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Objective: The increasing significance of medicolegal evaluation following maxillofacial traumatic events constitutes a complex issue. This clinical research aimed to assess the current etiology of oral and maxillofacial injuries in Portuguese population. Material and methods: An epidemiological clinical observational study was conducted in Centro Hospitalar Lisboa Norte on a sample of 384 subjects diagnosed with oral and maxillofacial trauma, between 2018 and 2020. Data were collected through clinical reports and analyzed using SPSS version 27. Results: Women and men were nearly identical in the number and distribution, with 49.5% females and 50.5% males. In 2020, there was a decrease in the number of traumatic incidents compared to other years. Falls or accidental descents were found to be the most common cause of injury, accounting for 44.3%, followed by assaults accounting for 24.7%. A total of 84 subjects exhibited soft tissue injuries related to periodontal region. The upper central incisors (174) were the most frequently affected teeth with uncomplicated fractures, and the predominant form of treatment was the administration of pain medication. Conclusion: A correlation between falls or accidental descents, female subjects, and advancing age, as well as between assaults, male subjects, and adults, has been established. Falls or accidental descents and assault were the predominant etiologies, and the year 2020 exhibited a decrease in the incidents of traumatic events., Cilj: Sve veće značenje sudsko-medicinske evaluacije nakon maksilofacijalnih traumatskih događaja složeno je pitanje. Autorima ovoga kliničkoga istraživanja cilj je bio procijeniti trenutačnu etiologiju oralnih i maksilofacijalnih ozljeda u portugalskoj populaciji. Materijal i metode: Epidemiološ-ka klinička opservacijska studija provedena je između 2018. i 2020. godine u Kliničkome bolničkom centru Lisabon-sjever na uzorku od 384 ispitanika s dijagnosticiranom oralnom i maksilofacijalnom traumom. Podatci su prikupljeni iz kliničkih izvješća i analizirani u SPSS verziji 27. Rezultati: Muški i ženski ispitanici bili su gotovo izjednačeni u broju i distribuciji – sudjelovalo je 49,5 % žena i 50,5 % muškaraca. U 2020. godini zabilježen je pad broja traumatskih incidenata u odnosu prema ostalim godinama. Ustanovljeno je da su padovi ili slučajna spuštanja najčešći uzrok ozljeda – čine 44,3 %, a slijede napadi koji čine 24,7 %. Ukupno 84 ispitanika imalo je ozljede mekog tkiva u parodontnoj regiji. Gornji središnji sjekutići (174) bili su najčešće zahvaćeni kad je riječ o nekompliciranim prijelomima, a prevladavajući oblik liječenja bili su lijekovi protiv bolova. Zaključak: Utvrđena je korelacija između padova ili slučajnih silazaka, ženskih subjekata i starije dobi, te između napada muških subjekata i odraslih. Padovi ili slučajni padovi i napadi bili su dominantni uzroci, a u 2020. godini smanjio se broj traumatskih događaja.

Allogeneic hematopoietic cell transplant (allo-HCT) provides the only potential route to long-term remission in patients diagnosed with blast phase transformation of mye-loproliferative neoplasm (BP-MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry-based study of BP-MPN patients undergoing allo-HCT. BP-MPN patients undergoing first allo-HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow-up of 62 months, the estimated 3-year overall survival (OS) was 36% (95% confidence interval [CI], 32-36). Factors associated with lower OS were Karnofsky Performance Score (KPS) < 90 (hazard ratio [HR] 1.65, p < .001) and active disease at allo-HCT (HR 1.45, p < .001), whereas patients undergoing allo-HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3-year OS of patients undergoing allo-HCT in complete response (CR) and with a KPS >= 90 was 60%. KPS < 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression-free survival (PFS). Conversely, most recent allo-HCT associated with a higher PFS (HR 0.96, p = .008). Active dis-ease at allo-HCT (HR 1.34, p = .03) was associated with a higher cumulative inci-dence of relapse (RI) and allo-HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS < 90 (HR 1.91, p < .001), active disease (HR 1.74, p = .003) and allo-HCT from mismatched related donors were associated with a higher non-relapse mortality (HR 2.66, p = .003). In this large series of BPMPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo-HCT in the more recent era, with a KPS >= 90 and in CR at transplant had a better prognosis.

Amaç: Bu retrospektif çalışmanın amacı, 2008-2019 yılları arasında Dicle Üniversitesi, Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Cerrahisi Anabilim Dalı’na başvurmuş travmaya bağlı maksillofasiyal kırık izlenen hastaların demografik dağılımını ve tedavi yöntemlerini geriye dönük analiz edip elde edilen bulguları değerlendirmek ve tartışmaktır. Gereç ve Yöntemler: Kliniğimize başvuran 374 maksillofasiyal travma vakasına ait dosya dokümanları toplanarak incelendi. Elde edilen veriler cinsiyet, yaş, etiyoloji, mevsim, anatomik lokalizasyon ve tedavi seçeneklerine göre analiz edildi. Bulgular: Yapılan istatiksel analiz sonucunda; 257’si erkek (%68,7), 117’si kadın (%31,3) olan 374 hastada 400 maksillofasiyal kırık tespit edildi. Ortalama yaş 25 (7-68) olarak tespit edildi. Etiyolojik nedenler sıralandığında 129 hasta (%34,5) ile düşme ilk sırada yer aldı. Daha sonra sırasıyla 124 hasta (%33) ile darp, 69 hasta (%18,4) ile trafik kazası, 21 hasta (%5,6) ile spor kazası, 12 hasta (%3,2) ile iş kazası, 12 hasta (%3,2) ile at tepmesi, 4 hasta (%1) ile ateşli silah yaralanması ve 3 hasta (%0,8) ile diş çekim sonrası oluşan çene kırığı etiyolojik sebepler arasında yer almaktadır. Tedavisi gerçekleştirilmiş 400 kırığın 334’ü (%83) mandibulada, 46 (%11) tanesi maksillada, 3 (%1) tanesi zigomatik kemikte, 3 tanesi (%1) orbitada ve son olarak 14 tanesi (%4) çoklu kırık şeklinde görüldü. Sonuç: Maksillofasiyal kırıkların insidansı, etiyolojisi ve hastaların demografik özellikleri bölgelere göre çeşitlilik göstermektedir. Coğrafik, sosyal ve ekonomik değişkenlere sahip sahaların katılacağı çok merkezli çalışmaların bölgeler arasındaki farklılığın daha detaylı anlaşılabilmesini sağlayarak hem hastaların tedavisine hem de literatüre büyük katkı sağlayacağını düşünmekteyiz., Background: The purpose of this retrospective study was to evaluate and discuss the demographic distribution and treatment methods of patients with maxillofacial fracture who admitted to the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery due to trauma between 2008-2019. Methods: The file documents of 374 maxillofacial trauma cases admitted to our clinic were collected and examined. The data obtained were analyzed according to gender, age, etiology, season, anatomical localization and treatment options. Results: As a result of statistical analysis, 400 maxillofacial fractures were detected in 374 patients, of whom 257 (68.7%) were male and 117 (31.3%) were female. The mean age was 25 (7-68) years. When etiological causes were listed, fall was in the first place with 129 patients (34.5%). Then, respectively, interpersonal violence with 124 patients (33%), traffic accident with 69 patients (18.4%), sports accident with 21 patients (5.6%), occupational accident with 12 patients (3.2%), horse kick with 12 patients (3.2%), gunshot wounds with 4 patients (1%) and jaw fractures that occured after tooth extraction with 3 patients (0.8%) were among the etiological causes. Of the 400 fractures treated, 334 (83%) were seen in the mandible, 46 (11%) were in the maxilla, 3 (1%) were in the zygomatic bone, 3 (1%) were in the orbit and finally 14 (4%) were multiple fractures. Conclusion: The incidence, etiology and demographic characteristics of maxillofacial fractures vary according to regions. We think that multicentre studies involving fields with geographic, social and economic variables will contribute to both the treatment of patients and the literatüre by providing a more detailed understanding of the differences between regions.

