Articles

Atypical Anti-GBM with ANCA Vasculitis- A Rarest of the Rare Entity: Index Case from Eastern India

Published on: 13th September, 2024

Anti-glomerular basement membrane (GBM) antibody glomerulonephritis is an extremely rare glomerular disease. Around 90% of the patients are positive for serum anti-GBM antibodies while up to 10% can be negative. In such patients, only a kidney biopsy can reveal the anti-GBM disease it is then labeled as an atypical anti-GBM disease. Though anti-GBM disease can be associated with Anti Neutrophil Cytoplasmic Antibodies (ANCA) positivity, it is extremely rare to find atypical anti-GBM with ANCA positivity so much so that till now there are very few such cases reported from across the world.The case presented here is one such case where the patient presented with adult-onset nephrotic syndrome features with active urinary sediments and mildly deranged renal function. Myeloperoxidase (MPO) ANCA was positive and it was considered ANCA-associated crescentic glomerulonephritis (GN) but after the renal biopsy the picture was of anti-GBM disease. She was treated with pulse methylprednisolone but her creatinine increased in the meantime and considering anti-GBM she was put on Plasma Exchange (PLEX). She received 5 sessions of PLEX after which her renal function improved. She was also planned for Rituximab which could not be given due to local infection. As there are no protocols for treating such cases because of the extremely rare nature of the presentation, this case will increase the understanding of such presentations for the clinicians. This will help to plan for building the approach for such cases.
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Effectiveness of Intercostal Stretch Technique on Pulmonary Conditions: A Narrative Review

Published on: 13th September, 2024

Background: The Intercostal Stretch Technique is one of the physiotherapy techniques that is used to solve different respiratory problems. It is used for increasing chest expansion and diaphragm excursion improvement and also intra-thoracic lung volume. Aim: The study aims to evaluate the effectiveness of the intercostal stretch technique.Methodology: A narrative review. In this study, an RCT study was used to review the intervention.Results: Several articles are used to discuss the effectiveness of the intercostal stretch technique. In stable COPD, diaphragmatic breathing and the intercostal stretch technique both work equally well to improve chest expansion and functional capacity while lowering dyspnea. Research has shown that IC stretch outperforms the anterior basal lift technique in lowering heart and respiratory rates while increasing oxygen saturation. According to this study, IC stretching in conjunction with breathing control may improve dynamic lung parameters, particularly FEV1/FVC%, more than breathing control alone. Patients with COPD have an increased functional exercise capacity and reduced dyspnea when aerobic training and respiratory muscle stretching are combined. Conclusion: Different articles demonstrated that IC stretch improved lung function, expired tidal volume, decreased dyspnea, and increased chest expansion.
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Response of Chemical Fertilisation on Six-year-old Oil Palm Production in Shambillo-Padre Abad- Ucayali

Published on: 13th September, 2024

It was proposed to determine the response of chemical fertilization in the production of oil palm (Elaeis guineensis Jacq.) six years old in the area of Rio Negro Shambillo Padre Abad in order to have a sustainable and economic alternative of chemical fertilization in the field stage, which contributes to the survival of the palm and provides the necessary resistance against pests and diseases. A completely randomized block design (DBCA) was used with four repetitions and treatments, 96 plants / UE / treatment were used, the spacing was 9x9 in rows and plants. Results obtained indicate the treatments; T3 and T2 (16,54 – 15,48 kg / plant) obtained the highest averages by bunch weight, T1 and T3 (17,48 – 15,42 fruits / bunch) obtained the highest averages regarding number of fruit / bunch, T1 and T3 (13,93 – 11,59 to 45 cm ) obtained the highest averages for bunch length, T1 and T3 (7,33 – 5,52 cm) obtained the highest averages regarding fruit length, T1 and T3 (11.37 – 9.54 g) obtained the highest averages regarding fruit weight, T1 and T3 (10,46 – 10,37 kg) obtained the highest averages to yield per plant. The addition of chemical fertilizers or organic amendments increases the weight of the oil palm bunch, consequently the production in soils with medium, low fertility; chemical fertilization influences the number of clusters of oil palm produced on a given surface, any dose is used as an alternative to phosphorous fertilization in oil palm with a direct relationship between plant height and root length. 
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Evaluation of Long-term Antithrombotic Management for Atrial Fibrillation Patients with a History of Coronary Stent Implantation

