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Acta Scientific Medical Sciences

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1 COVID-19: What Went Wrong. Ignoring the Tell-tale Signs! , Sara Surani and Salim Surani
The biggest pandemics of all, claiming more than 100 million lives, have long been forgotten. Technology, resources and ad-vancements in research have made people felt they we are invin-cible. SARS, MERS, Swine flu (H1N1), Ebola and other epidemics have challenged the world [1], but the complacence and delays fol-lowing public health advice have had immense implications, both on the societal level with high mortality rates, and on a global level with countries’ economies crashing. Social consequences of eco-nomic and health setbacks have been severe
2 DMFT Index and OHI-S in Children Attending Public Schools in Abuja, Nigeria , Nathan U Ikimi, Funmilayo Jumoke Morebise, Alade Azeez, Busayo Immaculate Oludara, Olumide Alabi and Wisdom Temitope Olatunbosun
To examine the relationship between DMFT and OHI-S among children attending the Local Education Agency (LEA) schools in Gwarinpa, Abuja.This is a descriptive cross-sectional survey of 270 pupils from the six primary Schools in Gwarinpa present at the 2019 National children’s day celebration organized by a non-governmental organization (NGO), “Eat Right Society of Nigeria”. Interviewer administered questionnaire was used to obtain socio-demographic data from the pupils and oral examination with children seated in an upright position under natural light was done by another NGO “Early 5years of Life International Initiative” (Abuja5). Collected data were tested statistically using SPSS software (ver.20.0; IBM, Chicago, IL, USA).The study population is made up of 44.1% males and 55.9% females, between 4 - 20 years of age with mean age (± SD) at 11.42 ± 2.6. Prevalence of tooth decay in children reported in this study was 11.9% with mean DMFT = 0.124 ± 0.5. Females had less tooth decay (11.3%) and statistical significantly better oral hygiene (70.2%) than males (47.9%).There was no statistically significant difference between gender and DMFT; however, females had less decayed teeth with a significantly higher percentage of good oral hygiene compared to their male counterpart.From this study, a clear relationship between DMFT and OHI-S exist among the pupils of six primary schools in Gwarinpa, Abuja. More oral health campaigns should be done to create oral health awareness among children. In addition, free oral health care for children should be prioritized by the Federal Government of Nigeria and implemented to local government level. School oral health visits by Dentist should be initiated by the Federal Ministry of health in collaboration with Non-governmental organizations.
3 A Benign Giant Prostate Hyperplasia Causing Fatal Death without any Prior Symptomatology, a Rare Case Study , Juna Musa, Elton Cekaj, Mohammed K Badi, Carlos Rivera, Edlira Horjeti, Henri Fero, Loran Rakovica and Ali Guy
Benign Prostatic Hyperplasia (BPH) is a common progressive disease of ageing men that is characterized prostate enlargement leading to lower urinary tract symptoms. Prostate volume have been shown to directly correlate with age, men over the age of 50 have a 40% risk of BPH and those over 80 years have 90% risk. Giant prostatic hyperplasia (GPH) is a rare form of BPH and it is commonly seen in patients neglecting their symptoms or inadequately treated disease. BPH symptoms vary with the grade of the disease ranging from asymptomatic to incontinence, nocturia, hematuria, dysuria and urinary retention in more severe forms such as in GPH. Herein we present a case of a 53 years old male patient that presented with altered mental status, pale skin and urinary retention. During the ultrasound examination a huge prostate gland was discovered.
4 Diagnostic Strategies for COVID-19 , Krishan Karla, Shashidhar KN and Krishna S Nallagangula
COVID-19; single stranded positive RNA (+ssRNA) virus causes common cold to severe diseases viz., Severe Acute Respiratory Syndrome (SARS). At this point of time, prevalence of this pandemic virus increases exponentially and become global health burden. Asymptomatic/paucisymptomatic respiratory failure; characterized by leucopenia, leukocytosis, lymphonia and thrombocytopenia along with elevated levels of hepatic aminotransferases [Aspartate transaminase (AST) and Alanine Transaminase (ALT)] and lactate dehydrogenase (LDH). Detection of viral genome by reverse transcription polymerase chain reaction (RT-PCR) is the World Health Organization (WHO) recommended diagnostic modality. Enhanced inflammatory cytokines level will be observed in serum of severe patients. In the present scenario, therapeutic strategies for this infection are only supportive. Drastic research is needed for structural characterization of virus and pathophysiology of the disease. There is a need for strengthening of research in diagnostic and therapeutic areas to control the prevalence and cure the disease; increases survival rate with decreased mortality. Aggressive social isolation is the best way for progressive reduction of prevalence
5 The Rationale for the Use of Antiretroviral Therapy in COVID-19: Where Hope Meets Skepticism! , Maha S Husain, Sahar Fatima, Iqbal Ratnani and Salim Surani
Affecting nearly 300,000 people around the world and claim-ing greater than 10,000 lives, the novel coronavirus-related respi-ratory illness has been declared a global pandemic and a public health emergency by the WHO [1]. The roots of this problem can be traced into early December of 2019, when the Index cases of what were investigated as ‘pneumonia of unknown origin’ were reported in Wuhan, the epicenter of the disease in China
6 Correlational Study between Dream Content and Somatic Symptoms: When the Dream Alerts on an Incubated Symptom , Mbangmou Romuald Stone and Nguimfack Léonard
This study questions the function of the dream in general, and the relation between the manifest content of the dream and the physical symptoms that the dreamer experiences during the period of illness. Based on studies on the relationship between manifest dream content and the onset of inflammatory somatic symptoms in dreamers, initiated by Vaschide and Pieron since the 1900s, and the observation of several clinical cases received during the last five years, we set ourselves the objective in this work of quantifying the link between the intensity of the somatic symptoms felt by the patient, and the frequency of appearance of dreams whose manifest content solicits the dysfunctional physiological system. In other words, it is a question of checking statistically if there is a relationship between the dream that the patient has during his nights, and, the place of expression and the intensity of the symptoms he feels in his body. The synthesis activation theory allowed us to formulate the hypotheses and to interpret the results. It turns out in the light of the results of this study that the physical symptoms experienced by the patient can significantly modify the manifest content of their dreams
7 Tuberculosis the Big Mime , S Benzerga, C Michaux, E Calvo Lasso De Lavega and T Staub
Tuberculosis is a high prevalence disease in different part of world. Even though pulmonary presentation is the most frequent, let’s not forget the extra-pulmonary one which is less frequent and which symptoms are not specific and can mime other diseases
8 Unusual Histological Variant of a Primary Osseous Tumor of the Jaw in a 27-Year-Old Female: Review of the Literature and Case Presentation , Erisa Kola, Leart Berdica, Teona Bushati, Alfred Aga, Ali Guy, Ina Kola, Edlira Horjeti, Klejda Hoxha, Fareeha Nasir and Juna Musa
Introduction: Osteosarcoma is the most common primary malignant bone tumor and represents 20% of head and neck malignancies. Meanwhile osteosarcoma of the jaw is a rare entity, distinct from the conventional type commonly arising in the long bones. According to literature it comprises 6.5 - 7% of all osteosarcomas. WHO has acknowledged several variants of osteosarcoma that differ in location, clinical manifestation and the degree of cytologic atypia [1]. These lesions can arise de novo and present as primary bone tumors, or in a pre-excisting condition such as previous head and neck radiation. Also, hereditary retinoblastoma, Paget’s disease of bone, previous history of fibrous dysplasia, or trauma has been associated with the development of osteosarcomas. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported.Material and Methods: The aim of this article is to highlight the importance of clinical, radiological and histopathologic correlations in order to reach an accurate definite diagnosis in the setting of effective surgical management of this kind of lesions. We share our experience presenting a case of chondroblastic variant of osteosarcoma of the maxilla in a 27-year-old woman, and a critical review of the literature.Conclusion: Osteosarcoma of the jaw is challenging both to diagnose and manage. The biological behavior of osteosarcomas in the jaws differs from tumors of other skeletal bones. Histopathological examination with adequate specimen evaluation is the key to accurate diagnosis and staging. Microscopically, the essential criterion of osteosarcomas is direct production of osteoid or immature bone by tumor cells. Osteosarcoma should always be considered in the differential diagnosis of expansile lesions of the jaws. Hence, early diagnosis and adequate surgical resection are the keys to better survival
9 Corona Virus Prevention , Dana Churchill
How to stay safe with the virus popping up all over the place: Keep your immunity strong so your body can fight it if necessary, takes several steps
10 Survey on Molecular Marker and Diagnosis of Helicobacter pylori , Bassam Oudh Al Johny
This paper will discuss Helicobacter pylori which is a bacterium start in human epithelial cells of the gastrointestinal tract. Its infection is related to many different diseases, such as chronic gastritis, peptic ulcers, gastric lymphoma and adenocarcinoma. The infection by Helicobacter pylori is found more than 50% of the world. It is found deep in epithelial cells that hide mucus in the human stomach, where neutral Helicobacter pylori are prevalent. This bacterium is reported as the leading cause of various gastrointestinal illnesses, chronic gastritis, excretory ulcer, abdominal cancer and gastric mucosa related lymphoid tissue (MALT) lymphoma. In this study for the improvement of two PCR-based techniques for detecting Helical kinds of Helicobacter pylori. Molecular diagnosis of Helicobacter pylori strain by using 16S rDNA PCR amplification and direct examination
11 The Relation of Helicobacter pylori Infection to Gastric Cancer , Abdulaziz Radhi S ALjohni, Bassam Oudh Al Johny and Mohamed Morsi M Ahmed
Background: Helicobacter pylori (H.P.) is a very common bacteria that affect half of the population. It has been incriminated in cancer stomach and gastric lymphoma.Objective: This work aims to discuss the relation and mechanism of H.P. in causing gastric carcinoma.Review of Literature: H.P. has different methods of transmission like oral-oral, fecal-oral, gastro-oral and gastro gastric. The microbiological features of H.P. support its growth and protect it from oxidative damage that enhancing its survival rate. H.P. is now determined as one of the most critical carcinogenic infectious agents because it's a high risk of developing stomach cancer. Gastric cancer is the third type of cancer leading to death and it is due to different causes and risk factors. There are many factors affect the outcome of patients who had infected with H.P. and increase the risk of developing cancer. These are environmental, host-related and virulence factors. All of these factors participate in the development of gastric cancer by two mechanisms, direct inflammatory effects and indirect through mutations in the cell-cycle regulating genes. Conclusion: H.P. infection has an important carcinogenic role in the development of cancer stomach. Eradication of H.P. will decrease the risk of developing stomach cancer.
