Recent Articles

Data on illness in preterm infants due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is limited. Duration of viral shedding and treatment options including use of dexamethasone to treat SARS-CoV-2 pneumonia in preterm newborns are scarce and not-well reported. We are reporting SARS-COV-2 positive sick preterm twins vertically infected from SARS-COV-2 positive unvaccinated mother. Twin B initially tested negative at 24 & 48 hours of life (HOL) but subsequently tested positive at 72 HOL and developed SARS-COV-2 pneumonia and required a longer duration of respiratory support. We treated her with 10 days of dexamethasone and noted a good clinical response. To our knowledge, we are first to report the use dexamethasone in a premature newborn with SARS-COV-2 pneumonia. Additionally, the duration of viral shedding in both Twin A and Twin B was between 4-5 weeks.

Autoimmune Myasthenia gravis is a neuromuscular junction disease caused by destruction of the acetylcholine receptor on the postsynaptic membrane, mediated by autoantibodies and clinically characterized by skeletal muscle weakness. This can be triggered by drugs, infections, and in rare cases by vaccines. During the COVID pandemic, de novo cases and exacerbations of myasthenia gravis due to viral infection have been documented. Although few cases related to COVID vaccination. A 69-year-old female patient with blurred vision, a clinic that began 10 days later after receiving first dose of COVID vaccine, and diplopia and right palpebral ptosis after the second dose, 30 days later. In the examination, Edrophonium test was clearly positive, treatment with pyridostigmine and prednisone was started and after 14 days the clinic showed improvement until the resolution of the symptoms There are few reports of exacerbations or triggers for the appearance of myasthenia gravis, a series of 27 cases has been published where there are outbreaks of immune-mediated diseases or the new appearance of autoimmune diseases, in which it is observed that the time of appearance of the outbreak was on average 4 days up to a maximum of 25 days. In conclusion, Myasthenia gravis is a rare complication of the BNT162b2 COVID-19 vaccine. Its potential severity and the current lack of knowledge of the real incidence after vaccination makes it necessary to maintain an attitude of vigilance in the face of symptoms that suggest it.

Overweight and obesity continue to be health-related issues in Alabama Black-Belt Counties with rates ranging from 35 to 48%. We aimed to determine the impact of a web-based nutrition education and physical activity intervention on participants’ health in Alabama Black Belt counties during the COVID-19 pandemic. Nutrition education was delivered to participants through a zoom online platform for 12 weeks. Participants’ knowledge, attitudes, and practices as well as changes in nutrition knowledge, anthropometry, and blood pressure were determined through online surveys. Of the participants, (100%) indicated that overweight and obesity are a result of unhealthy lifestyles, whereas 90.7% reported that obesity increased the risk of high blood pressure (90.7%), diabetes (86.04%), and heart disease (90.7%). Results showed that participants’ income was a significant determinant of their perception for the role of schools in fighting obesity (χ2=0.04). Similarly, data revealed that the age of participants was a significant factor for: their desire to learn more about obesity (χ2=0.04), perception of their knowledge of overweight and obesity compared to the average person (χ2=0.01), and the perception that they had an excellent knowledge of overweight and obesity (χ2=0.05). There were significant improvements in knowledge scores. Results showed a significant decline in waist circumference (p

Background: In Multiple Sclerosis, more efficient disease modifying treatment (DMT) are often accompanied by higher risks and side effects. Selecting the optimal DMT demands from patients and doctors therefore a complex decision-making process weighing risks and benefits. Patients and doctors often prefer to share responsibility when making these treatment decisions, but this shared decision-making model requests decision-making competence on both sides. The aim of our online study was to investigate whether patients’ decision-making competence relates to DMT selection. Method: 197 patients participated in the online survey, advertised by two patient organizations. Patients reported their DMT and who decided for or against a DMT: their neurologist, themselves, or both. We measured decision-making competence with two tasks from the Adult Decision-Making Competence Battery (A-DMC), the ability to follow decision rules and the consistency of risk perception. Perceived impairment of the disease was measured with Patient Determined Disease Steps (PDDS). Results: The ability to follow decision rules varied with the potency of the DMT. Patients receiving basic DMT were better able to follow decision rules compared to patients receiving medium DMT. Patients who did not take any DMT stated more frequently that this decision was their own choice and independent of their doctor’s advice. Conclusions: If patients without DMT decided against this treatment on their own behalf, doctors and caregivers potentially have to strengthen their effort to reach out to the patient and to ensure the decision is well taken.

