bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Management of COVID-19 Patients
Authors: El Khiat Abdelaati , Ait Hamdan Youssef , Tamegart Lahcen , Draoui Ahmed , Aglagane Abdessamad , El Fari Radouane , Gamrani Halima
Published: August 2021

Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCov-2) or COVID-19 is a pandemic that appeared in December 2019 in China and which is an RNA virus. It gave rise to a major health crisis at the start of 2020, with numerous hospitalizations. It was quickly important to understand the pathophysiology of this viral attack on the human body in order to be able to develop treatment. However, there is no vaccine or effective therapeutic agent against SARS-CoV-2. Most of the therapeutic strategies used to deal with this virus come from the work of previous epidemics of SARS, and other influenza viruses, such as antiviral therapies (chloroquine, hydroxychloroquine), adjuvant therapies by combining antivirals with drugs. Antibiotics or immunostimulants (vitamins C, Dm and Zinc, etc,) and several other therapies to be used depending on the region.
Herbal Products for Management of COVID- 19
Authors: Kaur Simran Jeet
Published: August 2021

COVID-19 is a human-infectious virus. The respiratory system is the primary target of the coronavirus, but it can also harm cardiac tissues and gastrointestinal organs. Many frequent circumstances, such as the medication's or medicine's purpose, the dosage/potency of the drug, and the patient's condition, can place patients in grave danger. Several cures have been reported using a variety of therapy methods. Among the various treatments, natural and synthetic medicines are the most commonly documented. Some herbal medicines, such as Tribulusterrestris, Withaniasomnifera, Curcuma longa, Ocimum sanctum, and Phyllanthusemblica, have powerful antiviral (AntiCOV-19) properties against novel coronavirus, heralding the start of a new era in herbal therapy.
Pharmaceutical Supply Chain Management Practices and Organizational Performance
Authors: Doumbia Musah Osumanu , Awudu Iddrisu , Yakubu Mariama , Gonela Vinay
Published: August 2021

The purpose of this paper is to use empirical data to examine the effect of supply chain management practices on organizational performance of pharmaceutical firms in a developing country. The conceptual model was based on supply chain management practices. Purposive sampling was used to gather data from cross section of pharmaceutical firms. Partial least square (PLS) structural equation modelling (SEM) approach was used to test the relationship among the constructs. The results show a strong statistically significant positive relationship between supply chain management practice and organizational performance. Supply chain performance was used as a mediating variable, but the result was inconsequential, and it had no effect on the relationship between supply chain management practices and organizational performance.
Demand Chain Strategy and Chinese Firm Performance
Authors: Bai Bingfeng , Gao Junjun , Yin Weili
Published: August 2021

The purpose of this research is to enhance the extant understanding of the information technology (IT)-strategy relationship. The study aims to test the robustness of the relationships among the concepts of IT analytic capability, demand chain strategy, and firm performance besides investigating the interaction effects of product life cycle (PLC) management on the IT-strategy relationship. Based on the resource-based view (RBV) of the firm and the research paradigm of “capability-strategy-performance,” 300 Chinese fashion firms were surveyed to collect data by Demand Chain Research Institute of Shanghai University. In order to test the hypothetical relationship in the conceptual model, valid questionnaires from 185 firms were collected in this study, and the effective rate reached 61.7%. Findings suggest that IT analytic capability associates positively with demand chain strategy, and PLC plays a moderation role between IT analytic capability and demand chain strategy. The findings further support the link between demand chain strategy and better firm performance. This study contributes to existing information systems and operation management literature by the above effects in the retail context. Overall, these results reflect recent business and transformation changes from supply chain strategy to demand chain strategy for the Chinese fashion industry.
Age and Education as Major Determinants of HIS's Adoption
Authors: Abu-Shanab Emad Ahmed
Published: August 2021

This study explored the perceptions of 264 nurses regarding their satisfaction with health information systems (HIS) in one of the public hospitals in the GCC area. The study adopted the information system success model and tried to predict satisfaction level utilizing information quality, system quality, and service quality. Results supported the role of information quality and service quality in predicting satisfaction. In addition, four factors were used as moderators of relationships assumed. Three moderation effects were witnessed: gender moderated the relationship between service quality and satisfaction, age moderated the relationship between service quality and satisfaction, and also moderated the relationship between system quality and satisfaction. A set of one-way ANOVA tests were used to compare different perceptions based on the four demographic factors (gender, age, education, and experience) on the item and construct levels. Conclusions and a summary of all results are reported in this study.
A Review of Computational Intelligence Models for Brain Tumour Classification and Prediction
Authors: Appati Justice Kwame , Brown Godfred Akwetey , Soli Michael Agbo Tettey , Denwar Ismail Wafaa
Published: August 2021

