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Background: Down syndrome (DS), or Trisomy 21, is the most common genetic disorder in the world and congenital heart disease (CHD) contributes significantly to morbidity and mortality in this population. Early diagnosis and prompt cardiac intervention improve their quality of life. This study was done to determine the prevalence and pattern of congenital heart disease among children with Down syndrome seen at the Paediatric Cardiology Unit of Federal Medical Centre (FMC), Bayelsa State.Method: A prospective study of children with Down syndrome referred for cardiac evaluation and echocardiography at the Paediatric Cardiology Unit of FMC, Bayelsa State over four years from 1st January 2016 to 30th December 2019. Data on socio-demographic information, echocardiographic diagnosis, and outcome were retrieved from the study proforma and analyzed.Results: A total of 24 children with Down syndrome were seen over the study period. Their age ranged from 0 to 16years. The majority, 20 (83.3%) of the children with Down syndrome were aged 5 years and below. There were 13 males and 11 females with a male to female ratio of 1.2:1. A total of 23 (95.8%) of the children with Down syndrome had CHD. The most common CHD was AVSD (including complete, partial, isolated, or in association with other defects) in 66.6% followed by TOF in 8.3%. Multiple CHDs were seen in 43.5% of the children. Only one child (4.2%) had a structurally normal heart on echocardiography. All the children with Down syndrome had pericardial effusion of varying severity while 33% had pulmonary artery hypertension (PAH). The fatality rate among the children seen with Down syndrome over the study period was 34.8% and only one child (4.2%) had open-heart surgery with the total repair of cardiac defect during the study period. Conclusion: Morbidity and mortality are high among children with Down syndrome due to the high prevalence of CHD. Early referral, diagnosis, and prompt intervention are encouraged.

Liver Transplantation is fraught with thrombo-hemorrhagic complications, due to the precarious hemostasis of the recipient, anhepatic conditions, and the release of hemostatic factors from the allograft. Disseminated intravascular coagulation and its “flat-line” variant are common causes of hemorrhage and thrombosis, and frequently force the clinician along with a delicate balance between hemorrhage and thrombosis. We present a case that highlights some of the more challenging diagnostic and management decisions in liver transplantation and presents a safe and carefully structured approach to hyperfibrinolysis in liver transplantation.

Background: The prevalence of cyanotic congenital heart diseases (CCHD) varies world wide. It accounts for a third of all congenital heart diseases. The common CCHD includes Tetralogy of Fallot(TOF), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), truncus arteriosus, and tricuspid atresia (TA). Less common variants include Ebstein’s anomaly, Hypoplastic left heart syndrome, pulmonary atresia, and single ventricle. Children of all ages can be are affected. The commonest presentation is cyanosis. Bradycardia and/or congenital heart block are rare presentations and mostly occur in the presence of an associated congenital atrioventricular block.Case report: We report a case of a 3-month-old female presenting with congenital heart block and bradycardia at 3 months of age and found to have complex cyanotic congenital heart disease on echocardiography.Conclusion: An infant presenting with bradycardia clinically should be screened for congenital heart defect as bradycardia may be an ominous sign of serious underlying cardiac defect.

We investigated the associations between circulatory dynamics and Body Composition (BC) of the peripheral lower limbs with Exercise Habits (EHs). We surveyed the EHs of 34 healthy older adults (6 men, 28 women) and measured their BC and skin perfusion (SP). SP did not correlate significantly with any other variable. Participants with established EHs had a lower body weight and Fat Tissue thickness (Fat-T) than those without. Multiple logistic regressions with the presence or absence of an EH as the dependent variable and BC values as the independent variables established Fat-T as a significant variable. Sex was independently associated with soleus muscle thickness, Fat-T, Bone Density (BD), and leg segmental water. Age was independently associated with Fat-T and BD, and body mass index was associated with Fat-T. EHs were not independently associated with any of the BC measurements. Physical characteristics and EHs have minimal influence on peripheral circulatory dynamics.

Background: WHO and UNICEF recommend breastfeeding to be initiated within an hour of birth. However, timely initiation of breastfeeding remains low in Ethiopia. Therefore, this study aimed to compare the timely initiation of breastfeeding and associated factors with cesarean and vaginal deliveries in public hospitals in Addis Ababa, 2021. Methods and materials: Comparative cross-sectional study was conducted from January 2021 to February 2021 in public hospitals of Addis Ababa. 322 mothers within three days of delivery at the postnatal ward of the respective public hospitals were selected. A multi-stage sampling method was employed with the final participants being recruited by systematic random sampling. Data was entered to Epi data Version 4.6 and analysis was performed by SPSS Version 26. A Binary and multivariate logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association. Result: Timely breastfeeding initiation was 79 (51.2%) and 123 (80%) for cesarean and vaginal deliveries. With a vaginal delivery, pre-lacteal feeding (AOR = 5.50, 95% CI: 1.83 - 16.57) was significantly associated with timely initiation of breastfeeding. Multiparity (AOR = 2.14, 95% CI: 1.02 - 4.50), support from health care workers (AOR = 2.602, 95% CI: 1.16 - 5.82), and pre-lacteal feeding (AOR = 2.55, 95% CI: 1.13 - 5.75) were significantly associated with timely initiation of breastfeeding with cesarean delivery. Conclusion: The rate of timely initiation of breastfeeding differs according to the mode of delivery. Cesarean delivery, as compared to vaginal delivery, was associated with a lower rate of timely initiation of breastfeeding.

