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Percutaneous tibial nerve stimulation (PTNS) is a non-invasive treatment for overactive bladder (OAB). PTNS involves peripheral neuromodulation that uses electrical stimulation to target the spinal cord roots, mainly S3, which controls bladder function. Neuromodulation is postulated to be the effect of cross-signaling between sympathetic and parasympathetic post ganglionic nerve terminals and synapses, causing alteration of nerve signals involved in the voiding reflex. de Groat, et al. described this neurophysiological process and the neural circuits involved in controlling the lower urinary tract [1]. Stimulation of peripheral nerves and subsequent “cross-talk” at the level of the postganglionic neuroeffector junctions can modulate transmission and facilitate detrusor inhibition [2].

Introduction: Child Protection Services (CPSs) are dedicated to providing protection and responding to any threats a child could face as children worldwide could be abused. Recently, the COVID-19 pandemic affected all aspects of life. Procedures implemented to restrict the spread of the disease (such as reduced access to services, school closure, and social distancing measures) had an impact on child life and maltreatment. Therefore, it is important to know the impact of this pandemic on child abuse and protection. Aim and rationales: This study aimed to assess the impact of COVID-19 on CPSs in Oman by studying the change in the number of reported cases of child abuse and the change in the reporting procedure at the Ministry of Social Development (MOSD). In addition, know the impact of the restriction measures on child rights and risk factors of child maltreatment based on CPSs workers’ opinions and experience. To understand the adaptation of the CPSs to the change in work and life environment imposed by COVID-19. Method: A cross-section study was conducted using a semi-structured questionnaire, that was distributed to the workers involved in the CPSs at the MOSD in Oman. Data also were collected from the statistical bulletins on the Ministry’s website. Results: COVID-19 pandemic was not found associated with a significant change in the number and type of child abuse cases reported to the MOSD. The reporting procedures also did not change. In addition, the pattern of child abuse types did not change before and during the pandemic, as neglect cases were the most. The participants judged the restriction measures affecting family life through separation, cyber abuse, and reduced educational support. With regard to intervention and follow-up procedures, the main difference was in the communication processes by using online communication methods and reducing the fieldwork for mild cases.Conclusion: CPSs in Oman were not much affected by the COVID-19 pandemic, which may reflect the success of this system in dealing with the restriction measures. However, more solutions should be developed to adapt to these circumstances in the future altogether.

Background: In India, the genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. Methods: A cross-sectional survey of selected health amenities from 454 medical officers (MO’s), 94 accredited social health activist (ASHAs) workers, 86 multipurpose health assistant-female (MPHA-F), 34 multipurpose health assistant-male (MPHA-M), 14 multipurpose health supervisors-female (MPHS-F), 10 multipurpose health supervisors-male (MPHS-M), 6 multipurpose health extension officer/ community health officer (MPHEO/CHO), 10 public health nurse (PHN), 45 lab technicians (LT’s) working in the government health sector and 254 in the private health sector, 409 nursing staff working in the government health sector and 995 in the private health sector, 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH), 3 referral hospitals (RH’s). From the side of private health institutions 25 corporate hospitals (CH’s), 3 medical colleges (MC’s), and 25 diagnostic laboratories (DL’s) were conducted. Results: The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. In 24% of CH’s, the basic biochemical units are available and 32% (8 out of 25) of DL’s have the advanced biochemical genetics units by study. Molecular genetics units were found to be available in 28% (7 out of 25) of DL’s during the study. About 6 (24%) diagnostic centers of cytogenetic laboratories were located in the Visakhapatnam district under the private sector. Conclusion: The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Background: The endemic nature of poliomyelitis in Nigeria was a source of concern to many given the global efforts aimed at eradicating the scourge. In this study, the factors that influenced the eradication of this malady in South-South Nigeria (Akwa Ibom and Cross River State) were investigated. Four null hypotheses, drawn on these factors (including culture belief, religious difference, language and the prevalence of ethnic conflict) guided the investigation. The main thrust of this study was to examine how socio-cultural factors negatively influenced the eradication of polio in the study area. Methods: Through stratified random and purposive sampling techniques, 600 adult men and women who had children were selected for the study. A structured questionnaire constructed by the researcher was used in data collection. Data analysis was carried out using one-way ANOVA and independent t-test statistical tools. Results: The findings were that cultural belief and religious affiliation exerted significant influence on the people’s effort towards polio eradication. Conclusion: The study indicated that the low use of health services by the people was brought about by variation in these variables. Among other things, it was suggested that continuous awareness campaigns be carried out to educate the people on the need for immunization anchored in science and technology.

