Addressing the disparities and the factors related to prolonged inpatient length of stay for solid tumor oncology patients during the COVID-19 pandemic: A narrative review
Published on: 17th September, 2021
OCLC Number/Unique Identifier: 9272370671
Solid tumor oncology treatments are primarily performed in the outpatient setting. However, hospitalizations are inevitable due to complications of cancer and treatment-related toxicities. With rising health care spending, the length of hospital stay (LOS) is increasingly considered a proxy for healthcare costs. There are several ongoing efforts to abbreviate the inpatient LOS and ensure a safe and timely discharge to the outpatient setting. In addition to the acute illness and the associated comorbidities, various factors affect the LOS: social determinants of health (SDOH), nutritional status in cancer patients, and end-of-life issues. Furthermore, it is unclear how the institutional policies on social distancing and visitation during the current coronavirus disease (COVID-19) pandemic may impact the LOS. The purpose of this article is to review various factors and barriers that lead to longer LOS for solid tumor patients during the COVID-19 pandemic, and identify the critical areas of quality improvement.
MALDI-MSI method for the detection of large biomolecules in plant leaf tissue
Published on: 6th August, 2021
OCLC Number/Unique Identifier: 9204611613
In this study we describe a method for the detection of biomolecules (in the polypeptide m/z range) directly from the surface of plant leaves by using Mass Spectrometry Imaging. The plant-pathogen interaction between Arabidopsis thaliana and the bacterium Xanthomonas campestris pv. campestris was analyzed by comparing infected and non-infected leaf discs submitted to mass spectrometry. The total surface area of ion distribution was calculated for both samples, revealing 23 ions, out of which 3 showed statistical significance. Although these ions were not identified, the results showed that this approach can be successfully applied for the detection of potential polypeptide biomarkers directly on leaf tissue, which is a major challenge in MALDI-Imaging studies.
Leiomyosarcoma in pregnancy: Incidental finding during routine caesarean section
Published on: 16th August, 2021
OCLC Number/Unique Identifier: 9272401197
Uterine leiomyosarcoma (LMS) is uncommon tumour arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature.We present a case of myomectomy performed during elective caesarean section for breech presentation, due to its easy accessibility and well contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical- radiological monitoring instead. This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine leiomyosarcoma in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during caesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumour and risk of bleeding needs to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.
Cannabinoids as a yield modifier in physical activit: A systematic review characters
Published on: 28th July, 2021
OCLC Number/Unique Identifier: 9272370672
Marijuana is considered illicit in much of the world, and is classified as a drug for recreational use, in recent decades the medicinal use of Cannabis sativa L. has grown and diversified, being considered the only therapeutic alternative in the control of serious and incurable diseases such as syndrome of Dravet. The world panorama has shown a more liberal position, since in several countries such as the United States of America, Holland, Australia, Italy, and more recently in Canada, the use of medications, or even the recreational use of this plant, have been regulated. In this context, the investigation of the modifying effects on physical activity of empirically used cannabinoids is fundamental nowadays, mainly due to the regulatory recognition of Cannabis sativa L. as a medicinal plant in a large part of the world. Therefore, the objective of this review was to verify the evidence related to the effect of cannabis on physical performance and to identify and highlight the challenges in the interpretation of information regarding the performance of practitioners of physical activity, as well as athletes, presenting new trends in this area of research to be addressed. To carry out the systematic review, a bibliographic survey of case reports was obtained through Pubmed, Science Direct and Google Academic databases. The following keywords were used to perform the research: cannabis, performance, pain, competition. The following filters were used as inclusion criteria a languages used english; species: humans; types of articles: original articles and reviews and period of publication of articles: 1981 to 2021.
