Search results for: inter-state cases

Authors: Afzaal Bashir, Sunaina Afzaal

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Background: Facial contour deformities associated with pigmentary changes are of major concern for plastic surgeons, both being important and difficult in treating such issues. No definite ideal treatment option is available to simultaneously address both the contour defect as well as related pigmentation. Objectives: The aim of the current study is to compare the long-term effects of conventional adipose tissue grafting and ex-vivo expanded Mesenchymal Stem Cells enriched adipose tissue grafting for the treatment of contour deformities with pigmentary changes on the face. Material and Methods: In this study, eighty (80) patients with contour deformities of the face with hyperpigmentation were recruited after informed consent. Two techniques i.e., conventional fat grafting (C-FG) and fat grafts enriched with expanded adipose stem cells (FG-ASCs), were used to address the pigmentation. Both techniques were explained to patients, and enrolled patients were divided into two groups i.e., C-FG and FG-ASCS, per patients’ choice and satisfaction. Patients of the FG-ASCs group were treated with fat grafts enriched with expanded adipose stem cells, while patients of the C-FGs group were treated with conventional fat grafting. Patients were followed for 12 months, and improvement in face pigmentation was assessed clinically as well as measured objectively. Patient satisfaction was also documented as highly satisfied, satisfied, and unsatisfied. Results: Mean age of patients was 24.42(±4.49), and 66 patients were females. The forehead was involved in 61.20% of cases, the cheek in 21.20% of cases, the chin in 11.20% of cases, and the nose in 6.20% of cases. In the GF-ASCs group, the integrated color density (ICD) was decreased (1.08×10⁶ ±4.64×10⁵) as compared to the C-FG group (2.80×10⁵±1.69×10⁵). Patients treated with fat grafts enriched with expanded adipose stem cells were significantly more satisfied as compared to patients treated with conventional fat grafting only. Conclusion: Mesenchymal stem cell-enriched autologous fat grafting is a preferred option for improving the contour deformities related to increased pigmentation of face skin.

Keywords: hyperpigmentation, color density, enriched adipose tissue graft, fat grafting, contour deformities, Image J

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Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

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Authors: K. Djellabi, M. E. H. Latreche

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The induction heating phenomenon depends on various factors, making the problem highly nonlinear. The mathematical analysis of this problem in most cases is very difficult and it is reduced to simple cases. Another knowledge of induction heating systems is generated in production environments, but these trial-error procedures are long and expensive. The numerical models of induction heating problem are another approach to reduce abovementioned drawbacks. This paper deals with the simulation model of induction heating problem. The simulation model of induction heating system in COMSOL Multiphysics is created. In this work we present results of numerical simulations of induction heating process in pieces of cylindrical shapes, in an inductor with four coils. The modeling of the inducting heating process was made with the software COMSOL Multiphysics Version 4.2a, for the study we present the temperature charts.

Keywords: induction heating, electromagnetic field, inductor, numerical simulation, finite element

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Authors: Sedrak Vardanyan

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The investigation of the vibrational character of magnetic cylindrical shells placed in an axial magnetic field has important practical applications. In this work, we study the vibrational behaviour of such a cylindrical shell by making use of the so-called exact space treatment, which does not assume any hypothesis. We discuss the effects of several practically important boundary conditions on the vibrations of the described setup. We find that, for some cases of boundary conditions, e.g. clamped, simply supported or peripherally earthed, as well as for some values of the wave numbers, the vibrational frequencies of the shell are approximately zero. The theoretical and numerical exploration of this fact confirms that the vibrations are absent or attenuate very rapidly. For all the considered cases, the imaginary part of the frequencies is negative, which implies stability for the vibrational process.

