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A Double-Edged Sword and Swinging Pendulum
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Article in press

  • 2015, March

    research

    Microbial Safety of Foods in the SupplyOpen Access

    Mohamed T. Elkhishin, Ravi Gooneratne and Malik A. Hussain
    DOI: http://dx.doi.org/10.17140/AFTNSOJ-3-141
    Provisional PDF980.81 KB 980.81 KB
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  • 2015, December

    case report

    Squamous Metaplasia in Colorectal PolypsOpen Access

    Naziheh Assarzadegan* and Felipe J. Solano
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-101
    Provisional PDF479.00 KB 479.00 KB
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  • 2016, January

    editorial

    Some Problems of Vaccination Campaigns in Developing CountriesOpen Access

    Chengjun Sun*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e001
    Provisional PDF272.33 KB 272.33 KB
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  • 2016, February

    opinion

    Liquid Biopsies: Handle With CareOpen Access

    Deyali Chatterjee*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-102
    Provisional PDF312.45 KB 312.45 KB
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  • 2016, February

    mini review

    Leading Ebola Vaccine CandidatesOpen Access

    Vincent Pavot*
    DOI: http://dx.doi.org/10.17140/VROJ-1-101
    Provisional PDF
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  • 2016, February

    mini review

    Mast Cells: The Key Players in Cardiac RemodellingOpen Access

    Amrit Pal Singh*, Harpal S. Buttar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-103
    Provisional PDF539.78 KB 539.78 KB
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  • 2016, February

    review

    Quality Improvement in Clinical Laboratories: A Six Sigma ConceptOpen Access

    Jawahar (Jay) Kalra* and Ashish Kopargaonkar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-104
    Provisional PDF496.92 KB 496.92 KB
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  • 2016, March

    editorial

    Cosmetology: Past, Presence and FutureOpen Access

    Varvaresou Athanasia*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e001
    Provisional PDF256.50 KB 256.50 KB
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  • 2016, March

    systematic review

    Is There Scientific Evidence that Panax Promotes Hair GrowthOpen Access

    Frederico EHFF*, Sá-Caputo DC, Dionello CF, Cardoso ALB, Morel DS, Maiworm A, Guimarães CAS, Santos R, Guedes-de-Aguiar EO, Gonçalves CR, Carvalho-Lima RP, Kutter CR, Machado-Rocha L, Pereira FG, Brandão-Sobrinho-Neto S, Jaña- Rosa A, Neves RF, Moreira-Marconi E, Paineiras-Domingos LL, Costa-Cavalcanti RG, Almeida-Farias C, Souza PL, Paoli S, Presta GA and Bernardo-Filho M
    DOI: http://dx.doi.org/10.17140/TCOJ-1-101
    Provisional PDF651.99 KB 651.99 KB
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  • 2016, March

    editorial

    A Novel Application for a Rheumatologic MedicationOpen Access

    Charles F. Haller, Matthew B. Carroll*, Christopher Smith, Yolanda Moulds-Love, William Pomeroy and Bryan C. Ramsey
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-e001
    Provisional PDF282.11 KB 282.11 KB
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  • 2016, April

    perspective article

    Perspective: Ultrastructural Origins of Bone FragilityOpen Access

    Jitin Samuel, Rohit Khanna and Xiaodu Wang*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-101
    Provisional PDF642.68 KB 642.68 KB
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  • 2016, April

    short communication

    The Use of Botulinum Toxin-A for Neck PainOpen Access

    Abdulrazzaq Alobaid*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-102
    Provisional PDF303.82 KB 303.82 KB
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  • 2016, April

    commentary

    C-C Chemokine Receptor Seven (CCR7): Coming of Age In VaccinesOpen Access

    Colin A. Bill, Olga B. Soto and Charlotte M. Vines*
    DOI: http://dx.doi.org/10.17140/VROJ-1-102
    Provisional PDF338.02 KB 338.02 KB
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  • 2016, April

    case report

    Bier Spots on the Face: The First Case ReportOpen Access

    Hamza Yildiz* and Huseyin Saman
    DOI: http://dx.doi.org/10.17140/TCOJ-1-102
    Provisional PDF950.96 KB 950.96 KB
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  • 2016, April

    original research

    Herd Immunity Conferred By Hepatitis B Vaccination Increases the Protection Efficacy against Hepatitis B Virus InfectionOpen Access

    Yuting Wang, Ling-Ling Lu, Dongmei Wang and Chunfeng Qu*
    DOI: http://dx.doi.org/10.17140/VROJ-1-103
    Provisional PDF375.02 KB 375.02 KB
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  • 2016, April

    mini review

    Is Normal Knee Biomechanics Reproduced by Modern Total Knee Arthroplasty Designs? The Role of FluoroscopyOpen Access

    Pier Francesco Indelli*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-103
    Provisional PDF530.35 KB 530.35 KB
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  • 2016, May

    original research

    Galdieria sulphuraria Relieves Oily and Seborrheic Skin By Inhibiting the 5-α Reductase Expression in Skin Cells and Reducing Sebum Production In VivoOpen Access

    M. Bimonte, A. De Lucia, A. Carola, A. Tito, S. Buono, A. L. Langellotti, V. Fogliano, G. Colucci and Fabio Apone*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-103
    Provisional PDF
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  • 2016, June

    editorial

    Model Based vs. Rule Based Designs in Phase I Dose Finding Clinical TrialsOpen Access

    Yunfei Wang, DrPH; Jichuan Wang, PhD*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-e001
    Provisional PDF330.16 KB 330.16 KB
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  • 2016, July

    case report

    Gouty Arthritis of the Axial Skeleton: A Case ReportOpen Access

    Yuko Kobashi*, Yohei Munetomo, Akira Baba, Shinji Yamazoe and Takuji Mogami
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-104
    Provisional PDF1.02 MB 1.02 MB
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  • 2016, July

    editorial

    Current Status of Human Immunodeficiency Virus VaccinesOpen Access

    Daniela Sosa, Rahul Dev Jayant*, Ajeet Kaushik and Madhavan Nair*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e002
    Provisional PDF359.54 KB 359.54 KB
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  • 2016, July

    mini review

    Cultural Adaptation for Common Orthopedic Disorders Pathology and Presentations With Focus on Middle Eastern and Asian PatientsOpen Access

    Abdulrazzaq Alobaid*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-105
    Provisional PDF342.66 KB 342.66 KB
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  • 2016, August

    letter to the editor

    A Simple Method for Breast De-epithelialization: The Monobloc MethodOpen Access

    Musa Kemal KELES, Ugur Horoz* and Hakan Cepni
    DOI: http://dx.doi.org/10.17140/TCOJ-1-104
    Provisional PDF3.82 MB 3.82 MB
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  • 2016, September

    editorial

    Medical Error Disclosure: A Point of ViewOpen Access

    Jawahar (Jay) Kalra*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e001
    Provisional PDF347.61 KB 347.61 KB
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  • 2016, September

    hypothesis

    Tumor Necrosis Factor Inhibitors May Improve Glycemic Control in Patients Rheumatoid Arthritis and Concomitant Type 2 Diabetes MellitusOpen Access

    Abhijeet Danve*, Shivtej Sehra, Divya jaykumar and Supriya Kulkarni
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-106
    Provisional PDF319.93 KB 319.93 KB
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  • 2016, September

    case report

    A Rare Cause of Shoulder Pain: Ganglion Cyst of the Acromioclavicular JointOpen Access

    Hakan Sarman*, Metin Celik and Mehmet Murat Bala
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-107
    Provisional PDF1.40 MB 1.40 MB
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  • 2016, September

    review

    Innovations in Microbial Biodiscovery, Targeting Silent Metabolism and New Chemical DiversityOpen Access

    Zeinab G. Khalil* and Robert J. Capon
    DOI: http://dx.doi.org/10.17140/VROJ-1-104
    Provisional PDF1.43 MB 1.43 MB
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  • 2016, September

    original research

    Dendritic Cell Maturation is a Critical Step in Dendritic Cell Vaccine Preparation for Cancer TherapyOpen Access

    Samad Farashi-Bonab and Nemat Khansari*
    DOI: http://dx.doi.org/10.17140/VROJ-1-105
    Provisional PDF961.51 KB 961.51 KB
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  • 2016, November

    original research

    The QuickDASH in the Assessment of Rheumatoid Arthritis Disease ActivityOpen Access

    Matthew B. Carroll*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-108
    Provisional PDF510.58 KB 510.58 KB
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  • 2016, November

    review

    Overview of Adult Immune ThrombocytopeniaOpen Access

    Leonard I. Boral*, Gregory P. Monohan and Valentina Moirangthem
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-105
    Provisional PDF469.63 KB 469.63 KB
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  • 2016, November

    editorial

    Innovation of Wound and Burn Care Dressings from Traditional to Nonwoven Polymeric ScaffoldsOpen Access

    Sukhwinder K. Bhullar*, Harpal S. Buttar
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e002
    Provisional PDF510.32 KB 510.32 KB
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  • 2016, December

    case report

    Invasive Moderately-Differentiated Mucinous Adenocarcinoma Incidentally Identified in Perforated Acute Diverticulitis With Abscess FormationOpen Access

    Mahmoud L. Soliman, Sandra R. Cerda and Huihong Xu*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-106
    Provisional PDF2.31 MB 2.31 MB
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  • 2017, January

    mini review

    Medical Micro-NeedlingOpen Access

    Ebtisam Elghblawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-105
    Provisional PDF513.12 KB 513.12 KB
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  • 2017, January

    editorial

    Chemical Peels: A Must Have ArmamentariumOpen Access

    Rahul Pillai*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e002
    Provisional PDF269.93 KB 269.93 KB
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  • 2017, February

    editorial

    Mesotherapy Cocktails Can be the Secrecy for Youthful KeepingOpen Access

    Ebtisam Elghblawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e003
    Provisional PDF276.52 KB 276.52 KB
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  • 2017, February

    systematic review

    Could Hair Loss be a Relevant Symptom Associated with ChikungunyaOpen Access

    Danúbia Sá-Caputo, Laisa Liane Paineiras Domingos, Eliane O Guedes-Aguiar, Rafaelle P. Carvalho-Lima, Severo de Paoli, Danielle Soares Morel, Igor Bastos, Clailson H. A. Farias, Claudia F. Figueiredo, Glenda Dias, Eric H. F. Frederico and Mario Bernardo-Filho
    DOI: http://dx.doi.org/10.17140/TCOJ-1-106
    Provisional PDF672.49 KB 672.49 KB
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  • 2017, March

    original research

    Distribution and Conduct of Clinical Trials Involving Music Therapy: Registered Clinical Trials in the Lost 15 YearsOpen Access

    Keiko Yukawa, Hitoshi Fuji and Hajime Sato*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-101
    Provisional PDF491.29 KB 491.29 KB
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    Abstract [+]

    Objective: This study aimed to conduct an evaluation of music therapy clinical trials
    worldwide, to understand what trials have been conducted and to show the chronological
    changes. Additionally, we sought to clarify issues related to providing clinical trial registration
    information.
    Methods: We searched the International Clinical Trials Registry Platform (ICTRP) database for
    “music therapy,” and identified the disease target for each article found.
    Results: A total of 150 clinical trial studies were found in the ICTRP using the term “music
    therapy.” In these trials, music therapy was used for improvement of social functioning in
    schizophrenia and/or serious mental disorders, anxiety and depressive symptoms, and cancer
    symptoms. Twenty-five clinical trials were actively recruiting. Sixteen of the 25 trials were
    registered in the United States at ClinicalTrials.gov, of which 9 trials were conducted in the US.
    Seven trials were conducted in other countries such as Spain, Taiwan, and China.
    Conclusion: A search for music therapy clinical trials retrieved 150 trials from the ICTRP, and
    the number of clinical trial registrations has increased yearly. Music therapy is widely used in
    patients with various diseases, including Alzheimer’s disease, anxiety, and arthritic pain and
    has the potential to improve certain disease outcomes, but there is not enough evidence to
    substantiate its efficacy. It is important to enlighten researchers and pharmaceutical companies
    on the proper management of the quality of such clinical trial information, as this is an important
    issue.


  • 2017, March

    letter to the editor

    Plaque Psoriasis Formation and Body Hair (Re)Growth: A Common Pathway ActivationOpen Access

    Linda Lazzeri, Antonietta D’Errico and Francesca Prignano*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-107
    Provisional PDF734.19 KB 734.19 KB
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  • 2017, May

    editorial

    Cell Derived Virus-Like Particles (VLP) in Future Vaccine DevelopmentOpen Access

    Pramila Walpita*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e003
    Provisional PDF258.24 KB 258.24 KB
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  • 2017, May

    editorial

    Essential Oils and Cosmetic AromatherapyOpen Access

    Saima Siddique*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e004
    Provisional PDF320.90 KB 320.90 KB
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  • 2017, May

    editorial

    Nanocosmetics: The Good, the Bad and the BeautifulOpen Access

    Rinti Banerjee*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e005
    Provisional PDF315.91 KB 315.91 KB
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  • 2017, May

    observational study

    Topical Corticosteroid Misuse Among Females Attending at Dermatology Outpatient Department in EthiopiaOpen Access

    Feleke Tilahun Zewdu*, Awel Abdulkerim, Mahelet Dessie Nigatu, Getasew Mulatu Akenaw and Mastewal Misganaw Alemayehu
    DOI: http://dx.doi.org/10.17140/TCOJ-1-108
    Provisional PDF400.65 KB 400.65 KB
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  • 2017, May

    review

    Ebola Virus: Promising Vaccine CandidatesOpen Access

    Reema Sameem and Sajani Dias*
    DOI: http://dx.doi.org/10.17140/VROJ-1-106
    Provisional PDF385.19 KB 385.19 KB
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  • 2017, June

    editorial

    The Swan Song of a Pathologist: “Why Do I Love Thee, Pathology? Let Me Count the Ways….”Open Access

    Bhagirath Majmudar*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e003
    Provisional PDF352.68 KB 352.68 KB
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  • 2017, June

    original research

    Fluorinated Lipids Conjugated to Peptide Antigens do not Induce Immune Responses Against Cervical CancerOpen Access

    Waleed M. Hussein, Saori Mukaida, Tzu-Yu Liu, Istvan Toth and Mariusz Skwarczynski*
    DOI: http://dx.doi.org/10.17140/VROJ-1-107
    Provisional PDF521.95 KB 521.95 KB
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  • 2017, June

    original research

    Aesthetic Crowns for Restoring Anterior Primary IncisorsOpen Access

    Baydaa Ali Othman Al-Rawi*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-109
    Provisional PDF823.32 KB 823.32 KB
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  • 2017, August

    editorial

    Recent Advances in Adenovirus-Vectored Vaccines DevelopmentOpen Access

    Alexander N. Zakhartchouk*
    DOI: http://dx.doi.org/10.17140/VROJ-1-e004
    Provisional PDF310.46 KB 310.46 KB
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  • 2017, October

    editorial

    Hair Loss and Chemotherapy: An Overview about What You Need To KnowOpen Access

    Danúbia Sá-Caputo and Mario Bernardo-Filho*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-e006
    Provisional PDF344.62 KB 344.62 KB
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  • 2017, October

    review

    Clinical Investigations on Medical Devices, after the New European Regulation (2017/745)Open Access

    Salvatore Bianco*, Alfredo Nunziata and Giacomo Pozzoli
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-102
    Provisional PDF387.89 KB 387.89 KB
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  • 2017, October

    mini review

    Cluster Randomized Controlled Trials: A Quick Update on Concepts and TypesOpen Access

    Bolaji Emmanuel Egbewale*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-103
    Provisional PDF348.57 KB 348.57 KB
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  • 2017, November

    review

    Immunobiology of Anticancer Virotherapy With Newcastle Disease Virus in Cancer PatientsOpen Access

    Samad Farashi-Bonab and Nemat Khansari*
    DOI: http://dx.doi.org/10.17140/VROJ-1-108
    Provisional PDF438.63 KB 438.63 KB
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  • 2018, April

    editorial

    Education and Health System Collaboration are Indispensable in Vaccination CoverageOpen Access

    Chengjun Sun*
    DOI: https://dx.doi.org/10.17140/VROJ-1-e005
    Provisional PDF402.68 KB 402.68 KB
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  • 2018, May

    editorial

    The Case for Flu VaccinationOpen Access

    Olukayode A. Akinlaja*
    DOI: https://dx.doi.org/10.17140/VROJ-1-e006
    Provisional PDF270.56 KB 270.56 KB
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  • 2018, August

    review

    The Concept of Developing a Plasmodium vivax Malarial Vaccine with a Focus on its Pre-erythrocytic StageOpen Access

    Tuan Imaad Aarif, Sajani Dias*
    DOI: https://dx.doi.org/10.17140/VROJ-1-109
    Provisional PDF318.29 KB 318.29 KB
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  • 2018, September

    editorial

    Don’t Shun the Shunt: Surgical Portosystemic Shunts in the Era of TIPS and Liver TransplantationOpen Access

    Her-HsinTsai*
    DOI: http://dx.doi.org/10.17140/LROJ-3-e004
    Provisional PDF260.48 KB 260.48 KB
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  • 2018, October

    systematic review

    Hair as a Specimen to Determine the Concentration of Cortisol Levels in Individuals that have Performed Physical ActivityOpen Access

    Alexandre Gonçalves de Meirelles*, Marcia Cristina Moura-Fernandes, Eloá Moreira-Marconi, Tânia Regina Lemos-Santos, Gefferson da Silva-Costa, Sérgio Oliveira De-Carvalho, Ivana de Cássia Araújo Ventura, Ygor Teixeira-Silva, Laisa Liane Paineiras-Domingos, Danúbia da Cunha de Sá-Caputo and Mario Bernardo-Filho
    DOI: http://dx.doi.org/10.17140/TCOJ-1-110
    Provisional PDF412.83 KB 412.83 KB
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  • 2019, January

    review

    Glucocorticoid Induced Hypothalamic-Pituitary Axis Alterations Associated with Hypogonadotropic HypogonadismOpen Access

    Navid Mahabadi, Ashley Doucet, Andrew Lun Wong, and Vahid Mahabadi*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-109
    Provisional PDF428.78 KB 428.78 KB
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  • 2019, January

    original research

    Fractional CO2 Laser Treatment for Vaginal Rejuvenation in Post-Menopausal Indian WomenOpen Access

    Rahul Pillai* and Safal Rahim
    DOI: http://dx.doi.org/10.17140/TCOJ-1-111
    Provisional PDF403.86 KB 403.86 KB
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  • 2019, February

    case report

    Actinic Lichen Nitidus with Dermoscopic Features, and Response to HydroxychloroquineOpen Access

    Smriti Shrestha* and Aditi Mishra
    DOI: http://dx.doi.org/10.17140/TCOJ-1-112
    Provisional PDF436.98 KB 436.98 KB
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  • 2019, February

    original research

    The Effectiveness of Transcutaneous Electrical Nerve Stimulation Versus Carbamazepine in Trigeminal Neuralgia: A Randomized Controlled TrialOpen Access

    Rebecca Millan-Guerrero*, Rebecca Isais-Millan, Gabriel Castillo-Varela, Gabriel Ceja-Espíritu and Martha Alicia Higareda Almaraz
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-104
    Provisional PDF538.47 KB 538.47 KB
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  • 2019, February

    editorial

    Alternative Effective Management of the Musculoskeletal PainOpen Access

    Olena Plotkina* and Andrei Bourdeinyi
    DOI: https://dx.doi.org/10.17140/ORHOJ-1-e002
    Provisional PDF319.79 KB 319.79 KB
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  • 2019, March

    review

    A Review of Vaccine Efficacy MeasuresOpen Access

    Sayan Dasgupta*
    DOI: https://dx.doi.org/10.17140/VROJ-1-110
    Provisional PDF379.93 KB 379.93 KB
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  • 2019, April

    review

    Salmonella-based Anticancer Vaccines and their EfficacyOpen Access

    Samad Farashi-Bonab* and Nemat Khansari
    DOI: https://dx.doi.org/10.17140/VROJ-1-111
    Provisional PDF365.81 KB 365.81 KB
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  • 2019, April

    perspective

    Consensus Meeting on International Standards for Oral Whole Cell Killed Cholera Vaccines, 17-18 May 2018, Seoul, Republic of KoreaOpen Access

    Lina Odevall, Sjoerd Rijpkema, Dean Smith, Tong Wu, Firdausi Qadri, Jan Holmgren, Julia Lynch and Viliam Pavliak*
    DOI: https://dx.doi.org/10.17140/VROJ-1-112
    Provisional PDF474.29 KB 474.29 KB
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  • 2019, May

    original research

    The Prognostic Value of PD-L1 Expression in Triple-Negative Breast Cancer: A Cohort Study and Systematic Literature ReviewOpen Access

    Daniel Schmolze, Carolyn E. Behrendt, Peter P. Lee and Sophia Apple*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-107
    Provisional PDF499.31 KB 499.31 KB
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  • 2019, July

    mini review

    Latest Results from Immunotherapy Clinical Trials in Triple Negative Breast CancerOpen Access

    Alexios Strimpakos*, Konstantinos Tsigaridas and Maria Avgoustidou
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-105
    Provisional PDF469.61 KB 469.61 KB
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    Abstract [+]

    Cancer immunotherapy has evolved enormously in the recent years with better understanding of immune reactions, immune microenvironment and immunosurveillance. Breast cancer is characterized by large heterogeneity, a fact which rather complicated the development and the approval of novel therapeutic options in comparison to the majority of other solid tumors since each subtype has required a unique scientific approach and different targets and goals. Triple negative breast cancer (TNBC) is considered the most aggressive of the breast cancer subtypes with limited treatment options and worse outcome compared to others. This article summarizes some of the early clinical studies and the recently presented phase III clinical study of immunotherapy checkpoint inhibitors in this difficult setting.

