bluuebunny/crossref_metadata_2025 huggingface dataset:
Topical Anesthesia With Sedation in Phacoemulsification and Intraocular Lens Implantation Combined With 2-Port Pars Plana Vitrectomy in 105 Consecutive Cases
Authors: Yepez Juan B , de Yepez Jazmin Cedeno , Azar-Arevalo Oly , Arevalo J Fernando
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy of topical anesthesia as an alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and intraocular lens implantation combined with our modified 2-port pars plana vitrectomy technique (phacovitrectomy).

* PATIENTS AND METHODS: Phacovitrectomy using topical anesthesia (4% lidocaine drops) was prospectively performed in 105 eyes with cataract and varied vitreoretinal pathology. In 75 eyes (71.4%), phacovitrectomy was combined with argon laser photocoagulation (endolaser). Preoperative and intraoperative sedation of varying degrees was necessary. Subjective pain and discomfort were graded from 1 (no pain or discomfort) to 4 (severe pain and discomfort).

* RESULTS: All patients had grade 1 pain and discomfort during most of the procedure. All patients had grade 2 (mild) pain and discomfort during pars plana sclerotomies, external bipolar cautery, and conjunctival closure. No patient required additional retrobulbar, peribulbar, or sub-Tenon's anesthesia.

* CONCLUSION: This technique avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. With appropriate case selection, topical anesthesia is a safe and effective alternative to peribulbar or retrobulbar anesthesia in phacovitrectomy.

[Ophthalmic Surg Lasers 2002;33:293-297]
Subconjunctival Dislocation of an Anterior Chamber Intraocular Lens
Authors: Kumar Atul , Nainiwal Sanjeev K , Dada Tanuj , Ray Manotosh
Published: April 2021

Abstract. Post-traumatic dislocation of an intraocular lens (IOL) is a serious complication, especially after a blunt trauma because the posterior chamber lenses can potentially dislocate subconjunctively. We report a case of subconjunctival dislocation of a Kelman multiflex AC IOL. Such cases require immediate wound repair with IOL explantation to prevent endophthalmitis.

[Ophthalmic Surg Lasers 2002;33:319-320]
Trabeculectomy in the Management of PosnerSchlossman Syndrome
Authors: Dinakaran Subramanian , Kayarkar Vishwas
Published: April 2021

Abstract. Posner-Schlossman syndrome (glaucomatocyclitic crisis) is a condition of unknown etiology. Patients present with blurred vision, show minimal anterior chamber activity, and raised intraocular pressure (IOP). Corneal edema may cause colored halos. The condition tends to be recurrent, usually responding to a topical steroid and ocular hypotensives. The eyes appear normal between attacks. We present a patient who had bilateral Posner-Schlossman syndrome and underwent filtering surgery to control raised intraocular pressure in both eyes. During the follow up of more than 4 years, the control of IOP was good and he had no further attacks. [Ophthalmic Surg Lasers 2002;33:321-322]
Use of an Oil-Hydraulic Microinjection Pump for Subretinal Infusions
Authors: Weichel Judith , Valtink Monika , Engelmann Katrin , Richard Gisbert
Published: April 2021

Abstract. The injection of cell suspensions or drugs into the subretinal space is a new promising option of vitreoretinal surgery for the treatment of degenerative retinal disorders. We used a manual oil-hydraulic microinjection pump to subretinally inject suspensions of retinal pigment epithelial cells in Royal College of Surgeons rats and in patients suffering from age-related macular degeneration with geographic atrophy. The histological examination of the treated rat eyes showed that cell suspensions could be placed precisely in the subretinal space. Intra- and postoperative outcome of the patients in the clinical trial revealed no retinal complications during 6 months of follow up. We suggest the oil-hydraulic microinjection pump to be a valuable instrument for controlled and precisely dosed atraumatic infusion or aspiration of small volumes of cell suspensions, fluids or drugs in vitreoretinal surgery. [Ophthalmic Surg Lasers 2002;33:340-342]
Retinal Microaneurysmal Closure Following Focal Laser Photocoagulation in Diabetic Macular Edema
Authors: Gogi Devina , Gupta Amod , Gupta Vishali , Pandav S S , Dogra M R
Published: April 2021

* OBJECTIVE: To determine the temporal relationship of microaneurysmal closure following focal laser photocoagulation in diabetic macular edema.

* PATIENTS AND METHODS: This prospective study included 25 eyes of 23 diabetic patients with clinically significant macular edema. Ten to 20 weU-defined microaneurysms were preselected and marked on an enlarged photograph of the prelaser fundus fluorescein angiogram. These preselected microaneurysms were focally lasered and followed up angiographically at 48 hours, 1 week, 3 weeks, 6 weeks, and 12 weeks after photocoagulation. Thereafter, the average time span between photocoagulation and the closure of the microaneurysms was determined.

* RESULTS: The mean number of preselected microaneurysms at baseline was 18.24 ±3.51, which remained the same at 48 hours. However, the mean microaneurysmal count decreased to 11. 76 ±2.65 (35% reduction) at 1 week, 9.12±2.53 (50% reduction), 7.12±2.26 (61% reduction), and 4.56±1.32 (75% reduction) at 3, 6, and 12 weeks, respectively. The majority of the microaneurysms (35%) closed between 48 hours and 1 week.

*CONCLUSIONS: The microaneurysmal closure following focal laser photocoagulation is a delayed process. None of the preselected microaneurysms showed closure within 48 hours, and 75% of the preselected microaneurysms closed at the end of 12 weeks.

