bluuebunny/crossref_metadata_2025 huggingface dataset:
Legal Protection of Workers in a Certain Time Work Agreement (PKWT) is Reviewed from Law No. 11 of 2020 Concerning Job Creation and Government Regulations
Authors: . Kusbianto , . Surianto
Published: October 2022

The presence of the Job Creation Law is expected to be able to protect the welfare of workers. Workers are an asset to a company. The 1945 Constitution of the Republic of Indonesia Article 27 paragraph (2) protects the basic rights inherent in workers. The implementation of Industrial Relations in line with the development of the economy in general-, is a logical consequence of the absolute development required. This research was conducted to find out and analyze the Legal Protection of Workers / Workers in PKWT, agreement clauses in certain time work agreements (PKWT), legal remedies that can be carried out in resolving problems between the Implementation of PWKT, legal protection for workers/workers who are bound by a Certain Time Work Agreement (PKWT) in Government Regulations and Law No. 11 of 2020 concerning Job Creation. This research shows that PKWT Contract agreements generally contain several clauses that must be included, including a termination clause, an employment agreement expiration clause, and a clause on the rights and obligations of the parties. Work protection for workers/workers can be carried out properly if the parties know their respective rights and responsibilities, and understand labor laws in accordance with norms, job creation laws, and government regulations. The government must socialize workers in providing work protection that includes the rights and obligations of workers in accordance with job creation laws and government regulations. So that the workers are not blind to their own rights and obligations in accordance with applicable Laws and Government Regulations.

Keywords: Legal Protection, Workers, PKWT
Analysis of the Effect of Transformational Leadership, Work Motivation and Compensation on Employee Performance on Sikamoni Group Radio
Authors: Paralisa Yuli Widya , Edward Yusuf Ronny , . Hendry
Published: October 2022

The purpose of this study was to determine the effect of transformational leadership, work motivation and compensation on employee performance at Radio Sikamoni Group, either partially or simultaneously. The population in this study were all employees who worked at Radio Sikamoni Group. Many samples in this study were 67 respondents. Data were collected using a questionnaire. The data is tested using validity and reliability tests, and the data must meet the elements of the classical assumption test. Furthermore, the data analysis test was carried out using multiple regression analysis, t test, F test, and coefficient of determination. The results of this study indicate that there is a positive and significant effect of transformational leadership on employee performance. There is a positive and significant effect of work motivation on employee performance. There is a positive and significant effect of compensation on employee performance. There is a positive and significant effect of transformational leadership, work motivation and compensation on employee performance at Radio Sikamoni Group. The magnitude of the ability to influence transformational leadership, motivation, compensation explains employee performance is 77.9% while the remaining 22.1% is explained by other variables that are not included in this research model.

Keywords: Transformational Leadership, Work Motivation, Compensation, Performance
Effects of Return on Assets, Firm Size, and Institutional Ownership on Financial Distress with Capital Structure as a Moderating Variable (An Empirical Study on the Manufacturing Companies Listed on Indonesia Stock Exchange)
Authors: Bahri Maharawati , Bukit Rina Br , Erwin Keulana
Published: October 2022

This research investigates and tests the effects of Return on Assets, firm size, and institutional ownership on financial distress in the manufacturing companies listed on the Indonesia Stock Exchange and whether the capital structure can moderate the correlation between independent and dependent variables. This causal research uses secondary data, which are analyzed using SPSS. It takes the manufacturing companies listed on Indonesia Stock Exchange from 2016 until 2020 as the population. The purposive sampling technique is employed to select 84 companies and obtain 420 observations by multiplying the sample by five years of research. The findings indicate that partially Return on Assets has positive and significant effects on financial distress, firm size has positive and significant effects on financial distress, and institutional ownership has negative and insignificant effects on financial distress. In addition, the capital structure cannot moderate the effects of Return on Assets, firm size, and institutional ownership on financial distress.

Keywords: return on assets, firm size, institutional ownership, capital structure, financial distress.
Macroglossia and amyloid deposition of the tongue
Authors:   University of Tennessee Health Science Center, Nashville, USA., Weidenbaum Chloe
Published: October 2022

Amyloidosis encompasses a group of disorders involving extracellu2lar deposition of an abnormally folded protein. Light chain amyloidosis is a common type of systemic amyloidosis and is typically associated with an underlying plasma cell neoplasm. Here we describe an uncom2mon presentation of light chain amyloidosis.
Late rectal hematoma after stapled hemorrhoidopexy: A case report
Authors:   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Marchetti Francesco , Pepe Francesco ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Baglioni Agnese ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Chimisso Laura ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Rossin Eleonora ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Aisoni Filippo ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy, Carcoforo Paolo , Ascanelli Simona ,   Department of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Italy
Published: October 2022

