All Articles in march, 2023

Coronary artery anomalies, myocardial bridging associated with fistula to pulmonary artery trunk. Case reports

Published on: 31st March, 2023

Between coronary artery anomalies, myocardial bridging means an epicardial coronary artery, mostly left anterior descending artery (LAD), running through an intramyocardial “tunnel” (usually in the middle segment), leading during systolic contraction, flow reduction, through the vessel. When this anomaly is associated with a coronary fistula, which “steals” more from the bloodstream, the symptoms are more pronounced, and the management complex is surgical in particular. Despite the presence from birth remains asymptomatic and it becomes clinically manifest later in the third to fourth decade of life, with a diverse palette of symptoms; angina, arrhythmias, and acute myocardial infarction up to sudden death. Diagnosis and particular management, medical, interventional, and surgical should avoid major cardiac complications and sudden death. We present two adult patients, with coronary artery bridging, one case associated with coronary artery fistula, LAD to pulmonary artery trunk, very symptomatic with surgical management, and the second only myocardial bridging controlled with medication and supervision.
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Management and use of vacuum systems in a surgery ward

Published on: 31st March, 2023

Vacuum therapy has become a new option in the treatment of wounds in surgery. More recently this therapy has also been used as a treatment for anastomotic leakages in association or not to emergency surgery. The management of these devices should be familiar to all the staff in a surgical ward.
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Assessment of on farm agrobiodiversity and its role in food sufficiency in mid hill, Nepal

Published on: 31st March, 2023

A survey was conducted in the agricultural farms in Dhulikhel Municipality, mid-hill, Kavre, Nepal aiming at assessing the status of agrobiodiversity with the purpose of understanding its role in food security taking altogether 133 farming households scattered in several settlements with lowland, upland, and home garden being the general agricultural land use systems. Biodiversity index: Shannon-Wiener Index was used to assess diversity of plant. The main purpose was to assess the farm agrobiodiversity and to find out whether biodiversity level has a direct link to household food self-sufficiency. For descriptive analysis frequency, percentage, mean and standard errors were used. In the case of inferential statistics independent sample t - test and binary logistic was used to find the odd ratio of practicing home garden. The result showed that the average landholding size was 0.66 ha/household with 0.37 ha, 0.3 ha, and 0.06 ha being upland, low land, and home garden, respectively. A total of 136 plant species were documented out of which 74 were the effective number of species in the study area. Among the used plants, fodder shared 27% of the total plant diversity followed by fruit (21%), vegetable (19%), medicinal plants (8%), pulses (8%), spices (7%), oilseeds (5%) and cereals (5%). Similarly, the mean livestock unit (LSU) was 2.65. The overall Shannon-Wiener Index was 4.30 indicating high diversity of species and 87.7% of the species were evenly distributed. The Index was higher for vegetable (3.11) followed by fruits (2.9) and fodder (2.85). Higher diversity was found in fodder trees in lowlands whereas vegetable species were more diverse in upland and home garden. Similarly, the Index was 4.29 in the upland whereas it was 4.078 in the home garden followed by 3.13 in the lowland. The evenness was 0.899, 0.87, and 0.74 in upland, home garden and lowland, respectively. Higher species diversity revealed that the site was rich in agrobiodiversity. A significant positive correlation (0.22) was observed between Shannon-Wiener Index and farming years. Similarly, positive correlation (0.33) was found between an increase in the level of agrobiodiversity and food self-sufficiency. The result demonstrated that increasing crop diversity increases the household’s ability towards food sufficiency implying the need for the formulation and implementation of efficient policy to conserve the agrobiodiversity at municipality as well as national levels.
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A rare case of foreign body in coronary sinus. A novel endovascular method for retrieval

Published on: 30th March, 2023

Central venous catheter fracture and migration are rare complications in patients receiving long-term infusions or chemotherapy. We present a rare case of a chest port catheter fracture that migrated into the coronary sinus. This case is likely the fourth report of a port catheter fracture with migration to the coronary sinus. Because of the difficult-to-retrieve location, multiple attempts were unsuccessful with traditional techniques using a loop snare. Finally, the fractured portion was disengaged from the coronary sinus using a navigational electrophysiology catheter guided by intracardiac echocardiography; the dislodged end was snared and eventually removed by the femoral route. This case of a chest port catheter fracture is unique because of the unusual migration to the coronary sinus and the use of a navigational electrophysiology catheter as a novel retrieval technique.
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Hypochlorous acid has emerged as a potential alternative to conventional antibiotics due to its broad-spectrum antimicrobial activity

Published on: 30th March, 2023

Hypochlorous acid (HOCl) is a potent antimicrobial agent that has recently gained attention as a potential alternative to conventional antibiotics. HOCl is produced by the human immune system in response to infection and is known for its broad-spectrum antimicrobial activity. It is effective against a wide range of microorganisms, including bacteria, viruses, and fungi, and has been shown to be more effective than many conventional antibiotics. One of the key advantages of HOCl is its ability to kill bacteria without promoting the development of antibiotic resistance. Unlike conventional antibiotics, which target specific bacterial structures or processes, HOCl acts by disrupting multiple cellular components, making it much more difficult for bacteria to develop resistance. Another advantage of HOCl is its safety profile. Unlike many conventional antibiotics, HOCl is not toxic to human cells and does not cause side effects such as gastrointestinal upset or allergic reactions. Overall, HOCl shows great promise as a potential alternative to conventional antibiotics, particularly in the face of rising antibiotic resistance. With further research, it may become an important tool in the fight against infectious diseases. Herein, we discuss the mechanisms of HOCl antimicrobial action, its potential clinical applications, and future directions for research. This review aims to provide an overview of the use of hypochlorous acid (HOCl) as an antibiotic agent.
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Quality of life in Ghanaian children and adolescents with type 1 diabetes mellitus compared with non diabetic controls and caregivers’ report

