bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study on Assessment of Knowledge on Self-medication Among the Students A Crossectional Study
Authors: Rawat Geeta
Published: October 2021

Self-medication is very frequent and common among the people. Several side effects have been reported to be associated with
inappropriate use of self-medication like risk of drug dependence, abuse, major drug interactions and adverse effects. The aim of this
study is designed to assess knowledge on self-medication among students. A cross-sectional study was conducted in students of
various department located in Ghaziabad, UP, India. A total of 200 students were enrolled and interviewed using prevalidated
questionnaire on self-medication. STATISTICAL ANALYSIS: Descriptive statistics were used to represent the sociodemographic
characteristics and knowledge levels. Association of various socio-demographic variables with Knowledge levels are determined using
the Chi-square test. A total of 200 students are recruited in these 53(26.5%) diploma in pharmacy, 128 (64%) bachelor’s in pharmacy,
19 (9.7%) master’s in pharmacy. Among 200 respondents, 90 (45.2%) good knowledge on self-medication. Subject’s age, residential
status, and occupation of their parents were significantly associated with knowledge and rational practice on self-medication with a P < 0.05.CONCLUSION: The study concludes there is lack of knowledge on responsible side effect of self-medication.
Preliminary Quantification of Phytochemicals in Methanolic Extract of Rosmarinus officinalis L Using HPTLC
Authors: Mamta Pathania Singh , Hitender Singh , Puspha Guleria , Sapna Sapna , Payal Bhardwaj , Dhirendra Pathania Singh
Published: October 2021

Rosmarinus officinalis L. commonly known as Rosemary belong to the family Lamiaceae. It is an aromatic herb which is hardy, dense
and evergreen in natural habitat. It is one of the medicinal plants which is cultivated around the world for its medicinal, therapeutic
purpose and is used as condiment and food preservative. It is one of the oldest Mediterranean shrub having strong, pungent aroma
having dark green and elongated leaves with white or purple flowers. It is a perennial herb reaching 100 to 210 cm in height having
pointed and hairy, resinous dark green leaves with lower white surface. The present study review about macroscopical/botanical
description of Rosmarinus officinalis L. and its methanolic extraction analysis for preliminary quantification of chemical constituents
by visualizing TLC plate under different wavelength of UV light i.e., 255nm, 366nm and 566nm to get chromatograph by HPTLC.
FACTORES DETERMINANTES DEL NIVEL DE SATISFACCIÓN DE LOS USUARIOS EN EMERGENCIAS DEL HOSPITAL DR. CARLOS DEL POZO MELGAR DE MUISNE
Authors: Vargas Concha Luis Eduardo , Falcones Benalcázar Mercy
Published: October 2021

Introducción: La percepción que tienen los usuarios y su nivel de satisfacción frente a servicios brindados durante su atención es considerada como un indicador de calidad en el sector salud, además de reafirmar que la atención se centra sobre el paciente, familia o comunidad. Objetivo: analizar los factores determinantes en el nivel de atención y su relación con la satisfacción de los usuarios que acuden a la sala de emergencias del hospital Dr. Carlos del Pozo Melgar de Muisne. Materiales y Métodos: El estudio fue de tipo mixto, con diseño transversal y alcance descriptivo. Se aplicó un cuestionario desarrollado por el Ministerio de Salud Pública y adaptado a la población de estudio. La muestra fue de 165 personas que acudieron a la emergencia del hospital. Además, para registrar los datos se utilizó una ficha de observación durante la atención que se brindaba. Resultados: el 45% de los usuarios se sintieron muy satisfechos en cuanto al grado de satisfacción por la ubicación de la casa de salud. El 78% de los usuarios consideraron que la atención recibida fue personalizada. El 10% expresaron percepciones de discriminación por parte del personal de salud durante su atención. Se encontró que del 17% que poseían grado académico superior, el 10% no se encontraba satisfecho con la atención recibida. Conclusiones: existe un alto nivel de satisfacción en la mayoría de la muestra estudiada, en donde los principales factores determinantes fueron el grado académico de los usuarios y el estado de la infraestructura de la casa de salud.
http://habibiaislamicus.com/index.php/hirj/article/view/192
Authors:   Chairman, Department of International Relations, Federal Urdu University Karachi,, Khan Mamnoon Ahmad
Published: October 2021

This research paper examines the attitude of People’s Republic of China towards Kashmir conflict. Chinese leaders have been evolving their own strategy towards the state of Jammu and Kashmir. Chinese concentration was focused basically to oppose the United States and the United Kingdom in the United Nations. Even when the Soviet Union began to favour the Indian stand, China remained neutral. China cooperated with Pakistan in every field including the Kashmir issue but the United States, Soviet Union and the Western block opposed Chinese efforts in the United Nations. That’s why China remained unsuccessful in resolving the Kashmir dispute.
LINGUAGEM MATEMÁTICA: CONHECIMENTO E USO DE SIMBOLOLOGIAS NA INTERPRETAÇÃO DE PROBLEMAS
Authors: Albuquerque Amanda de Souza , Gonçalves Lima Junior Heraldo
Published: October 2021