This review aims to systematically analyze ML models from four aspects: type of ML technique, estimation accuracy, model comparison, and estimation context. A systematic literature review of empirical studies was conducted on the ML models published in the last decades. Fifty-one primary studies relevant to the objective of this research were revealed. After investigating these studies, five ML techniques have been employed in brain tumor classification and prediction. Ultimately, the estimation accuracy of these ML models could be regarded and accepted and outperformed non-ML models. ML models have been revealed to be useful in brain tumor classification and prediction. Genetic algorithm among the ML models achieved an accuracy of 100%. Nevertheless, ML models are still restricted in the industry, so initiative and encouragement are needed to make ML models easier. Further work is required on these ML models to verify the accuracy and consider other performance metrics other than the accuracy.
Advancing English Language Learners' Speaking Skills Using VoiceThread in Mobile Learning for Russian Tertiary Context
Authors: Zemlyanova Maria , Muravyeva Natalia , Masterskikh Svetlana , Shilova Lyudmila , Shevtsova Anna
Published: August 2021

This research examines the effectiveness of using the VoiceThread (VT) application (both web and mobile-based) for the development of oral English skills of Russian university students. The study involved 44 full-time bachelor students in non-linguistic departments. The results were evaluated by on-line questionnaire using SurveyMonkey. The survey indicated that the majority of students agreed that mobile VoiceThread developed their oral language skills (M = 4.75) and they enjoyed using it for language learning (M = 4.13). The novelty of the research lies in a more integral assessment of the entire set of oral linguistic skills as a result of their development using a specific mobile learning platform widely used throughout the world. The results can be used in practice to implement mobile learning platforms for teaching oral language skills to students with basic knowledge of a foreign language.
Predicting Student Engagement in the Online Learning Environment
Authors: Wakjira Abdalganiy , Bhattacharya Samit
Published: August 2021

Students in the online learning who have other responsibilities of life such as work and family face attrition. Constructing a model of engagement with smallest granule of time has not been implemented widely, but implementing it is important as it allows to uncover more subtle patterns. We built a student engagement prediction model using 9 features that were significant out of 13 features to affect the levels of student engagement and emerged in the final model. The student engagement prediction model was built using non-linear regression technique from three factors: behavioral, collaboration and emotional factors across micro level time scale such as 5 minutes to identify at risk students as quickly as possible before they disengage. The accuracy of the model was found to be 83.3%. The results of the study will give teachers the chance to provide early interventions and guidelines for designing online learning activities.
Detecting Fake News Over Job Posts via Bi-Directional Long Short-Term Memory (BIDLSTM)
Authors: Divya T. V. , Banik Barnali Gupta
Published: August 2021

Fake news detection on job advertisements has grabbed the attention of many researchers over past decade. Various classifiers such as Support Vector Machine (SVM), XGBoost Classifier and Random Forest (RF) methods are greatly utilized for fake and real news detection pertaining to job advertisement posts in social media. Bi-Directional Long Short-Term Memory (Bi-LSTM) classifier is greatly utilized for learning word representations in lower-dimensional vector space and learning significant words word embedding or terms revealed through Word embedding algorithm. The fake news detection is greatly achieved along with real news on job post from online social media is achieved by Bi-LSTM classifier and thereby evaluating corresponding performance. The performance metrics such as Precision, Recall, F1-score, and Accuracy are assessed for effectiveness by fraudulency based on job posts. The outcome infers the effectiveness and prominence of features for detecting false news. .
Impact of Advertising on Educational Apps Used by Children
Authors: Iyer Kavitha Venkatasubramany , Dole Vikas Suresh
Published: August 2021

India’s education sector is being impacted by COVID-19 in unprecedented ways. The pandemic is disrupting the traditional education system, affecting over 320 million students. This sector is trying to develop robust, innovative approaches to foster a paradigm shift toward digital education. These efforts are being supplemented with the launch of quality-focused multilingual educational applications (apps). Parents are also swiftly adopting a variety of e-learning apps. This research addresses the role of advertisements to empower parents to be educated consumers for educational apps for children. The purposeful sample data were collected from 307 parents of students from the top 10 ICSE (Indian Certificate of Secondary Education) and CBSE (Central Board of Secondary Education) schools in Urban India. The findings indicate that advertising media accelerates the diffusion of educational technology and apps among parents. However, it does not help in overcoming insecurities that parents may have regarding these apps for their children.
The Role of Virtual Reality to Enhance Cultural Communication
Authors: Abokhoza Reneh Ramsis , Sobieh Yosra Mahmoud
Published: August 2021

This paper aimed to recognize the role of virtual reality to enhance cultural communication by allowing to the participators who divided into three groups to watch the same substance in three different displays—virtual reality, normal video, images and text—to measure the process of retrieving information or events with a specific cue. The results of the study indicate that the virtual world experience enhances people's awareness of the culture. This new medium, VR, allows for participants to be immersed in the culture in ways that are not possible through the use of other media. Also, it can have an effective impact in cultural communication by allowing the participators to be virtually present at civilized events.
Exploring the Formation Mechanism of Radical Technological Innovation
Authors: Sun Yun , Wang Hecheng , Yu Haiqing , Chen Yong , Kataev Mikhail Yu , Li Ling
Published: August 2021