Published on: 30th March, 2023

Background: Measurement of health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes mellitus (T1DM) is as important as metabolic control in the management and prevention of diabetes-related complications. Aim: To describe the self-reported HRQOL outcomes in Ghanaian children and adolescents with T1DM compared with healthy controls and perceived HRQOL by caregivers.Setting: Out-patient clinics of the Departments of Child Health, Medicine and Therapeutics, Family Medicine, and Ophthalmology, the National Diabetes Management and Research Centre (all at the Korle Bu Teaching Hospital), and the Cape Coast Teaching Hospital (CCTH).Methods: Socio-demographic and clinical characteristics of study participants were documented. Participants completed the PedsQL™ 4.0 Generic Core Scales. Data analysis was done with SPSS Version 25.0. An unpaired t-test was used in comparing the HRQOL scores between children and adolescents with T1DM and controls, and parental proxy reports. Results: Fifty children and adolescents with T1DM, 50 parents/caregivers, and 80 healthy non-diabetic controls took part in this study. There was no significant difference in mean score between the patients and the caregivers for overall HRQOL (p = 0.270). Patients reported significantly worse overall HRQOL than their controls (p = 0.001). Males with diabetes reported better HRQOL than females (p = 0.007). Conclusion: Children and adolescents with T1DM and their parents/caregivers reported lower HRQOL scores compared to healthy controls. Males reported better HRQOL than females. Potential implications: HRQOL should be routinely assessed together with proxy reports from parents to identify those who might benefit from further attention including referral to a psychologist.
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A proposal of risk indicators for pathological development from hemodynamic simulation: application to aortic dissection

Published on: 28th March, 2023

Cardiovascular diseases are the leading cause of mortality in the industrialized world. Among these diseases, aortic dissection affects the aorta wall and is a surgical emergency with a low survival rate. This pathology occurs when an injury leads to a localized tear of the innermost layer of the aorta. It allows blood to flow between the layers of the aortic wall, forcing the layers apart and creating a false lumen. Endovascular treatment seeks to obliterate the entrances to the false lumen with a covered stent. There are very few studies on the postoperative demonstration of blood flow phenomena in the aortic dissection endovascular treatment. It is crucial to study the hemodynamics of blood in the aorta after an intervention because the new geometrical configuration of the aorta with a stent leads to modifications in blood flow. For the surgeons, the procedure can only be performed empirically, using MRI-4D images to view the postoperative flow of the patient’s blood in the aorta with the stent.This paper aims to present a numerical tool developed from the open-source software FOAM- Extend®, allowing for multiphysics numerical simulations. Using MRI data, a bio-faithful model of the patient-specific case was built. Numerical simulations were performed to predict preoperative and postoperative (endovascular treatment) hemodynamics. The modifications of the flow in the aorta were analyzed focusing on the postoperative perfusions. The results were compared with the corresponding MRI data and have a good qualitative agreement. Biomarkers are calculated to localize possible zones of post-operative pathological developments and recommendations may be suggested to the surgeons.
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Development of qualitative GC MS method for simultaneous identification of PM-CCM a modified illicit drugs preparation and its modern-day application in drug-facilitated crimes

Published on: 28th March, 2023

Prescriptions for psychoactive substances such as Pregabalin, Methamphetamine, Caffeine, Clonazepam and Mirtazapine (PM-CCM) are common in the treatment of a variety of disorders. Indeed, the PM-CCM has been used in different therapeutic areas, including insomnia, anxiety, seizure disorders, etc. Unfortunately, these psychoactive substances are present in the illegal street market, leading to a lot of drug abuse among some addicted users, road insecurity and suicide. Hence, it has become essential to validate and develop a rapid and effective method to analyze the PM-CCM, a modified illicit drug, for drug abuse in the forensic sciences. A simple, rapid, specific and sensitive Gas Chromatography-Mass Spectrometry(GC-MS) method has been developed for the identification of Pregabalin, Methamphetamine, Caffeine, Clonazepam and Mirtazapine (PM-CCM) in forensic exhibits. At room temperature, the sample was ultrasonicated for 5 minutes before being extracted with methanol. A highly precise auto-injector is used to inject a very small quantity of samples for analysis. Helium is used as a carrier gas with a flow rate of 1 ml/min. The separation of PM-CCM was performed on SH-RXi-5 MS, ID.25 mm, film thickness. 25 µm, length of 30 m column. The constituents of PM-CCM were identified by the mass-to-charge ratio (m/z ratio) of fragments of the parent compound by comparing them with the NIST-17 MS Library. Separation and identification of PM-CCM were achieved within a 15-minute run. The proposed method has been successfully used for the routine analysis of PM-CCM in complex illicit drug preparations and in forensic exhibits as well. The application of above discussed qualitative analysis method and screening of PM-CCM, modified illicit drug samples demonstrates the potential and applicability of the technique to the fast chemical profiling of illicit samples.  
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Research into the fundamental building block of quantum theorem of the unified force field

Published on: 28th March, 2023

This is a work based on the extension of the work of Professor James Clerk Maxwell and Albert Einstein into a new framework of science built on provable mathematical theorem which serves as a basis for unifications of the fundamental forces which all together have become impossible to unify under the current framework of General relativity and Quantum Field theory.It is to be used as a piece for inspiring new innovations, discovering and exploring the terrains of the difficult pathways in physics where our modern physical theories have failed.This work is meant to be adapted and used by various physics professionals who are working on extending the frontiers of physics or providing solutions to problems that cannot be handled by current physics framework. In summary it is an inspirational tool that hopefully will help our professional in physics out there.It interpretations and applications is subject to the personal inspirations the reader who is a professional can derived from the work for his or her personal usage.
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Effectiveness of massage chair and classic massage in recovery from physical exertion: a pilot study

