bluuebunny/crossref_metadata_2025 huggingface dataset:
A Clinical Study on the Incidence and Visual Outcome after Surgical Management of
Lens-Induced Glaucoma
Authors: Bhuyan Jyoti , Baishyakh Pranoya
Published: January 2022

Aims and Objectives: To determine 1) the incidence of lens-induced glaucoma. 2) the more prevalent type of LIG. and 3) Visual outcome following surgical management of LIG.
Material and Methods: 50 patients of lens-induced glaucoma, who presented in OPD of Regional Institute of Ophthalmology, were included in the study. All patients were admitted and managed in indoor wards. Informed and written consents were taken. A detailed history and a thorough ocular examination was done. Surgical correction was done by SICS or Phacoemulsification or triple procedures operations.
Results: A standardized proforma was used to compile data and it was analyzed statistically using Chi-square test and Probability value. The incidence of LIG was found to be 0.174 among all OPD attendees. Phacomorphic glaucoma (58%) was found to be the highest followed by phacolytic glaucoma (32%). No significant association with respect to sex and age of the cases was found. The presenting symptoms varied in severity and were directly proportional to the degree of rise of IOP. 38% of cases in our study achieved best corrected visual acuity of 6/9 and 28% achieved 6/12 acuity at the end of 6 weeks. Visual outcome was found to be better for cases with early detection and treatment.
Conclusion: The mainstay to prevent and treat LIG is early diagnosis and treatment of cataract. Delayed treatment of LIG may result in poor visual outcome.

Keywords: LIG, IOP, Phacomorphic glaucoma, Phacolytic glaucoma, SICS, Phacoemulsification.
Endodontic instruments fracture in root canal: Integrative review
Authors:   Instituto de Odontologia das Américas (IOA)/ Instituto de Odontologia da Paraíba (IOP), Brazil., Dantas Pâmela de Medeiros , Sotero Dália Torres Renata Correia ,   Instituto de Odontologia das Américas (IOA)/ Instituto de Odontologia da Paraíba (IOP), Brazil., Macedo Filho Robeci Alves ,   Instituto de Odontologia das Américas (IOA)/ Instituto de Odontologia da Paraíba (IOP), Brazil., Marinho Sandra Aparecida ,   Curso de Odontologia, Universidade Estadual da Paraíba (UEPB), Campus VIII, Brazil.
Published: January 2022

Introduction: Endodontic instruments fracture is related to several factors from internal dental anatomy and type, to operator inability and inexperience. Objective: To review case reports related to fracture of endodontic instruments inside the root canal. Methodology: A literature review was carried out using papers available in the PubMed and Lilacs databases. Only case reports were included, with no restriction on language and publication year Results: It was analyzed eight papers with 11 instrument fracture cases, with the highest prevalence (45.5%) of rotary instruments fracture, occurring mainly in middle-cervical and middle-apical root canals thirds. In 90.9% of cases, techniques used for removal showed successful results and in only one case (9.1%), the technique was unsuccessful and the instrument was kept inside the root canal. Final considerations: Endodontic instruments fracture is a complication can directly affect prognosis and endodontic treatment success. Several techniques and devices can be used to remove fractured fragments inside root canals, however, there is no specific protocol for their removal. Keywords: accidents; endodontics; fracture; dental instruments; prognosis.
SARS-Cov-2: A proposal of algorithm for the overlapping of high-resolution microscopic images
Authors:   Institute of Cybernetics, Mathematics and Physics (ICIMAF), La Habana, Cuba., Rodríguez Roberto , Lau Leandro D ,   Institute of Cybernetics, Mathematics and Physics (ICIMAF), La Habana, Cuba., Mboro Gustavo A ,   Institute of Cybernetics, Mathematics and Physics (ICIMAF), La Habana, Cuba., Mondeja Brian A ,   Institute of Cybernetics, Mathematics and Physics (ICIMAF), La Habana, Cuba., Suárez Angelina Díaz y Raúl N ,   Institute of Cybernetics, Mathematics and Physics (ICIMAF), La Habana, Cuba.
Published: January 2022

The COVID-19 disease produced by the novel SARS-Cov-2 coronavirus has become a global pandemic that has affected, in one way or another, the socio-economic life of all humans. In order to analyze the morphology structure of it, the SARS-CoV-2 coronavirus samples are observed under the electron microscopic; and in [3,4], we proposed some algorithms to enhance the S-spikes in those microscopic images. In this work, we propose a new algorithm in order to overlap the obtained results of processing to original images, and we compared our algorithm with those proposed in MatLab. Keywords: COVID-19; SARS-Cov-2; enhancement; segmentation; overlap.
Fatal attraction: A case of multiple magnet ingestion in an infant
Authors:   Assistant Professor, Department of Paediatric Surgery, Ramaiah Medical College and Hospital, Bangalore, India., Patil Neehar , Chaturvedi Abhishek ,   Postgraduate, Department of General Surgery, Ramaiah Medical College and Hospital, Bangalore, India., Kadamba Padmalatha S ,   Professor, Department of Paediatric Surgery, Ramaiah Medical College and Hospital, Bangalore, India., Shetty Jeevak ,   Assistant Professor, Department of Paediatric Surgery, Ramaiah Medical College and Hospital, Bangalore, India., Somashekhar Manjiri ,   Assistant Professor, Department of Paediatric Surgery, Ramaiah Medical College and Hospital, Bangalore, India.
Published: January 2022

