Abstract : Trauma is a major worldwide problem. It is one of the major causes of death in industrial and civilized countries. Trauma is the most common cause of death between the age of 15 & 44 years and 3rd most common cause of death worldwide regardless of age. The most significant change in trauma patient's care over the last decades is represented by the switch to selective non-operative management (NOM)7. This was a study done among the patients admitted with alleged history of blunt abdominal trauma in tertiary care hospital. Total 50 patients were taken in the present study. The study participants are evaluated and recorded various variables like mechanism of injury, hemodynamic stability, and organ injured, grading of injury etc. All patients with hemodynamic stability were managed in surgical ICU with close observation, serial investigations & immobilization. Only 3(6%) patients required operative management later on in NOM group. Total 15(30%) patients were managed operatively. All patients were kept in surgical ICU. In OP group incidence of spleenic injuries is highest (47%). Hemodynamic instability remains the most important parameter in decision making between conservative and operative management of trauma patients with solid organ injury. Most of the patients were managed conservatively in intensive care unit with regular monitoring and serial CT scan. Non operative line of management is now considered the line of treatment for patients with intra-abdominal organ injury that are hemodynamically stable..
Full article

Abstract : In the program for prevention and protection against addictions, the family has an irreplaceable role. The aim of this research is to determine the role of parenting education styles in motivating and creating learning strategies for the prevention of risky behaviors of children. A quantitative analytical study was conducted on a sample of 600 respondents, students from primary and secondary schools on the territory of the Polog region in North Macedonia. The scale designed to assess parenting education styles - the "Egna Minnen Batraffande Uppfostran" (EMBU), was applied, as well as the survey questionnaire from the "Global Survey on Adolescent Health". The result shown that by increasing the value of the subclass "emotional warmness" of the mother, the risk of developing risky behavior among children in terms of cigarette smoking is reduced for 2.3% ; by increasing the value of subclass "favoring" of the mother per unit score, the risk of developing risky behavior among children in terms of cigarette smoking is increased for 12.6%, by increasing the value of the subclass "inconsistency" of the father per unit score, the risk of developing risky behavior among children in terms of smoking cigarettes is increased for 7.8%, by increasing the value of the subclass "rejection" of the father per unit score, the risk of developing risky behavior among children in terms of smoking cigarettes is increased for 3.5% and by increasing the value of the subclass "favoring" of the father per unit score, the risk of developing risky behavior among children in terms of smoking cigarettes is increased for 8.7%. The results of research have shown that the educational styles of parents have a significant impact on the risky behavior of adolescents in terms of cigarette smoking..
Full article

Abstract : Skin tags or Acrochordons present as pedunculated papules or tumors that are most commonly seen over the eyelids, neck, axillae, and groin. They are usually asymptomatic and are treated for cosmetic lesions. Metabolic syndrome (Met S) comprise of a cluster of risk factors of metabolic origin, which are accompanied by increased risk of cardiovascular disease and type-2 diabetes mellitus. To identify, the patients with skin tags and their positive relationship with Metabolic Syndrome, among the patients attending the Dermatology & Venereology department in a tertiary care teaching hospital. A pre-structured and pre-tested Proforma was used to collect data from 100 patients attending Dermatology outpatient department in a tertiary care teaching hospital. A total of 62% of the participants with skin tags had underlying metabolic syndrome. The proportion of people with metabolic syndrome gradually increased with increasing age. The association between age and metabolic syndrome was statistically significant (P value 0.002). Although there was no statistically significant association between gender and metabolic syndrome in study population. The proportion of people with Acanthosis. Nigricans gradually increased with increasing age. There was a statistically significant association between the skin tags and metabolic syndrome (P value < 0.016). We propose to consider skin tags as cutaneous findings frequently associated with the risk factors for Metabolic Syndrome and heart disease, and recommended that these patients should be carefully evaluated for Metabolic Syndrome and heart disease. Skin tag is an indicator of peripheral insulin resistance which may be an early marker of metabolic syndrome..
Full article

Abstract :

Chronic urticaria (CU) is a common dermatological condition that may occur spontaneously or may be induced by specific triggers. Heat shock proteins (HSPs) are molecular chaperones with critical roles in protein synthesis. They are induced in response to physiological and environmental stressors. The present study aimed to investigate the relation between serum levels of HSP-70 and severity of chronic urticaria. The present case control study included 70 patients with chronic spontaneous urticaria (CSU). In addition, there were 25 age and sex-matched healthy control. The severity of their urticaria symptoms were assessed using Urticaria Activity Score (UAS). Symptoms were classified as mild, moderate or intense. Serum levels of HSP70 measured by ELISA method. Patients had significantly higher HSP-70 levels when compared with controls [median (IQR): 62.0 (0.23-0.91 versus 0.26 (0.2-0.45) ng/ml, p0.001] (Fig. 1). Patients group included 29 patients (41.4 %) with mild disease, 29 patients (41.4 %) with moderate disease and 12 patients (17.2 %). Comparison between patients with different disease severity grades shows signification relation between disease severity grade and HSP-70 levels. Logistic regression multivariate analysis identified elevated HSP-70 levels as significant predictor of significant (moderate/intense) CU. The present study found a significant relation between increased serum HSP-70 levels and increased disease severity in CU patients.

.
Full article

Abstract : Nursing students must apply their knowledge and abilities in clinical settings in order to obtain the necessary qualifications to care for patients, and their success is dependent in large part on effective clinical training. The aim of this systematic review was to summarize learning experiences in clinical learning environments, identify which tools are most frequently used to measure clinical learning environments and report on outcomes of learning experiences of nursing students in clinical learning environments. In the present study searched for articles indexed in PubMed, Psyc INFO, Web of science, and CINAHL database using a combination of expressions including “learning experiences” and “nursing students” or “clinical learning environments”. Five empirical studies were identified as relevant to our research. Several types of tools are used to learning experiences of nursing students in clinical learning environments. We found that clinical learning environment and their satisfaction has been positively related to clinical learning environment constructs such pedagogical atmosphere, the leadership style of the ward manager, premises of nursing on the ward, the content of the supervisory relationship and the role of the nursing teacher at p < 0.001. This review underlines that the majority of nursing students are satisfied with their clinical learning environment, which was statistically significant with the frequency of meetings and use of e-communication tools with nursing teachers. It is important to assess the level of satisfaction among nursing students as it plays an important role in the educational process. Therefore, the clinical learning environment should be assessed by nursing students in a timely manner so that the desired outcome can be achieved. Thus, satisfaction could be used as a significant contributing variable to improve clinical learning situations in order to meet the requirements and wishes of nursing students..
Full article