Introduction: The incidence of pancreatic cancer has increased in recent years. Pancreatic cancer accounts for 2.9% of all cancers in our registry. Biliary drainage is frequently required and is mainly indicated in cases of cholangitis and/or hyperbilirubinemia. Our work aimed to evaluate the efficacy of endoscopic biliary drainage in pancreatic adenocarcinoma. Materials and Methods: A cross-sectional study was conducted between May 2019 and October2021 and included all patients with pancreatic adenocarcinoma, who underwent endoscopic biliary drainage. Results: Forty-five patients were enrolled, including 23 males and 22 females with a sex ratio of 1.04. The average age was 61 ± 10.9 years. Seven patients (16%) had a history of diabetes, 7 patients (16%) had a history of smoking, 4 patients (9%) had a history of alcoholism, 27 patients had no history. All patients were presented with cholestatic jaundice and 17 patients (37.7%) with abdominal pain. After morphological evaluation, only 11% of our patients had a resect able tumor and 89% of the patients had an unresectable tumor. Thirty-eight patients (84%) had a metallic biliary stent and seven patients (16%) had a plastic biliary stent. Biliary drainage associated with antibiotic therapy allowed controlling cholangitis in 98% of cases, only one patient (2%) died after drainage from sepsis. The average total bilirubin level before biliary drainage was 19.7 mg/dl and 4.8 mg/dl 2 weeks after drainage (P = 0.51), representing a decrease of 76%. Conclusion: Endoscopic biliary drainage is the gold standard for relieving the obstruction in pancreatic adenocarcinoma. Most of our patients (89%) had an unresectable pancreatic tumor. Drainage was ensured respectively by the metallic stent and plastic stent in 84% and 16% of patients and provided very sufficient biliary drainage with a decrease of 76% of bilirubinemia at 2 weeks post drainage.

Background: An umbrella term encompassing diseases that damage the joints and/or connective tissue and cause chronic, frequently intermittent discomfort is rheumatism. Rheumatism is a general term that refers to at least 100 distinct diseases and disorders. Given the dearth of research on this subject, the study's goal was to investigate the range of rheumatic disease among patients presenting as outpatients in the Physical Medicine & Rehabilitation department of a tertiary level hospital. Objective: To evaluate the spectrum of rheumatic disease in a tertiary level hospital in Bangladesh. Materials and Methods: This cross-sectional study was carried out at the Physical Medicine and Rehabilitation department of the DMCH for six months. The study sought to enroll patients who had musculoskeletal problems or systemic symptoms that would indicate rheumatic illness. After meeting the requirements, patients were accepted. Each respondent provided written informed consent, and those who refused to engage in the study or undertake additional research were not included. By conducting a face-to-face interview with the respondents and utilizing a pre-tested semi-structured questionnaire, information about the respondents' socio-demographic characteristics, disease duration, clinical symptoms and signs, and investigations report was gathered. Data analysis was done in SPSS-16. Results: Mean age of respondents was 46.36±12.25 years (male= 50±11.68 years and female= 44.19±12.03 years [age range 21-70 years] with 35.7% male and 64.3% female. Around 54.17% of the cases presented with articular symptoms, 43.23% of the patients had degenerative and 10.94% had inflammatory joint diseases. Among the inflammatory arthritis, (38.09%) rheumatoid arthritis and (30.95%) Ankylosing spondylitis was most common whereas (28.92%) lumbar spondylosis and peripheral (28.31%) osteoarthrosis were predominating among non-inflammatory arthritis. Nonspecific back pain was the commonest (60.12%) of specific disorders included in soft tissue rheumatism, followed by (25.77%) adhesive capsulitis of shoulder. Conclusion: Articular disorders both non-inflammatory & Inflammatory, soft tissue rheumatism, disorder of bone and multi-system disorders; these four types of disorder were encountered in this tertiary care hospital.

