History Of Medical Disease Research Articles

Medical student syndrome in Saudi Arabia; a cross-sectional study

Objective: This study aimed to investigate the prevalence of medical student syndrome (MSS) in Saudi Arabia by collecting samples from multiple universities. Methods: This was a cross-sectional questionnaire based study that included 347 medical students from multiple universities across Saudi Arabia. The questionnaire consisted of sociodemographic data and an 18-questions version of the Health Anxiety Inventory (HAI) score. Results: The study results showed that 7.5% medical students had MSS. It also showed that students aged 21 years or less had significantly higher median scores than those aged more than 21 years, according to the HAI. This study also showed that the prevalence of MSS among medical students with medical diseases was significantly higher than those without a history of medical disease. Conclusion: MSS was prevalent among medical students in Saudi Arabia. Several factors have been found to play a role in the development of the disease.

The evaluation of maternal serum glycodelin level as a marker for the presence and severity of preeclampsia

Abstract Background: Preeclampsia (PE) is a common multisystemic disorder of pregnancy. Glycodelin is a glycoprotein belongs to the lipocalin superfamily. It acts as a regulator of immunosuppression activity, fertilization, implantation, and placentation. Objectives: To analyze serum glycodelin levels in PE and evaluate whether it correlates with the severity of the disease. Materials and Methods: A prospective case–control study included 60 women diagnosed with PE (subdivided into 30 pregnant women with mild PE and 30 pregnant women with severe PE) and 30 healthy normotensive pregnant women. Patient with multiple pregnancies, gestational trophoblastic diseases, in active labor, a history of medical diseases, or taking treatment were excluded from the study. Blood samples were taken for biochemical study; serum glycodelin levels were measured using an enzyme-linked immunosorbent assay. Results: Patients with PE had significantly higher mean glycodelin levels as compared to the normal group. The glycodelin level ≥37.9 ng/mL had 96.70% sensitivity, 100% specificity, and 98% accuracy for the prediction of PE. The mean glycodelin was significantly higher in severe PE (102.3 ± 51.3) as compared to mild PE (45.2 ± 7.3) in pregnant women (P < 0.001). The glycodelin level ≥50.1 ng/mL had 86.7% sensitivity, 80% specificity, and 85% accuracy for the prediction of severe PE. Conclusions: Glycodelin is an appropriate marker for the diagnosis of PE and the categorization of disease according to severity.

Normative data of agility T-test as a measure of change of direction speed in children aged 10-11

The objective of the current study was to assess the relative agility T-test as a measure of change of direction speed and establish normative data specifically for children aged 10-11. A sample of 350 boys and 220 girls within the specified age range, with no medical history of disease, was randomly recruited from various schools. The mean and standard deviation, as well as the range of values, were determined for several variables including age, body mass, height, and BMI for both boys (n=350, age=10.83±0.38 years, body mass=34.42±5.61 kg, height=1.44±0.06 m, BMI=16.59±2.13 kg/m²) and girls (n=220, age=10.79±0.41 years, body mass=34.85±6.36 kg, height=1.44±0.07 m, BMI=16.61±2.15 kg/m²). The T-test, along with the FCMJ and 30mSS tests, were performed at least three times with a three-minute recovery period between trials and a five-minute recovery period between tests. Test-retest reliability of the T-test was evaluated using the intraclass correlation coefficient (ICC), which yielded values of 0.95 for girls and 0.97 for boys. Significant correlations were observed between the T-test and FCMJ as well as the 30mSS for girls (r=-0.384, p<0.0001 and r=0.416, p<0.0001, respectively) and for boys (r=-0.344, p<0.0001 and r=0.440, p<0.0001, respectively). The study provides percentile values that can be utilized to monitor the physical fitness levels of both girls and boys.

