Journal of Advances in Medicine and Medical Research <p style="text-align: justify;"><strong>Journal of Advances in Medicine and Medical Research (ISSN:&nbsp;2456-8899)</strong> aims to publish research papers, reviews and short communications in the areas of medicine and medical research.&nbsp; JAMMR will not only publish traditional full research reports, including short communications, but also this journal will publish reports/articles on all stages of the research process like study protocols, pilot studies and pre-protocols. JAMMR is novelty attracting, open minded, peer-reviewed medical periodical, designed to serve as a perfectly new platform for both mainstream and new ground shaking works as long as they are technically correct and scientifically motivated.&nbsp;The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer reviewed, open access INTERNATIONAL journal.</p> en-US (Journal of Advances in Medicine and Medical Research) (Journal of Advances in Medicine and Medical Research) Mon, 17 Jan 2022 09:26:22 +0000 OJS 60 Spontaneous Abortion in Pregnancies Having COVID-19 Infection in Bangladesh: A Series of Cases <p><strong>Background:</strong> Coronavirus Disease (COVID-19) is a highly contagious disease and spreading all over the world. Pregnant women are particularly vulnerable to this infectious disease. There are not many reports on missed-abortion or stillbirths in COVID-19 that affected pregnant women. Twelve cases are presented here among a few cases of spontaneous abortion or fetal demise without having remarkable cause other than laboratory-confirmed COVID-19 (RT-PCR) from March 2020 to July 2020 in a single medical university hospital in Bangladesh.</p> <p><strong>Cases:</strong> Enrolled 12 pregnant subjects of fetal demise ≥11 weeks of gestation had COVID-19 infection (RT-PCR) and the specimen taken was nasal swab. 10 patients were admitted to the hospital and 2 patients were managed in their home under the supervision of Bangabandhu Sheikh Mujib Medical University (BSMMU). We excluded all the possible causes of clinical and obstetric causes of abortion other than COVID-19 infection. However, most of them were asymptomatic COVID-19 infection carriers, and only had a history of low-grade fever. 5 cases had a history of medical disorder which were controlled before pregnancy.</p> <p><strong>Conclusion:</strong> All the 12 cases did not have any clinical and obstetric disorder during pregnancy, but they all had COVID-19 infection. This suggests COVID-19 infection might induce fetal death through possible inflammation in the placenta.</p> Tanzina Iveen Chowdhury, Tasrina Rabia Choudhury, Md. Mostafizur Rahman, Nazma Akter, Nafisa Anwar Mariana, M. Jahangir Alam, Tripti Rani Das ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000 Immediate Tooth Autotransplantation into Fresh Extraction Sockets: A Case Series and Literature Review <p>Autologous tooth transplantation has been used in various indications to replace missing teeth. In this case series, we investigated the long-term outcomes following immediate tooth autotransplantation into fresh extraction sockets in young individuals in our center. A consecutive retrospective study was conducted on patients treated at the clinic of Oral and Plastic Maxillofacial Surgery at Ludwigshafen hospital in Germany. Demographic factors, indication for tooth autotransplantation, donor site, and recipient site were extracted from patient records. The clinical and radiographic outcomes of 11 autotransplanted teeth were evaluated in a follow-up observation period ranging from 20 to 78 months. A total of 11 tooth transplantations were carried out in nine patients during the study period. Chronic apical periodontitis, non-restorable extended caries, hypodontia, ectopical eruption and accidental trauma were the reasons for tooth transplantation. Overall, nine third molars, one second molar, and one canine were autotransplanted. Donor teeth were mandibular third molars in seven cases, maxillary third molars in two cases, a maxillary second molar in one case, and a maxillary canine in one case. Six donor teeth had completely formed roots and five had incompletely developed roots and an open apex at the time of surgery. After a mean follow-up of 44 months, 10 cases (90.9%) were successful; one case failed because of root resorption and uneventful bone remodeling. In four cases, external root resorption was observed. No pulp revascularization was observed during the recall period. The survival rate and success rate of tooth autotransplantation were 90.9% and 63.6%, respectively. Our results are in agreement with other published observations. We conclude that autologous tooth transplantation into fresh extraction sockets in young individuals has a high long-term success rate. Although the indications for autotransplantation are quite narrow, careful patient selection coupled with an appropriate surgical technique can lead to exceptional long-term functional results.