A utilização de registros de representações semióticas no ensino de influência matemática no processo de ensino da aprendizagem pode facilitar a compreensão do conteúdo ou aumentar o grau de dificuldade dos alunos, de acordo com o nível de conhecimento que possuem no uso de sinais e símbolos. Nessa perspectiva, esta pesquisa analisou a influência da simbologia na aprendizagem matemática em grupos do 8º ano do ensino fundamental, em uma escola pública de Petrolina – PE. Para tanto, dois instrumentos utilizaram: 1) uma lista de atividades com pós-posta de nove problemas de diversos conteúdos com questões de linguagem, re-apresentação e contextualização, e 2) um questionário cujas perguntas são sobre as dificuldades de aprendizagem em matemática e o conhecimento da simbologia matemática. Os resultados mostraram que 44 % e 70 % dos participantes da pesquisa têm dificuldade em entender conceitos de linguagem e sinais matemáticos, respectivamente, mesmo julgando-os como importantes. Por outro lado, os alunos apresentaram melhor desempenho na resolução de questões contextualizadas, permitindo inferir que a capacidade de resolver questões cotidianas tem pouco significado para a resolução de questões em matemática formal em sala de aula, especialmente se elas não estiverem associadas. Diante dos resultados obtidos, concluiu-se que, na prática do ensino escolar, é essencial focar na resolução de problemas por meio da seleção de atividades que envolvam situações cotidianas em que os alunos possam associá-los aos conteúdos trabalhados em sala de aula.
ATTITUDE OF BENEFICIARIES & NON-BENEFICIARIES TOWARDS MAHATMA GANDHI NATIONAL RURAL EMPLOYMENT GUARANTEE ACT
Authors: Kumar Prakash , Jahanara Jahanara , Bose Dipak Kumar
Published: October 2021

The Government of India created a historic act, by enacting the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), the largest employment generating programme in the world, ensuring the right to work in a country with a population of over one billion. This Act gives legal guarantee of at least one hundred days of wage employment in a financial year to a rural household, whose adult members volunteer to do unskilled and manual work. The present study was conducted in Dinara block of Rohtas district of Bihar. Ex post facto research design was followed for the analysis because the research is conducted after the occurrence of a particular incident. There are 61 villages in Dinara block, including the village of Dinara itself. Total number of 6 villages were selected through random sampling based on existence of MGNREGA Program. A total number of 60 beneficiaries and 60 non-beneficiaries of MGNREGA scheme were selected through random sampling for the present study. From the above analysis, it was concluded that 51.67 percent of the beneficiaries’ respondents is having high level of Attitude, whereas in non-beneficiaries 56.67 percent of the respondents is having medium level of Attitude.
ADOPTION BEHAVIOUR OF BRINJAL GROWERS TOWARDS INTEGRATED PEST MANAGEMENT PRACTICES IN EAST GODAVARI DISTRICT OF ANDHRA PRADESH
Authors: Gowthami Kunche , Jahanara Jahanara , Mazhar Syed H.
Published: October 2021

The present study was conducted in Korukonda and Ramchandrapuram division having prominent area under brinjal in East Godavari district by selecting 4 villages from each mandal for study. Total 72 brinjal growers were selected. The study revealed that personal and socio economic characteristics of the respondents education, , land holding , extension participation , area under brinjal , extension contact and mass media exposure were positively and significantly correlated with their level of adoption of IPM practices. The variable age, family type, annual income and occupation had negative and significant correlation with the adoption level. Availability of biopesticides, pheromone traps and light traps at reasonable price and at local places were the important suggestions made by brinjal growers. The other suggestions were insect organization of demonstration campaign for proper guidance on IPM practices and for identifying insect pest from state department of agriculture and state agricultural universities.
Subnational Turnover, Accountability Politics, and Electoral Authoritarian Survival: Evidence from Museveni's Uganda
Authors: Wilkins Sam
Published: October 2021

Most non-democratic regimes engineer elections such that regime change is effectively impossible via the ballot. However, many of these elections see high turnover of politicians at the subnational level, often through competitive processes that occur within ruling parties. This is
the case for President Yoweri Museveni's dominant National Resistance Movement (NRM) in Uganda, the ranks of which have been decimated by intra-party competition at each election throughout its three decades in power. This competition includes high levels of voter participation in mass primaries
and general elections and is particularly acute in the rural southern areas where Museveni's simultaneous presidential candidacy draws most support. Based on qualitative data from the 2016 elections, this article investigates the relationship between this local, intra-party competition and
Museveni's survival, building a theory that local competition in electoral authoritarian regimes can provide an outlet for accountability politics by redirecting widespread voter frustrations away from a regime and towards expendable local politicians.
Penerapan Arsitektur Tropis pada Rest Area di Katoi Kabupaten Kolaka Utara
Authors: Fajar Fajar , Ilham Ilham , Nahdatunnisa Nahdatunnisa
Published: October 2021

