Safety in all sphere of life and in every field of working is prime concern for individuals. Thus, safety in surgery and safety in blood transfusion during pre-operative, intra-operative and in post-operative period is mandatory. We can pre-deposit our own blood before planed surgery is scheduled, called as pre-operative autologous blood donation (PABD), but it may not be possible for emergency surgery so we may have to go for allogenic blood transfusion in case of blood needed for life saving purpose. People are now much aware on transfusion reactions; some time fatal consequences have been noticed in blood transfusion. Transfusions of allogenic blood caries more risk than the autologous blood. Many of clinicians recommend autologous blood, so PABD will be wise step before individual person plans for planned surgery. A fear of transmission of transmissible infection such as HIV/AIDS, Hepatitis B, Hepatitis C, Malaria, syphilis, tuberculosis and many others, are possible in allogenic blood transfusion, which is not with PABD.

Anesthesia and anesthetist are the co-worker to surgery. Surgeon and anesthetist with other subordinates is the surgical team. Patient satisfaction, surgical comfort to surgeon, patient, anesthetist and surgical team is the main stray and key point to select the type anesthesia to be given to particular individual. We had been doing a lot of general surgery under spinal anesthesia. Here main focus is laid down on gall bladder and renal surgery, which are relatively difficult to get done in spinal anesthesia without good co-operation of anesthetist. We had been doing renal and gall bladder surgery under spinal for the last more than 40 years, as there used to have no anesthetist in peripheral hospitals of Nepal, so giving spinal anesthesia by self and then doing surgery was the trend, which is now changed, as well-trained anesthetists are now available even in every big peripheral hospital of the country. We are presenting a record of last 10 years of renal and gall bladder surgery done under spinal anesthesia. We have done total 248 cases of renal stones including 12 nephrectomies for gross hydronephrosis with nonfunctional kidney big mass and 355 cases of open cholecystectomy through classical transverse subcostal incision.

Introduction: The mean systemic filling pressure (PMSF) depends on volemic state, vasomotor tone and cardiovascular function. Therefore, it should be causally correlated with cardiac power, myocardial efficiency and venous return gradient. The aim of the present study was to correlate PMSF with cardiac output, myocardial efficiency and venous return gradient in the perioperative period of patients undergoing orthotopic heart transplantation. Material and methods. Retrospective, descriptive, analytical cohort study, from January 1, 2021 to January 31, 2022. Inclusion criteria included liver transplantation (ortothopic) adult patients with pulmonary artery catheter. Those with decompensated liver disease due to hemorrhage, grade III ascites or hepatic encephalopathy and those admitted to the ICU without pulmonary artery catheter were excluded. The aim was to correlate PMSF with cardiac power, myocardial efficiency and venous return gradient in the perioperative period of liver transplantation patients. Results. A strong positive correlation was reported between cardiac power and PMSF just after placement of the pulmonary artery catheter (initial) (r= 0.929, p= <0.001), as well as between cardiac power output and PMSF in the preanhepatic phase (r= 0.591, p= 0.013). For myocardial efficiency strong negative correlations with significant p-value were found for initial PMSF and myocardial efficiency r= -0.659, p= 0.04; between myocardial efficiency and PMSF in the preanhepatic phase r= -0.635, p= 0. 006; myocardial efficiency and PMSF in the anhepatic phase, r= -0.593, p= 0.012; between myocardial efficiency and PMSF in the neohepatic phase r= -0.502, p= 0.040; and for myocardial efficiency and PMSF on admission of patients to the ICU r=-0.571, p= 0.017. Related to the venous return gradient (PMSF - CVP) and PMSF, the correlation was r= 0.919, p= <0.001 (initial) and for the preanhepatic phase with a moderate positive correlation r= 0.490 p= 0.046. Conclusion. PMSF is useful as a marker for the diagnosis and hemodynamic management of patients undergoing liver transplantation.

