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Peripartum cardiomyopathy is a rare case of heart failure with reduced ejection fraction and is considered a diagnosis of exclusion. The symptoms of heart failure in patients with peripartum cardiomyopathy can mimic the physiologic conditions of normal pregnancy. In an acute decompensated state, PPCM can present with acute severe upper abdominal or epigastric pain. We are presenting a 24-year-old female with no personal or family history of heart disease and no identifiable risk factor for PPCM. Based on her initial presentation in the emergency department, a diagnosis of acute severe pancreatitis was sought, and she was referred to the Intensive Care Unit. After further evaluation of the serological tests and imaging, she was eventually diagnosed as a case of PPCM. We emphasize the rare nature of the disease with a diverse presentation which poses a diagnostic challenge, especially in a resource-limited setting where advanced diagnostic tools may be restricted and socioeconomic condition poses a barrier to further patient evaluation. This case exemplifies the infrequent occurrence and atypical manifestation, presenting a learning opportunity for future clinicians.

To prepare the population for first aid in case of traumatic shock, algorithms for the fundamentals of didactics of the educational topic “First aid to the population in case of traumatic shock during accidents, disasters, natural disasters and terrorist attacks” of the subject “Life Safety” are proposed. 32 years of experience in teaching the subject in humanitarian state educational institutions of higher professional education of a non-medical profile in the city of Syktyvkar are summarized. Educational questions are considered: 1) The concept of shock; 2) Traumatic shock; 3) Mechanisms of injury that contribute to the development of traumatic shock. Predisposing factors. Complications. At-risk groups; 4) Classification, phases, and degrees of shock; 5) Universal first aid algorithm; 6) Basic anti-shock measures in the source of mass destruction and at the stages of evacuation; 7) Features of anti-shock measures in children; 8) Typical first aid mistakes for traumatic shock. For each of the educational issues considered, a summary of the material presented is given. Depending on the purpose of studying the topic, purpose, content of educational material, and form of organization of training, the number of hours allocated to its presentation and study in various forms of the educational process is established. Their distribution includes 1 lecture (2 hours), 1 seminar (2), 1 practical lesson (2), and 6 hours of independent work by students.

Background: Bile duct injuries have been substantially increased after the introduction of laparoscopic cholecystectomy (LC). These are accompanied by major morbidity and mortality. Studies have shown varying degrees of success in the reduction of bile duct injury (BDI) using the Critical View of Safety (CVS) technique. The aim of this study was to see the efficacy of the CVS technique as the sole method of dissection in laparoscopic cholecystectomy. Methods: 1647 cases of LC were done between January 2012 and January 2022 for a period of 10 years in two hospitals. All were operated by the CVS dissection technique and none by the infundibular technique. Cases included acute cholecystitis, chronic cholecystitis, gangrenous cholecystitis, empyema, and Gallbladder (GB) polyp. Results: The average operating time was 42 minutes and the range was 13 to 80 minutes. In 92% of cases, all 3 criteria of CVS were achieved. In the remaining 8% cases were either converted to open or operated by a division of GB or subtotal cholecystectomy was done. There was only one case of cystic duct stump leak requiring drainage and common bile duct stenting.Conclusion: The excellent outcome of our study suggests that the CVS method will be the gold standard technique in the dissection of the gallbladder in LC. Further dissemination of the technique is necessary to improve safety in LC.