Evaluation of Maternal Serum Homocysteine in Pre eclampsia

Background: Pre-eclampsia affects about 2–8% of all pregnancies. It is one of the leading causes of maternal and perinatal morbidity and mortality hyperhomocysteinemia is considered as a risk factor for endothelial dysfunction and vascular disease. The vascular changes induced by homocysteine are similar to those with pre-eclampsia. The aim of the study is to identify the relationship between maternal serum homocysteine level and the development of pre-eclampsia.Method and patient: A case control study that was carried out in the Department of Obstetrics and Gynecology at Azadi Teaching Hospital in Kirkuk-Iraq, during the period of eight months from 1st of Feb. till 1st of October 2021. It included 80 pregnant women with singleton viable pregnancy, gestational age of > 20 weeks. They were divided into two groups: Case group included 40 pregnant women who had diagnosed as pre eclampsia (mild and severe) and control group included 40 healthy normotensive pregnant women. Patients with multiple pregnancy, history of medical disease or tacking treatment for hypertension were excluded from the study. Blood sample was taken from each woman for biochemical study, serum homocysteine level was measured using ELISA technique.Result: In this study, pregnant women with pre-eclampsia had significantly higher mean of serum homocysteine compared with controls. Homocysteine level > 8.95 μmol/l is a predictor for pre-eclampsia. Out of 40 women with pre-eclampsia, 42.5% were mild, while the remaining 57.5% were severe. Pregnant women with severe pre eclampsia had significantly higher mean of serum homocysteine compared to those with mild pre-eclampsia. The level of tested biomarkers and homocysteine was tested between the two study groups to assess their rule in pre eclampsia.Conclusions: Maternal serum homocysteine biomarker represents an early non-invasive marker for diagnosis of pre eclampsia and to name the disease according to the severity.

Testosterone Level and Risk of Diabetes: Follow-Up Study

Background: Epidemiological studies have documented an inverse relationship between testosterone levels and risk of cardiovascular disease. The present study aimed to explore the association between testosterone levels and risk of developing diabetes mellitus from 108 middle-aged men with no history of medical diseases. Methods: Data regarding the age of subjects, smoking, alcohol consumption, waist-to-hip ratio, and family history of cardiovascular disease were collected at the time of inclusion. Testosterone levels were also measured. 15 years later the medical history of the men was reviewed to record the development of medical incidents with references to diabetes mellitus. Two groups of men were identified based on testosterone levels: hypogonadal (testosterone ≤12 nmol/L) and eugonadal (testosterone >12 nmol/L). Results: In total, 10 (9.0%) out of 108 men developed diabetes during the 15-year follow-up period, of whom 6 (16%) out of 37 and 4 (6%) out of 71 were men in the hypogonadal and eugonadal cohorts respectively (p=0.08). Using Cox proportional hazards regression analysis, the adjusted risk for diabetes was significantly lower in eugonadal men compared to hypogonadal men (adjusted hazard ratio=0.236; 95% CI=0.062–0.898; P=0.03). Conclusion: Our results showed a significant increased risk of diabetes in men with low testosterone levels compared to men with normal testosterone.

COVID-19 Pandemisinin Çocuk Hastaların Diş Fırçalama Alışkanlıkları Üzerine Etkisi: Kesitsel Çalışma

Objective: Children's tooth brushing habits might have been affected by various factors such as social isolation, restrictions, and homeschooling due to the coronavirus disease-2019 (COVID-19) outbreak. The recent study aimed to determine whether there was a change in the brushing habits of a sample of pediatric patients during the COVID-19 pandemic compared to the pre-pandemic period. Material and Methods: This cross-sectional study was held on the patients referred to the Gülhane Faculty of Dental Medicine. The patients aged 3-15 years and homeschooling since March 2020 up to questionnaire time (March 2021) were included in the study. The exclusion criteria were having a systemic disease in medical history and attending face-to-face education. Informed consent was obtained, and eight questions, including demographic features of parents/children and daily brushing habits, were directed to the participants. Results: The total number of participants was determined as 203. The mean age of the participants was 9.4±3 (years), and 53% of them were girls, and 47% of them were boys. Participants declared that they 'rarely' brushed (31%) in the morning and 'every time' (31%) at night before the pandemic. Individuals' brushing frequency was also mentioned as 'rarely' (27%) in the morning and 'every time' (33%) at night during the pandemic. Regarding the answers, no difference was detected between pandemic and pre-pandemic brushing frequencies of participants (p>0.05). The most mentioned answers were detected as 'rarely-in the morning' and 'everytime-at night' for whole periods. Conclusion: This study revealed that the childrens' brushing frequencies have not been affected by COVID-19 pandemic period.

