bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare case of bilateral Vanishing Testicle Syndrome
Authors: Jayawickreme K. P. , Hashim R. , Antonypillai C. N.
Published: August 2023

Vanishing testicle syndrome (VTS) is due to regression of already formed testes. This could occur at any stage during or after testicular descent due any insult resulting in testicular atrophy. VTS is estimated to affect 1:1250 males. We present a rare case of a 12-year-old boy presenting with absent secondary sexual characteristics and short stature found to have bilateral vanishing testicle syndrome. His testes were impalpable at neonatal examination. At the age of 1.5 years an ultrasound scan detected the right testis in the inguinal ring, measuring 1.5 x 1 cm with features suggestive of ischaemia with likely acute or subacute torsion. The left testes was seen in the inguinal canal already atrophied by that time. Subsequently, on surgical exploration the right testis was found atrophied in the inguinal canal, and was replaced in the right sub-dartose pouch, but left testis could not be identified. Surprisingly, 4 months later laparoscopic exploration failed to identify either of the testes except for bilateral atrophied gubernaculum, indicating testicular regression. At the age of 7 years, magnetic resonance imaging confirmed the absence of either of the testes, with no remnants. On examination his height was 146.5cm, which was between the 25th and 50th percentile for that age, and below his mid-parental height range. He had no androgenic hair growth, testes were impalpable and had a prepubertal penis accounting to tanner stage of 1. He had hypergonadotrophic hypogonadism. Pubertal induction was done with testosterone injections which resulted in height gain and development of secondary sexual characteristics.Introduction: The entity Vanishing testicle syndrome (VTS) was coined by Abryaratne et al. in 1969, and is also referred to as "Testicular regression syndrome" [1][2]. The two essential diagnostic criteria are; visualizing the blind-ending spermatic vessels within the retro-peritoneum or spermatic vessels and vas deferens exiting a closed internal inguinal ring, and Testis not palpated during examination under anaesthesia[2][3]. A small fibrotic nodule or nubbin with dystrophic calcification and haemosiderin deposition is usually found at the end of the spermatic cord, with or without identifiable testicular or para-testicular structures [2][3]. Cryptorchidism is reported in 1 -4.6% full term and 1.1 -45.3% pre-mature male infants [4]. This prevalence of cryptorchidism decreases to 1 % by the age of 1 year [5]. Testes are non-palpable in 10 -20% cases of cryptorchidism, and of these VTS accounts for 35 - 60% [6] VTS occurs in < 5% cases of cryptorchidism [7]. VTS is estimated to affect 1:1250 males [8]. We present a rare case of bilateral VTS in a 12 year old boy who presented with short stature and absent secondary sexual characteristics with unpalpable testes.
Atypical facial pustular folliculitis by Klebsiella pneumoniae: a case report
Authors: Valenti Mario , Cortese Andrea , Facheris Paola , Sacrini Francesco , Narcisi Alessandra , Costanzo Antonio , Mancini Luca
Published: August 2023

Klebsiella pneumoniae is a gram-negative bacterium rarely responsible for skin infections that are often difficult to diagnose. We present the case of an atypical presentation of this particular disease by site, absence of predisposing factors and duration of the condition.
Projected shortfall of 10 million healthcare workers by 2030: implications for low- and middle-income countries and the way forward
Authors: Gulumbe Bashar Haruna , Usman Nazeef Idris
Published: August 2023

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Africa CDC's blueprint to enhance early warning surveillance: accelerating implementation of event-based surveillance in Africa
Authors: Mercy Kyeng , Balajee Arunmozhi , Numbere Tamuno-Wari , Ngere Philip , Simwaba Davie , Kebede Yenew
Published: August 2023

Event-based surveillance (EBS) is a core component of early warning surveillance. In 2018, Africa CDC developed the first edition of an event-based surveillance framework to guide African Union Member States in implementing EBS. Country experiences during the COVID-19 pandemic demonstrated the value of data from non-traditional sources for real time situational awareness; at the same time revealed the huge gaps in strengthening this arm of surveillance. Learning from these lessons and to begin to close those gaps, Africa CDC convened subject matter experts from African Union Member States and technical partners to develop the second edition of the EBS framework, 2023 and its training materials. The revised version includes additional sections such as, the multi-sectoral one health collaboration in EBS, monitoring and evaluation, cross border EBS, and use of event management systems. The current manuscript provides an overview of the 2023 Africa CDC EBS framework and highlights experience in two countries that have successfully employed this resource in their implementation efforts.
Spectrum of Pediatric Endocrine Disorders at the Aminu Kano Teaching Hospital, Kano, Northwestern Nigeria: a five-year review
Authors: Umar Umar Isa
Published: August 2023

