Background: The prevalence of musculoskeletal disorders is particularly high among garment workers, which poses a serious occupational health hazard. This issue is not taken seriously as an important issue in low-income countries like Bangladesh.Aim: Determine the prevalence of musculoskeletal conditions (MSDs) among garment workers in nine body regions and explore the relationship between MSDs and the general characteristics of the participants.Materials and methods: A cross-sectional study including 383 garment workers was done. A structured questionnaire (Standardized Nordic Musculoskeletal) was used. Results: The most common form of pain in the last year was lower back pain. Nine anatomical locations were studied, and workers most commonly experienced problems with their lower back (45.4%), upper back (36.6%), and knees (33.2%). Workers reported having more trouble in the knee (31.9%), upper back (35.0%), and lower back (43.9%) regions over the past seven days. In the past year and the last seven days, shoulder injuries were the least common. Conclusion: MSDs are widespread among garment industry employees. The back condition is the most commonly affected. The development of MSD is directly correlated with age and work experience.

Internet addiction is a growing addictive behavior and a major public health problem worldwide. Several psychological factors can contribute to the problematic use of the Internet. This study aimed to determine the prevalence of Internet Addiction (IA) in a sample of university students and to examine the relationship between IA, self-esteem, and attachment styles.The present study was a cross-sectional study, involving 135 students from the Faculty of Medicine of Monastir. The participants completed a questionnaire, which contained the socio-demographic data, the reasons for Internet use, the Young Cyberaddiction scale to seek IA, the Relationships-style-questionnaire-RSQ to assess attachment style, and the Rosenberg Self-Esteem Scale (RSES).The mean age of the students was 21.5 ± 1.9 years old. They were 112 (83%) females. The prevalence of Internet addiction was 23.7%. The average connection time was 3.5 ± 1.8 hours/day. The most frequent online activities were chat (online discussion, forums ...) in 94.8% of cases followed by download activities (78.5%), scientific research (75.6%), online games (23.7%), and online shopping (13.3%). IA was associated with school failure, alcohol use, online gaming, and low self-esteem. The majority of the participants (84.4%) in this study reported an insecure attachment style. Logistic regression analysis showed a strong association between IA and fearful attachment style.IA was frequent among students. Fearful attachment style was found to be a risk factor for IA. This study highlights the impact of relationships between child and their caregivers on the development of addiction.

Background: Stroke occurs in 11% of patients with SCA before 20 years of age. In Northwestern Tanzania, the prevalence of stroke among children living with SCA under the age 15 years is 16.9%, of which might be attributed to the absence of routine screening for the risk of stroke by using Transcranial Doppler Ultrasound (TCD). Screening with TCD allows preventive measures such as chronic blood transfusion to be done which has led to the reduction of stroke by 92%.Methods: This was a prospective analytical cross sectional study which enrolled 267 SCA children aged 2 to 16 years attending Bugando Medical Centre Pediatric Sickle Cell Clinic from July 2019 to June 2020. Assessment of factors associated with elevated TCD included a clinical history of stroke in sibling, death in sibling, temperature, oxygen saturation in room air, blood pressure, hemoglobin level and total white blood cell count. TCD was done by accessing transtemporal window and recording the highest time average mean of maximum velocity (TAMMV) of major vessels mainly, middle cerebral artery (MCA) and distal internal carotid artery (dICA).Results: The median age of enrolled was 6.6 (IQR: 4-9) years. The prevalence of elevated TCD (> 170 cm/s)was found to be 21% (56/267). By multivariate logistic regression, low oxygen saturation in room air, p - value = 0.037, OR 1.08 [95% CI 1.00-1.17] and low hemoglobin level, p - value = 0.001, OR 1.76 [95% CI 1.26-2.45] were statistically significantly associated with elevated TCD among children living with SCA.Conclusion: The high prevalence of elevated TCD velocity, with low hemoglobin and low oxygen saturation in room air as associated factors under multivariate logistic regression, warrants routine TCD screening for children with SCA aged 2 to 16 years.