Incidence of Preterm Infants, Indications of Admission, Risk Factors, and Discharge Outcome: A Retrospective Study

Background: Prematurity is still a major cause of neonatal and infant mortality and morbidity. Aim: This study aimed to describe the incidence of preterm infants, indications of admission, risk factors, and discharge outcome. Materials and Methods: A retrospective, descriptive design was used. A sample of 692 preterm infants admitted to the Neonatal Intensive Care Unit (NICU) was included. A structured sheet was used to gather the necessary data. It involved two parts: characteristics of preterm infants and their mothers and risk factors concerning preterm birth. Results: The study found that 49.4% of admitted neonates were preterm; among them, 48.1% died on discharge. Moreover, there were significant relations between the type of gestation (p=0.000), mothers' age (p=0.001), anemia, pregnancy-induced hypertension, preeclampsia, antepartum hemorrhage, premature rupture of membranes, obstructed labor, family history of medical diseases, and mothers' history of medical diseases with preterm infants' gestational age (p=0.01, 0.001, 0.02, 0.01, 0.000, 0.000, 0.000, 0.000, respectively). Moreover, it was observed that higher admission of preterm infants who had respiratory problems, followed by gastrointestinal problems. Conclusion: There was a higher prevalence with a higher mortality rate of admitted preterm infants to NICU. Likewise, the type of gestation, mothers' age, presence of complications during pregnancy, bad obstetric history, and family and medical history of diseases were the most common risk factors of prematurity. Moreover, respiratory problems were the main etiology for admission of preterm infants to NICU. Therefore, early screening of diseases and obstetric complications during pregnancy is recommended. Implications for Nursing Practice: Providing educational programs for pediatric nurses will increase their level of awareness regarding incidence, indications, risk factors, and discharge outcome of prematurity, thus reducing the rate of mortality and morbidity among preterm infants.

A comparative study: quality of life, self-competence, and self-liking among the caregivers of children with attention deficit hyperactivity disorder and other non-ADHD children

BackgroundThe presence of attention deficit hyperactive disorder (ADHD) causes great impairment in social and professional activities as well as in the quality of life (QOL) and increases level of parental stress.ObjectiveThis study aimed to compare the QOL, self-competence, and self-liking among the caregivers of ADHD and non-ADHD children.MethodA descriptive cross-sectional study was conducted on 216 caregivers. They were divided into two groups: caregivers of children with ADHD and caregivers of children without ADHD.SettingThis study was conducted in the Elsinbellawin City at Dakahlia Governorate in Egypt. Tools used were socio-demographic data sheet and WHO Quality of Life Scale-Brief (WHOQOL-Brief) and self-liking/self-competence scale.ResultsOur results showed that all QOL dimensions of the caregivers of ADHD children were markedly deteriorated, if compared to those of non-ADHD children, and two thirds of caregivers of ADHD children suffered from poor level quality of life (QOL). Caregivers of non-ADHD children had fair level of self-competence but a good level of self-liking. Caregiver of ADHD children who had no work or history of medical diseases has a fair level of QOL and self-competence but a good level of self-liking.ConclusionsWe found that caregivers of ADHD children have fair levels of QOL, self-liking, and self-competence, if compared to those of non-ADHD children. There are statistically significant correlations between QOL, self-competence, and self-liking among both caregivers of both non-ADHD children and ADHD children.

