bluuebunny/crossref_metadata_2025 huggingface dataset:
Myosteatosis in NAFLD patients correlates with plasma Cathepsin D
Authors: Ding Lingling , De Munck Toon. J. I. , Oligschlaeger Yvonne , dos Reis Inês Magro , Verbeek Jef , Koek Ger. H. , Houben Tom , Shiri-Sverdlov Ronit
Published: May 2021

Previously, we have shown that hepatic lipid accumulation induces the secretion of cathepsin D (CTSD), and that plasma CTSD levels are associated with increased inflammation and disease severity in nonalcoholic fatty liver disease (NAFLD). Although it is clear that the liver is a major source of plasma CTSD, it is unknown whether other metabolically active organs such as the muscle, also associate with plasma CTSD levels in NAFLD patients. Therefore, the aim of this study was to explore the relation between lipid accumulation in the muscle (myosteatosis) and plasma CTSD levels in forty-five NAFLD patients. We observed that hepatic steatosis positively associated with plasma CTSD levels, confirming the previously established link between plasma CTSD and the liver. Furthermore, a positive association between myosteatosis and plasma CTSD levels was observed, which was independent of sex, age, BMI, waist circumference and hepatic steatosis. By establishing a positive association between myosteatosis and plasma CTSD levels, our findings suggest that, in addition to the liver, the muscle is also linked to plasma CTSD levels in NAFLD patients. The observed link between myosteatosis and plasma CTSD levels supports the concept of a significant role of the skeletal muscle in metabolic disturbances in metabolic syndrome-related disorders.
COVID-19 and SARS-CoV-2: Everything we know so far – A comprehensive review
Authors: Naz Sumaira , Zahoor Muhammad , Sahibzada Muhammad Umar Khayam , Ullah Riaz , Alqahtani Ali S.
Published: May 2021

Coronavirus disease-2019 (COVID-19) emerged as a unique type of pneumonia outbreak in the Wuhan city of China in 2019 and spread to all its provinces in a matter of days and then to every continent of the world except Antarctica within 3–4 month. This paper aims to comprehensively consolidate the available information about COVID-19 and present all the possible information about this disease in form of a single paper to readers. Unparalleled research and exhaustive studies of everything about the disease and its causative virus, i.e., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are underway since its emergence. The genome sequence of the virus was made available within a record short time by China, making possible immediate study of its structure and characteristics. The routes of transmission of the disease, signs and symptoms, incubation period, pathogenesis, and pathophysiology have been extensively studied and presented in an organized way in this review paper. The number of confirmed cases and case fatality and mortality rates are updated regularly. The different diagnostic mechanisms have been characterized. Testing and management criteria and protocols have been adopted. Extensive efforts are underway for finding a treatment of the disease and developing a vaccine against it. A number of vaccines are available even in markets in different countries. More and more ways of personal protection, prevention, and mitigation of the disease are being explored and shared. While the outbreak has been declared as pandemic, the response of scientists was timely and enormous; thousands of publications about various aspects and impact of the diseases and its causative virus are there on the World Health Organization database and many more studies are underway. The purpose of writing this review article is to provide a comprehensive summary of the major aspects and important scientific findings so far, about COVID-19 and SARS-CoV-2, in a single article for ready reference.
On the drag force closures for multiphase flow modeling
Authors: Norouzi Hamid Reza , Golshan Shahab , Zarghami Reza
Published: May 2021

Drag force models are one of the most important factors that can affect TFM and CFD-DEM simulation results of two-phase systems. This article investigates the accuracies, implementation issues and limitations of the majority of the drag models for spherical, non-spherical and systems with size distribution and evaluates their performance in various simulations. Around 1888 data points were collected from 19 different sources to evaluate the drag force closures on mono-dispersed spherical particles. The Reynolds number and fluid volume fraction ranges were between 0.01 and 10,000 and between 0.33 and 1, respectively. In addition, 776 data points were collected from seven different sources to evaluate the drag force closures on poly-dispersed spherical particles. The Reynolds numbers were between 0.01 and 500, fluid volume fractions between 0.33 and 0.9, and diameter ratios up to 10. A comprehensive discussion on the accuracy and application of these models is given in the article.
A case of severe SARS-CoV-2 infection with negative nasopharyngeal PCR in pregnancy
Authors: Fuchs Anna , Harris Lauren , Huber Ashley , Heiligenstein Mia , Heiselman Cassandra , Herrera Kimberly , Garretto Diana
Published: May 2021

Objectives

SARS-CoV-2 remains a pressing issue for our obstetric community during the current pandemic. We present a case of a 22-year-old nulliparous woman 31 weeks pregnant, with significant clinical SARS-CoV-2 disease, in the setting of negative nasopharyngeal PCR testing but positive IgG antibodies.

Case presentation

This was a 22-year-old patient 31 weeks pregnant who presented with fever, tachycardia, and subsequently preterm premature rupture of membranes (PPROM) and pulmonary emboli with multifocal pneumonia. The patient underwent three negative SARS-CoV-2 tests via nasopharyngeal PCR testing during her hospital stay as well as a negative workup for fever. After a cesarean section for worsening maternal status after 7 days of hospitalization, the patient was admitted for worsening clinical status to the SICU. At the time of SICU admission patient was found to have serum IgG positive antibodies and was managed with intubation, antibiotics, and anticoagulation. Patient eventually left hospital against medical advice on hospital day 16 on oral antibiotics but was found to be recovering well at later outpatient follow up.

