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Abstract Low birth weight is a newborn delivered with birth weight of less than 2500 g regardless of gestational age is called. It is a significant issue affecting over 30 million infants worldwide. Thus, the study determine factors associated with low birth weight among newborns delivered at Mettu Karl Comprehensive Specialized Hospital, Southwest Ethiopia. A facility-based case–control study was conducted with 336 newborns (112 cases and 224 controls) from September 12 to December 23, 2022. The study population was newborns with birth weights of 2500 g to 4000 g as controls and newborns with birth weights

Abstract Eye-based communication languages such as Blink-To-Speak play a key role in expressing the needs and emotions of patients with motor neuron disorders. Most invented eye-based tracking systems are complex and not affordable in low-income countries. Blink-To-Live is an eye-tracking system based on a modified Blink-To-Speak language and computer vision for patients with speech impairments. A mobile phone camera tracks the patient’s eyes by sending real-time video frames to computer vision modules for facial landmarks detection, eye identification and tracking. There are four defined key alphabets in the Blink-To-Live eye-based communication language: Left, Right, Up, and Blink. These eye gestures encode more than 60 daily life commands expressed by a sequence of three eye movement states. Once the eye gestures encoded sentences are generated, the translation module will display the phrases in the patient’s native speech on the phone screen, and the synthesized voice can be heard. A prototype of the Blink-To-Live system is evaluated using normal cases with different demographic characteristics. Unlike the other sensor-based eye-tracking systems, Blink-To-Live is simple, flexible, and cost-efficient, with no dependency on specific software or hardware requirements. The software and its source are available from the GitHub repository ( https://github.com/ZW01f/Blink-To-Live ).

Objective: Premature ventricular contractions (PVCs) are a common arrhythmic condition. The first approach in patients with symptomatic and frequent PVC is medical treatment, primarily beta-blockers (BB) or calcium channel blockers (CCB), but it is still unclear which of the two should be chosen. This study investigated which drug treatment would be beneficial according to patient and electrocardiography (ECG) characteristics in patients with idiopathic PVC. Methods: We retrospectively analyzed 156 patients with PVC who came to the cardiology outpatient clinic. Seventy-one patients were responsive to BB, and 85 were responsive to CCB. Their demographic and ECG characteristics were compared. Results: The male ratio was higher (p

Abstract Background: The study aims to establish the pattern of fetal heart rates in the first and second trimesters and determine whether there is a statistically significant difference in the first-trimester fetal heart rate (FHR) of males and females. Methods: This retrospective observational research is a study of FHRs measured at 11 + 0 –13 + 6 wk and 18 + 0 –23 + 6 wk, and ultrasound scan-diagnosed fetal sex at 18 + 0 –23 + 6 wk. Singleton fetuses with nonambiguous external genitalia were recruited. The FHR was measured in B or M mode with Pulsed Wave Doppler, while ultrasound appearance of external genitalia determined the fetal sex at 18 + 0 –23 + 6 weeks. Student's t-test and Chi-square test were used for data analysis, and statistical significance was set at p < 0.05. Results: A total of 2437 pregnancies meeting the study criteria were analyzed. The fetal sexes were 1398 (57.4%) males and 1039 (42.6%) females. There was no statistically significant difference in the first-trimester FHR between males and females (p = 0.74). However, females had higher mean FHR in both the first and second trimesters (First trimester: 165.4 ± 18.2 bpm vs 163.2 ± 17.1 bpm and Second trimester: 150.9 ± 22.6 bpm vs 141.9 ± 23.1 bpm). The FHR reduces with the increase in gestational age. Conclusion: There is no statistically significant difference in the first-trimester FHRs between sexes.

Ischemic stroke is a rare and serious complication of coronary angiography and percutaneous coronary intervention, which has high morbidity and mortality. To our knowledge, there is no large-scale randomized controlled trial for the management of catheter-related ischemic stroke. In this case study, we presented a 46-year-old male with peri-procedural ischemic stroke during the coronary angiography (CAG). The CAG was terminated after the stroke and the left carotid artery was selectively cannulated, and digital subtraction angiography (DSA) revealed total occlusion (Modified Thrombolysis in Cerebral Infarction, mTICI, 0) of the M1 part of the left middle cerebral artery (MCA). A stent-assisted thrombectomy was performed and the DSA revealed restoration of flow to the left MCA with mTICI 3 flow in the distal branches. The next day, the neurological exam showed no sensory, motor deficits. The patient was discharged four days later. In the setting of catheter-related stroke, mechanical thrombectomy seems to be the least time-consuming and effective approach.