Contraception usage continues to be an important public health intervention that is hindered in the majority of low- and middle-income nations, including Nigeria, for a variety of reasons. This research aims at determining the contraceptive usage and related factors in Nembe, Bayelsa State. A descriptive survey design was employed to determine usage of contraception and its related factors among women of child bearing age in the local government area.Result showed that out of the total number of respondents (n = 398), 152(38.2%) have used modern contraceptive methods while 246(61.8%) have not. Among the respondents, only 76(19.1%) are currently using modern contraceptives while majority of the participants 322(80.9%) are currently not using any form of contraceptive. 42(10.6%) currently use male condom, 18(4.5%) use oral pills, 8(2.0%) use implants, 7(1.8%) use injectables, 1(0.3%) use IUD while 322(80.9%) use none. 50(12.6%) always use contraceptives, 8(2.0%) occasional use, 18(4.5%) rarely use while 322(80.9%) use none; 57(14.3%) used contraceptives to prevent pregnancy, 32(8.0%) use it to prevent sexually transmitted disease and pregnancy, 14(3.5%) to prevent sexually transmitted disease, 13(3.3%) to ensure child spacing while 282(70.9%) did not state any reason for not using. Binary logistic regression shows that the lower the knowledge of contraceptives, the less likely females of childbearing age will utilize modern contraceptives in Nembe, Bayelsa State and there was a statistically significant relationship between knowledge and usage of modern contraceptives (P = <0.001) at 95% Confidence Interval.The poor use of contraceptives is worrisome and there is therefore urgent need to design and significantly increase social and behavioral modification interventions and strengthen systems to encourage the usage of contraceptives for an improved maternal and child health outcomes amongst other benefits.

Background: Over 50% of young people between the ages of 15 and 24 are affected by HIV. This state of affairs is destroying youth, threatening the country's future and jeopardizing national development. The aim of this study is to assess the knowledge, attitudes and behaviour of young people in the city of Isangi with regard to HIV/AIDS. Materials and Methods: To collect the data, this descriptive cross-sectional study used a questionnaire administered to a non-probability convenience sample of 70 young people aged 16 to 20. The descriptive analysis enabled us to compare our results with previous work. Results: We observed that the average age of our respondents was 18, with a sex ratio of 1.4 in favor of males. 95% of young people had already heard of AIDS. Over 65% of subjects have acceptable knowledge of the risk of contracting HIV, the route of transmission and condom use. Prevention of mother-to-child transmission and voluntary testing were recognized. 70% of young people agreed to take care of a PLHIV in their family while keeping his or her serostatus secret (75.7%). For 40% of subjects, it is not normal for a woman to refuse to have sex with her unfaithful partner; she can demand a condom. Conclusion: To reduce HIV transmission among young people, an information and education program is needed.

Objective: When we say staple food, cereals & pulses come to our mind. The concept of food security that encompasses 3As & 1U is not to be thought of without cereals & pulses. These are Availability, Accessibility, Affordability and Utilization. This holds good for pulses as well. The current article deals with homoeopathic medicines made from pulses [1, 17]. Before going to therapeutics, the production, consumption & export of pulses in India has also been discussed from the past till date. The role of green revolution in decreasing the production & consumption has also been discussed. All these processes are essential part of the process of nutrition [14]. As pulses are a part of our life, some of the basics on pulses have also been discussed in a paragraph. Since eating pulses is an integral part of our life, Homoeopathy also has made pulses an integral part of its therapeutics. The medicines prepared from pulses have been used by Homoeopathic practitioners since the advent of 19th century after it was introduced to the world by Dr. Samuel Hahnemann in 1790 [18].

Background: CKD may be defined as either kidney damage or glomerular filtration rate <60 ml/mm/1.73 m2 for more than three months. Kidney damage is defined as pathological abnormalities or marks of damage including abnormalities in blood, urine, and imaging test. Objective: To analyze the changes in cortical thickness of the kidney and, the size of the kidney with progression to CKD. Methods: This study, conducted between May 2021 to April 2022, employed a retrospective cross-sectional design within the ultrasound department of a Tertiary Hospital. The study involved 200 CKD patients with a glomerular filtration rate (GFR) of < 60 ml/min. Serum creatinine estimation was performed alongside blood tests on the same day as ultrasonography, which assessed echogenicity, parenchymal thickness, cortical thickness, and longitudinal length. All gathered data were recorded in the pro forma. Results: The patient cohort had an average age of 54.62±13.3 years. Mean serum creatinine showed significant variance across echogenicity grades (p=0.0005). Comparable trends were observed for mean parenchymal thickness (p=0.0005), mean longitudinal length (p=0.0005), and mean corticomedullary distinction (p=0.0005). A statistically significant highly positive correlation emerged between serum creatinine and cortical echogenicity grading (r=0.915, p = 0.0005). Conclusion: Renal cortical echogenicity, particularly its grading, exhibited the most substantial correlation with serum creatinine among various sonographic parameters like longitudinal length, parenchymal thickness, and cortical thickness in CKD patients. As renal cortical echogenicity's irreversible nature contrasts with serum creatinine levels, it stands as a viable parameter for renal function assessment.