Most primary CNS tumors are astrocytic tumors. Glial tumors are classified according to histological criteria. The WHO classification for primary malignant gliomas in adults includes grades II through IV. Terms for tumors that classify in grade II are astrocytomas (A), oligodendrogliomas (ODG), or mixed gliomas (GM). Grade III tumors are named similarly, and preceded by the word anaplastic, for example, anaplastic astrocytoma (AA), anaplastic oligodendroglioma (ODGA), or mixed anaplastic glioma (GAM). The most malignant form, the grade IV tumor, is designated glioblastoma or GBM. GBMs are diagnosed more frequently than lower grade astrocytomas. The recent GBM classifications reflect the genetic aspects involved in the tumor and have prognostic value. The most important prognostic factor in malignant gliomas is the histopathological diagnosis of the tumor. The survival of patients with AA is much higher than that of patients with glioblastoma. Other important factors that are associated with the survival of patients with malignant gliomas are the age of the patients, Karnofsky scale, surgery, radiotherapy, and chemotherapy. There is evidence suggesting an association between younger patients and longer survival in adults with supratentorial AA and glioblastoma

Brugada syndrome is a genetic disorder that causes abnormalities in the correct functioning of the electrical system of the heart, which can end in health complications such as arrythmias, syncope or, in the most severe cases, sudden death. Nowadays, stratification of the risks derived from this disease is still a great challenge due to the disorders complex nature influenced by several factors. Such investigations have been able to obtain evidence of the role that autonomic imbalance plays in the pathology of the disorder. Subsequently, a Matlab code inspired by pre-existing algorithms was written, carrying out research on the methods currently used to detect this syndrome, in order to study the different biomarkers obtained through a simple and non-invasive procedure such as the electrocardiogram(EKG). After the study, the length of the QRS complex and the T wave, the absolute area , the RMS amplitude, as well as the length of the QT and QTc segments of each of the patients´ EKGs were measured.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous responses caused by drugs that are characterized by widespread necrosis and epidermal detachment. It is essential to know the risk factors and those agents involved in the development of this pathology in order to use them with caution in susceptible patients and to have a high index of suspicion.

Alopecia areata is a relapsing chronic condition that causes hair loss without leaving scars. Alopecia areatas clinical history varies; the condition may resolve spontaneously, persist, recur, or advance. Alopecia areata sufferers are treated in numerous ways, including: Information about the progression and prognosis of alopecia areata Consideration of medical treatment continuation; Treatment selection (for individuals who desire to continue treatment); Provision of psychological support resources; and Discussion of aesthetic possibilities.

Melasma management is frequently difficult, with many examples of inadequate remission and repeated relapses. Depending on the patients features and clinical presentation, a multimodal treatment involving photoprotection, skin lighteners, exfoliants, antioxidants, and rejuvenation operations is necessary in most situations.

Increase of blood glucose level In pregnant woman correlated with increased risk of maternal morbidity, and problems in labour also affect child outcome. This phenomena cause by physiological changes occur in pregnancy such as placental factor and inflammation factor in circulation. Changes in inflammation factor like tumor nerosis factor (TNF-a) and beta-cell correlated gene disfunction (potassium voltage-gated channel KQT-like 1 (Kcnq1) and glucokinase (Gck)) could affect blood glucose level. Blood glucose control in pregnant woman known to be effective to decrease and prevent complication in mother and fetus, such as preeclampsia, prematurity, low birth weight, and asphyxia baby. This research wish to know correlation of maternal blood glucose level to maternal delivery and fetal outcome. This research use seconder data from medical records as retrospective cohort study. Subject of this study are pregnant mother which given birth in Hasan Sadikin Hospital (RSHS) sbetween January 2018 – December 2021 and has been performed blood glucose test when first time administered in Hasan Sadikin Hospital. Analitic statistic was performed with contingency correlation test, association test with chi-square and continued with multivariate logistic regression. From 8996 subjects, positive correlation was founded between high random blood glucose with preeclampsia (r=0.154, p<0.001), premature labour (r=0.020, p=0.052), and low birth weight (r= -0.034, p=0.003). Correlation between random blood glucose and asphyxia was unfounded (r=0.003, p=0.809). There’s weak positive correlation between random blood glucose to preeclampsia and prematurity incidence. There’s also weak negative correlation between random blood glucose and baby birth weight. Correlation between blood glucose and APGAR score was unfounded.