Rest area in Katoi North Kolaka Regency is a stopover / resting place. Designing a rest area that can adequate the needs of road users who travel far, with the aim as a means of accommodation that can meet the needs. When resting and can be a means of recreation for rest areausers. The approach method used in this research is a descriptive analysis method, namely by collecting, describing, compiling and analyzing data so that a planning and design program approach is obtained for further use in the preparation of space programs and the basic concepts of planning and design. Discussion produces a concept of design reference, namely macro concept, and micro concept. Macro concepts discuss references in determining location, managing site / site, circulation, basic shape and appearance of buildings, and the arrangement of outdoor spaces. While the micro concept discusses the reference on the needs that can support functions in the building, including facilities and infrastructure in the rest areabuilding. With the planning and design of rest areas, it is expected to be an adequate facility for Trans Sulawesi road as a means of accommodation for road users, so as to reduce the accident rate. The application of tropical architectural themes in rest areas is expected to overcome the problems posed by the climate. Tropical architecture can provide solutions to buildings through natural lighting and natural conditioning, so that comfort can be felt for its users.
Differential absorption lidar for water vapor isotopologues in the 1.98 µm spectral region: sensitivity analysis with respect to regional atmospheric variability
Authors: Hamperl Jonas , Capitaine Clément , Dherbecourt Jean-Baptiste , Raybaut Myriam , Chazette Patrick , Totems Julien , Grouiez Bruno , Régalia Laurence , Santagata Rosa , Evesque Corinne , Melkonian Jean-Michel , Godard Antoine , Seidl Andrew , Sodemann Harald , Flamant Cyrille
Published: October 2021

Abstract. Laser active remote sensing of tropospheric water vapor is a
promising technology to complement passive observational means in order to
enhance our understanding of processes governing the global hydrological
cycle. In such a context, we investigate the potential of monitoring both
water vapor H216O and its isotopologue HD16O using a
differential absorption lidar (DIAL) allowing for ground-based remote
measurements at high spatio-temporal resolution (150 m and 10 min) in the
lower troposphere. This paper presents a sensitivity analysis and an error
budget for a DIAL system under development which will operate in the
2 µm spectral region. Using a performance simulator, the sensitivity of the DIAL-retrieved mixing ratios to instrument-specific and environmental parameters is investigated. This numerical study uses different atmospheric conditions ranging from tropical to polar latitudes with realistic aerosol loads. Our simulations show that the measurement of the main isotopologue H216O is possible over the first 1.5 km of atmosphere with a relative precision in the water vapor mixing ratio of
<1 % in a mid-latitude or tropical environment. For the
measurement of HD16O mixing ratios under the same conditions, relative
precision is found to be slightly lower but still sufficient for the
retrieval of range-resolved isotopic ratios with precisions in δD of a
few per mil. We also show that expected precisions vary by an order of
magnitude between tropical and polar conditions, the latter giving rise to
poorer sensitivity due to low water vapor content and low aerosol load. Such
values have been obtained for a commercial InGaAs PIN photodiode, as well as
for temporal and line-of-sight resolutions of 10 min and 150 m, respectively.
Additionally, using vertical isotopologue profiles derived from a previous
field campaign, precision estimates for the HD16O isotopic abundance
are provided for that specific case.
Review article: Brief history of volcanic risk in the Neapolitan area (Campania, southern Italy): a critical review
Authors: Carlino Stefano
Published: October 2021

Abstract. The presence of three active volcanoes (Vesuvius, Campi Flegrei and Ischia
island) along the coast of Naples did not contain the huge expansion of
the urbanized zones around them. In contrast, since the Greco-Roman era, volcanoes have featured among the favourite sites for people colonizing the Campania region. The stable settlements around Vesuvius, Campi Flegrei caldera and Ischia were progressively enlarged, attaining a maximum growth rate between 1950 and 1980. Between 1982 and 1984, Neapolitans faced the
last and most dramatic volcanic crises, which occurred at Campi Flegrei
(Pozzuoli) without an eruption. Since that time, volcanologists have
focused their attention on the problem of risks associated with eruptions in the Neapolitan area, but a systematic strategy to reduce the very high
volcanic risk of this zone is still lacking. A brief history of volcanic
risk in the Neapolitan district is narrated here in an effort to provide new food for thought for the scientific community that works for the mitigation of volcanic risk in this area.
Isolation and pathotyping of Newcastle disease virus isolated from birds in Kerala
Authors: K Vijayakumar , K Vijayakumar , K Vijayakumar , K Vijayakumar , K Vijayakumar
Published: October 2021

Newcastle disease (ND) is a pandemic viral disease of poultry. It is highly contagious
and causes high morbidity and mortality in affected flocks. The disease is caused by Avian
orthoavulavirus 1, commonly known as Newcastle disease virus (NDV) belongs to the family
Paramyxoviridae. The virus affects almost 241 species of birds. Based on the pathogenicity,
the virus is classified into five pathotypes viz., viscerotropic velogenic, neurotropic velogenic,
mesogenic, lentogenic and asymptomatic enteric NDV. The severity of the disease varies with the
viral pathotype. Isolation and identification along with pathotyping of the virus provides a basis
for understanding the type of virus circulating in the region. In the present study, tissue samples
from dead/ ailing birds showing lesions/clinical signs suggestive of ND were collected. They were
subjected to virus isolation in embryonated chicken eggs and identified by haemagglutination test
and confirmed by haemagglutination inhibition test. Eight NDV isolates were obtained out of 55
tissue samples and were classified into pathotypes by intracerebral pathogenicity index (ICPI) and
mean death time (MDT). The ICPI values varied from 0.75 to 1.53 and MDT from 54 h. to 79.2 h.
Out of eight isolates, three belonged to velogenic group and five were of mesogenic pathotype. The
study revealed the circulation of virulent NDV in Kerala. The pathogenicity tests provide a basis for
understanding the epidemiology of ND.
Haemato-biochemical studies in medically managed open and closed-cervix pyometra in dogs
Authors: Venugopal Syam K. , Venugopal Syam K. , Venugopal Syam K. , Venugopal Syam K. , Venugopal Syam K.
Published: October 2021

