Early Medical Intervention Research Articles

INCIDENTAL FINDINGS IN PANORAMIC RADIOGRAPHS: A DESCRIPTIVE STUDY OF PANORAMIC RADIOGRAPHS TAKEN ON X HOSPITAL IN JAMBI CITY INDONESIA

Abnormalities without symptoms can be detected through accurate diagnostic interpretation techniques in a wide range of panoramic radiographs. The number of publications describing various incidental findings on panoramic radiographs in Indonesia is still limited. The aim of this study is to find incidental findings in panoramic radiographs. The design of this study is descriptive, using 962 panoramic radiographs. A total of two observers interpreted 481 radiographs each and recorded incidental findings into five categories, namely soft tissue calcification, elongation of the styloid process, pathological conditions of the maxillary sinus, dense bone islands, and other incidental findings. The results shows that 142 panoramic radiographs (14,76%) had images of incidental findings, with descriptions of the types of incidental findings that were found are 42 radiographs (29,57%) of soft tissue calcification, 29 radiographs (20,42%) had an elongation of the styloid process, pathological conditions of the maxillary sinus were found on 35 radiographs (24,64%), 32 radiographs (22,53%) of dense bone island, and 17 radiographs (11,97%) were categorized as other incidental findings. The percentage of incidental findings which is not too high (14,76%), does not affect the fact that it is very important for a dentist to interpret panoramic radiographs in such detail manners and be alert of various pathological conditions that appear even without clinical symptoms, and ultimately be able to provide external referrals so that early medical intervention can be carried out in patients who needs it the most.

Analysis of Health Determinants in Cleft Palate Patients.

This study aims to analyze health determinants affecting patients with cleft palate, specifically examining the relationships between the Social Vulnerability Index (SVI), failure to thrive (FTT), and healthcare utilization within the initial 30 days and first year of life. A retrospective analysis was conducted on patients with a cleft palate at a tertiary care center over an 11-year period. Data included demographics, weight percentile trends, pediatric emergency department (PED) visits, hospital admissions, SVI scores, cleft palate type, and FTT diagnoses. Statistical analyses were performed using SPSS. Social Vulnerability Index was not significantly correlated with health outcomes in cleft palate. Patients with FTT exhibited lower gestational age (P = .002) and birth (P = .005), one-month (P = .001), and one-year (P = .001) weight percentiles. FTT diagnosis was associated with increased PED visits (P = .000) and hospital admission (P = .000) in the first year of life. Early presentation to the PED was associated with increased PED visits (P = .000) and hospital admissions (P = .004) within the first year of life. No direct link was found between SVI and FTT. Early hospital readmission emerged as a significant outcome, indicating increased healthcare utilization in patients that require early medical intervention. Failure to thrive significantly impacted healthcare utilization, emphasizing the importance of addressing feeding issues early in this patient population. This study contributes to understanding health disparities in cleft palate patients and highlights the need for nuanced exploration of regional factors influencing outcomes.

Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study

BackgroundSepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention. Globally, sepsis is common, with an estimated 31.5 million cases per year. Sepsis accounts for a significant in-hospital mortality rate of 17% in high-income countries, while in Malawi, it ranges from 17 to 50%. For Malawi, the trend can be reversed with improvements in patient referral system within the healthcare system. The study sets out to establish factors associate with delay referral of patients with sepsis from primary healthcare to tertiary hospitals and to understand healthcare workers and patients’ perspectives on barriers associated with delayed referral of patients with sepsis from primary to tertiary healthcare.MethodsA qualitative descriptive study in six health centres within Blantyre District health office. In-depth interviews were conducted with 22 respondents: healthcare providers [n = 12]; patients [n = 10] using semi-structured interview guides. Purposive sampling techniques were used in selecting healthcare providers (health centre in charges) and patients.ResultsThe study demonstrating that the main referral pathways for patients with sepsis include community-to-facility and facility-to-facility referrals. Ambulances and personal transport are common transportation mode used during referrals. Primary care facilities face several challenges that delay referrals from primary to tertiary health facility of patients with sepsis, such as lack of referral transport, poor communication, poor road network, shortage of skilled healthcare workers, patient preferences, delayed treatment-seeking action, and ambulances prioritising maternal conditions.ConclusionsPatients’ delay and failure to access prompt and timely referral services result from the healthcare system’s lack of transport, communication problems, bad road networks and shortage of well-trained personnel. Referral delays have deleterious effects on patient-care outcomes.

