Mycetoma is a chronic infection of the skin and underlying tissues caused by fungi or bacteria. It is endemic to tropical regions, mainly affecting men, peasants, between the third and fourth decade of life. The clinical picture is characterized by increased volume, deformity of the anatomical area, and fistulas that drain a stringy exudate with the presence of "pimples." The diagnosis and determination of the etiological agent is carried out by direct analysis and culture of the secretion.

This article aims to comprehensively describe a particular case of bilateral intraocular subluxated lens with pseudoexfoliation syndrome in a Moroccan woman with homocystinuria. We report a case of a 56-year-old patient who has a cataractous subluxated lens along with whitish deposits. The association of PEX syndrome with hyperhomocysteinemia has rarely been found. It worsens the lense zonular stability and causes multiple complications.

Background: Newborn sepsis is a clinical syndrome characterised by infection-related signs and symptoms in the first month of life, with or without bacteraemia. Sepsis is defined by the Brazilian Health Surveillance Agency (ANVISA) as a systemic reaction with at least two or more of the following signs and symptoms: thermal instability, bradycardia, apnea, intolerance, worsening of respiratory discomfort, hypoactivity and lethargy. Materials and Methods: This cross-sectional study was conducted in the Bal Chikitsalaya, M. B. Government Hospital, Udaipur (Rajasthan). A total of 100 sample sizes were included in between 6-month periods from March 2019 to August 2019. Blood culture reports were compared to haematological scoring parameters, C-reactive protein (CRP) levels, and other factors. Results: 27% of the 100 cases under investigation had positive blood cultures. There were 65% male. 35% of neonates had very low birth weights and 60% were premature. 74% of cases of septicemia had an early onset, compared to 26% of cases with a late onset. In 37.1% of cases, klebsiella was the most frequent organism identified, followed by E. coli and Coagulase Positive Staphylococcus. It has a higher sensitivity and a lesser specificity. The PPV range of the haematological grading criteria was 47% to 65%. C-reactive protein has extremely high sensitivity (81.5%) and extremely low specificity (9.6%), respectively. Conclusion: The early diagnosis of newborn sepsis can be made with the help of the Haematological Scoring System (HSS), which is a rapid, easy-to-use, readily accessible, bedside, cost-effective diagnostic. As opposed to blood cultures, haematological scoring factors are effective early diagnostic and treatment tools. Since the indicators have excellent sensitivity and specificity, antibiotics can be administered to asymptomatic patients with negative culture results. The accuracy of the sepsis diagnosis is improved.

Objective: The study aimed at identify some factors related to practices of mothers and acute respiratory infection disease in children under 5 years old in rural area, Vietnam. Material and methods: A cross-sectional study was conducted on among 194 mothers and their children under 5 years old in the rural area of Vu Ban District, Nam Dinh province, Vietnam from October 2020 to June 2021. The questionnaire includes 16 items and 3 technique checklists was used which was comprised of sociodemographic factors and information about practices of mothers in prevention and caring for children with acute respiratory infection. The questionnaire and diagnosis of acute respiratory infection (ARI) was based on the revised WHO guidelines. Then the data was collected, analyzed and entered into the SPSS 25.0 program. Using Chi-Square statistics and the odds ratio OR with 95% CI confidence to analyze and determine the relation factors between the two variables in the study. Results: Unsatisfactory practices of mothers in prevention and caring for children with ARI accounted for high percentage (61.9%). In addition, the incidence of ARI in children under 5 years old was 43.8% (85/194 children). There were some relationships between the mothers education level, receiving counseling information, number of children, the incidence of ARI in children and mothers practices about ARI. The difference was statistically significant with p <0.05. There were some relationships between the mothers education level, receiving counseling information about ARI, mothers practical skills in caring and the incidence of ARI in their children. The difference was statistically significant with p < 0.01. Conclusions: The practices of mothers in prevention and caring for their children with ARI were low. The study revealed that some factors related to practices of mothers and ARI disease in children under 5 years old.

During the American Civil War, contemporary accounts describe a peculiar luminescence phenomenon associated with untreated injuries sustained by fallen troops after the Battle of Shiloh (6-7 April 1862). While not experienced by all soldiers, field surgeons observed that the glow was somehow linked to reduced rates of wound infection and better outcomes. Given the wet springtime weather and unsheltered overnight conditions of the injured, it is plausible that some lacerations or punctures were incidentally infected with microscopic contaminants, including common soil nematodes. One endemic group likely present on riverbank groundcover is fam. Heterorhabditidae, a symbiotic host to Photorhabdus luminescens. Classified within the Morganellaceae, this Gram-negative pathogen is characterized by its unusual life cycle. With particular relevance to Shiloh, this sequence includes a blue-green phosphorescence phase accompanied by release of protein toxins having local antibiotic properties. Here, natural progression of this microbe from nematode symbiont to lethal secondary insect parasite lodged in an unclean wound is considered. Photorhabdus life-cycle is discussed as a component of the Martin-Curtis Hypothesis (2001), with new information on fluorophore isolation and recent genomic sequencing data. The Shiloh campaign is also placed within the context of the larger Western Theatre, noting that the engagement marked the heaviest Civil War casualty toll up to that point.

Nigeria recorded the first case of COVID-19 infection on Feb 27, 2020. Thereafter, National response was imposed with different curtailing measures including travel bans, closure of schools, markets and limiting the number of persons that could congregate in a place. The objective of this study was to evaluate the epidemiological situation of COVID-19 in Niger state, Nigeria using the data collected during the outbreak, describing the sociodemographic characteristics and epidemiological behavior and clinical symptoms of those tested and confirmed COVID-19 cases. We conducted a state wide population based analysis of the epidemiology of COVID-19 using data reported from all the 25 Local Government Areas of the state from March 2020 to March 2021 for the first, second and third waves of the epidemic. We calculated the overall incidence, case fatality rate, association of sociodemographic variables and the outcome of COVID-19 cases, frequency of different symptoms and drew an epidemic curve. A total of 1128 cases and 20 deaths were included in the analysis with sex distribution of 63.9% males and 36.1% females. The overall incidence rate was 20 cases per 100,000 populations. Commonest symptoms were cough (62.5%), Fever (54.2%) and difficulty in breathing (42%). We found that age was an important determinant of death in COVID-19 cases and health care workers were significant contributors of morbidity and mortality. We recommend strengthening of the health care system especially emergency response, availability of intensive care services, improvement of laboratory services, community surveillance and contact tracing capacities to prevent and control future epidemics.