Six dogs each with open and closed-cervix pyometra (Group I and II) were medically
managed with mifepristone @ 2.5mg/kg body weight orally twice daily for five days, followed by
cloprostenol @ 5?g/kg body weight subcutaneously on every alternate day after ensuring cervical
patency, till complete evacuation of uterus was assessed by ultrasonography. Haematological and
serum biochemical values were estimated on the day of presentation. The treatment response
was assessed by reviewing both haematological and serum biochemical values further on days
3, 7, 14 and 21 of treatment. The mean total erythrocyte count (TEC), haemoglobin concentration
and volume of packed red cells (VPRC) were significantly lower and mean total leucocyte count
(TLC) was significantly higher in all animals of both groups during the day of presentation. The
values significantly improved after initiation of treatment. Total thrombocyte count, serum total
protein, albumin, BUN and serum creatinine levels were within the normal range. TEC, TLC, Hb
concentration, VPRC could be used for prognostic markers of treatment evaluation in canine
pyometra.
Therapeutic study of Tephrosia purpurea (linn.) root extract on goat tapeworm with special reference to histopathological parameters
Authors: L. M. Mahale , L. M. Mahale , L. M. Mahale , L. M. Mahale , L. M. Mahale
Published: October 2021

Goat farming forms the backbone of the Indian livestock sector. The prevalence of helminth
infection is one of the major problems which affects the milk and meat production of small ruminants.
It causes diarrhea, anaemia, oedema, bottle jaw and reduce reproductive performance of animals.
Anthelmintic resistance and drug residues in animal products like milk and meat are the results of
indiscriminate use of anthelminthics by goat owners for helminth control. Herbal anthelminthics are
effective alternatives without any harmful effects. The paper presents the anthelminthic potential
of the root extract of Tephrosia purpurea (linn.) plant on common tapeworm of goat, Moniezia. The
in vitro study showed that the anticestodal activity of T. purpurea (linn.) at 125mg/ml dilution was
comparable to that of albendazole. The histopathological study revealed very prominent shrinkage
of scolex and suckers, tegument showed puff formation and was ruptured at the marginal position
with irregular folds and crumbling of the segments. Longitudinal section of segment showed more
marginal serrations indicating crumbling of the body segment as compared to albendazole, leading
to the death of the worm.
Variants in relation to clinical manifestation of rabies in dogs
Authors: J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith , J. G. Ajith
Published: October 2021

Rabies is one among the most dangerous diseases reported to have a wider range of
incubation period and clinical signs. The disease is manifested as furious or paralytic forms in dogs.
The combined effects of virulence and pathogenicity of the virus along with host immune factors are
the main variables leading to variation in manifestation of the disease. This paper reports the finding
of a study conducted in rabies positive canine cases to correlate the role of pathophysiological
factors in clinical manifestation of rabies. A total of 23 rabies positive cases were studied and their
anamnesis collected. Male dogs less than 5 years of age constituted major proportion of rabies
positive cases. Site of bite was observed as a critical factor in disease manifestation. Anti-rabies
prophylactic vaccination had significant effect as none of the vaccinated animals developed furious
form of rabies. But paralytic form was found in irregularly vaccinated dogs, probably due to effect of
vaccination imparting partial immune response in these animals.
Occurrence of poultry coccidiosis in different management systems in Thrissur, Kerala
Authors: R. Karthika , R. Karthika , R. Karthika , R. Karthika , R. Karthika , R. Karthika
Published: October 2021

Coccidiosis is one of the most prevalent and economically important parasitic diseases
caused by the infection with Eimeria species contributing to major economic losses of poultry
industry worldwide. In this study, occurrence of Eimeria spp. in chicken reared under different
management systems was studied. A total of 300 faecal samples from chicken were collected
from six organised poultry farms and six backyard poultry units in and around Thrissur, Kerala.
Out of this, 167 faecal samples were from organised farms and 133 from backyard poultry units.
All the samples were artificially sporulated and examined for studying the oocysts morphology and
morphometry. Out of 167 samples from organised farms 52 were found to be positive for Eimeria
spp. while 61 out of 133 samples from backyard poultry were positive. The overall occurrence of
Eimeria spp. in chicken from 12 different areas in and around Thrissur was 37.66 per cent (113/300).
The species of Eimeria identified on morphological examination were E. tenella, E. necatrix and
E. maxima. The occurrence rate of E. tenella was found to be significantly higher (46.01 %)
compared to E. necatrix (39.82 %) and E. maxima (14.15 %). The rate of occurrence of Eimeria
spp. infection was significantly higher in backyard poultry (45.86 %) compared to that in organised
farms (31.13 %).
A case of anaphylactic shock induced by sugammadex in China
Authors:   Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, China, Pan Wei , Xi Chen ,   Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, China, yongqiang Wang ,   Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, China, Lan Yuan ,   Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, China, Jiangang Song ,   Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, China
Published: October 2021