This paper identifies three stages in the radical technological innovation process, namely formation process in niches, breaking out of niches and entering regimes, and new regime formation. It then adopts Multi-level Perspective (MLP) to explore the formation process, operating mechanism, breakthrough path, and impact factors of radical technological innovation. A three-phase model, which includes formation of radical innovation, breakout of radical innovation, and new regimes construction, is proposed to analyze radical technological innovation. The model is adopted in a case study to analyze the leapfrogging development of technologies in China’s mobile communication industry. This paper enriches technological innovation theory and provides supports for policy making and guidance for industries/enterprises practices regarding technological innovation in emerging economies.
REFLETIR PARA MUDAR ATITUDES: EXPRESSÕES ARTÍSTICAS E DISCURSIVAS SOBRE ANIMAIS SINANTRÓPICOS ENTRE ESTUDANTES DO ENSINO MÉDIO
Authors: Lopes Paulo Henrique , Angelo Elisangela Andrade
Published: August 2021

O levantamento da percepção ambiental e das atitudes de grupos humanos em relação ao meio ambiente são importantes para a educação ambiental. Algumas teorias do campo da Psicologia Social consideram a atitude como a relação entre fatores: cognitivos, afetivos e comportamentais. Atentando-se a essa abordagem, o presente trabalho buscou investigar a relação de alunos de Ensino Médio com a fauna sinantrópica, por meio de uma sequência metodológica que buscou levantar seus sentimentos, conhecimentos e comportamentos em relação a essa fauna, contidos em seus discursos e na sua expressividade artística. Além disso, o trabalho buscou promover, através das diversas práticas adotadas, a participação dos alunos na reflexão sobre as representações dessa fauna. A sequência metodológica incluiu o uso de grupos focais e dinâmicas diversas. A análise dos resultados baseou-se no arcabouço teórico da Análise Textual Discursiva. Foi possível observar que, mesmo havendo a demonstração de alguns conhecimentos, os alunos apresentam uma visão negativa da fauna sinantrópica, influenciada por componentes afetivos e por visões antropocêntricas desta. A abordagem utilizada chama a atenção para a consideração dos aspectos que compõem as atitudes nas pesquisas em educação, bem como para a necessidade de permitir que o aluno seja sujeito reflexivo e ativo na mudança de atitude que se espera dele. Objetiva-se, portanto, com este trabalho, contribuir com as investigações de aspectos que permeiam a construção de atitudes pró-ambientais e, consequentemente, com o ensino de Ciências e Biologia.
Activities of Vavuniya Public Library and Its Challenges: A Survey Research
Authors: Kalaivani S. , Shanmugathasan S.
Published: August 2021

Public libraries are the best contributors to the community. In this way, Vavuniya Public Library is also providing its services to the community. This study is based on the Activities of the Vavuniya Public Library and its challenges. The descriptive study was selected by a random sampling method based on the population. Data were collected through research tools such as questionnaires, discussions, and documentations. Questionnaires were administered to 100 readers randomly selected from the total readers and the Chief Librarian. Data were analyzed with the adaption of the percentage system, rating scale and the MS Excel software. The results were presented in the form of tables, diagrams etc. The results state that the library faces challenges in their service providing and the readers are dissatisfied with the library activities. Current information sources and services of the library seem scarce. Students and higher education students are found to be dissatisfied with the infrastructure facilities of the library. Inappropriate and lack of staff appointments also cause the perception of unsatisfactory services of the library. It is revealed that the significant challenges of the Vavuniya Public Library are inadequate fund allocation, lack of reader-based information resource mobilization, less prominence for electronic information and braille section, and finding difficulties in the provision of essential social information services to the readers. There should be a clear awareness to be adopted among local government officials about the significance of public libraries.
Electronic vane anemometry - finding a suitable replacement of mechanical analog devices for mine airflow assessment
Authors: Hardcastle S G , Grenier M G , Butler K C
Published: August 2021

The most common method of determining airflow employed by mine ventilation engineers is the product of i) the average air velocity as measured by a vane anemometer and stopwatch through a continuous traversing technique, with ii) the cross-sectional area of the
roadway. This method requires the vane anemometer to accumulate the total flow over the duration of the traverse. Historically, this has been facilitated by a mechanical analog instrument that has either a counter or set of dials that display the flow. Common instruments of this type are Airflow
Development's AM5000, Davis's, or Taylor's Biram type anemometer. The AM5000 is widely used in the Canadian mining industry but is no longer available. Therefore, regulatory authorities have seen fit to evaluate presently available commercial instruments to replace the AM5000. This paper describes
an instrument evaluation contracted by the Atomic Energy Control Board of Canada which regulates the uranium industry.
Over the last two decades there have been numerous advances in the development of electronic air velocity meters. Currently available units have the following features: a) battery operation; b) are compact and can be hand-held; c) employ LCD's, and microelectronic circuitry; and d) provide a time
integration for the duration of a traverse. These features make such instruments a possible replacement to the analog units and stopwatch determinations.
This paper details five of the new generation of vane anemometers plus a vortex air meter, and it explores their limitations in comparison to analog units. Specific consideration is given to linear response, the effects of yaw, traversing speeds and ergonomics relating to both handling and use. The
paper concludes with some features that are attractive and should be considered when purchasing a new anemometer.
Coal pillar design for longwalls under the ocean
Authors: Forrester D J , Payne D A , Kochhar J
Published: August 2021

