Objectives: This novel study explores the leadership traits held by people with substance use disorder. The purpose of this study is to help advance understanding of the positive qualities people with substance use disorder possess which can produce positive societal and organizational benefits once that person enters recovery. Additionally, this understanding can provide insight into effective treatment approaches that incorporate personal attributes that are present within active addiction. Methods: A qualitative methodology was used which included semi-structured interviews, observations, and a focus group which allowed the researcher to conduct a thematic coding analysis. The participants came from diverse backgrounds and included participants from multiple regions across the United States. Leadership was defined as having various dimensions of effective leadership that are found in both Transformational and Authentic Leadership Theories. Results: The findings revealed that people in addiction possess numerous leadership traits which position them for effective leadership and are further enhanced during their recovery journey. The top three traits which emerged from the data indicate that people in recovery from addiction are authentic, tenacious, and empathetic. Additionally, those in recovery have strong abilities to empower and inspire others and demonstrate posttraumatic growth which helps establish significant bonds of trust and commitment among followers. Conclusion: The impact of this study will change how people view addiction. Identifying the hidden treasures of leadership which are present in those struggling with addiction could illuminate recovery pathways that help identify purpose and value. This would not only advance treatment opportunities but greatly assist organizations that need strong leadership. People with substance use disorder have all the right tools to become effective leaders, and this understanding can help mitigate the stigma associated with addiction and paint it in a more positive light. 

Cerebral brain injuries (CBIs) account for up to 20% of all injuries in boxing. Approximately 97% of sports-related brain injuries are mild, their neurological symptoms are unexpressed, and young, strong, highly motivated athletes tend to dismiss the severity of their injuries. This may lead to an underestimation of the severity and extent of brain injuries. Changes in computed tomography (CT) and magnetic resonance imaging (MRI) in mild traumatic brain injury are absent in the early stages, making diagnosis difficult. Frequent repetitive traumatic brain injuries, including mild brain injuries, can result in functional and structural brain lesions that affect athletes’ performance and, in the long term, significantly impair their quality of life. Also, the consequences of cerebral brain injuries, including mild brain injury, can be affected by the individual condition of the Circle of Willis.

Increased levels of bilirubin in blood serum may result from numerous physical conditions including hepatitis, cirrhosis, enzyme deficiency, drug reactions, autoimmune disorders and physiological trauma. No presumptive test for high bilirubin levels in blood serum stains currently exists, which could prove useful in the assessment of crime scenes involving victims with one of the above disorders. Here, the use of ultraviolet 365 (UV 365) is described as a simple, nondestructive method for the detection of blood serum containing elevated levels of bilirubin.

The birth of a high-risk infant such as an extremely premature infant can represent an important traumatic experience for mothers. Perinatal Post Traumatic Stress Disorder Questionnaire (PPTSDQ) explores retrospectively maternal post-traumatic stress reaction. This shelf-rating questionnaire explores the potential for experiencing posttraumatic symptoms related to childbirth and the ensuing post-natal period. The PTSD questionnaire was originally developed by DeMier and Hynan and their colleagues at the University of Wisconsin and has been widely used in research and in clinical practice for identifying mothers experiencing significant emotional distress during the post-natal period, so they may be referred for mental health services. The present study aims to introduce this tool in perinatal settings as an early intervention. It has been widely used with other measures of post-traumatic stress and depression, such as the Openness Scale from the NEO-PR, the self-report measure of depression BDI-II, the IES (Impact Event Scale) and the EPDS (Edinburgh Postnatal Depression Scale). Although already a useful clinical instrument the current study used the revised version. This modification refines the response options from dichotomous choices to a Likert scale format by Callahan Borja and Hynan. Numerous qualitative and quantitative studies state that premature delivery is a highly stressful event and document the full range of post-traumatic sequelae, such as intrusive recollections, behavioral avoidance, and hyperarousal, as well as attachment difficulties following childbirth. Furthermore, the severity of neonatal complications and gestational age have been found to be predictive of PTSD symptomatology in parents as measured by the PPQ. For this reason, the current study aims to give increased focus to mothers having a premature birth and often expecting their children to die. The sample comprises 25 mothers of prematurely born infants hospitalized in the NICU and 25 mothers of full-term infants born in the maternity ward of the same Greek hospital who responded to the Perinatal PTSD Questionnaire and equally the PERI a postnatal complication rating inventory and the clinical interview for parents CLIP.Mothers of high-risk infants present post-traumatic stress reactions related to prematurity. The Perinatal PTSD Questionnaire identifies postnatal maternal distress but should not substitute a clinical interview, yet findings indicate that equally identifies pre-existing distress symptoms associated with maternal personality traits that emerged with the traumatic event of the unexpected birth.Due to the consistency of the population of the experimental group, who come mostly from the provinces, the possibility of a follow- up of the cases is quite limited.

