Case report on bilateral cleft palate with protuded premaxilla

Cleft palate (ICD 10-Q 35.9) with Protruding of premaxilla is common feature in patient with bilateral cleft lip and palate it is due to the under trained growth at anterior nasal septal and vomero-premaxillary suture without lateral continuities. Hippocrates (400BC) AND Galen(150AD) mansion cleft lip, but not cleft palate in their writing, Cleft palate –Fanco.(1556), Repair of cleft lip –as early as 255-206 BC in CHINA. The first successful closure of a soft palate defect was reported in 1764 by LEMONNIERa French dentist.

Reasons for acute referrals to hospital from general practitioners and out-of-hours doctors in Norway: a registry-based observational study

Background General practitioners (GPs) and out-of-hours (OOH) doctors are gatekeepers to acute hospital admissions in many healthcare systems. The aim of the present study was to investigate the whole range of reasons for acute referrals to somatic hospitals from GPs and OOH doctors and referral rates for the most common reasons. We wanted to explore the relationship between some common referral diagnoses and the discharge diagnosis, and associations with patient’s gender, age, and GP or OOH doctor referral. Methods A registry-based study was performed by linking national data from primary care in the physicians’ claims database with hospital services data in the Norwegian Patient Registry (NPR). The referring GP or OOH doctor was defined as the physician who had sent a claim for the patient within 24 h prior to an acute hospital stay. The reason for referral was defined as the ICPC-2 diagnosis used in the claim; the discharge diagnoses (ICD-10) came from NPR. Results Of all 265,518 acute hospital referrals from GPs or OOH doctors in 2017, GPs accounted for 43% and OOH doctors 57%. The overall referral rate per contact was 0.01 from GPs and 0.11 from OOH doctors, with large variations by referral diagnosis. Abdominal pain (D01) (8%) and chest pain (A11) (5%) were the most frequent referral diagnoses. For abdominal pain and chest pain referrals the most frequent discharge diagnosis was the corresponding ICD-10 symptom diagnosis, whereas for pneumonia-, appendicitis-, acute myocardial infarction- and stroke referrals the corresponding disease diagnosis was most frequent. Women referred with chest pain were less likely to be discharged with ischemic heart disease than men. Conclusions The reasons for acute referral to somatic hospitals from GPs and OOH doctors comprise a wide range of reasons, and the referral rates vary according to the severity of the condition and the different nature between GP and OOH services. Referral rates for OOH contacts were much higher than for GP contacts. Patient age, gender and referring service influence the relationship between referral and discharge diagnosis.

Epidemiology and direct healthcare costs of Influenza-associated hospitalizations – nationwide inpatient data (Germany 2010-2019)

Introduction Detailed and up-to-date data on the epidemiology and healthcare costs of Influenza are fundamental for public health decision-making. We analyzed inpatient data on Influenza-associated hospitalizations (IAH), selected complications and risk factors, and their related direct costs for Germany during ten consecutive years. Methods We conducted a retrospective cost-of-illness study on patients with laboratory-confirmed IAH (ICD-10-GM code J09/J10 as primary diagnosis) by ICD-10-GM-based remote data query using the Hospital Statistics database of the German Federal Statistical Office. Clinical data and associated direct costs of hospital treatment are presented stratified by demographic and clinical variables. Results Between January 2010 to December 2019, 156,097 persons were hospitalized due to laboratory-confirmed Influenza (J09/J10 primary diagnosis). The annual cumulative incidence was low in 2010, 2012 and 2014 (1.3 to 3.1 hospitalizations per 100,000 persons) and high in 2013 and 2015-2019 (12.6 to 60.3). Overall direct per patient hospitalization costs were mean (SD) 3521 EUR (± 8896) and median (IQR) 1805 EUR (1502; 2694), with the highest mean costs in 2010 (mean 8965 EUR ± 26,538) and the lowest costs in 2012 (mean 2588 EUR ± 6153). Mean costs were highest in 60-69 year olds, and in 50-59, 70-79 and 40-49 year olds; they were lowest in 10-19 year olds. Increased costs were associated with conditions such as diabetes (frequency 15.0%; 3.45-fold increase compared to those without diabetes), adiposity (3.3%; 2.09-fold increase) or immune disorders (5.6%; 1.88-fold increase) and with Influenza-associated complications such as Influenza pneumonia (24.3%; 1.95-fold), bacterial pneumonia (6.3%; 3.86-fold), ARDS (1.2%; 10.90-fold increase) or sepsis (2.3%; 8.30-fold). Estimated overall costs reported for the 10-year period were 549.6 Million euros (95% CI 542.7-556.4 million euros). Conclusion We found that the economic burden of IAH in Germany is substantial, even when considering solely laboratory-confirmed IAH reported as primary diagnosis. The highest costs were found in the elderly, patients with certain underlying risk factors and patients who required advanced life support treatment, and median and mean costs showed considerable variations between single years. Furthermore, there was a relevant burden of disease in middle-aged adults, who are not covered by the current vaccination recommendations in Germany.

