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Aim: To improve management of the posterior urethral valve (PUV) in children in a hospital environment. Patients and Methods: This was a retrospective descriptive study that covered a sixteen (16) years period, from January 1, 2002 to December 31, 2017, In pediatric surgery and urology departments of our teaching hospital, 26 cases of posterior urethral valve (PUV) were involved. The diagnosis was made by retrograde urethrocystography and micturition, supplemented by ultrasound. Results: During this period, 26 patients (1.7%) had a PUV. The mean age of the patients was 73, 2 months with extremes ranging from 6 to 180 months. Fifteen patients consulted for dysuria, 8 for complete retention of urine. Only one patient had a history of rolling the valves to the benign ones. The main complications found were urinary tract infection in 15 children, urolithiasis in 3 children and renal failure in 2 children. Two children had serum creatinine values of 50 and 58 mg/L. The lamination of the posterior urethral valves was performed in all patients. In our series, we had one death from chronic renal failure in a 6-year-old child with a bilateral mute kidney at IVU. Conclusion: The valve diagnosis of the posterior urethra is made late because the diagnosis is still postnatal.

Background: Neurocognitive decline and depression are the most common unaddressed but noticeable adverse consequences linked with obstructive sleep apnea (OSA) which can affect work performance, social functioning, and quality of life. It is significant to explore both cognition and mood disorders in OSA, as there is adequate evidence in the literature supporting the efficacy of continuous positive airway pressure (CPAP) in the management. Aims and Objectives: The aim was to assess the neurocognitive profile and depression in patients with OSA in our center. Patients and Methods: This was a cross-sectional observational study conducted in a tertiary care center between January 2017 and January 2018. A total of 92 patients with an established diagnosis of OSA (by polysomnography) were included in the study. All patients were given questionnaires for the assessment of neurocognitive function and depression scoring. Results: Out of 92 OSA patients, 29 (31.5%) had normal cognition, 43 (46.7%) had mild cognitive impairment (CI), and 20 (21.7%) had major CI. Out of twenty patients with major CI, major attention deficit was observed in 17 (85%), memory impairment in 16 (80%), verbal fluency was affected in 13 (65%), deficit in language skills was observed in 7 (35%), and visuospatial abilities were affected in 17 patients (85%). Out of 92 OSA patients, 21 (22.8%) had depression and 71.4% of them were females. Conclusions: OSA is an independent risk factor for both depression and neurocognitive decline. It is highly recommended that patients with OSA should be screened for both, so as to provide better clinical outcomes.

Resume Objectif Analyser les aspects epidemiologiques, anatomocliniques, chirurgicaux et evolutifs des complications urologiques de la chirurgie gynecologique. Patientes et methodes Il s’agissait d’une etude retrospective, concernant 81 patientes hospitalisees dans le service d’urologie du CHU de Brazzaville de 2000 a 2008 pour complications urologiques de la chirurgie gynecologique. Les parametres epidemiologiques, diagnostiques, chirurgicaux et evolutifs ont ete analyses. Resultats Les complications urologiques de la chirurgie gynecologique etaient retrouvees chez 3 % des patientes hospitalisees en urologie. L’âge moyen etait de 37 ± 14,52 ans (17et 74 ans) la mediane etait de 36 ans. Le delai moyen de diagnostic etait de 15 jours (0 et 350 jours). Les signes cliniques revelateurs etaient : l’oligoanurie ( n = 12), l’incontinence urinaire ( n = 57), la douleur lombaire ( n = 9) et l’hematurie cyclique ( n = 2). Les interventions chirurgicales en cause etaient : la cesarienne ( n = 50), l’hysterectomie ( n = 26), la myomectomie ( n = 3) et l’hysterectomie pour cancer ( n = 2). Les lesions observees ont ete 55 (67,9 %) fistules vesico-vaginales, 12 (14,8 %) ligatures ureterales, huit (10 %) fistules uretero-vaginales, trois (3,7 %) fistules vesico-uterines, deux (2,4 %) plaies ureterales et une (1,2 %) fistule vesico-vaginales et uretero-vaginale. Le traitement avait consiste en une ureterorraphie termino-terminale, 20 reimplantations ureterovesicales, 57 cures de fistules vesico-vaginales et une nephrectomie. La guerison avait ete obtenue chez 96 % des lesions ureterales et 90 % des fistules vesico-vaginales. Conclusion Les lesions de l’uretere et de la vessie etaient souvent rencontrees au cours de la chirurgie gynecologique. La prise en charge necessite des connaissances de l’anatomie du petit bassin.

