bluuebunny/crossref_metadata_2025 huggingface dataset:
Stability and bifurcation analysis of a multi-delay model for mosaic disease transmission
Authors: Al Basir Fahad , Blyuss Konstantin B. , Venturino Ezio
Published: August 2023

A mathematical model is developed for analysis of the spread of mosaic disease in plants, which account for incubation period and latency that are represented by time delays. Feasibility and stability of different equilibria are studied analytically and numerically. Conditions that determine the type of behavior exhibited by the system are found in terms of various parameters. We have derived the basic reproduction number and identify the conditions resulting in eradication of the disease, as well as those that lead to the emergence of stable oscillations in the population of infected plants, as a result of Hopf bifurcation of the endemic equilibrium. Numerical simulations are performed to verify the analytical results and also to illustrate different dynamical regimes that can be observed in the system. In this research, the stabilizing role of both the time delay has been established i.e. when delay time is large, disease will persist if the infection rate is higher. The results obtained here are useful for plant disease management.
Paul Rabinow y la antropología de lo contemporáneo
Authors: Fernández de Rota Antón
Published: August 2023

A lo largo de los últimos veinte años de su vida, Paul Rabinow trabajó junto con sus colaboradores en el diseño y el testeo de una Antropología de lo Contemporáneo. Dicha antropología pretende remediar la lógica de la investigación, así como sus emplazamientos, modos de trabajo y el ethos con el cual conducirse. Este artículo presenta una visión global de la trayectoria de uno de los antropólogos más destacados centrándose en el proyecto comentado. Al aproximarse a su obra será posible, a su vez, identificar algunas de las razones que producen en la disciplina presente cierta grado de stasis.
Entre el hablar y el silencio: la transformación de roles de género en espacios de activismo religioso-secular
Authors: Cazarin Rafael , Davila Andres
Published: August 2023

El presente artículo aborda las narrativas de transformación manejadas por líderes de comunidades religiosas que participan en talleres para la prevención de violencia sexual y de género (VSG) llevados a cabo en distintas localidades africanas por una ONG con sede en Sudáfrica. En concreto, buscamos revelar las formas en que quienes participan en dichos talleres dan sentido a la transformación de género en territorios religiosos y seculares; así como, en relación con eso, explorar las tensiones y conformidades que emergen cuando tanto mujeres como varones analizan las desigualdades de género en sus entornos personales. El artículo muestra cómo tales participantes manejan la noción de transformación en el ámbito de la violencia de género, a tenor de un repertorio emocional enmarcado por expresiones en términos de hablar, escuchar, callar y silencio. Este proceso tiene al menos dos dimensiones: por una parte, articula los desafíos que enfrentan al tratar con VSG en sus vidas personales desde espacios concretos como la iglesia, la familia o en las relaciones afectivas y el entorno comunitario; por otra parte, ayuda a enmarcar las tensiones existentes entre nuevas perspectivas en torno a los roles y relaciones de género que se desdoblan en territorios seculares y religiosos.
Effectiveness of Real and Computer-Assisted Experimental Activities in Moroccan Secondary School Physics Education
Authors: Menchafou Youssef , Aaboud Morad , Chekour Mohammed
Published: August 2023

Experimental activities are widely recognized as an essential pedagogical tool in physics education that enables students to learn fundamental physical concepts. Experimentation sets physics apart from other disciplines by motivating learners to acquire knowledge, methods, scientific attitudes, and manipulative skills. Most current research focuses on the importance of conventional experimental work in the learning process or the contribution of new technologies to this process without pinpointing the experienced limitations hindering the two tools from achieving the pedagogical objectives for which they were originally designed. To gain a better understanding of what these issues are, we have performed the survey presented in this paper. First, the analysis investigated the challenges that impede the experimental approach from playing its vital role in the Moroccan education system and evaluated the efficiency of this approach in achieving its original pedagogical objectives. In doing so, the study indicates that the majority of Moroccan secondary physics teachers do not achieve the required rate of experimental activities due to several challenges, including the need for coaching and training, the lack of coordination between decision-makers and practitioners regarding the practical use of scientific laboratories, a shortage of necessary materials, and a lack of maintenance and repair of laboratory equipment. Thus, we conclude this paper by providing several solutions, implications, and limitations as potential directions for future research.
A Mobile Application Prototype Designed to Support Physical Therapy Assessment Learning Processes
Authors: Tavera Romero Carlos Andrés , Jaramillo Losada Jennifer , Díaz Velásquez María Fernanda , Domínguez Pineda Andrés Gerardo , Hurtado López Victor Manuel
Published: August 2023

