bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical therapy assistance in neurological disorders in people living with hiv / aids associated with neurotoxoplasmosis: literature review.
Authors: Pereira Brena Farias , Cohen Anath Raphaelle , Melo Yuri Sena
Published: December 2021

Introduction: Acquired Immunodeficiency Syndrome (AIDS) remains a major public health problem, where HIV-infected patients have severe and progressive immune compromise and are responsible for AIDS. Objective: to elucidate possible neurological changes caused by AIDS, as well as to review in the literature the physiotherapeutic role in neurological disorders in people living with HIV / AIDS associated with Neurotoxoplasmosis. Method: Literature revision, using the following databases: VHL (Virtual Health Library), Scielo (A Scientific Electronic Library Online), PubMed (National Library of Medicine), PEDro (Physiotherapy Evidence Database), MEDLINE ( Medical Literature Analysis and Retrieval System Online). Articles were selected that met the inclusion criteria. Results: A scarce number of scientific articles was observed in the databases on the subject, corresponding to 04 publications, of the selected studies the physiotherapy techniques used were stretching, isometric strengthening exercises, range of motion exercises, joint mobilization, neuromuscular facilitation proprioceptive and hydrotherapy. Conclusion: It was seen that physical therapy promotes good results in improving the functionality of patients with HIV associated with neurotoxoplasmosis, mainly in balance, functional mobility, motor coordination and motor symptoms, however there was a shortage of articles in relation to physical therapy treatment for people with HIV. associated with neurotoxoplasmosis, it is suggested that new studies of high methodological quality be developed in order to investigate further on this topic for better evidence-based practice.
Morbidity and Mortality of Traumatic Brain Injury in Hospitalized Patients in Brazil Between 2010 and 2020: An Ecological Study
Authors: Carvalho Vitória Bittencourt de , Madruga Kauan Alves Sousa
Published: December 2021

Background: Traumatic Brain Injury (TBI) is defined as any traumatic injury causing an anatomical lesion or functional impairment of the scalp, skull, meninges, brain or its vessels. Hospitalization of this patient, depending on the severity, can result in irreversible sequelae or death. Objective: To report the morbidity and mortality rates of patients suffering from TBI hospitalized in Brazilian hospitals between 2010 and 2020. Methods: Descriptive ecological study of the data collected at the Informatics Department of the Unified Health System (DATASUS). Results: There were 1,143,187 admissions due to TBI. There was a predominance of males with 871,999 (76.28%) cases and the age group between 20 and 29 years old 199,857 (17.48%). Brown patients were the ones with the highest hospitalization rate: 370,639 (32.42%). The mortality rate in the period was 9.52/100 hospitalizations, with the Southeast region occupying the first place (10.44 per 100 hospitalizations). In total, 108,853 deaths were recorded, of which 50,013 occurred in the Southeast, the region with the highest rate. Although the number of deaths was higher in people between 20 and 29 years old (16,687), the age group with the highest mortality rate was over 80 years old (19.84 per 100 hospitalizations). Conclusion: In the last 10 years, TBI has caused 1,143,187 hospitalizations in Brazil, with a predominance of males and the age group between 20 and 29 years. Brown patients had the highest rate of hospitalization. The region with the highest mortality was the Southeast and the smallest was the South.
Importance of early diagnosis of galactosemia and encephalopathy: case report
Authors: Rodrigues Bruno Cassis Antunes , Oliveira Francisco Tomaz Meneses de , Gagliardi Rubens José
Published: December 2021

Introduction: Galactosemia is an autosomal recessive genetic condition, with alteration of galactose metabolism, leading to increased serum concentration of galactose (galactosemia). The first symptoms occur in the neonatal period, associated with the ingestion of galactose. Untreated patients usually have growth failure, liver and kidney dysfunction, tubulopathies, encephalopathy and susceptibility to infections. Case report: We describe a case of diagnostic investigation of a patient born at 38 weeks, after an uncomplicated gestation, with congenital cataracts, hepatomegaly, diabetes and Fanconi syndrome, as well as encephalopathy, hypotonia and cognitive deficit. She remained in the service for 15 days for diagnostic investigation, leading to hypothesis of galactosemia, confirmed later with genetic testing. Until then, the patient received unrestricted food, being instructed to change the diet, eliminating foods with galactose. After diagnosis, guidance and appropriate treatment were possible. Currently, patient is 20 years old, being monitored by neurology, ophthalmology, hepatology, occupational therapy and speech therapy teams. Conclusions: Brazil does not have neonatal screening for galactosmia, thus, the clinical recognition of its initial signs is important for early diagnosis and treatment, avoiding further complications and sequelae.
Thromboembolic Central Nervous System Complications of COVID-19
Authors: Disserol Caio , Filpo Alessandra , Denicol Taís Luise , Della-Ripa Bruno , Mendonça Francine , Ferreira Rodrigo de Faria , Lange Marcos Christiano
Published: December 2021