COVID-19 and rhino-orbital mucormycosis – a case report
Published on: 5th October, 2021
OCLC Number/Unique Identifier: 9305369698
There is a constant rise in cases of rhino-orbital mucormycosis in people with Coronavirus disease 2019 (COVID-19). Generally, Mucormycosis develops in immunosuppression or debilitating diseases. In cases having head and neck involvement, the mold enters the respiratory tract with further involvement of nose and sinuses and there is consecutive progression into orbital and intracranial structures. Diabetes Mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. The clinical examination and direct smears are helpful for early diagnosis of the disease and timely intervention. For the better prevention and management of such opportunistic infections in COVID-19 patients, it is prudent to establish prophylactic treatment protocols along with rational use of corticosteroids. We here report a case of Rhino-orbital Mucormycosis infection caused by Rhizopus oryzae in a COVID-19 patient with Diabetes Mellitus.
Non-alcoholic fatty liver disease: Update on treatment options and translational implications of sleep disruption
Published on: 17th August, 2021
OCLC Number/Unique Identifier: 9206109721
Non-alcoholic fatty liver disease (NAFLD) is a condition that is associated with cirrhosis and hepatocellular carcinoma, and is increasing in prevalence worldwide. Sleep disruptions are commonly seen in NAFLD, and the disease process is associated with sleep disorders, including obstructive sleep apnea, circadian rhythm disorders, and insufficient sleep. The intermittent hypoxia seen in obstructive sleep apnea may contribute to fibrotic changes in the liver.A major component of this linkage may be related to gut microbiome changes. One notable change is increase in Bacteroidetes/Firmicutes ratio, and decrease in flora that ferment fiber into anti-inflammatory short-chain fatty acids. Several therapeutic options exist for NAFLD that target both sleep and NAFLD, including non-pharmacological factors, such as lifestyle modification (mainly diet and exercise). Pharmacological options include melatonin, Vitamin E, thiazolidinediones, and fecal microbiota transplantation.Core tipThe pathogenesis of non-alcoholic fatty liver disease is closely tied to sleep and circadian rhythm abnormalities, through shared inflammatory pathways and altered metabolism. This review explores the pathogenesis of NAFLD in the context of sleep and circadian abnormalities. The associated inflammatory response is linked to changes in gut-microbiome interactions that contribute to the disease process. Understanding of this linkage has implications for various therapies for disease mitigation.
A validated method for coumarin quantification in Meliloti herba and its ethanolic extracts using micellar thin-layer chromatography
Published on: 12th October, 2021
OCLC Number/Unique Identifier: 9305454757
A micellar thin-layer chromatography method for the quantitative determination and validation of coumarin in Meliloti herba and its ethanolic extracts was developed and validated. For achieving good determination, the mobile phase of 5 x 10-4 mol/L Tween-80 in a mixture propanol-2 – water (5:95 v/v) was used. Densitometric determination was carried out at 275 nm. The calibration curve was linear in the range of 0.1-2.5 μg per band. The proposed method is simple, rapid, precise and accurate; replacing hazardous solvents by greener ones correspond to the modern requirements in “Green chemistry” concepts. The obtained data can be used for the routine analysis of coumarin in medical plant and extracts.
Awareness level on the relevance of forensics in criminal investigation in Nigeria
Published on: 15th October, 2021
OCLC Number/Unique Identifier: 9305467463
The main aim of forensic science is to gather intelligence to enable the judge to credible and logical decisions in the court by means of scientific approach through evaluation of evidence for the administration of justice, and country around the world now considers forensic methodology as the gold standard for criminal investigation. Therefore, the present study examined the level of awareness on the relevance of forensics in criminal investigation in Nigeria. The design used in this study is the survey research design and the sample size of this study was a total of one hundred personnel of law enforcement and the judiciary. The study adopted descriptive statistics which involves the use of frequency and percentage. The result of the present study revealed that the participants were distributed socio-demographically as follows; there was an observable higher number of male participants (68%) relative to the female participants (32%), As per age distribution, a larger population of the participants were found to be > 40 years of age with 55%, and it was observed that age between 35-39 years ranked the least with 15%. On educational level, the result of the present study revealed that majority of the participants possesses a bachelor’s degree as the highest level of educational qualification with 75% from a pool of 100% of participants. The present study further examined responses on the relevance of forensics in criminal investigation, and the result revealed an inadequate level of awareness on the relevance of forensics in criminal investigation. Therefore, the study recommends that the Nigerian Police Force and the Judiciary should collaborate with Universities running programs on forensics for trainings.