Height loss starting in middle age is reported to be an independent risk factor for cardiovascular mortality. Recent studies have revealed an inverse association between height and hypertension, but the influence of hypertension on height loss is unknown. Since hypertension is an established cardiovascular risk factor, clarifying the association between baseline hypertension and height loss could lead to an efficient tool to estimate the risk of mortality. A retrospective study of 11,154 Japanese aged 40–74 years was conducted. Height loss was defined as being in the highest quintile of annual height decrease (≥2.015 mm/year for men and ≥1.756 mm/year). Baseline height was significantly inversely associated with incident hypertension for men only. The adjusted odds ratio (OR) and 95% confidence interval (CI) for incident hypertension for each 1 standard deviation increment of height (5.9 cm for men and 5.6 cm for women) was 0.90 (0.84, 0.97) for men and 1.07 (0.91, 1.26) for women, respectively. We also found that baseline hypertension is independently positively associated with height loss for men only. The adjusted OR was 1.25 (1.11, 1.42) for men and 0.93 (0.71, 1.21) for women. These results might lead to an efficient tool for estimating the risk of height loss, which has been reported to be associated with a higher risk of mortality in adults.

Myxopapillary ependymomas (MPEs) possess leptomeningeal, neural axis dissemination, seeding metastases, and extra-neural spread which are malignant characteristics, even they classified low-grade lesions as WHO grade II. Managing such lesions remains an arguable neurosurgical challenge. The study aimed to discuss the management of MPEs by evaluating the long-term surgical outcomes of consecutively treated MPEs in different 3 neurosurgical centers.Medical records of all diagnosed patients with spinal tumors at our institutions were reviewed retrospectively. This study included all consecutive MPE who underwent surgical intervention in our institutions in different periods between February 2004 and December 2020.A total of 44 patients with MPE were treated surgically in three institutions. 28 (63.6%) patients were males. Six patients were pediatric patients (≤18 years). The mean age was 36.2 years. The preoperative course was 19.2 months. The most common symptom was leg pain, observed in 35 (79.5%) patients. Gross-total resection was performed in 35 (79.5%) patients. 39 (88.7%) patients had good functional outcomes with an average follow-up period of 106.2 months. The progression was observed in 5 (11.4%) patients. Extending2 segments, unclear boundaries, bone-erosions were associated with poor prognosis and progression. Laminectomy and surgical complications were associated with poor functional outcomes. En bloc resection without violation of lesions' integrities reduced the progression.Radiological, intraoperative, and surgical factors can affect the functional outcomes and the progression of MPEs. Some precautions in the surgical interventions particularly in MPEs with defined radiological features can improve functional outcomes and reduce the progression risk.

Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. The World Health Organization (WHO) estimated that approximately 2.5 billion people living in dengue-endemic countries. Objective: To assess the various factors in pediatric to severe dengue infection-A Retrospective study. Methods: A hospital-based Retrospective study was conducted at Emergency, Observation and Referral Unit, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from January to June 2021. Number of patients included in the study was 52. In children with high degree clinical suspicion of Dengue infection NS 1 antigen (who came within first 48 hours of fever) and/or Dengue Antibody IgM, IgG (who came after five days of fever) were performed. Results: The study was enrolled 102 patients of suspected dengue fever of whom 52 (50.98%) were serologically confirmed to have dengue infection. 29 (55.8%) patients were males and 23 (44.2%) were females. 38 (37.25%) patients had classic dengue fever while 12 (11.76%) fulfilled the criteria of dengue hemorrhagic fever. Of those patients with dengue hemorrhagic fever, 6 patients had developed dengue shock syndrome. Most of dengue cases occurred during the month of June to September depicts the role of rainy season on clustering of cases. Maximum number of cases 52 cases (68.49%) was in the children age groups. All cases and is the most common symptom followed by headache, myalgia, vomiting etc. Hemorrhagic manifestations were seen that included petechiae, ecchymosis, gum bleeding, hematuria, malena, hematemesis and epistaxis. Most common complications were hepatic dysfunction, renal failure, multi organ failure, encephalopathy and ARDS. Conclusion: Dengue is one amongst the key causes of dedifferentiated fever. It presents as an extremely broad wellness and is hardly recognized as a clinical entity by primary health care physicians. This study support additional studies on applying intervention measures to boost the diagnostic accuracy and exactness at the first tending level in dandy fever endemic regions.

The prognosis of the Chiari malformation type 1 (CM1) demonstrates a variant spectrum that varies from full recovery to complicated worse neurological disability.To investigate the factors affecting the outcomes of conservative and surgical treatment for CM1 by evaluating adult patients consecutively managed at our institutions.We retrospectively reviewed the medical records of patients diagnosed with CM1 at two reference neurosurgical centers for eight years (2010-2017). We selected all CM1 adult patients who managed conservatively or surgically as the core sample for this study. For clinical evaluation, we used a Chicago Chiari Outcome Scale (CCOS). For radiological assessment, we adopted both craniocervical and contrast-phase MRIs. We investigate factors such as age, sex, pretreatment symptoms, symptoms duration, and radiological findings in both groups.Ninety patients were treated conservatively. After a progression, five of them were treated surgically later and included in a total of 72 patients who underwent decompressive surgery. We successfully managed 85 patients (94.4%) of the conservative group and 64 patients (88.9%) of the surgical group. We found that patients with aqueductal stroke volume (ASV) of 12 µl are surgical candidates. We observed a strong positive correlation between clinical improvement and the increase in ASV values.ASV≤12 µl is a significant predictor for surgical intervention. The presence of heavy sleep apnea or/and functional symptoms, tonsillar herniation13.4 mm on coronal images, low ASV, long symptom durations, and a syrinx are the independent prognostic factors that affected outcomes negatively.

Background There have been several reports about the prognosis of teeth adjacent to edentulous spaces for implant-supported fixed prostheses (ISFPs) and removable partial dentures (RPDs). However, there are few reports about the prognosis of the other remaining teeth comparing ISFPs with RPDs. Purpose The aim of this study was to evaluate and compare the prognosis of the remaining teeth for ISFPs and RPDs in terms of survival and complication-free rates. Methods Subjects were partially edentulous patients with ISFPs or RPDs inserted in 2003-2016. Teeth adjacent to edentulous spaces (A-teeth), teeth not adjacent to edentulous spaces (R-teeth), and teeth opposing edentulous spaces (O-teeth) were investigated. The endpoints were tooth extraction and complications. A multivariate cox regression model was used to estimate the risk factors for survival of the investigated teeth. Results A total of 233 (ISFP: 89, RPD: 144) patients were included in the statistical analyses. An IFSP prosthesis, when compared to an RPD prosthesis did not significantly decrease the tooth loss rate for A-teeth (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.30-1.92), for R-teeth (HR: 0.54; 95% CI: 0.28-1.05), or for O-teeth (HR: 0.45; 95% CI: 0.10-2.09). Conclusions In partially edentulous spaces, the difference between ISFPs and RPDs does not affect the prognosis of teeth adjacent to edentulous spaces, teeth not adjacent to edentulous spaces, and teeth opposing edentulous spaces. Namely, our findings suggest that it depends largely on the tooth type, jaw, endodontic therapy performed, not on the type of prostheses.