Context: COVID-19 is well-known to increase the risk of developing thromboembolism; thus, patients may present with diverse neurovascular manifestations. Case report: A 56-year-old man presented with sudden onset of incoordination of his left arm and leg. He also had a history of recurrent episodes of transient left hemithoracic pain radiating to his left arm, along with right visual hemi-field positive phenomena. Additionally, he reported self-limited fever and anosmia three weeks earlier. Examination revealed left hemiataxia (NIHSS score: 2). Initial assessment with brain CT, intracranial and cervical CT angiography was normal. Shortly after admission, the patient developed acute weakness of his four limbs and urinary retention. Neurological exam showed left homonimous hemianopia, asymmetric tetraparesis and a superficial sensory level at C4. Neuraxis MRI was performed and diffusion-weighted imaging revealed acute ischemic lesions in the occiptal lobes, cerebellum and cervicalthoracic spine. A thorough diagnostic work-up was conducted. Laboratory tests were unremarkable, including inflammatory markers, viral hepatitis, HIV and syphilis serologies, as well as rheumatologic tests and a thrombophilia panel, except for SARS-COV-2 serology, with detection of IgM antibodies. RT-PCR nasopharyngeal swab was negative. Further investigation with CSF analysis, CT angiography of the aorta, transthoracic echocardiogram, 24-hour holter monitoring and transcranial Doppler didn’t show any abnormalities. Transesophageal echocardiogram revelead a minor patent foramen ovale. Conclusion: This is a case of acute cerebral, cerebellar and spinal embolic infarction, probably related to Covid-19, illustrating the infection’s associated coagulopathy¹.
INPP5K-Related congenital muscular dystrophy: when juvenile cataracts give clues to a complex diagnosis
Authors: Machado Roberta Ismael Lacerda , Badia Bruno de Mattos Lombardi , Pinto Wladimir Bocca Vieira de Rezende , Farias Igor Braga , Albuquerque Filho José Marcos Vieira de , Souza Paulo Victor Sgobbi de , Oliveira Acary Souza Bulle
Published: December 2021

Introduction: Congenital muscular dystrophies (CMDs) are a group of rare genetic muscle diseases that present at birth or during infancy with hypotonia and weakness. Multiple forms of CMDs are also associated with cerebral and ocular phenotypes. Recently, INPP5K mutations have been described associated with CMD, cataracts and cognitive impairment. The INPP5K gene, encodes SKIP, one of the enzymes that phosphorylate the 5-phosphate position of phosphoinositides and is highly expressed in developing and adult brain, eye and muscle. Methods: We performed a case report of three Brazilian patients with INPP5KCMD with cataracts and intellectual disability under clinical follow-up at our service. Results: Case 1: 39 years old, female, presenting with progressive leg weakness since childhood, mild intellectual disability and bilateral cataracts at 20 years. Her 35-yearold sister (Case 2) had a similar clinical picture with limb-girdle weakness since childhood, cognitive impairment and early- onset bilateral cataracts. Both with myopathic pattern in EMG, elevated creatine phosphokinase (CK) and dystrophic pattern in muscle biopsy. Brain MRI studies disclosed a large megacistern in the elderly and no abnormalities in the younger sister. Genetic testing: c.653_655del(p.(Ser218del) in homozygosity in INPP5K gene. Case 3: 20 years old, female, normal motor development but learning difficulties since childhood. Presented with progressive pelvic girdle weakness in childhood and bilateral cataracts in late adolescence. Exams disclosed elevated CK, brain MRI was normal and genetic testing with the following mutation in INPP5K gene:c.[881_883del];[1088T>C];p.[Ser294del];[Ile363Thr]. Conclusion: We describe patients with CMD, cataracts and intellectual disability, caused by mutation in the INPP5K gene. In literature few cases are reported.
Diagnóstico de HIV e início da terapia antirretroviral em pacientes inseridos na atenção especializada
Authors: Alves Daniela Santos , Winkler Gerson Barreto , Egres Luciana , Hubner Dariana Pimentel Gomes , Silva Jonatan da Rosa Pereira da , Moraes Mateus Espíndola de , Casaroto Vinícius de Souza , Cazeiro Cristine Coelho , Hentges Bruna , Teixeira Luciana Barcellos
Published: December 2021

Introdução: O HIV é um importante agravo de saúde e seu tratamento deve ser iniciado logo após o diagnóstico, tendo em vista as altas taxas de morbimortalidade da doença quando não tratada adequadamente. O início oportuno da terapia antirretroviral é um indicador essencial no monitoramento do cuidado contínuo de pessoas vivendo com HIV. Porto Alegre (RS), cenário deste estudo, apresentou uma taxa de detecção de aids de 58,5 casos/100 mil habitantes em 2019, uma taxa 3,3 vezes maior que a taxa do Brasil. Objetivo: Avaliar o tempo de início da terapia antirretroviral em pacientes vivendo com HIV inseridos na rede de atenção especializada no município de Porto Alegre. Métodos: Trata-se de um estudo de coorte histórica baseado nos registros presentes em Sistema de Informação de Agravos de Notificação, Sistema de Controle de Exames Laboratoriais, Sistema de Controle Logístico de Medicamentos e Sistemade Informações sobre Mortalidade de todos os usuários com diagnóstico de HIV que compareceram a um serviço de assistência especializada no município no período de 2013 a 2019. Foi utilizada a estatística descritiva para exploração dos dados sociodemográficos e o método de Kaplan-Meier para estimar a primeira dispensação de terapia antirretroviral. Resultados: Foram acompanhados 194 usuários do diagnóstico até 2019. A amostra foi composta majoritariamente de homens (69,6%), com média de idade 35,5±10,4 anos. Entre os usuários, verificou-se que a população negra correspondia a 37,8% e que 27,8% dos usuários apresentava ensino médio completo. A mediana de tempo para a primeira dispensação de terapia antirretroviral após o diagnóstico foi de dois meses (intervalo de confiança de 95% 1,63-2,36), e 90,1% não haviam iniciado tratamento em 15 dias e 75,4% em 45 dias. Cerca de 20% dos pacientes ainda não havia iniciado tratamento após dez meses de diagnóstico. Conclusão: A proporção de pessoas com a primeira dispensação de terapia antirretroviral em 60 dias foi considerada baixa no estudo, evidenciando a necessidade de intervenções para ampliar a vinculação ao serviço de saúde e o início oportuno da terapia antirretroviral.
Acesso para todos à profilaxia pós-exposição ao HIV em São Luís, Maranhão
Authors: Meireles Alessandra Coelho Vivekananda , Firmo Wellyson da Cunha Araújo , Brandão Andressa Mayara Mendes
Published: December 2021

