bluuebunny/crossref_metadata_2025 huggingface dataset:
Central Venous Pressure and acute kidney injury in off-pump coronary artery bypass grafting
Authors: Zeng Zhihe , Zheng Jia , Sun Ye , Xiao Zhaoyang
Published: May 2024

A retrospective study investigated the relationship between Central Venous Pressure (CVP) levels during off-pump coronary artery bypass grafting (CABG) surgery and postoperative outcomes including Acute Kidney Injury (AKI), Low Cardiac Output Syndrome (LCOS), re-intubation, and in-hospital mortality. Data from 1,146 OPCABG cases from two hospitals were analyzed. Patients were divided into high CVP (≥ 10.1 mmHg) and low CVP (< 10.1 mmHg) groups based on Receiver Operating Characteristic (ROC) curve analysis. The high CVP group had significantly higher rates of AKI (47.21% vs. 20.04%) and LCOS (8.93% vs. 3.08%) compared to the low CVP group. An intraoperative CVP ≥ 10.1 mmHg was identified as an independent risk factor for post-OPCABG AKI. The multivariable regression model showed a 40% increased risk of AKI with CVP > 10.1 mmHg (OR: 1.434, p < 0.001). This study suggests that maintaining an average intraoperative CVP < 10.1 mmHg may help reduce the risk of OPCABG-associated AKI.
Exploring Cognitive and Behavioral Dynamics of Smoking among Medical Students: A National Cross-sectional Study
Authors: Aljunaid Mohammed A. , Bukhari Haneen Saud , Alsharif Rafal Hussain , Alharbi Shahad , Alsharif Rawaf Hussain , Mehdar Safaa A.
Published: May 2024

Background
Assessment of smoking behaviors and their dynamics is a crucial domain, particularly among medical students who serve as future healthcare providers. However, the association between smoking behaviors and academic progression remains understudied in Jeddah, Saudi Arabia.
Objectives
This study aims to determine smoking patterns, prevalence, and associated factors among medical students in Jeddah, focusing on experimentation, daily smoking, cessation efforts, awareness of health risks, and attitudes towards quitting.
Methods
A cross-sectional study was conducted in Jeddah, Saudi Arabia, from September to November 2023. Male and female medical students from the second to sixth year, enrolled in specific universities, were included. Data collection utilized a comprehensive questionnaire, adapted from the World Health Organization's questionnaire and enhanced with additional relevant items by the researchers. The questionnaire, comprising of eight sections, was administered online over a three-month period. Descriptive statistics were used for analysis.
Results
About 30.8% reported ever smoking, with 21.6% currently smoking. Among ever-smokers, 43.1% began smoking during college, mostly in the second year. Stress, exploration, and peer influence were frequent reasons for initiating smoking during college years. About 32.3% never considered quitting, while 67.7% thought about it. Regarding quit attempts, 46.2% did not try, 53.8% attempted seriously, and 5.3% quit in the last year. Protective factors against smoking included health concerns and setting a good example. Most participants recognized smoking-related health hazards, with strong consensus on the effectiveness of anti-smoking measures. Notably, many participants expressed proactive attitudes towards smoking cessation interventions.
Conclusion
Smoking is prevalent among Saudi medical students, often starting in college due to stress, new experiences, and peer influence. Many consider quitting, probably supported by the educational environment and a sense of responsibility towards personal and public health. Strengthened educational frameworks, including stress management training, are crucial for fostering a health-focused professional identity.
Drop tests and numerical simulation of composite beams with corrugated web
Authors: Yu Jian , Wu Jiawei , Wang Xinfeng , Li Yuxiang
Published: May 2024

To investigate the energy absorption ability of composite beams with corrugated web in the crash process, the drop tests of composite beams with corrugated web were carried out, and the morphology of fracture, load and energy history curves were obtained. Based on the Abaqus/Explicit platform, a simulation analysis model was developed to simulate the impact collapse process of composite beams with corrugated web using secondary development. The improved Hashin criterion and Choi-Chang criterion were used with the Cohesive interface element. The anisotropy and progressive damage of composite laminates were implemented. Average loads were obtained by numerical simulation, which was verified by experimental results. Based on this model, further studies on the energy absorption of composite beams with corrugated web were analyzed with different wavenumbers. The progressive damage of corrugated web beams under impact load was simulated by the developed FE model. The relative errors of average crushing load were small, which verified the validity of the FE model. When the wave length of web was defined, the length of corrugated web beam had influence on energy absorption under impact. The shorter beam with corrugated web was unstable and ineffective in energy absorption.
Examining Macroeconomic Factors and Environmental Sustainability: An OLS Regression Analysis of the Impact of Exports, Imports, Governmental Budget, and Oil Products on CO2 Emissions in Jordan
Authors: Atyeh Mohamad , Damrah Sadeq
Published: May 2024

