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Background: currently the Elderly population is rapidly increasing and with this increment comes more challenges for the healthcare system, non-adherence to medications especially in elderly can lead to economic and human lost that is avoidable by improving patients' compliance and address the related issues leading to the non-adherence. Objectives: 1-assess the level of adherence knowledge and belief to medications. 2-identify the related factors causing the non-adherence. Methodology: A cross sectional study was conducted in primary healthcare centers in Baghdad targeting geriatric age group of both genders attending the primary healthcare centers and having at least one diagnosed chronic disease, the study enrolled10 healthcare centers from both sides of Baghdad. Patients were directly interviewed and data was collected using a questionnaire. Results: The study showed that (83.4%) of the sample (n=385) had low adherence level, this percentage tend to increase as the age increases, no significant association was found with gender variable, and a significant association was found with the age variable. most of the participants has low beliefs level (86%) and only (7%) of the sample scored (high) on knowledge level which was significantly associated with adherence level, (13.5%)of the participants faced high difficulty to adhere to their medication. Conclusions: Elderly patients attending the primary healthcare centers in Baghdad had low level of adherence; most of them did not have enough knowledge about their medications. Patients who scored low level of adherence tend to pay more visits to the healthcare centers.

Background: PCOS is a leading cause of infertility globally. Polycystic ovarian syndrome (PCOS) is a complicated disease pigeon-holed by high testosterone levels, irregular menstruation, and/or tiny cysts on one or both ovaries. The disease can be anatomical (polycystic ovaries) or biochemical (hyperandrogenemia). Follicular developmental inhibition, ovarian microcysts, anovulation, and menstrual irregularities are all symptoms of hyperandrogenism, a clinical characteristic of PCOS. Objective: The objective is to determine the chances of infertility in a patient presenting with PCOS in childbearing age. Methodology: Data was collected from Medline, PubMed, ScienceDirect, and the Obsgyne online library for papers published between 2005 and 2021 using specified MeSH keywords in this systematic review. We examined 10 cross-sectional type analytical studies for data collecting in this systematic work. Results: 10 studies conducted between the years 2005 to 2021 were included in this systematic review. There were 3900 women in the study, ranging in age from 10 to 40. The 2nd most prevalent etiology of feminine factor-related infertility was determined to be PCOS in this investigation. In 70% of cases of anovulatory infertility, PCOS is the reason. As a result, it's critical to screen for and treat it in primary care settings. Ultrasound is the best modality for the detection of PCOS. PCOS has been identified using ultrasonography methods in several investigations. The basal follicle counts by TVS might be included among sonographic findings in the diagnosis of PCOS, with basal follicle counts of more than 10 is a PCOS criterion. Slightly swollen stroma, hypertrophy, enhanced ovarian mass and thickness, and the percentage of ovarian stroma to total ovary area are among the other characteristics. Conclusion: From this systematic review we concluded that infertility is most commonly caused by PCOS. In 70% of cases of anovulatory infertility, PCOS is the reason. Despite the fact that TVS is the gold standard for detecting ovarian abnormalities in young girls we examine trans-abdominally by using a high-frequency probe. Ultrasonography results for PCOS of the periphery cyst patterns include a considerable variety of small subcapsular follicles (10 follicles with a maximal diameter of 8 millimeter), enhanced ovarian volume (12.3 millimeter), and increased echo density of the ovarian stroma.

