bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship of Timings and Outcome of Tracheostomy Among Patients Requiring Prolonged Mechanical Ventilation
Authors: Shafique Muhammad Asim , Nadeem Muhammad Amir , Afzal Muhammad
Published: November 2021

Objective: To assess the indications of tracheostomy among patients requiring prolonged mechanical ventilation and to observe the relationship of the timings and outcome of tracheostomy with age and gender. Study Design and Setting: It was a descriptive study conducted at intensive care unit (ICU) of Department of Otorhinolaryngology at Bahawal Victoria Hospital from January 2017 to December 2018. Methodology: Secondary data was collected with the help of charts of ICU patients in which elective tracheostomy was done to replace orotracheal intubation for mechanical ventilation. Inclusion and exclusion criteria were designed. Clinical record was reviewed for the assessment of indications of the procedure (medical or surgical) along with age and gender distribution. The timing of tracheostomy in these patients with its outcome in terms of decannulation and weaning were recorded. Proforma was used to enter the findings. Finally results were obtained and assessed on SPSS Version 23. Results: Out of total 551 tracheostomies 42(7.6%) were indicated for the patients of ICU requiring prolonged mechanical ventilation. From the 42 mechanical ventilated patients majority had Guillain-Barre syndrome (GBS) 20(47.6%). Twenty six patients were adults (61.9%) and sixteen were children (38%).Twenty four were male patients (57.1%) and eighteen were females (42.8%). The timing of tracheostomy among majority of the patients (40) was from 7-10 days, with mean of 9th day with good outcome. Only two patients who underwent tracheostomy after two weeks had to face poor outcome (failed decannulation, late weaning) (4.7%). Conclusion: Neuroparalytic lesions were the common indication among the patients requiring prolonged mechanical ventilation with tracheostomy. Tracheostomy if performed earlier in such patients carries good outcome
Comparison of Cognitive-Affective Symptoms of Depression Between Cases of Low and High Suicidal Ideation in Medical Students
Authors: Akram Nuzhat Aisha , Jameel Nazia , Iftikhar Bushra , Assad Tahira , Qureshi Farhan Muhammad
Published: November 2021

Objective: To compare the severity of cognitive, affective and somatic symptoms of depression between two samples of medical students with high and low suicidal ideation using Beck Depression Inventory Study Design and Setting: This is a cross sectional study conducted in public and private medical colleges in Karachi from September-December 2018. Methodology: A total of 150 normal healthy students with 75 each from public and private medical colleges in Karachi were sampled through purposive sampling technique. Beck depression inventory (BDI) with twenty one items for depressive symptoms was used. Suicidal ideation was assessed using item 9 of BDI and participants were identified as having high and low suicidal ideation. Remaining twenty items of BDI were categorized as affective, cognitive and somatic symptoms of depression. Severity of each symptom was assessed through BDI score on a 4-point scale. Hypothesis testing for difference in BDI scores of depressive symptoms between high and low suicidal ideation cases was performed through independent sample t tests. Result: BDI showed significantly higher suicidal ideation in public medical colleges’ students. Cases with high suicidal ideation showed higher prevalence of five cognitive (past failure, feeling guilty, self-image, feeling of being punished, crying spells), four affective (sadness, irritability, decision making, self-dislike) and one somatic (physical health) symptoms of depression. Conclusion: Significant higher prevalence of affective and cognitive symptoms of depression was found among cases of higher suicidal ideation
Contemporary Trends Regarding Knowledge And Practices Of Dental Implants Among Dental Interns Working In Educational Institutes Of Karachi, Pakistan
Authors: Khan Muhammad Farhan , Khan Fatima Naseem A , Ali Irfan , Ahmed Muhammad Rashid , Jawed Rubab , Zahoor Qurratulain
Published: November 2021

Aim: The aim of this study was to assess the information about dental implants among dental interns and to relate their perception of future dental implant practice. Study Design and Setting: A cross-sectional study was conducted on dental interns of various dental teaching colleges of Karachi including public and private institutions. Methodology: The instrument used was a self-administered, structured, closed-ended questionnaire which was modified measuring tool for the dental interns’ knowledge and perception towards implant dentistry. The data collected from the study was analyzed using SPSS. Results: Two hundred and seventy dental interns of 5 different colleges of Karachi filled a questionnaire about the knowledge and future perception of dental implant practice in general dentistry. It was observed that majority of the dental interns 44.2% did not have adequate knowledge of dental implant and 87.6% encourage to improving the undergraduate syllabus of dental implants. Conclusion: This study showed limited knowledge and awareness about dental implants among dental interns, but they highly encouraged in improving the curriculum of dental implants at undergraduate level
Anatomical Variations of Frontal Sinuses Among The Male and Female Genders Living in Karachi
Authors: Javaid Quratulain , Usmani Ambreen , Qamar Aisha
Published: November 2021

Objective: To determine morphology and variation in dimensions of frontal air sinuses in male and female genders living in Karachi. Study Design and Setting: It was a cross sectional study and was conducted at Radiology Department, JPMC. Methodology: The total number of study participants were 216. The research subjects were divided into two equal groups of males and females each having 108 members. The mean age of the participants was calculated to be 35.14 ± 8.68 years. The study subjects were recruited from Radiology Department, JPMC, Karachi. After taking written informed consent, Water’s (occipito-mental) view radiography was done to measure the parameters of height, width and area of the frontal air sinuses. The included variables were the demographic data and the physical examination to exclude facial anomalies. All the measurements were recorded and the measurements were saved by the help of Radiant DICOM digital software. Results: The parameters of height, width and the area of frontal sinuses showed highly significant variability on both the right and the left sides. All the dimensions were highly significantly greater in the males as compared to the female study participants (p=0.000). The Independent-Samples T Test was applied to compare the two gender groups. Conclusion: The parameters of height, width and area of frontal sinuses were greater in the males as compared to the females on both the left and the right sides
Dengue: A Recent Challenge In Pakistan
Authors: Iqbal Sannia Perwaiz , Jaffri Sajid Abbas
Published: November 2021