Surgical treatment of vascular ring resulting in the formation of left aortic arch

Highlights. The described clinical case of surgical treatment of congenital anomaly of the aortic arch is of high interest to specialists due to the relatively late manifestation of symptoms, low incidence of the anomaly, prior surgical treatment of congenital heart disease in medical history, and characteristics of surgical intervention.Background. The described clinical case reports successful treatment of vascular ring formed by right aortic arch with aberrant left subclavian artery. The described clinical case of surgical treatment of congenital anomaly of the aortic arch is of high interest to specialists due to the relatively late manifestation of symptoms, low incidence of the anomaly in the population, prior surgical treatment of congenital heart disease in medical history, and the outcome of surgical treatment - newly formed left aortic arch.

Клинико-лабораторные маркеры тяжести течения новой коронавирусной инфекции (COVID–19)

The aim of the research. To study clinical and laboratory features of the new coronavirus infection (COVID-19) in order to develop a model that would allow, taking the publicly available research methods into account, to carry out early diagnosis of severe community-acquired pneumonia against the background of the new coronavirus infection. Material and methods. A total of 82 COVID-19 patients who complied with inclusion and exclusion criteria were enrolled. Depending on the clinical severity, three study groups were formed: group 1 included 13 patients with uncomplicated COVID-19, group 2 consisted of 39 patients with non-severe forms of pneumonia that developed against COVID-19 and group 3 was comprised of 30 patients with COVID-19 complicated by severe pneumonia. The groups were comparable in age and gender. All patients underwent general clinical examination, laboratory tests, including general and biochemical blood analysis, as well as chest computed tomography. Results. The clinical picture in COVID-19 patients differed depending on the disease severity. Coughing and shortness of breath were more often observed in patients with severe pneumonia; sore throat, on the contrary, was more often noted in patients with uncomplicated COVID-19. On admission to the inpatient facility, patients with severe pneumonia had higher body temperature and respiratory rate, with simultaneous decrease in blood oxygen saturation. One half of the patients with severe pneumonia had hypertensive disease in medical history, and one third had ischaemic heart disease. As a rule, uncomplicated COVID-19 patients did not have ischaemic heart disease. It was found through laboratory analysis of blood that groups of patients significantly differed in the levels of neutrophils, lymphocytes, monocytes, basophils and eosinophils. Conclusion. The use of such clinical and laboratory data as acute respiratory failure, fever, the levels of neutrophils, monocytes, lymphocytes, eosinophils and basophils makes it possible to identify patients with more severe pneumonia against the background of COVID-19 even before chest computed tomography.

К вопросу оценки сердечно-сосудистого риска у больных первичной хронической подагрой в сочетании с метаболическим синдромом

Цель исследования: изучить частоту метаболического синдрома (МС) и оценить суммарный сердечно­сосудистый риск у больных с первичной хронической подагрой в зависимости от наличия МС. Материалы и методы. Обследованы 82 больных с первичной хронической подагрой, диагностированной с учетом квалификационных критериев S.І. Wallаsе и соавт. В основную группу вошли больные подагрой с МС (n = 52), которые составили 63,4 % всех обследованных. МС диагностировали по критериям IDF. Группу сравнения составили больные МС, репрезентативные по полу и возрасту (n = 46). Проведено клиническое (антропометрические параметры, артериальное давление) и лабораторное обследование (уровень гликемии натощак, мочевой кислоты, липидограмма, пероральный тест толерантности к глюкозе), учтено наличие в анамнезе сердечно­сосудистых заболеваний и их осложнений, оценен сердечно­сосудистый риск по шкалам SCORE и PROCAM. Результаты. Частота ожирения в исследуемых группах составила 65,4 и 63,0 % соответственно. Частота дополнительных критериев МС была высокой в обеих исследуемых группах. Артериальная гипертензия и гипертриглицеридемия одинаково часто диагностировались у больных с МС независимо от наличия подагрического артрита (р < 0,001). Как минимум один дополнительный критерий МС выявлялся у всех обследуемых. У 28,8 % больных основной группы и у 4,3 % пациентов группы сравнения диагностированы все пять дополнительных критериев МС (р < 0,01). У больных основной группы чаще, чем в группе сравнения, выявляли более трех дополнительных критериев МС — 51,9 и 30,4% соответственно (р < 0,01). Суммарный сердечно­сосудистый риск по шкалам SCORE и PROCAM у больных основной группы был значимо выше, чем в группе сравнения (р < 0,05 и р < 0,01 соответственно). Выводы. МС диагностировали у 63,4 % больных с первичной хронической подагрой. Больные с первичной хронической подагрой в сочетании с МС имеют более высокий суммарный сердечно­сосудистый риск по шкалам SCORE и PROCAM в сравнении с больными с МС. Оценка критериев МС наряду с оценкой сердечно­сосудистого риска может быть использована в рутинной клинической практике для стратификации больных с первичной хронической подагрой, нуждающихся в модификации образа жизни и/или дифференцированных подходах к медикаментозному лечению.

