Search

Introduction. The article considers an approach to organization of research activity using medical information system. Materials and methods. Authors carried out retrospective analytical cohort study of adults with temporary incapacity to work based on the data from the State Medical Institution Galichskaya District Hospital (Kostroma Region of the Russian Federation) for a period 2014–2019. Sampling was done using the medical information system. Results. As the medical information system has been operating for many years and is designed in the way that the key information gaps should be filled, we consider the results of our study on research activity in a polyclinic using medical information system successful. Discussion. The organization of research activity is discussed using results of an epidemiological study aimed at identifying the correlation between the incidence of acute respiratory diseases and further development of circulatory system diseases carried out in Galichskaya District Hospital. For citation: Papicheva MA, Yakushina II. Organization of research activity in a polyclinic using medical information system. City Healthсare. 2021; 2(3):24-34. doi: 10.47619/2713-2617.zm.2021.v2i3;24-34

Background: Diabetes mellitus (DM) represents a major health-related problem in South Africa and throughout the world. The management goals of diabetes are first to maintain normal blood glucose levels and second to prevent the development of complications. Local guidelines developed by the Society for Endocrine Metabolism and Diabetes South Africa (SEMDSA) have shown that tight glycaemic control and appropriate monitoring can prevent or delay the development of diabetic complications. The demographic profile of patients with type 2 DM and the compliance of doctors to the guidelines were determined.Methods: Five hundred records of patients with type 2 DM were selected from the medical outpatients’ department (MOPD) by systematic sampling. Demographic information on age, sex and ethnicity was obtained. The performance and timing of recommended investigations were recorded and compared with the 2012 SEMDSA guidelines.Results: The mean age of patients was 61 years. Black and Indian patients formed the majority, comprising 44.4% and 43.0% respectively. Glycated haemoglobin was measured in 29.2% of patients once and 13.2% of patients twice in the past year. Lipid studies were done on 40.4% of patients. A serum creatinine (sCr), estimated glomerular filtration rate (eGFR) and serum potassium were done on 38.2% of patients. Eye examinations were done on 13.60% patients and examination of the foot was done on 7.8% of patients. Some 15% had a urine dipstick test done at least once in the past year and 10.4% had a urine albumin/creatinine ratio (ACR) requested. Only 21 patients (4.2%) were compliant with the SEMDSA guidelines. Measurements of blood pressure and blood glucose were 100% compliant. Anthropometric measurements (height, weight and body mass index), dietitian referral and foot examinations were the least compliant, being performed 4.2%, 5.0% and 7.8% of the time respectively.Conclusion: Black and Indian patients formed the majority of the study population. The screening for chronic complications of type 2 DM was poor in the majority of patients. Evaluation of selected records demonstrated compliance with the SEMDSA guidelines in only 4.2% of patients. There is an urgent need to review barriers to the implementation of guidelines in South Africa.

The National Formulary (Fornas) is a list of drugs stipulated in a Decree of the Minister of Health of the Republic of Indonesia, which is used as a guideline for hospitals in drug supply for participants of the National Health Insurance (JKN) program. Doctor's prescription is one indicator of the quality of hospital services. Prescribing drugs based on guidelines will provide efficiency in the supply of drugs. The purpose of this study was to facilitate controlling drug supplies, safe use of drugs and control costs and quality of treatment. K-Means Clustering is a method of grouping data into clusters using the K-Means algorithm. The data used in this study was a specialist doctor's prescription in December 2019 which was sourced from the Pharmacy department of the Meranti Islands District Hospital. The results of this research with the K-Means Clustering method consisted of 3 (three) clusters, namely cluster 0 obeying Fornas as many as 2 polyclinics, cluster 1 being less obedient to Fornas as many as 2 polyclinics and cluster 2 not obeying Fornas as many as 3 polyclinics. This research can be used as a reference and evaluation to hospital management on the efficiency level of using specialist doctor's prescriptions in improving the quality of hospital services.

The magnitude of ultrafiltration is the process of transferring dissolved substances and water due to hydrostatic differences in blood and dialysate which are carried out from the patient's body weight. The purpose of this research is of the amount of ultrafiltration on changes in blood pressure in clients with chronic kidney disease at Tangerang Regional Hospital. Methods: This study used a quasi-experimental design with a one group study, the population of all patients in the hemodialysis room, a sample of 150 people. Results: The study showed that the amount of ultrfiltration both experienced changes in normal BP was 17 respondents (50.1%), respondents with a moderate amount of ultrafiltration were experiencing a change in low BP, the most were 2 respondents (66.6%) and the number of respondents, the amount of ultrafiltration, was multiplying changes in high BP, around 42 respondents. (37.2%). Chi Square test obtained an Asymp.Sig. (2-sided) value of 0.035

Introduction: Special newborn care units (SNCUs) have been established in several district and subdivisional hospitals to meet the challenges of high neonatal mortality. With single digit target of infant mortality in 2030, we need to review the functioning of these SNCUs in order to strengthen them to reach the target. So this study was undertaken with primary objective to study mortality and referral pattern. Methods: This retrospective observational study was conducted in district hospital Udhampur by analysing case records from SNCU admissions over three years from 2017-2019 Results: There were total of 341, 352 and 414 admissions in 2017, 2018 and 2019 respectively with a cumulative sex ratio of 702/405(male/female) over these 3 years. Referral rate was 31.31%, 31.31% and 30.19% for 2017, 2018 and 2019 respectively, whereas mortality rate was 2.05%, 1.93% and 2.41% for these 3 years respectively. Respiratory distress syndrome (RDS), sepsis and birth asphyxia were the major causes for referrals. Conclusion: With stagnant, non decreasing referral rates over 3 years, and ventilatory support as a major cause of referrals, a lot needs to be improved as far as respiratory support at SNCU level is concerned.

The coronavirus disease 2019, which is caused by severe acute respiratory syndrome coronavirus 2, was first identified in December 2019 in Wuhan, China, and has since spread rapidly, evolving into a full-blown pandemic. We would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in Spain. There have been many changes (including new protocols) that our service and the hospital have undergone, to adapt to the new situation. We believe that this experience can be useful for other professionals who have lived and are living a similar situation.