This study aims to investigate the relationship between macroeconomic factors and CO2 emissions. The study used a sample of data covering the period from 1991 to 2019 and employed ordinary least squares (OLS) method to estimate the relationship. The study found that there is a strong relationship between CO2 emissions and the macroeconomic factors of exports, imports, governmental budget, and oil products. The R-squared value of 0.717668 suggests that these variables explain approximately 72% of the variation in CO2 emissions. The coefficients for exports, imports and oil products are statistically significant at the 5% level. A negative coefficient for exports indicates that an increase in exports is associated with a decrease in CO2 emissions. On the other hand, a positive coefficient for imports suggests that an increase in imports is associated with an increase in CO2 emissions. Additionally, the positive coefficient for oil products indicates that an increase in oil product consumption is associated with a significant increase in CO2 emissions. The coefficient for the government budget variable is not statistically significant, which suggests that changes in the government budget do not have a significant impact on CO2 emissions. The results are robust and reliable as the assumptions of linearity, normality and homoscedasticity of errors were met. The study results could help policy makers in taking potential actions to mitigate CO2 emissions in the country.
Phytoremediation potential and iron fortification of sorghum (Sorghum bicolor L. Moench) in rusty soil from sand filtration of groundwater
Authors: Ologidi Charles Godspower , Amaizu Priscillia Eberechukwu , Oweniwe Veracious Ijeoma , Ahiamadu Goodness Justice , Calabar Ekpobomene Appah , Irewande Taiwo Michael , Amanna Michael Henry , Godgift Comfort , Apiloko Jonathan Anabel , Akpofagha Ebiladei , Kunidei Jennifer Daumiebi
Published: May 2024

Rusty soil is a waste from sand filtration of groundwater, but it is improperly disposed of thereby resulting in environmental contamination. Therefore, the possibilities of cleaning up the rusty sand by phytoremediation was examined. However, given that the rusty sand is rich in iron, the possibilities of iron biofortification of crops using sorghum as a model was assessed. Sorghum plants were transferred to treatment (variable mixtures of rusty sand, sand, and manure) and control soils (rusty sand and sand) and concentration of iron was ascertained at six and thirty days after transplanting (DAT). Iron concentration in plant parts were also determined at 30 DAT and soil iron reduction, bioconcentration (BCF) and translocation factors (TF) were computed. Statistical analyses (p < 0.05) showed that the highest considerable reduction in iron was achieved with the positive control that, however, produced a lower iron concentration in plant parts. But plants in 75% three-components mixture had the highest iron concentration in plant parts. Therefore, the 75% three-component mixture was best suited for iron biofortification of vegetative plant parts. The BCF and TF were respectively below and above one (TF in leaf) and phytostabilisation/exclusion and phytoextraction/phytoaccumulation of iron were inferred.
Isolation of a virulent Vibrio alginolyticus Bacteriophage and Its Application in Shrimp culture
Authors: Wang Wenqi , Meng Xiansong , Wu Zhonghao , Fu Yubin , Li Xiaoling , Chen Shiyong
Published: May 2024

As an opportunist pathogen, Vibrio alginolyticus, causes disease outbreaks in marine farmed fish and invertebrates. Due to problems caused by the abuse of antibiotics, it is extremely important to develop green biocontrol methods for Vibrio diseases. Phage therapy is considered a safe and promising prevention and treatment method. Here, we report that a novel virulent bacteriophage VaPW, which infects V. alginolyticus, was isolated from seawater. The bacteriophage is morphologically similar to phages from Myoviridae family. It displayed good pH (7–9) and temperature (≤ 50°C) tolerance and had a narrow host range. Its genome consists of 34,637 bp with a GC content of 43.22%, while sequence analysis revealed the presence of 41 potential ORFs, of which 26 coding sequences showed homology to functionally characterized genes. The in vitro antibacterial experiment showed that phage VaPW could effectively inhibit the growth of V. alginolyticus ATCC 33787. Moreover, the shrimp survival test demonstrated that phage VaPW has the in vivo protection effect against V. alginolyticus infection. To determine whether the putative lysozyme and holin from phage VaPW have bactericidal activity, orf26 and orf27 were cloned for protein expression and analyses in E. coli. The data revealed that co-existence of holin and lysozyme exhibited a synergistic bactericidal effect on the lysis of target cells compared with single protein alone. These results suggest that phage VaPW and its proteins may provide good candidates to control recurrent diseases caused by V. alginolyticus in marine animals.
Short-term effects of air pollutants on hospitalizations risk for circulatory disease from 2018 to 2023: a time-series study in Shenzhen, China
Authors: Gao Jun , zhou Wanling , Duan Jun , Chen HanJie , Liu Chang , Gao Yun , Liu Yan
Published: May 2024

Analyzing the acute effects of air pollutants on the circulatory diseases of residents in Shenzhen City. Provide a rationale for disease prevention and related policy development. We obtained data on 47,440 cases of hospitalization for circulatory system diseases in Shenzhen from 2018–2023, Information on the daily average concentrations of air pollutants, and meteorological information. Control of air pollutants, weather, and workdays using a generalized additive model (GAM) combined with a distribution lag nonlinear model (DLNM). Our study found that short-term exposure to CO, NO2 increased the risk of daily hospital admission for circulatory diseases. The relative risks were 1.043 (95%CI 1.002–1.084), and 1.060 (95%CI 1.001–1.123), respectively. The association of CO and NO2 with daily hospital admissions for circulatory diseases was stronger in females and < 65 years of age. CO and NO2 are the risk factors affecting the development of circulatory diseases with a certain lag. Attention should be given to protecting the vulnerable populations.
Evaluation of Clinical Pharmacy Services in Patients Receiving Antithrombotic Treatment: A Randomized Controlled Trial
Authors: SOSYAL Damla , Bektay Muhammed Yunus , Acikgoz Nusret , Izzettin Fikret Vehbi
Published: May 2024