[Ophthalmic Surg Lasers 200233:362-367]
Threshold Determinations for Selective Retinal Pigment Epithelium Damage With Repetitive Pulsed Microsecond Laser Systems in Rabbits
Authors: Framme Carsten , Schuele Georg , Roider Johann , Kracht Dietmar , Birngruber Reginald , Brinkmann Ralf
Published: April 2021

* BACKGROUND AND OBJECTIVE: In both clinical and animal studies, it has been shown that repetitive short laser pulses can cause selective retinal pigment epithelium damage (RPE) with sparing of photoreceptors. Our purpose was to determine the ophthalmoscopic and angiographic damage thresholds as a function of pulse durations by using different pulsed laser systems to optimize treatment modalities.

* MATERIALS AND METHODS: Chinchilla breed rabbits were narcotized and placed in a special holding system. Laser lesions were applied using a commercial laser slit lamp, contact lens, and irradiation with a frequency-doubled Nd: YLF laser (wavelength: 527 nm; repetition rate: 500 Hz; number of pulses: 100; pulse duration: 5 µß, 1.7 µß, 200 ns) and an argon-ion laser (514 nm, 500 Hz, 100 pulses, 5 µß and 200 ms). In all eyes, spots with different energies were placed into the regio macularis with a diameter of 102 µp? (tophat profile). After treatment, fundus photography and fluorescein angiography were performed and radiant exposure for ED50 damage determined. Speckle measurements at the fiber tips were performed to determine intensity peaks in the beam profile.

* RESULTS: Using the Nd:YLF laser system, the ophthalmoscopic ED50 threshold energies were 25.4 µ] (5 µß), 32 µ] (1.7 µß), and 30 µ] (200 ns). The angiographic ED50 thresholds were 13.4 µ] (5 µ8), 9.2 µ] (1.7 µß), and 6.7 µ] (200 ns). With the argon laser, the angiographic threshold for 5 µß pulses was 5.5 µ). The ophthalmoscopic threshold could not he determined because of a lack of power; however, it was >12 µ}. For 200 ms, the ED50 radiant exposures were 20.4 mW ophthalmoscopically and 19.2 mW angiographically. Speckle factors were found to be 1.225 for the Nd: YLF and 3.180 for the argon laser. Thus, the maximal ED50-threshold radiant exposures for the Nd:YLF were calculated to be 362 mj/cm2 (5 µß), 478 mj/cm2 (1.7 µ-s), and 438 mj/cm2 (200 ns) ophthalmoscopically. Angiographically, the thresholds were 189 mj/cm2 (5 µß), 143 mj/cm2 (1.7 µ-s), and 97 mj/cm2 (200 ns). For the argon laser, the maximal ED50 radiant exposure threshold was 170 mj/cm2 angiographically.

* CONCLUSION: The gap between the angiographic and the ophthalmoscopic thresholds for the 200 ns regime (4.5 times above angiographic ED50) was wider than for the 1.7 µ$ regime (3.3 times above the angiographic ED50). This would suggest the appropriate treatment would be 200 ns pulses. However, histologies have yet to prove that nonvisible mechanical effects increase with shorter pulse durations and could reduce the "therapeutic window." When comparing the thresholds with 5 µß pulses from the argon and Nd:YLF laser, it demonstrates that intensity modulations in the beam profile must be considered.

[Ophthalmic Surg Lasers 200233:400-409]
Orbital Melanoma Metastatic From Contralateral Choroid: Management by Complete Surgical Resection
Authors: Shields Jerry A , Perez Noel , Shields Carol L , Singh Arun D , Eagle Ralph C
Published: April 2021

Abstract. We discuss a clinicopathologic correlation of orbital metastasis from a contralateral choroidal melanoma wherein the orbital tumor was removed completely by surgical resection. In October 1982, a 29-year-old woman was treated with cobalt-60 plaque radiotherapy for a choroidal melanoma in her right eye. The tumor responded well but recurred after 9 years, necessitating enucleation. In August 1999, 17 years after initial presentation, metastatic melanoma to liver, lung, and brain were found and the patient had a favorable response to chemotherapy and brain irradiation. Five months later, in November 2000, an enlarging orbital mass was documented to be compressing the left optic nerve. Complete surgical removal of the tumor was achieved by a superotemporal orbitotomy. Histopathologically, the tumor was a malignant melanoma with features similar to the choroidal tumor. The contralateral orbit can be the site of late metastasis from choroidal melanoma. In rare instances, an orbital metastasis can be completely removed surgically without subjecting the patient to orbital irradiation. [Ophthalmic Surg Lasers 2002;33:416-420]
Severe Pupil Distortion Following Transchamber Repair of a Cyclodialysis Cleft
Authors: Nichols John C , Lee Dave H , Feman Stephen S , Shields Steven A
Published: April 2021

Abstract. This report describes a potential complication following the repair of a traumatic cyclodialysis cleft in a pediatric patient using a novel technique. A healthy 11 -year-old boy suffered a blunt traumatic tennis ball injury to his left eye. He underwent repair of a retinal dialysis with detachment shordy after the injury. Postoperatively, he developed persistent hypotony, shallow anterior chamber, and hypotony maculopathy. An occult cyclodialysis cleft was suspected. Examination under anesthesia revealed a small cyclodialysis cleft. The cleft was closed by transchamber placement of prolene sutures across the cleft under direct visualization through a Tano lens. Postoperative course was complicated by severe pupillary distortion despite subsequent suture removal. [Ophthalmic Surg Lasers 2002;33:426429]
Silicone Plate-Haptic Posterior Chamber Intraocular Lens Implanted in the Anterior Chamber: Report of a Bilateral Case and Potential Complications
Authors: Izak Andrea M , Werner Liliana , Apple David J , Pandey Suresh K , Trivedi Rupal H
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate possible complications associated with implantation of a posterior chamber (PC) intraocular lens (IOL) in the anterior chamber.

