Male genital injuries treated at a tertiary hospital in the western region of Nepal: A two-year snapshot.

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as patients are hesitant to report such injuries. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries. Methods: A retrospective analysis of discharge summaries of the cases of male genital injuries was reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study. Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases. Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.

Burnout

The present paper deals with burnout as a challenge of our modern business world, given the phenomenon of heavy work investment in our society. The present article is emphasizing the strong connection between business, psychology, and medicine when dealing with people working in a modern, international business environment. The research methods are multi-disciplinary, combining elements of business, corporate culture, psychology, and even medical issues that are relevant in this context. The research methods used in the present paper are qualitative methods, metadata, and interviews (the questionnaire as a qualitative method) completed by the assessment of data and by proposing appropriate indicators ensuring the monitoring of burnout tendencies in companies. The paper proposes an interdisciplinary approach, bringing together aspects of business and economics, psychology, life sciences, sociology, ethical issues, and cultural issues related to work. A tool for detecting burnout is analyzed. The research results can be relevant for managers and human resources departments.

Oral care precautions for patients with cystic fibrosis

Cystic fibrosis (CF) is the most common severe autosomal recessive disease in the Caucasian population. Although it remains incurable, it is currently possible to extend the life expectancy of patients with modern therapeutic possibilities. Given the medical issues that a child with CF faces, oral health may be perceived as being of lesser importance. Thus, the establishment of good dietary and oral hygiene practices may not take place, leading to an increased risk of caries and gingivitis due to poor oral hygiene. A change in patient management may be necessary to ensure optimal care.

Dental Management of Generalised Developmental Defect of Enamel in A Child with Global Developmental Delay

Development Defect of Enamel (DDE) although not common, can bring about serious sequelae and needs immediate action. If we leave the teeth untreated, many complications such as poor dental aesthetics, chipping of teeth and dental pain often set in. These complications are further aggravated if the patient has any coexisting medical issues, such as Global Developmental Delay (GDD). Children with GDD often exhibit poor oral health with an abundance of plaque that leads to caries and periodontal disease progression because of poor motor and cognitive development. Many of them also exhibit negative behaviour toward dental treatment. This case describes the dental care for a Global Developmental Delay (GDD) child with sporadic generalised Development Defect of Enamel (DDE). The case management touches on the appropriate behaviour guidance strategies used to aid the child’s unfavourable behaviour towards treatment and the restorative treatment performed to preserve the structural durability of the affected teeth in a general dental setting.

The Mathematical Model for searching the Shortest Route for TB Patients with the help of Dijkstra’s Algorithm

In this research paper, we have studied TB (Tuberculosis) patients who come from different traffic routes in order to seek medical help and treatment in Karachi, Sindh, Pakistan. In this research work, we have focused on the transportation problems of the TB patients. These TB patients can travel on the paths having minimum distance as found out in this paper using Dijktra’s Algorithm. People hope that they have better treatment opportunities and financial medical relief in the government and private hospitals in Karachi. There are many private hospitals in the city but unfortunately, they provide expensive treatments. As a consequence, people belonging to the poor or lower and middle classes approach government hospitals adequately. Among them, Nazimabad Chest Hospital for TB patients (under the supervision of Dow University of Health Sciences) is providing better facilities as compared to the other hospitals involved in providing medical treatments for the similar medical issues. Nazimabad Chest Hospital for TB patients is renowned for its high quality treatment of TB patients. The hospital is located inside Government Hospital Nazimabad (under the control of Dow University), Karachi. It has latest equipments, competent and qualified staff to treat TB patients. Patients have to visit the hospital on weekly basis from their homes and residences. They use several combinations of traffic routes to reach the hospital as these patients live in different areas like, Malir Cantt, Safari Park, Hassan Square, North-Nazimabad, North Karachi, Gulshan-e-Iqbal, etc. A path or road is required which takes the least amount of time and subsequently reduces the transportation charges. In this paper, an effort has been made to locate the shortest route for the convenience for these TB patients. In this paper, a mathematical model has been developed by using the method of Dijkstra’s algorithm to attain the desired objective.

DETECTION OF LUNG CANCER USING IMAGE PROCESSING

This project constructs and assesses an image processing approach for lung cancer diagnosis in this study. Image processing techniques are frequently utilized for picture improvement in the detection phase to enable early medical therapy in a variety of medical issues. We suggested a lung cancer detection approach based on picture segmentation in this study. Image segmentation is a level of image processing that is intermediate. To segment a CT scan image, a marker control watershed and region growth technique is applied. Following the detection phases, picture augmentation with the Gabor filter, image segmentation, and feature extraction is performed. We discovered the efficiency of our strategy based on the experimental results. The results demonstrate that the watershed with the masking method, which has great accuracy and robustness, is the best strategy for detecting major features. Keywords: Lung cancer, MATLAB, CT images, Distortion removal, Segmentation, Mortality rate.

