Scapular Winging following Sports-Related Injury in a Rugby Player

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.

Social Interactions of TB Patients at Helvetia Community Health Center in Medan

Social interaction is a relationship between humans, both in individuals and in groups. Social interaction in society occurs because of social contact and communication. Pulmonary TB is an infectious disease caused by Mycobacterium tuberculosis. This study aimed to determine the social interaction of pulmonary tuberculosis patients at Helvetia Community Health Center in Medan. This study used a descriptive design. The population in this study were all patients suffering from pulmonary tuberculosis. The sample size was determined using a purposive sampling technique, and it was found that the sample size was 33 respondents. The data collection used observation form. The data analysis used frequency distribution. The result shows various respondents' characteristics. The majority were 29-43 years old, male, high school educated, self-employed, and have suffered from TB ≤ 3 years. Based on the study result, 25 of 33 sample patients with pulmonary tuberculosis still interacted socially with their community. The conclusion is that patients with pulmonary tuberculosis still socially interact with the community in their neighborhood.

Prevalence of hookah smoking and associated factors among male high school students in Iraq

Background The use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region. Hookah users are exposed to an array of chemical compounds and may suffer several chronic diseases as a result. The purpose of this study was to determine the prevalence of hookah use among male high school students in the region and to study different associated factors in order to provide local tobacco control officials with an understanding of this public health problem. Methods A convenient non-probability sampling study was conducted among students in three high schools in Al-Karkh district, Baghdad. The study period was from October 2017 till January 2019 and included 847 male students aged 15–18 years old. Using a simple random technique to select the high schools from a list of schools we chose one school from each directorate. Descriptive, chi-square test of significance, bivariate, and multivariate logistic regression analyses of data were carried out for identifying the risk factors associated with hookah smoking among these high school adolescent males. Results The overall prevalence of hookah smoking in the last 30 days among male high school students was 46.1% while in the past 6 months it was as high as 85.7%. More than two-thirds (70.6%) of the students thought that hookah smoking was more socially acceptable than cigarette smoking. Factors such as having first heard about it from friends, the media, or the presence of a hookah café near their residence were significantly associated (p > 0.05) with hookah smoking among the students. Similarly, being surrounded by friends who used hookah was also found to be significantly associated with hookah smoking, with an odds ratio of 0.18, 95% CI (0.087–0.394). Hookah smokers were less likely than non-hookah smokers to report its use as forbidden in Islam and more likely to say it is allowed in Islam. Conclusions We found an alarmingly high use of hookah smoking among male high school students in this study. Family members and peers had an important role in the prevention of hookah smoking among these students. There is a need for students to be educated about the toxicity of hookah tobacco smoking and its direct effect on their health.

Factors Associated with Gender-Based Violence Perpetration by Male High School Students in Eastern Ethiopia

Gender-based violence (GBV) perpetration is a severe problem among youths in schools and the community at large. As most studies focused on adults, this study aimed to investigate factors associated with GBV by male high school students in eastern Ethiopia. An institutional based cross-sectional survey was conducted with 1,109 male students aged 15–24 years in eastern Ethiopia in December 2018 using self-administered WHO Multi-Country Study on Women’s Health and Life Events and UN Multi-Country study on perpetration. Poisson regression model was used to determine the prevalence ratio. Multivariable analysis showed that having girlfriend, chewing khat, drinking alcohol, watching pornography and being sexually active increased the prevalence of perpetrating any type of GBV (emotional, physical, sexual, and overall GBV) by young male in the last 12 months. Compared to those who did not smoke tobacco, smokers had an prevalence of perpetrating emotional violence (adj. PrR = 1.22, 95% CI = 1.03–1.44) and any type of GBV (adj. PrR = 1.15, 95% CI = 1.00–1.31). Young males who had a mother who had completed Grade 9–12 (adj. PrR = 0.75, 95% CI = 0.59–0.96) had a 25% lower prevalence of perpetrating emotional violence compared to male students who had an illiterate mother. Young males who had used illicit drugs, smoked shisha (adj. PrR = 1.39, 95% CI = 1.10–1.77), and were married (adj. PrR = 1.89, 95% CI = 1.15–3.12) had a higher prevalence of perpetrating sexual violence compared to young males who hadn’t used smoked shisha and were not married, respectively. Young males who had discussed reproductive health with their family (adj. PrR = 1.13, 95% CI = 1.03–1.24) and who chewed khat (adj. PrR = 1.26, 95% CI = 1.02–1.55) had a higher prevalence of perpetrating any GBV compared to young men who hadn’t discussed reproductive health with their parents and who hadn’t chewed khat, respectively. Any type of GBV (emotional, sexual, or physical violence) was significantly associated with several individual and relationship factors. Effective prevention and intervention programs should be focused on education of the influence of pornography, prevention of substance use and interventions for those in romantic relationships could all assist in reducing GBV.