Ileosigmoid knotting: A review of 923 cases

Objectives: Ileosigmoid knotting (ISK) is a rare intestinal obstruction form worldwide. The aim of this study was to investigate changing trends in ISK. Methods: The Web of Science and PubMed databases were electronically searched to find all publications to evaluate all epidemiological, etiological, clinical, laboratory, radiological, therapeutic, and prognostic factors in ISK. Results: Most of the cases were reported from Asian and African countries. Mean age was 43.9 years with a 79.9%/20.1% of male/female ratio. Main symptom period was 48.1 hours, while the most common clinical features were abdominal pain/tenderness (99.1%), distention (88.3%), and obstipation/constipation (58.8%). Abdominal X-ray radiography, computerized tomography (CT), and magnetic resonance imaging (MRI) were diagnostic in 8.2%, 96.2%, and 100.0%, respectively, while the total diagnostic accuracy rate was 20.8%. Bowels were gangrenous in 85.6% of the patients. Ileum resection was applied in 14.0% of the cases, while sigmoid colon resection in 7.6%, and both segment resection in 67.1%. The mortality rate was 22.7%, while the morbidity rate was also 22.7%. Conclusion: ISK is a rare disease, but it is still catastrophic despite its two-century recognised past. As an exception, diagnostic convenience arising from CT or MRI looks like the most important change over the last half-century. doi: https://doi.org/10.12669/pjms.38.3.5320 How to cite this:Atamanalp SS, Disci E, Peksoz R, Atamanalp RS, Tatar Atamanalp C. Ileosigmoid knotting: A review of 923 cases. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5320 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Incidence of Emergency Peripartum Hysterectomy in a Tertiary Obstetrics Unit in Romania

Background and Objectives: Emergency peripartum hysterectomy (EPH) is a life-saving surgical procedure performed when medical and surgical conservative measures fail to control postpartum hemorrhage. The objective of this study was to estimate the incidence of EPH and to determine the factors leading to this procedure and the maternal outcomes. Materials and Methods: A retrospective cohort study with all cases of EPH performed at Filantropia Clinical Hospital in Bucharest between January 2012 and May 2021. Results: There were 36 EPH, from a total of 36,099 births recorded. The overall incidence of EPH was 0.99 per 1000 deliveries, most cases being related to placenta accreta spectrum disorder and uterine atony. Conclusions: Peripartum hysterectomy is associated with an important maternal morbidity rate and severe complications. Efforts should be made to reduce the number of unnecessary cesarean deliveries.

S100B in cardiac surgery brain monitoring: friend or foe?

Recent advances in perioperative management of adult and pediatric patients requiring open heart surgery (OHS) and cardiopulmonary bypass (CPB) for cardiac and/or congenital heart diseases repair allowed a significant reduction in the mortality rate. Conversely morbidity rate pattern has a flat trend. Perioperative period is crucial since OHS and CPB are widely accepted as a deliberate hypoxic-ischemic reperfusion damage representing the cost to pay at a time when standard of care monitoring procedures can be silent or unavailable. In this respect, the measurement of neuro-biomarkers (NB), able to detect at early stage perioperative brain damage could be especially useful. In the last decade, among a series of NB, S100B protein has been investigated. After the first promising results, supporting the usefulness of the protein as predictor of short/long term adverse neurological outcome, the protein has been progressively abandoned due to a series of limitations. In the present review we offer an up-dated overview of the main S100B pros and cons in the peri-operative monitoring of adult and pediatric patients.

Brucellosis morbidity in Russia and Primorsky region

Objective: Epidemiological data analysis concerning the spread of brucellosis in Russia and Primorsky Region, study of the manifestations of the epidemic process and the current state of brucellosis issue.Methods: Descriptive epidemiological analysis of materials on infectious morbidity based on state statistical reporting forms No. 1, No. 2 “Information on infectious and parasitic morbidity”.Results: Brucellosis affects workers in the main occupational groups of livestock breeders, workers involved in the processing of livestock, who contact sick animals and other sources of brucellosis infection. Primorsky Region is a territory with an unstable epidemiological situation on brucellosis. A different morbidity rates were registered over the years. However usually it does not exceed the national average rate. In 2009, the morbidity rate counted 27.5% less than in Russian Federation (0.21 and 0.29 per 100,000 respectively), compared to previous years, the average long-term morbidity rate in the region increased by 3.5 times. The disease rate for the period from 2009 to 2019 ranged from 0.05 to 0.21%. In 2012, it exceeded the index in the Far Eastern Federal District (0.1 per 100,000 population). Brucellosis cases were detected among livestock breeders during an extraordinary medical examination due to the bad situation on brucellosis among animals.Conclusions: In recent decades, the epizootic and epidemiological situation on brucellosis remains tense due to the decrease in the number of serological and bacteriological studies among animals and humans, the weakening of veterinary-sanitary control and the formation of new private farms.

