Duration Of Complaints Research Articles

Sickness absence duration of stress complaints, adaptation disorder or burnout in the Netherlands

Abstract In the Netherlands, occupational physicians can diagnose burnout when employees report sick. Their guideline distinguishes between stress complaints lasting < 3 months, adaptation disorder with complaints lasting 3-6 months and burnout with complaints lasting > 6 months at moment of diagnosis. The Four-Dimensional Symptom Questionnaire (4DSQ) is recommended to assess and monitor. The new Burnout Assessment Tool (BAT) might be an alternative. Research questions were: 1) What are the sickness absence duration, 4DSQ and BAT-scores of absentees diagnosed with stress complaints, adaptation disorder and burnout?; 2) Is the BAT a better predictor of sickness absence duration than the 4DSQ? From 2020-2023, data was collected among all 3,462 employees who were absent due to stress complaints, adaptation disorder or burnout at one large occupational health and safety service via registry data and an employee questionnaire. Results show that two-thirds of those with stress complaints, half of them with adaptation disorder and one third with burnout were absent for less than half a year. 4DSQ and BAT scores differed significantly between the three groups (p<.05). The BAT explained 0.8% of variance in absence duration (p< .001) when controlled for covariates, which explained 1.6% of variance (p< .001). The explanation by BAT was 1.9% within the group with stress complaints (p = 0.002), .4% within the group with adaptation disorder (p=.022) and absent within the group with burnout. Comparable results were found for the 4DSQ. The differences in absence duration between the three groups aligned with the Dutch guidelines. The BAT nor the 4DSQ were clinically relevant predictors of duration of absence for stress-related diagnoses among absentees in the Netherlands. To reduce productivity loss, it seems better to report sick when still in the stage of stress complaints than to wait until a full burnout has developed. The BAT and 4DSQ might help risk assessment in the working population. Key messages • The sickness absence duration of Dutch employees diagnosed with burnout is much longer than that of those with adaptation disorder or stress complaints. • Both the instrument recommended in the guideline and the new instrument have no clinical relevance in predicting sickness absence duration of stress-related diagnoses.

Evaluation and characterization of pelvic masses of gynecological origin b ultrasonongraphy and MRI reproductive age group.

Objective: To diagnostic accuracy of ultrasonongraphy and MRI for characterization of pelvic masses of gynecological origin in reproductive age group, with histopathology acting as the gold standard. Study Design: Cross-sectional. Setting: Department of Radiology, PAF Hospital Islamabad. Period: April 25th, 2021, to October 25th, 2021. Methods: In this investigation, non-probability consecutive sampling was utilized to collect data. A total of 220 women with pelvic mass were included in the study. Data regarding characterization of pelvic masses (malignant/benign) form ultrasound/MRI and histopathology was noted as per operational definition. Results: The study included participants aged 18-50, with a mean age of 31.6135.70 years, a mean parity of 3.130+1.37, and a mean duration of complaints of 7.186 +2.10 weeks. Ultrasound has shown sensitivity of 75.5%, specificity 88.8% and diagnostic accuracy by 83.2%, PPV 69% and NPV 88.3%. MRI has shown sensitivity of 83%, specificity 93.7% and diagnostic accuracy by 91%, PPV 83% and NPV 93.7% in characterization of pelvic masses. Conclusion: When sonographic characteristics of a pelvic tumor are inconclusive, MRI should be investigated for pathology investigation.

Tinnitus Prevalence, Associated Characteristics, and Treatment Patterns among Adults in Saudi Arabia.

