Effect of Age at Diagnosis on Cervical Cancer Patient Prognoses in Georgia

The current incidence of cervical cancer varies around 17.0/100,000 women per year. The study aims to describe the effect of age at diagnosis on CC patient prognosis in Georgia. Methods. Univariable and Multivariable survival analysis using Cox’s regression model was constructed. All women aged ≤80 years,  diagnosed with invasive CC (ICD10-site code C53) from 2015 to 2019,  were eligible for inclusion in the analysis. During analysis a hazard (mortality) ratio for the patients, who were diagnosed at different ages was estimated. Survival period was determined from the date of diagnosis until the date of death or the date of last follow up visit. High risk of death was defined as a mortality of CC patients whose survival period was less than 5 years.The level of statistical significance of the study findings is estimated by using p-value andthe 95% of confidence interval (95%CI). A p value < 0.05 was considered as statistically significant. In estimation of hazard ratio, the patients under 41 years were selected as a reference group. Data was analyzed using Statistical Package of SPSS version 23. Results.Totally 1646 CC patients were enrolled in the study. The median age at diagnosis was 54years and age range was 25 - 80 years. Univariable statistical analysis has revealed that cancer diagnosed over 60 years of age had a higher death hazard (HR=1.80, p<0.001), compared to cancer detected under 60 years (HR=3.30, p<0.001). Multivariable statistical analysis has detected that stage and age at diagnosis are independent, statistically significant predictors for high mortality in patients diagnosed with cervical cancer, while the role of histological grade has not been revealed. In addition, older age generally is related to a high prevalence of comorbidities. The reasons for the unfavourable cervical cancer prognosis in older patients that was detected  during statistical analysis might be explained by tumor stage at diagnoses and with higher ratesof comorbidity among the elderly. Conclusions: Finally, our study results are in concordance with numerous studies, which confirm that the age of patients at the moment of diagnosis is an independent predictor for cervical cancer early mortality

Prevalence And Prognosis Of Candidiasis Among Covid-19 Patients: Data From ICU Department

Yeast species belonging to the Candida genus, including Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, and Candida krusei, are the most prevalent fungal species inhabiting various mucosal surfaces, such as the skin and the respiratory, digestive, and urinary tracts [1]. Although being commensal within the human host, Candida species are equipped with virulence attributes, enabling them to invade when opportunities arise and cause various infections in humans, especially when the immune system is impaired. We retrospectively studied total lymphocytes count and   Candida infection in 142 patients   who were admitted to TSMU The First university Clinic Intensive care unit department between 14.10.20 – 02.02.21 . Among  142 patients Candida  spp  were isolated in 15,4%(22/142) patients. In all this patients  total lymphocytes count were low.  Candidemia was  not dectected.  Candiduria was observed in 2 patients(9%, 2/22). Our data is close to the  White, P.L. et al studies from UK which have reported 12.6%(17/135) of Candidiasis

Preoperative Screening And Preparation Of Patients For Orthopedic Surgery

Introduction: Staphylococcus aureus is a major pathogen implicated in orthopedic infections worldwide. Preoperative decolonization has been promoted but different strategies present mixed results. Staphylococcus aureus (S. aureus) is an independent risk factor for orthopedic surgical site infection (SSI).We studied whether or not local treatment with bacteriophage could eliminate nasal colonization with S. aureus.Materials and Methods: A total of 696 patients were screened for S. aureus nasal colonization between 2017– 2021 at a single institution. There were 23% (159 patients) initially S. aureus colonization preoperatively. They were decolonized with various medications: I group – with Mupirocin 35% (56), II group- with bacteriophage 65% - (103). In the II group Pyo bacteriophage were including 32% (33) and Staphylococcal bacteriophage 68% (70).After treatment, bacteriological control was done post- decolonization on the 5th -8 th days. MSSA persisted in 4% (7).Five patient who was persistently colonized for MSSA was not compliant with the decolonization protocol. There were 2 patients who had undergone decolonization and were persistently positive for MSSA at the time of surgery.Results: Decolonization of orthopedic surgical patients using the bacteriophage intro nasal is a practical and effective regimen for reducing MSSA and MRSA surgical site infections, treatment processes was without any post-decolonization complications.Conclusion: We hope the bacteriophage will be successfully used in the practice of decolonization S. aureus and this therapy will be reduce the resistant S. aureus to mupirocin

Coexistence of Bladder Cancer and Foreign Body in the Bladder: A Rare Case Report

