bluuebunny/crossref_metadata_2025 huggingface dataset:
Shistosomal myelitis and its diagnostic complexity: report of two cases in Alagoas
Authors: Almeida Juliana Oliveira de , Lins Alice Cavalcante de Almeida , Leão Bruna Acioly , Nunes Patrícia Pereira , Salvador Nayra Roberta Sales
Published: December 2021

Context: In Brazil, schistosomal myelitis is the third most common cause of myelopathy. The diagnosis of neuroschistosomiasis is not easy to make. In a study published in 2001, the author proposed a classification for the diagnosis of schistosomal myelorradiculopathy: Proven Diagnosis; Probable Diagnosis and Possible Diagnosis. Case Reports: Case 1, admitted in 2021 with 40 days of paraparesis and ascending paraesthesia, urinary retention and severe low back pain. He had proximal and distal grade 1 paraparesis, eosinophilia at blood count, CSF with hyperproteinorrhachia, normal cellularity and indirect immunofluorescence (IFI) for reactive schistosomiasis, as well as stool parasitology (EPF) and spine MRI with hypersignal in the spinal cord. Case 2, admitted in 2020 with 20 days of constipation and urinary retention followed by paraparesis and ascending paresthesia and sexual impotence. He presented proximal and distal grade 3 paraparesis and CSF with protein-cytological dissociation. Both had abolished deep reflexes and hypoaesthesia with levels in L2 and T10, respectively. As a result of the other exams and MRI with hypersignal of D6 to medullary cone with contrast impregnation and cauda equina roots, despite case 2 having EPF and IFI for schistosomiasis in the CSF negative, for presenting positive epidemiology for schistosomiasis, both were treated with solumedrol for 5 days, praziquantel and oral prednisone, with improvement afterwards. Conclusion: The outcome of schistosomal myelitis is directly related to early diagnosis and treatment. It is necessary to value all clinical, laboratory and epidemiological findings in patients living in an endemic area.
Creutzfeldt-Jakob disease: case report strongly suspicious with 14- 3-3 protein missing
Authors: Faur Maria Eduarda , Keil Emily Stefhani , Corti Gabriel Augusto , Filet Maria Eduarda Angelo de Mendonça , Oliveira Raddib Eduardo Noleto da Nóbrega de , Guimarães Rafael Pereira , Nunes Thábata Emanuelle Martins , Ribas Gustavo da Cunha , Moro Carla Heloísa Cabral , Longo Alexandre Luiz
Published: December 2021

Context: The Creutzfeldt-Jakob disease (CJd) is a rare spongiform encephalopathy caused by a prion. In clinical practice the presence of 14- 3-3 protein can be a insensitive marker of sporadic CJd, well as absent for genetic CJd and new variantes, being susceptible to false negatives. Case report: V.L, male, 57 years old, previously rigid, who presented na insidious picture of memory loss and a progressive functional decline for one month and a half. On admission, he was alert, non-contacting, with evidente myoclonus in the upper and lower members and spasticity in lower members. The picture is compatible with rapidly progressive dementia, and the hypothesis of CJd was suggested. The skull CT showed microangiopathy. Clean looking CSF, negative bacteroscopy, non-reactive VDRL, negative nanquim exam and missing 14-3-3 protein search. EEG recorded abnormal rhythm secondary to moderate diffuse and persistente encouragement of fund activity, indicating mild diffuse brain dysfunction, possibly encephalopatic. Skull MRI, signs of restriction and diffusion compromising the caudate nucleus of the putamen bilaterally and symmetrically, and the parietal córtex, predominantly the left, compatible with CJd. Patient had normal thyroid function and hypovitaminosis of mild B12, corrected with intramuscular injection. Evolved in 25 days to akinetic mutism and died in one month due to bronchial aspiration pneumonia. Conclusions: The CJd is a pathology difficult to diagnose, the 14-3-3 protein research is subject to bias, the clinical and radiological findings strongly indicate CJd.
Persistent headache after infection with the new coronavirus (COVID- 19): A Systematic Review
Authors: Paniago Samyla Coutinho , Lellis Caio de Almeida , Pereira Priscila Arantes e Silva , Martins Camila de Assunção , Silva Sara Raquel Souza , Silva Ledismar José da
Published: December 2021

Introduction: The new evidence has shown that infection with the new coronavirus is responsible for a series of neurological sequelae, which can persist even after the patient’s recovery, with headache being one of them. Objective: To assess the current evidence on the persistent headache after the infection with the new coronavirus. Design and setting: A systematic review conducted at the Pontifical Catholic University of Goiás. Methods: Systematic review. After filtering the duplicate studies and reading the title, abstract and full text of the remaining articles, studies that did not meet the objectives were excluded. Results: After the infiltration of the virus in the Central Nervous System, it can be observed that systemic disturbances occur, which lead to headaches with mild to intense intensity, with sudden and bilateral onset and frontotemporal localization being its most frequent presentation. Patients with a previous history of migraine were more susceptible to headache during COVID-19 infection, noting differences in the form of manifestation. In addition, several studies have concluded that this symptom can persist for more than 80 days and predispose to chronic headache. Conclusion: In view of the analysis of the articles exposed in this study, we can infer that headache is present as a clinical manifestation of great importance in cases of infection with the new coronavirus, and future multicenter randomized studies may clarify the possibility of a chronification of this symptom after this disease.
Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a Carotid-Cavernous Fistula: Case Report
Authors: Manzato Luciano Bambini , Vanzin José Ricardo , Karam Octávio Ruschel , Martio Artur Eduardo , Angeliero Victor Emanuel , Köhler Luiza Rech , Mesquita Filho Paulo Moacir , Azeredo Saulo de , Escher Yasmynni , Kerber Emanuel
Published: December 2021

