A study on growth and carcass performance was conducted to evaluate the effect of Balanites aegyptiaca seed cake meal (BASCM) as a substitute for groundnut cake in the diet of growing rabbit. Five experimental diets were formulated representing the following treatments: T1, T2, T3, T4 and T5 respectively. T1 (0% BASCM) was served as the control diet, while T2, T3, T4 and T5 contained 25%, 50% 75% and 100% BASCM respectively. A total of 100 weaner rabbits of mixed breeds were purchased from the National Animal Production Research Institute (NAPRI), Zaria, Nigeria. The rabbits were fed the control diet during the one week of adjustment period. They were given vitalyte as anti-stress and were dewormed using ivermectin, at the end of one week of adjustment; the rabbits were housed in different hutches and fed their respective experimental diet for one month. Each treatment contained 20 rabbits and these treatments’ (T1-T5) each were replicated in four portions and each portion had five rabbits each. Results showed that all the parameters were significantly different (P<0.05) among the treatment groups. Balanites aegyptiaca seed cake meal can replace groundnut cake at 25% level inclusion without adverse effect on the rabbit physiology.

Emerging evidence indicates that micronutrient deficiency could play a significant role in the pathogenesis and progression of many chronic diseases including diabetes mellitus, hypertension, obesity, dyslipidemia, hyperuricemia, kidney disease, cancer, anemia and other cardio-metabolic and neurodegenerative diseases through the induction of Insulin resistance (IR). However, there are still gaps in our scientific knowledge regarding the links between micronutrient deficiencies, IR, and cardio metabolic disorders. This review provides current information on recent advances and a global perspective regarding the relationship between micronutrient deficiency, IR, and cardio metabolic disorders. Empirical evidence indicates that deficiencies in either micronutrients associated with insulin activity (such as Chromium, manganese, magnesium, and iron) or antioxidant enzyme cofactors (such as vitamin A, copper, zinc, and manganese) could impact several physiological processes leading to a cascade of metabolic and biochemical derangements such as B-cell apoptosis, loss of islet cell mass, defective tyrosine kinase activity, oxidative stress, pancreatic β-cell dysfunction, reduction in lean body mass, defective insulin signaling mechanism, elevated protein kinase C activity, and excess intracellular calcium. Collaboratively, these states of metabolic malfunctioning are associated with IR, which triggers the onset of many cardio metabolic diseases. Undoubtedly, the prevention of micronutrient deficiency may indeed ameliorate the incidence of IR and cardio-metabolic disorders in those at risk and in the general population.

31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy. Her blood workup revealed a lipemic sample (Figure 1) due to markedly elevated serum triglycerides of 8178 mg/dl (Glycerol Phosphate Oxidase method). Total cholesterol and Low Density Lipoprotein were elevated at 1701 mg/dl and 788 mg/dl respectively. There was no family history of lipid disorders. Diagnosis was consistent with gestational hypertriglyceridemia with acute pancreatitis (Serum Amylase-50 U/L, Serum Lipase- 96 U/L), though genetic tests to rule out pre-existing primary hypertriglyceridemia was not feasible. In view of the life threatening condition, she was initiated on Insulin-Dextrose infusion and offered one session of Plasma Exchange. Figures 2,3 depict membrane plasma separation with the obtained effluent as lipemic plasma. Her serum triglycerides showed a declining trend and was discharged in good health (serum triglycerides at discharge-651 mg/dl). 

To repair articular cartilage (AC) defects in osteoarthritic patients, one approach is to engineer three-dimensional grafts with physicochemical properties similar to endogenous AC. Such grafts can be grown in bioreactors that provide environmental conditions favoring chondrogenesis. Studies show mechanical stimulation during the culturing process greatly enhances development of functional engineered grafts. A review of literature on bioreactor options reveals a lack of capacity to simultaneously stimulate cells with a combination of shear stress and oscillating hydrostatic pressure, both of which are important parts of the in vivo AC environment. It is hypothesized that combining both forces in a new bioreactor design will contribute to better AC tissue growth. In this paper, we provide a brief review of bioreactors and describe a new computer-controlled perfusion and pressurized bioreactor system, and the novelty of its control programming features for service in a host of applications. We briefly summarize results on synergistic effects in employing perfusion, oscillating hydrostatic pressure in a scaffold free environment and with the addition of encapsulation for inducing chondrogenesis. We further describe efforts to modify the newly developed system to include a continuous flow and pressurized centrifugal mode to enhance further the capabilities for inclusion of very high shear stresses. Applications for several other cell and tissue engineering approaches are discussed. 

