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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.

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. 

Jatropha dioica sesse ex cerv is a specie native to Mexico and Texas, commonly known as “sangre de drago“, its name is due to its colorless juice turning dark at exposure to the wind. This mini-review aims to collect information about the phytochemical and pharmacological properties of Jatropha dioica. The phytochemicals identified are diterpenes, (citlalitrione, jatrophone and riolozatrione), β-sitosterol, oxalic acid and ellagic acid. The stems, whole plant, or the root of J. dioica in traditional medicine are used to avoid hair loss, as an antibacterial, and antiviral, to strengthen teeth, and to heal some injuries among others uses. Among the biological activities attributed to Jatropha dioica are found in antiviral activity, antifungal, antimicrobial, chemopreventive, anti-hyperglycemic and cytotoxic. However, the little information about the chemical composition of this species and the scarce scientific studies validating its pharmacological properties make J. dioica an interesting species to study.

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. 

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.

Every society organizes itself to reduce the complexity of living together in order to ensure relative peace of mind for its members. Major technological accidents such as the Chernobyl or Fukushima nuclear accidents are violent disruptions that affect the quality of life of tens of thousands of people and generate increased distrust and anxiety among them as well as the questioning of the state system’s ability to restore some peace of mind. Past experience has shown that the measurement of radiation and the development of local projects with the support of professionals and experts prove to be effective levers for those affected to regain the ability to make decisions for their protection and to assess the protective actions implemented collectively. It also showed that restoring confidence and restoring the dignity of these people, seriously impaired by the accident, takes time.

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.

Background: Hemp seed (Cannabis sativa L.) is an annual herbaceous plant of the Cannabis genus that contains a large amount of protein, iron, and fatty acids, including linoleic, α-linolenic, and γ-linolenic acid. These compounds are involved in a number of biological activities, including immunity enhancement, hyperlipidemia, and inflammation reduction. Here, we investigated the antioxidant effects of hemp seed on human cognitive function.Methods: The test was administered to 34 healthy volunteers aged ≥ 20 years. Participants were selected according to age and sex and were administered 10 g of hemp seed three times daily (30 g/day) for 45 days. The outcome measurements were recorded using a survey, computerized neurocognitive tests, and artificial intelligence.Results: Survey analysis determined that both the Beck Anxiety Inventory and Beck Depression Inventory measurements decreased significantly after hemp seed consumption when compared to measurements taken before consumption (p < 0.05). Additionally, significant results were observed in the Stroop and Tower of London tasks (p < 0.05). The prediction performance for the antidepressant effect was 0.83 for the area under the curve in the random forest algorithm, which was superior to that of other machine learning methods. Conclusion: These results suggest that hemp seeds have a beneficial effect on cognitive impairment.

Parkinson’s disease is a progressive and debilitating neurodegenerative disorder affecting millions of people worldwide. The disease is characterized by motor symptoms such as tremors, rigidity and postural instability, as well as non-motor symptoms such as depression and cognitive impairment. While there is no cure for Parkinson’s disease, there are various treatments available to manage symptoms and improve quality of life for patients.This case study examines a 65-year-old retired accountant, Mr. John Smith, who was diagnosed with Parkinson’s disease five years ago. Mr. Smith has been treated with a combination of medications, including levodopa and carbidopa and physical therapy to manage his symptoms. However, his symptoms have not significantly improved.This literature review explores the current research on Parkinson’s disease, including its pathophysiology, diagnosis and treatment. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the brain, leading to a depletion of dopamine and the accumulation of alpha-synuclein protein, oxidative stress and inflammation. Diagnosis is based on clinical symptoms, neurological examination and response to dopaminergic therapy. Treatment focuses on managing symptoms, with medications and non-pharmacological interventions such as exercise and physical therapy. Deep brain stimulation is a surgical treatment option that has been shown to be effective in managing motor symptoms.While there is currently no cure for Parkinson’s disease, ongoing research into its pathophysiology and treatment holds promise for improving outcomes for patients. This case study highlights the importance of early diagnosis and personalized treatment plans for patients with Parkinson’s disease.