    Keywords: Cancer; Immunotherapy; Triple negative breast cancer (TNBC); Breast cancer.


  • 2019, July

    opinion

    Neoantigen: A New Hope for Effective Cancer ImmunotherapyOpen Access

    Nemat Khansari*
    DOI: https://dx.doi.org/10.17140/VROJ-1-113
    Provisional PDF232.53 KB 232.53 KB
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  • 2019, August

    original research

    Role of Sound Enhancer Device in TeleconsultationOpen Access

    Shijina Koliyath, Ravi Kumar Chittoria*, Vinayak Chavan, Abhinav Aggarwal, Saurabh Gupta, Chirra Likhitha Reddy, Padmalakshmi Bharathi Mohan and Imran Pathan
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-106
    Provisional PDF329.78 KB 329.78 KB
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    Abstract [+]

    Aim

    To study the role of sound enhancer device in teleconsultation.

    Methods

    This study was conducted in the plastic surgery department in a tertiary care centre in the month of May-June 2019. A sound enhancer device was used with mobile phone for videoconferencing as form of teleconsultation by plastic surgery trainees in operation theatre and outpatient department. At the end of the study feedbacks were taken from the trainees.

    Results

    It was found that on using the sound enhancer device, the sound quality improved and it was helpful in the teleconsultation sessions using videoconferencing.

    Conclusion

    The use of sound enhancer is a simple, cost-effective, innovative method of using a simple technology to aid in utilisation of teleconsultation facilities in a very non-sophisticated way.

    Keywords

    Sound enhancer device; Teleconsultation; Telemedicine.


  • 2019, August

    original research

    Self-Adjuvanting Peptide Vaccines Against Cervical CancerOpen Access

    Hannah Hanh-Hong Truong, Waleed M. Hussein*, Tzu-Yu Liu, Zhongfan Jia, James W. Wells, Michael J. Monteiro, Mariusz Skwarczynski and Istvan Toth
    DOI: https://dx.doi.org/10.17140/VROJ-1-114
    Provisional PDF603.54 KB 603.54 KB
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    Abstract [+]

    Background

    Cervical cancer is a common cause of cancer-related deaths in women worldwide, with a fatality rate second only to breast cancer. Human papillomaviruses (HPVs) are the main causative agents of cervical cancer, and are therefore obvious targets for vaccine development. Although two prophylactic HPV vaccines have been commercialized, therapeutic vaccines against HPVs have not been developed yet. Current vaccine technologies emphasize the power of small particles in targeting immune cells, and particles of 20-50 nm have been reported to induce optimal immune responses against a variety of pathogens and cancers.

    Methods

    We synthesized new nanoparticle-based vaccines against cervical cancer by using antigenic 8Qmin peptide epitope derived from HPV-16 E7 protein, a hydrophilic poly-(L-glutamic acid) (PGA) linker, and an 8-arm poly (tert-butyl acrylate) dendrimer-based delivery system (D8).

    Results

    Four different peptides containing 8Qmin and PGA of different lengths were successfully synthesized with high yield and purity. These were then conjugated to alkyne-functionalized D8 by copper-catalyzed alkyne-azide cycloaddition “click” reaction. The conjugates self-assembled into nanoparticles, with decreased particle size corresponding to a greater number of Glu units. The four vaccine candidates were tested in C57 black 6 (C57BL/6) mice bearing well-established (7-day-old) tumors to examine their therapeutic effects.

    Conclusion

    Interestingly, only one conjugate delayed tumor growth, and montanide adjuvanted antigen, used as a positive control, failed to demonstrate any therapeutic effect.

    Keywords

    Peptide-based subunit vaccine; Human papillomavirus; Polyglutamic acid; Therapeutic cancer vaccine; Polymer-peptide conjugate; Self-adjuvanting; Cervical cancer.


  • 2019, September

    opinion

    Clinical Research: The Future of Medicine Stuck in the Digital PastOpen Access

    Elizabeth Del Mastro Benincasa*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-107
    Provisional PDF250.67 KB 250.67 KB
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  • 2019, October

    case report

    Role of Bactiguard Infection Technology in Preventing Catheter-Associated Urinary Tract InfectionsOpen Access

    Shijina Koliyath, Ravi Kumar Chittoria*, Abhinav Aggarwal, Saurabh Gupta, Chirra Likhitha Reddy, Padmalakshmi Bharathi Mohan and Imran Pathan
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-108
    Provisional PDF351.27 KB 351.27 KB
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    Abstract [+]

    To study the role of bactiguard infection technology (BIP) in preventing Catheter-associated urinary tract infections. This study was conducted in a tertiary care centre in the Department of Plastic Surgery, JIPMER, Pondicherry, India in the month of August 2019. The study subject was a 55-year-old gentleman with Fournier’s gangrene and type 2 diabetes mellitus (DM). The Foley’s catheter with BIP technology was used and its role in preventing urinary tract infections (UTI) was studied over a period of 10-days. During the period of the catheter use in our subject, patient did not develop features of urinary tract infections. BIP technology is claimed to be effective in preventing Catheter-associated urinary tract infections but further studies in more individuals is required to validate the same.

    Keywords

    Bactiguard infection technology (BIP); Catheter associated urinary tract infection (CAUTI); Biofilm.


  • 2019, October

    opposite to the editorial

    Diagnosis and Cure: Intellectual Honesty is the Basis of All ScienceOpen Access

    Alfred Miller*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-110
    Provisional PDF271.12 KB 271.12 KB
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  • 2019, October

    commentary

    Remote Consent Clinical ResearchOpen Access

    Preethi Sriram*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-109
    Provisional PDF281.37 KB 281.37 KB
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    Abstract [+]

    Recruitment in clinical research trials can be challenging in trials that are time-sensitive and/or are rare disease and critical care trials. One of the hurdles for recruitment in these types of clinical trials is due to the consent process, and the need to have consent of the patient within a certain timeframe, or the patient unable to consent for themselves. This paper will discuss the usage of the utilization of remote consent options for these trials.

    Keywords

    Recruitment; e-consent; Remote consent; Clinical trials; Rare disease; Time-sensitive.


  • 2019, November

    review

    Circulating Tumor Cells: Beyond Isolation and DetectionOpen Access

    Michelle J. McNamara*
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-108
    Provisional PDF466.90 KB 466.90 KB
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    Abstract [+]

    Circulating tumor cells (CTCs) are the precursors to metastases and increased numbers of CTCs in the peripheral circulation have been shown to correlate with decreased progression-free and overall survival. Although the current clinical utility has been focused on the prognostic significance, other clinical applications are being explored, such as determining if a patient is a candidate for treatment, determining the efficacy of treatment, evaluation for resistance to therapy, prediction of metastatic site, or as an early predictor of metastases. Current methodologies are based on quantifying CTCs and include technologies based on physical, immunological, and molecular techniques. However, these have limitations, of which most of them do not have the ability to perform morphological evaluation. Using morphological evaluation, CTCs in body fluids could be used for primary diagnosis in the setting of cancer of unknown primary (CUP) or in initial or early diagnostic scenarios. Additionally, cytological specimens have been shown to be useful for ancillary testing in patients when surgical resection specimens or biopsies are not available. Evaluation of CTCs should incorporate histological, immunehistochemical, and molecular characterization to enable clinicians to obtain the comprehensive diagnostic, prognostic and therapeutic information necessary to provide appropriate personalized care to cancer patients.

    Keywords

    Circulating tumor cell (CTC); Circulating; Tumor cell; Cancer; Isolation; Detection; Metastasis; Prognosis.

    Abbreviations

    CTC: Circulating tumor cell; RT-PCR: Reverse transcriptase-polymerase chain reaction; EMT: Epithelial-mesenchymal transition; MET: Mesenchymal-epithelial transition; TRAIL: Tumor necrosis factor-related apoptosis-inducing ligand; CEA: Carcinoembryonic antigen; CUP: Cancer of unknown primary; CAP: College of American Pathologists; AMP: Association for Molecular Pathology; ASCO: American Society of Clinical Oncology.


  • 2019, December

    observational study

    Single-Blind Comparative Study of the Aesthetic Outcome of Armouring Procedures with PLLA/PCL- and HA-Enriched Absorbable ThreadsOpen Access

    Poleva Irina* and Kajaia Albina
    DOI: http://dx.doi.org/10.17140/TCOJ-1-113
    Provisional PDF644.25 KB 644.25 KB
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    Abstract [+]

    Background

    Absorbable threads represent one of the most exciting breakthroughs in aesthetic medicine. The innovative composition of absorbable poly-L-lactic acid (PLLA)/caprolactone (PCL) threads enriched with hyaluronic acid (HA) has triggered the interest of aesthetic practitioners.

    Objective

    To compare the aesthetic outcomes of armouring procedures with absorbable PLLA/PCL threads versus the same procedure performed with PLLA/PCL/HA threads (APTOS, Tbilisi, Georgia threads).

    Materials and Methods

    Eight patients underwent thread insertion in the face (PLLA/PCL threads on one side and PLLA/PCL/HA threads on the other). Aesthetic outcome was determined subjectively by the patient after 7 days using a 5-point rating questionnaire. Wrinkles were evaluated objectively using 3D photosystem software after 7, 30, and 90 days.

    Results

    Seven days after treatment there was significantly less pain, less swelling, less burning and a faster reduction of skin irregularities on the side treated with HA-enriched threads (all p<0.05). The side of the face treated with HA-enriched threads also demonstrated faster and more obvious improvement of wrinkles.

    Conclusion

    Absorbable PLLA/PCL threads have a reliable reputation for oval correction of the face and long-lasting biostimulation. The new HA-enriched threads shorten the post-procedure downtime, accelerate rejuvenation and provide more significant patient satisfaction.

    Keywords

    Absorbable thread; Thread lifting; HA-enriched threads; Aesthetics.


  • 2019, December

    original research

    Analysis of Antibiotic Resistance of the Probiotic Bacteria Found in Commercial Food ProductsOpen Access

    R. M. Asela Priyadarshana* and Clarencia R. Daniel
    DOI: https://dx.doi.org/10.17140/VROJ-1-115
    Provisional PDF644.82 KB 644.82 KB
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    Abstract [+]

    Aim

    The Lactobacillus is an industrially-important group of probiotic organisms that plays an important role in human health by inhibiting harmful and pathogenic bacterial growth, boosting immune function, and increasing resistance to infection. The aim of this study was to identify the probiotic bacteria Lactobacillus based on their phenotypic features and genotypic features. This study also shows the importance of probiotic bacterium, and the effects of their antibiotic resistance to human.

    Method

    Six different brands were cultured on man, rogosa and sharpe (MRS) agar. The identity of the culture was based on the characteristics of the strains of Lactobacillus spp. which was characterized using their phenotypic features (cell morphology, Gram’s staining tests which are specific for Lactobacillus genus). The bacterial deoxyribonucleic acid (DNA) was extracted by two different methods, boiled cell method and cetyl trimethylammonium bromide (CTAB) method. Furthermore, the extracted DNA yields were compared to determine which gives the best yield. The bacterial genus was detected with using genus specific primers, specific to the Lactobacillus. All the isolates were further subjected to antibiotic resistance test using disc diffusion method against a total of 4 antibiotics (Erythromycin, Tetracycline, Vancomycin and Ampicillin) and the antibiotic resistant genes of tet(M) & erm(B), were analyzed by polymerase chain reaction (PCR).

    Results

    Five isolates out of six samples (A to E) were found to exhibit multiple resistance against some of the most commonly used antibiotics. The isolates showed resistance toward tetracycline, erythromycin & vancomycin. Besides that, the isolates displayed a low-level of resistance toward ampicillin.

    Conclusion

    This study proves that antibiotic resistance is present in different species of probiotic strains, which may pose a food safety concern.

    Keywords

    Lactobacillus; Probiotics; Antibiotics; Tetracycline; Vancomycin; Erythromycin; Ampicillin; Antibiotic resistance.


  • 2020, January

    review

    Principles and Applications of Deoxyribonucleic Acid Microarray: A ReviewOpen Access

    Haben Fesseha* and Hiwot Tilahun
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-109
    Provisional PDF482.51 KB 482.51 KB
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    Abstract [+]

    Deoxyribonucleic acid (DNA) microarrays are collections of DNA probes arranged on a base pair and the latest commercialized molecular diagnostic technologies that offer high throughput results, more sensitive and require less time. It is the most reliable and widely accepted tool facilitating the simultaneous identification of thousands of genetic elements even a single gene. Microarrays are powerful new tools for the investigation of global changes in gene expression profiles in cells and tissues. The different types of DNA microarray or DNA chip devices and systems are described along with their methods of fabrication and their use. The DNA microarrays assembly process is automatized and further miniaturized. DNA microarrays are used in the search of various specific genes or in gene polymorphism and expression analysis. They will be widely used to investigate the expression of various genes connected with various diseases in order to find the causes of these diseases and to enable their accurate treatment. Generally, microarray analysis is not only applied for gene expression studies, but also used in immunology, genotyping, diagnostics and sequence analysis. Additionally, microarray technology being developed and applied to new areas of proteomics, cancer research, and cellular analysis.

    Keywords

    Application, DNA, Microarray, Principle.


  • 2020, January

    original research

    Nutrient-Dense, Functional Foods Enhance Hair, Skin, and Nail AppearanceOpen Access

    Kate Bauer, William Clearfield, Rochelle Ramacher, Pei-Ra Ling, Charles Marsland and Stacey J. Bell*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-114
    Provisional PDF332.45 KB 332.45 KB
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    Abstract [+]

    Objective

    The American diet is nutrient-poor and rich in unhealthy compounds like sodium, sugar, and saturated fats. Whether food has an effect on appearance has not been fully elucidated. The purpose of this prospective, single-armed study was to evaluate the impact of consuming two nutrient-dense functional foods, which are low in salt, sugar, and saturated fats, on hair, skin, and fingernail health.

    Methods

    Both subjective (self-reported questionnaires and photographs) and objective (i.e., salivary pH and skin hydration) tests were used to evaluate appearance. Weekly compliance with nutrient-dense foods, body weight, and quality of life assessment were also recorded.

    Results

    Participants(n=28) consumed most of the nutrient-dense foods and remained weight stable, which was the goal of the study to exclude the effect of changes in body weight on appearance. Neither objective measurement of appearance showed significant improvements. Subjective measurements using questionnaires specific to hair, skin, and fingernails improved significantly over the 8-week study. Rating of photographs that the participants took of themselves improved significantly over the 8-weeks. These included reduced redness, decreased pore size, and better skin color. Using an acne-rating scale, a significant improvement was observed at week 8 compared to baseline. The quality of life parameters improved significantly including feeling of well-being, feeling full, having more energy, sleeping better, having less stress, and being more focused.

    Conclusion

    Inclusion of two nutrient-rich, functional foods in the diet improved the appearance of hair, skin, and fingernails. These foods were well-received and easy-to-prepare, leading to excellent compliance with the dietary protocol.

    Keywords

    Appearance; Diet; Functional foods; Nutrient-dense foods; Hair; Skin; Nails.


  • 2020, February

    case study

    Non-Invasive Treatment for Adhesive Capsulitis Not Helped by Physical Therapy: A Case Study in Manipulative MedicineOpen Access

    Jason Strandberg*
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-111
    Provisional PDF287.82 KB 287.82 KB
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    Abstract [+]

    This case documents the treatment of a middle-aged woman with chronic, unresponsive adhesive capsulitis (frozen shoulder) using manipulation, active release therapy, and electronic acupuncture. She had not responded to typical physical therapy but did respond to active release therapy along with adjunctive manipulation and acupuncture. In our course of treatment we wanted to see if we could significantly improve pain-free range of motion and normal; function without using invasive treatments like surgery and manipulation under anesthesia. Over a course of five weeks, using a soft tissue manipulation technique known as active release technique along with electrified acupuncture and home exercises, we were able to increase her range of motion to near normal and her function to normal. She was not forced to miss any work because of the treatment and can now do all the things she needs to do for work.

    Keywords

    Frozen shoulder; Adhesive capsulitis; Manipulation; Active release therapy; Non-invasive treatment.


  • 2020, February

    editorial

    Outstanding Outcome of Pancreatic Cancer: What Lessons Do We LearnOpen Access

    Muhammad W. Saif*
    DOI: http://dx.doi.org/10.17140/POJ-4-e012
    Provisional PDF294.54 KB 294.54 KB
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  • 2020, February

    original research

    Recombinant Protein D from Haemophilus influenzae Induces Mouse Bactericidal Antibodies Against Typeable and Non-Typeable Haemophilus influenzae, which Partially Protect Infant Rats Against Serotype b BacteraemiaOpen Access

    Nathan Palmer*, Yajun Tan, Manolya Saydam, Arif Felek, Huajie Zhang, Shumin Zhang, Min Fang, Jun X. Wheeler, Qiming Hou, Xiao Ma, Junzhi Wang and Fatme Mawas
    DOI: https://dx.doi.org/10.17140/VROJ-2-116
    Provisional PDF745.98 KB 745.98 KB
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    Abstract [+]

    Aim

    To evaluate the immunogenicity of a recombinant protein D from Haemophilus Influenzae (Hi) and the functional activities of the induced protein D antibodies in a mouse model.

    Methods

    Female Balb/c mice were immunised subcutaneously with recombinant protein D in the presence or absence of adjuvants and the serum immunoglobulin G (IgG) response to protein D was assessed by ELISA. The functional activity of the immune sera was evaluated in vitro using bactericidal assay against typeable Hi serotype b (Hib) and non-typeable Hi (NTHi) clinical isolates and in vivo using an infant rat bacteraemia model and a Hib clinical isolate.

    Results

    A dose-dependent IgG response was induced in mice immunised with the recombinant protein D and this response was further increased by the adjuvants used [CPG, AlPO4 and Al(OH)3], with the latter showing the greatest effect on the antibody response. Immune sera were very effective in bactericidal assay against several Hib and NTHi clinical isolates, with a higher serum bactericidal titre against the NTHi than against the Hib isolates. This is possibly due to the lower expression of protein D on the Hib isolates used in our study, compared to the NTHi isolates. In addition, anti-protein D antibodies were partially protective in vivo infant rat bacteraemia model against a challenge with Hib Eagan strain.

    Conclusion

    Our results suggest that recombinant protein D is a good vaccine candidate against Hi and should be given in combination with other vaccine candidates to ensure complete protection against Hib and NTHi.

    Keywords

    Haemophilus influenzae (Hi); Haemophilus influenzae serotype b bacteraemia; Rats.


  • 2020, February

    case report

    Superior Mesenteric Artery and Nutcracker Syndromes in a Healthy 14-Year-Old Girl Requiring Surgical Intervention after Failed Conservative ManagementOpen Access

    David Wood, Andrew Fagbemi, Loveday Jago, Dalia Belsha, Nick Lansdale and Ahmed Kadir
    DOI: http://dx.doi.org/10.17140/GOJ-5-132
    Provisional PDF360.10 KB 360.10 KB
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    Abstract [+]

    This case report presents the diagnosis of superior mesenteric artery and nutcracker syndromes in a previously fit and well 14-year-old girl. Although these two entities usually occur in isolation, despite their related aetiology, our patient was a rare example of their occurrence together. In this case the duodenal compression of superior mesenteric artery syndrome caused intractable vomiting leading to weight loss, and her nutcracker syndrome caused severe left-sided abdominal pain and microscopic haematuria without renal compromise. Management of the superior mesenteric artery syndrome can be conservative by increasing the weight of the child which leads to improvement of retroperitoneal fat and hence the angle of the artery. The weight can be improved either by enteral feeds or parenteral nutrition. This conservative management initially helped but not in the long-term as the child started losing weight again. The next step in management is surgery (duodenojejunostomy – if the conservative management fails), which the child went through, remarkably improving their symptoms.