* MATERIALS AND METHODS: We analyzed a plate-haptic silicone IOL that had been explanted from the anterior chamber of an 83-year-old female. Additionally, the lens was experimentally reimplanted into the anterior chambers of 3 human cadaver eyes. After fixation of the eyes (Karnovsky's solution), the anterior-posterior length, the white-to-white diameter, the angle-to-angle diameter, and the sulcus-to-sulcus diameter were measured. Two different techniques to cut the eyes were used: sagittal section and corneal buttonhole technique. The plate-haptic silicone lens was then implanted in the anterior chamber and sulcus ciliaris of the eyes. A Kelman multiflex IOL was used as a control for anterior chamber implantation.

* RESULTS: This experiment demonstrated that the plate-haptic silicone IOL lens is too small and thick for implantation in the anterior chamber and in the sulcus. The lens could easily rotate in the anterior chamber and also dislocate inferiorly, obstructing the visual axis by its edge. The thickness of the lens theoretically could also cause endothelial cell damage and mechanical iris irritation resulting in chronic uveal inflammation.

* CONCLUSION: This case and experiment should help surgeons realize the risk and potential for IO Lmissizing complications that may be caused if a lens design for the capsular bag is implanted in the anterior chamber, especially if a plate-haptic PC-IOL design is used.

[Ophthalmic Surg Lasers 2002;33:480-487]
Partial Excision With A Conjunctival Advancement Flap After A Relaxing Incision for A Dissecting Glaucoma Filtering Bleb
Authors: Mandal Anil K , Vemuganti Geeta K , Ladda Narendra , Veenashree M P
Published: April 2021

Abstract. A 65-year-old male patient developed dissecting glaucoma filtration bleb following trabeculectomy with mitomycin-C (MMC). Surgical partial excision of the bleb was performed and the tissue was subjected to histopathological evaluation. The bleb area was covered by a conjunctival flap that was advanced with the help of a relaxing incision in the superior conjunctiva fornix. The dissecting bleb was successfully managed by controlling intraocular pressure, and the patient became asymptomatic without any medication. The light microscopic examination of the bleb showed irregularly arranged collagen bundles and hypocellularity of the subconjunctival tissue with places of nodular configuration of the fibroblast in the periphery. Surgical partial excision of the dissecting glaucoma filtering bleb is a reliable, simple, and precise method. Advancing the conjunctival flap by a superior conjunctival relaxing incision facilitates easy mobilization of the flap, ensures healthy resurfacing of the bleb, and prevents postoperative transconjunctival leakage. Histopathology of the bleb is compatible with the use of MMC during original filtering surgery. [Ophthalmic Surg Lasers 2002;33:497-500]
A Medical Student Initiative to Enhance the Pediatric Hemodialysis Experience
Authors: Ferrante Jennifer , Camhi Stephanie S. , Neumann Olivia , Chandar Jayanthi
Published: April 2021

Background:

Children and young adults receiving hemodialysis (HD) face unique challenges including frequent school absenteeism, psychosocial issues, and social isolation, placing them at risk for decreased academic achievement and health literacy.

Objective:

To address this, we implemented the Child and Adolescent Motivation and Enrichment Program (CHAMP) at Holtz Children's Hospital in Miami, FL. The objective of this study is to describe the organizational structure and program design of CHAMP and provide preliminary program opinions.

Methods:

Medical students served as longitudinal one-on-one mentors to patients receiving HD. Face-to-face intervention, books, board games, and electronic tablets were used to enhance patients' educational and recreational experience. We surveyed participating patients, medical students, and unit nurses regarding their opinions of CHAMP.

Key Results:

Patients responded to a series of questions on a Likert scale scored from 1 to 5 and reported the highest scores on questions pertaining to having fun with mentors (mean = 4.88), enjoying mentor visits (mean = 4.78), and learning during visits (mean = 3.88). Mentors reported the highest level of agreement (mean = 4.82) that CHAMP helped them gain empathy for patients with chronic and/or special health care needs. Nurses scored highly on the point that “overall, the program was useful and helped the patient” (mean = 6.86 of a possible 7).

Conclusion:

CHAMP is an academic and psychosocial enrichment program for children and adolescents receiving HD. The program is regarded highly by participating patients, medical students, and unit nurses. Patients report enjoying and learning from mentor sessions, whereas nurses report improved interactions with patients. Medical students who participate as mentors also gain important exposure to the field of pediatric nephrology. The program design as described herein positions CHAMP for replication at academic medical centers nationwide, allowing for optimization of the health and well-being of the pediatric HD population.

[
HLRP: Health Literacy Research and Practice
. 2021;5(1):e60–e69.]