Conclusions

Diagnosis of SARS-CoV-2 remains a complicated picture in the setting of testing limitations. This case highlights an antepartum clinical presentation of severe SARS-CoV-2 and recommends a high clinical suspicion for diagnosis of SARS-CoV-2 and initiation of treatment in the pregnant population, even in the presence of negative nasopharyngeal PCR testing.
Effect of whole-body vibration after a resistance exercise bout on heart rate variability in hypertensive population
Authors: Hanif Humaira , Orooj Munazzah , Parveen Adila
Published: May 2021

Objectives

To investigate the effect of whole-body vibration (WBV) in the recovery phase after resistance exercise (RE) bout on heart rate variability (HRV) and blood pressure (BP) in a hypertensive population.

Methods

Twenty hypertensive males and females were randomly allocated into group A (RE bout), and group B (RE bout with WBV). Pre-test and post-test measure of HRV, systolic blood pressure, and diastolic blood pressure were taken before and after RE and placebo WBV in one group and in another group of RE with WBV in the recovery phase.

Results

There were no significant differences in both RE bout group and RE bout with WBV on HRV parameters but on BP it has shown significant improvement in both groups with a p value of SBP and DBP as 0.001 and 0.03 respectively but comparatively RE with WBV in recovery has greater improvement.

Conclusions

Our data demonstrated that RE bout using WBV has no improvement on HRV but it has significantly improved BP in hypertensive population.
Constructing Cycles in Isogeny Graphs of Supersingular Elliptic Curves
Authors: Xiao Guanju , Luo Lixia , Deng Yingpu
Published: May 2021

Loops and cycles play an important role in computing endomorphism rings of supersingular elliptic curves and related cryptosystems. For a supersingular elliptic curve E defined over 𝔽
p
2
, if an imaginary quadratic order O can be embedded in End(E) and a prime L splits into two principal ideals in O, we construct loops or cycles in the supersingular L-isogeny graph at the vertices which are next to j(E) in the supersingular ℓ-isogeny graph where ℓ is a prime different from L. Next, we discuss the lengths of these cycles especially for j(E) = 1728 and 0. Finally, we also determine an upper bound on primes p for which there are unexpected 2-cycles if ℓ doesn’t split in O.
Seasonal diet composition of Himalayan goral (Naemorhedus goral) in Kajinag National Park, Jammu and Kashmir, India
Authors: Dar Jahangir Ahmad , Fazili Mustahson F. , Bhat Bilal A. , Wani Ishfaq Nazir , Ahmad Riyaz
Published: May 2021

In temperate environments, forage availability and quality are known to influence life history traits of wild ungulates. However, variations in foraging strategies of these mountain dwellers with changing plant availability have received little attention. The seasonal vegetation availability in temperate climatic conditions of Kajinag National Park (KNP) was assessed by plot method at different altitudes (1900–3600 m a.s.l.) from 2018 to 2020 on seasonal basis. The objective of this study was to determine the impact of availability of vegetation on seasonal diet composition of Himalayan goral (Naemorhedus goral) inhabiting the National Park. We recorded 61 plant species whose availability differed significantly across seasons (F
3,240 = 20.14, p < 0.05). We found seasonal variation in the diet composition of Himalayan goral depicting a strong relationship between plant consumption and dynamic availability in the study area. Himalayan goral consumed herbs in spring (dominated by Dioscorea deltoidea relative importance value (RIV) = 27.20, Poa pratensis RIV = 14.99 and Themeda spp. RIV = 12.87), grasses in summer (dominated by Themeda spp. RIV = 34.12, P. pratensis RIV = 30.14, Bothriochloa ischaemum RIV = 22.72) and autumn (dominated by Themeda spp. RIV = 34.64, P. pratensis RIV = 30.14, Stipa spp. RIV = 29.73) and shrubs in winter (dominated by Indigofera heterantha RIV = 47.05, Prunus tomentosa RIV = 17.51 and Lonicera spp. RIV = 16.98). The annual diet of Himalayan goral was dominated by graze species (72.66%). The proportion of graze items in the diet showed a sharp decline from spring (90.67%) to winter (19.23%) whereas that of browse showed a huge increment from spring (4.67%) to winter (74.43%). This shift shows a survival or foraging strategy of a temperate ungulate in harsh winters with limited forage availability.
New records and southern range extension of the Annamite striped rabbit Nesolagus timminsi in Vietnam
Authors: Nguyen An , Tilker Andrew , Le Duy , Le Huong Van , Le Son Van , Luu Truong Hong , Tran Bang Van , Wilting Andreas
Published: May 2021

The Annamite striped rabbit Nesolagus timminsi is a little-known and Endangered lagomorph endemic to the Annamites ecoregion of Vietnam and Laos. The species’ known distribution extends from the northern to central Annamites. Here, we report the first records of the species from the southern Annamites. We recorded camera-trap photographs of Annamite striped rabbit in Bidoup – Nui Ba National Park, located in Lam Dong province, Vietnam. The photographs represent the first records of the species from the southern Annamites, and a significant southern range extension. We discuss the implications of this finding for Annamite striped rabbit conservation.
Clinical and prognostic features of MMP-2 and VEGF in AEG patients
Authors: Zheng Qing-Kang , Yin Qing , Zhang Nan , Sun Zhi-Gang
Published: May 2021