PURPOSE: The aim of this study was to investigate the prevalence of long bone fractures among cats, presented at the Small Animal Clinic, Faculty of Veterinary Medicine, Trakia University, a center that attracts cases from all over Bulgaria, and to analyze their seasonal, breed-, sex- and age-related distribution. METHODS: The study cohort comprised 267 cats with long bone fractures. All patients were analyzed retrospectively for a period of five years (2016 to 2020). Data about cat signalment (breed, sex, age, body weight) and fractured bone were evaluated. RESULTS: The cases with fractured femur were statistically significantly (p=0.0001) more prevalent (n=139; 52.06%) than those of all other affected long bones. Long bone fracture tended to occur most commonly in male (54.68%), than female (45.32%) cats. Statistically significantly (p

Objective: Oral pathological lesions in the mouth vary greatly. However, few studies have evaluated these lesions with long-term data. This study aimed to analyze the demographic parameters (i.e., age, gender, anatomical location, and incidence) of oral pathologies in the Aegean Region. Materials and Methods: In this retrospective study, histopathological reports of 30 years in the Department of Oral Pathology, Faculty of Dentistry, Ege University, were analyzed. Data on sex, age, lesion location, and histopathologic diagnosis were analyzed. Results: The histopathological data of 6,330 patients were evaluated. Most of the pathological oral lesions were osseous lesions (n=3,858), and 2,472 soft tissue pathologies were identified. The posterior mandible was the most common location of these lesions (n=2,011). Conclusion: Determining the variety and frequency of oral pathological lesions at a societal level is important for the management of these lesions.

BACKGROUND Acute kidney injury (AKI) is one of the most common acute pancreatitis (AP)-associated complications that has a significant effect on AP, but the factors affecting the AP patients’ survival rate remains unclear. AIM To assess the influences of AKI on the survival rate in AP patients. METHODS A total of 139 AP patients were included in this retrospective study. Patients were divided into AKI group (n = 72) and non-AKI group (n = 67) according to the occurrence of AKI. Data were collected from medical records of hospitalized patients. Then, these data were compared between the two groups and further analysis was performed. RESULTS AKI is more likely to occur in male AP patients (P = 0.009). AP patients in AKI group exhibited a significantly higher acute physiologic assessment and chronic health evaluation II score, higher Sequential Organ Failure Assessment score, lower Glasgow Coma Scale score, and higher demand for mechanical ventilation, infusion of vasopressors, and renal replacement therapy than AP patients in non-AKI group (P < 0.01, P < 0.01, P = 0.01, P = 0.001, P < 0.01, P < 0.01, respectively). Significant differences were noted in dose of norepinephrine and adrenaline, duration of mechanical ventilation, maximum and mean values of intra-peritoneal pressure (IPP), maximum and mean values of procalcitonin, maximum and mean serum levels of creatinine, minimum platelet count, and length of hospitalization. Among AP patients with AKI, the survival rate of surgical intensive care unit and in-hospital were only 23% and 21% of the corresponding rates in AP patients without AKI, respectively. The factors that influenced the AP patients’ survival rate included body mass index (BMI), mean values of IPP, minimum platelet count, and hospital day, of which mean values of IPP showed the greatest impact. CONCLUSION AP patients with AKI had a lower survival rate and worse relevant clinical outcomes than AP patients without AKI, which necessitates further attention to AP patients with AKI in surgical intensive care unit.

Purpose This study aims to evaluate clinical efficiency and side effects of combined therapy of traditional Chinese medicine in female treating chronic pelvic pain. Methods A retrospective study was conducted by analyzing 179 patients with chronic pelvic pain. They were divided into the 3-course group and the 1-course group. Patients in the 3-course group received combined therapy of traditional Chinese medicine 10 days per menstrual cycle for three months, while the 1-course group received the same combined therapy for only one menstrual cycle. VAS scores of five kinds of pain were compared between the two groups. Meanwhile, SF-36 scores, menstruation, leucorrhea and major accompanying symptoms were analyzed. To assess side effects of the combined therapy, safety indices were recorded before and after treatment as well. Results VAS scores of patients in the 3-course group after treatment were significantly lower than that before the treatment. Total scores of SF-36 were significantly improved after the treatment, and persistently improved even after the discontinuation of the treatment. The menstrual and leucorrhea condition improved as well after the treatment. In addition, among the concomitant symptoms, insomnia, loss of appetite, mental fatigue symptoms were significantly improved after the treatment. More importantly, significances were observed in the improvement of most VAS scores between patients who underwent a 1-course treatment and patients with a 3-course treatment. Meanwhile, no significant change was observed in safety indices before and after treatment. Possible adverse events related to the treatment plan for all enrolled patients included mild skin rash in 16 patients, stomachache in 3 patients after taking medicine on an empty stomach, and oral ulcer in 1 patient. Conclusion Combined therapy of traditional Chinese medicine alleviated symptoms of chronic pelvic pain, soothed the accompanying symptoms, and hence helped to improve the life quality of women.

To retrospectively analyze local and systemic factors that resulted in the short-term tooth loss of teeth that were previously assigned a favorable prognosis in patients who were seen and treated over an observational five-year period. This retrospective study included the records of patients who had a minimum of two dental exams at least twelve months apart over a 5-year period. This study investigated extracted teeth with an initially favorable periodontal prognosis that were then divided into one of four categories based on the reason for extraction: caries, periodontal disease, endodontic reasons, or fracture. Patient- and tooth-related factors associated with the extracted teeth were recorded: crown-to-root ratio, initial pocket depth, initial periodontal diagnosis, maintenance interval, presence of existing restoration, furcation involvement, and systemic conditions. Data analysis was performed using a linear mixed model. A total of 50 patients with 111 teeth met the inclusion criteria for this study. A higher odds ratio (OR) for tooth loss due to caries, endodontic reasons, and fracture were found in teeth with a history of root canal treatment with an OR of 3.61, 3.86, and 2.52, respectively. For tooth loss due to periodontal disease, higher ORs were found in patients who were on anti-depressants (OR = 4.28) and patients who had an initial diagnosis of Stage III/IV periodontitis (OR = 2.66). In addition, teeth with initial probing depths ≥5 mm (OR = 4.32) and with furcation involvement (OR = 1.93) showed a higher OR for tooth loss due to periodontal disease. Within the limitations of this study, previously root-canal-treated teeth present a higher OR for early loss due to caries, recurrent endodontic lesions, or fracture. In addition, patients with anti-depressant medication use, sporadic maintenance, initial probing depths ≥5 mm, and furcation involvement represent a significantly higher OR of tooth loss due to periodontal disease even for initially favorable teeth.

The safety and efficacy of elective drug-coated balloon (DCB) angioplasty for unrestrictive de novo coronary stenosis in daily practice is not fully understood, especially in comparison to those of drug-eluting stents (DESs).A total of 588 consecutive de novo coronary stenotic lesions electively and successfully treated with either DCB (n=275) or DESs (n=313) between January 2016 and December 2019 at our medical center were included. The primary safety endpoint was the incidence of target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization. The secondary angiographic efficacy endpoint was angiographic restenosis frequency, defined as a follow-up percent diameter stenosis of50. The endpoints were compared after baseline adjustment using propensity score matching. In addition, the frequency and predictors of late lumen enlargement (LLE), defined as minus late luminal loss, were examined in 201 crude angiographic follow-up lesions after DCB angioplasty.A total of 31 baseline parameters were adjusted to analyze 177 lesions in each group. The TLF frequencies (DCB group: 9.6% during a mean observational interval of 789±488 days vs. DES group: 10.2%, 846±484 days, p=0.202) and cumulative TLF-free ratios of both groups were not significantly different (p=0.892, log-rank test). The angiographic restenosis frequency in the DCB group (6.3%, n=128) was not significantly different from that of the DES group (10.1%, n=100, p=0.593). LLE was observed in 45.3% of entire lesions, and a type-A dissection was a significant predictor of LLE among 23 variables (odds ratio: 3.02, 95% CI: 1.31-6.95, p=0.010).The present single-center retrospective study revealed statistically equivalent midterm clinical safety and angiographic efficacy among both elective DCB angioplasty and DESs placements in the treatment of unrestrictive de novo coronary lesions. In our daily practice environment, LLE was achieved in approximately half after DCB angioplasty.