Background: Bipolar affective disorder is an episodic illness characterized by fluctuating mood states. Association of dermatoglyphic traits with bipolar affective disorder has been observed in various studies. This study was undertaken to evaluate epidermal ridge patterns in bipolar patients as compared to healthy controls attending a super speciality district hospital in West Bengal. Context and purpose of study: Establishing dermatoglyphic parameters as biomarkers for early diagnosis and consequently, prompt intervention in bipolar affective disorder will ensure a greater scope of recovery, and thus promote a better quality of life for the individual as well as lower the burden of disease for the society. Methods: Quantitative dermatoglyphic parameters namely, Total Finger Ridge Count (TFRC), Total A-B Ridge Count (TABRC), and ATD Angle of 100 bipolar patients were compared to 100 age and gender matched healthy controls. Results: Statistically significant differences were found on comparing the dermatoglyphic parameters between cases and controls. TFRC was found to be decreased while ATD angle was increased in bipolar cases, as compared to the control group. However, no significant change was observed in TABRC between the two groups. Conclusions: This study found a significant association between dermatoglyphic pattern anomalies and the development of bipolarity. This may offer a scope of primordial prevention of bipolar disorder in future. Key words: Dermatoglyphics, ridge pattern, bipolar disorder, Total Finger Ridge Count (TFRC), Total A-B Ridge Count (TABRC), ATD angle.

Preterm births remain a major public health issue due to its weight in neonatal mortality and the significant socio-economic costs for its care. The aim of the current study was to identify factors associated with preterm births at Allada-Toffo-Ze zone hospital in Benin. This was a case-controlling study, which took place in April 2019. A total of 222 women's files were examined, including 74 cases and 148 controlling samples. Socio-demographic data, health status during pregnancy, previous state of being and health system were collected. Conditional logistic regression was used to identify explanatory factors for prematurity via Stata 15. The prematurity rate was 9.4%. Self-medication OR = 4.99 with 95% CI = [1.71-14.5], alcohol consumption OR = 19.55 with 95% CI = [5.89-64.90], threat to premature birth OR = 3.88 with 95% CI = [1.04-14.35], the mother's occupation OR = 13.22 with a 95% CI = [1.65-105.66] were related to prematurity. Prematurity is a problem that requires corrective actions. Promoting empowerment of women which guarantees good health during pregnancy, as well as enhancing health staff skills will significantly reduce preterm births at Allada-Toffo-Ze district hospital. Key words: Prematurity, factors, determinants, district, Allada-Toffo-Ze, Benin.

Os casos frequentes de diagnóstico de cancro da mama na sociedade atual faz com que o seu diagnóstico precoce seja primordial. A mamografia é o método de eleição para o rastreio da patologia mamária. A Mamografia Espectral com Contraste (CESM-Contrast-enhanced spectral mamografhy) permite que o tumor seja detetado ainda numa fase inicial da doença. Esta nova tecnologia pioneira no Hospital Distrital de Santarém (HDS) é um exame já de rotina nos Estados Unidos da América. O objetivo deste estudo é abordar os benefícios e vantagens do CESM em relação à Ressonância Magnética Mamária (RMM), método utilizado no diagnóstico tradicional, que fornece informações adicionais não obtidas em Mamografia. Através da revisão da literatura avaliámos a qualidade técnica do CESM comparativamente à RMM. Conclui-se neste estudo, que o CESM é uma ferramenta útil no diagnóstico do cancro da mama, com acuidade semelhante à RMM.

Background: The increased nutritional needs associated with the initiation of antiretroviral therapy exposes HIV-positive patients to an uncontrolled diet. This places them at an increased risk for diabetes mellitus and highlights the role of nutritional habits in the development of diabetes mellitus amongst HIV patients. Aim: In this study, we sought to investigate the feeding habits and their effect on the occurrence of diabetes amongst HIV-positive patients at the Nylon District hospital. Materials and Methods: A hospital-based cross-sectional study was carried out over eight months. A total of 182 participants were randomly selected of which 134 were HIV-positive and 48 HIV-negative. Blood samples were collected after at least an eight-hour fast. Results: The prevalence of diabetes in the HIV-positive group was 19 % compared to 10 % in the HIV-negative group. The total cholesterol and triglyceride levels were higher in HIV-negative participants compared to HIV-positive participants. Consumption of dairy products more than once per day (OR= 0.71, 95 % CI: 0.27-1.89), vegetable consumption more than once per day (OR= 0.79, 95 % CI: 0.25-2.56), more than one meal per day (OR= 0.13 95% CI: 0.02-1.04), breakfast more than twice per week (OR= 0.91 95 % CI: 0.2-4.11), and practicing physical exercise (OR= 0.7 95 % CI: 0.28-1.78), reduced the odds of having diabetes in HIV positive participants. Conclusion: The HIV status has an impact on the occurrence of diabetes mellitus in these patients, and it is highly associated with the feeding habits and the lifestyle of these patients. Keywords: HIV, diabetes mellitus, feeding habits, lifestyle, lipid profile.

Relevance: Infectious diseases are one of the most pressing problems in pediatrics, in particular the COVID-19 pandemic has had a huge impact on society and health.Purpose of the work: to analyze the frequency of infectious diseases in children of the Udmurt Republic during a pandemic of a new coronavirus infection using the example of rural and urban areas.Materials and methods: a statistical analysis of the official medical documentation (form No. 12) of the Udmurt Republic «Mozhginskaya regional hospital of the Ministry of Health of the Udmurt Republic» and the Budgetary Establishment of Health of the Udmurt Republic Alnash District Hospital of the Ministry of Health of the Udmurt Republic for 2019—2020 for children with infectious diseases up to 14 years old inclusive was carried out.Result: the incidence of infectious diseases decreased: in Mozhga it decreased by one third (33%) compared to the previous year (13889 and 9318 cases); in Al-nash experienced a more significant reduction in 2 times (3618 and 1513 cases, respectively). The rate of decline in Mozhga was 33%. The maximum values are traced among the following nosologies: influenza, viral hepatitis, meningococcal infections (the rate of decline was 100%). In Alnash, the rate of decline was 58%, the highest rates were in laryngitis and tracheitis (the rate of decline was 73%). The downward trend in infectious pathology during a pandemic is similar in urban and rural areas.Conclusion: restrictive measures against COVID-19 contributed to a decrease in the incidence of infectious pathology, which is more transmitted by airborne droplets, but also spread by fecal-oral and contact-household routes. Studying the characteristics of the incidence of infectious diseases during the period of self-isolation can help doctors control the level of morbidity in the future.

