bluuebunny/crossref_metadata_2025 huggingface dataset:
Private Telecommunication Companies and Climate Finance: Evidence from the Niger Republic
Authors: Abdoul-Azize Hamidou Taffa , Salé Ali , Soulé Moussa
Published: January 2022

Recently, the number of private telecommunication companies is increasing in the West African region. These private companies could be key actors in financing climate actions in their operating countries. Yet, the contribution of private telecommunication companies in financing climate actions in West African countries is not well documented. Accordingly, this study aims to examine the contributions of private telecommunication companies in financing climate actions in the Niger Republic. This study is based on secondary data collected through a systematic review. The literature search was conducted through Web of Science, Google Scholar, and the blog pages of the websites of the key private telecommunication companies operating in the Niger Republic. The findings of the study showed that several climate actions were executed by the key private telecommunication companies operating in the Niger Republic. These included both climate adaptation and mitigation strategies that targeted to combat desertification, fight against youth unemployment, alleviate poverty, reduce population illiteracy, and reduce the exposure of the vulnerable groups to food insecurity. Consequently, an implementation of a comprehensive public-private strategy between the government and the private telecommunication actors to finance climate actions could significantly reinforce the effort of the country to achieve the United Nations Sustainable Development Goals.
Association between Antidiabtic Medications and Worsening of Parkinson’s Symptoms: A Case Report
Authors: Aldajani Ghaida , Alhossan Abdulaziz
Published: January 2022

Introduction: Parkinson's disease (PD) is one of the most prevalent neurologic disorders, leading to progressive disability; it is characterized by tremors, slow movements, stiffness in arms and legs, and balance impairment; PD symptoms can be slowed but not stopped by treatment such as a combination of Carbidopa/ Levodopa. Although it's widely used for PD, it risks dyskinesia, orthostatic hypotension, and dizziness. The prevalence of PD in Saudi Arabia has been estimated to be 27 per 100,000 populations, and the occurrence of PD in the U.S. is approximately 20 cases per 100,000 people per year.

 Case presentation: A 61 years old male presented with worsening PD symptoms, especially dysarthria symptom; he had a history of diabetes with A1C of 8.5%, on metformin, insulin glargine, liraglutide, and linagliptin, with good adherence, and he had a history of Parkinson on levodopa/carbidopa. Even there are no known drug-drug interactions between antidiabetic medication and levodopa/ carbidopa, he reported that coadministration of antidiabetic medications with levodopa/carbidopa cause PD symptoms worsening, especially dysarthria worsening. This drug-drug interaction was noticed when the patient tried to stop all of his antidiabetic medication except insulin mixtard, when he noticed dysarthria symptoms improved. He is currently on insulin mixtard for diabetes with an A1C of 6.7%. 

Conclusion: Unintentional drug-drug interaction poses a challenge to the healthcare provider, so this report highlights the importance of adverse drug-drug interaction of antidiabetic with levodopa/carbidopa, its presentation, and management.
A Rare Case of Adult-onset Still's Disease Revealed by Acute Myopericarditis
Authors: El-Adaoui A. , Benmalek R. , Choukrani H. , Errami A. , Habbal R.
Published: January 2022

Background: Still's disease in adults is a systemic inflammatory pathology of unknown aetiology, characterized by clinical manifestations associating feverish peaks, arthritis or arthtralgia, transient rashes and hyperferritinemia.

Currently, this disease remains a multisystemic disease with generally poor outcome, poorly described in the literature with very few studies unlike other rheumatic diseases, probably underdiagnosed due to its clinical polymorphism.

Cardiac forms are quite rare and among the manifestations described, pericarditis remains the most reported entity, myocardial involvement is exceptional.

The aim of our observation is to report an exceptional case of discovery of stille disease following a myo-pericarditis mimicking a coronary Sd initially.
Influence of Different Herbicide Based Weed Management Practices on Growth and Yield of Flue Cured Tobacco in Northern Light Soils of Andhra Pradesh, India
Authors: Uma Mahesh M. N. V. A. , Srinivasan K. , Chinnamuthu C. R. , Shanmugasundaram S. , Chandrasekhar C. N. , Srinivas P.
Published: January 2022

Flue cured tobacco requires clean and weed free environment and thereby reduce the competition for nutrients and moisture for achieving quick early season growth. Deploying effective weed management practices play a key role in achieving better yields and quality. Field experiments were conducted at Peddpauram village of West Godavari district (Andhra Pradesh) during (Rabi) seasons of 2018-19 and 2019-20, to study the effect of different herbicide based weed management practices on growth and yield of flue cured Tobacco crop. The experiment was performed as Randomized Block Design with 11 weed management practices replicated thrice. The results recorded on growth parameters, in both the years revealed that six inter cultivations with two manual removal of weeds significantly impacted plant height (113.5 cm and 114.4 cm) and leaf area index (2.63 and 2.83) at 90 DAT over Imazethapyr applied at 0.05 kg a.i ha-1. Number of leaves plant-1 were higher with six inter cultivation and two manual removal of weeds (21.5 and 20.6) over Imazethapyr 0.05 kg a.i ha-1. Inter cultivations and manual weeding resulted in significantly enhancing yield attributes such as leaf thickness (0.143 mm and 0.143 mm for cutters and 0.183 mm and 0.173 for leaf) and lower leaf count (Number of leaves kg-1) (137 and 129) over weedy check. Application of Sulfentrazone 0.03 kg a.i ha-1 was comparable with inter cultivation and manual weeding. Sulfentrazone 0.3 kg a.i ha-1 contributed for significantly higher yield (2302 kg ha-1 and 2424 kg ha-1) over weedy check and comparable with six inter cultivations and two manual weeding operations. The application of pre emergence herbicides like Pendimethalin, Alachlor and Oxyflurfen resulted achieving higher yield levels over the application of post emergence herbicides such as Quiazalofop-p-ethyl, Fenoxaprop ethyl, Carfentrazone ethyl and Imazethapyr during both years of experimentation.
Screening of Lentil Genotypes against Highly Aggressive Strain of Fusarium oxysporum f. sp. lentis
Authors: Tarannum Naila , Kumar Anil , Kumar Ravi Ranjan , Kumar Anand , Srivastva J. N. , De Nitish
Published: January 2022

