bluuebunny/crossref_metadata_2025 huggingface dataset:
Health related quality of life among rural elderly using WHOQOL-BREF in the most backward district of India
Authors: Singh Abhishek , Palaniyandi Subramani , Palaniyandi Anitha , Gupta Vikas
Published: March 2022

Background:

In India, the population of above 60 years was approximately 8.2% in 2011, which is expected to rise to 11.6% by 2026. Due to epidemiological transition of diseases, morbidity of chronic nature will increase with increase of elderly population and it will affect the elderly quality of life (QOL). Aim: This study made an attempt to capture health-related quality of life HRQOL and its correlates among elderly subjects in most backward district of India.

Methods:

This cross-sectional study was conducted in Nagina for a duration of 4 months and included 430 elderly (60 years or above) dwelling in the same place for more than 1 year as participants. The information on sociodemographic details, WHOQOL-BREF scale details and history of chronic diseases or disorders was collected by multipurpose health workers female using a pretested, predesigned, standardized questionnaire. An association between variables and poor quality of life was significant if the P value was less than 0.05.

Results:

Nearly half of study participants were living in joint families (45.3%) and 67.7% of elderly gave history of chronic morbidity. There were nearly half of participants (48.8%) with poor QoL in physical health domain. Multiple linear regression analysis revealed that older age, male, no schooling, without spouse, lower economic status and chronic disorder were independently associated with low QOL score.

Conclusion:

The study reported that nearly half of the elderly (46.7%) had poor health QoL. The family physicians shall provide preventive and promotive measures to reduce the chronic morbidity among elderly to improve QOL.
Let’s talk about mucormycosis emergency with COVID-19: Invest in future
Authors: Malik Kamlesh , Arora Jyoti , Yadav Parvin K. , Rohilla Kusum K.
Published: March 2022

Despite recent breakthroughs in the detection and treatment during the COVID-19 pandemic, mucormycosis is a serious infection with a high death rate. It is a filamentous fungal infection from the zygomycetes class of order mucorales. It is a fatal fungal infection with a 50% or higher overall fatality rate. Mucormycosis is a fungal infection caused by mucor, which is a mold that can be found in soil, rotting fruits, and vegetables. It can primarily affect the brain, lungs, and sinuses. It is very much fatal in patients with diabetes or who are highly immunocompromised such as patients with cancer. In addition to more than 50% mortality rate, surgical intervention may require necrotic tissue removal, which leads to severely disfiguring surgery.
Primary hepatic Hodgkin’s lymphoma: A case report
Authors: Nasiri Abdulrahman M. , Alshammari Manal , Ahmed Abdulrahman , Elsir Bader , Alghethber Hamad
Published: March 2022

Introduction:

Hodgkin lymphoma (HL) is an uncommon hematological malignancy that primarily occurs in young adults and less frequently in elderly individuals. HL has characteristics cells derived from B lymphocytes (known Reed–Sternberg (HRS) cells). Primary hepatic Hodgkin disease is very rare presentation accounting for less than 0.4% of the cases. Due to its rare occurrence, the pathogenesis of PHL is still unclear, Clinical manifestations, laboratory findings, and imaging features are usually nonspecific, making it difficult to diagnose.

Patient Concerns:

69 years old Saudi Female, known case of Hypertension presented to our hospital with history of fever, jaundice, and poor appetite for about 2 weeks with significant weight loss.

Diagnosis:

Laboratory findings showed cholestatic pattern with total bilirubin 107.2 mg/dl, alkaline phosphatase 2076 IU/l, AST 153 IU/l and ALT 73 IU/l. Imaging with US revealed normal liver size with diffuse increase echogenicity, MRCP showed multiple stones within the gallbladder without evidence of obstruction or CBD dilatation and pan-computed tomography (CT) revealed mildly enlarged and fatty liver. CT-guided fine needle aspiration cytology (FNAC) and biopsy from the liver were consistent with primary hepatic Hodgkins lymphoma. Intervention: The patient received 5 cycles of ABVD.

Outcomes:

After the completion of the 5 cycles patient showed good response to the treatment with normalization of her liver function and regression in the size of liver on CT.

Conclusion:

PHL is a rare disease. The clinical presentation is variable and radiological features are not specific. Histology is mandatory for definitive diagnosis. The optimal therapy and outcomes for PHL is still unclear. ABVD is the most frequently used chemotherapy regimen. Multidisplinary approach including surgery and radiotherapy is another option.
Relationship of alcohol use pattern with locus of control and impulsivity: A cross-sectional study in hospitalized alcohol use disorder patients in Western India
Authors: Patel Nisheet , Sharma Himanshu , Mahida Ankur , Mistry Hansal
Published: March 2022

Background:

Alcohol use disorders (AUDs) are increasing in developing countries like India and it has high relapse rates. Locus of control (LOC) and impulsivity can be important predictors of relapse and knowledge about them can help in management of AUD.

Method:

Cross-sectional analytical study of 116 indoor patients in tertiary care hospital, between ages 18 and 65 years diagnosed as AUD according to DSM-5, after acute detoxification was done. For interview, a sociodemographic sheet, Alcohol Use Disorder Identification Test, Drinking-Related Locus of Control Scale, and Barrett’s Impulsiveness Scale 11 scale (Gujarati versions) were used. Patients with complicated withdrawal and any other comorbid organic brain conditions were excluded. The data were analyzed using SPSS version 25.