Sugammadex, an antagonist of neuromuscular blocking drugs, was used to rapidly reverse rocuronium induced neuromuscular blockade by encapsulating free rocuronium molecules as inclusion complexes. Because it can enhance the rapid recovery after surgery, summadex is gradually used in clinical. There are relatively few reports about anaphylactic reaction to it. We will present a case of severe anaphylactic shock induced by summadex, as the first in China. Author biography: At present, Wei pan is a junior doctor in Shuguang Hospital Affiliated to Shanghai University of traditional Chinese medicine. She graduated from the anesthesia College of Xuzhou Medical University with a master's degree at the age of 27.
Intra-cardiac cement embolism during hip arthroplasty
Authors:   Assistant Professor, Anesthesiology, McGill University Health Center, Canada, Amir Alexander , Bracco David ,   Assistant Professor, Anesthesiology, McGill University Health Center, Canada, Baldini Gabriele ,   Assistant Professor, Anesthesiology, McGill University Health Center, Canada, Denault André ,   Professor Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
Published: October 2021

A 92-year-old woman presented to the operating room with a right femoral neck fracture. She had a past medical history significant for atrial fibrillation, coronary artery disease with a history of coronary bypass, severely stenotic aortic valve (area 0.9 cm2), diabetes, dyslipidemia, hypertension and dementia. She underwent general anesthesia with continuous Transesophageal Echocardiographic (TEE) monitoring for a right hemi-arthroplasty. While cementing the prosthesis, small cement emboli were initially seen (ME ascending aorta SAX view) migrating in the pulmonary artery (Figure A*). Subsequently, a large (4 cm) cement embolus was visualized in the right atrium, adhered to the Eustachian valve, an embryonic remnant (Figure B*, supplementary video A). The patient experienced no significant hemodynamic compromise or issue with gas exchange. Given embolization risk and severe potential for harm, intervention may be indicated. Treatment options were discussed but given hemodynamic stability, patient age and comorbidities, the patient was monitored without further intervention.
Rarely seen accelerated progression of hidradenitis suppurativa
Authors:   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA, Williams Aquino , Clemen Britney ,   Department of Internal Medicine, Maimonides Medical Center, Brooklyn, New York, 11219, USA, Iyer Rita ,   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA, Shehata Alexandre ,   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA, Soliman Isaac ,   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA, El-Sayed Ali ,   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA, Mehta Bijal S ,   Department of Medicine, Hackensack Meridian Health Mountainside Medical Center, Montclair, New Jersey, 07028, USA
Published: October 2021

Malignant nodular hidradenoma, also known as Malignant Hidradenocarcinoma (MHA), is a rare tumor of sweat glands that accounts for less than 0.001% of all tumors [1-3,14]. Although it typically arises de-novo, MHA rarely progresses from hidradenitis suppurativa (HS), a disorder of apocrine glands characterized by chronic inflammation [5,6,9]. HS is due to recurrent follicular occlusion leading to painful debilitating cutaneous/subcutaneous abscesses requiring drainage [5,6,9]. Common sites include axillary, anogenital and inguinal regions [5,6,9]. The worldwide prevalence of HS is 1%-4% [5,6]. Incidence of all eccrine carcinomas is ~ 6% [14]. Risk-factors include family history, obesity, and smoking [5,6,9]. Severe complications associated with HS are squamous cell carcinoma and adenocarcinoma [2,6]. MHA progression is extremely aggressive with 60% cases having metastatic spread within the first 2 years of diagnosis [14].
Sudden onset hearing and visual loss: An unusual presenting manifestation of chronic phase chronic myeloid leukaemia
Authors:   Division of Paediatric Oncology, Department of Paediatrics, University Hospital Southampton, Southampton, United Kingdom, Tandon Sneha , Yadav Sanjeev ,   Department of Haematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, Gupta Ruchi ,   Department of Haematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, Nityanand Soniya ,   Department of Haematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
Published: October 2021

Chronic Myeloid Leukaemia (CML) commonly presents with generalized weakness, splenomegaly, leucocytosis with basophilia, while neurological manifestations like convulsions, hearing loss, papilledema are rare. Moreover, hearing and or vision loss is seldom encountered as a primary manifestation [1-6], with various mechanisms implicated for vascular obstruction and end organ dysfunction [4]. We hereby, report a retrospective series of six patients with CML in Chronic Phase (CP) who presented with visual loss and/or Sensorineural Hearing Loss (SNHL). Due to the rarity of this presentation we feel our case series could contribute to the existing scarce literature.
Bilateral symmetric ankles and feet cellulitis after fish pedicure: Case report and review of the literature
Authors:   CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, Tosoni Alberto , Lelli Diana ,   Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy, Serino Francesco Maria ,   R&D, Doctors in Italy Association, Rome, Italy, Incalzi Raffaele Antonelli ,   Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy, Mirijello Antonio ,   Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy, Addolorato Giovanni ,   CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Published: October 2021

