Can we Measure Speech Perception Ability Objectively in Young Children using Cochlear Implant?

Speech perception plays a significant role in the development of speech and language ability in children with hearing loss. There are various speech perception tests with the specific protocol to administer and score.

Auditory evoked potential is an objective measure used for assessing hearing acuity in young children. Higher cortical evoked potential test provides an effective indication of the physiological status of auditory cortex. CEAP can be obtained in young children with assistive devices.

The present research study aims to investigate whether latency and amplitude of aided cortical evoked potential can predict Speech perception score in cochlear implant users.

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Ureter Visualization on Tc-99m DMSA Scintigraphy in Pediatric Patients

Static renal follow imagings by means of Tc-99m DMSA scintigraphy is indicated in the acute and follow-up phases of the patients with urinary tract infection (UTI).

DMSA scintigraphy shows the renal damage as functionality loss and/or renal scars of the kidney. Additionally scintigraphy may provide important prognostic information in patients with UTI.

Accompanying findings to a static renal scintigraphy might be increased background activity which refers to end stage renal disease and second finding is visualization of the ureter which is usually recognized to be related with the high grade vesicoureteral reflux (VUR).

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Contraceptive Discontinuation, Method Switching and Associated Factors among Reproductive Age Women

Although there has been an increase in preference for modern methods in Ethiopia in recent years, high method discontinuation and switching are also common.

Apparently, there is a lot of study on the prevalence rate of contraceptive among couples, but not sufficient knowledge about the reasons switches the method used and why they give up the contraceptives after using for some time.

This implies that the study of discontinuation of contraceptive use, along with the associated factors for such discontinuation, becomes important that would have further implications for continuing the success of family planning programs in Ethiopia.

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Degrees of Recommendations and Levels of Evidence: What you Need to Know?

Clinical practice guidelines and other recommendations need to be used based on how much confidence can be placed in its recommendations.

Systematic and explicit methods to make judgments can reduce errors and improve communication. In this article we present a summary of the practice approach to medicine based on evidence through the degrees of evidence and recommendation levels.

We can define the practice of Evidence-Based Medicine (EBM) as the conscientious, explicit and judicious of the best available evidence in making decisions about care of a patient that requires integration of best evidence with clinical expertise and the values and circumstances of the patient.

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Intervention for Non-Communicative Children with Autism Spectrum Disorders

This open-label clinical trial examined the efficacy and safety of a d-amino oxidase inhibitor, sodium benzoate, in the treatment of non-communicative children with autism spectrum disorder.

We hypothesized that benzoate, through indirect glutamate stimulation, may enhance learning in communication. Method: Six children (five boys, one girl, 3-year-7-month to 9-year-6-month of age) completed the 12 weeks of study of receiving sodium benzoate in conjunction with communication training program.

The outcome measures were Receptive and Expressive Vocabulary Test-Chinese, parent-reported Adaptive Behavior Assessment System-II, number of core vocabularies learned in the applied communication learning system, Chinese child developmental inventory and parenting stress index.

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Anthropometric Measurement of Weight for Assessment of Nutritional Status of Anganwadi Children in Urban Mangalore - A Cross Sectional Study

Anthropometry is the part of anatomy used to do external measurement of human body to assess underlying disease, like assessing the nutritional status of a child.

The 254 Anganwadi children between age group 1 to 6 years of urban Mangalore during 2013year, measurements are calculated using WHO growth standard in assessing weight.

The underweight denotes in respect to age but doesn’t pin point whether acute or chronic, but the stunting is due to chronic malnutrition, the axial skeletal growth is stunted. Concludes that lower socioeconomic status and malnutrition are interrelated, which hampers the normal physical, intellectual, psychological development of children, there by affects the progress of the country.

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The Role of Emergency Department in Poland

Emergency department (ED) is an organizational unit of the hospital, which is also a unit of the National Emergency Medical Service. Its task is to promptly provide health care services as part of initial diagnosis and the necessary treatment to stabilize the vital functions of persons in a state of sudden danger to life or health.

In addition to patients being transported by ambulances and aviation rescue units to the ED, anyone can be contacted even if they do not have a referral to the hospital. Help is provided to everyone regardless of their place of residence.

For a hospital to be able to set up an SOR, it must be able to protect patients within general trauma surgery, internal medicine, anaesthesia and intensive care units, imaging diagnostic laboratories, paediatric surgery and paediatrics- if the hospital provides medical services to children.