Knowledge and Practice Regarding Breastfeeding among Primipara Mothers of Obstetrics Ward, Birganj, Nepal

Breastfeeding is an ideal form of feeding to neonate. It is most precious gift a mother can give and is free of cost. It should be started as soon as possible after birth. Breast milk is a species-specific complete food. Human milk facilitates effortless digestion for infant and is well absorbed by the newborn. It helps in stimulating the production of breast milk, protect against infection and facilitate mother infant bonding and promotes better brain growth. For mothers breastfeeding helps in involution of uterus, delays pregnancy and lower risk of breast and ovarian cancer. Every year around 57,000 children below 5 years of age lose their lives, among which 54 percent die within the first month of life. The data stated that 22 percent of newborn death can be prevented through breastfeeding within 1st hour of birth. Mother play a very important roles in reducing neonatal mortality and neonatal morbidity rate by their knowledge and practice while feeding their baby. Method: Descriptive correlation study design was conducted in the month of August 2021 National Medical College and Teaching Hospital, Birganj, Nepal. Sample size was 50 primi para mothers. Purposive sampling techniques was used to select the sample. Semi structure interview schedule and observation checklist was prepared according to objectives which comprised questions related to demographic variables, Knowledge to assess breastfeeding and observational checklist to assess practice Data was collected by administering this structured questionnaire to the primipara mothers. Result: In the study 31 (62.0%) had adequate, 19 (38.0%) had moderate and none of them had inadequate knowledge regarding breastfeeding. 23 (46.0 had good, 27 (54.0%) had satisfactory and none of them had poor practice on breastfeeding. The results show that there was moderate degree positive correlation between knowledge and practice. Key words: Knowledge, practice, breastfeeding and primipara mothers.

3D AGSE-VNet: an automatic brain tumor MRI data segmentation framework

Background Glioma is the most common brain malignant tumor, with a high morbidity rate and a mortality rate of more than three percent, which seriously endangers human health. The main method of acquiring brain tumors in the clinic is MRI. Segmentation of brain tumor regions from multi-modal MRI scan images is helpful for treatment inspection, post-diagnosis monitoring, and effect evaluation of patients. However, the common operation in clinical brain tumor segmentation is still manual segmentation, lead to its time-consuming and large performance difference between different operators, a consistent and accurate automatic segmentation method is urgently needed. With the continuous development of deep learning, researchers have designed many automatic segmentation algorithms; however, there are still some problems: (1) The research of segmentation algorithm mostly stays on the 2D plane, this will reduce the accuracy of 3D image feature extraction to a certain extent. (2) MRI images have gray-scale offset fields that make it difficult to divide the contours accurately. Methods To meet the above challenges, we propose an automatic brain tumor MRI data segmentation framework which is called AGSE-VNet. In our study, the Squeeze and Excite (SE) module is added to each encoder, the Attention Guide Filter (AG) module is added to each decoder, using the channel relationship to automatically enhance the useful information in the channel to suppress the useless information, and use the attention mechanism to guide the edge information and remove the influence of irrelevant information such as noise. Results We used the BraTS2020 challenge online verification tool to evaluate our approach. The focus of verification is that the Dice scores of the whole tumor, tumor core and enhanced tumor are 0.68, 0.85 and 0.70, respectively. Conclusion Although MRI images have different intensities, AGSE-VNet is not affected by the size of the tumor, and can more accurately extract the features of the three regions, it has achieved impressive results and made outstanding contributions to the clinical diagnosis and treatment of brain tumor patients.

Kinerja Petugas Kesehatan dalam Upaya Menurunkan Angka Kejadian Demam Berdarah Dengue di Puskesmas Kota Jambi

In Jambi Province, the morbidity rate of Dengue Hemorrhagic Fever (DHF) has increased for three consecutive years with a mortality rate of 0.74%. This study aimed to determine the performance of health workers to reduce the incidence of dengue fever at the Jambi City Health Center in 2020. This study used a cross-sectional design with several respondents 80 officers, the sampling technique used total sampling. The instrument in this study used a questionnaire. Data analysis using Chi-square test. The results showed that there was a significant relationship between the length of work (OR = 0.184), facilities and infrastructure (OR = 1.977), supervision (OR = 2.118), and superior support (OR = 2.029) with the performance of health workers, and there was no significant relationship between the last education (OR=1.152) and reward (OR=1.472) with the performance of health workers. Health officers DHF program are expected to maximize services such as environmental health inspections and PSN 3M counseling as well as increase supervision of the community so that they can participate in the prevention of DHF, namely by forming Jumantik cadres, maximizing outreach and outreach with the community, and fostering community self-hygiene.

