bluuebunny/crossref_metadata_2025 huggingface dataset:
Visualizing the obscure– Chromophore-assisted retinal break detection
Authors: Verghese Shishir , Joseph Verghese
Published: December 2024

Background:

Finding a retinal break which is responsible for retinal detachment is a critical step in the surgical treatment of this condition. In spite of improvement in visualization systems in pars plana vitrectomy, identifying the break which is the source of subretinal fluid (SRF) could pose a challenge, especially in complex retinal detachments or re-detachments with extensive laser scars.

Purpose:

The current technique of break identification involves direct detection of the break via peripheral indentation or using perfluorocarbon liquid (PFCL) to displace SRF from the posterior retina to the periphery and visualizing the proteinaceous SRF egress from the retinal break. In retinal detachments, if no peripheral breaks are visualized, surgeons tend to make a posterior draining retinotomy and drain SRF, the necessity of which can be confirmed after subretinal brilliant blue green (BBG) dye injection. In addition, in already vitrectomized eyes where it can be difficult to identify SRF egressing via the break, subretinal BBG dye provides a color contrast that enhances break visualization.

Synopsis:

A method to identify these occult breaks was required, which is described in this video. Hence, the idea of BBG dye injection into the subretinal space with a 41G subretinal needle was thought of. PFCL would be placed over the posterior pole, which would displace the dye to the periphery, and this would disperse out into the vitreous cavity into a blue plume via the break, thereby leading to its identification.

Highlights:

Subretinal dye injection is useful for occult retinal break detection as it provides a color contrast. A posterior draining retinotomy can be avoided. It is also useful in recurrent retinal detachments. We describe the use of BBG, which is the least toxic dye available, and report the use of this technique in Indian eyes.

Video Link:

https://youtu.be/JGXQjNV9asw
Klippel–Trenaunay syndrome presenting as pulmonary embolism in an elderly person
Authors: Surendran P. K. , Asha Krishnan L. , Ali Sayyad C. M. , Udayabhaskaran V.
Published: December 2024

An elderly woman was admitted with acute-onset breathlessness and right-sided chest pain suggestive of pleurisy. The initial impression of the chest X-ray was ‘right upper lobe consolidation’. Her hypertrophied leg along with the presence of large visible arteriovenous malformation was suggestive of Klippel–Trenaunay syndrome (KTS). A conscientious relook at the X-ray revealed other radiological features suggesting a possible pulmonary embolism. Subsequent D-dimer and echocardiography supported the diagnosis, and a computerised tomography pulmonary angiogram confirmed the same. Prompt systemic anticoagulation along with supportive therapy led to a smooth recovery of the patient over the next few days.
Guillain–Barré syndrome following Covishield vaccination in Telangana
Authors: Rao Veeramalla N. Madhava , Veeramalla Shivani , Tekuru Yogesh , Kandimalla Ramesh
Published: December 2024

We observed a noteworthy case of Guillain–Barré syndrome (GBS) in Telangana, India. The onset of GBS symptoms was observed 4 days after the patient received the initial dose of the Covishield ChAdOx1 nCoV-19 Corona recombinant virus vaccine. Our patient was a 54-year-old female with an unremarkable medical history. Her initial presentation included symmetrical weakness in the lower limbs, which subsequently progressed to involve the upper limbs, facial muscles and oropharyngeal area. Of particular note was the cranial nerve involvement, marked by facial paresis that advanced from House–Brackmann Grade III to Grade V within 2 days. The patient also reported severe dysaesthetic pain, and the condition exhibited a rapid progressive course, with the maximum deficit observed within just 7 days. Laboratory investigations, including magnetic resonance imaging of the lumbosacral spine, high-resolution computed tomography of the chest were normal. Administration of intravenous immunoglobulin had resulted in amelioration in muscle strength, paraesthesias and a complete remission of facial weakness. On re-evaluation at 2-months only mild residual weakness, hyporeflexia and an absence of sensation of sensory modalities were evident.
Role of Dobutamine Stress Echocardiography in the Evaluation of Patients Undergoing Noncardiac Surgeries in the Contemporary Era
Authors: Chaudhary Tanu , Bansal Manish , Kasliwal Ravi R.
Published: December 2024

Objective:

Dobutamine stress echocardiography (DSE) is a widely used diagnostic modality for preoperative cardiac risk assessment in patients undergoing major noncardiac surgeries. However, its role in facilitating safe noncardiac surgery in the contemporary era needs to be evaluated.

Materials and Methods:

A total of 1283 participants (mean age – 63.8 years and 54.9% males) undergoing DSE for preoperative cardiac evaluation before nonemergent, noncardiac, major surgeries were included. DSE findings were recorded, and the Revised Cardiac Risk Index or Lee’s score was also calculated. The patients were followed up for in-hospital adverse cardiac events.

Results:

DSE showed evidence of inducible myocardial ischemia in 19 (1.5%) patients, whereas Lee’s score was elevated (>3) in 43 (3.4%) patients. The overall in-hospital event rate was 0.7%. Among 1264 patients with normal DSE, 5 (0.4%) had a perioperative cardiac event (negative predictive value 99.6%). Of the 19 patients with abnormal DSE, all underwent coronary angiography which was abnormal in 16 patients. Of these 16 patients, 4 had a perioperative cardiac event. A Lee’s score value >3 had a sensitivity of 68.4% (95% confidence interval [CI] - 43.5–87.4), specificity of 97.6% (95% CI - 96.6–98.4), positive predictive value of 30.2% (95% CI - 21.4–40.9), and negative predictive value of 99.5% (95% CI - 99.1–99.8) for predicting abnormal DSE.