The present work is the result of applied research, which describes how the physical therapy program at the Universidad Santiago de Cali approached the support of the learning processes from the Guide to Physical Therapist Practice issued by the American Physical Therapy Association (APTA) from a teaching perspective using information technologies with an emphasis on mobile devices (D-Learning). The implementation process was conducted using the PSP (Personal Software Process) methodology, condensing its six characteristic moments to address the problem in four stages: planning, design, development, and validation, corresponding to phases 2 and 3 of the interdisciplinary project developed by and between the Schools of Engineering and Health Sciences, thereby understanding that the remaining phases exceed the scope of this paper (these phases include a systematic review, an analysis, and feedback from the academic community). A preliminary assessment describes the knowledge gathering and idea conception processes, as well as the solution design process in Enterprise Architect. Subsequently, the prototype was implemented, the corresponding documentation was prepared, and its usability was validated by the academic community at the university. Therefore, a supporting tool was generated, focusing specifically on learning about the Guide to Physical Therapist Practice.
Recruitment Algorithm in Edge-Cloud Servers based on Mobile Crowd-Sensing in Smart Cities
Authors: Muhammad Alkirom Wildan  , Mahmudah Enny Widyaningrum  , T. Padmapriya  , Basant Sah  , Pani Niroj Kumar
Published: August 2023

As more and more mobile devices rely on cloud services since the introduction of cloud computing, data privacy has emerged as one of the most pressing security concerns. Users typically encrypt their important data before uploading it to cloud servers to safeguard data privacy, which makes data usage challenging. On the other side, this also increases the possibility of brand-new issues in cities. A clever, effective and efficient urban monitoring system is required to address possible challenges that may arise in urban settings. In the smart city concept, which makes use of sensors, one strategy that might be used in IoT and cloud computing is to monitor and gather data on problems that develop in cities in real-time. However, it will take a while and be rather expensive to install IoT and sensors throughout the city. The Mobile Crowd-Sensing (MCS) method is proposed to be used in this study to retrieve and gather data on issues that arise in metropolitan areas from citizen reports made using mobile devices. And we suggest a budget-constrained, reputation-based collaborative user recruitment (RCUR) procedure for a MCS system. To construct an edge-assisted MCS system in urban situations, we first integrate edge computing into MCS. We also examine how user reputation affects user recruitment. Finally, we create a collaborative sensing approach using the edge nodes’ sensing capabilities.
Authentic Learning in Elementary Classrooms
Authors: Zengaro Franco , Zengaro Sally A.
Published: August 2023

The purpose of this chapter is to discuss the role of movement in authentic learning in the elementary classroom. First, this chapter discusses the role of movement education in fostering a classroom climate of curiosity, learning, and positive development for children. Next, the chapter explores the link between being active as a child and increases in learning. Movement is children's first contact with the world, and since the interaction between children and their environment is primarily via the body, movement can spur the development of conceptual understanding. Therefore, this chapter proposes that young learners benefit from having movement activities embedded into their educational experiences, especially in the elementary physical education classroom.
Enhancing the School Environment for Underprivileged Minority Children through Social Identity, Cultural Capital, and Preparedness
Authors: Uddin Emaj
Published: August 2023

The book chapter conducts a comprehensive investigation into the educational challenges faced by underprivileged minority children, aiming to identify pathways for their empowerment. The research emphasizes the significance of education as a potent catalyst for societal transformation and individual growth in a global context that seeks equal opportunities. Persistent disparities hinder the pursuit of equitable education, disproportionately affecting marginalized children trapped in the cycle of poverty and marginalization. To shed light on the complex factors contributing to their educational disadvantages, the study focuses on three crucial dimensions: social identity, cultural capital, and preparedness. Drawing on scholarly sources and empirical evidence, it uncovers the sobering realities faced by these young learners, including systemic barriers, economic deprivation, cultural biases, and limited access to educational resources.
Application of Maqasid al-Shariah-Based Public Policy Framework in SDGs Policies
Authors: Tajudeen Ahmad Labeeb , Lawal Manzoor Apenna
Published: August 2023

Public policy scholars have warned that the conventional public policy (CPP) framework is not effective enough to address the post-pandemic problems as it has blatantly failed the litmus test of time. The CPP framework has been criticised on various grounds and blamed for the problems of unsustainability and overarching poverty that plague humanity. The objective of this chapter is to explain a quadric public policy framework (PPI) that has recently been proposed as an efficient alternative public policy framework. The explanation is limited to only one out of the four components of the framework, called the Maqasid al-Shariah component, also known as public interest theory. The findings show that the PPI framework can link policymakers from different sectors and provide a platform for a whole-of-government approach to achieving the SDGs, especially poverty alleviation and eradication.
Analysis on the Legal System of International Technology Trade Management Based on Data Mining Analysis
Authors: Zuo Xiangbin , Yang Yi
Published: August 2023

With the rapid development of computer and information technology, people can obtain and store data in a faster and cheaper way, which makes the amount of data and information grow exponentially. Based on data mining technology, this paper systematically analyzes and compares the basic situation and evolution of international trade networks and international human relations networks using the bilateral trade data and human relations data of countries and regions in the world. The research shows that the strength external entropy, strength internal entropy, and network weight entropy of the whole international trade network from 2008 to 2014 are generally lower than 0.75. The whole network still showed a downward trend from 2010 to 2015, but it began to rise steadily after 2016. The monopolistic behavior in international technology trade has a significant impact on the fundamental freedoms and rights of citizens.
APLs and Oranges: Induction of T Cell Anergy by Altered Peptide Ligands
Authors: Jarjour Nicholas N , Jameson Stephen C
Published: August 2023

This Pillars of Immunology article is a commentary on “Induction of T-cell anergy by altered T-cell-receptor ligand on live antigen-presenting cells,” a pivotal article written by J. Sloan-Lancaster, B. D. Evavold, and P. M. Allen, and published in Nature, in 1993. https://www.nature.com/articles/363156a0
Are multiple courses of antibiotics a potential risk factor for COVID-19 infection and severity?
Authors: Shams Maiada Mahmoud , Hamdy Ebthal Mamdouh , Abd-elsadek Dina Fawzy
Published: August 2023

Background:

To determine the potential risk factor of COVID-19 severity and length of hospitalization, the association between multiple antibiotics administration and the risk of severe COVID-19.