Advances in metagenomics have facilitated population studies of associations between microbial compositions and host properties, but strategies to minimize biases in these population analyses are needed. However, the effects of storage conditions, including freezing and preservation buffer, on microbial populations in fecal samples have not been studied sufficiently. In this study, we investigated metagenomic differences between fecal samples stored in different conditions. We collected 46 fecal samples from patients with lung cancer. DNA quality and microbial composition within different storage Methods were compared throughout 16S rRNA sequencing and post analysis. DNA quality and sequencing results for two storage conditions (freezing and preservation in buffer) did not differ significantly, whereas microbial information was better preserved in buffer than by freezing. In a metagenomic analysis, we observed that the microbial compositional distance was small within the same storage condition. Taxonomic annotation revealed that many microbes differed in abundance between frozen and buffer-preserved feces. In particular, the abundances of Firmicutes and Bacteroidetes varied depending on storage conditions. Microbes belonging to these phyla differed, resulting in biases in population metagenomic analysis. We suggest that a unified storage Methods is requisite for accurate population metagenomic studies.

The research concerning a preventive treatment of an osteoporitic femoral neck fracture started in 1990 because the surgical procedure of unstable femoral neck fractures is difficult. After effects are frequent and their number will increase in the next decade. The goal is to reinforce the femur with a biomaterial acting as a bone graft. Natural coral is bioresorbable and biocompatible. It acts as an autofocus bone graft for reconstruction of either cortex or cancellous bone and increases their mechanical resistance. This work shows evidence of new bone formation in an osteoporotic unbroken femoral neck femur. Consequently, the preventive surgical treatment of osteoporosis should be taken in consideration [1]. The purpose of this work is to show the results on the mineralization of the cancellous bone of an upper femoral metaphyses when a natural biomaterial is set in an unbroken osteoporotic femoral neck. Summary: Mrs. L is an 84 years old lady. Her osteoporotic unbroken right hip was grafted preventively with a biomaterial in order to prevent the high risk of break in case of fall. The biomaterial used is beads of natural coral. The reasons of this preventive treatment is discussed, as well as the choice of the biomaterial. The results are shown including a two years follow up. Brief History: Before going further, few words of history. Three centuries BC, an Aristote’s follower, Théophraste thinks that Natural coral is a petrified plant. For Ovide natural coral is a soft alga air-hardening. Al Biruni classes it among animals, because that respond to touch. At the beginning of the XVIIth century, Marsigli thinks that they are flowers which open out there in aquarium. The French Jean-André Peyssonnel, a young naturalist, says as Biruni, that in fact, corals are animals. At last, Buffon claims: These marine plants, were classified first in the rank of minerals, then in those of plants, and finally in that of animals. Natural coral is obviously an animal. After the Second World War, coral samples were analyzed by American scientists. Among 800 corail species, 3 where specially analyzed: Acropora, Porites and Libophylia. Mrs Nane Guillemin did in France her PHD on natural coral and with her team made a complete fundamental analysis (physical, chemical and biological properties) of the material, while the American scientists worked on the chemical bone’s properties. In France, Pr Ohayoun and his team worked on the surgical application in the dental field, Dr. Yves Cirotteau in the orthopedic surgery, specifically for osteoporotic disease and for the traumatologic field