Endotheliosis, thrombotic microangiopathy and complement system over activation have been described as pathologic features of tissue damage in the setting of coronavirus disease. Interestingly, complement-mediated cell injury is also a typical feature of atypical Hemolytic Uremic Syndrome. Indeed, a growing body of literature has described a higher risk of microangiopathy recurrence, in aHUS patients who test positive for SARS-CoV-2. The correct clinical and therapeutic management patients with a history of HUS and SARS-CoV-2 infection is not well established.We report a case of SARS-CoV-2 infection in an aHUS patient who did not develop a recurrence of the disease and that was successfully treated with convalescent immune plasma therapy.

The manifestation of non-force electromagnetic fields in nature and in experiments on Earth is interesting and important in the part that would confirm the numerous physical models that have been calculated and presented in the scientific literature [5,6,15,17].

Papilledema is optic disc swelling due to high intracranial pressure. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydroce-phalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracranial hypertension (IIH) [1].

The effect of the novel coronavirus (SARS-CoV-2) pandemic has produced significant health concerns negatively impacting individuals. As the ongoing and constantly changing nature of SARS-CoV-2 continues, the unique characteristics of this pandemic trend toward anxiety and loneliness as significant behavioral health outcomes. Furthermore, the SARS-CoV-2 pandemic has significantly impacted the utilization of social media platforms such as Twitter. Utilizing over 1.6 million tweets from approximately 988,760 Twitter users geolocated in Washington state from the University of Pennsylvania’s publicly available Twitter database (from March 2020 to March 2021), this study evaluated the impact of SARS-CoV-2 by using expressions of loneliness and anxiety to predict mental and physical symptoms. Bivariate correlations revealed expressions of loneliness were correlated to trouble breathing while expressions of anxiety were correlated to skin lesions, body aches, flu-like, seasonal cold, trouble breathing, nausea or diarrhea, fever, chills, and cough. Multiple multivariate linear regressions were completed, and a significant regression equation was found in predicting trouble breathing symptoms on expressions of loneliness and anxiety, however, the proportion of variance was 8% of the observed variation in the model. Further implications revealed the importance of understanding mental and physical well-being during a public health crisis as well as the use of social media platforms as primary and supplementary stimuli.

Cardiac angiosarcomas are rare malignant neoplasms with an aggressive clinical course. These are characterized by the absence of specific clinical findings, rapid growth with frequent metastasis at the time of diagnosis, correlated with poor prognosis, and reduced response to treatment. But with early diagnosis, more possibilities for treatment and survival can be provided. We report the case of a young woman diagnosed with right atrial angiosarcoma locally advanced with bone metastases detected by 18F-FDG PET/CT, which revealed distant disease extent at diagnosis, consequently, chemotherapy was started.

Background: Arterial stiffness has been considered an independent predictor of cardiovascular disease in addition to the traditionally known cardiovascular risk factors. Objectives: This study aimed to investigate the associations between arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives. Methods: A descriptive cross-sectional study compared a control group in 210 study subjects (105 hypertensives and 105 normotensives). Measuring left ventricular mass index by echocardiography and carotid intima-media thickness by carotid doppler ultrasonography. Pulse wave velocity was measured using the Agedio B900 device and the Agedio K520 application. The manual method was measured by the ankle-brachial index.Results: There was a statistically significant positive correlation between pulse wave velocity and age (r = 0.922, p < 0.001). The ankle-brachial index had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.219 (p < 0.05) and 0.250 (p < 0,001), respectively. Pulse wave velocity also had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.188 (p < 0.05) and 0.289 (p < 0,001), respectively. Pulse wave velocity had a multivariable linear correlation with gender, pulse, mean blood pressure, and ankle-brachial index with statistical significance; and they were written in the form of the following equation: Pulse wave velocity (R2: 41.3%) = 0.641*(Gender) – 0.027*(Pulse) + 0.043*(Mean blood pressure) + 8.378*(Ankle-brachial index) – 3.254.Conclusion: Arterial stiffness was statistically correlated with left ventricular mass index and carotid intima-media thickness in the hypertensives. Through the above research results, we suggest that the hypertensives should be combined with the evaluation of hemodynamic parameters and arterial stiffness for contributing to the diagnosis and detection of cardiovascular complications, thereby improving the quality of monitoring and treatment in hypertensive patients.

