bluuebunny/crossref_metadata_2025 huggingface dataset:
Forms of human consciousness (मानव चेतना की प्रकृति)
Authors:   Research Fellow, Department of Integrated Medicine, Sri Devaraj URS Academy of Higher Education of Research, Kolar, Bangalore, suryavanshi Chanchal , Khandait Meenakshi ,   Student, Dev Sanskriti Vishwavidyalaya Haridwar
Published: July 2023

Human consciousness refers to bodily consciousness. In fact, human consciousness is one but it is manifested in many forms due to difference of titles. Consciousness is unique in every human being, in other words it can be said that as many beings are present in this world as much consciousness also exists. Human consciousness, in spite of being inseparable from the divine consciousness, gets separated due to the sense of ego, because of this sense of ego, the human consciousness is unable to manifest itself. Human consciousness can be called divine consciousness covered by the cover of ignorance. On the destruction of ignorance, human consciousness merges into its real form of God consciousness.
Pranavopasana: From the perspective of human consciousness (प्रणवोपासनाः मानव चेतना के दृष्टिकोण से)
Authors:   Assistant Professor, Department of Yoga and Naturopathy,  Sarala Birla University, Ranchi, Chauhan Dr. Namrata , Narvare Sheetal ,   Student, Dev Sanskriti Vishwavidyalaya, Haridwar
Published: July 2023

Out of many living beings in the world, human is the only one who is able to understand his goal and try to achieve it. Apart from humans, the capacity of animals other than humans is limited only to feed and reproduce. While human capabilities are limitless, he keeps within himself the ability to understand, contemplate, evaluate and achieve countless achievements. The credit of having all these capabilities with the human goes to the consciousness of the human. Indian ancient texts Vedas, Darshana, Smritis, Puranas and Upanishads have asked to awaken, elevate the consciousness from free voice and defined consciousness as the science of spirituality in essence and to pave the way for this spiritual progress. Out of the methods used for devotion, devotion, aarti, asana, yoga, one easy method emerges in the form of worship of Pranav. Pranav is another name of God i.e. Omkar. Pranava is an anahata sound, whose descriptive expression is Om. Various scriptures describe the worldly and spiritual benefits of Pranavopasana, in which the upliftment of consciousness is the main benefit. Pranavopasana plays an important role in developing human consciousness, the relationship between these two is inseparable.
Muhurta science in view of Valmiki Ramayana (वाल्मीकि रामायण की दृष्टि में मुहूर्त विज्ञान)
Authors:   Assistant Professor Astrology,  Maharishi University of Management and Technology, Mangala, Bilaspur (Chhattisgarh), Kumar Dr. Yogendra
Published: July 2023

If we look into the Indian tradition, we get the description of many high quality books. In that Valmiki Ramayana composed by Maharishi Valmiki has an important place in human life. Regarding this epic, Dr. Neelam Singh has told in his research paper that Ramayana is a unique Sanskrit epic written by Adi poet Valmiki. This is the part of Hindu memory through which the saga of King Rama of Raghuvansh was told. It is also called the poetry of the beginning. There are seven chapters of Ramayana which are known as Kanda. The story of Lord Shri Ram versed by Maharishi Valmiki is known as Valmiki Ramayana and is called Adikavi of Valmiki and Valmiki Ramayana is also known as Adi Ramayana.1 Throwing light on the importance of the epic, it has been told that the importance of Valmiki Ramayana is there even today and will remain so in the future. True literature has the ability to shape the future, it is in the Ramayana. Ramayana meets this criterion. He has the ability to show the way to the generations to come. In it, generosity, righteous meaning and work surrender and protection of the victim, superiority of human, friendship, obedience, fasting, sweet and plant speech etc. undoubtedly make Ramayana an immortal epic.2 Among the common people, the Ramkatha has come to be revered as the struggle of good against evil and the dignity and deep compassion of various human relationships. It is a kind of cultural document. It is a matter of pleasant surprise that even after so many years its attraction has not decreased at all. How deep is the attraction and impact of the original spirit of this epic, it can also be felt from the place Ramkatha has found in the folk tales, drama, dance, architecture, sculpture, etc. of many countries of Asia. Therefore, showing the description of importance, etc., in this research paper, astrologers will try to tell about the science of Muhurta in this epic.
Pseudochoreoathetosis in a patient with idiopathic sensitive ganglionopathy: a case report
Authors: Moraes Lucas Grobério Moulim de , Demuner Caroline Colnago , Oliveira Giselle Alves de , Dias Paula Zago Melo , Muniz Marcelo Ramos
Published: July 2023