Background: Human Immunodeficiency Virus (HIV) and thyroid function have been described. Prevalence pattern and atherogenic status significantly differ from HIV-negative control in several studies. Unfortunately, few studies have determined the prevalence of thyroid function and lipids among Nigerians living with HIV. Objective: This study is to evaluate thyroid hormones and lipid profiles in HIV-positive subjects attending a faith-based health facility in Anambra State Nigeria.Materials and methods: The serum concentration of Thyroid Stimulating Hormone (TSH), free Triiodothyronine (fT3), triiodothyronine (T3), free Thyroxine (fT4), Thyroxine (T4), Total Cholesterol [TC], Triglyceride [TG], High-Density Lipoprotein [HDL], Low-Density Lipoprotein [LDL] and Very Low-Density Lipoprotein [VLDL] was determined in 95 HIV positive subjects which include 48 patients who were on HAART- group 1 and 47 not on HAART- group 2; and compared to 30 HIV negative controls – group 3. Results: The level of TSH and fT3 was significantly (p < 0.05) higher in group 1 participants than in group 2 and the group 3 participants. The level of T4 was significantly higher in group 2 than in group 1 and group 3 participants. The level of T3 was significantly lower in Control participants in comparison to both HAART and non-HAART participants. The prevalence of fT4 dysfunction across the groups was significantly different from each other. The total mean of Cholesterol (163.5 ± 22.7), Triglyceride (163.5 ± 22.7), and Very Low-Density Lipoprotein (14.2 ± 2.4) of the HIV-positive participants were significantly (p < 0.05) lower than that of the HIV negative participants.Conclusion: The results obtained from this study indicate that serum levels of thyroid hormones may be used as baseline periodic markers during antiretroviral therapy and many people living with HIV may benefit from supplementation if appropriate.

COVID vaccination has been associated with serious disorders including thrombosis with thrombocytopenia syndrome (TTS), Guillain-Barré syndrome (GBS), and myocarditis. GBS has been reported in adults following COVID-19 infection and rarely following the COVID-19 vaccination. Post COVID vaccination GBS has been associated with prominent and early facial diplegia and quadriplegia. Extension of the COVID vaccination program to the pediatric age group of 5 to 17 years has exposed this population to the adverse effects of the vaccination. Only a few case reports of post-vaccination GBS have been reported in the pediatric age group without any data on the true prevalence. We report a case of a male in his early adolescence with GBS presenting as facial diplegia and rapid quadriplegia following the BECOV2D, (Corbevax) vaccination. Our case is the first case of GBS reported following BECOV2D, (Corbevax) vaccination and highlights the presentation with prominent and early diplegia, which is similar to the presentation in adults.

In developing countries, malnutrition represents a public health problem, which affects many children under five, during their complementary feeding period. One way to overcome this problem is through the supplementation of complementary flours with locally available food resources, such as Moringa oleifera leaf (MOL). An experimental study was conducted from June through November 2019 in the southern-Benin, with moderately acutely malnourished (MAM) children, using a porridge made of a mixture of corn, malted sorghum, soybean, peanut, milk, and moringa leaf powder. A total of 150 MAM children aged 12-59 months were recruited and divided into two groups, an intervention group (48) and a control group (75). The intervention group received the test food, a porridge made of maize flour supplemented with Moringa oleifera leaf flour (MOL-flour), at least 5 times/week for 6 months. The control group, whose mothers received nutritional education sessions on food diversification as well as the different ways of preparing MOL meals. Sensory evaluation, anthropometric and dietary diversity data were collected. Z-scores Weight/Height, Weight/Age et Height/Age were determined before and right after the intervention. Results showed that 70% of the children and more than 75% of the mothers assessed the porridge as palatable. A significant average weight gain of 1.720 g (p < 0.005) was observed in the intervention group at the end of the experimentation, with a reduction of the prevalence of underweight by 1,33% (p > 0.05), and the number of acute Malnutrition children by 10,42% (p < 0.005).

