidence interval. Ethical clearance was obtained from Wolaita Sodo University. Results The most frequently mentioned perceived causes for epilepsy were stress (91%), substance use (61.8%), and bad spirit (49.8%) while loss of consciousness and falling (80.7%) and sleep problems (78%) were considered symptoms of epilepsy. Only 13.1% of the participants think that they may be susceptible for epilepsy. Six hundred sixty (94.2%) participants will not employ a person with epilepsy while only 47 (6.7%) of the participants will allow a family member to marry a person with epilepsy. In multivariable analysis, understanding the illness as a medical problem was associated with perceived susceptibility and perceived benefit of modern treatment was significantly associated with having a current medical problem. Conclusions The knowledge about the cause, possible susceptibility, better treatment options, and attitude of the participants were similar to other low-income settings. The negative attitude was high and multidimensional. All stakeholders must work to increase awareness about the cause, symptoms, and treatment options for epilepsy and to decrease the negative attitude of the community.

Exploring the role of Design in the context of Medical Device Innovation

Technology is the leading driving force in healthcare and medical device design, however, innovations which emerge from these practices are often driven by clinical requirements. Such innovations are focused on developing products that addresses current health issues, diseases or medical problems – often lacking consideration of the end users’ needs. Design innovation advocates that user-centred design happens much earlier in the product development process so that the patient needs are prioritised. However, this emerging field is yet to be defined and explored in a medical context. This paper therefore proposes a framework of Medical Device Design Innovation to explore the role of design in medical device innovation through two medical device case studies. The proposed framework suggests a way to navigate the nuances and complexities of the medical device industry in order to put the patient first while ensuring commercial viability.

TOXICOLOGICAL ASSESSMENT OF THE EXPOSURE TO SOME ARYLHETEROALKANECARBOXYLIC COMPOUNDS ON THE BODY

Introduction. One of the current medical and social problems is the intoxication of the body of workers that occurs during the production of medicines in chemical-pharmaceutical enterprises. In this regard, it is necessary to substantiate and develop a hygienic rationing of the content of harmful substances in the air of the working area. Materials and methods. Toxicity parameters (1-benzylindol-3-yl-thio) acetic acid (BTAA) and tris-(2-hydroxyethyl) ammonium-1-benzylindol-3-ylthioacetate (VM-7-02) were studied. Experimental studies were conducted on outbred rats and mice, rabbits and guinea pigs. Using standard physiological, biochemical, hematological and morphological parameters, the effect of the substance on the experimental animals was evaluated. The parameters of acute inhalation toxicity of substances were determined during the experiment in the chamber for inhalation primers using spectrophotometry to analyze the amount of the substance in the air of the chambers. Processing and interpretation of the information obtained was performed using the software package “Statistic 10.0”. Results. In terms of mean lethal doses (DL50), both xenobiotics can be classified as moderately hazardous substances of hazard class III, and there are no specific species and sex differences in the sensitivity of animals to the substances under study. Local skin reaction and signs of resorption of substances through intact skin are absent. The irritant effect on the mucous membranes of the eyes of tris-(2-hydroxyethyl) ammonium-1-benzylindol-3-ylthioacetate can be classified as weak. The ability to material accumulation in the body of the compound VM-7-02 is medium: the cumulation coefficient is 3.7. At BTAA cumulative abilities are even weaker - the coefficient is equal to 5.1. In the subacute experiment, they have a toxic effect mainly on the hepatorenal system. The threshold of acute inhalation action of BTAA is 100.7, VM-7-02-57.8 mg/m3. Conclusion. A tentative safe level of exposure to VM-7-02 in the air of the working area is recommended at 0.3 mg/m3, BTAA is recommended at 2.0 mg/m3. Compliance with this standard will minimize the risk to the health of workers.

Development of New Serum Biomarkers for Early Lymphedema Detection.

Background: Early lymphedema detection may reduce the symptoms and improve clinical outcomes. However, the lack of reliable serum biomarkers capable of predicting lymphedema development is a current medical problem. In this study, we investigated if serum levels of hyaluronic acid (HA) and leukotriene B4 (LTB4), two molecules involved in lymphedema development, may work as predictors of this condition. Methods and Results: A mouse model of acquired lymphedema was generated through ablation of tail dermal lymphatic network. Tail diameter was measured daily, and HA and LTB4 serum levels were analyzed before and during the development of lymphedema. We found increased serum levels of HA and reduced levels of LTB4 at early days before the appearance of lymphedema signs. Similar results were observed in the lymphedema tissue. Increased local and systemic inflammation was also detected at early time points. Moreover, the ratio LTB4/HA arises as the strongest predictor for lymphedema development. In fact, we found an inverse correlation in our model, where reduced LTB4/HA levels showed increased lymphedema signs. Conclusions: These findings suggest that serum ratio of LTB4/HA may be a useful biomarker to predict acquired lymphedema development, with potential to be used in clinical conditions such as breast cancer patients.