Background: Cancer of the breast is the most common organ-specific cancer, affecting women worldwide with disproportionately higher mortality seen among women of Africa ancestry. Molecular phenotyping is crucial for tailored treatment of such patients. Aim: The aim of the study is to describe the molecular phenotypes of carcinomas of the breast based on their oestrogen, progesterone, and HER-2/Neu receptors status in our centre. Design: This was a retrospective analysis of 136 histologically diagnosed breast carcinomas, for which oestrogen, progesterone, and HER2 receptors status data were available at the Pathology Unit in a Nigerian District Hospital. Materials and Methods: Relevant biodata and pathology and molecular information of all patients with histologically diagnosed breast cancer (BC) were extracted from patients' forms and reports archived in the department. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue blocks of 136 (54.4%) cases of the BCs utilizing the avidin-biotin complex technique. Results: The ages of the patients ranged from 17 to 74 years, and the mean age was 47.3 ± 11.7 at diagnosis. All affected patients were females except for a male teenager. oestrogen, progesterone, and HER-2/Neu receptor-positive breast carcinomas were 43.4% (59), 39% (53), and 27.2% (37), respectively. Triple-negative breast carcinoma (39%, 53/136) was the most prevalent phenotype, followed by Luminal A (33.8%, 46/136) and Luminal B (14.7%, 20/136), while HER2-enriched (12.5%, 17/136) was the least common molecular subtype in our series. Conclusion: Breast carcinomas are predominantly of the triple-negative molecular phenotype in our setting and commonly affected young women.

Aim: Blood transfusion is a life-saving therapeutic intervention and essential element of a health care system that plays a crucial role in the overall management of patients. Transfusion-transmissible infectious agents such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV) and Syphilis are among the greatest threats to blood safety for recipients and WHO has recommended that these diseases should be screened to get safe blood. This study aimed to evaluate the prevalence of transfusion transmissible infections (TTI) among donors at District Hospital of Palanpur and compare it with other studies. Material and Methods: HBV, HCV and HIV were tested by ELISA and RAPID methods approved by NACO in voluntary as well as replacement blood donors. RPR was carried out for screening of syphilis. Results: Seroprevalence of Transfusion Transmitted Infections (TTIs) among blood donor is 1.712%. The prevalence of HIV, HBV, HCV and syphilis was found to be 0.043%, 0.259% 0.173% and 0.302% respectively in voluntary blood donors as against 0.238%, 1.549%, 0.715% and 1.788% being the seroprevalence of HIV, HBV, HCV and syphilis in replacement blood donors. The seroprevalence of TTIs in replacement donors (4.290%) is higher than voluntary donors (0.777%). Conclusion: Voluntary blood donors have been found to be safer than replacement blood donors. The present study concluded that motivating voluntary blood donors and diligent donor selection are the most effective way of ensuring adequate supplies of safe blood on a continuing basis. Keywords: Seroprevalence, Transfusion Transmitted Infections(TTIs), Blood donor, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV),Human Immunodeficiency Virus (HIV), Syphilis.

Relevance. Based on the appeal of the Governor of the Murmansk region to the Operational Headquarters on preventing import and spread of a new coronavirus infection in Russia due to the aggravation of the epidemiological situation and in order to localize the spread of COVID-19, the Russian Emercom allocated forces and capabilities, including an airmobile hospital (AMH) and a temporary accommodation center, in the region. AMH was deployed at the industrial site of the Center for the construction of large-scale offshore facilities of NOVATEK-Murmansk LLC and subcontractors in Belokamenka village, where more than 10 thousand people worked and lived on a rotational basis.Intention. Summarize and analyze the experience of the AMH of Emercom of Russia under field conditions of an outbreak of the new coronavirus infection.Methodology. Daily reports on the activities of Emercom of Russia AMH were analyzed for the period from April 17, 2020 to June 12, 2020.Results and Discussion. Field camp deployment and functioning of Emercom of Russia AMH integrated into a regional medical and preventive institution are described. The data on admitted patients, scope and types of diagnostic tests are presented. It is shown that AMH as a separate outpatient diagnostic department of the Kolsky Central District Hospital should provide special and sanitary treatment, patient referrals and an algorithm of personnel activities, and also comply with antiepidemic measures. During the period of AMH activities in the field, 1678 shift workers got medical advice, 3086 diagnostic studies were carried out for shift workers and employees of the Emercom of Russia. COVID-19 was detected in 500 persons, including 328 cases of mild disease, 98 cases of moderate severity, and 74 severe cases, without case fatalities. The outbreak and spread of the new coronavirus (COVID-19) infection as an emergency in the subject of Russia and at the large industrial and construction site were brought under control.Conclusion. This experience will help improve the activities of the Emercom of Russia AMH under field conditions.

Background Tuberculosis (TB) is a major public health problem among people living with Human Immunodeficiency Virus (HIV) in resource-limited countries like Ethiopia. Up-to-date information regarding TB co-morbidity and determinant factors among HIV sero-positive individuals is lacking in the study area. Objective This study aimed to determine the prevalence of TB co-morbidity and their determinants among HIV sero-positive individuals in Shegaw Motta district hospital. Methods A cross-sectional study was conducted among 326 people living with HIV from February to April 2019, in Shegaw Motta district hospital. The systematic random sampling technique was used to select the study participants. Data were entered into the EpiData version 3.1 and analysis was done using SPSS version 20.0. Results The prevalence of TB/HIV co-infection was 18.1%. TB/HIV patients whose drunk alcohol (AOR=2.36, 95% CI=1.07-5.19), BMI< 16 (AOR= 19.13, 95% CI=4.14-88.36), and BMI ranges between 16 and 18.5 (AOR=9.78, 95% CI=3.07-31.19), World Health Organization (WHO) clinical stage IV (AOR=23.02, 95% CI=3.76-140.97), WHO clinical stage III (AOR=14.36, 95% CI=3.50-58.92), and WHO clinical stage II (AOR=4.17, 95% CI=1.34-13.01), bedridden (AOR=13.79, 95% CI=5.44-34.95) and ambulatory functional status (AOR=5.30, 95% CI=1.87-15.05) were significant predictors for TB/HIV co-infection. Conclusion The prevalence of TB among HIV sero-positive individuals is high. Determinant factors, including drinking alcohol, BMI, WHO clinical stage and functional status, were significant predictors for TB/HIV co-infections. Therefore, diagnosis of TB among sero-positive individuals should be strengthened in health institutions.

Prof. Bekhterev, pointing out the attempt of prof. Ziehen'a in 1898 to establish, except for three known forms of periodical psychoses (mania, melancholia, psychosis hallucinatoria periodica), 2 more types - periodical neurasthenic mental disorder and periodical acute simple (not psychotic) paranoid, he said that he appeared im for a long time, still being his professor at Kazan University. On the recognition of periodic acute paranoia, as a special form of psychosis, he was led by a case of practice in the Kazan District Hospital in 1892. Further, the author expounds in great detail 3 stories of the illness of one patient, E.I.