Background: Antithrombotic drugs are frequently used in the Cardiology ward and patients receiving these drugs are thought to be vulnerable to drug-related problems (DRPs). The aim of this study was to evaluate clinical pharmacy services for the detection and prevention of DRPs in these patients.Methods: This prospective randomized controlled study included 400 patients receiving antithrombotic therapy in the Cardiology ward. The European Pharmaceutical Care Network Classification (PCNE v9.1) was used to assess DRPs. Patients were analyzed for readmission within 1 and 3 months after discharge.Results: The mean age of patients in the control and intervention groups was 67.2 ± 12.2 and 67.8 ± 12.3 years, respectively. Coronary artery disease (74.5%; 74.5%) and hypertension (70.5%; 70%) were the most common diseases. The number of DRPs detected was 561 in the control group and 497 in the intervention group. In both groups, the most frequently identified problem was related to treatment safety (73.62%; 74.25%). This was followed by treatment effectiveness (24.06%; 23.14%). The main causes of DRPs were drug selection (81.11%; 80.88%) and dose selection (19.08%; 16.10%). During the study, 248 (93.23%) recommendations were made for 266 clinically significant DRPs. Of these recommendations, 235 (94.76%) were accepted by physicians. The most common interventions at the drug level were changing the dose (29.65%) and starting a new drug (28.49%). There was no significant difference between the groups in terms of readmission within 1 and 3 months (p > 0.05), but a numerical decrease was observed in the intervention group.Conclusion: In our study, the number of clinically significant DRPs was statistically lower in the intervention group (p < 0.05). The high acceptance rates of the recommendations regarding the problems in the intervention group showed that the clinical pharmacist had a positive contribution to the reduction of DRPs. These results suggest that the inclusion of clinical pharmacists in the healthcare team and the expansion of their services will provide a better-quality healthcare service.
Advancing Photonic Communications: High-Density Integration of a 100 Gb/s O-Band QCSE Modulator on Silicon Substrates
Authors: Skandalos Ilias , Bucio Thalía Domínguez , Mastronardi Lorenzo , Yu Guomin , Zilkie Aaron , Gardes Frederic
Published: May 2024

With the growth of data-intensive artificial intelligence models and the roll-out of high-capacity 5G telecom networks, the use of ultra fast transceivers with low power consumption has become essential in data centres. Quantum-confined Stark effect (QCSE) modulators are one of the contender systems that offer the potential to achieve optical modulation at high data rate, whilst retaining low real estate, low power consumption and operation in the O-band. Such modulators can be fabricated using complementary metal-oxide semiconductor (CMOS) materials including Ge/SiGe multiple quantum-well (MQW) stacks grown on silicon (Si), and be integrated with silicon nitride (SiN) on a Si substrate to retain CMOS compatibility and potential for large scale manufacturing. Here we demonstrate an O-band 2.5×50 µm2 Ge/SiGe QCSE modulator butt-coupled to SiN waveguides on Si and silicon-on-insulator (SOI) substrates. With this novel waveguide integration technique and a high-index contrast waveguide interface that utilises anti-reflective coatings, coupling losses of less than 1 dB were achieved along with better than −13.58 dB back-reflection in the O-band. The static extinction ratio (ER) of the modulator remained unchanged in a 20-80 ◦C range achieving in excess of 5 dB, with a 3.01 dB dynamic ER at 50 Gb/s using an on-off keying (OOK) modulation scheme. The modulator also achieved a 100 Gb/s data rate with an ER of 2.28 dB and an average energy consumption of <70 fJ/bit, paving a way to fast and energy-efficient optical interconnects.
The carbon budget of continents is strongly influenced by overlooked lake littoral zones
Authors: Grasset Charlotte , Mesman Jorrit , Tranvik Lars , Maranger Roxane , Sobek Sebastian
Published: May 2024

In the littoral zone, at the land-water interface of lakes and running waters, the areal productivity of plants rivals that of rain forests, resulting in a potentially very high carbon (C) turnover. While tidal wetlands at the land-ocean interface are now included in global C budgets, littoral zones of inland waters are currently not accounted for. This is remarkable given that the total shoreline of inland waters is more than 20 times longer than that of the global ocean. Here we argue that ignoring littoral C turnover in inland waters potentially results in biased estimates of continental C cycling. By including for the first time the turnover of C fixed by aquatic plants in the littoral, we show that the estimated global C balance of lakes may reverse from a net C source to a net C sink. In addition, a large part of the C outgassed in the pelagic zone might originate from the littoral, implying that previous estimates of terrestrial C inputs to inland waters were too high. We argue that the quantification and modeling of littoral C fluxes is essential to more accurately estimate the feedbacks between the continents and climate.
Investigation of the Performance of Miniature Model of Venturi Flume
Authors: Hameed Hayder A. Al Thamiry Abdul Hameed Sadeq
Published: May 2024

Venturi flume is a device used to measure discharge in the open canal. It consists of a convergent section followed by the throat and a upstream section. The current study proposes a new design for a miniature Venturi flume with reduced width. The proposed Venturi flume consists of a uniformly converging section upstream 40 cm wide, a short-throated section 20 cm wide, and a uniformly spaced section below the estuary. The floor section is level in all directions. The purpose of this miniaturization is to facilitate and reduce the cost of calculating discharge. The study of the results of the miniature model of Venturi Flume for discharges 0.11, 0.43, 0.31 showed the value of the discharge coefficient of the device between 0.96 and 0.99, and the results indicate that the miniaturization of the model after comparing it with the volumetric method has a good ability to measure discharges. The results showed that a discharge exceeding 25 L/s requires more accuracy in measuring the actual discharge for calibration with miniature models.
Employment among patients with end stage renal disease on maintenance dialysis at a tertiary care centre in North India- a cross-sectional study.
Authors: pooniya vishal , chandra abhilash , Rao S Namrata
Published: May 2024

