Magnet hospitals are recognized for quality patient outcomes and nursing excellence. It was aimed to examine the effects of Magnet hospitals on mortality rate. Searches for this review were carried out using the PubMed, Scopus, and CINAHL databases without any year limitation. Search terms included Magnet hospitals, non-Magnet hospitals, and mortality. Inclusion criteria were: The identified 58 articles published in international journals, and 13 of those articles that met the inclusion criteria were included in this review. This systematic review adhered to the PRISMA guideline. Articles meeting the research criteria were evaluated for methodological quality with the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) Critical Appraisal Tool. The research types used of the included studies were descriptive comparative research (n = 8), cohort study (n = 4), and retrospective, two-stage panel design (n = 1). Three descriptive comparative studies found that there was no difference in the mortality rates of Magnet hospitals and non-Magnet hospitals. By contrast, five descriptive comparative studies and five longitudinal studies determined that mortality rates were lower in Magnet hospitals. Overall, the findings of this systematic review indicated that Magnet hospitals are associated with lower rates of mortality. Considering the organizational consequences of mortality such as quality and cost savings, this systematic review provides significant contributions to hospital executives, as well as the nurse-clinicians, whether or not to obtain magnet status.

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Background: Visual impairment is a global problem. The World Health Organization (WHO) in 2017 estimated that 36 million people were blind and 217 million people had moderate or severe visual impairment. An untreated or undetected eye problem becomes a threat to the general health of the individual, particularly the health of those that lack the basic needs of life. Most blind people live in low-income countries where increasing poverty perpetuates destitution. Aim: This study aimed at determining the prevalence of visual impairment among the destitute in Onitsha metropolis, which would provide a solid database for designing an effective eye care delivery system for them in the state. Subjects and Methods: This was a cross-sectional study of 168 destitute individuals in Onitsha. The study was carried out between June and July 2011. Destitute clusters were randomly selected, and all of the eligible participants were interviewed. Presenting visual acuity (VA) at 6 m, refraction, and anterior and posterior segment evaluation were done. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 16. Results: One hundred sixty-eight destitute individuals—consisting of 93 males (55.4%) and 75 females (44.6%)—were studied, and the age range was 11–78 years with a median age of 45 years. One hundred twenty-nine participants (76.8%) did not have any formal education, all were unemployed, and none had any personal assets or property. Fifty-six participants (33.3%) had ocular disorder. The prevalence of blindness was 12.5% and that of visual impairment was 10.2%. The causes of blindness were glaucoma (6, 28.6%), cataract (5, 23.8%), corneal acuity (5, 23.8%), and empty socket from tumor nucleation and trauma (2, 9.5%). Conclusion: Ocular findings in all eyes of the destitute are similar to that in the eyes of normal individuals. Destitution is an offshoot of health, social, and economic frustration, and therefore requires a comprehensive approach.

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Background: Depression is a widespread disorder with either an independent or interrelated relationship with chronic disease. Aim: This study aims to assess depression prevalence and its predictors among patients with sickle cell disease (SCD). Patients and Methods: This is a cross-sectional study conducted in Saudi Arabia where patients with SCD assessed for having depression through Patient Health Questionnaire (PHQ9). Results: Depression was evaluated among 88 patients with SCD with a median age of 32.6 ± 11.8. Out of 88 patients, 44 (50%) participants had some form of depression. Out of those with depression, 25 (56.8%) had mild depression and 18 (40.9%) had moderate depression. However, there was a significant relationship between depression and the number of annual emergency visits, intensive care unit admissions, and frequency of blood transfusion (P-value < 0.05). There was no significant relationship between depression with neither hemoglobin nor HbS (P-value > 0.05). However, depression score found to be inversely proportional to the HbF level. Both gender and annual emergency visits were significantly related to depression (P-value = 0.01, 0.001. respectively). Conclusion: Depression is quite prevalent in patients with SCD though it is still being overlooked. Several clinical and laboratory indices found to be closely linked to depression. Constellations of these factors may help early recognition of depression and disease severity modulation.

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Background: Peritoneal dialysis (PD) is frequently used in pediatric patients with renal failure. Aim: In the present study, we evaluated the indications and complications of PD and patients' outcomes in pediatric patients. Patients and Methods: Medical records of patients who underwent PD between 2012 and 2019 were analyzed retrospectively. The patients were divided into two groups as acute PD (APD) (Group 1) and chronic PD (CPD) (Group 2). If the patient was diagnosed with acute kidney injury (AKI), an APD catheter was inserted, while a CPD catheter was inserted for patients with stage 5 chronic renal failure or those in which AKI persisted for more than 6 weeks. Results: Group 1 and Group 2 consisted of 62 and 64 patients, respectively. The most common indications for PD were AKI (64.5%) in Group 1, and obstructive uropathy and reflux nephropathy (45.3%) in Group 2. The overall complication rate was 30%. These were leakage at the catheter insertion site (11.2%), catheter occlusion (4.8%), and peritonitis (4.8%) in Group 1; and peritonitis (14.1%), catheter occlusion (6.2%), and inguinal hernia (4.6%) in Group 2. The mortality rate was 72.5% and 23.4% in Group 1 and Group 2, respectively. The most common causes of mortality were multisystem organ failure (40%) and sepsis (33.5%) in both groups. A total of 83 patients (32 in Group 1 and 51 in Group 2) had omentectomy. Catheter revision and/or removal were performed in 11.9% of all patients. Omentectomy had no effect on the prevention of catheter occlusion (p > 0.05). Conclusion: The mortality rate is lower in CPD patients than in APD patients. Although PD in pediatric patients is associated with potential complications, its actual rate is relatively low. The primary catheter dysfunction rate is low, and omentectomy has no significant effect on preventing catheter occlusion.

