bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaginal Swelling After Intercourse: A Case Report
Authors: Bono Michael , Woolum Dylan , Jones A. , Counselman Francis
Published: May 2022

Introduction: A vulvar hematoma is a hemorrhagic fluid collection in the female external genitalia. The majority occur as an obstetrical complication, especially during labor. Non-obstetrical vulvar hematomas are usually the result of trauma, with coitus being the most common etiology.
Case Report: We present the case of a 25-year-old woman with significant vaginal pain and swelling after vigorous sexual intercourse. She exhibited tenderness and swelling of the left labia majora and minora. The differential diagnosis included bleeding, abscess, and deep venous thrombosis.
Laboratory studies were normal and computed tomography of the pelvis indicated the swelling was most likely due to blood. The patient was taken to the operating room, and approximately 150 cubic centimeters of clot was evacuated. The patient had an uneventful recovery and was discharged home the next day.
Conclusion: This case illustrates the unique presentation and challenges in making the diagnosis of vulvar hematoma.
Brugada-like ECG Changes After Conducted Electrical Weapon Exposure: A Case Report
Authors: Trumbetta Christopher , Galuska Michael
Published: May 2022

Case Report: A 38-year-old male with no pertinent medical history presented with suicidal ideation and alcohol intoxication after an altercation with the police. The patient received two CEW exposures during an encounter with law enforcement prior to transport to the emergency department. He was asymptomatic, but an ECG was performed as part of the triage process given his reported CEW exposure. His initial ECG showed ST-segment and T-wave changes in the precordial leads similar to those found in Brugada syndrome. After a three-hour period of observation and resolution of the patient’s alcohol intoxication, a repeat ECG was performed that showed resolving Brugada morphology.
Conclusion: Review of the literature surrounding the safety profile associated with CEW exposure shows few if any documented concerning cardiac electrophysiology changes and suggests that routine electrocardiographic studies or monitoring is not required. This case presents an isolated but interesting instance of a transient ECG abnormality associated with a CEW exposure.
A Rare Cause of Chest Pain Identified on Point-of-care Echocardiography: A Case Report
Authors: Chin Brian , King Kassandra , George Nicholas , Neeki Michael , Mistry Jamshid
Published: May 2022

Introduction: Cardiac masses are a rare cause of chest pain. They can often be missed on a chest radiograph performed to evaluate non-specific chest pain and are not readily evaluated with traditional laboratory testing. However, these masses can be visualized with point-of-care ultrasound.
Case Report: We present a case of a 19-year-old female presenting with intermittent chest pain, palpitations, and weakness present for two months. The patient had previously been evaluated at our emergency department one week earlier and was diagnosed with anxiety before being discharged. Besides a tachycardic and labile heart rate, physical examination and laboratory testing were unremarkable. Point-of-care cardiac echocardiography subsequently demonstrated findings concerning for a cardiac mass.
Conclusion: Cardiac masses are a rare cause of chest pain and palpitations that are easily missed. The advent of point-of-care ultrasonography has afforded us the ability to rapidly assess for structural and functional cardiac abnormalities at bedside, and incorporation of this tool into the evaluation of patients with chest pain offers the ability to detect these rare pathologies.
A Case of a Carotid Cavernous Fistula
Authors: Mahmoud Rami , Hensley Brooke
Published: May 2022

Case Presentation: A 73-year-old male presented to the emergency department complaining of pain in his right eye for four weeks. He denied any trauma, and the pain was accompanied by ptosis, proptosis, swelling, redness, blurred vision, and a frontal headache. On examination, conjunctival arterialization was also appreciated. Magnetic resonance imaging and angiography showed evidence of a carotid cavernous fistula for which the patient underwent successful transvenous coiling and embolization.
Discussion: Carotid cavernous fistulas are classified as higher flow, direct fistulas or lower flow, indirect fistulas; the latter is more insidious in onset. Classic symptoms include conjunctival arterialization, proptosis, ptosis, palpebral edema, ocular palsy, vibratory sensation, elevated intraocular pressure without pupillary or visual acuity deficits, and headache. The treatment of choice is transvenous embolization.
Valsalva Retinopathy Masking as a Retinal Detachment on Point-of-care Ocular Ultrasound: A Case Report
Authors: Johnson Steven , Ryan Thomas , Omari Amro , Schneider Samantha , Bahl Amit
Published: May 2022

Introduction: Approximately two million people present to the emergency department (ED) with eye-related complaints each year in the United States. Differentiating pathologies that need urgent consultation from those that do not is imperative. For some physicians, ocular ultrasound has eclipsed the dilated fundoscopic exam as the standard posterior segment evaluation in the ED. Case report: A 60-year-old female presented with sudden onset visual disturbance in her right eye. Point-of-care ultrasound showed a hyperechoic band in the posterior segment concerning for a retinal detachment. Ophthalmology was consulted and diagnosed the patient with a condition known as Valsalva retinopathy. The patient was discharged from the ED with expectant management. Conclusion: This case highlights an important differential diagnosis that should be considered when ocular ultrasound demonstrates a hyperechoic band in the posterior segment. While previous literature has demonstrated that emergency physicians are able to accurately identify posterior segment pathology using ultrasound, there is limited information regarding their ability to differentiate between pathologies, some of which may not require urgent consultation. We highlight the important differentials that should be considered when identifying posterior segment pathology on point-of-care ultrasound and their appropriate dispositions.
Infected Urachal Cyst Masquerading as Acute Appendicitis on Point-of-care Ultrasound
Authors: Quinn Victoria , Luks Francois , Constantine Erika
Published: May 2022