Tinnitus affects millions of people around the world and causes significant negative impacts on their quality of life (QoL). Tinnitus is rarely examined in Saudi Arabia. This study aimed to estimate the prevalence of tinnitus among adults, explore their experience with tinnitus, investigate the impact of tinnitus on their QoL, and discover their tinnitus management methods. A descriptive cross-sectional study design was performed utilizing a non-probability purposive sampling technique and a face-to-face in-person administered questionnaire. Descriptive statistics and a chi-square test were used to assess the data and find any correlation between the variables. Out of 4860 adults, 320 (males: n = 172; females: n = 148; age range = 18-90 years) had tinnitus, mainly described as a daily, gradual, continuous, whistling, and ringing tinnitus in both ears. Tinnitus prevalence was estimated at 6.54% with a slight predominance in males (6.9%) compared with females (6.2%). Most of the participants were unaware of the cause of their tinnitus. The modal value of the severity of tinnitus signals was severe for both genders. The modal value of the impact of tinnitus on the QoL was moderate for males and severe for females. Sleep, social activities, quiet settings, and concentration were largely affected by tinnitus. Significant associations (p < 0.05) between the impact of tinnitus on the QoL and risk factors, such as gender, age, hearing loss, and hyperacusis were determined. Also, the impact of tinnitus on the QoL was significantly associated (p < 0.05) with the duration of complaints and the severity of tinnitus signals. Approximately, 61% of the participants did not use any tinnitus treatment, while the remaining participants usually used hearing aids, medications, and counseling to manage their tinnitus. By increasing awareness, establishing standard practice, developing guidelines for managing tinnitus, expanding access to suitable interventions, and carrying out additional research, adults living with tinnitus in Saudi Arabia will have better support and, ultimately, an enhancement of their overall well-being.

Diagnostic Dilemma between Scrub Typhus Meningoencephalitis and Dengue Encephalopathy Resolved! - A Novel Prediction Score.

Scrub typhus and dengue, common etiologies of acute encephalitis syndrome, present with similar clinico-laboratory profiles but differ in management protocol. We aimed to devise a score differentiating between scrub typhus meningoencephalitis (STM) and dengue encephalopathy (DE). A prospective cohort of 204 children, (aged 6 months to 14 years) presenting with acute encephalitis syndrome in a public teaching hospital in northern India was subjected to standardized workup including serum IgM against Orientia tsutsugamushi and Dengue virus. Clinico-laboratory features were compared between STM and DE using univariate and multivariate analysis. Area under the receiver operating characteristic (ROC) curve (AUROC) for the score derived from independent predictors and its sensitivity, specificity, predictive values was calculated at cutoffs. STM and DE IgM ELISA were positive in 38 (18.6%) and 41 (20.1%) children, respectively. Longer duration of fever, prodromal stage, respiratory complaints and pneumonia were significantly frequent in STM; however, swelling, petechiae and myalgia were significantly prevalent in DE. STM had higher blood total leukocyte count (TLC), higher CSF protein and lower CSF sugar compared to DE. At admission, TLC >10,000/mm3, pneumonia, absence of myalgia and petechiae were independent predictors for differentiating STM from DE. AUROC of novel score (range: -5 to 5) was 0.879 (95% CI: 0.805-0.952). Score at cutoff ≥5 had 100% specificity and 100% PPV for differentiating STM from DE. Prediction score may benefit physicians to differentiate between these two infections and treat them accordingly.

Identifying pain profiles in employees including work-related factors and pain perceptions: a cross-sectional study in Belgian companies

ObjectivesStudies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of...

Surgical outcomes of trigonal intraventricular meningiomas: a single-centre study.

Trigonal meningiomas are rare intraventricular tumours that present a surgical challenge. There is no consensus on the optimal surgical approach to these lesions, though the transtemporal and transparietal approaches are most frequently employed. We aimed to examine the approach-related morbidity and surgical nuances in treating trigonal meningiomas. This retrospective review assimilated data from 64 trigonal meningiomas operated over 15 years. Details of clinicoradiological presentation, surgical approach and intraoperative impression, pathology and incidence of various postoperative deficits were recorded. In our study, Trigonal meningiomas most frequently presented with headache and visual deterioration. The median volume of tumours was 63.6cc. Thirty-one meningiomas each (48.4%) were WHO Grade 1 and WHO Grade 2, while 2 were WHO Grade 3. The most frequent approach employed was transtemporal (38 patients, 59.4%), followed by transparietal (22 patients, 34.4%). After surgery features of raised ICP and altered mental status resolved in all patients, while contralateral limb weakness resolved in 80%, aphasia in 60%, seizures in 70%, and vision loss in 46.2%. Eighteen patients (28.13%) developed transient postoperative neurological deficits, with one patient (1.5%) developing permanent morbidity. Surgery for IVMs results in rapid improvement of neurological status, though visual outcomes are poorer in patients with low vision prior to surgery, longer duration of complaints and optic atrophy. The new postoperative deficits in some patients tend to improve on follow up. Transtemporal and transparietal approaches may be employed, based on multiple factors like tumour extension, loculation of temporal horn, size of lesion with no significant difference in their safety profile.