Background: Foreign body ingestion is common amongst young children, and they tend to pass spontaneously in most. Multiple magnet ingestion, though not very common, requires early intervention to avoid serious complications. Case presentation: A 1 year old infant was brought to us with symptoms of bilious vomiting and abdominal pain. A plain abdominal x ray revealed presence of multiple radio opaque foreign bodies adherent to each other, lying in the small bowel. This raised the suspicion of accidental ingestion of multiple magnets, which was confirmed on detailed interrogation of the parents. An exploratory laparotomy revealed volvulus with pressure necrosis causing multiple perforations of the small bowel, for which a bowel resection with anastomosis and a loop ileostomy was performed, also all the magnetic beads were removed intact. The stoma was reversed after 4 weeks. At follow up the child has grown well with no residual complaints. Conclusion: The importance of early detection and intervention in a case of multiple magnet ingestion in children should be emphasised amongst the parents of young children. Spread of awareness by the primary paediatricians would help in reducing the morbidity and mortality. Keywords: multiple magnets; intestinal obstruction; perforation.
Second primary nasopharyngeal carcinoma after high - dose chemotherapy and autologous bone marrow transplantation due to Hodgkin’s lymphoma: Сlinical case with literature overview
Authors:   Medical Oncology Clinic, Radiation and Metabolic Brachytherapy Compartment, UMHAT “Queen Joanna” Sofia, Bulgaria., Vassileva Vaska , Petrov Viktor ,   Medical Oncology Clinic, Radiation and Metabolic Brachytherapy Compartment, UMHAT “Queen Joanna” Sofia, Bulgaria., Marinova Lena ,   Medical Oncology Clinic, Radiation and Metabolic Brachytherapy Compartment, UMHAT “Queen Joanna” Sofia, Bulgaria.
Published: January 2022

A second primary nasopharyngeal carcinoma diagnosed after Hodgkin’s Lymphoma is a rare disease. We present a 47-year old patient with nasopharyngeal carcinoma one year after high-dose chemotherapy and 8 months after autologous bone marrow transplantation due to Hodgkin’s Lymphoma with achieved clinical and hemopoetic remission. The diagnosis of the second primary neoplasm was made after nasopharyngoscopy with biopsy, MRI and PET/CT. The patient was positive for Epstein-Barr viral infection. Intensity-modulated radiotherapy combined with chemotherapy was performed using VMAT technique. In the primary nasopharyngeal tumor was achieved total dose of 70 Gy with 2.12 Gy per fraction while in the regional lymphatic basin (levels IB-V) with the retropharyngeal lymph nodes bilaterally is achieved a total dose of 59.4 Gy with 1.8 Gy per fraction. In the discussion the pathogenetic connection between the Epstein-Barr viral infection and the debut of nasopharyngeal carcinoma is focused on. The follow-up of patients who have undergone chemo- and/or radiotherapy due to Hodgkin’s Lymphoma is importance for the early diagnosis of a second malignant tumor and its proper treatment. Keywords: nasopharyngeal carcinoma; epstein-barr virus; hodgkin’s lymphoma; high-dose chemotherapy; radiotherapy.
Rhodococcus in foal, from diagnosis to treatment: Case report
Authors:   São Judas Tadeu University (USJT), Mooca, SP Brazil., Guedes da Luz Suellen Cristina , Ferreira Márcio Augusto ,   São Judas Tadeu University (USJT), Mooca, SP Brazil., Peña Muñoz Juliana Weckx ,   Centro Universitário das Américas FAM - São Paulo, Brazil., Fukushima André Rinaldi ,   Departamento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo/SP,Brasil
Published: January 2022

The present work reports a case of a foal affected by Rhodococcus equi, an optional intracellular gram-positive pleomorphic cocobacillus, which, when eliminated with the feces of infected animals, in the soil becomes a potential pathogen, capable of causing mainly piogranulomatous bronchopneumonia. The animal, a 23-day-old Brazilian equestrian foal, was sent to the veterinary hospital with hyperthermia, increased heart and respiratory rates, crackle in tracheal auscultation, loss of appetite and prostration. After hematological, ultrasound, radiographic examinations, and collection of tracheal lavages for culture and PCR, the definitive diagnosis of rhodococcosis was obtained, which is a bacterial disease that mainly affects foals, has a worldwide distribution and has a great economic impact on equine culture. Based on the results, treatment with azithromycin, rifampin, flunixin meglumine, sucralfate, ranitidine hydrochloride and amoxicillin with clavulanate was instituted, associated with nebulization with acetylcysteine diluted to 0.9% sodium hydrochloride solution. After a few weeks, there was no evolution in the results of the ultrasound and radiographic exams, however the hematological exams were within the reference levels, there was a significant clinical improvement, and the animal was discharged. It is noteworthy that early diagnosis was essential for the effectiveness of treatment and remission of clinical signs. Keywords: rhodococcosis; foals; rhodococcus equi.
Re-emergence of a rare syndrome: Mauriac syndrome
Authors:   Assistant Professor, Department of Medicine, IPGMER and SSKM Hospital, Kolkata, West Bengal, India., Siddhanta Sattik , Goswami Soumik ,   Tutor, Department of Endocrinology, NRS Medical College, Kolkata, West Bengal, India., Sengupta Nilanjan ,   Professor & Head, Department of Endocrinology, NRS Medical College, Kolkata, West Bengal, India., Kumar Sahana Pranab ,   Associate Professor, Department of Endocrinology, NRS Medical College, Kolkata, West Bengal, India.
Published: January 2022

