bluuebunny/crossref_metadata_2025 huggingface dataset:
Geoecologia do Monte Roraima: terras altas e terras baixas no extremo Norte da Amazônia Brasileira e Sul da Venezuela
Authors: Vidal Maria Rita , Silva Edson Vicente da , Mascarenhas Abraão Levi dos Santos
Published: July 2022

A Geoecologia caracteriza-se pelo estudo integrado das relações estabelecidas na paisagem, sendo um estudo que leva à determinação das dinâmicas e funcionamento da paisagem. Objetiva-se classificar as paisagens do Monte Roraima e seu entorno (Gran Sabana), cartografando e identificando as funções geoecológicas das unidades delimitadas. As bases metodológicas foram compostas a partir da Geoecologia que possibilitou desenhar o perfil geoecológico. Como resultados, tem-se que a variação da topografia determina os sistemas Terras altas e Terras baixas, nos quais foi possível delimitar 5 unidades que resguardam homogeneidade entre si: a) Topo de montanha com vegetação Pan-tepuyana sobre rochas; b) vertentes com vales em U com vegetação Pan-Tepuyana ombrófila mesotérmica; c) Gran Sabana com colinas e vegetação ombrófila densa; d) Gran Sabana com colinas e vegetação arbustiva; e) Gran Sabana com vegetação herbácea e/ ou solo desnudo. A estrutura metodológica apresentada e o uso combinado de NDVI permitiram delimitar e definir as principais funções geoecológicas para a área, apontando para o estudo de conservação da geodiversidade.
A estrutura da rede das companhias aéreas brasileiras: concentração empresarial e centralização territorial
Authors: Camilo Pereira Ana Paula
Published: July 2022

A estrutura da rede aérea brasileira apresenta-se há décadas configurada de maneira concentrada e centralizada. A concentração se dá em razão da atuação empresarial, que se manifesta pela realização dos voos por três grandes companhias aéreas. A centralização se conforma territorialmente com uma densificação das ligações aéreas nos principais aeroportos da região concentrada do país, rarefazendo-se na medida que se interioriza. Essa relação determina uma rede pouco capilarizada por parte das grandes companhias aéreas e focada em torno daqueles aeroportos que detém potencial de geração de tráfego evidenciando que no Brasil há uma rede de aeroportos consideravelmente extensa, mas organizada de forma polarizada, definindo uma relação com a tendência estrutural da rede urbana brasileira. Assim, o objetivo desse trabalho é apresentar uma abordagem da estrutura da rede aérea brasileira por meio da análise da atuação das companhias aéreas no ano de 2019, buscando com isso salientar o poder territorial das principais companhias aéreas brasileiras que atualmente dividem entre si o mercado aéreo nacional mediante estratégias de operacionalização nos aeroportos de maior potencial de tráfego.
Turismo e reinvenção de tradições: a relação entre marketing turístico e folclorização da cultura na Estrada Real, Brasil
Authors: Dutra Carina Amorim
Published: July 2022

La construction de l'imaginaire du Minas Gerais est fortement influencée par le mode de vie du mineiro. Cette figure folklorique est un intrant pour le tourisme qui, par l’intermédiaire de la « mineiridade », offre l'Estrada Real (ER) au marché. La route est basée sur le cycle de l'or qui aurait construit l'identité politique du gouvernement du Minas Gerais. Au XXe siècle, un glissement se produit du domaine politique au politico-économique, la mineiridade devenant une marchandise touristique. L’ER, expression de l'histoire minière, devient un représentant de la mineiridade. Dans cet article, nous discuterons des relations de pouvoir qui influencent cette appropriation identitaire. L’ER serait-elle capable de fonder de nouveaux territoires touristiques ? L'analyse s'appuie sur le matériel de diffusion de la route et sur des entretiens avec des touristes et l'Institut Estrada Real. Un jeu identitaire combine des paires d'opposés, le passé s'adaptant aux intérêts du présent : méfiant, le mineiro est accueillant ; simple, il peut être sophistiqué – en cas d'intérêt touristique ; charmant par son provincialisme, il est universel. Le local et le global se retrouvent dans la facette d'une mineiridade fluide. Un décalage entre le projet institutionnel, le territoire réel et l'adhésion du touriste à l'ER est évident. L'efficacité du discours identitaire régional est relative.
Comparing shear wave elastography and fine needle aspiration in the diagnosis of solid thyroid nodules
Authors: Naleini Farhad , Pirani Ali , Naseri Rozita , Karami Zahra , Shahpasandi Mohammad Hossein Rashidi , Kamangar Parisa Bahrami , Bakhtiari Negin
Published: July 2022

This descriptive study was performed on individuals who were referred to Imam Reza Hospital for fine needle aspiration biopsy (FNAB) based on the results of gray scale ultrasound and the decision of the referring physician. In addition to determining the gray scale characteristics of the nodules, shear wave elastography (SWE) was also performed and the results were recorded. These were also taken from the patients FNAB results. Finally, the findings of SWE and FNAB methods were compared and analyzed using SPSS software version 16. Based on the results presented herein, a significant relationship was observed between the results of SWE and FNA in the diagnosis of malignancy in solid thyroid nodules. This agreement was found to be higher in men (K = 0.866) than women (K = 0.849). Taken together, our data suggest that shear wave elastography can replace FNA in the diagnosis of malignancy in solid thyroid nodules.
Clinical Profile, Etiology, and Outcome of Acute Pancreatitis
Authors: Patel M. L. , Shyam Radhey , Atam Virendra , Bharti Harish , Sachan Rekha , Parihar Anit
Published: July 2022

Background:

Acute pancreatitis (AP) is an inflammatory process of the pancreas with varying degree of involvement of regional tissues. This was a population-based study on the incidence of AP. We aimed to determine the incidence, etiology, and outcome of AP.