It is planned to carry out a comprehensive experimental and theoretical study on the high temperature of low calorific gas combustion with oxygen-deficient oxidizers. The experimental research will be performed using the experimental facility with a combustion chamber. The oxygen concentration in combustion oxidizers will be varied from 21% by volume (normal) air to 2%. The test combustion chamber will be fed with propane or methane as the reference fuel, then with low calorific fuels as test gases obtained by mixing various combustible components, e.g. H2, CH4, CO, and neutral gases, e.g. N2, CO2. Gaseous fuels prepared in this way will be burned in the atmosphere of a deficient oxidizer with a temperature changing from 800 °C to 1100 °C. Oxidizers will be heated up to a certain temperature using two methods: by flue gas heat exchanger and kanthal rod electric preheater. Different burner geometry will be used. The burner will be equipped with annular swirl vanes for co-axial or under different angles, fuel, and oxidizers flow to have a high swirl number achieved by flow aerodynamics and mixing. Experimental data will be verified with numerical simulations with the use of ANSYS CFD Fluent code.

Quick and cost-effective recovery is foundational to high-quality training and good competition results in today’s sports. The aim of the research was to elucidate the effects of hand and massage chair massage on the biomechanical parameters of muscles of lower limbs and back, indicators of Pain Pressure Thresholds (PPT) and subjectively perceived fatigue. A total of 32 female recreational athletes (18 – 50 years old) were assigned to a hand massage, massage chair, or lying down the group. They were measured for muscle biomechanical properties (MyotonPro), PPT (Wagner Instruments) and subjectively perceived fatigue (VAS scale) before and after fatigue tests and treatment. The recovery procedure and subjective satisfaction with treatment were rated on a Likert scale. Changes in the median value of m. rectus femoris and m. gastrocnemius stiffness with treatment showed that hand massage could be more effective in reducing stiffness, as compared to chair massage. Hand massage may have benefits for recovery from physical exertion, but due to the individuality of subjects, detailed methodological studies are needed to evaluate the effects of massage chair vs. hand massage.

Background: Measurement of health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes mellitus (T1DM) is as important as metabolic control in the management and prevention of diabetes-related complications. Aim: To describe the self-reported HRQOL outcomes in Ghanaian children and adolescents with T1DM compared with healthy controls and perceived HRQOL by caregivers.Setting: Out-patient clinics of the Departments of Child Health, Medicine and Therapeutics, Family Medicine, and Ophthalmology, the National Diabetes Management and Research Centre (all at the Korle Bu Teaching Hospital), and the Cape Coast Teaching Hospital (CCTH).Methods: Socio-demographic and clinical characteristics of study participants were documented. Participants completed the PedsQL™ 4.0 Generic Core Scales. Data analysis was done with SPSS Version 25.0. An unpaired t-test was used in comparing the HRQOL scores between children and adolescents with T1DM and controls, and parental proxy reports. Results: Fifty children and adolescents with T1DM, 50 parents/caregivers, and 80 healthy non-diabetic controls took part in this study. There was no significant difference in mean score between the patients and the caregivers for overall HRQOL (p = 0.270). Patients reported significantly worse overall HRQOL than their controls (p = 0.001). Males with diabetes reported better HRQOL than females (p = 0.007). Conclusion: Children and adolescents with T1DM and their parents/caregivers reported lower HRQOL scores compared to healthy controls. Males reported better HRQOL than females. Potential implications: HRQOL should be routinely assessed together with proxy reports from parents to identify those who might benefit from further attention including referral to a psychologist.

