Articles

Renal angiomyolipoma (AML) is a rare tumor with an incidence of 0.3% - 3%.We reported a case of a 41-year-old male patient who presented with gross hematuria and hemorrhagic shock, due to a right giant angiomyolipoma he underwent urgent right nephrectomy by subcostal laparotomy, total weight of the mass was 6 Kg, histological examination concluded in a renal angiomyolipoma.Treatment of renal AML depends on the clinical presentation, tumor size, and single or multiple lesions: single small (< 4 cm) asymptomatic lesions require only clinical and radiological follow-up, however giant symptomatic (hematuria), life-threatening masses require urgent multidisciplinary treatment and especially surgery.Giant renal bilateral AML is very rare, conservative treatment in the absence of hemorrhage should always be first proposed to preserve renal function as possible.

As healthcare systems develop, there is an explicit call towards interprofessional learning and working, valuing observations and perspectives of all disciplines. Such a multi-perspective is pivotal for innovation, leading to optimal and sustainable health care. In such an interprofessional work environment, it is obvious that the nurses engage in the formulation of research questions within clinical practice settings. This case report describes a case in which nurses observed important issues that no physician or midwife on the team would have noticed. In collaboration with other team members, the nurses subsequently engaged in research which resulted in new information to improve care. The aim of this paper is to explore strategies to promote nurse participation in at least the formulation of research questions based on their observation and perspectives.For fostering critical nurse observation as a source of research topics, we propose four strategies. First, cultivating awareness through a culture of evidence-based practice and critical reflection on common practice. Second, stimulating persistence in addressing moral dilemmas concerning better care despite resistance. Third, facilitating interprofessional learning in an open culture, where diverse perspectives are valued, and it is psychologically safe to bring them in. Fourth, overcoming funding disparities and facilitating nurse-led research, acknowledging the underrepresentation of nurses in funding agencies. These measures aim to empower nurses to observe critically, use their unique perspectives, and bring in research topics.

Background: Stillbirth (SB), either because of intrauterine or intrapartum fetal death, is amongst the most devastating pregnancy complications, hardest to predict, real challenge for health systems. India probably accounts for the highest SB numbers in the world.Objectives: A community-based prospective study was carried out to know the burden, and causes of SBs in rural women of remote region.Material methods: After approval of the ethics committee of the Institute in Maharashtra for broader research, which was service-oriented, the present study was conducted in 100 villages around the village with health facilities. These villages were included keeping in mind future services. After obtaining the consent of women, information was prospectively recorded on their predesigned tool (which was for broader work), by asking women and seeing their records of antenatal and intranatal care on a regular basis. The study subjects were selected after obtaining information from nurse midwives, Accredited Social Health Activists (ASHAs), and Aaganwadi workers. As the plan was to serve, there was excellent cooperation. The tool was made for broader work. Villages were visited 5 days a week. Study was community-based in villages in remote, hilly region with various local issues so any information the women gave conclusion and was in the record was used.Results: A total of 3905 births occurred over two years, 3635 (93%) term, and 270 (7%) preterm. Amongst 3635 term births, 3474 (95.6%) were live births, 161 (4.4%) SBs, amongst 270 preterm births, 239 (88.5%) were live births, 31 (11.5%) SBs. Of 192 SBs, 48 (7.2%) SBs were amongst 2690 women with anaemia, (16 (2.4%) SBs amongst women with very severe anaemia, 12 (1.8%) SBs were amongst 667 women with severe anaemia, 12 (1.8%) SBs were amongst 664 women with moderate anaemia, 8 (1.2%) SBs were amongst 680 women with mild anaemia). Overall of 192 (4.9%) SBs, 31 (18.1%) SBs were among 517 women with hypertensive disorders of pregnancy (HDsP) 8 (4.4%) SBs amongst 280 women with moderate HDsP, 12 (6.9%) SBs amongst 175 women with severe HDsP, 11 (6.8%) SBs in 62 women with eclampsia. Overall of 192 SBs, 6 (3.1%) babies had weight < 1 kg, 8 (4.1%) of ≥ 1 to < 1.5 kg, 50 (26.0%) ≥ 1.5 to < 2 kg, 64 (33.3%) ≥ 2 to < 2.5 kg, 64 (33.3%) 2.5 kg and more, obviously fewer babies more deaths in birth weight less than 1. 5 kg, more so less than 1 kg.Conclusion: Overall SBs were in women with disorders but 4.5% SBs did occur in women with no disorder. SBs were significantly higher amongst babies weighing less than 1 kg, beyond this weight, numbers were similar.

The study on the remote effect of fascial manipulation on knee pain presents a case report of a patient with knee pain who underwent a single session of fascial manipulation to reduce pain and improve daily activities. The report explains the anatomy of the knee joint and the potential causes of knee pain, including bony and soft tissue involvement. Fascial manipulation is a technique that involves applying mechanical force to areas of fascial dysfunction to stimulate the body’s natural inflammatory response. The therapy is based on applying physical friction to the densified connective tissue with an elbow or knuckle to raise the temperature and change the consistency of loose connective tissue rich in hyaluronic acid. The locations picked were proximal and distal to the problematic area, and no point was treated over the painful region, which is consistent with the notion of pain being caused by aberrant fascial tensions. Manipulation of the connective tissue is thought to cause mechanical stress and heat, resulting in less macromolecular crowding and defragmentation of the Hyaluronic Acid (HA) polymers and normalised fascial gliding across the connective tissue. Reduced discomfort and enhanced range of motion are two more regularly reported effects of Fascial Manipulation. The patient was urged to resume his everyday activities after each treatment session to favour typical physiological motions that would align collagen fibres along normal lines of force. The report concludes that fascial manipulation can be a beneficial technique for managing knee pain, and it can be complemented with exercises and stretches to improve outcomes.

