bluuebunny/crossref_metadata_2025 huggingface dataset:
Los nuevos estudiantes en la carrera de Medicina. La visión de ocho generaciones: 2008 a 2015
Authors: Nava Bernabé Ríos , Estrada J. Ramón Olivo
Published: July 2021

RESUMEN

La Unidad Académica de Medicina (UAM) de la Universidad Autónoma de Nayarit (UAN) es la principal institución formadora de médicos en la entidad. Cada ciclo escolar, de acuerdo al número de aspirantes, se muestra como la primera opción y la más solicitada para los egresados de la educación media superior. El pasado ciclo 2015-2016 el número de aspirantes superó los 1,400. Se ha observado que los estudiantes de primer ingreso, desde hace ocho años, han mostrado, a lo largo de su vida familiar y social, diversos cambios socioeconómicos y familiares, que han impactado de manera importante el curriculum y la organización interna de la institución. A partir de esta realidad, se hace un análisis de estos y se los relaciona con aspectos de infraestructura, situación y condiciones laborales del personal y cuerpos académicos.

 

ABSTRACT

The Academic Unit of Medicine (UAM) of the Autonomous University of Nayarit (UAN) is the main medical training institution in the state. Each school year, according to the number of applicants, it is shown as the first and most requested option for high school graduates. Last 2015-2016 cycle, the number of applicants exceeded 1,400. It has been observed that first year students, since eight years ago, have shown, throughout their family and social life, several socioeconomic and family changes, which have significantly impacted the curriculum and the internal organization of the institution. Based on this reality, an analysis of these changes is made and they are related to aspects of infrastructure, situation and working conditions of the staff and academic bodies.
Juridical Analysis of Implementation of a Virtual Trials for Criminal Case during the Covid-19 Pandemic
Authors:   Faculty of Law, Universitas Pembangunan Nasional Veteran Jakarta, RS. Fatmawati Street, South Jakarta City, 12450, Mukti Abdul
Published: July 2021

The COVID-19 pandemic has led to changes in human order and patterns of life by implementing a new normal life. One of those affected is the law enforcement sector in Indonesia. Enforcement of Criminal Law ultimately applies an adjustment mechanism when conducting a case review in court. If during this time the examination of the case bases KUHAP with face-to-face directly methods, then with COVID-19 turn it into a mechanism of remote trial electronically (virtual) using the Supreme Court Regulation (PERMA) as the basis. Further research is needed to ensure the legality of the use of PERMA in the application of such electronic hearings. This research method is a normative approach that combines conceptual approach in the form of prevailing views and doctrines, statute approach by attracting conformity between rules, sociological, philosophical, juridical and case approach as a form of implementation or application of norms. The results of the study stated that PERMA is a legal product that is legally binding and have binding legal force. It's just that the arrangement of this virtual trial needs to be raised to the level of law so that it has parallels with Criminal Procedure Code (KUHAP), or at has the force of law least can be proposed to the President to be published into Government Regulations in Lieu of Laws or Peraturan Pemerintah Pengganti Undang-Undang (Perppu).
Legal Protection towards Fiduciary Recipients in Disputes of Fiduciary Object
Authors:   Postgraduate Student of Master of Law UPN Veteran Jakarta., Dayanti Niken Sarah
Published: July 2021

This thesis addressed the issue to examine the legal responsibility of the Collateral Manager as the object fiduciary administrator and how the legal protection effort to the fiduciary recipient is based on the principle of lex specialist derogate lex generalist. This writing is motivated by non-performance of contract settlement as well as acts against the law from the importer to the exporter in an international trade relationship based on credit facilities. The results of the research, the responsibility of the Collateral Manager in conduct of transferred objects should be referred to the mechanism for exercising power based on the principles of Good Corporate Governance through the Collateral Management Agreement. This is to depreciate the risk, in order to the objects cannot be transferred by another party as a Fiduciary. Legal fiduciary recipient has accounts receivable on an object can obtain executorial rights protected by the Law on Fiduciary which is equal as court decisions that has permanent legal force. This research is used normative juridical, through statutory approach and a case approach in the case of the Supreme Court Verdict Number 2239 K/Pdt/2014. Conclusion is based on the principle of lex posterior derogate lex priori, the Judicial Review Verdict Number 997/PK/Pdt/2018 provides permanent legal force and certainty of the executorial rights of the fiduciary recipient over the object of collateral which is still a dispute between the importer and the exporter.
The Urgency of Public Prosecution Service of The Republic of Indonesia In The Settlement of Replacement Money In Criminal Acts of Corruption Based on Law Number 3 of 1971
Authors:   Faculty of Law, University of Pembangunan Nasional Veteran Jakarta, Supardi.S Lusiana Lamture,
Published: July 2021