Background The World Health Organization (WHO) promotes long-lasting insecticidal nets (LLIN) and indoor residual house-spraying (IRS) for malaria control in endemic countries. However, long-term impact data of vector control interventions is rarely measured empirically. Methods Surveillance data was collected from paediatric admissions at Tororo district hospital for the period January 2012 to December 2019, during which LLIN and IRS campaigns were implemented in the district. Malaria test positivity rate (TPR) among febrile admissions aged 1 month to 14 years was aggregated at baseline and three intervention periods (first LLIN campaign; Bendiocarb IRS; and Actellic IRS + second LLIN campaign) and compared using before-and-after analysis. Interrupted time-series analysis (ITSA) was used to determine the effect of IRS (Bendiocarb + Actellic) with the second LLIN campaign on monthly TPR compared to the combined baseline and first LLIN campaign periods controlling for age, rainfall, type of malaria test performed. The mean and median ages were examined between intervention intervals and as trend since January 2012. Results Among 28,049 febrile admissions between January 2012 and December 2019, TPR decreased from 60% at baseline (January 2012–October 2013) to 31% during the final period of Actellic IRS and LLIN (June 2016–December 2019). Comparing intervention intervals to the baseline TPR (60.3%), TPR was higher during the first LLIN period (67.3%, difference 7.0%; 95% CI 5.2%, 8.8%, p Conclusion IRS can have a dramatic impact on hospital paediatric admissions harbouring malaria infection. The sustained expansion of effective vector control leads to an increase in the age of malaria positive febrile paediatric admissions. However, despite large reductions, malaria test-positive admissions continued to be concentrated in children aged under five years. Despite high coverage of IRS and LLIN, these vector control measures failed to interrupt transmission in Tororo district. Using simple, cost-effective hospital surveillance, it is possible to monitor the public health impacts of IRS in combination with LLIN.

Objective This study aimed to compare the patient experiences of the inpatient unit at Makassar District Hospital and Haji Regional Hospital. Methods This research was a cross-sectional study with a descriptive approach. The study involved 118 respondents in Makassar General Hospital and 120 respondents in Haji Regional Hospital. Result The results showed patients in Makassar district hospital had good experiences in 6 dimensions (information and communication, convenient environmental, medicine management, employee availability, respecting patient's experience, and service assistance). Patients in Haji regional hospital experienced good service in 6 dimensions of patient experience (waiting time, emotional support, pain management, trust inservice providers, perceived nutrition care, and family and friend involvement). Conclusion Both of the hospitals have the same number of good experience dimensions. The study recommended the hospital to make improvements in terms of the quality of service by paying attention to other dimensions.

Background: Glaucoma, a leading cause of blindness in the world, has a global burden of 64.3 million. Studies in other States in India have described the clinical profile of glaucoma. However, no such study was conducted in Goa. Hence, our study was undertaken to identify and the clinical profile and subtypes of glaucoma in Goa. Methodology: A prospective hospital-based study was conducted over 6 months among patients attending Ophthalmology OPD at the North Goa District Hospital. The study participants underwent a detailed Ophthalmological evaluation by the senior Ophthalmic surgeon. The data so collected was entered in pre-tested semi-structured proformas. Statistical analysis was done using SPSS version 22. Result: Most glaucoma patients were females (62.5%) and elderly (60.71%). The most common glaucoma was primary angle closure glaucoma (58.93%), followed by primary open angle glaucoma and glaucoma suspects. Majority patients had associated risk factors such as diabetes, hypertension and family history of glaucoma. How to cite this article:Naik S, Cacodcar J, Naik S, Raiturcar TP. Clinical Profile and Subtypes of Glaucoma in a District Hospital in North Goa. Epidem Int 2020; 5(3): 15-18. DOI: https://doi.org/10.24321/2455.7048.202022

Introduction Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. Material and methods The study was conducted in the Independent Public Healthcare Institution in Kraśnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. Results The stroke patients hospitalised in the Independent Public Healthcare Institution in Kraśnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. Conclusions Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.

The widespread impacts of malaria in the tropical regions of the developing world are not only on healthcare issues but also an agricultural output. Malaria causes manpower loss when it strikes farmers at critical planting, weeding, and harvesting times. Given the above, the expected outcome to malaria prevention programs in farming communities remains a far cry, especially where the predisposing factors are not properly identified and long-lasting solutions proffered. Consequently, this study was designed to assess the malaria predisposing factors among the crop production farmers attending the Ndop District Hospital. The microscopy method was used to determine the presence of malaria parasitaemia. The following categorical variables were considered predisposing factors: Sex, history on malaria illness/treatment, use of long-lasting insecticide nets (LLINs) and knowledge on malaria transmission/prevention. A four-point Likert-type rating scale was adopted for the scoring of the responses given on the predisposing factors, while Fisher’s exact test was used to assess the associations between malaria and each of the predisposing factors. The prevalence of malaria parasitaemia among the crop production farmers was 20% (143/715). The predisposing factors tested were found to be significantly associated to the occurrence of malaria among the crop production farmers. Therefore, the combination of improved existing and innovative malaria control strategies may possibly ensure sustained malaria decrease among the farmers in the Ndop Health District.

The condition of high and uncontrolled high blood sugar levels in Diabetes Mellitus patients increases the risk of other diseases, such as; heart attacks, strokes, blindness, kidney failure, gangrene, and even death. Various studies state that there is a relationship between Murottal Al-Qur'an therapy with the stability of blood sugar. The study aims to determine the effectiveness of Murottal Al-Qur'an on Blood Sugar Levels of Diabetes Mellitus Patients in Rasyidin District Hospital, Padang City in 2019. Interventions were conducted during August until September 2019. The population was inpatients diagnosed with Type 2 DM in RSUD Dr. Rasyidin Padang at the time of the study. A sample of 32 people consisted of a case group (given Murottal Al-Quran therapy) and a control group, each with 16 people. Data collection was carried out through observation and examination of blood sugar before and after the intervention. Data were tested by paired sample T-test. The results showed that there were differences in blood sugar levels at both the case and control groups before and after the intervention. The average blood sugar level of the patient in the case group was more controlled, namely 173.94 mg / dl (GDS 200 mg / dl). Murottal Al-Quran therapy can be used as an alternative to maintain blood sugar stability for people with diabetes.

