All Articles in May, 2020

Dysfunctional breathing in children

Published on: 30th May, 2020

OCLC Number/Unique Identifier: 8607009162

Objective: Dysfunctional breathing (DB) refers to abnormal patterns of breathing. No gold standard exists for diagnosis. In clinical practice we regularly see children with functional breathing problems. We collected data from this patient group to gain more insight into the characteristics of children with dysfunctional breathing. Methods: We composed a retrospective, cross-sectional study. The population consisted of children referred to a physiotherapist by a pediatrician due to suspected dysfunctional breathing. Data from 2013-2015 were collected from patient files, selected according to patterns and onset of symptoms, concomitant asthma, Nijmegen questionnaire (NQ) score, maximum exercise capacity and breathing pattern. Results: A total of 201 patients were included in the study, 66% of whom were female. The mean age was 13.9 years; 26% of the children were overweight. The most frequently reported symptoms were breathlessness, chest pain/tightness and dizziness. Fifty-two percent had a NQ score ≥23, mainly female. Twenty-eight percent of the children scored < p5 for their age on maximum exercise capacity; this proportion was substantially higher among males. Of the total population, 78% scored < p50 for their age. Subgroups with a higher body mass index (BMI) showed lower maximum exercise capacity. Children presenting with pulmonary symptoms were primarily misdiagnosed with asthma. Conclusion: Dysfunctional breathing is a common cause of respiratory complaints. Most children with dysfunctional breathing have a high BMI and are in poor physical condition, which suggests a clinically relevant comorbidity and possible options for therapy. Children are often falsely diagnosed with asthma; better recognition will decrease unnecessary medication use.Introduction
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Maternal, neonatal and children´s health in Sub-Saharan East Africa

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8611934005

The Czech model for reducing maternal and neonatal mortality for countries in sub-Saharan East Africa was created on the basis of the Archdiocesan Charity Prague project for a specific region-subcounty Buikwe, Diocese of Lugazi, Mukono Region in Uganda, a region with about 30,000 inhabitants. The aim of the first phase of the project was to build a new hospital, equip it completely for obstetric and surgical operations from the Czech Republic, ensure its activities with Czech and Slovak doctors experts, junior Ugandan doctors and Ugandan medical staff, provide obstetric training for villagers, ensure connections with villages and possibility of fast transport and urgent solution of all acute pathologies in the hospital, capable of 24-hour surgical readiness. In the second phase of the project, a school for midwifery was to be established. This second part of the project has not yet been implemented. The project could serve as an example and guide for similar humanitarian activities in other regions of Uganda and other countries in equatorial Africa.
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Therapeutic benefits of lemongrass and tea tree

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8609734816

Lemongrass is a culinary herb with a lemony aroma.it is mostly cultivated in Southeast Asia, Sri Lanka, Indonesia and India. It is conventionally used for relieving anxiety, stress and pain. Because of the presence of limonene and citral, lemongrass extracts exhibits antimicrobial, antidandruff and anti-inflammatory effects. However Tea tree extracts are mostly employed in the treatment of dermal, inflammatory and microbial infections.
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Study of the influence of relay elements on the erosion process on the basis of GIS technology

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8609748943

Erosion has become widespread in the local climatic conditions of Azerbaijan. From this point of view, different types of erosion (washing, erosion, deflation, etc.) can often be found in many soil types formed in the territory of the republic. It should be taken into account that as a result of erosion, the top fertile layer of the soil is washed away and as a result, the soil is deprived of the humus layer. In the presented article, the effect of relief elements on the erosion processes occurring in the lands of Gadabay region was studied on the basis of GIS technologies.
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Patients suffer when healthcare stocks rise

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8603896492

When a stock price rises or has a better P/E ratio, this is generally considered a measure of success. Is this true for health insurance stocks? Stock holders certainly are happy, but what about the purchasers of the carriers’ policies? Are patients smiling when the stock price goes up? 
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Levosimendan in sepsis

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8872659589

Levosimendan is a calcium sensitizer and its inotropic effect is mainly attributed to the troponin C of the myocardial fine filaments with calcium. Levosimendan also inhibits phosphodiesterase III. In contrast to inotropic effects, this does not increase calcium entry into the cell, which explains that levosimendan does not worsen myocardial diastolic dysfunction and may even improve diastolic function. Levosimendan does not increase the use of myocardial oxygen and increases coronary vasodilation and myocardial oxygen delivery. Levosimendan opens potassium channels and causes hyperpolarization in smooth muscle cell membrane, thus causing vasodilatation [1]. Levosimendan has also been reported to have antiinflammatory [2,3] and antiapoptotic effects [2].
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Demystifying the power of magnesium

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8874832459

Epsom salts was inadvertently discovered in Epson spring in England and used as magnesium salt in 1697. It is simply the magnesium sulphate, a commonly used ingredient in beauty and wellness kiosks for soothing joints, muscles and mind. Richard Martin Willstatter working on plant pigments begged a Nobel Prize in 1915 for his discovery of chlorophyll containing magnesium. The magnesium holds the centre position in chlorophyll in a manner as iron in hemoglobin.
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Preventive treatment in an osteoporotic femoral upper metaphysis-A clinical case: Me Louise V…

Published on: 29th May, 2020

OCLC Number/Unique Identifier: 8872657831

In 1992, a patient, born July 10, 1910, aged 82, with major osteoporosis [1-3], was operated on her left hip. The surgeon performs a biomaterial transplant using natural coral [4]. Follow-up is two years. She died in 1994 of acute respiratory failure. Three bone graft osteodensitometry [5] shows a regular increase in mineralization; however, on the opposite side, bone mineralization decreases. The anatomical part is examined using x-rays, scanners, photographs, histology [6]. The article reports the findings of this study. It is noted a partial resorption of the biomaterial essentially at the periphery of the graft as well as the different local connections of the preexisting bone with the newly formed bone from the grafted area. The severity of fractures of the femoral neck is no longer to be demonstrated [7]. Multiple therapeutic trials have demonstrated their effectiveness [8,9]. Twenty two patients were transplanted. There was no failure. All died without fracturing their grafted hips. 
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Twin-stage technique for occlusal rehabilitation of a mutilated dentition – A case report

Published on: 28th May, 2020

OCLC Number/Unique Identifier: 8627834705

Functional and aesthetic rehabilitation of an extremely worn dentition is one of the most challenging aspects of Prosthodontics. A thorough examination and diagnosis & selection of appropriate occlusal scheme are key factors to achieve optimal clinical outcome. Among the variety of techniques suggested in the literature, the twin-stage technique given by Hobo & Takayama has emerged as a popular choice for clinicians in recent times. Instead of the condylar path, it utilizes standard cuspal angle as the main determinant of articulation to produce predictable disocclusion in eccentric movements. It is relatively simple, does not require special armamentarium and can be incorporated easily with commonly used clinical techniques such as face bow transfer. The present case report describes the full mouth rehabilitation of a severely mutilated dentition using Hobo’s twin-stage technique to achieve a functionally and aesthetically favourable outcome.
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Characterization of plastic degrading bacteria isolated from landfill sites

Published on: 28th May, 2020

OCLC Number/Unique Identifier: 8605989023

The plastic pollution is threatening the environment because it has very slow degradation rate and high usage in regular activities. The present study aims at the isolation of novel microorganisms that would assist faster degradation process of polyethylene. The waste samples were collected from different landfills and dumpsites. Out of forty samples, eight samples were found to degrade polythene strips in liquid medium. Further screening of these samples showed that two strains of microbes had high potential for polythene degradation. Biochemical tests and ribotyping were performed for characterization of isolated bacteria. Resultantly, two novel bacterial strains were identified named; Bacillus wudalianchiensis_UMT (2A) and Pseudomonas aeruginosa_UMT (6). Analysis of these microbes further revealed that Bacillus wudalianchiensis_UMT and Pseudomonas aeruginosa_UMT have capability to degrade 6.6% and 4.8% polyethylene respectively. So, the results disclosed that these bacteria have great potential to degrade polythene in less time as compare to natural degradation process and can contribute to reduce pollution from our environment.
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Opera-glass hand with arthritis mutilans in psoriatic arthritis

Published on: 28th May, 2020

OCLC Number/Unique Identifier: 8605993421

A 42 years old gentleman who was a known case of Psoriasis vulgaris since last 5 years presented to the Rheumatology clinic with inflammatory arthritis predominantly involving the joints of the upper extremities. Musculoskeletal examination of both hands revealed dactylitis and distal interphalangeal joint arthritis. He had a shortened right ring finger with excessive transverse skin folding suggestive of an Opera-Glass hand
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Management of gestational diabetes during ‘COVID19 time’

Published on: 27th May, 2020

OCLC Number/Unique Identifier: 8605985151

The measures put in place by many governments around the world to fight the spread of COVID-19 have drastically reduced visits to diabetes centres. To keep providing people with diabetes the professional support they need and reduce the inconvenience caused by the interruption of traditional assistance, the typical control visit can be carried out by virtual visit, telemedicine (TM) that should have the necessary characteristics to provide a correct execution. Especially this is important for pregnant women first diagnosed with gestational diabetes mellitus (GDM), they have the necessity to frequent checks in a short time due to the pregnancy.
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Risk evaluation and modeling of soils contaminated with Polycyclic Aromatic Hydrocarbons (PAHs) in parts of Bonny Island, Niger Delta, Nigeria