Minor salivary glands are present in most parts of the mouth. They are the important components whose secretion directly bathe the tissues of the oral cavity. Smoking is the most commonly seen deleterious habit among men which directly affects minor salivary glands in the palate. Smoking also causes stomatitis nicotina in the oral cavity.

Backgrounds: Neurolathyrism is a disease, which is linked with the consumption of Lathyrus sativus ( L. sativusi) pulse that contain the neurotoxin-beta-N-oxalyl-L-alpha-beta-diamino propionic acid (beta-ODAP). Patients with Lathyrisum suffer with gradual enhancement in spasticity and bony changes, which are responsible for appearing the crippling condition throughout life. Objective: The present study has been done as to establish the present situation of L. sativusi consumption and Lathyrisum. Materials and Methods:We performed the survey in the village of Mohammadabad Block of Gazipur district in Eastern Uttar Pradesh (a state with maximum population in India) which have population of million, and L. sativusi is the main pulse of the year, which sustains the economy of these populations. Results:Out of 21,234 subjects L. sativusi eating population for more than 10 years, none had Lathyrisum. On contrary, to popular belief, this population enjoys various dishes made by L. sativusi pulse which in popular are local delicacy. Conclusions:There is no evidence of L. sativusi causing Lathyrisum in 2021. On contrary, L. sativusi pulses have become an inheriting part of the food habits in these populations.

Hyperglycaemia is a key symptom in diabetes mellitus associated with long term damages, dysfunction and eventually failure of organs, especially the eyes, kidneys, nerves, heart and blood vessels. This study is to evaluate the hypoglycaemic potential of orally administered aqueous and ethanol extracts of Zyziphus spina-christ fruit on alloxan induced hyperglycaemic Wistar rats. The plant was extracted using maceration using aqueous and 80% ethanol as extraction solvents. Qualitative phytochemical analysis was done. An in vitro assessment of both aqueous and ethanol extract to demonstrate hypoglycaemic activity via inhibition of alpha amylase enzyme and alpha glucosidase enzymes were done. Total of 45 albino rats were used in the study of both sexes divided in 9 groups. Group 1: normal control group, group 2: diabetic control group, group 3: positive control group (metformin 300mg/kg), group 4-6: (150mg/kg, 300mg/kg and 600mg/kg) aqueous extract and group 7-9: (150mg/kg, 300mg/kg and 600mg/kg) ethanol extract. Groups were compared using one way ANOVA for significant differences and Dunnet’s posthoc test was deployed were differences exit. Data were represented as mean ± SEM and p value

Objective: To determine the prevalence of minority drug resistance variants in the protease and Gag regions among patients failing a protease inhibitor (PI) based regimen with or without a susceptible genotype based on Sanger sequencing technology. Methods: Samples were obtained from patients who were failing on a protease inhibitor-based regimen (n = 500). Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was grouped into two categories: those failing a PI based with mutations in the protease region (n = 100) and those failing on a PI based regimen without mutations in the protease region (n = 128). These samples were then analyzed in the protease and Gag regions using Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cutoffs. Results: An initial analysis of the protease region for patients failing with drug resistance mutations revealed that most patients harbored mutations that confer resistance to Lopinavir and Atazanavir, but these mutations had little effect on Darunavir. Furthermore, NGS revealed that in patients failing with and without drug resistance mutations, minority drug resistance mutations were present at each of the drug resistance codons and at codons that confer multi-drug resistance to protease inhibitors. Further analysis of the Gag gene revealed more genetic diversity among patients failing with no mutations in the protease as evidenced by the proportion of polymorphisms at each codon. Conclusion: Based on Sanger sequencing, a proportion of patients fail a PI based regimen with a susceptible genotype. However, these patients harbor minority variants in the protease and numerous polymorphisms in the Gag region which when combined these could explain their poor response to therapy. Therefore, in order to improve patient care in low resource settings, there is need to adapt NGS as the standard genotyping technique so that minority variants are captured much earlier. In addition, since mutations in the Gag region also play a role in response to PIs, this region should be included in the routine monitoring for response to therapy in patients on a PI based regimen.