</p> Andreas Sakkas, Robert A. Mischkowski, Oliver C. Thiele ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000 Role of Vitamin D Supplementation in Allergic Rhinitis <p><strong>Background:</strong> Allergic Rhinitis (AR) is one of the inflammatory diseases of the nasal mucosa, caused by immunoglobulin E (IgE) after allergens exposure, Severity measurement of the AR symptoms can be conducted subjectively by counting the total nasal symptom score (TNSS) and objectively by counting the serum IgE levels. Vitamin D (VD) plays a significant part in inborn and adaptive immunity; however, this is not completely understood. It is reported that over 900 genes are regulated by VD. The aim of this study is to assess the role of VD supplementation in AR.</p> <p><strong>Methods:</strong> This prospective randomized controlled study was carried out on 90 patients Test group (n = 45): received standard medications and supplementation of oral VD3 (cholecalciferol; 1000 IU) for 3 months. Control group (n = 45): received standard medications without supplementation of oral VD3.</p> <p><strong>Results: </strong>Comparison between both groups showed insignificant difference between both groups in VD level at the start of the study. According to TNSS in test group, there was significant improvement after 3 months compared to before the study. According to TNSS in control group, there was significant improvement after 3 months than before the study. There was significant improvement in test group than control group as regard to TNSS after 3 months.</p> <p><strong>Conclusions: </strong>There was highly significant reduction in the TNSS after VD supplementation. Thus, VD supplementation alters the course of AR towards clinical improvement.</p> Mai Mohamed El Gharably, Mohammed Abdel-Rahman Amer, Mohamed Nasser El-Sheikh ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Drugs and Substances Reported in Emergency Department Presentations with Acute Recreational Drug / Substance Toxicity <p><strong>Aims: </strong>To evaluate the self-reported drugs/substances in the emergency department presentations with acute recreational drug toxicity in a tertiary hospital.</p> <p><strong>Study Design:</strong> Cross sectional study.</p> <p><strong>Place and Duration of Study:</strong> Clinical Toxicology Department, Tanta University. Between January 2019 and December 2020.</p> <p><strong>Methodology:</strong> The data regarding the self-reported drug(s) / substance(s) in patients presenting to an Emergency Department in a tertiary hospital were collected and analyzed. The prevalence of each recreational drug/substance reported by the patients was calculated.</p> <p><strong>Results:</strong> There were 373 recreational drugs/substances reported by 248 cases. The most frequently self-reported drug(s)/substance(s) were ethanol (reported by 122 cases), followed by cocaine (94 cases), opiates (36 cases), cannabis (30 cases), and amphetamine-like stimulants (29 cases). Other drugs/substances as spice (synthetic cannabinoids), benzodiazepines, pregabalin, methadone, and&nbsp; others were reported by the patients as well. In the remaining 16 of the total 264 cases (6.1%), the recreational drug(s) that had been used were unknown to or not reported by the patients.</p> <p><strong>Conclusion:</strong> In conclusion, this study revealed that in this tertiary hospital ED, the main recreational drugs leading to the ED presentation with acute recreational drug/substance toxicity as reported by the patients were ethanol followed by cocaine, opiates, cannabis and amphetamine-like stimulants. Other drugs/substances as spice (synthetic cannabinoids), benzodiazepines, pregabalin, methadone, and others were reported by the patients as well.</p> Aisha Emad, Enas El Madah, Neven Hassan, Khaled Saad ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Unrecognized Diaphragm Hernia <p><strong>Introduction:</strong>&nbsp;Post-traumatic diaphragmatic hernia is defined as the passage of abdominal viscera into the thorax through a post-traumatic diaphragmatic breach. They are rare and may be unrecognized in 10-30% of cases at initial management.