Coexistence of common gallstones and sinusoidal obstruction syndrome: Case report and review of the literature
Published on: 15th October, 2021
OCLC Number/Unique Identifier: 9305369903
Purpose: The sinusoidal obstruction syndrome (SOS) of the liver is an obliterative vasculitis that involves the terminal branches of the hepatic venules and sinusoids. When it is not treated, it will be a serious risk of mortality. Here, we aim to present our patient who has been associated with recurrent cholangitis attacks due to cholelithiasis and choledocholithiasis and is associated with sinusoidal obstruction syndrome with the literature.Description of the case: A 30 years old male patient had complaints of abdominal pain and nausea for a long time. The patient had a history of choledocholithiasis and cholangitis attacks. Although ERCP was performed and a stent was placed in the biliary tract, his jaundice did not disappear. Liver function tests were high. Tumor markers were negative.Methods: We could not make a definitive diagnosis with imaging methods and biopsy and we planned surgery. We performed segmental liver resection and biliary diversion in the surgery. Histopathological examination of the resected liver tissue was compatible with SOS.Conclusion: Many studies have been done on the etiology of SOS and different causes have been revealed. Accompanied with clinical findings, a definitive diagnosis is made with the exclusion of the presumptions considered. Surgery can be performed for both diagnostic and therapeutic purposes. If patients with elevated liver function tests and bilirubin have long-term abdominal pain, SOS should be bear in mind.
Metabolic profiling and antibacterial activity of Eryngium pristis Cham. & Schltdl. - prospecting for its use in the treatment of bacterial infections
Published on: 3rd November, 2021
OCLC Number/Unique Identifier: 9331573236
Morbidity and mortality of the infected patients by multidrug-resistant bacteria have increased, emphasizing the urgency of fight for the discovery of new innovative antibiotics. In this sense, natural products emerge as valuable sources of bioactive compounds. Among the biodiversity, Eryngium pristis Cham. & Schltdl. (Apiaceae Lindl.) is traditionally used to treat thrush and ulcers of throat and mouth, as diuretic and emmenagogue, but scarcely known as an antimicrobial agent. With this context in mind, the goals of this study were to investigate the metabolic profile and the antibacterial activity of ethanolic extract (EE-Ep) and hexane (HF-Ep), dichloromethane (DF-Ep), ethyl acetate (EAF-Ep) and butanol (BF-Ep) fractions from E. pristis leaves. Gas Chromatography-Mass Spectrometry (GC-MS) was performed to stablish the metabolic profile and revealed the presence of 12 and 14 compounds in EAF-Ep and HF-Ep, respectively. β-selinene, spathulenol, globulol, 2-methoxy-4-vinylphenol, α-amyrin, β-amyrin, and lupeol derivative were some of phytochemicals identified. The antibacterial activity was determined by Minimal Inhibitory Concentration (MIC) using the broth micro-dilution against eight ATCC® and five methicillin-resistant Staphylococcus aureus (MRSA) clinical strains. HF-Ep was the most effective (MIC ≤ 5,000 µg/µL), being active against the largest part of tested Gram-positive and Gram-negative bacterial strains, including MRSA, with exception of Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 9027) and (ATCC 27853). These results suggest that E. pristis is a natural source of bioactive compounds for the search of new antibiotics which can be an interesting therapeutic approach to recover patients mainly infected by MRSA strains.