12 Evaluation of Stability Studies on Transdermal Patches of Econazole and Luliconazole , Gaurav Jain and Rakesh Patel
TDDS i.e. transdermal drug delivery system has been an increased interest in the drug administration on diseased skin (topical delivery) as well as for systemic delivery of drugs. Econazole and Luliconazole is synthetic antifungal agent used for most kinds of fungal infections including superficial and invasive fungal infections. The formulated patches of the drug were evaluated for stability studies. Stability studies were carried out as per ICH guidelines at three different temperature and RH for 3 months for the optimized formulations of transdermal patches of econazole. The results indicates that the transdermal patches of econazole and luliconazole showing better results at 32°C ± 2°C/60% RH ± 5%
13 Coronavirus Disease (Covid-19) in India - An Overview , PK Kavitha
Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new Coronavirus was identified as the cause of a disease outbreak that originated in China. After starting in China, Coronavirus is now spreading fast in many countries including India.The virus is now known as the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The disease it causes is called Coronavirus disease 2019 (COVID-19). COVID-19 is spreading fast across the globe, currently affecting 177 countries, with around 234000 patients and 10000 deaths as on 21st March. It took around three months to reach first 100,000 patients, but the next 100,000 came in under two weeks.In India, a total of 15,404 samples from 14,514 individuals have been tested for SARS-CoV2 as on 20th March 2020 6 PM IST. A total of 236 individuals have been confirmed positive among suspected patients and contacts of known patients. As on 21st March, four deaths have been reported in India due to COVID-19.Cases of COVID-19 have been reported in a growing number of countries, including the U.S. Public health groups, such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), are monitoring the situation and posting updates on their websites. The World Health Organization called it a pandemic on March 11, 2020. COVID-19 was identified in Wuhan, China on December 31, 2019; the disease has spread across the world, affecting over 200,000 people in 166 countries and more than 8,700 deaths.
14 Epidemiological Profile and Classification of Autoimmune Diseases in an Internal Medicine Service in Lomé (Togo) , Komi Dzidzonu Nemi, Lihanimpo Djalogue, Abou Bakari Tchala, Toyi Tchamdja, Kossi Kodjo, Abdou Razak Moukaila, Komi Edem Mossi, Kodjo Agbéko Djagadou, Abago Balaka and Mohaman Awalou Djibril
The purpose of this study was to describe the epidemiology and classification of autoimmune diseases in the department of Internal Medicine of Sylvanus Olympio teaching hospital of Lomé. This is a retrospective study conducted from 1st January 2018 to December 31st 2019 in this department. During the study period, 959 patients were received in the department. Among them, 72 had autoimmune diseases, i.e. a prevalence of 7.5%. The average age of the patients was 31.51 years (range: 17 and 74) and the sex ratio (M/F) was 0.46. The 20 to 39 age group was the most represented (69.44%). Organ-specific autoimmune diseases were type 1 diabetes mellitus (N = 48; 66.7%), Graves' disease (N = 13; 18.05%), autoimmune hemolytic anemia (N = 4; 5.6%) and autoimmune atrophic thyroiditis (N = 2; 2.77%). Graves' disease was associated with type 1 diabetes in one patient. Systemic autoimmune diseases were Rheumatoid arthritis (N = 4; 5.6%), systemic lupus erythematosus (N = 3; 4.2%) and MCTD (N = 1; 1.38%). Rheumatoid arthritis was associated with diabetes in one patient. MCTD was associated with atrophic thyroiditis in also one patient. This study shows that the autoimmune diseases in the Internal Medicine department of Sylvanus Olympio teaching hospital of Lomé are dominated by endocrinopathies namely type1 diabetes and Graves' disease
15 Remarks about Immunosenescence , PhD. Zamir Calamita
This is a mini-review addressing the main aspects of immunosenescence, including: predisposition towards infections, inflammation, autoimmunity, cancer, response to vaccines, allergy, stress, nutrition and physical activity. Remarks are made about this complex network of possible alterations relating to aging.
16 Liddle’s Syndrome Associated with Acromegaly due to Enhanced Renal and Extrarenal ENaC Channel Activity: The First Case Report that Explained this Rare Association , Juna Musa, Jovan Basho, Florian Toti, Suela Mumajesi, Mohammed Badi, Adi Abduli, Loran Rakovica and Ali Guy
Liddle’s syndrome is a rare genetic autosomal dominant disease affecting the activity of the epithelial sodium channels (ENaC) or the amiloride-sensitive sodium channels, which leads the kidneys to excrete potassium but retain too much sodium and water causing early, frequent and severe, high blood pressure associated with low plasma renin, metabolic alkalosis and normal to low levels of aldosterone [1,2]. Disease-associated mutations either activate the channel directly or abrogate aldosterone-inhibited retrieval of ENaC subunits from the plasma membrane [3]. The end result of these mutations is increased expression of activated ENaC channels at the plasma membrane of principal cells which manifests as severe early onset hypertension with hypokalemia unresponsive to spironolactone [4]. We observed an isolated case of a Liddle’s syndrome in a 23-year-old man who presented with signs of acromegaly. The patient initially presented to the emergency room with palpitations, weakness of the extremities and a three-year history of low potassium levels and uncontrolled hypertension. Six months later he was admitted again to the hospital with signs of hypokalemia, including palpitations, fatigue and weakness. Upon further evaluation, he was found to have low renin and aldosterone levels. Physical examination revealed mild diastolic hypertension, acromegalic features, weight gain, excessive sweating, widening of both hands and feet [5]. Laboratory results revealed increased levels of GH and IGF-1-a. After oral administration of oral glucose levels of IGF-1 remained elevated. MR imaging of the brain revealed a 1.3 x 1.2 x 0.7 cm pituitary adenoma. A diagnosis of acromegaly and Liddle syndrome was made. Coexisting acromegaly and Liddle syndrome are reported together only in rare cases and it can be explained due to enhanced renal and extrarenal ENaC activity
17 Atypical Hemolytic Uremic Syndrome in a One-Year Old Male Patient, Successfully Treated with Eculizumab , Henri Fero, Juna Musa, Diamant Shtiza, Ergys Cuka, Loran Rakovica, Blina Abdullahu, Klejda Hoxha, Fareeha Nasir and Ali Guy
Atypical hemolytic uremic syndrome is a rare form of thrombotic microangiopathies resulting from various genetic mutations of the complement factors. Thrombotic microangiopathies include Thrombotic thrombocytopenic purpura, primary HUS further divided into typical HUS or Shiga-toxin related HUS, atypical HUS and secondary forms of HUS.The most common clinical features of the Hemolytic Uremic Syndrome are: kidney failure, thrombocytopenia resulting in hemorrhagic phenomena and also intravascular hemolytic anemia. Most commonly HUS is a diagnosis made from excluding all other plausible causes. HUS predominantly affects pediatric ages
18 Normal-Pressure Hydrocephalus: Past, Present and Future Management and the Relevance of New Insight of Neuropsychology Assessment for Measure of the Cognitive-Behavioral Sequelae , Juna Musa, Angela Guy, Henri Fero, Kristi Saliaj, Ergys Cuka, Loran Rakovica, Inva Mamica, Viola Sulollari and Ali Guy
Normal Pressure Hydrocephalus (NPH) is a neurological disorder characterized by normal or mildly elevated intracranial pres-sure. Distinguishing NPH from other neurodegenerative disorders such as Alzheimer’s disease and vascular dementia is challenging. Therefore, it may be undiagnosed and inappropriately managed. Patients with NPH are treated surgically with placement of a ven-triculoperitoneal shunt; subsequently, most of them have shown clinical improvement in gait disturbance, bladder dysfunction, and cognitive functions. The case study within the present report aims to contribute new insights relative to the management and assess-ment of NPH. The present case additionally helps to inform the relevance of neuropsychological evaluation specific to the cognitive and behavioral sequelae of NPH. The case discussion provides data relative to the intersection of medical and psychological domains that further advance the classification and differentiation of NPH from other medical diseases or cognitive impairments. Further, the implementation of prospective neuropsychological assessments is discussed to help distinguish and inform more succinct diagnoses and appropriate treatment modalities for future providers managing the care of those suffering from NPH or NPH-like symptoms
19 Recurrent Sweet’s Syndrome in a Case of Smoldering Multiple Myeloma and Chronic Hepatitis C , Mark Obri, Arjun Pandya, James Lerakis, Alexander Isla, Michael Rich MD, Ania Henning MD
Background: Sweet’s Syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin disorder that presents as a rapid onset of tender, inflammatory lesions, which usually appear on the arms, face, and neck. It is histologically characterized by a neutrophilic infiltrate in the dermis with karyorrhexis and massive papillary dermal edema. Sweet’s is subdivided into three classifications based on etiology: classical, malignancy-associated, and drug-induced.Case Presentation: We present the case of a 55 year old African American woman with a past medical history of smoldering multiple myeloma and hepatitis C who presented to the emergency department with widespread tender bullous lesions on the extremities, trunk, inguinal area, and vulva, along with accompanying polyarthritis. The patient was treated empirically with intravenous methylprednisolone for suspected autoimmune disease following rule out of infectious etiology and vasculitis. Biopsies of the lesions on subsequent hospitalization demonstrated neutrophilic infiltrate of the dermis, and the patient was diagnosed with Sweet’s Syndrome. Conclusion: It is unknown whether this patient's Sweet’s Syndrome was secondary to her smoldering multiple myeloma, hepatitis C, or idiopathic. We believe that smoldering multiple myeloma was the likely underlying culprit given the link between blood malignancies and Sweet’s Syndrome, the widespread presentation of the lesions, and similar presentations reported in cases of multiple myeloma. Based on our case study, we recommend patients diagnosed with Sweet’s Syndrome receive appropriate workup for blood malignancies and hepatitis C
20 Does Work at Fuel Station for Long Period Affect Leukocytes Count? , Rana Zaini, Haytham Dahlawi, Sara Al-Shehri, Mariam Al-Fahmi, Jawaher Khaled3, Norah Al-Barakah and Wojdan Ahmed Al-Sayyali.