In this study, the authors systematically examined the anatomical and biomechanical properties of the ligaments in the normal rat knee. These biomechanical data will facilitate the use of the rat knee model for future studies of knee ligament injury, repair, and reconstruction. Fifty-six fresh cadaver male Sprague-Dawley rats, aged 16 weeks, were used for this study, with 48 rats for biomechanical testing and 8 for micro-CT and histological evaluation. Our findings suggest that the gross anatomy of the rat knee joint and ligaments is very similar to humans despite some minor differences and features unique to the rat knee. The patella tendon and ACL are the two strongest soft tissue structures in the rat knee joint, with the highest failure force and stiffness, and both play a role in the anterior stability of the knee. In comparison, the failure force and stiffness of the LCL is half of the MCL, suggesting that other structures, such as the popliteal tendon, may play some role in lateral knee stabilization besides the LCL. In addition, our data suggest that anterior knee stability was improved after ACL reconstruction, but was not fully restored to intact ACL function. In conclusion, our study indicates the anatomical and biomechanical properties of the knee joint and ligaments of rat knees. Then we could confirm a reproducible and realistic rat model of knee ligaments like the clinical cases, and provide a basis for the study of knee ligament biology that simulates techniques used in humans.

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.

The manifestation and severity of Allergic rhinitis symptoms show diurnal variation which negatively impacts the patient’s quality of life, day-to-day activities, and productivity at the workplace. The symptoms worsen at night or early morning and therefore administration of levocetirizine towards evening may be more acceptable. Consequently, the present study evaluated the effectiveness of evening Levocetirizine administration on 24-hour symptom control, Physical and mental health, and daytime somnolence in patients with allergic rhinitis the study was a prospective, open-labeled, single-arm, two-center, observational study among patients with allergic rhinitis. Levocetirizine was prescribed as 5 mg or 10 mg once a day evening oral dose for at least 7 days before sleep. The 24-hour total nasal symptom scores (TNSS) for self-reported signs and symptoms of allergic rhinitis were recorded. Additionally, study evaluations included the SF-12 scale (Quality of Life), Stanford Sleepiness Scale (degree of sleepiness), and work productivity and activity impairment (WPAI) questionnaires. These evaluations were performed at baseline (Day 0) and at scheduled intervals of Day 1 (24-hour), Day 3, and Day 7. Results demonstrated that evening administration of Levocetirizine facilitates 24-hour symptom control while having no significant effect on daytime somnolence, daily activities, and the work productivity of patients.

Background: Since 2019, remote patient monitoring (RPM) for patients with chronic heart failure (CHF) has been supported by the European Society of Cardiology. However, real-world data on the use of such solutions has been limited and not primarily based on patient-reported outcomes. The aim of this study was to describe the Satelia® Cardio solution in France within the French ETAPES funding program and assess the security and performance of its clinical algorithm.Methods: A retrospective observational study was conducted on CHF patients monitored by RPM through Satelia® Cardio. From September 1, 2018, to June 30, 2020, patients were included if they had completed over six months of follow-up. The risk of a possible CHF decompensation was categorized by the system in three levels: green, orange and red. The algorithm security and performance were assessed through the negative predictive value (NPV) of the prediction of hospitalization of a patient within seven days.Results: In total, 331 patients were included in this study with 36,682 patient self-administered questionnaires answered. Patients were mostly males (70.4%) and had a mean age of 68.1 years. The mean left ventricular ejection fraction (LVEF) was 35.4% (± 12.3) and 73.3% of patients had a LVEF ≤ 40%. The questionnaire response rate was 90.9%. A green status was generated for 95.3% of answers. There were 4.5% (n = 1,499) orange alerts and 0.2% (n = 74) red alerts. Overall, 92.1% of patients had at least one CHF related hospitalization and 31.7% (n = 105) of these cases were non-scheduled. The NPV at seven days was 99.43%.Conclusion: Satelia® Cardio is a feasible, relevant and reliable solution to safely monitor the cohorts of patients with CHF, reassuring cardiologists about patient stability.