Materials and Methodology:

This prospective study was conducted in the Department of Medicine, King George's Medical University, Lucknow, India, on 120 patients of AP. Clinical history, examination, and laboratory investigations were done. Severity of AP was assessed using the modified Atlanta classification.

Results:

A total of 120 patients comprising of 88 men (73.33%) and 32 women (26.66%) were recruited. The mean age of study participant was 36.96 ± 13.44 years. The most common presentation was abdominal pain followed by vomiting. The leading etiological factors were alcohol in 85 patients (70.8%) and gallstones in 25 (20.8%). It was idiopathic 5 patients (4.1%). Mortality was seen in three (2.5%) patients, all of which had severe pancreatitis. Patients with body mass index (BMI) ≥25 kg/m2, Hematocrit (HCT) ≥44% and C-reactive protein (CRP) ≥150 mg/l had an increased risk of developing a severe AP.

Conclusions:

Alcohol and gallstones were the most common etiological factors of AP, whereas HCT, CRP, and BMI were the useful predictors of severe pancreatitis.
Chemotherapy-Associated Nausea and Vomiting
Authors: Manyega Kelvin Mogesa , Joseph Benjamin Nasara , Rotkangmwa Okunlola Charity , Dapar Maxwell P.
Published: July 2022

Background:

The management patterns for chemotherapy-associated nausea and vomiting (CANV) in Sub-Saharan African settings have not been previously reported. The objectives of this study were to describe the prescribing pattern of antiemetics for CANV, to assess their adherence to guidelines, and to determine the occurrence of CANV.

Subjects and Methods:

This was a cross-sectional study, with data extracted from the records of adult patients who received chemotherapy from 2015 to 2018 at Jos University Teaching Hospital, Nigeria. The National Comprehensive Cancer Network Harmonized Guidelines™ for Sub-Saharan Africa for Antiemesis Version 3.2018 was used to determine the extent of guideline adherence.

Results:

Records of 165 patients were analyzed. Majority of the patients (76.4%, n = 126) received moderate-to-high emetic risk intravenous (IV) chemotherapy. Out of 129 antiemetic prescriptions for acute-phase prophylaxis, ondansetron (75.2%), corticosteroids (61.2%), and promethazine (24.8%) were the most prescribed agents. In the delayed phase, 50 patients received prophylactic antiemetics in the order of corticosteroids, ondansetron, and promethazine at 74%, 34%, and 26%, respectively. Guideline adherence was low for the acute-phase (23.6%), delayed-phase (20.6%), and overall period (17.6%). Among inpatients (n = 85), occurrences of nausea were negligible, whereas acute vomiting (9%) and delayed vomiting (15%) levels were considerable. Not receiving highly emetogenic IV chemotherapy was associated with significantly lower odds for nausea or vomiting occurrence, odds ratio 0.228 (95% confidence interval 0.054–0.967).

Conclusions:

Antiemetic guideline adherence was low due to antiemetic under-prescribing. A few nausea and vomiting events were recorded predominantly among patients who received highly emetogenic IV chemotherapy.
Clinical outcome of endoscopic balloon dilatations employed in benign paediatric oesophageal pathologies
Authors: Durakbasa Cigdem Ulukaya , Ersoy Furkan , Pirim Ahmet , Oskayli Meltem Caglar
Published: July 2022

Background:

Oesophageal dilatations can be done either by bougies or balloons for differing aetiologies in children. We investigated the efficacy and safety of endoscopic balloon dilatations (EBDs) employed by a single surgeon.

Patients and Methods:

Relevant data over 12 years were retrospectively evaluated with an ethical committee approval.

Results:

Ninety-seven children underwent 514 EBD with a median EBD of 3 (1–50). The primary diagnoses were oesophageal atresia (OA) in 51 children, corrosive ingestion in 21, peptic strictures in 13, achalasia in 8 and congenital oesophageal stenosis in 4. The balloon size varied between 3 and 30 mm. The EBD was successfully ended in 72 patients and unsuccessful in six patients. Six children are still under EBD and 13 are lost to follow-up. The overall success rate was 92%. The age at the time of first dilatation was the youngest in OA group followed by corrosive strictures. The balloon sizes differed regarding the age of the patients with larger balloons used as the patient age increased. The sizes of the balloons used at the first and the last EBD differed among diagnostic groups. The total number of dilatations or the time interval between the first and the last EBD dilatation did not show a statistically significant difference among groups. The anatomical type of OA or the height of corrosive stricture revealed no significant difference in any of the above parameters. A transmural oesophageal perforation occurred during 2 (0.4%) EBD sessions.

