bluuebunny/crossref_metadata_2025 huggingface dataset:
Processos de ensino e formação em ciências por investigação
Authors: Lima Daiana de , Güllich Roque Ismael da Costa , Bremm Daniele
Published: September 2024

Esta pesquisa busca analisar os processos de ensino e formação em Ciências por Investigação, no sentido de verificar se a Investigação-Formação-Ação no Ensino de Ciências (IFAEC) amplia a aprendizagem de professores e alunos. Foram utilizados como fonte empírica de dados, as narrativas contidas no Diário de Formação (DF) de uma professora em formação inicial e as atividades desenvolvidas pelos seus alunos. Os resultados encontrados possibilitaram aprofundar discussões em relação: i) ao papel do planejamento da ação em Ciências por meio de espirais autorreflexivas; ii) a aprendizagem de conceitos científicos; iii) ao papel dos experimentos investigativos para o processo de aprendizagem. Evidenciamos a relevância do planejamento a partir da IFAEC, por meio de uma espiral autorreflexiva para o desenvolvimento do ensino e da formação por investigação. Verificamos também que as estratégias de ensino e formação investigativas possibilitam aprendizagens aos alunos e a professora.
Que tipo de professor você quer ser? Um olhar crítico da Física na escola e considerações epistemológicas para melhor pensar metodologias
Authors: Arthury Luiz
Published: September 2024

Buscando melhorar a ensinagem de física, diversas propostas metodológicas têm sido apresentadas na literatura. Contudo, alguns elementos epistemológicos subjacentes a essas propostas são pouco discutidos, ao mesmo tempo em que pouca atenção é dada para elementos de incentivo à aprendizagem. O foco costuma ser nas práticas propostas e nos conteúdos avaliados, não se atentando que o ensino de física, e ciências em geral, possui também outras finalidades. Entre essas, defendemos que promover a atenção sincera do aluno é um fator que deve acompanhar uma aula mais significativa, problematizando o ensino para a testagem que, não apenas resume os conhecimentos trabalhados a ferramentas para se fazer provas, como também não permite uma aproximação do pensamento científico para além de arremedos desconexos de pouco ou nenhum significado ao estudante. Visando otimizar a predisposição para o aprendizado, trazemos algumas proposições que podem ajudar o professor a pensar em práticas mais relevantes ao aluno.
Iterative LMI-Tuned PID Controller for Robust Decentralized Multi-Area Automatic Generation Control in Deregulated Electricity Markets
Authors: Gbadega Peter Anuoluwapo , Sun Yan Xia
Published: September 2024

This study proposes an Iterative Linear Matrix Inequality (LMI)-Tuned Proportional-Integral-Derivative (PID) controller for robust decentralized AGC in the context of deregulated electricity markets. The study addresses the challenges posed by market uncertainties and diverse generation sources, aiming to enhance the stability and performance of power systems. This study is driven by the urgent need to develop robust AGC strategies that are adapted to the complex dynamics of decentralized power systems operating in deregulated markets. The conventional centralized control approaches are often inadequate to address the diverse and distributed nature of modern generation units. Furthermore, the intermittent and variable nature of renewable energy sources adds a layer of complexity that demands innovative control solutions. The impact of bilateral contracts on the dynamics is taken into consideration while modifying the conventional LFC of interconnected power networks. To model these bilateral contracts, the distribution company (DISCO) participation matrix (DPM) is presented, and the multi-area block diagram reflects these concepts. Simulation studies are conducted to evaluate and compare the performance of the proposed Iterative LMI-Tuned PID Controller and Conventional PID Controller. Results are analyzed against key performance metrics, considering scenarios reflective of diverse market conditions. Comparative studies with the conventional PID controller provide insights into the efficacy and robustness of the proposed approach.
Modeling Stress Concentration Factors for Fatigue Design of KT-Joints Subjected to In-Plane Bending Loads Using Artificial Neural Networks
Authors: Iqbal Mohsin , Karuppanan Saravanan , Perumal Veeradasan , Ovinis Mark , Faizan Muhammad , Rasul Adnan , Iqbal Muhammad
Published: September 2024

Stress concentration factor (SCF) is an important parameter for the fatigue design of offshore joints. There are many empirical equations for quick estimation of SCF in tubular joints, based on experimental and numerical investigations. However, most of these equations apply at the crown and saddle points only, even though the maximum SCF may not always occur at these points, resulting in overestimated fatigue life. As the maximum SCF location varies due to multiplanar loads, damage, or reinforcement of joints, its location and magnitude are critical for a realistic fatigue life estimation. However, conventional statistical tools cannot approximate the complex behavior of SCF around the brace axis. On the other hand, artificial neural networks (ANN) can efficiently approximate complex phenomena. This study uses ANN to develop empirical models for determining SCF around the weld toe of KT-joints subjected to in-plane bending (IPB) loads. Eighteen hundred and fifty-eight (1858) designs were simulated using finite element analyses to generate data for training the ANN. Two IPB load conditions were focused on, and empirical equations were proposed for SCF around the chord side of the central brace-chord interface. These equations approximate maximum SCF with less than 5% error. This methodology applies to other joints and load configurations also.
Survey of Melanoplus gaspesiensis and other alpine Acrididae (Orthoptera) on four summits of Gaspésie National Park, Québec, Canada
Authors: Gauthier Kevin , Saint-Germain Michel , Larrivée Maxim
Published: September 2024