  • 2020, March

    mini review

    Beyond Placebo: Alternative Options to the Randomized Control Trial Design in Rare Disease StudiesOpen Access

    Preethi Sriram*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-110
    Provisional PDF289.55 KB 289.55 KB
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    Abstract [+]

    Unique difficulties and challenges can arise for rare diseases and orphan disease indications within a clinical trial. Some of the challenges encountered by trials that are working on rare diseases can include recruitment and enrollment. One of the explanations for the challenges that are encountered in rare disease trials is because of the trial design of study, where the investigational product is being compared to the placebo. This review paper discusses the usage of placebo and when other options could be taken into consideration while creating the protocol, specifically with consideration to rare disease studies. It is essential for the investigators and those designing the protocol to consider alternative options from the standard randomized controlled trial. The aim of this paper is to review alternative trial design options. The trial designs discussed in this review paper include crossover trials, single arm studies and historical data, and n-of-1 trials.

    Keywords

    Recruitment; Enrollment; Placebo controlled; Clinical trials; Rare disease; Crossover trials; Single arm study;
    Historical data; n-of-1 trials.


  • 2020, March

    case report

    A Rare Cutaneous Manifestation of the Systemic Erythematosus Lupus: The Chilblain Lupus – A Clinical CaseOpen Access

    David Castro-Corredor*, Prado Sánchez-Caminero, Isabel M. de Lara-Simón and Fiorella L. Piaggio-Muente
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-112
    Provisional PDF408.66 KB 408.66 KB
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    Abstract [+]

    Perniosis or chilblain pernio is an inflammatory skin disease, typically located on acral skin surfaces secondary to prolonged exposure to cold temperatures and damp conditions. This disorder can appear as an idiopathic dermatosis, usually in young women, but occasionally it is associated with diseases such as anorexia, intestinal lymphoma, chronic myelomonocytic leukemia, monoclonal gammopathies, cryoproteinaemia, viral infections, as well as connective tissue diseases, especially lupus, picture that is known as chilblain lupus. We present a case of perniosis associated with Systemic Lupus Erythematosus and review the literature.

    Keywords

    Chilblain lupus; Perniosis; Chilblain pernio; Rare cutaneous; Myelomonocytic leukemia; Systemic Lupus Erythematosus.


  • 2020, March

    mini review

    Rechargeable Battery Solutions for Digital Hearing Aids: A Mini ReviewOpen Access

    Neha Taneja*
    DOI: http://dx.doi.org/10.17140/OTLOJ-SE-5-104
    Provisional PDF331.53 KB 331.53 KB
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    Abstract [+]

    Everyday all of us use rechargeable solutions either its smartphones, televisions, or any other electronic devices. Faster streaming of these electronic devices to other external devices may be facilitated through wireless connectivity. Wireless streaming demands much more battery backup. With advancement of hearing aid technology many features exists in hearing aids which may facilitate better spectral information, improved speech understanding in presence of background noise and thus improving communication and quality of life of the users. The use of these advanced features often requires continuous uninterrupted power supply. Traditional disposable hearing aid batteries cannot be assured of their performance due to their inopportune time discharge. Recently rechargeable solutions in hearing aids have been discovered that can support long-lasting wireless streaming. Modern day rechargeable batteries are expected to be easy to charge which can last for longer duration with more reliability and durability. Rechargeable as a feature is added on over and boon. Rechargeable battery solutions based on its various benefits may support as boon for environment, hearing aid users and professionals (better counseling and more satisfied users). The aim of this article is to highlight the awareness of these different rechargeable solutions for the users and professionals. In addition mentioning in brief the superiority of Lithium ion battery which is widely accepted in rechargeable hearing aids.

    Keywords
    Rechargeable hearing aids; Wireless streaming; Batteries for hearing aids; Li-ion batteries.


  • 2020, April

    review

    Bone Grafting, Its Principle and Application: A ReviewOpen Access

    Haben Fesseha* and Yohannes Fesseha
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-113
    Provisional PDF413.45 KB 413.45 KB
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    Abstract [+]

    Bone grafting is a surgical procedure that replaces missing bone through transferring bone cells from a donor to the recipient site and the graft could be from a patient’s own body, an artificial, synthetic, or natural substitute. Bone grafts and bone graft substitutes are indicated for a variety of orthopedic abnormalities such as comminuted fractures (due to car accidents, falling from a height or gunshot injury), delayed unions, non-unions, arthrodesis, osteomyelitis and congenital diseases (rickets, abnormal bone development) and are used to provide structural support and enhance bone healing. Autogenous, allogeneic, and artificial bone grafts are common types and sources of grafts and the advancement of allografts, synthetic bone grafts, and new operative techniques may have influenced the use of bone grafts in recent years. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone grafting and help bone tissue to regenerate completely. A bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs, and sternum. An ideal bone graft substitutes should be biologically inert, readily available, must possess osteogenic, osteoinductive and osteoconductive properties, provide mechanical support, easily adaptable in terms of size, shape, length and substituted by the host bone. Bone banks are the source of bone grafts and implants and necessary for providing biological material for a series of orthopedic procedures. Bone grafts and implants can be selected as per clinical problems, the equipment available and the preference of the surgeon. A search for an ideal bone graft is on and may continue time to time.

    Keywords

    Application; Bone; Bone graft; Bone replacement; Bone bank; Principle.


  • 2020, May

    original research

    An In-Depth Analysis of Our Myositis Cohort Following the Example of the EuroMyositis RegistryOpen Access

    Stylianos Tomaras* and Jörn Kekow
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-114
    Provisional PDF437.57 KB 437.57 KB
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    Abstract [+]

    Background

    To describe our myositis cohort in-depth.

    Methods

    From January 2006 to December 2018, all newly diagnosed myositis patients were retrospectively enrolled in the study. We performed a subtype reclassification using the 2017 EULAR/ACR criteria, following the example of the EuroMyositis registry. Disease activity and damage were measured by the newest standardized assessment-tools for clinical studies. Comparisons between myositis subgroups were conducted using Fisher’s exact test.

    Results

    We enrolled 32 patients (25 were female): six patients with dermatomyositis, six with polymyositis, eleven with overlap myositis, six with antisynthetase syndrome, one with autoimmune necrotizing myopathy, one with juvenile antisynthetase syndrome and one with juvenile dermatomyositis. The overall median follow-up period was 23-months (9-44.75). Interstitial lung disease (ILD) was most frequently seen in patients with antisynthetase syndrome. Patients with overlap myositis were more likely to have polyarthritis mimicking rheumatoid arthritis, reduced capillary density in the nail fold capillaroscopy and Raynaud syndrome. Ovarian cancer during the follow-up period occurred in two patients (one with polymyositis and one with dermatomyositis). Myositis-related death was reported in two patients: acute respiratory failure in autoimmune necrotizing myopathy and dysphagia-related complications in polymyositis. Cyclophosphamide, methotrexate and rituximab demonstrated a significant steroid-sparing effect. In 22 of 32 patients, the myositis subgroup classifications made on the basis of our opinion and the new EULAR/ACR classification criteria were different, showing strong disagreement, especially in the subtype polymyositis.

    Conclusion

    Our analysis highlights the heterogeneity in myositis subgroups and shows the steroid-sparing effect of cyclophosphamide, methotrexate and rituximab.

    Keywords

    Myositis; Idiopathic inflammatory myopathy; Dermatomyositis; Antisynthetase syndrome; Overlap myositis; Rituximab.

    Abbreviations

    CCP: Cyclic Citrullinated Peptide; CK: Creatine kinase; CYC: Cyclophosphamide; IIM: Idiopathic Inflammatory Myopathy; ILD: Interstitial lung disease; IMACS: International Myositis Assessment and Clinical Studies Group; MDI: Myositis Damage Index; MMT8: Manual muscle test 8; MTX: Methotrexate; MYOACT: MYOsitis disease ACTivity; RTX: Rituximab; TIF-1γ: Transcriptional factor-1γ.


  • 2020, May

    original research

    Correlation of 18F-Fluorodeoxyglucose Glucose Uptake by Liver Cancer and Transcriptional Regulation of the Warburg Effects in ATT-MYC Mouse Model of Liver CancerOpen Access

    Mahmoud Elalfy* and Juergen Borlak
    DOI: http://dx.doi.org/10.17140/LROJ-3-112
    Provisional PDF463.83 KB 463.83 KB
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    Abstract [+]

    Background

    It was previously reported that diethylnitrosamine (DEN) enhanced liver cancer progression in ATT-MYC mouse model of liver cancer. Radiogenomics is a new tool in advanced science technology that gives information on tumor biology, non-tumor surrounding tissue, the degree of tumor size and presence of necrosis of cells especially with joined micro computed tomography – positron emission tomographys (CT/PETs).

    Aim

    To evaluate the correlation of gene expression and non-invasive microPET information of the liver tumors at different points of the stage of growth.

    Methods

    Exon array expression of the liver of ATT-MYC mice treated with DEN or butylated hydroxytoluene (BHT) compared to control non-transgenic mice were analyzed by array track and the current data were also compared to microarray expression of liver tumor of ATT-MYC mice.

    Results

    The expression of genes responsible for glucose transport such as glut1, 3, 4, hk1, slc1a5, slc1a1, slc1a4, slc1a2, gp6c and gpc-1-3-4 were up-regulated significantly in DEN-treated transgenic mice immediately after end of treatment (p≤0.05), while glut2 (fold change 0.9503, p-value 0.4385) and hk2 (fold change 3.0589, p-value 0.0565) genes were increased not significantly immediately after end of treatment. Additionally, at 4.5-months of observation after the end of treatment slc1a5, slc38a2, glut1, glut4 and gpc3-4 genes had a significant fold change in liver tumor tissue in DEN treated mice when compared to BHT or control transgenic or non-transgenic one. While hk1, 2, slc5a1, slc1a4, glut2, glut3, g6pc and gpc-1 genes were increased non-significantly in the liver of treated mice when compared to control group at 4.5-months of observation after the end of treatment. Notably, c-myc, hif-1 and aldoa glycolytic genes were expressed significantly both time points of 4 and 8.5-months while ldhb, hk-2 and PKM2 were increased non-significantly in DEN treatment when compared to BHT/control non-transgenic animals.

    Conclusion

    There is a definitive correlation between genes responsible for glucose transport and 18F-Fluorodeoxyglucose (FDG) uptake in the early and advanced degree of liver carcinogenesis. This study of glucose pathway in Hepatocellular carcinoma (HCC) at different stages of early and advanced one is the potential for therapeutic anticancer therapy.

    Keywords

    18-FFluorodeoxyglucose (FDG); MicroPET; Exon array expression; Hepatocellular carcinoma (HCC); Att-myc transgenic mice; Diethylnitrosamine (DEN), Butylated hydroxytoluene (BHT); Glucose metabolism.


  • 2020, May

    case report

    Cutaneous Polyarteritis Nodosa in Adult PatientOpen Access

    Cristiana S. Santos*, Samuel S. Álvarez and González Moran
    DOI: http://dx.doi.org/10.17140/ORHOJ-1-115
    Provisional PDF363.61 KB 363.61 KB
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    Abstract [+]

    Cutaneous polyarteritis nodosa is a rarer variant of classic polyarteritis nodosa with unknown etiopathogenesis. It presents with skin, articular and nervous involvement, after systemic involvement is ruled out. This work reports the case of a 41-year-old male patient diagnosed with cutaneous polyarteritis nodosa with skin lesions, polyarthralgia and sensory axonal polyneuropathy.

    Keywords

    Skin; Polyarteritis; Vasculitis; Biopsy; Immunofluorescence; Histology.


  • 2020, June

    letter to the editor

    Pancreas and Coronavirus Disease-2019Open Access

    Lorenzo Dioscoridi*
    DOI: http://dx.doi.org/10.17140/POJ-4-111
    Provisional PDF293.93 KB 293.93 KB
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  • 2020, June

    observational study

    The Digital Stethoscope in Telemedicine: A Health Camp StudyOpen Access

    Imran Pathan, Ravi K. Chittoria*, Saurabh Gupta, Chirra L. Reddy, Padmalakshmi B. Mohan, Shijina Koliyath, Nishad K and Mohamed Ishaq Z
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-111
    Provisional PDF398.09 KB 398.09 KB
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    Abstract [+]

    India is a vast country with limited human resources. People living in remote areas often have limited access to healthcare facilities. To address this need and to increase healthcare awareness, health camps have been established. These camps are often supervised by junior physicians. Telemedicine, and in particular use of a digital stethoscope may provide better diagnosis and better consultation to the patient by senior physicians located remotely. This article highlights the clinical use of a digital stethoscope in such a health camp.

    Keywords

    Health camp; Telemedicine; Digital stethoscope.


  • 2020, June

    review

    Diversity and Recruitment of Minorities in Clinical Trials: An Unmet NeedOpen Access

    Nathalie Vives*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-112
    Provisional PDF338.00 KB 338.00 KB
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    Abstract [+]

    Patient centricity has led to the idea that drugs should answer medical needs not only defined by the medical bodies but relevant for the patients themselves. This implies that the diversity of the patients should be represented in clinical trials. Disparities in representation of diverse populations in clinical trials have been well-documented for several pathologies like arterial hypertension, diabetes but also in oncology. Today, Caucasian patients included in clinical trials represent at least 75% of the clinical trials population even in pathologies where minorities are largely more affected than Caucasians. Filling the gap in diversity is an important matter to ensure ethics, good practices, regulatory compliance, patient safety and scientific validity. To achieve their recruitment goals and being patient centric, sponsors and investigational sites need to pay attention of this problem and put in place specific strategies. Mistrust of patients of minority groups toward clinical research is one of the main barriers along with lack of access to clinical trials (low awareness, communication barriers, distance to investigational sites). Adapted communication, community-based strategies are some of the useful strategies directed to the patients. Investigators may not encounter diverse populations in their area or may not be aware of unconscious bias when identifying patients suitable for a clinical trial. Looking for referrals and raising awareness of the risk of bias with training on culturally sounded approaches could help investigators to recruit more diverse populations. Lack of awareness and costs may prevent sponsors to focus on diversity but ethics, benefits of data acquisition and patient centricity should be enough motivators to modify this trend. Patients, investigators and sponsors have their own barriers to tackle the lack of diversity in clinical trials. The cultural background of all stakeholders is an important factor in those barriers. Only multidisciplinary approaches including human sciences would help to define patient recruitment strategies that would mitigate the current lack of diversity.

    Keywords

    Clinical trials; Patient recruitment; Diversity, Minorities.


  • 2020, July

    perspective

    Innovation in Clinical Trials is Possible: The Hidden Opportunity in the Coronavirus Disease-2019 EmergencyOpen Access

    Valeria L. Scarano* and Davide Smaldone
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-113
    Provisional PDF341.84 KB 341.84 KB
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    Abstract [+]

    The coronavirus disease-2019 (COVID-19) emergency has clearly shown the need to discover, test and produce a new vaccine but also in general the fragility of the current chain of clinical trials. Through this emergency, is it possible to look at the current clinical trial processes with new eyes? Is it possible to seize the opportunity for change and to have confidence in the possibility of their improvement? In this short article the authors wanted to give an optimistic answer to this question by pushing on the possibilities of innovation nowadays.
    Keywords
    Clinical trials; Innovation; Covid-19; Digital transformation.


  • 2020, July

    commentary

    How a Network Came Together to Manage a Large Research Program During the PandemicOpen Access

    Tamara Friedman*, Elli G. Paleoudis, Avery Freed, Susan Adler, Cheryl Fittizzi and Ihor Sawczuk
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-114
    Provisional PDF300.51 KB 300.51 KB
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    Abstract [+]

    Hackensack Meridian Health, a large New Jersey network comprised of 17 hospitals, a medical school, and 200 ambulatory care centers, executes a large research program with approximately 1000 active human subjects studies. With the arrival of the coronavirus disease-2019 (COVID-19) pandemic, the Office of Research Administration was confronted with a series of challenges. These included minimizing face-to-face contact among research participants and staff, allocating limited resources to handle the influx of COVID-19 related proposals, providing human subjects protection training to the physicians and staff who were needed to run the clinical trials, adjusting bio-repository activities to meet the increased demand for samples, and disseminating all of the new regulatory and operational information to the thousands of researchers in the network. The network’s success in modifying its research program quickly and effectively to adapt to the changing landscape can be attributed, in large part, to the centralized nature of the research administration.
    Keywords
    Research administration; COVID-19; Network.


  • 2020, July

    case study

    The Role of Negative Pressure Wound Therapy with Instillation and Dwell Time in the Preparation of Wound BedOpen Access

    Nishad Kerakada, Ravi K. Chittoria*, Saurabh Gupta, Chirra L. Reddy, Padmalakshmi B. Mohan, Imran Pathan, Shijina Koliyath and Neljo Thomas
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-115
    Provisional PDF374.58 KB 374.58 KB
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    Abstract [+]

    Introduction
    Although the negative pressure wound therapy (NPWT) is a time tested method of wound preparation, the role of NPWT with instillation and dwell time (NPWTi-d) in decreasing the downtime of wound preparation needs to be evaluated.
    Objective
    The objective of this study is assess the role of NPWTi-d in wound bed preparation.
    Materials and Methods This study was conducted in a tertiary care center, after getting informed consent and ethical clearance. NPWTi-d was done on a 36-years-old female with no known co-morbidities admitted with infected raw area over the right below knee amputation stump and exposed bone who was not responding well to conventional wound dressing. NPWT was applied with the help of sterile polyurethane sponge and two tubes. The antimicrobial solution used was ionic silver solution, just enough to wet the sponge completely and up to the point when the transparent occlusive covering begins to lift. Negative pressure was applied at 125 mmHg. The wound was bathed with ionic silver solution and it was allowed to stay in the wound for 10-minutes, after every 2-hours of negative pressure application. This was continued for 1-week. The dressing was opened at the end of 1-week, wound irrigated with normal saline, exudate swabs for culture taken and debrided, following which fresh NPWTi-d was applied. This was repeated for the next 3-weeks.
    Result
    By the end of third week, the wound became clean, fully covered with healthy granulation and the wound bed was ready to undergo the definitive wound cover procedure.
    Keywords
    Negative pressure wound therapy (NPWT); Negative pressure wound therapy with instillation dwell time (NPWTi-d); Ionic silver solution; Wound bed preparation; Amputation stump.


  • 2020, August

    original research

    Model Liposomal Delivery System for Drugs and VaccinesOpen Access

    Farrhana Z.Firdaus, Zeinab G. Khalil, Robert J. Capon, Mariusz Skwarczynski, IstvanToth* and Waleed M. Hussein*
    DOI: https://dx.doi.org/10.17140/VROJ-1-117
    Provisional PDF467.78 KB 467.78 KB
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    Abstract [+]

    Background

    Liposomes have been used for drug delivery since their discovery 60-years-ago. The advantages they provide as carriers have been recognised and exploited to improve the delivery of numerous drugs and eliminate harmful side-effects. Liposomal delivery has been tested for anticancer drugs, anti-tuberculosis drugs, variety of vaccines, just to list a few.

    Methods

    We developed a series of liposomal formulations with the addition of cholesterol and polyethylene glycol. The uptake of these formulations by human epithelial prostate cancer (PC-3) cells and mouse macrophages was examined and analysed by flow cytometry and confocal microscopy.

    Results

    Among the liposomes tested, small anionic liposome vesicles (≤200 nm) prepared with egg phosphatidylglycerol as the main lipid were most effectively taken up by PC-3 cells and macrophages.

    Conclusion

    We produced a liposome formulation that can be used as a model system for the delivery of drugs and vaccines.

    Keywords

    Liposomes; Drug delivery; Vaccines delivery; Egg phosphatidylglycerol; Polyethylene glycol.


  • 2020, October

    original research

    The Effect of Internal Locus of Control and Social-Emotional Learning on Life and Relationship SatisfactionOpen Access

    Sibylle Georgianna* and Jennifer Jagerson
    DOI: https://www.doi.org/10.17140/PCSOJ-6-157
    Provisional PDF527.91 KB 527.91 KB
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    Abstract [+]

    Objective

    The current study examined the impact of a non-governmental organization’s academic tutoring and mentoring program on the social-emotional learning (SEL) and subjective well-being of 240 marginalized young women.

