bluuebunny/crossref_metadata_2025 huggingface dataset:
Improve Autism Rehabilitation Services by Providing Solutions Based on the Perception and Experience of Parents and Providers: A Qualitative Study
Authors: Aarabi Mahta Alsadat , Abdi Kianoush , Khanjani Mohammad Saeed
Published: October 2022

Background: Children with autism spectrum disorder (ASD) need a variety of services. One of the most essential needs of these children with ASD is the use of rehabilitation services. However, these services pose many challenges for these individuals. Providing strategies to solve these barriers is essential. Objectives: The purpose of this study was to identify strategies to overcome barriers to using rehabilitation services and improve them based on the perceptions and experiences of rehabilitation service providers and parents of children with ASD. Methods: This study was conducted with a conventional qualitative approach. Twenty-seven participants were selected from rehabilitation service providers and parents of children with ASD based on purposive sampling with maximum diversity. Data were collected through semi-structured face-to-face interviews. The interviews lasted from July to December 2020 for 20 to 60 minutes and continued until the data was saturated. Data were analyzed with MAXQDA 10 software. Results: After the interviews, 1057 initial codes were extracted by deleting similar codes. Strategies for using rehabilitation services for these children with ASD were classified into 5 main categories and 20 subcategories, which are: Improving the level of knowledge and attitude, creating and strengthening a systematic support system, systematic rehabilitation policies, developing a comprehensive autism rehabilitation management program and facilitating access. Conclusions: In previous studies, many challenges have been identified for all services for children with ASD. The findings of this study showed that considering facilitators to solve the existing challenges in order to use of rehabilitation services for these children with ASD and their families. Therefore, policy makers, service providers and managers need to be aware of the strategies collected and pay special attention to these issues. To achieve a more favorable situation, they should adopt and implement the necessary mechanism in the field of policy and planning, so that finally lead to fundamental steps to improve the rehabilitation services needed by children with ASD.
Design of campus emergency response system in public health emergencies
Authors: Sun Yan
Published: October 2022

Safety and health are essential factors of any organization to ensure smooth and effective functioning. Occupational safety and health (OSH) awareness is vital in preventing occupational injuries and illness. Various programs have been implemented by the organization to increase the knowledge and awareness of OSH in the workplace, including among institution higher learning staff in Malaysia. A study was undertaken to identify factors influencing the awareness level of OSH among the staff of Universiti Teknologi MARA (UiTM) in Penang, Malaysia. A self-administered online questionnaire was distributed to the staff through UiTM email and 193 staff were responded. The questionnaire covered 43 questions and was divided into 7 factors that influence awareness level. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20 and presented in descriptive statistics. The study revealed that the highest level of awareness factor was OSH policy, with a mean score of 4.90, while the lowest level was the safety and health committee, with a mean score of  3.90. The university management should increase the role of the safety and health committee to increase the safety and health programs such as safety talks, training, and campaign through posters and signage on the campus. OSH management is critical to prevent an accident at the workplace towards the development of a safety culture.
How to target the Digital health development of children in preschool education
Authors: Wang Lili , Yan Teng
Published: October 2022

Youth improvement alludes to a kid's physical, mental, phonetic, and socio-enthusiastic advancement from origination until the age of eight. This improvement happens in various settings (homes, schools, well-being offices, local area-based focuses). It incorporates a broad scope of exercises from youngster care to sustenance to parent training. Administrations can be given by open, private, and non-benefit associations. There are different periods of youth advancement, each with its interesting arrangement of necessities. Pre-birth care, went to births, enlistment, post-pregnancy care 0-3 parent instruction, early feeling, and sustenance intercessions, locally situated care, crèches 3-6 parent training, preschool 6-8 exchange to formal tutoring, further developed early grade younger students from the most vulnerable and disadvantaged families, particularly children with special requirements for early childhood development, require the most high-quality services and care in terms of development. Appropriate investment in early childhood development is required to ensure that a country's children develop correctly. In this work, we examined the Questionnaire's dependability and the impact of school training on the development of pre-school education.
«The Others» in Polıtıcs Durıng the era of the Young Turks: Ottoman Greeks ın the Parlıament (1908-1918)
Authors: Doygun Pelin
Published: October 2022

This article analyzes the role and the discourses of the Ottoman Greeks in the parliament during the Young Turks’ rule between 1908 and 1918. In this way, it attempts to contribute to the knowledge about the newly established so-called constitutional order in the Ottoman Empire, the parliament and its impact over the socio-political fluctuations which mostly affected the non-Muslims. In order to do it, this work focuses on the speeches, discourses and topics of discussion which were brought to the agenda by the Ottoman Greeks in the parliament. The research is formed upon the parliamentary minutes as well as both Ottoman Turkish and Greek newspapers of the related period. The examination of these sources allows us to conclude that the efforts of the Young Turks for bringing equality, freedom and justice in fact created a reverse effect and further deepened the gap between the Greeks and the Turks; difference in the interpretations of the terms propagated by the Young Turks such as equality, freedom and Ottomanness as a uniting identity, contrary to expectations, accelerated the disintegration of the Empire.
De paria a aliado indispensable: Pakistán y Estados Unidos durante la administración Carter, 1977-1981
Authors: Gil Guerrero Javier
Published: October 2022

