bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication, characterization, antimicrobial, toxicity and potential drug-delivery studies of PEGylated Sesamum indicum oil based nanoemulsion system
Authors: Bamisaye Abayomi , Eromosele Catherine O. , Dare Enock O. , Akinloye Oluseyi A. , Idowu Mopelola A. , Ighodaro Osasenaga M. , Manickam Sivakumar
Published: March 2023

Background

The actively mutating properties of disease-causing pathogens and GI intolerance associated with certain antibiotics among other challenges necessitated the adoption of colloidal system for drug delivery. Nanoemulsions (Ciprofloxacin (Cp) -loaded and non-drug loaded) were prepared by spontaneous emulsification method, characterized using Cryo-TEM, FTIR and Zetasizer. Antimicrobial activities were carried out using agar well diffusion method on Klebsiella pneumoniae and Bacillus subtilis. The in-vitro and dermal toxicological assessment were carried out using adult Wistar rats.

Results

The Cryo-TEM micrographs showed spherical morphology while zetasizer results showed polydispersity index (PDI), mean droplet size and zeta potential (ZP) of 0.553, 124.3 ± 0.29 nm and − 15.3 mV respectively for non-drug loaded sesame oil-based emulsion (SOAB). While 0.295, 244.8 ± 0.33 nm and − 5.54 mV were recorded for Cp-loaded sesame oil-based emulsion (SOAB + Cp). The effective voltage charge of the emulsions was 147.4 V. FTIR results of Cp recorded O–H adsorption value of 3429 cm−1, while SOAB and SOAB + Cp showed superimposition at 3427.76 cm−1 showing no drug-excipient interactions. No skin irritation was observed after 14 days of skin corrosion assessment. No significant difference (p > 0.05) in body weight gain of both test and control animals, the treatment did not cause any observable alterations in blood-chemistry parameters and hematological indices. Photomicrographs of liver and heart shows an uncompromised histological architecture.

Conclusion

The finding of the study shows a skin friendly, nanosized, spherical negatively charged emulsion with no cardiotoxic, hematotoxic and hepatotoxic effects on Wistar rats, and as such appears promising as a safe vehicle for drug delivery.

Graphical Abstract
Impact of capital structure on financial performance of oil and gas firms in Nigeria
Authors: Anozie Obumneme Renato , Muritala Taiwo Adewale , Ininm Victor Edet , Yisau Nurudeen Salako
Published: March 2023

This study examines the impact of capital structure on the financial performance of Nigerian oil and gas companies. Using an ex-post facto research methodology, the short-term debt to total asset, long-term debt to total asset, total debt to total equity, and return on asset variables were investigated as proxies for capital structure and financial performance, respectively. Based on the data's availability at the time of the inquiry, the study used an easy sampling strategy to gather secondary data. These data covers the years 2011 through 2020 and were compiled from the annual financial reports of five Nigerian oil and gas companies. Descriptive statistics and panel regression analysis were used to analyze the data. The analysis' findings shows that while long-term debt to total assets has a negative significant influence on return on assets, short-term debt to total assets and total debt to total equity had positive insignificant impacts. According to the findings, managers of oil and gas companies should reduce the amount of long-term debt they have because doing so has a negative effect on their performance. They should also exercise caution when making capital structure decisions.
Comparative application of derivative spectrophotometric and HPLC techniques for the simultaneous determination of lamivudine and tenofovir disoproxil fumarate in fixed-dose combined drugs
Authors: Vaikosen Edebi N. , Bunu Samuel J. , Oraeluno Jude N. , Friday David
Published: March 2023

Background

Lamivudine (LAM) and tenofovir disoproxil fumarate (TDF) are part of a fixed-dose combination (FDC) therapy recommended by WHO. Both drugs exhibit similar solubility in many solvent systems and tend to have overlapping spectra with maxima at 260 and 270 nm, respectively, in the UV spectrum—thus making their spectrophotometric assay difficult in FDCs. A third-order derivative (D3, d3A/dλ3) spectrophotometric technique was applied to simultaneously evaluate TDF and LAM in FDC drugs, with amplitudes at 240 and 262.5 nm, respectively. Pharmacopoeia-recommended chromatographic method was also applied for comparative purpose.

Results

Method performance by the proposed D3technique showed linearity for LAM and TDF from 2–10 µg mL−1to 8–24 µg mL−1, respectively (R2 ≥ 0.998), while for HPLC method both drugs ranged from 0.25 to 5.0 µg mL−1(R2 ≥ 0.999). The intercepts and slopes of the regression equations were ≤ 1.62 × 10−4and ≤ 3.58 × 10−5, respectively, while calculated standard errors were ≤ 8.04 × 10−5. Limits of detection and quantification for both methods were ≤ 0.46 μg mL−1and ≤ 1.40 μg mL−1, respectively, for LAM, while corresponding limits for TDF were ≤ 2.61 and ≤ 7.90 μg mL−1. The percentage recovery for both drugs and methods ranged from 94.80 to 100.33%. The amount of LAM and TDF in brands I and II was ≥ 99.59 ± 1.19% and ≥ 99.39 ± 0.63%, respectively, for the proposed D3spectroscopic method, while corresponding values for the HPLC method were ≥ 99.86 ± 0.50 and ≥ 99.87 ± 0.32%. Statistically, both methods were adjudged to have no significant difference at 95% confidence level as the student’st-test values; experimental pairedt-andF-test values were found satisfactory.

