bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative Atrial Fibrillation is associated with long-term morTality in patients undergoing suRgical AortiC valvE Replacement
Authors: Farag Mohamed , Kiberu Yusuf , Reddy Ashwin , Shoaib Ahmad , Egred Mohaned , Krishnan Unni , Fares Mina , Peverell Marta i , Gorog Diana , Elmahdy Walid , Berman Marius , Osman Mohamed
Published: May 2021

Introduction Atrial fibrillation (AF) is frequent after any cardiac
surgery, but evidence suggests it may have no significant impact on
survival if sinus rhythm (SR) is effectively restored early after the
onset of the arrhythmia. In contrast, management of preoperative AF is
often overlooked during or after cardiac surgery despite several
proposed protocols. This study sought to evaluate the impact of
preoperative AF on mortality in patients undergoing isolated surgical
aortic valve replacement (AVR). Methods We performed a retrospective,
single-centre study involving 2,628 consecutive patients undergoing
elective, primary isolated surgical AVR from 2008 to 2018. A total of
268/ 2,628 patients (10.1%) exhibited AF before surgery. The effect of
preoperative AF on mortality was evaluated with univariate and
multivariate analyses. Results Short-term mortality was 0.8% and was
not different between preoperative AF and SR cohorts. Preoperative AF
was highly predictive of long-term mortality (median follow-up of 4
years [Q1-Q3 2-7]; HR: 2.24, 95% CI: 1.79-2.79, P<0.001),
and remained strongly and independently predictive after adjustment for
other risk factors (HR: 1.54, 95% CI: 1.21-1.96, P<0.001)
compared with preoperative SR. In propensity score-matched analysis, the
adjusted mortality risk was higher in the AF cohort (OR: 1.47, 95% CI:
1.04-1.99, P=0.03) compared with the SR cohort. Conclusions Preoperative
AF was independently predictive of long-term mortality in patients
undergoing isolated surgical AVR. It remains to be seen whether
concomitant surgery or other preoperative measures to correct AF may
impact long-term survival.
Theoretical and numerical investigation of the mode I delamination of composite laminate with uneven thickness
Authors: Pan Xiao , Jiang Yi , Li Mingjun
Published: May 2021

In this paper, a theoretical analysis model and two simulation methods
are applied to characterize the quasi-static and fatigue delamination of
composite laminate with uneven thicknesses. The test data of partially
reinforced double-cantilever beam (DCB) were used as benchmark to verify
the analysis model and simulation, and cohesive zone models (CZMs) and
virtual crack closure technique (VCCT) are used in simulation. It’s
shown that the partially reinforced DCB has a unique double-peak
load-displacement relationship, and produces instability development
during the delamination. By comparing the results of simulation and
experiment, it is found that the simulation based on the exponential CZM
can simulate the delamination process of partially reinforced DCB under
both quasi-static and fatigue loading; while VCCT method will generate a
straight delamination front edge in the area of reinforcement, and lost
the micro-damage of the previous loading step between load steps, and
result in an incorrect delamination behavior.
Neonatal outcomes after neuraminidase inhibitor use during pregnancy: a meta-analysis of cohort studies
Authors: Lian Jiangshan , Adilijiang Munire , Chang Caihua , Jiang Hai-yin , Zhang Yongping
Published: May 2021

AIM: Influenza infection poses a severe threat to pregnant mothers, and
antiviral treatment is recommended. However, the safety of
neuraminidase-inhibitor antiviral medications during pregnancy has not
been well described. METHODS: A systematic review and meta-analysis were
performed to evaluate the adverse neonatal outcomes associated with
exposure to neuraminidase inhibitors during pregnancy. The PubMed,
Embase, and Cochrane Library databases were searched to identify
potential studies for inclusion. RESULTS: Nine cohort studies that
estimated adverse neonatal outcomes associated with exposure to
neuraminidase-inhibitor medication during pregnancy were included.
Exposure to a neuraminidase inhibitor during pregnancy was not
associated with an increased risk of congenital malformation (odds ratio
[OR] 0.9, 95% confidence interval [CI] 0.72–1.12, P = 0.341),
low Apgar score (OR 0.96, 95% CI 0.77–1.2, P = 0.733), or preterm
birth (OR 0.99, 95% CI 0.89–1.09, P = 0.771) compared with no
exposure. However, exposure to a neuraminidase inhibitor was associated
with a reduced risk of low birth weight (OR 0.79, 95% CI 0.68–0.92, P
= 0.002) and giving birth to a small-for-gestational-age infant (OR
0.78, 95% CI 0.69–0.88, P < 0.001). Further analyses limited
to oseltamivir exposure were consistent with the overall results.
CONCLUSION: Exposure to neuraminidase-inhibitor medication during
pregnancy does not appear to be associated with adverse neonatal
outcomes. We recommend further studies to investigate this association,
which will help clinicians determine whether to prescribe a
neuraminidase inhibitor during pregnancy.
Development of the Swiss Database for Dosing Medicinal Products in Paediatrics
Authors: Tilen Romy , Panis Dalibor , Aeschbacher Samuel , Thomas Sabine , Meyerzuschwabidissen Henriette , Berger Christoph
Published: May 2021

