Search results for: forensic cases

Authors: Aline F. C. Pereira

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In recent years, modern slavery has increasingly gathered attention in scholarly discussions and policy debates. Whereas the mainstream studies focus on forced labour and trafficking, little attention is paid to other forms of exploitation, such as degrading conditions of work –criminalised in Brazil as an autonomous type of slavery since 2003. This paper aims to bridge this gap. It adopts a mixed method that comprises both qualitative and quantitative analysis, to investigate the adjudication of 164 cases of degrading conditions of work by Brazilian labour courts. The research discloses an ungrounded reluctance to apply the domestic legal framework, as in most of the cases degrading conditions of work are not recognised as contemporary slavery, despite the law. In some cases, not even situations described as subhuman and degrading of human dignity were framed as slavery. The analysis also suggests that, as in chattel times, lack of freedom and subjection remain relevant in the legal characterisation of slave labour. The examination has further unraveled a phenomenon absent in previous studies: normalisation of precarity. By depicting precarity as natural and inevitable in rural areas, labour courts ensure conformity to the status quo and reduce the likelihood of resistance by victims. Moreover, compensations afforded to urban workers are higher than granted to rural employees, which seems to place human beings in hierarchical categories -a trace of colonialism. In sum, the findings challenge the worldwide spread assumption that Brazil addresses slavery efficiently. Conversely, the Brazilian Labour Judiciary seems to remain subservient to a colonial perspective of slavery, legitimising, and sanctioning abusive practices.

Keywords: adjudication, contemporary slavery, degrading conditions of work, normalisation of precarity

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Authors: Seyed Mohammad Mahdi Zamani, Kamran Behdinan

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In this study, a multiscale framework is performed to model the strength of Nextel fibers in presence of an atomistic scale pre-crack at finite temperatures. The bridging cell method (BCM) is the multiscale technique applied in this study, which decomposes the system into the atomistic, bridging and continuum domains; solves the whole system in a finite element framework; and incorporates temperature dependent calculations. Since Nextel is known to be structurally stable and retain 70% of its initial strength up to 1100°C; simulations are conducted at both of the room temperatures, 25°C, and fire temperatures, 1200°C. Two cases are modeled for a pre-crack present in either phases of alumina or mullite of the Nextel structure. The materials’ response is studied with respect to deformation behavior and ultimate tensile strength. Results show different crack growth trends for the two cases, and as the temperature increases, the crack growth resistance and material’s strength decrease.

Keywords: Nextel fibers, multiscale modeling, pre-crack, ultimate tensile strength

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Authors: Manas Kotepui, Chatree Ratcha, Kwuntida Uthaisar

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Malaria infection is still to be considered a major public health problem in Thailand. This study, a retrospective data of patients in Surat Thani Province, Southern Thailand during 2012-2015 was retrieved and analyzed. These data include demographic data, clinical characteristics and laboratory diagnosis. Statistical analyses were performed to demonstrate the frequency, proportion, data tendency, and group comparisons. Total of 395 malaria patients were found. Most of patients were male (253 cases, 64.1%). Most of patients (262 cases, 66.3%) were admitted at 6 am-11.59 am of the day. Three hundred and fifty-five patients (97.5%) were positive with P. falciparum. Hemoglobin, hematocrit, and MCHC between P. falciparum and P. vivax were significant different (P value<0.05).During 2012-2015, prevalence of malaria was highest in 2013. Neutrophils, lymphocytes, and monocytes were significantly changed among patients with fever ≤ 3 days compared with patients with fever >3 days. This information will guide to understanding pathogenesis and characteristic of malaria infection in Sothern Thailand.