Background/Aim: There has been a progressive rise in the incidence and prevalence of End Stage Renal Disease (ESRD). It has also been observed that the most important reasons for a rapid increase in Chronic Kidney Disease (CKD) patients are the rapidly increasing worldwide incidence of diabetes and hypertension. The present study evaluates the effect of diabetes, hypertension, and comorbid state of hypertension and diabetes (hypertensive-diabetic) on renal function using serum creatinine and urea as markers. Method: A total number of 120 persons were recruited for the research; 30 controls, 30 hypertensive, 30 diabetic, and 30 hypertensive-diabetic persons. Of the 30 control persons, 18 were females and 12 were males; of the 30 hypertensive subjects, 17 were females and 13 were males; of the 30 diabetics subjects, 20 were females and 10 were males, whereas of the 30 hypertensive-diabetic subjects, 21 were females and 9 were males. In total, there were seventy-six (76) females and 44 males. The respondents were pulled from Central Hospital (Auchi) Diabetic and General Clinic and Auchi Polytechnic Cottage Hospital. Verbal consent was sort and questionnaires were used to extract information regarding biodata and patients’ history of diabetes and hypertension. Height and weight were measured, and blood pressure was determined taken. Blood samples were collected into fluoride oxalate and lithium heparin bottle for the assessment of FBS and (serum urea and creatinine) respectively. Results: The mean (±SD) serum creatinine was higher in the hypertensive-diabetic group (2.08 ± 1.06) and declined as follows: diabetic group (1.75 ± 1.01), hypertensive group (1.34 ± 0.96) and control group (0.70 ± 0.14). The mean (±SD) serum urea was also found to be higher in the hypertensive-diabetic group (17.5 ± 9.06) and declined as follows: diabetic group (14.5 ± 6.13), hypertensive group (12.7 ± 6.23) and control group (7.18 ± 5.06). There was a positive correlation between serum creatinine and fasting blood sugar The study also established a positive correlation between serum creatinine and blood pressure but not between serum urea and blood pressure with r values of 0.31 and 0.16 respectively. Conclusion: Good control of blood glucose and blood pressure levels reduces the likelihood of the development of renal impairment which is usually associated with both diabetes and hypertension. Co-morbidity of diabetes and hypertension poses a higher risk of developing renal disease than individual problems of diabetes and hypertension. Serum creatinine and serum urea are important biomarkers for renal impairment hence the two should be monitored on a regular basis for diabetic and hypertensive patients and much more frequently for hypertensive-diabetic patients.

Introduction: Myopia is a refractive disorder commonly diagnosed in childhood that follows a progressive course. It is considered a global epidemic with nearly 23% of the world’s population being diagnosed with this condition. Moreover, myopia is increasing in prevalence worldwide, demonstrated by studies in Asian and Western populations. This has important implications as myopic progression to high myopia is associated with significant morbidity and visual disability if left untreated. Of these treatments, the pharmacologic agent atropine has demonstrated the greatest efficacy in reducing myopia progression.Case report: This is a case report of an 11-year-old male treated with 0.01% atropine drops for myopia progression that developed new-onset seizures. The seizures were characterized as benign epilepsy with central temporal spikes and ceased when drops were discontinued. Discussion: Atropine 1% drops have previously been associated with new or increased seizure activity in a handful of case reports, however, it is our knowledge that this is the first report associated with 0.01% drops. This is important given the growing use of 0.01% drops as well as higher concentrations such as 0.025 % and 0.05% for the treatment of pediatric myopia. Conclusion: While it cannot be proven that the drops were causative in the seizure events, it is important to consider prior seizures as a relative contraindication to the use of these drops.  Atropine has the potential to exacerbate seizure activity, so it is possible that the 0.01% atropine drops played a role in the patient’s seizures. Also, any diagnosis of new-onset seizures in pediatric patients should prompt discontinuation of drops at seizure onset.

