bluuebunny/crossref_metadata_2025 huggingface dataset:
The application of next generation and whole genome sequencing in the diagnosis of hematological disorders and challenges to apply in routine diagnosis
Authors: Getawa, Solomon , Melku Mulugeta
Published: February 2023

By assessing a patient's genetic makeup at a low cost, next-generation sequencing (NGS) technologies have begun to change the area of hematological malignancies. High-throughput, massively parallel DNA sequencing technologies are rapidly revealing new information in hematology, cancer, clinical genetics, and a variety of other diseases. It provides researchers with a new viewpoint on the onset of sickness, risk assessment, and therapeutic action. In hematology these technologies are used to diagnose hematological malignancies, inherited coagulation bleeding disorders, minimal residual diseases, hereditary hemolytic anemia, and blood typing. The use of next-generation sequencing in regular diagnostic procedures raises a number of challenges, including result interpretation, laboratory workflow, data storage, and ethical concerns.
Analysis of leukocyte cell population data (CPD) as biomarkers in the diagnosis of sepsis
Authors: Rigo IM Portell , Rodríguez R Alarcón , Bellido MP Benayas , Oyonarte C Avivar
Published: February 2023

Background: Leukocyte cell population data (CPD) are parameters currently being studied as biomarkers in sepsis and other pathologies. CPD was procured with the BC 6800 Plus Mindray® hematology analyzer that also provides information on the internal cellular complexity, nucleic acid content, and size of leukocytes. This study aimed to assess the efficacy of CPD parameters as biomarkers in the diagnosis of sepsis by comparing these with the standard sepsis biomarker, procalcitonin (PCT). Methods: In total 107 patients with suspected sepsis were included in the study, and serum procalcitonin levels were measured and WBC cell population data (CPD) were analyzed in a hemogram to confirm the diagnostic accuracy of these biomarkers. ROC curves were plotted for all parameters and patients were categorized based on their serum procalcitonin levels. IBM SPSS Stadistics version 24 was used for statistical analysis of the data. Results: All parameters except the CPD NEU-X (neutrophil complexity), NEU-Z (neutrophil size), LYM-Z (lymphocyte size) and MON-Z (monocyte size) showed statistically significant results (p<0.05). ROC curve analysis showed that the CPD parameters MON-X and NEU-Y had area under the ROC curve (AUC) > 0.7, reflecting the better diagnostic performance in sepsis. A lower AUC of 0.650 was obtained for PCT; 87.8% of septic patients had serum PCT levels between ≥5 ng/mL and 51.2% ≥ 2 ng/mL. Conclusion: This study suggests that some of the new CPD parameters (MON-X and NEU-Y) have the potential to be a useful diagnostic marker for sepsis.
SARS-CoV-2 pandemic and its impact on blood transfusion services: challenges, experience and lessons learnt at king Abdullah medical city, Makkah, Saudi Arabia
Authors: M Aljedani Hanadi , F Alshaikh Abdulaziz , Mokhtar Arwa , Anwar Farzal
Published: February 2023

SARS-COVID (COVID-19) epidemic is a great challenge for blood transfusion practice. Hospitals were overwhelmed with increasing number of admitted patients with severe COVID-19 infections as well as limitation of variable medical and pharmaceutical resources partly due to lockdown. This retrospective study analyzes the transfusion medicine practice and approach of health institution toward the pandemics before and during the pandemic era over the four years period, 2018 through 2021. Data was collected from blood bank records and laboratory information system for the whole blood donors, apheresis platelets donors, numbers and types of prepared blood components, details of blood components storage and expiry, and blood components for the study period. The data analyzed showed that the total number of whole blood donors dropped during 2020. However, there is a steady increase in number of voluntary non-numerated whole blood donors. The production of packed Red Blood Cells units, Fresh Frozen Plasma units, and Cryoprecipitate units were actually more or less similar or slightly higher in 2020 compared to 2019 and 2018. However, the production of Platelets components showed a drop during 2020. The transfusion for patients at the institution has slightly increased for 2020 compared to 2019. Therefore, the need to procure blood components from other facilities was increased in 2020 compared to pre COVID-19 pandemics. The percentage of expired and wasted blood components units steadily decreasing over the past few years. The data of expired and or wasted collected blood components were compared through the study period and it illustrates that the percentage of expired and wasted units was steadily dropped over the years. This to mention that automated blood transfusion system was implemented late 2019 and put in full effect in 2020. The presence of validated and secured electronic system supports blood bank to eliminate the number of expired and wasted units due to proper inventory management. Along with all the hard work to maintain adequate and safe blood supply to increasing requests of blood transfusion, blood bank at KAMC participated in the national multidisciplinary study of Convalescent Plasma use for critically ill COVID-19 patients.
Correlation between morphology and immunophenotype in the diagnosis of pure erythroid leukemia
Authors: Raúl Aragón Abrantes Ariel , Elena Sosa Saez Liekna , Hernández Aguiar Danelis
Published: February 2023