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Disabling Bilateral Hip Disease and Femoral Bone Defects Revealing Systemic Sarcoidosis

One involvement in sarcoidosis is rare and often asymptomatic. The small bones of hands and feet are the most common localizations, while skull, knee, rib, pelvic and sternal localizations are rarely reported. Here we report a hip localization.

A 52-year-old woman consulted for acute bilateral coxopathy. Chest radiography objectified bilateral interstitial syndrome with mediastinal lymphadenopathy. The X-ray of the pelvis and both hips showed no abnormalities and CT scan revealed a moth-eaten osteolytic lesion of the left femoral head.

It was associated with inflammatory syndrome and cholestasis. Liver biopsy revealed epithelioid and giant cell granulomas without caseous necrosis. The pathology specimens were interpreted as representing sarcoid.

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Sickle Cell Trait, Malaria and Sensorineural Hearing Loss–A Case-Control Study from São Tomé and Príncipe

Hearing loss is a problem with higher incidence in South Asia, Asia Pacific and sub-Saharan Africa. In these countries there is also associated history of anemia and malaria.

This study aims to identify a putative role of Beta globin mutation - sickle cell trait and HL in São Tomé and Príncipe population. A retrospective case-control study of a convenience sample was collected during Otolaryngologist Humanitarian Missions in São Tomé and Príncipe.

Control group includes individuals with normal hearing in both ears, and the case group has participants presenting bilateral or unilateral HL.

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Identification of Patient-Perceived Barriers to Communication between Patients and Physicians

Barriers to full disclosure and communication of complete and accurate health history from patients to their physicians can compromise patient care.

Identification of barriers to communication between patients and their physicians, and assessing communication techniques to overcome putative barriers may improve medical training, quality patient care, and patient experience.

The authors performed a cross-sectional study using a novel questionnaire at an urban, inner-city hospital in Toronto, Ontario between January 1, 2011 and January 1, 2012, in order to evaluate potential barriers to communication.

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Human Papilloma Virus (HPV) Vaccines: Scope and Implications

High risk human papilloma virus has often been associated with cancer onset and progression by the virtue of the viral oncogenes.

Genital cancers and Oropharyngeal cancers are the two leading carcinomas often induced by HPV infection.

These viral encoded oncogenes are known for their ability to integrate, recombine and interfere with the host cellular genes.

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Determinants of High Fertility among Ever Married Women in Enderta District, Tigray Region, Northern Ethiopia

Fertility is one of the major components of population dynamics, which determine the size and structure of a population. According to Ethiopian Demographic and Health Survey 2011 report, the total fertility rate is decreasing from 5.5 children in 2000 to 4.8 in 2011.

However, the rate of decline has been very slow as compared to the developed world. Thus, the objective of this study was to determine the magnitude and factors associated with high fertility among ever married women aged 25-49 years in Northern Ethiopia.

A community based cross-sectional study was conducted on randomly selected 531 subjects in Enderta district using an interviewer administered questionnaire.

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The Need of Incorporating Pharmacoeconomics in Pharmacy Curriculum of Pakistan

The fundamentals of Pharmacoeconomics compare value of a pharmaceutical system over another. Being a sub-discipline of health economics, Pharmacoeconomics appraises the cost and effects of a pharmaceutical product or service hence directs best possible healthcare resource allotment, in a homogeneous and scientifically acceptable approach.

Indeed the use of Pharmacoeconomics in pharmaceutical and medical sciences is a valid and valuable method that is beyond doubt and comparison.

However, there are multiple factors that affect practical application of the Pharmacoeconomical processes in a real time environment.

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Left Ventricular Non-Compaction: Mid-myocardial Distribution of Late Gadolinium Enhancement in Compacted Segments

Cardiovascular Magnetic Resonance (CMR) with Late Gadolinium Enhancement (LGE) is a proven method for detecting myocardial fibrosis. Previous CMR studies described the distribution of LGE in patients with LVNC.

however, it still remains unclear. The purpose of the study was to describe the distribution of LGE in patients meeting cardiovascular magnetic resonance criteria for Left Ventricular Non-Compaction (LVNC).

We retrospectively enrolled 15 patients adult patients (11 males and 4 females; mean age, 42 ± 13 years) considered to meet standard CMR criteria for LVNC.

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Results of Investigations for Tuberculosis in Patients with Serpiginous Like Choroiditis in Comparison to Patients with Central Serous Retinopathy and Non-Serpiginous Uveitis

To compare results of tuberculosis investigations in cases of serpiginous like choroiditis (SC), central serous retinopathy (CSR) and non serpiginous uveitis.