The relevance of the use of mpMRI (multiparameter prostate magnetic resonance imaging) to evaluate the prostate in the context of PCa diagnosis lies in its ability to visualize primarily high-grade cancerous lesions that may be missed in routine diagnostic biopsies. standard. In several studies, mpMRI has shown improved performance compared to clinical models in identifying candidates who will benefit most from different therapies such as SA. Although data on mpMRI of the prostate during follow-up in men undergoing SA are sparse, there is potential to significantly improve AS programs through more accurate selection of optimal candidates which could achieve more accurate identification of progression of prostate cancer. disease and a reduction in the number of biopsies that would be needed to retest patients.

Systemic lupus erythematosus (SLE) is a systemic inflammatory disease secondary to an autoimmune response that is characterized by the deposition of immune complexes that activate complement and cause tissue damage. The American College of Rheumatology (ACR, American College of Rheumatology) in 2012 established the new diagnostic criteria for SLE, identifying 17 criteria of which at least 4 must be met (at least one clinical, and one immunologic) or lupus nephritis as the sole criterion in the presence of antinuclear antibody (ANA) or double-stranded anti-DNA for diagnosis.1

Cutaneous larva migrans is a skin infection caused by the subcutaneous migration of larvae of different species of nematodes. Also called Creeping eruption or serpiginous eruption, it is an endemic skin parasitosis of tropical and subtropical areas with hot and humid climate. In our environment it is unusual, predominating in individuals who have come to these areas, although there are rare cases of acquisition in European countries. It was first described by Lee in 1874 and since then its prevalence has been increasing, affecting millions of people each year. It is an endemic process in tropical and subtropical areas. Due to growing immigration and booming travel to these geographical areas, its prevalence in developed countries has increased in recent decades. For all these reasons, we believe it appropriate to disclose the existence of this parasitic dermatosis among dermatologists and primary care physicians.

Pancreatitis is the disease that affects the organ of the pancreas and should be given early attention, since its complications are quite lethal and can involve other organs. This research work provides a compilation of important information that expresses, through its development, the most common complications associated with pancreatitis, especially in its hemorrhagic presentation, as well as the necessary treatments used in this condition. In the course of pancreatitis, the first two to four days of symptoms are the most important because this is the period during which 15% to 25% of patients progress to its severe form. According to clinical and experimental data, this period is characterized by an initial state of hypovolemia. The morbidity of severe acute pancreatitis is known to occur in two stages. The first two weeks are characterized by a systemic inflammatory response syndrome (SIRS), which results from the release of inflammatory mediators. Organ failure is common and usually occurs even in the absence of infection. The early mortality rate is 42 to 60%. The second stage begins approximately two weeks after symptom onset and is characterized by sepsis-related complications resulting from infection of pancreatic necrosis. Therefore, there is an association with systemic complications, such as pulmonary failure, renal failure, and cardiovascular failure, known as multiple organ failure syndrome (MOFS).

Pseudoptosis or “bottoming-out” is a common complication following breast reduction. It is secondary to five causal phenomena: improper determination of nipple placement, dissociation of the nipple from the gland, dissociation between different parcels of a reconstituted breast, improper evaluation of the skin to be resected and weakness of the inferior dermal arch. The total posterior pedicle breast reduction technique was described by Richard Moufarrege in 1982. It consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, the preservation of the nipple areolar complex sensation, and for the conservation of the breastfeeding function. In this article, we also elucidate the reasons why the Moufarrege Total Posterior Pedicle breast reduction technique has a lowest rate of postoperative pseudoptosis.

Introduction: Liver damage due N-diethylnitrosamine (DEN) is a global health challenge. The aim of this study was to assess the efficacy of roselle (Hibiscus sabdariffa L.) calyces’ water-extract as a Hepatoprotective material against liver damage induced by DEN in rats. Material and methods: Twenty-five (25) adult female albino Wistar rats were grouped randomly into five groups (Gs): G1, Normal healthy animals (act as control); G2, DEN; G3, Roselle extract; G4, DEN + roselle-extract; G5, DEN + nanoselenium. Tissue malondialdehyde (MDA) as oxidative stress marker, and antioxidant enzymes, superoxide dismutase (SOD) and catalase (CAT) were measured. Also, caspase-3 as apoptotic marker and tumor necrosis factor-alpha (TNF-a) as inflammatory factor, were assessed. Results: The results revealed decrease in MAD level and significant increase in antioxidant markers, SOD and CAT in DEN-group compared with control group. Moreover high increase in apoptotic marker, caspase-3; and significant decrease in TNF-a in DEN-group were recorded compared with normal control. Administration of roselle-extract led to significant increase in MDA and decrease in SOD and CAT parameters. In addition, high decrease in caspase-3 and increase in TNF-a was noticed. These findings were ensured by histopathological results. Conclusion: The roselle-extract improve liver architecture, and might be involved in the hepatoprotective activity against DEN exposure. Further studies are needed for elucidation clinical applications of the plant bioactive materials and explore its mode of action in attenuating and preventing carcinogenesis.

The patient with a hostile abdomen is a challenge, where the abdominal cavity is open, with the edges retracted, healed and compacted into a single block of fibrous tissue that does not allow its adequate dissection or separation, carrying a high risk of injury to the intestinal loops. and appearance of concomitant fistulas. The term catastrophic abdomen was used for the first time in 1937 by Abell I, describing a dramatic post-surgical condition, involving the presence of intestinal leakage in an open abdomen with severe adhesions, having a high associated mortality.

Amyand s hernia is defined as the presence of the cecal appendix inside the sac of an inguinal hernia. The appendix can be normal, inflamed, perforated or gangrenous, but the first situation is the most frequent. The name "Amyands hernia" is due to the English surgeon Claudius Amyand (1681-1740), who in 1735 performed the first appendectomy on an 11-year-old boy during surgery for an incarcerated inguinal hernia that contained the perforated cecal appendix in its inner.1,2 When the vermiform appendix is found inside a femoral hernia, it is called Garengeots hernia, in recognition of René Jacques Croissant de Garengeot (1688-1759), a French surgeon who was the first to describe the presence of the vermiform appendix inside the femoral hernia sac from an indirect inguinal hernia in 1731; in this case, the appendix did not present inflammatory signs. Diagnosis is generally intraoperative, since being an infrequent pathology, without specific symptoms and requiring high diagnostic suspicion, preoperative diagnosis is usually exceptional.