TRANSTORNO MENTAL E COMPORTAMENTAL NO ESTADO DE SÃO PAULO: VARIAÇÕES DA MORTALIDADE E MORBIDADE DE 2017 A 2020

Mental and behavioral disorders are influenced by a combination of factors that affect an individual's emotional balance and affect people of all ages, sex and social classes, although each group has its specificities. The present study aims to determine the prevalence of hospitalizations caused by Mental and Behavioral Disorders (CMD), considering an age group, gender and an ICD-10 morbidity list in the State of São Paulo between the years 2017 to 2020. This research was an ecological study on the prevalence of cases of mental and commercial disorders in the State of São Paulo. Data were collected on the DATASUS platform, where the number of admissions according to gender, age and ICD-10 morbidity list in the 2017-2020 period were surveyed. The results obtained revealed a growing increase in CMD cases in the state, especially from 2018 to 2019 with a subsequent fall in 2020, with, from 2017 to 2020, approximately 58.81% prevalence of CMD in sex and approximately 41.19% prevalence in sex female, mainly affecting people aged 30 to 39 years, higher prevalence of mood in females (67.18%) and CMD due to alcohol use in females (87.89%). It is concluded that amidst the pandemic against COVID-19, several patients considered without a diagnosis of Mental and Behavioral Disorders, because of this, it is possible that after the pandemic there are a greater number than expected of patients with more advanced conditions due to the absence of an early diagnosis.

Dapsone is an anticatalysis for Alzheimer’s disease exacerbation

This study investigated leprosy patients with Alzheimer's disease (AD) treated with dapsone (4,4’-diaminodiphenyl sulfone, DDS) as a cytosolic DNA sensor cyclic-GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway and neuroinflammasome competitor. We searched the Sorokdo National Hospital medical records and the National Health Insurance Service in South Korea with the International Classification of Diseases (ICD)-10 code and Electronic Data Interchange (EDI) from January 2005 to June 2020. Four groups were defined: Treatment (T) 1: DDS prescription (+) AD prevalence (+), T 2: DDS (+) AD nondiagnosed (-), T 3: DDS nonprescription (-) AD (+), T 4: DDS (-) AD (-). The T1:T3 tests demonstrate that the incidence of AD is significantly reduced in the presence of dapsone among AD patients. The T1:T3 tests demonstrate that the incidence of AD is significantly reduced in the presence of dapsone among AD patients. T1 (M = 0.18, SD = 0.074):T2 (M = 0.55, SD = 0.14) and T3 (M = 0.18, SD = 0.074):T4 (M = 0.55, SD = 0.14) explain that dapsone effects on AD can be clearly distinguished according to its presence or absence.The T1:T4 and the T2:T3 test demonstrate a causal relationship in which the presence or absence of dapsone determines the onset of AD. The T1:T3 test proved that the incidence of AD was significantly reduced by dapsone. (The t-value is -23.1, p-value is < .00001, significant at p < .05) The T2:T3 test proved that the prevalence of AD was significantly high without dapsone, and without AD was increased with dapsone. (The t-value is -6.38, p-value is < .00001, significant at p < .05) AD is increased in the absence of dapsone. Our study has demonstrated that dapsone has the potential for the prevention of AD. This study indicates that dapsone is a valid preventive therapeutic for AD. KEYWORD: Neuroinflmmasome, Alzheimer's disease, Dapsone