Conclusion:

Our study reinforces the clinical utility of DSE in facilitating major, nonemergent, noncardiac surgeries in a contemporary setting in India. A normal DSE had a very high negative predictive value for an adverse cardiac event, whereas an abnormal DSE identified the population at high risk for perioperative cardiac events requiring appropriate risk mitigation strategies.
Blood Pressure Variability as a Predictor of Left Atrial Dilatation in Hypertensive Patients: A Comparative Cross-sectional Study
Authors: Setouhi Amr , Taha Mohammad-Alaa S. , Ibrahim Alaa M. , Farrag Hazem M. A.
Published: December 2024

Background:

Short-term blood pressure variability (BPV) has been associated with adverse cardiovascular outcomes, but its impact on left atrium (LA) function and structure remains unclear. This study aims to explore the relationship between short-term BPV and LA function in patients with controlled and uncontrolled hypertension, using speckle-tracking echocardiography (STE).

Methods:

In this cross-sectional study, 150 hypertensive patients were recruited and categorized into controlled and uncontrolled hypertension groups based on ambulatory blood pressure (BP) monitoring. BPV was calculated from 24-h ambulatory BP recordings, and LA function was assessed using STE to measure LA volume, strain, and strain rate parameters. Univariate and multivariate analyses were performed to investigate associations between BPV and LA functions.

Results:

Higher short-term BPV was significantly associated with impaired LA function, including reduced LA strain and increased LA volume index, in both hypertensive groups. After adjusting for confounding factors such as age, body mass index, and duration of hypertension, BPV remained an independent predictor of LA dysfunction (P < 0.01). The relationship was more pronounced in the uncontrolled hypertension group.

Conclusion:

Short-term BPV is independently associated with left atrial dysfunction in hypertensive patients, particularly in those with uncontrolled hypertension. These findings suggest that BPV could serve as a potential marker for early left atrial remodeling in hypertensive populations, providing insights for better risk stratification and management.
Evaluation of the Primary Stability of 73 Implants with a New Macrogeometry in the Treatment of the Edentulous Maxilla by the All-on-Four Technique
Authors: Sant'Anna Falce de Macedo Bruno Eduardo , Manfro Rafael , de Souza Patrícia Tolentino da Rosa , Rosa Maurício , Garcia Gislaine Fernandes Felipe , Macedo Nayara Flores
Published: December 2024

Introduction: Primary stability depends on factors such as bone quality and availability, surgical technique, implant microgeometry and is decisive to load implants immediately or wait for their osseointegration period. The implants used in this study (Implantes Maestro Implacil de Bortoli − São Paulo, SP, Brazil) have a conical shape with decompression chambers that increase the implant and bone contact area and reduce the implant insertion torque without affecting the primary stability. Evaluate the primary stability of 73 implants subjected to immediate loading and correlating this result with implant diameter and length. A cross-sectional clinical study. Methods and Material: Twenty one patients were selected clinically and by imaging with cone bean computed tomography. The implants were installed up to a torque of 35 N cm, measured at the end of the fixture installation. Statistical analysis used: Spearman’s correlation analysis and Mann–Whitney U test analysis, both with 5% significance. Results: The values obtained were 51.51 N cm for the 3.5 mm implants and 59.50 N cm for the 4.0 mm implants. These values were statistically significantly in favor of the 4.0 mm implants (P = 0.03). There was no statistically significant difference (P = 0.373) between the variation of the primary stability of the implants in relation to their length. Conclusions: Implants with larger diameter tend to have a greater primary stability, all of them showed average primary stability when sub-instrumented to perform immediate loading.
Assessing the Accuracy of Cameriere’s Model for Dental Age Estimation on Seven Mandibular Teeth on the Right and Left Sides of Orthopantomogram
Authors: Prabhu Rachana V. , Nair Prabhisha G. , Shenoy Prashanth , Chatra Laxmikanth
Published: December 2024

Introduction: The present study aimed to determine the accuracy of Cameriere’s formula on both the right and left sides of the mandible in the Dakshina Karnataka population of South India and to identify which side is most efficient in determining age. Materials and method: In total, 80 archived digitized panoramic radiographs of healthy children (35 males and 45 females) in the age group of 5–15 years were retrieved and analyzed. Data analysis was conducted using R programing, version 4.3.1, employing paired t-test and Pearson correlation coefficient. Results: The mean chronological age of the entire sample was 11.438 ± 3.039 years. The mean estimated age of the whole sample using Cameriere’s method was 10.463 ± 2.574 years on the left side and it was 9.929 ± 2.937 years on the right side. The difference was significant and indicated a consistent underestimation of age using Cameriere’s method. However, when Cameriere’s method was applied on both sides of the orthopantomogram, there was no significant difference noted even though there was a slight underestimation of age on the right side. This suggests that the left side is comparatively better than the right side for age estimation. Conclusion: Future research on Cameriere’s formula for age estimation could benefit from detailed side-specific analyses and longitudinal studies. Investigating why accuracy differs between the left and right sides of the mandible, focusing on anatomical or physiological factors, is crucial. Additionally, longitudinal studies tracking age estimation accuracy over time and across dental development stages can provide insights into how the formula’s precision evolves as individuals grow. These approaches aim to refine the formula and enhance its reliability in various contexts.
Basal cell carcinoma of the lower eyelid is an actinic-induced cancer: The ABCDE concept to explain the relationship between the invasiveness of basal cell carcinoma and actinic damage
Authors: Minussi Luiza Abreu , Sakabe Felipe Key , Barin Roxana , Marcotte Emily , Abreu Elvira Barbosa , Burnier Miguel Noel
Published: December 2024