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Background: Extended-spectrum beta-lactamases (ESBL) are the most widespread of the new beta-lactamases and are a significant threat to patient care in the hospital and the community. Aim: The study assessed the prevalence, antibiotic susceptibility profile, and major ESBL encoding genes among Escherichia coli isolated from clinical specimens of patients in the National Hospital, Abuja (NHA). Materials and Methods: E. coli isolated from diverse clinical specimens obtained from clinically proven cases of infection managed at the NHA were included in the study. The antimicrobial susceptibility was performed by the Kirby–Bauer method and E-test was used to confirm the ESBL phenotype. Multiplex polymerase chain reaction (PCR) was used to detect the genes mediating ESBL production. Results: Meropenem, fosfomycin, and tigecycline demonstrated excellent activities against all isolates: of the 400 isolates, 392 (98%), 386 (96.5%), and 362 (90.5%) were susceptible, respectively. Similarly, 358 (89.5%) were susceptible to amikacin, 323 (80.3%) nitrofurantoin, 281 (70.3%) ceftazidime, and 279 (69.8%) cefotaxime. A total of 271 (67.8%), 219 (54.8%), and 208 (52.0%) were resistant to amoxicillin–clavulanate, ciprofloxacillin, and gentamicin, respectively. However, all the isolates were resistant to ampicillin. There was a significantly higher proportion of multidrug resistance among ESBL-producing isolates compared to non-ESBL-producing isolates (P = 0.0001). Of the 121 phenotypically detected ESBL isolates, 119 (98.3%) harbored genes mediating the production of Cefotaximase– Munich (CTX-M), Temoniera (TEM) or Sulfhydryl Variable (SHV) enzymes. Conclusion: The prevalence of ESBLs among E. coli was relatively high, at 30.2%. About 81% of all blood isolates were ESBL-producers. bla_CTX-M is the predominant type of ESBL gene among E. coli. A high proportion of the ESBL-producing isolates expressed a combination of two or three genes together.

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Aims and Background: Shoulder pathologies are frequently linked to sleep disturbances. The aim of this study is to investigate the effect on sleep disorders in patients with arthroscopic rotator cuff repair. Materials and Methods: Thirty-three patients who underwent arthroscopic rotator cuff repair due to a full-thickness rotator cuff tear were prospectively analyzed. The Pittsburgh Sleep Quality Index (PSQI), the American Shoulder and Elbow Surgeons Shoulder Score (ASES), visual analog scale (VAS), and Constant and Murley shoulder scores before surgery and at 6 months postoperatively. Preoperative clinical and radiological parameters of the patients were also evaluated. Results: The study analyzed 33 patients with a median age of 59.79 ± 9.0 years. There was a significant difference preoperatively versus postoperatively in terms of all PSQI global scores and subdivisions (P < 0.001). A statistically significant improvement was determined by the simple shoulder test, the Constant and Murley shoulder scores, and VAS (P < 0.001). Conclusion: Sleep disturbance is common in patients with symptomatic rotator cuff tear, and sleep disturbance can resolve after arthroscopic rotator cuff repair.

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Background: Despite benefits, autopsy rates continue to fall globally. The effects of education, religion, and culture on autopsy rates are well documented. Aim: This study examines the knowledge and attitudes of health personnel, aiming to identify other factors affecting autopsy rates in our environment. Subjects and Methods: This is a cross-sectional non-intervention study using semi-structured questionnaires and Statistical Package for Social Sciences Version 21, for data collection and analysis. Results: Seventeen percent, 50%, and 33% of participants had good, fair, and poor knowledge about autopsies, respectively. Poor understanding of the legal framework governing autopsies accounted for significant gaps in knowledge. Knowledge grade differed significantly amongst the different professional groups (χ² = 33.14; P value = 0.016). Eighty-two percent had good attitudes toward autopsy, though only 63% indicated approval. About 74% percent indicated willingness to consent to autopsies on relations, while 45.3% indicated willingness to consent to autopsy on self-remains. Autopsy-related work experience correlated strongly with both knowledge (χ² = 22.34; P value = 0.004) and attitude (χ² = 24.28; P value = 0.004) grades. Multinominal regression analysis showed autopsy-related work experience to be an independent determinant of willingness to consent to autopsy on self (P value = 0.023). Conclusion: Autopsy rates in Benin city and environs may reflect lack of knowledge or a misunderstanding of the laws guiding autopsy. Autopsy-related work experience is an important factor influencing knowledge and attitude of health personnel in this study. Its effect on autopsy request and acceptance rates should be further evaluated.

