bluuebunny/crossref_metadata_2025 huggingface dataset:
Side-to-side penoscrotal anastomosis: a reliable technique for repair of recurrent urethrocutaneous fistula in male children
Authors: Okoro Philemon E. , Onyeanunam Ngozi O.
Published: August 2021

Background: Surgical repair of urethrocutaneous fistulae (UCF) is relatively simple and results are often satisfactory. However, in some cases of UCF, recurrence results despite several attempts at repair. Reports are scanty on the management of such recalcitrant UCF. The aim of the study was to present our experience with recurrent UCF, and describes our technique of side-to-side penoscrotal anastomosis for repair of such fistulae.Methods: This was a 10 years analytical comparative study of the outcome of repair of recurrent UCF in paediatric patients using the simple double layer repair technique, and our technique of anastomosing the penis to the scrotum between 2008 and 2019 in our centre. Data obtained and analysed with SPSS 21 version included the number of previous attempts at repair, number, site and size of UCF, technique of repair, and the incidence of recurrence of UCF.Results: Nineteen patients were studied. Nine had conventional double layer repair of UCF with recurrence in 5 (55.6%). Two of the recurrent cases were added to the remaining 10 patients to make a total of 12 cases who had the staged repair by penoscrotal anastomosis (PSA) and there was no recurrence during the average follow up period of 1 year. P value was <0.05.Conclusions: Findings in this study suggest a superior outcome when the penoscrotal anastomosis is used for repair of recurrent UCF. We think it is better to apply this technique in cases of UCF which the surgeon considers potentially difficult than to wait to have a failed attempt before deploying it.
A prospective study of 100 cases of day care surgery in inguinal hernia
Authors: Vaishnani Bhavesh , Khokhar Rahul , Chauhan Mohit
Published: August 2021

Background: Day care or ambulatory surgery is a concept familiar to surgeons since time immemorial more so now as world over it has been re-evolved into a specialty in the modern medical care scenario. The patients and the procedures are selected in such a way so as to cause minimal harm or disturbance to the patient and his life.Methods: Present prospective study was conducted on 100 patients at the department of surgery, PDU medical college, Rajkot, Gujarat for the duration of one and half years. Patient's history had been taken regarding duration of illness, complain, and physical examination was done. With local examination of each specific cases done and then post-operative follow up was taken.Results: None of the patients had major immediate complications out of 100 patients, 18% of patients had minor immediate post op. 2 out of 100 patients had stay for more than 23 hours, due to immediate post-operative complications and 4 patients had to be re admitted post discharge. 96% of inguinal hernia patients are satisfied with the concept of day care surgery that proves acceptance for day care surgery.Conclusions: Day care surgery is suitable for patients of all age groups as seen in our study for inguinal hernia management. Looking at the advantages of reduction of hospital stay, less post-operative pain and greater satisfaction, day care hernia should be promoted.
Role of thyroxine in reducing the size of benign thyroid swellings and pre-treatment thyroid stimulating hormone as a predictor of response to therapy
Authors: Madathil Jasira Padinhare , R. Rajesh T. , Babu P. J.
Published: August 2021

Background: Conservative management for benign thyroid swellings which do not require surgery is a matter of controversy. There has been studies and trials on the role TSH suppression in reducing thyroid volume, but low dose thyroxine was never been properly studied. Being such a common disorder, more studies have to be undertaken to have an idea on managing the goitres conservatively.Methods: Patients with benign thyroid goitres without indications for surgery and who were on 50-100 µg of thyroxine per day was included in the study. Their initial thyroid hormone levels, volume on ultrasonogram, and fine needle aspiration cytology were collected along with biodata. They were reassessed after 6 months and 1 year for change in volume of thyroid.Results: Majority of patients showed a decreasing trend in volume of thyroid after 1 year of thyroxine therapy, even though the amount of reduction was not statistically significant. Rate of decrease in thyroid volume was significantly higher in patients with higher TSH values.Conclusions: Thyroxine therapy has got a role in reducing and arresting further growth of benign thyroid swellings which doesn’t require surgical management. Pre-treatment TSH can be used a predictor of response to thyroxine therapy.
Management of extra hepatic biliary obstruction, in a rural tertiary care hospital India
Authors: Joshi Divyanshu , Monga Y. P. , Mishra Shashank , Bansal Rani , Agrawal Sachin
Published: August 2021