Published on: 27th May, 2020

OCLC Number/Unique Identifier: 8609740211

Environmental impact of a recent oil spill incident in Bonny terminal using soil media was studied using a risk-based modeling approach. The establishment of the presence of contaminants of concern (CoC), evaluation/assessment, modeling spilled volume and ascertaining potential health risk associated with the spill incident was carried out. The Contaminant of Concern (CoC) included Total Petroleum Hydrocarbons (TPH) and Polycyclic Aromatic Hydrocarbons (PAHs). Soils and groundwater were sampled in the vicinity of the spill incident and further away into the surrounding communities. Soils were sampled into the depths (0.1 m, 0.5 m,1.0 m, 1.5 m), and the results of sieve analysis revealed that the area is predominantly silty sand in composition. This study also revealed that TPH concentration at all locations and depths exceeded DPR target value of 50 mg/kg. The TPH model revealed that a total volume of 222,500m3 of the spill area exceeded DPR intervention value of 5000 mg/kg. The results of PAH showed that only BS-1, BS-6, BS-8, BS-9 and BS-10 exceeded DPR target value of 1.0 mg/kg at some depths. All other sample depths and locations were within the target limit. The 3-D grid generated for PAH showed that 563,000m3 of the study area exceeded the DPR target value. The 3-D block models generated for TPH and PAH, along with the cross-sections and extracted time slices all showed that the concentration of the Contaminant of Concern (CoC) generally decreased with depth, and the centre of the spill located at the south-eastern part of the survey area. Based on these models, three spill zones were identified; Zone 1-highly contaminated areas (BS-8, BS-9, BS-10); Zone 2 - moderately contaminated areas (BS-1, BS-2, BS-6, BS-7); and low contaminated areas (BS-3, BS-4, BS-5). The entire soil in the area were contaminated with TPH and 47% of the area contaminated with PAH. This study has shown the effectiveness of the use of a model-based approach in quantifying hydrocarbon contamination volumes in the area. There is therefore the need for continuous monitoring of hydrocarbon spills in the area.
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Role of nanotechnology in diagnosing and treating COVID-19 during the Pandemic

Published on: 27th May, 2020

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in December 2019 in Wuhan, China. To date, the virus has infected roughly 5,000,000 people and caused approximately 345,000 deaths worldwide, and these numbers are increasing rapidly. Because of the rapid spread and the rising disease burden, several antiviral drugs and immunomodulators are in clinical trials, but no drugs or vaccines have yet been approved against this deadly pandemic. At present, computed tomography scanning and reverse transcription (RT)-PCR are used to diagnose COVID-19, and nanotechnology is being used to develop drugs against COVID-19. Nanotechnology also plays a role in diagnosing COVID-19. In this article, we discuss the role of nanotechnology in diagnosing and potentially treating COVID-19.
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PISA Syndrome-Orthopedic manifestation of a neurological disease?

Published on: 26th May, 2020

OCLC Number/Unique Identifier: 8603897033

Pleurothotonus, commonly known as Pisa Syndrome (PS), is a rare neurological disorder characterized by lateral bending of the trunk with a tendency to lean to one side. This is typically mobile and resolves in supine position. It often presents as an incapacitating symptom of underlying neurodegenerative conditions like Parkinson’s disease, alzheimer’s disease, multisystem atrophy, dementia with Lewy bodies, progressive supranuclear palsy and even subacute sclerosing panencephalitis. It is known to be associated with neuroleptics, dopaminergic agents, valproic acid and lithium. PS is also seen in neurosurgical disorders like subdural hematoma, normotensive hydrocephalus, or as a late complication of pallidotomy in patients with PD. It can present either as an acute emergency or can develop gradually over time.PS tend to happen in coronal plane and can be controlled and managed if diagnosed in early stage. However, a chronic form known as “camptocormia” occurs often in a combined fashion with anteroposterior flexion which can improve to some extent, remain stable or even get worse. Pathophysiologic mechanism is not completely understood. This review will discuss all the updated literatures published in PS in terms of prevalence, pathophysiology, clinical manifestation, and treatment modalities.
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Role of yoga in Parkinson’s disease-A comprehensive update of the literature

Published on: 26th May, 2020

OCLC Number/Unique Identifier: 8605987262

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by progressive degenerative motor symptoms (e.g., tremors, impaired balance and gait) and nonmotor symptoms (e.g., fatigue, sleep disturbances, pain) that can negatively influence health and mental wellbeing by decreasing quality of life. It affects nearly 10 million people and more and more cases are diagnosed because of the advancement seen in movement disorder clinics and diagnostic tools worldwide. Individuals with PD also complain about anxiety arising out of these symptoms of postural instability, low back pain etc., which may lead to increased risk of falls and fall related injuries of brain, bone or other organ systems. Stress is one factor which has been shown to directly correlate to neurodegenerative pathology. Ways to reduce stress at a given point of time and across one’s life span is considered to be a prime necessity in today’s world. Various body-mind exercises like yoga, tai chi, qi gong, tango, ballet etc., has been in research for quite some time now, which has shown benefits in PD patients. In this article evidences related to yoga and its role in PD will be reviewed in a detailed fashion.
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The evaluation of bandage soft contact lenses as a primary treatment for traumatic corneal abrasions

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8605482786

Background: Corneal abrasions are a common result of eye trauma. Corneal injuries are very common in both the adult and pediatric population and account for a significant proportion of the workload of most emergency departments. Although abrasion heals well with preservative treatment, it still causes pain and job lost. The abrasion result from the scrabble of the corneal epithelium. These injuries cause pain, tearing, lids spasm, light scare, foreign body sensation, decreased visual acuity/blurring, and a gritty feeling. The light, friction & wink was worse the condition. Most abrasion cure within 24-27 hours and seldom proceed to erosion or infection. The study aims to use bandage soft contact lens [BSCL] as a primary treatment for traumatic corneal abrasion [TCA] instead of traditionally use pressure patch [PP]. Patients and methods: The present prospective study has been conducted on 50 patients attending the out-patient department of ophthalmology in an Alyarmouk teaching hospital for six months after taking ethical permission. Before subjecting the patient to the treatment of bandage soft contact lens therapy, a detailed clinical history and thorough local examination have been done. A history indicating the occurrence of recent ocular trauma followed by severe pain, redness, lids spasm, photophobia, and tearing of the involved eye is suggestive of a corneal abrasion. Always we ask about contact lens wear as this can complicate the presence of an abrasion. To confirm the diagnosis of traumatic corneal abrasion we examine the cornea by slit-lamp under cobalt-blue filtered light after the application of tetracaine eye drops & fluorescein strips. The treatment of 50 consecutive patients presenting with traumatic corneal abrasion has been treated with anesthetic eye drop (tetracaine 0.5%) to relieve pain and lids spasm, antibiotic eye drop (ofloxacin 0.3%), therapeutic bandage soft contact lens was applied to provide pain relief and once again act as a splint to promote epithelial healing, then visual acuity was measured by Snellen chart, a cycloplegic eye drop (cyclopentolate 1%) was applied to relieve ciliary spasm & then preservative-free lubricant eye drop were applied lastly. This criterion dramatically relieves most, if not all of the pain the patient may be experiencing (which is a big plus for the patient and earns instantaneous trust), but it also allows the patient to return to work/school or any other daily activities. Patients have been evaluated after 24hours, 72hours and after 1week regarding pain, visual acuity, and complications. Though pressure patch [PP] occasionally advice in abrasion therapy, it does not assist and may prevent recovery. Employ the protective eyewear can preclude the traumatic corneal abrasion. Results: A total of 50 cases were enrolled in our study during the study period of 6 months. Out of 50 patients, there were 30males and 20 females and the male/female ratio was 3:2. The patient’s age was ranged from 5-35years. The commonest cause of injury was direct minor trauma (80% of cases), with cosmetic & optical contact lenses related problems accounting for 20% of presentations, visual acuity was documented correctly in 90% of adult and pediatric group and difficult to documented in children less than 6-year-old 10%. Traumatic corneal abrasion treated with bandage soft contact lens has an apparent advantage over the traditional pressure patch in terms of reduced pain, speedier healing, and an advantage of faster rehabilitation, facilitation epithelial healing, and proper surface hydration. Evaluation of pain revealed sufficient comfort with this regimen, allowing 45 patients (90%) to go back immediately to their occupations. Moreover, visual function is retained without any complication. Healing of the traumatic corneal abrasion occurred within 1 to 3 days in all patients, with minimal or no pain. The infection did not occur at the time of the follow up. We remove the bandage soft contact lens after 1 week to allow epithelial migration and attachment without the interference of the shearing forces of the upper lid. Conclusion: The use of bandage soft contact lens as a primary treatment for a traumatic corneal abrasion is a safe and effective method with anesthetic eye drop (tetracaine 0.5%), antibiotic eye drop (ofloxacin 0. 3%), cycloplegic eye drop (cyclopentolate 1%), preservative-free lubricant drop instead of traditionally pressure patch. Bandage soft contact lens causes dramatic improvement from pain, lid spasm, tearing & visual function is retained without any complication, and patients can immediately resume their regular activities.
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Anaesthetic management of an elderly patient with ischaemic heart disease and previous MI undergoing elective inguinal hernia repair: Case report