Context: Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are arteriovenous connections located in the dura mater leaflets of this region. DAVFs usually present with ocular symptoms such as diplopia, conjunctival hyperemia, involvement of cranial nerves III/IV/VI, etc. Trigeminal neuralgia caused by a cavernous DAVF is rare, being reported only three times in the literature. Case report: A 46-year-old female smoker sought care with a complaint of multiple daily episodes of shock-like right temporal headache and facial pain in the V1/V2 dermatomes, of 2 years’ duration. A clinical diagnosis of trigeminal neuralgia was established. Magnetic resonance (MR) imaging of the brain and MR angiography of the cerebral and cervical vessels were both normal. Conservative treatment and balloon compression of the trigeminal ganglion were ineffective. Therefore, we chose to perform an angiography for diagnostic clarification, which demonstrated a DAVF of the right cavernous sinus, fed by branches of the external carotid artery. We decided to catheterize the fistula and complete obliteration was achieved. Soon after the procedure the patient reported pain relief. At 3-month follow-up the patient remained pain free and required no analgesia. Conclusion: Trigeminal neuralgia caused by a cavernous DAVF is rare. The fistula in this case was only diagnosed after an angiography was performed, so clinicians must be aware that not all vascular conditions can be identified non invasively, and that cavernous DAVFs may be an underdiagnosed cause of trigeminal neuralgia.
Açaí: potential anticonvulsant agent
Authors: Tsukimata Márcio Yutaka , Silva Bianca Lumi Inomata da , Guimarães Jennison Alves
Published: December 2021

Background: Convulsion is an involuntary contraction of skeletal muscles. When considering vulnerable populations exposed to the mentioned pathophysiological situation, it is recognized that many of them will not have access to the indicated pharmacological treatment. Therefore, the ingestion of açai, Euterpe oleracea (EO) attenuates the problem, acting as an anticonvulsant. Objectives: evaluate the EO as an anticonvulsant agent. Design and setting: It is a bibliographic research and the data collection was done from the PubMed and Scielo databases. Methods: The descriptor used was “Euterpe oleracea” and the inclusion criteria adopted were: articles published in the last five years, available in full and publications related to epilepsy. Results: The EO acts on the GABAergic system when interacting occurs with the GABA receptor of cortical neurons and, above all, of astrocytes in an inhibitory mechanism for the uptake of the neurotransmitter GABA, that accumulates in the synaptic cleft, preventing the exaggerated neurotransmission that causes convulsions. In pentylenetetrazol-induced seizure (PTZ), EO showed some results similar to diazepam: reduced duration of tonic-clonic convulsion and increased latencies for the first myoclonic spasm and for the first generalized tonic-clonic seizure. Conclusions: Studies suggest that EO can be classified as an anticonvulsant, considering its inhibitory activity during synapses. Furthermore, the consumption of EO is more viable at a socioeconomic level compared to traditional drug treatments.
Epidemiological profile of hospitalizations in Brazil for malignant brain neoplasm among 2017 and 2020
Authors: Desteffani Karine Gomes Bandeira , Maia Jade Menezes , Souza Letícia Karen Rodrigues de , Nascimento Andressa Schmidt do
Published: December 2021

Introduction: The malignant brain neoplasm is the cerebral tumor constituted by primitives cells with neuronal and glial diferentiation. Objective: To evaluate the profile of hospitalizations due to malignant brain neoplasm registered in Brazil among 2017 and 2020. Methods: We performed a cross secctional study from public health system database of hospitalar morbity related to hospitalizations by year and federative unit among 2017 and 2020. Results: In the period from 2017 to 2020, Brazil registered a total of 58.177 admissions for Malignant Neoplasm of the Brain. The Southeast region had highest rate of hospitalizations in that time interval, with a total of 25,266 cases (highest rate was 2019, with 6.636 cases). South region was the second place, with 13.738 hospitalizations (highest rate was 2020, with 3.613 cases). Third, Northeast region with 11,197 hospitalizations (the highest rate was 2018, with 2,837 hospitalizations). Fourth, the Central-West region, where 5.586 were hospitalizaed (with highest number of hospitalizations in 2018, 1.469 cases). The North region has the lowest incidence, with 2,390 hospitalizations (highest rate was 2019, with 665 hospitalizations). In relation to the total result of hospitalizations, the year 2019 has the highest rate of hospitalizations (n = 14.966) and the year 2020 the lowest rate (n = 14.235). Conclusion: The Southeast region had the highest rates of hospitalizations due to malignant brain câncer and the year of 2019 had the higher prevalence of hospitalized.
Transcranial Direct current Stimulation (tDCS) in Treatment of Chronic Migraine
Authors: Medeiros Milton C. R.
Published: December 2021