Methods:

A case-control study of 58 hospitalized COVID-19 patients (the case group) and 120 non-hospitalized home isolated COVID-19 patients (the control group) was conducted. Data were collected using hospital medical records and verbal questionnaires for the participants.

Results:

Totally 89.2% of non-hospitalized mild COVID-19 patients received ⩽2 courses of antibiotics/year, while 36.0% of hospitalized patients received ⩾4 courses of antibiotics, 56.9% received 2-3 courses of antibiotics/year and only 6.9% of them were exposed to ⩽2 courses of antibiotics/year. our study emphasizes that the usage of 4 courses or higher per year was a significant risk factor for hospitalization [OR: 17.5; 95%CI(2.596-118.263); P=0.003], while the usage of ⩽2 courses was a preventive predictor for severity and hospitalization [OR: 0.072; 95%CI(0.006-0.900); P=0.041]. Furthermore, age was associated with 8.4% increase in the odds of severe COVID-19 [OR: 1.084; 95%CI(1.024-1.148), P=0.005], and females were 89.1% less likely to hospitalized than males [OR: 0.109; 95%CI(0.024-0.498); P= 0.004]. Our study shows that 70.4% of cases misused antibiotics and administered the antibiotics themselves without a physician's prescription. Around 50.0% of cases never completed the ideal duration of the course in contrast to controls, of which only 23.2% did not complete the ideal duration.

Conclusions:

Our study shows that antibiotics misuse and overuse may be a potential risk factor for COVID-19 severity and hospitalization.
Awake Fibreoptic Intubation
Authors: Nyima Tenzin , Gupta Deepika , Mitra Sukanya , Kaur Ramandeep
Published: August 2023

Achondroplasia, also known as dwarfism, is a rare autosomal dominant disorder. We, hereby, describe the successful anaesthetic management of a 32-year-old female patient with a height of 90 cm and weighing 35 kg (body mass index of 43.2 kg/m2) posted for an elective caesarean section at 34 weeks 4 days of gestation. We emphasise the need for proper preoperative evaluation of the patient and anticipate difficult regional or general anaesthesia in these patients.
Evolution of eye banking in India – A review
Authors: Christy Josephine S , Bhadari Anand Hari , Mathews Priya , Srinivasan Muthiah , Vanathi Murugesan
Published: August 2023

Corneal blindness ranks third among the causes of blindness worldwide, after cataract and glaucoma. Corneal transplantation offers us a means to address this, and is currently the most commonly performed transplantation procedure worldwide – restoring the gift of sight to many an eye. Eye banks play a very important role in these procedures. India was quick to develop its own eye bank in 1945 soon after the launch of world’s first eye bank in 1944. The evolution over the past six decades has been tremendous, placing India on the top, with one of the largest eye-banking system in the world. As of 2023, around 740 members are registered under the Eye Bank Association of India. The highest-ever collection of 71,700 donor eyes was achieved in 2017-2018. The overall tissue utilisation rate ranged between 22 - 28 % for voluntary donations and 50% for hospital-based corneal retrieval programs. Though India has an excellent infrastructure and readiness for corneal transplantation surgery, the need of the hour is to create a strong and independent nodal system. It shall take care of the logistics and factor in technological advances – surgical and otherwise. Public awareness, a national corneal grid, and reducing the red-tape barriers, shall improve availability of grafts nationwide. This review aims to detail the evolution of eye banking in India, to provide a comprehensive understanding, and help the stakeholders focus on the road ahead to attain our targets faster.
Indications and types of keratoplasties: Trends in the past 10 years (2011-2020) in Eastern India
Authors: Kaur Amanjot , Parida Priyadarsani , Priyadarshini Smruti Rekha , Mohanty Amrita , Sahu Srikant K , Das Sujata
Published: August 2023

Purpose:

To observe the trends of various types of keratoplasties in different etiologies over a period of 10 years (2011-2020) in a tertiary eye care center of eastern India.

Methods:

A retrospective review of patients undergoing keratoplasties from 2011 to 2020 was performed in a tertiary eye care hospital situated in eastern part of India. Apart from demographic data, primary indication for each surgery and type of procedure carried out was recorded. For comparison, data were divided into two time periods: Group I: Jan 2011 to Dec 2015 and Group II: Jan 2016 to Dec 2020.