Mauriac syndrome (MS) is one of the rare complications of poorly controlled Type 1 Diabetes Mellitus (T1DM). It is characterized by poor glycemic control, short stature hepatomegaly, Cushingoid features and delayed puberty [1]. Since the introduction and easy availability of longer acting insulin and insulin analogues, cases of Mauriac syndrome are hardly reported now [2]. This syndrome is more frequently encountered in children and adolescents with poor glycemic control and increases susceptibility of micro vascular complications of Diabetes like diabetic retinopathy and diabetic nephropathy. It is the most common cause of hepatic dysfunction in children and adolescents with Type 1 diabetes mellitus [3]. A classical case of Mauriac syndrome (MS) in an adolescent girl of uncontrolled Type 1 Diabetes Mellitus is being presented.
A review on covid-19 and acute ischemic stroke, malignant cerebral edema & decompressive hemicraniectomy: A perfect storm; tackling this crisis by understanding it
Authors:   Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran., Ahmadvand Ardavan , Seifmanesh Hamidreza ,   Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran., Ghandali Maryam ,   Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran., Afrasiabi Ali ,   Department of Internal Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran., Tajiknia Vida ,   Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran., Amoujani Mahtab ,   Department of Endocrinology, Tehran University of Medical sciences, Tehran, Iran.
Published: January 2022

Since the world was hit by novel coronavirus pandemic, so many challenges for all healthcare providers have been arisen. It is safe to say that no specialty was singled out in the matter of different complication from this viscous covid-19 situation and neurologists and neurosurgeon were no different. There are some studied reporting neurological complication associated with coronavirus infections but when it comes to life threatening and acute neurological complications such as strokes and malignant cerebral edema the data is scant. Here we are going to review the possible pathophysiology of this phenomenon, the relationship between covid-19 and acute ischemic stroke and malignant cerebral edema by taking a closer look at current data regarding this matter. Keywords: covid-19; acute ischemic stroke; malignant cerebral edema; covid-19 associated neurological complications. Abbreviations: DHC: Decompressive Hemicraniectomy; ELVO: Emergent Large Vessel Occlusion; MCE: Malignant Cerebral Edema.
The moderated mediation role of malaria knowledge and household income in the relationship between insecticidetreated mosquito nets and malaria prevalence
Authors:   School of Management, Harbin institute of technology, Harbin P.R China, 150001., Hong Tao
Published: January 2022

Objectives: The study was premised on the notion that insecticidetreated mosquito nets are positively related to malaria prevalence, and that knowledge mediates the relationship between insecticide-treated mosquito nets and malaria. Furthermore, household income was hypothesized to have a moderating effect on the direct and indirect relationships (through malaria knowledge) between insecticide-treated mosquito nets and the prevalence of malaria. Methods: The hypothesized relationships were examined using panel data collected from ten regions of Ethiopia during 2011 – 2015. Structural equation modeling and the random effect model were used to test the hypotheses. Statistical analyses were performed using Stata version 13.0. Results: The results were consistent with our proposed hypotheses, showing a significant relationship between the research variables. The findings suggest that malaria knowledge contributes to improving the relationship between insecticide-treated mosquito nets and malaria prevalence. A positively significant indirect effect (β = 0.47, p = 0.003) as well as direct effect (β = 0.28, p = 0.001) was revealed in the study. Furthermore, a positive impact of household income in strengthening the relationship between insecticide-treated mosquito nets and malaria through knowledge reported, with a considerable value (β = 0.13, p = 0.000). The result also reveals differences in the outcome of malaria prevalence at different levels of household income category, where the indirect effect of insecticide-treated mosquito nets on malaria prevalence via malaria knowledge was positive and significant for households under the second-level income category (β = 0.15, p = 0.000). Conversely, the indirect effect of insecticide-treated mosquito nets on malaria prevalence via malaria knowledge was negative for the high level-income category (β = -0.14, p = 0.022). Besides, insignificant and negative relationships were reported for households under low-level income categories (β = 0.024, p = 0.539). Conclusion: The findings are potentially useful for the health sector to ensure success in infectious disease prevention and control, particularly malaria, and to explain how various factors contribute to the relationship. Keywords: malaria; insecticide-treated mosquito nets; malaria knowledge; household-income; structural equation modelling.
A systematic review of the neglect of non-COVID patients amidst COVID pandemic
Authors:   Department of Anesthesiology and Critical Care, AIIMS Rishikesh, India., Mishra Priyanka , Nath Amborish ,   Department of Anesthesiology and Critical Care, AIIMS Rishikesh, India., Sharma Surbhi ,   Department of Anesthesiology and Critical Care, AIIMS Rishikesh, India., Kumar Ajit ,   Department of Anesthesiology and Critical Care, AIIMS Rishikesh, India.
Published: January 2022