Fish pedicure (feet immersion in a tank containing fish Garra rufa or Cyprinion macrostomus) is a widely diffuse cosmetic practice, usually considered safe. However, this practice is regulated only in a few Countries, and the risk of infection related to this practice is not quantified. We report a case of bilateral symmetric ankles and feet cellulitis in a previously healthy young woman without risk factors for infections, after a fish pedicure in Greece. Three cases of foot infection after fish pedicure have been described in the English literature, two sustained by S. aureus and one by Mycobacterium marinum, but none of them was so extensive, involving not only feet but also ankles. The practice of the aesthetic fish pedicure should be regulated in all Countries to reduce the risk of complications related to this procedure. Moreover, studies targeted at investigating the risk of infection associated with this procedure are warranted. Keywords: Fish pedicure; Cosmetic procedure; Cellulitis; Risk infection.
Intraoperative trans-esophageal echographic evaluation of the celiac artery flow after arcuate ligament resection in a case of Dunbar Syndrome. A case report
Authors:   Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy, Coppalini Giacomo , Giustiniano Enrico ,   Humanitas Clinical and Research Hospital IRCCS, Department of Anesthesia and Intensive Care Units, Via Manzoni 56, 20089, Rozzano, Milan, Italy, Nisi Fulvio ,   Humanitas Clinical and Research Hospital IRCCS, Department of Anesthesia and Intensive Care Units, Via Manzoni 56, 20089, Rozzano, Milan, Italy, Castoro Carlo ,   Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy, Cecconi Maurizio ,   Humanitas Clinical and Research Hospital IRCCS, Department of Anesthesia and Intensive Care Units, Via Manzoni 56, 20089, Rozzano, Milan, Italy
Published: October 2021

Dunbar Syndrome (DS), also known as Median Arcuate Ligament (MAL) syndrome, is a rare disease in which the celiac trunk is compressed by a fibrous attachment at the diaphragmatic crura causing abdominal angina with a large spectrum of symptoms including nausea, vomiting, weight loss, and postprandial epigastric pain.
Fracture in a girl with graves’ disease induced by osteoporosis: A case report
Authors:   Professor of Pediatrics, Pediatric Endocrinology Unit, Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt, Metwalley Kotb Abbass , Farghaly Hekma Saad ,   Professor Pediatrics, Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt
Published: October 2021

A 6-year-old girl with long-standing Graves’ Disease (GD) presented with a left oblique non-displaced humeral fracture. Examination reveals signs of thyrotoxicosis and mild swelling of her left humerus. Investigations confirmed severe overt hyperthyroidism due to GD. A dual-energy X-ray Absorptiometry (DXA) of the lumbar vertebrae (L1-4) and femoral neck revealed that Z-score were -2.9 and -2.1, respectively, representing below the expected range for age which is consistent with osteoporosis. The girl was commenced on carbimazole in a dose of 5 mg two times daily and propranolol 10 mg two times daily. After one year of treatment, she returned to a euthyroid state, and Bone Mineral Density (BMD) increase by 19% and 23% of the lumbar spine and femur neck, respectively Keywords: Osteoporosis; Graves’ disease; Fracture.
Intestinal obstruction due to primary ileocolic diffuse large B-cell lymphoma: A case report
Authors:   Department of General and Digestive Surgery, Hospital de Sagunto, Valencia, Spain, Iranzo Marina Alarcón , Calomarde Matías Gómez ,   Department of General and Digestive Surgery, Hospital de Sagunto, Valencia, Spain, Zorraquino Estefanía ,   Department of Pathological Anatomy, Hospital de Sagunto, Valencia, Spain, Sanz Miguel Ángel ,   Department of Hematology, Hospital de Sagunto, Valencia, Spain, Trujillo Roberto Lozoya ,   Department of General and Digestive Surgery, Hospital de Sagunto, Valencia, Spain, Carmona Maria Dolores Ruiz ,   Department of General and Digestive Surgery, Hospital de Sagunto, Valencia, Spain, Bueno Amparo Solana ,   Department of General and Digestive Surgery, Hospital de Sagunto, Valencia, Spain
Published: October 2021

The Gastrointestinal (GI) tract is the most frequent site of extranodal lymphoma involvement. Most GI lymphomas are non-Hodgkin’s mature B-cell lymphomas, being diffuse large B-cell lymphoma one of the most common histologic subtypes. About 7% of GI lymphomas are located in the colon, usually at the ileocecal valve, and may grow into the terminal ileum. Abdominal pain and weight loss are common presenting symptoms, although complications such as intestinal obstruction may occur. Abdominal CT scan and barium enema are the most frequently used imaging tests for diagnosis, although colonoscopy with biopsies is required to confirm the diagnosis. Treatment includes surgery and chemotherapy with or without rituximab. Keywords: Primary colonic lymphoma; Diffuse large B-Cell Lymphoma; Obstruction; Surgery; Management.
Syphilis and pregnancy: Review
Authors:   Obstetrician Gynecologist Specialized in the Pontifical Catholic University of Ecuador, Subspecialty in Maternal Fetal Medicine by the Latin American Fetal Medicine Foundation, Sao Paulo- Brazil., VJ Samaniego Haro
Published: October 2021