Adenocarcinoma of the esophagogastric junction (AEG) has been increased in recent years and has become a worldwide problem that seriously affects human health. The purpose of the study is to investigate the clinical and prognostic characteristics of the matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) expression in AEG patients. A total of 69 patients were enrolled in this study. The result showed that the high expression of MMP-2 was significantly associated with tumor differentiation (P < 0.05) and depth of invasion (pT, P < 0.05). The high expression of VEGF was significantly associated with pT (P < 0.05) and lymph node metastasis (pN, P < 0.05). There was a positive correlation between MMP-2 and VEGF expression (P < 0.01). The 5-year survival rate for the 69 AEG patients was 40.6% and it was significantly associated with tumor differentiation (P < 0.05), pN (P < 0.01), pTNM stage (P < 0.01), MMP-2 expression (P < 0.05), and VEGF expression (P < 0.05). Cox multivariate regression demonstrated that tumor differentiation and pN were independent factors for the 5-year survival rate. Our study showed that MMP-2 and VEGF could work synergistically in AEG development.
Correlation between MTHFR 677C > T polymorphism and response of pemetrexed-based chemotherapy in advanced NSCLC: A meta-analysis
Authors: Han Feng , Xu Wengui
Published: May 2021

Objective

The aim of this study was to investigate the correlation between MTHFR 677C > T polymorphism and response of pemetrexed-based chemotherapy in advanced non-small-cell lung cancer (NSCLC) by pooling the open published relevant studies.

Methods

Clinical studies associated with MTHFR 677C > T polymorphism and response of pemetrexed-based chemotherapy in advanced NSCLC were systematically searched in databases of Pubmed, Embase, Cochrance Library, China national knowledge infrastructure (CNKI) and Wanfang. The correlation was expressed by odds ratio (OR) and corresponding 95% confidence interval (95% CI). The publication bias of the included studies was evaluated through Begg’s funnel plot and Egger’s line regression test.

Results

Ten prospective clinical studies relevant to MTHFR 677C > T polymorphism and response of pemetrexed-based chemotherapy in NSCLC were included in the present meta-analysis. The pooled results indicated that the partial response in NSCLC patients with TT or CT genotype was inferior to CC genotype in a dominant gene model (TT + CT vs CC) (OR = 0.16, 95% CI: 0.06–0.41, P = 0.001). NSCLC cases with T genotype were inferior to C genotype in the objective response rate treated with pemetrexed-based chemotherapy for dominant (OR = 0.28, 95% CI: 0.18–0.45, P = 0.001), recessive (OR = 0.43, 95% CI: 0.19–0.94, P = 0.03) and homozygous models (OR = 0.30, 95% CI: 0.13–0.67, P = 0.003). However, there was no statistical difference in disease control rate, progressive disease between different genotypes of different gene models (P
all > 0.05).

Conclusion

The pemetrexed-based chemotherapy response was decreased in NSCLC cases with T genotype, which can be applied as a potential pemetrexed-based chemotherapy response marker.
Investigating the field effectiveness of respirators against metal particle exposure in various workplaces: a systematic review
Authors: Rafiee Ata , Laskar Imranul , Quémerais Bernadette
Published: May 2021

Welders are exposed to high levels of metal fumes, which could be resulting in various health impairments. Respirators became a practical protective option in workplaces, as they are lightweight and easy to use. This systematic review attempts to explore the field effectiveness of using respirators to reduce metal particle exposure in workplaces. We reviewed papers published from 1900 to April 2019 in five major bibliographic databases, including Embase, Web of Science, Medline, Scopus, and CINAHL, along with organizational websites to cover gray literature. In total, 983 references were identified from the databases, out of which, 520 duplicates were removed from the EndNote database. The remaining 463 references were screened for their title and abstract. Out of 463, 70 references went through the full-text screening. Finally, eight papers, including 19 workplace respirator studies, satisfied all the inclusion criteria and were reviewed in this report. The geometric means for metal levels in workers’ breathing zone with and without respirators were 9.4 and 1,777 µg/m3 for iron, 1.1 and 139 µg/m3 for lead, 2.1 and 242 µg/m3 for zinc, and 27 and 1,398 µg/m3 for manganese oxide, respectively. Most reviewed studies reported significant differences between measured metal particle levels among workers who worn respirators and who did not. In addition, results showed that N95 provided significantly less protection than elastomeric half facepieces, full-face respirators, and powered air-purifying respirators (p<0.001). More field studies are recommended to investigate Workplace Protection Factor (WPF) and fit factor (FF) of different respirators to understand the actual protection levels that they could be provided to control welding fume exposure among welders in various workplaces.
Visual outcomes in diabetic macular edema patients after avastin injection
Authors: Masih Charles , Parveen Kanwal , Brohi Samreen , Bano Siyal Shehar , Zia Fatima , Pari Bhutto Shabnam , Faisal Fahim Muhammad
Published: May 2021

