Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter:A case report

BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.

Exploring multi-level risk factors and post-war burdens of trachomatous trichiasis among displaced population in Raya Kobo districts, implication for urgent action

AIM:To estimate post-war burdens of trachomatous trichiasis(TT)and multi-level risk factors among displaced population in Raya Kobo districts,implication for urgent action.METHODS:A community-based cross-sectional study was conducted among 603 participants from randomly selected 14 displaced slums in the Raya Kobo district.The data was collected from February 16th to March 30th,2023.Study participants were selected using the multistage sampling technique.A structured questionnaire and ophthalmic loupe with×2.5 magnificence were used to collect from participants.Multi-level binary logistic regression was used to determine associated factors with TT infection.Adjusted odds ratio(AOR)with 95%confidence interval(CI)were claimed for the strength of association at P<0.05.RESULTS:We recruited 602(99.9%)participants for the final analysis.From the total,126(20.9%)and 98(16.3%,95%CI:13.5%-19.4%)participants were diagnosed with active trachoma&TT infection,respectively.Being age≥45y(AOR=7.9,95%CI:2.4-25.3),having multiple eye infections(AOR=2.73,95%CI:1.47-5.29),poor wealth index(AOR=9.2;95%CI:2.7-23.7)and twice face washing per day(AOR=0.082,95%CI:0.03-0.21)has identified as individual as factors for TT infection.Whereas,distance between clean water source≥10 km(AOR=6.5,95%CI:3.9-31.3),and latrine availability(AOR=0.35,95%CI:0.21-0.58)were the two community-level factors associated with TT infections.CONCLUSION:The high prevalence of TT infection post-war throughout the study districts indicates a need for urgent clinical intervention in addition to rapid scaling up surgery,antibiotics,facial cleanliness,and environmental improvement(SAFE)strategies,strategy for high-risk population.Age≥45y,distance from the clean water source,poor wealth indexes,and eye infection are identified to be risk factors for TT infection.Furthermore,community-level preventative factors for TT infection are found as latrine availability and face washing practice.

Reciprocal Association between Psychological Distress and PTSD and Their Relationship with Pre-Displacement Stressors among Displaced Women

It is established in the psychological literature that pre-displacement stressors,PTSD symptoms,and psycholo-gical distress are associated among internally displaced persons.However,existing studies have not demonstrated the mechanism underlying these associations.This study compared two explanatory models;one with PTSD symptoms severity explaining the indirect association between pre-displacement stressors and psychological dis-tress,and the other with psychological distress explaining the indirect relationship between pre-displacement stressors and PTSD symptoms severity.In a cross-sectional design,631 women(Mean age=31.18±8.59)were conveniently and purposely selected from the displaced women harboured in two camps in Borno State,Nigeria,due to the Boko-Haram insurgency.Data were collected utilizing structured questionnaires and subjected to path analyses.Results demonstrated that PTSD symptoms severity and psychological distress indirectly explained their respective and independent association with pre-displacement stressors.However,PTSD symptoms had a statis-tically larger standardized indirect effect size,greater indirect effect percentage,and bigger kappa-squared(k2)effect size than psychological distress.PTSD symptoms and psychological distress may have a reciprocal influence on each other from pre-displacement stressors.However,PTSD symptoms can better explain the association between pre-displacement stressors and psychological distress than the other way around.These outcomes have important implications for the psychological treatment of displaced persons.

Gut Bacteria and Nutritional Status of Nigerian Children at an Internally Displaced Persons’ Camp in Benue State, Nigeria: A Pilot Study

This study was conducted to determine the gut bacteria and nutritional status of children (n = 30) aged 2 - 11 in Benue’s largest internally displaced persons (IDP) camp since information on this is lacking. Gut bacteria were identified using culture techniques, while Body Mass Index (Kg/m2), Weight-for-Height (WHZ), and Weight-for-Age (WAZ) z scores were computed from anthropometric measurements. Socio-demographic and economic variables were collected via structured questionnaires. IBM SPSS v25 was used to analyze the data, with p Salmonella spp., Shigella spp., and Escherichia coli compared to children from a nearby private school (n = 10), except for E. coli, where the prevalence was equal. The results for BMI revealed that 23 (57.5%) of the children had a healthy weight while 17 (42.5%) were underweight.WAZ z-scores were between (-0.02 - 2.51) with evidence of mildly underweight (20%) and mildly overweight (5%) children. WHZ z-scores were between -0.03 - 2.37, with moderately wasted (30%) and severely wasted (5%) found. To ensure better health outcomes for residents, conditions in the camp must be improved.

