Objective: Colorectal cancer is one of the most commonly occurring cancers in men and women worldwide as well as one of the most common causes of death from cancer. It has a higher prevalence in men than women. The treatment of colorectal cancer (surgically or through chemotherapy) severely affects both patients and their families. The objective of the study was to identify cases of colorectal cancer, evaluate their demographic and clinical data, and identify any statistical relationship. Methods: This is a retrospective study. The data were collected through the revision of cancer patients’ files in the Chemotherapy Center at Vlore Regional Hospital, Vlore, Albania. The analysis included files from 2015-March 2019. A total of 72 patients’ files with colorectal cancer were analyzed. Result: Mean age of patients 66.36 ± SD10.99 years old, range 38-86. Most of the patients were male (n = 45) and with colon cancer type (n = 44). 19 patients had treatment with surgery, radiation, and chemotherapy. 56.34% of patients with colorectal cancer are still alive. The results of the study are the same as the global trend in terms of age, gender, type of cancer but not in terms of years of survival, which appear lower. Conclusion: The study suggests that in demographic terms patients with colorectal cancer have no difference from world trend. There was also a marked lack of documentation regarding the clinical data of patients. The complete and accurate documentation of cases with colorectal cancer is recommended to develop quality models of nursing care as well as to design effective promotional and preventive campaigns for colorectal cancer.

Introduction: Serology (antibody) tests for the SARS-CoV-2 have been proposed as an instrument to inform health authorities about immunization during the COVID-19 pandemic. As there is a significant part of the population that may have some degree of immunity, it is of great interest to communicate the immunization results obtained in the first 500 healthcare workers (HCW), patients and relatives tested in a community-based Oncological Center. Materials and methods: Between April 9th, 2020 and May 8th, 2020, a group of healthcare workers (HCW), their families, and general public who had had the COVID-19 or had been in close contact with confirmed cases of COVID-19 were screened for IgG SARS-CoV-2 antibodies. The tests were carried out in a rigorous manner, strictly following the guidelines approved by the Spanish Ministry of Health (Ministerio de Sanidad). Results: The major objective of this study was to determine the proportion of asymptomatic infected individuals and those who had already secreted IgG against SARS-CoV-2 in our cancer treatment center or in the community of Barcelona. Patients were tested with PCR, Rapid diagnostic test (RDT) or enzyme-linked immunoabsorbent assay (ELISA). A total of 521 participants were tested, 206 with RDT and 315 with ELISA, 59 (11,32%) resulted positive to SARS-CoV-2. Conclusion: RDT and ELISA proved to be effective and sensible enough to determine the extent of SARS-CoV-2 immunization in a community-based oncological center. The degree of immunization reached is nowadays far away from what can be considered desirable for a herd immunization.

Background: Prevalence of malnutrition in Chronic Kidney Disease (CKD) patients is due to their lower appetite level. Diabetic patients experience polyphagia. Hence it is necessary to understand the impact of diabetes on the nutritional status of CKD patient. Aim: To compare the nutritious status between the CKD patients with and without diabetes. Objectives: To find out the impact of diabetes on the nutritional status of CKD patients. Method and Materials: A prospective random sampling method was adopted to select the subjects. Eighty CKD patients were divided equally into two groups. Tool which has been used to collect the data was SOAP format. Results: While comparing BMI between group 1(CKD without diabetes) and group 2(CKD with diabetes) it was noticed that the percentage of normal nourished subjects in group 2 were greater than that of group1. About 63% and 25% of subjects with CKD in group1 had normal BMI and grade 1 undernourished respectively. In group 2, about 75% and 10% of patients had normal BMI and grade 1 over nourished respectively. About 80% of subjects in group 2 were on insulin treatment. About 88% of subjects in group1 were anorexic and about 55% and 25% of subjects in group 2 had polyphagia and normal appetite respectively. The difference in the energy and protein intake between the two groups was statistically significant at p<0.01 level. Conclusions: It can be concluded from the above study that a better nutritional status was found in the CKD patients with Diabetes Mellitus (DM) than the CKD patients without DM which may be due to their normal appetite/ polyphagia, hence allowing a better food intake among group2 subjects. Weight gain in CKD with DM patients may be due to increase in fat mass which is subsequent to lipogenic effect of insulin.