Published on: 12th September, 2024

Purpose: American expert consensus publications recommend discontinuation of antiplatelet agents 6 to 12 months after Percutaneous Coronary Intervention (PCI) in patients with Atrial Fibrillation (AF) who require chronic anticoagulation, and use of oral anticoagulant monotherapy thereafter. This study aimed to assess real-world long-term antithrombotic therapy management practices and factors associated with the continuation of antiplatelet agents past 12 months post-PCI in patients with AF requiring chronic anticoagulation. Methods: Patients with AF and a history of PCI greater than 12 months before their most recent encounter with physicians at an outpatient electrophysiology clinic were identified by chart review. Patient demographics, clinical characteristics, and current antithrombotic regimen were collected from encounters that occurred between July 2019 and June 2022. The independent predictive factors associated with the continuation of antiplatelet agents were identified using univariate and regression analyses. Results: Out of 66 patients, 67% continued antiplatelet therapy for greater than 12 months post-PCI. Patients on antiplatelets were significantly less likely to have bare metal stents (p = 0.006), be greater than five years post-PCI (p = 0.002), and have a HASBLED score of two or less (p = 0.028) when compared to patients on oral anticoagulant monotherapy. Bare metal stent history (p = 0.045) and HASBLED score of two or less (p = 0.016) were also significant in regression analysis.Conclusion: This study found that most patients with AF and a history of PCI continued antiplatelet therapy longer than 12 months post-PCI, often despite the high bleeding risk.
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En Bloc Palmar Desquamation in Extensive Chickenpox

Published on: 10th September, 2024

A 25-year-old man presented with fever and rash which progressed to extensive vesicular eruptions all over the body by the 4th day (Figure 1A).
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Drug Abuse and Mental Illness in Erigavo Mental Hostiptal, Erigavo, Somalia

Published on: 10th September, 2024

Mental illness is an international health crisis that puts the lives of over three hundred million people (Four percent of the world’s population) at risk. The study was conducted at the Erigavo Mental Hospital in Somaliland and its main focus was the bond between substance abuse and mental illness. The research was to check the influence of the different drugs, screen mental health problems, and draw a link between drugs and mental illness. The sources of the quantitative data were a total of 27 employees and managers. This study is cross-sectional. We employed the measure of the magnitude and direction of a linear relationship between two variables with the Pearson correlation coefficient. The outcomes that were acquired show that there was use and particularly abuse of khat, substance smoking, and alcohol consumption, the score means of which were quite high. The investigation results, however, imply that through drug use and other forms of alcohol drug abuse, one of them counter various mental health problems. Furthermore, the addicted people demonstrated the tendency to use force in their attempt to solve the conflicts and to experience the highest degree of tension, with the mean score of the former giving 4.11 while the standard deviation of the latter giving 1.086, thus this shows the mental impact of drug use on the inhabitants of Erigavo. The main result of the study was the strong, positive relationship between drug addiction and mental illness, which became evident through an r - value of 0.509 and a p - value of 0.559. It means that those people who are involved in drug misuse are the ones who are likely to have mental health disorders. Based on the findings of the study, we suggest a combination of measures to recover drug addiction and mental illness. This consists in strengthening prevention. The study that lays the groundwork for suggestions, involves an approach that is holistic in nature. The main ideas of preventing drug usage, psychological health care, enhancing mental health services, and working towards certified professionals are key integrated activities of the whole concept. The hospital, thus, will be in a better position to eliminate the two major disease components namely; drug abuse and mental ailment. Thus, in this way, with the help of the new treatment approaches, a hospital provides and their patients who are quite likely to recover and lead healthy.
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Dental Age Estimation using the Cameriere Method in Different Countries: A Review