Hypersexual disorder, also known as compulsive sexual behavior or sex addiction, is a complex and clinically significant condition characterized by intense and recurrent sexual fantasies, urges, or behaviors that significantly disrupt an individual’s daily life and overall well-being. Despite its importance, hypersexual disorder remains a controversial and debated topic, lacking standardized diagnostic criteria in major classification systems.This review paper provides a comprehensive examination of hypersexual disorder, encompassing its definition, conceptualization, etiology, co-occurring conditions, effects on mental and physical health, assessment, treatment approaches, cultural and ethical considerations, and future research directions. By synthesizing information from existing literature and research, this review aims to deepen our understanding of hypersexual disorder and contribute to the development of evidence-based interventions.The review begins by exploring the evolution of the term “hypersexual disorder” and its current status in diagnostic classifications. It then delves into the potential etiological factors contributing to the development of hypersexual behaviors, including neurobiological, genetic, and psychosocial factors.Furthermore, the review discusses the common comorbidities associated with hypersexual disorder, emphasizing the importance of addressing co-occurring mental health conditions in treatment planning. The psychological and physiological effects of hypersexual behaviors on affected individuals are examined, underscoring the urgency of early intervention and comprehensive treatment.The assessment and diagnosis of hypersexual disorder are thoroughly examined, considering the challenges and methodologies involved in identifying and evaluating affected individuals. Cultural and ethical considerations are highlighted, stressing the significance of providing culturally sensitive and ethical care to diverse populations.In the context of treatment, the review discusses various therapeutic approaches, including psychotherapy, medication, support groups, and harm-reduction strategies. The need for evidence-based treatments tailored to hypersexual disorder is underscored while recognizing the challenges of developing standardized protocols in this evolving field.Finally, future research directions are outlined, focusing on the standardization of diagnostic criteria, prevalence studies, neurobiological investigations, and the integration of cultural competency in treatment approaches.In conclusion, this review paper aims to contribute to a comprehensive understanding of hypersexual disorder and its implications for affected individuals and society. By exploring the multifaceted aspects of the condition, this review seeks to provide insights into effective treatment approaches and inspire further research in the study of hypersexual disorder.

The prevalence of intra-uterine dysfunction of ductus arteriosus is unknown and the clinical consequences are poorly understood. We report a case of prenatal diagnosis of premature closure of the ductus arteriosus due to maternal intake of metamizole during pregnancy. Fetal echocardiography at 37 weeks of gestation revealed a right ventricular hypertrophy and suspected stenosis of the tricuspid valve. A cesarean section led to an excellent neonatal outcome. The aim of this report is to show echocardiographic abnormalities and outcomes of this rare phenomenom.

Background: Postdated pregnancy is one of the most common obstetric problems associated with increased maternal morbidity, prenatal morbidity, and mortality. Pregnancy at 37-40 weeks of gestation is called the term from the last menstrual period. If the pregnancy exceeds 40 weeks, it is called a postdated pregnancy, but when pregnancy is prolonged beyond 42 weeks, it is called post-maturity or post-term pregnancy. Objective: This study aimed to determine the adverse effects of postdate pregnancy on mothers and fetuses.Methodology: This was a descriptive, prospective, cross-sectional, hospital-based study conducted at Omdurman Maternity Hospital from January 2018 to June 2018.An interview questionnaire was used to collect data. Data were collected by trained doctors in the labor room. One hundred and thirty-eight (138) postdated pregnant women were included in this study after obtaining informed consent through a structured questionnaire. Demographic and clinical data concerning personal history, booking status, mode of delivery, maternal complications, and fetal complications were recorded.Results: During the study period, 2751 women delivered, of which 138 were postdated deliveries, with a prevalence of 5%. Most women's age range was 31-34 years 48.6%). Their education level was mostly secondary school (42%). Primigravida 65%), booked were 75.4%. Previous history of postdate pregnancy was 34.1%, normal vaginal delivery was 79 .7%, cesarean section was 14.5%, and instrumental delivery 5.8%. Cesarean section indications were cervical dystocia (14.4%), cephalopelvic disproportion (9.5%), meconium-stained liquor with fetal distress (33.3%), pathological cardiotocography (CTC) (19%), and failure to progress (23.8%).Maternal complications included post-partum hemorrhage (PPH) (7.2%), perineal tears (.7%, cervical tears (1.4%), and postpartum infections (1.4%). Fetal complications were 14.5%, Shoulder Dystocia 2.9%, asphyxia (6.5%), and meconium aspiration (5.1%). The mean APGAR score was 1.1667, less than three in only 3.6%, and > 7 in 86.9%.Neonatal death was 3%. Approximately 18 neonates were admitted to the Neonatal Intensive care unit (NICU) and only five of them were admitted for more than one week.Conclusion: Postdate pregnancy prevalence in this study was 5%, which was associated with maternal risk of cesarean section delivery, instrumental delivery, postpartum hemorrhage, and postnatal infection.