Sensitive ganglionopathy has been associated with systemic diseases. In general, this rare neurological syndrome predates the onset of systemic symptoms. It affects selectively large nerve fibers and, accordingly, is manifested with loss of protopathic touch, vibratory perception, and proprioception. We describe a case of pseudochoreoathetosis in an elderly female patient with idiopathic sensitive ganglionopathy, manisfested with unsteadiness and weight loss in the last six months. The patient had systemic arterial hypertension, and a history of tobacco and alcohol abuses. The neurological examination showed a mild cognitive impairment, preserved proximal appendicular strength and reduced distal strength, generalized areflexia, bilateral nonevoked plantar reflex, dysmetria of the four limbs with significant impairment of position perception (worsening with eyes closed), tactile, thermal and painful hypoesthesia on the upper limbs, in the trunk and cervical region, bilateral anesthesia and crural apalesthesia, and marked loss of proprioception. Involuntary movements were observed, predominantly distal to the limbs, with sustained spontaneous bilateral extension of halluces, alongside slow, constant, low amplitude, serpentine, and involuntary movements of the toes, fingers and wrists, better defined as pseudochoreoathetosis due to severe loss of proprioception. A thourough diagnostic evaluation, performed by cranial and spinal magnetic resonance imagem, cerebrospinal fluid analysis, autoantibodies dosing, cyanocobalamin and folic acid dosing, infections diseases testing and neoplasic screening, yielded no positive results. The electroneuromyography of the four limbs showed marked axonal impairment, exclusively restricted to sensitive neurons. Accordingly, a diagnosis of sensory ataxia due to idiopathic ganglionopathy was established.
Fibrocartilaginous embolism causing spinal cord infartion: case report Fernanda Mari
Authors: Moura Fernanda Maria Gonçalves de Sousa , Albuquerque Deborah Inayara Mendes Tenorio de , Schelp Andreas Batista , Santillan Thiago Ivan Vilchez , Toloi Marcella Canato , Soares Neto Herval Ribeiro
Published: July 2023

A 41-year-old male presented with strength, sensitivity and sphincters deficits of acute evolution after a mild car accident, characterized by paraplegia and areflexia of the lower limbs, hypoesthesia with sensory level at T6 and preserved artresthesia. A major diagnostic evaluation was carried out with neuroxias imaging tests, extensive laboratory investigation and exclusion of occult neoplasia. Cerebrospinal fluid was normal. Magnetic resonance imaging of the thoracic spine revealed signal alteration between T4-T7 without enhancement after contrast injection. A short course of intravenous corticosteroid therapy was attempted without any clinical improvement. Due to the acute presentation, history of minimal trauma, absence of findings in laboratory investigations, no other risk factors, clinical and images compatible with anterior spinal cord infarction, Fibrocartilaginous Embolism (FCE) was defined as a probable etiology. FCE is a rare cause of spinal cord infarction and consists in the migration of fibrocartilaginous nucleus pulposus material through the nearby vasculature into one of the spinal cord vessels, usually at the thoracic level and affects the territory of the anterior spinal artery. It can be associated with minor trauma and other causes. The probable diagnosis of FCE is based on data from the clinical history, exclusion of other alternative diagnoses and neuroradiological findings, such as changes in the spinal cord signal in the vascular territory and degenerative changes in the vertebral disc. Definitive diagnosis is possible only with biopsy. Treatment is supportive with physical rehabilitation. Although rare, FCE should be considered as a differential diagnosis in cases of unexplained medullary infarction in young patients without cardiovascular risk factors. The case in question is important and exemplifies that a high diagnostic suspicion is necessary to elucidate these cases.
Wernicke encephalopathy in a patient with uncontrollable vomiting. A case report
Authors: Demoner Caroline Colnago , Moraes Lucas Grobério Moulim de , Oliveira Giselle Alves de , Dias Paula Zago Melo , Muniz Marcelo Ramos
Published: July 2023

Wernicke encephalopathy is a neurological disorder caused by lack of thiamine. The main symptoms include ophthalmoplegia, ataxia, and confusion. We described a case of an elderly woman who presented with suddenonset vertigo, uncontrollable vomiting and blurred vision on the left eye. On the following days, she evolved with gait imbalance with a tendency to fall to the left side, fluctuating drowsiness and bilateral ophthalmoplegia. She had a previous history of systemic arterial hypertension, depressive disorder, gastritis and gastric cancer 15 years ago, treated with chemotherapy and radiotherapy. No history of tobacco or alcohol abuse. Neurological examination showed disorientation in time and space, drowsiness, gait ataxia and positive Romberg test. Furthermore, she had Babinski sign on the right toe. In addition, she had bilateral ophthalmoplegia, visual acuity in the right eye 20/40 and left eye 20/50. Serum tests were normal, including thyroid function, ions/metabolics, and viral serologies. Cerebrospinal fluid analysis showed six leukocytes (100% mononuclear) and 51 mg/dL of protein. A brain nuclear resonance imaging showed hypersignal on T2 and FLAIR (Fluid-Attenuated Inversion Recovery) sequences located in the medial portions of the thalamus, symmetrically and bilaterally, in the periaqueductal gray matter, around the fourth ventricle and in the cortico-subcortical transition of the post-central gyri, which in the context suggested Wernicke’s encephalopathy. The treatment was performed with thiamine (300 mg/ day), with significant neurological deficit recovery.
Quality indicators of a stroke unit in Curitiba (Brazil)
Authors: Kishi Nathália Mitsue , Rodbard Gabriela Ávila , Ducci Renata Dal-Prá , Lange Marcos Christiano
Published: July 2023