Background: Extra hepatic biliary obstruction (EHBO) is not a rare surgical problem; our experience in managing 36 patients over a period of two years at a tertiary care hospital in a rural setting in India. The objective was to study the etiology and clinical presentation of patients with EHBO, role of various investigative modalities and management strategies in these patients and their outcome.Methods: This was a prospective study conducted between September 2018 to August 2020 in the department of surgery in tertiary care center Subharti medical college (SMC) Meerut. Data was taken in a pre-formed performa and the results were tabulated and analyzed (descriptive analysis).Results: Out of 36 patients, 2 (5.5%) patients underwent choledochoduodenostomy, 1 (2.7%) exploratory laparotomy with CBD exploration with t tube drainage, 1 (2.7%) ERCP with pigtail drainage; 17(47.2%) ERCP (endoscopic retrograde cholangiopancreatography) followed by cholecystectomy, 1 (2.7%) open cholecystectomy with t tube drainage, 4 (11.1%) ERCP alone, 2 (5.5%) hepaticojejunostomy, 1 (2.7%) ERCP followed by diverticulectomy, 2 (5.5%) PTBD (percutaneous transhepatic biliary drainage) followed by a triple bypass surgery, 2 (5.5%) PTBD, 1 (2.7%) pylorus preserving pancreaticoduodenectomy, 1 (2.7%) ERCP with sphincterotomy, 1 (2.7%) PTBD followed by whipples procedure. Patients were followed up and 5 (13.8%) patients had recurrence of the disease.Conclusions: EHBO is a hepatobiliary surgical condition caused by both neoplastic and non-neoplastic etiology. Benign pathologies common in younger patients whereas neoplastic conditions in older age. Ultrasonography is the most common investigative modality followed by ERCP with PTBD/ENBD playing an important role in decompression of biliary obstruction as a palliative measure in advanced malignancies.
I gel versus endotracheal intubation for percutaneous tracheostomies: a randomised study to ascertain amicable approach
Authors: Sharma S. P. , Singh Anuj
Published: August 2021

Background: Percutaneous tracheostomy or percutaneous dilation tracheostomy (PDT) is an airway management procedure routinely performed in critically ill patients, requiring prolonged ventilation. It is safely performed bedside by anaesthesiologist/intensivist in ICUs. Complications as endotracheal tube (ET) damage, loss of airway due to accidental extubation and piercing of guide wire through ET tube during procedure has led to exploration of safer/effective and viable airway alternatives while performing the procedures.Methods: In this study we randomised 60 patients to group E (ET) and group I (I gel) 30 each and studied ease of carrying out procedure and associated complication rates in both groups.Results: In ET group (group E), 9% of patients suffered with potentially catastrophic complications, e.g. loss of airway, inadequate ventilation of lungs, haemorrhage, airway leak due to ET tube cuff rupture and accidental extubation. In ETT group there was incidence of 18% cuff puncture by guide wire (p=0.025) and 3% accidental tracheal extubation. Group I witnessed lower incidence of haemorrhage (3%) and the incidence of guide wire piercing airway device was nil. Group I also demonstrated better hemodynamic stability attributed to lesser tissue trauma and airway manipulation.Conclusions: This study demonstrates enhanced safety with usage of I gel for PCDT, with less complication, better hemodynamic stability and shorter procedure duration.
Study of incidence of hypocalcaemia in patients undergoing total thyroidectomy for papillary carcinoma: a retrospective study
Authors: Gayathre S. P. , Kumar R. Niranjen , Prabu M. J.
Published: August 2021

Background: Hypocalcaemia following total thyroidectomy is a fairly common complication. Occurrence of acute hypocalcaemia can be predicted in patients undergoing thyroid surgery for malignancy, based on serial calcium measurement and this helps in early prediction of hypocalcaemia. The aim of the study was to assess the incidence of post thyroidectomy hypocalcaemia and methods to treat hypocalcaemia and prevention of its complication at the earliest.Methods: The incidence of hypocalcemia was analysed with serial calcium estimation in immediate post-operative period, 4 hours and 24 hours after surgery and on 5th post-operative day. The factors analysed included pre-operative and post-operative serum calcium levels, clinical features, the disease type and factors related to surgery and histopathologically diagnosis as malignant papillary thyroid carcinoma is confirmed.Results: In this study 30 patients underwent total thyroidectomy for papillary carcinoma were studied. Incidence of 22% of hypocalcemia, with transient hypocalcemia in 20% and permanent hypocalcemia in 2% of cases were noted.  Conclusions: Patients underwent thyroid surgery for malignant conditions showed higher incidence and severity hypocalcaemia. This complication can be prevented with meticulous peroperative dissection, prompt identification of parathyroid gland. Avoiding injury or spasm of the blood vessels supplying them and frequent postoperative monitoring of serum calcium levels.
The impact of COVID-19 related lockdown and restrictions on general surgery resident training program in India-outcome of a survey
Authors: Ramavath Krishna , Nagaraj Satish Subbiah , Palle Pranay , Singh Charan
Published: August 2021

The global spread of the disease COVID-19 pandemic occurred due to novel virus corona 2019-nCoV, first time detected in China Wuhan city then spread throughout the world. In our country during 2020 march to up to starting of June, the government of India has put lockdown all over the country. Some restrictions were continued throughout the year and again has put lockdown in 2021 also. Again, in 2021 February last week second wave of COVID-19 pandemic has started and many states in the country has implemented lockdown as phase wise. COVID-19 lockdown has so much effect on surgery resident training program in India. The aim of this study is to assess the effect of the lockdown and COVID-19 pandemic restriction on general surgery residents training programs across India. It is an online based questionnaire survey using apps like Facebook, WhatsApp, Telegram and telephonic services. Data from students was collected through social media who were responded to our questionnaire. Our survey showed that majority surgery trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training.
Calcinosis cutis in systemic sclerosis: a conundrum
Authors: Mourad Youssef W. , Loius Martine A.
Published: August 2021

