Background: Postoperative pneumonia is a preventable complication associated with adverse outcomes, that greatly aggravates the medical expenses of patients. The goal of our study is to identify risk factors and outcomes of postoperative pneumonia.

Artificial intelligence (AI) is an area of computer science that emphasizes the creation of intelligent machines or software that work and react like humans. Some of the activities computers with artificial intelligence are designed for include, Speech, recognition, Learning, Planning and Problem solving. Deep learning is a collection of algorithms used in machine learning, It is part of a broad family of methods used for machine learning that are based on learning representations of data. Deep learning is a technique used (...) to produce Pneumonia detection and classification models using x-ray imaging for rapid and easy detection and identification of pneumonia. In this thesis, we review ways and mechanisms to use deep learning techniques to produce a model for Pneumonia detection. The goal is find a good and effective way to detect pneumonia based on X-rays to help the chest doctor in decision-making easily and accuracy and speed. The model will be designed and implemented, including both Dataset of image and Pneumonia detection through the use of Deep learning algorithms based on neural networks. The test and evaluation will be applied to a range of chest x-ray images and the results will be presented in detail and discussed. This thesis uses deep learning to detect pneumonia and its classification. (shrink)

In developing nations, pneumonia is the leading cause of death for young children; however, mortality can be effectively decreased with early diagnosis and care. The objectives of the review are to evaluate the significance of clinical signs and symptoms in diagnosing pneumonia, and treatment in children under the age of five, as well as to examine the precision of WHO criteria in diagnosing clinical pneumonia in general people. According to the World Health Organization's definition and the Integrated (...) Management of Childhood Illness (IMCI) initiative, pneumonia is clinically characterized by an acute cough, with or without fever, accompanied by dyspnea or tachypnea. Acute infections of the gut and gastroenteritis can be effectively controlled and treated. Acute respiratory infections, particularly pneumonia, are increasingly regarded as the leading infectious cause of mortality among children in developing nations. The diagnosis of pneumonia is primarily clinical and categorized into four domains: clinical assessment, epidemiological factors, radiographic imaging, and standard laboratory results. Pneumonia can be classified into three categories: bacterial, viral, and acute pneumonia. In every instance, a potential diagnosis should be made and the appropriate course of therapy should be administered based on the features of that pneumonia. Preventing and lowering the death and morbidity of this significant disease in children can be greatly aided by physicians having precise and accurate information on how to identify and treat it without incurring additional expenses. (shrink)

Objective: This study aimed to investigate and compare the effects of tubular gastroesophageal anastomosis and traditional gastroesophageal supra-arch anastomosis on the postoperative lung function of patients with esophageal carcinoma. -/- Methods: A total of 90 patients with middle-lower segmental esophageal cancer admitted in our hospital from August 2014 to August 2016 were recruited to our study. They were randomly divided into two groups. The observation group underwent tubular gastroesophageal anastomosis, whereas the control group underwent traditional gastroesophageal supra-arch anastomosis. Changes (...) in the postoperative pulmonary function were compared between the two groups. -/- Results: The numbers of CD4 cells (27.45 ± 5.48), CD8 cells (35.97 ± 7.16), and natural killer cells (20.79 ± 2.49), as well as the CH4/CD8 ratio (0.69 ± 0.18), of the patients in the observation group were significantly higher than the (38.45 ± 5.98), (20.45 ± 6.41), (39.44 ± 3.49), and (1.31 ± 0.48), respectively, of the patients in the control group. The differences between the two groups were statistically significant (P<0.05). By contrast, the preoperative forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and maximum voluntary ventilation (MVV) did not significantly differ between the two groups (P>0.05). The FEV1 (1.76 ± 0.41 L), FVC (2.33 ± 0.32 L), and MVV (33.7 ± 5.2 L/min) of the observation group were significantly higher than those of the control group (P<0.05). Meanwhile, the complication rate of the observation group was 42.2%, which was significantly lower than that of the control group (75.6%) (P<0.05). -/- Conclusion: Tubular gastroesophageal anastomosis can benefit patients with esophageal cancer by significantly reducing the adverse effects on their postoperative pulmonary function and control the occurrence of postoperative complications. (shrink)