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8615126196

Ischemic heart disease may occur in isolation, or in combination with the pathological process of vascular ageing, arteriosclerosis. These two conditions have differing impacts on the haemodynamic changes in response to anaesthesia and surgery. Hypertension is not a feature of ischemic heart disease, and vice versa, but where the two conditions co-exist, hypertension aggravates and accelerates the pathological processes of ischemic heart disease. Patients older than 40 yrs. presenting for anaesthesia and surgery must therefore be considered at risk of any combination of these three conditions. Anaesthetic techniques must also be chosen to minimize haemodynamic changes which in the normal healthy patient cause no serious morbidity, but which, in the patient with ischemic heart disease, can lead to serious morbidity or death. Here we report a 70 years old (BMI of 23.3) elderly, hypertensive Male patient with ischemic heart disease with previous MI (EF of 40% - 5%) undergoing elective Inguinal hernia repair. We Opted Spinal anesthesia over General anaesthesia as it should be an asset in cardiac patients undergoing non-cardiac lower abdominal surgeries to reduce preload and after load, stress response, coagulation responses, improves coronary perfusion, provides better postoperative analgesia, reduces incidence of perioperative MI, maintains myocardial oxygen supply demand ratio and avoids harmful effects of GA such as hypotention due to intravenous induction drugs, tachycardia and hypertension due to pressor response during direct laryngoscopy and tracheal intubation.
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Measurement of background ionizing radiation in the federal university of technology owerri, Nigeria using calibrated digital geiger counter

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8621042354

The measurement of the natural ionizing radiation in the Federal University of Technology Owerri, Nigeria was carried out using a well calibrated Digital Geiger Muller counter models GCA – 04w. Measurements were taken randomly in thirty (30) diff erent locations outside the building and thirty (30) locations inside diff erent buildings in the University. Results obtained for outdoor Dose rate ranges from 0.07 μSv/hr to 0.23 μSv/hr with a mean value of 0.144 μSv/hr. While the result for the indoor dose rate ranges from 0.08 μSv/hr to 0.21 μSv/hr with a mean of 0.14 μSv/hr. The highest value recorded for the outdoor radiation is from the university front gate which is .023μSv/hr. While the highest value recorded inside the buildings is from the School of Agriculture and Agricultural Technology (SAAT) which is 0.21 μSv/hr. All these values are lower than the world safely limits of 0.247 μSv/hr. This shows that the risk of ionizing radiation on the staff and students of the Federal University of Technology is minimal.
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Risk taking sexual behaviors among young adults – findings from a cross sectional population based survey in Barbados

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8600330342

Background: The National Strategic Plan for HIV Prevention and Control 2014-2018 recognized the need for the utilization of research findings to guide the development of HIV policies, programs and interventions for the general population and key population groups and to inform the allocation of government resources to the areas of greatest impact and need. To this end, a Knowledge, Attitudes, Beliefs and Sexual Practices Survey (KABP) was conducted among adults’ ages 15 to 49 years. Objectives: To identify the sexual behaviors among adolescents and young adults that exposed them to the risks of HIV/STIs and to identify factors that may have to be addressed, in order to achieve further reduction in the spread of HIV in this population. Methods: This is a population based cross-sectional survey undertaken in 2016. Sample was taken from among persons’ ages 15 – 49 years using a multistage sampling methodology. The survey questionnaire was developed from Family Health International’s guidelines for repeated behavioral surveys in populations at risk of HIV. It was interviewer-administered and consisted of ninety-nine (99) closed-ended questions. The topics covered by the survey included sexual history; use of and access to condoms; and HIV testing. Participants were asked about their sexual behaviors over the last 12 months, and about their experience with their most recent partner. Results: Overall, 87.8% described themselves as heterosexual, 1.2% as bisexual and 0.5% as homosexual. By the age 16, 17 1nd 19 years 25%, 50% and 75% of respondents have had sex respectively. Among the 763 respondents reporting vaginal or anal sex over the past 12 months, 80.6 and 19.4% had a single and multiple sex partner respectively. Also, 94.4%, 13.3% and 1.6% reported to have regular, non-regular and commercial sex partners respectively. Overall, 54.6% used condom at the last sex, the corresponding figure for the regular and non-regular partners were 41.2% 80.8% respectively. Only 40.9% reported to have had a HIV test done over the past 12 months and of those who did not, 42.8% had never been tested for HIV. Conclusion: Inconsistent and infrequent condom use and low HIV testing especially among the adolescents and younger adults, in the setting of young ages at sexual debut and multiple sexual partners. Findings form this study strongly recommends for a much greater effort from the public health at promoting condom use and HIV testing especially targeting the younger persons who risk their own protection and that of their partners.
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Identifying patterns in COVID-19: Morbidity, recovery and the aftermath

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8600329092

The infectivity and pathogenesis: SARS-CoV-2, the causative agent of Covid-19, involves Angiotensin-converting enzyme 2 (ACE2) receptors on type II alveolar type 2 (AT2) cells in lungs. Apart from, the upper and lower respiratory tracts, the disease affects the gastrointestinal system prominently, as evidenced by the significant GI symptoms, early in the course of the disease. In addition, the virus infects ACE2-bearing cells in other organs including the heart and blood vessels, brain, and kidneys. Clinical features and morbidity: The clinical spectrum of COVID-19 varies from asymptomatic or pauci-symptomatic presentation to moderate to severe states characterized by respiratory failure necessitating mechanical ventilation and ICU support and those manifesting critical clinical condition with complications like sepsis, septic shock, and multiple organ dysfunction failure. The CT chest is an important tool for early identification of COVID-19 pneumonia as well as for prognostic purposes. The recovery and residual damage: The recovery and other outcomes vary depending on age and other aspects including sex, comorbidities, and genetic factors. The outlook for older adults, who account for a disproportionate share of critical disease, is unfavorable, and most of those who survive are unlikely to return to their previous level of functioning. The disease affects their long-term health and quality of life as well as brings in propensity for truncated post-disease survival. COVID-19 aftermath and follow up: The patients discharged from hospital following severe COVID-19, continue to suffer with lingering impact of the disease as well as that of the emergency treatments that saved their life. The post-infection reduced exercise tolerance and other subtle factors, like post viral fatigue syndrome, post-traumatic stress disorder, impaired concentration, delirium, and disturbed sleep-wake cycle often underly the functional impairment. In fact, there is need of step-down care and later a multidisciplinary support involving regular clinical assessment, respiratory review, physiotherapy, nutritional advice, and psychiatric support. Conclusion: The life after COVID-19: After recovery from the disease, the virus SARS-CoV-2, may persist for uncertain period. In addition, the chance of reinfection cannot be ruled out. The vitamin D supplementation may be helpful. In general, the quality of life (QOL) in ICU survivors improves but remains lower than general population levels, but most of the patients adapt well to their level of self-sufficiency and QOL. Also, the debility due to co-morbidities may further compromise the activity of daily living and QOL issues. The Age and severity of illness appear to be the major predictors of post-discharge physical functioning.
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Vaginal embryonal rhabdomyosarcoma in young woman: A case report and literature review

Published on: 25th May, 2020

OCLC Number/Unique Identifier: 8605988997

Rhabdomyosarcomas are the most common soft tissue tumors of childhood. They are characterized by their poor prognosis. Vaginal location is very rare after puberty and exceptional in the post menopause. Treatment is based on several therapeutic measures combining neoadjuvant chemotherapy followed by surgery and/or external beam radiation therapy. We report herein the case of a 25 years-old woman, presented with vaginal embryonal RMS revealed by metrorrhagia and pelvic pain. The diagnosis was confirmed by biopsy and histopathological study. Pre-treatment workup was negative for metastatic disease. She has received chemotherapy based on vincristine, doxorubicin, and cyclophosphamide. The clinical evolution was marked by improvement of symptoms, unfortunately the patient died following febrile neutropenia after the third cycle of chemotherapy.
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South Asia is more vulnerable to COVID-19 pandemic

Published on: 22nd May, 2020

OCLC Number/Unique Identifier: 8599932087

Coronavirus disease 2019 (COVID-19) which originated in China spread progressively all over the world [1]. On 11th March 2020 WHO declared COVID-19 outbreaks as a pandemic [2]. As of 22nd May 2020, there have been more than 5.3 million confirmed cases of COVID-19, with more than 340 thousand deaths and more than 2.2 million recovered [3]. Slowly, South Asia is also entering the ranks of COVID-19 affected regions. This region comprises more than 21% of the world’s population which remains vulnerable to COVID-19 [4].
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Can we predict Alzheimer’s Disease through the eye lens?