Calcinosis cutis (CC) is an autoimmune disorder that presents with a wide range of systemic manifestations. Respiratory and gastrointestinal tracts along with skin are affected. Skin manifestations can progress to significant deformities, causing discomfort to patients severely affecting quality of life. Management of patients with Scleroderma requires a multidisciplinary approach in order to attain the best possible outcomes. Wound care is not yet standardized and multiple approaches exist with varying degrees of success. Surgical approaches vary based on anatomical location along with the depth and area of the wound. It is imperative to provide continuity of care with this patient population. If there is not adequate communication with regards to expectations, the disease burden may progress and ultimately prolong patient treatment. We presented the case of a 65 year old female with scleroderma that is followed within our wound care clinic for long term care of cutaneous lesions. Wound healing varied throughout the duration of treatment with moderate success seen with the use of wound vac therapy.
Hydatid disease with pseudo-aneurysm formation of the descending thoracic aorta: a case report
Authors: Mushtaq Ruqia , Rauf Fatima , Hanif Muhammad , Ameer Aqsa
Published: August 2021

Cystic echinococcosis, also known as hydatid disease, rarely occurs in aorta. In this article, we report a rare case of pseudo-aneurysm of the lower descending thoracic aorta communicating with the hydatid cyst; surgical excision was performed with primary repair of aorta. This report emphasizes the need for early diagnosis of hydatid cyst with high index of suspicion in endemic areas, particularly if in the vicinity of a major vessel and aggressive investigations followed by subsequent early treatment before disabling and life-threatening complications occur.
Retained plastic biliary stent presenting with obstructive jaundice: a case report
Authors: Muley Gayatri , Ansari Waqar , Parikh Atish , Kachare Dhiraj , Jain Urvashi , Vekariya Harikrishna
Published: August 2021

Forgotten stents may lead to serious complications. We present a case report of a forgotten common bile duct (CBD) fully covered plastic stent presenting with Obstructive Jaundice. A 66 years-old female patient presented with features of obstructive jaundice. Further enquiry revealed a history of ERCP guided biliary stent placement 12 years ago, after which she was lost to follow up. An endoscopic attempt to retrieve the old stent and relieve biliary obstruction was unsuccessful, and a fresh stent was placed across the CBD following a sphincterotomy. CT showed evidence of a stent in situ, alongside calcified fragments of the previous stent and multiple CBD stones. Patient was taken up for surgery and Roux-en-y hepaticojejunostomy was performed following CBD exploration and retrieval of the stent-stone complex.
A rare case of acquired tracheo-esophageal fistula in adult
Authors: Swami Ganesh A. , Punpale Ajay , Samudre Sayali S. , Asawa Ganesh R.
Published: August 2021

Acquired trachea-esophageal fistula (TEF) is a rare condition caused by cuffed tracheal tube, surgical trauma and blunt injuries. Surgical approach for the treatment is successful in surgical units with specialized TEF surgery. Herein, we presented such a rare case of post intubation acquired TEF in a 23 year old female patient who presented with cough and regurgitation of food 7 days after extubation. Patient had history of organophosphate poison ingestion after which she was intubated in emergency room and kept on mechanical ventilation for 11 days. Upper gastrointestinal endoscopy, fibre optic bronchoscopy and computed tomography scan of neck and chest revealed the presence of TEF, 2.5 cm below glottis. Patient was managed with elective single step surgical approach after which patient recovered well. Fistula resection with crico-tracheal anastomosis with primary closure of esophageal defect and suture line buttressed using strap muscle flap cover was done.
Main pulmonary artery swing back for univentricular heart
Authors: Babu Jecco Ani , Vaidyanathan Swaminathan , Solomon Neville , Musthafa Janeel
Published: August 2021

Left pulmonary artery (LPA) surgical arterioplasty done for juxtaductal pulmonary artery coarctation is a challenging technique that has often produced unsatisfactory outcomes because of poor outcome later and incomplete understanding of the evolution of structural changes in these vessels. We report a unique technique for LPA plasty involving main pulmonary artery (MPA) swing back, in a toddler who presented with history of increased work of breathing, cyanosis and failure to thrive since birth, where the MPA was detached and was swung back cranially to be anastomosed to LPA. This technique can be done, especially in univentricular heart (future Fontan candidate), since MPA needs to be interrupted. The patient had heterotaxy syndrome, left atrial isomerism, hypoplastic pulmonary valve with severe sub-valvar stenosis, duct dependent pulmonary circulation, good sized confluent branch pulmonary arteries with LPA narrowing at ductal insertion site, interrupted IVC with hemiazygous continuation and left SVC draining into coronary sinus. Initially underwent right modified Blalock taussig (BT) shunt, atrial septectomy, LPA plasty and PDA ligation at 6 months of age. Upon follow up after a year, diagnostic angiogram confirmed good flow in BT shunt and LPA re-stenosis with malpositioned great arteries. Redo sternotomy and Kawashima procedure was performed. BT shunt and MPA stump were divided. To conclude, the detached MPA segment was swung cranially and anstomosed to LPA (end to end) inferiorly and left SVC-LPA anstomosed superiorly onto this by end to side fashion. The early outcome was satisfactory, however long-term outcome needs to be followed up
Rectal perforation caused by a self-inserted foreign body: a case report
Authors: Sanjay R. , Bargee Rajendra , Panwar Pradeep , Kumar Prashant
Published: August 2021