Purpose:

Basal cell carcinoma (BCC) originates from the basal cells in the epidermis and is particularly prevalent on the eyelid. Ultraviolet (UV) radiation, a key factor in BCC development, induces fibroblast actinic damage and abnormal elastic fiber deposition, leading to cancer development. This study investigates the relationship between UV radiation and BCC on the lower eyelid by examining the incidence and characteristics of this cancer across diverse geographic regions.

Materials and Methods:

A cohort of 813 BCC eyelid patients from Canada was analyzed. Tumor locations (lower vs. upper eyelid) were recorded. The histopathological evaluation included 707 lower eyelid BCC cases and 493 benign lesions of the lower eyelid. Actinic damage was graded on a scale of 0–3. The presence of in situ BCC was assessed.

Results:

Results revealed a consistent trend: 87% of Canadian BCC cases occurred on the lower eyelid. Severe actinic damage was observed in 89% of pathological lesions, with 11% showing moderate damage. In contrast, 93% of benign lesions had no detectable actinic damage, whereas 7% showed mild damage. Notably, no BCC cases were in the in situ phase, indicating advanced disease upon diagnosis.

Conclusion:

These findings confirm that BCC of the lower eyelid is primarily induced by UV radiation exposure. Actinic damage in fibroblasts leads to DNA alterations in dermal fibroblasts and is the hallmark feature in sclerosing BCC. This highlights the critical role of UV-induced genetic damage in the pathogenesis of lower eyelid BCC, emphasizing the need for preventive strategies.
Effectiveness of low-dose topical atropine in preventing the progression of myopia – A prospective interventional cohort study in pediatric patients
Authors: Mohan Tara Susan , Menon Liji , Shimy Mary , Balan Binu , Panicker Latha
Published: December 2024

Background:

Myopia is a very common pathological condition in the pediatric age group which can lead to devastating complications if not treated early. Recent studies support the use of atropine drops of various concentrations to prevent the progression of myopia in children. Not many studies have been published from India in this regard.

Aims and Objectives:

We attempt to assess the effectiveness of low-dose atropine (0.01%) in preventing myopia progression in children.

Materials and Methods:

80 eyes of 40 myopic children who attended our Institute were studied after dividing them into control and test groups and followed up for a period of 1 year.

Results:

Significant reductions in change in axial length and refractive error were noted at the end of 1 year. There is no significant pupillary dilatation with the use of 0.01% atropine and side effects like photophobia were not reported.

Conclusion:

We concluded that atropine sulfate 0.01% is safe and effective in slowing down the progression of myopia.
A cross-sectional study to evaluate ocular manifestations in end-stage renal disease patients attending tertiary care center
Authors: Kaushik D. S. , Ashwini K. V. , Angraje Srivatsa
Published: December 2024

Context:

Chronic renal failure leads to end-stage renal disease (ESRD), where patients rely on hemodialysis (HD). ESRD affects multiple organ systems, including the eyes, there is limited data on ocular complications among HD patients in India.

Aims:

The aim of the study was to analyze the clinical spectrum of ocular manifestations in ESRD patients on HD and investigate the relationship between the duration of dialysis and ocular complications.

Settings and Design:

A hospital-based cross-sectional study was conducted at a tertiary care center involving 75 ESRD patients.

Methodology:

Participants underwent comprehensive ophthalmic examinations, including tonometry and fundus examination. The study excluded patients with corneal dystrophy, renal transplant history, ocular trauma, or malignancy. Data on dialysis duration, frequency, and ESRD etiology were collected.

Statistical Analysis Used:

Nonparametric Mann–Whitney U test assessed the relationship between dialysis duration and ocular complications, with significance set at P < 0.05.

Results:

Among 150 eyes, 83.33% exhibited ocular abnormalities, with cataracts (50%) and conjunctival calcification (16%) being the most common findings. Significant correlations were found between dialysis duration and diabetic retinopathy (P = 0.01), hypertensive retinopathy (P = 0.005), and conjunctival calcification (P = 0.012).

Conclusions:

Ocular abnormalities are prevalent in ESRD patients undergoing HD, with dialysis duration significantly associated with specific conditions. Regular ophthalmologic evaluations are essential for managing ocular health in this population.
Postoperative Outcomes among COVID-19-infected Pediatric Patients in a Philippine Tertiary Pediatric Specialty Hospital
Authors: de Mesa Yuri Mikael Garcia , Gamo Allan Benson Abanador
Published: December 2024

ABSTRACT

Introduction:

Multiple studies in adults have shown that infection with COVID-19 have increased mortality and pulmonary complication rates in postoperative patients. Data comparing the clinical course of adult and pediatric COVID-19 patients showed that the latter had generally a milder course. However, data for outcomes of COVID-19-infected children who underwent surgery are still lacking especially in the local setting.