</p> <p><strong>Materials and Methods:&nbsp;</strong>A retrospective descriptive study including all the patients taken in charge for post-traumatic neglected diaphragmatic lesions over two years between December 2018 and January 2021 within the service of visceral emergencies of the universitary hospital center Ibn Rochd of Casablanca. Our work aims to define the epidemiological, clinical, and therapeutic characteristics of patients admitted for post-traumatic diaphragmatic lesions.</p> <p><strong>Results</strong><strong>:</strong> The average age of the patients was 30 years (range 18 to 43 years). All patients were male. They were due to a closed trauma in 11 patients (32%) and a penetrating trauma in 58%. The diagnosis was guided preoperatively by the different imaging techniques, in particular chest radiography and CT scan. Treatment was mainly by laparotomy and consisted of closure of the diaphragmatic breach by simple sutures.</p> <p><strong>Conclusion</strong><strong>:</strong> Post-traumatic diaphragmatic hernias can go unnoticed and can be life-threatening in case of associated lesions or complications.&nbsp;</p> Khalid Elhattabi, Hasna Benghait, Zakaria Essaidi, Abdelilah Elbakouri, Mounir Bouali, Fatimazahra Bensardi, Abdelaziz Fadil ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Impact of Physician and Patient Education on Type 2 Diabetes Outcome in Primary Health Care Units, Al-Gharbiyah Governorate, Egypt <p><strong>Background: </strong>Diabetes mellitus (DM) leads to multiple complications that include macrovascular and microvascular complications. Proper management will result in decreased morbidity and mortality. The aim of this study was to evaluate the impact of Physicians and patients’ education on diabetes outcome in primary health care units, Al-Gharbiya Governorate, Egypt.</p> <p><strong>Methods: </strong>The study was carried out on primary health care physicians and their assigned patients in Al-Gharbiyah Governorate from October 2015 till October 2017. Study was carried-out in 2 phases. <strong>Phase 1 (Physician's phase): </strong>A sum of forty of primary health care physicians working in primary health care were recruited in the study. <strong>Phase 2 (Patient's phase): </strong>Those 200 patients were engaged in an educational program for self-management of diabetes using IDF (International Diabetes Federation) education maps.</p> <p><strong>Results: </strong>Knowledge and attitude of physicians were significantly higher after completion of educational program than Baseline. The mean Body mass index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP)and Glycated HaemoglobinHbA1cafter 1 year and after 6 months were significantly lower than before and after 1 year than after 6 months. The number of patients who have exercised activities after 1 year and after 6 months were significantly higher than before and after 1 year than after 6 months.</p> <p><strong>Conclusions: </strong>The educational program applied in this study led to significant improvement of physician’s knowledge and attitude which helps in providing better care of diabetic patients. The educational program applied in this study led to significant improvement of diabetic patients’ lifestyle and outcome, which will subsequently lead to reduction in diabetic complications.</p> Hadeer Magdy Kamal Khalil, Noha Elsayed Esheba, Wael Farrag Mohammad, Laila Mahmoud Sayed Ahmed ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Comparison of the Immunoglobulin Levels in Maternal and Cord Blood and Influence of Parity on Maternal Immunoglobulin Concentration in Port Harcourt, Nigeria <p><strong>Aim:</strong> This study was carried out to compare the immunoglobulin levels in maternal and cord blood and to find out if parity has any effect on the immunoglobulin concentration of the maternal blood.</p> <p><strong>Place and Duration of Study:</strong> Department of Human Physiology, Faculty of Basic Medical Sciences, University of Port Harcourt, between June 2018 and September 2019.</p> <p><strong>Methodology:</strong> A total of 25 paired maternal and cord serum was used for the study. About 5ml of venous blood was collected from mothers immediately after delivery and cord blood was also collected after the cord has been cut and the clamp released slightly to allow blood flow into a plain bottle. The serum levels of IgA, IgG and IgM were measured using Turbidimetric immunoassay method.