Introduction: Induction of labour is a common obstetric intervention, occurring in approximately 25% of term pregnancies in developing countries. Pharmacological and mechanical methods commonly used are prostaglandin preparations (PGE1 and PGE2) and various intracervical catheters (single or double balloon), respectively.Material and methods: Study was conducted in Siliguri District Hospital, Siliguri, Darjeeling, west Bengal. 100 antenatal woman admitted in obstetrics ward with pog more than 37 weeks were taken for study after applying inclusion and exclusion criteria. 50 were induced with cerviprime gel and 50 with intracervical foley catheter. Statistical analysis done.Results: Mean interval between treatment initiation and delivery was not statistically significant, tachysystole was more common in group B women, rate of LSCS and NVD was similar in both groups.Conclusion: It can be concluded from the present study that Foley’s catheter (mechanical) and prostaglandin E2 gel [pharmacological] both are effective agents for preinduction cervical ripening which substantially improve the bishops score and increase the chances of successful labour induction. There is no significant difference in their efficacy, mode of delivery and perinatal outcome.

Commonly referred to as an ecstatic, non-inflammatory disease, Keratoconus, usually bilateral and asymmetric, is characterized by progressive steeping and thinning of the cornea. This results in irregular astigmatism which compromises vision [1,2]. Traditionally, early Keratoconus stages have been treated by prescribing a hard contact lens to obtain a regular anterior optical surface. This tendency was discontinued when contact lens intolerance in advanced stages required the use of penetrating keratoplasty (PKP) or deep anterior lamellar Keratoplasty (DALK). An alternative technique of corneal cross-linking was designed in 2003 as a treatment option for keratoconus. The cornea measured at least 400 um thickness after epithelium removal and pre-operative maximum keratometry (Kmax) measured 58D or less. As a result, no corneal transplantation was required or postponed [3].

SARS-CoV-2 is a virus that has a positive-sense, single-stranded RNA genome that encodes 4 structural proteins, the main one being the S protein (Spike) responsible for mediating with ACE2 and TMPRSS2 for entry into the host cell. The study of single nucleotide polymorphisms (SNPs) of ACE2 and TMPRSS2 can elucidate their possible intervention in the action of the protein, its activity, and the gene expression of encoding these enzymes, which may increase susceptibility to viral infection. From this, literature searches were carried out until December 2021, listing 11,820 publications for literary analysis on the described genetic variations of these protein structures, as well as their relation and influence on the pathology. It was possible to conclude that there is a great influence exerted by genetic variability in ACE2 and TMPRSS2 increasing the ability of the virus to bind to the host cell and the development of COVID-19 with complications. 

A literature-based review was made to assess available information on bovine hemoparasites related to their epidemiology, distribution, and economic importance in Ethiopia. Babesiosis, anaplasmosis, cowdriosis, theileriosis, and trypanosomosis are the major hemo-parasitic disease of bovine in Ethiopia. Their adverse effects on the health of the animals can decrease production and productivity. Hemoparasites generally cause fever, anemia, jaundice, anorexia, weight loss, milk drop, malaise, swelling of lymph nodes, dyspnoea, diarrhea, nervous disorders, and death by affecting blood vessels and/or lymphatic system of the animal. Reports from different parts of the country displayed there is a high distribution of bovine hemoparastic disease throughout the country. Anaplasmosis, Babesiosis (redwater), Ehlichiosis (Heartwater), Theileriosis, and Trypanosomosis are the major hemoparasitic diseases with heavy economic losses. Their mode of transmission was by arthropod vectors ticks and flies. Applying effective vector control and using vaccines drugs are the two most important control methods for hemoparasites diseases. Also having knowledge of parasite life cycles, their biological vector, and the immune response of bovines to vectors and parasites were also used in the successful application of control strategies. Creating awareness of the mode of transmission, method of control, and prevention of hemoparastic disease of bovine to livestock owners were warranted to decrease the effect of the disease.

Willingness to pay (WTP) and sensory acceptability for minimally processed (MP) vegetables were studied. A total of 116 participants of two different household incomes (HI) were considered. Two types of preparations (bags with whole vegetables and trays with MP vegetables), and two types of presentations (mix vegetables for soup and mix vegetables for salad), were evaluated. Low income (LI) participants offered more money in general than the medium-high income (MI) participants. However, the offers of the two preparations (soup and salad) did not show significant differences. The 4 samples (two preparations: soup and salad; and two presentations: bags and trays) had good sensory acceptability with values between 6.5 and 8.3, on a scale of 1-9. MI consumers had higher acceptability for mixed vegetables for soup than for salad vegetables; however, LI participants showed no difference between the types of preparation, observing for both samples (soup and salad) high acceptability. For both HI, Check All That Apply (CATA) questions showed that phrases such as “It is unreliable” and “I distrust how it was prepared” were associated with the trays, while the phrase “It takes time to prepare or cook” was associated with bags.