Lentil is one of the most nutritious pulse crops known as masur and grown as a rainfed crop throughout the world in winter season. It is rich in protein, starch, micronutrients and dietary fiber. In the global scenario, India ranked first in the area and second in the production with Bihar being one the major lentil growing state. The majority of the lentil crop is grown in Tal area of the state. As it is cultivated as a rainfed crop, it gets severely affected by several biotic and abiotic stresses. Among the biotic stresses, Fusaium wilt, caused by Fusarium oxysporum f. sp. lentis (Fol) is one of the major fungal diseases and remarkably causing severe crop damage from vegetative to reproductive stage producing significant yield reduction. Fol isolate exhibit great variability and aggressiveness based on agro- climatic conditions. AGLF-11 isolate of Fol collected from Tal area of Bihar was found to be highly aggressive based on previous studies. For this, 50 diverse genotypes were screened against this isolate under greenhouse condition, out of which 14 genotypes showed high susceptibility, 29 genotypes showed moderate susceptibility, 5 genotypes exhibited moderately resistance and only 2 genotypes (L 7920 and DPL 58) exhibited resistance reaction.
Transmitted HIV-1 Drug-resistance Mutations among Newly Diagnosed Patients of the North Western Region of Cameroon
Authors: Abongwa Lem Edith , Torimiro Judith Ndongo , Nyamache Anthony Kebira , Okemo Paul , Tchapda Laure Arlette , Clauvis Yengo , Désire Takou , Charles Fokunang
Published: January 2022

Background: First line antiretroviral treatment (ART) regimens in Cameroon comprises of reverse transcriptase inhibitors (RTIs). As ART continues to expand, the emergence of HIV drug resistance mutations (DRMs) is a challenging problem. The ongoing scale up of ART in Cameroon has prompted the interest in surveillance of transmitted drug resistance (TDR).  The aim of this study was to evaluate the prevalence of TDR among drug naïve individuals residing in the North West Region (NWR) of Cameroon.

Methods: Ethics approval was obtained from the National Ethics Committee of Cameroon and patients informed consents were obtained. A total of 81 HIV-1 infected and drug naïve patients were recruited from randomly selected clinics located in the NWR of Cameroon from February 2016 and April 2016. HIV-1 protease-reverse transcriptase region was sequenced using an in-house protocol. HIV drug resistance mutations were identified and analyzed using Stanford HIVDR database and the Calibrated Population Resistance (CPR) tools. Data was analyzed using SPSS version 23.

Results: Of the 81 samples analyzed, the prevalence of TDR was 11.1% (9/81). Of these 9.9% (8/81) had drug resistance mutations to nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTIs and NNRTIs) and a single individual (1.2%) with protease inhibitors. A total of 8.6 % (7/81), 4.9(4/81), and 3.7 % (3/81) individuals had a major mutation to NRTIs, NNRTIs, and both NRTIs and NNRTIs respectively. Thymidine analogue mutations [TAM] (M41ML, D67N, K70T/R, T215TA/F, and K219Q) were detected in five individuals.  The most frequent NRTI and NNRTI DRMs were K219Q (n=2) and E138A (n=2) respectively. Mutations associated with NRTIs were TAM and M184MV; NNRTIs were A98G, K103N, V108I, V179E, and Y181C and I54IFV for PI. CPR tool revealed a 4.9% (4/81) prevalence with the following single mutations K103N D67N, K70R, M184V, T215F, K219Q.The difference between two methods was statistically significant p=0.0001. These mutations confer resistance to all NRTIs and NNRTIs drugs.