Intestinal wall hematoma can occur after a blunt abdominal trauma or can be a spontaneous event. Spontaneous intramural rectal hematomas are rare but can occur in patients taking anticoagulant therapy or with hematologic disorders and associated blood clotting disorders. We present a case of a spontaneous symptomatic rectal wall hematoma occurred 10 years after a stapled hemorrhoidopexy which was successfully treated with non-operative management. Keywords: Hemorrhoids; Longo’s hemorrhoidopexy; Stapled hemorrhoidopexy; Long-term complication; Rectal wall hematoma.
Nutritional adequacy of essential vitamins and minerals consumed by edentulous elderly at Little Sisters of the Poor in Enugu, Enugu State, Nigeria
Authors:   Department of Dental Therapy, Faculty of Dental Health, Federal College of Dental Technology and Therapy, Trans-Ekulu, P.M.B. 01473, Enugu, Nigeria., Adimora Ethel Ebere , Uzoeto Henrietta Onyinye ,   Department of Dental Therapy, Faculty of Dental Health, Federal College of Dental Technology and Therapy, Trans-Ekulu, P.M.B. 01473, Enugu, Nigeria., Nancy Oforkansi Chioma ,   Department of Dental Therapy, Faculty of Dental Health, Federal College of Dental Technology and Therapy, Trans-Ekulu, P.M.B. 01473, Enugu, Nigeria.
Published: October 2022

Edentulism is having few or no teeth in the oral cavity, which is an irreversible condition. It has been shown to be more prevalent in the aged especially among the female. Edentulism which is an age related problem is associated with inability to eat, which render the aged deficient of essential vitamins and minerals. The aim of study is to determine the Nutritional Adequacy of Essential Vitamins and Minerals consumed by Edentulous Elderly at Little Sisters of the Poor, Home for the Elderly, Enugu. The home houses 54 inmates. All inclusive sampling technique was adopted for the study. Oral examination was conducted using mouth mirror to ascertain the number of elderly with tooth loss. The food menu used for feeding the inmates was collected from the home and it served as a guide for collection of food samples for chemical analysis to determine the adequacy of essential vitamins and minerals (vitamin D, vitamin B12, calcium, potassium and magnesium). Minerals and Vitamin D and Vitamin B12 were analyzed using Wet Ashing method. The result showed that out of 54 elderly inmates, 44 inmates are edentulous of which females are mostly affected. The result from chemical analysis of food showed 32.5 mcg intake of vitamin D,12.2 mcg intake of vitamin B12, 0.017 mg intake of calcium, 0.346 mg intake magnesium and 0.034 mg intake of potassium and this as compared with recommended daily intake that there is adequate intake of vitamin D, excessive intake of vitamin B12 but inadequate intake of calcium, magnesium and potassium. This in turn shows that there is inadequate consumption of essential vitamins and minerals by edentulous elderly at Little Sisters of the Poor, Home for the Elderly, Enugu. This shows that there is need to include food rich in essential vitamins and minerals and also give supplement that are in form of medicine to the inmates to meet the adequacy.
Role of mitomycin-C to reduce post FESS adhesion and ostial stenosis
Authors:   Department of ENT Head & Neck Surgery, Shaheed Mohtarma Benazir Bhutto Medical College & Lyari General Hospital, Karachi, Pakistan., Humayun Nabeel Hassan , Usman Rahila ,   Department of Radiology, Chughtai Medical Center, Karachi, Pakistan., Ahmed Shehzad ,   Department of ENT Head & Neck Surgery, Shaheed Mohtarma Benazir Bhutto Medical College & Lyari General Hospital, Karachi, Pakistan.
Published: October 2022

The aim of this study is to determine adhesion formation rate and antrostomy closure rate after the use of Mitomycin-C in patients underwent FESS. This is a prospective case control study conducted at ENT Department Lyari General Hospital, Karachi, Pakistan. Fifty one patients included with diagnosis of bilateral chronic rhinosinusitis or allergic fungal sinusitis and were the surgical candidate, underwent bilateral Functional Endoscopic Sinus Surgery (FESS). The patients were evaluated using Lund-Mackay staging system prior to surgery. At the completion of surgery Mitomycin-c (MMC) was applied in one nasal cavity the other nasal cavity served as a control. Among fifty one patients both nostrils were used hence we have 51 cases and 51 controls. The patients were followed for a minimum period of three months after surgery. Subjective improvement of symptoms were recorded as well as rigid nasoendoscpic examination was also performed regularly. The adhesion formation rate in MMC applied nasal cavities was 11.7% as compared to 64.7% of controls. The middle meatal antrostomy closure rate was 41% and 5% in controls and MMC applied group respectively. Hence mitomycin-c application has shown benefit in reducing post FESS ostial stenosis and adhesion formation between middle turbinate and lateral nasal wall. Application of Mitomycin-C has impact on reducing post FESS adhesion formation and middle meatal antrostomy closure.
Monosomy 18p and trisomy 17q in a boy with unilateral absence of the right pulmonary artery
Authors:   Genetics Department, Hospital Universitario “Dr. José Eleuterio González” and Medicine Faculty, Autonomous University of Nuevo León, Monterrey, Mexico, Calzada-Davila Melissa
Published: October 2022

Unilateral absence of the pulmonary artery (UAPA) is an infrequent finding, with an estimated prevalence of 1 in 200,000 young adults. The percentage of syndromic UAPA is not known but mostly does not have a syndromic association, only being reported with the 22q11 deletion syndrome.
Fahr syndrome presenting with epileptic seizure: A rare case report
Authors:   Department of Neurology, Ankara Training and Research Hospital, Turkey.
Published: October 2022