Introdução: A profilaxia pós-exposição no Sistema Único de Saúde está disponível para todos; cabe ao profissional acolher a pessoa exposta em local adequado, em que seja garantido o direito à privacidade e ausência de julgamentos morais, visando à ampliação do acesso, principalmente das pessoas mais vulneráveis à infecção, como as populações-chave (gays e outros homens que fazem sexo com homens, travestis e pessoas transexuais, trabalhadoras/trabalhadores do sexo, pessoas que usam álcool e outras drogas e pessoas privadas de liberdade) e as populações prioritárias (indígenas, jovens, população negra e pessoas em situação de rua). Objetivo: Descrever o perfil de usuários que iniciaram a profilaxia pós-exposição ao HIV e avaliar o acesso das populações-chave recomendadas pelo Ministério da Saúde. Métodos: Estudo transversal e descritivo realizado em dois centros de testagem e aconselhamento em infecções sexualmente transmissíveis, referências para dispensação e segmento clínico da profilaxia pós-exposição, em São Luís, Maranhão, realizado com dados secundários de 2016 a 2020 coletados com instrumento composto de 53 variáveis, análise dos dados realizada por meio de software estatístico, considerando-se um nível de significância de 5% (p<0,05). Resultados: Dos 733 usuários, 76,10% homens, 56,89% adultos jovens, 37,24% pardos, 38,61% com ensino médio. Quanto à orientação sexual, 45,16% eram heterossexuais e 32,3% homossexuais. Das populações vulneráveis presentes, houve menor frequência das profissionais do sexo, com 0,82%, 8,46% usuários de álcool e drogas, 0,95% travestis e 0,14% presidiários, que fizeram o menor uso de profilaxia pós-exposição. Conclusão: O uso da profilaxia pós-exposição não foi homogêneo entre os grupos vulneráveis, com baixa frequência de pessoas transgêneras e profissionais do sexo. A profilaxia pós-exposição, assim como outras estratégias de prevenção, precisam ser divulgadas na sociedade para garantir que todos possam utilizá-la. Cabe aos gestores e profissionais traçar estratégias para que diminuam estigmas e preconceitos existentes e quebrem as barreiras ao acesso aos serviços de saúde.
Infecciosidade da sífilis e de outras infecções sexualmente transmissíveis em atendimento à profilaxia pós-exposição sexual em São Luís, Maranhão
Authors: Meireles Alessandra Coelho Vivekananda , Firmo Wellyson da Cunha Araújo , Brandão Andressa Mayara Mendes
Published: December 2021

Introdução: A profilaxia pós-exposição busca a atenção integral à pessoa exposta ao risco das infecções sexualmente transmissíveis, do vírus da imunodeficiência adquirida e de hepatites virais no Sistema Único de Saúde, sendo importante o controle desses agravos, inclusive da sífilis, que apresenta crescente número de casos no país. O protocolo recomenda investigação de sinais e sintomas de infecções sexualmente transmissíveis para pessoas com exposição sexual de risco e avaliação de tratamento imediato. Objetivo: Caracterizar usuários dos serviços de saúde que buscam a profilaxia pós-exposição sexual e verificar prevalência e rastreamento da sífilis e de outras infecções sexualmente transmissíveis durante o atendimento. Métodos: Estudo transversal e descritivo desenvolvido em dois centros de testagem e aconselhamento em infecções sexualmente transmissíveis/aids, referências para dispensação e segmento clínico da profilaxia pós-exposição, em São Luís, Maranhão, realizado com dados secundários de 2016 a 2020 coletados com instrumento composto de 53 variáveis, análise dos dados realizada por meio de software estatístico, considerando-se um nível de significância de 5% (p<0,05). Resultados: Analisados 630 prontuários que realizaram profilaxia pós-exposição sexual, 69,84% eram adultos jovens, 58,73% homossexuais, 85,71% homens, 82,54% não apresentavam investigação em prontuário de sintomas clínicos para infecções sexualmente transmissíveis, 14,29% não apresentavam sintomas e 3,17% relatavam sintomas de infecções sexualmente transmissíveis. Os resultados do teste rápido no momento da exposição foram de 60 casos de sífilis e 4 de hepatite C. Não realizaram coleta de material biológico para Chlamydia trachomatis e/ou Neisseria gonorrhoeae. Conclusão: Em pessoas com exposição sexual, a realização de investigação laboratorial e de sintomas clínicos é o procedimento recomendável em razão do risco de desenvolvimento de resistência bacteriana com o tratamento preemptivo. Considerando a alta taxa de não investigação de sintomas e evidências de teste rápido reagentes para sífilis e hepatite C, tornam-se importantes a atualização e a sensibilização dos profissionais para avaliação criteriosa em pessoas expostas sexualmente e o investimento em políticas públicas municipais para investigação de Chlamydia trachomatis e/ou Neisseria gonorrhoeae.
Gardnerella vaginalis - agente de infeção em homens sexualmente ativos?
Authors: Lacerda Luísa , Ribeiro Manuela , Teixeira Cláudia
Published: December 2021