Objective: To study the epidemiology of xerophthalmia in children 2-6 years of age in North India. Methods: A prospective clinical study was done at two tertiary care centers of North India between 2010 to 2016, Cases were selected from routine OPD and children less than 6 years of age were examined by an ophthalmologist. Diagnosis and classification of Xerophthalmia was done according to WHO classification. All the data recording demographic profile, socioeconomic status, other health problems etc were recorded in a fixed proforma. Data was analyzed by SPSS version 16. Findings: Two thousand nine hundred forty six cases were included in the study after satisfying inclusion and exclusion criteria. The prevalence of night blindness was estimated to be 2.93% (95% Confidence Interval [CI]: 2.53-3.33) among children between 2 and 6 years of age. Xerophthalmia prevalence was 4.43% (95% CI: 4.19-4.67). Prevalence was more in girls than boys and higher in low socioeconomic status. Conclusion: Vitamin A deficiency is recognized to be a severe public health problem leading to corneal opacity and childhood blindness in most of the areas of North India

Tinnitus-derived from the Latin “tinnire” meaning “to ring” is a perceived ringing, buzzing, or hissing in the ear(s) or around the head-which has multiple etiologies and is sometimes idiopathic. As of 2009 in the United States, approximately 50 million Americans were affected for six months or greater, while a United Kingdom study in 2000 reported a 10% prevalence in the adult population [1]. Tinnitus may vary widely with regard to pitch, loudness, description of sound, special localization, and temporal pattern [2]. Most often, tinnitus is associated with other aural symptoms, such as hearing loss and hyperacusis [3]. Tinnitus may result in sleep disturbances, work impairments, and distress. The severity varies within this cohort of chronic sufferers, with some unable to fulfill daily activities. Though tinnitus is more likely to affect adults and the incidence increases with age, children can experience tinnitus as well [4]. Males are more likely to suffer as are individuals who smoke [5]. 

Obesity is a chronic and metabolic disease with a high increasing prevalence worldwide. It has multifactorial pathogenesis including genetic and behavioral factors [1-5]. Overweight and obesity have been defined and classified by the World Health Organization (WHO) and the National Institutes of Health (NIH) [2,3]. A person with a normal weight has Body Mass Index (BMI) of 18.5-24.9. A person with a BMI under 18.5 is called underweight. An adult having a BMI of 25-29.9 is overweight and pre-obese. Class 1 obesity is defined as a BMI between 30.00-34.99. Class 2 (Severe) Obesity is to have a BMI between 35.00-39.99. Morbid (Extreme, Class 3) obesity is to have a BMI over 40 [1-5]. Obesity is significantly associated with enhanced morbidity and mortality rates. It has also various economic, medical and psychological effects and causes health problems including many systemic diseases, economic costs and burdens, social and occupational stigmatization and discrimination and productivity loss [4-6]. Obesity carries the increased risk of development of many systemic and chronic diseases, including sleep apnea, depression, insulin resistance, Type 2 (adult-onset) diabetes, Gout and related arthritis, degenerative arthritis, hypertension, dyslipidemia, heart disease such as myocardial infarction, congestive heart failure, or coronary artery disease, polycystic ovary syndrome and reproductive disorders, Pickwickian syndrome (obesity, red face and hypoventilation), metabolic syndrome, non-alcoholic fatty liver disease, cholecystitis, cerebrovascular accident, colonic and renal cancer, rectal and prostatic cancer in males, and gallbladder, uterus and breast cancer in females [6-12]. In recent years, some publications reported that obesity has been strongly associated with some ocular diseases including age-related cataract and maculopathy, glaucoma, and diabetic retinopathy [13-16]. The recent reports demonstrated that the central corneal thickness and intraocular pressure were increased while as mean thickness of RNFL and retinal ganglion cell and choroidal thickness (CT) were decreased in the morbidly obese subjects [17-19]. However, another study has reported that CT increased in obese children [20]. On the other hand, a recent study reported that all values of the specific tests used to evaluate the ocular surface were within the normal range [21]. In some experimental studies, it has been demonstrated that obesity may cause retinal degeneration [22,23]. Additionally, in a past meeting presentation, it has been speculated that keratoconus is associated with severe obesity [24]. Teorically, idiopathic intracranial hypertension, and papilledema may also be associated with obesity [25]. Obesity may be also a cause of mechanical eyelid abnormalities such as entropion [26]. However, further investigations are needed to detect the significant relationship between these diseases and obesity. On the other hand, the ocular surgeries of obese patients are difficult compared to normal weight-subjects. The posterior capsule rupture and vitreous loss may easily develop during cataract surgery of these patients because obese patients have an elevated vitreous pressure and operating table cannot often be lowered or surgeon’s chair cannot be elevated sufficiently to provide the clear viewing of the operating area and tissues. So, some different surgical manipulations such as standing phacoemulsification technique and reverse Trendelenburg position have been developed. Additionally, the standing vitrectomy technique has been used for vitreoretinal interventions in morbidly obese patients [27,28]. In conclusion, all obese subjects should be subjected to a completed ophthalmological examination and to relevant clinics for the detection of possible comorbidities and diseases