Acute Pancreatitis: An Update of Evidence-Based Management and Recent Trends in Treatment Strategies.

Acute pancreatitis is a common gastrointestinal disease leading to hospitalisation. Recent advancements in its management have primarily focussed on the development of early phase medical interventions targeting inflammatory pathways, optimisation of supportive treatment (including fluid resuscitation, pain management and nutritional management), appropriate use of antibiotics, implementation of minimally invasive interventions for infected necrosis, and the necessity of follow-up for long-term complications. These advancements have significantly improved personalised management and overall outcomes of acute pancreatitis. Despite these efforts, early-phase medical interventions to mitigate disease progression are still lacking and acute pancreatitis remains a heterogeneous disease. Future research and clinical trials are imperative to further optimise current strategies and develop new therapeutic approaches. This review presents an evidence-based approach to the management of acute pancreatitis, highlighting recent developments.

Gender Dysphoria – The Importance of In‐depth Psychological Assessment

AbstractThe increasing prevalence of gender dysphoria or transgender identity in children and adolescents has raised clinical, ethical and psychological concerns, particularly regarding the efficacy and appropriateness of medical interventions. This paper explores the critical role of thorough psychological assessment in addressing gender dysphoria, with a focus on the closure of the Tavistock NHS Gender Identity Service (GIDS) and the findings of the Cass Review. The author draws on her clinical experience to argue for a comprehensive, individualized approach to the treatment of children and young adults with gender identity conflicts. Key issues discussed include the lack of a robust evidence base for early medical treatments, such as puberty blockers and cross‐sex hormones, and the ethical implications of medicalising the bodies of children before psychological and physical maturity. The paper argues that many children presenting with gender confusion may be navigating complex psychological conflicts, including issues of identity, sexual orientation, anxiety and trauma, and that rushing into potentially harmful and life‐changing medical treatments may remove opportunities for addressing these emotional struggles. The author critiques the affirmative model of treatment, advocating for a more cautious, holistic and empathetic framework that prioritises improved assessment, psychological support and the time required between early adolescent pubertal changes and full sexual, psychological maturation. The paper highlights the implications of the Bell v. Tavistock Judicial Review and questions the issue of informed consent to hormone treatments. The author calls for the restoration of ethical clinical practices aiming to reduce potential harm and improve long‐term outcomes.

A Simple Prediction Model for Clostridioides difficile Infection: A Hospital-Based Administrative Database Study.

Few prediction scores for Clostridioides difficile infection (CDI), a potentially life-threatening nosocomial diarrhea, combine high accuracy with simplicity. A simple prediction score for routine clinical practice is needed. We conducted a retrospective cohort study of all inpatients aged ≥ 18 at a secondary care hospital in Japan. The derivation and validation cohorts consisted of patients from January 2016 to December 2020 and January 2021 to September 2022, respectively. Demographic and clinical data were retrieved using electronic medical records and an administrative database. The primary outcome was to derive and validate an accurate, simple prediction score for primary hospital-onset CDI. A derived prediction score by logistic regression analysis was calibrated and validated. CDI developed in 102 of 25 517 and 25 of 6259 patients in the derived and validation cohorts (2.7 cases/10 000 patient-days). The derived model for predicting CDI, including antibiotic use, acid suppressant (proton pump inhibitors or vonoprazan) use, Charlson comorbidity index, and Barthel index, yielded c-statistics of 0.89 and 0.82 in the derivation and validation cohort. The model was well calibrated. This simple prediction score enables early medical intervention and modification of treatment plans to reduce the risk of developing primary hospital-onset CDI.

A novel diagnostic model for fetal coarctation of the aorta with ventricular septal defect.