Pure erythroid leukemia is a rare entity that represents less than 5% of pediatric acute myeloid leukemias and is classified according to the World Health Organization (WHO) within the group of unspecified acute leukemias. A clinical case of a 5-year-old patient admitted with septic arthritis in the Pediatric Hospital, he also presenting with fever and anemia, for which a medullogram and immunophenotype were performed and erythroleukemia was diagnosed. It can be concluded that it is necessary for its diagnosis to integrate clinical, morphological and immunophenotypic, genetic and molecular studies.
Ecthyma gangrenosum complicating first line treatment of chronic lymphocytic leukemia
Authors: Drideb N Alami , Bouchnafati S , Khoussar I , Ouazzani M , Ghandour W , Khammar Z , Berrady R
Published: February 2023

Ecthyma Gangrenosum is a severe skin disease commonly associated with Pseudomonas aeruginosa septicemia, there is an increased risk of infection in patients with malignancy undergoing chemotherapy notably Chronic lymphocytic leukemia (CLL). We present a case report of CLL patient infested by P. aeruginosa.
Primary immune thrombocytopenia and cytomegalovirus infection About a case
Authors: Raúl Aragón Abrantes Ariel , Elena Sosa Saez Liekna , Hernández Aguiar Danelis
Published: February 2023

Primary Immune Thrombocytopenia (ITP) is an acquired coagulation disease characterized by a decrease in platelets below 100 x 109/L in the absence of other causes of thrombocytopenia and that may be preceded by viral processes or vaccination. A 16-year-old male adolescent who presented a febrile syndrome was diagnosed as part of the studies as an infection by cytomegalovirus, later he began to present purpuric hemorrhagic manifestations on the skin and mucous membranes, for which a medulogram was performed and the diagnosis of Primary ITP was made. Conclusions: an adolescent who developed a TIP after cytomegalovirus infection, requiring treatment with steroids and valganciclovir for its management.
Comparative study between a deterministic and stochastic model´s for the hematopoietic reconstitution
Authors: Ángel Martínez Hernández Miguel , Lumpuy Obregón Dennis
Published: February 2023

The dynamics of the processes of cell maturation and regeneration is a branch currently in development for medicine, so taking advantage of the facilities of mathematics to model and solve environmental problems, different models of differential equations have been developed to describe these processes. From the existing deterministic models, the particular case of the hematopoietic cell is chosen, for of a comparative study on the influence of the medium on the process of cell maturation. For this, a probabilistic model of differential equations with six compartments is used. The stochastic term or environmental noise in this particular case modeled by a Weiner process. The inclusion of this term makes it possible to perform an analysis conditioned on the influence of the medium of the different processes of cellular maturation, in this case, of the hematopoietic cell. It is established that the stochastic model reflects a more precise approach to the clinical data used.
Rhesus (Rh) blood group antigens in multiparous women attending antenatal clinic in tertiary hospital, port harcourt, Nigeria
Authors: Baribefii Jacob Ransom , Covenant Eboh , Dorka ThankGod Sorgah , Beatrice W Moore-Igwe
Published: February 2023

The routine blood screening test carried out for pregnant women attending antenatal clinic in Tertiary Hospital Port Harcourt, Nigeria especially with regards to blood group system is limited to ABO/Rh D antigen screening. This cross-sectional, hospital-based study was aimed at determining the prevalence of the Rh C, c, E and e blood group antigens in multiparous women attending antenatal clinic in Tertiary Hospital Port Harcourt, Nigeria. A total of one hundred and twenty (120) pregnant females within the age range of 18-40years were recruited randomly into the study between February-June, 2022. Blood samples were aseptically collected by venipuncture into EDTA sample bottle; Rh C, c, E and e blood group antigens were assay for using microwell agglutination technique. Data generated was statistically analyzed by simple percentage calculation and defining the percentage frequency of Rh antigens. Results obtained showed the percentage distribution of 17.5% for Rh C, 89.2% for Rh c, 39.2% for Rh E and 90.8% for Rh-e. Percentage distribution of Rh antigens amongst studied population based on parity showed that G3P2 group had the highest percentage positivity of 8(6.7%) for Rh-C antigen while those carrying their first pregnancy (prime) had the highest percentage positivity of 33(27.5%), 15(12.5%) and 36(30.0%) for Rh-c, Rh-E and Rh-e respectively. Distribution of Rh antigens with respect to previous transfusion history in studied participants showed 6 (5.0%), 15 (12.5%), 6 (5.0%) and 17 (14.2%) percentage positivity for Rh-C, Rh-c, Rh-E and Rh-e respectively. This study revealed a percentage positivity of 17.5%, 89.2%, 39.2 % and 90.8% for Rh-C, Rh-c, Rh-E and Rh-e respectively with high percentage expression for Rh-c, E and e antigens found on the red cells of Antennal Women carrying their first pregnancy. Furthermore, there is a high percentage expression of Rh antigens in previously transfused pregnant women in this study. Although routine phenotyping of these blood group antigens will be a financial burden in a resource limited country like Nigeria. It is expedient and needful to take into cognizance the fact that the presence of Rh C, c, E and e antigens may likely be the cause of some delayed transfusion reactions and haemolytic disease of the foetus and new born. Therefore, there is need for the inclusion of Rh C, c, E and e in routine antigen typing for pregnant women in other to help ameliorate red blood cell alloimmunization and delayed haemolytic transfusion reaction during pregnancy. Furthermore, there is need to promulgate policies that promote the optimum stocking of Rh-e, c antigen negative blood in blood banks in the area for emergency use.
Influence of soil compaction and moisture variation on development of sesame (sesamum indicum l.) plant in a sandy loamy soil
Authors: Mamman Mohammed J , SM Musa , AS Abdullahi
Published: February 2023