Dengue is one of the fast emerging diseases of humans and is among the most widespread vector-borne tropical viral disease in the world today. The current incidence of dengue infections around the world is more than 58.4 million cases per year with mortality between 10,000 to 20,000
Diabetes Self-Management Education and Practices among Type 2 Diabetic Patients
Authors: Jaffri Muhammad Sajid Abbas , Riyaz Saja , Riyaz Sara , Rida Mah
Published: November 2021

Objective: To compare the knowledge and practices of diabetes self- care management among type 2 diabetic patients in two hospitals of Karachi. Study Design and Setting: A cross sectional study was carried out at two Tertiary Care Hospital of Karachi from March 2018 to August 2018. Methodology: A total of 120 subjects of type 2 diabetes were included in the study. Data was collected through structured questionnaire. Knowledge regarding diabetes includes normal blood sugar level, symptoms of low and high blood sugar and management of these symptoms. Structured questionnaire was used to collect information of sociodemographic characteristics, knowledge and attitude of diabetes and self-care management practices. Data was analyzed by SPSS version 21. P value less than 0.05 considered as significant Results: Majority of the participants were females (55%) and males were (45%).The duration of diabetes in majority of participants, (43.3%) was less than 5 years. From total 53.3% of our study participants were aware about the knowledge of diabetic complications. Approximately ,59.6% participants thought visit to eye specialist is important and about 44.16% thought that monthly visit to hospital for general health is important for diabetic patients. When asked about early signs of development of complications 48.3% participants thought that development of foot ulcers ,83% thought diabetes was strongly associated with obesity. Total, 76.6% participants thought that plan of meal is important. Total, 30.83% participants were in agreement with this thought that diabetes was strongly associated with obesity. Conclusion: The knowledge of self-care practices in diabetic patients was average in this study
Frequency and Location of Supernumerary Teeth in a Private Hospital of Karachi City
Authors: Omer Syed Ahmed , Nisar Seema , Memon Perveen , Arif Hamidullah , Ali Raza , Faheem Samra
Published: November 2021

Objective: To investigate frequency of supernumerary tooth in relation to gender, age and location. Study Design and Setting: Cross-sectional Study was conducted at Mamji Hospital, Karachi from June 2017 to June 2019. Methodology: A total of 2160 patients seen and out of which 45 clinically diagnosed patients of supernumerary teeth were participated in this study. Supernumerary teeth were classified on the basis of location. Descriptive statistics were checked by means of percentages and frequency of all variables. Chi-Square test was applied, P-value < 0.05was considered significant. Results: The total patients were 45 which comprised of 26 male and 19 females with ages ranging from 15 to 60 years. The prevalence of ST was 1.59%, the higher predilection of supernumerary teeth was seen in males than females. The male to female’s ratio was 1.36:1. On the basis of location ST were further classified on Mesiodens, Paramolars and Distomolars category. Of the 45 supernumerary teeth, 36 were had Mesiodens (m= 62.1%, f=37.8%), 5 were Paramolars (m=60%, f=40%) and 3 were Distomolars (m=0, f= 100%). Conclusion: The present study findings showed high prevalence of ST was dominant in males. Present study emphasizes the timely diagnosis and appropriate management of supernumerary teeth to avoid unwanted complications
Polycythemia Vera Complicated by Portal Vein Thrombosis and Budd-Chiari Syndrome:
Authors: Iqbal Nabeela , Shah Syed Khalid , Haneef Shamima
Published: November 2021

Polycythemia vera is a medical condition characterized by raised hematocrit. Owing to increased viscosity, the blood flow in the vessels become sluggish leading to the clinical features of polycythemia such as headache, blurring of vision, red skin, dizziness, raised blood pressure, itching and more serious medical events like vaso occlusion, thrombosis and strokes. In this case report, polycythemia vera presenting unusually with heamatemesis, melena and abdominal distension. Physical examination of this case revealed massive ascites with dilated veins around the umbilicus. The diagnosis of polycythemia vera complicated by Budd Chiari Syndrome and Portal Vein Thrombosis was made. Patients with polycythemia vera are at risk of vaso occlusive sequelea like portal vein thrombosis and Budd chiari syndrome
Determinants of airport train operational performance
Authors: Ricardianto Prasadja , Wibowo Heriyanto , Agusinta Lira , Abdurachman Edi , Suryobuwono Abdullah Ade , Fachrial Peppy , Setiawan Agus , Rafi Salahudin , Maemunah Siti , Endri Endri
Published: November 2021

This study aims to analyze the improvement of the operational performance of Indonesia’s Soekarno-Hatta Airport train through service quality which is mediated by train passenger loyalty and passenger satisfaction. The main problems in this study are the use of the same railway for long-distance train, airport train, and commuter Line train, the limited use of airport railway with four schedules, the headway which becomes 30 minutes since the number of travels becomes 82 trips, and the tariff being applied now is considered as burdening the passengers. The research method uses a quantitative analysis approach with the technique of Structural Equation Modeling-Lisrel. Data collection is done through observation and questionnaire distribution. The respondents are 306 passengers of trains heading for Soekarno-Hatta Airport. The benefit of this study for the domestic railway company is that by improving service quality, passenger loyalty and satisfaction, it will improve the operational performance of airport trains. The result of this research indicates the significant influence of service quality variable on passenger loyalty through passenger satisfaction, the significant influence of service quality variable on operational performance through passenger satisfaction and passenger loyalty as well as the significant influence of passenger satisfaction variable on operational performance through passenger loyalty.
特殊教育專業英文字彙
Authors: 白亦方 白亦方
Published: November 2021