Keywords: prevalence, malaria, Surat Thani, Thailand

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Authors: Sudhanshu Sharma

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Lisinopril, 1-[N-{(s)-I-carboxy-3 phenyl propyl}-L-proline dehydrate is a lysine analog of enalaprilat, the active metabolite of enalapril. It is long-acting, non-sulhydryl angiotensin-converting enzyme (ACE) inhibitor that is used for the treatment of hypertension and congestive heart failure in daily dosage 10-80 mg. Pharmacological activity of lisinopril has been proved in various experimental and clinical studies. Owing to its importance and widespread use, efforts have been made towards the development of simple and reliable analytical methods. As per our literature survey, lisinopril in pharmaceutical formulations has been determined by various analytical methodologies like polaragraphy, potentiometry, and spectrophotometry, but most of these analytical methods are not too suitable for the Identification of lisinopril from clinical samples because of the interferences caused by the amino acids and amino groups containing metabolites present in biological samples. This report is an attempt in the direction of developing a simple and reliable method for on plate identification and quantification of lisinopril in pharmaceutical formulations as well as from human urine samples using silica gel H layers developed with a new mobile phase comprising of micellar solutions of N-cetyl-N, N, N-trimethylammonium bromide (CTAB). Micellar solutions have found numerous practical applications in many areas of separation science. Micellar liquid chromatography (MLC) has gained immense popularity and wider applicability due to operational simplicity, cost effectiveness, relatively non-toxicity and enhanced separation efficiency, low aggressiveness. Incorporation of aqueous micellar solutions as mobile phase was pioneered by Armstrong and Terrill as they accentuated the importance of TLC where simultaneous separation of ionic or non-ionic species in a variety of matrices is required. A peculiarity of the micellar mobile phases (MMPs) is that they have no macroscopic analogues, as a result the typical separations can be easily achieved by using MMPs than aqueous organic mobile phases. Previously MMPs were successfully employed in TLC based critical separations of aromatic hydrocarbons, nucleotides, vitamin K1 and K5, o-, m- and p- aminophenol, amino acids, separation of penicillins. The human urine analysis for identification of selected drugs and their metabolites has emerged as an important investigation tool in forensic drug analysis. Among all chromatographic methods available only thin layer chromatography (TLC) enables a simple fast and effective separation of the complex mixtures present in various biological samples and is recommended as an approved testing for forensic drug analysis by federal Law. TLC proved its applicability during successful separation of bio-active amines, carbohydrates, enzymes, porphyrins, and their precursors, alkaloid and drugs from urine samples.

Keywords: lisnopril, surfactant, chromatography, micellar solutions

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Authors: Katie Hudson

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A growing body of scholarship is dedicated to the concept of imperial nationalism, denoting a nostalgia for empire amongst former imperial powers and a yearning to recapture the grandeur of the imperial ‘golden age.’ Much research within this field has focused on Brexit, arguing that Britain’s imperialist identity has spawned Euroscepticism. However, the interaction between imperial nationalism and foreign policy remains underdeveloped and thus far has failed to consider cases outside of the UK. Using maximum variation sampling across post-2000 Britain, Spain and the Netherlands, this comparative analysis aims to explore the discursive invocation of empire in foreign policy framing, under which circumstances and in what ways imperial nationalism emerges. Preliminary findings demonstrate that empire is most often cited when there is a perceived threat to the sovereignty of the nation and that all cases frame foreign policy options according to their acute concerns with regaining the prestige associated with empire. This is present to a lesser extent in Spain, whose earlier period of decolonisation affected the extent to which imperialism has permeated their national psyche. This, therefore, provides an alternative lens through which we can view both Euroscepticism and international relations, conditioned by an imperial legacy.

Keywords: empire, nationalism, foreign policy, IR

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Authors: D. Furuya, H. Ryujin, S. Takahira, Y. Sekine, Y. Oya, K. Sonoda, H. Ogawa, Y. Nomura, R. Maruyama, H. Kim, T. Kudo, A. Nakano, T. Saruta, S. Sugita, M. Nemoto, N. Tanahashi