This study determines the influence of soil compaction on shoot, root development and nutrients uptake of sesame (sesamum indicum l.) plant in a sandy loamy soil. The research was carried out in Mokwa local government of Niger state during wet season. Three soil samples of 300g weight from the top 20cm of the soil profile were taken from college farm. The initial moisture content of the soil was determined using oven-drying method. The soil samples were air dried, large clods broken and grounded. The soil samples were then mixed to obtain a homogenous mixture of the sample. The soil moisture content was then raised to varying moisture levels of 10%, 12%, and 14% exceeding the optimum moisture content of sandy loam which is 12% moisture. Each sample was subjected to five levels of compaction energy using 0,5,10,15,20 blows of a standard proctor hammer in cylindrical cores of 17cm in height and 10cm diameter in accordance with the standard proctor compaction procedure. Four holes were made in each can and four seeds were sown in each hole to be thinned into one seed per hole (four plants in each can). The depth of sowing was one cm. The seedlings were tinned to a maximum of five (5) per core at 15 days after planting. The heights (cm) of the seedling were taken with a measuring tape at 5-days interval to 20 days after planting. The experiment was laid out in randomized complete block design (RCBD). The data collected were subjected to descriptive statistical analysis, regression analysis and analysis of variance. The results from the soil physical properties analysis shows that the soil is sandy loam with sand being 76.8 % and clay as 11.2%. The bulk average density was 1.75 g/cm3. Results obtained from the study shows that compactive efforts significantly affect plant growth and development. It also shows that as compactive effort increases, the soil bulk density and penetration also increases. The effect of number of hammer blows on soil bulk density and penetration resistance was significant. The effect of excessive moisture also affects germination and plant growth. Moderate soil compaction has beneficial effect. This is due to greater water retention. In general, it appears that there is a great potential in growing sesame on sandy loam soil, if the level of compaction is maintained at moderate level, which does not impede root development and other plant requirements.
Utilization of cargo from extra cellular vesicles as a biomarker for endometrial receptivity for enhancement of implantation success during attempted IVF/ICSI- a short communication
Authors: Kochar Kaur Kulvinder , Allahbadia Gautam , Singh Mandeep
Published: February 2023

Earlier we reviewed how the Extra cellular vesicles (ECV) s might work as biomarkers in case of both female as well as male reproductive diseases that is inclusive of ART, besides the methods of obtaining the same. Here in extension of the same Li evaluated the ECVs obtained from the uterine fluid aspirated with observing small noncoding ribonucleic acids(sncRNA) that were identified from these ECV’s. Despite, their conclusions of this being the first study that exhaustively profiled sncRNA in endometrial ECV s from uterine fluid as well as isolated biomarkers of endometrial receptivity in addition to implantation the critiques have not accepted it with flaws of the study of utilization of only fresh embryo transfers (ET) for evaluation with current utilization of frozen ETs besides not attempting preimplantation genetic testing for aneuploidy(PGT-A), for distinguish ng euploid from aneuploid embryo s further in the fresh ETs as wella. Further it is accepted that once 3 euploid embryos transferred in case of 3 consecutive IVF <5% had chances of recurrent implantation failure((RIF) as well as further studies are required for establishment of these sncRNA from ECVs as biomarkers
Clinical manifestations, complications and management of chickenpox infection in pediatric
Authors: Bereda Gudisa
Published: February 2023

Chickenpox can be defined as a highly communicable viral infection caused by varicella zoster virus; most frequently influences pediatric in five to nine yrs old. The commonly occurred signs and symptoms of chickenpox are comprises vesicular rash appears on the scalp, face and trunk, and then disseminates distally to limbs (centrifugal distribution). The most common complications of chickenpox are bacterial soft-tissue infection, pneumonia, and encephalitis. Encephalitis is a most commonly occurred central nervous system complications expose the pediatric to other problems or death. The main goal chickenpox infection management in children is to alleviate the symptoms such as skin infections, fever, itching etc and making the children confortable. Adequate intravenous acyclovir administration is crucial for successful management of chickenpox, but it must be administered within twenty-four hrs. after the onset of the disease. Management of chickenpox with oral acyclovir given within twenty four hrs of onset of rash may be more effective.
Second emergency transvaginal cerclage placement for the management of inevitable abortion: a case report
Authors: Chanda Kasonde , Lian Liang Sheng , Abulikem Gulidiya , Yan Kong Yi , Xia Chen Yun , Yan Ying Xiao
Published: February 2023

Cervical cerclage placement procedure is one of the important approaches in the management of cervical insufficiency to prevent miscarriages and preterm labor. The purpose of this report was to show the importance of second transvaginal cervical cerclage placement in failed first emergency transvaginal cervical cerclage placement to prolong the gestation age towards term, thereby increasing fetal survival, prevent miscarriages and preterm births
Transverse uterine fundal incision - an alternative to vertical uterine incision for anterior placenta accreta involving the entire uterine wall: a case report
Authors: Mathur Shweta , Gupta Neha
Published: February 2023