Objective: This study was conducted to assess accessibility of ESRD patients to health care services of a specialized hospital. Methods: The study was a cross-sectional study, which was conducted at the National Institute of Kidney Diseases and Urology (NIKDU), Sher-E-Bangla Nagar, Dhaka, Bangladesh during the period from January to December 2021. The study included 384 ESRD patients, who were selected by purposive sampling technique. Data were collected by face-to-face interview with a pretested, semi- structured questionnaire and data were analyzed by current Statistical Package for Social Sciences (SPSS) 25 version. Associations of the categorical data were assessed by using Chi-square (x2) test. Prior to data collection, informed written consent was taken from each patient. Results: The study revealed that males (67.2%) and females (32.8%) were portion with mean age of 48.2±12.1 years. More than three fourth (79.9%) were married and 32.3% had graduation and it’s above of education level while 1.6% were illiterate. One forth was housewives; average family size was 5.17 (±2.00) and average monthly family income was Tk.44820.31 (±48545.87). More than fifty percent (58%) of the patients had come to the hospital from 30 kilometer away. About three forth (75.3%) of the patients went to the hospital by bus and 1.6% by rickshaw. Most of the patients (82%) were needed for admission within last one month and very fewer (10%) had got bed for admission. Average waiting time was 5.6 (±3.4) months to get dialysis schedule. Off all, 70.6 % got fewer prescribed drugs for dialysis treatment, majority (81.8%) got Femoral/Jugular catheterization service and only 2% got arteri-venous fistula services by the hospital. Among all participants, more than fifty percent (55.7%) got easy access for laboratory test and 28.1% got for radiological test. About half (56%) of the patients got cooperation by hospital staffs. It was found that males (46.5%) had significantly (p<0.05) average accessibility to the health care services than their counterpart females (21.8%). On the residency, rural patients (8.3%), had significantly (p<0.05) poor accessibility to health care services than urban patients (4.4%). Majority (68%) ESRD patients had average level of accessibility to health care services followed by “good” (19.0%) and “poor” (13.0%). Conclusion: To improve the accessibility of the End-Stage Renal Disease patients to the health care services of a specialized hospital, associated problems must be overcome by effective measures and program interventions.

Introduction: Acute Respiratory Syndrome related Coronavirus 2 (SARS-CoV2) is a novel Coronavirus causing the current pandemic. Among all the efforts to curtail the pandemic, vaccination is an important pillar towards halting transmission and reducing morbidity and mortality due to this disease. SARS-CoV2 has affected healthcare professionals (HCPs) globally. HCPs were a priority group that was vaccinated in the first phase in India. No vaccine is 100% effective. The effectiveness of the SARS-CoV2 vaccine in this high risk group needs to be studied. Objective: This study was undertaken to understand the number of breakthrough infections among doctors and nurses, their clinical presentation and outcomes after SARS-CoV2 vaccination was started in January 2021. Materials & Methods:This was a prospective study conducted in a 221 bed tertiary care hospital in Mumbai. Data regarding vaccination of doctors and nurses were collated from 16th Jan 2021 to 30th July 2021. The vaccines used were Covisheild (ChAdOx1-S/nCoV-19) and Covaxin (BBV152). A total of 638 HCWs were enrolled into the study comprising of 519 nurses and 119doctors. Relative risk and chi-square test analysis was performed to determine if there was a significant difference between breakthrough infections among those fully vaccinated versus the partially or non vaccinated HCWs. Results: 582/638 (84.3%) of our HCWs were vaccinated with atleast one dose of the vaccine as of 31st July 2021 . 404/638 (63.3%) of the HCWs were vaccinated with both doses of the vaccines. 178/638 (27.9%) were vaccinated with only the first dose. 48/638 (7.52%) were not vaccinated till 31st July 2021 . Breakthrough infections (BTIs) were seen in 5.2% (21/404) of HCWs. 22.9%(11/48) of unvaccinated HCWs had the infection in 2021 after vaccines were introduced . 17.4%(31/178) HCWs got infected after the first dose of vaccine. 13.5 % (7/52) of infected HCWs got admitted but did not require any oxygen support indicating they all had mild disease. All HCWs recovered completely. Conclusion: Our data clearly indicates that vaccination has a protective effect to SARS-CoV2 infection, with 22.9% infection among the unvaccinated HCWs and only 5% infection among HCWs who had taken two doses of the SARS-CoV2 vaccine. All infections post vaccination were mild in our study.

