Papua New Guinea ; Medical ; Medical History ; Journals ; Health Care

Objective To evaluate the potential of a sliding multi-slice (SMS)fast low-angbe shot 2-dimensional (FLASH-2D) sequence for abdominal lesion detection in patients with rectal cancer.Methods Nineteen paired SMS MRI( FLASH-2D sequnce) and MSCT examinations of the whole abdomen and pelvis in 15 patients (four of them were examined twice) with rectal cancer were retrospectively analyzed by two radiologists.While the lesion-based agreement between the two methods and the diagnostic agreement between two observers were tested by means of Kappa statistics,the sensitivities of SMS FLASH-2D and MSCT to detect liver metastases,lymph node metastases and bone metastases were calculated.Standard of reference consisted of a consensus evaluation of SMS,MSCT and all available follow-up examinations after a period of 6 months.Results Using SMS FLASH-2D cumulatively,both observers detected 56 of all 60 lesions respectively resulting in same sensitivities of 93.33% (56/60).Using MSCT,both observers detected 50 lesions,resulting in same sensitivities of 83.33 % (50/60) respectively.The sensitivities of SMS FLASH-2D to detect hepatic metastases were 97.44% (38/39) and 100% (39/39) for both observers respectively,compared to 100 % (39/39)and 100% (39/39)for MSCT.The sensitivities for lymph node metastases were 85.71% (12/14) and 71.43% (10/14) for SMS FLASH-2D compared to 78.57% (11/14) and 71.43% (10/14) for MSCT.The sensitivities for bone metastases were 85.71% (6/7) and 100% (7/7) for SMS FLASH 2D compared to 0(0/7) and 14.29% (1/7) for MSCT.Conclusion SMS FLASH-2D imaging and MSCT exhibit equal ability of detecting lymph node and liver metastases,but SMS FLASH 2D seems better than MSCT in dectecting bone metastases.

We studied 510 patients in a retrospective, nonrandomized, comparative survey of vaginal births and repeat caesarean section after one primary caesarean section at the Port Moresby General Hospital. 478 (94%) were allowed a trial of scar (TOS). The most common indications for elective caesarean section in the other 32 patients were cephalopelvic disproportion (CPD) 31%, contracted pelvis 19% and preeclampsia 12.5%. In 41% of patients TOS was terminated by emergency caesarean section. Logistic regression analysis showed that the following were significantly associated with repeat caesarean section after TOS: parity of one, no vaginal birth after the primary caesarean section, narrow obstetric conjugate, birthweight of 2500 g or greater, short stature, high level of the head at admission to the labour ward and region of origin.
Cesarean Section / statistics & ; numerical data Data Collection Delivery, Obstetric - methods Delivery, Obstetric - statistics & ; numerical data ;

A 64-year-old marathon runner presented to our clinic with a history of worsening pain in her left knee. Following magnetic resonance imaging, the diagnosis of subchondral insufficiency fracture of the knee (SIFK) was made. A course of conservative management via bisphosphonates was initiated. The patient successfully recovered and returned to full athletic function, having recently returned to competitive marathon running. This article aims to present this unusual case of lateral compartment SIFK and summarise the literature on this uncommon condition.
Diagnosis ; Diphosphonates ; Femur ; Fractures, Stress ; Humans ; Knee ; Magnetic Resonance Imaging ; Middle Aged ; Running ; Sports

Myofascial pain syndrome (MPS) is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The pain and dysfunction caused by MPS were primarily treated with physical therapy and pharmacological agents in order to achieve painfree movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximise therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with MPS were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this inverse electrode placement may be more appropriate for chronic pain management.
Chronic Pain ; Electric Stimulation* ; Electrodes* ; Humans ; Myofascial Pain Syndromes* ; Nervous System ; Shoulder Pain ; Shoulder*

Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemic.