An internist with an eagle’s eye can diagnose many hidden diseases through careful examination. One such hereditary metabolic disorder is Albright’s Hereditary Osteodystrophy (AHO). Characteristic presentations in an individual affected by AHO were short stature, obesity, mild mental retardation and brachydactyly especially of 4th and 5th digits, which are the phenotypic features of genetic mutation. Pseudohypoparathyroidism (PHP) is characterized by inability of the body to respond appropriately to parathormone, mainly characterized by hypocalcaemia, increased serum parathormone concentration, insensitivity to the biological activity of parathormone and hyperphosphatemia. AHO when seen in association with resistance to parathormone (PTH), it is called PHP. Here is a case report of 22-year-old female patient with AHO with distinctive physical characteristics who presented to us with recurrent hypocalcaemic tetan

Diagnosis and choice of therapeutic rational tactics in patients with closed pancreatic injuries still remain and actual problem of urgent abdominal surgery. The results of treatment of 70 patients with pancreatic injuries being treated in a surgical department of RSCUMA of Uzbekistan Public Health and its branches during 2009-20021 with analyzed. Intraoperative inspection of omental bursa is still a single reliable method to reveal injuries to the pancreas. Depending on the character and localization the differ following kinds of surgical treatment of pancreatic injuries were used: based on adequate drainage of the impaired zone; removal of lifeless pancreatic tissues; restoration of passage or rational derivation of pancreatic juice. It is necessary to underline that in all cases of pancreatic injuries antisecretory, antianzymatic, antibacterial and desintoxicating therapy must be carried out.

Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retro orbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue hemorrhagic fever/dengue shock syndrome, characterized by hemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, and cardiac involvement, have been increasingly reported called expanded dengue syndrome. The renal complications of dengue virus infection cover a wide spectrum of manifestations from acute kidney injury to glomerular injury with nephritic/nephrotic syndrome. Majority of cases remain symptom free and show full recovery. We report a 55 years old lady with atypical and rare presentation of dengue disease marked by rapidly progressive glomerulonephritis. Condition improved after initial 5 days pulse methylprednisolone followed by oral prednisolone therapy and mycophenolate mofetil. The main mechanism of dengue glomerulonephritis is still unknown though both direct viral infection and immune mediated damage have been suggested to be the cause. To avoid otherwise preventable morbidity and mortality, physicians should have a high index of suspicion for renal complications in patients with dengue illness and should manage this accordingly

Progressive supranuclear palsy (PSP) is a rare neurodegenerative parkinsonian syndrome with distinct clinical features which tends to be progressive, causing vertical supranuclear gaze palsy, frontal lobe cognitive decline, postural instability and progressive axial rigidity. Clinical examination typically reveals ocular motor dysfunction including restricted vertical gaze, slow vertical saccades and “eyelid opening apraxia” with intact vestibule ocular reflex. PSP falls under the rubric of Parkinsonism plus syndromes that are a group of heterogeneous degenerative neurological disorders that differ from the classical idiopathic Parkinson’s disease. PSP is often underreported, making it important for clinicians to be aware of this disorder. Here we report a case of PSP, which presented primarily with speech disturbances and recurrent falls due to postural instability. On investigating, the magnetic resonance imaging (MRI) revealed a classical sign diagnostic of PSP. This teaching case report describes management and prognosis of the disease

The Lord-Shulman theory with one relaxation time and the dual-phase-lag model with two relaxation times of thermoelasticity are used in this article to study the influence rotation micro-elongated thermoelastic layer, when a piezo electric layer is above it. To convert a partial differential equation to an ordinary differential equation, the normal mode method is utilized. Numerical computations are implemented for aluminum epoxy, and the results are charted. A comparison is made among the two theories in the complete absence and the presence of a rotation. The presence of a rotation has a major effect on all physical quantities.