In many developing countries, including Nigeria, non-communicable diseases, such as endocrine disorders, are not given much attention because of the enormous burden posed by infectious diseases like malaria, tuberculosis, and other childhood killer diseases. In addition, endocrine disorders are thought to be uncommon due to a lack of specialized screening facilities and trained healthcare professionals to diagnose and manage these endocrine diseases. This study aims at defining the burden of pediatric endocrine disorders (PEDs )in Kano. A review of records of children who presented at the pediatric endocrine unit of Aminu Kano Teaching Hospital with pediatric endocrine disorders from 2018 to 2022 was carried out. A total of 6,314 new pediatric cases were seen during the study period, and 178 of these were pediatric endocrine disorders accounting for 2.8% of the total. The mean age of all the cases at presentation was 6.35±4.95 years, and male to female ratio was 1:1.3. Disorders of endocrine pancreas/lipids metabolism (68/178, 38%) were the commonest, followed by thyroid disorders (23/178, 12.9%) and pubertal disorders (16/178, 9%) respectively. Other disorders seen were calcium, phosphate metabolism, and bone disorders (15/178, 8.4%), syndromes (genetic syndromes/ multiple congenital abnormalities) with endocrine system involvement (13/178, 7.3%), adrenal disorders (10/178, 5.1%) and disorders of energy balance (6/178, 3.4%). More females presented with disorders of the pancreas/lipids, thyroid, precocious puberty, and congenital adrenal hyperplasia. The highest number of cases was seen in the last year of review, while the lowest was in the third year of review. Type 1 diabetes mellitus and disorders involving the thyroid gland, pubertal development, adrenal gland, and bone were the five leading groups of childhood endocrine disorders encountered in our clinical practice at Aminu Kano Teaching Hospital.
Immune regulation of the gut-brain axis and lung-brain axis involved in ischemic stroke
Authors: Xie Xiaodi , Wang Lei , Dong Shanshan , Ge ShanChun , Zhu Ting
Published: August 2023

Local ischemia often causes a series of inflammatory reactions when both brain immune cells and the peripheral immune response are activated. In the human body, the gut and lung are regarded as the key reactional targets that are initiated by brain ischemic attacks. Mucosal microorganisms play an important role in immune regulation and metabolism and affect blood-brain barrier permeability. In addition to the relationship between peripheral organs and central areas and the intestine and lung also interact among each other. Here, we review the molecular and cellular immune mechanisms involved in the pathways of inflammation across the gut-brain axis and lung-brain axis. We found that abnormal intestinal flora, the intestinal microenvironment, lung infection, chronic diseases, and mechanical ventilation can worsen the outcome of ischemic stroke. This review also introduces the influence of the brain on the gut and lungs after stroke, highlighting the bidirectional feedback effect among the gut, lungs, and brain.
MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder
Authors: Martinez Bridget , Peplow Philip V.
Published: August 2023

Inappropriate levels of hyperactivity, impulsivity, and inattention characterize attention deficit hyperactivity disorder, a common childhood-onset neuropsychiatric disorder. The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected, and these symptoms may persist to adulthood if they are not treated. The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing. Treatments for attention deficit hyperactivity disorder in children include medications, behavior therapy, counseling, and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it. There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions, which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated. Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder. The recent studies reviewed had performed microRNA profiling in whole blood, white blood cells, blood plasma, and blood serum of children with attention deficit hyperactivity disorder. A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies. From the studies that had included a validation set of patients and controls, potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p, let-7g-5p, -30e-5p, -223-3p, -142-5p, -486-5p, -151a-3p, -151a-5p, and -126-5p in total white blood cells, and miR-4516, -6090, -4763-3p, -4281, -4466, -101-3p, -130a-3p, -138-5p, -195-5p, and -106b-5p in blood serum. Further studies are warranted with children and adults with attention deficit hyperactivity disorder, and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder. Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.
Astrocytic endothelin-1 overexpression impairs learning and memory ability in ischemic stroke via altered hippocampal neurogenesis and lipid metabolism
Authors: Li Jie , Jiang Wen , Cai Yuefang , Ning Zhenqiu , Zhou Yingying , Wang Chengyi , Chung Sookja Ki , Huang Yan , Sun Jingbo , Deng Minzhen , Zhou Lihua , Cheng Xiao
Published: August 2023

JOURNAL/nrgr/04.03/01300535-202403000-00041/inline-graphic1/v/2023-09-27T141015Z/r/image-tiff

Vascular etiology is the second most prevalent cause of cognitive impairment globally. Endothelin-1, which is produced and secreted by endothelial cells and astrocytes, is implicated in the pathogenesis of stroke. However, the way in which changes in astrocytic endothelin-1 lead to poststroke cognitive deficits following transient middle cerebral artery occlusion is not well understood. Here, using mice in which astrocytic endothelin-1 was overexpressed, we found that the selective overexpression of endothelin-1 by astrocytic cells led to ischemic stroke-related dementia (1 hour of ischemia; 7 days, 28 days, or 3 months of reperfusion). We also revealed that astrocytic endothelin-1 overexpression contributed to the role of neural stem cell proliferation but impaired neurogenesis in the dentate gyrus of the hippocampus after middle cerebral artery occlusion. Comprehensive proteome profiles and western blot analysis confirmed that levels of glial fibrillary acidic protein and peroxiredoxin 6, which were differentially expressed in the brain, were significantly increased in mice with astrocytic endothelin-1 overexpression in comparison with wild-type mice 28 days after ischemic stroke. Moreover, the levels of the enriched differentially expressed proteins were closely related to lipid metabolism, as indicated by Kyoto Encyclopedia of Genes and Genomes pathway analysis. Liquid chromatography-mass spectrometry nontargeted metabolite profiling of brain tissues showed that astrocytic endothelin-1 overexpression altered lipid metabolism products such as glycerol phosphatidylcholine, sphingomyelin, and phosphatidic acid. Overall, this study demonstrates that astrocytic endothelin-1 overexpression can impair hippocampal neurogenesis and that it is correlated with lipid metabolism in poststroke cognitive dysfunction.
Challenges in the Prevention of Surgical Site Infections in India
Authors: Princess Isabella
Published: August 2023