Materials and Methods:

This is an analytic cross-sectional study that included all COVID-19 pediatric patients who underwent surgery from 2020 to 2022 in a tertiary government hospital. Mortality rate and postoperative pulmonary complications (PPCs) were the primary and secondary outcomes in the study, respectively. Multiple logistic regression analysis was used to determine the factors associated with mortality and PPCs.

Results:

Fifty-five COVID-19 patients were included in the study. PPCs were noted in 22% (n = 12) of patients. One patient (2%) died during the study. Fifty-five percent (n = 30) of patients presented with preoperative pulmonary symptoms and were associated with risk of developing PPCs (adjusted odds ratio [aOR] 3.7 [95% confidence interval 1.27–10.75], P = 0.016). Undergoing a subsequent surgery was also noted to increase risk for PPCs (aOR 29.43 [2.53–342.37], P = 0.007). ASA three patients, patients with allergy, patients needing O2 support and those who were diagnosed with COVID-19 postoperatively were noted to have higher proportions of patients who developed PPCs but were not statistically significant.

Conclusions:

Patients with pulmonary symptoms and patients who underwent another procedure were factors noted to be associated with increased risk of developing PPCs.
Artificial Intelligence Integration and Data Governance in Pharmacy and the Healthcare sector: A Position Statement on Behalf of the Saudi Society of Clinical Pharmacy (SSCP) and the Saudi Health Informatics Pharmacists (SHIP)
Authors: Alshaya Abdulrahman I. , Alowais Shuroug A. , Badreldin Hisham A. , Alqahtani Tariq , Alzeer Abdullah , Alghamdi Hazza , Alomeen Abdulgader , BinDos Amal , Ashmawi Hasan , Joharji Hala , Alawagi Mohammad , Almudaiheem Hajer , Al-jedai Ahmed
Published: December 2024

The Saudi Society of Clinical Pharmacy (SSCP) and the Saudi Health Informatics Pharmacists (SHIP) collaborated to develop a position statement on the integration of artificial intelligence (AI) and data governance in the pharmacy practice and the healthcare sector. The SSCP and the SHIP have established a focused group dedicated to creating a comprehensive overview and formulating the position paper. Through a modified Delphi method of two rounds, the task force developed 12 key recommendations with a≥80% consensus rate covering a wide range of areas, including policy development, regulatory frameworks, education and training, ethical considerations, data governance, and patient privacy, to create an environment that supports the responsible and effective utilization of AI in pharmacy practice. This position statement calls on stakeholders in the pharmacy profession and the healthcare sector to embrace AI as a transformative tool while ensuring that ethical principles, patient safety, and the promotion of optimal healthcare outcomes guide its implementation. The SSCP and SHIP are addressing these crucial aspects as an opportunity for Saudi Arabia to spearhead advancements in AI integration in pharmacy and contribute to the global progress in healthcare innovation.
Cost-Utility Analysis and Comparative Effectiveness Analysis of Biologic Treatment of Moderate-to-Severe Psoriasis in Saudi Arabia
Authors: Hamadah Issam R. , Al Tawil Esraa S. , Alsaqa’aby Mai , AlFada Mohammed A. , Al-Haddab Mohammed A. , Abu-Shraie Nada , Mohamed Omneya , Basu Sujata , Roshdy Ahmed , Rateb Mohamed , Nour Yasser , Al-Sheikh Afaf A.
Published: December 2024

Background:

Psoriasis is a chronic, immune-mediated disease of the skin and joints, with a global prevalence of 2%–3%. Psoriasis area and severity index (PASI) 75 is accepted as a scoring system to evaluate baseline reasonable response to therapy. However, with advent of newer biologics, the PASI90 outcome is now potentially achievable.

Objective:

To assess the cost-utility of achieving PASI75 or PASI90 using risankizumab in psoriasis patients in Saudi.

Materials and Methods:

A Markov model was developed with a 12-week cycle length and 40-year time horizon from a healthcare payer perspective. Costs considered were related to drug acquisition, drug administration, medical resource use, adverse event management, and physician visit costs. The model compared the current treatment sequence anti-tumor necrosis factor alpha (adalimumab), interleukin (IL)12/23 inhibitors (ustekinumab), and IL-17A inhibitor (secukinumab), as the first-, second-, and third-line treatments, respectively, targeting PASI75 versus IL-23 inhibitor (risankizumab) as the first-line treatment option, targeting PASI90.

Results:

Using the current treatment sequence and targeting PASI75 as a clinical outcome, the overall cost of moderate-to-severe psoriasis management in Kingdom of Saudi Arabia was estimated to be 8.9 billion United States Dollar (USD), yielding 921,039 quality-adjusted life-year (QALYs). The average cost and QALY per patient was USD 0.4 million and 23.64, respectively. The use of risankizumab as the 1st line option targeting PASI90 yielded an overall cost of 8.4 billion USD and 951,512 QALYs. The cost savings and the high QALY gain were attributed to the lower healthcare resource utilization and increased probability of achieving PASI90, respectively.