Rectal foreign bodies have a storied history as a part of anorectal trauma. Objects encountered are most commonly household objects consisting of bottles and glasses. Other objects include tooth brushes, deodorant bottles, food articles, knives, sports equipment, cell phones, flash lights, wooden rods, broom sticks, sex toys including dildos and vibrators, light bulbs, nails, or other construction tools, christmas ornaments, aerosol canisters, cocaine packets, and many more. The reasons for insertion in decreasing order of frequency are autoeroticism, concealment, attention-seeking behavior, accidental, assault and to alleviate constipation. Here we presented a case of 32 years old presented to the ER with complaints of pain in lower abdomen and anal region for 12 hours. He complained of severe pain when he tried to defecate. He gave history of self-insertion of an empty drug vial into his rectum. Rectal foreign bodies represent a challenging and unique field of colorectal trauma. The important factors in dealing with these patients are careful history and physical examination. Patients are often embarrassed about this condition and may conceal the truth. So, a high index of suspicion is required to accurately diagnose.
Small bowel perforation secondary to foreign body ingestion mimicking appendicitis: a case report
Authors: Medhi Bijit B. , Gupta P. D. , Tauheed Fahad , Chauhan Vikram Singh
Published: August 2021

Admittance in the emergency room with complaints of acute abdominal pain is a common scenario. Patients who see the doctor due to foreign object ingestion present transitory symptomatology. In most cases, foreign object ingestion in adults is accidental, although it may be linked to physiological, anatomical, mechanical, social and psychiatric factors. The frequency of voluntarily ingested objects is higher among children and teenagers than in any other age group. Few people go to the doctor because of persistent clinical manifestations or secondary manifestations of previous complications. In most cases, the foreign body is found incidental to another medical procedure. Here we report a case of small bowel perforation due to ingestion of a sharp foreign body in a 2 years old child. We further elaborate that how, in paediatric age group these conditions are frequently misdiagnosed and usually present late to us. Hence, the increasing need and importance of a thorough pre-op workup, especially in the pediatric age group.
A curious case of a large enterolith in small bowel presenting with obstruction
Authors: Barman Seema , Kamat Manmohan , Shetye Shravani , Sharma Varsha , Sathyan Jeena K.
Published: August 2021

Most reported cases of enteroliths causing obstruction occur in large bowel. If in small bowel, it is usually associated with underlying pathology. This is a curious case of a large enterolith in a normal small bowel, causing obstruction without any underlying pathology at the site of impaction, makes this case a rare one.
Conservative management of subcutaneous emphysema and pneumomediastinum in a COVID-19 viral pneumonia patient-case report
Authors: Ramavath Krishna , Rao Sidharth S. , Sindhu Nyna , Nagaraj Satish S. , Palle Pranay
Published: August 2021

In viral pneumonia, the incidence of subcutaneous emphysema and spontaneous pneumomediastinum are rare. But it can occur due to COVID-19 SARS (severe acute respiratory syndrome) corona infection. In this condition like COVID-19 disease the underlying pathology may be due to diffuse alveolar injury. High pressure levels in the alveoli can cause to the alveoli to rupture and ultimately to forms subcutaneous emphysema. We report one case of COVID-19 admitted in the hospital and later developed subcutaneous emphysema and pneumomediastinum without mechanical ventilation. He was managed conservatively without any intervention. 45 old male without co morbidities having post COVID-19 subcutaneous emphysema and pneumomediastinum developed without mechanical ventilation and he was managed conservatively without any surgical intervention. In COVID-19 viral pneumonia patients can develop subcutaneous emphysema without mechanical ventilation and should be careful for severe pneumomediastinum which can cause death. It can be managed conservatively in hemodynamic stable condition
Nonrotation of gut with nutcracker syndrome: a rare presentation
Authors: Jha Saket , Deshmukh Shahaji , Kulkarni Apoorva , Gupta Abhaya , Kothari Paras
Published: August 2021

Nutcracker syndrome is a rare diagnosis which presents with hematuria, abdominal pain and is caused by left renal vein entrapment in between abdominal aorta and superior mesenteric artery. Symptomatic presentation of rotational abnormalities of gut are rare in adults though it can present with abdominal pain. Simultaneous presence of nonrotation with nutcracker syndrome was very rarely reported in literature. The authors reported a 38 year old female who presented with chronic pain in left side of abdomen and was diagnosed as nutcracker syndrome with nonrotation of gut. Patient underwent Ladd’s procedure with left renal vein transposition. Patient was asymptomatic on follow up. Search of literature showed only two previous cases being reported making it a very rare presentation.
A rare case of caudate lobe liver abscess
Authors: V. Neetha , M. Rajesh B. , S. Varsha
Published: August 2021

