bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic syndrome and sleep disorders in Brazil: a short review
Authors: Domingues Sidney Marcel , Piccaro Paola Cocchi , Silva Lizzi Elisangela Aparecida Da , Barboza Galdencio Roberta Cristina
Published: March 2023

Purpose: The present study analyzed the production on metabolic syndrome and sleep disorders in Brazil in the indexed scientific literature. Methods: Keywords such as “ Metabolic Syndrome”, “Cardiometabolic Risk Factors”, and “Sleep Wake Disorders” were used to find relevant research papers in PubMed and Latin American and Caribbean Literature in Health Sciences – Virtual Health Library (LILACS - VHL). Additionally, a table was built with the synthesis of the publications recovered in the two databases to characterize the publications found and an analysis of textual bodies and similarity was carried out, in order to better understand the connections between the terms that emerged from the analyzed abstracts. Results: Regarding the central theme, of the 15 publications 9 were related to the quantity and quality of sleep, focusing mostly on obstructive sleep apnea (OSA), with metabolic syndrome. In addition to these, 2 publications present the relationship between metabolic syndrome with ethnicity and chronic non-communicable diseases. And 4 publications have as their main theme sleep-related disorders only. The similarity analysis showed us that there is a relationship between the structure that circumscribes the term “sleep” with strong connective features, that is, with greater width, between the aforementioned term and the following: “metabolic syndrome”; "index"; “risk factor”, “obstructive sleep apnea – OSA” and “association”. Conclusion: This short review evidenced that the theme related to metabolic syndrome and sleep disorders in Brazil, based on the search strategies carried out, showed little literature, as well as indicating a high relationship perceived by the mathematical model of co-occurrences between the term “sleep” with “OSA”, “risk factor” and “metabolic syndrome”.
Effect of a sleepless night combined with 2 cups of instant coffee on heart rate variability in an elderly man
Authors: Domuschiev Ivan
Published: March 2023

Insomnia is harmful and has negative effects on the human body. Coffee is the most commonly used beverage to invigorate. Measurement of heart rate variability is the most accurate method for quantitative assessment of the sympatho-vagal balance of the autonomic nervous system, which determines adaptive capacity to stress. In our Case Report, after 1 sleepless night, the stress index rises and the sympathetic over parasympathetic prevails.
Use of omega-3 as adjunctive therapy in the control of hyperlipidemia in metabolic and endocrine diseases in dogs
Authors: José Lahm Cardoso Mauro
Published: March 2023

Omega-3 from fish is commonly recommended for the control of hyperlipidemia, however, there are few studies in dogs proving its efficacy, and no studies have compared doses of omega-3 in patients with severe hyperlipidemia.
Ultrasonographic evaluation of canine pyometra
Authors: Suresh Kumar R , Rasool Akhter , Umamageswari J , Sarath T , Rangasamy S
Published: March 2023

Pyometra is the most common disease found in adult intact female dogs, caused by acute or chronic suppurative bacterial infection of the uterus and is characterized by accumulation of inflammatory exudates in the uterine lumen with diverse clinic-pathological manifestation either locally or systemically. Disease is frequently noticed in adult female dog in luteal phase of estrous cycle during which progesterone level is high (progesterone sensitized uterus) and thus playing key role in pathogenesis. The preliminary diagnosis of pyometra is determined by case history, physical examination findings and laboratory test results in combination with radiography or/and ultrasonography showing a fluid-filled enlarged uterus. A late diagnosis of pyometra, when kidney failure has already occurred, may result in irreversible damage to the kidneys. Effects of sepsis and endotoxaemia can further cause multi-organ dysfunctions, but despite being a potentially life-threatening illness. In this communication, ultrasonography as an accurate procedure for the qualitative and quantitative examination and diagnosis of canine pyometra has been described.
Use of ciprofibrate in dogs with hypertriglyceridemia
Authors: González Franco , de Marco Martina , Valenci Daniela , Bustos Daniela
Published: March 2023

The objective of this study was to evaluate the effect of ciprofibrate on serum triglyceride concentrations in canine patients. A sample size of 21 canines was study, that had a diagnosis of familial dyslipidemia, and was established with triglyceride levels above 500mg/dl, treatment with ciprofibrate was evaluated at 2 months. The analysis of the variation in triglyceride levels was performed using the non-parametric Wilcoxon matched-pairs signed-rank test. The Wilcoxon test revealed that the triglyceride concentration decreased significantly after two months of treatment with ciprofibrate; from 621 (512 to 1046)mg/dL to 136 (67 to 215)mg/dL (p <0.0001). The difference in medians was -482.0md/dL with a 97.3% confidence interval of -579.0 to -443.0mg/dL. It was concluded that the use of drugs such as ciprofibrate in the treatment of patients with familial hiperlipidemia, had a significant decrease in serum triglyceride concentrations, without generating adverse reactions in this study.
Lithic net weights: subsistence and strategic uses of space at the El Porvenir site, in Colombia
Authors: Meneses J César
Published: March 2023