Background
Employment is associated with a host of benefits including better self esteem, quality of life and financial independence. Maintenance dialysis is a major barrier to employment in patients with ESRD. This observational cross-sectional study was conducted to determine the proportion of patients suffering from ESRD on maintenance dialysis who were employed and various factors associated with loss of employment.
Methods
Patients suffering from ESRD, aged 18 to 65 years, who were on maintenance dialysis for ≥ 3 months were included. Their clinical and demographic characteristics, employment status before dialysis and change in employment after initiating dialysis was recorded and various factors associated with change in employment were analyzed.
Results
We observed that 39 (15.6%) out of 225 study subjects were employed on maintenance dialysis, whereas 155 (68.9%) patients were employed before initiating dialysis. Patients who lost employment were significantly younger and a higher proportion were on HD. Being on maintenance PD, residing in a nuclear family and at a shorter distance from the dialysis centre, self financing of treatment and professional employment category were associated with a greater likelihood of retaining employment after initiating dialysis.
Conclusion
This study revealed that only a small proportion of patients on maintenance dialysis are employed and a large number of patients lose employment after initiating dialysis. Nuclear family, PD as dialysis modality, professional category job before initiating dialysis, self-financing of treatment and living closer to dialysis centres was associated with retaining employment on maintenance dialysis.
Financial Development and CO2 Emissions in Emerging Markets: Evidence from Dynamic Panel Regression Models
Authors: Ogboghro Vincent Ikumariegbe , Nnaji Kennady Kelechi
Published: May 2024

This study examines the dynamic relationship between financial development and CO2 emissions in BRICS and Non-BRICS emerging markets from 2000 to 2022. The study also considers the role of energy consumption, economic growth, trade openness, and foreign direct investment in the relationship between financial development and CO2 emissions. Based on a sample of 22 emerging markets and Germany, we provide evidence that financial development and CO2 emission are cointegrated. Also, economic growth and energy consumption are the main drivers of CO2 emission in the short run, while financial development, energy efficiency, economic growth foreign direct investment all have a positive effect on CO2 emissions in the long run. However, trade openness reduces CO2 emissions in the long run. Further, we find that all, except energy consumption, are significant explanatory factors for financial development in the long run. Besides, there is evidence that unobserved country-specific factors are significant determinants of both financial development and CO2 emissions. However, while all the BRICS countries have positive country-specific effects, most African countries are associated with negative unobserved country-specific effects. Hence, the scope of global and regional environmental policies and interventions can be expanded to accommodate country idiosyncrasies for better and more dependable results.
JEL: F65, Q56, C23.
A Rare Case of Epithelial-Myoepithelial Carcinoma Breast in A Young Female with HER2neu Positivity
Authors: Verma Shipra , Guleria Bhupesh , Raut Vrushali , Anand S , Guleria Prerna , Tevatia M S
Published: May 2024

Epithelial-myoepithelial tumors of breast are biphasic neoplasms, with dual participation of epithelial and myoepithelial components. It is a very rare tumor, common in elderly females. EMC breast resembles its salivary gland counterpart, which itself forms less than 1% of all salivary gland tumors. Herein, we report one such rare case of EMC breast in a young female with aberrant HER2 positivity, a feature not yet reported in literature.
Renal Medullary Carcinoma, A Rare But Aggressive Sickle Cell Nephropathy: A Case Report
Authors: Kumar Lakshmy S , Nair Vijayalekshmi , Aravindan K P , Warrier Narayanankutty
Published: May 2024

Renal Medullary Carcinoma (RMC) is a highly aggressive cancer that typically affects adults in second to third decades of life with male preponderance and dismal prognosis. As the name indicates, it is medulla centric and is almost exclusively associated with sickle cell hemoglobinopathy. Tumor shows SMARCB1 /INI-1 deficiency and hence called SMARCB1 deficient renal medullary carcinoma. As there are only around 600 cases been reported worldwide till date, we report this case as an eye opener for having high degree of clinical and pathological suspicion in renal cancer patients of younger age, especially if there is no known history of hemoglobinopathy. Prompt diagnosis and treatment is warranted to prolong survival.  Our case is that of a 36yr old male who presented with hematuria and loin pain of six months without any significant past history. Radiological evaluation showed right renal mass with extensive metastatic disease. Palliative right radical nephrectomy was done which on thorough histomorphological and immunohistochemical examination was diagnosed as renal medullary carcinoma. Tumor cells showed loss of INI 1 expression which is a surrogate marker for SMARCB1 deficient status. High performance liquid chromatography was done which revealed sickle cell trait. He was started on immunotherapy and chemotherapy, following which he had a favorable treatment response.
Human Parvovirus B19 Induced Pure Red Cell Aplasia in a Known Case of Hereditary Spherocytosis; A Bone Marrow Diagnosis
Authors: Waghmare Tejaswini Priyadarshan , T P Meera , Prabhat Daksha Piyush , Asthana Ankita
Published: May 2024