跟進2030年「雙語國家政策藍圖」，全英教學、國際教育與全球教育將不再是教科書（或期刊）上的教育名詞，而是課堂裡一幕幕正在上演的動名詞。白亦方教授長期關注雙語教育，為使即將成為教師者以及在職教師能自在地以英語融入領域課程，先後出版《教育專業英文字彙：基礎篇》與《教育專業英文字彙：進階篇》，提供教學現場所需的基本字彙、閱讀例句，給予最實質的幫助。有感於愈來愈多學生的個別差異顯著，無法適應一般教育，特殊教育尤顯重要。編輯團隊以特殊教育概念之沿革、法源依據與制度、較為常見的障礙類別、課程與教學及支持系統，有系統地整理出融合醫學與教育的常用字彙，可謂跨領域的詞彙寶典。

主編簡介
白亦方

美國威斯康辛大學麥迪遜分校（University of Wisconsin-Madion）課程與教學博士，學術專長為課程史、資訊社會學、高等教育等，曾任小學教師，教育部公費留學考試及格（1990），中華民國教育學術團體聯合年會年度優秀教育學術研究著作獎（2010），現為國立東華大學教育與潛能開發學系退休教授。

審訂：林坤燦
編輯：朱怡珊、王道偉、吳俊穎、陳勇安、陳秋惠、曾恕璇
COVID-19 na gestação: caraterísticas das gestantes com infecção por coronavírus em um hospital da região amazônica
Authors: Espinosa Yuramis Montirl , Simões Maria da Conceição Ribeiro , Novais Atinelle Teles , Silva Elton Lemos
Published: November 2021

Introdução: Mulheres grávidas são consideradas um grupo de alto risco para o novo coronavírus (COVID-19). A existência de novas cepas na região amazônica em 2021 aumentou rapidamente o número de casos confirmados, elevando a morbimortalidade materna. Diante das preocupações sobre o efeito da COVID-19 durante a gravidez e nos neonatos, a quantificação de seus fatores de risco, resultados maternos e perinatais é essencial para o planejamento de estratégias de combate à atual pandemia. Objetivo: Caracterizar as variáveis associadas, em gestantes, com confirmação de infecção por coronavírus (COVID-19) de um hospital da região amazônica. Métodos: Estudo transversal e retrospectivo que utilizou o banco de dados do hospital. O critério de inclusão foram gestantes com confirmação de COVID-19, admitidas no setor de isolamento do hospital por qualquer motivo no período de fevereiro a março de 2021. Resultados: Foram incluídas 54 mulheres grávidas. Observamos que 34 (62,96%) gestantes se internaram no hospital por COVID-19 com sintomas de moderados a graves e 20 (37,04%) por outras causas; delas, 23 (42,5%) possuíam comorbidades preexistentes, 10 (18,5%) apresentavam hipertensão arterial crônica ou gestacional, oito (14,8%) diabetes mellitus prévia ou gestacional, quatro (7,4%) obesidade e uma (1,8%) lúpus eritematoso sistêmico. Com relação à faixa etária: quatro (7,4%) eram menores de 20 anos, 18 (33,3%) tinham de 20 a 24 anos, 12 (22,2%) de 25 a 29 anos, 10 (18,5%) de 30 a 34 anos e 10 (18,5%) eram maiores de 35 anos. Sobre o parto, 24 (44,4%) tiveram cesárea e oito (14,8%) parto vaginal; 24 (44,4%) tinham entre sete e 10 dias de sintomas, 30 (55,5%) necessitaram de suplementação de oxigênio e 15 (27,7%) de ventilação invasiva. Quanto à necessidade de suporte em unidade intensiva, a incidência foi de 16 (29,6%), o tempo de internação foi menor que sete dias na maioria dos casos (30, ou 55,6%), 15 (27,7%) gestantes apresentaram síndrome respiratória aguda grave e cinco (9,2%) vieram a óbito. Já entre os recém- nascidos, 11 (34,4%) foram prematuros. Conclusão: O estudo mostrou que a maioria das mulheres se encontrava no terceiro trimestre da gestação. As comorbidades preexistentes, como hipertensão crônica, diabetes e alto índice de massa corporal, são fatores de risco para COVID-19 grave na gravidez. As gestantes têm risco aumentado de serem admitidas na unidade de terapia intensiva, de precisaram de ventilação invasiva ou de sofrerem morte materna. Por se tratar de uma doença recente ainda, faz-se necessário maiores estudos quanto ao potencial do vírus na gestação, entre outros desfechos. Podemos, assim, recomendar a vacinação de todas as gestantes como forma de minimizar a gravidade da doença e diminuir a mortalidade materna por essa causa.
Esteatose hepática aguda da gravidez: fatores de risco, diagnóstico e tratamento
Authors: Corrêa Geovanna Calazans , Coelho Isabella Nascentes Tanizaki , Mota Márcio Rabelo
Published: November 2021

