Articles

Liver Transplantation is fraught with thrombo-hemorrhagic complications, due to the precarious hemostasis of the recipient, anhepatic conditions, and the release of hemostatic factors from the allograft. Disseminated intravascular coagulation and its “flat-line” variant are common causes of hemorrhage and thrombosis, and frequently force the clinician along with a delicate balance between hemorrhage and thrombosis. We present a case that highlights some of the more challenging diagnostic and management decisions in liver transplantation and presents a safe and carefully structured approach to hyperfibrinolysis in liver transplantation.

Background: Down syndrome (DS), or Trisomy 21, is the most common genetic disorder in the world and congenital heart disease (CHD) contributes significantly to morbidity and mortality in this population. Early diagnosis and prompt cardiac intervention improve their quality of life. This study was done to determine the prevalence and pattern of congenital heart disease among children with Down syndrome seen at the Paediatric Cardiology Unit of Federal Medical Centre (FMC), Bayelsa State.Method: A prospective study of children with Down syndrome referred for cardiac evaluation and echocardiography at the Paediatric Cardiology Unit of FMC, Bayelsa State over four years from 1st January 2016 to 30th December 2019. Data on socio-demographic information, echocardiographic diagnosis, and outcome were retrieved from the study proforma and analyzed.Results: A total of 24 children with Down syndrome were seen over the study period. Their age ranged from 0 to 16years. The majority, 20 (83.3%) of the children with Down syndrome were aged 5 years and below. There were 13 males and 11 females with a male to female ratio of 1.2:1. A total of 23 (95.8%) of the children with Down syndrome had CHD. The most common CHD was AVSD (including complete, partial, isolated, or in association with other defects) in 66.6% followed by TOF in 8.3%. Multiple CHDs were seen in 43.5% of the children. Only one child (4.2%) had a structurally normal heart on echocardiography. All the children with Down syndrome had pericardial effusion of varying severity while 33% had pulmonary artery hypertension (PAH). The fatality rate among the children seen with Down syndrome over the study period was 34.8% and only one child (4.2%) had open-heart surgery with the total repair of cardiac defect during the study period. Conclusion: Morbidity and mortality are high among children with Down syndrome due to the high prevalence of CHD. Early referral, diagnosis, and prompt intervention are encouraged.

Background: Cerebral visual impairment (CVI) is a bilateral visual impairment that affects children in all industrialized countries. It has become more common in low-income countries as a result of the increased survival rates of children who suffer from severe neurological conditions during the perinatal period. The purpose of this study was to determine the characteristics of children with CVI in a tertiary children’s eye care center population.Methods: From October 2020 to September 2021, a cross-sectional study was conducted to select all consecutive patients with a diagnosis of cerebral visual impairment aged 6 months to 16 years. On the neurological deficit, information was gathered from the patient’s referral: parental interviews, observations, and direct assessment were used for functional vision characteristics, and an ophthalmic examination was performed for eye findings. The interviewees’ responses were matched to the ten specific behavioral characteristics shared by children with CVI. Cortical visual impairment was diagnosed using three criteria: [the vision loss is not explained by abnormalities found on the eye examination, a neurological medical diagnosis, and the child exhibits one of the unique visual and behavioral characteristics described by Roman Lantz]. A descriptive statistical analysis (frequency, mean, and range) was calculated. Results: Forty children with CVI (1.96% of total children) were seen. The mean age was 2.56 ( 1.98) years. There were 24 (60%) males. On a referral paper of 28, hypoxic-ischemic encephalopathy was the commonest cause mentioned (70.0%). Seizures were the most frequent neurological deficit at presentation. Ophthalmic and neurologic impairments were found in 42.5% of children with CVI. Based on Roman-Lantzy’s three phases of the CVI Range, 90% of children with CVI at the test time had Phase I or Phase II vision.Conclusion: According to the findings of this study, visual impairment is critical in the diagnosis of CVI. The prevalence of CVI as a cause of childhood vision impairment is significant. Hypoxic-ischemic encephalopathy is the most common cause of CVI. All children with CVI have serious neurological issues, and the majority have associated ophthalmic abnormalities.

Coronary artery disease is the leading cause of death worldwide.Percutaneous coronary intervention (PCI) is one of the most widely performed medical procedures used to save lives, currently over 3 million annually worldwide.The femoral artery has been the preferred vascular access site. However, radial access is gaining extensive popularity due to the benefits of earlier ambulation, fewer access site complications, and decreased rates of bleeding. Improvements in technology and understanding of the anatomic features of the vascular system have led to new insights into coronary angiography procedures.Distal radial access, which was first used in 2017, shows a higher success rate and fewer complications than previous sites; therefore, it might be the future for cardiovascular intervention.For this purpose, we conducted this prospective study at Beirut Cardiac Institute (BCI) comparing the two arms: radial vs. distal radial artery techniques through the anatomical snuffbox, in terms of patient’s length of stay, complication rate, and success rate of each procedure.