Introduction: Stroke represents the second leading cause of death and disability in Latin America. Thus, there is a constant need to understand the profile of patients admitted for stroke, as well as to analyze the quality indicators of treatment in stroke centers. Objectives: The aim of this study was to analyze the quality indicators of a stroke center and to determine the epidemiological profile of inpatients. Methods: This is an observational cross-sectional study that included individuals admitted with stroke or transient ischaemic attack (TIA) in the stroke unit of Complexo Hospital de Clínicas da Universidade Federal do Paraná from November 2020 to October 2022. The variables and quality indicators were collected through the application of questionnaires in two moments, on admission and hospital discharge. Results: Of the 407 patients included, 49.1% were men, with a mean age of 65.4 years (standard deviation ±15.3). Ischemic stroke was the most common type of stroke (84.5%). The majority of patients (62.6%) did not receive specific intervention, while 41.9% underwent intravenous thrombolysis, with a median door-to-needle time of 30 minutes. In 69.1% of the individuals, thrombolysis started in less than 60 minutes. All patients underwent neuroimaging, 90.9% carotid imaging and 92.6% had their cardiac rhythm rated by EKG or 24h-Holter. Dysphagia screening was applied in 62.4% of the cases and smoking cessation advice was provided in 50.5%. Of the patients with ischemic stroke and TIA, only 5 (1.3%) did not receive anticoagulant or antiplatelet agent for secondary prophylaxis and in 14 (3.75%) this data was unknown. Conclusion: Intravenous thrombolysis is not performed in most hospitalized patients, however, when performed, it presents an adequate door-to-needle time. Most patients received secondary prophylaxis. Management of patients in a stroke unit allows for a thorough etiological investigation and optimization of secondary prevention and rehabilitation.
Non-motor symptoms and signs of Myotonic Dystrophy type 1
Authors: Rodbard Gabriela Ávila , Kishi Nathália Mitsue , Ducci Renata Dal-Prá , Cirino Raphael Henrique Déa , Kay Cláudia Suemi Kamoi , Fustes Otto Jesus Hernandez , Lorenzoni Paulo José , Scola Rosana Herminia
Published: July 2023

Introduction: Myotonic Dystrophy Type 1 (DM1) is a genetic disease that presents neuromuscular manifestations and multisystemic clinical repercussions, such as cardiac and respiratory disorders, sleep disorders and impaired swallowing, among others. It is the most common muscular dystrophy in adults. Objectives: To determine the epidemiological profile of patients with DM1 treated at the Neuromuscular Diseases Outpatient Clinic of the Complexo Hospital de Clínicas da Universidade Federal do Paraná (CHC-UFPR). Methods: A total of 27 individuals diagnosed with DM1, assisted at the Neuromuscular Diseases Outpatient Clinic of the CHC-UFPR, were evaluated between May 2021 and March 2022. For this purpose, their medical records with the clinical data were analyzed. Results: The sample consisted of 78% male subjects with mean age at onset of symptoms of 27.6 ± 10.8. The most frequent muscular manifestations were myotonia (100%), weakness of the distal muscles of the upper (96.3%) and lower (96.3%) limbs, myotonic facies (92.6%). The most common non-motor manifestations were excessive daytime sleepiness (74.1%), frontal baldness (66.7%), pharyngeal globus (62.9%), choking or coughing during and/or at the end of swallowing (62.9%), cataracts (59.2%), dysphagia (55.6%), chest pain (55.6%), cognitive impairment (44.4%), dyspnea (44.4%). Of the patients, 22.2% had a previous history of pneumonia. Conclusion: The DM1 patients in this study presented an epidemiological profile consistent with that described in the literature. Non-motor manifestations are common and should be investigated, since complications such as bronchopneumonia are important causes of mortality in these patients and may negatively impact the quality of life. Therefore, DM1 patients require multidisciplinary monitoring and evaluation.
Atypical course of schistosomal myelitis: a diagnostic challenge
Authors: Moraes Lucas Grobério Moulim de , Demuner Caroline Colnago , Dias Paula Zago Melo , Oliveira Giselle Alves de , Muniz Marcelo Ramos
Published: July 2023

Acute myelitis is a severe neurological complication of schistosomiasis which clinical features present as lower limb weakness, sensory disturbance and intestinal or bladder dysfunction. A 60-year-old male farmer presented with low back pain and progressive paresis of right lower limb that worsened to plegia over ten months. MRI demonstrated hypersignal lesions in the T2/FLAIR (T2- weighted-Fluid-Attenuated Inversion Recovery) sequence in the ninth dorsal segment level. A Kato-Katz examination was negative for Schistosoma mansoni and a rectal biopsy confirmed an active infection. The patient received methylprednisolone (MTP) and a single oral dose of praziquantel (50 mg/kg), with partially improvement, being able to walk with assistance. Six months later, after coronavirus disease 2019 vaccine (Pfizer), he reported a worsening of neurological symptoms. New magnetic resonance imaging revealed no change compared to previous one. Aquaporin-4 antibodies were negative in serum, cerebrospinal fluid analysis showed 15 leukocytes (93% mononuclear), protein and glucose within the normal range. Autoimmune profile, serology for syphilis, hepatitis B, Hepatitis C, and human immunodeficiency virus were negative. The patient received a second pulse of MTP and repeat course of praziquantel, after which he improved his left lower limb weakness. Oral corticosteroid therapy was weaned. Nine months later, he experienced new exacerbation of crural paraparesis. Repeat cerebrospinal fluid analysis showed a normal pattern and new spine magnetic resonance imaging had no changes, but stools testing was positive for hookworm eggs, taenia sp and entamoeba coli in three different occasions. Therefore, he also received treatment with ivermectin and albendazole. The delay in diagnosis and treatment likely contributes to poor outcomes. As praziquantel is effective only on the mature adult worms but not on the larval form, a second dose should be considered in recurrent myelitis related to spinal neuroschistosomiasis.
Stiff Person syndrome and lumbosacral plexopathy post COVID-19
Authors: Malagutti Beatriz Cocato , Oliveira Lucas da Silva , Spilari Matheus , Mestriner Victoria Lot Avezum , Andrade Helen Maia Tavares de
Published: July 2023