The rapidly evolving health concern for COVID-19 has considerably overshadowed the non-COVID ailments. Ranging from delays in diagnosis and treatment, neglect of mild-moderate diseases resulting into their progression, adverse pregnancy outcomes and many others, an array of the collateral damage of this pandemic is still evolving. We have performed this systematic review about the impact of COVID pandemic on patients suffering from other ailments. Our search was conducted through PubMed, Cochrane and Google scholar databases. We included systematic reviews and meta- analysis, and randomized controlled trials, observational studies, case series and case reports to ensure comprehensiveness of our search. We excluded abstract only articles, news articles, the non-scientific commentaries and reports from the review. Primary outcome was assessment of the impact of COVID pandemic on non-COVID diseases and management strategies for tackling the same. This review showed that this crisis has resulted into a significant delay in routine diagnostic procedures and workup with p value < 0.00001 (OR of 0.36; 95% CI, 0.24 to 0.55). The highest impacts will be seen with preexisting major health priorities like HIV, tuberculosis, malignancy, various non-communicable diseases, reproductive and child health. The chief culprits for this include inadequate supplies of medicines, healthcare staff, diagnostics and other technologies. Expansion of the health care workforce, enhanced health financing and supply chain resilience can help us override this pandemic. Hence, the intersection of COVID-19 with other non- COVID ailments can have drastic effects. To minimize this surplus morbidity and mortality, we need to adopt comprehensive strategies and maintain the momentum even after this pandemic is surpassed. Keywords: COVID-19; neglect; non-COVID; non-communicable diseases; communicable diseases; management.
Endotracheal tube mal-insertion via Zenker’s diverticulum to trachea
Authors:   Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan., Chen Yan-Cheng , Chen Yi-Hsun ,   Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Published: January 2022

An 86-year-old woman with chronic respiratory failure was under endotracheal tube insertion and mechanical ventilator support for 2 months due to previous intra-cranial hemorrhage. She presented with difficult nasogastric (NG) tube insertion after changing endotracheal tube and was transferred to our emergency room. The initial vital signs were blood pressure: 136/85 mmHg, heart rate: 100 bpm, respiratory rate: 20 cpm, body temperature: 36.5o c, and SpO2 : 100% under ventilator support, and stupor consciousness was remained as usual. The physical examination showed bilateral clear breath sound. We tried the NG tube insertion again but in vain; therefore, the esophagogastroduodenoscopy (EGD) was performed for NG tube insertion and revealed malposition of the endotracheal tube over upper esophagus and Zenker’s diverticulum with ulcerations (Panel A). Endotracheal tube was inserted to the esophagus, via the Zenker’s diverticulum, and then to the trachea. The neck CT confirmed the diagnosis (Panel B). After endotracheal tube replacement via bronchoscopy and supportive care with antibiotics treatment, the patient was discharged after admission for two weeks.
Repeat percutaneous tracheostomy in a COVID-19 patient
Authors:   Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Catania, Italy, Sanfilippo Filippo , Mascari Marta ,   Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Catania, Italy, Via Luigi La ,   Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Catania, Italy, Astuto Marinella ,   Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Catania, Italy
Published: January 2022

A 73-year-old man with history of hypertension and chronic obstructive pulmonary disease was admitted to the emergency department with acute respiratory failure from COVID-19. After 10 days of mechanical ventilation (MV) the patient underwent a successful trial of extubation. However, 3 days later his neurological status deteriorated and required re-intubation. A brain computed tomography (CT) scan showed right cerebellar hemorrhage. Considering extent and location of the hemorrhage we decided to perform a percutaneous tracheostomy on the 18th day. The patient was then successfully weaned from MV (day 47th), and finally decannulated (day 50th). On day 62nd, the patient experienced an episode of septic shock, requiring oro-tracheal re-intubation, for we decided to perform a repeat percutaneous tracheostomy. All the procedure steps were uneventful. The patient was subsequently transferred to another ICU, and then successfully discharged to the Respiratory Ward. Keywords: coronavirus; airways; dilational tracheostomy
An unusual case of breast abscess caused by Proteus mirabilis and Prevotella buccalis
Authors:   Department of Internal Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Parnasa Elhanan , Cohen Adiel ,   Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Avital Bar ,   Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Parnasa Yafa Shani ,   Department of surgery, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Oster Yonatan ,   Department of Clinical Microbiology and Infectious Diseases, Hadassah University Medical Center, Jerusalem, Israel.
Published: January 2022

A 56-year-old nulliparous woman presented to the emergency department with acute onset of redness, sensitivity, and local fever in the left breast. Mastitis with abscess was diagnosed. Unusual pathogens were identified in the culture obtained from the abscess - Proteus mirabilis and Prevotella buccalis. Keywords: breast abscess; Proteus mirabilis; Prevotella buccalis.
Implant mobility: Revisited
Authors:   Post Graduate Student, Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India., Anil Liya , Sharma Nilima ,   Associate Professor and Head, Department of Dentistry, HIMSR & HAHC Hospital Jamia Hamdard, India., KL Vandana ,   Senior Professor, Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India.
Published: January 2022

The success lies in achieving and maintaining the stability of a dental implant. However, implant failures are common and among them the most serious issue is the implant mobility. This paper reviews on the implant mobility, its causes, methods to detect mobility and also possible treatment approaches. Keywords: implant; implant failure; implant mobility; osseointegration.
Extramedullary plasmacytoma of the tongue: A case report
Authors:   Faculty of Medicine, University of Medicine of Tirana, Albania., Berdica Leart , Bushati Teona ,   American Hospital of Tirana, Albania., Aga Alfred ,   American Hospital of Tirana, Albania., Vajushi Emirjona ,   American Hospital of Tirana, Albania., Sukaj Erion ,   American Hospital of Tirana, Albania., Ndoja Albina ,   Faculty of Medicine, University of Medicine of Tirana, Albania., Dogjani Agron ,   Faculty of Medicine, University of Medicine of Tirana, Albania.
Published: January 2022