Indian subcontinent has high incidence of both amoebic and pyogenic liver abscess. Currently most of the liver abscesses are managed with interventional radiology based percutaneous drainage (either ultrasound or CT guided). Caudate lobe liver abscess is both a rare and at a peculiar location for such intervention as well as carries a high risk of rupture posing a great challenge for the surgeon in planning the appropriate management. In view of viscinity to vascular structures and viscera near liver hilum and difficult approach by laparoscopic technique, open surgical drainage seems to be a feasible option.
A curious case of toddler with hernia and much more
Authors: Ramu Abhirup H. , Kenchetty Priyanka , Chidananda Aishwarya K.
Published: August 2021

Transverse testicular ectopia (TTE) with fused vas deferens is an extremely rare clinical entity. Herein, we presented a case of a 2 years old patient with left inguino-scrotal swelling associated with pain lasting for 3 days. Clinical examination revealed an empty right hemi-scrotum, a left-sided giant inguino-scrotal swelling. Laboratory tests were normal. Ultrasound imaging (US) of the scrotum demonstrated the presence of both testes in the same left hemi-scrotum with inguinal hernia and enterocele as content. Surgical intervention in suspicion of obstruction was carried out through inguinal incision. There was a congenital inguinal hernia with appendix (type 1-Amyand’s hernia) and cecum as content with two well developed testes on the same side with separate epididymis and vas deferens. Both the testes were united by a mesorchium. Hence, reduction of contents with herniotomy and both the testes were anchored to inner aspect of left thigh one above the other. We reviewed the literature for rare diagnosis of TTE.
Giant solitary fibrous tumour breast: a case report
Authors: Shengulwar Sayanna S. , K. R. K. Prasad , S. Swarnalatha , Reddy P. Purendar , Reddy E. Prapul Chandra , D. Priyanka
Published: August 2021

Although giant solitary fibrous tumor is a rare soft tissue tumor but is to be considered in the differential diagnosis of benign breast tumors like fibroadenoma and phyllodes tumor at the time of clinical evaluation.
Assessment of bowel vascularity using indocyanine green fluorescence in incarcerated hernia
Authors: Ganguly Abhishek , Acharya Abhijith , Pai Manohar V. , Augustine Alfred J.
Published: August 2021

Intra-operative assessment of bowel vascularity is often needed during emergent surgery. An objective test to determine the viability could reduce postoperative ischemic complications. Indocyanine green dye has been used for assessing bowel vascularity in colorectal surgery. The following study involving two patients demonstrates its use for assessing the viability of bowel in obstructed hernias after intraoperative intravenous injection. Stryker 1588 AIM laparoscopic setup was used for intraoperative fluorescence. In both cases, dusky areas were noted over the obstructed bowel segment on visual inspection. However, satisfactory fluorescence was seen after dye injection, and hence mesh repair was done without resecting the bowel. All the patients had a good post-operative recovery. Indocyanine green fluorescence may be a good modality to intraoperatively assess bowel vascularity.
Rare presentation of ectopic thymoma
Authors: Nehla Aisha , Tanthry Deepalakshmi , R. Chethana , Santhraya G. Mahesh , P. Devan P. , Bhandary Rukma , Pai Vishwas
Published: August 2021

Thymoma is the most common tumor of the anterior mediastinum with an incidence of 0.15 cases per 100,000. Ninety percent of all thymoma occur in the anterior mediastinum, with the remainder occurring in the neck or other mediastinal areas. Ectopic cervical thymoma (ECT) is an extremely rare tumor that originates from ectopic tissue and is caused by the aberrant migration of the embryonic thymus. ECTs are often confused with thyroid or parathyroid swellings due to their anatomical positioning. Intrathyroid epithelial thymoma is a rare tumour comprising about 0.08% of all primary thyroid malignancies. It is low-grade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Here we presented a case of 43 year old female, came with swelling in front of the neck since many years. Ultrasound neck and fine needle aspiration cytology (FNAC) was performed. Patient underwent total thyroidectomy and specimen obtained was sent for histopathological examination. It revealed ectopic intrathyroid thymoma.
Rectal perforation, a rare presentation of a swollen limb
Authors: G. M. Sreenidhi , S. Jyothi , Satish Vikyath
Published: August 2021

Soft tissue infection of right lower limb secondary to perforation of the gastrointestinal tract is very rare and the true incidence is probably higher, as some cases will be misdiagnosed as gas gangrene unless careful clinical examinations are performed. Only rapid recognition of the probable origin of the gas, coupled with aggressive, definitive therapy, can prevent the usually fatal course of this condition. In the absence of trauma or infection in a previously normal leg, subcutaneous emphysema of a limb should alert the clinician to the possibility of a gastrointestinal perforation as a source of the gas. Perforations of the gastrointestinal tract into the subcutaneous tissue can occur anywhere from the neck to the lower extremities. The mechanisms and anatomical pathways are discussed in this case report. Diversion colostomy with incision and drainage of the lower limb of the same is a safe and feasible option.
Primary subcutaneous extra skeletal Ewing’s sarcoma: a case report on a very rare clinical entity
Authors: Ahire Priya P. , Nichat Pramod D. , Ansari Kashif F. , K. B. Vismaya , Parmar Kuldeep , Mohanraj Aishwarya , Kadam Akshay
Published: August 2021