Fahr’s syndrome is a rare neurodegenerative disorder characterized by abnormal symmetrical calcifications of the basal ganglia, thalami, subcortical hemispheric white matter and deep cerebellar nuclei.
MELAS exhibiting multiple mass enhancement and dural enhancement: Case report
Authors:   Department of Radiology, The Affiliated Hospital of Qingda University, Qingdao, Shandong, China., Sun Wei , Bai Di ,   Department of Radiology, The Affiliated Hospital of Qingda University, Qingdao, Shandong, China., Fu Shengli ,   Department of Radiology, The Affiliated Hospital of Qingda University, Qingdao, Shandong, China., Niu Zongren ,   Department of Radiology, The Affiliated Hospital of Qingda University, Qingdao, Shandong, China., Ren Yande ,   Department of Radiology, The Affiliated Hospital of Qingda University, Qingdao, Shandong, China.
Published: October 2022

MELAS is maternally-inherited encephalomyopathy, characterized by seizures, migrainous headaches, lactic acidosis, vomiting, and recurrent stroke-like episodes. The strokes are affecting mainly the cerebral cortex and can be visualized by MRI. Most of the reported cases in the literature present with no enhancement or slight enhancement on MRI enhanced scan, but exhibiting multiple nodular enhancement and dural enhancement has never been reported. We here report a case of MELAS with multiple nodular enhancement and dural enhancement inside the brain on enhanced MRI.
A case of hemorrhagic septicemia in pasteurellosis
Authors:   National Science Center for Extremely Dangerous Infections, Almaty, Kazakhstan, AM Dmitrovskiy
Published: October 2022

The patient (DH 8993), a mail, 17 years old, a resident of the rural district of the Zhambyl region of Kazakhstan, participated in the cutting and butchering of farm animals. He became acutely ill on 2.12.21 (1 day of illness), - the temperature increased (up to 38), headache, weakness appeared, appetite decreased.
Unilateral blindness following elective nasal septoplasty
Authors:   Associate Professor of Ophthalmology, Eye Research Center, Mashhad University of Medical Science, Mashhad, Iran., M Sharifi , F Shekarchian ,   Fellowship in Strabismus, Eye Research Center, Mashhad University of Medical Science, Mashhad, Iran.
Published: October 2022

Purpose: To report a case of unilateral blindness following nasal septoplasty. Method: A 38 years old man, who referred to ophthalmology service one day after nasal septoplasty. He complained of vision loss in his right eye and right eye lids swelling and ecchymosis. The paranasal and orbital computed tomography scan revealed direct traumatic lesion to medial part of optic nerve in orbital apex. Result: Ophthalmic examination revealed a visual acuity of no light perception in right eye and 20/20 in left eye. There was positive marcus gunn in right eye and no direct reaction to light.Indirect ophthalmoscopy was normal in both eyes. Conclusion: Nasal septoplasty is an otorhinolaryngology surgical procedure that performed frequently for the correction of nasal septal deviation. It can be associated with baneful complications Unilateral blindness is a rare, complication of nasal septoplasty. Keywords: Blindness; Nasal septoplasty; Optic nerve injury.
Post covid thromboembolic catastrophe: Any management readdressal needed in covid era?
Authors:   Professor of Cardiology, Dayanand Medical College & Hospital, Unit Hero DMC Heart Institute, Ludhiana, India., Chabbra Shibba Takkar
Published: October 2022

COVID-19 predisposes to a hyper-coagulable state. Thromboembolic sequelae of COVID-19 might be the first presentation of the disease. A raised titer of anti-SARS-CoV-2 antibodies might suggest an underlying pro-thrombotic milieu secondary to post-COVID status. The present case report cites a 29-year-old obese male presenting with acute pulmonary embolism and right atrium to right ventricle thrombus in transit diagnosed to be post-COVID on the basis of raised anti-SARSCoV-2 antibodies. The patient had recently completed a guidelinedirected 3-month anticoagulation regimen for distal DVT. Despite apt anti-coagulation therapy, the patient presented with a catastrophic thromboembolic event, later diagnosed to be a post-COVID sequela. Notwithstanding the prior guidelines, the duration of the anticoagulation regimen needs to be redefined in the COVID pandemic era given its thromboembolic potential.
Rare recurrent solitary plexiform neurofibroma of the dorsum of the finger: A case report
Authors:   Department of Hand Surgery, The Second Hospital of Jilin University, No. 218 Lane Ziqiang, Nanguan District, Changchun 130041, Jinlin Province, China, Ou Xiao-Lan , Li Rui ,   Department of Hand Surgery, The Second Hospital of Jilin University, No. 218 Lane Ziqiang, Nanguan District, Changchun 130041, Jinlin Province, China, Qu Wen-Rui ,   Department of Hand Surgery, The Second Hospital of Jilin University, No. 218 Lane Ziqiang, Nanguan District, Changchun 130041, Jinlin Province, China, Tian Heng ,   Department of Hand Surgery, The Second Hospital of Jilin University, No. 218 Lane Ziqiang, Nanguan District, Changchun 130041, Jinlin Province, China
Published: October 2022

