Graves’ disease combined with acute myocarditis and thyrotoxic periodic paralysis in a male:a case report and review of the literature

Graves’ disease is the most common reason for hyperthyroidism which manifest as multi-system changes.Among these clinical manifestations acute myocarditis and thyrotoxic periodic paralysis are very rare and patients who are combined with both two haven’t been reported yet.The etiology may attribute to autoimmunity.

Hospital revisits after paediatric tonsillectomy: a cohort study

Background Tonsillectomy, with or without adenoidectomy, is the leading reason for paediatric unplanned hospital readmission, some of which are potentially avoidable. Reducing unplanned hospital revisits would improve patient safety and decrease use of healthcare resources. This study aimed to describe the incidence, timing and risk factors for any surgery-related hospital revisits (both emergency presentation and readmission) following paediatric tonsillectomy and adenotonsillectomy in a large state-wide cohort. Methods We conducted a population-based cohort study using linked administrative datasets capturing all paediatric tonsillectomy and adenotonsillectomy surgeries performed between 2010 and 2015 in the state of Victoria, Australia. The primary outcome was presentation to the emergency department or hospital readmission within 30-day post-surgery. Results Between 2010 and 2015, 46,583 patients underwent 47,054 surgeries. There was a total of 4758 emergency department presentations (10.11% total surgeries) and 2750 readmissions (5.84% total surgeries). Haemorrhage was the most common reason for both revisit types, associated with 33.02% of ED presentations (3.34% total surgeries) and 67.93% of readmissions (3.97% total surgeries). Day 5 post-surgery was the median revisit time for both ED presentations (IQR 3–7) and readmission (IQR 3–8). Predictors of revisit included older age, public and metropolitan hospitals and peri-operative complications during surgery. Conclusions Haemorrhage was the most common reason for both emergency department presentation and hospital readmission. The higher risk of revisits associated with older children, surgeries performed in public and metropolitan hospitals, and in patients experiencing peri-operative complications, suggest the need for improved education of postoperative care for caregivers, and avoidance of inappropriate early discharge. Graphical Abstract

Opóźnienia w funkcjonowaniu językowym jako wczesny symptom zaburzeń w rozwoju dziecka1

Human linguistic development is constitutionally conditioned and is achieved through contact with adult language users. All children follow the same rules and stages in the development of speech. The knowledge of their course and consequences enables early recognition of deviations from the norm, which may be delayed speech development or a symptom of other, often serious developmental disorders. The analysis of the research results shows that the most common reason for parents’ seeking diagnosis and therapeutic support is an incorrect linguistic functioning of the child. Diagnostic procedures often end with the diagnosis of other developmental disorders in which linguistic retardation was an early symptom. Therefore, it is legitimate to increase social knowledge and sensitivity of parents and specialists in monitoring the linguistic development of children under 3 years of age.

Factors Influencing Trainees’ Interest in Breast Imaging

Purpose: To gauge the level of interest in breast imaging (BI) and determine factors impacting trainees’ decision to pursue this subspecialty. Methods: Canadian radiology residents and medical students were surveyed from November 2020 to February 2021. Training level, actual vs preferred timing of breast rotations, fellowship choices, perceptions of BI, and how artificial intelligence (AI) will impact BI were collected. Chi-square, Fisher’s exact tests and univariate logistic regression were performed to determine the impact of trainees’ perceptions on interest in pursuing BI/women’s imaging (WI) fellowships. Results: 157 responses from 80 radiology residents and 77 medical students were collected. The top 3 fellowship subspecialties desired by residents were BI/WI (36%), abdominal imaging (35%), and interventional radiology (25%). Twenty-five percent of the medical students were unsure due to lack of exposure. The most common reason that trainees found BI unappealing was repetitiveness (20%), which was associated with lack of interest in BI/WI fellowships (OR = 3.9, 95% CI: 1.6-9.5, P = .002). The most common reason residents found BI appealing was procedures (59%), which was associated with interest in BI/WI fellowships (OR, 3.2, 95% CI, 1.2-8.6, P = .02). Forty percent of residents reported an earlier start of their first breast rotation (PGY1-2) would affect their fellowship choice. Conclusion: This study assessed the current level of Canadian trainees’ interest in BI and identified factors that influenced their decisions to pursue BI. Solutions for increased interest include earlier exposure to breast radiology and addressing inadequacies in residency training.

A Survey on beggars with reference to Pune city

Begging, a social scourge, has become a relatively common profession in India. As for as Pune city is a concern there are several beggars. These beggars are at the age of minority to adult age. The majority of the beggars are physically disabled and this physical disability is the most common reason to beg. Through the present study an attempt has been made to focus on the types of physical disability of beggars, reasons for getting into the begging profession, daily earing of beggars in Pune city and the relation between physical disabilities with respect to daily earning of baggers.

Foreign bodies in the nasal cavity in children

Foreign bodies in the nasal cavity in children are a fairly common reason for contacting an otorhinolaryngologist. Most foreign bodies can be removed quite easily. However, some cases are associated with significant difficulties in their searching and removing and require the use of special technical methods and general anesthesia. We present two cases of unusual foreign bodies in the nasal cavity in children.