Methods: 40 patients each of SC (Group 1), CSR (Group 2) and other non serpiginous uveitis (Group 3) were studied. Mantoux test and chest radiography results were compared. P values for the results were calculated by using a Pearson Chi-square test and Fisher exact test. P value ≤0.05 was considered significant.

56/120 patients (53.3%) were Mantoux positive. 23/40 were Mantoux positive in Group 1, 17/40 positive in Group 2 and 16/40 positive in Group 3. Difference between the groups was not statistically significant (p=0.237). On chest radiography four in Group 1, three in Group 2 and five in Group 3 had past evidence of extraocular tuberculosis (p=0.757).

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A Rare Case of Non-rheumatic Streptococcal Acute Myocarditis

on-rheumatic Streptococcal Acute Myocarditis, also known as Strep Pharyngitis Acute Myocarditis (SPAM) occurs in young adults, typically within five days of the initial streptococcal pharyngitis, and is characterized by typical cardiac symptoms, abnormal electrocardiography, and elevated cardiac biomarkers in the absence of obstructive coronary artery disease.

Patients may also report myalgias, arthralgias, and constitutional symptoms. Although a rare complication of Group A and G streptococcal infections, prompt recognition is important to ensure appropriate management.

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"Obesity paradox" and Cardiovascular Disease: Myth or a Better Clinical Outcome?

Obesity is linked to traditional cardiovascular risk factors like, metabolic syndrome, hypertension, hyperlipidemia and diabetes, dyslipidemia, diabetes mellitus, sleep apnoea syndrome, reduced insulin sensitivity, enhanced free fatty acid turnover, increased basal sympathetic tone, a hypercoagulable state, systemic inflammation and suspected to incur increased morbidity and mortality.

Body Mass Index (BMI) is a patient's weight in kilograms divided by the square of height in meters.

BMI to define underweight, normal weight, overweight, and various classes of obesity

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Clinical Validation of a Next Generation Sequencing Panel Test for Hereditary Colorectal Cancer

Application of next generation sequencing (NGS) is revolutionizing the clinical molecular diagnostics industry. As this occurs, guidelines for validating NGS processes are limited, non-specific, and rapidly evolving.

NGS validation projects are complex and expensive, so the validation experiments must be carefully considered, while being certain all current and evolving regulatory requirements are met.

We validated an end-to-end genetic testing process for a 16-gene hereditary colorectal cancer NGS panel. Global work flow was designed to provide high quality sequencing data for 100% of our targeted regions.

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A Validated Method for Titanium Implant Anchorage Analysis using Micro CT and Biomechanical Testing

The use of uncemented titanium endosseous implants for restorative dentistry and orthopaedic surgery has been the standard of care for several decades.

Still, the mechanisms involved in this fascinating and unique interaction between a living tissue and foreign substance are poorly understood. An important reason for the absence of sufficient mechanistic information is the lack of robust experimental models combined with solid tools to analyze structurefunction relationships of the implant-bone system.

Qualitative and quantitative ex vivo analysis of peri-implant tissues is typically done by means of light microscopy using thin histological sections following implant removal or thicker ground sections which contain the implant and undecalcified bone.

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Experiences, Strengths and Challenges of Integration of Mental Health into Primary Care in Ethiopia

The burden of mental disorders is increaasing in low and middle income countries including Ethiopia but the number of psychiatry professionals is scarce. Integrating mental health in primary health care is vital to address the problem. This survey aimed in assessing the experiences, strengths and challenges of integrating mental health in primary health care in Ethiopia.

Facility based supervisions was done in primary health care centers where the scale up program was implemented and giving mental health services. Semi structured and standardized WHO mental health Global Action Programme support and supervision questionnaires was used to collect information's.

Findings: A total of 1576 mental, neurological and substance use (MNS) disorders were identified and treated in selected four regions. Majority of identified cases were epilepsy (46.64%) followed by psychosis (28.49%). Essential drugs for treating psychosis, depression and epilepsy were available in almost all health institutions.

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Dynamics of Swallowing Tablets during the Recovery Period following Surgery for Tongue Cancer

Compared to foods, medicinal tablets are difficult to swallow: even 10-20% of healthy subjects have trouble swallowing tablets. Compared to healthy subjects, patients with dysphagia reportedly experience more difficulty swallowing tablets and require an increased volume of water for tablet ingestion, a longer ingestion time, and an increase in the number of swallowing attempts.