Alpine tundra areas are threatened by anthropogenic climate change. They are also often represented as hotspots of endemism. Studying the insect communities associated with these habitats is therefore highly relevant. Melanoplus gaspesiensis Vickery is a grasshopper species known for its extremely limited distribution; it is considered endemic to Mont Albert, on the Gaspé Peninsula, Québec, Canada. Given its extremely limited distribution and with its habitat being particularly sensitive to climate change, the species is likely to soon be considered “at risk” at both the provincial and national levels. In order to confirm the current distribution of M. gaspesiensis, we sampled Acrididae on four alpine summits of the Gaspé Peninsula. Four species of Acrididae were captured. Almost 85% of the captured specimens were M. gaspesiensis, all of which were captured on Mont Albert. Our data are thus coherent with the species being endemic to that summit. The unique geology of Mont Albert (serpentine) may explain why M. gaspesiensis appears to be restricted to this one summit.
Trapping studies reveal phenology and reproductive behaviour in two solitary sweat bees (Hymenoptera: Halictidae)
Authors: Proulx Alex , Richards Miriam H.
Published: September 2024

To reconstruct behavioural changes that underpin evolutionary transitions between solitary and eusocial behaviour, we need detailed behavioural information about both solitary and eusocial species. Most behavioural studies of sweat bees have focused on sociality. We addressed the lack of detailed information about solitary species using pinned specimens of Lasioglossum leucozonium (Schrank) and L. zonulum (Smith) from Ontario (2003–2019) and Alberta (2016). We used weekly abundance of trapped bees to evaluate flight phenology (univoltine versus bivoltine), delineating two phases of flight activity, P1 and P2, before and after the first appearance of males, and evaluated female traits related to reproduction (body size, wear, and ovary development). All populations were confirmed to be solitary. The Ontario L. leucozonium and Alberta L. zonulum were univoltine, with P1 and P2 females being similar in size but P2 females more worn and with less-developed ovaries. Ontario L. zonulum were bivoltine, with P2 females being larger, more worn, and having more ovary development than P1 females, a unique pattern among bivoltine sweat bees. Contrasting observations between univoltine and bivoltine populations support the contention that solitary reproduction is not necessarily “simple” and that detailed information is needed to illuminate behavioural changes during bee social evolution.
Python version of Simplified Level 2 Prototype Processor for retrieving canopy biophysical variables from Sentinel-2 multispectral data
Authors: Djamai N. ,   Geomatics Canada, Fernandes R. A. , Sun L. , Canisius F. , Hong G.
Published: September 2024

La mission Sentinel-2 de Copernicus est conçue pour fournir des données pouvant être utilisées pour cartographier les variables biophysiques de la végétation a une échelle globale. Les estimations des variables biophysiques de la végétation ne sont pas encore produites de manière opérationnelle par le segment au sol de Sentinel-2. Plutôt, un algorithme de prédiction, appelé Simplified Level 2 Prototype Processor (SL2P), a été défini par l'Agence Spatiale Européenne. SL2P utilise deux réseaux neuronaux à rétropropagation, un pour estimer le variable biophysique de la végétation et l’autre pour quantifier l'incertitude de l'estimation, en utilisant une base de données de conditions de canopée globalement représentatives peuplée à l'aide de simulations de modèle de transfert radiatif de la canopée. SL2P a été mis en œuvre dans la boîte à outils LEAF du Centre Canadien de Télédétection qui s'appuie sur Google Earth Engine. Ce document décrit une implémentation PYTHON de SL2P (SL2P-PYTHON) qui fournit des estimations identiques estimations obtenues avec LEAF en utilisant la même image Sentinel-2 en entrée.
Electronic health records model to improve the quality of patients’ healthcare
Authors: Lovemore Motsi
Published: September 2024

Background: Electronic health records (EHR) has been acknowledged for bringing down healthcare costs and enhancing hospital service standards.Aim: The aim of this study was to develop an EHR model to lower patient treatment costs and enhance healthcare quality in South African public healthcare.Methods: In this study, a cross-sectional quantitative methodology was used. The research data for this study were provided by medical healthcare professionals, at Dr. George Mukhari Academic Hospital (DGMAH). This included doctors, nurses, pharmacists, radiologists, and radiographers who completed a semi-structured questionnaire.Results: The final model’s findings show that the use of EHR significantly improves information quality (IQ) and positively influences medical errors reduction (MER). Knowledge quality (KQ) has a positive significant impact on MER, whereas IQ has a considerable negative impact on MER. Furthermore, cost reduction in patient treatment (CRPT) has a positive significant influence on MER.Conclusion: Patients obtain better medical care when medical professionals have access to complete and accurate information. Medical errors can be reduced or even prevented with the use of EHRs, which can lead to better patient outcomes.Contribution: The quality of patient care at South African public hospitals and in other developing countries can be enhanced by using this framework as a guide to reduce treatment costs.
The ordinary and the mystical? Exploring the intersections of Spirituality and Public Theology
Authors: Forster Dion A. , Marchinkowski George W.
Published: September 2024

This article starts from the premise that the ordinary is the mystical. It does so by delving into the dynamic relationship between Spirituality and Public Theology against the backdrop of Christianity’s societal roles. It explores how Christian theology extends beyond private faith to address broad societal issues. Through a critical examination of Public Theology’s distinct contributions to contemporary discussions, the article emphasises the necessity of engaging Spirituality – with its focus on the divine-human relationship into this discourse.Contribution: This synthesis aims to enrich our comprehension of Christianity’s impact on public life, advocating for a faith that actively contributes to societal transformation across diverse contexts.
Social Media Use and Body Dysmorphia among Adolescents in Western Mindanao, Philippines: A Cross-sectional and Case Series Study
Authors: Usman Anna Paula Kue , Punzalan Mary Germeyn Durias
Published: September 2024

Introduction:

The widespread use of social media has raised concerns about its impact on mental health among the youth. Body dysmorphic disorder (BDD) is a debilitating mental disorder, involving an excessive fixation on the belief that certain body parts are distorted. The study sought to determine the relationship between social media use and body dysmorphia symptoms and explore reasons influencing these.