Remote electrocardiographic techniques were used in outpatient departments of the city clinical hospital (CCH) and the Central district hospital (CDH). The CDH performed 18,654 electrocardiographic studies (ECS). The automatic conclusion of devices was corrected by specialists of functional diagnostics (FD). In complex cases, an in — depth analysis was performed- an electrocardiogram of 12 leads (ECD -12) — using vectorcardiography (VCD). Pathological ECD syndromes were detected in 5038 individuals (27%). Among the obtained number of ECSs with abnormalities, the most frequently detected were: right leg block ( RLB) — 1029 (20.4%), left ventricular hypertrophy (LVH) — 981 (19.4%), left leg block — 661 (13%), myocardial scarring — 442 (8.7%), extrasystole — 377 (7.4%), atrial fibrillation-310 (6%). The method of VCD was able to clarify 39% of cases of LVH, 40% of cases of focal scarring of the myocardium, and 92% of matches for atrial fibrillation (AF). The use of VCD supplemented the diagnostic capabilities of the remote ECD-12. According to the results of AF screening by remote single-channel ECD, 69 cases with AF (3.2%) of the total number of examined patients (2,146 people) were detected in the CCH. When analyzing the history, it was clarified that 24 (34.7%) patients had AF for the first time, and 45 (65.3%) individuals had a history of AF. Remote long-term Holter ECD monitoring system (LTHECD) 27 studies were performed in 20 individuals. Complex, combined heart rhythm disorders were detected in 85%, and ST-T depression was detected in three cases (15%). Using new electrocardiographic techniques in addition to single-channel ECD, ECD-12 improves the quality of diagnostics of cardiovascular diseases (CVD).

Stroke is an important health problem. The speed with which a stroke sufferer gets the right treatment cause a big influence on stroke management. This study analyze the influence of various factors in the family on the arrival time of stroke patients in the emergency department of the Kediri district hospital. The study was conducted during May-July 2019 and found stroke patients as many as 88. The result show that educational factors have a significant relationship with the level of knowledge, and the family age, job, people who knew the stroke and decision-makers in the family have a significant relationship with the time interval between the stroke attack with the arrival of patients in the emergency room. From this study, it can be concluded that family factors play an important role in the time interval between a stroke and the arrival of a patient on IGD to get proper treatment.

Background: Healthcare policy decisions are driven by many factors, including cost, hence the need to show costs of diabetes mellitus-related lower limb amputations (DMLLA) to inform amendments to ...

Background: Iron Deficiency Anaemia (IDA) is one of major factors for human health, especially young children. Iron supplementation can indicate a good response in haemoglobin concentration. Objective: This study is to observe prevalence of anaemia and effectiveness of iron supplementation for children in Purbalingga district, Central Java. Methods: This study was a quasi-experimental study by measuring haemoglobin concentration before (pre) and after (post) treatment. Its participants were determined by a purposive sampling method. 64 children (less than 5 years old) were included in criteria of anaemia. Their blood samples were collected before the treatment to measure SI (Serum Iron) and TIBC (Total Iron Binding Capacity). Administering 4 mg of iron per kg of body weight per day was conducted for a month. Data of participants such as age, nutritional status, socio-demographic, and medical history were also collected. A paired t-test was used to analyse mean differences of haemoglobin levels before and after treatment. Results: Among the 64 children with anaemia, 98.4% indicated Iron Deficiency (ID) with 59.4% of them indicating IDA based on level of SI and TIBC. Anaemia has more prevalence in group of 6

Treatment of acute coronary syndromes (ACS) and critically ill cardiac patients can be resource intensive and may not be available in humanitarian settings. If reperfusion therapy is available for an acute ST segment elevation myocardial infarction (STEMI) in humanitarian settings, it is generally performed with fibrinolysis. We report our experience of implementing a package of care for ACS and STEMI including training, treatment algorithms, resources, and infrastructure in a remote region of Pakistan, its implications on both cardiac and non-cardiac critically ill patients, and patient outcomes. This was a descriptive study of acute STEMI patients receiving streptokinase in an emergency department in Timergara district hospital, using routine monitoring data and patient follow-up by phone interviews at 1 and 3 months after discharge. From July 2015 to December 2016, 739 STEMI patients presented to the emergency department, of whom 567 received streptokinase. Post-fibrinolysis, there were 527 patients admitted to the hospital and 440 were subsequently discharged home. At 1 month after hospital discharge, 317 patients were contacted, of whom 304 were alive. At 3 months after hospital discharge, 281 patients were contacted, of whom 280 were alive. Implementing a package of care for ACS and STEMI in a humanitarian setting was feasible but associated with challenges inherent in providing advanced post-reperfusion care. Operational considerations when implementing specialized medical activities, such as fibrinolysis, in humanitarian settings should focus on regional and cultural contexts as well as the entire patient care continuum from emergency department presentation to hospital discharge.

Introduction:. Hospitals are integral component of health care and hospital staff to do their best for good quality services and patients satisfactions. Quality standards of National Accreditation Board for the Hospital and Health care providers (NABH) / National Accreditation Board for testing and calibration Laboratories (NABL) are today highest benchmark standards for hospital quality in India Aim and Objectives: To study the requirements of quality standards of NABH/NABL and try to implement the same in District hospital. Materials and Methods: For this project study requirements of quality standards of NABH/ NABL in District hospital Vijayapur selected. To make project literatures were referred for review of hospital and facilities. This Project was done with pre assessment study and then intervention of implementation of quality standards done by sensitizing staff about the quality standards of NABH/NABL in this hospital and implemented of quality standards across the hospital and also with the help of questionnaires by taking patients interview about their satisfaction towards quality of health services. Results: Majority quality standards are implemented and made them complianced. And remaining non complianced quality standards reviews are noted. Conclusion: Implemented many quality standards, successfully made noncompliance standards to compliance and recommendations are suggested for noncompliance standards to make compliance in future and non available services and staffs. Most of the patients were satisfied with the quality of hospital services. Keywords: Hospital, NABH, Standards, Accreditation, Quality.