Foreign bodies in the bladder are a rare but significant medical condition that can lead to complications and severe health consequences. While it can be challenging to access the bladder, foreign bodies can occasionally find their way inside. These objects may be intentionally introduced, as in cases of self-insertion or insertion by others, or may enter the bladder accidentally, as in cases of migration from adjacent organs or tissues.Various objects have been found in the bladder, including but not limited to electric cables, pencils, catheters, aluminum braids, and removable parts of medical cystoscopy equipment. In addition, unusual objects such as candles, pens, thermometers, and other household items have been reported. Patients who insert foreign bodies into the bladder may have underlying psychological disorders or curiosity, while accidental insertion may occur due to medical procedures, trauma, or other causes. (A W Badenoch)Complications associated with foreign bodies in the bladder can be acute or chronic and may include pain, infection, inflammation, hematuria, urinary retention,bloody urine or urinary tract obstruction. Patients may present with various symptoms, including dysuria, frequency, urgency, or incontinence. Diagnosing foreign bodies in the bladder is typically done through imaging studies, such as X-rays or ultrasound, and confirmed by cystoscopy.In some cases, foreign bodies in the bladder may be discovered incidentally during medical interventions for other conditions. For example, the discovery of a post-osteosynthesis bolt in the urinary bladder, as in the case presented in this report, is a rare finding that may be associated with asymptomatic conditions and tissue formation of the bladder. The prompt and appropriate management of foreign bodies in the bladder is critical to prevent serious complications and improve patient outcomes. (FOREIGN BODIES IN THE URINARY BLADDER – CASE SERIES, 2017) Categories: Urology, Traumatology

COVID-19 Vaccination and Pregnancy: Single Hospital Case Report

Reported case has been taken under consideration because of its close relation to the fact of vaccination against COVID-19 (Pfizer BionTech)  first dose.Multiparous woman at age of 40 years with normal progressive 15 weeks of gestation, has been admitted to the University Clinic on the 10-th day after COVID -19 vaccination with general weakness, joint pain, severe to moderate head ache, fever, at the admission COVID-19 PCR testing occurs to be positive.Following the protocol of COVID-19 pregnancy management anticoagulant treatment has been started (D-dimer 0.9 mg/dl). The   patient were under observation of infectious disease specialist.  Almost all other protocol based test results within normal ranges, on the 14-th day of vaccination gingival bleeding of moderate severity has been started together with progressive thrombocytopenia (63-103 m/L later 57-103 m/L), test of thromb agglutination was positive and the diagnose of idiopathic thrombocytopenia has been announced by hematologist.  Dexamethasone treatment has been initiated with following progressive positive results of thrombocyte count.  On the 12-th day of the admission with normal clinical and laboratory data’s patient has been discharged from the hospital with biweekly follow up for 8 weeks. All follow up laboratory values and clinical data were normal during this period. Based on literature, vaccination induced thrombocytopenia is a rare complication although has been documented and only several of them has proven to be vaccination induced complication. The reported case after assessment of patient’s history, clinical, lab data and VITT adapted scoring system revealed intermediate probability of VITT, coincidence of COVID-19 made difficulties for differentiation of thrombocytopenia reason which needs more accurate laboratory assessment, but unremarkable medical history and short time between vaccination and clinically revealed thrombocytopenia highly suspicious for VITT

COVID-19 Pregnancy and Psycho-neurological Disturbance: Single Hospital Case Report

31 years old pregnant woman at 38 1/7 week of gestation with fever has been admitted to the TSMU   First University Clinic Emergency, with positive COVID-19 PCR test. With characteristic complains of COVID-19 infection.  Family history not significant. Personal history reveals childhood seizure as a result of fever. Vital signs at the admission within normal ranges. All protocol based laboratory tests has been done and protocol based treatment initiated. On the seventh day of Covid-19 infection because of episodes of desaturation and termed gestation, pregnancy termination by induction has been done successfully. At the end of early puerperal period because of hypoxemia resistant to oxygen therapy and CT scan diagnosed severe viral induced pneumonia, with symptoms of encephalopathy has been documented.  Later patient transferred to the mechanical ventilation, protocol based lab tests, diagnostic procedures and treatment initiated. After 1 month with improved condition patient has been transferred to the ob/gyn department for ongoing treatment and rehabilitation at this time severely expressed symptoms of encephalopathy were documented.The underlying mechanisms of neurologic complications in patients with COVID-19 are diverse and, in some cases, multifactorial. Neurologic complications may arise from direct effects of the virus as well as systemic response to the infection or as a result of long lasting inadequate oxygenation of all tissues. Although mechanical ventilation is highly complicated by brain damage, covid-19 induced encephalopathies are as well documented and need more scientifically proved facts of the viral role in this complication