Case Presentation: A seven-year-old male presented to the pediatric emergency department with one day of abdominal pain. His physical exam was significant for rebound, guarding, and tenderness in the right lower quadrant, and his labs demonstrated a leukocytosis. Both a point-of-care ultrasound and radiology-performed ultrasound were concerning for acute appendicitis with a periappendiceal abscess, but on emergent laparoscopy the patient was found to have an infected urachal cyst.
Discussion: Infected urachal remnants are a rare but important cause of pediatric abdominal pain. In this case, inflammation surrounding the patient’s midline urachal cyst triggered a serositis that involved the appendix and pulled the cyst to the right. This created a clinical and radiologic presentation similar to appendicitis. This atypical presentation of an already rare anomaly highlights the importance of maintaining a broad differential during the work-up of pediatric abdominal pain.
A Pop from a Shock: A Case Report of an Unusual Cause of Achilles Tendon Rupture
Authors: Lee Chia-Yuan Michael , Newberry Mark
Published: May 2022

Introduction: Achilles tendon ruptures often occur during physical activity where the tendon is frequently stressed. Although rare, rupture can also result from electric shock.
Case Report: We present the case of a 63-year-old female who presented with pain in the lower leg after enduring an electric shock. She was diagnosed with a ruptured Achilles tendon based on physical exam and ultrasound.
Conclusion: This case highlights an uncommon mechanism for a relatively common injury. Because Achilles tendon ruptures are frequently misdiagnosed, clinicians need to be aware of unusual causes and use tools at their disposal to ensure timely and accurate diagnosis.
Uterine Sacculation on Point-of-care Ultrasound in a Pregnant Female Patient: A Case Report
Authors: Puri Ajay , Kaur Hersimran , Roit Zhanna , Nelson Matthew
Published: May 2022

Introduction: Uterine rupture is a rare but potentially fatal complication of pregnancy. The incidence of uterine rupture is estimated to be between 0.3 and 11 per 10,000. Additionally, uterine sacculation is a sac or outpouching of the uterus that can lead to uterine rupture in pregnancy. Here we describe a case of a patient who was found to have a uterine sacculation on point-of-care ultrasound in the emergency department (ED) that was complicated by uterine rupture.
Case Report: A 32-year-old female at approximately 18 weeks gestation presented to the ED with three days of abdominal discomfort. The patient’s medical history was significant for prior uterine fibroids requiring recent myomectomy. On arrival the patient was tachycardic, and her abdominal exam revealed distention with mild tenderness to palpation in all quadrants. A point-of-care transabdominal obstetric ultrasound was performed to evaluate the fetal heart rate, which was 157 beats per minute; it also revealed a defect in the uterine wall compatible with a uterine sacculation. The patient underwent magnetic resonance imaging, which revealed a sac-like structure in the fundal portion of the uterus containing a portion of gestational sac and pregnancy contents. Subsequently, she became hypotensive and tachycardic and was taken emergently to the operating room for concern for uterine rupture. Intraoperatively, uterine rupture was confirmed. The patient underwent surgical repair with evacuation of fetal tissue and recovered in the surgical intensive care unit.
Conclusion: Point-of-care ultrasound is a useful and readily available procedure to identify uterine sacculation. Early identification can help escalate the urgency of the patient complaint and may lead to a need for further maternal-fetal evaluation. Emergency physicians should keep a high index of suspicion when evaluating the pregnant patient with a history of uterine surgery.
Newly Diagnosed Multiple Sclerosis Presenting as Brown-Séquard Syndrome: A Case Report
Authors: Hoebee Shelby , Howard Levi , Komara James , McElhinny Megan
Published: May 2022

Introduction: Brown-Séquard syndrome is a rare neurological disorder due to hemisection of the spinal cord that can occur from a variety of causes, most commonly trauma.
Case Report: We present a case of a 25-year-old woman presenting with Brown-Séquard syndrome as her first clinical presentation of multiple sclerosis.
Conclusion: This case highlights the need to have demyelinating disease on the differential as an exceedingly rare, but important, possible cause of Brown-Séquard syndrome.
Case Report: Vertebral Artery Dissection After Use of Handheld Massage Gun
Authors: Sulkowski Kathryn , Grant Georgina , Brodie Thomas
Published: May 2022

Introduction: Arterial dissection is well known as a potential cause of stroke in young patients. Vertebral artery dissection occurs most commonly in the setting of minor trauma but has been seen in cases of cervical manipulation. With advances in at-home therapeutic modalities for neck pain came the advent of handheld massage guns. These massage guns have gained considerable popularity in recent years, but their safety for use in the cervical region has not been well studied.
Case report: In this case report, we discuss a 27-year-old female who presented with headache, neck pain, and dizziness who was found to have vertebral artery dissection after repetitive use of a handheld massage gun.
Conclusion: In young patients presenting with headache, neck pain, and vague neurologic symptoms it is important to consider vertebral artery dissection as a cause of symptoms as it can lead to serious morbidity. When considering an inciting event such as minor trauma, it may also be important to assess whether there has been use of a handheld massage gun. Although causality is difficult to establish, with the increase in use of handheld massage guns we may find more frequent association between
their use and vertebral artery dissection.
Submucosal Duodenal Artery Pseudoaneurysm Causing Massive Gastrointestinal Hemorrhage: A Case Report
Authors: Elliott Stephen , Trtchounian Anna , Danesh Babak , Bober Wojciech , Levy David
Published: May 2022

