Percentage Of Cases Research Articles

Neuroleptic Malignant Syndrome: Typical Antipsychotic Drugs Versus Atypical Antipsychotic Medications

Introduction: Neuroleptic malignant syndrome is an idiosyncratic reaction and a severe disorder caused by an adverse reaction to drugs with dopamine receptor- antagonist properties and is characterized by a tetrad of rigidity, fever, altered mental status, and autonomic instability. In the present assessment, typical or conventional antipsychotics have been contrasted with atypical antipsychotics with respect to recorded cases of neuroleptic malignant syndrome among a sample of nonwestern psychiatric inpatients. Methods: For assessment, all the cases with a diagnosis of neuroleptic malignant syndrome during the last sixty-two months, after exclusion of other conceivable differential diagnoses, were incorporated in the current retrospective, record-based evaluation. The clinical diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. The valuation of independent variables was analyzed by ‘Compression of proportions. Statistical significance is defined as p value ≤0.05. Results: Amongst 19814 psychiatric inpatients, in the course of sixty-two months, eighteen cases received the diagnosis of neuroleptic malignant syndrome. As said by the findings, neuroleptic malignant syndrome was meaningfully more frequent among males, in comparison with females, and it was importantly more prevalent among cases suffering from schizophrenia, in comparison with bipolar disorder. Also, the highest risk of neuroleptic malignant syndrome was found in the age group of 30-39. In the current assessment, only one of the patients, who had received haloperidol, died due to aspiration pneumonia and respiratory failure, and the most prevalent symptom was fever, which was observable in one hundred percent of cases. In addition to a similar clinical profile, ‘Compression of proportions’ did not show any significant difference between the conventional (typical) antipsychotics versus the atypical antipsychotic medications with respect to the occurrence of neuroleptic malignant syndrome. Conclusion: As said by the findings, no significant difference was evident between the typical antipsychotic drugs versus the atypical antipsychotic medications, with respect to incidence and clinical profile of neuroleptic malignant syndrome.

Telephone medical consultation during the COVID-19 pandemic in Mexico.

e18564 Background: Telephone consultation has emerged as an alternative method for outpatient medical follow-up during the COVID-19 pandemic, reinforcing the necessary distancing measures. However, there are multiple factors that the medical team must contend with, which could limit the monitoring of patients. Methods: We retrospectively analyzed the remote medical consultation database of a university-based oncology referral center in northeast Mexico. The telephone calls were made from the medical center by specialized health personnel. The data obtained correspond to the monitoring conducted over six months. Results: We included 1,140 patients in the analysis, of which 79% were women and 21% were men; the median age was 55 years. All individuals had a pathology-confirmed diagnosis of cancer. The main oncological diagnoses were breast, cervix, and prostate cancer which corresponded to 46, 13, and 7% of the cases, respectively. Ninety-four percent of cases corresponded to cancer surveillance, while the remaining 6% were receiving active oncological treatment, administered orally. Ninety-three percent of the patients were from the city of Monterrey and its metropolitan area, 6% came from the rest of the municipalities of the state of Nuevo Leon, and 1% were from other states of the Mexican Republic. Ninety-eight percent of the patients had a public health insurance as a method of coverage for health services, while 2% received care through private health insurance. At remote follow-up, only 53% of the patients responded to the telephone calls, none of them reported a diagnosis or any symptom of SARS-CoV-2 infection. Among the 536 patients who had a telephone communication failure, 68% did not respond to the call after 4 attempts, while in 32% of these cases the number provided by the patient was incorrect or non-existent. Conclusions: The high rates of failure to establish telephone communication documented in our population of patients with cancer is a worrying phenomenon. As the COVID-19 pandemic progresses worldwide, we must seek to establish measures to optimize logistics for more effective remote communication, to achieve the best possible outcomes.

