Objectives: This study assesses the knowledge, attitude, practice and perceived barriers to subject recruitment into randomized controlled trials, and determine strategies to maximize subject recruitment and retention. Methods: A cross sectional, quantitative survey of 73 physicians working in Ghana was conducted assessing their knowledge and attitude towards randomized controlled trials, subject recruitment practices, self-reported barriers to subject recruitment and strategies to enhance subject recruitment. Results: Responses from 73 Ghanaian physicians were analyzed. 23 (31.5%) respondents knew of ongoing clinical trials in their specialty in Ghana while 32 (43.8%) physicians knew about trials in their specialties in various places in the world. 23 (31.5%) physicians responded that they had referred patients for recruitment into clinical trials before. 49 (67.1%) respondents had never referred any patient for recruitment into clinical trials. Conclusion: Most Ghanaian doctors are unaware of ongoing trials in their specialty and thus do not refer patients for recruitment.

Arteriovenous malformation of the uterus (AVMU) is a terminology that is used for an abnormal and non-functional connections between the uterine arteries and uterine veins. Even though patients who have AVMU typically tend to manifest with vaginal bleeding, some patients tend to experience life-threatening massive bleeding in some circumstances. Cases of AVMU had previously been safely and effectively treated by means of hysterectomy which meant that the patients would no longer have the ability to conceive and have their own babies in the future. Less than 100 cases of AVMU have been reported in the literature. Recently a minimal invasive procedure of Uterine Artery Embolization has been utilized to safely and effectively treat some patients who had AVMU that was associated with severe bleeding that led to cessation of their bleeding and associated symptoms as well as which enabled the patients to maintain their fertility. We report the case of a 27-year-old woman. Gravida 1. Para 0, who was known to have irregular menstrual periods pursuant to her per vaginal passage of conception products. She was diagnosed as having AVMU based upon various radiology imaging options including: ultrasound scan of the pelvis; magnetic resonance imaging of the pelvis, and percutaneous left anterior internal iliac angiography. The AVMU was safely and effectively treated by means of percutaneous interventional radiology embolization of the AVMU and the final angiogram demonstrated satisfactory embolization which led to cessation of her vaginal bleeding and subsequently her retained products of conception were evacuated completely. As a result of the successful embolization of her AVMU, hysterectomy which was the alternative treatment option that was discussed, her uterus has remained intact which has given her the chance to be pregnant again in the future which would enable her have her own child. Considering that less than 100 cases of AVMUs have been reported in the literature, there is the chance that some clinicians may not be familiar with the manifestation, diagnosis, and management of AVMUs, in view of this we have also included miscellaneous narrations and discussions related to some case reports, case series, and studies related to AVMUs. Considering that there are few well-trained interventional radiologists globally as well as few interventional radiology units globally with fewer unts in the developing countries, we would recommend that more interventional radiologists should be trained globally and more interventional radiology units should be established globally especially in the developing countries.

Background Among factors which affect the outcome of rehabilitation after hip fracture, the role of pre-fracture frailty has not been defined. Objective To assess the impact of frailty on rehabilitation outcome in elderly persons with proximal hip fracture. Setting Geriatric rehabilitation center. Design Retrospective observational study. Subjects Forty consecutive patients with proximal hip fracture. Methods The following parameters were calculated: FI-MDS frailty index, Rockwood Clinical Frailty Scale (FI Rockwood), Functional Independence Measure (FIM) on discharge, absolute functional gain (?FIM), length of stay (LOS), and FIM gain per day (?FIM/LOS). FIM discharge =90 and motor FIM discharge >58 indicated success in rehabilitation. Results There were 31 women and 9 men, mean age 80 years. The mean pre-fracture FI MDS was 10 points (SD 5.8) out of 58 possible, the mean FI Rockwood score was 3 (SD 1.7) out of 7 possible. The mean admission FIM was 76.6 (SD 16), the mean discharge FIM was 92.7 (SD 19.3), mean LOS 22.5 days (SD 9.7), mean ?FIM/LOS 0.8 (SD 0.6). Pre-fracture frailty was associated with worse outcome of rehabilitation: FI MDS predicted discharge FIM =90 with OR 0.86, p 0.012; FI Rockwood predicted discharge FIM =90 with OR 0.68, p 0.027; FI MDS predicted discharge motor FIM >58 with OR 0.91, p 0.07; FI Rockwood predicted discharge motor FIM >58 with OR 0.71, p 0.027. Conclusions Though pre-fracture frailty correlated with FIM on discharge, neither frailty tool was specific enough to predict success in rehabilitation and the necessary length of rehabilitation. Translating frailty scores in tools adequate for clinical decision making remains an aim for future studies.

