Articles

The paper reviews enclosure asphyxia as a cause of death of three Nigerian children aged three years, five years and seven years respectively, who were found dead and locked in the boot of a Mercedes Benz 200E Sedan car a day after they were declared missing. The first two were siblings of the same parent whose fathers actually owned the car, while the older child was a neighbour kid all of whom were well known to each other as friends and playmates. They had gone missing for a few hours prior to being seen playing together. Search parties were raised and they were never found until the following day when they were found dead in the boot of the car parked a few meters away from the house under a tree. Incidentally the same car was driven round the neighbourhood for 3 hours during the search the previous day with no inkling that they were in the boot of the car. Autopsy was ordered by the coroner to determine the cause of death.

Chronic venous leg ulcers (VLU), especially long-lasting non-healing ulcers, are among the risk factors for squamous cell carcinoma (SCC) with particularly aggressive behaviour. We present a case of a 71-year-old female patient with a relevant personal history of multiple SCC and basal cell carcinoma (BCC) excision and chronic venous insufficiency showing for about three years a ulcerated lesion located on the anteromedial distal third of the left leg non-responsive to specific treatment, which subsequently increased their size and merged. Biopsy sample was taken. Histopathology revealed a G2 SCC in all biopsy samples. After the staging, a left inguino-femoral lymphadenectomy and the excision were done. The treatment of bone exposure with a soleus muscle flap in the upper half of the defect and skin graft for all the defect and a specific oncologic treatment were proposed as possible curative solutions. Patients with chronic venous leg ulcers and clinically suspicious lesions should be evaluated for malignant transformation of the venous lesion. When diagnosed, malignancy complicating a chronic venous leg ulcer requires a resolute treatment as it may be fatal.

The main purpose of the present study was to find out the differences on suicidal ideation, hostility, hopelessness and negative self-evaluation among heroin addicts with comorbid depression. After reviewing the literature, it was hypothesized that heroin addicts with high depression may have high scores on variable of suicidal ideation, hostility, hopelessness, and negative self-evaluation as compared to those with low depression. The sample was consisted of 60 males from Low-socioeconomic status (SES) (34 of them were screened as having high scores on the variable of depression and 26 were screened as low scorers). Siddiqui Shah Depression Scale (Siddiqui & Shah, 1997) and Urdu version of Suicide Probability Scale (Cull & Gill, 1982) was administered. To compare heroin addicts with high and low depression on various variables, t - test was applied. The research findings showed that heroin addicts with mean age of 30 years (range 20 to 40) having the mean duration of heroin dependence of 10 years with high depression were significantly high on the variable of suicidal ideation, hostility and hopelessness ((p < .05) as compared to those with low depression. And there was no significant difference on the variable of negative self-evaluation for both groups (p > .05). So it was concluded that services for patients with Heroin addiction should include periodic screening for suicidal behavior along with psychiatric treatment and psychosocial support.

It is well known that depression is more common in women than in men with more prescriptions for antidepressants, hospital admissions for depression and suicide attempts. However another aspect to be considered is that depression is different in women than men because women have depressive episodes at times of hormonal shift which is a physiological phenomenon not encountered in men. This is why hormone therapy is so important.

Purpose: To compare the outcomes of Abdelhamid technique in treatment of inguinal hernia to conventional TAPP with mesh stapling, Prolene hernia system (PHS) and Lichtenstein repair. Background: the mesh is applied and fixed externally aiding in decreasing port size and cost. There is controversy concerning the necessity of securing the mesh during laparoscopic TAPP repair. Patients: The study was carried out at the faculty of medicine – Beni Suef University, Egypt from September 2008 to April 2018. 672 patients with unilateral inguinal hernia participated in the study. 432 were treated using Abdelhamid Technique, 382 of which were unilateral primary inguinal hernia and 50 were unilateral recurrent. 50 patients were treated using Prolene Hernia System (PHS). 50 patients with recurrent hernias were treated using Lichtenstein repair and 140 patients went TAPP with mesh stapling. Results: Abdelhamid technique showed more cost effectiveness than stapling (1800$ vs 3000$) , pronounced less recurrence rate in comparison with Liechtenstein and PHS (2% vs 4%), same LOS compared to other techniques and mean operative time of 76 minutes which is longer than stapling (60 mins), Liechtenstein (65 mins) and PHS (55 mins). Conclusion: Abdelhamid technique was a more lengthy operation costing more than open surgery but less than mesh stapling. The recurrence rate is considerably reduced with shorter recovery period. The technique is done with smaller port size that leads to cost reduction