Conclusion

The D3spectrophotometric technique was time saving, cheap, simple and more environmental friendly and shows reliability, precision and accuracy and could be used for routine analysis of FDCs where HPLC is not available.

Graphical abstract
Misinterpretation of a giant idiopathic concealed right iliac artery aneurysm as infantile pelvic tumor imaged by non-angiographic computed tomography: a case report
Authors: Tangsiwong Thipsumon , Tangsriwong Tipsuda
Published: March 2023

Background

Idiopathic pediatric artery aneurysm is extremely rare and sometimes behaves like a pelvic neoplasm. As it is associated with a high mortality while ruptured, the accurate diagnosis is indispensable to avoid life-threatening complications. Angiographic imaging is the gold standard for diagnosis and treatment planning of the aneurysm. Due to the considerably higher radiation sensitivity of children, single portal venous-phase scanning of the abdominopelvic computed tomography (CT) is, however, reasonably utilized for the evaluation of a clinically palpable mass; the erroneous diagnosis of such aneurysm can be feasible.

Case presentation

A giant idiopathic concealed right iliac artery aneurysm in a 47-day-old girl presented with a palpable pelvic mass regardless of unidentifiable predisposing factors. Non-angiographic abdominopelvic CT was reappraised by the radiology consultant according to discordance between the mass characteristics on initial CT report and those on second-look sonography, revealing the concealed aneurysm instead of solid neoplasm as it originated from right internal iliac artery. The patient underwent an emergency laparotomy with successful proximal ligation of right internal iliac artery despite intraoperative aneurysmal rupture.

Conclusions

Typical CT features for the infantile iliac artery aneurysms may be overlooked, especially if the angiographic phase is omitted; thus, the imaging characteristics of the aneurysms are more difficult to appreciate and can mimic a pelvic neoplasm. Therefore, the identification of the origin of the mass should be more practical to achieve the precise diagnosis.
Otago Home Exercise Program along with other physiotherapy interventions for the management of prolapsed intervertebral disc and its associated symptoms in an elderly: a case report
Authors: Chakraverty Sneha , Jagtap Tanmay , Mahapatra Charuhasini
Published: March 2023

Prolapsed intervertebral disc or herniated disc (PIVD) is a common cause of back pain between the ages of 30 and 50 years. But, in the elderly PIVD is associated with associated symptoms whose management is often ignored. We reported a case of an 85 years old male patient with existing symptoms of PIVD for the last 5 years. However, the patient has never gone for physiotherapy treatment for the past 5 years due to unawareness and ignorance of the same. Since it was a geriatric case, the patient presented with associated symptoms along with PIVD. We tried to focus on the associated symptoms of the patient as well along with PIVD like fall risk and balance. The intervention program constituted 3 weeks of physiotherapy intervention focusing on pain management, strength conditioning, and balance training followed by an Otago Home Exercise Program.
Cavitatory necrotising pneumonia with extrapulmonary multi-systemic involvement — a rare presentation of macrolide-resistant Mycoplasma pneumoniae
Authors: Mohan Namitha , Sawant Vishal Dnyaneshwar , Kondekar Alpana
Published: March 2023

Background

Mycoplasma pneumoniae is one of the leading causes of community-acquired pneumonia. Due to its microbiological variation, clinical presentations of mycoplasma infections are atypical and diverse. Multiple pulmonary and extrapulmonary manifestations of Mycoplasma pneumoniae have been documented. Among pulmonary, common manifestations are fever, malaise, lymphadenopathy, pneumonia, upper respiratory tract infections, sinusitis, etc. Necrotising pneumonia leading to cavitation as a manifestation is rather an uncommon presentation.

Case presentation

We are reporting a rare case of a 5-year-old female child who presented with bilateral haemorrhagic pleural effusion and necrotising pneumonia with cavitation along with extrapulmonary manifestation in the form of maculo-papular rash, Coombs-positive haemolytic anaemia and serositis. The child was started on azithromycin and symptomatic management, but she did not respond to it; she had clinical worsening and evidence of radiological necrotising pneumonia. The child was treated as macrolide-resistant mycoplasma pneumonia with levofloxacin, steroids and rigorous physiotherapy.

Conclusions

Accurate clinical acumen along with timely radiological imaging is the need of the hour for early diagnosis of macrolide-resistant mycoplasma pneumonia (MRMP). This case also emphasises role of fluoroquinolones and steroids in treatment of macrolide-resistant mycoplasma pneumonia.
Hospital at home: emergence of a high-value model of care delivery
Authors: Kanagala Sai Gautham , Gupta Vasu , Kumawat Sunita , Anamika FNU , McGillen Brian , Jain Rohit
Published: March 2023

Background

With increasing healthcare demands for acute illness in patients especially in the times of pandemic, healthcare organizations require modern solutions. Hospital at home (HaH) is one such tool that has the potential to solve these problems without compromising the care of the patients.

Main body

Hospitals have been the conventional setting for managing acute sickness patients; however, it could be a very challenging environment for a few patients, especially for the older population who are highly susceptible to hospital-acquired infections. Health care in a hospital setting can also be very expensive, as it often involves a lot of healthcare professionals providing care. HaH service can provide the same quality of care expected in traditional settings.

