All Articles in december, 2021

To study the effect of square stepping exercise and balance exercise to improve balance impairment and reducing the fear of falling on Parkinsonism patient. This is a pre-test and post-test experimental design comparative in nature. Subject aged between 60 – 70 years having Parkinson’s disease were included for the study. Group A (15 subjects) participated in square stepping exercise for 5 times in a week for 4 weeks and Group B (15 subjects) participated in balance exercise for 5 times in a week for 4 weeks. The outcome was measured by using Berg balance scale, Time up and go (TUG) test and fall efficacy scale. Statistical analysis done by using pair ‘t’ test and unpair ‘t’ test showed that there is significant improvement in subject who underwent the square stepping exercise program compared to balance exercise on fear of fall and balance in parkinsonism patients. It is concluded that square stepping exercise group exhibited statistically significant improvement in Berg Balance Scale, Time up and Go test score and fall efficacy test score compared to the balance training exercise group.

Cancer, as a disease, has found a place in the social imaginary. Individuals construct ideas based on pre-established discourses—be they medical, media, or popular—which often hinder its prevention. Educational interventions have tended to focus on spreading information about the disease, ignoring its social connotations. The objective of the present study is to investigate the concept of cancer prevention in 980 adolescents, aged between 12 and 18 years, attending primary and secondary school in three public schools and one private school in the metropolitan region of São Paulo and the municipality of Dom Viçoso, Minas Gerais. The notion of prevention implies the dominant feeling of performing medical examinations from a symptom, against the idea of preventing, even when there is no clinical manifestation of the body. The majority of students emphasize the advantages of early diagnosis and that the decisive factor for the cure corresponds to the moment of detection: "cancer must be discovered in time". This is a solid belief within the body of knowledge about the disease that can be used as a starting point in prevention messages.However, even when the importance of early detection of cancer is understood as an essential element for its cure, care practices do not accompany the set of principles that regulate prevention or its demands.

The article shows that the current level of physiology does not disclose the biological mechanisms of the organism’s transition from one range to adapt to a higher one with an increase in the regular forces of the stimulus above sub-extreme. A new trend in the physiology of adaptation - proqredient adaptation, explains the mechanism of increasing the tolerance of the organism, with dependence on psychoactive substances (PAS). Scientific has reasonably shown that depending on the organism from PAS - not the disease, and the states like proqredient adaptation.

A 69-year-old man presented with a one-month history of a painful mass in the right breast. Pathologic evaluation of the excision of the mass revealed a proliferation of both glandular and stromal elements consistent with gynecomastia. In addition, histologic examination revealed peripheral nerves in the deep portion of the specimen were entrapped in the proliferative changes associated with gynecomastia. It is proposed that the expansile proliferation led to compressive pressure on the nerves and caused the pain associated with gynecomastia.

Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol.Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol.Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis. 

Acute myeloid leukaemia (AML) is the forefront disorder of the bone marrow among others that disrupt the normal production of blood cells and platelets. The bone marrow microenvironment or the bone marrow niche (BM niche) that orchestrates the proliferation and survival of Leukaemic stem cells (LSC) is the reason for relapse after complete remission and also chemotherapy drug resistance. As for most cancers oxidative phosphorylation, a fundamental mitochondrial process of energy production, is under focus for the treatment of AML and a novel strategy of targeting heat shock proteins appears as a promising route for further research.

For a long time there was no explanation of a study which had revealed that people with schizoaffective disorders and in particular suicidal attempts rarely get cancer. But now, we can assume that there are diseases that are “mirrored” because they occur with reverse/feedback pathophysiological mechanisms so that they are, in fact, antagonists.

Background: Chronic kidney disease is a worldwide public health issue which is associated with an increased risk of end-stage renal failure and cardiovascular disease. Systemic inflammation exists during chronic renal failure. Recent researches have highlighted the pivotal role of inflammation between renal and cardiovascular disease. The aim of our study is to determine the inflammatory profile of the patient suffering from chronic kidney disease and the influence of hemodialysis on this profile.Methods: We carried out a cross sectional study on 93 patients in the Nephrology Department at Hedi Chaker University Hospital, Sfax, South of Tunisia. Among those patients, 72 patients underwent hemodialysis and 21 patients had chronic kidney disease at stage 3. Clinical data and antecedents were collected. Biological samples were taken after informing the patients and taking their consent. Biological data consisted in lipid profile, albumin rate, hemoglobin rate, uric acid concentration and the usual markers of inflammation noting sedimentation rate, C - reactive protein and orosomucoid.Results: Hemodialysis group of the 72 patients had mean hemodialysis vintage of 54.6 ± 43 months. The inflammatory profile was worse in hemodialysis patients compared to chronic kidney disease patients. Both sedimentation rate, C - reactive protein and orosomucoid were higher in hemodialysis group than in chronic kidney disease group with 71 ± 35.3 mm vs. 42.1 ± 15.5 mm (p < 0.05); 14.6 ± 28.7 mg/l vs. 6.7 ± 8 mg/l (p = 0.02); 1.3 ± 0.7g/l vs. 0.9 ± 0.4 g/l (p = 0.01), respectively.Conclusion: Inflammation increases in dialysis patient. It deserves the nephrologist’s consideration in order to minimize its harmful effects. The monitoring of inflammation markers must be integrated into the nephrologist’s medical practice.