Results:

Over a period of 10 years, a total of 2365 (Group I: 902, Group II: 1463) keratoplasties were performed. The average age of patients was 45.8 ± 19.9 and 46.9 ± 20.9 years in Group I and Group II, respectively. Among all the corneal grafts, 1747 (74%) surgeries were full-thickness. Although optical penetrating keratoplasty (OPK) was most the common indication for full-thickness keratoplasties, Descemet’s stripping endothelial keratoplasty (DSEK) remained most performed lamellar keratoplasty. Keratitis, corneal scars, and bullous keratopathies remain to be most common indications in both groups. Number of lamellar keratoplasties increased significantly from Group I to Group II for corneal scars (P = 0.02), bullous keratopathies (P = 0.01), and endothelial dystrophies (P = 0.00).

Conclusion:

With change in time, the indication and technique of keratoplasty has witnessed a changing trend from full-thickness keratoplasty to lamellar keratoplasty. There is rise in trend of lamellar keratoplasties over the period.
Methods for a population-based Comprehensive Eye care Workload Assessment (CEWA) study in Southern India
Authors: Vardhan Ashok , Rajendran Vinoth Kumar , Joseph Sanil , Pooludaiyar Lakshmanan , Datta Dipankar , Fletcher Astrid E , Ravilla Thulasiraj D
Published: August 2023

Eye care programs, in developing countries, are often planned using the prevalence of blindness and visual impairment, often estimated from Rapid Assessment of Avoidable Blindness (RAAB) surveys. A limitation of this planning approach is that it ignores the annual overall eye care requirements for a given population. Moreover, targets set are arbitrary, often influenced by capacity rather than need. To address this lacunae, we implemented a novel study design to estimate the annual need for comprehensive eye care in a 1.2 million populations. We conducted a population-based longitudinal study in Theni district, Tamil Nadu, India. All permanent residents of all ages were included. We conducted the study in three phases, (i) household-level enumeration and enrollment, (ii) basic eye examination (BEE) at household one-year post-enrollment, and (iii) assessment of eye care utilization and full eye examination (FEE) at central locations. All people aged 40 years and above were invited to the FEE. Those aged <40 years were invited to the FEE if indicated. In the main study, we enrolled 24,327 subjects (58% aged below 40 years and 42% aged 40 years and above). Of those less than 40 years, 72% completed the BEE, of whom 20% were referred for FEE at central location. Of the people aged ≥40 years, 70% underwent FEE. Our study design provides insights for appropriate long-term public health intervention planning, resource allocation, effective service delivery, and designing of eye care services for resource-limited settings.
Antibiotic prophylaxis for cataract surgery - Practice patterns amongst Indian Ophthalmologists
Authors: Kelkar Aditya S , Sharma Namrata , Verma Lalit , Chandorkar Shraddha A , Saxena Rohit , Mishra Deepak , Kelkar Jai A , Sengupta Sabhyasachi
Published: August 2023

Purpose:

To assess the current trends in use of perioperative antibiotic prophylaxis, especially intracameral antibiotics (ICAB), for cataract surgery in India.

Methods:

This was an E-survey using a previously validated questionnaire carried out by the All India Ophthalmological Society (AIOS) in August 2022. An E-mail invitation to complete an online 40-point survey was sent to all members of the AIOS using a digital E-mail service (Survey Monkey) and social media platforms.

Results:

Out of 1804 total respondents, 58% (n = 1022) reported using routine ICAB prophylaxis. Of those using ICAB, 89% (n = 909) reported using it for all cases, whereas the rest used it for specific indications such as post-PC rent (n = 43), one eyed patient (n = 19), and high-risk cases (n = 50). Commercially available moxifloxacin was by far the commonest agent used for ICAB (n = 686, 67%). Eighty respondents (8%) reported noticing occasional toxic reactions and nontoxic corneal edema (n = 64, 6%) with ICAB. Surgeons with >10 years’ experience especially practicing in medical colleges used fewer ICAB (OR = 0.52, 95%CI = 0.38 – 0.72, P < 0,001) compared to younger surgeons (<5-year experience) in solo clinics. The commonest reason for nonadoption of IC antibiotics was “unconvinced of the need to use it in my setting” (n = 296, 52% of those who answered this question).

Conclusion:

IC antibiotic prophylaxis for cataract surgery has significantly increased in India from 40% in 2017 to 58% in 2022. Commercially available moxifloxacin was preferred by the majority users. Intraocular inflammation may occur occasionally and needs safer formulations to avoid this.
Understanding Charaka Samhita in light of Samanya-Vishesha Siddhanta
Authors: Meghwal Suman , Bhatnagar Shailza
Published: August 2023