In daily paediatrics, drugs are commonly used off-label, as they are not
approved for children. Approval is lacking because the required clinical
studies were limited to adults in the past. Without clinical studies,
evidence-based recommendations for drug use in children are limited. In
the meantime, paediatric regulation came into force where the approval
of new drugs requires clinical studies in children. Still, most of the
drugs currently prescribed to children are not yet covered by this new
regulation. Information on drug dosing in children can be found in
different handbooks, databases, and scientific publications but the
dosing recommendations can differ considerably. Accordingly, prescribing
medicines to children remains a challenge. To improve drug safety and
efficacy in children and assist the prescribers, stakeholders in Swiss
paediatrics started a pilot project, supported by the Federal Office of
Public Health, with the aim to create a database, providing healthcare
professionals with so called “harmonised” dosage recommendations based
on national consensus. A standardised process for dosage harmonisation
was defined, guided, and documented in an electronic tool, developed for
this purpose thereby integrating the latest available scientific
evidence and best clinical practice for optimal dosage recommendations.
As proof of principle, a total of 102 dosage recommendations for 30
different drugs have been nationally harmonised in the pilot phase
considering the current literature and the consent of the most
experienced national experts in the field. This approach paved the way
for unified national dosage recommendations for children.
Projecting the Incidence of Type 2 Diabetes–Related End-Stage Kidney Disease Until 2040: A Comparison Between the Effects of Diabetes Prevention and the Effects of Diabetes Treatment
Authors: Morton Jedidiah I. , McDonald Stephen P. , Salim Agus , Liew Danny , Shaw Jonathan E. , Magliano Dianna J.
Published: May 2021

OBJECTIVE

This study sought to examine the effects of two diabetes prevention approaches and of widespread use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) among people with diabetes on the future incidence of diabetes-related end-stage kidney disease (ESKD-D).

RESEARCH DESIGN AND METHODS

We developed a life table model to project the incidence of ESKD-D for type 2 diabetes in Australia until 2040. We projected incident ESKD-D under three separate scenarios: a large-scale lifestyle modification program for diabetes prevention; a population-wide sugar-sweetened beverage tax for diabetes prevention; and widespread use of SGLT2is among people with diabetes.

RESULTS

Assuming current trends, we projected that the annual incidence of ESKD-D will increase from 3.7 per 100,000 of the general population in 2014 to 5.7 by 2040. Incorporating the diabetes prevention approaches, we projected that the annual incidence of ESKD-D will be between 5.2 and 5.5 per 100,000 by 2040. When we modeled scenarios in which 50% and 70% of eligible people with diabetes were prescribed an SGLT2i, the annual incidence of ESKD-D by 2040 was projected to be 4.7 and 4.3 per 100,000, respectively. SGLT2is were projected to reduce the total number of incident ESKD-D cases between 2020 and 2040 by 12–21% compared with current trends, whereas diabetes prevention reduced cases by 1–3%.

CONCLUSIONS

It is likely that the number of people developing ESKD-D will increase over the coming decades, although widespread SGLT2i use will be effective at limiting this increase. Diabetes prevention will be crucial to prevent an ever-increasing burden of diabetes complications.
Penerapan Metode Discovery Learning Dengan Pendekatan Adiksimba Untuk Meningkatkan Ketrampilan Bertanya dan Hasil Belajar Pendidikan Kewarganegaraan
Authors: Kristini Elly
Published: May 2021

Keberhasilan proses pembelajaran sangat bergantung pada keaktivan siswa dan pemahaman siswa. Pemilihan metode pembelajaran yang tepat dapat menjadi kunci keberhasilan dalam suatu proses pembelajaran. Penelitian ini bertujuan untuk mengetahui efektivitas salah satu metode pembelajaran yaitu penerapan metode Discovery Learning dengan pendekatan teknik AdikSimba untuk meningkatkan ketrampilan bertanya siswa dan output hasil belajar siswa. Penelitian ini merupakan penelitian tindakan kelas. Korelasi antara ketrampilan bertanya siswa dengan nilai belajar siswa dianalisis dengan analisis statistic bivarat. Hasil penelitian menunjukan adanya korelasi positif antara frekuensi bertanya dengan hasil belajar siswa. Terdapat peningkatan rerata skor hasil belajar siswa dari 65.72 (Prasiklus), menjadi 70.76 (Siklus I), dan 81.24 (Siklus II). Terdapat perbedaan yang signifikan antara rerata skor hasil belajar siswa pada siklus II dibandingkan dengan prasiklus atau siklus I. Dapat disimpulkan bahwa penerapan metode pembelajaran Discovery Learning dengan pendekatan AdikSimba mampu meningkatkan ketrampilan bertanya siswa dan menghasilkan output berupa peningkatan skor belajar siswa.
HUBUNGAN ANTARA MOTIVASI BELAJAR DAN MINAT BACA SISWA DENGAN HASIL BELAJAR FISIKA SISWA KELAS VIII SMP PGRI 2 SEKAMPUNG
Authors: Kinasih Ayang , Mariana Erni
Published: May 2021

AbstractBerdasarkan hasil pengamatan di kelas yang telah dilakukan pada saat proses pembelajaran berlangsung banyak siswa yang mengobrol sendiri, tidak memperhatikan penjelasan guru pada saat pelajaran. Tujuan dari penelitian ini adalah untuk mengetahui Hubungan antara Motivasi Belajar dan Minat Baca Siswa dengan Hasil Belajar Fisika Siswa SMP PGRI 2 Sekampung semester genap tahun pelajaran 2020/2021. Jenis penelitian ini adalah Korelasi dengan subjek penelitian adalah siswa kelas VIIIc SMP PGRI 2 Sekampung yang terdiri dari 36 siswa sebagai sampel. Rancangan penelitian yang telah dilakukan dalam penelitian ini adalah penelitian yang bersifat kuantitatif. Hasil penelitian tersebut, maka dapat ditarik kesimpulan bahwa Ada hubungan yang signifikan antara motivasi belajar siswa dan minat baca siswa dengan hasil belajar fisika siswa. Hal ini terlihat pada fhit > fdaf bernilai positif artinya motivasi belajar dan minat baca siswa sebesar 33,3% dalam meningkatkan hasil belajar fisika siswa.
Analisis Tingkat Kepatuhan Wajib Pajak Umkm dalam Pelaporan SPT Tahunan Setelah Berlakunya PP No. 23 Tahun 2018 (Studi Pada KP2KP Baradatu)
Authors:   Universitas Lampung, Fania Lailani Gita , Yulianto Yulianto ,   Universitas Lampung, Hutagalung Simon Sumanjoyo ,   Universitas Lampung
Published: May 2021