    Participants

    One-hundred-fifty-nine currently enrolled 7-12th grade students with a mean age of 16.39, SD=1.55; 40 students who were enrolled in college with a mean age of 20.25, SD=1.57, and 25 who had graduated from college with a mean age of 22.48, SD=2.16 and their leaders participated.

    Methods

    All participants completed in a survey that assessed the degree of participants’ locus of control, expectations of success (self-efficacy), current goals and career-related aspirations and their satisfaction with their relationships and life in general. Twenty-one of the participants and all leaders also were interviewed.

    Results

    Regression analyses revealed that both the participants’ self-management and the leader’s locus of control were significant predictors of the participants’ internal locus of control. Congruent with interview findings, latent structural equation analysis revealed that three manifest variables of social-emotional learning, “self-management”, “social awareness”, and “self-efficacy” had direct positive effects on participants’ subjective well-being (i.e., their satisfaction with life and relationships).

    Conclusion

    Culturally sensitive approaches to mentoring and training are needed and helpful. Future research should be carried out to mitigate design limitations and further the current study’s addition to the body of research on social-emotional learning and well-being.

    Keywords

    Self-management; Self-efficacy; Social awareness; Social-emotional learning (SEL); Internal locus of control; Life satisfaction; Relationship satisfaction; Subjective well-being (SWB).


  • 2020, October

    case report

    Implant-Supported Removable Partial Denture: An Approach to Rehabilitate Maxillary Kennedy Class IOpen Access

    Imed Ouni*, Sinda Ammar, Hiba Triki, Imen B. Afia, and Lamia Mansour
    DOI: https://dx.doi.org/10.17140/DOJ-6-142
    Provisional PDF475.41 KB 475.41 KB
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    Abstract [+]

    Patients with maxillary Kennedy Class I are frequent visitors to the dental office, the missing of posterior teeth makes the control of the movement of removable partial dentures difficult due to the axis of rotation and the different resiliencies between the supporting structures. The use of implants in association to the conventional metal frame denture provides favorable long-term stability and retention, good clinical outcomes in terms of occurrence of complications and maintenance. In this clinical case, a patient with a maxillary Kennedy Class I was rehabilitated using a 3 implants to support metallic removable partial denture. A three dimensional (3D) surgical guide was used for the well-placement of the strategic implants and ball attachments were tightened as connectors between implant and denture. The patient was satisfied after 4-years of follow-up and reported good occlusal stability, esthetic and functional satisfaction.
    Keywords
    Dental implant; Distal extension removable partial denture; Kennedy Class I; Attachment denture.


  • 2020, October

    editorial

    Laparoscopic Sleeve Gastrectomy for the Surgical Treatment of Obesity: Is It an Easy Procedure?Open Access

    Emilio Manno*
    DOI: http://dx.doi.org/10.17140/SROJ-6-e004
    Provisional PDF175.72 KB 175.72 KB
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  • 2020, October

    observational study

    Accuracy of Bioimpedance Modalities for Fluid Assessment in Hemodialysis Patients: A Randomized Observational StudyOpen Access

    Jacob C. John*, Graham T. Gipson, Christopher D. King, Timothy E. Bunchman and Oliver Karam
    DOI: https://dx.doi.org/10.17140/NPOJ-6-124
    Provisional PDF507.74 KB 507.74 KB
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    Abstract [+]

    Aim
    Fluid overload is a major contributor to mortality in critically ill patients but is difficult to estimate clinically. Bioimpedance has been used to estimate fluid volumes with three different methods of analysis:1. single-frequency; 2. multi-frequency; 3. bioimpedance spectroscopy. The aim of this study is to assess the accuracy of different types of bioimpedance analysis in detecting changes in fluid volumes.
    Methods
    Prospective observational study, in end-stage renal disease patients requiring dialysis, in a tertiary care center. During hemodialysis, we assessed the correlation between change in estimated total body water volumes, as measured by all three methods of bioimpedance, and fluid volumes removed, as measured by changes in body weight.
    Results
    Twenty-four pediatric and adult patients were included in the study (median age 42.4 years) with a total of 30 study assessments performed. There was a weak correlation between change in body weight and change in estimated total body water volumes (R=0.15, 0.41, and 0.38, respectively). In the Bland-Altman analysis, the mean biases along with their associated 95% confidence limits of agreement were -0.23 L (-4.1 to 3.5 L) for single-frequency; -1.1 L (-4.1 to 1.9 L) for multi-frequency; and -0.6 L (-6.1 to 4.8 L) for bioimpedance spectroscopy.
    Conclusion
    In this study of end-stage renal disease patients requiring dialysis, the accuracy of bioimpedance measurement to evaluate fluid changes was poor, regardless of bioimpedance modality.
    Keywords
    Body composition/physiology; Body fluid/physiology; Electric impedance; Extracellular fluid/metabolism; Renal dialysis.


  • 2020, November

    original research

    The Athletic Intelligence Quotient and Performance in the National Football LeagueOpen Access

    James K. Bowman*, Thomas R Boone, Leonard Zaichkowsky, Scott Goldman and Alex Auerbach
    DOI: https://dx.doi.org/10.17140/SEMOJ-6-180
    Provisional PDF488.70 KB 488.70 KB
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    Abstract [+]

    Introduction
    In the realm of competitive athletics, numerous variables have been examined for predictive utility with respect to player selection/development and outcomes on the field. Notwithstanding important advances, the current predictors only account for a modest amount of variance in outcomes of relevance in the National Football League (NFL).
    Objective
    The primary objective of this study was to investigate the predictive validity of a new measure of athletic intelligence, the Athletic Intelligence Quotient (AIQ), which is based on the empirically supported Cattell-Horn-Carroll (CHC) Theory of Intelligence. The predictive validity of the AIQ was determined in relation to performance metrics from 146 NFL players across several seasons.
    Results
    Hierarchical regression analyses indicate that specific AIQ factors accounted for a statistically significant increase in the explanation of variance beyond the current level of evaluation for several performance metrics (e.g., career approximate value; sacks, tackles, rushing yards). Further, specific factors of the AIQ are related to position specific statistics, offering the possibility that performance prediction can be focused in for the specific skills required by a given position.
    Discussion
    Given the recent impact of analytics in professional sports, and the significant findings noted in the current investigation, the authors discuss the potential importance of the AIQ in the selection and coaching processes.


  • 2020, November

    case study

    Role of Low-Level Laser Therapy as an Adjunct in the Management of Diabetic UlcerOpen Access

    Shijina Koliyath, Ravi K. Chittoria*, Chirra L. Reddy, Padmalakshmi B. Mohan. Imran Pathan, Neljo Thomas and Nishad Kerakada
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-116
    Provisional PDF328.58 KB 328.58 KB
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    Abstract [+]

    Diabetes mellitus (DM) is a chronic debilitating condition affecting people worldwide and diabetic foot ulcers are also a common problem. The treatment of diabetic ulcers requires a multimodal approach. Adjuvant low-level laser therapy (LLLT) may be useful in lesions with protracted healing course but the evidence is still limited. In this study, we share our experience regarding the use of low-level laser therapy as an adjuvant treatment modality in a patient with diabetic foot ulcer.
    Keywords
    Low-level laser therapy; Diabetic ulcer.


  • 2020, November

    original research

    Prevalence and Economic Significance of Hydatidosis on Cattle Slaughtered at Nekemte Municipal Abattoir, Western EthiopiaOpen Access

    Tuge Temesgen*
    DOI: https://dx.doi.org/10.17140/VMOJ-5-150
    Provisional PDF349.75 KB 349.75 KB
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    Abstract [+]

    Aim
    The study was conducted to determine the prevalence of hydatidosis, to identify the association between expected risk factors and occurrence of the disease, to investigate economic importance and to evaluate fertility and viability of the hydatid cyst in cattle slaughtered at the abattoir.
    Materials and Methods
    A cross-sectional study, which involves both ante-mortem and post-mortem examination, was conducted at Nekemte municipal abattoir from November 2015 to March 2016.
    Results
    A total of 355 local cattle breed was randomly sampled and examined for the presence of hydatid cysts in the organs of the animals using the standard meat inspection procedures, 66 (18.6%) animals were found harboring hydatid cysts. Statistical analysis showed that there was a significant difference (p<0.05) between the prevalence of bovine hydatidosis in all risk factors with exception of sex of the animals. Among 207 hydatid cysts recorded, 93 (44.92%) were from lungs, 65 (31.40%) from livers, 4 (1.93%) from heart, 3 (1.44%) from kidney, 1 (0.48%) from spleen and 41 (19.8%) were in two organs from lung and liver. Fifty-seven (57) of these 207 cysts were randomly selected and subjected to fertility and viability test which revealed 19 (33.33%) as fertile, 25 (43.86 %) sterile and 13 (22.81%) calcified. Viability test proved 7 (12.28%) of 19 fertile cysts as viable and 12 (21.05%) of 19 fertile cysts as non-viable. Viability of cysts in different organs revealed that 5 (16.1%) and 2 (10%) of cysts from lungs and liver, respectively. The estimated financial loss during the study period both due to condemnation of organs and an in direct carcass weight loss from hydatidosis was 2,190,143.52 ETB.
    Conclusion
    The results of this study revealed that bovine hydatidosis was an economically important disease of cattle which need serious attention for prevention and control actions in and around Nekemte. Hence, establishment of well-equipped standardized abattoirs, prohibition of backyard slaughter, creation of public awareness, deworming and control of stray dogs are of paramount importance.
    Keywords
    Abattoir; Cattle; Economic loss; Hydatidosis; Nekemte; Prevalence.


  • 2020, November

    original research

    Seventy Cases of Partial Gastric Pull-Up According to the Schärli Technique for Esophageal Replacement in PediatricsOpen Access

    Martín Rubio, Mariano Boglione*, Carlos Fraire, Silvia Takeda, Cristian Weyersberg, Fermín Prieto and Marcelo Barrenechea
    DOI: https://dx.doi.org/10.17140/PNNOJ-7-131
    Provisional PDF336.82 KB 336.82 KB
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    Abstract [+]

    Introduction
    Esophageal replacement (ER) is indicated in patients with long gap esophageal atresia (LGEA) or failure of the primary anastomosis. Also, severe caustic or peptic strictures, resistant to conservative treatment with medication and dilations, may require an ER. Numerous techniques with different organs and routes have been described, all with satisfactory results.
    Objective
    Our objective is to describe the experience obtained with partial gastric pull-up according to the Schärli principles (SGPA).
    Materials and Methods
    Medical records of patients who required a SGPA between October 1995 to June 2018 were reviewed. The analysis was observational, longitudinal, retro-prospective and descriptive. Epidemiological data, surgical aspects and postoperative complications of the patients were considered.
    Results
    Seventy ER were performed with SGPA. The indication was esophageal atresia (EA) in 58 cases (44 long gap and 14 failure of the anastomosis), 10 caustic strictures, one peptic stricture resistant to conservative treatment and the other due to a retained foreign body. The age of the ER was on average 2-years and 9-months. The route was: posterior mediastinal (35), retrosternal (29) and transpleural (6); without a thoracic approach in 59 patients. The duration of the procedure was 4.7-hours on average. There were 13 cases of intraoperative complications, 8 cases of pneumothorax, 5 bleeding injuries (3 in the spleen, 1 liver and 1 cervical), and one injury to the cervical trachea. Anastomotic dehiscence was observed in 37 patients (52%), which closed spontaneously after an average of 17.8-days in all except one patient. Thirty-one patients (44%) developed anastomotic stenosis, requiring redo anastomosis in 6 cases; 37% developed dumping and 23% gastroesophageal reflux disease. There were 3 deaths (4.2%): all in EA patients with associated malformations, following a morbid postoperative period with infectious complications in intensive care at 10-days, 7 and 8-months after ER. Follow-up was an average of 8-years. All 67 living patients are currently tolerating oral feeding.
    Conclusion
    In our experience with ER using SGPA, we observed a high incidence of complications, generating a longer post-operative evolution and with greater morbidity than that described in other techniques. Given these results, we changed our strategy to complete gastric transposition, in order to reduce morbidity and improve the evolution of this complex group of patients.
    Keywords
    Esophageal replacement; Partial gastric pull-up; Esophageal atresia; Caustic stricture.


  • 2020, December

    mini review

    The Effects of Societal and Structural Barriers on Participation among Individuals with Physical DisabilitiesOpen Access

    Nathan Perkins*
    DOI: https://dx.doi.org/10.17140/SEMOJ-6-181
    Provisional PDF316.79 KB 316.79 KB
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    Abstract [+]

    The 2008 Physical Activity Guidelines recommend that the more than 53 million people living with a physical disability in the United States to participate in regular physical activities consisting of both aerobic and anaerobic components, if possible. Also, if individuals with physical disabilities are unable to meet the recommended physical activity guidelines, they are encouraged to do as much as their physical disability permits. Despite the recommended guidelines, several individuals with physical disabilities do not participate in regular physical activities. Prior research suggests that several societal and structural barriers in sport and exercise environments often negatively affect individuals with physical disabilities. Thus, it is essential for family members, healthcare practitioners, rehabilitation/recreational teams, and community leaders to encourage individuals with physical disabilities to conquer barriers that restrict participation.


  • 2020, December

    case series

    Natural Honey as a Safe and Efficacious Alternative to Skin Grafting Post-Surgical Excision for Necrotizing Fasciitis at Primary Care Level: A Preliminary StudyOpen Access

    Badryia Al Lenjawi, Rasheed Prieiyl, Diovanni Mendoza, Lowlwa Al Meslamani and Hashim Mohamed*
    DOI: https://dx.doi.org/10.17140/DRMTOJ-5-143
    Provisional PDF563.09 KB 563.09 KB
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    Abstract [+]

    Necrotizing fasciitis is a soft tissue bacterial infection that spreads rapidly resulting in the destruction of muscles, skin, and underlying tissue. Necrotizing fasciitis is defined as a fast and progressive inflammatory infection of the fascia leading to secondary necrosis of the subcutaneous tissue moving along the facial plane. Fournier gangrene is a type of necrotizing fasciitis involving the scrotum and perineal area. Patients suffering from acute necrotizing fasciitis require an effective regimen which includes surgical removal of devitalized tissues, systemic antimicrobials and mitigating underlying systemic disease processes. The burden of treating wounds following surgical debridement, on the other hand, can be challenging especially in the third world where resources are scarce resulting in suboptimal wound coverage and function. At primary care level we had the opportunity of using natural honey in 5 patients with non-healing wounds in either the lower limb or scrotum due to acute necrotizing fasciitis. This natural noninvasive approach offers a cost-effective and efficacious alternative to dermatotraction, skin grafting and negative pressure wound therapy. In these patients, the use of natural honey led to the restoration of the appearance and function of the fasciotomy wound especially in patients with co-morbidities or those refusing skin grafting due to cost, religious factors, etc. The authors present the clinical results followed by a discussion on the therapeutic properties of natural honey. This case series demonstrates the efficacy of topical raw honey as a catalyst for speeding the healing process by secondary intention thereby offering a safe and efficacious
    alternative for managing various wounds resulting from acute necrotizing fasciitis.
    Keywords
    Natural honey; Necrotizing fasciitis; Primary care; Wounds.


  • 2020, December

    opinion

    The Right to Abortion in North MacedoniaOpen Access

    Daniela Antonovska*
    DOI: http://dx.doi.org/10.17140/WHOJ-7-139
    Provisional PDF263.99 KB 263.99 KB
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    Abstract [+]

    Equitable access to safe abortion is part of the corpus of human rights. Providing women with access to safe abortion means protection and realization of one of their fundamental human rights. However, around the world, even nowadays, women face not only legal obstacles, but as well stigmatization and conviction against fulfillment of the right to abortion. In North Macedonia there a multiple type of barriers and large inequalities related to the accessibility and availability of reproductive healthcare
    services. Women with low socio-economic status are mostly affected. The need for contraception has not been met and reproductive healthcare services are unevenly distributed across the country.
    Keywords
    Laws; Abortion; Safe; Women’s sexual and reproductive rights; Healthcare services.


  • 2021, January

    case series

    The Promise of Small Data for Telemedicine in Chronic Condition Management: A Real-World Case SeriesOpen Access

    Steven M. Schwartz*, Brigid Byrd, Helen Dempster and Tim Payne
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-117
    Provisional PDF578.99 KB 578.99 KB
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    Abstract [+]

    Connected care is defined as the “real-time, electronic communication between a patient and a provider, including telehealth, remote patient monitoring, and secure email communication between clinicians and their patients” (Alliance of Connected Care). Connected care can create a high-value interaction strategy with patients when it makes thoughtful use of commercially available digital health technologies with demonstrated both clinical and economic effectiveness. Karantis360™, is a home sensor technology that enables real-time tracking, data analytics and predictive care for personal (at home) care powered by IBM Watson Health. IndividuALLyticsTM is a telemedicine platform driven by a patent-pending an N-of-1 analytical engine and related digital dashboards that provides individual, patient level evaluation of treatment response. The underlying technology combines disparate digital health technology data with the best evidence-base guidelines with N-of-1 methodology. The output allows for creation of personalized treatments empirically tested at the patient level over time (aka over the course of care). When aggregated both within and across persons,
    the time-ordered data can build predictive pathways of behavior and ensure the relevant care and medical treatments are in place to support effective medical and self-management of chronic illness. This case-series report describes the implementation of a joint home sensor technology (big data) and an N-of-1 analytic engine (small data) with three elderly consented volunteer customers-patients of Karantis360™. Each person underwent successive, 2-week behavioral change treatment phases to determine usability, utility regarding medical and self-management and any proximal effects on health risks.
    Keywords
    Telemedicine; Small data; n-of-1; Internet of things; Chronic conditions; Self-management; Predictive analytics.


  • 2021, January

    case report

    Prolonged Cardiac Arrest in Severe Bupropion Intoxication: Everything You Should Know About Anti-Arrhytmics, Transesophageal Echocardiography Guided Resuscitation and Extracorporeal Membrane OxygenationOpen Access

    Caitlin Celis, Melvin Willems, Ben Pellens and Stefanie Vandervelden*
    DOI: http://dx.doi.org/10.17140/EMOJ-7-158
    Provisional PDF474.59 KB 474.59 KB
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    Abstract [+]

    A 30-year-old woman was admitted to the emergency department one and half hours after severe bupropion extended-release intoxication, estimated to be between 18 and 36 g. She initially presented with seizures and later developed signs of cardiotoxicity with persisting sustained ventricular tachycardia. Despite multiple defibrillation attempts and the administration of sodium bicarbonate,
    calcium gluconate and magnesium, restoration of sinus rhythm was found unsuccessful. In another attempt to treat this refractory ventricular tachycardia lidocaine was given followed by deterioration to asystole. During cardiopulmonary resuscitation (CPR), the quality of chest compression was assessed and optimised using transoesophageal echocardiography. Eventually venoarterial extracorporeal membrane oxygenation (VA-ECMO) was needed to achieve hemodynamic stability. In this case report we discuss the successful use of VA-ECMO after bupropion intoxication, which has only been reported in 3 other cases but should be considered as one of the treatment options in severe overdose cases. Also, the rare complication of asystole after lidocaine administration and the value of transoesophageal echocardiography during CPR will be discussed.
    Keywords
    Bupropion; Intoxication; Extracorporeal membrane oxygenation; TEE guided resuscitation; Antiarrhythmic therapy.


  • 2021, January

    editorial

    Nothing is SimpleOpen Access

    Mark Wesson*
    DOI: https://dx.doi.org/10.17140/EPOJ-6-e002
    Provisional PDF198.30 KB 198.30 KB
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  • 2021, January

    original research

    Barriers to Community Integration for Older People in Malaysia: A Qualitative Study from Occupational Therapist PerspectivesOpen Access

    Yau Y. Hui, Nathan Vytialingam and Sangeeta K. Singh*
    DOI: https://dx.doi.org/10.17140/PHOJ-6-152
    Provisional PDF383.46 KB 383.46 KB
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    Abstract [+]

    Introduction
    Existing research has addressed the importance of community integration (CI) and its benefits of dwelling in a community but has yet to address the methods and efficiency of improving these activities among older people. Thus, it is vital to understand how healthcare workers can integrate the benefits of CI among older people, especially with the use of occupational therapists (OTs). The latter are actively working to improve ageing individuals mobility within the community.
    Objective
    This study aims to identify Malaysian OTs’ perspectives on CI’s and its implication on older people.
    Method
    Occupational therapist from different states of Malaysia participated in a semi-structured interview, through a virtual medium (Zoom Cloud Meetings). The interview guide encapsulated the theory of critical incident technique (CIT).
    Results
    Thematic content analysis, over fourteen participants from 13 states of Malaysia, provided insights into CI’s barriers for older people in Malaysia. The findings revealed that multifaceted factors from an individual, organisational and socio-environmental perspective limit older people’s active CI engagement.
    Conclusion
    South-East Asia hierarchal and collectivist culture play a significant role in influencing all factors of CI. OTs must understand and incorporate appropriate cultural norms during CI practice development for the older population in Malaysia.
    Keywords
    Occupational therapist; Critical incident technique; Older people; Community integration; Qualitative study; Societal norms; Cultural norms.


