Search results for: pulmonary involvement

Authors: Sukhee Park, Gaab Soo Kim

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Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: Vandna Raghuvanshi, Vikrant Thakur, Anupam Jhobta

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Objective: To design HRCT criterion to forecast the threat of pulmonary tuberculosis. Material and methods: This was a prospective study of 69 patients with clinical suspicion of pulmonary tuberculosis. We studied their medical characteristics, numerous separate HRCT-results, and a combination of HRCT findings to foresee the danger for PTB by utilizing univariate and multivariate investigation. Temporary HRCT diagnostic criteria were planned in view of these outcomes to find out the risk of PTB and tested these criteria on our patients. Results: The results of HRCT chest were analyzed, and Rank was given from 1 to 4 according to the HRCT chest findings. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Rank 1: Highly suspected PTB. Rank 2: Probable PTB Rank 3: Nonspecific or difficult to differentiate from other diseases Rank 4: Other suspected diseases • Rank 1 (Highly suspected TB) was present in 22 (31.9%) patients, all of them finally diagnosed to have pulmonary tuberculosis. The sensitivity, specificity, and negative likelihood ratio for RANK 1 on HRCT chest was 53.6%, 100%, and 0.43, respectively. • Rank 2 (Probable TB) was present in 13 patients, out of which 12 were tubercular, and 1 was non-tubercular. • The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the combination of Rank 1 and Rank 2 was 82.9%, 96.4%, 23.22, and 0.18, respectively. • Rank 3 (Non-specific TB) was present in 25 patients, and out of these, 7 were tubercular, and 18 were non-tubercular. • When all these 3 ranks were considered together, the sensitivity approached 100% however, the specificity reduced to 35.7%. The positive likelihood ratio and negative likelihood ratio were 1.56 and 0, respectively. • Rank 4 (Other specific findings) was given to 9 patients, and all of these were non-tubercular. Conclusion: HRCT is useful in selecting individuals with greater chances of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, multivariate, HRCT

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Authors: Hotlan Siagian, Han Tae Hee

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This study aims to examine the effect of supplier trust and top management involvement on the supply chain risk management through buyer-supplier relationship. The population of the research is 44 Korean companies domiciled in East and Central Java of Indonesia. The respondent consists of a top management level from each company. Data collection used a questionnaire designed with five-item Likert scale. Collected data were analyzed using structural equation modeling (SEM) technique with SmartPLS software version 3.0 to examine the hypotheses. The result revealed that supplier trust has an effect on supply chain risk management, top management involvement affects supply chain risk management, supplier trust influences buyer-supplier relationship, top management involvement affects the buyer-supplier relationship, and buyer-supplier relationship affects supply chain risk management. The last finding is that buyer-supplier relationship empirically mediates the effect of supplier trust and top management involvement.

Keywords: buyer supplier relationship, supplier trust, supply chain risk management, top management involvement

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Authors: Chassel T. Paras, Tryxzy Q. Dela Cruz, Ma. Carmela Lousie V. Goingco, Pauline L. Tolentino, Carmela S. Dizon

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In implementing inclusive education, parental involvement is measured to be an irreplaceable contributing factor. Parental involvement is described as an indispensable aspect of the teaching-learning process and has a remarkable effect on the student's academic performance. However, there are still differences in the viewpoints, expectations, and needs of both parents and teachers that are not yet fully conveyed in their relationship; hence, the perceptions of SNED teachers are essential in their collaboration with parents. This qualitative study explored how SNED teachers perceive the roles of parental involvement in the teaching-learning process of students with special needs. To answer this question, one-on-one face-to-face semi-structured interviews with three SNED teachers in a selected public school in Angeles City, Philippines, that offer special needs education services were conducted. The gathered data are then analyzed using Interpretative Phenomenological Analysis (IPA). The results revealed four superordinate themes, which include: (1) roles of parental involvement, (2) parental involvement opportunities, (3) barriers to parental involvement, and (4) parent-teacher collaboration practices. These results indicate that SNED teachers are aware of the roles and importance of parental involvement; however, despite parent-teacher collaboration, there are still barriers that impede parental involvement. Also, SNED teachers acknowledge the big roles of parents as they serve as main figures in the teaching-learning process of their children with special needs. Lastly, these results can be used as input in developing a school-facilitated parenting involvement framework that encompasses the contribution of SNED teachers in planning, developing, and evaluating parental involvement programs, which future researchers can also use in their studies