Background: Blood transfusion is an effective treatment that saves millions of lives. Nevertheless, transfusion transmitted infections (TTIs) are a major problem. The aim of this study is to assess the prevalence and trends of TTI in healthy blood donors in tertiary care hospital blood banks and compare it with national data and other studies in different regions. Methods: A retrospective cross-sectional study was conducted from January 2017 to December 2021 in healthy donors aged between 18 to 65 years. TTIs tests were performed using CLIA (Chemiluminescent Immunoassay) for HIV, HBV, HCV, and HBsAg, and RPR (Rapid Plasma Rea-gin) for syphilis. Results: Of the 12,193 normal healthy donors enrolled in this study, 124 (1.01%) donors were sero-reactive to various TTIs. Of the 124 donors, 11 (0.09%) were seropositive for HIV, 13 (0.106%) for HCV, 95 (0.7%) for HBsAg, and 5 (0.04%) for VDRL. There were no reactive donors for malaria. The most common age group for sero-reactivity was 21–30 years (50.8%) of all seropositive donors. Conclusion: The overall positive rate for all test combinations for TTI showed a steady trend with a gradual decrease from 2017 to 2021. We should raise public awareness and target people in their 21s to 30s, and contribute to safe blood transfusion.

Background: Sepsis is a common life threatening medical problem and first leading cause of death in Myanmar. This study was aimed to determine the predictive values of initial mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count for mortality in patients with sepsis and septic shock. Method: A hospital based prospective observational study done in No.(1) Defence Services General Hospital, Yangon, from January 2021 to October 2022. All patients above 18 years old admitted with sepsis and qSOFA = 2 were enrolled and sample size was 121 patients. The predictors were mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count, which were assessed within 24 hour of admission and the mortality was observed for 28 days. Logistic regression was used to find out the predictive value and the predictors were compared by receiver operating characteristic curve analysis. Results: The initial mSOFA score, point-of-care lactate and neutrophil-lymphocyte ratio of non survivors were significantly higher than survivors (mSOFA score 9 vs 4), (blood lactate 3.3 mmol/L vs 2 mmol/L), (neutrophil-lymphocyte ratio 13.4 vs 8.3). Platelet count was significantly lower in non-survivors than survivors (175 x 10^9/L vs 290 x 10^9/L). The mortality was 33.1%. The mSOFA score and lactate were strongly correlated (rho = 0.650, p < 0.001). The adjusted odds ratio of mSOFA score was 1.350 (1.135 – 1.606) with adjusted R2 0.478 and accuracy 80.2%. The adjusted odds ratio of lactate was 1.819 (1.168 – 2.834); NLR, 1.108 (1.023 – 1.200); platelet 0.992 (0.987 – 0.998) with adjusted R2 0.616 and accuracy 86.8%. Each predictor had moderate prognostic value (AUC > 0.7) and the combinations of mSOFA score and/or lactate with NLR and platelet count, good prognostic value (AUC > 0.8). Conclusion: The mSOFA score, lactate, NLR and platelet count had predictive value for mortality assessment in patients with sepsis or septic shock. Lactate level was strongly correlated with disease clinical severity of the sepsis, mSOFA score. The combination of mSOFA score and/or lactate with NLR and platelet count had better predictive value.

Objective: Identify the incidence of Petersens hernia in gastric bypass patients at our institution.

