Search results for: case history

Authors: Vibhushan Subba

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B-movies are almost always ‘glanced over’, ‘swept beneath’, ‘hidden from’ and ‘locked away’ to live a secret life; a life that exists but enjoys only a mummified existence behind layers of protective covering. They are more often than not discarded as ‘trash’, ‘sleaze’, ‘porn’ and put down for their ‘bad taste’ or at least that has been the case in India. With the art film entering the realm of high art, the popular and the mainstream has been increasingly equated with the A grade Bollywood film. This leaves the B-movie to survive as a degraded cultural artifact on the fringes of the mainstream. Kanti Shah’s films are part of a secret, traversing the libidinal circuits of the B and C grade through history. His films still circulate like a corporeal reminder of the forbidden and that which is taboo, like a hidden fracture that threatens to split open bourgeois respectability. Seeking to find answers to an aesthetic that has been rejected and hidden, this paper looks at three films of Kanti Shah to see how the notion of taboo, censorship and the unseen coincide, how they operate in the domain of his cinema and try and understand a form that draws our attention to the subterranean forces at work.

Keywords: B-movies, trash, taboo, censorship

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Authors: Carmela Perta

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Among the studies flourished in the field of historical sociolinguistics, mainly in the strand devoted to English history, during its Medieval and early modern phases, multilingual texts had been analysed using theories and models coming from contact linguistics, thus applying synchronic models and approaches to the past. This is true also in the case of contact phenomena which would transcend the writing level involving the language systems implicated in contact processes to the point of perceiving a new variety. This is the case for medieval administrative-commercial texts in which, according to some Scholars, the degree of fusion of Anglo-Norman, Latin and middle English is so high a mixed code emerges, and there are recurrent patterns of mixed forms. Interesting is a collection of multilingual business writings by John Balmayn, an Englishman overseeing a large shipment in Tuscany, namely the Cantelowe accounts. These documents display various analogies with multilingual texts written in England in the same period; in fact, the writer seems to make use of the above-mentioned patterns, with Middle English, Latin, Anglo-Norman, and the newly added Italian. Applying an atomistic yet dynamic approach to the study of contact phenomena, we will investigate these documents, trying to explore the nature of the switching forms they contain from an intra-writer variation perspective. After analysing the accounts and the type of multilingualism in them, we will take stock of the assumed mixed code nature, comparing the characteristics found in this genre with modern assumptions. The aim is to evaluate the possibility to consider the switching forms as core elements of a mixed code, used as professional variety among merchant communities, or whether such texts should be analysed from a switching perspective.

Keywords: historical sociolinguistics, historical code switching, letters, medieval england

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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Background: The worldwide increase in pediatric presumptive tuberculosis (TB) is the most life-threatening challenge in effectively controlling TB. The objective of this study was to determine the proportion of presumptive TB and the factors associated with it. Methods: A cross-sectional study was conducted between March and November 2013 at ICDDR-Bangladesh. Two hundred twelve pulmonary and extra-pulmonary specimens were collected from 84 suspected pediatric patients diagnosed with TB based on their clinical symptoms/radiological findings. Presumptive TB and confirmed TB were considered presumptive TB and non-presumptive TB and were isolated by smear-microscopy, culture, and GeneXpert. Logistic regression was used to analyze associations between outcome and predictor variables. Results: The proportion of presumptive TB was 85.7%, and 14.3% of non-presumptive TB. In presumptive TB, vaccine scars, family TB history, and school-going children were 16.6%, 33.3%, and 56.9%, respectively. In contrast, vaccine scars and family TB history were 8.3%, and school-going children were 58.3% in non-presumptive TB. Significant factors did not appear in the logistic regression analysis. Conclusion: Despite the high proportion of presumptive TB, there was no statistically significant between presumptive TB and non-presumptive TB.

Keywords: presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis

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Authors: S. Mohd Afzal, R. O'Connell

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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

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Authors: Gökhan Yüksel, Serdar Akça, İlker Kalkan

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The present study is an attempt to demonstrate the significant levels of contribution of the moment-resisting beam-column connections with side plates to the earthquake behavior of special steel moment frames. To this end, the moment-curvature relationships of a regular beam-column connection and its SidePlate counterpart were determined with the help of finite element analyses. The connection stiffness and deformability values from these finite element analyses were used in the linear time-history analyses of an example structural steel frame under three different seismic excitations. The top-story lateral drift, base shear, and overturning moment values in two orthogonal directions were obtained from these time-history analyses and compared to each other. The results revealed the improvements in the system response with the use of SidePlate connections. The paper ends with crucial recommendations for the plan and design of further studies on this very topic.