Keywords: bending vibrational frequencies, exact space treatment, free vibrations, magnetic cylindrical shells

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Authors: Kathleen Cooney, Jennifer Coates, Lesley Leach, Kristin Hrenchir

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The objective of this retrospective study was to determine whether intrarenal injection of pentobarbital sodium is a practicable method of euthanasia in client-owned cats. 131 Cats were anesthetized using a combination of tiletamine, zolazepam, and acepromazine given by of subcutaneous or intramuscular injection. Once an appropriate plane of anesthesia was reached, 6 ml of pentobarbital sodium was injected into either the left or right kidney. The patient’s age, sex, estimated weight, presenting condition, estimated dehydration level, palpable characteristics of the kidney pre and post injection, physical response of the cat, and time to cardiopulmonary arrest were recorded. Analysis of 131 records revealed that cats receiving an intrarenal injection of pentobarbital sodium had an average time to cardiopulmonary arrest of 1 minute. The great majority (79%) experienced cardiopulmonary arrest in less than one minute with the remainder experiencing cardiopulmonary arrest between 1 and 8 minutes of the injection. 95% of cats had no observable reaction to intrarenal injection other than cardiopulmonary arrest. In the 19% of cases where kidney swelling was not palpable upon injection, average time to cardiopulmonary arrest increased from 0.9 to 1.6 min. Conclusions and Clinical Relevance: Intrarenal injections of pentobarbital sodium are similar in effect to intravenous methods of euthanasia. Veterinarians who elect to use intrarenal injections can expect cardiopulmonary arrest to occur quickly in the majority of patients with few agonal reactions. Intrarenal injection of pentobarbital sodium in anesthetized cats has ideally suited for cases of owner observed euthanasia when obtaining intravenous access would difficult or disruptive.

Keywords: euthanasia, injection, intrarenal, pentobarbital sodium

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Mohd Asrul Affedi, Nyi Nyi Naing

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Overdispersion is present in count data, and basically when a phenomenon happened, a Negative Binomial (NB) is commonly used to replace a standard Poisson model. Analysis of count data event, such as mortality cases basically Poisson regression model is appropriate. Hence, the model is not appropriate when existing a zero values. The zero-inflated negative binomial model is appropriate. In this article, we modelled the mortality cases as a dependent variable by age categorical. The objective of this study to determine existing overdispersion in mortality data of AIDS co-infection patients in Kelantan.

Keywords: negative binomial death rate, overdispersion, zero-inflation negative binomial death rate, AIDS

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Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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Authors: Karen Boaz, C. R. Charan

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Background: The infiltration of tumour stroma by eosinophils, Tumor-Associated Tissue Eosinophilia (TATE), is known to modulate the progression of Oral Squamous Cell Carcinoma (OSCC). Eosinophils have direct tumoricidal activity by release of cytotoxic proteins and indirectly they enhance permeability into tumor cells enabling penetration of tumoricidal cytokines. Also, eosinophils may promote tumor angiogenesis by production of several angiogenic factors. Identification of eosinophils in the inflammatory stroma has been proven to be an important prognosticator in cancers of mouth, oesophagus, larynx, pharynx, breast, lung, and intestine. Therefore, the study aimed to correlate TATE with clinical and histopathological variables, and blood eosinophil count to assess the role of TATE as a prognosticator in Oral Squamous Cell Carcinoma (OSCC). Methods: Seventy two biopsy-proven cases of OSCC formed the study cohort. Blood eosinophil counts and TNM stage were obtained from the medical records. Tissue sections (5µm thick) were stained with Haematoxylin and Eosin. The eosinophils were quantified at invasive tumour front (ITF) in 10HPF (40x magnification) with an ocular grid. Bryne’s grading of ITF was also performed. A subset of thirty cases was also assessed for association of TATE with recurrence, involvement of lymph nodes and surgical margins. Results: 1) No statistically significant correlation was found between TATE and TNM stage, blood eosinophil counts and most parameters of Bryne’s grading system. 2) Statistically significant relation of intense degree of TATE was associated with the absence of distant metastasis, increased lympho-plasmacytic response and increased survival (diseasefree and overall) of OSCC patients. 3) In the subset of 30 cases, tissue eosinophil counts were higher in cases with lymph node involvement, decreased survival, without margin involvement and in cases that did not recur. Conclusion: While the role of eosinophils in mediating immune responses seems ambiguous as eosinophils support cell-mediated tumour immunity in early stages while inhibiting the same in advanced stages, TATE may be used as a surrogate marker for determination of prognosis in oral squamous cell carcinoma.