Background: This study compares the incidence of post-contrast acute kidney injury (PC-AKI) in patients who received a single administration of iodine-based contrast medium (ICM) with that in patients who received a sequential administration of ICM and gadolinium- based contrast agents (GBCA) in a single visit to an emergency department (ED) to determine the risk factors for PC-AKI. Methods: Patients who received one or more contrast media in the ED from 2016 to 2021 were included in this retrospective study. They were divided into the ICM alone and ICM + GBCA groups, and the incidence of PC-AKI was compared between the groups. The risk factors were assessed using a multivariable analysis after propensity score matching (PSM). Results: Overall, 6,318 patients were analyzed, of whom 139 were in the ICM + GBCA group. The incidence of PC-AKI was significantly higher in the ICM + GBCA group than in the ICM alone group (10.9% vs. 27.3%, p < 0.001). In the multivariable analysis, sequential administration was a risk factor for PC-AKI, and single administration was not (adjusted odds ratio [95% confidence interval] in the 1:1, 2:1, and 3:1 PSM cohorts: 2.38 [1.25–4.55], 2.13 [1.26–3.60], and 2.28 [1.39–3.72], respectively). In subgroup analyses of the ICM + GBCA group, osmolality (1.05 [1.01–1.10]) and estimated glomerular filtration rate (eGFR, 0.93 [0.88–0.98]) were associated with PC-AKI. Conclusion: Compared with a single administration of ICM alone, sequential administration of ICM and GBCA during a single ED visit might be a risk factor for PC-AKI. Osmolality and eGFR might be associated with PC-AKI after sequential administration.

Background: Aim of present study to evaluate the Clinico-epidemiological profile and treatment outcome of Lip Cancer. Methods: This was a retrospective study performed in our hospital. All necessary clinical and epidemiological details of the 11 cases diagnosed with lip cancer from January 2016 to December 2021 were analysed. Results: The total number of new malignant cases diagnosed as lip cancer between January 2016 and December 2021 were 11, which comprised 6 male (55%) and 5 (45%) female. The male-to-female ratio was (1.2:1). The most common histological type was SCC, i.e., in 9 (81.8%) of the total number of cases and BCC was in 2 patients (18.2%). Overall survival at 5 years was 89% in our study. Conclusions: In conclusion, we have reported higher levels of lip cancer among men and those above 45 years of age. The important prognostic factors for overall survival in these patients were cancer stages. Better survival is achieved with surgery alone in the early stages and with adjuvant radiotherapy in the later stages.

Objective This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade.Methods A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy.Results From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations.Conclusion Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.

Aim: to examine an efficacy of various stimulation methods in a group of successful pregnancies.Materials and Methods. In a single center retrospective study 47 pregnancy cases were examined after performing embryo transfers at our institution from the years 2017 to 2021. Patients were divided into four groups: i) clomiphene hyperstimulation (CH), ii) stimulation with gonadotropin-releasing hormone (GnRH) agonist, iii) with GnRH antagonist, and iv) progestin-primed ovarian stimulation (PPOS). Age, anti-Mullerian hormone, presence of chronic disease, number of in-vitro fertilizations prior to conception, dosage of follicle stimulating hormone (FSH), presence of premature luteinizing hormone surge, number of egg retrievals, fertilization rate, and live birth rate were assessed.Results. The number of pregnancies obtained by CH, agonist, antagonist, and PPOS methods comprised 25, 12, 2, and 8 cases, respectively. No significant difference in parameters between CH group and non-CH groups, excepting FSH was observed. The FSH was used in CH group and non-CH group at dose of 1108 ± 468 IU and 1756 ± 394 IU, respectively (p < 0.0001).Conclusion. CH is not commonly used due to potential luteal phase defects, but it is thought to be cost-effective, requiring lower FSH doses, requiring no ovulation suppression antagonists, and exerting no effect on frozen embryos or fetuses. Hence, CH could be a suitable protocol for egg retrieval in Japan.

Purpose: There are various factors associated with the incidence of dry socket, which includes operator experience, perioperative crown, and root fractures, periodontal disease, posterior teeth, and, interestingly, the use of mental health medications to be significant independent risk factors for the development of alveolar osteitis. This study aims to determine the risk factors associated with dry socket and to compare the prevalence of dry socket on the basis of gender, smoking habit, systemic condition, extraction site and use of antibiotics. Methodology: This is a retrospective study using the patients’ files at Muneseya campus, Riyadh Elm University. A total of 385 patient files were accessed after seeking approval from the hospital director. Information from patients’ files was recorded including gender, operator’s level, habits, medical history and extraction site. Results: According to the findings, the percentage of male participants was 70.9%, whereas the percentage of female participants was 29.1%. The findings indicate that 25.3% of the population suffers from systemic illness, whereas the remaining 74.7% does not have any systematic disease. Dry sockets, which are caused by inflammation of the alveolus bone, are present in upper teeth 40% of the time, whereas lower teeth inflammation affects 60% of individuals with lower teeth. Unique Contribution to Theory, Policy and Practice: In this study significant differences were observed for dry socket prevalence when compared the groups on the basis of smoking, systemic disease and gender.

Background: Sickle cell disease is the most common inherited condition. Due to recent advances in medical care for patients with sickle cell anaemia, more women with SCD are able to survive up to the reproductive age group. This has given rise to a higher number of pregnant women with SCD. It results in increased fetal and maternal risks due to the metabolic demands, hypercoagulable state and vascular stasis often associated with pregnancy. It has therefore become imperative to explore what progress has been made over the last decade as well as what can be done to achieve the best outcome in these women. Methods: This was a retrospective study of women with SCD who accessed antenatal care (ANC) at the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi over a ten year period. Folder numbers were obtained from the obstetrics clinic and thereafter the folders were assessed and data retrieved using a checklist. Data analysis was done using SPSS 24. Results: The prevalence of sickle cell disease among pregnant women in this centre was 0.03%. All the women had the HbSS variants. The mean age of the subjects was 28.3 ± 5.6years. Majority of the women were gainfully employed. The mean gestational age at booking was 26 9.5 weeks. Half of the neonates had fetal distress at birth. Commonest maternal complication was anemia (100%) followed by vaso-occlusive crisis (89%). Eighty nine percent of the women were delivered by emergency caesarean section prior to 37 weeks gestational age. Preterm birth and fetal distress were the commonest neonatal complications. Conclusion: The study revealed that pregnancy associated with sickle cell disease still carries high maternal and fetal morbidity in this environment. Majority of the women with SCD in pregnancy did not receive preconception care and also did not commence their ANC early enough. There is need to educate women with SCD on the need for preconception care to ensure optimization of health prior to conception. They should also book early enough to facilitate close fetal monitoring throughout pregnancy.