Conclusion:

Targeting PASI90 using risankizumab as a 1st line treatment for moderate-to-severe psoriasis patients was found to be cost-effective.
Fabrication and High-Temperature Performance Evaluation of Light-Weight Insulation Materials and Coatings for Reusable Thermal Protection Systems
Authors: Nam Min-Soo , Kim Jong-Il , Shin Jaesung , Kim Hyeonjun , Oh Bum-Seok , Kim Seongwon
Published: December 2024

Light-weight ceramic insulation materials and high-emissivity coatings were fabricated for reusable thermal protection systems (TPS). Alumina-silica fibers and boric acid were used to fabricate the insulation, which was heat treated at 1250 °C. High-emissivity coating of borosilicate glass modified with TaSi2, MoSi2, and SiB6 was applied via dip-and-spray coating methods and heat-treated at 1100°C. Testing in a high-velocity oxygen fuel environment at temperatures over 1100 °C for 120 seconds showed that the rigid structures withstood the flame robustly. The coating effectively infiltrated into the fibers, confirmed by scanning electron microscopy, energy-dispersive X-ray spectroscopy, and X-ray diffraction analyses. Although some oxidation of TaSi2 occurred, thereby increasing the Ta2O5 and SiO2 phases, no significant phase changes or performance degradation were observed. These results demonstrate the potential of these materials for reusable TPS applications in extreme thermal environments.
Unraveling the Impact of Destabilizing Shoes on Balance Control and Fall Prevention in Older Adults: A Systematic Review
Authors: Kim In-Ju
Published: December 2024

Background: Falls pose a significant risk to older adults, often leading to severe injury and disability. One potential contributing factor to falls is footwear, particularly shoes with destabilizing features. This systematic review assessed the effects of destabilizing shoes on stability control and fall prevention in older adults, highlighting their effectiveness in balance control and fall prevention, and the detailing the specific review methodology. Methods: We thoroughly searched relevant databases and meticulously screened the identified studies based on predetermined inclusion and exclusion criteria. We then extracted data from 30 eligible studies with various study designs and shoe types and synthesized this information to assess the impact of destabilizing shoes on balance and gait measures, fall incidence, and other relevant outcomes. Results: While certain types of destabilizing shoes may improve specific aspects of balance and proprioception, they can also adversely affect steadiness control and potentially increase the risk of falls if not appropriately used. Therefore, the use of destabilizing shoes should be carefully considered and tailored to individual needs, with proper guidance and training to minimize fall risk.Conclusion: The findings of this review significantly inform footwear design and selection in older adults and emphasize the need for additional research. By synthesizing the available evidence, this review highlights the potential benefits and risks associated with destabilizing shoes and suggests the need for careful evaluation of their use on a case-by-case basis. This review serves as a basis for future guidelines on the use of destabilizing shoes in older adults with the aim of developing effective fall prevention interventions.
Letter from the Focus Issue Editors
Authors: Lakhlani Hardik , Kumar Vivek , Wenbin Yu , Bagga Kalyan , Gundlapally Santhosh , Di Blasio Gabriele , Splitter Derek , Rajendran Silambarasan
Published: December 2024

Letter from the Focus Issue Editors
Detection of Neurological Complications by Cranial Ultrasound in Neonatal Sepsis: A Cross-sectional Study
Authors: Hossain Nadia , Rumman Rumman , Alam Mohammad Sazzaddul , Jahan Alpana , Mahmud Rajib , Parajuli Samrat , Shahidullah Mohammod , Mannan Abdul
Published: December 2024

Neonates with sepsis are at risk of neurological complications. Cranial ultrasound (CUS) has been widely used in neonates for early detection of these intra-cranial abnormalities. It is a convenient, non-invasive, safe with no radiation exposure and quick imaging technique to visualize the neonatal brain parenchyma and ventricular system. To detect neurological complications in neonates with sepsis by CUS. This cross-sectional study was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from June 2019 to September 2020. Inborn neonates with sepsis and inborn preterm neonates without sepsis satisfying the inclusion and exclusion criteria who were admitted into neonatal intensive care unit (NICU), BSMMU during study period were the study population. Among 110 neonates, 75 neonates with sepsis and 35 pre-term neonates without sepsis were assessed for eligibility. Among these 75 septic neonates 19 were excluded. Finally,56 septic neonates were analyzed. Out of them 21 (37.5%) neonates had abnormal neurological findings in CUS. Distribution of abnormal CUS findings were intraventricular hemorrhage (33%), features of meningitis (24%), hydrocephalus (14%), prominent lateral and third ventricles (10%), intracerebral hemorrhage (5%), features of ventriculitis (5%). Among 35 non-septic pre-term neonates, 5 were excluded due to guardians did not give consent to perform CUS. So, 30 non-septic pre-term neonates were analyzed, among them, 2 neonates (7%) had feature of intraventricular hemorrhage in CUS. Septic neonates with abnormal CUS findings, most of the neonates were male (71%), gestational age (34.57±3.043) weeks and birth weight (1985.2±684.132) gm. In babies with abnormal CUS, convulsion was significantly associated (p value 0.01). This study showed proven sepsis was significantly associated with abnormal CUS findings. The abnormal CUS findings in newborn with sepsis was 37.5%. So CUS may be an important investigatory modality in NICU for early detection of intracranial complications.
Hirschsprung Disease in a Female Infant: A Case Report
Authors: Rojas-Urrea Alejandro , Arias-Mariño Daniela , Landines-Peña Fernanda E. , García-Agudelo Lorena , Niño-Patarroyo Brumel Armando
Published: December 2024