Introduction: tDCS is a method of low intensity direct current electrical stimulation, modulating neuronal depolarization. Objective: to evaluate the efficacy of tDCS in the treatment of chronic migraine. Method: monitoring 4 women with ages varying from 27 to 46 years (mean 37.5 years), with chronic migraine according to ICHD-3 beta criteria. Randomized into 2 groups. Group 1, two patients with a mean age of 37.6 years, with pains 7 to 10 on the AVS (analogic visual scale). They received anodal tDCS, 2 mA for 20 minutes, in a primary motor area (M1), daily for 5 consecutive days, followed by a weekly stimulus for the next 3 weeks. Group 2 had two patients, with a mean age of 36 years, with pains ranging from 7 to 10 on AVS. They received SHAM, at the same frequency. Results: the patients in tDCS group had a reduction of 77% and 88% in pain intensity, in addition to a reduction of 53.3% and 46.6% in the frequency of crises. The sham group, on the other hand, had a 20% and 12.5% reduction in pain intensity, 20% and 13.3% in frequency. Conclusion: tDCS showed good efficacy in patients with chronic migraine when compared to simulated stimulation. The method proved to be safe, with no side effects in the cases monitored.
Main neurological changes in patients infected with Covid- 19: literature review
Authors: Maia Jade Menezes , Desteffani Karine Gomes Bandeira
Published: December 2021

Background: The world is experiencing a pandemic caused by COVID-19, which has already led to the death of 3.5 million individuals. In this context, the scientific community has made several discoveries, above all, that COVID-19 can promote other disorders, in addition to respiratory, such as the impairment of the nervous system. Objectives: To analyze the main neurological changes resulting from the infection by COVID-19. Design and setting: Cross-sectional observational study. Methods: Literature review with articles published in 2020, in journals indexed in the PubMed and Scielo databases, using the descriptors “Neurologic Manifestations” AND “covid-19, including articles in Portuguese and English. Results: Neurological symptoms have become increasingly recurrent in patients with COVID-19. SARS-CoV-2 reaches the Central Nervous System (CNS) through hematogenous or retrograde neuronal dissemination. Peripheral neuropathies and cerebrovascular events are associated with the severity of the disease. The elevation of D-dimer in critically ill patients triggers cerebrovasculares events, especially the development of ischemic stroke (stroke), which becomes more evident due to its risk factors. Changes in mental status are not limited to severe cases, and can occur at any stage of the disease, especially neuropsychiatric syndromes, such as anxiety, depression and post- traumatic stress. Conclusion: COVID-19, in an advanced stage, promotes peripheral neuropathies and cerebrovascular events. Furthermore, regardless of the severity stage, it can lead to changes in mental status.
Neurological findings of a series of patients with chromosome 18 trisomy (Edwards syndrome) in mosaic
Authors: Silva Bruno Custódio , Martins Hugo Roberto Sampaio , Salvador Thais Vanessa , Bobsin Guilherme Parmigiani , Zen Paulo Ricardo Gazzola , Rosa Rafael Fabiano Machado
Published: December 2021

Introduction: Chromosome 18 trisomy or Edwards syndrome (ED) is characterized by wide clinical manifestations, usually associated with neurological symptoms and a poor prognosis. Objective, materials and methods: Describe the clinical findings, especially the neurological ones, of a sample of patients with mosaic chromosome 18 trisomy. These were evaluated at a Clinical Genetics Service from 1975 to 2008. Results: During the study, 50 patients with ED were diagnosed, 5 of them (10%) in mosaic. The average number of cells analyzed in these cases was 27,8. Three of the 5 patients (60%) were male. The age at evaluation ranged from 14 to 5926 days (median 93 days). The small number of clinical findings described was noteworthy, both in the dysmorphological evaluation and complementary exams. The main changes were micrognathia (n = 3), low ears implanted (n = 2), retroverted ears (n = 3), clenched fists with overlapping toes (n = 2) and clubfoot (n = 1). As for internal organs, congenital heart disease was reported in 2 cases (40%). All patients had a history of delayed neuropsychomotor development. The older patient also had a description of cognitive impairment and seizures. Conclusions: The clinical presentation of our patients is consistent with what is described in the literature, since they point out due to small number of changes. However, the delay in neuropsychomotor development and neurological symptoms are constant findings. Thus, pediatricians and neurologists should be aware of this possibility.
Report of a family affected by fragile X syndrome and type 1 diabetes mellitus
Authors: Silva Bruno Custódio , Delazeri Gisele , Konopka Ana Luíza Kolling , Vargas Giulia Righetti Tuppini , Zen Paulo Ricardo Gazzola , Rosa Rafael Fabiano Machado
Published: December 2021

Context: The fragile X syndrome is characterized by intellectual deficit and some physical characteristics, which become more evident during growth, especially craniofacial and macroorchidism. Case report: A 22 year-old male patient with diabetes mellitus type 1 (DM1) diagnosed at 7 years of age is following-up with ophthalmology due to low visual acuity. On physical exam, he did not maintain eye contact and performed repetitive movements. In addition, he had an elongated face and upward slanting eyelid clefts, a high palate and prognathism, large and prominent ears. In the family history, 3 of his siblings, one male and two female, also had intellectual deficit, and two of them had concomitant DM1. One brother had only DM1 and the other none of the diseases. The parents had consanguinity (they were cousins in the 3rd degree). The patient’s karyotype, using the chromosomal breaks technique after cultivation in medium-low folic acid, showed the presence of fragility on the X chromosome in the region q27.3 [46, XY, fra (x) (q27.3)], compatible with the diagnosis of fragile X syndrome. This result was confirmed using the PCR-multiplex technique. Conclusions: In this family, the concomitant presence in several individuals of the fragile X syndrome and DM1 stands out. However, although both conditions are not related, they are frequent, which could justify their simultaneous occurrence.
Effects of Euterpe oleracea Martius (açaí) consumption on the nervous system: a literature review
Authors: Santos Fernanda Barbosa Gomes dos
Published: December 2021