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune chronic multi-organic disease characterized by a deregulated innate and adaptive response. A series of viral and bacterial agents have been associated with SLE activation. Coronavirus family represents important infectious pathogens in both humans and animals, being responsible for approximately one third of community acquired superior respiratory tract infections. At the end of 2019, a new coronavirus (SARS-CoV-2) was detected as responsible for the COVID-19 disease. It was decided to evaluate if SLE patients had a greater risk of lupus activation when contracting COVID-19. Material & Method: Sixty two COVID-19 infected SLE patients were studied, comparing those who had suffered lupus reactivation versus those who had not. Renal function, autoinmunity and inflammation markers, and SLE reactivation risk was compared between both groups. Result: COVID-19 infection in SLE patients did not elevate lupus reactivation risk: OR: 0.8 (0.3-2.6), p: 0.7. Conclusion: COVID-19 is not, at the moment and as documented, a risk factor for SLE reactivation.

Saccular cyst of the larynx is a benign supraglottic lesion, filled with mucus. It forms from the laryngeal sac, which is a soft tissue mass that is an extension of the laryngeal ventricle. Due to the extreme rarity, the true prevalence of the disease is unknown, although congenital laryngeal cysts have been reported to affect 1 in 300,000 newborns. The gold standard for diagnosing of saccular laryngeal cysts is laryngoscopy. Treatment of saccular cysts can only be done surgically, using endoscopic or external access. It is believed that endoscopic CO2 laser excision is the treatment of choice.

Perineum and genital burns are infrequent, especially as isolated episodes. The primary objective of perineum burn care is to maintain urine and fecal continence. Cleaning, gentle debridement of loose burnt tissue with gauze, topical antibacterial treatments, and dressing changes are all part of the first therapy for burns on the perineum and genitals. Before attempting acute debridement, burns should be delineated.

Background: Client satisfaction is the degree of positive feeling that patients or clients having used a service. It indicates also the gap between quality-of-service expectation and the actual experience of the service provided from the patients’ point of view. Patient satisfaction has become an integral component of the quality of health care services. Objective: This study was conducted to assess the client satisfaction regarding drug dispensing services in tertiary public hospital during COVID-19 pandemic Methods & materials: The study was a cross-sectional study, which was conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from January to December 2021. The study includedpurposively selected 407patients who were received prescribing drugs according to prescription in selected hospital. 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 (44%) and females (56%) were portion with mean age of 33.71 years. Among 407 respondents, 89.4% (364) were dissatisfied and only 10.6% (43) of the respondents were satisfied with staff explanation on medication side effect, maximum 85% (346) of the respondents were dissatisfied and only 15% (61) of the respondents were satisfied with given counseling to proper storage of medication by the pharmacy staff, 76.9% (313) of the respondents were dissatisfied for attention during drugs supply and only 23.1% (94) of the respondents were satisfied for attention during drugs supply from pharmacy staff. Maximum 70.8% (288) of the respondents were satisfied and only 29.2% (119) of the respondents were dissatisfied for the medication storage of the dispensary. Mostly 98.5% (401) of the respondents were satisfied with labeling and packaging and rest of the 1.5% (6) of the respondents were dissatisfied and 61%, (247) of the respondents were dissatisfied with availability of required medicine and only 39% (160) of the respondents were satisfied on availability of necessary medicine in dispensary. Among 407 respondents, almost all of them around 91.9% (374), of the respondents were satisfied for wearing mask in the COVID-19 pandemic and minimum only 8.1% (33) of the respondents were dissatisfied for wearing mask in the COVID-19, around 91.9% (374) of the respondents were satisfied and only 8.1% (33) of the respondents were dissatisfied for not maintain etiquette of coughing and sneezing courtesy during drug dispensing by another person. The overall satisfactions among the total respondents were, 66.1% (269) respondents satisfied 33.9% (138) of the respondents were dissatisfied for overall satisfaction during drug dispensing. Conclusion: In conclusion, this study showed that the overall mean satisfaction level of clients of the outpatient’s pharmacy was average. Many of the clients described pharmacist as polite and just about half the patients rated the pharmaceutical service as good.

Background: Rabies is an important public health problem in Bangladesh and is at the top of the list among the zoonotic diseases. Objective: The objective of the study was to assess the level of knowledge regarding rabid animal bite among rural community people. Methodology: This cross sectional study was conducted among 345 rural community people from 1st January to 31st December, 2019 in several villages of Kaligonj in Gazipur district. Convenience sampling was adopted and a semi-structured interviewer administered questionnaire was used to collect data. Results: The mean age of the respondents was 39.63 ±13.35 years where majority (84.1%, n=290) of them were female and 81.7% (n=282) were literate. Only 4.9% (n=17) heard about rabies from health personnel, 14.2% (n=49) from mass media, 20.0% (n=69) from books and 60.9% (n=210) from general people. Most of the respondents 98.8% (n=314) knew that rabies is caused by infection from bite of rabid animal. Most of the respondents (97.7%, n=337) had knowledge that one should be vaccinated after bite of an animal. Majority of the respondents (92.8%, n=320) knew that rabies is preventable, 84.6% (n=292) knew about fatality of the disease.Half of the respondents (50.7%, n=175) had knowledge that rabies can be prevented by vaccination of rabid animals.Majority of the respondents (58.8%, n=203) had average knowledge regarding rabid animal bite while others had good (38.8%, n=134), and poor (2.3%, n=8) knowledge. Statistical significancewas found regarding level of knowledge and educational status (p<0.001). Conclusion: Majority of the rural community people had average level of knowledge regarding rabid animal bite. There is strong need for educational initiatives involving the local population and the public health authorities to support the rabies elimination program in Bangladesh.

Background: Health care workers are at increased risk of acquiring blood-borne infections as they are occupationally exposed to blood and body fluidsoccupational hazards such as needle stick injuries, sharps injury. Properly use of Personal Protective Equipment or PPE to help protect health care workers. Objective: This study was conducted to assess the level of Knowledge Regarding Needle Stick Injury & use of Personal Protective Equipment among Nurses at Dhaka Medical College Hospital, Dhaka. Methods & materials: The study was a cross-sectional study, which was conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from January to December 2021. The study included purposively selected 200 nurses who are directly works with patients. Data were collected by face-to-face interview with a pretested, semi- structured questionnaire and an observational checklist. Data were analyzed by current Statistical Package for Social Sciences (SPSS). Informed written consent was taken from each nurse. Results: The study findings show that, among 200 respondents, 65% had good knowledge about Needle sticks injury, 30% had average knowledge and only 5% had poor knowledge about Needle sticks injury and 56% had good knowledge about personal protective equipment, 26% had average knowledge and only 18% had poor knowledge regarding personal protective equipment at Dhaka Medical College Hospital, Dhaka. Conclusion: In conclusion, the best way to reduce NSI is to impart knowledge and awareness about it. Reporting of sharp injuries, preventive measures and post exposure prophylaxis and follow up should be the core issues to Infection prevention and control.