Background: Tongue extramedullary plasmacytoma is a very rare pathology. Despite rare cases, extramedullary plasmacytoma should be considered as a differential diagnosis in case of a mass in the tongue. A total of 19 cases were reported with EMP in English literature along with the case we will address. It is characterized by a monoclonal neoplastic proliferation of plasma cells in the absence of multiple myeloma (MM). Histopathology and immunohistochemistry are very important for the diagnosis and differential diagnosis. Case presentation: The case we will describe is an 80-year-old lady from Albania who presents with a vegetative lesion in the form of a thick plate on the dorsal part of the tongue with dimensions 6 X 5 X 1.5 cm. A material of 0.5 cm diameter was taken from the lesion for the biopsy. After histopathological examination, immunohistochemical examinations, and after correlations with laboratory, clinical and imaging data, the diagnosis of extramedullary plasmacytoma of the tongue was reached. The patient underwent radiotherapy treatment. Conclusions: EMP is a rare tumor, accounting for 3% of plasma cell neoplasms and <1% of all head and neck tumors. The diagnosis of EMP, in this case, was reached with biopsy, immunohistochemistry, and the correlation with laboratory and imaging data. We will show the importance of biopsy along with immunohistochemistry in the diagnosis and differential diagnosis of extramedullary plasmocytoma of the tongue. Keywords: plasmacytoma; immunohistochemistry; biopsy; plasma cell. Abbreviations: EMP: Extramedullary plasmacytoma; MM: Multiple myeloma; Cm: centimeter
A pneumatocele observed in the thoracic cavity after bronchoalveolar lavage
Authors:   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Tanaka Satoshi , Kitou Riiko ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Komuta Kiyohide ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Tanizaki Satoshi ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Kanai Tomohiro ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Uchida Junji ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan., Ueno Kiyonobu ,   Department of Respiratory Medicine, Osaka General Medical Center, 3-1-56 Bandai-higashi, Sumiyoshi, Osaka 558-8558, Japan.
Published: January 2022

A 76-year-old man was admitted to the respiratory medicine department with 5 days of a non-productive cough and exertional dyspnea. A computed tomography revealed multiple mild patchy consolidations in both lungs (Figure 1). Despite antibiotic therapy, there was poor improvement in laboratory and radiological parameters. A bronchoscopy was performed on day 5. The bronchoscopy was wedged in left B5 and a bronchoalveolar lavage (BAL) was performed. After the BAL, we noticed a fistula in the depth of left B5 and saw a structure like a pleural cavity in the back of the fistula (Figure 2). We diagnosed the patient’s condition as pneumatocele (PC). BAL showed 46% lymphocytes and the CD4/8 ratio as 3:7. These findings suggested cryptogenic organizing pneumonia (COP). It took 3 weeks for the PC to improve. Bilateral multiple consolidations improved after the administration of a steroid (PSL 0.5 mg/kg). PCs can occur in infections, chest trauma, barotrauma from mechanical ventilation, and bronchial interventions [1,2]. The mechanism of PC formation is closely related to that of a check valve. The check valve may be composed of exudate from inflammation and the destroyed wall of the respiratory tract [3]. In this case, it was considered that the wedged bronchoscopy and collapsed bronchial wall became the check-valve. PCs can be a severe condition including tension pneumothorax, bronchopleural fistula, and secondary infections [4]. In our case, as we were concerned about new complications due to the PC we did not prescribe a steroid for COP until the PC had improved. To our knowledge, no papers have reported internal observations of PC. We herein report the first case of PC observed in the thoracic cavity after BAL.
Severe obesity in a patient on long-term treatment of chronic myeloid leukemia with imatinib: Body composition, associated disorders and outcome
Authors:   Services of Hematology, Hospital Universitario de Navarra, Pamplona, Spain., Illarramendi Jorge Illarramendi , Goñi María Angeles ,   Services of Hematology, Hospital Universitario de Navarra, Pamplona, Spain., Alvarellos Montserrat ,   Services of Hematology, Hospital Universitario de Navarra, Pamplona, Spain., Zugasti Ana ,   Services of Endocrinology & Nutrition, Hospital Universitario de Navarra, Pamplona, Spain., Illarramendi Jose Juan ,   Services of Medical Oncology, Hospital Universitario de Navarra, Pamplona, Spain.
Published: January 2022

Chronic Myeloid Leukemia (CML) is a highly curable malignancy with tyrosine kinase inhibitors (TKI) as target therapy. As treatment is usually prolonged, there is a need to improve our knowledge about the impact of comorbidities in this context. Severe obesity is among the common comorbidities in these patients. We present the case of a patient with morbid obesity and associated sleep apnea hypopnea syndrome who was succesfully treated during 14 years with imatinib, a cornerstone TKI for this disease. Visceral fat area was extremely elevated in this patient. Keywords: chronic myeloid leukemia; obesity; imatinib; sleep apnea hypopnea syndrome. Abbreviations: CML: Chronic Myeloid Leukemia; BMI: Body Mass Index; TKI: Tyrosine Kinase Inhibitors.
Massive pneumomediastinum following orotracheal intubation in an emergency setting
Authors:   ICU division, Infectious and Parasitic Diseases Department, Faculty of Medicine, University of Sao Paulo, Brazil., Theotonio dos Santos Lucas Ferreira , Li Daniel Joelsons; Ho Yeh ,   ICU division, Infectious and Parasitic Diseases Department, Faculty of Medicine, University of Sao Paulo, Brazil.
Published: January 2022