Diabetes Mellitus (DM) is a frequent comorbidity in hospitalized patients, with prevalence ranging from 15% - 35%. However, in almost half of the cases, this antecedent is omitted in the medical records or even unknown by the patient. Furthermore, about 10% of hospitalized individuals may have hyperglycemia of stress, a condition characterized by transient and reversible elevation of blood glucose, in the presence of acute circumstances, such as trauma, surgery, medications, shock, or infections [1].

Dynamic Knee Valgus (DKV) is correlated with both, Anterior Cruciate Ligament (ACL) injury and hip and ankle disorders in female athletes and has a more significant prevalence compared with male athletes because of numerous factors. The aim of this study is to determine if the connexion between DKV, landing errors, and non-contact ACL injury and re-injury in high-performance, adult, female team sport athletes can be eliminated by changing the frontal plane movement pattern and the landing errors during the rehabilitation process (RHB), a process which was focussed on dynamic knee stability with multidimensional single-leg jump landing training, on 3D knee balance improvement and multistimulus perturbation challenges and tasks,+ eccentric & concentric exercise, strength & conditioning, aerobic training that lasted from 26 - 44 weeks.Assessing and eliminating-reducing DKV during the RHB is mandatory in lowering the re-rupture rates in female professional athletes after ACL surgery and in preventing opposite knee trauma.

Aim and objective:1.    To study the manifestations of fungal corneal ulcer in different age groups and sex 2.    To study the distribution of fungal corneal ulcer in relation to occupation3.    To know the effect of Natamycin and Fluconazole as anti-fungal agents.Materials and methods: This is a retrospective analysis of microbiology records of patients presenting with suspected microbial keratitis seen between January 2021 and June 2021. Patients with positive fungal cultures were analyzed in detail for the type of fungus isolated.Results: 90 patients with suspected microbial keratitis were reviewed. A microbiological diagnosis of mycotic keratitis was established 9 (10%) patients over a period of 6 months, based on positive fungal cultures. Filamentous fungi were isolated more often than yeasts. Aspergillus species followed by Fusarium species were the commonest filamentous fungi isolated. Conclusion: Over a period of 6 months, the cumulative incidence of mycotic keratitis was 10%. The pathogenic organisms most frequently responsible for mycotic keratitis were Aspergillus species. When beginning an empirical therapy for mycotic keratitis, etiological factors were helpful. Eight of the 90 patients with corneal ulcers who were admitted to the patient department for treatment had positive fungal cultures in Sabouraud’s media. The age range of 50 to 60 years had a high prevalence of illness. There were 90 total cases of corneal ulcers. Out of those there were 8 (8.8%) incidences of fungal ulcers. More men than women were impacted. Workers in agriculture are more impacted than others. The main cause of a fungus-induced corneal ulcer was trauma.Natamycin was the better option for the treatment of fungal keratitis. Filamentous fungi (Aspergillus species, fusarium, and curvularia) responded effectively to Natamycin 5% eyedrop.