Background: This case study explores an integrated approach to managing a complex cardiac condition, presenting a comprehensive single-session intervention. This includes balloon valvuloplasty using a Nucleus 18 mm balloon, complex angioplasty with rotational atherectomy (rotablator) targeting calcified lesions in the left main and left anterior descending artery, and Transcatheter Aortic Valve Implantation (TAVI) with a 23 mm Sapien 3 valve, all performed on an 81-year-old woman. Furthermore, this report underscores the strategic left atrial appendage closure conducted three months post-procedure due to the patient’s elevated hemorrhagic risk.Case presentation: Facing critical coronary and valvular pathologies, the patient underwent a meticulously planned, single-session intervention. The process began with a balloon valvuloplasty using a Nucleus 18 mm balloon to address the aortic stenosis. This was followed by a high-risk angioplasty, during which the Impella CP device provided hemodynamic support and rotational atherectomy was employed to address the calcified coronary artery disease effectively. The same session saw the successful execution of TAVI using a 23 mm Sapien 3 valve. The comprehensive approach notably diminished procedural complications, illustrating the benefits of an integrated treatment pathway in managing high-risk patients. Three months later, the patient underwent a left atrial appendage closure, a critical move considering her high risk of hemorrhage. This procedure also provided an opportunity to assess the favorable outcomes of the previous angioplasty.Conclusion: This case validates the feasibility and efficacy of performing multiple advanced percutaneous interventions in a single session for high-risk cardiac patients. It underscores the crucial role of innovative and personalized treatment strategies in improving patient outcomes, particularly in complex clinical scenarios. Moreover, the case exemplifies the essential relationship between immediate, comprehensive intervention and subsequent follow-up procedures in ensuring optimal long-term patient care.

This study aimed to examine the disparities of childhood cancer survival among different racial and ethnic groups in Texas. The analysis was mediated by socioeconomic status (SES) and spatial accessibility to Children Oncology Group (COG) hospitals. The relationship between race-ethnicity and overall survival was measured using the Cox proportional hazards model with a robust variance estimator. The counterfactual model measures the total effect of race-ethnicity on survival through all mediating pathways while adjusting for baseline confounders (age, sex, and stage at diagnosis), which are then decomposed into natural direct and indirect effects. Considering all cancer site groups, African Americans showed a statistically significant higher hazard ratio in death (HR = 3.63; 95% CI = 1.87 - 6.62) compared with non-Hispanic White children. At the same time, the mortality hazard ratio among Hispanic children is not significant (HR = 1.23; 95% CI = 0.80 - 1.93) when compared with non-Hispanic White children. Analysis results also suggested that both mediators significantly contribute to racial-ethnic survival disparities for specific cancer site groups such as Leukemia for African American children. This study builds knowledge and understanding about underlying factors (mediators) responsible for the disparities in the outcomes among childhood cancer patients.

In the biopharmaceutical production field, the purification process is a crucial step in order to obtain Drugs with an impurity profile according to the regulatory agency requirement.The aim of this work is to verify some relevant and recent literature and after analysis to submit to the researcher new Solutions in order to improve global safety and the toxicological profile: Submit a project related to the continuous testing of the purified materials using Raman spectroscopy – with pre-treatment of the sample: using solvents.Nanolipis Payload of Biopharmaceutical is not efficiently detected by direct Raman spectroscopy allowed by the regulatory agency for PAT process analytical technology.

Essential oils (EO) are extracted from different plant species and can be present in different plant organs. Rosemary-pepper EO is composed of around 50% to 70% thymol, a phenolic compound proven to be active against fungi and bacteria. The active components present in these compounds can affect the vital functionality of bacterial cells, leading to protein denaturation and cell lysis. Therefore, the present study aims to evaluate in vitro the antibacterial potential of Lippia origanoides EO against gram-negative bacteria. This is an exploratory study, with a technical-experimental procedure, with a quantitative approach, carried out at the Federal University of Campina Grande. The strains used were Pseudomonas aeruginosa ATCC 27853, Proteus mirabilis ATCC 25933, and Escherichia coli ATCC 25922, using concentrations of 1024, 512, 256, and 128 μg/ml using the disc diffusion method in triplicate. After the incubation period, the formation of halos of bacterial growth inhibition was not observed. There are possible causes for the lack of antibacterial activity of the EO concerning the strains of gram-negative bacteria used in the study, including the possibility of not containing components with antibacterial properties in concentrations sufficient for the expected activity at the concentrations tested. Based on the results obtained, the Rosemary-Pepper EO (Lippia organoids) did not demonstrate antimicrobial activity against the gram-negative bacteria used in the study. Therefore, the development of new research with Lippia origanoides essential oil with gram-positive bacteria is suggested.