Child abuse remains a complex issue affecting individuals, families, groups and society, and one which WHO prevalence figures show as a significant ongoing problem. The nature of the abuse, be it physical, sexual, psychological, or neglect, places the child at high risk of experiencing the multiple sequelae of the trauma. Depending on the child’s country, the disclosure of abuse by the child or a third party will either be moved into criminal justice system or directed to the medico-psycho-social sector. In 1985, in Belgium, specialist teams were established to evaluate and support situations involving child abuse. More than thirty years later, we considered it opportune to update the parameters that our team has developed based on four reflexive themes. The first discusses the transformation of our society, families and individuals, exploring how each influences the others. The second theme describes the diagnostic process, holding in mind the complexity of any situation. The third theme describes the reasoning behind these teams, considering this as a de-judicialisation of such situations. Finally, we describe the different treatments available. This paper describes the evolution of clinical practice including developments in several aspects that have arisen through handling situations of abuse.

Purpose: Benign paroxysmal positional vertigo (BPPV) is the most frequent peripheral vertigo syndrome in otoneurological clinical practice and is characterized by short and paroxysmal objective vertigo crises caused by changes in the position of the head on specific planes of space. Secondary microvasculitis is characterized by inflammatory destruction of the small vessels. Starting from this point, this work is based on the research of correlation between microvasculitis (especially secondary), recurrent BPPV and nasal cytology, an aspect, among other things, poorly documented. Materials and methods: To evaluate the relationships between recurrent BPPV and secondary microvasculitis, nine patients with this disorder, 5 males and 4 females aged between 25 and 40 years were observed (average age 30.6). Non allergic pains in the small joints and in the anamnesis nothing relevant in the gentiles and collaterals: Evaluated with vestibular audiometric examination, nasal cytology and vascular examination with corneal HRT results. Nasal cytology, in all cases, has documented the presence of rare mast cells. The hemodynamics of the microcirculation with a confocal microscope has revealed blood flow alteration in all subjects. Discussion: Analyzing the results, both the prevalence of the right side and a close relationship between vasculitis and BPPV could be seen. Conclusion: The study of the nasal mucosa and the research of inflammatory cells could be fundamental for the study of BPPV in which as we have seen the important biochemical role for the onset of these diseases.

Background: Alcohol and chat use during adolescence is associated with academic and health problems, including abuse or dependence in adulthood. The aim of the present study was to investigate associations between adverse childhood experiences (ACEs) and early initiation of alcohol and chat use among school-going adolescents. Methods: A cross-sectional study was performed with 546 school-going adolescents. The ACE International Questionnaire (ACE-IQ) was used to assess ACEs, Alcohol and chat use was assessed by questions prepared by the authors. Multiple logistic regression models were used to examine the associations between overall ACE score and alcohol use and the potential moderating effects of confounders. Results: prevalence of chat chewing behavior was 26.6% followed by alcohol use 20%. A total of 66.2% of participants reported at least one ACE, and 5.93% reported four or more ACEs. High/Multiple ACEs (ACEs=1-3 and above 3) were significantly associated with increased alcohol use behaviors (AOR=1.491(1.072-3.078) and (AOR=3.171(1.330-7.560) respectively and increased chat use behaviors by 4.92 times (AOR=4.92, 95%CI=2.640-8.432) and 11.022 times (AOR=11.022, 95%CI=1.230-25.560) respectively controlling other factors. Conclusion: ACEs were significantly associated with risk behaviors, alcohol and chat use may lead to poor health, and educational outcomes among adolescent students and numbers of ACEs have graded association. Social support, sex, residence, parent educational status, and current level of depressive symptoms were significant modulating factors, which parents, school teachers, psychologists, and adolescent health care providers should give the concern to decrease the effect on school-going adolescents. 