Background: Plexiform neurofibroma (PN) is a subtype of neurofibroma that is rather uncommon in the clinic. Plexiform neurofibroma is usually associated with neurofibromatosis type I (NF1). Only very few patients have isolated PN, which means they have neither NF1 signs nor relevant family history. Solitary PN is extremely rare. There have been no instances of finger back PN or solitary PN all around the world, which could lead to misdiagnosis, missed diagnosis, and mistreatment. Case presentation: We present a rare case of a 50-year-old middleaged woman who experienced numerous postoperative recurrences of painful tumors on the dorsal side of her proximal middle finger on her right hand. Following surgery, the pathology diagnosis was PN. The pathology diagnosis after surgery was PN. After the operation, the wound healed in stage I, and the outcomes were satisfactory. Conclusion: In the dorsal finger nerve, solitary PN can occur. As a result, the differential diagnosis of NF1, PN, and isolated PN as hand masses is crucial for early diagnosis and rational treatment, especially for masses with pain associated with neuropathy should be considered as a possibility of this disease. The lesion may be invasive or multiple in character, Keep a close eye on cautious probing throughout the surgery. To reduce recurrence, to avoid further deterioration, and to alleviate patients’ agony and psychological strain, the lesion tissue must be entirely removed. Keywords: Plexiform neurofibroma; Solitary plexiform neurofibroma; Neurofibromas; Recurrence; Case report.
Atlantoaxial subluxation of the C1/C2 vertebrae in the pediatric patient: A case study
Authors:   Department of Bioengineering, Clemson University, Clemson, SC, USA., Saenz Sebastian , Wong Jonathon ,   Department of Pediatric Surgery, Albert Einstein College of Medicine, Bronx, NY, USA., Percy Stephen ,   Department of Pediatric Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA., Monoky David J ,   Department of Radiology, Medical College of Ohio, Toledo, OH, USA., Mazzola Catherine A ,   Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Published: October 2022

A nine-year-old male presenting with neck pain and head tilt was referred for neurosurgical evaluation. According to the referring pediatrician, the head tilt and torticollis had persisted for the previous three weeks. Of note, a prodromal upper respiratory viral illness was reported, with erythema of the left mastoid area that had resolved after a few days of conservative management. The boy’s family had attempted neck massages and heat compresses without resolution of the head tilt. On examination in the office, the child was well developed and in mild distress.
A case of syndrome of inappropriate anti-diuretic hormone during treatment for lung cancer with uncommon EGFR mutations
Authors:   Department of Thoracic Surgery, Saku Central Hospital Advanced Care Center, 3400-28 Nakagomi, Saku, Nagano 385-0051, Japan., Endoh Hideki
Published: October 2022

Syndrome of inappropriate anti-diuretic hormone (SIADH) sometimes occurs in patients with lung cancer, and it has been reported as a complication after chemotherapy with platinum agents. A 55-yearold woman relapsed after right lower lobectomy for adenocarcinoma harboring uncommon EGFR mutations (G719A in exon 18 and L861Q in exon 21). Brain metastases were found seven months after the operation, and subsequent whole brain irradiation followed by oral treatment with afatinib maintained her status for one year. She was subsequently administered erlotinib with bevacizumab as the third-line treatment for refractory meningeal carcinomatosis, but she developed altered consciousness and was transported to the hospital by ambulance. Laboratory evaluation showed a decrease in serum sodium concentration from 142 to 122 mEq/L. Her altered consciousness was improved by the administration of hypertonic saline; however, the patient died 2 months post-treatment. Although SIADH is sometimes seen before or after treatment for lung cancer, this is the first report of the occurrence of SIADH in a patient with uncommon EGFR-mutated lung cancer.
Antibacterial effect of Amlaki (Phyllanthus emblica) extract against Pseudomonas aeruginosa
Authors:   Lecturer, Department of Pharmacology, Uttara Adhunik Medical College (UAMC), Dhaka, Bangladesh., F Farhana
Published: October 2022

Background: The emergence of bacterial resistance is creating a global health issue. The newer generations of antimicrobials used to combat this problem are expensive and their adverse effects are also notable. Natural herbal remedies have shown promising antimicrobial properties and fewer side effects compared to synthetic antimicrobial agents. In this regard, one of the reputed medicinal plants, Phyllanthus emblica (Amlaki) was investigated for potential antibacterial effect against the most common nosocomial pathogen (Pseudomonas aeruginosa). Objective: The experimental study was to determine the antibacterial effect of aqueous as well as ethanolic extract of (P. aeruginosa) against standard strains of P. aeruginosa. Methods: The study was conducted during the period of July 2018 to June 2019 in the Department of Pharmacology and Therapeutics in collaboration of Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Six separate experiments were done e.g. (Expt-I) Determination of the antibacterial activity of aqueous extract of Amlaki (AAE) and (Expt-II) ethanolic extract (EAE) against P. aeruginosa by Kirby-Bauer disc diffusion method, (Expt-III) Determination of minimum inhibitory concentration (MIC) of aqueous extract, (Expt-IV) ethanolic extract and (Expt-V) a standard antibiotic ciprofloxacin against test organism by broth dilution technique as well as making a comparison with MIC of AAE and EAE and (Expt-VI) Subculture studies of materials from effective AAE, EAE and ciprofloxacin preparations for confirmation of respective results of Experiments III, IV and V. Result: Both aqueous and ethanolic extract of Amlaki was found active against P. aeruginosa in disc diffusion method. Aqueous and ethanolic extracts were used in six different concentrations 100 μg/ml, 200 μg/ml, 400 μg/ml, 600 μg/ml, 800 μg/ml and 1000 μg/ml. For aqueous extract and ethanolic extracts dose dependent inhibitory effect was observed against the test organism. Showing greater inhibitory effect at the same concentrations [AAE vs EAE: 6vs6, 6vs8, 7.5vs17, 15.5vs23.5, 24vs25, 27.5vs35]. The MIC of ciprofloxacin was lowest in comparison to MICs of AAE and EAE for the test organism. The subculture studies also confirmed the results of the previous experiments Conclusion: This study demonstrates that there is definite antibacterial effect of both aqueous and ethanolic extract of P. emblica (Amlaki) against P. aeruginosa. Detection and isolation of the biologically active ingredients responsible for this antibacterial effect demands further large scale study.
Covid-19 in pregnancy: A case series of complexities and challenges in management, pregnancy outcome and review of literature at Northampton General Hospital UK
Authors:   Trainee in Obstetrics and Gynaecology, Northampton General Hospital NHS Trust, NN1 5DR UK., Ekanem Emmanuel
Published: October 2022