Keywords: tumour-associated tissue eosinophilia, oral squamous cell carcinoma, prognosticator, tumoral immunity

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Authors: Khabat Barkhordari

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Hepatitis delta virus (HDV) is a RNA virus that needs the function of hepatitis B virus (HBV) for its propagation and assembly. Infection by HDV can occur spontaneously with HBV infection and cause acute hepatitis or develop as secondary infection in HBV suffering patients. Based on genome sequence analysis, HDV has several genotypes which show broad geographic and diverse clinical features. The aim of current study is determine the molecular epidemiology of hepatitis delta virus genotype in patients with positive HBsAg among different ethnic groups of Iran. This systematic review study reviews the results of different studies which examined 2000 Iranian patients with HBV infection from 2010 to 2015. Among 2000 patients in this study, 16.75 % were containing anti-HDV antibody and HDV RNA was found in just 1.75% cases. All of positive cases also have genotype I.

Keywords: HDV, genotype, epidemiology, distribution

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Authors: Tasneem Firdous Islam, G. D. Kedar

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The aim of this paper is to study the effect of internal heat generation in a transient infinitely long annular cylinder subjected to hygrothermal loadings. The linear dependence theory of moisture and temperature is derived based on Dufour and Soret effect. The meticulous solutions of temperature, moisture, and thermal stresses are procured by using the Hankel transform technique. The influence of the internal heat source on the radial aspect is examined for coupled and uncoupled cases. In the present study, the composite material T300/5208 is considered, and the coupled and uncoupled cases are analyzed. The results obtained are computed numerically and illustrated graphically.

Keywords: temperature, moisture, hygrothermoelasticity, internal heat generation, annular cylinder

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Authors: Shaghayegh Rafatpanah, Mehrnaz Rad, Ahmad Reza Movassaghi, Javad Khoshnegah

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The purpose of the present study was to investigate the prevalence of isolation, antimicrobial susceptibility and ERIC-PCR typing of staphylococci species from dogs with pyoderma. The study animals were 61 clinical cases of Iranian domestic dogs with the first-time pyoderma. The prevalence of pyoderma was significantly higher amongst adult (odds Ratio: 0.21; p=0.001) large breed (odds Ratio: 2.42; p=0.002)dogs. There was no difference in prevalence of pyoderma in male and females (odds Ratio: 1.27; p= 0.337). The 'head, face and pinna' and 'trunk' were the most affected lesion regions, each with 19 cases (26.76%). An identifiable underlying disease was present in 52 (85.24%) of the dogs. Bacterial species were recovered from 43 of the 61 (70.49%) studied animals. No isolates were recovered from 18 studied dogs. The most frequently recovered bacterial genus was Staphylococcus (32/43 isolates, 74.41%) including S. epidermidis (22/43 isolates, 51.16%), S. aureus (7/43 isolates, 16.27%) and S. pseudintermedius (3/43 isolates, 6.97%). Staphylococci species resistance was most commonly seen against amoxicillin (94.11%), penicillin (83.35%), and ampicillin (76.47%). Resistant to cephalexin and cefoxitin was 5.88% and 2.94%, respectively. A total of 27 of the staphylococci isolated (84.37 %) were resistant to at least one antimicrobial agent, and 19 isolates (59.37%) were resistant to three or more antimicrobial drugs. There were no significant differences in the prevalence of resistance between the staphylococci isolated from cases of superficial and deep pyoderma. ERIC-PCR results revealed 19 different patterns among 22 isolates of S. epidermidis and 7 isolates of S. aureus.

Keywords: dog, pyoderma, Staphylococcus, Staphylococcus epidermidis, Iran

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Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

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Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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Authors: Engy Eissa, Dina M. Yousri

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COVID-19 has hit massively the world economy, financial markets and even societies’ livelihood. The infectious disease caused by the most recently discovered coronavirus was claimed responsible for a shrink in the global economy by 4.4% in 2020. Shortly after the first case in Wuhan was identified, a quick surge in the number of confirmed cases in China was evident and a vast spread worldwide is recorded with cases surpassing the 500,000 cases. Irrespective of the disease’s trajectory in each country, a call for immediate action and prompt government intervention was needed. Given that there is no one-size-fits-all approach across the world, a number of containment and adoption policies were embraced. It was starting by enforcing complete lockdown like China to even stricter policies targeted containing the spread of the virus, augmenting the efficiency of health systems, and controlling the economic outcomes arising from this crisis. Hence, this paper has three folds; first, it examines the impact of containment policies taken by governments on controlling the number of cases and deaths in the given countries. Second, to assess the ramifications of COVID-19 on financial markets measured by stock returns. Third, to study the impact of containment policies measured by the government response index, the stringency index, the containment health index, and the economic support index on financial markets performance. Using a sample of daily data covering the period 31st of January 2020 to 15th of April 2021 for the 10 most hit countries in wave one by COVID-19 namely; Brazil, India, Turkey, Russia, UK, USA, France, Germany, Spain, and Italy. The aforementioned relationships were tested using Panel VAR Regression. The preliminary results showed that the number of daily deaths had an impact on the stock returns; moreover, the health containment policies and the economic support provided by the governments had a significant effect on lowering the impact of COVID-19 on stock returns.