Surgical site infections (SSIs) are health-care-associated infections that burden not only patients undergoing various surgical procedures but the health-care facilities providing care as well. Although preventable, SSIs contribute to complicated and lengthy hospital stays for patients undergoing surgeries, especially in developing countries more than in developed nations. Anticipating and implementing measures to curtail such preventable events in a health-care facility are of utmost importance in providing quality health care. Enhancing and strengthening infection control practices lie in the hands of all health-care workers coming in contact with a patient from the time of admission to discharge. The standard guidelines and protocols are in place by various organizations worldwide on SSI prevention. These guideline-based recommendations are discussed in this review to guide clinicians, microbiologists, infection control specialists, and nurses to excel in safe surgery practices, thereby achieving effective and sustainable patient care. Apart from this, hurdles in our country and ways of handling the same are also discussed.
Study on Intratumoral Heterogeneity of Expression of Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Factor Receptor 2 in Carcinoma Breast
Authors: Uthayasuriyan Ragavi , Jacob Sheba K , Shah Saloni Naresh
Published: August 2023

Aim:

The aim of this study was to study intratumoral heterogeneity in the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) between two different cores/blocks of core needle biopsy (CNB), two different blocks of the same lesion in resection specimen (RS), and in between the CNB and RS.

Materials and Methods:

This is a prospective observational study of all the cases of breast carcinoma received in the department of histopathology for 2 years. All the patients with breast carcinoma diagnosed by CNB and RS were analyzed by three pathologists independently by immunohistochemistry.

Results:

Of the 75 cases, 74 were females and 1 male with a peak incidence of 60–70 years. Invasive breast carcinoma of no special type (97%) was the most common, followed by invasive lobular carcinoma (3%). Grade III tumors (44%) were more common, followed by Grade II (39%) and Grade I (17%). ER and PR showed a concordance rate of 96% ( P < 0.05), whereas the HER2 showed a concordance rate of 93% ( P < 0.05%). The concordance of ER decreased with increasing tumor size and grade, while PR and HER2 showed variable concordance with tumor size and grade.

Conclusion:

The concordance rate of ER and PR (96%) was higher than (93%) HER2. In most cases, biomarker expression in core biopsy and single tumor block was reflective of breast carcinoma as a whole. However, because of the heterogeneous expression of biomarkers, we recommend testing tumors with negative biomarker expression on CNB, again on the RS.
The Prevalence of Nonvenereal Dermatoses in Male External Genitalia: A Hospital-based Study
Authors: Raja S Karthik , Premlal K S
Published: August 2023

Introduction:

Nonvenereal skin diseases are often confused with sexually transmitted diseases. It is responsible not only for the physician's diagnostic dilemma but also for significant patient concerns. Identifying the cause or aggravating factors can save the patient from distress. Therefore, this study was conducted to determine the clinical pattern and prevalence of nongenital diseases.

Methods:

All males attending the dermatology outpatient department in our hospital are included in the study after getting informed consent. Detailed history, including demographic data, chief complaints related to skin, any symptoms in genitalia, drug history, and history of sexual exposures, was recorded.

Results:

The prevalence of nonvenereal genital lesions during the period was 8.2% of patients attending the dermatology department. A total of 21% of nonvenereal genital dermatoses were studied in 82 patients. The most common ones encountered are pearly penile papules and tinea cruris, contributing 19.5% each. Vitiligo is the following most expected condition, involving 13.4% of patients. Among the total 82 patients with nonvenereal genital dermatoses, 65.8% had symptoms in external genitalia, and the rest of the 34.2% of patients did not have any complaints in genitalia.

Conclusion:

Among the 82 patients with nonvenereal dermatoses, 54 (65.85%) had symptoms in external genitalia. The study helped us understand the pattern and clinical characteristics of various nonvenereal genital dermatoses.
Custodiol over cold blood cardioplegia in minimal invasive cardiac valve surgery
Authors: Mohamed Mohamed Nabil , Mohamed Ibrahem Shady Maged Ahmed , Fadala Mohsen Abd-elkerim , Moustafa Moustafa Gamal El-din
Published: August 2023

Background

Custodiol has been used as a multi-organ preservation solution and as cardioplegia in cardiac surgery in several nations, but not elsewhere in the globe. Long procedures can be completed without interruption with just one dosage, which offers myocardial protection for up to three hours.

Objective

This study compared the effects of Custodiol and Cold Blood Cardioplegia on the protection of the myocardium during minimally invasive cardiac valve surgery.

Patients and methods

On 82 patients receiving Custodiol and Cold Blood Cardioplegia during Minimally Invasive Cardiac Valve Surgery, a prospective research was done. The investigation took place between January 2021 and March 2022. There were two groups of patients. There were 41 patients in Group (A) who received Custodiol cardioplegia, and there were 41 patients in Group (B) who received cold blood cardioplegia. The study’s secondary endpoint was the measurement of Left ventricular ejection fraction in serial echocardiograms, whereas the study’s primary result was the detection of increased cardiac enzymes in serial measurements, signifying myocardial damage.