Result:

Total participants consisted of 65% middle-aged (35–50 years) rural inhabitants. Eighty-six-percent of patients were employed and around 80% were educated >5th standard. No association was found between sociodemographic variables and severity of alcohol use. Severity of alcohol use increased with more duration of alcohol consumption (P = 0.001). Patients being earlier aged for first intake of alcohol had a high external LOC (r = 0.209, P = 0.050). Patients with high external LOC (P = 0.003) and more impulsivity (P = 0.001) had more relapses (more numbers of attempts to quit alcohol). With increased external LOC (r = 0.315) and increased impulsivity (r = 0.716), severity of alcohol use also increased. As impulsivity increased, patients’ LOC was found more toward external side (P = 0.007) (r = 0.345).

Conclusion:

External LOC and impulsivity have a strong association with alcohol use. Patients with high external LOC and more impulsivity had early age of first intake, severe alcohol use, and more duration of alcohol consumption.
A study of electrocardiographic and 2D echocardiographic changes in type 2 diabetes mellitus patients without cardiovascular symptoms
Authors: Sardesai Vasudha V. , Kokane Hemant T. , Mukherjee Souradip , Sangle Shashikala A.
Published: March 2022

Context:

Cardiovascular diseases in diabetic patients are mostly asymptomatic due to autonomic neuropathy. Many patients with left ventricular dysfunction remain undiagnosed and untreated until advance disease causes disability. This delay could be avoided if screening techniques are used to identify left ventricular dysfunction in its preclinical phase.

Aims:

This study was undertaken to find out the incidence of electrocardiographic (ECG) and 2D echocardiographic (2 D Echo) abnormalities in diabetic patients without cardiovascular symptoms. The correlation of control of diabetes with these abnormalities was also studied. Settings and Design: A hospital-based, cross-sectional observational study.

Methods and Material:

Type 2 diabetic patients (outpatient and indoor) without cardiovascular symptoms like palpitations, chest pain, syncope, and breathlessness were included in the study. Their ECG and 2D Echo findings were noted and correlated with their blood sugar levels. Statistical Analysis Used: Chi-square test. Results: Type 2 diabetic patients without cardiovascular symptoms had significant abnormal findings on ECG and 2D Echo. Control of postprandial blood sugar level was of primary importance to prevent cardiovascular abnormalities.

Conclusions:

Type 2 diabetics without cardiovascular symptoms must be screened for cardiovascular abnormalities so that early interventions can be done to prevent further progression to symptomatic cardiovascular abnormalities. There is a significant number of people having normal ECG but abnormal 2D Echo and vice versa, so not only ECG but also 2D Echo should be done to predict cardiovascular risk in type 2 diabetic patients without cardiovascular symptoms.
The socio-economic burden of cancer: An observation from the palliative care OPD
Authors: Ghoshal Sushmita , Arora Minni , Chakrabarti Adrija , Datta Avradeep , Dey Treshita
Published: March 2022

A cross-sectional study was planned to assess the socio-economic burden of cancer among patients referred for palliative care. Patients referred within 6 months of diagnosis were grouped as early while others were late referrals. The socio-economic status, out-of-pocket expenditure (OOPE), and budget adjustments were noted and compared between the two groups using SPSS v 23.0. A total of 96 patients were included among which 57 were referred late. Most patients belonged to middle- and lower-income groups but only 22/96 had some kind of social security. The demographic profiles of the two groups were comparable. Although the patients referred late had more OOPE compared to the early ones, the difference was not statistically significant. Patients receiving chemotherapy had a significantly higher OOPE (P = 0.001). Job interruptions and loss of family income leading to budget adjustments were reported by 50 patients. The study indicates that there is a significant economic impact and OOPE that needs to be addressed in our patient population.
Impact of lockdown and unlocking on symptomatology and emergency department visits during the first wave of the COVID-19 pandemic
Authors: D’Silva Rachel E. , Kola Ashwin K. , Vijay Joshua , Jacob Mariam , Selvaraj Bagyalakshmi , Joseph Jeremiah N. , Abhilash Kundavaram Paul Prabhakar
Published: March 2022

Background:

The COVID-19 pandemic resulted in a complete nationwide lockdown on March 24, 2020. The months of April and May had stringent lockdown measures followed by a gradual loosening of restrictions in a graded manner.

Methods:

This observational study was performed in the emergency department (ED) of a tertiary hospital in south India triage Priority 1 and Priority 2 patients presented during the COVID-19 lockdown and unlock periods spanning from April 2020 to August 2020. The three different lockdown periods and the subsequent unlock periods were categorized as lockdown 1 (LD1), lockdown 2 (LD2), lockdown 3 (LD3), and unlock phase (UL), and a 7-day time period in each were taken for 7-day incidence analysis.

Results:

During the 5-month study period, a total of 1,954 patients were analyzed for the study that included 405, 440, 492, and 617 patients during the 7-day time periods in the LD1, LD2, LD3, and UL periods, respectively. The 7-day incidence of COVID-19 suspects increased significantly by 101.9% from LD1 to UL phases, whereas trauma cases increased by 52.9% in the same two time periods. Compared with LD1, in the UL phase, the 7-day ED admission and in-hospital mortality rates increased by 50.3% and 66.7%, respectively.

