Prevalence and Correlation between HbA1c Control and Duration of Diabetes with Blindness in the Eastern Part of Libya: Double Centers Study
Published on: 9th October, 2024
A prospective cross-sectional study of diabetic patients registered at the Eye department of Tobruk Medical Center in Tobruk-Libya between (01.06.2023 to 29.02.2024). At the same time data was collected in the eye department in Alwahda Derna Teaching Hospital, Data was collected using the same administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by an ophthalmologist. Descriptive analysis included percentage mean, median, and p - value by using SPSS 25. There were 185 diabetic patients, ages ranging between 30 and 90 years, with a mean of 58, the majority (97.6%) were of Libyan nationality. There were 86 males and 99 females. Patients with a duration of diabetes ranging between 11 and 15 years were at almost a five-fold risk of developing DR compared to those with a duration of < 10 years. Most of advanced complicated diabetic retinopathy cases had diabetes for more than fifteen years, and no advanced disease in the cases with a duration of less than 10 years.
Association Between Electrocardiographic Abnormalities and In-Hospital Adverse Outcome in COVID-19 Patients
Published on: 10th October, 2024
Background: SARS-CoV-2 is increasingly recognized for its cardiovascular complications. To address the knowledge gap in our region, this study investigated the relationship between electrocardiographic (ECG) features and in-hospital mortality among COVID-19 patients.Methods: A prospective cohort study was conducted involving 140 RT-PCR-confirmed COVID-19 patients at Dhaka Medical College Hospital from August 2021 to July 2022. Patients were divided into two groups based on ECG findings: normal (Group A) and abnormal (Group B). Clinical data and ECG parameters were analyzed using SPSS 24.0.Results: Patients with abnormal ECGs were older, more likely male, and presented with higher rates of dyspnea and palpitations. They were also at increased risk of severe COVID-19 and had longer hospital stays. In-hospital mortality was significantly higher in Group B (21.4% vs.4.3%). ST-T changes and atrial fibrillation were associated with increased mortality. Independent predictors of in-hospital mortality included ECG abnormalities and admission SpO₂ < 90%.Conclusion: ECG abnormalities are significantly associated with adverse outcomes in COVID-19 patients. Further large-scale studies are warranted to strengthen these findings.
The Role of Diet Therapy in Reducing the Cardiovascular Disease Risk in a Patient with a Long-Standing and Recurring History of Obesity
Published on: 11th October, 2024
Insulin resistance, often referred to as impaired insulin sensitivity. This clinical case focusses on a woman with insulin resistance and a long-standing and recurring history of obesity to demonstrate how diet therapy can be applied in addition to standard medication therapy.
Impact of Latex Sensitization on Asthma and Rhinitis Progression: A Study at Abidjan-Cocody University Hospital - Côte d’Ivoire (Progression of Asthma and Rhinitis related to Latex Sensitization)
Published on: 15th October, 2024
Background: The frequency of latex allergy is increasing, posing a major health problem. This increase is related to the widespread use of latex materials and cross-reactions between latex proteins and certain foods. This cross-reactivity makes latex avoidance difficult, and latex sensitization is likely to worsen atopic conditions. Objective: The authors evaluated the role of latex sensitization in the poor control of asthma and rhinitis. Methodology: An analytical cross-sectional study was conducted on 1860 patients of all ages and genders, followed up for allergic asthma and rhinitis since March 2012 in the Immuno-Allergology Unit of the Cocody University Hospital in Abidjan. Prick tests with native extracts and the European standard battery were performed to identify allergenic sensitization. The impact of latex sensitization on asthma and rhinitis control was assessed by calculating odds ratios. Results: A high frequency of latex sensitization was associated with asthma and rhinitis. The risks of poor control were related to monosensitization to latex and were even higher in the context of polysensitization. Conclusion: The impact of latex sensitization on the progression of asthma and rhinitis has been well demonstrated. It is recommended to integrate the latex sensitization status into the therapeutic management strategy of these two pathologies.
A Case Report on Paradoxical Emboli
Published on: 17th October, 2024
Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.