Hirschsprung’s disease (HD) is a congenital disease characterized by the absence of ganglion cells in the intestinal muscularis nerve plexus. The segment most affected was the rectosigmoid colon (80%). The clinical manifestations are non-specific; the common signs include vomiting, abdominal distention, and defecation alterations in early-life another feasible alteration is anemia. Anorectal manometry and contrast enemas are also highly useful. We present the case of a 9-month-old female with refractory constipation who was diagnosed with HD. Some theories explain that there is dysregulation of the microecological balance and intestinal mucosa. Imaging diagnostic methods are useful tools for screening HD. The mortality rate of these conditions is between 2% and 5%; therefore, a group of qualified professionals is necessary for treatment and postsurgical care.
Historical Power Imbalances and the Branding of Vannam Dances as Sinhalese Cultural Heritage
Authors: Peiris Eshantha
Published: December 2024

Vannam is a genre of music and dance associated with the Sinhalese ethnicity of Sri Lanka. This article takes the historical development of vannam as a lens to focus on inter-ethnic cultural politics in Sri Lanka and its postcolonial contexts, offering nuance to widespread ideas about cultural heritage and decoloniality.
Mario Santoro, Tristano Caracciolo, la filologia, i giovani
Authors: Corfiati Claudia
Published: December 2024

The 1950s gave an important impulse to the birth of Medieval and Humanistic Philology and in general to Neo-Latin studies: however, there are still few contributions dedicated to the intellectuals of that period, and investigations about their approach and objectives. The aim of this paper is to propose a critical reflection on the first monograph dedicated to Tristano Caracciolo by Mario Santoro in 1957, and on the method with which the scholar approached the reading of the works of the Neapolitan humanist. After analyzing the way in which Caracciolo’s works are cited and the quality of the quotations, particular attention has been paid to the historical and cultural context in which Santoro’s interests in humanistic literature were born, a period that we can define of great change and crisis of traditional values. The pedagogical meaning of Caracciolo’s thought is emphasized to the point that Santoro builds a singular parallelism between the Neapolitan culture of the early sixteenth century and that of the 1950s.
Juana Dantisca (1527 – 1601), nieślubna córka polskiego dyplomaty, matka hiszpańskich humanistów, teologów i mniszek
Authors: Skolimowska Anna
Published: December 2024

The life of Juana Dantisca (1527–1601), the daughter of the Polish diplomat and humanist Ioannes Dantiscus (Jan Dantyszek), later bishop of Chełmno (Kulm) and Warmia (Ermland), and his Spanish lover Isabel Delgada, serves as an example of the atypical fate of an illegitimate child. Initially supported by her father and even a source of pride to him, Juana was ultimately abandoned by him. Nevertheless, she received a thorough upbringing and education at the expense of Diego Gracian de Alderete, a Spanish humanist and courtier, whom she later married, and with whom she had numerous children who belonged to the Spanish secular and ecclesiastical elites. Talented descendants of the Gracian‑Dantisco family held prestigious ositions in the court of the Spanish monarchs until the early eighteenth century. Juana herself maintained a close friendship with St. Teresa of Avila, and one of her sons, Jeronimo Gracian‑Dantisco, became Teresa’s confessor and collaborator, as well as the first provincial of the Discalced Carmelites in Spain.
The Most Dangerous, because the Most Carnal? The Sense of Touch in the Monastic Sources from the 10th to the 12th Century
Authors: Białas Karolina
Published: December 2024

The purpose of this paper is to characterise the meaning of the sense of touch for medieval monastic culture from the tenth to the twelfth century using selected sources created at the Cluny abbey as example in comparison to other monastic sources. The paper discusses methodological approaches to the study of the history of the senses. Then, the issues of the sense of touch in Christian theology are described based on the analysis of moralistic and exegetical works created in Cluny Abbey. Examples of the association of touch with particular sins are also indicated, taking into account the temporal context, in which the sources were created (including treatises, poems, sermons and hagiography). Finally, the meaning and function of touch in the daily life of a medieval monastery is described, using the content of Cluniac consuetudines from the eleventh century. The papers concludes with a summary containing reflections on the sensual type of monastic culture and what may have been the basis for the authors’ bias against the sense of touch.
A Thing about Diseases of the Body and the Minds of the Archbishops of Gniezno in the 15th Century
Authors: Wilk-Woś Zofia
Published: December 2024

The role of the archbishops of Gniezno for the state encourages research on various aspects of their lives and activities. It is therefore worth trying to look at their physical condition and state of health. The primary source of observation for this is the works of Jan Długosz.
Information about the health of the archbishops is very sparse, but falling off a horse, stroke and dropsy are known causes of their death. The hierarchs’ health was probably affected by their age and public activity, and could have limited their mobility.
Hubungan Nafsu Makan pada Anak Balita dengan Kejadian Stunting di Wilayah Kerja Puskesmas Ahuhu
Authors: Al Dhamir Muh Fitrah , Abadi Ellyani , Demmalewa Jenny Qlifianti
Published: December 2024