Las relaciones entre Estados Unidos y Pakistán alcanzaron su punto más bajo durante los años de la administración Carter (1977-1981). Decidido a poner los derechos humanos y la lucha contra la proliferación nuclear en el centro de su política exterior, Carter colisionó de inmediato con la determinación de las autoridades pakistaníes a no ceder a las nuevas exigencias de Washington. El idealismo de Carter pretendía enterrar el realismo de Nixon y Kissinger y abrir un nuevo capítulo en la relación de Estados Unidos con el mundo. La invasión soviética de Afganistán, sin embargo, propició un giro abrupto en la agenda de Carter y reforzó la posición de Islamabad en su relación con Washington.
El delito social durante los años del pistolerismo: evolución e impacto en Aragón (1919-1923)
Authors: Calvo Prat David Manuel
Published: October 2022

El delito social como tal no estaba tipificado en el código penal de 1870, a grandes rasgos el mismo texto que el de 1850, con algunas variaciones. En cualquier caso, bajo tal denominación se daba cabida a una gran cantidad de tipos penales que, por su especial trascendencia e impacto, eran considerados como ilícitos especiales. En este artículo se ha querido mostrar la evolución de la tipología penal relacionada con la cuestión social durante los años del pistolerismo en Aragón, sobre todo en su capital, a través de series estadísticas basadas en el análisis y estudio de los datos provenientes de organismos oficiales de la época. La acción represiva y preventiva fue por lo tanto evolucionando y adaptándose a la propia acción delictiva de tipo social. Su desarrollo, evolución e impacto en la región aragonesa durante este período ha resultado esencial para explicar las dinámicas de la cuestión social y su problemática.
Reseña de: Malkasian, Carter: The American War in Afghanistan: A History
Authors: Avilés Farré Juan
Published: October 2022

Reseña de: Malkasian, Carter: The American War in Afghanistan: A History, Oxford University Press, 2021, 576 pp. ISBN 9780197550779.
Reseña de: Pérez Martínez, José Emilio: La voz de las sin voz. El movimiento de radios libres entre la Transición y la época socialista (1976-1989)
Authors: Peñate Domínguez Federico
Published: October 2022

Reseña de: Pérez Martínez, José Emilio: La voz de las sin voz. El movimiento de radios libres entre la Transición y la época socialista (1976-1989). Madrid, Sílex ediciones, 2022, 474 pp., ISBN: 978-84-19077-11-0.
Bullous pemphigoid and the associated co-morbidities: A prospective study at a tertiary-care center
Authors: Vaishnavi Veerapaneni , Babu Tambisetti Naresh , Ramadevi Birudala , Pujitha Bangaru Bhavani , Ramadas Kuna
Published: October 2022

Background: Bullous pemphigoid is an autoimmune blistering disorder of the skin. Recent studies have shown that there are various associated co-morbidities existing even before the diagnosis of the condition. Objectives: The aim was to study the association of co-morbidities in bullous pemphigoid at a tertiary-care center. Methodology: This was a hospital-based prospective study of forty cases of bullous pemphigoid conducted over a period of thirty months at a tertiary-care center. Results: The mean age of the participants was 73. There was a male preponderance, with a male-to-female ratio of 1.8:1. Bullous pemphigoid was significantly associated with hypertension in 80% (32) of the patients, followed by diabetes mellitus in 75% (30), cerebrovascular accidents in 35% (14), coronary artery disease in 27.5% (11), depression in 12.5% (5), hypothyroidism in 12.5 % (5), and chronic kidney disease in 5% (2). Conclusion: Screening for co-morbid health conditions is paramount in patients with bullous pemphigoid for an optimal outcome since treatment options have an impact on the control of comorbidities and vice versa. It should be a multidisciplinary approach for optimal management and the improvement of the quality of life, thus reducing the number of hospital visits and medications to reduce the economic burden and morbidity, hence improving the quality of life.
In-hospital mortality in a dermatology department
Authors: Alami Sofia , Meziane Mariame , Ismaili Nadia , Benzekri Laila , Senouci Karima
Published: October 2022

Background: Far from popular belief making dermatological conditions benign and harmless, we know that some dermatoses may be life-threatening. The aim of our study was to evaluate the overall mortality resulting from dermatological disorders in our department because of the rarity of similar studies. Materials and Methods: We conducted a retrospective, observational study on all patients who died in the Ibn Sina Hospital of Rabat between January 2017 and December 2021 (a period of five years), after they were initially admitted to the dermatology department. Results: Among 1731 patients hospitalized during this period, 45 died, corresponding to an average of 2.6%. The male-to-female ratio was 1.9 and the mean age at death was 63.2 years. The mean number of comorbidities per patient was 1.2, dominated by diabetes. The reasons for hospitalization were as follows: twenty-three cases of extensive bullous dermatoses (60.5% of the cases), four cases of severe toxidermia (10.5%), three cases of erythroderma (7.8%), one case of acro-lentiginous melanoma, one case of squamous cell carcinoma, and one case of pyoderma gangrenosum. In twenty patients (52.6%), the cause of death was directly related to the dermatosis. In sixteen, the cause of death was septic shock of cutaneous origin. Sixteen patients (42.1%) died of causes unrelated to dermatosis. Conclusion: This study showed that life-threatening dermatoses are not uncommon. Among these conditions, autoimmune bullous dermatoses and severe toxidermia, such as TEN and DRESS syndrome, were found to be the most lethal. An advanced age, a surface area of skin involvement, mucosal involvement, associated comorbidities, and the development of sepsis may be considered poor prognostic factors.
Dermatophagia: A case series from a dermatology clinic
Authors: Sharquie Khalifa Ebeid , Younis Maha Sulaiman
Published: October 2022

