A Relook into Visceral Slide Test as a Preoperative Screening Modality to Detect Abdominal Wall Adhesions- A Prospective Observational Cohort Study

Background: Background: Ultrasound has become an invaluable tool in our daily practice. Its role in screening for adhesions has been tested since the 1990s. Objective: This study aims to determine the role of the visceral slide test as a screening method to predict abdominal wall adhesions in women undergoing gynecological surgery. Methods: We conducted a prospective observational cohort study from August 2017 to July 2019 in women undergoing elective abdominopelvic surgery for a gynecological indication. Preoperatively, a visceral slide test was performed in 5 specified zones on the abdomen and the test results were clinically correlated with the presence, severity, and extent of adhesions intra-operatively. Results: Results were reported as mean, standard deviation, range of values or number and percentage. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (including 95% confidence interval for all) of visceral slide test were calculated to determine intra-abdominal adhesions . We also found a correlation between the number of negative slide tests and PAI scores using Spearman’s correlation test. Of the 339 women who completed the study, 41.2% had a previous history of abdominopelvic surgery. In this study, the visceral slide test was found to have a sensitivity of 70.87% ( 95%CI 62.15-78.59), specificity of 86.32% (95% CI 80.95-90.64), positive predictive value (PPV) of 75.63% ( 95% CI 68.49-81.59), negative predictive value (NPV) of 83.18%( 95% CI 78.95-86.70) and diagnostic accuracy of 80.53%( 95% CI 75.91-84.61)with p-value less than 0.001. The number of negative slide tests positively correlated with the Peritoneal Adhesion Index score (r = 0.662, p < 0.001) and also with increasing operative time and intraoperative blood loss. Accuracy and positive predictive value of the test were significantly higher in patients with a history of abdominal surgeries, endometriosis and PID. Conclusion: Visceral slide test is an easy, rapid, non-invasive and reliable screening test to predict abdominal adhesions in women undergoing gynecological surgery. The presence of risk factors for adhesions increases the accuracy of the test.

Prevalence of Scapular Dyskinesis in Breastfeeding Postnatal Women in Satara District - An Observational Study

BACKGROUND Poor posture like hunching forward is one of the most commonly practiced postures by women during breastfeeding. The maintenance of such postures for prolonged period can result in progressive weakness of the scapular muscles and subsequent increase in the kyphotic curve. Both lordosis and kyphosis increase during pregnancy and are observed to be maintained for up to 2 months postnatally. The thoracic spine position and slouched position significantly affects the scapular dynamics during scapular abduction resulting in decreased muscle forces. Thus, scapular dyskinesis, defined as an alteration of normal position or motion of the scapula during coupled scapulohumeral movements can occur as a result of decreased muscle forces. Thus, this gives rise to the need for evaluating scapular dyskinesis and its prevalence in postnatal women. The purpose of the study was to find the prevalence of scapular dyskinesis in breastfeeding postnatal women. METHODS An observational analytical study was undertaken at Krishna Institute of Medical Sciences, including a total of 40 subjects within the age group of (15 - 40) yrs. who had been breastfeeding for 6 months or more. These subjects were assessed for scapular dyskinesis using Yes / No test and the lateral scapular slide test (LSST). Kyphosis was assessed on observational basis through postural assessment in these individuals. Statistical analysis was done using the InStat app. RESULTS 67 % and 75 % of the subjects were found to be positive for scapular dyskinesis through Yes / No Test and LSST test respectively. Observational assessment showed that 55 % of the subjects were positive for kyphosis. Subjects demonstrated significant prevalence of scapular dyskinesis and subsequent kyphosis in postnatal females due to wrong ergonomic practice of breastfeeding. CONCLUSIONS The study shows that women lack proper knowledge about the breastfeeding ergonomics leading to weakness of scapular muscles. Thus, a significant prevalence of scapular dyskinesis was seen in breastfeeding postnatal women. KEY WORDS Breastfeeding, Scapular Muscle Weakness, Kyphosis, Ergonomics, Scapular Dyskinesis

