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Diverticula can affect all segments of the gastrointestinal tract, from the esophagus to the colon. In order of decreasing, the jejunoileal location is the least frequent location [1] and has  a prevalence of less than 2% of the population [2]. This location was first described by Sommering in 1794 [3]. More than two-thirds of small bowel diverticula occur in the jejunum. They appear mainly after the age of 60 with higher prevalence in males and rarely occur in patients under the age of 40 [4]. Jejunal diverticula are in general multiple and bigger than ileal ones [5]. Most of them are asymptomatic and do not require surgical treatment. Clinical presentations are diverse and not specific with no pathognomonic clinical symptoms.

Climate change is increasing the frequency of climate-related disasters, creating greater risks of hunger and the breakdown of food systems. The sustainability of our planet is currently a major concern for the global community and has been a central theme for a number of major global initiatives in recent years. Climate change has prevalent, multi-faceted, and temporal impacts on food security. Higher temperatures, water scarcity, extreme events like droughts and floods and greater CO2 concentrations in the atmosphere have already begun to impact staple crops around the world. The warming climate is already taking a toll on human health, causing widespread hunger and illness that will grow exponentially worse, and will pose a major threat to human well-being. In this article, an attempt has been made to discuss some critical issues relevant to the four dimensions of food security and to provide broader perspectives on climate change and its impacts on the food system, food security and human well-being.“Humanity is facing a rare challenge. But it is a common challenge. There are no sides in the fight for climate justice” (Kofi Annan’s message prior to the UN Climate Conference in Copenhagen 2009).

‘Let food be thy medicine and medicine be thy food’, the age-old quote by Hippocrates is evidently proved in today’s life management as probiotics have become a valuable part of human day-to-day life [1]. 

A growing number of synthetic plastics derived from fossil fuels are produced, and improper plastic waste management has caused a lot of pollution problems. There are many microplastics in the environment, and they disintegrate slowly in soil and water. The properties of microplastics (MPs) include long residence times, high stability, high fragmentation potential, and the ability to adsorb other contaminants. Invertebrates and planktonic organisms are easily able to accumulate microplastics in aquatic species. Therefore, microplastics (MPs) must be removed from the water and other media. This paper aims to review the occurrence, raw polymers and additives, and remediation methods for removing microplastics from the environment. Several methods are available for removing contaminants, including sorption, filtration and chemical treatments. Various removal methods are discussed along with their methods, efficiency and advantages.

Renal impairment is one of the most severe non-communicable diseases around the world. Especially patients with diagnosed/newly diagnosed renal impairment who needed surgery are more focused on preoperative and postoperative preparation. Serum creatinine is the prime biochemical marker for assessing renal function and the level of impairment is widely measured by this marker as well as Glomerular Filtration Rate (GFR). Objective: Factors responsible for fluctuating serum creatinine during preoperative and postoperative periods and minimizing the process of serum creatinine is the ultimate goal of this study. Method: 37 patients participated in this cross-sectional study who were previously diagnosed/newly diagnosed. They were admitted to different tertiary-level hospitals for emergency or elective surgery. 15 patients were admitted in the renal function impairment stage and 22 were admitted as normal patients’. Values of creatinine at the pre-admission stage and 2nd/3rd post-admission follow-up were compared. Results: 0.41 was the average of 22 patients’ creatinine between pre-admission and 2nd/3rd follow-up. The responsible factor like prolonged staying, immobilization, co-morbidities, different preoperative antibiotics and NSAIDs were also inducers for creatinine elevation. After postoperative hemodialysis rapid decrease of creatinine is seen in normal patients but this decrease is very much minor in CKD-diagnosed patients. 

A 25 years old pregnant woman had a painful labor in her 38th week of pregnancy. Because of a previous delivery by a cesarean section, she underwent a second cesarean section. Her past medical and family history was unimportant. We performed the surgery under spinal anesthesia. The surgery was uneventful and the baby was in a good health. After 9 hours of surgery, she complained of painless swelling in the parotid glands. Physical examination and laboratories were normal. We started rehydration with normal saline and one dose of hydrocortisone (100 mg IV route). Close monitoring showed no problems in swallowing or any purulent discharge. Two days later, we had a complete resolution of the swelling. We discharged the woman with her child with no complaints. Our case is one of the rare cases of anesthesia mumps after spinal anesthesia. Physicians should be careful in considering such rare cases. Early diagnosis and management is the key.