The following article presents some of the findings associated with the site of El Porvenir, in the department of Cesar, in the northern region of Colombia. It presents some of the subsistence strategies and possible uses of space of the ancient inhabitants of the site, based on the evidence of fishing activities, which reveal the establishment of social relations associated with aquatory, symbolic constructions in aquatic spaces, and the establishment of a social network associated with the use of the site.
Shortage and bounty: cosmological categories and subjectivity in festivals of the holy ghost among Portuguese immigrants in Rio de Janeiro (Brazil)
Authors: Contins Marcia , Reginaldo Gonçalves José
Published: March 2023

This article explores the Azorean immigrants’ native cosmology such as it is expressed in the festivals of the Holy Ghost in Rio de Janeiro/Brazil. In this cosmology, the relationship of men with the Holy ghost is crucial. Human beings are not defined by their “basic needs”, as they are with western cosmology and anthropology in the interpretation of Marshall Sahlins,1 but by their reciprocal relationship with the Holy ghost. It is only to the extent that they move away from this relationship that they can then be exposed to needs, hunger, sickness, shortage. The Holy ghost thus performs a fundamental mediating role: he is the mediator between heaven and earth, between the soul and the body, between God and men, soul and body, hunger and taste, containment and excess, shortage and bounty. In this cosmology the category “work” has a pervasive role. It appears simultaneously as an economic category and as a moral and religious one. It is through intense and disciplined work that shortage becomes bounty, where honor is maintained, and grace is granted. It is through this intermediary that the individual and collective self-consciousness is formed, and a balanced relationship is achieved between the soul and the body, between the supra-mundane and the mundane.
Management of drug resistant tuberculosis: isoniazid resistant, rifampicin resistant, multi drug resistant, and extensively drug resistant
Authors: Bereda Gudisa
Published: March 2023

Mycobacterium tuberculosis strains that are resistant to an elevating number of second-line medicines used to treat multidrug-resistant tuberculosis are becoming a threat to public health worldwide. Recent guidelines recommended at least 20 months of treatment, but recent regimens are toxic, poorly tolerated and insufficiently effective, with cure rates as low as 36% and failure rates as high as 50%. The emergence of multidrug-resistant tuberculosis can be defined as strains resistant to at least isoniazid and rifampin has introduced as they are challenging, but overcome the complexities to tuberculosis programs that have responded by treating multidrug-resistant tuberculosis with second-line drugs. Longer multidrug-resistant tuberculosis regimens are treatments for rifampicin resistant tuberculosis or multidrug-resistant tuberculosis which last 18 months or more according to the new 2019 updated World Health Organization drug-resistant tuberculosis guidelines and which may be standardized or individualized. Longer multidrug-resistant tuberculosis regimens are usually designed to involve a minimum number of second-line tuberculosis medicines considered to be effective based on patient history or drug-resistance patterns. The exact number of drugs used to treat extensively tuberculosis drug-resistant is unknown, but most individuals will receive five to six drugs. Identically, as the majority of patients with extensively tuberculosis drug-resistant have been previously treated for multidrug-resistant tuberculosis, prior exposure to drugs like ethionamide and terizidone frequently excludes their use.
Rv2746c and Rv2881c, a potential drug target of Mycobacterium tuberculosis revealed by insilico investigation of proteins involved in lipid biosynthesis
Authors: Jha Vikas
Published: March 2023

Tuberculosis is a serious disease that requires a greater understanding of its pathophysiology to develop effective treatment strategies. To gain a better understanding of mycobacterial physiology, researchers are focusing on the key components associated with cell wall synthesis. Although mycolic and fatty acids are the primary lipid components of the mycobacterial cell envelope, understanding the proteins involved in the lipid biosynthesis pathway may open up new avenues for fundamental research. This research included a thorough computational examination of proteins from the fatty acid biosynthesis pathways. Rv2881c and Rv2764c are essential genes for lipid synthesis. It is a potential drug target because knocking out these genes has an impact on Mtb growth. The study's findings provide researchers with specific cues and concrete information that can be applied in a variety of biotechnological applications.
Nomogram of baseline CT-radiomics from small-cell lung cancer patients: evaluation of added prognostic value for overall survival and probability of distant metastasis
Authors: Zhang Ruiping
Published: March 2023

Objectives: To evaluate the added prognostic value of baseline CT-radiomics using nomogram for overall survival and probability of distant metastasis in small-cell lung cancer patients. Materials and methods: This retrospective study consisted of 122 patients with stage IIA-IIIB small-cell lung cancer,which 97 patients for training dataset and 25 for validation dataset. The function defined as rad_score was constructed by the linear combination of selected radiomics features from baseline CT images weighted by their respective logistic coefficients and intercept in the LASSO-Cox model. The nomogram was developed based on the above function for overall survival (OS) and calibrated by the Harrell’s concordance index (C-index). The performance of the classifiers for DM was evaluated by receiver operating characteristics (ROC) curves with the indictor of area under curves (AUC). Furthermore, survival curve depicted by Kaplan-Meier method was compared with Log-rank test between low- and high-risk group. Results: The nomogram performance of radiomics features and risk clinical factors (c-index of 0.64) don’t take advantage over the one of risk clinical factors-based alone (c-index of 0.596). The probability prediction of combination of the radiomics and clinical risk factor, radiomics alone, and clinical factors alone was shown, namely AUC of 0.673, 0.640 and 0.650, respectively. No significant different was found between ROCs (p-value > 0.4, Delong test). Moreover, we compared the Kaplan-Meier curves between low- and high-risk group, and showed p<0.001 with Log-rank test. Conclusion: In the study, we can not confirm the hypothesis that baseline CT-radiomics contribute to predict the OS and probability of DM significantly. Moreover, the nomogram model based on combination of radiomics and clinical parameters has disadvantage over clinical parameters alone, probably affected by heterogeneity of datasets or SCLC need more valuable information for prediction outcomes.
Treatment of brain metastases in lung cancer
Authors: Blasco  Alejandro Santini
Published: March 2023