Kaposis Sarcoma (KS) is an angioproliferative neoplasm, the causative agent is human herpes virus 8 and the second most frequent tumor after non-Hodgkin lymphoma related to the human immunodeficiency virus (VIH). We present the case of a 40-year-old male with no history of chronic diseases, who began his condition with adenopathies in the bilateral inguinal region, adding a productive cough, lymphedema, and skin lesions with nodular characteristics and bleeding ulcers. A positive HIV test was reported, and a biopsy was performed, showing evidence of a spindle cell neoplasm compatible with KS. Laboratories with hemoglobin 8.3 mg/dL, platelets 239,000/uL, leukocytes 7.29/uL, glucose 76 mg/dL, creatinine 2.2 mg/dL, urea 80 mg/dL, albumin 1.69 g/dL, TGO 18 IU/L, TGP 5 IU/L, DHL 189 IU/L, viral load 283,259 copies and CD4 192 cells. Chest and abdomen computed tomography with evidence of pleural effusion, and multiple retroperitoneal and inguinal adenopathies. Starting concomitant retroviral treatment with liposomal doxorubicin, improving clinical status and laboratory parameters. HIV-infected people are at high risk of developing KS, early initiation of antiretroviral therapy, and maintenance of high CD4 cell counts are essential to reduce the incidence.

Introduction: Enterococcus faecalis is a bacteria found in failed root canal treatment cases. Enterococcus faecalis can tolerate significant environmental changes and invade the dentinal tubules, so under certain conditions, irrigants cannot altogether remove them in the chemomechanical process. Basil ( Ocimum basilicum ) is a natural ingredient with many benefits and is known to have high antibacterial activity against Gram-positive and Gram-negative bacteria. This study aimed to determine the antibacterial effect of ethanol extract from basil leaves ( Ocimum basilicum ) against Enterococcus faecalis ATCC 29212. Methods: This research was conducted by testing the bacteria Enterococcus faecalis ATCC 29212 with ethanol extract of basil ( Ocimum basilicum ) leaves made from 256,000 ppm – 1,000 ppm, using the disc diffusion method, carried out with three repetitions. Precise zone measurements were carried out using a caliper. Results: There were no clear zones produced by the ethanol extract of basil leaves ( Ocimum basilicum ) against Enterococcus faecalis ATCC 29212 at various test concentrations. Discussion: the test results in this study can be influenced by (i) the solubility factor of the extract, (ii) the active compounds contained in the plant, and (iii) the method used in this study. Conclusion: The ethanol extract of basil leaves ( Ocimum basilicum ) has no antibacterial potential against Enterococcus faecalis ATCC 29212. Further research can be carried out using the agar diffusion method or by conducting a minimum inhibitory concentration (MIC) test to confirm the antibacterial effect.

Talking about thyroid carcinomas leaves a fairly wide slope, in which it should be considered not only the variants and their clinical frequency, but the mutant genetic finding that gives preamble to the malignancy, its clinical variability, histological as well as the prognosis. It is important to note that the most frequent thyroid carcinoma in the population is papillary, with an index greater than 80% of all cases, being rare in pediatrics. The papillary thyroid subtype is the result of one of two possible alterations affecting the genes encoding tyrosine kinase, either in the RET gene of chromosome 10q11 or in the BRAF gene, by an early mutation in the MAP kinase signaling pathway. Statistically, it is known that the mutation in the BRAF gene represents most of the alterations that give rise to papillary thyroid carcinoma, and in turn, this BRAF gene presents an alteration in the amino acid 600, which gives rise to the BRAF 600E gene. That is why, in this research work focuses on the role BRAF V600E and papillary thyroid carcinoma, from the pathogenic mechanism that gives rise to the mutation, the genetic location of the mutation. Clinical and histopathological relationship with the BRAF mutation as well as prognosis and certain related complications are mentioned.