Our study aimed to develop a novel diagnostic model for fetal coarctation of the aorta with ventricular septal defect(CoA/VSD). We respectively included 70 fetuses with suspected CoA/VSD(January 2017-June 2023). After birth, 26 fetuses (26/47, 55.3 %) were confirmed to be true-positive CoA/VSD (TP-CoA/VSD), 21 cases had only VSDs without CoA, namely false-positive CoA/VSD (FP-CoA/VSD), and the remaining 23 fetuses were excluded due to additional major malformations, multiple pregnancies or other reasons. Large VSDs and doubly committed subarterial VSDs were more prevalent in true coarctation fetuses(all p < 0.05). Among morphological parameters of echocardiography, the aortic isthmus (AoI)/VSD ratio had the highest area under the curve (AUC) of 0.81 (95 % CI: 0.68-0.94, p < 0.001) and cutoff value of ≤0.67. Three new diagnostic models were constructed by adding different functional variables, namely left ventricular longitudinal strain(LVLS), LV ejection fraction, and LV fractional area of change to the morphological variable AoI/VSD ratio. The diagnostic model of AoI/VSD ratio and LVLS had the highest AUC of 0.96 (95 % CI: 0.86-1.00; p < 0.001). In addition, risk stratification revealed a high risk of prenatal CoA/VSD when the risk probability was greater than 0.80, which required early medical counseling and intervention. In fetuses suspected with having CoA/VSD, myocardial strains of both ventricles were lower in true CoA group. Additionally, a diagnostic model of new morphological parameter AoI/VSD ratio and functional variable LVLS, was highly valuable in diagnosing fetal CoA/VSD.

Automated Non-Supervised Eye Disorder Screening System Using Virtual Reality.

Neglecting eye disorders can lead to visual impairment or even vision loss, making early diagnosis and medical treatment crucial. This paper presents the development of an automated non-supervised eye disorder screening system that utilises Virtual Reality (VR) to provide a preliminary screening for common eye disorders. The system integrates advanced pupil-tracking techniques, image-processing methods, and eye disorder screening algorithms into one package for comprehensive eye disorder monitoring, including a strabismus test, a pupil test, and a contrast sensitivity test. Patients can wear a VR headset and use a joystick to interact with the VR scenario. The system is validated through experiments conducted on both healthy subjects and patients in hospitals, demonstrating an agreement rate exceeding 90% when compared to diagnoses by doctors. The test results highlight its potential for real-world applications, ultimately improving the accessibility of early screening for eye disorders and remote healthcare.

Associations of schizophrenia with arrhythmic disorders and electrocardiogram traits: genetic exploration of population samples.

An important contributor to the decreased life expectancy of individuals with schizophrenia is sudden cardiac death. Arrhythmic disorders may play an important role herein, but the nature of the relationship between schizophrenia and arrhythmia is unclear. To assess shared genetic liability and potential causal effects between schizophrenia and arrhythmic disorders and electrocardiogram (ECG) traits. We leveraged summary-level data of large-scale genome-wide association studies of schizophrenia (53 386 cases, 77 258 controls), arrhythmic disorders (atrial fibrillation, 55 114 cases, 482 295 controls; Brugada syndrome, 2820 cases, 10 001 controls) and ECG traits (heart rate (variability), PR interval, QT interval, JT interval and QRS duration, n = 46 952-293 051). We examined shared genetic liability by assessing global and local genetic correlations and conducting functional annotation. Bidirectional causal relations between schizophrenia and arrhythmic disorders and ECG traits were explored using Mendelian randomisation. There was no evidence for global genetic correlation, except between schizophrenia and Brugada syndrome (rg = 0.14, 95% CIs = 0.06-0.22, P = 4.0E-04). In contrast, strong positive and negative local correlations between schizophrenia and all cardiac traits were found across the genome. In the most strongly associated regions, genes related to immune and viral response mechanisms were overrepresented. Mendelian randomisation indicated that liability to schizophrenia causally increases Brugada syndrome risk (beta = 0.14, CIs = 0.03-0.25, P = 0.009) and heart rate during activity (beta = 0.25, CIs = 0.05-0.45, P = 0.015). Despite little evidence for global genetic correlation, specific genomic regions and biological pathways emerged that are important for both schizophrenia and arrhythmia. The putative causal effect of liability to schizophrenia on Brugada syndrome warrants increased cardiac monitoring and early medical intervention in people with schizophrenia.