Lung cancer is the most frequent oncological disorder and has been the main topic in most oncological congresses. There have been countless changes in diagnosis and treatment, improvements in the diagnostic methods, more effective and less invasive curative care and improvements in systemic treatments (new drugs and molecular targets). In the whole therapeutic spectrum, radiotherapy plays a significant role and at the brain metastasis level the changes are very relevant. Brain metastases are the most frequent neuro-oncologic complication in lung cancer patients. Managing this situation has become increasingly complex in recent years. The results have been improving, not only in terms of responses to treatment but also in terms of an increasing reduction in side effects. This paper reviews the latest advances and current management of patients with brain metastases from lung cancer.
Molds as a cause of asthma and exacerbations
Authors: Jusufovic Edin
Published: March 2023

Molds are often found in patients with pre-existing asthma, when they can be the cause of worsening asthma and even death. However, they can also represent a risk factor for the development of asthma in a previously healthy person. The most allergenic molds causing respiratory diseases are: Aspergillus, Alternaria, Penicillium and Cladosporium with an emphasis on Aspergillus in patients with asthma. In order to be inhaled their spores must be ≤5 µm in size. Germination of inhaled mold spores in the lungs is related to Th2 and Th17 pathways, as well as activation of the innate immune system, but also could promote sensitization to allergens of other mushrooms, as well as allergy to pollens and dust mites. Sensitization rates in asthma patients range from 5-50% of patients. Molds can act as internal or external sources of respiratory allergens depending on the climatic conditions. The diagnosis of fungal allergy is complicated by the fact that patients with mold allergy are often polysensitized to pollen as well. Therefore, a good allergic anamnesis and clinical picture play a key role. Regarding diagnostic procedures, the most important are serum fungal-specific IgE or precipitins, total IgE, IgG against suspected fungus, peripheral blood eosinophils and fungal-specific skin prick tests. The role of antifungal therapy in severe asthma remains unclear. Further research is needed to better define the potential utility of antifungal drugs in patients with asthma and mold sensitization or allergy to identify drugs and populations of patients who would benefit from such treatment. There is also insufficient evidence for the safety and efficacy of allergen immunotherapy in mold-sensitive patients. About 70% of patients with severe eosinophilic asthma with sensitization or allergy to Aspergillus and Penicillium could benefit with Mepolizumab therapy. On the other side, measures to avoid mold still remain key factor in therapy.
Dysembryoplastic neuroepithelial tumour - a reversible cause of neuroregression in children
Authors: M Jyothi , S Ganapathy , K Nivetha , S Nidhi , A Prakash , R Raykar , A Mahadevan
Published: March 2023

Dysembryoplastic Neuroepithelial Tumour (DNET) is a rare brain tumour commonly involving the temporal lobe and presenting with intractable seizures. However, neuroregression as a presenting feature of DNET is uncommon. We report a case of a 12-year-old boy with DNET arising from the parietal lobe presenting with intractable seizures & neuroregression. The child was subjected to neurosurgical resection of the lesion following which he made a full recovery. A review after surgery showed his epilepsy under control with good progress in scholastic, social adaptive and motor skills. This is the third report in literature of DNET surgery producing epilepsy control and reversing milestone regression. This demonstrates Epilepsy Surgery as a powerful tool in combatting neuro-regression secondary to lesional epilepsy.
The performance of a multidisciplinary team in a hospital and outpatient stroke unit in SUS
Authors: Alvarenga Telles Vanessa Ghidetti , Sfalsini Rúbia Rasseli , Fiorot Júnior José Antônio , Neto Silvestre Dalmaso , Nunes Bassetti Elida Maria
Published: March 2023

