Oussama Ssouni*, Latifa Oualili, Tarek Dendane, Amine Ali Zeggwagh and Khalid Abidi
Published on: 28th July, 2023
Introduction: Aluminum Phosphide (AlP) poisoning is a life-threatening condition that commonly occurs in developing countries, often resulting in cardiac, respiratory, and metabolic complications, leading to multi-organ failure and mortality. Extracorporeal Membrane Oxygenation (ECMO) has been proposed as a potential therapy for severe AlP poisoning cases refractory to conventional management, though its use remains controversial. Methodology: for this literature review, we conducted a comprehensive analysis of existing literature concerning the utilization of ECMO in patients with severe AlP poisoning. We meticulously examined available publications to explore the relationship between ECMO initiation and patient outcomes. Discussion: The review reveals that early ECMO initiation within 6 hours of presentation is associated with better outcomes and higher survival rates in severe AlP poisoning cases. However, uncertainties persist regarding the optimal timing and duration of ECMO support, and potential complications, including bleeding, acute renal injury, and ventilator-associated pneumonia, need careful consideration. Conclusion: Despite promising results in certain cases, the risks and benefits of ECMO in AlP poisoning require meticulous evaluation. Ethical considerations, encompassing resource allocation and implications for other patients, necessitate appropriate patient selection criteria.
Melanie Tess Mahoney*, Elisabeth Lapp Kincaide, Joelle Nelson, Kelsey Anne Klein, Reed Charles Hall and Suverta Bhayana
Published on: 28th July, 2023
To evaluate the safety and efficacy of weight-based mycophenolate mofetil (MMF) dosing in adult kidney transplant recipients (KTR), this single-center retrospective study of adult KTR compared biopsy-proven acute rejection (BPAR), infections, hospitalizations, granulocyte colony-stimulating factor (G-CSF) use, and MMF dose changes within one year of transplant pre-and post-implementation of a weight-based MMF dosing protocol. Adult patients who received a kidney transplant at University Health Transplant Institute were reviewed for inclusion. Patients in the weight-based MMF group received 1000 mg twice daily by the first clinic visit if ≥ 80 kg, 750 mg twice daily if 50-79 kg, and 500 mg twice daily if < 50 kg. Patients in the fixed-dose MMF group received MMF 1000 mg twice daily. A total of 170 KTR (50.0% ≥ 80 kg, 44.1% 50-79 kg, 5.9% < 50 kg) were included. Baseline characteristics were similar between groups. The majority of patients were middle-aged Hispanic males and received lymphocyte-depleting induction therapy. Incidences of BPAR, infection, and hospitalization were similar between both groups at one-year post-transplant. Weight-based MMF dosing is safe and effective in adult KTR.
Ignace Bwana Kangulu*, Jules Ngwe Thaba Moyambe, Michel Kabamba Nzaji, Ange Assumani Kibibi, Alain Mbayo Kazadi, Elie Kilolo Ngoy Umba, John Ngoy Lumbule, Eric Kiwele Zongwe, Xavier Kinenkinda Kalume, Albert Mwembo Tambwe A'Nkoy and Jean Baptiste Kakoma
Published on: 28th July, 2023
Introduction: Every woman should receive quality antenatal care during pregnancy wherever she lives. We carried out this research with the objective of evaluating the quality of antenatal consultations (ANC) in terms of periodicity, screening, and prophylaxis interventions during antenatal consultations in Kamina and to identify the determinants associated with inadequate ANC. Material and methods: This was a descriptive and analytical cross-sectional study carried out in 6 health facilities in Kamina over a period of 17 months with 476 women who had given birth having attended antenatal consultations at least once. A scoring grid of periodicity standards, screening, and prophylactic interventions with a score of 40 was used to qualify the ANC as adequate. Logistic regression was performed to identify the determinants of inadequate ANC. Results: 40.3% of mothers had reached at least 4 antenatal visits (3.4±1.36); 21.2% had started the ANC no later than 16 weeks for an average age of 22.8 weeks ± 6.19. Overall, 72.5% of pregnant women had benefited from ANC qualified as inadequate. After adjustment, the determinants of inadequate ANC were multigestity (aOR=1.86[1.08-3.19]), low level of education of the mother (aOR=3.93; 95% CI=[2, 08-7.42]), and attendance at a first-level health facility (aOR=3.22; 95% CI=[2.06-5.05]. Conclusion: In the majority of cases, the ANC received by pregnant women in Kamina is inadequate. The determinants thus identified should serve the actors to direct the means to improve the quality of antenatal care in Kamina.
Georgina George Balyorugulu, Emmanuela Ambrose, Patrick S Ngoya, Yusuf S Jamnagerwalla, Iddi S Buri, Primrose Songoro and Protas D Komba
Published on: 28th July, 2023
Background: Stroke occurs in 11% of patients with SCA before 20 years of age. In Northwestern Tanzania, the prevalence of stroke among children living with SCA under the age 15 years is 16.9%, of which might be attributed to the absence of routine screening for the risk of stroke by using Transcranial Doppler Ultrasound (TCD). Screening with TCD allows preventive measures such as chronic blood transfusion to be done which has led to the reduction of stroke by 92%.Methods: This was a prospective analytical cross sectional study which enrolled 267 SCA children aged 2 to 16 years attending Bugando Medical Centre Pediatric Sickle Cell Clinic from July 2019 to June 2020. Assessment of factors associated with elevated TCD included a clinical history of stroke in sibling, death in sibling, temperature, oxygen saturation in room air, blood pressure, hemoglobin level and total white blood cell count. TCD was done by accessing transtemporal window and recording the highest time average mean of maximum velocity (TAMMV) of major vessels mainly, middle cerebral artery (MCA) and distal internal carotid artery (dICA).Results: The median age of enrolled was 6.6 (IQR: 4-9) years. The prevalence of elevated TCD (> 170 cm/s)was found to be 21% (56/267). By multivariate logistic regression, low oxygen saturation in room air, p - value = 0.037, OR 1.08 [95% CI 1.00-1.17] and low hemoglobin level, p - value = 0.001, OR 1.76 [95% CI 1.26-2.45] were statistically significantly associated with elevated TCD among children living with SCA.Conclusion: The high prevalence of elevated TCD velocity, with low hemoglobin and low oxygen saturation in room air as associated factors under multivariate logistic regression, warrants routine TCD screening for children with SCA aged 2 to 16 years.
Chronic infectious, granulomatous and suppurative dermatosis, classified among the subcutaneous mycoses, prevalent in tropical and subtropical regions and caused by the traumatic implantation of dematiaceous fungal species, where the presence of muriform bodies is an expression of the causal agent in the grafted tissue, are characteristic of chromoblastomycosis. Considered the second implantation mycosis in the world, it manifests itself with slow and progressive growth lesions of exophytic and verrucous plaques and black dots on the surface.The disease is considered a neglected and occupational disease, which occurs mainly among agricultural workers, coconut and babassu harvesters, lumberjacks, and traders of agricultural products. It is important to highlight that people at risk of contracting chromoblastomycosis work in tropical countries, where the temperature can be above 40 °C in summer, and generally refuse to wear protective equipment during the day (shoes, gloves, clothes, etc.), although they know that this type of prophylactic measure can prevent different types of diseases. These vulnerable people often live in low-income countries and sometimes live far from medical services and, once infected, do not seek medical attention. We report below an exuberant and unusual case due to multiple simultaneous inoculations on the back after the patient suffered an accidental fall while working on his farm. The diagnosis was established by direct mycological examination, histopathological examination, culture, microculture, and MALDI-TOF MS analysis that identified the agent of the Fonsecaea pedrosoi.
Laurence Fruteau de Lacos, Andréanne Blanchette, Kadija Perreault, Raoul Daoust, Jacques Lee, Jeffrey J Perry, Marcel Émond, Eddy Lang and Nathalie Veillette and Marie-Josée Sirois*
Published on: 1st August, 2023
Background: Around 75% of seniors seeking treatment for injuries in Emergency Departments (ED) are discharged home with minor injuries that put them at risk of functional decline in the following months. Objectives: To 1) describe seniors’ characteristics using or not physiotherapy services following ED visits for minor injuries and 2) examine their functional status according to physiotherapy use. Methods: Secondary data analyses of the Canadian Emergency Team Initiative cohort study. Participants were 65 years and older, discharged home after consulting EDs for minor injuries and assessed three times: ED, 3- and 6-months. Physiotherapy use was recorded as yes/no. Functional status was measured using the Older American Resources Scale (OARS). Multivariate linear regressions were used to examine change in OARS scores over time, accounting for confounders. Results: Among the 2169 participants, 565 (26%) received physiotherapy, and 1604 (74%) did not. Physiotherapy users were more likely females (71% vs. 64%), more educated, and less cognitively impaired. The overall change in OARS at 6 months was -0.31/28 points (95% CI: -0.55; -0.28) with no difference across groups after adjustment. Subgroup analyses among frail seniors showed that physiotherapy users maintained their function while non-users lost clinically significant function (-0.02 vs. -1.26/28 points, p = 0.03). Among the severely injured (Injury Severity Scale ≥ 5), physiotherapy users’ results were higher by almost 1/28 points (p = 0.03) compared to non-users. Conclusion: These results suggest that among seniors discharged home after consulting the ED for minor injuries, the frail and severely injured may benefit from being systematically referred to physiotherapy services.
FU Ukodei*, NK Nnamah, AJ Onuegbu, CE Onah and OB Ezenwa and AN Adimuo
Published on: 1st August, 2023
Background: Human Immunodeficiency Virus (HIV) and thyroid function have been described. Prevalence pattern and atherogenic status significantly differ from HIV-negative control in several studies. Unfortunately, few studies have determined the prevalence of thyroid function and lipids among Nigerians living with HIV. Objective: This study is to evaluate thyroid hormones and lipid profiles in HIV-positive subjects attending a faith-based health facility in Anambra State Nigeria.Materials and methods: The serum concentration of Thyroid Stimulating Hormone (TSH), free Triiodothyronine (fT3), triiodothyronine (T3), free Thyroxine (fT4), Thyroxine (T4), Total Cholesterol [TC], Triglyceride [TG], High-Density Lipoprotein [HDL], Low-Density Lipoprotein [LDL] and Very Low-Density Lipoprotein [VLDL] was determined in 95 HIV positive subjects which include 48 patients who were on HAART- group 1 and 47 not on HAART- group 2; and compared to 30 HIV negative controls – group 3. Results: The level of TSH and fT3 was significantly (p < 0.05) higher in group 1 participants than in group 2 and the group 3 participants. The level of T4 was significantly higher in group 2 than in group 1 and group 3 participants. The level of T3 was significantly lower in Control participants in comparison to both HAART and non-HAART participants. The prevalence of fT4 dysfunction across the groups was significantly different from each other. The total mean of Cholesterol (163.5 ± 22.7), Triglyceride (163.5 ± 22.7), and Very Low-Density Lipoprotein (14.2 ± 2.4) of the HIV-positive participants were significantly (p < 0.05) lower than that of the HIV negative participants.Conclusion: The results obtained from this study indicate that serum levels of thyroid hormones may be used as baseline periodic markers during antiretroviral therapy and many people living with HIV may benefit from supplementation if appropriate.
Lutfor Nessa*, Arjan Singh, Muhammad Waqar Sharif, Joud Enabi and Mamoun Bashir
Published on: 1st August, 2023
Objective: This case study presents a young female patient diagnosed with symptomatic electrolyte disturbances, later confirmed as Gitelman syndrome (GS). It highlights the underlying pathophysiology and emphasizes the importance of its proper management. Background: GS is a rare genetic disorder affecting kidney electrolyte reabsorption, leading to symptoms like weakness, muscle cramps, fatigue, nausea, and vomiting. Diagnosis involves lab tests and genetic confirmation, with treatment comprising electrolyte supplementation and medications. Ongoing management is vital to prevent complications. Case presentation: A 23-year-old Caucasian female presented to the ED with sudden weakness in all extremities, thirst, and lightheadedness. Lab results showed hyperglycemia 166 (70-100 mg/dL),severe hypokalemia 1.1 (3.6-5.1 mmol/L), mild hypercalcemia 11 (8.9-10.4 mg/dL), and severe hypophosphatemia 0.6 (2.3-7.0 mg/dL). Incidentally, she had prior hypokalemia history from a motor accident hospitalization and managed it with KCl for a year but stopped when symptoms improved. She was treated with electrolyte replacement and discharged with oral potassium. Five days later, she returned with severe hypokalemia 1.3, mild hypercalcemia 10.7, and severe hypophosphatemia 0.6. A 24-hour urinary test showed distal convoluted tubulopathy indicative of GS. She was treated with replacement therapy and spironolactone, with instructions for ongoing supplementation and follow-up with a nephrologist. Discussion: GS is mostly caused by mutations in the SLC12A3 gene, affecting the kidneys’ sodium chloride cotransporter function, as confirmed in our patient. Conclusion: While GS has no cure, appropriate treatment with medication and dietary adjustments can enhance patients’ quality of life by maintaining electrolyte balance. Healthcare providers’ awareness is crucial for effective care and complication prevention.
Introduction: Minimal change disease (MCD) is a common subtype of primary nephrotic syndrome in adults. The pathogenesis of MCD is still not well understood, but some studies suggest that MCD is a T cell-mediated disease related to podocyte dysfunction. Previous research has also indicated the crucial role of B cells in the pathogenesis of MCD. Rituximab (RTX) is a recombinant chimeric mouse/human antibody targeting CD20 antigen. In recent years, RTX has been increasingly used in adult MCD patients.Methodology: We searched the PubMed database using the keywords “Minimal change disease”, “Nephrotic syndrome”, and “Rituximab” and obtained a total of 140 articles. We will now provide a literature review based on these 140 articles, according to our research topic.Discussion: This article provides an overview of the mechanisms and clinical research progress of RTX in the treatment of adult MCD. We have also discussed the current treatment methods for MCD, exploring the potential of using RTX as a first-line therapy for refractory adult MCD.Conclusion: MCD is a common pathological type of nephrotic syndrome, and the exact mechanisms are still not fully understood. Although RTX as a treatment of adult MCD has shown promising clinical results in patients with refractory adult MCD, the safety and efficacy of RTX still lack high-quality clinical evidence. Further research is needed to explore the pathogenesis of MCD and the RTX treatment for MCD.
Adnan Yaqoob*, Rafat Jan and Salma Rattani and Santosh Kumar
Published on: 4th August, 2023
Introduction: Nursing theories are critical as they drive nursing education, practice, and research. Neuman Systems Model (NSM) considers a person a complete system with integrated psychological, physiological, spiritual, social, and developmental components. Nurses give their patients physical, emotional, and psychological assistance and are subjected to mental and physical pressure due to these responsibilities, impacting their health, psychological well-being, and interpersonal relationships. This paper aims to perform a concept analysis of stressors proposed in NSM about lines of defense and the level of preventive interventions that can affect a person’s well-being. Further, this paper discusses knowledge generation through NSM’s applicability to preventing exhaustion and burnout among nurses. Methodology: This theoretical attempt is carried out using the theory analysis approach suggested by Walker and Avant (2019).Discussion: Nursing is a career that requires a great deal of dedication and personal engagement. Nurses are subjected to recurrent stresses due to technological advances and rising demands. Burnout occurs when nurses get discouraged and have less compassion for the patients due to recurrent burdens. Stress and burnout are two of the most common reasons for nurses to quit hospitals. The NSM is concerned with stresses that may affect a person’s health and well-being (prediction). Nurses assist patients at the most vulnerable and challenging times, such as surgical procedures, traumas and personal and physical losses.Conclusion: The NSM enables the investigation of preventative and protective treatments. Because of the model’s flexibility, it may be used in a wide range of nursing situations. Administrative, hospitals, clinics, and other nurses can benefit from this paradigm. Evaluating the many distinct elements contributing to burnout is also feasible. The model’s client factors of physiological, sociocultural, developmental, and spiritual characteristics are used to achieve this. Viewing the individual as an open system that responds to environmental stimuli encourages the existence of stressors that might lead to burnout.
The present study focuses on students and teachers in Swedish Municipal Adult Education, in a project aimed at helping students with diagnoses within the neuropsychiatric spectrum. The project aimed to support students to complete their studies for further higher education. As this is an overlooked group of students research results provide insights into students’ views on the project and conclusions regarding the sustainability of school development. In this qualitative study, five teachers and four teachers were observed and in-depth interviewed. Data were analyzed through inductive content analysis. Authentic relations between students and teachers, signified by mutual trust, proved important. As the teachers themselves had originated the ideas guiding the project, the development work had good prior conditions for further sustainable development. We conclude that autonomous teachers, who set up joint goals and provide individualized support for these students, enable academic success when flexibility, relations, and self-esteem characterize the work.
Mahin Eslami Shahrbabaki, Roya Pooyanfard* and Mohammadamin Abdi*
Published on: 24th August, 2023
Background: Goldenhar syndrome is a congenital condition primarily affecting eye, ear, and spine development. In some cases, it can also impact the heart, lungs, kidneys, and central nervous system. The exact cause of Goldenhar syndrome is not fully understood, and its incidence is estimated to range from 1 in 3500 to 1 in 5600 live births. While intellectual disability is associated with the condition, no established link exists between Goldenhar syndrome and psychiatric disorders.Case presentation: In the presented case, a patient with Goldenhar syndrome has been diagnosed with an episode of mania with psychotic features in the context of bipolar disorder. The patient had no history of prior mental disorders and had an independent life.Discussion: There are few case reports of Goldenhar syndrome patients with mental disorders. In all instances, including our own case, patients exhibited psychotic features during psychiatric examinations.Conclusion: Based on the studies cited and our own research, it is recommended to further investigate the potential association between this syndrome and psychiatric disorders.The following sections provide details on the examination, medical history, and treatment of this patient.
Mohammad Yousaf*, Rita Ramos and Rehmatullah Inzar Gull
Published on: 17th August, 2023
Background: Breast Cancer is the most common cancer in women and the quality of life of women with breast cancer is a significant healthcare issue specifically in developing and underdeveloped countries.Globally quality of Life (QoL) has become an important indicator to measure the outcomes of medical and nursing interventions. The QoL studies have an imperative role in healthcare especially in chronic disease as the latest diagnostic and treatment modalities have increased the survival rates and duration of cancer patients. Similarly, breast cancer itself and its treatment with Chemotherapy, in particular, has many complications and negative impacts on the QoL of cancer women. Aim: The aim of this study was to assess the QoL of Pakistani women with Breast Cancer patients undergoing chemotherapy and the relationship of QoL with socio-demographic variables.Methodology: A descriptive cross-sectional correlational study was conducted on 110 female breast cancer patients undergoing chemotherapy. FACIT-B questionnaire was used to assess the quality of life of these patients. Statistical analysis was done by using SPSS version 20 using the Pearson correlation coefficient, Chi-square test, and Spearman’s rho correlation coefficient. Results: The mean age of participants was (mean ± SD) 42.98 ± 8.98. A significant negative correlation was observed with age and QoL, r = -0.218, p - value 0.022. No significant association was observed between QoL and marital status; education status; and socioeconomic status.Conclusion: The majority of breast cancer women 59(53.6%) had moderate QoL and Chemotherapy also showed moderate impacts on different domains: physical, functional emotional, social, and sexual well-being of the women.
COVID vaccination has been associated with serious disorders including thrombosis with thrombocytopenia syndrome (TTS), Guillain-Barré syndrome (GBS), and myocarditis. GBS has been reported in adults following COVID-19 infection and rarely following the COVID-19 vaccination. Post COVID vaccination GBS has been associated with prominent and early facial diplegia and quadriplegia. Extension of the COVID vaccination program to the pediatric age group of 5 to 17 years has exposed this population to the adverse effects of the vaccination. Only a few case reports of post-vaccination GBS have been reported in the pediatric age group without any data on the true prevalence. We report a case of a male in his early adolescence with GBS presenting as facial diplegia and rapid quadriplegia following the BECOV2D, (Corbevax) vaccination. Our case is the first case of GBS reported following BECOV2D, (Corbevax) vaccination and highlights the presentation with prominent and early diplegia, which is similar to the presentation in adults.
MZ Hossain, MUH Musfika, N Arobi, T Siddiqua, HM Jamilc, AKM Moinul Haque Meaze and Md Shakilur Rahman*
Published on: 8th August, 2023
A critical component of the radiation regimen for treating cancer patients is the precise dose delivery to the treatment organ while minimizing the dose to the healthy tissue. This study aims to evaluate in-field organ dose and dose distribution outside the target organs to estimate the excess lifetime risk of second cancer. The study was carried out with a male Alderson Rando Phantom. 20 sets of thermoluminescence dosimeters (MTS-100) were used in this study. The in-field organs absorbed dose was measured by inserting TLDs at different geometrical depths of the left lung, right lung, and stomach, and for peripheral organs skin dose TLDs were placed at the surface of the corresponding organs. Target organs were irradiated at 100 cGy and 200 cGy by a 60Co teletherapy unit, and irradiated TLDs were read out by a RE-2000 TLD reader. For precise dose delivery to the cancerous organs by 60Co teletherapy, the depth dose correction factor for lung cancer treatment is 0.8667 ± 0.01, and for the stomach is 0.7856 ± 0.017. In the case of the treatment for the lung and stomach, the closest organs received significant doses compared to the other distant organs. Thus, the risk of second cancer due to the peripheral dose is obtained. The stomach is at the highest risk when the lung is the target and the liver is at the highest risk when the stomach is the targeted organ.
Background: Early childhood caries may develop as soon as teeth erupt. Promoting oral health care programs is very important and helps to reduce dental caries in young children. The aim of this study was to assess the infant/child oral health (IOH) related knowledge, attitudes, and practices (KAP) of parents in Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional descriptive study was conducted among 327 parents. Visiting the family medicine center at prince sultan military medical city, Riyadh Saudi Arabia. A 39-item questionnaire covering socio-demographic characteristics and questions pertaining to KAP regarding OH care will be used to collect the data. Descriptive statistics, Student’s t-test, one-way analysis of variance, and Scheffe’s test will use for the statistical analysis (p ≤ 0.05). Results: The result showed that the majority of the parents had good knowledge regarding OH, knowledge of cleaning (92.4.%), and knowledge of the amount of sugar (88.1.%). the parent’s age group (30 to 39) years (n =147) reported the highest mean (knowledge, attitudes, and practice) scores among all other age groups with a knowledge mean score of (6.80 ± 1.73), an attitude mean score of (8.86 ± 1.37), and a practice mean score of (5.14 ± 1.86). Female parents showed significantly higher mean knowledge, attitude, and practice scores than male parents. In addition, the middle-income level parents’ group (n = 295) reported higher knowledge mean score compared to the low-income parents’ group (n = 15) with a mean difference of d = 1.15, p = .041. Conclusion: Parents’ knowledge about maintaining oral and dental health care for infants/children was inadequate. Essentially, medical professionals are the initial ones to interact with expecting and new moms. Therefore, need to raise parents’ awareness about oral and dental health for infants/children, through the development and implementation of long-term education and promotions programs.
Laleye Flora Tinouade Founmilayo* and Fanou Fogny Nadia and Kayode Polycarpe
Published on: 10th August, 2023
In developing countries, malnutrition represents a public health problem, which affects many children under five, during their complementary feeding period. One way to overcome this problem is through the supplementation of complementary flours with locally available food resources, such as Moringa oleifera leaf (MOL). An experimental study was conducted from June through November 2019 in the southern-Benin, with moderately acutely malnourished (MAM) children, using a porridge made of a mixture of corn, malted sorghum, soybean, peanut, milk, and moringa leaf powder. A total of 150 MAM children aged 12-59 months were recruited and divided into two groups, an intervention group (48) and a control group (75). The intervention group received the test food, a porridge made of maize flour supplemented with Moringa oleifera leaf flour (MOL-flour), at least 5 times/week for 6 months. The control group, whose mothers received nutritional education sessions on food diversification as well as the different ways of preparing MOL meals. Sensory evaluation, anthropometric and dietary diversity data were collected. Z-scores Weight/Height, Weight/Age et Height/Age were determined before and right after the intervention. Results showed that 70% of the children and more than 75% of the mothers assessed the porridge as palatable. A significant average weight gain of 1.720 g (p < 0.005) was observed in the intervention group at the end of the experimentation, with a reduction of the prevalence of underweight by 1,33% (p > 0.05), and the number of acute Malnutrition children by 10,42% (p < 0.005).
Background: This retrospective study examines the importance of preoperative cardiology consultations in optimizing patient care and anesthesia surgical perioperative management.Methods: The study includes 7,756 patients from the Department of Anesthesiology at Mohammed V Military Teaching Hospital. Out of these, 122 patients were referred to cardiology consultations. Demographics, surgical specialties, reasons for referral, diagnostic tests, and interventions were analyzed.Results: Referred patients (average age 61.45 years) were mainly over 65 years old, with 59.01% being male. Common surgical specialties seeking consultations were abdominal surgery (30.327%), orthopedic surgery (26.230%), and urological surgery (19.672%). Hypertension, dyslipidemia, and diabetes were prevalent risk factors. Most patients were classified as ASA II (50%) or ASA III (27.04%), with NYHA I (61.5%) or NYHA II (31.2%) classifications. Referrals were due to ECG abnormalities (41.0%), routine evaluation (19.7%), and history of myocardial infarction or previous coronary angiography (39.3%).Discussion: Preoperative cardiology consultations accounted for 1.57% of all pre-anesthesia clinic patients. They were vital in assessing and managing cardiovascular risks, consistent with previous studies. The impact of these consultations was evident in optimizing patient management through treatment plan adjustments and interventions.Conclusion: Preoperative cardiology consultations play a crucial role in identifying and managing cardiovascular risks, contributing significantly to patient care and improving perioperative management. Further research should evaluate long-term outcomes and cost-effectiveness across different patient populations.
Ethnomedicine, synonymous with traditional medicine, is a crucial healthcare system practiced by various ethnic groups worldwide, especially among those with limited access to modern Western medicine. This study explores the rich bio-cultural diversity of the North Central Western Ghats in Karnataka, India, which harbors diverse ethnomedicinal practices. The region's tropical forests are home to an extensive array of plant species, with over 600 endemic to southern India and 95 exclusively endemic to Karnataka. The research focuses on documenting and analyzing the traditional knowledge of local communities regarding the use of plants for treating various human diseases. However, this task presents significant challenges and requires collaborative efforts from the government, NGOs, and Herbal Drug Companies. Over the last decade, ethnomedicinal studies have seen a rise, but there is still limited understanding of ethnomedicine's role in the traditional healthcare system in India. The forests of North Central Western Ghats, including Agumbe, Arbail Ghat, Chorla Betta, and others, exhibit a combination of deciduous and evergreen vegetation. These forests hold a variety of medicinal plants, adding to the region's bio-cultural richness. Scientific validation of the locally used ethnomedicinal plants further supports the development of herbal drug formulations with the support of the Ministry of Ayush, enabling the conservation and sustainable utilization of threatened and endangered species. The study emphasizes the importance of preserving traditional healers' knowledge and promoting collaboration for the preservation of ethnomedicinal practices in the region.
Brf1 (TFIIB-related factor 1) is a transcription factor, which specifically modulates the transcription of RNA polymerase III-dependent genes (RNA Pol III genes), such as tRNAs and 5S rRNA. The products of tRNAs and 5S rRNA transcription will be changed with the alteration of Brf1 expression. Whereas deregulation of Brf1 and RNA Pol III genes are tightly associated with cell proliferation and transformation, and tumorigenesis. In recent years, emerging studies indicate that Brf1 expression is increased in patients with cancers. In this review, we summarize the progress of the abnormal expression of Brf1 in different human cancers to explore an underlying mechanism and its clinical implication, as well as to prompt its application prospect. With the depth of the Brf1 study and the progress of biotechnology, the status of Brf1 expression may be used as a universal indicator of the early detection and prognosis observation of human cancers.
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