Purpose: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. TBIs are increasing in Uganda, but little is known about outcomes and their predictors in post-ICU patients. This study assessed outcomes and their predictors in post-ICU patients admitted with TBI at Mbarara Regional Referral Hospital (MRRH) in south-western Uganda. Methodology: Retrospective study was used to review hospital records of patients admitted to the Intensive Care Unit (ICU) for MRRH with TBI. Data were entered into Excel, cleaned and exported to Stata version for analysis and presented as mean (standard deviation), median (interquartile range) and number (percent), while using the chi-square test and multinomial logistic regression as predictors for Post-ICU outcomes were used Findings: In the study, males dominated at 73%, while 81% were of working age (15-64 years). Road traffic accidents (83%) were the most common injury mechanism, followed by physical injury at 11%. Length of stay in the Intensive Care Unit was 9 (IQR = 4–8) days, mean GCS at ICU admission and discharge was 7.7 (±2.65) and 10 (±3.27), respectively. Fifty-seven patients (63%) were discharged home; with 73% good recovery Glasgow coma Outcome Scale of hospital discharges. Post-ICU outcomes were associated with GCS at ICU discharge ( . Having moderate Glasgow Coma Scale on ICU discharge was 3.59 times higher of being discharged home than dying compared to severe GCS on ICU discharge (OR=3.59; 95%CI, 1.11 to 11.63). This study established GCS as a statistical predictor of patient outcomes at ICU discharge. Unique Contribution to Theory, Practice and Policy: Based on the findings of this study, prevention of TBI is critical in order to reduce incidence of TBI related mortality. Policy makers to put rules that continuously teach and enforce road safety and traffic rules to all road users.

Background. Anemia has up to 87% prevalence in high tuberculosis (TB) and human immunodeficiency virus (HIV) burden settings of the sub-Saharan Africa (SSA) including Ethiopia. It increases lost to follow-up (LTFU) rate, reduces quality of life, and shortens the survival of TB/HIV coinfected patients. However, there is limited information on severity level and determinants of anemia in TB/HIV coinfected adults in the study setting in particular. Therefore, this study is aimed to assess severity level and determinants of TB/HIV-associated anemia. Methods. A hospital based retrospective study was conducted among 305 TB/HIV coinfected adults who enrolled for antiretroviral therapy (ART) from January, 2009 to December, 2016 in two public hospital of Mekelle, Ethiopia, by reviewing ART register. A multiple logit model was fitted to identify the baseline determinants of anemia using 95% confidence level or 5% level of significance for adjusted odds ratio (AOR). Results. In the current study, the cumulative baseline prevalence of anemia was 59.0% (95% CI: 53.3%–64.6%). Considering severity level, the prevalence was 6.2%, 28.2%, and 24.6% for severe, moderate, and mild anemia, respectively. Being female (AOR = 0.380; 95% CI: 0.226–0.640), body mass index (AOR = 0.913; 95% CI: 0.836–0.998) reduces the odds of developing anemia whereas baseline ambulatory functional status (AOR = 2.139; 95% CI: 1.189–3.846), bedridden functional status (AOR = 2.208; 95% CI: 1.002–4.863), HIV clinical stage III (AOR = 2.565; 95% CI: 1.030–6.384), and HIV clinical stage IV (AOR = 2.590; 95% CI: 1.006–6.669) increased the odds of developing anemia for TB/HIV coinfected adults. Conclusions. In the current study, significant TB/HIV-associated severe anemia was assessed which accounted for nearly one-ninth of all anemia cases while nearly half were moderate anemia. Therefore, curious attention has to be given for the management of TB/HIV-associated severe anemia in particular and anemia in general to reducing anemia associated bad outcomes most importantly death.

Introduction: Glioblastoma is often associated with a poor prognosis. The end-of-life signs and symptoms of these people differ from the rest of the cancer population. Objective: To identify the main signs and symptoms present in the last seven days of life of patients with glioblastoma in a neurological oncology service. Methods: A descriptive and retrospective study was carried out. The sample included patients diagnosed with glioblastoma with medical and nursing records of the last seven days of life that were admitted to the Neurology service and admitted to the institution by the neuro-oncology consultation between 2019 and 2020. Data was collected from the medical records of the patients. Results: Medical records of 17 patients were selected for this study. The main signs and symptoms present in the last seven days of their lives were decreased level of consciousness (94%), rare and unexpected events (94%), respiratory dysfunction (88%), and loss of swallowing ability (76%). Conclusion: The objectives of this study were achieved. However, it is important to conduct studies in this population with more representative samples, since most literature is focused on the oncologic population in general.

Background: Obstetricians and paediatricians are concerned about multiple pregnancy because of its high association with maternal and perinatal morbidity and mortality. This study aims to determine the obstetric and perinatal outcome of multiple pregnancy at a teaching hospital in Southern India. Methods: This retrospective study was conducted in the department of obstetrics and gynecology, Basaweshwar teaching and general hospital, and Sangmeshwar teaching and general hospital, attached to Mahadevappa Rampure medical college, Kalaburagi from August 2020 to August 2022. The analysis included data on 36 women between 20 and 35 years of age, with ≥ 24 completed weeks gestation, having multiple pregnancy during the study period after applying the exclusion criteria. The data was retrieved from the hospital medical records that included demographic details, complications of pregnancy, and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, mean and standard deviation. Statistical data was analyzed using SPSS 20.0 software. Qualitative data of the maternal problems during intrapartum and postpartum period was done using the test of proportion and chi-square test was applied for significance. Quantitative data was analyzed by t test considering a p value less than 0.05 as statistically significant. Results: There were a total of 36 women with multiple pregnancy with the overall incidence of 12.5 per 1,000 births (1.25%) during the study period. Preterm labour complicated 27.7% of multiple pregnancies, 13.8% of the multiple pregnancies were complicated by severe preeclampsia, 11.1% were complicated by imminent preeclampsia, 8.3% had intrauterine death in 1 of the twins, and 2.7% had oligohydramnios. 33.3% had iron deficiency anaemia, 22.2% had gestational hypertension, and 13.8% had hypothyroidism. There was no maternal morbidity. Majority (55%) were delivered by LSCS, whereas 44.4% were delivered vaginally. Postpartum haemorrhage complicated 5.5% of twin deliveries. The total fetal loss was 2.4%. There was no maternal mortality in our study. Conclusions: There is higher incidence of adverse maternal and perinatal outcomes among multiple pregnancies than singleton pregnancies. This mandates adequate counselling about risks and required monitoring to avoid adverse outcomes.

Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer, and it accounts for 20% of all skin cancers. It occurs typically on parts of the skin exposed to sunlight and begins as firm erythematous papules or nodules that enlarge over a period of months in most cases. This study investigates the unusual presentation of cSCC with the goal of raising awareness of rare presentations and promoting accurate diagnostic tools. It is a five-year retrospective study retrieving patient data to study the demographic, clinical and histological features of cSCC with unusual presentations that were clinically unsuspected. It was carried out in Al Baha Province, southern Saudi Arabia. A total of 25 cases were included; males predominated (60%), and the mean age of the cohort was 59.8 years. However, three patients were

Objectives: The objectives of this study were to determine the trends of microorganisms and their antimicrobial resistance pattern among ICU patients diagnosed with bacteremia. Methods: This retrospective study was conducted in the microbiology laboratory at a tertiary care teaching hospital from August 2021 to July 2022. A total of 2492 blood culture samples were collected from hospital ICUs from the patient with suspected septicemia. All samples were processed using the automated blood culture system BACT/ALERT 3D/60 for the recovery of pathogenic microorganisms, and antimicrobial susceptibility testing was performed using the automated VITEK 2 Compact system. A Chi-square test was done to assess the statistical significance of our results. Results: Out of 2492 blood culture samples, 296 (11.87%) were identified as culture positive, in which 252 (85.13%) were Gram-negative isolates, 38 (12.83%) were Gram-positive isolates, and 06 (2.02%) were other organisms (contaminants). Gram-negative isolates showed maximum sensitivity to colistin 205 (81.40%), and Gram-positive isolates showed maximum sensitivity to vancomycin 35 (92.10%). Conclusion: Early blood culture results could provide the basis for the appropriate use of antibiotics that can improve clinical prognosis and help in reducing mortality.