A prediction model of low back pain risk: a population based cohort study in Korea.

BackgroundWell-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence.MethodsA population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service–National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models.ResultsDuring median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell’s C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence.ConclusionsLBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

Sociodemographic Variables and History of Trauma and Disease Influence Consciousness after Hypnotic Induction

Over the last 30 years, several neuroimaging and neurophysiological experiments have lent support to the neuropsychology of consciousness, and several definitions have followed to describe it. The phenomenological perspective of consciousness facilitates the description of the individual’s awareness experience of internal states (e.g., perception, sensations, emotion, volition, or memories), thus helping us to better understand the relationship between the brain and mind. Although significant research has been aimed at evaluating the neurobiological aspects underlying the phenomenon of consciousness, there is a lack of information regarding the effect of clinical and sociodemographic factors on the modification of the altered state of consciousness in hypnosis. Therefore, the main objective of this study was to investigate how the variables of demographic and clinical history affected the alteration of consciousness during hypnotic induction. Consciousness was investigated within a single session using the PCI (Phenomenology of Consciousness Inventory) Italian translation, during the administration of the hypnotic susceptibility scale HGSHS:A (Harvard Group Scale of Hypnotic Susceptibility, Form A) Italian translation. Three hundred and forty-nine subjects from the general population (aged 19–72 years; 112 male and 237 female) were investigated in a single session. Twenty-six subjects (7.4%) reported a history of recent psychological trauma, 6.6% reported a history of substance misuse, 7.7% had a history of psychiatric disorder, and 9.7% had a history of medical disease. Age was observed to be a negative predictor of hypnoidal state, intended to be a general measure of trance (β=–0.12; p=0.01). However, age also contributed to changing the phenomenology of consciousness, predicting greater vividness of imagery, reduction in time sense, fear, arousal, anger, negative affect, and perception. Females were more hypnotizable than males (β=0.18; p=0.000), with a reduced memory of suggestions, and an increase in the altered state. Subjects with perceived psychological trauma were more prone to have reduced memory of suggestions (β=0.14; p=0.01). A hypnotic state is the result of a combination of several individual predisposing traits and variables that are contextual to a specific situation. Age, gender, and perceived psychological trauma play a critical role in the hypnotic state, making the experience more subjective and influencing the quality of sensation, emotion, volition, and thought (consciousness phenomenology), which are fundamental for an appropriate response to suggestions.