Dementia Disease Prediction By Using Internet of Things and Nodejs

Abstract: Dementia is not a single disease; it’s an overall term like heart disease that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behaviour, feelings and relationships. Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. In order to overcome this problems and provide proper treatment to theelder people our project aims at developing an application for elderly age people dementia prediction where I can lively monitor the blood glucose, blood pressure, blood oxidation level which is measured using the sensors and if the condition is abnormal the SMS API will send a message to a mobile phone of the care taker or the old age home in-charge. The web application developed in this project displays the three parameters to the user on a computer that can be lively monitored using IoT. An efficient real time microcontroller is used to process the information and a Wi-Fi gateway is used to transmit the data wirelessly. Thus this project helps in taking care of the elder people at the right time and avoid difficulties. Keywords: MQTT protocol, Publishing, Subscribing, Web application module.

Provider directory accuracy and timely access to mammograms in California

ABSTRACT Provider directory accuracy and access to timely appointments are crucial determinants of health outcomes. However, to our knowledge, no studies have analyzed provider directory accuracies or network adequacy for mammograms, an important preventive service. We fill that gap using large-scale, random, and representative surveys of provider directories and timely access for all managed care plans in California for mammogram providers, obtained from the Department of Managed Health Care for 2018 and 2019 for commercial, ACA marketplace, and Medicaid plans with more than 33,000 observations. Directory inaccuracies ranged from a low of 23 percent to a high of 38 percent. Consumers were able to schedule appointments with specific providers within 15 days in between 59 percent to 73 percent of cases. Comparisons of accuracy and adequacy between the three markets (commercial, ACA, Medicaid) were inconsistent. Even with one of the nation’s strictest and most well-resourced regulatory regimes for provider networks, our findings show substantial inaccuracies and inadequacies exist.

Evaluation of Ab externo subretinal bands removal during pars plana vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

BackgroundTo compare the safety and efficacy of Ab-externo subretinal bands removal in comparison with the classical Ab-interno approach during pars plana vitrectomy for primary rhegmatogenous retinal detachment.MethodsSubjects aged 28–62 years with primary RRD complicated by proliferative vitreoretinopathy (PVR) with subretinal bands interfering with retinal flattening were treated by pars plana vitrectomy (PPV) and silicone oil injection. Subretinal bands were removed using the classical AB interno approach through one or more retinotomies in ten patients (group A) and using AB externo approach in twenty cases (group B). Post-operative follow-up visits occurred at 1 day, 1 week, 1 month, and 3 months, after surgery. The main outcomes were assessment of subretinal bands removal efficacy, documentation of complications, anatomical reattachment rate, and postoperative best-corrected visual acuity (BCVA).ResultsThere was no statistically significant difference between both groups regarding patients’ age, gender, lens status, and the onset of retinal detachment. Seventy percent of both groups presented with inferior retinal detachment while ten percent presented with temporal detachments and twenty percent had a total retinal detachment. Both groups had a statistically significant improvement in postoperative visual acuity in comparison with preoperative visual acuity (P = 0.005 for group A and P = < 0.001 for group B). There was no statistically significant difference between both groups regarding preoperative (P = 0.928) and postoperative (P = 0.185) visual acuity. A higher incidence of complications was reported in group A (40%) in comparison with group B (30%) but this difference was not statistically significant (P = 0.69). More Epimacular membranes were seen postoperatively in group A (30%) in comparison with group B (20%) but again this difference was not statistically significant (P = 0.657). Subretinal hemorrhage was seen in ten percent of cases in both groups. Intraocular pressure was measured in every follow-up of all patients in both groups, no statistically significant difference was found between both groups.ConclusionsBoth techniques are effective and safe to remove subretinal bands with similar outcomes.