Background: The increasing number of elderly populations also increases the number of chronic degenerative diseases, including diabetes mellitus (DM). Therefore, diabetes control is needed to prevent various complications and improve the health quality of the elderly patient. This study aims to obtain preliminary information about diabetes control in elderly patients in the geriatric clinic of Karangasem District Hospital to provide appropriate management to improve diabetes control.Method: This research is a cross-sectional study and consecutive sampling of 46 DM patients who seek treatment at the geriatric clinic of Karangasem District Hospital in the period May-July 2019. Inclusion criteria were DM patients aged ≥60 years. We exclude diabetes person with acute infection and end-stage renal disease. The criteria for DM control used in this study is body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), postprandial glucose (PPG), and HbA1c levels. Data were analyzed using SPSS version 25 for Windows and depicted descriptively. Results: Among 46 samples, there were 23 (50.0%) male and 23 (50.0%) female enrolled in this study. We find median of each, BMI was 23.2856 kg/m2, SBP 120 mmHg, DBP 70mmHg, 153.5 mg/dl for FPG, 238 mg/dl for PPG, and 7.8% for HbA1c. In this study, patients who met target of diabetes control is 34.8% for BMI, 53.8% for SBP, 76.9% for DBP, 43.5% for FPG, 17.4% PPG, and 28.3 % for HbA1c levels. Conclusion: In this study, it was found that DM control in elderly patients in our Hospital is not optimal on the parameters of BMI, SBP, DBP, FPG, PPG, and HbA1c levels. Better results were obtained in systolic and diastolic blood pressure control.

Evidence to support widespread adoption of digital health tools in hospitals is still lacking, and proof of their acceptance within the health system is largely missing. This study compared patient's pre-consultation waiting time (time spent at the pay-point, registration, and nursing-station prior to consultation) in two hospitals, one using paper based registration system and the other using an electronic (eHealth) registration system. Structured questionnaires were administered to both patients and health workers to determine and compare factors affecting care delivery wait times and how the use or non-use of eHealth in patient's registration process influence it. In addition, patient wait times were measured in both hospitals at these care points. Overall aggregate waiting time was observed to be longer in Maitama District Hospital (MDH) using the electronic hospital information system. This variance was found to be statistically significant as can be seen (t= 58.405, p=0.024). Inspite of this, wait times at registration and pay-point was significantly lower for MDH.

Introduction. Isolated jejunal perforation from blunt abdominal trauma is an extremely rare intra-abdominal injury that poses a huge diagnostic challenge. Delay in diagnosis and initiation of treatment often leads to significant morbidity and mortality. Diagnosis particularly in resource-poor settings may be extremely challenging and often relies on a high index of suspicion. This is due to lack of adequate diagnostic facilities and human resource to deal with the condition with resulting high occurrence of adverse outcomes. Case Presentation. We report a case of isolated jejunal perforation with associated mesentery injury in a young college student who sustained a kick to his abdomen while playing soccer. This is an unusual presentation since most reported cases often resulted from motor vehicular accidents, bicycle handlebar, and fall from a height. We emphasized the role of critical level of suspicion with a good history and physical examination as the major source of diagnosis since diagnostic procedures, such as abdominal ultrasonography and computed tomography, are largely unavailable in most resource-constraint settings. Early surgical intervention following diagnosis leads to good recovery and reduced mortality. Conclusion. Sufficient vigilance and suspicions of small bowel perforation should always be considered after blunt trauma even when symptoms and physical findings are minimal and when diagnostic capacity is limited.

Background and Objective: The objective of the study was to document the epidemiological patterns of significant pediatric orthopedic trauma in a district hospital in Mizoram, India. The information so collected may be used as baseline data in health-care planning and resource mobilization in areas where workforce and resources are limited, especially in the orthopedic specialty. Materials and Methods: A retrospective analysis of 570 pediatric age group patients, attending accident and emergency services at district level hospital from January 2013 to December 2017 was done. Significant traumatic orthopedic trauma, defined as fractures, dislocations, and ligaments injuries for this study, was taken into account. Record was analyzed for age, sex, type, and mode of injuries and seasonal variations. Results: A total of 431 (75.61%) patients attending orthopedics emergency had significant trauma. This accounted for 23.68% of all orthopedics emergency cases in a calendar year. The male-to-female ratio was 2.75:1 and injuries were predominantly high in 5–8 years of age. Injury pattern is similar to other reported series while the mode of injuries is significantly different from those in Western world. Conclusion: Pediatric orthopedic traumas do well with early intervention. Proper referral system is the need of the hour. Supportive health-care policy and decision-making based on epidemiological trends of injuries would result in favorable outcome of such management.

In 2013, in Togo, the Demographic and Health Survey III estimated the proportion of low birth weight at 10%. The objective of this study was to determine the factors associated with low birth weight in Togo. We conducted a case-control study on newborn records from Tchamba Hospital from 2014 to 2016. Cases were newborns with birth weight strictly below 2500 g whereas controls were those with a weight greater than or equal to 2500 g. There was one case for every two controls. Odd ratios were estimated using a multivariate logistic regression analysis. The sample consisted of 305 cases and 610 controls. Factors associated with low birth weight were gestational age less than 37 weeks (OR = 62.60, 95%CI [24.51 - 159.87], p i‚£ 0.0001), maternal age below 18 years (OR = 2.41, 95%CI [1.11 - 5.22], p = 0.026), non-use of long-lasting treated mosquito nets (OR = 5.3, 95%CI [3.42 - 8.18], p ≤ 0,0001), and severe malaria during pregnancy (OR = 3.7, 95%CI [1.24 -11.04], p = 0.019). Almost all factors associated with low birth weight identified could be modified. We recommend raising awareness about the risk factors of low birth weight and malaria prevention. Key words: Associated factors, low birth weight, newborn, Tchamba, Togo

Objective Short-term, high-volume surgical training experiences can lead to successful skills transfer and be an effective method of training surgical providers in low-resource settings. However, immediate skills acquisition does not guarantee long-term performance of surgical procedures by trainees. This study aims to determine the long-term impact of a short-term plastic surgery training rotation (STR) on general surgeon contribution to plastic surgery capacity building in Rwanda. Design A retrospective survey study was conducted. Surveys were distributed to credentialed general surgeons who previously participated in the Operation Smile STR in Rwanda. Questions focused on exposure to procedures during the rotation and current practice demographics. The percentage of current practice volumes dedicated to plastic surgery was mapped to demonstrate participant contribution to plastic surgery capacity in the country. Setting Surveys were distributed remotely. Surgeon respondents previously participated in the STR at the Rwinkwavu District Hospital, a primary level hospital in eastern Rwanda. Participants All 8 prior participants of the STR who completed residency and are currently practicing as general surgeons in Rwanda were included. Results Six out of 8 prior participants completed the survey (75.0%). All respondents work as general surgeons in governmental hospitals around the country. Up to 75% of surgeon caseloads are dedicated to plastic surgery procedures. Half of respondents work in regions without a credentialed plastic surgeon. Exposure to cleft and congenital hand surgery during the rotation did not lead to durable performance in practice. All participants felt the rotation improved their performance in multiple core competencies. Conclusion Participation in a short-term plastic surgery training experience in Rwanda was associated with increased long-term surgical capacity in the country through a task-sharing model. A mission-based rotation may provide sufficient exposure for basic plastic surgery procedures, but does not provide enough volume or time to durably teach more complicated surgeries such as cleft repair. Further studies are needed to determine how longer durations of training exposure impacts long-term performance of plastic surgery procedures.