Objective: The purpose of this study is to decide the prevalence of primary and secondary infertility. Material and Method: In this systematic review facts extracted by Medline, PubMed, science direct and Obs gyne online library that were queried for studies posted between 2005 to 2021 by using specific MeSH terms. We extracted data from 15 cross sectional studies that was carried out in discipline exercise regions of tertiary care health facility. Results: This study shows data from population surveys reporting on occurrence of number one and secondary infertility. Fifteen research furnished estimates of primary and secondary infertility incidence in 6400 infertile couple. Out of 6400 infertile patients 3600 (fifty six.25%) offering with primary and 2800 (43.2%) supplying with secondary infertility. Age distribution with number one infertility confirmed that the majority of the participants belong to the most fertile age institution. Age distribution of women with secondary infertility confirmed that majority belongs to the age institution of 30–39 years. The primary results of the modern researches had been the primary infertility’s high rate (fifty six.25%) and excessive charge of female factors among infertile couples. Although, it has been said in other researches that female variables (40%), male variables (40%) or a combination (20%) of each could be associated to the causes of infertility. Motive of the couple’s infertility turned into determined on the basis of their examination results and medical history. As compared to the secondary infertility, number one infertility occurrence was higher within the people approaching a tertiary care middle of public zone. Conclusion: From this systematic evaluate we concluded that as compared to secondary infertility, the primary infertility’s superiority is higher. The marriage age is increasing which impacts reasons with male variables and unexplained infertility greater generally observed with increasing age of marriage. Female component stays a principle reason for the infertility including some unexplained reasons and means. In the population coming to a public region tertiary care center, the number one infertility’s prevalence is higher as compared to the prevalence of secondary infertility.

Background: Imaging plays a key role in the diagnostic evaluation of women for infertility. The pelvic causes of female infertility are varied and range from tubal and peritubal abnormalities to uterine, cervical, and ovarian disorders.

Objective: The purpose of this study was to investigate the causes of infertility in both urban and rural regions. Materials and method: In this systematic review data published by Medline, PubMed, the science straightforward and Obs gyne online library were asked about studies published between 2000 and 2021 using specific MeSH terms. We provided data on 15 phase 6 studies undertaken at a tertiary care facility in rural and urban training locations. Results: In this study, we examined the causes of infertility variability in all habitats. Our revised study shows that fertility rates are very high in small towns and rural areas and very low in the capital, as expected. The study included 7100 married people between the ages of 15 and 49 when 2600 were infertile. The reason for infertility in a couple is assigned on the basis of history and test results. Most women in rural areas are educated. There was a substantial difference between the amount of education and occupation of the site of residence for infertile women. In both rural and urban regions, couples experiencing infertility for less than 5 years were 46 percent and 42 percent, respectively. Women with a familial history of infertility were nearly comparable. In rural places, the history of marriage is common. Female characteristics, male characteristics, and associated features have been claimed to be responsible for infertility in 40percent, 40percent and 20percent of cases, respectively. Conclusion: The poor state of education in rural areas is a major obstacle to encouraging couples to access health care in rural areas. Though PCOS is still a major issue, diseases are still a significant factor in tubal factor infertility, and smoking and liquor enhance the male factor. Most women in rural areas are illiterates. Thus our revised research shows that fertility rates are much higher in small towns and rural areas and compared with the capital due to lack of information and medical services.

Background: Polycystic Ovarian Syndrome (PCO), also called Hyper androgenic anovulation (HA), or Stein-Leventhal syndrome is a very common disorder of ovaries that only occurs in females mainly of reproductive age of 4% to 20% approximately. It is a condition in which multiple cysts, almost 9 to 10 are noted in the ovary, can be on one side or both sides and the volume of the ovary exceeds 10ml. The common representation of PCOS includes obesity, acne, hirsutism, and complications in pregnancy. Objective: To evaluate among the largest population which age group is the most having polycystic ovarian syndrome. Methodology: A literature search was performed with the use of search engines. The search engines that provided the articles for systemic review are Google Scholar, MDPI, PubMed, Medscape, and NCBI. For article searching following keywords were used: Polycystic ovaries, reproductive age changes, and age group. Conclusion: It is concluded that there is a specific age that has Polycystic syndrome ranging from 12-25.

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. To cope with anxiety, people employ potentially harmful strategies like alcohol, cigarettes, medication, withdrawal etc. which may cause panic disorder to worsen. Gongronema latifolium (GL) is one of the medicinal plants used in the treatment of ailment including mental disorders. This study was therefore aimed to elucidate effects of administration of ethanolic leaves extract of fear and anxiety using light/dark transition box. Thirty (30) adult male Swiss white mice were assigned into three groups of ten mice each, thus: control, low and high dose groups placed on 0.9% normal saline, 200 mg/kg and 400 mg/kg of ethanolic leaves extract of GL respectively. All the animals were allowed food and water ad libitum. Results showed significant (p<0.001) increase in the frequency of line crosses, rearing activities in the extract treated groups when compared to the control. There was a corresponding decrease (p<0.001) stretch attend posture, freezing, grooming frequency and grooming duration in the test groups when compared to the control. These indices show that the extract treated groups of mice exhibited decreased fear and anxiety behaviours when compared to the control group. In conclusion, extract of Gongronema latifolium could be used as an anxiolytic for anxiety related disorders due to its ability to attenuate fear and anxiety related behaviours in mice.