Objectives: To describe the complexities and challenges in managing very complex and fascinating cases of Covid-19 in pregnancy at a district hospital in the UK.
Aortic regurgitation in rheumatoid arthritis: A case report
Authors:   Department of Rheumatology, University of Tunis El Manar, Faculty of Medicine of Tunis, Mongi Slim Hospital, Tunisia., Mabrouk Yosr El
Published: October 2022

Recent epidemiological studies have reported an increase in cardiovascular morbidity and mortality in Rheumatoid Arthritis (RA). The most common cardiac involvement in RA is pericarditis, followed by myocarditis, coronary vasculitis, then aortitis. However, valvular heart disease has been rarely reported especially the aortic one. We report here a case of RA associated with a severe aortic insufficiency (AI) with a thickened aortic valve on the echocardiography and aortic regurgitation. All causes of AI other than RA were excluded before concluding to a complication of cardiac RA complication. In long-standing RA, echocardiography should be assessed if patient complain about dyspnea in order to not overlook the valvular lesions.
Granulomatosis with polyangiitis presenting with strawberry gingivitis: Images in rheumatology
Authors:   Vice Chairman and Senior Consultant, Department of Medicine, Sir Ganga Ram Hospital, New Delhi, India., A Kakar
Published: October 2022

A 17 years old girl presented with complaints of painful, swollen and bleeding gums. On examination, she had diffuse reddish nodular gingival swelling with dusky margins that bleed (Figure 1). Her inflammatory markers were high, including markedly elevated anti-PR3 (147.2 AU/ml). The gingival biopsy revealed marked epithelial hyperplasia with ulceration, and the CECTchest showed bilateral nodular cavitary lesions, thus confirming our diagnosis for Granulomatosis with Polyangiitis. The patient received rituximab and methylprednisolone, and the symptoms had started resolving on the follow-up post a fortnight.
Intestinal resection via perineal in a patient with recurrent perineal hernia
Authors:   Department of General Surgery and Digestive System, Hospital Regional Universitario de Málaga, Spain, Sanchez AI Fernandez
Published: October 2022

Colorectal cancer is a pathology whose incidence is increasing, which leads to an increase in associated intestinal resections. The incidence of perineal hernia after abdominoperineal amputation varies according to the series between 1 and 26%.
A cutaneous nodule in the gluteal region revealing an anal fistula
Authors:   Dermatology Department, Ibn Rochd University Hospital, Casablanca, Morocco., Y El Arabi
Published: October 2022

A 32-year-old female patient, primiparous, with no particular pathological history, presented a painful cutaneous nodule located at the perianal level of the left buttock evolving since her delivery 3 years ago, and through which seropurulent fluid flows intermittently. The symptomatology evolved in a context of apyrexia and conservation of the general state. It was treated many times as an abscess by oral antibiotherapy with no total remission. She has no digestive symptoms. Clinical examination found an erythematousdermo-epidermal nodule of renitant consistency measuring 1 cm, with a whitish satellite swelling measuring 0.5 cm. The perilesional skin was flesh-colored and retractile. Examination of the lymph node areas didn’t find palpable lymphadenopathy. Skin biopsy showed non-specific fibrous dermatitis. The soft tissue ultrasound revealed an anal fistula unclogging to the skin. The patient was referred to the gastroenterology department for specialized care of her anal fistula which was cryptoglandular. A fistulectomy was planned.
A linear variant: A case of falx cerebri interhemispheric subdural hematoma
Authors:   Internal Medicine Department, Reading Hospital – Tower Health, Reading, Pennsylvania, USA., Oke Ibiyemi
Published: October 2022

An 80-year-old female with a past medical history of chronic heart failure with reduced ejection fraction, Aortic valve replacement, atrial fibrillation, and recurrent pulmonary embolism on Xarelto presented to the Emergency Room with complaints of cough, shortness of breath, and head trauma following a fall. HR 112 bpm, RR 18/min, SPO2 96% on 6L, BP 160/80 mmHg, Temp 37.2. She was fully oriented and had no focal neurologic deficit; however, she was in respiratory distress and had diffuse rhonchi and rales in both lungs.
Brown sequard syndrome as a manifestation of acute spontaneous spinal haematoma: A diagnostic challenge
Authors:   Stroke Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy., Crupi Domenica
Published: October 2022

