Most Viewed Articles

Background: Nutritional awareness among caregivers plays a crucial role in ensuring optimal pediatric health and development. This study assesses the level of nutritional awareness among caregivers and examines its association with demographic factors.Objectives: This study aimed to assess the knowledge and awareness of caregivers regarding dietary advice and complementary feeding for children under five years at Wad-Albasheir Family Health Center, Um-Bada locality.Methods: A cross-sectional study was conducted among caregivers in selected healthcare facilities. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics and chi-square tests were used to evaluate associations between variables.Results: The majority of caregivers demonstrated moderate awareness (60%), while 22.5% had low awareness and 17.5% had high awareness. A significant association was observed between education level and awareness (p < 0.05). Employment status also influenced awareness levels, with employed caregivers showing higher knowledge scores.Conclusion: Nutritional awareness is a key determinant of pediatric health. Strengthening educational programs targeting caregivers can improve child nutrition outcomes.

Gilbert’s Syndrome (GS) is a hereditary disease that can cause hyperbilirubinemia due to a mutation in the promoter of the UGT1A1 gene, which causes a decrease in uridine diphosphate glucuronyltransferase enzyme activity. Polymorphisms in the UGT1A1 gene are associated with induced hyperbilirubinemia by Tyrosine Kinase Inhibitors (TKI) in Chronic Myeloid Leukemia (CML). We report a case of patient who developed hepatotoxicity when treated on Imatinib and subsequently diagnosed with Gilbert’s syndrome. Eight months after initiating Imatinib, the patient developed conjunctival jaundice and signs of hepatotoxicity with increase in liver enzymes and hyperbilirubinemia with elevated level of unconjugated bilirubin. Gilbert’s syndrome was suspected in the presence of predominantly unconjugated hyperbilirubinemia and a prior history of transient episodes of jaundice. Genetic testing revealed homozygosity for the UGT1A1 TA7 (*28) polymorphism. Imatinib was stopped due to continuous increase of aminotransferases and hyperbilirubinemia and restarted after improvement of Liver Function Tests (LFTs) with a reduced dose of 200 mg/day but LFTs worsted again, and the patient was switched to Dasatinib 100 mg/day, without hepatic cytolysis and a mild persistent hyperbilirubinemia after a follow up of 20 months.Patients with an unexplained rise in serum bilirubin levels on Imatinib therapy should be screened for the genetic UGT1A1 polymorphisms.

Iin 2015 we obtained non-hermitian extensions of Heisenberg type and Schrödinger type uncertainty relations for generalized metric adjusted skew information or generalized metric adjusted correlation measure and gave the results of Dou-Du in 2013 and 2014 as corollaries. In this paper, we define generalized quasi-metric adjusted Q skew information for different two generalized states and obtain corresponding uncertainty relation. The result is applied to the inequalities related to fidelity and trace distance for different two generalized states which were given by Audenaert, et al. in 2009 and 2008; and Powers-Strmer in 1970. 2010 Mathematics Subject Classification: 15A45, 47A63, 94A17.

Introduction: Menarche, the onset of a girl's first menstrual cycle, often introduces menstrual taboos in certain eastern cultures. These taboos may manifest as social isolation, dietary restrictions, and exclusion from religious spaces, which can adversely affect health and promote gender inequality.Case history: A 10-year-old girl developed gastroenteritis while in cultural confinement after reaching menarche. Her parents strictly adhered to traditional customs that limited her interactions with the outside world and deprived her of healthy foods. They believed that her fatigue was a result of hormonal changes associated with menarche. Although her condition worsened over four days, they did not seek medical treatment. The child succumbed upon admission. The autopsy revealed extensive cyanosis in the left hand due to multiple thrombotic occlusions of the brachial vein. Microscopic examination confirmed the presence of brachial venous thrombi. The cause of death was determined to be Multiple Organ Dysfunction Syndrome (MODS) as a consequence of hypovolemic shock.Discussion: Key medico-legal issues in this case include parental negligence and failure to provide medical care under Section 308A of the Penal Code, potentially leading to criminal liability for negligence-related death under Section 298. Violations of the child's rights, protected by the Children and Young Persons Ordinance (CYPO) and the Protection of Children's Rights Act, form the legal framework for child protection in Sri Lanka. The ISD has interviewed family members and collected witness statements from neighbors and teachers, referring the case to the police for further investigation and notifying the National Child Protection Authority for an additional inquiry. Additionally, Sri Lanka is a signatory to the United Nations Convention on the Rights of the Child (UNCRC), which guarantees children's fundamental rights.