Effect of preterm premature rupture of membranes on neurodevelopmental outcome of infants among preterm infants born at Hawassa comprehensive specialized Hospital of Sidama Region, Ethiopia, 2022
Published on: 11th November, 2021
OCLC Number/Unique Identifier: 1296044588
Objective: To verify whether preterm premature rupture of membranes has effect on neurodevelopmental outcome of Infant among preterm infants born at Hawassa Comprehensive Specialized Hospital of Sidama region, Ethiopia, 2022.Methods and materials: A prospective cohort study design will be conducted for 2 years and 6 months from March 1/2022 to August 30/2024. A total of 12 Midwives. 6 supervisors and 1 pediatric neurologist or psychiatrist will be involved in the data collection process. All preterm infants will be recruited consecutively from preterm infants admitted to neonatal intensive care unit from March 1/2022 to August 30/2022. The preterm infants will be categorized into Exposed group (preterm infants born after preterm PROM) and non-exposed group (preterm infants born after spontaneous preterm labour) and followed until 2 years of age to assess neurodevelopmental outcome of infants The data will be entered into Epidata software and exported to SPSS software for windows version 23. For analysis. Descriptive statistics will be computed. One-way Anova and post hoc comparisons with Scheffe’s procedure will be used X2 test or Fisher’s exact test will be used to compare categorical variables.
Clinical presentation, diagnosis and therapeutic management of Dipylidium caninum (Cestoda: Dilepididae) infection in a domestic cat (Felis catus): a case report
Published on: 15th November, 2021
OCLC Number/Unique Identifier: 9341176181
Background: Dipylidium caninum, a zoonotic cyclophyllidean tapeworm, mainly infects dogs, cats, and occasionally humans as well. Here, we present D. caninum infection in a domestic cat. A cat of about one year of age with a history of intermittent diarrhea and shedding stool containing whitish cooked rice like soft particles. Methods: The case was identified by thorough clinical, coprological, and parasitological examinations, and treated accordingly.Results: During the physical examination, the cat was found to be infested with flea, and coprological investigation revealed the presence of gravid segments of cestodes. By preparing a permanent slide, we conducted a microscopic examination, and the cestode was confirmed as D. caninum. The cat was treated with albendazole and levamisole, which were ineffective; additionally, levamisole showed toxicity. Then, we administered niclosamide which completely cured the animal. On re-examination after a week, feces were found negative for eggs/gravid segments of any cestode. Conclusion: Niclosamide was found effective against dipylidiasis and can be treated similar infections in pets.
Idiopathic tumoral calcinosis in children: Case report
Published on: 24th November, 2021
OCLC Number/Unique Identifier: 9359478500
Tumoral calcinosis is a rare, benign entity characterized by the deposition of calcium in periarticular soft tissues. We report the original case of an idiopathic tumoral calcinosis of the elbow in a 6-year-old girl successfully treated by drainage with no signs of recurrence after a 3-year follow-up. We discuss the particularities of this joint location and our therapeutic management.