Keywords: parental involvement, special needs education, teaching-learning process, teachers’ perceptions, special needs education teachers, interpretative phenomenological analysis

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Authors: Anu Jose, Sapna Nair

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By using the baseline data of a randomized cluster trial aiming to understand the effects of social, technological and business innovation on child development in two districts of Tamil Nadu, India, we examine the determinants of father involvement in childcare. While there is a growing literature on the role of fathers in child development and family systems, we particularly look at the effect of the attitude of mother and father towards father's involvement in childcare in rural South India. We find that father's own attitude and the mother's gatekeeping attitude significantly affect the father's behavior when other socio-economic characteristics of the parents are controlled. Further, the results are corroborated using different empirical models in which father involvement is conceptualized into three categories broadly; play, caretaking, and affection. We also examine the other socio-economic characteristics affecting paternal involvement using both quantitative and qualitative methods. For instance, child characteristics such as the age and birth order have a significant influence on the level of paternal involvement. That is, older the child, the more involved the father is and the father gets more involved in childcare of the second child as compared to the first child. The participants of the study included 1516 children of age 0 to 22 months from 1476 households. Results indicate that fathers of households where the mother and the father have less traditional attitude exhibit a higher level of involvement in childcare as opposed to parents having a more traditional attitude towards gender role in parenting. The results of this paper provide a major policy lesson aiming to improve paternal involvement in childcare.

Keywords: child development, father involvement, gender, parent’s attitude towards paternal involvement

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Authors: Chi-Yueh Hsu, Hsuan-Liang Hsu, Hsiu-Hui Chiang

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This study is to explore the relationship between the conspicuous consumption, leisure involvement and physical and mental health, and to understand the prediction of conspicuous consumption and leisure involvement to physical and mental health. The data was collected and analysed by purposive sampling, and the research objects were the dog walkers in Taiwan area. A total of 300 questionnaires were issued and after shaving the invalid questionnaire, a total of 246 valid samples were collected, and the effective rate was 82%.. The data were analyzed by correlation analysis and multiple stepwise regression analysis. The results showed that there was a significant correlation between conspicuous consumption and leisure involvement, and the conspicuous consumption and leisure involvement of dog walkers have a significant impact on physical and mental health, especially in self-expression, attractiveness and centrality of leisure involvement have a significant impact on physical and mental health.

Keywords: walking dog, attractiveness, self-expression, multiple stepwise regression analysis

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Authors: Esraa Alhadad

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Recently, there has been considerable debate surrounding the definition, conservation, and management of heritage. Over the past few years, there has been a growing call for the inclusion of local communities in heritage management. However, the perspectives on involvement, especially concerning key stakeholders like community members, often diverge significantly. While the theoretical foundation for community involvement is reasonably established, the application of this approach in heritage management has been sluggish. Achieving a balance to fulfill the diverse goals of stakeholders in any involvement project proves challenging in practice. Consequently, there is a dearth of empirical studies exploring the practical implications of effective tools in heritage management, and limited indication exists to persuade current authorities, such as governmental organizations, to share their influence with local community members. This research project delves into community involvement within heritage management as a potent means of constructing a robust management framework. Its objective is to assess both the extent and caliber of involvement within the management of heritage sites overall, utilizing a cultural mapping-centered methodology. The findings of this study underscore the significance of engaging the local community in both heritage management and planning endeavors. Ultimately, this investigation furnishes crucial empirical evidence and extrapolates valuable theoretical and practical insights that advance understanding of cultural mapping in pivotal areas, including the catalysts for involvement and collaborative decision-making processes.