Keywords: COVID-19, government policies, stock returns, VAR

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Authors: Ellen Bryant, Virginia Behmer, Rebecca Garbed, Jeanette O’Quin, Dana Howard

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As it currently stands, veterinary care in the United States is not accessible to everyone, and veterinarians regularly face cases of clients who are unable to provide necessary care to their animals regardless of the client’s desire to do so. There is currently limited research into how veterinarians address these issues of access to care. It is apparent that veterinarians regularly utilize funding or offer discounted services to treat cases that otherwise would go without care. With need currently exceeding the amount of funds and services available, veterinarians are tasked with deciding which cases are most deserving of assistance. This mixed methods study distributed a survey to companion animal veterinarians practicing in the United States to identify current trends in how these professionals apply principles of distributive justice in the scope of veterinary medicine. Ethical frameworks identified in human bioethics research into distributive justice were presented, along with demographic questions, to identify relationships between veterinarian priorities and the scope of their practice/respective roles/geographic region. By surveying veterinarians across a wide range of specialties, practice types, and clientele this study was able to assess how priorities and opinions shift based on external factors as well as among the respondents themselves. Participants were asked not only to choose how to distribute aid between different clients and case scenarios, but also asked directly which is the best way to distribute aid when need exceeds the resources available.

Keywords: access to veterinary care, bioethics, decision-making, distributive justice, subsidized care

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Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman

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People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5 % of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.

Keywords: Egypt, HCV infection, psycho-social adjustment, stigma

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Authors: V. K. Tewari, M. Hussain, H. K. D.Gupta

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Aims/Background: The existing Intraoperative-MRI(IMRI) of developed countries is too costly to be utilized in any developing country. We have used the preexisting 3-side open 0.2-tesla MRI for IMRI in India so that the maximum benefit of the goal of IMRI is attained with cost effective state of the art surgeries. Material/Methods: We have operated 36-cases since 13thNov2005 via IMRI to till date. The table of MRI is used as an operating table which can be taken to the P3 level and as and when we require MRI to be done then the table can slide to P1 level so that the intraoperative monitoring can be done. The oxygen/nitrous tubes were taken out from vent made in the wall of the MRI room to outside. The small handy Boyel’s trolley was taken inside the MRI room with a small monitor. Anesthesia is been given in the MRI room itself. Usual skin markings were given with the help of scout MRI fields so the preciseness is increased. Craniotomy flap raised or the laminectomy and the dura opened in the similar fashion by same instruments as for the non IMRI case. Now corticectomy is planned after the T1 contrast image to localize and minimize the cortical resection. Staged and multiple P3 to P1 position and vice versa is planned respectively so that the resection is optimized to around 0.5 mm for radiotherapy. Immediate preclosure hematoma and edemas can be differentiated and cared for it. Results: Same MRI images as compared to highly expensive MRI of western world are achieved. Conclusion: 0.2 tesla Intraoperative MRI can be used for operative work for cranial and spinal cases easily with highly cost effectiveness.

Keywords: intraoperative MRI, 0.2 tesla intraoperative MRI, cost effective intraoperative MRI, medical and health sciences

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Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu

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Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.

