bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Comprehensive Lifestyle Interventions in Managing Gastroesophageal Reflux Disease Complicating COPD-OSA Overlap Syndrome”
Authors: Khan Iqbal Akhtar , Malik Hamza Iltaf
Published: November 2021

Although the term “lifestyle medicine” was first used as the title of a symposium in 1989 and of an article in 1990, its concept is not new. The towering figures in medicine: Huang Ti (2698-2598 BCE), Hippocrates (460-377 BCE) and Ibn Sina (980-1037CE) had the credit to link the natural effects of diet, lifestyle, emotion and environment with the preservation of health. Unhealthy lifestyle behaviors, a well proven primary source of the global burden of chronic diseases, are among the leading risk factors for increased disability-adjusted life years around the world. While, Gastroesophageal Reflux Disease and Chronic Obstructive Pulmonary Disease augument each other, COPD and Obstructive Sleep Apnea have a common pathophysiology and are known to coexist leading Flenley to coin the term “Overlap Syndrome” ,in 1985. Behavioral therapy on each modifiable item, including diet and weight management, physical activity, smoking, sleeping pattern, stress and mood states have all been evaluated in the present study.
Technical Considerations In Performing One Anastomosis Gastric Bypass In Case of Intestinal Malrotation
Authors: Sneineh Midhat Abu
Published: November 2021

Intestinal malrotation is a rare congenital anomaly that originates from the failure of the normal rotation and fixation of the midgut during embryologic development. There are different types of Midgut Malrotation which includes non-rotation, incomplete rotation, reverse rotation, or anomalous fixation of the mesentery. Methods: We present a case of a 58-year-old woman with a BMI of 45.3 kg/m2. The patient underwent laparoscopic appendectomy 15 years ago and was diagnosed with a partial situs inversus. She has no other past medical conditions. Results: At the operation, four meters of small bowel were counted backward from the ileocaecal valve until the duodenum. We performed a one anastomosis gastric bypass with three meters of common limb and one meter of biliopancreatic limb, gastro-intestinal anastomosis made with a linear stapler, and the defect sutured with absorbable suture. Conclusion: One anastomosis gastric bypass is a feasible and safe alternative for morbidly obese patients with intestinal malrotation or multiple intestinal adhesions.
A Rare case of Menetrier’s disease presenting with Protein Losing Gastropathy Mimicking Carcinoma Stomach
Authors: Gomes Richmond Ronald
Published: November 2021

Ménétrier's disease (MD) (also known as giant hypertrophic gastritis or hypoproteinemic hypertrophic gastropathy) is a rare premalignant entity characterized by markedly hypertrophied mucosal folds of the fundus and the gastric corpus typically associated with , hypochlorhydria, protein losing enteropathy causing hypoalbuminemia and anemia. However, the natural history of MD in adults remains unclear and is rarely reported in the literature. Its constellation of classic symptoms includes nausea, vomiting, abdominal pain and peripheral edema, and it is associated with increased risk of gastric cancer. Nevertheless, its pathophysiology is not yet fully understood and clinical and endoscopic diagnosis can be difficult to establish. Malignant transformation in MD should not be overlooked, and regular monitoring of the gastric mucosa via endoscopy is necessary.
Neuropathy Case Seen After Bariatric Surgery
Authors: Alp Hayriye
Published: November 2021

Peroneal neuropathy is a rare complication after bariatric surgery, but it occurs in 15% of mononeuropathy. The etiology of peroneal neuropathy is multifactorial and is often blamed for these factors due to rapid weight loss and nutritional imbalance. Emine Karaca, 25 years old, female Patient 1 year ago, she had a stomach reduction (obesity surgery) surgery due to her weight of 130 kg. Six months after the operation, it decreased to 60 kg. Meanwhile, numbness in his right foot began to be pain and loss of strength after the operation. In the EMG performed on May 10, 2016, he was diagnosed with Fibulahead entrapment neuropathy-low foot. He was tied to lie in the same position for a long time during the operation. After this diagnosis, 15% prolotherapy was applied around the peroneal nerve of the fibular head on 11.05.2016. Prolotherapy was applied 2 times with 10 days intervals. L4-5 and L5-S1 segmental neural therapy in the lumbar region and neural therapy around the fibular head of the peroneal nerve and along its trace were applied twice a week. After a total of 2 prolotherapy and 6 neuraltherapy applied in 3 weeks, complete clinical recovery was achieved. This complete recovery was confirmed by EMG. Since electrophysiological findings of denervation occur after 2-3 weeks, it is recommended that EMG examination be performed 3 weeks later. Treatment includes relief of complaints (analgesics and gabapentin), physical therapy applications and support immobilizers. In cases that do not respond to treatment, nerve exploration and relaxation is provided with a surgical approach. Prolotherapy and neural therapy, among complementary medicine modalities, can also be used in peroneal nerve neuropathy.
Rapid Liquid Phase Gastric Emptying May Be The Harbinger Of Sustained Weight Loss After Laparoscopic Sleeve Gastrectomy
Authors: GÜNAL Ömer , KARA Burak , Özgüven Salih , ERDİM Aylin , ERDİL Tanju Yusuf
Published: November 2021

