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Coronary artery aneurysm is an uncommon condition defined as abnormal dilatation of the coronary artery.We report the case of a man admitted to the Emergency Department for suspected intestinal obstruction. At abdominal/thoracic Computed Tomography (CT) it was reported a suspected pericardial cyst. Contrast echocardiography showed a clear pattern of blood flow inside the mass with a probable origin at a very limited region where it was also possible to sample an ECG-synchronized system-diastolic Pulse-Wave (PW)-Doppler pattern, typical for a coronary artery flow. Our suspicion of a giant coronary artery aneurysm was then confirmed by coronary CT and coronary angiography. The patient was transferred to a Cardiac Surgery center where he underwent surgical treatment for the aneurysm.Most coronary aneurysms are clinically silent and are often incidentally detected. Coronary angiography is the ‘‘gold standard’’ for diagnosis and evaluation of coronary artery aneurysms. Among non-invasive diagnostic techniques, Computed Tomography Coronary Angiography is the best method for coronary artery anatomy and coronary abnormalities. However, echocardiography with the use of a contrast agent, a cost-effective non-radiation nature, and a widespread use method, maybe a reliable method to detect and characterize the masses, allowing a differential diagnosis.Learning objective1.    Recognition and evaluation of cardiac masses require first-line imaging methods such as echocardiography.2.    The use of additional non-invasive (cardiac CT or MRI) and/or invasive imaging methods are often required. 3.    Contrast echocardiography may be helpful, as second-line imaging methods, to better characterize the mass and approach the correct diagnosis.

Xanthogranulomatosis is an uncommon disease affecting non-Langerhans histiocytes. Laryngeal involvement is very rare.We describe the clinical case of an adult patient with disseminated xanthogranulomas affecting the supraglottic region of the larynx, leading to thickening and immobility of the epiglottis. The patient experienced inspiratory dyspnea on exertion. A transoral supraglottic epiglottectomy was performed, and a tracheostomy was subsequently required.

This study presents a comprehensive simulation and analysis of photonic band gaps in one-dimensional (1D) photonic crystals using the open-source software MEEP. Photonic crystals, with their periodic structures, exhibit photonic bandgaps that prevent the propagation of specific wavelengths of light, making them crucial for various optical applications. Unlike previous studies that primarily focused on theoretical and experimental methods, this research introduces a novel computational approach that enhances the accuracy and flexibility of modeling these bandgaps. Through detailed simulations, we explore the impact of different structural parameters on the photonic bandgap properties, providing valuable insights into optimizing these crystals for practical use. Our findings demonstrate significant improvements in the design and understanding of 1D photonic crystals, particularly in tailoring bandgaps for specific applications in optical devices. This work contributes to the advancement of photonic crystal technology by offering a robust framework for their analysis and application.

Introduction: Cognitive impairment is defined as a new deficit in at least two areas of cognitive functioning. These may include disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. It has been shown that cognitive impairment is associated with the severity of kidney disease. Methods: The study was a descriptive research design, with participants purposively sampled from the general chronic kidney disease population which included haemodialysis and peritoneal dialysis patients at Steve Biko Academic Hospital in Pretoria, Gauteng Province, South Africa. Hundred and fifty-one participants (76 hemodialysis & 75 peritoneal dialysis patients), 58% were males, and 42% were females aged 19-61 years. To establish the prevalence of cognitive impairment by testing the level of cognition the Mini-Mental State Examination was utilized to provide a brief screening test to quantitatively assess the cognitive abilities and cognitive changes of patients while on dialysis. Results: Ninety-nine percent (99%) of the recruited population reported no cognitive impairment, irrespective of dialysis modality, demographic characteristics, and socio-economic status. Conclusion: Despite the findings highlighting that the majority of the chronic kidney disease population at Steve Biko Academic Hospital reported no cognitive impairment, it is crucial to increase awareness of the potential effects of cognitive impairment on daily activities, quality of life, and treatment adherence. Early detection and management of cognitive impairment can significantly impact the quality of life and adherence to treatment among these patients. Further research is needed to understand the prevalence and impact of cognitive impairment in different populations and to develop effective interventions for its prevention and management.