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Background: Although warfarin is the most effective treatment approved to prevent atrial fibrillation-associated stroke, it remains underused in clinical practice due to patient noncompliance. Therefore, novel oral anticoagulants (NOACs) have been developed. Aims: This study aimed to identify bleeding complications in patients who were taking oral anticoagulants and compare the rates of major and minor bleeding events between NOACs and warfarin groups. Patients and Methods: We conducted a retrospective, observational study of warfarin- and NOAC-treated patients who presented to an emergency department between January 2015 and December 2019 with bleeding events. We compared patients with major and minor bleeding in terms of age, gender, comorbid diseases, type of anticoagulant, and site of bleeding. Results: An electronic search yielded 95 (21.9%) cases of patients taking a NOAC (i.e., dabigatran [19], rivaroxaban [45], apixaban [29], or edoxaban [6]) and 354 taking warfarin. There were no significant differences between the warfarin and NOACs groups in the frequency of minor bleeding complications. Similarly, there were no significant differences between the groups in the frequency of major bleeding complications. No significant difference in intracranial bleeding was seen between the NOACs- and warfarin-treated patients, although the incidence of gastrointestinal bleeding was significantly higher in the NOACs (P = 0.102 and P = 0.021, respectively). Conclusion: Our findings indicate that rates of major and minor bleeding complications in patients taking NOACs are similar to those in patients taking warfarin. While warfarin was associated with fewer complications than NOACs in terms of gastrointestinal bleeding, the risk of intracranial bleeding, was similar between the groups.

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Background: Chronic kidney disease (CKD) is a global growing public health epidemic with attending morbidity and huge financial cost. Cardiovascular disease (CVD), a major complication of CKD, contributes to its excessive mortality rate. The aetio-pathogenesis of the excess burden of CVD in CKD is a feature yet to be unravelled. Fibroblast growth factor-23 (FGF-23) has been implicated as a risk factor for CVD among patients with CKD. However, most of these studies were predominantly among the Caucasian population. Aim: This study aims to determine the correlation between FGF-23 and CVD among Nigerians with CKD. Patients and Methods: A cross-sectional comparative study composed of three groups: participants with CKD, hypertensives without CKD, and healthy individuals, represented as group 1, 2, and 3, respectively. Information obtained included demographic data and occurrence of risk factors for CVD. Cardiovascular risks were assessed by echocardiography and all the participants had kidney function tests done with plasma FGF-23. Results: The study sample size consisted of 135 participants. The mean (SD) age for participants with CKD and controls were 50.2 (12.7), 54.3 (15.5), and 40.2 (14.1) years, respectively. The median [interquartile range (IQR)] of plasma FGF-23 for participants with CKD 210 (139–304) RU/ml, and controls 124 (86–170) RU/ml, and 71 (38 – 89) RU/ml P < 0.001. Most participants with CKD had left ventricular hypertrophy (LVH) (80.0%), compared to the controls; 28.9% and 6.7% P < 0.001. Similarly, majority of participants with CKD had elevated plasma FGF-23 with LVH (85.7%) compared to controls 55.6% and 11.5%, whereas for aortic valve calcification with elevated plasma FGF-23 among CKD and controls were 53.6% (P = 0.29), 37.0% (P = 0.03), and 19.2% (P = 0.06), respectively. Conclusion: Individuals with CKD had frequencies of elevated plasma FGF-23, LVH, and cardiac valve calcification, which are surrogates of cardiovascular events.

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Background: Acute phase reactants and inflammation biomarkers such as ferritin, procalcitonin, C-reactive protein (CRP), and complete blood count parameters (White blood cell, platelet count) are usually used to evaluate and monitor the disease severity and treatment response of systemic inflammatory diseases. In addition to these parameters, Immature granulocytes (IG) that increase during systemic infection, hematological malignancy, and drug treatments (such as chemotherapy and glucocorticoids) are important parameters for evaluating systemic inflammation. The sensitivity and specificity of IG are as high as the abovementioned inflammatory biomarkers for monitoring disease severity and treatment response. Aim: The aim of the study is to evaluate the relationship between IG count and the need for mechanical ventilation and mortality in patients hospitalized in the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). Patients and Methods: The medical records of the 401 patients who were followed up in the ICU due to COVID-19-related acute respiratory distress syndrome between October 2020 and February 2021 were retrospectively reviewed. On the day of admission to the ICU complete blood count (CBC), arterial blood gas analysis, coagulation parameters (fibrinogen, D-dimer) are recorded. CRP, procalcitonin, and ferritin levels are also recorded at the day of admission. During the follow-up period, the survival status and mechanical ventilation status of the patients were recorded and the relation between IG count and these parameters was evaluated. Results: The mean IG at the admission was 0.2 ± 0.4 109/L. The IG level of the intubated patients at the time of intubation was 0.3 ± 0.5 109/L. There was a significant positive correlation between mortality and IG levels at admission and at the time of intubation (IG admission; P = 0.001, r = 0.347 and IG at intubation; P = 0.001, r = 0.228). Conclusion: IG levels in CBC data could be a potential practical biomarker. This issue requires further research and the development of therapies targeting IG cells is needed.