Conclusion:

The number of COVID-19 suspects saw a near-constant increase through the different phases of lockdown, culminating in the UL phase. The stringent lockdown measures resulted in a significant reduction in the incidence of trauma with a rebound increase in the UL phase.
A community-based cervical cancer screening program in Alappuzha district of Kerala using camp approach
Authors: Mohan Lakshmi , Karthika M
Published: March 2022

Background:

Cervical cancer is a major cause of preventable cancer related death in women, particularly in middle-income developing countries. Screening of cervical pre-cancer by cytology remains an effective strategy for prevention of mortality. However, there is paucity of community-based studies in Kerala. The aim of this study was to determine the prevalence of cervical precancerous lesions and to study the associated epidemiological factors through camp approach.

Materials and Methods:

A cross–sectional study was carried out among women in Alappuzha district, Kerala, by conducting community-based screening camps covering all the panchayaths from February 2017 to January 2019.

Statistical Analysis Used:

Descriptive statistics including mean for continuous variables and frequency along with their percentage for categorical variables were determined. Pearson’s Chi-square test was used to determine the strength of the association between variables. Statistical significance was set at P value less than 0.05.

Results:

Out of 5241 women screened, majority (62.9%) were in the reproductive age group (31–50 years) with mean age of 47.1 ± 10.3 years. The prevalence of precancerous lesions of cervix was 6.37%, which consisted of low-grade squamous intraepithelial lesion (LSIL) in 2.2%, high-grade squamous intraepithelial lesion (HSIL) in 0.5% and Carcinoma-in-situ in 0.2%. Risk factors that had significant association with cervical precancerous lesions were lower education status, genital infections, early marriage age and high parity.

Conclusion:

Well planned community-based screening programs can help to identify the exact prevalence of cervical pre-cancer in a region and the associated epidemiological factors leading to formulation of effective elimination strategies.
Oral manifestations in COVID-19 patients: An observational study
Authors: Muthyam Alka Kumari , Reddy M. Padma , Kulkarni Suhas , Srilatha Adepu , Sahithi Kommuri , Satyanarayana Dantala
Published: March 2022

Background:

Viral diseases continue to emerge as a threat to mankind and are a serious concern to public health. The latest lethal SARS-CoV-2 or COVID-19 is a highly contagious disease, which propagated quickly across the globe. Similar to other influenza-like viral infections, symptoms such as fever, dry cough, myalgia, arthralgia, headache, diarrhea, dyspnea, and fatigue were reported among COVID-19 patients. Evidence suggests that the oral cavity is affected by this virus either directly or indirectly. Aim: The aim of this observational study was to determine the oral manifestations among COVID-19 patients.

Materials and Methods:

A cross-sectional, questionnaire-based study was carried out among COVID-19 recovered patients. A sample of 100 subjects, diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria.

Results:

The study comprised an almost equal number of male (51%) and female (49%) participants and among them, 48% belong to the health professional group. A total of 54% of subjects were aged above 35 years and 46% below 35 years. Oral manifestations among study subjects during and after the disease illness included xerostomia being the commonest symptom (44%), followed by swallowing difficulty (16%), mouth ulcerations (10%), chewing problem (7%), gum bleeding (6%), and burning sensation (4%).

Conclusion:

Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery. Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.
A study to correlate effect of dietary modification on biochemical and cardiovascular parameters among prediabetics
Authors: Saboo Neha , Kacker Sudhanshu
Published: March 2022

Objectives:

Dietary factors are important in the prevention and treatment of prediabetes and diabetes mellitus (DM). This study was designed to evaluate the prevalence, associated risk factors, dietary modification, and calories consumption calculated by the food frequency questionnaire and correlate them with the metabolic parameters, namely blood glucose, HbA1c, lipid profile, and cardiovascular parameters as heart rate variability and carotid intima media thickness (CIMT) among the prediabetics.

Methods:

An experimental interventional study was carried out in the Department of Physiology and Medicine at the RUHS College of Medical Sciences and Associated Group of Hospitals. The assessments were done at baseline and after 6 months of post-dietary modification. The total duration of the study was 6 months. A total of 250 prediabetic subjects were enrolled. Study Group A (n = 125) was engaged in dietary modification, whereas Group B (n = 125) was considered as control. The dietary assessment was done by a food frequency questionnaire.

Result:

After dietary modification, a decrease in the body mass index (1.3%), systolic blood pressure (3.1%), diastolic blood pressure (3.1%), blood glucose (2.8%), triglyceride (2.8%), high density lipoprotein (0.9%), HbA1c (2%), cholesterol (1.4%), and low-frequency/high-frequency ratios (1%), carotid intima media thickness (1.6%), as compared to control, was noticed after 6 months of dietary modification.

Conclusion:

This study suggested that prediabetics required health education including nutritional education as diet modification can play an important role to encourage diabetes-onset prevention and its related complications. The health-care providers and workers should increase the awareness about the importance of diet and encourage the prediabetics toward a healthy lifestyle, which may help in the quality of life and appropriate self-care, primary prevention of diabetes and its complications. CTRI Registration: CTRI/2017/06/008825.
Managing COPD exacerbation at home- Teleconsultations amid COVID-19
Authors: Shahnawaz Mir , Dar Mohd Yousoof , Nabi Shabnam , Mustafa Hena , Samreen Sheema , Shah Naveed Nazir
Published: March 2022

Background:

Due to an enormous health care crisis arising out of COVID-19 pandemic, alternate methods of seeking treatment like tele-consultation proved useful to patients. We assessed the role of teleconsultation in managing COPD exacerbations at home in the times of COVID-19 crisis.