Background: With the coming of the Industrial Revolution, the levels of pollution grow significantly. This Technological development contributed to the worsening of shortness breath problems in great shape. especially in infants and children. There are many shortness breath diseases that infants and children face in their lives. Shortness of breath is one of a very serious symptom in children and infants and should never be ignored. Objectives: Along these lines, the main goal of this expert system is to help physician (...) in diagnosing and describe some common causes of shortness of breath in infants and children by diagnosing their cases through our expert system. Moreover, this system which we are presenting will give patient the appropriate diagnosis of disease and the treatment required. Methods: In this paper the strategy of the expert system for diagnosing a number of the existed shortness of breath in infants and children diseases such as (Asthma , Bronchiolitis, Viral Pneumonia, cough, Shortness of breath' dyspnea ', Epiglottitis, Croup, ABSCESS in the tonsil 'peritonsillar abscess', Bronchitis, Viral Bronchitis, Wheezing, sudden infant death syndrome 'SIDS' ) is introduced, an overview about the shortness of breath in children and infants diseases are delineated, the cause of diseases are sketched and the treatment of disease whenever conceivable is given . SL5 Object Expert System language was utilized for designing and implementing the proposed expert system. Results: The proposed shortness of breath in children and infants diseases diagnosis expert system was estimated by Medical students and they were satisfied with its result. Conclusions: The Proposed expert system is very useful for Respiratory physician, pediatrician, recently graduated physician, and for children's parents with shortness of breath problem. (shrink)

RD, a 32-year-old male, was admitted to the hospital with hypoxic COVID pneumonia–a potentially life-threatening condition characterized by dangerously low levels of oxygen in the body- during one of the pandemic’s surges. While RD’s age gave the clinical team hope for his prognosis, his ability to recover was complicated by his being unvaccinated and having multiple comorbidities, including diabetes and obesity. His condition worsened to the point that he required extracorporeal membrane oxygenation (ECMO), a machine that maintains the functioning (...) of a person’s heart and lungs. -/- Given its scarcity–only 264 of the over 6,000 hospitals in the United States offer ECMO, according to the Extracorporeal Life Support Organization–as well as its high cost and the inadequate supply of staff required to maintain it, ECMO primarily serves as a bridge to support critically ill patients until they can receive an organ transplant or implanted medical device. For RD, ECMO was started to support him until he could be evaluated for, and possibly receive, a bilateral lung transplant. Despite its intended use as a treatment of last resort, some patients can remain on ECMO for weeks or months. And some are awake, alert, and capable of medical decision-making. -/- RD was one such patient. However, the transplant evaluation committee ruled out RD’s candidacy for bilateral lung transplantation, based on his poor potential for recovery and a lack of family and friends to provide post-transplant support. This determination raised the prospect of continued ECMO treatment being a bridge to nowhere. But RD was comfortable on ECMO and wanted to remain in the ICU. The ICU intensivist contacted the ethics consult service with questions about whether continued ECMO support was medically and ethically inappropriate. (shrink)

Background: With the coming of the Industrial Revolution, the levels of pollution grow significantly. This Technological development contributed to the worsening of shortness breath problems in great shape. especially in infants and children. There are many shortness breath diseases that infants and children face in their lives. Shortness of breath is one of a very serious symptom in children and infants and should never be ignored. Objectives: Along these lines, the main goal of this expert system is to help physician (...) in diagnosing and describe some common causes of shortness of breath in infants and children by diagnosing their cases through our expert system. Moreover, this system which we are presenting will give patient the appropriate diagnosis of disease and the treatment required. Methods: In this paper the strategy of the expert system for diagnosing a number of the existed shortness of breath in infants and children diseases such as (Asthma , Bronchiolitis, Viral Pneumonia, cough, Shortness of breath' dyspnea ', Epiglottitis, Croup, ABSCESS in the tonsil 'peritonsillar abscess', Bronchitis, Viral Bronchitis, Wheezing, sudden infant death syndrome 'SIDS' ) is introduced, an overview about the shortness of breath in children and infants diseases are delineated, the cause of diseases are sketched and the treatment of disease whenever conceivable is given . SL5 Object Expert System language was utilized for designing and implementing the proposed expert system. Results: The proposed shortness of breath in children and infants diseases diagnosis expert system was estimated by Medical students and they were satisfied with its result. Conclusions: The Proposed expert system is very useful for Respiratory physician, pediatrician, recently graduated physician, and for children's parents with shortness of breath problem. (shrink)