Plain Language Summary:

Pediatric patients undergoing hemodialysis (HD) are at risk for decreased academic achievement and health literacy. To address this, we implemented the Child and Adolescent Motivation and Enrichment Program, a longitudinal mentorship program pairing medical students as one-on-one mentors to patients undergoing HD. Preliminary results from this program demonstrate satisfaction and enjoyment by participating patients, medical students, and dialysis unit nurses.
Uncertainty‐driven business cycles: Assessing the markup channel
Authors: Born Benjamin , Pfeifer Johannes
Published: April 2021

Precautionary pricing and increasing markups in representative‐agent DSGE models with nominal rigidities are commonly used to generate negative output effects of uncertainty shocks. We assess whether this theoretical model channel is consistent with the data. Three things stand out. First, consistent with precautionary wage setting, we find that wage markups increase after uncertainty shocks. Second, the impulse responses of price markups are largely inconsistent with the standard model, both at the aggregate as well as the industry level. Finally, and in contrast to times‐series evidence, our theoretical model robustly predicts that uncertainty shocks have a quantitatively small impact on the economy.
Dealing with misspecification in structural macroeconometric models
Authors: Canova Fabio , Matthes Christian
Published: April 2021

We consider a set of potentially misspecified structural models, geometrically combine their likelihood functions, and estimate the parameters using composite methods. In a Monte Carlo study, composite estimators dominate likelihood‐based estimators in mean squared error and composite models are superior to individual models in the Kullback–Leibler sense. We describe Bayesian quasi‐posterior computations and compare our approach to Bayesian model averaging, finite mixture, and robust control procedures. We robustify inference using the composite posterior distribution of the parameters and the pool of models. We provide estimates of the marginal propensity to consume and evaluate the role of technology shocks for output fluctuations.
Affectbehaviour as a determinant of motivation of machine operators in the apparel sector: the moderating effect of employee creativity
Authors: Deegahawature M. M. D. R. , Rajapaksha R. A. U. K.
Published: April 2021

Being the largest total national export earning industry in the country, the Sri Lankan apparel industry provides more than 990,000 employment opportunities, allocating a large fraction of it to the women labour force. Through it is competitive at present, the industry has been facinga gradually intensifying competition due to the presence of efficient manufacturers in other countries. The competition is further intensified since international buyers expect a long-term partnership with fewer efficient suppliers. Being a labour-intensive industry, the labour efficiency of the sewing machine operators has become salient in order to remain competitive. This demands the industry to maintain the employee motivation that will result in an efficient and productive workforce while helping the industry address other pivotal issues including employee turnover and absenteeism. The motivation can positively be influenced by the affect behaviour in a learning setting. Thus, the main objective of this study is to investigate the influence of the affect behaviour developed through the training of the newly hired sewing machine operators on the motivation. Also, the study examines whether the operators’ creativity moderates the said effect. The analysis of data, collected from 116 operators through a questionnaire, by the regression analysis, reveals that the affect behaviour positively influences employee motivation. Further, the PROCESS tool used to examine the moderating effect of employee creativity does not indicate suchan effect. Consequently, the apparel industry can use training programs in order to develop the affect behaviour of the newly hired sewing machine operators as a strategy to motivate them. Further, the operators’ creativity is not an influential factor. This study identifies the affect behaviour as a determinant of the motivation of the machine operators in the apparel sector. The study also presents a scale to measure the affect behaviour. Moreover, the study provides several implications and further research opportunities.
Shifting from autograph to Selfie: consumer self in the Facebook world
Authors: Wijesundara T. R.
Published: April 2021

The recent revolution of information technology has diffused Facebook widely among consumers, and it has a considerable impact on consumer self and modern marketing communication. Purpose of this study is to investigate the acceptance and impact of dematerialized Facebook possessions on consumer extended self. The theoretical foundation of Technology Acceptance Model (TAM) and extended self were used to develop the hypotheses of the study. The current study is based on primary data collected through a self-administered questionnaire, among a sample of 327 Sri Lankan undergraduates. Partial Least Squares Structural Equation Modeling (PLSSEM) was used to estimate the path coefficients and test the hypotheses developed in the study. Findings reconfirmed the original TAM relationships, enabling the use of TAM in identifying the predictors for accepting dematerialized Facebook possessions. Moreover, findings revealed that dematerialized Facebook possession usage extended consumer self. Theoretical and practical implications of these study and directions for further research are discussed.
The study on brand loyalty and repeat purchase intention of the shampoo market in Colombo
Authors: Jayasuriya N. A. , Kodippili N. , Perera K. M. , Priyadarshani L. , Wijesekera B. D.
Published: April 2021

Brand Loyalty occurs when a customer is a lifelong fan of a particular brand. Loyal customers are always an asset to a company because they are their stable base of income. Customers who stay loyal towards one brand for a long period of time are those that even pass down their favorites to the next generations. On the other hand, repeat purchase intention is when a particular product has been purchased again- but due to the action of a previous purchases. When a customer purchases the same product again, this means that the product has a positive impact on the customer’s behavior and that they really like it. When such situation applies to the purchase intention of several purchases afterwards- it can be clear that, that particular customer has started building brand loyalty towards that particular brand. This relationship is understood by many companies loyalty programs has been initiated The Sri Lankan shampoo market is cluttered with so many brands providing so many solutions, therefore it is a challenge for these companies to keep their customers to be loyal. The purpose of this research is to study whether brand loyalty has an impact on repeat purchase intention in the shampoo market in Sri Lanka while the objective is to identify the impact on brand loyalty and repeat purchase intention. For the purpose of this study, used non-probability convenience sampling technique has been used and selected a sample of 384 people residing in the Colombo district in Sri Lanka. One of the major findings of this research is that males use shampoo more than females in the Colombo district and one of the most favorite brands of the population is Dove. In conclusion, the study also proves that repeat purchase intention and brand loyalty has a positive relationship.
A Study on the Essentials of Dilation (Extension) and (Sources of) Acute Contraction of Lung
Authors: Lee Jae gyu , Kim Taek Jae
Published: April 2021