The low awareness of nurses to carry out nursing actions causes nurses to be very vulnerable to transmission of infection because nurses in providing nursing care to patients will have direct contact with blood and body fluids. Universal precautions require health workers to treat all patients equally using universal precautions regardless of the disease. The purpose of this study was to determine the relationship between the knowledge of nurses about Universal Precaution and the prevention of Nosocomial Infections at the Royal Prima Prima Hospital in Medan. This type of research is analytic with a cross-sectional design. The population in this study were all nurses in the ICU, NICU, PICU, and inpatient disease rooms and postoperative rooms as many as 58 people. Sampling in this study was to use a saturated sampling of 58 people. The results of the study with the results of the chi-square test with a degree of significance (a) = 0.05 and df = 4 obtained the calculation results, namely X²count 16.948 > X²table 9.488 and p-value = 0.002, then Ha is accepted, namely there is a relationship between nurses knowledge about Universal Precautions and Nosocomial infection prevention measures. In conclusion, there is a relationship between nurses knowledge of Universal Precaution and Nosocomial Infection prevention measures in hospitals. It is expected that respondents will increase their knowledge about Universal Precautions so that preventive measures are carried out properly and in accordance with standards so that Nosocomial Infections can be prevented

Breast sarcoma is an uncommon clinical entity that represents less than 1% of all breast malignancies. This tumor has a mesenchymal origin and is classified into primary breast sarcomas and secondary breast sarcomas which develop as a result of previous irradiation or chronic lymphedema. A 73-year-old female was admitted to the Mankweng Academic Hospital, University of Limpopo, South Africa, with a rapidly enlarging, painful lump in her left breast with duration of 3 months. The patient had no previous history of malignancy or irradiation. Clinical local examination revealed asymmetrical breasts with the left breast bigger than the right. Mammogram revealed a large dense retro-areolar mass containing suspicious intralesional calcifications within the left breast. Histopathological results from biopsy reported features of sarcoma with a heterologous chondroid and osseous differentiation. A left mastectomy was performed, resulting in a complete removal of the tumor with clear margins. The patient was subsequently discharged home in good general condition, without complications, with appointments for follow up at the outpatient clinic, as well as a referral to the oncologists for radiotherapy.

This study aims to determine the relationship between noise levels and work stress levels in employees of the Gotri Gentong Factory in Semarang. The research location in the working area of the Gotri Gentong Factory in Semarang in the administration and production department. The research sample was 36 samples in employees in the production department and 36 samples of employees in the administrative department. Analysis of the relationship between noise levels and work stress levels in employees of the Gotri Gentong Factory Semarang using the chi-square test. The results showed that there was a meaningful relationship between noise intensity and stress levels with a prevalence value of 0.000 (< 0.05). For further research, it is necessary to use different types of treatment with different time periods.

Background: Continuous bleeding will inhibit the formation of blood clots and cause the wound healing process to be hampered, thereby endangering the patients life. Kenikir leaves contain flavonoid compounds, tannins, and saponins which have the potential as natural hemostatic agents in shortening bleeding time. Aim: To analyze the effectiveness of kenikir leaf extract (Cosmos caudatus kunth) on bleeding time in the tails of mice (Mus musculus). Material and Methods: This type of research is a laboratory experiment with a post test only control group design method. The samples used were 12 mice and divided into 3 groups, namely negative control (K-), positive control (K+), and treatment (P). All samples were adapted for 7 days, then fasted for 4 hours, then given each ingredient according to the group, then waited for 60 minutes and cut the mice tails along 0.5 cm from the tail end. Blood is dropped on filter paper every 30 seconds until the bleeding stops, the results of the calculation of bleeding time were analyzed using the Anova and LSD analysis. Results: The average bleeding time in the K-, K+, and P groups was 7.25 minutes, 1.87 minutes and 3.37 minutes. Anova analysis results obtained a significance value (p<0.05), which means that there are differences in all groups. LSD analysis showed that there were significant differences between K- and K+ groups and K- and P groups, whereas in the K+ and P groups no significant differences. Conclusion: Kenikir leaf extract can shorten the bleeding time in mice tails.