Introduction: Coronavirus diasease 2019 (COVID-19) has been associated with inflammatory, ischemic and autoimmune neurological complications. We report a case of Stiff Person Syndrome (SPS) as an autoimmune neurological complication in COVID-19, an association still rare in the literature. Case report: A 45-year-old woman, presented with back pain of strong intensity with irradiation to the left lower limb, associated with painful muscle contracture and weakness in the same limb with progressive worsening in two days. Neurological examination revealed strength grade II, hyporeflexia, tactile and vibratory hypoesthesia, and paresthesia of the left lower limb, with increased tonus and impossibility to bend the left knee. She presented with positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction 12 days before the onset of symptoms. cCerebrospinal fluid and lumbosacral magnetic resonance imaging without significant changes, left thigh MRI with nonspecific edema and electroneuromyography compatible with left lumbosacral plexopathy. Stiff Person syndrome and autoimmune lumbosacral plexopathy were hypothesized. The treatment was started with methylprednisolone 1 g/day for five days and immunoglobulin 0.4 g/kg/day for five days with partial improvement. Anti-GAD AC performed, non-reactive. Screening for neoplasms was negative. In evolution, the patient progressed with involvement of the right lower limb, trunk, and upper limbs, respectively, with a fluctuating course and partial and temporary response to human immunoglobulin infusion and methylprednisolone pulse therapy. Conclusion: We report the associated time between SPS and COVID-19. SPS is a rare autoimmune disease related to anti-GAD AC and other antibodies. The temporal link with infectious agents that may trigger the autoimmune attack is uncommon in the literature, as the diagnosis is usually made years after the onset of symptoms. In this case, the diagnosis was made soon after infection, which allowed us to report another autoimmune neurological complication in COVID-19.
Cytotoxic lesion of the corpus callosum associated with Tumor Lysis Syndrome
Authors: Silvério Gabriel André , Weber Isabela Louise , Alves Renata Cristine , Possan Pedro Arthur , Marchetti Mateus Pinto , Terra Vera Cristina , Socher Karen Luiza Ramos , Watanabe Nancy , Caggiano Carlos Cesar Conrado
Published: July 2023

Case presentation: MCP, 39 years, female, with primary rectal cancer with lung metastases being treated with weekly cycles of chemotherapy, without other comorbidities. At the end of 46 hours of another cycle of this treatment, patient presented an episode of weakness associated with release of the sphincters, without clonism. Physical examination with stable vital signs, closed eyelids, non-contacting and glasgow coma scale (GCS) 10. Laboratory tests with hypocalcemia, uremia, hyperphosphatemia, increased creatinine, hypomagnesemia, hyperuricemia. On the following day she underwent hemodialysis and evolves with improvement in the level of consciousness (GCS 14), communicative, mild confusion and anterograde amnesia. No alteration at neurological examination. cranioencephalic magnetic resonance imaging with contrast demonstrating signs of diffusion restriction in the splenium region of the corpus callosum. With this, it was possible to determine the diagnosis of cytotoxic lesions of the corpus callosum (CLOCCS) due to tumor lysis syndrome. Discussion: CLOCCs are secondary lesions associated with varied etiologies, including drug therapy, malignancy, metabolic abnormalities (e.g. electrolyte imbalance) and infections. Cell-cytokine interactions lead to massively increased levels of cytokines and extracellular glutamate, resulting in dysfunction of callosal neurons and microglia, and cytotoxic edema develops as water becomes trapped whitin the cells. CLOCCs appears in magnetic resonance imaging as areas of increased signal intensity on FLAIR and low diffusion on diffusion weighted. This lesion is usually midline, reversible and symmetric. Conclusion: It is important to know the radiographic features of CLOCCS and theirs known causes, so the source can be found and addressed and avoid misdiagnosis of primary colossal conditions.
Alzheimer’s: what is the difference between or frontotemporal dementia
Authors: Dias Jéssica Azevedo , Vale Matheus de Serpa , Oliveira Raquel Penido , Pio Thaís Helen Rezende
Published: July 2023

Introduction: In the study of neurodegenerative diseases, Alzheimer’s disease (AD) has been classically considered with a typical presentation of cognitive symptoms and neuroanatomical changes. However, there are clinical phenotypes of AD whose neurobiological bases are similar to frontotemporal dementia (FTD). In this sense, the heterogeneity of these pictures leads to inaccurate evaluation and diagnosis processes, due to the scant knowledge about their neurocognitive symptoms. The early stages of Alzheimer’s-type dementia are classically characterized by memory impairment, whereas behavioral and personality changes appear in the early stages of FTD. However, in clinical practice, the differential diagnosis is difficult. Objectives: The objective of this systematic review is to establish neuropsychological characteristics and similarities in patients with AD and FTD, identifying key elements for their differential diagnosis, through clinical and imaging exams, with the objective of enhancing the clinical management of the patient. Methods: A bibliographic survey was carried out in SciELO and PubMed databases and indexers, using the terms “frontotemporal dementia”, “alzheimer’s” and “neuropsychology”, in Portuguese and English. Six updated articles were then selected, considering their adequacy to the objective of the work. Results: Evidence suggests that there are important differences in cognitive domains such as language (eg, verbal fluency), memory, social cognition, executive functioning, and behavior; These aspects should be considered fundamental in any process of neuropsychological evaluation and diagnosis. Conclusion: There are linguistic aspects that promise to be powerful biomarkers for the differential diagnosis between AD and FTD, namely semantic and phonemic verbal fluency and semantic-grammatical alterations, which may be fundamental in differentiating the diseases leading to an adequate conduct for each patient.
Structural MRI analysis of basal ganglia volume and white matter tracts in upper limb dystonia
Authors: Faria Danilo Donizete de , Paiva Joselisa Péres Queiroz de , Paulo Artur Jose Marques , Gomes Sonia Maria Cesar de Azevedo , Borges Vanderci , Ferraz Henrique Ballalai , Aguiar Patrícia Maria de Carvalho
Published: July 2023