Stroke affects millions of people worldwide each year. There are some types of stroke like ischemic stroke, when stroke patients need secondary prevention of new events. One of the options of a secondary prevention is through the use of oral anticoagulants such as dabigatran, rivaroxaban (direct oral anticoagulants - DOACS) and warfarin; however, the home use of such drugs is a matter of concern due to the risks of Adverse Drug Reaction (ADR) related to poor adherence to drug treatment, in addition to the difficulty of access to the drug by the population. Objective: To provide access to medication, monitor possible ADRs, and also to reduce patient dropout, and increase patient compliance. Methods: The Neurologist fills out the DOACS documents to be picked up at the State Citizen Pharmacy or prescribes warfarin. While still hospitalized, the patient receives pharmaceutical orientation, dispensation of the DOACS for 30 days of use and the date of the next laboratory test, requested every 6 months, or monthly for warfarin. The evaluation of the results and the orientation is done by the Neurologist. Faced with possible questions that arose, patient evasion reached 60% in one year. The Clinical Pharmacy team was inserted in the outpatient clinic, with the following flow: the patient does TAP/INR or creatinine and the result is evaluated by Neurology. Prescriptions and medical reports are forwarded to the Clinical Pharmacy, which delivers to the patients in the pharmaceutical consultation; at this moment, adherence to drug treatment and ADR monitoring are evaluated. Results: From March/2019 to August/2020, 1,892 consultations were scheduled, being 946 pharmaceutical consultations, with 805 face-to-face visits (85% adherence). Regarding the users’ profile: 8 rivaroxaban (4%), 58 warfarin (26%) and 156 dabigatran (70%). Conclusion: Multiprofessional outpatient care with clinical pharmacy consultation contributed to reduce patient dropout, provided access to medication, monitored ADRs, ensuring patient safety when using oral anticoagulants in SUS.
Functional performance of children with Myelomeningocele submitted to intrauterine repair and conventional surgery
Authors: Silva e Borges Maria Beatriz , Pereira Paula Cristina , Boscato Kelly Letícia , Safons Marisete Peralta , Carioca Vitor Gabriel
Published: March 2023

Introduction: Myelomeningocele (MMC) is an embryonic malformation that occurs in the first four weeks of gestation due to a failure in the closure of the neural tube. They have multifactorial etiology such as genetic and environmental factors that affect folic acid metabolism. Several anomalies may be associated with MMC, with the occurrence of hydrocephalus and Arnold Chiari type II malformation being most present. Surgical repair should ideally occur within the first 24 hours after birth to prevent or decrease the risk of infection, preservation of all viable nerve tissue, anatomical reconstitution. However, surgical repair of MMC intrauterine has shown substantial benefit in all babies submitted to this intervention. Objective: To compare the functional performance of children with MMC who underwent intrauterine surgical repair and those who did traditional surgery at birth. Methods: Cross-sectional study carried out at the UCB School-Clinic, where children treated with MMC were evaluated, analyzing their motor status and functional performance using the Pediatric Evaluation of Disability Inventory (PEDI) for a quantitative record of functional capacity and autonomy in daily activities, in the areas of self-care, mobility and social function. Results: There was a statistically significant relevance on the mobility function (p=0.01) for children who underwent intrauterine repair when compared to children who underwent traditional surgery. Conclusion: There is a strong relationship of better functionality of children who underwent intrauterine surgery when compared to children who underwent traditional surgery.
Economic cost savings with the use of total body phototherapy for the treatment of severe neonatal jaundice in Nigeria
Authors: OE Onwe , OB Ezeanosike , CD Obu , OW Daniyan , HO Amadi
Published: March 2023

Kernicterus and severe jaundice are major contributors to neonatal morbidity in Nigeria, and they are commonly treated using invasive exchange blood transfusion (EBT) techniques. Total body phototherapy exposure (TBPE) is a new technique that avoids the risks of EBT and has been shown to be effective. The aim of this study was to evaluate the typical economic savings that result from the clinical success of the TBPE as provided by the Firefly® system in a Nigerian new-born centre. Severely jaundiced neonates who were treated using EBT between January 2017 and December 2017 were assessed as control cases. These neonates were compared to neonates who received TBPE using the Firefly® system (MTTS Asia, Hanoi Vietnam) as a first course intervention (test cases) after February 2018 onward. A total of 82 severely jaundiced new-borns qualified for inclusion, including 19 control cases and 63 test cases. All TBPE cases were successfully discharged, but two mortalities relating to EBT complications were recorded. The mean direct cost of treatment per patient was ₦94,553 (US$262) in the control group and ₦18,897 (US$52) in the test group. The mean patient burdens for other parameters (control: test) were bacterial infection burden (100% : 11%), human labour man-hours (9.8 : 1.2), and blood contamination burden (25% : 3%). The huge relative amount of savings recorded in this study has clearly demonstrated that Firefly® TBPE is an application that is both affordable and effective in a resource-constrained setting. Hence, we recommend its use in low- and middle-income countries.
Accelerated pulse oximetry in the neonate: a proposal
Authors: IE Hoffman Julien
Published: March 2023

Pulse oximetry is used as a screening test for critical congenital heart disease. Current algorithms involve one or to re-screenings for some patients. That may take 2-8 hours before a diagnosis is made. I propose that after the initial screen, patients who do not pass the test be given a short exposure to high oxygen concentration in order to eliminate lung disease as a cause of the desaturation.
Enteroviral meningitis at a pediatric hospital in Dakar (Senegal)
Authors: Lamine Dia Mouhamadou , M Soumbounou , SF Ndiaye , A Fall , O Kébé , Kader Ndiaye
Published: March 2023