&nbsp;</p> <p><strong>Results:</strong> The mean IgA, IgM and IgG levels in maternal blood were 163.20 ± 13.35mg/dl, 88.16 ± 7.74 mg/dl and 351.60 ± 36.83 mg/dl respectively while their corresponding levels in the cord blood were 12.00±1.00mg/dl, 19.36 ± 1.67 and 300.60 ± 27.83 mg/dl respectively. The version 20.0 of the statistical package for social sciences (SPSS) and Microsoft Excel 2012 for the statistical analysis were employed for analyzing the various sets of data.</p> <p>The Mean, standard errors of mean and ranges were determined for the different parameters for the two groups of subjects. The analysis of variance (ANOVA) was used to determine the variations between the subjects. The P-value of less than 0.05 was regarded as significant. The IgA and IgM showed significant variation in maternal and cord blood (P&lt;0.05) while IgG showed no significant variation (P&gt;0.05). Also, parity had no significant correlation with immunoglobulin concentration (P&gt;0.05).</p> <p><strong>Conclusion:</strong> IgA and IgM concentrations were found to be significantly higher in maternal blood than in the cord blood, IgG showed no significant variation. There is a significant variation.</p> S. O. Ojeka, V. Z. Zabbey ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Characteristics of Patients Undergoing Open Radical Cystectomy for Management of Muscle Invasive Bladder Cancer in A Tertiary Centre in Egypt <p><strong>Aims</strong><strong>:</strong> To represent the demographic and functional data of a cohort of patients with invasive bladder cancer managed with Open Radical Cystectomy (ORC) in the Urology Department of Tanta University Hospital between January 2019 and January 2021.</p> <p><strong>Methodology</strong><strong>:</strong> A retrospective analysis was performed on the records of ORC for the period between January 2019 and January 2021. This cross-sectional study was done in the Urology Department, Tanta University Hospital in Egypt.</p> <p><strong>Results</strong><strong>:</strong> Data of 47 patients were collected. Most of the patients in were males (34 patients (72.3%), with male to female ratio of 3:1. Most of the patients were either smokers or ex-smokers, while only 18 patients (38.3%) never smoked before. Visible hematuria was the most common symptom at presentation (35 patients) 74.5%. The main radiological imaging used for staging was CT Urography. Most of the tumors were urothelial in 66% of patients. Squamous differentiation was the most common non urothelial variant with 8 patients. The presence of other non-urothelial variant histology was present in 6 patients.</p> <p><strong>Conclusion</strong><strong>:</strong> This study revealed that in the tertiary hospital of Tanta University, the mean age of patients presented with bladder cancer and undergoing ORC, was 63.5 years. Visible haematuria was the most common complaint reported. The use of MRI is valuable in staging of locally advanced bladder cancer. Most of the tumours were urothelial (66%) with significant reduction in the incidence of squamous cell bladder cancer than the previously reported data. Neoadjuvant chemotherapy has become an integral part of the treatment protocol in cases of muscle invasive bladder cancer.</p> Mohammed Lotfi Amer, Mohamed Radwan, Ayman Hassan, Mohamed El-bendary ##submission.copyrightStatement## Wed, 22 Dec 2021 00:00:00 +0000 Effect of Rotating Shift on Biomarkers of Metabolic Syndrome and Inflammation among Health Personnel in Gaza Governorate <p><strong>Background:</strong> It's been suggested that shift employment is linked to an increased risk of metabolic syndrome (MetS). It is a complex syndrome that has been linked to the development of cardiovascular disease and/or type 2 diabetes mellitus. The goal of the study was to determine the prevalence of MetS among health-care workers and to investigate the impact of rotating shift work on MetS biomarkers and inflammation.</p> <p><strong>Methods: </strong>100 current daytime workers were compared to 210 rotating shift workers in comparative analytical cross-sectional research involving 310 health care personnel. A questionnaire on socio-demographic (sex, age, marital status, job), health-related behaviors such as a physical activity) and occupational history about shift work, as well as a health examination with anthropometric and arterial blood pressure measurements, and laboratory investigations. For the diagnosis and determination of MetS, we used the Adult Treatment Protocol III National Cholesterol Education Program of America (ATPIII) indicators. SPSS version 20 was used for the statistical analysis.