Complications after the percutaneous release of trigger thumb in adults

Aim: Trigger finger is a common orthopedic problem causing pain and could restrsict daily activities. Surgical intervention can be done via open or percutaneously. There is not much data about minor complications in literature. In this study, we reported our results and complications of percutaneous release (PR) of trigger thumb.Material and Methods: Retrospective data of patients treated for trigger thumb with PR between September 2017 and January 2019 were reviewed. Age, gender, affected side, preoperative Quinnell grade of triggering; previous history of steroid injection and history of medical diseases (e.g. diabetes mellitus, rheumatoid arthritis) were recorded.Results: Thirty thumb of 28 patients who met the inclusion criteria treated with PR for trigger thumb included in the study. Mean age of patients was 53.7 ±9.95 months (range 36-73). Twenty (71%) of patients were female, 8 (29%) were male. Right hand was dominant side in all patients. Right thumb was affected in 18 (64%) patients, left thumb in 8 (29%) and 2 (7%) were bilateral. Due to Quinnell grading system 9 (32%) patients were grade 2 and 19 (68%) were grade 3. Twenty (71%) of patients had previous history of steroid injection. There were 5 complications in our patients. One recurrence of triggering and 4 ecchymosis and edema have been reported.Conclusion: Percutaneous release of trigger thumb is safe and reliable technique with low complication rate. To prevent complication surgeon should be careful during the procedure and should well inform patient what to do after procedure.

A prediction model of Nephrolithiasis Risk: A population-based cohort study in Korea.

PurposeWell-validated risk prediction models help to stratify individuals on the basis of their disease risks and to guide health care professionals in decision-making. The incidence of nephrolithiasis has been increasing in Korea. Racial differences in the distribution of and risk for nephrolithiasis have been reported in Asia but no population-specific nephrolithiasis models have been developed. We aimed to develop a simplified nephrolithiasis prediction model for the Korean population by using data from general medical practice.Materials and MethodsThis was a prospective, population-based cohort study in Korea. A total of 497,701 participants from the National Health Insurance Service–National Sample Cohort (NHIS-NSC) were enrolled from 2002 to 2010. A Cox proportional hazards model was used.ResultsDuring a median follow-up time of 8.5 years (range, 2.0–8.9 years) and among 497,701 participants, there were 15,783 cases (3.2%) of nephrolithiasis. The parsimonious model included age, sex, income grade, alcohol consumption, body mass index, total cholesterol, fasting blood glucose, and medical history of diseases. The Harrell's C-statistic was 0.806 (95% confidence interval [CI], 0.790–0.821) and 0.805 (95% CI, 0.782–0.827) in the derivation and validation cohorts, respectively.ConclusionsThe results of the present study imply that nephrolithiasis risk can be predicted by use of data from general medical practice and based on predictors that clinicians and individuals from the general population are likely to know. This model comprises modifiable risk factors and can be used to identify those at higher risk who can modify their lifestyle to lower their risk for nephrolithiasis. This study also offers an opportunity for external validation or updating of the model through the incorporation of other risk predictors in other settings.

The influence of pelvicalyceal system anatomy on minimally invasive treatments of patients with renal calculi

Nephrolithiasis has a multifactorial etiology, wherein, besides metabolic factors, the anatomy of the pelvicalyceal system might play a role. Using 3D-reconstructions of CT-urography (CT-U), we studied the morphometric properties of pelvicalyceal anatomy affecting kidney stone formation and compared those with existing literature on their effect on minimally invasive treatment techniques for renal calculi. CT-U's were made between 01-01-2017 and 30-09-2018. Patients were chronologically included in two groups: a nephrolithiasis group when ≥ 1 calculus was present on the CT-U and a control group of patients with both the absence of calculi on the CT-U and no medical history of urolithiasis. Patients with a medical history of diseases leading to higher risks on urolithiasis were excluded. In the nephrolithiasis group affected kidneys were measured. In the control group, left and right kidneys were alternately measured. Twenty kidneys were measured in both groups. Mean calyceopelvic tract width was significantly larger in the lower segments of affected kidneys (3.9 vs. 2.7mm). No significant differences between the groups were found in number of calyces, infundibular length, infundibular width, calyceopelvic angle, upper-lower angle and diameters of the pelvis. Transversal calyceal orientation in hours was significantly smaller in the upper and lower segments of the nephrolithiasis group (7.69 vs. 8.52 and 8.08 vs. 9.09h), corresponding with more dorsally located calyces in stone-forming kidneys. Pelvicalyceal anatomy differs between stone-forming and non-stone-forming kidneys. Understanding the pelvicalyceal system and etiology of stone formation can improve development of endourological techniques.