Background: Hydatidiform mole is a gestational trophoblastic disease with the highest incidence in Indonesia where the incidence is 1 in 40 pregnancies. The cause of the high incidence of Hydatidiform mole is influenced by the reproductive performance of patients such as disorders of the hypothalamic-pituitary-ovarian system which causes hyperproliferation of trophoblastic cells, hydrophic degeneration of chorionic villi, and increased levels of ß-hCG. Methods: This research was involving human subjects so that was related to the issues of ethical consideration. It was done at the Anatomical Pathology Laboratory and the medical record division of the Hasanuddin University Hospital and Dr Wahidin Sudirohusodo Hospital Makassar from September - November 2019. The number of samples was 28 which used the total sampling method that fulfill the inclusion and exclusion criteria. Data analysis used chi-square. Results: There are correlation between the histopathologic features with ß-hCG levels, they are hydrophic degeneration of chorionic villi with ß-hCG levels (p= 0.008) and proliferation of trophoblast cell with ß-hCG (p= 0.001). Conclusions: There is a correlation between the histopathologic features and ß-hCG levels in the event of hydatidiform mole at Hasanuddin University Hospital and Dr. Wahidin Sudirohusodo Hospital Makassar. The higher levels of ß-hCG, the histopathologic features of hydropic degeneration villi will increase and trophoblastic cells will become hyperproliferation.

Background and Objectives: Nosocomial infections, especially in intensive care units as well as increased mortality and costs associated with them are considered as one of the major health problems in the communities so that successful control of them requires awareness on their problems in the hospitals and a precise planning. This study was conducted to "provide a model for prevention and control of nosocomial infections in intensive care units".

Background and objectives: Intravaginal practices are quite common among women worldwide and expose to bacterial vaginosis. The aim of our study is to evaluate the prevalence of intravaginal practices in women of childbearing age who came for consultation at the Gynaeco-Obstetric and Pediatric Hospital of Yaoundé and to determine its association with bacterial vaginosis. Methods:We conducted a prospective and cross-sectional study among 212 women from April 12 to July 30, 2021. Each participant was submitted to a questionnaire and was taken a vaginal swab. For the diagnosis of bacterial vaginosis, we made a flame-fixed slide smear and then stained by Grams method. We classified the vaginal flora into four types according to Thomason and to make the diagnosis of bacterial vaginosis.

Background: Chronic DM sequelae include microvascular complications like retinopathy, nephropathy, and neuropathy as well as macrovascular concerns including coronary artery disease, cerebrovascular disease, and peripheral vascular disease. The most frequent long-term microvascular consequence of diabetes mellitus and a major contributor to vision impairment and blindness is diabetic retinopathy, which is also potentially preventable. In this study, an effort has been made to measure and detail the relationship between severity of diabetic retinopathy and duration of type 2 diabetes mellitus. Aim: The aim of the study was to correlate the severity of Diabetic Retinopathy with duration of Type 2 Diabetes Mellitus Materials and Methods: 50 cases of type 2 DM were included in this study. Detailed history including age & sex of the patient, duration of diabetes, anterior segment and detailed fundus examination was carried out & grading of DR was done based on ETDRS (Early Treatment Diabetic Retinopathy Study). Results: Out of all,35 patients were having some form of DR on presentation. The mean ages of mild, moderate, severe NPDR & PDR were 57.94±3.99, 59.82±5.28, 62.67±13.38, 68.33±3.33 years respectively. The mean duration for DM in the study for mild, moderate, severe NPDR and PDR were 7.17±1.98, 9.73±3.17, 13±3.06 & 21.33±9.33 years respectively. Conclusions: Severity of diabetic retinopathy was strongly associated with duration of type 2 DM.