Published on: 22nd May, 2020

OCLC Number/Unique Identifier: 8601971854

Alzheimer’s Disease (AD) is a common dementia problem of the old population. The two main hallmarks of AD are tau protein and amyloid-beta protein. The relevant investigations on AD suggest that these proteins are also seen in the eye. There are many tests and imaging modalities are used for AD diagnosis. But these techniques are still unable to predict the disease effectively. In this regard, the lens of the eye may help in diagnosing AD. Therefore, a reliable technique for measuring the lens or retina must be selected. In this paper, we focus on the different types of retinal diseases occur in AD patients and the use of the Optical Coherence Tomography (OCT) technique is used for diagnosing AD. 
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Review on impacts of COVID-19 pandemic on life animals and dairy product processing industries of the world

Published on: 22nd May, 2020

OCLC Number/Unique Identifier: 8617040327

This review was conducted for the objective of assessing causes of COVID-19 pandemic impacts on life animals and dairy product processing industry of the world. Since its outbreak in Wuhan town of China, the newly emerged strains of corona virus COVID-19 causes incredible crisis both on life animal and its product especially dairy industry of the globe. During the outbreak of the virus, majority of the world people were stayed home to prevent the spread of the diseases. At that time, the wildlife found in the zoo were exposed to diseases and missed human attention, global wildlife trade was spotlighted and wildlife was running… wild. For the reason of COVID-19 pandemic, many schools and restaurants which received dairy product from dairy producers and cooperatives were shutdown. Due to schools and restaurant shutter, milk supply chain was disrupted. For this moment milk demand and supply was decreased, huge volume of milk was dumped, mode of milk trade was changed, market and farm prices was fluctuated, import- export route was interrupted and Farm workforce absenteeism were some of the challenges cases dairy industry crisis. Trade law modification, provision of financial assistance for dairy industry and farmers, and expansion of export route were the measures taken by concerned bodies to save dairy industry from corona virus crisis. Therefore, COVID-19 pandemic is the disaster diseases which causes social and economic crisis on dairy producers of the world. So, to save wildlife and dairy industry from corona virus crisis, global solidarity prevention is mandatory.
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Risk Factors Associated to Patients with Type 2 Diabetes in Lahore District

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8605996006

Our research aimed to check the impact of some significant risk variables on diabetes growth and the specific goal of this study was to evaluate the connection of industrial fields with diabetes risk variables. The current research also informs us about the most important risk factor for male and female people with diabetes. A cross-section and convenient sample of 100 people, male and female, without discernment of risk factors and diabetes mellitus (Meta-Analysis on the effect of major risk factors on the diabetic patients form Jinnah Hospital Lahore). The risk factors in the general assessment i.e. lack of exercise, kidney problems, high ranges of tests and residence in industrial areas are found to be significant. Assessment of these factors is helpful in early diagnosis and in prognosis of diabetes.
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Frequent, Genetic Polyps-Familial Adenomatous Polyposis

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8605379723

Familial adenomatous polyposis is an autosomal dominant syndrome of variable penetration and constitutes the second frequent inherited syndrome enunciating the emergence of a colorectal carcinoma. The syndrome is accompanied by exemplification of defective adenomatous polyposis coli (APC) gene located upon chromosome 5q21 with a prototypic denomination of colonic adenomatous polyps usually exceeding a > 100. Incriminated individuals develop innumerable colonic and rectal polyps, particularly during early teenage years and are accompanied by an almost 100% possible emergence of colorectal carcinoma within 40 years in untreated subjects [1]. Prophylactic colectomy is advisable to substantially reduce possible occurrence of colorectal carcinoma. Familial adenomatous polyposis is concurrent with associated neoplasms such as gastric or duodenal cancer, hepatoblastoma or desmoid tumour along with a probable emergence of extra-colonic carcinomas [1,2].
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Microbiome and Gastroesophageal Disease: Pathogenesis and Implications for Therapy

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8603898545

There is growing evidence that gastroesophageal disease is influenced by the esophageal microbiome, and that commensal bacteria of the oropharynx, stomach, and colon are thought to have a role in modulatiing pathogenesis. These emerging hypotheses are based on observed changes in the composition of the esophageal flora, notably, repeated observations: 1. There is an abundance of gram-positive bBacteria in the healthy esophagus. are more gram positive prevalent 2. The esophageal bacterial population becomes increasingly gram negative with disease progression. Associated with this shift to a more gram negative prevalence is an increase in the potential for the presence of antigenic lipopolysaccharide (LPS). The immunoreactivity of LPS endotoxin thought to promote susceptibility to inflammation and disease. The pathogenesis of the more common diseases of the esophagus e.g. gastroesophageal reflux disease (GERD), esophageal dysmotility (achalasia), eosinophilic esophagitis (EoE), Barrett’s esophagus (BE), and esophageal cancer, are well-established. Emerging data suggest however, that these are all characterized by an immune-mediated inflammatory cascade, propogated by a dysbiotic state. Thereby, the ability of the healthy “normative state” to protect against foreign bacteria is compromised. This dysbiosis thereby can create adverse inflammatory or immunoregulatory responses with progression of disease. In the normal healthy state, the esophageal microbiome is constituted in-part, by a multitude of gram positive bacteria, many of which produce antibacterial peptides called bacteriocins. Bacteriocins are selective and used to maintain population integrity by killing off foreign bacteria. When the “normative biome” is interrupted (e.g. antibiotics, medications, diet, environmental factors), the constitutional changes may allow a more hospitable imbalance favoring the proliferation of opportunistic pathogens. Therefore it seems rational that defining, perhaps that defining, perhaps cultivating, a protective bacterial community that could help prevent or mitigate inflammatory diseases of the esophagus. Furthermore, in conjunction with evidence demonstrating that some bacteriocins are cytotoxic or antiproliferative toward cancer cell lines, further exploration might provide a rich source of effective peptide-based drug targets. Therapeutic options targeting the microbiome, including prebiotics, probiotics, antibiotics and bacteriocins, have been studied, albeit the attributable effects on the esophagus for the most part, have been unrecognized by clinicians. This review focuses on the current knowledge of the involvement of the microbiome in esophageal diseases (most notably GERD/Barrett’s esophagus/esophageal cancer) and identifies emerging new concepts for treatment.
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Acute pancreatitis with uncommon presentation of myocardial infarction

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8616347855

Acute pancreatitis is inflammation of the pancreas that may be accompanied by a systemic inflammatory response which results in impairment of the functioning of various organs, systems. Pancreatitis associated vascular complications very often cause morbidity and mortality. There are various cardiovascular complications like shock, hypovolemia, pericardial effusion, and sometimes ST–T changes in the electrocardiogram (ECG) presenting as acute myocardial infarction (AMI). Acute myocardial infarction complicating acute pancreatitis has rarely been studied and the exact process of myocardial injury still remains unclear. We here report a case of Acute Pancreatitis associated with acute myocardial Infarction.
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COVID-19: Targeting the cytokine storm via cholinergic anti-inflammatory (Pyridostigmine)

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8620528033

Background: The development of COVID-19 having been set apart as the third presentation of an exceptionally pathogenic coronavirus into the human populace after the extreme intense SARS-COV and MERS-COV in the twenty-first century. The infection itself doesn’t make a crucial commitment to mortality, anyway “cytokine storm” created by the unreasonable invulnerable reaction activated by the virus can result in a hyperinflammatory response of lung tissues and deadly lung injury, and in this way increment death rate. In this manner, immunomodulatory medications ought to likewise be remembered for treatment of COVID-19. Presentation of the hypothesis: the virus particles invade the respiratory mucosa firstly and infect other cells, triggering a series of immune responses and the production of cytokine storm in the body, which may be associated with the critical condition of COVID-19 patients. Once a cytokine storm is formed, the immune system may not be able to kill the virus, but it will certainly kill many normal cells in the lung, which will seriously damage the of lung function. Patients will have respiratory failure until they die of hypoxia. It is not yet clear what the death rate of Covid-19 will be, though the best estimate right now is that it is around 1 percent, 10 times more lethal than seasonal flu due to cytokines storm which trigger a violent attack by the immune system to the body, cause acute respiratory distress syndrome (ARDS) and multiple organ failure, and finally lead to death in severe cases of COVID-19 infection. Therefore, inhibiting cytokine storm can significantly reduce inflammatory injury in lung tissues. Pyridostigmine (PDG), cholinergic anti-inflammatory pathway (CAP) is a neural mechanism that modulates inflammation through the release of acetylcholine (ACh), resulting in decreased synthesis of inflammatory cytokines such as TNF-α and IL-1. This finding emphasis, the nervous and immune systems work collaboratively during infection and inflammation. Implications of the hypothesis: Administrations of Pyridostigmine (PDG) as cholinergic agonist inhibits the inflammatory response and lower the mortality of COVID-19 patients. Likewise, activation of the CAP during systemic inflammation down-regulates the production and release of inflammatory cytokines. 
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Bee venom: a case of effectiveness on skin varicosities veins with review of its dermatological benefits

Published on: 21st May, 2020

OCLC Number/Unique Identifier: 8870468269

Bee venom is a very rich and varied biochemical complex, which explains the multitude of its physiological effects as well as its medical indications. In dermatology, apart from psoriasis, few studies have been conducted concerning its interest and effectiveness; however the preliminary results remain so promising and encouraging. We present a clinical case illustrating the efficacy of bee venom in cutaneous varicosities, with a review of the literature of its main dermatological indications.
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Changes in intraocular pressure after ND-yag laser posterior capsulotomy