Subjects and Methods:

A cross-sectional study design and a case series were utilized. The participants (n = 154) were adolescents 15–19 years old in Zamboanga City, Philippines. Self-administered questionnaires were utilized to measure social media use, and the Appearance Anxiety Inventory (AAI) questionnaires were used to screen for BDD. A case series was done through key informant interviews among the three highest-scoring participants on the AAI. Descriptive statistics, Chi-square test, t-test, Pearson correlation, and Spearman correlation were utilized in the study.

Results:

Positive BDD screening was significantly associated with increased time spent on TikTok and was correlated with posting text-based comments on one’s profile, looking at photos and posts on others’ profiles, and editing photos before posting. Increased time on Facebook, TikTok, and total time spent on all platforms positively correlated with AAI scores, while time on Threads exhibited a negative correlation.

Conclusion:

The study presents the concerning impact of social media on the mental health of young people, associating significant use to increased symptoms of BDD. It underscores the importance of fostering digital literacy and responsible social media usage to mitigate these negative effects among adolescents in Zamboanga City.
Myoepithelial Carcinoma of the Breast - A Case Report and Review of 72 Cases Reported in Literature
Authors: Singh Kaalindi , Negi Ratti Ram , Thakur Preyander Singh , Negi Anup
Published: September 2024

Objective:

Myoepithelial carcinoma of the breast is an extremely rare malignancy. A study of all reported cases was undertaken to understand the behavior of this disease entity and the response to different treatment modalities.

Data Sources:

Databases, like Pubmed, Scopus, Web of Science, etc. were searched using the keywords myoepithelial carcinoma breast and adenomyoepithelial carcinoma breast from 1984-2022. A total of 1551 results were reviewed.

Study Selection:

Studies reporting a diagnosis of myoepithelial carcinoma on histopathology and immunohistochemistry were selected. Seventy-one cases of myoepithelial carcinoma of the breast were identified and found to be suitable for our review. The individual data of these cases and our patient were then compiled and evaluated.

Results:

The median age at presentation was 57 years, and there was no side preponderance. The average tumor size at presentation was 2.6 cm – most patients presented with a lump in the breast. Surgery remained the mainstay of treatment, with wide local excision and mastectomy performed in 50% and 30% of the patients, respectively. The benefits of radiotherapy and chemotherapy could not be ascertained, and most patients had a poor response to both. Of the patients in whom follow-up data were available, 28.3% and 13.1% were alive at 2 and 5 years, respectively. Locoregional recurrence was reported in 18 (25%) patients, and distant metastases were reported in 17 (23.6%) patients.

Conclusion:

Myoepithelial carcinoma of the breast is a rare and aggressive cancer. Surgery with negative margins is the primary treatment.
Post-Traumatic Stress Disorder and Orthopedic Patients’ Emotional Distress: Moderated Effects of Family and Friends’ Support
Authors: Chukwuemeka Nkechi A. , Akintunde Tosin Y. , Isangha Stanley O. , Obioha Wisdom C. , Nweke Joy C.
Published: September 2024

Abstract

Background:

Research indicates that the psychological well-being of orthopedic patients can benefit from a robust social support system that offers emotional assistance both before and after surgery. However, the impact of social networks on mental health outcomes remains inconclusive due to variations in availability.

Objectives:

This study investigated the influence of support from family and friends in the relationship between post-traumatic stress disorder (PTSD) and emotional distress among orthopedic patients in Nigeria.

Materials and Methods:

The study employed a hospital-based research design, using the 17-item PTSD self-report measure (PCL-C) and depression anxiety stress scales (DASS-21) to assess psychological distress and dimensions of social support from friends and family, involving 542 orthopedic patients from the National Orthopedic Hospital in Enugu, Nigeria.

Results:

The findings revealed a significant association between PTSD and emotional distress (β = 0.866; t = 9.245; P < 0.001). Family support was found to exacerbate emotional distress among orthopedic patients (β = 0.448; t = 4.176; P < 0.001), while support from friends showed an inverse effect on emotional distress (β = −0.310; t = −2.880; P < 0.01). Moreover, moderation analysis indicated that high family support reduces the effect of PTSD on emotional distress for orthopedic patients (β = −0.035; t = −3.539; [CI: −0.055, −0.016], P < 0.01).