Coronavirus is a viral irresistible sickness brought about by SARS- COV2. Its clinical signs and side effects are on an expansive range going from asymptomatic to serious confusions like multi-organ disappointment, thromboembolism, and extreme pneumonia with respiratory disappointment. More awful results and higher death rates have been accounted for in the old, individuals with co-morbidities, and malnourished people. Sustenance is central to acceptable wellbeing and safe capacity. It frames an essential segment of therapy modalities for different intense and persistent (...) infections, particularly where a causative therapy isn't yet perceived. Despite the fact that reviews tending to the part of explicit supplements in COVID-19 are still at a beginning phase, accessible proof recommends that addressing the necessities of a variety of large scale and miniature supplements (energy, proteins, fats, nutrients A, D, E, C, B nutrients, iron, selenium, zinc, and so forth) Additionally, supplements are Immune System Might Promote Recovery for Mild COVID-19 Patients Impact of Coronavirus on Education in India Review 466 determinants of the sythesis of the gut microbiota that thusly impacts the attributes of safe reactions in the body. (shrink)

Background: Facial attractiveness influences our perceptions of others, with beautiful faces reaping societal rewards and anomalous faces encountering penalties. The purpose of this study was to determine associations of visual attention with bias and social dispositions toward people with facial anomalies. -/- Methods: Sixty subjects completed tests evaluating implicit bias, explicit bias, and social dispositions before viewing publicly available images of preoperative and postoperative patients with hemifacial microsomia. Eye-tracking was used to register visual fixations. -/- Results: Participants with higher (...) implicit bias scores fixated significantly less on the cheek and ear region preoperatively (P = 0.004). Participants with higher scores in empathic concern and perspective taking fixated more on the forehead and orbit preoperatively (P = 0.045) and nose and lips (P = 0.027) preoperativel. -/- Conclusions: Participants with higher levels of implicit bias spent less visual attention on anomalous facial anatomy, whereas participants with higher levels of empathic concern and perspective taking spent more visual attention on normal facial anatomy. Levels of bias and social dispositions such as empathy may predict layperson gaze patterns toward those with facial anomalies and provide insights to neural mechanisms underlying the "anomalous is bad" paradigm. (shrink)