Published on: 24th March, 2023

Quick and cost-effective recovery is foundational to high-quality training and good competition results in today’s sports. The aim of the research was to elucidate the effects of hand and massage chair massage on the biomechanical parameters of muscles of lower limbs and back, indicators of Pain Pressure Thresholds (PPT) and subjectively perceived fatigue. A total of 32 female recreational athletes (18 – 50 years old) were assigned to a hand massage, massage chair, or lying down the group. They were measured for muscle biomechanical properties (MyotonPro), PPT (Wagner Instruments) and subjectively perceived fatigue (VAS scale) before and after fatigue tests and treatment. The recovery procedure and subjective satisfaction with treatment were rated on a Likert scale. Changes in the median value of m. rectus femoris and m. gastrocnemius stiffness with treatment showed that hand massage could be more effective in reducing stiffness, as compared to chair massage. Hand massage may have benefits for recovery from physical exertion, but due to the individuality of subjects, detailed methodological studies are needed to evaluate the effects of massage chair vs. hand massage.
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Economic feasibility of using agricultural wastes for catalyst development

Published on: 24th March, 2023

Resource recovery provides an opportunity to transform limited and abundant materials in form of waste into biobased products. In the production system, this technique could offer an economic means to utilize wastes to generate valuable products which are fundamental to a sustainable economy.
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Mercury toxicity and amyotrophic lateral sclerosis

Published on: 23rd March, 2023

Recent clinical, experimental and epidemiological studies report that ALS is thought possibly due to a multi-stage process, arising from a combination of genetic susceptibility and environmental factors, which alone or superimposed, perhaps on genetic polymorphism yet to be identified, may contribute to the incidence rate of sporadic ALS. In particular, a large amount of evidence suggests that mercury is toxic to motor neurons and may be a risk factor for ALS, playing a part in its pathogenesis. In fact, there have been case reports of ALS or ALS-like symptoms associated with mercury exposure, thus raising the possibility that mercury could be one of the non-genetic factors of the multistep process that is thought to underlie ALS. In order to give recent elucidations on the putative relationship between mercury exposure and ALS, we reviewed all the papers reported in the literature and published on Pubmed from 2006 to 2022. Despite a number of pathogenetic mechanisms that have been linked to mercury, evidence linking exposure to mercury to ALS is not consistent and discordant and, based on the evaluation of the articles, which emerged from our analysis that to date no convincing correlation between mercury and ALS has been established and no conclusive evidence has been enlightened suggesting increased mercury exposure is associated with ALS.
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Is binge watching among medical students associated with depression and anxiety?

Published on: 21st March, 2023

Objectives: Investigate binge-watching (BW) behavior among students and assess its correlation with anxiety and depressive symptoms. Methods: Medical students who met the definition of BW were divided, according to their viewing frequency, into three groups: G1: once a month or less, G2: once a week or once every two weeks, and G3: twice a week or more. Beck Depression Inventory and State-Trait Anxiety Inventory were used. Results: Ninety-four participants were recruited. The prevalence of BW was 72.3%. Depression and anxiety scores didn’t differ between binge watchers and the non-binge watcher group. G2 was found to be significantly less depressed (p = 0.014) and had a lower anxiety state (p = 0.05) and anxiety trait scores (p = 0.026) than the control group. Feeling tired was the most prevalent reason to stop viewing among G3 (p = 0.001). Conclusion: Binge-watching could be when used in a specific manner, a way to cope with negative feelings. 
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A pregnant with markedly elevated alkaline phosphatase: a case report

Published on: 21st March, 2023

Alkaline Phosphatase (ALP) is produced from the liver, kidney, bone and placenta. During pregnancy, ALP may raise markedly with no clear reason. Here, we present a rare case of highly elevated ALP in a 21 years old pregnant woman during the third trimester who had no important past medical history. It was 2800 U/L. Bone, renal, or liver was all normal. Close monitoring of the fetus and his mother until birth was the way of treatment. We had seven weeks postpartum to decline in ALP concentration but did not return to the normal range. The placenta showed lesions of chronic villitis. The extreme incline in ALP during the gestational stages is riskier because the threat here is posed to 2 lives. In such conditions, constant monitoring of ALP in the maternal serum backed with necessary medication is required. 
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A case of hepatic intraductal papillary neoplasm of the bile duct

Published on: 21st March, 2023

Introduction: Intraductal Papillary Neoplasm of the Bile ducts (IPNB) is a rare entity characterized by exophytic growth of the bile ducts.Case presentation: In this report, we present a 57-year-old male with no prior medical history consulted for upper right abdominal pain, jaundice and pruritus. Abdominal Ultrasound (US) and magnetic resonance imaging/Bili-magnetic resonance were performed. They revealed that the circumferential parietal thickening of the common hepatic duct had extended approximately 4 cm with moderate dilatation of the left intrahepatic bile ducts. Computed tomography showed no evidence of distant metastasis.Biopsy revealed a high-grade intraductal papillary neoplasm. After 40 days, the patient had left hepatectomy with resection of the main bile duct and the gallbladder. Macroscopic examination of the surgical specimen showed a dilatation duct at the hilum with thickening of their walls.The histopathology report revealed multiple intra-hepatic papillary neoplasms with high-grade dysplasia with an invasive carcinoma component in the left hepatic duct without extending to the biliary wall, classified as pT1N0.Conclusion: This premalignant lesion has the potential to transform into invasive carcinoma if not properly diagnosed.Our case illustrates how early identification can lead to potential surgical resection.
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Requirement for object-oriented database management systems in forensic science

Published on: 21st March, 2023

The complex requirements of a database system for recording regulated chemicals exceed the capabilities of a relational database system. Inheritance, which is part of object-oriented programming, must also be logically transferred to chemical objects. This issue is illustrated here by means of examples of the Chemical Weapons Convention (CWC) and the German version of the New Psychoactive Substances Law (NpSG).
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Three-phase partitioning for isolating peroxidase from lemon peels