No abstract available.
Influential Factors upon Tuberculin Reaction Following B.C.G. Inoculation (The First Report) 1. Effect of Ray of Light (The First Edition)
Authors: Lee Seong-Gwan
Published: April 2021

No abstract available.
Tuberculous Change of the Draining Bronchus From Pulmonary Tuberculosis Lesions
Authors: Kim Chin Shik
Published: April 2021

No abstract available.
A Value of Elevated Beds in the Treatment of Pulmonary Tuberculosis
Authors: Kim Sung Chin
Published: April 2021

No abstract available.
Result of Chemotherapy on Primary Tuberculosis especially reagdiological changes
Authors: Pynn Hae Wan , Park Seung-Seo
Published: April 2021

No abstract available.
Treatment of Pulmonary Tuberculosis
Authors: Lee Chan She
Published: April 2021

No abstract available.
Vertigo Developed in a Patient with Pulmonary Tuberculosis
Authors: Park Yun Kyu
Published: April 2021

No abstract available.
The Bacteriologic Study of the Tubercle Bacilli in Resected Pulmonary Lesions
Authors: Kim Ki Ho
Published: April 2021

The usage of antituberculous agents in combination with surgical resectional procedures in the treatment of pulmonary tuberculosis has becoming popular in the past year. However recently it has been a tendency to divert our attention from the pathologic study of the resected specimens to bacteriologic investigation. This was the common findings, in many cases in which antituberculous therapy has been done, that the lesions in resected lung specimens may contain many tubercle bacilli which do not grow on culture or produce disease in guinea pigs. It is of great clinical importance to determine whether this phenomenon is due to natural mechanisms associated with healing or a direct result of antituberculous therapy. l have had the apportunity to study the bacteriology of the lesions from three tuberculous patients who had had no preoperative chemotherapy. Also my present report includes he bacteriologic finding from other cases in which resection was performed after laryillg periods of chemotherapy as well IS experimental bacteriologic procedures which were carried out in connection vith this relation.1. This is to present a report of bacteriologic study for tubercle bacilli 47 surgical specimens from 25 patients.2.The specimens are divided in three groups according to preoperative management.The first group had certain period of chemotherapy continuously prior to surgey; the second group had several Courses of chemotherapy irregularly before surgery; and third had no chemotherapy.3. The non-culturable tubercle bacilli were found in some cases in all of the groups. 4. It may be emphasized that the further correlative studies of the pathologic and bacteriologic manifestations of both treated and untreated tuberculous lesions is nescessary.
Leucocyte Picture after B. C. G. Inoculation
Authors: Rhee S. K. , Choi T. W.
Published: April 2021

In the observation of leucocyte change after B. C. G. inoculation especially the leucocyte picture was compared with tuberculin allergy.1) After B. C. G. inoculation the number of leucocyte increased and it continued 1 to 2 months duration.2) In leucocyte picture the number of lymphocyte decreased within 1 to 2 weeks after B. C. G. inoculation. On the contrary. the number of neutrophil leucocyte increased and moncyte was late in increasing, moreover irregular in rate. Eosinophil leucocyte always increased within 1 to 2 weeks after inoculation and it continued 1 to 2 months duration.3) In relation between tuberculin allergy and leucocyte picture. especially eosinophilia, the appearance of eosinophilia was earlier than that of tuberculin allergy.
Ct Findings of Covid-19 Pneumonia in Icu-Patients
Authors: Cau Riccardo , Falaschi Zeno , Paschè Alessio , Danna Pietro , Arioli Roberto , Arru Chiara D. , Zagaria Domenico , Tricca Stefano , Suri Jasjit S. , Kalra Mannudeep K. , Carriero Alessandro , Saba Luca
Published: April 2021

Background

In December 2019, a cluster of unknown etiology pneumonia cases occurred in Wuhan, China leading to identification of the responsible pathogen as SARS-coV-2. Since then, the coronavirus disease 2019 (COVID-19) has spread to the entire world. Computed Tomography (CT) is frequently used to assess severity and complications of COVID-19 pneumonia. The purpose of this study is to compare the CT patterns and clinical characteristics in intensive care unit (ICU) and non- ICU patients with COVID-19 pneumonia.

Design and methods

This retrospective study included 218 consecutive patients (136 males; 82 females; mean age 63±15 years) with laboratory-confirmed SARS-coV-2. Patients were categorized in two different groups: (a) ICU patients and (b) non-ICU inpatients. We assessed the type and extent of pulmonary opacities on chest CT exams and recorded the information on comorbidities and laboratory values for all patients.

Results

Of the 218 patients, 23 (20 males: 3 females; mean age 60 years) required ICU admission, 195 (118 males: 77 females, mean age 64 years) were admitted to a clinical ward. Compared with non-ICU patients, ICU patients were predominantly males (60% versus 83% p=0.03), had more comorbidities, a positive CRP (p=0.04) and higher LDH values (p=0.008). ICU patients’ chest CT demonstrated higher incidence of consolidation (p=0.03), mixed lesions (p=0.01), bilateral opacities (p<0.01) and overall greater lung involvement by consolidation (p=0.02) and GGO (p=0.001).