Study Contextual: 15-20 % Of laparoscopic sleeve gastrectomy patients need revisional surgery after LSG, because of inadequate weight loss. Aim: The aim of our study is, primarily to analyze the relationship between liquid-phase gastric emptying rate and weight loss, to find a parameter that may be the harbinger of successful weight loss after LSG. Methods: Patient records who have undergone laparoscopic sleeve gastrectomy were examined retrospectively. 44 Patients were included in the study. Preoperative weight and BMI, postoperative weight loss at first, third, and sixth months, surgical operation reports, preoperative and postoperative liquid-phase gastric emptying study values were mainly collected. Results: The male/ female ratio was 18/82. Mean age 38 (19-60), mean body mass index 48,1(40-66) kg/m² and mean (EWL%) 63,17±13,94 were found. Mean pre and post-operative gastric emptying half times were found to be (T½) 41,86 minute(min), T½ 6,82 min (p<0.0001). Significant correlation was found between patients’ post-operative third and sixth month EWL% and post-operative T½ (p=0,020, p=0,032). Patients who have post-op gastric T½ above 10 min had decreased sixth-month EWL% significantly (p=0.03). Conclusion: Post-operative gastric emptying time (T½) may be a harbinger of weight loss after LSG.
A Rare Cause of Acute Abdomen in Children: Spontaneous Rupture of Choledochal Cyst Causing Peritonitis
Authors: Kadirhan Ozlem , Aydin Sonay , Kantarci Mecit
Published: November 2021

Spontaneous rupture of the common bile duct cyst is a rare cause of acute abdomen in children. In our case, we present a 3-year-old patient with no history of trauma, whose diagnosis was confirmed by laparotomy, with a possible suspected common bile duct cyst due to massive ascites and a cystic lesion in the portal area. Although common bile duct cysts are mostly asymptomatic, various studies have shown that malignant transformation can cause important complications such as pancreatitis.Numerous causes have been suggested in the etiopathogenesis of rupture, such as parietal necrosis associated with pancreatic reflux irritation.Since rupture of cysts may require urgent laparotomy such as biliary peritonitis, it is important to know imaging findings that may be warning for early diagnosis. Because of the increased risk of cholangiocarcinoma after cyst excision, cholecystectomy and Roux-en-Y hepaticojejunostomy are the most common treatment procedures.
Solitary Rectal Ulcer Syndrome: An Exceptional Entity in the Elderly
Authors: Bouomrani Salem , Ourida Safa , Elleuch Mariem , Lamloum Ines
Published: November 2021

Solitary ulcer of the rectum or better the syndrome of solitary rectal ulcer syndrome (SRUS) is a rare benign pathology with a prevalence estimated at 1/100,000 inhabitants. It mainly affects young patients with a maximum incidence between the third and fourth decade of life, but can be seen at any age. It remains exceptional in the elderly with only few sporadic cases in the world literature. We report an original case of SRUS occurring in a 70-year-old man with no particular pathological history, who was explored for rectal bleeding with anal pain that had been evolving for two years. As rare as it is, this entity deserves to be known by any healthcare professional caring for elderly subjects because can sometimes progress unfavorably with severe and even fatal complications such as massive bleeding and perforation.
Multiple Colonic Radiopaque Foreign Bodies in a 7-Year-Old Child: The Plain Radiographic Features and a Case Report
Authors: MB Sule , IH Gele , YB Shirama , M Abacha , MM Ribah
Published: November 2021

Foreign bodies are uncommon and may be ingested, inserted into a body cavity or deposited in the body by traumatic or iatrogenic injury. Foreign body ingestion is more common in children with equal incidence in males and females, and has a peak incidence in the ages between six months to three years. This is a case of a seven-year-old male child with behavioral abnormality and long history of ingestion of foreign bodies who presented with abdominal pain and discomfort with passage of hard solid stone like particles in feaces. The patient had a conventional abdominal radiograph that showed multiple radiopaque structures of varying sizes, some of which are clump-like in the peripheral abdomen; the large colon and region of the rectum.
World Health Situation after September 11, 2001
Authors: Loyola Benjamín Ruiz
Published: November 2021

Has the global health situation improved, worsened or remained at the same level, after the attack on the twin towers in 2001? We make a brief analysis of some epidemiological outbreaks that have arisen in these twenty years, their consequences and what could come in the future.
A Case Report of Skip Lesions in Perianal Mucinous Adenocarcinoma
Authors: Shah Nirali , Gates Michael , Saeed Imran
Published: November 2021

Perianal Mucinous Adenocarcinoma (PMA) is a rare gastrointestinal malignancy, known to occur in patients with a long-standing history of recurrent perirectal abscesses or a chronic fistula. In this case report, we present a unique presentation of perianal mucinous adenocarcinoma, which began as a rectal abscess and progressed to a case of perianal mucinous adenocarcinoma, with a skip lesion present all the way up in the mid-rectal region. To the best of our knowledge, this is the first case in which PMA presented with skip lesions as opposed to a continuous lesion, and presented without a long standing history of fistulas and recurrent abscesses, but instead just a 4-day history of perianal burning, itching and tingling. The use of CT imaging, MRI’s and PET scans as diagnostic modalities for PMA are further elucidated in the report, along with a discussion of NCCN guidelines on using radiation therapy followed by an APR with inguinal node dissection for the management and treatment of PMA. Sharing this unique and atypical presentation of PMA with multimodality speciality groups and tumor boards helps in the development of various diagnostic and therapeutic approaches for PMA, as well as enhances our understanding of this rare malignant entity.
Squamous Cell Carcinoma of the Thyroid Gland in an elderly Female
Authors: Al-Shahr Talal Mohammed , Hammami Dema Wahid , Jaber Mutassem , Alenezi Ghadeer Mazlooh
Published: November 2021