Within-host dynamics of antiviral treatment with remdesivir for SARS-CoV-2 infection.

The effectiveness of antiviral treatment with remdesivir against COVID-19 has been investigated in clinical trials suggesting earlier recovery. However, this effect seems to be rather modest. In this study, we tracked the clinical course of SARS-CoV-2 infections in 369 COVID-19 individuals across a spectrum of illness severities, including both untreated individuals and individuals who received antiviral treatment with remdesivir. Moreover, using a process-based mathematical model, we quantified and analysed the within-host infection dynamics of a total of 88 individuals, of which 69 were untreated and 19 antiviral-treated individuals. For untreated individuals, we found that those hospitalized exhibit lower levels of early immune response and higher cumulative viral loads than those who were not. For treated individuals, we found that those who died were on average hospitalized later after symptom onset than those who survived, underscoring the importance of early medical intervention for severe COVID-19. Finally, our model estimates a rather limited antiviral activity of remdesivir. Our results provide valuable insights into the clinical course of COVID-19 during antiviral treatment with remdesivir and suggest the need for alternative treatment regimens.

ECG as a screening tool for detection of significant functional mitral regurgitation in patients with left bundle branch block

Abstract Background Functional mitral regurgitation (FMR) may occur in the left bundle branch block (LBBB) due to mechanical left ventricular (LV) dyssynchrony, by the imbalance between the tethering and the closing forces exerted on the mitral apparatus1-3. Progressive FMR and LV remodeling result in a reciprocal worsening downward spiral and worse clinical outcomes1-3. Therefore, timely screening and follow-up of these patients to prevent the irreversible progression of FMR is required. To date, only LBBB morphology and QRS duration have been proven predictors of FMR4. Purpose This study aimed to assess the relationship between ECG parameters of LV dyssynchrony and the severity of FMR in patients with LBBB. Methods We retrospectively included 154 consecutive patients with LBBB, in sinus rhythm, who had an echocardiogram, with no more than mild organic valvular heart disease. We measured the following intraventricular dyssynchrony markers: LV activation times (LVAT), intrinsicoid deflection (ID) in lateral and aVF leads and a newly defined marker – the difference (Diff) between aVL and aVF ID’s (Diff_IDaVL_aVF). These two leads record the electrical activation of the two opposing myocardial segments adjacent to the posteromedial and anterolateral papillary muscles, respectively5 (Figure 1). Based on the severity of FMR, the patients were divided into two groups: no/mild FMR (grade II or less) (61%), and significant FMR (grade III and IV) (39%). Results In patients with significant FMR, the LVAT measured in lateral leads, the IDaVL and Diff_IDaVL_aVF were significantly longer, but IDaVF was significantly shorter compared to patients with no/mild FMR (p&amp;lt;0.001). Of all studied ECG parameters, the Diff_IDaVL_ aVF was the parameter that had the strongest correlation with significant FMR (r correlation coefficient 0.82, p &amp;lt; 0.001). In multivariable analysis the Diff_IDaVL_aVF (p = 0.010) was the only parameter independently correlated with significant FMR. On ROC analysis the best cut-off for significant FMR prediction was 55 ms (AUC of 0.99, sensitivity 90% and specificity 97%) (Figure 2). Conclusions In LBBB, a simple intraventricular dyssynchrony ECG parameter can provide insights into FMR severity. A 55 msec Diff_IDaVL_aVF identifies significant FMR that may benefit from early medical or CRT treatment to avoid progression and worse prognosis.

Global, regional, and national burden of brain and central nervous system cancers for males from 1990 to 2021 and its predicted level in the next 25 years.