Published on: 21st March, 2023

Background and objective: Peroxidase is an oxidoreductase that uses different compounds as substrates and thus can be utilized for different applications. The goal of this work is to isolate peroxidase from lemon peels using Three-Phase Portioning (TPP). Methods: TPP was set by adding varying amounts of salts and alcohol and the enzyme activity recovery was measured for each variable. Different parameters were optimized successively in order to achieve the highest enzyme activity recovery including salt type, salt concentration, pH, alcohol/crude extract ratio and type of alcohol and then, combining all optimized conditions together.Results: Salt that gave maximal recovery was sodium potassium tartrate, optimal salt concentration was 15%, optimal pH was 8, optimal alcohol/crude extract ratio was 1 and t-butanol was preferred to 1-butanol. Efficiently, upon combining all optimized factors, an activity recovery of 175% was obtained.Conclusion: This protocol provides an easy, feasible method to efficiently isolate peroxidase from lemon peels using TPP.
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A case of true hermaphroditism: presenting as congenital bilateral inguinal hernia

Published on: 20th March, 2023

True hermaphroditism (TH) is a cause of intersexuality in which both ovarian and testicular tissue is present in the same individual [1]. The gonadal distribution in cases of true hermaphroditism varies from [2]
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Pomaded and unctuous- spindle cell lipoma

Published on: 17th March, 2023

Spindle cell lipoma and pleomorphic lipoma emerge as benign, adipocytic neoplasms representing a morphologic continuum of a singular neoplasm. In addition to myofibroblastoma and cellular angiofibroma, spindle cell lipoma or pleomorphic lipoma configures as a constituent of chromosome 13q/RB1 family of tumors. Initially scripted by Enzinger and Harvey in 1975 with an obsolete terminology of dendritic fibromyxolipoma, aforesaid adipocytic neoplasms articulate an estimated 1.5% of lipomatous tumors. In contrast to conventional lipoma, spindle cell lipoma or pleomorphic lipoma is an uncommonly discerned variant, demonstrating a proportion of 1: 60.
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Pregnancy and exogenous constitutional obesity. possibilities of ozone therapy

Published on: 16th March, 2023

The aim of the study was to evaluate ozone therapy in obese pregnant women. 118 pregnant women with varying degrees of obesity were examined and treated. It turned out that the course of intravenous drip administration of ozonated saline solution leads to the normalization of a number of important indicators of homeostasis including stimulation of the antioxidant system and reduction of peroxide stress. The reduction in the frequency of miscarriage, preeclampsia, premature birth, and bleeding during childbirth and the postpartum period is achieved. It`s possible to recommend the inclusion of ozone therapy in the preventive treatment of pregnant women with exogenous constitutional obesity.
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Renal denervation for resistant hypertension and heart failure with a reduced ejection fraction

Published on: 16th March, 2023

Hypertension is a risk factor for the development of heart failure and has a negative impact on the survival of these patients. Although patients with these two conditions usually take different antihypertensive medications, some patients do not achieve adequate blood pressure control and their hypertension becomes resistant or refractory. In this scenario, percutaneous renal denervation has emerged in recent years as an alternative to achieve blood pressure control goals. We present the case of a 53-year-old woman with a medical history of essential hypertension, hypercholesterolemia, unipolar depression, and diabetes, who was diagnosed with dilated cardiomyopathy with reduced left ventricular ejection fraction (33%). Despite the initiation of multiple antihypertensive medications and placement of a cardiac resynchronization therapy pacemaker, the patient remained hypertensive with a left ventricular ejection fraction of 40%. At that time, percutaneous renal denervation was performed without complications, and one year after the procedure, the patient had improved better blood pressure control and the left ventricular ejection fraction increased to 51%. This case illustrates one of the clinical scenarios in which it has been suggested that renal denervation may be more beneficial, as in the situation of patients with refractory hypertension and heart failure.
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Natural color performance from nine species origins of lowland wood wastes

Published on: 15th March, 2023

In the past, natural pigments derived from plant-biomass wastes had been widely used for coloring purposes (e.g. fabrics/batik), before finally getting pushed aside by the imported synthetic/inorganic pigments. Thorough attempts to revive the use of such natural pigments then deserve carrying out. Relevantly, conducting storage of liquid/wet or dry natural coloring pigments, extracted from wood wastes; and use of fixatives for batik fabrics intended to impart fabric-color variations. Wood wastes (i.e. leaves and barks) were obtained from nine plant species (Acacia mangium Willd, Avicenia marina L, Caesalpinia sappan L, Ceriop tagal Perr. CB. Rob, Pelthophorum ferruginum Benth, Rhyzophora mucronata Lamk, Tectona grandis Linn.f., Terminalia catappa L and Xylocarpus granatum KD Koenig.), prevalently growing on plain/lowland areas; and their wood portions commonly utilized by wood industries, which generate similar wastes enormously. The pigments in liquid/wet and then in dry forms were produced from those wastes. The production process of pigments adopted traditions by local batik crafters in Bogor. Variations occurring in fabric colors could be due to fixatives, i.e. lime (CaCO3), ferrous sulphate/tunjung (FeSO4); and various wastes. Six-month storage insignificantly changed the coloring qualities of natural coloring pigments applied to fabrics, compared to those of corresponding initially produced pigments. Leaf wastes always contained green-colored compounds, while bark wastes appeared aptly brownish in color. Color performances of bark extracts at fabrics with ferro-sulfat fixative brought about strong grey colors, and with lime fixative produced brown colors. Coloring of fabrics using leaf waste extracts with ferro-sulfat fixative aptly exhibited greenish grey; while with lime fixative became reddish brown. Testing results on the leaching resistance of pigment-colored and fixative-treated fabrics against rubbing and exposure to sunlight revealed a very good category (4-5), but against detergent, washing was very low (2-3).
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‘Life-Changing Bubbles’ – How carbonated water can relieve swallowing problems for many dysphagia sufferers worldwide