Background: Dystonia is known as a network disorder. There is evidence of volumetric changes in structures associated with the traditional physiopathology, such as basal nuclei. One approach to studying the neural pathways is through tractography, which can provide insights into the structural connectivity of neural networks that may be disrupted in dystonia. Objectives: To evaluate brain structural changes of motor networks and basal ganglia volume in dystonia. Methods: Twenty-six patients with right upper limb dystonia and 29 healthy controls underwent 3T magnetic resonance imaging and evaluated in terms of DTI and T1 data. The XTRACT FSL tool was utilized to examine fractional anisotropy of the bilateral anterior thalamic radiation, superior thalamic radiation, superior longitudinal fasciculus, cortical spinal tract, middle cerebellar peduncle, forceps major and forceps minor. Using T1-weithed data, volunteers were also evaluated in terms of volumetric changes in bilateral Putamen, Caudate, Pallidum and Thalamus extracted using Freesurfer 7.0 volumetric segmentation. For group comparison, we conducted an analysis of covariance controlling for sex and estimated intracranial volume. Results: For uncorrected p-values, patients with upper limb dystonia show diminished FA volume in the right corticospinal tract relative to controls (P = 0.025). Region of interest analysis of subcortical regions volume based on T1-weighted images shows that patients had diminished left caudate volume (P = 0.031) and right putamen (P = 0.041). However, using FDR multiple comparisons correction, no difference was observed between groups: right corticospinal tract (P = 0.329), left caudate volume (P = 0.16), right putamen volume (P = 0.16). Conclusion: Our study could not replicate previous findings describing structural changes in dystonia. This could be to methodological differences, as well as the fact that we selected only patients with upper limb dystonia, as opposed to studies that included other types of dystonia. The neuroimaging analyses were conducted with the utmost rigor, utilizing the optimal preprocessing and statistical analysis methods. The nature and characteristics of structural alterations remain unclear and may vary depending on the subtype of dystonia. Therefore, additional structural studies and meta-analyses are warranted to advance our knowledge of this network disorder.
A 15-year-old boy with sudden short-memory impairment and ataxia
Authors: Massruha Karina Silveira , Marques Alexandre Coelho , Ferreira João Henrique , Freitas Christian Henrique de Andrade , Dutra Livia Almeida
Published: July 2023

A previously healthy 15 years-old male was taken to the hospital because of acute onset short-term memory impairment in the last two months. He would ask questions repeatedly and forgot about daily activities. He had no prodromal symptoms or any history of fever, nausea, or diarrhea. Physical examination was normal, except for an episodic memory deficit. Brain magnetic resonance imagin (MRI) was normal, cerebrospinal fluid (CSF) analysis revealed 9/mm³ cell, Hem 255, protein 35, glucose 50. Serology for human immunodeficiency virus, syphilis, and hepatitis were negative. Complete blood count, thyroid, liver and renal function were normal. After two months, he evolved with cephalic and upper limbs tremor, speech disturbances and imbalance. Physical examination showed global ataxia and dysarthria. A novel MRI disclosed T2/FLAIR (T2-weighted-Fluid-Attenuated Inversion Recovery) hyperintensities in cerebellar right vermis, with gadolinium enhancement suggesting glial tumor. At this point, CSF analysis showed positive oligoclonal bands. Electroencephalogram was unremarkable. Brain Positron Emission Tomography-Computed Tomography (PET/CT) revealed a nodular region of increased FDG uptake along the right cerebellum hemisphere and vermis. Brain biopsy showed a polyclonal immune cells infiltrate, chronic meningitis, and focal cerebellar atrophy. No neoplastic cells were found. The patient was first treated IV methylprednisolone and IVIG, with partial tremor and imbalance improvement, but persistent cognitive impairment. By this time, the antineuronal antibodies panel were positive for Anti-AMPA (Anti-alphaamino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor). As the patient developed partial improved he was started on Rituximab. Autoimmune encephalitis associated with anti-AMPA antibodies was first described in 2009 and the initial description involved adult patients with limbic encephalitis and seizures. We report an atypical presentation in an adolescent, with cerebellar pseudotumoral presentation. This report extends the clinical presentation of the disease among the young, and shows that the disease may initiate as cognitive impairment evolving with important cerebellar symptoms. Moreover, this case illustrates PET-CT may not differentiate between neoplasia and inflamamatory mechanism in AMPA encephalitis.
Critical review on the psychoemotional effects on children due to the vacancy of classes due to the COVID-19 pandemic
Authors: Bustamante Luiza Goulart Bacha , Labes Laís Lecy , Martins Larissa Raminelli Da Silva , Luciano Maria Eduarda Andrade , Maia Milena De Barros , Rosário Sarah Araújo Do , Menezes Carlos Alexandre Gomes Passarinho , Lima Patrick Venâncio Soares , Castro Ana Paula dos Reis , Lopes Ana Cláudia Vieira , Melo Amandra Gabriele Coelho Rodrigues , Altomani Ana Luiza Ract
Published: July 2023