Results

Our data’s statistical analysis revealed that none of the outcomes under investigation exhibited a statistically significant difference between groups.

Conclusion

As determined by CK-MB and EF, a single-dose of antegrade cold custodiol cardioplegia during minimally invasive cardiac surgery is just as effective at preserving the myocardial as repeated antegrade cold blood cardioplegia.
Outcomes of thermal ablation combined with u/s guided foam sclerotherapy in treatment of superficial venous reflux in patients with postphlebitic venous leg ulcer
Authors: Mohamed Mohamed Ismail , ELGaly Mohamed Ahmed , Rady Mohamed Ahmed Hassan , Fakhr Mohamed Emam
Published: August 2023

Background

Venous leg ulcers are a considerable health problem because of their high incidence, slow healing, high recurrence rate, and high cost of treatment. Minimally invasive treatments such as endovenous thermal ablation and foam sclerotherapy proved to be safe and effective. However, there is a paucity in studies focusing on the management of postphlebitic venous ulcers using endovenous thermal ablation of the superficial system in combination with foam sclerotherapy.

Objectives

The aim of our study was to assess the healing time, procedure-related complications and recurrence rate in patients having a postphlebitic venous leg ulcer after being treated with EVLA associated with ultrasound-guided foam sclerotherapy to incompetent perforators with compression therapy.

Subjects and methods

This is a prospective observational study, conducted at Ain Shams University Hospitals and Nasser institute hospital in Cairo on 30 patients presented with postphlebitic venous leg ulcers.

Results

After one year, 90% of cases had a totally healed ulcers, 10% with ulcer decrease in size of more than 50%, and recurrence rate 6.7%. The adverse events of this procedure were DVT (6%), hematoma (6%), ecchymosis (43%), thrombophlebitis (6%), and pain (70%). There was significant improvement of the VCSS as regard pain, edema, inflammation, ulcer size, and number. There was highly significant (P < 0.0001) improvement in the mean (SD) VCSS (preoperative 18 [2.808] vs. postoperative 6.367 [2.3449]).

Conclusion

Patients with totally recanalized deep venous system post deep venous thrombosis, presenting with nonhealing venous leg ulcers, may benefit from thermal ablation of superficial varicose veins combined with ultrasound-guided foam sclerotherapy. This combined approach is a feasible, safe, and effective modality in terms of improved healing rate, low recurrence rate, low complications, and significant improvement in quality of life.
The perioperative challenge of umbilical hernias management in chronic liver disease: a multicentric comparative study
Authors: Khedr Ehab M. , Awad Selmy S. , Asiri Majed , AlThomali Musab , Kaheel Esraa J. , Alkhammash Shumukh , Altalhi Abdullah , Atallah Hashim M. , Alshehri Hamed A. , Al-Amri Nadiah G. , Assmary Zahra'a A. , Alotaibi Abdulaziz F. , Kaabi Manal A. , Alshamrani Abdullah A. , Alzahrani Azzah , Almogathali Malak F. , Salim Abdou , Tarabay Ahmed
Published: August 2023

Background

Umbilical hernias are likely to develop in liver cirrhosis patients with ascites as the disease progresses. It is debatable how to handle cirrhotic patients who have an umbilical hernia. Our goal was to examine the perioperative outcome, safety, and efficacy of surgical management of umbilical hernia in ascitic patients using anatomical repair and intraperitoneal mesh repair.

Methods

180 patients who reported to between June 2017 and September 2022 with umbilical hernias complaints related to chronic liver disease were included in the study and divided into three groups: − Group A (56 cases) 4 instances were lost to followup, Group B (60 cases), and Group C (60 cases).

Results

There was a little difference between cases treated surgically and ones treated conservatively. Typically, child B was involved. In group A, 34 patients (60.7%) experienced solitary or combined problems in total. Of these, 14 candidates (25%) involved strangling, eight (14.3%) involved blockage, and twelve (21.4%) involved leaking hernias. Four instances (6.7%) of seroma, four cases (6.7%) of hematoma, twelve cases (20%) of ascitic leak, 32 cases (53.3%) of recurrence, and four cases (5.6%) of encephalopathy were in group B cases. In group C, there were 16 instances (13.3%) of ascetic leak, 12 cases (20%) of wound infection, 12 cases (20%) of seroma, ten cases (16.7%) of recurrence, and four cases (6.7%) of encephalopathy.

Conclusion

It is advised to do elective treatment for umbilical hernias. mesh reinforcement of abdominal wall hernias is more common as it has a lower risk of hernia recurrence.
Indocyanine green direct injection into gallbladder during laparoscopic cholecystectomy: a safety method to outline biliary anatomy
Authors: Hedaya Mohammed Saied , Ayad Amr Mohamed Abd-Elfatah , Helmy Ayman Salah , Sultan Engy
Published: August 2023

Background

One of the most frequently done operations in digestive surgery is the laparoscopic cholecystectomy (LC). Despite several safety precautions and guidelines, iatrogenic bile duct damage (BDI) during LC still occurs at a very high incidence. Fluorescence of biliary system may minimise surgical difficulties that might emerge owing to unintended harm to the common bile duct.

