Search results for: oral and maxillofacial surgery

Authors: Odoh Ben Uruchi

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Information Technology is an outcome of the nexus between the computer technology and the communication technology which has grown as silver fiber in Nigeria. Information Technology represents the fourth generation of human communication after sight, oral and written communications. The internet, as with all path-breaking technological developments gives us all the ample privileges to act as a global community; advertise and operate across all frontiers; over boarders and beyond the control of any government. The security concerns, computer abuse and the side effects of this technology have moved to the forefront of the consciousness of law enforcement agencies. Unfortunately, Nigeria is one of the very few countries in the world to have not legislated Cyber Laws, although several unsuccessful attempts have been made in recent times at providing the legal framework for regulating the activities in Nigerian cyberspace. Traditional legal systems have led to great difficulty in keeping pace with the rapid growth of the internet and its impact throughout Nigeria. The only existing legal frameworks are constantly being challenged by technological advancement. This has created a need to constantly update and adapt the way in which we organize ourselves as Legal Practitioners in order to maintain overall control of its domestic and national interests. This paper seeks to appraise the challenges facing the legal profession in Nigeria because of want of Cyber Laws. In doing this, the paper shall highlight the loopholes in the existing laws and recommends the way forward.

Keywords: information technology, challenges, legal profession, Nigeria

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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: Muzaffar Iqbal, Essam Ezzeldin, Khalid A. Al-Rashood

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Pomalidomide is a second generation oral immunomodulatory agent, being used for the treatment of multiple myeloma in patients with disease refractory to lenalidomide and bortezomib. In this study, a sensitive UPLC-MS/MS assay was developed and validated for high-throughput determination of pomalidomide in rat plasma using celecoxib as an internal standard (IS). Liquid liquid extraction using dichloromethane as extracting agent was employed to extract pomalidomide and IS from 200 µL of plasma. Chromatographic separation was carried on Acquity BEHTM C18 column (50 × 2.1 mm, 1.7 µm) using an isocratic mobile phase of acetonitrile:10 mM ammonium acetate (80:20, v/v), at a flow rate of 0.250 mL/min. Both pomalidomide and IS were eluted at 0.66 ± 0.03 and 0.80 ± 0.03 min, respectively with a total run time of 1.5 min only. Detection was performed on a triple quadrupole tandem mass spectrometer using electrospray ionization in negative mode. The precursor to product ion transitions of m/z 272.01 → 160.89 for pomalidomide and m/z 380.08 → 316.01 for IS were used to quantify them respectively, using multiple reaction monitoring mode. The developed method was validated according to regulatory guideline for bioanalytical method validation. The linearity in plasma sample was achieved in the concentration range of 0.47–400 ng/mL (r2 ≥ 0.997). The intra and inter-day precision values were ≤ 11.1% (RSD, %) whereas accuracy values ranged from - 6.8 – 8.5% (RE, %). In addition, other validation results were within the acceptance criteria and the method was successfully applied in a pharmacokinetic study of pomalidomide in rats.

Keywords: pomalidomide, pharmacokinetics, LC-MS/MS, celecoxib

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Authors: H. R. Kelidari, M. Saeedi, J. Akbari, K. Morteza-Semnani, H. Valizadeh

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Spironolactoe (SP) a synthetic steroid diuretic is a poorly water-soluble drug with a low and variable oral bioavailability. Regarding to the good solubility of SP in lipid materials, SP loaded Solid lipid nanoparticles (SP-SLNs) and nanostructured lipid carrier (SP-SLNs) were thus prepared in this work for accelerating dissolution of this drug. The SP loaded NLC with stearic acid (SA) as solid lipid and different Oleic Acid (OA) as liquid lipid content and SLN without OA were prepared by probe ultrasonication method. With increasing the percentage of OA from 0 to 30 wt% in SLN/NLC, the average size and zeta potential of nanoparticles felled down and entrapment efficiency (EE %) rose dramatically. The obtained micrograph particles showed pronounced spherical shape. Differential Scanning Calorimeter (DSC) measurements indicated that the presence of OA reduced the melting temperature and melting enthalpy of solid lipid in NLC structure. The results reflected good long-term stability of the nanoparticles and the measurements show that the particle size remains lower in NLC compare to SLN formulations, 6 months after production. Dissolution of SP-SLN and SP-NLC was about 5.1 and 7.2 times faster than raw drugs in 120 min respectively. These results indicated that the SP loaded NLC containing 70:30 solid lipid to liquid lipid ratio is a suitable carrier of SP with improved drug EE and steady drug release properties.