Tax is the most source of financing for development in Indonesia. The tax reformation make policy and administration more comphrehensive by Directorate General of Taxes. The expectation of The tax reformation could be increase compliance of taxpayer. The rise of UMKM almost five years in District Way Kanan make Way Kanan has good potential in taxtation. In 2018 The governance has realeased regulation, it is PP No. 23 Th. 2018. The regulation about tariff reduction for UMKM, the rate reduction of 0,5%. Aim of this regulation is taxpayers get easier for do some taxation include to report tax return every year, to encourage taxpayers get into formal economics, and to give taxpayers a sense of justice. The research aim get to know how much tariff reduction influence toward to increase compliance of taxpayer about report the tax return in every year in District Way Kanan. The research applies quantitative approach and descriptive method. The research applies data collection technique by questionnaire, document, and observation. The data analysis technique by simple analysis tabulation, validy test, reliability test, normalitiy test, correlation test, determinasi coefficient test, simple linear regression test, and hypotheses test. The result of this study is that hypotheses of this study is accepted and be found how much influence tariff reduction influence toward to increase compliance of taxpayer about report the tax return in every year in District Way Kanan is 18,2%.
BESS Assisted Frequency Management for Black Start Process of Microgrid
Authors: Ahmed Mushfiqul , Khan Ferdous Irtiaz , Huq S. M. Ishraqul
Published: May 2021

This paper proposes a method for restoring the nominal frequency and improving the system recovery time using battery energy storage system (BESS) for an islanded microgrid (MG) which is operated by a black start unit (BSU). The frequency stability is controlled by varying the apparent power (MVA) rating of the BESS after simultaneously connecting with the BSU during the post fault scenarios. Simulations are performed on the IEEE Std. 399-1997 test MG using DIgSILENT PowerFactory. Results show that the nominal frequency of the system can be retained by connecting the BESS during the transient period and increasing the MVA rating up to a maximum value. Simulation results also show that with a higher distributed connection of the BESS units over the system, the frequency recovery time can be reduced.
Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2020(COVID-19) in Palestine: A Report of 200 Cases
Authors: Hjouj Mohammed , Smerat Sami , Samra Murad Abu , Sada Maram Ghassan , Alarab Azzam , Al Hroush Issa Sameeh , Al-Makhamreh Moath , Najjar Osama
Published: May 2021

Purpose: Prove that Computed Tomography (CT) is a more effective diagnostic tool for diagnosing Coronavirus Disease 2019 (COVID-19) in comparison with Reverse Transcription Polymerase Chain Reaction (RT-PCR) due to its higher sensitivity.

Methods and materials: A total of 200 cases that had records of chest CT scans and RT-PCR tests were collected from Palestinian governmental hospitals from September to November 2020.

Results: CT indicated COVID-19 in 62.5% of sample population (125 of 200) whereas RT-PCR indicated COVID-19 in 37.5% (75 of 200) cases. A P-value of 0.028 signifies the existence of a relationship between gender and CT sensitivity.

Conclusion: High resolution computed tomography (HRCT) of the chest is a more rapid, sensitive, and effective tool than the current gold standard (RT-PCR); therefore, should be considered a primary diagnostic method for COVID-19.
Impact of Divorce and Separation for the Women with Spinal Cord Injury in Community Reintegration
Authors: Taoheed Farjana , Haque Md. Obaidul , Nipa Shamima Islam , Husain Rakib , Hossain Muhammad Millat , Roy Apurbo , Ahmed Md. Shahoriar
Published: May 2021

Introduction: Marriage is a lawful agreement between a man and woman. They can share their rights and responsibilities under the provision of Law, whereas divorce or separation is dissolving these bonds between married couples. Among Spinal Cord Injury patients this divorce or separation rate is high in Bangladesh.

Objectives: The main aim of this study was to identify the impacts of divorce and separation for the women with spinal cord injury during community reintegration.

Methodology: This was a mixed-method-type of study where the participant’s demographics data were analyzed by quantitative analysis by using a standard developed questionnaire (CIQ-R) and semi-structured open ended questionnaire to explore the best possible feedback from the participants for maximum 25-minutes duration. The present study conducted with 39 women participants since July 2011 to June 2016 at the CRP. Data were analyzed by SPSS 20 version.

Result: Total community integration score was 12.03 and SD was ± 3.87. This score was significantly lower to compare other study for person with SCI. The mean and SD of home integration (2.89, ±1.53), social integration (3.74, ±1.16), productivity (3.12, ±1.81) and electronic social networking (2.54, ±1.86) scores were also lower than the other study. Age, education, occupation, religion, living area, monthly income, marriage before or after injury, duration of marriage, number of children, duration of divorce or separation, ASIA, neurological level was found to be significant predictors of divorce or separation. Four major themes were found in this study (1) Causes of divorce and separation (2) Impact on relationship with family member (3) Impact on social participation (4) Impact on productive activities. Regardless of all participants reported loss of autonomy and functional ability, loss of sex life, loss of self-identity, loss of intimacy within laws, loss of autonomy were the main causes of divorce and separation.