The placenta accreta spectrum is on rise. If the placenta is covering the entire anterior uterine wall, there are definite challenges involved in delivering the fetus without exsanguination and with minimal maternal blood loss. We present a case report that highlights the use of transverse uterine fundal incision (TFUI) in an anterior placenta previa with accreta involving the entire uterine wall. It can be considered as an option to vertical uterine incision in such cases where the patient is not desirous of future fertility and caesarean hysterectomy is planned
Oral versus intravenous iron therapy for correction of iron deficiency anaemia in pregnancy
Authors: Hooja Nupur , Fatima Andaleeb
Published: February 2023

Background: The high prevalence of anaemia in pregnancy has serious adverse consequences in both mother and baby. Management of anaemia in pregnancy should be given great importance in obstetric practice.The study was undertaken to compare the efficacy of oral iron (ferrous sulphate) and intravenous iron sucrose complex in the management of moderate anaemia in pregnancy. Method: A randomized comparative hospital–based longitudinal analysis was conducted in the Department of Obstetrics and Gynaecology of a tertiary care hospital, involving 70 women with haemoglobin between 7- 9.9 g/dl and serum ferritin < 50 mcg/l, attending antenatal clinic. Intravenous iron sucrose complex was given in one group and tablet ferrous sulfate (100 mg elemental iron) to the oral group. Treatment efficacy was assessed by measurement of haemoglobin and reticulocytes on days 8, 15, 21 and 30 and ferritin on day 30. Result: An increase in haemoglobin was observed in both groups, rising from 8.26 ±0.764g/dl to 11.08± 0.71g/dl in the intravenous group and from 8.14±0.767 g/dl to 10.98 ±0.61 g/dl on day 30 in the oral group. S.ferritin on day 30 was significantly higher in the intravenous group. The side effects in both groups were negligible though there were there were 3 dropouts due to adverse effects. Conclusion : Both oral ferrous sulphate and intravenous iron sucrose complex are safe, convenient and effective in treatment of iron deficiency anaemia in pregnant women with negligible side effects, but intravenous iron sucrose complex is better in improving serum iron and in restoring maternal iron stores
Impact of a spinal cord injury in employment: a cross-sectional study in a Portuguese population
Authors: Ferro Inês , Pires César , C Sá Pedro , Verraest Xénia , Margalho Paulo , Carvalho Filipe , Lains Jorge
Published: February 2023

Background: Patients who have sustained a spinal cord injury (SCI) frequently face a fundamental change in their employment situation, as the demands of their previous job often exceed their remaining physical abilities. Aim: To study which factors associated with the SCI may influence the employment status. Design: Descriptive cross-sectional study. Setting and population: Seventy-three individuals who had sustained a SCI, admitted in our Rehabilitation Center in 2015. Intervention: Not applicable. Methods: Besides clinical information, a telephone questionnaire was applied in 2019 to the patients, in order to identify demographic and injury-related status, functionality (FIM, SCIM-III, nFAC scales), and work-related information. The data was analyzed in SPSS Statistics® version 26, using χ2 test for categorical variables and t test for independent samples between continuous and categorical variables. Results: The employment rate after SCI was 27.8%. The need of a caregiver showed a significant relationship with not being employed (p<0.001), consisting in an independent determinant for employment (OR 5.38). Return-to-work was associated with higher functional scores, lower mean age values (p<0.001), previous higher education level (p<0.001), and pre-injury intellectual job (p=0.009). Conclusion and clinical rehabilitation impact: The employment rate and factors influencing return-to-work were in line with those available in literature. Additionally, we consider that the “need of a caregiver” is essential in the evaluation of a SCI patient, as it gives a clearer understanding of the patients’ work ability (participation domain), in contrast with functional scores, best suited in the activity domain of the International Classification of Functioning Disability and Health.
Recent topics on repetitive peripheral magnetic stimulation (rPMS) and transcutaneous electrical nerve stimulation (TENS) in clinical rehabilitation
Authors: Bando Hiroshi
Published: February 2023

In recent rehabilitation, treatments include electrical stimulation and magnetic stimulation. They are transcranial magnetic stimulation (TMS), repetitive peripheral magnetic stimulation (rPMS), transcutaneous electrical nerve stimulation (TENS), and others. rPMS has been effective technique for non-invasive neuromodulation. Clinical effects of rPMS have been reported such as generalized sarcopenia and dysphagia, measurement of rectus femoris muscle (RF), strength of suprahyoid muscles and association of hand splint materials. TENS also shows clinical efficacy for decreasing peripheral and central neuropathic pain (PNP, CNP). Beneficial efficacy is found in diabetes and herpes zoster for PNP, and in stroke and spinal cord injury for CNP.
Case report: transcaval impella placement in a patient with acute lv dysfunction from ethylene glycol toxicity
Authors: Singanallur MD Prashanth , Goswami MD Nilesh , Pandompatam MD Govind , Qaseem MD Muhammad Kashif
Published: February 2023