RENÉ DESCARTES: UMA BIOGRAFIA -/- RENÉ DESCARTES: A BIOGRAPHY -/- Emanuel Isaque Cordeiro da Silva - CAP-UFPE, IFPE-BJ e UFRPE. E-mails: [email protected] e [email protected]. WhatsApp: (82)98143-8399. -/- -/- Nascido em 1596 em Haia, nas fronteiras de Touraine e Poitou, em uma família nobre, René Descartes vem ao mundo ao mesmo ano em que Johannes Kepler (1671-1630), em seu primeiro trabalho publicado (Mysterium cosmographicum), prova a superioridade da astronomia moderna (a de Nicolau Copérnico (1473-1543)) da astronomia antiga (a de Ptolomeu (90-168 (...) d.C.)). Ao mesmo tempo, Galileu Galilei (1564-1642), que detém a cadeira de matemática da Universidade de Pádua, funda o método experimental. As descobertas de Galileu tiveram forte impacto sobre o Colégio Real de La Fleche, realizado pelos jesuítas e onde Descartes recebeu, a partir de 1606, uma forte educação. Ele menciona, no Discurso do Método, seu “desejo extremo” em aprender, seguido, no final de seus estudos, de uma grande decepção: decepção com a filosofia ensinada, cujas controvérsias perpétuas revelam um caráter questionável, e que não pode fornecer um alicerce, em seu estado atual, para outras ciências. Também é proferido um desapontamento, mas esse desapontamento é inverso e diz respeito às matemática, capaz de fornecer esse fundamento que a filosofia não confere, mediante sua certeza e evidências, mas sobre o qual ainda não construímos nada. -/- -/- Numa Europa marcada pelo choque do tradicionalismo católico e do mercantilismo protestante, o lento declínio do poder espanhol e a luta dos Países Baixos pela sua independência, Descartes escolheu, primeiramente, após a graduação, a carreira militar. Engajado no exército do Príncipe Maurício de Nassau, ele é retirado da ociosidade da vida da guarnição pelo encontro, em 1618, de um jovem cientista holandês, Isaac Beeckman (1588-1637), que se tornou seu amigo íntimo por algum tempo. Conhecedor de todas as pesquisas científicas do momento e partidário da nova concepção “mecanicista” da natureza, Beeckman compartilhou com Descartes um entusiasmo que foi acompanhado, segundamente, da ambição de realizar a ciência universal por si mesma, mediante um método único: na noite de 10 de novembro de 1619, ele concebe em três “sonhos”, “os alicerces de uma ciência admirável”. -/- Nos anos seguintes a essa iluminação decisiva, Descartes viajou por toda a Europa, estimando, como Michel de Montaigne (1533-1592), que a demonstração de boas maneiras e costumes diferentes podem gerar muitos preconceitos. Toda sua vida, além disso, esteve vagando, isto é, foi marcada por múltiplas mudanças de residências, e a recusa de estabelecer um vínculo muito de perto com alguém. Foi na Holanda que ele, finalmente, buscará a tranquilidade que não encontrara na França ainda abalada pelas guerras religiosas, antes de ser assim pelas convulsões da Fronda. Todavia, mesmo na Holanda, ele não pôde evitar os ataques de calvinistas e polemicas teológicas que o repugnaram, como evidenciado em suas discussões com a Universidade de Utrecht entre 1643 à 1645 e a Universidade de Leiden em 1647. -/- -/- Além de sua amizade com Beeckman, outro encontro teve uma influência indubitavelmente decisiva sobre o destino de Descartes: o encontro com o cardeal de Bérulle. Fundador da congregação do Oratório (ao qual pertencem Nicolas Malebranche (1638-1715) e Jean-Baptiste Massillon (1663-1742)), o cardeal de Bérulle enxerga na nova física mecanicista, um meio de lutar contra o naturalismo resultante do Renascimento e seu paganismo latente: em uma longa entrevista com Descartes, no outono de 1647, ele fez dessa última uma obrigação de consciência para se dedicar, nesse sentido, à filosofia. -/- Em 1628, Descartes começa a escrever as Regras para a direção do espírito, um tratado inacabado e que não foi publicado durante a vida do autor. Em 1631, desenvolvera a geometria analítica que combina curvas geométricas com equações algébricas. Em 1633 escreveu O Tratado do Homem e preparava-se para publicar O Tratado do Mundo quando a notícia da condenação de Galileu Galilei pelo Santo Ofício (a Inquisição) o deixou receoso e decide, por prudência, não publicar o seu Tratado no qual a tese do movimento da Terra ao redor do Sol é apoiada. Alguns anos depois, foi divulgado em público cultivada de algumas de suas descobertas científicas: além da geometria, a dioptria (a teoria da refração da luz) e meteoros (teoria dos fenômenos atmosféricos luminosos). Esses três tratados aparecem no apêndice do Discurso do Método, e como “ensaios” desse método, em 1637. No século XIX, Victor Cousin (1792-1867) publicou pela primeira vez o Discurso sozinho, sem os ensaios. -/- Então vem a principal obra de Descartes no ramo da metafísica: as seis Meditações, aumentadas pelas objeções dos mais famosos filósofos da época (incluindo Thomas Hobbes (1588-1679), Antoine Arnauld (1612-1694) e Pierre Gassendi (1592-1655)), e as respostas a essas objeções, apareceram em 1641. Ansioso para expor sua filosofia para que pudesse ser ensinada, ele também a caracteriza em forma de manual com os Princípios da Filosofia de 1644. -/- Além dos trabalhos publicados, foi por meio das cartas trocadas com personalidades do mundo erudito que Descartes encontrou a oportunidade de esclarecer vários pontos de sua filosofia. Seus principais correspondentes foram o Prade Marin Mersenne (1588-1648), o Padre Denis Mesland (1615-1672), Pierre Chanut (1601-1662), Claude Clerselier (1614-1684), Christiaan Huygens (1629-1695) e Henry More (1614-1687). A partir de 1643, Descartes sustentou, com a Princesa Isabel da Boêmia (1596-1662), uma correspondência dedicada essencialmente a questões morais, que lhe permitiu a formulação de suas ideias nesse campo: esse esforço conduziu, em 1649, ao tratado das Paixões da alma. -/- Nesse mesmo ano, 1649, a Rainha Cristina da Suécia (1626-1689) o convida para ir a Estocolmo, que ele aceitou após muita hesitação. Recebido com todas as honras, mas forçado a um modo de vida bastantemente distinto daquele que era acostumado, e submetido a um clima do qual não se adequou, ele sucumbiu a pneumonia em fevereiro de 1650. -/- Descartes deixou-nos uma espécie de autobiografia intelectual na primeira parte do Discurso do Método: em seus anos de treinamento, seus entusiasmos e suas decepções. O discurso é, também, o primeiro livro para quem busca compreender o projeto filosófico cartesiano desde sua gênese até sua realização. Existem expostos, o método claro (na segunda parte), mas também a moral (terceira parte), a metafísica (quarta parte) e finalmente a física (quinta e sexta partes). (shrink)