Coal pillar design in longwall mining must balance the need to ensure roadway stability with economic extraction of reserves. In particular, the design must accommodate the effects of stress redistribution providing stability not only during roadway formation but
also by the extraction of longwall panels.
There are four types of pillars usually involved, as illustrated in Figure 1, namely: Pillars between main access roadways; Pillars between access roadways and a longwall panel (start/stop pillars); Pillars between adjacent longwalls (rib pillars); Boundary pillars between adjacent mines.
This paper outlines the approach of the Cape Breton Development Corp. (CBDC), Nova Scotia, Canada, to meeting the challenges of designing pillars in modem longwall coal mining under the North Atlantic Ocean.
In addition to complying with regulatory requirements, other influences must be considered, such as: Protection from interaction effect of working other seams; Protection of the seabed by maintaining strata mass integrity.
After discussing the mainly empirical, current practices in pillar design, two longer-term strategies are discussed: (1) pillar reduction (smaller sizes), where appropriate, and (2) elimination of rib pillars completely, where possible. A key feature in developing these strategies is an innovative
research and development program run jointly by CBDC and CANMET's Cape Breton Coal Research Laboratory (CBCRL). Several projects are summarized involving development of appropriate geotechnical monitoring and numerical modeling procedures.
Knowledge and Attitude toward Depression among Adolescents Attending Secondary Schools in an Urban Local Government Area of Lagos State, Nigeria
Authors: Lesi Awujoola F. , Balogun Mobolanle R. , Ladi-Akinyemi Temitope W. , Igwilo Ugonnaya U.
Published: August 2021

Background:

Globally, depression is the fourth leading cause of mental illness and disability among adolescents (15–19 years). This study aimed to assess knowledge and attitude toward depression among adolescents attending secondary schools.

Methods:

This was a descriptive cross-sectional study among 257 adolescents attending secondary schools in an urban area of Lagos State. Multistage sampling technique was used to identify appropriate schools, and a semi-structured self-administered questionnaire that contained a vignette depicting depression was used to collect data. Data were analyzed using SPSS version 20.

Results:

Overall, 257 students participated in the study. The mean age was 15.8 ± 1.3 years. Majority (91.5%) had prior knowledge about depression. The most common sources of information were from school (38.9%), family and friends (23.3%), and social media (20.6%). Majority (87.9%) correctly recognized depression in the vignette. Attempted suicide and social withdrawal from friends (71% and 67.3%, respectively) were less recognized as symptoms of depression. Similarly, only 36.2% recognized depression as a real medical condition. Students in science (76.9%) had better knowledge about depression than students in arts (43.5%) and commerce (43.8%) (P = 0.006). The teacher was considered as the primary access to care compared to the need for specialized care. Majority of the respondents had positive attitudes toward depression and 75.4% believed that people with depression should not be stigmatized.

Conclusion:

This study showed important gaps in knowledge of causes, symptoms, and the need for professional or psychiatric care of depression. It highlights the need to promote mental health literacy in schools.
Risk factors for new-onset heart failure with reduced or preserved ejection fraction in patients with ischemic heart disease
Authors: Abdissa Senbeta Guteta
Published: August 2021

Background:

Risk factors for heart failure (HF) with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF) in Ethiopian and Sub-Saharan African patients with ischemic heart disease (IHD) is not well-known.

Methods:

This is a cohort study where 228 patients with IHD were recruited and followed retrospectively over 24 months period. Exclusion criteria were known HF at baseline and absence of echocardiography data. From baseline clinical and echocardiographic patient characteristics, risk factors for incident HFpEF and incident HFrEF were analyzed.

Results:

New-onset HF was diagnosed in 67.1% (153/228) of the patients. Median time to HF diagnosis was 12.02 (3.42–13.31) months in HFrEF and 12.06 (2.66–15.28) months in HFpEF. There was no significant difference between HFrEF and HFpEF in time to incident HF. On univariate regression analysis risk factors for incident total HF were age, diabetes, and left atrium (LA) size. Diabetes, systolic blood pressure (SBP), diastolic blood pressure, LA and diastolic left ventricular dimension (LVD) had significant association with HFrEF. Age, sex, hypertension, SBP, and diastolic LVD were significantly associated with HFpEF. On cox regression analysis diabetes and LA dimension were associated with total HF while diastolic LVD was associated with incident HFpEF and HFrEF. Age, diabetes, and dimension of LA were also associated with HFrEF.

Conclusion:

These data suggest a major role for age, sex, diabetes, bigger LA size, and diastolic LVD as predictors of HFrEF and HFpEF in patients with IHD. Strategies directed to prevention and treatment of diabetes, dilatation of left ventricle and LA may prevent a considerable proportion of HFrEF or HFpEF.
An investigation of the relationship of the admission hyperglycemia to severity and 30-day outcome in acute ishemic and intracerebral hemorraghic stroke
Authors: Agabi Osigwe Paul , Ojo Oluwadamilola Omolara , Danesi Mustapha Abudu , Ojini Frank Ibe , Okubadejo Njideka Ulumna
Published: August 2021

Background:

Hyperglycemia is implicated as deleterious in acute stroke, although the impact may vary by stroke subtype. We sought to determine the frequency of admission hyperglycemia (subcategorized as diabetes related or reactive) and explore the relationship to stroke severity and functional motor outcome in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) stroke subtypes.