Background: Cancer treatment frequently depends on the intricate and potent effects that are acknowledged for their potential to save lives. Chemotherapy can have adverse effects on both the central and peripheral nervous systems, posing significant challenges.Objective: •    To assess the causative agent, development, and timing of occurrence.•    To improve management of neurological complications.•    To discriminate the iatrogenic effects of cancer therapy and neurological progression.Method: A prospective observational study was conducted in a hospital setting, focusing on the neurotoxic effects of chemotherapy in cancer patients over a span of six months. The research involved participants from both the oncology in-patient and daycare departments. After obtaining informed consent, individuals in the study population were interviewed to gather information about any neurological symptoms they encountered following their chemotherapy sessions.Results and discussion: Within our study population, a predominant 67% comprised female patients, while male patients constituted 33%. Of the total participants, 66% reported experiencing neurological symptoms. Among these symptoms, the majority of patients encountered sensations such as tingling, numbness, and a burning sensation. Other reported symptoms included headaches, distal weakness, myalgia, seizures, and ataxia.Conclusion: In this current study, 66% of the study population encountered neurological side effects. Generally, the presence of comorbidities, vitamin deficiencies, and advanced age can significantly contribute to the development of peripheral neuropathy. Depending on the severity of neuropathy, recommendations for interventions include the prescription of vitamin supplements, calcium supplements, duloxetine, and pregabalin.

Millets are physiologically and therapeutically healthy with high nutritious value and are in rising demand in emerging markets like India, China, Africa, and other developing countries including the Western world. Germinated Millets have high digestibility and are used as healthy food for children’s growth and development. Climate change resilience technology, high nutritional value, and the announcement of the year 2023 as “International Millet Year” have made it very popular. Bakery items based on Millet, particularly cookies, are becoming more popular in both urban and rural areas. Jaggery is raw sugar prepared from sugarcane juice and is considered superior to white sugar. It offers numerous nutritional and therapeutic benefits, including anti-carcinogenic with antitoxic actions. Hence, this study aimed to prepare healthy food items with germinated finger and pearl Millets for better nutritional quality that are attracting the attention of health-conscious people on a worldwide scale. Cookies made from blends of germinated wheat flour (GWF), germinated finger millet flour (GFMF), and germinated pearl millet flour (GPMF) were examined for their physicochemical qualities, in vitro digestibility, antioxidant activity, and overall acceptability by consumers. In vitro protein digestibility (62.24-82.34%), starch digestibility (47.48-62.41%), total phenolic content (11.45–49.12 mg GAE/100 g), and antioxidant activities significantly increased as the proportion of GFMF and GPMF flour increased in the cookie samples, whereas total starch, dietary fiber, carbohydrate, and phytic acid decreased. The physical qualities of the cookies were also improved by the addition of GFMF and GPMF flours. Cookies with acceptable sensory properties, including taste, aroma, appearance, mouthfeel, crispiness, and overall acceptability, were produced by blending 60% GWF, 20% GFMF, and 20% GPMF (T2). This study demonstrated that GFMF and GPMF flour blends may be used as functional ingredients to create superior goods.

Caregivers of Children Living with HIV/AIDS experience severe burdens in Africa amidst unmet needs while seeking care from hospitals. This study aimed to explore the diagnosis history, health-seeking behaviour, and care provided by hospitals and whether the services meet caregivers’ expectations. We used a qualitative approach and conducted individual in-depth interviews among purposively sampled caregivers of children living with HIV/AIDS from three hospitals. We achieved data sufficiency after interviewing nine participants. Audio-recorded interviews were transcribed verbatim and thematically analyzed manually through Collaizi’s steps. Four themes developed including; history of pregnancy and poor HIV testing, effective care for caregivers and CLWH, attitude of healthcare providers, and unmet expectations of care. Healthcare providers showed positive attitudes towards caregivers and provided services (counselling, dispensing Anti-retrovirals, health monitoring, and coordination of clinical care). Expectations bordered on financial support (for food, education, health care), and treatment for opportunistic infections. Findings indicate gaps in HIV voluntary testing for pregnant women, enrollment in Prevention of Mother to Child Transmission (PMTCT), and unmet needs. It is imperative to improve coverage of testing for pregnant women and efforts made to meet their needs. Financial support, provision of food security, and assistance for caregivers are essential for care.