Human Parvovirus B19 (HPV B19) is a single stranded DNA virus belonging to parvoviridae family causing an acute self-limiting viral infection transmitted through respiratory droplets. However, in patients with hemolytic anemia, it can cause pure red cell aplasia and eventually aplastic crisis. We report a case of 27-year-old male, who presented with complaints of fever, nausea and body ache for 15 days. Physical examination showed pallor, icterus and splenomegaly. Complete blood count (CBC) revealed pancytopenia. Plasmodium Vivax infection was seen on peripheral blood smear (PBS) and hence was treated with antimalarials, however fever persisted. Bone marrow examination done in view of panytopenia revealed large proerythroblast with eosinophilic intranuclear inclusions.  The impression given was hypercellular marrow with erythroblastopenia with parvoviral inclusions. Parvovirus B19 quantitative PCR showed elevated titers. He is also a diagnosed case of Hereditary Spherocytosis and Gilberts syndrome since 2015. Acute onset pancytopenia in individuals suffering from chronic hemolytic anemias should raise a suspicion of viral infection. Timely diagnosis and supportive management is vital.
Triple Heterozygosity: A Riveting Coinheritance
Authors: Dhawan Vishesh , Atreja Charu Batra , Batra Neha , Kediya Ayushi
Published: May 2024

Medical literature has witnessed various heterozygous combinations between thalassemia and hemoglobin variants posing diagnostic challenges but very few case reports have been reported stating double heterozygosity among hemoglobinopathies themselves, let alone in a combination with thalassemia. We report one such rare presentation of triple heterozygosity on cation exchange-high performance liquid chromatography (CE-HPLC) of beta thalassemia trait coexisting with Hb D Punjab and Hb Q India in an adult female who presented with fever, pain abdomen, vomiting and had a past history of intermittent jaundice and recurrent anemia in childhood as well. A positive family history of patient’s father’s beta thalassemia trait and patient’s mother’s Hb D Punjab and Hb Q India helped us clinch the diagnosis in our index case, thus proving family screening to be an inexpensive and rapid way to resolve HPLC patterns.
Distribution of Acute Phase Proteins in Post-SARS CoV2 Mucormycosis Infection
Authors: Dixit Deepti , Shettar Vishwanath G , Joshi Vikas , Javalgi Anita P , Athanikar Vidisha S , H Kavana
Published: May 2024

Background
This study was aimed to estimate the serum levels of acute phase reactants/proteins (APR) which includes serum ferritin, C Reactive Protein, D-dimer and Procalcitonin in mucormycosis infection following SARS CoV2 infection and to determine the clinical, biochemical and histopathological findings in the same.
Methods
It was an observational cross-sectional study. All cases of mucormycosis following SARS CoV2 infection were reviewed.  Demographic and clinical details with comorbidities and relevant laboratory investigations which included serum glucose, serum ferritin, C Reactive Protein, D-dimer, Procalcitonin were noted at the time of diagnosis of mucormycosis. Diagnosis of mucormycosis was based on frozen section examination and histopathological examination.
Results
Thirty-two cases of mucormycosis following SARS CoV2 infection confirmed on histopathology were studied. Majority of the cases (77%) were with comorbidity especially having diabetic mellitus type 2.  C-Reactive protein, Procalcitonin and serum Ferritin were raised in almost all cases with mean of 80.92±62.5mg/l, 17.99±26.87ng/ml. and 464.9±422.03ng/ml respectively. D Dimer was raised in less than 50% cases with a mean of 828.5±245.9 ng/ml.
Conclusion
Acute phase proteins like C reactive Protein, Procalcitonin, Serum ferritin and D Dimer were raised in Post-SARS CoV2 infected individual who presented now with mucormycosis infection. These markers were raised markedly in critically ill patients thus indicated its pathogenetic role in severe morbidity, thus estimation of serum acute phase reactants can help in predicting the course and severity of illness.
Epidermoid Cyst Localized in Bilateral Palatine Tonsils – A Rare Case Report
Authors: Mistry Krishna Vijaykumar , Kahar Manoj A
Published: May 2024

Epidermoid cysts (ECs) are benign lesions that can occur throughout the body, but they have a low incidence in the head and neck region (1.6 to 7%). In the oral cavity, the most commonly affected site is the floor of the mouth, while tonsillar location remains extremely rare (less than 0.01%). Here, we present a case of bilateral epidermoid cysts of the palatine tonsils, which were incidentally detected in a patient.
PULMONARY EWING SARCOMA/PRIMITIVE NEUROECTODERMAL TUMOR : A CASE REPORT
Authors:   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Lahmar Soukayna , Ait Erraisse Mohamed ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Khelfi Saqmia ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Sossy Kawtar ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Hassani Wissal ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Zahraa Farhane Fatima ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Alami Zenab ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco., Bouhafa Touria ,   Radiation Oncology Department, Oncology Hospital, Hassan II University Hospital. Fez, Morocco.
Published: May 2024