Methods

We outline a technique for directly injecting Indocyanine Green (ICG) into the gallbladder to clarify the architecture of the cystic duct and common bile duct. Fifty patients who underwent elective laparoscopic cholecystectomy participated in the study, which was a randomised controlled clinical trial. Patients who had intraoperative direct injection of ICG into the gallbladder were chosen at random using closed envelope technique, then using near-infrared fluorescence (NIF) imaging during LC) and controls (who underwent standard LC technique) Twenty five patients in each limb. Patients were studied pre-operative, intraoperative & postoperative. 50 patients in all, 25 of whom received LC with intracholecystic ICG injection, and 25 of whom underwent standard LC without the use of ICG, were included in our study.

Results

ICG dye was successful to delineate extrahepatic biliary anatomy well in 20 cases out of 25, while without ICG, 9 cases out of 25 were without clear delineation of common bile duct intraoperative even if cystic duct was clear enough to avoid complications in both groups . Operative Time average in cases with ICG-assisted LC was 78±15.0 min which was less than the average of time consumed in LC without ICG to dissect cystic duct and visualize critical view of safety, 101±11.87 min

Conclusion

Direct gallbladder ICG infusion enables quick extrahepatic biliary system imaging and clarifies the dissection, increasing protection against BDI and reducing intraoperative dissection time.
Healthy Progeny and Epigenetic Programming an Ayurvedic Perspective
Authors: Geetanjali  , Sabharwal Pooja
Published: August 2023

The ancient concept of Putreshna (healthy progeny) depends on several factors. Every individual is solely responsible for producing a healthy future generation. An inappropriate lifestyle and exposure to unfavorable conditions lead to several diseases. Especially in pregnant women, daily regimen interactions with the environment may cause epigenetic modifications that affect gene expression and change the phenotype or well-being of their progeny. The human body is constituted by what type of nourishment and environment we provide to it. The quality and functioning of every single unit of the body can be improved through a balanced diet (Ahar), sleep (Nidra), and Brahmacharya (Triupstamb). Understanding good morals and thoughts and all pregnant women should protect themself with a healthy lifestyle as mentioned in Garbhini Parichaya. Garbha Samskara is one of the traditional procedures by which parents can avoid the Beeja Dushti or Beejbhag avyav dushti (epigenetic mutation). Garbhini is very much susceptible to disease due to the aggravation of Doshas because the body is in a highly sensitive state, so the use of a balanced diet plays important role in pregnant women for their health and the development of the fetus. Quality and quantity of nutrition directly affect the functioning of the body during the pregnancy period.
Gender Differences in Chronic Musculoskeletal Pain – Role of Kinesiophobia, Acceptance Behaviors, Pain Catastrophizing, and Quality of Life
Authors: Panhale Vrushali P. , Walankar Prachita Pravin , Sayed Mahvish A.
Published: August 2023

Background:

Chronic pain not only has an impact on the daily functioning but also affects the society, family, professional, and social environment, thus disrupting the quality of life. Pain-related characteristics vary between the genders and have an influence on the physical and mental well-being of patients having chronic musculoskeletal pain.

Aim and Objective of the Study:

The aim of study was to assess the gender differences in kinesiophobia, pain catastrophizing, acceptance behaviors, and quality of life in patients with chronic musculoskeletal pain.

Methodology:

A cross-sectional study was conducted in 219 (males = 103 and females = 116) chronic musculoskeletal pain patients. The following parameters were measured: Kinesiophobia using Tampa scale of kinesiophobia; pain catastrophizing using the pain catastrophizing scale; pain acceptance using chronic pain acceptance questionnaire; and quality of life using 36-Item Short Form Health Survey questionnaire.

Results:

No significant differences were observed between genders in kinesiophobia (P = 0.495), pain acceptance (P = 0.539); and pain catastrophizing (P = 0.422). However, a significant difference between genders was observed in quality of life, both physical (P = 0.000) and mental component summary (P = 0.01).

Conclusions:

Kinesiophobia, pain acceptance, and pain catastrophizing showed no difference between the genders in chronic musculoskeletal pain patients. However, women reported lower quality of life as compared to men. Pain-related characteristics and quality of life are important aspects to be evaluated and targeted rehabilitation programs addressing them in chronic musculoskeletal pain.
Association between Clinical and Ultrasound Diagnoses of Aetiologies of vaginal Bleeding in the First Trimester
Authors: Samuel Nkengfua , Saidu Yauba , Abigail Ngalame , Gaetan Kwasseu , Ben-Lawrence Kemah , Edie Halle-Ekane Gregory
Published: August 2023

Introduction:

The prevalence of first-trimester vaginal bleeding (FTVB) ranges worldwide from 4% to 24%. In resource-limited settings, there is a heavy reliance on clinical presentation to establish the cause of bleeding due to the limited availability of ultrasounds (US) imaging modalities.

Objectives:

The objective is to determine the association between clinical and US diagnoses in FTVB at the Buea and Limbe regional hospitals (BRH and LRH).

Subjects and Methods:

We recruited 144 participants, with <14 weeks of gestational age at the BRH and LRH. Data on sociodemographic, clinical, and US diagnoses were obtained from patients. Statistical significance was considered at P < 0.05.