Exposure to benzene has been significantly associated with many health disorders and reported to cause abnormality in hematological parameters; haemoglobin (Hb) concentration, red blood cells (RBCs) and white blood cells (WBC) level. Thus, the aim of this study was to evaluate the association between exposure to benzene for a long period of time (more than 12 months with daily 8-hour time) and the level of hematological parameters among fuel station workers at Taif city in Western region of the Saudi Arabia. This case-control study involved thirteen participants (10 fuel station workers and three control individuals) aged between 25 to 45 years. Three healthy individuals were considered as control group. The result of this study showed normal level of all haematological parameters including haemoglobin (Hb), red blood cells (RBCs), white blood cells and platelets when complete blood count (CBC) was investigated for ten workers. Moreover, the level of neutrophils and lymphocytes were reported within the normal ranges. We conclude that benzene exposure had no effects on haematological parameters among workers who exposed to benzene for long period of time when compared to the control group. However, further study are required to confirm these finding with larger sample size
21 Propositions for Improvement of Health Care Organization (Lessons of Covid-19 Crisis) , Coulic Véry, Dobos S, Mboti F and Martin M
The so called “COVID-19 crisis” has shown some insufficiencies in the national health care services all over the world, the difficulties of WHO to be respected, but also the reserves of local inventiveness and adaptation abilities. The aim of the present work is to try to a better understanding of the possible ways of improving the organization of health care including help to WHO and reinforcing its task
22 What is the Best Needle for Spinal Thoracic Anesthesia: Pencil Point Needle or Cut Point Needle? Letter to Editor   , Luiz Eduardo Imbelloni
We recently demonstrated the safety of thoracic spinal anesthe-sia by the study with MRI in 50 patients [1]. In order to verify the incidence of neurological complications in spinal thoracic anesthe-sia, a study was carried out comparing the two most frequently used needles (Cut vs Point Pencil) in 300 patients divided into two groups of 150 patients, puncture success was observed in all pa-tients with 20 (6.6%) paresthesia with no significant difference between the needles [2]. All paresthesia were transient and no neurologic complications were observed. In 2012, we conducted a study of 636 patients undergoing spinal thoracic anesthesia in different types of surgery (laparoscopic cholecystectomy, hernior-rhaphy, urologic, gynecologic and orthopedic surgeries) with hy-perbaric or isobaric bupivacaine, showing that low doses of local anesthetics (5 to 10 mg) and thoracic puncture reduce the latency time, the degree of motor block and cardiocirculatory changes, without neurological complications (3)
23 Anxiety Level and Associated Factors during Coronavirus Disease 2019 (COVID-19) Pandemic in Pregnant Women   , Leo Simanjuntak and Patrick Anando Simanjuntak
Background: Coronavirus disease-2019 (COVID-19) pandemic is spreading widely throughout the world, causing global health crisis and one of the greatest challenges we have ever faced. Indonesia is one of the countries that has been severely affected by COVID-19. The COVID-19 pandemic has created some serious concerns including anxiety in pregnant women. However, due to mental and physical changes in pregnancy, pregnant women are likely to be affected by the virus. At present there is no evidence that pregnant women are at higher risk of severe illness from COVID-19 than the general population. Research is currently ongoing to understand the impacts of COVID-19 in pregnant women. This study aimed to assess the anxiety level and associated factors during COVID-19 pandemic in pregnant women. Methods: This study used cross-sectional design using primary data on April 2020 at Leo Simanjuntak (Obstetrician and Gynecologist) outpatient clinic. Based on defined criteria, 120 subjects were recruited in this study. Anxiety level assessed using Hamilton Anxiety Rating Scale (HAM-A). Demographic data collected using research questionnaire. Logistic regression were used to identify associated factors on anxiety level.Results: Our results showed majority of the pregnant women (71%) showed no anxiety. The rest of these pregnant women (29%) showed mild anxiety level (23%) and moderate anxiety (6%). Multivariate data analysis showed that healthcare workers were associated to higher anxiety level, with OR 5.56 (95% CI .33 - 24.09).Conclusion: Informative and educative advices and suggestions of COVID-19 to pregnant women and their family, such as washing hands frequently, maintain social and physical distancing, using mask to cover the mouth and nose when around others, living healthy life, and doing all the activities from home, can make pregnant women not worried about COVID-19 pandemic, which is supported by this study.
24 Physical Activity Level and Prevalence of Obesity among Adults’ Population of Abeokuta, Ogun State, Nigeria , AS Adekoya, CI Ojo, OA Mafimidiwo and FO Oyeleke
Objective: To examine the effect of physical activity level (PAL) on the prevalence of obesity among adults (20 - 64 yr) in Abeokuta, Ogun State, Nigeria.Designs: 120 adult males and 120 adult females were randomly selected to participate in the study. Body mass index (BMI) was measured using cut-off ≥ 30 kg/m2 and the physical activity assessed according to WHO/FAO work classification.Results: Mean BMI was high above the cut-off (7.2% for rural male and 11% for urban male, p = 0.169) and (28.3% for urban female but lower than the cut-off among rural female 7.7%, p = 0.006). The pattern of physical activity significantly fell on the sedentary side, mostly among the urban subjects. There were positive changes (statistically insignificant) in physical activity level (PAL) and a similar shift in obesity prevalence among the sub-population.Conclusion: The PAL among the population, emphasize the adverse effect of sedentarism on the increasing risks of obesity and chronic degenerative diseases. Participation in physical activity programs should be emphasized
25 Karydakis Flap Reconstruction for Pilonidal Disease , Aybala Yildiz, Alp Yildiz, Veysel Baris Turhan, Engin Kucukdiler and Erkan Karacan
The reported incidence rate of pilonidal disease is 25 per 100,000 people. Initially, the pathogenesis was considered to be congenital. Today, however, the theory that it is acquired is more widely accepted. Work by Georgios Karydakis who highlighted 3 main factors contributing to pilonidal disease had a pivotal role in this paradigm shift. As the primary treatment still surgery, we present our karydakis flap experience in this study. Fourty-four patients has enrolled for this study. All patients has diagnosed pilonidal sinus disease and treated by the same surgical team with Karydakis flap reconstruction. The most common post-operative complication was fluid collection. 2 patients developed fluid collection under the flap site which reduce spontaneously. No hemorrhagia has occurred. 1 patient developed wound infection. No hematoma, bleeding occurred and no need for secondary powder application. No flap necrosis occurred, also wound dehiscence and early recurrence were not found. When low recurrence rates, patient comfort and cosmetic results are evaluated together, Karydakis technique emerges a method that is preferred by physicians and patients.
26 21 Days of Social Synergistic Pilot Survey on Community Participation to Determine the Level Virulence of COVID-19 in Africa before Re-Opening of the Education Sector in an efficiency, Affordable and Sustainable Approach , Maurice B Silali
21 days of Synergistic community participation survey [2] to determine reopening of education sector in Africa remain a key cradle to create psycho social confidence in parents, pupils and students since they left school colleges and universities without completion of their first term or semester exams in mid-march 2020 after the confirmation of the first case of COVID-19 virus [9]. 21 days study period is the maximum incubation period of COVID - 19 Virus to show sign and symptoms in an infected individual
27 Failed ERCP in Extrahepatic Cholangiocarcinoma with Obstructive Jaundice and Cholangitis: An Alternative Approach , Amit Sahu and Arpita Sahu
Cholangiocarcinoma accounting for 2% of all human malignancies is a rare malignant neoplasm of the biliary tract epithelium. Early stages, being asymptomatic, may go unnoticed and by the time it manifests, the disease process is advanced and usually unresectable. The most common presentation is obstructive jaundice with a lot them progressing to biliary sepsis, septicemia, liver failure and death. Chemotherapy and radiotherapy are ineffective in inoperable tumors. Biliary drainage, either endoscopic or percutaneous, remains the mainstay of palliation in these tumors. Endoscopic cannulation retrogradely across the tumor tissue is difficult and may often prove futile. Percutaneous transhepatic biliary drainage and biliary stenting is a viable, rewarding palliative option with high technical success and low complication rates.
28 Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine , Huang Wei Ling
Introduction: Homeopathy is based on the study of the symptoms caused by each substance given to a normal subject, and then applied to each patient who presents similar symptoms (similimum). However, there is still doubt regarding exactly the origin of these symptoms and how the medication act in the energy point of view. Purpose: To demonstrate that the signs and symptoms presented by the patients are related to the Five Elements Theory (Wood, Fire, Earth, Metal and Water) of Traditional Chinese Medicine and to expose the development of specific treatment with homeopathy medications for each massive organ of the Five Elements Theory, treating the root and not only the symptom. Methods: Observational studies were conducted from Western medicine, homeopathic medicine, and Traditional Chinese Medicine. These different types of reasoning were compiled on the metaphor of the tree, a diagram comparing the differences between the three approaches. Results: The diagram showed the roots as the Five Elements (Wood-Liver-Phosphorus; Fire-Heart-Sulphur; Earth-Spleen-Calcaria carbonica; Metal-Lung-Silicia; Water-Kidney-Natrum muriaticum), the branches representing each specialty in Western medicine, the leaves of each branch representing the signs and symptoms. Conclusion: Instead of treating the symptoms presented by the patients using homeopathic medications according to Western Medicine reasoning (horizontal model), the author proposes the premise of the use of Traditional Chinese Medicine, in an energy-based treatment (vertical model). Focusing on the root of the problem and not only on the symptoms.
29 The Covid-19 Treatment Soup: Is Combination Therapy Better? , Pooja H Patel and Salim Surani.
The number of people affected by SARS-CoV-2 virus and con-tracting the coronavirus disease (COVID) continues to increase worldwide. While everyone eagerly awaits the discovery of a vaccine to help curb this pandemic, there will still be a few more months before a vaccine is approved and available in the market. In the interim, it is imperative to identify treatment modalities that can help improve outcomes for COVID infected patients as well as reduce mortality. Developing a new antiviral drug may take years before it is approved for clinical use and may not be the most fea-sible route during these immediate needs. T
30 Rate of Recurrence After Isolated Coarctation Repair: A Retrospective Study in a Single Tertiary Centre , Sami M AlAhmari, Khalid S Alnajashi, Ahmed Elway, Howida Alqethamy, Turki AlQahtani and Merna M Atiyah.
Objectives: To retrospectively determine the incidence of recoarctation within two years of repair of isolated coarctation of the aorta in patients aged less than 14 years and operated on in our institution, and to identify the risk factors for recoarctation in our study cohort.Methods: Review of hospital records from 1990-2016 yielded 350 patients aged less than 14 years who had undergone repair of coarctation of the aorta, 84 of whom had isolated coarctation and comprised the study cohort. We studied possible factors influencing the risk of recoarctation, including sex, delivered term or preterm, age group at diagnosis (neonate, infant, child), administration of prostaglandin E1, type of aortic valve (bicuspid, tricuspid), type of coarctation (juxtaductal, preductal, postductal), surgical approach and type of surgical procedure (end-to-end anastomosis, extended end-to-end anastomosis, subclavian flap). We use binary logistic regression to analyse associations between the above-listed patient characteristics and identify independent predictors of recoarctation requiring intervention.IntroductionResults: Reintervention by catheterisation was required within two years of surgery by 23 (27.4%) of the 84 patients with isolated coarctation, 11 of whom (47.8%) had developed recoarctation within one year of surgery. Binary logistic regression of the examined variables between those who did and did not develop recoarctation failed to identify any significant risk factors for recoarctation (χ2 (8) = 6.532, p = 0.558).Conclusion: In our cohort, the incidence of recoarctation within two years of repair of isolated coarctation of the aorta in patients aged less than 14 years is 27.4%. We were unable to identify any risk factors for recoarctation
31 Detection of Malignant Region of Diseased Images Using Thermal Camera , Lakshman K, Siddharth B Dabhade, Sachin Deshmukh, Ranjan Maheshwari and Mrudul Behare.