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Purpose: To study the clinical characteristics of hypoglycemic coma in adult patients with type 1 or type 2 diabetes mellitus (DM). Methods: Participants in this retrospective study comprised 91 patients (54 men, 37 women; mean age ± standard deviation, 71.5 ± 12.6 years; range, 42-97 years) brought to our emergency department by ambulance with disturbance of consciousness in the 7 years from April 2007 to March 2014. Patients with hypoglycemia caused by alcoholic ketoacidosis, nutrition disorder, malignancies and psychological disorder were excluded. Results: Patients with type 1 (8 of 91) or type 2 DM (83 of 91) were analyzed. Mean blood sugar level was 31.6 ± 10.4 in all patients. A sulfonylurea (SU) was more commonly used in elderly (>75 years old; n=44)(70.5%) than in younger patients (36.2%, p < 0.05). Cases showing prolonged unconsciousness (range, 1 hour to 21 days; n=30) included many (p < 0.05) patients with dementia (13.3%; 0.5% without dementia) and fewer (p < 0.05) patients with type 1 DM (0%; 13.1% in type 2 DM). Specialists for DM (n=33) used SU less often (24.2%) than general physicians (69.0%, p < 0.05). Conclusion: In cases of hypoglycemic coma, SU was frequently used in elderly patients with DM.

Keywords: hypoglycemic coma, Diabetes mellitus, unconsciousness, elderly patients

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Authors: K. Suresh, M. Padmavathi, N. Darga Kumar

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The objective of this study is to investigate the significance of coal mine waste and improved clay soil when used as a fill and for the construction of embankment. To determine the bearing capacities of coal mine waste and improved clay soil, tests are conducted apart from laboratory experiments. PLAXIS 2D software is used to make the analysis simpler. Depending upon the bearing capacities obtained for different cases, a conclusion can be drawn. Load carrying capacities are determined for coal mine waste, clay and by altering their height ratio when clay (H2) is at the bottom, and coal mine waste (H1) is on the top with three different cases (H = 0.25H1 + 0.75H2, 0.5H1 + 0.5H2, 0.75H1 + 0.25H2) in addition to this bearing capacity of improved clay soil (by replacing clay with 10% CMW, 30% CMW and 50% CMW in addition polycom) is also determined. The safe height of the embankment that can be constructed with the improved clay for different slopes, i.e., for 1:1, 1.5: 1, 2: 1 is also determined by using PLAXIS 2D software by limiting the factor of safety to 1.5.

Keywords: cohesion, angle of shearing resistance, elastic modulus, coefficient of consolidation, coal mine waste

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Authors: Mojtaba Eshraghi Arani

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According to the international conventions for the carriage of goods by sea, the consignee is the person who is entitled to take delivery of the cargo from the carrier. Such a person is usually named in the relevant box of the bill of lading unless the latter is issued “To Order” or “To Bearer”. However, there are some cases in which the apparent consignee, as above, was not intended to take delivery of cargo, like the L/C issuing bank or the freight forwarder who are named as consignee only for the purpose of security or acceleration of transit process. In such cases as well as the BL which is issued “To Order”, the so-called “real consignee” can be found out in the “Notify Party” box. The dispute revolves around the choice between apparent consignee and real consignee for being entitled not only to take delivery of the cargo but also to sue the carrier for any damages or loss. While it is a generally accepted rule that only the apparent consignee shall be vested with such rights, some courts like France’s Cour de Cassation have declared that the “Notify Party”, as the real consignee, was entitled to sue the carrier and in some cases, the same court went far beyond and permitted the real consignee to take suit even where he was not mentioned on the BL as a “Notify Party”. The main argument behind such reasoning is that the real consignee is the person who suffered the loss and thus had a legitimate interest in bringing action; of course, the real consignee must prove that he incurred a loss. It is undeniable that the above-mentioned approach is contrary to the position of the international conventions on the express definition of consignee. However, international practice has permitted the use of BL in a different way to meet the business requirements of banks, freight forwarders, etc. Thus, the issue is one of striking a balance between the international conventions on the one hand and existing practices on the other hand. While the latest convention applicable for sea transportation, i.e., the Rotterdam Rules, dealt with the comparable issue of “shipper” and “documentary shipper”, it failed to cope with the matter being discussed. So a new study is required to propose the best solution for amending the current conventions for carriage of goods by sea. A qualitative method with the concept of interpretation of data collection has been used in this article. The source of the data is the analysis of domestic and international regulations and cases. It is argued in this manuscript that the judge is not allowed to recognize any one as real consignee, other than the person who is mentioned in the “Consingee” box unless the BL is issued “To Order” or “To Bearer”. Moreover, the contract of carriage is independent of the sale contract and thus, the consignee must be determined solely based on the facts of the BL itself, like “Notify Party” and not any other contract or document.