In ensnaring the corruptors, not from the upstream, but from the downstream, namely by tracing where the flow of corruption funds ends up. It must be understood that a corruptor who then drains the proceeds of corruption means that he has committed two crimes at once. Therefore, the follow the money method is more effective than the follow The Suspect method, namely the handling of criminal acts that prioritize the perpetrators of crimes. With the follow the money approach, activities to hide or disguise the proceeds of corruption can be prevented and eradicated. However, this must still be regulated so that its implementation can be carried out in a concrete manner so that there is no legal vacuum in the implementation of its execution by the Indonesian Prosecutor's Office. The data collection technique in this research is using the library research method. While the analysis technique carried out on the legal materials that have been collected by the author will be done deductively. The results of this study indicate that the regulation of replacement money in criminal acts of corruption is contained in Law Number 3 of 1971 and has been revoked and amended by Law Number 20 of 2001 jo. so that in this case, there is an important role by the Attorney General's Office of the Republic of Indonesia, finally the Attorney General's Office issued Perja Number PER-020/A/JA/07/2014 and then upgraded to Perja Number 19 of 2020 and followed up with a Circular Letter of the Deputy Attorney General for Civil and Administrative Countries with Number SE-001/G/Gs/03/2021 dated March 26, 2021.
Transnational Organised Crimes: An Assessment of Human Trafficking and the Challenges Militating against a Total Elimination in Nigeria
Authors:   Department of Peace Studies and International Development, University of Bradford, United Kingdom, Abado Abraham Lubem,
Published: July 2021

Transnational crimes have remained one of the menaces that has continued to threaten global security, peace, and tranquillity, hence requiring a multilateral and multilevel approach in effectively curtailing them. One among these transnational crimes is human trafficking, which has been estimated to be generating $150.3 billion annually (IMF, 2018), with the Asia-Pacific region ranked as the most lucrative .It is against this background that this paper examines the crime of human trafficking in Nigeria, tracing the evolution of human trafficking in general, the efforts at tackling the crime in Nigeria, as well as some of the challenges hampering the total elimination of the crime in Nigeria. Using secondary sources of data for analysis, the paper identified some of themajor drivers of the crime in Nigeria to include but not limited to, poverty and underdevelopment, weak laws and inadequate enforcement, systematic corruption, stigmatization, sophistication and financial war chest of cartels, influence of the social media, traditional and cultural practices, among others. To mitigate the crime of human trafficking in Nigeria, the paper proffers: the addressing of social in equality, creation of more employment opportunities, awareness campaigns at all levels, and the use of ―triangulated nexus of human-trafficking enforcement‖ among countries, among others.
Management – Re-Defined - A Step Forward Towards Modern Management Philosophy
Authors:   Senior Faculty, University Department of Commerce and Business Management & Ex. Registrar, Ranchi University, Ranchi, Chaudhary Dr. Amar Kumar
Published: July 2021

Mind is very restless, forceful and strong, O Krishna, it is more difficult to control the mind than to control the wind. ~ Arjuna to Sri Krishna- Bhagavad Gita Management is a process of aligning people and getting them committed to work for a common goal to the maximum social benefit - in search of excellence. The critical question in all managers' minds is how to be effective in their job. The answer to this fundamental question is found in the Bhagavad Gita, which repeatedly proclaims that "you must try to manage yourself." The reason is that unless a manager reaches a level of excellence and effectiveness, he or she will be merely a face in the crowd. The classical Indian epics written thousands of years ago, enlightens us on all managerial techniques leading us towards a harmonious and blissful state of affairs in place of the conflict, tensions, poor productivity, absence of motivation and so on, common in most of Indian enterprises today and probably in enterprises in many other countries. The modern (Western) management concepts of vision, leadership, motivation, excellence in work, achieving goals, giving work meaning, decision making and planning, are all discussed in the Bhagavad Gita. While Western management thought too often deals with problems at material, external and peripheral levels, the Indian thought tackles the issues from the grass roots level of human thinking. Once the basic thinking of man is improved, it will automatically enhance the quality of his actions and their results.Management is, therefore, all about man and about his development, not merely his body, mind or intellect but his heart. It is when heart responds to heart that a static organization becomes transformed into dynamic one
Shariah Hospital Social Responsibility: Maqashid Syariah at Muhammadiyah Hospital
Authors:   Doctoral Program in Economics, Faculty of Economics and Business, 17 August University Surabaya, Indonesia, Tri Ratnawati Andrianto
Published: July 2021

This study aims to discuss and study the practice of sharia hospital social responsibility which should be implemented by Muhammadiyah hospitals using the maqashid sharia approach as the ultimate goal of sharia values. The research was conducted using a qualitative type with a phenomenological perspective. Wherewith this perspective is to open the phenomenon in the measurement of hospital social responsibility carried out by the Muhammadiyah Hospital. The results showed that most Muhammadiyah hospitals still use conventional-based practices. Where this practice is very suitable for use in conventional entities that are oriented towards maximum profit or profit. In practice, the concept of social responsibility practices that are suitable for sharia business entities such as Muhammadiyah Hospital is to use the concept of a maqashid sharia approach which focuses more on sharia values in achieving the welfare of both the hospital and the community. The values of maqashid sharia (religion, soul, mind, descent, and property) are the scope and guidelines for sharia business entities that focus more on sharia principles.
The MAGNITSKY Law and the RICO Law - The Solution and the Answer against the Order of the Mafia Made by Judge VESSELA EVSTATIEVA and Through the Prosecutors Yaneva, Dimitrova, Stankova, Petrov in Order to Steal Private Property Worth Billions of USD and Caused Losses for US Companies for 8 Billion USD
Authors:   Scientific Research Institute Dobrev & Halachev.JSC., Sofia.Bulgaria, Dobrev-Halachev Lord Prof. PhD PhD Momtchil
Published: July 2021