In medical science, abnormal growth of any cell is called cancer. Malignant region is nothing but the location of extra growth of any cell in the body. In this paper, we make attention on the different types of malignant region detection techniques using Thermal Infrared Images. We studied various imaging methods like thermal imaging, x-ray, magnetic resonance imaging (MRI), optical imaging of abnormal cell in human body. It is analyzed that malignant regions of body helps to prove the cancer cells those are present within the body. The early detection of malignant region helps in saving the life of an individual. To obtain thermal images, a thermal camera is used which can detect temperature variations in the body, as low as 0.1°C. Thermal cameras capture the surface skin temperature which can vary due to emotion-specific, bio-physiological states in the human body.
32 Teething Problems and its Management through Unani Medicine , Neelam Quddusi, Misbahuddin Azhar and Nighat Anjum.
Teething is the emergence of teeth sequentially through the gums in infants. In this period, infants are become irritable due to gingival swelling and sensitivity. The management of this phase through Unani Medicine has been documented in Unani Classics. The Unani drugs used in this period are completely safe and effective. This article aims to describe the clinical signs and symptoms and role of Unani medicine in teething problems.
33 The Best Way to Prevent and Treat coronavirus Infections , Leonid Tell.
The method goes as follows:Do not attempt to reduce body temperature increase by endo and exogenous pyrogens.2. Breath hot alkaline vapor on a regular basis.3. If pneumonia develops, use conventional methods of treatment ,but no use of antipyretics.4. If there is a need to switch to artificial ventilation for the patient (which would occur rarely considering the rules are fol-lowed), then be sure to use hot, humid, alkaline air during ventilation
34 Calf Pressure Ulcers: Facts Defying the Prevailing Concept   , Jochanan E Naschitz, Segal Galit, Zaygraykin Natalia, Starikov Natalia and Leibovitz Gregory.
Background: According to the classical concept the capillary closing pressure is 30 - 32 mmHg and the calf interface pressure is 10 - 20 mmHg. So, pressure ulcers cannot occur on the calf. Observations from the bedside oppose the concept.Aim: To examine the features and clinical context of what appear to be calf pressure ulcers.IntroductionResults: Six out of 1631 patients newly admitted to our institution during a 15 month period had skin ulcers on their calves, resembling typical pressure ulcers. In four patients the calf ulcers evolved concurrently with pressure ulcers at other sites. Two patients had a single calf ulcer and no other pressure ulcer. By the ulcers' location, the clinical context and the normal appearance of the adjacent skin, the calf ulcers differed from venous, ischemic, neuropathic and vasculitic ulcers. Except for their elongated shape, contrasting to the round shape of pressure ulcers at other sites, the calf ulcers were similar to typical pressure ulcers. Calf pressure ulcers have been ignored in the literature, maybe as a consequence of the longtime dominant theory concerning pathophysiology of pressure injury. Recent studies have revised the classical concept, showing that tissue pressures can become critical at levels inferior to conventional capillary closure pressure, depending on systemic influences. Conclusion: Six case histories provide evidence that calf ulcers may be genuine pressure ulcers and lend support to the contemporary, comprehensive theory of pressure injury. Design: Prospective observational study in a long-term geriatric and palliative care unit.Methods: Guideline directed diagnosis and treatment of skin ulcers.
35 The Difficulties of Socio-professional Reintegration of Patients Suffering from Chronic Psychiatric Affections in Lomé , Komi Dzidzonu Nemi, Kokou Dodzi Mawulolo Dogbe, Essohanam Tambourou, Mohaman Awalou Djibril and Kolou Simliwa Dassa
The aim of this study was to describe the difficulties of socio-professional reintegration of patients suffering from chronic mental disorders in Lomé. This is a transversal and descriptive study conducted from 1st February to 31st April 2018 concerning patients with chronic mental disorders but stabilized and monitored by the Psychiatry service of the Campus University Hospital of Lomé. Fifty-one (51) stabilized patients were involved. The social and family reintegration was almost total (N = 50). Professional reinte-gration was not effective in 37 patients (72.5%). The sex ratio (M/F) was 0.94. The mean age was 40.7 +/- 10 years (range 15 and 59 years). The majority (46%) were single. Psychoses represented 62.16% (N = 23) of the diagnoses retained, followed by severe depression (N = 11; 29.72%) and mania (N = 3; 8.10%). Neuroleptics were used in 81% and antidepressants in 46% of cases. Before chronic mental disorders and their management, 64.8% (N = 24) of patients were in the private sector. The reasons for the non-resumption of activity according to the patients were: the side effects of psychotropic drugs (N = 16; 43.2%), the lack of motivation (N = 15; 40.5%), the dismissal (N = 4; 10.8%) and social stigma (N = 2; 5.4%). The obstacles to professional reintegration according to the accompanying persons were: non-compliance with customary laws (N = 11), possession by the spirits (N = 7), the curse (N = 5) and enchantment (N = 5). The difficulties of professional reintegration of patients suffering from chronic psychiatric affections are topical in our country. A refocused study including the community level and supporting the daily experience of these patients would be desirable to complete our work.
36 Obstetrical Complications Linked to Female Genital Mutilation in the 3rd Reference Obstetric Service at Chu Point G. Bamako/Mali , Kanté Ibrahim Ousmane, Coulibaly Ahmadou, Traoré Mamadou Salia, Sima Mamadou, Théra Tiounkani Augustin, Daou Seydou Z, Fané Seydou, Traoré Alassane, Traoré Youssouf and Teguété Ibrahima.
Aim: To study obstetric complications linked to female genital mutilation (FGM). Patients and Methods: Our study was carried out in the obstetrics department CHU Point G. It was a case/control study. The case be-ing the excised woman and the witness, the non-excised woman. Our study lasted sixteen months, from 01/01/2019 to 04/30/2020. Were included, primiparas from 14 to 49 years old excised or not. Not all non-consenting women were detained. The sample size was calculated based on the case/control sample. Data collection was done on individual questionnaires. Data analysis and processing was done on SPSS 12.0 and Word 2013. Statistical tests: Chi2. P < 0.05. Results: During our study we had 1518 deliveries of which 266 women included. The major age group was 14 - 19, or 51.1% in the cases and controls. The Bambara’s and Songhai’s were the majority ethnic groups in the two cases with respectively 34.6% and 31.1% with P < 0.00. The illiterate and the secondary level were respectively in the majority in the cases and the controls with re-spectively 57.8% and 59.3% with P < 0.00. Type 3 circumcision accounted for 12%. Episiotomy was performed in 56.4% of the cases and 5.3% in the controls with P < 0.05. The tears were noted in 51.1% in the cases against 11.3% in the controls and complicated in 23.5% with P < 0.05. Conclusion: FGM was a frequent practice in our countries and can be a source of obstetric complications such as hemorrhage due to tear of the soft parts. Measures must be taken to eradicate this scourge.
37 The Human Body-Field   , Edward F Block.
This work details the interaction of the human body-field with the electromagnetic phenomena of the biosphere of the earth. The overall Human body-field is described in detail and the role of healing modalities in maintaining the harmony of the Human body-field is elucidated.A protocol for healer-client interaction to harmonize the client Human body-field is presented
38 Guidelines for Using Personal Protective Equipment while Exercising , Daniela Benavidez.
Daily life has changed drastically for nearly the entire world following the outbreak of the Covid-19 pandemic. Personal protective equipment (PPE) such as facemasks, gloves, face shields, and goggles have become the norm in many communities for people engag-ing in societal activities outside the home
39 Echocardiographic Assessment at 1-Year Follow-Up Post-Percutaneous Pulmonary Valve Implantation at the Prince Sultan Cardiac Center: A Single-Center Experience , Al Asmari Own, Atiyah Merna, Al Essa Mohammed, Almohaizy Omar, Al Sahari Atif, Mohsin Shazia, Al Khalaf Khalaf and Al Najashi Khalid
Background:Congenital heart defects affect roughly 1 in 150 people and are often associated with right ventricular outflow tract (RVOT) dysfunction. The aim of the study was to evaluate the echocardiographic changes within the right ventricle following percutane-ous pulmonary valve implantation (PPVI).Methods: The echocardiographic data of 57 patients who had pulmonary valve stenosis and/or regurgitation and had undergone PPVI treatment and completed at least 1 year of regular follow-up at the Prince Sultan Cardiac Center from January 2012 to December 2015 were analyzed at the baseline level (before PPVI) and at 6 and 12 months following the PPVI treatment. Pulmonary insufficiency was graded from 0 to 4 based on severity: 0, none; 1, trivial; 2, mild; 3, moderate; 4, severe/free).Results: There was a significant reduction in the RVOT gradient. At baseline, 95% of the subjects demonstrated pulmonary insufficien-cy (grades 2-4); at 12 months, 28% had decreased pulmonary insufficiency and 72% had limited to no pulmonary regurgitation. Other parameters, including right ventricular volumes, fractional area change, and the tricuspid regurgitant jet width/body surface area, did not demonstrate any significant change. Early follow-up echocardiographic data demonstrated persistent improvement in the RVOT gradient and pulmonary regurgitation level over the 1-year follow-up.Conclusion: PPVI was seen to ameliorate RVOT dysfunction in most subjects.