Background: Euterpe oleracea Martius, popularly known as açaí, is an abundant palm in the Amazon region. Its fruit is consumed after pulper processing, to obtain the açaí drink, whose flavonoid-rich composition draws attention to its antioxidant properties and can be used in neurodegeneration processes, slowing the progression of dementia and neurological disorders. Objectives: to list what is known at the time of this review regarding the effects of the consumption of the pulp, juice or extract of the fruits of Euterpe oleracea Mart. on the nervous system. Methods: systematic review of the literature carried out in the PubMed database using the descriptors provided by the DeCS platform: (effects) AND (euterpe oleracea) OR (açaí) AND (nervous system). A total of 33 results were obtained. Using inclusion and exclusion criteria, 24 articles were selected. Results: a positive action of this plant was observed in the modulation of free radicals and prevention of premature aging, which reveals the ability of açaí to delay the natural deterioration of cognitive function that occurs with advancing age. In addition, flavonoids act in the perivascular sheath, aiding in the growth of neuronal cells, among other things, such as the containment of neurotoxin- induced neuronal lesions and protecting from others neurotoxical compounds. Finally, the Euterpe oleracea was able to attenuate depressive symptoms and epileptic seizures. Conclusions: there is a need for further studies on this topic, in order to ratify the findings that are known to date, opening the way for new strategies to protect the nervous system’s functions.
Cannabidiol in the treatment of Dravet Syndrome: a literature review
Authors: Lacerda Luiz Müller Pimentel Delfim , Assis Laís Costa Lage de , Santos Letícia Silva Brandão dos , Gonçalves Mateus Figueiredo , Viana Ivan Magalhães
Published: December 2021

Background: Dravet syndrome (DS) is a rare treatment-resistant epileptic encephalopathy, with a high mortality rate, resulting from mutations in the SCN1A gene (encoding the α1 subunit of the NaV1.1 channel). Studies show that cannabidiol is effective in reducing the frequency of seizures. Objective: Analyze the efficacy of cannabidiol for the treatment of refractory epilepsy in DS. Methods: In April 2021, the PubMed database was queried to search for the terms “Cannabidiol” AND “Dravet Syndrome”, with the filters: Clinical trial, Randomized controlled trial and the articles were limited to the last 5 years. With this, 8 articles were found, of which 3 were selected. Exclusion criteria: (1) articles that didn’t evaluate the effectiveness of treatment (2) review articles. Results: A randomized, double-blind study of 120 patients, which a dose of 20 mg/kg/day was used, found that cannabidiol use led to lower frequency of seizures, reducing from 12, 4 to 5.9 seizures per month; and 5% of participants were seizure-free. A similar reduction was documented by an open clinical trial, which there was a reduction of 39.5% in total seizure frequency and 2.9% were seizure-free. Additionally, another randomized, double-blind study reported a percentage reduction in seizure frequency of 48.7% for the group of patients given 10 mg/kg/day, and 45.7% for the group given 20 mg/kg/day. Conclusion: In DS patients, cannabidiol shows efficacy to reduce the frequency of seizures. However, more studies are needed to validate its application.
Epidemiological analysis of live births with microcephaly in Brazil
Authors: Lopes Gustavo Vieira , Sousa Liliane Emilly dos Santos , Silva Antonio Márcio Teodoro Cordeiro
Published: December 2021

Introduction: Microcephaly is a congenital malformation in which babies are born with a head circumference equal to or less than 32 cm. This pathology can be the result of a number of different factors: chemical substances and biological agentes, such as bacteria, viruses and radiation. Objectives: To characterize the epidemiological profile of cases of live births with microcephaly in Brazil. Methods: This is a descriptive and observational epidemiological study. Data from the Informatics Department of the Unified Health System (DATASUS) were extracted, about the number of live births with microcephaly between 2009 and 2019, in Brazil, according to: year, state and ethnicity. Results: 6,267 live births with microcephaly were recorded. The year of 2016 was responsible for the largest number of cases (n = 2,276; 36, 3%). As for ethnicity, brown births represent the majority, with 3,957 (63.1%) cases, followed by white ethnicity, with 1,562 (24.9%) cases. The state of São Paulo, with 1,265 (20.2%) cases, had the highest number of live births with microcephaly, followed by the state of Pernambuco, with 929 cases (14.8%), and Bahia, with 704 cases (11.2%). Conclusions: The number of live births with microcephaly was more frequent in the years 2015 and 2016. São Paulo, Pernambuco and Bahia were the most affected states. It was found that individuals born with brown and white ethnicity were responsible for the majority of cases of live births with microcephaly. In this sense, public health policies are necessary aiming to decrease the incidence of births with the studied pathology
Complementary Exams for Dementia Diagnosis
Authors: Paiva Mateus Coelho , Dornelas Ana Júlia Santana , Pereira Anne Caroline Castro , França Bruna Paiva de , Pereira Camila Nakamura Perissê , Castro Camila Taveira de , Vitoi Catherine Rezende , Freitas Gabriel Serpa de , Sá Guilherme Fonsêca de Azevedo e , Martins Mariana Cunha Campos , Luz Pedro Enzo Camargo , Perissê Rafaella Afonso Tormin , Aguiar Yngrid Carneiro
Published: December 2021