Conclusions

CT imaging features of ICU patients affected by COVID-19 are significantly different compared with non-ICU patients. Identification of CT features could assist in a stratification of the disease severity and supportive treatment.
The role of PET in a clinically silent and ultrasound negative synovitis in the course of rheumatoid arthritis - a case report
Authors: Skoczynska M. , Figus F. , Arena V. , Massazza G. , Iagnocco A.
Published: April 2021

We present a case report of a rheumatoid arthritis patient, who underwent a PET scan, which revealed inflammation of multiple joints, which was missed by both physical and ultrasound examinations. A 55-year old woman with a long-term rheumatoid arthritis, who had undergone arthroplasty of the left knee in the past, consulted with the rheumatologist for pain in the left knee. The physical examination revealed signs of inflammation in the left knee and right elbow. The inflammatory parameters were high. Ultrasound showed intraarticular effusion without signs of active synovitis in the left knee. The ultrasound assessment of the other joints (hands, wrists and feet) was also negative for active synovitis, while positron-emission tomography (PET) revealed increased glucose metabolism at the level of the medial side of the left knee, left radio-ulno-carpal joint, I-II-III metacarpo-phalangeal joints bilaterally, right II metatarso-phalangeal joint, and left II-III metatarso-phalangeal joints. This case report demonstrates that PET might be more sensitive than ultrasound in detecting subclinical joint inflammation.
Does human serotonin-1A receptor polymorphism (rs6295) code for pain and associated symptoms in fibromyalgia syndrome?
Authors: Tanwar S. , Mattoo B. , Kumar U. , Dada R. , Bhatia R.
Published: April 2021

Genetic predisposition may play an important role in the development of fibromyalgia syndrome (FMS). Serotonin is known to be involved in pain modulation and serotonin-1A receptor plays a considerable role in determining the central 5-HT tone. Consequently, variation in 5-HT1A receptor gene (HTR1A) may be responsible for inter-individual variability in pain sensitivity and other clinical symptoms of FMS. Therefore, the objectives of this research work were to study the gene polymorphism of 5-HTR1A gene and to explore the correlation between rs6295 genotype (−1019C/G HTR1A) and duration of pain, pain intensity and pain related depression and anxiety, if any, in FMS. 5-HTR1A genotype for the C(-1019)G polymorphism was typed in 62 patients with FMS and 42 healthy subjects. Present pain intensity, components of pain and pain related depression and anxiety were assessed using the numerical pain rating scale, McGill pain questionnaire and Hamilton depression and anxiety rating scale respectively. 5-HTR1A gene was represented by three different genotypes, homozygous C/C, heterozygous C/G and homozygous G/G. Analysis of the 5-HTR1A gene showed a frequency of 58%, 31% and 11% for the C/C, C/G and G/G genotypes, respectively in FMS group. This proportion was 69%, 23% and 8% in healthy subjects. No significant correlation was observed between 5-HTR1A gene polymorphism and pain and related symptoms in FMS patients. To the best of our knowledge this is the first study which investigated the correlation between the 5-HTR1A gene polymorphism and pain intensity, the affective component of pain, pain related depression and anxiety in FMS.
Knuckle pads mimic early psoriatic arthritis
Authors: Giovannini I. , Zandonella Callegher S. , Errichetti E. , De Vita S. , Zabotti A.
Published: April 2021

Knuckle pads or Garrod’s nodes are a rare, non-inflammatory condition. They consist of benign, well-circumscribed fibro-adipose tissue over the small joints of hands and feet. Knuckle pads may be under-diagnosed and mistaken for early arthritis. The rheumatologist should perform an accurate differential diagnosis in which he can be helped by ultrasound and by other colleagues, such as the dermatologist. Ultrasound is considered useful in the assessment of the thickening of the subcutaneous tissue, located usually on the extensor site of proximal interphalangeal and metacarpophalangeal hand joints. Dermoscopy may play a role in detecting epidermal and dermal changes. We hereby report the case of a female patient with knuckle pads mimicking psoriatic arthritis.
Denosumab for the treatment of HIV-associated osteoporosis with fractures in a premenopausal woman
Authors: Marasco E. , Mussa M. , Motta F. , Bobbio-Pallavicini F. , Maserati R. , Montecucco C. , Bogliolo L.
Published: April 2021

The prevalence of osteoporosis is about three times greater in people living with HIV than in the general population. Bisphosphonates are the only class of antiresorptive drugs which have proved to be safe and effective in HIV patients. However, bisphosphonates are not recommended in women of childbearing age due to an increased rate of associated neonatal complications. To the best of our knowledge no reports on the use of denosumab in HIV-infected individuals have been published so far. We describe a 38 year-old woman with HIV, osteoporosis and vertebral fractures treated with denosumab, a monoclonal antibody targeting RANKL. After four years of treatment, bone mineral density improved, no new fractures occurred, and neither HIV reactivation nor opportunistic infections were observed. We show that denosumab could be a safe and effective approach for osteoporosis in patients with HIV and could be considered in women of childbearing age.
On the Finiteness length of some soluble linear groups
Authors: Santos Rego Yuri
Published: April 2021