Background: Assessment of knowledge of acute kidney injury (AKI) among healthcare workers (HCWs) is necessary to identify areas of deficiency and key topics to focus on while organizing educational programs to improve AKI care. The objective of this study was to assess AKI knowledge and practice among health care providers in North Kivu province, the eastern Democratic Republic of the Congo. Material and methods: This was a cross-sectional study conducted in six public hospitals in North Kivu province using a self-administered questionnaire. Results: A total of 158 HCWs completed the survey, among them 66 (41.78%) were physicians. The mean age of respondents was 36.07 ± 10.16 years and the male gender was 56.33%. Only 12 (7.59%) of the respondents had a good knowledge of the definition and classification of AKI. The respondents’ mean scores were 6.76 out of a total of 18 about risk factors for AKI and 6.29 out of a total of 11 with regard to nephrotoxic drugs. Regarding practices, 28.48% of the respondents assess the risk of AKI in their patients in their daily practices; 31.65% report AKI in the patients’ medical history, and 33.54% call on a nephrologist specialist to get specialized advice. Conclusion: This study found considerable gaps in knowledge and practice regarding AKI among most of HCWs in North Kivu province. 

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. During mood swings, there may be features of psychosis (delusions and hallucinations) that are mood-congruent. Although psychotic symptoms are seen only in a minority of patients, they explain the early terminology of manic–depressive psychosis. Stage 1a is defined as mild or non-specific symptoms of mood disorder and intervened as formal mental health literacy; family psychoeducation; substance abuse reduction; cognitive behavioral therapy. Euphoric means the experience of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music, and dancing, can induce a state of euphoria. Racing thoughts are consistent, persistent, often intrusive thoughts that come in rapid succession. There is a direct link between depression and anxiety and racing thoughts. Whereas jumping from topic to topic as in the flight of ideas can be observed by others, ascertainment of racing thoughts requires asking the child whether his or her thoughts seem to be going too fast.

Plant-parasitic nematodes (PPNs) are famous aggressive pests that attack several crops worldwide. A lot of farmers are suffering from nematode diseases which cause critical crop losses. At the same time, the most of available solutions for this problem are depending on synthetic nematicides. These chemical nematicides not only cause environmental and health problems but also may cause resistance in nematodes. Despite the occurrence of resistance in nematodes under field conditions still less clear. Therefore, this note is about the registered nematicides in Egypt which may help those who are interested in nematicides. Also, the chemical group and mode of action of nematicides were mentioned according to the insecticide resistance action committee (IRAC) [1] and fungicide resistance action committee (FRAC).

Sleep and menstrual cycle both are normal physiological processes in women’s life but they are regulated by different centers. Sleep is a daily rhythm whereas the menstrual cycle lasts for 28 days. During this period the estrogen peaks twice. We have shown earlier that there is an inverse relationship between estrogen and the hormone melatonin which aids sleep. Because of this menstruating women will have sleep disorders.

Ceftriaxone is having many uses and useful “third-generation” cephalosporin that necessitates being given every day. Ceftriaxone acts as binds to one or many of the penicillin-binding proteins which inhibit the final transpeptidoglycan step of peptidoglycan synthesis in the bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.Ceftriaxone-associated biliary adverse events in children less than eighteen years cause biliary pseudolithiasis and scarcely nephrolithiasis often happen in children less than eighteen years after receiving overdoses of ceftriaxone. Ceftriaxone perhaps binds with calcium and figure insoluble chelation leading to biliary pseudolithiasis. Cholelithiasis, increased biliary thickness, and pseudolithiasis rarely happen in a period of being a child, but there are two modes of distribu¬tion described by two peaks, the first being at an early stage of development and the second is a period of life when a child develops into an adult. Hyperbilirubinemia is significantly contraindicated for neonates administrated ceftriaxone, particularly premature neonates, because of the displacement of bilirubin from albumin-binding sites and increase in blood concentrations of free bilirubin. A child than one month old and a child less than twelve-month old in special are at great risk of poor results because of bilirubin encephalopathy. Coincident administrations of ceftriaxone with aminoglycosides such as gentamycin and loop diuretics (furosemide) perhaps increase the risk of nephrotoxicity (rapid degeneration in the kidney function to the toxic outcome of double or triple medications). Coincident administrations of ceftriaxone with anticoagulant medications such as warfarin are associated with bleeding due to increased prothrombin times, which is reversible with vitamin K.

In the present study, omental adipose tissue was collected from, the animals that underwent ovariectomy and ovariohysterectomy, surgical procedures, at the age of seven months to 11/2 years of age groups. The sample was digested with 0.1% (W/V) collagenase type I and transferred to a beaker with a magnetic stirrer and kept in a stirrer with 600 rpm at 37 °C for 30 minutes. The viability of the cell was evaluated by the trypan blue exclusion method using a hemocytometer. Trypan blue had a high affinity to nuclear DNA, which traverse the member in a dead cell and dye it blue. In the present study, the cell yield of fAD-MSCs was 8.15 ± 0.68, 6.55 ± 0.26, 4.85 ± 0.42, 3.90 ± 0.34, and 3.51 ± 0.43 in different age groups viz., 7,8,9 month 1 and 1½ year respectively. In younger age groups, cell yield and viability percentage were more than in animals of higher age groups. In the younger age group, stem cells proliferation status is considered potent for therapeutic application.