The concept of Samanya-Vishesha (similarity and dissimilarity) is one of the major ideologies of Ayurveda. These are widely described and implemented in Charaka Samhita and are mentioned under six factors required for the action of Dhatusamya (equilibrium) in the body. Many scholars face difficulty in understanding the meaning and implementation of these principles. Elementary knowledge and clear understanding of the fundamental principles is very necessary and of utmost importance for their practical implementation. So, it is mandatory to understand these principles in a descriptive manner. An effort has been made to comprehend Charaka Samhita in the light of Samanya-Vishesha Siddhanta in this study. The facts have been collected from Charaka Samhita along with Ayurvedadipika Sanskrita commentary and its Hindi and English translations. Indian philosophical texts have also been referred. The matter has been extensively explored, systematically organized followed by rational analysis. After exploration and analysis it was concluded that the systematic organization of Charaka Samhita, etiology, symptoms and treatment of the diseases are basically dependent on these principles.
A Quasi-experimental Study to Assess the Effectiveness of Structured Counseling among Caregivers of Heart Failure Patients on Selected Outcomes
Authors: Chauhan Shivani , Tirwa Milan , Seth Sandeep , Satapathy Sujata , Hote Payal Kahol , Gopichandran Lakshmanan
Published: August 2023

Background:

In India, heart failure (HF) is one of the most prevalent chronic diseases. Caregivers are essential and play an important role in bridging the gap in providing care to HF patients. Caregivers’ demanding and difficult roles can result in a significant burden, which may lead to stress and symptoms of depression.

Aim and Objectives:

The objective of the study is to assess the effectiveness of structured counseling on caregiver burden, stress, and depression among caregivers of HF patients.

Materials and Methods:

Sixty caregivers of patients with HF were selected using consecutive sampling and divided into control and experimental groups. A one-on-one, 30-min structured counseling session was delivered telephonically to caregivers of HF patients. A pretest was taken before the intervention and posttest 1 month later, through telephone, on caregiver burden, stress, and depression using the caregiver burden interview, Perceived Stress Scale, and Patient Health Questionnaire-9.

Results:

The experimental group showed a significant reduction in caregiver burden (P = 0.001), stress (P = 0.001), and depression (P = 0.001) scores at 1 month. Female caregivers showed a significantly higher caregiver burden (P = 0.046) and depression (P = 0.019), and nuclear families showed a significantly higher caregiver burden (P = 0.016) and depression (P = 0.027). There was a significant positive correlation between stress and the presence of comorbidities (P = 0.021) and depression and the presence of comorbidities (P = 0.042).

Conclusions:

Structured counseling was effective in reducing caregiver burden and decreasing stress and depression in caregivers of HF patients.
Aspirin Strategy for Secondary Prevention of Atherosclerotic Cardiovascular Diseases: A Narrative Review
Authors: Hegde Nischal N. , Mathew Navin
Published: August 2023

Aspirin is the most used antiplatelet agent for secondary prophylaxis of atherosclerotic cardiovascular diseases. Individual variability in aspirin responsiveness has been widely reported. The current recommendations do not take these variations into consideration. Current guidelines recommend 75–100 mg of once-daily aspirin in all patients for secondary prevention. However, “one-dose-fits-all” may not be the appropriate aspirin dosing strategy. Based on our review, we suggest that patients with inadequate aspirin responsiveness are at increased risk of recurrent cardiovascular events. Noncompliance is the most common cause of poor aspirin response. Ensuring adequate compliance and avoiding concomitant ingestion of nonaspirin nonsteroidal anti-inflammatory drugs and bedtime ingestion of aspirin can help achieve adequate aspirin-mediated antiplatelet activity. A low-dose, twice-daily regimen is the preferred strategy in “high-risk” groups.
A cross-sectional study to determine the relationship between diabetic retinopathy and diabetic nephropathy in type 2 diabetes mellitus patients in South India
Authors: Roche Anjali L. , Prabhu Rajashree S. , Govind Indu
Published: August 2023

Background:

This cross-sectional study aims to determine the risk factors and correlation between diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetes mellitus in South India.

Materials and Methods:

A hospital-based analytical cross-sectional study was conducted on 200 type 2 diabetes mellitus patients and were assessed for diabetic retinopathy and nephropathy. Patients were classified into two groups: no-diabetic nephropathy (Group A) and diabetic nephropathy (Group B) based on eGFR. Fundoscopy was performed in all patients to look for DR. Multivariate regression analysis was used to determine risk factors associated with diabetic nephropathy. This study was approved by the institutional review board, and written informed consent was obtained from all participants.

Statistical Analysis:

Statistical Package for Social Sciences (SPSS) version 20.0 for Windows was used. Descriptive statistical methods were used to outline the basic characteristics, and a P value less than 0.05 was considered statistically significant. Differences between the groups were analyzed using independent-sample t-test for continuous variables and χ2 test for categorical variables.

Results:

In this study, 52% patients with DN had retinopathy when compared to 23% patients in no-DN (P < 0.001). The distribution of different types of retinopathies was 44% NPDR, 28% PDR, and 32% CSME in patients with DN and 31% NPDR, 8% PDR, and 7% CSME in the no-DN group (P < 0.001). The age, hypertension, duration of diabetes, serum creatinine, urine protein levels, and diabetic retinopathy gradings were found to be more positively correlated with DN; no diabetic retinopathy and insulin treatment data showed negative correlation. Multivariate regression analysis confirmed age, creatinine, eGFR, DR, and CSME as risk factors for progression to DN (P < 0.05).