Background: A large body of evidence suggests that child abuse and neglect by a caregiver is a recurrent event linked to increased psychopathology symptoms. The Childhood Trauma Questionnaire (CTQ) is commonly used to assess abuse/neglect during childhood. However, even though the Minimization-Denial (MD) subscale was originally designed to assess response bias (i.e., underreporting of childhood maltreatment), it is possible that the scale may reflect coping strategies that play an effective role in the relationship between childhood trauma and their negative outcomes. Also, even though MD has been associated with decreased psychopathology symptoms, it is also strongly associated with other scales of the CTQ. Method: This study (n = 133) examined whether (1) the MD-scale is negatively associated with alexithymia, emotion dysregulation and psychopathology, if (2) these associations will hold when adjusting for different subtypes of abuse and neglect and (3) and the role of MD as a possible moderator in these relationships. Results: The analyses showed that, although MD scores have relatively strong and (mostly) significant (negative) associations with the CTQ, emotion dysregulation strategies and psychopathology symptoms, these associations were weak and failed to remain significant when adjusting for the effect of CTQ. Conclusion: Our findings suggest that the MD scores should be viewed as an accurate reflection of the absence (or little) of exposure to childhood abuse/neglect. 

Perineal burns are a rare finding in children that may cause severe complications. Vesicovaginal fistulas are an uncommon complication of a perineal burn that can be a tragedy for girls suffering from them. Fistula and/or its treatment are a socially debilitating problem with significant medicolegal implications. We present a rare case of a girl with a history of traumatic perineal burns who was diagnosed with a vesicovaginal fistula and repaired through a transvaginal approach.

Study design: Descriptive study.Background: Many risk factors contributing to ankle sprains have been studied in medical literature with coordination and balance being two of the major endogenous factors described. These are influenced by lateralization – a developmental and adaptive ability determined by the asymmetrical construction of the human brain, with cross-laterality referring to mixed limb dominance.Objectives: To determine whether cross lateralization is a risk factor for the severity of ligamentous injuries in ankle sprains since no data is yet available on such correlation. Methods: Two hundred forty-four patients with acute ankle sprains (136 men and 108 women) were prospectively evaluated between April 2006 and March 2009. The mean age was 30 (ranging from 18 to 76). Clinical and ultrasonographic examinations were performed on the study subjects. Laterality was then assessed by the Coren questionnaire and the AOFAS score was calculated. Patients with syndesmotic injuries and fractures were excluded from the study. Those qualified were divided into straight and crossed groups, according to their laterality type. Results: One hundred forty-four patients displayed straight lateralization, while cross-laterality was found in 100 subjects. Patients in the crossed group experienced more multi-ligamentous injuries than those in the straight group (p = 0.02). Following trauma, a higher AOFAS score was attributed to subjects that displayed a straight lateralization pattern, in comparison to subjects presenting with crossed laterality (p = 0.04).Conclusion: Crossed lateralization is associated with higher severity of ligament injuries in ankle sprains and may be considered a risk factor for calcaneofibular ligament injuries.

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycleMethods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.

Glomus tympanicum (GT) is a highly vascular, benign, and slow-growing tumor of the middle ear. It can be confused with other common ear diseases such as acute middle ear infection, otitis media with effusion, ear trauma… It is accurately diagnosed by history and endoscopy. CT scan showing: the presence of eroding jugular bulb is the most important thing to distinguish glomus tympanicum and glomus jugulare and assess the extension of the tumor to make good surgical planning. We present here the three cases in Can Tho ENT hospital: where total excisions were achieved trans-canal endoscopically without embolization. These procedures were safe, quick, and effective due to the better visualization of the surgical field with the endoscope.

Eye donation and eye banking are a boon in eye health care services for visual rehabilitation and corneal tattooing aesthetic purpose in post-trauma corneal opacities.A young female reported to our hospital with a complaint of corneal opacity and difficulty in closing her left eye. On examination, she was diagnosed with a “Corneal scar with an Inadvertent bleb”. The patient reported a history of corneoscleral injury for more than four years. A slit lamp examination showed a corneal scar with a micro leak at the inferotemporal scleral region.

Gardner-Diamond syndrome or psychogenic purpura is a rare vasculopathy disorder characterized by spontaneous painful purpuric rash without a history of trauma or antiplatelet or anticoagulant therapy. It occurs in women with mental health disorders. Gardner and Diamond in 1955 described a syndrome of auto erythrocyte sensitization which presented in abnormal crops of painful inflammatory ecchymosis in 4 patients at the site of trauma followed by progressive erythema and edema. We present a 52-year-old age woman who was admitted to the internal medicine department and referred for dermatological consultation for recurrent spontaneous purpuric eruptions. The patient was under treatment for depression for many months. Her investigations and coagulation profile were nearly within normal.