Published on: 15th March, 2023

Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems – probably about 4 million in the UK. Either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospitals every day.Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice – but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently until further studies are undertaken, Carbonated Water should be limited to individual patient use.My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations, and Conclusions.
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Case study (A and B): a patient with Parkinson’s disease

Published on: 15th March, 2023

Parkinson’s disease is a progressive and debilitating neurodegenerative disorder affecting millions of people worldwide. The disease is characterized by motor symptoms such as tremors, rigidity and postural instability, as well as non-motor symptoms such as depression and cognitive impairment. While there is no cure for Parkinson’s disease, there are various treatments available to manage symptoms and improve quality of life for patients.This case study examines a 65-year-old retired accountant, Mr. John Smith, who was diagnosed with Parkinson’s disease five years ago. Mr. Smith has been treated with a combination of medications, including levodopa and carbidopa and physical therapy to manage his symptoms. However, his symptoms have not significantly improved.This literature review explores the current research on Parkinson’s disease, including its pathophysiology, diagnosis and treatment. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the brain, leading to a depletion of dopamine and the accumulation of alpha-synuclein protein, oxidative stress and inflammation. Diagnosis is based on clinical symptoms, neurological examination and response to dopaminergic therapy. Treatment focuses on managing symptoms, with medications and non-pharmacological interventions such as exercise and physical therapy. Deep brain stimulation is a surgical treatment option that has been shown to be effective in managing motor symptoms.While there is currently no cure for Parkinson’s disease, ongoing research into its pathophysiology and treatment holds promise for improving outcomes for patients. This case study highlights the importance of early diagnosis and personalized treatment plans for patients with Parkinson’s disease.
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Modeling of low calorific gas burning in a deficient oxygen environment and high-temperature oxidizer

Published on: 15th March, 2023

It is planned to carry out a comprehensive experimental and theoretical study on the high temperature of low calorific gas combustion with oxygen-deficient oxidizers. The experimental research will be performed using the experimental facility with a combustion chamber. The oxygen concentration in combustion oxidizers will be varied from 21% by volume (normal) air to 2%. The test combustion chamber will be fed with propane or methane as the reference fuel, then with low calorific fuels as test gases obtained by mixing various combustible components, e.g. H2, CH4, CO, and neutral gases, e.g. N2, CO2. Gaseous fuels prepared in this way will be burned in the atmosphere of a deficient oxidizer with a temperature changing from 800 °C to 1100 °C. Oxidizers will be heated up to a certain temperature using two methods: by flue gas heat exchanger and kanthal rod electric preheater. Different burner geometry will be used. The burner will be equipped with annular swirl vanes for co-axial or under different angles, fuel, and oxidizers flow to have a high swirl number achieved by flow aerodynamics and mixing. Experimental data will be verified with numerical simulations with the use of ANSYS CFD Fluent code.
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Detection of extended-spectrum betalactamase and carbapenemase-producing Enterobacteriaceae in Tunisia

Published on: 15th March, 2023

The emergence of dramatic urinary tract infections (UTIs) caused by the members of the Enterobacteriales is an important public health problem in the community as well as in Tunisian hospitals. This study aims to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing uropathogenic isolates of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Based on decreased susceptibility to β-lactams antibiotics and analyzed for the presence of ESBL and carbapenemase genes by Real Time- polymerase chain reaction (RT-PCR), 56 uropathogenic isolates of E. coli (n = 36) and K. pneumoniae (n = 20) were confirmed positive for ESBLs. The CTX-M-type β-lactamases were mostly detected in E. coli isolates (21 strains, 58.33% [95% CI 38.09% - 72.06%]) followed by blaSHV-like (18 strains, 50% [95% CI 32.92% - 67.07%]), blaTEM-like and blaCMY-2-like simultaneously (15 strains, 41.67% [95% CI 25.51% - 59.24%]). Furthermore, the RT-PCR system on the K. pneumoniae strains demonstrated that blaSHV-12-like was the most predominant (16 strains, 80% [95% CI 56.33% - 94.26%]) followed by blaTEM-like (14 strains, 70% [95% CI 45.72% - 88.10%]), blaCTX-M belonging to groups 9 and 1 (11 strains, 55% [95% CI 31.52% - 76.94%]) and finally blaCMY-2-like (10 strains, 50% [95% CI 27.19% - 72.80%]). In addition, E. coli and K. pneumoniae strains harbored a carbapenemase gene blaOXA-48-like with 22.2% [95% CI 10.11% - 39.15%]; 20% [95% CI 12.83% - 43.66%], respectively.Our results confirm the need to monitor the resistance to extended-spectrum β-lactams and to carbapenems among enterobacteria in Tunisia.
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A challenging case of cutaneous sarcoidosis with unusual findings in a Syrian woman: a case report and review of literature

Published on: 14th March, 2023

Sarcoidosis is a granulomatous disease that involves multiple systems. Cutaneous involvement can manifest in patients with sarcoidosis and can present with or without systemic involvement. We present a case of cutaneous sarcoidosis in a Syrian woman that showed improvement after a combination of methotrexate and prednisolone therapy. The patient had unusual chest radiography findings and developed an unexplained fissured tongue after 5 days of receiving methotrexate therapy. In addition, the patient developed indurated erythematous plaque and papules on her upper right arm at the same location as a performed biopsy, which increased the diagnosis of a newly formed scar sarcoidosis although she was receiving her treatment.
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Soliton phenomena in the process of the functioning of the heart