Crohn's disease is a chronic syndrome of the gastrointestinal tract that produces idiopathic inflammation. Approximately half of the patients develop abscesses and/or fistulas throughout their history that are located, mainly, in the perianal region. Current treatments are based on individualized plans that generally use combined pharmacology for symptomatic relief based on glucocorticoids, immunosuppressants or immunomodulators, antibiotics, anti-inflammatories, probiotics, and antibodies, or surgical therapies such as intestinal resections or ostomizations (colostomy and ileostomy) that tend to cause notable side effects in a considerable percentage of patients and a significant decrease in their quality of life.Perianal fistulas consist of abnormal tracts, inflammatory tunnels, or chronic tracts of granular tissue that connect two surfaces lined with epithelium, have an external hole in the skin that borders the anus, and an internal hole located inside it around the anal canal, rectus and sphincters. Treatment is a complex process that requires a multidisciplinary approach and the combination of several treatments. In the short term, the goal is to drain abscesses, reduce inflammatory and infectious processes, guard the fistulous tract with seton or lax lines, facilitate patency, and hinder new formations. In the long term, a total cure and the avoidance of complications that require surgery or the creation of intestinal stomas are pursued.For this reason, new effective remedies with fewer adverse effects continue to be investigated, one of the most promising being the use of mesenchymal stem cells for the regeneration and cure of perianal fistulas and the remission of symptoms. The present bibliographic review delves into this new therapy and analyzes the current state of the situation regarding its efficacy and safety.

As shown e.g. in ref.[1] Zitterbewegung (trembling motion) of the free Dirac electron is generated if transitions between positive and negative energy states occur. Here we treat this effect in a single-mode configuration using a density matrix method. As compared with more elaborate conventional treatments, this method allows an easy estimate of the amplitude of the motion. The result is by predicted spreads of the free electron charge.

Plants have a high concentration of biologically active molecules. Aloe plants tend to store water and important chemical constituents in their swollen and succulent leaves due to their ability to survive in hot and dry conditions, which makes them a unique source of phytochemicals. The Aloe leaf contains more than 200 nutritional substances, including vitamins, minerals, amino acids, and active enzymes. These constituents are analyzed as phytochemical screening (qualitative analysis) or proximate and mineral content analyses (quantitative analysis). Aloe is used as a food product and beverage ingredient. Functional and nutraceutical foods, edible coatings/films, Aloe species as cooked vegetables, and raw eating of Aloe species are how the Aloe plant is considered in food applications. The researchers reported edible Aloes for several species. However, it is not mean that all species of Aloe are edible. It is not only the leaves of Aloe that have nutritional values also other parts of the plant do. The study evaluated the nutritional value of Aloe flowers and their possible use as edible flowers. Aloe species are increasingly being incorporated into different health drinks, foods, and beverages due to the beneficial biological activities of the phytochemicals.

Background: Sepsis among newborns is common and a major cause of neonatal deaths in developing countries. Annually, about 4 million neonatal deaths occur around the world. Of these, more than 30% are caused by infections majority of which start as umbilical cord infections. Topical umbilical cord care can reduce omphalitis (umbilical cord infection) and neonatal mortality among newborns.Objective: This study aimed to compare the incidence of omphalitis in different cord care interventions (Dry, Chlorhexidine, and Alcohol) in Nakuru County, Kenya. Methodology: A randomized controlled trial was carried out between July 2018 and June 2019. A total of 540 newborns were randomly assigned to receive 1 of 3 cord care regimens; twice cord cleansing with 4% chlorhexidine (Group 1), twice cord cleansing with 70% alcohol (Group 2), and dry cord care (Group 3) as control. Results: The risk of omphalitis was significantly reduced in the chlorhexidine group than in dry and alcohol cord care groups. The incidence of omphalitis was 1.95 times more likely to occur among the dry cord care group [AOR = 1.95; 95% CI = 1.13-3.38; p = 0.017] compared to the chlorhexidine group. Similarly, babies in the alcohol group were nearly 2 times more likely to develop omphalitis [AOR = 1.98; 95% CI = 1.15-33.40; p = 0.014] compared to those in the chlorhexidine group.Conclusion and recommendation: Chlorhexidine topical cord care significantly reduces the risk of umbilical infection in neonates when compared to both topical alcohol application and dry cord care approach. It should be recommended to be used topically for the prevention of omphalitis in our setup.