Chronic infectious, granulomatous and suppurative dermatosis, classified among the subcutaneous mycoses, prevalent in tropical and subtropical regions and caused by the traumatic implantation of dematiaceous fungal species, where the presence of muriform bodies is an expression of the causal agent in the grafted tissue, are characteristic of chromoblastomycosis. Considered the second implantation mycosis in the world, it manifests itself with slow and progressive growth lesions of exophytic and verrucous plaques and black dots on the surface.The disease is considered a neglected and occupational disease, which occurs mainly among agricultural workers, coconut and babassu harvesters, lumberjacks, and traders of agricultural products. It is important to highlight that people at risk of contracting chromoblastomycosis work in tropical countries, where the temperature can be above 40 °C in summer, and generally refuse to wear protective equipment during the day (shoes, gloves, clothes, etc.), although they know that this type of prophylactic measure can prevent different types of diseases. These vulnerable people often live in low-income countries and sometimes live far from medical services and, once infected, do not seek medical attention. We report below an exuberant and unusual case due to multiple simultaneous inoculations on the back after the patient suffered an accidental fall while working on his farm. The diagnosis was established by direct mycological examination, histopathological examination, culture, microculture, and MALDI-TOF MS analysis that identified the agent of the Fonsecaea pedrosoi.

Introduction: Nursing theories are critical as they drive nursing education, practice, and research. Neuman Systems Model (NSM) considers a person a complete system with integrated psychological, physiological, spiritual, social, and developmental components. Nurses give their patients physical, emotional, and psychological assistance and are subjected to mental and physical pressure due to these responsibilities, impacting their health, psychological well-being, and interpersonal relationships. This paper aims to perform a concept analysis of stressors proposed in NSM about lines of defense and the level of preventive interventions that can affect a person’s well-being. Further, this paper discusses knowledge generation through NSM’s applicability to preventing exhaustion and burnout among nurses. Methodology: This theoretical attempt is carried out using the theory analysis approach suggested by Walker and Avant (2019).Discussion: Nursing is a career that requires a great deal of dedication and personal engagement. Nurses are subjected to recurrent stresses due to technological advances and rising demands. Burnout occurs when nurses get discouraged and have less compassion for the patients due to recurrent burdens. Stress and burnout are two of the most common reasons for nurses to quit hospitals. The NSM is concerned with stresses that may affect a person’s health and well-being (prediction). Nurses assist patients at the most vulnerable and challenging times, such as surgical procedures, traumas and personal and physical losses.Conclusion: The NSM enables the investigation of preventative and protective treatments. Because of the model’s flexibility, it may be used in a wide range of nursing situations. Administrative, hospitals, clinics, and other nurses can benefit from this paradigm. Evaluating the many distinct elements contributing to burnout is also feasible. The model’s client factors of physiological, sociocultural, developmental, and spiritual characteristics are used to achieve this. Viewing the individual as an open system that responds to environmental stimuli encourages the existence of stressors that might lead to burnout.

Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as a complication of gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, or even cardiac tamponade. Clinical pathognomonic signs of pneumopericardium include pericardial metallic tinkling friction rub and mill wheel murmur. Diagnostic work-up includes electrocardiogram, chest radiography, and, computed tomography imaging. A gastro pericardial fistula should be considered a rare differential diagnosis for acute chest pain in patients with a history of gastroesophageal surgery. Rapid recognition and treatment avoid life-threatening complications. The successful outcome of gastro pericardial fistula treatment depends on both emergency and definitive surgical management. The survival rate with conservative management is poor.We present the case of a 78-year-old patient suffering from pneumopericardium and pericardial infusion, due to a fibrotic fistula between the Nissen’s valve, occurring 10 years after redo antireflux surgery. Treatment included broad-spectrum antibiotics, and emergency surgery for pericardial drainage, biopsy of the valve’s defect, suture, and omentoplasty.