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.

An enquiry into the lack of attention awarded to serotonin antagonism in the treatment of arterial thrombosis revealed that the mode of action of serotonin and its platelet receptor antagonists was an action upon thrombus growth, and not, as with other anti-platelet drugs upon the initiation of thrombosis. This lack of effect could explain why this approach has been considered not to be effective. However under conditions of arterial stenosis in which there is platelet activation by increased shear stress, and during the growth phase of arterial thrombi, serotonin 5HT2A antagonism has been demonstrated to have great potentcy in dispersing thrombotic obstruction to blood flow. This mode of action, the lack of participation of serotonin in haemostasis, and the absence of serotonin in wounds accounts for the proven lack of effect of effect of pure specific 5HT2A antagonists (i.e., not those with other actions) on operative bleeding and skin bleeding times. This lack of effect on haemostasis solves the dosing problem encountered with other anti-thrombotic drugs, with which drug concentration cannot be controlled with single fixed doses, leading to the association between increased anti-thrombotic efficacy and increased bleeding complications. Thus 5HT2A antagonism appears to be the preferred approach, from the point of view of safety and lack of bleeding risk; this consideration applies particularly to thrombosis therapy in the context of traumatic accidents, surgical operations and invasive procedures such as angioplasty.

Seizure is clinical manifestation of sudden disruption of the normal electrical activity of cortical neurons. The brain electrical activity is periodically disturbed, alteration in neural cell integrity, increase in firing impulses and spread to adjacent normal neurons result in temporary brain dysfunction with alterations in consciousness, behavior or motor function. It may be triggered by illness, infection, stress, stroke, brain tumor, or the underlying cause may not completely understand. Status epilepticus (SE) is a medical emergency and requires prompt diagnosis and treatment. Treatment includes general support measures, drugs to suppress epileptic activity and relieving the underlying condition. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. For SE treatment, benzodiazepines are the first line antiepileptic agents, and if benzodiazepines fail to control seizures, Phenytoin is usually indicated; Phenobarbital or Valproate may also be considered. For refractory SE, Propofol and Thiopental represent first line agents after careful assessment of potential risks. In refractory SE, general anesthesia may be required. There is currently no unique consensus for definite treatment option of RSE. In this review, the management protocol of seizure, assessment, monitoring, and different alternative therapy would be discussed.

Disruptions in Maternal-infant Bonding are shown to be the mediating variable between maternal distress and the subsequent expression of childhood asthma. When the mothers’ bonding is repaired, their children’s asthmatic symptoms diminish or remit. This study evaluated 16 asthmatic children before and after their mothers were treated with Bonding Therapy. Fourteen improved on 11 measures, including reduction in the STEP classification system and medication use. Thirteen children were able to stop all medications. Surprisingly, all mothers scores on the Beck Depression Inventory improved through Bonding Therapy, suggesting that impaired bonding can lead to maternal depression or even Postpartum Depression. The link between bonding disruptions and airway inflammation are discussed. Bonding Therapy is described.

Introduction: DSM-5 mentions autoerotic asphyxia in the paraphilic disorders section, as a specifier for the diagnostic of sexual masochism disorder. Strangulation activities have also been observed in the “choking game”. The term “strangulation activity” is considered as more appropriate than “choking game”. While sharing a same behavior, autoerotic asphyxia and non auto-erotic strangulation activities might represent a very distinct pattern of disorders. We describe here a case report of a 25-year old male internship student who has practiced manual self-strangulation up to 40 times a day since adolescence. In the examination of this case we identify individual clinical aspects of this case in a process-based holistic case conceptualization. Case description: The patient is a 25 years old male with a post-graduate degree who presented with a recent history of poor work performance and work-related stress during an internship. He has a concomitant history of both ketamine and cannabis use disorders, and reports urges to self-strangulate, sometimes specifically avoiding contact with friends engage in this behavior and that he has never attempted to discontinue self-strangulation. Neuropsychological assessment found a cognitive functioning below that expected given his educational level. Our intervention consists of a 3-weeks cognitive and motivational therapy program in addiction unit with associated abstinence. Conclusion: Autoerotic asphyxia is a behavior observed not only in the context of sexual masochism disorder, but also as a specific addictive behavior, in the absence of sexual arousal, possibly as a result of emotional dysregulation.