Keywords: drug release, lipid nanoparticles, spironolactone, stability

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Authors: Gayatri Kanwar

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The purpose of this research paper is to explore the power of myth in changing human lives; it establishes patterns in the human psyche, affects the way of thinking, as myths unveil various subjects, ideas, and challenges. Through mythological stories one comes to understand the images behind the emotions and feelings, they influence him as it changes his thought patterns, their therapeutic sets the individual on the path of healing and transforms human lives. Every civilization in the olden times had a vast source of myths which they lived by. They were not ordinary stories of everyday life, but exemplary cases narrated through oral traditions in a sacred manner revealed the 'way to live life'. The mythical stories have a spiritual touch which brought him to the acceptance of suffering or finding a solution to his life problems. In modern times, the significance of the age old myth has lost their touch. Each one of us bears countless stories inside ourselves of our own lives and all its happenings. Therefore, each being is a natural narrator. Everybody tells stories about their lives; hence, one tends to know oneself as well as seeks understanding of others through them. When one remembers their stories they speak in narratives. As stated by Jung, these narratives grow into a personal mythology one lives by. Nonetheless, there are times when one becomes stuck in their own stories or myths. Hence, mythology can change one’s perception and can open pathways to other ways of discovering, feeling and experiencing one’s lives.

Keywords: Power of Myths, Significance of myths in modern times, Transforming human lives, Benefits to Society

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Authors: Farid Noor Romadlon

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Welcoming the ASEAN Economic Community and globalization, people need to have a good communication skill. Being able to speak English is one of important qualification in this skill and as global citizen. This study focused on fostering fresh graduate students’ confidence in speaking English. So, students have good performance in speaking. There were thirty (30) students from first semester of English Education Department who joined Intensive Course class as the subject. They had poor motivation to speak English since English is a foreign language which is not exposed in their environment. This study used Three Communicative Activities technique in twelve successive meetings totally. It was done in two cycles (six meetings for each) since there were some activities should be improved in the first session (cycle). Oral test was administered to find the quantitative result and observation conducted to strengthen the finding. The result indicated that Three Communicative Activities improved students’ confidence in speaking English. They had significant progress in their performance in the class. The technique which allowed students to have more spaces to explore and express their ideas to their friends increased their confidence in their performance. The group or cooperative activities stimulated students to think critically in the discussion and promoted their confidence to talk more.

Keywords: students’ confidence, three communicative activities, speaking, Muria Kudus University

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Authors: Tahmineh Hasanzadeh, Afshin Farahbakhsh

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There is some report about the hypoglycemic effect of Juglans rejia L. leaf in alloxan induced diabetic rats and hypoglycemic effect of its fruit peel administered intraperitoneally.In Iranian traditional medicine, septum of walnut shell (SWS) was recommended to reduce blood glucose. For this purpose, 41 male bulb/C mice 25-30 gm were divided into five groups. All the animals received IP injection of streptozotocin (STZ) (220 mg/kg). Two weeks later, the diabetic animals were received daily oral treatment of normal saline and aqueous extract of SWS (200, 400, 600 and 800 mg/kg) respectively for four weeks. Blood samples were taken from retro orbital sinus before the start of the experiment and repeated each two weeks. At the end of the experiment, the animals were sacrificed and the pancreatic tissues were fixed, prepared and stained by Hematoxylin-Eosin for light microscope studies. The results showed that in each group, the SWS extract reduced blood glucose in a long time (p < 0.05). metabolic extract in STZ- induced diabetic rats, which was accompanied by the hypoglycemic effect of leaf extract. However, this effect should be determined with scientific researches. Therefore, the aim of this study is to evaluate the effect of the aqueous extract of SWS on blood glucose and histopathological structure of pancreas.