Lord prof PhD PhD Momtchil Dobrev-Halachev and Prof. Mariola Garibova-DObreva developed 2006 “Theory of degree of democracy” and “Theory of degree of justice / injustice /” based on their practice in court, prosecutor's office, state. Prof. Momchil Dobrev has been creating Theory of Corruption, "Theory of the Mafia," Theory of Mafia "," Financial Banking Resource Technological Mafia Materialism "since 2003"
Meditaciones dermatológicas
Authors: Woscoff Alberto
Published: July 2021

Encuentro la hoja de interconsulta. Voy al piso y el residente, con displicencia, me cuenta que al paciente lo vio el infectólogo, el alergista, el ortopedista, el clínico general y que no arribaron al diagnóstico. Con objetividad, miro las palmas y allí relucían, como sello diagnóstico, unas sifílides “de libro”. Pregunto: ¿por qué no llamaron al dermatólogo de entrada? Y la respuesta es un cachetazo mental: “porque entendemos que el dermatólogo se dedica a la estética”. Y parcialmente es así. La estética es un complemento de la dermatología. La belleza es inherente al ser humano. Todos quieren llegar a viejos. Nadie quiere parecerlo. Pero el complemento ha desplazado a la esencia. Buen número de colegas se anuncian como expertos en “Dermatología y Cosmética”.
Hipomelanosis macular progresiva: respuesta al tratamiento con minociclina
Authors: Giusti Fátima , Consigli Carlos , Consigli Javier , Cippitelli Lorena , Mazzotta Marco
Published: July 2021

La hipomelanosis macular progresiva (HMP) es una dermatosis caracterizada por máculas hipopigmentadas, que se observa con mayor frecuencia en las mujeres y en los fototipos III y IV. Se ha asociado a Cutibacterium acnes (C. acnes) de tipo III como factor etiológico.

Se presenta el caso de una paciente de 30 años, con máculas hipopigmentadas redondeadas en el tronco y la raíz de los miembros inferiores, de 10 años de evolución. El estudio histológico informó disminución del número de melanocitos y de pigmento melánico en la capa basal e infiltrado inflamatorio mononuclear perivascular superficial. Se indicó minociclina 100 mg/día por vía oral durante 8 meses, tras lo cual se observó la resolución total de las lesiones.
The future of contract law: Three conversations at the Cape
Authors: Brownsword R
Published: July 2021

This contribution considers the future of the English law of contract in the form of three conversations that are alert to the disruptive impact of technologies on both the content of legal rules and the way that lawyers think – and indeed on the kind of conversations that lawyers have with one another. The first conversation is concerned with ‘coherence’ in contract law, with the application of general principles to novel fact situations and to new phenomena, with the smoothing of tensions within the law, and with the internal integrity of legal doctrine. The second conversation focuses on a tension between, on the one hand, what may be called a traditional private law ‘coherentist’ concern for doctrinal integrity and the primacy of principle over policy and, on the other hand, a more ‘regulatory’ approach to contracts, especially to consumer contracts, in which policy and instrumental rationality prevail. The third conversation focuses on the use of emerging transactional technologies (such as blockchain-supported smart contracts and AI) that have the potential to displace the rules and principles of contract law. Instead of legal code governing transactions, might we find that technological coding does all the work, making, performing and enforcing ‘contracts’? Each conversation suggests a different future for contract law. The first conversation suggests that contract law will have difficulty in living up to the private law ideal of coherence; the second suggests that coherentism will struggle to survive as it is challenged by an increasingly regulatory approach to the governance of transactions; and the third suggests that, in a world of smart transactional technologies, there is a serious question mark about the relevance of contract law as a body of rules that governs transactions.
Polifunctional Liposomes with Trace Elements and Vitamins to Prevent SARS-Cov2 Infection
Authors:   Representative Lipotech, 56022 Castelfranco di Sotto (PI), Via dei Lazzeri, Italy, Riccardi Bruno , Resta Sergio ,   Surgeon, general surgery specialist, freelancer, 53043 Chiusi (SI), Via Montegrappa, Italy, De Paoli Tomas ,   Lipotech’s President, Parque Industrial La Cantabrica, Tres Arroyos 329 1706 Haedo-Buenos Aires, Republica Argentina
Published: July 2021

After many months of the SARS-CoV2 pandemic, in the absence of a vaccine or effective drug therapy, we offer a new generation supplement. The supplement is formulated with trace elements and vitamins of undisputed immunostimulating efficacy, included in the individual liposomes, which act as carriers and therefore we define multifunctional, to improve the absorption and bioavailability of the substances used. We focus the discussion on the role of Zinc as an effective immunostimulant and specific antagonist of the SARS-Cov2 virus.
Genome Editing: New, Emerging, and Interesting Developments for Clinical Applications
Authors:   Former Associate Director, Center for Devices and Radiological Health, Food and Drug Administration, Rockville, USA, Aziz Kaiser Jay
Published: July 2021