Conclusions

The median length of stay and the rate of readmissions were lower in people under HaH care. Compared with patients in a hospital setting, patients in HaH had better clinical outcomes. HaH unit provides an integrated, flexible, easy-to-scale platform that can be cost-effectively adapted to high-demand situations.
Managing unpredictable challenge of a metastatic nodule in radiation treatment field—a case report
Authors: Sikdar Debanjan , Gupta Sweety , Charavarty Abhishek , Kaushik Bhoomika , Joseph Deepa M. , Gupta Manoj
Published: March 2023

Background

Despite the high prevalence of locally advanced head and neck cancer, treatment failure in the form of a cutaneous deposit in the treatment field during radiation is not common. There has never been a cytology-proven published case of marginal treatment failure in the cutaneous region during radiotherapy.

Case presentation

A 51-year-old male patient was diagnosed with squamous cell carcinoma of the left tonsillar fossa. After a partial response to induction chemotherapy, the patient was treated with definitive chemo-radiotherapy. After the 23rd fractionation of radiotherapy, there was a clinical progression in the form of a solitary skin nodule within the treatment field, which was further treated with an electron boost to a total dose of 70 Gy followed by palliative chemotherapy.

Conclusion

During definitive chemoradiotherapy, failure outside the high-dose radiation field is not common, and a skin nodule during treatment had never been described. Our case demonstrates the importance of performing thorough clinical examinations on a weekly basis, not only for toxicity assessment but also for treatment response.
Development of an Arabic test for assessment of semantics for the Arabic-speaking children: the Arabic semantic test
Authors: Abd-Elmoneim Dina Mohammed , Ghandour Hassan Hosney , Elrefaie Dina Ahmed , Khodeir Mona Sameeh
Published: March 2023

Background

Semantics is the study of meaning, and it pertains to the meanings of linguistic expressions such as words, phrases, grammatical forms, and sentences. Studying semantic development for preschool children has several applications in research design, assessment, and intervention. In English and most Indo-European languages, there is a long tradition of examining aspects of child language by computing different developmental indices from spontaneous language samples and by applying different language tests. However, for the Arabic language, these aspects are lacking in this valuable area of research. Thus, this study aimed to develop and standardize a comprehensive test for assessing semantic language development suitable for preschool children in Arabic-speaking countries. The constructed Arabic semantic test (AST) was administered to 120 typically developed Egyptian Arabic-speaking children between the ages of 2 to ≤ 4 years divided into 4 age groups, with a 6-month age interval between each group. Children’s responses were statistically analyzed to assess the test’s validity and reliability. Ranks of percentiles were calculated to describe the semantic language development in preschool Egyptian Arabic-speaking children.

Results

A statistically significant difference was found over the scores of the Arabic semantic test in both receptive and expressive aspects of semantics among the 4 participating age groups. Semantic growth was positively correlated to the chronological age of the participating children, with good validity and reliability of the test.

Conclusions

The Arabic semantic test is a valid and reliable test that can be applied to assess semantic development among preschool Arabic-speaking children.
Effect of hot saline pack versus topical tranexamic acid in post adenoidectomy bleeding
Authors: Mandour Yasser Mohammed Hassan , El Hamshary Ahmed Ashraf Salah , Elrazeq Mohsen Mahmoud Abd , Elbosraty Omnia Abd Elrahman , Sobhy Mostafa Gomaa
Published: March 2023

Background

Adenoidectomy is a popular surgical technique in the field of otolaryngology that is successful, safe, and effective. Diffuse microvascular post-adenoidectomy bleeding, on the other hand, is still a common concern.

Aim

The objective of this study is to do a comparison between the efficacy of a hot saline pack versus topical tranexamic acid when administered topically in children who have had only adenoidectomy in terms of intra-operative blood loss and post-operative bleeding.

Methods

This prospective case-control study contained a total of 180 patients, divided into three classes. Class A: This included 60 patients with application of a hot saline pack in control of intra-operative adenoidectomy bleeding. Class B: This included 60 patients with application of a topical tranexamic acid pack in control of intra-operative adenoidectomy bleeding. Class C: This included 60 patients with the use of a pack to hold intra-operative adenoidectomy bleeding

Results

The mean intraoperative blood loss in class B was lower than classes A and C, the mean pre- and post-operative HB level was lower in class C than in classes A and B, the difference was statistically considerable between the three classes, comparison between classes showed statistically considerable differences between classes A and C and also between classes B and C, while there was a statistically non-considerable difference between classes A and B.

Conclusion

The current study found that a topical tranexamic acid pack was more effective for post-adenoidectomy haemostasis than a hot saline pack, with a shorter time to haemostasis and fewer recurettage and electrocauterization procedures.

Trial registration

Name of registration trial: Research ethics committee faculty of medicine Benha university. Registration number: Ms1-1-2020. Date of registration: 22-1-2021.
Outcomes of canal wall down mastoidectomy in cholesteatoma: a 5-year experience
Authors: Yusof Asfa Naimi Mohamad , Boon Wei Jie , Ali Aisyah , Tang Ing Ping
Published: March 2023

Background

Cholesteatoma is an atticoantral disease that potentially causes life-threatening complications. Therefore, canal wall down mastoidectomy is a well-established technique to eradicate the disease, especially in extensive cholesteatoma.

Aim

To evaluate the status of dry ear and hearing outcome post-retrograde canal wall down mastoidectomy.