Planned or recent first consultation with the general practitioner for knee complaints: Is it indicative of early-stage knee osteoarthritis?

ObjectiveNo established definition for early-stage knee osteoarthritis (KOA) is available, nor classification criteria. Identifying the characteristics of individuals presenting with early-stage KOA symptoms can enhance diagnosis to prevent progression. This study aimed to describe clinical and structural features of individuals presenting with knee complaints within two years after their first consultation, while exploring differences in the duration of knee complaints. MethodBaseline data was used from the LITE randomized controlled trial, assessing the effectiveness of a lifestyle intervention for individuals with knee complaints and overweight in primary care. Baseline assessments included questionnaires, clinical assessment, and MRI of the most symptomatic knee. Differences between groups with varying durations of knee complaints (<12, ≥12-<24, ≥24 months) were evaluated. ResultsParticipants (N ​= ​218, 65% female, mean age 59 ​± ​6 years, mean BMI 32 ​± ​5 ​kg/m2) had a median knee complaint duration of 14 months, with an average KOOS pain score of 60 ​± ​17.46% reported their symptoms as unacceptable. Structural MRI-defined KOA was observed in 71% of participants. There were no significant differences in clinical or structural MRI features between different durations of knee complaints. ConclusionWithin 24 months of initial consultation, over two-thirds of participants displayed MRI-defined structural KOA, and nearly half reported unacceptable symptom states. This study found no association between the duration of knee complaints and symptoms severity or structural KOA presence, underscoring the complexity of identifying stages of KOA among individuals with overweight. Future studies should explore additional features beyond current considerations to facilitate early-stage KOA diagnosis, specifically for individuals with overweight.

Clinical reflection of anatomical evaluation in coccydynia

Coccydynia is a pain in the coccyx and the surrounding anatomical structures. Our aim in the study was to evaluate whether the disease duration, pain assessment, and coccyx morphological type had an effect on this clinic in patients with a diagnosis of coccydynia. A total of 68 coccyx Magnetic Resonance Imaging (MRI) results were evaluated. Coccyx segment number, morphological typing, lumbosacral, sacrococcygeal, and intercoccygeal angle measurements were made. Disease duration, day and night movement and the rest of Numerical Pain Scale (NRS) values were recorded from existing records of patients with a diagnosis of coccydynia. When the morphological typing was evaluated, type 4 subluxation was found to be high in the group with coccydynia. Pain complaint duration was 13.94 ± 12.22 months, sitting time was 16.82 ± 14.22 minutes, and the numerical pain scale was 7.62 ± 1.48. Morphologically, type 1;14 (3 coccydynia), type 2;22 (9 coccydynia), type 3;14 (6 coccydynia), type 4;18 (16 coccydynia) images were also detected. A moderately statistically significant positive correlation was found between the sacrococcygeal and intercoccygeal angles (p&lt;0.05). We believe that evaluating clinical data and anatomical measurements together will contribute to the treatment of coccydynia, which is especially difficult to treat.

Association between Usage of Prophylactic AYUSH Medicines and Disease Severity in COVID-19 Patients: A Retrospective Cohort Study.

Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals. This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery. Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% (n = 1,556) and 56.81% (n = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ2 = 9.01; p = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group (p = 0.002). AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study. Clinical Trials Registry-India (CTRI/2020/08/027000).

Evaluation of the Relationship between Total Vertebral Artery Flow and Quality of Life in Patients with Vertebrobasilar Insufficiency

Background: Vertebrabasilar insufficiency is a common problem in the community and causes limitation in daily physical activities of patients. A questionnaire called the dizziness disability inventory is used to show the change in the quality of life of the patients. In our study, we wanted to show the change in quality of life indexes of patients with vertebrabasilar insufficiency depending on the degree of insufficiency. Material and metod: Dizziness disability inventory was filled in patients diagnosed with vertebrabasilar insufficiency by Doppler ultrasonography and the relationship between the degree of vertebrabasilar insufficiency and the results of the questionnaire was investigated. Results: A statistically significant difference was found between the groups according to the mean questionnaire results in patients classified as mild, moderate and severe according to their vertebrabasilar insufficiency. The mean questionnaire scores of those with severe vertebrabasilar impairment were significantly higher than those with moderate and mild impairment, but no significant difference was found between those with moderate and mild impairment. There was no significant difference in mean questionnaire scores between gender, treatment intake and duration of complaints. It was found that there was a significant decrease in total vertebral artery output depending on age. Conclusion: In patients with vertebrabasilar insufficiency, restriction in activities of daily living, deterioration in quality of life are observed. It should be noted that the decrease in the quality of life index of the patients will be higher according to the severity of the vertebrabasilar insufficiency