A Rare Case of Cutaneuos Angioleiomyoma: A Case Report
Published on: 17th October, 2024
Cutaneous Angioleiomyoma is a very rare benign tumour of which incidence is unknown. We report a case of a 42-year-old male patient who presented with a symptomless solitary nodule over the left nostril for one and a half years duration. Complete surgical excision of the tumour was done and the sample was sent for histopathological examination. Diagnosis of this tumour was done on the evidence of histopathological examination with haematoxylin and eosin mounts. Sometimes achieving the best aesthetically accepted results may be challenging due to the site of involvement.
Flood Risk Management in South-west Nigeria: Lagos as a Case Study
Published on: 18th October, 2024
Flooding is a significant natural hazard impacting societies worldwide, with increasing severity in urbanized regions. This paper presents a case study of Lagos, Nigeria, examining flood risk management efforts in the city. The purpose is to evaluate the effectiveness of current strategies and suggest improvements for reducing the impacts of flooding. Findings highlight the roles of government and private stakeholders, as well as policy challenges. Recommendations for sustainable flood management practices are provided, with implications for other high-risk areas.
Prolonged Latency in Previable PPROM in Twin Pregnancies: A Case Series
Published on: 18th October, 2024
Previable Preterm Premature Rupture of Membranes (PPROM) before 24 weeks of gestation in dichorionic diamniotic (DCDA) twin pregnancies is a rare and challenging obstetric complication. Three cases are presented in this case series, all involving prolonged latency periods of 74, 98, and 158 days following membrane rupture. The management strategy employed was expectant, utilizing antibiotic prophylaxis and close monitoring to prevent infection. Neonatal outcomes varied, with pulmonary hypoplasia and respiratory distress observed in some cases. One twin from Case 2 died due to sepsis, while the remaining twins in all three instances survived after extended neonatal intensive care. This series highlights the potential for extended latency and favorable outcomes in select cases, though neonatal morbidity remains a significant risk, underscoring the need for individualized counseling and vigilant care.
Minimising Carbon Footprint in Anaesthesia Practice
Published on: 19th October, 2024
Carbon footprint refers to the total amount of greenhouse gas emitted in the atmosphere by an individual or by an organization causing global warming. There are various causes of greenhouse gas emissions and anaesthetic gases are one amongst them. Greenhouse gases warm the earth by absorbing infrared energy and slowing the rate at which the energy escapes into space. Each greenhouse gas has two important properties. One is the amount of infrared energy that a gas can absorb and the other is the lifetime of that gas in the atmosphere. Anaesthesia as a speciality contributes to carbon footprinting in three ways: direct emission, energy use, and operating room wastes and supplies. Direct emission of Waste Anaesthetic Gases (WAG) from anaesthesia workstations can either be scavenged and thrown out into the environment causing a green greenhouse gas effect or can pollute the operating room due to poor scavenging. Various techniques such as reducing direct emissions, energy use optimisation, and waste management have been tried in minimising carbon footprint in anaesthesia practice but providing safety to the patient is considered of utmost importance.
The Impact of Globalization on World Nations: A Study on Protection, Welfare, and Producer Gain
Published on: 21st October, 2024
This paper examines the effects of globalization on nations, focusing on economic, social, and cultural dimensions. It analyzes the roles of protectionism and globalization in shaping consumer welfare and producer earnings through qualitative methods and the Customs Union theory framework. The study discusses the benefits and drawbacks of globalization in the context of World Trade Organization (WTO) regulations.
The findings indicate that globalization has intensified financial flows between countries, which can exacerbate economic crises. Countries with abundant human resources can capitalize on the international division of labor to specialize in high-value sectors, while those with limited resources risk falling behind in the digital landscape. This division of labor fosters specialization and improves production efficiency through targeted education.
However, multinational corporations often impede cost-effective production in developing nations, underscoring the necessity to restructure research and development to facilitate technology adoption in underdeveloped areas. This restructuring can help close the technological gap and encourage equitable participation in the global economy.
Jel code Classification: D6: Welfare economics, Fo1 Global outlook, F40: General F4: Macroeconomics aspects of international trade and finance
The Pores of Kohn, an Overlooked Pulmonary Structure: A Review
Published on: 25th October, 2024
Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.