Objective: To determine the visual outcome in Diabetic Macular Edema patients after 3rd Avastin injections attending a tertiary eye care hospital. Materials and methods: This was a cross sectional study with Non probability convenient sampling technique. The study was carried out at Diabetic clinic of Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi-Pakistan. Ethical approval was taken from the institutional review board of Institute. Data collection were done retrospectively from January 2017 to June 2019. Data were retrieved for DME patients who have completed three follow-ups with Avastin injection. Inclusion Criteria were patients with age 30 to 60 years, Patient with PDR and NPDR with diabetic macular edema after 3rd injection. Data Analysis was done using SPSS version 23.0. Results: A total of 40 eyes of 40 patients were included in this study after getting information from the record sheet. Analysis were done in 30 eyes of 30 patients because 10 patients were missed their follow-up due to certain reason which were observed from record sheet. Mean age of patients was found to be 41.25±10.24.Pre-operative Avastin injection best corrected visual acuity (BCVA) was noticed by using Log MAR without glasses was 0.49 and with glasses was 0.40. Post-operative best corrected visual acuity Log MAR without glasses 0.51 and with glasses 0.42 after Avastin injection. Improvement of visual acuity was classified as Improved, worsen and Stable. There were 22 (73.33%) patients observed with improvement in visual acuity, 5 (16.66%) patients retained their vision stable and only 3 (10%) patients worsen their visual acuity after all three Avastin injections. Conclusion: The most common cause of diabetic macular edema is non-proliferative diabetic retinopathy and proliferative Diabetic Retinopathy. The Intravitreal injection play vital role, the timely treatment would improve prognosis of visual outcomes in Diabetic macular edema. So the study significantly shows the improvement in best corrected visual acuity before and after three visits.
Worldwide statins prescription pattern: is it similar?
Authors: Amiri Masoud
Published: May 2021

Statins are commonly prescribed to prevent or treat of cardiovascular diseases (CVD) worldwide, preventing about 80,000 stroke and heart attack cases annually. Various statins have been initiated with different biologic properties, chemical structure, safety, efficacy and side effects, with no similar prescription pattern in different countries. One of the most common reasons of the changes among different countries, might be due to the behavior of physicians in various continents.
The impact of intraoperative gloves changing by the surgical team on the post operative wound infection after a Caesarean section, in a tertiary care hospital
Authors: Hameed Nazli , Jamshed Rabia , Ali Muhammad Asghar , Butt Binyamin , Iqbal Faiza , Rashid Saira
Published: May 2021

Background:Cesarean delivery is a major obstetrical surgical procedure aiming to save the lives of mothers and fetuses. Cesarean deliveries were initially performed to separate the mother and the fetus in an attempt to save the fetus of a moribund patient. Access to nonmedical interventions during labor, such as continuous support during labor and delivery, should be increased. The safe practice during cesarean can provide the protection from infection. Objective:To compare the outcome with changing gloves intra-operatively by entire team versus standard practice (no changing gloves) during cesarean section Material & methods: study design:Randomized controlled trial. Setting:Department of Obstetrics & Gynaecology, Shalamar Hospital Lahore for 6months. Data collection:After meeting the inclusion criteria 160females were enrolled. Then females were randomly divided into two groups. Group A females operated with changing gloves of entire team and group B operated with no changing gloves. During ward follow-up, females were evaluated for febrile morbidity. At the time of stiches removal wound infection was observed. All the collected data was entered and analyzed on SPSS version 21. Results:The mean age of females was 29.06±6.79years, the mean gestational age at delivery was 38.88±1.47weeks. In changing gloves group the wound infection was found in 4(5.0%) females while in no changing gloves group the wound infection was found in 15(18.8%) females (p-value=0.013). Conclusion:The adopting changing gloves practice by entire team during cesarean section showed better outcome in terms of wound infection and febrile morbidity than no changing glove practice.
Brain Catastrophe presented with endocrine disruption
Authors: AlJadir Saadi JS
Published: May 2021

Pituitary Apoplexy (PA) is an acute critical endocrine condition that is infrequently encountered in daily medical practice. Its life-threatening condition that mandates prompt diagnosis and urgent treatment and may be neurosurgical intervention. Majority of cases are attributed to ischemic infarction or hemorrhage of the pituitary gland usually in the vicinity of pituitary adenoma, and in most cases could be the initial manifestation of these tumors! In reviewing the literatures there is conflicting evidence of which are the predominant, non-functional, or functional adenomas, some reports were showed that prolactin-secreting are at highest risk. There are recognizable risk factors that might precipitate this endocrine emergency like hypertension, medications, major surgery, head injury, radiation, or dynamic testing, but in majority of cases at presentation no identifiable risk factor could be detected. The typical clinical scenario includes persistent worsening headache, vomiting, and altered level of consciousness, visual defect or loss with extreme hormonal derangements which are shown by hemodynamic instability, adrenal crises with variable hormonal deficiencies.
A case report of recurrent uterovaginal prolapse and cervical elongation in anulliparous female with a distorted Pelvis
Authors: Hameed Nazli , Butt Binyamin , Jamshaid Rabia
Published: May 2021

Recurrent uterovaginal prolapse adversely affects the life quality in women. Genitourinary prolapse affects around 40-50 % of women in their lifetimes with a higher incidence in women of advanced age and parity. It is less common in females of reproductive age, being particularly rare in nulliparous females. The reported incidence in this group is only 1%. In this case report we are highlighting a rare case of uterine prolapse in a young nulliparous woman after pelvic fracture. The cervix was also unusually long None of the previous surgeries took into account the elongated cervix with the prolapse, contributing to the so-called recurrence in this patient. The treatment of this patient was done by combining Sacro hysteropexy with Manchester Repair.
Clinical profiles of thyroid dermopathy: a dermato-endocrinology minireview
Authors: Azeez Taoreed Adegoke , Egbu Ayobami Chioma
Published: May 2021