Keywords: seismic detailing, special moment frame, steel structures, beam-column connection, earthquake-resistant design

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Authors: Seyed Sadegh Naseralavi, Mohsen Khatibinia

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In structural optimizations through meta-heuristic algorithms, analyses of structures are performed for many times. For this reason, performing the analyses in a time saving way is precious. The importance of the point is more accentuated in time-history analyses which take much time. To this aim, peak picking methods also known as spectrum analyses are generally utilized. However, such methods do not have the required accuracy either done by square root of sum of squares (SRSS) or complete quadratic combination (CQC) rules. The paper presents an efficient technique for evaluating the dynamic responses during the optimization process with high speed and accuracy. In the method, first by using a static equivalent of the earthquake, an initial design is obtained. Then, the displacements in the modal coordinates are achieved. The displacements are herein called basic modal displacements (MBD). For each new design of the structure, the responses can be derived by well scaling each of the MBD along the time and amplitude and superposing them together using the corresponding modal matrices. To illustrate the efficiency of the method, an optimization problems is studied. The results show that the proposed approach is a suitable replacement for the conventional time history and spectrum analyses in such problems.

Keywords: basic modal displacements, earthquake, optimization, spectrum

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Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman

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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.

Keywords: leuprolide, lupus nephritis, scleroderma, SLE

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Authors: Lur N. Dreier

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Spontaneous transformation in Ursus maritimus is generally considered to be seldom, albeit not, to this author's best knowledge, previously unpublished in the medical literature. However, no case series has to date described transformative spontaneous processes to filios hominum species. Norwegian public hospital system, is, however, especially the grounds of the specific climate in the Northern hemisphere, and because of a high suited to observe such transformations, both on income level. Hence, this paper describes, to our knowledge, the first case series of 25 patients undergoing treatment for spontaneous transformation in four Norwegian hospitals. The methodology was to include patients on a consecutive basis, identifying clinically and laboratory the typology in each of the four hospitals. The major findings were that the archetypes were heterogeneous, with coercive laboratory findings, with a high degree of redundancy of the process. This might potentially lead to many advances in the diagnostics.

Keywords: case series, transformation, hominum species, maritimus species

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Authors: Utsha Barua Joy

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Buddhism has been playing as a cultural mediator in the world Asia. Buddhism spread as a living spiritual tradition and philosophy and spread mostly as a part of the cultural heritage. Culture and religion concern and deal with some similar human issues in terms of the concept of values. This article mainly focuses on some pertinent issues. The Buddha created a revolutionary awareness in the history of mankind by giving equal status to all. With equality, man gets social, mental, economic, and political freedom. This article moreover discusses the concept of morality, educational system, and finally, missionary services. After the first rainy retreat, Buddha asked the monks to go from place to place and spread the Dharma for the welfare of mankind. Since then, all the monks took part in missionary work. Emperor Asoka’s missionary steps are the brightened example in the history of Buddhism. The goal of this article is to provide to the wise readers with a delineation of reference on how equality, morality, education system, and missionary services through Buddhism rendered great contribution to the cultural arena around the globe.

Keywords: equality, morality, educational system, missionary works

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Authors: Mohamed Abdalla Saleem

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Around one hundred wells were drilled in the Cyrenaica platform north-east Libya, and almost all of them were dry. Although the drilled samples reveal good oil shows and good source rock maturity. Most of the upper Cretaceous age and the above deposit successions are outcrops in different places. We have a thorough understanding and mapping of the structures related to the Cretaceous and above Cenozoic Era. But the subsurface beneath these outcrops still needs more investigation and delineation. This study aims to give answers to some questions about the tectonic history and the types of structures that are distributed in the area using gravity, magnetic, and well data. According to the information that has been obtained from groups of wells drilled in concessions 31, 35, and 37, one can note that the depositional sections become ticker and deeper southward. The topography map of the study area shows that the area is highly elevated at the north, about 300 m above the sea level, while the minimum elevation (16–18 m) exists nearly in the middle (lat. 30°). South to this latitude, the area is started elevated again (more than 100 m). The third-order residual gravity map, which was constructed from the Bouguer gravity map, reveals that the area is dominated by a large negative anomaly working as a sub-basin (245 km x 220 km), which means a very thick depositional section, and the basement is very deep. The mentioned depocenter is surrounded by four high gravity anomalies (12-37 mGal), which means a shallow basement and a relative thinner succession of sediments. The highest gravity values are located beside the coast line. The total horizontal gradient (THG) map reveals various systems of structures, the first system where the structures are oriented NE-SW, which is crosscut by the second regime extending NW-SE. This second system is distributed through the whole area, but it is very strong and shallow near the coast line and at the south part, while it is relatively deep at the middle depocenter area.