Background: It is estimated that by 2050, over 130 million people will have dementia. These syndromes are neuropathologies that can be diagnosed with higher accuracy with a support of complementary exams. Objectives: Review literature about de importance of complementary exams for a better management of dementia syndromes. Methods: A search was carried out in the databases PubMed/MEDLINE, LILACS and Google Scholar using the DeCS descriptors: “dementia”, “mental status and dementia tests” and “diagnosis”. Nine articles, from 2005 to 2020, in English and Portuguese, were submitted to critical analysis. Results: A clinical evaluation, biomarkers and neuroimage techniques can improve diagnosis management of dementia syndromes. Changes in the early stages include memory loss. Therefore, Mini Mental State Exam can be used. The biomarkers include ß-amiloid and tau protein in the cerebrospinal fluid. Other exams can detect the lack of vitamin B12 and folate, hypothyroidism and infectious diseases. The computed tomography (CT) is fundamental to exclude secondary causes. In magnetic resonance the brain is seen atrophied. Conclusions: This review shows studies that indicate the relevance of complementary exams for the diagnosis of dementia. It could be seen that the association of molecular analysis and neuroimage can be benefic for a better diagnosis.
Analysis of the performance of adults and elderly people in the mini-mental state examination in Recife-PE
Authors: Plácido Talita Gabriele de Queiroz , Rocha Filho Pedro Augusto Sampaio , Silva Júnior Mário Luciano de Mélo
Published: December 2021

Background: The Mini-Mental State Examination (MMSE) is the most widely used cognitive screening test in the world. However, there is no standardization as to the cutoff points to be used in Brazil, and the influence of education on performance is still under debate. Objectives: To analyze the performance of individuals in the MMSE, comparing the results according to different scoring criteria and correlating it with schooling. Design and setting: Cross-sectional, descriptive study with 18 individuals, from January to April 2021, in Recife, Pernambuco. Individuals over 40 years old, with schooling from 4 years on, were included. Methods: Data were analyzed using the SPSS software, Shapiro-Wilk test, and Pearson’s correlation coefficient (PCC). Results: The population is composed predominantly of women (89%), with an mean age of 56.3 years (SD = ± 8.58), education level of 12.4 (SD = ± 4.26) and an average score of 25.7 points (SD = ± 2.31). Performance was correlated with education (PCC = 0.589; P = 0.001). The fields with the highest prevalence of errors were the copy of the pentagons (61.1%), and the writing of the authorial sentence (44.4%). The percentage of individuals with cognitive decline varied according to the criteria used, ranging from 33.3% to 77%. Conclusions: Education is correlated with test performance. The variation in the prevalence of individuals who scored below the cutoff point shows that standardization of the assessment could minimize possible disparities
Management of road transport-induced air pollution in urban areas: A case study of Owerri, Nigeria
Authors: Onyeka JO  , Obi LE  , Igiri VC
Published: December 2021

Environmental concerns have continued to be on the increase as human activities soar. One such environmental concern is air pollution. A major contributor to air pollution is the road transportation activities. This paper sets out to provide a management strategy for air pollution owing to road transportation in urban areas, with Owerri Nigeria as a case study. A field study was conducted in Owerri to ascertain the total passenger requirement, number and mix of passenger vehicles as well as measure three main road transport-induced air pollutants at five locations in the city. The result of the field work showed existing commuter vehicles mix of 56.2:63.7: 19.6:1.6:1 of salons, wagons, mini-buses, coaster buses and big buses respectively, of a total of 85,950 vehicles and air ambient pollutants level higher than the recommended standards. A new model was developed to achieve a remix of 10:33:53: 14:1 of same vehicle types and reduction in traffic volume and target air pollutants. The analyses show that mini-buses and coaster buses have advantage over salon cars, wagon vehicles and big buses in terms of traffic congestions and pollutants release into the environment. The two bus types could be said to have least pollutants release per passenger carried. An optimal vehicle remix, which gives higher priority to these buses have been shown to reduce congestion by 40%, Carbon monoxide by 40%, Nitrogen Dioxide by 50% and Methane by 50%. It therefore recommends that vehicular remix of 10:33:53: 14:1, for salon: wagon: mini-buses: coaster buses: big buses be adopted for Owerri commuters’ transportation need. It concludes that governments should adopt economic instruments embedded in a “push and pull” strategy, leveraging on disincentive and incentive measures to skew road transportation to the use of mini and coaster buses as a deliberate means of reducing air pollution in cities.
Investigation of water and heat response to the compression property of raffia, bamboo and coconut fiber-reinforced-polyester composites
Authors: Obi LE  , Uwanugo RG  , Uchejiora M
Published: December 2021

The dearth of construction materials has been the bane of the global construction industry. In a bid to curb this menace, it becomes very imperative to source for construction materials from discarded and least costly materials from raffia, bamboo and coconut fibers. This research investigates the hydrothermal response of plant fiber-reinforced-polyester composites (PFRC). Imperical methods were used to determine the mechanical properties of PFRC (bamboo, raffia and coconut fiber composites), with the usage of Monasanto Tensometer testing machine. All the samples were chemically modified with 12.5g of sodium hydroxide. Numerical and micro-soft excel graphics were used to model compressive responses of the PFRCs. From the analyses, the compressive strengths of raffia, bamboo and coconut composites are 40, 45 and 38MPa respectively.
Study of the effect of process parameters on the yield of fermentable sugar from red cocoyam (Xanthosoma sagittifolium) peels via acid and enzyme hydrolysis
Authors: Onoh Ikechukwu Maxwell  , Anho Lawrence Oghenerivwe  , Egwuagu Onyekachi
Published: December 2021