Conclusion:

The study recommends prompt intervention for orthopedic patients to enhance their well-being by leveraging the available support from family and friends to alleviate the emotional distress associated with PTSD. Additionally, it underscores the importance of educating families and friends of orthopedic patients on their role in supporting the patient’s recovery journey.
Validation, Diagnostic, and Monitoring Roles of Multiomic Studies in Putative Immunotoxiepigenetic Models of Immune-Mediated Inflammatory Diseases
Authors: Okafor Michael T.
Published: September 2024

Abstract

Immune-mediated inflammatory diseases (IMIDs) are mediated by immune dysfunction. Putative models of T-cell-mediated immune dysfunction in IMIDs exist and are yet to be validated by multiomics studies. Prompt diagnosis and monitoring are crucial for IMID management. The aim of this review was to discuss the putative T-cell dysfunction model of IMIDs and the role of multiomics studies for validation of the disease models as well as its diagnostic and monitoring potential in IMIDs. Online searches on databases such as Google Scholar, PubMed, Biomed Central, and SciELO were carried out. An attempt was made to review articles with keywords such as genomics, proteomics, transcriptomics, metabolomics, T cell immunopathogenesis/dysfunction, immune dysfunction, and IMIDs. The putative T-cell dysfunction model of IMIDs and its validation with multiomics studies were discussed. The diagnostic and monitoring roles of multiomic studies for management of IMIDs were also discussed. The review concluded that multiomic studies have validating potential for the putative T-cell dysfunction model of IMIDs as well as diagnostic and monitoring roles in IMIDs.
Erectile Function in Men Presenting with Lower Urinary Tract Symptoms from Benign Prostate Enlargement: Association with Quality of Life Scores in the Context of Interviewer-Assisted Questionnaire Administration
Authors: Nnabugwu Ikenna I. , Anyimba Solomon K. , Amu Okwudili C. , Nnabugwu Chinwe A. , Okolie Louis T.
Published: September 2024

Abstract

Background:

Interviewer-assisted administration of International Prostate Symptoms Score (IPSS) and Internal Index of Erectile Function-5 (IIEF-5) questionnaires in men with lower urinary tract symptoms (LUTS) due to benign prostate enlargement (BPE) may generate inconsistent outcomes.

Objectives:

To assess the correlation between the scores from interviewer-assisted administration of the IPSS questionnaire and the IIEF-5 questionnaire in men with uncomplicated LUTS due to BPE.

Materials and Methods:

The IPPS and the IIEF-5 questionnaires were administered with interviewer assistance to a cross-section of men presenting to the hospital with symptoms of LUTS due to uncomplicated BPE. The demographics were ascertained, and the association between IPPS and IIEF-5 scores was determined using linear correlation.

Results:

There were 211 participants in 18 months with a mean age of 66.5 ± 9.5years. The mean prostate volume, prostate-specific antigen, peak flow rate, and post-void residual volume were 55.2 ± 10.1 mL, 3.1 ± 0.7 ng/mL, 20.8 ± 8.2 mL/s, and 38.1 ± 21.5 mL, respectively. One hundred and eighty-six participants (88.2%) attained post-primary level of formal education. Moderate LUTS was reported in 51.7% (n = 109), while severe LUTS was reported in 10.4% (n = 22) participants. The mean storage LUTS (sLUTS) score was 6.25 ± 2.84, the mean voiding LUTS (vLUTS) score was 4.27 ± 4.56, and the mean IPSS was 10.38 ± 6.44. The mean IIEF-5 score was 15.17 ± 6.09. There was a poor correlation between IIEF-5 and sLUTS (Spearman rho –0.02; P = 0.77), vLUTS (Spearman rho –0.058; P = 0.403), IPSS scores (Spearman rho –0.048; P = 0.49), as well as with quality of life (QoL) preferences (F 1.722; P = 0.117).

Conclusions:

Interviewer-assisted IIEF-5 scores do not relate with sLUTS, vLUTS IPSS, and QoL due to LUTS, as is the case with reports on self-administered IIEF-5 scores.
A Retrospective Audit of Placental Weight and Fetal Outcome at the Lagos University Teaching Hospital, Southwest Nigeria
Authors: Oluwole Ayodeji A. , Omisakin Sunday I. , Ugwu Aloy O.
Published: September 2024

Abstract

Background:

The placenta is an organ unique to mammals that connects the developing fetus to the uterine wall. The placenta supplies the fetus with oxygen and nutrients and allows fetal waste to be disposed of effectively via maternal circulation.

Objective:

The objective of this study is to determine the relationship between placenta weight at delivery and fetal outcomes.

Materials and Methods:

This was a retrospective study carried out between January 2022 and December 2023 at the labor ward of the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.

Results:

The mean age of the women was 32.5 (3.4) years. The majority of the women were between 20 and 34 years of age. The mean placental weight was 657.5 (221.5) g. Maternal obesity and increasing parity were significantly associated with larger placenta weight (P = 0.04 and 0.01, respectively). Heavier placentas were also associated with fetal macrosomia and poor Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores at 5 min (P < 0.05).

Conclusion:

This study concludes that a heavier placenta is associated with increasing parity, more operative delivery, bigger newborns, and a higher placenta-birth weight ratio.
Knowledge, Attitude, and Practice of COVID-19 Prevention among Medical Undergraduates of a Higher Institution in Enugu Metropolis: A Cross-Sectional Study
Authors: Okereke Promise U. , Chiedozie Chiedozie Emmanuel C. , Chiwetalu Chinedu , Ogamba Nzubechukwu , Okpechukwu Chidubem P. , Nnegboh Chukwunonso P. , Orie Orie Daniel U. , Umah Victor
Published: September 2024

Abstract

Background:

Coronavirus disease 2019 (COVID-19), caused by Severe acute respiratory syndrome coronavirus 2, has posed a global health crisis since its emergence in late 2019.

Objectives:

To assess the knowledge, attitudes, and practices related to COVID-19 prevention among medical undergraduates in Enugu Metropolis, Nigeria.