Published on: 20th May, 2020

OCLC Number/Unique Identifier: 8605488676

The Nd-Yag L has been developed in Europe since the mid-1970s [10]. Today Nd-Yag LPC has become an established procedure for after cataract. Before the Nd-Yag L came into use, the capsulotomy was done by performing a small puncture with a needle knife or 27 gauge needle, either at the time of original operation or as a secondary procedure through the limbus in aphakic or through pars plana in pseudophakic. The Nd-Yag L preferred because it is non-invasive and infection cannot occur. The most important complication is a transient rise in IOP 1-3 hrs of Nd-Yag LPC [1]. Occasionally the pressure rise is high and can cause serious damage to the optic nerve, so that the IOP should be monitored and appropriate measures should be taken if necessary. Only if we can minimize its frequency or, better still, avoid it, altogether, can we accept Nd-Yag L as a safe procedure in our effort to restore vision. In otherwise normal eyes, a mild elevation of IOP is of no consequence because it usually resolves within 24 hour especially when the patient receives anti-glaucoma drugs before and after laser application. However in eyes with pre-existing glaucoma, the incidence of IOP elevation is higher and its duration is longer than in otherwise normal eyes. Some glaucomatous eyes may therefore require additional glaucoma therapy for several weeks following Nd-Yag LPC [3]. So monitoring is particularly important in the cases of glaucoma with optic nerve damage and field loss as these eyes are susceptible to small pressure rises for even a short period. A single rise to 40mmHg for a few hours can cause irreversible damage to the damaged optic nerve and lead to permanent visual loss or even blindness [1]. The purpose of this study is to evaluate the changes in IOP at 1hour,24hour and 1 week after Nd-Yag LPC.
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Evaluation of the efficacy of transcorneal electric stimulation therapy in retinitis pigmentosa patients with electrophysiological and structural tests

Published on: 20th May, 2020

OCLC Number/Unique Identifier: 8604562702

A Statement of significance: This study shows that the effect of transcorneal electrical stimulation (TES) therapy as a stimulator device in retinitis pigmentosa (RP)patients with have a significant increase in visual acuity and shortening of p100 latency in pattern visual evoked potential (pVEP) test during 3 months follow up. Purpose: To assess the safety and efficacy of TES therapy with electrophysiological and structural tests in RP patients. Methods: Thirty four eyes of 17 RP patients were included in the study. Initial examination included best corrected visual acuity (BCVA) and visual field (VF) test (Humphrey). Central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) were measured with using swept-source optical coherence tomography (OCT). The patients were tested by Metrovision brand monpack model visual eletrophysiology device for pVEP and flash electroretinogram (fERG) tests. Patients were seen 12 times during 3 months: initial visit for screening and weekly visits for TES. All tests were repeated 3 times. The results of pre and post TES therapy were compared. Results: Patients’ baseline BCVA was 0,34 ± 0,22. The increase in the last visit BCVA was significant (p : .001) and it was 0.50 ± 0.29. The difference between CMT, RNLF and CT pre and post TES therapy were not significant (p > .05). The mean latencies of the 120’ pattern p100 waves that patients could see were shortened and statistically significant (p = .04). The peaks amplitudes of the 120’ pattern p100 waves that patients could see were increased; but not statistically significant (p :. 19). Conclusion: This study shows that the safety of TES as a stimulator device in our patient group and the effect on this group have a significant increase in visual acuity and shortening of p100 latency in pVEP test during 3 months follow up.
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Prognosis of peripartum cardiomyopathy in sub-Saharan Africa (Burkina Faso South-West PPCM register)

Published on: 19th May, 2020

OCLC Number/Unique Identifier: 8605481207

Peripartum cardiomyopathy is one of the curable cardiomyopathy. It’s a severe and frequent disease arising among women of childbearing age. Its evolution in the long-term among some patients leads to chronic heart failure. Our study aims to determine from a prospective cohort, the factors associated with the non-recovery of myocardial function upon 12 months of diagnosis. Sociodemographic, clinical and echocardiographic data were collected at the time of diagnosis and then in months 3, 6 and 12. The outcome was the non-recovery of myocardial function at one year, defined by a left ventricular ejection fraction (LVEF) below 50%. 60 patients were analyzed after 12 months of follow-up. Mortality was about 13.3% and recovery rate of myocardial function reached 42.3%. After logistic regression, delay diagnosis and observance were the factors related to non- recovery of myocardial function.
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Case reports of observed significant improvement in patients with ARDS due to COVID-19 and maximum ventilatory support after inhalation of sodium bicarbonate

Published on: 19th May, 2020

OCLC Number/Unique Identifier: 8599065026

The emergence of COVID-19 worldwide in an unprecedented pandemic. COVID-19 has a significant mortality, mostly from acute lung injury. We reviewed the available literature from China and Europe in regard to the behavior of SARS-Cov2 and ability to adhere to the cell wall [1,2]. The evidence based literature describes three component for the virus to grant entry to the target cells including Cathepsin B/L (the viral cap protein needed for initial connectivity to the cell wall), the angiotensin converting enzyme 2 and a low PH environment to allow the first connectivity of the virus to the cell wall [3]. The goal of our Case study was to prevent SARS- SARS-Cov2 from entering target cells by raising the airways PH using sodium bicarbonate inhalation. The sodium Bicarbonate inhalation (4.2% concentration) has been used safely in Cystic fibrosis (CF) patients with inspissated mucoid impaction [3,4] and in chloride inhalation toxicity by opposing the effect of the low PH induced by the insulting agent [4,5]. It has not been administered for COVID -19 patients particularly prior to this study. 
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Contemporary American stupidity

Published on: 18th May, 2020

OCLC Number/Unique Identifier: 8598723680

The American character is filled with contradictions and paradoxes [1], so it is understandable that, being susceptible to the imperfections, weakness and evils afflicting all peoples [2], it features its share and many types of injustices and stupidity.
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Contemporary learning or E-Learning in physiotherapy, pre and post COVID-19: Short communication

Published on: 18th May, 2020

OCLC Number/Unique Identifier: 8605488147

Since December 2019, an outbreak of novel corona virus disease was reported in Wuhan, which has subsequently affected more than 160 countries worldwide. The ongoing outbreak has been declared as a pandemic by WHO, a global public health emergency. Several countries are successfully fighting with the pandemic by taking strict measures like nationwide lockdown or by sequestering the areas that were suspected of having risk of community spread. The corona virus pandemic has upended our educational system worldwide [1-3]. The academic calendar all over the world has been disturbed as a result of lockdown. Even after lockdown it would take probably many more months for universities, colleges and schools to reinstate. Caught in the turmoil, some parts of urban Indian education system have turned towards delivery of education via internet or online education. The NCAER skills report 2018 discussed the immense potential of online learning, conversely as complementary to more traditional methods. Centuries old, lecture based approaches, institutional biases, and outmoded classrooms changed. Covid 19 has become an impetus for educational institutions worldwide to search for innovative solutions in a relatively short duration. In the prevailing situation, online education is turning out as an alternative to traditional modes [2,4,5]. Contemporary/E-learning prepares students across all curriculum and learning stages with skills and potential to flourish in a rapidly changing and interlinked world. It connects students and engages their sense of inquisitiveness. E-teachers know and understand the needs and talents of their students. They are trained, flexible and select from a wide range of effective teaching strategies based on need. The new learning environment and resources galvanize students to be leaders of their independent learning. Thus students collaborate and use critical and creative thinking to solve complex problems and become apprehensive and sentient global citizens [4-6]. In physiotherapy, apart from traditional institution based learning, there implies a need for technological inputs and E-learning as a need to develop critical, creative thinking and reasoning. These technological arrays do provide better concepts and understanding regarding academics and practice [6]. As physiotherapy is advancing and growing in academics, research and practice, the need for an interlinking platform through which learning becomes unconditional and globally accessible was never addressed. Covid- 19 lockdown and strategies imposed us to think apart from institutional mode, ostensibly got a worldwide acceptance. Research suggests that online learning has been shown to increase retention of information, and take less time. On average, students retain 25% - 60% more information when learning online compared to only 8% - 10% in a classroom. E-learning requires 40-60% less time to learn and understand than in a traditional setting, because students can learn at their own pace, re-reading, skipping or accelerating through concepts as they choose. Contemporary learning or E-learning at present situation is intended to have the desired effect such as physical distancing, schedule flexibility, cost effective, fast learning, course variety, boost memory, reasoning and innovative teaching [2,4]. Adoption of online learning will continue to persist post pandemic, and how such a shift would impact the worldwide education market should be studied. Some believe that the unplanned and rapid move to online learning with no training, insufficient bandwidth, and inadequate preparation will result in a poor user experience that is deleterious to sustained growth [5,8]. The current crisis has acted as a thwack to encourage digital education among physiotherapy institutions. However, to achieve its prospective in the long run, physiotherapy institutions and universities should implement a digital platform, training as well as a curriculum regulation. “We believe that, the integration of information technology, E-learning in education will be further accelerated and eventually transpire to an integral component of physiotherapy education and practice”.
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Chronic subdural haematoma associated with arachnoid cyst of the middle fossa in a soccer player: Case report and review of the literature

Published on: 16th May, 2020

OCLC Number/Unique Identifier: 8628644362

Introduction: Arachnoid cyst (AC) is a congenital, benign, extra-axial lesion often found incidentally on intracranial imaging and makes up almost 1% of all intracranial masses. It arises from the splitting of arachnoid membranes with components similar to the cerebrospinal fluid. It’s reported that AC can be complicated by chronic subdural haematoma in athletes with repeated head injuries. Case report: we describe a case of a soccer player with an AC that underwent surgery for a chronic subdural haematoma with full recovery. Material and method: From a PubMed research, we found 14 relevant studies reporting a total of 15 patients who met the inclusion criteria: playing soccer, subdural hematoma and arachnoid cyst. Results: Patients underwent different surgical treatment. In the case of hygroma with no midline shift, a conservative treatment was performed. In all cases the reported follow up was a full recovery. Discussion: Soccer is not usually considered a contact sport related to a high risk of head trauma or shaking head. From our review we can postulate that a soccer player with AC has an augmented risk to have a subdural haemorrhage, more rarely intracerebral haemorrhage. Conclusion: ACs are common meningeal abnormalities. They may bleed after minor head trauma, although it is rare. Asymptomatic patients with known AC should be monitored by a neurosurgeon and decision to engage this patient in soccer sport participation is still controversial.
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Determination of calcium in the tooth structure by using flame emission spectrophotometer