A study of the global burden of cerebral and central nervous system (CNS) cancers from the Global Burden of Diseases (GBD) indicates that these cancers significantly contribute to morbidity and mortality internationally. To fully understand the global impact of CNS cancer, expanded research efforts are essential. We analyzed the temporal trend of the disease burden from 1990 to 2021 and made projections for the expected burden from 2020 through 2044. We tapped into GBD 2021 Study data to evaluate CNS cancer incidence and trends among males. Prevalence was assessed with DisMod-MR, trends via cluster analysis, and Estimated Annual Percentage Change (EAPC) calculated via linear regression. Forecasts for 2022-2044 used APC and BAPC models, with a P-value &lt; 0.05 considered significant. Analyses relied on R software 4.0.2. In 2021, males experienced between 148,118 and 232,469 new brain and CNS cancer cases, indicating increased global burden from 1990 to 2021. An observed link between the prevalence's EAPCs and Human Development Indices (HDIs) suggests higher incidence in more developed regions. Projections using the APC model suggest rising numbers of cases and losses in Disability-Adjusted Life Years (DALYs) from 2020 to 2044, while Age-Standardized Rates (ASRs) are expected to decrease overall. In summary, a higher Socio-Demographic Index (SDI) correlates with better outcomes for CNS cancer due to early medical interventions in regions with strong healthcare systems. This demonstrates the need for equitable healthcare policies that focus on improving diagnostic capabilities and professional training to enhance survival rates universally.

Knowledge and Awareness of Congenital Inguinal and Umbilical Hernia and Its Complications in the Pediatric Population Among Parents in Qassim Region, Saudi Arabia.

Background Congenital umbilical and inguinal hernias are prevalent in infants and children. The exact incidence of congenital umbilical hernias remains unclear due to their typically asymptomatic nature, resulting in limited medical attention-seeking by parents. As these hernias are associated with serious complications such as incarceration, strangulation, and, rarely, obstruction, timely recognition and early medical intervention play a critical role in preventing these complications. This study aimed to investigate the level of knowledge and awareness of congenital inguinal and umbilical hernia and its complications in the pediatric population among parents in the Qassim region of Saudi Arabia. Methodology This cross-sectional study was conducted among parents living in the Qassim region of Saudi Arabia. A self-administered questionnaire was sent to the targeted parents using an online survey. The questionnaire included sociodemographic data (i.e., gender, marital status, education), general awareness about umbilical and inguinal hernia, and a six-item questionnaire to measure parents' knowledge regarding umbilical and inguinal hernia. Results A total of 440 parents responded to our survey (30.9% males vs. 69.1% females). Overall, 49.5% had at least four or more children. Of the study participants, 19.8% knew of both umbilical and inguinal hernias. The overall median knowledge score of six knowledge items was2.00 (interquartile range = 2.00). Most parents (64.3%) had poor knowledge, and only 2.3% of them had good knowledge. Higher education, awareness of the meaning of congenital inguinal or umbilical hernias, and having children with a previous history of umbilical or inguinal hernia symptoms were the factors associated with increased knowledge. Conclusions The parents' knowledge regarding congenital umbilical or inguinal hernia was deficient. Parents with self-knowledge of the disease were likely to demonstrate better umbilical and inguinal hernia knowledge than the rest of the groups. This study highlights the importance of awareness campaigns in bridging the knowledge gap.

Strategies for prevention and treatment of vascular and nerve injuries in mandibular anterior implant surgery

Important anatomical structures such as mandibular incisive canal, tongue foramen, and mouth floor vessels may be damaged during implant surgery in the mandibular anterior region, which may lead to mouth floor hematoma, asphyxia, pain, paresthesia and other symptoms. In severe cases, this can be life-threatening. The insufficient alveolar bone space and the anatomical variation of blood vessels and nerves in the mandibular anterior region increase the risk of blood vessel and nerve injury during implant surgery. In case of vascular injury, airway control and hemostasis should be performed, and in case of nerve injury, implant removal and early medical treatment should be performed. To avoid vascular and nerve injury during implant surgery in the mandibular anterior region, it is necessary to be familiar with the anatomical structure, take cone-beam computed tomography, design properly before surgery, and use digital technology during surgery to achieve accurate implant placement. This article summarizes the anatomical structure of the mandibular anterior region, discusses the prevention strategies of vascular and nerve injuries in this region, and discusses the treatment methods after the occurrence of vascular and nerve injuries, to provide clinical reference.