Scapular Dyskinesis, Shoulder Joint Position Sense, and Functional Level After Arthroscopic Bankart Repair

Background: Scapular kinesia is an important component of glenohumeral rhythm and shoulder stability. No studies have evaluated scapular dyskinesis and its relationship to shoulder proprioception in patients who have undergone arthroscopic Bankart repair (ABR). Purpose: To investigate scapular dyskinesis, proprioception, and functional level after ABR. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 13 male patients who underwent ABR (ABR group; mean age, 30 years; range, 24-36 years) and 13 sex- and age-matched healthy individuals (control group). The age, height, weight, and dominant side of all participants were collected. Scapular dyskinesis was evaluated using the lateral scapular slide test and the scapular dyskinesis test; proprioception was measured by the active angle reproduction test using a smartphone goniometer application, and functional level was assessed using the upper-quarter Y-balance test for dynamic stability as well as the Rowe score and Walch-Duplay score for quality of life and return to activities of daily living. Results: The presence of static scapular dyskinesis in the neutral position, at 45° of abduction, and at 90° of abduction as well as the presence of dynamic scapular dyskinesis was higher in the ABR group compared with the control group ( P ≤ .04 for all). Shoulder joint position sense (absolute error) at 40° and 100° of shoulder elevation and shoulder functional level according to the Rowe score were worse in the ABR patients compared with the healthy controls ( P ≤ .02 for all). Dynamic scapular dyskinesis was negatively related to shoulder joint position sense at 40° of shoulder elevation ( r = –0.64; P = .01). Static scapular movement as measured on the lateral scapular slide test was moderately related to the Rowe score ( r = 0.58; P = .03). Conclusion: Scapular kinematics and proprioception should be evaluated after ABR. Treatment approaches to improve scapular control and proprioceptive sense should be included in the rehabilitation program for patients after ABR.

Investigation of a child malaria death during COVID-19 pandemic in a hamlet of Angul district, Odisha (India)

Background: This study aimed to find out the cause of child death due to Plasmodium falciparum and associate co-morbidities in a hamlet of Garud village of central district of Odisha (India), Angul during the COVID-19 pandemic and to recommend necessary actions to prevent such unwanted death.Methods: A retrospective investigation was conducted bases on the death audit report of a female child belonging to Garud village of Angul district. Death was reported at the district headquarters hospital, Angul. Detailed history from the starting of first symptom till death with laboratory investigations were reviewed using the malaria death audit format of NVBDCP, Odisha. Along with in-depth interview with family members, mass screening using bivalent rapid test and slide test, treatment and malaria preventive measures were undertaken in the community.Results: During the COVID-19 pandemic, one child death was recorded due to falciparum malaria infection. Along with the child, all two family members were infected with falciparum. The family belongs to small hamlet with eight households and 39 population. All 39 populations were screened for malaria and out of these, 11 number people were found positive of falciparum.Conclusions: COVID-19 pandemic resulted the major societal disruption due to lockdown and shutdowns affecting routine health care which may be attributed to the death of a child even in a in a well-resource setting district of Odisha. In such pandemic situation much more attention need to be given on the traditional infectious diseases which may cause unnoticed death.

ANALISIS PEMERIKSAAN GOLONGAN DARAH DONOR PADA METODE MICROPLATE TEST

Pemeriksaan golongan darah merupakan pemeriksaan pre transfusi pada transfusi darah. Terdapat beberapa metode pemeriksaan, yakni Slide, tabung dan Microplate Test. Masing-masing mempunyai kelebihan dan kekurangan. Slide Test merupakan paling tidak sensitif dibanding metode lain namun dapat menentukan golongan darah dengan cepat. Microplate Test sedikit lebih maju diantara kedua metode karena tersedia dengan peralatan otomatis yang memungkinkan pemeriksaan dengan cepat dan lebih sensitif. Salah satunya adalah peralatan Qwalys 3. Tujuan penelitian ini adalah mengetahui perbandingan hasil pemeriksaan golongan darah donor dan derajat aglutinasi antara metode Slide dan Micropate Test. Penelitian Cross Sectional ini dilakukan pada Januari-Februari 2021 di UTD PMI Kota Padang. Sampel penelitian sebanyak 96 sampel darah donor yang diambil secara Purposive Sampling diperiksan dengan Microplate Test dan kemudian dengan Slide Test.