Published on: 10th September, 2024

Age estimation is an essential aspect of profile building in forensic investigations. Age estimation using teeth is one of the exciting applications of Forensic Odontology because teeth can survive post-mortem damage, so it is considered more suitable for age estimation. This study aims to estimate the age of individuals using the Cameriere method on teeth in various countries. The approach used in this research is a literature review study design compiled based on the Preferred Reporting System for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from several articles with a period from 2007-2024. Scientific articles that meet the criteria will be analyzed using the Cameriere method to estimate the age of individuals. The search yielded 222 studies and only 12 scientific articles that met the requirements from the specified articles obtained. The population represents countries from various countries. The sample was in the age range of 4 years - 16 years. The results showed that the Cameriere method can be used to estimate the age of individuals quite accurately in various countries. However, there were some differences in accuracy between countries when using this method.
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Comparative Analysis of Demographic and Clinical Profiles of Conventional Retinopathy of Prematurity with Aggressive Posterior Retinopathy of Prematurity

Published on: 10th September, 2024

Aim: To compare the demographic and clinical profile of conventional retinopathy of prematurity (ROP) with aggressive posterior retinopathy of prematurity.Material and methods: A prospective, unmasked, and observational study involving 150 ROP patients was conducted over a period of one year. The risk factors including maternal and neonatal risk factors were recorded. The data was entered into the Excel sheet and analyzed to compare the risk factors between the conventional ROP and APROP.Results: A total of 17 (11.3%) babies were found to have AP-ROP and 133 (88.7%) babies were found to have conventional ROP. There was no significant difference in average gestational age between infants diagnosed with AP-ROP (29.6 ± 2.9 weeks) and those with Conventional ROP (30.1 ± 2.2 weeks) (p = 0.428). However, infants with AP-ROP had a significantly lower average birth weight (1022.7 ± 123.5 g) compared to infants with Conventional ROP (1208.2 ± 261.0 g) (p  = 0.004). Multivariate logistic regression analysis revealed that birth weight, surfactant use, number of days of oxygen supplementation, and metabolic acidosis were independently associated with the development of AP-ROP.Conclusion: The development of APROP is multifactorial and complex. Although we have identified factors such as birth weight, surfactant use, number of days of oxygen supplementation, and metabolic acidosis in the causation of APROP, further long-term multicentric studies are required for validation.
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Emerging Trends in Sports Cardiology: The Role of Micronutrients in Cardiovascular Health and Performance

Published on: 6th September, 2024

Micronutrients are critical components of an athlete’s diet, affecting both performance and cardiovascular health. This review summarizes current studies on the importance of micronutrients in sports cardiology, focusing on their effects on energy metabolism, antioxidant defense, and cardiac function. Key findings emphasize the relevance of micronutrient sufficiency in improving athletic performance and avoiding long-term health issues linked to strenuous training programs. Micronutrients like B vitamins help energy generation pathways, while antioxidants like C and E reduce exercise-induced oxidative damage. Minerals like magnesium and iron are important for muscle function and oxygen delivery, which are required for endurance and recovery. Effective nutritional practices include balancing food intake and, if required, supplementing under medical supervision to address individual needs and enhance performance results. Future research paths will focus on individualized nutrition techniques based on genetic and metabolic profiles, allowing for more precise food recommendations for athletes. Collaboration between sports medicine and nutrition disciplines is critical for establishing evidence-based practices and improving cardiovascular health in athletes.
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Assessment of Nutritional Knowledge, Alcohol and Tobacco Consumption in Amateur and Elite Youth Football Players

Published on: 6th September, 2024

Introduction: Nutrition is increasingly recognized as a key component of optimal sports performance. On the other hand, insufficient and continuous food intake can compromise athletic performance and success where Nutritional Knowledge can play a leading role.Methods: One hundred and three youth athletes from 6 different clubs belonging to the District, Honor, and National Championship participated in this study. To assess Nutritional Knowledge, consumption of alcohol and tobacco the Abridged Nutrition for Sport Knowledge Questionnaire was applied.Results: The percentage of Nutritional Knowledge obtained in the District Championship was 31.25%, in the Honors it was 35.56% and in the National Championship it was 35.02%. No significant differences were found between the Nutritional Knowledge of athletes. In turn, there were statistical differences in the consumption of alcohol and tobacco among the athletes of the 3 Championships, with the District division having the highest percentage of smokers (100%) and alcohol consumers (42.6%).Conclusion: It is essential to increase the Nutritional Knowledge observed in these young athletes since it can have an influential role in their food choices.
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