Introduction: Flow analysis in the apical view of transthoracic echocardiography is validated to assess fluid responsiveness at the bedside. Still, it is not always reachable, especially in mechanically ventilated patients and during surgery. We compared it to supra-sternal and sub-xiphoid views to evaluate their validity in assessing fluid responsiveness in critically ill patients.Method: A cross-sectional prospective monocentric pilot study of three months duration has been led in the critical care unit for surgical emergencies of Ibn Sina University Hospital of Rabat (Morocco). We used the time-velocity index (VTI) and peak velocity variation (∆Vpeak) values correlation between the three acoustic windows as the main judgment criteria. Measurement of data was made in the Left Ventricle Outflow Tract (LVOT) in the 5-chamber apical view, Descending Thoracic Aorta (DTA) in the supra-sternal view, and Right Ventricle Outflow Tract (RVOT) in the sub-xiphoid view.Results: There were 14 adult patients involved in the study, and the data presented are preliminary results. There was no significant difference in VTI and ∆Vpeak values between the three acoustic windows at each time of the study protocol, with a very high correlation for initial VTI value between 5-chamber apical view and supra-sternal view (r = 0.96, p < 0.001), and sub-xiphoid view (r = 0.86, p < 0.001). A very high correlation of initial ∆Vpeak value was also observed between the 5-chamber apical view and supra-sternal view (rho = 0.89, p < 0.001) and sub-xiphoid view (rho = 0.79, p < 0.001).Discussion: Supra-sternal and sub-xiphoid views showed high potential to predict fluid responsiveness, but further data are needed to validate their use for this purpose in ICU and in operating room.

Purpose: American expert consensus publications recommend discontinuation of antiplatelet agents 6 to 12 months after Percutaneous Coronary Intervention (PCI) in patients with Atrial Fibrillation (AF) who require chronic anticoagulation, and use of oral anticoagulant monotherapy thereafter. This study aimed to assess real-world long-term antithrombotic therapy management practices and factors associated with the continuation of antiplatelet agents past 12 months post-PCI in patients with AF requiring chronic anticoagulation. Methods: Patients with AF and a history of PCI greater than 12 months before their most recent encounter with physicians at an outpatient electrophysiology clinic were identified by chart review. Patient demographics, clinical characteristics, and current antithrombotic regimen were collected from encounters that occurred between July 2019 and June 2022. The independent predictive factors associated with the continuation of antiplatelet agents were identified using univariate and regression analyses. Results: Out of 66 patients, 67% continued antiplatelet therapy for greater than 12 months post-PCI. Patients on antiplatelets were significantly less likely to have bare metal stents (p = 0.006), be greater than five years post-PCI (p = 0.002), and have a HASBLED score of two or less (p = 0.028) when compared to patients on oral anticoagulant monotherapy. Bare metal stent history (p = 0.045) and HASBLED score of two or less (p = 0.016) were also significant in regression analysis.Conclusion: This study found that most patients with AF and a history of PCI continued antiplatelet therapy longer than 12 months post-PCI, often despite the high bleeding risk.

A 24-year-old male presented with epistaxis and gingival bleeding, physical examination revealed pallor and purpuric spots on the left upper limb. Laboratory findings showed pancytopenia. As part of the etiological workup for pancytopenia, a bone marrow aspirate was performed, revealing moderately cellular marrow with rare megakaryocytes and intranuclear inclusions in proerythroblasts. Parvovirus B19 testing in the bone marrow was conducted via nucleic acid extraction followed by PCR.

Custard apple is a tropical fruit that is cultivated all over India. The seeds of this fruit are found to have medicinal properties as they contain active compounds such as alkaloids, cyclohexapeptides, and acetogenins. It has been used in powdered form for the treatment of scalp lice and dandruff in our part of the world as a native medicine for a long time. We report a case of bilateral severe toxic keratoconjunctivitis following accidental exposure to custard apple seed powder.

This article examines the relationship between Premenstrual Dysphoric Disorder (PMDD), neurovascular dynamics, and sensory sensitivities in autistic women during menstruation. The redirection of blood flow to the uterus during the menstrual cycle has been found to exacerbate cerebral perfusion deficits in neurodivergent individuals, particularly in the Prefrontal Cortex (PFC), which contributes to the mood dysregulation and emotional instability characteristic of PMDD. Autistic women, who often exhibit heightened sensory sensitivities, experience intensified discomfort during menstruation, as sensory overload and altered pain perception compound the emotional challenges of PMDD. These findings emphasize the need for neurodivergent-friendly menstrual products that mitigate both physical and emotional discomfort. Additionally, innovations using biodegradable materials, smart fabrics, and custom-fit menstrual solutions are discussed as potential breakthroughs to improve the quality of life for autistic women managing PMDD. This research highlights the importance of addressing both neurobiological and sensory aspects when designing interventions for PMDD in neurodivergent populations.