Introduction: Acute upper gastrointestinal bleeding is a common emergency presentation. The United States Centers for Disease Control and Prevention 2018 survey of emergency department (ED) visits reported 436,000 ED visits for unspecified gastrointestinal bleeding that year.
Case Report: We present the case of a submucosal duodenal pseudoaneurysm causing massive gastro-intestinal hemorrhage in a male on anticoagulation.
Conclusion: Prompt recognition of critical gastrointestinal bleeding, appropriate ED management, and early consultation for emergent intervention are the essential components to reduce morbidity and mortality for patients with massive gastrointestinal hemorrhages.
Why Philosophy of Language is Unreliable for Understanding Unreliable Filmic Narration
Authors: Champagne Marc ,   Institute of Philosophy, Russian Academy of Sciences
Published: May 2022

A typical device in film is to have a character narrating what is going on (sometimes by voice-over), but this narration is not always a reliable guide to the events. According to Maier, distortions may be caused by the narrator’s intent, naivety, use of drugs, and/or cognitive disorder/illness. What is common to these various causes, he argues, is the presence of a point of view, which appears in a movie as shots. While this perspective-based account of unreliability covers most cases, I unpack its methodological consequences and gesture at a possibility that Maier’s analysis overlooks. A narration, I suggest, can be unreliable simply because it is ill-timed with the events shown on screen. In such a case, the distortion is not due to any character’s point of view; rather, it comes from the film medium’s ability to divorce what is seen and what is heard. As a consequence of this mismatch, it is possible to have a reliable narrator but an unreliable narration. Since voice and context of utterance usually match in ordinary speech, I conclude that philosophy of language may be ill-suited to properly understand this particular phenomenon.
What Is Unreliable in Fiction and Where It Comes From
Authors: Zolyan Suren ,   Institute of Philosophy, Russian Academy of Sciences
Published: May 2022

Maier’s article recalls the idea of finding common ground between different points of view on the truth in fiction and the problem of reliability that it generates. However, the criteria by which it is possible to determine the characteristics of the reliability or unreliability in the artistic narrative are unclear. A naive-realistic approach leads to contradictions. We propose to proceed from the already established approaches to the problem of “truth in fiction”, and consider as determining for the modal pragmasemantics of narrative the concept of narrator bifurcated between the actual and fictional worlds.
The assessment of the influence of religiosity and existential well-being on the consumption of alcohol of the adult population of the Orthodox religion
Authors: Jandrić-Kočić Marijana
Published: May 2022

Background/Aim: Excessive consumption of alcohol is the important public health problem. Individual attitudes toward religion and God as well as the level of perceived meaning of one's own life are important predictors of a wide spectre of attitudes and behaviors including alcohol consumption. The research aimed to determine frequency of consumption of alcohol of adults of Orthodox religion and to estimate the correlation between the determined consumption and religiosity and existential well-being. Methods: The research is cross-sectional study implemented in the period of three months, from August 1 st 2021. to November 1 st 2021 year. The sample consisted of 103 randomly chosen adults, 57 (55,3%) males and 46 (44.7%) females, approximately 44.7 ± 10.45 years old. The instrument of the research was the Alcohol Use Disorders Identification Test (AUDIT) and two subscales of the Spiritual Well-Being Scale (SWBS): the Religious Well-Being subscale (RWB) and the Existential Well-Being Subscale (EWB). Contingency tables were used in statistical data analysis. Results: Alcohol weren't consumed by 21 (20.4%) respondents, while 82 (79.6%) consumed it with different frequency (low-risk drinking 53.4%, risky drinking 16.5%, harmful drinking 2.9% and abuse alcohol 6.8%). Moderate religiosity had 68% of respondents, low 3.9% and high 29.1%. Moderate existential well-being was achieved by 68% of respondents, high by 24.2% and low by 7.8%. Highly significant statistical correlation was determined at the level of p <0,0001 of the alcohol consumption pattern with religiosity and existential well-being of the respondents. Conclusion: Almost 80% of participants in the research consume alcohol, of which two thirds low-risk drinking. The participants with intensive religiosity as well as high existential well-being significantly less or never consume alcohol, compared to the participants who are moderately or low religiosity and existential well-being.
Subclinical hypothyroidism
Authors: Aleksić Željka , Aleksić Aleksandar , Đorđević Branka
Published: May 2022