Background and purpose: The aim of this study was to correlate obstetric admissions at a tertiary perinatal center with biometeorological forecast and weather conditions. Materials and methods: This retrospective study was conducted at the Department of Gynaecology and Obstetrics Clinical Hospital “Sveti Duh” over five years, from January 1, 2014 to December 31, 2018. The hospital’s emergency data was used for record of obstetric admissions on each day. The selected days were sorted in 4 groups based on biometeorological forecast. Results: In the observed period, there were a total of 18,072 obstetric admissions. There were 216 days with fifteen or more admissions. The results showed no significant difference between obstetric admission based on the biometeorological forecast one day before or three days before. Most hospitalization were on days with a favorable biometeorological forecast in the observed period, 68 days with more than fifteen admissions per day. The day before, the biometeorological forecast was mostly favorable or relatively favorable. Conclusion: Our retrospective single-center study did not show a significant difference between obstetric hospital admissions depending on biometeorological conditions, but the higher number of admissions during days with a favorable forecast is definitely the basis for future studies with larger dataset.

Despite major advances that were made in intensive care unit, mortality rate remains high. The objective of our study was to analyze the incidence and predictive factors of mortality in a surgical intensive care unit, in order to apprehend these factors for an optimal management. We have conducted a retrospective study about 100 consecutive cases of patients admitted to the surgical intensive care unit of Ibn Sina University Hospital in Rabat, during a 3-month period (02/01/2021-02/04/2021). Nearly 20 parameters were collected, analyzed and compared between the group of survivors and the group of deceased. The results shows that the mean age of the patients was 56.86 years, and the sex ratio of men to women was 1,56. Medical comorbidities were dominated by hypertensive and/or ischemic heart disease (38%), diabetes (22%), smoking (27%), neoplasia (17%). 61% of patients were admitted for a surgical pathology, 30% for a medical pathology, and 9% for a traumatic reason. The average APACHE II score at admission was 14,61. On the therapeutic level: 39% of the patients had recourse to vasoactive drugs, 49% had recourse to mechanical ventilation, 6% benefited from extra-renal purification, and 46% from a transfusion of blood derivatives. The average length of stay was 6,46 days. Multivariate analysis using binary logistic regression identified the following factors as independent mortality factors: the existence of neoplastic comorbidities, admission for a medical reason, the elevated APACHE II score, the need for vasoactive drugs, the prolonged mechanic ventilation, the need for transfusion, and the elevated length of stay, all of them were significant. Knowing the predictive factors of mortality will allow us to improve the quality of the care provided, and to target an eventual preventive action to improve the prognosis and to decrease mortality in intensive care unit.

Background and Aim: The orthodontic tooth movements should be such that the tooth moves safely within the alveolar bone. The alveolar bone around the mandibular central incisors of patients with skeletal class I and II malocclusion is thicker in comparison to those with skeletal class III malocclusion. The present study aimed to investigate an association between low angle inclination skeletal class-III malocclusion and the alveolar bone morphology around it. Materials and Methods: A retrospective study was carried out on 75 malocclusion patients in the Orthodontics Department of a Tertiary Care Hospital of Islamabad, Pakistan from January 2020 to December 2022. The malocclusions were confirmed in the patients via cone beam computed tomography (CBCT) imaging. The low angle, skeletal class III malocclusions were categorized into three different groups: Group-I (lingual-inclination), Group-II (upright), and Group-III (labial-inclination). Outcomes such as height of alveolar bone and area of cortical as well as cancellous thickness were determined independently on each side. Results: The labial cancellous bone thickness, thickness of labial cortical bone, alveolar bone total thickness, labial alveolar bone total area, and labial alveolar bone height were highest in group-III (labial-inclination). There was a positive correlation between mandibular central incisors and other aforementioned variables.

While 44-83% of children with steroid-resistant nephrotic syndrome (SRNS) without a proven genetic cause respond to treatment with a calcineurin inhibitor (CNI), current guidelines recommend against the use of immunosuppression in monogenic SRNS. This is despite existing evidence suggesting that remission with CNI treatment is possible and can improve prognosis in some cases of monogenic SRNS. Herein, our retrospective study assessed response frequency, predictors of response and kidney function outcomes among children with monogenic SRNS treated with a CNI for at least three months. Data from 203 cases (age 0-18 years) were collected from 37 pediatric nephrology centers. Variant pathogenicity was reviewed by a geneticist, and 122 patients with a pathogenic and 19 with a possible pathogenic genotype were included in the analysis. After six months of treatment and at last visit, 27.6% and 22.5% of all patients respectively, demonstrated partial or full response. Achievement of at least partial response at six months of treatment conferred a significant reduction in kidney failure risk at last follow-up compared to no response (hazard ratio [95% confidence interval] 0.25, [0.10-0.62]). Moreover, risk of kidney failure was significantly lower when only those with a follow-up longer than two years were considered (hazard ratio 0.35, [0.14-0.91]). Higher serum albumin level at CNI initiation was the only factor related to increased likelihood of significant remission at six months (odds ratio [95% confidence interval] 1.16, [1.08-1.24]). Thus, our findings justify a treatment trial with a CNI also in children with monogenic SRNS.

Yuan Liu,&ast; Chen Song,&ast; Zhiqiang Tian, Wei Shen Department of General Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Shen, Department of General Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China, Tel +86 13385110723, Email shenweijs@outlook.comPurpose: This study aims to construct a machine learning model that can recognize preoperative, intraoperative, and postoperative high-risk indicators and predict the onset of venous thromboembolism (VTE) in patients.Patients and Methods: A total of 1239 patients diagnosed with gastric cancer were enrolled in this retrospective study, among whom 107 patients developed VTE after surgery. We collected 42 characteristic variables of gastric cancer patients from the database of Wuxi People’s Hospital and Wuxi Second People’s Hospital between 2010 and 2020, including patients’ demographic characteristics, chronic medical history, laboratory test characteristics, surgical information, and patients’ postoperative conditions. Four machine learning algorithms, namely, extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), and k-nearest neighbor (KNN), were employed to develop predictive models. We also utilized Shapley additive explanation (SHAP) for model interpretation and evaluated the models using k-fold cross-validation, receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and external validation metrics.Results: The XGBoost algorithm demonstrated superior performance compared to the other three prediction models. The area under the curve (AUC) value for XGBoost was 0.989 in the training set and 0.912 in the validation set, indicating high prediction accuracy. Furthermore, the AUC value of the external validation set was 0.85, signifying good extrapolation of the XGBoost prediction model. The results of SHAP analysis revealed that several factors, including higher body mass index (BMI), history of adjuvant radiotherapy and chemotherapy, T-stage of the tumor, lymph node metastasis, central venous catheter use, high intraoperative bleeding, and long operative time, were significantly associated with postoperative VTE.Conclusion: The machine learning algorithm XGBoost derived from this study enables the development of a predictive model for postoperative VTE in patients after radical gastrectomy, thereby assisting clinicians in making informed clinical decisions.Keywords: gastric neoplasms, gastrectomy, venous thromboembolism, risk factors, machine learning, prediction model

Laparoscopic resection of the pancreas (LRP) has been implemented to a varying degree because it is technically demanding and requires a long learning curve. In the present study we analyze the risk factors for complications and hospital readmissions in a single center study of 105 consecutive LRPs.We conducted a retrospective study using a prospective database. Data were collected on age, gender, BMI, ASA score, type of surgery, histologic type, operative time, hospital stay, postoperative complications, degree of severity and hospital readmission.The cohort included 105 patients, 63 females and 42 males with a median age and BMI of 58 (53-70) and 25.5 (22,2-27.9) respectively. Eighteen (17%) central pancreatectomies, 5 (4.8%) enucleations, 81 (77.6%) distal pancreatectomies and one total pancreatectomy were performed. Fifty-six patients (53.3%) experienced some type of complication, of which 13 (12.3%) were severe (Clavien-DindoIIIb) and 11 (10.5%) patients were readmitted in the first 30 days after surgery. In the univariate analysis, age, male gender, ASA score, central pancreatectomy and operative time were significantly associated with the development of complications (P0.05). In the multivariate analysis, male gender (OR 7.97; 95% CI 1.08-58.88)), severe complications (OR 59.40; 95% CI, 7.69-458.99), and the development of intrabdominal collections (OR 8.97; 95% CI, 1.28-63.02)) were associated with hospital readmission.Age, male gender, ASA score, operative time and central pancreatectomy are associated with a higher incidence of complications. Male gender, severe complications and intraabdominal collections are associated with more hospital readmissions.