Objective: Psychocutaneous diseases, such as dermatophagia, are skin manifestations of psychological distress. Cases of this nature are not well documented. Therefore, this study aimed to record cases of skin biting and perform a complete clinical evaluation. Methods: This descriptive case study enrolled sixteen patients treated in a dermatology and psychiatry clinic in Baghdad, Iraq, from 2014 to 2021. All patients with self-inflicted skin disease induced by skin biting were enrolled. A complete medical history was collected and a clinical examination and psychiatric assessment were performed. Results: Out of the sixteen patients who had demonstrated self-skin biting (dermatophagia), ten were males and six were females, with a median age of twenty years, ranging from 14 to 45 years. All patients accepted responsibility for their illness. The type of skin manifestation was nail-biting in seven (46.66%) patients, consisting of five (33.3%) patients with nail dystrophy due to proximal nail fold biting and two (13.33%) patients with nail deformity due to grinding of the distal part of all nail plates. Six (40%) patients presented with skin nodules on the dorsal side of their hands, a single nodule in one patient, and multiple in five patients. Two patients (13.33 %) revealed dermatitis-like, pigmented patches on the dorsal aspect of the hand and fingers. Psychological evaluation revealed the absence of psychosis and brain disorders. Conclusion: Dermatophagia is an emerging form of psychological health problem that has not been well documented. However, diverse dermatological manifestations localized in the hands, such as nail dystrophy, skin nodules, and chronic, dermatitis-like plaques, have been reported.
Efficacy of propranolol in severe segmental infantile hemangioma of the face
Authors: Diané Boh Fanta , Tounkara Thierno Mamadou , Bangoura M’Mah Aminata , Soumah Mohamed Maciré , Keita Fatimata , Kanté Mamadou Diouldé , Keita Moussa , Savané Moussa , Touré Mariame , Baldé Houleymatou , Cissé Mohamed
Published: October 2022

Infantile hemangioma (IH) is the most common benign vascular tumor of childhood. Most of IHs regress spontaneously, yet some require a more rapid intervention. Herein, we report the case of a two-month-old female who was brought in for consultation by the mother with a voluminous segmental IH of the face in respiratory distress. The infant was hospitalized, after taking advice from other specialists and performing a pre-treatment check-up, the patient was administered oral propranolol. Respiration returned to normal after several hours. The evolution was marked by the regression of the hemangioma and positive drug tolerance. Our observation shows the value of early diagnosis and the need for the rapid management of severe segmental IH of the face treated with oral propranolol. Apart from the efficacy of propranolol in the treatment of IH, we report the difficulties due to the unavailability of the adapted syrup form for infants in Guinea.
Metastatic brain melanoma in a patient with Noonan syndrome with multiple lentigines
Authors: Eleni Klimi , Rallis Efstathios
Published: October 2022

Metastatic melanoma of unknown primary origin often presents a major diagnostic and therapeutic challenge to the clinician. Herein, we present a case of metastatic brain melanoma of unknown primary origin in a patient with generalized lentiginosis and features of Leopard syndrome, which is the first case reported to date as of reviewing the literature. This case presents features suggestive of Leopard syndrome. Clinicians must be aware that a malignancy may occur even in the absence of the complete clinical picture of Leopard syndrome.
Generalized eruptive keratoacanthomas of Grzybowski in the practice of a dermatologist: A case report
Authors: Kuklin Igor , Malishevskaya Nina , Kokha Muza , Safonova Galina , Rimar Olga , Kuklina Maria , Ignatkova Svetlana
Published: October 2022

The article deals with a case of the clinical observation of a rare disease: generalized eruptive keratoacanthomas of Grzybowski. The disease pattern is characterized by the presence of small, generalized, itchy papules on the skin of the face, eyelids, trunk, extremities, genitals, and oral and laryngeal mucosae. The authors present a case of their own clinical observation of multiple eruptive keratoacanthomas of the Grzybowski type in a fifty-year-old patient seeking medical advice from a dermatologist. The duration of the disease was 2.5 years and its occurrence was preceded by repeated visits to countries with excessive insolation, which may be considered an etiological factor in the development of the disease. The diagnosis was verified by the disease pattern and pathomorphological studies on a biopsy of the affected skin.
Morphea overlapping borderline leprosy: An unusual association
Authors: Torres-Guerrero David Edoardo , Alcocer-Salas Michelle , Ramírez-Hobak Lourdes , Atoche-Diéguez Carlos Enrique , Ilizaliturri Ixtabay , Toussaint Sonia , Hernández-Castro Rigoberto , Arenas Roberto
Published: October 2022