</p> <p><strong>Results:</strong> The overall prevalence of MetS among healthcare workers was 8.4% (9.0% among current daytime workers and 8.1% among rotating shift workers) with no significant difference between males and females, and shift category. Elevated C-reactive protein (44.5%) was the most commonly altered component among healthcare workers, followed by high triglyceride (35.5%), raised total cholesterol (24.8%), and elevated BMI&gt;30&nbsp;(20.6 %). In descending order, the following were the main risk factors for MetS in both sexes among rotating shift workers: high blood pressure (OR = 59.5; 95 percent CI, 16.4- 215.8), high fasting blood sugar (OR = 43.9; 95 percent CI, 12.9- 149.1), high triglyceride (OR = 42.3; 95 percent CI, 5.5- 326.6), obesity (BMI &gt;30) (OR = 11.8; 95 percent CI, 4- 34.6), and low HDL cholesterol (OR = 1.6; 95 percent CI, 0.3- 6.1)</p> <p><strong>Conclusion: </strong>MetS was prevalent amongst Gaza Strip healthcare workers, with a consistent increase in prevalence as people were older and had a higher BMI. There was no direct relationship between shift category and the occurrence of MetS and inflammation; however, other factors such as genetics, lifestyle factors, and the work itself may have a greater impact than shift category.</p> Heba Mohammed Arafat, Nahed Ali Al Laham, Ohood Mohammed Shamallakh, Kholoud Mohammed Shamallakh ##submission.copyrightStatement## Thu, 23 Dec 2021 00:00:00 +0000 Comparative Study of the Incidence of Co-infection of Soil-transmitted Helminths and Helicobacter pylori among Children and Women of Reproductive Age Living in Slum Settlements in Rivers State, Nigeria <p><strong>Background:</strong> Soil-transmitted parasites, bacterial and other biological contaminants constitute the major causes of food-borne diseases often transmitted through food and water borne routes contaminated with faeces in developing countries. Children and Women of reproductive age (WRA) have high of getting infected and being potential sources of pathogenic micro-organisms.</p> <p><strong>Objective: </strong>This study was aimed to assess and compare the prevalence and risk factors of soil-transmitted helminths and <em>Helicobacter pylori</em> (<em>H. pylori</em>) among school-aged children and women of reproductive age at selected area in Eleme Local Government Area, Rivers State.</p> <p><strong>Methods:</strong> Cross-sectional study was conducted 580 participants were enrolled in May-August 2019. The gastrointestinal parasites were examined with wet mount and formol-ether concentration techniques. Chi-square (χ2) test was used to evaluate the association between categorical variables and infection prevalence using SPSS version 21, values were considered significant when the p-value was less than 0.05.</p> <p><strong>Results:</strong> The overall prevalence of soil-transmitted helminths among children was 12.3% (37/300) whereas WRA had 12.5% (35/280). <em>Trichuris trichura</em> was found to be prominent among the children with 18 (6.0%) while<em> Ascaris lumbricoides</em> 10 (3.6%) was most prevalent among WRA. Gender based Prevalence was 56.8% (21/37) and 43.2% (16/37%) for males and females respectively. The age-related prevalence is most common among age group 11-15 years. This prevalence was not statistically significant (<em>p</em>&gt;0.05).<em> H. pylori </em>infection prevalence among the children and WRA were 11.7% (35/300) and 26.8% (75/280). The gender-related prevalence among the males had 18 (51.4%) and females 17 (48.6%) of the children group. The age group 1-5 years showed high prevalence of <em>H. pylori</em> than other groups. Among WRA, age group 23-27 and 33-37 years had equal prevalence of 20 (26.7%). In consideration of co-infection between children and WRA,<em> A. lumbricoides</em> coinfection <em>H. pylori</em> 15 (53.5%) was most prevalent among children while among women of reproductive age, hookworm co-infection <em>H. pylori </em>8 (50.0%) was most prevalent. Risk factors that were statistically significant (p&lt;0.05) were among those who wash hands with soap after playing/touching soil and those dewormed in the last three months.</p> <p><strong>Conclusion: </strong>The distribution of soil-transmitted helminth infections co-infection <em>H. pylori </em>among children and WRA is low, however strategic planning of treatment regimen of community based should be encouraged.