Background: Maternal near-miss (MNM) events occur more frequently than maternal deaths; therefore, more detailed and comprehensive studies on maternal morbidity have been conducted and are of value to clinical audits and practices. Purpose: This study aimed to determine the frequency of maternal near misses and the nature of near-missevents. Methodology: This descriptive, retrospective, cross-sectional study over 12 months duration was conducted at the Alobied Teaching Hospital in 2018. Data were collected from patient notes, partographs, and other relevant documents. Demographic and clinical data concerning personal history, obstetric history, and near-miss events. Results: A total of 15202 women were admitted, 339 cases of maternal near misses, maternal near-missrate (MNMR) of 22.3|1000 live births, 200(59%) had an infection, 80(23.6%) hemorrhage, 20(5.9%) severe pre-eclampsia,12(3.5%) eclampsia, 20(5.9%) anemia, convulsions 5 (1.5%) 17(5%) of the cases were admitted to intensive care unit (ICU), 9(2.7%) had liver dysfunction, 9(2.7%) coagulation dysfunction, 8(2.4%) renal dysfunction, 5(1.5%) cerebral problems, 4(1.2%) cardiac dysfunction, and 2(0.6%) had developed respiratory dysfunction.Conclusion: The maternal near-miss rate was 22.3|1000 live births. Most near-miss cases occurred before the women arrived at the hospital. The major causes of maternal near misses were infection, hemorrhage anemia, pre-eclampsia, and eclampsia.

Bone choristoma within a dermolipoma is a rare epibulbar tumor with a low prevalence. It is a benign tumor that does not usually cause discomfort or functional problems to patients who suffer from it. Its treatment is surgical and with an aesthetic purpose.We report the case of a 17-year-old patient with a bone choristoma, a tooth, within a dermolipoma.Epibulbar bone choristoma is a rare benign tumor that causes little discomfort to patients who suffer from it and is asymptomatic in most cases. Computed tomography (CT) is essential in its diagnosis and its treatment is surgical, but always due to aesthetic reasons.

Penile cancer, a rare but highly morbid disease, primarily manifests as squamous cell carcinoma (PSCC) originating from the squamous cells of the glandular and preputial skin. Late-stage diagnosis is common due to social stigma, psychological barriers, and nonspecific initial symptoms, resulting in poor overall survival rates, especially in metastatic cases. This case report illustrates a 38-year-old man with advanced metastatic PSCC, showcasing severe systemic manifestations and delayed presentation of the disease. Despite aggressive treatment options, the patient opted for palliative care, succumbing to the disease months after his diagnosis. Risk factors for PSCC include HPV infection, phimosis, chronic inflammation, and lifestyle factors, with higher prevalence in regions of low socioeconomic status. The psychological and sexual burden of penile cancer is significant, impacting patients’ well-being, mental health, and quality of life. In conclusion, efforts to reduce the stigma associated with penile cancer are crucial to prompt early diagnosis and treatment initiation. Encouraging seeking medical attention for symptoms can enhance the chances of recovery and minimize the need for invasive treatments. Addressing the psychosocial impact of the disease is imperative for holistic patient care.

