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Background. Pharmaceutical care is currently an increasingly common tool facilitating the optimisation of pharmacology. Implementation of pharmaceutical care in collaboration with healthcare units, especially the Primary Health Care (PHC), will result in higher integration of the medical and pharmaceutical professions, resulting in tangible benefits for the patient. Due to this innovative approach, the scope of healthcare services provided by pharmacists has not been thoroughly researched. Objectives. This research investigates the issue of assessing the scope of the services provided within the framework of pharmaceutical care. The paper presents an original concept created by the Medical and Diagnostical Centre in Siedlice, Poland (MCD). Material and methods. The research methodology started with a literature analysis and systematic review. The second stage was brainstorming based on the current practical experiences of the MDC. The research and literature analysis were carried out in electronic databases to identify published studies on the scope of services provided within the framework of pharmaceutical care. Considering the practical and widely discussed nature of the subject, an Internet search was performed as a supplementary strategy to identify articles. The results were then analysed and brainstormed by the managing staff at the MDC. Results. In the research and analysis process, the authors found, named and stated seven types of pharmaceutical services: medication review, medication consultation, pharmaceutical assistance, prophylaxis diagnosis, intervention/urgent visit, patient digitisation, internal pharmaceutical consultation. The above services together comprise the coordinated pharmaceutical care process over a patient. It has been tested in the MDC and is now in the implementation phase. Conclusions. Identification and reinforcement of the scope of the services provided within the framework of pharmaceutical care may have a crucial influence on the quality and effectiveness of patient care. This care is provided by the pharmacy in close cooperation with the ambulatory medical facilities. [ABSTRACT FROM AUTHOR]

Background. The paper deals with the possibilities for implementation of professional competences of physical therapists working in different systems of education and health protection with regard to the holistic health concept, psychophysical education and interdisciplinary collaboration inside rehabilitation teams. Objectives. The main objective of the study was to compare the possibilities for implementation of professional competences of physical therapists working in rehabilitation teams of education and health protection systems. Material and methods. The survey encompassed 200 physical therapists working in the education (n = 98) and health protection (n = 102) systems of Lithuania. A questionnaire-based method employing closed-type questions was used, which was aimed at revealing whether implementation of professional competences of physical therapists working in different systems differed. Results. The competences of communication and collaboration, i.e. interdisciplinary activities inside rehabilitation teams, were more developed by physical therapists working in the education system (t = 23.483, df = 2, p = 0.001). In the process of physical diagnosis, physical therapists of the health system make a diagnosis of physical therapy independently. The same statistically significant difference was also noticed in the aspect of communication of groups of these specialists when psychosocial problems occur, specifically: t = 14.768, df = 3, p = 0.002. Physical therapists of the education system more actively participate in qualification development, delivery of talks at conferences and organising health promotion programmes, even though no statistically significant difference was found (t = 4.830, df = 3, p = 0.185). Conclusions. The competences of interdisciplinary collaboration are more developed by physical therapists working in the education system; whereas physical therapists working in the health system are more concerned with the making of a physical therapy diagnosis, design of a programme and application of more diverse methods. [ABSTRACT FROM AUTHOR]

Background. The current study aimed to investigate the rational drug use characteristics of physicians and the effect of a patient-centered approach on rational drug use. Material and methods. This cross-sectional and descriptive study was conducted with 182 assistant doctors from November 2020 to April 2021 in a university hospital. Rational drug use features are evaluated by World Health Organization (WHO) prescribing indicators. The patient-centered approach of physicians was measured by the Patent-Practitioner Orientation Scale (PPOS-14). Results. The mean number of drugs per prescription in the study was 3.0 ± 1.03. 66.5% of the doctors reported that they prescribed drugs to more than half of their patients. Physicians with high patient-centered approach scores were more likely to “call their patients by their names”, “use more from drug guides”, “follow their patients’ treatment processes”, and showed interest in “interest in rational drug use studies”, and “rational drug use training”. Physicians who prefer ready-to-use prescriptions for common conditions had lower patient-centered approach scores. There was a significant positive correlation between the PPOS-14 total score and the rational drug use score (r = 0.153, p = 0.039), and there was a significant negative correlation between PPSO share and care scores and the average number of drugs per prescription. Conclusions. Physicians with a patient-centered approach were more willing to use rational drugs, follow rational drug guidelines, and receive training on rational drug use. Bringing the patient-centered approach to physicians may improve rational drug use. [ABSTRACT FROM AUTHOR]

Background. Clostridioides difficile infection is the most common diarrheal disease associated with antibiotic use. Treatment includes fidaxomicin, vancomycin, metronidazole, rifaximin, fecal flora transplants, and bezlotoxumab. There are numerous reports of the potential beneficial effects of using probiotics in Clostridioides difficile infection. Objectives. This study aimed to analyze the effects of the use of probiotics on patients with Clostridioides difficile infection who were hospitalized at the University Clinical Hospital in Wroclaw from 2016 to 2018. Material and methods. The study was conducted by analyzing the medical records of patients treated from 2016 to the end of 2018 at the University Clinical Hospital in Wroclaw. We examined the frequency of use of probiotics in Clostridioides difficile infection, differences in the use of probiotics by year of hospitalization, mortality among patients taking probiotics and not receiving this type of treatment, length of hospitalization by probiotic use, and the relationship between the gender of patients and the use of probiotics. Results. 313 patients were enrolled in the study, out of 319 patients total. Almost half of the patients (45.54%) received no probiotic during hospitalization. The most commonly administered probiotics were preparations containing Saccharomyces boulardii, which were received by 24.2% of patients. The use of probiotics did not affect mortality in Clostridioides difficile infection. Patients receiving probiotics were hospitalized longer. There was no significant statistical difference in probiotic use by patient gender. Conclusions. Probiotic use did not reduce the risk of death or shorten the length of hospitalization of patients with Clostridioides difficile infection [ABSTRACT FROM AUTHOR]

Introduction: Due to the increasing incidence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the world, it is necessary to examine the level of knowledge among different parts of population, especially among students, in order to establish remedial preventive interventions. Therefore, the aim of this study was to determine the knowledge, attitude, and practice of dormitory students of Shahid Sadoughi University of Medical Sciences in Yazd towards HIV/AIDS. Material and methods: This descriptive, cross-sectional study was performed among 658 dormitory students of Shahid Sadoughi University of Medical Sciences in 2019, who were recruited through multistage sampling. A valid and reliable questionnaire was used to collect students' data. SPSS version 22 was employed to analyze the data. Results: In total, 59.9% of students had high knowledge level. There was a significant association between students' knowledge and gender, field of study, and grade point average of the last half year. Positive/neutral attitude was observed among 77.7% of the students. Age and sex had a significant association with attitude. A total of 32 students (4.9%) had experienced extra-marital sex, and 9.4% of them were condom ever users during sexual contacts. Conclusions: The results revealed relatively high knowledge and neutral to positive attitude about HIV/AIDS among dormitory students. However, preventive measures among participants with highrisk behaviors were not properly employed. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of acquired immune deficiency syndrome (AIDS) requires proper awareness and attitude towards the disease, and ways of transmission and prevention. This study aimed to investigate the awareness and attitude of students at Kurdistan University of Medical Sciences and University of Kurdistan towards AIDS in 2020. Material and methods: This was cross-sectional, descriptive-analytical study. The study population was students at Kurdistan University of Medical Sciences (MUK) and University of Kurdistan (UOK) in 2020. 369 students were selected based on relative sampling. Data collection tool was international AIDS questionnaire (IAQ). Independent t-test and analysis of variance were applied for analysis. Results: The total IAQ score among students of MUK (75.38 ± 7.66) was higher than that of UOK students (71.17 ± 8.52) (p = 0.023). Although the total score in men (74.04 ± 8.14) was slightly higher than women (72.71 ± 8.50), there was no significant difference (p = 0.13). The difference in the scores of students living in single house with students living with their parents (p = 0.002) and students living in dormitories (p = 0.006) was statistically significant. The average score of undergraduates was the lowest, and doctorates the highest (p = 0.035). Conclusions: In light of the need to increase the awareness of ways of AIDS transmission, and appropriate attitudes towards people living with HIV/AIDS, with a focus on non-medical students, schemes should be designed and implemented to raise awareness and attitudes among people. [ABSTRACT FROM AUTHOR]