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Background: It has been reported that the most affected organ by the coronavirus disease 2019 (COVID-19) is the lung, closely followed by the kidney. Aim: Over the course of the COVID-19, the factors affecting mortality in acute kidney injury requiring renal replacement therapy (AKI-RRRT) have not been known. This study was conducted in order to shed light on this issue. Patients and Methods: There were 64 patients in total. Subjects were divided into two groups. Group 1 consisted of a control group that comprised 33 subjects who did not have AKI during the time in which they were infected with COVID-19. Group 2 was COVID-19 related AKI requiring renal replacement therapy (COVID-19 AKI-RRRT), which included 31 subjects who were exposed to AKI-RRRT. Results: İn Group 2, 27 (87%) patients died and 4 (13%) patients were recovered. The predominance of comorbidity and presence of more than one additional disease (p < 0.05), the excessive number of inpatients in intensive care unit (ICU) (p < 0.05), high mortality rates (p < 0.05), advanced age (p < 0.05), and long hospitalization periods (p < 0.05) were evident in Group 2. Serum levels of variables such as white blood cells (WBC), neutrophils, C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, glucose, lactate dehydrogenase (LDH), and prothrombin time (PT) were high for patients in the Group 2 (p < 0.05) group. However, serum levels of lymphocyte, hemoglobin (HGB), and albumin were low. Conclusions: It can be argued that COVİD-19 AKI-RRRT is associated with higher mortality.

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Background: Alloimmune hemolytic disease of the newborn (AIHDN) results in hemolysis, anemia, hyperbilirubinemia with the potential for brain damage. Intravenous immunoglobulin (IVIG) has been investigated as an alternative low-risk procedure for the treatment of AIHDN in addition to traditional treatment methods such as phototherapy and exchange transfusion (ET). Aim: To evaluate the effectiveness of IVIG therapy in decreasing ET needs based on risk factors and clinical outcomes. Materials and Methods: Charts of neonates born >30 weeks of gestation who underwent phototherapy and were administered IVIG therapy due to AIHDN between January 2013 and July 2018 were retrospectively reviewed. Results: Sixty-three neonates were included in our study. Forty-three of them (68.3) % were full-term infants. ABO incompatibility (n = 33, 52.4%) was the major cause of AIHDN (n = 63). Additional risk factors for jaundice were found to coexist in 95.2% (n = 60) of the infants. Fifteen infants (23.8%) required ET, mostly due to Rh incompatibility (n = 11, 73.3%). Mortality was observed in 3.2% (n = 2) of the patients, 1.6% (n = 1) of whom were related to ET. Serum albumin value was found to be negatively correlated with the requirement for ET (r = 0.713, P < 0.001), whereas serum bilirubin albumin ratio was positively correlated (r = 0.489, _P < 0.001). Nine (14.3%) infants needed a simple transfusion during the hospitalization period, whereas five (7.9%) infants had readmission for simple transfusion after discharge. Apnea was the only complication seen in one (1.6%) patient. Conclusion: IVIG treatment should be considered due to its relative benefits when compared to exchange transfusion. In addition to its safety, it is a less complicated treatment modality with low side effect rates. It may be justified for elective use in neonates suffering from AIHDN, who will require ET with a risk of mortality by decreasing the peak of total serum bilirubin levels.

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Background: The COVID-19 (coronavirus disease-2019) outbreak has its social, economic, and political effects on wider society, as well as physical and mental health effects on individuals. The psychological and social impacts are more apparent and common on emergency health care workers who have close contact with patients. Aim: Our study aims to investigate coronaphobia in emergency health care workers. Subjects and Methods: A cross-sectional study was carried out in July 2020 with 253 people working under the Bingöl 112 Provincial Ambulance Service Chief of Staff. The data of the study were collected using a questionnaire including sociodemographic characteristics, working conditions, pandemic process, and the Coronavirus-19 Phobia Scale. P < .05 was considered statistically significant. Results: The mean total score of COVID-19 phobia in 112 employees was 58.03 ± 18.78. The sub-dimension scores are psychological 21.92 ± 6.19, somatic 10.83 ± 5.68, social 15.98 ± 5.60, and economic 9.28 ± 4.18. Psychological and social sub-dimension scores and total COVID-19 phobia score of women, the somatic sub-dimension score of married people, all sub-dimension scores, and total COVID-19 phobia score of those who had contact with COVID-19-positive patients were found to be significantly higher (P < .05). Conclusions: Close contact with patients, working conditions, and the heavy schedule of nightshifts increase psychological and social fear in emergency health care workers. It is important to provide psychosocial support to emergency health care workers during the pandemic period.

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Background: Respiratory diseases constitute a significant cause of morbidity globally. There is limited information on the epidemiology of respiratory diseases in North Central Nigeria particularly with the changing trend in risk factors. Aim: This study aimed at evaluating the pattern and morbidity related to respiratory diseases among adult outpatients attending a chest clinic in a tertiary healthcare facility, especially with increasing environmental pollution and biomass exposure globally. Patients And Methods: This was a retrospective review of the case records of 338 newly referred patients seen in the chest clinic of the University of Ilorin Teaching Hospital (UITH) with respiratory illnesses over a 2-year period (January 2017–December 2018). Results: The mean age of the recruited patients was 47.6 ± 19.8 years with a male to female ratio of 1.1:1. Microbiologically confirmed tuberculosis (30.2%), chronic obstructive pulmonary disease (COPD) (24.3%), and bronchial asthma (17.8%) were the commonest conditions managed in the clinic. Overall, noncommunicable respiratory diseases (61.2%) constituted a larger proportion of cases when compared to infective respiratory conditions. Almost 90% of the patients were never smokers. Systemic hypertension (15.1%) and human immunodeficiency virus infection (3.6%) were the commonest comorbid illnesses. Conclusion: Although tuberculosis constituted the most observed single condition, noncommunicable respiratory diseases predominated cumulatively among the new cases seen in the chest clinic of UITH, Ilorin. This raises the need for significant attention in terms of prevention and management of noncommunicable respiratory diseases, which appear to be on the uprising.