Primary extra skeletal Ewing’s sarcoma is a very rare clinical entity. Patients are normally females in the second decade of their life. Clinically it normally presents as a fleshy mass which is mobile, not attached to the underlying structures. Diagnosis is difficult, final diagnosis being made by histopatholoical, immunohistochemistry and cytoskeletal studies combined. Ewing’s sarcoma is a tumour which normally affects the bones, and to a much lesser extent (10%) the soft tissues. Primary extra skeletal Ewing’s sarcoma affecting the back (as in the case we are discussing) is an extremely rare clinical entity with lesser than 50 cases reported worldwide. The entity being so rare doesn’t have any much literature for review.
Current status and research progress of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of biliary and pancreatic system diseases
Authors: Yuehu Li , Jianp Gong , Dong Shu
Published: August 2021

Endoscopic retrograde cholangiopancreatography (ERCP) has been used clinically since the 1960s, after nearly half a century of development, it has become an important method for clinical diagnosis and treatment of biliary and pancreatic system diseases. In recent years, with the continuous updating of endoscopy equipment, the advancement of endoscopists’ technology, and the progress in understanding of biliary and pancreatic diseases, the application of ERCP in the diagnosis and treatment of biliary and pancreatic diseases has become more extensive, and the diagnosis and treatment procedures have become more standardized. At the same time, the diagnostic role of ERCP has declined slightly with the advancement of noninvasive imaging technology. But, its intervention role in treatment is more prominent, reducing dependence on traditional trauma therapy. The aim of the study was to summarize the application status of ERCP technology in biliary and pancreatic system diseases and the research progress in recent years.
Risky behavioral factors associated with preterm deliveries among women of childbearing age (15-49 years) at Pumwani Maternity Hospital, Nairobi County, Kenya
Authors: Mwangi Daniel K. , Waithaka Stanley K. , Odongo Alfred O.
Published: August 2021

Background: Worldwide, pre-term delivery (PTD) or pre-term birth (PTB) is on the rise. World Health Organization (WHO) data shows an increase from 2 million in 1990 to 2.2 million in 2012 with about 60% of the preterm deliveries occurring in developing countries and 12.3% in Kenya. The study objective was to determine risky behavioral factors associated with preterm deliveries 1among women of childbearing age (15- 49 years) at Pumwani Maternity Hospital (PMH).Methods: Maternity delivery register (MDR) was used to identify and recruit eligible study participants. A sampling frame constituting of serial numbers assigned to the mothers was made. Data was collected using pretested and structured questionnaire and a data abstraction tool. The statistical package for social sciences (SPSS) version 23 was used to perform statistical analysis. Descriptive statistics were used to summarize categorical variables. Chi-square was used to examine the differences among the categorical variables. Prevalence adjusted odds ratios (PAOR) with their respective 95% confidence interval (CI) was used to estimate the strengths of associations.Results: The study recorded proportional differences among the study variables in their association with preterm deliveries. Among them, 100%, 40%, 22.2% and 17.1% of the mothers who used firewood, charcoal, kerosene and gas/electricity respectively had preterm deliveries.Conclusions: There was no statistically significant association between the study variables (general maternal smoking, maternal smoking during pregnancy, husband smoking, husband smoking during pregnancy, main household type of fuel) and preterm delivery.
Study among geriatric people residing in urban and rural area and associated factor with depression in Nepal
Authors: Gaire Deepika , Gahatraj Nand Ram , Yadav Rajesh Kumar , Shah Geeta , Baral Sushila
Published: August 2021

Background: Depression is a common and major public health problem among geriatric people, but it is not a normal part of aging. It is not just a low mood or feeling sad, but a serious condition that needs treatment and has serious effects on physical as well as mental health. It is one of the hidden problems of the geriatric people.Methods: A cross-sectional study was conducted among 196 elderly people from Kaski district of Nepal using geriatric depression scale to assess the level of depression. Wards of metropolitan was randomly selected and represented as urban area and ward of rural municipality were randomly selected and considered as rural areas. Data were collected by face-to-face interview among geriatric people. Data were analyzed by SPSS v.16 version. The appropriate statistical tests were applied based on the nature of the data, setting the level of significance at p<0.05.Results: Out of total 196 study participants 101 were from urban area and 95 from rural area. The overall prevalence of depression was 55.1%. In this study geriatric depression was significantly associated with: spouse status, living arrangement, satisfaction with living condition, family support, family care, abuse, relationship with son, relationship with daughter in law, work, discrimination, social isolation and loneliness and health problems.Conclusions: More than half of the elderly population had developed depressive symptoms. Immediate addressing of geriatric depression by providing health services, counseling and harmonious relationship among geriatric people and family members especially their son and daughter in law should be created by providing social support and counseling to family members.
Influence of mental health perception and willingness-to-pay towards intention-to-support inclusion of mental health coverage in health insurance schemes: a cross sectional study in Malaysia
Authors: Kumaran Maaheend R. , Mathialagan Amuthaganesh , Katheravan Kayilvezhi , Kadamane Kumaraswamy , Rajagopal Priyananthini , Mahabot Fuad R. , Oblenda Java K. M. , Begum Arshad , Suppiah Arulmuli , Ramalinggam Renu
Published: August 2021