Methods

A retrospective study of patients with cholesteatoma who underwent modified radical mastoidectomy (MRM), a form of canal wall down mastoidectomy between January 2014 and December 2018.

Results

Fifty-seven patients were included with a mean age of 40 years. The majority of cases were adults, 86%, and 14% were children. Most of them complained of ear discharge (73.7%), followed by hearing loss (31.6%). Intraoperatively, cholesteatoma was primarily found in cases involving mastoid air cells, antrum, attic, and mesotympanum (47.4%). The presence of granulation tissue with cholesteatoma was noted in 57.9% of cases. Furthermore, 73.7 % of ossicular chain erosion cases involved erosion of all ossicles (47.6 %). In 26.3 % of cases, tegmen erosion was identified. Facial canal dehiscence accounted for 15.8% of MRM cases, sclerotic mastoid was noted for 10.5%, and lateral semicircular canal dehiscence involved 5.3%. Up to 3 months of follow-up post-MRM showed 70.2% had a dry ear. After 6 months, there were 15.8% complaints of ear discharge in the subsequent follow-up. In this study, 33 out of 57 patients underwent a postoperative hearing evaluation, and 21.2 % of patients showed an improvement in the air-bone gap.

Conclusion

Canal wall down mastoidectomy is a treatment of choice in extensive cholesteatoma to achieve a dry and safe ear with maintaining functional hearing outcomes.
The effect of wearing face masks on voice and intelligibility of speech during the COVID-19 pandemic
Authors: Abdel-Hady Aisha Fawzy , Dessouky Hossam Mohamad El , Saqr Hagar Hussein , Farag Heba Mahmoud
Published: March 2023

Background

The study aims at evaluating the effect of wearing face masks on voice and intelligibility of speech in Egyptian working individuals during the COVID-19 pandemic to identify if there are any adverse effects of wearing face masks in the working environment.

Materials and methods

A cross-section analytical study was conducted on 153 participants. Personal data and data about the nature of their workplaces were collected. The evaluation included a subjective assessment of voice and intelligibility of speech using a specifically designed questionnaire addressing self-perception of voice fatigue, speech unintelligibility, received auditory feedback and breathing difficulty, and objective voice assessment by Computerized Speech Lab, while objective speech unintelligibility assessment by the Arabic Speech Intelligibility Test.

Results

The study revealed poor workplace acoustics and increased their self-perception of voice fatigue, speech unintelligibility, auditory feedback, and breathing difficulty while wearing masks. Medical professionals showed increased self-perception of speech unintelligibility and the received auditory feedback. No significant difference was found in absolute jitter with and without a face mask. Increasing shimmer and mean fundamental frequency and decreasing noise to harmonic ratio and maximum phonation time were found. The study revealed decreased speech intelligibility especially with the N95 mask.

Conclusion

Wearing face masks negatively affects communication in the workplace, with poor room acoustics. It affects both speech intelligibility and voice subjectively and objectively. It caused increased self-perception of voice fatigue and changes in objective voice parameters.
Modified sutureless recess/tunnel technique for fixation of the internal receiver-stimulator in cochlear implantation
Authors: Sefein Ihab K. , Gaballah Mohammad M.
Published: March 2023

Background

Fixation of receiver-stimulator (RS) in cochlear implantation is an important step of surgery, while the technique used is still debatable.

Aim of study

The aim of our study is to evaluate the applicability of our modified recess/tunnel (R/T) fixation technique.

Materials and methods

De novo cases between august 2018 and December 2020 were included. A bony recess was drilled deep to the full thickness of RS. A tunnel was fashioned for the fantail and electrode lead with a groove to slide it without trauma. No tie-down sutures were used. The length between the RS magnet and tragus was measured during follow-up visits.

Results

Seventy-eight patients received the new R/T; 37 (47.4%) were females. Children were 50 (64.1%) with an average age of 4.3 ± 2 years, while adults were 28 (35.9%) with an average age of 36.4 ± 10 years. Right implants were 69 implants while left ones were only 9. The average total operative time was 86 ± 13 min, while the average R/T preparation time was 11 ± 4 min which represents 12.8% of the total operative time. No RS migration, hard. or soft failures were detected. One case had postoperative haematoma originating from the skin, while other minor complications were not related to fixation and were treated medically.

Conclusion

The R/T fixation technique provides good fixation to RS, fantail, and electrode lead protection and fixation. The disadvantages of wide exposure especially longer operative time can be avoided with this technique.
Apoptosis in lupus nephritis patients: a study of Bcl-2 to assess glomerular and tubular damage
Authors: Labib Hossam Salaheldin , Salman Manal Ibrahim , Halim Mariam Ibrahim , Fawaz Shereen Ismail
Published: March 2023

Background

Systemic lupus erythematosus (SLE) is an immune-mediated disease, due to exposure of self-antigens, through impairment of apoptosis and failure of lymphocytic tolerance. Impaired regulation of the pro- and anti-apoptotic gene products which coordinate programmed cell death may result in autoreactive B and T cells and autoimmunity. Genetically engineered mice that over-express the anti-apoptotic molecule Bcl-2, B cell lymphoma 2 (Bcl2) in B-lymphocytes advance a lupus-like illness. Lupus nephritis (LN) is one of the most serious manifestations of this autoimmune disorder. Glomerulonephritis (GN) is caused by either impaired regulation of apoptosis and/or clearance of apoptotic cells leading to a T cell-mediated autoimmune reaction with initiation of pathological immune complex deposits.