Background: Thyroid disorders sometimes have extra-thyroidal manifestations. Hyperthyroidism is a clinical syndrome resulting from excessive secretion of thyroid hormones. The commonest cause is Graves’ disease. About 0.5 – 4.3% of patients with Graves’ disease have an infiltrative dermopathy called thyroid dermopathy. It is due to excessive deposition of glycosaminoglycans from activated fibroblasts. Skin fibroblasts are activated by thyroid stimulating hormone receptor antibodies and the whole process is initiated by T lymphocytes. Thyroid dermopathy is rarely also found in other thyroid disorders such as Hashimoto thyroiditis. The diffuse non-pitting oedema variant is the commonest clinical presentation. Other variants include the nodular, plaque, mixed and elephantiasis types. The main concerns of the patients usually are cosmetic, discomfort and difficulty in wearing shoes. Thyroid dermopathy usually presents after the diagnosis of Graves diseases but it may present together or sometime after. Rarely, thyroid dermopathy presents before the diagnosis of Graves’ disease is made. Apart from the shin and feet, other sites that can be affected include arms, forearms, back, thighs, pinna and nose. Conclusion: The management is multidisciplinary, involving Dermatologists and Endocrinologists. Usually, controlling the thyroid dysfunction does not translate into regression of the skin lesion. However, many patients have their thyroid dermopathy regressing spontaneously while others usually require local therapy. Other therapeutic options include systemic therapy such as pentoxifylline, compressive physiotherapy and surgery.
Eruptive xanthomas, lipemia retinalis in a lean young female patient with new onset diabetes mellitus and hypertriglyceredemia
Authors: Ullah Asad , Ali Sobia Sabir
Published: May 2021

Eruptive xanthomas and lipemia Retinalis are a very rare finding which is pathognomonic of underlying Hypertriglyceridemia and Diabetes mellitus. Both these clinical entities are an indication of underlying metabolic derangements, so prompt action in the form of life style modification and drug therapy is important to avoid the development of serious long term complications like atherosclerosis and pancreatitis. We present a rare case of Eruptive xanthomas and lipemia Retinalis in 16years old young lean female patient as the first presentation of new onset Diabetes mellitus and underlying hypertriglyceridemia.
Role of therapeutic phlebotomy in management of case of porphyria cutanea tarda (PCT) admitted in tertiary care hospital Vadodara
Authors: Dogra Ashu
Published: May 2021

Porphyria cutanea tarda is the most frequent type of Porphyria worldwide & presents with skin symptoms mainly. Porphyrias can affect peripheral, autonomic and central nervous system. In Porphyria conditions there is accumulation of heme precursors 5 Aminolevulinic acid, Porphobilinogen and porphyrins which are associated with characteristic clinical feature with acute neurovisceral attacks and skin lesions. This case report summarizes Case of PCT that was successfully managed with Therapeutic Phlebotomy.
Peripheral blood smear pathologist tool
Authors: Kapil Menka , Sareen Rateesh , Gupta GN
Published: May 2021

Microscopic evaluation of a peripheral blood smear is one of the most valuable test for the diagnosis and differential diagnosis of disease inclusive of clinical history and physical examination. Despite advances in haematology automation and application of molecular techniquesits diagnostic relevance is enormous.
Prevalence of ABO blood groups in patients with haematological malignancies: a retrospective study
Authors: Mathew Ashwin , Pailoor, Kirana , Deepthi Konchady , Shenoy Suresh
Published: May 2021

Background: The pattern and distribution of Haematological malignancies vary depending on age, sex and geographical location. Studies on the association between Haematological cancers and ABO blood types have been largely conflicting. The objective of our study was to determine the distribution of ABO blood groups among patients with Haematological malignancies and to correlate with age and gender. Materials and Methods: This was a chart based observational descriptive study involving the review of records of 85 patients with various Haematological malignancies in Father Muller Medical College Hospital for a period of two years from July 2017- June 2019. Age, gender, malignant condition, ABO and Rh blood group were collected for each case. Data was analyzed statistically by frequency and percentage. Results: The peak age incidence for various Haematological malignancies was in the fifth and sixth decades of life with a mean age of 47.The male to female sex ratio was almost 1:1. Majority of the patients were of the O blood group and an association of O blood group with various hematological malignancies with male preponderance was noted. Altogether, Leukemias were the most common Haematological malignancy observed in this study. Conclusion: The distribution, age and sex ratio of Haematological malignancies in our study was comparable to those reported by other authors with Acute Myeloid Leukemia (AML) being the most common Haematological malignancy in our environment. There was no significant association between Haematological cancers and ABO blood type of the patients, but probably individuals with O Rh positive blood group are more prone to
Is a severe and early neuropathy related to bortezomib? Is it related to the treatment response?
Authors: Sanchez Maria Pereiro , Fernández Gonzalez María Perfecta , López Doldán María del  Carmen , Gómez Marquez Aurea María , Sastre Moral José Luis , Redondo Carlos Ulibarrena
Published: May 2021