Validity and reliability of the Dutch version of the displaced aggression questionnaire

BACKGROUND Displaced aggression occurs when a person encounters a provoking situation,is unable or unwilling to retaliate against the original provocateur,and subsequently aggresses against a target that is not the source of the initial provocation.The displaced aggression questionnaire(DAQ)was developed to measure individual differences in the tendency to displace aggression.AIM To develop a Dutch version of the DAQ and examine relationships between the DAQ and novel individual differences.METHODS The Dutch version of the DAQ was created using a back-translation procedure.Undergraduate students(n=413)participated in the current study.The questionnaires were administered online.RESULTS The results confirmed the original three-factor structure and showed good reliability and validity.We also found differential relationships between trait displaced aggression,social anxiety and cognitive distortions.CONCLUSION The results may indicate that distinct patterns exist in the development of the different dimensions of trait displaced aggression.This study adds to the growing cross-cultural literature showing the robustness of trait displaced aggression in several different cultures.

Analytical and numerical investigations of displaced thermal state evolutions in a laser process

We investigate how displaced thermal states （DTSs） evolve in a laser channel. Remarkably, the initial DTS, an example of a mixed state, still remains mixed and thermal. At long times, they finally decay to a highly classical thermal field only related to the laser parameters κ and g. The normal ordering product of density operator of the DTS in the laser channel leads to obtaining the analytical time-evolution expressions of the photon number, Wigner function, and von Neumann entropy. Also, some interesting results are presented via numerically investigating these explicit time-dependent expressions.

Use of ketamine sedation for the management of displaced paediatric forearm fractures

AIM To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS Following an agreed interdepartmental protocol, fractures of the radius and ulna(moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine. A single attempt at manipulation was performed. Pre and postmanipulation radiographs were requested and assessed to ensure adequacy of reduction. Parental satisfaction surveys were collected after the procedure to assess the perceived quality of treatment. After closed reduction and cast immobilisation, patients were then followed-up in the paediatric outpatient fracture clinic and functional outcomes measured prospectively. A cost analysis compared to more formal manipulation under a general anaesthetic was also undertaken.RESULTS During the 4 mo period of study, 10 closed, moderate to severely displaced fractures were identified and treated in the paediatric emergency department using our ketamine sedation protocol. These included fractures of the growth plate(3), fractures of both radius and ulna(6) and a single isolated proximal radius fracture. The mean time from administration of ketamine until completion of the moulded plaster was 20 min. The mean time interval from sedation to full recovery was 74 min. We had no cases of unacceptable fracture reduction and no patients required any further manipulation, either in fracture clinic or under a more formal general anaesthetic. There were no serious adverse events in relation to the use of ketamine. Parents, patients and clinicians reported extremely favourable outcomes using this technique. Furthermore, compared to using a manipulation under general anaesthesia, each case performed under ketamine sedation was associated with a saving of ￡1470, the overall study saving being ￡14700. CONCLUSION Ketamine procedural sedation in the paediatric population is a safe and cost effective method for the treatment of displaced fractures of the radius and ulna, with high parent satisfaction rates.

Algebraic and group treatments to nonlinear displaced number states and their nonclassicality features:A new approach

Recently, nonlinear displaced number states （NDNSs） have been manually introduced, in which the deformation function f（n） has been artificially added to the previously well-known displaced number states （DNSs）. Indeed, just a simple comparison has been performed between the standard coherent state and nonlinear coherent state for the formation of NDNSs. In the present paper, after expressing enough physical motivation of our procedure, four distinct classes of NDNSs are presented by applying algebraic and group treatments. To achieve this purpose, by considering the DNSs and recalling the nonlinear coherent states formalism, the NDNSs are logically defined through an algebraic consideration. In addition, by using a particular class of Gilmore-Perelomov-type of SU（1,1） and a class of SU（2） coherent states, the NDNSs are introduced via group-theoretical approach. Then, in order to examine the nonclassical behavior of these states, sub-Poissonian statistics by evaluating Mandel parameter and Wigner quasi-probability distribution function associated with the obtained NDNSs are discussed, in detail.

