Role of Sub-Silicone Oil Application of Triamcinolone Acetonide (TA) Drops on Outcomes After 360° Relaxing Retinectomy in Extreme Proliferative Vitreoretinopathy Cases- A Pilot Study.

Purpose: To perform a pilot study to evaluate the role of sub-silicone oil Triamcinolone Acetonide (TA) crystal drops in complex Retinal Detachment (RD) with extreme proliferative vitreoretinopathy (PVR) requiring 360-degree relaxing retinectomy (RR). Design: It was a retrospective pilot studyMaterials & methods : It was a retrospective, case-control pilot study. TA assisted 23G or 25G vitrectomy was done in 24 complex RDs with extreme PVR where 360 degree RR had to be performed. Group A (n=13) included cases where additional TA crystal drops were applied, after settling the detached retina, over the site of RR under silicone oil (SO 5000 cSt) tamponade. In control arm, group B (n=11), additional TA crystals were not applied. Main outcomes measured : Mean pre and post operative BCVA, ultra-widefield retinograph by Optos 200Tx, macular OCT and the propensity to remove silicone oil were measured. Results: Mean preoperative and postoperative BCVA at final follow up were Log MAR 2.69 (20/9795) ± 0.41 and Log MAR 1.51 (20/647) ±0.90 (p<0.05) respectively in Group A and Log MAR 2.9 (20/15886) and Log MAR 2.37 (20/4688) ±0.86 (p<0.05) respectively in group B. Visual improvement in group A was significantly better than group B (two-sample t-test, p<0.05) with significantly less recurrence of RD (Fisher’s Exact Test, p=0.002). Silicone oil removal was done significantly more in group A (Fisher’s Exact Test, p=0.0017). Conclusion: Sub-silicone oil TA crystals application over sites of RR after 360-degree relaxing retinectomy leads to improved postoperative visual recovery as well as improved anatomical outcomes with fewer complications.

A Cross Sectional analysis on the Impact of COVID-19 Pandemic on Plastic Surgery among Plastic Surgeons in India

Background: The COVID-19 pandemic reduced the amount of elective procedures dramatically. We, as healthcare workers, are at grave danger of contracting COVID-19. It is consequently critical for plastic surgeons to maintain their safety while attempting to resume routine activities as soon as possible. The goal of this research is to learn more about plastic surgery practises during the COVID-19 pandemic. We plan to serve as many people as possible while conserving medical resources for future crises. Objective: To study the impact of COVID-19 pandemic on plastic surgery among plastic surgeons in India Materials and Methods: A cross-sectional study was carried out using a questionnaire. The study population is made up of plastic surgeons, and the study location was chosen from several hospitals in India. The study duration was 6 months. Data was obtained using the snowball sampling method using a pre-tested, semi-structured questionnaire with 27 questions. The data was entered into an excel spreadsheet and analysed with SPSS version 16 software, with Fisher's exact test used for statistical analysis. Results: A total of 61 participants were included in the study. The majority (60.7%) do not work in COVID-19 care in their hospital but the majority of the participants who took part in this study work in a hospital which is recognised as a COVID-19 centre for treatment (65.6%). 31 participants in their working hospitals there are more than 100 COVID-19 patients are being treated currently in Intensive Care Unit (ICU) and covid ward (50.8%) and but majority of the participants do not work in COVID-19 centre (60.7%). The Association between centres having separate wards for COVID and non-COVID patients and whether plastic surgeons working in COVID-19 centre on applying fisher’s exact test the p-value was found to be 0.215. The Association between centres having separate wards for COVID and non-COVID patients and practicing microsurgery during this pandemic on applying Fisher’s exact test the p-value was found to be 0.884. The Association between screening patients for COVID during emergency and group of patients operated without waiting for COVID report during emergency on applying Fisher’s exact test the p-value was found to be 0.408 Conclusion: The current study demonstrates how the COVID-19 epidemic has affected the plastic surgery department and imposed restrictions. Plastic surgeons should be kept up to speed and informed on the latest information and techniques for treating this problem, as well as infection prevention and control. Using online lectures and webinars to continue education for young plastic surgery trainees is beneficial during this time.