An autoimmune condition known as Systemic Lupus Erythematosus (SLE) affects several systems and manifests itself in a variety of ways. It is far more common among young women who are fertile.It has been demonstrated that a mix of environmental and genetic variables may trigger immunological responses, triggering T and B cells, and leading the B cells to overproduce pathogenic autoantibodies and dysregulate cytokines, which ultimately result in harm to many organs and tissues. One feature of SLE is the presence of antibodies against cytoplasmic and nuclear antigens. An autoimmune illness is also type 1 diabetes. β-cell antibodies (Ab) and other antibodies that cause the autoimmune death of the pancreatic β-cells, which make insulin, are part of the multifactorial pathophysiology of type 1 diabetes mellitus (T1DM).Immunosuppression is the therapy for systemic lupus erythematosus (SLE), and diabetes itself compromises immunity, making infections more opportunistic. We came across an unusual instance of a patient with SLE, T1DM, hypothyroidism on immunosuppression who subsequently acquired pulmonary TB.Key phrase: Autoimmune diseases such as type 1 diabetes mellitus (T1DM) and Systemic Lupus Erythematosus (SLE).

Primary adrenocortical insufficiency or Addison’s disease (AD) is a rare, life-threatening condition with different aetiologies, but the most common cause is autoimmune destruction of the adrenal cortex. Autoimmune Addison’s disease (AAD) can present as an isolated condition or associated with others, as part of an autoimmune polyglandular syndrome (APS). The aim of this work is to investigate and emphasise the roles of autoantibodies in adrenocortical insufficiency, through the description of three clinical cases.

Purpose of the study:  To evaluate the performance of Best Practice Recommendation (BPR) compliance in reporting abdominal aortic aneurysm findings on imaging, comparing the results before and after its deployment.Methods: Best Practice Recommendations for AAA were deployed in 2020 at a large radiology practice site. Reports between January 2018 through October 2022 were reviewed, representing studies read prior to and subsequent to the implementation of the reporting standards. Cases of abdominal aortic aneurysms ≥ 2.6 cm were counted by year. Adherence to the BPR for each year was calculated as [total number of confirmed cases of ≥ 2.6 cm AAAs with compliant reports] * 100 / [the total number of confirmed ≥ 2.6 cm AAAs]. A secondary analysis was performed to determine whether there was a statistically significant difference in the proportion of BPR-compliant reports for AAA cases before (from 2018 to 2019) and after (from 2020 to 2022) BPR deployment using a chi-square test. Results: From January 2018 to December 2022, there were 8,693 reports referencing AAA. After excluding cases of suspected AAA (N = 2,131), confirmed AAAs with indeterminate sizes (N = 103), and confirmed AAAs with sizes < 2.6 cm (N = 85), the number of AAA cases ≥ 2.6 cm in size was 6,374. Concordance with the BPR standards for the remaining cases with sizes ≥ 2.6 cm were 1.6% and 4.1% in 2018 and 2019, respectively. Post-implementation of BPRs, there was a substantial improvement in guideline adherence to 32.1%, 84.3%, and 83.6% in 2020, 2021, and 2022, respectively. In general, the proportion of BPR-compliant reports of AAA cases in the pre-deployment (3.6%) period statistically differs (p - value < 0.0001) from those in the post-deployment period (73.9%)Conclusion: Adherence to reporting standards increased after the BPR deployment in 2020. The inclusion of management recommendations in the radiology report when AAA is identified is a simple and cost-effective way of improving outcomes for patients with AAAs through appropriate follow-up treatment.