We admitted in our intensive care unit, a 34-year old, Female patient from the emergency room, with a hypothesis of COVID-19 disease, who was intubated before transportation due to hypoxemic respiratory insufficiency. In physical examination the patient showed a massive subcutaneous emphysema. A computed tomography confirmed the hypothesis of pneumomediastinum/pneumothorax (Figure 1A). Refractory hypoxemia issued despite optimized mechanical ventilation, so we opted to submit the patient to Extracorporeal Membrane Oxygenation (ECMO). A diagnostic bronchoscopy showed an important laceration of the trachea (Figure 1B, black arrow, and Figure 1C), near the carina. Despite rare, tracheal lesion after intubation may have a dramatic outcome.
Dead man sign of ECG: An unique predicting sign of acute coronary syndrome
Authors:   PGIMER, Advanced Cardiac Center, Sector 12 Chandigarh 160012, India.
Published: January 2022

Coronary artery disease is the most common cause of morbidity and mortality worldwide. Acute coronary syndrome which includes STEMI, NSTEMI and unstable angina commonly diagnosed with the help of 12 lead in ECG in ER with or without elevated biomarkers. Inferior wall myocardial infarction is common cause of ST elevation myocardial infarction with low mortality rate. In this case report, we present a 52 years old male presented to ER with the complain of typical chest pain for more than 2 hours duration. Pain was in center of chest with radiation to back and left arm and associated with excessive sweating. Patient is a known smoker for past 10 years. At presentation Blood pressure was 110/70 mmHg and pulse rate of 55/min. Troponin I level was five times of upper normal limit. Basic investigations including ECG were done at presentation. ECG was showing typical changes of inferior wall myocardial infarction with infarction of right ventricle with hidden unique sign known as dead man sign commonly predict the location of obstruction and course of disease in the setting of acute coronary syndrome.
Variations in treatment of an anastomotic leakage after Ivor Lewis Esophagectomy
Authors:   Hospital Group Twente (ZGT), Department of Surgery, Zilvermeeuw 1, 7609 PP, Almelo, The Netherlands., Lubbers Merel , Workum Frans van ,   Radboud University Medical Centre, Department of Surgery, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., Berkelmans Gijs ,   Catharina Hospital, Department of Surgery, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Rosman Camiel ,   Radboud University Medical Centre, Department of Surgery, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., Luyer Misha D ,   Catharina Hospital, Department of Surgery, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Nieuwenhuijzen Grard AP ,   Catharina Hospital, Department of Surgery, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands., Det Marc J van ,   Hospital Group Twente (ZGT), Department of Surgery, Zilvermeeuw 1, 7609 PP, Almelo, The Netherlands., Kouwenhoven Ewout A ,   Hospital Group Twente (ZGT), Department of Surgery, Zilvermeeuw 1, 7609 PP, Almelo, The Netherlands.
Published: January 2022

Background: Anastomotic Leakage (AL) after Ivor Lewis Esophagectomy (ILE) is a severe complication that often needs immediate treatment. However, there is no consensus on the optimal treatment. The aim of this study was to describe the outcomes of the different treatment options in patients with either contained or uncontained AL after ILE. Methods: A retrospective analysis was performed on patients that developed AL after ILE in three high volume hospitals. Treatment was based on local preference. Endoscopic and surgical treatment were compared for patients with either contained (leakage confined to the mediastinum) or uncontained AL (leakage with intrapleural manifestations). Results: In total, 73 patients with an AL were included. A contained leak was observed in 39 patients. Twenty-five patients (64%) underwent an endoscopic approach that was successful in 19 patients (76%); fourteen patients (36%) underwent a surgical approach that was successful in 11 patients (79%). Significantly more patients were (re)admitted to the ICU in the surgical group; other outcomes were similar. An uncontained leak was observed in 34 patients. Endoscopic treatment was chosen in 14 patients (41%) and was successful in 10 patients (71%). A surgical approach was performed in 20 patients (59%) and was successful in 12 patients (60%). (Re) admission rate to the ICU was significantly higher in the surgical group, other outcomes were similar. Conclusions: This study demonstrates that there is high variability in the treatment of AL after esophagectomy. Surgical and endoscopic techniques are both successfully used for patients with either contained or uncontained leakages. However, more research is necessary before a treatment algorithm can be developed. Keywords: esophageal cancer; esophageal surgery; minimally invasive surgery; anastomotic leakage; endoscopic procedures.
Կրկին հայոց բդեշխությունների գլխավոր գործառույթի մասին
Authors: Hakobyan Aleksan
Published: January 2022