The Impact of the COVID-19 Pandemic Lockdown on Pediatric Infections—A Single-Center Retrospective Study

Since the SARS-CoV-2 outbreak, many countries have introduced measures to limit the transmission. The data based on ICD-10 codes of lower respiratory tract infections and microbiological analysis of respiratory and gastrointestinal infections were collected. The retrospective five-year analysis of the medical records revealed a substantial decrease in respiratory tract infections during the pandemic year (from April 2020 to March 2021). We noted an 81% decline in the LRTI-associated hospital admissions based on the ICD-10 analysis (from a mean of 1170 admissions per year in the previous four years to 225 admissions between April 2020 through March 2021). According to microbiological analysis, there were 100%, 99%, 87%, and 47% drops in influenza virus, respiratory syncytial virus, rotavirus, and norovirus cases reported respectively during the pandemic season until April 2021 in comparison to pre-pandemic years. However, the prevalence of gastrointestinal bacterial infections was stable. Moreover, in August 2021, an unexpected rise in RSV-positive cases was observed. The measures applied during the COVID-19 pandemic turned out to be effective but also had a substantial contribution to the so-far stable epidemiological situation of seasonal infections.

THỰC TRẠNG HỘI CHỨNG SẢNG Ở NGƯỜI TỪ 60 TUỔI TRỞ LÊN TẠI KHOA CẤP CỨU BỆNH VIỆN LÃO KHOA TRUNG ƯƠNG

Chúng tôi thực hiện nghiên cứu với mục tiêu mô tả thực trạng hội chứng sảng ở người bệnh từ 60 tuổi trở lên tại Khoa cấp cứu bệnh viện Lão khoa Trung ương. Đây là một nghiên cứu mô tả cắt ngang, thực hiện trên 106 bệnh nhân từ 60 tuổi trở lên đến khám và điều trị tại Khoa cấp cứu bệnh viện Lão khoa Trung ương và được chẩn đoán hội chứng sảng theo tiêu chuẩn chẩn đoán của ICD 10. Kết quả: Người bệnh có hội chứng sảng thường gặp là nhóm tuổi 80 – 89, tuổi trung bình là 78,3 ± 10,9, nam giới gặp nhiều hơn nữ giới (52,8% và 47,2%). Phần lớn bệnh nhân đang sống cùng gia đình (68,9%), chỉ có 2 trường hợp sống trong nhà dưỡng lão (1,9%). Đa số người bệnh có biểu hiện suy giảm thị giác (87,7%) và suy giảm thính giác (81,1%). Triệu chứng gặp nhiều nhất là biểu hiện rối loạn định hướng không gian và giảm trí nhớ gần với tỉ lệ là 89,6%. Tiếp đó đến biểu hiện giảm khả năng duy trì sự chú ý (61,3%). Ít gặp nhất là biểu hiện đảo ngược chu kì thức ngủ (24,5%).

ĐIỀU TRỊ RỐI LOẠN SỰ THÍCH ỨNG VỚI PHẢN ỨNG TRẦM CẢM NGẮN

Nghiên cứu được thực hiện với mục tiêu mô tả điều trị rối loạn sự thích ứng với phản ứng trầm cảm ngắn. Bằng phương pháp mô tả cắt ngang ở 66 người bệnh điều trị nội trú tại Viện Sức khỏe Tâm thần Quốc Gia, bệnh viện Bạch Mai, được chẩn đoán chính xác rối loạn sự thích ứng với phản ứng trầm cảm ngắn (F43.20) theo tiêu chuẩn chẩn đoán của ICD 10. Kết quả cho thấy trong nhóm nghiên cứu, Amitriptylin được sử dụng nhiều nhất với liều khởi đầu trung bình là 40,3 ± 23,9 mg/ngày và liều cao nhất trung bình là 75,0 ± 35,4 mg/ ngày. Tiếp theo là Remeron với liều khởi đầu trung bình là 30,0 ± 13,6 mg/ngày và liều cao nhất là 47,6 ± 14,8. Tác dụng không mong muốn thường gặp nhất của nhóm thuốc chống trầm cảm là khô miệng (62,1%)

