New Horizons in Medicine and Medical Research Vol. 8

Rosai Dorfman disease is a rare histiocytic condition with an unknown cause that primarily affects the cervical lymph nodes. Extranodal involvement is extremely uncommon. Author report a case of extranodal involvement of the skin in a young male. Radiation therapy is rare to be used. In Skin Involvement surgical removal is treatment of choice.

This study aimed at investigating whether serum thymidine kinase 1 concentration (STK1p) based on the TK1-IgY-pAb to assess the progression risk from colorectal adenoma polyp/dysplasia to colorectal carcinoma (CRC). A total of 25 publications containing patients with CRC (n=2,251), patients with colorectal polyp/dysplasia (n=1,165) and tumour-free controls (n=1,887) were analysed in the present meta-analysis. The publications were collected from PubMed, Embase, CENTRAL, CNKI, WanFang, VIP and SinoMed databases from January 1, 2009, until January 31, 2022. Articles were analysed using fixed or random effect models to calculate the mean difference. The Newcastle-Ottawa Scale was used for assessing the quality of collected studies. The meta-analysis followed the PRISMA statement. The results revealed that STK1p significantly distinguished tumour-free individuals from patients with CRC, and from patients with colorectal adenoma polyp/dysplasia (p<0.0001). Meanwhile, STK1p levels decreased by 34.1% within one month following surgery in CRC patients (p<0.0001). No significant publication bias was identified in this study. It was concluded that TK1-IgY-pAb is a reliable biomarker for early detection of colorectal adenoma polyp/dysplasia or pre-cancerous lesions, which may therefore prevent progression into colorectal carcinoma and give the patient a best chance of cure. Combining STK1p with colorectal-associated biomarkers, in addition to the determination of tumour stage and grade may therefore be of use.

Background: The aim was to know gender-wise developmental and morphological variations of the frontal sinuses in the pediatric age group of Gurugram district of Haryana(Central India). The development and pneumatisation of the frontal sinuses predict the pattern of skeletal growth. The craniofacial structures develop in proportion to the rest of the body's structures.

Methods: There were a total of 36 patients investigated from January 2019 to March 2019, the research was carried out in the Department of Radio-diagnosis at SGT Medical College, Hospital and Research Institute in Budhera (Gurugram), Haryana. This included 12 females and 24 males between the ages of 8 to 18. The frontal sinuses were assessed based on morphological characteristics. Caldwell's perspective was used to analyse plain X-ray of the paranasal sinuses.

Results: The average width and height of the left frontal sinuses were 23.8 mm, ranging from 5.5 to 43 mm, and 28.4 mm, ranging from 13 to 45 mm, respectively. The average width and height of the right frontal sinus were 20.4 mm and 20 mm, respectively, with a range of 9.8 – 39 mm and 13-38 mm. On the right and left, the average number of scalloping was 1.9 and 2.19, respectively. The septations were noticed in 13 (36.11%) on left and in 16 (44.44%) on the right side. Supraorbital cells were found in 16 (44.44%) on left side and 17 (47.22%) on right side.

Conclusion: In the paediatric age range, there is a lot of variety in the appearance and development of the frontal sinuses. The dimensions on the right side were discovered to be smaller than on the left side. The right side had more scalloping and supraorbital cells than the left side. In comparison to the right side, the left side had greater septation.

Background: Getting an accurate temperature measurement is a critical step in evaluating health or disease especially in children, particularly those with fever and the immuno- compromised subjects. Inaccurate temperature measurement may lead to improper diagnosis, wrong treatment or inappropriate intervention. Also some countries have raised concerns over the continuous use of Mercury-in-glass thermometer because its disposal after use may contaminate the soil and water and finally get into human food or drink and so gradual shift to other methods of temperature measurement is advocated. Several methods of temperature measurements exist and comparing these gives room for choosing a near ideal method in terms of speed, safety and accuracy.

Aim: This study therefore, aimed at comparing the forehead non touch infra-red thermometer with the axillary mercury-in-glass method of temperature measurement in the Paediatric age-group. This would help determine the liability of accepting one over the other.