At present, it can be assumed with great confidence that the main function of the Armenian pitiashkhs-governorships was mi¬litary. They were responsible for protecting the external border of neighboring small allied states, and in this matter the entire ar¬my of the satellite state was subordinate to them.
Thus, the pitiashkhs of Gugarq were responsible for pro¬tec¬ting the external border of the kingdom of Iberia (Virq), the pi¬tiashkhs of Ałdzniq were responsible for protecting the external border of the kingdom of Osroene (Edessa), the pitiashkhs of the Nor-Shirakan sides were responsible for protecting the external bor¬der of the kingdom of Adiabene (Assyria), and the pitiashkhs of Kor¬duq were responsible for protecting the external border of the kingdom Aruastan (Migdonia). As compensation for their ser¬vice, the pitiashkhs received control over small areas of the neighboring satellite states. Probably, such an Iranian institution of pitiashkhs was introduced in Armenia by Tigran II during the acceptance of the rights and duties of the king of kings.
Analysis of information from Armenian sources shows that several border principalities / governorships also had similar pi¬tiashkh functions. Thus, specific rela¬tions were formed between some individual pitiashkhs of the Ar¬menian Kingdom (the bdeašxs) and neighboring states, which sometimes led to sepa¬ra¬tist tendencies. One of the striking examples of this is the relationship between the Armenian principalities / governorship of Gardman on the right bank of the Kura River and the kingdom of Albania Proper on the left bank of the Kura.
In the 4th century the principalities / viceroyalties of the Eas¬tern side of Armenia (Gardmanatsiq and Gorozuayq - “Gargara¬tsiq” who were separated from Syuniq) - on behalf of the king of Greater Armenia, performed military pitiashkh functions with respect to the Albanian and Bağasakan kingdoms on the left bank of the Kura, bearing supreme responsibility for the pro¬tec¬tion of their external (northern) borders.
Transformations of the Islamic Extremism and the Emergence of the “Islamic State”
Authors: Grigoryan Sargis
Published: January 2022

The Islamic extremism has deep roots in the Middle East. They were especially
active towards the end of the 20th century and in the first and second decades of
the 21st century. They took on a new nature with the terrorist acts against the US
on September 11 in 2001. In the mid-2000s new and dangerous trends of the
Islamic extremism became evident in the Middle East, which became visible in
Syria with the declaration of the “Islamic State” (IS) in 2014.
A Short Story of Mullah Nasreddin in the Anbarāni Dialect of the Talyshi Language: Text,Translation, Glossary and Comments
Authors: Avchyan Hakob
Published: January 2022

Talyshi, classified as belonging to the Northwestern Iranian group of languages, includes a wide range of dialects, which, based on phonological, grammatical and lexical factors, are traditionally divided into three main clusters: Northern, Central and Southern (see Bazin 1980; Stilo 1981; Yarshater 1996). Anbarāni is a Northern Talyshi dialect spoken in Anbarān district (baxš) of Namin sub-provincial district (šahrestān) (Ardabil province) of Iran, in the city of Anbarān and adjacent villages. Relatively a large number of studies deal with the Northern Talyshi dialects spoken in the Republic of Azerbaijan. For example, “The Talyshi Texts” by Professor of Iranian Studies Boris Miller, includes short stories, anecdotes, conversations, poetic verses (see Miller 1930) written down in these dialects. Unlike the Northern Talyshi dialects spoken in the Republic of Azerbaijan, the Anbarāni dialect is little known and less studied therefore the number of texts, published in this dialect, is quite limited. The aim of this paper is to broaden the scope of knowledge on Anbarāni by introducing a short story of Mullah Nasreddin and analyzing a number of morphological, syntactical and lexical dialectal features based on the text.
The Impact of the Integration Between the Resource Consumption Accounting System and Theory of Constraints on Reducing Production Costs(Proposed Model)
Authors: أحمد الأمين أحمد د.غسان
Published: January 2022

The study aimed to present a proposed model for the of the accounting system for the consumption of resources. the problem of the study is to try to propose a model for the development of the accounting system for the consumption of resources in light of the constraints and bottlenecks imposed by economic resources, through the integration between the accounting system for the consumption of resources and the theory of constraints and its impact on r educing production costs, the study used an approach that combines induction, deduction and descriptive approach to study the problem of the study and answering questions and its application in the Saeed Foodstuff Factory. The study concluded that the integration between the resource consumption system and the theory of constraints leads to increaseaccuracy in measuring costs and optimal utilization of available energies and managing the restricted resources, which will result in increase profitability  and reduce costs
Sosialisasi Belajar Calistung Pada Anak Usia Dini Bersama Orang Tua Hebat
Authors: Julianingsih Denok , Isnaini Indri Dwi
Published: January 2022

Pengabdian ini bertujuan untuk memberikan pemahaman dan keterampilan kepada wali murid dari TK Dharmawanita Ngembeh tentang bagaimana mengajarkan calistung pada anak usia dini di rumah selama masa pandemi. Pengabdian ini dilaksanakan dengan melakukan kegiatan parenting berupa sosialisasi kepada wali murid dengan memberikan materi tentang mengajarkan CALISTUNG pada anak usia dini melalui permainan. Langkah-langkah dalam pengabdian ini terdiri dari tiga tahapan yaitu perencanaan, pelaksanaan, dan evaluasi kegiatan. Setelah dilakukannya kegiatan parenting ini, ada hasil yang positif seperti, puasnya mereka pada materi yang disampaikan oleh narasumber kemudian pemberian contoh konkrit terkait aplikasi dalam mengajarkan CALISTUNG di rumah melalui kegiatan bermain dan juga banyaknya antusias dari wali murid saat kegiatan berdiskusi.
Human Thymus Gland in Young and Old Age; A Comparative Study
Authors: Rizwana Jafri Syeda , Waseem Uzma , Shahbaz Samia , Khan Sadia Wazir , Muneeb Amna , Rehman Amna
Published: January 2022