Conclusions: Although moderate transmitted drug resistance (11.1%) levels were detected in this study, this calls for routine drug resistance surveillance among patients on ART. This will ensure relative maintenance of low viral suppression amongst HIV patients.
Constraints Encountered by Wheat Producers in Adoption of Wheat Production Technology in Faizabad District of Uttar Pradesh, India
Authors: Islam Alimul , Alam Naushad , Kumar Avdhesh
Published: January 2022

Wheat is a major staple food crop; it is one of the major sources of protein in the least developed countries and middle-income countries and in terms of caloric and dietary intake. The present study was conducted to identify the constraints in the adoption of wheat production technology in the Masaudha and Sohawal community developments blocks of Faizabad district. Data were collected with the help of personal interview methods and a pre-trial interview schedule. One hundred and twenty respondents were selected from twelve villages that were selected at random. Findings showed that 52.5% of the wheat-growers were of middle age (36–50 years) and 53.33% were literate, while 22.5% of the respondents had received education up to the primary level. Agriculture was the main occupation of most of the respondents and the income level of the respondents was also low, while farmers met the respondents occasionally to increase their income and to learn new skills. So the results showed that the constraints were responsible for the low adoption of wheat production techniques, however, some of them were the most significant such as lack of seed technology, lack of knowledge about seed treatment, lack of knowledge about soil analysis technology, plant protection and Lack of knowledge about irrigation technology Lack of knowledge about advanced types of equipment, etc. This trend means that more educational effort needs to be made by the extension agency by way of improving knowledge, adopting new wheat farming techniques, and accelerating the pace of production.
A Case Report on 2 years Child: Hirschprung’s Disease
Authors: Kale Anushri , Badwaik Aditi , Dhulse Pallavi , Maurya Archana , Kurian Bibin
Published: January 2022

Introduction: Hirschsprung's disease is the most common cause of large intestinal obstructing in neonates. Hirschsprung's disease is a congenital anomaly caused by migratory failure of neural crest cells leading to abnormal innervations of the bowel .The defect begins in the internal and sphincter and extends proximally for a variable length of gut. Hirschprung's disease is a disorder of the gut caused due to congenital absence of ganglion cells in the sub-mucosal and myenteric plexus of intestine. This disease is also known as megacolon or congenital Aganglionic megacolon. Case presentation: A 2 years old male child, known case of Hirschprung’s disease, was brought to AVBRH for further management. As narrated by the mother, the child was not passing stool since birth. There was no history of abdominal distention, vomiting or fever. The child pass the stool with the help of enema which was given to the child in the morning and evening. Mast. Devansh has past history of NICU stay. In View of not passing stools, USG of abdomen and pelvis done. Endorectal pull through surgery was done on 4/02/2021 under general anesthesia. No any past surgical history. There is a past history of rectal biopsy done in 1 1/2 month of age. Conclusion:The patient was admitted in AVBRH for further management. Then the report mainly focused on surgical management and quality nursing care due to which patient was discharged without any further complication and satisfaction.
Handling of Medical Devices: Reforms and Regulations
Authors: Charmila M. , Venkatesh M. P. , Shree G. Ramya
Published: January 2022

With the evolving technology and changing regulations, the medical device sector is set to grow quickly soon. Even though they are an integral part of patient care they present several unique problems which are not sufficiently addressed by the device manufacturer or the medical community in general. Medical device is widely used by professionals in a clinical setup, by patients, family members at home. As step towards better understanding the rules, regulations, and the required reforms for the safe use of medical devices various measures taken by different regulatory authorities to ensure the minimization of use error are discussed. Human factor engineering and ergonomics are considered while designing a medical device. It is evident that all the stakeholders involved contribute to the safety of the medical device keeping in mind the welfare of the patient but is that enough and what can be done is discussed in this review work.
Review on Tauopathies: Clinicopathological Aspect
Authors: Kushwaha Sonaakshi , Wanjari Anil
Published: January 2022

A group of neurodegenerative diseases that differ in their morphology, biochemistry, and clinical presentation are Tauopathies. They are distinguished by aberrant tau protein accumulation in the brain. Currently, there is no conclusive method for preventing or curing tauopathies, but new scientific advancements have transformed this gloomy picture. Evidence from genetic research, experimental animal models, and molecular and cell biology has offered insight into the illnesses' underlying causes. Advances in radiology and biochemistry, notably in PET imaging, may offer critical biomarkers for clinical diagnosis and therapy. Tau, in addition to its role as a microtubule-associated tau protein, is involved in gene regulation, signal transduction, and metabolism. Experimental models allow for the development of novel diagnostic and treatment methods. Tauopathies are a set of disorders that can present with a wide range of clinical signs. It is still difficult to distinguish this disease from other protein-pathologies. In the last year, there has been a lot of interest in cerebrospinal fluid biomarkers and radiotracers. Although the accuracy of diagnosis in non-disease Alzheimer's tauopathies remains debatable, PET tau tracers may be utilised to identify disease process. Although primary tauopathies are uncommon and diverse conditions, their combined incidence, as well as the importance of tau malfunction in Alzheimer's disease and secondary tauopathies, make tauopathy research a top priority since it might assist many people.
Study of Prevalance of Nephropathy among Sickle Cell Disease Patients in Waghodia Region, Vadodara, Gujarat
Authors: Thakkar Charmi C. , Sailaja Inampudi
Published: January 2022

Introduction: Sickle-cell disease (or drepanocytosis) is a life-long blood disorder Characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickle cell disease (SCD) has several complications, including chronic renal failure, manifesting with hypertension (high blood pressure) proteinuria (protein loss in the urine), hematuria (redblood cells in urine) and worsening anaemia. Progression to end-stage renal failure confers a poor prognosis.

Objective: The objective of the study was to determine the Prevalence of Nephropathy among sickle cell disease patients.