Results:

From 144 participants enrolled, 55 (38.2%) were from BRH and 89 (61.8%) were from LRH. The main causes of FTVB were threatened abortions (42.36%), incomplete abortion (27.8%), complete abortion (3.5%), missed abortion (1.4%), ectopic pregnancy (22.91%), molar pregnancy (0.91%), and pregnancy with fibroids (1.4%). Cohen's kappa analysis revealed a good degree of agreement between clinical and US diagnoses for elective consultations (κ = 0.634, P < 0.001) and an average degree of agreement for those consulting as referrals (κ = 0.520, P < 0.001). Our study revealed a significant statistical association between clinical and US diagnoses for the following pathologies: threatened abortion (P < 0.001), incomplete abortion (P = 0.004), complete abortion (P < 0.019), and ectopic pregnancy (P < 0.001).

Conclusion:

This study reveals an overall average consistency between clinical and US diagnoses, especially for common etiologies of bleeding in early pregnancy. Hence, the need for US to confirm clinical diagnoses.
A Prospective Randomised Study Comparing Transabdominal Pre-Peritoneal Versus Totally Extra-Peritoneal Laparoscopic Approaches for Inguinal Hernia Repair
Authors: Manda Satish Reddy , Philip Sujith , Rajesh C. N. , Sam Sruthy Merry , Varma Deepak
Published: August 2023

Background:

Inguinal hernia repair is one of the most common surgical procedures undertaken in routine surgical practice worldwide. Laparoscopic inguinal hernia repair has now become accepted as a standard method of treatment There are two widely accepted methods of laparoscopic inguinal hernia repair, transabdominal pre-peritoneal (TAPP) and totally extra-peritoneal (TEP).

Materials and Methods:

Our study was a prospective randomised study to compare the outcome of both TAPP and TEP for inguinal hernia repair and included a total of 120 patients who were diagnosed to have inguinal hernia and underwent surgical management electively for the same. They were randomised into both TAPP and TEP groups and the results were compared.

Results:

Amongst the two groups, laparoscopic TAPP repair required more time compared to laparoscopic TEP repair. However, post-operative pain, duration of hospital stays, complication rate and return to normal work did not show any significant difference between the two groups.

Conclusion:

Both laparoscopic TAPP and laparoscopic TEP repair are acceptable and equally efficacious treatment choices for inguinal hernia repair.
An Observational Study to Evaluate the Efficacy of Micronised Purified Flavonoid Fraction in Improving Venous Clinical Severity Score
Authors: Adhip G. , Gopi E. V.
Published: August 2023

Background:

Medical care of chronic venous disease (CVD) entails different strategies that can be used either alone or in combination. Micronised purified flavonoid fractions (MPFFs) are venomodulator drugs used for CVD.

Aim:

In the present study, the efficacy of MPFF in lowering Venous Clinical Severity Scoring (VCSS) for CVD [Clinical, Etiological, Anatomical and Pathological (CEAP) C3 disease] is assessed and identified a subgroup who will benefit from the therapy.

Materials and Methods:

This was an observational study based on 35 cases of CVD CEAP Class C3 attending a tertiary hospital. Their initial VCSS was assessed and the same was reassessed after 6 months of MPFF therapy. The data were statistically analysed.

Results:

The mean age among the study participants was 45.9 ± 9.4 years. Almost half of the study participants, 16 (45.7%), belonged to 41–50 years. More than half of the study participants were female. The median pain score was statistically significantly lower after flavonoid administration compared to baseline (P < 0.001). Similarly, statistically significant lower median oedema and VCSS scores were obtained after flavonoid administration (P < 0.001). However, no significant decrease was observed in the VCSS after flavonoid administration. The median VCSS was statistically significantly lower in females aged 41–50 years after flavonoid administration compared to baseline (P < 0.001).

Conclusion:

MPFFs are efficient in lowering VCSS in CEAP Class C3 cases of CVD in all age groups. The best efficiency was noted in 41–50 years' age group females. Patients with venous pain and venous oedema had the best response. The least response was noted in clinically demonstrable varices.
Dysglycemia and arrhythmias
Authors: Sun Dong-Kun , Zhang Nan , Liu Ying , Qiu Jiu-Chun , Tse Gary , Li Guang-Ping , Roever Leonardo , Liu Tong
Published: August 2023

The incidence of type 2 diabetes mellitus is growing in epidemic proportions and has become one of the most critical public health concerns. Cardiovascular complications associated with diabetes are the leading cause of morbidity and mortality. The cardiovascular diseases that accompany diabetes include angina, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure. Among the various risk factors generated secondary to hyperglycemic situations, advanced glycation end products (AGEs) are one of the important targets for future diagnosis and prevention of diabetes. In the last decade, AGEs have drawn a lot of attention due to their involvement in diabetic patho-physiology. AGEs can be derived exogenously and endogenously through various pathways. These are a nonhomogeneous, chemically diverse group of compounds formed nonenzymatically by condensation between carbonyl groups of reducing sugars and free amino groups of protein, lipids, and nucleic acid. AGEs mediate their pathological effects at the cellular and extracellular levels by multiple pathways. At the cellular level, they activate signaling cascades via the receptor for AGEs and initiate a complex series of intracellular signaling resulting in reactive oxygen species generation, inflammation, cellular proliferation, and fibrosis that may possibly exacerbate the damaging effects on cardiac functions in diabetics. AGEs also cause covalent modifications and cross-linking of serum and extracellular matrix proteins; altering their structure, stability, and functions. Early diagnosis of diabetes may prevent its progression to complications and decrease its associated comorbidities. In the present review, we recapitulate the role of AGEs as a crucial mediator of hyperglycemia-mediated detrimental effects in diabetes-associated complications. Furthermore, this review presents an overview of future perspectives for new therapeutic interventions to ameliorate cardiovascular complications in diabetes.
Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats
Authors: Long Hong , Zhao Lei , Xiao Zhong-Sheng , Li Shu-Xiang , Huang Qiu-Lin , Xiao Shuai , Wu Liang-Liang
Published: August 2023