Introdução: Gardnerella vaginalis é um microrganismo cocobacilar, Gram-variável e anaeróbio facultativo, cujo reservatório principal é o trato genital feminino, sendo o principal agente de vaginose bacteriana na mulher. Há evidência da sua transmissão sexual ao homem, que poderá ser portador ou desenvolver infeção sintomática, principalmente em doentes imunocomprometidos ou com fatores de risco de doença urogenital. Objetivo: Caracterizar a infeção por Gardnerella vaginalis em homens sexualmente ativos. Métodos: Revisão dos isolamentos de Gardnerella vaginalis em cultura microbiológica num hospital terciário português entre janeiro de 2001 e janeiro de 2021. Resultados: No período estudado, obtiveram-se 514 isolamentos de Gardnerella vaginalis em pacientes com idade sexualmente ativa, 2,9% em homens. A média de idades foi de 34,7 anos (mínimo de 29 anos e máximo de 53 anos). Os isolamentos foram realizados a partir de amostras de sêmen (n=12), zaragatoa peniana (n=2) e zaragatoa retal (n=1). Dos isolados, 76,9% (n=10) foram obtidos em contexto de estudo de infertilidade, havendo um caso de proctite e um caso de lesão ulcerada do pênis em doentes com HIV. Foi ainda descrito um caso de prostatite. Conclusão: A detecção de Gardnerella vaginalis no homem deve ser contextualizada clinicamente. Apesar de a infeção ser, muitas vezes, assintomática, estão descritos casos de infecção do trato urinário, balanite, prostatite crônica e infecções extragenitais. Atualmente não se recomendam o rastreio e o tratamento dos parceiros, no entanto o homem portador assintomático pode ser responsável pela recidiva da infecção na parceira e pela perpetuação da infecção no casal. De acordo com os nossos resultados, é um agente que deverá ser considerado no diagnóstico diferencial de doenças sexualmente transmissíveis, particularmente na uretrite e balanite não gonocócicas. Alguns autores associam o estado de portador de Gardnerella vaginalis com a diminuição da qualidade do sêmen, porém são necessários mais estudos para que se estabeleça uma relação com quadros de infertilidade secundária.
Ansiedade e sintomas psiquiátricos menores durante a pandemia de COVID-19: comparação entre pessoas vivendo com e sem HIV na população LGBTQIA+
Authors: Dornelles Thayane , Brito Emerson , Wendland Eliana
Published: December 2021

Introdução: A população LGBTQIA+, assim como pessoas vivendo com HIV, apresentam altas prevalências de doenças relacionadas à saúde mental. Com a pandemia de COVID-19, a população teve de adotar medidas de isolamento e restrição social com o intuito de conter a propagação do vírus. Entretanto, essas mudanças trouxeram impactos para a saúde mental da população, principalmente para a população LGBTQIA+ e pacientes vivendo com HIV. Objetivo: Comparar os impactos da pandemia na saúde mental de indivíduos LGBTQIA+ vivendo com e sem HIV. Métodos: Estudo transversal realizado entre setembro e outubro de 2020, de forma on-line, incluindo 655 participantes. Os dados foram coletados por meio dos instrumentos Anxiety Disorder Screener (GAD-7) e Self Report Questionnaire (SRQ-20). Considerou-se nível de confiança de 95%. Resultados: A prevalência de HIV foi de 9,1%, com média de idade de 36,6±8,98 e 28,74±809 em pessoas vivendo com e sem vírus da imunodeficiência humana, respectivamente. No geral, indivíduos sem HIV apresentaram maiores níveis de transtornos psiquiátricos menores (62,3%) e ansiedade grave (57,0%) quando comparados aos indivíduos com HIV (42,6% e 40,7%, respectivamente) (p<0,01). Os participantes sem HIV também relataram aumento de ansiedade (74,2%) e tristeza (62,3%), irritabilidade quase todos os dias (22,3%), assim como ideação suicida (15,3%). Conclusão: Os impactos negativos da pandemia de COVID-19 na saúde mental foram maiores em pessoas sem HIV, quando comparadas às pessoas vivendo com HIV, podendo indicar que os últimos apresentam mais recursos psicológicos para lidar com situações difíceis. Tendo em vista a sua maior proximidade com os serviços de saúde, podem ter adquirido habilidades para trabalhar com situações como a atual. Além disso, pessoas com mais idade já enfrentaram diversos acontecimentos em suas vidas e, consequentemente, podem ser mais capazes de regular suas emoções quando comparadas a pessoas mais jovens.
Understanding the Needs of Geriatric Rehabilitation Care
Authors: Abbas Jaffri Samar , Rida E Zehra Syeda , Sultan Sadia
Published: December 2021