Impact of COVID-19 on healthcare access for Australian adolescents and young adults

ABSTRACTBackgroundAccess to healthcare for young people is essential to build the foundation for a healthy life. We investigated the factors associated with healthcare access by Australian young adults during and before the COVID-19 pandemic.MethodsWe included 1110 youths using two recent data collection waves from the Longitudinal Study of Australian Children (LSAC). Data were collected during COVID-19 in 2020 for Wave 9C1 and before COVID-19 in 2018 for Wave 8. The primary outcome for this study was healthcare access. Both bivariate and multivariate logistic regression models were employed to identify the factors associated with reluctance to access healthcare services during COVID-19 and pre-COVID-19 times.ResultsAmong respondents, 39.6% avoided seeking health services during the first year of the COVID-19 pandemic when they needed them, which was similar to pre-COVID-19 times (41.4%). The factors most strongly impacting upon reluctance and/or barriers to healthcare access during COVID-19 were any illness or disability, and high psychological distress. In comparison, prior to the pandemic the factors which were significantly impeding healthcare access were country of birth, state of residence, presence of any pre-existing condition and psychological distress. The most common reason reported (55.9%) for avoided seeking care was that they thought the problem would go away.ConclusionsA significant proportion of youths did not seek care when they felt they needed to seek care, both during and before the COVID-19 pandemic.What is known about the subject?Some adolescents and young adults do not access healthcare when they need it.Healthcare access and barriers to access is best understood through a multi-system lens including policy, organisational, and individual-level factors. For instance, policy barriers (such as cost), organisational barriers (such as transportation, or difficulty accessing a timely appointment) and individual barriers (such as experiences, knowledge or beliefs).Barriers to care may differ for sub-groups e.g. ruralDuring the COVID-19 pandemic, public health restrictions including the stricter “lockdowns” have reduced healthcare access. The burden of cases upon the healthcare system has further reduced healthcare access.What this study adds?A significant proportion of youth did not seek healthcare when they felt they needed to seek care, both before (41.4%) and during the first year of the COVID-19 pandemic (39.6%)Youth with a disability or chronic condition, asthma and/or psychological distress were more likely to avoid accessing healthcare during COVID-19 times.The most common reason for not seeking healthcare when it was felt to be needed was because the youth thought the problem would go away (pre-COVID-19 35.7% of the sample versus during the first year of COVID-19 55.9%)During the coronavirus restriction period (“lockdown”) the most common reason for not seeking healthcare when it was felt to be needed was because the youth did not want to visit a doctor during lockdown (21.8%) with the next most common reason being because telehealth was the only appointment option available at the time (8.4%)

Parental leave policy information during residency interviews

Background During interviews, medical students may feel uncomfortable asking questions that might be important to them, such as parental leave. Parental leave policies may be difficult for applicants to access without asking the program director or other interviewers. The goal of this study is to evaluate whether parental leave information is presented to prospective residents and whether medical students want this information. Methods Fifty-two program directors (PD’s) at 3 sites of a single institution received a survey in 2019 to identify whether parental leave information is presented at residency interviews. Medical students received a separate survey in 2020 to identify their preferences. Fisher exact tests, Pearson χ2 tests and Cochran-Armitage tests were used where appropriate to assess for differences in responses. Results Of the 52 PD’s, 27 responded (52%) and 19 (70%) indicated that information on parental leave was not provided to candidates. The most common reason cited was the belief that the information was not relevant (n = 7; 37%). Of the 373 medical students, 179 responded (48%). Most respondents (92%) wanted parental leave information formally presented, and many anticipated they would feel extremely or somewhat uncomfortable (68%) asking about parental leave. The majority (61%) felt that these policies would impact ranking of programs “somewhat” or “very much.” Conclusions Parental leave policies may not be readily available to interviewees despite strong interest and their impact on ranking of programs by prospective residents.

Quantitative study of lecture attendance and the association between this attendance and academic outcomes for nursing and nonnursing students in an introductory pathophysiology course

Since the availability of lecture recordings, there have been limited studies of any associations between face-to-face lecture attendance and academic outcomes. The aims of the study, in an introductory pathophysiology course, where lecture recordings were available, were 1) to quantify lecture attendance and any associations between academic outcomes and lecture attendance, and 2) to determine why students do or do not attend lectures. Data were analyzed for the whole cohort before separating the nursing (∼60%) and nonnursing students. Of 288 enrolled students, 205 consented to sign the attendance register, and 139 to undertake the online survey. Lecture attendance was higher (41%) before the midsemester exam than afterwards (24%), P < 0.001, due to higher attendance by the nursing than nonnursing students. Students who attended ≥50% of lectures consistently got higher academic outcomes than those that attended <50%, e.g., examinations, 11 percent points higher. Pearson’s or Spearman’s correlation coefficients for students from both the sign-in and survey showed that there were positive associations between lecture attendance and academic outcomes, which were mainly weak for nursing students ( P ≤ 0.05), with no association for nonnursing students. From the survey, most students who attended lectures did so because they considered they learned more by attending lectures, whereas not liking the lecture time was the most common reason for not attending lectures. In conclusion, even though students have access to lecture recordings, lecture attendance is still a determinant of academic outcomes for some students of pathophysiology.