Sol koroner arterin pulmoner arterden orijin alması (ALCAPA) nadir olmakla birlikte, ilk olarak 1866’da tarif edilen bir major konjenital kardiyak anomalidir. Sol koroner arterin direkt aortaya reimplantasyonu ve koroner arter baypas greftleme prosedürleri de dahil olmak üzere çok sayıda cerrahi teknik ikili koroner arteriyel sistem oluşturmayı amaçlamaktadır. Sol koroner arter nadir olarak non-facing pulmoner sinüsten köken alır ve bu nativ aortaya uzak mesafede bir bölge olduğu için, direkt reimplantasyonun teknik olarak oldukça zor olduğu cerrahi onarımdır. Bu vaka sunumunda, non-facing pulmoner sinus kökenli sol koroner arterin, otolog pulmoner arter duvarından tünel oluşturularak aortaya rekonstrüksiyonu cerrahi tekniği bir seçenek olarak sunulmuştur.

The role and efficacy of exclusive enteral nutrition (EEN) in the treatment of luminal Crohn’s disease (CD) has been well established over the last 2 decades. Consequently, in many centers nutritional therapy is now considered first line therapy in the induction of remission of active CD. However, the use of nutritional therapy in complicated CD has yet to be fully determined. This article aimed to review case reports and clinical trials published in the last decade that have considered and evaluated nutritional therapy in the setting of complicated CD in children and adults. Published literature focusing upon the use of nutritional therapy as part of medical therapy in the management of complicated CD were identified and reviewed. Although there continue to be various interventions utilized for complicated CD, the currently available literature demonstrates that nutritional therapies, especially EEN, have important roles in the management of these complex scenarios. Further assessments, involving large numbers of patients managed with consistent approaches, are required to further substantiate these roles.

INTRODUCTION[|]This study aimed to determine the relationship between the diameter of coronary artery stents and age, gender, diabetes mellitus (DM), left ventricular ejection fraction (LVEF), renal dysfunction, and the clinical presentation of myocardial ischemia in the cohort of patients with implanted stents in coronary arteries with severe stenotic lesions.[¤]METHODS[|]This study included 2256 patients (mean age, 59.3+-10.9 years; men, 62%) who underwent percutaneous coronary intervention (PCI). The clinical status of the patients at presentation was subcategorized as follows: ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina pectoris, and stable angina pectoris. The diameters, without any type or brand differentiation, were divided into two groups as follows: Group I, which included 2.5- and 2.75-mm-diameter stents, and Group II, which included ≥3-mm-diameter stents.[¤]RESULTS[|]The type of procedure, including primary PCI, early invasive strategy, and elective stenting, was not found to be a significant factor affecting the diameter of coronary artery stents. Univariate and multivariate analyses revealed a relationship between the diameter of coronary artery stents and age, gender, DM, and LVEF.[¤]DISCUSSION AND CONCLUSION[|]This study demonstrated that the diameter of coronary artery stents was independently associated with gender, age, a history of DM, and moderate-to-severe systolic left ventricular dysfunction.[¤]

COMPARATIVE STUDY BETWEEN STAPLER AND HAND SEWING IN GASTROINTESTINAL ANASTOMOSIS Mustafa Adnan Maatooq* & Issam Merdan@ *MB,ChB, Board candidate, Al-Sadir Teaching Hospital, Basrah. @MB,ChB, FICMS, CABS, Professor of Surgery, Department of Surgery, College of Medicine, University of Basrah, IRAQ. Abstract Gastrointestinal anastomosis is an important part of gastrointestinal operations and can be achieved by hand sewn anastomosis or by the newly developed staplers. The study aims to compare between the two surgical methods of anastomosis in a prospective , randomized design, regarding: operation time, post operative hospital stay and the incidence of post operative anastomotic leak in both groups. The study was carried out in Department of Surgery at Alsader Teaching Hospital in Basrah, Iraq from October 2015 to December 2016, it included 40 patients of both gender and with a different age, they divided into 2 groups (hand sewn and stapler groups), each group included 20 patients, comparing the following parameters: time of anastomosis, duration of surgery, post operative leak and hospital stay. There were no significant differences in the age, gender distribution, the indication for resection, post operative anastomotic leak (p=1) and hospital stay (P Value 0.15 ) in both group but there was significant differences in duration of anastomosis (P Value0 .00001) and operation time (P Value 0.00001). Our study concluded the superiority of stapler on hand sewing in gastrointestinal anastomosis in term of reducing operative time.