Evaluation of Plummer-Vinson syndrome in pediatric patients with dysphagia

Aim: In our study, after excluding all other causes of dysphagia in the pediatric age, we tried to present the patients who were followed up and treated with the diagnosis of Plummer-Vinson syndrome(PWS) with iron deficiency anemia and dysphagia. Our aim is to emphasize that there may be dysphagia that can only be cured with anemia treatment and that it can be improved with treatment by a pediatrician. Material method: Pediatric patients who applied to our hospital with the complaint of dysphagia between May 2019-November 2020 were included in the study. After excluding all other causes of dysphagia, patients diagnosed with PWS were evaluated retrospectively. It was aimed to evaluate the age, gender, type, characteristics and duration of dysphagia of the patients retrospectively and to present them in the light of the literature. Results: PWS was detected in 24 of 200 pediatric patients who presented with dysphagia. The proportion of male patients was 37.5%, and their mean age was 97 months. The mean duration of dysphagia complaints was 11.2 months. Four patients had difficulty swallowing liquid food only, 12 patients had solid swallowing difficulties, and 8 patients had difficulty swallowing both solid and liquid food. Anemia was diagnosed by performing a complete blood count and having hemoglobin and hematocrit levels below 2 standard deviations appropriate for age; Those with vitamin B12 levels below 200 pg/ml were defined as cobalamin deficiency. Esophageal web was detected in 4 patients who underwent contrast esophagography. In esophagogastroduodensoscopy, stenosis was treated endoscopically in patients with web. In 20 patients, dysphagia did not persist after six months of iron deficiency anemia treatment. Conclusion: Although the diagnosis of PVS is rare in children, it should be considered and treated in all children with dysphagia associated with iron deficiency anemia. Patients whose complaints continue after treatment at the appropriate dose and duration should be referred for pediatric gastroenterology evaluation.

Oral cavity salivary gland pleomorphic adenoma: a histomorphological case series

BackgroundPleomorphic adenoma (PA), the most common benign salivary gland epithelial lesion, has a biphasic epithelial-mesenchymal pattern and great histopathological diversity. MethodsThis study's objective was to conduct a retrospective clinicopathological analysis, focusing on the histopathology characteristics of salivary gland PA. ResultsThere were ten cases of pleomorphic adenoma. The mean age was 33.5 years and no gender predilection was observed. All the patients presented with an asymptomatic mass and the duration of presentation was 31.2 ± 19.4 months. The cellular subtype (50 %) of PA was the most common. Capsular infiltration and incomplete capsules occurred in 20 % of cases. All the cases had round (100 %) and myxoid stroma.The cellular subtype was more common in the major salivary glands; showed capsular abnormalities (incomplete capsule, absent capsule, and tumor infiltration); and had more plasmacytoid, angular, spindled non-luminal cells as well as inflammation and cystic degeneration. The classic subtype had more clear and oncocytic cells along with sebaceous and squamous differentiation. The stroma-rich subtype had the shortest duration of complaints (three months) and showed giant cell reaction. ConclusionsThese findings confirm previous studies on the clinicopathological features of pleomorphic adenomas and highlight important morphologic characteristics like capsular invasion and squamous metaplasia, which can otherwise indicate malignancy.

Prospective analysis of optic nerve diameter and NSE values in patients with refractory headaches

Purpose: This study aims to investigate the usability of ultrasonographic optic nerve diameter measurement and plasma neuron-specific enolase (NSE) levels in detecting secondary causes of headaches in patients with refractory headaches in emergency department.&#x0D; Materials and Methods: The study was conducted in a university-based adult emergency department over 3 years. Sixty-six consecutive patients presenting to the emergency department with refractory headaches and 50 healthy volunteers for the control group were included. Information recorded included the duration of complaints, type and location of headache, symptoms, co-morbidities, results of imaging studies, optic nerve diameters, results of lactate, arterial blood gas and NSE levels.&#x0D; Results: A total of 66 patients were included, comprising 33 females. The mean age was 43.05 ± 17.06 years. Secondary causes of headache were identified in 45 patients (68.2%). Evaluation of ultrasonographic optic nerve diameter revealed that 17 (25.8%) right and 21 (31.8%) left optic nerve diameters were ≥5 mm. Optic nerve diameter values were significantly higher in patients diagnosed with secondary headache compared to those with primary headache, with no statistically significant difference observed in NSE values. Lactate levels in patients with secondary headaches were significantly higher than those in patients with primary headaches.&#x0D; Conclusion: In patients admitted to the emergency department with refractory headaches and normal imaging, ultrasonographic optic nerve diameter measurement may be preferred as an easily accessible method to guide the detection of secondary causes. NSE was not an effective in the early selection of patients with secondary headaches.