Background: Ocular diseases affect every individual in this world, with the only difference being in the pattern of occurrence of disease depending on age, gender, region, and climatic conditions. In Ethiopia there is shortage of literatures stating pattern of ocular diseases which is very important for planning preventive, curative and rehabilitative health service concerning prevalence of eye problems. Objective: This study is aimed to determine the pattern of eye diseases at Borumeda Hospital, Amhara region, Ethiopia from July 10 to December 15, 2018. Method: Institutional based cross- sectional retrospective study was conducted among 384 patients attending in ophthalmic OPD of Borumeda primary hospital. Nine hundred three newly diagnosed patients who were registered on OPD registration book in the study period were study population. Systematic random sampling was conducted to select study participants from study population. The collected data were then analyzed using descriptive statistics (mean and frequency percentage). Results: From all study participants who had ocular disorders 92(24%) of them were came by Allergic conjunctivitis, followed by cataract 16.9%, refractory disorders 13%, Glaucoma 7.1%, infective conjunctivitis 4.7%, Pterygium 3.1%, Blepharitis 3.1%, NLDO 2.6%, Pseudoaphekia 2.4% and Corneal opacity 2.1%. Conclusion: Significant number of patients 182(47.5%) of them came for treatment of adnexa (lid, margin, conjunctiva, lacrymal system) disorders. So every health professional should be responsible to deliver preventive, curative and rehabilitative services to control the most prevalent ocular disorders. Significance of study: This study will be very important for health managers to distribute medical resources and staffs according to the prevalence of ocular disorders. This study result will be useful for health care workers for planning preventive, curative and rehabilitative health services for those common eye disorders.

Laccase catalyzes oxidation of lignin and aromatic compound with similar structure to this one. Their low substrate specificity results on degradation of similar phenolic compounds. In this context, Molecular Docking was performed with different ligands suggesting potential bio-degradation. Binding active-sites prediction of fungal laccase (access number uniprotkb: A0A166P2X0), from Ganoderma weberianum was performed using machine learning algorithm based on Deep Convolutional Neural Networks (DeepSite-CNNs chemoinformatic tool). Herein, ligands like 2,4 - dichlorophenol, benzidine, sulfisoxazole, trimethoprim and tetracycline were analyzed and two additional reference controls which were 2,2 – azinobis 3 – ethylbenzothiazoline – 6 - sulfonic acid (ABTS) and 2,6 - dimetoxyphenol (2,6 DMP) were used in comparison with the other former mentioned ligands based on high laccase affinity. The five ligands were carried out because their potential biotechnological interest: the antibiotics sulfisoxazole, trimethoprim and tetracycline, and xenobiotics 2,4 - dichlorophenol and benzidine. Molecular docking experiments returned Gibbs free energy of binding (FEB or affinity) for laccase-ligand complexes. The best docking binding-interaction from each laccase-ligand conformation complexes suggest great ability of these ligands to interact with the laccase active-binding site. Herein, FEB values (kcal/mol) were obtained with higher affinity values for reference controls like 2,6 - dimethoxyphenol with -4.8 Kcal/mol and ABTS with -7.1 Kcal/mol. Furthermore, the FEB values were -4.7, -6.5, -6.8, -5.2 and -6.5 Kcal/mol, for 2,4 - dichlorophenol, benzidine, sulfisoxazole, tetracycline and trimethoprim respectively with high prevalence of hydrophobic interaction with functional laccase binding residues. Lastly, this study presents for first time at the bioinformatics field a molecular docking approach for the prediction of potential substrate of laccase from Ganoderma weberianum towards biotechnological application.

Objective: The purpose of the study was to evaluate if there is a link between salivary pepsin levels and tooth erosion. Also, to determine if gastroesophageal reflux disease (GERD) is responsible for much of the tooth erosion seen by dentists. Background: Pepsin is only produced within the stomach. If found within other parts of the body [for example within saliva or sputum samples], the only mechanism by which that would be possible is via the reflux of gastric contents. One of the causes of dental erosion is thought to be due to direct contact between tooth surfaces and acidic substances and digestive enzymes present in gastric refluxate. GERD is a common condition, with its prevalence seemingly trending higher in recent decades. It is reportedly a known cause of tooth erosions. From the hypothesis, there was an expectation to see patients with dental erosions to have pepsin detected [and perhaps at high levels] and to see patients without dental erosions to have no or low levels of pepsin. Method: Three saliva samples were collected [on waking and 2 post-prandial] from 50 anonymous participating patients (26 females, 24 males) from a single dental practice. Extra information was collected related to lifestyle, Reflux Symptom Index (RSI – reflux questionnaire) and tooth erosions. These samples were analyzed for the stomach enzyme pepsin using the validated medical device Peptest. Results: There was no correlation between positive pepsin levels and the presence of tooth erosion during this study. There was a statistical difference between the on waking pH vs. positive pepsin levels and post prandial pH vs. positive pepsin levels. The average pH was lower for on waking and post-prandial samples with positive pepsin, suggesting that the saliva was acidic and gastric reflux had occurred. Conversely, the average pH was higher for on waking and post-prandial samples with negative pepsin. There was no statistical difference between pH vs. tooth erosion in the on waking and post- prandial. Conclusion: Patients identified as having tooth erosion did not have higher levels of pepsin detected, suggesting that pepsin was not associated with dental erosion in these patients.