  • 2021, January

    mini review

    Coronavirus Disease-2019 Clinical Trial Case Studies Within the Biotechnology and Clinical Research Organizations IndustryOpen Access

    Melanie K. Pearce and Nathanael E. Hughes*
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-118
    Provisional PDF290.07 KB 290.07 KB
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  • 2021, January

    original research

    The Effects of the Oral Supplementation with a Natural Keratin Hydrolysate (Kera-Diet®) on Hair and Nails: Randomized, Placebo and Benchmark-Controlled Clinical Trial on Healthy FemalesOpen Access

    Vincenzo Nobile, Francesco Tursi, Enza Cestone, Renaud Sergheraert and Joel Duperray*
    DOI: http://dx.doi.org/10.17140/TCOJ-1-115
    Provisional PDF1.03 MB 1.03 MB
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    Abstract [+]

    Background
    Telogen effluvium (TE) and its acute form (aTE) are two of the commonest occurrences in a trichology clinic, with patients claiming excessive hair shedding. ATE can occur in people of any age and ethnicity and is considered to be a quite common condition in either sex even if women are more likely to have a lowered quality of life and restricted social contacts as compared to men as a result of hair loss. Brittle nail syndrome (BNS) is a common condition affecting up to 20% of the population, especially women over 50 years of age. Nails affected by BNS appear ragged, thin, and dull. The clinical features of BNS include horizontal splits within the nail plate (onychoschizia) and increased longitudinal ridging or splitting (onychorrhexis). In BNS oral supplementation, trace elements and amino acids (especially L-Cystine) have been reported to be useful to ameliorate the nail plate condition.
    Objective
    We hypothesized that a nutritional approach, with nutrients of which the composition is close to the human keratin, could be effective to decrease hair loss during telogen effluvium and to improve brittle nails condition. At this purpose, a clinical study was designed to investigate the efficacy of a natural keratin hydrolysate obtained from a non-human source (feathers) on both aTE and BNS.
    Methods
    The in vivo effects of a natural keratin hydrolysate, Kera-Diet® (KD) upon human hair and nails condition was tested in a randomized, double-blind, parallel-group, benchmark (BE) and placebo (PL) controlled study involving 60 women during 90 days. In all subjects, Anagen/Telogen hair, hair volume and density, pull test, global photography, hair and nails brightness, and nail plate
    growth were measured at baseline and after 45 and 90 days of products use. A self-assessment test was carried out at the end of the study.
    Results
    With the KD treatment group, hair density, percentage of hair in anagen phase, hair and nails brightness, and nails growth were significantly increased compared to PL treatment group. Interestingly, with this same group, the diagnosis of aTE by pull testing was negative from 45 days. The efficacy of KD was equal to or greater than PL treatment group.
    Conclusion
    In this study, we demonstrated that daily oral administration of 1000 mg during 3 months of a natural extensively keratin hydrolysate, Kera-Diet®, associated to trace elements and specific vitamins was effective to improve both hair and nails condition. Furthermore, it demonstrates the role of nutrients in both aTE and BNS.
    Keywords
    Keratin hydrolysate; Oral supplementation; Telogen effluvium; Hair growth; Brittle nail syndrome; Onychoschizia; Clinical study.


  • 2021, February

    original research

    Development of Yoghurt Spread from Goat Milk and its Qualitative Valorization Using Chia Seed OilOpen Access

    Sana Shahid, Ali A. Leghari, Maira Anam, Tayyaba Gull, Jahanzaib Ashraf, Hafsa Tahir, Humna Liaqat and Muhammad W. Iqbal*
    DOI: https://dx.doi.org/10.17140/AFTNSOJ-7-172
    Provisional PDF975.72 KB 975.72 KB
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    Abstract [+]

    Aim
    Present study was conducted with a theme to develop yoghurt spread from goat milk owing to its therapeutic significance and ameliorate nutritional value and quality of the finished product via supplementation of chia seed oil.
    Methodology
    Four treatments (T0, T1, T2 and T3) possessing varying concentrations of chia seed oil (0, 2, 4 and 6%) were formulated and the first was opted as control. Samples were evaluated on 0th, 10th and 20th day for physicochemical (pH, acidity, TSS, total protein, fat), microbiological (total plate count) and sensory acceptance.
    Results
    Significant changes (increasing or decreasing trends) were perceived in all physicochemical parameters as the storage span progressed however minute differences were observed among different treatments except moisture content which varied significantly among different formulations. Total microbial count also increased with increase in storage days however decreased with increase
    in concentration of chia seed oil. Sensorial attributes particularly product acceptability was considerably reduced at the end of storage period.
    Conclusion
    Generally, addition of chia seed oil at different concentration to yoghurt spread improves the sensory properties and overall acceptability, extends the shelf life and enhances nutrition values. Goat milk is preferable to cow milk owing to essential nutrients it provides to infants and substantial therapeutic significance.
    Keywords
    Yoghurt spread; Goat milk; Chia seed oil; Qualitative valorization; Shelf life.


  • 2021, February

    opinion

    Legalities in All Wound Care Negligence of CareOpen Access

    Lydia A. Corum*
    DOI: http://dx.doi.org/10.17140/EMOJ-7-159
    Provisional PDF254.44 KB 254.44 KB
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  • 2021, February

    short communication

    Ethical Challenges to Respecting and Meeting Patients’ Requests: Lessons from Providing Palliative Care for Coronavirus Disease 2019 PatientsOpen Access

    John Weru*
    DOI: http://dx.doi.org/10.17140/PMHCOJ-7-141
    Provisional PDF328.24 KB 328.24 KB
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  • 2021, February

    retrospective study

    Paediatric Urolithiasis an Emerging Concern: Single Centre Experience in a Non-Endemic Region in South IndiaOpen Access

    Krishna M. B.Vijayaraghavan*, Rohan Rajendran, Appu Thomas and Anil Mathew
    DOI: https://dx.doi.org/10.17140/UAOJ-5-136
    Provisional PDF405.54 KB 405.54 KB
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    Abstract [+]

    Introduction
    Paediatric urolithiasis is an emerging disease in developing nations especially in India, but a rarer entity compared to its adult counterpart. There is significant geographic variation in the incidence of urolithiasis within India itself. Given the changing dynamics of the disease, this study evaluated paediatric urolithiasis patients in a non-endemic region in South India.
    Methods
    This is a retrospective study of children and adolescents diagnosed with urolithiasis from January 2009 to December 2019 in a single tertiary care centre in South India. The purpose of this study was to investigate and identify the demographic and clinical characteristics, aetiology, management, clearance rates after surgical intervention and disease recurrence of paediatric stone disease
    in a non-endemic region in South India.
    Results
    We evaluated 29 patients which included a total of 97 hospital admissions. Predominantly the study population consisted of males (80.0%), with a mean age of symptom onset of 9.44±5.53-years. All patients were metabolically evaluated, 16 patients (55.2%) had metabolic abnormalities and the most common abnormality was hypocitraturia (37.5%). Spontaneous elimination rate was 6.9% and clearance rates for surgical procedures ranged from 72% to 100%. Recurrent stones were seen in 37.9%. No patient developed chronic kidney disease or mortality due to stone disease within the evaluation period of this study.
    Conclusion
    Paediatric urolithiasis is an emerging disease in India. There is a high prevalence of metabolic abnormalities in paediatric stone disease which supports the need for metabolic evaluation in all cases. There is more similarity of our study with western literature than the available Indian data which may be due to the lifestyle changes, significant geographic variation within India itself between
    endemic and non-endemic regions or changing epidemiology of paediatric stone disease per se.
    Keywords
    Paediatrics; Urolithiasis; Urinary tract infection (UTI).


  • 2021, February

    original research

    Treatment of Acute Antibody-Mediated Rejection in Children Post-Kidney Transplantation: A Single Center’s ExperienceOpen Access

    Issa Alhamoud, Ei Khin, Rong Huang, Lesli McConnell, and Mouin G. Seikaly*
    DOI: https://dx.doi.org/10.17140/NPOJ-6-125
    Provisional PDF418.90 KB 418.90 KB
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    Abstract [+]

    Introduction
    Acute antibody-mediated rejection (aAMR) can negatively impact renal allografts outcomes. To date, there has not been a consistent therapeutic approach to manage aAMR. The aim of the study is to evaluate the tolerance and efficacy of an institutional protocol of methylprednisolone, intravenous gamma globulin (IVIG), rituximab, and bortezomib used to treat aAMR in pediatric renal transplant recipients (pRTRs).
    Methods
    A retrospective chart review was performed on 10 pediatric renal transplant recipients (pRTRs) who were diagnosed with aAMR on a renal biopsy performed between January 2014 and November 2015.
    Results
    Over the study period, 9.5% of pRTRs had aAMR. Sixty percent of whom had concurrent acute cellular rejection (ACR). Renal allografts survival was 100% during the the first post-aAMR. At the time of diagnosis of aAMR, estimated glomerular filtration rate (eGFR) had decreased by 42% (mean at baseline eGFR=67.2±19.5 mL/min/1.73 m2 vs mean at aAMR eGFR=38.9±14.2 mL/min/1.73 m2; p=0.002). At 1-year post rejection, eGFR had increased by 26% as compared eGFR at the time of rejection (mean eGFR=49.0±13.2 mL/min/1.73 m2; p=0.006). Immuno-dominant donor-specific anti-HLA antibody titers (iDSAs) class I and class II decreased by 69% and 15% at 6-month follow-up visit. No serious opportunistic infections nor malignancy were reported in our subjects.
    Conclusion
    Our study suggests that our protocol improved kidney function with 100% graft survival at 1-year post aAMR episode. The percentage decline in iDSAs class I titers was more significant than class II. Furthermore, our treatment protocol was well-tolerated with no life threatening complications.
    Keywords
    Acute antibody-mediated rejection (aAMR); Intravenous gamma globulin (IVIG); Pediatric renal transplant recipients (pRTRs).


  • 2021, February

    Surrogacy: A Novelty Concept in North MacedoniaOpen Access

    Daniela Antonovska*
    DOI: http://dx.doi.org/10.17140/WHOJ-7-140
    Provisional PDF301.00 KB 301.00 KB
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    Abstract [+]

    Surrogacy has existed since ancient times. Depending on the way of creating an embryo, two types of surrogacy differ, traditional and gestational. When it comes to monetary compensation, two types of surrogacy exist, altruistic and commercialized. A lot of questions come to light such as: Is the altruistic surrogacy a humane gesture for all contracted parties? What if the mother changes her mind? Do the babies born of surrogacy mothers have rights? In North Macedonia, surrogacy was introduced for
    the first time in 2014 in the amended Law on Biomedicine and Assisted Fertilization. It was a novelty having in mind that in the Law of 2008 the surrogacy as a practice was outlawed. The amended law applies the term gestational mother and provides a
    liberal stance, but many provisions are unclear.
    Keywords
    Laws; Gestational carrier; Commercialization; Altruism; Child rights; Health consequences.


  • 2021, February

    original research

    Design and Validation of the Quality of Work Life Scale for Call Center Workers of a Private Company in Downtown of Lima, 2019Open Access

    Joanne E. M. Yllescas*
    DOI: https://www.doi.org/10.17140/PCSOJ-6-158
    Provisional PDF429.78 KB 429.78 KB
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    Abstract [+]

    Objective
    The purpose of the research was to build a scale of quality of working life, in telemarketers of a call center company in Downtown of Lima, with a sample of 700 telemarketers.
    Methods
    The methodology was obtained through a non-probabilistic convenience sampling, the validity was carried out through the judgment of 10 experts and the indices were obtained using the V. of Aiken p>0.80 and the Binomial test p<0.05 in 29 questions.
    The construct validity was obtained through confirmatory factor analysis, to explain the quality of working life composed of five dimensions according to Maslow’s theory.
    Results
    In the results, the Kaiser Meyer Olkin (KMO) measurement test yielded a value of 0.930, which means that it is greater than>0.80 over the number of observations for the base of respondents (700), for the test of Bartlett’s sphericity. is not significant
    (p<0.05), which means a correlation between the variables, in the total variance explained indicates that the instrument has five factors that explain 54.982% of the total variance, it tells us that the test is acceptable, whose factorial the loads ranged between 0.4 and 0.8 respectively. The reliability by internal consistency with a value of 0.919.
    Conclusion
    The relevance of the theoretical model to explain the quality of working life composed of five dimensions according to Maslow’s theory was verified, showing adequate adjustment indices: X2/gl=4.920 and 4.711, CFI=0.835 and 0.90, RMSEA=0.075 and
    0.073, except TLI=0.805 and 0.815 that did not show an adequate value.
    Keywords
    Quality of work life; Quality-of-life; Design; Validation; Psychometry.


  • 2021, February

    systematic review

    A Shared Information Technology-Business-Health Model: Lessons for Healthcare Leaders on Integrating Technology from InvestmentOpen Access

    Donald M. Hilty*, John Luo, Evangelina Giron and Dong-Gil Ko
    DOI: https://www.doi.org/10.17140/PCSOJ-7-159
    Provisional PDF766.27 KB 766.27 KB
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    Abstract [+]

    Objective: Technology is rapidly shifting our day-to-day existence, education, social relationships, health care and business. Psychiatric leaders have slowly explored telepsychiatric services – but few have an approach to technology in general–due to
    competing clinical, educational and research demands. Technology has typically been added on, rather than integrated, to institutional functions.
    Method: This narrative review used a literature search of Medline, PsycNET, PsycINFO, Embase, Cochrane, SpringerLink, Scopus, ABI/Inform, Business Source Complete, and Web of Science, using subject headings and keywords along with a manual search of reference lists of articles published by November 2020. The keywords explored four areas: 1) business; 2) service delivery; 3) system change; and 4) technology. Articles were reviewed by title/abstract, full text review and review of references. They were included if they discussed integration of technology into health care and compared literature from medicine/health, psychiatry/behavioral health, business, technology, leadership and health care administration. The goal was to explore how medicine/psychiatry has integrated technology compared to business, and apply business approaches to health care and training.
    Results: From a total of 2,710 potential references, two authors found 327 eligible for full text review and found 69 papers directly relevant to the concepts. Business and medicine/psychiatry have similarities/differences from both historical and contemporary views. Many health care systems and companies lack a strategic plan for technology and focus only on short-term due to administrative demands. Clinical informatics is a rapidly expanding area and would be central to this process. It has started to facilitate patient-centered care as defined by quality, affordable, and timely health care. While in principle information systems use integrative approaches, electronic health records, electronic means of communications with patients and staff, behavioral health indicators and related digital advances are often added to existing systems rather than integrated. Effective businesses use integrative approaches to share domain knowledge and streamline practices to link information technology (IT) with research and development, production, financing and marketing management. A case example highlights the IT strategy and business leaders’ comments in shifting to straight through processing (STP) from the banking industry for investments. It also exemplifies a model of shared IT-business understanding, which improves performance via efficiency, quality of data/information processing/integration and managerial teamwork.
    Conclusion: When it is integrated into health care service delivery workflow, evaluated and quality improved, IT facilitates the translation of strategic planning into organizational change. Incremental versus strategically innovative approaches to technological integration for care, education and administration are considered. Successful implementation requires a needs and impact assessment for patients, staff, clinicians and leaders across all levels of the organization. Benefits to the mission, limited disruptions of core operational workflow and reasonable costs reduce the likelihood of failure.
    Keywords
    Health care; Business; Information technology; Shared; Leadership; Understanding; Straight through processing.


  • 2021, February

    opinion

    My 84-Year-Old Mother Lost Her Wedding Ring?Open Access

    Michael S. Kennedy*
    DOI: https://www.doi.org/10.17140/PCSOJ-7-160
    Provisional PDF271.62 KB 271.62 KB
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  • 2021, February

    Autopsy Data to Refine Healthcare Quality: A Fresh PerspectiveOpen Access

    Jawahar (Jay) Kalra*, Zoher Rafid-Hamed and Patrick Seitzinger
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-e004
    Provisional PDF327.67 KB 327.67 KB
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  • 2021, February

    original research

    Pain and Pain Management in Veterinary Medicine: A ReviewOpen Access

    Endeg Alamrew and Haben Fesseha*
    DOI: https://dx.doi.org/10.17140/VMOJ-5-151
    Provisional PDF492.58 KB 492.58 KB
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    Abstract [+]

    Pain is the distress feeling, most commonly encountered in diseases, which accompanies from an early age and it is one of the important aspects of determining the level of well-being of animals. Pain is more complex in animals and it can rather difficult to determine the seriousness and impact of painful events. Hence, we have to identify the signs of pain in animals consistent with indirect markers which involve behavioral, physiological, and at last clinical responses. Moreover, specifically, the behavioral changes related to pain will be together with the overall signs also species-specific and hardly recognizable especially for an inexperienced observer seemingly unimportant which makes pain assessment even more complicated. The veterinarians have an ethical responsibility to assist in alleviate the animal pain. Although most veterinarians accept the actual fact that animals feel pain, still, post-operative pain relief isn’t a routine practice in veterinary hospitals and clinics today the feeling and assessment of pain are subjective. The assessment of pain and also the documentation of the effectiveness of any interventions are fundamental principles of successful pain management. The most important aim is pain management while efforts are made to spot and treat the underlying disease and to reinforce healing and recovery. Adequate management of acute pain may additionally prevent the event of chronic pain.
    Keywords
    Animal; Pain assessment; Pain; Pain management.


  • 2021, February

    case report

    A Case of Glomus Tympanicum During Stapedotomy Surgery for OtosclerosisOpen Access

    Leonardo Ordoñez-Ordoñez*, Fabio Leon and Juanita Beltran
    DOI: https://dx.doi.org/10.17140/OTLOJ-7-162
    Provisional PDF334.21 KB 334.21 KB
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    Abstract [+]

    Glomus tympanicum is a tumor classified as a paraganglioma. We report a case of a 66-year-old female with two middle ear pathologies: an incidental finding of a glomus tympanicum during stapedotomy surgery for otosclerosis.
    Keywords
    Glomus tympanicum; Otosclerosis; Paraganglioma; Stapedotomy.


  • 2021, April

    original research

    Immunotoxic Effects of Cypermethrin in Male Wistar Rats: Attenuation by Co-Administration of Zinc and Alpha-Lipoic AcidOpen Access

    Anurag Paramanik, Angsuman D. Chaudhuri, Barun Chakraborty, Dibyendu Giri, Anirban Majumder, Debjani Chatterjee, Ananya Pradhan, Prasanta Maiti and Sujata M. Choudhury*
    DOI: https://dx.doi.org/10.17140/TFMOJ-6-135
    Provisional PDF571.46 KB 571.46 KB
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    Abstract [+]

    Aim
    The present study investigated the effects of cypermethrin exposure on humoral and cellular immune response in rat and its attenuation by zinc and alpha-lipoic acid.
    Methods
    Cypermethrin at the dose levels of 40 mg and 80 mg/kg body weight were orally administered and pre-treatment of zinc (227 mg/L in drinking water) and alpha-lipoic acid (35 mg/kg body wt.) were done. Total leukocyte and differential leukocyte counts (DLC), phagocytic index, serum nitric oxide (NO) activity, total immunoglobulin concentration, quantitative hemolysis, proliferation assay of blood mononuclear cells were estimated and histological examination of spleen was accomplished.
    Results
    Total white blood cell (WBC) count and percentage of lymphocyte, serum nitric oxide activity (p<0.001) and quantitative hemolysis were increased significantly increased whereas neutrophil %, total serum immunoglobulin, and blood mononuclear cell proliferation (p<0.001) and the phagocytic function of peritoneal macrophages were significantly reduced in cypermethrin treated rats compared to control group rats at a dose-dependent manner. Zinc and alpha-lipoic acid pre-treatment reversed the results. Conclusion From the findings it can be concluded that the co-administration of zinc and alpha-lipoic acid significantly attenuated the immunotoxic effects in cypermethrin exposed rat. Keywords Cypermethrin; Zinc and alpha-lipoic acid; Total serum immunoglobulin; Blood mononuclear cell proliferation; Phagocytic index.