Materials and Methods:

A prospective study of 527 diagnosed cases of COPD seeking treatment for exacerbation of their illness telephonically because of difficulty in visiting the hospitals created by the COVID-19 lockdown. Data were collected telephonically and via social media platforms from April 7,2020 to October 29, 2020.The patients were treated for exacerbation and followed telephonically at day 3,5,7, 14 and day 30. Patients who turned to be COVID-19 positive were referred to COVID health facility centers.

Results:

509 patients out of 527 patients were treated for exacerbation of COPD, 18 patients tested positive for COVID-19. Out of 509, 13 patients did not improve and had to be referred to hospital. All of them had acute respiratory failure (Type 2) as documented by their arterial blood gas analysis. 2 out of them did not survive. 496 out of 509 (97.4%) patients of COPD exacerbation were successfully treated via teleconsultations and with a follow-up of 4 weeks period minimum for all the patients.

Conclusion:

Teleconsultation provided excellent means to manage COPD exacerbation remotely with equally effective outcome as seen in hospital care in the times of health care crises due to COVID-19 pandemic.
A cross-sectional study on determinants of indoor air pollution and its perceived impact among the residents of urban field practice area of AMCH, Salem, Tamil Nadu
Authors: Priyadarsini S. P. , Ibrahim R. Mohammed , Somasundaram V. M. , Nayeem R. Abdul , Balasubramanian R.
Published: March 2022

Background:

Over the past 20 years, indoor air pollution (IAP) has received much attention as the quality of the indoor air is affected a lot. IAP means the presence of substances which are redundant in the indoor air at concentrations toxic to health. Very few studies have addressed the determinants of indoor air pollutants in places like urban slum areas in Tamil Nadu. To reduce this research gap, this study has been undertaken. Aim: To study the determinants of IAP and its perceived impact on health.

Settings and Design:

This was a community-based cross-sectional study. Complete information from 440 households consisting of 1606 individuals was collected through a semi-structured questionnaire.

Materials and Methods:

Residents of an urban field practice area of Annapoorana Medical College and Hospitals (AMCH) were the study participants. The study period was from April 19 to March 2020. The study area was an urban field practice area around Department of Community Medicine, Karungalpatty, AMCH. Frequency, proportions, and Spearman test were used to find out the significance between various household environmental conditions and the respiratory diseases using Epi Info software.

Results:

Results showed that 52.3% of the participants were using incense sticks at home in the evening during pooja and 17.7% of the houses were using mosquito coil in the evening and at night. Also, 29.5% houses reported overcrowding and 66.4% of the houses were not having chimney or exhaust. Results also showed that 71.4% households were practicing opening their windows while cooking. One hundred and fifty-two (34.5%) female respondents had perceived the symptoms like dizziness (12.3%), eye irritation (10.2%), difficulty in breathing (4.5%), dry cough (3.06%), running nose (1.4%), and nasal congestion (1.1%) due to IAP. Among under-five respondents, 1.6% reported having acute respiratory infections in the last 15 days and 10.5% reported the same in the last 1 year 10.5%.
A mysterious case of recurrent fracture: Tumour-induced osteomalacia
Authors: Shetty Sahana , Ravindra Shruthi , Acharya Himamshu , Rao Sharath K
Published: March 2022

We report a case of tumour-induced osteomalacia in a 59-year-old man who presented with a long-standing history of myalgia, bone pain and pathological fracture of the bilateral femur at different intervals in the past 4 years. A biochemical evaluation revealed hypophosphatemia secondary to phosphaturia. Localization study by Ga-68 DOTANOC PET-CT for adult-onset hypophosphatemic osteomalacia revealed a tumour in the right femoral head. Resection of the tumour resulted in clinical improvement as well as normalization of biochemical parameters.
Syphilis D’ Emblée: A case series of the great masquerader
Authors: Narasimhan Murali , Lagoo Mayank , Ramachandran Ramakrishnan , Fernandes Soosai Donald
Published: March 2022

Syphilis, a chronic infectious disease caused by Treponema pallidum subspecies pallidum, progresses through three arbitrary stages resulting in varied clinical manifestations. The aberrant presentation of syphilis in the secondary stage without any clinical evidence of the primary stage is referred to as syphilis d’ emblée. Here we report a series of six cases in male patients. Five out of six patients presented with multiple, non-pruritic, macular palmar, and/or plantar lesions. One patient had typical facial and perianal lesions of condyloma lata. The diagnosis was confirmed by a reactive VDRL with titers ranging from 1:16 to 1:64 and a positive Treponema pallidum hemagglutination assay (TPHA). Syphilis being a great imitator can present in different ways without a typical history of primary chancre following sexual exposure, and can mimic many dermatological disorders in its secondary stage. Unless physicians have a high index of suspicion, the diagnosis may be missed. Early identification aids in prompt initiation of therapy and prevention of disease progression to chronic stages and systemic manifestations.
Vast gap in iodization from production to plate - Hurdles in achieving Universal Salt iodization in India
Authors: Krishna Ekta , Pal Anjali , Khobragade Ashish , Panigrahi Sunil Kumar
Published: March 2022

Iodine deficiency is the most prevalent micronutrient deficiency in India and is one of the most important causes of preventable brain damage. Iodine deficiency disorders affect an individual’s ability to work efficiently, which directly impacts the overall development and economic productivity of any nation. Global experiences have shown that salt fortification is the most effective way to control and reduce the burden of IDD in the community. Thirty-six years have passed since the declaration of universal salt iodization (USI) implementation in India by the Central Council of Health in 1983. However, iodine deficiency still remains a public health problem in the whole country.
Case Report
Authors: Skelly James R. , MacColgáin Siaghal
Published: March 2022