Principles of Genome Editing can be applied in the various areas of medical diagnosis and treatments ---from early process design/development through maintenance of the validated state during commercial manufacturing and post-marketing surveillance. Gene editing and clinical applications comprises of systematically assessing, monitoring, and reviewing manufacturing processes and subsequently monitoring measures to control output risks. Quality risk management (QRM) principles have been described in various FDA’s regulatory guidances for several aspects of good manufacturing practices (GMPs) such as several stages of process validation and verification in the drug product lifecycle including critical quality attributes (CQA’s) and monitoring critical process parameters (CPPs). A CPP is defined as a process parameter whose variability has an impact on a CQA and, therefore, should be monitored or controlled to ensure that manufacturing process produces end product of the desired quality. FDA’s mission is to facilitate the premarket review and evaluation of new genomic products for clinical use. The FDA guidances emphasize quality management approach to design of studies by providing oversight and objective review based on risk-benefit analysis and guides the use of new medical products by providing patients organized data and appropriate labeling information in support of the new product’s intended clinical use [1-3].
Evaluation of Deinking Performance of Active Calcium Silicate Filled Paper
Authors:   College of Textile and Light Industry, Inner Mongolia University of Technology, Zihui Su ,   Hohhot, The Inner Mongolia Autonomous Region, China, Peng Xu ,   College of Textile and Light Industry, Inner Mongolia University of Technology; Hohhot, The Inner Mongolia Autonomous Region, China
Published: July 2021

The deinking effect of printing paper filled with CaSiO3 and CaSiO3/French chalk was investigated. As a result, it shows that the two kinds of paper samples have better deinking effect, and the whiteness of the former is slightly higher than that of the latter. However, the strength index of the former is slightly lower than that of the latter. The adhesive removal effect of the paper sample filled with CaSiO3 is better than that of the paper filled with CaSiO3/ French chalk powder.
Synthesis, Characterization, In-Silico Docking Study and In-Vitro AntiInflammatory Activities of Novel Chalcone Derivatives
Authors:   Research and Development Centre, Bharathiar University, Coimbatore, 641046, India, Bharathi R , Santhi N ,   Department of Chemistry, Govt Arts College, C Mutlur, Chidambaram, 608102, India
Published: July 2021

A series of chalcones were synthesised by condensation of appropriate acetophenones with appropriate aromatic aldehydes, and their anti-inflammatory activities were investigated. In comparison to standard drugs, some have been found to have important activity. In silico docking, tests on chalcones were shown to be more selective to COX-2. Further anti-inflammatory results were supported by docking studies with COX-2. The results from the anti-inflammatory and docking indicate that the synthesised compounds 3b, 3g and 3h can be seen as therapeutic drugs.
Gene Therapy: Development, Design of Studies, and Approval Process
Authors:   Former Associate Director, Center for Medical Devices, Food and Drug Administration, USA, Jay Aziz Kaiser
Published: July 2021

Genome editing can be applied to various areas of medical diagnosis and treatments. Gene therapy pre-market applications comprise of systematically assessing a product’s design controls, manufacturing process controls, and proposed protocols for post-marketing surveillance. Quality risk management principles have been described in various FDA regulatory guidances for several aspects of good manufacturing practices (GMPs) such as several stages of process validation and verification in the genome product’s life cycle including critical quality attributes (CQAs) and monitoring critical process parameters (CPPs). A CPP is defined as a process parameter whose variability has an impact on a CQA of genome product and, therefore, should be monitored or controlled to ensure that the manufacturing process produces an end product of the desired quality. FDA’s mission is to facilitate the premarket review and evaluation of new genomic products for clinical use. The FDA guidances emphasize a quality management approach to the design of studies by providing oversight and objective review based on risk-benefit analysis of new genomic products. FDA reviews, evaluates, verifies and validates the implementation of the regulatory design-control requirements which are applied to the control genomic product’s quality throughout the total product life cycle (TPLC) [1-5].
Irrational Usage of Antibiotics in El-Mohandeseen Area in September 2015
Authors:   Lecturer at faculty of medicine – Omdurman Islamic university, Community Medicine registrar –Sudan Medical Specialization Board, Sudan, A.M.Ali Mohammed ,   General practitioner, Sudan, H.El-Mard Mazen
Published: July 2021

Irrational refer to inappropriate use of antibiotics in modern times, this descriptive cross-sectional community-based study was conducted in El-Mohandeseen area in the period from January to September 2015 to study the knowledge, attitude and practice towards the irrational use of antibiotics. A sample of 117 residents was taken randomly from the residents. We found that 51.3% of the residents have knowledge about the consequences and side effects of the antibiotics, while 48.7%of the residents have no knowledge about the consequences and side effects of the antibiotics. A sum of 66.7% use antibiotics without a medical prescription, while 33.3% do not use antibiotics on their own. Most of the residents seek medical advice if they don’t feel better after using antibiotics. And we formed some recommendations that may prevent the irrational use of antibiotics, namely: Presence of a regulatory destination to pharmacies to prevent dispatch of antibiotics without prescription must be present.
An Incidental Finding of Situs Ambiguus with Polysplenia in an Asymptomatic 70-Year-Old Male
Authors:   Department of Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA, Ambrogi Christopher , Ndoye Madina ,   Department of Urology and Andrology, Hopital General Idrissa Pouye, Dakar, Senegal
Published: July 2021

The term “Situs ambiguus” describes the configuration when some, but not all thoracic and abdominal organs are abnormally positioned. It is commonly associated with polysplenia, or multiple spleens. 50-100% of situs ambiguus with polysplenia have associated cardiac malformations [1]. We present a 70 year old male who came to our hospital for complete, acute, urinary retention, and was found to have invasive prostate cancer. Incidentally, the liver was positioned on the left side, and the spleen was located on the right side. There were multiple perisplenic nodular formations with peripheral calcifications that had enhancement kinetics similar to those of the spleen, suggesting polysplenia. In low thoracic cuts, the tip of the heart was clearly on the left side. The presence of situs ambiguus with polysplenia in the absence of cardiac abnormalities makes this case a unique presentation of an already rare condition. Clinicians should regularly consider the possibilities of anatomical variation in their medical and surgical practices.
Selected Landmark Studies in the Role of the Mesolimbic System
Authors:   Johns Hopkins University, Baltimore, Suresh Prakul , Patel Karan ,   Cooper Medical School of Rowan University, Camden
Published: July 2021