40 A Chronicle from the Eye of the Storm: Impact of the Coronavirus Pandemic on the Cremona’s Hospital , Lia A Beccara, Francesca Mangiatordi, Simone Francavilla, Patrizia Arisi, Laura Bocchi, Maurizio Taglia, Sara Ponton, Elena Bucella, Giacomo Marino, Andrea Nocchi, Carlotta Pacioni, Antonio Labate, Maria Perrone, Anna Savini, Luca Andriollo, Giang Truong, Giorgio Morelli, Michela Pollastri and Antonio Cuzzoli
Objective:To draw an accurate picture of the condition of the Cremona public Hospital from February 21st to April 20th 2020, in par-ticular the Emergency Unit management of the Coronavirus pandemic.Design:A retrospective analysis of data from the institutional database was conducted. Setting: Data from the Emergency Unit of the ASST Cremona Hospital (Lombardia, Italy), a secondary level public hospital. Patients:All the patients aged > 13 years that were admitted to the Emergency Room (ER) during the Coronavirus pandemic. Intervention:We retrospectively analyzed the ER access records, the discharge/hospitalization reports from ER department and data from the national discharge register were analyzed by the informatic services using the Sql Oracle language. Measurements and Main Results:From February 21st to April 20th 2020, 5078 patients were admitted to the ER at the Cremona Hospital. Out of 5078 patients evaluated, 2226 (43.8%) were hospitalized and 2852 (56.2%) were discharged. Of the 2226 patients hospitalized (average age 67.1 ± 37.4, 1791 (76.4%) received a diagnosis of SARS-CO-V2 infection. 1198 hospitalized patients recei-ved a diagnosis of SARS Covid interstitial pneumonia. The average stay in ER was 771 ± 919 min for patients who have subsequently been hospitalized, while the patients discharged had an ER stay of 465 ± 808 min. The total COVID positive patients’ deaths, hospita-lized through the ER, were 333, equal to the 19.6% of the total admissions from ER.Conclusion:ER team has put together all the competences and abilities to exploit the limited resources available, in order to better manage the emergency
41 Caregivers’ Perception and Practices on Malaria in Children Under Five in EkombeBonji Health Area, Kumba Health District, South West Region of Cameroon , NkengafacNyiawung Fobellah, Anna Njunda Longoh, FolefockAjua Richard Medterrand and Efengo Vanessa
Background:Malaria is one of the diseases which contribute significantly to morbidity and mortality in Africa with 91% of deaths being children under-five. Despite all efforts to combat malaria, this disease still remains the leading killer of under five children kill-ing a child every minute. Malaria usually progress to its severe state within a very short period of time. Generally mothers/caregivers are the first to recognize fever in children and also determine the decision to seek care. Therefore, recognition of the symptoms of malaria by caregivers and their practices toward seeking treatment is invaluable in order for malaria to be treated in a timely manner. Objectives:The objective of this study was to determine the prevalence of malaria in children under five, and also to investigate the local perceptions, practices and treatment-seeking behaviour for malaria among their caregivers. Methodology:This study was a cross sectional descriptive, community based study done from January to march 2014. Children under five years were enrolled for the study. Malaria RDT was done for parasitological evaluation. Questionnaires were administered to children’s caregivers to collect socio-demographic data, knowledge regarding malaria, preventive measures and treatment seeking behavioursResults:Of the 350 children examined, 174 (49.7%) [95% CI: 44.37- 55.07%] were infected with malaria (plasmodium falciparum). Male and females were similarly infected (41.4% vs. 51.6%) with no significant difference (p = 0.4).The prevalence appeared to be highest 41 (23.6%) in the age group [24-36] months. Caregivers 280(80%) had proper knowledge on malaria with 316(90.3%) mentioning mosquito bite as the cause of malaria. Likewise fever/hot body was perceived as the commonest symptom of malaria by 332 (95%) of caregivers [95% CI: 91.9-987%]. With regards to caregivers’ practices on prevention, 308(88%) use insecticide treated nets (ITN) as a preventive method. Only 205 (58.6%) of caregivers sought treatment at the health facility when their child was ill. As few as 119 (34%) did so within 24 hours of onset of symptoms. The most common home remedies employed were tepid sponging and use of anti pyreticsConclusion:Caregivers had a good knowledge of malaria (including its aetiologic agent, signs and symptoms and preventive mea-sures). They also had a good practice towards preventive measures. However, the prevalence of malaria in under-five was high and only a lesser majority of caregivers sought treatment at the health facility in a timely manner
42 The Influence of Pre-Existing Heart Failure on Community-Acquired Pneumonia Outcomes , Cașcaval Virginia, Fetco-Mereuță Diana, Caproș Natalia, Grib Livi, Matcovschi Sergiu and Dumitraș Tatiana
Background: Community-acquired pneumonia is a common infectious disease, that is being associated with high mortality, especially in patients with comorbidities, such as heart failure. Also, preexisting heart failure increases pneumonia mortality by 30 - 50%, therefore it is important to identify patients who are in the risk group.Methods: This is a retrospective study, where we examined causes of death in 62 patients with community-acquired pneumonia and heart failure, with emphasis on clinical, laboratory and microbiological characteristics. Results: Our results show that cardiovascular disease, especially heart failure, represents a heavy load on the outcomes of community-acquired pneumonia patients and that progression of heart failure, it's complications and other co-morbidities increase the risk of death associated with pneumonia.Conclusion: The obtained data suggests that community-acquired pneumonia is not only affecting the respiratory system, but it is also a systematic inflammation process that affects the cardiovascular system
43 Comparison of Propofol and Fentanyl in Prevention of Emergence of Delirium after Sevoflurane Anesthesia, Hiren R Patel and Geeta Parikh
Introduction:The occurrence of emergence agitation in children after sevoflurane anaesthesia is common with an incidence ranging between 10 to 80%. Aim: To study Propofol and Fentanyl in Prevention of Emergence of Delirium after Sevoflurane Anesthesia.Material and Methods: After approval from ethical committee and written informed consent from parents or guardian, 115 chil-dren with ASAI and II aged 2 to 6 years, were selected for elective urological surgery, under sevoflurane anaesthesia. Patients were divided into three groups i.e. Group C (Control), Group F (Fentanyl), and Group P (Propofol). All collected data enter into the IBM SPSS 20th (statistical parameter of soci 20th and analyzed it. Continuous data expressed as mean ± sd and non-continuous expressed as in percentages. Anova test, kruskal wallis and chi square (fisher exact) test have been performed to carry out p value at 95% CI. p value
44 Endoprosthetic Replacement of the Distal Femur for Giant Cell Tumor: A Case Report , Khaled Khelil, Saber Saadi, Abderrazek Rafrafi, Khalil Amri, Rami Ben Arab, Talel Znagui and Lotfi Nouisri
Giant cell tumor occur mainly in young adults and account for 5% of all primary tumors of bone. It generally affect the metaphysoepiphyseal region of long bones, as well as less often flat bones. Distal femur and proximal tibia are the most common sites followed by the distal radius. Though this tumor is classified as benign, it is characterized by a high potential of local aggressiveness, a high risk of recurrence, a risk of metastasis and malignant degeneration. Although these tumors are fully studied, their treatment remains a subject of debate, in fact the challenge is to resect the entire tumor while maintaining the proper functioning of the affected limb. Currently, with the technical advances in the prosthetic field, the use of massive prosthesis after resection showed it superiority compared to the other methods of reconstruction. In this presentation, we aimed to report the case of a patient with distal femoral giant cell tumor treated by en bloc resection and reconstruction by a hinge massive prosthesis with good functional outcome
45 Infection Control Measures in Dialysis Units during COVID-19 Pandemic   , Ahmed Daoud, Mahmoud Mohamed, Hatem Ali, Mostafa Alfishawy and Karim Soliman
The world is passing through a serious pandemic caused by the novel coronavirus (COVID-19). The clinical course of infection is widely variable ranging from asymptomatic presentation to multi-organ system failure and death [1,2]. Comorbidities as hyperten-sion, cardiovascular diseases, acute and chronic kidney diseases in COVID-19 patients portend poor outcome and are associated with high mortality rate
46 Priority Setting in Surgical Management of Breast Abscess in Newborn: Case Report , B Hamillour
Neonatal breast enlargement often occurs during the neonatal period is a common response which occurs under the influence of falling levels of maternal estrogen at the end of pregnancy [1]. This situation takes place in both sexes without prevalence, with sometimes milk secretion [4]. Spontaneous resolution requires reassuring parents [1-4].Mastitis or abscess of the breast in the newborn is a rare condition which is observed in 5% of cases [3]. Staphylococcus aureus is the bacterium commonly responsible for all major of breast abscess [11].Ultrasonography as an essential non-invasive diagnostic approach is well recognised as a first-line examination in the setting of breast abscess [6]. Our case illustrates the importance of rapid surgical management as a compliment to medical treatment and the ideal time to undertake surgical breastfeeding in order to avoid serious complications as generalized sepsis breast hypoplasia, and scarring [
47 Does Sneezing Play a Role in Multiple Sclerosis? , Homayoun Roshanisefat
Objectives: The modern era of multiple sclerosis (MS) biomarkers has been ongoing for many years, with the periodical approval and renewing of MS criteria we are still facing many challenges. The new revision was recently approved, a few years after McDon-ald’s Criteria, it was also followed by a promise to find new landmarks for the establishment of an MS diagnosis and its courses. An innate immunological clinical sign - which can better connect the suspected etiology and the disease is of major interest. Data Sources: A literature search was performed using medical and health science search engines to find publications from Janu-ary 1940 to December 2019.Data Extraction: Data were extracted if any of the following keywords were mentioned in combination: sneezing, MS, stroke, bio-marker, the nasal cavity. The search was expanded to the medical conditions included in this study.Data Synthesis: Sneezing is a very clear sign and health reaction which has never been studied in MS and may potentially have a clinical impact. The sneeze function can, through other diseases and life events, teach us its importance and common understanding with MS. This review will focus on the sneeze in different medical conditions and use these comorbidities as a proxy to understand inflammation and their association with MS.Conclusion: Sneezing is one of the common health reactions against pathogens, allergens, temperature changes, lightning, and cerebral injuries. This study has found a sign that sneezing has an untold role in MS and comorbidities such as a stroke. Measuring sneezes has the potential of becoming a clinical biomarker in MS.