Purpose: Loop Diuretics (LD) are the first-line pharmacotherapy to address Heart Failure (HF)-associated edema and dyspnea. However, LD causes frequent urinary, resulting in inconvenience and possibly undermining the quality of life. While prescription adjustment is an essential part of Palliative Care Consultation (PCC), it remains unclear how PCC affects the deprescribing of diuretics for adults with HF. Methods: We conducted a pre-post analysis of the percentage of HF patients who were prescribed LD in a national Electronic Health Record (EHR) database 12 months before and after the first PCC. The difference in prescription rates between the periods was determined. Adjusted associations of post-PCC LD prescription with pre-PCC LD prescription and patient’s characteristics, insurance, provider type, and clinical factors were quantified.Results: From 2010 to 2018, 5,969 patients with newly diagnosed HF received at least one PCC, among whom 2,539 (42.5%) were prescribed LD before and 1,552 (26.0%) after their first PCC. Despite a decrease in LD prescription rate encompassing the date of PCC, post-PCC LD prescribing was strongly associated with pre-PCC prescribing (aOR[95%CI] 3.2[2.8,3.7]) and varied by age at first PCC, year of HF diagnosis (aOR[95%CI] 2.1[1.9,2.4]) and months from HF diagnosis to first PCC. While our finding demonstrates reduced polypharmacy associated with PCC, the strong association between pre- and post-PCC indicates reverse therapeutic inertia. Future research should investigate the benefits and costs of polypharmacy among specific patient groups to help develop personalized treatment for HF.

Background: Linagliptin is an anti-diabetic drug that claims no adverse effects and treatment of gestational diabetes mellitus (GDM) demands a safe anti-diabetic medication. Therefore, this study investigates the anti-diabetic efficacy of linagliptin in an induced GDM.Materials and methods: Thirty-two matured female rats (100 - 200 g) were utilized. Sixteen non-pregnant/diabetic animals were fed with a normal diet and sixteen rats were fed with a high-fat (HFD), mated at the estrous stage in 2:1, and pregnancy was confirmed with a spermatozoa in a vaginal smear. The pregnant rats were intraperitoneally injected with a single dose (30 mg/kgb. wt)of streptozotocin (STZ) to induce GDM. The animals were grouped into 4 groups, 8 rats/groups. Group I: control; Group II: control + 10 mg/kgb.wt linagliptin; Group III: GDM; Group IV: GDM + 10 mg/kgb.wt linagliptin. The animals were sacrificed after 14 days of treatment. Blood samples were collected for biochemical parameters.Results: Fasting blood glucose (FBG) insulin, glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), malondialdehyde (MDA), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-alpha (TNF-α) levels significant (p < 0.05) elevated in GDM rats, with significant reduction in high-density lipoprotein-cholesterol (HDL-C), catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH). Linagliptin administration significantly (p < 0.05) decreased the FBG, insulin, HbA1c, TC, TG, LDL-C, MDA, IL-6, IL-1β, and TNF-α and ameliorates the HDL-C, CAT, SOD, and GSH levels significantly.Conclusion: Linagliptin remarkably showed anti-hyperglycemic, anti-oxidative, and anti-inflammatory properties. Linagliptin could be a promising drug for hyperglycemia treatment during gestation.

Dentistry is a challenging and demanding physical profession, and this impacts not only the quality of the task outcomes but also the professional’s quality of life. The nature of dentistry demands prolonged static and awkward seated postures, frequent motions, positioning struggles, and working distances to the oral cavity for strategic procedure management, which become cumulative challenges over the working days, prone to discomfort, pain, or injuries, and musculoskeletal disorders for the operator.The limitations of the naked eye in dentistry, particularly in terms of visual information and resolution, underscore the need for visual aids. These aids are crucial for achieving the precision required for accurate procedures. Also, visual aids, such as magnifying loupes and the operative microscope, have been in the market for a while, and their proper use has shown ergonomic benefits that promote a neutral working posture and changes in work practice-oriented to control unbalanced awkward posture and motions.In this study, the Rapid Upper Limb Assessment RULA compares the posture between naked-eye dentistry, conventional loupes, and operative microscope, and with the observational assessment, determine the risk of developing musculoskeletal disorders and the need for priority of change. The Rodgers muscle fatigue analysis RMFA is used to predict fatigue in the muscular regions of the body during specific dental tasks.