Subclinical hypothyroidism (SKH) is a thyroid disorder in which the level of thyroid hormones, thyroskin and triiodothyronine in the blood is normal, but the level of thyrotropin - TSH, pituitary hormone, which regulates the work of the thyroid gland with negative feedback, is elevated. This is a biochemical diagnosis, because patients are typically asymptomatic and without signs of disease and the detection of SCC is usually accidental. Gender, age, race, geographical area, iodine status. Depending on the degree of increase in baseline TSH levels, 5-8% of patients with SCH annually have progression to clinical hypothyroidism. Iodine is chronic autoimmune thyroiditis. Existing guidelines for the treatment of SKH differ from each other, as there is conflicting evidence on the benefits of long-term levothyroxine substitution in this condition. Although there are data from several comprehensive reviews of the clinical outcomes of SKH treatment, no definitive conclusion has yet been reached on the benefits of this approach. Factors that support application of levothyroxine therapy are: clinical trial due to symptoms of hypothyroidism, patient's desire, depression, infertility / ovulatory dysfunction, progressive increase in TSH, pregnancy, or pregnancy planning, children, adolescents. Research data show that pregnant women with SCC have an increased risk of gestational diabetes, miscarriage, gestational hypertension, preeclampsia, premature birth, and the therapeutic procedure in pregnancy differs from the rest of the adult population. The approach in children with SKH, amiodarone-induced SKH and micronutrients will be briefly mentioned.
Factors that may affect the success of the esophageal voice and speech education in laryngectomized patients
Authors: Uzelac Jovana , Dragičević Danijela , Glamočak Sandra
Published: May 2022

Introduction: The most humane, economically most justified, and according to many authors, also the first method of choice in vocal rehabilitation of totally laryngectomized patients is the use of esophageal voice and speech. While mastering this method, it is necessary to train the patients to form and use the air reservoir in the upper third of esophagus that serves as a voice activator whose airstream causes the vibrations of the pharyngoesophageal segment as the new voice generator. Objective: To investigate the factors that may affect the success of esophageal voice and speech education in clinical practice and emphasize the importance of knowing them in order to further improve this method of rehabilitation. Methods: Comprehensive review of the literature was performed by using the following databases: Google Scholar, SCIndex, PubMed and ResearchGate. The search was based on the following terminology: laryngectomy, esophageal speech, education, factors, success, treatment outcome, and their counterparts in Serbian language. Results: There are numerous factors that may affect the success of esophageal voice and speech education (anatomical-physiological, psychosocial, patient related, treatment and rehabilitation related factors, socio-demographic, physiological and others), among which the motivational status of the patient is of the greatest importance. Conclusion: There are still no clearly defined, generally accepted and comprehensive criteria for assessing the degree of success of mastered esophageal voice and speech, and consequently the lack of defined uniform factors affecting this success, positively or negatively, is present. Of the numerous observed factors, the importance of the patient's motivational status is most often emphasized.
Can we treat urgent medical conditions without adequate drugs?
Authors: Jokšić-Mazinjanin Radojka , Vasović Velibor , Gojković Zoran , Mikov Momir , Mikov Ivan , Đuričin Aleksandar , Jokšić-Zelić Milena , Saravolac Siniša
Published: May 2022

Emergency Medicine does not represent a simple collection of various medical conditions, but rather an urgent approach to life threatening conditions. This urgent approach progresses as fast as the science in medicine does. Modern protocols for treatment of injured and ill patients are introduced, demanding more and more knowledge and skills as well as more modern equipment and wider spectrum of drugs. However, innovations are not followed by changes within the lists of medications set by National Health Insurance Fund of Serbia (NHIFS). Paper describes drugs necessary for adequate pre-hospital treatment that are not available to the physicians due to administrative barriers. On one hand, there are drugs from B list that are necessary for treatment, and are approved for use by NHIFS at hospital level only. The use of any of these drugs at pre-hospital level may lead to severe penalties to the physician in case of complications or adverse reactions in a patient following the treatment. On the other hand, there are drugs from D list which are also necessary for the urgent treatment of patients with life threatening conditions, according to latest recommendations. These drugs may be applied at pre-hospital level, but their procurement is complicated due to NHIFS regulations and that's why some of them may rarely be used (Propafenone and Magnesium sulfate). We particularly emphasize that one of the most effective drugs for the conversion of heart rhythm, Adenosine (6 mg/ml and 10mg/ml ampoule), is not registered in the Republic of Serbia and therefore cannot be used at pre-hospital level. Through these exclusive administrative barriers adequate treatment is rendered impossible while the system of urgent treatment of patients with life threatening conditions at pre-hospital level is degraded.
An Inquiry into the Intentions of the English Language Curriculum in Saudi Arabia
Authors: Mitchell Brendan , Lewthwaite Brian , Carter Margaret Anne
Published: May 2022

The research described and reported on in this article focuses on an analysis of the current English language curriculum in Saudi Arabia and the documents and underlying influences on its construction. The investigation involved a document analysis in order to identify associated curriculum
orientations (Eisner, 1985) to determine what Saudi Arabia is seeking to achieve in the current English language curriculum. The analysis revealed that the current curriculum is clearly defined with attention to alignment between national education goals and economic development whilst ensuring
that educational practices are consistent with Islamic beliefs. In brief, as evidenced in the documents, the analysis reveals that the imperative of education in Saudi Arabia is to establish a ‘Saudized’ knowledge-based economy; and English language acquisition is seen to be a
means by which this imperative is to be fostered.
Neuro-pedagogy Course - Breaching the Borders Between Neuroscience and Education
Authors: Shalom Maya , Luria Ela
Published: May 2022