Introduction: Retinal diseases especially those due to diabetes and AMD are coming up as important causes of blindness and visual impairment. Our study is to evaluate the frequency and pattern of retinal diseases in ophthalmic outpatient department of a district hospital in Bangladesh. Materials and Methods: A total number of 173 referred new retina cases were reviewed at outpatient department of the 250 beded General Hospital, Jamalpur, Bangladesh, between February 2017 and November 2017. Data was analyzed according to age, sex and clinical diagnoses and detailed fundus evaluation done with binocular indirect ophthalmoscope and slit lamp using 20D and 90D lenses respectively. Results: Out of 7164 new patients,of whom 173 patients were (2.42%) presented with retinal diseases.139 patients were reviewed and followed up. Male: female ratio was 1.24:1. Out of 139 patients 77 (55.4%) were males and 62 (44.6%) females with a peak age group of 41-50 years. Diabeticrelated retinal conditions were 36 cases (25.9%), the most common cause.16 (44.44% of total DR) patients had CSME and 5(14.9%) had ADED. Diabetic retinopathy 36 cases (25.9%), Chorioretinitis 20 cases (14.4%), ARMD 11 cases (7.9%), and Optic atrophy 10 cases (7.2%). Conclusion: Retinal diseases remain an important cause of visual morbidity. There is increasing incidence of retinal blindness especially diabetic retinopathy in Bangladesh. The impression based on hospital practice is that the problem is increasing. This entails the necessity for accessible comprehensive eye care services, establishment of human resources, screening and awareness of the disease and affordable eye health policy. Medicine Today 2020 Vol.32(1): 1-4

Background: Pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. Patients and methods: This is a prospective, descriptive and analytical study performed at Parakou teaching hospital and Tanguieta district hospital. It has been conducted from January 1st to July 31st 2016. All children were included aged 0 to 15 years and admitted for an abdominal surgical emergency with a Clinical Classification of Emergency Patients listed from 3 to 5. Results: Pediatric abdominal surgical emergencies accounted for 42.8% of pediatric surgical emergencies. The average age was 9.3 ± 3.5 years old. The sex ratio was 1.7. The most encountered etiologies were peritonitis (36.76%), abdominal trauma (16.17%) and anorectal malformations (14.71%). The comparison of the delay in operative treatment with the World Society of Emergency Surgery shows a delay in 82.35% of cases. Mortality was high preoperatively and was related to the neonatal period (p = 0.027) and to a resuscitation length of stay higher than 36 hours (p = 0.035). Conclusion: Surgical care was delayed, mainly due to the lack of technical capacities. Morbidity and mortality were relatively low.

Introduction The correct diagnosis of acute pancreatitis should be made in all patients within 48 hours of admission. According to recently published NICE (NG 147) guidelines for diagnosis of aetiology of acute pancreatitis should be determined in at least 80% of cases and no more than 20% should be classified as idiopathic. We aim to overview our current practice compared to guidelines. Early identification of aetiology is essential. Materials and Methods Patients diagnosed to have pancreatitis presenting to surgical assessment unit from March 1st 2019 to December 31st 2019. Sample size audited 291. The diagnosis of acute pancreatitis is made with a combination of history, physical examination and laboratory evaluation. Further investigations were done for the ethology. These patients were identified from their discharge information. They had raised amylase along with history suggestive of pancreatitis and were analysed retrospectively. Results Of all the pancreatitis patients admitted in SAU, 88 (30%) were due to biliary, 40 (16%) alcohol related, 20 (7%) other causes whereas 134 (46%) were classified as idiopathic. 3 patients self-discharged. Conclusion In our trust it seems that aetiology of acute pancreatitis is not adequately investigated. Most of other blood investigations were not performed in index admission and relevant drug history was not elicited. This failure of non-identification of gallstones could be attributed to operator dependant and they didn’t have second USS as advised. We formulated an action plan with detailed history with adequate step wise investigations which will benefit the patients.

Aim The Aim of the study is assessment of the compliance with the updated Royal College of Surgeons of England (RCS) guidelines in management of acute appendicitis in a general district hospital during COVID-19 pandemic. Conservative treatment of acute appendicitis is encouraged unless unresponsiveness to treatment or complications ensues. Method Collection of retrospective data using hospital coding system was done from 63 patients medical records who were diagnosed with acute appendicitis from April 2020 to June 2020. Results The collected data analysis showed adherence to conservative treatment in 16 out of 63 (16/63) patients (25.4%). It succeeded in 10/16 patients (63 %). 6/16 patients were switched to operative intervention (37 %). There were no complications in patients who needed operative intervention after failure of conservative management. Operative management was primarily chosen in 47/63 patients (74.6 %). Re-admissions were 3/16 patients (18.75 %) in conservative group in comparison to 1/47 patient (2.12 %) in primarily operative group. Conclusions The work showed a promising rate of success of conservative treatment. However, there is a low level of compliance with RCS guidelines in management of acute appendicitis during COVID-19 pandemic. The study showed increased re-admission rate for conservative management versus primarily operative management pathways. No complications were detected in cases who needed operative intervention after failure of conservative management. Re-auditing is to follow. The study recommends national comparison of data as it might be worthwhile considering primary management of acute appendicitis.

The World Health Organization states that essential, cost-effective surgical care should be delivered at district hospitals. In South Africa significant skills gap exist at district hospitals, particularly in the area of surgery and anaesthesia. These small to moderate sized hospitals are too small to support a range of full time specialists even if they could be recruited and were cost-effective. Family physicians (FPs) are trained in the clinical skills required for district hospitals and primary health care. Clinical associates have also been introduced to perform procedures at district hospitals. This report illustrates the contribution of a FP to surgical care at Zithulele Hospital in the Eastern Cape. Family physicians not only bring the necessary clinical skills set but also increase the confidence and capacity of the whole team. Outreach and support by surgeons, as well as continuing professional development, are important. Surgical and anaesthetic skills must be developed together. Family physicians also bring leadership and clinical governance skills that ensure the inputs to support surgery, such as equipment and information systems are available. The contribution of FPs to surgery and district hospitals is overlooked in both policy and practice. Human resources for health policy should recognise their contribution and increase the numbers available and FP posts at district hospitals. There is also a need to update the package of emergency and essential surgical procedures in policy.