  • 2021, April

    original research

    Psychological Effects of Coronavirus Disease 2019 on StudentsOpen Access

    Sreeja R. Kuppam*
    DOI: https://www.doi.org/10.17140/PCSOJ-7-161
    Provisional PDF612.02 KB 612.02 KB
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    Abstract [+]

    Background
    This qualitative study investigated the psychological effects on 21 U.S. high school students during the coronavirus disease 2019 (COVID-19) pandemic.
    Aim
    The study aimed to identify and assess the pandemic’s effect on the mental health of these students.
    Method
    To determine the stress and anxiety students faced during the pandemic, an online survey used five open-ended questions that focused on awareness of the pandemic surrounding the major themes of insight, stress, anxiety, social support, and adapted coping strategies. NVivo software analyzed the raw data. Colaizzi’s descriptive phenomenological analysis method converted the quantitative results into a visual/verbal form. Based on the analysis, the researcher identified the pandemic’s effects on students’ mental health and well-being.
    Results
    All 21 participants responded to each of the five questions. Of the participants, 72% demonstrated a negative outlook on their future. Seventy percent (70%) of the participants felt that COVID-19 hurt their social life because of safety precautions, such has social distancing. Even though schools and their faculty tried to keep students engaged and active, 64% of the participants found it challenging to be physically distanced from friends and teachers while learning from home. Of the students, 62% worried about missing out on sports and activities canceled due to the pandemic. 63.14% of the students felt the pandemic stressed
    them to the point that fear and anxiety overwhelmed them with many questions about the future.
    Conclusion
    This study’s results may help create programs that better meet students’ mental and social needs.
    Keywords
    COVID-19; Pandemic; High school; College students; Mental health; Stress; Anxiety; Coping strategies; Depression.


  • 2021, April

    case report

    Using PF-MOUTH GELTM for Sore or Painful Tongue Improved Symptoms and Stabilized Dryness and Trapping of Food: A Case ReportOpen Access

    Shuichi Tsubura*, Masahide Kanazawa, Shunya Oka, Rika Hirama and Tsutomu Tsubura
    DOI: https://dx.doi.org/10.17140/DOJ-6-143
    Provisional PDF947.48 KB 947.48 KB
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    Abstract [+]

    We describe herein the case of a 72-year-old woman with persistent and symptomatic sore or painful tongue (SPT) treated using PF-MOUTH GELTM (PF-Gel; Daiichi-Sangyo, Osaka, Japan), which includes 30% fucoidan and 0.75% sword bean. PF-MOUTH GELTM was applied to the tongue and kept in place for 3-min. Application was performed twice a day (morning and evening) for 3-months, and resulted in marked improvement of symptomatic sore or painful tongue. Because only one case was reported in this study, clinical trials are required to confirm the efficacy and safety of topical PF-MOUTH GELTM for the treatment of symptomatic sore or painful tongue.
    Keywords
    Tongue; Fucoidan; Inflammation; Treatment; Gel.


  • 2021, April

    original research

    Comparative Study of the Antimicrobial Activity of Clove Oil and Clove Extract on Oral PathogensOpen Access

    Charu Gupta* and Dhan Prakash
    DOI: https://dx.doi.org/10.17140/DOJ-6-144
    Provisional PDF344.51 KB 344.51 KB
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    Abstract [+]

    Objective
    The main objective of the present study was to do the comparative study of clove oil and clove extract on the oral micro-biota causing dental caries and also to assess the antifungal activity.
    Materials and Methods
    The antimicrobial activity of clove oil and clove extract was assessed against Halobacterium sp., Lactobacillus sp., Pseudomonas sp., Micrococcus sp. and Streptococcus mutans (major causative bacteria of dental plaque) by the paper disc diffusion method. For each extract
    three replicate trials were conducted against each organism. The antifungal activity of clove oil and extract was also assessed against seven fungal species (Aspergillus niger, A. fumigatus, Aspergillus sp., Alternaria sp., Rhizomucor sp., Rhizopus sp. and Penicillium sp.)
    by agar disc diffusion method.
    Results
    Both clove oil and clove extract was found to exhibit broad spectrum of antibacterial activity inhibiting all the ten test bacterial species involved in dental caries. Clove oil produced maximum inhibition zone of diameter (IZD) against the major causative bacteria of dental plaque as compared to clove extract, thereby, showing that clove oil possesses strong bactericidal activity against oral pathogens. The highest inhibition zone of diameter was observed by clove oil as compared to clove extract against the test fungal species
    Conclusion
    The clove oil has the potential to be used as a natural antibacterial agent for oral pathogens.
    Keywords
    Syzygiumaromaticum; Clove extract; Clove oil; Antimicrobial; Oral pathogens.


  • 2021, April

    case report

    Ultra-Early Cord Decompression in the Emergency Setting and its Impact on OutcomeOpen Access

    Ali Ahmadvand, Mohammad J. Behzadnia, Amin Jahanbakhshi and Mohammad R. Zarei*
    DOI: http://dx.doi.org/10.17140/EMOJ-7-160
    Provisional PDF476.06 KB 476.06 KB
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    Abstract [+]

    Background
    Traumatic cervical are injuries are very common due to high motility of cervical spine and its vulnerability to traumatic injuries. Optimal time for stabilizing the patients with traumatic spinal fractures remains controversial. It is almost due to different outcomes in various studies and the lack of consensus about it. Here we explain an ultra–early cord decompression that led to complete recovery of a patient with severe cervical cord injury.
    Case Presentation
    The patient was a 27-year-old gymnast woman with a recent history of spinal cord injury caused by high jumping with head back and neck hyperextension presented within 2-hours of trauma. As a critical case and lack of advanced radiologic equipment, only cervical spinal radiographs were used for decision-making within the first 3 hours of injury to save the patient’s cord function by surgical decompression.
    Conclusion
    Many studies have proposed different intervention times for achieving the optimal result; however, we present an ultra-early surgery (within 3-hours of injury), conducted in a context of limited medical facilities. This case revealed an excellent result after 12-months follow-up.
    Keywords
    Cervical spine; Early decompression; Surgery; Trauma.


  • 2021, April

    editorial

    Living Well with Kidney Disease by Patient and Care-Partner Empowerment: Kidney Health for Everyone EverywhereOpen Access

    Kamyar Kalantar-Zadeh*, Philip Kam-Tao Li, Ekamol Tantisattamo, Latha Kumaraswami, Vassilios Liakopoulos, Siu-Fai Lui, Ifeoma Ulasi,Sharon Andreoli, Alessandro Balducci,, Sophie Dupuis, Tess Harris, Anne Hradsky, Richard Knight, Sajay Kumar, Maggie Ng, Alice Poidevin, Gamal Saadi and Allison Tong
    DOI: https://dx.doi.org/10.17140/NPOJ-6-e012
    Provisional PDF424.44 KB 424.44 KB
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  • 2021, April

    What is Measured Matters and What Matters should be MeasuredOpen Access

    Erin L. O’Reilly*
    DOI: http://dx.doi.org/10.17140/WHOJ-7-141
    Provisional PDF306.36 KB 306.36 KB
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  • 2021, April

    opinion

    The Importance of Teaching and Fostering Clinical Research in Primary Health CareOpen Access

    Gerald L. Klein* and Mark A. Brown
    DOI: http://dx.doi.org/10.17140/CTPOJ-1-119
    Provisional PDF302.16 KB 302.16 KB
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  • 2021, April

    original research

    A Comparison of Efficacy, Safety and Cost Between MANTATM and Proglide Vascular Closure Devices Following Transfemoral Transcatheter Aortic Valve ImplantationOpen Access

    Noman Ali*, Ciprian Dospinescu, Michael S. Cunnington, Christopher J. Malkin and Daniel J. Blackman
    DOI: https://dx.doi.org/10.17140/HROJ-7-156
    Provisional PDF455.52 KB 455.52 KB
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    Abstract [+]

    Aims
    Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs.
    Methods
    This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs.
    Results
    A total of 136 patients were included in this study; 86 in the ProGlide® group and 50 in the MANTATM group. Baseline characteristics of the two groups were well-matched. Three patients in the ProGlide® group required surgical repair compared to none in the MANTATM group. However, no significant differences were observed with respect to overall primary access site-related VARC-2 vascular complications (10.5% vs. 10%; p=0.93) or VARC-2 bleeding (9.3% vs. 4.0%; p=0.25). There was no significant difference in the mean cost per patient when taking into consideration the use of additional VCDs and treatments for vascular complications (£568.79 vs. £599.95; p=0.90).
    Conclusion
    The use of the MANTATM VCD following TF TAVI is cost-neutral compared to ProGlide® VCDs, whilst being associated with no increase in VARC-2 vascular or bleeding complications.
    Keywords
    Transcatheter valve interventions; Vascular complications; Vascular closure devices (VCD).


  • 2021, April

    systematic review

    Cardiovascular Health and Healthcare Use of United States-Born and African-Born Blacks: A ReviewOpen Access

    Olubukunola Oyedele* and Dona Schneider
    DOI: https://dx.doi.org/10.17140/HROJ-7-157
    Provisional PDF547.41 KB 547.41 KB
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    Abstract [+]

    Cardiovascular disease (CVD) is the leading cause of death globally, with Blacks in the United States (U.S.) disproportionately affected. Healthcare access and utilization have been reported as risk factors for poorer cardiovascular health among several U.S.
    populations.
    Aims and Objectives
    The purpose of this systematic literature review was to examine the results of existing studies reporting on cardiovascular health and healthcare utilization by African-born compared to U. S. -born Blacks.
    Methods
    A systematic literature review was conducted using keywords and medical subject headings (MESHs) in the PUBMED, Web of Science and CINAHL electronic databases. Exclusion and inclusion criteria determined articles to be reviewed for eligibility and methodological soundness. A pooled analysis was performed on all studies.
    Results
    Only seven studies met inclusion criteria. Four compared U. S. -born with African-born Blacks residing in the United States, while three compared U. S. -born Blacks with Blacks residing elsewhere. None of the studies examined the associations between healthcare utilization and cardiovascular health for these populations.
    Conclusion
    The results of this review indicate a need to examine the impact of healthcare utilization for increasing awareness, prevention and treatment of CVD in Blacks who reside in the United States regardless of their nativity.
    Keywords
    Cardiovascular health; African-born Blacks; U.S-born blacks; Healthcare utilization.
    Abbreviations
    CVD: Cardiovascular disease; US: United States; MESHs: Medical subject headings; sBP: Systolic blood pressure; dBP: Diastolic blood pressure; BMI: Body mass index; BP: Blood pressure.


  • 2021, April

    mini review

    Oral and Gut Health Can Play an Important Role in Psychosomatic Illness Associated with Coronavirus Disease 2019 PatientsOpen Access

    Ravish Huchegowda*, Manoj K. Sharma, Nithin Anand and Darshana Devadiga
    DOI: https://dx.doi.org/10.17140/NOJ-8-135
    Provisional PDF324.60 KB 324.60 KB
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    Abstract [+]

    With physicians and patients fearful of coronavirus disease 2019 (COVID-19), this has a profound impact on the working and personal life and living style of individuals. In United States (U.S.), around 10.7% reported perceiving severe thoughts of hurting themselves and contemplating suicide as a reaction. There is a 3-4 times rise in the incidence of mental well-being disorders in the past year relative to the year prior as reported in the article in US. It was also confirmed that salivary glands of throats had affected by coronavirus and many patients infected have developed dysgeusia and anosmia which are also happened to be found in patients taking angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers, thus pointing out the role of ACE receptors for entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reducing technologic use and addiction would be feasible by adequate sleep and preventing during work hours through reducing task triggering anxiety-related use of mobile phones. Consuming plenty of Vitamin C can protect against such viral infections. Study have also shown that sufficient vitamin D supplementation could boost humoral and cellular immune responses and reduce intestinal leakiness among COVID-19 infected population.
    Keywords
    COVID-19; SARS-CoV-2; Dental; Stress; HPA.


  • 2021, April

    review

    Current Opinion in Pharmacological and Non-Pharmacological Treatment of Migraine: A Focus on Calcitonin Gene-Related PeptideOpen Access

    Babar Mirza* and Wageha Akel
    DOI: https://dx.doi.org/10.17140/NOJ-8-136
    Provisional PDF403.02 KB 403.02 KB
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    Abstract [+]

    The most common neurologic disorder is migraines. Migraine is defined as throbbing headaches that can be associated with auras. The headaches are episodic and can be debilitating in quality. Migraines can be triggered by emotional stress, lack of sleep, bright lights, loud noise, certain foods, and other environmental factors. The most effective way of preventing migraines is to avoid these triggers. A migraine can begin with prodromes or warning signs such as loss of vision, loss of motor reflexes or sensation. In this review, the types of migraine, signs and symptoms, pathways leading up to auras, and detailed pathophysiology will be discussed. The pathophysiology of a migraine consists of three different mechanisms: 1) cortical spreading depression, 2) the trigemino vascular system, and 3) sensitization. Three different treatment methods for a migraine will be discussed: 1) pharmacological, 2) non-pharmacological and 3) lifestyle modifications. Lifestyle modifications include eating a healthy diet, exercising, and maintaining proper sleep hygiene. Pharmacological treatments can be preventative or abortive. The latest migraine treatment of calcitonin gene-related peptide (CGRP) antagonist use will be discussed in this review and compared to other treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, and Triptans. Future research methods to prevent and better treat migraine headaches are considered a hot topic in medicine and these novel methods will be discussed.
    Keywords
    Migraine treatment; CGRP antagonists; Neuromodulation; Nerve stimulation; Trigeminal activation; Cortical spreading depression.


  • 2021, April

    original research

    Papillary Microcarcinoma of Thyroid in Resected Benign Multinodular Goiters Shows Correlation with Weight of the SpecimenOpen Access

    Shamsul Hadi*, Mohammad M. Khan, Mehwish Waris, Quaratul Ain, Hafiza M. Shahzadi, Nasuhi E. Aydin, Gyan P. Bajgai and Mahid Iqbal
    DOI: http://dx.doi.org/10.17140/PLMOJ-1-110
    Provisional PDF587.06 KB 587.06 KB
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    Abstract [+]

    Introduction
    The thyroid cancer in Pakistan is accountable for 1.2% cases of all cancers. Earlier information from Pakistan showed papillary thyroid carcinoma (PTC) to comprise 57-89% of all thyroid malignancies As per World Health Organization (WHO), papillary microcarcinoma of thyroid (PMCT) is a small area of malignant transformation measuring up to 1 cm or less being defined by WHO, that is currently being diagnosed more often than the past. Albeit small, they have the capability of metastasizing to regional lymph node and may disappear after metastasis.
    Objective
    To evaluate the prevalence of PMCT in benign multinodular goiter in thyroidectomy specimens.
    Materials
    The study was performed in Histopathology Laboratory of Peshawar Medical College, where 32 specimens of multinodular goitre (MNG) patients were received from its affiliated hospitals. The patients’ details were obtained from the hospital records. The specimens were closely examined for the presence of suspicious foci both grossly and microscopically. Results obtained were
    recorded and data was analyzed statistically.
    Results
    All the 32 specimens of the patients were thyroids. The results show a predominance of female patients in surgically resected MNGs with a relatively low incidence of neoplastic transformation. Our study reported two cases of PMCT and both were from different age groups, one was below 25-years and the other was 48-years. Patients mean age was 38.63-years with a SD±12.95-years. The size and weight of the samples varied. The mean of weight was 206.31±304.50 grams, which is due to the reason that many outliers were noted in weight category.
    Conclusion
    In thyroid excisions the weight of the excised specimen holds much great importance in determination/diagnosis of the disease. The risk of malignancy is higher in MNG compare to solitary nodules. The prevalence of PMCT (6.25%) are higher in smaller nodules is compare to PTC (3.12%). Furthermore, the fact that our both PMCTs occurred in total thyroidectomy specimens cautions us for their prudent assessment both in gross and histopathological levels.
    Keywords
    Papillary microcarcinoma thyroid; Multinodular goiter; Thyroidectomy.


  • 2021, April

    commentary

    A Physicians Commentary on Electronic Health Records in the United States Medical PracticeOpen Access

    Irina V. Angel*
    DOI: https://dx.doi.org/10.17140/PHOJ-6-153
    Provisional PDF316.05 KB 316.05 KB
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    Abstract [+]

    This commentary presents a point of view on how the arrival of electronic health records (EHR) in the United States (U.S.) has changed physicians’ practice. EHR implementation has pros and cons. EHR systems have been a great asset during the
    pandemic and help with efficiency, safety, and cost reduction. Despite their benefits, healthcare providers and organizations still face challenges, including usability and interoperability across systems, contributing to physicians’ burnout. Can physicians adopt new technologies and adapt to current challenges? Is it the right time for physicians to stop being observers and become active
    participants in the process of healthcare innovation and implementation?
    Keywords
    Physician; EHR; Implementation; Physicians’ burnout.


  • 2021, April

    original research

    Towards Universal Health Coverage: Designing a Community Based Intervention to Scale Up Coverage with Health Insurance, in A-Duiem Administrative Unit, Sudan 2018-2019Open Access

    Samia Y. I. Habbani*, Egbal A. B. A. Karaig, Sumaia M. Al-Fadil, Maisa El-Fadul, Siddik M. A. Shaheen, Nahid A. A. Gadir, Hashim Al-Amin S. Abu Zaid and Elfatih M. Malik
    DOI: https://dx.doi.org/10.17140/PHOJ-6-154
    Provisional PDF345.55 KB 345.55 KB
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    Abstract [+]

    Background: Community engagement has proved effective in increasing access to healthcare including health insurance, in developed and developing countries.
    Aim: The study aims at designing and testing the effectiveness of engaging the community in awareness-raising and increment of health insurance coverage.
    Methods: The study was a social interventional community-based study, conducted in A-Duiem Administrative Unit, A-Duiem Locality, Sudan. Baseline data on enrollment in health insurance was collected from 800 heads of households, whereas data on knowledge and attitudes about health insurance was collected from 420 heads of non-insured households using a standardized questionnaire. Strategies to scaleup health insurance through community engagement was collected from community leaders, local authorities, and health insurance policymakers through in-depth interviews and focus group discussions. The community promotion package of health insurance was implemented for one year and post-intervention data were collected from 420 heads of households. Quantitative data were analyzed using SPSS version 20. Statistical significance was set at p<0.05 when the confidence interval was 95%. Qualitative data was analyzed manually using the thematic approach. Results: The study showed significant improvement in the knowledge of the heads of the non-insured households about health insurance after the intervention; knowledge about the enrollment process and service’s package has increased from 34.4% to 61.8% and from 55.8% to 84.7% respectively (p-value 0.0001 in both). The health insurance coverage increased by 17.3% with a significant difference and p-value at 0.0001. Conclusion: The study concluded that community members have a considerable role in awareness-raising and scaling up of health insurance coverage if they are properly organized, trained, monitored, and supervised. The insufficient commitment of local officials in the unit was a challenge to address during further testing and expansion of the experience. Keywords Health insurance; Population coverage; Knowledge; Attitudes; Community engagement; Intervention; Sudan.


  • 2021, April

    case report

    Electrical Injury and Prolonged Cardiac Arrest: A Case Report of Complete Neurological RecoveryOpen Access

    Uma Hariharan* and Vinoth Natarajan
    DOI: http://dx.doi.org/10.17140/RPAOJ-5-127
    Provisional PDF280.40 KB 280.40 KB
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    Abstract [+]

    Introduction
    Sudden cardiac arrest continues to have a high mortality rate. Out of hospital cardiac arrest (OHCA) has a poor outcome compared to those occurring in a healthcare setup due to lack of awareness and appropriate resources. The most common rhythm abnormality in out of hospital cardiac arrest is ventricular fibrillation which requires early defibrillation, ideally on the location.
    Case Report
    A 19-years male was witnessed by lay bystanders to have become unresponsive following contact with an electric lighting pole on the road median in Chandigarh. A passer-by medical resident detected no pulse and initiated chest compression. Since there was no immediate return of spontaneous circulation and aetiology suggested a defibrillate rhythm. The patient was taken in the car
    and rushed to a tertiary care centre, 10-minutes away. Cardiopulmonary resuscitation (CPR) was interrupted during transport for lack of adequate personnel. Ventricular Fibrillation was noted and shock was delivered along with inotropes. Around 26-minutes into the resuscitation, the patient had the return of spontaneous circulation. After post-cardiac arrest care in intensive care unit (ICU), he was extubated and discharged home in 1-week with full neurological recovery.
    Discussion
    Recovery of full neurologic function could be explained by the alternating presence of stable and unstable cardiac rhythms and in part at least brought about by immediate attempts at resuscitation. The report seeks to review these aspects of emergency care besides highlighting the need for both immediate and accurate emergency medical services such as lay responder training, public
    access defibrillation and responsive transport systems for such patients.
    Keywords
    Sudden cardiac arrest; Out of hospital cardiac arrest; Ventricular fibrillation; Early defibrillation; Electrical injury.