Comparing the Efficacy of Topical 4% Benzoyl Peroxide Versus Topical 0.1% Adapalene for Treatment of Acne Vulgaris in Skin of Color Population: A South Asian Perspective.

Introduction Acne vulgaris is one of the most common skin problems encountered in the dermatology department. It is a chronic, inflammatory disease of the pilosebaceous unit, clinically presenting with comedones, papules, pustules, nodules, and cysts. With its particularly high prevalence in the younger population, it has significant adverse sequelae on patient's quality of life. At present, due to an enhanced understanding of the pathogenesis of acne, various therapeutic modalities are available. The current management strategies generally follow a systematic treatment escalation based on disease severity and treatment response. However meticulous choice of appropriate anti-acne medicine for the acne type is the key to the management plan. Starting with mild to moderate types of acne as per the Leeds photometric grading scale, the most useful topical agents include topical retinoids, benzoyl peroxide, and topical antibiotics while systemic therapies such as oral antibiotics or isotretinoin are generally reserved for moderate to severe acne treatment. The skin of color (SOC) population is a relatively neglected group concerning the optimum and safe management strategies in different dermatological conditions and acne is no different, where there remains a need for comparing the available topical modalities for appropriate drug selection in the treatment of mild to moderate acne in SOC population. Objective The objective of this study was tocompare the efficacy of topical 4% benzoyl peroxide versus topical 0.1% adapalenein the treatment of acne vulgaris in the SOC population. Methods The participants were divided into two groups, groups A and B. A total of 64 patients of both genders, with acne vulgaris (duration > three months) were included in the study. In group A, 32 patients were administered topical 0.1% adapalene whereas, in group B, 32 patients were given topical 4% benzoyl peroxide. Both medicines were applied at night daily. Patients were called for follow-up after 12 weeks. In both groups, the final efficacy evaluation was done using the Global Acne Grading System (GAGS) scoreafter 12 weeks of treatment period. Results In group A, the age ranged from 15 to 40 years with a mean age of 25.781±3.93 years while the duration of complaint was 5.843±1.27 months. GAGS score was 25.281±2.65 and mean BMI was 23.092±3.51 kg/m2. In group B, the mean age was 25.187± 4.06 years, the duration of complaint was 7.375±2.25 months, the GAGS score was 23.906± 2.60 while the mean BMI was 21.485±3.88 kg/m2. Efficacy in group A was noted in 25 (78.1%) patients as compared to 24 (75%) patients in group B (p =0.768). Conclusion The present study showed that the safety and efficacy of 0.1% adapalenethe traditional drug 4% benzoyl peroxide in the SOC population was comparable.

Using Group History-Taking and Individual Reasoning to Identify Shortcomings in Clinical Reasoning for Medical Students.

It is crucial that teaching faculties determine and remain informed of medical school learners' clinical reasoning competence. We created an innovative assessment method for fourth-year medical students to identify deficiencies in various components of their clinical reasoning ability. This was a cross-sectional observational study of fourth-year medical students' reasoning assessments from 2019 to 2022. Teams of four-five trainees questioned standardized patients in clinical scenarios, including fever, abdominal pain, and weight loss. They then individually documented key information to reflect comprehension of patient problems. Trainees were tasked with differentiating diagnoses and associated statuses and reaching the most likely diagnosis along with two tentative diagnoses. The correlations observed between 2020 and 2022 for abdominal pain were analyzed using student t-tests. A total of 177 students participated in this study. Across the scenarios, there was no significant difference in key information representation scores (56%-58%). Reasoning ability scores were 49% for fever, 57% for abdominal pain, and 61% for weight loss. A comparison between 2020 and 2022 revealed a significant improvement in the objective structured clinical examination scores and differential diagnoses (P < .01). Shortcomings included brief chief complaint duration, lack of detailed presentation, and insufficient description of negative information. Differential diagnosis and diagnostic justification were inadequate for acute and chronic conditions, and disease location clarity within the organ system was lacking. On average, students presented two correct diagnoses. Fourth-year medical students exhibited inadequate reasoning abilities, particularly in fever and abdominal pain scenarios, with deficiencies in hypothesis generation and differential diagnosis. Group history-taking with individual reasoning assessment identified students' shortcomings and provided faculty feedback to improve their teaching strategies.