Materials and Methods:

A descriptive cross-sectional study was conducted, involving undergraduate medical students from the University of Nigeria, Enugu, and Ituku-Ozalla campuses. A total of 450 participants were recruited through convenience sampling, and a structured questionnaire was used for data collection. The questionnaire covered sociodemographic information, COVID-19 knowledge, attitudes, and preventive practices. Data were analyzed using the Social Package for Social Science version 28, with statistical significance set at P < 0.05.

Results:

The majority of participants demonstrated good knowledge of COVID-19 prevention (89.6%), with significant associations observed between knowledge and the level of study (P = 0.001). A significant relationship was also noted between knowledge and attitude (P = 0.000). In terms of practice, 24.2% of medical students reported good COVID-19 prevention practices. Additionally, a majority of participants (n = 405; 90%) had not been vaccinated against COVID-19, largely influenced by vaccine hesitancy.

Conclusion:

Efforts should focus on transforming knowledge into positive attitudes and encouraging better COVID-19 preventive practices among medical undergraduates. Addressing vaccine hesitancy through targeted education and awareness campaigns is imperative to mitigate the risks associated with the pandemic and potential future waves.
Effect of Kinesthetic-based Perceptual Integrative Games on Visual Perception and Academic Performance in Children with Autism Spectrum Disorder: A Quasi-Experimental Study
Authors: Kumar M. Arun , Nagalakshmi P.
Published: September 2024

Background:

Children learn everything through play and games. Visual perceptual skills are prerequisites for other areas of functioning, such as academic skills, activities of daily living, play, and leisure activities. Hence, visual perception can be improved using kinesthetic movement-based perceptual integrative games, as the children will be more interested in games rather than doing activities.

Objective:

The study aimed to identify the effect of kinesthetic-based perceptual integrative games on visual perception and academic performance in children with autism spectrum disorder (ASD).

Study Design:

Quasi-experimental study design was used.

Methods:

Fifty children diagnosed with mild and moderate ASD were selected based on convenient sampling. The experimental group (n = 25) received the kinesthetic-based perceptual integrative games for 36 sessions, 45 min per session, while the control group (n = 25) received conventional occupational therapy for the same period. Beery–Buktenica Developmental Test of Visual-Motor Integration (Berry VMI) scale and Academic Performance Rating Scale (APRS) were used.

Results:

The result revealed that the kinesthetic-based perceptual integrative games significantly improved visual perception (P = 0.042, 95% confidence level (CL) range 13.326–0.846) and academic performance (P = 0.001, 95% CL range of − 8.3718–−2.1882) compared to conventional occupational therapy but there was no correlation between the APRS and Berry VMI (P = 0.114).

Conclusion:

The kinesthetic-based perceptual integrative games intervention improved the visual perceptual skills and academic performance of children with ASD in this study. Hence, it can be used as a new therapeutic modality in treating children with ASD and other forms of disorders who have deficits in visual perception and academic skills.
EBV-triggered secondary macrophage activation syndrome in the backdrop of lupus in an adult
Authors: Gohri Jay , Satish Suchitha , Muniz Joshua P , Arellano Martha
Published: September 2024

Macrophage activating syndrome (MAS) is a potentially life-threatening condition falling under the spectrum of secondary hemophagocytic lymphohistiocytosis, in the backdrop of rheumatological conditions. In this case of a middle-aged man, we see how an initial Epstein Barr virus infection triggered a chain of events, which after serial monitoring of labs was promptly diagnosed as MAS and treated appropriately, resulting in overall clinical improvement of the patient.
Tuberculosis-induced Autoimmune Hemolytic Anemia
Authors: Biswal Shreya , Chatterjee Prasun
Published: September 2024

Autoimmune hemolytic anemia (AIHA) is a rare disorder characterized by antibodies against one’s own red blood cells, often difficult to diagnose and treat in the elderly. It can be secondary to an infection, drug, or a myeloproliferative disorder. We report a rare case of tuberculosis (TB)-induced AIHA in an older woman. A 70-year-old woman complained of progressive weakness, weight loss, and abdominal pain over 6 months. Examination revealed anemia, jaundice, and splenomegaly. Routine blood investigations showed pancytopenia and Coombs test that was positive for autoantibodies. Workup for autoimmune disease like systemic lupus erythematosis was negative. Lymphoma, disseminated TB, and lymphoproliferative disorders were considered. Bone marrow biopsy was reported as normal. Mycobacterium tuberculosis was isolated from the bronchoalveolar lavage. A diagnosis of autoimmune hemolytic anemia secondary to disseminated TB was made. She was treated with steroids and antitubercular therapy, which improved her health and laboratory parameters. A positron emission tomography–computed tomography showed the resolution of splenic lesions and reduced metabolic activity of mediastinal and abdominal lymph nodes.
Impact of Frailty on Omani Older Adults: A Retrospective Cohort Study Using the Multidimensional Prognostic Index in Primary Health Care
Authors: Chaouacha Chefi Ben , Al Farsi Yahya , Al-Reesi Hamed
Published: September 2024

Background:

Frailty, a state of diminished physiological reserve and increased vulnerability to stressors, is common among geriatric Omani patients attending primary health-care settings. Frailty has been shown to be a dominant predictor of multiple adverse health outcomes such as falls, functional disability, delirium, health-care utilization, and all-cause mortality.

Objective:

We aimed to explore the relationship between frailty and adverse health outcomes in Omani older adults.