Exposing teachers to the basic concepts of neuro-pedagogy could lead to a deeper understanding of the teaching-learning processes. This study examines 24 preservice teachers’ perceptions and attitudes towards neuro-pedagogy. The study was qualitative in design. The participants
were interviewed prior to and following a neuro-pedagogy course with respect to their perceptions and attitudes towards using neuroscientific insights in the classroom. Findings illustrate that the neuro-pedagogy course fostered long-lasting learning, by allowing students to connect neuroscientific
theory to educational practice.
Academics’ and Institutional Leaders’ Perception of Transparency: Lesson from Ethiopian Public Universities
Authors: Mekonnen Geberew Tulu , Kilpatrick Sue , Kenny John
Published: May 2022

This study explored academics’ and institutional leaders’ perception of transparency in decision-making in Ethiopian higher education institutions. Three universities were selected from the 31 public universities using a stratified sampling technique. The study employed
a mixed-method exploratory research design. Descriptive statistics (mean and standard deviation) and inferential statistics (ANOVA and Tukey’s post-hoc test) were used to analyse the quantitative data while thematic analysis was used to identify emerging themes and meanings within qualitative
data. The findings of this study showed that the Ethiopian public universities have hierarchal (top-down) governance lacking in transparency in decision-making. Academics and institutional leaders called for greater transparency in the flow of information and decision-making for the academic
community to accomplish their academic core activities effectively. Transparency is a key element of the university governance, and we argue that a lack of transparency at the university upper levels of the university will discourage transparency at lower levels. We recommend shift to more
shared governance or consultative governance for mutual accommodation if the Ethiopian universities are to become transparent and optimise their contribution to national development.
DCA Method in Mineral Exploration, Example: Predict the Location of New Samples
Authors: Nazerian Hamed , Hedayat Bahareh , Kakavand Behnam
Published: May 2022

As the name implies, Discriminant Correspondence Analysis (DCA) is a format of Discriminant analysis (DA) and correspondence analysis (CA). Like differential analysis, the goal is to categorize observations into predefined groups and, like Correspondence analysis, to use nominal variables. The main idea of the DCA is to represent each set of observations and perform a simple Correspondence analysis on the variables (a matrix). The main observations are complementary elements, and each observation is attributed to the closest group. A comparison between the predictions and predictions of classification leads to evaluating the Discriminant correspondence. This information can be used for a similar case to classify new observations, and the validation of estimates can also be examined using cross-validation techniques such as Jack Knife or Bootstrap. For example, samples were taken from different regions. After scoring the parameters and training in this analysis, a new sample was entered, and a group (region) was determined compared to the previous samples.
Distribución y abundancia de la merluza del Pacífico, Merluccius productus, y su relación con el ambiente en el golfo de California, México
Authors: Alvarez-Trasviña Eduardo , Arizmendi-Rodríguez Dana I , Marín-Enríquez Emigdio , Salcido-Guevara Luis A , Sánchez-Cárdenas Rebeca , Rodríguez-Domínguez Guillermo
Published: May 2022

Las condiciones climáticas y oceánicas determinan el patrón de distribución de la merluza del Pacífico (Merluccius productus). El presente trabajo tuvo como objetivo conocer la relación espaciotemporal entre la distribución y la abundancia de la merluza del Pacífico y el ambiente en el golfo de California. Se analizó la información obtenida de 6 cruceros de investigación realizados entre 2014 y 2019. Los resultados mostraron que la merluza del golfo de California alcanza tallas de 105 cm de longitud total y presenta dimorfismo sexual a tallas >73 cm de longitud total. La mayor biomasa del recurso (68,260.37 t) se encontró en febrero de 2019 entre los 200 y 300 m de profundidad, y la menor, en octubre de 2016 (6,917.80 t) a profundidades de 100–150 m. Los centros de abundancia se localizaron a temperaturas de fondo de entre 13 y 14 °C, al norte de la isla Ángel de la Guarda y entre las grandes islas (isla Tiburón e isla Ángel de la Guarda). Al ajustar modelos aditivos generalizados entre las capturas de merluza de cada estación y distintas variables ambientales, espaciales y temporales, se encontró que la temperatura de fondo fue la variable que mejor describió estos centros de abundancia.
Evaluation of Knowledge, Attitudes, and Practices Related to Dietary Supplements Intake among College Students: A Cross-sectional Study
Authors: Ghazzawi Hadeel ALi , Hazem Enas Salem Abu , Amawi Adam Tawfiq
Published: May 2022