Frequency of Urinary Tract Infection among Neonates with Persistent Jaundice at Lady Reading Hospital, Peshawar

Jaundice refers to yellow-orange discoloration of the skin and sclera, resulting from an excessive accumulation of bilirubin in the dermis and mucous membranes. Indirect neonatal hyperbilirubinemia is a prevalent and frequent etiology of jaundice, leading to the hospitalization of neonates in healthcare institutions worldwide. Objective: To determine the frequency of urinary tract infection among neonates with prolonged jaundice. Methods: The present study, a cross-sectional design, was carried out at the Department of Pediatrics, Lady Reading Hospital, Peshawar, from June 20th to December 20th, 2022. The study consisted of 87 infants, encompassing both genders, who presented with persistent jaundice. Two samples of clean urine were collected from neonates, with a time interval of many minimums of two hours between each collection. These samples were then sent to the hospital laboratory for diagnosing urinary tract infection. Results: The age range of participant neonates in this study ranged from 14 to 28 days, with a mean age of 20.597±4.50 days. The mean duration of complaint was also 18.20±4.077 days, and the mean weight was 2.855±0.27 Kg. The proportion of male patients was 58.6%, while the proportion of female patients was 41.4%. Among these 11.5% were found to have urinary tract infection. Conclusions: It is concluded that significant number (11.5%) of patients with persistent jaundice has urinary tract infection. It is likely a potential etiological factor contributing to neonatal unexplained prolonged indirect hyperbilirubinemia.

Comparison of diagnostic accuracy of conventional ultrasonography for characterization of axillary lymph nodes with histological findings.

Objective: To determine the diagnostic accuracy of conventional ultrasonography for characterization of axillary lymph nodes. Study Design: Cross-sectional study. Setting: Department of Radiology, Aziz Fatima Medical and Dental Hospital, Faisalabad. Period: 1st of October 2022 to 31st of March 2023. Material &amp; Methods: A total number of 145 female patients above the age of 18 years who reported with mastalgia and diagnosed clinically with the presence of suspicious axillary lymph nodes were included in the study. The conventional ultrasonic evaluation index was used for characterization. The ultrasonological results of characterization of axillary lymph nodes were compared with histopathological results where results of histopathology were taken as gold standard. Results: The Mean±SD of age in this study was 44.15±8.42 years with an age range of 29-62 years. The Mean±SD of duration of complaints was 10.17±5.60 months. USG diagnosed 89 (61.37%) patients while histopathology diagnosed 92 (63.44%) patients with metastasis of ALN. USG showed sensitivity of 86.957%, specificity 83.019%, diagnostic accuracy 86%, PPV 89.888% and NPV 78.571% in diagnosis of metastasis of axillary lymph nodes (p &lt; 0.000). Conclusion: Conventional USG is a commonly available and affordable diagnostic tool which is useful with a good accuracy for characterization of axillary lymph nodes and detecting the metastasis.

Unveiling Myasthenia Gravis: A Comprehensive Analysis of Diagnostic Tools and Clinical Insights