Introduction: smear layer is a thin layer formed from tooth structure instrumentation which can prevent the restoration material bonds the tooth structure. Partial smear layer should be removed using dentin conditioner. One of dentin conditioners that is often used is 10% polyacrylic acid. The natural ingredient that is thought to be an alternative to dentin conditioner is cocoa pulp juice because it contains many acidic compounds. Methods: This research is a laboratory experimental study to determine the ability of 100% cocoa pulp juice (Theobroma cacao L.) to remove the crown dentin smear layer and compare it to 10% polyacrylic acid. Eight dental elements were prepared for class I cavities on the middle 1/3 of buccal surface to reach 3 mm in diameter and 2 mm in depth, enamel was prepared until 1 mm in depth of cavity left. The samples were irrigated with sterile aquades and dried. Furthermore, 4 samples were applied 10% polyacrylic acid and 4 samples used cocoa pulp juice, left for 20 seconds, irrigated, dried, and put in the oven for 2x24 hours. The samples were examined for their cavity cleanliness score using Scanning Electron Microscope (SEM) photo with 2000x of magnification. Result: both groups have the same score and statistical test shows that there is no significant difference between them. Conclusion: the 100% cocoa pulp juice was able to clean the smear layer of crown dentin and its ability equal to 10% polyacrylic acid.

The objectives of this study were to detect pre-heart failure based on NT-proBNP in subjects with hypertension and to identify the risk factors for pre-heart failure. Research methods: We conducted a cross -sectional study between August and December 2022. This study was included 526 subjects with hypertension aged from 35- to 64 years, who had no clinical symptoms of heart failure. Cardiovascular risk factors were detected by clinical examinations and laboratory test. Hypertension was defined as systolic BP?=?130 mm Hg, diastolic BP?=?80 mm Hg, and/or receiving treatment with anti-hypertensive agents. NT-pro BNP determination was performed on an immunoassay analyzer (Getein 1100). An elevated NT-pro BNP was defined as a NT-pro BNP = 125pg/ml. Pre-heart failure was based on elevated NT-pro BNPlevel. Ethical statement Research ethical permission was obtained from the Biomedical Ethics Committee of Mongolian National University of Medical Sciences. Research results: In total, 526 hypertensive subjects s aged 35-64 year enrolled in this study, of which, 243 (46.2%) were men and mean age was 52.5±7.7 years.

Toxic megacolon is a fatal condition defined as a rare, life-threatening, acute colonic dilatation of colitis. The case of a 41-year-old male with a history of irritable bowel syndrome is presented, who starts with diarrhea on more than 20 occasions accompanied by blood and mucus, emesis is added, and a fever of 39°C. Laboratories with hemoglobin 8.1g/dL, positive clostridium difficile toxin AB, positive glutamate dehydrogenase, simple abdominal tomography with distended intestinal loops, and presence of rectovesical fistula, performing total colectomy with ileostomy reporting ischemic colitis, perforation with ulcerated areas and pseudopolyps. Continued with well tolerated feeding. There are case reports of megacolon as a complication of inflammatory bowel disease and clostridium difficile infection. Total colectomy plus ileostomy is the surgical procedure of choice when conservative treatment fails. Inflammatory bowel pathology can show in its spectrum various clinical characteristics of debut or evolution, so a multidisciplinary approach and management must be taken from the diagnosis.

Objective: The objective of this study was to compare the advantages and disadvantages of patients undergoing either immediate or delayed breast reconstruction after mastectomy. Methods: This review was compiled using information from numerous web databases. Scientific articles were selected based on the inclusion criteria. Data were collected, organized, and summarized. Results: Mastectomy or breast removal is frequently performed as part of breast cancer treatment. Psychological issues following a mastectomy may get better for some patients after breast reconstruction. The most common type is immediate reconstruction, which preferably uses a nipple-sparing or skin-sparing mastectomy and implant-based reconstruction (but can also be autologous reconstruction). Delayed reconstruction is often performed using autologous tissue flaps or implant-based using either the definitive implant or temporary expanders. Conclusion: Immediate reconstruction creates better cosmetic outcomes, shorter overall costs, quicker recovery, higher quality of life, and increases the psychological well-being of patients. Besides, delayed reconstruction is a beneficial option for post-mastectomy radiation therapy (PMRT) cases and reduced the incidence of postoperative complications than immediate reconstruction.