ACADEMIC STATUS OF THE COACH AND TEAM PERFORMANCE IN THE KENYAN NATIONAL SOCCER AND VOLLEYBALL LEAGUES

Purpose: The study sought to establish whether academic status of the coach predicted team performance in the Kenyan national soccer and volleyball leagues. Methodology: The Cross-Sectional survey used a population of the 53 head coaches handling team in the Kenyan soccer and volleyball leagues in the 2020-2021 season. Census sampling was used to pick the 53 coaches for the study. Data collection instrument was a self-administered questionnaire. The Leadership Scale for Sport questionnaire (LSS) was used to capture player’s perception on coach competence. The coaches’ questionnaire was divided into sections which captured demographics and academic background. The study used Statistical Package for Social Sciences (SPSS Version 22) for data analysis. Information was organized and presented using descriptive statistics and was analyzed at 0.05 significance level. Chi-Square and Fisher’s Exact test was used to predict coach academic status on the team’s performance. Data was projected in figures and tables and relevant discussions were made. Findings: Chi square and Fisher’s Exact Test results showed that coaches academic status had a significant effect on team performance (χ2 =18.419, 0.031 ≤ p 0.05 9df). The fisher’s exact test had a p value of 0.016 which was also less than 0.05 confirming that there was a significant relationship between coaches’ academic status and team performance. Conclusion and Recommendation: The study concluded that coaches’ academic status had a significant effect on team performance. Team managers, owners and other stake holders in sports need to take up educated coaches. This is because educated coaches learn a diverse way of communication including humor, which in turns benefits communication between coaches and players which enhances team performance in the long run. In addition, coaches that are not educated need to go back to school and further their education. This will enable them to gain more skills that will be help in their teams’ performance.

Superior Verbal Memory Outcome After Stereotactic Laser Amygdalohippocampotomy

Objective: To evaluate declarative memory outcomes in medically refractory epilepsy patients who underwent either a highly selective laser ablation of the amygdalohippocampal complex or a conventional open temporal lobe resection.Methods: Post-operative change scores were examined for verbal memory outcome in epilepsy patients who underwent stereotactic laser amygdalohippocampotomy (SLAH: n = 40) or open resection procedures (n = 40) using both reliable change index (RCI) scores and a 1-SD change metric.Results: Using RCI scores, patients undergoing open resection (12/40, 30.0%) were more likely to decline on verbal memory than those undergoing SLAH (2/40 [5.0%], p = 0.0064, Fisher's exact test). Patients with language dominant procedures were much more likely to experience a significant verbal memory decline following open resection (9/19 [47.4%]) compared to laser ablation (2/19 [10.5%], p = 0.0293, Fisher's exact test). 1 SD verbal memory decline frequently occurred in the open resection sample of language dominant temporal lobe patients with mesial temporal sclerosis (8/10 [80.0%]), although it rarely occurred in such patients after SLAH (2/14, 14.3%) (p = 0.0027, Fisher's exact test). Memory improvement occurred significantly more frequently following SLAH than after open resection.Interpretation: These findings suggest that while verbal memory function can decline after laser ablation of the amygdalohippocampal complex, it is better preserved when compared to open temporal lobe resection. Our findings also highlight that the dominant hippocampus is not uniquely responsible for verbal memory. While this is at odds with our simple and common heuristic of the hippocampus in memory, it supports the findings of non-human primate studies showing that memory depends on broader medial and lateral TL regions.