Keywords: HIV, hyperglycemia, doluteravir, diabetes

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Authors: Zhao Xinlei

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In general, interstate relations are diverse and include economic, political, military, and diplomatic. Therefore, by analyzing the development of the relationship between Malaysia and China, we can better verify how the Hirschman effect works between small countries and great powers. This paper mainly adopts qualitative research methods and uses Malaysia's 2020-2022 political crisis as a specific case to verify the practice of the Hirschman effect between small and large countries. In particular, the interest groups in small countries that are closely related to trade with extraordinary abilities, as the primary beneficiaries in the development of trade between the two countries, although they may use their resources to a certain extent to influence the decisions of small countries towards great powers, they do not fundamentally determine the small countries' response to large countries. In this process, the relative power asymmetry between states plays a dominant role, as small states lack trust and suspicion in political diplomacy towards large states based on the perception of threat arising from the relative power asymmetry. When developing bilateral relations with large countries, small states seek practical cooperation to promote economic and trade development but become more cautious in their political ties to avoid being caught in power struggles between large states or being controlled by them. The case of Malaysia-China relations also illustrates that despite the ongoing political crisis in Malaysia, which saw the country go through the transition from (Perikatan Nasional) PN to (Barisan Nasional) BN, different governments have maintained a pragmatic and proactive economic policy towards China to reduce suspicion and mistrust between the two countries in political and diplomatic affairs, thereby enhancing cooperation and interactions between the two countries. At the same time, the Malaysian government is developing multi-dimensional foreign relations and actively participating in multilateral, regional organizations and platforms, such as those organized by the United States, to maintain a relative balance in the influence of the US and China on Malaysia.

Keywords: Hirschman effect, interest groups, Malaysia, China, bilateral relations

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Authors: Urbánek Jiří J., Krahulec Josef, Urbánek Jiří F., Johanidesová Jitka

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These Computational assistance for the research and modelling of critical infrastructure subjects continuity deal with this paper. It enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It serves for crisis situations investigation and modelling within the organizations of critical infrastructure. In the first part of the paper, it will be introduced entities, operators and actors of DYVELOP method. It uses just three operators of Boolean algebra and four types of the entities: the Environments, the Process Systems, the Cases and the Controlling. The Process Systems (PrS) have five “brothers”: Management PrS, Transformation PrS, Logistic PrS, Event PrS and Operation PrS. The Cases have three “sisters”: Process Cell Case, Use Case and Activity Case. They all need for the controlling of their functions special Ctrl actors, except ENV – it can do without Ctrl. Model´s maps are named the Blazons and they are able mathematically - graphically express the relationships among entities, actors and processes. In the second part of this paper, the rich blazons of DYVELOP method will be used for the discovering and modelling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission. The crisis management of energetic crisis infrastructure organization is obliged to use the cycles for successful coping of crisis situations. Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process bring for crisis management fruitfulness and it is a good indicator and controlling actor of organizational continuity and its sustainable development advanced possibilities. The research reliable rules are derived for the safety and reliable continuity of energetic critical infrastructure organization in the crisis situation.

Keywords: blazons, computational assistance, DYVELOP method, critical infrastructure

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Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

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Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

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Authors: Dalson Figueiredo, Enivaldo Rocha, Ranulfo Paranhos, José Alexandre

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This paper analyzes the effects of institutional capacity on corruption. Methodologically, the research design combines both descriptive and multivariate statistics to examine two original datasets based on secondary data. In particular, we employ a principal component model to estimate an indicator of institutional capacity for both state audit institutions and subnational judiciary courts. Then, we estimate the effect of institutional capacity on two dependent variables: (1) incidence of administrative irregularities and (2) time elapsed to judge corruption cases. The preliminary results using ordinary least squares, negative binomial and Tobit models suggest the same conclusions: higher the institutional audit capacity, higher is the probability of detecting a corruption case. On the other hand, higher the institutional capacity of state judiciary, the lower is the time to judge corruption cases.

Keywords: institutional capacity, corruption, state level institutions, evidence from Brazil