Tuberculosis is a tropical pathology caused by Mycobacterium Tuberculosis. Public heath problem in developing countries with a polymorphous clinical picture. OBSERVATION: It was a 67-day-old infant, weighing 3350 g, admitted for fever, whining, hacking cough, prostration for which traditional treatment based on chest massage and medical treatment at home was unsuccessful. The clinical examination revealed conjunctival pallor, dry skin, a temperature of 38°3c, and a bulging anterior fontanelle. The blood count returned to 11000/Fields. Faced with this picture, a neonatal infection or meningitis was mentioned. An initial treatment based on dual antibiotics (Ampicillin, Gentamicin) was administered without success. The evolution was marked by the persistence of the cough, respiratory distress and the lumbar puncture suggesting neonatal tuberculosis placed under protocol 2 RHZ(E) /10RE. After 22 days, the infant died.

Background: EHRs have the potential to improve patient healthcare by providing real-time access to patient information, improving communication between healthcare providers, and reducing medication errors. However, the evidence on the impact of EHRs on clinical outcomes is mixed. Objective: To review the literature on the impact of EHRs on clinical outcomes and to provide recommendations for improving the use of EHRs to improve patient healthcare. Methods: A literature review was conducted to identify studies on the impact of EHRs on clinical outcomes. The search was limited to English-language studies published in peer-reviewed journals. Results: The literature review found that EHRs have the potential to improve clinical outcomes, such as mortality, morbidity, hospital readmission rates, and bed utilization. EHRs can also help to reduce medication errors and improve patient safety. However, the impact of EHRs depends on a number of factors, such as the quality of the EHR system, the way it is implemented, and the training of healthcare providers. Recommendations: For improving the use of EHRs to improve patient healthcare include: Developing high-quality EHR systems that are easy to use and can integrate with other systems, Providing adequate training for healthcare providers on how to use EHRs effectively, Encouraging interoperability between EHR systems from different vendors, Addressing privacy and security concerns, Reducing user resistance to EHRs. Conclusion: EHRs have the potential to improve patient healthcare by providing real-time access to patient information, improving communication between healthcare providers, and reducing medication errors. However, the impact of EHRs depends on a number of factors, such as the quality of the EHR system, the way it is implemented, and the training of healthcare providers. By following the recommendations above, we can make EHRs a more effective tool for improving patient healthcare.

Background: The increase in prevalence of diabetes mellitus among Saudi population is being associated with many health consequences among diabetic patients. One of the serious complications is diabetic ulcer. Aim: To assess the awareness, attitudes, practices and risk factors influencing diabetic foot ulcers among diabetes patients in the eastern province of Saudi Arabia. Method: A cross-sectional study consistent of 38 questions conducted in Eastern region of Saudi Arabia, distributed between 8-Feb-2018 to 1-June-2018 through social media. The structured questionnaire was designed to collect demographic characteristics, in addition to several questions about history of foot problems, current foot or leg problems, foot care, foot wear, safety and prevention and foot care education. Result: Two hundred and ninety-three participated in the questionnaire, of whom 197 were female and 96 were male. The majority of participant (154) had been diagnosed with T2DM. About the treatment which was multiple choice: 55.3% were using oral hypoglycemic drugs, 34.1% using insulin and 31.1% were using diet while the rest were using parenteral hypoglycemic drugs. Most participants (60.1%) reported having altered sensation (i.e. numbness) in their lower limbs. One hundred twelve of participants examined their feet only when they had problem. Only 50.2% drying well between the toes. About using moisturizing cream for the foot and using cream between toes 39.2%, 19.8% were saying yes 37.9% and 31.1% were answer sometimes while the rest 22.9% and 49.1% answer no, respectively. Participants wore more than one type of shoe, with athletic being used by 46.8% of participants, 29.4% wear broad and round toes, 23.2% were wear shoes which made of leather or canvas. Walking barefoot inside the home was 44.7%. Most participants (50.2%) didn’t inspect the shoes before wearing them. Forty participants didn’t check about the water temperature before soaking feet, 42% check about it while the other didn’t soak the feet. For sitting with legs crossed 54.9%. Around 95% of participants want handout on how to care for the feet. Conclusion: Foot care is crucial to prevent serious complications in diabetic patients. Pharmacological and non-pharmacological measures should be followed to ensure adequate and proper foot care. The participants in this study had inadequate information and poor practice toward the appropriate foot care.