Objective: This research offers a comprehensive analysis of Myasthenia Gravis (MG), uncovering the remarkable accuracy of spinal accessory, ulnar, and facial nerve repetitive nerve stimulation (RNS), along with the precision of single fiber electromyography (SF-EMG) in MG diagnosis. We also embark on an exploration of clinical features and autoantibody test results in generalized MG patients.&#x0D; Methods: In this prospective study, we welcomed 31 individuals definitively diagnosed with generalized MG into our quest. The categorization of patients was conducted in accordance with the criteria set by the Myasthenia Gravis Foundation of America (MGFA). We examined patients' trapezius, nasalis, and abductor digiti minimi (ADM) muscles using RNS. We meticulously recorded the presence of MG autoantibodies, clinical subtypes based on affected muscle groups, and SF-EMG jitter rates.&#x0D; Results: The mean age of the 31 patients of whom 19 (61.3%) were male, was 64 ± 13.9 years. Among them, 20 showed positivity in the Anti-AChR antibody test. In 28 patients, accounting for 90.3% of the study group, single fiber electromyography (EMG) displayed increased jitter. There were 4 (12.9%), 24 (77.4%) and 12 (38.7%) patients featuring a decremental response of exceeding 10% in ADM, trapezius and nasalis muscles, respectivelyOur investigation revealed notable findings, such as the absence of substantial correlations between decremental response rates and age, gender, duration of complaints, antibody test results, thymus abnormalities, affected muscle types, familial history, or increased jitter rates in SF-EMG (p&gt;0.05).&#x0D; Conclusion: As our findings clearly show, we can confidently attest to the remarkable sensitivity of RNS in MG diagnosis when muscle selection is precise. A gem discovered on our study is the high sensitivity of the spinal accessory nerve, a revelation that should guide the course of routine RNS studies, particularly for those facing ocular-onset myasthenia.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KELUHAN KELELAHAN MATA PADA PEKERJA KANTOR X KARANGANYAR

Office workers X Karanganyar are computer users, with an average duration of computer use in a day of more than 4 hours. The average worker has been working for more than three years and is still exposed to lighting intensity that is less than standard (&lt; 300 lux) with an eighthour workday, putting them at risk of experiencing eye fatigue. This study aims to determine the relationship between lighting intensity, working period, and duration of computer use with complaints of eye fatigue in Karanganyar X Office workers. This study uses an analytical observational method with a cross-sectional approach. The research population was 80 people. The sampling technique used is purposive sampling with criteria of age 50 and working on a computer for at least 2 hours continuously, and the research sample is 45 people. Measurement of lighting intensity using a Lux meter and eye fatigue using a Visual FatigueIndex (VFI) questionnaire. The results of the bivariate analysis with Somers'd showed that there was a relationship between lighting intensity and complaints of eye fatigue (p-value = 0.030, r = 0.333), there was a relationship between years of service and complaints of eye fatigue (p-value = 0.003, r = 0.457), and there is a relationship between the duration of computer use and complaints of eye fatigue (p-value = 0.028, r = 0.326). To reduce eye fatigue, it can be done by setting up the layout of the workplace, taking breaks in between work, and getting regular eye health checks.

Evaluation of multidetector CT Hounsfield unit measurements as a predictor of efficacy and complications in percutaneous vertebroplasty for osteoporotic vertebral compression fractures

IntroductionMore than 30 years after the initial experience of Galibert and Deramond with percutaneous vertebroplasty, the procedure has gone through countless refinements and clinical evaluations. Predictors for the success and failure of the procedure in the literature vary and are focused on the duration of complaints, type of fracture, presence of edema on MRI scans, etc. We propose using a quantitative method based on a standard CT examination of the thoracic or lumbar spine to assess the risks and potential success of performing vertebroplasty.Materials and methodsThis is a single-center prospective observational study on 139 patients treated with percutaneous vertebroplasty (pVPL) for a single symptomatic osteoporotic vertebral compression fracture (OVCF). We measured the levels of disability and pain preoperatively and again at the 3-, 6- and 12-month marks using the standardized VAS and ODI questionnaires. Every patient in the study was evaluated with postoperative multidetector CT (MDCT) to determine the presence, extent, and localization of vertebral cement leakage and to measure the adjacent vertebrae’s minimal and mean density in Hounsfield units (HUmin and HUmean, respectively).ResultsWe determined that a slight (r = −0.201) but statistically significant (p = 0.018) correlation existed between HU measurements taken from radiologically intact adjacent vertebrae and the procedure’s effect concerning the pain levels at the 3-month follow-up. This correlation failed to reach statistical significance at 12 months (p = 0.072). We found no statistically significant relationship between low vertebral cancellous bone density and cement leakage on postoperative scans (p = 0.6 for HUmin and p = 0.74 for HUmean).ConclusionWe have moderately strong data that show a negative correlation between the mean values of vertebral cancellous bone density in patients with OVCF and the effect of pVPL in reducing pain. Lower bone densities, measured this way, showed no increased risk of cement leakage.