INTRODUCTION[|]Red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been found to be associated with non-valvular atrial fibrillation (AF) and cardiovascular diseases. However, correlation of these parameters with presence of left atrial (LA) thrombus and/or spontaneous echo contrast (SEC) in patients with non-valvular AF has not been clarified. This study was an investigation of correlation of RDW, NLR, and clinical risk factors with LA thrombus and dense SEC in patients with non-valvular AF in the Turkish population.[¤]METHODS[|]The demographic, laboratory, and echocardiographic properties of 619 non-valvular AF patients who underwent transesophageal echocardiography (TEE) examination before direct current cardioversion (DCCV) or AF ablation treatment were retrospectively investigated. Complete blood count (CBC) and biochemical parameters were studied 6 to 12 hours before TEE examination. Left atrial stasis (LAS) markers were noted as presence of left atrial/left atrial appendage (LA/LAA) thrombus or dense spontaneous echo contrast (DSEC).[¤]RESULTS[|]Total of 325 (52%) patients with LAS were compared with 294 patients (48%) without LAS. In the LAS group, there were 274 (84%) patients with LA/LAA thrombus and 51 (16%) patients with DSEC. LAS (+) group, values for RDW (14.85+-1.48 vs. 13.77+-1.30; p6 months, and international normalized ratio

Background: Imaging has a critical role in the diagnosis and evaluation of cardiac diseases, beginning with chest radiography and fluoro-scopy and progressing to coronary angio-graphy, echocardiography, nuclear medicine and recently multidetector computed tomo-graphy (MDCT) as well as magnetic resonance (MR) imaging Objective: To highlight the role of Multi-detector CT in the evaluation of coronary artery disease and its importance of being noninvasive diagnostic technique. Methods: A cross sectional study for 20 patients. Patients were asked to fast 6 hours prior to the examination and the patients with heart rates above 65 beats per minute were given cardio-selective beta-blocker and for heart rate above 75 (up to 85) beat/min, the best systole phase was used for reconstructing our images Results: for Evaluation of native coronary arteries, the CTCA showed significant lesions (occlusion or >60 % stenosis) in the native arteries of 13 patients and insignificant lesions in 7 patients. Evaluation of CABG (8 arterial grafts); for (LIMA) graft, 83% were patented, and 17% were narrowed and 100 % of (radial graft) were patent. For Venous Grafts the study included 10 venous grafts; 70 % were patent, 20% were narrowed and 10 % were totally occluded. Conclusion: The multi-slice CTCA is now a clinically reliable noninvasive tool that allows the evaluation of the native coronary arteries, the bypass grafts, coronary stents.

Over the past decade, percutaneous coronary interventions (PCIs) performed via radial artery (RA) access have become popular among interventional cardiologists. Since the radial approach may limit the options in complex cases, most interventional cardiologists prefer femoral access to RA access for complex procedures, such as chronic total occlusions (CTOs) and bifurcation lesions. Presently described is a case of CTO of the right coronary artery that was successfully treated with PCI via the left RA. This study demonstrates that if there is an indication for revascularization and the CTO lesions are short and without poor prognostic factors, an intervention for CTO should still be considered, even if there is no femoral access.

Objective: Therapeutic hypothermia improves neurologic prognosis after cardiac arrest. The aim of this study was to report clinical experience with intravascular method of cooling in patients with cardiac arrest resulting from ST-segment elevation myocardial infarction (STEMI). Methods: Thirteen patients (11 male, 2 famele; mean age was 39.6+-9.4 years) who had undergone mild therapeutic hypothermia (MTH) by intravascular cooling after cardiac arrest due to STEMI were included. Clinical, demographic, and procedural data were analyzed. Neurologic outcome was assessed by Cerebral Performance Category (CPC) score. Results: Anterior STEMI was observed in 9 patients. One patient died of cardiogenic shock complicating STEMI. Mean cardiopulmonary resuscitation (CPR) duration and door-toinvasive cooling were 32.9+-20.1 and 286.1+-182.3 minutes, respectively. Precooling Glasgow Coma Scale score was 3 in 9 subjects. Twelve patients were discharged, 11 with CPC scores of 1 at 1-year follow-up. No major complication related to procedure was observed. Conclusion: In comatose survivors of STEMI, therapeutic hypothermia by intravascular method is a feasible and safe treatment modality.