Traditionally, a typical phase II trial has been conducted using a single-arm design recruiting patients only to the experimental therapy to be compared with a historical control. Due to a small sample size and heterogeneity of patient population, the patient characteristics of the patients in a new phase II trial is often different from that of the selected historical control, so that the single-arm phase II trial may lead to biased conclusions. A randomized phase II trial can resolve such problems by randomizing patients between an experimental arm and a control arm. We propose a software package for designing and analyzing randomized phase II trials. We develop a user-friendly Java software that will help us find optimal two-stage phase II trial designs. Although the programs accommodate trial designs based on various statistical methods and different types of early stopping rules, the main part of our paper is focused on randomized phase II trials based on Fisher’s exact test with futility and superiority early stopping values. If users enter input parameter values, the software generates a graphical output displaying all efficient two-stage designs. Minimax, optimal, and admissible designs are highlighted as good designs, but users can select any of the displayed designs. When the circle representing a design is clicked, all the specifics of the selected design are displayed. Fisher’s test is an exact method whose critical values depend on the total number of responders from two arms. So, the computations required to search for optimal randomized multi-stage phase II trial designs based on Fisher’s exact test is very heavy. By using efficient algorithms, our software provides output at almost real time speed

Psychoactive substances, also known as psychotropic substances are substances that alter the mental state of a person by affecting the way the nervous system and brain work [1]. Psychoactive substances can cause intoxication and this is generally the major reason why most individuals engage in their use. Individuals who take psychoactive substances experience changes in brain function which alter their mood, consciousness, and/or perceptions. Psychoactive substances are present in different medications, alcohol, plants, and animals [2], many, but not all of which are addictive [1]. The most common psychoactive drugs used by people to alter their mental state are caffeine and alcohol [3]. Although they are available legally, yet, they are harmful both psychologically and physically when used in excess. Usually, the decision of how and when to use these psychoactive drugs is left to the individuals [3], however, in certain situations, the drugs are used for exploitation of others by the alteration of their mental state. For example, Rohypnol has been used as a date-rape [4]. Some of the psychoactive drugs are very unpleasant making the users quit their use. This is the case in certain classic psychedelics (e.g., psilocybin), powerful dissociatives (e.g., Salvia divinorum), and deliriants (e.g., Jimson weed) [5]. Addiction and dependence resulting from the misuse of psychoactive drugs have led to moral debate and legal measures, while governmental controls on prescription, supply, and manufacture have been efforts made to minimize the additive use of these drugs. Also, ethical concerns exist about the marketing of these drugs by manufacturers and their clinical over-use. However, in some countries, there are ongoing popular campaigns geared towards legalizing and decriminalizing the use of some recreational drugs such as cannabis. Many individual, genetic and environmental factors have been reported to work individually or synergistically to decrease or increase the probability that an individual will use a psychoactive drug and to what extent [6]. This review aimed at updating information on the different uses of various psychoactive drugs by humans, the different effects on the biological system, and their reported DNA damaging potential in simulated and real-life scenarios.

Bite marks are commonly observed in cases such as slaughter, sexual assault, child abuse cases, and during sports events. Bitemark is a type of ‘patterned injury’ which played an important role as evidence in judicial system. Bite marks can find on various body parts and various edible leftovers at the Crime Scene which can be used as evidence for identification of the criminals. Teeth impression shows sexual dimorphism and therefore helps in gender estimation. The various dental characteristics are individual-specific. A piece of exhaustive information and examination of indentations can help in the vindication of the guiltless as well as give decisive proof to the conviction of criminals. In certain violations, indentation proof is the main proof on which conviction has been accomplished, especially in rape and kid abuse cases. The present review describes the importance of bite mark analysis, estimation of gender through bite marks, and stability of teeth impression in diverse conditions. This article can give a better comprehension of the methodology used in forensic dentistry when investigating dental impressions.