Objective

To evaluate the correlation between Bcl2 glomerular and tubular expression and pathological findings and laboratory data in different types of SLE GN.

Results

Compared to the control group, patients with lupus nephritis have significantly higher glomerular, interstitial and tubular expression level (P value < 0.001). BCL2 expression was positively correlated with serum anti-ds-DNA, urine 24-h protein and with the chronicity index. All LN patients had significant glomerular, interstitial and tubular deposits of BCL2, P value < 0.001, P value 0.004, and P value 0.03, respectively.

Conclusion

The intrinsic pathway of apoptosis interferes not only with the pathogenesis of lupus glomerulonephritis but also interferes with the pathogenesis of tubulointerstitial lupus nephritis. tubulointerstitial lesions may not only be a result of glomerular injury but also a significant factor in lupus nephritis.
First-day computed tomography: does it has a role in the assessment of patients with inhalation lung injury?
Authors: Megahed Mohammad A. , Elhelbawy Rana H. , Agha Mohammed A. , Abdelatty Nehad B. , El-Koa Amal A. , El-Kalashy Mai M.
Published: March 2023

Background

Inhalation lung injury occurs in almost one-third of all serious burns and is responsible for a considerable proportion of burn patient fatalities each year. History of closed space fire or unconsciousness at the accident site, occurrence of pharyngeal or facial burns, hoarseness, and wheezing, and laboratory tests that include blood gas abnormalities or Carboxyhemoglobin levels in blood ˃ 10% are used to diagnose inhalation lung injury. It is also characterized by radiological findings of alveolar or interstitial edema, atelectasis, and/or consolidations, as well as the presence of erythema with laryngeal or tracheal edema in the bronchoscope.

Objectives

To study the diagnostic and prognostic efficacy of radiologist score and bronchial wall thickening as radiological CT findings in inhalation lung injury.

Methods

This prospective case–control study included 48 patients with inhalation lung injury (ILI) as a case group and 10 patients without ILI were selected as the control group, all recruited from the burn and plastic department. Within the first 12 h of suspected ILI, a fiberoptic bronchoscope was done to confirm the diagnosis. An initial chest X-ray was done followed by computed tomography through which the radiologist score (RADS) together with bronchial wall thickening (BWT) was done.

Results

Duration of ventilation was higher in cases than in controls (8.50 ± 3.94 vs 3.25 ± 0.50). The hospital duration was higher in cases than in controls (13.6 ± 4.68 vs9.50 ± 4.52). The BWT was 2.12 ± 0.66 (mean ± SD) in the ILI group while the control group was 1.32 ± 0.48 (mean ± SD). Correlating between baseline PaO2 and RADS score and BWT, it was found that there was a highly significant negative correlation between PaO2 and RADS score and BWT among inhalation lung injury patients (P value 0.001). The sensitivity of BWT in the detection of the need for mechanical ventilation was 83% at a cut-off point of 1.65. Its specificity was 78% and accuracy 75%.

Conclusion

CT done within 24 h of burn patients has a good role in the diagnosis and management of ILI from the burn.
Increased antimicrobial resistance in bacterial pneumonia among Egyptian Children during the COVID-19 pandemic
Authors: Hussein Mahitab Morsy , Shaheen Malak Ali , Sleem Abdelrahman Mahmoud , Mahmoud Fatma Mostafa , Ishak Sally Raafat
Published: March 2023

Background

Pneumonia is the major cause of morbidity and mortality among children worldwide. During the COVID-19 pandemic, the use of antibiotics increased which led to the development of antibiotic-resistant strains of pathogenic organisms causing pneumonia in children. So, studies should be directed to register antimicrobial resistance in each country and to develop local antimicrobial stewardship. This study aimed to identify the distribution of bacteria causing pneumonia among Egyptian children in the year 2020 and their antimicrobial sensitivity. A cross-sectional study was done, it included fifty immunocompetent children with pneumonia admitted to Children's Hospital, Ain-Shams University from June 2020 to December 2020. Bacterial cultures were done on sputum collected using cough swab, or endotracheal tube aspirate, with their antimicrobial sensitivity.

Results

Thirty children had Community-acquired pneumonia (CAP), while twenty had Hospital-acquired pneumonia (HAP). Streptococcus pneumonia was the most frequently cultured organism in CAP group 7/30 (23.3%). The sensitivity results found linezolid (50%), followed by fluoroquinolones to be the least resistant. While in the HAP group, Klebsiella pneumonia 9/20 (45%) was the most common organism. Colistin (90%) followed by tigecycline (50%), Amikacin (35%), fluoroquinolones (25%), gentamicin (25%), and imipenem (20%) had the least resistance in the HAP group.