Methods:

We conducted a retrospective cohort study at a single center, from April 2020 to December 2022, involving 197 participants aged 65 years and older. Frailty was determined using the Multidimensional Prognostic Index (MPI). The adverse outcomes under investigation included a history of falling, utilization of primary health-care services, and all-cause mortality. We calculated unadjusted and adjusted odds ratios (ORs), along with their corresponding 95% confidence intervals (CIs), to evaluate the relationships between frailty and these adverse outcomes.

Results:

In the adjusted logistic regression model, frail older patients exhibited an elevated risk of falling in comparison to nonfrail patients (OR: 1.44, 95% CI: 0.68, 3.05; OR: 5.94, 95% CI: 1.49, 23.69, respectively). Notably, frailty status demonstrated a significant difference in terms of primary health-care utilization (P = 0.016), particularly for prefrailty (mean ± standard deviation 18.8 ± 10.8). Furthermore, a weak positive correlation was identified between MPI means and the level of primary health-care utilization (r = 0.229, P < 0.001). In addition, it was observed that prefrailty and frailty significantly heightened the risk of all-cause mortality (OR: 1.45, 95% CI: 0.16, 13.30; OR: 27.96, 95% CI: 3.37, 232.24, respectively).

Conclusion:

Prefrailty and frailty exert detrimental effects on older adults. It is imperative to focus on addressing prefrailty and frailty within primary health care to mitigate adverse outcomes and enhance the overall well-being of older adults.
Prevalence and Determinants of Postischemic Stroke Cognitive Impairment in Older Persons
Authors: Thomas Alisha S. , Viggeswarpu Surekha , Prabhakar Appaswamy Thirumal , Divya K.
Published: September 2024

Background:

It is essential to identify the burden of poststroke cognitive impairment (PSCI) and to frame strategies for its prevention and progression in a developing country.

Aim:

The aim of the study was to estimate the prevalence and identify the risk factors of PSCI in older persons who survived an ischemic stroke.

Materials and Methods:

Patients with acute stroke satisfying the inclusion criteria were recruited. Clinical and demographic data, baseline functional capacity, and cognition as assessed by the Barthel index and the Informant Questionnaire on Cognitive Decline in the Elderly, respectively, were collected. The patients were then administered the Confusion Assessment Method, Mini-Cog, Montreal Cognitive Assessment (MoCA), and Frontal Assessment Battery within the 1st week of stroke and were reassessed at 1 month. The diagnosis of PSCI was done based on MoCA score within 1 week and at 1 month after stroke, and the analysis of risk factors for PSCI was done based on MoCA score at 1 month.

Results:

The prevalence of PSCI in this study was 63.8% within the 1st week and 71.8% at 1 month after the stroke. Lower educational and occupational status, higher Charlson Comorbidity Index, presence of delirium during the 1st week after stroke, poststroke depression, higher National Institutes of Health Stroke Scale score, and higher Modified Rankin Scale score were found to be risk factors for the development of PSCI on univariate analysis. Lower socioeconomic status was found to be a risk factor on both univariate and multivariate analyses.

Conclusion:

The prevalence of PSCI was 71.8% at 1 month after stroke. Lower socioeconomic status was found to be a risk factor for PSCI. Larger studies are needed to identify various modifiable risk factors, to improve the quality of life in older stroke survivors.
Nepal’s Geriatric Health Strategy 2021–2030: A Narrative Review
Authors: Kandel Ramesh
Published: September 2024

Nepal’s national geriatric health strategy 2021–2030 focuses on enhancing the health and well-being of senior citizens by providing comprehensive health services and promoting healthy aging. The strategy addresses the increasing prevalence of chronic conditions and multimorbidities among the older people, emphasizing the need for tailored health-care services. Key priorities include improving access to quality health services, promoting social health insurance, and strengthening family and community support systems. The strategy also aims to integrate geriatric health issues into the national health system, enhance the capacity of health facilities, and ensure gender-equitable and inclusive services. By fostering multisectoral coordination and collaboration, the strategy supports Nepal’s pursuit of universal health coverage and aims to build state capacity to support healthy aging, ensuring that senior citizens can lead active and quality lives.
A Rare Case of Castleman Variant of POEMS Syndrome
Authors: Dewangan Gevesh Chand , Singhal Sunny , Bansal Rishav , Chakrawarty Avinash
Published: September 2024

POEMS syndrome is a rare multisystemic disease, characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes. The presence of polyneuropathy and monoclonal plasma cell proliferation is mandatory for the diagnosis of typical POEMS syndrome. However, some patients lack one of the mandatory features and are classified as the variants of POEMS syndrome. A 61-year-old male presented with the clinical picture of progressive numbness in both lower extremities and weakness in all four extremities for a 6-month duration associated with bilateral axillary lymphadenopathies, pedal edema, clubbing, and unintentional weight loss of 15 kg in 6 months. A nerve conduction study showed severe sensorimotor polyneuropathy of demyelinating type in all four extremities. A lymph node biopsy showed Castleman disease, and the computed tomography scan was suggestive of multiple osteosclerotic lesions. A diagnosis of the Castleman variant of POEMS syndrome was made, and the patient was treated with Bortezomib-based therapy with improvement in his symptoms on follow-up at 1 year. Due to the lack of definite treatment guidelines for this disease, the information provided through case reports and case series becomes very important for the treatment of such patients leading to the resolution of polyneuropathy and the maintenance of functionality in patients.
Knowledge, Attitude, and Practice of Breastfeeding among South Indians: A Cross-sectional Study
Authors: Sarojini Subbarayan , Kesudeen Mohamed , Saranya S. , Maikandaan C. J. , Srinivasan Jeyaram
Published: September 2024

Introduction:

Research shows that exclusively breastfed infants have a 13% lower mortality risk. However, only 37% of infants in Low and middle income country (LMIC) are exclusively breastfed.