This study was conducted in South west Shewa zone, to describe phenotypic characterization of indigenous goat type in Tole and Becho districts. Morphological and Linear body measurement were carried out to collect necessary raw data during the current study. Morphological characters and linear body measurements were collected from a total of 460 adult goats. Data collected from each site were coded and entered into the computer (Excel 2016 and SPSS, V21, 2013) computer software to facilitate for further analysis. Data collected through Morphological and linear body measurements were analyzed using (SPSS, V21, 2013 and SAS, release 9.2, 2008). Most frequently observed coat color pattern in study was plain 62.8%. Multiple correlations between body weight and linear body measurements were computed for the population within each sex and correlations among body weight and linear body measurements were positive for both sexes. The strong, positive and significant correlation between heart girth and body weight was observed (r = 0.97, 0.93) for male and female population, respectively. Generally, this study was aim to describe phenotypic characterization of indigenous goat type in the study area. The Most observed body color type was plain in the study area so its need investigation because farmers need plain color rather others.

Introduction: Morphologically abnormal blood cells in peripheral blood of a person reflect underlying pathological condition affecting formation, function, and lifespan of these cells. A properly identified morphological defect in peripheral blood cells is important to manage anemia, leukemia and other disorders of blood. This study aimed to assess magnitude and severity of morphological abnormality in blood cells of patients with abnormal complete blood count in public hospitals found in southern Ethiopia. Method: A facility-based cross-sectional study was conducted from January 01 to March 31, 2019 among five public hospitals in Southern Ethiopia. Peripheral blood sample and socio-demographic data were collected from 423 patients with abnormal complete blood count. Thin blood smear was prepared by Wedge method, stained with Wright’s Stain, and examined under microscope by 1000X magnification to detect and characterize abnormality in blood cells’ morphology. Descriptive statistical analysis was done using Statistical Package for Social Sciences version 20.0, and results are presented in tables and figures. Result: Prevalence of blood cell morphological abnormality was 63.8%. From this, 21.8% is marked and 78.2% is moderate abnormality. In 41.9% of the affected patients, the defect involved at least two blood cell types mainly affecting red blood cells. Females (73.8%), children (70.1%) and elderly (82.1%) carried higher prevalence of the abnormality. Conclusion: High prevalence of abnormality in PBS morphology was observed, chiefly among female, children and elderly. Stakeholders should work to alleviate the high prevalence, with particular attention to women, children and old-age people.

Purpose:This study aimed to assess contrast sensitivity and acquired color vision deficiency in patients with primary open-angle glaucoma and to evaluate their correlations with visual field parameters. Methods: The current study included 100 patients with primary open-angle glaucoma and 40 healthy control subjects. The 100 glaucoma patients were divided into 3 groups (mild, moderate and sever). Ophthalmic examination included best corrected visual acuity (BCVA), gonioscopy, slit lamp biomicroscopy, visual field assessment by perimetry and intraocular pressure was measured using Goldmann applanation tonometry. Contrast Sensitivity evaluated by the Pelli-Robson chart and the Mesotest II b. Color vision was evaluated by the Farnsworth- panel D15. Results: The mean age of the studied cases was 52.61±14.86 years with male to female ratio 50.2/49.8. Cup-To-Disc (C/D) ratio was statistically significant increase in severe cases followed by moderate and lastly mild glaucoma subgroups. There was highly statistically significant increase in the mean C/D ratio among cases with glaucomatous eyes compared to normal .There was a significant correlation between worsening visual field indeces and decreased contrast sensitivity. Color vision was demonstrated to be significantly correlated according to severity, duration of affection, age and uncontrolled IOP. Conclusion: Mesotest II b is a better alternative to conventional reliable and reproducible Pelli Robson chart test for assessment of contrast sensitivity in patients with glaucoma.