Introdução: A esteatose hepática aguda da gravidez (EHAG) é uma emergência obstétrica rara, mas letal, determinada pela insuficiência hepática materna e que pode causar consequências para a mãe e para o feto, até mesmo a morte. A fisiopatologia dessa doença tem sido relacionada a defeitos no metabolismo de ácidos graxos na gravidez, principalmente no contexto de defeitos genéticos fetais na oxidação desses ácidos, que resultam em aumento materno no nível sérico de ácidos graxos durante a gestação. Por sua raridade e letalidade, torna-se crucial abordar a fisiopatologia dessa doença cada vez mais. Objetivo: Analisar os fatores de risco, o diagnóstico e os meios de tratamento da EHAG. Métodos: Trata-se de uma revisão de literatura realizada por meio de busca na base PubMed com os descritores (“acute fatty liver” AND “pregnancy”), na qual foram encontrados 79 artigos dos últimos cinco anos. Como critérios de inclusão: publicações na íntegra e nos idiomas inglês e português. Por fim, foram selecionados os estudos que descreviam minuciosamente a fisiopatologia da EHAG e foram utilizados 13 artigos para a revisão. Resultados e conclusão: A EHAG já foi considerada uma doença extremamente rara na gravidez, mas com o avanço do conhecimento e o diagnóstico precoce os casos mais leves estão sendo reconhecidos. Atualmente, a prevalência estimada é de um a três casos a cada 10 mil gestações. Em uma revisão de literatura do ano de 2019, os fatores de risco associados à EHAG encontrados foram múltiplas gestações, fetos masculinos, distúrbios gordurosos do metabolismo de ácidos graxos no feto e episódios anteriores de EAHG. Um estudo de caso controle realizado entre 2010 e 2019 em um hospital terciário para doenças hepáticas na China considerou os seguintes aspectos clínicos e laboratoriais para o diagnóstico: sintomas de anorexia, náusea, vômito, icterícia, fadiga, preferência por comida fria e função hepática anormal durante o terceiro trimestre da gravidez ou no início do período pós-parto; resultados laboratoriais característicos, incluindo níveis elevados de alanina transaminase, bilirrubina e creatinina sérica, tempo de protrombina prolongado e hipoglicemia; ultrassonografia mostrando fígado gorduroso ou biópsia hepática com alterações patológicas características; além de todas as pacientes exibirem seis ou mais dos critérios de Swansea, o que confirmou objetivamente o diagnóstico de EAHG. Em relação às medidas terapêuticas, assim que houver diagnóstico ou alta suspeita de EAHG, a interrupção imediata da gravidez e o tratamento de suporte são cruciais, uma vez que não há relatos de continuação da gravidez sem aumentar a deterioração da função hepática, o que pode levar, até mesmo, à falência total hepática.
Fatores associados ao desenvolvimento da depressão pós-parto
Authors: Florentino Amanda Silva , Nader Priscilla Rocha Araujo , Loureiro Rubens José
Published: November 2021

Introdução: O período puerperal envolve muitas transformações ocasionadas pela chegada do novo ser, que demanda responsabilidade, tempo e cuidados. Com isso, podem surgir diversas dúvidas e medos acerca da maternidade que, associadas às mudanças emocionais, físicas e hormonais e aos fatores de risco, podem levar ao desenvolvimento da depressão pós-parto. Esta é um transtorno psiquiátrico de humor que causa efeitos negativos sobre a mãe e a criança e está diretamente relacionada aos aspectos subjetivos de cada mulher. Objetivo: Investigar os principais fatores de risco associados ao desenvolvimento da depressão pós-parto. Métodos: Trata-se de uma revisão integrativa realizada na base de dados Biblioteca Virtual em Saúde durante o mês de abril de 2021. Para a busca, utilizaram-se os descritores “fatores de risco” AND “depressão pós-parto” AND “gravidez”. Com a finalidade de analisar a literatura nacional, foram selecionados artigos disponibilizados em texto completo na língua portuguesa e publicados entre julho de 2011 e janeiro de 2020, dos quais somente um era de 2011 e os demais dos últimos três anos. A princípio foram identificados 1.528 artigos e, após a aplicação dos critérios de inclusão, restaram 30 artigos, dos quais oito compuseram a amostra final. Resultados e conclusão: O surgimento da depressão pós-parto pode estar associado a diversos fatores psicológicos, sociais, sociodemográficos e hormonais. Acerca dos fatores psicológicos, tem-se histórico de depressão familiar e da própria mulher, seja relacionado ao parto ou não, estresse durante a gestação e insatisfação com a gravidez. A falta de apoio por parte da família e do parceiro durante a gestação e o puerpério, a sobrecarga que pode ser ocasionada pela multiparidade, o uso de tabaco e álcool e a ocorrência de violência contra a gestante e puérpera configuram-se como fatores de risco sociais. Além disso, questões sociodemográficas como ser solteira, mãe jovem, ter perfil socioeconômico baixo e baixa escolaridade também influenciam no surgimento da patologia, assim como a desregulação hormonal. Por ser um problema de saúde pública, essa doença traz prejuízos na interação mãe-bebê, assim como no desenvolvimento social, cognitivo e afetivo da criança. Outrossim, pode levar ao suicídio e ao infanticídio. Diante dessa perspectiva, mostra-se necessário conhecer os aspectos preponderantes para o aparecimento da doença, com a finalidade de investir na construção de estratégias de prevenção e diagnóstico precoce, para que puérperas tenham o tratamento adequado e as consequências sejam reduzidas. Dessa forma, a promoção do cuidado integral às mulheres no pós-parto permitirá reduzir as mazelas do modelo biomédico. Por fim, verifica-se que o fomento de políticas de enfrentamento da desigualdade social e a participação de grupos de apoio são boas alternativas, principalmente para as mulheres que não têm apoio dos seus parceiros.
Gestação heterotópica: diagnóstico ultrassonográfico em ectópica não rota
Authors: Santos Isabella Soares da Costa dos , Teixeira Aline Ramos , Beralto Andre Luiz Clemente , Rodrigues Lara de Siqueira
Published: November 2021