  • 2021, April

    systematic review

    The Role of Intravenous Lidocaine in Preventing Chronic Post-Operative PainOpen Access

    Luís M. F. Ramos*
    DOI: http://dx.doi.org/10.17140/RPAOJ-5-128
    Provisional PDF314.04 KB 314.04 KB
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    Abstract [+]

    Background and Goal of Study
    Chronic post-operative pain (CPOP) is an increasing public health issue considering its impact on the patients quality of life and and the associated costs for the healthcare system. The incidence of CPOP can be as high as 75%, depending on the surgical procedure and other factors. Lidocaine is a local anesthetic with anti-inflammatory, analgesic and antihyperalgesic properties. Several studies have shown its use in controlling acute post-operative pain when used intravenously. The goal of this study was to define the role of intravenous lidocaine in preventing CPOP.
    Materials and Methods
    The PubMed database was searched from 2006 and 2019 with the keywords: “Chronic post-operative pain” or “Chronic post-surgical pain” or “Chronic pain” and “Intravenous lidocaine”. Adequate papers for the purpose of this study were selected.
    Results and Discussion
    Three randomized controlled trials that met criteria were obtained: two on breast surgery and the other on open nephrectomy. All trials used intravenous lidocaine during surgery, suspending the infusion up to the first 24-hours of the post-operative period. All three of them showed a significant decrease on the incidence of CPOP. There was a 20-fold decrease six months after breast
    surgery.
    Conclusion
    Intravenous lidocaine seems to decrease the incidence of CPOP however, there is limited evidence. More trials are necessary to define the efficacy and safety of intravenous lidocaine. A generally accepted definition of CPOP is needed.
    Keywords
    Chronic pain; Chronic post-operative pain; Chronic post-surgical pain; Intravenous lidocaine.


  • 2021, April

    original research

    Comparison of Anthropometric Equations and Dual X-ray Absorptiometry to Determine Body Composition in Active Breast Cancer SurvivorsOpen Access

    Riggs J. Klika*, Shelby Cox and Brooklyn Herbert
    DOI: https://dx.doi.org/10.17140/SEMOJ-7-182
    Provisional PDF408.16 KB 408.16 KB
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    Abstract [+]

    Objective
    The purpose of this study was to 1) compare the body composition values of an active group of breast cancer survivors (BCS) determined by dual X-ray absorptiometry (DXA) and anthropometry, and 2) compare the bone mineral density of the upper thoracic region to assess the effect of tumor burden on bone health.
    Design and Methods
    Forty (n=40) breast cancer survivors from a local competitive Dragon Boat Team were measured as part of team assessments. ANOVA with Dunn’s post-hoc testing was used to compare results of DXA, body density, and body composition estimated from anthropometry. Bland-Altman testing and correlational analysis were calculated.
    Results
    Percentage of fat measure by DXA was significantly higher than values used to estimate body fat from skinfold measures or from body density equations (DXA 41.1±6.0% vs. 3-site skinfolds 28.8±4.9%, 4-site skinfolds, 22.1±4.1%, skinfold and body density, 31.8±9.4%, respectively, p<0.05). Post-hoc testing revealed that all values were significantly different and the strongest correlation with DXA was skinfolds at three sites was r=0.81. Regional (upper thoracic) bone mineral density was not significantly different based on tumor side diagnosis (breast cancer diagnosis side versus healthy, 0.971±0.198 vs. 0.988±0.190 gm*cc-1). Anthropometry and bilateral bone mineral density characteristics are presented to serve as a comparative sample of BCS for future studies. Conclusion As body composition is an important factor in long-term cancer survivorship, we found the use of skinfold measures inadequate to accurately determine percentage of fat in this group of active female BCS. As a result, recommendations aimed at achieving an ideal body composition based solely on anthropometry would have grossly underestimated fat mass, which may lead to overall clinically poorer outcomes. Keywords Breast cancer; Body composition; Percentage fat; Bone mineral density.


  • 2021, April

    case report

    Idiopathic Primary Retroperitoneal Cyst: A Case ReportOpen Access

    Ahmad E. Al-Mulla*, Ali Al-Tabeekh, Raghad Al-Huzaim and Kareem A. Elayouty
    DOI: http://dx.doi.org/10.17140/SROJ-6-124
    Provisional PDF496.53 KB 496.53 KB
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    Abstract [+]

    Retroperitoneal cysts are rare; they are divided into neoplastic and non-neoplastic cyst. Incidences are 1 in 5750 to 1 in 250,000. They are often asymptomatic. Lymphangioma are benign cyst whereas 95% of them are found in the neck and axilla only 1% is in the abdomen. This is a case report describing the course of management for a 30-year-old male who presented to our outpatient
    clinic with abdominal discomfort due to retroperitoneal cyst.
    Keywords
    Retroperitoneal Cyst; Ultrasound; Histopathology.


  • 2021, April

    case report

    Autonomic Dysreflexia: Atypical Complication from Immediate Release TapentadolOpen Access

    Claudia Diaz* and Veli Solyali
    DOI: https://dx.doi.org/10.17140/TFMOJ-6-136
    Provisional PDF312.94 KB 312.94 KB
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    Abstract [+]

    Neurological disorders are a ubiquitous part of our lives, and with innovative technological advancements there are increasing numbers of people being diagnosed with a variety of conditions. While these advances uncover the underlying pathological process, the requisite need to manage a patient’s condition necessitates renewed vigour in the realm of key therapeutics. This case study looks at a patient with a rare neurological condition, transverse myelitis (TM), and a complication that many spinal cord injury patients suffer, autonomic dysreflexia (AD). However, what makes this case unique is when the patient was administered with immediate-release Tapentadol, a synthetic opioid, the patient suffered more frequent and prolonged attacks of AD. The exploration
    of the functional anatomy of TM as it applies to this case is highlighted, and how the role of Tapentadol was a causative agent in increasing the patient’s AD.
    Keywords
    Spinal cord injury; Transverse myelitis; Pharmacokinetics; Opioids.
    Abbreviations
    TM: Transverse myelitis; CNS: Central nervous system; AD: Autonomic dysreflexia; VAS: Visual analogue scale; MET: Medical emergency team.


  • 2021, April

    case report

    Pulsed Electromagnetic Stimulation Therapy for Erectile DysfunctionOpen Access

    Chirag Bhandari* and Trilok Mahajan
    DOI: https://dx.doi.org/10.17140/UAOJ-5-137
    Provisional PDF304.15 KB 304.15 KB
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    Abstract [+]

    Erectile dysfunction (ED) is a significant and common medical problem. Currently, there are several treatment available options for patients with ED, both non-invasive and invasive like phosphodiesterase 5 inhibitors, intra-cavernosal injections (BIMIX,TRIMIX), intraurethral prostaglandin E1 pellets, vacuum erection devices and insertion of a penile prosthesis. Most of these options are
    invasive, which can be troublesome for patients, and also have side-effect profiles. Pulsed-electro magnetic stimulation therapy (PLMST) has gained interest in the field of sexual medicine. In the given case author presented a successful effect of in a case of erectile dysfunction.
    Keywords
    Erectile dysfunction; Electromagnetic stimulation therapy; Latest treatment; Non-invasive treatment;
    Erection hardness scale (EGS).


  • 2021, April

    retrospective study

    Assessment of the Reasons for Culling and its Relation to Age at Culling in Dairy Cows in and around Mekelle City, Tigray, EthiopiaOpen Access

    Gutema D. Idesa* and Sultan Aman
    DOI: https://dx.doi.org/10.17140/VMOJ-6-152
    Provisional PDF363.68 KB 363.68 KB
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    Abstract [+]

    Background
    Culling is defined as the departure of cows from the herd because of sale, slaughter, salvage, or death. Culling is an important cost for dairy farms. At the same time, culling is a way to increase herd productivity and profitability, as keeping diseased and unproductive cows might result in lower herd milk production and deteriorated reproduction. In order to maximize profitability, the proportion of voluntary culling (selling for dairy purposes or culling due to low production) should be highest among the total culling rate. Previous studies indicate an ascending trend in the proportion of involuntary culling. This observational study used registry data of all cows from herds with ≥5 cow-years in 2016-2017.
    Objective
    This study was conducted to assess the reason for culling a dairy cow and its association with age at culling in and around Mekelle using a structured questioner format and direct observation. Visits were performed to each farm to collect data directly from owners or animal attendants and using direct observation.
    Materials and Methods
    The cross-sectional study was conducted in and around Mekelle city dairy farm from November, 2016 to April, 2017.
    Results
    The most common causes of culling were disease and economic reasons. The most common causes of voluntary culling were economic reasons (17.39), low milk yield (20.29%), and aging (8.70%). The common causes of involuntary culling were diseases (34.78%), injury (7.25%), and infertility (5.80%). In this study rates of culling increased with parity. The highest rate of culling was
    in animals between parity 2 and 5, increased from (14.49%) to (21.74%) and slightly decreased from parity 6 to 7, i.e. (13.04)% to (8.70)%, respectively. The highest rates of culling were between 3 and 5-years, (17.39)% and (23.19)%, respectively.
    Conclusion
    This study indicated animals were culled at premature age because of involuntary culling, which is economically not feasible, diseases were the most common causes of involuntary culling and voluntary culling was the most type of culling in dairy cattle farms and animals mostly culled for decreased production and economic reasons.
    Keywords
    Culling; Dairy cattle; Milk yield; Parity.


  • 2021, April

    review

    Review on Molecular Diagnosis of Cestode and Metacestode in CattleOpen Access

    Ziyad M. Bilal* and Kedir S. Musa
    DOI: https://dx.doi.org/10.17140/VMOJ-6-153
    Provisional PDF553.29 KB 553.29 KB
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    Abstract [+]

    Cestode infestations in animals are the most important parasite of livestock and humans because most of these parasites are zoonotic causing cysticercosis and hydatidosis in man and it causes economic and production losses in livestock. Diagnosis of Taenia Spp by microscopic observation lack sensitivity and specificity and detection by enzyme-linked immunosorbent assay (ELISA)
    technique form cross-reaction. The molecular diagnostic can be best to detect in adult and larval stage in definitive and intermediate host based on the amplification of deoxyribonucleic acid (DNA) of target gene with the primer using a different technique of polymerase chain reaction (PCR) such as multiplex PCR. Conventional PCR, real-time PCR, nested PCR, and PCR-restriction
    fragment length polymorphism (RFLP) are highly sensitive for the diagnosis of cestode and metacestode. Those diagnoses are used for differentiation of Taenia species and differentiation of Taenia and Echinococcus species. As compared to other diagnostic techniques most molecular methods have higher sensitivity and specificity but due to the relatively higher cost, few are commercially
    available. Most of the molecular diagnostic tests developed to date are generally applicable for laboratory research purposes. The developments in the genomic and proteomic analysis should be used for further understanding of parasite-animal host interaction to find additional targets for diagnosis.
    Keywords
    Cestode; Molecular test; Metacestode; Veterinary importance.
    Abbreviations
    Bp: Base pair; DNA: Deoxyribonucleic acid; ELISA: Enzyme-linked immunosorbent assay; gDNA: Genomic DNA; AMP: Loop-mediated isothermal amplification; NAD: Nicotinamide adenine dinucleotide; NADH: reduced form of NAD; PCR-REA: Polymerase chain reaction restriction enzyme analysis; PCR: Polymerase chain reaction; RFLP: Restriction fragment length polymorphism; rRNA: Ribosomal ribonucleic acid; REA: Restriction enzyme analysis; SSCP: Single-strand conformation polymorphism.


  • 2021, April

    original research

    Study on Prevalence of Major Gastrointestinal Nematodes of Sheep in Wayu Tuka and Diga District, Oromia Regional StateOpen Access

    Adamu R. Chali* and Fedhiko T. Hunde
    DOI: https://dx.doi.org/10.17140/VMOJ-6-154
    Provisional PDF464.35 KB 464.35 KB
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    Abstract [+]

    Aim
    This study was devised to be conducted to determine the prevalence and identify the major gastrointestinal nematode parasites based on fecal examination.
    Methods
    A cross-sectional study was carried out to determine the prevalence and associated factors with ovine gastrointestinal nematode infestation by fecal examination of 384 sheep from Wayu Tuka and Diga district, Eastern Oromia regional state.
    Results
    Out of the total 384 sampled sheep, 169 (44.0%) had been infected with gastrointestinal nematode parasite. Haemonchus species were the most frequently (20.8%) recovered nematode eggs followed by Trichostrongylus (13.0%) and Nematodirus (10.2%). There was no significant difference (p>0.05) in prevalence between age groups and sex. Sheep with poor body condition had a significantly
    higher prevalence of gastrointestinal nematode parasite (p<0.05) than those sheep in moderate or good body condition. There was no significant association between the gastrointestinal nematode infection in animals of different ages and sex groups. Conclusion The study shows that the gastrointestinal nematode parasite was a major important health problem and impact on the production of sheep in the study area. Therefore, a detailed study should be conducted to identify the parasite at the species level and special consideration should be taken on the management of sheep in poor body condition to reduce the burden of gastrointestinal nematodes. Keywords Diga; Eastern Wollega; Gastrointestinal nematodes; Prevalence; Sheep; Wayu Tuka.


  • 2021, April

    review

    Hepatic Diseases in Canine and Feline: A ReviewOpen Access

    Kassahun A. Negasee*
    DOI: https://dx.doi.org/10.17140/VMOJ-6-155
    Provisional PDF527.19 KB 527.19 KB
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    Abstract [+]

    Dogs and cats are belonging to canine and feline family respectively. The liver is the largest gland in the body and is located in the cranial abdomen between 3rd and 4th ribs in dogs and cats. This review is mainly focused on: to understand the anatomy and physiology of liver, the liver diseases pathophysiology, to diagnose the liver diseases, managemental and ameliorative methods of liver diseases. The dual blood supply to the liver is hepatic artery and portal vein. The function of liver includes the regulation of digestion and metabolism, the synthesis of hormones and proteins, immune response and filtering of toxins from the blood stream. Any problem that affects the liver is liver disease. Inflammation of liver is hepatitis. Hepatitis caused by infectious, non-infectious, auto-immune and reactive. It can be acute and chronic. The most encountered liver diseases in dogs and cats are hepticlipidosis, cholangiohepatitis, portosystemicshunt, cholelithiasis, choledocholithiasis, cholecystitis, pneumobilia and hepatic neoplsia. The clinical symptoms of liver diseases include jaundice, hepatic encephalopathy, gastro intestinal disorders and nonspecific signs include polyuria/polydipisia. The liver disease diagnosed based on history, liver function tests, medical imaging. The latest imaging procedures are endoscopic retrograde cholagio pancreatography (ERCP) and computed tomography (CT). For confirmatory diagnosis liver biopsy and histopathological interpretation is required. Therefore, based on diagnosis appropriate treatment should be selected: bile stasis is treated urodeoxycholic acid (URDA), fluid therapy include sugar and salt solution for
    replacement fluid loss, gastrointestinal protectors include ranitidine, cimitidine and lactulose, albumin to treat hypoalbuminimia, antioxidant for scavenging free radicals include vitamin E, Selenium, S-adenosyl-L-methionine (SAMe), diuretic fursimid for treatment of ascites and supplementation low protein diets. This laparoscopic technique for removal of gallstones and endoscopic retrograde cholagiopancreatography (ERCP) to treat gall stones on bile ducts and to widen the slipped ducts and liver transplantation for cirrhotic dogs and cats. Early accurate diagnosis and managing any predisposing factors that affects the health of dogs and cats are important for controlling the liver diseases.
    Keywords
    Canine; Feline; Liver disease; Hepatitis; Hepatocyte; Kuppfer cells.


  • 2021, April

    case study

    Criminal Justice Alcohol and Drug Screening in Practice: Using the Substance Abuse Subtle Screening Inventory to Identify Substance Use Disorder in OffendersOpen Access

    Nelson J. Tiburcio*, Scarlett L. Baker and Kristin S. Kimmell
    DOI: https://dx.doi.org/10.17140/SBRPOJ-6-129
    Provisional PDF414.96 KB 414.96 KB
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    Abstract [+]

    Objective
    The substance abuse subtle screening inventory (SASSI) has been used successfully in correctional treatment settings and correctional screening since 1988. These screenings include outpatient evaluations of offenders within community settings, as well as assessments of incarcerated individuals within federal, state, city, and county correctional facilities. One key element towards reducing recidivism and reoffending, is that individuals receive treatment for substance use disorders (SUD’s) while in the correctional
    system. While SUD is not the only contributing factor to criminality, it does significantly increase the likelihood of legal infraction and violations, placing these individuals at a higher risk of re-offending. Thus, identifying SUD as early as possible helps provide tailored treatment to those who need it, while simultaneously reducing the risk of future legal difficulties. Now in
    its fourth iteration (SASSI-4), this article discusses the SASSI screening tools’ utility with criminal offenders and serving clinical needs, and reviews a case study of a young male’s clinical evaluation while incarcerated.
    Results
    For this case study, we reviewed the SASSI-4 screening results of a 24-year-old male whom we will call “Bryon”. Bryon was in his 4th week of detention at a local mid-western jail in the United States. He was arrested after turning himself in for a prior domestic violence offense committed while under the influence of alcohol and for which he had fled the state. Bryon had one prior arrest (for receiving stolen property, which he subsequently traded for drugs). The intake counselor conducting Bryon’s assessment had been meeting with him at the jail for several weeks. The court was particularly interested in determining the level of risk that Bryon would again flee the area.
    Conclusion
    This case presents us with a good example of the value of early identification of substance use disorder, and potential problems in criminal justice settings. Bryon’s SASSI results clearly demonstrate a well-established pattern of substance misuse that will require relatively intensive intervention. Therefore, he may be a solid candidate for diversion into an alcohol and drug treatment program as a way of reducing the risk of future offenses.
    Keywords
    Subtle SUD screening; The SASSI Institute; Criminal offenders; Corrections; Recidivism; Alcohol and drug screening.


NOTE: The DOIs of the In-Press Articles will only function after the final publication of the articles and once they are uploaded to the Current Issues.
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Current Issue

  • 2015, March

    research

    Microbial Safety of Foods in the SupplyOpen Access

    Mohamed T. Elkhishin, Ravi Gooneratne and Malik A. Hussain
    DOI:
    PDF980.81 KB 980.81 KB
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  • 2015, September

    editorial

    Hepatitis C UpdateOpen Access

    Omar Massoud*
    DOI:
    PDF297.12 KB 297.12 KB
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  • 2016, July

    original research

    Comparisons between Portosystemic Shunting Modalities in Patients with Liver Cirrhosis and Portal HypertensionOpen Access

    Firuz Gafurovich Nazyrov, Castro-Benitez C, Andrey Vasilyevich Devyatov, Azam Khasanovich Babadjanov*, Umid Ravshanovich Salimov and Laziz Lappasovich Mardonov
    DOI:
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  • 2017, January

    mini review

    Iron and Copper Toxicity in Rat Liver: A Kinetic and Holistic OverviewOpen Access

    Rosario Musacco-Sebio, Christian Saporito-Magriñá, Juan M. Acosta, Alberto Boveris and Marisa G. Repetto*
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    PDF775.76 KB 775.76 KB
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  • 2017, May

    short communication

    Pediatric Acute Liver Failure: Current PerspectivesOpen Access

    José Colleti Jr., Rafael Teixeira Azevedo and Werther Brunow de Carvalho
    DOI:
    PDF342.40 KB 342.40 KB
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  • 2018, May

    original research

    Training of Future Surgeons in Minimally Invasive Surgery Needs Intensification: A Multicentre StudyOpen Access

    Srinath Ranjit, Farhan Rashid, Sami Mansour, Khaleel Fareed, Neda Farhangmehr, Bruno Lorenzi and Alexandros Charalabopoulos*
    DOI:
    PDF1.19 MB 1.19 MB
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  • 2018, August

    editorial

    New Ideas on Limitations to VO2max: Five Major Determinants for VO2maxOpen Access

    Masahiro Kohzuki*
    DOI:
    PDF398.63 KB 398.63 KB
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  • 2018, October

    review

    Dementia and Oral Health: Is There A Connection?Open Access

    Suellan Go Yao and James Burke Fine*
    DOI:
    PDF387.93 KB 387.93 KB
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  • 2018, December

    case report

    Cranial and Spinal Subdural Hygroma Following Lumbar Epidural for Labour AnalgesiaOpen Access

    Elizabeth Thompson*, Nicholas Haden and David Hutchins
    DOI:
    PDF322.01 KB 322.01 KB
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    Abstract [+]

    Intracranial hygroma is a rare and probably missed complication of epidural analgesia secondary to accidental dural breech. The patient presented had a presumed spinal cerebrospinal fluid leak with symptoms of intracranial hypotension. Unusually the patient had both an intracranial subdural hygroma and rarely reported extensive spinal intradural (extra-arachnoid) collection following a lumbar epidural, administered in labour. Given the potential for progression to symptomatic neurological deficits, anesthetists should consider subdural hygroma when encountering patients with features of intracranial hypotension, or altered neurology following epidural. Pathophysiology, imaging and management are discussed.