Published on: 14th March, 2023

The biochemical model explains the intricate mechanisms of psychobiological life. He still cannot explain what the transition from inanimate to living matter is all about. Where is the threshold and what is its essence, what role do biochemical processes play in the coherence of the soma with consciousness and its impact on the soma and vice versa? A similar problem is with other mental processes, their nature does not fit into the biochemical model of life and is inexplicable on the basis of biochemical interactions, again it is much easier to describe it in the light of quantum processes - including wave physics. It is similar to the functioning of the heart or other organs, where only the biochemical processes of the cell are considered, ignoring the bioelectronic processes. Man is not only a purely biological construct but also contains the basis of biochemical, bioelectronic, information, and cybernetic processes that are responsible for shaping the psychobiological processes of man. Contemporary biosystems in science are considered at the level of corpuscular structures, ignoring energy and information structures. By shifting the cognitive emphasis towards energy and information structures, the organism can be perceived as a quantum generator of information: electromagnetic, soliton, acoustic, spin and bioplasma. This bioelectronic construction creates homo electronics with his electronic personality.
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Importance of the radiations in water splitting for hydrogen generation

Published on: 14th March, 2023

The review article examines the production of molecular hydrogen from the decomposition of water by various irradiation methods. The article shows different types of radiation: UV radiation, visible radiation, gamma radiation, X-ray radiation and neutron radiation. Electrons generated by radiation inside a nanoparticle of radius R suspense in fluid water are diffused with equal probability in all directions inside the particle and gradually lose their kinetic energy as a result of elastic and inelastic collisions. Some of these electrons are transported to the nanoparticle surface during the physical and physicochemical stages of the process and emitted into the water. It is extremely important for the formation of nanostructured materials after exposure to ordered nanostructure from the new phase with a period of a few nanometers, promoting the preservation of the properties of materials under high irradiation.
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Hereditary spherocytosis: review of cases and discussion of hematologic characteristics and updated diagnostic testing

Published on: 13th March, 2023

Hereditary spherocytosis is a common inherited type of hemolytic anemia that results from abnormal morphology of erythrocytes. It has a high occurrence in North Americans and northern Europeans with a prevalence of 1/2000. There is a wide range in age and symptoms at presentation with some individuals being asymptomatic and others having severe diseases requiring blood transfusions. Based on the severity of symptoms, management may vary from simple observation to frequent blood transfusions, cholecystectomy for gallstones, and splenectomy. Timely diagnosis may be critical to minimize complications. Diagnostic tests have been available with varying degrees of accuracy. However new diagnostic tests with greater specificity and sensitivity are now available for more accurate diagnosis of Hereditary Spherocytosis in individuals of all ages including newborns. Illustrative cases are presented that show the variability in presentation, symptoms, complications, and care. Information is presented updating diagnostic testing that allows earlier diagnosis of children with hereditary spherocytosis. Additionally, the hematologic findings suspicious and consistent for this diagnosis are presented, serving as a guide when testing should be initiated.
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Influenza B myositis, case report, in hospital Roosevelt, Guatemala city

Published on: 11th March, 2023

Influenza B myositis is a self-limited process that is typically accompanied by myalgia and muscle weakness, which can be caused by an acute respiratory infection. It occurs in the convalescence phase of the disease. It can usually affect preschool and school children, who present bilateral pain and tenderness in the muscle groups of the lower limbs without alterations in the neurological examination. Being able to generate an alteration in the brand or bipedestation. Its main complication is rhabdomyolysis. In Guatemala is difficult to test for viral respiratory infection and the incidence of viral myositis is unknown, for which we consider the report important because it presents a benign course and is easy to manage with the use of non-steroidal anti-inflammatory drugs, to avoid unnecessary hospitalizations. We present to case report to an 8-year-old male patient, previously healthy, with diagnostic de Influenza B myositis.
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The effects of hemp seed consumption on depression, anxiety and cognitive improvement based on machine learning

Published on: 11th March, 2023

Background: Hemp seed (Cannabis sativa L.) is an annual herbaceous plant of the Cannabis genus that contains a large amount of protein, iron, and fatty acids, including linoleic, α-linolenic, and γ-linolenic acid. These compounds are involved in a number of biological activities, including immunity enhancement, hyperlipidemia, and inflammation reduction. Here, we investigated the antioxidant effects of hemp seed on human cognitive function.Methods: The test was administered to 34 healthy volunteers aged ≥ 20 years. Participants were selected according to age and sex and were administered 10 g of hemp seed three times daily (30 g/day) for 45 days. The outcome measurements were recorded using a survey, computerized neurocognitive tests, and artificial intelligence.Results: Survey analysis determined that both the Beck Anxiety Inventory and Beck Depression Inventory measurements decreased significantly after hemp seed consumption when compared to measurements taken before consumption (p < 0.05). Additionally, significant results were observed in the Stroop and Tower of London tasks (p < 0.05). The prediction performance for the antidepressant effect was 0.83 for the area under the curve in the random forest algorithm, which was superior to that of other machine learning methods. Conclusion: These results suggest that hemp seeds have a beneficial effect on cognitive impairment.
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Assessment of self-injurious behavior in major depressive disorder: a case report

Published on: 10th March, 2023

Introduction: Self-harm and depression are two related mental health issues that often co-occur and can have serious impacts on individuals and their well-being. Major Depressive Disorder (MDD) is a complex and multifaceted mental health condition that is prevalent among young adults. It is a significant public health concern that affects individuals, families and society as a whole, contributing to considerable social, economic, and health-related costs. Despite the high prevalence of depression in young adults, there is a lack of understanding of its etiology, risk factors, and optimal treatment strategies. Self-harm behavior is a concerning manifestation of MDD that can have serious consequences, including injury, infection, or even death.Methods: In this article, we report a case of an MDD patient with self-harm behavior and discuss the assessment method and treatment options. Our aim is to raise awareness of these pathologies among psychiatrists and the general population and to highlight the importance of early diagnosis and effective treatment in reducing the risk of self-harm behavior and suicide.Conclusion: In light of the case presented, it is evident that early detection and targeted intervention are crucial in mitigating the risk of self-injurious behavior in MDD patients. The utilization of a comprehensive assessment methodology, inclusive of a thorough review of the patient’s clinical history and utilization of standardized rating scales, proved indispensable in the tailoring of an individualized treatment regimen. The amalgamation of pharmacotherapy and psychotherapy proved to be a successful strategy in the amelioration of depressive symptoms and consequent self-harm behavior. As such, we trust that this case report will serve to sensitize clinicians to the importance of early identification and prompt management of these pathologies, in the quest for enhanced mental health outcomes.
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Left ventricular assessment in patients with significant mitral incompetence: a multi-modality imaging study