Safety of immediate use of totally implantable venous access ports in adult patients with cancer: a retrospective single-center study

Purpose: Totally implantable venous access ports (TIVAPs) can be used long-term for safe administration of intravenous drugs. TIVAP complications include catheter-related infections, venous thrombosis, extravasation, TIVAP migration, and pain. The relationship between the timing of the first chemotherapy administration after port implantation and complications is controversial. This study aimed to investigate the safety of immediate use of TIVAPs and the associated risk factors for complications.Methods: Between January 2016 and December 2018, 305 patients (median age, 53 years; 256 women) who underwent TIVAP placement at our institution were included. Chemotherapy was administered within 2 days of implantation. A retrospective analysis of patients’ clinical data was performed to investigate catheter days and complications of TIVAPs.Results: Overall, 305 patients were evaluated over 57,324 catheter days (median, 168 catheter days; interquartile range, 105). The median interval between placement and first use of TIVAPs was 0.98 days. The overall morbidity rate was 2.95%. Nine complications occurred in nine patients, including TIVAP-related infection (4), pain (2), port occlusion (1), thrombosis (1), and scar disunion (1), of which five required port removal (1.64%). The median number of catheter days before complications occurred was 61 (range, 10–457 days; interquartile range, 51). No complications occurred within 7 days of implantation. Body mass index was an independent risk factor for TIVAP-related complications in the Cox proportional hazards model (multivariable analysis: hazard ratio, 1.221; 95% confidence interval, 1.054–1.414; P = 0.008).Conclusion: This study suggests the safe long-term use of TIVAPs following their immediate chemotherapy administration within 2 days of implantation.

Epidemiological analysis of the malignant tumors of the larynx in Belarus over 2000–2019

Objective. To analyze basic medico-statistical indices of the morbidity rates of the malignant tumors of the larynx in the Republic of Belarus.Materials and methods. Data of the Belarusian Cancer Register on all detected cases of the malignant tumors of the larynx in the Republic of Belarus over 2000-2019 served as the material of the study. The following rates were studied: age standardized morbidity, gross intensive morbidity, morbidity separately in the general population and working age population, in urban and rural population, males and females. All epidemiological indices for the periods 2000-2005 and 2015-2019 in the country and across the regions of the Republic of Belarus were compared.Results. The age standardized morbidity rate in Belarus increased from 4.2 cases/year per 100,000 population in 2000 to 5.8 in 2019. The gross intensive morbidity rate increased from 5.5 to 7.3, respectively. An increase in the morbidity rate from 4.0 in 2000 to 4.3 in 2019 was noted in the working age population. The gross intensive morbidity rates in males were on average 33.9 times higher than in females, and in the urban population – 1.7 times lower than those in the rural population. The maximal increase in the morbidity rate was registered in the working age population of rural areas – by 60.3% during the monitored period. A statistically significant increase in the morbidity rate was noted in the city of Minsk. The morbidity rates registered in Minsk were statistically significantly lower than those in the republic. In other regions, there was no significant difference in the morbidity rates and growth dynamics from the indices in Belarus as a whole.Conclusion. Malignant tumors of the larynx are characterized by a slow increase of the morbidity rate for the last 20 years in Belarus. The observed epidemiological trends deter

The seeking medical attention in the urban adult population prior and during the coronavirus pandemic (COVID-19)

Introduction. The appeal of the population for medical care in the conditions of a pandemic and strict quarantine measures has not been sufficiently analyzed in the scientific medical literature to date. The purpose of the work. Analysis of the urban adult population’s access to medical care before and during the COVID-19 pandemic. Material and methods. Based on the materials of the consolidated statistical reports of Krasnoyarsk, the indicators of the appeal and morbidity of the adult population for 2017-2020 were studied. The obtained information was analyzed using absolute and relative values. Results. The analysis of the adult population’s appeal indicators in the pre-pandemic period and the COVID-19 pandemic period showed a decrease of 43.8%. The decrease in the population’s treatment for preventive purposes occurred in all points, except for points Z20-Z29 (potential health hazard associated with infectious diseases), the indicators of which increased by 67.4% or 11.4%. The decrease in the overall morbidity rate during the pandemic was due to a decrease in the frequency of referrals with previously known diseases by 80.4%. The primary morbidity rate increased by 64.3%. Discussion. The indicators of the incidence of the adult population of COVID-19 obtained by us have differences but do not contradict the data obtained by other researchers. As our study showed, the measures taken did not lead to a significant decrease in the population’s appeal to medical institutions. Conclusion. The comparative data obtained allows assessing the impact of the COVID-19 pandemic and the ongoing anti-epidemic measures on the treatment and morbidity of the adult population.