Formation around planetary displaced orbit

The paper investigates the relative motion around the planetary displaced orbit. Several kinds of displaced orbits for geocentric and martian cases were discussed. First, the relative motion was linearized around the displaced orbits. Then, two seminatural control laws were investigated for each kind of orbit and the stable regions were obtained for each case. One of the two control laws is the passive control law that is very attractive for engineering practice. However, the two control laws are not very suitable for the Martian mission. Another special semi-natural control law is designed based on the requirement of the Martian mission. The results show that large stable regions exist for the control law.

Damping of displaced chaotic light field in amplitude dissipation channel

We explore how a displaced chaotic light (DCL) behaves in an amplitude dissipation channel, and what is its time evolution formula of photon number distribution. With the use of the method of integration within ordered product product of operator (IWOP) and the new binomial theorem involving two-variable Hermite polynomials we obtain the evolution law of DCL in the channel.

A new optical field generated as an output of the displaced Fock state in an amplitude dissipative channel

We propose a new optical field and show that such an optical field can be generated as an output of a displaced Fock state in an amplitude dissipative channel. We derive new generating function formulas and binomial formula involving twovariable Hermite polynomials to reach this result. The photon number average in this new optical field is m＋｜α｜^2e^-2κt,which indicates that controlling the photon number can be realized by adjusting the value of m or ｜α｜2 or κ. The time evolution law of displaced Fock state in a thermo reservoir is thus revealed.

Coupled trajectory and attitude stability of displaced orbits

Coupled trajectory and attitude stability of displaced solar orbits is studied by using sailcraft with a kind of two-folding construction with two unequal rectangular plates forming a right angle. Three-dimensional coupled trajectory and attitude equations are developed for the coupled dynamical system, and the results show that all three types of displaced solar orbits widely referenced can be achieved through selecting an appropriate size of the two-folding sail. An anal- ysis of the corresponding linear stability of the trajectory and attitude coupled system is carried out, and both trajectory and attitude linearly stable orbits are found to exist in a small range of parameters, whose non-linear stability is then examined via numerical simulations. Finally, passively stable orbits are found to have weak stability, and such passive means of station-keeping are attractive and useful in practice because of its simplicity.

Operative vs nonoperative treatment of displaced intraarticular calcaneal fracture: A meta-analysis of randomized controlled trials

AIM: To investigate clinical efficacy of displaced intraarticular calcaneal fracture(DIACF) following operation and nonoperation. METHODS: Literature search was performed of Pub Med and Cochrane Library by two independent authors to identify randomized controlled trials(RCTs) comparing operative vs nonoperative treatment of DIACF from inception to December 31 st, 2013. RCT quality was evaluated by the modified Jadad scale. Dichotomous variables were pooled using risk ratios by review manager 5.3 software. Fixed-effects or randomeffects models were adopted with P > 0.05 or P ≤ 0.05 for heterogeneity tests, respectively.RESULTS: Eight RCTs comprising 767 cases met inclusion criteria. Results revealed that more surgically treated patients could resume pre-injury job(P = 0.006). No statistical differences were found between the two groups in residual pain(P = 0.33), shoe fitting problems(P = 0.07), limited walking distance(P = 0.56) or secondary late arthrodesis(P = 0.38). However, operative treatment was associated with a higher complication rate(P = 0.003). Subgroup analyses of specific complications revealed that except for a higher risk of superficial wound problems(P < 0.0001) in operative group, the two groups had similar complication rate in deep wound infection(P = 0.34),compartment syndrome(P = 0.46), thromboembolism(P = 0.32), reflex sympathetic dystrophy(P = 0.51) or traumatic arthritis secondary to DIACF(P = 0.43).CONCLUSION: Current evidence demonstrates that compared with operative treatment, conservative treatment of DIACF lead to similar clinical outcomes regarding residual pain, shoe fitting, walking distance and secondary subtalar arthrodesis but a significantly lower complication rate.