For the most majority of children in developing nations, breastfeeding is thought to be the most vital factor that influences whether they will live or die, although the pattern of breastfeeding and exclusive breastfeeding are more crucial factors, which are frequently neglected by most mothers. This descriptive type of cross-sectional study was conducted among 384 respondents from 250 bedded General Hospital, Jashore, Bangladesh to find out the factors influencing Womens Knowledge, attitudes, and practices regarding breastfeeding who are visiting Pediatric OPD from October, 2021 to Marc, 2022.Respondents were enrolled in the study using Purposive sampling technique. Data was collected by face to face interview with a semi-structured questionnaire. Here, 53.0% womens knowledge on breast feeding was Good as well as 41.0% womens knowledge was Fair and 6.0% womens knowledge was Poor on the other hand 22.0% womens Attitude on breast feeding was Good as well as 54.0% womens Attitude was Fair and 24.0% womens Attitude was Poor & 28.0% womens Practice on breast feeding was Good as well as 39.0% womens Practice was Fair and 33.0% womens Practice was Poor. While there was typically good knowledge about breastfeeding, there was still inadequate practice. Breastfeeding expertise and mothers employment position were revealed to be modifiable factors that predicted exclusive breastfeeding.

Background: There has been increased interest in identifying the associated factors to Type 2 Diabetes Mellitus (T2DM) remission after bariatric surgery. One of these factors is the BP limb length. The objective of our study was to evaluate the T2DM remission rate in patients subjected to Roux -en- Y gastric bypass (RYGB) who had different Biliopancreatic (BP) limbs length. Bariatric surgery, Biliopancreatic limb length, type 2 diabetes mellitus, Roux-en-Y gastric bypass.

Oronasal fistula is one of the unfortunate consequences of cleft palate surgery. This can be done after palate surgery in patients with cleft palate, defined as an abnormal connection between the oral and nasal cavities. Multiple systems have attempted that classification. It can be a small, symptomatic or asymptomatic fistula that needs correction. Its speed varies greatly depending on many factors. Both surgical and non-surgical methods (the advantages and disadvantages of each should be considered) are available for correction, and there are combination therapies that help improve surgical outcomes. Platelet-rich fibrin (PRF) is a novel Generation platelet concentrate, very easy to prepare and handle without the use of biochemicals. Its production is dependent on the accumulation of platelets that release cytokines and growth factors. Enriched with growth factors, this hemostatic plug is easy to prepare and operate. Adapted for soft and hard tissue healing. It is used in various fields of dentistry, especially oral and maxillofacial surgery. Reports on the role of PRF in repairing oronasal fistula closure are sparse in the literature, especially in relation to other soft tissue flaps.

Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, especially in its human and bovine varieties, either directly or through its antigenic components, and the clinical pictures it gives rise to depend not only on its pathogenicity, but also on the the hosts immune response. It is generally accepted that the skin integument is an organ that is not very receptive to Kochs bacillus and that even the latter suffers, when invading it, its virulence is attenuated: the manifestations are less frequent than those observed in other sites, more chronic and with fewer bacilli since the skin is not an ideal environment for this, however, it is not free from presenting affectations that could put the integrity of patients at risk.

Marjolins ulcer is a malignant neoplasm originating from long-standing or previously healed skin lesions. Well-differentiated squamous cell carcinoma (SCC) is the most common histologic type. It is an aggressive neoplasm with a poor prognosis and high recurrence rates. It predominates in men and has a higher incidence in the fifth decade of life. The diagnosis is histopathological. Surgical excision is the treatment of choice. Early diagnosis and prevention in wound management reduce complications and guide the correct therapeutic approach.

Health care associated infection (HAI) can be defined as an infection acquired in hospital by a patient who was admitted for a reason other than that of infection or an infection occurring in a patient in the hospital or other health care facility in whom the infection was not present or incubating at the time of admission. Infections occurring more than 48 hours after admission is considered as HAI. Bacteria, fungi, viruses, or other, less common pathogens can cause HAIs. Patients being susceptible to common infections due to diminished immune responses and infections at surgery sites (SSIs), many HAIs are due to implants and prostheses. These include central line-associated bloodstream infections (CLABSIs), catheter-associated UTIs (CAUTIs), and ventilator-associated pneumonia (VAP). This study was conducted from October 2021 to October 2022 in a tertiary care hospital. All wards of SSB Heart and Multispecialty Hospital were included. The incidence, prevalence and risk factors of healthcare associated infection were determined and analyzed. The specimens were processed by standard microbiological methods to isolate and identify etiology. Clinical and laboratory data were collected using structured case report formats. HAIs (CAUTI, CLABSI, VAP, SSI) data from the month of October 2021 to October 2022 has been described in Table 1 to Table 5. In a period of one year a total of 5 cases of Ventilator associated pneumonia from 1124 ventilator days and 7 cases of CAUTI out of which 4731 catheter days. Highest incidence of HAI were 10 cases of CLABSI out of which 1421 central line days in a year and lowest HAI was 1 case of SSI in 3853 days of patients susceptible to SSI in a year. This study reveled that infections rate were very less in ICU because of patient care and well mange infection rate and well defined infection guidelines at SSB Heart and Multispecialty hospital, Faridabad.

Tuberous breast deformity is a common congenital breast anomaly that remains one of the most challenging deformities to correct in plastic surgery. It is characterized by a large areola with a cupola deformity, a short breast lower segment, a “nosing down” of the breast, and a narrowness of the breast implantation base. The classification and surgical treatment of this pathological condition have varied extensively. The Total Posterior Pedicle breast reduction technique, described by Richard Moufarrege in 1982, is an effective corrective surgery for treating this often insightful and rebellious deformity. It consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, the preservation of the nipple areolar complex sensation, and for the conservation of the breastfeeding function. In this article, we also elucidate the reasons why the Moufarrege Total Posterior Pedicle breast reduction technique corrects all the vicious details inherent to the tuberous breast.

Musa paradisiaca is a medicinal plant that is used widely in Nigeria for the preparation of various herbal remedies. This study investigated the effects of premature Musa paradisiaca (plantain) fruit on the reproductive hormones and characteristics of female wistar rats. Twenty female Wistar rats with regular oestrous cycle with an average weight of 145g were used. The animals were randomly grouped and divided into four groups of five animals each. Musa paradisiaca extract was administered for 14 days while monitoring the estrous cycle. Twenty hours after the last administration, animals in their proestrus were mated while animals on the oestrous phase were sacrificed, and blood samples taken. Phytochemical analysis of premature Musa paradisiaca revealed that terpenes, sterols, terpenoids, alkaloids were heavily present. The extract of premature Musa paradisiaca altered the estrous cycle of Wistar rats. Resorption was observed in high dose group. Significant increase in FSH, LH were observed in the treatment groups. Reduction in Progesterone level was observed in the high dose treatment group.