Procedural Complications of Central Venous Catheter Placement in Pediatric Oncology Practice (a Clinical Case Series)

The availability of central venous access is the cornerstone of contemporary pediatric oncology and hematology. As a result, the percentage of pediatric patients receiving infusion chemotherapy who require a central line remains high. Central venous catheter insertion can be associated with procedural complications, including life-threatening ones.Aim — to investigate the potential factors leading to complications during central venous catheterization in order to develop preventive strategies.Materials and methods. The study included 1,512 original cases of patients aged 1 month to 20 years treated at the D. Rogachev National Research Medical Center between 2019 and 2022. The following 10 complications were examined: failed first venipuncture attempt, guidewire/catheter malpositioning, guidewire knotting, lifethreatening arrhythmias, guidewire entrapment in the trabecular network of the right ventricle, arterial puncture, pneumothorax, hemothorax, puncture of lung parenchyma, Horner's syndrome. In addition, four rare complications were noted, including phrenic nerve injury, cardiac tamponade, alveolar hemorrhage, and arterial pseudoaneurysm.Results. The primary cause of all complications was direct mechanical injury to anatomical structures by a needle or guidewire/catheter. When inadvertent vascular injury and bleeding occur, the resulting hematoma may lead to further damage by compressing soft tissues. Excessively deep insertion of the guidewire may cause its knotting or cardiac arrhythmias. Adequate physician training and strict adherence to procedural protocols are essential to avoid these complications.Conclusion. Central venous catheterization remains a procedure with potential complications. Although ultrasound guidance does not eliminate all risks, it increases the likelihood of successful venipuncture at the first attempt, thereby reducing complication rates. Recognizing the potential causes of procedural complications during central venous access placement, including uncommon ones, facilitates early diagnosis and appropriate medical intervention.

Maternal outcomes in pregnant women with COVID-19: impact of disease severity, timing of intervention, and SARS-CoV-2 variants

This study aimed to analyze maternal outcomes in pregnant women infected with COVID-19, focusing on the impact of disease severity, timing of medical intervention, and the effect of different SARS-CoV-2 variants. A retrospective analysis was conducted on 9,288 pregnant women diagnosed with COVID-19. Disease severity was classified as mild (30%), moderate (52%), severe (17%), and critical (2%). The study also examined the timing of medical care, with 41.6% of women seeking care within 7 days of symptom onset and 58.4% after 7 days. The average gestational age was 271.8 days, with the majority (93.8%) at full-term pregnancy. Results indicated that 88.2% of women continued their pregnancies during treatment, while 11.9% experienced pregnancy termination, including preterm deliveries and miscarriages. The study found a significant (p&lt;0.01) association between COVID-19 severity and adverse outcomes, such as preterm birth and maternal mortality. Severe and critical cases demonstrated increased risks of uteroplacental insufficiency (52.1% and 85.5%, respectively), the need for intensive respiratory support, and ICU admission. The differences in outcomes between the Delta and Omicron variants are also highlighted. The Delta variant was associated with more severe disease and higher rates of complications, including a higher need for cesarean sections, compared to the Omicron variant. The overall 30-day survival rate was 98.05%, with a noticeable drop to 43.59% in critically ill patients. This study underscores the importance of early medical intervention and continuous monitoring in managing COVID-19 in pregnant women. The findings also emphasize the need to consider the variant-specific effects of SARS-CoV-2 on maternal and neonatal outcomes, which can guide clinical decision-making and improve the prognosis for both mother and child.

Early diagnosis, effective treatment: modern approaches to the management of ectopic pregnancies

Purpose of research: The aim of this article is to provide an overview of the diagnosis and management of atypical ectopic pregnancy, with particular reference to pregnancy in the cesarean scar. The importance of early detection and medical intervention will be described, as well as the impact of advanced diagnostic techniques and modern treatments on the curability of patients.This article aims to provide valuable insights into the development of effective strategies for the diagnosis, treatment and prognosis of ectopic pregnancy. State of knowledge: Ectopic pregnancies account for 1-2% of all pregnancies, with the majority (90%) occurring in the fallopian tube. Less commonly, they present as ovarian, cervical or abdominal pregnancies. Advances in diagnosis and treatment have made it possible to identify rare forms such as cesarean scar pregnancy (0.15% of all pregnancies), interstitial pregnancy and recurrent ectopic pregnancy on tubal remnants. Techniques such as transvaginal ultrasound (TVS), MRI and laparoscopy have the potential to improve diagnostic accuracy and treatment outcomes. Modern interventions such as transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and methotrexate have shown promise in terms of safety and efficacy. Conclusions: Ectopic pregnancy and its complications have a significant impact on the psycho-physical health of patients, requiring ongoing research to improve diagnostic and therapeutic methods. Future studies should focus on long-term outcomes and the coordination of multidisciplinary medical care to further improve diagnosis and treatment.

