ntroduction: Shantala is a technique that was created by an Indian mother, with the aim of massaging the baby. Your movements must be performed rhythmically and follow an order, becoming delicate and providing pleasure to the recipient. Many benefits are reported with Shantala, some of which include reducing intestinal colic, improving sleep quality and reducing stress and anxiety.Objective: To analyze the effectiveness of applying the Shantala massage technique to a group of babies enrolled in a school in the Midwest of Santa Catarina. Methods: This study is characterized as experimental research of an exploratory and descriptive nature. The sample consisted of 7 babies aged 4 to 12 months, of both sexes. The assessment was applied through a questionnaire on the perception of babies behaviors, answered by their guardians, and sleep quality was assessed using the Brazilian version of the Childrens Sleep Habits Questionnaire (CSHQ), both were applied pre and post -treatment. Afterwards, patients underwent 10 Shantala sessions. Participants only received care after consent from their guardians and approval from the ethics and research committee.Results: The results demonstrated that the babies eating habits improved when compared pre-(28.6%) and post-treatment (57.9%), being classified as very good and 42.9% as excellent. In relation to social behavior, only 14.3%were classified as excellent before massage applications, increasing to 57.1% post-treatment. No child showed any symptoms of intestinal colic, anxiety or stress after the applications, which were present pre-application. The quality of sleep also improved post-treatment, showing an improvement in this habit in relation to the time of going to bed and waking up, including during the night. Conclusion: The research demonstrated that the Shantala technique promoted the reduction of stress levels, anxiety, reduced symptoms of intestinal colic and improved the quality of sleep, eating habits and social interaction, which consecutively generates a better quality of life in children

Tuberculosis is an infection thatcontinues to be a global health problem, mainly in underdeveloped countries. Intestinal presentation is rare but increases in immunocompromised patients. Its symptoms are variable and can mimic chronic inflammatory diseases, leading to a difficult initialdiagnosis, complications, and increased mortality. We present the case of a young and recently diagnosed HIV patient with chronic and nonspecific condition of diarrhea and abdominal pain, which was complicated by intestinal perforation triggered by an extrapulmonary infection and Mycobacterium tuberculosis. It was resolved by surgery, leading to a pathological diagnosis by biopsy, followed by effective antibiotic treatment.

Introduction: The review addresses ankle injuries in athletes, highlighting their prevalence and impact on sports performance. Injuries, such as sprains and fractures, result from a variety of factors, including direct trauma and sudden movements. Prevention is crucial and involves specific training, use of appropriate equipment and innovative strategies. Objective: Check current challenges in preventing ankle injuries in athletes.Methods: This study constitutes a systematic review, classified as exploratory and descriptive. The preparation of the research was a bibliographical search in electronic databases on methods associated with RSL (Systematic Literature Review) and the applications of SMARTER (Simple Multi-Attribute Rating Technique using Exploiting Rankings). The study methodology is a systematic, exploratory and descriptive review, using qualitative and quantitative methods. The bibliographic search covered several databases, with well-defined inclusion and exclusion criteria. Data analysis was conducted by three independent researchers. Results and Discussion: The results revealed 399 articles, 11 of which were included in the review. Various studies addressed diagnostic, preventive and therapeutic methods. Interventions such as weight-bearing MRI, neuromuscular training programs, low-friction adhesives and proprioceptive training stand out. The understanding of radiographic patterns and the analysis of innovative techniques, which enrich the preventive approach. Conclusion: The conclusion highlights important insights, highlighting the need for more comprehensive research, standardization and long-term studies. Despite limitations, promising advances indicate a positive shift in ankle injury prevention, requiring a collaborative approach between researchers, healthcare professionals and athletes.