Aim Aim of the study is assessment of awareness and knowledge of colorectal Enhanced Recovery Program (ERP) of newly joined junior doctors at a general district hospital. ERP is an essential evidence-based element of surgical colorectal patients’ management during preoperative, operative, and postoperative periods. Junior doctors play an integral part in patients’ management. Local hospital guidelines require 100 % awareness and knowledge of ERP among surgical team members. Method A questionnaire of 15 points for assessment of awareness (1 point) and knowledge of Colorectal ERP (14 points) among 8 newly joined junior doctors (Senior House Officers, Foundation year 2 and Foundation year 1) was developed in our surgical department in August 2020. Results The responses showed that average score of doctors’ knowledge of ERP was (52.9 %). Two doctors (25%) scored 9 out of 14 (9 /14), two (25 %) scored 8/14, one (12.5 %) scored 7.25 /14, one (12.5 %) scored 7/14, one (12.5%) scored 6/14, one (12.5%) scored 5 /14. Regarding awareness of ERP, 5/8 doctors were aware of ERP (62.5 %). Conclusions The study showed presence of a variable average level of awareness and knowledge of ERP among newly joined junior doctors. This was less than local guidelines target (100%). The study recommends education (power point presentation) for improving awareness and knowledge of ERP among newly joined junior doctors. This is to be followed by re-auditing and closing the audit loop.

Lipomodelling has been increasingly used recently for the correction of defects and asymmetry following oncologic breast cancer treatment [1]. Current evidence on the efficacy of breast reconstruction using lipomodelling after breast cancer treatment is inadequate and the evidence raises no major safety concerns [2]. We have audited our outcome results against the NICE guidelines criteria for both safety and efficacy. Data was collected retrospectively of all the lipomodelling cases performed in Northumbria Healthcare NHS Foundation Trust between 04/2011-04/2013. A total of 36 patients were included in the study, the average amount of fat injected was 113.91mls per session, Cytori technique gave the least complications rate 11% vs Coleman and body jet techniques 44% and 45% respectively. We met the NICE guidelines criteria in; number of sessions for each patient, the duration of hospital stay and we documented the amount of fat harvested and injected in each patient. We didn’t fulfil the guidelines in: volume change; as no definite tool was used other than clinical assessment; 80% were very good and good aesthetic outcome compared to NICE’s 87%, while aesthetic outcome was absent in 8% compared to NICE’s 2.7%. Regarding the safety, we met the NICE’s guidelines in local recurrence rates

COVID-19 pandemic has an impact on the socio-economic, cultural, and health of people. There is increased morbidity if a patient with comorbidities (hypertension, diabetes) is infected with SARS-CoV 2. On the other hand, there are increased complications related to hypertension, diabetes, and unwanted pregnancies during this pandemic. We did a retrospective study in a district hospital in Nepal to see this effect. We found that there was an increased incidence of uncontrolled diabetes, hypertension, and safe abortions. So while making plans for overall health during this pandemics, proper management of non-communicable diseases and reproductive health services should be considered.

OBJECTIVE This study aims to assess factors related to preeclampsia in Makassar, South Sulawesi, Indonesia. METHOD This research has been approved by the recommendation of the ethics from the Hasanuddin university ethics commission with letter number 459/UN4.6.4.5.31/PP36-/2019. It was a cross-sectional study, the sample was 25 pregnant mothers who were diagnosed with preeclampsia and 25 normal pregnant mothers who came to the Daya District Hospital, Siti Fatimah Regional Mother and Child Hospital, Mother and Child Hospital (RSIA) Sitti Khadijah 1 at Makassar City from July to August 2019. Variables studied were age, occupation, parity, Body Mass Index (BMI), exposure to cigarette smoke, type of delivery, and dental caries. RESULTS Mothers who had exposure to cigarette smoke had a frequency of preeclampsia of 68% (17 people), the relationship of cigarette smoke exposure with preeclampsia was statistically significant (p=0.046, p

Introduction: There is a high burden of tuberculosis (TB) in the Western Province, Papua New Guinea. This study aims to describe the spatial distribution of TB in the Balimo District Hospital (BDH) catchment area to identify TB patient clusters and factors associated with high rates of TB. Methods: Information about TB patients was obtained from the BDH TB patient register for the period 26 April 2013 to 25 February 2017. The locations of TB patients were mapped, and the spatial scan statistic was used to identify high- and low-rate TB clusters in the BDH catchment area. Results: A total of 1568 patients were mapped with most being from the Balimo Urban (n = 252), Gogodala Rural (n = 1010) and Bamu Rural (n = 295) local level government (LLG) areas. In the Gogodala region (Balimo Urban and Gogodala Rural LLGs), high-rate clusters occurred closer to the town of Balimo, while low-rate clusters were located in more remote regions. In addition, closer proximity to Balimo was a predictor of high-rate clustering. Discussion: There is heterogeneity in the distribution of TB in the Balimo region. Active case-finding activities indicated potential underdiagnosis of TB and the possibility of associated missed diagnoses of TB. The large BDH catchment area emphasizes the importance of the hospital in managing TB in this rural region.

Propósito: caracterizar los factores epidemiológicos relacionados con el parto en pacientes adolescentes en el Hospital Distrital de Poptún. Material y método: estudio descriptivo retrospectivo, en el período de Enero – Mayo del 2019. Nuestra muestra quedó constituida por 222 pacientes adolescentes, incluyendo variables como edad, paridad, edad gestacional, tipo de parto, causa de cesárea, peso al nacer. Resultados: de las variables estudiadas, la edad de las pacientes que más predominó fue entre los 14 a 16 años de edad, con un total de 144 pacientes para un 65.1%. Según la paridad, las nulíparas fueron 112 pacientes para 50.4 %. Es significativo destacar que casi la mitad de estas pacientes ya tenían antecedentes de un parto y más, siendo adolescentes. La edad gestacional que más incidió fue de 37 a 39 semanas, para un 67.1 %. El tipo de parto que más aportó fue el eutócico con un 62.2%. La causa de cesárea que más incidió fue la Desproporción cefalopélvica con 20 pacientes para un 23.8 %, y cesárea previa con un 13 %. El peso al nacer que más prevaleció fue de3001 a 4000 g con un 50.4 %. Conclusión: El embarazo en adolescentes sigue siendo un problema prevalente en Guatemala.