Introduction: Food intake has been connected to health status for a long time. There are some products that are used to boost the nutrient density of the food intake, such as dietary supplements (DS). DS can defined as a concentrated source of nutrients with a nutritional or physiological effect that adds further nutritional value to the normal diet. Aim: This study investigated the intake of DS among students at the University of Jordan (JU) in Amman, as well as consumer’s Knowledge, Attitudes and Practices (KAP) regarding DS according to gender, Body Mass Index (BMI), science and humanities, and academic year streams. Materials and Methods: A descriptive cross-sectional questionnaire-based study was conducted over three months on 381 students selected by using convenient sampling method from the JU from different faculties including freshmen students and senior students between April and May 2018. The KAP was used to assess awareness of the study group on the topic. The questionnaire was divided into two parts, part I included questions related to participant’s socio-demographic characteristics and part II included 11 questions for assessing KAP related to DS. Face to face interview technique was used for data collection. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) program (version 22.0). Pearson’s chi-square test for independence was used for the qualitative variables to detect the relationship between gender, BMI, faculty (humanities or science) and academic year and the corresponding KAP toward DS. p-value less than 0.05 was considered as statistically significant. Results: The results showed that the overall percentage of student’s knowledge of DS is only 13.65%, which indicates lack of knowledge in regard to DS. It was found that the percentage of intake of DS at least one per week among students was approximately 42%, which is considered relatively high. Regarding the results of the present study, there were statistically significant differences in faculty (p=0.001**) and BMI subdivisions (p=0.03*) in term of previous knowledge. Science facultie’s students had more information than humanities about the risks of DS (p=0.008*). Nearly (80%) of science and humanities faculties’ students have not received any training or attended in any health campaign about DS. Most of the students trusted the information that comes from health care professionals (65%). One third of DS users consumed them for no certain purpose (34%). Pharmacies were the most common source to buy supplements (87%). Furthermore, vitamin D and iron were the most frequently reported DS type used, while herbal supplements, omega 6, omega 9, multi minerals were the least common DS among participants. Conclusion: It can be concluded from results of this study that there was a relative high prevalence of DS consumption among JU students and students in general lacked knowledge about DS.
Study of Colonisation Pattern and Antifungal Sensitivity Profile of Candida Species in Diabetic Patients
Authors: Singh Anurag Ambroz , Tank Rakesh , Singla Pooja
Published: May 2022

Introduction: In recent times, various studies have pointed out the rise in prevalence of Candida species causing Urinary Tract Infections (UTIs). Candiduria appears to be underdiagnosed entity and thus has been the source of morbidity and mortality. Emergence of drug resistant Candida species has further complicated the patient management. Aim: To understand the colonisation pattern and antifungal sensitivity profile of Candida species in diabetic patients. Materials and Methods: This cross-sectional study was conducted for a period of six months (July 2019 to December 2019) at a tertiary care teaching centre of southern Haryana, India. A total of 360 urine samples were collected from patients admitted both outpatient and in-patient. Glycated Haemoglobin (HbA1c) ≥6.5% was taken as having diabetes. The urine samples were collected as per standard guidelines. Urine wet mount examination was performed. Confirmation of identification and antifungal susceptibility testing was done for all the Candida isolates. Data was analysed using statistical software. Results: The prevalence of candiduria was 65 (18.1%) among study subjects. Out of significant candiduria patients 19 (29.23%) were having Candida albicans, 30 (46.16%) were Candida tropicalis, 10 (15.38%) were Candida krusei, 6 (9.23%) Candida glabrata. Candida albicans was found to be sensitive to amphotericin-B in 100% of cases. Sensitivity to flucytosine, voriconazole and fluconazole was found to be 89.47%, 89.47% and 84.21% respectively in case of Candida albicans. Conclusion: The prevalence of candiduria is definitely high in this region. Non albicans Candida species are more resistant to antifungal drugs compared to Candida albicans.
Relationship Between Disorders of Lipid Profile and Features of Liver Cirrhosis- An Open Prospective and Comparative Analysis of Patients of Stavropol Territory in Russian Federation
Authors: Dudov Temirlan Ruslanovich , Sarithala Vijaya Jawahar , Koroy Pavel Vladimirovich , Yagoda Alexander Valentinovich
Published: May 2022

Introduction: Liver plays an essential role in the metabolism, synthesis, transport and clearance of lipids and lipoproteins, therefore, changes in the lipid profile in liver pathology reflects the degree of its dysfunction. Leading role in the development of atherosclerosis belongs to lipid spectrum disorders in the form of hyperlipidaemia and dyslipidaemia, associated with an increased cardiovascular risk in liver cirrhosis. Aim: To study the relationship between violations of lipid profile of blood with the features and the clinical picture of Liver Cirrhosis (LC). Material and methods: The study was an open prospective and comparative analysis of patients with LC, conducted at Stavropol State Medical University (Stavropol State, Russia). Research was conducted from June 2020 till August 2020. In 108 patients with LC, blood concentration of total cholesterol, triglycerides, High Density Lipoproteins (HDL) and Low Density Lipoproteins (LDL) were studied in association with manifestations of the disease. Control group constituted of 45 healthy individuals, comparable in sex, age and ethnicity. Two sample Student’s t-test, Newman Keuls test, chi-square test with Yates’s correction and Pearson’s linear correlation coefficient (r) were calculated. Receiver Operating Characteristic (ROC) analysis was used, the Odds Ratio (OR) and its 95% Confidence Interval (CI), sensitivity, specificity, positive and negative predictive value, and accuracy were determined. Differences were considered statistically significant at p≤0.05. Results: Regardless of gender and age of patients, decrease of serum levels of total cholesterol (p<0.05), triglycerides (p<0.05), HDL (p<0.05) and LDL (p<0.05) were marked, associated with expression of portal hypertension and severity of liver cirrhosis. Parameters of LDL more than 2.16 mmol/L {OR 6.78-95% CI (2.74-16.78)} were connected with absence of oesophageal varices. Levels of triglycerides less than 0.83 mmol/L {OR 10.85-95% CI (2.86-41.19)} were associated with presence of oesophageal varices of grade III. Generally, hyperlipidaemia was observed in 17.6% of patients, and it was associated with alcoholic etiology of liver cirrhosis (c2 =3.7; p=0.053). Hypocholesterolaemia (81.5 % of cases) or hypotriglyceridemia (48.1 % of cases) was more commonly observed in patients with ascites (c2 =8.8; p=0.003), and classes B, C according ChildPugh score (c2 =4.0; p=0.045). Conclusion: In this study it was found that, in liver cirrhosis, there is a decrease in the serum content of total cholesterol, triglycerides, HDL and LDL, regardless of gender and age of patients. The LDL values of more than 2.16 mmol/L are associated with an increased chance of absence of oesophageal varices in patients with liver cirrhosis.
Staff Training Needs Assessment for Development of Employees at Alternative Learning and Adult Education and Vocational Training, Zanzibar
Authors: Fakih Mashavu Ahmada
Published: May 2022