Purpose: To describe our experiences with the development of an elective course on the pharmacist’s role in disaster management for third-year pharmacy students and to evaluate its effects on students’ knowledge and their perceptions of the introduction of this course into the curriculum. Methods: An expert team of physicians, surgeons, and pharmacists of the Service de Santé des Armées, pharmacists teaching at the Faculty of Pharmacy, and pharmacists from the Bataillon des Marins Pompiers de Marseille developed a program consisting of 30 hours of modules on disaster response training based on previously published recommendations, a literature analysis, and international guidelines. Students’ knowledge of key competencies was assessed after some teaching sessions through a multiple-choice quiz. Students’ self-perceived knowledge, perceptions of teaching quality, and degree of satisfaction were evaluated through a voluntary survey after the last teaching session on November 15. Results: The final curriculum consisted of 6 modules. Students’ knowledge of key competencies was assessed using multiple-choice quizzes, with a mean score of 19 of 25. Almost all students (98.3%) reported that this training program improved their knowledge of the pharmacist’s role in disaster management, and 79.3% stated that they would recommend this optional course. Conclusion This training course demonstrated the potential to increase the number of pharmacists prepared to respond to disasters. It also expanded students’ understanding of the pharmacist’s role and stimulated their interest in emergency preparedness. Further refinement of the program, including a simulation of mass triage in an emergency setting, will be conducted next year.

External volume expansion of the recipient site by suction has been proposed as a way of improving fat graft survival. The objective of this study was to present an innovative and simple intraoperative external expansion system to enhance small-volume autologous fat grafting (40–80 mL) and to discuss its background and its mechanism of action. In this system, expansion is performed using a complete vacuum delivery system known as the Kiwi VAC-6000M with a PalmPump (Clinical Innovations). The recipient site is rapidly expanded intraoperatively 10 times for 30 seconds each with a negative pressure of up to 550 mm Hg before autologous fat injection. During this repetitive stimulation, the tissues become grossly expanded, developing macroscopic swelling that regresses slowly over the course of hours following the cessation of the stimulus. The system sets various mechanisms in motion, including scar release, mechanical stimulation, edema, ischemia, and inflammation, which provide an environment conducive for cell proliferation and angiogenesis. In order to maintain the graft construct in its expansive state, all patients are encouraged postoperatively to use the Kiwi three times daily for one minute per session over the course of three days. The handling of this system is simple for both the patients and the surgeon. Satisfactory clinical outcomes have been achieved without significant complications.
Adipose Tissue ; Cell Proliferation ; Cicatrix ; Contracture ; Edema ; Graft Survival ; Humans ; Inflammation ; Ischemia ; Subcutaneous Tissue ; Suction ; Transplants* ; Vacuum

The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra into the bladder to measure pressure variations. Unfortunately, this method is inaccurate because measurement is affected by disturbances in catheter lines as well as delays in response time owing to the inertia of urine inside the bladder. Moreover, this technique can cause infection during prolonged use; hence, it is only suitable for short-term measurement. Development of discrete wireless implantable sensors to measure bladder volume/pressure would allow for long-term monitoring within the bladder, while maintaining the patient's quality of life. With the recent advances in microfabrication, the size of implantable bladder sensors has been significantly reduced. However, microfabricated sensors face hostility from the bladder environment and require surgical intervention for implantation inside the bladder. Here, we explore the various types of implantable bladder sensors and current efforts to solve issues like hermeticity, biocompatibility, drift, telemetry, power, and compatibility issues with popular imaging tools such as computed tomography and magnetic resonance imaging. We also discuss some possible improvements/emerging trends in the design of an implantable bladder sensor.
Aged ; Biocompatible Materials ; Catheters ; Child ; Hostility ; Humans ; Magnetic Resonance Imaging ; Microtechnology ; Quality of Life ; Reaction Time ; Reference Values ; Renal Insufficiency ; Sensation ; Telemetry ; Urethra ; Urinary Bladder* ; Urinary Incontinence