Introduction: Ethylene glycol is a toxic alcohol commonly found in antifreeze, or other household and industrial agents. Patients usually survive ethylene glycol toxicity when promptly treated but delay in care can cause significant morbidity and mortality. Significant metabolic acidosis can lead to multisystem organ dysfunction including Left ventricular dysfunction which can pose a unique challenge. Case report: The patient is a young female who presented with acute encephalopathy, intraventricular hemorrhage (IVH), severe metabolic acidosis, and severe left ventricular dysfunction following acute ethylene glycol toxicity. A diagnosis was quickly made due to presence of calcium oxalate crystals in the urine. The patient received timely interventions with Fomepizole and kidney replacement therapy (KRT), which failed to reverse her severe shock. The patient required mechanical circulatory support (MCS) in the form of Transcaval peripheral ventricular assist device (pVAD). Conclusion: This case showed the use of the transcaval approach to place an pVAD in a young patient suffering from ethylene glycol toxicity and severe left ventricular dysfunction. Although it remains an uncommon approach, it can be used when more traditional access points have failed, and the patient requires MCS.
A great tool that resurfaced during the pandemic: Remifentanil
Authors: Fragoso Miguel Angel Sosa
Published: February 2023

During anesthetic management, drugs such as fentanyl are required. This is a synthetic opioid used routinely. However, there are options derived from fentanyl, such as remifentanil, which has been referred to in the literature as an ideal opioid in anesthesiology due to its pharmacokinetic characteristics. Remifentanil is used in general or local anesthesia, as analgesic premedication for induction of anesthesia, and as an adjuvant in the maintenance of general anesthesia. In addition, it is suggested as a sedative in patients admitted to intensive care in patients undergoing mechanical ventilation, for analgesia and sedation in postoperative cardiac surgery and other types of surgeries, even in minor procedures. In this review, we focus on describing the use, properties, and anesthesiologic characteristics of remifentanil, as well as its repercussions of use.
Risk factors related to delayed post-anesthetic awakening in the elderly operated by elective video laparoscopic surgery
Authors: Castillo Assel Antonio Villalón , Sanchez C Yurisnel Ortiz , Bazán Yacnira Martínez , León Paz Kenia Dalia , Ginarte Titania Grecia Rodríguez , Martínez Sandra Blanco
Published: February 2023

In all surgical procedures, the organism presents different physiological alterations that expose the patient to a series of difficulties that, if not taken into account, can cause very severe complications in the post-anesthetic awakening of elderly patients. A longitudinal prospective cohort study was carried out on elderly people who underwent laparoscopic video surgery at the general provincial hospital "Carlos Manuel de Céspedes de Bayamo, from the Cauto region during the period from January 1, 2019 (,) to December 31, 2019. December 2021; with the aim to identify the risk factors related to a delay in post- anesthetic awakening. It was established that the exposed cohort consisted of 39 elderly people with delayed post-anesthetic awakening in the study period who met the inclusion criteria. The magnitude of the associations was estimated by calculating the relative risks (RR) of delay. There is an association between patient-dependent risk factors: smoking, obesity, presence of comorbidities and use of chronic pharmacological therapy, with a delay in post-anesthetic awakening in the elderly. The duration of the intervention, fasting time greater than 12 hours and hypoglycemia were the factors dependent on the surgical-anesthetic act associated with a delay in post-anesthetic awakening in the elderly.
Factors associated with maternal decision against hospital delivery despite ANC attendance in Kakamega central sub county
Authors: Lusweti Consolata Namisi , Ngambwa Thomas
Published: February 2023

Despite a large proportion of woman attending ANC during pregnancy, a significant percentage still avoid delivering at the health facility. This increases the risk of adverse pregnancies outcomes and deaths. Knowledge of factors associated with the decision against health facility delivery is limited. The main objective was to describe health facility factors associated with maternal decision against despite ANC attendance in Kakamega Central Sub-County. A community based cross sectional study was undertaken focused on a structured interview method in collecting quantitative data. Sample of 332 mothers who attended ANC but did not deliver in a health facility were drawn from a study population. A multistage random sampling method was applied in the selection of a primary data. Factors that made mothers to decide against health facility delivery despite ANC attendance included costs of transport and lunch, lack of supplies and commodities and lack of sufficient preparatory service for delivery emerges as more crucial determinant for decision against health facility. Chi-square tests were used describe single variables and to assess associations between variables. The statistical significance level was set at p<0.05. Income source of the women were also associated with the perception on all staff always being available at the facility. We found significant associations between costs, and other costs. Availability of different levels of health facility will not alone solve the problem of low health facility delivery rates. These facilities need to be equally empowered with supplies, staffs who can give quality comprehensive service. Furthermore the women need to be economically empowered to be able to meet other costs like transport and lunch. Focus on increasing financing for maternity service by the government and intersectoral approach for maternal health is crucial in Kakamega Central Sub County. The county government should provide ambulance services for pregnant women, decentralization of delivery services in all health facilities and provide with staffs, supplies and commodities for equity of usage of delivery services, improved road network. Need for constructive and collaborative approach to promote maternal health and need to multi-sectoral approach to overcoming the barriers to health facility deliveries.
Byotubers: active methodologies in marine environmental education for children
Authors: Barrella Walter , Dias Sabrina Quintas Pedreira , Giordano Fabio
Published: February 2023

The present study measured the effectiveness of educational technologies, combining the Internet and Smartphone devices used in environmental education program-guided field trips in a Brazilian coastal city public school (Guarujá-SP, Brazil). For this purpose, we organized a YouTube channel called “Byotubers.” It had 5,355 views in 24 countries and 22 uploaded videos in 9 months. In 2017, the program served a hundred elementary school ages between 9 and 12 years. With active methodologies and investigations applied to the group, the studies indicated us to strengthen ties between school and family.
Outdoor airborne fungal spores in Queensland, Australia
Authors: Wilkie Alexander D , Venz Lauren , Letters Sarah
Published: February 2023