Hyperglycemia due to abnormalities in insulin production, insulin action, or both characterizes the metabolic disorders known collectively as diabetes [1]. 

Fox, et al. [1] reported on the relevant cardiopulmonary findings in a series of autopsies of patients deceased from SARS-CoV-2 infection. In particular, regarding the histologic examination of the lungs, they observed bilateral diffuse alveolar damage with a lymphocytic infiltrate, thickened alveolar capillaries, fibrin thrombi within the capillaries and small vessels, and entrapment of neutrophils, without any significant neutrophilic, infiltrate within airways or the interstitium. 

Introduction: In an earlier study, we described and validated a VKA dose-finding algorithm (B2A), based on a novel bidirectional factor (BF). We designed a prospective study to evaluate the B2A in a daily care setting. Methods: In this open-label prospective study, we compared the outcomes of the B2A over the year 2020 with the outcomes of the previous year (2019), using regular algorithms. The outcomes were the duration of Time in the Therapeutic Range (TTR), the percentage of automated dose proposals (PAuP) and the percentage of accepted dose proposals (PAcP). The data were obtained from three anticoagulation centers in the Netherlands, in four locations. The outcomes of this study were based on a non-inferiority level.Results: The TTR over the year 2020 was at least non-inferior compared with the standard of care treatment. The percentage of automated proposals increased in all centers to approximately 96% of all dosages. Conclusion: The B2A performs non-inferior compared with the existing algorithms and in some aspects even better.

Background: Chronic kidney disease is a progressive loss in renal function that is more accepted as global public health importance and its magnitude is overgrowing in the least developed countries like Ethiopia. No data was found in Debre Birhan Central Ethiopia on the magnitude of chronic kidney disease among type 2 diabetes patients. Methods: Institution-based cross-sectional study was conducted among 327 at Debre Berhan Referral Hospital from March to June 2019 in Adult (≥ 18 years) type 2 diabetes follow-up patients who volunteered to give informed written consent were included in the study. Systematic random sampling was used. Data were collected by interviews using structured and pre-tested questionnaires. Descriptive statistics of the continuous and categorical variables were done. The bi-variable and multivariable logistic regression was done to show the net effect of explanatory variables on chronic renal disease. Results: A total of 327 study participants were involved in the final analysis. The Prevalence of CKD among type 2 diabetic patients was 15.9%. A significant association was found with age > 60 years [AOR 3.5 (95% CI 1.8-6.8)], alcoholic patients [AOR 2.4 (95% CI 1.2-5.1)], glycated hemoglobin levels above 7% [AOR 2.5 (95 CI 1.5-4.1)], higher level of LDL greater than 100 g/dl [AOR 2.7 (95% CI 1.9-4)] and lower level of HDL [AOR 2.9 (95% CI 1.4-6)].Conclusion: The magnitude of chronic kidney disease among type 2 diabetic follow-up patients was 15.9%. Estimated GFR should be determined for diabetic patients at regular intervals of time for earlier diagnosis of chronic kidney disease.

Indonesia is the fourth largest country in the world by population and has made considerable progress since the 1960s in terms of economic growth and structural transformation. But in recent years it has become apparent that the health of the nation is far from satisfactory. The purpose of this article is to review recent literature on health problems in Indonesia and to outline the policy challenges which face the government. Since 2001, the provision of primary health care has been decentralized to sub-provincial levels of government but they lack often lack the resources, and trained staff to provide adequate services to rural populations in particular. The literature suggests that while most health indicators have shown some improvement in recent years, there are still large variations by region and social class. The country is still far from achieving the goal of universal health coverage.

Oncological diseases are one of the most significant medical and social diseases in most countries of the world. Over the past decades, the search and development of new drugs, treatment regimens and methods of molecular diagnostics of malignant neoplasms remains relevant. In turn, an important goal of molecular genetic research is to suppress the expression of genes responsible for the development of tumors. The key targets taken into account in the development of antitumor drugs are proteins involved in carcinogenic changes in the cell. One of the promising molecular targets for the development of medicinal compounds in targeted therapy of tumor diseases is poly(ADP-ribose)polymerase 1 (PARP1). A potential way to inhibit PARP1 even at the stage of protein translation is RNA interference due to small interfering RNAs (siRNAs). For the penetration of siRNAs into the target cell, it is necessary to develop a method of their transportation controlled in space and time. An actual direction for solving this problem is the use of highly stable porous silicon-based nanoparticles. In the current study, in order to increase the functionality of nanoparticles, their surface was modified with various agents (functionalization), providing increased efficiency of drug loading and more uniform release. 