This research focused on assessing the levels of selected metal contamination in seven different rice brands (Jasmine, Basmati, Mapembe, Morogoro, Shinyanga, Mbeya, and Cheju). Cheju rice was obtained from local producers from the Cheju area in Zanzibar, while the remaining rice brands namely, Jasmine, Basmati, Mapembe, Morogoro, Shinyanga, and Mbeya were randomly taken from local markets at Darajani and Mwanakwerekwe in Zanzibar. Samples were prepared in accordance with applicable Safe Operating Procedures (SOPs) and laboratory SOPs using information provided by field sample preparation. The samples were ground to fineness and an aliquot of about 10.0 g was measured on the beam balance and mounted on the sample holders for laboratory analysis. An Energy Dispersive X-Ray Fluorescence (EDXRF) technique with a Rigaku NEX CG EDXRF model spectrometer was used for metal analysis. The study revealed that the percentage of metal contamination varied considerably from one rice brand to another, with Basmati and Jasmine rice each exhibiting a contamination level of 50%, while Shinyanga, Mbeya, Mapembe, and Cheju rice showed a level of 25% each. Notably, Morogoro rice had no observable heavy metal contamination. Additionally, a significant positive correlation was observed between several metal pairs: Au and Cr (r² = 1.00), Au and Ti (r² = 0.613), Cr and Ti (r² = 0.613), Ni and Pb (r² = 0.748), Ni and Hf (r² = 0.660), Pb and Hf (r² = 0.656), and Ti and Sn (r² = 0.671). The individual occurrence (percentage) for metals across all rice brands were as follows: 71.42% for Sn, and 28.57% for Hf, Ni, Pb, and Ti, while traces of Au, Cr, and Y each had an occurrence level of 14.28%. While Morogoro rice showed no metal discernible analyzed heavy metal contamination, the other rice brands were observed to have a considerable heavy metal contamination trend. The patterns of metal occurrence in each rice brand were observed as follows: Basmati: Sn > Ti > Au > Cr; Jasmine: Sn > Hf > Ni > Pb; Shinyanga: Sn > Pb; Mbeya: Sn > Hf; Mapembe: Sn > Ti; Cheju: Ni > Y. The patterns, then yield the ranking of metal contamination across all seven rice brands from lowest to highest is as follows: Morogoro < (Mapembe, Cheju, Mbeya, Shinyanga) < (Jasmine, Basmati). Furthermore, the data analysis indicated that the concentrations of Cr (1.08 mg/Kg), Ni (4.65 mg/Kg), and Pb (3.05 mg/Kg) detected in the samples surpassed the maximum permissible limits established by WHO/FAO which were 1.0 mg/Kg, 0.10 mg/Kg and 0.20 mg/Kg respectively. Consequently, the study concludes that Morogoro rice is the most superior and considered the safest choice for consumption, while Jasmine and Basmati rice are associated with higher levels of metal contamination. Thus, it is highly recommended that Tanzania intensify its rice cultivation efforts to reduce reliance on rice imports from other nations.

In this study, we evaluated the assessed the hypoglycemiant, toxicogenetic and genotoxic effects of nanoencapsulate extracts of Bauhinia forficata Link. Phytochemical evaluations of extracts were carried out, as well as the evaluation using HPLC-MS and of antioxidant capacity in vitro. DM2 was induced in mice with streptozotocin and extracts were given orally for 28 days. That dried extract from infusion (ESIN) had a higher rate of bioactive compounds compared to the dried extract from decoction (ESDC), and higher antioxidant capacity. Glucose levels decreased from 77.26% to 57.79% and 45.15% after supplementation with ESIN (200 and 600 mg/kg/day) and ESDC (600 mg/kg/day), respectively, when compared to the diabetic group treated with metformin (600 mg/kg/day) (21.53%), with an improvement in the glycemic response e recovery of pancreatic β cells. Thus, our study has shown that these extracts exhibit hypoglycemiant activity, with a beneficial effect superior to metformin, as a result they could be considered as potential therapeutic agents for application in pharmaceutical formulations in the treatment of DM2.