Keywords: septum of walnut, blood glucose, pancreas, diabetes, walnut leaf, walnut peel, insulin

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Authors: Kartika Marta Budiana

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Low competence in speaking for the students of Non English native speakers have been crucial so far for the teachers in language teaching in Indonesia. This study attempts to explore the effect of video using in teaching speaking onstudents of non-native English speakers at STIE Perbanas Surabaya. This includes investigate the students` attitudes toward the video used in classroom. This is a quantitative research that is an experimental one based on analyses derived the concepts of from teaching speaking and the use of video. There are two classes observed, the experimental and the control one. The experimental consist of 28 students and the control class consists of 25 students. Before the treatment given, both of the group is given the pre-test to check their ability level. Then, after the treatment is given, the post-test is given to the both groups. Then, the students were given treatment how to conduct a meeting that they learnt from a video of business English. The post test was held after they undergone a treatment. The instruments to get the data are the oral test and questionnaire. The data of this study is students` score and from the tests` score it can be seen there is a positive significant difference in the experimental group. The t-test to test hypothesize also shows that it is accepted which said that there is an improvement on the students` speaking competence achievement. In conclusion, the video effects on the significant difference on the students speaking competence achievement.

Keywords: video, teaching, speaking, Indonesia

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Authors: M. T. Becerra-Traver, M. Montanero, R. Alejo, A. Antúnez, P. Cañamero, M. J. Fernández, M. Gómez, A. L. Medialdea, J. D. Martínez, A. M. Piquer-Píriz, M. J. Rabazo

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The introduction of new subjects at university level, brought about with the implementation of the European Higher Education Area (EHEA), has meant changes for students and lecturers that, in the case of the latter, have also revealed a need for further training. In our context, one of the main changes has been the introduction of Undergraduate Thesis Projects (UTPs) in the degrees taught in our faculty: Pre-Primary and Primary Education. The aim of this paper is to analyze UTPs and to provide some suggestions that can help both students and lecturers in the process. UTPs complete the university training cycle of the Degree Studies and entail the elaboration of a written piece of work, supervised by a professor and presented to a panel in order to ensure that students acquire the required competences of these Degrees to develop an autonomous, responsible and comprehensive activity. In addition, UTPs develop students’ abilities for oral presentations and to defend and argue their own ideas. One of the first difficulties in the supervision of UTPs is that most of the students do not know how to write an academic text. To solve this problem, we propose a three-phase model based on planning, textualization and review. The implementation of this model has enabled us to see a successful evolution in the correct development of the academic dissertations that students submit at the end their degrees.

Keywords: academic task, student, tutoring, university

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Authors: Sarah Nasr, Maha M. A. Nasra, Ossama Y. Abdallah

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The present work aimed to prepare Silymarin loaded MCM-41 type mesoporous silica nanoparticles (MSNs) and to assess the system’s solubility enhancement ability on the pharmacodynamic performance of Silymarin as a hepatoprotective agent. MSNs prepared by soft-templating technique, were loaded with Silymarin, characterized for particle size, zeta potential, surface properties, DSC and XRPD. DSC and specific surface area data confirmed deposition of Silymarin in an amorphous state in MSNs’ pores. In-vitro drug dissolution testing displayed enhanced dissolution rate of Silymarin upon loading on MSNs. High dose Acetaminophen was then used to inflict hepatic injury upon albino male Wistar rats simultaneously receiving either free Silymarin, Silymarin loaded MSNs or blank MSNs. Plasma AST, ALT, albumin and total protein and liver homogenate content of TBARs or LDH as measures of antioxidant drug action were assessed for all animal groups. Results showed a significant superiority of Silymarin loaded MSNs to free drug in almost all parameters. Meanwhile prolonged administration of blank MSNs had no evident toxicity on rats.