The mesolimbic system has been demonstrated to have a major role in the perception of pain, but the mechanisms by which this occurs are poorly understood. In this paper, we review selected landmark studies that have contributed to our present understanding of the role of the mesolimbic system. The included studies outline the molecular mechanisms of the mesolimbic system's role in analgesia, pain relief, and feelings of decreased motivation and depression as a result of chronic pain. Because chronic pain is among the most highly-cited reasons for decreased quality of life, advancing our understanding of the function and mechanism of the mesolimbic system may be critical to improving the quality of life for millions of people around the globe.
Risk Factors Associated with Congenital Heart Disease in Patients Presenting to Aljalila Cardiology Clinic between January 2020- May 2020: A Case Control Study
Authors:   Pediatric Cardiologist, AlJalila Children Heart Center, Dubai UAE, Alasrawi Samah
Published: July 2021

Objective: To investigate the association of maternal diabetes, maternal smoking and syndromes with congenital heart disease (CHD) in patients attending Aljalila cardiology clinic between January 2020 and May of 2020. Methods: A case control study to assess the association of maternal diabetes, maternal smoking and syndromes with CHD. All patients that presented to the clinic between January 2020 and May of 2020 were included. An interviewer administered questionnaire was used to record the presence of maternal diabetes, maternal smoking, and the type of syndrome and type of CHD. Patients with CHD were included in the case group and patients who did not have CHD were in the control group. Age, gender, and nationality were also collected from the hospital records. Fisher exact test and logistic regression was used to analyze the results. Results: A total of 177 cases and 211 controls were recruited. All the risk factors increase the risk of CHD, with maternal diabetes (OR 6.3, 95% CI 2.7-14.6) having the strongest association, then syndromes (OR 5.1, 95% CI 2.3-11.3) and lastly maternal smoking (OR 4.0, 95% CI 1.0-16.3). The most common type of CHD is ventricular septal defect.
Selected Landmark Studies in the Role of the Mesolimbic System
Authors:   Johns Hopkins University, Baltimore, Suresh Prakul , Baccouche Basil M ,   Stanford University School of Medicine, Palo Alto
Published: July 2021

The mesolimbic system has been demonstrated to have a major role in the perception of pain, but the mechanisms by which this occurs are poorly understood. In this paper, we review selected landmark studies that have contributed to our present understanding of the role of the mesolimbic system. The included studies outline the molecular mechanisms of the mesolimbic system's role in analgesia, pain relief, and feelings of decreased motivation and depression as a result of chronic pain. Because chronic pain is among the most highly-cited reasons for decreased quality of life, advancing our understanding of the function and mechanism of the mesolimbic system may be critical to improving the quality of life for millions of people around the globe
Isolated Cleft of the Posterior Mitral Leaflet in 8 Year Old Patient
Authors:   Department Of Cardiac Surgery, Heart Center Sarajevo, Sarajevo, Bosnia and Herzegovina, Karavdic Merjema , Halimic Mirza ,   Department Of Pediatric Cardiology, Heart Center Sarajevo, Bosnia and Herzegovina
Published: July 2021

Cleft of the mitral valve is a rare cause of the congenital mitral regurgitation. Isolated cleft is uncommon finding and is more often found associated with some form of endocardial cushion defect. Cleft of the septal leaflet is found much more often than the defect in the posterior leaflet. Mitral clefts can extend to the mitral annulus or they can be less ''deep'' and show only minor regurgitation. Clinical importance of the isolated cleft of the mitral valve (ICMV) is that it can be successfully corrected by surgery and that it can have good long-term results.
Diagnosis of Pregnant Women with Seizures at Tikur Anbessa Hospital
Authors:   Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Ethiopia, Kebede Beliyu Ejo , Adugna Geleta Meseret ,   Federal Ministry of Health, Pharmaceutical and Medical Supplies Directorate, Addis Ababa, Ethiopia.
Published: July 2021

Information is yet scanty concerning current antiepileptic drugs prescribing patterns for women of childbearing age with epilepsy. Most women with epilepsy can give birth to perfectly healthy children after uneventful pregnancies. Best approach to management of epilepsy in pregnancy requires knowledge of the teratogenic effects of antiepileptic drugs, of the risks with uncontrolled seizures. Understanding the effects of pregnancy on seizure control and of gestational effects on antiepileptic drugs disposition is useful in early clinical diagnosis and patient management systems. We evaluated utilization of antiepileptic drugs among women of childbearing age against pre-set standards in epilepsy clinic of Tikur Anbessa Special and Referral Hospital from May 2017 to May 2018. The mean age of the women were 24.92± 6.54, where majority 217 (56.5%) of them aged between 15-25. Eighty-five (22.1%) of the women diagnosed with epilepsy were found to be pregnant, among them 20(5.2%) were breast-feeding. Generalized tonic clonic seizure (62.8%) was found to be the commonest seizure type diagnosed followed by unidentified or uncategorized seizures (16.7%), focal seizures (11.5%), and complex partial seizures (6.3%). Among the variety of anti-epileptic drug regimen or combinations used to treat epilepsy in 384 mothers, monotherapy 259 (67.4%) was the commonest drug regimen prescribed followed by dual therapy 97 (25.3%), and polytherapy 28 (7.3%). We here concluded that Valproic acid 44(51.8%) followed by phenytoin 36(42.4%) and phenobarbital 17(20%) were commonly given for breast-feeding women at Tikur Anbessa hospital.
In Shortly about Shortness of Breath
Authors:   Independent Researcher, Franjic Sinisa
Published: July 2021