48 Coronavirus and Multiple Sclerosis, Autopsy and Biopsy and Choice of Therapy , Homayoun Roshanisefat
Background: Coronavirus in trigeminal nerve (TGN) has for decades been studied as a candidate neurotropic virus associated with multiple sclerosis (MS). The novel coronavirus 2019 (COVID-19) outbreak in infected cases is challenging the whole immune system. The lesson from MS treatment and a new era of COVID-19 therapies are of value to review.Method: Searched databases to identify the strongest evidence of biopsy, autopsy, and cerebrospinal fluid (CSF), when using key-words MS and coronavirus, from January 1940 to April 2020. The result presents a solid knowledge of biopsy and autopsy for the association of COVID-19 and MS, then COVID-19 single and combination therapies being evaluated as presented in clinical use or clinical trials and compare common sites with MS. Results: All therapies with proven clinical efficacy against COVID-19 and its current deployment in COVID-19 and their common aspect with MS therapies (MSTR) and immunology are screened. Some MSTR despite some different side-effect e.g. risk for infection or cardiac arrest are candidates of being used as COVID-19 life-saving therapy. Conclusion:This global health disaster caused by airborne virus COVID-19, has created a new break to learn more about MS etiology and this airborne agent and future drug choices when reviewing the five months COVID-19 data through significant medical reports on World Wide Web
49 Relationship between Educational Level and Incidence of Obesity among Adults in Abeokuta, Ogun State, Nigeria ,   AS Adekoya, CI Ojo3, OA Mafimidiwo and FO Oyeleke
This study examined the relationship between educational level and the incidence of obesity among adults in Abeokuta, Ogun State, Nigeria. A total of 240 respondents were selected from two different localities i.e. rural and urban, with their ages ranging from 20 years and 64 years. The educational level details were obtained based on the personal information given. The prevalence of obesity was determined using the Body Mass Index cut-off (≥ 30 kg/m2) to estimate those obese. The data were analyzed using descriptive and correlative parameters to demonstrate the influence of educational level and its resultant effect on income level and incidence of obesity across the sampled population. The results showed the highest level of among the rural males of lower educational status. Adjustments were made to establish relationship between educational attainments and BMI graphically. Conclusively, the study affirmed that educational level determines the income level and obesity mostly among the urban population. Findings of this nature can further provide functional insights into some socioeconomic developments that can help to overcome obesity epidemic
50 Nutritional Challenges and Management in Post-surgical Non-Hodgkin Lymphoma , Edwina Raj, Shivaram H V, Girish3, Prakash Dorraiswamy, Rebecca Renee, Deeksha Acharya
Non-Hodgkin Lymphoma (NHL) is a type of cancer that arises in the white blood cells called lymphocytes, when the cells start dividing uncontrollably. We present a 46 year old woman who was a known case of NHL (proximal jejunum which is quite uncom-mon) post 5th cycle of chemotherapy who presented with history of fever, abdominal pain with vomiting. The patient underwent ex-ploratory laparotomy, resection of perforated segment of distal jejunum and peritoneal lavage with primary anastomosis. a nutrition care plan was devised to prevent nutritional deficiencies and minimize the effect of catabolism. Nutrition intervention supports the overall recovery and surgical outcome. the patient showed remarkable improvement despite the nutritional risk and the nutritional challenges presented to us. The treatment included total parenteral nutrition progressing to soft diet with high protein prior to dis-charge, which aids in quick recovery, faster wound healing and tissue repair.
51 Complementary Feeding Practices Associated with Wasting of Children 6 - 23 Months Old in Dilala, Lualaba Province, Democratic Republic of the Congo, 2017 , Ngoy Bulaya Emmanuel, Horwood Christiane, Mapatano Mala Ali, Muyer Telo M-C, Ntiba Assumpta Ruth, Mutombo Beya P
Malnutrition is in high prevalence in some developing countries, like Democratic Republic of the Congo mostly among children from six to 23 months. Complementary feeding is among the main causes of malnutrition worldwide. Objective: The present study aimed to assess the complementary feeding practices associated with acute malnutrition in Democratic Republic of the Congo. Design (Methodology):A community-based cross-sectional study was conducted from October 23rd to November 25th 2017 in DI-LALA Health Zone, using a three-stage stratified sampling technique. In 10 Health Areas, 698 children six to 23 months old were as-sessed on nutritional status and their mothers interviewed on complementary feeding practices. Household questionnaire pretested and revised, standardized anthropometry equipment and World Health Organization recommendations were used with trained data collectors. ENA for SMART and Logistic regression on SPSS 23 were used to data analysis. Results:Wasting was associated with lack of knowledge on minimum meal frequency (adjusted odds ratio = 2.4, CI 1.14 - 5.11), minimum dietary diversity (adjusted odds ratio = 0.23, CI 0.055 - 0.981) and protected source of drinking water (adjusted odds ratio = 0.50, CI 0.26-0.93). Conclusion:Wasting was more increased among children whose mothers were without knowledge on minimum meal frequency of complementary feeding, but more prevented in children having met minimum dietary diversity and in children from household with protected source of drinking water.
52 Burnout Syndrome (BS) among Emergency Medical Workers , Nataliya Petrova, Michail Duben, Sarkis Pogosyan and Vladimir Bratslavsky.
The doctors and nurses belong to “person-person” professions. The features of these professions are: high responsibility, a large number of contacts with people, including the people with negative emotions. So they have the high risk of emotional stress. The work in emergency services is the work in difficult and even extreme situations with a high level of response, consequences for life and health. So this medical staff have a real risk of BS with its negative influence to health. In this article the results of BS study among emergency medical workers are presented. It was used a three-factor model of K. Maslach and S. Jackson (in the adaptation of N.E. Vodopianova): the level of emotional exhaustion, depersonalization, reduction of professional achievements were analyzed. The study involved 125 employees. The distribution according to the degree of emotional exhaustion was as follows: 10.8% of the respondents had a low degree, 16.2% had an average degree, 32.4% had a high degree and 40.6% had an extremely high degree of emotional exhaustion. The distribution by the degree of depersonalization was as follows: 5.4% of the respondents had a medium degree, 10.8% had a high degree, 83.8% had an extremely high degree. The distribution by the degree of depersonalization was as follows: 62.2% of the respondents had a low degree, 32.4% - an average degree and 5.4% of employees had a high degree. The distri-bution of emotional burnout in total was as follows: 2.7% of respondents had a low degree, 8.1% had an average degree, 37.8% had a high degree, and 51.4% of respondents had an extremely high degree of emotional burnout. There are differences between some groups of respondents. The necessity of measures for the prevention of the syndrome among doctors has been proved
53 Madelung’s Disease and Upper Airway Involvement: A Case Report , Daniela Furno, Giovanni Addolorato2., Gaetano Paludetti and Gabriella Cadoni.
Madelung’s disease is a rare condition characterized by multiple and symmetrical deposits of adipose tissue concerning especially neck, shoulders, upper limbs and upper thorax. This lipomatous tissue could cause extrinsic compression or recurrent laryngeal nerve compression because of infiltration of fat [1,2].In this case, we will describe a 66-year-old man affected by Madelung’s disease, with larynx-tracheal anatomical alteration, showed by CT scan and flexible laryngoscopy
54 Prevalence of Depression and Anxiety in Rural Health Centre Chitral: A Cross Sectional Study , Sidra Kanwal, Nisar Hussain and Waris Qidwai
Introduction:Globally depression is a leading cause of disability and contributes to one third of global burden of diseases. More than 150 million adults suffer from depression at any point in time and nearly one million commit suicides every year. Despite immense diversity in the socio-cultural environments in Pakistan, there is an overall very high prevalence of anxiety and depression in rural Pakistan.Patients and Methodology: All patients from March to August 2015 presented to family medicine clinics in rural health area Booni Centre Chitral for general medical problems fulfilling the inclusion criteria recruited via convenience sampling. Data then entered in SPSS 21. Patient health questionnaire (PHQ 9) and generalized anxiety disorder (GAD) 7 questionnaires were administered for as-sessment of depression and anxiety respectively. Sociodemographic factors were also assessed.Results:In a sample size of 230 patients 71% of participants were of range of 18 - 35 years. Mean age was 31.3 years. Male were 118 (51.3%) were found to be in higher proportion as compare to females.Prevalence of depression of found to be 67%, and GAD was found to be 33.5%, living alone and female gender were found to be associated with Depression and anxiety with p-value = < 0.005 and p-value = 0.025 respectively.Conclusion: As there is a high rate of depression in Chitral, education and support from family, friends is a strong factor in dealing with depression. Launch of a mental health program in Chitral specifically addressing gender and different age groups will be a big step towards successful rehabilitation of individuals.
55 Prediction of Fall among Patients with Parkinson’s Disease: A Cross-Sectional Study, India , Aiswarya Anilkumar, M Bagavandas and Geetha Veliah.
Background: The cross-sectional study aimed to identify the risk factors that lead to fall among patients with Parkinson’s disease, assess the stage of severity; its contribution to fall, and also predict fall among the patients. Methods: 94 patients diagnosed with Parkinson’s disease were included using non-probability convenience sampling. A semi-struc-tured questionnaire was employed to understand the demographic data, risk factors, disease severity, balance, and level of function-ing using the Hoehn and Yahr scale, Berg Balance scale and Activities-Specific Balance Confidence scale respectively. Regression analysis was performed to identify the risk factors that lead to fall. A logistic regression analysis was performed to predict fall and Multivariate Analysis of Variance was employed to understand the difference in scores concerning the different stages of severity.Results: The regression model showed that the Activities-Specific Balance Confidence score and severity of disease are the strongest contributing risk factors of fall among the participants (p < 0.001). Using Multivariate Analysis of Variance we conclude that there is a significant difference in the average mean Activities-Specific Balance Confidence score from 52.45 to 28.57 when patient proceeds to stage 3 (mild to moderate bilateral disease) from stage 2.5 (mild bilateral disease with recovery on pull test) according to the Hoehn and Yahr staging. Activities- Specific Balance Confidence score which in turn implies the level of functioning was found to be the variable used for prediction of fall.Conclusion: An effective awareness regarding the stage transition where there is a high risk of fall needs to be understood. The Activities-Specific Balance Confidence score helps us predict the risk of fall among patients
56 An Approach to Visualize Digital Transformation in Healthcare , Shuichiro Yamamoto.
Background: The healthcare industry is faced to the digital transformation (DX) to realize the digital healthcare enterprises using digital technology for healthcare services. Japanese Ministry of Economy, Trade and Industry published the DX promotion index (DXPI) to assess the DX maturity of Japanese companies. Although the DXPI provides the requirements of DX, it lacks design approaches on business values, models and processes to digitalize healthcare services. We are trying to propose ArchiMate based diagrams on the business value, model and process to create healthcare services to meet the DXPI. ArchiMate is the EA modelling language to represent business, application and technology architecture.Method: Three key business diagrams are extracted from DXPI. The business diagrams are business value, business model, and business process diagrams. We define the three corresponding tables for business diagrams. These table elements are shown to be mapped to ArchiMate model elements. By using the mapping, three business diagrams are able to develop in ArchiMate.Results: The approach is applied to visualize a digital transformation in healthcare service in a large hospital. The visual diagrams have been described by the proposed approach using ArchiMate, an EA modeling language. The result showed the applicability of the method to visualize healthcare digital transformation.Conclusion: The proposed approach is effective to visualize the digital transformation in the healthcare industry by clarifying business values, models and processes.