Methods: Study was given ethical approval as part of a larger study. Four hundred and thirty seven children aged 1 to 24 months were studied at the well-baby/ immunization clinic of the University of Ilorin Teaching Hospital over a 6-months period. Both Non-Touch Infrared and the regular Mercury-in-Glass Thermometers were used to take the body temperatures. Data were analysed with SPSS version 21. Pearson correlation was used to determine the relationship between the two methods of temperature measurements, while Bland-Altman method was used to test for level of agreement between them.

Results: The  mean age and SD was 5.81 ± 4.04months. Pearson correlation showed a positive correlation between the Axillary Mercury-in-Glass and Forehead Non-Touch Infra-red thermometry readings (r=0.281, p<0.001). Also, Bland-Altman method revealed a good agreement between both methods of thermometry as 96% of the readings were within the limits of agreement. Mean difference was 0.09 (95% confidence interval 0.05 - 0.13)°C.

Conclusion: Axillary Mercury-in-Glass thermometer and Forehead Non touch Infra-red thermometers have a good agreement and can be used interchangeably.

The medicinal plants are known to the Traditional Medicine Practitioners (TMPs) of Côte d’Ivoire. Several studies and scientific research have proved the effectiveness of medicinal plants used in the management of common pathologies, such as malaria (KROA, 2004), diabetes (N’GUESSAN et al, 2013).

The current policy is to integrate traditional medicine and pharmacopeia into the national health system in order to improve the health coverage of the health needs of populations, in particular in the management of commonly encountered diseases such as malaria, ENT diseases, diarrhea, typhoid fever and anemia in the Abidjan District by PMT.      

The aim of this study is to promote the use of traditional medicine and pharmacopeia in the national health system.

This study was conducted with fifty (50) PMTs in the District of Abidjan over a three-month period.

At the end of this study, 30 out of 50 of the PMTs surveyed, or 60%, were plant therapists. 61 species of medicinal plants belonging to 36 families are used in traditional medicine centers against five pathologies.  Thirty-four (34) plant species are used for malaria, nineteen (19) for ENT diseases, fourteen (14) for diarrhea, seventeen (17) for typhoid fever and fourteen (14) for anemia. The most commonly used plant parts are leaves and bark in the form of decoctions, infusions and macerations for oral or dermal administration.

Medications used by PMTs are essentially herbal substances. This therapeutic arsenal explains the important place that the Ivorian pharmacopeia occupies in the management of the health problems of the populations.

The pharmacological effects reported in this study are consistent with the literature. However, this rich potential of herbal medicine requires further investigation of the properties of these plants in order to improve their use.

This study assessed the importance of medicinal plants in addressing population health problems. The contribution of PMTs is essential in the process of producing improved traditional medicines. These species are potential resources that may lead to the isolation of phytocompounds of therapeutic interest whose efficacy and safety are guaranteed by scientific studies.

Ligation of the carotid artery was formerly used as an emergency technique to control massive haemorrhages in the head and neck region. Though it was discarded due to the high mortality and morbidity of patients. But over the succeeding decades, a more selective branch of the carotid artery that is ECA ligation have been popularized for the same purpose due to lack of or minor postsurgical complications compared to Transarterial embolization (TAE). However, sometimes a good surge seal pack especially in the maxilla is necessary to control both the collateral circulation and backflow of blood distal to carotid from the internal carotid arteries (ICA). Nonetheless, ECA ligation would be a better option to control life-threatening uncontrolled bleeding in this region.

The rupture of a cerebral aneurysm may hide the clinical and radiological signs of a coexisting tumor. The aim of this study is to warn about the risks of such delayed diagnoses, describing the case of a patient with a subarachnoid hemorrhage who masked -for several months- the presence of a glioblastoma. In the literature are reported just few similar cases: We here discuss the management in the occurrence of two contemporary severe neurosurgical diseases.

Patients' satisfaction and patient-related outcomes (PROs) improve when postoperative pain is managed properly. Understanding the patients' point of view is critical since it aids in the development of improvement methods.

Patients' attitudes and beliefs are crucial because incorrect attitudes and assumptions might obstruct pain relief. As a result, a multicenter survey was conducted in Maharashtra's tertiary institutions to learn about patients' attitudes, beliefs, experiences, and satisfaction levels with acute postoperative pain care. Also, replies were compared to see if the Acute Pain Service (APS) led to better patient outcomes and satisfaction.