A major dietary issue that can impact a child's growth and development before the age of five is stunting. Appetite is one of the elements that affects the prevalence of stunting. The purpose of this study is to examine the connection between stunting rates in the Puskesmas Ahuhu working region and the appetite of children under five. This study employed a cross-sectional methodology and a descriptive correlational design. Seventy-two stunted toddlers, ages six to fifty-nine months, made up the research population. Purposive sampling was the method of sampling that was employed. Questionnaires and observation were used to gather data, which were subsequently subjected to univariate and bivariate analysis. The majority of toddlers with stunting had weak appetites, according to the research. Statistical analysis shows that there is a significant relationship between appetite and the incidence of stunting, where a good appetite contributes to reducing the risk of stunting. There is a significant relationship between appetite in children under five and the incidence of stunting. It is recommended that parents pay more attention to their children's diet and increase their appetite by providing nutritious and attractive food
A Typical Cross-Border Metaverse Model as a Counteraction to Its Fragmentation
Authors: Kostenko Oleksii , Zhuravlov Dmytro , Nikitin Volodymir , Manhora Volodymyr , Manhora Tamila , Gabani Ivan
Published: December 2024

The paper addresses the issue of the Metaverse's territoriality and its connection with national and international law. The study provides a brief overview of hypotheses related to the territoriality of the Metaverse and its connection with national and international law. It explores the concept of electronic jurisdiction for the Metaverse amidst the general absence of a unified transnational legal system for virtual environments. The Internet and the Metaverse are increasingly subject to the reality of fragmenting into separate segments, which can have serious consequences for global security and the economy.
The risks associated with the trend of "Metaverse fragmentation" or "Splinternet"—the division of the single global internet space into isolated segments governed by different rules and technical standards—are analysed.
Innovatively, a theoretical model of a typical Metaverse is presented, potentially creating a cross-border "sandbox" for modeling technological processes, social relations, business, and legal regulation of virtual technologies to develop proposals for unifying the fundamental components of the Metaverse and simplifying cross-border interactions.
The proposed Transborder Standard Model of the Metaverse is an abstract representation of systems used to understand, predict, and explain the behaviour of a complex of systems known under the generalised name Metaverse. This model is characterised by a specific structure composed of modules or ecosystems that functionally differ in purpose and structure and are not connected by similar features. However, their combined application ensures the functionality of virtual environments, and their legal regulation, and can serve as the basis for electronic jurisdiction.
Overriding Mandatory Rules in EU Private International Law
Authors: Moravcová Dominika
Published: December 2024

As a result of the increasing incidence of private law relationships with a foreign element, courts hearing cases are frequently obliged to apply foreign law. The interference of foreign law is liable to produce effects that may conflict with the public interest of the lex fori. Precisely for this reason, we consider it essential to be aware of the available protective mechanisms through which the court can protect the public interest, not only of the lex fori, but even, under certain circumstances, of the public interest of the foreign legal order. The present article deals with the mechanism of overriding mandatory provisions in private international law in order to identify the requirements for the activation of the selected mechanism in the Slovak courts' application practice. Given that this mechanism is not covered by the Slovak Act on International Private and Procedural Law, the article deals mainly with the rules enshrined in the Rome I Regulation. The first part of the present article deals with the definition of overriding mandatory provisions, the application in private international law, and the historical perspectives in the light of the so-called Rome Convention. Subsequently, the article focuses on the classification of overriding mandatory provisions and their impact within the limits relevant to Slovak courts.
Deviatnikovaitė, Ieva (Ed.): Comparative Administrative Law. Perspectives from Central and Eastern Europe
Authors: Handrlica Jakub
Published: December 2024

This is a book review on the newly published book, entitled "Comparative Administrative Law. Perspectives from Central and Eastern Europe."
Lecture by ICC Judge Nicolas Guillou at Comenius University Bratislava
Authors: Zsemlyová Sara , Čentéš Jozef
Published: December 2024

This report covers a lecture by International Criminal Court Judge Nicolas Guillou, held at the Faculty of Law of the Comenius University Bratislava, on the occasion of the Law Day, on the topic: Current Challenges of the ICC in Affirmation of the Rule of Law. In this lecture, the Judge examined the 5 main challenges that the ICC is currently facing. These are hybridisation, efficiency, technologisation, digitisation of evidence and fragmentation.
Escritores argentinos en Galicia: la identidad gallega como referente patrimonial para la Argentina
Authors: Lojo María Rosa
Published: December 2024

Los intelectuales argentinos buscaron al principio independizarse política y culturalmente de España y exaltaron otros paradigmas, como el francés o el inglés. Hacia fines del siglo XIX surgieron corrientes que reivindicaron el legado español. Sin embargo, esa apreciación no solía incluir a Galicia como cultura fundadora. Esto no es proporcional a la gran importancia de la inmigración gallega en la Argentina y se debe en parte a la carga de un estereotipo étnico despectivo. Sin embargo, algunos escritores que viajaron a Galicia rechazaron el estereotipo degradante y constataron su profunda conexión afectiva y cultural con esta tierra. Reconocieron, así, la identidad gallega como valioso patrimonio de la identidad argentina.
SYED MUHAMMAD JAUNPURI AS REFORMER OF ISLAM: AN HISTORICAL OVERVIEW
Authors: Riaz Masood , Ahmed Fouzia , Ali Fizza
Published: December 2024