Introduction: Enteroviral meningitis is the main cause of meningitis for all causes combined. They are frequent and most often benign, but underdiagnosed due to the limited technical platforms of laboratories. This is why we deemed it important to carry out this study aimed at determination of the role of these viruses in aseptic meningitis at the pediatric hospital of Diamniadio in Dakar. Materials and methods: This was a prospective study covering the period from the 1st of January to the 31st of August 2017 involving 30 patients from the children’s hospital of Diamniadio. The cytochemical tests and the assessments of soluble antigens in the CSFs were carried out at the laboratory of the hospital of Diamniadio. The virological tests were carried out at the Pasteur Institute of Dakar. Results: All up, 30 aseptic CSFs were received by the laboratory during the study period. The patients were aged from 0 to 15 years. The analysis of the CSFs found an average protein concentration level of 1.15g/L and an average glucose level of 0.52g/L. No microbial organisms were detected by conventional bacteriological analyses. The virological analyses, on the other hand, allowed 9 Enteroviruses and 1 cytomegalovirus (CMV) to be found in the CSFs. Conclusion: Enteroviruses constitute a significant part of the etiologies of viral meningitis in Senegal. Larger scale studies are needed, however, to obtain a more accurate indication of the viral causes of meningitis in Senegal.
Knowledge, attitude and practice of parents’ of children with congenital heart disease in a developing country
Authors: Hafiz Elshazali Osama , Farouk Farah Tayseer , Zaki Mariam
Published: March 2023

Background: Congenital heart disease (CHD) is the most common type of birth defects and remain the leading cause of death from congenital malformations. The knowledge of the parents of children with CHD; is important for the long term wellbeing of their children. In 2017 we have conducted study looking at the knowledge of the parents of children with CHD; about the disease, after that study we have implemented some measures to improve the knowledge of the parents and we wanted to see if there was any improvement in the parents knowledge. Objectives: To assess the parent’s knowledge regarding diagnosis and management of their children with CHD. Methods: This is a prospective questionnaire based study, conducted at the Paediatric Cardiology Outpatient clinic Ahmed Gasim cardiac Centre, over a six months period from June to November 2019. Results: The total study population was 120 parents of children with CHD. Of these children, females were 65 (54.2%) and males were 55 (45.8%). The most common age group was 1-5 years old, with 51 (42.5 %) children. 71 (59.2%) of the study population resided in urban areas. 103 (85.8%) of the responders were mothers. 32 (31.0%) mother and 11 (64.7%) fathers were > 40 years old. 9 (52.9%) fathers and 37 (35.9%) mother were primary school graduate. 87 (84.5%) of the mothers were housewives, and10 (58.9%) fathers were unskilled workers. 66 (55%) and 54 (45%) of the parents were of moderate and low social class respectively. 14 (11.7%) children were known to have Down’s syndrome. 60 (50%) had previous cardiac surgery, 26 (21.7%) had previous cardiac catheterizations and 3 (2.5%) had documented episodes of infective endocarditis. The commonest Cardiac diagnoses were Ventricular Septal Defect 49 (40.8%), Atrial Septal defect 23 (19.2%) and Tetralogy of Fallot 18 (15%). 118 (98.3%) were attending the appointment visits regularly. 119 (99.2%) confirmed that the diagnosis of their children heart problem was explained to them. 84 (70%) reiterated their children heart problem correctly. 100 (83.3%) and 113 (94.2%) stated correctly the symptoms and risk factors of Infective Endocarditis (IE) respectively. 44 (36.7%) received information regarding the importance of oral hygiene, 102 (85%) were aware about need for antibiotics before dental procedures and 120 (100%) were aware about measures to maintain a good oral hygiene. The knowledge of parents was considered fair in 49 (40.8%), good in 46 (38.3%) and poor in 25 (20.8%). Conclusion: The knowledge of the parents of children with congenital heart disease was generally good, but there is a room for improvement. Simple measures like providing more information especially written is beneficial. The knowledge of the parents should be assessed and measures should be implemented to improve the knowledge of the parents, empowerment of the parents will improve the wellbeing of children with CHD.
Chloroma: an uncommon presentation of the acute lymphopblastic leukaemia (ALL) in a child
Authors: Taksande Amar , Meshram Rewat , Lohakare Amol
Published: March 2023

Leukemia is the most common malignancy of childhood. Chloromas are a rare presentation of an underlying leukemia. Here, we discuss a rare case of acute lymphoblastic leukemia (ALL) presenting with swelling over right eye. The patient was evaluated radiologically for the extension of disease and treatment planning. ALL was diagnosed with complete blood count and bone marrow examination. The orbital swelling was the initial presentation which led to further diagnosis of acute lymphoblastic leukemia (ALL) in our case. Chloroma is usually a common clinical presentation of acute myeloid leukemia (AML), however, it may rarely be found in a case of acute lymphoblastic leukemia (ALL) such as ours.
Serum matrix metalloproteinases MMP-9 and MMP-2 and tissue inhibitors TIMP-2 in necrotizing enterocolitis
Authors: Khvorostov Igor , Smirnov Ivan
Published: March 2023

The analysis of the balance of elastase (MMP-2, MMP-9) and TIMP-4 was performed in order to determine their involvement in the pathogenesis of NEC. A progressive duration of NEC with sepsis is accompanied by increased serum concentrations of MMP-9, MMP-2 and TIMP-4. Increases in concentrations of MMP-2>503 ng/ml, MMP-9>812 ng/ml TIMP-4>1404 ng/ml can be regarded as statistically significant predictors of fatal outcome of NEC. The proposed method for determination of the outcomes of NEC in newborns is characterized by high sensitivity (94%) and specificity (87%).
Oxygen therapy and respiratory support in SARS COVID 19 infection in children
Authors: Lakra Mahaveer , Taksande Amar , Lakhkar Bhavana
Published: March 2023