Whiteflies (Bemisia tabaci Genn.) are aggressive hemipteran species that depend primarily on leaf tissue for their nourishment, causing substantial damages and yield losses in their hosts. This study was carried out to assess the effect of whitefly infestation on the growth parameters of one of the commercial eggplant cultivars (round green  Solanum melongena L) under filed conditions. The trial consists of four treatments (T1= 15, T2= 30, T3= 45 and control (T4) = 0 whiteflies/plot) replicated four times. The result revealed that all the parameters assessed are negatively affected by whitefly infestation with plants in treatment (T3) being most affected while those in T1 are least affected. The dry weight recorded least value (1.1 g/leaf) having the highest percentage reduction (69.11%) followed by leaf area with 152.5cm2 (48.83% reduction) while the number of leaves was least affected recording 50.3 leaves/plant (18.09% reduction) at 90 days after infestation in 2022 experiment. In 2023 experiment, similar results were recorded with plants in T3 being most affected. Dry weight of the leaves had the lowest value  (1.3g/leaf) representing the highest reduction (68.30%) followed by the  leaf area with 167.3cm2 (44.8% reduction) with the number of leaves also being least affected, recording 52.1 leaves/plant representing 9.40% reduction with plants in treatment T1,  at 90 days after infestation. The highest reduction in yield was also recorded with plants in T3 (92.10, 90.10%) while the least was observed in T1 (86.8 and 85.70%) for the respective trials (2022 and 2023). The result shows the level of susceptibility of the variety examined to whitefly infestation, demonstrating the urgent needs for the development of eco-friendly and sustainable whitefly management regimes for improved eggplant production in the area.

The present study aims to assess and compare the quality of drinking water according to WHO Standards and then illustrate the resulting diseases. Eight samples have been taken from selective different schools in the Mount Lebanon Region. The laboratory tests of the collected samples were performed to determine various physical (e.g., temperature, pH, electrical conductivity, etc.), chemical (Ca+2, Cl-, Fe, Mg2+, NO3, Na+, SO2-4), and microbial such as E. coli, coliform, and non-coliform. Several techniques were used for the analysis including Atomic Absorption Spectrometry, Flame Photometer, and Total Organic Carbon (TOC). The resulting water quality was compared with the standard limits. Each school has different defects according to specific contamination that existed. To save local residents and according to the results of this study, regular monitoring for water quality was proposed; besides more water filtration plants should be installed to provide safe drinking for children’s health.

This study examines the intricate interplay among poverty, unemployment, education, and rural-urban migration in Nigeria, employing both quantitative and qualitative analyses. Quantitative data were analyzed using SPSS software, computing descriptive and inferential statistics such as regression analysis. Quantitative findings reveal income inequality, with many individuals earning below average. Education emerges as a key determinant of economic opportunities, with higher education associated with better outcomes. Moreover, poverty and unemployment exhibit a strong positive correlation with adverse outcomes, emphasizing the need for targeted interventions. Qualitative insights delve into the motivations behind rural-urban migration, shedding light on the economic drivers compelling individuals to seek opportunities in urban areas. Participants’ narratives uncover the challenges faced by migrants, from housing to accessing essential services. Additionally, the role of remittances in sustaining sending communities is highlighted, underscoring their significance. This study underscores the multidimensionality of poverty, unemployment, and migration and emphasizes the need for holistic, evidence-based approaches to promote inclusive development. Recommendations include investments in education, job creation, social safety nets, income inequality reduction, and support for migrant integration. These measures can contribute to equitable economic growth and improved well-being in Nigeria.