Shortness of breath is an uncomfortable feeling of lack of breathing air. Shortness of breath can occur while walking, climbing stairs, running, and even while sitting or lying down. Shortness of breath is a common symptom that can be associated with serious illness or can occur as a symptom if a person is not in physical shape. In addition to other symptoms, it may indicate diseases such as: asthma, lung disease, anemia, heart disease, etc. Frequent occurrence requires clinical determination of the cause, and treatment is in accordance with the diagnosis.
Diagnosis and Control for the Second Degree of Lateral Gastrocnemius Muscle Tear in High-School Soccer Player: A Case Report
Authors:   Department of Medical Technology, Teikyo University, 359 Otsuka, Japan, Hiruma Eisuke
Published: July 2021

This case study presents the epidemiology, etiology, diagnostic criteria, therapeutic intervention and modification, and rehabilitation of a lateral gastrocnemius tear in high school male soccer player. The patient injured his left gastrocnemius during soccer practice without contact. His injured leg was controlled with heel pad for equine to reduce the stress on injured gastrocnemius muscle for the initial of two weeks. The patient returned to regular practice 8 weeks after injury.
The Association between Gut Microbiome and Post-Cholecystectomy Syndrome and Diarrhoea: A Review
Authors:   Liver Solutions Clinic, R Lim ,   Monash University Clayton (Melbourne, Australia), SKY Chang ,   Liver Solutions Clinic,   GLAD Clinic,   National University of Singapore (NUS)
Published: July 2021

Cholecystectomy is a common surgical gold-standard treatment for cholelithiasis and its complications. Generally, gallbladder removal has no long-term ramifications, and most patients recover quickly without impairment on daily living activities. Nonetheless, some patients are found to develop postcholecystectomy syndrome (PCS) or diarrhoea (PCD), which can be uncomfortable, inconvenient and impair living quality. There is neither clear aetiology, nor clear solution for PCS/PCD. The significance of gut microbiome in maintaining a healthy gastrointestinal system is well-established. Dysbiosis, an imbalance between commensal and pathogenic bacteria, can lead to multiple GIT disorders like IBS or functional dyspepsia and has a strong association with change in stool consistency [1-3]. Alteration in gut microbiota can easily occur with physical or chemical changes. An invasive procedure like cholecystectomy exposes the intestinal lumen to exogenous bacteria and causes inflammatory changes, while secretory pattern changes of bacteriostatic bile acid disrupt the pH and microbial composition of the intestinal lumen. As such, it is worth understanding GIT microbiota changes post-cholecystectomy. While the concept of gut microbiome changes potentially causing PCS/PCD is not unknown, there is lack of literature reviewing research on what these microbial alterations are and establishing their association with PCS/PCD. In this review, we consolidate previous findings on post-cholecystectomy microbial alterations, effectiveness of diet on PCS/PCD based on gut microbiota and discuss the overall link between gut microbiome and PCS/PCD. This can deepen insight into aetiologies of idiopathic PCS/PCD, provide better management of PCS/PCD-associated comorbidities, and potentially offer a resolution for PCS/PCD through prescription of probiotics and prebiotics.
Case Report of Ischemic Colitis Post Mild Covid 19 Infection
Authors:   Sahel General Hospital, Gastroenterology Department, Lebanese University, Michael Bouhairie Malek , Seblani Racha ,   Sahel General Hospital, Gastroenterology Department, Lebanese University
Published: July 2021

Background: COVID-19 has emerged as a global health pandemic emergency with a massive effect on public health globally. In addition to its effects on respiratory tract, COVID-19 disease had been linked to many gastrointestinal symptoms. Rarely, it has been associated with intestinal ischemia due to the resultant hypercoagulable state. Case Summary: We report a case of a young lady previously healthy, who presented with severe abdominal pain associated with tenesmus and mucoïdbloody diarrhea, diagnosed to have ischemic colitis post covid19 infection. One of the port of entry of coronavirus 2 (SARS-CoV-2), to cause infection, is via an angiotensin-converting enzyme2 (ACE2). View that these ACE 2 receptors are highly expressed at the level of gastrointestinal tract, a variety of symptoms will occur. Recently, coagulopathy due to COVID-19 has emerged as a major component of the disease. The resultant ischemia has been reported to be associated with a hypercoagulable state. Lately, few cases were described worldwide of intestinal ischemia due to COVID-19 infection, mainly occuring in patients presenting with severe respiratory illness. Our patient did not complain of severe COVID-19 infection in the context of dyspnea or respiratory distress and did not have any features of shock requiring a vasopressor therapy. Treatment for ischemic colitis mainly involves supportive care with bowel rest. Conclusion: New datas concerning covid 19 infection are emerging. Ischemic colitis is a new aspect of manifestation of the infection, which can take place without necessarily being linked to a severe infection with covid 19 as in our case.
Enigmatic Case of Bladder Hematoma Masquerading as Massive Hemoperitoneum in Postpartum Phase: Cystoscopic Management
Authors:   Department of Minimally Invasive Gynaecology, Paras Hospitals, Gurugram, India, Panwar Akshita , Lata Kusum ,   Department of Minimally Invasive Gynaecology, Paras Hospitals, Gurugram, India
Published: July 2021