Introduction: Barriers ralated to patients, physian, nurses, and health system were the mostly responded by nurses as factors influencing them in pain management for patients. So, the valiable and riliable questionnaire is verry importence to measure the perception of Vietnamese nurses about pain management barriers The study objective: was to translate, adapt and conduct initial psychometric validation of the Vietnamese version of Perceived Obstacles to Pain Assessment and Management Practices questionnaire (V-POPAMP). Material and method: Translation, adaptation, and validity and reliability testing were performed . 6 expert panels evaluated content validity, and I-CVI, SCVI were applied to measured the content validity. The Cronbach alpha and ICC were used to measured for intenal consistence and stable reliability of V- POPAMP, respectively. A sample of 30 nurses was sellected in prepilot testing, and 30 other nurses participted in pilot testing. Results: The study found that I-CVI of each item ranged from 0.83-1 and S-CVI =0.96, indicating the V- POPAMP is good content validity. In addition, the V- POPAMP is good reliability, with Cronbach alpha for each subscale of 0.729 and more, and ICC for total score was 0.952 and for each subscale ranges from 0.822 to 0.984(p=.000) Conclusion:The V-POPAMPQ has good psychometric properties. It can be used to measure the perception of nurses about pain management barriers in Vietnam.

Polycystic ovarian syndrome (PCOS) is the most frequent endocrinopathy in women of childbearing age with a prevalence of approximately 9 to 18%, being more frequent in overweight women. It is a pathology that is manifested by irregular cycles and/or amenorrhea. At the same time, this pathology, also called Chronic Hyperandrogenic Anovulation, is usually accompanied by manifestations such as acne, hirsutism, and insulin resistance that can lead to diabetes, arterial hypertension, and alterations in the lipid profile in the long term. Therefore, a Descriptive-Retrospective study of patients who presented metabolic complications due to Polycystic Ovarian Syndrome was carried out. By knowing the clinical manifestations and pathophysiology of the disease, pharmacological treatment can be applied early, which will promote a healthy lifestyle in women with PCOS in order to limit and prevent the aforementioned subsequent metabolic complications.

Childrens dental and oral hygiene is the concern and concern of parents, besides that parental knowledge affects their attitudes and actions in maintaining childrens dental and oral hygiene. School-age children tend to experience dental health problems because at that age children prefer to snack on cariogenic foods and drinks. Purpose: The purpose of this study was to determine the relationship between the role of parents in dental and oral hygiene in grade IV-VI students of SDN Nogosari 2 in the Jember Agroindustry area. Methods: This type of research is analytic observational with a cross sectional approach. Results: There is a significant relationship between the role of parents on the dental and oral hygiene of grade IV-VI children at SDN Nogosari 2, Rambipuji District, Jember Regency. Coclusion: The results of the study found that there was a relationship between the role of parents in class VI, the majority of whom worked as farm laborers at SDN Nogosari 02, on dental and oral hygiene. The role of good parents does not determine good dental and oral hygiene, while the role of adequate parents can form good dental and oral hygiene of children.

Introduction: Body composition is becoming important to be taken into account, as it is not only an integral part of individual nutritional assessment but also as a biomarker in acute or chronic diseases. Percentage and distribution of body fat is clinically most interest as it play a significant role in determining cardiovascular risk. Various modern methods have been developed to determine percentage body fat for hospital setting, however, low-cost body composition technology for health surveillance is also required. The aim of this study was to determine the effect of energy intake on percentage body fat and to determine whether the CUN-BAE equation formula has an accuracy comparable to BIA, so that it can used as a low-cost body composition technology for health surveillance. Material and Method: This crossed sectional study is part of The Jember Body composition Study. This study invited 84 female dental students with an ideal range of Body Mass Index (21.06±0.17) to participate in this study. Calorie intake was calculated using the 24 hour recall method. Assessment of percentage body fat was performed using Bioelectrical Impedance Analyzer (BIA) and CUN-BAE equation formula. Result: Total energy intake was positively associated with total body fat in female dental students, higher energy intake was associated with higher percentage body fat as determined by CUN-BAE equation (95% CI 16.69, 16.94) as well as by BIA (95% CI 14.11, 15.38). Percentage body fat determine by the CUN-BAE equation method was highly correlated with that determine by the BIA method (95% CI -1.07, 0.33). The average results of FM measurements by the two measurement methods are also same. Conclusion: Higher energy intake is associated with higher percentage body fat. The CUN-BAE equation method has the same accuracy as the BIA method in calculating percentage fat mass. CUN-BAE equation formula is simple and suitable for low-cost body composition assessment method to assess percentage body fat in a population based study.

India is currently having a deceased donation rate of 0.05–0.08 per million population. The National Organ and Tissue Transplant Programme have planned strategies to improve organ donation by creating awareness and capacity building. There is a great need to assess the knowledge regarding organ donation among the general population. In our community, so many myths and misconceptions people have regarding organ donation. This prevents people to come forward to donate their organs whenever the need arises. When we educate and motivate the student population they will not only donate their organs but also motivate others also to donate their organs to form a very healthy society. Hence, this study has been undertaken to assess the knowledge, attitude, and practice regarding organ donation among college students as they are going to be tomorrows responsible citizens of our nation. The objectives of the study were to assess the pre-test and post-test levels of knowledge and attitude, to assess the effectiveness of Video-assisted teaching, to find out the association between post-test levels of knowledge and attitude, and to assess the correlation between knowledge and attitude regarding organ Donation. The research design used was a pre-experimental group pre-test and post-test design. The data collection tool was validated by General Physician and the four Nursing experts. Reliability was established by the test-retest method, r = 0.8 for the structured knowledge questionnaire and 0.87 for the attitude rating scale. The samples for the study were chosen by using the purposive sampling technique, and 40 samples were selected. Data was collected by using a structured knowledge questionnaire and an attitude rating scale. Data was collected for a period of one month. The data collected were edited, tabulated, analyzed, and interpreted manually. The obtained overall post-test Mean for knowledge was 24.37, SD 7.8, and for attitude Post-the test Mean was 23 SD 6.56. The obtained mean difference for knowledge was 17.62 and the attitude was 6 and the paired-test value for knowledge was 13.15 for knowledge and for attitude it was 4.47 significant at the level of P <0.05. The demographic variables Residential area, Sources of information regarding organ donation, and the persons to whom you are willing to donate were associated with post-test scores on knowledge, and the demographic variables Sex, residential area, and persons whom you are willing to donate were associated with the post-test scores on attitude. Other demographic variables were not significant with the post-test scores on knowledge and attitude. The studys findings revealed that there was a significant difference in pre-test and post-test scores on the level of knowledge and attitude regarding organ donation and a significant association between the post-test level of knowledge and attitude with their selected demographic variables.