Covid 19 pandemic has been a very dreadful experience and affected all of us badly. Although children are asymptomatic and less severely affected by covid illness as compared to adult population, however the patients presenting with severe symptoms require hospitalisation and need oxygen and respiratory support. Inappropriate, prolonged use and failure to monitor oxygen therapy can have serious consequences. Oxygen therapy in children requires the selection of proper oxygen delivery system that suits the patient's size, needs, and the therapeutic goals. Low flow and high flow oxygen devices are being used to deliver oxygen in children. High flow nasal cannula has been used proved to be wonderful modality for respiratory support in children. We need to follow all guidelines laid down by various agencies while delivering oxygen and respiratory support to sick children suffering from covid infection. All precautions should be taken to avoid aerosol generation. Close monitoring of oxygen therapy is a must. In this article we have tried to cover the indication and modes, it’s relation with mucormycosis, monitoring and the precautions which we should take while giving oxygen therapy in covid era. Update of knowledge of indication of use and other modalities of treatment by treating doctors and patients are equally important so that we can fight a battle of third wave if it arrives.
Predictors of breastfeeding practice, evidence from mothers of children less than two years of age in southern Ethiopia
Authors: Yeheyis Tomas , Wuletaw Getahun , Birhanu Betelhem , Admasu Sentayehu , Shewangzaw Zewdu
Published: March 2023

Background: The World Health Organization recognizes that continuous and on-demand breast feeding until two years of age and beyond is essential for health, growth and development of young children, and protection against infectious diseases. In Ethiopia, breastfeeding is promoted by providing information on benefits during ante-natal care and by supporting mothers during post-natal visits. Objective: To assess the current breast feeding practices and associated factors among mothers of children less than two years of age in Areka town, southern Ethiopia. Methods: A community-based cross-sectional study was conducted among 286 randomly selected mother-child pairs living in Sothern, Ethiopia, Areka town community. A structured questionnaire was used to collect data on maternal characteristics and assess breast feeding practice. Descriptive summaries were done to present pertinent findings. Multivariate logistic regression analysis was done to establish statistical associations between dependent and independent variables with p <0.05. Results: From the total of 274 mother- child pairs participated in the study,132 (48.2%) have good breast feeding practice of breast feeding and 142(51.2%) mothers have poor practice of breast feeding. Mothers of age less than 35 practiced appropriate breastfeeding were less likely than mothers with age greater than 35 years. Like wise mothers who are none governmental employed have good breast feeding practice compared to government employees. Conclusion: The finding in the study showed that magnitude of good breast feeding practice in the study area is lower than the national level. In this study maternal age and maternal occupation have been found to be predictors of breast feeding practice.
Thermal comfort assessment of active cooling technology for agricultural end use: a field study
Authors: M McQuerry , JG Grzywacz
Published: March 2023

Migrant agricultural workers endure harsh environmental conditions for extended periods of time while working in crop and livestock production. Despite their elevated risk for heat-related illnesses and injuries, agricultural workers’ clothing needs are rarely considered outside of pesticide use. The purpose of this field study was to explore the potential value of providing garments with printed cooling technology to agricultural workers as an engineering tool for reducing elevated risk for heat-related illness. An eight-day field study with 20 migrant farmworker participants measured thermal comfort perceptions at the end of each workday for a t-shirt with active cooling technologies, including phase change materials, compared to the same 100% polyester t-shirt with no cooling finishes applied. Participants reported greater perceived comfort when wearing the t-shirts with the printed cooling technology compared to the control shirts.
Behcet’s syndrome associated with Sjogren’s syndrome, an infrequent combination: Case report and literature review
Authors: Ariana Ringer , Mariano Palatnik , Mariana Racosta
Published: March 2023

58-year-old woman with a history of xerophthalmia and xerostomia, asthenia and alopecia beginning at the age of 27, oral ulcers and recurrent episodes of bilateral parotitis. She attends rheumatology at the age of 52 (year 2016), without treatment. Laboratorial, ophthalmological and oral cavity examinations were performed, along with the biopsy of 2 minor salivary glands. Sjogren's syndrome (SS) was concluded, excluding other differential diagnosis. Hydroxychloroquine 400 mg/day was indicated, improving symptoms. After three years (year 2019), she added polyarthritis, large and recurrent oral ulcers and the appearance of genital ulcers. Behcet's syndrome (BS) was suspected and a genetic study was performed: HLA-B27 histocompatibility antigen negative, HLA Class I, locus B molecular typing: HLA B* 35 and HLA B*51 positive (nomenclature B35; B51 positive). This case is reported due to the infrequent association of SS and BS, both fulfilling the diagnostic criteria. A literature review was performed. Both pathologies were scarcelyn reported together in the literature. A common pathophysiological mechanism cannot be defined at the moment. It is intended to highlight the broad thinking of differential diagnoses in everyday situations in rheumatology. A high index of suspicion, a profuse history and correct physical examination are essential to arrive at the diagnosis.
Case report: Tuberculosis as a cause unilateral of sacroiliitis in lupus patients
Authors: Ribeiro Cláudia Holanda , Carpinetti Cristina Lauren , de Freitas, Márcio Felipe , de Sá Roris Angélica Ferreira , Bezerra Fernanda MS , Carneiro Bárbara Seabra , Euzébio Ribeiro Sandra Lúcia
Published: March 2023