Introdução: A gestação heterotópica é uma condição rara em que há uma gestação ectópica simultânea à gestação intrauterina. Na primeira, a localização mais frequente é a tuba uterina, mas ela pode ser também cornual, cervical, ovariana, abdominal e em cicatriz de cesárea. A incidência varia de 1:30.000 gestações, contudo, após reprodução assistida, a frequência dessa complicação foi para 1:100-500 gestações. Os fatores de risco são os mesmos relacionados à gravidez ectópica e são representados, principalmente, pelas desordens mecânicas e/ou funcionais que impedem a passagem do embrião para a cavidade uterina. Entre elas, citam-se doença inflamatória pélvica, malformação uterina, idade avançada, tabagismo, cirurgia pélvica anterior e história de infertilidade pela aplicação da técnica de reprodução assistida. Relato de caso: Paciente N.R.M.D.S., 21 anos, G1P0, procurou serviço de emergência com ultrassonografia externa de rotina que evidenciou útero gravídico contendo dois embriões e dois sacos gestacionais: um tópico, de contornos normais, com diâmetro de 14 mm, com embrião cujo comprimento cabeça-nádega (CCN) era de 3,4 mm e que tinha batimento cardíaco fetal (BCF)=169 bpm, compatível com seis semanas de desenvolvimento. Em anexo esquerdo, observou-se tuba uterina distal, formação em imagem sugerida de embrião e vesícula vitelínica (VV) presente. Embrião com CCN de 16 mm e vesícula vitelínica aumentada, medindo 16 mm, BCF=120 bpm, o que sugeria gestação de oito semanas de desenvolvimento. À repetição da ultrassonografia, viu-se útero de volume aumentado, com saco gestacional normoimplantado, paredes íntegras, 18 mm de diâmetro, presença de embrião com BCF=112 bpm, CCN 7 mm, VV sem alteração; em anexo direito, imagem hipoecogênica regular com fluxo sanguíneo, medindo 24x22 mm, com área cística de 14 mm. Não era possível excluir gravidez ectópica. A paciente, estável, seguiu em acompanhamento e ultrassonografias sequenciais. Conclusão: O diagnóstico precoce é difícil e ocorre em sua maioria após a rotura tubária. Quanto ao tratamento, não há consenso da melhor conduta a ser seguida, que se relaciona ao local da implantação do saco gestacional ectópico e à época do diagnóstico. A abordagem cirúrgica por via laparotômica ou laparoscópica é a escolha quando a ectópica é tubária, como no caso da paciente em questão. A gestação heterotópica, mesmo sendo rara, é um diagnóstico que deve ser bem pesquisado, uma vez que a presença de egstação tópica não exclui uma ectópica concomitante. Para isso, o estudo ultrassonográfico ainda é o método de escolha para avaliação inicial e diagnóstico.
Gestante portadora de síndrome de Marfan: relato de caso
Authors: Teixeira Raissa Gracio , Torres Annita Martins Rocha , Mocarzel Carolina Carvalho
Published: November 2021

Introdução: A síndrome de Marfan (SM) é uma doença genética autossômica dominante, com prevalência de dois a três casos em 10 mil e igual distribuição em ambos os sexos. Acomete tecido conjuntivo, com envolvimento multissistêmico, afetando principalmente os aparelhos cardiovascular, musculoesquelético e ocular, e a dissecção e a rotura da aorta são as principais causas de morbidade e mortalidade. Relato de caso: T.E.C., 20 anos, primigesta, com diagnóstico de SM na infância, sem uso de medicação no período gestacional, foi submetida a procedimento cirúrgico de troca valvar mitral aos 11 anos para correção de comunicação interatrial e insuficiência mitral, além de artroplastia bilateral de quadril. Ecocardiograma realizado no 2º trimestre de gestação mostrava diâmetro da aorta de 34 mm, insuficiência mitral discreta e fração de ejeção de 59%. O irmão faleceu aos 16 anos por complicações da SM. A paciente foi admitida na maternidade, a termo, com sinais de iminência de eclâmpsia. Indicou-se cesariana após estabilização clínica. Houve indicação de profilaxia para endocardite infecciosa. Recém-nascido do sexo feminino, Apgar 8/9, com peso de 3,2 kg. A paciente manteve sulfato de magnésio no pós-parto, com boa evolução clínica. Conclusão: A SM consiste em um defeito no gene FBN1 situado no cromossomo 15, que afeta a produção de fibrilina (especificamente fibrilina-1). Essas moléculas formam as microfibrilas, necessárias para fornecer elasticidade e apoio aos tecidos conjuntivos. As principais manifestações clínicas da SM estão relacionadas aos sistemas esquelético, cardíaco e ocular. Durante a gravidez há aumento de débito cardíaco por conta do aumento do volume sanguíneo e da frequência cardíaca, além de modificações hormonais que contribuem para alterações histológicas na aorta. Em relação ao risco materno, o manejo é individualizado de acordo com os limites de diâmetro dessa artéria. Dilatações inferiores a 40 mm apresentam risco relativamente baixo de dissecção e rotura (1 a 4%). Esse risco aumenta proporcionalmente com o aumento das dimensões. Diâmetros de 41 a 44 mm apresentam risco estimado de 10% e diâmetros superiores a 45 mm apresentam risco superior a 25%. Mulheres com SM devem realizar aconselhamento genético e ser orientadas a evitar a gestação por conta do risco aumentado nesse período de alargamento de aneurismas aórticos e dissecção de aorta, em decorrência das alterações hormonais e metabólicas inerentes ao período gravídico. A partir do momento em que houver gestação e desejo de seguimento dela, o acompanhamento deve ser rigoroso e feito em pré-natal de alto risco, com equipe multidisciplinar, pois essa assistência tende a minimizar desfechos materno-fetais desfavoráveis.
Mushrooms (Basidiomycetes) as a significant source of biologically active compounds for malaria control
Authors: Happi Gervais Mouthé , Meikeu Livine Zemo , Sikam Klev Gaïtan , Dzouemo Liliane Clotilde , Wansi Jean Duplex
Published: November 2021