Conclusion:

The results of our study suggest that diabetic nephropathy has a positive correlation with diabetic retinopathy in type 2 diabetes mellitus patients. We found that PDR and CSME were associated with diabetic nephropathy, and PDR and CSME were risk factors for DN. Hence, renal parameters can be used as a reliable predictor for diabetic retinopathy in type 2 diabetes mellitus patients and also contribute to prevention of DR.
Assessment of Skeletal Relationships in Cleft Palate with or Without Cleft Lip
Authors: Qadeer M , Jaafar S , Khamis MF , Khan H , Khan T , Saeed MQ
Published: August 2023

Background:

Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities.

Aims:

The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement.

Materials and Methods:

Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant.

Results:

We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05).

Conclusions:

Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.
Tissue Doppler Echocardiographic Evaluation of Cardiac Functions in Children with Mucopolysaccharidosis Type III Disease
Authors: Altin H , Dorum S , Ture E
Published: August 2023

Background:

Mucopolysaccharidosis type III (MPS III) is an extremely rare group of diseases among all MPS types. In recent years, there are studies about the presence and importance of cardiac involvement in MPS III patients as in other types of MPS.

Aim:

The aim of our study is to evaluate the cardiac functions of MPS III patients in pediatric age by using the M-mode, 2D, and Tissue Doppler echocardiographic measurements.

Methods:

The study was conducted prospectively between September and December 2020. Fifteen MPS III patients and 15 healthy volunteers were included in the study.

Results:

The mean Tei indexes of all three regions including left ventricle (LV), right ventricle (RV), and interventricular septum (IVS) were higher in MPS III patients compared to the control group (0.43/0.36 for LV and 0.44/0.37 for RV and 0.41/0.35), respectively. Diastolic function parameters of MPS III Patients were worse than the control group. In MPS III patients, eight (53.3%) patients had valvular dysfunction, three (20%) patients asymmetric septal hypertrophy and four (26.7%) patients LV concentric remodeling pattern. We detected an increase of z score above +2 in aortic valve annulus, sinuses of Valsalva, IVS diastole diameter and also in the LV posterior wall diastole diameter measurements in some MPS III patients.

Conclusion:

We conclude that cardiac monitoring of MPS III patients is very important in terms of early detection and treatment of cardiac problems that may arise. Cardiac evaluation of larger series of MPS III patients are needed to make a better decision.
The Efficacy of the ON-Q Elastomeric Pump System in Post-Thoracotomy Acute Pain Control
Authors: Çinar HU , Çelik HK , Çelik B
Published: August 2023

Objectives:

We aimed to evaluate the efficacy of continuous local anesthetic infusion to the incision site with the On-Q elastomeric pump system in postoperative acute pain control after thoracotomy.

Methods:

A retrospective comparative analysis of of sixty patients who underwent thoracotomy for lung cancer by the same surgical team was performed between January 2016 and December 2017. The patients were divided into two groups according to postoperative pain management, those who were traditionally received tramadolol (15 mg/h) by intravenous continuous infusion (Group IVT, n = 30) and those who were administered continuous local anesthetic (0.5% bupivacaine, 4 ml/h) infusion to the incision site through an elastomeric pump in addition to the traditional treatment (Group LA, n = 30). The primary outcomes were postoperative acute pain scores on the numeric rating scale and postoperative rescue opioid consumption for 72 hours following surgery reported as pethidine equivalents. The secondary outcomes were frequency of analgesia related adverse events/complications, ICU and hospital stay, drug and total hospital cost.

Results:

The mean pain scores at 2, 12, 24, 48 and 72th hours at rest and during coughing were found to be significantly lower in group LA (p < 0.05). Rescue opioid consumption on postoperative 0, 1, 2 and 3rd days and in total was found to be significantly lower in Group LA (p < 0.05). In Group LA, postoperative length of hospital stay was significantly shorter (5.8 ± 2.1 days vs. 8.0 ± 3.1 days; p = 0.034), drug costs (95.24 vs. 160.08 Euro; p = 0.023) and total hospital costs were lower (434.26 vs. 685.75 Euro; p = 0.014) than Group IVT.

Conclusions:

We believe that continuous local anesthetic infusion to the incision site in addition to systemic analgesic treatment for multimodal acute pain management after thoracotomy is an effective and safe method.
A New Perspective on the Relationship between Anchorage and Palatal Morphology
Authors: Metin-Gursoy Gamze , Tortop Tuba
Published: August 2023

Background:

The tooth movements were generally analyzed in two dimensions on cephalometric radiographs. Nowaday, 3D digital model analysis, which does not have any harmful effects on patients, can be used to evaluate the palatal morphology and coronal tooth movements in a very comfortable and easy way.

Aims:

To investigate the effect of palatal morphology on anchorage reinforcement during intraoral molar distalization with pendulum appliance using 3D model analysis.

Materials and Methods:

The material consisted of before (T0) and after (T1) dental plaster models of Class II malocclusion patients (17 females, 3 males) treated with pendulum appliance for molar distalization and Nance appliance for anchorage. T0 and T1 digital models were superimposed using the palatal area as a reference via three points and surface-matching software, and the changes in teeth movement were calculated for left and right central incisors, first premolars, and first and second molars. Palatal morphology was evaluated at T0 on digital models as palatal inclination, palatal depth angles, and anterior hard palate area. Wilcoxon test was used to evaluate the treatment results and Spearman's correlation analysis was performed to evaluate the relationship between palatal morphology and dental movement. The upper limit for the level of significance was taken as 0.05.

