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eal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation.Sleep quality has a long-term impact on health leading to depression among adolescent students. We conducted a cross-sectional study to assess the prevalence of sleep quality and its associated factors among adolescents of western, Nepal. 514 adolescents from different schools were selected by the probability proportionate to size (PPS) method. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among adolescents. The collected data were entered in EpiData 3.2 version, then extracted to excel 2019 and was analyzed with the help of RStudio (version 1.2.5033). Frequency distribution and percentage were identified as descriptive analysis whereas chi-square test was done. Variables that were found statistically significant (P less then 0.05) were further analyzed using the logistic regression model. The prevalence of sleep quality in this study was 39.1%. In a bivariate analysis, ethnicity, religion, place of residence, drinking status of father, reason for selecting the currently studying faculty, satisfaction with academic performance, use of tobacco, relationship with friends or classmates, more use of internet per day, and use of internet before falling asleep were found to be statistically significant with sleep quality. Those students who left their home without informing their parents were more than three times at the risk of sleep quality than those students who never ran away from their home without informing their parents (AOR = 3.435, CI 1.237-9.540). The overall prevalence of sleep quality among school going adolescent students was 39.1 percent which was comparatively high.

Sleep disturbances are more common in cancer patients than in the general population; however, there is limited research pertaining to the occurrence of such disturbances that subsequently impact patients' quality of life. The aim of our study is to describe the prevalence of insomnia among pancreatic cancer patients who have recently undergone recent pancreaticoduodenectomy.

We performed a 6-year (2014-2020) retrospective cohort analysis of all adult patients aged 18 and above with pancreatic cancer who underwent pancreaticoduodenectomy at our institution. Insomnia was characterized using the Pittsburgh Sleep Quality Index (PSQI). Symptoms of insomnia and the impact caused by these symptoms on daily lives were assessed with the Insomnia Severity Index (ISI), and patients were divided into mild insomnia (ISI 8-14) or moderate to severe insomnia (ISI ≥ 15).

Out of forty patients with pancreatic cancer that have undergone pancreaticoduodenectomy, 19 (47.2%) reported that their sleep disturbances had a significant effect on their quality of life. A total of 22 (55.0%) patients reported insomnia, with 63.2% reporting mild insomnia. Chemotherapy was found to significantly increase the risk of moderate to severe insomnia. The mean ISI score was 7.2 ± 6.9, and the mean PSQI score was 7.0 ± 5.1. ISI and PSQI showed a strong positive correlation (

= 0.78,

< 0.01).

Sleep disturbances such as insomnia following pancreatic cancer surgery are highly prevalent. Treating physicians and surgeons should recognize and routinely screen for sleep disorders through the management of a multidisciplinary team in order to alleviate some of the burden on the patients' mental well-being.

Sleep disturbances such as insomnia following pancreatic cancer surgery are highly prevalent. Treating physicians and surgeons should recognize and routinely screen for sleep disorders through the management of a multidisciplinary team in order to alleviate some of the burden on the patients' mental well-being.

This study aims to evaluate the outcome after the internal fixation of diaphyseal metacarpal fractures by a single intramedullary K-wire.

In this prospective case series study, conducted from July 2017 to June 2019 in 23 adult patients with a single, unstable, diaphyseal metacarpal fracture, outcomes after internal surgical fixation using a single antegrade intramedullary K-wire were evaluated. The outcomes were evaluated by union rate, time to union, handgrip measurements at 6 and 12 months, and the modified Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months.