Materials and Methods: This cross sectional study includes a total 150 participants who suffering from sickle cell anemia and attending our Institute. Renal function test and Urine examination of all participants was done. Estimated Glomerular Filtration Rate (eGFR) calculated using the Cockroft Gault formula. Comparison of results was done between Sickle cell trait and Sickle cell disease Group.

Results: The mean age of the SCA patients were 25.54±10 years. Maximum participants are found to be from age group 25-30 yr(n=35) followed by 20-25 yr(n=30). Of the 150 SCA patients, 89 (59.33%), and 61 (40.66%) were males and females, respectively. The Mean value of S.Creatinine of SCT group is 0.73±0.46 mg/dl and SCD is 1.0±0.35 mg/dl, while the Mean value of eGFR is 134.19±87.21 ml/min and 124.20 ±58.25 ml/min in SCT and SCD Group respectively.

Conclusions: From our study we conclude that the Derangement of Kidney function in sickle cell disease is frequent in our setting especially among young adult. It concerns SCD as well as SCT patients. Albuminuria is more frequent in homozygote patients and its prevalence increase with age. Age ≥ 25 years is associated with high risk of CKD in SCA group and albuminuria in SCD.
Vaccine Regulation, Licensing and Approval in USA
Authors: Shashank S. , Venkatesh M. P.
Published: January 2022

Vaccines are the foremost effective public and personal preventive health interventions, leading to vital reductions in vaccine-preventable diseases and in substantial price savings to the United States health care system. A vaccine is a biological preparation that will increase the immunity to a particular illness. Vaccine development is commonly found to be difficult and needs sharp understanding and information of recent developments by physicians and experts to confirm that safe and effective vaccines are manufactured with minimum risk. A strict regulative method to see the safety, efficacy, and quality should be achieved throughout the event of vaccine development for its authorization. The Office of Vaccines Research and Review at the CBER of the US-FDA is the federal administrative body charged with guaranteeing the safety, purity, and efficacy of vaccines within US. The licensing rules are published in the Title 21 CFR Part 60. Current authority for the regulation of vaccines is in Section 351(a) of the Public Health Service Act (PHS). Vaccine licensure, development of recommendations to be used, and implementation of these recommendations resulting in uptake, community protection, and result on illness burden represent a posh system that needs collaboration within the areas of basic science, public health, vaccine delivery and outcome observance, and public perception.
Herpes Zoster in Immunosuppressed Patients
Authors: Wadbudhe Akshad , Damke Smita
Published: January 2022

Herpes zoster (HZ) is a disease caused by the activation of the virus in the latent phase. The name of the virus is varicella-zoster virus (VZV). This virus remains in the dorsal root ganglia, the collection of neuronal cell bodies. It is known as reactivation because it is a secondary infection. The main or the old infection is chickenpox; it generally occurs in the early stages of life. This secondary infection is caused in the later stages of life in old age patients; if the patient is immunocompromised, this type of infection can cause death or make the patient unconscious. But in the world, many people have a variety of standard or uncommon signs and symptoms of this disease based on their body, diet, area, or even genetic features.

This Herpes Zoster acts on the immune response called cell-mediated immunity and decreases it rapidly with the advance of age of the person. In the coming years, the incidences of this disease are gradually increasing because of the weakening of the immune system. The incidences also happened in people with defective immunity of cell-mediated type or due to the abuse of certain drugs.

The herpes zoster is caused to the immunosuppressed patient more quickly than the average population. As there is no immune system to defend the body, some secondary infections can also be induced in these conditions and lead to death. This multiple infection can make a differential diagnosis.

This review explains and understands the herpes zoster virus causing different complications in the body and other clinical things related to immunocompromised patients.
Eradication of Helicobacter Pylori with Triple Therapy Comprising Probiotic & Proton Pump Inhibitor
Authors: Amjad Hina , Sundus Sadia , Ata-ur-Rehman . , Khan Kiran , Pasha Ghazala Nasim , Furqan Muhammad
Published: January 2022

Objectives: The current clinical trial compared the effects of conventional triple therapy and probiotic (Lactobacillus reuteri) plus omeprazole combination in peptic ulcer patients. The secondary objectives included estimating the effects of these regimens on safety and tolerability.

Study Design: Randomized clinical trial

Abode and Period of Study: This was a six month research study conducted at the National Medical Centre, Karachi, Pakistan in October 2020 – March 2021.

Materials & Methods: A total of 100 patients were recruited, had baseline positive stool antigen test. All the participants were separated into dual groups: conventional triple remedy (group A1) and probiotic with omeprazole combination (group B1). The study's primary endpoint was stool antigen assay and secondary included change in Hb, LFTs and renal function test.

Results: The primary endpoints for combination therapy led to significantly greater reductions in positive stool antigen assay than triple therapy. This means that combination therapy is far better than triple therapy. The stool antigen test showed 56.5% positive and 43.5% negative in group A1 while in group B1 34.8% positive while 65.2% negative after treatment were seen with statistically significant difference (p=0.036). Insignificant findings were observed for level of Hb, LFTs and renal function test between both groups during the entire study.