“Class is part of the meaninglessness of reality,” says Lacan. An abundance of narratives concerning post-communist Romanian camps may be found.In a sense, Derrida’s essay on education suggests that the goal of the artist’s social comment, given that art is interchangeable with a lack of joy. The characteristic theme of educator’s model of roles camp is a self-sufficient reality, leading to depression and anxiety.But the subject is contextualized into a cultural Marxism that includes art as a whole. Popescu examines the teacher’s camp; in The Crying of Lot, however, he denies the education system’s fault.In this article, we determine the factors, leading to depression and anxiety during the current shutdown of schools in permanenting constructional underestimation of teacher´s formation. Maybe, the current situation is better in the way it was than it was. The future will tell.

The lockdown, implemented in response to the COVID-19 epidemic, restricted the operation of various sectors in the country and its highlights a good environmental outcome. Thus, a comparison of air pollutants in India before and after the imposed lockdown indicated an overall improvement air quality across major Indian cities. This was established by utilizing the Central Pollution Control Board’s database of air quality monitoring station statistics, such as air quality patterns. During the COVID-19 epidemic, India’s pre-to-post nationwide lockdown was examined. The air quality data was collected from 30-12-2019 to 28-04-2020 and synthesized using 231 Automatic air quality monitoring stations in a major Indian metropolis. Specifically, air pollutant concentrations, temperature, and relative humidity variation during COVID-19 pandemic pre-to-post lockdown variation in India were monitored. As an outcome, several cities around the country have reported improved air quality. Generally, the air quality, on a categorical scale was found to be ‘Good’. However, a few cities from the North-eastern part of India were categorized as ‘Moderate/Satisfactory’. Overall, the particulate matters reduction was in around 60% and other gaseous pollutants was in 40% reduction was observed during the lockdown period. The results of this study include an analysis of air quality data derived from continuous air quality monitoring stations from the pre-lockdown to post-lockdown period. Air quality in India improved following the national lockdown, the interpretation of trends for PM 2.5, PM 10, SO2, NO2, and the Air Quality Index has been provided in studies for major cities across India, including Delhi, Gurugram, Noida, Mumbai, Kolkata, Bengaluru, Patna, and others.

Background: Diabetic retinopathy (DR) is one of the most common causes of preventable blindness. Patients with Diabetes Mellitus (DM) develop not only DR but also corneal endothelial damage leading to anatomical and physiological changes in cornea. Central corneal thickness (CCT) is a key parameter of refractive surgery and Intraocular pressure (IOP) estimation. The role of CCT and higher glycemic index in DR needs to be researched upon.Objectives: To identify the corneal endothelial morphology in patients with type 2 DM, to measure the Central Corneal thickness (CCT) in patients with type 2 Diabetes Mellitus, to assess the relationship of CCT with HbA1C levels in the study group and to correlate the CCT with the severity of Diabetic retinopathy in the study group.Methods: A cross-sectional observational study was conducted between January 2018 and June 2019 in Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The study included 100 subjects with type 2 DM for 5 years or more. Patients with comorbidities that may affect the severity of DR or alter CCT and other corneal endothelial parameters such as glaucoma, previous ocular surgery or trauma, corneal degenerations and dystrophies, chronic kidney disease and Hypertension were excluded. DR was assessed by dilated fundoscopy, fundus photography and optical coherence imaging of the macula and graded as per the Early Treatment of Diabetic Retinopathy Study (ETDRS) classification. CCT and other corneal endothelial parameters were measured through specular microscopy. Relevant blood investigations including blood sugar levels were done for all patients.Statistical analysis: Relationship between CCT and grades of DR and HbA1c levels were established using the Chi-Square test. The level of significance was set at p < 0.05.Results: The mean CCT in patients with no diabetic retinopathy, very mild and mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe and very severe NPDR and PDR was 526.62 ± 8.084 μm, 542.07 ± 8.713 μm, 562.16 ± 8.255 μm, 582.79 ± 7.368 μm and 610.43 ± 18.256 μm respectively. Analysis of the relationship between CCT and severity of DR showed a statistically significant positive correlation between the two parameters (Pearson r = 0.933, p = 0.001). Beyond this, a correlation was found between all the corneal endothelial parameters and severity of DR. Multivariate analysis showed that advanced DR was positively correlated with CV (r  = 0.917) and CCT (r = 0.933); while it was negatively correlated with ECD (r = -0.872) and Hex (r = -0.811). A statistically significant correlation was also found between CCT and HbA1c. Also increasing age, duration of DM and higher glycemic index were positively correlated with severity of DR. Conclusion: This study, by demonstrating a strong correlation between the central corneal thickness to the severity of DR and HbA1c levels emphasizes the importance of evaluation of corneal endothelial morphology in the early screening and diagnosis of microvascular complications of DM.

