Outcome and Mortality of Hospitalized children with Severe Acute Malnutrition at Aden, Yemen

Severe acute malnutrition (SAM) is considered a common cause of morbidity and mortality among children in low- and middle-income countries, being responsible for 45% of deaths among under-five children. The aim of the study was to determine the outcome and mortality of severe acute malnutrition among hospitalized children in Aden, Yemen. This is a descriptive, retrospective study. The studied population includes hospitalized children of both sexes with SAM admitted to the nutritional unit of Al-Sadaka General Teaching Hospital/Aden during the period from January 1st to December 31st 2021. Of a total of 537 under 5 years, males constitute 53.4% over females 46.6%. In this study, 509 children had a favorable clinical evolution, while 28 deaths were recorded. This corresponds to a mortality rate of 5.2%. The most common cause of death is due to Acute diarrhea in 60.7% of cases .Mortality is higher among males 67.8 % than females and high 85.7% among children \u3c 24 months. Of these 28 deaths, most mortality cases occurred in the non-edematous type of SAM in 89.3% of cases. The most common nutritional feeding formula was F75 in 66.3% of cases. Only 28% of cases achieved target weight; edema had been resolved in 75.8% of cases of edematous SAM at discharge. Severe acute malnutrition remains a severe public health problem, and it mainly affects children under 24 months. A national policy of nutritional intervention should be implemented

Percutaneous Holmium Laser Fulguration of Calyceal Diverticula

Introduction. Calyceal diverticular stones are uncommon findings that represent a challenge in their treatment, due to the technical difficulty in accessing the diverticulum, and the high risk of their recurrence. Current percutaneous technique for calyceal diverticular stones involves establishing a renal access, clearing the stone, and fulguration of the diverticular lining with a roller-ball cautery electrode using hypotonic irrigation solution such as sterile water or glycine solution which may be associated with the absorption of hypotonic fluids with its inherent electrolyte disturbances. Case Report. In this paper, we present for the first time percutaneous holmium laser fulguration of calyceal diverticula in 2 patients using normal saline. Their immediate postoperative sodium was unchanged and their follow-up imaging showed absence of stones. Both patients remain asymptomatic at 30 months post-operatively. Conclusion. This demonstrates that holmium laser is a safe alternative method to fulgurate the calyceal diverticulum after clearing the stone percutaneously

Monitoring Historic Concrete and Associated Cementitious Repair- A Case Study of Boathouse 4, Portsmouth Historic Dockyard, UK

This study presents a method of monitoring historic concrete and associated repairs. A case study of Boathouse 4, Portsmouth Historic Dockyard, UK is presented. Boathouse 4 is an iconic building within Portsmouth Historic Dockyard which was constructed during the 1930’s rearmament period. It was used during World War ll to construct the three-man midget X-Craft submarine. The building was restored and converted into a Boatbuilding Skills Training Centre in 2015. A field investigation was conducted to analyse the concrete damage and to monitor microscale changes to the surface of the original concrete and repairs over a period of three years. Three patches of concrete lying in the undercroft of the building, located in an intertidal zone were chosen to be monitored for material changes as part of an ongoing PhD research study. These areas were scanned three times at intervals of up to 9 months within three years using a NextEngine portable laser scanner to obtain high-resolution 3D images of the concrete surface so that gradual changes to the microtopography, appearance and texture of the concrete surface and associated repairs could be detected. The data was analysed and the results indicated slight topographic changes in the concrete surface as well as the colour of the cementitious repair materials

Lupus cystitis presenting with urinary symptoms.

We present a case of a young woman presenting with irritative lower urinary tract symptoms and microscopic hematuria who was diagnosed with systemic lupus erythematosus (SLE). Abdominal ultrasound revealed bilateral hydronephrosis and a thickened bladder wall. Cystoscopic evaluation revealed severe diffuse inflammation, erythema and hemorrhage at the trigone with punctate extensions to the bladder base. She was treated with prednisone and mycophenolate mofetil with improvements in her symptoms and ultrasound findings. Lupus cystitis is a rare manifestation of SLE

Meta-analysis and systematic review of skin graft donor-site dressings with future guidelines.

Background: Many types of split-thickness skin graft (STSG) donor-site dressings are available with little consensus from the literature on the optimal dressing type. The purpose of this systematic review was to analyze the most recent outcomes regarding moist and nonmoist dressings for STSG donor sites. Methods: A comprehensive systematic review was conducted across PubMed/MEDLINE, EMBASE, and Cochrane Library databases to search for comparative studies evaluating different STSG donor-site dressings in adult subjects published between 2008 and 2017. The quality of randomized controlled trials was assessed using the Jadad scale. Data were collected on donor-site pain, rate of epithelialization, infection rate, cosmetic appearance, and cost. Meta-analysis was performed for reported pain scores. Results: A total of 41 articles were included comparing 44 dressings. Selected studies included analysis of donor-site pain (36 of 41 articles), rate of epithelialization (38 of 41), infection rate (25 of 41), cosmetic appearance (20 of 41), and cost (10 of 41). Meta-analysis revealed moist dressings result in lower pain (pooled effect size = 1.44). A majority of articles (73%) reported better reepithelialization rates with moist dressings. Conclusion: The literature on STSG donor-site dressings has not yet identified an ideal dressing. Although moist dressings provide superior outcomes with regard to pain control and wound healing, there continues to be a lack of standardization. The increasing commercial availability and marketing of novel dressings necessitates the development of standardized research protocols to design better comparison studies and assess true efficacy.R01 EB021308 - NIBIB NIH HHSPublished versio

Validation of a Visual Prostate Symptom Score in Men With Lower Urinary Tract Symptoms in a Health Safety Net Hospital

OBJECTIVE: To evaluate the correlation between the International Prostate Symptom Score (IPSS) and the Visual Prostate Symptom Score (VPSS), a visual assessment of urinary stream, frequency, nocturia, and quality of life using pictograms, in a health safety net population. METHODS: Men presenting to San Francisco General Hospital with lower urinary tract symptoms completed the IPSS and the VPSS without and then with assistance. Statistical analysis was performed using the chi-square test, the Wilcoxon signed rank test, and the Spearman rank correlation. RESULTS: One hundred twenty-one patients were enrolled between December 2013 and May 2014 with a mean age of 54 years. There were statistically significant correlations between total VPSS and total IPSS (ρ = 0.71; P <.001) and for frequency (ρ = 0.47; P <.001), nocturia (ρ = 0.69; P <.001), force of stream (ρ = 0.65; P <.001), and quality of life (ρ = 0.69; P <.001). In addition, there were statistically significant correlations between total VPSS and both VPSS quality of life (ρ = 0.69; P <.001) and Q(max) (ρ = −0.473; P = .006). The mean absolute disagreement for participants who took the IPSS independently vs with assistance was greater than for those who took the VPSS independently vs assistance for all symptoms: frequency (0.64 vs 0.3, respectively; P <.001), weak stream (0.82 vs 0.14, respectively; P <.001), nocturia (0.38 vs 0.23, respectively; P = .023), and quality of life (0.63 vs 0.32, respectively; P = .005). CONCLUSION: Many men altered their IPSS responses when they received assistance. There was significantly less alteration in responses using the VPSS, suggesting that the VPSS is useful in determining lower urinary tract symptoms, particularly in patients with limited education and literacy