Central nervous system (CNS) involvement by antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare presentation. The affected nerve structure determines the symptoms of AAV. Presentation as seizures can make early diagnosis difficult by necessitating the ruling out of other etiologies, which increases mortality in these patients. Serological and imaging studies facilitate the identification of AAV and initiation of timely treatment focused on remission of the autoimmune pathology. We present the case of a young female patient who, after diagnosis with AAV by renal biopsy, presented with several epileptic seizures. With angioresonance, we evidenced vascular involvement and began remission treatment with an adequate resolution of the seizures

In the intricate landscape of metastatic pancreatic tumors, the therapeutic approach continues to evolve, with a burgeoning emphasis on innovative strategies to enhance patient outcomes. This comprehensive case review delves into the nuanced realm of gastrojejunostomy as a pivotal intervention in the management of metastatic pancreatic tumors. The case under scrutiny presents a compelling narrative of a patient grappling with the formidable challenge of pancreatic malignancy, wherein the judicious application of gastrojejunostomy emerged as a strategic maneuver to navigate the complexities of gastrointestinal obstruction.Our analysis unfolds the intricate details of the patients clinical journey, exploring the diagnostic intricacies, treatment modalities, and the ultimate decision-making process leading to the implementation of gastrojejunostomy. The discussion encapsulates the anatomical and physiological considerations inherent to this procedure, delineating its role in mitigating symptoms, improving nutritional status, and fostering an enhanced quality of life for the afflicted individual.Furthermore, we illuminate the broader implications of gastrojejunostomy within the context of multidisciplinary care, underscoring its integration into the evolving landscape of therapeutic options for metastatic pancreatic tumors. This case review endeavors to contribute valuable insights into the clinical decision-making matrix, providing clinicians with a nuanced understanding of the role and potential benefits of gastrojejunostomy in the comprehensive management of patients with metastatic pancreatic malignancies. As the medical community continues to unravel the intricacies of gastrointestinal anastomosis, this exploration serves as a testament to the evolving armamentarium available to confront the challenges posed by metastatic pancreatic tumors, ultimately fostering a more informed and effective approach to patient care

Introduction: Crohns disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. This report explores a case of intestinal obstruction resulting from stenosis of ileotransverseanastomosis, secondary to Crohns disease. Epidemiology:The macroscopic features of Crohns disease vary, including patchy inflammation, ulcers, and stenosis. Stenosis is a common occurrence, particularly in the terminal ileum, affecting 30-40% of individuals with Crohns disease. OBJECTIVE: To describe a clinical case of intestinal obstruction due to ileotransverse anastomosis stenosis secondary to Crohns disease, aiming to recognize its behavior and determine surgical management in patients with a high suspicion of this condition. Patient and Method: A 35-year-old female diagnosed with ankylosing spondylitis, recent Crohns disease, and intestinal obstruction. Surgical history includes exploratory laparotomy, right hemicolectomy, and ileotransverse anastomosis due to acute appendicitis. Current symptoms led to surgical exploration, revealing extensive adhesions and stenosis at the anastomosis. Results: The patient underwent resection of the affected intestinal segment and the creation of a terminal ileostomy, successfully resolving the obstruction. Comprehensive preoperative evaluation, diagnostic confirmation through imaging, and appropriate surgical intervention played critical roles in achieving a positive outcome. Discussion: The discussion emphasizes the complexities associated with Crohns disease surgery, highlighting common complications such as infection, fistulas, and anastomotic stenosis. The case underscores the need for a cautious surgical approach and the importance of early considerationof Crohns disease in patients with intestinal obstruction. Conclusions:This case report underscores the significance of recognizing Crohns disease in patients presenting with intestinal obstruction. Appropriate surgical management, though challenging due to the heightened risk of complications, is essential for improving treatment outcomes. A comprehensive approach, from timely diagnosis to surgical intervention, is crucial for effectively addressing Crohns disease manifestations and enhancing patientquality of life

CarneyComplex(CNC)isarare,complex,andmultisystemdisorderwithvariableclinicalmanifestations,characterizedbythedevelopmentofbenigntumorsandhyperplasticlesionsinseveral organ systems. This article provides a comprehensive overview of CNC, encompassing its clinical features, genetic underpinnings, and current therapeutic interventions. With an emphasis on the diverse clinical presentations and challengesassociated with this condition, the aim of this review is to enhance our understanding of CNC, shed light on the latest research findings, andexplorepotentialdirectionsforfuturestudies.AthoroughexplorationofthepathophysiologyofCNC is essential to guide early diagnosis, management, and improved patient outcomes.