Leprosy, or Hansen’s disease, is a chronic infectious disease with a low transmission rate, affecting the skin, peripheral nerves, eyes, and mucous membranes of the upper respiratory tract, yet it may also be systemic. Cases of borderline leprosy are the acute or subacute stages of the disease. They are immunologically unstable and reflect the gradual variation in resistance against the etiological agent. Localized scleroderma or morphea is a fibrosing disease of the skin and underlying tissues that results from the disrupted function of growth factors (platelet-derived growth factor, i.e., PDGF) and receptor expression (as in the case of transforming growth factor b, i.e., TGF-b). Herein, we report a female patient with borderline tuberculoid leprosy (BT) who, during multidrug treatment (MDT), developed an indurated lesion of morphea exactly on the surface of an infiltrated patch.
Spinular follicular keratosis of Siemens associated with wooly hair in two sisters: Trichoscopic description and anatomopathological correlation
Authors: Dassouli1 Ryme , BayBay Hanane , Couissi Imane , Kalmi Nora , Douhi Zakia , Elloudi Sara , Rimani Mouna , Mernissi Fatima Zahra
Published: October 2022

Spinular follicular keratosis (SFK) is a rare X-linked inherited disorder of keratinization characterized by diffuse follicular hyperkeratosis and progressive scarring alopecia of the scalp, eyebrows, and eyelashes. Trichoscopy is a non-invasive dermatological tool that has improved the differential diagnosis of hair pathologies. In fact, dermoscopic models have been developed for several entities of scalp diseases, allowing early diagnostic confirmation and rapid action without the need for histopathology, as well as good follow-up for patients and signs of pathological activity. To date, the specific trichoscopic signs of KFSD have not been developed. Herein, we report the case of KFSD of Siemens in two sisters associated with wooly hair. We employed trichoscopy as a highly useful tool for diagnosis, then performed an anatomopathological study to confirm the diagnosis and explain the signs found on trichoscopy.
Smegma remains a diagnostic dilemma
Authors: Mezni Line , Elhadadi Farah , Meziane Mariame , Ismaili Nadia , Benzekri Laila , Senouci Karima
Published: October 2022

A healthy, uncircumcised, two-year-old male presented with a six-month history of an asymptomatic, mobile, yellowish nodule near the base of the glans penis. An examination revealed a 1 × 0.5 cm, yellowish-white, soft, and mobile nodule between the glans and the foreskin of the penis (Fig. 1). No signs of infection or irritation were noted and the rest of the body was free of lesions. Ultrasound revealed soft tissue thickening, excluded a solid formation. The urine dipstick test was negative. Based on the clinical features, the diagnosis of a smegma cyst was reached. A smegma cyst is composed of epithelial debris, fat, and proteins and is covered by a well-formed, epithelial wall [1]. When there is no covering sac of lump, it is called the smegma pearl. Frequently located on the ventral surface of the glans, within the subpreputial space, the urethral meatus is not affected and the prepuce is partially retractable. It develops in uncircumcised patients. As phimosis resolves the inner foreskin, adhesions begin to undergo a gradual process of separation from the glans penis. Smegma may become entrapped during this process, forming smooth, palpable pearls [2]. It is neither damaging nor irritating. The differential diagnosis concerns either acquired or congenital penile cysts (e.g., trichilemmal cysts, preputial Epstein pearls, dermoid cysts, median raphe cysts, para meatal cysts, mucoid cysts, epidermoid cysts, pilosebaceous cysts, juvenile xanthogranuloma) [3]. Given the paucity of published reports, these collections are a diagnostic challenge for clinicians unfamiliar with this entity and a source of concern for parents. Smegma pearls are a benign entity. Bimanual retraction or gentle expression may be performed with a risk of paraphimosis, irritation, and recurrence [2,3]. Thus, these techniques must be discussed with the parents considering the spontaneous resolution. In the case of chronic evolution, smegma may evolve to preputial stones in adults and the elderly. No investigations or treatments are required. Only monitoring and parental reassurance are recommended.
Amicrobial pustulosis of the folds mimicking Hailey-Hailey disease in a patient with systemic lupus erythematosus and Sjögren’s syndrome
Authors: Hanami Yuka , Yamamoto Toshiyuki
Published: October 2022

Sir, Amicrobial pustulosis of the folds (APF) is a rare disease of neutrophilic dermatosis involving the scalp, ears, axillae, umbilicus, groin, and buttocks [1–3]. Herein, we describe a case of APF involving the bilateral axillae mimicking Hailey-Hailey disease in association with systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SjS). A 63-year-old female had been undergoing treatment for SLE and SjS for six years. She had been taking prednisolone at a dose of 4 mg per day on the first visit to us. She also had a history of Crohn’s disease in remission. She complained of recurrent, erosive erythema on the axillae and beneath the breasts, which worsened in summer. A physical examination revealed infiltrative erythema with superficial erosions on the bilateral axillae (Figs. 1a and 1b). A laboratory examination revealed normal liver and kidney function, yet positive results for serum antinuclear antibodies (1:1280), anti-double strand DNA antibody (128 IU/mL), anti-Sm antibody (index: 6.7), anti-SS-A antibody (index: 131.5), and anti-SS-B antibody (index: 93.7). The erythrocyte sedimentation rate was high (32 mm in the first hour), and the CRP level was slightly increased (1.19 mg/dL). Bacterial cultures were positive for group G streptococci and the Corynebacterium species. A biopsy specimen did not reveal acantholysis of the epidermis, yet mild epidermal acanthosis without intense infiltration of inflammatory cells. Hailey-Hailey disease was excluded, and the patient was followed under treatment with topical corticosteroid ointment. During the course, the skin lesions exacerbated, and new pustules and erosive erythemas appeared on the groin and the anogenital areas (Fig. 1c). A histopathological examination revealed subcorneal neutrophilic abscesses in the epidermal and dermal perifollicular areas (Figs. 2a – 2d).
Artificial pearl-induced penile annular lichen planus
Authors: Trinh Ngo Binh , Tran Giang Huong
Published: October 2022