Background: With the increasing age, the body undergoes several physical and psychiatric changes; it is important to address the healthcare management apprehensions among the elderly and promote geriatric rehabilitation care both socially and economically. Objective: To evaluate the need for rehabilitation amongthe geriatric population living in Pakistan. Design: Cross-sectional study Place and Duration of Study: Department of Medicine, Liaquat National Hospital, Karachi from 1st January 2020 to 30th June 2020 Methodology: One hundred and three geriatric subjects aged between 65 to 90 years were enrolled. The data were collected using a structured questionnaire designed to obtain information regarding home care and geriatric rehabilitation care. Results: Sixty (58.2%) were females and 43 (41.7%) were males. The majority were <80 years of age, 82 (79.6%). Around 52 (50.5%) subjects knew about rehabilitation care and most believed that geriatric rehabilitation care is beneficial. Sixty four (62.1%) subjects were involved in socialization once a week, 29 (28.2%) once in a month, 6 (5.8%) biannually and 4 (3.9%) marked not at all. Among all, 41% reported being isolated, and 86% were getting enough psychiatric/physical care at home. Conclusion: Although 52 (50.5%) of the study subjects reported knowing geriatric rehabilitation care, due to limited resources and economic constraints in Pakistan, we have been unable to set up centers to rehabilitate the elderly. There is a need to design and conduct rehabilitation programs to control morbidity and improve the quality of the geriatric population. Keywords: Geriatric rehabilitation care (GRC), Home care, Geriatric population
Prevalence of First Birth Order with Myopia Among KPK Population
Authors: Saba Shah Syeda Gulrukh , Majeed Mutayyaba , Ul-Haq Shams- , Jabeen Shah Farhana , Ali Waqas
Published: December 2021

Objective: To find out the prevalence of myopia and hyperopia among the population of KPK. Study Designed: Cross-sectional analytical study. Place and duration of Study: OPD of tertiary care hospitals of KPK, Khyber Teaching Hospital and Hayatabad Medical Complex from 1st July 2020 to 30th June 2021. Methodology: Four hundred patients visiting to OPD of tertiary care hospitals of KPK, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar were enrolled. Both male and female were included from 17 to 24 years visiting to the hospital were included. All patients on any medication for any systemic illness like asthma, TB, cardiac issues, liver problems etc. patients suffering from eye disorders like glaucoma, cataract, diabetic retinopathy, uveitis etc. and patients who refused to give consent and uncooperative patients were excluded from the study. Results: Two hundred and seventy seven got normal eye structure, function and vision while 123 got abnormal eye vision, with the frequency of myopia 26.5% (106) while hyperopia was 4.3% (17). Among gender the refractive errors of an eye was found to be 25% in male while 35.5% in female pvalue-0.024. The frequency of refractive error was not significant in age 17, 18, 23 and 24years the refractive error was found to be less as compare to age 19-22 years the refractive errors were seen to be greater. The patients visiting to hospital for eye examination with abnormal refractive errors were 41.1% while the result was significant p value was 0.0001. Genetically 1st order birth got 40% refractive errors while other got 23.5% the results were significant (P=0.004). Conclusion: The prevalence of eye defects related to refractive errors was present among adult population of KPK. Age is not related to refractive errors and refractive errors can be genetically determine. Key words: Myopia, Hyperopia, Refractive errors, Birth order
Management of Intraocular Inflammatory Disease
Authors: Amin Muhammad , Ahmed Atif Mansoor , Abbas Irum , Tariq Manal
Published: December 2021

Background: Intra ocular inflammatory disease is a broad-spectrum eye inflammatory condition. Objective: To evaluate various management protocols for Intra ocular inflammatory disease. Study Design: Retrospective study Place and Duration of Study: Department of Ophthalmology, Lorallai Medical College, Loralai from 1st January 2020 to 31st March 2021. Methodology: One hundred and twenty medical files of patients with various intra ocular inflammatory diseases were recruited. Patients were managed by various pharmacological drugs including corticosteroids, second line agents, anti-metabolites as well as biologics (anti-TNF-alpha) therapy. Results: There were 45% females while 55% were males. The mean age of the patients was 45±4.4 years. Majority of the patients were within 41-50 years with 37.5% followed by those >50 years of age. Corticosteroids were efficient in 50% of patients with intra ocular inflammatory disease as a secondary condition while azathioprine in 75% patient and tacrolimus 93.4% patients. Conclusion: Second line agents and antimetabolites have higher prevalence of acceptance and efficacy in managing intra ocular inflammatory disease. Keywords: Management, Intraocular inflammatory disease, Broad spectrum
Pregnancy and Congenital Rubella Incidence
Authors: Sohail Tareen Muhammad , Shoaib Maryam , Afridi Uzma , Saifullah Samia
Published: December 2021

Background: Rubella is major cause of neonatal abnormalities and miscarriages on worldwide level. Objective: To find the incidence of rubella in congenital births by assessing antibodies against rubella. Study Design: Cross sectional study Place and Duration of Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta 1st April 2019 to 31st March 2021. Methodology: Four hundred pregnant women were analyzed for their IgG and IgM levels. A complete socioeconomic, demographics and clinical information was recorded on a well designed questionnaire. Results: The mean age of pregnant women was 24.5±4.1 years. Majority of women were between 35-40 years. High IgG were seen in all patients compared with IgM. The seropositivity for IgG increased with increasing age. Conclusion: The total reported IgG positive cases were up to 16% while of IgM were 3%. Keywords: Rubella, Pregnancy, Birth defects
Perinatal Outcome in Term Pregnancies with Isolated Oligohydroamnios
Authors: Manzoor Saeqah , Usman Fareeha , Maqsood Sumaira , Arif Afzal , Manzoor Sumaira , Hijazi Abida
Published: December 2021