Conclusion: Participants scored low in total community integration was lower than compare to other. Suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals of women with divorce and separation with spinal cord injury in the community.
Commentary: Ethnocentric Considerations in the Allocation of Vaccines in Africa
Authors: Norman Ishmael D.
Published: May 2021

This paper suggests that, just as the world community is concerned with ‘vaccine nationalism’ in the acquisition and distribution of vaccines, it should also be concerned with ‘vaccine tribalism’ in the respective African nations. This call is made because, African nations do not have impressive records of ethical distribution and apportionment of scarce resources, be it the delivery of healthcare services, medical doctors, or the national wealth, jobs, and the siting of national projects. Ethnocentric considerations, cronyism, big-man-ism, power, often trump ethical values of beneficence, non-malfeasance, equity, and fairness.
Flawed Studies of SIMS’s Diagnostic Accuracy by Teams of Puente-López and Capilla Ramírez
Authors: Cernovsky Zack Z.
Published: May 2021

Background: The teams of Puente-López and Capilla Ramírez evaluated diagnostic accuracy of the Structured Inventory of Malingered Symptomatology (SIMS), a test often used to assess malingering by persons injured in motor vehicle accidents (MVAs). Yet all SIMS items represent legitimate medical symptoms, and more than 50% of them are those experienced by severely injured motorists, but they are fallaciously scored as indicative of malingering. Thus, more injured patients with more symptoms obtain higher SIMS scores for malingering. Method: The studies by Puente-López and by Capilla Ramírez were carried out on SIMS scores of injured motorists. The present article assesses the severity of their injuries, as documented by Puente-López and by Capilla Ramírez. Results and Discussion: The study by Capilla Ramírez’s team excluded patients with pathological results on physical examinations, or on X-Rays, EMG, and MRI: thus, only mildly injured motorists were included. The patients of Puente-López had signs of only a mild cervical whiplash. Almost none reported lower back pain or dizziness. Thus, both studies included patients with only mild symptoms that resulted in very low SIMS scores: they scored within the non-malingering range as defined by the SIMS manual. Their scores were below SIMS scores of healthy persons instructed to feign whiplash symptoms from an MVA. The teams of Capilla Ramírez and of Puente-López erroneously interpreted these results as demonstrating diagnostic accuracy of the SIMS for detection of malingering in injured motorists. Conclusions: The two studies of very mildly injured motorists fail to demonstrate “diagnostic accuracy of the SIMS” because the SIMS is mostly used by insurance contracted psychologists on more severely injured MVA patients (those with whiplash and post-concussion syndrome), i.e., those with more symptoms and thus, with higher SIMS scores that fallaciously classify them as “malingerers.”
Conservative Management of Isolated Proximal Traumatic Pancreatic Injury: A Case Report
Authors: Alsaifi Masoud , Alaraimi Badriya , Alkindy Ahmed
Published: May 2021

Background: Blunt traumatic pancreatic injuries are rare conditions in case of motor vehicle collision (MVC) and isolated injuries even rarer. Surgical approach is usually preferred in case of advanced pancreatic injuries. In this study we try to shed the light on the role of completely conservative approach in the management of a proximal pancreatic injury. 

Case Summary: A 19-year-old male patient presented to the ER three days following MVC with upper abdominal pain. Abdominal US showed free intraperitoneal fluids and laboratory results showed elevated total leukocyte count, serum amylase and lipase. CT showed transection at pancreatic head which was grade 5 with free intrabdominal fluids; hence isolated pancreatic injury was diagnosed. At that point, the patient was hemodynamically stable and conservative management was implemented. He was admitted in the ICU for three days followed by 28 days in the ward where patient condition was closely monitored on daily bases.  Serial interval imaging showed spontaneous resolution of the intraperitoneal collection together with improvement of the injury, respectively. After completing his course, the patient was discharged and monitored as an outpatient.

Conclusion: Conservative treatment can be adopted in patients with proximal pancreatic injuries with complete duct disruption in otherwise hemodynamically stable patients.
Papillary Thyroid Carcinoma Occurring in Branchial Cleft Cyst: Case Report and Review of Literature
Authors: Tsung Swei H.
Published: May 2021

Ectopic thyroid tissue is ubiquitous in the body, most frequently seen at the base of tongue, accounting for approximately 95% of reported cases. Branchial cleft cyst, a congenital abnormality, can occasionally harbor thyroid tissue inside the cyst. These ectopic thyroid tissues can develop the same disease as the orthodox thyroid gland, including the malignant diseases. Papillary thyroid carcinoma arising in the branchial cleft cyst was extremely rare, total of only 14 cases were reported in the literature. Herein, I report additional case which was discovered incidentally after surgery.
HIV Exposure through Heterosexual Contacts: Analysis of Demographic, Behavioral and Structural Risk Factors among Black Men in Ottawa and Windsor, Ontario
Authors: Omorodion Francisca I. , Etowa Egbe B. , Ker Jelani , Ghose Bishwajit , Etowa Josephine
Published: May 2021

We determined the association of demographic, behavioral, and structural factors with risk of HIV exposure through heterosexual contact among Black men in Ottawa (n=210) and Windsor (n=156), Ontario. We applied hierarchical linear regression model in the analysis. Mean HIV exposure risk scores were Windsor (12.08±8.42) and Ottawa (17.16±11.80) in Ottawa (Scale = 48). Age, marriage, employment, masculinity, and condom attitudes were statistically significant (p <0.05). Age groups (15-29 years and 40-49 years), traditional masculine ideology, and negative condom attitudes associated with increased risk of HIV exposure by heterosexual contact. Marriage and full-time employment associated with reduced risk of exposure the ACB heterosexual men.
How Micro Current Created by Grounding Stimulates Meridian Points in Acupressure?
Authors: Khalid Madiha , Madvin Jeremy
Published: May 2021