The childhood obesity is increased more than three folds in last two decades in developed world. There is nutritional transition seen in the developing world including India. The westernization in diet of the Indian population along with prosperity brings the brunt of overweight and obesity. This has future implications of liver diseases, heart diseases, hypertension, hyperlipidaemia, insulin resistance; malignancies. Mumbai is the prosperous city and an economical capital of India. Also, the rampant use junk food, common outdoor eating’s, no grounds to play for children make the high likelihood that the prevalence of obesity to be higher than rest of the country. It can profoundly affect children’s physical health, social, and emotional well-being and self-esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of the entire family. Treating and preventing childhood obesity helps protect the child’s health and has tremendous impact on child’s Physical and academic performance. And hence we at Aastha Bariatrics took initiative and launched ECHO... for a change (‘E’radicating ‘C’Hild ‘H’ood ‘O’besity), a pan Mumbai campaign against childhood obesity. This campaign was done in 15 high schools across Mumbai, which covered in total of 9000 students.

Introduction: Pulmonary hypertension (PH) is prevalent in hemodialysis (HD). In the general population, more women than men have PH due to left ventricular (LV) disease with preserved ejection fraction (EF). Little is known about the gender-specific prevalence of PH and associated LV abnormalities in patients with end stage renal disease (ESRD) on HD. Our aim was to evaluate gender differences and LV structural and functional changes in PH among ESRD patients on HD. Methods: Ninety-four patients (ages 23-77 years) underwent echocardiography after HD. Patients were divided based on estimated pulmonary artery systolic pressure (PASP) (Group A PASP < 40 mm Hg, Group B PASP ≥ 40 mm Hg). LV measurements included LV mass, LV internal dimensions, and LV ejection fraction (EF). LV diastolic function (LVDF) was assessed from mitral inflow deceleration time (DT) and E/A ratio. Results: Fifty-five patients (59%) had PH, including 32 of 49 men (65%) and 23 of 45 women (51%). LVEF was lower in Group B (46.4 ± 17.6 vs. 62.4 ± 14.4%, p < 0.001). Men with PH had higher LVIDd, cm (5.52 ± 0.89 vs 4.78 ± 0.75, p < 0.001), LVIDs, cm (3.75 ± 0.94 vs 3.14 ± 0.91, p = 0.03) LV mass, g (236 ± 74vs 189 ± 56, p = 0.02) and lower LVEF (40.0 ± 16.7 vs 52.0 ± 15.6, p = 0.008) than women. Conclusion: Patients on HD have a high prevalence of PH. PH was not associated with clear LV structural changes. There was a depression in LV systolic function without changes in LVDF. PH patients were more often men with hypertrophied LV with depressed LV systolic function. 

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and its prevalence and incidence is also related to smoking behavior [1]. COPD is still a chronic inflammatory and progressive disease caused by multifactorial agents including environmental pollutants [2]. Besides that, it is emerging that endogenous epigenetic factors induced by lifestyle and environment [3] could play a role in the etiopathogenesis of the disease [4]. In the last years, several authors suggested that low vitamin D levels seem to be related with the increase of COPD manifestations [5]. Moreover, a multicentre, double-blind, randomised controlled trial documented that vitamin D supplementation protects against moderate or severe exacerbation of the disease, but not by upper respiratory infections [6]. However, low levels of vitamin D can be extended to many other diseases, including multiple sclerosis, diabetes, colon rectal cancer, headache or drug use [7-11]. Moreover, it is also important to remember that Vitamin D deficiency is common in high latitude regions, such as northern Europe, New Zealand, northern USA, and Canada where weaker ultraviolet B rays is not able to produce enough vitamin D. Finally, methodological factors (using low sensitivity methods) could contribute to misleading evaluation of circulating vitamin D levels. In any case, here we shall remind that vitamin D has a fundamental role in immunity [12]. In particular, it has been reported that vitamin D is able to shift the pro-inflammatory T-helper cell 1 to anti-inflammatory T-helper cell 2 [13]. Therefore, benefits of vitamin D supplementation in chronic diseases which directly or indirectly affect immune system are obvious. Today, the burden of COPD in never smokers is higher than previously believed. Therefore, more research is needed to unravel the characteristics of non-smokers COPD [1]. Notably, vitamin D levels are reported to be significantly lower in smoker’ssubjects than in non-smokers ones [14]. Therefore, low plasma vitamin D levels in COPD seems to be more a causality than a correlation.

Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Bacillus of Koch), and presents chronic evolution affecting the lungs frequently. Objectives: Analyse, in the state of Maranhão, the epidemiological prevalence of tuberculosis between 2014 and 2016. Materials and Methods: Documentary and descriptive study of secondary data collected in the database of the dates, epidemiological information and morbidities, between 2014 and 2016. Results: 3,897 cases of tuberculosis in the state of Maranhão were recorded. The most affected age range was 15 to 59 years, totaling 3,111 cases, for both gender; of 60 to 79 years, 577 cases were totaled. Conclusion: Tuberculosis affects more adolescent males from adolescence to old age, and it is necessary to promote knowledge of the disease for the population in order to advance in the control of the same and obtain satisfactory clinical results.

Background: The burden of depression as a mental disorder has continued to increase and constituting an enormous public health concern among all age groups. A number of socio-demographic, and other factors including a stressful and rigorous academic programme or curriculum such as the one run in most medical schools could contribute to the occurrence of depression among medical students. AIM: To determine the socio-demographic and other factors associated with depression among medical students in the University of Port Harcourt. Methodology: This study was a descriptive cross-sectional study. Appropriate sample size was calculated and the stratified random sampling method was used to select the subjects. A well-structured open ended self-administered socio-demographic questionnaire was administered to the students. The Zung Self-Rated Depression Scale was used to assess the depression status of each respondent. The data were analyzed via descriptive and analytical methods. Results: The prevalence of depression among the medical students was 5.3%. Fourteen students (4.6%) were mildly depressed while only two respondents had moderate depression. Year 3 had the highest prevalence with 10.5% followed by final year with 5.3%, while the only 2 cases of moderate depression were found among students in year 2 of their medical programme. Two hundred and seventy-one respondents (88.8%) were found to have good knowledge of depression, 32 (10.5%) were found to have average knowledge of depression and 2(0.7%) had poor knowledge of depression. Conclusion: Depression does occur among medical students at the University of Port Harcourt albeit low, and was associated with a number of socio-demographic and other factors. The present medical curriculum and programme should be sustained and more efforts at making it less stressful and academically friendly, be made to further reduce the current rate of psychological stress and depression among the students.

Introduction: Fractures of both the anterior and posterior pelvic ring are common injuries in polytrauma and the elderly that extend beyond those of simple low-impact trauma. While conventional X-rays predominantly show the ventral aspect of the injury, computed tomography often detect additional fractures of the sacrum. A large number of these fractures are B-injuries by AO, mainly compression fractures at an advanced age. In addition, the prevalence of pelvic insufficiency fractures caused by osteoporosis rather than subsequent to an obvious trauma is increasing, with such an injury often associated with pain that impairs mobilization. The standard sacroiliac screw fixation is often characterized by loosening and thus failure of the osteosynthesis especially in osteoporotic bone of elderly patients. Method: A new alternative surgical minimal invasive technique, the “iliosacral bridging”, stabilizes the fractures of the sacrum with an internal fixation from S1 pedicle of the uninjured side to the ilium on the affected side. The combination of this internal fixation with the standard single sacroiliac screw on the injured side allows an immediate full weight bearing and pain free mobilization. We present a case series of 8 patients. Results: The clinical and radiological analysis analogous to the pelvic-outcome-score brought forward that 2 patients showed an excellent and 2 patient a good result. The other 4 patients achieved sufficient results. Conclusions: The “iliosacral bridging” we have introduced in the present study provides evidence of an expected increased stability of the pelvis after B-injuries

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. 

Erectile dysfunction (ED) is a common disorder whose prevalence increases with age. Over time a strong correlation between erectile dysfunction and cardiovascular disease has been established as the result of the same pathophysiological process: endothelial dysfunction and atherosclerosis. Because small vessels of the penis can be affected by atherosclerotic plaque earlier than coronary arteries, carotids or femoral arteries, men often have symptoms of ED long before the signs of cardiovascular disease appear. For this reason, ED can act as a marker of early atherosclerosis that predicts the onset of cardiovascular disease at a later time.