In order to improve compliance with taking medication, investigations into the dosage forms and physical properties of tablets that can be easy to ingest have been conducted in the past.

The larger the tablets, the harder they are to ingest; conversely, if they are too small, they can be difficult to handle. A tablet size of 7-8 mm in diameter is considered the easiest for Japanese people to swallow.

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Is there a Gender Difference in Cost-related Medication Non-adherence?

Access barriers to medication have been a persistent challenge in care for the poor in the U.S. According to a study funded by the Commonwealth Fund and the Henry J. Kaiser Family Foundation, twenty-six percent of the elderly did not take medication as prescribed due to a cost barrier.

The Medicare Part D outpatient prescription drug program, aiming to reduce access barriers to medication use, was seen to have increased medication utilization in the general Medicare population.

However, for those high-need patients with high-cost disease, multiple morbidities, and disabilities, access to medications has not been shown to improve after the implementation of the Medicare Part D.

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Economic Evaluation of Social Care Interventions: Lessons Drawn from a Systematic Review of the Methods Used to Evaluate Reablement

Reablement helps individuals to regain or retain the ability to live independently after an injury and/or exacerbation of an illness.

Despite the lack of clear evidence on its effectiveness and cost-effectiveness, or on the optimal model for its implementation, reablement is hailed as one solution to the increased demand for long term care.

This study systematically reviews, synthesises and critically appraises the economic evidence on reablement, and makes recommendations to improve future research. A total of 13 studies were included.

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Multimodality Imaging for Malignant Transformation Assessment in Neurofibromatosis Type 1

Neurofibromatosis is a common autosomal dominant neurocutaneous disorder.

It is also defined as a RASopathy (developmental syndromes caused by germ line mutationsin genes that alter the Ras subfamily and Mitogen activated protein kinases that control signal transduction).

It has an incidence of 1:3000 live births and has variable expressivity. Half of the cases of NF demonstrate de novo mutations and it has equal male to female preponderance.

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Hematemesis from Bleeding Pancreatic Pseudocyst Ruptured into the Duodenum

A 44-year-old alcoholic man with a history of multiple episodes of acute pancreatitis was transferred to our hospital with complaints of intense mid-epigastric pain and hematemesis for 3 h.

He was diagnosed as pancreatic pseudocyst by abdominal CT examination (Figure 1a and 1b) 6 months ago. The abdomen was markedly tender, and an impulsatile mass measuring 10 cm × 15 cm was palpable.

Emergent abdominal CT revealed giant hyper-attenuation cyst communicating with duodenum, suggestive of blood presence. Large amount of blood was also noted in stomach, duodenum and small bowel.

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Leptospirosis: a Global Health Burden in Review

Leptospirosis is a zoonotic disease transmitted by fresh water and mammalian vectors in predominantly tropical regions, with an incidence of 0.1-10 per 100,000 in temperate climates, 10 or more per 100,000 in tropical climates, and up to 100 or more per 100,000 during outbreaks.

Its rate of transmission spikes in areas affected by natural disasters such as floods and heavy rainfall and, because it often presents with non-specific symptoms, it can be difficult to diagnose.

The case fatality rate in severe leptospirosis from <5 - 30% makes it a pathogen of clinical importance. This review aims to summarize the most recent literature on the subject and provide recommendations to providers who may encounter afflicted patients.

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Intraabdominal Pseudocysts in Males in a Developing Community

The recent literature on the intraabdominal pseudocyst emanated as single case reports from such diverse countries as UK, Taiwan, Turkey and USA.

Therefore, aided by the establishment of a histopathology data pool, this study concerns 6 cases from the Ibo Ethnic Group in Nigeria.

It spanned from 1970 to 1990; the age group was from 6 years to 60 years; and the submissions were by individual physicians who realized that the lesions were simple cysts, including one who named it as pseudocyst.

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Geriatric Care at a Time of Accelerated Aging in the World Population and Emerging Global Challenges

It is a well-known fact that the world population has been aging since mid-20th century. The number of older people aged 60 years and above has more than quadrupled since 1950’s and older people’s share of the world population reached 11.7 percent in 2013.

The older population itself is also aging. In 2013, 14 percent of the older population consisted of those who were 80 years of age or older. The trend in aging is expected to accelerate in the next four decades.

Population aging has major implications for several sectors of the society. In the health sector, these demographic changes will likely result in increasing pressures for geriatric services.

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