Keywords: real consignee, cargo, delivery, to order, notify the party

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Authors: Arunai Nambi Raj N., Kaviarasu Karunakaran, Krishnamurthy K.

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The purpose of this study was to create American Association of Physicist in Medicine (AAPM) Task Group 119 (TG 119) benchmark plans for flattening filter free beam (FFF) deliveries of intensity modulated radiation therapy (IMRT) and volumetric arc therapy (VMAT) in the Eclipse treatment planning system. The planning data were compared with the flattening filter (FF) IMRT & VMAT plan data to verify the dosimetric commissioning accuracy of FFF deliveries. AAPM TG 119 proposed a set of test cases called multi-target, mock prostate, mock head and neck, and C-shape to ascertain the overall accuracy of IMRT planning, measurement, and analysis. We used these test cases to investigate the performance of the Eclipse Treatment planning system for the flattening filter free beam deliveries. For these test cases, we generated two sets of treatment plans, the first plan using 7–9 IMRT fields and a second plan utilizing two arc VMAT technique for both the beam deliveries (6 MV FF, 6MV FFF, 10 MV FF and 10 MV FFF). The planning objectives and dose were set as described in TG 119. The dose prescriptions for multi-target, mock prostate, mock head and neck, and C-shape were taken as 50, 75.6, 50 and 50 Gy, respectively. The point dose (mean dose to the contoured chamber volume) at the specified positions/locations was measured using compact (CC‑13) ion chamber. The composite planar dose and per-field gamma analysis were measured with IMatriXX Evaluation 2D array with OmniPro IMRT Software (version 1.7b). FFF beam deliveries of IMRT and VMAT plans were comparable to flattening filter beam deliveries. Our planning and quality assurance results matched with TG 119 data. AAPM TG 119 test cases are useful to generate FFF benchmark plans. From the obtained data in this study, we conclude that the commissioning of FFF IMRT and FFF VMAT delivery were found within the limits of TG-119 and the performance of the Eclipse treatment planning system for FFF plans were found satisfactorily.

Keywords: flattening filter free beams, intensity modulated radiation therapy, task group 119, volumetric modulated arc therapy

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Authors: E. Behmanesh, J. Pannek

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The distribution-allocation problem is known as one of the most comprehensive strategic decision. In real-world cases, it is impossible to solve a distribution-allocation problem in traditional ways with acceptable time. Hence researchers develop efficient non-traditional techniques for the large-term operation of the whole supply chain. These techniques provide near-optimal solutions particularly for large scales test problems. This paper, presents an integrated supply chain model which is flexible in the delivery path. As the solution methodology, we apply a memetic algorithm with a novelty in population presentation. To illustrate the performance of the proposed memetic algorithm, LINGO optimization software serves as a comparison basis for small size problems. In large size cases that we are dealing with in the real world, the Genetic algorithm as the second metaheuristic algorithm is considered to compare the results and show the efficiency of the memetic algorithm.

Keywords: integrated logistics network, flexible path, memetic algorithm, genetic algorithm

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Authors: Fatima Meirkhankyzy Shaizadina, Alua Oralovna Omarova, Praskovya Mikhailovna Britskaya, Nessipkul Oryntayevna Alysheva