Factors associated with poor glycemic control in diabetic patients in Kirkuk

Background Iraq's health-care system has faced tremendous obstacles in its recovery from the Islamic State's conflict. There is no public insurance system in place. Iraq has set targets to prevent and control noncommunicable diseases (NCDs) such as diabetes, but safety confrontation and governmental insecurity have made these objectives difficult to achieve. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications. The goal is to identify the roadblocks to better glycemic management. The participants in this cross-sectional study were recruited from a diabetes out-patient clinic at Baba Gurgur diabetic facility. From April to December 2019, K1 hospital – North oil company in Kirkuk city. A validated questionnaire was used to interview those with an uncontrolled glycemic index (AIC7%). Patients were asked to name the primary causes of inadequate glucose control and to select more than one response based on their opinion. The mean A1C was 8.3 2.1 percent, with 256 (22.5 percent) patients having an A1C less than 7% and 880 (77.5 percent) having an A1C equal to or greater than 7. Poor glycemic control is caused by a lack of medication and/or a lack of drug supply from PHC in 51.1 percent of cases. Diet and medication non-compliance, as well as illiteracy, account for 35.1 percent and 19.8 percent of the population, respectively. Glycemic regulation is greatly influenced by one's financial situation. However, security issues and political instability play a significant impact. Conclusion: Diabetic patients confirmed poor glycemic control, with the majority of cases being linked to Iraq's current health situation.

ENDOMETRIAL TUBERCULOSIS REVEALED BY POST-MENOPAUSAL METRORRHAGIA REPORT CASE

Because genital tuberculosis is frequently asymptomatic, the disease may not manifest itself for years after the initial infection. Clinical symptoms usually appear 10 to 15 years after the initial infection. We report a case of 47 years old women with a history of right breast cancer who was suffering from post menauposicmetrorrhagia, ultrasound revealed thickening of the endometrium, and the biopsy revealed endometrial tuberculosis, Genital tuberculosis is uncommon in postmenopausal women and accounts for 1% of postmenopausal metrorrhagia. In 60-70 percent of cases, the endometrium is affected. It is difficult to explain the diseases low prevalence in this age group. The majority of authors believe that the endometrial atrophy and decreased vascularity associated with this hypoestrogenic phase provide an unfavorable environment for Mycobacterium growth. The standard treatment regimen is currently well codified and is based on daily administration of Isoniazid and Rifampicin for 6 months, followed by Pyrazinamide and Ethambutol for the first 2 months. Throughout the treatment, clinical and paraclinical monitoring is performed on a regular basis.

Efektivitas Penggunaan Website GEKA.id dalam Peningkatan Pengetahuan tentang Pencegahan Seks Bebas Bagi Remaja pada “PIK-R Klorofil” di Kabupaten Kampar

The GEKA.id website is an educational website for the prevention of free sex for teenagers, in Kampar Regency. Data in 2020 there are 6,797 AIDS cases in Riau Province, 82 of them are in Kampar Regency, where the cause is 2240 cases due to free sex and 2 percent of cases are teenagers aged 15-19 years. On the other hand, technological advances, various information can be obtained easily. Without guidance and education, teenagers can be plunged into misery free sex. The GEKA.id website is part of the GEKA.id Program implemented with partners, namely the School-level Information and Counseling Center (PIK-R). The purpose of this study was to analyze the effectiveness of using the GEKA.id website in increasing knowledge about the preventing free sex for youth. The method used is an evaluative research method, which is a design or procedure in collecting and analyzing data systematically to determine the success and benefits of a program. The results achieved in the GEKA.id Program are the development of a website with various features, and is equipped with a web usage manual and educational programs. The GEKA.id website has been proven to be effective in increasing adolescent knowledge about the prevention of free sex, and is rated very good based on a user satisfaction survey.