ARTERIAL HYPERTENSION IN THE YOUNG AGE GROUP, LONGITUDINAL RESEARCH FOR THE PERIOD JANUARY 2023 - JANUARY 2024

Arterial hypertension (HAT) in young people in recent years is a frequent phenomenon and with its duration, harmful consequences may appear for their health. Uncontrolled and unbalanced HTA can cause damage to various organs of the body, including the heart, blood vessels, brain, kidneys, and eyes. Hypertension is a risk factor for the development of cardiovascular diseases (acute myocardial infarction, stroke, heart failure, etc. A large number of studies on HTA in young people have verified that it appears as a consequence of physical inactivity, adiposity, malnutrition, stress, smoking, etc. HTA can cause damage to blood vessels, including their narrowing (atherosclerosis), damage to the coronary arteries, kidney, causing kidney failure, damage to the retina (hypertensive retinopathy), etc. Therefore, early detection HTA at a young age and in the early stages and medical treatment should be the main focus of health professionals in order to prevent the aforementioned complications. Aim: To prevent the risks and diseases that have a predisposition to appear in young people from HTA and to make the youth population aware of the harmful effects that can appear from HTA. Materials and Methods: as working material, the diaries of the 18-30-year-old age group in the department of internal diseases near the Clinical Hospital of Tetovo in the period January-2023-January-2024 were used. Results: According to statistics, men were 3 times more prone to hypertension compared to women. From total age to 80% of young people (women + men) HTA manifestations were as a result of physical inactivity, stress, malnutrition, anxiety, excessive consumption of salt, adiposity, lifestyle, while close to 20% of young people express during the history taking that also influence social networks, mistrust in the circle they live in and bullying. Conclusion: in conclusion, we can propose that education about the management of HTA in young people through awareness and drug treatment can apparently affect the prevention and prevention of this frequent phenomenon and the aforementioned complications.

An Overview of Common Infectious Diseases in Children Under Five

Infectious diseases remain a significant concern for children under five, often leading to substantial morbidity and, in some cases, mortality. This review provides an overview of prevalent infectious diseases affecting this vulnerable age group, including Measles, Chickenpox, Common cold, Pertussis, Conjunctivitis, Eczema, Gastroenteritis, Influenza, Sore throat, Fever in children, Malaria, Meningococcal disease, and Urinary tract infection. Each condition is discussed in terms of its etiology, clinical presentation, diagnosis, treatment, and preventive strategies. Understanding the unique aspects of these diseases in young children is critical for effective management and prevention. Vaccination, improved hygiene practices, and early medical intervention play pivotal roles in reducing the incidence and impact of these infections. This comprehensive review aims to equip healthcare providers, caregivers, and policymakers with the knowledge needed to protect and promote the health of children under five. Key words Chickenpox, Common cold, Conjunctivitis, Eczema, Gastroenteritis, Infectious diseases, Influenza, Malaria, Measles, Meningococcal disease, Pertussis, Sore throat, Urinary tract infection.

Computed Tomography of Contemporary Occupational Lung Disease: A Pictorial Review.

Occupational lung disease remains one of the most common work-related illnesses and accounts for most deaths from occupational illness. Occupational lung diseases often have delayed manifestation over decades and nonspecific clinical presentations, making it challenging for clinicians to promptly identify the disease and implement preventive measures. Radiologists play a crucial role in identifying and diagnosing occupational lung diseases, allowing for removal of the exposure and early medical intervention. In this review, we share our clinical and radiologic approach to diagnosing occupational lung disease and its subtypes. A collection of sample cases of occupational lung diseases commonly encountered in the modern era at a large Canadian university hospital is included to facilitate understanding. This review will provide radiologists with valuable insights into recognizing and diagnosing occupational lung diseases.