In pregnancy, the incidence of pulmonary embolism (PE) is increased fivefold when compared to nonpregnant women of the same age, and PE is one of the leading causes of death during pregnancy.However, the diagnosis of PE among pregnant women is complicated by concerns regarding radiation exposure. Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide array of presentations and a predilection to affect women of certain ethnic backgrounds. The hallmark of the disease is multisystem involvement, dispersed in time and severity. Usual pulmonary involvement includes pleuritis, pleural effusions, pneumonitis, shrinking lung syndrome, pulmonary hypertension, and alveolar hemorrhage. Pulmonary embolism (PE) is a relatively unusual presentation of SLE. We report the case of a 20-year-old primi at 21 weeks gestation with an acute PE with central chest pain and shortness of breath. The absence of overt signs and symptoms and traditional risk factors prompted a fragmentary workup. This led to the detection of antibodies sensitive for SLE, in the absence of overt signs and symptoms. We revive the concept of latent lupus, a condition construed as early lupus. We firmly suspect direct causation between SLE and PE. Further studies are needed to establish pathogenesis to facilitate early diagnosis and prevent morbidity and mortality from PE. Due to persistent hypotension, thrombolytic therapy with streptokinase was administered and the clinical and hemodynamic response was excellent, with no maternal or fetal hemorrhagic complications. The clinical presentation of pulmonary embolism is sometimes camouflaged by the physiological changes that occur in pregnancy and diagnosis is often delayed by a reluctance to expose the fetus to ionizing radiation. 

Purpose: Adding dydrogesterone (DYD) to vaginal micronized progesterone (VMP) and postponing embryo transfer in order to improve outcomes in patients with low progesterone (P) levels in hormonally substituted cycles prior to frozen/thawed embryo transfer (FET). Methods: Endometrial preparation comprised sequential administration of vaginal estradiol until endometrial thickness reached 7 mm, followed by transdermal estradiol combined with 800 mg/day VMP. Our previous analysis of serum P levels on FET day showed that the optimal P level was > 11 ng/mL for live birth. Serum P was measured on day1 (D1) following exogenous VMP introduction in the evening. When P levels were > 11 ng/mL, FET was performed “in phase” on day-2, day-3, or day-5 depending on embryo stage at cryopreservation (n = 139 cycles). When P levels were < 11 ng/mL, DYD 10 mg three times a day orally, was added to VMP and FET was postponed by one day (n = 237 cycles, 63%). The primary endpoint was the comparison of live birth rates (LBR) between the two groups.Results: Mean serum P level on D1 was 10.2 + 3.7 ng/mL. Characteristics of patients in both groups were similar for age, body mass index, endometrial thickness prior to P introduction, quality of transferred embryos, and embryo transfer stage. Regarding the primary endpoint, LBR was similar between the VMP+DYD group and the VMP group (26.1% vs. 27.3%, NS). Conclusion: These results suggest that adding DYD to VMP and postponing the transfer in patients with low P levels in hormonally substituted FET cycles might optimize outcomes.

Introduction: In accordance with the requirements for the preparation of a report, a physician must provide information on scientific research in the following sections to obtain a qualification category of a specialist: 6. Scientific and practical work (participation in scientific and practical conferences, medical scientific societies, presentations, publications); 11.2. List of publications of the attested in scientific journals and collections, abstracts and 11.3. List of speeches at international, all-Russian and republican conferences. Material and methods: The analysis of 5 qualification works of a psychiatrist (1997, 2002, 2008, 2013 and 2018) for the scientific component as part of the mandatory requirements for the processing of documents when they are submitted to the Attestation Commission on the assignment of a qualifying medical category in psychiatry . The depth of the study was 24 years. When working on the material, the following methodical approaches were used: system, complex, dynamic, normative, quantitative and situational. Methods of analysis included: historical, analytical and comparison. For the analysis, methods were used: groupings, absolute values, continuous and selective observations. Results: The psychiatrist GAUZ “KDC” independently or in co-authorship published 223 scientific and educational-methodical publications (total volume of 182.65 conventional author’s sheets), including 90 scientific (39.81) and 143 educational-methodical (142.84) works, in including one monograph and eight textbooks (two of them with the stamp of the Ministry of Education of the Russian Federation). In the e-library (www.e-library.ru) of the Russian Scientific Citation Index (RINC): publications - 31; citations - 123; Hirsch index - 3, publications in the journals of the VAK - 13. (https://elibrary.ru/author). Discussion: The scientific work of a practicing outpatient psychiatrist is assessed both quantitatively and qualitatively, the integral indicator of the psychiatrist’s own participation in each publication of 0.78 conventional printed sheets can be considered as a serious personal contribution to scientific research. In the regulatory framework of indicators and requirements for registration of the report there is no synchronization in the daily work of a practical doctor, his job duties with the statements of the report. When concluding an employment contract with the employer, there is no mention in it that the doctor should engage in scientific work, and it is an integral part of his functional duties and qualification requirements. The scientific work does not mention the “Unified qualification directory of positions of managers, specialists and employees, the section “Qualification characteristics of the positions of employees in the field of health care” for a psychiatrist. Conclusion: The attitude to the Administrative Regulations on the provision of a public service for assigning a qualification category to specialists engaged in medical and pharmaceutical activities should be reviewed in terms of synchronization with the duties of a doctor. The Regulation on the compulsory conduct of scientific research should be introduced, substantiated and provided by the employer or be excluded from the administrative regulations as an independent section and be exclusively recommendatory in nature. Publications of physicians in scientific journals and collections, theses of reports should motivate their interest, and within the limits of the possibilities of the medical institution to have reasonable financial support, fixed in the employment contract. An example of a practical doctor who speaks at international, all-Russian or republican congresses, congresses and conferences is an important indicator of his professional growth, an incentive for the disclosure and development of the potential of the medical institution team and the result of proper administrative and organizational-methodological guidance. The scientific work and publications of a psychiatrist’s practical doctor should be a weighty additional argument in favor of a positive decision on awarding the qualification category he has declared.