The study's major goal was to look at the Department of Alternative Learning and Adult Education in Zanzibar's staff training needs assessment for employee development. This research was carried out in the Urban Western Region, at the Department of Alternative Learning in Stone Town, Unguja. The survey included 132 Zanzibar's Department of Alternative Learning and Adult Education employees. A case study design was employed to enable the researcher to concentrate on gathering enough information in the Department of Alternative Learning and Adult Education. Collected data from questionnaires were analyzed through descriptive design to provide a deep understanding of the phenomena through frequency tables, while interviews data were analyzed through thematic analysis. This study shows that all of the factors used for TNAs, such as training, sponsorship, time, and strategic planning, encourage the development of TNAs and staff performance. 45.2 percent of respondents strongly agreed that strategic planning promotes TNA and helps to improve employee performance. In the second objective, various TNA procedures were found to be friendly and familiar to the majority of employees; 57.3 percent of respondents strongly agreed that providing an incentive induction program is a foundation of TNA and employee performance, while several benefits were discovered within the department after an assessment of their training needs, such as career development or future orientation. Moreover, the study revealed that (55.6%) of respondents strongly agreed that TNA is capable enough to enhance the succession plan and staff performance at the department. The study recommended that the government assist the Department of Alternative Learning and Adult Education with budget revisions, employment, sponsorship, and the provision of a training needs assessment specialist who can advise the department on how to reform TNA activity, as well as the development of a comprehensive strategic plan for the effective implementation of identified programs.
Prescribing Pattern of Antibiotics in Bacterial Infectious Diseases in a Corporate Care Hospital
Authors: Ramanath K. V. , Harshitha . , Chamundi . , Supriya Penumaka Rina , Krishnan R. Sai , Channaraya V.
Published: May 2022

Background: The antibacterial preparations are commonly used to control various bacterial infections, which may vary from one hospital to other. Hence, understanding the antibiotic practice will help the pharmacist gain knowledge and implement the safe use of drugs.

Objectives: To assess the antibacterial use in the management of the selected bacterial infections

Methodology: This study is a retrospective, observational, cross-sectional study over six months as per the inclusion & exclusion criteria in the Inpatients. A well-designed questionnaire was used for collecting the required data, and the obtained data were subjected to descriptive statistics.

Results and Discussion: Out of 334 cases observed, 54.19% were female, and 45.81% were male. The mean stays 3.81±2.21 days. Acute gastroenteritis was

59.58%, followed by UTI 25.15%. Pneumonia was 8.68%, and 6.29% had COPD. 0.30% had Acute gastroenteritis with UTI. 39.87% of patients were overweight18.35% were obese, and only 3.16% were underweight. Most of them were in the age group of 61-70, and the least was from 10-20. The mean age of the patients observed in this study was 55.21 ± 18.46. Single antibiotic therapy in 142 cases,165 cases had two antibiotics, in 24 instances three antibiotics were used, in 4patients 4 antibiotics were used for management of the infections. The commonly used antibiotics in managing bacterial infections are penicillin, cephalosporin, carbapenems, macrolides, Nitorimidazoles, quinolines, etc. The clinical outcome showed all the patients were improved, except 3 cases were discharged on request. 139 drug-drug interactions were present in this study and metronidazole (63.01%) was found to have highest major drug-drug interactions. The average cost of antibiotics used in treating Pneumonia (6534 Rs), AE of COPD (4459.7 Rs)., UTI 3778 Rs, acute GE 1176.2 Rs.

Conclusions: This study showed that pharmaceutical care services are essential in the bacterial infection management for the prevention of drug-drug interactions and minimization of the cost (rational drug usage promotion)
Post-Natal Daily Living Experiences of Unmarried Teenage Mothers: A Phenomenological Study in Enyan Denkyira, Ghana
Authors: Ababio Mark Opoku , Awuviry-Newton Kofi , Nkansah Jacob Oppong , Abekah-Carter Kwamina
Published: May 2022

Aim: This study explored the post-natal daily living experiences of teenage mothers in Enyan Denkyira, Ghana.

Method: The study employed the phenomenological research design, and utilized the snowballing sampling technique to recruit 15 teenage mothers. Data for this research were gathered via in-depth interviews and Focus Group Discussion, and they were analysed thematically.

Results: According to the findings, these mothers faced hunger and nutritional deficiencies due to financial difficulties, and this subsequently compromised their health. Furthermore, majority of the adolescent mothers were dropouts who had failed to learn any vocation to enable them earn income, as well as enhance their self-esteem.