Brown-Sequard Syndrome (BSS) is a neurological disorder caused by hemisection lesion of the spinal cord. BSS causes can be dichotomized in traumatic and atraumatic, and they can include vascular causes, as ischemia or haemorrhage. We describe the case of a 52-year-old woman presenting with limbs paraesthesia and right leg hyposthenia, associated with cervical acute nontraumatic pain (C6-C7 level). Neurological consultant was requested with a suspicious of vertebral artery dissection: clinical examination revealed right leg flaccid weakness, loss of pain and temperature sensation in left hemisoma, hypopallesthesia of right limbs and T1-T2 sensory level. Those symptoms were suggestive of a Brown Sequard Syndrome. MRI showed an epidural haematoma compressing spinal cord, associated with abnormal signal to C6-C7 and D1 level of spinal cord. Urgent laminectomy and evacuation were performed. Neurological symptoms improved avoiding permanent paraplegia
Acute intestinal spirochetosis presenting as an IBD mimicker
Authors:   Department of Internal Medicine, University of Illinois College of Medicine, Rockford, Illinois, USA., Zoubi Moamen Al
Published: October 2022

25-year-old male with a history of polysubstance abuse (cocaine and crystal meth) and risky sexual behavior, who presented with a 1-month history of intermittent hematochezia, loose stools and lower abdominal pain. ROS revealed subjective fevers, night sweats, and chills for the preceding 4 days. He used intra-rectal cocaine and crystal meth injection with a needleless syringe.
Mutation in TBX18 and renal abnormalities: A case report and review of literature. Point of view of Nephrologist
Authors:   Complex Oncology Center, Department of Radiotherapy, Boubaker Karima ,   Russe, Bulgaria
Published: October 2022

Mutation in TBX18 is rare. It was linked to some various phenotypes mainly congenital anomalies of the kidneys and urinary tract but never renal angiomyolipoma.
Clostridium difficile and helicobacter pylori co-infection
Authors:   Department of Gastroenterology, King Hussein Medical Center, Amman, Jordan., Yassin Muhammad
Published: October 2022

A 64 year old male patient presented with ulcerative colitis exacerbation along with dyspepsia, nausea and weight loss. He was found to have stool Clostridium Difficilis toxin test positive and H.Pylori stool antigen positive. It is rare to have both of these infections in the same patient and there is no guideline on management of this co infection. The plan was to start treatment of Clostridium Difficilis then to treat Helicobacter Pylori. The patient responded well to this management indicating the possibility of adopting this approach in such patients.
Long term follow-up of vitamin D dependent rickets type IA caused by novel mutation in cyp27b1 in a 2.5 years old Pakistani boy: A case report
Authors:   National Institute of Child Health (NICH), Hospital in Karachi, Pakistan., Rai Versha Rani
Published: October 2022

Rickets usually caused by deficiency of vitamin D and it’s a condition which affects bone development and leads to softening and weakling of bones in children. But there are rare inherited problems reported which leads to rickets and these are, Vitamin D Dependent Rickets Type 1, Vitamin D Dependent Rickets Type 2 (also known as Vitamin D resistant rickets) and 25 hydroxylase deficiency rickets.
Initial clinical experience with radium 223: Case based series with review of the literature
Authors:   Clinic of Nuclear Medicine, University hospital “Alexandrovska”, Bulgaria., V Hadzhiyska
Published: October 2022

The incidence of prostate cancer in Bulgaria is steadily increasing over the last few decades [1,2]. While the therapeutic strategy for hormone sensitive prostate cancer is well established, Metastatic Castration-Resistant Prostate Cancer (mCRPC) is still a challenge with an average life span of not more than two years [3]. Nevertheless, treatment options in this setting have emerged considerably during past ten years and showed significant improvement in survival rates compared to the preexisting palliative regimens [4-6].
Choroidal melanoma in the setting of nevus of ota
Authors:   Trinity Health Mid-Atlantic, Nazareth Hospital, Department of Ophthalmology, Philadelphia, PA, USA., Rabiee Behnam
Published: October 2022

The patient is a 56 years old female who presented to the office with a complaint of blurry vision OS for a few weeks. Upon initial encounter, several pigmented macules were visible around the left eye and on the lids. The patient mentioned she had these lesions since birth.
Kikuchi Fujimoto disease: A rare case of recurrence
Authors:   Clinical Pathology Department, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, Estrada do Forte do Alto do Duque, 1449-005 Lisbon, Portugal., Azevedo Ana Paula
Published: October 2022

Background: Kikuchi-Fujimoto’s Disease (KFD) is rare, benign and more frequent in Asia. It is characterized by the appearance of lymphadenopathies and fever. Histological examination of the lymph nodes make the diagnosis. It is a self-limited disease. Relapses rarely occur. Case presentation: We described a case in Europe, with the particularity of having presented recurrence. Man, 66-year-old, leukodermic, admitted for weight loss, fever, multiple lymphadenopathies, hepato-splenomegaly, severe bicytopenia and acute kidney injury. Infectious, autoimmune and haematological diseases were excluded. Histological examination of cervical lymphadenopathy was compatible with necrotic KFD. After corticosteroid therapy, the condition resolved. Two years later, he was hospitalized for similar symptoms, hepato-splenomegaly, mediastinal and lumboaortic lymphadenopathies. Recurrence of KFD was admitted Conclusions: This case report is intended to alert to the difficulty of diagnosing a rare cause of lymphadenopathies in the western world. The diagnosis isn´t obvious, required the exclusion of other, much more frequent causes and whose treatment is more specific.
Abernethy malformation
Authors:   Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen 9 University, Guangzhou 510080, China., Lui Ka Yin , Cai Changjie ,   Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen 9 University, Guangzhou 510080, China.
Published: October 2022