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Background: Diarrhoea is a major cause of childhood morbidity and mortality in developing countries including Nigeria. Rotavirus is a leading cause of acute watery diarrhoea in children under 5 years of age. Aims: The aim of the study is to determine the prevalence of rotavirus diarrhoea in children less than 5 years old presenting with watery diarrhoea at the University of Maiduguri Teaching Hospital. The cross-sectional study was carried out at University of Maiduguri Teaching Hospital (UMTH), a referral tertiary centre for northeast Nigeria and neighbouring Cameroon, Chad, and Niger Republic. Study population were children under five presenting to UMTH with acute diarrhoea. Freshly passed stool was collected from each participant in a universal sterile container and transported to the department of medical microbiology laboratory UMTH, Rotavirus antigen was detected using Rota – dipstick an immunochromatographic test. The positive samples were subjected to RT-PCR to detect the VP 7 gene of the dsRNA. Patients and Methods: SPSS Version 25. Results: The prevalence was found to be 14.5% in the population studied and was highest among children below 1 year of age. Conclusions: This study has confirmed that rotavirus is an important cause of childhood diarrhoea. The burden of childhood diarrhoea can be reduced by introduction of vaccines, and children of 1 year old and younger will benefit from this vaccine as most study participants have not been vaccinated. Creating awareness on prevention and control of this infection with mass vaccination will go a long way in reducing the prevalence and mortality rate of rotavirus diarrhoea.

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Background and Aim: The aim of the study was to examine the demographic, clinical features, treatment responses, and outcomes of Hodgkin lymphoma (HL) patients and to investigate the factors affecting their survival. Patients and Methods: A retrospective analysis was made of patients diagnosed with HL in our department between 2009 and 2019. Treatment regimen, treatment response, and follow-up times were recorded for all patients. Using these data, complete response (CR) rates, overall survival (OS), and progression-free survival (PFS) were calculated. The effects of parameters on survival were investigated with Cox regression analysis. Results: Evaluation was made of 60 patients with a median age of 33.5 years [18.0–80.0] and mean follow-up duration of 29.34 ± 23.64 months. Median OS and PFS could not be reached with a mean OS of 85.6 months, and PFS of 71.7 months at the final visit. Only initial leukocyte and neurophil count were determined to have a statistically significant impact on survival (OR = 1.004; P = 0.031 vs OR = 0.996; P = 0.036). Conclusion: In HL patients, in addition to the many prognostic scoring systems, leukocyte and neutrophil count can be used as an independent prognostic parameter. Patients with higher leukocyte and lower neutrophil counts at the time of diagnosis should be managed more carefully.

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A 19-year-old male undergraduate presented to the eye clinic with a history of poor vision in the left eye since childhood. The best-corrected visual acuity was 6/6 in the right eye and hand movement in the left eye respectively. Examination of the anterior segment of the right eye was essentially normal, whereas the anterior segment examination of the left eye revealed a small globe, microcornea, and an iris coloboma inferiorly at the 6 o'clock position. Binocular indirect ophthalmoscopy of the right eye revealed a pink disc, normal vessels and macula, lattice degeneration with retinal holes, and a flat retina. The left eye had a pink disc, normal macula and vessels with an inferior arc-shaped excavation with exposure of the sclera, which involved both the disc and macula and was in keeping with a retinochoroidal coloboma. Systemic examination revealed low-set ears with a left atrophic pinna, mild kyphoscoliosis, pectus excavatum, and an atrophic left lower limb with anomalies of the toes and talipes equinovarus. A pan-systolic murmur was present on cardiovascular examination.

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Background: Serum proteins serve as biomarkers for athletes and recreationally active individuals; they reflect the positive nitrogen growth balance alongside the onset of fatigue. Aim: To investigate the impact of training sessions on serum proteins is crucial to monitor their impact on athletes' future performance. Patients and Methods: A cross-sectional study to compare serum blood protein biomarker (albumin blood, blood urea nitrogen, total protein, uric acid, and creatinine), in 43 young Saudi professional soccer players in Riyadh, levels were measured pre- and post-training sessions across a 3-day period. Results: Significant differences were found between training sessions from day 1 to day 3 in addition to the significant differences between post- and pre-training sessions with P > 0.05. Creatinine levels increased significantly in the players' blood samples post-training on all 3 days of training (P = 0.01). Albumin was the only serum protein biomarker that showed no significant changes pre- and post-training, while albumin levels varied by a statistically significant amount (P = 0.02) between pre-training (day 1 and day 2) and post-training (day 1 and day 3) periods. Conclusion: As biomarkers, serum proteins may provide good indicators that can be used to organize training schedules to achieve optimal outcomes. In this study, creatinine was the most sensitive biomarker measured post-training; it can be considered a critical biomarker while blood urea was the least sensitive.