Conclusion: This is the first randomized clinical trial in peptic ulcer patients of Pakistan treated with probiotic plus omeprazole combination. Combination therapy was generally well-tolerated and effective in eradicating the Helicobacter pylori after initiation of therapy.
Evaluation of Anti-inflammatory and Antioxidant Effects of Punicalagin (Pomegranate Extract) on IL-1 Beta and Superoxide Dismutase Levels in Patients with Chronic Periodontitis – A Randomized Controlled Trial
Authors: Kumar Tamilselvan , Raja S. A. Jacob , James Johnson Raja , Sankar M. S. Ravi , Fairlin P. , Rajendhran Dhivya
Published: January 2022

Purpose: Pomegranates have been shown to possess anti-inflammatory and antioxidant properties. This study aimed to evaluate the effects of Punicalagin (Pomegranate extract) on IL-1β and SOD levels in chronic periodontitis patients.

Materials and Methods: 30 patients were included in the study. The sites were randomly divided into control site and test site. Control sites were treated with Scaling and Root Planing (SRP) alone and test sites were treated with punicalagin gel along with SRP. Clinical parameters such as probing pocket depth, Clinical Attachment Level (CAL), Gingival Index (GI), Plaque index (PI), Sulcus Bleeding Index (SBI) and biochemical markers such as IL-1β and Superoxide Dismutase levels were compared between baseline and at 21 days post therapy.

Results: Test sites showed significant differences when compared to control sites in relation to all clinical and biochemical parameters.

Conclusion: Within the limitations of this study, there is an improvement in the clinical parameters with an increase in the anti-oxidant marker level and a decrease in inflammatory marker level when punicalagin gel was placed along with Scaling and Root Planing in patients with Chronic Periodontitis.
Knowledge, Perception and Attitude of the Undergraduate Healthcare Students Relative to COVID-19 Infection at a Teaching Institute of Karachi
Authors: Rehman Ata Ur , Khan Kiran , Maheshwari Jai Dev , Bhatti Muhammad Aslam , Kainat . , Khan Kashmala
Published: January 2022

Coronavirus disease 2019 (COVID-19) has been declared a pandemic by the World Health Organization. Efforts are being made all over the world to raise awareness in order to prevent the disease from spreading. The purpose of this study was to assess undergraduate healthcare students' attitudes, perceptions, and knowledge of COVID-19 disease. We conducted a cross- sectional survey in which a questionnaire with 12 questions was transformed online on Google forms and distributed online to healthcare students. Data was collected between May and June of 2021. The convenience sampling technique was used, resulting in a sample size of 926 people. A total of 926 individual questionnaires were evaluated. The findings revealed that the majority of participants learned about COVID-19 through social media and electronic media, which was the most common source of information. The majority of participants stated that older and middle-aged people are more likely to be affected. The protective measure against symptomatic and asymptomatic COVID 19 is N95 and surgical masks, as well as sanitization.

Half of the participants believe that COVID 19 is a bioweapon, and that it affects all religious groups equally. In general, undergraduate healthcare students had a fair understanding of the disease and a favorable attitude toward preventive measures. The government and the public are taking effective measures to combat disease spread; however, there is still a need for additional awareness campaigns and knowledge of safe interventions to combat disease spread.
Therapeutic Role of Element Anhydrase Inhibitors in Treatment of Glaucoma: A Review
Authors: Kadu Akshata , Zilate Sarju
Published: January 2022

Eye disease may be a cluster of inveterately progressive disorders of the nervus opticus. during this article, I gift the medicine, Pathophysiology, risk factors, ophthalmic examination, and therapeutic role of carbonaceous anhydrase inhibitors in treating eye disease. In European countries, the prevalence of eye disease is a pair of.93% among persons aged 40-80 years, reaching ten you tired of persons over ninety years old-time. There is a unit many differing types of eye disease, and that they are classically divided into classes of open-angle and closed-angle eye disease. Use of topical selective or nonselective beta-blockers is used in the treatment of eye diseases. Second-line drugs of alternative embody alpha – agonists and topical carbonaceous anhydrase inhibitors. Parasympathomimetics drugs, most ordinarily alkaloid, area unit thought-about third-line treatment. For patients, the United Nations agency doesn't reply to antiglaucoma remedy, optical laser incisional and trabeculoplasty surgery area unit more ways that may be accustomed lower the pressure. The inhibitors area unit used medication in the treatment of symptom coronary failure, brain disease, and hypoxia conjointly. A Corollary of Friedenwald's construct of hydrogen carbonate secretion within the formation of liquid body substance is that inhibition of the protein carbonaceous anhydrase could be expected to decrease the speed of secretion and lower IOP. The carbonaceous anhydrase matter, Diamox (acetazolamide) is employed in the treatment of eye disease. Preliminary trials of Diamox in rabbits created a definite lowering of pressure to once ten to one hundred mg. carbonaceous anhydrase inhibitors diminish ocular high blood pressure in glaucomatous patients by reducing the hydrogen carbonate formation.
The Outpatient Prescribing Pattern of Sevelamer in Al Seih
Authors: Ahmed Nehad J. , Khan Mohd Faiyaz
Published: January 2022

Aim: The present study aimed to explore the outpatient prescribing pattern of sevelamer in Al Seih.

Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained sevelamer among outpatients in the city of Al Saih.