Conclusions:

EBD is an effective mean in relieving paediatric oesophageal pathologies with a variety of aetiologies and has a low complication rate.
Psychological stress among anesthesia residents during COVID-19 pandemic and how to mitigate them
Authors: Ahuja Vanita , Nair Lekshmi V. , Das Subhash , Sandhu Sukhman
Published: July 2022

The impact of the novel coronavirus disease 19 (COVID-19) has overburdened the anesthesia fraternity both physically and mentally. The academic and training schedule of the medical residents in the last year was also disrupted. Since we are in the early phase of the second peak of the COVID-19 pandemic, it is time to reconsider the causes of stress in anesthesia residents and methods to mitigate them. In this non-systematic review, authors have included articles from PubMed, Medline, and Google scholar with keywords “identify strategies” “preventing and treating psychological disorders,” and “medical students” from year 2010 onwards were included. Apart from these keywords, we have included the coping strategies and early psychiatric consultation methods. This review article aims at early identification, workplace environment changes, and implementation of early coping strategies in anesthesia residents during this second peak of COVID-19.
Physiological effect of prone positioning in mechanically ventilated SARS-CoV-2- infected patients with severe ARDS: An observational study
Authors: Roy Avishek , Behera Srikant , Pande Aparna , Bhattacharjee Anirban , Bhattacharyya Amrita , Baidya Dalim K. , Anand Rahul K. , Ray Bikash R. , Subramaniam Rajeshwari , Maitra Souvik
Published: July 2022

Background and Aims:

Mechanical ventilation in prone position was associated with a reduction in mortality and increase in arterial oxygenation in acute respiratory distress syndrome (ARDS) patients. However, physiological effects of prone position in COVID ARDS patients are unknown.

Material and Methods:

In this prospective observational study, data of n = 47 consecutive real time RT- PCR confirmed SARS-CoV-2-infected patients with severe ARDS were included. Respiratory mechanics and oxygenation data of recruited patients were collected before and after prone position.

Results:

Median (Interquartile range, IQR) age of the recruited patients was 60 (50–67) years and median (IQR) PaO2/FiO2 ratio of 61.2 (54–80) mm Hg with application of median (IQR) positive end expiratory pressure (PEEP) of 12 (10–14) cm H2O before initiation of prone position. Out of those patients, 36 (77%) were prone responders at 16 hours after prone session, evident by increase of PaO2 by at least 20 mm Hg or by 20% as compared to baseline, and 73% patients were sustained responders (after returning to supine position). Plateau airway pressure (p < 0.0001), peak airway pressure (p < 0.0001), and driving pressure (p < 0.0001) were significantly reduced in prone position, and static compliance (p = 0.001), PaO2/FiO2 ratio (p < 0.0001), PaO2 (p = 0.0002), and SpO2 (p = 0.0004) were increased at 4 hours and 16 hours since prone position and also after returning to supine position.

Conclusion:

In SARS-CoV-2-infected patients, mechanical ventilation in prone position is associated with improvement in lung compliance and oxygenation in almost three-fourth of the patients and persisted in supine position in more than 70% of the patients.
Prone cardiopulmonary resuscitation: Relevance in current times
Authors: Bhatia Nidhi , Yaddanapudi Sandhya , Aditya Ashish S.
Published: July 2022

The most common and recommended position for performing cardiopulmonary resuscitation (CPR) is the supine position. However, clinicians may encounter situations when patients suffer cardiac arrest in prone position. Prone CPR has been described previously in a number of settings, most commonly intraoperative. In the current COVID-19 era, with more patients being nursed in prone position, an increase in the incidence of cardiac arrests requiring prone CPR is expected. Hence most of the resuscitation guidelines have made prone CPR a vital component of their recommendations. To date, most of our health-care workers have limited knowledge about prone resuscitation and the literature surrounding it. Nonetheless, with the current evidence at hand, it seems to be a reliable method of providing resuscitation and all health-care workers should be well versed with it. Thus, the goal of this narrative review is to try and fill the gaps in our knowledge about prone CPR. Literature search was done on PubMed, Medline, EMBASE using keywords ‘CPR’, ‘Resuscitation’, ‘Prone Position’, ‘Prone’, ‘Prone CPR’.
Use of rotational thromboelastometry to predict the outcome of COVID-19 patients: A retrospective observational study
Authors: Kamal Manoj , Hariprasad R , Bhatia Pradeep K. , Misra Sanjeev , Sharma Praveen , Garg Mahendra K. , Kothari Nikhil , Gupta Manoj , Singariya Geeta
Published: July 2022

Background and Aims:

The hypercoagulability occurring in COVID-19 patients is detected only by Rotational thromboelastometry (ROTEM). However, the benefit of performing ROTEM in the management of disease and predicting the outcome of COVID-19 patients is yet to be established.

Material and Methods:

The data of 23 critically ill and 11 stable COVID-19 adult patients were extracted from the hospital information system admitted between July and August 2020 and patient charts and analyzed retrospectively. The critically ill patients were divided as a survivor and non-survivor groups. The Intrinsic pathway part of ROTEM (INTEM) and Fibrinogen part of ROTEM (FIBTEM) were performed on day 0 for both critically ill and stable patients, and on day 10 for critically ill patients. The statistical package for social science (SPSS) version 26 was used for statistical analysis.