Acupressure in Oriental medicine is used as a core therapeutic method due to its therapeutic efficacy and minimal side-effects. However, microcurrent stimulation, combined with acupressure and grounding, has not been studied under acupressure conditions in terms of how this combination might affect acupressure therapy's effectiveness. This paper clarifies the new concept of acupressure stimulation combined with a microcurrent that generates electron flow during earthing. In grounding the body, there is free electron movement from and to the body that creates microcurrent. Acupressure uses these currents to activate specific acupoints for therapeutic purposes and activating these acupoints adjust the imbalance between Qi across channels (meridians) and ultimately treat diseases. It is time for proper research and implementation of this technique to increase acupressure efficacy and reduce society's cost.
Existence and Implications of Women Who Have Sex with Women in Tanzania: A Public Health Perspective
Authors: Kamazima Switbert R. , Saronga Happiness P. , Mbishi Jackline V. , Bakar Saidah M. , Shabani Saumu K. , Stanslaus Beatrice R.
Published: May 2021

Women who engage in sexual activities with other women are known existing in all societies around the globe. However, the understanding of the size, trends and implications of female same sex behaviors and practices is generally lacking and vary within and among many countries including Tanzania. As a result, there is limited understanding of the public health importance of this group, which is often cited as the reason for not investing in work targeted at women who have sex with women and other minority groups in the country. It is from this perspective, that we conducted a formative qualitative study that aimed at, among other objectives, to establish the existence of women who have sex with women and the magnitude of female same sex behaviors and practices in Tanzania using a case study of the Dar-es-Salaam administrative region. Our findings prove that women who have sex with women exist mainly in urban areas in the country and for several reasons, their number is perceived rapidly increasing. We recommend further multidisciplinary (public health) research among women who have sex with women in the country to facilitate the availability of comprehensive and informative data on this population group.
Frequency of Formication Symptoms in Injured Motorists and in Normal Controls
Authors: Cernovsky Zack Z. , Velamoor Varadaraj R. , Mann Stephan C. , Oyewumi L. Kola , Mendonça James D. , Litman Larry C.
Published: May 2021

Background: Formication is the sensation or feeling as if insects were crawling on or under the skin. It is observed in a variety of clinical situations including drug intoxications, multiple sclerosis, and diabetic neuropathy, among many others. Furthermore, it can be associated with injuries incurred during motor vehicle accidents (MVAs). We examined the frequency of reports of formication in a normal control sample as well as in a sample of motorists who sustained concussive and whiplash injuries following high impact MVAs. We also evaluated the correlations of the formication to measures of pain, insomnia, and of various post-accident neuropsychological symptoms. Method: De-identified data on 23 injured motorists (mean age=38.0 years, SD=12.8) and on 20 normal controls (mean age 42.8 years, SD=19.9) were available. All motorists responded to the following True/False item: “I have pain in my body which seems to feel like bugs crawling under the surface of my skin.” Their data were also available on the Brief Pain Inventory, Post-MVA Neurological Symptoms (PMNS) scale, Insomnia Severity Index, and on the Rivermead Post-Concussion Symptoms Questionnaire. The data of normal controls included responses to the following specific item of the formication questionnaire: “Do you sometimes have an annoying feeling in some of your limbs or in some other part of your body as if insects were crawling on or under your skin?” The participants were to circle one of the following responses: “never, very rarely, sometimes, often, or almost constantly.” Results and Discussion: Almost a third (30.4%) of the motorists who sustained whiplash trauma in their MVA reported the formication. In contrast, only one of the 20 normal controls (i.e., 5%) reported formication (this was an elderly man with MRI documented pathology in lumbosacral spine). Notably, formication correlated significantly with the ratings of “reduced feeling in the limbs” (r=.55, p=.010), but not with ratings of “tingling in the limbs” (r=.21, p>.05). Conclusion: The painful form of formication has been reported by almost a third of motorists who sustained whiplash injuries in their accident.
Effects of Baby Massage in Reducing Body Temperature after Combined Diptheri Pertussis Tetanus/Hepatitis B Immunization
Authors: Meliati Linda , Ekayani Ni Putu Karunia , Suwanti .
Published: May 2021

Background: Side effects that may often occur after immunization include fever in infants after to combined Diptheri Pertusis Tetanus/Hepatitis B (DPT/HB) vaccine. Fever in infants or toddlers is a case that cannot be ignored because it can interfere with the comfort and development of infants and toddlers.

Objectives: This research aims to analyze the effects of baby massage in lowering body temperature among babies given combined DPT/HB immunization.

Material and Methods: It is a quasi-experiment using one intervention group. The population and sample are babies aged 2-5 months visiting the Work Area of Puskesmas Lombok Barat in Indonesia that meet inclusion criteria. Baby massage was administered in the morning and in the afternoon for 5 days, with the first 2 days prior to combined DPT/HB immunization 1, the second 1 day at the time of immunization, and the last 2 days after immunization. The same treatment was also carried out for combined DPT/HB immunization 2. Prior and after massage, baby temperatures were measured at the axila using a digital thermometer, with the results put in an observation sheet (graph). Body temperature measurement was observed for 2 months. Data gathered were then tested using non-parametric test (Wilcoxon).