In 2022, 47 child cases with low birth weight were found in Indonesia. It is one of the risk factors for stunting. The role of mothers is very necessary in preventing children from being stunted. This study aims to analyze what efforts are made by the mothersso that the children with a history of low birth weight do not experience stunting. This type of research is qualitative research. The research was conducted in Bengkulu City, in May -July. Seven mothers with a birth history of Low Birth Weight (LBW) became the research informants. Interview guidelines were used to gather information. Furthermore, the data were analyzed with stages of analysis (reduction, presentation, and conclusion). Mothers realized that stunting is a condition in which children experience impaired growth and development. However, all mothers said the cause is malnutrition and intestinal worms. Therefore, the precautions taken by mothers are only related to intake. The mothers implement early initiation of breastfeeding, exclusive breastfeeding, and continue to give until the age of two years, complete immunization, and concern for the childs diet. Especially for mothers who have children with a history of low birth weight, special assistance should be carried out and given comprehensive education about stunting prevention efforts, not only from dietary factors but also from environmental health

The advancement of regenerative medicine in the realm of plastic surgery has witnessed a paradigm shift with the advent of in vitro cultivated human keratinocytes. This groundbreaking research explores the dynamic landscape of these cultured keratinocytes, shedding light on their pivotal role in reshaping the landscape of reconstructive and plastic procedures.This comprehensive investigation delves into the intricate cellular mechanisms and proliferative capacities of in vitro cultivated human keratinocytes, elucidating their potential applications in addressing cutaneous defects, scars, and other dermal imperfections. Notably, the utilization of these cultured cells presents a novel avenue for promoting wound healing, tissue regeneration, and enhancing overall outcomes in various plastic surgery interventions.Moreover, the study investigates the feasibility of incorporating in vitro cultivated human keratinocytes into tissue-engineered constructs, emphasizing their role in bolstering the structural integrity of grafts and flaps. The integration of these cultured cells into the realm of plastic surgery not only holds promise for augmenting traditional approaches but also opens doors to innovative strategies for optimizing plastic outcomes.This article further explores the safety and efficacy of incorporating in vitro cultivated human keratinocytes in diverse plastic surgery scenarios, ranging from facelifts to breast reconstruction. Insights gained from this research pave the way for a deeper understanding of the cellular dynamics involved, thereby facilitating the development of tailored approaches that harness the regenerative potential of these keratinocytes.In conclusion, the integration of in vitro cultivated human keratinocytes into the landscape of plastic surgery represents a transformative leap forward. This research not only accentuates the scientific progress achieved in understanding the cellular intricacies but also underscores the potential of these cultured cells as a cornerstone in reshaping the future of regenerative medicine within the field of plastic surgery

Introduction:The presence of multiple primary malignant neoplasms is an unusual finding during the diagnostic approach of patients with cancer. The coexistence of melanoma with lung adenocarcinoma is extremely rare according to some cohort studies since a prevalence of 0.05% is estimated in this group of patients. The most relevant risk factors for the development of multiple malignant tumors are genetic, environmental exposures to carcinogenic substances, and treatment of a preexistent cancer. Case description: Male, 32 years old who denies family history of malignant neoplasms, drug addiction, chronic degenerative diseases, allergies, surgeries, and hospitalizations. His main symptom was a progressive weakness of the right upper and lower limb which, over a period of days, made it impossible to walk. During his hospitalization, MRI revealed metastatic lesions associated with vasogenic edema. For this reason, an evaluation was requested by the neurosurgery service, who performed a decompressive craniectomy with a biopsy that reported malignant cells consistent with metastatic melanoma. As part of the diagnostic approach, a thoracoabdominal CT with IV contrast was performed, which revealed another tumor at the lung level in the left lower lobe that obliterates the bronchus, not suggestive of metastatic activity, for this reason a lung biopsy was performed, which reported findings of poorly differentiated adenocarcinoma with angiolymphatic invasion present and extensive necrosis. The patient was discharged home with the palliative care measures due to the poor prognosis of both stage IV cancers reported synchronously. Conclusion:The coexistence of 2 primary different cancers in the same patient is an unusual phenomenon which represents a challenge for the multidisciplinary team that treats the patient. Likewise, the coexistence between melanoma and lung adenocarcinoma is exceptionally reported in the literature, which in advanced phases confers a poor prognosis and few therapeutic options