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Background: Benign prostatic hypertrophy (BPH) is a common urological condition in men older than 50 years. It is important in the aetiologies of life-threatening obstructive uropathies. Ultrasound measurement of prostate volume is non-invasive, easily available, and a cost-effective method, useful in assessing bladder outlet obstruction (BOO). The International Prostate Symptoms Score (IPSS) on the other hand objectively assesses symptoms severity in BOO patients. Aim: This study was aimed at determining the correlation between ultrasound-measured prostate volume and IPSS in men with BPH. Patients and Methods: Following ethical approval from the Nnamdi Azikiwe University Teaching Hospital Ethical Committee, 100 patients who met the inclusion criteria and were diagnosed with clinical BPH were enrolled into the study. They had no other identifiable cause of BOO except BPH after clinical evaluation. The IPSS, Quality of life score (QOL), and prostate volumes were measured. Correlation between prostate volume, IPSS, and QOL were done using SPSS version 20. P value <0.05 was considered significant. Results: The mean age of patients was 69.3 ± 10.6 years with a range of 48–100 years. The mean prostate volume, IPSS, and QOL were 96.0 ± 70.5 cm³, 15.63 ± 8.6, and 4.8 ± 1.3, respectively. The highest recorded IPSS was 35 and the lowest was 4, whereas the smallest and largest recorded prostate volumes were 19 cm³ and 350 cm³, respectively. Nocturia was the major IPSS subscore. There was a weak positive correlation between prostate volume and IPSS in men with BPH (r = +0.109; P = 0.28) and between prostate volume and QOL (r = +0.072; P = 0.45). There was also a weak positive correlation between patients with only severe symptoms and corresponding prostate volumes (r = +0.122; P = 0.125). The correlation between patients with severe symptoms and their corresponding QOL was strong (r = +0.537; P = 0.135, respectively). These findings were, however, not statistically significant. Conclusion: There is a weak positive correlation between prostate volume measured by ultrasound and symptoms severity scores in patients with BPH, although not statistically significant. This may be as a result of the small sample size. A larger sample size may be able to achieve statistical significance.

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Background: The lung recruitment maneuver (LRM) applied in acute respiratory distress syndrome (ARDS) may increase the intra-cranial pressure (ICP). Aims: This study evaluated the effect of LRM on intra-cranial pressure changes in patients with ARDS by measuring the optic nerve sheath diameter (ONSD). Patients and Methods: LRM was applied to patients undergoing follow-up for ARDS, with a positive pressure of 30 cmH₂O for 30 s. ONSD on ultra-sonography, dynamic lung compliance (C_dyn), oxygen saturation (S_pO2), and hemodynamic parameters were measured before (T0), immediately after (T1), and 10 min after (T2) LRM. The primary endpoint was the effect of LRM on ONSD changes. The secondary endpoints included the effect of LRM on C_dyn, S_pO2 change, and relationship between C_dyn and ONSD changes. Results: The study included 60 patients. ONSD was higher at T1 than at T0 (median [interquartile range]: 5.13 [0.4] vs. 5.3 [0.3] mm, P < 0.001) but was similar at T0 and T2 (5.13 [0.4] vs. 5.09 [0.37] mm, P = 0.36). C_dyn and S_pO2 were significantly higher at T1 and T2 than at T0 (C_dyn: 22.3 [5.8] vs. 23.7 [7.5] vs. 19.4 [6.6] mL/cmH₂O, P < 0.001; S_pO2: 90[2] vs. 92[4] vs. 88[4] %, P = 0.013). A significant correlation existed between C_dyn and ONSD changes, which increased at T2 compared to T0 (P < 0.001). Conclusion: LRM applied in ARDS causes a short-term increase in ONSD. However, C_dyn increases 10 min after LRM and causes ONSD, thereby leading to a decrease in ICP.

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Background: Gestational trophoblastic disease (GTD) is a rare and often curable group of diseases that has a large range of morphological features, sometimes making the diagnosis difficult. Aim: The objectives of this study were to evaluate the pathological frequency and histopathological profile of GTD diagnoses in the Madinah region of Saudi Arabia (KSA). Materials and Methods: The computerized record of the pathology department of the Maternity and Children's Hospital (MCH) in Madinah, KSA, was reviewed from July 2015 to June 2021. During the study period, all the pathology reports with diagnosis of GTD were included in the study for the following parameters: age, nationality, year of diagnosis, type of GTD, and total annual number of pregnancies. Simple statistical analysis was performed, utilizing the SPSS-19 software. Results: A total of 289 cases of GTD were diagnosed during the study period. The mean age was 33.47 ± 9.3, and most of the patients (n = 106, 36.2%) were in the fourth decade [31-40 age group]. Histologically, the most common type diagnosed was Hydatidiform mole [HM] (n = 284, 98.6%), followed by three cases of trophoblastic neoplasm (1.0%) and one case of tumor-like condition called exaggerated placental site (0.3%). Complete HM (n = 53, 50%) was common in the fourth decade, whereas partial HM (n = 50, 53.8%) was common in the third decade. Conclusion: In the Al Madinah region of KSA, the most common type of GTD in women was HM. Most GTD cases were found in women between the ages of 31 to 40 years. The frequency of GTD, its histopathological subtypes are consistent with most of the studies on GTD; however, larger studies involving multiple centers are recommended, for confirmation of present study's findings.