Sir, Annular lichen planus is an uncommonly reported variant of lichen planus, especially on the penis [1]. Herein, we report a case of penile annular lichen planus induced by artificial pearls. A 42-year-old, circumcised male presented to our hospital with asymptomatic, annular lesions of the glans penis. Around one month prior to presentation, he reported a history of inserting artificial pearls inside his penis by stainless steel. He denied a history of drug intake or a personal history of hepatitis C. A physical examination revealed multiple, reddish-purple, annular plaques with central atrophy on the glans penis (Fig. 1a). Inguinal lymph nodes and other mucocutaneous lesions were absent.
Atopic dermatitis in Senegalese children with skin phototype VI: Prevalence, clinical features, and risk factors of severity
Authors: Seck Birame , Diallo Moussa , Ndiaye Mame Tene , Diop Assane , Ba Idrissa Demba , Ly Fatimata
Published: October 2022

Background: Atopic dermatitis (AD) is the most common inflammatory skin disease of childhood. Yet, in sub-Saharan Africa, data on AD in children is scarce. Herein, we aimed to determine the prevalence, clinical features, and risk factors of severity of AD in Senegalese children with skin phototype VI. Materials and Methods: This was a cross-sectional study including children with AD and skin phototype VI younger than fifteen years old seen in two dermatology centers in Senegal over a period of six months. The diagnosis of AD was based on the United Kingdom Working Party (UKWP) criteria. The severity of AD was evaluated with SCORing of Atopic Dermatitis (SCORAD). Results: Among the 630 children consulted during the study period, 104 had AD, yielding a hospital prevalence of 16.5%. The mean age of children with AD was 36 months with a sex ratio of 1. A personal and family history of atopic disease was reported in 86.5% and 84.6% of the patients, respectively. Xerosis was the most common clinical feature, observed in 80.8% of. Post-inflammatory hyperpigmentation and keratosis pilaris were observed in 44.2% and 37.5%, respectively. Severe AD was noted in 12.5%. Risk factors associated with the severity of AD were exposure to incense smoke, an age of onset before 24 months, food allergies, and impetiginisatio. Daily use of shea butter was a protective factor. Conclusion: Our study showed a high hospital prevalence of AD in Senegalese children with skin phototype VI. The result observed with shea butter as a protective factor against severe AD is highly important, although it needs to be confirmed by randomized studies.
Sprue-like disease possibly related to a single dose of methotrexate
Authors: El Gaitibi Fatima Azzahra , Khallaayoune Mehdi , Palamino Hind , Meziane Mariame , Benzekri Laila , Ismaili Nadia , Hassam Badereddine , Senouci Karima
Published: October 2022

Sir, Methotrexate is an antimetabolite commonly used in dermatology for inflammatory and autoimmune diseases, including psoriasis. Malabsorption secondary to treatment with methotrexate after its use in high doses and/or long-term has been described in the literature. However, only several cases of a sprue-like disease secondary to a low dose of methotrexate have been described. Herein, we report an exceptional case of a sprue-like disease after a single dose of methotrexate. A 43-year-old female was admitted to our department with psoriatic erythroderma (Figs. 1a and 1b). Treatment with MTX was administered at a dose of 12.5 mg/week as well as folic acid supplements. Three days later, the patient developed bilateral leg edema, associated with biological malabsorption syndrome (hypoalbuminemia at 19 g/L, hypocholesterolemia at 0.98 g/L, prothrombin time at 45%, blood glucose at the lower limit of 0.7 g/L, and normocytic normochromic anemia at 9.4 g/dL). A duodenal biopsy performed three weeks later revealed no villous atrophy (Fig. 2). The discontinuation of methotrexate led to the disappearance of the leg edema and the progressive correction of biological parameters.
Hidradenoma with an atypical localization mimicking lipoma
Authors: Marraha Farah , Al Faker Ibtissam , Chahoub Hanane , Benyamna Youness , Rahmani Najlae , Salim Gallouj
Published: October 2022

Sir, Nodular hidradenoma is a rare, benign adnexal tumor usually located in the head, neck, and extremities [1]. The difficulty of the diagnosis is due to the non-specificity of the clinical and histological presentation, often requiring a clinicopathological correlation [2]. Herein, we report a case of atypical abdominal hidradenoma mimicking lipoma. Our patient was a 51-year-old Moroccan female operated for bowel obstruction and fibroma presenting with a slowly growing, painless, subcutaneous abdominal nodule persistent for the last two years. The nodule had gradually increased in size in a context of apyrexia and general state preservation. A clinical examination was remarkable for a subcutaneous nodule (2.5 cm long axis) at the left iliac fossa, painless, indurated, and not fixed to the deep tissues, with slightly purplish skin (Fig. 1). The rest of the examination was featureless. In addition, dermoscopy was non-specific.
Diltiazem-associated, photo-distributed hyperpigmentation in a patient with Sjögren’s syndrome
Authors: Watanabe Yukina , Kato Yasunobu , Yamamoto Toshiyuki
Published: October 2022