Significant spontaneous bladder trauma at vaginal birth is rare and affects <1% of deliveries. Bladder contusion resulting in urinary retention 5 days after normal delivery is being described here in a 23-year-old primiparous lady who underwent cystoscopic fulguration of the bleeder. Early diagnosis and prompt treatment can prevent long term, irreversible damage to the detrusor muscle that can have a permanent impact on a woman’s quality of life. A multidisciplinary surgical team comprising gynaecologists, urologists and anaesthetists carried out examination under anaesthesia and cystoscopy. An arterial bleeder below the interureteric ridge in the area of bladder neck was identified and coagulated with Resectoscope loop to secure hemostasis ensuring a safe distance from both ureteric orifices. Postoperative continuous bladder drainage for 3 weeks resulted in complete recovery. Careful evaluation of the stable patient with radiologic imaging and endoscopic management in competent hands should be considered before proceeding with any open surgical procedure in such cases
Bilateral Fallopian Tube Hydatid Disease Masquerading as Pelvic Malignancy: A Case Report with Review of Literature
Authors:   Departments of Pathology * and General Surgery**, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India, Kumar Gupta Rakesh , Rai Nidhi ,   Departments of Pathology * and General Surgery**, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
Published: July 2021

Echinococcosis is a zoonotic disease commonly known, as hydatid disease is endemic in India and mostly caused by Echinococcus granulosus. Hydatid cyst most commonly involves liver followed by lungs with a frequency of 60% and 20–30% respectively. Rarely, it can primarily involve pelvic organs in females such as uterus, ovaries, fallopian tubes etc. either separately or sometimes together, which may mimic malignancy and create diagnostic dilemma. Till date, around 30 case reports of primary fallopian tube hydatid disease are reported, however none of them mentioned bilateral involvement. Herein, we report a case of bilateral fallopian tubal hydatid disease in a 45-years-old female presented with a 4 months history of lower abdominal pain and abdominal distension with review of literature
Myomectomy under Cervico-Isthmic Tourniquet: Experience of the Gynecologic-Obstetric Department at the University Teaching Hospital of Cocody (Abidjan)
Authors:   Department of Obstetric Gynaecology of Angré’s University Teaching Hospital/ Abidjan, Cassou Roland Adjoby , Priva Akobé ,   Department of Obstetric Gynaecology of Angré’s University Teaching Hospital/ Abidjan
Published: July 2021

Objective: To report the experience of Cocody’s University Teaching Hospital in the practice of myomectomies under cervico-isthmic tourniquet and to assess its impact on per and post-operative blood loss. Methodology: It was a case control study covering a 10-year period (that is from January 2009 to December 2018), and a population of 600 patients divided into two groups (A and B). The first (A) includes all patients admitted and operated on uterine myomas after the introduction of a cervico-isthmic tourniquet (CIT) by Foley catheter (case) and the second all patients admitted and operated on without CIT(Control). Results: The average age of patients was 37 years with extremes of 24 and 50 years They were nulligestous in 38.3% of cases and nulliparous in 61.7% of cases. Hemorrhagic complications made up 65% of the surgical indications. The practice of myomectomy under cervico-isthmic tourniquet was associated with a relatively significant reduction in the duration of intervention including 20 minutes of time saved and a considerable reduction in blood loss(p<0,001). Blood loss was estimated at 438.8 ml (+/- 127) in the CIT group, compared to 685.4 ml (+/- 182) in the control group(p<0,001). The postoperative hemoglobin rate in the cervico-isthmic tourniquet patients was 10.1 g/dl compared to 8.7 g/dl in the non-distort patients(p<0,0012). No complications related to the presence of CIT were observed after sufficient follow-up. The length of stay in the hospital was estimated to be 2.8 days compared to 4.4 days in patients who did not use a tourniquet (p=0,15). Conclusion: The use of the cervico-isthmic tourniquet in myomectomy, considerably limiting blood loss and reducing postoperative morbidity, appears to be an alternative to blood transfusion in countries of sub-Saharan Africa, where the dispensing of blood products remains a problem.
Combined Hormonal Contraception and the Adenoviral Vector Covid-19 Vaccines
Authors:   Program Director at Maternal & Fetal Health Program at Dr Arab Medical Center, Jeddah, Saudi Arabia, Arab Hisham
Published: July 2021