Review Article on Guillain Barre Syndrome

Guillain-Barré syndrome (GBS) is an autoimmune disease caused by a viral or viral infection and can be reduced. The most common HIV virus is Campylobacter June, which is a major cause of bacterial gastroenteritis worldwide. Immune-mediated immune responses may play a role in the development of GBS by interacting with brain tissue. Because the infected organism contains homologous epitopes, it initiates molecular and cell immune responses that interact with the ganglioside surface areas of the peripheral nerve (cell imitation). The immune response to epitopes in the upper layer of Schwann cells acts as a target for acute inflammatory demyelinating neuropathy (85%) caused by a reaction to epitopes found in the Schwann-cell surface or myelin. A strong axonal variation of GBS is caused by a reaction to epitopes found in the axonal membrane (15 percent of cases). Although caring for these people may be difficult, complete predictions are good. The basis of treatment is to provide the best supportive care and expectation and avoidance of complications. Patients in need of intubation and respiratory assistance should be admitted to the intensive care unit by 33% of cases. Immunomodilution with IgG infusions or plasma exchange therapy can accelerate the progression of this condition. Conclusion: High-quality intensive care is the necessary aspect of management of cases of GBS. Clinical studies show plasma exchange is one of the most promising treatments. Intravenous immunoglobulin is also effective but has side effects. Corticosteroid with IMG is insufficient and the evidence of this working is less.

Case Report On Wilm's Tumor In Child

Wilms tumor is the most frequent kind of kidney cancer in kids. It is responsible for around 6% of all tumors in children. In children under the age of 15, the incidence is 7.6 cases per million, with 75 percent of cases occurring before the child reaches the age of five. A variant term is nephroblastoma. It is most widespread between the ages of three and four, after which it becomes much less frequent. Clinical findings: Wilms tumor in children produces one or more of the following signs and symptoms: abdominal pain, increasing abdominal girth, lack of appetite, fever, blood in the urine, nausea or vomiting, constipation, shortness of breath. Diagnostic evaluation: Increase abdominal girth, pain, fever,vomiting, cried at the time of urination, hematuria, black stool, pallor, hypertension, and moderate microcytic anemia (iron deficiency). Ultrasonography: Showed splenomegaly. Therapeutic investigation: X-ray of abdomen and chest, IVP, USG, MRI, CT scan, renal function test and urine analysis, liver function test, bone marrow study, and histology. Outcome: After treatment, the child shows great improvement, his fever, abdominal pain, blood in urine is minimized, and his Hb level is increased from 9gm% to 11.1gm%.

Use of Point-of-care upper airway ultrasound during preanesthetic airway assessment to predict difficult intubation in adult patients with obesity

BackgroundUltrasound is a simple, noninvasive complementary tool for preoperative airway assessment. This study compared airway ultrasound and conventional airway assessments to predict difficult intubation. MethodsAirway assessment was performed in 99 patients scheduled for bariatric surgery using the following two parameters: El-Ganzouri score (EGS) and oblique transverse ultrasound view. The following measurements were gathered with ultrasound: pre-epiglottic space depth (pre-E), distance from the epiglottis to the mid-vocal cords (E-VC), mean distance between the skin and epiglottis (mDSE), distance between the skin and hyoid bone (DSHB), and tongue volume. After induction of anesthesia, direct laryngoscopy was performed and Cormack–Lehane (CL) classification was reported.CL grades 1 and 2 were classified as the easy laryngoscopy (EL) group, Grades 3 and 4 were classified as having a difficult laryngoscopy (DL). The crucial performance measure was the E-ability VC's to anticipate difficult intubation. Association between these factors and the CL categorization was a significant indication. ResultsIn 12.12 percent of cases, hard intubation was seen. The DL group had a lower E-VC than the EL group (0.9 ± 0.28 cm vs. 1.52 ± 0.3 cm; P -value less than0.001). The DL cutoff point was <1.22 cm, with 91.7% sensitivity and 83.9% specificity. The CL classification indicated a strongly positive association with the EGS and strongly negative association with the E-VC measurement (r = 0.700 and –0.828, consecutively; P-value less than 0.001), moderately positive correlation with mDSE and DSHB (r = 0.433 and 0.566, consecutively; P-value less than 0.001), and weakly positive correlation with pre-E and tongue volume (r = 0.331 and 0.344, respectively; P-value less than 0.001). ConclusionsUltrasound as a complementary measure to anticipate difficult intubation is beneficial with high sensitivity and low specificity in avoiding the hazards of unanticipated, difficult intraoperative laryngeal visualization.