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In recent years in the Republic of Kazakhstan there have been registered outbreaks of measles among the population. The objective of work was the analysis of outbreak of measles in 2014 among the population of North-Kazakhstan region of the Republic of Kazakhstan. For the analysis of the measles outbreak descriptive and analytical research, techniques were used and threshold levels of morbidity were calculated. The increase of incidence was noted from March to July. The peak was registered in May and made 9.0 per 100000 population. High rates were registered in April – 5.7 per 100000 population, and in June and July they made 5.7 and 3.1 respectively. Duration of the period of increase made 5 months. The analysis of monthly incidence of measles revealed spring and summer seasonality. Across the territory it was established that 69.2% of cases were registered in the city, 29.1% in rural areas and 1.7% of cases were brought in from other regions of Kazakhstan. The registered cases and threshold values of measles during the outbreak revealed that from 12 to 24 week, and also during the 40th week the cases exceeding the threshold levels are registered. Thus, for example, for the analyzed 1 week the number of the revealed patients made 4, which exceeds the calculated threshold value (3) by 33.3%. The data exceeding the threshold values confirm the emergence of a disease outbreak or the beginning of epidemic rise in morbidity. Epidemic rise in incidence of the population of North-Kazakhstan region was observed throughout 2014. The risk group includes 0-4 year-old children, who made 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The analysis of measles cases registration by gender revealed that women are registered 1.1 times more often than men. The ratio of women to men made 1:0.87. In social and professional groups often ill are unorganized children – 23.3% and students – 19.8%. Studying clinical manifestations of measles in the hospitalized patients, the typical beginning of a disease with expressed intoxication symptoms – weakness, sickliness was established. In individual cases expressed intoxication symptoms, hemorrhagic and dyspeptic syndromes, complications in the form of overlay of a secondary bacterial infection, which defined high severity of the illness, were registered both in adults and in children. The average duration of stay of patients in the hospital made 6.9 days. The average duration of time between date of getting the disease and date of delivery of health care made 3.6 days. Thus, the analysis of monthly incidence of measles revealed spring and summer seasonality, the peak of which was registered in May. Urban dwellers are ill more often (69.2%), while in rural areas people are ill more rarely (29.1%). Throughout 2014 an epidemic rise in incidence of the population of North-Kazakhstan region was observed. Risk group includes: children under 4 – 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The ratio of women and men made 1:0.87. The typical beginning of a disease in all hospitalized with the expressed intoxication symptoms – weakness, sickliness was established.

Keywords: epidemiological analysis, measles, morbidity, outbreak

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Authors: Alaa Jawad Hassan, Saad Marza Al-Aaraji, Fadil Abbas Hamad

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The current study was designed to assess some immunological parameters and pedigree analysis for atopic dermatitis patients, as the study included 64 patients (37 males and 27 females) and 24 healthy individuals (12 males and 12 females) with no history of the AD. The cases of this study were divided into two age groups; the first is infant and children (1-10 years), while the second is adolescent and adults (11- 60 years). The number of cases was 51 and 13 in each age group respectively. Sera samples from confirmed AD patients and healthy control were analysed by mean of ELISA for assessment the concentrations of IL-1β, IL-2, IL-4 and IgE. The study showed that a significant increase (P < 0.05) in IL-1β, IL-4 and IgE levels in the patients compared with the control group in both age groups and gender, while there was no significant difference (P < 0.05) in the concentration of IL-2. The study of pedigree analysis shows the genetic tendency in the frequency of disease depending on the genetic history of family, where more patients returning to families in which both parents or one of them infected with AD, whereas the patients were no parents infected with AD they are suffering from asthma and the disease recurs in their uncles.

Keywords: atopic dermatitis, cytokines, IgE, molecular biology

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Fatemeh Fallah, Ensieh Lotfali, Leila Azimi, Hannan Khodaei, Maryam Rajabnejad, Nafiseh Abdollahi, Hossein Tayebi, Saham Ansari, Saeedeh Yaghoubi, Abdollah Karimi

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Background: Coronavirus disease 2019 (COVID-19) has become a worldwide issue due to its high prevalence and rapid transmission. Fungal infections have been detected in COVID-19 patients, leading to increased morbidity and mortality. Objectives: This study aimed to isolate Aspergillus fumigatus and Mucor spp. on mini-bronchoalveolar lavage samples obtained from children with COVID-19 hospitalized in an Iranian children’s hospital. Methods: A cross-sectional descriptive study was performed on mini-bronchoalveolar lavage samples from children confirmed positive for COVID-19 admitted to ICU with a ventilator from April 2021 to February 2022. Demographic characteristics were recorded, and fungal DNA was extracted from mini-BAL samples taken from children. Nested PCR was made with two primers for Aspergillus fumigatus and Mucor spp. Results: Out of 100 children with COVID-19, all samples were negative for Aspergillus fumigatus; however, 12 cases were positive for BAL PCR for Mucor spp. Among the 12 patients, fever, shortness of breath, cough, and decreased level of consciousness were reported in 8.3% (n: 1), 16.6% (n: 2), 25% (n: 3), and 25% (n: 3), respectively. Most cases (41.7%; n: 5) suffered from heart disease, followed by underlying malignancy (33.4%; n: 4). All positive BAL PCR for Mucor spp. cases had significantly higher chest CT scan scores and spent more time under a ventilator. Conclusions: The identification of COVID-19 with Mucor spp. was observed among 12% (n: 12) of children hospitalized in a COVID-19 ICU. When dealing with pediatric COVID-19 patients, clinicians should consider the differential diagnosis of fungal co-infections and have a low threshold to begin treatment. Moreover, it is highly advisable to take prophylactic measures, such as properly using corticosteroids and shortening the intubation time.