Background: Anxiety and depression are under reported, underdiagnosed mental illness in health worker in Nepal especially during COVID pandemic. The study was carried out as an observational study on nurses in Nepal. In this study we attempted to assess the incidence and impact of depression and anxiety in nurses who are working upfront in different hospitals during this crisis. Objective: The purpose of the study is to assess the prevalence of anxiety and depression among nurses in Nepal during COVID pandemic who are working in various hospitals. Method: A cross-sectional non-probability purposive sampling with observational analysis was carried out and the sample was collected from nurses working in different hospitals. Prevalence of anxiety and depression was assessed using a structured and validated questionnaire. Anxiety was assessed with the Hamilton Anxiety Scale (HAM-A), General Anxiety Disorder Questionnaires (GAD) with a cut-off score for various levels of anxiety while Hamilton Depression Rating Scale (HAM-D) was used to assess depression. Result: The analysis of these different scales revealed that disabling anxiety prevailed at highest (43.6%) in nursing staff according to HAM-A scale. Moderate anxiety also seemed to be higher (> 20%) in GAD questionnaire. Conclusion: This is the first study carried out in Nepal that investigates the mental health of nurses who are working in the frontline in this COVID pandemic situation. The study revealed that our nurses who have given their life in the line are suffering from serious mental health problems. 

The use of cell phones has remarkably increased in the last two decades with several pros and cons. The negative consequences of cell phones on mental health have not been studied widely. Aggression, in this regard was a completely neglected area. The present study, therefore, was carried out to investigate the relationship between cell phone use and aggression and to further identify the moderating roles of gender and marital status between cell phone use and aggression. The inquiry included 500 young adults from Rawalpindi, Pakistan. Buss and Perry Aggression Questionnaire was administered. It was hypothesized that there would be a strong positive relationship between cell phone use and aggression. It was further hypothesized that gender and marital status would be significant moderators between cell phone use and aggression. The results supported the hypotheses on significant differences and made a significant contribution in the existing scientific literature.

Primary closure of the common bile duct following exploration has been safely and effectively performed, as advocated by Halsted, provided no evidence of pancreatitis, cholangitis, or ampullary obstruction exists. This study was to gain back confidence to primary closure in selected cases. This study was conducted at Beniswaif University Hospital. Between July 2008 to May. 2014. Using this precedent, the operative management and post-operative course of 19 patients undergoing common bile duct (CBD) exploration for choledocholithiasis were studied, twelve had primary closure of the common bile duct following choledochotomy and exploration, and seven had T-tube placement. Patients were selected for T-tube if there were pancreatitis, cholangitis, undue trauma, ampullary obstruction. Two patients in that study had bile leak, one in each group. Intravenous fluids were less in primary suture (P<0.001). The long of stay were significantly less in primary suture (P<0.001). The outcome of this study greatly support the safety of primary common bile duct closure in selected cases.

This study presents the frequency of old myocardial infarctions (OMI), and the frequency of unrecognized myocardial infarction (UMI) in elderly people in a forensic material. It was also examined if predisposing factors of UMI could be identified. Of special interest was also to investigate the value of the police’s records as a source for medical information in a forensic setting. The study is based upon medico-legal autopsies of persons above the age of 60 at the time of death during the period 1999-2003. The study included 325 cardiovascular deaths. Of these, 166 died from OMI. UMI accounted for 123 of these (74%). Most UMI were located in the interventricular myocardial septum and left anterior wall (>60%), but no significant differences could be found between UMI and recognized MIs (RMI). No obvious reason could be found as to why the UMI remained unrecognized. Police records were inferior to the hospitals records, regarding medical information to the pathologist, with information about cardiac disease in about 60%, and with information about OMI in 11-17%. Hospital records supplying information about OMI were found in half the cases. It is concluded that unrecognized myocardial infarction is not uncommon among elderly persons, and with a high risk of sudden death. More emphasis should be put in recognizing OMI in ECGs to attempt to reduce the risk of sudden cardiac death.

The issues investigated in the current study pertain to selected psychological aspects of human functioning in long-term stress conditions. Results of the analyses performed in this study have submitted evidence to confirm the hypothesis in which it is stated that staying on the sea for a long time is a difficult situation which contributes - to a greater or smaller extent - to starting the stress process in sailors. The role of interpersonal competencies that has been found most distinct; high level of this variable contributed to reducing both anxiety and the feeling of loneliness. It has been evidenced in the research that the skill of good functioning in varied social groups, which results from high level of development of several traits including: openness, spontaneity, responsibility, and sensitivity, becomes particularly important in long-term difficult situations in which there is little possibility of eliminating the real menace. Another conclusion to be inferred from the research is the one confirming the theoretical suggestion in which the importance of ‘ego strength’ in modifying the course of stress process is emphasised. This personality dimension has turned out to constitute the factor capable of protecting an individual against increase in both anxiety states and the feeling of loneliness during sea isolation. Another issue considered in the current study pertains to defining the role of ‘family variable’ in mediating the course of stress process under conditions of long-term task isolation. The analyses have confirmed the hypothesis in which it was assumed that sailors functioning in family systems characterised by high level of integration and quality, experience lower emotional costs during a voyage. Generally, it may be claimed that - according to the research results of the study - ‘family variables’ may constitute a significant predictor of both the ‘quality’ of a man’s functioning and personal costs he experiences in long-term stress conditions.