Hospitalized Patients with Medically Unexplained Physical Symptoms: Clinical Context and Economic Costs of Healthcare Management.

Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475′409.73 €. The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.

A Comparative Study between the Efficacy of Ritodrine Hydrochloride Versus Nitroglycerin Patch as a Short Term Tocolysis

AbstractBackground: Preterm birth continues to be a problem for obstetricians. Preterm birth complicates 8-10% of birth. Although the causes of preterm labour are not well understood, the burden of preterm birth is clear. The majority of neonatal deaths and over one third of infant deaths are linked to preterm birth. Methods to detect preterm labour at early stage include ultrasound examination of cervix and detection of biochemical markers of preterm labour in blood, saliva and cervicovaginal secretion. Given the methods to predict and prevent preterm birth are imperfect, attention focuses on the treatment of women admitted with preterm labour.Aim of the Work: The aim of the study to compare the safety and efficacy of transdermal nitroglycerine patch versus ritodrine hydrochloride in treatment preterm labour.Patients and Methods: This retrospective study was in-cluded 50 cases of threatened preterm labour attending the Obstetrics and Gynecology Department of Tanta University Hospital who were involved in this study. Woman were randomly divided in this retrospective study into two groups: Group 1: Included twenty five (25) patient, they received B-sympathomimetc ritodrine (yutopar). Ritodrine was giving in dose of: 150mg in 500ml saline infusion starting dose is 0.05mg/min this to be increased 0.05mg/min every 10-15 minutes (1ml contain 0.3mg and 1ml about 16 drops so 0.05mg about 3 drops) until a dose that provide tocolytic effect is reached or maternal tachycardia above 130 beats/minute occur. Group 2: Included twenty five (25) patients treated with 10mg nitrodermal patch directly applied on the abdominal skin.Inclusion Criteria: Pregnant woman in the age of 20-35 years, gestational age between 28-34 weeks, body mass index (25-30), singleton pregnancy, uterine contraction 2 per 10 minutes or 4 per 20 minutes, cervical dilatation 3 centimeters, effacement up to 80%, intact membranes and primigravida or multigravida.Exclusion Criteria: Fetal Fetal congenital anomalies, fetal growth restriction and fetal distress. Maternal Medical problems: Chronic hypertension, chronic renal disease, cardiac disease, diabetes mellitus, contraindi-cation to beta agonists, non-steroidal anti-inflammatory drugs and other tocolytics, cigarette smoker, anemia (HB less than 10mg/dl), thyroid disorders, maternal tachycardia .Obstetric problems: Preeclampsia, polyhydraminos and oligohydrami-nos, ante-partum hemorrhage and rupture of membranes and Chorioamnionitis. All patients were subjected to thorough history taking with special emphasis on gestational age (in weeks), history of medical disease) and clinical examination regarding blood pressure and body mass index. Obstetrical abdominal ultrasound was done for gestational age (BPD, AC, FL), amniotic fluid, viability. Routine investigations as fasting blood sugar blood group and Rh factor, blood urea, creatinine, haemoglobin concentration and analysis of urine albumin, sugar, microscopy, culture and sensitivity.Results: Equal percentage in cases which delivered in the same day and not responding to the drugs only 2 cases in each group present 8.0%. In the next day 3 cases delivered in group 1 present 12.0% and 1 case in group 2 present 4.0%. The delivery in the first 48 hours present failure rate of the drug, in our study the failure rate was 20% in group 1 and 12% in group 2. Labour by 7 day occur in 2 cases in each group presenting 8.0% in each group. Labour by 14 day occurred in 2 cases in group 1 and 1 case in group 2 presenting 8% and 4% respectively. Labour at 32 week occurred in 3 cases in group 1 and 2 cases in group 2 presenting 12% and 8% respectively. Labour at 34 week occurred in 4 cases in each group presenting 16% to each group. Labour at 37 week occurred in 6 cases in group 1 and 8 cases in group 2 presenting 24% and 32% respectively. Labour by 32 week occurred in 6 cases in group 1 and 2 cases in group 2 presenting 24 and 8 respectively. Labour by 34 week occurred in 2 cases in group 1 and 3 cases in group 2 presenting 8% and 12% respectively. Labour by 37 week occurred in 4 cases in group 1 and 6 cases in group 2 presenting 16% and 24%.Conclusion: Both glyceryltrinitrate and ritodrine were comparable in prolongation of gestation in patients in preterm labour, both in duration and in terms of success. The advantages of glyceryltrinitrate patch over ritodrine are lesser side effects and simplicity of administration and it also allows the patient to remain ambulatory.