Results: During 2017 and 2018, 47 patients received sevelamer from the outpatient pharmacy in a public hospital in Alkharj. More than 23 % of the prescriptions were prescribed in January and about 21.28% of the prescriptions were prescribed in May. All of the prescriptions that contained sevelamer were prescribed for the duration of 1 month (100.00%), all of the sevelamer prescriptions were written by residents (100.00%) and all of the prescriptions were prescribed by nephrology department (100.00%). More than half of the patients who received sevelamer were females (60.00%). The age of about 90% of the patients who received sevelamer was more than 39 years.

Conclusion: The present study showed that the prescribing of sevelamer was uncommon in Al Seih. Further studies are required to investigate the pattern and the frequency of sevelamer in the outpatients setting and in other settings.
The Outcome of Cervical Spine Injury Associated with Traumatic Brain Injuries: Tertiary Care Hospital Study
Authors: Hassan Sher , Kalhoro Aurangzeb , Rehman Lal , Samad Abdul
Published: January 2022

Objective:  Outcome of cervical spine injury associated with traumatic brain injuries.

Materials & Methods: This study is a cross-sectional descriptive study that was performed at the Jinnah Post Graduate Medical Centre, Karachi. 158 total patients were included in the study, this study by non-probability consecutive sampling. The diagnosis was based primarily on a CT scan brain plain and an x-ray of the cervical spine of all the patients who were admitted to the ward.

Results: Among 158, the age distribution of the patient was observed as 43(27%)patients presented as less than 20 years, 32(20%) were between the age of 21-30 years range, 28(18%) patients were ranged between 31-40 years, 16(10%) patients aged in a range of 41-50 years while 39(25%) were above 50 years. Head injury severity was observed at 47% as mild head injury, 32% as moderate injury and 21% had a severe head injury while cervical injury in association with traumatic brain injury was found in 10% of patients.

Conclusion: The prevalence of cervical traumatic injury associated with moderate to severe head injury remained similar in the world overall with minute differences in the percentages that we have noticed in our study. The severity of the head injury is directly proportional to cervical injury.
Evaluation and Management of Mallory – Weiss Syndrome: A Review
Authors: Hussein Mohammed Salah , Alfaraj Fatimah Ali , Alshabwi Abdulrahman Dhafer , Altheyab Aljawhara Abdullah , Alhasan Khulood Tariq , Alghamdi Omar Mohammed , Ahmed Manal Abdulla Jaafar Saleh , Alamri Amal Ali , Alhabeeb Mohammed Tariq , Elsherif Abdelhalim A. , Zaki Lojain Saoud
Published: January 2022

Upper gastrointestinal bleeding is a symptom of Mallory-Weiss syndrome, which is caused by longitudinal mucosal lacerations (known as Mallory-Weiss tears) near the gastroesophageal junction or gastric cardia. Mallory-Weiss syndrome is rather prevalent, accounting for 3 to 10% of all upper gastrointestinal bleeding episodes. In mild circumstances, the disease may be asymptomatic. Hematemesis is the presenting symptom in 85 percent of patients. Blood is present in varying amounts, ranging from blood-streaked mucous to huge bright red haemorrhage. Other symptoms such as melena, dizziness, or syncope might occur as a result of heavy bleeding. The majority of the time, the bleeding is little and ends on its own. Endoscopy is frequently used to confirm the diagnosis of MWS. Although most patients may be treated with monitoring or conservative medicinal treatment, certain cases require endoscopic or surgical treatment. Despite the fact that MWS is a common cause of nonvariceal upper gastrointestinal bleeding (NVUGIB), little research has been done on it. This article discusses MWS Etiology, epidemiology, evaluation and management.
Incidence of Corneal Inflammation of Varying Severity among Contact Lens Wearers
Authors: Osmani Yusuf , Kela Krishna , Sune Mona
Published: January 2022

The human cornea is an avascular, transparent tissue that permits or allows light rays to enter or reach the retina. The cornea is made up of several layers, each of which plays an important role in preserving the transparency and power of cornea. The epithelium, Bowmans layer, Descemet’s membrane and endothelium are the layers of the cornea. This study aimed to discover the incidences of severe and non-severe corneal inflammation amongst wearers of modern technology touch lenses. Studies on touch lens users providing with a corneal ulcer/infiltrates were reported. On the basis of severity, a medical severity matrix was utilized among cases of severe and non-severe corneal inflammation. There was a large distinction in severe corneal infection among ew-hydrogel and ew-silicone hydrogel. When it comes to evaluating touch lens-related corneal inflammation, a medical severity matrix is available in hand. Wearers of contact lenses who sleep with them have a appreciably low risk of severe corneal inflammation than those who simplest  put on lenses for the duration of the day. Those cases who everyday sleep with lenses have a 5-fold lower risk of severe corneal inflammation as compared day-to-day hydrogel lenses for prolonged utilization.
The Outpatient Prescribing of Miconazole in a Tertiary Hospital in Riyadh Region
Authors: Ahmed Nehad Jaser , Yusufoglu Hasan Soliman
Published: January 2022

Aim: The present study aimed to describe the use of miconazole in the outpatient setting of a tertiary hospital in Riyadh Region.

Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained miconazole among patients in a public hospital in Riyadh Region.