Objective: The objective of this study was to evaluate the clinical efficacy and appropriateness of colistin therapy in patients with hematological malignancies. -/- Methods: Age, gender, type of hematologic malignancy, and potential carbapenem-resistant microorganism risk factors were all noted in this retrospective study. In empirical and agent-specific treatment groups, differences in demographic features, risk factors, treatment responses, and side effects were compared. -/- Results: Sixty-three patients were included, 54% were male, and the median age was 49. In the last three (...) months, the hospitalization rate history was 68%, and four patients had a hospitalization history in the ICU. Carbapenem-resistant K. pneumoniae colonization was present in 22 patients (35%). Gram-negative microorganisms were isolated in 34 patients (54%). The carbapenem, quinolone, and colistin resistance rates were 82%, 76%, and 4% respectively. Clinical and microbiological response rates were 60% and 69%. 7 and 28-day mortality rates were 17% and 35%. There was no significant difference in demographic data and comorbidities in empirical (n=48) and agent-specific (n=15) treatment groups. The rate of carbapenem and glycopeptide treatments before colistin was higher in the empirical treatment group (p = 0.004; p = 0.001). The rate of starting combined antibiotics was higher in the empirical treatment group (p = 0.016). Two of the patients developed renal failure in the first week after treatment. -/- Conclusion: The use of empirical colistin may be unavoidable given the risk considerations. Shortly, colistin-resistant strains may also be a factor affecting treatment success negatively. (shrink)

Today the whole world is facing a very difficult time due to corona virus which initially originated in Wuhan city of China. In China an unusual pneumonia was noticed earlier which later recognized as a pandemic. There have been two events in the past wherein crossover of animal corona viruses to humans has resulted in severe disease, one was SARS-CoV and the other was MERS-CoV. The genetic sequence of the COVID19 showed more than 80% similarities to SARS-CoV and 50% (...) to the MERSCoV. Corona viruses are enveloped positive sense single-stranded RNA virus belongs to a large family in which all strains of the family do not have virulent capacity. World Health Organisation has classified COVID-19 as a β CoV of group 2B. Structurally, SARS-CoV-2 has four main structural proteins and several accessory proteins through which it enters into the cell. This virus enters the through ACE2 receptors, which are found on various organs in human body. After entering into one body, it enters to another body via transmission through sneezing, coughing etc. People who have had diabetes, chronic respiratory disease, cardiovascular disease, or even high blood pressure and cancer are at higher risk of coronavirus. (shrink)