Methods:

This cross-sectional study recruited 170 stroke patients (85 AIS, 85 ICH) presenting within 72 h of onset. Baseline characteristics including stroke severity (National Institutes of Health Stroke Scale score), random blood glucose (RBG), and glycated hemoglobin (HBA1C) were documented. The outcomes were 30-day case fatality rate (CFR) and functional motor outcome.

Results:

The frequency of admission hyperglycemia was 24.7% in AIS and 22.4% ICH, with 18.8%/5.9% of AIS and 9.4%/12.9% of ICH presumed diabetes related and reactive, respectively. Stroke severity and infarct size were positively correlated with admission RBG and HBA1C (P = 0.000) in AIS but not ICH. Presumed mechanism of hyperglycemia did not relate significantly with either infarct size or hematoma volume (P > 0.05). Thirty days CFR was higher in AIS with hyperglycemia (42.9%) compared to normoglycemia (12.5%) (P = 0.003), but did not vary significantly in ICH (42.1% with and 36.4% without hyperglycemia; P = 0.65). There was no significant relationship of hyperglycemia to functional outcome in either stroke subtype.

Conclusions:

The association of admission hyperglycemia to stroke severity and short-term case fatality is evident in AIS. In ICH, hyperglycemia was not associated with significantly greater stroke severity and death at 30 days, even though case fatality was higher in those with hyperglycemia.
Prevention of Thromboembolism in Elderly
Authors: Sahoo Panchanan , Padhee B. N. , Jena Anupam , Mishra H. N.
Published: August 2021

Venous and arterial thrombosis and thromboembolism are a leading cause of suffering in elderly population. The prevalence of venous and arterial thrombosis (formation of blood clot) and thromboembolism (breakage of thrombus to travel somewhere in circulation) is high in elderly population those above 60 years and poses important cause of morbidity and mortality. Annual incidence of venous thrombosis is 1 in 1000 which rises after age of 45 years and arterial thrombosis as high as 20% as per pooled MPN. Spectrum of thromboembolism (TE) is diverse and etiology, and pathogenesis is varied ranging from atrial fibrillation, hypertension, diabetes mellitus (DM), dilated cardiomyopathy and ischemic cardiomyopathy (ICM), congestive heart failure, acute coronary syndrome, and cases of fracture immobilization leading to deep venous thrombosis and pulmonary embolism or else arterial occlusion leading to cardiac or cerebral strokes Aim of the update is to bring a broad overview of the problem to prevent late disastrous outcomes, putting forth two exemplary case studies of imminent TE risk. Case 1 – elderly hypertensive presenting with paroxysmal AF with high CHA2DS visual analog scale score needing anticoagulation and Case 2 – case of DM, post- percutaneous transluminal coronary angioplasty (PTCA), ICM, severe left ventricular (LV) dysfunction with LV thrombus in sinus rhythm needing anticoagulation. Elderly population suffer from diseases of diverse etiology exposing to high risk of TE and at the same time high bleeding risk of the anticoagulants. Elderly population with diverse disease ailments exposed to high risk of TE and bleeding complications and hence should be dealt with utmost care and sympathy to avoid TE and bleeding complications.
Septic Arthritis of the Hip After Percutaneous Coronary Intervention
Authors: Koduru Gopala Krishna , Basineni Hari Krishna , Dandamudi Srinivas , Palaparti Raghuram , Pendyala Suman , Chowdary P. S. S.
Published: August 2021

Infective complications of cardiac catheterization have come down significantly in the past few decades but are occasionally reported. We report one such complication in an elderly female who developed septic arthritis of the hip due to Staphylococcus aureus infection following percutaneous coronary intervention through right femoral access. After an initial conservative strategy with girdlestone excision arthroplasty, she underwent a total hip replacement surgery as a staged procedure after the complete resolution of infection. With the increasing usage of femoral vascular access and vascular closure devices for various complex cardiac interventions in the present-day cardiac catheterization laboratory, a morbid complication like septic hip arthritis should be borne in mind whenever a patient presents with fever and hip joint pain, particularly when there are disproportionate or no significant local findings. Strict aseptic precautions, early identification by considering a magnetic resonance imaging scan early in the clinical course, and aggressive management are the key to better outcomes.
Massive Hemothorax Following Failed Internal Jugular Vein Access During An Electrophysiological Procedure
Authors: Harish Ponnana Hemanth , Satish Oruganti Sai
Published: August 2021

We report an unusual case of massive hemothorax in a female patient undergoing electrophysiological (EP) procedure for drug-refractory supraventricular tachycardia. She underwent percutaneous intervention with a drug-eluting stent to the right coronary artery 6 months back and was on dual antiplatelet drugs. Timely detection and management of hemothorax prevented a major catastrophe in this patient. This case highlights the importance of keeping a strict vigil for possible occurrence of life-threatening bleeding complications during EP procedure in patients on multiple antiplatelet drug therapy.
Balloon Inflation-Assisted Trapping and Successful Retrieval of Partially Fractured and Entrapped Guidewire
Authors: Sinha Santosh Kumar , Razi Mahmodullah , Sharma Awadesh Kumar , Pandey Umeshwar
Published: August 2021