Results: Most of the patients who received miconazole were females (89.29%) and the age of 51.79% of them was between 30 and 39 years. Most of the prescriptions were written by residents (96.43%) and most of the prescriptions were prescribed by emergency department (66.07%). Most of the patients received miconazole as vaginal suppository (50.00%) or as cream (39.29%).

Conclusion: The present study showed that miconazole was uncommonly prescribed in in Riyadh Region. Further studies are needed to explore the frequency and pattern of miconazole use as well as to explore the frequency of prescribing other antifungal medications in different settings.
A Recent Update on Oral Anticoagulants
Authors: Mishra Jijnasha , Deolia Shreem , Kumar Sunil
Published: January 2022

Atrial Fibrillation is very common among Americana; it is the irregular rhythm of the heart usually present with or without symptoms. It causes the formation of clots, clots go to the brain and cause a stroke. Anticoagulants have been known for a few decades to cause abrupt decrease around 50%) in the rate of stroke and prevent clotting at the required location and can cause bleeding. Anticoagulants aims for the safeguard and therapy of thromboembolism to prevent stroke. Previously used Anticoagulants are Warfarin, low molecular weight heparin and heparin. There were shortcoming of the drugs like parenteral route of administration, requires frequent monitoring due to variability in response, the onset of action is slow and there is bleeding in response to the drugs .In addition to heparin and vitamin k antagonist, anticoagulants that act on enzymatic agility or vigor brought about by of thrombin and factor Xa was exquisitely formulated. Implementation of the foresaid oral Anticoagulants requires knowledge of necessitate the comprehension of discrete indication, contraindications, characteristics. Research and repeated clinical trials have led to acceptance of few newer drugs which are working classically styled but better than Warfarin. In the last few years, Pradaxa (dabigatran), Xarelto (rivaroxaban), and Eliquis (dabigatran) have all been authorised by the FDA (apixaban). All three are ‘blood thinners,’ like warfarin, that lessen the overall risk of stroke associated with atrial fibrillation while also causing bleeding.
Point of View about Corona Pandemic: An Approach towards Health Perspectives
Authors: Singh Anmol , Sudame Bharat S.
Published: January 2022

It's been about a half year since there's been a word that's spread throughout the globe faster than wildfires, and it's not only the most talked-about topic, but also the most feared; yes, it's "crown." Hearing the word itself strikes dread in all individuals around the world. So what is this crown or COVID-19 truly? Coronavirus is an irresistible sickness brought about by the newfound strain of Covid, the SARS-CoV-2. Covid was accounted for from china in late December and early January from the province of Wuhan in China. Covid was found in the absolute most punctual known cases connected to Wuhan’s discount wet food market. The word crown got its fear of India on 30th January 2020 in Kerala. The patient was an understudy, concentrating in the city of source, and had returned to the nation because of the pandemic. Since January, this infection has been spreading and is accounted for everywhere in the world. Crown has become a dread that has not saved anybody from its effect. The everyday existence surprisingly around the globe has been affected since. This infection is a freak type of crown that is novel Covid covid19. Covid pandemic has instructed us that there are different exercises to be scholarly in the current pandemic circumstance. Crown has carried our thoughtfulness regarding how much progress should be around us. An alternate view and viewpoint have become known about our nation's current medical services plan. The establishment of medical care framework with medical services suppliers has come to stake. Ample opportunity has already passed that we investigate the current wellbeing administrations and strengthen them at the center level. Natural selection is one of the oldest adages in clinical research, and it has stayed consistent in situations like this. In the current circumstances, endurance has become an essential component.
Nomophobic Prevalence and Academic Achievement of Higher Secondary Students Practicing Blended Learning during COVID-19 Pandemic
Authors: Elias Jijish , Jayalakshmy P. M. , Jayaraman K. , Mirunalini M. , Paul Issac
Published: January 2022

Introduction: Smartphone usage for academic and non academic processes increased among the adolescent students, especially among Higher Secondary students. This increased usage developed a kind of addiction among them towards the smartphones and other mobile gadgets. The mode of delivering learning experiences also changed due to the pandemic and this makes the need of the current study.

Aim: To identify the smartphone addiction termed as nomophobia and academic achievement of higher secondary students during blended learning activities which known for the mixing of appropriate theories, methods and technologies to optimise learning in a particular context.

Materials and Methods: A standardised nomophobic rating scale utilised to check the extent of smartphone addiction among the higher secondary students. Their academic achievement is identified using an achievement test in the relevant subject. The higher secondary students from Kerala constitute the population of the current study and 30 among them practicing blended learning activities are selected for the study in a convenient manner.

Results: The results show that students are more prevalent to the smart phone addiction during the blended learning process. The male students show a higher level of smartphone addiction when compared to their female counterparts while academic achievement does not differ with respect to gender. Locality of the higher secondary students has no significant role on their nomophobic prevalence and academic achievement.  Nomophobic prevalence correlated negatively with academic achievement but not at a significant level.