Breast augmentation is currently one of the most common plastic surgery procedures performed worldwide. However, patients who underwent this procedure always complain of postoperative sensory changes at the nipple areolar complex. The nipple nervous system includes a tactile sensation system and an erogenous sensation system, the latter being less described and commonly overlooked by plastic surgeons performing breast augmentations. The erogenous sensation is supplied by the IVth, Vth and VIth intercostal nerves who run laterally on the surface along the muscular aponeurosis. Both subpectoral (dual plane) breast augmentations and sub-glandular breast augmentations present a real and constant risk of damage to these nerves, resulting in a permanent loss of nipple erogenous sensation. In the Total Submuscular Breast Augmentation approach, the implant is inserted behind the four muscles: the external oblique, the serratus anterior, the pectoralis minor and the pectoralis major. This approach will preserve the three intercostal nerves responsible for the erogenous sensation of the nipple. In this article we describe the surgical technique and the advantages of the total submuscular breast augmentation.

Diabetes is a metabolic disease characterized by hyperglycemia caused by a disruption in insulin secretion, insulin function, or both. An individual with diabetes have a greater likelihood to develop chronic non-healing wounds, and if untreated, various chronic complications are associated with psychiatric stress and depression. In diabetic wounds, the inflammatory phase becomes persistent and excessive with impaired cell proliferation and greater risk of infection. Several studies have shown that metformin has potential effect for diabetic wound healing. Here, we reported a case of diabetic wound in East Jangkat, a rural area in Indonesia, with premorbid type 2 diabetes mellitus and obesity class II with a deeper discussion about the potential effect of metformin for wound healing in diabetic ulcers.

Introduction: Burn patients deserve more attention because of their high morbidity and mortality rates. According to the World Health Organization, approximately 180.000 deaths per year are associated with burns. We aim to obtain the characteristics of burn patients at Tarakan Regional General Hospital Jakarta as a type A referral center hospital from 2018 to 2022 to examine patient trends, provide appropriate services for burn patients, and reduce the rate of poor quality of life caused by disability and death. Methods: A cross-sectional method with descriptive study was used. Medical records of patients with burns admitted to Tarakan regional general hospital Jakarta between January 2018 and September 2022 were evaluated. 191 burn patients were reviewed based on age, sex, total burn surface area, burn degrees, etiology, intervention, and discharge status. Results: The total number of burn patients at the Tarakan hospital Jakarta from 2018 - 2022 was 191, with an increase of 248% from 2018 to 2022. With a gender ratio of 1.03:1, 97 subjects were male, and 94 were female. Most patients have dominated with adults as much as 80.1%. The highest incidence of burns is due to gas explosions, with a total area of burn injury at 21-30% TBSA occurring at 40.84%, and most burns ensue in the second degree as much as 59.69%. In the age group under 18 years, 73,05% of the common cause of burns is scald. The most extensive burns occur on 10-20% of the body surface area, and 73.68% of subjects suffer from second-degree burns. Debridement and wound dressing were done in the operating room on average four times per patient. The mortality rate in Tarakan Regional Hospital is 2.6% due to > 40% TBSA burns. Conclusion: Burn injury patients at Tarakan regional hospital Jakarta from 2018 to 2022 have increased, with gas explosions being the most common cause in the adult age group while in the children group by scald. Third-degree burns cause most deaths. According to these results, the proper facilities and infrastructure at hospitals in Jakarta may also improve the quality of treatment for burn patients.

This study examines the effects of prolonged consumption of soft and bullet drinks on different sex hormones i.e. luteinizing hormones (LH), Follicle Stimulating Hormone (FSH), Testosterone (T), testicular antioxidative parameters ie Malondialdehyde (MDA), superoxide dismutase (SOD)and the histopathological effects of soft drinks consumption on the testis. Thirty five (35) male wistar rats were employed in this study for seven weeks.Group1 (control) was giving normal feeds and water ad libitum, group2 was administered 1.2ml coca cola drinks,Group3 double dose (2.4ml) coca cola drinks,Gruop4 (0.6ml) bullet drinks while 1.2ml sugar solution was given to group5 including normal feeds and water ad libitum.The results from this study shows significant decrease in superoxide dismutase mean values among the test groups compared with control while in Malondialdehyde there was an increased significantly in group4 administered bullet drinks (13.60µg/mg), group2 mean values administered 1.2ml coca cola drinks was (7.50 µg/mg), group3 administered double dose of 2.4ml Coca Cola drinks daily was (6.60µg/mg) while gruop5 mean values administered 1.2ml sugar solution daily was (5.00 µg/mg) compared with the control group of (2.60 µg/mg) mean significant values of <0.05. There was a significant increase in the mean reproductive hormones mean values among the test groups compared with the control group. except the testosterone mean value in group5 administered sugar solution that has lower value than the control group. Findings from this study have shown the toxicological adverse effect of prolonged consumption of coca cola and bullet soft drinks on testicular pathophysiology and significant increase in male reproductive hormones signaling testicular damaged which can result in infertility among males.

Introduction: Knowledge and attitude regarding pain management is one of the factors with the highest predictive value and it can explain 69% of nurses s pain management practice [2]. Therefore, a standard tool to measure the pain management knowledge and attitude of nurses in Vietnam is needed. Objective: Testing the validity and reliability of the Knowledge and attitudes survey regarding pain tool Vietnamese version (KASRP -V), so as to measure the nurses pain management knowledge level in Vietnam Method: The psychometric properties testing of KASRP tool Vietnamese version has undergone a strict standardization process including testing for content validity, discriminant validity, test-retest reliability, internal consistency reliability. 6 experts assessed the content validity. 50 nurses and 73 nursing students were selected to collect data for the discriminant validity testing. Thirty nurses out of 50 nurses were selected to collect data for the internal consistency reliability and test-retest reliability testing. Results:The KASRP tool Vietnamese version includes 41 items, the CVI index for each item ranged from 0.83-1, S-CVI=0.996. The discriminant validity was verified because there was a difference in knowledge scores between the group of nurses with experience in patient care and the group of 4th years nursing students (Z=-2.256, p=0.01).. Internal consistency reliability was measured by Cronbach alpha score. The Cronbach alpha value of each item ranged from 0.885 - 0.887 and the total score was 0.888. The correlation coefficient between each item with the total ranged from 0.300 - 0.446. The ICC score = 0.977 (with 95% CI=0.631-0.994, p = .000) was measured to assess test-retest reliability Conclusion: This evaluation of the KASRP -V demonstrated acceptable validity and reliability