Background: Squamous cell carcinoma of the thyroid gland is a rare tumor. The tumor may arise as a primary tumor within the thyroid gland. Case Presentation: A 62-years-old lady with history a history of a long-standing left neck mass presented with progressive enlargement of the mass for the last 2 months. The mass was associated with dyspnea, dry cough, and difficulty in swallowing but no change of voice. On examination, it was hard and fixed, and other parts of the general examination were unremarkable. Fine needle aspiration revealed malignant cells with squamous cell cancer (BETHESDA VI). On surgical exploration, there was a mixed cystic and solid mass arising from the left thyroid gland locally invading strap muscles, esophagus and trachea. Complete excision was not possible, debulking was done with modified radical neck dissection. The histopathology showed Invasive poorly differentiated squamous cell carcinoma of the thyroid with cystic changes in background of Hashimoto’s thyroiditis. Conclusion: Thyroid squamous cell carcinoma is a rare malignancy with significant management implications. Less than three hundred clear cases of thyroid squamous cell carcinoma have been reported. In this report we describe one additional case of a thyroid squamous cell carcinoma and provide a comprehensive discussion of the clinical significance, and appropriate surgical management.
Autonomic dystonia syndrome in conditions of failure of the Bauhinia valve and after its surgical correction as a possible link in the etiopathogenesis of peptic ulcer disease
Authors: Vladimir Leonidovich Martynov
Published: November 2021

The classic works of I.P. Pavlov shows strong communication mechanisms between the two most important life-supporting systems of the body - the nervous and the digestive. The role of the autonomic nervous system (ANS) in the occurrence of acute gastroduodenal erosions and ulcers has been proven [1]. The flow of sympathetic impulses causes an excessive release of mediators (catecholamines), which leads to disruption of tissue trophism. An important role in ulceration belongs to the parasympathetic nervous system.
Duplicated inferior vena cava - a throwback to embryologic atavism
Authors: A Rekha , Devi J Nandhija , M Meyyappan , B Muthiah
Published: November 2021

Duplication of the inferior vena cava( IVC) is only rarely reported and often detected as an incidental finding(0.5-3%). In our patient, the anomolous vessel is the continuation of left iliac vein crossing anterior to the aorta, joining the right IVC at the level of inferior border of L1 vertebra.The association with a prothrombotic state,was exacerbated after splenectomy for this patient who had sickle cell anemia.
Negative Appendectomy Rate and Its Correlation with Use of Radiology; a Clinical Audit of Our Department
Authors: Ishaq Aliya , Naureen Sameera , Amin Yasir , Hussain Khan Jamshaid , Siyab Anwar Atif Latif , Hassan Ghazi Esaaf
Published: November 2021

Introduction; Appendectomy is the most common surgical emergency and negative appendectomy is a one of recognized consequence of appendectomy. Recently an increased use of radiology is seen in diagnosing appendicitis and it has significantly decreased the rate of negative appendectomy. Every effort should be made to establish an exact diagnosis. If, however, this is impossible and a suspicion of appendicitis exists, exploration is mandatory. It is far better to subject a moderate number of patients to a theoretically unnecessary operation than to let one patient suffer perforation. Aim; Recently we have seen an increased use of radiology in our department for diagnosing appendicitis. The idea of conducting this audit was to calculate our negative appendectomy rate by correlating it with use of radiology and to compare it with international figures and to set up guide lines for use of radiology in diagnosing appendicitis on basis of results of our audit . Methods; Records of all patients who underwent appendectomy in Dubai Hospital, UAE from jan 2018 to jan 2019 were retrospectively analyzed using electronic record system. Clinical diagnosis and radiological findings were compared with histopathology as gold standard for negative appendectomy rate. The sensitivity and specificity of different radiological procedures was calculated as well. Results; Total 165 patients underwent appendectomy in specified duration. Over all negative appendectomy rate was 17 % with male being 9.7 % and female rate 31% . CTSCAN was found to be 100% specific and 91.4 % sensitive in diagnosing appendicitis while clinical diagnosis was accurate in 88.5 % cases.
A Rare Case of Bilateral Primary B-Cell Non-Hodgkin Lymphoma of Breast
Authors: R. Raval Maharshi , Patel Yash , D. Shah Suchi , G. Patel Kishan , Sharma Kamal
Published: November 2021

Primary B-Cell Non-Hodgkin Lymphoma of Breast is a rare presentation of breast malignancy and it is necessary to differentiate it from secondary breast lymphoma as prognosis and treatment varies based on the diagnosis. We report a case of 47-year-old female with bilateral PBNHL of Breast which is rare due to younger age of presentation than earlier reported cases of this malignancy, lump with “peau de orange” appearance seen in both the breasts which is usually seen with high grade lymphoma and complete recovery of the patient while bilateral PBL outlines poor prognosis. Mammosonography findings included dilated ducts with hypoechoiec areas. MRI showed altered signal intensity. Findings of the imaging studies are non-specific and vary widely from case to case which is why biopsy which is gold standard was done to confirm the diagnosis
Of Equestrians and Endocarditis
Authors: DeVoe Louis
Published: November 2021