Materials and Methods:

This cross-sectional study was conducted in a Chennai hospital’s outpatient department, focusing on pediatrics. The study commenced after obtaining ethical clearance (99/IEC-SMMCHRI). Breastfeeding knowledge, attitude, and practice (KAP) scales were developed by modifying existing KAP tools. The KAP questionnaire was based on the World Health Organization. The same was applied to 250 consenting mothers.

Results:

Participants had a mean age of 27 years, with the youngest mother at 19 and the oldest at 40. Forty-one percent had finished high school, and 37% had completed undergraduate studies. Eighty-eight percent had strong breastfeeding comprehension, and 96% had a favorable attitude. However, only 32% exclusively breastfed. The study found significant correlations between knowledge and behavior (χ2 = 4.27, P = 0.04) and between attitude and behavior (χ2 = 5.69, P = 0.017). Mothers with adequate knowledge tended to follow recommended feeding practices, and those with a positive attitude displayed good practices.

Conclusion:

Despite positive attitudes toward breastfeeding, the cultural practice of introducing prelacteal food hinders exclusive breastfeeding, leading to negative outcomes. While there have been some improvements in exclusive breastfeeding rates, addressing this disparity could reduce child mortality rates. The outcomes of the research will be highly beneficial for primary care physicians in their efforts to promote exclusive breastfeeding among expectant mothers.
A Mysterious Foe in a Case of Malaria: Rare Case of Coinfection with Review of the Literature
Authors: Singh Anurag , Verma Anuragani , Rawat Shalini , Kushwaha Rashmi
Published: September 2024

Parvovirus B19 and Plasmodium vivax coinfections are rarely documented. Parvovirus B19 may cause bone-marrow suppression, reticulocytopenia, and anemia in malaria patients. Here, we describe an 11-year-old boy with fever, jaundice, and anemia who was diagnosed with P. vivax and treated with chloroquine. Jaundice and fever subsided, but anemia persisted. A blood smear showed no malarial parasites after the completion of antimalarial treatment. Because of persisting anemia, a bone-marrow aspiration was requested, which revealed erythroid suppression and giant proerythroblast with nuclear inclusions. Parvovirus B19-specific IgM antibodies are also found in peripheral blood. The patient received supportive treatment and red blood cell transfusions. After 3 months, the patient was asymptomatic and had normal blood counts. Any chronic anemia should be examined for parvovirus B19 infection, even in cases of well-known factors of anemia. To the best of our knowledge, this is an index case of P. vivax and parvovirus B19 coinfection.
Impact of COVID-19 Lockdown on Academic Studies and Behavioral Pattern of Undergraduate Medical Students of Delhi
Authors: Dhamnetiya Deepak , Goel Shelesh Kumar , Goyal Ritik , Abhishek Kumar , Hitesh Tanishq , Agarwal Komal , Jha Ravi Prakash
Published: September 2024

Introduction:

The novel coronavirus pandemic is currently a worldwide public health emergency. This study aimed to assess the impact of lockdown on academic studies and behavioral patterns of undergraduate medical students of Delhi and to assess the association of academic studies and behavioral patterns with sex and academic year.

Materials and Methods:

A cross-sectional study was conducted in September 2020 through a prevalidated, semi-structured questionnaire. Data were analyzed using a statistical package for social sciences (version 16.0; SPSS Inc., Chicago, IL, USA). Mann–Whitney U and the Kruskal–Wallis test were applied to check the significant difference in median of 2 and more than two independent groups, respectively. A P < 0.05 was considered significant.

Results:

Of 163 students, 109 (66.9%) were male, and 54 (33.1%) were female. Ninety-seven (59.5%) students prefer regular classroom study, and 7 (4.2%) prefer online live classes. There is a statistically significant difference for study hours of males as compared to females before lockdown (P = 0.024) and for students of 2nd year and 1st year also between 3rd year and 1st year (P = 0.015) and for the completion of tests/assignments on time during lockdown (P = 0.000) for 2nd year and 3rd year, also 2nd year-final year and 1st year-final year students.

Conclusion:

Medical education is highly skilled and practical; thus, it cannot be learned through online lectures, and students are losing interest in online lectures. Students’ behavioral patterns altered in lockdown as sitting idle at home increased social media usage and food intake.
Diclofenac-induced Acute Generalized Exanthematous Pustulosis: A Rare Case Scenario
Authors: Hasharudeen Ayisha , Bullapur Prasannakumar C , Nyamagoud Sanatkumar B , Abhishek BJ
Published: September 2024

ABSTRACT

Diclofenac, categorized as a nonsteroidal anti-inflammatory drug, is commonly employed in medical settings due to its effectiveness in alleviating pain and reducing inflammation. Despite its widespread usage, diclofenac is associated with a range of adverse drug reactions (ADRs). Acute generalized exanthematous pustulosis is an infrequent and serious skin condition marked by the abrupt appearance of multiple sterile pustules on an inflamed, red base. This case report seeks to illuminate a unique and severe adverse drug reaction directly linked to diclofenac use, underscoring the importance of increased awareness among healthcare practitioners regarding the varied and occasionally serious nature of ADRs associated with diclofenac.
The Mystery of an Ulcerated Plaque Over Vulva in a 62-year-old Woman
Authors: Awake Praneet , Bhosale Anand , Dugad Vivek , Chaudhari Pallavi , Bindu Rajan , Sawant Rashmi , Gaikwad Prabodh , Shende Aditi , Gokhale Neeta , Nanda Keoysha , Gandhi Kritika
Published: September 2024