Jiayi Li,1,2 Jiao Zhang,2 Xu Wang,2 Xumin Zheng,2 Hongmei Gao,2 Shimin Jiang,2 Wenge Li1,2 1Department of Nephrology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, People’s Republic of China; 2Department of Nephrology, China-Japan Friendship Hospital, Beijing, People’s Republic of ChinaCorrespondence: Wenge Li, Department of Nephrology, China-Japan Friendship Hospital, No. 2, Yinghua Dong Street, Chaoyang District, Beijing, 100029, People’s Republic of China, Email wenge_lee2002@126.comIntroduction: Complement activation is highly involved in membranous nephropathy. Identifying the mechanism of the complement activation pathway carries crucial therapeutic implications yet remains controversial. This study explored lectin complement pathway activation in PLA2R-associated membranous nephropathy (MN).Methods: One hundred and seventy-six patients with biopsy-proven PLA2R-associated MN were enrolled in the retrospective study and divided into the remission group (24-hour urine protein < 0.75g and serum albumin > 35 g/L) and the nephrotic syndrome group. The clinical manifestation and C3, C4d, C1q, MBL, and B factor in renal biopsy tissues and C3, C4, and immunoglobulins in serum were evaluated.Results: Deposition of glomerular C3, C4d, and mannose-binding lectin (MBL) was significantly higher in the activated state than in the remission state in PLA2R-associated MN. MBL deposition was the risk factor for no remission. During follow-up, the persistent non-remission patients have significantly lower serum C3 levels.Conclusion: Activation of the lectin complement pathway in PLA2R-associated MN may contribute to proteinuria progression and disease activity.Keywords: membranous nephropathy, anti-PLA2R antibody, complement, lectin pathway

Human adenovirus (HAdV) is one of the most common viruses causing respiratory infections among young children. Most adenovirus infections are mild and self-limited; however, these infections may occasionally cause severe pneumonia and even death. The mortality risk factors for severe adenovirus pneumonia are not completely clear. This study aimed to evaluate the mortality risk factors in children with severe adenovirus pneumonia.A retrospective study of children with severe adenovirus pneumonia hospitalized in Guangzhou Women and Children's Hospital between July 2018 and January 2020 was performed. Binary logistic regression analysis was used to identify independent mortality risk factors for severe adenovirus pneumonia after univariate analysis.Our study included 189 patients (123 males and 66 females). Among them, 13 patients did not survive with a mortality of 6.88%. In multivariate analysis, the independent mortality risk factors in children with severe adenovirus pneumonia were age less than 1 year (OR = 18.513, 95% CI: 2.157-158.883, p = 0.008), hypoxia (OR = 62.335, 95% CI: 2.385-1629.433, p = 0.013), and thrombocytopenia (platelet100∗10ˆ9/L) (OR = 13.324, 95% CI: 1.232-144.075, p = 0.033).In children with severe adenovirus pneumonia who are younger than one year old, hypoxia and platelet counts less than 100∗10ˆ9/L represent mortality risk factors.

Background and Aim: Dogs and cats are popular pets that play integral roles in human societies worldwide. Unfortunately, they can carry potential zoonotic helminths that can be transmitted to humans. However, data on the gastrointestinal helminths affecting dogs and cats in Bogor, Indonesia, are currently lacking. This study aimed to investigate the occurrence of gastrointestinal helminth parasites in pets from this area using a retrospective analysis. Materials and Methods: A retrospective study was conducted at the Veterinary Teaching Hospital of IPB University, Bogor. Cat and dog patients from January 2014 to April 2019 were tested for helminth infections and the results as well as their age, sex, and breed data were analyzed using the Chi-square test. Results: Among the dogs and cats examined for internal parasites, 61.11% (33/51) of the dogs and 53.80% (92/171) of the cats were infected by helminths. Among the dogs, hookworm (37.04%) and Toxocara spp. (24.07%) were detected, while in the cats, hookworm (11.11%), Toxocara spp. (38.01%), and Dipylidium caninum (4.68%) were detected. The prevalence of hookworm and D. caninum was higher in older pets, while Toxocara spp. infected younger cats and dogs (

Introduction: Locked pediatric inpatient psychiatric units are vulnerable to the emergence and spread of infections, and nosocomial infection, especially respiratory tract infection is potentially a major problem. This study aimed to explore the risk factors for lower respiratory tract infection (LRI), in particular, pneumonia. Methodology: We conducted a retrospective study comprising 4643 patients with schizophrenia (SZ) and 1826 patients with major depressive disorder (MDD), and the chi‐square test was performed to analyze the categorical variables. Results: The risk ratio for LRI, including pneumonia, in intensive care unit (ICU) was higher than in the general ward, and electroconvulsive therapy (ECT) increased the patients’ susceptibility to LRI and pneumonia. Our data have revealed that patients treated with restraint or clozapine showed a higher prevalence of LRI and pneumonia, and the results indicated that the increased risk of LRI, not pneumonia, was dose‐dependently observed in patients with clozapine treatment. Conclusions: Our study shows that ICU and ECT treatment were risk factors for LRI and pneumonia in patients with SZ or MDD, and patients with SZ has a prevalence of hospital-acquired infection because of restraint and clozapine treatments.

Aim: To assess the clinical presentation and laboratory derangements of pediatric covid-19 patients admitted to the tertiary care hospital. Methodology: The present retrospective study was started after the approval of the Institutional Ethics Committee. Clinical (Sp02, final diagnosis and outcome) and biochemical parameters (Complete Blood Count, Liver Function Test, Renal Function Test, Lactate De-Hydrogenase, D-dimer, C-Reactive Protein, and Serum ferritin) of pediatric covid-19 patients were collected from Central Laboratory and Medical Record Department of our institution. Patient names were anonymized and data were analyzed. The results are expressed in percentages. Results: A total of 16 pediatric covid-19 patient details were identified and collected who were admitted during our study period. Out of 16 patients, 09 (56.2%) were female and the remaining 07 (43.7%) were male. Out of 16, 05 patients had mild covid, 07 were moderate and the remaining 04 suffered from severe covid-19 infection. The mean values of oxygen saturation, LDH, D-dimer, CRP, and Ferritin were 88%, 249.4U/L, 1140.9 ng/ml, 16.17 mg/dl, and 61.7 µg/L respectively. Mean values of 17.9 mg/dl and 0.4 mg/dl were recorded for blood urea and S.creatinine. Regarding liver function tests, mean values of 1.7mg/dl, 0.2mg/dl, 1.5mg/dl, 82.4 U/L, 55 U/L, 135.6 U/L respectively noted for total bilirubin, direct, indirect, SGOT, SGPT and ALP. Regarding patient outcomes, all the patients were covered and discharged from the hospital. Conclusion: The present study has found an increase in laboratory mean values of liver function tests but the mean values of C-Reactive protein, LDH, and d-dimer which are the acute inflammatory markers are highly disrupted compared to normal ranges.