Known since antiquity, migraine is a complex primary disorder, an episodic painful Autonomic Nervous System (ANS) storm, generally following the stress/post-stress phase. Despite exhaustive study of neuropeptides, neurochemicals, molecules, neurogenetics, neuroimaging along with animal and human experiments over the last 50 years, the scientific basis of migraine remains unknown. Straddling eight decades from Cortical Spreading Depression (CSD) to Calcitonin-Gene Related Peptide (CGRP) and its antagonists, exponentially increasing data have failed to create a gestalt synthesis. This article lays cohesive and robust fundamental principles for the comprehension and management of migraine. The continuum between migraine and non-congestive Primary Open-Angle Glaucoma (POAG), Normal Tension Glaucoma (NTG), or Low-Tension Glaucoma (LTG) is advancing. The case of sustained remission of migraine attacks (> 75%) over 3 years - 5 years with ocular hypotensive topical Bimatoprost Ophthalmic Solution (BOS) 0.3% in an N-of-1 trial in 3 patients with refractory migraine is presented. A cause-effect-adaptive process underlies the ANS-stress/post-stress-linked biology of migraine. Vasopressin-serotonin-norepinephrine ‘homeostatic-adaptive system’ Lowers Intraocular Pressure (IOP), while enhancing anti-stress, antinociception, vasomotor, and behaviour control functions, thereby selectively decreasing algogenic neural traffic in the ophthalmic division of trigeminal nerve (V1), and, raising the threshold to develop migraine. Striking migraine headache-aborting feature of vomiting is also likely linked to a several hundred-fold increase in arginine-vasopressin secretion. Eye-cover tests and self-ocular digital displacement are essential to studying the visual aura. Real-time physical displacement of Scintillating Scotoma (SS) and floating ‘stars’ is reported. The basis of spontaneous onset and offset, self-limited duration of migraine attacks, as well as female preponderance, and age/menopause decline in prevalence, are elucidated. Intraocular implants with long-term ocular hypotensive effects, including bimatoprost, are the future of migraine management. Controlled trials are required to establish the migraine-preventive effect of topical bimatoprost, a revolutionary advance in neuroscience.

Accumulated condylomas are exophytic tumors with a warty and hyperkeratosic surface due to the Human papillomavirus (HPV). Its prevalence in children is difficult to estimate due to limitations in epidemiological data. Its recurrent character is found in 30% of patients. Its management is very complex in children because of skin fragility. Circumcision is an operation consisting of the removal of part of the foreskin. This practice is done either with a simple knife or a pair of non-aseptic scissors which can be a source of contamination including HPV (Condyloma). Traditional circumcision does not seem to be reported in the literature as a mode of contamination. We report a case of genital condyloma in a child 2 years after circumcision. This is a 2-year-old male with no medical history but with a surgical history of circumcision that was brought by his parents in dermatological consultation for papular lesions accumulated on the penis. At the interrogation, we found the notion of recent circumcision performed by a tradithérapeute. The physical examination finds a good general condition. Dermatological examination reveals on the glans of multiple papules, exophitic, with warty and hyperkeratotic surface, of normal skin color. Furthermore, the physical examination of both parents was normal. The diagnosis of accumulated condyloma secondary to probable circumcision was retained before the clinical appearance of the lesions. Two electrocoagulation sessions spaced one month apart under local anesthesia were the treatment with a favorable evolution.

Antibiotic resistance is a growing global crisis, straining healthcare systems and leaving us with limited options to combat drug-resistant bacteria. This retrospective, cross-sectional study examines the prevalence of antibiotic resistance patterns among urinary tract infections (UTIs) in Al-Shifa Hospital’s medical departments in comparison with non-medical departments using data from microbiology laboratory archives over a one-year period. From the examined urine cultures about 25% were obtained from internal medicine departments and double the number was obtained from non-medical departments. The positive rate was around 35% and about two-thirds of the samples were collected from female patients. Among all departments, Enterobacteriaceae spp. were found to be the most frequently isolated uropathogens, accounting for 80% of cases. However, resistance rates varied depending on the specific organism and antibiotic used. For instance, E. coli showed a resistance rate of only 5% against meropenem, while amoxicillin-clavulanic acid exhibited a resistance rate exceeding 95%.Importantly, the study revealed a significant disparity in resistance rates between medical and non-medical departments, specifically concerning third-generation cephalosporins. In internal medicine departments, resistance rates were alarmingly high, with cefotaxime, ceftriaxone, and ceftazidime showing resistance rates of 75%, 75% and 66.5% respectively. In contrast, non-medical departments displayed lower resistance rates, approximately 60%, 60% and 40%, respectively.In summary, this research sheds light on the escalating problem of antibiotic resistance in UTIs and emphasizes the discrepancy in resistance rates between medical and non-medical departments. Urgent efforts are required to address this issue and find effective solutions to prevent the rise of untreatable bacterial infections.