Syphilis is a disease that has not been eradicated in part due to inadequate management of antibiotic therapy which is selected according to the stage of the disease and to the misuse of the type of penicillin. Treatment of this disease should be done to prevent it´s chronic complications, to avoid infecting sexual partners and the fetus in a pregnant woman. Syphilis in pregnancy causes increase in the rate of recurrent abortions and neonatal morbidity and mortality, that´s the main reason why early detection and treatment without delay is extremely important. Pregnancy alters immunity, so the serological diagnosis can provide false positives, with the use of inverse algorithms these results may decrease, by increasing the sensitivity of the tests. Today, after 69 years since the advent of penicillin, it has become the drug of choice for any stage of syphilis and in pregnant women; if the patient has allergy, desensitization is indicated either orally or intravenously and other antibiotic shouldn´t be used because of the security offered by penicillin in the cure rate and in the reduction of congenital syphilis. Keywords: Syphilis; Pregnancy; Inverse algorithms.
Mediastinal eggshell calcifications
Authors:   Pulmonary Disease and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, USA, Glass Lisa N , Delio Joseph ,   Pulmonary Disease and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, USA, Ahari Jalil E ,   Associate Professor in the Division of Pulmonary, Critical Care and Sleep Disorders Medicine, The George Washington University School of Medicine and Health Sciences, USA
Published: October 2021

A 71-year-old man, who is non-smoker with past medical history notable for hypertension and right lower extremity deep vein thrombosis three years prior, presented with progressive dyspnea on exertion of two weeks duration. He did not have any chest pain; heart rate and blood pressure were normal. His DVT had occurred in the setting of trauma, where he was injured by a falling tree. He was treated with anticoagulation for six months and recovered.
Acute myocardial infarction and allergy, causal or casual relationship?
Authors:   Cardiology Department, Juan Ramon Jimenez University Hospital, Huelva, Spain, Garcia-Polavieja José I Morgado , Paredes Margarita Castillo ,   Internal Medicine Department, Juan Ramon Jimenez University Hospital, Huelva, Spain, Herrero Enrique López ,   Internal Medicine Department, Juan Ramon Jimenez University Hospital, Huelva, Spain, López Francisco Javier Fernández ,   Emergency Department, Juan Ramon Jimenez University Hospital, Huelva, Spain, Pérez Ana Blanca Paloma Martínez ,   Cardiology Department, Juan Ramon Jimenez University Hospital, Huelva, Spain, Fernández José Francisco Díaz ,   Cardiology Department, Juan Ramon Jimenez University Hospital, Huelva, Spain
Published: October 2021

A 53-year-old man with a known allergy to metamizole presented for acute gonalgia, receiving metamizole by mistake. He suffers a severe allergy reaction accompanied by chest pain and signs of acute lower myocardial infarction, which subsides with treatment of anaphylactic shock and fibrinolysis, without observing intracoronary thrombus or signs of complication of atherosclerotic plaque. Keywords: Kounis syndrome; Allergic myocardial infarction; Myocardial infarction with normal coronary arteries.
A continuous cough after COVID-19
Authors:   Pulmonary Disease and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, USA, Glass Lisa N , Hanna Sandrine ,   Pulmonary Disease and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, USA, Lichtenberger John P ,   Chief of Thoracic Imaging, The George Washington University Medical Faculty Associates, USA, Milojevic Ivana ,   Assistant Professor, Division of Pulmonary, Critical Care and Sleep Disorders Medicine, The George Washington University School of Medicine and Health Sciences, USA, Ahari Jalil E ,   Associate Professor in the Division of Pulmonary, Critical Care and Sleep Disorders Medicine, The George Washington University School of Medicine and Health Sciences, USA
Published: October 2021

Organizing pneumonia is a process of lung parenchymal injury caused by multiple etiologies. Although organizing pneumonia may be an idiopathic process, it usually occurs secondary to infection, aspiration, autoimmune disease, and after organ transplantation or radiation. We present a case of organizing pneumona after confirmed SARS-CoV-2 (COVID-19) infection manifesting as chronic cough. Keywords: Organizing pneumonia; COVID-19; Post-viral syndrome; Chronic cough.
A rare etiology of posterolateral pain subsequent to a total knee arthroplasty
Authors:   Orthopedic Surgery Residency, Medicol - Ouchy Orthopedic Center, Av. D’Ouchy 41, CH - 1006 Lausanne, Switzerland, Rebecca Olden Theresa , Jacques Vallotton, ,   Specialist in Orthopedic Surgery, Sports Medicine, Medicol - Centre or-thopédique d’Ouchy, Av. d’Ouchy 41, CH - 1006 Lausanne, Switzerland
Published: October 2021