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease, with variable manifestations, which is frequently exacerbated, requiring differential diagnosis with infectious conditions. In the case report, the patient satisfied the following criteria as per ACR/EULAR (2019): FAN 1:640 homogeneous nuclear, fever, alopecia, hypocomplementemia, antidsDNA 1:80 and lymphopenia. She was on: prednisone 20mg/day, hydroxychloroquine 400mg/day and calcium+vitamin D3. She was pale (3/4+), dehydrated and tachycardic. Osteoarticular examination: Patrick-Fabere positive for left sacroiliac; pain in external and internal rotation in left hip and painful palpation in the metacarpal, proximal interphalangeal, wrists, knees, ankles, hip and thigh joints, especially in the left and right. Radiography showed extensive sclerosis (grades 3 and 4) in left sacroiliac and rectified lumbar lordosis. Later, magnetic resonance imaging revealed extensive subcortical bone marrow edema at the left sacroiliac associated with capsulitis. In addition to positive BAAR TRM-TB, Lupus patients present a high incidence of TB, which is an important hypothesis in febrile cases with inflammatory lombalgy, since its osteoarticular form mainly affects the spine. Therefore, the importance of differential diagnosis for effective management is evident.
Lung ultrasound in children and adolescents with rheumatologic diseases in clinical practice
Authors: Guissa Vanessa Ramos , Tonidandel Paulo Roberto , Nascimento Coelho Vanessa Félix , Russo Macchi María Verônica , Garcia Igor Tadeu , Sanches Fernanda Bertucci , Lyrio André Marun , Bonfigliol Rubens
Published: March 2023

Pulmonary complications from autoimmune diseases are rare in the pediatric age group, but with significant morbidity, compromising the patients’ quality of life in adulthood. The objective of this study was to evaluate the presence of interstitial lung disease in pediatric rheumatologic patients with connective tissue diseases, who were submitted to investigation through lung ultrasound during outpatient follow-up. The medical records of 40 patients were reviewed from April 2014 to December 2021. The patients evaluated were those who had already undergone lung ultrasound and presented changes suggestive of interstitial lung disease and were submitted to complementary investigation with chest high-resolution computed tomography and pulmonary function tests. The sample consisted of 20 patients, 70% of whom were female. The average age was 14 years. Half of the patients with connective tissue diseases showed changes suggesting pulmonary fibrosis on lung ultrasound and underwent further investigation with chest high-resolution computed tomography and pulmonary function test. In this group, 40% had tomography with abnormal patterns in the lung parenchyma, suggestive of interstitial lung disease, predominantly with normal spirometry. Older age and longer duration of disease were statistically significant in the analysis between the group with both altered imaging tests and the 20 patients underwent lung ultrasound (p= 0.008 and p= 0.006, respectively). Lung ultrasound can be a valuable screening tool for the early detection of interstitial lung changes in pediatric collagenosis. Larger prospective and longitudinal studies are needed in the pediatric age group, so that its specificity for interstitial syndrome can be determined.
Non-surgical management of Trapezium canal syndrome an uncommon presentation of Flexor carpi radialis tenosynovitis
Authors: Bu Ali Basil M , Al Fehaid Mohammad S
Published: March 2023

Flexor carpi radialis (FCR) tendonitis is described as an uncommon condition that is causing pain at the palmar aspect of the radial wrist. FCR tendonitis is a middle-aged condition which tends to affect the dominant hand. Patients with FCR tendonitis usually presents with pain and swelling over the palmar side of the radial wrist. Resistance against radial deviation of the wrist may illicit tenderness. FCR tendinitis can be diagnose clinically, however, radiographs MRI can help confirm the diagnosis. Management of FCR tendinitis includes physiotherapy, oral anti-inflammatory medication, steroid injection and surgical decompression. Surgical release showed a high rate of symptomatic satisfaction, and a reduced rate of recurrence.
Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report
Authors: Rob Chowdhury Foyzur , Hossain Jahangir , Mustof Md Gulam
Published: March 2023