Background. Not only causing major implications on physical medicine, COVID-19 had changed the landscape in psychiatric medicine. The world is facing an impending surge of psychiatric disorders, and the early signs are now clearer than ever. These early signs might help psychiatrist and physicians, in general, to more accurately analyse, diagnose and treat these psychiatric disorders. Objectives. To report the epidemiological and clinical characteristics of COVID-19 patients who experience psychiatric symptoms. Material and methods. The data was collected by secondary data in the form of medical records from patients treated at Udayana University Hospital within the period April 2020 to March 2021. Results. Patients with psychiatric disorders admitted to this hospital (n = 94) had a mean age of 48.5 (SD ± 14.5) years of age, with males constituting 51.1%. The psychiatric diagnoses found were insomnia (44.7%), adjustment disorder (26.6%), anxiety disorder (16.0%), depression (6.4%), psychosis (4.3%), bipolar disorder (3.2%), as well as delirium, acute stress reaction and schizophrenia at 2.1% each. These patients had a mean duration of hospitalisation of 13.2 (SD ± 6.1) days. The hospital recorded a fatality rate of 7.4% in this particular element of patients, higher than the fatality rate observed in those of the whole population. Conclusions. The first year of the COVID-19 pandemic in Indonesia, though not directly implying, was a warning sign of the impending surge of the number of psychiatric diagnoses in the future. These psychiatric patients are not to be left alone and ignored, as they suggest a possible increase in fatality rate. [ABSTRACT FROM AUTHOR]

Purpose: To determine the dosimetric impact of brachytherapy applicator displacement during intracavitary (IC) and combined intracavitary/interstitial (IC/IS) high-dose-rate brachytherapy in the treatment of cervical cancer. Material and methods: Data from 27 consecutively treated patients undergoing IC or IC/IS high-dose-rate brachytherapy with tandem and ovoid-based applicators at a single academic medical center were analyzed. Virtual applicator displacements (a single shift of whole applicator with tandem/ovoid/associated needles) of 0 (clinical position), 2, 5, 7, and 10 mm in the inferior direction were modeled on treatment planning CT or MRI scans, with maintaining the same dwell times. Radiation dose to target volumes (D90 of high-risk clinical target volume) and organs at risk (OARs) (D0.1cc, D1cc, and D2cc of bladder, rectum, and sigmoid) were calculated for each virtual applicator shift, and significance of displacements was assessed using general linear model and Kruskal-Wallis test. Results: Mean dose to high-risk clinical target volume (HR-CTV) D90 was 95.7%, 88.9%, 84.6%, and 77.1% of the prescribed dose in clinical position with displacements of 2, 5, 7, and 10 mm, respectively. Rectal D2cc significantly increased by 28% and 44% at displacement of 7 mm and 10 mm, respectively. IC/IS cases showed relatively greater dosimetric differences than IC cases, with HR-CTV D90 doses of 94.4%, 85.8%, 80.4%, and 72.4% at virtual displacements of 2, 5, 7, and 10 mm, respectively. Conclusions: Applicator displacements of 5 mm or greater result in statistically significant and clinically meaningful decreases in radiation dose to HR-CTV during 3-dimensional high-dose-rate brachytherapy treatment planning, with corresponding increase in radiation dose to the rectum. IC/IS applicator displacements lead to relatively greater differences than those of IC applicators. [ABSTRACT FROM AUTHOR]

Background. Cardiovascular diseases (CVD) are chronic diseases that can be asymptomatic for a long time, and the first symptom may be sudden death. Objectives. This study was designed to draw attention to the frequency of both individual and occupational cardiovascular risk factors and to warn health professionals about variable risk factors. Material and methods. This research was conducted between 01.03.2022–01.09.2022. 160 participants were included in the study. The questionnaire form in which sociodemographic data was asked, the international physical activity questionnaire (short) form and the work stress scale form were directed to the participants. Blood pressure, height, weight and waist circumference were measured, and CVD risks were calculated using the SCORE (Systematic Coronary Risk Evaluation) 2 cardiovascular risk estimation algorithm. Results. Medium, high and very high CVD risks were determined in 41.8% of the employees. The risk was found to be significantly different among occupational groups (p < 0.001) and economic status (p = 0.036). Considering the relationship between shift work status and CVD risk, the risk was found to be significantly higher in those working only during day shifts compared to those working during alternating day and night shifts (p = 0.033). It has been shown that work stress does not increase the CVD risk of healthcare workers (HCW) (p = 0.857). However, it was observed that work stress significantly increases LDL and total cholesterol (p = 0.026 and p = 0.018). Conclusions. In this study, it is emphasised that work-related risks should be taken into consideration, as well as individual CVD risks. [ABSTRACT FROM AUTHOR]

Introduction: The authors present the prevalence of refractive errors in premature infants, demonstrating the relationship between refractive development and selected demographic characteristics and the forms of treatment used: diode laser, anti-vascular endothelial growth factor (anti-VEGF) and combination therapy. Material and methods: The study included 56 healthy children without retinopathy of prematurity (ROP) and 63 children with ROP. Ophthalmologic evaluation and diagnosis were performed according to the International Classification of Retinopathy of Prematurity assessed in Ret-Cam 3. Treatment of ROP was carried out according to the guidelines of the Polish Ophthalmological Society using a diode laser (IRIDEX IQ 810) and an anti-VEGF intravitreal preparation (ranibizumab, Lucentis) at a reduced dose of 0.18 mg. Refractive measurements were taken at 7 months of age using a handheld computerized autorefractometer (Retinomax) after 1% tropicamide cycloplegia. Results: A statistically significantly higher prevalence of high myopia (p = 0.019) and low astigmatism (p < 0.001) was observed in the eyes of premature infants with ROP and moderate hyperopia in the group without ROP (p = 0.031) regardless of the treatment used [mean +1.33 spherical diopters (Dsfr.); SD ±3.09 for eyes with ROP vs. mean +2.42 Dsfr.; SD ±2.11 for eyes without ROP]. Birth weight (p = 0.01) and gestational age (p = 0.048) correlated with changes in spherical refraction in children with ROP. There were statistically significant differences in high myopia (p = 0.041), low myopia (p = 0.010) and low hyperopia (p = 0.014) in the group of premature infants treated for ROP depending on the form of therapy. Conclusions: There were statistically significant differences in high myopia (p = 0.041), low myopia (p = 0.010) and low hyperopia (p = 0.014) in the groups of premature infants with ROP and high myopia (p = 0.019) and low astigmatism (p < 0.001) in the groups treated with monotherapy or combined therapy. Birth weight (p = 0.01) and gestational age (p = 0.048) had a significant effect on refractive development in eyes with ROP. [ABSTRACT FROM AUTHOR]