Results:

The median FIBTEM amplitude at 5 min (A5) and maximum clot firmness (MCF) were elevated in both stable and critically ill patients (24 vs 27 mm, P = 0.46 and 27.5 vs 40 mm, P = 0.011) with a significant difference in FIBTEM MCF. But there was no significant difference between number of survivors and non-survivors with FIBTEM MCF >25 at day 0 and day 10.

Conclusion:

The Hypercoagulability state as detected by ROTEM parameters at day 0 and day 10 had no association with the outcome (mortality) of critically ill COVID-19 patients. Hence it cannot be used as a prognostic test. The increasing age, comorbidities and D-dimer values were associated with a poor prognosis in COVID-19 patients.
Low-volume ultrasound-guided supraclavicular block in a multicomorbid patient for emergency vascular surgery – In COVID-19 era
Authors: Lonikar Abhishek V. , Diwan Sandeep M. , Sancheti Parag K.
Published: July 2022

Supraclavicular block is the most commonly used block in upper limb surgeries, right from the day it was introduced into clinical practice in Germany by Kulenkampff in 1911. The block underwent many changes in its application due to the advent of peripheral nerve stimulator and ultrasonographic application in regional anesthesia. This case report focuses on supraclavicular block’s application in a multicomorbid patient, the drug dose required, and how the scope of regional anesthesia can be extended in times of pandemic, like coronavirus disease 2019 (COVID-19), in coming future.
Anesthesia management in a post Covid-19 obstetric patient-What we need to know
Authors: Bajwa Sukhminder J. S. , Sharma Ridhima , Kurdi Madhuri S. , Katikar Manisha , Bajwa Sukhwinder K. , Choudhary Ripon
Published: July 2022

The outbreak of the coronavirus disease (COVID)-19 pandemic has led to unprecedented challenges globally. At the outset of the receding second wave and third wave of COVID-19, many patients who have recovered from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are coming for elective/emergency surgery. This demands a noteworthy emphasis on the post-COVID-19 obstetric patients. The administration of quality and safe obstetric anesthesia are quite challenging in this mentioned subset due to the overlap of signs and symptoms of COVID-19 with the constitutional signs and symptoms of pregnancy. The physiological changes in normal pregnancy and vascular, metabolic alterations in high-risk pregnancy may affect or exacerbate the pathogenesis or clinical presentation of COVID-19, respectively. This article highlights the specific concerns in recovered COVID-19 pregnant patients with associated comorbidity posted for surgery and their repercussions on anesthesia management.
Analysis of trimodal pattern of mortality among hospitalized COVID-19 patients- Lessons from tertiary care hospital
Authors: Paul Gunchan , Gautam Parshotam Lal , Sharma Shruti , Kumar Jeevan , Gupta Apoorva , Sharma Mukul , Khehra Akashdeep Singh , Paul Birinder S. , Mohan Bishav
Published: July 2022

Background and Aims:

Many patients with COVID-19 become critically ill and requireICU admission. Risk factors associated with mortality have been studied, but this study provides insight regarding disease progression and hence help to plan rescue strategies to improve patient outcome.

Material and Methods:

This retrospective, observational study included all patients with diagnosis of COVID-19 from March1 to June30,2021 who died in hospital.

Results:

During the study period, 1600 patients were admitted, with 1138 (71%) needing ICU care. There were 346 (21.6%) deaths, distributed as 15.8%(n = 55) within 48h of admission, 46.2%(n = 160) in next 10 days, and 37.8%(n = 131) thereafter. This trimodal mortality pattern of distribution was similar to polytrauma patients. Patients were divided into categories according to time duration from admission to death. In our cohort, 235 (14.7%) patients required mechanical ventilation, with a mortality of 85.4%(n = 201). Tachypnea was significantly (P < 0.001) associated with death at all times; however, hypotension was associated with early death and low oxygen saturation with poor outcome upto 10 days (P < 0.001). Refractory hypoxia was cause of death in all three groups, while other causes in group II were AKI (28%), sepsis (18%), and MODS (10%). Group III patients had different causes of mortality, including barotrauma (9%), pulmonary thromboembolism (8%), refractory hypercarbia (12%), MODS (13%), AKI (10%), sepsis (7%), and cardiac events (6%).

Conclusion:

While physiological dearrangements are associated with rapid progression and early death, complications related to hyper-coagulable state, lung injury, and organ failure lead to death later. Providing quality care to a high volume of patients is a challenge for all, but posthoc analysis such as air crash investigation can help find out potential areas of improvement and contribute to better outcomes and mortality reduction.
Anxiety and Depression among Caregivers of the Children with Thalassemia, Attending at Thalassemia Control Unit of a Rural Tertiary Care Medical College, Darjeeling, West Bengal
Authors: Bhandari Kallol , Gazi Eashin , Mandal Bidhan Chandra , Saha Tushar Kanti
Published: July 2022

Background of Study:

Caregivers of the children with thalassemia often experienced a life with varied degree of anxiety and depression due the chronic illness like of their children. Mothers as the main caregivers for most of the thalassemic children suffers with different forms of psychological problems.

Objectives:

The aim of this study was to assess the levels of anxiety and depression of the caregivers of children with Thalassemia and also to find out sociodemographic factors associated with their anxiety and depression.

Materials and Methods:

Descriptive cross-sectional study conducted in Thalassemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Complete enumeration method was used to include 136 caregivers of children (≤12 years) with thalassemia. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) was used to assess the levels of anxiety and depression. Collected data were entered into MS-Excel and analyzed by using SPSS software program, version 22.0.