Whole genome sequencing delineates regulatory, copy number, and cryptic splice variants in early onset cardiomyopathy

Cardiomyopathy (CMP) is a heritable disorder. Over 50% of cases are gene-elusive on clinical gene panel testing. The contribution of variants in non-coding DNA elements that result in cryptic splicing and regulate gene expression has not been explored. We analyzed whole-genome sequencing (WGS) data in a discovery cohort of 209 pediatric CMP patients and 1953 independent replication genomes and exomes. We searched for protein-coding variants, and non-coding variants predicted to affect the function or expression of genes. Thirty-nine percent of cases harbored pathogenic coding variants in known CMP genes, and 5% harbored high-risk loss-of-function (LoF) variants in additional candidate CMP genes. Fifteen percent harbored high-risk regulatory variants in promoters and enhancers of CMP genes (odds ratio 2.25, p = 6.70 × 10−7 versus controls). Genes involved in α-dystroglycan glycosylation (FKTN, DTNA) and desmosomal signaling (DSC2, DSG2) were most highly enriched for regulatory variants (odds ratio 6.7–58.1). Functional effects were confirmed in patient myocardium and reporter assays in human cardiomyocytes, and in zebrafish CRISPR knockouts. We provide strong evidence for the genomic contribution of functionally active variants in new genes and in regulatory elements of known CMP genes to early onset CMP.

The brown tumour in untreated hyperparathyroidism

The brown tumour (osteitis fibrosa cystica) is a rare, non-neoplastic, expansively growing lesion containing giant cells. Hyperparathyroidism (hyperparathyroidism [HPT]) leads to the development of a brown tumour in 2 to 3 percent of cases. This can manifest itself in any part of the skeleton.

Characteristics of recurrent cases after conservative therapy in adolescent lumbar spondylolysis

Occasionally lumbar spondylolysis in adolescents will recur after conservative treatment. The goal of this study was to retrospectively review the conditions in which recurrence transpired in a subset of adolescent patients diagnosed with acute lumbar spondylolysis. A retrospective survey was conducted in 141 patients who had been treated for spondylolysis and had obtained bone union. Twenty subjects were selected who had recurrent lumbar spondylolysis after returning to sports activity following the initial spondylolysis treatment. There were 18 males and two females with an average age at the time of initial visit of 13.3 years and 14.1 years at the time of recurrence. The average period of initial treatment was 101 days, and the average time to recurrence after healing was 149 days. There were three cases at L3, two cases at L4 and 15 cases at L5. At recurrence, 18 patients had unilateral involvement and two patients presented with bilateral occurrence. Four cases did not achieve bony union. In this study, the recurrence rate was 13.2%. Eighty percent of cases had recurrence within six months after healing. After recurrence, 20% of the cases reached pseudoarthrosis. It is useful to take regular MRI images to detect recurrence within six months after returning to sports.

Sudden cardiac death in young people and in adults: primary and contributing causes. The experience of the multidisciplinary network in Emilia-Romagna

The multidisciplinary network of Emilia-Romagna for the study of juvenile sudden cardiac death (SCD) was started in Bologna in June 2018 in order to: (1) define the spectrum of etiologies and mechanisms of SCD in young people; (ii) standardize diagnostic terminology and categories; (iii) identify potentially hereditary genetic heart diseases and define the contribution of post-mortem genetic analysis (so-called molecular autopsy) to the overall diagnostic process; (iv) identify preclinical forms of the pathologies in the first-degree relatives of the deceased subject using both phenotypic and genotypic evaluation and, where possible, undertake therapeutic/prophylactic measures (primary prevention). In the first 2 years of activity (01/06/2018-27/08/2020) 50 cases of SCD came to the attention of the Cardiovascular Pathology Unit of the S. Orsola-Malpighi Polyclinic in Bologna, from Centres of Forensic Medicine and Pathological Anatomy in most of the region. Sixty-two percent of cases were sent by forensic pathologists, 36% by clinical pathologists and 2% by the family of the deceased. Medico-legal cases were prompted by autopsies requested by the Judicial Authority in 70% of cases; 55.5% of patients referred by pathologists came from the Cardiovascular Tissue Bank, as part of the regional program for the quality and safety control of organs and tissues from multiorgan-multitissue donors. The average age of the subjects was 35 ± 13.6 years (70% male, range: 1-55 years; median: 38 years). The spectrum of the final diagnoses includes: structurally normal hearts 14%, cardiomyopathies 40%, coronary heart disease 23%, Brugada syndrome 6%, aortic dissection 4%, substance abuse 6%, valvular heart disease 2%, mixed causes 2%. The network is necessarily centered on post-mortem pathological activities, but it does not end with these. If in 60% of cases the pathological autopsy examination was decisive in identifying the cause of death, in the other cases a detailed final diagnosis was reached only with more complex pathways involving molecular genetics, clinical genetics, and toxicology.