Results: there is reduction in body temperature among babies given combined DPT/HB immunization 1 and combined DPT/HB immunization 2. Babies given combined DPT/HB immunization 1 had average body temperature of 0,2±0.18 °C in the morning and 0,21±0.25 °C in the afternoon. Meanwhile, babies given combined DPT/HB immunization 2 had average body temperature of 0,26±0.19 °C in the morning and 0,2±0.23 °C in the afternoon. Effect of massage in reducing body temperature among babies given combined DPT/HB immunization 1 is at (p<0.005) and at (p<0.005) for combined DPT/HB immunization 2.

Conclusion: massage can be performed before or after babies are immunized with combined DPT/HB to lower their body temperature.
Spontaneous Retropharyngeal Space Hematoma: How to Manage?
Authors: Lakhdar Y. , Elazizi D. Berrada , Elbouderkaoui M. , Rochdi Y. , Raji A.
Published: May 2021

Introduction: Spontaneous Retropharyngeal Hematoma (SRH) is a rare affection which occurs without traumatism.

Case report: A 68 years old woman brought to the emergency department with a cervico-thoracic swelling rapidly increasing in size without any previous traumatic history or anticoagulant medication. Complicated by dysphagia and dysphonia without signs of dyspnea. The clinical examination revealed a painful anterior cervico-thoracic swelling with an ecchymotic cupboard on it. Cervico-thoracic CT scan found a voluminous retro-pharyngeal collection, spontaneously hyperdense, extended to the oropharynx and antero-superior mediastinum without further lesions. Biological assessment was without abnormalities. The diagnosis of retropharyngeal hematoma was retained. The treatment was based on corticosteroids and antibiotics drugs with strict clinical and radiological monitoring. With conservative treatment, the evolution was favorable, marked by progressive regression of the hematoma until its disappearance and an absence of recurrence after a retreat of one year.

Conclusion: The clinical presentation of a retropharyngeal hematoma out of an evocative context is misleading and lead to radiological investigation without delaying the treatment which varies from supervision to surgery according to respiratory status and evolution under strict control.
Rare Case Report of Primary Gastric Melanoma
Authors: Ashwini K. T. , Mahesh Deepa , Sandeep M. S.
Published: May 2021

Gastric melanomas are usually metastatic, and primary is almost rare entity.

Present case is a rare malignant melanoma of the gastric region with barely reported cases in the literature. A 65 year old male presented with pain abdomen and melena He was evaluated with relevant investigation. UGI endoscopy and PETCT shows large polypoidal irregular gastric mass in the proximal curvature extending upto gastroesophageal junction. Endoscopic biopsy a ulcero-infiltrating tumour, Individual cells are large, round, having moderately pleomorphic, hyperchromatic nuclei with prominent eosinophilic nucleoli and moderate eosinophilic cytoplasm. Immunohistochemistry of S100 and HMB45 was positive and negative for CK7 and CK20.

Early diagnosis of primary gastric melanoma allows for better prognosis of the patient from the right intervention.
Retroperitoneal Hodgkin Lymphoma with Giant Renal Cyst: Case Report
Authors: Lachhab H. , Moudlige H. , Waffar C. , Moataz A. , Dakir M. , Debbagh A. , Aboutaieb R.
Published: May 2021

Detection of Hodgkin’s lymphoma at earlier stages increases the chances of successful chemotherapy treatment. Retroperitoneal localization makes the diagnosis difficult, which can delay treatment. we report here the case of 65-year-old patient presenting right lumbar pain for 2 years, who was admitted for surgical exploration of a fluid retroperitoneal mass, after an inconclusive CT-guided biopsy and a surgical biopsy showing reactive lymph node tissue remodeled without tumor element. after operating the patient, the pre-cellar lymph node dissection concluded with classic Hodgkin lymphoma.
Vitamin D Deficiency in the Elderly Patients and Role of Vitamin D in the Prevention of COVID-19 Infection
Authors: Khan Nauman , Tahmina .
Published: May 2021

SARS Covid'19 is declared as a global pandemic by World Health Organization [1]. The aim of this short report is to find out the association of Vitamin D in prevention of Covid'19 in elderly patients who are already having other co-morbidities. People of any age are susceptible to Corona virus but the elderly patients and patients with chronic underlying diseases are at higher risk. Many elderly patients with COVID-19 are at risk of mal-nutrition [2].

Vitamins are of two types, Lipid soluble vitamins and water-soluble vitamins [3]. Lipid soluble vitamins can be stored in the body while water soluble vitamins cannot be stored in the body, hence needed to take regularly [4]. Vitamin D is a lipid soluble vitamin also it can be synthesized by our own body.
Safety and Efficacy of Bivalirudin in Diabetic Acute Coronary Syndrome (ACS) Patients Undergoing Percutaneous Coronary Intervention (PCI)
Authors: Golam Mostofa A.B.M. , Parvin Tanjima , Mandal Mohammad Rayhan Masum , Afrin Rawnak , Ahsan Syed Ali
Published: May 2021

Objective: To determine and compare the incidence of in-hospital and 30-day hemorrhagic complications and major adverse cardiac events (MACEs) as evidence of safety and efficacy using Bivalirudin versus Heparin in diabetic acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) in a tertiary care cardiac hospital.

Background: Prevention of hemorrhagic complications has emerged as a priority in patients undergoing PCI in addition to suppressing thrombotic complications. This goal is challenging to achieve in diabetic ACS patients as DM itself is a prothrombotic state with more pronounced vascular injury response and have a worse outcome after PCI compared with non-diabetic patients. In patients with ACS, Bivalirudin has been shown to result in similar rates of composite ischemia as Heparin plus GPI (GP IIb /IIIa inhibitor), while significantly reducing major bleeding and has received class I recommendation for PCI. Whether Bivalirudin is safe and effective in diabetic ACS patients undergoing PCI, as compared with Heparin (UFH) monotherapy, is unknown.