Introduction: There is no study investigating the factors predicting postoperative febrile urinary tract infection (fUTI) in pediatric patients. We aimed to determine the factors predicting postoperative fUTI in pediatric patients who underwent ureterorenoscopic lithotripsy (URS-L). -/- Methods: Pediatric patients who underwent URS-L due to ureter or kidney stones in our clinic between 2012 and 2019 were analyzed retrospectively. The demographic data, stone characteristics, intraoperative and postoperative data of those with and without postoperative fUTI were compared. Univariable (...) and multivariable binary logistic regression analysis was performed to determine predictors of fUTI. -/- Results: A total of 136 patients were included in the study. Postoperative fUTI developed in 17 patients (12.5%). History of stone surgery, history of UTI, presence of nephrostomy/D-J stent, type of surgery, operation time, length of stay, and presence of complication except fUTI were found to be significantly different in the fUTI group. In the univariate analysis, history of stone surgery, history of UTI, presence of nephrostomy/D-J stent, type of surgery, operation time, and presence of complication except fUTI were determined as factors predicting fUTI. In multivariate analysis, only the history of UTI was identified as an independent predictive factor. -/- Conclusion: In pediatric patients, infectious complications constitute the majority of complications after URS-L. History of UTI is the only independent factor that predicts postoperative fUTI after URS-L. (shrink)

Nos meses de Junho/Julho - 2019, houve relatos de vazamento de patógenos do Fort Detrick, instalação do Comando Médico do Exército dos EUA, conhecido por desenvolver armas biológicas e que abriga um dos muitos laboratórios BSL-4 do país. Em agosto de 2019, a instalação foi fechada para investigação e a imprensa não teve acesso a informações detalhadas. -/- Em setembro de 2019, um vírus mortal começou a se espalhar nos EUA infectando 26 milhões de pessoas naquele outono, com pelo menos (...) 250.000 hospitalizadas e 20.000 mortes. Posteriormente o Dr. Robert Redfield, diretor do Centro de Controle e Prevenção de Doenças dos EUA, reconheceu perante o Comitê do Congresso, que algumas mortes por influenza foram mais tarde diagnosticadas como de Covid-19. -/- Em 18 de outubro de 2019, dia do início dos Jogos Mundiais Militares em Wuhan, que contou com a presença de militares americanos, a Fundação Bill & Melinda Gates e o Johns Hopkins Center for Health Security em parceria com o Fórum Econômico Mundial, promovem uma simulação de pandemia de coronavírus em Nova York, reunindo líderes empresariais e agentes do governo. -/- Em novembro de 2019, o prefeito de Belleville, Nova Jersey, Michael Melham, passou mal e seu diagnóstico foi uma grave pneumonia posteriormente confirmado como sendo Covid-19. Falei com Michael sobre a veracidade dos fatos e ele me confirmou o diagnóstico. Disse que possui dois testes de anticorpos positivos para a Covid-19. -/- Em janeiro de 2019 a revista Science publicou um artigo questionando a teoria oficial de que o vírus havia sido transmitido de um animal para um ser humano no mercado de Wuhan e outro estudo publicado na revista The Lancet, concluiu que 13 das primeiras 41 pessoas diagnosticadas com Covid-19 não tiveram nenhum contato com o mercado de Wuhan, além disso, o Dr. Daniel Lucey, professor de doenças infecciosas da Georgetown University Medical Center, disse baseado em evidências, que o "paciente zero", foi infectado antes de dezembro de 2019, mais precisamente entre outubro e início de novembro de 2019, mas o diagnóstico era de pneumonia e assim o vírus começou a se espalhar por Wuhan. -/- Agora, não é porque o novo coronavírus surgiu na China, que sua origem seja o laboratório de Wuhan, a gripe espanhola por exemplo, se disseminou no mundo a partir da Europa matando 50 milhões de pessoas e sua origem estava no Fort Riley, em Kansas, EUA. (shrink)