Extraosseous Ewings sarcoma is an extremely rare neuroectodermal tumor,Although thoracic Ewing sarcoma/primitive neuroectodermal tumor (PNET) usually developson the chest wall, there have been reports of primary Ewing sarcoma/PNET of the lung Wereport the case of a 30-year-old manwho presented with right-sided pulmonary mass.Radiology, histopathology, and immunohistochemistry confirmed the diagnosis of primarypulmonary Ewings sarcoma, the patient wastreated by chemotherapy ( regimen ofvincristine, doxorubicin, cyclophosphamide alternating with ifosfamide, etoposide ) andradiotherapy.
COMPARATIVE PHYTOCHEMICAL EVALUATION AND ANTIMICROBIAL ACTIVITY STUDIES ON MEDICINAL TREE AEGLE MARMELOS (L.) CORREA AND ITS INTRASPECIFIC VARIANT EKABILVA
Authors:   Department of Botany, Plant Systematics, Biodiversity and Conservation Laboratory, University College of Science, Saifabad, Osmania University, Hyderabad -500 004, Telangana State, India., Alijala Sandhya , Ramana Munigela Venkat ,   Department of Botany, Plant Systematics, Biodiversity and Conservation Laboratory, University College of Science, Saifabad, Osmania University, Hyderabad -500 004, Telangana State, India., Kante Nethaji ,   Department of Botany, Plant Systematics, Biodiversity and Conservation Laboratory, University College of Science, Saifabad, Osmania University, Hyderabad -500 004, Telangana State, India.
Published: May 2024

The present study is focused on the comparative phytochemical analysis and antimicrobial activity in the typical form of the Aegle marmelos(AM1) and its intraspecific variant EkaBilva(AM2). Since ancient times Bilvais highly used in the indigenous systems of medicinesfor various disorders but extensively for dysentery and diabetes.Its intraspecific variant EkaBilvahas more extensively used rather than Bilva by the locals in Telugu speaking states. To find out the variations in the phytochemical components and their activity in the both typical form and intraspecific variant the studies were carried out. The powdered leaf materials of both were extracted by using Aqueous, ethanol, chloroform and pet-ether extracts. The following chemical compounds were reported Alkaloids, Steroids, Triterpenoids,Tannins, Glycosides, Flavonoids, Reducing sugars, Phenolsin AM1&AM2. Tannins, Flavonoids are present in Alcohol extracts in AM1 differing with AM2. The antimicrobial activity was carried out by disk-diffusion method by using four different microorganisms with the nutrient agar medium the high zone of inhibition shown in the leaf extracts of AM2 in all extracts except aqueous in all isolates.
A REPERTOIRE OF ACUTE DACRYOCYSTITIS
Authors:   Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra., Aranke Chaiti , Chavan Waman ,   Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra.
Published: May 2024

Background: Clinical features of acute dacryocystitis comprise of three stages- stage of cellulitis, lacrimal abscess and fistula formation. Infective odontogenic focus is one of the known etiologies for acute dacryocystitis. Pre-septal cellulitis is the most common presentation associated with epiphora. Tenacious inflammation of sac or distal nasolacrimal duct obstruction can result in a lacrimal abscess. Unattended abscess may consequently form a fistula. Acute dacryocystitis rarely can get complicated to cause orbital cellulitis overstriding the anatomic barriers. Case Presentation: Case1: A 72/F complained of toothache since a week, followed by diffuse swelling below lower eyelid, pain and discharge near medial canthus. The case was diagnosed as acute dacryocystitis with pre-septal cellulitis due to apical abscess of right maxillary molar which was visualised on orthopantomogram. Case2: A 36/M presented with mild pre-septal cellulitis and lacrimal abscess. Case3: A 79/M presented with diminution of vision, pain and inability to move the right eye. He had history of watering for8 years. He was diagnosed to have orbital cellulitis with fistula secondary to acute on chronic dacryocystitis. Discussion: Case 1: Symptoms resolved spontaneously with emergency access opening of right first maxillary molar and systemic intravenous broad-spectrum antibiotics. She further underwent dacryocystectomy with fistulectomy. Case 2: Lacrimal abscess was managed with incision and drainage followed by dacryocystorhinostomy. Case 3: Orbital cellulitis was managed with broad-spectrum intravenous antibiotics. Dacryocystectomy with fistulectomy was performed after the eye was quiet. Conclusion: Presentation of dacryocystitis can have variable causes hence proper history and addressing underlying cause at the earliest can help in early resolution. Aggressive management of complications can help in steady subsidence without progression.
HEPATOCELLULAR CARCINOMA IN CHILDREN: 2 CASE REPORT
Authors:   Pediatric Hematology and Oncology Department, Mohammed the VI University Hospital, Marrakech., Kaouani D. , Houdzi J. El ,   Faculty of Medicine and Pharmacy, Cadi Ayad University - Marrakech.
Published: May 2024