Klippel–Feil Syndrome (KFS) is a complex heterogeneous entity that can result in cervical spondylosis and thoracolumbar vertebral fusion. Combined, these features contribute to both a difficult airway and neuraxial anaesthesia. Previously, these patients required general anaesthesia in the obstetric setting, incorporating advanced airway techniques as the first line. Herein, we describe the novel use of the paramedian approach to epidural anaesthesia in a primigravid woman, with a background of KFS. The patient had a vaginal septum and double cervix and was considered at higher risk of obstetric complications. Antenatal assessment and forward planning within the multidisciplinary team setting were vital in the formulation and provision of safe care for this patient. Neuraxial ultrasound (US), undertaken at preassessment, yielded adequate views of the posterior complex in the paramedian sagittal oblique plane only. An anaesthetic plan with emphasis on early paramedian epidural insertion was thus formulated. The patient was admitted to early labour by the obstetric team. Neuraxial US replicated the previously attained windows and in keeping with the plan, the paramedian approach was utilised with successful insertion on the first attempt. Patient-controlled epidural anaesthesia infusion was utilised over her 6-hour labour with instrumental delivery. Epidural analgesia was maintained with a bilateral T6 sensory block with the patient comfortable throughout. This case study outlines the novel use of the paramedian approach to epidural anaesthesia in a patient with KFS. We also believe it exemplifies the need to pre-assess patients with abnormal spinal anatomy and utilises the neuraxial US to formulate an anaesthetic plan.
A Rare Case of Fetal Gas Gangrene Following Premature Rupture of Membranes in the Second Trimester Diagnosed with the Aid of Computed Tomography
Authors: Venkatesha Gupta K. V , Ajith Kumar A. K , Bhattacharya Modhulika , Murthy Pooja R. , Sarath K
Published: March 2022

Introduction:

To report a rare case of foetal gas gangrene following premature rupture of membranes in the second trimester diagnosed with the aid of computed tomography.

Case Report:

A 33-year-old lady, with G4A2L1, booked and vaccinated, developed premature rupture of membranes at 25 weeks of gestation. She developed severe abdominal pain with high-grade fever on the fourth night after expectant management with intravenous antibiotics and close monitoring. As there was a new-onset shock, she was referred to the higher centre from the obstetric care unit. The ultrasound of the abdomen and pelvis in the emergency room ruled out other causes of shock but confirmed intrauterine death. After planning for vaginal delivery, she had further deterioration requiring intubation and vasopressors. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was performed which showed foetal gas gangrene and bilateral acute cortical necrosis. Emergency hysterotomy, performed under high-risk consent delivered macerated foetus. She had atonic uterus and required obstetric hysterectomy under general anaesthesia (GA). Her post-partum course was complicated by disseminated intravascular coagulopathy (DIC), acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome requiring multiple transfusions, prone ventilation and multiorgan support. However, she could not be salvaged and died on the 2nd day of surgery.

Conclusion:

We describe a rare fatal case of foetal gas gangrene in the second trimester following premature rupture of membranes which was diagnosed by a computed tomography (CT) scan of the abdomen and pelvis. The CT scan reliably identifies emphysematous changes in the amniotic cavity and foetal parts which helps in decision-making from the induction of labour to early surgical approach to prevent peritonitis and multiorgan failure. We recommend early CT scan in pregnancies complicated by intrauterine infections with shock which can change the line of management.
Sur la lissité du schéma Quot ponctuel emboîté
Authors: Monavari Sergej , Ricolfi Andrea T.
Published: March 2022

Dans cet article on caractérise la lissité du schéma Quot ponctuel emboîté d’une variété lisse—c’est-à-dire l’espace de modules paramétrant les drapeaux de quotients de dimension
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d’un faisceau localement libre fixé. Nos résultats étendent la classification de Cheah dans le cadre des schémas de Hilbert ponctuels emboîtés.
Statistical Modeling of Deaths from COVID-19 Influenced by Social Isolation in Latin American Countries
Authors: da Silva Rafael André , de Souza Ferreira Luiz Philipe , Leite Jean Michel Rocha Sampaio , Tiraboschi Fernanda Assunção , Valente Thiago Maciel , de Paiva Roda Vinicius Moraes , Duarte Sanchez Jeniffer Johana
Published: March 2022

Social isolation is extremely important to minimize the effects of a pandemic. Latin American countries have similar socioeconomic characteristics and health system infrastructures. These countries face difficulties in dealing with the COVID-19 pandemic, and some of them have very high death rates. The government stringency index (GSI) of 12 Latin American countries was gathered from the Oxford COVID-19 Government Response Tracker project. The GSI is calculated by considering nine social distancing and isolation measures. Population data from the United Nations Population Fund and number-of-deaths data were collected from the dashboard of the WHO. We performed an analysis of the data collected from March through December 2020 using a mixed linear model. Peru, Brazil, Chile, Bolivia, Colombia, Argentina, and Ecuador had the highest death rates, with an increasing trend over time. Suriname, Venezuela, Uruguay, Paraguay, and Guyana had the lowest death rates, and these rates remained steady. The GSI in most countries followed the same pattern during the months analyzed. In other words, high indices at the beginning of the pandemic and lower indices in the latter months, whereas the number of deaths increased during the entire period. Almost no country kept its GSI high for a long time, especially from October to December. Time and GSI, as well as their interaction, were highly significant. As their interaction increases, the death rate decreases. In conclusion, a greater GSI at the start of the COVID-19 pandemic was associated with a decrease in the number of deaths over time in Latin American countries.
Prevalence of Epilepsy, Human Cysticercosis, and Porcine Cysticercosis in Western Kenya
Authors: Diaz Monica M. , Sokhi Dilraj , Noh John , Ngugi Anthony K. , Minja Frank J. , Reddi Prabhakhar , Fèvre Eric M. , Meyer Ana-Claire L.
Published: March 2022