Objective: To evaluate the frequency of adversative perinatal outcome in pregnancies with oligohydramnios isolation at term. Study Design: Case series Place and Duration of Study: Department of Obstetrics & Gynecology, Sadiq Abbasi Hospital Bahawalpur from 1st January 2021 to 30th June 2021. Methodology: Two hundred women with term pregnancy 37+0 to 41+6 weeks, pregnancy with isolated oligohydramnios, active phase of labour were included. CTG and obstetrical ultrasound for biophysical profile were done. Patient’s labour was monitored closely and followed till delivery. Results: Majority of the patients 87 (43.5%) were between 20-25 years with mean age was 28.43±4.27 years. Seventy six (38%) were between para 1-2, 83 (41.5%) were para 3-4, while 41 (20.5%) were para >4. Perinatal outcome reveals that APGAR score <6 at 1 minute was calculated in 21 (10.5%) and <7 at 5 minutes in 17 (8.5%) which is not very significant. Conclusion: Oligohydramnios Isolation was not related with adversative perinatal consequences. Keywords: Isolated oligohydramnios, Perinatal outcome, Amniotic fluid index, Term pregnancy, APGAR score
Addressing Systemic Causes of Physician Burnout: Improving Joy in Work
Authors: Lincoln Katherine , Lopez Jamie , McGowan Michele
Published: December 2021

Healthcare provider burnout has been shown to result in lower staff engagement levels and reduced work satisfaction, which correlates with lower patient experience scores, lower productivity, and increased workplace accidents. By making work engaging and restoring joy, healthcare leadership can reframe barriers to reduce burnout. This paper presents the results of an organizational system-wide intervention designed to rethink the approach to lowering burnout by improving joy in work to address provider well-being at the Guthrie healthcare system. System wide and targeted area strategies were used to create change over a 1-year interval of intervention. After endpoint data was collected, eight power items had positive change for this healthcare system. Scheduling and recognition emerged as system wide areas in need of reform.
Reducing Violations to the 80-hour Work Rule with Electronic Health Record to Establish Rapid Culture Change, Does It Work?
Authors: Yeung Enoch , Golden Daniel B , Miner Jean F , Marica Silviu C , Cagir Burt
Published: December 2021

Introduction

In our free-standing general surgery residency program, it was noted over the past decade that we had an exorbitant number of resident work hours violations. This resulted in multiple citations from the Accreditation Council for Graduate Medical Education (ACGME) with subsequent probation. To restore accreditation requirements and provide trainees with a balanced learning environment, work hours were restructured. Reporting of work hours in the residency management software was authenticated by the organizational electronic health record (EHR). This quality improvement project evaluated the effectiveness of compliance to the 80-hour work rule in a single rural surgical training residency program with the aid of EHR.

Methods

The hours are actively monitored in the residency management software, New-Innovations, and cumulative weekly reports were created. With the design, residents were scheduled to work a maximum of 13 hours per day beginning at 0600 and operating room (OR) time concluding by 1700. During each 4-week rotation, residents were assigned one Friday call, one Saturday call and four hours of transitional call. The primary outcome of this project was the number of resident violations to the 80-hour rule before and after implementation of those measures. The secondary outcomes were the residents’ comparative academic and clinical performances. This project also evaluated the overall cultural change and satisfaction with the program using ACGME survey data.

Results

Compared with the non-EHR era (2013–2015), the number of violations during the EHR era decreased significantly (mean non-EHR = 167.3, EHR = 24.6) ( p = 0.0009). Case volumes and board pass rates were a central focus throughout the changes. No decrease in operative volume was noted for graduating residents (N = 8, non-EHR = 1062, Mean EHR = 1110) ( p = 0.5). Over the three years since the changes, the board pass rates have improved from 64% to 80% in Certifying Examination (CE) (N = 8, Passing % non-EHR = 64%, EHR = 80%) ( p = 0.03); Qualifying Examination (QE) (N = 8, Passing % non-EHR = 100%, EHR = 93%) ( p = 0.1).

Conclusion

Reduction in work hour violations can be achieved with a reliable schedule, promotion of accurate reporting by residents, and monitoring through EHR reports. Adherence to work hour guidelines is essential for resident wellbeing and a healthy and conducive clinical learning environment without diminishing operative experience.
THE EFFECT OF CAPITAL STRUCTURE, LIQUIDITY AND PROFITABILITY ON COMPANY VALUE IN THE FOOD SUB SECTOR AND BEVERAGES ON THE INDONESIA STOCK EXCHANGE
Authors: Ni Wayan Rudini  , Gusti Ayu Mahanavami  , Nyoman Parta  , Ni Nyoman Menuh
Published: December 2021

This research is motivated by the inconsistency of the results of previous studies so that the purpose of this study is to determine the effect of capital structure, liquidity and profitability on firm value in the Food and Beverage Sub-Sector on the Indonesia Stock Exchange in 2016-2019. The population in this study is the Food and Beverage Sub-Sector companies on the Indonesia Stock Exchange in 2016-2019 through the website www.idx.co.id, where the sample used is 12 companies with 48 observations and the analytical technique used is the classical assumption test, multiple linear regression, and t test.  The results of the analysis show that the capital structure has a negative effect on firm value in the food and beverage sub-sector companies on the Indonesia Stock Exchange. Liquidity has a negative effect on firm value in food and beverage sub-sector companies on the Indonesia Stock Exchange. Profitability has a positive effect on firm value in food and beverage sub-sector companies on the Indonesia Stock Exchange.