</p> Evelyn Orevaeghene Onosakponome, Amudatu Ambali Adedokun, Clement Ugochukwu Nyenke ##submission.copyrightStatement## Thu, 23 Dec 2021 00:00:00 +0000 Correlation between Late Second and Third Trimester Placental Thickness Detected by Ultrasound and Gestational Age in Normal and IUGR Pregnancies <p><strong>Background: </strong>Ultrasonography has played a significant part in obstetric care. This has progressed from basic 2-D imaging to Doppler imaging to monitor foetal and maternal circulation, as well as 3-D imaging of foetal anatomy .).Obstetrical ultrasound has proven crucial in a variety of ways, two in particular being more accurate pregnancy dating and detection of fetal anomalies. The aim of this study is determine to Correlation between late second and third trimester placental thickness detected by ultrasound and gestational age in normal and IUGR pregnancies.</p> <p><strong>Methods: </strong>This study was a prospective study that was conducted on100 pregnant women who attended the outpatient clinics or admitted at inpatients wards of Obstetrics and Gynecology department, Tanta University during the period from December 2019 to December 2020.</p> <p><strong>Results</strong> In the majority of gestational age groups, the mean placental thickness was lower in group I than that detected in group II (P&lt;0.01) except that detected between 28 and 29 weeks and 29 and 30 weeks, where there was no significant difference between two studied groups regarding placental thickness (P&gt;0.05). In addition, the present study indicated that 26 out of 50 (52%) of newborns in group I had a birth weight below the fifth percentile and 24% of them had a birth weight ranged between 5 th -10 th percentile for gestational age and sex at the time of birth whereas all newborns of group II had a birth weight &gt;10th percentile for gestational age and sex. A comparison of neonates’ birth characteristics and outcomes between two groups showed a statistically significant difference in the birth weight among both studied groups</p> <p><strong>Conclusions: </strong>The mean placental thickness was steadily increased with increased gestational age both IUGR and normal fetal weight cases. in addition, In the majority of gestational age groups, the mean placental thickness was lower in IUGR than that their normal weight conterparts.</p> Basma M. Elmahdy, Amal A. El sokary, Adel E. AlGergawy, Dina G. El Kholy ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000 Epidemiological Profile of Stroke patients at Neuropsychiatry Department, Tanta University Hospitals <p><strong>Background: </strong>Stroke is the second most common cause of death and long-term disability worldwide with up to one of every six survivors remaining permanently disabled. It is a devastating and disabling cerebrovascular disease with significant amount of residual deficit leading to economic loss and disease burden worldwide.</p> <p><strong>Aim: </strong>Describe the epidemiological profile of stroke during the period of five years (2014-2018).</p> <p><strong>Study Design: </strong>cross- sectional study.</p> <p><strong>Place and Duration of Study:</strong> This study was carried out in the Neuro-psychiatry hospital (free and economic departments) at Tanta University Hospital. This study started from the first of April 2019 and completed by July2021.</p> <p><strong>&nbsp;Methodology: </strong>The sample we included 3435patient medical records. Tools of the study were: file extracted sheets of the five years (2014-2018).It was about data related to epidemiological profile of stroke.</p> <p><strong>Results: </strong>This study included 3435patient medical records admitted with stroke at the years2014-2018 and had the following epidemiological profile: the age ranged from 30-95 years and the median age was 65 years old .Male constituted 51.8% of patients, about two thirds, (64.9%) of patients were from urban residence and 66.8%were married. As regards type of stroke: ischemic stroke presented by 63.5%of patients and hemorrhagic stroke by 36.5%.Of all patients 30% had favorable outcome, 67.4% had stable condition and 2.7% were died.</p> <p><strong>Conclusion: </strong>The rate of stroke was increasing through the studied five years with most cases at year 2018 and the epidemiological profile was not different from other studies.</p> Samar Samir Alnamla, Ashraf Ali Aboelsafa, Abdelaziz Farouk Eldeeb, Nadira Mansour Hassan ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000 Relationship of C-reactive Protein to Lymphocyte Ratio with Prognosis and Mortality in COVİD 19 <p><strong>Background:</strong> The Covid 19 pandemic is a serious disease that has infected millions of people and died tens of thousands. The clinical findings of the disease is observed in a wide range from asymptomatic to death. On the other hand, abnormal pathological variety is findings in laboratory parameters.