Published on: 15th May, 2020

OCLC Number/Unique Identifier: 8595799073

Calcium is the most common element in the tooth’s structure. In addition, calcium is one of the elements that are effective in maintaining dental health. As a result of calcium deficiency, the tooth becomes brittle and begins to rot. Calcium deficiency usually occurs in acidic beverage consumption and during canal treatment. A study was conducted to determine the degree of calcium removal in the root canal dentin after 17% EDTA, 17% EGTA, 15% EDTAC and 1% tetracycline-HCl treatment; later with or without 2.5% NaOCl [1]. Extracted single-rooted human teeth were bisected longitudinally and the root halves (n = 100) were isolated with nail varnish, leaving the root canal exposed. The samples were immersed in the test solutions for 1 and 5 minutes, after which the amount of calcium ion (Ca2+) release into the solutions was determined by flame photometry. The calcium ions (Ca2+) present in hydroxyapatite crystals are one of the main inorganic elements of dentin [2]. It has been reported that some chemicals used for endodontic irrigation are capable of causing alterations in the chemical composition of dentin [3-6]. MethodsDetermination of calcium in the tooth’s structure is very important. Calcium determination, Flame Emission Spectrofometry and inductively coupled plasma optical emission spectrometry (ICP-OES) methods can be performed. These methods can be analyzed in a short time without interference effects. In both methods, the calcium in the tooth is stimulated and the emission intensity it emits is measured as it becomes basic. These emission intensities are directly proportional to the calcium concentration. Also, in these methods, calibration graph or standard addition method is used for calcium determination. The roots were then bisected longitudinally, and the pulp tissue was removed with a toothbrush. All root halves (n = 100) were dehydrated in a sterilizer at 120 °C until they reached a fixed weight, as verified by consistent readings using a precision scale (Sartorius, Gotingen, Germany; precision = 0.0001 g). Thereafter, the specimens were covered with two consecutive layers of nail varnish, leaving the root canal surface exposed. The samples were randomly distributed into the following treatment. Groups: Group 1: 2.5% NaOCl Group 2: 17% EDTA Group 3: 17% EGTA Group 4: 15% EDTAC Group 5: 1% Tetracycline-HCl Group 6: 17% EDTA _ 2.5% NaOCl Group 7: 17% EGTA _ 2.5% NaOCl Group 8: 15% EDTAC _ 2.5% NaOCl Group 9: 1% Tetracycline-HCl _ 2.5% NaOCl Group 10: Distilled water (negative control) In each group, the specimens were immersed in a magnetic stirrer bath containing 10 ml of test solution for 1 and 5 minutes. In groups 1 and 10, the same samples (n = 10) were used for 1- and 5-minute treatments. Calcium is measured between 10 and 1000 ppm (mg/L) with Flame emission intensity. Calcium at a lower concentration cannot be measured. Inductively coupled plasma optical emission spectrometry (ICP-OES) is a widely used method recently. ICP-OES is an advanced high-end method of flame emission spectrophotometer. In this method, the energy source required for excitation is provided by plasma and its temperature is between 4000 and 10000 ⁰C. There is a certain wavelength of light to which each element is stimulated. The wavelength of the light used for calcium is 455,531 nm. At this wavelength, a calibration graph is prepared from standard solutions of calcium. Calcium in the tooth is measured using the calibration chart. The sensitivity of this method is high. Calcium analysis in ppm (mg/L) and ppb (µg/L) concentration can be analyzed with ICP-OES. In this method, the analysis takes minutes. Therefore, it is used in routine analysis. ConclusionUsing these methods, you can easily analyze the calcium found in the structure of the tooth. Also, disinfectant like hypochlorite used during canal treatment increases the calcium release of the tooth. Therefore, the released calcium can also be analyzed using these methods. Here, each sample takes at least 5 measurements and gives the results in accordance with the scientific representation.
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Fever is not a symptom in COVID-19: None of the diseases require fever as its symptom

Published on: 14th May, 2020

OCLC Number/Unique Identifier: 8603903069

We have been hearing for centuries that ‘fever is not a disease but a symptom’. Physicians say that fever is a symptom of diseases like flu to cancer.
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The influence of HBV or HCV infections on the pregnancy course

Published on: 14th May, 2020

OCLC Number/Unique Identifier: 8667859611

The incidence of HBV infections among the pregnant in Europe falls within the range of 1% - 7%, whereas it is 1.7% - 4.3% for HCV. The aim was to assess the course of pregnancy among women infected with HBV or HCV, and the condition of neonates in the fifth minute after the birth. The study included 157 pregnant individuals infected with HBV, 53 infected with HCV, and 330 healthy pregnant women. None of the women infected with HBV and HCV as well as from the control group were infected with HIV, and none of them took intoxicants. Weight of neonates delivered by healthy women was higher as compared with children born by women infected with HBV or HCV (3,517 vs. 3,347 and 3,366). The Apgar score of neonates delivered by women with HBV and HCV infections was lower as compared with the children born by healthy women (9.4 vs. 9.3 vs. 9.7; p < 0.05). Premature births occurred more often in HBV and HCV-infected women than in the control group (14.6% and 24.5% vs. 6.96%; p < 0.05). Miscarriages were significantly more common among the pregnant with HCV infections as compared with the pregnant who were healthy (9.4% vs. 1.8%; p < 0.05). In comparison with the healthy individuals, this group of patients experienced pruritus (10.5% vs. 4.2%; p < 0.05), oedemas (9.4% vs. 2.4%; p < 0.05), and hypertension (9.4% vs. 1.5%; p < 0.05) more often. An increase in HBV loads was observed between the 6th and 28th – 32nd week of pregnancy among the infected with HBV, and then, a decrease was observed in the 6th months after the delivery. The pregnant infected with HBV without HBsAg (-) and the infected with HCV are subject to common incidence of premature births. Women infected with HCV often experience oedemas, hypertension, and pruritus.
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Socio-demographic characteristics and other factors associated with depressive illness among medical students at the University of Port Harcourt

Published on: 14th May, 2020

OCLC Number/Unique Identifier: 8691259611

Background: The burden of depression as a mental disorder has continued to increase and constituting an enormous public health concern among all age groups. A number of socio-demographic, and other factors including a stressful and rigorous academic programme or curriculum such as the one run in most medical schools could contribute to the occurrence of depression among medical students. AIM: To determine the socio-demographic and other factors associated with depression among medical students in the University of Port Harcourt. Methodology: This study was a descriptive cross-sectional study. Appropriate sample size was calculated and the stratified random sampling method was used to select the subjects. A well-structured open ended self-administered socio-demographic questionnaire was administered to the students. The Zung Self-Rated Depression Scale was used to assess the depression status of each respondent. The data were analyzed via descriptive and analytical methods. Results: The prevalence of depression among the medical students was 5.3%. Fourteen students (4.6%) were mildly depressed while only two respondents had moderate depression. Year 3 had the highest prevalence with 10.5% followed by final year with 5.3%, while the only 2 cases of moderate depression were found among students in year 2 of their medical programme. Two hundred and seventy-one respondents (88.8%) were found to have good knowledge of depression, 32 (10.5%) were found to have average knowledge of depression and 2(0.7%) had poor knowledge of depression. Conclusion: Depression does occur among medical students at the University of Port Harcourt albeit low, and was associated with a number of socio-demographic and other factors. The present medical curriculum and programme should be sustained and more efforts at making it less stressful and academically friendly, be made to further reduce the current rate of psychological stress and depression among the students.
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Impact of Community Oriented Ear Care (COEC) on national programme for control of deafness in India: A critical look

Published on: 13th May, 2020

OCLC Number/Unique Identifier: 8592937878

The National Programme for Prevention and Control of Deafness (NPCD) was launched in 2006 by Government of India, but despite its phase wise implementation, the community oriented ear care has not been properly realized in view of existing IPHS Standards 2012 at PHC Level. So understanding of its real impact after implementation is desired. Therefore the Impact of Implementation status of community oriented ear care at the primary health system level on NPCD in India needs exploration.
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Role of community health fairs in providing health services, improving health of rural residents