Results:

Mesial movement of first premolars and distal movement of first and second molars were found to be statistically significant (P < 0.001). A weak negative correlation was found between the palatal inclination and the movement of first premolars (P < 0.045 and P < 0.003). Palatal depth angles and anterior hard palate area had no correlation with dental movements.

Conclusion:

Presented results supported that the mesial movement of premolar teeth decreased as the inclination of the palate increased.
Prevalence and Pattern of Self-medication with Alternative Medicine
Authors: Gondivkar SM , Sarode SC , Gadbail AR , Gondivkar RS , Sarode GS , Patil S , Gaikwad RN , Yuwanati M
Published: August 2023

Aim:

The aim of this study was to investigate prevalence and pattern of self-medication with alternative medicine (ALM) among oral submucous fibrosis (OSF) patients with emphasis on treatment-switch analysis.

Methods:

A total of 115 OSF patients were recruited and subjected to scientifically validated questionnaire. Two groups were identified: S-ALM: patients who have previously received modern medicinal treatment but switched to ALM; and DN-ALM: patients who started ALM from De Novo.

Results:

A total of 37 (32.18%) patients reported use of the ALM at some point of time. Twenty-five (67.56%) switched to ALM, whereas 12 (32.43%) patients used ALM from De Novo. The pattern of switching to ALM in short period was significantly prevalent in patients with advanced stages (stage III and IV) as compared to early stages (stage I and II) of OSF. Clarified butter, glycerin, and honey were the most commonly used ALM in both the groups. The most common reasons for switching to ALM were the cost of treatment (32.00%), longer duration of medicinal treatment (24.00%) and ineffectiveness of the medications (24.00%).

Conclusions:

ALM usage is common in OSMF patients with significant percentage of patient switched from modern medicine to ALM. Therapeutic efficacy of ALM in OSF needs exploration in future.
Systematic Review
Authors: Simsek Uzunoglu S , Akca H
Published: August 2023

Coronavirus disease 2019 (COVID-19) caused by the new [novel] coronavirus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic with exceeding 72 million cases and 1.2 million deaths by the end of November 2020. We aimed to evaluate clinical, laboratory, and radiology findings of COVID-19 in children as reported worldwide and thereby to increase the clinical knowledge about the disease. Bibliographic searches were conducted in December 2020 using PubMed and Google Scholar. The search was limited to children [below 18 years of age]. The search strategy yielded a total of 336 potential articles but finally a total of 25 valid studies covering a total of 2446 (China: 1109, Europe: 663, North America: 674) pediatric patients. In the studies covered by this review, it was observed that the median age was calculated at various values between the ages of 1 and 7 years. In the studies, overall rate of the asymptomatic patients was 24.8% (ranging between 10.7 and 56.6). Acute upper respiratory tract infection (URTI) [mild disease] was observed in 40.7 (ranging between 22 and 50.6%), mild pneumonia in 27% (ranging between 9.5 and 40.6%), and severe pneumonia in 5.3% (ranging between 1.9 and 10.6%). A total of 3% (ranging between 0.7 and 5.1%) of the patients had critical severity. Among the most common clinical symptoms and findings; 61.7% (ranging between 57.4 and 64.3%) of the patients had fever, 53.2% (ranging between 30.6 and 75.1%) had cough, 16.8% (ranging between 4.6 and 27.2%) had diarrhea or nausea, and 15% had lymphopenia. Abnormal radiological findings were detected in 47.2 of the children with COVID-19 and ground glass opacity was in 22.2%. COVID-19 manifests milder and the clinical signs and symptoms vary widely in children. Laboratory and radiological findings of COVID-19 in pediatric patients are not mostly disease-specific, except lymphopenia may have a limited value, and ground glass opacity may have a significant diagnostic value.
Building a Responsive Healthcare System – A Nigerian Experience
Authors: Dada A , Olaopa OI , Chukwuanukwu TO , Asumah A
Published: August 2023

Background:

A healthcare system must be responsive to the needs of its clients, and this entails elements such as dignity, confidentiality, autonomy, prompt attention, social support, basic amenities, and choice of provider. This is targeted toward improvement and maintenance of the quality of healthcare with consequent improvement in patient outcomes at a reduced cost.

Aim:

The aim of this study is to articulate the approach that was adopted by the Federal Medical Centre, Ebute-Metta, Lagos, Nigeria, to confront some of the challenges faced by the health sector in Nigeria and make recommendations for the future.

Materials and Methods:

To identify and solve the problems mitigating quality service delivery in the hospital over an initial 18-month period, the management deployed the following tools: (i) mystery shopping; (ii) patient experience survey; and (iii) quality improvement using the SafeCare methodology.