Introduction:Ovarian cancer is the third most common cancer in Indonesia after breast cancer and cervical cancer. The global prevalence of mucinous ovarian carcinoma is lower than other subtypes, but the relative frequency of the mucinous subtype in Indonesia is the third highest after Singapore and South Korea. Ovarian cancer develops in the tubal fimbria before metastasizing to the ovaries. Genes involved in the carcinogenesis of mucinous ovarian carcinoma include KRAS, BRAF, p53. The expression of YY1 (Yin Yang 1) is associated with increased survival in ovarian cancer patients.Objective:The aim of this study was to determine the relationship between histopathological features of the fallopian tubes and the expression of p53 mRNA and YY1 mRNA.Methods:This study used a cross sectional research design. The sampling technique used was purposive sampling. The sample for this study were 27 mucinous ovarian carcinoma patients at Regional General Hospital Prof. Dr. Margono Soekarjo Purwokerto. Examination of p53 and YY1 expression using qPCR and tubal histopathology using hematoxylin eosin staining.Results:.Of the 27 study samples, 24 patients had high p53 mRNA expression and 3 patients had low p53 mRNA expression. Meanwhile, 24 patients had low expression of YY1 mRNA expression, 3 patients had high expression. Based on the results of the Fishers Exact statistical test analysis, there was no relationship between tubal histopathological features and p53 mRNA expression in mucinous ovarian carcinoma patients, with a significance value (p) of 0.231. There was no relationship between tubal histopathological features and YY1 mRNA expression with a significance value (p) of 0.569. Conclusion:There is no relationship between the histopathological features of the fallopian tubes and the expression of p53 mRNA and YY1 mRNA

Cardiologycontinuestoevolvefromyeartoyearwithmajoradvancesinitsdifferentdisciplineswhichwehavesummarizedinthisreviewbyselectingthemainchaptersallowingustoimproveourdailypractice

Rhinoplasty is a surgical technique used to restore and modify nasaltissues for both functional and aesthetic reasons.There are two primary methods for doing a rhinoplasty: open and closed. While both methods change the bone and cartilage, there are variations in the ways that the nasal components are reached.Both open and closed rhinoplasty have changed significantly over the past 20 years due to the introduction of various cartilage transplants, sutures, and improvements in surgical technology.Rhinoplasty is a very difficult procedure that calls for a high level of expertise and training from physicians. Because of the lifelong learning curve, the surgeons skill set—rather than their technique—determines the best possible patient outcomes

Background: High-voltage electrical burns are caused by the direct transmission of electric current through the body and the conversion of electric energy into heat energy, which directly heats the tissues and leads to organ function damage. Especially after high-voltage electric burns (more than 1000W), it can not only cause coagulation necrosis of the skin and even carbonization, but also cause serious deep tissue damage.The degree of tissue damage depends on the type of current, the magnitude of current, the frequency, the voltage, the resistance of the tissue, the skin humidity, the duration, the contact area, and other factors.Low voltage and low frequency electric shock mainly affect the heart and respiration, which can lead to insignificant soft tissue damage. High voltage electric shock mainly causes serious soft tissue damage, which can be accompanied by changesin the circulatory system and respiratory system.[1]Subject and Method: We collected the data of a case of multiple organ failure caused by high-voltage electricity that was successfully treated in July 2023.In the course of this patients successful treatment,Themain nursing measures were analyzed:The intake and output volume were actively controlled.Albumin supplementation,Debridement and dressing change were performed daily,Covered with nano-silver ion dressing,Try to ensure a sterile environment during operation,Maintain ambient temperature and humidity.Results:Twenty days later,the skin damage caused by electric burns was reduced from 30% to 1%.Conclusion:These are very important links:The intake and output volume were actively controlled,The balance of intake and output was maintained for 24 hours, and lactic acid was less than 2mmol/L.Albumin supplementation Controlled above 30g/L,Debridement and dressing change were performed daily,Covered with nano-silver ion dressing,Try to ensure a sterile environment during operation,Maintain ambient temperature 28~30°C and humidity 40%~50%.

A 41-year-old presented with unilateral painful eye, with reduced vision since a YAG laser procedure. This was carried out by a local ophthalmologist when she presented with hazy vision in the right eye and gave a previous history of lens implantation.