Background: Having a child in hospital is a stressful experience for most parents, especially for mothers. In Bangladesh, the number of hospital admission of under-5 children is gradually increasing. Support from nurses can assist mothers to maintain their parenting role and promote quality nursing care. Objective: The study was conducted to assess the nursing support perceived by the mothers of hospitalized children in Bangladesh. Methods: A Descriptive cross-sectional study was conducted among 112 mothers whose children were admitted at Dhaka Medical College Hospital. Convenience sampling technique was used to select the study participants. Data was collected by using self-administered structured questionnaires including (1) The Demographic Data Questionnaires and (2) Perception of Nursing Support Questionnaire. Data were analyzed by using descriptive and inferential statistics. Results: The total mean of nursing support was 3.68 (SD=.25). The findings showed that there was a statistically significant difference between mothers’education and nursing support (F=2.73, p=.033). There was a statistically significant positive relationship between child age and nursing support (r=.22, p=.019). There were statistically significant differences between a child’s gender and nursing support of mothers (t=1.99, p=.048) which means mothers who had a male child had more nursing support. Conclusion: The findings of the present study provide information for the nurses ‘that help to increase nursing support among mothers of hospitalized children in Bangladesh. Nurses can promote the quality of care and should be aware of the importance of nursing support. Further study is crucial for identifying factors influencing on nursing support perceived by the mothers of hospitalized children. It is important that nurses continue to develop their knowledge about communication and establishing parent support system.

Spontaneous intracerebral hemorrhage (ICH) has remained the least treatable form of stroke despite recent improvements in medical treatment. Treatment usually supportive and medical such as ventilatory support, blood pressure reduction, osmotherapy, fever control, seizure control and nutritional support and treatment of co morbidconditions. This study was carried out to see demographic variability, clinical presentation, causes and outcome of spontaneous intracerebral hemorrhage. Methods and materials: This was a cross sectional observational prospective in study on 50 spontaneous ICH patients admitted in Medicine department of Khulna Medical College Hospital from November 2020 to April, 2021. Result: The study showed that spontaneous ICH was most common in between 41-70 years. Their age frequency were 14 (28%) in 41-50 years, 15 (30%)in 51- 60 years, 12 (24%) in 61-70 years, 5 (10%) in 71- 80 years and 4 (8%) in more than 81 years age group. Among the patients, 64% (32) were male and 36% (18) were female. No of smoker male was 25(50%) and female was 1(2%) and no of nonsmoker male was 7(14%) and female was 17(34%). Headache was present in 56% (28) and absent in 44% (22) of patients. Vomiting was present in 54% (27) and was absent in 46% (23)of patients.Seizure was present in 16% (8) and was absent in 54% (42) of patients. Diabetes mellitus was present in 22% (11) of patients and absent in 78% (39) patients. Range of blood pressure –<140/90 in 24%(12), Systolic BP:140-159/Diastolic BP:90-99 (mm Hg) in 10%(5), Systolic BP:160-179/Diastolic BP:100-109 (mm Hg) in 22%(11),Systolic BP:180 or more/Diastolic BP:110 or more (mm Hg) in 44%(22) patients. Dyslipidemia was present in 30% (15) & absent in 70% (35) patients. Glasgow Coma Scale Score was 8 or less in 42% (21) and 9 or more in 58% (29) patients. Conclusion: Spontaneous ICH is common in Indian subcontinent. As death occur due to ICH itself, associated co morbidities or due to complications, management in stroke care unit, High dependency unit and Intensive care unit is required.