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THE EFFECT OF ORGANIZATIONAL CULTURE ON EMPLOYEE PERFORMANCE AT ALFAMIDI PROSPERITY MINIMARKET OUTLET SOPPENG
Authors: Andi Asrijal  , Rusnaedi  , Irmawati
Published: December 2021

The performance of an organization can be determined by the existence of a good organizational culture that exists within an organization. This work culture will not just appear, but must be pursued in earnest through a controlled process involving a controlled process involving all Human Resources (HR) in a set of systems, tools and supporting techniques. The objectives of the research carried out by the Alfamidi Prosperity Minimarket Outlet Soppeng are: to find out the description of organizational culture and employee performance at the Alfamidi Prosperity Soppeng Minimarket Outlet, Soppeng Regency. To answer these questions, the stages of the research method were used, starting from the literature review and field study, proposal preparation, testing the validity and reliability of the instrument, data collection, analysis and discussion. The data analysis used is descriptive quantitative. The results showed that the work culture of the employees at the Alfamidi Prosperity Minimarket Outlet Soppeng was high, as well as the employee performance at the Alfamidi Prosperity Soppeng Minimarket Outlet showed that the employee's performance was very good in achieving organizational goals.
MERDEKA BELAJAR-KAMPUS MERDEKA IN DEVELOPING BUSINESS THE ANALYSIS OF A POLICY IMPLEMENTATION: SLUM FREE URBAN PROGRAM (KOTAKU) IN BINJAI CITY
Authors: Khaira Zakya  , R Hamdani Harahap  , Sakhyan Asmara
Published: December 2021

Slum-free Urban Program (KOTAKU) is arranged by the Directorate General of Human Settlements, Presidential Regulation Number 2 of 2015, which instructs the development and expansion of urban regions by handling the residential environment's quality. The research shows that Binjai City has 21 Urban Villages included in the slums residential area. They are Tanah Merah, Bhakti Karya, Tanah Seribu, Puji Dadi, Binjai Estate, Rambung Barat, Rambung Timur, Timbang Langkat, Sumber Mulyorejo, Sumber Karya, Bandar Sinembah, Limau Mungkur, Paya Roba, Suka Maju, Suka Ramai, Tangsi, Satria, Berngam, Pekan Binjai, Damai, and Cengkeh Turi. The KOTAKU program gets its fund from the Kotaku program, Regional Budget (APBD), and communities' funds to manage the program. In this research, the methodology used was the descriptive method using a qualitative approach to focus on the current issues or phenomena during the research. The research shows the decrease of slums residential area from 315.6 Ha to 224.57 Ha. The implementation of the KOTAKU program has a resistor factor: the lack of socialization from the government regarding the program and the lack of community participation in the development process. This research concludes that the implementation of the KOTAKU program in Binjai City has corresponded to the local people requirements, and it creates a decrease of residential slums area to 30%. This research provides a recommendation: the government needs to make more socialization regarding the program and conduct direct coordination to the community to increase people's participation to run the KOTAKU program. The suggestion for future research is to conduct a bottom-up strategy so that many people are actively involved in the program
Information on the Bulgarian History in the IX – XI Centuries, Reflected in the Russian Chronograph
Authors: Petrova Denitsa
Published: December 2021

Object of the present research is the Russian chronograph, an extensive chronicle in which the history of the Slavs is described as part of the world. The information about the Bulgarians occupies an important place. The data about the Bulgarian history in the 9th – 11th c. is taken from Slavic translations of Byzantine chronicles and from some Russian historical works, most notably from the Bulgarian additions to the Manasses Chronicle. This article seeks to answer the question of how productive the Chronograph is as a historical source. Unpublished editions and copies of the Chronograph were also used for the purposes of the research. The method of comparative analysis shows that although some of the information is found in earlier Russian historical texts, different points of view are presented in the Russian chronograph. The chronograph contains rich information about Bulgarian history, part of which remains out of scientific interest. It is valuable for science and can be productively used as a source for Bulgarian medieval history.
Russian Propaganda During the First World War: Technologies and Forms
Authors: Hedo Anna , Liaskovska Svitlana
Published: December 2021

The purpose of the article is to analyse the use of political propaganda methods employed by the Russian Empire before and during the First World War, in particular, on the Ukrainian lands, which became a direct theatre of military operations and a field of confrontation between intelligence and counterintelligence services of belligerent powers, which exercised manipulative influence upon great masses of population and implemented special technologies for the formation of public opinion. The research methodology is based on the principles of objectivity, systematicity, dialectics, historicism and interdisciplinarity. The study is grounded on problemchronological, institutional and historical methods, as well as social psychology methods, used in propaganda practices. Scientific novelty: on the basis of printed materials: brochures, First World War periodicals, published posters and woodcuts (lubki prints), as well as memoirs of people, involved in the organization of propaganda campaigns, certain objects, technologies and forms of propaganda, in particular, the involvement of intelligence officers of the Russian Imperial Army in manipulative technologies, were defined. The widespread use of propaganda and counter-propaganda by the states that were the main players of the First World War, became a kind of hallmark of that war. In Russia, unlike other states, there were no special bodies and no such bodies were created later to influence public opinion in their own, hostile or neutral states. The peculiarity of the propaganda of the Russian Empire was the use of mainly constructive (positive) propaganda aimed at neutralizing social conflicts within the state, uniting the population and the authorities and their joint struggle against the enemy. The ideas of Pan-Slavism and Neo-Slavism were actively applied in the international realm. They were aimed at the unity of the Slavic world under the auspices of Russia as the defender of the Slavic peoples and the Orthodox Christian faith. The use of destructive propaganda technologies was aimed at creating the image of the “enemy” and uniting patriotic forces against it. At the same time, Russia failed to offer Slavic peoples of the empire, in particular Ukrainians, to realize their political aspirations in resolving the national issue; it did not feel a change of mood and did not restructure the content of propaganda rhetoric, which eventually led to its defeat in the information and psychological space.
Bulgarian Blagoev Commune in the Context of the Formation of the Soviet Totalitarian System (1920s – 1930s)
Authors: Zhurba Mykhailo , Dotsenko Viktor , Chernihovets Nataliia
Published: December 2021