HUBUNGAN ANTARA PENGETAHUAN IBU TENTANG IODIUM DENGAN KETERSEDIAAN GARAM BERIODIUM DI RUMAH TANGGA

Latar Belakang. Iodium merupakan mikronutrien penting terutama bagi perkembangan otak janin dan anak. Iodium berperan untuk proses pertumbuhan dan perkembangan sebagian besar organ terutama otak. Konsumsi iodium yang rendah dalam jangka panjang merupakan salah satu faktor yang dapat menyebabkan gangguan akibat kekurangan iodium (GAKI). Tingkat pengetahuan mengenai GAKI dan garam beriodium berpengaruh terhadap ketersediaan dan praktik penggunaan garam beriodium. Pemerintah telah mengupayakan penanggulangan GAKI melalui fortifikasi garam dengan iodium. Tujuan. Penelitian ini bertujuan untuk menganalisis pengetahuan ibu tentang iodium dengan ketersediaan garam beriodium di rumah tangga dan faktor yang memengaruhinya. Metode. Penelitian ini merupakan penelitian cross-sectional. Data diambil dari 198 rumah tangga menggunakan teknik proportional stratified random sampling. Penilaian pengetahuan ibu dilakukan dengan menggunakan kuesioner dalam bentuk pertanyaan tertutup. Sementara itu, penilaian ketersediaan garam diperoleh dengan pengujian kandungan iodium (KIO3). Uji statistik yang digunakan adalah chi-square test/fisher’s exact test dan Mann Whitney U/Kruskal Wallis untuk mengetahui hubungan antar variabel. Hasil. Sebagian besar responden tinggal di daerah dataran tinggi (74,2%), berpendidikan SD (47,5%) dan bekerja sebagai petani (41,4%). Karakteristik lokasi geografi tempat tinggal responden berhubungan dengan pengetahuan responden mengenai GAKI serta dampak dan faktor risiko GAKI (p=0,023 dan p<0,001), sedangkan pekerjaan responden berhubungan dengan pengetahuan mengenai dampak dan faktor risiko GAKI (p=0,020). Tidak ada hubungan antara pengetahuan dengan pemenuhan syarat mutu kandungan KIO3 pada garam yang digunakan di rumah tangga. Namun ada kecenderungan responden yang mempunyai garam dengan KIO3 sesuai, lebih banyak pada responden dengan pengetahuan yang baik. Kesimpulan. Responden dengan pengetahuan baik lebih banyak yang memiliki garam dengan kadar iodium sesuai standar. Perlu adanya program edukasi mengenai GAKI, penggunaan dan penyimpanan garam beriodium, serta faktor penyebab penurunan kualitas garam di rumah tangga.

Hubungan Pengetahuan Ibu dengan Kelengkapan Imunisasi Dasar pada Balita Usia 1-5 Tahun

Imunisasi merupakan upaya untuk meningkatkan kekebalan tubuh terhadap penyakit infeksi, dapat berupa kekebalan pasif maupun aktif sehingga dapat digunakan sebagai upaya pencegahan yang telah berhasil menurunkan angka kesakitan dan angka kematian penyakit infeksi pada bayi dan anak. Tujuan penelitian ini untuk mengetahui hubungan pengetahuan ibu dengan kelengkapan imunisasi dasar pada balita usia 1-5 tahun, dengan menggunakan metode survei analitik dengan pendekatan cross sectional. Populasi penelitian ini adalah ibu yang memiliki balita usia 1-5 tahun dan tinggal di Lingkungan 01 Rw 03 Kelurahan Ciriung. Sampel dipilih dengan menggunakan teknik simple random sampling dengan jumlah sampel 95 orang. Pengumpulan data menggunakan kuesioner, sedangkan analisisnya menggunakan uji chi square Fisher’s exact test ( ). Hasil analisis univariat menunjukkan sebagian besar responden termasuk kategori usia dewasa awal (88,4%), pendapatan keluarga < UMK (54,7%), pendidikan ≤ SMA (86,3%), memiliki sikap positif (53,7%), mendapatkan imunisasi lengkap (94,7%) dan berpengetahuan baik (92,6%). Hasil analisis bivariat terdapat hubungan antara pengetahuan ibu dengan kelengkapan imunisasi dasar pada balita usia 1-5 tahun dengan p-value = 0,002. Rekomendasi penelitian ini adalah memberikan pendidikan kesehatan mengenai imunisasi dan melakukan penelitian menggunakan metode studi korelasi.