Keywords: cyrenaica platform, gravity, structures, basement, tectonic history

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Authors: Rimma Kiseleva

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The hotel business has a long history. The basis of the service of hospitality industry enterprises is the service, attitude, and consciousness of employees as hospitable “hosts of the house”. It is generally accepted that the founder and main expert of quality service is Caesar Ritz, “the king of hoteliers and the hotelier of kings.” However when deeply immersed in the history of the universe, it turns out that the very first book about hospitality, standardization of guest reception processes and the basics of better service is nothing more than the Bible. A unique study on the topic of considering the Church as a hotel, as well as the hotel business itself as the most gracious work of Jesus Christ Himself, which is confirmed by verses from the Gospel, includes the following approaches: analytical, comparative, empirical. The study shows that it was Jesus Christ who became the founder of the rules of the most sacrificial service, real service to people, filled with brotherly love, humility, love for strangers, those qualities that are the foundation, the “three pillars” of the hospitality industry. And also that the hotel is the most charitable cause, which is still relevant today.

Keywords: Augustine Aurelius, Bible, Gospel, guest house, hospitality, hotel, humility, inn, Jesus Christ, Joseph Fletcher, New Testament, Paul Tillich, service, strangeness

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Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

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Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

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Authors: Foad Alzoughool

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Conflicting studies on the association between the rs5219 polymorphism and type 2 diabetes, some studies have confirmed a strong relationship between this variant and type2 diabetes, on the other hand, many studies denied the existence of this association. This study aimed to provide evidence about whether the rs5219 polymorphism has or hasn't a role as a risk factor for diabetes and meta-analysis to investigate the role of the control age group in the association. Genotyping of the rs5219 polymorphism was performed in a cohort of 266 healthy elderly subjects with a mean age (60.2 ± 5.1) with no history of diabetes (HbA1c < 6%) using standard Sanger sequencing methods. Lys/Lys alleles were detected in 20 persons (7.5%), Lys/Glu alleles in 96 persons (36.1%), and Glu/Glu in 150 persons (56.4%). The genotype distribution was consistent with Hardy–Weinberg equilibrium (P =0.7). Meta-analysis notably indicates no association between rs5219 polymorphism and type 2 diabetes in all studies used the younger age of the control group compared to the patient's age. In conclusion, our study sheds light on the importance of age factor among the control group recruited in case-control studies.

Keywords: Type 2 diabetes, rs5219 polymorphism, E23K, KCNJ11 gene

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Authors: Sabra Saeidi

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This research focuses on the historical techniques associated with the lajevardina and Haft-Rangi production methods in creating tiles, with emphasis on the identification of the techniques of inserting gold sheets on the surface of such historical glazed tiles. In this regard, firstly, the history of the production of enamel, gold plated, and Lajevardina glazed pottery work made during the Khwarizmanshahid and Mongol era (eleventh to the thirteenth century) have been assessed to reach a better understanding of the background and the history associated with historical glazing methods. After the historical overview of the production technique of glazed pottery work and introductions of the civilizations using those techniques, we focused on the niches production methods of enamel and Lajevardina glazing, which are two categories of decorations usually found in tiles. Next, a general classification method for various types of gilt tiles has been introduced, which is applicable to the tile works up to Safavid period (Sixteenth to the seventeenth century). Gilded lajevardina glazed tiles, gilt Haft-Rangi tiles, monolithic glazed gilt tiles, and gilt mosaic tiles are included in the categories.

Keywords: gilt tiles, Islamic art, Iranian art, historical studies, gilding

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Authors: P. J. Moore-Jones

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Emirati students studying at the University of the Emirates, one of three major public institutions of higher learning in the United Arab Emirates (UAE), have a wide demographic of faculty members teaching them an equally wide variety of courses. These faculty members bring with them their own cultural assumptions, methods, expectations, educational practices and use of language. The history of multiculturalism in the UAE coupled with the contemporary multiculturalism that exists in higher education Dubai create intriguing phenomena within the classroom. This study seeks to delve into students’ and faculty members’ perceptions of the social stratification that exist in this context. Data were collected via semi-structured interviews with both and analyzed from an interpretive perspective. Findings suggest the social stratification with is deeply-seeded in the multicultural history of the region and country are reflected in the everyday interworkings of education in modern day Dubai. The relevance of this research lies in that these findings can provide valuable insights into not only the attitudes and perceptions of these Emirati students might also be applicable to any of those student populations may exist.