an 80-year old female was transferred from an outside hospital for concerns of a mitral valve vegetation and sepsis. Her past medical history included untreated chronic lymphocytic leukemia (CLL) and atrial fibrillation on warfarin therapy. The patient was otherwise very active and enjoyed daily rides on her horses. She initially presented with altered mental status and was found to be in septic shock with respiratory failure requiring intubation. Initial head CT showed an ischemic stroke in the bilateral frontal lobes. Echocardiogram showed a large mitral valve vegetation. A repeat CT of her head obtained for clinical decline revealed hemorrhagic conversion of her ischemic stroke. She began to have seizure activity that was treated with Keppra. Blood cultures grew Streptococcus zooepidemicus, and she was subsequently transferred to our tertiary medical center for increased level of care.
Assessment of Knowledge, Attitude and Practices of Colostrum Feeding among Postnatal Mothers in Harar Town governmental Hospital Harar, Ethiopia 2019
Authors: Zewde Gosaye Teklehaymanot
Published: November 2021

Background: Colostrum is yellow to orange color, thick and sticky first milk produced by the mammary glands which was universally recommend to feeding for every newborn. It has Laxative effect and contains bioactive immune factors which protect a neonate against a variety of infections and allergic diseases. Globally, around 5.6 million children died before reaching their fifth birthday, of those, 2.6 million (46%) died in the first 30 days of life. Approximately 7000 newborns died every day, most of which occurred within first 7 days after birth, with about 1 million dying on the first day and close to 1 million dying within the next 6 days in 2016. Various factors can effectively reduce neonatal mortality to greater levels early initiation of Colostrum feeding and exclusive breastfeeding for the first 6 months of life is one of them which prevent around 20% newborn deaths and 13% under-five deaths. Even those few studies conducted on Colostrum feeding in Ethiopia there is no sufficient information in our study area. There for this study will try to fill the information gaps and serve as implementation guide and reference for stake holder and other researchers. Objective: To assess knowledge, attitude and practices of colostrum feeding among postnatal mothers in Harar Town governmental Hospital Harar, Eastern Ethiopia 2019. Methods and Material: Health facility based cross sectional study was condcted on 306 women attending delivery service in Harar Town Jugal and Hiwot Fana Specialized university Hospitals. Sample was allocated proportionately and study participant was selected by systematic random sampling. Collected and checked data were entered in to Epi Data software version 3.02 and exported and analyzed using SPSS version 21. Mean value were used to classify as good or Poor knowledge, altitude and practice on colostrum feeding. Finding was summarized and presented in different forms of diagrams and tables and statement. Result: The overall prevalence of good knowledge, altitude and practice on this study was 96 %, 89 % and 70 % respectively. Majority 65.5 % and 94 % of the mother replied that colostrum feeding is important for growth and development of baby and it protect disease from their new born. Few 8% provide other than colostrum after birth due to different reasons. Conclusion and Recommendation: Even if the overall prevalence of good knowledge. Altitude and practice was higher on this study few clients does not now initiation time of breast and also provide other substance instead of colostrum and discard it due to fear of abdominal cramp and their believed that it was not clear. Therefore responsible bodies and stake holders need to work for alleviating such misconception and information gaps.
Still’s disease mimicking sepsis in a young woman. A case report and literature review
Authors: Gaddam Maneesh , Reyes Olga Alexandra , Zean Cosmina , Diaz-Fuentes Gilda
Published: November 2021

Background Adult onset Still’s disease (ASD) is a rare systemic auto-inflammatory condition that often poses a diagnostic dilemma due to nonspecific clinical signs and symptoms. We report a case of ASD that dramatically improved after a short course of steroids. Case presentation A 23-year-old women from Ghana presented with a two-week history of fever, sore throat, right-sided neck swelling and an evanescent, pruritic rash on her extremities. On exam she was febrile to 103 F, tachycardic, tachypneic, had tender, right-sided cervical lymphadenopathy, and diffuse joint tenderness with decreased range of motion. She was admitted to the ICU for possible sepsis and started on broad-spectrum antibiotics. Extensive work-up for possible infectious and auto-immune etiologies, including a bone marrow biopsy was negative. The diagnosis of Still’s disease was made based on the Yamaguchi criteria. The patient was started on methyl-prednisolone and significantly improved within 24 hours. Conclusion Patients presenting with ASD often represent a diagnostic challenge. Clinicians should be aware of this rare disorder, exclude other more frequent diseases and start early anti-inflammatory therapy to avoid poor outcomes.
Mental Health Reflections and Self-Rating at Population Contexts and Paradigms
Authors: Salim Nezar Ahmed , Hussain Hamid Yahya , Chehab Fouad Hussein , Tuffaha Mohammed , Aguilar Katrina
Published: November 2021