Mushrooms represent a large family of fleshy fungi that have been of high interest since ancient ages due to their medicinal and nutritional importance. Therefore, it can represent a significant source of bioactive compounds in malaria control. The few numbers of studies on in vitro antiplasmodial and insecticidal properties of their extracts and chemical constituents led to interesting results reported in numerous scientific publications. This review aims to provide a comprehensive compilation of literature up to 2021 on the antiplasmodial, insecticidal as well as cytotoxic chemical constituents of medicinal mushrooms that can help in the management of malaria both against the parasite Plasmodium falciparum and the mosquitoe Anopheles stephensis acting as a vector of malaria through its bites. For this purpose, some searches have been done in some online libraries using keywords like Basidiomycete, mushroom, malaria, Plasmodium, Anopheles and antiplasmodial without language restriction. Among the reported compounds, 51 selected ones displayed significant antiplasmodial potency with IC50 values lower than 10 μM against P. falciparum strains sensitive or resistant to chloroquine. For instance, ganoderic acid AW1 demonstrated a strong antiplasmodial activity with IC50 of 257.8 nM against P. falciparum D6, while strong activities were displayed by ganoweberianones A (IC50 = 0.050 μM) and B (IC50 = 0.46 μM) against P. falciparum K1. Moreover, some mushroom methanol extracts demonstrated good larvicidal and ovicidal activities against Anopheles stephensis. This paper provides further insights into the development of new antiplasmodial drugs or new potent eco-friendly pesticides to control mosquito vectors.
ENANTIOSELECTIVE ANALYSIS OF GUAIFENESIN IN BULK AND PHARMACEUTICAL DOSAGE FORMS BY CHIRAL REVERSE PHASE HPLC-PDA METHOD
Authors: Tharunkumar B. , Kalyani P. , Lakshmiprasanna M. , Nalluri B. N. ,   Department of Pharmaceutics, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada - 520 010, Andhra Pradesh, India.
Published: November 2021

A novel, accurate and precise chiral reverse-phase high pressure liquid chromatographic method was developed for enantioselective analysis of guaifenesin (GFN) in bulk and tablet dosage forms. Chiral separation was achieved on phenomenex Lux Cellulose-4 column (250×4.6mm, 5μ) using 0.02% formic acid: acetonitrile (90:10 V/V) as the mobile phase at a flow rate of 1mL/min at 230nm. The retention times of GFN enantiomers A and B was 15 and 16 minutes, respectively, with good peak resolutions and showing good linearity in the concentration range of 10-50 μg/mL (R2 > 0.999). The developed method was validated as per the International Conference on Harmonization guidelines and the results were well within the acceptable limits. The percentage assay in tablet dosage form was found to be 98.8 and 98.2 respectively, for enantiomers A and B and was with in the compendial specifications, demonstrating the suitability of developed method for enantioselective analysis of guaifenesin racemic mixture.
A PROSPECTIVE STUDY BASED ON THE EVALUATION OF DAILY AND INTERMITTENT DOSAGE REGIMEN OF ANTI-TUBERCULAR (ATT) DRUG THERAPY
Authors: Sankar V. , Nimitha M. , Rama P ,   Department of Pharmacy Practice, PSG College of Pharmacy, Coimbatore - 641 004, Tamilnadu, India.
Published: November 2021

Anti-TB drug induced hepatotoxicity causes treatment interruption, poor compliance, increased mortality and morbidity, and modification of treatment regimen. Hence, we need to assess the effect of dosing schedule of daily and intermittent regimens and identify patients with increased risk of developing drug induced hepatotoxicity. To determine the frequency and risk factors associated with anti-tuberculosis drug induced hepatotoxicity in daily and intermittent dosage regimen of anti- tubercular therapy, a prospective study was conducted with 130 patients diagnosed with tuberculosis, followed clinically and biochemically before and after the initiation of anti-tuberculosis drugs. Complete history including demographic details and physical examination were documented. Among 53 patients, 28.3% of the patients developed anti- tuberculosis drug induced hepatotoxicity with higher incidence in those receiving daily regimen than the intermittent regimen (P = 0.00). On comparing the site of tuberculosis, higher risk of drug induced hepatotoxicity was reported in cases with pulmonary tuberculosis (P = 0.01) than with extra-pulmonary tuberculosis. Among the 23 patients with anti– tuberculosis drug induced hepatotoxicity, 52% were noted to have moderate hepatotoxicity based on the severity grading of hepatotoxicity and 44% noted as probable based on the Roussel-Uclaf causality assessment method. Body mass index < 20kg/m2 (P = 0.042) and concomitant use of other hepatotoxic drug (P = 0.005) were risk factors for anti-TB DIH. Higher incidence of anti- tuberculosis drug induced hepatotoxicity was found in patients who received daily regimen rather than intermittent regimen. Extreme precaution should be taken in patients with body mass index < 20kg/m2 and also among those using concomitant hepatotoxic drugs.
SIMULTANEOUS ESTIMATION OF ATAZANAVIR SULFATE AND RITONAVIR IN MARKETED FORMULATIONS – UV SPECTROSCOPIC THREE WAVELENGTH METHOD
Authors: Kasula P , Nanda Kumar K. V. ,   Department of Pharmaceutical analysis, Kasula P.a and K. V. Nanda Kumara* Sri Padmavathi School of Pharmacy, Tiruchanoor, Tirupati, Andhra Pradesh - 517 503, India.
Published: November 2021