Tree-ring history of Swiss needle cast impact on Douglas-fir growth in Western Oregon: correlations with climatic variables
Published on: 25th November, 2021
OCLC Number/Unique Identifier: 9359481103
The fungal pathogen, Nothophaeocryptopus gaeumannii, occurs wherever Douglas-fir is found but disease damage is believed to be limited to the Coast Range and is of no concern outside the coastal fog zone (Shaw, et al., 2011). However, knowledge remains limited on the history and spatial distribution of Swiss Needle Cast (SNC) impacts in the Pacific Northwest (PNW). We reconstructed the history of SNC impacts on mature Douglas-fir trees based on tree ringwidth chronologies from the west slope of the Coast Range to the high Cascades of Oregon. Our findings show that SNC impacts on growth occur wherever Douglas-fir is found in western Oregon and is not limited to the coastal fog zone. The spatiotemporal patterns of growth impact from SNC disease were synchronous across the region, displayed periodicities of 25-30 years, strongly correlated with winter and summer temperatures and summer precipitation, and matched the patterns of enriched cellulosic stable carbon isotope indicative of physiological stress. While winter and summer temperature and summer precipitation influenced pathogen dynamics at all sites, the primary climatic factor of these three limiting factors varied spatially by location, topography, and elevation. In the 20th century, SNC impacts at low- to mid-elevations were least severe during the warm phase of the Pacific Decadal Oscillation (PDO, 1924-1945) and most severe in 1984-1986, following the cool phase of the PDO (1945-1977). At high elevations on the west slope of the Cascade Mountains, SNC impacts were the greatest in the 1990s and 2000s, a period of warmer winter temperatures associated with climate change. Warmer winters will likely continue to increase SNC severity at higher elevations, north along the coast from northern Oregon to British Columbia, and inland where low winter temperatures currently limit growth of the pathogen. Surprisingly, tree-ring records of ancient Douglas-fir logs dated ~53K radioactive years B.P. from Eddyville, OR displayed 7.5- and 20-year periodicities of low growth, similar to those found in modern day coastal Douglas-fir tree-ring records which we interpret as being due to cyclic fluctuations in SNC severity. Our findings indicate that SNC has persisted for as long as its host, and as a result of changing climate, may become a significant forest health problem in areas of the PNW beyond the coastal fog zone.
Stiff “Left Atrial” syndrome post-mustard procedure
Published on: 1st December, 2021
OCLC Number/Unique Identifier: 9359567131
Objectives: We describe the clinical course and management of two patients with post-capillary pulmonary hypertension due to diffuse pulmonary venous baffle calcification decades post-Mustard procedure.Background: From the late 1950s to the early 1990s, the definitive surgical repair for children with D-transposition of the great vessels (D-TGA) was an atrial switch procedure (either Senning or Mustard operation) which utilizes atrial-level baffles to shunt pulmonary venous blood to the morphologic right (systemic) ventricle and caval blood to the morphologic left (sub-pulmonary) ventricle. From a hemodynamic standpoint, baffle leaks and stenoses as well as precapillary pulmonary hypertension have all been described as both early and late complications [1]. Recently, delayed post-capillary pulmonary hypertension (in the absence of discrete baffle obstruction) decades post-atrial switch has also been described [2]. The underlying pathophysiology for this postcapillary pulmonary hypertension is unclear but is theorized to involve impaired diastology referable to the pulmonary venous baffle. Methods/Results: Using hemodynamic and imaging data, we describe two patients with extensive pulmonary venous baffle calcification and resultant pulmonary hypertension from the so-called “stiff left atrial (LA) syndrome.” This problem can be difficult to treat medically and is not amenable to catheter-based interventions. We hypothesize that this is an underlying mechanism for pulmonary hypertension in at least some post-Mustard and Senning patients. Conclusion: We describe the treatments and clinical course for each of these patients, and in particular describe how the surgical revision of the pulmonary venous baffle in one case led to the complete resolution of symptoms.
Short-term environmental impact of ambient air quality trends in during the COVID-19 pandemic in India
Published on: 17th December, 2021
OCLC Number/Unique Identifier: 9396212083
The lockdown, implemented in response to the COVID-19 epidemic, restricted the operation of various sectors in the country and its highlights a good environmental outcome. Thus, a comparison of air pollutants in India before and after the imposed lockdown indicated an overall improvement air quality across major Indian cities. This was established by utilizing the Central Pollution Control Board’s database of air quality monitoring station statistics, such as air quality patterns. During the COVID-19 epidemic, India’s pre-to-post nationwide lockdown was examined. The air quality data was collected from 30-12-2019 to 28-04-2020 and synthesized using 231 Automatic air quality monitoring stations in a major Indian metropolis. Specifically, air pollutant concentrations, temperature, and relative humidity variation during COVID-19 pandemic pre-to-post lockdown variation in India were monitored. As an outcome, several cities around the country have reported improved air quality. Generally, the air quality, on a categorical scale was found to be ‘Good’. However, a few cities from the North-eastern part of India were categorized as ‘Moderate/Satisfactory’. Overall, the particulate matters reduction was in around 60% and other gaseous pollutants was in 40% reduction was observed during the lockdown period. The results of this study include an analysis of air quality data derived from continuous air quality monitoring stations from the pre-lockdown to post-lockdown period. Air quality in India improved following the national lockdown, the interpretation of trends for PM 2.5, PM 10, SO2, NO2, and the Air Quality Index has been provided in studies for major cities across India, including Delhi, Gurugram, Noida, Mumbai, Kolkata, Bengaluru, Patna, and others.