Results:

Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (54.4%) had moderate depression followed by 30.1% with mild mood disturbances. Majority (69.9%) of the study participants had mild anxiety and 30.1% moderate anxiety. The median (IQR) of BDI score was 21(23–18) and median (IQR) of BAI score was 20(22–18).

Conclusions:

Early counseling, psychotherapy, appropriate treatment should be prioritized. Social support, community involvement with their full participation should be emphasized.
Dietary Pattern Assessment and Body Composition Analysis of Adult Patients with Type 2 Diabetes Mellitus Attending Diabetes and Endocrine Center in Mirjan Teaching Hospital, Babil / 2021
Authors: Al-Bayati Hayder F. , Al-Diwan Jawad K.
Published: July 2022

Background:

Type 2 diabetes mellitus is an array of dysfunctions characterized by hyperglycemia resulting from a combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion; it accounts for 90–95% of all adults. Poor glycemic control is associated with complications of diabetes, and it could be avoided by good diabetic control, where different factors such as age, gender, obesity, exercise, and education have been reported to be associated with poor control in different settings.

Objectives:

This study showed the relation of some body compositions and intake of certain food items as assessed by a 24-h dietary recall and glycemic control among the study groups.

Materials and Methods:

A cross-sectional study has been conducted on 60 type 2 diabetes patients attending Diabetes and Endocrine Diseases Center in Mirjan Teaching Hospital in Babil, sociodemographic characteristics being studied, glycemic control of patients was studied according to their HbA1c. Glycemic control was studied among patients concerning some anthropometric measures; all these were measured with the aid of an InBody device, which was used in this study. Diet was investigated among the study group by using the 24-h dietary recall method to investigate the relationship between certain food being eaten and glycemic control. Glycemic control was studied among patients in relation to the glycemic index (GI) of foods eaten.

Results:

Sociodemographic characteristics showed that type 2 diabetes was higher among people in age group between 40 and 60 years with mean age 54.75 ± 10.2 years, male gender, urban residents, married people, housewives, and people with secondary and higher education. Regarding glycemic control rate, 75% patients had poor control and 25% had good control. Poor glycemic control was statistically significant with waist circumference (P = .010 for males and P = .003 for females), waist-to-hip ratio (P = .031 for males and P = .008 for females), and percentage of body fat (P = .002 for males only). There was a statistically significant association between starch and refined grain intake (P = .000) and added sugar and other sweetened beverages (P = .003), and glycemic control but no statistical association with vegetables, fruits, and milk and its products. Glycemic control was highly statistically significant with the intake of foods with a high GI (P = .000).
Strengthening the Delivery of Feedback in Medical Institutions by Establishing Feedback Culture
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: July 2022

The training imparted to medical students is quite vast and complex, and a lot is expected from them at the end of the overall training. Considering that each student differs from another, it is important to understand that a number of approaches should be adopted to ensure that they continue to learn. Feedback is an integral component of the medical education delivery process and it aids the students as well as teachers in performing better while discharging their roles. Even though the feedback carries immense significance in the teaching–learning or assessment process, it is not being widely practiced in different settings. In order to ensure successful implementation of a feedback culture, we have to pay attention to three interdependent aspects, namely the teacher, the student, and the environment. To conclude, feedback is an essential tool to facilitate learning among medical students. However, this will essentially require us to establish a culture of giving feedback to students in the medical institution and capitalize on each of the learning opportunities for the benefit of students and teachers.
Association between Gestational Hypertension and Preeclampsia with Spontaneous Prelabor Rupture of Membrane
Authors: Wenas Amal Faraj , Al-Massawi Helema Yasser
Published: July 2022

Background:

Hypertensive disorders of pregnancy constitute one of the leading causes of maternal and perinatal mortality worldwide. Prelabor (premature) rupture of membranes (PROM) occurs in 10% of all pregnancies, of which 7%–8% occur after 37–42 weeks.

Aim of the Study:

The aim of the study was to investigate the association between gestational hypertension and preeclampsia with the risk of spontaneous PROM.

Materials and Methods:

This is a case-control study; 150 pregnant women with gestational age ≥20 weeks were included in this study. Eligible women were divided into three equal groups: 50 pregnant women with preeclampsia, 50 pregnant women with gestational hypertension, and 50 normotensive pregnant women. In addition, the risk of spontaneous PROM was assessed among these groups.

Results:

This study shows that 52% was primigravida in the preeclampsia group, whereas 26% in the gestational hypertension group and 38% in the normotensive group; this was statistically significant. Regarding the gestational age, 88% were full term in the preeclampsia group, 94% in the gestational hypertension, and 94% in the normotensive; there was no significant difference among the three study groups. In the preeclampsia group, seven (14%) have PROM with no significant association, whereas in the gestational hypertension group, 19 (38%) have PROM, which was statistically significant. In the normotensive group, 18 (36%) have PROM, which is also significant. The risk of PROM between each study group was compared: there was significant difference between percentages when comparing the normotensive group with the preeclampsia group (more percentage of PROM among the normotensive) and highly significant difference when comparing the gestational hypertensive group with the preeclampsia group.