Sir, Herein, we report a case of hyperpigmented macules on ultraviolet exposed areas during the intake of diltiazem hydrochloride (DTH) in a patient with Sjögren’s syndrome. A 63-year-old Japanese female with a history of Sjögren’s syndrome and vasospastic angina presented to our hospital with brown, irregular macules on the neck, face, and both hands, which she first noticed one year earlier. The patient had a history of taking DTH for vasospastic angina for the previous fifteen years. A physical examination revealed pale brown macules and plaques irregularly scattered around the corners of the mouth, lower lip, and neck (Figs. 1a and 1b). In addition, there were numerous erythematous papules on the dorsal side of both hands. The oral mucosal membrane, scalp, and nails were not involved. A biopsy specimen taken from the dorsal side of a hand revealed individual cell keratinization in the epidermis, intercellular edema, liquefaction degeneration of the basal layer, and band-like lymphocyte infiltrate with melanophages in the superficial dermis (Fig. 2a). Immunohistochemistry revealed the infiltration of CD3+, CD4+, CD8+, and HLA-DR+ lymphocytes in the superficial dermis (Figs. 2b and 2c). Routine laboratory examinations of the blood cell count, serum, and urine showed no abnormalities. Other tests showed positive antinuclear antibody (1:80, nucleolar) and anti-SS-A antibody (240 U/mL; normal: < 9.9), whereas hepatitis C virus antibody, rheumatoid factor, anti-CCP antibody, and anti-SS-B antibody were negative. DTH was switched to another medicine, and ascorbic acid, calcium pantothenate, and topical steroids were initiated. In addition, we advised the patient to avoid sun exposure. Although no improvement was observed in the rash in the first four months, it disappeared at follow-up several years later (Figs. 3a and 3b).
Pseudoepitheliomatous, keratotic and micaceous balanitis: A case report
Authors: Kerrouch Hasna , Titou Hicham , Khalidi Meryem , Frikh Rachid , Hjira Naoufal , Boui Mohammed
Published: October 2022

Sir, Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is an uncommon premalignant and rare condition occurring over the glans in older men who undergo circumcision late in life [1]. It was first described in 1961 by Lortat-Jacob and Civatte, who described it as locally advancing thick hyperkeratotic plaque on the glans penis [2]. It was previously thought a benign condition, but is now believed to be premalignant [3]. Herein, We report a patient with PKMB who, having declined definitive surgery was managed with cryotherapy and lifelong followup. A 52 year old circumcised male patient presented at the dermatology departement with a 1 year history of gradually enlarging thick scaly plaque on the glans penis. There was no history of itching, or difficulty in urination. He was an ex-smoker. Patient was non diabetic and there was no history suggestive of sexually transmitted infections. There was no history of bleeding either spontaneously or following minor trauma. He was not taking any medication. He was treated with antiseptic applications and herbal medicines on various occasions. Examination revealed a thick scaly plaque on the glans penis measuring about 2 cm by 2 cm (Fig. 1). The plaque was not tender or itchy, and was not obstructing the urethral meatus. The rest of the genitalia were normal.
D-dimer levels in patients with chronic urticaria: A case-control study on a Kashmiri population
Authors: Khursheed Uzair , Shah Shuhaab , Aslam Aaqib , Sultan Javeed , Younus Faizan , Rather Shagufta
Published: October 2022

Background: Chronic urticaria (CU) is a common skin condition, affecting 0.5-1% of the population. Multiple studies have demonstrated that plasma D-dimer levels could be employed as a biomarker for disease activity and treatment response in patients with CU. Aim: The aim was to evaluate the correlation between D-dimer levels and the disease activity of CU. Materials and Methods: This study was a case-control study conducted on 120 patients suffering from CU and 50 healthy subjects. Plasma D-dimer levels were measured using ELISA. Results: Mean plasma D-dimer levels in the patients with CU (720.5 ng/mL) were significantly higher than those in the controls (405.6 ng/mL) (p < 0.001). A significant correlation was observed between plasma D-dimer levels and the UAS (urticaria activity score). Conclusion: The patients with CU had higher plasma D-dimer levels than the control group. A positive statistical correlation was observed between plasma D-dimer levels and the severity of CU.
Mucosal involvement in bullous pemphigoid in Northeast Morocco
Authors: Kassel Jihad , Baybay Hanane , El Harch Ibtissam , Couissi Imane , Elloudi Sara , Douhi Zakia , El Fakir Samira , Mernissi Fatima Zahra
Published: October 2022