We present non-viable fungi concentrations from December 2021 to November 2022 in Queensland, Australia taken from outdoor reference samples collected during mould inspections. Our data indicate an average total mould concentration of approximately 6000 FS/m³ across the December 2021-November 2022 period. Trends in the data indicate higher levels of Aspergillus/Penicillium like spores in the December-May period changing to higher levels of Cladosporium in the July to September period. These data may be useful to mould inspectors in gauging normal mould ecology or unusual spore concentration levels in Queensland, Australia.
Selfie culture in social media age: understanding racism in democratic populism
Authors: Hossain Sarkar Saddam
Published: February 2023

The ongoing century is a Social Media communication century where the traditional concept of time and space has been considered as a myth and been successful to make a global village by the help of science and technology revolution. In this new medium, now, selfie has been come out as a new popular culture of the global society beside lot of new other concepts and ideas. But taking this ideas of communication critically, it has seen that there are some issues which making the globe more racially divided than ever. Making a deep analysis of the popular selfie culture of a nod (India) in the global internet democracies, this paper will try to analyse the role of the new most usable social media applications in promoting racism more horribly than ever in India. Also, taking the Psychoanalysis theory of Sigmund Freud and the Anti/ Post-Colonial Theory of Frantz Fanon as the base, this study will try to understand the new imperial hegemony of such responsible new media and photo-capturing applications. Moreover, its impact on Indian democracy in a long term and the reasons for the lack of proper law of the political institutions against virtual racism will also be understood.
Infectious complications following bronchoscopy: does sedation play a role?
Authors: Aguñín Pablo Rubinstein
Published: February 2023

Bronchoscopy is an invasive procedure, which could favor infectious complications. Deep sedation may increase this risk. In this article, the available current evidence and the pathogenic mechanisms involved are analyzed.
Respiratory muscle power and lung function in healthy obese Sudanese medical students
Authors: Abdalla Omer Abdalla Elbedri
Published: February 2023

There is an increasing prevalence of obesity worldwide (Body Mass Index equals or above 30kg/m2). Obesity may cause changes in pulmonary mechanics, as measured by spirometric values: mild reduction in vital capacity and proportionate reduction in Forced Expiratory volume in the first second (FEV1) depending upon the age, type of body fat distribution and severity of obesity. Changes in respiratory muscle strength in healthy obese individuals have not been widely investigated. The aim of this study is to assess the effect of obesity on respiratory muscle strength and pulmonary function in healthy obese subjects. A cross sectional study was carried out at National Ribat University, Faculty of Medicine, among ninety-five healthy male and female medical students aged 17-25 years (52 obese with BMI equals or above 30kg/m2, 43 non-obese with BMI< 0.05). These results were also found to be consistent in female subjects. Significant negative correlation was also observed between % fat and lung function parameters (FVC, FEV1). Increased strengthening of respiratory muscles in healthy obese adults (as measured by elevated MEP and MIP) might be a compensatory effect to bring lung function to comparable values of the non- obese. Percent of body fat could be a good predictor for decline in lung function in obese individuals.
The role of interleukin-33 in the pathogenesis, and treatment of severe asthma
Authors: Syabbalo Nightingale
Published: February 2023

Interleukin-33 (IL-33) belongs to the IL-1 family of cytokines, which has 11 members, including IL-1α, IL-1β, IL-1Ra, IL-18, IL-36α, IL-36β, and IL-37. Unlike its family members, IL-33 mediates T helper type-2 (Th2) immune responses, and promotes eosinophilic inflammation, similar to the other epithelial-derived cytokines, such as IL-25, and thymic stromal lymphopoietin (TSLP). Epithelial injury due to viral, and bacterial infections, allergens, chemical irritants, and trauma lead to secretion of alarmin cytokines, including IL-25, IL-33, and TSLP. IL-33 plays an important role in activating Th2 lymphocytes, group 2 innate lymphoid cells, dendritic cells, mast cells, basophils, and eosinophils, which result in secretion of cytokines, such as IL-4, IL-13, and IL-5; chemokines, including CCL2, and CXCL8, and adhesion molecules. The inflammatory mediators promote eosinophilic airway inflammation, airway hyperresponsiveness, and remodeling. IL-33 signaling is via a complex heterodimeric receptor comprising of IL-1 receptor-like 1 (IL-1RL1), and IL-1 receptor accessory protein. Downstream signaling cascade leads to the transcription of multiple cytokines and chemokines, which orchestrate eosinophilic asthma. Treatment of severe eosinophilic asthma include long-acting beta2-agonists, and inhaled corticosteroids, and addition of biologics at GINA step 4/5, such as omalizumab, mepolizumab, dupilumab, and tezepelumab. Currently, there are no anti-IL-33 biologics which have been approved for the treatment of eosinophilic asthma. Etokimab is a first-in-class IgG1 monoclonal antibody which blocks the activity of IL-33, thereby, inhibiting its biological effects. Phase 2a proof-of-concept clinical trial in 25 patient with severe eosinophilic asthma, showed that a single intravenous dose of etokimab (330 mg) resulted in a rapid and sustained improvement in lung function, and reduction in the asthma control questionnaire-5 scores throughout the study period of 64 days. Recently, itepekimab has been shown to improve asthma control, lung function, and quality of life, although the effects of itepekimab were slightly lesser than those observed for dupilumab. The dual therapy of itepekimab plus dupilumab did not achieve optimal outcomes, moreover, treatment with the doublet resulted in minimal change in pre-bronchodilator FEV1 compared with placebo. Dual blockade of interleukins incriminated in the pathogenesis of eosinophilic asthma need further careful studies, because of the immunological consequences in the era of SARS-CoV-2.
Potential soluble angiotensin-converting enzyme 2 in oral and salivary coronavirus infection therapy
Authors: Cheepsattayakorn Attapon
Published: February 2023