Conclusion:  This study reveals the major issues about the need for adequate supervision of adolescent mobile phone usage especially during blended learning. It also emphasises the need and importance of timely interventions from teachers, parents, and professionals as the learning process shifted to blended methods after the pandemic among higher secondary level.
Review of the Literature on Existing Management of Dry Eye Disease
Authors: Chandrakar Isha , Sanghavi Shruti
Published: January 2022

Dry eye disease (DED) is a multifactorial disease in which the tear film’s homeostasis is lost, along with other ocular symptoms such as tear film instability and high osmolarity, neurosensory abnormalities, and ocular surface inflammation and damage. DED is a condition of lacrimal apparatus which is responsible for tear production. The tear film is a mixture of mucin, aqueous (water and solutes like NacI, sugar, urea, proteins,), lipids secreted by goblet cells, lacrimal glands, and meibomian glands, respectively. It keeps the eye moist, provides oxygen to the cornea, and has antibacterial properties. The lipid layer prevents the evaporation of the aqueous. DED is categorized into (i)Aqueous-tear deficiency, characterized by a deficiency of lacrimal glands to secrete tears, (ii)Evaporative DED, associated with increased tear loss by evaporation because there is a deficiency of the meibomian glands. The mechanism of DED might be loss of tear through evaporation or insufficient aqueous production or a combination of the two. DED is a widespread eye problem, which is often left untreated. It causes irritation, itching, dryness, foreign body sensation, and discomfort; severe case causes conjunctival congestion, keratinization, erosion of the corneal epithelium, and plaque formation. If left Univision- threatening vision-threatening, leading to complications like corneal ulceration and perforation. Various clinical tests are used to diose DED, including tear breakup time, tear osmolarity, Schirmer test, Rose Bengal staining, and expression of inflammatory markers. There is no cure for DED at present. The following modalities are used for its treatment:

use of punctual and canalicular plugs,

artificial tear products like polyethylene glycol/propylene glycol with guar HP,

consuming food rich in omega-three fatty acids, antioxidants zeaxanthin, and lutein,

Use of anti-inflammatory drugs, mucolytics, secretagogues.

Reducing or avoiding mild risk factors like prolonged reading, prolonged use of contact lenses, excessive screen time, etc.

Treatment of causative disease.

 Appropriate management and establishing reasonable patient expectations are necessary to ensure patient satisfaction and adherence to the treatment.
Dermatofibrosarcoma Protuberans: A Systematic Review of the Literature
Authors: Alnooh Alaa , Al-Qubaisy Yasser , Alshammari Nujud , Alhowshan Ibrahim
Published: January 2022

Background: Dermatofibrosarcoma Protuberans (DFSP) is a rare slow growing cutaneous soft tissue sarcoma, that is characterized to be locally invasive with high recurrence rate. However, it has poor metastatic capacity.

Objective: We are conducting this literature review to gather evidence-based medicine knowledge regarding Dermatofibrosarcoma Protuberans. Moreover, this study highlights the gaps of knowledge in regard to this disease entity.

Methods: The literature search was conducted by searching the keywords “Dermatofibrosarcoma Protuberans” and “soft tissue sarcomas” in PubMed and Web of Science databases.

Results: 1,769 potentially relevant results showed matched titles, of which 13 articles met the requirements and were included in the literature review.

Limitations: Vague nonspecific clinical manifestations, makes it challenging to establish an early diagnosis and seek an appropriate counseling.  In addition, it is difficult to diagnose due to the slow growing behavior and the tumor’s benign appearance. As a result of all of that there is no enough cases reported in the literature.

Conclusion: This review highlights the need of high index of suspicion to help reach an early and proper diagnosis and to raise awareness. Dermatofibrosarcoma Protuberans needs a specialized center in order to identify and recognize the disease. The knowledge and awareness of the disease is low since it is rare.
Addition of Cognitive Behavioral Therapy with Motor Control Exercises on Pain and Function in Elderly Individuals with Chronic Low Back Pain
Authors: Subramanian Shenbaga Sundaram , Gaowgeh Riziq Allah Mustafa , Altaim Thamer Ahmad , Neamatallah Ziyad , Alfawaz Saad S. , Maayah Mikhled F.
Published: January 2022

Introduction: Low back pain is a common, disabling, costly medical problem in most countries. CLBP is one of the most frequently reported conditions affecting the older adults. Numerous studies have also documented the associations of pain-related beliefs and appraisals with pain intensity and related problems, including depression, physical disability, and activity and social role limitations. Recently there is an increased attention to the role of cognitions in mood, anxiety, and other psychological disorders sparked interest in incorporating cognitive therapy techniques into behavioral therapies for chronic pain. CBT is a form of psychological therapy. It focuses on actions are the behavioral part. CBT is a feasible treatment for cognitively intact, older persons with CLBP, and may be efficacious as well. The aim of the study is to analyze the effect of cognitive behavioral therapy with Motor control exercises programme on CLBP.

Methods: Study is an experimental study design includes 40 patients with CLBP with more than 6 months duration. 20 participants underwent motor control exercises with moist heat pack and 20 participants underwent motor control exercises with cognitive behavioral therapy and moist heat pack. Study was conducted for 8weeks of duration and the outcome measures were pain and disability which was measured using numerical pain scale and Oswestry disability index.

Results: The between group comparison was made using the unpaired t test and the results were found to be 10.15 ±0.502, at the 95% of the Confidence intervals for disability. The between group comparison was made using the unpaired t test and the results were obtained are 7.47 ± 0.22, at the 95% of the Confidence intervals for Pain.

Conclusion: The study concluded that motor control exercises with cognitive behavioral therapy were significantly effective in reducing pain and disability.