Background: Bullous pemphigoid is a common autoimmune bullous disease that mainly affects the elderly. Mucosal involvement in bullous pemphigoid remains rare and is in the order of 10% to 30%. Our objective was to evaluate the prevalence of mucosal involvement in our patients with bullous pemphigoid and to study its epidemiological, clinical, and therapeutic particularities. Material and Methods: We conducted a prospective epidemiological study, collecting patients with bullous pemphigoid, over a period of eleven years. We divided our study population into two groups, with and without mucosal damage, and compared different parameters between these two groups. Results: We collected 85 patients diagnosed with bullous pemphigoid. The mean age at diagnosis was 70.54 years. A neurological history was reported in nine (10.7%) of our patients, Drug intake was noted in 14.3%. Associations with autoimmune diseases were found in 25 patients. The typical form of PB was found in 74% of our patients with extensive skin involvement of more than 30% of the body surface in 44.7% of the patients. Twenty-nine patients (34.1%) presented mucosal lesions. The oral mucosa was the most frequently affected surface. Among the patients with mucosal involvement, twenty-five (86.2%) had isolated mucosal surface involvement. In patients with oral involvement, the most frequent mucosal lesions were erosions of the soft palate and the inner face of the cheeks. The comparative analysis between the two groups revealed that patients with mucosal involvement were younger, with an average age of 69.5 years vs. 71.12 years, p = 0.54. We also noted that patients with mucosal involvement more frequently presented with heard skin disease (p = 0.01). Regarding therapeutic management, we noted a more frequent need for the addition of systemic treatment to topical corticosteroids as compared to other patients (p = 0.01). Conclusion: The involvement of the oral mucosa remains rare and is correlated with more severe and extensive involvement of the disease with the ineffectiveness of first-line treatment. Further studies are needed at the national level to better assess these characteristics in the Moroccan population.
Comparative Evaluation of Salivary Flow Rate in Smokers and Non Smokers: A Cross-sectional Study
Authors: Bhargave Anushka Devidas , Prakash Nilima , Agrawal Amit
Published: October 2022

Introduction: Saliva is a complex and significant body fluid which is exceptionally fundamental for oral health and is the most effectively available fluid in the human body. Structural and function changes in saliva occur when it is exposed to cigarette smoke that contains several toxic components and is known to be one of the main risk factors for developing numerous oral conditions. There are conflicting reports about the correlation between cigarette smoking and mouth dryness. Additionally, there is paucity of studies to investigate the Salivary Flow Rate (SFR) in smokers in India. Aim: To assess the salivary flow rate in smokers and non smokers and also to study the effect of duration and frequency of smoking habit on SFR. Materials and Methods: This analytical cross-sectional study was conducted in which unstimulated whole saliva of 50 smokers and 50 non smokers visiting Outpatient Department (OPD) at Mahatma Gandhi Vidyamandir’s, Karmaveer Bhausaheb Hiray Dental College and Hospital Nashik, Maharashtra, India, was from January 2019 to January 2020. Unstimulated SFR was measured and expressed in mL/minute using a graduated glass tube. Comparison of SFR was done among the smokers and non smokers using Unpaired t-test. One-way Analysis of Variance (ANOVA) test was used to compare the frequency and duration of smoking habit and SFR among smokers. Results: There was a statistically significant reduction (p-value <0.0001) in the salivary flow rate of smokers in comparison to non smokers. It was also observed that there was reduction in salivary flow rate with increase in the duration (p-value <0.001) and frequency (p-value=0.012) of tobacco smoking habit. Conclusion: Salivary flow rate is significantly reduced in smokers when compared to non smokers. The duration and frequency of smoking habit had a significant impact on the reduction in SFR. Reduced SFR has a high impact on oral health and may further lead to several oral complications. Therefore, measures should be taken by counseling the smokers to quit the habit and educating them about the ill-effects of xerostomia.
Impact of the COVID-19 Pandemic Lockdown on Oral Health and Behaviour Change among Children in the Eastern Province of Saudi Arabia
Authors: Ezzeldin Tarek , Alzayer Yasmin , Aljandan Jawhara , Alsahwan Bayan , Siddiqui Intisar Ahmad
Published: October 2022

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has been concomitant to a number of alterations in children’s dental health. The indoor activities and intermittent eating during the COVID-19 pandemic lockdown had an impact on oral hygiene practices and behavioural change in children. Aim: To assess the impact of the COVID-19 pandemic lockdown on oral health and behaviour change among children in the eastern province of Saudi Arabia. Materials and Methods: This cross-sectional study was conducted in Department of Paediatric Dentistry, Dammam Specialised Dental Center, Dammam, Eastern Province, Saudi Arabia, from 6th October 2021 to 8th March 2022, among 510 children. A well-structured questionnaire consisting of 24 closed-end items related to socio-demographic data, children’s behavioural change during lockdown and oral health practices in the eastern province of Saudi Arabia was tailored. All parents or legal guardians of children aged between 6 and 12 years old were asked to sign a written informed permission to complete a questionnaire voluntarily. Statistical analysis was executed by using Statistical Package for Social Sciences version 22.0 (IBM Product, USA). Results: Of 510 children to be evaluated for the impact of the COVID-19 pandemic lockdown, 284 (55.7%) mothers, 209 (41%) fathers, and 17 (3.3%) caregivers were the respondents. Although one-half of the children 273 (53.5%) had no change in oral health attention, 72 (14.1%) had increased, while 165 (32.5%) had decreased oral health attention during the COVID-19 pandemic lockdown. There were three significant predictors of children’s oral health behaviour during the COVID-19 pandemic lockdown including frequency of tooth brushing increased (OR=18.7), decreased brushing (OR=28.3), consumption of sugary meals (OR=4.6), and noticing of caries, toothache, bad breath, bleeding/ swelling of the gingiva (OR=3.1). Conclusion: Study findings demonstrated that the COVID-19 pandemic caused considerable behavioural and psychological alterations in children. The frequency of brushing, dental visits, and sugar consumption all decreased significantly
Optimization of Amylase Production in Three Fungal Species
Authors: Ekedegba F. E. , Ogbonna A. I. , Nwibari B. M. W. , Okoye C. T. , Ogbonna U. S. A. , Onyimba I. A. , Madu J. M. , Njoku A. I.
Published: October 2022

Aim: Amylase is an important enzyme that is employed in starch processing industries, used in the hydrolysis of polysaccharides such as starch into simple sugar constituents. In this study, we investigated the abilities of several isolated amylolytic soil fungi to produce amylase.