Introduction: Sports injuries can affect athletes across all ages, sexes, and levels of competition. The mental aspect of acute sports injury is often overlooked by coaches, trainers, and medical professionals. This study investigated if and how an acute traumatic sports injury affects an athlete’s psychological well-being, adherence to sport, and athletic identity. Methods: The study consisted of surveys sent to former or current athletes over 18 with one or more athletic injuries. The Qualtrics surveys were anonymous, and participants consented to the study within the survey. Results: There were 101 total participants (20.2% response rate) with an average age of 36. All reported one or more acute athletic injuries throughout their athletic careers. Specific survey sets were compared against each other using a variable correlation analysis (p - value < 0.05) and via Pearson’s Correlation.Conclusion: The results indicated that injury impacts the lives of athletes most significantly on the field and can harm their performance based on their perception of the severity of the injury. However, this decline in performance and decrease in confidence does not correlate to an athlete’s desire to leave their sport or how they identify as being an athlete. 

Mesenteric cysts and cystic mesenteric tumors are very rare abdominal growths. They may be localized all over the mesentery, from the duodenum to the rectum, however, they are mostly found in the ileum and right colon mesentery. There are several classifications of these formations, among which the one based on histopathologic features including 6 groups has been most commonly used: 1) cysts of lymphatic origin--lymphatic (hilar cysts) and lymphangiomas; 2) cysts of mesothelial origin--benign or malignant mesothelial cysts; 3) enteric cysts; 4) cysts of urogenital origin; 5) dermoid cysts; and 6) pseudocysts-infectious or traumatic etiology.A dermoid cyst is a benign, epithelial-lined cavitary lesion composed of ectoderm and mesoderm that can arise anywhere in the body, with a tendency to develop in midline structures.In 20% - 45% of cases, accompanying diseases that were not previously clinically manifested can be diagnosed during emergency interventions, requiring additional surgical interventions for their correction.The aim of the study is to demonstrate the successful treatment experience of a dermoid cyst of the mesentery of the jejunum, detected after traditional appendectomy.Clinical case:  A mother brought her 9-year-old son, V., to the emergency department of the Kursk Regional Children’s Clinical Hospital with complaints of moderate-intensity pain in the right iliac region, multiple episodes of vomiting, and fever. Ultrasound features indicative of destructive appendicitis and peritonitis. In an emergency situation, after preoperative preparation, a traditional appendectomy was performed under intravenous anesthesia, using the Volkovich-Dyakonov approach. The postoperative period was uneventful. Moderate infiltration was observed on the control abdominal ultrasound examination, in the intestine (presumably the small intestine) in the right half of the abdominal cavity, with a solid formation measuring 27*33 mm, producing a dense acoustic shadow. On the 7th day after the initial intervention, a revision of the abdominal organs was performed. The loop of the jejunum with the formation was brought out into the wound. The capsule above the formation was dissected: the formation of bone density, when the capsule is separated, resembles a fecal stone in structure, considering the localization - a dermoid cyst. Step-by-step enucleation of the cyst was performed. The postoperative wound was tightly sutured in layers.

Introduction: The evolution of a patient with severe traumatic brain injury may require the use of a tracheostomy as part of respiratory weaning. The central question revolves around the optimal timing to replace intubation with tracheostomy. The aim of this study is to evaluate the hypothesis that early tracheostomy reduces the incidence of ventilator-associated pneumonia (VAP), the duration of mechanical ventilation (MV), and the length of stay in the intensive care unit (ICU).Materials and methods: This was a retrospective study including all patients admitted to the department over a period of 08 months. Various historical, demographic, clinical, biological, and progression-related covariates were collected upon admission.Results: Among the 69 patients included in the study who underwent surgical tracheostomy, two groups were formed: those who underwent early tracheostomy (within the first 8 days of mechanical ventilation) and those with late tracheostomy (after 8 days). The early group showed a significant reduction in the duration of mechanical ventilation (16 ± 3 days) and length of stay in the intensive care unit (17 ± 3 days) compared to the late group (23 ± 6 days and 30 ± 11 days, respectively). No significant differences were observed regarding the incidence of ventilator-associated pneumonia (VAP) and mortality between the two groups.Conclusion: This study strengthens the existing literature by demonstrating that early tracheostomy is associated with a reduction in the duration of MV and length of stay in the ICU.