Susceptibility-weighted imaging (SWI) is based on a 3D high-spatial-resolution, velocity-corrected gradient-echo MRI sequence that uses magnitude and filtered-phase information to create images. It SWI uses tissue magnetic susceptibility differences to generate signal contrast that may arise from paramagnetic (hemosiderin), diamagnetic (minerals and calcifications) and ferromagnetic (metal) molecules. Distinguishing between calcification and blood products is possible through the filtered phase images, helping to visualize osteoblastic and osteolytic bone metastases or demonstrating calcifications and osteoid production in liposarcoma and osteosarcoma. When acquired in combination with the injection of an exogenous contrast agent, contrast-enhanced SWI (CE-SWI) can simultaneously detect the T2* susceptibility effect, T2 signal difference, contrast-induced T1 shortening, and out-of-phase fat and water chemical shift effect. Bone and soft tissue lesion SWI features have been described, including giant cell tumors in bone and synovial sarcomas in soft tissues. We expand on the appearance of benign soft-tissue lesions such as hemangioma, neurofibroma, pigmented villonodular synovitis, abscess, and hematoma. Most myxoid sarcomas demonstrate absent or just low-grade intra-tumoral hemorrhage at the baseline. CE-SWI shows superior differentiation between mature fibrotic T2* dark components and active enhancing T1 shortening components in desmoid fibromatosis. SWI has gained popularity in oncologic MSK imaging because of its sensitivity for displaying hemorrhage in soft tissue lesions, thereby helping to differentiate benign versus malignant soft tissue tumors. The ability to show the viable, enhancing portions of a soft tissue sarcoma separately from hemorrhagic/necrotic components also suggests its utility as a biomarker of tumor treatment response. It is essential to understand and appreciate the differences between spontaneous hemorrhage patterns in high-grade sarcomas and those occurring in the therapy-induced necrosis process in responding tumors. Ring-like hemosiderin SWI pattern is observed in successfully treated sarcomas. CE-SWI also demonstrates early promising results in separating the T2* blooming of healthy iron-loaded bone marrow from the T1-shortened enhancement in bone marrow that is displaced by the tumor.SWI and CE-SWI in MSK oncology learning objectives: SWI and CE-SWI can be used to identify calcifications on MRI.Certain SWI and CE-SWI patterns can correlate with tumor histologic type.CE-SWI can discriminate mature from immature components of desmoid tumors.CE-SWI patterns can help to assess treatment response in soft tissue sarcomas.Understanding CE-SWI patterns in post-surgical changes can also be useful in discriminating between residual and recurrent tumors with overlapping imaging features.

The rising prevalence of chronic diseases and the aging population globally are diminishing the overall quality of life, especially for those with demanding daily routines. As medical advancements extend lifespans, the proportion of individuals over 60 is set to double by 2050, necessitating societal shifts toward health-responsible citizenship. Despite longer lifespans, evidence suggests that older age often accompanies mental health challenges such as anxiety, depression, and substance misuse. Social isolation and loneliness further compound these issues, affecting both physical and mental well-being. Digital wellness empowers individuals to take charge of their health, promoting proactive care and literacy to foster health-conscious citizenship. This paper explores the intersection of mental health, aging populations, preventive wellness initiatives, and health literacy, emphasizing their significance within the Health 5.0 framework, especially for older adults. Traditionally, health regulators offer static workflows for adopting standard procedures in health and well-being, reflecting a reactive approach. However, the evolving landscape of wearable and mobile devices connecting to healthcare IT systems through secure online networks necessitates a shift. Technology now facilitates remote patient monitoring and telemedicine service subscriptions and empowers individuals to manage their health proactively.The BE4YOU project, conducted in Portugal, serves as a case study, facilitating individual maintenance of health and well-being through intelligent and dynamic workflows, which are defined based on analytical models considering each person’s risk profile. By facilitating data sharing, promoting healthy lifestyles, and enabling early detection of mental health issues, the project leverages technology to support personalized monitoring and enhance overall health outcomes. Through technology-driven empowerment, individuals and healthcare professionals are better equipped to assess risks and ensure ongoing wellness monitoring, underscoring the role of technology in fostering personal health and supporting healthcare effectiveness.

Alpine skiing is popular at varying levels of competitiveness with many skiers participating recreationally and elite skiers competing in downhill, super-G, giant slalom, slalom, and combined events in the World Cup and in the Winter Olympic Games. The rate of injury in alpine skiing is high both recreationally and competitively and methods to reduce injury rates are needed. Additionally, it is well-established in other sports that the risk of injury for an athlete varies based on gender. The purpose of this review is to determine how injury risk differs for each gender of alpine skier. Injury rates vary throughout the literature but point towards males being at a higher risk for overall injury and upper body injuries while females are at a higher risk for knee injuries. Even the specific knee injuries for which each gender is at risk varies with medial collateral ligament (MCL) injuries more common in males and anterior cruciate ligament (ACL) injuries more common in females. More studies are needed to confirm the differences in injury risks and how these risks may differ across levels of competition, thus allowing regulations and injury prevention methods that may be tailored specifically to the injuries an alpine skier is most susceptible to.