Keywords: mesoporous silica nanoparticles, safety, solubility enhancement, silymarin

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Authors: Nawel Ouennoughi, Kamel Daoud

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During recent years, new pharmaceutical dosage forms were developed in the research laboratories and which consists of encapsulating one or more active molecules in a polymeric envelope. Several techniques of encapsulation allow obtaining the microparticles or the nanoparticles containing one or several polymers. In the industry, microencapsulation is implemented to fill the following objectives: to ensure protection, the compatibility and the stabilization of an active matter in a formulation, to carry out an adapted working, to improve the presentation of a product, to mask a taste or an odor, to modify and control the profile of release of an active matter to obtain, for example, prolonged or started effect. To this end, we focus ourselves on the encapsulation of the antidiabetic. It is an oral hypoglycemic agent belonging to the second generation of sulfonylurea’s commonly employed in the treatment of type II non-insulin-dependent diabetes in order to improve profile them dissolution. Our choice was made on the technique of encapsulation by complex coacervation with two types of polymers (gelatin and the gum Arabic) which is a physicochemical process. Several parameters were studied at the time of the formulation of the microparticles and the nanoparticles: temperature, pH, ratio of polymers etc. The microparticles and the nanoparticles obtained were characterized by microscopy, laser granulometry, FTIR and UV-visible spectrophotometry. The profile of dissolution obtained for the microparticles showed an improvement of the kinetics of dissolution compared to that obtained for the active ingredient.

Keywords: coacervation, gum Arabic, microencapsulation, gelatin

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Authors: Raka Aldy Nugraha, Kiwah Andanni, Aditya Indra Pratama, Aswin Guntara

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Background: Torus palatinus is a bony protuberance in the hard palate. Sex and race are considered as influencing factors for the development of torus palatinus. Hence, the objective of this study was to determine the prevalence and characteristics of torus palatinus and its correlation with sex and ethnicity among Western Indonesian Population. Methods: We conducted a descriptive and analytical study employing cross-sectional design in 274 new students of Universitas Indonesia. Data were collected by using consecutive sampling method through questionnaire-filling and direct oral examination. Subject with racial background other than indigenous Indonesian Mongol were excluded from this study. Data were statistically analyzed using chi square test for categorical variables whereas logistic regression model was employed to assess the correlation between variables of interest with prevalence of torus palatinus. Results: Torus palatinus were found in 212 subjects (77.4%), mostly small in size (< 3 mm) and single in number, with percentage of 50.5% and 90.6%, respectively. The prevalence of torus palatinus were significantly higher in women (OR 2.88; 95% CI: 1.53-5.39; p = 0.001), dominated by medium-sized and single tori. There was no significant correlation between ethnicity and the occurrence of torus palatinus among Western Indonesian population. Conclusion: Torus palatinus was prevalent among Western Indonesian population. It showed significant positive correlation with sex, but not with ethnicity.

Keywords: characteristic, ethnicity, Indonesia, mongoloid, prevalence, sex, Torus palatinus

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Authors: R. V. Dahibhate, A. B. Deoghare, P. M. Padole

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Maintaining natural integrity of biosystem is paramount significant for orthopedic surgeon while performing surgery. Restoration is challenging task to rehabilitate trauma patient. Drilling is an inevitable procedure to fix implants. The task leads to rise in temperature at the contact site which intends to thermal necrosis. A precise monitoring can avoid thermal necrosis. To accomplish it, data acquiring instrument is integrated with the drill bit. To contemplate it, electronic feedback system is developed. It not only measures temperature without any physical contact in between measuring device and target but also visualizes the site and monitors correct movement of tool path. In the current research work an infrared thermometer data acquisition system is used which monitors variation in temperature at the drilling site and a camera captured movement of drill bit advancement. The result is presented in graphical form which represents variations in temperature, drill rotation and time. A feedback system helps in keeping drill speed in threshold limit.

Keywords: thermal necrosis, infrared thermometer, drilling tool, feedback system

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Authors: Mallem Leila, Aiche Mohamed Amine, Boulakoud Mohamed Salah

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A number of chemical compounds are being used to protect agricultural crops from diseases. Residues of these chemicals lead to environmental pollution and pose some threat to non target organisms, human and animal. The aim of this study is to detect the toxicity of these fungicides and their mixtures in the fertility and biochemical’s parameters in the rat. The male of rats (28) were used, they were divided in four groups (7 rats of each group) and one group was used as control. Rats were dosed orally with propiconazole (60 mg/kg body weight/day), propinebe (100 mg/Kg body weight/day) and their mixture (50:50) for 4 weeks. Animals were observed for clinical toxicity. At the end of treatment period, animals of all groups were scarified and samples of different organs were fixed in the formol 10% for histopathological study, and blood was collected for hematological and biochemical’s analysis. The results indicated that the fungicide and their mixture of fungicides were toxic in the treated animals. The semen study showed a decrease in the count, mobility and speed of spermatozoa in all treated group especially those dosed with the mixture and Propiconazole, it was also a decrease in the weight of the testis and epidydimis in the treated group as compared with control. Remarquable histological changes were observed in the testis and epidydimis and liver in the group treated with mixture.