Accessibility and availability of health care services to internally displaced persons, in Kitgum and Pader districts, northern Uganda

Introduction: During 1986-2009, an estimated 1.6 million persons were internally displaced from northern and eastern regions of Uganda due to civil war. We investigated accessibility to and availability of health care services for the internally displaced persons in Kitgum and Pader districts, northern Uganda. Methods: This was a cross-sectional study conducted in Kitgum and Pader districts, northern Uganda. We interviewed a total of 1383 respondents comprising 968 (70%) adults and 415 (30%) adolescents;60% were females and 40% males, randomly selected from 35 of 67 (52.2%) internally displaced persons (IDP) camps. We held 27 key informant interviews and 52 focus group discussions. Data were entered in EPI data version 3.02 and analysed using SPSS version 12.00 statistical packages. Findings: Two thirds of the respondents 67.5% lived within 5 km distance of a health facility. The majority 62.9% of respondents mentioned that health related information was readily provided. 43.5% of health providers were always available in a health facility. A quarter 25.1% of health facilities always had drugs available, while 56.9% of the drugs prescribed were always available. Two thirds of the respondents 65.9% were satisfied with the health care services provided. The main reasons for the choice of a health facility were proximity 29.6%, provision of free treatment 24.7% and availability of drugs 17.2%. Main barriers to health care access were due to the lack of financial resources, trained personnel, and inadequate drugs and supplies in the health facilities. Conclusions and Recommendations: The majority of IDPs lived in close proximity to health facilities and obtained health care services from public health facilities. Access to health care was determined mainly by proximity and availability of free services and drugs. Although geographic accessibility to health services was high, lack of finances, information and decision power hindered access to health care services.

Prevalence of <i>Helicobacter pylori</i>Infection among Internally Displaced Persons from Bakassi Peninsular and Etim Ekpo in South Southern, Nigeria

Helicobacter pylori (H. pylori), is an important global infection with a worldwide prevalence of about 40 percent. This infection is contagious and mostly acquired during childhood through the fecal-oral and oral-oral route. A total of 1560 blood specimens were aseptically collected from Internally Displaced Persons comprising female and male from the warring communities of Bakassi Peninsular and Etim Ekpo Local Government Area in South Southern, Nigeria. The specimens were screened for H. pylori using Elisa kits following standard serological techniques. The overall prevalence rate was 464 (29.7%). There was significant difference (p H. pylori infection;its distribution varied between age group, educational status, habits or behaviors of the subjects with children within 5 to 14 years having the highest rate of 274 (17.6%), followed by 78 (4.99%) from adults (51 years and above) and 17 (1.08%) from active age range of 36 - 45 years old. Subjects with primary and quranic level of education showed a total of 274 (17.56%) positive cases to H. pylori. Analysis of sex-specific distribution revealed that females had the highest prevalence of 312 (20%). The helicobacter infection shows a significant difference at (p H. pylori infection. Crowding in camps and increasing household contact have been considered as risk factors of H. pylori infection. Adequate infrastructural provision and availability of portable water with good hygienic environment will drastically reduce the high rate spread of H. pylori bacterium in the IDPs communities in Nigeria.

Chaotic state as an output of vacuum state evolving in diffusion channel and generation of displaced chaotic state for quantum controlling

We show that chaotic state can be produced as an output of vacuum state evolving in diffusion channel,while displaced chaotic state is output of a coherent state evolving in diffusion channel.We also introduce the thermo vaccum state for the displaced chaotic state and evaluate the average photon number.The displaced chaotic state may be used exhibiting quantum controlling.

Critical Appraisal Focusing on Tuberculosis Risks among Displaced Persons: Do We Have a Smoking Gun?

The UNHCR 2017 report stated that about 44,400 people are displaced from their homes daily and about 68.5 million people are currently displaced globally. This article aims at critically analyzing the tuberculosis risks among displaced people especially as there is an increase in the number of migrants globally and proliferation of man-made and natural disasters. Research conducted among displaced persons and most of the studies concluded that active surveillance and proper case follow-up are the best ways to ensure adequate tuberculosis case management. In conclusion, the application of diverse methods in tackling tuberculosis risks should be especially through a culturally, acceptable precise and feasible plans without compromising international standards.