Keywords: aspergillosis, COVID-19 identification, mucormycosis, paediatrics

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Authors: Bih Ni Lee

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This paper discusses the unending coronavirus (Covid-19) pandemic. The activity of detecting, testing those with symptoms, and isolating their contacts is the most effective method of stopping the chain of coronavirus infection. The number of cases of coronavirus continues to increase with some reporting a cure, but not a few die. Efforts to treat and prevent continue to fight COVID-19 with flu-like symptoms. The importance of the study is to identify smartphone applications that can track the movement of individuals in an effort to curb the spread of COVID-19, especially in Malaysia. This research method used a literature review, which included new insights into the quality of action and scientific papers. It synthesized information gleaned from a variety of sources. The findings of the study are that the Government of Malaysia has launched three main applications to track the movement of individuals, namely Gerak Malaysia, MyTrace, MySejahtera. Similarly, every state in Malaysia has its own state government application to track individual movements. Overall, Malaysia is one of the countries in the world that has successfully curbed the spread of COVID-19; Covid-19 cases in Malaysia are under control.

Keywords: COVID-19 app, national security council, Gerak Malaysia, MyTrace, MySejahtera

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Authors: Shila Khayambashi

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Iran’s long history of patriarchy, coupled with the devaluation of women’s rights after Iran’s Islamic revolution of 1979, has subjected Iranian women to different forms of domestic abuse. Upon their migration, however, many Iranian women end their abusive relationship by filing for divorce. In many instances, leaving the abusive environment exposes these Iranian women to more dangerous circumstances. Iranian diasporic community has witnessed several domestically-charged fatalities in the past few years after the abused wives either ended their violent marriages or attempted to establish some control in their marital relationships. While the casualties have been reported in Iranian new media and press, the Canadian media failed to pay much attention to any of these cases. In this paper, I examine the post-migratory factors that encourage the abused Iranian women to leave their abusers after years of endurance. Additionally, I indicate the roles of organizational and governmental support for minority women who decide to terminate their violent relationships. I will also explore how the Canadian media outlets circumvent and ignore the cases of these minority victims.

Keywords: women's right, Divorce, Patriarchy, Domestic Abuse

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Authors: Melanie Moen, Christiaan Bezuidenhout

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Cases of parents murdering their offspring are incomprehensible but sadly as old as humanity itself. The act of killing your own child is known as filicide. Revenge filicide is an act where one parent kills their own offspring for retribution for hurting and upsetting the other parent. The true extent of filicide in South Africa is unknown, but in the United States, filicide constitutes more or less 2.5% of all murders. The focus of this contribution is to extend the knowledge of revenge filicide. Data was collected through court documents and newspaper articles. Newspapers that cover murder cases are between 75% to 100% accurate compared to official sources. Often family-related murders are violent in nature, and for this reason, these crimes receive extensive media coverage. The cases of twenty revenge filicide murderers (14 male and 6 female) were qualitatively analyzed to determine the motivations and offense characteristics of revenge filicide offenders. Findings related to a loss of social identity due to rejection; extreme rage-type anger; external locus of control; sadism; a desire to cause pain, and a need to inflict harm. The initial emotional response may escalate from mild anger to a level of narcissistic rage which eventually culminates in the murdering of the child to punish and hurt the other parent and to restore control. To our knowledge, our study is the first to systematically examine the motivations related to revenge filicides from a South African perspective. Filicide is a complex phenomenon with diverse possibilities and reasons why it occurs. However, it was apparent in this study that the motivations for revenge filicides were often linked to complex personal and interpersonal relationship problems. Further research within this field is imperative.