Purpose: Intra-cavitary brachytherapy is an integral component of cervical cancer management, and uterine perforation is the most significant complication, which may lead to prolonged overall treatment time and decreased local control in these patients. Material and methods: A retrospective analysis of cervical cancer patients who completed radiotherapy (external beam radiotherapy and brachytherapy) in our department was conducted to determine the incidence, effect on overall treatment time, and final outcome in patients with uterine perforation during brachytherapy procedure. Results: Among 55 women, of the 398 applications, 85 (21.36%) resulted in uterine perforation. Out of these 85 applications, treatment time was extended among 3 (3.5%) applications only, as re-insertion was done nearly after one week, while the remaining 82 (96.5%) applications were completed in time. At the time of analysis, the median follow-up was 12 months, and 32 patients were disease-free, 3 had distant metastatic disease, 2 had residual disease, and 18 were lost to follow-up. Conclusions: In our study, uterine perforation incidence was found to be comparable with other centers worldwide. In asymptomatic and uncomplicated uterine perforation, treatment can be continued with computer-based optimized treatment plans without loading a specific dwell position and without affecting overall treatment time. [ABSTRACT FROM AUTHOR]

Background. During the coronavirus disease 2019 (COVID-19) pandemic, most hospitals have faced a heavy load of patients. In this situation, it is very important to consider the resilience and endurance of medical staff, as well as to identify and investigate the relevant factors which can increase their resilience. Objectives. The aim of this study was to identify the factors affecting the resilience of hospital medical staff during the COVID-19 pandemic. Material and methods. The present study is a qualitative study using a semi-structured interview. Participants included doctors, nurses, clinicians and managers working in tertiary referral hospitals during the COVID-19 pandemic. Interviews were conducted as needed until data saturation was reached using the purposive sampling method. A total number of 20 people, including 6 physicians, 2 hospital managers, 7 nurses, 1 radiologist, 3 laboratory technicians and 1 clinical psychologist, were interviewed in 7 educational hospitals of the Kerman Province. Results. After data analysis and coding, 127 initial codes were identified. By reviewing the codes, 127 initial codes were merged by the research team, and 23 codes in 6 main categories, including Personal Factors (7 codes), Family-Related Factors (2 codes), Community Related Factors (2 codes), Virus-Related Factors (2 codes), Organisational Factors (7 codes) and Economical Factors (3 codes) were extracted. Conclusions. Paying attention to the identified factors on the maintenance of medical human resources in the form of the “Surge Capacity Programme” can increase the resilience of medical staff. Such measures pave the way for a better response to other threats similar to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background. Smoking is the most dangerous modifiable risk factor all over the world and requires the lowest cost to quit. Objectives. In this study, we aimed to determine the relationship between the Fagerström Test for Nicotine Dependence (FTND) and carbon monoxide (CO) levels and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR) and RDW, WBC, MPV values. Material and methods. 138 participants who applied to the Smoking Cessation Clinic of Bolu Izzet Baysal Training and Research Hospital between January 2022 and March 2022 were included in our study. After obtaining the necessary consent, the FTND test and CO levels in expiratory air were measured. The required haematological values of the participants were evaluated. Results. It was found that there was statistical significance between the CO levels of the participants and their FTND scores, and it was observed that the FTND scores increased as the CO level increased (p = 0.000). There was a statistically significant correlation between CO levels and PLR ratios and WBC levels (p = 0.024, p = 0.000). It was determined that as the CO level increased, the PLR ratios decreased, and the WBC values increased. Conclusions. In our study, a positive correlation was found between FTND levels and exhaled CO levels. We can say that CO levels can be a marker in predicting the level of addiction. In addition, it was observed that there was a significant relationship between exhaled CO levels and FTND levels, as well as PLR and WBC values. [ABSTRACT FROM AUTHOR]

Background. Primary health care physicians are at high risk of burnout. In addition, with the current conditions, they can have an effort-reward imbalance. However, studies on this topic concerning public primary health care (Puskesmas) physicians in Indonesia are still limited. Objectives. To assess whether the effort-reward imbalance among Puskesmas physicians is associated with two main burnout dimensions: emotional exhaustion and depersonalisation. Material and methods. This cross-sectional study surveyed physicians working in Puskesmas in Indonesia using the short version of the Effort-Reward Imbalance Questionnaire and Maslach Burnout Inventory-Human Services Survey questionnaires. Results. Of 226 physicians, 45.6% perceived high effort and low reward. A perceived effort-reward imbalance was higher among those working more than 40 hours weekly in work shifts and in urban areas. Significant predictors of emotional exhaustion included effortreward ratio (β = 0.426; p < 0.001), overcommitment (β = 0.393; p < 0.001) and working period at Puskesmas (β = - 0.122; p = 0.038). Predictors of depersonalisation include effort-reward ratio (β = 0.257; p -= 0.001), overcommitment (β = 0.170; p = 0.024), and night shift (β = 0.134; p -= 0.042). Conclusions. The effort-reward imbalance is significantly associated with emotional exhaustion and depersonalization. Therefore, it is important to set up the maximum working hours, balanced shift work arrangements, and standardized rewards for Puskesmas physicians. [ABSTRACT FROM AUTHOR]

Background. Students with poor sleep quality will undoubtedly disturb their daily activities, such as being absent from lectures due to illness and falling asleep during lectures. A further impact of poor sleep quality is decreased student academic achievement. Objectives. To analyse the relationship between sleep hygiene and the prevalence of insomnia in medical students during the COVID-19 pandemic at the Faculty of Medicine, Universitas Sumatera Utara. Material and methods. The research design was analytic with a cross-sectional approach. The study population was medical students in clinical clerkships, which amounted to 152 people using consecutive sampling methods. The data was collected using a Sleep Hygiene Index (SHI) and Insomnia Severity Index (ISI) questionnaire, conducted online via Google Forms. Data processing was carried out using SPSS and the Chi-square statistical test. Results. Most students, as many as 101 people (66.4%), had moderate sleep hygiene, and most students were without insomnia (approx. 61.8%). The results of the Chi-square test bivariate analysis showed a relationship between the degree of sleep hygiene and the prevalence of insomnia in the medical students of Universitas Sumatera Utara. Conclusions. Students are exposed to psychological impacts that can affect the quality of their sleep. Sleep hygiene and sleep cycles in students change due to changes in daily activities, such as physical activity, class schedules, assigned tasks and the use of electronic equipment. [ABSTRACT FROM AUTHOR]