Conclusion:

In this study, we concluded that gestational hypertension is associated with the risk of PROM, and preeclampsia is not associated with the risk of PROM.
Hypothyroidism in Paediatric Patients with Prader-Willi Syndrome; Regular Monitoring is Recommended
Authors: Alsaffar Hussain , Abdullah Wasnaa Hadi , Hussein Sawsan Ali
Published: July 2022

Prader-Willi syndrome (PWS) is a genetic disorder described by multifaceted clinical features with implications on the endocrine system, metabolism, and behavior. Some symptoms of PWS syndrome can be confused with the relative clinical aspects of hypothyroidism, such as lethargy, muscular hypotonia, and poor sucking ability. In this review, we would like to enlighten the importance of checking thyroid function in PWS patients at birth, at least annually, in those on growth hormone (GH) treatment, in any child of PWS with growth failure, and in those in whom there is an insufficient response to GH therapy, to ensure that any aberrant thyroid function is not overlooked and adequately treated.
Changes in Coagulation Status in Patients with β-Thalassemia in Iraq
Authors: Wadaha Hussein Abdalzehra , Meshay Hassan Dede , Khamees Mohammed Haseeb
Published: July 2022

Background:

The pathogenesis β-thalassemia is characterized by anemia resulting from reduced β-globin synthesis with low hemoglobin A (HbA) production and higher production of hemoglobin A2 (HbA2) and fetal hemoglobin (HbF). However, thromboembolic events have been recently identified in patients with β-thalassemia due to hypercoagulable state.

Objectives:

The aim of this study was to evaluate the levels of some coagulation markers in Iraqi patients with β-thalassemia major and β-thalassemia intermedia.

Materials and Methods:

The study included three groups. The first group included patients with β-thalassemia major (n = 39), the second group included patients with β-thalassemia intermedia (n = 11), and third group included 20 apparently healthy control subjects. Each of prothrombin time (PT), activated partial thromboplastin time (APTT), antithrombin III (ATIII), and thrombin-antithrombin III (TAT) complex were measured according to the standard protocols.

Results:

Both PT and APTT in β-thalassemia major and β-thalassemia intermedia were higher than that of the control group with a highly significant difference (P = 0.002), whereas no significant differences were observed between patients with β-thalassemia major and β-thalassemia intermedia. Mean ATIII level was highest in the control group followed by β-thalassemia intermedia and then by β-thalassemia major groups (P < 0.001), whereas mean TAT complex was highest in thalassemia major group followed by β-thalassemia intermedia and then by control groups (P < 0.001).

Conclusions:

Prolonged PT and APTT in patients with β-thalassemia together with the reduction in the level of anticoagulant factor (ATII) suggest a role for liver impairment; however, the significantly higher TAT complex is suggestive of ongoing activation of coagulation cascade in patients with β-thalassemia.
Iatrogenic Aortic Dissection
Authors: Al-Gburi Abdulameer Jasim Jawad
Published: July 2022

Acute aortic dissection (Stanford Type A) is a life-threatening medical emergency associated with a high rate of early mortality (57 percent) without surgical intervention. During coronary catheterization, it occurs at a rate of 0.02 percent to 0.06 percent. There are no clear guidelines regarding the optimal management of this fatal condition. The critical importance of preventing dissection propagation by stenting the dissection's entrance in the coronary artery had been emphasized in prior review articles. Iatrogenic aortic dissections that do not involve the coronary arteries can be managed conservatively and closely followed-up with repeated imaging.
Hypersensitivity Reactions to Liposomal Amphotericin in a Bone Marrow Transplant Patient
Authors: Alsajri Alaa Hussein , Al-Hishma Shadan Waleed , Shubber Mazin Abbas
Published: July 2022

Introduction:

Hodgkin's lymphoma is one of the treatable types of blood cancer. Autologous bone marrow transplantation is used as one way to treat this disease. Neutropenic fevers are treated with antibiotics and antifungals, including amphotericin B. Adverse effects and hypersensitivity to liposomal amphotericin, Ambisome, are very uncommon compared with conventional amphotericin.

Case Report:

In this case, we noticed hypersensitivity reactions to the Ambisome, represented by an increase in body temperature, a drop in blood pressure, and hypo-oxygenemia, in addition to an increase in the heart rate.

Case Management:

The patient was treated with injections of hydrocortisone, chlorpheniramine, and normal saline, in addition to giving oxygen; he was improved.

Conclusion:

In spite of the few cases that have recorded hypersensitivity reactions to the Ambisome, it is necessary to conduct an allergy test and to monitor the patient well when giving the Ambisome, especially in the first dose.
Intracapsular Total Thyroidectomy Experience and Outcome for Benign Thyroid Diseases
Authors: Safi Mohammad Abbas , Alhelfy Sajid Hameed
Published: July 2022

Background:

The total intracapsular thyroidectomy is a new procedure that removes all the thyroid tissue for benign thyroid diseases and two third of thyroid capsule with better intraoperative and post-operative consequences and less operative time than the capsular dissection and no recurrence rate of goiter or Graves’ disease that was detected during the follow up period.

Objectives:

To evaluate the outcome of total intracapsular thyroidectomy of benign thyroid diseases in term of safety and efficacy.