Background:Hepatocellular carcinoma (HCC) is the second most common liver cancer in children.In this article we sought, through our two observations, to examine the evolving clinical aspect as well as the therapeutic management of hepatocellular carcinoma in children, since this affection is rare in the childhood. Case presentation:We report two cases of hepato carcinoma. The first case of an 11-year-old girl from Marrakech with glycogenosis complicated by hepatic cirrhosis at the portal hypertension stage. After diagnostic confirmation; the patient benefited from systemic treatment with Atezolimumab + Bevacizumab with good progress in the short term (5 months follow-up). The second case concerns a 14-year-old girl from Marrakech region with hepato carcinoma on a healthy liver who received the same treatment but the evolution was marked in the long term by an increase in the size of the mass and portal hypertension and death at age 17 years old. Conclusion: HCC is rare in childhood. The etiological predisposition and biological behavior differ from adults. In cases of cirrhosis or liver disease, HCC must be suspected based on a high AFP level and an abnormal nodule on ultrasound. Hepatoblastoma should be considered first in the differential diagnosis. Treatment of pediatric HCC is difficult. Complete surgical resection is essential to cure it. For tumors that cannot be resected, liver transplantation is decided on a case-by-case basis. However , HCC remains difficult to treat as cure requires complete surgical resection.
CLINICO-RADIOLOGICAL DIAGNOSIS OFAPPENDICITIS
Authors:   Senior Resident, MGM Medical College and Hospital, Navi Mumbai., A. Kalokhe Shifa , Mathews Saumya ,   Senior Resident, MGM Medical College and Hospital, Navi Mumbai., Vardey Mohit ,   Senior Resident, MGM Medical College and Hospital, Navi Mumbai., Guntupalli Akhil ,   Senior Resident, MGM Medical College and Hospital, Navi Mumbai., Kaur Amolpreet ,   Senior Resident, MGM Medical College and Hospital, Navi Mumbai., Reza Ali ,   Senior Resident, MGM Medical College and Hospital, Navi Mumbai.
Published: May 2024

Background : The symptom of right lower quadrant pain had puzzled clinicians for many centuries. Appendicitis needs to be considered in the differential diagnosis of nearly every patient presenting with acute abdomen, misdiagnosis of appendicitis is significantly higher in females. Early diagnosis remains the most important goal in patients, despite use of ultrasonography, CT scanning and diagnostic laparoscopy the rate of misdiagnosis of appendicitis and rate of negative appendicectomy is significantly high. Surgical treatment is a highly successful medical intervention In this study we have attempted to find a co-relation between the efficiency of clinical diagnosis with radiological diagnosis of appendicitis. Aim and Objectives: To determine the sensitivity, specificity and diagnostic accuracy of clinical scores, ultrasonography and CT of abdomen in a case of acute appendicitis. Materials and Method: 50 patients with acute onset lower abdominal pain and diagnosed as appendicitis were evaluated by the emergency surgical team.A detailed clinical evaluation was carried out as per criteria of the three clinical scores (Alvarado, Fenyo, Ohman).The inference from each of the scores was noted.The patients underwent ultrasonography(USG) and contrast CT of the abdomen and pelvis.The findings of both these investigations and intra operative findings were noted. The specimen was sent for histopathological examination which was considered as gold standard for the diagnosis of acute appendicitis. Result: In this study we found that Alvarado score had the highest sensitivity among females 92.31% and also the highest NPV 66.67%.Ohmann score had the overall highest sensitivity 100% and NPV Hence, it can be used as a simple, quick and effective screening score for detection of appendicitis in a large number of patients. The score is simple to use and can also be calculated by paramedical staff. USG of the abdomen is a useful screening tool however CT had a high specificity 88.89% and PPV 97.30% and diagnostic accuracy of 88%. Conclusion: Despite the advent of various investigation modalities, a surgeons clinical acumen should never be compromised. The clinical scores and investigations should always be used as an adjunct history taking and clinical examination. Appendicitis should always be considered as a differential diagnosis in every case of acute pain abdomen.
ASSOCIATION BETWEEN VITAMIN D LEVELS AND GLYCEMIC CONTROL AMONG ADULT DIABETIC PATIENTS IN AHSA, SAUDI ARABIA
Authors: Alomran Salma , Alsaleh Essa , Aljasem Majdi
Published: May 2024

Background: Vitamin D deficiency is highly prevalent in the Middle East region including Saudi Arabia. Emerging evidence links vitamin D status to glycemic control in diabetes. However, findings on the effects of vitamin D correction on HbA1c levels have been inconsistent. Objective: To assess the association between vitamin D correction and changes in HbA1c levels among adult diabetic patients in Ahsa, Saudi Arabia. Methods:The present study used quasi-experimental design, and evaluated 344 patients with vit D deficiency. Patients received vitamin D supplementation, dietary counseling, or sun exposure advice for 6 months. HbA1c was measured at baseline and end-line. Change in HbA1c was compared between intervention groups using statistical analyses. Results:Improvements in vitamin D levels significantly reduced HbA1c, indicating vitamin Ds role in insulin regulation(r = -0.452, p < 0.001). However, direct vitamin D correction showed no statistically significant HbA1c changes (t: 0.898, p 0.37, CI (-0.071 -0.19)), suggesting individualized approaches may be needed. Multiple regression identified significant effects of sickle cell disease(t: 2.615, p =0.005) on glycemic control independent of vitamin D. Conclusions: While vitamin D may modulate insulin and glycemic control, diabetes management requires comprehensive strategies accounting for individual health profiles. Future research should explore personalized vitamin D interventions in diverse patient subgroups.
数字水务—新加坡的经验分享
Authors:   PUB, Singapore's National Water Agency
Published: May 2024

This book provides an overview of the digital tools available in the market as well as the impact of digitalisation on the water sector by sharing Singapore's experiences. PUB, Singapore's National Water Agency, unveiled its SMART PUB Roadmap in 2018 to digitalise Singapore's entire water system to improve the utility's operational excellence and meet the nation's future needs. This book shares PUB's digitalisation drive, highlights the deliberations behind its decisions, showcases its projects, and underlines the infrastructural, cybersecurity and human elements in digitalisation that other water utilities need to consider in crafting their own path forward.