Introduction: The aim was to assess the usefulness of blood analytical markers such as systemic immuneinflammation index (SII) and neutrophil-lymphocyte ratio (NLR) in pediatric burned patients. Material and methods: The study group included 73 children (23 girls and 50 boys; mean age: 3.83; SD: 4.77; min–max: 0–17 years old) hospitalized due to burns. A retrospective analysis of selected complete blood cell count parameters (leucocytes; platelets – PLT; SII; NLR) collected on the day of injury and selected parameters of burns (extent, depth of the injury, duration of hospitalization, type of treatment) was performed. Results: Children with burns that exceeded 10% total body surface area had higher levels of leucocytes than children with less extensive burns (p = 0.023). The PLT count on the day of injury was higher in children with burn wounds that required surgical treatment (p = 0.021). The analysis of groups of children that differed in the values of NLR revealed that children with NLR over 3 were hospitalized longer (on average 3.5 days) than children whose NLR was lower than 3 (p = 0.048). It was found that children with SII over 250 were hospitalized longer than children with SII less than 250 (p = 0.019). There were no differences in the type of treatment (p = 0.21), but children with SII over 250 had more often full thickness burns (p = 0.036). Children under 2 years old with SII over 200 more often required surgical treatment than children with SII less than 200 (p = 0.005). Children under 2 years old with SII over 200 more often had full thickness burn wounds than children with SII less than 200 (p = 0.045). Children under 2 years old with NLR over 2 had more extensive burn wounds (p = 0.049) than children with NLR under 2. Conclusions: The systemic immune-inflammation index and NLR can be useful in assessment of pediatric patients with burns. Further studies on larger groups including children with major burns are necessary. [ABSTRACT FROM AUTHOR]

Introduction: Social marketing is an innovative measure that benefits different aspects of human life. It has been suggested that it could also be employed in fighting human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and promote family planning. The purpose of this study was to investigate the effect of social marketing methods on reducing high-risk sexual behaviors in HIV-positive individuals. Material and methods: This study was a randomized controlled trial, involving sixty patients who visited voluntary counseling and testing (VCT) center of Imam Khomeini Hospital in Tehran, during 2017-2018 period. Respondent-driven sampling was used, and participants were divided into two groups through block randomization. Intervention group received a weekly social marketing training program in ninety minutes sessions, while control group did not receive any educational intervention. Questionnaire collected data on risky sexual behaviors (RSB) were evaluated using analysis of variance ANOVA. Results: Social marketing training package delivered in this study could significantly reduce RSB after 6 weeks of implementation (p < 0.001). Conclusions: Social marketing measures could be effective in reducing RSB in HIV-positive individuals. However, developing well-tailored social marketing interventions, which could address sexual health issues of the society is a challenging endeavor in religious countries, such as Iran. [ABSTRACT FROM AUTHOR]

Background. Diabetic nephropathy is the main cause of impaired renal function and chronic kidney disease (CKD) in diabetic patients. Objectives. The aim of this study was to estimate the prevalence and characteristics of normal to mildly increased albuminuria in type 2 diabetes mellitus (T2DM) patients with chronic kidney disease. Material and methods. This retrospective study was performed on 310 patients diagnosed with T2DM and renal insufficiency (eGFR < 60 mL/min/1.73 m² ) referred to Ahvaz hospitals between 2014–2020. Demographic and clinical data, as well as laboratory parameters, were extracted from patients’ medical records. After considering the inclusion criteria (adult diabetic patients with renal failure (eGFR < 60 mL/min/1.73 m² ) and exclusion criteria (patients with hypertension, cardiovascular disease (ischemic heart disease, chronic heart failure, peripheral vascular disease, cerebrovascular disease), urinary tract infection, anatomical disorders of the urinary tract, kidney stones, benign prostatic hyperplasia, history of diuretic use, nephrotoxic drugs such as ACEI, ARB, NSAIDs, physiological causes of albuminuria such as prolonged standing and exercise, systematic disease (e.g. systemic lupus erythematosus) and dialysis patients), in terms of age, gender and duration of diabetes and lipid profile and retinopathy and neuropathy and HbA1C, patients were divided into three groups based on the severity of albuminuria (albumin-to-creatinine ratio): normal to mildly increased albuminuria (ACR < 30 mg/g), moderately increased (ACR: 30–300 mg/g) and severely increased (ACR > 300 mg/g). Results. A total of 310 T2DM patients with a mean age of 57.2 ± 9.5 years, including 164 women (52.9%) and 146 men (47.1%), participated in the study, of which 4 patients (1.3%) had normal albuminuria, 76 patients (24.5%) had mildly increased albuminuria, 142 patients (45.8%) had moderately increased albuminuria, and 88 patients (28.4%) had severely increased albuminuria. Individuals with normal to mildly increased albuminuria compared with moderate to severe albuminuria had lower duration of diabetes, age, creatinine, retinopathy, neuropathy, HbA1c, LDL, Tchol (p < 0.001), higher GFR (p < 0.001) and lower TG (p = 0.003), while HDL-c (p = 0.07) and patients’ gender (p = 0.2) were not significantly different. Examination of the odds ratio (OR) showed that retinopathy, high age and high HbA1c levels had the greatest effect on the development of moderate to severe albuminuria, whereas increased GFR and a small increase in LDL had a preventive effect on moderate to severe albuminuria. Conclusions. The results of the present study showed that although the majority of diabetic patients with renal insufficiency had moderate to severe albuminuria, a considerable proportion of patients with diabetes and renal insufficiency had normal to mildly increased albuminuria. This can limit the role of microalbuminuria as a screening tool to detect the onset of diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Introduction: Adequate nutrition plays a major role in delaying disease progression and improving quality of life of people living with human immunodeficiency virus (PLHIV). Therefore, it is important to assess their nutrition knowledge and practice of dietary diversity, especially in resource-limited settings, where most HIV infections occur. Aim of the study was to assess the nutrition knowledge and dietary diversity practice of PLHIV in a resource-limited setting. Material and methods: This was a health facility-based cross-sectional analytical study conducted at two tertiary HIV clinics in Enugu, Nigeria. Using a systematic random sampling technique, 370 adult HIV patients were recruited. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with good nutrition knowledge and high dietary diversity among respondents. P-value < 0.05 was considered statistically significant. Results: Good nutrition knowledge was observed in 69.7% of the respondents, while 60.0% had high dietary diversity. In multivariate analysis, secondary educational level (AOR: 0.54; 95% CI: 0.29-0.97; p = 0.040) and earning a family monthly income of 31,000-60,000 (AOR: 2.12; 95% CI: 1.11-4.06; p = 0.024) were predictors of good nutrition knowledge. Number of children in a household (AOR: 2.09; 95% CI: 1.19-3.67) was predictive of high dietary diversity. Conclusions: Educational level and family monthly income are predictors of nutrition knowledge, while number of children in a household is a predictor of dietary diversity. Nutrition education should be incorporated into HIV care program targeting those with low educational levels and low family monthly incomes for improvement of their nutrition knowledge. [ABSTRACT FROM AUTHOR]