Buccal bifurcation cyst: A case series and review of the literature

IntroductionBuccal bifurcation cyst is an inflammatory odontogenic cyst and constitutes up to 5% of all odontogenic cysts. The aim of this study was to report a series of cases, review the recent literature, and facilitate recognition and proper treatment of this entity. MethodsWith institutional review board approval, the authors retrieved all archival cases of buccal bifurcation cyst from the oral pathology biopsy service from 1994 through 2018. Patient age and sex, cyst location, clinician’s impression, radiographic appearance, diagnosis, and treatment data were recorded. ResultsA total of 10 cases were identified. Average patient age was 9 years. A slight male predilection was observed (n = 6, 60%). One hundred percent of cases were in the mandible, including 3 (30%) bilateral cases. ConclusionsMandibular buccal bifurcation cyst is an important entity in pediatric patients but may be less likely to be recognized by clinicians not regularly treating children. The results of this study are mostly consistent with the literature. Treatment is typically via enucleation or even more conservative modalities, and extraction should be avoided if possible. Practical ImplicationsBuccal bifurcation cysts should be treated via enucleation or even more conservative methods. If possible, the affected teeth should be preserved.

A single-centre analysis of in-stent restenosis after left main stenting

Abstract Funding Acknowledgements Type of funding sources: None. Background Percutaneous coronary interventions (PCI) can be the standard of care for left main (LM) coronary artery disease. In-stent restenosis (ISR) is a rare complication and is associated with patient- and procedure-specific aspects. The aim of our analysis is to evaluate the incidence and the predictors of ISR after left main PCI. Methods From June 2018 till June 2019, 156 LM procedures were performed in our centre with second-generation drug-eluting stents (DES). Our registry includes a wide spectrum of patients, with stable coronary artery disease and with acute coronary syndrome, including STEMI, unprotected and protected LM, high and low SYNTAX scores, with or without true bifurcation disease (engagement). Results In 22.3 percent of the patients, previous percutaneous or surgical revascularization was found. In 78 percent of cases, the recommended care method was provisional stenting, and in 68 percent, IVUS support was used. In hospital discharge the 1st, 6th, 12th month, and each year afterwards, patients were prospectively followed up for MACE (defined as death, stroke, symptom triggered repeat revascularization). According to our data, the only predictor of ISR at multivariate analysis turned out to be type II diabetes mellitus (OR = 3.84; 95% CI: 1.18-13.65, p = 0.007), while sex, age, prior revascularisation and the clinical presentation at admission (stable or acute), stent technique and complex anatomy were not. All patients with significant ISR were retreated successfully; 38 (24%) of them interventionally and in 3 (1.92%) of the cases, surgically. Conclusions According to the results from our registry, composed of all-comer patients, restenosis after PCI of LM with second-generation DES is an infrequent event. The most common location of IRS is at the ostium of the circumflex artery and distal left main. Type II diabetes mellitus is the only predictor of ISR at multivariate analysis.