Impact of the COVID-19 Pandemic on road traffic collision injury patterns and severity in Al-Ain City, United Arab Emirates

Background The COVID-19 Pandemic lockdowns restricted human and traffic mobility impacting the patterns and severity of road traffic collisions (RTCs). We aimed to study the effects of the COVID-19 Pandemic on incidence, patterns, severity of the injury, and outcomes of hospitalized RTCs trauma patients in Al-Ain City, United Arab Emirates. Methods We compared the data of two cohorts of patients which were collected over two periods; the Pandemic period (28 March 2020 to 27 March 2021) and the pre-pandemic period (28 March 2019 to 27 March 2020). All RTCs trauma patients who were hospitalized in the two major trauma centers (Al-Ain and Tawam Hospitals) of Al-Ain City were studied. Results Overall, the incidence of hospitalized RTC trauma patients significantly reduced by 33.5% during the Pandemic compared with the pre-pandemic period. The mechanism of injury was significantly different between the two periods (p < 0.0001, Fisher’s Exact test). MVCs were less during the Pandemic (60.5% compared with 72%), while motorcycle injuries were more (23.3% compared with 11.2%). The mortality of hospitalized RTC patients was significantly higher during the Pandemic (4.4% compared with 2.3%, p = 0.045, Fisher’s Exact test). Logistic regression showed that the significant factors that predicted mortality were the low GCS (p < 0.0001), admission to the ICU (p < 0.0001), and the high ISS (p = 0.045). COVID-19 Pandemic had a very strong trend (p = 0.058) for increased mortality. Conclusions Our study has shown that the numbers of hospitalized RTC trauma patients reduced by 33.5% during the COVID-19 Pandemic compared with the pre-pandemic period in our setting. This was attributed to the reduced motor vehicle, pedestrian and bicycle injuries while motorcycle injuries increased. Mortality was significantly higher during the Pandemic, which was attributed to increased ISS and reduced GCS.

Epidemiology, etiology, and diagnosis of health care acquired pneumonia including ventilator-associated pneumonia in Nepal

Epidemiologic data regarding health care acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) from Nepal are negligible. We conducted a prospective observational cohort study in the intensive care unit (ICU) of a major tertiary hospital in Nepal between April 2016 and March 2018, to calculate the incidence of VAP, and to describe clinical variables, microbiological etiology, and outcomes. Four hundred and thirty-eight patients were enrolled in the study. Demographic data, medical history, antimicrobial administration record, chest X-ray, biochemical, microbiological and haematological results, acute physiology and chronic health evaluation II score and the sequential organ failure assessment scores were recorded. Categorical variables were expressed as count and percentage and analyzed using the Fisher’s exact test. Continuous variables were expressed as median and interquartile range and analyzed using Kruskal-Wallis rank sum test and the pairwise Wilcoxon rank—sum test. 46.8% (205/438) of the patients required intubation. Pneumonia was common in both intubated (94.14%; 193/205) and non-intubated (52.36%; 122/233) patients. Pneumonia developed among intubated patients in the ICU had longer days of stay in the ICU (median of 10, IQR 5–15, P< 0.001) when compared to non-intubated patients with pneumonia (median of 4, IQR 3–6, P< 0.001). The incidence rate of VAP was 20% (41/205) and incidence density was 16.45 cases per 1,000ventilator days. Mortality was significantly higher in patients with pneumonia requiring intubation (44.6%, 86/193) than patients with pneumonia not requiring intubation (10.7%, 13/122, p<0.001, Fisher’s exact test). Gram negative bacteria such as Klebsiella and Acinetobacter species were the dominant organisms from both VAP and non-VAP categories. Multi-drug resistance was highly prevalent in bacterial isolates associated with VAP (90%; 99/110) and non-VAP categories (81.5%; 106/130). HAP including VAP remains to be the most prevalent hospital-acquired infections (HAIs) at Patan hospital. A local study of etiological agents and outcomes of HAP and VAP are required for setting more appropriate guidelines for management of such diseases.