This research was conducted over period of 3 months with the aim of studying Age related changes of selected bones of forelimb (Scapula, Humerus, Radius and Ulna) in Local Mongrelian Dog (Canis lupus familiaris). The study entails biometrical and gross observations on the bones. The sample bones were acquired from the experimental animals of comparative anatomy in the department. The bones were categorized into various age groups for the research. The length, width, diameter and circumference of the samples (scapula, humerus, radius and ulna bones) were determined for all the groups. The shape, size, color, location, position and relation of each segment of the samples at various stages of development were determined. The differences across the age groups of different samples were observed and recorded. Based on the research result, it was concluded that, the biometric and morphometry data was found to be increasing with advancement of age. A baseline data was established with the view to enhance learning.

The case report presents a neuromyelitis optica in a 19 years old male. Brain and spinal cord MRI showed bilateral optic neuropathy, multiphasic demyelinating process involving the cervical and thoracic spinal cord. Cerebrospinal fluid showed negative NMO Ig G. We will describe the radiological aspect of neuromyelitis optica with a review of the literature.

Introduction: Although worldwide maternal and neonatal mortalities have decreased, but Achieving sustainable development goals remains an unfinished agenda and global challenge. This study aimed to predict neonatal and maternal index based on development and demographic indicators.Methods: In this ecologic study, the dependent variables were Maternal mortality ratio (MMR), Neonatal mortality rate (NMR), and Under 5 Mortality Rate (U5MR) and the independent variables were Gender gap index (GGI) and its four components, human development, life expectancy, total fertility rate, and population growth. Data conducted using international secondary data published data bases of health metrics from 2016 to 2018 in 149 countries from WHO (World Health Organization), World Economic Forum, UNICEF (United Nations Children's Fund), and UNDP (United Nations Development Programme). Data analysis was performed using correlation model in Stata version 14.1 software.Results: In this study, economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with MMR. Human Capital Index, Educational attainment, and Life expectancy are negatively associated with NMR. Economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with U5MR. Discussion: To reduce the maternal and neonatal mortality rate, it is important to pay attention to indirect causes such as equal conditions for men and women to demographic and population indices such as economic participation, educational attainment, Human Capital Index and life expectancy.

Objectives: We describe the clinical course and management of two patients with post-capillary pulmonary hypertension due to diffuse pulmonary venous baffle calcification decades post-Mustard procedure.Background: From the late 1950s to the early 1990s, the definitive surgical repair for children with D-transposition of the great vessels (D-TGA) was an atrial switch procedure (either Senning or Mustard operation) which utilizes atrial-level baffles to shunt pulmonary venous blood to the morphologic right (systemic) ventricle and caval blood to the morphologic left (sub-pulmonary) ventricle. From a hemodynamic standpoint, baffle leaks and stenoses as well as precapillary pulmonary hypertension have all been described as both early and late complications [1]. Recently, delayed post-capillary pulmonary hypertension (in the absence of discrete baffle obstruction) decades post-atrial switch has also been described [2]. The underlying pathophysiology for this postcapillary pulmonary hypertension is unclear but is theorized to involve impaired diastology referable to the pulmonary venous baffle. Methods/Results: Using hemodynamic and imaging data, we describe two patients with extensive pulmonary venous baffle calcification and resultant pulmonary hypertension from the so-called “stiff left atrial (LA) syndrome.” This problem can be difficult to treat medically and is not amenable to catheter-based interventions. We hypothesize that this is an underlying mechanism for pulmonary hypertension in at least some post-Mustard and Senning patients. Conclusion: We describe the treatments and clinical course for each of these patients, and in particular describe how the surgical revision of the pulmonary venous baffle in one case led to the complete resolution of symptoms.