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 9272371549

Introduction: Obesity (BMI ≥ 30 kg m-2) is epidemic globally and is associated with increased risk for a wide range of physical and mental health comorbidities. This is a particular concern for rural residents who have a greater rate of obesity than urban residents, but are disadvantaged in obtaining care because of a shortage of health care professionals. Community health fairs provide an opportunity for rural residents to receive health care services and education at reduced or no cost. Therefore, this study explored the role of community health fairs for providing health services and improving the health of residents in a rural community where obesity is a serious health concern. Methods: This study involved a retrospective longitudinal analysis of data collected during community health fairs conducted in a rural western Nebraska, USA community during 2014, 2015, and 2016 (n = 83). The Planned Approach to Community Health (PATCH) framework was used to target health education in this rural community. This approach involved 1. Mobilizing the community (via health fairs), 2. Collecting and organizing data (from consented attendees), 3. Selecting health priorities (obesity), 4. Developing a comprehensive intervention (nutrition and physical activity education), and 5. Evaluating the effectiveness of the framework (declines in measures of obesity over time). Analyses characterized BMI, percent body fat, visceral fat, and BP and explored differences between genders. The sample was recruited by advertising with flyers for health fairs at the College of Nursing. Most booths provided printouts of results for participants in order for them to keep and track their health information. Once potential participants arrived at the health fair site, there were asked if they would like to participate in the study via an invitation letter. They could then decline or sign the consent. Results: Percent body fat and visceral fat level differed between genders (p = < .001 and .001, respectively). Mean body fat levels (women 39.4%, men 28.8%) were unhealthy. Mean visceral fat level was unhealthy in men (16), but healthy in women (10). BMI and systolic and diastolic blood pressure did not differ between genders. Mean BMI was 31 kg m-2; 33% of participants were overweight, 44% were obese. Mean systolic and diastolic BP were 134 and 78 mg Hg, respectively. Most participants were hypertensive (systolic: men 57%, women 32%; diastolic: men 24%, women 7%) or prehypertensive (systolic: men 21%, women 39%; diastolic: men and women 36%). Conclusion: Obesity and high BP were common in this rural population, supporting the need for effective education and intervention efforts to address these health issues. Health fairs provide a manner in which to reach community persons needing referrals to local clinics, mental health providers and physicians. Education provided at such events is valuable as well and may in fact be the only health care contact they receive. Though community health fairs provide an economical way for individuals to receive screenings and health information, few men participated and few individuals attended in multiple years. The lack of repeat attendees prevented assessment of the efficacy of the education intervention. Means of enhancing participation, particularly by men and previous attendees, need to be explored. Repeatedly attending health fairs enables participants to monitor their progress, seek physical and mental health screenings and discuss any health concerns and helps researchers assess the efficacy of interventions. 
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Neutrophils, NETs, NETosis and their paradoxical roles in COVID-19

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 8592950514

The pandemic of COVID-19 has adversely affected the world in many aspects. The health and economic sectors suffer most of the repercussions of this disease. The search for a cure for this rapidly spreading virus which is causing massive life losses worldwide requires clear understanding of the immunopathogenesis of this virus so as to develop pinpointed targeted therapies rather than relying mainly on supportive care measures and drug repurposing to fight this life-threatening virus infection. Neutrophils, neutrophil extracellular traps (NETs), and NETosis are not well studied not only in COVID-19, but also in coroviruses in general. The review will shed lights on the functions of neutrophils, NETs, and NETosis in various infectious complications as well as in sepsis and acute lung conditions in an attempt to understand their actual roles and in order to help in designing targeted therapies in the near future.
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Studies of the possibility of determining amplifications in kinematic pairs

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 8608084505

The article discusses approaches to solving problems of accurately determining strength in kinematic pairs. It is known that the nature of the bonds imposed by kinematic pairs is determined by the geometric shapes of the elements of the pairs. For what, here, the bonds acted during the entire time the mechanism was moving, so that the elements of the kinematic pairs would continuously touch each other. Where it is recognized that one of the simplest methods for taking into account the inertia of a link is the principal moment method. How the contradiction is sought is here because the normal acceleration has a direction opposite because normal acceleration has a direction opposite to the link (directed toward the center), and the image of tangential acceleration is directed parallel to this acceleration. The following simplification can be made if the main vector of inertia is considered together with the weight of the link.
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Physicochemical and microbiological quality of tanker waters in Bengaluru urban for safe water supply

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 8601971117

This study investigated the water quality of tanker waters that was collected from Bengaluru urban areas to assess its suitability for domestic purpose. A total of 50 samples were collected in dry (March 2019) season. All samples were analyzed for various hydrochemical parameters, such as pH, total dissolved solids (TDS), electrical conductivity (EC), turbidity, dissolved oxygen (DO), total hardness (as CaCO3), calcium (CaCO2+), chloride (CaCO−) and nitrate (NO3−). Bacteriological analyses of water samples were analyzed for total coliform count. A very high level of total hardness (186 - 434.6 mg L-1) was determined in 27 water samples tested in this study indicating the necessity of water treatment before used for domestic purpose. Of the 50 samples tested, 7 showed a most probable number (MPN) index of < 23 and 9 showed < 240 and the remaining 34 were unsatisfactory with an MPN index of > 1600 per 100 ml. In some locations, the presence of high MPN index, in particular, rings the bell before using the tanker water in houses and restaurants. Exploration of the mechanisms by which water quality deteriorates during supply chain and potential implication for regulatory policy for monitoring of tanker water while distribution is the need of the hour.
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Role of T-Helper cells (CD4+ T Cells) in human immune system against some microbial infection: A mini review

Published on: 11th May, 2020

OCLC Number/Unique Identifier: 8601982623

The human immune system consists of innate and adaptive immune responses which both provide protective immunity to microbial infection. The adaptive immune system consists of T and B cell which act as second line defense through production of neutralizing antibody by B cells and cytotoxic activity of CD8+ T cells. The CD4+ T-cell performs a central role in the immune responses. These cells also known as T4 or helper/inducer T lymphocytes recognize antigens presented by antigen presenting cells (APC) such as macrophages and monocytes. Once antigens such as bacteria and viruses are presented, CD4+ T lymphocytes orchestrate the body’s antigen-specific immune response by Coordinating B-lymphocyte production of antibodies to these antigens, producing cytokines and induction of cytotoxic T-lymphocytes. The paper was aimed to review the role of T-helper cells (CD4+ T cells) in human immune system against some microbial infections.
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Gene polymorphisms CVPDr on some plants citrus in Bali Island

Published on: 7th May, 2020

OCLC Number/Unique Identifier: 8604563550

Citrus Vein Phloem Degeneration (CVPD) is the main disease of citrus plants in Indonesia. This disease is caused by Gram negative bacteria, Candidatus Liberibacter asiaticus. Almost all citrus plants are susceptible to this disease and only a few citrus plants such as seedless lime (Citrus aurantiifolia var. Seedles) and kinkit citrus (Triphacia trifoliate) are tolerant. Both of these citrus plants store DNA fragments of CVPDr which are considered as tolerant factors (841 bp). However, this study found that CVPDr DNA fragments were also found in citrus plants susceptible to CVPD disease. This research aims to study DNA polymorphisms from CVPDr DNA fragments in citrus plants on the island of Bali. The PCR test showed T. trifoliate and C. aurantifolia that are resistant to CVPD and Pylogenically are in the same group as C. nobilis var Buleleng, C. reticulate var. Slayer Buleleng, and C. amblicarpa. On the other hand, citrus plants susceptible to CVPD are in a different group. There are two types of citrus plants not containing CVPDr DNA fragments, namely C. nobilis var. Petang and M. paniculata L. These results indicate that the CVPDr DNA fragment polymorphism is a factor tolerant to CVPD disease.
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Trial of labor after cesarean outcomes with excessive gestational weight gain

Published on: 6th May, 2020

OCLC Number/Unique Identifier: 8601973455

The success of vaginal birth after cesarean section (VBAC) has been correlated with a variety of maternal characteristics such as age, ethnicity, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The patient’s BMI just prior to delivery has been shown to be a better prognostic indicator of success than pre-pregnancy BMI. Gestational weight gain was previously associated with a decreased rate of successful VBAC. More recent research has not supported such an association. The objective of our study was to further validate these findings with a larger population. We performed a retrospective cohort study of women undergoing trial of labor after cesarean (TOLAC) at our institution from January 2010 to December 2019. Women were divided into three groups based on weight gain in pregnancy as compared to the American College of Obstetrics and Gynecology (ACOG) recommendations (i.e. < 25 pounds (lbs), 25-35 lbs, > 35 lbs). We further subdivided the pregnancies between term and preterm deliveries. The primary outcome was a successful VBAC. Of 1087 patients attempting a TOLAC, 772 (71%) were successful and 315 (29%) failed VBAC. When grouped according to ACOG weight gain recommendations, 303 (31%) women were below ACOG guidelines, 318 (33%) met guidelines, and 339 (35%) exceeded guidelines. There was no difference in the rate of VBAC success among the three groups. When counseling patients, providers should still promote healthy dietary habits but should not correlate excess weight gain with chance of TOLAC success.
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8 Gy single dose radiotherapy for bone metastasis in COVID-19 pandemia period: Review

Published on: 6th May, 2020

OCLC Number/Unique Identifier: 8592937425

Bone metastases in cancer patients are highly painful and decrease the quality of life for these group of population. Covid-19 pandemia is a global challenging issue that mostly affect the patients with immune suppression or having comorbid diseases older than 65 years old. The palliation and management of bone metastases varies from single dose to several fractionation. The main goal of this article is to decide that short or long term fit for the cancer patients with bone metastasis in the Covid-19 era. We reviewed the topic about the short course and long term radiotherapy in the patients with painful bone metastases via novel literature.
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Implications on mental health by the coronavirus disease 2019 (COVID-19) pandemic: The role of general practitioner