Introduction: Acquired immune deficiency syndrome (AIDS) is a medical condition caused by human immunodeficiency virus (HIV), and has been the major concern worldwide. Despite antiretroviral treatment (ART) has shown significant clinical importance by meeting the goal of the rapy, there is still a number of deaths due to socio-economic, demographic, and health-related factors. Therefore, this study was aimed to investigate the survival status and predictors of mortality for adult HIV-positive patients treated with ART. Material and methods: A retrospective cohort study was conducted with 1,285 of HIV-infected patients aged 15 years and greater, who were enrolled in ART at Mizan-Tepi University Teaching Hospital from September, 2007 to January, 2015. A multivariable Cox regression model was applied to assess significant predictors of mortality. Results: During follow-up period, a total of 1,285 patients contributed to 59,237 person-year of followup, and 273 (21%) of the patients died, showing overall incidence rate of 4.6 per 1,000 person-year (273/59,237). The median follow-up period was 44 months. During follow-up, 273 (21%) patients died, of whom nearly 32% and 12% of deaths occurred within 6 months and between 6 and 12 months of highly active antiretroviral therapy (HAART) initiation, respectively. Conclusions: Multivariable Cox proportional hazards model revealed that having concomitant tuberculosis infection, low baseline CD4 count, low baseline weight, living in rural area, using of a substance, older age, lower educational level, higher World Health Organization (WHO) clinical stages, functional status, and marital status were all significantly associated with progression to death for HIV/AIDS-infected patients. [ABSTRACT FROM AUTHOR]

Aim of the study: All over the world people are increasingly turning to dietary supplements, the market for which is growing every year. Unfortunately, still little is known about the use of dietary supplements in paediatric population. The aim of the study was to assess the frequency of use of dietary supplements among children in Lesser Poland Voivodeship and to verify the source of parents' knowledge about dietary supplements. Material and methods: A multiple-purpose survey was conducted anonymously among 229 parents of patients hospitalized in the Department of Paediatrics, University Children's Hospital in Krakow. Each parent answered 41 questions regarding dietary supplements use in his/her hospitalized child throughout the whole child's life. The data was statistically analyzed. Results: 71.4% of parents supply dietary supplements to their children, 57% admitted that they serve it daily. Parents most often give their children a single vitamin or mineral preparation (39.2%). Mostly the choice of a particular preparation was conditioned on the opinion of a physician (68%) or a pharmacist (37%). Families with a high socioeconomic status more often take advice from health professionals regarding their knowledge about supplements. Nearly half of the respondents admit that they do not have sufficient knowledge on the dietary supplements they give to their children. Conclusions: Most parents give or gave dietary supplements to their children. Although a well-balanced diet provides all vitamins and micronutrients that young organisms need, many parents find it necessary to use dietary supplements. It is alarming how many people use alternative sources of information. It is necessary to educate and build awareness among parents that they take an active role and are responsible for their child's health and that they should have reliable knowledge about the preparations they decide to give their child. [ABSTRACT FROM AUTHOR]

Aim of the study: Although the recognition of acute pancreatitis in children has been increasing over the last decades, knowledge this condition is limited. Thus, we aimed to evaluate the aetiology and clinical course of the first episode of acute pancreatitis in children. Material and methods: We retrospectively analysed medical records of patients hospitalized due to the first episode of acute pancreatitis in the Department of Paediatrics and Gastroenterology, Medical University of Lublin, from January 2011 to December 2019. The analysis took into account the age and sex of patients, clinical symptoms, abnormalities in physical examination, past and family history data, and results of laboratory and imaging tests. The review of consecutive hospitalizations of patients from the study group was carried out to assess the number of recurrences of pancreatitis in the analysed period. Results: The study group consisted of 72 patients, including 37 boys and 35 girls. The age of patients ranged from 2 to 18 years, with a median of 12 years. The vast majority (62%) of acute pancreatitis cases were diagnosed in the latter 4 years of the study period. In 43% of patients, acute pancreatitis was of idiopathic origin, followed by infectious (22%), toxic (18%), and biliary (8%) aetiology. The most common initial symptoms included abdominal pain (93%), vomiting (66%), and nausea (28%). In the study period recurrence of acute pancreatitis occurred in one-third of the children. Conclusions: Paediatric acute pancreatitis is an increasing health care issue with various aetiologies. Acute pancreatitis should be considered in every child with acute abdominal pain, vomiting, or nausea. Further studies are needed to determine the risk factors of recurrent acute pancreatitis. [ABSTRACT FROM AUTHOR]

Background. Patients with Chronic Kidney Disease (CK D), with an additional burden of cardiovascular disease, should be monitored, educated and treated through the close cooperation between multidisciplinary nephrology and cardiology teams. One of the elements by which this can be achieved is cardiac rehabilitation programs. Objectives. The aim of this study is to assess the effect of chronic kidney disease on exercise performance within cardiac patients. Material and methods. 92 patients qualified for stationary cardiac rehabilitation took part in a study conducted at the Cardiac Surgery Clinic of the SPSK 2 Pomeranian Medical University in Szczecin. Among them, a group with CK D (n = 24) and without (n = 68) was selected. Statistical analysis was performed on the basis of data from medical records and the results of the 6-minute walk test. Results. Patients with and without CK D improved the results of the 6-minute test. From an average result of 256.21 (± 138.99) at the beginning of the rehabilitation to an average of 385.96 (± 109.09) after that for patients with CK D and from average result of 281.01 (± 110.16) to an average result of 422.29 (± 96.39) for patients without CK D. Conclusions. Cardiac rehabilitation has a positive effect on physical fitness and exercise tolerance both in patients with CK D and without. However, the coexistence of CK D results in less satisfactory results compared to the control group. [ABSTRACT FROM AUTHOR]

Background. Pemphigus vulgaris (PV) is a rare, life-threatening autoimmune disease and varies in its clinical profile and epidemiology in different regions of the world. Objectives. This study aimed to evaluate the demographic and clinical characteristics of oral PV patients in the lower north and northeast of Thailand. Material and methods. A retrospective study of PV patients who visited the Oral Medicine Clinic, Dental Hospital, Naresuan University and Khon Kaen University during the 2010–2020 period. Results. 21 oral PV patients were included. Among these, 16 (76.2%) were female, and 5 (23.8%) were male, with a female to male ratio of 3.2:1. The mean age of the patients was 47.7 ± 14.2 (range 25 to 74) years. 8 patients (38.1%) had a history of systemic diseases, and hypertension was predominant. The mean duration of the disease was 6 ± 3.42 (range 1 to 12) months. The most common complaint at presentation was oral ulceration with a burning sensation. The most affected sites were the buccal mucosa and gingiva (80.9%). Extraoral involvement was found in 14 patients (66.7%). Patients who had oral lesions before skin lesions found the mean duration was 4.63 ± 5.13 (range 1 to 16) months. Most of the patients (61.9%) were prescribed a combination of topical and systemic steroids. Conclusions. The present study illustrates the demographics and clinical characteristics of oral PV in Thai patients. Early diagnosis and timely treatment are critical for the patients. Since oral mucosa is often the first site of PV involvement, healthcare professionals must recognize the disease’s clinical characteristics and manage PV patients appropriately. [ABSTRACT FROM AUTHOR]