Keywords: community involvement, heritage management, cultural mapping, stakeholder mangement

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Authors: Taghreed Abu-Salim

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This paper develops and investigates a framework for the assessment of customer involvement in the service design process of result oriented product-service systems in order to improve the service offering in a business to business (B2B) context. The framework comprises five main criteria and fifteen sub-criteria that contribute to customer involvement in a hierarchy using a maturity grid to highlight the strengths and weaknesses for each criterion. To develop the customer involvement framework, an extensive literature review related to service design, result oriented product-service system (PSS) and customer involvement in service design was carried out. Key factors that significantly influence customer involvement from industry and literature were identified to develop an initial framework. This framework was tested in six companies from four different sectors of industry: district cooling, medical equipment, transportation and oil storage. Validation of the framework was carried out using expert opinions and industrial case studies. A major contribution of the developed framework includes a hierarchy of appropriate criteria for assessing customer involvement in the service design process within results oriented PSS; the definition of four maturity levels which are suitable to describe the whole spectrum of customer involvement in the service design process; and finally, The paper concludes by enabling service providers to: take proactive decisions; screen and evaluate new services; improve perceived service quality; and provide barriers against imitation.

Keywords: customer involvement, maturity grid, new service development, result oriented product-service system, service design

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Authors: Ali H. Muhammad

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The present study examines some antecedents and consequences of employee job involvement in Kuwaiti business organization. The model presented in the current study suggests that job satisfaction and organizational commitments are determinates of job involvements. Employees who are satisfied with their jobs tend to be more attached to their jobs and view their jobs as an essential part of their existence. Similarly, employees who are committed to organizational goals, and identify with organizational values, tend to have high level of involvement. Furthermore, our model suggests that job involvement is positively related to work performance and organizational citizenship behavior. The negative consequences of job involvement include burnout and work family conflict. To test the hypotheses, a sample of 204 Kuwaiti employees representing 8 Kuwaiti work organizations is used. The sample covers a variety of business sectors in Kuwait, including manufacturing, services, and transportation. The data were analyzed using non-parametric tests, Pearson correlations, and structural equation modeling. Results indicate that job satisfaction and organizational commitment have significant positive effects on job involvement. Furthermore, findings reveal that job involvement is positively associated with performance, organization citizenship behavior, and work family conflict. Findings are discussed, and future areas of research are identified.

Keywords: job involvement, organizational citizenship behavior, work family conflict, burnout

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Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Alemayehu Belay Emagnaw

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This study was conducted to investigate the relationship of mother and father involvement with students’ school performance and the effect of selected family demographic variables (mother and father education, family structure and sex of students) to the involvement of mothers and fathers in their children’s school performance. In addition, this study attempted to differentiate the level of involvement of mothers’ and fathers’ in their children’s school performance. The research was conducted in Bahirdar City, Ethiopia. A total of 175 students (boys were 85 and girls were 90) of grade 7th and 8th private primary schools were selected as respondents using stratified random sampling technique. The data were collected using a questionnaire. Analysis of the data showed that fathers and mothers have significant involvement in their children’s school performance. A significant difference was also found between mothers and fathers involvement in their children’s school performance. Mothers were better involved in their children school performance than fathers. The analysis of inter-correlation between variables showed that there is a statistically significant relationship between mother and father education, mother and father involvement, and school performance whereas, family structure and sex of the child had no significant relationship with school performance.

Keywords: family structure, parental education, parental involvement, school performance

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Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes

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Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.

Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis

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Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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Authors: B. O. Oyedoyin, M. O. Ilori, T. O. Oyebisi, B. A. Oluwale, O. O. Jegede

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The study was designed to evaluate the business development and transfer of technologies to small manufacturing companies by research institutes in South Western Nigeria. The study covered all the industrial research institutions with headquarters in South Western Nigeria. The study showed that the involvement of scientists in innovation process was rated highest in the idea generation (4.14) and idea screening (4.29) phases; high in R&D (3.86) and fairly high in pilot plant development (2.71) and commercialization (2.43) phase. Their involvement was rated low in business analysis and development (2.14), and test marketing (2.29) phase. The involvement of engineers was rated highest in idea generation (3.28), fairly high in R&D (2.71), pilot plant development (2.57), and idea screening (2.40) phases. However, their involvement was rated low in business analysis and development (2.0), test marketing (2.0), and commercialization (1.28) phases. The involvement of technology marketers in innovation process was generally rated fairly high in R&D (2.7) and business analysis and development (2.6), and low in all the other phases of innovation. However, their involvement at IAR&T, FIIRO, and NIOMR in all the phases was rated very high (3.0-5.0). The involvement of entrepreneurs was generally rated from fairly high to low (2.7-2.3) in all the phases of innovation. The involvement of financial institutions in all the phases of innovation was generally rated low (1.28-1.71). In conclusion, the study showed that the involvement of stakeholders like entrepreneurs and financial institutions in technology packaging for commercialization is very low.

Keywords: research institutes, national innovation system, Nigeria, entrepreneurs, financial institution

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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Authors: Mona Bakry Abdel Meguid Abdelaal

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Despite growing evidence that parental involvement in their adolescents’ lives affects the way they perceive the community around them, little effort has been made to address the importance of this relationship and how it affect the adolescents' interaction with their environment. Adolescents are influenced by their parents while they are growing up and this socialization process services to shape the adolescents sense of self, influencing not only how adolescents feel about themselves, but affecting how they interact with their surroundings. In order to effectively understand this issue, it is important to understand the adolescents’ understanding of healthy parental involvement in their lives, in addition to the obstacles that hinder their communication styles with their parents. Understanding parental involvement in their adolescents’ lives will provide further understanding of the role that social work can perform in this field. The rationale for undertaking this study grew out of the literature on adolescents’ studies in addition to the researchers’ interaction with freshmen female students, who are still in the adolescent stage, in the university. The primary purpose of this study was to understand female adolescents’ awareness of healthy parental involvement in their freshmen year in the university life, as well as obstacles that might hinder that healthy involvement. Using semi-structured interview with a purposive sample of the first year female students in the university, the study managed to determine if the type of parental involvement and parental emotional responsiveness between the adolescents and their parents affects the way they interact with their environment, in addition, to determine the obstacles that hamper the communication between adolescents and their parents.

Keywords: adolescents, parental involvement, interaction, university life

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Authors: Wera Supa, Panita Wannapiroon

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This paper is a report on the designing of the social collaborative learning model based on proactive involvement to Promote the global merit principle in cultivating youths’ morality. The research procedures into two phases, the first phase is to design the social collaborative learning model based on proactive involvement to promote the global merit principle in cultivating youths’ morality, and the second is to evaluate the social collaborative learning model based on proactive involvement. The sample group in this study consists of 15 experts who are dominant in proactive participation, moral merit principle and youths’ morality cultivation from executive level, lecturers and the professionals in information and communication technology expertise selected using the purposive sampling method. Data analyzed by arithmetic mean and standard deviation. This study has explored that there are four significant factors in promoting the hands-on collaboration of global merit scheme in order to implant virtues to adolescences which are: 1) information and communication Technology Usage; 2) proactive involvement; 3) morality cultivation policy, and 4) global merit principle. The experts agree that the social collaborative learning model based on proactive involvement is highly appropriate.

Keywords: social collaborative learning, proactive involvement, global merit principle, morality

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Authors: Kwok W. Mui, Ling T. Wong, Nai K. K. Fong

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Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in Hong Kong. Investigators are eager to explore the environmental risk factors for COPD such as air pollution and occupational exposure. Through a cross-sectional survey, this study investigates the impact of air quality to the quality of life of patients with the COPD in terms of the scores of the (Chinese) chronic respiratory questionnaire (CCRQ) and the measurements of indoor air quality (IAQ) and Moser’s activities of daily living (ADL). Strong relationships between a number of indoor/outdoor environmental parameters were found and CRQ sub-scores for patients of COPD and thus indoor air pollutants must be monitored for future studies related to QOL for patients with COPD.