Thalassemia is one of the most prevalent inherited blood disorders worldwide. We reported a case of 20-year-old G1P0A0pregnant woman diagnosed with thalassemia intermedia since childhood based on chronic anemia, facies Cooley, and family history. She had 6 times red blood cell transfusion throughout current pregnancy. On 38 week 2 day gestation, she was admitted with chief complaint of painful regular uterine contractions and bloody show. Physical and laboratory findings were low hemoglobin, hematocrit, MCV,andMCH. Thalassemia can be alpha or beta type, depending on the affected globin chain. Clinical severity varies. The main therapies are repeated blood transfusions and iron chelation. During pregnancy, optimal evaluation and management are crucial to prevent maternal and fetal complications. This patient will undergo cesarean section and needs thorough high-risk antenatal care

Laparoscopic cholecystectomy quickly became the procedure of choice for treating patients with biliary discomfort and gallstone problems after the initial reports appeared in the late 1980s.Technical advancements, particularly in miniature video cameras and specialized equipment, played a crucial role in the evolution of laparoscopic cholecystectomy. Subsequent improvements in the design and production of instruments and equipment have further enhanced the safety and efficacy of minimally invasive surgery, extending its application to the treatment of various gastrointestinal illnesses, including gallstone disease.

Performing a comprehensive history and physical examination is the first stage in treating any hand injury. This includes finding out the mechanism and timing of the injury, hand dominance, tetanus status, the patients occupation, and baseline function.It is critical that the primary care physician oversee initial care in order to promote prompt healing and reduce long-term morbidity. Its crucial to identify injuries that need to be sent to hand surgeons as away. To enable prompt therapy of such an accident, direct phone communication between the on-call hand surgeon and the primary care physicianis crucial

Herpes zoster (HZ) is caused by the reactivation of the latent varicella zoster virus (vZv). The cause of reactivation may be associated with predisposing factors such as age, stress or the impaired immune system and an association with autoimmune diseases has been seen. Its clinical presentation is characterized by the appearance of multiple vesicles that rupture quickly, leaving small, very painful ulcers that are distributed respecting specific dermatomes. The diagnosis in most cases is clinical, and complementary tests may be necessary and differential diagnoses may be excluded in cases of atypical presentation. The main sequelae after the disappearance of skin signs is postherpetic neuralgia, which is more common in the elderly. Early diagnosis and rapid initiation of treatment determine the prognosis, especially in immunocompromised individuals.In this work we report a case of atypical clinical presentation in a woman with autoimmune disease, immunocompromised and belonging to the elderly population, being a clear example of the patient in whom special attention should be paid when establishing the diagnosis with the aim of emphasizing early detection and rapid establishment of appropriate treatment, avoiding deleterious outcomes

Skin cancers known as basal cell carcinomas (BCCs) can cause significant localized damage. They represent the most prevalent kind of cancer in the West. A lifetime incidence of up to 39% is possible. The most prevalent risk factor is UV exposure. Most of these tumors are seen in the head and neck region. Even though BCCs are often benign, the great occurrence of these conditions implies that treating them adds significantly to the health services already heavy workload. Its critical to havea solid grasp of your potential possibilities. A number of variables, such as the patients age and comorbidities, the location and subtype of the lesion, and others, may affect management choices. Treatment choices for BCCs on the face may differ greatlyfrom those for BCCs originating elsewhere due to the significance of a favorable cosmetic and curative result. Good randomized controlled studies comparing different treatment methods are hard to come by. While conventional excision has historically been the preferred course of treatment, there are now a number of other alternatives as well, including as radiation, cryosurgery, curettage and cautery, Mohs micrographic surgery, topical imiquimod, photodynamic therapy, and topical 5-fluorouracil. We go over and evaluate the research and literature supporting the current range of face BCC treatment options

The treatment of esophageal varicesusually requires invasive procedures for the administration of sclerotherapy and ligation. Among the main related complications are pleuropulmonary location, esophageal fistula toward the pleura, and the development of pleural infection (empyema). In rarecases, the condition is caused by esophageal perforation.10,12We present here a report on a patient with left esophagopleural fistula and empyema as complications of sclerotherapy and the ligation of esophageal varices