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Background: Circulatory failure (shock) is a life-threatening emergency referring to a state of poor tissue perfusion and resultant anaerobic respiration at a cellular level. It is a common pathway for several severe pediatric morbidities. Aim: We evaluated the clinical predictors of shock and coexisting morbidities in acutely-ill children. Patients and Methods: This was a descriptive, cross-sectional study. Data were collected using a researcher-administered questionnaire eliciting demography, clinical features, diagnoses/differentials, and comorbidities. After binary analysis, multiple logistic regression identified variables that independently predict circulatory failure in the participants, using odds ratio (OR) and 95% confidence intervals (CI). Results: Five hundred and fifty-four children took part in the study. Their median age was 60 (IQR: 24–132) months, mean weight 16.3 ± 13.6 kg and mean height was 90.8 ± 33.2 cm; 53.7% of them were males while 46.3% were females. The incidence of shock was 14.3% among the participants on arrival at the emergency room. Febrile seizure (14.9%), dehydration (4.7%), pallor (3.1%), and coma (1.8%) were the clinical findings significantly associated with shock (P < 0.05). Leading underlying diagnoses and comorbidities associated with shock were severe malaria (85.4%) and severe sepsis (25.0%) (P ≤ 0.01). Also, seizure (OR = 0.07, 95% CI: 0.04–0.13; P ≤ 0.001) and severe sepsis (OR = 0.31, 95% CI: 0.15–0.65; P = 0.002) were independent predictors of circulatory failure. Conclusion: The presence of acute neurologic morbidities and severe infection predicts circulatory failure in the pediatric emergency setting. Early detection and prompt treatment will forestall shock-related complications in affected children.

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In addition to the esthetic outcomes, autologous breast reconstruction offers satisfactory functional results via sensory recovery of the flap. A herpes zoster infection developed after an autologous breast reconstruction provides objective evidence of spontaneous reinnervation in a reconstructed breast. One previous case of a herpes zoster infection on autologous latissimus dorsi flap has been reported to date; the infection developed 2 years after the breast reconstruction operation. However, our case presents a herpes zoster infection developing only 2 months after surgery. To our knowledge, the present case represents the first reported instance of a herpes zoster infection that developed shortly after the breast reconstruction using a latissimus dorsi flap.

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Background: Although, sickle cell trait (SCT) was considered a benign condition with most patients being asymptomatic, however, there is an impressive increase in the number of sudden deaths in the military recruits and athletes, which has led to SCT as a rapidly emerging medical issue. Genetic factors have been extensively investigated in the etiopathogenesis of SCT but, environmental factors have not been studied in depth. Aims: The main aim of this study was to investigate the effect of high temperature on the red blood cells (RBCs) in those with SCT and compare this to a control group lacking SCT. Patients and Methods: Heat stress to RBCs was induced by in vitro incubation of freshly drawn blood at high temperatures (45°C for 35 min). Additional information such as hemoglobin (Hb) level, RBC count, mean corpuscular volume (MCV), and hemoglobin S level was obtained from the medical record of the case and control groups. Data were entered in Statistical Package for Social Sciences version 22.0 (IBM Corp, Armonk, NY, United States) and analyzed to examine the research hypothesis. Results: A total of 17 blood samples from SCT (HbAS subjects) labeled as cases and 16 samples from controls (HbAA subjects) were included in this study. The results of this study showed no significant change in sickled erythrocytes in SCT in response to in vitro heat stress. Conclusion: This study's findings appear to suggest that hyperthermia could be excluded as one of the major factors inducing sickling complications during exhausting exercise. Long-term studies in the future are recommended in this area, particularly to assess the effect of high temperature and sudden death in SCT.

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Background: Glaucoma is a global public eye health concern, being the number one cause of irreversible blindness. Aim: It is commoner, has an earlier onset, and is more aggressive in people of African descent. Awareness creation and screening activities have been identified as key components of the glaucoma care pathway. Subjects and Methods: This was a cross-sectional, descriptive study with analysis. The screening took place at the eye clinic, University College Hospital, Ibadan. Participants comprised all consenting adults aged 40 years and above who presented following a prescheduled telephone appointment during the 2021 World Glaucoma Week (WGW) activities. The main outcome variables were the awareness of glaucoma, and the uptake of and satisfaction with the free screening program. The associations between participants' prior awareness of glaucoma and their socio-demographic and clinical features were explored using the Chi-squared test. A P value of <0.05 was considered significant. Results: A total of 94 (47%) participants presented for the screening out of the 200 people who scheduled an appointment through the telephone appointment booking system. Forty-nine (52.1%) were males, and the mean (SD) age of participants was 55 years (10.9) with a range of 40–80 years. Fifty-eight (61.7%) participants had heard of glaucoma before the 2021 WGW awareness programs and 75.9% (44) gained some new knowledge from the programs. Newly diagnosed glaucoma was 9.6% (n = 9) of which seven (77.8%) had advanced glaucoma (CDR ≥0.9) in at least one eye. One hundred percent of the participants reported that they would recommend the screening to others. Conclusion: Targeted eye screening can help with the early detection of glaucoma. Patient satisfaction should be at the fore of eye health services to improve uptake.