Superficial mycosis were diagnosed in 1231 cases, a prevalence of 62.07%. The average age of the patients was 45 years, the sex ratio M/F was 1.19. The majority of the patients were followed as outpatients (96.99%). Of all superficial mycosis, onychomycosis was the most frequent with a rate of 52.32%, followed by epidermomycosis (37.44%), scalp mycosis (8.37%), oral mycosis (1.71%) and genital mycosis (0.16%). Dermatophytes were the most isolated (85.05%), followed by yeasts (13.65%), molds (1.30%). The main dermatophytic species were represented by Trichophyton rubrum (80.99%), followed by Trichophyton mentagrophytes var. interdigitale (8.88%) and Microsporum canis (6.59%). The most common yeasts found were Candida albicans (67.86%), followed by Malassezia furfur (22.02%). Scopulariopsis brevicaulis was the most isolated mold (68.75%). At the end of this study we conclude that mycological examination is essential in the management of patients with superficial mycoses; which must also include the elimination of favourable factors in order to avoid recurrence.

Background: In last few decades, childhood obesity has become a burdensome challenge globally. The most important long-term consequence of childhood obesity is its persistence into adulthood, with all the associated health risks. Persistent obesity is established before the age of 11. Methods: A descriptive cross sectional study with non-probability convenient sampling was carried out over a period of three month in a private sector school Islamabad, Pakistan. The sampling frame was 250 students of grade 4 of roots school system. The response rate was 67%. Results: Mean age in our sample was 10 years. Mean BMI was 18.14 with a standard deviation of 4.4. The frequency of obesity in children was 22% (more than 97th percentile and equivalent to BMI of 30kg/m 2) and that of overweight was 32% (more than 85th percentile and BMI of). Among obese children 28% were reasonably physically active the past week. Regarding eating habits 52% children ate their breakfast every day, 16% of the children never had their breakfast because they didn’t like breakfast or because they were never given breakfast at home. 55% of the children thought that obesity can be prevented by making sure that children are into sports and games, by promoting healthy snacks and banning fast foods, by launching fitness programs and by health education. Conclusion: We found a high frequency of obese and overweight children in the private sector school of Islamabad. Physical inactivity and relationship with other factors like watching TV, gaming and over consumption of junk food was found to be associated with overweight and obesity adds some useful data to the previous researches.

Background: Non-ST Segment elevation myocardial infarction is heterogeneous in its presentation. Like ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction is life-threatening of a major cause of emergency medical care and hospitalization. Patients with non-ST segment elevation myocardial infarction are at risk for adverse cardiac events, so the initial treatment is very important. Increasing age is a strong predictor of adverse events in non-ST segment elevation myocardial infarction patients. Objective: To determine the in-hospital outcome and severity of coronary artery disease of older patients with Non-ST Segment elevation myocardial infarction. Methods: This was a descriptive cross-sectional study. The study was carried out in the cardiology department, National Heart Foundation Hospital, and Research Institute from June 2011 to May 2012. Patients of Non-ST Segment elevation myocardial infarction admitted at National Heart Foundation & Research Institute who fulfill the inclusion criteria were the study population. Patients were recruited by nonrandom sampling. One hundred and thirty-four patients were recruited in this study. Data were prospectively collected in a pre-designed data collection form and analyzed using SPSS - 16 software. Results: In this study, patients had a greater prevalence of hypertension diabetes mellitus. Chest pain and shortness of breath were common presentations observed in study patients during admission. They had a lower left ventricular ejection fraction than their younger counterparts. The older group was associated with an increased risk of triple vessel disease. In-hospital complications were significantly higher in older patients. Duration of hospital stay was longer in older patients. Conclusion: Older patients with Non-ST Segment myocardial infarction strongly predict adverse in-hospital outcomes and severe coronary artery disease profiles. Older patients should alert physicians to an increased risk of morbidity and mortality, which may, in turn, support more judicious treatment, including appropriate utilization of cardiovascular diagnostic tests and therapeutics used in current cardiovascular care to optimize outcomes in these high- risk patients.

