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Introduction: Severe cases of COVID-19 presented a high incidence of multi-organ dysfunction syndrome (MODS) during their evolution. This was attributed to a theoretical cytokine storm, where microcirculatory disorders would play a fundamental role, causing these patients to present a sepsis-like pattern as observed in sublingual microcirculation studies. The evidence in this regard is controversial. The Peripheral Perfusion Index is a reliable method to continuously and non-invasively assess the microcirculatory bed, which assesses the pulsatile (PPI) component of the plethysmographic pulse curve.Methods: We conducted a prospective observational study to evaluate the behavior of the PPI in patients with severe respiratory failure due to SARS-CoV-2 and its association with SDOM.Results: We evaluated 60 patients with APACHE II 14.6 ± 4.4 and SOFA 4.7 ± 2.1. 55% of the patients presented SDOM. Perfusion monitoring showed IP values of 5.32 ± 1.87 that were associated with normal lactate levels of 1.49 mmol/L (min 0.89/ max 2.20 mmol/L). The PPI values between the living and the dead did not show a significant difference (p = 0.854) or the presence of SDOM.The PPI values between the patients who presented renal failure, hemodynamics, or perfusion disorders were determined by the presence of hyperlactatemia, and for those who did not present these characteristics, no statistical difference was found; neither when stratified by PaFiO2 ratio. Mortality was 55%.Conclusion: In our series of patients with severe pneumonia due to COVID-19, we found high PPI values, which would correspond to a pattern of capillary recruitment, and the associated organ injury could not be substantiated by this phenomenon.

Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy(Idiopathic neuropathy, now designated as chronic idiopathic axonal polyneuropathy (CIAP).There are three kinds of nerves within the PNS. Sensory nerves relay messages from the sense organs to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time. Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.We report a case of idiopathic polyneuropathy presented with frequent acute pulmonary edema for a year.

The finite element method (FEM) is an engineering resource used to predict the stresses in structures that have complex geometries, specific material properties and are subject to complex loading patterns, being widely used in medical and biological research. It has the advantage of being a noninvasive and accurate method, which provides quantitative and detailed data about the physiological reactions that can occur in the tissues [1-5].

Aim and methodology: This article describes a periodontally compromised, hopeless incisor tooth that was purposefully replanted, along with the results after six months. This entails the deliberate removal of the tooth and its subsequent correct manipulation and endodontic restoration before reinserting it into the socket.Results: Hopeless lower incisors with periodontal involvement were transplanted utilizing an implant surgical drilling approach after receiving root canal therapy and tetracycline-HCI conditioning. Bone graft material was added and the procedure was monitored for six months. The tooth was observed to be asymptomatic, functioning normally, and showing no pathologic radiological changes. With minimal bleeding during probing and no growth of pathological pockets, the periodontal condition was within normal limits. Alveolar bone support was seen to be adequate. The results may suggest that, in some circumstances, purposeful replantation is a viable strategy of treatment for maintaining native dentition.Conclusion: Intentional tooth reimplantation can be an alternative treatment option for periodontally involved teeth with poor or hopeless prognoses.

Background: The socioeconomic impact of drug and substance abuse on secondary school students in Nigeria is yet to be fully evaluated even in the face of the current surge in abuse of substances among the younger folks who constitute more than half of the entire population.Objective: This study narratively reviewed the studies on the socioeconomic impacts of drug and substance abuse on secondary school students and studies by researchers in Nigeria. Methods: The study was a narrative review of the literature covering the socioeconomic impacts of drug and substance abuse on secondary school students in Nigeria from 1980 to 2023. Data were extracted and summarized with descriptive statistics. Results: All the studies took place between 2012 and 2023; 6 (100%). The studies carried out were all observational studies 6 (100%). All the studies fell below average in the benchmark for the hierarchy of evidence-based studies. The studies mostly took place in the South-West 3 (50.00%), while 1 (16.67%) took place in the South-East, North-West, and North-Central respective regions of Nigeria.Conclusion: The available studies done on the impacts of drug and substance abuse focused more on the social impacts, with little or no attention to the economic effect. The available studies however remain at the observational level in the evidence-based ladder. Future Research on the reviewed theme should focus on the economic implications of the social effects of drug and substance abuse on secondary school students in Nigeria.