Patients' experiences with postoperative pain management were collected using a 13-item questionnaire adapted from prior studies. The study includes the replies of 179 patients. The results showed the incidence of postoperative pain was 91.6% with 75.5% having moderate to severe pain. Despite this, 91.06% of patients were satisfied. Patients in APS set up had lower incidence of moderate –severe pain (44.23%) and higher satisfaction rates (100%). Although, 35.2% of patients pronounced that postoperative pain management should be done in best possible way, they also had many misconceptions, which were possibly reinforced by counselling done by health providers.  The findings indicate that postoperative pain control is insufficient even with an APS in place. For better pain treatment and results, it is critical to emphasise patient and health-care provider education.

Respiratory depression, immunosuppression, muscle rigidity, negative inotropism, nausea, vomiting, hyperalgesia, urine retention, postoperative ileus, and drowsiness are all clinically significant adverse effects of opioids. Perioperative opioids are a significant contributor to the opioid epidemic in the united states and other nations. As a result, non-opioid analgesics, particularly lidocaine, are becoming more popular for perioperative use.

A total of 185 adult patients were divided into two groups: control group i (105 patients) [fentanyl group] and group ii (80 patients) [opioid free anesthesia group]. Patients of both groups received at anesthetic induction: lidocaine 1.5 mg/kg bolus followed by 1.5 mg/kg/h infusion intraoperatively, and 1.5-2 mg/kg/h infusion for 2-8 hours postoperatively. Both groups received other analgesic adjuvants such as diclofenac 75 mg, paracetamol 1 gm, and mgso4 30-50 mg/kg intraoperatively. A supplemental fentanyl 1 mcg/kg was used if there is increase of mean arterial pressure (map) and/ or heart rate (hr) more than 20% above baseline. Analgesic requirements were documented following intraoperative fentanyl consumption and a visual analog scale (vas) pain score evaluation at the time of immediate recovery and after 24 hours postoperatively.

Supplemental intraoperative fentanyl was needed in 8.6% of cases in group i, and in 30% of cases in group ii. Group ii also needed a higher minimum alveolar concentration (mac) of sevoflurane during first 30 minutes. Both groups needed analgesia immediately post extubation if surgeries were less than 3 hours. After 8 hours of lidocaine infusion, there was no need for additional opioids for 24 hours and only paracetamol 1 g and/or diclofenac 75 mg were enough in both groups. No significant differences in bowel function were observed between the 2 groups.

Safety and efficacy of perioperative lidocaine infusion have been demonstrated. With minimal non-opioid analgesia for 24 hours, a post-operative lidocaine infusion for 5-8 hours was sufficient to ease discomfort. Opioid use during induction gives more hemodynamic stability and it is reasonable to use it in combination with lidocaine.

This retrospective study aimed to highlight the experience of intravenous ketamine use in a general practice hospital in Auchi, Nigeria.  From January 1994 to January 2014, case records of all patients who were operated on with intravenous ketamine were collected, and pertinent data was taken for the study. A total of 1,370 patients were operated on, with 463 (33.8%) major surgeries and 907 (66.2%) intermediate/minor operations. Females (725 [53.0%]) were operated on more than males (645 [47.0%]). In 31 individuals, side effects included transient increase of blood pressure with mild tachycardia, postoperative disorientation and confusion, emergent delirium, and priapism. In these patients, intravenous ketamine anaesthesia is found to have great clinical efficacy and safety.

The present study aims to assess the perception and confidence of female surgical residents in clinical examination of inguinal hernia and intimate of opposite sex in five hospitals, Makkah holy city. Study also sought to shed light on the barriers and the impact of different teaching modalities that are currently used in undergraduate education. Despite clear cultural limits and religious traditions, deficiencies in the clinical examination abilities of female surgical residents of the male groyne hernia and genitalia have not been addressed or investigated in the Arab and Muslim populations. The kids' ethnic backgrounds have also influenced their future training and skills. Due to their sensitive nature, many systems' examinations for patients are considered particularly sensitive to execute by students and professionals of both sexes.