The incidence of type 2 diabetes mellitus is growing in epidemic proportions and has become one of the most critical public health concerns. Cardiovascular complications associated with diabetes are the leading cause of morbidity and mortality. The cardiovascular diseases that accompany diabetes include angina, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure. Among the various risk factors generated secondary to hyperglycemic situations, advanced glycation end products (AGEs) are one of the important targets for future diagnosis and prevention of diabetes. In the last decade, AGEs have drawn a lot of attention due to their involvement in diabetic patho-physiology. AGEs can be derived exogenously and endogenously through various pathways. These are a nonhomogeneous, chemically diverse group of compounds formed nonenzymatically by condensation between carbonyl groups of reducing sugars and free amino groups of protein, lipids, and nucleic acid. AGEs mediate their pathological effects at the cellular and extracellular levels by multiple pathways. At the cellular level, they activate signaling cascades via the receptor for AGEs and initiate a complex series of intracellular signaling resulting in reactive oxygen species generation, inflammation, cellular proliferation, and fibrosis that may possibly exacerbate the damaging effects on cardiac functions in diabetics. AGEs also cause covalent modifications and cross-linking of serum and extracellular matrix proteins; altering their structure, stability, and functions. Early diagnosis of diabetes may prevent its progression to complications and decrease its associated comorbidities. In the present review, we recapitulate the role of AGEs as a crucial mediator of hyperglycemia-mediated detrimental effects in diabetes-associated complications. Furthermore, this review presents an overview of future perspectives for new therapeutic interventions to ameliorate cardiovascular complications in diabetes.
New environmental factors related to diabetes risk in humans: Emerging bisphenols used in synthesis of plastics
Authors: Moreno-Gómez-Toledano Rafael , Delgado-Marín María , Cook-Calvete Alberto , González-Cucharero Claudia , Alcharani Nunzio , Jiménez-Guirado Beatriz , Hernandez Ignacio , Ramirez-Carracedo Rafael , Tesoro Laura , Botana Laura , Sánchez-Esteban Sandra , Diez-Mata Javier , Zamorano Jose Luis , Bosch Ricardo J. , Zaragoza Carlos , Saura Marta
Published: August 2023

The incidence of type 2 diabetes mellitus is growing in epidemic proportions and has become one of the most critical public health concerns. Cardiovascular complications associated with diabetes are the leading cause of morbidity and mortality. The cardiovascular diseases that accompany diabetes include angina, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure. Among the various risk factors generated secondary to hyperglycemic situations, advanced glycation end products (AGEs) are one of the important targets for future diagnosis and prevention of diabetes. In the last decade, AGEs have drawn a lot of attention due to their involvement in diabetic patho-physiology. AGEs can be derived exogenously and endogenously through various pathways. These are a nonhomogeneous, chemically diverse group of compounds formed nonenzymatically by condensation between carbonyl groups of reducing sugars and free amino groups of protein, lipids, and nucleic acid. AGEs mediate their pathological effects at the cellular and extracellular levels by multiple pathways. At the cellular level, they activate signaling cascades via the receptor for AGEs and initiate a complex series of intracellular signaling resulting in reactive oxygen species generation, inflammation, cellular proliferation, and fibrosis that may possibly exacerbate the damaging effects on cardiac functions in diabetics. AGEs also cause covalent modifications and cross-linking of serum and extracellular matrix proteins; altering their structure, stability, and functions. Early diagnosis of diabetes may prevent its progression to complications and decrease its associated comorbidities. In the present review, we recapitulate the role of AGEs as a crucial mediator of hyperglycemia-mediated detrimental effects in diabetes-associated complications. Furthermore, this review presents an overview of future perspectives for new therapeutic interventions to ameliorate cardiovascular complications in diabetes.
Double Dutch: Illumina/GRAIL, Article 22 and the General Court
Authors: Burnside Alec , Kidane Adam
Published: August 2023

This article explores the jurisdictional issues underlying the decision of the European Commission to review Illumina’s acquisition of GRAIL. It marked the first the time the Commission investigated an acquisition where the target had no activities in the EU; nor indeed any nexus to any individual Member State. The decision to review a concentration where the target had no EU revenues was premised on a re-interpretation of Article 22(1) of the EU Merger Regulation, which allows Member States to request the Commission to examine a concentration. This interpretation is intended to expand the jurisdictional reach of the regulation to capture transactions involving companies with low turnover, but high competitive potential in the internal market, in cases where neither EU nor any Member State merger control thresholds are met. The General Court upheld the Commission’s position on Article 22 jurisdiction, but the judgment is on appeal to the Court of Justice. This article argues that the Court should overturn the earlier ruling on the basis that the GC was mistaken in its approach to Article 22, in view of its history and purpose. It also considers that flaws in the conduct of the procedure which deprived the merging parties of due process warranted an annulment of the decision to open an investigation. Moreover, this article calls out the incompatibility of the Commission’s application of Article 22 in Illumina/GRAIL with international law concepts of comity, fairness and sovereignty.
Woman in the “Feminized” East: Breaking the Wall of Veil with Scheherazade
Authors: DAĞOĞLU Tülay
Published: August 2023