Conclusion: In light of the findings, the paper recommends for the establishment of interventions that would provide teenage mothers some income support, as well as opportunities for education and microenterprise development. These interventions could help enhance their wellbeing.
In vitro Antiplasmodial Activities of Crude Extracts and Compounds Derived from Selected Indigenous Medicinal Plants used Traditionally to Treat Malaria in Kenya
Authors: Guya S. O. , Njagi E. N. M. , Guantai A. N. , Lang`at -Thoruwa C. C. , Yenesew Abiy , Mdachi Raymond , Auma Joann E. , Peter Owino , Chemulit Judith , Muleke C. I.
Published: May 2022

Aims: To identify viable phytomedicines traditionally employed for the treatment of malaria in Kenya that could be developed into antimalarial agents.

Study Design: Quantitative analysis of antiplasmodial activities and brine shrimp bioassays were carried out using standard procedures. The experiment was set in duplicate for each concentration of the drug and average IC50 determined.

Place and Duration of Study: Seven indigenous plants: Achyranthesaspera, Heinsiacrinita, Brideliacathartica, Citrus limon, Microglossapyrifolia, Vernoniaglabra and Carissa edulis obtained from Kilifi and Homa-Bay counties in Kenya were evaluated for their anti-Plasmodium falciparumpotential.Collection of samples and analysis took about three months.

Methodology: Both Chemical and aqueous crude extraction methods were carried out to identify the most active extracts against P. Falciparum and thenisolatepureactive phytochemicals. Pure compounds were subjected to Nuclear Magnetic Resonance (NMR), Infra-Red (IR) and Mass Spectroscopy (MS) analyses for structure elucidation.

Results: Four extracts of hexane, dichloromethane (DCM), methanol and water of seven different species of plants were analyzed for their anti-plasmodial activities.W2 and D6 strains of Falciparum were tested. However, the three most active extracts were from Citrus lemon roots (DCM) with IC50 value of 7.017 µg/mL, C. edulis root (aqueous) with IC50 value of 8.054 µg/Ml and B. Cathertica leaves (methanol) with IC50 value of 15.647 µg/Ml. However, three pure compounds were obtained; suberosinIC5026.7 (Strain W2), 53.1 (Strain D6) and xanthyletin IC501580 (Strain W2) from C. Limon (DCM) and spinasterolIC5043.2 (Strain W2) fromM. pyrifolia (hexane).

Conclusion: The three different species of plants with most active compounds have demonstrated their potentiality in treatment for falciparum malaria. Structures of the isolated three compounds can be modelled to synthesise anti- plasmodial drugs as they are active in vitro.
Overcoming Seed Dormancy of Enterolobium contortisiliquum (Vell.) Morong
Authors: Júnior Manuel Tomaz Ataíde , Barros Daniella Inácio , Nunes Helber Veras , Abreu Higor Ângelo de , Oliveira Liomar Borges de , Sales Paulo Victor Gomes , Quirino Mariana Senna , Damascena Jossimara Ferreira , Silva Lorrayne Martins da , Silva Lara Alves Valério da , Araújo Geovana Bispo de , Santos André Ferreira dos , Ribeiro Evandro Alves
Published: May 2022

The use of new methods may facilitate the production of seedlings for reforestation since the seed market is scarce and seedlings take time to be produced. The Earpod tree is a native species that can be used for the floristic recomposition of the biome and  with the possibility of using wood for commercial purposes. In this sense, the present work aimed to evaluate different methods of overcoming dormancy of the Enterolobium contortisiliquum (Vell.) Morong. Seven treatments were performed with 5 replications: T0: control, T1: mechanical scarification with a rasp, T2: mechanical scarification with welding electric appliance, T3: mechanical scarification with cutting pliers, T4 y T5: chemical scarification with sodium hydroxide 30% for 25 minutes and 30 minutes, respectively, and T6: immersion in 100°C water for 7 minutes. The following variables were evaluated: percentage of emergence, emergence speed index (ESI), the height of seedlings, number of leaves per seedling, stem diameter, and length of a root system. The mechanical scarification method with cutting pliers was the most efficient, with an emergence percentage of 96% and plant emergence speed indexes of 9.79. The treatments, chemical scarification with sodium hydroxide 30% for 30 and 25 minutes, and control showed low efficiency in overcoming dormancy, with an emergence percentage of 2, 6, and 4% and emergence rates of 0.14, 0.37 and 0.24.
Carbamazepine efficacy in a severe electro‐clinical presentation of SLC13A5‐epilepsy
Authors: Santalucia Roberto , Vilain Catheline , Soblet Julie , De Laet Corinne , Vuckovic Aline , König Jörg , Aeby Alec
Published: May 2022

Recessive mutations in the SLC13A5 gene encoding the sodium‐dependent citrate transporter are a recently identified cause of developmental and epileptic encephalopathy. Here, we describe a child harboring a novel homozygous loss‐of‐function mutation in the SLC13A5 gene (c.1496C>T–p.Ser499Phe) and exhibiting an unusual extremely severe neonatal presentation with drug‐resistant seizures and burst‐suppression EEG pattern. Early carbamazepine use resulted in dramatic improvement both clinically and on EEG features. Follow‐up from the neonatal period to the age of 4 years is documented. This case expands the electro‐clinical phenotype associated with SLC13A5‐related disease and confirms the efficacy and safety of carbamazepine in nonstructural early‐onset epilepsies.