The aim of this work is to study the acid and enzymatic hydrolysis of cocoyam peels using HCl, H2S04 acids and cellulase enzyme. The cellulase was secreted from Aspergillus Niger (A. niger) fungi. The proximate analysis of the substrate showed that cocoyam peel is a lignocellulosic biomass with a cellulose composition of 48%. The effect of the process parameters (time, temperature, acid concentration and pH) on the yield of glucose in acid and enzymatic hydrolysis of the cocoyam peel was respectively investigated. Maximum glucose yield of 44.5% was obtained after 3 days of enzymatic hydrolysis at 30°C and pH 5. The HCl acid hydrolysis showed a maximum glucose yield of 27.3% at 70°C, 5% HCl after 180 minutes. The glucose yield in H2S04 hydrolysis was relatively lower than that of the HCl with a maximum yield of 26.5% at 70°C, 5% H2SO4 after 180 minutes. In addition to, the functional groups present in the glucose synthesized from cocoyam ground peels and the standard glucose were evaluated using Fourier Transformed Infrared (FTIR). The FTIR results showed similarities in the functional groups present in both sugars. Cocoyam peel can be used for the production of glucose and further fermentative process to produce ethanol.
Reflective Practice at a Private Sector Medical College
Authors: Mughal Aamir Abbas , Razaq Nadeem , Saif Ullah Muhammad , Ikram Sadia , Sarfraz Farrukh , Sarfraz Fahad
Published: December 2021

Introduction: To create both professionally and actually, wellbeing professionals need to construct fundamental aptitudes in reflective practice. Facilitators in general are agree that these skills should be created as portion of educational module for the wellbeing of professional students. The aims were to present reflective practice to third-year medical students and to evaluate the students’ self-perceived reflective aptitudes before and after their reflective exercises. Objective: Using a composed survey, third-year medical students’ perceptions of reflective practice were accumulated before and after their clinic placement. Students moreover completed two reflective writing pieces about their clinical placements. Material and Methods: Study design: Quantitative, Cohort study. Settings: Akhtar Saeed Medical College, Lahore Duration: 1 Year i.e. 1st September 2020 to 30th August 2021. Results: The students’ reflective writing papers were distributed into one of the three categories: non-reflector, reflector and critical reflector. Content investigation of students’ perceptions of reflective practice uncovered nine topics. Eight fundamental topics emerged from students’ proposals for moving forward their reflective capacities. Conclusion: It concludes that student’s issues around the appraisal of reflective writing are discussed, and students’ recommendations for progressing their reflective capacities are displayed. Key words: Reflection in practice, reflective learning, quality assurance
Knowledge and Attitude Towards Organ Donation Among Medical Students
Authors: Shoaib Najma , Yousaf Nida , Akram Roman , Inam Asma , Saeed Saboohi
Published: December 2021

Objective: To analyze the knowledge and attitude among medical students regarding organ donation. Study design: A cross sectional study Placement and Duration: The study was conducted during the period of six months from September 2019 to March 2020 at Azra Naheed Medical College Lahore. Materials and Methods: Sample size was 150 a predesigned close ended questionnaire was used to collect data, out of which 8 incomplete questionnaires were excluded. SPSS version 21 was used to analyze the data. Results: Overall, 130 respondents were aware of the term organ donation out of which 74 wish to donate their organs. The main barriers related to organ donation during life and after death include mainly religious beliefs, fear of surgical procedures, misconception that they cannot donate because of some medical illness, having a cultural belief that the body should be kept intact after death or having a fear that their body will be disfigured after donating an organ. 90.8% respondents believe that there is a need to promote organ donation. Greater load of information come from social media. Conclusion: It can be concluded that there is a need to promote organ donation. Identified barriers should be taken in the account while motivating the population to donate in future. Key words: Organ donation, Attitude, Barriers
Evaluation of Elbow Range of Motion Following Delayed Surgical Fixation of Pediatric Supracondylar Humerus Fractures: A Prospective Study
Authors: Majeed Farhan , Ashraf Maham , Tahir Mohsin , Shams Ahmad , Hussain Mumtaz
Published: December 2021

Introduction: To achieve excellent functional outcome in Pediatric Supracondylar fractures, early surgical fixation is recommended. Unfortunately, there are still some cases which have delayed presentation to the medical health care, leading to delay in appropriate management required for a good functional outcome. We studied the functional outcome, in terms of range of motion following fixation of type III supracondylar fracture of humerus in children presenting 10 days after initial injury. Materials & Methods: This was a prospective study conducted at The Children Hospital and Institute of Child Health, Lahore between February 1st, 2020 and July 30th 2021. Following approval from the Institutional Ethical committee, 44 pediatric patients presenting to the Emergency and outpatient department with initial trauma to affected elbow more than 10 days old with Supracondylar Fracture of Humerus extension type III were admitted and Open Surgical Fixation with K-wires was performed and Half Cast above elbow was applied for 3 weeks. Goniometer was used to measure range of motion of the effected elbow following the removal of half cast on the day of removal of cast, at 1 week, 2 weeks, and then at 2 weekly intervals until 90 % of Range of motion of the contralateral normal elbow was achieved. Results: The mean delay in presentation was 13.20 ± 2.66 days. None of the patients had close manipulation attempted. Mean Hospital stay was 40.20 ± 1.46 hours. It took a mean of 35.25±2.79 and 49.43± 1.21 days to achieve 90% range of motion in extension and flexion (p-value ≤ 0.001). On average extension was achieved earlier than flexion range of motion. Conclusion: Our study showed good functional outcome in terms of elbow flexion and extension in patients managed after delayed presentation of supracondylar humerus fracture but taking longer time to achieve 90% ROM of the normal elbow. Despite delayed presentation being common in our population, it is not associated with increased peri and post-op complications. Because the ROM improves over time, prolonged follow up is all that is required in such patients. Key words: Delayed fixation, Pediatric, Supracondylar Fracture
Characteristics of Ovarian Cysts Observed in Doppler Ultrasound
Authors: Akram Saba , Ashraf Aasma , Zahur Zainab , Saleem Aniqua , Ashraf Safia , Nazir Nadia
Published: December 2021