Introduction: Aim of this study to evaluate the clinical efficacy and highlight their relevance in present orthopedics practice where multiple newer choices have been become famous. Accordion maneuver design with modified Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection place dynamic compression plate (DCP) in situ. Femoral shaft fractures (FSFs) are frequently occurring injury due to RTA. Infection (0.4%) and non-union (1.1 - 14%) are the morbid complications of femur fractures. The healing rate for femora shaft non-unions is too high (90%).1 Accordion Maneuver (AM) is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It comprises of alternate compression and distraction which produce stress in living tissue and also convert biologically inactive scar tissue at non-union site into tissue capable of neo-osteogenesis.2 The suggested treatment for quiescent type of infected non-union is a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ.3 Case Report: In the case, a 26 years man treated by DCP with MIPO for his Gustilo type – Ⅰ open, comminuted fracture of mid femoral shaft (Left) following RTA. Post-operative infection occurred within 2 weeks of operation. Infection controlled by exploration and surgical toileting with antibiotic. After four (4) months later he was sustained re-fractured with bending plate due to fall again. Finally he was diagnosed as H. Rosen`s type 3 Quiescent infected non-union (Oligotrophic) and Romano stage -1 post-implant infection with re-fracture mid shaft of left femur. Then he was treated following accordion principles with modified Ilizarov frame. AM was applied according to protocol of Baruah and Patowary of non-union treatment. Result: After complete union and consolidation, substantiated by radiological evidence Ilizarov apparatus was dispelled six (6) months later of installation without removal of plate and four (4) months of that finally plate was removed. After one (1) year and four (4) months of mounted Ilizarov frame, the patient was in full free movement of knee and hip. He had no problem during walking even running. Conclusion: We pursue for the treatment, accordion maneuver with Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection kept plate in situ. Few authors reported, Accordion Maneuver (AM) techniques with Ilizarov apply over intramedullary nail (IMN) in situ for aseptic non-union of femur. In this study, we discussed the role of this tool (AM) for the treatment of femoral shaft non-union and re-fracture with quiescent infection place plate (DCP) in situ.
Giant ossifying fibroma of the mandible treated with en bloc resection and reconstruction plate placement in pediatric patient: case report and literature review
Authors: Guifarro Juan José , Díaz Francisco , Umanzor Vilma , Gabriel Mario
Published: March 2023

Ossifying Fibroma is a benign fibro-osseous tumor, but osteolytic and invasive, as well as being a rare lesion. It manifests itself more frequently in the mandible than in the upper jaw, being located preferably in the molar (52%) or premolar (25%) region. It is most commonly diagnosed in women (5:1) between the 3rd and 4th decades of life. It is related to other pathologies such as bone dysplasia, florid cement-osseous dysplasia, among others. This lesion was called a tumor by the World Health Organization (WHO) in 1992 in its classification of Odontogenic tumors, because its possible etiopathogenesis is due to periodontal ligament cells. In 2003, the WHO called it a single entity, classified like a bone tumor. The following case that is presented is about a pediatric patient with a diagnosis of Ossifying Fibroma in the mandibular area of large size, which was treated surgically with an en bloc resection of the affected area due to the great extension of the lesion and the compromised tissue. and literature review.
Literature review of biomechanics of the ankle/ foot complex: changes in functional activities postoperatively for ankle fractures
Authors: de Ávila Viviane Ribeiro
Published: March 2023

The ankle plays an important role in daily life under the functional point of view. It is essential to perform basic movements such as walking, running, etc. The ankle joint complex is a part of the body most frequently injured of the musculoskeletal system. Orthopedic fractures in this joint may be classified as low trauma and high energy, the latter trauma, usually found in traffic accidents and falls from great heights are the most disabling. In the general context often this type of fracture compromises neighboring joints due to misalignment of the loading axis of the involved segment, emerging pain and progressive functional disability. In this context, this study aimed to review the literature of studies that were willing to analyze the biomechanical causes of the functional outcome of fractures of the complex orthopedic foot/ankle trauma generated by high and low energy. For this, a search was made in electronic databases indexing scientific articles, using the keyword search previously created. For better understanding we divided the literature review on topics: classification of ankle fractures, surgical treatment, no surgical indications and contraindications in cases of surgery, types of surgery with open reduction and internal fixation (ORIF), external and hybrid; wounds and complications consequences: amputation, obesity, arthritis and osteoarthritis, early motion, range of motion, gait pathology. From this review study, it is necessary that other publications in the field of physical therapy related biomechanical results of ankle fractures are carried out, since most studies were found in articles reporting on the medical surgeries.
Magnitude and associated factors of acute post streptococcal glomerulonepheritis among pediatric patients in aksum public hospitals, tigray, Ethiopia
Authors: Berhane Alema Haileselasie , Alem Amanuel , Gebremedhin Meresa , Birhane Tadis , Mengstu Abraham
Published: March 2023

Objective: Acute post streptococcus glomerulonephritis is reported from all over the world with higher rates among children than in adults. The objective of this study was to assess the magnitude and associate factors of acute post streptococcal glomerulonephritis among pediatric patients in Aksum city public hospitals, Tigray, Ethiopia. Methods: Institution based cross sectional study was conducted to retrieve data from 384 medical records of pediatric patients admitted to pediatric wards of Aksum city public hospitals between 2016 and 2018. The collected data were entered in to SPSS version 21 database for analysis. Finally, multivariate logistic regression was employed to identify determinants of adverse birth outcome at P value<0.05. Results: Acute post streptococcal glomerulonephritis was diagnosed in 31.51% of pediatrics patients. Nutritional status [AOR=2.37, 95%CI (1.28–4.41)], previous history of sore throat and skin infection [AOR=7.23; 95%CI (1.12–46.50)], duration of sore throat infection [AOR=0.35; 95%CI (0.18–0.66)], and season of infection [AOR=9.93; 95%CI (4.78–20.62)] were factors significantly associated with the development of acute post streptococcal glomerulonephritis among children. Conclusion: There is high burden of acute poststreptococcal glomerulonephritis among pediatric age group patients in Aksum public hospitals. Focus should be given to the early diagnosis and treatment of streptococcal pharyngitis.