Keywords: chronic obstructive pulmonary disease (COPD), indoor air pollutants, quality of life, chronic respiratory questionnaire (CRQ)

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Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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Authors: Mohamed Abdullahi Gure, Farhia Ali Abdi

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There is almost a complete certainty among educators that parental involvement is the remedy for many of the problems facing schools. It is also widely acknowledged that school administrators and teachers have important roles in promoting parental involvement in children’s education. This work aims at examining the views of parents and teachers on school-partnership practices for promoting parental involvement in education in selected primary schools in Mogadishu-Somalia. The method, which has been employed in this study, is a mixed-method approach; data were collected from parents as well as from teachers of the selected schools using survey questionnaires and interviews. A sample size of 377 parents and 214 teachers participated in this study. This study used an instrument that has been developed by Epstein and Salinas (1993) to assess the perceptions of parents and teachers about parental involvement. Furthermore, data was collected qualitatively through interviews with parents and teachers of the selected schools. The findings of this study show that parents and teachers had similar positive perceptions towards school practices for parental involvement. This study is significant for several reasons. It contributes to the limited information on parental involvement in Somalia and therefore, filling a gap in the existing empirical literature. It offers information to educators as well as to parents, which will help them understand the issues that relate to parental involvement in education. It is hoped that information from this study will facilitate parents and teachers to understand each other’s ideas on parental involvement and develop positive working relations to support children to become successful in their education.

Keywords: Mogadishu, parents, school-partnership, practices, teachers

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Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

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We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

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Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

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Authors: Aroona Hashmi

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Parental Involvement is a strategic key to both traditional and contemporary way of ‘face-to-face’ schooling, including public/private schools and home schooling. Present research is destined to find out whether this connection happens in Pakistani schools, a land which faces educational hurdles. This study aims to find out the parental involvement in schooling of female students and its impact on their achievement at elementary level. In this study quantitative research approach is used. Survey is conducted by utilizing reliable and valid instrument named as Parental Involvement Project Questionnaire (PIP). A stratified random sampling technique applied to select twenty schools in total from District Lahore. Schools were selected from public and private sectors. All selected schools were registered with Punjab Examination Commission (PEC), therefore standardized tests are conducted by PEC for class 8 every year in Punjab province, Pakistan. In total 1000 students and their 1000 parents constituted the sample. Data were analyzed by using SPSS version 17. T-test and Regression was applied to independent samples to test the null hypotheses. The result of this study indicated that parents of female students showed more involvement as compared to parents of male students at elementary level. There was significant difference in the impact of parental involvement on achievement of female students and male students i.e. there was more impact of parental involvement found on achievement of female students as compared to male students.

Keywords: parental involvement, achievement, schooling, elementary level, PEC

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Authors: Camilo Andres Agudelo-Velez, Lina María Martinez-Sanchez, Natalia Perilla-Hernandez, Maria De Los Angeles Rodriguez-Gazquez, Felipe Hernandez-Restrepo, Dayana Andrea Quintero-Moreno, Camilo Ruiz-Mejia, Isabel Cristina Ortiz-Trujillo, Monica Maria Zuluaga-Quintero

