Articles

Background: Elite handball female players are at high risk of injury to the lower limbs. The modified Star Excursion Balance Test (mSEBT) is efficient in detecting players with a risk of injury. However, performed once before the season, the mSEBT cannot determine with precision when the injury will occur. Purpose: The objective of the study was to investigate if a repeated measure of mSEBT across the season would help in identifying with precision the period at risk of injury for each player.Methods: Eleven elite female handball players took part in the study. The mSEBT was measured weekly for 25 weeks and the injuries were recorded. Composite Scores (CS) and distances on each axis were computed for both legs of each player. The 94% cut-off on the composite score and the 4 cm difference between the right and left leg on the anteroposterior axis (ANT) was investigated for each player.Results: Five players reported injury. The 94% cut-off on the CS and the 4 cm difference on ANT were not significant indicators of risk of injury in our study. However, for each injured player, a drop in the composite score was noticed the week before the injury.Conclusion: We propose the drop of CS as an indicator for the detection of the risk of injury in a follow-up of elite athletes using repeated mSEBT. This indicator allows the detection of injury a week before it occurs. Further work is needed to confirm, investigate and validate this indicator.

Malignancy of the small bowel is exceedingly rare, accounting for 3% - 5% of all gastrointestinal malignancies [1-3]. However, in recent years because of improved diagnostic accuracy, the incidence of small bowel cancer is rising. It is estimated that 10, 470 new cases of primary SI cancer will be diagnosed in the US with 1450 cancer-related deaths [4]. The most frequent histologic types of small bowel malignant tumors include adenocarcinomas, carcinoids, lymphomas, and sarcomas. Adenocarcinoma of the small intestine is the second most common histologic type of SI cancer. The most frequent location of SI adenocarcinoma is the duodenum (57%), followed by the jejunum (29%) and ileum (13%) [5]. SI cancers are more common in men than women [6]. They occur more commonly in the African-American population and after 60 years of age [7].

Pulmonary edema is a rare but potentially life-threatening iatrogenic complication after treatment through therapeutic thoracentesis of a collapsed lung due to a hydro- or pneumo-thorax. We present a case of a 25-years male, without any pathological antecedents, who went to our emergency services with dyspnoea, tachypnea, and hypoxemia. The final diagnosis made after a clinical examination and chest X-ray showed a complete collapse of the right lung due to spontaneous pneumothorax [1-3] (Figure 1).

Congenital cystic adenomatoid malformation of the lung (CCAM) is characterized by an adenomatoid proliferation of bronchiole-like structures and cysts formation. The condition is most commonly found in newborns and children and may be associated with other malformations; rarely, the presentation is delayed until adulthood. We herein report two cases of CCAM in adult patients. 22 years old healthy female with pre-employment health screening chest x-Ray showed a lesion in the upper lobe of the right lung. In another case, a computed tomographic scan of the thorax (CT) confirmed a mass in the upper right lung. A 28-year-old male presented with recurrent respiratory tract infection resistant to antimicrobial therapy. CT scan of the thorax showed a mass in the left lung upper zone. Surgical resection was performed in both cases, and histopathology of the resected specimen showed both cases were consistent with the CCAM.

Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.

Invagination or intussusception is the protrusion of proximal intestinal segments through the distal segments, Transient Intussusception can be easily diagnosed by Abdominal CT.In this report, an incidentally found ‘’Duodeno-jejunal Invagination’’ tilted case, was presented with CT images.