Background: Depression is a major source of distress and can have a profound impact on the quality of life and consider leading cause of death and morbidity. Early treatment and identification of depression reduces the burden on caregivers and family member along with medical costs. About 3% of the global population proved to be affected by depressive disorders currently according to global statistics. People are most likely to develop their first depressive episode between the ages of 30-40. There is a second, smaller peak of incidence between ages of 50-60 years. Objectives: The main goal of this study is to determine the prevalence of depression in people living in Dubai, United Arab Emirates. Methodology: Community based-study was conducted in 2019 with the use of a cross-sectional, multistage, stratified, cluster random sample. Families were visited and interviewed at their homes. Data was collected by adapted tool from the World Health Survey and developed by WHO. 2532 families were interviewed by approximately 100 well trained data collectors 25 nurses. Results: The present study showed that the prevalence of depressive disorder among Adults aged 18 and above was 2.1 %. This fluctuates between 2.3% for females and 2% for males. The estimated number of adults who were affected by depressive disorder was 54,733 who age 18 years and above. Out of all clients having depressive disorder, only 19% were diagnosed. While approximately 81% did not realize that they were suffering from a depressive disorder. The results show the depression prevalence was 4.7% for local clients compared to 2% for non-local clients. Conclusions: Depression tends to adversely impact individual’s quality of life. Males are less likely to suffer from depression than females and UAE nationals more than expatriate. Depressive disorders among Dubai population is not uncommon, in spite of revealing the lowest level of global depressive rating, it does reflect significant public health implications which necessitate effective containment strategies.
A Commonly Missed Well Known Entity- Acute Intermittent Porphyria: A Case Report
Authors: Gomes Richmond Ronald
Published: November 2021

Acute intermittent porphyria (AIP) is a rare autosomal dominant hereditary metabolic disorder having protean manifestations. It usually presents with short duration of gastrointestinal symptoms followed by rapidly progressive fulminant neurological syndrome. It is a neurological emergency and mimics many other psychiatric and medical disorders and can be fatal if it remains undiagnosed and untreated. Further, speciﬁc treatment in the form of Heme arginate is not universally available and very costly, so high clinical suspicion and early diagnosis and management of acute attack and prevention of further attacks are very important. Here, we report a 23 years old married female nurse presenting with recurrent acute abdomen requiring frequent hospital admissions along with convulsion during her last attack. The presence of porphyrins in urine confirms the diagnosis of AIP.
Kaposi Sarcoma of the Lower Extremity with HIV and Kaposi's Sarcoma
Authors: Dertlioğlu Selma Bakar
Published: November 2021

Kaposi's sarcoma is the most common malignancy seen with HIV infection. It is a lymphoangioproliferous tumor first described by Moritz Kaposi in 1872. It is characterized by bluish red or dark brown plaques and nodules, especially in the distal of the lower extremities, often the heels and feet. Organ involvement without skin findings is observed in approximately 15% of the cases. There are four clinical variants, the classical, endemic, iatrogenic and the epidemic associated with AIDS. Kaposi's sarcoma in AIDS cases apart from the skin, it can also be seen in the oral cavity, gastro-intestinal system and respiratory system. Antiretroviral therapy (ART) should be started immediately in newly diagnosed HIV infected patients. In this research, a 65 year old male patient, who was diagnosed AIDS and Kaposi's sarcoma at the same time, is described.
On primary care leadership
Authors: Carelli Francesco
Published: November 2021

It is good to lead. It is axiomatic that it is good to lead. For differing reasons around Europe leadership is celebrated and actively promoted in primary care circles. It is apposite to consider why this might be so, what it might mean and whether it is of value. Initially the challenges facing European health care in general, and primary care in particular could be said to call for leadership – there is a perception of crisis in many countries health care systems for example. Crisis in funding and organisations to name but two, and good leadership among other factors can help address it by facilitating new ideas and practical responses.
Empirical test of a model of attitudes and stigma towards Covid-19
Authors: García-Lirios Cruz , Sandoval-Vázquez Francisco Rubén , Bustos-Aguayo José Marcos , Juárez-Nájera Margarita , Amemiya Michiko
Published: November 2021

The objective of the document is to empirically test a structural model of the relationship between stigma and attitudes. A cross-sectional, psychometric, and predictive work was carried out with a sample of 100 students, considering their exposure to Covid-19 in their professional practices and social service. A factorial structure was found that explained 89% of the variance and the relationship between both variables, suggesting the inclusion of other variables such as the need for information, media framing, and government communication strategy.
The Use of the Low-Intensity Laser Therapy (LLLT) Technique for Face Burning
Authors: Raffaele Regina Maria , Baldo Mario Eduardo , Moraes da Silva Edilma , Gaetti Jardim Ellen Cristina , Pacheco Juliano Abreu
Published: November 2021

This work describes a case report by the Hospital Dentistry team of the Beneficent Association of Campo Grande Santa Casa MS, where a patient presented with a burn caused by the explosion of the carbon dioxide gas (Co2) through the inhalation of the vapor with acute physical changes, which resulted in burns that reached approximately 10% of the anterior area of the skull with involvement of the cervical and pharyngeal region. Admitted under Orotracheal Intubation, he was treated using the LLLT technique with the use of the InGaAIP low intensity laser on the injured tissues. Through a multi professional approach, using the Low Level Laser Therapy (LLLT) technique as a therapeutic alternative for the treatment of burn injuries of the periorbital region, lips and oral cavity, with the daily monitoring of the patient and regular on-site applications of laser therapy, there was a significant improvement in the injured region, and healing with rapid evolution, in addition to analgesia with reduced bleeding and site inflammation
Influence of hepatic Graft-Versus-Host-Disease (GVHD) on the pharmacokinetics of ciclosporin in a case of acute myeloid leukemia treated at the EHU Oran
Authors: H Toumi , H Betaouaf , Boudia Boudia , H Fettati , N Yafour
Published: November 2021