Keywords: fungicides, mixture, fertility, hematological, biochemical's parameters

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Authors: Muhammad Younus, Muhammad Sajid, Muti-ur-Rehman Khan, Aftab Ahmad Anjum, Muhammad Asif Idrees, Iahtasham Khan, Aman Ullah Khan, Sajid Umar, Raheela Akhtar

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The present study was conducted to investigate the hazardous effects of lead on health and edible organs of Lohi sheep. The adult Lohi sheep (n=48) were randomly divided into two equal groups. The first group was administered lead acetate at dose of 70 mg/kg live body weight daily as 10% solution by oral route for a period of 90 days and the second group served as a negative control. Blood and tissue samples were collected at day 0, 30, 60 and 90 and analyzed for lead concentration by atomic absorption spectrophotometry. The kidney showed the highest lead concentration (p < 0.05) followed by liver and then muscle. Lead acetate treated sheep showed structural and behavioral changes during the last month of trial. Liver showed necrosis, hemorrhages and hyperactivation of macrophages. Kidney showed degenerative and necrotic changes in glomeruli and tubules and the characteristic intranuclear inclusion bodies in tubular epithelial cells on H and E staining. It was concluded that Lohi sheep is affected by lead intoxication at low dose for longer period and hence exhibits lead accumulation in edible tissues.

Keywords: Lohi sheep, lead acetate, edible tissue, histopathology

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Authors: Shaival Dalal, Nilesh Shah, Dinshaw Pardiwala, David Rajan, Satyen Sanghavi, Charul Bhanji

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Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.

Keywords: knee, chondrocyte, autologous chondrocyte implantation, fibrin gel based

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Authors: Turan Çalban, Oral Laçin, Abdüsselam Kurtbaş

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The experimental production methods Chevreul’s salt being a intermediate stage product for copper recovery were investigated by dealing with the articles written on this topic. Chevreul’s salt, Cu2SO3.CuSO3.2H2O, being a mixed valence copper sulphite compound has been obtained by using different methods and reagents. Chevreul’s salt has a intense brick-red color. It is a highly stable and expensive salt. The production of Chevreul’s salt plays a key role in hiydrometallurgy. In recent years, researchs on this compound have been intensified. Silva et al. reported that this salt is thermally stable up to 200oC. Çolak et al. precipitated the Chevreul’s salt by using ammonia and sulphur dioxide. Çalban et al. obtained at the optimum conditions by passing SO2 from leach solutions with NH3-(NH4)2SO4. Yeşiryurt and Çalban investigated the optimum precipitation conditions of Chevreul’s salt from synthetic CuSO4 solutions including Na2SO3. Çalban et al. achieved the precipitation of Chevreul’s salt at the optimum conditions by passing SO2 from synthetic CuSO4 solutions. Çalban et al. examined the precipitation conditions of Chevreul’s salt using (NH4)2SO3 from synthetic aqueous CuSO4 solutions. In light of these studies, it can be said that Chevreul’s salt can be produced practically from both a leach solutions including copper and synthetic CuSO4 solutions.

Keywords: Chevreul’s salt, ammonia, copper sulpfite, sodium sülfite, optimum conditions

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Authors: Abdelmaguid Ramzy, Mohamed Bahaa