Three-wavelength spectrophotometric method has been developed for the simultaneous estimation of atazanavir sulfate (ATZ) and ritonavir (RIT) in pharmaceutical preparations. The absorbance value at 279.7nm was used for the estimation of ATZ where RIT showed zero absorbance. The absorbance value for RIT was estimated by taking difference in absorbance at two wavelengths 248 nm and 252 nm. This method obeyed Beer’s law in the concentration range of 9-45 μg/mL for ATZ, and 3-15 µg/mL for RIT. The results of analysis have been validated statistically and recovery studies confirmed the accuracy of the proposed method. The percentage recoveries were found to be 101.3±0.4 for ATZ and 99.8± 0.2 for RIT. The assay values of atazanavir and ritonavir were found to be 100.7±0.7 and 103.0±1.2, respectively. The method was found to be simple, rapid, accurate, precise and sensitive. Hence, this method can be used for routine analysis of these drugs in formulations.
Proliferan leyes y reglamentos perjudiciales durante la crisis del COVID-19 Sur y sudeste de Asia
Authors:   Asia Indigenous Peoples Pact (AIPP),   Coalition for Tenure Justice in Indonesia,   Rights and Resources Initiative
Published: November 2021

Este informe analiza los desarrollos legislativos durante el COVID-19 en la India, Indonesia y Filipinas que han socavado las interacciones sostenibles entre humanos y el medio ambiente y el pleno disfrute de los derechos sobre territorios consuetudinarios por parte de los PI y de las CL. Aunque la India, Indonesia y Filipinas no han ratificado todavía el Convenio Núm. 169 sobre Pueblos Indígenas y Tribales, publicado en 1989 por la OIT, ya ratificaron la Declaración de las Naciones Unidas sobre los Derechos de los Pueblos Indígenas (DNUDPI). Asimismo, cada uno de esos países ha promovido reformas de tenencia de tierras y bosques a nivel nacional, aunque su implementación ha sido débil.
Het Dravetsyndroom: van paradox tot therapie
Authors: Van Wijk Elise
Published: November 2021

Het Dravetsyndroom is een ernstige epileptische encefalopathie bij jonge kinderen. Het merendeel van de patiënten heeft een mutatie in het SCN1A gen dat codeert voor een onderdeel van het natriumkanaal NaV1.1. Diermodellen tonen aan dat dergelijke mutaties leiden tot een verminderde functie van inhiberende neuronen, resulterend in verminderde remming van exciterende neuronen. Deze bevinding biedt, naast inzicht in de pathogenese van het Dravetsyndroom, een aangrijpingspunt voor therapie.
Epilepsie speelt bescheiden rol als oorzaak van gedragsproblemen bij patiënten met een verstandelijke beperking
Authors: Schelhaas Jurgen
Published: November 2021

Op 9 oktober 2019 promoveerde Francesca Snoeijen-Schouwenaars aan de Universiteit Maastricht op haar proefschrift ‘Diagnostic, Neuropsychiatric and Therapeutic considerations in Epilepsy and Intellectual Disability - medical perspectives’. 1 In het proefschrift wordt het onderzoek naar het complexe samenspel tussen epilepsie en gedrags- en stemmingsproblemen bij mensen met een verstandelijke beperking beschreven. De verstandelijke beperking lijkt meer invloed te hebben op de gedragsproblemen dan de epilepsie.
Reversible Gate Logic Adder with Parity Preserving Design
Authors: K Kannadasan
Published: November 2021

Reversible logic circuits have drawn attention from a variety of fields, including nanotechnology, optical computing, quantum computing, and low-power CMOS design. Low-power and high-speed adder cells (like the BCD adder) are used in binary operation-based electronics. The most fundamental digital circuit activity is binary addition. It serves as a foundation for all subsequent mathematical operations. The main challenge today is to reduce the power consumption of adder circuits while maintaining excellent performance over a wide range of circuit layouts. Error detection in digital systems is aided by parity preservation. This article proposes a concept for a fault-tolerant parity- preserving BCD adder. To reduce power consumption and circuit quantum cost, the proposed method makes use of reversible logic gates like IG, FRG, and F2G. Comparing the proposed circuit to the current counterpart, it has fewer constant inputs and garbage outputting devices and is faster.
Old Wall Paintings Restored Using Digital Technology
Authors: R Logeshwaran
Published: November 2021

The ancient mural pictures are virtually recreated in this study using a technique that takes a weighted average of the mean image and the original image. There are four phases to this approach. Correlation and convolution are used to detect and extract lines. Toggle filter is used to improve the extracted lines. Templates with various orientations are used for correlation and convolution. Using k-means clustering, the pixels are grouped and each pixel is replaced by the cluster's mean value. After that, the weighted average is used to restore the ancient wall paintings.
Smart Shopping with Automated Billing System Using Zigbee and RFID
Authors: R Logeshwaran
Published: November 2021

In the future, smart commerce will serve as a platform for smart cities. This method is fully automated, and billing may be completed without the assistance of a cashier. It is a mobile gadget that will be installed in the PICk and Drop basket (trolley) at department shops. Billing can be done via a swipe machine or by using their smart phones to access online banking. Instead of a bar code reader, we utilise RFID. Each item will be assigned an ID number, allowing for easy billing. In addition, the product update will be transmitted to the server. As a result, if any of the products becomes null, an alert will be sent to the main server or the master PC administrator. The bill will be sent to the customer's cellphone number through GSM. ZIGBEE is used to communicate from the trolley to the main server. We employ a PIC microcontroller in our suggested system, which is cost and performance efficient. The ultimate goal of this article is to automate billing and move India closer to being a Digital India. Time may be saved for the client, and manpower can be decreased.
Wavelets based estimation of trend in sub-divisional rainfall in India
Authors: RANJIT KUMAR PAUL , SANDIPAN SARKAR , DIPANKAR MITRA , SANJEEV PANWAR , A K PAUL , L M BHAR
Published: November 2021