KOGNITIF BIDAN TERHADAP PEMERIKSAAN DIASTASIS RECTI PADA IBU NIFAS

Diastasis rectus abdominis dapat terjadi kapanpun pada ibu hamil trimester dua, dampaknya pada ibu post partum yang mengalami diastasis rectus abdominis adalah melemahnya dinding abdomen, mengurangi kontraksi kekuatan otot abdomen dan kestabilan pelvis. Risiko seorang perempuan mengalami diastasis recti ini jauh lebih besar jika ukuran tubuhnya tergolong kecil, mengandung janin kembar, hamil pada usia 35 tahun ke atas, serta berat janin yang besar.Tujuan penelitian ini untuk mengetahui Hubungan kognitif terhadap pemeriksaan diastasis recti pada ibu nifas .Penelitian ini menggunakan pendekatan cross sectional . Populasi pada penelitian ini adalah seluruh tenaga kesehatan ( bidan ) di wilayah kerja UPT Puskesmas Bangsal Kabupaten Mojokerto. Sampel penelitian ini adalah sebagian tenaga kesehatan ( bidan ) yang ada di wilayah kerja UPT Puskesmas Bangsal Kabupaten Mojokerto, jumlah sampel 23 orang . pengambilan sampel pada penelitian adalah simple random sampling dilkasanakan pada bulan Agustus – November 2020. Instrumen pada penelitian menggunakan kuisioner , kemudian dianalisis secara univariat dan bivariat . untuk mengetahui hubungan menggunakan Analisis statistik Fisher’s Exact Test. Berdasarkan hasil penelitian bahwa sebagian besar responden memiliki kognitif yang baik sebanyak 13 ( 56.53 %)dan sebagian besar melakukan pemeriksaan diastasis recti sebanyak 17 ( 73.92%) responden .Berdasarkan uji Analisis Fisher's Exact Test dengan tingkat kemaknaan ( α< 0.05) didapatkan nilai (α = 0,022) menunjukkan bahwa ada hubungan kognitif dengan pemeriksaan diastasis recti pada ibu nifas .Pengetahuan didapat dari informasi sepanjang hidup seseorang. Pengetahuan tenaga kesehatan ( bidan ) tentang pemeriksaan diastasis recti yang mempengaruhi tenaga kesehatan ( bidan ) tersebut untuk melakukan pemeriksaan diastasis recti. Sebagai tenaga kesehatan seyogyanya selalu melakukan pemeriksaan diastasis recti pada ibu nifas yang datang kepelayanan baik di Rumah Sakit , Puskesmas maupun PMB

Hubungan Pengetahuan dan Sikap dengan Pemeriksaan Payudara Sendiri (SADARI) di SMAN 8 Sidrap

Pemeriksaan payudara sendiri (SADARI) merupakan salah satu cara yang efisien dan efektif sebagai pendeteksi dini kanker payudara selain mammografi. untuk mengetahui hubungan pengetahuan dan sikap dengan pemeriksaan payudara sendiri pada remaja putri Kelas 2 dan 3 SMA Negeri 8 Kabupaten Sidrap Tahun 2020. Jenis Penelitian ini merupakan penelitian kuantitatif analitik dengan desain cross sectional dengan dengan menggunakan teknik pengambilan sampel yaitu teknik purposive sampling sebanyak 50 sampel dianalisa dengan menggunakan uji statistik Fisher’s Exact Test. Dari Hasil penelitian diperoleh bahwa variabel pengetahuan dan sikap terdapat hubungan terhadap pemeriksaan payudara sendiri pada remaja putri kelas 2 dan 3 di SMA Negeri 8 Kabupaten Sidrap tahun 2020. Kesimpulan dalam penelitian ini adalah ada hubungan antara pengetahuan dengan pemeriksaan payudara sendiri dan ada hubungan antara sikap dengan pemeriksaan payudara sendiri pada remaja putri kelas 2 dan 3 di SMA Negeri 8 Kabupaten Sidrap. Saran bagi penelitian ini adalah diharapkan kepada peneliti selanjutnya untuk mengambil variabel dan lokasi yang berbeda tentang hubungan pengetahuan dan sikap remaja putri dengan pemeriksaan payudara sendiri pada remaja putri kelas 2 dan 3 SMA.