Introduction: With the advent of the coronavirus diseade 2019 (COVID-19) pandemic and social isolation policies many school institutions have had to suspend classes or adapt to the online system. However, the lack of this learning model and greater exposure to the Internet can cause health problems and psychic and emotional development. Objectives: This study aims to critically analyze the implications in children due to the suspension of classes during the COVID-19 pandemic period. Methods: Review of integrative literature, consulted the Databases PubMed, SciELO and Google Scholar. Chosen as descriptors (DeCS): “COVID-19”, “Children” and “Classes” separated by Boolean connectors, and articles in English and Portuguese. Results: The first years of teaching were the most affected by the absence of classes with a fall in learning from 6.02 to 5.64 in Brazil. In Latin America, school delay sits up to 15 months after the isolation period causing delays in learning and development. The problematic use of the Internet is defined as an excessive concern and use the internet to the point of causing clinical damage in various domains, such as the commitment of relationships and the education of the individual. Conclusion: The total or partial interruption of classes causes negative effects in any school phase, but mainly in the phase of cognitive development, which is early childhood. Distance education did not work effectively for several children. Increased anxiety, irritation and financial instability causes students to leave schools.
Congenital syphilis in the city of Vitória/ES in 2010-2020
Authors: Guimarães Leonardo Luiz Moreira , Ribeiro Anézia Lima Chaves
Published: July 2023

Introduction: Syphilis is a systemic infectious disease caused by Treponema pallidum and is a public health problem in Brazil, since it is epidemiologically growing in the Brazilian population. Objective: To describe the occurrence of congenital syphilis and the profile of reported cases in the population of the city of Vitória-ES. Methods: This was a descriptive study with a quantitative approach aimed at analyzing congenital syphilis. The study population consisted of all notifications found in the Notifiable Diseases Information System referring to congenital syphilis cases in the municipality of Vitória – ES in the period 2010–2020. Results: A total of 1,158 cases of congenital syphilis were reported in Vitória, where 36.4% were in the first trimester of pregnancy; most infants (95.7%) were diagnosed less than 7 days after birth. There was a predominance of mothers aged between 20 and 29 years (48.1%), and 61.8% of cases were recorded in brown-skinned pregnant women with low education. Prenatal care was provided to 76.2% of the pregnant women, but the treatment regimen was considered inappropriate in 54.1% of the cases. Conclusion: The large number of cases, despite failure in prenatal coverage with inadequate maternal treatment, point to poor quality of prenatal care, with congenital syphilis in the absolute majority of cases failing prenatal care. The findings indicate the need of improvements in the implementation of prenatal care that, if diagnosis and proper treatment occurs before the 36th week up to the 40th week, the case will be properly treated syphilis and will not be a congenital syphilis case.Keywords: Syphilis, Congenital. Pregnant women. Prenatal care.
Knowledge on post-exposure prophylaxis, sexual behavior, and vulnerabilities to HIV and other STIs among young adults in Brazil
Authors: Santos Vinicius Nascimento dos , Souza Eveline Xavier Pereira de , Timbó Maiara Santos , Travassos Ana Gabriela Alvares
Published: July 2023

Introduction: Post-exposure prophylaxis (PEP) is the use of antiretroviral drugs (ARVs) to reduce the risk of human immunodeficiency virus (HIV) infection after potential risk exposure. ARV-based interventions are recommended as part of combination HIV prevention, especially for key populations. Objective: The aim of this study was to measure knowledge about PEP among university students. Methods: A cross-sectional study was conducted on university students from the Health, Education, Exact, and Human Sciences Departments of the State University of Bahia, Brazil. Sociodemographic data, information on sexual behavior, and knowledge of PEP were collected through a standardized self-applied questionnaire. Results: We analyzed 1580 questionnaires, of which 66.7% (1024/1536) were from females, with a mean age of 23.9 (±6.5) years, and 35.4% (448/1264) reported irregular use of condoms and regular use was not associated with being students from the health area (p=0.44, OR 0.90, 95%CI 0.69–1.17). Regarding PEP, 28.5% (449/1578) had known about it and their knowledge was statistically associated with men who have sex with men (MSM) (p<0.01, OR 3.92, 95%CI 2.45–6.28). It was noted that 94.0% (1485/1579) did not know the time limit for starting PEP, 95.1% (1500/1578) did not know the duration of prophylaxis, and 91.1% (1437/1577) did not know where to get PEP. Finally, 0.4% (7/1578) referred to previous use and 96.6% (1488/1540) would not change their sexual behavior after knowing about PEP. Conclusion: PEP is a prevention strategy available for decades and is safe, effective, and cost-effective. However, it is underutilized and a lack of knowledge on PEP is one of the main obstacles to access. Among university students, there is a limited knowledge about PEP acting as a barrier in preventing new infections, which shows the need for interventions based on sexual-health education, stimulating the reduction of risk behaviors and disseminating information about combination prevention.
Comparação entre tipo de parto e padrão da amamentação usando escala latch, tempo e intervalo de mamada no puerpério imediato
Authors: Carnaroli Ana Caroline , Fioravante Marina Armani , Souza Samanta Dias de , Ferreira Rebeca Garcia Rosa
Published: July 2023