Septic Iliac vein thrombophlebitis with associated psoas abscess is a rare and severe entity, which diagnosis is challenging when no risk factor is clearly present. We are presenting a case of severe septic cavitary pulmonary emboli complicated with Acute Respiratory Distress Syndrome (ARDS) that evolved rapidly to respiratory distress and multi organ failure. A 61-year-old Hispanic male, had multiple emergency department visits due to back pain, being most of them intramuscular pain medications and steroids. In the history, he had back pain that worsened accompanied by poor mobility, generalized malaise, fever and chills. Computed tomography (CT) scan showed a paravertebral psoas abscess with L5 - S1 diskitis/spondylitis inflammatory changes, which was then later evidenced by a gallium study. Further imaging studies were done, showed bilateral cavitary lung lesions, consistent with septic emboli. Subsequent blood cultures were positive for Methicillin Resistant Staphylococcus Aureus (MRSA), for which a successful combined therapeutic regimen was used. Transthoracic and transesophageal echocardiogram were not suggestive of endocarditis. Staphylococcus aureus (SA) bacteremia is one of the most common serious bacterial infections with a high risk of metastatic complications, which makes this pathogen a unique one. The combination of factors iliac vein thrombophlebitis, psoas muscle abscess, diskitis/spondylitis with ARDS makes cavitary pulmonary disease a challenging perspective. After a 6-week antimicrobial treatment, full anticoagulation, his clinical condition and image findings improved, and he was recently admitted for physical rehabilitation. Major vessels thrombophlebitis should always be considered, when primary source of septic pulmonary emboli is not clear. This case illustrates the complexity of illness and complications that may arise from a source of infection as the one in this patient. Further therapeutic strategies were tailored accordingly.

According to the World Health Organization definition, palliative care is an approach aimed at increasing the quality of life of patients and their relatives by addressing physical, psychosocial and spiritual needs and treating conditions early, such as pain while they are coming to terms with a life-threatening disease [1]. Palliative care services have started a rapid progress in developed countries such as Scandinavian countries, England and Canada since the beginning of 1990 [2]. Although palliative care cares for any patient who is in need of care, whether bed-bound or unable to look after themselves, one of the main area of interest is of course oncological patients and their relatives. Patients with advanced cancer, frequent sufferings from physical and psychological symptoms - primarily pain, reduced functional capacity, and reduced quality of life are in the scope of palliative care protocol [3]. The most common end-of-life symptoms and signs in palliative cancer patients are pain, anorexia, nausea, cachexia, weakness, dyspnea, ascites, anxiety, agitation, delirium, confusion and pressure sores. In order to achieve quality and continuous care in case management, a family doctor, specific branch specialist, nurse, dietician, psychologist, cleric, etc. should work together in a multidisciplinary approach and clinical guidelines and care protocols should be implemented [4]. However, it should be kept in mind that increasing the medication dose may not always be beneficial to the oncological patients in palliative services. The goal should always be maximum benefit with minimal tests and treatment. Palliative care does not aim to accelerate or postpone death; but it has many benefits in cancer patients and their relatives including the integration of the psychosocial and spiritual aspects of patient care into physical care, providing support for patients to live as active as possible until the last moment, improving the quality of life and the disease process, providing help and support in the grieving process [1,5]. Providing good care to advanced cancer patients requires that caregivers are educated and supported about their patients’ physical, psychological and social care needs. Balancing the physical and emotional needs of the caregivers will reduce the stress they experience, as well as increase the quality of life of their patients [6,7]. Professionalism in palliative care comes into play right at this point. There is no consensus in the medical world about by whom, when and to whom palliative care should be given. In this regard, the conflicts of opinion between specific branches such as anesthesia, internal medicine and neurology are inevitable. We think that the team leader should be a family physician or a palliative care specialist. The reason for this is the family medicine’s principles of core competencies including biopsycosocial, holistic, comprehensive approach and equal distance to specific branches. Of course when the palliative care specialist is the team leader the patient’s own family doctor still provides invaluable service because of his intimate and long-term knowledge about the patients. One key difference in some countries is that no distinction is being made between palliative and hospice care. Neither the insurance companies nor the state demands such classification because it doesn’t serve any practical purpose at the moment. However, in due time such distinction will be inevitable as one of the cost-cutting measure. Medical oncology will have to report about the expected survival of the cancer patients and it will further increase their workload given the exponential increase in cancer cases.