Effective communication is evident when the sender conveys a message that the receiver readily receives and understands. The study examined the effective communication practices and challenges among nurses as perceived by student nurses in Anambra state. The population was 425 students from two randomly selected schools of nursing and one Department of nursing science in Anambra State. Yaro Yamane’s formula was applied to draw a sample size of 206 respondents. Using validated structured questionnaire data were collectedand presented in charts and tables with frequency and simple percentages. The descriptive statistics was employed in the data analysis while Chi square was applied in testing the two null hypotheses at 0.05 level of significant. Findings from the study revealed that the student nurses in Anambra state have positive perception towards effective communication practices in nursing with an average mean score of 3.3. The Majority of the students 99.5% saw effective communication to mean a two-way process through which the sender conveys a message that the receiver readily receives and understands. 96.1% saw it as feedback, documentation, report writing and handover. 97.5% were of the opinion that manner of approach to client is an aspect of effective communication. 97.1% saw it to embraces patient education, informed consent and involving client in his care. (94.6%) believed that asking open ended questions (95.2%), and attention to non-verbal communication (99%); were the best approaches to effective communication in nursing practice. 80.6% were of the opinion that time, conflict among health workers (91.2%), language barrier (90.8%), heavy workload (69.9%) constitutes the cogs in the wheel of effective communication in nursing practice. Gender (p > 0.692) and training institution (p cal = 0.106) had no significant influence on their perception. The study recommends that lectures on communication skills be given to the students in both native and English languages.

Introduction: Crohns disease is a chronic intestinal inflammation caused by genetic, immunological, microbiotic and environmental factors. The intestinal microbiota plays a crucial role in its pathogenesis, increasing the predisposition in genetically susceptible patients. Identification of changes in the gut microbiota is an important goal for predicting recurrence and remission of Crohns disease. Methodology: The relationship between Crohns disease, microbiota, and postoperative recurrence was investigated through keyword search on the ResearchRabbit search engine from 2008-2023. 834 results were obtained, of which 22 relevant articles were selected for the preparation of the article. Theoretical Framework: The intestinal microbiota plays a crucial role in the pathophysiology of inflammatory bowel diseases such as Crohns disease. The alteration of the microbiota can increase the prevalence in genetically susceptible patients and affect the physiology of mammals. Intestinal surgery can alter the colonic microbiota in various ways, which can affect the composition and function of the microbiota. Understanding how these changes affect the colonic microbiota can help develop strategies to maintain or restore a healthy microbiota after surgery. The healthy microbiota is a protective factor for the host due to its resistance to colonization by harmful bacteria and its role in the immune system. Conclusions: The intestinal microbiota has the potential to predict the postoperative course and recurrence of Crohns disease

Background: Teneligliptin is a novel, highly selective DPP-4 inhibitor with long half-life, approved in Japan (2012) and in Korea (2014) to treat patients of type 2 DM. It is characterized by a considerably rigid structure formed by five consecutive rings. Teneligliptin, 20mg/day as monotherapy and combination therapy in type 2 DM was shown to be effective in reducing HbA1c and fasting plasma glucose levels without any significant adverse events. Present study was conducted to determine the safety and efficacy of Teneligliptin (20 mg) in naive type 2 diabetes mellitus. Materials and methods: The present study was a hospital based prospective study undertaken to study the safety and efficacy of teneligliptin (20 mg) in naïve type 2 diabetes mellitus. Newly diagnosed type 2 diabetes mellitus patients within age group 18-70 years were studied. All patients were assessed for Blood sugar levels (Fasting and Postprandial HbA1C, Serum urea, Serum Creatinine, Serum uric acid, Lipid profile and ECG. Results: The mean age of total patients was 52.86 ±9.24 years. The mean HbA1c among patients with DM was 7.76 ±1.61. The mean serum urea was 29.12±6.58mg/dl while Serum creatinine was 1.08±0.18 mg/dl. The mean fasting Blood sugar of the patients before treatment was 123.55 ±10.72 and 103.12 ±8.63 mg/dl after treatment with statistical significant difference (p<0.05). The mean blood urea of the patients before treatment was 29.12 ±6.58 and 20.86 ±5.04 mg/dl after treatment with no statistical significant difference. (p >0.05) The mean QT interval of the patients before treatment was 0.37±0.03 and 0.38±0.03 seconds after treatment with statistical non-significant difference (p <0.05). Conclusion: The present study concludes that, Teneligliptin, a novel DPP-4I, when prescribed as a monotherapy antidiabetic agent in a dose of 20 mg daily, significantly improved glycemic parameters. The results of this study suggest that teneligliptin can be considered to be an effective antidiabetic agent in the management of Indian patients with type naive 2 Diabetes Mellitus.

Background - Sunburn is a radiation burn of the skin by exposure to UV light. UVB is the most dangerous UV light for humans and can cause skin cancer risk. UVB rays can damage DNA so that it can cause a response in the form of apoptosis of keratinocyte cells or also called sunburn cells. Objective - Determined the effectiveness of snail (Achatina fulica) slime cream on inhibited the formation of sunburn cells on the skin of BALB/c mice (Mus musculus) induced by UVB radiation. Metodhs - Experimental research using randomized post-test only control group design with 35 male BALB/c (Mus musculus) mice divided into 7 groups. There was a group without treatment, a negative control group, a control group with Parasol Face Sunscreen Cream, and 4 treatment groups with topical application of snail slime cream with varying doses. All groups except the untreated group were irradiated with UVB 200 mJ/cm2 for 1x irradiation. The mices back skin was taken 24 hours later to make histology slide and sunburn cell counting. Data were analyzed using One Way ANOVA comparative test, Post-hoc LSD test, and Spearmans rho correlative test with each significance value p<0.05. Results - There are a significant difference in the mean number of sunburn cells in One Way ANOVA test p=0.00 (p<0.05) between all groups. LSD post-hoc test shows the group with the most significant mean difference (16.20) was between the negative control group and treatment group 4 (X4) with p=0.00 (p<0.05). There is a relationship between the dose of snail slime cream and the percentage of sunburn cells in the Spearmans rho test with p=0.00 (p<0.05) and the strength of the relationship between the dose of snail slime cream and the percentage of sunburn cells is very strong indicated by the Pearson Correlation (r)= -0.900. Conclusion - Snail slime cream effectively inhibits the formation of sunburn cells with the most effective dose in this study is the 10% dose.