Background: One of the types of the complex control system is medico-biological, which includes a set of methods and measures aimed at assessing the health, and functional state of the athlete’s body, taking into account the reaction of his systems to various loads. CrossFit is a constantly varied and high-intensity functional training program in which with increasing the training load, the pulse rate increases.The context and purpose of the study: The research was aimed to find out the frequency of heart rate of adolescent judokas in the presence of CrossFit-trainings in the process of physical fitness, for which a pedagogical scientific experiment was held at the youth sports and cultural training center after V. Zakaryan (Hrazdan city). From the groups of 10-12-year-olds practicing judo at the sports school, one experimental and control group was formed, each with 10 athletes. During CrossFit-trainings “Tabata”, “AMRAP”, “21-15-9” and “WOD” methods were mainly used. Athletes’ pulse rate was measured manually at the wrist before training, during training, and immediately after training in order to control the athletes’ feelings toward the training load.Results: In the September-June period, with the implementation of the CrossFit-training program, the heart rate of athletes before training was on average 102,2 bpm, during training 158,3 bpm and immediately after training – 157,8 bpm.Conclusion: The indicators obtained as a result of the research correspond to the norms suggested in literature sources.

Background: Having claimed lives, HIV/AIDS is still a significant global public health concern. Antiretroviral therapy (ART) is now widely available, and this rapid expansion of access is dramatically improving HIV epidemic survival rates worldwide.Objectives: The aim of this study was to identify the mortality risk factors and survival status of ART patients attending Hawassa Comprehensive Specialized Hospital in 2020.Methods: In a five-year retrospective cohort research, all patients seen between January 2015 and December 2019 were analyzed. The data were analyzed with SPSS 25.0. The Kaplan-Meier Log-rank model was employed to gauge the survival time of ART patients based on explanatory variables. Both bivariate and multivariate Cox proportional hazards regression models were employed to identify the independent causes of mortality.Results: Patients on ART had a 74% overall survival probability. With a median survival of 34 months, there are 0.135 deaths for every 100 person-years. Hemoglobin level (HR = 2.38; 95% CI = 3.3-6.3), WHO clinical stage III and IV (HR = 3; 95% CI = 2.2-9.5, p = 0.04), Age >=60 (HR = 1.6; 95% CI = 1.3-2, p = 0.04) and Functional status bed ridden (HR = 3.1; 95% CI = 1.2-9.4,p = 0.04) were all independent predictors of death among RVI patients.Conclusion: In comparison to trials conducted in wealthy countries, the survival rate of ART patients in this study was low. Patients who are anemic; WHO advanced clinical stage; old age, and functional status bedridden should be closely followed and monitored.

Subacute sclerosing panencephalitis is a rare, slow, and insidious neurodegenerative disease caused by measles. This disease mostly has a classic course. However, sometimes it can be presented with atypical manifestations. In this paper, we aim to present a six years old male patient that was hospitalized due to seizures and ataxia. Cerebral magnetic resonance imaging was normal on the first day of admission, but within a few days, the patient started to be apathetic. On the seventh day, magnetic resonance imaging showed hyperintense lesions in the thalamic, brainstem, and periventricular areas. Periodic epileptiform discharges were detected in the repeated electroencephalogram. Investigations from the cerebrospinal fluid showed markedly elevated measles virus IgG at 230U/ml consistent with the diagnosis of SSPE which should always be ruled out when a patient comes in with uncontrollable seizures, ataxia and apathy.

The study aimed to examine the chemical composition of Acacia melanoxylon wood as a potential raw material for pulp and paper manufacturing. Samples of Acacia melanoxylon were taken systematically based on tree height at the bottom (10%), middle (50%), and top (90%) of market height. The sample was sorted, dried, milled, and sieved, and all chemical compositions were determined by the standards outlined in ASTM except cellulose and hemicellulose, which were determined by the Kurschner-Hoffer and alkali extraction methods, respectively. The results of the study showed that the overall average values of chemical composition along tree height levels were 45.02%, 21.94%, 23.79%, 5.52%, 3.24% and 0.48% for cellulose, hemicellulose, Klason lignin, hot-water solubility, alcohol-benzene extracts, and ash content, respectively. Except for hot-water extractives, the chemical composition of the bottom and top portions differed significantly. Generally, this study suggests that the chemical composition of Acacia melanoxylon wood is well suited for pulp and paper production.