Given a commutative unital ringR, we show that the finiteness length of a groupGis bounded above by the finiteness length of the Borel subgroup of rank one$\textbf {B}_2^{\circ }(R)=\left ( \begin {smallmatrix} * & * \\ 0 & * \end {smallmatrix}\right )\leq \operatorname {\textrm {SL}}_2(R)$wheneverGadmits certainR-representations with metabelian image. Combined with results due to Bestvina–Eskin–Wortman and Gandini, this gives a new proof of (a generalization of) Bux’s equality on the finiteness length ofS-arithmetic Borel groups. We also give an alternative proof of an unpublished theorem due to Strebel, characterizing finite presentability of Abels’ groups$\textbf {A}_n(R) \leq \operatorname {\textrm {GL}}_n(R)$in terms ofnand$\textbf {B}_2^{\circ }(R)$. This generalizes earlier results due to Remeslennikov, Holz, Lyul’ko, Cornulier–Tessera, and points out to a conjecture about the finiteness length of such groups.
Cancellation of two classes of dirichlet coefficients over Beatty sequences
Authors: Ma Qiang
Published: April 2021

Let
$\pi $
be an automorphic irreducible cuspidal representation of
$\mathrm{GL}_{m}$
over
$\mathbb {Q}$
. Denoted by
$\lambda _{\pi }(n)$
the nth coefficient in the Dirichlet series expansion of
$L(s,\pi )$
associated with
$\pi $
. Let
$\pi _{1}$
be an automorphic irreducible cuspidal representation of
$\mathrm{SL}(2,\mathbb {Z})$
. Denoted by
$\lambda _{\pi _{1}\times \pi _{1}}(n)$
the nth coefficient in the Dirichlet series expansion of
$L(s,\pi _{1}\times \pi _{1})$
associated with
$\pi _{1}\times \pi _{1}$
. In this paper, we study the cancellations of
$\lambda _{\pi }(n)$
and
$\lambda _{\pi _{1}\times \pi _{1}}(n)$
over Beatty sequences.
Audit of head and neck fine needle aspiration cytology from a tertiary institution in south - west Nigeria
Authors: Akinmoladun V.I. , Okolo C.A. , Aladelusi T.O. , Gbolahan O.O.
Published: April 2021

Objective: FNAC is a well-established initial investigative tool for head and neck masses due to its being cost effective, quick to perform, low associated morbidity, high patient acceptability and high diagnostic accuracy. This study aimed to audit the utilization and deployment of FNAC in the management of head and neck masses in our hospitalMethods: This is a retrospective study of all patients presenting for fine needle aspiration cytology of lesions in the head and neck region at our hospital for fifteen years (from 2008 to 2017). All data were extracted from the FNA clinic records. The data was analyzed using the SPSS version 21 and results presented as figures and percentages.Results: During the study period, 3194 patients were seen, 2789 had complete information for analysis. There were 875 males (31.4%) and 1914 females (68.6%). The ages ranged between 1 year and 103 years. Overall mean age was 39.7 + 17.9 years. The commonest site was the anterior neck, accounting for 1323 (47.4%) of the lesions. Cervical lymph nodal swellings accounted for 548 (19.6%)]. Benign lesions constituted 35%. A total of 160 (5.7%) specimens were reported as inconclusive. Malignant lesions had the highest prevalence in the 1-10year age group. There was no complication reported with any of the procedures.Conclusion: FNAC is an established tool for investigating head and neck lesions in our hospital. The practice however needs to be further developed in line with the recommendations of National Institute for Clinical Excellence for improved outcomes.Keywords: Fine needle aspiration cytology, head neck masses
Congenital granular cell epulis: report of a case and review of the literature
Authors: Edetanlen E.B. , Ogboh C.B.
Published: April 2021

Congenital granular cell tumour of the new born is a rare benign lesion of soft tissues which normally affects the maxillary alveolar ridge in neonates. Though benign, it can cause respiratory embarrassment and prevent feeding causing physical distress to the infant and psychological distress to the parents or guardian. Very few cases are reported in the literature. We aimed to highlight the clinical presentation, management and a brief review of the literature of the lesion.A case of a 3-day old baby who presented to the Oral and Maxillofacial Surgery Clinic University of Benin Teaching Hospital (UBTH) was used to illustrate the clinical presentation and management of congenital epulis.Congenital epulis of the new-born is a rare occurrence, though it can grow to a frightening size, it still remains a benign lesion with li le or no recurrence following surgical excision. The role of counselling to the parents cannot be over-emphasized.Keywords: Congenital, epulis, granular, newborn
Oral squamous cell carcinoma in patients less than 40 years in a Nigerian population
Authors: Lawal A.O , Adisa A.O , Effiom O.A
Published: April 2021

Objectives: Oral cancer ranks amongst the sixth to eight most common cancers worldwide and exhibits a great variation in incidence among countries. Oral squamous cell carcinoma (OSCC) is rare in individuals less than 40 years of age, with occurrences averaging 4 to 6% in people less than 40 years. The aim of this study was to review the clinical and pathological characteristics of OSCC cases in patients less than 40 years of age in five tertiary health facilities in Nigeria.Methods:All OSCC in the period from 1970 to 2015 from case file records and biopsy reports were retrieved from the records of the five teaching hospitals, to obtain age, gender, location and histologic grades.Results: Ninety-seven (17.4%) cases of OSCC were diagnosed in patients less than 40 years of age. These included 58 males and 38 females giving a male: female ratio of 1.5:1. The mandibular mucosa with 27 (28.7%) cases was the most common site followed by the maxillary mucosa with 24 (25.5%) and palate with 14 (14.4%) cases. Only 5 (5.3 %) cases of OSCC occurred in the tongue. The well differentiated OSCC was the most common histological grade accounting for 48 (50.0 %) cases while the moderately differentiated and poorly differentiated OSCC accounted for 31 (32.3 %) and 17 (17.7 %) cases respectively.Conclusion: OSCC was relatively more common in patients less than 40 years of age in this study than those of previous studies from other regions and OSCC in patients less than 40 years of age was relatively rare in the tongue when compared with similar cohorts from other continents.

