Introduction: Upper gastrointestinal bleeding (UGIB) is a frequent cause of medical care. They constitute medical and surgical emergencies that quickly involve the patient’s vital prognosis. The main objective of this work is to study the epidemiological profile of UGIB. Materials and Methods: Our work is a descriptive prospective study including all patients admitted for upper gastrointestinal bleeding from January to December 2020. All patients received specific emergency care as well as upper endoscopy. Results: 72 patients with UGIB were included, 31 men (43.1%) and 41 women (56.9%). The average age is 56.5 ± 6.8 years. UGIB was manifested as isolated melena (40.3%), hematemesis associated with melena (25%). On admission, hemoglobinemia was below 7 g/dl in 51.4% of cases. The history of the patients was dominated by portal hypertension (PHT) (13.7%), taking antiplatelet agents (13.7%) and anticoagulants (11%). The average time for completion of the upper endoscopy is 36.97h ± 8.9. The main diagnoses were ulcer bleeding (34.7%), PHT related bleeding (23.67%), and gastritis (16.6%). Bleeding recurrence and mortality were estimated at 25% and 5.6% of cases respectively. Conclusion: The majority of upper gastrointestinal bleeding occurred in patients over 60 years old. The most common etiologies are ulcer disease and bleeding related to portal hypertension. Gastroscopy is the key examination and constitutes the main stage for diagnostic, etiological, prognostic and therapeutic purposes.

Although COVID-19 vaccines are now widely available in Bayelsa State, adequate immunization of the population is hampered by vaccine hesitancy. This study aimed to identify factors associated with COVID-19 vaccine hesitancy. One thousand and a hundred (1,100) adults aged ≥ 18 years were selected from 300 randomly selected households in two semi-urban communities in Bayelsa State and were interviewed in this descriptive cross-sectional survey. Willingness to receive COVID- 19 vaccines and the associated factors were assessed using an interviewer-administered structured questionnaire. A slim majority of the 1,100 participants were women (51.1%) and single (72.6%). About half of the participants were university undergraduates (52.2%). Awareness of COVID-19 among the participants was 67.1%, and less than a third of respondents were unwilling to take the COVID-19 testing. However, the unwillingness to accept the COVID-19 vaccine was high in the population (45.5%). On bivariate analysis, willingness to take the COVID-19 vaccine was associated with having ever heard of the vaccine (p<.001), willingness to take COVID-19 testing (p<.001), and educational qualification (p<.001). On regression analysis, only willingness to take testing (p=0.000, CI=0.267, 0.446) and prior vaccine awareness (p= 0.049, CI = 0.592, 0.446) independently related to a willingness to take the vaccine. Common reasons for unwillingness to take COVID-19 vaccines included possible side effects, safety, and efficacy concerns. The willingness to receive the COVID-19 vaccine in this mostly educated and youthful populace was relatively poor. Public health education concerning the safety and efficacy of the vaccine should be intensified to improve the community’s willingness.

The aim of investigation: to study the effect of early administration high doses of atorvastatin in the acute period of STEMI on the indicators of low dose dobutamine stress-echocardiography and parameters of left ventricular remodeling. Material and Methods: The study included 164 patients with STEMI All patients underwent myocardial revascularization (TLT or PCI) within the first 6 hours. The 1st group included 82 patients who received basic therapy (atorvastatin 20 mg), the 2nd group included 82 patients who took a loading dose of atorvastatin (at a dose of 80 mg per day). Low dose dobutamine stress-echocardiography was performed to detect myocardial stunning after stabilization of the patients condition on 4–6 days of the disease. In addition to general clinical and conventional laboratory research methods, on the 1st day and on the 10th day of treatment, the level of CPK MB, ESR, the number of blood leukocytes, and the level of fibrinogen (FN) were determined. Results: On the 10th day of therapy in patients of both groups, there was a significant increase in ESR (in the 1st group by 2.1 times, in the 2nd - by 1.6 times) and a decrease in the level of CRP (by 3 and 2.65 times, respectively) compared to the first day. The dynamics of these indicators reflects the regular processes of the course of AMI. A more significant change in these parameters was recorded in patients of the 2nd group who took atorvastatin at a dose of 80 mg. At the same time, on the 10th day of AMI, the number of peripheral blood leukocytes significantly decreased in them (p<0.05 when compared between groups). The number of dobutamine-responsive segments (segments with reversible dysfunction) in the group of patients treated with atorvastatin at a dose of 80 mg during myocardial reperfusion was significantly higher than in the control group (p<0.05). Conclusion: It was revealed that conducting of myocardium reperfusion in infarct-related coronary artery with simultaneous use of atorvastatin’s high doses promoted the limitation of myocardial necrosis development, reducing ischemic and reperfusion injuries of myocardium and influenced on the formation of myocardial stunning zones which is a reversible disfunction. The use of atorvastatin in the dose of 80 mg/per day in the first hours after acute myocardial infarction development promotes the improvement of LV systolic indices, prevents the progressing of LV cavity postinfarction dilatation.

We report a case of a 25-year-old female, with a history of gastrojejunal anastomosis 6 years ago for pyloric stenosis due to intentional corrosive ingestion, who was admitted for jaundice related to the common bile duct stones diagnosed at MRI. The patient had undergone Endoscopic retrograde cholangiopancreatography (ERCP) and upper endoscopy that allowed the diagnosis of afferent loop syndrome related to pyloric stenosis and duodenal stenosis. The afferent loop syndrome was related to hyper pressure in this afferent loop and was managed surgically by performing a jejuno-duodenal anastomosis.