Introduction: Respiratory distress (RD) is a major emergency to which infants are particularly vulnerable. It can lead to neurological sequelae and even death when treatment is not adequate and rapid. Objective: To evaluate the management of RD in infants at the CNHU-HKM in Cotonou. Methods: The study was of a transversal and analytical nature and took place over a period of 06 months, from 1st January to 30th June 2015. Included in the study were all infants hospitalised for DR. The (...) therapeutic modalities were analysed according to the recommendations of the World Health Organization. Results: A total of 96 infants were included. The hospital frequency of DR was 38%. The average age was 12 months. One in 3 infants had SaO2 less than 90% on admission, and in 58.3% of cases, the infant showed at least 3 signs of struggle. The initial assessment was as recommended. The systematic use of oxygenrequires a revision of the criteria for oxygentherapy in the unit. The three main causes were severe pneumonia (31.3%), severe malaria (18.8%) and bronchiolitis (15.6%), and their treatment was correct. However, none of the infants had been able to benefit from ventilatory support. Mortality was high (31.2%) linked to the intensity of DR (p = 0.04) and sepsis (p = 0.006). Conclusion: The procedures for the diagnosis and treatment of RD in infants at the CNHU are fairly consistent with WHO guidelines. Ventilatory support is necessary for some children with severe RD. (shrink)

Coronavirus disease (Covid-19) is an infectious disease caused by the SARS-CoV-2 virus. Spreading rate of mutated corona virus (delta variant) during second wave was very fast. Most of the people infected with the COVID-19 virus experienced mild to moderate to severe respiratory illness. Although patients in the second wave were younger but the duration of hospitalization and case fatality rate were lower than those in the first wave. During first wave of Covid-19 it was observed that persons above 55 years (...) of age and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease and cancer were more susceptible to develop serious illness but in second it was observed that person between 30 to 55 years along with old age and younger people suffering from hypertension, diabetes and respiratory diseases were more susceptible to this covid-19 virus. The most frequent signs and symptoms in both waves were fever, dyspnea, pneumonia, and cough, and the most relevant comorbidities were cardiovascular diseases, type 2 diabetes mellitus, and chronic neurological diseases. Every country has lost its human resources due to covid-19 virus which not only disturb the social life but economic conditions are also very badly affected. Now we use the resources so rapidly that may create economic imbalance in future. The psychological effect is an essential component of disaster management of infectious pandemics. (shrink)

Objective: microRNAs (miRNAs) have important potential as biomarkers in the diagnosis and prognosis of ischemia/reperfusion (I/R) injury in coronary artery bypass grafting surgery (CABG). This study investigated the relationship between preoperative (preop) and postoperative (post-op) cardiac parameters and miRNA expressions in CABG. -/- Methods: We analyzed a total of 94 individuals (CABG, n= 46 and healthy control, n=48). Quantitative real-time polymerase chain reaction (qRT) was performed to determine plasma miRNA expressions (miR-21, miR-181a, miR-199a, miR-199b, and miR-320a-5p) in triplicates: before (...) surgery, 1 hour after surgery, and 24 hours after surgery. The target genes and pathways of miRNA were determined using bioinformatic analysis. The biomarker potentials of miRNAs were evaluated with receiver operating characteristic (ROC) curve analysis. -/- Results: All miRNAs were significantly downregulated (p < 0.05). Troponin I, LVEF, CPK, and CK-MB were found to be statistically significant for operation groups (p < 0.05). miRNA expressions and cardiac markers were associated with troponin I and/or CK-MB. In ROC analyses, miR-199a was a good diagnostic marker. CREBRF and ZNF704 genes may be a target for these miRNAs. -/- Conclusions: Downregulation of miR-199a has a regulatory role in ischemia/reperfusion. They may contribute to CABG pathology through these two genes involved in signaling cascades to turn on protein response and ion binding. (shrink)