Patients and Methods:

This is a prospective descriptive study carried out in department of general surgery including a total of 80 patients with benign thyroid disease who underwent intracapsular total thyroidectomy. Patients were followed up for 6 months to 3 years with a median of 41.4 months for postoperative complications.

Results:

The mean age of the patients was 42.72 ± 8.12 years. The majority of patients were females (87.5%). The study showed that 97.5 % of the patient had no intraoperative complications. Postoperatively, only 4 patients (5%) developed complications. The mean operative time and blood loss was 71.78 ± 9.32 min and 82.8 ± 32.5 ml, respectively.

Conclusion:

The total intracapsular thyroidectomy is new procedure and more sophisticated than other operation types to treat benign thyroid disease. However, it is safe and efficient.
Capturing Racial & Gender Inequities on Social Media Platforms using Machine Learning
Authors: Malik Sonika , Chopra Harshita , Vashishtha Aniket
Published: July 2022

Online social media platforms provide a continuously evolving database due to the highly increasing popularity and rapid expansion of its user base. Users share their life experiences towards various inequity incidents faced at the workplace on the basis of their race or gender on these platforms while maintaining their anonymity. We aim at utilising famous social media platforms to perform extensive analysis and classification tasks for posts capturing instances of various types of Inequalities prevalent in today’s workplace. We present a framework to mine opinions expressed towards sexual harassment, mental health, racial injustice and gender-based bias in the corporate workplace using NLP techniques on social media data. The documents are represented by semantic similarity to aspect embedding’s captured using an attention-based framework for aspect extraction. In addition, we used scores from Empath categories to add information related to emotional facets.
Picard modular forms and the cohomology of local systems on a Picard modular surface
Authors: Bergström Jonas , van der Geer Gerard
Published: July 2022

We formulate a detailed conjectural Eichler–Shimura type formula for the cohomology of local systems on a Picard modular surface associated to the group of unitary similitudes

\operatorname{GU}(2,1, \mathbb{Q}(\sqrt{-3}))

. The formula is based on counting points over finite fields on curves of genus three which are cyclic triple covers of the projective line. Assuming the conjecture we are able to calculate traces of Hecke operators on spaces of Picard modular forms. We provide ample evidence for the conjectural formula.

Along the way we prove new results on characteristic polynomials of Frobenius acting on the first cohomology group of cyclic triple covers of any genus, dimension formulas for spaces of Picard modular forms and formulas for the numerical Euler characteristics of the local systems.
Ahlfors regular conformal dimension of metrics on infinite graphs and spectral dimension of the associated random walks
Authors: Sasaya Kôhei
Published: July 2022

Quasisymmetry is a well-studied property of homeomorphisms between metric spaces, and the Ahlfors regular conformal dimension is a quasisymmetric invariant. In the present paper, we consider the Ahlfors regular conformal dimension of metrics on infinite graphs, and show that this notion coincides with the critical exponent of

p

-energies. Moreover, we give a relation between the Ahlfors regular conformal dimension and the spectral dimension of a graph.
Blood lipid levels and all-cause mortality in older adults: the Chinese Longitudinal Healthy Longevity Survey 2008-2018
Authors: Wang Rongxi , Yu Xiaoyue , Wang Zhiqiang , Liu Yujie , Chen Hui , Liu Shangbin , Xu Chen , Chen Yingjie , Ge Xin , Xia Danni , Chang Ruijie , Xu Gang , Xiang Mi , Wang Ying , Shen Tian , Hu Fan , Cai Yong
Published: July 2022

OBJECTIVES: Proper blood lipid levels are essential for survival in older adults, but inconsistent relationships have been reported between blood lipids and all-cause mortality in the elderly.METHODS: This retrospective longitudinal study analyzed data from 1,067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey collected in 2008 and followed up until death or December 31, 2018. The outcome was all-cause mortality. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with stratification by age (60-80, 80-100, or ≥100 years) for further analysis. The survival probability according to lipid profile quartiles was calculated using Kaplan-Meier curves and the log-rank test.RESULTS: The participants’ mean age was 84.84 years, and 57.0% were female. In total, 578 individuals died, and 277 were lost to follow-up. The mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were higher among those who died than among those who survived. Participants in the second HDL-C quartile and the highest LDL-C and triglyceride (TG) quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality, respectively. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99, respectively).CONCLUSIONS: Older adults should maintain an LDL-C level of 1.91-2.47 mmol/L and a TG level of no less than 1.66 mmol/L.
Medical cannabis and cannabidiol: A new harvest for Malawi
Authors: Bandawe Gama
Published: July 2022

In February 2020 parliament passed the Cannabis Regulation Bill (2020) which regulates the cultivation and production of industrial hemp and medical cannabis. The country will only fully benefit from this development if the medical and scientific community can take the lead in enabling the country to exploit the plant’s potential to help address some of our economic and public health challenges. This special communication provides some basic information on cannabis and discusses its history and medical uses. Cannabidiol (CBD) has emerged as one of the most important cannabis-derived phytochemicals and has formed the basis for the growth of the medical cannabis industry. The scientific data on the mechanisms of the effects of CBD on the human neuroendocrine-immune network is reviewed and the first effective cannabis-based FDA-approved treatment for epilepsy discussed. Some clinical research that is being done on the antipsychotic and neuroprotective properties of CBD is also reviewed. A case is made for the potential of CBD as a neuroprotective adjunctive therapy for the prevention of neuropsychological sequelae associated with complicated malaria. The safety profile of CBD is reviewed and finally, the potential importance of the re-medicalization of cannabis-based therapies for the broader field of phytomedicine is pointed out
Prevalence and correlates of common mental disorders among children and adolescents in Blantyre-Urban, Malawi
Authors: Matandika Ian , Mategula Donnie , Kasenda Stephen , Adeniyi Yetunde , Muula Adamson
Published: July 2022