Cysticercosis is the leading cause of acquired epilepsy worldwide and has been shown to be highly prevalent in pig populations in western Kenya. We conducted a community-based door-to-door survey in a region of western Kenya with a high proportion of pig-keeping households. Persons with epilepsy (PWE) were determined using a screening questionnaire followed by a neurologist evaluation. Cysticercosis serum apDia antigen ELISAs and Western blot for LLGP and rT24h antigen were performed on all PWE and 2% of screen-negative patients. All PWE or people with positive apDia underwent contrast-enhanced brain computed tomography (CT). Of a sample of 810 village residents, 660 (81%) were present in the homestead, of whom 648 (98%) participated. Of these, 17 were confirmed to have lifetime epilepsy, an estimated crude prevalence of 2.6%. No humans with (N = 17) or without (N = 12) epilepsy had serological evidence of cysticercosis infection. Fourteen PWE and one individual with borderline positive apDia antigen ELISA underwent brain CT; none had radiographic findings consistent with neurocysticercosis. Nearly 30% of households kept pigs, with 69% always tethered in both wet and dry seasons. More than 8% (6/72) of pigs had palpable lingual cysts; these pigs all originated from homesteads with latrines, one-third of which were free-ranging at least some of the time. Epilepsy prevalence in our study was greater than the national prevalence, but we found no individuals with epilepsy attributable to cysticercosis. Additional studies are required to identify causes of epilepsy, human and porcine cysticercosis, the role of spatial clustering, and protective factors like host-pathogen immunity.
Analytically Sensitive Rickettsia Species Detection for Laboratory Diagnosis
Authors: Chung Ida H. , Robinson Lauren K. , Stewart-Juba Jeri J. , Dasch Gregory A. , Kato Cecilia Y.
Published: March 2022

Clinical and laboratory diagnosis of rickettsial diseases is challenging because of the undifferentiated symptoms (commonly fever, headache, and malaise) and low bacteremia (< 100 genomic copies [gc]/mL) during the early acute stage of illness. Early treatment with doxycycline is critical for a positive outcome, especially in Rickettsia rickettsii (Rocky Mountain spotted fever) infections where cases may be fatal within 5 to 10 days from symptom onset, emphasizing the need for more sensitive diagnostics. A real-time reverse transcriptase polymerase chain reaction (PCR) assay, RCKr, was developed and validated for Rickettsia spp. nucleic acid detection in human clinical samples. The limit of detection for RCKr was determined to be 20 gc/mL, compared with our 2013 (Kato et al.) laboratory developed test, PanR8 at 1,800 to 2,000 gc/mL. Inclusivity, exclusivity, accuracy, and precision results correlated as expected. From an evaluation of 49 banked clinical samples, RCKr detected 35 previously positive samples, as well as two specimens that were PanR8 real-time PCR negative yet clinically diagnosed as possible rickettsiosis. Ct values from RCKr clinical sample testing show a 100-fold increase relative to PanR8. Additional testing is needed to understand the clinical sensitivity of RCKr; however, this study demonstrates RCKr to have high analytical specificity and sensitivity for Rickettsia detection.
India Needs to Consider Planning a Change to Artemether–Lumefantrine to Treat Plasmodium falciparum Malaria
Authors: Rahi Manju , Chaturvedi Rini , Goswami Ritu , Sharma Amit
Published: March 2022

As the malaria elimination target draws closer for India, it must be ensured that the country’s policies, strategies, and tools remain effective. Artemisinin-based combination therapies are the mainstay of Plasmodium falciparum malaria management. India has a differential standard therapy for uncomplicated falciparum malaria in the form of artemether–lumefantrine in its northeastern states and artesunate + sulfadoxine–pyrimethamine in the rest of the country. The clinical failure of artesunate + sulfadoxine–pyrimethamine in the northeast regions was attributed primarily to parasite resistance resulting from mutations in the enzymes dihydropteroate synthase and dihydrofolate reductase. Artemether–lumefantrine was therefore substituted for artesunate + sulfadoxine–pyrimethamine in the region. The change has been a success, as evidenced by the therapeutic efficacy studies conducted at regular intervals in India. However, studies suggest that resistance may be emerging toward sulfadoxine–pyrimethamine in multiple parts of the nation. Hence, there is a possibility that the artesunate + sulfadoxine–pyrimethamine combination may be acting in part as a monotherapy, and this makes the longevity of the artesunate + sulfadoxine–pyrimethamine drug combination therapy uncertain. The increasing presence of drug-resistant mutants in P. falciparum dhps and dhfr genes suggests the need for a policy switch for uncomplicated P. falciparum malaria from artesunate + sulfadoxine–pyrimethamine to artemether–lumefantrine.
Usefulness of Malachite-Green LAMP for Diagnosis of Plasmodium and Five Human Malaria Species in a Nonendemic Setting
Authors: Martín-Ramírez Alexandra , Lanza-Suárez Marta , Muñoz-García Carlota , Hisam Shamilah R. , Perez-Ayala Ana , Rubio José M.
Published: March 2022