Introduction: T2DM causes a heavy burden on individuals, patients families and communities because it affects quality of life, requires a long-term and comprehensive health care. Self-care behavior is an important factor in reducing the disease impact and progression. Objective: The study was conducted to investigate the status and factors related to self-care behaviors of self-care behavior of patients with type 2 diabetes mellitus. Methods: A cross-sectional descriptive study was conducted on 408 patients diagnosed with type 2 diabetes mellitus at Thai Nguyen National Hospital through a questionnaire to assess self-care behaviors in people with diabetes mellitus (SDSCA). Results: The highest percentage of patients who performed good self-care behaviors (from 5 to 7 days) was physical activity (88.0%) and the lowest was blood glucose level testing (2.7%); the rates of patients who followed the diet well, took care of their feet, and adhered to medication was 62.3%, 17.6%; and 13.0%, respectively. Number of people in the family were related to the diet (t* = -2.294, p = 0.022). Number of people in the family (t* = -1.984,; p = 0.048), education qualification (t* = -2.112, p = 0.035), and income (t* = -2.147, p = 0.032) were related to physical activities. Education qualification was related to blood glucose level testing (t* = -2.501, p = 0.013). Duration of diabetes mellitus was related to drug adherence (F** = 6.412, p = 0.002). Education qualification (t* = -2.340, p = 0.02), and income (t* = -3.356, p = 0.001) were related to foot care activities of people with diabetes mellitus. Self-care knowledge was related to self-care behavior in the areas of diet, physical activity, blood glucose level testing and foot care activities (p = 0.001, 0.00, 0.00, 0.008). Conclusion: This study has proven that people with diabetes mellitus had low self-care behaviors in many areas. There were many factors related to self-care behaviors. Therefore, health workers need to personalize in counseling, health education, and provide knowledge about self-care activities of people with diabetes mellitus.

One of the most typical sources of hospital infection is surgical site infection. The term "Surgical Site Infection", which is separated into "Wound infections" and "organ or space infections," was coined by the Centers for Disease Control to describe the issue of postoperative infections. The organization also created the criteria that identify this type of infection. It might be difficult to recognize the problem early and to start evidence-based treatments quickly. The prognosis of these individuals can be considerably improved by early discovery, protocolized therapy based on the first bundle, prompt control of the septic focus, and the use of adjuvant therapies.

Background: Streptococcus viridans is the most frequently isolated bacterium from infected root canals (63%) and the leading cause of life-threatening sub-acute endocarditis (35%). The use of 2.5% NaOCl as a root canal irrigation material has disadvantages, it is a bad smell and taste, causing allergies, irritating and toxic, so other alternatives are needed. The green okra fruit extract has secondary antibacterial metabolites such as flavonoids, alkaloids, saponins, tannins, and terpenoids. Purpose: This study aims to determine the inhibition of green okra fruit extract against S. viridans. Methods: This research is an experimental laboratory in vitro with a post-test-only control group design. Antibacterial test using the disk diffusion method which consisted of 5 research groups (green okra extract with a concentration of 1,56%, 3,125%, 6,25%, 12,5%, and 2,5% NaOCl) and 4 repetitions. The result was analyzed using non-parametric statistical tests. Results: The average diameter of inhibition zone of each concentration of green okra fruit extract is 1,56% (0 mm ), 3,125% (0 mm), 6,25% (14,58 mm), 12,5% (18,19 mm), and 2,5% NaOCl (23,55 mm). The Kruskal-Wallis test showed a significance value of less than 0.05 which meant that there was a difference in inhibition in all groups. The Mann-Whitney test showed that there were significant differences between the study groups (a<0,05), except for the green okra extract with a concentration of 1,56% with 3,125%. Conclusion: Green okra fruit extract (Abelmoschus esculentus) has inhibition against S. viridans at concentrations of 6,25% (14,58 mm) and 12,5% (18,19 mm) including the strong category.

A 74-year-old male with alkaptonuria (AKU) was admitted to the emergency department with left distal femur pain and Rorabeck type 2 periprosthetic femur fracture following total knee arthroplasty (TKA). AKU is an autosomal recessive disorder characterized by homogentisic acid buildup in connective tissues and joints, leading to ochronosis and arthritis. Multiple joint replacements are common in AKU patients, and periprosthetic fractures may occur due to osteopenia. Rorabeck type 2 fracture is treated with intramedullary nailing or locked plating. The patient underwent internal fixation with locking plate and bone grafts using minimally invasive plate osteosynthesis (MIPO) procedure, resulting in good fracture healing. The case highlights the importance of considering AKU as a differential diagnosis in arthritis patients and managing periprosthetic fractures with care in AKU patients.

Diabetes Mellitus (DM) is a metabolic disease characterized by hyperglycemia. Patients with diabetes mellitus tend to experience distress related to their health problems, as well as self-acceptance of the disease and the various medical actions that must be taken. The stress felt by DM patients will affect the patient quality of life. Poor quality of life can make metabolic disorders worse, either directly through hormonal stress or indirectly through complications that can arise. This study aims to analyze differences in quality of life and stress levels of patients type 2 DM patients at the North Pontianak Public Health Center and Pontianak Kitamura Clinic. This research used observational method with a cross sectional design. This research is prospective using the Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ) and Diabetes Distress Scale 17 (DDS 17). The population in this study were all type 2 DM patients undergoing treatment at the North Pontianak Public Health Center and Kitamura Clinic. Data collection was carried out by accidental sampling and a sample of 150 patients was obtained, consisting of 100 Public Health Centers patients and 50 Clinics patients. The results showed that the quality of life of type 2 DM patients at the Public Health Center was higher than the patients at the Kitamura Clinic and there was a significant difference between the quality of life of type 2 DM patients at the Public Health Center and Clinics with a sig value of 0.013 (p<0.05). The stress indicator on the emotional burden of patients at the Clinic was higher compared to the patients at Public Health Center, but there was no significant difference between the stress levels of type 2 DM patients at the Public Health Center and the Kitamura Clinic with a sig value of 0.196 (p>0.05).

Introduction : Breast cancer is still the most common type of cancer, and surgery is still an alternative available. Postoperative care for breast cancer is an action that must be evaluated from a variety of perspectives. Methods : The information retrieval feature of the PubMed and Cambridge Core literature search engines was used to find review of literature articles for this journal. The periodicals on which the literature was predicated were obtained. Result Vitamin C has various functions in cases of breast cancer. A special review in this paper is in terms of wound healing and anti-pain modulation in postoperative breast cancer. The existence of this is considered significant and can be used as postoperative therapy. Conclusion : Vitamin C involvement in postoperative therapy for breast cancer is expected to have benefits in terms of wound healing as well as modulation of anti-pain interventions. Furthermore, vitamin C therapy is not permitted as an adjunctive treatment or to lower the risk of breast cancer or to inhibit post-surgical complications within those cases.