The stem cell secretome is a collective mixture of soluble and insoluble factors released by stem cells during paracrine communication and/or autocrine signaling. In addition to intracellular communication, these paracrine factors play an integral role in tissue development and generation, acting as the primary driving force in the regenerative properties of stem cells. Despite such great potential of stem cell secretome in therapeutic applications, the lack of secretome-based treatments available for the public at the time of writing is odd and puzzling. Hence, this review aims to provide insights into recent advancements in understanding the stem cell secretome, as well as discuss future possibilities and current limitations that must be overcome for the proper development of secretome-based therapies. Through utilizing the MEDLINE database from the National Library of Medicine® (NLM), we found that while there is much evidence of the therapeutic effects of secretome-based therapy, flaws involving regulations and standardization hinder it from revolutionizing regenerative medicine at present. It is cardinal to emphasize that while secretome-based therapy may be the solution for many untreatable conditions, much research is still required before it is approved for clinical practice.

The mainstays of nuclear substance radiation and isotopic synthesis are nuclear-powered power plants, however effective safety evaluation is made tougher by the complicated construction topologies and physical connection effects. This work proposes a multiphysics-linked technique for evaluating both the kinetic and steady-state behaviors of the MPRR and LVR-15 laboratory reactors. To represent complicated member geometries, homogenized assembling sections are generated using two-dimensional whole-core computational simulations. It is discovered that the steady-state findings and the so-called Monte Carl solution comparisons correspond quite nicely. The greatest assemble power mistakes for LVR-15 and MPRR are 6.49%/10%, and the highest command rod value mistakes are 31 pcm/136 pcm, and the mistakes are 377 pcm/383 pcm, accordingly. Meanwhile, the study is done on transitory procedures, such as reactivity-initiated disasters and exposed loss-of-flow mishaps. Both units' modeling findings show plausible adverse feedback events. Furthermore, it is shown that the two reactors' accident-related behaviors are comparable though having different core architectures since they employ the exact same kinds of water as a fluid. The technique for studying nuclear power plant kinetics known as Multi-Physics Simulation (MPM) is explained. Drawing on many research and verification efforts conducted at Politecnico di Milan, Italy, MPM is shown to be a valuable instrument for managing reactors' security and oversight. It may be viewed as a holistic analytical tool that is implemented during the reactor architecture design phase. The capacity to concurrently answer the interrelated equations that control the many physical processes taking place in a nuclear plant inside the same simulated setting is a core characteristic of MPM.

The article deals with such issues as storage of industrial waste, causes, examples and prevention of accidents, NGO operation and reclamation, and methods of dealing with the consequences of accidents. When storing industrial waste in large volumes, various complications arise, including accidents in waste storage facilities. The article provides examples of accidents for specific objects and analyzes their causes and consequences. The methods of dealing with the consequences of accidents and their prevention are considered. The materials of the article can help specialists improve the design and operation of waste storage facilities.

WhatsApp, a widely used instant messaging application, has become a valuable source of digital evidence in forensic investigations. This review article explores the forensic analysis techniques, challenges, and future directions associated with WhatsApp. It covers the extraction and analysis of data from various sources, including mobile devices, cloud backups, and network traffic. The article discusses the challenges faced by forensic examiners, such as encryption, data volatility, and the need for proper validation of tools. It also highlights the importance of keeping up with the latest updates and changes in WhatsApp’s features and security measures. The future directions for WhatsApp forensics are explored, focusing on the development of more advanced and efficient analysis techniques, the need for standardization, and the importance of international cooperation in addressing cross-border investigations. This review provides insights for forensic examiners, researchers, and legal professionals involved in cases requiring WhatsApp evidence.

Chemical submission is a crime where criminals use substances to impose their will on victims. A 44-year-old woman comes to the Health Center disoriented in the temporal sphere, stating that “she does not remember what happened.” Her brother, the companion who brings her to the health center, says that he has found her in a place he does not usually frequent. The patient missed a bag she was carrying and could not locate her mobile phone. The patient and companion suspect that she may have been “drugged” in order to rob them. Given the suspicion that the patient may have been a victim of chemical submission, the Emergency Service is called to inform that the victim is going to be referred. The detection of biological samples of the substances used for submission is of vital importance.

The aspects that affect the well-being of patients after neurosurgery are diverse. While most contemporary research argues that well-being is multidimensional and related to how individuals, communities, and societies feel when they are successful, there is no single agreed-upon definition [1]. Well-being is defined in the Oxford Dictionary as the state of feeling healthy and happy (Cambridge Dictionary). Well-being is a term used synonymously with a wide range of concepts including self-esteem, self-efficacy, self-determination, resilience, quality of life, improved mood, positive mental health, life satisfaction, and value [2].