Myeloma is characterized by the neoplastic proliferation of a clone of plasma cells that invades the bone, causes destruction of the skeleton, and causes bone pain and fractures. In addition, other important features are anemia, hypercalcemia and renal failure. The standard treatment in Spain for autologous stem cell transplant (ASCT)-eligible patients is VTD (bortezomib, thalidomide, dexamethasone). Both bortezomib and thalidomide can cause or exacerbate an existing neuropathy. The mechanism by which they produce it is different in the two drugs.1 A 52-year-old white male was referred to our hospital for the evaluation of anemia (12 g/dL) and serum monoclonal protein (>4 g/dL). The diagnosis was a high cytogenetic risk MM stage R-ISS IIIA, without bone lesions. He only presented mild anemia. He started treatment with standard doses and in accordance to the usual protocol in a candidate patient for autologous stem cell transplant, based on a thalidomide and bortezomib scheme. On the 15th day of the 2nd cycle, the patient showed an autonomic neuropathy and an affectation of the deep sensibility, predominantly the vibratory and proprioceptive with generalized muscle weakness predominant in the lower limbs. He had no pain. He was totally dependent for the basic activities of daily life. Regarding the MM response, the patient showed a strict complete response. This case illustrates a young man with a high cytogenetic risk MM who developed an acute and early polyneuropathy grade IV after 1.5 cycles of standard treatment and with myeloma in strict complete response. The remarkable aspect about this case is the severe and early neuropathy, and an early, deep and persistent myeloma response. On some occasions this relationship has been reported, and we report an example of it.
The quality of blood dropped from an unmanned aerial vehicle (Drone)
Authors: Yakushiji Koki , Yakushiji Fumiatsu , Fujita Hiroshi
Published: May 2021

Objective: To evaluate the risk of deterioration in the quality of blood transported by a fixed-wing drone. Materials and methods: Red blood cell (RBC) solutions were categorized into “travel group” (transported by train or car to test place) and “non-travel” group. The travel group was further subcategorized into “dropped,” and “non-dropped” groups. One bag each from the dropped and non-dropped groups were wrapped in an Absorption Sheet (A-Sheet) and an Under Sheet (U-Sheet). RBC solution of dropped group was dropped onto the ground from an altitude of 10 Lactate dehydrogenase (LD) levels from the samples of RBC solution were measured and the LD ratio (LDR) was calculated as the rate of increase of the LD which can be compared. We compared the differences in LDR between the dropped and non-dropped groups. Results: In the dropped group, there was an increase in LDR before filtration in the blood wrapped in the A-sheet. No increase was noted in the blood wrapped in the U-sheet. LDR levels after filtration were slightly increased in the blood samples wrapped in the U-sheet and clearly increased in blood samples wrapped in the A-Sheet. Conclusion: We considered the possibility of blood getting hemolyzed due to a fall and observed that hemolysis was affected by packing. Thus, since it may be difficult to find good packaging for blood, dropped blood may not be safe for transfusion due to the likelihood of hemolysis. Hence, for practical purposes, using a drone without a fixed-wing may be preferable for transportation of blood.
An active transport refrigerator is optimal for blood preservation in small medical facilities
Authors: Fujita Hiroshi , Tsuno Katsuhiro , Tanaka Asashi
Published: May 2021

Objective: In small medical institutions in Japan, red blood cell (RBC) solutions are commonly stored in household refrigerators because of the high cost of blood-only refrigerators. Therefore, we assessed and compared the methods used for preserving the RBC solutions in an active transport refrigerator (ATR), a blood-only refrigerator, and a household refrigerator. Materials and Methods: Irradiated RBC solution samples (280 mL) supplied by the Japanese Red Cross Society (experiments 1–8) and in-house whole blood waste (experiments 9–10) were each divided into two bags. The quality of blood stored in an active transport refrigerator was compared with that of blood stored in a blood-only refrigerator or a household refrigerator. We tested the hemolytic effects of storage and filtration through a transfusion set on the lactate dehydrogenase ratio (LDR) of the RBC solutions. Results: Although the LDR of the RBC solutions stored in the ATR was similar to that of the RBC solutions stored in the blood-only refrigerator, the LDR of the RBC solutions stored in the household refrigerator was significantly higher than that of the RBC solutions stored in the ATR. Conclusion: Temperature management using an ATR is critical for the maintenance of the quality of the RBC solution, which is not achieved by a household refrigerator.
Papillary thyroid carcinoma: case presentation and literature report
Authors: Jiménez Báez María Valeria , María Margarita Chávez Hernández , Lorena Berenice Hernández Hoil , Jurado Luis Sandoval
Published: May 2021

We present a case of classic papillary thyroid carcinoma in a 35-year-old patient who initially consulted dermatology for hair loss and dry skin, fatigue, and mild fatigue. The thyroid hormone report was standard, and the neck ultrasound reported two thyroid nodules and cervical lymphadenopathy TIRADS 4. The BAAF Bethesda V report. The patient underwent total thyroidectomy and left lymphadenectomy I-VI, classifying as pT2 (m) pN1b cM0, followed by adjuvant management with I-131 with the complete biochemical response at six months. In recent decades, thyroid carcinoma has increased in incidence.
Prevalence of hearing impairment in patients with diabetes mellitus at tertiary care center of Nepal
Authors: Bhat Neeti , Bahadur Mahotra Narayan , Shrestha Lava , Shrestha Tirtha Man , Tripathi Prashant , Gupta Mudit , Gurung Sanyukta
Published: May 2021