Methods: 218 diabetic ACS patients (age>18 years and ≤ 75 years) who underwent PCI from May 2018 to April 2019 at UCC, BSMMU, Dhaka, Bangladesh were randomly assigned to have UFH or Bivalirudin. Before the guide wire crossed the lesion, 111 patients in the UFH group received a bolus of 70-100 U/kg (targeted activated clotting time, ACT: 200-250 s). 107 patients in the Bivalirudin group received a loading dose of 0.75 mg/kg, followed by an infusion of 1.75 mg/kg/h for up to 4 hours. Dual antiplatelet (DAPT) loading as Aspirin 300 mg plus P2Y12 inhibitors (Clopidogrel 600 mg or Prasugrel 60 mg or Ticagrelor 180 mg) was given in all patients before the procedure. The maintenance dose of DAPT was continued for at least one month and patients were followed telephonically up to 30 days. The outcome measures were in-hospital and 30-day hemorrhagic complications and MACEs [death, MI, target vessel revascularization (TVR) and stroke].

Results: Patients treated with Bivalirudin compared with Heparin had a significantly lower in-hospital incidence of QMI (0% vs. 6%; p=0.03) and major bleeding (0% vs. 7%; p=0.02). However, the incidence of cardiac death, stent thrombosis, TVR were no differences between the groups (p>0.05). There was only one NQMI in the Bivalirudin group as opposed to 8% in the Heparin group in 30 days following stenting (p=0.04). No other adverse effects were found significantly different between groups in 30 days of PCI.

Conclusion: In this small scale, prospective, randomized controlled study of diabetic ACS patients undergoing PCI in a single center showed that Bivalirudin is safe and effective as it reduces immediate and short-term hemorrhagic complications as well as MACEs as compared with Heparin.
High Salt Diet Blunted Baroreflex Sensitivity (BRS) to Bilateral Common Carotid Artery Occlusion (BCCO) in Male Sprague –Dawley Rats – Permissive Effect of Testosterone
Authors: Oloyo A. K. , Elias S. O. , Tom S. N. , Ezemadu D. C. , Ismail-Badmus K. B. , Sofola O. A.
Published: May 2021

Autonomic dysfunction is involved in the onset of salt-sensitive hypertension as baroreflex sensitivity (BRS) is blunted in salt-sensitive hypertension. However, salt sensitivity exhibits sex disparity because in salt-sensitive hypertension, blood pressure (BP) is usually higher in males when compared with females. The mechanism(s) underlying this sexual dimorphism is not clear. We, therefore, designed this study to determine BRS in weanling male Sprague – Dawley rats that were either bilaterally orchidectomized or sham-operated (under ketamine and xylazine anaesthesia (90 mg and 10 mg/kg/body weight i.m) respectively, with or without testosterone replacement (10 mg/kg sustanon 250® i.m once in 3 weeks) and were placed on normal (0.3%) or high (8%) NaCl diet for 6 weeks. Blood pressure (BP) and heart rate (HR) were measured via arterial cannulation under urethane and α-chloralose anesthesia (5 ml/kg body weight i.p). BRS was determined as change in HR per unit change in BP in response to 30 seconds bilateral common carotid artery occlusion (BCCO). Serum concentration of testosterone was measured using enzyme-linked immunosorbent assay (ELISA). High salt diet (HSD) increased both the basal BP and peak BP after BCCO when compared with control. Orchidectomy attenuated but testosterone replacement restored the elevated BP in rats fed HSD. HSD blunted BRS to BCCO. However, this effect of HSD was lost in the absence of testosterone as there was no significant difference in BRS between rat fed a normal or high salt diet. Our results suggest that blunting of the BRS may be one of the mechanisms by which testosterone promotes salt-induced hypertension and serves as one of the bases for sex disparity in salt-sensitive hypertension.
Neuropsychological Correlates and Frequency of Tinnitus in Patients Injured in Motor Vehicle Accidents
Authors: Cernovsky Zack Z. , Mann Stephan C. , Velamoor Varadaraj R.
Published: May 2021

Background: There is a lack of data on the frequency and neuropsychological correlates of tinnitus in distinct clinical populations such as persons injured in high impact motor vehicle accidents (MVAs).

Method: Tinnitus severity and frequency were analyzed statistically in de-identified data of 106 post-MVA patients (mean age=39.5, SD=13.1; 31 males and 75 females). Correlations of tinnitus to the patients’ scores on the Rivermead Post-Concussion Symptoms Questionnaire, Subjective Neuropsychological Symptoms Scale (SNPSS), Brief Pain Inventory, Insomnia Severity Index, PTSD measure (PCL-5), and to ratings of depression, anger, and anxiety on the Whiplash Disability Questionnaire were evaluated. The patients were interviewed an average of 53.6weeks (SD=39.9) after their MVA; all continued to suffer from post-MVA symptoms requiring therapy.

Results: Tinnitus was reported by 70 of the 106 post-MVA patients (66%). Slightly less than a half of the 70 rated their tinnitus as “frequent” or “persistent” and slightly more than a half as “occasional.”

With respect to Rivermead and SNPSS items, the severity and frequency of tinnitus correlated significantly (at p<.01, 2-tailed) with oversensitivity to light, restlessness, word finding difficulty, hand tremor, stutter, and instances of reduced muscular control over hand or arm (rs ranging from .28 to .37). Tinnitus severity correlated also with tingling in the limbs (r=.31), and with impaired balance (r=.28). Tinnitus frequency correlated also with difficulty articulating words (r=.28). Tinnitus also significantly correlated with ratings of pain and of insomnia (rs ranging from .26 to .32), but not with variables such as PTSD, depression, or anxiety.