Published on: 9th March, 2023

Background: Detection of the deleterious effect of MR on LV is crucial in guiding the surgical decision. Aim of the study: Comprehensive assessment of LV with significant primary MR using (2D, 3D echo and CMR). Methods: 40 patients with significant MR have been recruited in a prospective study. Patients underwent 2D and 3D echo and CMR studies. LV volumes, function and GLS were calculated. Results: End diastolic and systolic volumes were significantly larger when measured by CMR (all p < 0.001). EDV measures were strongly correlated with CMR and 3D echocardiography. Conclusion: It’s important to identify early deleterious LV changes.
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Outcome of Outpatient Autologous Hematopoietic Stem Cell Transplantation in Patients with Multiple Myeloma and Relapsed and Refractory Hodgkin Lymphoma. The Experience of King Fahad Specialist Hospital in Dammam, Saudi Arabia

Published on: 8th March, 2023

Background: Autologous hematopoietic stem cell transplants (HSCT) is the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (MM) and patients with relapsed and refractory Hodgkin lymphoma (R/R-HL) who achieve chemosensitivity after salvage therapy. Although autologous HSCT is routinely performed in an  inpatient setting, the procedure can safely be performed in an  outpatient setting.Methods and materials: A retrospective study of patients with MM and R/R- HL who received outpatient autologous HSCT at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia between the first of April 2017 and the 31st of January 2022 was performed.Results: Over the study period of 4 years and 10 months, a total of 90 outpatient autologous HSCTs were performed for 79 patients (54 patients with MM; 4 of them received planned tandem autografts and 7 other myeloma patients received second autologous HSCTs for relapsed or progressive disease; and 25 patients with R/R-HL) at our institution. The median ages of patients with MM and those with R/R-HL at HSCT were 50.4 years and 27.8 years respectively.At the presentation of their MM, the following high-risk (HR) features were encountered: stage II and III diseases according to the revised international scoring system (RISS) in 53.7%; adverse cytogenetics in 42.6% and extensive bone involvement in 53.7% of patients. In patients with HL at presentation, 48% of patients had stage IV disease according to Ann Arbor staging classification and 84% of patients had B symptoms.Survival for 100 days post-HSCT for all patients with MM and HL who received outpatient autologous transplants was 100%. For patients with MM, the overall survival (OS) rates at 3 years and 4 years post-HSCT were 80% and 67%, while the progression-free survival (PFS) rates over 3 years and 4 years were 58% and 38% respectively. For patients with HL, the OS at 6 years post-HSCT was 95% while the PFS rates at 3 years and 6 years post-HSCT were 84% and 62% respectively.Conclusion: Outpatient autologous HSCT for patients with MM and HL is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation performed in an  inpatient setting. Additional benefits of outpatient autologous include saving beds and reducing hospital costs.
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SARS-CoV-2 infection does not affect ovarian reserve in women undergoing assisted reproduction

Published on: 7th March, 2023

Information regarding the effects of the novel coronavirus on human reproduction is currently limited. The objective of our work was to assess whether, in women who have passed the disease, there was a variation in the ovarian reserve through the determination of AMH levels. During May-June 2020, women performing an Assisted Reproductive treatment and who had a positive IgG for SARS-CoV-2 were included in the study; this group of women had a previous AMH determination of no more than 6 months. Women were stratified into two groups, according to their previous AMH levels: low responders (AMH<1 ng/ml) or normal-high responders (AMH ≥ 1 ng/ml) Statistical analyses were performed using the Statistical Package for Social Sciences 19.0 (IBM Corporation, Armonk, NY, USA). A total of 46 patients were included in the study; 16 women were diagnosed as having low ovarian reserve (AMH < 1 ng/ml), with an average age of 38.6 years, whereas 30 were classified as having normal ovarian reserve (AMH ≥ 1 ng/ml), with an average age of 34.7 years. Generally, the data show no variation in AMH levels before and after SARS-CoV-2 infection (1.73 ng/ml vs. 1.61 ng/ml, respectively). However, when we analyzed these differences according to the study groups, the results were consistent with the patient's ovarian status. It is possible to conclude that the fact of having passed the disease does not affect the ovarian reserve status but the degree of the variation of AMH levels depending on the patient was a low or high responder.
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The effects of exercise intensity on the gut microbiota of college basketball players

Published on: 4th March, 2023

Purpose: Exercise has a positive regulatory effect on gut microbiota and is also involved in regulating multiple physiological functions of the human body. This article tested the effects of basketball exercises at different exercise intensities on the gut microbiota of college students. Methods: Athlete research subjects (male, aged 18 - 25) were selected from the basketball team and trained at different intensities to obtain a total of 101 fresh fecal samples. DNA was extracted by a DNA extraction kit and bacterial 16S rRNA gene V3-V4 region high-throughput sequencing using the Illumina Hiseq platform. The downstream data were spliced, filtered and de-trimerized and then used to study the difference in gut microbiota. Results: Key bacterial taxa in the gut that responded to exercise intensity differed among athletes of different exercise intensities but most belonged to Firmicutes. With increasing exercise intensity, Butyricicoccus, Anaerostipes, Oxalobacter and Clostridium_IV in basketball players enrich. Further analysis of the functional prediction revealed that carbohydrate metabolism, amino acid metabolism, metabolism of xenobiotics and glycans and metabolism were significantly expressed in the gut microbiota of basketball athletes with high intensity. Conclusion: The study demonstrated that after long-term professional training, the gut microbiota of athletes adapts to exercise stimulators and can quickly respond to changes in exercise intensity. In high-intensity training, the organism is protected from harm by enriching some beneficial bacteria.
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Clinical profile, prognosis and post COVID-19 Illnesses among attendants to private general practitioner (GP) clinic at Urban Amman Area: a clinical case-series study