Pregnancy Outcomes of the Internally Displaced Women in Juba, South Sudan

Background: Conflict and displacement substantially affect maternal reproductive health by increasing the risks formorbidity and mortality. However, most literature on pregnancy outcomes is from cross-border refugees and migrants. To date, scanty literature is available on pregnancy outcomes of internally displaced women. South Sudan, with 16 women dying daily is badly affected by internal conflicts of which by the end of December 2013 about 2.2 million people were internally displaced. The aim of this study was to determine pregnancy outcomes of women living in the United Nations House Internally Displaced People (UN IDP) camp and factors associated with poor outcomes. The study was ethically cleared by MUHAS and the Ministry of Health in South Sudan. Methods: A cross sectional study was conducted in UN House IDP Camp in Juba among internally displaced women who attended antenatal services in the camp, from September to November 2016. Among them, women who became pregnant in last 3 years, excluding the index, were interviewed about their immediate past pregnancy experiences. Additionally, the women were interviewed on reproductive health and gender violence matters. Interviews were guided by a structured questionnaire. Data were analyzed using SPSS software version 20. Descriptive and multivariate logistic regression analyses were computed for associations with poor pregnancy outcome. Results: A total of 300 internally displaced women participated in the study. Data for 289 participants were analyzed for poor pregnancy outcome. More than half of the women, 157 (54.3%), had poor pregnancy outcome. Poor Maternal outcome was established in 47% of the women and poor fetal outcome in 27.7%. Delivery in IDP camp compared with outside the camp, was independently associated with a 3-fold increase in risk for poor pregnancy outcome, OR = 2.9 (95% CI: 1.47 - 5.56). Conclusion: The prevalence of poor pregnancy outcome is unacceptably high among internally displaced women seeking antenatal services in the IDP camp in Juba and delivery in the camp seems to increase the risk.

Clinical Outcome of Conservative Treatment of Displaced Mandibular Fracture in Adults

The article evaluates 12 cases of conservative treatment of displaced mandibular fractures in adults. Twelve cases of displaced mandibular fractures treated surgically, either by closed reduction (IMF) or open reduction internal fixation (ORIF) served as controls. Occlusion, maximal mouth opening, lateral jaw movements, neurological dysfunction (=sensory deficit), and bone remodeling were evaluated and scored in both groups, and results were compared. No significant differences were found between the two groups in all the evaluated parameters. It is concluded that in certain cases, with displacement of 2 - 4 mm, where a surgical approach is not feasible, reasonable spontaneous reduction and bone remodeling can occur. Meticulous follow-up is mandatory.

Prevalence of Various Cancer-Related Risk Factors among the Forcibly Displaced Myanmar National Community, the Rohingya, in Bangladesh: A Preliminary Assessment

Background: Large numbers of Forcibly Displaced Myanmar Nationals (FDMN), also called the Rohingya community, in Bangladesh face chronic life-threatening illnesses. Symptoms concerning for a cancer diagnosis are not easily evaluated and treated by healthcare systems available to this population. We conducted a rapid needs assessment of cancer screening and pain and palliative care with the goal of identifying the prevalence of cancer risk factors among the Rohingya who attended local health facilities. Methods: A cross-sectional study was conducted in the Kutupalong camp of Ukhiya, Cox’s Bazar among the Rohingya community. Data were?collected through purposive sampling. Face-to-face interviews were done using a structured questionnaire. Statistics were analyzed by using IBM SPSS 23.?Results: Out of 85 participants, 75 were female and 10 were male. 70 (82.4%) were uneducated (defined as lacking any formal institutional education), 10 (11.8%) people completed the primary level education and only 5 (5.9%) people received secondary level education. There were many participants with pulmonary disease with 35 (41.2%) people endorsing a history of asthma, bronchitis, and/or tuberculosis. There was a lack of female menstrual sanitation and hygiene with only 25 (29.4%) patients using sanitary napkins, that were donated by Non Government Organizations. Only 5.9% of the women had received any form of cervical cancer screening.?Conclusion: This study identifies risk factors associated with cancers and life-limiting diseases among the FDMN Rohingya refugees in Bangladesh. It is necessary to develop targeted education, cancer screening and cancer awareness programs for this population.