Methods: A cross-sectional design based on a self-administered questionnaire which was distributed to 80 female surgical resident trainees across five Hospitals in Makkah, Holy city, Saudi Arabia. The study was carried out between the period of September 2020 to July 2021 and involved all the female surgical residents from level 1 - 5 (R1 to R5).

Result: Our study showed that overall perception of most of female residents on their performance on clinical examinations is less than expected. This study revealed that the main factor affecting the female resident’s clinical examination of the opposite sex intimate is the gender difference. 56 (81.2%) participants stated that their gender impacted their confidence and skills in examination of intimate of opposite sex, while 13 (18.8%) stated that gender has no effect.

Conclusion: Gender effects medical student clinical learning in a conservative culture in a variety of ways, including clinical exposure, supervisor support, patient willingness and consent, and some undergraduate methods of learning clinical skills that are not linked with postgraduate demands.

Since the Vedic time, local vaidhyas have had a traditional understanding of medicinal plants and their usefulness in local health care. In phytochemical research, screening medicinal plants has become a potential source of bio-dynamic chemicals with therapeutic utility. One method of capturing this corpus of knowledge is ethnobotanical documentation. As a result, traditional practitioners in Badami taluk of Bagalkot district conducted a survey of medicinal plants and their traditional applications. Badami taluk has a long history of medicinal plants dating back to the Chalukyan period.

In the end of 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; which also known as 2019 novel coronavirus or 2019-nCoV) disease (COVID-19) outbreak occur in China represent one of the most chief health problems. World health organization in February shown that about 43 000 well confirmed cases have been diagnosed in number of countries and regions all over the world, most of them was in China.

WHO stated that COVID- 19 as sixth public heath disaster of global concern on the end of January 2020COVID- 19 outbreak happen regarding as one of most aggressive pandemic occur in near close decades with uncommon viral pneumonia started in Whuhan , China and then globally.

During Pandemic many challenges face by every country and education lies the most and one of the biggest challenge during these days.

 Challenges arising from the COVID pandemic arise around:

• Psychological
• Teaching and Learning
• Health and wellbeing
• Assessment and  Progression of students
• Social
• Economic
• Transportation ,Mobility, Travel, accommodation, campus safety

The aim of this study is to identify a possible link between macrovascular hemodynamic status and microvascular hemodynamic indices in patients with periodontal disease. The interactions between the macrovasculature and microvasculature have been little studied but understanding the interaction between these vessels may open new targets for treatment and management strategies. Seventeen adult patients are recruited on a voluntary basis at the Dentistry Department of the “Mater Domini” University of Catanzaro, with sampling that that determines the lipid profile, blood glucose, inflammatory mediators, blood plasma viscosity: anamnesis, blood pressure measurement, and detection of anthropometric parameters: eco-Doppler of the carotid arteries and brachial arteries with noninvasive measurements of hemodynamics and evaluation of inflammation and periodontal circulation with a noninvasive spectroscopic technique. The sites with high probing depth differ from the healthy ones, showing low oxygen saturation and a notable increase in tissue edema, but no correlation between macro- and microvascular values was found. Periodontal probing and spectroscopic examination revealed a correlation between low oxygen saturation levels and tissue edoema values as probing depth increased; however, no correlation between macrovascular hemodynamic status and microvascular hemodynamics indices was discovered, most likely due to the heterogeneity of the population studied, the small sample size, and the low number of data collected. It is possible that the two circulatory districts were not strongly connected in the gingival pathology, and due to the enlargement of the local gingivopathy, it was only the systematic inflammation which gave the verified worsening of the carotid hemodynamic situation in patients with periodontal disease.

It has been observed that the Syndrome of Contractures and Deformities (SofCD) is the causal influence of malformations in locomotor”s system in children and the insufficiency and pain in adults patients. According to Prof. Hans Mau there exists a list of symptoms in newborns and babies. He describes this syndrome as 'the Seven Contracture Syndrome' (in German "Siebenersyndrom”). In the article the 8-th deformity, namely the varus deformity of shanks, is described by the authors in 2006. The article thoroughly presents the Syndrome of Contractures and Deformities and its influence to development of hip dysplasia, as the primary cause of wry neck (torticollis) and one of the four causes of Blount disease. Additionally, the explanation of the biomechanical etiology of the so-called idiopathic scoliosis is also provided.