Discussion and Conclusions: Tinnitus is correlated with some aspects of whiplash trauma and the post-concussion syndrome. However, the size of these relationships is rather weak.
Comparative Stereological Analysis of Intracranial Volume fractions among Patients with Brain Atrophy and Normal Pressure Hydrocephalus from a Nigerian Population
Authors: Abba Mohammed , Ugwu Anthony Chukwuka , Asomugha Azuoma L. , Ismail Hassan
Published: May 2021

Background: Differentiation between symptoms of normal pressure hydrocephalus (NPH) and other neurodegenerative disorders such as Brain Atrophy (BA) are usually confusing. Available diagnostic methods are invasive while the few non-invasive methods did not take care of potential factors known to influence intracranial volumes. We, therefore, aim to determine and compare the intracranial volume fractions among patients with NPH and BA.

Methods: This was a prospective, cross-sectional age-matched control study among consenting patients that were diagnosed with NPH, BA and healthy control in Aminu Kano Teaching Hospital from March 2018 to November 2020. Each patient was routinely examined with CT-Scan; However, control participants were from other reasons. Participants with a medical history known to influence the intracranial volume were excluded. Volume estimation was based on a stereological Cavalieri method and three volume fractions were determined mathematically for each of the group. Test-point computing was facilitated through a locally developed software (voXas_2018). Ethical approval was sort prior to the study.

Results: Patients with NPH have higher total CSF: brain ratio, intraventricular volume: brain ratio and extra-ventricular: brain ratio. Similar pattern was exhibited according to age grouping, except in the older age category where BA volume fractions were higher.

Conclusion: Age, gender and statue are known to influence intracranial volumes. We controlled their potential effects through age-matched control of participants between groups and the use of intracranial volume ratios for objective diagnosis of NPH and BA. However, Tcsf:Br and InV:Br volume fraction ratios were found to be reliable indices for distinguishing patients with NPH and BA.
Acute Retinal Necrosis (ARN): Time is Retina (A Case Study)
Authors: Akioud W. , Abdellaoui T. , Elkhouyali A. , Elasri F. , Mozari Y. , Reda K. , Oubaaz A.
Published: May 2021

Acute retinal necrosis (ARN) is an inflammatory condition characterized by a peripheral retinal necrosis due to an infection with varicella-zoster virus or herpes simplex virus. It is commonly seen in immunocompetent adults and is known for its rapid evolution and poor prognosis. Our case study illustrates the gravity of this condition with an extremely rapid ARN that was hard to diagnose.
COVID-19 in Kerala: Health Index Theory
Authors: Shervani Zameer
Published: May 2021

The recent surge in COVID-19 cases in the state of Kerala in India has been studied in this article. The dynamics of virus spread, sero-survey results, health index, and herd immunity concept have been applied. Kerala, with the highest score on the health index among all the states of India, is most susceptible to the SARS-CoV-2 virus. Kerala has nearly the same number of cases as Germany. The “Health Index Theory” established in this review article first has explained well the surge in the cases. Briefly, the concept of COVID-19 herd immunity has also been tested first.
A Rare Case of Synchronous Ovarian Adenocarcinoma and Squamous Cell Carcinoma of Cervix
Authors: Nadarajan Logeswary , Oo Lee Saw J , Nusee Zalina
Published: May 2021

Synchronous tumours of gynaecological malignancies occur rarely and most of these cases are represented by synchronous ovarian and endometrial cancer. Synchronous malignancies of cervix and ovary are rare with poor prognosis. Only few cases of synchronous cancer of cervix and ovary are found in the literature as case reports. Here, we report a case of a 63 year old patient who was diagnosed with synchronous squamous cell carcinoma of cervix and high grade serous carcinoma of ovary in which her clinical presentation, investigation and intraoperative findings were atypical. Patient presented with postmenopausal bleeding and mass per abdomen. Pipelle sampling revealed squamous cell carcinoma of cervix. Examination under anaesthesia noted endocervical growth measuring 3×4 cm with endoluminal extension into the whole endometrial cavity. Computerized tomography (CT) imaging showed left ovarian mass measuring 10.0×11.7 cm. Uterine corpus involvement in this case mislead us to the initial diagnosis of ovarian metastasis in cervical cancer. The distinct histopathological features of the ovary, cervix and endometrial lesion post operatively helped in establishing the diagnosis of two separate primaries which was synchronous cervical and ovarian cancer rather than metastatic spread of one primary malignancy.
Subliminal Messages – Unconsciuosly Perceived Sensations and Study Research on Subliminal Knowledge
Authors: Tanasic Branislav R.
Published: May 2021

Some content can be so well crafted that consumers are not aware that they are actually part of the promotion activity. The message is concealed, transformed, and communicates with consumers with associative connections at the subconscious level. Subconscious communication is a technique that marketers will use more and more, so in the design and realization of promotional activities, they combine the knowledge of other sciences and the latest technological inventions. Subconscious communication is often far more effective than direct addressing, provoking, and causing the desired effect, sometimes completely contrary to what the content posted seems to indicate. Content placed so as to address consumers at the subconscious level is called subliminal messages or subliminal. Very weak signals, stimuli below the threshold of conscious perception are not registered consciously. It is especially important to note that reason cannot resist this type of message because it is not recognized, it is circumvented even in the stage of stimulus. This is the main danger of subliminal messages; bypassing reasoning insert direct information in a mind that cannot be confronted. This is a very unusual method of manipulative persuasion technique for individuals and the masses exposed to the effects of subliminal marketing.