Five key sectors of transport have been selected as the target groups: seafarers, truck drivers, dockworkers, rail workers and airline workers. Transport workers often operate under stressful working conditions, long-work hours, lack of good sleep, healthy diet and physical exercises that contribute to fatigue, impaired well-being, mental ill-health, stress and chronic diseases. The hypothesis is that good mental health workplace culture depends on good education, staffing and management. Objectives: To create, implement and evaluate a research based mental health culture promotion program Determinate existing researches and training programs, To study the knowledge, skills and needs for specific training in diferent age-groups Create and implement effective and relevant training, Produce training materials and scientific evidence available for ship owners, students and workers and to develop proposals for new mental health policies, legislations and regulations Methods: Multidisciplinary training and research methodology with quantitative and qualitative research methods will be used. Validated mental health culture promotion methods with new programs for the specific sectors. Expected impact • Significant less sickness absence and suicides • Benefit for the workers’ health including benefit for the company economy. • Policies developed for improved mental health culture based on the research. • The training programs are ready to be continued at the end of the project.

Tinnitus-derived from the Latin “tinnire” meaning “to ring” is a perceived ringing, buzzing, or hissing in the ear(s) or around the head-which has multiple etiologies and is sometimes idiopathic. As of 2009 in the United States, approximately 50 million Americans were affected for six months or greater, while a United Kingdom study in 2000 reported a 10% prevalence in the adult population [1]. Tinnitus may vary widely with regard to pitch, loudness, description of sound, special localization, and temporal pattern [2]. Most often, tinnitus is associated with other aural symptoms, such as hearing loss and hyperacusis [3]. Tinnitus may result in sleep disturbances, work impairments, and distress. The severity varies within this cohort of chronic sufferers, with some unable to fulfill daily activities. Though tinnitus is more likely to affect adults and the incidence increases with age, children can experience tinnitus as well [4]. Males are more likely to suffer as are individuals who smoke [5]. 

Introduction: The problem of protecting and strengthening the mental health of the population is the most important task of ensuring the socio-economic well-being of the Komi Republic (RK) as an integral part of the Russian Federation (RF), since it is a key resource for the development of a subarctic region. The aim of the work: was to characterize diseases of the mental sphere revealed by the psychiatrist at contingent of patients of the consultative outpatient admission at the 1State Autonomous Health Agency of the Republic of Komi “Consultative and Diagnostic Center of the Republic of Komi” (SAHA RK “CDC”) of the subarctic territory. Materials and methods: The analysis of a continuous sample of 6255 patients of the psychiatrist of the consultative department in 2015-2017 was carried out. on the basis of medical records. Analysis methods included: analytical and statistical. The control group consisted of a continuous sample of 5,356 psychiatric patients in 2010–2012. The depth of the study was 8 years. Discussion: Trends in changes in demographic indicators, including gender and age, in the structure of patients of a psychiatrist in an outpatient consultative procedure are considered. Indicators of the identified pathology of the mental sphere, including the first identified and pathology in patients suffering from epilepsy in comparison with the control group are given. Attention is paid to the organizational and methodological work of an outpatient counseling psychiatrist on the targeted identification by internists of signs of mental pathology in patients referred to a diagnostic center with somatic diseases. Priorities for the improvement of specialized advisory (including psychiatric) assistance to the population of the RK and ensuring its quality were identified. Conclusions: 1. The psychiatrist of the advisory department in 2015-2017. 6255 people were accepted (889 more than in the control group of 2010-2012). The increase was 16.78%. Primary patients account for 64.38% of the total number of people who applied to a psychiatrist (4027 people). 2. In the structure of the psychiatric pathology of the outpatient psychiatric appointment, the proportion of organic, including symptomatic, mental disorders (F00-F09) is 47.9±0.6%; neurotic, stress-related and somatoform disorders (F40-F49) - 39.6±0.6%; mental and behavioral disorders associated with the use of psychoactive substances (F10-F19) - 3.5±0.2%; mood disorders (affective disorders) (F30-F39) - 2.8±0.2%. 3. The most frequently detected pathologies in patients with epilepsy are: 1) Mild cognitive impairment; 2) Personality disorders; 3) Organic emotionally labile (asthenic) disorders. Their share annually accounts for 71.5%-75.8% of all types of nosological forms. The fourth and fifth ranking places are taken by: 4) Organic anxiety disorders; 5) Non-psychotic depressive disorders. Rarely diagnoses are established: “Organic Amnesia Syndrome” and “Dementia”. 4. Organic, including symptomatic, mental disorders prevail in the structure of newly discovered mental disorders; neurotic, stress-related and somatoform disorders (up to 87.7%). Mental and behavioral disorders associated with the use of psychoactive substances and mood disorders (affective disorders) do not exceed 8.4%.