Keywords: social stratification, intercultural competence, Dubai, United Arab Emirates

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Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: Reversal of vision metamorphopsia is a transient form of metamorphopsia described as an upside-down alteration of the visual field in the coronal plane. Patients would describe objects, such as cups, upside down, but the tea would not spill, and people would walk on their heads. It is extremely rare as a stable finding, lasting days or weeks. We report a case wherein this type of metamorphopsia occurred only in written words and lasted for six months. Objective: To the best of our knowledge, we report the first rare occurrence of reversal of vision metamorphopsia described as inverted words as the sole initial presentation of an underlying stroke. Case Presentation: We report a 59-year-old male with poorly controlled hypertension and diabetes mellitus who presented with a 3-day history of difficulty reading, described as the words were turned upside down as if the words were inverted horizontally then with the progression of deficits such as right homonymous hemianopia and achromatopsia, prosopagnosia. Cranial magnetic resonance imaging (MRI) revealed an acute infarct on the left posterior cerebral artery territory. Follow-up after six months revealed improvement of the visual field cut but with the persistence of the higher cortical function deficits. Conclusion: We report the first rare occurrence of metamorphopsia described as purely inverted words as the sole initial presentation of an underlying stroke. The differential diagnoses of a patient presenting with text reversal metamorphopsia should include stroke in the occipitotemporal areas. It further expands the landscape of metamorphopsias due to its exclusivity to written words and prolonged duration. Knowing these clinical features will help identify the lesion locus and improve subsequent stroke care, especially in time-bound management like intravenous thrombolysis.

Keywords: rare presentation, text reversal metamorphopsia, ischemic stroke, stroke

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Authors: Beverly Wang

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Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

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Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli

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Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.

Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome

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Authors: Melkamu A., Woldu B., Sitotaw C., Seyoum M., Aynalem M.

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Background: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. Methods: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood was collected and analyzed by the Genrui CA51 coagulation analyzer. Data was entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. Result: In this study, a total of 307 study participants were included. Of them, the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. Conclusion: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

Keywords: coagulation, liver disease, PT, Aptt

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Authors: Hazem Abuorf

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From the perspective of viewing urban design as the architecture of public spaces, the latter has many advantages; for example, in achieving attractive and vibrant public spaces, ensuring safety and amenity, supporting a strong sense of place and local character. Besides all advantages, such spaces nevertheless trigger numerous dilemmas, how to design urban spaces preserving the quality of life in the long term while equally achieving cohesion between new urban developments and the already existing urban structure without causing a split in history through the cause of functional and aesthetic degradation. Analysis of this article seeks to propose a methodology deemed essential for assessing and stimulating design criteria of the public spaces when rehabilitating urban sites. The method’s utility is shown by analyzing rehabilitation projects in Gaza Strip, whose design of the public spaces has mainly focused on the physical aspect ignoring the place’s local identity, users’ needs, and history. The proposed methodology serves as a guide for municipal authorities and technical teams to deal with interventions that would rework the role of urban design towards making sense of place.

Keywords: urban design, public realm, rehabilitation projects, quality of life

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Authors: Yuyun Sri Wahyuni, Fathih Misbahuddin Islam

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Nanggroe Aceh Darussalam is the special district with its long conflict history. The long conflict history started from The Free Aceh Movement’s intentions to implement Islamic principles in Aceh Province, it was actually contradicted with the principles of state. This long conflict was finally ended on 2005. Then, since 2005 Aceh had special authority to administer its local government affairs by applying Islamic principles (syariah), included criminal law matters. To administer it, Aceh Government enacted Law Number 6 of 2014 on the Jinayah. This law consists the criminal act (jarimah) and the punishment (uqubat). Khamr, maisir, khalwat, ikhtilath, zina, sexual harrasment, rape, qadzaf, liwath, and musahaqah are the kinds of the criminal act which are ruled within. Meanwhile, Hudud and Takdzir as the kinds of punishment (uqubat). After 2 years of the issuance of this law inflicting controversy from any sides and being discussed not only locally but also globally. The objectives of this paper are to analyze the fundamental value of the flagellation punishment within this law and Aceh Government review in formulating the law.