An estimated 1 million people die each year from HBV infection. This investigation aimed to determine the frequency, distribution, and risk factors for HBV infection in a healthy Bangladeshi community. A cross-sectional study among the general population was conducted in Dhaka Medical College Hospital. A series of 100 patients with the chronic liver disease between 18 to 49 years. Diagnosed based on clinical and biochemical parameters were collected. All medicine units of Dhaka Medical College Hospital have been analyzed regarding the seroprevalence of HBsAg and its correlation with the demographic pattern. Among 100 cases of liver disease, the number of CLD patients was 85, of which 56 (65.88%) were HBsAg positive 29 (34.11%) were HBsAg negative. The number of patients with acute viral hepatitis was 15, of which 4(26.66%) were HBsAg positive, 11(73.33%) were HBsAg negative, and the overall seroprevalence was 60%. The age incidence was more below 40 years (83%) less above the age of 40(17%). Males had higher seropositivity (70.31%) than females (41.66%). People of all ages are susceptible, particularly the farmers (21.66%) and manual laborers (13.33%). Most of the patients belong to the poor (62.79%) and middle class (62.22%). Urban people were more (60.93%) susceptible than rural people (58.33%). Married persons were more (70.27%) prone than unmarried (30.76%). Seroprevalence of HBsAg was more in those people who had a history of blood and blood product transfusion (84.61%). Illiterate persons were more (75%) susceptible than literate (59.37%). Seroprevalence of HBsAg was more in those who had a history of instrumental tooth extraction (68.42%) than those who had not (58.02%). People who cut their beards and mustache in the barbershop were more susceptible (73.91%) than those who got it by themselves (68.29%). Among female persons, those who underwent instrumental delivery were more susceptible than those who delivered their baby by normal vaginal delivery.

Cryptococcosis is a frequent and severe opportunistic mycosis caused by encapsulated yeast of the genus Cryptococcus. It is common in immunocompromised patients, particularly those infected with the human immunodeficiency virus. We report in our work a case of cryptococcemia in a patient with covid-19 under anti-inflammatory treatment. The diagnosis was based on the presence of encapsulated yeasts with Indian ink and positive culture on Sabouraud medium without cycloheximide with identification of Cryptococcus neoformans as the causative agent. The patient's outcome was fatal.

Since the late 2019, the COVID 19 has had a series of illnesses in patients who had an attack of infection. These symptoms exist in patients even long after the recovery phase. These are called the long COVID syndromes. The current article examines the contribution of Homoeopathy to deal with these long COVID issues. The article traces the syndrome in its major forms & its implications on other aspects of the body. Thereafter, it deals with the subject of the changing face of the pattern of symptoms through the dimension of how, why, when, where and whom of these patterns. Following that the burden of the long COVID is explained through the social & economic impacts that it has exerted while perpetuating poverty. Taking cue from one of the elaborate & established books in the Homoeopathic world, it deals with what Homoeopathy had offered, is offering & the potential to offer in the future to deal with this long COVID pandemic.

POEMS syndrome is a rare paraneoplasic syndrome associated to a plasma cell proliferative disorder, which is characterized by the presence of peripheral neuropathy (P), organomegaly (O), endocrinopathy (E), monoclonal gammopathy (M) and skin change (S). Because of the rarity of this disease, the small number of cases described in the literature and the polymorphism of the clinical manifestations, the diagnosis of POEMS syndrome remains difficult. The prognosis of the disease is related to the early onset of specific treatment. We hereby present a clinical case of POEMS syndrome in a 41-year-old woman revealed by a polyneuropathy, in order to highlight the diagnostic problems and to raise awareness of this syndrome.