A 59-years-old woman presented to the emergency department with sudden onset of intermittent hematemesis and melena. The patient had a history of stage IV cervical cancer, sigmoid colostomy (because of rectovaginal fistula). A complete blood count showed normocytic anemia (79 g/l) and other laboratory evaluation showed the elevation of ammonia (38 µmol/l). The total bilirubin, transaminase and creatinine level were normal. Upper endoscopy revealed hemorrhage of esophageal varices that was stopped by local treatment with the combinations of spraying hemostatic and sclerotherapy (Figure 1). The CT-scan revealed no cirrhosis and liver lesion but did 10 show the absence of the portal vein with a complete extrahepatic shunt of the portal blood, considered Abernethy Malformation Ib (Figure 2,3), determined to be the possible reason of esophageal varices and megalosplenia. The old patient suffered from first-onset gastrointestinal bleeding and was diagnosed the only curative treatment is liver transplantation. This patient was stopped bleeding and transferred to cancer center for tumor therapy.
Forgotten double J stent with maximum stone burden
Authors:   Department of Radiology, Sher-e-kashmir Institute of Medical sciences, (SKIMS) SOURA, J&K, INDIA., Aamir Shah
Published: October 2022

The Double J stent, or DJ stent, is a self-retaining ureteral stent that is widely used in urologic practice. The primary goal of the DJ stent is to enable adequate kidney drainage into the urinary bladder. However, because of widespread use, lack of patient education, or due to a lack of adherence to regular follow-up, patients may end up with a forgotten DJ stent, which can stay undiagnosed in the pelvi-ureteral system for years and cause a lot of complications before coming to attention. In addition to increasing patient morbidity, mortality, and healthcare costs, it can also pose legal issues for the practitioner.
Predicting hemodynamic performance of Fontan Operation for Glenn physiology using computational fluid dynamics: Ten patient-specific cases
Authors:   Mechanical and Industrial Engineering Department, Northeastern University, Boston, MA, USA., Javadi Elahe
Published: October 2022

Single ventricle hearts have only one ventricle that can pump blood effectively and the treatment requires three stages of operations to reconfigure the heart and circulatory system. At the second stage, Glenn procedure is performed to connect Superior Vena Cava (SVC) to the Pulmonary Arteries (PA). For the third and most complex operation, called Fontan, an extracardiac conduit is used to connect Inferior Vena Cava (IVC) to the PL and there after no deoxygenated blood goes to the heart.
Inflammatory myofibroblastic tumor of the orbital floor: A case report
Authors:   Maxillofacial Surgery and Stomatology Department, IBN SINA University Hospital, Rabat, Morocco., Bouchra Dani
Published: October 2022

Inflammatory myofibroblastic tumors are rare benign tumors of unknown etiology. Initially described in the lungs, they have been observed in several other locations, mainly abdominal and pelvic. Cervicofacial localization is very rare and orbital localization is exceptional.
Cutaneous Mucormycosis in a kidney transplant patient: A case report
Authors:   Department of Nephrology, Sahloul Hospital, Tunisia., Mahfoudh Olfa
Published: October 2022

Mucormycosis is a fungal disease that evolves rapidly and is associated with a high risk of morbidity and mortality in immunodepressed patients, and which requires multidisciplinary medical and surgical approach. Invasive Fungal Infections (IFIs) is still a diagnostic and therapeutic issue
Three-vessel spontaneous coronary artery dissection: A case report
Authors:   Department of Cardiology, Cardiovascular Research Center, Mazandaran University of Medical sciences, Sari, Iran., Ranjbar Maryam
Published: October 2022

The patient was a 42-years-old vegan man, without any risk factor for atherosclerosis, admitted with the diagnosis of non-ST segment elevation myocardial infarction after a common cold.
Role of SPS temperature and holding time on the properties of Ti3AlC2-doped TiAl composites
Authors: Akhlaghi Maryam , Salahi Esmaeil , Tayebifard Seyed Ali , Schmidt Gert
Published: October 2022

In order to study the effects of sintering conditions on the properties of TiAl-based materials, two different compositions (TiAl-15 wt% Ti3AlC2 and TiAl-25 wt% Ti3AlC2) were chosen and manufactured by spark plasma sintering at 900 ºC/7 min and 1000 ºC/15 min. The results showed that increasing the MAX phase content had positive effect on the relative density and mechanical properties, but simultaneous increasing the temperature and holding time is more effective in improvement of properties. For TiAl-15 wt% Ti3AlC2 sample, the relative density, Vickers hardness, fracture toughness, and bending strength increased from 92.3%, 3.6 GPa, 10.9 MPa.m1/2, and 206 MPa to 95.2%, 4.5 GPa, 12.0 MPa.m1/2, and 336 MPa, respectively, as the sintering temperature and holding time increased from 900 ºC/7 min to 1000 ºC/15 min. In the case of TiAl-25 wt% Ti3AlC2 sample, increasing the sintering temperature and holding time from 900 ºC/7 min to 1000 ºC/15 min led to the improvement of relative density, Vickers hardness, fracture toughness, and bending strength from 92.8%, 4.1 GPa, 11.2 MPa.m1/2, and 270 MPa to 97.5%, 4.6 GPa, 11.8 MPa.m1/2, and 340 MPa, respectively.
Comunicación asertiva en el clima laboral de la carrera de Medicina Campus Cuenca de la UCACUE
Authors:   Universidad Católica de Cuenca, Ecuador, Serrano Paredes Karina de Lourdes , Alvarez Gavilanes Juan Edmundo ,   Universidad Católica de Cuenca, Ecuador
Published: October 2022