Positive Effects of a Short-Term Intense Elastic Resistance Training Program on Body Composition and Physical Functioning in Overweight Older Women.

This study was a randomized controlled trial with pre- and postintervention measures. Participants included OOW, aged 60-85 years, with no medical history of disease that would preclude them from engaging in physical exercise. Participants were randomly divided into the following groups: elastic tubes with handles group (ETG; n = 22), traditional elastic bands group ( n = 21), and control group (CG; n = 20). Exercise groups (EGs) performed the following supervised RTP: 8 weeks, twice weekly, six overall body exercises, and 3-4 sets of 10 repetitions at a rate of perceived exertion (RPE) of 7-9 on the OMNI-Resistance Exercise Scale of perceived exertion. The controls did not change their usual lifestyle. Outcome measures included body composition (BC; total and regional percentage of fat mass [FM] and fat-free mass [FFM]) and physical performance (PP; dynamic and isometric strength, flexibility, agility/dynamic balance, and endurance). Both EGs exhibited significantly reduced FM in the upper limbs (ULs) and trunk and increased FFM in the UL, while the ETG exhibited a significantly increased trunk FFM. Both EGs improved in PP, and there were no intergroup differences. Trunk FM and FFM and meters walked differed significantly between the ETG and CG. The CG did not exhibit any significant changes. Training with elastic devices at a moderate-high RPE produces short-term improvements in BC and PP in OOW.

Abstract 190: Improvements In Door To Needle Time Among Acute Ischemic Stroke Patients, 2008-2016

Introduction: The clinical benefit of intravenous thrombolysis (IV tPA) in acute ischemic stroke (AIS) is time dependent. Achieving a door-to-needle time (DTN) ≤60 minutes for IV tPA is a quality care measure endorsed by the National Quality Forum. Methods: A total of 433,410 AIS admissions from 520 participated hospitals were identified in the Paul Coverdell National Acute Stroke Program (PCNASP) from 2008-2016. We assessed the overall temporal changes in DTN time and examined the factors associated with DTN ≤60 minutes by performing generalized estimating equations (GEE) modeling. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were obtained. Results: There were total of 33,456 (8%) patients who received IV tPA (transfers excluded) with available door to needle times. The percentage of AIS patients who received IV tPA increased from 4.8% in 2008 to 9.8% in 2016, and significant increases were also observed among those with DTN ≤45 minutes (11.6% in 2008 to 35.1% in 2016, p<0.001), as well as with DTN ≤60 minutes (26.9% in 2008 to 60.5% in 2016, p<0.001) (Table). Patients aged 55-84 years were more likely to receive IV tPA within 60 minutes as compared to those aged 18-54. Arrival by EMS was a significant factor associated with DTN ≤60 minutes (AOR: 1.84, 95%CI: 1.74-1.95). Conversely, women, black patients as compared to white, patients with mild stroke (NIHSS score 0-4) as compared to ≥25, and patients with medical history of diseases associated with stroke were less likely to achieve DTN ≤60 minutes. Conclusion: Rapid improvements on DTN time were observed in PCNASP. Opportunities for quality improvements within these disparities should be further examined.