Background: Across the globe, there have been many mental health disorders and one of the suggested ways of financing mental health disorders is mental health insurance coverage. This study is aimed at determining the influence of mental health perception (MHP) and willingness- to-pay (WTP) towards supporting inclusion of mental health coverage in health insurance schemes in Malaysia.Methods: A validated questionnaire was utilized for this study whereby three variables of the study (MHP, WTP and intention-to-support) were measured. The structured questionnaire contained closed ended questions where present of dichotomous (yes/no), multiple choice questions and 7-point Likert scale questions. 800 questionnaires were distributed to target respondents through online platforms. The inclusion criteria were local citizen of Malaysia, those who gave consent to take part in the study, literate in English, aged 21 years old and above. The data were analysed utilizing statistical package for the social sciences (SPSS) software version 23.0.Results: More than half (87.7%) of the respondents agreed to pay for monthly mental health insurance premiums. Among those who were unwilling to pay (12.4%), were unable to afford the mental health insurance. Similarly, majority of respondents had favourable perception of mental health disorders. Correlation and regression analysis revealed that both WTP and influence of MHP were significant predictors of intention to support.Conclusions: WTP and influence of MHP are important predictors that should be highlighted in creating equitable mental health care for all.
Catastrophic health expenditure: a community-based study in Sarawak, Malaysia
Authors: Pangkas Johnny , Rahman M. Mizanur , Suhaili Raili Bin
Published: August 2021

Background: Accessing health services can lead to individuals having to pay catastrophic proportions of their available income and push many households into poverty.  The aim of the study was to estimate the catastrophic health expenditure in respect of household expenditure and to determine the factors affecting it in Sarawak, Malaysia.Methods: We collected household expenses based on a recall period of one month through a face-to-face interview. We calculated the catastrophic health expenditure in terms of 10% of household expenditure and 40% of the capacity to pay. A binary logistic regression analysis was done to determine the factors associated with catastrophic health expenditure. Data analysis was done by IBM SPSS version 27.0.  Results: The analysis revealed that one-quarter (25.7%) of the household expenditure was on food, equivalent to MYR 373.562, and 18.83% of the total household expenditure was on health (MYR 292.83). About two-fifths (37.4%) of the households had incurred catastrophic health expenditure on 10% of household consumption and 15.6% catastrophic health expenditure on 40% of household expenditure. Multivariate analysis with forward and backward linear regression methods revealed that age, gender, family size, socioeconomic status, and chronic illness appeared to be potential predictors of 10% catastrophic health expenditure (p<0.05). In contrast, socioeconomic status and level of education appeared to be potential predictors for 40% catastrophic health expenditure (p<0.05).Conclusions: Subsidised health care may not protect against the occurrence of catastrophic health expenditure among the household in the lower socioeconomic status. Family size and age also could affect household catastrophic health expenditure.
Knowledge, attitudes and practices of female genital mutilation among health care workers in Somali region of Ethiopia
Authors: Oladeji Olusola , Farah Abdifatah Elmi , Aden Bukhari Shikh
Published: August 2021

Background: Female genital mutilation (FGM) is a global challenge with estimated over two hundred million girls and women worldwide having undergone the procedure and another three million girls are at risk of being cut yearly. The prevalence of FGM among women and girls aged 15-49 years in Somali region of Ethiopia is 99% compared to the national average of 65%. The study assessed the knowledge, attitude, and practice of health care workers on FGM practices in the region.Methods: The study was a cross-sectional descriptive survey and used quantitative method.Results: 36 (17.8%) of the health workers believed FGM was a mandatory religious practice, while 158 (78.2%) regarded it as a cultural practice. All the respondents knew it caused health problems, 32 (15.8%) believed it was a good practice though 176 (87.1%) of the respondents believed it violated human rights of the girls/women and 99 (49%) wanted the practice to continue. 15 (40.5%) had conducted FGM on a girl before, 5 (13.5%) claimed medicalization made FGM practice safer and 5 (13.5%) of the respondents intended to circumcise their daughters in future.Conclusions: Health care workers still have attitudes and practices that positively promote and could encourage FGM practices in spite of their knowledge of the health consequences and their acceptance as a violation of the rights of women and girls. This attitude has high tendencies of depriving the community members of access to accurate information that will enable them to make informed decision about FGM and efforts to eradicate the practice.
Efficacy Bacillus thuringiensis var. israelensis serotype H-14 (Bti H-14) for control Aedes spp. density in Denpasar, Bali
Authors: . Suwito , Purnama Sang G. , Kardiwinata Pasek
Published: August 2021