Introduction: poor oral health can be caused by the growth of pathogenic bacteria. Mouthwash is a solution or liquid that can be used to eliminate pathogenic bacteria, thereby preventing halitosis and dental caries. Betel leaf (Piper BetleL.) and Cetylpyridinium chloride (CPC) have antibacterial inhibition that can reduce the number of bacteria.Differences in concentration and composition in betel leaf and CPC can affect the effectiveness in inhibiting bacterial growth in the oral cavity.Purpose:to further analyze the potential of betel leaf (Piper Betle L.) and Cetylpyridinium chloride (CPC) to reduce the number of bacteria in the oral cavity.Methods:based on the exclusion and inclusion criteria, a total of fifteen (15) journals wereanalyzed from the Google Scholar, Research Gate, PubMed’s and NCBI. The journals that analyzed are regarding an article that discusses the potential of betel leaf and CPC to reduce the number of oral bacteria. Results:research with gargling using betel leaf and CPC shows that betel leaf are as effective as mouthwash containing CPC in reducing the number of oral bacteria. However, there are studies that state that gargling with mouthwash containing CPC is significantly higher inhibition of bacterial growth compared mouthwash containing betel leaf extract. Conclusion: this review reveals that betel leaf (Piper Betle L.) and Cetylpyridinium chloride (CPC) are equally effective in reducing the number of bacteria in the oral cavity.

Background:Myoepithelial carcinomas are extremely rare in occurrence with limited number of published articles of malignant myoepitheliomas arising from the breast Case Report: A 42 year old female patient presented at an outside center with complaints of pain in left breast , sonomammogram was suggestive of lobulated inhomogenous hypoechoic tumor with smooth margins and multiple cystic areas within the tumor involving all quadrants of breast with size of 13.31X8.83X12.04cm.Patient received Adjuvant Radiation of 50Gy in 25 fractions to the chest wall and axilla and followed by Adjuvant Chemotherapy with four cycles of Adriamycin and Cyclophosphamide and four cycles of paclitaxel.Conclusion: Early detection and multimodality approach is usually required for the management of Myoepithelial carcinoma of Breas

Introduction: Hospital is a complex industry organization comprises providers, therapies, physical location, technology and innovation. Digital transformation from Indonesian Health Coverage making us to give their patient excellence health service. For maintain our team to give patient best quality service excellence, we aplicated one of tool lean management such as kanbanPurpose: to see either kanban is effective way to evaluate and improve our quality service deliveryMethod: We made kanbanboard from discussion within our team include, director, head divison, manager and staff. After we settle it, we choose which item in backlog going to in progress for first week until foruth week. we done it one by one and if there blocked that we cant achive about the item in backlog collum we will move it to blocked colloumn.Result: As lean management philosophy, we must correct our process and eliminate waste. Under supervising. from 30 October -6 november 2023 our score just 38 -39%. after 4 weeks use kanban, our score imprvoe to above 90%. We make change in our workflow and its an effective way.Conclusion: Kanban with kanban board is one of many tool in lean management to improve our product. They can be done in healthcare industry. Lean is recognised as a systematic approach, it will improve about efficiency and effectivity by eliminating waste and pursuing perfection with minimal resources

Autologous tissue-based reconstruction and prosthetic implant-based reconstruction are the two main categories of breast reconstruction. The natural feel, size, and form of the breast can be restored by breast reconstruction with breast implants. Followinga nipple-and skin-sparing mastectomy and a modified radical mastectomy, implant-based breast reconstruction is most readily executed. The most popular technique for immediate and delayed postmastectomy breast reconstruction is implant breast reconstruction, which makes use of silicone tissue expanders, which were initially utilized for breast reconstruction by Radovan in 1978 and Austad in 1979. As a sign of femininity, breasts might be lost, which can cause a woman great psychological discomfort and negatively impact her sexual life and self-image. Women are given the choice of breast reconstruction following a breast cancer removal treatment, which can enhance their quality of life. However, implant-based reconstruction ought not to be seen as an adjuvant treatment. Procedures like skin-sparing mastectomy and nipple-areola-sparing mastectomy, which enable conservative surgery with an instant implant breast reconstruction, can only be carried out with an early diagnosis

A 51-year-old man presented to the hospital with right-sided paresis, reported within 1 hour of onset, and a National Institutes of Health Stroke Scale score of 4. Initial evaluation revealed elevated blood pressure, a heart rate of 120 bpm, and electrocardiography indicating sinus rhythm with anteroseptal wall infarction. Computed tomography confirmed cerebral infarction, particularly in the temporal lobe, and elevated Troponin I levels, suggesting cardiac involvement. The neurologist initiated intravenousActilyse and Manitol, and the patient was admitted to the intensive care unit with a subsequent referral to a cardiologist. Cardiologist-approved interventions included Furosemide and Morphine due to emerging left chest discomfort. The patient experiencedsomnolence, leading to additional prescriptions of subcutaneous Diviti and oral Carvedilol. By the third day, the patient regained consciousness, and chest discomfort alleviated. Days four to five marked minimal chest discomfort, with improved right-sidedmuscle strength. Physiotherapy was initiated, and echocardiography revealed ischemic cardiomyopathy with left atrial and ventricular dilatation, anteroseptal and apical akinesia, mild mitral regurgitation, and a 23% ejection fraction. Thrombus in the leftventricular apex was identified. After day 8, the patient was discharged home