Acute myeloid leukemia (AML) is a malignant blood disease that affects hematopoietic cells in the bone marrow. The best treatment for AML is allogeneic hematopoietic stem cell transplantation (HSC). To prevent and treat the main complication of allogeneic marrow transplant, graft versus host disease (GVHD), it is necessary to combine immunosuppressive therapy which includes ciclosporin (CsA). The objective of our work is to study the influence of hepatic GVHD on the pharmacokinetics of cyclosporin in an AMLcase. This is an allografted patient (CSH), presented to our Pharmacovigilance department at the EHU of Oran in Algeria, with the aim of carrying out therapeutic pharmacological monitoring (TPM) of ciclosporin. We proceeded to assay for residual ciclosporinaemia from D1 of the allogeneic transplant. The patient presented a fluctuation of the trough concentrations, the explanation of which was an onset of acute hepatic GVHD, confirmed by biopsy with an elevated hepatic function, which represents an incidence varying between 10 and 50% in patients receiving transplant from a genoidentical donor. Without forgetting the great inter-individual and intra-individual variability of the response to ciclosporin, the environmental and pathological factors and the numerous drug interactions which can be the cause of modification of the pharmacokinetics and the pharmacodynamics of this drug. In conclusion, the pharmacological monitoring of cyclosporin, which is the treatment of choice to prevent or treat GVHD, is mandatory due to its low therapeutic index and high inter- and intra-individual variability.
Analysis of Covid - 19 Situations in Davanagere District, Karnataka
Authors: Sakre Gouri , Devagappanavar Gulappa
Published: November 2021

Background: According to CDC, Coronavirus disease 2019 (COVID-19) is caused by a new coronavirus which was first identified in Wuhan, China, in December 2019. Although most people who have COVID-19 have mild symptoms, it can also cause severe illness and even death. Some groups, including older adults and people who have certain underlying medical conditions, are at increased risk of severe illness. On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Objectives: Analysis of COVID 19 data in the Davanagere district from April 2020 to August 2020. Methods: In this current study the secondary data is obtained from the Official Website of Government of Karnataka, Covid-19 Informational Portal – Media Bulletin. By using different indicators Davanagere district covid data is further used to calculate Attack rate, Case fatality rate and complete case fatality rate. Results: In this study it is found that, in the month of April there were no covid positive cases reported till fourth week of month, by fourth week, total two positive cases were reported the first case being encountered on 28th April 2020, with discharge of those patient in the end of the month. The attack rate has steeped up from 8.018 to 355.74 per one lakh population i.e. about 44 times more than initial months of pandemic. The strict preventive measures were followed by public and government too. So the prevalence rate is less in May, June and went on increasing once the unlocking is done. In summer the total positive cases steeping up from 2 cases to 154 total positive cases for the month April to May, and there is steady in rise of total positive cases for the month June with total positive cases of 153. In the beginning of summer there were fewer cases as pandemic was just begun and chances of transmission were very less. As monsoon appeared in June last week there is surge in total positive cases. With added burden of Unlock 1.0 phase, as public started moving out from home without any freak of infection. Conclusion: In this study it is found that due to strict nationwide lockdown and social distancing, hygiene practices among the Davanagere people has made it possible to restrict the spread of covid among the people, although the international immigration of Davanagere residents lead to transmission of infection. Further removal of lockdown after three months has lead to three fold spread of disease. Also there is rise in death rate, attack rate and case fatality in Davanagere district.
CT and MRI Evaluation of Bilateral Enlarged Vestibular Aqueduct Syndrome with Curved Reconstructions – A Case Report and Short Review of Literature
Authors: Ram Chithra , Seroogy Erik , Sherry Richard
Published: November 2021

Enlarged Vestibular Aqueduct Syndrome (EVAS) is a known, but rare entity. It represents a common cause of congenital sensorineural hearing loss, diagnosed more often in children with a slight female predominance. Herein, we report a case of bilateral Enlarged Vestibular Aqueduct Syndrome [EVAS] in a 26-year-old male. As it is a subtle finding on imaging, the interpreting radiologist must be aware of this entity to make the diagnosis. The diagnostic CT and MRI images of this patient are given along with curved CT and MRI reconstructions along the plane of the Vestibular Aqueduct [VA] extending to the endolymphatic sac [ES]. The CT reconstructions demonstrate the bony anatomy in great detail and the bilateral dilated VA. These help in excluding diseases like otospongiosis and inner ear anomalies. The curved MRI reconstruction CISS images through the VA demonstrate the entire endolymph channel. The reconstructed MRI Images clearly demonstrate a patent endolymph channel without any focal abnormality such as stricture, or other associated congenital anomalies.
Perinatal Sacroiliitis Diagnostic Challenges: A Case Report
Authors: M. Kheder Emam , H. Sharahili Hussain , Albahrani Salma y. , M. Alfarhan Abdullah , M. Alquraynis Abdulrahman , B. Maitigue Mahmoud , Al Wehaibi Ahmed M
Published: November 2021