This case report illustrates a very rare problematic after Total Knee Arthro-plasty (TKA), yet that you have to think of if posterolateral pain appears. The postoperative outcome of our patient was initially very good, but pain appeared after 6 weeks, in an atypical mode, that couldn’t be attributed to the most common differential diagnosis. The characteristics of the symptoms directed us to a mechanical cause and the solution finally came up by means of a radiography: the images showed an impingement between one of the tibial tuberosity fixation screw’s head and the fibular neck. What couldn’t be seen on the primary images was an irritating callus, that was detected at 3 months postoperatively. The pain disappeared after surgical removal of the screw. Keywords: Total knee arthroplasty; Posterolateral knee pain; Pain after total knee ar-throplasty; Tibial screw impingement.
COVID-19 patient with elevated D-dimer. Is anticoagulation the answer? A case report
Authors:   Allergy, Pneumology and Pharmacy Departments, Hospital Universitario de La Plana, Vila-Real, Spain., El-Qutob David , García-Sidro Patricia ,   Allergy, Pneumology and Pharmacy Departments, Hospital Universitario de La Plana, Vila-Real, Spain., Nieto María ,   Allergy, Pneumology and Pharmacy Departments, Hospital Universitario de La Plana, Vila-Real, Spain., Carrera- Hueso Francisco J ,   Allergy, Pneumology and Pharmacy Departments, Hospital Universitario de La Plana, Vila-Real, Spain.
Published: October 2021

Context: We are progressively learning about COVID-19 every day. An aspect that we would like to highlight and that is becoming increasingly clear is that patients develop a hypercoagulable state that causes microthrombi and becomes life threatening. We are considering starting the use of early anticoagulation in these cohort of patients who become critically ill to halt and prevent progression of the disease. Case report: We present a case report of a SARS-CoV-2 infected patient admitted in a hospital in Vila-real, Spain. We present the characteristics and evolution of laboratory parameters of our patient during the admission in our hospital. The patient needed intubation and was transferred to the Intensive Care Unit (ICU) where the patient continues evolution. Conclusions: Probably these patients must be anticoagulated earlier and for a longer duration along the duration of the disease. Keywords: D-dimer; SARS-CoV-2; Hypercoagulability
A common disease masked by complex clinical manifestations: A case report of hypothyroidism
Authors:   Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, Wang Qiumei
Published: October 2021

Background: Hypothyroidism is a common disease in elderly people. Although hypothyroidism can theoretically have clinical implications related to nearly all major organs, it is often excluded from diagnostic algorithms for elderly patients with multi-system disease because its symptoms are non-specific. Case summary: A 61-year-old woman presented with dizziness, fatigue, facial swelling, dry cracked skin, and myalgia. She had a 2-year history of impairment of multiple organs and multiple adverse drug events. Blood tests showed abnormal liver and kidney function, an elevated creatine kinase concentration, and hyperlipidaemia. During the last 2 years, she had experienced multiple severe adverse drug events, including eosinophilia and systemic symptoms caused by carbamazepine, acute kidney impairment related to ceftriaxone and cefdinir, exfoliative dermatitis caused by ceftazidime, and intolerance to statins. After visiting several large hospitals, she was finally diagnosed in our clinic with hypothyroidism. At the time of diagnosis, she was extremely ill and unable to walk independently. After taking levothyroxine, all of her symptoms and signs completely resolved. Conclusion: Hypothyroidism might be overlooked in elderly patients, especially those with complex and severe clinical conditions. Keywords: Aged; adverse drug events; multiple organ dysfunction; hypothyroidism.
Syphilis mimicking pseudotumor cerebri in an immunocompetent patient
Authors:   Division of Medicine, The Miriam Hospital, Providence, Rhode Island, USA, Selvaraj Vijairam , Dapaah-Afriyie Kwame ,   Division of Medicine, The Miriam Hospital, Providence, Rhode Island, USA, Beaubrun Anneliese ,   Division of Medicine, The Miriam Hospital, Providence, Rhode Island, USA, Migliori Michael ,   Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Published: October 2021

Ocular syphilis and neurosyphilis are infrequently reported in immunocompetent patients. Generally, these conditions are seen in HIV positive individuals and commonly present with uveitis. Here, we describe a 40-year-old immunocompetent female who presented with ocular symptoms, found to have papilledema and was diagnosed with neurosyphilis. Keywords: Syphilis; neurosyphilis; ocular syphilis; papilledema; optic disc edema.
Renal biopsy teaching case: A patient with scleroderma, hypertension, acute kidney injury and PR3 ANCA positivity
Authors:   Johns Hopkins University Hospital, Baltimore, MD, United States., Kant Sam , Rosenberg Avi ,   Johns Hopkins University Hospital, Baltimore, MD, United States., Wigley Fred ,   Johns Hopkins University Hospital, Baltimore, MD, United States., D Duvuru Geetha ,   Johns Hopkins University Hospital, Baltimore, MD, United States.
Published: October 2021

Scleroderma Renal Crisis (SRC) is the most common cause of Acute Kidney Injury (AKI) in scleroderma and occurs early during the disease course while ANCA Associated Vasculitis (AAV) is a rare cause of acute kidney injury occurring late in the disease course. We report a case of AKI with positive PR3 ANCA serology late in the disease course with a renal biopsy revealing findings of SRC.