The study population consisted of 17 males and 6 females, with a mean patient age of 28.4 ± 8.5 years (range, 16-45 years). The median time to final follow-up was 14 ± 1.8 months (range 12-24 months). The mean duration of the union was 7.3 ± 1.6 weeks (range 5-11 weeks), with a union rate of 95.7% (22 cases). The mean handgrip strength was 68% ± 12.8% of the strength of the uninjured hand after 6 months and 92.7% ± 6.9% after 12en used to treat an unstable metacarpal shaft fracture.Retrograde popliteal access has long been established as an alternative to the antegrade approach to occlusive lesions in the superficial femoral artery (SFA). However, early reports with high complication rates (dissection, hematomas, aneurysms, and arteriovenous shunts at the puncture site) reduced enthusiasm for this technique. In recent years, with the development of thinner sheaths and low profile angioplasty devices, retrograde popliteal access has resurfaced as a viable technique, mostly in combination with or after failure of the more classical antegrade approach. In this retrospective study, we will report the safety and efficacy of the retrograde popliteal approach in the treatment of superficial femoral artery chronic total occlusions, in 13 consecutive patients between January 2017 and January 2021. The results showed 100% successful puncture of the popliteal artery and 100% successful recanalization and stenting of the superficial femoral artery with a total of 2 complications related to the puncture site and zero periprocedural mortality. In conclusion, the retrograde popliteal approach appears to be an effective and safe alternative to the common SFA complete total occlusion (CTO) treatment approach.Malnutrition is common among dialysis patients, but there is insufficient literature on the problem from resource-poor settings of the sub-Saharan region. We conducted a cross-sectional investigation of dietary intake and nutritional status of haemodialysis (HD) patients to inform the current status of this population group in the region. HD patients aged ≥18 years, with dialysis vintage of ≥3 months, at one nephrology unit in Tanzania were assessed for their habitual diet and nutrient intake. Anthropometric measures and biochemistry tests were also performed. The diet was predominantly starchy food based, accompanied by a limited selection of vegetables. Fruits and animal protein were also minimally consumed (1 portion/day each). Fruit consumption was higher in females than males (median (25th, 75th) = 2 (1, 2.3) versus 0.5 (0, 1.7) portions, p = 0.008). More than 70% of participants had suboptimal measures for protein and energy intake, dietary iron, serum albumin, muscle mass, and hand grip strength (HGS). Inadequacies in protein and energy intake and dialysis clearance (URR) increased with the increase in body weight/BMI and other specific components (MAMC and FMI). Consumption of red meats correlated significantly and positively with serum creatinine (r = 0.46, p = 0.01), potassium (r = 0.39, p = 0.03), and HGS (r = 0.43, p = 0.02) and was approaching significance for a correlation with serum iron (r = 0.32, p = 0.07). C-RP correlated negatively with albumin concentration (r = -0.32, p = 0.02), and participants with C-RP within acceptable ranges had significantly higher levels of haemoglobin (p = 0.03, effect size = -0.28). URR correlated negatively with haemoglobin concentration (r = -0.36, p = 0.02). Patients will benefit from improved nutritional services that deliver individually tailored and culturally practical dietary advice to enable them to make informed food choices whilst optimizing disease management.

The role of the "traditional" radiologist has shifted from imaging centered to patient focus, which underscores the utmost importance of the clinical radiologist in the multidisciplinary team in patient management. For the clinical radiologist to effectively play this key role, the referring clinician must provide adequate and useful patient information to assist the radiologist in making a diagnosis or provide differential diagnosis. The objectives were to assess the level of completion of the radiology request form and to determine whether the clinical history provided aided in the final impression/diagnosis.

. We conducted a prospective review of 500 radiology request forms at the Cape Coast Teaching Hospital (CCTH) between September and October 2018. The forms were consecutively sampled and reviewed for each field/area such as patient's name, age, and clinical history. Data were analyzed descriptively for the level of completeness and usefulness of clinical history entered by the clinician.

No request form was completed in full. Cynarin All the request forms did not have X-ray serial number and previous examination details documented. The proportions of forms with various fields completed were as follows more than 90% of the forms had patient's name, investigation required, date of the request, doctor's name, and clinical history fields filled. The patient's age, patient's ward/address, and doctor's address were filled in 88%, 75%, and 18.4%, respectively. Twenty percent of the request forms were not useful to the radiologist in the final diagnosis.

A significant proportion of radiology request forms are incompletely filled and therefore denies the radiologist, the critical information needed to make a diagnosis, or narrow differential diagnosis.

A significant proportion of radiology request forms are incompletely filled and therefore denies the radiologist, the critical information needed to make a diagnosis, or narrow differential diagnosis.Sickle cell disease (SCD) is a well-characterized hemoglobinopathy affecting more than 20 million individuals worldwide and carries an increased risk of cerebral vasculopathy, cerebral infarct, and stroke. As mechanisms of cerebral infarction in SCD are partly attributable to microvascular vaso-occlusive crises, manifesting as altered cerebral blood flow and associated impaired oxygen delivery, magnetic resonance imaging (MRI) methods that can quickly provide a comprehensive perspective on structural and functional disease status, without exogenous contrast administration or ionizing radiation, have emerged as crucial clinical tools for surveillance. However, early ex vivo MRI work in suspended erythrocytes containing hemoglobin S at 0.35 Tesla (T) suggested that sickled erythrocytes can orient preferentially in the presence of an external magnetic field, and as such, it was suggested that MRI exams in sickle cell hemoglobinopathy could induce vaso-occlusion. While this observation has generally not impacted were consistent with a typical SCD population; however, no participants exhibited evidence of acute infarction. These findings are consistent with 3 T MRI not inducing acute infarction or vaso-occlusion in individuals with SCD and suggest that earlier low-field ex vivo work of erythrocytes in suspension is not a sufficient cause to discourage MRI scans in patients with SCD.

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