Objective:Socioeconomic and cultural factors influence breast cancer prognosis. The effect of these factors on breast cancer was evaluated among women who live in Gaziantep and its surroundings.Materials and Methods:female patients who were admitted to Gaziantep University Oncology Hospital with a diagnosis of breast cancer between October 2006-July 2013 were included in the study. The effects of socio-demographic characteristics on clinical-pathological features were evaluated.Results:The mean age of 813 women was 48.8 years. The majority were premenopausal women. Advanced stage disease on diagnosis was detected more in our region. The rate of breast cancer with unfavorable prognostic features was higher among patients who were illiterate, with low economic income and residing in rural areas.Conclusion:Socioeconomic-cultural factors influence the biology and clinical course of breast cancer among women who live in Gaziantep province.

Behçet's disease (BD) is a multisystem vasculitis that may involve vessels of all sizes. Acute coronary syndrome (ACS) due to secondary involvement of BD is rare and its management less clear. In this case, a 29-year-old man admitted to the emergency room with ongoing chest pain was interned to the coronary care unit with a diagnosis of ACS. The patient had been diagnosed 1 year before with BD and had been without regular follow-up, despite the suggested use of cholchium. An immediate coronary angiography revealed a fresh thrombus image in the proximal segment of the right coronary artery (RCA), an aneurysm of the left anterior descending artery (LAD) at proximal segment, and a hemodynamically significant lesion following the aneurysm. Intervention was ended because of normal flow (TIMI III) of distal RCA. An intravenous infusion of glycoprotein IIb/ IIIa receptor inhibitor (tirofiban) was administered, and a control angiography showed dissolution of a thrombus in RCA, but enlarged aneurysm of LAD and a new aneurysm in RCA.

Nerium oleander is a popular ornamental plant grown in many tropical and subtropical countries and in the Mediterranean region. It is dangerous because it has been shown to contain several types of cardiac glycosides, and hence can cause cardiac arrhythmias resembling digoxin in their toxicologic manifestations. We report a patient presenting to our hospital with Mobitz type II atrioventricular block after drinking herbal tea prepared from oleander leaves. Three hours after admission, a 200-mg empiric dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. A 12-lead electrocardiogram (ECG) revealed sinus rhythm at the end of infusion. After 72 hours, the patient was discharged without any symptoms.

BACKGROUND: The estimated prevalence of nonalcoholic fatty liver disease (NAFLD) in Saudi Arabia is 7% to 10%. Despite the high prevalence of risk factors including diabetes, obesity, and hyperlipidemia, no recent epidemiological studies have measured the disease burden. We aimed to determine the characteristics of Saudi NAFLD patients attending a university hospital, and study factors affecting alanine aminotransferase (ALT) levels. DESIGN AND SETTING: A prospective study among patients referred for ultrasonography in King Khalid University Hospital in Riyadh, Saudi Arabia from February to May 2009. PATIENTS AND METHODS: NAFLD was defined as an appearance of fatty liver on routine abdominal ultrasound in the absence of coexisting liver disease and alcohol consumption. Patients were classified into normal and high ALT (ALT >60 U/L) level groups for analysis. RESULTS: The prevalence of NAFLD was 16.6% (218/1312). Patients with normal ALT had the mean (SD) age of 45.9 (10.6) years and the mean body mass index of 34.5 (7.9) kg/m2. Forty percent of the 151 patients with normal ALT had diabetes, 66.2% were obese, and 29.1% had hypertension. Forty-three patients (23%) had high ALT levels. These patients had significantly lower age (P=.003) and fasting blood sugar (P=.03) than the normal ALT group. Non-diabetic patients (odds ratio 0.30, 95% CI 0.1-0.8), men (female OR 0.23, 95% CI 0.1-0.5), lower cholesterol (P=.001), high-density lipoprotein (P=.006), and low-density lipoprotein (P=.008) levels were more likely to be observed among patients with high ALT levels. In a multivariate analysis, younger age (OR 0.96, 95% CI 0.93-0.99), being male (OR 0.23, 95% CI 0.09-0.57), and a lower cholesterol level (OR 0.55, 95% CI 0.37-0.82) were significant predictors of high ALT levels. CONCLUSION: Based on the high prevalence of obesity and diabetes, the prevalence of NAFLD will continue to be high, unless awareness is inculcated among the local population.

The management of valvular heart diseases with mechanical valves has been performed for several years. Warfarin has been used in patients with mechanical heart valves to protect against thromboembolic complications; nevertheless, in these patients, thromboembolic event rates range from 0.5% to 1.7%. Acute occlusive embolism to the coronary arteries due to a mechanical valve is an uncommon occurrence. In this report, we present a case of a left coronary system occlusion due to thrombus embolization from a prosthetic aortic valve, which was successfully treated by thrombolytic therapy.