Background: Diabetes mellitus is a chronic, systemic and metabolic disorder known to affect almost every organ due to its unequivocal complications. The auditory organ is often affected but usually ignored complications of diabetes mellitus. With the rise in the prevalence of diabetes mellitus and hearing impairment in developing countries, it becomes a crucial public health issue if both of them are found to be associated. Objective: To find the prevalence of hearing impairment in diabetic patients. Materials and Methods: This was a cross-sectional study conducted at the Department of Clinical Physiology in collaboration with the Department of General Practice and Emergency Medicine and the Department of Otorhinolaryngology- Head and Neck Surgery, Tribhuvan University Teaching Hospital. After applying exclusion criteria, 55 subjects were recruited for the study. Pure Tone Audiometry, a non-invasive test was used to assess hearing threshold in this study. Audiogram findings of diabetics were then analyzed. Results: Outcomes of the tests revealed that 17 (30%) of subjects with diabetes mellitus had hearing loss, out of which 13 had mild hearing loss. A significantly positive correlation was found between age and hearing threshold at every frequency. Higher frequencies were found to be more affected. The best cut-off age for onset of hearing loss in diabetics was found to be 51.50 years. Conclusion: Current study suggests a 30% prevalence of hearing loss in diabetes mellitus. We observed hearing loss more among the elderly at higher frequencies
Ota's nevus: about a case
Authors: Oukarfi Sara
Published: May 2021

We report the case of a 4 month old patient, with no specific history, with congenital oculo palpebral melanocytosis. The dermatological examination had objectified a homogeneous slate gray macular cupboard occupying the cutaneous territory of the 1st and 2nd branches of the trigeminal nerve on the left side (Figure 1), in dermoscopy we objectified a blue aspect to slate gray in clod with yellowish zones without structure, without peri follicular hypopigmentation (Figure 2). The ocular examination was normal.
Microneedling with radiofrequency for improvement in neck skin laxity and texture
Authors: Kaufman Joely
Published: May 2021

In recent years, the number of patients presenting with neck rhytides has been increasing. This increase is in part due to the availability of newer non-invasive technology to treat the normal aging process, but also due to the postural and behavioral changes of this generation where people adopt a head down posture in order to be able to use their computers or smartphones. We present the successful treatment of a case of anterior neck skin laxity and texture with microneedling and radiofrequency.
Pregnancy tumor: a case report
Authors: Benkirane Selma
Published: May 2021

During pregnancy, some skin tumors can occur accidentally due to hormonal changes. Pyogenic granuloma is part of it by acting on the vascular system and deserves special attention in treatment. The diagnosis is based on the clinic, dermoscopy and histology. We report a case.
Detrimental effects of perfumes, aroma & cosmetics
Authors: Athar Mohammad
Published: May 2021

Perfumes have been historically used primarily for fragrance. Aroma or fragrance has also been added to the cosmetics to make it more attractive. These fragrance products emit a range of chemicals including hazardous pollutants but the ingredients do not fully disclosed on the product label. Hence, they are found to cause various detrimental effects ion human health. The detrimental effects associated with the use of perfumes are contact dermatitis, contact urticaria, and photo allergy and photo toxicity. Detrimental effects of cosmetics are lungs disease, damage to reproductive organs, skin allergies, excessive hair problems, headache and cancer. The present review summarizes some of the harmful effects caused by the use of fragrance products including perfumes, aroma and cosmetics. Moreover, the preventive measures which have to be taken care of have also been discussed.
Myositis ossificans degenerating into extra-skeletal osteosarcoma: a rare disorder, which degenerates more rarely: case report
Authors: Dahhouki Sara
Published: May 2021

Myositis ossificans is a benign lesion characterized by focal heterotopic soft tissue ossification and occurring in young people generally after localized trauma. It can mimic osteosarcoma but it rarely degenerates. We report a case of a patient with myositis ossificans which degenerates into extra-skeletal osteosarcoma
Superior vena cava syndrome and lung cancer: survival and prognostic factors
Authors: Fahem Nesrine , Migaou Asma , Ben Saad Ahmed , Jobeur Sameh , cheikh Mhammed Saoussen , Rouatbi Naceur
Published: May 2021

Introduction: The superior vena cava syndrome (SVCS) is a set of signs related to the obstruction of the upper cava current caused by a compression, an invasion or a thrombosis of the superior vena cava. Its etiologies are numerous but dominated by neoplastic causes mainly of bronchopulmonary origin. Aim of the work: The aim of this study is to evaluate survival and to identify the prognostic factors of superior vena cava syndrome in patients with lung cancer. We also propose to draw up the clinical profile as well as the therapeutic management in SVCS of malignant origin. Materials and methods: A total of 108 patients with SVCS complicating primary bronchial cancer were hospitalized in the Pneumology Department at Fattouma Bourguiba University Hospital during a period of 25 years. Results: The results showed the existence of a clear male predominance (98.1%) and an average age of 60.2 years. Smoking was found in 68.5% of cases .The superior vena cava syndrome revealed a neoplasm in 55% of cases and it was metachronous in 30.5% of cases. Median survival was 7months. In univariate study, survival was reduced in patients having general health impairment with Performans Status (PS) score≥2, signs of severity of SVCS, altered respiratory function, chronic respiratory failure, histological type of non small cell lung carcinoma and exclusive symptomatic treatment for bronchopulmonary cancer. Multivariate analysis revealed that gender, smoking, PS score and signs of severity were independent prognostic factors. Conclusion: The management of the SVCS is multidisciplinary. It requires medical treatment whose effectiveness is still uncertain and radiotherapy which is considered the gold standard of treatment for SVCS.
Prevalence of mycobacterium tuberculosis and their possible risk factors in suspected tuberculosis patients of district mardan khyber pakhtunkhwa, Pakistan
Authors: Naveed Muhammad , Shahid Muhammad , Hassan Adil , Ur-Rehman Mujeeb- , Hayat Azam
Published: May 2021