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Authors: Rupert G. S. Legg

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The connection between poor health outcomes and living near contaminated land has long been understood. Less examined has been the impact of remediation on residents’ health. The cleaning process undoubtedly changes the local area in which it occurs, leading to the possibility that local housing and rental prices could increase resulting in the displacement of those least able to cope. Whether or not this potential displacement resulting from remediation has a considerable impact on health remains unknown. This review aims to determine how these health effects have been approached in the health geography literature. A systematic review of health geographies literature was conducted, searching for two-word clusters: ‘health’ and ‘remediation’ (100 articles); and ‘health’, ‘displacement’ and ‘gentrification’ (43 articles). 43 articles were selected for their relevance (7 from the first cluster, 20 from the second, and 16 from those cited within the reviewed articles). Several of the reviewed cases identified that potential displacement was a contributor to stress and worry in residents living near remediation projects. Likewise, the experience of displacement in other cases beyond remediation was linked with several mental health issues. However, no remediation cases followed-up on the ultimate effects of experiencing displacement on residents’ health. A reason identified for this was a tendency for reviewed studies to adopt a contextual or compositional approach, as opposed to a relational approach, which is more concerned with dimensions of mobility and temporality. Given that remediation and displacement both involve changing mobility and temporality, focussing solely on contextual or compositional factors is problematic. This review concludes by suggesting that more thorough, relational research is conducted into the extent to which potential displacement resulting from remediation affects health.

Keywords: contamination, displacement, health geography, remediation

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Authors: Mengqi Wu, Haiping Zhu, Chin J. Leo

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In this study, six experimental cases with different components (dry and wet soils and rocks) were considered to elucidate the influence of material composition on landslide profiles. The results show that the accumulation zone for all cases considered has a quadrilateral shape with two different bottom angles. The asymmetry of the accumulation zone can be attributed to the fact that soils in different parts of the landslide sliding can produce different speeds and suffer different resistances. The higher soil moisture can generate stronger cohesion between soils to reduce the volume of the sliding body during the landslide. The rock content can increase the accumulation angles to improve slope stability. The interaction between the irregular shapes of rocks and soils provides more resistance than that between spherical rocks and soils, which causes the slope with irregular rocks and soils to have higher stability.

Keywords: landslide, soil moisture, rock content, experimental simulation

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Authors: Ali Ilter Akdag, Pratima Ray

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Background:This acute gastroenteritis viruses such as rotavirus, astrovirus, and adenovirus are mainly responsible for diarrhea in children below < 5 years old. Molecular detection of these viruses is crucially important to the understand development of the effective cure. This study aimed to determine the prevalence of common these viruses in children < 5 years old presented with diarrhea from Lala Lajpat Rai Memorial Medical College (LLRM) centre (Meerut) North India, India Methods: Total 312 fecal samples were collected from diarrheal children duration 3 years: in year 2014 (n = 118), 2015 (n = 128) and 2016 (n = 66) ,< 5 years of age who presented with acute diarrhea at the Lala Lajpat Rai Memorial Medical College (LLRM) centre(Meerut) North India, India. All samples were the first detection by EIA/RT-PCR for rotaviruses, adenovirus and astrovirus. Results: In 312 samples from children with acute diarrhea in sample viral agent was found, rotavirus A was the most frequent virus identified (57 cases; 18.2%), followed by Astrovirus in 28 cases (8.9%), adenovirus in 21 cases (6.7%). Mixed infections were found in 14 cases, all of which presented with acute diarrhea (14/312; 4.48%). Conclusions: These viruses are a major cause of diarrhea in children <5 years old in North India. Rotavirus A is the most common etiological agent, follow by astrovirus. This surveillance is important to vaccine development of the entire population. There is variation detection of virus year wise due to differences in the season of sampling, method of sampling, hygiene condition, socioeconomic level of the entire people, enrolment criteria, and virus detection methods. It was found Astrovirus higher then Rotavirus in 2015, but overall three years study Rotavirus A is mainly responsible for causing severe diarrhea in children <5 years old in North India. It emphasizes the required for cost-effective diagnostic assays for Rotaviruses which would help to determine the disease burden.

Keywords: adenovirus, Astrovirus, hospitalized children, Rotavirus

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Authors: Gemma Garcia Lopez

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The goal of this study is to perform an emotional analysis of the hooks used in Facebook by three of the most important daily newspapers in the USA. These hook texts are used to get the user's attention and invite him to read the news and linked contents. Thanks to the emotional analysis in text, made with the tool of IBM, Tone Analyzer, we discovered that more than 30% of the hooks can be classified emotionally as joy, sadness, anger or fear. This study gathered the publications made by The New York Times, USA Today and The Washington Post during a random day. The results show that the choice of words by the journalist, can expose the reader to different emotions before clicking on the content. In the three cases analyzed, the absence of emotions in some cases, and the presence of emotions in text in others, appear in very similar percentages. Therefore, beyond the objectivity and veracity of the content, a new factor could come into play: the emotional influence on the reader as a mediatic manipulation tool.