Guidewire fracture (either partial or complete) is an exceedingly rare complication of which is mostly encountered in percutaneous coronary intervention (PCI) of complex lesions. It can be managed mostly with using percutaneous techniques, but at times requires a surgical approach as well. Here, we report a case of a 67-year-old male who underwent PCI of totally occluded proximal left anterior descending artery. Due to excessive manipulation, tip of Sion blue wire (polymer-jacket guidewire) got trapped into the lesion. To unloop the wire, spring tip got partially fractured. The guiding catheter was pushed over the fractured wire near the fracture point and a 2.5 mm × 10 mm Sapphire semi-compliant balloon (Orbus Neisch, Netherland) was inflated near the tip of guiding catheter at 12 atm pressure, and whole assembly was pulled out to successfully retrieve the partially fractured and retained wire.
Percutaneous Coronary Intervention Using Rotational Atherectomy and New-Generation Drug-Eluting Stents in Mild Versus Moderate-To-Severe Chronic Kidney Disease Patients with Coronary Artery Disease
Authors: Malik Fazila-Tun-Nesa , Kalimuddin  , Ahmed Nazir , Badiuzzaman Mohammad , Khan Abdul Kayum , Dutta Ashok , Huq Tawfiq Shahriar , Banik Dhiman , Ahmed Mir Nesaruddin , Rahman Habibur , Iqbal Abu Tareq
Published: August 2021

Background:

The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable strategy to treat heavily calcified coronary lesions in CKD patients. Aim: The aim of the study was to compare the effectiveness and safety of PCI using RA and new-generation DES for treating calcified coronary lesions in patients with mild versus moderate-to-severe CKD.

Methods:

This was a single-center, retrospective study. Data were collected from the medical records of all CKD patients with calcified coronary artery lesions who underwent RA + DES implantation from November 2014 to October 2019. The primary outcomes were the rates of in-stent restenosis (ISR), repeat revascularization (RR), and major adverse cardiovascular and cerebrovascular events. Secondary outcomes included procedural success, death after intervention, and procedural/in-hospital complications.

Results:

A total of 77 and 126 patients with mild and moderate-to-severe CKD were treated with RA + DES. Patients with moderate-to-severe CKD were significantly older when compared to patients with mild CKD (mean age: 66.6 ± 8.2 vs. 59.5 ± 7.7 years, respectively, P < 0.0001). Body mass index was significantly lower in moderate-to-severe CKD group compared to the mild CKD group. The number of patients in whom postdilatation was performed after stent implantation was significantly higher in the moderate-to-severe CKD group compared to the mild CKD group (100% vs. 96%, P = 0.025). Overall procedural success was 97.5% with minimal periprocedural complications. The rates of ISR and RR were not significantly different between patients with mild and moderate-to-severe CKD. The two groups did not differ significantly in terms of procedural success, postprocedural complications, and procedural mortality.

Conclusion:

RA followed by DES implantation is an effective and safe strategy to treat calcified coronary artery lesions in patients with CKD, regardless of the degree of renal dysfunction.
Cytological Diagnosis of Ocular Metastasis of Squamous Cell Carcinoma Cervix
Authors: Vedant Deepak , Kaushal Vijay , Gulati Anchana
Published: August 2021

Ocular metastasis is considered a rare phenomenon. Metastatic spread of tumors in the eyeball is usually discovered only when it affects the visual acuity. In women, breast tumors are to known metastasize in and around the eyeball. Cervical carcinomas are rarely known to metastasize in the eyeball. We present here a rare case of ocular metastasis, diagnosed on fine-needle aspiration cytology, in a known case of squamous cell carcinoma of the cervix.
Role of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration with Cellblocks in Diagnosis and Subtyping of Intrathoracic Lesions
Authors: Verma Vikrant , Khan Ajmal , Rao Ram Nawal , Nath Alok , Hashim Zia
Published: August 2021

Background:

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) allows precise real-time sampling of intrathoracic lesions and is a minimally invasive, safe, and cost effective technique with high diagnostic yield. The aim of the current study is to evaluate utility of EBUS-TBNA cytology with cellblocks (CBs) in the diagnosis and subtyping of the intrathoracic lesions.

Materials and Methods:

It was a prospective study conducted from October 2015 to October 2017. We received 233 cases of intrathoracic lesions for EBUS-TBNA, of which CB was made in 217 cases. A flexible endobronchial ultrasound scope was used to sample the lesions.

Results:

There were 89 females and 128 males amongst the total 217 patients (age range: 14–85 years, mean age: 48.35 years). The smears from EBUS-TBNA contained adequate material in 137/144 [95.1%] non-neoplastic cases and 34/36 [94.4%] of the neoplastic cases, whereas the CBs provided adequate material in 94/144 [65.3%] non-neoplastic cases and 37/40 [92.5%] neoplastic cases. The CB helped subtyping the malignancy in 19 cases and of these immunohistochemistry (IHC) was done on the CB in 15 cases. The biopsy was non-diagnostic in 17/36 cases of granulomatous pathology and 4/18 neoplastic cases diagnosed with EBUS-TBNA.3.