Background. Diabetes mellitus (DM) is a metabolic disorder caused by many factors and related to serious complications. Diabetes mellitus includes oxidative stress and inflammation, in addition to hyperglycemia and resistance to insulin. Objectives. This study aimed to evaluate the effect of supplementation with vitamin C on blood glucose control and body mass index in type 2 diabetic patients of the family medicine outpatient clinic in Suez Canal University, Ismailia, Egypt. Material and methods. This was a double-blind, randomized, controlled clinical trial. Sixty patients (n = 60) were distributed randomly into two groups: the intervention group (on 1 g of vitamin C orally for 12 weeks), and the control group (on a placebo for the same period). Only 55 patients completed the study (28 in the intervention group and 27 in the control group). Glycated hemoglobin (HbA1C%) and body mass index (BMI) were assessed at the beginning and after 12 weeks. Results. The HbA1C percentage significantly decreased in the intervention group, supplemented with vitamin C, after 12 weeks as compared to the placebo group. The body mass index did not change significantly after the intervention. The intervention group had 75% glycemic improvement, while only 33.3% of the subjects improved in the control group. Absolute risk reduction (ARR) was 42%, the number of patients in need of treatment (NNT) was 2.38, the relative risk (RR) was 0.37, and the relative risk reduction (RRR) was 62%. Conclusions. Patients with type 2 diabetes may benefit from adding vitamin C to their routine management to control blood glucose. [ABSTRACT FROM AUTHOR]

Background. Depression is one of the most common medical illnesses worldwide. Medical students during their training will be subjected to many stressors, both mentally and emotionally. Objectives. Assess the prevalence of depressive symptoms among medical students and to identify any association between depressive symptoms and some socio-demographic factors. Material and methods. A descriptive cross-sectional study was conducted in Baghdad city, and our study sample was 800 medical students from all six stages at Al-Kindy College of Medicine. Out of those sample students, only a convenient sample of 301 students was selected, and they agreed to take part in the current study. Data was collected using a self-administered questionnaire form. Results. The overall prevalence of depressive symptoms is 55.48% among students. The stage of the study, gender and social relationship were significantly associated with depression symptoms, with no significant association between chronic disease and monthly family income. The highest percentage of depressive symptoms was seen among students of the first, third, and fourth grade, being female, and social students with a p-value less than 0.05. Conclusions. A high level of depressive symptoms among students at Al-Kindy College of Medicine was reported, with females being more depressed than males, more than half of the participants showing symptoms and most students in the pre-clinical stage, whereas the lowest level appeared among stage six students. [ABSTRACT FROM AUTHOR]

Background. Today, the concept of health literacy is used to determine the health needs of the population in parallel with ever-increasing health knowledge. Objectives. The aim of the study is to evaluate the health literacy level of patients who apply to the Family Medicine preventive health services of Düzce University Hospital and to investigate the relevant factors that may be related to health literacy. Material and methods. This study was a cross-sectional study carried out between October 2018 and April 2019. The patients were evaluated utilizing the “Health Literacy Survey-European Union (HLS-EU)” scale. The study took place in Düzce Medical Faculty Hospital, Turkey. Results. A total of 816 patients, 48.5% (n = 396) of them male and 51.4% (n = 420) female, were included in the study. The general health literacy levels of the patients were as follows: 30.6% (n = 250) insufficient, 33.4% (n = 272) limited, 28.9% (n = 236) sufficient, 7.1% (n = 58) excellent. According to all subdimensions and matrix averages of the scale used in the study, the mean score that patients received in understanding and applying health information in the disease prevention dimension (8.45 ± 2.30, 8.10 ± 2.38, respectively) was found to be lower than health care (11.20 ± 2.72, 11.63 ± 3.01, respectively). Conclusions. The study results revealed a lower level of health literacy in terms of disease prevention rather than healthcare utilization. Initiatives to increase people’s knowledge of disease prevention should be planned. [ABSTRACT FROM AUTHOR]

Background. Pregnancy is one of the most sensitive periods in a woman's life, causing great changes and emotional instability. Pregnancy, apart from the pleasure of being a mother, is the most stressful period of the life of women. Objectives. This study aimed to investigate the relationship between mothers' personality types and their perceived stress. Material and methods. This cross-sectional descriptive-analytic study was conducted on 210 eligible mothers in three hospitals affiliated with the Shiraz University of Medical Sciences. Personality and Perceived Stress Questionnaires were completed by the mothers. Data analysis was performed with Pearson and Spearman statistical tests, using SPSS software (version 22). Results. The highest score of the personality type belonged to the conscientiousness, with an average score of 39.68 ± 6.09. The highest frequency was also related to conscientiousness personality type (48.1%). Mothers in the study had a moderate perceived stress level, with a mean score of 26.98. Using the Pearson correlation test, we found there was a significant positive relationship between the two variables of neuroticism and perceived stress (r = 0.149, p = 0.031). There was also a significant relationship between openness to experience and perceived stress (r = 0.265, p = 0.001). Conclusions. According to the results, personality types are related to the level of perceived stress in mothers, and maternal stress can be predicted through personality traits. Therefore, identifying the personality types, training of mothers and holding psychotherapy sessions can be very important. [ABSTRACT FROM AUTHOR]

Background. Long-term exercise contributes to the inhibition of osteoblast cell activity and to the decrease of bone resorption. Objectives. The research objective was to analyze the chronic effect of regular, long-term physical activity and physical inactivity on carboxyterminal collagen cross-linking telopeptide levels (CTx) and calcium levels in healthy adults. Material and methods. This study was a prospective cohort study. Fifty-four men and women, aged 17-26 years, were divided into 2 groups of 27 people each: exercise and non-exercise. This research was carried out from April 2015 to April 2016 at the Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia. Bone resorption can be determined by measuring the carboxyterminal cross-linking telopeptide of collagen (CTx). The data were analyzed using Student's t-test and regression correlation analysis with a significance level of 5%. Results. The highest levels of CTx were found in the non-exercise group; the lowest levels of CTx were in the exercise group (1.6 ng/mL and 0.30 ng/mL, respectively). This difference in CTx levels between groups was statistically significant (0.52 ± 0.22 ng/mL vs 0.72 ± 0.28 ng/mL; p = 0.005). Calcium was significantly higher in the exercise group than in the non-exercise one (9.67 ± 0.30 vs 9.01 ± 0.21 mg/dl; p = 0.006). There was a negative correlation between calcium levels and CTx in the exercise group (r = 0.038; p = 0.001). Conclusions. Regular exercise led to lower CTx levels and increased calcium levels. The increase in calcium is an effect of the decrease in CTx in healthy adults. Regular exercise decreases bone resorption and increases bone calcium deposition in healthy adults. Regular exercise has the potential to prevent and treat osteoporosis non-pharmacologically. [ABSTRACT FROM AUTHOR]