Published on: 5th May, 2020

OCLC Number/Unique Identifier: 8588739409

Coronavirus disease 2019 (covid-19) pandemic gives rise to a significant number of psychological consequences and health problems. The GP must recognize the feelings generated in their patients and address them. This task includes 4 areas: 1. Knowing and managing the epidemic of anxiety and fear in patients; 2. Assessing possible de-compensation of patients with previous mental problems; 3. Knowing and managing effects of quarantine and social distancing; and 4. Knowing and managing possible truncated mourning. The recommendations for GPs intervention are: 1) In the clinical interview (identify maladaptive thoughts and emotions; comprehensive health); 2) Health information (clear, evidence-based communication); 3) Health education (healthy behaviors); 4) Telecare (support, monitoring and attention over the phone, via WhatsApp or video calls); 5) Crisis interventions (psycho education, cognitive behavioral techniques or referral to specialist); 6) Bibliotherapy (free electronic copies for the public); 7) Special efforts directed at vulnerable populations (infected and sick patients, the elderly, with a compromised immune function and those living or receiving care in congregated settings and people with adverse medical, psychiatric or with substance use problems, their families and caregivers); 8) Psychosocial monitoring (stressors related to COVID-19: exposures to infected sources, infected family members, loss of loved ones and physical distancing, secondary adversities such as economic loss, psychosocial effects such as depression, anxiety, psychosomatic concerns, insomnia, increased use of substances and domestic violence, and vulnerability indicators such as pre-existing physical or psychological conditions); and 9) Follow-up of the “complicated” mourning (“accompaniment” and transmit compassion, love and affection).
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Exploring pathophysiology of COVID-19 infection: Faux espoir and dormant therapeutic options

Published on: 5th May, 2020

OCLC Number/Unique Identifier: 8620512199

COVID-19 virus structural components: The 2019-nCoV, also called SARS-CoV-2, was first reported in Wuhan, China in December 2019. The disease was named Coronavirus Disease 2019 (COVID-19) and the virus responsible for it as the COVID-19 virus, respectively, by WHO. The 2019-nCoV has a round, elliptic or pleomorphic form with a diameter of 60–140 nm. It has single-stranded RNA genome containing 29891 nucleotides, a lipid shell, and spike, envelope, membrane and hemagglutinin-esterase (HE) proteins. Steps in progression of COVID-19 illness: Once inside the airways, the S protein on the viral surface recognizes and mediates the attachment to host ACE-2 receptors and gains access to endoplasmic reticulum. The HE protein facilitates the S protein-mediated cell entry and virus spread through the mucosa, helping the virus to attack the ACE2-bearing cells lining the airways and infecting upper as well as lower respiratory tracts. With the dying cells sloughing down and filling the airways, the virus is carried deeper into the lungs. In addition, the virus is able to infect ACE2-bearing cells in other organs, including the blood vessels, gut and kidneys. With the viral infestation, the activated immune system leads to inflammation, pyrexia and pulmonary edema. The hyperactivated immune response, called cytokine storm in extreme cases, can damage various organs apart from lungs and increases susceptibility to infectious bacteria especially in those suffering from chronic diseases. The current therapeutics for COVID-19: At present, there is no specific antiviral treatment available for the disease. The milder cases may need no treatment. In moderate to severe cases, the clinical management includes infection prevention and control measures, and symptomatic and supportive care, including supplementary oxygen therapy. In the critically ill patients, mechanical ventilation is required for respiratory failure and hemodynamic support is imperative for managing circulatory failure and septic shock. Conclusion: Confusion, despair and hopes: There is no vaccine for preexposure prophylaxis or postexposure management. There are no specific approved drugs for the treatment for the disease. A number of drugs approved for other conditions as well as several investigational drugs are being canned and studied in several clinical trials for their likely role in COVID-19 prophylaxis or treatment. The future seems afflicted with dormant therapeutic options as well as faux Espoir or false hopes. As obvious, not all clinical trials will be successful, but having so many efforts in progress, some may succeed and provide a positive solution. Right now, though, confusion and despair prevail.
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Incidence and disease control of Zucchini yellow mosaic potyvirus

Published on: 5th May, 2020

OCLC Number/Unique Identifier: 8874829502

Zucchini yellow mosaic potyvirus (ZYMV) was first identified in northern Italy. It likes other species of the family Potyuiridue. ZYMV has been recorded in many countries since 1981. The efficient intercontinental spread of the virus can be explained by international trading of infected seeds. Since coat protein (CP) analysis has become a primary method for taxonomic assignment of potyviruses the aims were to characterize this genomic region of ZYMV originating from virus-infected cucurbitaceous seedlings. Virus infection in cucurbits is typically associated with mosaic symptoms on leaves and lumpy, distorted fruit. The range of symptoms produced by each virus can overlap and plants are commonly infected by more than one virus at once. The viruses are spread by many species of aphids moving through or within a crop. Control options include: destroying old cucurbit crops as soon as harvesting is completed destroying weeds and volunteer cucurbits, within and around crops as these harbor the viruses and/or the aphids separating new crops from maturing crops as these will have high levels of virus infection avoiding overlapping crops of cucurbits.
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‘Rotational alignment on patients’ clinical outcome of total knee arthroplasty: Distal femur axillary X-ray view to qualify rotation of the femoral component

Published on: 4th May, 2020

OCLC Number/Unique Identifier: 8588740322

Background: Rotation of the femoral component in total knee replacement (TKR) is very important for good long-term results. Malrotation of the femoral component usually requires subsequent reimplantation. We performed X-ray projections of the knee at 90° to determine proper rotation of the femoral component without use of computed tomography. Methods: The axial projection of the distal femur was measured in post-TKR cases. During the TKR operation, Whiteside’s method had been used to provide symmetrical flexion space. The exact outer rotation of the femoral component was measured by x-ray determination of the middle condylar twist angle, from the central epicondylar axis and posterior condylar axis. Results: The middle condylar twist angle was in outer rotation, with an average of 3.36° (range: 1-7.6), similar to the literature. Six of the patients underwent bilateral TKR. In total, the case series included 18 women and 15 men, with average age of 71.34 years-old (range: 56-85). As a clinical evaluation we used Knee Society Score (2011). From results 2 patients were not very satisfied with the instability TKR. Axially X-ray seemed to be only which could distribute these patients. Summary: X-ray values have the same evaluation as computed tomography. The results were 2 patients in pattern of 48, which were sufficient to extrapolate to whole population according to the statistical methods. This corresponds to 4% which we can add to evaluate satisfaction of all patients after TKR and eventually lower the total of unsatisfactory patients which is total of ¼ of total. It is also forensic reason for all patients. Our recommendation to have good results and patient satisfaction in TKR is to do x-rays before and after operation. Important are x-rays antero-posterior, lateral, and Kanekasu projection to know the rotation after TKR. Other cases without stability in flexion are nor very rarely planed for revision surgery, which is much more expensive, and burdens overall health system. 
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The benefits of biochemical bone markers

Published on: 4th May, 2020

OCLC Number/Unique Identifier: 8613464627

Clinical benefits 1. To improve efficiency in Osteoporosis treatment 2. To adjust the dosage of medication for osteoporosis with BMK 3. To adjust bone life cycle as needed 4. To prevent bone necrosis which dentists have been worried. 5. To reduce cost of treatment 
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Acute and post burn reconstructive surgery of the female trunk with artificial dermis to facilitate healthy pregnancy

Published on: 4th May, 2020

OCLC Number/Unique Identifier: 8628640095

The sequelae of deep and extensive burns to the abdomen can lead to serious complications during pregnancy. Studies and publications covering this subject are scarce and outdated. The complications described arise during the 3rd trimester of pregnancy, and surgical treatments to address these complications can initiate premature labor with a risk of fetal demise. We felt it would be of interest to prevent these complications through surgical treatments performed before the pregnancy. The need to reconstruct large regions of abdominal scar tissue prompted us to turn to the Integra® dermal equivalent for preventative surgical treatments.
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Parabens: The love - hate molecule

Published on: 2nd May, 2020

Parabens are the esters of para-hydroxybenzoic acid [1], mimicking oestrogen, the hormone which makes a woman a woman; women love it and men hate it. 
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Our experience with single patch repair of complete atrioventricular septal defects

Published on: 2nd May, 2020

OCLC Number/Unique Identifier: 8588716552

Background: Various surgical methods have been utilized in the management of complete atrioventricular septal defects (CAVSD). Early intervention and achievement of a competent left atrioventricular valve are the key factors for successful treatment. Methods: A total of 66 patients with complete atrioventricular septal defect have been operated in a tertiary care center. Patient group consisted of 28 males and 38 females with an average age of 6.2 ± 3.3 months. Ventricular and atrial defects were repaired generally with single-patch technique using autogenous pericardium. Results: Preoperative catheterization and angiography was performed in 41 patients. Single patch and modified single patch techniques were preferred in 57 and 9 patients respectively. The average duration for respiratory support, intensive care unit stay and discharge from hospital were 36 ± 49.3 hours, 4.1 ± 1.9 days, and 10.1 ± 3.3 days respectively. In the left atrioventricular valve mild, moderate and severe regurgitation were detected in 44 (66.6%), 17 (25.7%) and 2 (3%) patients postoperatively. No regurgitation was determined in 3 patients (4.5%). Two cases ended up with mortality (3%). Conclusion: Single patch repair technique can provide satisfactory surgical outcomes in patients with complete atrioventricular septal defect.
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