Background: Vitamin D deficiency is common all over the Indian subcontinent, with a prevalence of 70-100% in the general population. Vitamin D deficiency has a role in several diseases of the respiratory system including chronic obstructive pulmonary disease (COPD). Studies have shown that vitamin D deficient COPD patients have lower lung function measured by FEV1. We conducted a study to see prevalence of Vitamin D deficiency in COPD patients and it’s correlation with Forced Expiratory Volume in 1 second.Methods: A cross sectional observational study was performed in a tertiary care hospital in Hyderabad, Telangana during the period of one and half year. This included 104 COPD cases attending outpatient department of pulmonary medicine. Serum vitamin D levels were measured, and spirometry was done in all patients and data was analyzed accordingly.Results: Among 104 patients, 87 were males and 17 were females. Most of the study population (44.2%) was aged between 60-70 years. Mean BMI was 26.40 (±5.77) kg/m2. Majority of study populations (66.34%) were in GOLD stage 1 and 2. The mean Vitamin D value of the study population was 20.77±11.74ng/ml. Majority of the COPD patients were vitamin D deficient (69.2%). 25.0 % was severely deficient of vitamin D. The mean FEV1 volume (%) was 83.15±11.53, 60.97±17.47, 30.71±7.96 in sufficient, deficient and severe deficient patients.Conclusions: Vitamin D deficiency is common in COPD patients. Serum vitamin D deficiency increases with increased severity of COPD. There is positive correlation between serum vitamin D levels and post bronchodilator FEV1 (%).

Background: In India, patients visit a number of hospitals generating a lot of paper-based records, which are gradually lost with time. Because of this loss of health records, proper monitoring of health care in India is almost unendurable. Proper monitoring of ADR and prevention of antibiotic resistance cannot be efficiently fulfilled. So, in order to fulfil the health needs of Indian citizens, an integrated health care system like EHR is necessary. Materials and methods: A cross-sectional questionnaire study on barriers and benefits of EHR with their solutions was performed in five multispeciality hospitals in Rajamahendravaram city of Andhra Pradesh. A total of 102 individuals were involved in study. Results: Benefits of EHR were evaluated, in which individuals felt it beneficial for effective treatment during emergency conditions. Rating of EHR-related barriers showed individual barrier and financial barrier as major barriers in implementing EHR. The individual barrier, which consists of lack of belief in EHR, was the main barrier faced; rating the solutions for individual barriers and implementing a backup plan in the system will be helpful to regain lost data. Discussion: Based on participants’ perspective, it was considered that the lack of knowledge and experience with using computers was the main barrier of all. This could mean that hospitals have low knowledge of using EHR systems. Conclusion: We should be aware that successful EHR system implementation consists of more than just implementing a single system. Overcoming current and potential difficulties to these implementations, which are significant factors, is needed for implementation to succeed.

Sarcoidosis is a chronic granulomatous disease involving multiple organs. Most commonly affected organs are lungs, followed by skin, lymph nodes. Hematological manifestations of sarcoidosis are uncommon and may include hemolytic anemia, leukopenia, eosinophilia, peripheral lymphopenia but severe thrombocytopenia is very rare. Our patient presented with petechial rash, papular skin lesions and had severe thrombocytopenia. Skin biopsy showed granulomatous inflammation without necrosis with good clinical, radiological and hematological response to oral prednisolone. [J Med Allied Sci 2018; 8(2.000): 94-97]

Meckel's diverticulum is the commonest congenital abnormality of the gastrointestinal tract. Hemorrhage, obstruction and inflammation are the three main categories of complications resulting from Meckel's diverticulum. Spontaneously perforation of Meckel's diverticulum is very rare and mimics acute appendicitis. We report a case of 26 year-old male, who presented since 5 days worsening abdominal pain predominantly in the right iliac fossa associated with high grade fever. On physical examination his abdomen was distended with guarding and rigidity. A provisional diagnosis of appendiculaire peritonitis was made. Our patient had an emergency laparotomy, where a perforated Meckel's diverticulum and advanced peritonitis were discovered. A diverticulectomy with ileostomy were performed. Heterotopic mucosa of diverticulitis was confirmed on histopathology. The patient made an uneventful recovery postoperatively and ileostomy reconstruction was done two months later. This case report is an interesting and unusual case of Meckel's diverticulum complications and highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen.