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Background: Cerebral visual impairment (CVI) is a bilateral visual impairment that affects children in all industrialized countries. It has become more common in low-income countries as a result of the increased survival rates of children who suffer from severe neurological conditions during the perinatal period. The purpose of this study was to determine the characteristics of children with CVI in a tertiary children’s eye care center population.Methods: From October 2020 to September 2021, a cross-sectional study was conducted to select all consecutive patients with a diagnosis of cerebral visual impairment aged 6 months to 16 years. On the neurological deficit, information was gathered from the patient’s referral: parental interviews, observations, and direct assessment were used for functional vision characteristics, and an ophthalmic examination was performed for eye findings. The interviewees’ responses were matched to the ten specific behavioral characteristics shared by children with CVI. Cortical visual impairment was diagnosed using three criteria: [the vision loss is not explained by abnormalities found on the eye examination, a neurological medical diagnosis, and the child exhibits one of the unique visual and behavioral characteristics described by Roman Lantz]. A descriptive statistical analysis (frequency, mean, and range) was calculated. Results: Forty children with CVI (1.96% of total children) were seen. The mean age was 2.56 ( 1.98) years. There were 24 (60%) males. On a referral paper of 28, hypoxic-ischemic encephalopathy was the commonest cause mentioned (70.0%). Seizures were the most frequent neurological deficit at presentation. Ophthalmic and neurologic impairments were found in 42.5% of children with CVI. Based on Roman-Lantzy’s three phases of the CVI Range, 90% of children with CVI at the test time had Phase I or Phase II vision.Conclusion: According to the findings of this study, visual impairment is critical in the diagnosis of CVI. The prevalence of CVI as a cause of childhood vision impairment is significant. Hypoxic-ischemic encephalopathy is the most common cause of CVI. All children with CVI have serious neurological issues, and the majority have associated ophthalmic abnormalities.

The Meckel’s diverticulum (MD) is the most common anomaly of ductus omphaloentericus that surgeon encounters in clinical practice. The accurate incidence is unknown because most patients with the Meckel’s diverticulum are asymptomatic. Most studies report an incidence of about 2%. Approximately 4% of patients with the Meckel’s diverticulum become symptomatic. A 10 years old boy, was sent from regional hospital. His symptoms started the day before he was hospitalized and represented as gastrointestinal bleeding, lower abdominal pain and four times vomiting, without fever. Ultrasound and X-ray of the abdomen were normal. Blood findings showed: RBC 3,19, hemoglobin 0,95, hematocrit 0,27. During a physical examination abdomen was palpatory soft, with no presence of the pain. Digital rectal examination showed blood. A scintigraphy pathologic scan showed a focal lesion of the right hemi abdomen consistent with the Meckel’s diverticulum.Patient was treated byLaparoscopic-Assisted Transumbilical Extracorporeal Resection of the Meckel’s Diverticulum.

Background: Due to variations in hospital protocols and personnel availability, individuals with myocardial infarction admitted on the weekend may be less likely to receive invasive procedures, or may receive them with a greater latency than those admitted during the week. Whether or not this occurs, and translates into a difference in outcomes is not established. Method: Using the Nationwide Inpatient Sample (2008-2011) database, we identified all patients admitted with a principle diagnosis of acute myocardial infarction. They were stratified by weekend or weekday admission. Baseline clinical characteristics, procedure utilization and latency to procedure were compared, and logistic regression models were constructed to assess the relationship between these variables and in-hospital mortality. Results: Patient demographics and provider-related characteristics (hospital type, geography) were similar between weekend and weekday admission for myocardial infarction. Adjusted for covariates, we found that the odds of mortality for a weekend admission are 5% greater than for a weekday admission (OR: 1.05; 95% CI: 1.01, 1.09, p=0.009). For the utilization of an invasive procedure, we found that the odds of receiving a procedure for a weekend admission were 12% less than the odds for a weekday admission, adjusted for the other covariates (OR: 0.88; 95% CI: 0.86, 0.91, p<0.001). In addition, we found that the time to procedure was an average of 0.18 days (4.32 hours) longer for weekend admissions compared to weekday admissions (95% CI: 0.16, 0.20, p<0.001). However, we did not observe a significant difference in the overall length of stay for weekend and weekday admissions (0.004 days; 95% CI: -0.04, 0.05, p=0.87). Conclusion: In a large and diverse subset of patients admitted with myocardial infarction, weekend admission was associated with fewer procedures, increased latency to those procedures, and a non-significant trend towards greater in adjusted in-hospital mortality.

This research centered on the transition from sustainability to the post-COVID-19 era, significantly altered and transformed cities, city plans, and housing models holistically approach. Although the academic world concentrating on sustainable urban and housing design since the 1990s, the pandemic has emerged as a critical paradigm shift in context since 2019. During the COVID-19 period the Paris city 15 minutes concept, first introduced by Paris Mayor A. Hidalgo initially sparked controversy as temporary now considered permanent in Paris recently, Oxford. In the post-pandemic era, sustainability has become significant on the global agenda, shaping cities, city models, and residences through profound and radical changes. Some efforts are supported by Climate-change conferences in the world and subsequently some determinations like the Paris Agreement and UN declarations that guide more livable environments and houses. Due to COVID-19 the newly emerged conditions and compulsory changes that have taken place in the cities the social isolation, distance living, and remote working led to radical changes in the living style, environment, city plans, housing models, and typologies holistically. Although many publications have been published in the last few years about the pandemic and the Paris City 15 minutes concept, they only address the city and urban scale solutions. There is no research with a holistic approach that relates the subject from the urban scale to the architectural scale, housing, and blocks. Within the 15-minute concept, searched, developed, innovative, and sustainable urban and housing-oriented suggestions for cities in the future are presented at the end of the research. In conclusion, it is revealed that the issue of sustainability has gained importance with an increasing momentum in the world agenda, witnessed the radical changes in cities and residences, in the post-COVID-19 period in the last 2-3 years.

Stress in acute stroke may increase mortality and complications, but there is a paucity of information on the efficacy of beta blockers  over other anti-hypertensive. To report efficacy of metoprolol over amlodipine in reducing mortality, disability and infections in acute stroke. CT/MRI confirmed stroke patients within 3 days of onset were included whose age was 18 to 75 years. Patients with secondary intracerebral hemorrhage, organ failure, pregnancy, malignancy, and immunosuppressant or on beta-blocker/amlodipine were excluded. Stroke risk factors, Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score and CT/MRI findings were noted. Patients with a blood pressure of > 160/90 mm of Hg were randomized using 1:1 randomization to metoprolol (25 mg on day 1, 50 mg if BP is not controlled) or amlodipine (2.5 mg on day 1, then 5 mg then 10 mg on, subsequent days if BP is not controlled). Other standard treatment was continued. The primary outcome was mortality at 1 month; secondary outcomes included  were in-hospital gastrointestinal hemorrhage, pneumonia, sepsis and 3 months functional outcome based on modified Rankin Scale (mRS). Side effects were noted. 18 (14.4%) patients died; 6 (9.7%) in metoprolol and 12 (19%) in amlodipine (p = 0.20) group. At 3-months, 66 patients had good outcome; 45 (80.4%) in metoprolol and 21 (43.3%) in amlodipine group (p < 0.001). The other secondary outcomes were comparable between the two groups. Metoprolol was withdrawn in 6 patients due to bradycardia, and amlodipine in 5 due to hypotension and in 1 due to allergic reaction. Metoprolol is associated with improved functional outcomes in acute stroke  compared to amlodipine.

Successful implant restoration is depending on an adequate surgical and prosthetic protocol. In the last few years an increase in Peri-Implantitis has been attributed, in part, to the excess cement left around the implant collar and threads, leading in many cases to bone loss and even the complete failure of the implant treatment [1-5]. This article will attempt: 1. To describe a proper cementation protocol for cement-retained implant restorations to reduce cement induced implant failures, and 2. To review the alternative implant restorative options to cement-retained crowns such as screw-retained restorations, screwless and cementless implant restorations, screw-retained-cemented implant crown, angulated screw channel restorations, the lingual locking screw-retained restorations and the multi-unit abutment restorations.