Presence of long memory in climatic variables is frequently observed. The trend assessment becomes difficult in the presence of long-memory as the usual methods are not capable to take care of this property during trend estimation. In order to estimate the trend in presence of long memory, the non-parametric wavelet method has become popular in the recent time. The discrete wavelet transformation (DWT) re-expresses a time-series in terms of coefficients that are associated with a particular time and a particular scale. In the present study, DWT has been applied to estimate the monthly rainfall trend for the monsoon months: June-September in ten selected sub-divisions of India using “Haar” wavelet filter. The results from DWT were cross checked with the non-parametric Mann-Kendall (M-K) test. The investigation reveals that the monthly rainfall trend for the monsoon months of different sub-divisions in India are significantly decreasing over the years. However, in some of the sub-divisions, rainfall trend is increasing. DWT reveals significant trend in most of the sub-divisions whereas M-K test reveals that most of the trends are not significant at 5% level.
Vulnerability of agricultural households to climate change in hill state of north Western Himalaya
Authors: PANKAJ PANWAR , V K BHATT , SHARMISTHA PAL , NANCY LORIA , N M ALAM , N K SHARMA , P K MISHRA
Published: November 2021

In the present study, vulnerability level of individual farming households to climate change is examined in Himachal Pradesh, North-western state of India. Principal Component Analysis (PCA) was used to develop vulnerability index for individual household. Mean household vulnerability index in the study area was 0.27. The farming households from Kullu district were the most vulnerable (5.94) while those from Hamirpur district were least vulnerable (-3.37). The study successfully identified the regional sources of vulnerability and prioritises the districts for adaptation planning. Implication of the study results lays with the policy makers in formulating region specific and targeted climate adaptation policies that foster asset building so as to reduce vulnerability and build long-term resilience to climate change.
Impacts of the Madden-Julian Oscillation (MJO) on rainfall in Sri Lanka
Authors: I M SHIROMANI PRIYANTHIKA JAYAWARDENA , MATTHEW C WHEELER , W L SUMATHIPALA , B R S B BASNAYAKE
Published: November 2021

The influence of the Madden Julian Oscillation (MJO) on rainfall in Sri Lanka (SL) is examined based on 30 years of daily station data from 1981-2010. Composites are constructed for each of the eight phases of the MJO defined with the Real-time Multivariate MJO (RMM) index, using daily rainfall data from 44 stations over SL for four climatic seasons and comparing to similar results from a satellite-based rainfall product. Composites of lower tropospheric wind and convective anomaly are also investigated in order to examine how the local rainfall anomalies are associated with large-scale circulations. The greatest impact of the MJO on rainfall over SL occurs in the Second Inter-Monsoon (SIM) and Southwest Monsoon (SWM) seasons. Enhanced rainfall generally occurs over SL during RMM phases 2 and 3 when the MJO convective envelop is located in the Indian Ocean and conversely suppressed rainfall in phases 6 and 7. This rainfall impact is due to the direct influence of the MJO’s tropical convective anomalies and associated low-level circulations in the vicinity of SL. In contrast, the MJO influence during the Northeast Monsoon (NEM) season is slightly less than during the SWM and SIM seasons as a result of the southward shift of the MJO convective envelop during boreal winter. Occurrence of extreme rainfall events is most frequent during phase 2 in First Inter-Monsoon (FIM) phases 2 and 3 in SWM, phases 1, 2 and 3 in SIM and phases 2 and 3 in NEM seasons. The analysis of this study provides a useful reference of when and where the MJO has significant impacts on rainfall as well as extreme rainfall events during four climatic seasons in SL. This information can be used along with accurately predicted MJO phase by dynamical or statistical models, to improve extended range forecasting in SL.
Operational site selection for disaster management bases in Tehran, Iran
Authors: SAYYED ALI ALAVI , ABOLFAZL MESHKINI , MOHAMMAD EBRAHIMI
Published: November 2021

Natural disasters play a main role in human life. It should be taken into consideration that it is impossible to predict these disasters from happening, but preparation for a good response for these disasters can be a good solution to decrease post-damage casualties in the cities. Herein, Disaster Management Bases in terms of prevention, preparation and dealing with the crisis play a key role, especially in Tehran and in times of natural disasters. There is no doubt that a high level and efficient function of these bases has a striking correlation with the way they are located in both an urban and regional level in a way that in addition to providing security of the bases against disasters, based on the service area they could be able to provide good services for the areas of crisis. This paper tries to use Multi Criteria Decision Making (MCDM) techniques and spatial analysis method in order to assess the effectiveness of these bases. Based on assessments Disaster Management Bases have spontaneously distributed in Tehran and have located in inappropriate places. Thus using MCDM with GIS analysis, the best locations in case study area was proposed.
Spatial-temporal distribution of atmospheric temperature anomalies connected with seismic activity in Tien-Shan
Authors: L G SVERDLIK , S A IMASHEV
Published: November 2021

In this paper we analyzed spatial-temporal temperature changes in the upper troposphere/lower stratosphere (UTLS) above the Northern and Central Tien-Shan detected by satellite remote sensing which have been compared against seismic activity in (1992-2015). These anomalous changes in temperature time series were used as pre-seismic indicators. Anomalous variation parameters were calculated accounting for amplitude and phase of short-time temperature variations at UTLS isobaric levels separated by the tropopause. The results show that the spatial structure and dynamics of temperature anomalies in the area of UTLS have a sufficiently stable relation to seismic activity. We estimated the spatial and time variability of anomalous temperature perturbations on the basis of 12 strongest earthquakes with magnitudes Mï5.0. The temperature anomalies were observed in all considered cases from ~3 to 72 hours before the main seismic event.