Background: A liquid bioinsecticide formulation containing Bacillus thuringiensis var. israelensis Serotype H-14 (Bti H-14) was tested in the field in household containers. The aim was to determine the effectiveness of Bti H-14 biolarvicide in controlling the density of Aedes spp. Larvae.Methods: This study was conducted in two phases of testing. First, to test the effective dose with 5 doses, namely (50 ul, 40 ul, 30 ul, 20 ul, and 10 ul) in 2.5 liters of water. Furthermore, the number of deaths was calculated after 24 hours of treatment and control by doing four repetitions. In the second phase, by conducting tests on containers in the household as many as 3171 containers were continuously observed every month, given Bti H-14 for 6 months. Observations were made before and after the application of Bti H-14 on larva density, mosquito density, and dengue cases. Data analysis was performed using paired t-test. Bti H-14 formulation to kill 50% of mosquito larvae (LC50) within 6 hours requires a concentration of 4 µl per liter.Results: Bti H-14 liquid formulation with delta-endotoxin and spores content of 600 ITU per ml or 1.2x109 CFU is effective in reducing larva density in household containers if done regularly.Conclusions: Bti H-14 liquid formulation is proven to be effective and easy to use for the control of Aedes larvae.
Safe sex practices among women who have sex with women in Tanzania: implications for HIV and STIs control among this group
Authors: Saronga Happiness P. , Mbishi Jackline V. , Bakar Saidah M. , Kamazima Switbert R. , Shaaban Saumu K. , Stanslaus Beatrice R.
Published: August 2021

Background: Women who have sex with women (WSW) are at an increased risk of sexually transmitted infections (STIs) due to engagement in high-risk sexual behaviors. Safe sex practice is hence critical for the WSW. The aim of the study was to assess safe sex health behaviors and practices among WSW to inform sexual and reproductive interventions targeting this group in Tanzania.Methods: This study was cross-sectional descriptive and retrospective conducted in Dar-es-Salaam region, the largest commercial city in Tanzania. Study population included WSW aged 18 years and above who met inclusion criteria. Data was collected using focus group discussions, in-depth interviews, key informant interviews and life stories. Data analysis applied thematic analysis.Results: Few WSW reported practicing safe sex. WSW used condoms only when engaging in sex with men. Some WSW lacked information on availability of protective devices; while some WSW did not use of protection despite having information on availability of protective devices. Majority of WSW used good hygiene practice (cleaning body, vagina, mouth, and sex toys) before and after sex to prevent transmission of infections; and some WSW used pre- and post- exposure prophylaxes. Low access and high cost of protective devices, being in a monogamous relationship, low health risk perception, fear of developing cancer from using lubricants, and advise from health worker against using lubricants, were reasons given by WSW for not practicing safe sex.Conclusions: Given the current evidence of overlap between the homosexual and heterosexual populations in STI transmission, comprehensive education on potential routes of STI transmission among WSW is critical.
Prevalence and intensity of urinary schistosomiasis among selected people in Tulus area, South Darfur State, Sudan
Authors: Maki Adel A. , Hajissa Khalid , Ali Gafar A.
Published: August 2021

Background: Urinary schistosomiasis is a major public health issue in Sudan. The disease is endemic in many rural communities across the country.Methods: This is a cross-sectional study conducted to determine the prevalence and intensity of urinary schistosomiasis among selected individual in the city of Tulus, South Darfur state, Sudan. One hundred terminal urine samples were collected and examined for Schistosoma haematobium eggs using standard filtration technique.Results: A total of 100 individual were enrolled in the study with a mean (±SD) age of 17.7±0.73 years. Out of them, 62 (62%) were found to be infected with Schistosoma haematobium. The statistical analysis showed significant association with gender (p=0.043) with higher prevalence 70.9 % (39/55) in female than males 51.1 % (23/45). Majority of the S. haematobium infections were classified as intense infection (82%, 51/62) with egg count ≥50 eggs/10 ml urine, while gross haematuria was observed in 10% of urine samples.Conclusions: In conclusion, the prevalence of S. haematobium infection in the study participants was remarkably high. However, further studies, including large sample size will be essential to assess the burden of the disease in the study area.
Knowledge, attitude, and practice regarding molar incisor hypomineralization among general dental practitioners in Saudi Arabia
Authors: Alshammari Naji Hubaykan , Almugren Amjad Ali , Lopez Jose Nazareno J. , Almarshedy Samaher Mohammad
Published: August 2021

Background: Molar Incisor hypomineralizationis an enamel defect caused by a systemic disturbance that could have occurred during child development. It affects one or more permanent molars with or without incisors involvement. Many factors could contribute in presence of MIH, for instance, chronic illnesses during pregnancy or during the first three of childhood. However, the actual etiological factor has not been determined yet. The study aim is to evaluate the knowledge and the perception on MIH among GDPs in KSA.Methods: This is a descriptive cross sectional study, web-based survey conducted on 500 participants. An online questionnaire was distributed to all GDPs working in KSA. The data analysis done using SPSS version 23 (IBM Crop USA).Results: We found that the majority of GDPs perceptions were found that 64.7% had the thought that MIH is a public problem next to dental caries. When we assessed the perceptions about diagnosis MIH, it was found that 35.7% not confident and 58.3% showed some confidence in diagnosing the same. The dentists’ confidence about treating MIH showed that 49.5% were confident.Conclusions: We found that the majority of GDPs have a good knowledge. The perception was found that 64.7% had the thought that MIH is a public problem next to dental caries. When we assessed the perceptions about diagnosis MIH, it was found that 58.3% showed some confidence in diagnosing the same. The dentists’ confidence about treating MIH showed that 49.5% were confident.