A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienceDirect, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between 2004 and early 2022. With strict literature search and screening processes, it yielded 4 articles from 142 articles of initial literature database. In oral cavity, tongue has the highest angiotensin-converting enzyme 2 (ACE 2) expression and lesser amounts in the other oral tissues, oral mucosa, including the gingival tissue. By Pre-incubation with SARS-CoV-2 (COVID-19) RBD, CTB-ACE 2 activity was absolutely inhibited, offering an the description for decreased saliva ACE 2 activity in COVID-19 patients. Through minimizing or debulking virus transmission, SARS-CoV-2 (COVID-19)-trapping proteins proposes an affordable strategy for protecting people from most oral re-infection, whereas newly evolving strains have higher viral load in saliva and greater transmission. Delta variant viral load in a patient is about 1,260 times higher than those infected with previous strains. In conclusion, ACE 2 fusion proteins or chewing gum can be used as the rapid methods of decreasing SARS-CoV-2 (COVID-19) from saliva and oral cavity of the infected patients for minimizing infection and transmission, diagnosis, inhibitors, vaccine development, and therapy of SARS-CoV-2 (COVID-19) disease.
Cognitive behavioral perspective on how to curtail children's fears of surgery
Authors: Alkuwari Kaltam Jabor MD
Published: February 2023

The moment a patient is admitted to a hospital for surgery, certain factors such as life pressure with negative behaviors and emotions involved fear, anxiety and surgery declining. The problem exacerbates when the patient is a child depicting lack of sleep, and rejection of medical treatment as a whole not to mention the disregard of the physician's directions. Other negative behaviors include withdrawal, bedwetting, intense fear, and bursts of anger. Professional practice in hospitals rely on a working team of inter-disciplinary with the importance of the social worker in the transitional period. The team adopts several professional models to enable disorder interventions in children. One common model utilized is the Cognitive Behavioral Therapy an effective treatment of mental disorders, in particular social disorders. Summarized in the abstract is the present research problem, identifying program indicators reducing children’s fears of surgical intervention through Cognitive Behavioral Therapy (CBT). The study considering the following: the first question is what are some children's disorders due to surgical intervention? In addition to the second question, what are the indicators prevalent in a program designed to reduce children’s surgical intervention using the Cognitive Behavioral Therapy? The present research is one of the basic research types providing basic information on phenomena and problems examined by researchers to find answers to theoretical questions. Results provided answers to research questions after review of related literature and previous studies. The researcher has concluded that it is of great importance to identify children's disorders related to surgical intervention with details of the suggested program to reduce and eliminate such fears using Cognitive Behavioral Treatment.
Self-efficacy and conscientiousness in caregivers of the mentally challenged: a randomized controlled trial
Authors: Koutrouki Aikaterini
Published: February 2023

Little research has evaluated the obstacles and challenges that complicate the daily life of mentally challenged individuals and their caregivers. The involvement in the provision of care for the mentally challenged constitutes a lifetime commitment for their family members that form the main core of care, compelling them both to experience most of the health-care inequalities in comparison with the rest of the general population. Self-efficacy and conscientiousness consist two behavioral signatures/personality traits that guarantee the uncompromising enthusiasm and undivided commitment in circumstances that are defined as specifically difficult and demanding, enabling caregivers to adopt in the given conditions. The results of the survey indicate that the involvement in the provision of care for the mentally challenged (N=81) is not random and doesn't depend on the score of the Intelligence Scale, but is in fact the result of a conscious selection, a mental commitment, whose success is ensured by the perception of self-efficacy and conscientiousness, that are statistically significant and at the same time bidirectional. Furthermore, the survey also indicates that caregivers who chose willingly to take care of the mentally challenged, have a statistically significant higher self-efficacy perception
A case of neonatal lupus erythematosus with multiorgan involvement and complete heart block
Authors: Alshafei Atef , Ahmed Mahmoud , Hussein Fadhil , Hassan Mustafa , Mohamed Amira
Published: February 2023