BackgroundThe high global prevalence of mental disorders justifies the need to quantify their burden in the sub-Saharan Africa where there is a dearth of information. These mental disorders are linked to different socio-demographic factors.ObjectiveTo determine the prevalence of, and factors associated with mental disorders among children and adolescents in Blantyre City, Malawi.Methods

Children and adolescents aged 6 to 17 years were interviewed to determine their socio-demographic characteristics and assess their mental health status using the Strengths and Difficulties Questionnaire (SDQ) and Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Associations between mental disorders and socio-demographic characteristics were tested using Chi-square and logistic regression analysis.ResultsThe prevalence of symptoms of psychopathology on the SDQ was 7.3% (95%CI 4.8-10.5%) while for the K-SADS was 5.9% (95% CI 3.7%-8.9%). The prevalence of mental disorders across the age ranges of 6 to 12 years and 13 to 17 years was 5.4% and 7.9 % respectively. Males had a higher prevalence (7.1%) compared to females (4.7%). Conduct disorder was most prevalent (3.4%), followed by either type of ADHD- Attention Deficit Hyperactive Disorders (2.0%). Having a single parent (p<0.001), staying with a non-biological guardian (p<0.030), engaging in paid work (p<0.039), not attending school (p<0.019) and having teacher difficulties(p<0.028) were positively associated with a mental disorder.ConclusionThe socio-demographic factors associated with the risk of developing mental disorders may be important targets for mental health intervention programs.
Relationship of maternal factors and obstetric complications with term singleton vs term twin neonatal outcomes: A retrospective study in China
Authors: Li Hui , Nawsherwan  , Nabi Ghulam , Gul Rahmat , Ahmed Zahoor , Fan Cuifang
Published: July 2022

BackgroundNeonatal birth weight and length are important indicators of neonatal survival and morbidity during later life and are influenced by maternal factors and obstetrical complications. Therefore, we aimed to determine the relationship of maternal factors and obstetric complications with term singleton vs term twin neonatal outcomes in Wuhan University Renmin Hospital, Hubei, China. MethodsA total of 10517 neonatal births were recorded in a tertiary-hospital-based retrospective study and term singleton (n=7787) and termtwins (n=169) were included for data analysis. Birth weight and birth length were measured immediately after birth. Correlation, independent student t-test, and backward multiple linear regression were used for statistical analysis. ResultsWomen with singleton gestation have an increased rate of obstetric complications compared to women with twin gestation. However, a higher frequency of cesarean section and breech were found in twin gestation compared to singleton gestation. Weight before pregnancy, gestational weight gain, and gestational diabetes mellitus were significantly positive (p<0.05) associated with singleton neonatal birth length and weight. In contrast, preeclampsia, placenta previa, oligohydramnios, premature rupture of membrane, breech, and multiparity had a significantly negative (p<0.05) association with singleton neonatal birth length and weight. Maternal age was significantly positive (p<0.05) associated with only singleton neonatal birth weight. Moreover, the nuchal cord was significantly positive (p<0.05) associated with singleton neonatal birth length. On the other hand, maternal age and multiparity were significantly positive (p<0.05) associated with twins’ neonatal birth length and weight. Furthermore, gestational weight gain was significantly positive (p<0.05) associated with only twins’ neonatal birth weight. ConclusionIn term gestation, obstetric complications were significantly associated with singleton birth size rather than twin birth size.
Effect of activated persulfate on the properties of contaminated soil and degradation behavior of PAHs
Authors: Hong Yamin , Yue Xiupeng , Zhang Yaping , Shen Kai , Jiao Wentao , Zhao Lei , Li Beibei
Published: July 2022

Sulfate radical-based advanced oxidation processes have been applied in the remediation of polycyclic aromatic hydrocarbons (PAHs) contaminated soil, during which sulfate can be activated in different ways. In this work, effects of four different ways (FeSO4, NaOH, H2O2, and Heat) activated sodium persulfate (PS) on PAHs removal and soil physicochemical properties (pH, organic matter, functional groups, surface morphology, and partial heavy metal elements) were compared, and the influencing factors and mechanism of soil PAHs removal by thermally activated PS were also studied. The results showed that at the dosage of 3% of persulfate, the removal efficiency of PAHs followed the sequences of Heat (91.4%) > FeSO4 (86.6%) > H2O2 (86.2%) > NaOH (72.9%). However, thermal activation decreased the soil pH and organic matter content more significantly than other treatments. The reaction tended to reach equilibrium at 6 h when the dosage of persulfate was 3% and the activation temperature was 60 °C, and the reaction obeyed pseudo-first-order kinetics. Through quenching experiments, it was found that the free radicals playing a dominant role in the oxidation process were sulfate radicals. Compared with pH, liquid to soil (L/S ratio) and the temperature had more significant impacts on the degradation efficiency of PAHs.