Background: The impact of COVID-19 and long-term COVID-19 on gastrointestinal neoplasms remains underexplored. The current review investigates the potential link between these conditions and the role of gut microbiota in mediating oncogenic processes. Dysbiosis, characterized by alterations in gut microbial composition, may exacerbate inflammation and immune dysregulation, contributing to cancer development.Methods: A comprehensive literature review was conducted using databases including PubMed, Scopus, Embase, SciELO, and Web of Science. Inclusion criteria encompassed studies published between 2020 and 2024 that explored the intersection of COVID-19, long-term COVID-19, and gastrointestinal cancers. The articles were critically appraised for quality and relevance, and data were synthesized to elucidate common mechanisms and outcomes.Results: The review identifies several mechanisms by which gut microbiota may influence cancer risk in COVID-19 patients. Persistent inflammation, oxidative stress, and immune dysfunction observed in Long COVID were associated with dysbiosis. Specific microbial metabolites, such as secondary bile and short-chain fatty acids, were implicated in promoting tumorigenesis. Comparative analysis of studies suggests that SARS-CoV-2-induced dysbiosis may heighten susceptibility to gastrointestinal cancers, particularly in patients with prolonged post-infection symptoms.Conclusion: The findings underscore the need for further research to clarify the role of gut microbiota in cancer development among COVID-19 patients. These mechanisms could inform preventative strategies and therapeutic interventions, particularly for those experiencing COVID. The review highlights gaps in current knowledge and advocates for longitudinal studies to assess the long-term effects of COVID-19 on gastrointestinal health.

Mesoscopic modeling of complex systems involves thermodynamic nonequilibrium of discrete scaling. Further from quantum correlation on a chip retrieved quantum nonlinear optics with single photons enabled by strongly interacting atoms. Accompanied by mesofractals as the development of meso & micro size fractal structures is required to mimic various biological systems for various functions. Showed through fluorapatite in gelatin‐based nanocomposite, fractal in DNA knots driven by balance of fission & fusion in mtDNA/mitochondrial DNA mechanism, for optical engines for light energy detection described the proportional integral derivative [PI(D)]‐controller set in microbial cells to HCCI/Homogeneous Charge Compression Ignition.

The World Drug Report highlights that the prevalence of hepatitis C virus (HCV) is one of the leading causes of cirrhosis and hepatocellular carcinoma globally. This report estimates that HCV is responsible for the annual death of around 700,000 people due to liver disease and is associated with high levels of morbidity and mortality with high health and socio-economic costs. This exploratory study aims to evaluate the socio-economic return provided by HCV treatment of individuals integrated into the MOP developed by the NGO Ares do Pinhal in Portugal. Using the SROI (Social Return on Investment) methodology is estimated that for every euro invested in this program, the return for society is 3,75€. This is a significantly positive SROI value, highlighting the importance of this investment in the creation of monetized value for society, as well as to provide greater well-being to those who need it and to society as a whole.

Inclusively new to econophysics studies, herewith proposed technoeconophysics as part of techno-economy, econophysics & sociophysics to interpret the description between probability and hypothesis found between fractal realms and econophysics of markets, physics markets, or stock markets any chaotic evidence [exergy destructive] could present if effective & efficient criterion doesn’t comply. A more precise iterative study ought to be held to configure how fractal dimension is involved in the techno-econophysics study of the Helium Nat Gas Project which is not integer, but also proofed numerically & analytically.

Introduction: Nutrition is increasingly recognized as a key component of optimal sports performance. On the other hand, insufficient and continuous food intake can compromise athletic performance and success where Nutritional Knowledge can play a leading role.Methods: One hundred and three youth athletes from 6 different clubs belonging to the District, Honor, and National Championship participated in this study. To assess Nutritional Knowledge, consumption of alcohol and tobacco the Abridged Nutrition for Sport Knowledge Questionnaire was applied.Results: The percentage of Nutritional Knowledge obtained in the District Championship was 31.25%, in the Honors it was 35.56% and in the National Championship it was 35.02%. No significant differences were found between the Nutritional Knowledge of athletes. In turn, there were statistical differences in the consumption of alcohol and tobacco among the athletes of the 3 Championships, with the District division having the highest percentage of smokers (100%) and alcohol consumers (42.6%).Conclusion: It is essential to increase the Nutritional Knowledge observed in these young athletes since it can have an influential role in their food choices.