Keywords: emotional analysis of newspapers hooks, emotions on Facebook, newspaper hooks on Facebook, news publication on Facebook

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Authors: Samira-Sadat JamaliDinan, Haidar Almohri, Mohammad-Reza Nazem-Zadeh

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Lateralization of temporal lobe epilepsy (TLE) is very important for positive surgical outcomes. We propose a machine learning framework to ultimately identify the epileptogenic hemisphere for temporal lobe epilepsy (TLE) cases using magnetoencephalography (MEG) coherence source imaging (CSI) and diffusion tensor imaging (DTI). Unlike most studies that use classification algorithms, we propose an effective clustering approach to distinguish between normal and TLE cases. We apply the famous Minkowski weighted K-Means (MWK-Means) technique as the clustering framework. To overcome the problem of poor initialization of K-Means, we use particle swarm optimization (PSO) to effectively select the initial centroids of clusters prior to applying MWK-Means. We demonstrate that compared to K-means and MWK-means independently, this approach is able to improve the result of a benchmark data set.

Keywords: temporal lobe epilepsy, machine learning, clustering, magnetoencephalography

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Authors: Ahmed Assem Abd El Rahim

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BACKGROUND: Low back pain (LBP) is enormously common health problem& most of subjects experience it at some point of their life. Kinesio-taping is one of therapy methods introduced for studied cases with nonspecific low back pain. OBJECTIVES: to look at how Kinesio-taping affects studied cases with non-specific low back pain in terms of discomfort, range of motion, & back muscular strength. SUBJECTS: 40 mechanical LBP patients aged 20-40 years had been assigned haphazardly into two groups, They had been selected from outpatient clinic, KasrAl-AiniHospital, Cairo university. Methods: GroupA: 20 patients received the I-shape KT longitudinally & conventional physiotherapy program. Group B:20 studied cases received application of the KT Horizontally & conventional physiotherapy program. pain had been measured by visual analog scale, Range of motion had been measured by Roland Morris Disability Questionnaire (RMDQ), & strength had been measured by an isokinetic dynamometer before & after therapy. Therapy sessions had been three times weekly for four weeks. RESULTS: Groups (A & B) discovered decrease in pain& disability and rise in their flexion, extension ROM & peak torque of trunk extensor after end of 4 weeks of program. mean values of pain scale after therapy had been 3.7 and 5.04 in groups A & B. mean values of Disability scale after treatment had been 7.87.and 9.35 in groups A & B. mean values of ROM of flexion had been 28.06, and 24.53 in groups A & B. mean values of ROM of extension had been 13.43 & 10.73 in groups A & B. mean values of Peak torque of lumbar extensors were 65.43 and 63.22 in groups A & B. Though, participants who received the I-shape KT longitudinally as well as conventional physiotherapy program (group A), discovered more reduction in pain& disability and more improvement in ROM of flexion, extension, and Peak torque of lumbar extensors value (P<0.001) after therapy program CONCLUSION: Therapeutic longitudinal Kinesio-taping application with conventional physiotherapy will be more valuable than Therapeutic horizontal Kinesio-taping application with conventional physiotherapy when treating nonspecific low back pain studied cases.

Keywords: Kinesio taping, function, low back pain, muscle power

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Authors: Bo Sun, Ni Zhong

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Bilateral investment treaties have played a role in the construction of the Belt and Road, providing institutional protection for Chinese companies' overseas investments. However, such treaties between China and countries along the Belt and Road were signed in the 1980s and 1990s, and their provisions are outdated and insufficiently detailed to provide adequate legal protection for Chinese investors when they initiate investment arbitration against host countries. By studying cases involving China in international investment arbitration, this paper suggests that China should pay attention to further clarifying the identity of "investors", the scope of disputes that can be submitted to arbitration, and the concept of "indirect expropriation" when updating bilateral investment treaties in the future, in order to reduce the risk of losing cases for Chinese investors.

Keywords: belt and road, bilateral investment agreement, investment arbitration, indirect expropriation

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