Materials and Methods: Soil samples collected from the botanical garden, Department of Plant Science and Biotechnology, University of Jos was serially diluted and screened for the presence of amylase producing fungi. Optimization studies was performed across different parameters; Incubation period (7 days), different temperatures (25-60°C), different pH (5-9), different starch concentration (0.2-2%), carbon source (sucrose, maltose, lactose).

Results: A total of 15 isolates belonging to 7 genera were isolated. Soil samples were analyzed for their ecological parameters. The plate assay showed that three species T. viride (62mm), P. citrinum (50.25mm), and A. niger (67mm) had the largest zones of clearance and highest amylolytic activity thus were selected for further studies. For submerged fermentation, optimum amylolytic activity was observed at 24 hours of incubation for all three species T. viride (7.92 IU/ml), P. citrinum (5.04 IU/ml), and A. niger (7.00 IU/ml). Maximum enzyme activity was observed at incubation temperature of 45°C (17.10 IU/ml) for T. viride, 50°C (33.60 IU/ml) for P. citrinum, and 50°C (14.30 IU/ml) for A. niger. The maximum enzyme activity was at pH 9 (20.40 IU/ml) for T. viride, pH 11 (18.50 IU/ml) for P. citrinum, and pH 7 (25.80 IU/ml) for A. niger. T. viride and P. citrinum recorded an optimum enzyme activity of 15.40 IU/ml and 13.20 IU/ml respectively when sucrose was used as a carbon source while A. niger recorded an optimum activity of 7.28 IU/ml when maltose was used. Starch concentration of 2% showed the highest enzyme activity of 16.52 IU/ml, 15.4 IU/ml and 14.00 IU/ml, for T. viride, A. niger and P. citrinum, respectively.

Conclusion: Trichoderma viride, Penicillium citrinum, and Aspergillus niger showed potential of producing amylase which is useful in the biodegradation of biological wastes.
Determination of Trophic Status Based on Chlorophyll-a in Cikidang River Pangandaran, West Java – Indonesia
Authors: Rahmawati Rita , Zahidah . , Herawati Heti , Arief Mochamad Candra W.
Published: October 2022

Trophic status is an indicator of water fertility. In general, there are 3 classifications of trophic status, namely oligotrophic, mesotrophic and eutrophic [1]. According to Linus et al. [2] Chlorophyll-a phytoplankton is often used as an indicator of water quality and water fertility status. This research is to determine the trophic status of the waters based on the concentration of chlorophyll-a in the Cikidang Pangandaran river for the development of fisheries management. The research was conducted from November 2021 - January 2022. The method used was a survey method with a purposive sampling technique. The results showed that the concentration of chlorophyll-a ranged from 3.10-7.77 mg/m3. So it can be said that the trophic status of the Cikidang River is mesotrophic or moderate fertility. Parameters of supporting water quality are temperatures ranging from 26.75-29.570C, Light Transparency ranging from 16.12-135.75 cm, pH ranging from 7.38-7.48, Carbon dioxide ranging from 19.8-47.3 mg/L, BOD ranging from 10.41-16.36 mg/L, DO range from 4.38-5.06 mg/L, Nitrates ranged from 0.25-0.37 mg/L and Phosphate ranged from 0.009-0.02975. The water quality in the Cikidang River generally meets the requirements of class II and III quality standards according to Government Regulation Number 22 of 2021 concerning the Implementation of Environmental Protection and Management, so it is still supportive for the survival of fish resources.
Structure of the Fish Community in the Jatigede Reservoir Post Six Years of Flooding
Authors: Herawati Titin , Saputri Maria Sintiyani Woro , Yustiati Ayi , Hamdani Herman
Published: October 2022

Jatigede Reservoir began to be inundated in August 2015. The fish caught at the beginning of the 2017 inundation were 9 families consisting of 17 species in 2017. This research aims to determine the structure of the fish community living in the Jatigede Reservoir after six years of inundation. The research was carried out from November 2020 to April 2021 at the Jatigede Reservoir, using the survey method. Primary data which includes the relative abundance of fish, diversity index and fish uniformity. The fish sampling method used a purposive sampling method with 3 repetitions carried out at five stations representing the Jatigede Reservoir area. Data processing using Microsoft Excel to produce fish community structure in Jatigede Reservoir. The fish community structure in Jatigede Reservoir during the research consisted of 9 families, namely cyprinidae, cichlidae, eleotridae, bagridae, loricariidae, pangasiidae, zenarchopteridae, ambassidae and poeciliidae. At stations 2 and 3, it was categorized as stable with a moderate diversity index ranging from 1.08 to 1.73, moderate uniformity ranging from 0.56 to 0.83. At stations 1, 4 and 5 the fish community structure was categorized as unstable, with low diversity ranging from 0.57 to 0.97 and moderate uniformity ranging from 0.51 to 0.60.