Keywords: Aceh province, flagellation punishment, Islamic Principle, Qanun Jinayah

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Elionai Moura, José A. Cunha, César Analide

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This work introduces a proposal scheme for an Intelligent System applied to Pedagogical Advising using Case-Based Reasoning, to find consolidated solutions before used for the new problems, making easier the task of advising students to the pedagogical staff. We do intend, through this work, introduce the motivation behind the choices for this system structure, justifying the development of an incremental and smart web system who learns bests solutions for new cases when it’s used, showing technics and technology.

Keywords: case-based reasoning, pedagogical advising, educational data-mining (EDM), machine learning

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Authors: Bruno Trstenjak, Dzenana Donko

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Data mining and classification of objects is the process of data analysis, using various machine learning techniques, which is used today in various fields of research. This paper presents a concept of hybrid classification model improved with the expert knowledge. The hybrid model in its algorithm has integrated several machine learning techniques (Information Gain, K-means, and Case-Based Reasoning) and the expert’s knowledge into one. The knowledge of experts is used to determine the importance of features. The paper presents the model algorithm and the results of the case study in which the emphasis was put on achieving the maximum classification accuracy without reducing the number of features.

Keywords: case based reasoning, classification, expert's knowledge, hybrid model

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Authors: Ayed Mouris Gad Elsayed Khalil

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This research focuses on historical techniques associated with the Lajevardin and Haft-Rangi production methods in tile production, with particular attention to identifying techniques for applying gold leaf to the surface of these historical glazed tiles. In this context, the history of the production of glazed, gilded and glazed Lajevardin ceramics from the Khwarizmanshahid and Mongol periods (11th to 13th centuries) was first evaluated in order to better understand the context and history of the methods of historical enameling. After a historical overview of glazed ceramic production techniques and the adoption of these techniques by civilizations, we focused on the niche production methods of glazes and Lajevardin glazes, two categories of decoration commonly found on tiles. A general method for classifying the different types of gold tiles was then introduced, applicable to tiles from to the Safavid period (16th-17th centuries). These categories include gold glazed Lajevardina tiles, haft rangi gold tiles, gold glazed monolithic tiles and gold mosaic tiles.

Keywords: ethnicity, multi-cultural, jewelry, craft techniquemycenaean, ceramic, provenance, pigmentAmorium, glass bracelets, image, Byzantine empire

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Authors: Neha Adsul, Rohit Shah

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Background: The global history of nursing is exclusively a history of deep contradictions as it seeks to negotiate inclusion in an already gendered world. Although a powerful 'clinical gaze exists, nurses have toiled to re-negotiate and subvert the 'medical gaze' by practicing the 'therapeutic gaze' to tether back 'care into nursing practice.' This helps address the duality of the 'body' and 'mind' wherein the patient is not just limited to being an object of medical inquiry. Nevertheless, there has been a consistent effort to fit 'nursing' into being an art or an emerging science over the years. Especially with advances in hospital-based techno-centric medical practices, the boundaries between technology and nursing practices are becoming more blurred as the technical process becomes synonymous with nursing, eroding the essence of nursing care. Aim: This paper examines the history of nursing and offers insights into how gendered relations and the ideological belief of 'nursing as gendered work' have propagated to the subjugation of the nursing profession. It further aims to provide insights into the patriarchally imbibed techno-centrism that negates the gendered caregiving which lies at the crux of a nurse's work. Method: A literature search was carried out using Google Scholar, Web of Science and PubMed databases. Search words included: technology and nursing, medical technology and nursing, history of nursing, sociology and nursing and nursing care. The history of nursing is presented in a discussion that weaves together the historical events of the 'Birth of the Clinic' and the shift from 'bed-side medicine' to 'hospital-based medicine' that legitimizes exploitation of the bodies of patients to the 'medical gaze while the emergence of nursing as acquiescent to instrumental, technical, positivist and dominant views of medicine. The resultant power asymmetries, wherein in contemporary nursing, the constant struggle of nurses to juggle between being the physicians "operational right arm" to harboring that subjective understanding of the patients to refrain from de-humanizing nursing-care. Findings: The nursing profession suffers from being rendered invisible due to gendered relations having patrifocal societal roots. This perpetuates a notion rooted in the idea that emphasizes empiricism and has resulted in theoretical and epistemological fragmentation of the understanding of body and mind as separate entities. Nurses operate within this structure while constantly being at the brink of being pushed beyond the legitimate professional boundaries while being labeled as being 'unscientific' as the work does not always corroborate and align with the existing dominant positivist lines of inquiries. Conclusion: When understood in this broader context of how nursing as a practice has evolved over the years, it provides a particularly crucial testbed for understanding contemporary gender relations. Not because nurses like to live in a gendered work trap but because the gendered relations at work are written in a covert narcissistic patriarchal milieu that fails to recognize the value of intangible yet utmost necessary 'caring work in nursing. This research urges and calls for preserving and revering the humane aspect of nursing care alongside the emerging tech-savvy expectations from nursing work.