Slow Down: New-Onset Atrial Fibrillation Challenges for Ambulatory Surgical Facilities

As patient safety liaisons (PSLs), we are continually educating and collaborating with our Pennsylvania healthcare facilities. We often are asked questions about reportable events under the Medical Care Availability and Reduction of Error (MCARE) Act. One of the most common examples we discuss is cancellations and transfers out of an ambulatory surgical facility (ASF). The top three reasons for cancellations include preop instructions not followed, missed medical issues identified during preop screening, and no shows. The top three reasons for transfers include cardiac arrhythmias, aspiration, and hypertension. Interestingly, between discussions with facilities and review of event reports, new-onset atrial fibrillation (AF) has come up often as a common reason for cancellations or transfers out of the ASF setting, especially in gastrointestinal (GI) procedures. In fact, as PSLs, when educating ASFs on reportable events we often give the example of placing a patient on the cardiac monitor in preop and the patient is found to be in AF. In 2009, it was estimated that 13.1% of AF cases were undiagnosed,3 which may explain why patients are presenting with new-onset AF. People with AF are at an increased risk of complications (e.g., stroke);3,4 therefore, a cancellation or transfer may be necessary depending on the patient’s condition. These events are considered reportable to the Pennsylvania Patient Safety Reporting System (PA-PSRS) under MCARE.

Complex respiratory and motor rehabilitation program in a patient with post-pulmonary tuberculosis conditions and multiple sequelae after SARS-CoV-2 infection: case report

Introduction: A great variety of medical issues can occur after the COVID-19 infection including fatigue, muscle weakness, locomotor disability, self-care dysfunction, polyneuropathy, persistent dyspnea on exertion and a hypercoagulable state. Materials and methods: This paper presents the case of a nonsmoker 49-year-old male with right lung lower lobe lobectomy for post tuberculosis bronchiectasis and diabetes mellitus, who developed multiple serious physicals, neurological, hematological and respiratory consequences, related to critical COVID-19 infection and prolonged hospitalization, Results: A favorable evolution of the patient’s respiratory sequels and motor impairment on both lower limbs was noticed after a complex individualized rehabilitation program started in the post COVID-19 Rehabilitation Department of Balneal and Rehabilitation Sanatorium, Techirghiol, Romania, consisting in better functional parameters and exercise tolerance, significant improvement in daily activities, remission of exertional dyspnea, social and family reintegration. Conclusions: multidisciplinary approach and complex individualized programs of rehabilitation is required after a critical form of COVID in a patients known with tuberculosis, and other complex pathologies, in order to restore physical function and mobility and optimize respiratory parameters. Keywords: COVID-19, Rehabilitation, Tuberculosis,

Epidemiology of Musculoskeletal Disorders in Musicians - Systematic Review

Musicians performing over an instrument demands repetitive, awkward postures and postural stress from prolonged sitting or standing. Musicians are found to be more prone to the development of Playing-Related Musculoskeletal Disorders (PRMDs) due to these factors. PRMDs are defined as ‘pain, weakness, numbness, tingling or other symptoms that interfere with their ability to play an instrument’. There is an increasing interest seen in the medical issues faced by the musicians performing over an instrument. There are different type of musicians playing different instruments which means different instrumentalists face different musculoskeletal disorders depending upon many factors. There are intrinsic and extrinsic factors involved which contribute to the development of PRMDs in musicians. Development of PRMDs is seen to be a cause of early termination of musician’s career. The purpose of study is to review the epidemiology of musculoskeletal disorders in musicians. Key words: Musculoskeletal disorders, Musculoskeletal problems, Prevalence of musculoskeletal injuries, Postural disorders, Playing-related strain in instrumentalists and musicians.

Performance of a new symptom checker in patient triage: Canadian cohort study

Background Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. Only limited evidence currently exists about symptom checker safety or accuracy when used by real patients. We developed a new prototype symptom checker and assessed its safety and accuracy in a prospective cohort of patients presenting to primary care and emergency departments with new medical concerns. Method A prospective cohort study was done to assess the prototype’s performance. The cohort consisted of adult patients (≥16 years old) who presented to hospital emergency departments and family physician clinics. Primary outcomes were safety and accuracy of triage recommendations to seek hospital care, seek primary care, or manage symptoms at home. Results Data from 281 hospital patients and 300 clinic patients were collected and analyzed. Sensitivity to emergencies was 100% (10/10 encounters). Sensitivity to urgencies was 90% (73/81) and 97% (34/35) for hospital and primary care patients, respectively. The prototype was significantly more accurate than patients at triage (73% versus 58%, p<0.01). Compliance with triage recommendations in this cohort using this iteration of the symptom checker would have reduced hospital visits by 55% but cause potential harm in 2–3% from delay in care. Interpretation The prototype symptom checker was superior to patients in deciding the most appropriate treatment setting for medical issues. This symptom checker could reduce a significant number of unnecessary hospital visits, with accuracy and safety outcomes comparable to existing data on telephone triage.