Laboratory-based evaluation of a simplified point-of-care test intended to support treatment decisions in non-severe bovine clinical mastitis

To limit the use of antimicrobials in dairy cattle, farmers are increasingly encouraged to adopt targeted treatment decisions based on knowledge of the pathogens causing clinical mastitis (CM), whereby treatment of non-severe CM is generally recommended for gram-positive mastitis but not for gram-negative or culture-negative mastitis. The objectives of this study were to conduct a laboratory-based evaluation of the performance of a simplified slide test as a tool to differentiate gram-positive CM from other cases of CM, and to compare its performance against a commercially available on-farm test that is commonly used in our area (VétoRapid). Test outcomes after 24–48 h incubation were compared to results from bacteriological culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF MS). Milk samples (n = 156) were obtained from cases of severe and non-severe CM on seven farms and collected by farm personnel. After removal of small numbers of contaminated samples and organisms with unknown species identity, the simplified slide test showed high sensitivity and accuracy (>80%), similar to the comparator test. For most outcomes of interest (culture positive, Escherichia coli, or gram-positive growth), the specificity of the slide test was higher than the specificity of the comparator test. When considering non-severe cases of CM only, and interpreting detection of gram-positive organisms as indicative of the need for antimicrobial treatment, the simplified test had higher specificity (77.4% v. 60.4%) and higher positive predictive value (79.7% v. 70.0%) than the comparator test and similar sensitivity (83.9% v. 87.5%). The proportion of sampled CM cases, contaminated samples and gram-positive mastitis cases – which affects the positive and negative predictive value, the economic value of diagnostic testing and its potential to reduce antimicrobial use – differed between farms. The simplicity and accuracy of the slide test could make it an attractive tool for farmers to target antimicrobial treatment of non-severe clinical mastitis.

Effect of Mechanical Neck pain on Neck Disability and Scapula position among School Teachers in Delhi and NCR

Neck pain found to be most common musculoskeletal condition in office workers with 12-month prevalence. Mechanical neck pain can be classified into two categories in clinical studies mechanical neck pain which has patients without any identifiable anatomic cause and leaves patients having neurological dysfunctions cervicogenic headache and inflammatory disorders. Current research work has total of 150 participants out of which there were 100 females school teachers having mean age of 37.8 years(median 38 years) and 50 male school teachers having mean age 40 years (median 39 years). Participants included in the study were professionally active school teachers of primary, secondary and senior secondary. Scapula position and neck disability was examined as per keiblers lateral scapular slide test and Neck disability index. Total 150 teachers were included in the study 80 teachers having mechanical neck pain (study group) and 70 teachers not having mechanical neck pain (control group) statistically significant difference found in scapula position and neck disability. In the present research, it is found that there is statistically significant difference in scapula position protraction and upward rotation at three different levels as well as there are statistically significant changes observed in neck disability.

State-Transition Model for Malaria Symptoms

Aims/ objectives: To develop a state-transition model for malaria symptoms. Study design: Longitudinal study. Place and Duration of Study: Department of Mathematics Masinde Muliro University of Science and Technology between January 2015 and December 2015. Methodology: We included 300 students (patients) with liver malaria disease, with or without the medical history of malaria disease, physical examination for signs and symptoms for both specific and non-specific symptom, investigation of the disease through laboratory test (BS test) and diagnostic test results. the focus of this study was to develop state-transition model for malaria symptoms. Bayesian method using Markov Chain Monte Carlo via Gibbs sampling algorithm was implemented for obtaining the parameter estimates. Results: The results of the study showed a significant association between malaria disease and observed symptoms Conclusion: The study findings provides a useful information that can be used for predicting malaria disease in areas where Blood slide test and rapid diagnostic test for malaria disease is not possible.