57 Acute Toe Ischemia in a Patient Receiving Ergotamine , W Skouri, O.Hentati, H Tounsi, W Garbouj, M Eleuch, J Ouali, R Amri.
58 Relief Helpline by Voluntary Doctors in the Times of COVID19 , Ankur Rakesh and Shubhank Singh.
The World Health Organization (WHO) declared the COVID19 as a pandemic on 11 March 2020 and as mitigation measures, countries adopted different strategies to control the spread, in-cluding social distancing and strict lockdown measures [1]. The re-public of India went into a strict nationwide lockdown on 24 March 2020. This was expected to deaccelerate the spread of the virus in the country but had expected collateral damage which included limited access for people with common ailments and psychological stress [2]. In any disaster, the first responders are always a mem-ber of the local community and COVID19 was no different. Here we share the experience of how a group of doctors came together to provide voluntary service to the public through phone and online consults to contribute to alleviating the suffering of the population amidst the pandemic.
59 Effects of a Combined Therapy of ATRA+VEGF on Distal Organs of Emphysematous Mice Model   , Shivangi Mishra, Megha Neolia, Sherya Patil, Amit Kumar Tyagi and Jai Prakash Muyal.
Pulmonary emphysema is principally associated with the lung. The inflammation is the main cause of emphysema that triggers release of inflammatory mediators. Such inflammatory mediators might get spilled out from the lung to the proximal and distal or-gans, hence may affects other organ’s functioning as well. In this light, firstly, we attempted to determine the spillage of inflammatory mediators on liver and heart organs of emphysematous lung mice model. Secondly, to elucidate the beneficial role of ATRA+VEGF supplementation towards such spillage of inflammatory mediators by studying the antioxidant levels, which leads in tissue damage and hence affects its function. To analyse these two objectives, in silico study has been performed for the prediction of the gene interaction network between elastase, ATRA, and VEGF, respectively with extracellular regulated kinases (ERK) pathway. Furthermore, antioxidant levels and histo-pathology were studied in before elastase-treatment, after elastase-treatment and after elastase-treated group received ATRA+VEGF conditions using liver and heart tissues. Elastase-treated group received ATRA+VEGF has proven to be beneficial in reducing inflammation as the levels of anti-oxidants was significantly reduced. Moreover, the tissue architecture of liver and heart was improved due to the ATRA+VEGF supplementation. At last, gene interaction network results provide a promising role of ATRA and VEGF in rectification of inflammation via involvement of spilled out inflammatory mediators. However, an elaborate experimental study is further required to investigate the beneficial role of ATRA+VEGF therapy on ERK pathway towards amelioration of inflammation.
60 Effects of a Combined Therapy of ATRA+VEGF on Distal Organs of Emphysematous Mice Model , Shivangi Mishra, Megha Neolia, Sherya Patil, Amit Kumar Tyagi and Jai Prakash Muyal.
Pulmonary emphysema is principally associated with the lung. The inflammation is the main cause of emphysema that triggers release of inflammatory mediators. Such inflammatory mediators might get spilled out from the lung to the proximal and distal or-gans, hence may affects other organ’s functioning as well. In this light, firstly, we attempted to determine the spillage of inflammatory mediators on liver and heart organs of emphysematous lung mice model. Secondly, to elucidate the beneficial role of ATRA+VEGF supplementation towards such spillage of inflammatory mediators by studying the antioxidant levels, which leads in tissue damage and hence affects its function. To analyse these two objectives, in silico study has been performed for the prediction of the gene interaction network between elastase, ATRA, and VEGF, respectively with extracellular regulated kinases (ERK) pathway. Furthermore, antioxidant levels and histo-pathology were studied in before elastase-treatment, after elastase-treatment and after elastase-treated group received ATRA+VEGF conditions using liver and heart tissues. Elastase-treated group received ATRA+VEGF has proven to be beneficial in reducing inflammation as the levels of anti-oxidants was significantly reduced. Moreover, the tissue architecture of liver and heart was improved due to the ATRA+VEGF supplementation. At last, gene interaction network results provide a promising role of ATRA and VEGF in rectification of inflammation via involvement of spilled out inflammatory mediators. However, an elaborate experimental study is further required to investigate the beneficial role of ATRA+VEGF therapy on ERK pathway towards amelioration of inflammation.
61 The Effect of Over the Counter and Synthetic Vitamin B6 (Pyridoxine) and Vitamin B12 (Cyanocobalamin) on the Behavior of Liver and Non-Liver Cells , Adriatico Aileen, Garcia Victor, Vega Huerta Salvador, Conway Michelle and Tawil Bill.
The class B vitamins are involved in numerous essential metabolic pathways, it is critical to study the effects of these vitamins at length. In this study, the use of Human Foreskin Fibroblast (HFF) was used to optimize the Vitamin B concentration to be used later in Clone 9 (C9), liver epithelial cell line. The initial cell adhesion and cell proliferation percentages were measured at 5 ug/mL, 10 ug/mL, and 20 ug/mL of synthetic and over the counter (OTC) formulations of Vitamins B6 and B12. In general, HFF-1 and Clone 9 cells displayed favorable rates of proliferation when treated with varying concentrations of Vitamin B6 and Vitamin B12 and the combination of these with concentrations of 5 ug/mL, 10 ug/mL and 20 ug/mL. When administered separately, synthetic Vitamin B12 increased C9 cell proliferation more dramatically than synthetic Vitamin B6. The data suggests a synergistic effect increases cell proliferation the most. This is evident in combined synthetic vitamins B6 and B12 (10,000% increase at 20 ug/mL), but also present in the combined OTC vitamins B6 and B12 (6000% increase at 20 ug/mL). C9 cell morphology appears consistent in all the condi-tions except for the presence of dark pigmentation in the cells treated with combined B vitamins. The liver is an important organ in the body and performs a fundamental role in the regulation of metabolism, secretion, storage and detoxification. In conclusion, hepatic diseases are areas of concern, thus, it is necessary to identify substances for the treatment of liver diseases, protection of the liver and regeneration of hepatic cells.
62 Effect of COVID-19 Pandemic on Mental Health of Medical Students: Incite to Post-pandemic Response by Medical Educator , Dolapo Babalola.
The pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 has halted the education and clinical ex-posure of trainee medical doctors in medical education institutes as soon as the spread of the infection proofed uncontrollable in the country or region that homes the medical school. In addition, lock-down and reduction of social contact is a needed measure imposed on medical students just like on other undergraduate academic students, regular citizens, and other facet of the socio-economic system [1]. And this is understandable due to the high infectious rate of the novel coronavirus, the need to safeguard the lives of medical students, and the need to keep medically unripe medical students off the frontline COVID-19 treatment risk, among many other reasons.
63 Dural Arteriovenous Fistula Presenting with Exophthalmos, Hemiparesis and Seizures: Resolution after Endovascular Treatment - Case Report , Aminur Rahman, Sirintara Pongpech, Pakorn Jiarakongmun, Ekachat Chanthanaphak, Wittawat Takong, Kittiphop Somboonnithiphol, Thanaboon Worakijthamrongchai and Firoz Ahmed Quraishi.
A concomitant focal seizure with left hemipaeresis and exophthalmos in the context of an aggressive cavernous dural arteriove-nous fistula (dAVF) is a variable neurological presentation. Here, we report a 73 years old female who presented with a 5-months history of progressive painless exophthalmos with conjunctival chemosis of right eye without any visual impairment. But now she had admitted to the hospital due to new onset of focal seizures with mild left hemipaeresis. Emergency MDCT scan brain showed suspected small malignant dural ateriovenous fistula of right sphenoparietal sinus with cerebral venous congestion and tiny hem-orrhagic venous infarction at right operculum and right exophthalmos. Cerebral angiography demonstrated right cavernous dAVF fed by branches from the right ascending pharyngeal artery and right middle meningeal artery, right accessory meningeal artery, bilateral arteries of foramen rotendum, dural branch of left vertebral artery with drainage to the right superior ophthalmic vein, right sphenoparietal sinus and right frontal cortical vein which was consistent with Cognard Type IIb dAVF. Successful transvenous embolization of the right cavernous via the right inferior petrosal sinus was done by using fibre coils and NBCA. Post- embolization control angiogram showed complete obliteration of right cavernous dAVF feeding vessels. Subsequent clinical follow up revealed that she had dramatic improvement of proptosis, chemosis and neurological symptoms along with cessation of seizures.
64 COVID-19: Containment Strategy and Related Complexities in Developing Countries; New Normal and New World Order , Sheikh Mohammad Fazle Akbar, Mamun Al Mahtab, Md Sakirul Islam Khan, Ananta Shrestha, SP Singh and Hasan Ozkan.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most likely originated from zoonotic coronavirus in China, has caused coronavirus disease 2019 (COVID-19). Currently, COVID-19, a pandemic declared by World Health Organization (WHO) in March 2020, has spread widely across the world, affecting 215 countries and territories, leading to more than 21 million confirmed cases, and 762,000 deaths. The virus is transmitted mainly via droplet infection and recently airborne infection has also been identified as a possible mode for transmission. The pathogenesis of COVID-19 seems to be highly complex and involve organs other than lungs and bronchial tree. Although the virus is not so cytopathic, it causes serious types of diseases by modulation the immune system of the infected persons. The health care delivery systems of developed and advanced countries, especially the Group Seven (G7) countries, formulated different programs to contain the pandemic. However, almost all developed countries, including the United States of America (USA) failed to provide a viable program for containment of the virus even after spending trillions of dollars. UK initially took an aberrant path to contain the virus and finally altered it. Germany, France, and Italy also had high morbidity and mortality. Canada tried to control the pandemic, but it also embraced considerable mortality. Among G7 member countries, Japan contained the virus with minimum cases and minimum mortality by profound cooperation from its people and due to its unique health system for all of it’s citizen. The countries those are in between G7 countries and developing ones are also highly affected by COVID-19 pandemic with considerable morbidity and mortality. Developing and resource-constrained countries are highly variable regarding their population, economic status, and nature of governance. All of them did their best to contain the pandemic. However, several long-lasting problems and realities as well as the
65 Parkinson’s Disease Patients with Dopamine Dysregulation Syndrome-Editorial Review , Hristina Popovska and Igor Petrov.
Over the past decade, it has been identified a novel disease entity in patients with Parkinson’s disease, impulse-compulsive spec-trum disorder. Dopamine dysregulation syndrome (DDS) included in this group, is a syndrome characterized for a patients treated with dopaminergic therapy, especially Levodopa. The phenomenology of this syndrome is in a close relation with the current under-standing of the basal ganglia function and its impact on a long-term management in patients with Parkinson’s disease. Patients treated with dopaminergic therapy, develop cognitive and behavioral disturbances besides motor symptoms. The PD therapy which basically is dopamine replacement therapy (DRT) can relieve the motor symptoms. On the other hand, recent studies show that the same therapy can be a cause of behavioral alterations, especially when it is abused by the patients. It is very important to differentiate the psychological symptoms whether they are related to the disease itself or are а side effect from the therapy.