Background: Lumbo-pelvic (LPP) pain is common and non specific problem during pregnancy and post partum. Despite the fact that perinatal pyogenic sacroiliitis (PSI) during this period is rare, it should be considered as a vital differential diagnosis in women who have debilitating lower back and pelvic girdle pain. Case: A 34 years old primigravida presented to the emergency department with extreme right sided lower back pain radiating to the right gluteal region and down to the back of the right thigh. This pain began twelve days prior to her presentation and eventually worsened to the point that she couldn't stand or walk. Her vital signs were within normal limits, and she was febrile. Apart from a slight widening of the symphysis pubis, her pelvic and lumbo-sacral plain x-rays revealed no important findings. With the clinical impression of right LPP, the patient was admitted for pain management and further inquiries. Conclusion: Despite the fact that lower back and pelvic girdle pain are normal throughout pregnancy and the postpartum period, perinatal PSI is uncommon. It's a tough diagnosis to make because the symptoms and signs aren't clear, and the tests aren't definitive. When pathognomonic clinical and radiologic signs indicate an infectious process and isolation of pathogenic bacteria is not possible, medical management with empirical antibiotics should not be delayed.
Sekizinci sınıf öğrencilerinin akademik ertelemeleri ile sınav kaygısı düzeyleri arasındaki ilişkinin incelenmesi
Authors: ÇAKICI Arzu
Published: November 2021

Bu araştırmada, 2018-2019 eğitim-öğretim yılında Kocaeli-İzmit İlçesinde öğrenim gören 8. sınıf öğrencilerinin akademik erteleme ile sınav kaygı düzeyleri düzeyleri arasındaki ilişki incelenmiştir. Araştırmaya 81 öğrenci katılmış ve kendilerine “Sınav Kaygı Ölçeği”, “Ortaokul Öğrencilerinin Akademik Erteleme Ölçeği” ve Demografik Bilgi Formu” uygulanmıştır. Verilerin analizinde normal dağılım varsayımının sağlandığı durumlarda iki grup ortalamalarının karşılaştırılması için bağımsız örneklem t testi; normal dağılım varsayımının sağlanmadığı durumlarda ise Mann Whitney U testi kullanılmıştır. İkiden fazla grup ortalamasının karşılaştırılmasında normal dağılım olan testlerde ANOVA; normal dağılmayan verilerde Kruskal Wallis H testi kullanılmıştır. Sürekli verilerde Spearman korelasyon analizi; kategorik verilerde Ki Kare analizi yapılmıştır. Araştırmada akademik erteleme davranışı erkek öğrencilerde daha fazladır ve öğrencinin yaşına, ekonomik durumuna, LGS süreci sonucunda girdiği liseye ve algılanan başarı durumuna göre farklılaşmamıştır. Sınav kaygısı ölçeği ve alt boyut puanlarından elde edilen skorlara göre erkek öğrencilerin gelecek ile ilgili endişeleri kız öğrencilerden fazladır. Diğer alt boyutlarda ve ölçek genelinde cinsiyete göre farklılaşma yoktur. Sınav kaygısı puanları öğrencinin yaşına, ekonomik durumuna, LGS süreci sonucunda girdiği liseye ve algılanan başarı durumuna göre farklılaşmamıştır. Akademik erteleme ile sınav kaygısı ve sınav kaygısı alt boyutları olan başkalarının görüşü, elecek ve hazırlanmak ile ilgili endişeler, zihinsel ve bedensel tepkiler ve genel sınav kaygısı alt boyutu arasında anlamlı bir ilişki bulunmamıştır. Akademik erteleme ile kişinin kendi görüşü alt boyutu arasında anlamlı, pozitif yönlü ve zayıf düzey bir ilişki vardır. Akademik erteleme, sınav kaygısı düzeyine göre farklılaşmamıştır.
İşbirlikli öğretim yönteminin Türkçe dersinde akademik başarı ve tutum üzerindeki etkisi
Authors: ARSLAN Aysel , ENGİN Ali Osman
Published: November 2021

Bu çalışmanın amacı; işbirlikli öğretim teknikleri arasında yer alan Birleştirilmiş İşbirlikli Okuma ve Kompozisyon (BİOK), Öğrenci Takımları Başarı Bölümleri (ÖTBB) ve Jigsaw II’nin Türkçe dersinde uygulanmasının öğrencilerin Milli Kültürümüz ile Doğa ve Evren ünitelerinde yer alan kazanımlara ilişkin başarıları, Türkçe dersine yönelik tutumları üzerindeki etkisinin belirlenmesidir. Araştırmanın verileri öntest-sontest kontrol gruplu yarı deneysel desen tasarımı kullanılarak elde edilmiştir. Araştırmanın çalışma grubunu 2019-2020 eğitim yılı birinci döneminde Sivas ili merkez ilçede bulunan iki farklı ortaokuldaki dört şubede 7. sınıfta öğrenim görmekte olan 36 kız, 47 erkek toplamda 83 öğrenci oluşturmuştur. Araştırmada yer alan şubelerden üçünde işbirlikli öğretim teknikleri birinde ise mevcut öğrenme programına uygun olarak dersler yapılmıştır. Araştırma verilerinin elde edilmesinde her iki üniteye ilişkin modüler testler ve Türkçe Dersine Yönelik Tutum Ölçeği kullanılmıştır. Verilerin analizinde; kümeleme analizi, tanımlayıcı istatistikler, ANOVA, Tukey, bağımlı gruplar t testi uygulanmıştır. Araştırma sonuçlarına göre; işbirlikli öğrenme tekniklerinin uygulandığı deney gruplarının her iki üniteye ilişkin öntest-sontest puanları arasında sontest lehine anlamlı farklılık bulunduğu saptanmıştır. Mevcut yöntemin uygulandığı kontrol grubunda ise ilk ünitede sontest lehine anlamlı farklılık olduğu ancak ikinci ünitede anlamlı farklılık olmadığı saptanmıştır. Tutum ölçeğinden elde edilen sonuçlar incelendiğinde; bütün gruplarda öntest puanlarına göre sontest puanlarında bir artışın olduğu görülmektedir. Deney grubu ÖTBB (DÖ) ve Deney grubu Jigsaw II (DJ) gruplarında sontest lehine olmak üzere anlamlı farklılık olduğu ancak Deney grubu BİOK (DB) ve Kontrol grubunda (KM) da sontestlerde öntestlere göre bir miktar puan artışı olduğu ancak bunun istatistiki hesaplamalara göre anlamlı olmadığı bulgusuna ulaşılmıştır.
Managing Coastal Sand Drift in the Anthropocene: A Case Study of the Manawatū-Whanganui Dune Field, New Zealand, 1800s-2020s
Authors: Sampath Dissanayake Mudiyanselage Ruwan , Beattie James , De Freitas Joana Gaspar
Published: November 2021