Background: Ovarian cysts known as ovarian masses, are commonly found incidentally in asymptomatic women. Ovarian cancer is the 7th most frequent cancer in women worldwide, as well as the eighth leading cause of cancer death. Ultrasonography is the principal imaging technique for confirming the mass ovarian origin and determining whether the mass is benign or malignant. Method: This descriptive cross sectional study was conducted from 15 June to December 2019 in the Radiology Department of Avicenna Medical College. A total of 90 ultrasounds undertaken at the Gynecological Ultrasound Unit. A total of 32 patients with functioning ovarian cysts were included. A total of 46 individuals with benign tumors and 9 patients with malignant cysts were included in the control group. The remaining patients were not followed up on and were treated at a different center. The majority of the patients had issues with their menstrual cycle and pain. Results: The mean age of the patients was 35.6+9.16. In functioning ovarian cysts, benign tumors & ovarian tumors. The functioning ovarian cysts had a mean size of 40.8 mm +16.35 mm. Differences were significant found between1this group & other1two groups: A mean size of 61.75 +65.5; P, 0.001 was seen for non-functional benign ovarian disease; and the average size of malignant cysts was 85.9 +50.6; P = 0.001. Out of 32 functional1ovarian cysts, 22 were found by ultrasonography, 8.0 were not identified and 2.0 cases were1diagnosed ultra-sonographically as functional ovarian cysts but histologically revealed to be benign ovarian cysts (non-functional). The sensitivity of color Doppler ultrasound was determined to be 82.0%. Conclusion: The study's findings revealed that ultrasound had an 82 percent sensitivity in diagnosing ovarian masses, increasing its accuracy. As a result, ultrasonography appears to be the first modality of choice in the examination of any woman suspected of having an ovarian tumor. Also, to rule out the need for unnecessarily surgical procedures in benign lesions. Keywords: Ovarian Cysts, cancer, ultrasound
Análise da confiabilidade humana em um laboratório de análises clínicas utilizando FMEA e FTA
Authors: Rosa Ariane Ferreira Porto , Brito Jordana Rubin , Royer Rogério , Santos Gilberto Tavares dos
Published: December 2021

A análise de confiabilidade humana surge como suporte para quantificar e qualificar as falhas relacionadas às pessoas na execução de processos. Este trabalho apresenta um estudo de caso com o objetivo analisar a confiabilidade humana nos processos de atendimento de clientes e coleta de material biológico em um laboratório de análises clínicas. A pesquisa constituiu-se das seguintes etapas: revisão da literatura sobre os conceitos de falhas humanas e métodos para análise dessas falhas; mapeamento dos processos a fim de caracterizar falhas, levantamento do quantitativo de falhas por tipo e processo; análise do risco das falhas por meio da aplicação do método FMEA (Failure Mode and Effect Analysis); análise das causas das falhas, com o suporte de FTA (Fault Tree Analysis); e conclusões acerca das análises realizadas durante a pesquisa. Os levantamentos e análises realizados permitiram categorizar as falhas entre erros e transgressões e priorizar ações para preveni-las. Constatou-se que a ocorrência dessas falhas pode ser reduzida, se a qualificação profissional dos funcionários for consolidada.
Reflexões sobre o conceito de direito e seu encontro com a literatura a partir da desconstrução
Authors: Nogueira Bernardo Gomes Barbosa , Ribeiro Fernando  José Armando
Published: December 2021

O presente texto dialoga com a obra “A besta e o soberano” de Jacques Derrida em um encontro com o pensamento de Slavoj Zizeck a respeito da violência, além de tratar alguns conceitos de Roland Barthes com o intuito de evidenciar a noção violenta que constitui o próprio do direito, apontando como a literatura, na perspectiva do movimento “Direito e Literatura”, pode contribuir para avivar a discussão acerca da necessidade de desconstrução do conceito de direito instituído na história ocidental.
Optimalisasi Penatalaksanaan Kegawatan di Ruang Kegawatdaruratan pada Era New Normal
Authors: Yari Yarwin , Rahmawati Veronica Yeni , Ernawati Ernawati , Yesayas Fendy , Lestari Ayu , Jaya Arizton Putra , Sari Eni Fatma
Published: December 2021

Abstract: Since COVID-19 was first discovered in Wuhan, it has caused COVID-19 referral hospitals to be "overwhelmed" including in Indonesia. In patients with confirmed COVID-19 or in patients with suspected COVID-19, the Basic Life Support (BHD) does not need to be postponed. However, there are some principles that must be adapted to keep patients and caregivers safe. The purpose of this community service activity is to increase the knowledge and insight of participants in general regarding emergency management during the COVID-19 pandemic. The method in implementing community service activities is divided into several stages, namely first conducting socialization, conducting webinars, followed by FGD. The result of this activity is that there is an increase in BHD knowledge among emergency room nurses before and after participating in the training. The provision of online BHD knowledge and training has proven to be effective in increasing the knowledge of emergency room nurses
Penyuluhan Bahaya Petasan di Pesekutuan Anak dan Remaja (PAR) Rayon Remu Selatan Jemaat GKI Maranatha Remu Kota Sorong
Authors: Talakua Febry , Etnis Baktianita R. , Ruhukail Pricilya P.
Published: December 2021