There are at least 4 different types of covid-19 vaccines that are available worldwide. The most widely used ones are the mRNA genetic vaccine and the viral vector vaccine. In the midst of the COVID-19 pandemic and after the administration of millions of those vaccines globally over few months, several national health authorities across Europe decided to pause the administration of the chimpanzee adenovirus-vectored vaccine1 (ChAdOx1nCoV-19, AZD1222; Oxford/AstraZeneca) after sporadic reports of severe cases of thrombocytopenia, bleeding, or thrombosis in those who received this vaccine. This complication has been identified as Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) that affects mostly woman under the age of 55 years at a rate of 1:100,000 vaccine doses. Combined hormonal contraceptives (CHC) are known to carry the risk of thrombosis in certain high-risk population. Accordingly, women taking those contraceptives raised their concern of getting such vaccine. This review will attempt to explain the different mechanisms of thrombosis which abolish any link between the VITT complication and the use of CHC. Reassuring statements from authoritative agencies are also included.
Effects of Umbilical Cord Blood Stem Cells on Coronary Artery Damage in Mice with Kawasaki Disease By High-Frequency Ultrasound
Authors:   Childrens Hospital, Shaanxi Provincial People’s Hospital, Xi’an, China, Zhao Na , Zhang Xue-mei ,   Ultrasonic diagnostic center, Shaanxi Provincial People’s Hospital, Xi’an, China, Guo Hua ,   Clinical Laboratory of Shaanxi provincial people’s hospital, Xi’an, China
Published: July 2021

Objective: to use lactobacillus casein cell wall extract (LCWE) to induce Kawasaki disease (KD) mouse model, and analyse the process of coronary artery damage and effects of umbilical cord blood stem cells by high-frequency ultrasound in small animals. Methods: LCWE was prepared and 18 BALB/c pups were randomly divided into two groups: 15 in KD model group and 3 in the normal control group. KD model was induced by a single intraperitoneal injection of 0.5ml LCWE in the model group, and changes of the coronary artery were observed at 2d, 21d and 30d after the injection, respectively. From the 16th day of modeling, 300 μL PBS was injected intraperitoneally daily in the control group and model group. The hUC-MSCs 300 μL (105/mL) were intraperitoneally injected daily for 10 consecutive days in the stem cell group. The mice were sacrificed in batches on day 2, 15, 21 and 30, and the morphological changes of coronary arteries were observed by echocardiography and histopathology. Results: the change of coronary artery diameter could be accurately measured by high-frequency small animal ultrasound. At 21d, the coronary arteries of the model group were widened compared with those of the control group. At 30d, there was no significant difference between the model group and the previous model group. Histopathology showed slight swelling of the epicardium of aortic valve, mitral valve, right ventricle and atrium, scattered infiltration of a few neutrophils, dilatation of the coronary artery lumen, necrosis and disintegration of a small number of myocardial cells, and significant hyperplasia of local fibrous connective tissue accompanied by solid calcium salt deposits. After hUC-MSCs intervention treatment, B-ultrasound showed a decrease in the main coronary artery diameter, histopathology showed multiple lymphocytes, eosinophilic granulocytes, and mononuclear cell infiltration in the left atrial appendage of mice, and no obvious vascular inflammatory reaction or other obvious abnormalities were observed. Conclusion: high-frequency ultrasound can be used to clearly obtain the coronary artery image of KD mice and dynamically observe the evolution process of coronary artery diameter, which provides more diagnostic basis for the treatment of clinical KD. And hUC-MSCs intervention reduced the pathological lesion of coronary artery inflammation in mice compared with the model group.
Clinical Analysis and Study of Smecta in the Treatment of Rotavirus Enteritis in Children
Authors:   Department of Pediatrics, Xi ‘an Bei che Hospital, XI’AN, China, Xiao Cheng
Published: July 2021

Objective: To explore the clinical effect of Smecta in treating rotavirus enteritis. Methods: 40 children with rotavirus enteritis treated in our hospital were randomly divided into observation group and control group. The observation group was treated with smecta plus routine treatment, while the control group was treated with routine treatment. The efficacy and adverse reactions of the two groups were compared. Results: The effect of smecta in observation group was not clear.
A Contemporary Evaluation of Calculated and Directly Measured LDL
Authors:   Department of Laboratory Medicine, Changi General Hospital, Singapore, CS Lau , WJ Loh ,   Department of Endocrinology, Changi General Hospital, Singapore, SK Phua ,   Department of Medicine, National University of Singapore, Singapore
Published: July 2021

Background: There are few contemporary evaluations of directly measured LDL (dLDL) assays. We evaluated the performance of the Roche Gen.3 dLDL assay and compared it to the Friedewald LDL (cLDL) in a large cohort, tested on the Cobas c702 analyser. Methods: We evaluated assay precision, linearity, and limit of detection (LOD). To compare cLDL/dLDL, lipid panels (TC/TG/HDL/cLDL) from 2017- 2019 (n=117,090) were tested for dLDL. Samples with TG >400mg/dL (4.5mmol/L) (n=605) and negative cLDL (n=32) were excluded. We examined the difference between cLDL/dLDL (n=116,453), the influence of increasing levels of TG/LDL on their measurements, and how cLDL/dLDL classified cardiovascular risk by LDL levels. Results: The Roche dLDL assay has a CV of 1.0%/0.9% at 58.4/106.4mg/dL, is linear from 19.4-374mg/dL, and has a verified LOD of 4.2mg/dL. Despite close agreement between dLDL/cLDL [Pearson r=0.98 (95%CI 0.9795-0.9800)], cLDL underestimates dLDL in 98.5% (n=114,750) of subjects across all levels of LDL/TG. The underestimation increases with LDL/TG levels. cLDL classified more subjects (63.5%) as having a desirable LDL (<100mg/dL) than dLDL (46.9%). Conclusions: The Cobas c702 dLDL assay performs well, and contemporary cLDL results underestimate dLDL across all levels of TG/LDL. cLDL classifies more patients into lower cardiovascular risk categories than dLDL