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Introduction: The effects of ovarian endometrioma on fertility outcomes with IVF have been always related to poor outcomes. Objective: To evaluate the effect of unilateral unoperated ovarian endometrioma < 2cm on the number of developing follicles and compare them with the contralateral ovary as a control. Design: Retrospective case control study. Setting: KasrEl-Aini IVF center. Patient(s): We studied 32 women with unilateral endometrioma who underwent their first IVF cycle. Methods: 32 Patients aged between 20-35 years selected for IVF who were diagnosed with one unilateral endometrioma (diameter <2 cm) and who did not undergo previous ovarian surgery were retrospectively identified. The number of follicles > 17 mm during folliculometry on the day of HCG trigger in the ovary that contained endometrioma were compared with those from the contralateral ovary. They were all hyperstimulated using long protocol with (225-300 IU) gonadotrophins. Primary outcome: The number of follicles > 17 mm during folliculometry on the day of HCG trigger. Result(s): The mean ± SD age, Day 3 serum FSH and LH were 27± 3.7 years, 5.8 ± 1.6 IU/ml and 4.5 ± 1.7 IU/ml respectively. There was no significant difference in the number of follicles > 17 mm on the day of HCG trigger in the ovary that contained endometrioma (4.4 ±2.5) and in the opposite ovary (4.5 ± 2.8) (P= 0.48). Conclusion: The presence of ovarian endometrioma in a controlled ovarian hyperstimulation cycle for IVF treatment is not associated with a reduced number of follicles > 17 mm during folliculometry on the day of HCG trigger.

Keywords: endometrioma, folliculometry, hyperstimulation, fertility

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Monica Trifitriana, Rido Mulawarman

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Introduction: Androgenetic alopecia (AGA) is a genetically predetermined disorder due to an excessive response to dihydrotestosterone (DHT). Currently, non-surgical treatment of androgenetic alopecia is more in demand by the patient. There are many non-surgical treatments, ranging from topical treatments oral medications, and procedure treatments. Objective: We aim to assess the latest evidence of the efficacy of non-surgical treatments of androgenetic alopecia in men in comparison to placebo for improving hair density, thickness, and growth. Method: We performed a comprehensive search on topics that assess non-surgical treatments of androgenetic alopecia in men from inception up until November 2021. Result: There were 24 studies out of a total of 2438 patients divided into five non-surgical treatment groups to assess the effectiveness of hair growth, namely: minoxidil 2% (MD: 8.11 hairs/cm²), minoxidil 5% (MD: 12.02 hairs/cm²), low-level laser light therapy/LLLT (MD: 12.35 hairs/cm²), finasteride 1mg (MD: 20.43 hairs/cm²), and Platelete-Rich Plasma/PRP with microneedling (MD: 26.33 hairs/cm²). All treatments had significant results for increasing hair growth, particularly in cases of androgenetic alopecia in men (P<0.00001). Conclusion: From the results, it was found that the five non-surgical treatment groups proved to be effective and significant for hair growth, particularly in cases of androgenetic alopecia in men. In order of the best non-surgical treatment for hair growth is starting from PRP with microneedling, Finasteride 1mg, LLLT, minoxidil 5%, to minoxidil 2%.

Keywords: androgenetic alopecia, non-surgical, men, meta-analysis, systematic review

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Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

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Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the review type to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen levels in the blood after non-surgical periodontal treatment of periodontitis in the patient's cavity is visible data and supported by literature sources. Also, the influence of a high amount of fibrinogen in the blood on the occurrence of arteriosclerosis is also another important data that again relies on many sources of literature. Conclusions: Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment

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Authors: Hadi Abdollahi, Bijan Iraj, Maryam Mirpourian, Behzad Shariatifar

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Background: The aim of the present study was to determine the relationship between neck circumferences (NC), as an indicator of upper body obesity, with anthropometric and cardio-metabolic factors among the first degree relatives of diabetes patients. Materials and Methods: This cross-sectional study was performed on first degree relatives of diabetes patients (n = 213). Weight, height, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and NC were measured. Laboratory data included oral glucose tolerance test (OGTT) results, high density lipoprotein (HDL), low density lipoprotein, triglyceride (TG) and total cholesterol. Results: There was no difference in NC among different results of OGTT in men or women. Factors including weight, body mass index (BMI), WC and HC were strongly associated with NC in both genders (r = 0.420-0.711). NC was weakly associated with SBP in women (r = 0.195) and moderately with DBP in men (r = 0.314). Regarding lipid profile, HDL and TG were associated with NC only in women (r = −0.268-0.325). Conclusions: NC has a significant correlation with gender and anthropometric variables, including BMI, weight and waist and HCs in both men and women, but it does not differ significantly in patients with different status in OGTT.