Background: The burgeoning issue of drug addiction, coupled with its intricate linkages to psychiatric aspects, necessitates innovative interventions. This research delves into the efficacy of awareness campaigns as a strategy for addressing the psychiatric dimensions of drug addiction, specifically within the confines of a tertiary level hospital in Bangladesh. Methods: This prospective study examined the impact of awareness campaigns on drug addiction's psychiatric dimensions. Using purposive sampling, 100 patients were selected from the Department of Psychiatry, Rajshahi Medical College, between January 2020 and December 2022. Quantitative surveys and qualitative interviews were conducted to measure changes in awareness, attitudes, and behaviors. Standardized scales gauged shifts over time. Ethical considerations were adhered to. Pre- and post-campaign comparisons facilitated longitudinal assessment. Results: Preliminary findings reveal a positive shift in participants' awareness of psychiatric aspects linked to drug addiction after exposure to awareness campaigns. Initial awareness levels of 25% concerning psychiatric dimensions rose significantly to 68% post-campaign. Moreover, willingness to seek comprehensive treatment increased from 32% before the campaign to 75% afterward. Actively seeking treatment information also saw a rise, climbing from 18% pre-campaign to 56% post-campaign. Qualitative insights highlighted that 83% of participants acknowledged the campaigns' role in enhancing understanding. Additionally, participants displayed improved attitudes towards seeking treatment for both addiction and concurrent psychiatric issues. These results collectively indicate the campaigns' efficacy in fostering heightened awareness, altering attitudes, and driving proactive behaviors. Conclusions: The initial results indicate that awareness campaigns hold promise as effective tools in addressing the psychiatric dimensions of drug addiction treatment. A comprehensive analysis of the complete dataset will provide deeper insights into the extent of these changes and their potential long-term implications for treatment outcomes.

Lipids are indispensable in the SARS-CoV-2 infection process and studies have focused on investigating the clinical significance of plasma lipid profile on COVID-19 patients. There are studies in patients with COVID-19 that document that blood lipid levels change in individuals who have been infected by SARS-CoV-2 and that their increase is consistent with the degree of morbidity and mortality. At the same time, it has been measured that during the complete recovery of the patients there is also a complete normalization of the lipid profiles. Furthermore, it has been reported that a large proportion of COVID-19 patients continue to receive lipid-lowering therapy after recovery. Lipid-lowering medication is generally continued throughout the period of active infection and beyond. The present review focuses on investigating the relationship between low-density lipoproteins (LDL) and SARS-CoV-2 infection and how lipid levels can predict prognosis or mortality in patients with COVID-19.

Objective: To investigate the sensitivity, specificity and diagnostic accuracy of contrast-enhanced computed tomography (CECT) and contrast-enhanced ultrasound (CEUS) for hepatocellular carcinoma (HCC). Methods: The clinical data of patients who underwent hepatectomy in the first Affiliated Hospital of Guangxi Medical University and underwent CECT and CEUS before surgery were retrospectively analyzed. The gold standard was postoperative pathological examination results. Results: A total of 554 patients were included, and 650 lesions were found. The sensitivity and coincidence rate of CECT and CEUS for lesions were more than 94% and 83%, respectively. 14 lesions with diameter less than 2cm which were detected by CUES were not detected by CT and 26 such lesions which were detected by CT were not detected by CUES. Conclusion: CUES and CECT have similar high sensitivity and diagnostic accuracy for HCC. Combined CT and CUES detection could find more small lesions in the liver.

Providing medical knowledge and ability to give high-quality patient care, physicians are long acknowledged as crucial players in the healthcare system. To address the challenges and challenges within contemporary healthcare systems, however, physicians' roles as healthcare leaders are becoming more and more important. This manuscript addresses the challenges and opportunities that physicians encounter in their leadership positions and emphasizes how crucial it is for them to lead effectively to transform the course of healthcare. The first section of the paper examines the difficulties faced by physicians in their roles as healthcare executives. These difficulties include limited opportunities for leadership training and development, resistance to change, balancing clinical responsibilities with leadership obligation, navigating complex organizational structures, managing conflicts of interest, and time constrain. Additionally, the manuscript emphasizes how important it is for physicians to embrace technology improvements and the shift to a digital healthcare system while protecting patient privacy and data security. In contrast, the manuscript also presents various opportunities that physicians can seize to enhance their leadership effectiveness. These opportunities include; enhancing patient safety and quality of care, driving interdisciplinary collaboration, advocating for healthcare policy reform, value-based care, organizational support, and technological advancements. A lead physician can shape the healthcare organization by properly understanding these issues and avail opportunities.