Microchimerism is a bidirectional exchange of fetal and maternal cells during pregnancy (Figure 1). Pregnancy is the most common and natural cause of chimerism, and bi-directional trafficking of hematopoietic cells occurs through the placenta. Therefore, we are all born as microchimera [1,2]. Although there are many unanswered questions it is thought that chimerism has an important role in human health. For many years, the clinical effects of maternal microchimeric cells (MMcCs) in organ repair and cancer therapy have just begun to be understood. While the mission of chimerism is straight forward, the subject is profound. Chimerism carries the potential for disease as well as for health benefits. Recent studies have shown that maternal stress and infections in pregnancy affect fetal neuro development and increased the risk of neurological or psychiatric disorders in the future life of the fetus. This article describes the role of Mc in the etiology of psychotic disorders.

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).

In COVID-19 pandemic we focused on epidemiology and somewhat we neglect the possibility of biochemical influencing of the infection. Therefore we try to find some properties of the virus, which are impressionable by drugs. Droplet infection transmission is mainly (hypochloric acid) by nose and mouth. Diseases of nose and paranasal sinuses are most often of viral or bacterial origin.

WHO declared the coronavirus disease 2019 (COVID-19) outbreak, caused by SARS-CoV-2, to be a pandemic on March 12, 2020. In Morocco, the first case was reported in March 2nd 2020. The mental health of general population, medical and nursing staff especially has been greatly challenged. The aim of the present article is to explore the stress status of medical and nursing staff associated with exposure to the COVID-19. The medical staff was asked to complete a self-reported questionnaire anonymously. In University Hospital Mohamed VI, in Marrakesh, Morocco. During May 2020. In total, 120 valid questionnaires were collected. Among them, there were 57 residents (47,5%), 30 internes (25%), 22 nurses (19%) and others: medicine students and technical staff. The age was between 23 and 60 years. 15% of professional lived alone, 85% with their family, 74% lived with an old person or with a person having a chronic disease. In our study: the severity of symptoms in 36% of the asked professional, deaths among health professionals in 15%, death of a family member in 14%, the rapid spread of pandemic in 90%, the lack of knowledge in 83%, and finally contamination risk especially if comorbidity associated in 2%. Further risk factors: feelings of being inadequately supported by the hospital in 42%, fear of taking home infection to family members or others in 80%, being isolated, feelings of uncertainty and social stigmatization in 43%. The psychological presentation was the nightmare 19 in %, the insomnia in 48%, the somatization in 18%, the irritability in 22%, the aggressiveness in 14%, the nervousness in 70% and the drowsiness in 5%. During the vulnerability of the individual’s conditions during and after the COVID-19, psychological intervention should be done and a mental health support for the health professional.

The expansion of social media platforms has given birth to a specific professional category in charge of « sanitizing » social media and keeping it free of “inappropriate” content. These content moderators, as a result of being constantly exposed to potentially traumatic images, may be at risk of developing stress-related symptoms. Here we present the case of a social media content moderator who experienced intrusive images, anxiety symptoms and insomnia. Literature about this subject is very scarce, while the need is increasing to assess this phenomenon and set up strategies of monitoring, counseling and treating this category of workers. Key points The expansion of social media platforms has given birth to a specific professional category: content moderators. As a result of being constantly exposed to potentially traumatic images, content moderators may be at risk of developing stress-related symptoms. The need is increasing to assess this phenomenon and set up strategies of monitoring, counseling and treating this category of workers.

The present study was designed to measure the relationship between the consumption of Information Technology (IT) and anxiety among Pakistani youth. The inquiry included 200 conveniently selected Pakistani youth aged 16 to 24 years from 4 cities. The anxiety subscale of Depression Anxiety and Stress Scale was administered along with a demographic information questionnaire. It was hypothesized that higher use of IT would be positively correlated with higher levels of anxiety among Pakistani youth. The results significantly supported the hypothesis, and it was established that the excessive use of IT is positively and significantly correlated with anxiety. The results are consistent with similar studies carried out in countries other than Pakistan.