Orientalism is portrayed by Edward Said within the context of how cultural differences have made the West construct an image of the East with the dichotomy of Orient/Occident. Numerous writings have been engendered depicting Eastern culture, tradition, and religion that shaped the West’s perceptions of the East. These writings have revolved around not only ethnicity and religion but also gender, hence leading to the juxtaposition of the dichotomy Orient-Occident with that of feminine-masculine. This alignment has brought forward the most common stereotype pertaining to the place of woman, in other words, the veiled woman which is a predominant symbol of the East. Thus, the East can be said to have been “feminized” by the West. Initiated by the cultural, political, and religious divide between the West and the East, this “feminization” was deepened by ongoing representations of Oriental women by Westerners in the history of Orientalism: how veiled woman has been kept “silence” in the East. Unlike these representations, there is a powerful woman who broke this silence and inspired Oriental women: Scheherazade. Through her stories, Scheherazade encouraged men to look past their own ignorance and biases, recognize the existence and value of women, and encourage women to remove their own veil to demand their rights. In this paper, the aim is to explore how Scheherazade in The Tales of One Thousand and One Nights (The Arabian Nights) inspirited Oriental women through the art of storytelling to fight for emancipation from the engrained stereotypes.
A Study of the Carnivalesque Rebellion of Eve Through Bakhtin’s Notions of the Carnival and the Grotesque Body
Authors: MIZIKYAN Arpine
Published: August 2023

This study aims to explore the grotesque mode of representing the female body and bodily life in John Milton’s Paradise Lost, especially in Book IX, which is regarded to be the key book of the poem: the book of Man’s Fall. My main purpose is to display from a Bakhtinian perspective how the grotesque concept of the female body operates as a considerable way of representing the “monstrous-feminine.” That is, the female, in the character of Eve and in some places, of Sin, in relation to their femininity/maternity, deviates from the norm established by patriarchal male ideology and poses a constant threat to the male order. Predicating upon Bakhtin’s notion of the carnival in its alliance with the grotesque image of the body, I argue that although for Bakhtin, the “bodily element” of the carnival and grotesque realism dwells upon bodies in general and not upon bodies as determined by gender, the grotesque images can be associated with the feminine, particularly with those females who revolt against male domination. Thus, in this particular study, the body of the nonconformist female who stands for a fearful and threatening form of sexuality, will be discussed as “grotesque.” I also contend that in Paradise Lost, Eve, as well as Adam, by tasting the forbidden fruit, embraces a world turned upside down in which the marginalized and suppressed overthrow the order represented by God.
AR-GE PROJESİ SEÇİM PROBLEMİ: CAM SEKTÖRÜNDE BİR UYGULAMA
Authors: DUZDAR ARGUN İrem , ACAR Elif
Published: August 2023

Günümüzde Araştırma Geliştirme projelerinin seçimi, bir şirketin başarısı için en önemli yatırım kararlarından biri haline gelmiştir. Bu çalışmada bir cam üretim firması için en uygun AR-GE proje seçimi, Çok Kriterli Karar Verme yöntemleriyle yapılarak değerlendirme sonucunda fabrika için en ideal alternatif sıralaması yapılması amaçlanmıştır.

AR-GE projelerinin seçim problemi fazla sayıda kriter ve alternatif içrdiğinden karmaşık bir problem olarak değerlendirilmiş ve bu nedenle ÇKKV Yöntemleriyle çözümü ele alınmıştır. Çalışmada kriterlerin ağırlıklarını belirlemek için AHP yöntemi kullanılmıştır. Bulunan değerler alternatiflerin sıralamasında kullanılmış ve sıralamaları yapmak için literatürde sıklıkla rastlanan TOPSIS ve literatür incelendiğinde AR-GE proje seçim çalışmalarında daha önce çözümüne rastlanmamış olan MOORA yöntemi kullanılmıştır. Yöntem sonunda çıkan alternatif sıralamalarını tek bir noktada toplamak ve genel nihai bir sıralamaya ulaşmak için BORDA Sıralama yöntemi kullanılmıştır.

Yapılan çözümler sonucunda 7. alternatif firma için en uygun alternatif olarak görülmüş ve bu aşamadan sonra firmanın ihtiyaç durumuna göre tercih firmaya bırakılmıştır.

Literatür incelendiğinde AHP ve TOPSIS yöntemleri AR-GE proje seçimlerinde sıklıkla kullanılmış fakat cam sektöründe böyle bir çalışmaya rastlanmamıştır. Bu çalışmanın sonucunda Firma çalışmayı devam ettirip bundan sonraki süreçlerde farklı alternatif projeler ile de aynı çözümleme yolunu kullanabilir.