</p> <p><strong>Aims:</strong> In this study, it was aimed to relation&nbsp; laboratory parameters with prognosis and mortality in the admission intensive care.</p> <p><strong>Study Design:</strong> This study was done in Ersin Arslan Training and Research Hospital Covid Intensive-care unit between July 1, 2021 and September 30, 2021.</p> <p><strong>Methodology:</strong> Patients over the age of 18 who were positive Polymerase Chain Reaction test and admitted in the intensive-care unit were included in the study. The data of a total of 197 patients who were compatible with this criteria was retrospectively analyzed. White blood cells, C-reactive protein, procalcitonin and lymphocyte values (within the first 24 hours) ​​of the patients, use history of steroid, and whether they were intubated and their mortality were investigated.The relations of the obtained data with each other were evaluated. Statistical analysis was performed using the Wilcoxon Signed-Rank test.</p> <p><strong>Results: </strong>113 were males (57.3%), and 84 were females (42.7%). The mean age was 64.6 ±2.16 (21-95) years.&nbsp; Most of the patients (67.5%) were over 60 years old. WBC values ​​of the patients were 46.8% high and 53.2% normal (normal value range 4-10 μL). Lymphocyte values were 55.3% lymphopenia, 43.6% normal lymphocytes, 1.1% lymphocytosis (normal value range 0.8-4 μL). CRP results were 98.9% high (normal value range 0-5 mg/L). High PCT value was 26.3% of the patients (normal value range 0-0.5 ng/ml). 86.8% of the patients were used steroids. 58.3% intubated (in Intensive-care unit) and 54.8% died of the patients. According to the lower and upper reference values; WBC/Lymphocyte:1-12.5 and CRP/Lymphocyte: 0-6.25 values ​​were accepted normal ranges.</p> <p><strong>Conclusion:</strong> Mortality is more often in patients with females and over 60 years of age admitted to the intensive-care unit in Covid-19. If the CRP to Lymphocyte ratio is more than 100, it is related with mortality.</p> Bayrakçi Onur, Bayrakçi Sinem ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000 Survival Outcomes of Histopathological Subtypes of Colorectal Adenocarcinoma in Ugandan Patients <p><strong>Background:&nbsp; </strong>High grade mucinous adenocarcinomas have been found to be more common in younger patients and are associated with a poor prognosis in the West. In Uganda, survival outcomes of the different histopathologic subtypes of colorectal adenocarcinoma (CRC) and lymphovascular invasion (LVI) is unknown. We determined the survival outcome of the different histopathologic subtypes of CRC and LVI among Ugandan patients.</p> <p><strong>Methods: </strong>A retroprospective cohort study on patients diagnosed with CRC from 2008 to 2018 were identified from the Kampala Cancer Registry and hospital medical records. Retrieved data included date of diagnosis, demographics, stage, grade and location of CRC. Our outcome was survival, and the main predictor variables were the histopathologic subtype, stage, grade and LVI. We plotted Kaplan-Meier curves for survival, tested the equality of survival by log-rank tests and used multivariable Cox regression to determine factors associated with survival.</p> <p><strong>Results: </strong>12.4% patients predominantly had mucinous adenocarcinoma/signet ring colorectal carcinoma (MAC/SRCC) and 87.6% patients had classical adenocarcinoma (AC). The median age (SD) at diagnosis of MAC/SRCC was 47.8 (16.6) years and 53.8 (15.9) years for AC. SRCC/MAC was significantly associated with more LVI than AC (p=0.002).&nbsp; In multivariate analysis, factors associated with increased mortality included stage III (aHR=2.56; p=0.009) and stage IV (aHR=6.64; p &lt;0.001). After adjusting for lymph node involvement and metastasis, SRCC/MAC patients had a shorter survival than AC patients; however, this difference was not statistically significant (p=0.229).</p> <p><strong>Conclusions: </strong>In Uganda, the proportion of MAC is similar to that found in the Western world. SRCC/ MAC were associated with more LVI than AC. SRCC/MAC showed a tendency towards decreased overall survival. In Uganda, more patients present with advanced-stage CRC which was associated with poor survival hence national screening guidelines are necessary to improve survival.</p> Richard Wismayer, Julius Kiwanuka, Henry Wabinga, Michael Odida ##submission.copyrightStatement## Fri, 24 Dec 2021 00:00:00 +0000