Published on: 4th March, 2023

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored.This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan.Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms.Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.
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Nutrition as the cornerstone of immunity

Published on: 3rd March, 2023

Nutrition plays an essential role in the maintenance of a healthy immune system. The body requires a variety of essential nutrients to support the development and function of the immune system. A balanced diet that includes a variety of vegetables, whole grains, fruit, and lean proteins can provide the necessary nutrients for optimal immune health. Additionally, research has shown that certain dietary components may have specific immunomodulatory effects. This review will discuss the evidence linking nutrition to immunity and highlight recent findings on the potential benefits of certain dietary components for immune health. 
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Responding to disasters: about the governance of post-nuclear accident situations

Published on: 3rd March, 2023

Every society organizes itself to reduce the complexity of living together in order to ensure relative peace of mind for its members. Major technological accidents such as the Chernobyl or Fukushima nuclear accidents are violent disruptions that affect the quality of life of tens of thousands of people and generate increased distrust and anxiety among them as well as the questioning of the state system’s ability to restore some peace of mind. Past experience has shown that the measurement of radiation and the development of local projects with the support of professionals and experts prove to be effective levers for those affected to regain the ability to make decisions for their protection and to assess the protective actions implemented collectively. It also showed that restoring confidence and restoring the dignity of these people, seriously impaired by the accident, takes time.
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Clinical and immunological characteristics of depressive patients with a clinical high risk of schizophrenia

Published on: 3rd March, 2023

Objective: To study clinical and immunological characteristics of depressive patients with high clinical risk of schizophrenia.Materials and methods: We examined 30 depressive patients with attenuated positive symptoms (APS), which indicates a clinically high risk of schizophrenia, 20 depressive patients without APS and 27 healthy volunteers with no mental disorders. APS identified according to the presence of three or more scores on at least one of the following items on the Scale of Prodromal Symptoms (SOPS) positive symptoms subscale: P1 (Unusual thought content/Delusional ideas), P2 (Suspiciousness/Persecutory ideas) and P4 (Perceptual abnormalities/Hallucinations). The psychometric assessment was carried out on the Hamilton Depression Rating Scale (HDRS), SOPS, and the Scale for Assessment of Negative Symptoms (SANS). The activity of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI), the autoantibodies to neoantigens S100B and myelin basic protein, and the ratio of LE and α1-PI activity or Leukocyte Inhibitory Index (LII) were determined. Results: The activity of inflammatory markers LE and α1-PI was increased in patients in both clinical groups compared with controls. In the total group of patients, the associations between LII and the score on the positive subscale SOPS, and between LII and the score on the negative subscale SOPS and SANS scale with the most pronounced association with the SANS subscales «Affective Flattening or Blunting» and «Alogia» were established. Conclusion: The identified correlations between immune response features and positive and negative symptoms in depressive patients may have prognostic value for establishing a high risk of schizophrenia.
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Hospital-acquired infections and antibiotic use in a geriatric hospital: a point prevalence study

Published on: 3rd March, 2023

Background: Healthcare-Associated Infections (HAIs) are the most common healthcare-associated complications, particularly in elderly patients. The aim of this study is to describe the prevalence of HAIs and associated risk factors in the IRCCS INRCA of Ancona.Methods: A cross-sectional study has been carried out. Data has been collected in accordance with the European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey 2022-2023 (PPS3) protocol in the IRCCS INRCA of Ancona in November 2022.Results: Out of the 128 patients included in our study, 75.0% were over 78 years old and 9.1% presented an active HAI on the day of the survey. The prevalence of HAIs varied based on the length of the hospital stay (OR 1.1, CI 95% 1.05 - 1.17, p < 0.001) and hospitalization > 7 days (OR 5.9, CI 95% 1.2 - 28.7, p = 0.02).Conclusion: It is clear from our findings that HAIs are associated with advanced patient age, prolonged hospital stay, and use of medical devices, especially in those patients that, due to their clinical situation, are more vulnerable. Although some of these infections can easily be treated, it is important to develop effective infection control strategies thanks to antimicrobial stewardship programs.
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Optimization of the kinetics of siRNA desorption from the surface of silicon nanoparticles

Published on: 2nd March, 2023

Oncological diseases are one of the most significant medical and social diseases in most countries of the world. Over the past decades, the search and development of new drugs, treatment regimens and methods of molecular diagnostics of malignant neoplasms remains relevant. In turn, an important goal of molecular genetic research is to suppress the expression of genes responsible for the development of tumors. The key targets taken into account in the development of antitumor drugs are proteins involved in carcinogenic changes in the cell. One of the promising molecular targets for the development of medicinal compounds in targeted therapy of tumor diseases is poly(ADP-ribose)polymerase 1 (PARP1). A potential way to inhibit PARP1 even at the stage of protein translation is RNA interference due to small interfering RNAs (siRNAs). For the penetration of siRNAs into the target cell, it is necessary to develop a method of their transportation controlled in space and time. An actual direction for solving this problem is the use of highly stable porous silicon-based nanoparticles. In the current study, in order to increase the functionality of nanoparticles, their surface was modified with various agents (functionalization), providing increased efficiency of drug loading and more uniform release. 
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