Kinesiophobia is described as pain-related fear of movement and plays a role in the development of chronic musculoskeletal pain. Several approaches have been described in the literature, but there does not seem to be a consensus on the most appropriate way to evaluate and treat patients with kinesiophobia. The aim of this study was to identify clinically relevant assessments and treatments recommended by a consensus of experts. Fourteen experts were identified to participate in a three-round internet-based Delphi study. Participants were asked to propose assessments and treatments (round 1), to grade each proposal on a Likert scale of 9 (round 2), and to reassess their level of agreement (round 3). The consensus was defined with 75% agreement. Five methods of assessment and six treatment approaches reached a consensus. The TAMPA scale reached the top position as an assessment of kinesiophobia. Graded exposure to movement, cognitive and behavioral therapy, and pain neuroscience education were the highest-rated interventions. These results provide the first expert consensus on preferred assessments and treatments for patients with kinesiophobia and correspond with the evidence base in the literature.

Due to extensive COVID-19 prevention measures, millions of tons of chemicals penetrated the natural environment. Alterations of viruses in the environment, the neglected perceiver of environmental fluctuations, remain obscure. Chemicals especially trihalomethane restrained the virus community diversity. Segments of SARS-CoV-2 RNA have been detected near hospitals that suggesting the environment as a missing link in the transmission route. Human viruses lurking in the environment were potentially activated by pandemic prevention chemicals, warning an overlooked burden to human health. This letter warns of the risk of activation of human viruses in the environment following the overuse of COVID-19 prevention devices and emphasizes the long-term monitoring of environmental viruses in the post-pandemic period.

Bronchiolitis is one of the most common respiratory infections in children under 2 years of age predominantly caused by Respiratory syncytial virus and other viruses like influenza, Para influenza, and Adenovirus. Rhinovirus, etc. Most children have mild symptoms however bronchiolitis has also been well linked to severe morbidities and mortalities. Even though bronchiolitis has been well recognized for many years, there are still very few therapeutic strategies available beyond supportive management. There are many controversies about therapeutic management in bronchiolitis published in standard guidelines and research in this area. Management can be divided into pharmacological and supportive therapy. Evidence suggests that the current management of bronchiolitis is purely supportive consisting of oxygen supplementation, frequent suctioning, and maintaining good hydration and nutrition. Regarding pharmacological therapy, neither bronchodilators nor corticosteroids have significant efficacy in the treatment of bronchiolitis. However, some studies suggest that adrenaline and nebulizer 3% saline showed some benefit only in terms of outcome. The current recommendation also supports the use of Palivizumab as prophylaxis in certain groups of infants and young children.

Ischemic Heart Disease (IHD) remains a significant cause of morbidity and mortality worldwide. We present a case report of a 54-year-old individual presenting with symptoms suggestive of IHD, including palpitations and chest heaviness. Utilizing a Spandan device at home, the patient detected anteroseptal and lateral wall ischemia, prompting consultation with a cardiologist. Subsequent diagnostic evaluations revealed Left Ventricular Hypertrophy (LVH), concentric LVH, regional wall motion abnormality, and Grade I diastolic dysfunction. Hypertension and dyslipidemia were identified as prominent risk factors, with additional findings of carotid artery disease. Management strategies included antihypertensive medications, lipid-lowering therapy, and lifestyle modifications. This case underscores the complexity of diagnosing and managing IHD, highlighting the importance of comprehensive assessment and multidisciplinary care in optimizing patient outcomes.

Coronavirus disease 2019 (COVID-19) had affected both developed and developing countries too. The first case in Nepal was confirmed on 23 January 2020. It was also the first recorded case of COVID-19 in South Asia. Nepal reported its first COVID-19 death on May 16. At the end of October, the number of death stood 937 and 1126 on 9 November. In September and October, deaths doubled, and with winter setting in, fatalities may skyrocket. Among the total CP cases in Nepal nearly 50% are from the Capital Kathmandu. So, Kathmandy is the new epicenter of COVID-19 in Nepal. There are no proper community-based isolation centres and ICU beds are also still limited. Due to increasing trend of COVID-19 cases and death people have fear of psychological stress. A study shows at least one symptom of psychological distress whereas 32% suffered from two or more symptoms of psychological distress such as restlessness, fearfulness, anxiety and worry and sadness. Despite limited resources, the government’s major challenges are early diagnosis, management of confirmed cases, contact tracing, and implementing some public health measures to reduce the infection’s transmissibility.