Keywords: body mass index, cardiovascular, diabetes, neck circumference, obesity

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Authors: Sadeq Al Yaari, Fayza Al Hammadi, Nassr Almaflehi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background: The language of EFL learners is of special interests to linguists. Little research has been tackled on issues concerning English Discourse Markers (EDMs) among Saudi EFL learners. Aims: Employing a corpus-based descriptive analysis, the current study attempts at detecting EDMs in the talk of Saudi EFL learners, their frequency, use, usage, etc., in comparison to other EFL learners as well as native speakers. Methods: Two hundreds Saudi EFL learners were randomly selected from 20 public and private schools (ten students from each school) across the Kingdom of Saudi Arabia (KSA). Subjects were individually recorded while they were studying English in class. Recordings were then linguistically and statistically analyzed by the researchers. Conclusion: Results illustrate that EDMs “and”, “but” and “also” are the most frequent EDMs in the talk of Saudi EFL learners. These devices are randomly used by Saudi EFL learners who mix their use (appropriateness) with usage (correctedness) due to the influence of their L1 (Arabic). In compare to other EFL learners (native and non-native), Saudi EFL learners use less EDMs. These results confirmed the claims that EFL learners use EDMs less than native speakers. This paper, although preliminary in nature, can help arrive a better understanding of using EDMs by Saudi EFL learners. Further, it can also assist in getting appropriate insights into the way how these EDMs are used in Arab Gulf countries. The researchers decided to conduct an in-depth study into the use of EDMs in the oral work of Saudi EFL learners.

Keywords: English discourse markers, Saudi EFL learners, use, usage, frequency, native speakers

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Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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Authors: Bindya Jacob

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The aim of the present study was to assess the quality of catchup growth induced by Oral Nutrition Supplement (ONS), in animal model of growth restriction due to under nutrition. Quality of catch-up growth was assessed by proportion of lean body mass (LBM) and fat mass (FM). Young SD rats were food restricted at 70% of normal caloric intake for 4 weeks; and re-fed at 120% of normal caloric intake for 4 weeks. Refeeding diet had 50% calories from animal diet and 50% from ONS formulated for optimal growth. After refeeding, the quantity and quality of catch-up growth were measured including weight, length, LBM and FM. During nutrient restriction, body weight and length of animals was reduced compared to healthy controls. Both LBM and FM were significantly lower than healthy controls (p < 0.001). Refeeding with ONS resulted in increase of weight and length, with significant catch-up growth compared to baseline (p < 0.001). Detailed examination of body composition showed that the catch-up in body weight was due to proportionate increase of LBM and FM, resulting in a final body composition similar to healthy controls. This data supports the use of well-designed ONS for recovery from growth restriction due to under nutrition, and return to normal growth trajectory characterized by normal ratio of lean and fat mass.

Keywords: catch up growth, body composition, nutrient restriction, healthy growth

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Authors: Adriana B. Ribeiro, Camila B. Araujo, Frank L. Bueno, Luiz Eduardo V. Silva, Caroline V. Fortes, Helio C. Salgado, Rubens Fazan Jr., Claudia H. L. da Silva

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Denture-related stomatitis (DRS) has recently been associated with deleterious cardiovascular effects, including hypertension. This study evaluated salivary parameters, blood pressure (BP) and heart rate variability (HRV), before and after DRS treatment in edentulous patients (n=14). Collection of unstimulated and stimulated saliva, as well as blood pressure (BP) measurements and electrocardiogram recordings were performed before and after 10 days of DRS treatment. The salivary flow (mL/min) was found similar at both times while pH was smaller (more neutral) after treatment (7.3 ± 2.2 vs. 7.1 ± 0.24). Systolic BP (mmHg) showed a trend, but not a significant reduction after DRS treatment (158 ± 25.68 vs. 148 ± 16,72, p=0,062) while diastolic BP was found similar in both times (86 ± 13.93 and 84 ± 9.38). Overall HRV, measured by standard deviation of RR intervals was not affected by DRS treatment (24 ± 4 vs 18 ± 2 ms), but differences of successive RR intervals (an index of parasympathetic cardiac modulation) increased after the treatment (26 ± 4 vs 19 ± 2 ms). Moreover, another index of vagal modulation of the heart, the power of RR interval spectra at high-frequency, was also markedly higher after DRS treatment (236 ± 63 vs 135 ± 32 ms²). Such findings strongly suggest that DRS is linked to an autonomic imbalance with sympathetic overactivity, which is markedly deleterious, increasing cardiovascular risk and the incidence of diseases such as hypertension. Acknowledgment: This study is supported by FAPESP, CNPq.