In 1497, Syed Muhammad Jaunpuri of India claimed to be a reformer with the mission to purify Islam by justifying his claim according to the teachings and sayings of the Prophet of Islam. He started by curbing the innovations, focusing on belief in Allah, offering prayers, search for God and the truth, and also challenging the religious scholars of his time. Thus, he was criticized by religious scholars by refuting Jaunpuri’s claim of being a reformer, interestingly, academicians have also ignored Jaunpuri’s role as a reformer, but this paper discusses the life of Jaunpuri by focusing on his role as a reformer in India, moreover, this paper limits its scope with the life of Jaunpuri as a reformer. The research used a descriptive cum analytical approach which was aimed at making the research a qualitative one and for that various libraries of Pakistan and personal collections of followers of Jaunpuri were accessed, and at the same time, various websites were also surveyed.  So, the research resolved that Jaunpuri was a reformer of the 15th century India who did his best to reform the people and society of his time by bringing them closer to their Creator.
THE ROLE OF ASSESSMENTS IN ENHANCING MOTIVATION OF UNIVERSITY STUDENTS’ OF KARACHI
Authors: Khemchand Kavita , Kang Muhammad
Published: December 2024

The education system of Pakistan has always remained a cause of concern mainly for the educators, stakeholders, ruling political parties, students and parents’ community. A lot of effort has been put to upgrade the education system, increase the literacy rate and maintain the interest and motivation of the learner. One of the main reasons lies in the manner, in which the students are assessed, as assessments are considered to be the means of betterment and improvement. The main aim of the study was to identify the views of university students of Karachi, towards the enhancement of motivation, through assessments. It was a quantitative research, in-person survey was conducted to investigate the role assessment plays in enhancing motivation of students. A 5-point Likert scale questionnaire was constructed, to collect the data from two hundred and fifteen, randomly selected university students of Karachi. Data were analyzed using SPSS version 22. The Psychometric Scale exhibited a positive perception of the construct amongst the respondents. The reliability=.76, with the highest M=4.44, regarding teachers’ attitudes and M=4.44 revealing teachers’ remarks have a deep effect on students’ motivation. Conflicts in the family play a vital role in university students' academic motivation with M=4.34.
THE NEXUS BETWEEN HEALTH CARE SPENDING AND ECONOMIC GROWTH IN SELECTED COUNTRIES IN SUB-SAHARA AFRICA
Authors: Anthony OSOBASE , Joshua OJO , Abiola AJAO
Published: December 2024

The study investigates the relationship between healthcare spending and economic growth in six selected Sub-Saharan African countries: Nigeria, Ghana, Togo, Benin, Cameroon, and Ethiopia. The study employs the Autoregressive Distributed Lag (ARDL) model as an estimation technique to analyse the panel data which spans from 2000 to 2020.  The research examines both the short- and long-run impacts of healthcare spending, population growth, and life expectancy on real GDP (a proxy for economic growth). Based on the ARDL panel results, it is stated that, in the short run, both healthcare spending and life expectancy exert a significant negative impact on real GDP. However, in the long run, real GDP is positively and significantly influenced by all the regressors, highlighting the crucial role of healthcare investment in driving economic development. Additionally, the Granger causality test reveals a bidirectional relationship between real GDP and per capita health spending, suggesting that enhancements in healthcare can stimulate economic growth, and economic growth, in turn, can lead to increased healthcare investments. The study strongly recommends that policymakers in these countries adhere to the Abuja Declaration by allocating 15% of their national budgets to the healthcare sector to bolster economic outcomes. These findings emphasize the critical importance of sustained healthcare investment as a catalyst for long-term economic growth in Sub-Saharan Africa.
ANALYSES AND DETERMINATION OF THE CHEMICAL COMPOSITIONS OF MOSQUITO REPELLANTS SOLD IN IMO STATE, NIGERIA – INDICATING THEIR LEVELS OF ECO-FRIENDLINESS AND TOXICITY
Authors: Enedoh M. C.
Published: December 2024

A lot of persons make use of mosquito repellants in order to be free of mosquito bites irrespective of the aftereffects of these repellants. More serious illnesses other than those infected by mosquitoes seem to arise from some of these repellants. In this research, the chemical composition and safety profile of various chemically synthesized mosquito repellants commonly used in Imo State, Nigeria were carried out. X-ray fluorescence was done to find out the elements present in each. GC-MS analyses were carried out to identify the organic compounds while the ADMET (toxicity) test was followed to evaluate the level of toxicity in each repellant. From the GC-MS analyses, it was deduced that six of the ten types of repellants analyzed contain a non-friendly compound generally known as DEET (Diethyltoluamide). These are medi soft cream with 3.567% of DEET, gardia cream = 22.544%, fly killing bait powder = 7.602%, Rambo coil = 2.822%, reptogel cream = 7.972% and super kill coil = 0.094% all by mass. X-ray done indicated the presence of lead, a harmful element though found at a low concentration in medi soft cream, super kill coil, Swan Green coil, Rambo paper, Rambo coil, odomos cream and fly killing bait powder. Sulphur too detected in Rambo powder, Rambo coil and reptogel cream seems not threatening. Considering the ADMET test, it reveals that most of these repellant are not safe especially when applied for long as each of their prediction toxicity does not correspond to a manageable extent to the DrugBank% database. Odomos cream with no DEET and no elemental sulphur may be less toxic as its toxicity prediction tallies more with the DrugBank% data base. This research therefore recommends that the use of chemical mosquito repellants be discouraged till the producers get back to the drawing board. Natural repellants could be resorted to.