Background: Computed tomography urography (CTU), is a radiological examination and has largely replaced traditional intravenous urography (IVU) as the gold standard in the imaging of the genitourinary tract, hence it is now used as a primary imaging technique to evaluate patients with diseases involving the urinary tract. Objective: The aim of this study is to ascertain and document the indications as well as possible findings on CTU carried out on various patients sent to the Radiology department of a tertiary hospital in our environment. Methods: A retrospective study and descriptive design was employed in this study. A total of 140 patient’s data was used. A P-value below 0.05 was considered statistically significant. Results: One-hundred and forty patients were studied over a 24months period. The commonest age range is 41 to 50 years and also with most abnormalities. It also showed that more males presented for CTU than females. The most frequent indication for CTU is flank pain (31.4%, n=44). The most common finding in this study is hydronephrosis (39.3%, n=55) and it showed significant association with age (P-value=0.036). Stone is the next common finding with the inferior pole (n=23, 48.9%) as the commonest site for stones. Few congenital anomalies were noted with kinked ureters (n=9, 50.0%) been the most common. Right sided renal cyst is more frequent that left (n=21, 44.7% vs n=20, 42.6%) and inferior pole is the most common location. Conclusion: CTU is the imaging modality of choice in evaluating the genitourinary system with the advantage of giving additional information about other abdominal structures. Flank pain is the most prevalent indication in this study. Hydronephrosis is the commonest finding with significant association with age.

INTRODUCTION: Assessment of the patient’s condition and prediction of outcomes is critically important during pre-transport stabilization and remains the most complex challenges of the activities of transport teams. A significant variety of scales and different requirements for their application indicates that there is no consensus on the choice of a specific scale and predictive tool. OBJECTIVE: To study hospital outcomes in transported newborns, depending on the assessment on the TRIPS scale (Transport Risk Index of Physiological Stability for Newborn Infants). MATERIALS AND METHODS: The оbservational, cohort, retrospective study included data from 604 trips of the transport team to newborns consulted by resuscitation and consultative center from August 1, 2017 to December 31, 2018. The total sample was divided into groups depending on the assessment of the score, followed by a comparison of characteristics and outcomes in these groups. RESULTS: There is a significant difference in birth weight and gestational age between TRIPS groups. An increase in the TRIPS score in transported newborns is associated with an increased risk of death with a maximum relative risk of 21.4 (3.35–136.72) (between 6 and 1 groups). For other outcomes, there are significant differences between groups with minimum and maximum TRIPS scores. CONCLUSIONS: The TRIPS scale allows to stratify newborns requiring inter-hospital transportation by the risk of developing a fatal outcome and complications at the upcoming hospital stage.

Kawasaki disease (KD) is a common pediatric vasculitis with a risk of coronary artery aneurysm. In this report, we review some particularities of KD disease, especially coronary involvement, and highlight its aspects during the COVID-19 epidemic which saw the emergence of a syndrome named multisystem inflammatory syndrome in children (MIS-C). Because of its many similarities with KD, MIS-C is often referred to as Kawasaki-like disease (KLD) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS).We report on a retrospective study on the different epidemiological, clinical, and evolutionary aspects of KD and the coronary involvement resulting from this disease before and after the pandemic. The study is based on the echocardiography records of the P4 Department at Rabat Children’s Hospital, from January 2002 to December 2021. A total of 379 patients were diagnosed with KD during that period. This includes 47 cases that were reported during the first year of the COVID-19 epidemic in Morocco (March 2020). Echocardiography results for our series show that cardiac complications wererelatively more frequent among KD patients during the COVID-19 period, perhaps because they were relatively older (67 months on average) than classic KD patients (37 months on average). However, all patients had a favorable outcome after treatment with a combination of intravenous immunoglobulin (IVIG) and aspirin. The few patients who did not respond to standard treatment received corticosteroids, and no mortality occurred. We conclude that as far as cardiac complications,KD, KLD, and MIS-C are the same core disease that is triggered under different conditions for different age groups.The emergence of the Sars-Cov-2 virus changed the epidemiologic profile of KD but not its treatment. Insights from this study would help in the decision to initiate targeted immunotherapy quickly and reduce the risk factors associated with KD.

What is Known and Objective? In China, patients with drug-induced liver injury (DILI) are commonly treated with one or more types of hepatoprotective drugs, despite a lack of evidence. We performed this study to investigate the association between the treatment pattern of DILI, including withdrawal of suspected drugs and use of hepatoprotective drugs, and recovery following DILI. Methods. A retrospective study was conducted at a tertiary hospital in Central China. Data of patients with a diagnosis of DILI hospitalized between January 2015 and December 2020 were collected through the Electronic Medical Records System. We excluded cases that did not meet the biochemical criteria of DILI and had a Roussel Uclaf Causality Assessment Method score of less than 3. Univariate and multivariate logistic regression models were used to analyze the association between treatment patterns and clinical outcomes. Results and Discussion. In total, 699 patients were included. Suspected drugs were discontinued in 619 patients (88.6%). 693 patients (99.1%) were treated with hepatoprotective drugs, among whom only 14.7% patients received monotherapy with hepatoprotective drugs. Recovery following DILI was seen in 593 cases (84.8%). By multivariate analysis, the number of hepatoprotective drugs combined did not show significance ( p = 0.363 ), while the withdrawal of suspected drugs was associated with recovery following DILI ( p = 0.015 ). What is New and Conclusion. The withdrawal of suspected drugs is associated with the recovery following DILI, and hepatoprotective drug combinations do not contribute to better outcomes than monotherapy. The findings indicate that DILI patients should stop suspected drugs as soon as possible and the combination therapy of hepatoprotective drugs is unnecessary.

Background: Segmental Spinal anaesthesia (SA) is reported to be having excellent results in terms of post-operative pain, analgesia requirement, relatively less complications and reduced hospital stay. General anaesthesia (GA) is the anaesthetic technique of choice for laparoscopic cholecystectomy (LC). The main reasons for selecting spinal anaesthesia (SA) as the first choice for laparoscopic cases were its advantages like total muscle relaxation, a conscious patient, economical, relatively uneventful recovery after, pain free early postoperative period and the protection from potential complications of general anaesthesia. Materials and Methods: It is a retrospective study conducted between October 2020 and September 2022. 160 Patients in study group undergoing laparoscopic abdominal procedures were operated under Spinal Anesthesia. In study group 45 patients had acute cholecystitis and 115 underwent elective cholecystectomy were included. 100 Patients who were operated under General anesthesia were kept as control. Results: Out of 160 patients, 105 patients were females, average age was 43.8 years and 55 male patients with average age was 39.2 years laparoscopic cholecystectomy was performed in all patients. Out of 160 patients 45(28.12%) of had acute cholecystitis. 32 (20%) patients HAD hypotension, 35 (21.88%) observed anxiety, neck or shoulder pain, and 1 (0.62%) patient required conversion because of anxiety, despite sedation where as one patient required conversion to general anaesthesia due to failure of SA effect. Conclusions: Laparoscopic surgery done with the patient under spinal anaesthesia has several advantages general anaesthesia. Laparoscopic cholecystectomy using spinal anaesthesia is a better alternative as there is no intubation related airway obstruction. There was excellent muscle relaxation; decreased surgical bed oozing, economical, pain free early post-operative period. A little risk of unrecognised hypoglycaemia was observed in a ..........