Analysis and Comparison of Social Media Applications Using Forensic Software on Mobile Devices
Published on: 22nd October, 2024
With the integration of mobile systems into daily life, social media applications used especially on Android and iOS platforms contain a significant amount of sensitive information. Social media applications on mobile systems have huge personal and sensitive content. Therefore, it is important to design effective techniques for forensic analysis of social media applications and to detect personal data. In this research, three different paid mobile forensic software and 4 different brands and models of smartphones with different operating systems were used and analyzed. The study shows that private messages, e-mails, time information, shared data, location and time information, and other personal data can be obtained by a forensic expert who performs an examination, and it is seen that one software can access the deleted data, but another software cannot access it. In proportion to the technology used in today’s world, mobile forensics incidents are increasing day by day, and a competitive environment is created among the software used to illuminate these incidents. With this competition, software companies dealing with forensic informatics are trying to obtain different data to illuminate forensic events that may occur due to the active use of social media accounts with the developing technology, and software that does not meet the needs in the face of this situation remains in the background. The criminal elements in the investigation areas of mobile forensics differ daily, and the scope of crimes in the virtual environment is expanding with the developing technology. Therefore, mobile forensic analysis applications should be successful in social media applications other than standard data.
Advances in Physiological Research: Consideration on Arterial Hypercapnia in Acute Cardiogenic Pulmonary Edema (ACPE)
Published on: 24th October, 2024
The causes of hypercapnia in Acute Cardiogenic Pulmonary Edema are still unknown. Our hypothesis recognizes an alteration of the ventilation-perfusion ratio in the apical areas of the lung as the major cause. The redistribution of blood to the apical lung zone in hypertensive pulmonary circulation determines an excess of perfusion compared to ventilation and consequently hypercapnia. Our suggestion might be in favor of Bilevel-PAP over Continuous Positive Airway Pressure (CPAP) as the first line of therapy.
Pseudocalcinosis Tumorale (Teutschlander Disease) in Chronic Hemodialysis Patients
Published on: 24th October, 2024
Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.
Precessional Motion Emerging from Relativistic Component of External Force
Published on: 25th October, 2024
The external force in the relativistic equation of motion can be separated into two components: Fr and Fp. The first is expressed by the physical force divided by the square of the relativistic Lorentz factor, i.e γ2. This force dominates for non-relativistic velocities and vanishes for velocities approaching the speed of light c. On the other hand, the second term increases from zero with increasing velocity and dominates for velocities close to c. It is then a purely relativistic component. The characteristic feature of this component is its zero power, Fp ⋅ v = 0, but it is responsible for the relativistic precession. The effect was confirmed by numerical solutions of the equation of motion. Relativistic formulas for the precession frequency for point objects moving in selected fields of central forces were also derived analytically. It has been shown that for weak gravitational interactions, the correction for relativistic precession is small, negligibly small for Earth, and relatively small, though measurable, for Mercury. In turn, for the microworld and electrostatic forces (e.g., for the hydrogen atom), relativistic precession can fundamentally affect the movement of the electron.
About Efficiency of High-order Harmonic Generation in Attosecond Physics
Published on: 29th October, 2024
For the first time, the interaction between Hydrogen atom and Free-Electron Lasers (FEL) is simulated. The conversion efficiency of High-order Harmonic Generation (HHG) can be enhanced by utilizing a two-color free electron laser with frequency multiplication. It is found that the conversion efficiency of HHG is improved to the largest extent when fourth-fold frequency multiplication is introduced into two-color FEL. The microscopic mechanism of improving the efficiency of HHG is analyzed and discussed.
Pharmacological Manipulation of the Aging Pathways to Effect Health Span and Lifespan with Special Reference to SGLT2 Inhibitors as Powerful Anti-aging Agents in Humans
Published on: 30th October, 2024
Calorie restriction has been shown to slow the aging process in numerous organisms including primates. Caloric excess states, such as type 2 diabetes, are associated with accelerated aging and the incidence and severity of chronic diseases. The nutrient-sensing pathways and intestinal microbiome are important systems that affect aging and chronic disease development. This manuscript reviews the various pathways involved with aging and chronic disease development and examines the pharmacological manipulation of these systems which appear to slow aging and the chronic diseases of aging in experimental model organisms and collaborating human data when available. Finally, the abundance of experimental and human data suggesting the newer diabetic medications, the sodium-glucose transport inhibitors, are potent anti-aging agents is provided.