ФІЗИЧНА РЕАБІЛІТАЦІЯ ДІТЕЙ ШКІЛЬНОГО ВІКУ З МІОПІЄЮ І–ІІІ СТУПЕНЮ

Physical rehabilitation of children with myopia is a difficult process and requires a long-term, systematic and stage-by-stage use of a complex of means for restoration acuity of vision. Kinesiotherapy (respiration and twist exercises), finger and articulatory gymnastics, methods of Onnuri Therapy, reflexotherapy, instrumental physiotherapy, etc. are usually used for this, and that taken together leads to the positive effect and restoration of visual system. Nevertheless, in progressive forms of myopia these physical methods are not always effective. The objective – theoretical justification of the necessity and the essence of physical rehabilitation during myopia, analysis and summation of list of research and methodological literature concerning the study of influence of physical rehabilitation on physical development and psychoemotional state of pupils with myopia of various degrees. Methods. Sources of literature (scientific papers, textbooks, manuals, synopses of thesis works) chosen from the electronic database of the Vernadsky National Library of Ukraine, Russian scientific electronic library «eLibrary», Web of Science, PubMed, PEDro, etc. Results. On the basis of literary sources, it has been established that the increase in number of cases of myopia of pupils is, in the first place, connected with the increase in visual loadings. The main pathogenic link of the acquired myopia is sclera distension. Children affected by the acquired myopia have a combination of corneal thinning and the increase of its horizontal diameter and the length of the anterior-posterior axis of the eye that indicates the distension of the eye cornea. The corneal thinning is accompanied by its sensory decrement from 19 % to 57 % depending on the degree of the disease and by the decrease of the rigidity of the outer layer of the eye. The corneal thinning is one of the objective criteria of myopia progression, that involves inclusion of keratopachymetry to the complex of obligatory examinations of myopia patients for defining a rational therapeutic approaches. Children with myopia with corneal thinning form a risk group in regard to the development of retinal degeneration. Conclusions. Myopia is a current medical and social problem of the present. Physical rehabilitation of such children is a difficult and long-term process, which requires a systematic and stage-by-stage use of its various means.

Scabies –still current medical and social problem. A retrospective analysis of 193 cases

Scabies is a parasitic skin disease caused by Sarcoptes scabiei. About 200 million casesworldwide each year in people of all ages are reported. Retrospective analysis of records of patients hospitalized at the Department with scabies. Six-year retrospective analysis of medical records of patients hospitalized with scabies at the Department of Dermatology. Gender, age of patients, comorbidities, clinical course of the disease and treatment were considered. In this period 193 patients were hospitalized with scabies, 96 females (49.7%) and 97 males (50.3%), including 33 children (17%). Mean age of patients was 52.9. Skin lesions persisted 142 days in average; reoccurrence was noted in 14% of cases. Lesions were observed most often in winter (31%). The most common manifestations were erosions (80.8%), excoriations (73.6%), papules (72.6%) and crusts (24.3%), localized mainly on trunk (92%), lower (91%) and upper (86%) limbs. 181 patients (93.8%) reported pruritus which intensified at night in 35.8%. Previous contact with people with scabies reported 41 patients (21%). The most common comorbidity was hypertension, diabetes mellitus and coronary heart disease. Accompanying dermatoses were eczema, secondary superinfection and psoriasis. 85 patients (44%) were overweight or obese. Patients received mostly topical permethrin (57%), crotamiton (29%), glicocorticosteroids (73%) and antibiotics (11%), also oral antihistamines (91%). Analysis revealed more frequent occurrence in adults with no evident sex prevalence. Greater incidence in winter may be caused by people’s tendency to spend more time indoors closer to each other at this time of year. Pruritus, the most common subjective symptom, typically worsens at night.

Menopause-Related Symptoms and Help Seeking Behavior among Women Attended at a Tertiary Care Hospital in Bangladesh

Background: Women have experienced different menopause-related symptoms. Objective: The purpose of the present study was to see the menopause-related symptoms and help seeking behavior among the women attended at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the outpatient Department of Kushtia Medical College Hospital, Kushtia, Bangladesh from October 2015 to September 2016 for a period of one (01) year. Menopausal women who were attended in the outpatient Department of Hospital were included as study population. The eligible women had at least one year of amenorrhoea. Surgical menopause or due to severe illness, extreme weight loss endocrine disorders or radio therapy were excluded. Each subject completed a questionnaire that elicited their sociodemographic information, personal and family history and current medical problems. Result: A total number of 437 women were recruited for this study. The most prevalent menopausal symptom among the participants was generalized body ache 91.30%. Followed by low back pain 88.55%, muscle & joint pain 87.18%, tiredness 86.04%, hot flush 64.30%, urinary symptoms 43.93%, vaginal dryness 48.28%, insomnia 73.91%, irritability 23.56%. Most of the participants consulted at first with village doctors (63.15%) followed by general practitioners 20.82% due to their health problems. Some sought help from traditional healers like kobiraj 3.20%. Conclusion: In conclusion, body ache, low back pain, muscle and joint pain and tiredness are the most commonly reported menopause-related symptoms that are mostly consulted with village doctors.