Conclusion

No pathognomonic shift of the bacteria that causes pediatric pneumonia was detected. Although, an increase in antimicrobial resistance was noticed.
Salicylic acid-related ribosomal protein CaSLP improves drought and Pst.DC3000 tolerance in pepper
Authors: Zhang Huafeng , Pei Yingping , He Qiang , Zhu Wang , Jahangir Maira , Haq Saeed ul , Khan Abid , Chen Rugang
Published: March 2023

The ribosomal protein contains complex structures that belong to polypeptide glycoprotein family, which are involved in plant growth and responses to various stresses. In this study, we found that capsicum annuum 40S ribosomal protein SA-like (CaSLP) was extensively accumulated in the cell nucleus and cell membrane, and the expression level of CaSLP was up-regulated by Salicylic acid (SA) and drought treatment. Significantly fewer peppers plants could withstand drought stress after CaSLP gene knockout. The transient expression of CaSLP leads to drought tolerance in pepper, and Arabidopsis’s ability to withstand drought stress was greatly improved by overexpressing the CaSLP gene. Exogenous application of SA during spraying season enhanced drought tolerance. CaSLP-knockdown pepper plants demonstrated a decreased resistance of Pseudomonas syringae PV.tomato (Pst) DC3000 (Pst.DC3000), whereas ectopic expression of CaSLP increased the Pst.DC3000 stress resistance in Arabidopsis. Yeast two-hybrid (Y2H) and bimolecular fluorescence complementation (BiFC) results showed that CaNAC035 physically interacts with CaSLP in the cell nucleus. CaNAC035 was identified as an upstream partner of the CaPR1 promoter and activated transcription. Collectively the findings demonstrated that CaSLP plays an essential role in the regulation of drought and Pst.DC3000 stress resistance.

Graphical Abstract
Experimental and numerical analysis of rainfall-induced slope failure of railway embankment of semi high-speed trains
Authors: Aqib Mohammad , Usmani Shadab , Khan Tanveer , Sadique Md Rehan , Alam Mohd Masroor
Published: March 2023

Safety and maintenance of railway tracks has been very crucial, for sustainable economic development of many nations. Almost the entire Indian railway tracks were built over the raised earth embankments. These embankments are susceptible to slope failure due to numerous reasons. One of the major cause is seepage and surface runoff during rainy (monsoon) season. Erosion by gullying has regarded as most significant failure scar. Various researches had studied the embankment failure due to rainfall. However, the gullying effect on the slope failure has been missing in these studies. Hence, in this study slope stability analysis of the railway embankment has been performed considering the gullying. Embankment of Dedicated Freight Corridor (India) has been taken up in this study. The present study has three sections (a) Field observation, (b) scaled laboratory modelling, and (c) FEM-based numerical analysis. The effect of vegetation, degree of compaction, and the intensity of rainfall on the slope stability has been evaluated. Effect of gullying has incorporated through change in shape and dimension of embankment. It has been found that vegetation significantly reduced the gully formation and also the less compacted slope experienced more gullies formation as compared to the more compacted slope. While varying the rainfall intensity from 20 to 100 mm, it has been observed that without consideration of gully higher FOS (factor of safety) was reported. Moreover, FOS decrease with increase of rainfall from 20 to 100 mm and becomes constant after that.
Developing optimal wear performance for nylon 6 loaded up with Boron Nitride (PA6/BN) composites using Taguchi direct and aspect ratio-based Taguchi-Pareto method
Authors: Adekoya Abdulganiyu Adegboyega , Adedeji Wasiu Oyediran , Oke Sunday Ayoola , Rajan Amaladas John
Published: March 2023

Although the wear performance of nylon-6/Boron Nitride (PA6/BN) composites has been studied, their concurrent optimization and prioritization are scarce in the literature. Considering this shortcoming, this paper proposes a Taguchi-Pareto-based framework incorporating a discrimination signal-to-noise ratio analysis, to enhance the wear performance of PA6/BN composites. Besides the direct factors that consider the weight percentage of particulate additives to nylon 6, sliding distance, sliding speed and normal load, the combinations of direct factors and aspect ratios of the factors were considered in eighteen cases where all four factors are considered in rotation. The novel contribution of the developed Taguchi-Pareto-oriented direct and aspect ratio (TPDA) framework based on its stepwise application to wear performance analysis is noted as follows: (1) establishment of the principal factors by contemplating their importance together with their impact levels on wear performance and (2) establishment of optimal and prioritization of the wear factors threatening the operational efficiency of the structures in which they are made up by considering their signal to noise ratios based on the 80-20 rule of Pareto analysis. The results obtained from the proposed TPDA were validated using experimental data obtained from the literature. It is thought that the application of the proposed framework to the experimental data aids the composite engineer in making prudent fabrication decisions, assisting them to successfully maintain how levels for the fabricated composites while in operation.
Pituitary hypoadrenocorticism and hypothyroidism after immunochemotherapy followed by salvage surgery for lung cancer: a case report
Authors: Nakagami Chikara , Endoh Makoto , Nakatsuka Marina , Nakahashi Kenta , Ota Hiroki , Aso Mari , Sugiyama Takuma , Suzuki Hiroki , Shiono Satoshi
Published: March 2023

Background

Immune checkpoint inhibitors (ICIs) have been shown to prolong the survival of patients with non-small cell lung cancer (NSCLC) and have allowed complete resection for advanced lung cancer. However, immune-related adverse events (irAEs) have been recognized as concerning side effects of ICIs.

Case presentation

A 62-year-old man visited our hospital because of fever, dyspnea, and anorexia. A tumor was found in the right hilum of the lung. It compressed the left atrium and was also thought to be invading the esophagus and a vertebral body. A bronchoscopic biopsy revealed squamous cell carcinoma of the lung (cT4N2M0-IIIB). We thought that a complete resection was impossible because of the N2 status of the tumor and because it had invaded several organs. Radiotherapy was thought to be contraindicated because of the patient’s marked emphysema. Therefore, we administered 4 courses of pembrolizumab plus carboplatin plus nab-paclitaxel immunochemotherapy.