Disruption to contrast agent supply chains for radiology investigations has become an additional consequence of the COVID-19 pandemic. Various recommendations, including dose reductions and choices of alternative agents, have been made to help account for this limited availability. This case demonstrated how two separate CT venograms with different contrast agents, undertaken on the same day for the same patient, yielded different results; venous thromboses were more prominent in the subsequent scan. Although there was some evidence of venous sinus thrombosis on the first scan, repeat imaging was required to further characterize the lesions identified. The case exemplifies the notion that diagnostic imaging should always be guided by a detailed history and examination. It also raises the discussion point of whether more strict or uniform protocols should be developed to facilitate contrast administration for radiology investigations. It is important that appropriate doses are always administered to maximize diagnostic yield.

Monitoring the life cycle of physical assets (PA) implies addressing issues, such as PA’s energy efficiency and its replacement and definition of the most proper moment to renew. The goals of this article are: to present a characterization of energy sources and analyze the PA life cycle in a food sector company. First, it will be characterized the costs and the expenses of the organization’s energy sources, then, a study about the replacement of PA is presented; Traditional methods were used, such as economic life; The models that underlie it are discussed throughout the article, using actual data, for validation. Three methods for depreciation of PA are used: Linear Depreciation; Sum of Digits and Exponential. Other methods were used to determine the Economic Cycle for replacing PA: Uniform Annual Expenditure (MRAU); Minimizing the Average Total Cost (MCMT); and the MCMT-Reduced to Present Value (MCMT-RVP). The equipment of the study was bakery ovens (gas and electrical). Results and conclusions from the application of the methods used in the evaluation of these PAs are presented.

Background: Healthcare-Associated Infections (HAIs) are the most common healthcare-associated complications, particularly in elderly patients. The aim of this study is to describe the prevalence of HAIs and associated risk factors in the IRCCS INRCA of Ancona.Methods: A cross-sectional study has been carried out. Data has been collected in accordance with the European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey 2022-2023 (PPS3) protocol in the IRCCS INRCA of Ancona in November 2022.Results: Out of the 128 patients included in our study, 75.0% were over 78 years old and 9.1% presented an active HAI on the day of the survey. The prevalence of HAIs varied based on the length of the hospital stay (OR 1.1, CI 95% 1.05 - 1.17, p < 0.001) and hospitalization > 7 days (OR 5.9, CI 95% 1.2 - 28.7, p = 0.02).Conclusion: It is clear from our findings that HAIs are associated with advanced patient age, prolonged hospital stay, and use of medical devices, especially in those patients that, due to their clinical situation, are more vulnerable. Although some of these infections can easily be treated, it is important to develop effective infection control strategies thanks to antimicrobial stewardship programs.

Purpose: Exercise has a positive regulatory effect on gut microbiota and is also involved in regulating multiple physiological functions of the human body. This article tested the effects of basketball exercises at different exercise intensities on the gut microbiota of college students. Methods: Athlete research subjects (male, aged 18 - 25) were selected from the basketball team and trained at different intensities to obtain a total of 101 fresh fecal samples. DNA was extracted by a DNA extraction kit and bacterial 16S rRNA gene V3-V4 region high-throughput sequencing using the Illumina Hiseq platform. The downstream data were spliced, filtered and de-trimerized and then used to study the difference in gut microbiota. Results: Key bacterial taxa in the gut that responded to exercise intensity differed among athletes of different exercise intensities but most belonged to Firmicutes. With increasing exercise intensity, Butyricicoccus, Anaerostipes, Oxalobacter and Clostridium_IV in basketball players enrich. Further analysis of the functional prediction revealed that carbohydrate metabolism, amino acid metabolism, metabolism of xenobiotics and glycans and metabolism were significantly expressed in the gut microbiota of basketball athletes with high intensity. Conclusion: The study demonstrated that after long-term professional training, the gut microbiota of athletes adapts to exercise stimulators and can quickly respond to changes in exercise intensity. In high-intensity training, the organism is protected from harm by enriching some beneficial bacteria.