Molecular methods are necessary to detect low-density malaria infections. The purpose of this study was to assess the diagnostic performance of six malachite-green loop-mediated amplification method (MG-LAMP) assays (MG-LAMP-Pf, MG-LAMP-Pv, MG-LAMP-Po, MG-LAMP-Pm, MG-LAMP-Pk, and MG-LAMP-Pspp) for the species-specific detection of each human Plasmodium, including P. knowlesi, and the Plasmodium genus compared with the nested-multiplex malaria polymerase chain reaction (NM-PCR), using 161 malaria-positive and 274 malaria-negative samples. MG-LAMP-Pspp assay detected the five human Plasmodium species and each species-specific MG-LAMP assay detected only its corresponding species. Sensitivity, specificity, and predictive values of MG-LAMP assays, compared with NM-PCR, were > 90%, except in the case of the MG-LAMP-Pm assay, which dropped to 47%. Limit of detection for MG-LAMP-Pspp assay ranged from 0.1 parasites/µL for P. falciparum to 16.9 parasites/µL for P. malariae samples, and it was similar for the rest of MG-LAMP assays except for the MG-LAMP-Pm assay. Turnaround time was estimated to be 2 hours and 35 minutes for one MG-LAMP assay and 4 hours and 15 minutes if all species-specific MG-LAMP is set up, whereas for the NM-PCR, turnaround time was ∼6 hours and 15 minutes. Costs per determination ranged from 1 to 6 euros for MG-LAMP assays and 5 euros for NM-PCR. Therefore, MG-LAMP assays appear to have good concordance compared with the reference method, except for the MG-LAMP-Pm assay. They can detect low parasitemia and identify malaria species, with lower costs and shorter time to obtain results, and they are suitable tools to be used in endemic and non-endemic countries for malaria detection.
CHARACTERIZATION OF COFFEE SHRUB BIOCHAR CHARGED WITH COW MANURE AND EFFECTIVE MICROORGANISMS
Authors: Dumas José A. , Chong Joaquín A. , Rivera-Goyco Christian
Published: March 2022

CHARACTERIZATION OF COFFEE SHRUB BIOCHAR CHARGED WITH COW MANURE AND EFFECTIVE MICROORGANISMS
Trayectoria histórica de las escuelas ocupacionales agrícolas en Puerto Rico
Authors: Carrión-Guzmán Javier , Berríos-Rivera Reinaldo , Burgos-Carrasquillo Johanna , Báez-Pérez Alfredo J. , Colón-Rosa Yamira
Published: March 2022

El propósito de esta investigación fue documentar el desarrollo histórico los orígenes y fundamentos de las tres escuelas ocupacionales agrícolas de Puerto Rico, describir los trabajos que estas escuelas realizan, conocer sus fortalezas, su composición estructural e identificar sus áreas de oportunidad. Las escuelas objeto de estudio fueron: la Escuela Vocacional Agrícola José B. Barceló Oliver (Adjuntas), la Escuela Vocacional Agrícola Bucarabones (Toa Alta) y la Escuela Vocacional Agrícola Soller/Agron. Héctor M. Cordero Rivera (Camuy). Esta investigación se ancló en el paradigma cualitativo y utilizó el diseño de investigación histórica, tomando en consideración las cartas constitutivas de las escuelas ocupacionales agrícolas, los documentos normativos del Departamento de Educación de Puerto Rico, las medidas legislativas, las auditorías de gobierno, las investigaciones recientes, los artículos de prensa y los censos de agricultura. Los resultados de esta investigación reafirman la importancia de visibilizar las escuelas ocupacionales agrícolas por el rol socioeducativo que ejercen en la sociedad puertorriqueña.
Efecto de la raza paterna y sexo de las crías en el crecimiento de conejos hasta las 13 semanas de edad
Authors: Tosado-Martínez Tatiana , Domenech-Pérez Katherine
Published: March 2022

La producción mundial de carne de conejo se basa en razas cárnicas; sin embargo, en Europa los cruces entre razas cárnicas y gigantes han resultado en canales de mayor tamaño. En las principales razas, las conejas alcanzan mayores tamaños adultos que los conejos. La presente investigación evaluó el efecto de la raza paterna y el sexo de las crías sobre la curva de crecimiento en conejos. Se compararon los pesos vivos (PV) semanales (primeras 13 semanas de vida; sexados a los 42 días) de la progenie de un padrote Nueva Zelanda Rojo (NZR; n=21) y de uno Gigante de Flandes (GF; n=31) con conejas cruzadas Californianas. Los datos de PV promedio individual (en el pre-sexado y post-sexado) se analizaron mediante el Proc GLIMMIX (SAS). En el pre-sexado no hubo interacción semana x padrote (P=0.3333) ni efecto de padrote (P=0.2051) afectando el PV de los conejos. Durante este periodo, el PV promedio de los conejos aumentó unos 641.50 g (P<0.0001). En el postsexado las interacciones semana x sexo x padrote (P=0.8821), sexo x padrote (P=0.2409), semana x padrote (P=0.1597) y semana x sexo (P=0.5663) no afectaron el PV. Sin embargo, se observaron diferencias en PV entre semanas (aumento total promedio de 1,417.61 g; P<0.0001), sexos (1,748.68±115.28 vs. 1,545.21±109.40 g en hembras y machos, respectivamente; P=0.0194) y padrotes (1,523.68±123.15 vs. 1,770.21±107.24 g en los hijos del NZR y del GF, respectivamente; P=0.0170) durante este periodo. Utilizar padrotes gigantes en madres cárnicas podría mejorar el crecimiento post-sexado de los conejos, especialmente en las hembras.
Lady beetles of Puerto Rico (Coleoptera: Coccinellidae)
Authors: Segarra-Carmona Alejandro E. , Franqui Rosa A. , Pérez-Martínez Hariette
Published: March 2022