Background. A stapedectomy or stapedotomy is known as the best treatment option for patients with otosclerosis. Otosclerosis is a primary disease of the bony labyrinth capsule, which is characterized by one or more localized foci, where bone deposition occurs repeatedly. The best and most effective treatment option is a stapedectomy or stapedotomy. Objectives. The present study evaluated the short-term hearing results in patients with otosclerosis after primary stapes surgery. Material and methods. In this retrospective study, the short-term hearing results of all patients with otosclerosis after a primary stapedotomy admitted to the Ahvaz Emam hospital from 2007 to 2017 was evaluated. Improvement in hearing was evaluated according to the pre- and post-audiometry results. Air Conduction (AC), Bone Conduction (BC) and Air-Bone Gap (ABG) thresholds were recorded at 500, 1 000, 2 000 and 4 000 Hz. SPSS software (Version 22.0) was used for statistical analysis. Results. Of the 413 cases, 231 (55.93%) and 182 (44.07%) were females and males, respectively. The mean age of patients was 39.06 ± 11.29 years. The disease in 131 (31.72%) was bilateral. The mean ABG in 341 patients (82.63%) ≤ 10 dB and in 52 patients (12.47%) was 10-20 dB. Conclusions. The results of the study showed that a primary stapedotomy is a successful and effective way to improve short-term hearing results in adults with otosclerosis. [ABSTRACT FROM AUTHOR]

Background. The use of over-the-counter (OT C) medications without consulting a doctor has become increasingly common. Objectives. To compare the scale of self-treatment in a population of students of the Medical University of Bialystok in 2012 and 2017. Material and methods. The study included 217 students in 2012 and 220 students in 2017, and used a proprietary questionnaire. Results. A total of 78.8% of students in 2012 and 86.4% in 2017 were familiar with the meaning of the abbreviation OT C. When using an OT C drug for the first time, most students consulted a nurse (66.4%) in 2012, while in 2017, students usually consulted a family member (68.8%). Headache was the main reason for using OT C drugs (89.4% in 2012, and 92.7% in 2017). The use of analgesics (87.1%) and the use of OT C medicines in accordance with the leaflet (47%) predominated in 2012, while vitamin therapy (83.2%) took first place in 2017. When purchasing OT C medications, students usually based their decision on their own experience (63.1% in 2012 and 84.1% in 2017). A total of 35.5% of the students in 2012 and 39.1% in 2017 always read the leaflet. Conclusions. Self-medication was practiced by most students in both years, with lack of time for a medical appointment being the main reason. Over the last 6 months, the students most often used prescription and non-prescription drugs simultaneously. [ABSTRACT FROM AUTHOR]

Background. Acute otitis media in children is one of the most common causes of patients reporting to the family doctor and pediatrician. In rare cases, the inflammatory process spreads deeper into the temporal bone despite proper treatment, resulting in mastoiditis. Objectives. The aim of this article is to present the most common complication of inflammation of the middle ear. This is mastoiditis. The authors describe mastoiditis by means of its characteristics, the most common symptoms, incidence and treatment. Material and methods. Data about the patients hospitalized in the Pediatric Otolaryngology Department of the Poznan University of Medical Sciences from January 2017 to April 2018 was analyzed and subjected to a retrospective study. Statistical analysis of the results was performed. Results. Based on the analyzed medical documentation, the incidence of mastoiditis was evaluated. In addition, the parameters characterizing the diagnostic procedure, along with the treatment methods and the effectiveness of the applied therapies in the hospital conditions, were assessed. The number of outpatient ambulatory visits and the frequency of necessary hospitalizations for patients with uncomplicated otitis media were additionally subjected to evaluation. Conclusions. The number of cases of inflammation of the middle ear requiring hospitalization in the Pediatric Otolaryngology Department Poznan University of Medical Sciences is minimal, although the complications may present severe health consequences. Uncomplicated acute otitis media may be successfully treated in ambulatory conditions by family physicians and pediatricians. Early detection of the potential complication is essential in the practice of the family doctor. [ABSTRACT FROM AUTHOR]

Background. The average waiting time for cataract treatment in Poland is 441 days - the longest for any surgical procedures in the country. Objectives. The aim of the study was to examine the availability of surgical cataract treatment among older Polish patients. Material and methods. Using data from 25,970 hospitalizations at the Ophthalmology Ward of the University Clinical Hospital in Wrocław, Poland in years 2012-2017, we analyzed the demographic structure of the patients, the duration of hospital stay, and the average cost; the level of statistical significance was taken to be p < 0.05. Results. Patients 65 years of age or older made up 78% of patients receiving surgical cataract treatment. This treatment required significantly shorter hospitalization time in 2017 than in 2012 (an average of 1.89 vs. 2.19 patient-days, respectively). The average hospital stay length among the older patients was significantly shorter than among younger patients (2.3 vs 3.2 patient-days, respectively) and the average hospitalization cost for patients aged 65 years or older was significantly lower (2105.63 PLN vs 2929.57 PLN , equivalent of 495.44 EUR vs 689.31 EUR , respectively). Conclusions. The duration of the average hospital stay in the ophthalmology ward was shorter, and the average hospitalization cost was lower, for patients aged 65 years or older than for younger patients because older patients mostly undergo modern standardized less-invasive cataract treatment. As more ophthalmological medical staff, infrastructure, and financial assets are available for cataract treatment and have not yet been assigned or spent, Polish hospitals should introduce newer medical technology, process adjustments, and organizational innovations to fully utilize their potential and improve the availability of cataract treatment. [ABSTRACT FROM AUTHOR]

Background. Long-term care (LTC ) services involve long-lasting continuous supervision, care, nursing, therapy, and rehabilitation of patients who do not qualify for acute medical care. Demand for LTC services is on the rise, because of the aging of society and increasing number of dependent young and middle-aged people. Objectives. The aim of the study was to examine the dysfunction of LTC services in Poland, taking the phenomenon of prolonged hospitalization as an example. Material and methods. We examined data on patients at the University Clinical Hospital in Wroclaw, Poland, who were waiting for transfer from hospital to LTC facilities in the years 2012-2017. The statistical threshold of significance was p < 0.05. Results. There were 1006 cases of hospital stays prolonged by waiting for transfer to LTC facilities; 77% of patients affected were 65 years or older. This age group saw a large increase in the total number of patients transferred from hospital to LTC facilities. Patients 65 years and older made up the majority of patients on transfer waiting lists, but their average waiting time was significantly shorter than that of younger patients (38.7 vs 69.6 days, respectively). Conclusions. The demonstrated forced prolonged hospitalizations, which result from a lack of capacity on the part of LTC facilities to accept patients who have undergone hospital treatment, confirmed the dysfunction of the Polish LTC system. This results in a lack of adequate medical care continuity, increased total costs of medical care, and a shifting of expenses from the LTC facilities to the acute treatment facilities, which are most often hospitals. [ABSTRACT FROM AUTHOR]