ABSTRACT

Genital ulcers may be located on the genital region and may be due to infectious or noninfectious etiology. Although sexually transmitted infections are a common cause of genital lesions, it is essential to consider nonvenereal disorders in the differential diagnosis. Squamous cell carcinoma appearing in lesions of chronic vulval lichen sclerosus et atrophicus is a rare occurrence of clinical significance. We present a case report of a 62-year-old postmenopausal woman who presented with a long-standing history of vulval pruritus, and mild pain.
Congenital Segmental Absence of the Bowel Muscle Layer with Duplication of then Bowel in an Adult - An Exceedingly Rare Case Report
Authors: Kothari Ravi K. , Panchal Avani , Shah Nilesh , Bhalodia Jignasa
Published: September 2024

ABSTRACT

Congenital segmental absence of bowel muscle layer which is also known as Segmental absence of intestinal musculature (SAIM) is rare cause of obstruction in neonates and exceedingly rare in adults. We present 35 years old male with right iliac fossa (RIF) pain since 7 daysandnot passing stool since 3 days, was operated with suspicion of intestinal tuberculosis (TB). Our case shows two rare anomalies, SAIM and duplication in single patient which makes itunique. Histopathologically it was diagnosed as Congenital segmental absence of bowel muscle layer with duplication of bowel wall.
A Rare Case of Adult-Onset Diffuse Midline Glioma
Authors: Khandait Pranit , Rohatgi Shalesh , Nirhale Satish , Rao Prajwal , Naphade Pravin , Dubey Prashant , Gitay Advait , Hatekar Khusboo
Published: September 2024

ABSTRACT

Diffuse midline glioma is a WHO grade IV tumor of the central nervous system (CNS). The most common sites from which diffuse midline glioma arises are the spinal cord, brain stem, thalamus, and rarely cerebellum. This is a highly aggressive and rare tumor of CNS, more common in the pediatric population. MRI brain lesions are T1-weighted (T1W) image hypointense and T2-weighted (T2W) image hyperintense and may show subtle contrast enhancement, with a more exophytic component and adjacent structure infiltration. Here, we report a case of 30 years old male who presented with symptoms of headache since 15 days, associated with one episode of transient blurring of vision and imbalance while walking. On examination, bilateral early papilledema and subtle bilateral cerebellar signs were present. MRI brain study showed multiple rounds to oval lesions in the corpus callosum, left thalamus, left periventricular region, vermis, and right cerebellar hemisphere, with low apparent diffusion coefficient and diffusion restriction and no blooming on gradient echo sequences images. Initially, no postcontrast enhancement was seen. Later on, the patient’s condition deteriorated despite intravenous steroids and anti-epileptics. On repeat, MRI contrast showed subtle contrast enhancement with an increase in the size of lesions. Stereotactic biopsy from the corpus callosum lesion was done. Histopathology showed diffuse midline glioma WHO grade IV tumor. Even after receiving chemotherapy and radiotherapy, patient succumbed within 4 months of diagnosis. This is a case of adult-onset diffuse midline glioma with a very atypical lesion on the MRI brain as compared to prior studies where the midline structure is more commonly involved.
Oncocytic Lipoadenoma of the Parotid Gland against a Background of Multifocal Oncocytic Hyperplasia: Report of a Rare Case
Authors: Patil Soniya A. , Naidu Raji T. , Chaturvedi Uma P. , Gaddam Prachi R.
Published: September 2024

ABSTRACT

Oncocytic lipoadenoma is an extremely rare benign salivary gland tumor with only few cases reported in the literature. We herein report a case of oncocytic lipoadenoma originating in the parotid gland of a 65-year-old man. The tumor presented as a slowly growing asymptomatic right-sided parotid gland mass. On MRI, right parotid showed a 40 × 32 × 20 mm well-encapsulated, neoplastic mass in the superficial lobe. On core biopsy, differentials considered were nodular oncocytosis and oncocytoma. Subsequently, superficial parotidectomy was performed. The resected tumor was encapsulated, yellowish brown, and homogenous. Microscopically, it was composed of oncocytoma-like epithelial component admixed with mature adipocytes, each contributing to 50% of the mass. Adjacent salivary gland showed multiple foci of oncocytosis. Differential diagnosis includes lipomatous tumors as well as neoplastic and non-neoplastic oncocytic lesions of the salivary gland. The present case of oncocytic lipoadenoma against a background of multifocal oncocytic hyperplasia has been reported for its rarity.
Clinical, Dermoscopic, and Histopathological Analysis of Blaschko-Linear Atrophic Lichen Planopilaris (LPP) of the Face: A Case Series of a Rare Entity
Authors: Rout Aradhana , Chauhan Ratika , Pandey Ashish Kumar
Published: September 2024

ABSTRACT

Blaschko-linear pigmented lesions over the face are encountered rarely, and may either be macular or atrophic. A descriptive clinical, dermoscopic, and histopathological analysis of six such cases of hyperpigmented atrophic lesions in a Blaschko-linear distribution that we saw recently in our outpatient department is presented emphasizing the potential of dermoscopy to facilitate prompt management thereby averting cicatrization.