To guide the digitalisation efforts, PUB has come up with four major goals: to create value for the utility through new capabilities,more efficient operations,a better work environment, andimproved customer service.

With these goals, PUB has been able to focus their research and investments, plan their digitalisation journey in greater detail, and consider more deeply how to collect and use data in innovative ways.

ISBN: 9781789064957 (eBook)

The English edition of this book is on our website here: https://iwaponline.com/ebooks/book/806/Digitalising-Water-Sharing-Singapore-s-Experience
Evolución y tratamiento legal del derecho a descanso de pre y postnatal
Authors: Serrano España Andrea
Published: May 2024

Desde las desigualdades y discriminaciones que enfrentan las mujeres en el mundo laboral remunerado, se aborda el tratamiento legal, administrativo y jurisprudencial al derecho de pre y postnatal en Chile, su adaptación a normas internacionales y un análisis comparado al mismo. Se destacan así las problemáticas y brechas aun existentes, pero desde un texto que pretende refundir los principales aspectos de este derecho maternal.
Neovascularization as a Leading Mechanism of Intraplaque Hemorrhage and Carotid Plaque Destabilization: A Narrative Review
Authors: Migdalski Arkadiusz , Jawien Arkadiusz
Published: May 2024

:

Intraplaque neovascularization (IPN) is considered a leading mechanism causing
carotid plaque destabilization. We provide an objective and comprehensive summary of the biology,
imaging techniques, and treatment options related to carotid IPN. Plaque neovascularization
has been reported to originate mainly from the adventitial vasa vasorum as a response to hypoxia.
The leakage and rupture of neovessels lead to the formation of extravasations and foci of inflammation
that destabilize the plaque. Vascular endothelial growth factor and its receptors are key regulators
of neoangiogenesis. Neovascularization can be analyzed by advanced computed tomography
and magnetic resonance imaging. The basic tools for the ultrasound assessment of IPN are
contrast-enhanced ultrasound, superb microvascular imaging, and ultrasound molecular imaging.
A promising direction of research seems to be the identification of patients with advanced plaque
neovascularization. A simple test assessing low-velocity flow in the IPN can detect patients at risk
of stroke before they experience rupture of defective neovessels and intracerebral embolism. In addition
to surgical treatment, the stabilization of carotid atherosclerotic plaque can be supported
pharmacologically. Statins have the best-documented role in this respect. The ideal moment of intensified
therapeutic intervention in patients with previously stable carotid plaque is its increased
neovascularization. However, the time frame in which intracerebral embolization may occur is unknown,
and therapeutic intervention may be too late. The formation of deficient neovessels can
currently be non-invasively evaluated with ultrasound. Superb microvascular imaging may change
the clinical approach for asymptomatic patients at risk of cerebral ischemia.
Metal-Organic Frameworks (MOFs): Chemistry, Properties, and Energy Storage Applications
Authors: Kumar Nikhil , Gupta Nisha , Bhattacharya Pallab
Published: May 2024

The scarcity of natural stocks of fossil fuels and the rising pollutant ions
evolved from the burning of carbon-containing fuels, has triggered the necessity for
clean, renewable, and sustainable energies to be generated and its subsequent storage in
portable form to meet the on-demand consumption. However, the performances of
storage materials are still limited for extensive real-world applications due to their
sluggish ion diffusion kinetics, lack of efficiency in extreme weather conditions, poor
chemical stability, and many more. Therefore, it is highly requisite to discuss the
development and assess the performances of new advanced energy storage materials. In
this chapter, we are specifically keen to discuss the design, synthesis, chemistry, and
properties of various MOFs based electrode materials for energy storage devices like
batteries and supercapacitors, which can necessarily store electrical energies by
implementing the use of suitable electrode and electrolyte materials through an upright
fabrication technique. Generally, MOFs contain both inorganic metal ions and organic
ligands/linkers which enable great control over their structural and compositional
modifications to optimize the properties like porosity, stability, surface area, redox
activity, and electrical conductivity and show great promise to generate high energy
storage performances, in the recent past. However, despite the current success, MOFs
based electrode materials have faced a lot of challenges in terms of the choice of
suitable metals and organic ligand moieties, rich host-guest interactions, preparation of
composites with desired morphology and properties, control over composite
composition, scalability of the process and many more which needs to be addressed for
its full-proof use in the real-world application as energy storage materials and thusly,
this chapter is important to discuss.
Triazoles and their Derivatives as Anti-Inflammatory Agents
Authors: Bhathiwal Anirudh Singh , Bendi Anjaneyulu , Tiwari Aditi
Published: May 2024

Heterocyclic compounds are a large group of organic chemical compounds
that have at least one and sometimes more than one heteroatom. For their anti-fungal,
anti-inflammatory, anti-bacterial, anti-cancer, and other properties, heterocyclic
compounds are used a lot in pharmaceuticals, agrochemicals, veterinary products,
sanitizers, antioxidants, co-polymers, and other products. Triazoles are a type of
chemical compound that has a five-membered heterocyclic ring with three nitrogen
atoms and are used in a significant number of different pharmaceutical applications
along with anti-inflammatory agents. Nowadays, a significant amount of research is
being done on triazoles as potential anti-inflammatory agents. This chapter is mainly
focused on the synthesis of triazoles and their various derivatives, along with their antiinflammatory properties.