Keywords: revenge filicide, child murder, rage, anger, narcissistic rage, parent kills child

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Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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Authors: Ghandehari Motlagh, Mohammad

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Purpose: We tried to find the most common etiologies for anisometropia in pre-op cataract cases: axial or refractive. Methods: In this cross-sectional study ,41 pre-op cataract eyes with more than 0.33 difference between axial lengths of 2 eyes were enrolled.Considered for each 1mm difference between axial lengths in long eyes( AXL more than 25):1.75-2.00 D of anisometropia, for normal eyes(AXL: 22- 25):2.50D and for short eyes (AXL less than 22):3.50-3.75 D as axial anisometropia. If there are more or lesser anisometropia, we recorded as refractive anisometropia. Results: Average of anisometropia :4.24 D, prevalence of PK or LK :1 (2.38%), kc:1(2.38%), glaucoma surgery: 1(2.38%), and pseudophakic status of the opposite eye 8(19.04%). Prevalence of axial anisometropia:21 (52.4%) and refractive anisometropia 20(47.6%).Then on basis of this study we can rely on the patient’s refraction exactly before phaco for evaluation of axial length differences between the 2 eyes, because most of the anisometropias are axial. Conclusion: In most cases, cataract does not induce significant change in refractive error (secondary myopia) and AXL difference between the 2 eyes are correlated with anisometropia.so it can be used for cataract patient’s ocular biometry evaluation. Pre-cataract refraction is a valuable variable should be measured and recorded in routin eye examination.

Keywords: ocular axial length, anisometropia, cataract, ophthalmology and optometry

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Lajeesh Jabbar, Shibu T. Varghese

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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

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Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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Authors: Alireza Moghtaderi, Negin Khakpour

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Disc Herniation is a common complication in the society and it is one of the main reasons for referring to physical medicine and rehabilitation clinics. Despite of various methods proposed for treatingthis disease, still there is disagreement on success of these methods especially in non-surgical methods, and thus current study aims at determining effect of laser beam and magnet on treatment of Intervertebral Disc Herniation. During a clinical trial study, 80 patients with Intervertebral Disc Herniation underwent a combined package of treatment including magnet, laser beam, PRP and Prolotherapy during 6 months. Average age of patients was 51.25 ± 10.7 with range of 25 – 71 years. 30 men (37.5%) and 50 women (62.5%) took part in the study. average weight of patients was 64.3 ± 7.2 with range of 49 – 79 kg. highest level of Disc Herniation was L5 – S1 with frequency of 17 cases (21.3%). Disc Herniation was severe in 30 cases before treatment, but it reduced to 3 casesafter treatment. This study indicates effect of combined treatment using non-invasive laser beam and magnet therapy on disco genic diseases and mechanical pains of spine is highly effective.

Keywords: hallux, valgus, botulinum toxin a, pain

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Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak

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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.

Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation

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Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Benedikt Munzar, Jagraj Singh, Alice Mei, David Musheyev, Sandeep Gandhi

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Clostridium glycolicum is a gram-positive, anaerobic, spore-forming rod that is not commonly identified as a primary human pathogen. Here is presented a case of a 60-year-old patient with a history of opioid use disorder who underwent a number of abdominal surgeries for small bowel obstruction. His hospital course was complicated by Clostridium glycolicum infection, resulting in an acute abdomen. The patient clinically improved with antibiotic therapy. A thorough review of the National Institute of Health database revealed that only a small number of cases have been reported since 2007, with the last postsurgical cases documented in 2009 and the last clinical case documented in 2012. Clostridium glycolicum infections have been noted in patients with immunosuppressive conditions or those undergoing medical treatments that compromise immune function. This case was unusual due to the patient being immunocompetent. We suggest that a case of an acute abdomen should consider this organism as an etiological agent.

Keywords: acute abdomen, bacterial infection, clostridium glycolicum, Meckel’s diverticulum, pneumoperitoneum, small bowel obstruction

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