Causes of Coronary Angioplasty Denial in Patients Diagnosed with Significant Coronary Artery Disease in East Afghanistan
Published on: 30th October, 2024
Coronary Artery Disease (CAD) is a leading cause of mortality worldwide, with coronary angioplasty being a crucial intervention for patients with significant disease. This study aimed to identify and analyze the causes of coronary angioplasty denial in patients with significant coronary artery disease in Afghanistan, focusing on demographic, socioeconomic, and clinical factors.A case-control study was conducted with a sample size of 213 patients diagnosed with significant CAD at tertiary care center in Afghanistan. The case group consisted of 106 patients who were denied angioplasty, and the control group included 107 patients who underwent the procedure. Data were collected on demographic characteristics, comorbidities, education, residence, functional status, income, and the reasons for angioplasty denial. Descriptive statistics and comparative analyses were performed to assess the factors associated with denial.The primary reasons for angioplasty denial were financial constraints (45.3%, p < 0.001), limited hospital facilities (15.1%, p = 0.045), patient refusal (23.6%, p < 0.001), and physician preference for conservative management (12.3%, p = 0.091). Denial rates were higher among patients who were older, had multiple comorbidities, were from rural areas, and had lower education and income levels. Illiteracy and cultural beliefs contributed significantly to patient refusal, while inadequate healthcare infrastructure disproportionately affected rural populations.Financial and infrastructural barriers are the leading causes of coronary angioplasty denial in Afghanistan, exacerbating disparities in healthcare access, particularly among low-income and rural patients. Addressing these issues through policy reforms, improved healthcare infrastructure, and targeted public health education is essential to reducing CAD-related morbidity and mortality in the country.
Forest History Association of Wisconsin
Published on: 30th October, 2024
The Enterprise Radiation Forest (ERF) study was initially introduced as a topic of discussion at the Institute of Forest Genetics, USDA, USFS, in the late 1960s. During that period, a program was endorsed for investigating the impacts of radiation on the forest ecosystem. The rationale for this was to facilitate the prediction of potential outcomes in the occurrence of a nuclear disaster. The research location was situated within the forested lands in Enterprise of Oneida County, Wisconsin, United States. The radiation source in question was a 10,000 curie source of Cesium-137, characterized by a halflife of 33 years. Furthermore, a study concerning lichens was also carried out, the data, photographs, and micrographs were meticulously gathered to illustrate the pre-irradiation activity of the species. This subject holds significant value for dissemination among peers in the scientific community, particularly considering the resilience exhibited by natural ecosystems in response to varying levels of radiation. The information is reviewed with the objective of the entire program to ascertain the potential consequences for a northern forest ecosystem in the event of a nuclear disaster, in addition to the two publications from the Atomic Energy Commission.
Understanding and Managing Caesarean Scar Ectopic Pregnancy: A Retrospective Analysis of Risk Factors, Strategies, and Outcomes
Published on: 31st October, 2024
Objective: Caesarean Scar Ectopic Pregnancies (CSEP) pose distinct diagnostic and management challenges. This study investigates the risk factors, treatment options, and outcomes for CSEP cases treated at Prince Sultan Medical Military City, Riyadh.Methods: Over a two-year period, medical records of 28 patients with CSEP were reviewed, collecting data on patient demographics, obstetric history, and treatment outcomes. This analysis aimed to identify influential risk factors and assess the effectiveness of various management strategies.Results: Treatment success was achieved in 85.7% of cases, with Methotrexate (MTX) proving effective in over half of the cases. The findings suggest significant risk factors and best practices for managing this rare condition.Conclusion: Early detection, risk factor awareness, and tailored treatment strategies are key to optimizing outcomes in patients with CSEP.
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