Amyand’s hernia refers to the condition in which an inflamed, perforated, or normal appendix is present in the hernia sac. It accounts for 1% of all inguinal hernias and its preoperative diagnosis in patients is difficult. A 67-year-old male patient who underwent right-sided inguinal hernia repair with a mesh approximately 2 years before at another healthcare center was referred to our clinic with complaints of pain in his right inguinal area and swelling, which became evident while coughing or straining, for (...) approximately 2 months. A surgical procedure to repair his recurrent inguinal hernia was planned, and appendiceal tissue was observed in the hernia sac during the procedure. Appendectomy was not performed because the appendix was observed to be normal. Tension-free mesh hernioplasty was performed. The patient was discharged on postoperative day 1, without any complications. Amyand’s hernia is generally intraoperatively diagnosed and is a rare form of hernia with no specific symptoms. In this case report, we showed that despite the patient undergoing a surgical procedure, the appendix was present in the hernia sac because of recurrence, and we aimed at reviewing Amyand’s hernia with the literature. (shrink)

Objective: During the pandemic, elective cases other than those requiring emergency thoracic surgery were postponed. Depending on the magnitude of the impact the pandemic posed on hospitals and clinics, there have been changes in the number and variety of cases of thoracic surgery. The intention behind conducting this study was to share the experiences gained by a thoracic surgery clinic during the pandemic period. Methods: Altogether, 214 patients were included in the study. Patient data that were recorded included those on (...) age, gender, lung pathology, duration of hospital stay, positivity for COVID-19, survival, and causes of death. Results: Of the 214 patients operated on, 12 died during the postoperative period. Eight of these patients died due to their primary disease and one died due to gastrointestinal bleeding, whereas the remaining three patients died due to COVID-19 infection. Conclusions: If opportunities and facilities favorable for the administration of surgical treatment are made available, surgical treatment services can be offered safely to all patients. (shrink)

Introduction: Liposomal bupivacaine (LB) is a long-acting analgesic that, due to its liposomal formulation, purportedly extends its analgesic effect up to 72 hours. However, the clinical efficacy of LB appears mixed. This systematic review seeks to evaluate the effectiveness of liposomal bupivacaine in improving postoperative outcomes compared to ropivacaine (ROPI), another commonly used long-acting analgesic. -/- Materials and Methods: Prospective and randomized controlled trials (RCTs) evaluating the efficacy of LB compared to ROPI were selected for review. Primary outcomes included (...) hospital length of stay (LOS) and postoperative opioid consumption measured in oral morphine equivalents (OME). Secondary outcomes included analgesic cost. -/- Results: 14 studies met the review criteria. We found that LB and ROPI are equivalent in managing postoperative pain. 8 of the 14 trials reported equal efficacy between LB and ROPI as determined by OME post-procedure and 10 of the 14 trials reported similar LOS after surgery. These findings remained consistent across multiple surgical procedures and multiple drug administrative modalities. -/- Conclusion: Our systematic review found that LB was not superior to ROPI in reducing postoperative OME use and hospital LOS. The only consistent finding was the significantly increased cost of LB compared to that of ROPI. Therefore, the use of LB over ROPI cannot be justified. (shrink)

Objective: Otitis media is one of the most common ear disorders occurring in childhood, which causes alterations in communication between parents and children, thereby having a significant effect on the health-related quality of life. Otitis Media-6 questionnaire (OM-6) is a Likert-type scale used to assess the health-related quality of life in children with otitis media. In this study, our aim was to create a consistent, reliable, and valid Turkish version of the OM-6. Methods: Children with otitis media presenting with effusion (...) and healthy children were enrolled in this study between February 2019 and September 2019. The OM-6 test was administered to three different groups, including preoperative, postoperative, and control, among the children who had undergone ventilation tube insertion operation and among the healthy children. Results: The overall scores of children with otitis media presenting with effusion exhibited a changing pattern, indicating a statistical significance in the evaluation of the health-related quality of life. The Turkish version of OM-6 includes the scores of construct validity (Spearman values between 0, 58-0, 89), internal consistency (Cronbach’s alpha values between 0, 88-0, 96), and reliability (Pearson correlation value between 0, 67-0, 91). These scores exhibited a statistical significance. Conclusion: The Turkish version of OM-6 is a stable, valid questionnaire with internal consistency. (shrink)