Introduction: The individual program of rehabilitation and (or) habilitation of children with disabilities (IPRH) is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational-legal forms and forms of ownership.Objective: To conduct a pilot analysis of the implementation of the IPRH contingent of patients of children with disabilities in an urban children’s clinic.Patients and methods: There were 366 reports on the implementation of measures provided for by an IPRH for a disabled person (disabled child) of 222 disabled. The organization of the study was in the nature of a continuous sample. The criterion for the inclusion of patients in it was the passage of an IPRH in a disabled child within a specified time frame. The following techniques were used: grouping, absolute and relative values, average values, detailing, and generalization. The threshold error probability for statistically significant differences was set at a level of 0.05.Results: The structure of the results of the control of the performance of IPRH in 222 disabled children according to the classes of diseases that caused the onset of disability (ICD) was as follows 1) G00-G99 - 35.47 ± 3.13%; 2) Q00-Q99 - 23.50 ± 2.77%; 3) 11.11 ± 2.05%; 4) C00-D48 - 10.25 ± 1.98%; 5) H60-H95 - 7.26 ± 1.67%; 6) M00-M99 - 2.99 ± 1.11%; 7-8) H00-H59 and P00-P96 - 2.14 ± 0.95%; 9-10) K00-K93 and S00-T98 - 1.29 ± 0.74% each; 11-12) I00-I99 and N00-N99 - 0.85 ± 0.60% each; 13-14) J00-J99 and L00-L99 - 0.43 ± 0.42% each.Conclusion: 1. In the structure of IPRH in 222 disabled children, according to the classes of diseases that caused disability (ICD), the following prevailed: 1) VI Diseases of the nervous system G00-G99 – 35.47%; 2) XVII Congenital anomalies, chromosomal disorders Q00-Q99 - 23.50%; 3) IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders E00-E90 – 11.11%; 4) II Neoplasms C00-D48 - 10.25%; 5) VIII Diseases of the ear and mastoid process H60-H95 - 7.26%; 6) XIII Diseases of the musculoskeletal system and connective tissue M00-M99 - 2.99%; 7-8) VIII Diseases of the ear and mastoid process H60-H95 and VII Diseases of the eye and its adnexa H00-H59 - 2.14% each.2. The effectiveness of medical rehabilitation of disabled children was as follows: 1) Improvement - 23.26%; 2) Stabilization - 74.88%; 3) Deterioration - 1.86%. Dynamic observation was carried out on 94.26% of disabled children, drug therapy - 77.32%, non-drug therapy - 66.93%, and other types of medical rehabilitation were received by 14.48% of patients. Reconstructive operations were performed on 11.26% of disabled children.3. Prosthetics and orthotics were performed on 38.74% of disabled children. 32.43% of disabled children in need received sanatorium treatment, and 30.18% are currently in line to receive a voucher. For various reasons, 24.32% refused this type of rehabilitation; 3.60% of patients had contraindications at the time the voucher was provided.4. The obtained research results become the initial everyday statistical tool for objectifying the process of rehabilitation of patients and determining the strength and means of a medical institution to monitor and successfully implement an individual rehabilitation/habilitation program for a disabled person.