Neonatal lupus erythematosus (NLE) is a rare autoimmune- mediated spectrum of disorders occurring in 1/20,000 live births and causing fetal tissue damage due to trans placental passage of anti-Sjögren’s-syndrome-related antigens A and B (anti Ro/SSA and anti La/SSB immunoglobulin G). Approximately 60% of the mothers are asymptomatic on diagnosis of NLE, while the remaining may have SLE, Sjögren syndrome, or other autoimmune disorders. Clinical presentation of NLE varies from dermatologic, cardiac, hepatic, splenic, hematologic, or neurogenic abnormalities. All except cardiac manifestations are reversible and benign. We report a case of NLE in a late preterm infant presenting with multi-organ involvement and congenital complete heart block. The mother was completely asymptomatic but had a significantly high anti-Ro/SSA antibody level. Antenatal fetal echocardiography revealed a structurally normal heart with significant bradycardia and complete heart block. After birth, the infant had multi-organ involvement and persistent bradycardia ranging from 45 to 65bpm with respiratory distress secondary to cardiac decompensation. A permanent epicardial pacemaker was implanted at the age of 2weeks with gradual improvement of respiratory and cardiac functions. Upon follow-up, the infant was thriving well and gaining weight with a stable general condition and reasonable pacemaker function at a rate of 100bpm.
Children admitted to PICU after hematopoietic stem cell transplantation: a predictive model of mortality
Authors: Fabio Torres MD Silvio , Iolster MD Thomas , J Reyes Haczek MD Pablo , J Schnitzler MD Eduardo , G Longo MD Pablo , J Siaba Serrate MD Alejandro , Chantada MD Guillermo , D Kusminsky MD Gustavo
Published: February 2023

Introduction: Hematopoietic stem cell transplantation (HSCT) in children is associated with severe complications that need admission to critical care units. Mortality in this group of patients remains high with reported survival that ranges between 38 and 71%. Goals: To analyze the predictive factors of mortality of pediatric patients who received HSCT and were admitted to the pediatric intensive care unit (PICU) Material and methods: Retrospective review and analysis of a population of children and adolescents who underwent hematopoietic stem cell transplantation from 12/01/2008 to 11/30/2018 and were admitted to the pediatric intensive care unit (PICU) of a university hospital. Results: Of 248 patients subjected to the analysis, 109 patients were admitted. Overall mortality was 29% (n=32). After univariate analysis, the type of transplant (unrelated), baseline disease (malignant vs non-malignant), febrile neutropenia, cytomegalovirus (CMV) infection, multiorgan failure, respiratory failure, graft versus host disease (GVHD), conditioning regimen with myeloablative chemotherapy and pre-transplant malnutrition were associated with higher mortality. After the Multivariate Analysis of Logistic Regression, the variables GVHD (OR 2, 23 95% CI: 1.92 a 2, 98), need of mechanical ventilation ( OR 2.47,95% CI 1.39 a 5.73) unrelated allogeneic transplants (OR 1.58, 95% CI 1.14 a 2.17) and previous malnutrition (OR: 1.78, 95% CI 1,223-3.89) were statistically associated with mortality. Conclusion: In our population two of three children receiving HSCT and admitted to PICU survived. Graft vs. host disease, need of mechanical ventilation, unrelated transplantation and previous malnutrition were predictors of mortality.
Respiratory morbidity in children with esophageal atresia
Authors: MC Meyer Viviane , W Folescu Tânia , WF Cohen Renata , AP Silveira Deborah , FD Amoed Renato , YS Higa Laurinda , A Ferreira Bárbara , R Sad Izabela , FBM Costa Patrícia
Published: February 2023

Objectives: Analyze clinical and epidemiological data of patients with repaired esophageal atresia who presented with respiratory complications, and their clinical progress on follow up. Methods: Retrospective data was gathered from charts of patients with EA who had corrective surgery in a tertiary hospital, were referred to the pediatric pulmonology clinic due to respiratory complications and had at least two appointments in the clinic, the latest between 2009 and 2016. Results: 37patients were included, 72,9% of whom had esophageal atresia with distal tracheoesophageal fistula. Recurrent wheezing was the most common respiratory complication, present in 75,7% children in the 1st appointment, followed by recurrent pneumonia (54%) and chronic cough (45,9%). Short Action Beta Agonists was the most common prescribed medication. Spirometry results were abnormal in 66,7% of patients, with 60% presenting with obstructive disorder. Tracheomalacia was the most frequent pathological finding in bronchoscopy exams. Incidence of all respiratory complications decreased during follow up, which can be an effect of both lung growth or appropriate treatment. Conclusions: Pathophysiology of respiratory complications of EA is still unclear. Several risk factors have been proposed, such as GERD and tracheomalacia, but do not account for all patients.
Management of retinopathy of prematurity: an updated review
Authors: El-Atawi Khaled , Alansar Nayef , ElHalik Mahmoud , Abdelsamed Amani , Mahfouz Rim
Published: February 2023

Retinopathy of prematurity (ROP), previously named retrolental fibroplasia, is a vascular disease of the premature retina that appeared after the advances in preterm neonatal care, potentially causing irreversible vision loss. The most vital part of ROP management is reducing modifiable risk factors such as blending protocols for oxygen delivery, rigorous infection control, restrictive blood transfusion strategies, and parents' education. Laser remains a highly effective therapeutic modality and the gold standard of care in most ROP cases. On the other hand, Anti-VEGF agents emerged as a potential solution to clinical situations where laser delivery is not feasible, as in poor pupillary dilatation with advanced tunica vasculosa lentis (TVL), vitreous haze, corneal opacification, rubeosis iridis, and vitreous hemorrhage. The current recommendations indicate surgery for ROP stages 4-5. For stage 4, surgical modalities incorporate scleral buckling and lens-sparing vitrectomy (LSV).