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Background and Aims: Evaluation of the optical properties of restorative materials is an important parameter for identifying clinical success. The aim of this study was to compare the translucency of contemporary resin-matrix ceramics (RMCs) and to evaluate the effect of cement shade on the final color of RMCs indicated for laminate veneers and full crowns. Materials and Methods: A hundred A2 shade RMC specimens were fabricated by using Mazic Duro (MD), CAMouflage NOW (CN), KZR-CAD HR2 (KZR), Grandio Block (GB), and Brilliant Crios (BC) at 0.7-mm and 1.5-mm thicknesses (n = 10). A2 shade composite resin was used for the foundation structure. Twenty resin-cement specimens were prepared from A2 and translucent shades at 0.1-mm thickness. Interchangeably, the foundation-cement-resin matrix ceramic assemblies were created with optical gel. The color coordinates were recorded using a spectrophotometer. After calculating translucency parameter (TP₀₀) and color difference (ΔE₀₀) values, data were analyzed statistically (P = 0.05). Results: TP₀₀ values were influenced by RMC type and thickness. TP₀₀ values of RMCs can be listed in descending order as MD>GB = CN>BC=KZR. ΔE₀₀ values were significantly influenced by all parameters and their interactions. MD exhibited higher ΔE₀₀ values among tested RMCs. The effect of A2 cement was not perceived visually while TR cement demonstrated visually perceptible but clinically acceptable values for both laminate veneers and full crowns. As the material thickness decreased, the TP₀₀ and ΔE₀₀ values increased in all RMCs. Conclusions: Clinicians should carefully prefer cement shade and RMC material by contemplating their impact on the optical properties particularly when the restoration is thin.

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Traumatic bone cysts (TBCs) are uncommon, nonneoplastic lesions occurring more commonly in the metaphysis of the long bones and contribute to only 1% of the cysts occurring in the jaws. Seen more commonly in the mandible between the canine and third molar, their occurrence in the ramus-condyle region is very rare. The radiographic appearance of this lesion is like odontogenic keratocyst (OKC) or ameloblastoma and, therefore, extremely challenging to diagnose. Misdiagnosis often results in aggressive treatment for an otherwise innocuous entity. The purpose of this article is to encourage the surgeon to consider the possibility of a TBC when encountering asymptomatic large lytic lesions in the ramus of the mandible especially in younger individuals to avert an extensive radical surgery.

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Background: Herniation through foramen of Winslow is a relatively rare group of hernias characterized by protrusion of the abdominal contents into the lesser sac. To our knowledge, this is the youngest and the only reported case related to adolescents in the last five years. Case Presentation: A 15-year-old male patient presented to our emergency department after experiencing 4 hours of acute dull upper abdominal pain. We diagnosed the patient with herniation through foramen of Winslow by computed tomography (CT) and other complementary diagnostic methods. After a 3-trocar laparoscopic procedure, the hernia was successfully repositioned and no bowel resection was required. The patient was discharged on the fourth postoperative day without complications. He was no recurrence six months after operation. Conclusions: Through the review of the literature, it is clear that herniation through foramen of Winslow (HFW) is a more challenging condition to diagnose preoperatively, which can be achieved with the help of complementary diagnostics especially CT. As a category of diseases with a very low postoperative recurrence rate, clinical experience tells us that only three-trocar laparoscopic surgery can successfully return HFW.

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Background: Ureteropelvic junction obstructions (UPJOs) occur more frequently on the left than on the right side. Among patients diagnosed during the neonatal period, those with left-side UPJO have a more severe course than those with right-side UPJO. Aim: This study examined clinical advances in the surgical management of right and left symptomatic UPJOs preoperatively and postoperatively, based on a retrospective analysis of cases. Patients and Methods: In this retrospective clinical trial, 650 patients were evaluated at the time of diagnosis and at surgery. Results: Left-side UPJO was diagnosed in 66.1% of patients (P = 0.017). The median age of the patients at surgery for left- and right-side UPJO was 1.5 and 4.2 years, respectively (P = 0.001). At the preoperative evaluation, the ratio of parenchymal thickness (RPT) on the UPJO side versus the contralateral side was 0.55 ± 0.3 and 0.7 ± 0.3 for patients with left-side and right-side UPJO, respectively (P = 0.029). RPT during the first postoperative year was 0.83 ± 0.2 for patients treated on the left side and 0.9 ± 0.3 for those treated on the right side (P = 0.25). The respective values at 3 years postoperatively were 0.8 ± 0.3 and 0.9 ± 0.2 (P = 0.09). The preoperative kidney function value in the left-side group was 42.5 ± 13.4, which declined to 39.52 ± 15.8 at the 3-year follow-up examination. In the right-side group, preoperative kidney function was 38.8 ± 16.1, which increased to 40.2 ± 13.2 at 3 years postoperatively. Both the decline and improvement were significant (both P = 0.006). Conclusions: Those with left-side UPJO had a more severe course than those with right-side UPJO.

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