Tuberculosis (TB) is one of the chronic contagious diseases caused by Mycobacterium Tuberculosis that affect humans and animals. It is stated that TB is one of the major leading cause of morbidity and mortality throughout the globe. According to the WHO, approximately one-third people of the world are infected and about 3 million people die annually due to this disease. The present study reported the incidence rate of pulmonary TB and their possible risk factors in suspected TB patients according to age, gender, and location-wise prevalence of the disease in District Mardan, Khyber Pakhtunkhwa, Pakistan. A total of 380 sputum samples were collected from infected Tuberculosis patients and initially screened for acid-fast bacilli through Zeihl Neelson (ZN) microscopy and positive samples were further assayed by Real-time Polymerase Chain Reaction (GeneXpert). Out of these sputum samples 40% were positive for ZN staining and 31.57% were positive by GeneXpert. The prevalence rate was reported high in the age group of above sixty while a lower prevalence rate was found in the age group of 5-20 years. Male to female ratio was recorded at 37.83% and 41.37% respectively. Geographically, rural populations were highly infected by M. Tuberculosis which showed 45.19% as compared to the urban population showed 26.16% prevalence rate. All the relative risk factors are statistically significant having p-value (<0.05). It was concluded from our finding that TB was considerably increased in the general population of District Mardan, and proper supervision, diagnosis, treatment, and awareness of rapid prophylactic measures are needed to eradicate the risk.
Pulmonary blastoma in an adult male
Authors: A Alim Mohammad , Alam Dina Abo , Sayed Yaser El , Abdellateef Amr , Ghareeb El Sayed Al , Nafee Mohammad , Sayed Mohammad El , Eid Mohammad , Mageed Suzan A , Sayed Sahar El
Published: May 2021

Pulmonary blastoma is one of the rare lung tumors and is considered to be dissnct from other lung tumors by its pathological features, clinical course and prognosis.1 Classic pulmonary blastoma is composed of both malignant mesenchymal stroma and epithelial components resembling embryonic lung tissue. Surgery is the standard treatment and the efficacy of adjuvant chemotherapy and radiotherapy has not yet been established
Success from Lease-based farming-a case study of Dalit women farmer group from Bhagwanpur Rural Municipality (RM), Siraha, Nepal
Authors: GC Sagar , Khatri Laxman , Shah Dilip Kumar , Sharma Jibnath
Published: May 2021

The case study reflects the impact of leasehold farming promoted on the livelihood of women group in Bhagwanpur RM. The data for the analysis of results of leasehold farming were collected through survey of the individual farmer involved and through key informant interview. The study revealed that people encouraged with the motivation from local government, supporting organizations and visitors of the site has brought measurable positive changes(food security, occupation, education, income, policy etc.) in the lives of the landless people and has set a good example among other local governments for its scaling.
Marriage Conflicts Against the Psychology of Children
Authors: Kurniati Pat , Maftuh Bunyamin , Malihah Elly , Subkhan Muhamad , Rumiati Sri
Published: May 2021

The reality in society shows that not all married couples have the same relationship pattern. In the sense that the life forms they have to live are different from one another. There are married couples who after marriage have to live separately. On the other hand, husbands are also found in living their domestic lives in an effort to form a harmonious and happy family, always dealing with various conflicts that can affect the child's psychology. This research is a qualitative research with a descriptive approach through library research or library research that refers to sources of books, journals, and other references related to research.
Strategic Management Teacher Performance Development to Improve Learning Quality
Authors: Syahid Abdu , Wasliman Iim , Muchtar Hendi Suhendraya , Hanafiah Nanang
Published: May 2021

Strategy Management for Teacher Performance Development to Improve the Quality of Lessons is a response to the quality of learning that still needs to be improved, by developing teacher performance, is a solution to improving the quality of learning. Focus of the problem: How to Implement Strategic Management of Teacher Performance Development to Improve the Quality of Learning. Specific objectives of this study are to identify and analyze: (1) Internal and External Environments, (2) Formulation of Strategy Formulation, (3) Strategy Implementation, (4) Teacher Performance Monitoring and Evaluation Management, (5) Strategic Steps to Overcome Problems and Weaknesses. Research methods and procedures refer to the qualitative research approach. The theories that underlie this research are strategic management theory, performance coaching theory, higher order thinking learning theory and madrasah culture theory. The main findings of this study are: (1) The principal of madrasah has not analyzed and combined strengths, weaknesses, opportunities and challenges into a strategic assumption conclusion that can be used as a basis for further strategic planning, (2) Strategy formulation is not based on strategic assumptions that maximize strength factors and minimizing the weakness factor by taking advantage of opportunities in facing challenges.