Keywords: biofilm, denture stomatitis, HRV, blood pressure

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Authors: Nura Bello

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Sokoto caliphate is the product of a hectic revolutionary movement that took place in the first decade of the nineteenth century under the leadership of Seikh Usmanu Danfodio. The movement led to the overthrow of the Sarauta system in Hausa Land, leading to the emergence of the Sokoto caliphate and Sokoto city as its headquarters. This development led to the collapse of Alkalawa (headquarters of the Gobir Kingdom) in 1808. A year later, in 1809, Sokoto city emerged as the headquarter of the Sokoto Caliphate. Due to the open door policy adopted by the leaders, the city came to experience an influx of people especially craft manufacturers from all over Hausa Land and beyond, who occupied many areas of the city and engaged in different craft production. This paper aims to highlight the development of crafts manufacturing in the 19th century Sokoto city and its contribution to transforming the city into a major economic base of the caliphate. In dealing with the above issue, qualitative research methods that mainly involve the use of oral and archival data will be adopted. Finally, the paper identified that the expansion of craft manufacturing in the 19th century Sokoto city could have resulted from the role played by the leadership of the caliphate, which favoured such development. The paper argues that if those industries were revived in Nigeria today, they would ultimately create various jobs among the younger generations, which would result in economic prosperity.

Keywords: craft manufacturing, diversification, economy, migration

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Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

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Authors: Christian Nwaoha

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This study investigates taboo expressions and classifications in Igbo discourse, their socio-cultural factors affecting their usage. The study classifies Linguistic taboo expressions by their discourse into five categories: morality-related taboo, veneration-related, decorum-related, religion-related and fear-related taboo expressions. This study argues that while religion-related and decorum-related taboos are unmentioned and have no euphemistic synonyms is because they are closely tied to various Igbo deities and objects, while morality, veneration, and fear-related have permissible alternatives. A descriptive research design was adopted and the data collection was by questionnaire and oral interview. The result of the research proves that aside of the categories of taboos in Igbo, socially, the styles of discourse have some levels of gender, age and class-connected taboos, which for instance, in gender-connected taboos, women in Igbo are forbidden to use style of discourse that are connected with genital organs in social gathering comprising men and women. The same has to do with class-connected where much younger men can use some certain expressions that are taboo, but in much older men gathering such expressions would be tagged forbidden in the context. The study further reveals that there are occasions in which these taboos can be used with reasons. The research concludes that using these taboos in literary text can enhance clear understanding of Igbo taboos to the users and learners of Igbo language.

Keywords: taboo expressions, classifications, Igbo, socio-cultural factors, discourse

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Authors: Xia Chen, Yulan Wang

Abstract:

purpose: To compare the accuracy of Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, Emmetropia Verifying Optical (EVO) and Kane for intraocular lens power calculation in patients with axial length (AL) ≥ 28 mm. Methods: In this retrospective single-center study, 50 eyes of 41 patients with AL ≥ 28 mm that underwent uneventful cataract surgery were enrolled. The actual postoperative refractive results were compared to the predicted refraction calculated with different formulas (Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, EVO and Kane). The mean absolute prediction errors (MAE) 1 month postoperatively were compared. Results: The MAE of different formulas were as follows: Haigis (0.509), SRK/T (0.705), T2 (0.999), Holladay 1 (0.714), Hoffer Q (0.583), Barrett Universal II (0.552), EVO (0.463) and Kane (0.441). No significant difference was found among the different formulas (P = .122). The Kane and EVO formulas achieved the lowest level of mean prediction error (PE) and median absolute error (MedAE) (p < 0.05). Conclusion: The Kane and EVO formulas had a better success rate than others in predicting IOL power in high myopic eyes with AL longer than 28 mm in this study.

Keywords: cataract, power calculation formulas, intraocular lens, long axial length

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