With the increase in incidence and prevalence of myeloid neoplasms in India, it has become a necessity to understand its molecular mechanisms, acquisition of genomic alterations, and understand its primary and secondary resistance pathways which ultimately impact the decision of therapeutics. The objective of this review is to investigate the molecular aspects of this disease type and identify the biomarkers that help with diagnosis, risk assessment, prognosis, and selecting the best line of treatment for a specific myeloid neoplasm. Advancements and innovations in molecular technologies from simplest Real-Time PCR to high throughput next-generation sequencing have played a vital role in screening the most common mutations and fusions to the novel and rare. Molecular technologies have helped to enumerate the genomic landscape of myeloid malignancies. The understanding of both- the mechanisms and the technology is a strong combination as it has helped revolutionize precision oncology and helped in giving better therapeutic choices with better clinical outcomes. The importance of cellular morphology, clinical symptoms, and molecular pathology in assessing the risk of myeloid malignancies is emphasized and summarized in the review. The review concludes that understanding molecular pathogenesis can be improved by using clinical-pathological-molecular strategies for diagnosis and therapy decision-making.

Cognitive impairment (CI) can be defined as a clinical syndrome characterized by a decline in at least two of several domains of cognitive function. Chronic kidney disease (CKD) is an independent risk factor for cognitive decline, and the prevalence in patients with end-stage renal disease is estimated at 50% - 80%. However, it appears that CI in patients on renal replacement therapy (RRT) may be underdiagnosed. In this cross-sectional study, 33 patients on Peritoneal Dialysis from the AOU Federico II were recruited, and matched by sex, age, and dialysis age to 33 patients on Hemodialysis and 33 controls belonging to healthy volunteers. The total 66 patients and their 33 controls were assessed for cognitive function using the Cognitive Reserve Index Questionnaire (CRIq) test. Between PD and HD patients, a statistically significant difference emerged in all subscores and in the total CRI. Between PD patients and controls, a statistically significant difference emerged in education, CRI- CRI-leisure time, and the total CRI. Therefore, CI may occur in patients undergoing PD earlier and with a greater frequency than in the general population, but with a lower incidence than in patients on HD. These considerations should be communicated to patients when they are educated about different replacement methods.

Introduction: Corticosteroid therapy is widely used in dermatology for treating various conditions. In France, the cost of corticosteroid treatment varies, and in Mali, a significant prevalence of corticosteroid-treated diseases has been reported. Given the prolonged treatment duration often required, understanding the cost implications in resource-limited settings is crucial.Patients and methods: This descriptive cross-sectional study took place at the dermatology department of the University Hospital Center of Dermatology in Bamako. Data were prospectively collected from patients undergoing corticosteroid therapy over one year. Variables included sociodemographic data, clinical information, and medication costs.Results: During the study period, 24 cases of dermatoses treated with corticosteroids were identified among 125 hospitalized patients, representing a prevalence of 19.2%. Most patients were women (58.3%), with an average age of 37.5 years. Lichen planus (54.2%) and pemphigus (37.5%) were the most common pathologies. Many patients had extensive lesions before treatment, but the majority responded well to corticosteroids.Discussion: Despite study limitations, such as its descriptive nature, it provided valuable insights into the economic evaluation of long-term corticosteroid therapy. The predominance of women, the age distribution, and the prevalence of specific dermatoses were highlighted. The study also revealed the substantial financial burden of corticosteroid treatment, primarily driven by direct costs.Conclusion: The study underscores the financial challenges associated with long-term corticosteroid therapy in dermatology in Mali. The high costs adversely affect patients and their families, especially considering the socioeconomic status of many patients. Moreover, the findings emphasize the importance of comprehensive care strategies and the need for accessible healthcare solutions to address these challenges effectively.