Conclusions:

EBUS-TBNA provides rapid diagnosis through cytology and the material recovered in the same setting for the CB preparation can be used for immunohistochemical analysis and it may at times provide the diagnosis in cases where the smears are non-diagnostic.
SnakeBite Wound with Open Volar Proximal Interphalangeal Joint Dislocation of Little Toe
Authors: Dharmshaktu Ganesh Singh
Published: August 2021

Snake-bite injuries are uncommon events but a significant number of cases are reported from rural areas. The basic principles of diagnosis and management of snake-bite injuries should be known to rural practitioners and prompt referral should be done in selected cases. The extremity bite may occasionally result in localized cellulitis and soft tissue infection that may complicate later into underlying bone invilement. Dislocation following the open wound in these setting is rare occurrence that needs proper knowledge for its diagnosis and management.
Clinico-hematological profile of pancytopenic adult patients in a tertiary care teaching hospital
Authors: Jain Anil , Garg Ravinder , Kaur Rupinderjeet , Nibhoria Sarita , Chawla Sumit Pal Singh , Kaur Sarabjot
Published: August 2021

Objective:

The causes of pancytopenia vary in different populations depending on age, gender, nutrition, geographic location, standard of living, and exposure to certain infections and drugs. As the severity of pancytopenia and its underlying etiology determine the management and prognosis, identifying the correct etiology in a given case is crucial and helps in implementing timely and appropriate treatment. The objectives of this study were to study the clinical profile and hematological parameters of pancytopenic adults and to identify different etiologies of pancytopenia. This observational study was conducted in the Medicine department of a tertiary care teaching hospital.

Materials and Methods:

The study was conducted on 100 adult patients aged 18–65 years presenting with pancytopenia. All the participants were subjected to detailed clinical examination and relevant investigations including bone marrow (BM) examination. Categorical variables were presented in number and percentage (%). Qualitative variables were correlated using the Chi-square test. A P =0.05 was considered statistically significant.

Results:

A female preponderance was observed, and the majority of patients were aged between 18 and 40 years. The most common clinical features were generalized weakness, fever, and pallor. Seventy-four percent of patients were vegetarians; 58% had vitamin B12 deficiency, 25% had folic acid deficiency and 19% had a deficiency of both. The most common cause of pancytopenia was megaloblastic anemia (MA) (37%), followed by dimorphic anemia (DA) (26%), aplastic anemia (AA) (20%), and hematological malignancies (11%).

Conclusion:

MA, DA, and AA are the most prevalent etiologies of pancytopenia. BM examination is of utmost importance in the definitive diagnosis of pancytopenia and is useful in initiating timely treatment as a significant number of causes of pancytopenia are potentially curable.
The feasibility of Kimny guiding catheter for ST-segment elevation myocardial infarction
Authors: Tsai Sou-Chan , Chen Michael Yu-Chih , Chuo Sing-Kai , Wang Ji-Hung
Published: August 2021

Objectives:

The Kimny guiding catheter is a single universal guiding catheter used for performing percutaneous coronary intervention (PCI) in both the right coronary artery (RCA) and the left coronary artery (LCA). Although this guiding catheter has been shown to yield high procedural success rates in nonemergent conditions, its feasibility for patients with ST-segment elevation myocardial infarction (STEMI) remains unknown and therefore needs to be further investigated.

Materials and Methods:

We retrospectively enrolled 62 consecutive STEMI patients who underwent primary PCI using the Kimny guiding catheter from January 2016 through December 2017. We then evaluated the rates of engagement and procedural success for PCI of the LCA and RCA with the Kimny guiding catheter.

Results:

Primary PCI of the infarct-related artery (IRA) by means of the Kimny guiding catheter proved to be successful in 61 of the STEMI patients (98.3%). Besides, the procedural success rate was found to be 100% (44/44) for the LCA and 94.4% (17/18) for the RCA (P = 0.293). With regard to contralateral (non-IRA) angiography, engagement rates of 97.4% (38/39) and 100% (18/18) were obtained for the RCA and LCA, respectively, (P = 1.0). No coronary artery ostial dissection was observed during the procedures. The mean number of total catheters used for each patient turned out to be only 1.035.

Conclusion:

Using the Kimny guiding catheter for primary PCI is feasible and results in high procedural success rates, particularly for the treatment of the LCA, with fewer catheters, and at a lower cost.
Higher Prevalence of Extended Spectrum β-Lactamase Producing Uropathogenic Escherichia coli Among Patients with Diabetes from a Tertiary Care Hospital of Kathmandu, Nepal
Authors: Nayaju Tulsi , Upreti Milan Kumar , Ghimire Alina , Shrestha Basudha , Maharjan Basanta , Joshi Rajesh Dhoj , Lekhak Binod , Thapa Shrestha Upendra
Published: August 2021