Purpose: The role of healthcare workers in cervical cancer prevention is pivotal because healthcare workers’ recommendations have been reported to be a key motivational factor for cervical cancer screening among women in Nigeria. Assessing their knowledge, attitudes, and practices on cervical cancer prevention is necessary.Patients and methods: This is a cross-sectional survey involving healthcare workers in Ekiti State, Nigeria. A questionnaire designed for the study was used to obtain data about the knowledge, attitudes, and practices of the healthcare workers. Logistic regression was used to assess the determinants of practice and a p - value of less than 0.05 was taken as statistically significant.Results: Out of 188 participants that completed the study, 165(90.7%) had good knowledge about the prevention of cervical cancer while 24(13.2%) had good practice concerning the prevention of cervical cancer. positive attitude (Odds ratio 1.24, 95% CI 1.14 - 1.35, p < 0.001) increased the odds of good practice.Conclusion: There was no association between the knowledge of cervical cancer prevention and the practice of the healthcare workers. Further research is required to explore the incongruence between knowledge and practice of cervical cancer prevention and its practice.

Oral Cancer (OC) or squamous cell carcinoma of the oral cavity accounts for approximately 3% of all cancers worldwide, with increased incidence in developing countries. The use of tobacco is directly associated with approximately 80% of oral cancers, especially in older men over 40 years of age. As nearly one-third of the Indian population over 15 years consume smokeless tobacco in one or the other forms, a recent increase has been observed in OC incidence among women and young adults. Lately, the sexual behaviors of young & homosexuals have resulted in the emergence of oropharyngeal cancers due to infection with HPV 16. About 60% of oral cancer cases in India have a five-year survival rate, and this can be improved to 70% to 90% by mere early detection in stages I and II and with various treatment modalities. Despite the well-known benefits of oral cancer screening for the whole population in developing countries remains controversial. It is imperative to address the cultural barriers and societal norms, which limit the acceptability and participation in screening programs in India and many developing countries. This unique challenge of increasing OC morbidity in India and developing countries requires horizontal integration of the health systems with new services focused on cancer control, which gives the best chance for long-term survival, improved outcomes, and affordable care!This article is based on the author’s experience of overseeing 1 case of early detection and 2 cases of delayed diagnosis, outcomes and relevant literature review, and current guidelines for the management of OC.

Neurodegenerative disorders (NDDs) pose a significant global health challenge, impacting millions with a gradual decline in neurons and cognitive abilities. Presently, available NDD therapies focus on symptom management rather than altering the disease trajectory. This underscores the critical necessity for groundbreaking treatments capable of addressing the root causes of neurodegeneration, offering both neuroprotection and neuro-restoration. This in-depth review delves into the forefront of emerging NDD therapies, encompassing gene therapy, stem cell therapy, immunotherapy, and neurotrophic factors. It sheds light on their potential advantages, hurdles, and recent advancements gleaned from both preclinical and clinical studies. Additionally, the document outlines existing NDD treatments, spanning pharmacological and non-pharmacological interventions, along with their inherent limitations. The overarching conclusion emphasizes the immense potential of emerging therapies in NDD treatment, yet underscores the imperative for continued research and optimization to ensure their safety, efficacy, and specificity.

Strep throat, a common affliction known for its hallmark symptom of a severe and sudden sore throat, is caused by the bacterium Streptococcus pyogenes, classified under Group-A Streptococcus (GAS) [1]. This condition not only impacts millions globally but also carries the risk of severe complications if left untreated [2]. Understanding strep throat goes beyond recognizing its symptoms; it entails an appreciation of its transmission dynamics, potential complications, and the evolving landscape of treatment and prevention strategies [3].