66 Acral Myxoinflammatory Fibroblastic Sarcoma of the Foot: A Case Report , Khaled Khelil, Saber Saadi, Abderrazek Rafrafi, Rami Ben Arab, Talel Znagui, Nadia Boujelben, Mounira Khezami and Lotfi Nouisri.
Myxoinflammatory fibroblastic sarcoma is a rare low grade malignant soft tissue tumor, mainly affecting middle-aged persons, and located in the distal extremities. The absence of clinical and radiological signs specific to this tumor makes it confused with many benign lesions and leads to inappropriate treatment. Though it is classified as a low grade tumor, it is reported to have an important infiltrative character responsible for a considerable rate of local recurrence. The therapeutic management of this tumor remains a subject of debate, there are no formal standard treatment protocols. In this presentation, we aimed to report the case of a patient with myxoinflammatory fibroblastic sarcoma of the foot treated successfully by surgery with adjuvant radiotherapy
67 Forecasting the Trends and Probable Impact of COVID-19 on South Asian Region Based on the Publicly Available Data , Ramesh Athe, Rinshu Dwivedi, Sravan Kumar Yadav Paka, Vishal Ambavade, Spoorthi M and Rajendra Hegadi.
The COVID-19 pandemic has become a public-health threat globally exerting a devastating impact on patients, healthcare provid-ers, healthcare systems, and the financial health of economy. Undoubtedly, both developed and developing nations are struggling to control the pandemic, the situation is not different in the South Asian Region (SAR). Lack of social-distancing due to higher popula-tion, health-inequalities, lack of adequate health infrastructure, and unpreparedness of health-system is placing tremendous chal-lenge to control COVID-19 in these countries. Accurate predictions and forecasting are required for the readiness of healthcare sys-tems for future plan-of-action. The present study was undertaken to forecast the trends in outbreak of COVID-19 in SAR (7 countries) based on the publicly available cases data, drawn from the https://ourworldindata.org/coronavirus-source-data. We used Double Exponential Smoothing Model to predict the trends in the total confirmed and death cases caused by COVID-19. Findings reveal the highest point-forecast for confirmed (2.54%) and death (1.77%) cases in India. Similarly, lowest confirmed case rate has been recorded for nepal (0.71%) and in terms of death rate, Maldives (1.54%) recorded the lowest number of cases across SAR. Keeping in view the limited healthcare resources in SAR, accurate forecasting, strong disease-surveillance, and avoidance of acute-care for infected-cases is vital.
68 Occupational Hazards, Illnesses and Injuries among Nurses Working in Different Clinical Areas of Work (Units) , Namrata Arora Charpe and Rennie Joshua.
Health and wellbeing of employees in the workplace are important concerns that should continue to receive attention in any organisation. Traditionally hospitals are directed towards curative services, not preventive services, it is very important to maintain optimum health of the staff in the healthcare industry as they take care of the sick clients. The study was conducted with the major objective to assess the risk and hazards faced by nurses in different clinical areas of work (Units). Quantitative descriptive cross-sectional method was used for the study. The study was conducted with a sample of 588 respondents (unit managers, registered nurses and assistant nurses). The findings revealed that nurses do encounter a considerable level of occupational hazards. Critical Care and Cardiology Unit were found to be the units with the highest risk of occupational hazards and injuries while the lowest risk was observed in the outpatient and day care unit. Chi square analysis of data revealed a significant association of Clinical Area of work (Unit) with exposure to blood borne pathogens and biological hazards, radiation, toxic fumes and anaesthetic agents, irritation from disinfectants and sterilants and chemical/toxic medicatio
69 Synthesis of Some Oxazine Compounds Derived from TDI and Schiff Bases   , Ghufran T Sadeek, Mohammad S Al-Ajely and Neam H Saleem.
It is known from ongoing research on heterocyclic compounds that these compounds are used as drug and drug carriers, Accord-ing to FDI reports that these compounds forms 90% drug for cancer and 75% drugs for different diseases. It was also known from our studies on oxazine compounds that this type of heterocyclic compounds had versatile application in medicine. In this study, new 3,1-Benzoxazine compounds (S7-12) were prepared by cyclization reaction of some 2-(benzylidene-amino) benzoic acids (S1-6) with Toluene diisocyanate (TDI) under reflex conditions in chloroform. The structure of the synthesized compounds were confirmed by IR, 1HNMR spectral studies
70 Concept and Management of Nephritis (Waram- i Kuliya) in Unani Medicine , Quddusi N, Bilal Ahmad, Usama Akram, Mohammad Fazil and AA Khan.
Unani System of Medicine puts great emphasis on lifestyle management for the promotion of health and prevention and treatment of disease. Therefore, it is of immense relevance to present times as lifestyle diseases are imposing the greatest burden on healthcare. With the changes in the lifestyle, many diseases have emerged in the past few decades. These include diabetes, hypertension lead-ing to kidney failure and other disorders especially in developing countries. Unani physicians have described a number of drugs to strengthen and tone up kidneys. These drugs help in restoring the functions of kidneys. The paper includes the concept of kidney disease with special reference to nephritis, its types and the single drugs along with their evidence based researches.
71 Successful Handling of Covid-19 in a Young Patient with SCID due to CARMIL2 (RLTPR) Deficiency: Case Report and Review of Literature , Khaled Mohammed Al-Qahtani, Ali Saleh Alhamdan, Wael F Alblowi, Mohammed Manei Al-Amri and Mohammed Hasan Almalki.
The authors herein report a case of severe combined immunodeficiency (SCID) secondary to a rare genetic mutation of CARMIL2. Presented initially as a case of celiac disease then further investigated to reach the diagnosis of SCID secondary to CARMIL2. Further-more, the patient has got infected by the recent pandemic COVID-19 and surprisingly passed through the infection asymptomatically. Consequently, discussion regarding of the association and pathophysiology of SCID and COVID-19 and how the underlying disease affected the results of the course of the disease. Interestingly, in our case the rationale of asymptomatic presentation of the disease is not clearly explained in the current literature whether its due to escape of the cytokine storm that the infection causes. Our hypoth-esis is that due to the severe immunodeficiency in our patient, it evidently helped her to avoid dysregulated immune responses to the virus and escape possible immunopathology status.
72 Do Training Programs Change the Attitude of Health Care Providers toward Venous Thromboembolism Prophylaxis? , Ebtisam Bakhsh, Anas H Barakat and Emad R Issak.
Background: Venous thromboembolism (VTE) is a universal health problem` which causes mortality. Prophylaxis of venous throm-boembolism is useful in decreasing mortality and morbidity rates. There is a worldwide deficiency in awareness about venous thromboembolism.Aims: To investigate the knowledge, attitude, and practice of venous thromboembolism prophylaxis between medical staff in Saudi medical community before and after a training workshop.Materials and Methods: This study includes three medical professions from 20 rural hospitals in Saudi Arabia. A survey was used to record their answers. Data analyzed using suitable statistical methods.Results: Training has a significant (p < 0.001) positive impact on the awareness of the availability of VTE guidelines (39.9% and 90.9%) before and after training, respectively. Also, the availability of risk assessment form has been increased (p < 0.001) after train-ing (37.5% and 89.1%) before and after training, respectively. Participants’ prescription of VTE prophylaxis for patients upon admis-sion was significantly (p-value < 0.001) increased (23.2% and 67.6%) before and after training, respectively. Before training, most of the hospitals had no mechanical prophylaxis devices (84.3%). However, after training this percent decreased (38.9%) significantly (p < 0.001). The most prevalent barrier to implement thromboprophylaxis guidelines fully was that each physician had his own ap-proach to provide thromboprophylaxis (50.2%). That was decreased significantly (p < 0.001) after training (35.6%).Conclusion: Training and education are very important to help increase the awareness and to change attitudes of health care provid-ers toward VTE prophylaxis. Addressing the barriers toward VTE prophylaxis implementation is necessary. Health care providers are willing to help in planning and implementation and this is an excellent strategy for implementation of VTE prophylaxis
73 Mini Review - Semi-solid Media for Transformed Cell Culturing   , Pratibha M and Abirami B
Cell culture techniques help us to understand the cell biology in a much better way. Transformed cell culturing will be one of the useful methods to understand the cancer cell physiology and morphology but culturing of transformed cells in-vitro is a challenging task. The cellular outcome read-outs such as cell signals, cellular secretions, gene expression and downregulation, morphology, etc., vary depending upon the microenvironment given to the cells. Therefore, it is essential to culture the cells in an environment similar to in- vivo for understanding the cell biology behind various mechanisms. This mini review aims at summarizing the conventional and advancements in culturing the transformed cells. Different techniques are highly exploited to study transformed cells, with the most commonly used 3-D semi-solid media culturing method. It is a selective media with suitable substrate that supports the growth of anchorage-independent transformed cells and is useful to elucidate results from products of each cell differentially localized in the media. Early research using soft agar helped to understand and characterize the transformed cells whereas advancements in the semi-solid media helps to screen a wide range of anti-cancer drugs, to study gene regulation, and in biosensors. The major setback of this technique remains a hindrance to extract viable cells from the media. There by to overcome the drawback of conventional semi-solid media technique, over the years, various components are incorporated and substituted to provide a within reach in-vivo condi-tions. More recently, using semi-solid matrix/scaffolds like matrigel/laminin/alginate, co-culturing of other cells with transformed cells provides the in vivo like niche
74 Sleep Disturbances in Era of COVID-19 Pandemic , Shaleen Sunesara and Salim Surani.
Coronavirus illness, also known as COVID-19, is an illness caused by a new coronavirus now referred to as severe acute respi-rational syndrome coronavirus 2. The virus was first identified in an outbreak of respiratory cases in Wuhan City, China. Most of the people who initially suffered from the illness in Wuhan had visited the Huanan Seafood market and as a result, the virus is perceived to have a zoonotic cause [1]. Coronavirus was first reported to the World Health Organization (WHO) on December 31, 2019. WHO, then declared the coronavirus pandemic an international medical emergency on January 30th 2020. Currently, the total coronavirus cases are more than 11.6 million with 537,000 deaths and 6.27 million recoveries [2]. In the United States, there are more than 3 million confirmed cases of COVID-19 where 132,000+ victims have died from this virus while 901,000 others have fully recovered