Aim: Research was undertaken to compare the findings between patients of different ages in terms of human thymus gland parameters. Study Design: Comparative/observational study Place and study: This study was conducted at anatomy department of Jinnah Hospital, Services Hospital and General Hospital Lahore during the period from November 2013 to October 2014. Methods: Total 70 specimens of human thymus of 54 patients were enrolled in this study. All specimens were divided in to two groups I and II, Group I contains 35 patients with ages < 30 years and group II with 35 patients having ages 45 to 60 years. All specimens were fixed in 10% formalin solution and then processed for paraffin embedding. Compare the different parameters such as thickness of interlobular connective tissue and thymic capsule, length and number of Hassal’s corpuscles between both groups. Data was analyzed by SPSS 23.0. Results: In group I mean age of the patient was 24.16±3.43 years with mean BMI 21.55±6.37 kg/m2 and in group II mean age was 52.11±2.87years with mean BMI 25.07±4.39 kg/m2. There was a significant difference observed between both groups regarding thickness of interlobular connective tissue and thymic capsule, quantity and length of Hassal’s corpuscles with p-value <0.05. Conclusion: As a result of this study, it can be inferred that younger patients had a substantially thinner thymic capsule and interlobular connective tissue, as well as more and smaller Hassal's corpuscles, than older patients. Keywords: Human Thymus Glands, Young Age, Old Age
Epidemiological Study on Overweight and Obesity among Adolescent Boys and Girls
Authors: Zahid Ali Pirzado , Mukhtar Sayed Tahir , Akhtar Qureshi Mahwish , Tahir Huma , Shaikh Gul Muhammad , Imran Muhammad
Published: January 2022

Background and Aim: Overweight and obesity has a great impact on individual health and quality of life. Most of the psychosocial and physical health problems are considerably related with overweight and obesity in adolescents. The incidence of overweight and obesity accelerated in the developing world over the last decade. The present study aims to evaluate the prevalence of overweight and obesity among Pakistani adolescents. Methodology: This epidemiological study was conducted on 1764 Pakistani adolescents attending multi medical centers of Pakistan with an age ranges from 12 years to 19 years. The socio-demographic questionnaire was completed by each individual with a consent form. Demographic and anthropometric parameters were included in the questionnaire. The prevalence of overweight and obesity was determined based on body mass index calculation. Obesity and associated factors were analyzed through analysis of Univariate and multivariate logistic regression. Results: Out of total adolescents, 885 (50.2%) were male and 879 (49.8%) were females. The prevalence of overweight and obesity was 14.1% (male 18.5%; female 11.4%) and 5.4% (male 8.3%; female 4.4%) respectively. Boys were prevalent in overweight and obesity compared to girls (p<0.001). Using Multivariate logistic regression, male gender (OR=1.89, 95% CI 1.37-2.56), eating fruits 3 or more times per week (OR=1.39, 95% CI 1.03-1.79), and fast eating (OR=1.29, 95% CI 1.03-1.68) were considerably related to the overweight and obesity. Adolescents whose parents were overweight or obese (0.69, 95% CI 0.49-0.93) were improbable to be overweight or obese. Conclusion: Our study found a higher risk and prevalence of overweight and obesity among adolescent boys compared to adolescent girls in the recent few years. Gender, parental weight, and diet were key parameters for adolescents' obesity. There is a need for further intervention and national program establishment to decrease the incidence of overweight and obesity. Keywords: Overweight; Obesity; Adolescents
Frequency of Backache and its Management in Pregnant Women Attending IUH OPD
Authors: Parveen Uzma , Parveen Brohi Zahida , Sadaf Aneela
Published: January 2022

Objective: Frequency of backache and its treatment among pregnant women attending Isra University Hospital (IUH) OPD. Material and methods: This cross-sectional study was conducted at Out patient’s department of obstetrics\Gynaecology Isra hospital Hyderabad from February 2019 to Augusts 2019. A total of 80 pregnant women irrespective of their age, marital and literary status, visiting out-patient department of Isra University were included. All the females were assessed regarding backache and its treatment at gynaecological OPD. All the information was recorded via study proforma. Data was analyzed via SPSS version 20. Results: A total of 180 pregnant women were studied, and most of the women 40% were in age group of 31-40 years. Out of all, 22.2% women were primigravida, 40.6% were multigravidas and 36.7% women were grand multigravidas. The history of backache before pregnancy was among 20% of the females and 62.2% of women had developed backache during pregnancy, while 12.8% women had no complaint of backache. Out of 121 females who had backache during pregnancy, 28.30% had an onset of pain during 1st trimester, in 23.30% during 2nd trimester and in 48.30% during 3rd trimester of pregnancy. Out of all 32.20% women got relieved by taking rest, 63.90% women took analgesics as a treatment measure and 3.3% women took some other treatment options. Conclusion: It was observed that the more than 60% of all pregnant women experienced backache and mostly during 3rd trimester. Most of the females took treatment in the form of analgesics and some women got relieved by taking rest. Keywords: Pregnancy, backache, Management