Playing firecrackers has become a tradition for the community, including children when welcoming big holidays such as Christmas, Eid, and New Year's Day. However, not infrequently playing firecrackers brings disaster to those who play them, especially children. Counseling about the dangers of firecrackers is one of the efforts to increase the understanding of children and adolescents about the dangers of firecrackers and their negative impacts. This activity aims to increase the knowledge of children and youth of the South Remu district of the GKI Maranatha Remu Congregation about the dangers of firecrackers. The method used is counseling with lecture and discussion methods. Submission of material through using PowerPoint. The results showed that the average pretest value of knowledge of the dangers of firecrackers in children and adolescents was 4.6 and the posttest was 8.4, with a change in value before and after counseling was given as much as 3.8 points. This activity concludes that the knowledge of children and adolescents about the dangers of firecrackers increases after being given counseling, for that it is hoped that the government, religious institutions, universities, and NGOs will always carry out outreach activities on the dangers of firecrackers to children and adolescents.

Keywords: Knowledge, Danger of Firecrackers, Children, and Adolescents.
Perubahan Mood saat Premenstrual Syndrome pada Remaja Putri
Authors: Gurning Maylar , Pademme Dirgantari
Published: December 2021

Premenstrual syndrome (PMS) is a common cyclical disorder teenage girl, characterized by consistent physical and emotional symptoms. Symptoms are predictable and usually occur on a regular basis 7-10 days before menstruation and will disappear at the time of menstruation. The most common PMS symptoms experienced by women during premenstruation include feelings of irritability and anxiety when dealing with PMS, lack of energy or weakness and irritability. Therefore, providing education related to PMS can provide input and knowledge to young women during PMS. The method of implementing the service is by providing education and assistance to adolescents about mood changes that occur during the occurrence of Premenstrual syndrome (PMS), because providing education related to PMS can provide input and knowledge to young women during PMS.
TRATAMIENTO ENDOSCÓPICO DE UN TUMOR URETERAL
Authors: González León Tania , Hernández Campoalegre Michel , Quintana Rodríguez Maykel , Rodríguez Cabrera María , Sánchez Tamaki Roberto , Castillo Rodríguez Mariano
Published: December 2021

OBJETIVO: Presentar el caso clínico de un paciente con diagnóstico de tumor urotelial del uréter al que se le realizó ablación con láser. ANTECEDENTES:   El tumor urotelial del tracto urinario superior es una entidad infrecuente. Representa entre el 5-10% de las neoplasias uroteliales. En las últimas décadas la conservación de la unidad renal ha conferido un papel importante al tratamiento endoscópico de estos tumores en pacientes seleccionados. MATERIAL Y MÉTODOS: Se reporta un paciente de 71 años con un tumor del uréter pélvico. Se hace referencia a los estudios imagenológicos y se muestran, al igual que la cirugía. Se realiza una breve revisión del tema. RESULTADOS: Se trata mediante ureteroscopia con ablación con láser. Evolucionó satisfactoriamente. En el seguimiento a seis meses no se comprueba recurrencia local ni vesical. CONCLUSIONES: La cirugía conservadora de nefronas es una opción en los tumores del urotelio del tracto urinario superior localizados, no músculo-invasivos y de bajo grado. La ablación con láser mediante ureteroscopia es una de sus modalidades cuando se localiza en el uréter distal. Después de este tratamiento los pacientes requieren un seguimiento estricto.
¿CÓMO HA IMPACTADO LA PANDEMIA COVID 19 EN LA PRÁCTICA DE UROLOGÍA EN EL ECUADOR?
Authors: Alarcón Salvador Juan Felipe , Rosero Morillo María Fernanda , Coronel Godoy Francisco Xavier
Published: December 2021

Introducción: El objetivo principal de este estudio es conocer como ha impactado la pandemia COVID-19 en la práctica urológica en el Ecuador. Material y Métodos: Se realizó un estudio epidemiológico descriptivo de conjunto a médicos urólogos/as y residentes de Urología del Ecuador utilizando una encuesta de 25 preguntas acerca de la práctica urológica y su afectación por la pandemia de COVID-19, encuesta realizada durante los primeros meses de la emergencia sanitaria : marzo abril y mayo de 2020. Resultados: Se  recibieron  un  total  de  90 respuestas;  69 hombres y 21 mujeres, de los cuales el 30 % contestó que en la institución en la que laboran continuaban realizando cirugías electivas, el 82,2 % han participado en cirugías de emergencias, siendo la nefroureterolitiasis su principal causa, el 14,4 % ha realizado alguna intervención quirúrgica en un paciente COVID-19 positivo, el 70 % considera que la principal medida para protegerse es el uso de equipos de protección personal, pero el 53,3 % de los médicos han sufrido alguna afección por el uso de EPP; con el fin de continuar con la atención con los pacientes el 44 % atendió a sus pacientes personalmente y el 24,4 % difirió sus consultas externas. Conclusiones: La pandemia de COVID-19 representa un reto global y principalmente a países en vías de desarrollo como Ecuador con un sistema de salud donde la falta de insumos, protocolos de manejo y capacitaciones es un problema cotidiano; la práctica urológica se enfrentará sin lugar a dudas a cambios sin precedentes.