El presente artículo aborda el problema del clima laboral a consecuencia de la comunicación asertiva. El objetivo de este trabajo es analizar la correlación que existe entre la comunicación asertiva en el clima laboral de docentes y administrativos de la Carrera de Medicina, Campus Cuenca, de la Universidad Católica de Cuenca (UCACUE). Se realizó un estudio de corte cuantitativo, de nivel descriptivo correlacional, la población participante estuvo conformada por 141 docentes, 17 administrativos y 4 directivos, la muestra del grupo de directivos y administrativos se consideró el 100%, para el personal docente se utilizó un muestreo probabilístico aleatorio simple, como técnica de recolección de datos fue la encuesta, el instrumento es un cuestionario estructurado con escala tipo Likert, la confiabilidad se lo analizo por medio del coeficiente de Alfa Cronbah, la correlación se realizó por medio de estadística no paramétrica utilizando el coeficiente de Sperman el cual nos indica el grado de correlación que existe entre las variables. En la investigación se mostró que existe predominio de participantes hombres, con respecto a los años de servicio tenemos una moda de 1 año, y su media aritmética de 7,54, existe correlación baja positiva entre las variables Comunicación asertiva y Clima laboral. Se concluye que, asertividad es una estrategia comunicacional que se debe incorporar en la carrera, posibilitando la interacción en el ámbito laboral y social.
Pak-Afghan Relations (2001-2017): A Prisoner’s Dilemma Analysis
Authors: Tehseena Usman and Minhas Majeed Khan
Published: October 2022

Pak-Afghan relations in post-Taliban era are a narration of mistrust and a display of the Prisoner’s Dilemma. Despite Pakistan’s efforts to maintain good neighbourly relations, it is being blamed for chaotic situation in Afghanistan, providing safe havens for miscreants in FATA, sponsoring terrorism and suicide bombing in the latter. On the other hand, Pakistan is also suspicious of Afghanistan’s India-centric policies, which results in insurgency and unrest in FATA, Balochistan and different parts of the country. Despite several commonalities and both being allies in the war against terrorism, the trust gap however is so broad that both the countries cannot decipher their disagreements bilaterally. Resultantly, both have become a recipe of never ending violence and allowing regional powers to interfere in their affairs and exploit the situation to their own advantage. Pak-Afghan relations cannot afford mistrust and hostility, which has repeatedly caused negative repercussions on their relations. The paper employs Prisoner’s Dilemma approach to examine the nature of Pak-Afghan relations and draw a conclusion for trust building via its repeated reciprocal strategies. In addition, the theoretical framework explains that reciprocal strategies, if adopted, will enable Pakistan and Afghanistan to break Prisoner’s Dilemma, sustain trust and convert their limited cooperation into full cooperation based on mutual trust.
Conflict and Peace Journalism: Role of Media in Pakistan
Authors: Muhammad Zubair Iqbal and Shabbir Hussain
Published: October 2022

This study aims to investigate the reporting of major conflicts in Pakistan by two leading TV channels i.e. Geo TV and Dunya TV, to ascertain the nature of the coverage in terms of being escalatory or de-escalatory. It aims to explore these conflicts from a peace journalism perspective. The conflicts include: the Taliban conflict, Balochistan conflict, sectarian conflict and ethno-political conflict in Karachi. The study is primarily a quantitative content analysis to explore the media coverage of conflicts during both high and low intensity periods from 2014 to 2015. The findings suggest that Pakistan news TV channels reported the Taliban and the ethno-political conflict in Karachi in an escalatory fashion, ridden in a de-contextualised pattern. While, on the other hand, the Balochistan and the sectarian conflict were mainly reported in de-escalatory terms owing to various socio-cultural reasons impacting the coverage. The findings are quite consistent with the existing literature on conflict journalism, which suggests that the media, in general, adopts a more propagandist and nationalistic stance, when the threats to national security are highest whereas it adopts a more humanistic stance, when the threats to national security are assumed to be low.
Teixobactin: A powerful antibiotic from natural resource
Authors: Phumkhachorn Parichat , Rattanachaikunsopon Pongsak
Published: October 2022

Antibiotics have been introduced and employed as therapeutic agents against bacteria since 1930s. However, most bacterial strains resistant to a particular antibiotic have emerged a few years after its discovery. Therefore, after 1960s, new antibiotics have rarely been introduced. At present, drug resistance has become a major global concern urging many countries to conscientiously enforce antibiotics policies and regulations to control the drug resistance problems. In the midst of hopelessness about antibiotics, a new antibiotic from a soil bacterium, teixobactin, has recently been discovered and claimed not to produce drug resistance in bacteria. In this review, some interesting aspects of teixobactin are discussed including isolation method, structure, mechanism of action and challenges for further development. If the technical problems about teixobactin analogs synthesis and a huge clinical trials expense are solved, it might be a new magic bullet to fight with drug resistant bacteria.