The study is based on the characterization of different AI models applied in the public furniture design analyzing the conditions of risk, materiality, and integration of variables in two AI generative modeling algorithms. As risky since they contain flood-prone areas, low vegetation coverage, and underdevelopment of infrastructure; therefore, these characterizations are tested through artificial simulation. The experimental method is applied through laboratory tests of various material components and their structuring in 3D simulators to check their resistance and risk scenarios. The case study of one of the most risky and populated areas of the informal settlement area of the Northwest of Guayaquil, such as the Coop, is analyzed. Sergio Toral is the focal point for on-site testing. It is concluded that the generation of a planned scheme of ecological furniture with different materials responds more effectively to the territory and that through artificial simulation an advantage can be obtained in terms of execution time and results, thus demonstrating that artificial intelligence is an ideal tool. To generate furniture design proposals that are more diverse, innovative, and functional with the environment, but it generates a minimum level of error for specific designs in the experimental model_01 of 0.1% to 3% and a high level in the experimental model_02 with an increasing error from 20% to 70%. As a future line of research, it is proposed to generate a simulated system of all the new informal settlements in Guayaquil and establish focal points for the implementation of new ecological furniture.

Introduction: The tracheobronchial injuries are usually fatal and some of the lucky people can reach emergency services without dying in the place of trauma. They can cause severe symptoms which can be lifetreathing. This type of injuries must been taken carefully and need to decide fast what treatment you going to give. Case report: We present a 53 years old patient who has been stabbed during a fight and got his trachea ruptured. His complaints shortness of breath and neck swelling. He can be treated conservatively with bronchoscopic and clinical evaluation. Discussion: Tracheobronchial injuries are life-threatening and the airway must be secured first. They can be treated conservatively in some cases. CT can be useful but fiberoptic bronchoscopy is the key in diagnosis. Conclusion: Although early treatment of tracheal lacerations is urgent surgery, it is reported that these injuries can be treated with conservative methods under appropriate conditions.

The basic aim of the present study was to relate tooth decay with the pH of the urine. pH is very important aspect which affects and depends upon the urine specificity. The glomerulus is a necessary part in the structure of kidney. The glomerulus is involved in the filtration of blood, which is involved in acidification with the help of kidneys. A cavity or hole is formed within the tooth and it can leads towards tooth decay. Cavity in its structure is so small when it is at its starting point but with the passage of time cavity becomes large in between of the teeth and it can be a main reason to the complex diseases. A total of 100 students get participated in this study from Bahauddin Zakariya University Multan, Pakistan. In this subjects went into the lab with their urine samples taking in the urine collection bag. In this a strip is used to find the values pH. Strip is placed in the urine collection bag for a minute. Then we noted the different values of different subjects. We designed a research project based upon the results that depend upon either there was any relation among tooth decay and pH. The aim of the project was either there is any relation among the tooth decay and urine pH. It was concluded that there was no any kind of relation among urine pH and tooth decay.

We described a case of specific (tuberculous) encephalitis in a patient after kidney transplantation. Immunosuppressive therapy, continuously required in post-tranplant period, may cause various complications, such as infections. Specific meningoencephalitis is an infection that is rarely diagnosed and more common in immunocompromised patients. Case report: A 30-year-old man had kidney transplantation (kidney donor was his father). He previously was two years on chronic hemodialysis treatment because of end-stagerenal disease based on diabetic nephropathy. He has diabetes type 1. The early post-transplant period duly passed with satisfactory clinical and laboratory parameters of renal function. Two months after transplantation, he presented with febrile condition, signs of septicemia and dehydration with significant neurological deficit and expressed meningeal signs. In cerebrospinal fluid we found lymphocytosis, elevated proteins and positive micobacterium tuberculosis antibodies (Hexagon method) and we suspected to specific etiology of meningitis. Performed computed tomography (CT) scan of the brain with contrast confirmed the expected finding. Due to the poor prognosis of infections of the central nervous system (CNS) in immunocompromised patients, only prompt diagnosis can improve survival in this group of patients. The therapeutic protocol after kidney transplantation include the prophylactic use of antituberculous drug (Isoniazid 300 mg) during the 9 months.