Patients who suffer severe facial trauma not only face the burden of social isolation due to disfigurement, but they also frequently lose the ability to breathe on their own, eat without the use of substantial accommodations like straws or pureed food, or communicate verbally or through expressions. FT may be beneficial in improving quality of life and may even be able to avert potentially fatal consequences. To overcome the experimental nature of FT and strengthen evidence, future outcome reports should include information on problems and the capacity to smell, breathe, eat, speak, grimace, and feel facial sensations before and after FT. Unfortunately, many data are lacking from these reports

One frequent and serious side effect of peritoneal dialysis (PD) is peritonitis. Following the acquisition of the necessary microbiologic specimens, empirical antibiotic therapy covering both Gram-positive and Gram-negative organisms (including Pseudomonasspecies) should be initiated when a patient on PD exhibits clinical signs consistent with PD-associated peritonitis. The best administration route is intraperitoneal. To stop subsequent fungal peritonitis, antifungal prophylaxis should be administered, ideally in the form of oral nystatin. Antibiotic therapy can be modified in accordance with the results of the PD effluent Gram stain or culture and sensitivity tests. The most recent ISPD guidelines include a thorough explanation of how each antibiotic should be used. Antibiotics are often used for two to three weeks, depending on the particular organisms that are being treated. For refractory, relapsing, or fungal peritonitis, catheter removal and interim hemodialysis support are advised. Following full resolution of the peritonitis, a new PD catheter may be placed in certain individuals. Refractory exit site or tunnel infections should also be taken into consideration while removing PD catheters. The use of PD as a first-line dialysis modality is supported by a global trend of declining PD-associated peritonitis rates following improvements in clinical management

Introduction: Back pain during pregnancy is one of the discomforts that pregnant women often complain about. Even though it is not a serious problem during pregnancy, it can have a negative impact on the quality of life of pregnant women. This study aims to examine complementary care services from several studies that can be provided to pregnant women to treat lower back pain, especially in the third trimester. Method: The method used is to review research related to providing complementary care to pregnant women who complain of back pain in pregnant women. Conclusion: There are 4 complementary methods that can be used to reduce back pain, namely, acupressure techniques, endorphin massage, pelvic rocking, and pregnancy exercises.

Introduction: The latest research on quality of life in Parkinsons patients has emphasized the importance of a comprehensive approach to the care of these individuals. In addition to motor symptoms, non-motor aspects such as sleep disorders, depression, anxiety, cognitive changes and communication difficulties play a crucial role in the general health and well-being of these patients.Objective: Analyze and synthesize the available evidence on the quality of life and health profile in individuals diagnosedwith Parkinsons disease. Methods: This study constitutes a systematic review, classified as exploratory and descriptive. The preparation of the research was a bibliographical search in electronic databases on methods associated with RSL (Systematic Literature Review) and the applications of SMARTER (Simple Multi-Attribute Rating Technique using Exploiting Rankings). The study methodology is a systematic, exploratory and descriptive review, using qualitative and quantitative methods. The bibliographic search covered several databases, with well-defined inclusion and exclusion criteria. Data analysis was conducted by three independent researchers. Results and discussion: The results revealed 1659 articles, 18 of which were included in the review. The discussion of the findings of the current article can be enriched by a comprehensive analysis of the existing literature that explores various facets of quality of life (QoL) in individuals with Parkinsons disease (PD). Several studies have investigated different dimensions, providing insights into the factors that influence QoL in PD patients. Conclusion: The findings gathered emphasize the importance of a comprehensive and personalized approach in the treatment of PD, considering not only motor symptoms, butalso psychosocial and nutritional aspects and the external context. This integrated approach can serve as a basis for developing more effective strategies to improve QoL in individuals with PD and provide more comprehensive and adaptable support throughout the course of the disease.