The Frequency and Characteristics of Postsurgical Problems in Individuals who had got Neurosurgical Operations

Aim: The main aim of our current research was to assess occurrence and prevalence of postsurgical problems in individuals who had had neurosurgical operations. Methods: From January 2020 to December 2021 a descriptive study is conducted at Neurosurgery department Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, most patients remained monitored surgically in post anesthesia care unit or critical care unit for up to four hours. The investigators noted relevant problems and clinical records on a standardized form. Respiratory, cardiovascular, nausea and vomiting, hypothermia, and other problems have been identified. Age, gender, ASA status, kind of surgery, elective or emergency surgery, in addition postoperative placement were all examined as lifestyle factors for the incidence of problems. Results: Six hundred patients treated studied monitored, although the trachea remained deeply sedated in 57 of them after the four-hour study period, hence they were eliminated from the postoperative effects assessment. At least one situation happened in 56.6 percent of the remaining 437 individuals. Respiratory issues occurred in 3.9 percent of cases, airway damage in 5.6 percent of cases, cardiovascular complications in 7.8 percent of cases, neurological abnormalities in 6.8 percent of cases, and nausea and/or vomiting in 39 percent of cases. The most patients had problems throughout spine (68%) and trauma (68%) surgery, comparing to tumor (48%) and other (47%) surgery, P 0.06. Other lifestyle factors for nausea and vomiting were being over 70 years old (P 0.01) and having elective spine also trauma surgery (P 0.002). Conclusion: In patients presenting, here had been very significant rate of early postoperative problems. The most prevalent issue included nausea and vomiting, that was more prevalent among young patients receiving elective spine surgery. Keywords: Occurrence and prevalence of postsurgical problems, neurosurgical operations.

An Approach to Nasopharyngeal Mass in Newborns: Case Series and Systematic Literature Review.

ObjectiveCongenital nasopharyngeal masses (CNMs) are rare. Presenting symptoms vary, and the differential diagnoses cover a wide spectrum of possibilities. As it is uncommon, most examples discussed in literature are described as case reports or series. Guidelines on CNM patient management do not exist. In this study, we present two (2) cases of neonates with CNMs that were encountered at our tertiary center. Additionally, to best elaborate a comprehensive, case-based approach to CNM management, we offer an up-to-date, diagnosis-to-treatment review of current literature.MethodsCase series and systematic literature review.ResultsTwenty-eight (28) studies are included since January 2000 to October 2021, with a total of 41 cases. Most common diagnosis was teratoma (78%). Female-to-male ratio was 2.5:1. Twenty percent of cases presented prenatally with polyhydramnios or elevated alpha-fetoprotein. Postnatally, the presenting symptoms most frequently encountered were respiratory distress (78%), oral mass (52%), and feeding difficulties (29%). Seventy-five percent of affected newborns showed symptoms within the first 24 hours of life. Forty percent of cases had comorbidities, especially in the head and neck region.ConclusionsCongenital nasopharyngeal masses can be detected antenatally, or symptomatically immediately after birth. Airway protection is a cornerstone in the management. Selecting the right imaging modality and convening a multidisciplinary team meeting are important toward the planning of next steps/therapeutic approach. Typically, a transnasal or transoral surgical approach will be deemed sufficient to address the problem, with a good overall prognosis.

Frequency of Genital Tuberculosis in Patients Undergoing Diagnostic Laparoscopy for Infertility

OBJECTIVES: To determine the frequency of genital tuberculosis in patients undergoing diagnostic laparoscopy for infertility. METHODOLOGY: It is a descriptive (cross-sectional) prospective study. The study was performed within the duration of six months i.e., February 12th, 2020 to August 12th, 2020 at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. A total of 196 patients were observed by using 47.1% proportion of genital tuberculosis in infertility, 95% confidence interval with margin of error 7%, using software of WHO for sample size calculation. Further, sample collection was performed using non-probability (consecutive) sampling techniques. RESULTS: The mean age of the patients in our study was 30 years (SD+3.92). Fifty seven percent of cases were having primary infertility and 43% of patients were having secondary infertility. The incidence of genital tuberculosis undergoing infertility was 45%. CONCLUSION: Our study concludes that the incidence of genital TB in infertility in our setup was 45%.