The present study was aimed to compare the serum levels of total protein, albumin and uric acid in oral submucous fibrosis patients.

Patients were allotted into three categories: Group I comprised 25 healthy individuals, Group II comprised of 25 individuals with chewing tobacco habit without OSMF, and Group III comprised of 25 patients with chewing tobacco habit with OSMF.

The mean serum levels of Total protein fell from group I to group III; variation was not found to be statistically considerable. Serum levels of Albumin fell from group I to group III; dissimilarity was found to be statistically considerable (p < 0.05). Serum levels of Uric acid decreased from group I to group II; difference was found to be statistically significant (p < 0.05).

OSMF is caused by a variety of reasons, including local irritants such as capsaicin, nicotine, betel nut, punget, and spicy food, as well as chronic candidiasis, iron and nutritional deficiencies, human papillomavirus (HPV), genetic abnormalities, Herpes simplex virus (HSV), and human autoimmunity. Several case control studies have linked areca nut, a component of betel quid, to an increase in the prevalence of OSMF. Decrease in level of serum proteins can be considered as an important event by which oxidative stress can cause toxic effects on antioxidant defense system in our body and initiate precancerous transformation and other oral diseases. Results of our study will not only be useful in understanding the pathogenesis of OSMF but it also focuses on antioxidant therapeutic approaches and in treatment of OSMF.

The current study aimed to examine barriers influencing evidence-based Practice among critical care nurses in Qatar. The Barriers to Research Utilization Scale(BTRUS) was used to collect data from 278 nurses from February to March 2021 via a cross-sectional survey . The BTRUS included information on different information sources used by nurses for practise support, potential impediments to evidence-based practise, and perceived competencies in applying research-based evidence. Lack of time, lack of empowerment to modify Practice, lack of support from colleagues in integrating research evidence, and lack of access to research papers were the most important organisational impediments. The relevance of research data to present practise, studies with methodological faults, scepticism about research conclusions, a significant amount of research evidence, and inability to understand statistics were all identified as self-perceived impediments. Self-reported barriers and use of evidence sources were influenced by the Nurse's age, years of nursing practise, academic attainment, and organisational position. Organizational support, improved self-belief, and evidence-based practice expertise may reduce barriers to implementing research evidence in clinical Practice. Nursing administrators and educators have the leading role in facilitating evidence-based practice implementation among nurses. Therefore, training and education are essential to enhance the knowledge and skills of nurses to use evidence-based Practice. Time management, providing the required resources, and adequate supervision can facilitate the implementation of evidence-based Practice, which positively influences the quality of care.

Laryngeal papilloma can lead to respiratory difficulties, obstruction, hypoxia and death. Diagnosis in children is delayed due to more common childhood illnesses. Fibre optic bronchoscopy is used for early diagnosis. In operations involving a shared airway, anesthesia involving TCI and jet ventilation (HPSV) is a good approach for surgical debulking of laryngeal papillomata. Adhering to safe practice guidelines will ensure a good outcome, minimise complications but its clinical practice requires skilled personnel. Apnoeic oxygenation is used in preventing early desaturation and maintaining oxygen saturation in procedures involving airway disease. Human Papilloma Virus (HPV) vaccination decreases the prevalence of the disease.

Since the beginning of 2020, the new COVID-19 has a significant impact on all facets of living around the world. Despite the fact that there is no specific cure for this disease, the importance of preventive actions cannot be overstated. Prevention of pandemic transmission is especially critical in hospital settings, but if COVID-19 clinics are routinely treating infected patients while adhering to all suggested preventive regulations, clinics that are not yet treating these patients are always on the lookout for COVID-19. As a result, preventive measures for clinics that are not yet on the front lines are specialised, and distance work, an adequate number of diagnostic tests, and protective equipment are required. The formation of interchangeable health-care teams is an important preventive step.  In this article we will discuss the tactic of these hospitals for keeping of operating room personnel during COVID-19 pandemic.