Objective:This narrative review seeks to compare the advances and efficacy of various anti-VEGF therapies in the treatment of diabetic retinopathy, using the PICO format. Methods: A comprehensive search of medical and scientific literature was conducted to identifystudies investigating the efficacy of anti-VEGF therapies in the treatment of diabetic retinopathy. The PICO format guided the research question and review process. Accurate diagnosis, side effects, quality of life, and patient satisfaction were analyzed and compared for each treatment option. Results:Anti-VEGF therapies were shown to be effective in reducing the progression of diabetic retinopathy, improving visual acuity and decreasing macular edema. Although generally safe, differences in side effect profiles were observed between the different anti-VEGF agents. Conclusion: The selection of an appropriate Anti-VEGF therapy for diabetic retinopathy should consider accurate diagnosis, side effects, quality of life, and patient satisfaction. Although anti-VEGF therapies are promising, more research is needed to optimize their use and fully understand their benefits and limitations

Introduction:Ludwigs Angina (LA) is a bacterial infection of the submandibular space that can cause airway obstruction. Prompt surgical treatment and antimicrobial therapy are crucial. Airway evaluation is important to identify risk factors for difficult intubation and anatomical distortion that may require awake endotracheal intubation.Case presentation:A 22-year-old female presented to the emergency department with left submandibular pain, edema, increased skin temperature, and erythema with a history of grade IIIcaries of 6 months evolution without treatment. Physical examination revealed extension to the left lateral neck region and mild respiratory distress. Classified as ASA grade III, the patient underwent awake intubation using dexmedetomidine (DXM) and ketamine (KET), followed by balanced general anesthesia for the surgical procedure.Clinical discussion:The patients condition predicted high difficult airway, therefore awake intubation was performed to maintain spontaneous ventilation and reduce cardiac arrest risk. In this case, DXM was used to avoid anxiety and respiratory depression, while KET was employed for its analgesic, bronchodilator, and tachycardic effects.Conclusion:Ketamine and dexmedetomidine allow adequate spontaneous ventilatory mechanics,without respiratory depressant effect. Further research is needed to find more anesthetic drugs that can be used for intubation without suppressing autonomic ventilation, and to develop guidelines to prevent respiratory depressant effects in patients withLA.

With a 0.5–3% incidence following initial closure of a laparotomy incision, wound dehiscence is a significant postoperative complication that signifies an abrupt mechanical failure of wound healing. Both clinical entities have common pathophysiological andclinical processes, as recently as the idea of "intentional open abdomen" was defined ("postoperative open abdominal wall"). While early restoration is the goal, a considerable number of patients may experience adhesions between the anterolateral abdominal wall and abdominal viscera; this condition is commonly referred to as "frozen abdomen," and the only practical option seems to be to postpone wound closure. We provide the "Coliseum technique" as the last surgical approach to treat it. This new method offers a creative substitute for abdominal exploration in situations with frozen abdomen that is considered "malignant" because of peritoneal carcinomatosis. Lifting the surgical wounds edges upward and suspending them from a retractor above the abdomen with threads makes it easier to approach the peritoneal cavity, maximizes the exposure of internal organs, and reduces the risk of operating-related damage to the blood supply and innervation of the abdominal wall muscles, which is an essential step for hernia repair later on.

Stunting is a severe health problem in toddlers. Considering the impact of stunting, which risks hampering cognitive development, there is a provision of additional food, in which Dim Sum with tuna fish will be developed. This study analyzed the nutritional quality, energy value, descriptive, and organoleptic quality of Dim Sum with the formulation of yellow fin tuna fish (Thunnus albacares), chicken meat, sweet corn, and chayote as the additional food for toddlers at risk of stunting ranging 12-23 months old. The approach is qualitative through descriptive and oragnoleptic analysis on the product and quantitative through mean calculation and nutritional value are obtained by calculating the value with the estimated yield and retention factor. The procedures were first performed by formulating three treatments with chicken and tuna as the comparison ratios. In all treatments, treatment 3 had the highest nutritional value, receptivity, containing 367 kcal of energy, 21,1 grams of protein, 14 grams of fat, and 39 grams of carbohydrate. These limitations were due to the lack of intervention during the process. Dim Sum Formulation of tuna fishis a healthy local snack containing high energy and protein for toddlers at risk of stunting in 12-23 months old