Introduction: Patients with aortic stenosis often develop hypertrophy and fibrosis, regardless of symptoms. Cardiac Magnetic Resonance (CMR) represents the gold standard for the evaluation of fibrosis despite numerous limitations: cost, availability, atrial fibrillation, claustrophobia, kidney failure or inability to apnea.Purpose: The aim is to validate the role of echocardiographic parameters, such as Global Longitudinal Strain (GLS), as early markers of fibrosis. Clinical and laboratory data, particularly B-type Natriuretic Peptide (BNP), were also analyzed.Material and methods: In our study we recruited 33 patients with severe aortic stenosis, correlating echocardiographic values of GLS with the qualitative analysis of Late Gadolinium Enhancement (LGE) and the quantitative analysis of T1 mapping of CMR.Results: 70% of patients with an alteration of GLS had LGE+. Univariate logistic regression shows that the factors associated with the presence of LGE on CMR are hypertension (p = 0.043), GLS (p = 0.032), and elevated BNP values (p = 0.021); for GLS, Odds Ratio (OR) is 5 so the chance of finding fibrosis on CMR increases 5 times in presence of an altered GLS. The multivariate analysis confirms the association with impaired GLS values (p = 0.033) and hypertension (p = 0.025), but not with elevated Pro-BNP values.Conclusion: In patients with severe aortic stenosis, the association between GLS, LGE, and T1 mapping can help identify earlier those patients with structural changes caused by the disease, who could benefit from early intervention. It remains to be established how the presence of these alterations has a role in determining the intervention time and the outcome of these patients.

Introduction: Child Protection Services (CPSs) are dedicated to providing protection and responding to any threats a child could face as children worldwide could be abused. Recently, the COVID-19 pandemic affected all aspects of life. Procedures implemented to restrict the spread of the disease (such as reduced access to services, school closure, and social distancing measures) had an impact on child life and maltreatment. Therefore, it is important to know the impact of this pandemic on child abuse and protection. Aim and rationales: This study aimed to assess the impact of COVID-19 on CPSs in Oman by studying the change in the number of reported cases of child abuse and the change in the reporting procedure at the Ministry of Social Development (MOSD). In addition, know the impact of the restriction measures on child rights and risk factors of child maltreatment based on CPSs workers’ opinions and experience. To understand the adaptation of the CPSs to the change in work and life environment imposed by COVID-19. Method: A cross-section study was conducted using a semi-structured questionnaire, that was distributed to the workers involved in the CPSs at the MOSD in Oman. Data also were collected from the statistical bulletins on the Ministry’s website. Results: COVID-19 pandemic was not found associated with a significant change in the number and type of child abuse cases reported to the MOSD. The reporting procedures also did not change. In addition, the pattern of child abuse types did not change before and during the pandemic, as neglect cases were the most. The participants judged the restriction measures affecting family life through separation, cyber abuse, and reduced educational support. With regard to intervention and follow-up procedures, the main difference was in the communication processes by using online communication methods and reducing the fieldwork for mild cases.Conclusion: CPSs in Oman were not much affected by the COVID-19 pandemic, which may reflect the success of this system in dealing with the restriction measures. However, more solutions should be developed to adapt to these circumstances in the future altogether.

Cities with developing economies experience exhausted waste collection services, and inadequately managed and uncontrolled dumpsites; which is an ongoing challenge and many struggles due to weak institutions and rapid urbanization. The purpose of the research is to design and construct a smart garbage disposal system using a two-way power supply unit (that is, the electrical power supply unit and solar power supply unit) based on Arduino Nano that utilizes ATMEGA 328p microcontroller. Two pairs of ultrasonic sensors, the pair that faced upward detects the presence of garbage disposal agent at a close distance of (5 - 50) cm and then opens the lid while the other pair faced the inside of the container senses when the container is filled up and then closes the container until it is emptied are used.

pH buffer solutions are those in which minimal pH variations occur when moderate amounts of strong acids or bases are added or diluted. The most common buffers are those used in the intermediate pH zone and are made up of an acid-base conjugate pair (HA/A-), with Ca and Cb as analytical concentrations of acid and base respectively. The buffer capacity of a solution is the measure of its effectiveness in preserving the pH value when adding an acid or a base. Three new programs working under the Windows 10 environment have been developed. The first one, the BUFFER program, allows to prepare buffers of known ionic strength without the need of adding an inert electrolyte, calculating the pH and buffering capacity. On the other hand, the BRÖMSTED method allows calculating the pH of conjugated acid-base systems applying the Newton-Raphson method. In this work two more programs are described, one applying the Brömsted method to monoprotic acids and another new one to diprotic acids.