Introdução: O início precoce da amamentação é recomendado de preferência dentro de 1 hora após o nascimento. Muitos são os fatores que influenciam nessa prática, e a via de parto pode ser uma delas. Objetivo: Comparar o padrão de amamentação entre o parto normal e a cesariana eletiva, utilizando a escala LATCH e a ficha de avaliação pós-parto de cada paciente, que fornece o intervalo e tempo de mamada. Métodos: Estudo comparativo que contou com a participação de 22 puérperas, que se encontravam nas primeiras 24 horas do pós-parto, sendo 11 de parto normal e 11 de cesariana eletiva. A avaliação do aleitamento materno foi feita por meio da Escala LATCH e pela ficha pós-parto. Foi utilizado o teste de Mann Whitney e o intervalo de confiança considerado foi de 95%. Resultados: A mediana da escala LATCH foi discretamente maior no grupo das mulheres do parto normal (9) do que no grupo da cesariana eletiva (8), e os lactentes da cesariana eletiva tinham uma média de tempo de mamada maior (35 min) com intervalo de tempo menor (102,7 min) entre as mamadas em relação aos lactentes nascidos de parto normal (tempo de mamada de 27,3 min e intervalo de tempo de 128 min). No entanto, não foi encontrada diferença estatisticamente significativa entre os grupos. Conclusão: O presente estudo não encontrou diferença estatisticamente significativa ao comparar o padrão da amamentação (intervalo e tempo de mamada) e a escala LATCH entre o parto normal e a cesariana eletiva.
The role of beneficial soil microbes for degraded-land rehabilitation
Authors: Betty Natalie Fitriatin  , Anne Nurbaity  , Shantosa Yudha Siswanto  , Marenda Ishak Sule
Published: July 2023

Various human activities that involve many activities such as forest clearing, logging, mining, clearing of agricultural and urban land can have a negative impact on the environment in the form of damage to forest vegetation as animal habitat and the possibility of loss of rare endemic flora/fauna species as a source of nuftah plasma. potential, damage to the water system (watershed), increase the rate of surface erosion, reduce land productivity and stability as well as the biodiversity of flora and fauna. To support the success of the revegetation and rehabilitation of degraded lands, this study discusses the role and prospects of benefecial microbes such as arbuscular mycorrhizal fungi (AMF) and root nodule-forming N-fixing bacteria (Bradyrhizobium/Rhizobium) which are alternative strategies that need to be tried. and developed. The role of mycorrhizal fungi and Bradyrhizobium/Rhizobium bacteria in accelerating the growth rate, increasing the quality and viability of forestry plant seedlings on nutrient-poor marginal lands has been widely demonstrated.
Spectrum of computed tomography manifestations post COVID
Authors: Somanth Samineni  , Jenson Isac John  , Praveen Kumar John
Published: July 2023

Introduction: Chest CT is an important diagnostic, prognostic and follow up technique used for COVID 19 infections. It can detect ground glass opacities (GGO) as early as 5th day following symptoms with maximum CT findings at around 10 days of symptoms. Initially detected as unilateral lesions, it acutely progresses bilaterally. Hence, in this study, we evaluated the CT findings in COVID 19 illness, and correlated the same with severity. Methodology: It is a hospital based ambispective cross-sectional study conducted among 1544 patients attending the Department of Radio-diagnosis with symptomatic COVID-19 infections. Sociodemographic characteristics were taken, followed by history and HRCT imaging. This was followed by reporting of CT imaging with CO-RADS staging and CT severity scoring. Results: The most common lesions noted were ground glass opacities (87.7%), consolidation (44.2%), hilar/mediastinal lymphadenopathy (20.1%), reticular opacities (14.3%), septal thickening (9.1%), pleural effusion (4.5%), bronchiectasis (4.5%), emphysematous changes (1.3%), pleural thickening (2, 1.6%) and reticulonodular opacities (0.6%). Conclusion: Bilateral, multifocal, and peripheral distribution of lesions are common in HRCT of symptomatic COVID cases. GGO is the most common lesion noted.
Knowledge, Attitudes, and Practices (KAP) of breastfeeding in developing nations- how far have we come?
Authors: Rishima Nahata  , Vikramjeet Singh Bhadouria
Published: July 2023

Introduction: In a developing nation such as India, breastfeeding is a prevalent practice among most mothers. Despite that, there exist several myths and wrongful practices regarding the ideal nursing techniques. The lack of knowledge and know-how for breastfeeding creates a high-risk situation and can be detrimental to the growth and development of the neonate. Hence, we aimed to conduct a study to analyze the knowledge, attitudes, and practices on breastfeeding in a tertiary care center in India and to identify the factors that influence breastfeeding behaviors. Design and Methods: This was a prospective, cross-sectional, questionnaire-based study that was carried out on mothers who were patients or outpatients at the Obstetrics and Gynaecology Department. Once the mothers provided informed consent, they were put through an interview process that contained questions to assess their knowledge, attitude, and practices of breastfeeding. The data was recorded in an MS Excel spreadsheet and analyzed using SPSS v21. Results: It was observed that 52.5% of the mothers were primigravida and had only primary school education, with 79.64% being unemployed. Of the 200 women enrolled in the study, only 102 received timely antenatal care, and 89 were counselled regarding breastfeeding practices. Only 38.3% of women-initiated breastfeeding within 1 hour of normal vaginal delivery, 47.91% of mothers discarded the colostrum and 57.19% gave additional feeds of water/cow’s milk/honey. 46.33% of women believed that exclusive breastfeeding is essential for the adequate development of the neonate. Additionally, when we questioned the mothers regarding the non-nutritive importance of breastfeeding such as bonding and warmth to the neonate, 64.8% were unaware of the same. Conclusion: Despite the average household in India having 2 or more children, there is a dearth of knowledge and ideal practices in such mothers. With adequate counseling, health awareness programs, and education, we can bridge this wide gap. These educational activities can be carried out by ASHA workers and Anganwadi teachers.
As a solution during COVID-19, mandarin language learning system development to support HSK certification exams
Authors: Darmanto  , Yulius Hari  , Budi Hermawan  , Endang Setyawati
Published: July 2023