Keywords: nursing history, technocentric, power relations, scientific duality

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Authors: Nguyen Trong Nghia, Nguyen Huu Uy Vu, Dang Huu Phuoc, Sanjay Kumar Shukla, Le Gia Lam, Nguyen Van Cuong

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This paper introduces a matching scheme for selection of soil/drain properties in analytical solution and numerical modelling (axisymmetric and plane strain conditions) of a ground improvement project by using Prefabricated Vertical Drains (PVD) in combination with vacuum and surcharge preloading. In-situ monitoring data from a case history of a road construction project in Vietnam was adopted in the back-analysis. Analytical solution and axisymmetric analysis can approximate well the field data meanwhile the horizontal permeability need to be adjusted in plane strain scenario to achieve good agreement. In addition, the influence zone of the ground treatment was examined. The residual settlement was investigated to justify the long-term settlement in compliance with the design code. Moreover, the degree of consolidation of non-PVD sub-layers was also studied by means of two different approaches.

Keywords: numerical modelling, prefabricated vertical drains, vacuum consolidation, soft soil

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Authors: Kiavash Heidarzadeh

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The seismic behavior of portal frames is mainly based on the shape of their joints. In these structures, vertical and inclined connections are the two general forms of connections. The shapes of connections can make differences in seismic responses of portal frames. Hence, in this paper, for the first step, the non-linear performance of portal frames with vertical and inclined connections has been investigated by monotonic analysis. Also, the effect of section sizes is considered in this analysis. For comparison, hysteresis curves have been evaluated for two model frames with different forms of connections. Each model has three various sizes of the column and beam. Other geometrical parameters have been considered constant. In the second step, for every model, an appropriate size of sections has been selected from the previous step. Next, the seismic behavior of each model has been analyzed by the time history method under three near-fault earthquake records. Finite element ABAQUS software is used for simulation and analysis of samples. Outputs show that connections form can impact on reaction forces of portal frames under earthquake loads. Also, it is understood that the load capacity in frames with vertical connections is more than the frames with inclined connections.

Keywords: inclined connections, monotonic, portal frames, seismic behavior, time history, vertical connections

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Authors: Neda Torabi Farsani, Mohammad Mortazavi, Maryam Masaeli

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Nowadays intangible heritage as a creative product plays an important role in promoting tourism. The intangible heritage is transmitted from past generation to the present and future generation and constantly recreated by communities and groups in response to their environment, nature and history. In recent decade, intangible heritage especially Pahlevāni and Zoorkhāneh rituals as creative cultural product attract many tourists to a destination and they well-known as tourist attractions in Iran. The study was conducted in Isfahan city. This research has two major purposes: 1) to introduce Pahlevāni and Zoorkhāneh ritual as tourist attraction and, 2) to investigate the attitude of domestic tourists towards Pahlevāni and Zoorkhāneh ritual in Isfahan city. On the basis of the results of this study, it can be concluded that the domestic tourists are interested in gaining experience and increasing their knowledge in Pahlevāni and Zoorkhāneh ritual.

Keywords: Isfahan, Pahlevāni and Zoorkhāneh ritual, tourist attitude, Iran

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Authors: J. J. M. Trienekens, H. L. Romero, L. Cuenca

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While process harmonization is increasingly mentioned and unanimously associated with several benefits, there is a need for more understanding of how it contributes to business process redesign and improvement. This paper presents the application, in an industrial case study, of a conceptual harmonization model on the relationship between drivers and effects of process harmonization. The drivers are called contextual factors which influence harmonization. Assessment of these contextual factors in a particular business domain, clarifies the extent of harmonization that can be achieved, or that should be strived at. The case study shows how the conceptual harmonization model can be made operational and can act as a valuable assessment tool. From both qualitative, as well as some quantitative, assessment results, insights are being discussed on the extent of harmonization that can be achieved, and action plans are being defined for business (process) harmonization.

Keywords: case study, contextual factors, process harmonization, industrial company

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