Background. Women in some social groups of the population may be less supported by their partners and may be more reliant on their employees. Objectives. This study was designed to investigate the impact of paternal-attachment training skills on the extent of maternal neonatal attachment in primiparous women referred to the hospitals affiliated with the Shiraz University of Medical Sciences. Material and methods. A randomized controlled trial was done in hospitals affiliated with the Shiraz University of Medical Sciences from October 2012 to September 2013. The present clinical trial was conducted on 150 husbands of qualified pregnant women. The intervention group took part in 90-minute sessions of maternal-fetal attachment training held once a week. On the other hand, the control group received routine pregnancy care. Both groups filled out Avant's checklist after the intervention to determine maternal-neonatal attachment. The data was then analyzed in SPSS using the independent t-test, chi-square test and Fisher's exact test. A rating of p < 0.05 was considered as statistically significant. Results. The median score in the total maternal-neonatal attachment group was [84; IQR,70-103], and in the control group it was [66; IQR, 49-86; p < 0.001]. The Mann-Whitney U test showed a significant difference between the median of the groups. In the five aspects of the checklist, Avant included dimensions such as mothers' emotional behavior, maternal-infant proximity behavior, maternal-infant caring behavior and maternal-infant attention. The relationship between the attachment and control groups was significant (p < 0.001). Conclusions. Paternal attachment behavior training skills increased the score of maternal-neonatal attachment. Thus, there is a need to educate fathers on prenatal care. [ABSTRACT FROM AUTHOR]

Background. Toxoplasmosis is caused by infection from a ubiquitous obligate intracellular parasite known as Toxoplasma gondii, which can infect both human and warm-blooded animals. This infection is commonly prevalent in developing country. Objectives. The purpose of this study is to report on a 7-year review of ocular toxoplasmosis patients that presented to the Universiti Sains Malaysia Hospital. Material and methods. This is a retrospective review of cases. The demographic data, ocular manifestations, clinical and laboratory profiles, treatment and disease outcome were collected from the patients' medical records from January 2010 to December 2016. Results. A total of 16 patients with a diagnosis of ocular toxoplasmosis were identified. The mean age was 43.2, with standard deviation ± 15.4 years old. The percentage was 62.5% (10 patients) females and 37.5% (6 patients) male. The majority of patients were Malay (93.4%, 15 patients). The most common classification of uveitis was panuveitis (56.3%, 9 patients), followed by posterior uveitis (25%, 4 patients), anterior uveitis (12.5%, 2 patients) and intermediate uveitis (6.2%, 1 patient). Keratic precipitate (75%, 12 patients) and vitritis (75%, 12 patients) were the most common ocular manifestation of ocular toxoplasmosis. A serological test for toxoplasmosis found only 1 patient with positive serum immunoglobulin M, while all patients displayed non-reactive serum immunoglobulin G (except 1 missing data). All ocular toxoplasmosis patients were treated with oral Azithromycin 500 mg daily for 6 weeks, 81.3% (13 patients) were given an instillation of a steroid eye drop, while 25% (4 patients) required administration of an oral steroid. All of the patients responded well to treatment, but 25% (4 patients) suffered from recurrence, which required a second course of treatment. Conclusions. Ocular toxoplasmosis is a serious and depilating disease that can cause serious ocular morbidities. This review shows a diverse presentation of ocular toxoplasmosis as a result of toxoplasmosis infection. [ABSTRACT FROM AUTHOR]

Wstęp: Zgodnie z wytycznymi Towarzystwa SOSORT, w leczeniu zachowawczym skoliozy idiopatycznej (SI) stosuje się fizjoterapię oraz leczenie gorsetowe, a jego głownym celem jest zapobieganie progresji skrzywienia i poprawa estetyki sylwetki. Celem pracy jest przedstawienie wynikow leczenia zachowawczego 12-letniej dziewczynki z progresywną skoliozą idiopatyczną. Opis przypadku: Diagnostykę fizjoterapeutyczną przeprowadzono po raz pierwszy w marcu 2010 roku z powodu zaobserwowanej przez matkę asymetrii ustawienia łopatek. Pacjentkę skierowano do poradni ortopedycznej w celu dalszej diagnostyki. W badaniu radiologicznym stwierdzono: prawostronne wygięcie kręgosłupa w odcinku piersiowym (Th6-Th11, 30°) oraz lewostronne w odcinku piersiowo-lędźwiowym (Th11-L4, 30°), test Rissera (0). Zalecono leczenie gorsetem Cheneau (23 godz./dobę) oraz intensywną fizjoterapię. Na podstawie wywiadu z rodzicami dziewczynki ustalono, że zalecenia dotyczące noszenia gorsetu i ćwiczeń nie były w domu przestrzegane. Kontrolne zdjęcie rentgenowskie wykonane we wrześniu 2010 roku wykazało progresję prawostronnego skrzywienia w odcinku piersiowym (Th6-Th11, 36°). Zalecono zwiększenie systematyczności noszenia gorsetu i wykonywania ćwiczeń. Zdjęcie rentgenowskie wykonane w czerwcu 2011 roku wykazało zmniejszenie wartości kątowych skrzywienia: Th6-Th11, 18° oraz Th11-L4, 14°. Test Rissera określono na (1). Wystąpienie pierwszej miesiączki odnotowano w listopadzie 2011 roku. Pacjentka kontynuowała leczenie gorsetem i fizjoterapią. We wrześniu 2013 roku wykonano kontrolne zdjęcie rentgenowskie (Th5-Th11, 15°, Th11-L4, 11°). Test Rissera określono na (4). Zalecono zakończenie leczenia gorsetem oraz kontynuację fizjoterapii w celu poprawy estetyki sylwetki. Podsumowanie i wnioski: Leczenie zachowawcze (gorset i fizjoterapia) może prowadzić do zmniejszenia wielkości kątowej skrzywienia u dzieci z progresywną SI. Introduction:According to SOSORT, conservative treatment of idiopathic scoliosis (IS) includes physiotherapy and bracing. The main goal of treatment is to prevent of progression of the curvature as well as improvement the appearance. The aim of the study is to present the results of conservative treatment of girls aged 12 years with progressive idiopathic scoliosis. A case study: The first diagnostic was performed in March 2010 due to asymmetry of scapulas observed by the mother. The girl was referred to an orthopedist for a more detailed diagnostics. The radiographic assessment found: the right-sided curvature in the thoracic (Th6-Th11, 30°) and left-sided in the thoraco-lumbar (Th11-L4, 30°). The Risser sign was determined (0). It was recommended Cheneau brace (23 hours per day) as well as intensive physiotherapy. In the conversation with parents and girl, it was established that they failed to comply the recommendation. The control radiographic exam (September, 2010) revealed the progression of the right thoracic curve (Th6-Th11, 36°). It was recommended more systematic wearing the brace and exercises. The X-ray performed in June 2011 showed decrease of the Cobb angle (Th6-Th11, 18° right and Th11-L4, 14° left). Risser sign value was (1). The menarche occurred in November 2011. The patient continued the treatment with the brace and physiotherapy. In September 2013 performed the control X-ray exam (Th5- Th11, 15°, Th11-L4, 11°). The Risser sign was determined (4).The physician decided by the end of treatment with Chenenau brace and recommended the continuation of physiotherapy to improve the appearance. Summary and conclusion: The conservative treatment (Cheneau brace and physiotherapy) can lead to decrease the Cobb angle in children with IS. [ABSTRACT FROM AUTHOR]