After immunochemotherapy, the tumor was downstaged to ycT2bN0M0-IIA and was determined to be acceptable for salvage surgery. A right lower lobectomy and systematic dissection of the mediastinal lymph nodes were performed. The histopathological examination of the resected specimen found that the proportion of the remaining tumor cells was 5%, indicating achievement of a major pathologic response.

On postoperative day 79, the patient visited the emergency room because of anorexia. Blood tests showed hyponatremia, hypoglycemia, and eosinophilia. The serum thyroid hormone and thyroid-stimulating hormone levels were low and high, respectively. A corticotropin-releasing hormone stimulation test revealed levels of adrenocorticotropic hormone and cortisol far below the normal ranges. We speculated that the patient had developed pituitary hypoadrenocorticism and hypothyroidism as irAEs associated with ICI treatment. We administered hydrocortisone and levothyroxine, with improvement in the patient’s appetite and normalization of the patient’s serum sodium level. The patient has been receiving ongoing supplementation with oral hydrocortisone and levothyroxine and is doing well 11 months after surgery.

Conclusions

The increasing numbers of patients treated with perioperative ICIs might lead to increasing numbers of patients who develop perioperative irAEs. Careful attention should be paid to the possible development of irAEs during the perioperative management of patients undergoing surgery for lung cancer.
A surgical case of solitary severe tricuspid regurgitation mimicking constrictive pericarditis
Authors: Kaku Daisuke , Hirai Hidekazu , Seo Hiroyuki , Murakami Tadahiro
Published: March 2023

Background

It has been reported that severe tricuspid regurgitation may demonstrate constrictive pericarditis-like hemodynamics. In this article, we report a surgical case of solitary severe tricuspid regurgitation in which the hemodynamic features are consistent with constrictive pericarditis.

Case presentation

The patient was a 78-year-old man with chronic atrial fibrillation and tricuspid regurgitation. He was admitted to our hospital with complaints of edema and dyspnea, and transthoracic echocardiography showed severe tricuspid regurgitation and enlargement of the bilateral atrium. A right heart catheterization revealed “dip and plateau” patterns in the biventricular pressure waveforms, and both right and left ventricle endo-diastolic pressure had increased to 30 mmHg. Although there were no signs of calcification or thickening of the pericardium in computed tomography, we diagnosed the patient with constrictive pericarditis with severe tricuspid regurgitation and underwent surgical intervention since his heart failure symptoms were resistant to medication. The surgical findings did not show any pericardial thickening or adhesions either; therefore, we diagnosed the patient with solitary severe tricuspid regurgitation showing constrictive pericarditis-like hemodynamics. We performed tricuspid valve replacement with a bioprosthetic valve and his heart failure symptoms improved postoperatively.

Conclusions

To determine the best timing for surgery, it is essential to recognize the existence of severe tricuspid regurgitation mimicking constrictive pericarditis.
Increasing awareness of the connection between breastfeeding and mental health through an educational session for healthcare providers
Authors: Dalley Sara , Hickey Catherine
Published: March 2023

Aim of the study

The relationship between breastfeeding and mental health is complex and complicated by various confounding factors. Although no direct causative link has been established, several trends have arisen in the literature. The aim of this study was to see if an educational session on these trends could increase awareness of how breastfeeding affects mental health in women. Specifically, we aimed to see if this session could increase awareness in a group of clinicians (nurses, physicians, and lactation consultants) who provide care in the peripartum.

Subject or material and methods

A 45-minute education session was offered to health care providers for members of this population. The goal of this session was to increase awareness of how breastfeeding impacts mental health and how, when it is going well, it can positively affect mood. The session also emphasized the importance of support in the perinatal period.

Results

The session was evaluated for changes in awareness and knowledge and perceived usefulness and relevance via a short pre-and post- 8 question survey. There were significant differences in the post answers for Questions 1-5 compared to the pre- answers.

Discussion

These particular questions dealt with awareness and perceived relevance of the topic, the understanding of the complexity of the topic, perceived knowledge of the topic, and training on the topic.

Conclusions

These findings suggest that an educational session may improve awareness, knowledge levels, and perceived importance of this topic.
Motivation for stuttering therapy and its concept and other determinants
Authors: Humeniuk Ewa , Tarkowski Zbigniew , Góral-Półrola Jolanta , Samardakiewicz Marzena
Published: March 2023

Aim of the study

Purpose: The objective of this research was to determine the level of motivation for stutter treatment and its dependence on age, gender, and the conception of stuttering.

Subject or material and methods

Methods: In our study, the Conception of Stuttering Scale (CSS) and the Motivation for Stutter Therapy Scale (MSTS) were used.
Participants: The research involved 297 participants, 81 women and 216 men, all aged from 18 to 54 years. All participants had started to stutter before the age of 7, they all had stutter symptoms (confirmed by an experienced speech therapist), thought themselves to be stutterers, and had undergone at least one therapy.