Aim: To compare the demographic and clinical profile of conventional retinopathy of prematurity (ROP) with aggressive posterior retinopathy of prematurity.Material and methods: A prospective, unmasked, and observational study involving 150 ROP patients was conducted over a period of one year. The risk factors including maternal and neonatal risk factors were recorded. The data was entered into the Excel sheet and analyzed to compare the risk factors between the conventional ROP and APROP.Results: A total of 17 (11.3%) babies were found to have AP-ROP and 133 (88.7%) babies were found to have conventional ROP. There was no significant difference in average gestational age between infants diagnosed with AP-ROP (29.6 ± 2.9 weeks) and those with Conventional ROP (30.1 ± 2.2 weeks) (p = 0.428). However, infants with AP-ROP had a significantly lower average birth weight (1022.7 ± 123.5 g) compared to infants with Conventional ROP (1208.2 ± 261.0 g) (p  = 0.004). Multivariate logistic regression analysis revealed that birth weight, surfactant use, number of days of oxygen supplementation, and metabolic acidosis were independently associated with the development of AP-ROP.Conclusion: The development of APROP is multifactorial and complex. Although we have identified factors such as birth weight, surfactant use, number of days of oxygen supplementation, and metabolic acidosis in the causation of APROP, further long-term multicentric studies are required for validation.

Age estimation is an essential aspect of profile building in forensic investigations. Age estimation using teeth is one of the exciting applications of Forensic Odontology because teeth can survive post-mortem damage, so it is considered more suitable for age estimation. This study aims to estimate the age of individuals using the Cameriere method on teeth in various countries. The approach used in this research is a literature review study design compiled based on the Preferred Reporting System for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from several articles with a period from 2007-2024. Scientific articles that meet the criteria will be analyzed using the Cameriere method to estimate the age of individuals. The search yielded 222 studies and only 12 scientific articles that met the requirements from the specified articles obtained. The population represents countries from various countries. The sample was in the age range of 4 years - 16 years. The results showed that the Cameriere method can be used to estimate the age of individuals quite accurately in various countries. However, there were some differences in accuracy between countries when using this method.

Mental illness is an international health crisis that puts the lives of over three hundred million people (Four percent of the world’s population) at risk. The study was conducted at the Erigavo Mental Hospital in Somaliland and its main focus was the bond between substance abuse and mental illness. The research was to check the influence of the different drugs, screen mental health problems, and draw a link between drugs and mental illness. The sources of the quantitative data were a total of 27 employees and managers. This study is cross-sectional. We employed the measure of the magnitude and direction of a linear relationship between two variables with the Pearson correlation coefficient. The outcomes that were acquired show that there was use and particularly abuse of khat, substance smoking, and alcohol consumption, the score means of which were quite high. The investigation results, however, imply that through drug use and other forms of alcohol drug abuse, one of them counter various mental health problems. Furthermore, the addicted people demonstrated the tendency to use force in their attempt to solve the conflicts and to experience the highest degree of tension, with the mean score of the former giving 4.11 while the standard deviation of the latter giving 1.086, thus this shows the mental impact of drug use on the inhabitants of Erigavo. The main result of the study was the strong, positive relationship between drug addiction and mental illness, which became evident through an r - value of 0.509 and a p - value of 0.559. It means that those people who are involved in drug misuse are the ones who are likely to have mental health disorders. Based on the findings of the study, we suggest a combination of measures to recover drug addiction and mental illness. This consists in strengthening prevention. The study that lays the groundwork for suggestions, involves an approach that is holistic in nature. The main ideas of preventing drug usage, psychological health care, enhancing mental health services, and working towards certified professionals are key integrated activities of the whole concept. The hospital, thus, will be in a better position to eliminate the two major disease components namely; drug abuse and mental ailment. Thus, in this way, with the help of the new treatment approaches, a hospital provides and their patients who are quite likely to recover and lead healthy.