Key words: oral squamous cell carcinoma; age less than 40; tongue; mandibular mucosa, Nigeria
Prevalence and Pattern of Peripheral Nerve Injuries in Kano Metropolis, Nigeria
Authors: Mukhtar N.B. , Umar Y.I. , Mayana K.I. , Sumaila F.G.
Published: April 2021

Peripheral nerve injury (PNI) are a worldwide problem and are among the leading cause of disabilities, thereby posing a major social and economic burden in the society. The prevalence of PNI needs to be known for healthcare actions to be taken and implementation of policies, however, such information is not readily available in this part of the world. Therefore, the objective of the study was to determine the hospital-based prevalence and pattern of PNI in Kano metropolis. The medical records of 28,374 patients who attended five (5) major hospitals in Kano metropolis from 2010- 2014 were reviewed in this retrospective study. The records of patients diagnosed with PNI were screened and 454 met the inclusion criteria. A research pro-forma was used to collect the relevant data, including age, gender, injury aetiology, region, nerve affected and referral for physiotherapy. Data was analysed using descriptive statistics of frequency, tables and percentages. The prevalence of PNI was found to be 1.6%, with males constituting 77.5%. The majority (70%) of the patients were younger than 40 years, and 42% of the PNI were located in the upper limb, with a high prevalence at the ulnar nerve (18%). Motor vehicle accidents (MVA) accounted for the highest number of cases(26.5%). The majority (81.5%) of the patients were not referred for physiotherapy. The hospital-based prevalence of PNI in Kano metropolis is low, so also is referral for physiotherapy and MVA is the leading cause of PNI.KEY WORDS: peripheral nerves injuries, prevalence, pattern
Implementation Issues in Rural Development in Sub-Saharan African Countries: Problems and Prospects
Authors: Okosun VA , Ezomo JO
Published: April 2021

It is a credo amongst scholars cum academics all over the globe that well coordinated and elaborate programmes and policies of rural development mounted by the third world countries in sub-Saharan Africa will lift her entire citizenry from manacle of gross underdevelopment to a region of  development in all facets of their economies. The countries in sub-Saharan African have spent trillions of dollars in rural development sector but an overview of the economies of these countries show that the vast population are marooned and encapsulated in gross poverty, ignorance, and  underdevelopment. The reason is attributable to poor implementation of rural development policies and programmes coupled with a host of  variegated factors. This paper therefore defines the concept of  implementation and rural development. The authors of this paper adopt the modernization theory to explicate the work. It discusses the significance of rural development to the economies of Sub-Saharan African countries. The paper also explains how poor implementation of rural  development programmes affects these countries. Moreover, it  orchestrates the factors/problems that impede rural development drives of various governments in Sub-Saharan African. Furthermore, it elucidates on the prospects of rural development. The paper finally suggests that an effective implementation of rural development programmes in all  ramifications is the only vehicle for rapid growth and economic  development in Sub-Saharan Africa.
Political Advertising Design in Nigeria, 1960-2007
Authors: Amifor J
Published: April 2021

No Abstract
An ecofeminist study of Flora Nwapa’s ‘Efuru’
Authors: Sanjo Ojedoja
Published: April 2021

This paper identified the great contribution of Flora Nwapa’s Efuru to ideas of ecological consciousness, and environmental protection, using theory that interlaces ecocriticism cum feminist criticism. The methodology therefore involves the conversation or ideas on the images of women and nature in ‘Efuru’, the association between the oppression of women and exploitation of nature by male chauvinist, thereby enslaving the female and nature in the commercial market value. From an ecofeminist perspective, this paper discovered that Flora Nwapa inculcates her novel with a theme of feminine and natural liberation from domination and violence. Flora Nwapa foresees the establishment of symbiosis, in which there is no male oppression or environment exploitation.Keywords: ecological conscience, male oppression, ecofeminism, domination, interconnectedness
Prospects and Challenges of Community-Based Tourism as a Livelihood Diversification Strategy at Sehlabathebe National Park in Lesotho
Authors: Makwindi Ngonidzashe , Ndlovu Joram
Published: April 2021

The purpose of this article was to examine the prospects and challenges of community based tourism as a livelihood diversification strategy for people living adjacent to the Sehlabathebe National Park in Lesotho. The main objective was to explore how rural communities living close to the World Heritage Site shift and diversity their livelihoods from farm to non-farm activities in order to sustain their livelihoods. This study adopted a mixed method approach. Data was collected through surveys (286) and in-depth key informant interviews (11). The results show that local communities support the use of tourism as a livelihood diversification strategy to provide off-farm entrepreneurial opportunities. The greatest challenge is that local communities are often pushed into marginal lands, with harsh climatic conditions resulting in the disruption of local fabric and their economies. The study concludes that the establishment of Sehlabathebe National Park has not significantly improved the status quo of the community. Therefore, local communities should be given opportunities to sell their products and services to tourists and work in partnership with park authorities in conserving the park resources. The paper contributes to the current discourses on the use of community based tourism as a livelihood diversification strategy in rural areas.