ĐẶC ĐIỂM LÂM SÀNG RỐI LOẠN SỰ THÍCH ỨNG VỚI PHẢN ỨNG TRẦM CẢM NGẮN

Nghiên cứu đặc điểm lâm sàng rối loạn sự thích ứng với phản ứng trầm cảm ngắn với mục tiêu mô tả đặc điểm lâm sàng rối loạn sự thích ứng với phản ứng trầm cảm ngắn. Bằng phương pháp mô tả cắt ngang ở 66 người bệnh điều trị nội trú tại Viện Sức khỏe Tâm thần Quốc Gia, bệnh viện Bạch Mai, được chẩn đoán chính xác rối loạn sự thích ứng với phản ứng trầm cảm ngắn (F43.20) theo tiêu chuẩn chẩn đoán của ICD 10. Kết quả: phần lớn người bệnh rối loạn sự thích ứng với phản ứng trầm cảm ngắn gặp ở độ tuổi từ 20 – 29 và 30 – 39 với tỉ lệ cùng bằng 27,3%. Tuổi trung bình của nhóm người bệnh này là 33,6 ± 13,9. Sang chấn tâm lý trong nhóm nghiên cứu gặp nhiều nhất là những sang chấn trong công việc/học tập 69,7%. Trong 3 triệu chứng chính của trầm cảm, triệu chứng giảm năng lượng và tăng mệt mỏi là triệu chứng gặp nhiều nhất với tỉ lệ 80,3%. Trong 7 triệu chứng phổ biến của trầm cảm, triệu chứng rối loạn giấc ngủ là triệu chứng thường gặp nhất với tỉ lệ 93,9%. Không gặp triệu chứng có hành vi tự sát. Trong 8 triệu chứng cơ thể của trầm cảm thì triệu chứng tỉnh giấc vào lúc sáng sớm hơn 2 giờ là triệu chứng gặp nhiều nhất với tỉ lệ 93,9%. Ít gặp nhất là triệu chứng chậm chạp tâm thần vận động (39,4%).

Associations Between Canada's Cannabis Legalization and Emergency Department Presentations for Transient Cannabis-Induced Psychosis and Schizophrenia Conditions: Ontario and Alberta, 2015–2019

Objective Cannabis legalization in many jurisdictions worldwide has raised concerns that such legislation might increase the burden of transient and persistent psychotic illnesses in society. Our study aimed to address this issue. Methods Drawing upon emergency department (ED) presentations aggregated across Alberta and Ontario, Canada records (April 1, 2015–December 31, 2019), we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models to assess associations between Canada's cannabis legalization (via the Cannabis Act implemented on October 17, 2018) and weekly ED presentation counts of the following ICD-10-CA-defined target series of cannabis-induced psychosis (F12.5; n = 5832) and schizophrenia and related conditions (“schizophrenia”; F20-F29; n = 211,661), as well as two comparison series of amphetamine-induced psychosis (F15.5; n = 10,829) and alcohol-induced psychosis (F10.5; n = 1,884). Results ED presentations for cannabis-induced psychosis doubled between April 2015 and December 2019. However, across all four SARIMA models, there was no evidence of significant step-function effects associated with cannabis legalization on post-legalization weekly ED counts of: (1) cannabis-induced psychosis [0.34 (95% CI −4.1; 4.8; P = 0.88)]; (2) schizophrenia [24.34 (95% CI −18.3; 67.0; P = 0.26)]; (3) alcohol-induced psychosis [0.61 (95% CI −0.6; 1.8; P = 0.31); or (4) amphetamine-induced psychosis [1.93 (95% CI −2.8; 6.7; P = 0.43)]. Conclusion Implementation of Canada's cannabis legalization framework was not associated with evidence of significant changes in cannabis-induced psychosis or schizophrenia ED presentations. Given the potentially idiosyncratic rollout of Canada's cannabis legalization, further research will be required to establish whether study results generalize to other settings.