This study aimed to determine the occurrence of antibiotic resistance genes for β-lactamases; blaTEM and blaCTX-M in uropathogenic Escherichia coli isolates from urinary tract infection (UTI) suspected diabetic and nondiabetic patients. A hospital-based cross-sectional study was conducted in Kathmandu Model Hospital, Kathmandu, in association with the Department of Microbiology, GoldenGate International College, Kathmandu, Nepal, from June to December 2018. A total of 1,267 nonduplicate midstream urine specimens were obtained and processed immediately for isolation of uropathogens. The isolates were subjected to antibiotic susceptibility testing and extended spectrum β-lactamase (ESBL) confirmation. In addition, blaTEM and blaCTX-M genes were detected using specific primers. The overall prevalence of UTI was 17.2% (218/1,267), of which patients with diabetes were significantly more infected; 32.3% (31/96) as compared with nonpatients with diabetes, 15.9% (187/1,171). A total of 221 bacterial isolates were obtained from 218 culture-positive specimens in which E. coli was the most predominant; 67.9% (150/221). Forty-four percent (66/150) of the total E. coli was multidrug resistant and 37.3% (56/150) were ESBL producers. Among 56 isolates, 92.3% (12/13) were from patients with diabetes, and 83.0% (44/53) were from nondiabetics. Furthermore, 84.9% of the screened ESBL producers were confirmed to possess either single or both of blaTEM and blaCTX-M genes. The blaTEM and blaCTX-M genes were detected in 53.6% and 87.5% of the phenotypically ESBL confirmed E. coli, respectively. Higher rates of ESBL producing uropathogenic E. coli are associated among patients with diabetes causing an alarming situation for disease management. However, second-line drugs with broad antimicrobial properties are still found to be effective drugs for multidrug resistance strains.
Perceptions of workers on the benefits of institutional source sorting: A case of the Council for Scientific and Industrial Research - Institute of Industrial Research (CSIR-IIR), Accra, Ghana
Authors: Yeboah A. B. , Adu-Ntim J. K. , Koranteng J. , Tagbor T. A. , Aniagyei A. , Kwawu C.
Published: August 2021

The management of solid wastes at the workplace in Ghana is characterised by mixed wastes pickup delays, dustbin overflows and leakage of plastic bags into the environment. Benefits from the pilot of source sorting as a mitigation measure at the workplace are unavailable in literature. Hence, the study employed descriptive statistical tools to assess the advantages of a piloted source sorting system at the CSIR-IIR. The sampled size was 100 staff with an 80% questionnaire recovery rate. The analysis of data showed that, the implementation of segregation at source transformed the social approach of workers towards waste management. Most workers (97.7%) preferred sorting their wastes at source irrespective of the location of the generation point. A congenial environment was created by the source separation infra­structure, which made staff worked better, (70% responses). The majority of staff (95.2%) confirmed the savings made by the Institute on the cost of landfilling. The sorting at source improved cleanliness of the compound (97.6% responses) and eliminated open-air burning of wastes (95.1% responses). In all, the source segregation was beneficial to the social, economic and environmental well-being of staff and management of the Institution.
Exploring the ethical dilemmas of afro-centric social media use through agent-based modeling: A review
Authors: Nwokoye C. H. , Umeh I. I. , Odo I. J.
Published: August 2021

Social media (SM) has become indispensable for individuals and workplaces/organizations in Africa and beyond. Therein, ethical concerns are posed due to the inability to create virtual boundaries (VM), the intractability of guidelines for managers and other unintended risks/con­sequences. Operations research was used for modeling ethical concerns but have been defeated due to reasons of several ethical values and various assessment criteria for stakeholders. Conse­quently, this review paper initially x-rays the import of ethical dilemmas in older studies so as to conceive a strategy characterized by engaging stakeholders that utilize SM via Agent-Based Modeling (ABM), in such a manner that ethics can be evaluated. Additionally, it presented the rudiments of social media ABM explorations and the peculiarities of Africa. Finally, the review provided a suitable methodology and sheds light on the possible challenges of ABM implementation. Besides the benefit of increased patronage, the agent technology may also constitute a pedagogical tool for learning ethical behavior. Moreover, it is our hope that with the involvement of experts of related disciplines in Africa, attendant theories are formalized and used for building agent models that allows ethical decision making, weighing of pros and cons, analyzing differences and dimensions inherent in VM creation.
Ecological Threats of an Ecotourism Destination: The Case of Owu
Waterfall, Kwara State, Nigeria
Authors: Babafemi Geoffrey , Chika Anunta , Olabanji Adediran , Sunday Odewumi , Kayode Apaokagi , Omololu Fapajuwo
Published: August 2021

Every Ecotourism destination consists of its own physical and climatic condition with its potentials of natural resources like wildlife, hills, mountains and vegetation to be nurtured and preserved for tourism, educational and research purposes amongst other uses. Maintenance of the physical environment of tourism activity is crucial for site sustainability. To examine the real state of affairs at one of Nigeria’s ecotourism destinations, field surveys were implemented within an area approximately 2160 hectares of land which forms the main-bow of Owu Waterfall. Woody plant composition, faunal species and anthropogenic threats were assessed. A total of 34 woody plant species in 20 families were encountered. There were differences in the woody species composition of the Waterfall site. Six species of wild animals: Cercopithecus mona, C. tantalus, Papio anubis, Galagoides Spp Xerus Sp and Epixerus Sp were directly sighted. Four major threat activities were reported as logging, farming, annual burning and grazing. This study made recommendations that all sustainable measures be explored to maintain the site. More so, development of the site should be a multidisciplinary approach given that it has the capacity to be developed as a world-class tourism destination.