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored.This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan.Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms.Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.

Influenza B myositis is a self-limited process that is typically accompanied by myalgia and muscle weakness, which can be caused by an acute respiratory infection. It occurs in the convalescence phase of the disease. It can usually affect preschool and school children, who present bilateral pain and tenderness in the muscle groups of the lower limbs without alterations in the neurological examination. Being able to generate an alteration in the brand or bipedestation. Its main complication is rhabdomyolysis. In Guatemala is difficult to test for viral respiratory infection and the incidence of viral myositis is unknown, for which we consider the report important because it presents a benign course and is easy to manage with the use of non-steroidal anti-inflammatory drugs, to avoid unnecessary hospitalizations. We present to case report to an 8-year-old male patient, previously healthy, with diagnostic de Influenza B myositis.

Background: Autologous hematopoietic stem cell transplants (HSCT) is the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (MM) and patients with relapsed and refractory Hodgkin lymphoma (R/R-HL) who achieve chemosensitivity after salvage therapy. Although autologous HSCT is routinely performed in an  inpatient setting, the procedure can safely be performed in an  outpatient setting.Methods and materials: A retrospective study of patients with MM and R/R- HL who received outpatient autologous HSCT at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia between the first of April 2017 and the 31st of January 2022 was performed.Results: Over the study period of 4 years and 10 months, a total of 90 outpatient autologous HSCTs were performed for 79 patients (54 patients with MM; 4 of them received planned tandem autografts and 7 other myeloma patients received second autologous HSCTs for relapsed or progressive disease; and 25 patients with R/R-HL) at our institution. The median ages of patients with MM and those with R/R-HL at HSCT were 50.4 years and 27.8 years respectively.At the presentation of their MM, the following high-risk (HR) features were encountered: stage II and III diseases according to the revised international scoring system (RISS) in 53.7%; adverse cytogenetics in 42.6% and extensive bone involvement in 53.7% of patients. In patients with HL at presentation, 48% of patients had stage IV disease according to Ann Arbor staging classification and 84% of patients had B symptoms.Survival for 100 days post-HSCT for all patients with MM and HL who received outpatient autologous transplants was 100%. For patients with MM, the overall survival (OS) rates at 3 years and 4 years post-HSCT were 80% and 67%, while the progression-free survival (PFS) rates over 3 years and 4 years were 58% and 38% respectively. For patients with HL, the OS at 6 years post-HSCT was 95% while the PFS rates at 3 years and 6 years post-HSCT were 84% and 62% respectively.Conclusion: Outpatient autologous HSCT for patients with MM and HL is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation performed in an  inpatient setting. Additional benefits of outpatient autologous include saving beds and reducing hospital costs.

Information regarding the effects of the novel coronavirus on human reproduction is currently limited. The objective of our work was to assess whether, in women who have passed the disease, there was a variation in the ovarian reserve through the determination of AMH levels. During May-June 2020, women performing an Assisted Reproductive treatment and who had a positive IgG for SARS-CoV-2 were included in the study; this group of women had a previous AMH determination of no more than 6 months. Women were stratified into two groups, according to their previous AMH levels: low responders (AMH<1 ng/ml) or normal-high responders (AMH ≥ 1 ng/ml) Statistical analyses were performed using the Statistical Package for Social Sciences 19.0 (IBM Corporation, Armonk, NY, USA). A total of 46 patients were included in the study; 16 women were diagnosed as having low ovarian reserve (AMH < 1 ng/ml), with an average age of 38.6 years, whereas 30 were classified as having normal ovarian reserve (AMH ≥ 1 ng/ml), with an average age of 34.7 years. Generally, the data show no variation in AMH levels before and after SARS-CoV-2 infection (1.73 ng/ml vs. 1.61 ng/ml, respectively). However, when we analyzed these differences according to the study groups, the results were consistent with the patient's ovarian status. It is possible to conclude that the fact of having passed the disease does not affect the ovarian reserve status but the degree of the variation of AMH levels depending on the patient was a low or high responder.