This work presents accounts and illustrations of the lady beetle species reported from Puerto Rico. Fifty-three species are discussed, including rare and uncommon lady beetles occurring on the Puerto Rican archipelago. The work also includes keys for subfamilies and species, the description of a new species (Zilus barbosi sp. nov.), and a redescription of Diomus ochroderus (Mulsant). Brief accounts of the history of coccinellid collections and collectors, and of classical bio-control efforts in Puerto Rico are given, including an annotated list of 24 historical biological control introductions.
Fenomenología de la sangre. El autosacrificio como mito del cuerpo
Authors: Venebra Muñoz Marcela
Published: March 2022

El autosacrificio es un modo más radical de relación yo–cuerpo, es un modo de apropiación fenomenológicamente descriptible como un acto que exhibe y explota la escisión autoconsciente de la vida concretamente humana. El autosacrificio es el acto de un yo, de un sujeto lúcidamente consciente que experimenta o constituye su cuerpo bajo una orientación mítica de sentido (sacralizante o no ordinaria), como momento generador o regenerador de un orden; sacrificar es sacralizar el cuerpo, esto es, consagrarlo en la ley, asumir su sentido colectivo, espiritual, en carne propia. Desarrollo esta tesis en tres momentos, primero describo las determinaciones estructurales de la persona como el campo concreto de comprensión de lo social que el autosacrificio exhibe: un yo reflexivo que en el autosacrificio constituye su propio cuerpo como un valor (entre los más altos) en su materialidad vivida, tema que trato en el segundo apartado, donde deslindo el sacrificio de otras muertes autárquicas como el suicidio; finalmente, en el tercer momento, describo el sentido de la sacralización como concreción socializante del individuo exhibida en el autosacrificio.
Finite Element and Neural Network Based Predictive Model to Determine Natural Frequency of Laminated Composite Plates with Eccentric Cutouts under Free Vibration
Authors: Seba Mohamed Rida , Kebdani Said
Published: March 2022

This research proposes a predictive model to identify changes in the mechanical and geometrical properties of composite plates with eccentric cutouts based on natural frequency. Finite elements (FE) and neural networks are used to develop the model based on machine learning. First, the numerical analysis of free vibration is performed by the FE model on the laminated composite plates with a stacking sequence [0/90]2s under a clamped-free (CFFF) boundary condition. The outputs of the FE model (520 configurations) are then utilized to train the artificial neural network (ANN) model through the Levenberg-Marquardt method, and the developed ANN model is then used to evaluate the influence of various parameters on the natural frequency. The results show that the changes in the mechanical and geometrical properties of composite plates have impacts on the natural frequency. Furthermore, the findings of the ANN model are substantially identical to those of the numerical model, with a small margin of error.
Behavior of Built-Up Cold-Formed Steel Stub Columns Infilled with Washed Bottom Ash Concrete
Authors: Mohd Sani Mohd Syahrul Hisyam , Muftah Fadhluhartini , Mohsan Nor Maslina , Kado Bishir
Published: March 2022

The main objective of the study is to determine the behavior of built-up cold-formed steel (CFS) stub columns infilled with washed bottom ash (WBA) concrete and also their failure mode. Five proportions of WBA as sand replacement in concrete and five specimens of built-up CFS stub columns infilled with WBA are produced in this study. There are four parts of the testing conducted: material properties of CFS, material properties of WBA concrete, mechanical properties of the connection, and mechanical behavior of built-up CFS stub columns. The result shows that the specimen with 25% WBA is reported to have the highest value of compressive strength in the material properties of WBA concrete and the mechanical behavior of built-up CFS stub column. The percentage difference of the ultimate load of the built-up CFS column filled with normal concrete and filled with WBA concrete is noted to have a range of 3% to 25%.
Empleo informal y motivaciones intrínsecas para participar en la venta ambulante en la ciudad de Machala, Ecuador
Authors: Martínez Valarezo Josue Daniel , Uriguen Aguirre Patricia Alexandra , Campuzano Vásquez John Alexander
Published: March 2022

En la ciudad de Machala se puede observar que la afluencia de vendedores ambulantes ha ido incrementando luego de la pandemia ocasionada por el Covid-19, por lo que la presente investigación tiene como objetivo analizar las motivaciones intrínsecas que crean el empleo informal en la ciudad ecuatoriana. Para realizar esta investigación se revisó las motivaciones inherentes al subempleo desde las teorías de la autodeterminación e informalidad. La investigación fue de tipo descriptiva y explicativa usando datos de corte transversal y con una muestra aleatoria. Se realizaron encuestas a 300 informales que se ubican en los sectores más concurridos en la ciudad de Machala, la información recopilada fue procesada con el programa estadístico SPSS. Los resultados de las encuestas permiten percibir que el 67% de las personas entre los 18 y 50 años de edad son jefes de hogar, motivados en su gran mayoría por el desempleo a realizar actividades informales, con ingresos por debajo del salario básico unificado, con falta de estudios y con fracasos o errores al momento de emprender. En conclusión, el determinante más fuerte de las motivaciones intrínsecas para el trabajo informal, es la desocupación laboral.