Background: The cytotoxic chemotherapy is the mainstay treatment of cancer and it is usually complicated with infections. Appropriate antibiotics and other supportive medications must be started immediately as bacterial infections may progress with the absence of granulocytes. Improved outcomes can be seen with empirical administration of broad-spectrum antibiotics and they remain as the standard of care. Patients with intermediate-risk for Febrile Nuetropenia (FN) (10%-20%) need to be evaluated for additional patient risk factors, after assessment, patients who present with at least one of the risk factors for FN is recommended for treatment with a G-CSF. Methodology: Our study was a retrospective cohort single centered observational study carried out randomly in 104 patients in the oncology department of Lourdes hospital, Cochin Data of the patients were collected from Mediware system, medical records and Statistical software SPSS were used for analysis of the data. Results: In our study febrile neutropenia was managed using antimicrobials, of which antibiotics and antifungals prescribed were 12.09% and 1.97% respectively and with granulocyte-colony stimulating factors (G-CSFs) (6.15%). Principally used empirical monotherapy was meropenem sulbactum / meropenem (n = 48) which was followed by piperacillin tazobactum (n=18) and cefoperazone sulbactum (n=15) This study had a leading prescription of Cyclophosphamide containing chemotherapy regimens which led to neutropenia. Breast cancer patients accounts the majority of febrile neutropenic episodes despite of receiving GCSF prophylaxis. The most common type of cancer patients who are suffering from neutropenia were breast cancer. The compliance with National Comprehensive Cancer Network (NCCN) guidelines were analyzed in that we can see 84.6% patients had partial compliance and 14.4% patients had full compliance. Conclusion: A total of 66 patients received both antibiotics and G-CSF treatment however 13 patients and 25 patients were managed only with G-CSF and antibiotic therapy respectively. This study had a leading prescription of Cyclophosphamide containing chemotherapy regimens which led to neutropenia. These regimens were used mainly in breast cancer patients. Breast cancer patients accounts the majority of febrile neutropenic episodes despite of receiving GCSF prophylaxis. The most common type of cancer patients who are suffering from neutropenia were breast cancer. The NCCN guidelines, majority of patients showed partial compliance(86.6%) and about (14.4%) showed full compliance.

Diabetes is a growing health concern worldwide and now emerging as an epidemic world over. Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia or increased blood glucose levels, resulting from insufficient or inefficient insulin secretion, with alterations in carbohydrate, protein and lipid metabolism. Type-2 diabetes is the most prevalent form, of the total diabetics about 90% have type-2 diabetes, which is characterized by post-prandial hyperglycaemia (increase in blood sugar level after a meal). Many medicinal plants are reported to have insulin-mimetic effect, modulation of insulin secretion and inhibition of carbohydrate digesting enzymes. The currently available anti diabetic agents include sulfonylureas, thiazolidinediones and alpha glucos idase inhibitors and are widely used to control the hyperglycemia. These drugs fail significantly to alter the course of diabetic complications. They have limited use because of undesirable pathological conditions and high rates of secondary failure. This it is essential to look for more effective antidiabetic agents with fewer side effects. Traditional medicinal plants having anti diabetic properties can be a useful source for the development of safer and effective oral hypoglycaemic agents. More than 350 traditional plants are used in the treatment of diabetes mellitus, which have been recorded. Only a small number of these have received scientific and medical evaluation to assess their efficacy. However, plant remedies are the mainstream of treatment in underdeveloped regions. This review focuses on diabetes mellitus and the role of plants in the treatment of diabetes mellitus.

Background: Functional results after low anterior resection for rectal cancer are an issue of increasing attention among colorectal surgeons and others interested in this subject. The aim of the study to compare the nocturnal bowel movement and frequency of bowel movement between TCP & SA groups after low anterior resection. This study also compare the urgency of bowel movement between two groups and the incontinence of flatus & loose stool between two groups. Methods: This prospective observational study was carried out in the Department of Surgery Bangabandhu Sheikh Mujib Medical University Shahbag, Dhaka, during 1st January 2016 to 30lh June 2017. For this purpose, a total of 40 patients with low rectal cancer undergoing low anterior or ultra-low anterior resection with TCP or straight anastomosis in the above mentioned hospital were both male & female patients and age group (18-75 years) were enrolled in this study. Data was expressed as mean with standard deviation (Mean±SD). Collected Data were statically analyzed applying student‘t’ test and chi-square test using SPSS-24. P value of <0.05 was considered statically significant. Results: The mean age was 45.9±13.29 years in group-I and 47.55±10.86 years in group-II. Male female ratio was 1.2:1 in TCP group and 1.5:1 in SA group. Anal tone on 3rd month 1(5.0%) in group-I and 10(50.0%) in group-II. Anal tone was significantly (p<0.05) improve in group I at 3rd month. Finger grip on 3rd month 18(90.0%) in group-I and 19(95.0%) in group-II. Finger grip was almost alike between two group, no statistical significant (p>0.05) was found between two groups. Conclusion: Most of the patients were in 5th and above decade and male predominant. Transverse coloplasty pouch anastomosis provided not only better functional results than straight anastomosis, but also improved quality of life, thus may be the better choice.