Based on the analysis of the sources and academic literature, the article comprehensively presents a critical analysis of the activities of the Bulgarian Blagoev Commune. The article covers the details of the organisation and functioning of the collective, the tasks set by the Bolshevik authorities. The article characterises the process of adaptation to a different country, the relations of the members of the commune with the local population and ties to Ukrainian associations. The results and consequences of the economic and financial activities of the international commune on the territory of Ukraine are generalised. The authors draw attention to the fact that the conscientious work of the members of the commune was used by the political regime under the slogans of building a bright future for the sake of an unrealistic socialist goal. Special focus is put on the party and public activities of the members of the commune. The contradictory nature of the position of the Soviet government regarding the newly created collective, the evolution of its party and state policy and the tragic fate of the leadership of the commune in the 1930s are discussed. The article outlines the recommendations on the practical application of the historical experience of the international collective in the context of international cooperation.
Editorial
Authors: Somaya Brinda
Published: December 2021

I was invited by Prof. Kurt Seemann in June 2019 to guest edit this Special Issue: ‘India & Jugaad - the impact of innovation by the resilient Indian mind on habitat’. Little did I realise that this topic would become so relevant in the Indian context and more broadly, when globally we have seen systemic solutions fail and people challenged with increasing scarcity. But armed with ingenuity, the resources within their grasp, and the capacity to make a change within their networks, we have witnessed much agency, innovation, and resilence. In India, our lives are intertwined with our history, geography, culture and architecture. India is almost as large as Europe, not including Russia. It has a multiplicity of civilizations within it, being many countries in one. So the solutions and answers will be complex and multiple. We will need new and relevant long-term strategies based on what we can learn from the situation today, and we will then be able to plan the way forward. In this process, the importance of the built environment should never be underestimated, thus the significance and power of good design is ever more crucial in the Global South. Until one lives in India and experiences the country fully immersed in its wonder, culture, poverty and generosity, it is difficult to understand the complexity of the Indian mind and how it enables over a billion people live to together in this democratic nation.
La segmentation du marché urbain du riz local au Bénin: Une analyse par la méthode de classification par cluster
Authors:   Laboratoire d’Économie Publique (LEP), Faculté des Sciences Economique et de Gestion (FASEG) Université d’Abomey-Calavi (UAC), Abomey-Calavi, Bénin, Fiamohe Rose
Published: December 2021

L’objectif de cette étude est d’identifier les segments de marchés appropriés pouvant permettre aux coopératives rizicoles de commercialiser efficacement leurs productions. Ainsi, des enchères expérimentales ont été menées en 2015 pour collecter les données auprès de 291 consommateurs urbains. La méthode de segmentation two-step cluster a permis d’identifier trois segments de marché de riz local déterminés par les caractéristiques socio-économiques et géographiques des consommateurs et les attributs du riz: le premier composé majoritairement d’hommes qui consomment le riz local en faible proportion; le deuxième composé uniquement de femmes ne consommant pas le riz local et le dernier à majorité féminine consomme exclusivement le riz local. Des actions de marketing spécifiques ciblant chacun des segments sont nécessaires pour accroître significativement la consommation du riz local et améliorer les revenus des principaux acteurs.
Health and environmental effects of adopting an integrated fruit fly management strategy among mango farmers in Kenya
Authors:   Department of Agricultural Economics and Resource Management, Moi University, Eldoret, Kenya, Miyinzi Mwungu Chris , Muriithi Beatrice ,   International Centre of Insect Physiology and Ecology, Nairobi, Kenya, Ngeno Vincent ,   Department of Agricultural Economics and Resource Management, Moi University, Eldoret, Kenya, Affognon Hippolyte ,   West and Central African Council for Agricultural Research and Development (CORAF/WECARD), Githiomi Caroline ,   Department of Agricultural Economics, University of Nairobi, Nairobi, Kenya., Diiro Gracious ,   International Centre of Insect Physiology and Ecology, Nairobi, Kenya, Ekesi Sunday ,   International Centre of Insect Physiology and Ecology, Nairobi, Kenya
Published: December 2021

Integrated pest management (IPM) has been promoted globally as an alternative approach to the widespread broad-spectrum chemical insecticidal application for the control of pests and diseases in agricultural production to minimise the harmful effects of the chemicals on humans and the environment. This study examines the impact of an IPM strategy developed to control mango fruit flies on humans and the environment. Using a random sample of 371 mango farmers from Meru County in Kenya, health and environmental outcomes were measured using the environmental impact quotient (EIQ) field use and causal impacts, which were estimated using the endogenous switching regression (ESR) model. The results indicate that the adoption of the IPM strategy reduced pesticide use and pesticide toxicity. Policy efforts therefore should focus on promoting and disseminating fruit fly IPM to improve the livelihoods of rural mango farmers, but also reduce human health and environmental threats as a result of pesticide use.