Results:

The diagnosis identified the following problems: (i) service failure; (ii) financial and material leakages; (iii) challenges of human resources – poor attitude, indiscipline, inadequacy, and poor understanding of roles; (iv) infrastructural deficit and dilapidation; and (v) absence of technological support. The baseline quality assessment conducted with the SafeCare Standards gave a score of 45%, while performance at the follow-up quality assessment was 69%.

Conclusion:

As a direct result of the findings, the hospital designed an 18-month renewable strategic plan premised on five pillars: (i) human resources development; (ii) improvement of quality of service; (iii) expansion of services and infrastructure renewals; (iv) financial re-engineering and partnership; and (v) appropriate utilization of technology. Through this policy redirection and constant re-evaluation, our quality improvement journey continues to yield desired positive health system outcomes. We recommend collaborative quality improvement initiatives with strong internal political will that can harness both the institution's resources and independent experts on health system development.
Case Report: Recurrent Mpox in a Healthcare Worker in Nigeria
Authors: Ogoina Dimie , Oru Oru Inestol , Yinka-Ogunleye Adesola , Ihekweazu Chikwe , Ndodo Nnaemeka , Aruna Olusola
Published: August 2023

We report the first case of recurrent Mpox from Africa. The patient is a 36-year-old, previously healthy, HIV-negative male healthcare worker who developed two episodes of laboratory-confirmed Mpox in 2017 and 2018, 9 months apart. In both cases, he had prior close contact with confirmed Mpox cases in the hospital setting. On follow-up in 2022, he also reported recurrent postcoital skin eruptions over a previously healed genital scar from the first episode of Mpox. We highlight the need for future studies to investigate the true burden and risk factors for Mpox reinfection, relapse, and recrudescence.
Clinical Presentation of American Tegumentary Leishmaniasis in a Leishmania (Viannia) braziliensis Endemic Hotspot: A 35-Year History
Authors: Almazán María Cristina , Cajal Silvana Pamela , Díaz-Fernández Melisa , Juárez Marisa , Quipildor Marcelo , Portal Guillermo , Tejerina Valeria , Vargas Carlos , Copa Griselda Noemí , Gil José Fernando , Cimino Rubén Oscar , Krolewiecki Alejandro Javier
Published: August 2023

American tegumentary leishmaniasis (ATL) is a neglected tropical disease affecting the skin and mucosa. American tegumentary leishmaniasis due to Leishmania (Viannia) braziliensis is endemic in Argentina, where the Department of Oran is a hyperendemic focus. All cases of ATL with laboratory confirmation evaluated at a referral center in Oran city between 1985 and 2019 were analyzed retrospectively. Information from cases included clinical form, lesion size and number, time of evolution, and anatomical location; sex, age, and geographic origin were also studied. The temporal distribution of cases was analyzed. A total of 3,573 cases were included in the analysis. The ratio of males to females was 3:1 and the median age was 33 years old. Eighty-seven percent of cases were from Oran city and its surroundings, highlighting the hyperendemic nature of the area. Regarding clinical forms, 92.5% of cases were cutaneous and 7.5% were mucosal, with a median evolution time until clinical evaluation of 30 days and 7 months, respectively. Single cutaneous lesions were more frequent, localized mainly on the exposed areas in the upper and lower limbs. Secondary events were observed and described in 140 (4%) cases, with a median interval of 3.8 years for the appearance of recurrent mucosal disease in previously cutaneous forms. This is the largest case series of ATL due to L. (V.) braziliensis. The most classic presentation is of adult males with single cutaneous ulcers in exposed body areas, with < 10% of cases with mucosal complications. This comprehensive clinical characterization serves as a basis for future studies of the care and control of this neglected tropical disease.
Distribution of sialoglycoconjugates – gangliosides and PSA-NCAM in the brain of two venomous snakes
Authors: Viljetić Barbara , Dragun Dario , Labak Irena , Bogdanović Tomislav , Jelić Dušan , Heffer Marija , Kovačić Mislav , Blažetić Senka
Published: August 2023

The Bosnian adder (Vipera berus bosniensis) and the horned viper (Vipera ammodytes) are two venomous snake species with different ecological preferences. The Bosnian adder occurs in a range of habitats and is endemic to the Balkan Peninsula, while the horned viper thrives in dry, rocky areas with little vegetation. The horned viper is best known for its highly venomous venom, making it the most dangerous of the European vipers. The aim of this study was to compare the expression and distribution of complex gangliosides and to identify migratoryzones in the brain of Bosnian adder and horned viper. Immunohistochemistry was performed using specific antibodies for the major brain gangliosides (GM1, GD1a, GD1b, GT1b) and PSA NCAM and analysed in differentbrain regions. Both snake species showed expression of all four complex gangliosides with similar distribution patterns. GD1b was the most prominent ganglioside expressed in all brain structures, while GM1 showed varying distribution between the species. The strongest expression of PSA NCAM was observed in the periventricular zones of the telencephalon, suggesting that these areas are associated with neurogenesis, whereas other regions with lower expression may serve as migratory zones. In addition, it is important to note that the specific distribution of gangliosides and PSA NCAM may be influenced by factors such as brain region, developmental stage, and species-specific characteristics.