Results

Overall, the respondents were likely to consider stuttering a speech impediment, logoneurosis, communication disorder, or an illness. They mostly supported the idea of comprehensively diagnosing stuttering and they did not have a uniform conception of stutter therapy. They were most likely to opt for therapies based on speech practice or psychotherapy. Their motivation for speech therapy was mostly moderate. Motivation for stutter therapy was markedly higher in women than in men.. A significant positive correlation was revealed between speech practice and non-acceptance of stuttering.

Discussion

Stuttering persons have differing conceptions of the etiology, basis, diagnosis, and treatment of stuttering. Motivation for stutter therapy in adults is moderate and is not associated with their concept of stuttering.

Conclusions

Stuttering persons have differing conceptions of the etiology, basis, diagnosis, and treatment of stuttering. Motivation for stutter therapy in adults is moderate and is not associated with their concept of stuttering.
Cognitive-behavioral therapy in ultra high risk states of psychosis (UHR)
Authors: Rek-Owodziń Katarzyna , Konopka Anna
Published: March 2023

Ultra-high risk of psychosis (UHR) is a condition associated with a higher risk of developing schizophrenia or another psychotic disorder as compared to the general population. Three groups of symptoms are reported to be related to UHR states: attenuated psychotic symptoms (APS), brief limited intermittent psychotic symptoms (BLIPS) and genetic risk and deterioration syndrome (GDR). In addition, specific cognitive deficits within attention, verbal and visual memory, executive functions and processing speed are all described as linked to UHR. UHR individuals also manifest negative cognitive beliefs and attribution biases, which affect their everyday lives. Hence, a first-line treatment recommended in UHR states is cognitive-behavioral therapy (CBT), whose effectiveness has been assessed across different studies. In this paper we describe the characteristics of UHR states, including specific cognitive difficulties they are linked with, alongside therapeutic recommendations and specificity of dedicated cognitive-behavioral treatment options.
Facial emotion recognition deficits in schizophrenia - a review of research and a model of pathogenesis
Authors: Subocz Dawid
Published: March 2023

Objective: The aim of the paper is to describe in detail the problems in the field of recognising emotional facial expressions in patients with schizophrenia. This paper also analyses studies and theoretical literature on the potential connections between deficits in recognition of emotional facial expressions and neuronal dysfunctions and attachment styles.
Materials and method: The literature review was performed using the following databases: EBSCO, PsycINFO, PubMed, and Google Scholar. The databases were searched using the following keywords: ‘emotion’, ‘facial emotion’, ‘facial expression’. Those terms were combined with the words 'recognition', 'perception', 'genetic', 'attachment style' and each time with the term 'schizophrenia'.
Results: The literature review clearly confirms that among people suffering from schizophrenia there are problems with recognising emotional facial expressions. Studies suggest that the visual perception of patients is related to the recognition of facial expressions. Studies also confirm the relationship of neuronal dysfunctions and genetic factors with the recognition of emotional facial expressions.
Discussion and conclusions: The genesis of problems in recognising emotional facial expressions in patients with schizophrenia is multifactorial in nature. The influence of attachment styles on epigenetic mechanisms and the development of neural structures related to emotion recognition remains unverified. In the future, this study will allow for the creation of more accurate models of the pathogenesis of these deficits.
Quality of life and functionality in patients suffering from chronic pain, anxiety and depression
Authors: COSTA MICHELLE , Gomez Renato
Published: March 2023

Aim of the study

Mental illnesses are common in patients with chronic pain, and this association may result in changes in functional status. This study assessed the functionality and quality of life of patients with chronic pain, anxiety, and depression.

Subject or material and methods

A total of 103 patients were interviewed at Federal University of Minas Gerais’ (UFMG) Hospital das Clínicas Pain Center, in 2020 and 2021. The presence of depression and anxiety symptoms, pain intensity, quality of life, and functionality was assessed. The cohort studied was stratified into groups suffering from mild, moderate, and intense pain in accordance with the visual numeric scale, and these patients then underwent descriptive and comparative analyses. Subsequently, a multivariate analysis was performed, followed by linear regression analysis to identify risk factors and variables that contributed to the pain being felt.

Results

In total, 16.5% of the patients were diagnosed with symptoms of anxiety, 13.59% with depression, and 34.95% presented symptoms of both anxiety and depression. The functionality assessment revealed severe incapacity, with the highest levels of incapacity present in those suffering from the most intense pain.

Discussion

Patients with symptoms of anxiety and depression presented a worse quality of life than those without these symptoms, with some aspects directly related to pain intensity.

Conclusions

Chronic pain, in the presence of symptoms of anxiety and depression, produces severe functional psychosocial incapacity and a low quality of life, which are directly related to pain intensity. Skin color, suicidal ideation, and psychosocial issues are associated with depression, anxiety, and chronic pain.
Editorial
Authors: Lew Starowicz Michał , Cyranka Katarzyna , Samochowiec Jerzy
Published: March 2023

This year’s first issue of APP appears with a variety of relevant clinical topics presented by nine groups of authors from different countries. It opens with two original articles raising awareness about postpartum mental health conditions. Anida Vrcić Amar and Hana Sejfović from Serbia presented correlations of reduced social support from partners, friends and family, difficult newborn temperament, and low socioeconomic status with postpartum depression. In the second paper, Sara Dalley and Catherine M. Hickey from Memorial University of Newfoundland show the effects of implementation of an educational session aimed at increasing awareness of the impact of breastfeeding on mental health and it’s possible protective influence on female’s mood.