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Chronic obstructive pulmonary disease is common condition, characterized by a persistent blockage of airflow, partially reversible and progressive, that represents 5% of total deaths around the world, and it is expected to become the third leading cause of death by 2030. Objective: To establish the clinical and epidemiological profile of patients with chronic obstructive pulmonary disease in a medical institution from the city of Medellin, Colombia. Methods: A cross-sectional study was performed, with a sample of 50 patients with a diagnosis of chronic obstructive pulmonary disease in a private institution in Medellin, during 2015. The software SPSS vr. 20 was used for the statistical analysis. For the quantitative variables, averages, standard deviations, and maximun and minimun values were calculated, while for ordinal and nominal qualitative variables, proportions were estimated. Results: The average age was 73.5±9.3 years, 52% of the patients were women, 50% of them had retired, 46% ere married and 80% lived in the city of Medellín. The mean time of diagnosis was 7.8±1.3 years and 100% of the patients were treated at the internal medicine service. The most common clinical features were: 36% were classified as class D for the disease, 34% had a FEV1 <30%, 88% had a history of smoking and 52% had oxygen therapy at home. Conclusion: It was found that class D was the most common, and the majority of the patients had a history of smoking, indicating the need to strengthen promotion and prevention strategies in this regard.

Keywords: pulmonary disease, chronic obstructive, pulmonary medicine, oxygen inhalation therapy

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Authors: Adeyemi Adeyinka, Yemisi Ilesanmi

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This study investigated parental involvement and motivation as predictors of students’ learning outcomes in value concepts in Yoruba language in Ibadan, Nigeria. Value concepts in Yoruba language aimed at teaching moral lessons and transmitting Yoruba culture. However, feelers from schools and the society reported students’ poor achievement in examinations and negative attitude to the subject. Previous interventions focused on teaching strategies with little consideration for student-related factors. The study was anchored on psychosocial learning theory. The respondents were senior secondary II students with mean age of 15.50 ± 2.25 from 20 public schools in Ibadan, Oyo-State. In all, 1000 students were selected (486 males and 514 females) through proportionate to sample size technique. Instruments used were Students’ Motivation (r=0.79), Parental Involvement (r=0.87), and Attitude to Yoruba Value Concepts (r=0.94) scales and Yoruba Value Concepts Achievement Test (r=0.86). Data were analyzed using descriptive statistics, Pearson product moment correlation and Multiple regressions at 0.05 level of significance. Findings revealed a significant relationship between parental involvement (r=0.54) and students’ achievement in and attitude to (r=0.229) value concepts in Yoruba. The composite contribution of parental involvement and motivation to students’ achievement and attitude was significant, contributing 20.3% and 5.1% respectively. The relative contributions of parental involvement to students’ achievement (β = 0.073; t = 1.551) and attitude (β = 0.228; t = 7.313) to value concepts in Yoruba were significant. Parental involvement was the independent variable that strongly predicts students’ achievement in and attitude to Yoruba value concepts. Parents should inculcate indigenous knowledge in their children and support its learning at school.

Keywords: parental involvement, motivation, predictors, learning outcomes, value concepts in Yoruba

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Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Dipti Chand, Riya Saboo

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OBJECTIVES: Early and correct diagnosis may present a significant clinical challenge in diagnosis of patients presenting to Emergency Department with Acute Dyspnoea. The common cause of acute dyspnoea and respiratory distress in Emergency Department are Decompensated Heart Failure (HF), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Pneumonia, Acute Respiratory Distress Syndrome (ARDS), Pulmonary Embolism (PE), and other causes like anaemia. The aim of the study was to measure NT-pro Brain Natriuretic Peptide (BNP) and exhaled End-Tidal Carbon dioxide (ETCO2) in patients presenting with dyspnoea. MATERIAL AND METHODS: This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the Medicine Intensive Care Unit. Three groups of patients were compared: (1) HFrelated acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas analysis, lung ultrasound examination, 2D echocardiography, chest X-rays, and other relevant diagnostic laboratory testing. RESULTS: 96 patients were included in the study. Median NT-proBNP was found to be high for the Heart Failure group (11,480 pg/ml), followed by the sepsis group (780 pg/ml), and pulmonary group had an Nt ProBNP of 231 pg/ml. The mean ETCO2 value was maximum in the pulmonary group (48.610 mmHg) followed by Heart Failure (31.51 mmHg) and the sepsis group (19.46 mmHg). The results were found to be statistically significant (P < 0.05). CONCLUSION: NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD.

Keywords: NT PRO BNP, ETCO2, dyspnoea, lung USG

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