Periocular capillary hemangioma treated with low dose oral propranolol - presentation and outcome of 30 patients
Published on: 31st December, 2021
OCLC Number/Unique Identifier: 9382537723
Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol.Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol.Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis.
Pediatric brainstem glioma
Published on: 3rd January, 2022
OCLC Number/Unique Identifier: 9396216057
Background and objectives: Brainstem gliomas are tumors of the central nervous system which have varying presentations and clinical courses. This study aims to analyze the frequency, clinical and therapeutic aspects of brainstem glioma.Methods: We retrospectively analyzed the data from the record of the patients treated for brainstem glioma under the age of 20 between January 2007 and July 2020 in the Radiation Oncology department of the Ibn Rochd UHC.Results: There were fifteen patients (10 males and 5 females). The mean age of onset was 12 years (range 8 - 14 years). The duration of symptoms varied from 1 month to 2 years. Nine of the patients had intracranial hypertension due to hydrocephalus, six had cranial nerve deficits at presentation, and five patients had cerebellar signs. The lesion was pontine in 12 cases. None of the patients had a tumoral resection, nine had a ventriculo-peritoneal shunt insertion for the hydrocephalus and three had a Stereotactic biopsy that revealed one astrocytoma grade 1, one low grade glioma and one glioblastoma. The radiotherapy was indicated in all the cases but only nine patients had a 3D radiotherapy with a total dose of 54 Gy. Three patients received chemotherapy. Six patients are still alive, two are lost to follow up and seven patients are dead with a mean survival period of 8 months.Conclusion: Brainstem glioma is a devastating disease with a bad prognosis. The clinical presentation is variable and the management is multidisciplinary. Our study illustrates the importance of treatment by radiation.
Agaricus brasiliensis (Sun mushroom) and its therapeutic potential: A review
Published on: 10th January, 2022
In recent decades, the chemical, nutritional, and functional properties of edible mushrooms have attracted considerable attention, resulting in numerous reports on their health-associated benefits. One among such edible mushrooms, Agaricus brasiliensis, is native to Brazil and is an important food supplement. This review discusses the therapeutic potential of Agaricus brasiliensis and summarizes the current studies on this edible mushroom.
Impact of the COVID-19 infection on the “benign” nature of the illness of Schönlein-Henoch
Published on: 11th January, 2022
OCLC Number/Unique Identifier: 9391761803
The incidence of COVID-19 in children has been variable. Although now the number of infected children worldwide, and in particular nationally, is small, they are not protected from the infection. Moreover, in the most severe cases septic shock, metabolic acidosis, irreversible bleeding, and coagulation dysfunction have been registered.In February 2021 a 17-year-old boy showed for examination with complaints of pain in the upper part of the abdomen, accompanied by involvement of the ankle joints, the appearance of a rash on the lower extremities with the characteristic of hemorrhagic vasculitis, and a positive test for COVID-19. The characteristics of the skin purpura, the abdominal pain, and the arthralgia led us to the diagnosis of Schönlein-Henoch purpura. The verification of past COVID-19 infection was done by the established high titer of specific IgG antibodies. The clinical evolution of the disease went beyond its generally accepted benign nature - the first manifestation of the illness had been followed by four more relapses, which necessitated new hospitalizations and a change in the therapeutic approach.COVID-19 infection is the cause of a more aggressive course of vasculitis.
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