In the Anthropocene, dunes act as a natural defence from sea-level rise and storm surges while providing 'ecosystem' services. This article uses scientific and historical data to examine the Manawatū-Whanganui dune field in New Zealand from the nineteenth to the twenty-first century. Dunes that were destabilised due to European settlements and their activities were drifting inland causing social, economic and political problems. Attempts to prevent dune mobility occurred at the time in many parts of the world. Thus, knowledge was shared between countries through experts and migrants. The consequences of the implemented solutions and new environmental conditions mean that dunes are still a major issue in the region. A comparative analysis of historical and present-day dune management practices provides a better understanding of long-term dune drift. In conclusion, interdisciplinary analyses of long-term relations between dunes and society must be taken into account for their holistic management.
Improving the formulation of baursaks with the use of eggplant fruit powder
Authors:   Saratov State University named after N.I. Vavilov, Saratov, Russian Federation, Abdusheva A.Y. , Sadygova M.K. ,   Saratov State University named after N.I. Vavilov, Saratov, Russian Federation, Kondrashova A.V. ,   Saratov State University named after N.I. Vavilov, Saratov, Russian Federation
Published: November 2021

The article experimentally substantiates the prospects of obtaining powder from eggplant pulp, and its application in the technology of the national fried bakery product-baursaks. There are two ways to prepare eggplant for processing in order to remove bitterness. With preliminary freezing of raw materials, there is a slight bitterness in the aftertaste, and when soaked in a 3% salt solution, the taste of the powder is salty. The optimal parameters and modes of convective drying of eggplant fruits for the most complete preservation of biologically active substances in the product are established. The scientific novelty is confirmed by the patent of the Russian Federation № 2733117, a method for obtaining powder from the pulp of eggplant. The formulations of the experimental variants differed in the content of eggplant fruit powder by 15, 20, 25%. With an increase in the amount of eggplant pulp flour in the recipe to 20–25%, the color of the semi-finished product darkens, the dough becomes incoherent, breaks, because the content of raw gluten decreases in mixtures. According to the results of a comprehensive assessment of the quality of finished products, the best sample with the addition of eggplant pulp flour up to 15% in the product formulation. The authors found that in 100 g of baursaks with the addition of eggplant powder, the content of dietary fiber is 37,5% higher, vitamin B6 is 3 times, silicon, manganese, copper is 1,5 times. A new recipe of the national bakery product - baursaks has been developed, which contributes to the expansion of the range of products of increased nutritional value
Enhanced Artificial Bee Colony method for node deployment and routing in Wireless Sensor Networks
Authors: Madagouda Basavaraj , Sumathi R.
Published: November 2021

Wireless networks provide small sensing, machine and wireless networking nodes. Different designs and implementation techniques were built based on the device requirements for wireless network sensors (WSN). Sensor networks are used in various applications, such as environmental monitoring, home automation, military applications, etc. In this study introduce an architectural survey and deployment of nodes in the Wi-Fi Sensor network in this article. The environmental features that can be added to the sensor networks are given. The program relies on the node installed in the WSN and is deterministic or random. But the biggest issue in both cases is the coverage of the region involved. Researcher also describe WSN routing protocols. In this paper, a new technique to deployment problem is proposed based on the artificial bee colony (ABC) algorithm which is enhanced for the deployment of sensor networks to gain better performance by trying to increase the coverage area of the network and energy consumption. The good performance of the proposed EABC algorithm shows that it can be utilized in the deployment of WSN.
A Discourse Analysis of Education Memes on Instagram
Authors: Destira Yosi , Hidayat Didin Nuruddin , Alek Alek , Sufyan Agus
Published: November 2021

In the modern era, human has many ways to communicate, interact, and spread the idea. With the advancement of digital technologies, there are various media to convey messages; one of which is through internet memes. The present aims to investigate memes on Instagram through the lense of Critical Discourse Analysis. The objectives are to find out (1) the similarities and differences between Indonesian students and foreign students, (2) to analyze the relationship between pictures and text, and (3) to know the social function of memes. To seek answers, the researchers chose the ten best memes randomly from two Instagram accounts: Best Memes and Zona Mahasiswa” Furthermore, The memes have taken randomly depend on the researchers' needs. The study revealed no significant evidence of differences in education culture between Indonesia's and other countries memes. The results also indicated that the memes were able to serve as a means to communicate people’s activities to the readers. Further, the memes could be a compliment in communication and serve as a media for internet literacy development.