The COVID-19 epidemic has prompted an increase in self-study; as a result, preparation for HSK Certification exams should also be stepped up. The Hanyu Shuiping Kaoshi (HSK) Exam can be taken either digitally or on paper. Students taking an exam through the internet are not limited by time or location when taking the test. The HSK test is designed to objectively and accurately assess a student's level of proficiency in Mandarin Chinese. Examinees' comprehension of the HSK exam's material and the quantity and quality of time spent working through sample HSK questions both play a role in whether or not they pass the exam. In order to help test takers prepare for the HSK, an online practice exam system is required. The primary goal of the online artificial HSK examination system is to allow prospective examinees to attempt to replicate the HSK test through the system and receive the same outcomes as the provisions of the genuine HSK exam. As one of the coordinators of the HSK exam in East Java, Nurul Jadid Probolinggo put this medium through its paces with a group of high school pupils. This article discusses issues of user approval of the program in addition to the analysis of its features
SONOGRAPHIC ASSESSMENT OF PROSTATE VOLUME IN MEN WITH RAISED PROSTATE-SPECIFIC ANTIGEN (PSA) IN ONITSHA METROPOLIS
Authors: Ohagwu Christopher C. , Nwadike Sharonrose Ogochukwu , Ugwu Anthony C. , Elugwu Chukwuemeka Henry , Ukibe Nkiru R.
Published: July 2023

The prostate-specific antigen (PSA) level is a useful indicator of prostate volume and may inform the choice between treatment options for benign prostatic hyperplasia and other benign conditions. The observation of greater testing of men living in more affluent areas is consistent with previous studies. Therefore, this study was aimed at evaluating the actual volume of the prostate gland in different age groups, in men with raised PSA value. This cross-sectional study was conducted sonographically among men aged 40-89 years in Onitsha Anambra State of Nigeria with clinical indication of raised prostate specific antigen (PSA). Both laboratory and ultrasound procedures were carried out following the standard procedures after obtaining ethical approval from Anambra State of Nigeria Ministry of Health.  Data such as age, prostate volume (PV), PSA, total PSA and free PSA were obtained using data capture sheet. The statistical package for social sciences (SPSS) version 20.0. (SPSS Incorporated, Chicago, Illinois). Descriptive (mean, standard deviation, percentage, frequency, and charts) and inferential (Pearson correlation test) statistical tools were adopted for statistical data analysis. The level of statistical significance was set at p < 0.05. The mean and standard deviation for prostate volume were 26.6±7.576 cm3. The mean and standard deviation values for prostate volume at different age group are 24.47±5.438 cm3, 25.06±5.94132 cm3, 28.76 cm3±9.814 cm3 and 27.22±8.0638 cm3 for age group 40-49years, 50-59years, 70-79years and 80-89years of age respectively. There were no statistically significant correlations between TPSA and PV (r=0.003, p= 0.96), and between FPSA and PV (r=0.031, p= 0.66).There were no statistically significant correlations between TPSA and age (r=0.04, p=0.56), and between FPSA and age (r=0.02, p= 0.72). There was a positive statistically significant correlation between prostate volume and age(r=0.21, p=0.002). The study population has normal value of prostate volume. The prostate volume was not significantly influenced by the TPSA and FPSA values. However, the subject’s age has significant positive correlation with the prostate volume. Therefore, in assessing the prostate volume, the age of the individual should be taken highly into consideration.
Ocular lateral deviation as a vestibular sign to improve detection of posterior circulation stroke
Authors: Alraies Amr Abdulwarth , Ghanaim Mahmood Mohammed
Published: July 2023

Posterior circulation is affected by approximately twenty-five percent of all strokes, & many studied cases visit emergency rooms diagnosis is frequently difficult because studied cases frequently appear with variety of symptoms and frequently minimal clinical indicators. Chronic nystagmus, nausea, vomiting, head motion intolerance, & poor balance are all symptoms of acute vestibular syndrome, which is prevalent condition with significant number of cerebrovascular causes. Studied cases with A ICA strokes have positive head impulse test, although nystagmus frequently reverses direction, & big amplitude skew have been useful on central localization. If HINTS has been peripheral, possibility of posterior circulation stroke has been unlikely. Therefore, it is necessary to look at any single triad component that points to central HINT. Peripheral HINTS avoid needless medical resource waste by not requiring emergency MRI or angiography tests.
Hypertensive encephalopathy in a patient with unconsciousness
Authors: Alkalaf Mouhammad Ekbal
Published: July 2023

Hypertensive encephalopathy (HE) is characterized by acute onset severe arterial hypertension associated with confusion, headache, seizure and even unconsciousness. It is usually reversible but any delay in recognition and treatment can be life threatening. Typical abnormality in MRI is increased intensity in both occipital white matter areas indicative of edema. Differentials can be ischaemic stroke, ICH, Tumor, acute toxic metabolic encephalopathy. We here describe a patient with no history but admitted with hypertension and loss of consciousness and had several seizures. She recovered with appropriate treatment for hypertension.
Atypical presentation of pulmonary embolism
Authors: Alkalaf Mouhammad Ekbal
Published: July 2023

In spite of high incidence of pulmonary embolism (PE), its diagnosis can be challenging due to vagaries of symptoms. Conversely, right shoulder pain is a relatively easy clinical presentation which is mostly musculoskeletal in nature. But right shoulder pain only in a case of PE, has proven to be a difficult correlation to make. We here describe a patient with no prior history of DVT or PE, no history of prolonged bed rest or recent surgery but admitted to emergency department with right shoulder pain for two days. CTPA revealed pulmonary thromboembolism. Her symptoms improved with subcutaneous Clexane followed by Rivaroxaban oral therapy.