    Keywords

    Subdural hygroma; Epidural; Dural puncture.


  • 2019, January

    editorial

    Pediatric and Neonatal Malnutrition: A Collaborative, Family-Centered Approach Improves OutcomesOpen Access

    Dena L. Goldberg* and Holly A. Van Poots
    DOI:
    PDF315.00 KB 315.00 KB
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  • 2019, March

    mini review

    Burden, Access, and Disparities in Kidney DiseaseOpen Access

    Deidra C. Crews*, Aminu K. Bello, Gamal Saadi and for the World Kidney Day Steering Committee**
    DOI:
    PDF466.97 KB 466.97 KB
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  • 2019, March

    retrospective study

    The Causes of Marginal Discrepancy of Fixed Dental Prostheses: A Cross-Sectional StudyOpen Access

    Asma Ismail, Yosra Gassara, Dalenda Hadyaoui and Mounir Cherif*
    DOI:
    PDF466.02 KB 466.02 KB
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  • 2019, March

    editorial

    Challenges Facing Pediatric Dentistry Diplomates and the American Board of Pediatric Dentistry: Setting the Bar for Minimal Competency vs. ExcellenceOpen Access

    John E. Nathan*
    DOI:
    PDF248.71 KB 248.71 KB
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  • 2019, May

    letter to the editor

    Endoscopic Treatment of Refractory Variceal BleedOpen Access

    Shreyas Saligram*, Marina Roytman, Helen Wong and ThimmaiahTheethira
    DOI:
    PDF307.70 KB 307.70 KB
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  • 2019, May

    case report

    Anesthetic Considerations in Bilateral Congenital Anophthalmia: A Rare Clinical EntityOpen Access

    Lalit Gupta* and Manisha Manohar
    DOI:
    PDF317.55 KB 317.55 KB
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    Abstract [+]

    Congenital anomalies planned for ocular surgeries range from the rare to atypical to common. Many of this rare ophthalmopathy are associated with clinical syndromes and have important anesthetic implications. Not only is it important to know the syndrome we are dealing with, but it’s also the more important to understand the systems that are involved, the extent of involvement, potential anesthetic complications, right from the cerebrovascular, cardiovascular, endocrine, metabolic, neuromuscular, genitourinary systems to airway. Understanding these aspects becomes more important in rare clinical scenarios as it helps to plan the case, anticipate and treat the complications. Congenital anophthalmia is one of the rare conditions with an incidence of <3/1000 with microphthalmia reported in up to 11% of blind children, hence we report a rare case of bilateral congenital anophthalmia planned for excision of right ocular swelling.

    Keywords

    Ophthalmopathies; Congenital anophthalmia; Microophthalmia; Ocular surgery.


  • 2019, May

    case report

    Hardware Causing Hard Times: Use of the SuperNO2VA™ Nasal PAP Device to Address Airway Challenges Caused by Eroding Mandibular HardwareOpen Access

    Michael Marotta* and Geoffrey S. Kilgore, Jr
    DOI:
    PDF361.87 KB 361.87 KB
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    Abstract [+]

    Background

    Maintenance of the airway and adequate ventilation are essential for the anesthetized patient and may be compromised in patients with pan-facial trauma, abnormal dentition, abnormal mandibular space, or presence of dental hardware. We present an unusual case of a patient with a lack of natural mandibular structure and exposed mechanical hardware with fistula complicating intubation and ventilation prior to surgery.

    Case Presentation

    A 35-year-old male with a history of a self-inflicted gunshot to the left submandibular region approximately 6 years prior was scheduled for urgent mandibular hardware removal, closure of left facial fistula, and removal of several teeth. Pre-oxygenation and ventilation were complicated by extruding hardware and eroded skin, causing interference with a conventional facemask seal. The patient was pre-oxygenated using the SuperNO2VA™ nasal mask with which an adequate seal was achieved without use of a nasal trumpet and with a modified grip. Tracheal intubation via oral video laryngoscopy was successful, and the case proceeded uneventfully.

    Conclusion

    Adequate ventilation and airway maintenance can be difficult to achieve in patients with abnormal facial structure or mandibular mechanical hardware using conventional methods. The SuperNO2VA™ nasal mask can address airway issues for these patients peri-operatively.

    Keywords

    Anesthesiology; Airway management; Difficult airway; Airway devices; Difficult intubation; Ventilation; Oxygenation; Facial trauma; Mask ventilation.


  • 2019, May

    case report

    Pneumocephalus Caused by an Epidural Ozone Injection for Treatment of Disc ProlapseOpen Access

    Surath Manimala Rao*, Laxmi Kotgire and B.V. Savitr Sastri
    DOI:
    PDF319.44 KB 319.44 KB
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    Abstract [+]

    Pneumocephalus is a complication seen either after head trauma or post-neurosurgical procedure. It can be life-threatening if it turns into tension pneumocephalus. The presence of intracranial air indicates the presence of an open communication of cerebrospinal fluid. Air enters dura matter even without connection. Thin air flows upstream along the cerebrospinal fluid (CSF) pathway. Herein, we report a case of pneumocephalus in a 62-year-old female after epidural injection of Bupivacaine and Ozone for the treatment of a prolapsed disc. She was shifted to our hospital post-epidural injection for the management of severe headache. Though it is a rare complication, keeping this in mind will help to quickly diagnose, if need arises.

    Keywords

    Pneumocephalus; Head trauma; CT; Thunderclap headache.


  • 2019, June

    original research

    Changes in Estimated Glomerular Filtration Rate, Biochemical and Hematological Profile of Workers in Spray Painting Industry: A Cross-Sectional StudyOpen Access

    Christopher E. Ekpenyong* and Nseobong N. Nkereuwem
    DOI:
    PDF480.31 KB 480.31 KB
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    Abstract [+]

    Introduction

    There is a global increase in occupational exposure to solvents, some of which are suspected to cause acute or chronic toxic nephropathies in humans. However, limited studies have been done to evaluate the systemic effects of exposure to some of the commonly used solvents such as paints.

    Aim

    The aim of the present study was to assess the effect of chronic exposure to paint fumes on renal and hepatic functions of industrial spray painters. Methodology In this cross-sectional study, 49 occupationally exposed male industrial spray painters who had served for greater than 5 years were evaluated for changes in renal, hepatic and hematological indices using standard instruments and results were compared with levels in the unexposed (sex and age-matched) participants.

    Results

    Significant changes in markers of renal, hepatic and hematological functions were observed in the exposed compared with unexposed participants including significant decrease in estimated glomerular filtration rate (eGFR) and serum levels of potassium (K+) and chloride (Cl-), and significant increases in serum levels of creatinine (Cr), sodium (Na+), urea (Ur) and uric acid (UA) in the exposed compared to levels in the unexposed group. Abnormal serum levels of hepatic enzymes (AST, ALT and ALP) and hematological indices (PCV, total-RBC, nuetrophils, basophils, monocytes and lymphocytes) were also observed in the exposed compared to levels in the unexposed participants.

    Conclusion

    Prolonged exposure to paint fumes may be associated with a significant risk for hepato-renal dysfunction and hematotoxicity. Preventive measures should include limiting exposure and using antioxidant medications.

    Keywords

    Spray painting; Toxicity; Workers; Kidney; Liver; Blood cells.
    Abbreviations ALT: Alanine transaminase; ALP: Alkaline phosphatase; AST: Aspartate transaminase; eGFR: Estimated glomerular fitration rate; C-G: Cockroft-Gault; MDRD: Modification of diet in renal disease; Na+/K+/ATPase: Sodium potassium adenosine triphosphatase; PH: Hydrogen Concentration; PCV: Packed cell volume; RBC: Red blood cells; ROS: Reactive oxygen species; UA: Uric acid; Ur: Urea.


  • 2019, July

    original research

    Loss of Pancreatic β-cell Secretory Function During Disease Progression in Type 2 Diabetes Mellitus – A Small Cross-Sectional StudyOpen Access

    George B. Kudolo*
    DOI:
    PDF517.99 KB 517.99 KB
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    Abstract [+]

    Introduction: Overt type 2 diabetes mellitus (T2DM) is a chronic progressive disease which is produced by the collusion of three metabolic defects-increased hepatic glucose production, impaired pancreatic β-cell insulin secretion and decreased insulin action. The measurement of plasma glucose 2 hours post-ingestion of 75 g of glucose during the oral glucose tolerance test (OGTT) may be used to classify individuals as normal glucose tolerant (NGT), impaired glucose tolerant, T2DM and T2DM with pancreatic β-cell failure.
    Objectives: This study was undertaken primarily to show the importance of assessing the pancreatic β-cell function especially during the care of the diabetic patient.
    Methods: A standard 75 g glucose tolerance test (OGTT) was administered to four groups of 8 subjects (4 male, 4 female). Blood was drawn every 15 minutes for 2 hours for the measurement of glucose, insulin and C-peptide and the measurement of the area under the curve (AUC(0→2)) over the 2-hour period.
    Results: American Diabetes Association (ADA) criteria were used to classify the subjects. The normal glucose tolerant (NGT), had 2 h glucose 111±11 mg/dL, those with impaired glucose tolerance (IGT) had 2 h glucose 160±13 mg/dL. The 2 h glucose for the T2DM group was 258±27 mg/dL and those for the T2DM-PE group was 260±42 mg/dL. The AUC(0→2) for NGT group were 254±40 mg/dL/h, 112±61 μU/mL/h and 10.2±4.6 ng/ml/h for glucose, insulin and C-peptide, respectively. The AUC(0→2) for the IGT group were 394±32 mg/dL/h, 160±48 μU/mL/h and 19.8±7.7 ng/ml/h for glucose, insulin and C-peptide, respectively. The AUC(0→2) for the T2DM group were 474±62 mg/dL/h, 194±40 μU/mL/h and 13.4±4.7 ng/mL/h for glucose and insulin, and C-peptide, respectively. The AUC(0→2) for the T2DM-PE group were 481±80 mg/dL/h, 51±29 μU/mL/h and 7.2±2.8 ng/mL/h for glucose, insulin and C-peptide, respectively. There was no significant difference between the diabetic groups with respect to the glucose AUC(0→2) but a significant difference existed in the insulin AUC(0→2), (p<0.0001) mirrored by the fasting plasma insulin levels (30±8 μU/mL vs 14+8 μU/mL, for T2DM and T2DM-PE, respectively, p<0.0005). Although there was about a 300% increase in fasting insulin between the IGT and T2DM groups, the corresponding fasting C-peptide levels were only about 15%. This is probably due to differences in hepatic and renal functions in those two groups, the processes that control insulin and C-peptide levels in the body.
    Conclusion: Although measurement of blood glucose appears adequate in the diagnosis of the diabetes, it seems that plasma insulin/C-peptide measurements could guide physicians in their choice of medications for the treatment of diabetic patients, especially when the pancreas begins to fail. To that end, larger studies are warranted to study the effects of hypoglycemic agents on hepatic insulin extraction and renal C-peptide excretion to ascertain the reliability of the plasma insulin and C-peptide levels.
    Keywords
    Type 2 diabetes mellitus; Pancreatic β-cells; Oral glucose tolerance test; Pancreatic exhaustion.


  • 2019, July

    case report

    Transcatheter Arterial Embolization in Postpartum Hemorrhage: A Case ReportOpen Access

    Alka Chhabra*, Anil Bhiwal, Neha Pandey, Sitaram Barath and Sunanda Gupta
    DOI:
    PDF763.34 KB 763.34 KB
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    Abstract [+]

    Background

    Postpartum haemorrhage is the leading cause of maternal mortality and morbidity. The significant impact of postpartum haemorrhage (PPH) on maternal mortality can be reduced if timely measures are implemented. Transcatheter arterial embolisation (TAE) is an alternative therapeutic strategy for PPH.

    Case report

    We report a case of postpartum haemorrhage which was managed by transcatheter arterial embolization in lieu of hysterectomy to preserve fertility and menstruation in a 27-year-old patient.

    Conclusion

    The critical role of obstetrician, anaesthesiologist and interventional radiologist as a team, improve the quality of care and patient safety.

    Keywords

    Postpartum hemorrhage (PPH); Peripartum hysterectomy; Transarterial embolisation.


  • 2019, July

    original research

    In Need of Care but Providers of Care: Grandparents Giving Fulltime Care to their Grandchildren in Rural UgandaOpen Access

    Neema Stella* and Nankwanga Annet
    DOI:
    PDF382.67 KB 382.67 KB
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    Abstract [+]

    Background

    In most African countries, the elderly face challenges that affect their health and wellbeing and are more pronounced because of the systemic factors of inadequate health care, food insecurity and the general care. Increasing population of the elderly persons in Uganda is raising concern than ever before. The purpose of this paper to ascertain care available to the rural elderly persons and their role as carers for their grandchildren and implications on their wellbeing.

    Methods

    This was a qualitative study conducted among the rural elderly aged 60 years and above in eight purposively selected district that included Lira, Nebbi, Kampala, Luwero, Pallisa, Jinja, Mbarara, and Ntungamo. The study sample consisted of 101 elderly person from whom in-depth interviews were conducted. Data was analysed using qualitative thematic content analysis.

    Results

    Rural elderly in Uganda face a lot of constraints that include access to healthcare and information, poor economic status, food insecurity and poor nutrition, and poor accommodation and housing conditions. Two broader themes emerged inductively from the analysis that include care available for the rural elderly and providing care to grandchildren. These themes generated several subthemes. Taking care of grandchildren crippled the elderly and reduced the economic benefits. That said some rural elderly were happy and felt fulfilled to care of the grandchildren despite the lack of resources.

    Conclusion

    The rural elderly in Uganda are living in doleful conditions with limited care and support. They need care but are the providers of care to the grandchildren. They are frails and may not afford to provide adequate care. They care for grandchildren many of whom are orphans and vulnerable yet they themselves need care. It is important the government and the community re-enforce this care not to put strain on elderly. The rural elderly unique challenges necessitates special targeting and mobilization of resources at the household, local, district and national levels.

    Keywords

    Grandparents; Care; Orphans; Grandchildren; Skip-generation; Uganda.


  • 2019, August

    review

    The Use of Single-Cell Transcriptomics’ to Detect Cellular Transition through Notch Signaling and Receptor Expression in Differentiated Kidney Collecting Tubule Cells in Adult Mice: A ReviewOpen Access

    Matthew A. Cornacchia*, Soroush Nomigolzar, Giovanni Charles, Himax Patel and Kenneth Luberice
    DOI:
    PDF361.62 KB 361.62 KB
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    Abstract [+]

    Transcriptomics has allowed for a better understanding of disease, and the sequencing of individual genes is becoming a leading approach to discovering novel germ lines. A newly defined cell type, described as transitional cells, was characterized based on their expression of key marker genes that define principle cells (PC) and intercalated cells (IC). Gene expression patterns suggested that a Notch signaling pathway was activated during the transition from IC to PC. An experimental model studying the transition in an inducible transgenic mouse demonstrated that Notch signaling and receptor expression is sufficient to drive cell transition in differentiated adult kidney collecting tubule. The identification of novel cell lines allows for a more accurate diagnosis of kidney disease and precise staging of disease. Molecular profiling and precision therapy will continue to revolutionize the field of medicine and warrants further exploration.

    Keywords

    Transcriptomics; Kidney disease; Principle cell; Intercalated cell; Notch signaling; Gene sequencing.

    Abbreviations

    PC: Principle cell; IC: Intercalated cell, DNA: Deoxyribonucleic acid; RNA: Ribonucleic acid; mRNA: Messenger ribonucleic acid.


  • 2019, September

    letter to the editor

    Call Me Anything but Thoughtless or Misguided in IBD ManagementOpen Access

    Nicholas V. Costrini*
    DOI:
    PDF242.88 KB 242.88 KB
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  • 2019, November

    opinion

    What IBD Physicians Can Learn from Major League Baseball ManagersOpen Access

    Nicholas V. Costrini*
    DOI:
    PDF214.56 KB 214.56 KB
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  • 2019, November

    review

    The Evolving Field of Stereotactic Body Radiation Therapy in Pancreatic CancerOpen Access

    Maged Ghaly*, Emile Gogineni and Muhammad W. Saif
    DOI:
    PDF437.42 KB 437.42 KB
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    Abstract [+]

    Pancreatic cancer remains a devastating disease with dismal outcomes despite the development of novel chemotherapeutic regimens and radiation techniques. Stereotactic body radiation therapy (SBRT) offers an advantage both in image guidance and radiation dose delivery to direct ablative doses to tumors with acceptable toxicity compared to conventional techniques. Recent literature is clustered with data pertaining to SBRT in patients with resectable, borderline resectable and locally advanced pancreatic tumors. We here present a summary of the current data and highlight the limitations and potential for future growth. Further clinical study in the form of multi-institutional trials is warranted to establish the role of SBRT in combination with new chemotherapeutic agents as well as a non-invasive alternative to surgery.

    Keywords

    Pancreatic neoplasms; Pancreas cancer; Radiosurgery; Stereotactic; Stereotactic body radiation therapy (SBRT); Radiation; Radiotherapy.


  • 2019, November

    editorial

    Challenges Ahead for Advanced Training Programs in Pediatric Dentistry in the Area of Sedation for Pediatric Dentists and the Commission on Dental AccreditationOpen Access

    John E. Nathan*
    DOI:
    PDF226.62 KB 226.62 KB
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  • 2019, November

    observational study

    An Observational Study to Evaluate Infection Risk in Two Staff Warming Devices and a Review of Current Literature into Thermal Comfort in the Operating Room and BeyondOpen Access

    Mark Silverberg*
    DOI:
    PDF401.09 KB 401.09 KB
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    Abstract [+]

    Objective

    To compare the degree of bacteria dissemination using two currently available operating room (OR) personnel warming devices. The “off-label” use of 3MTM’s Bair HuggerTM vs. a fairly new device, worn around the torso and under a scrub warm-up jacket or surgical gown, the OPERATIONHEATJAC® transformer only (TRO) powered by a transformer and controlled by a 4-level controller, and best for anesthesia providers and perfusionists.

    Methods

    Initially, staff members in scrubs sat in a room for 3 and 6-hours with agar plates placed in various positions throughout the room. Then staff members sat in the same room under the same conditions for 3 and 6-hours, and placed the hose from 3M’s Bair Hugger under their scrubs. Agar plates were positioned in the room in the same positions as in the control. Then staff members sat in the same room under the same conditions for 3 and 6-hours, wearing the OPERATIONHEATJAC® TRO over their scrub shirt and under a scrub warm-up jacket. Agar plates were again positioned in the room in the same positions as in the control. Bacteria colony counts were compared.

    Results

    The bacteria colony counts were 43.78% and 46.18% higher at 3 and 6-hours respectively from placement of the hose from 3MTM’s Bair HuggerTM under scrubs vs. the control. There was no significant difference in bacteria colony counts with using the OPERATIONHEATJAC® TRO vs. the control.

    Conclusion

    ORs are maintained cold, mostly for surgeon comfort. In an attempt to keep comfortable in this environment, peripheral OR staff opt for the “off-label” use of 3M’s Bair Hugger hose placed under scrubs. An increased spread of bacteria throughout the OR can result from this practice. Currently, there are now safer OR personnel warming devices available. In addition, this paper reviews the significance and benefits of keeping staff warm and comfortable.

    Keywords

    Warming devices; OPERATIONHEATJAC®; surgical site infections (SSIs); Operating room (OR); Temperature.


  • 2019, December

    case report

    Melorheostosis: A Rare Cause of Limb PainOpen Access

    Matthias Z. H. Lu* and Narlaka Jayasekera
    DOI:
    PDF398.00 KB 398.00 KB
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    Abstract [+]

    Melorheostosis is a rare skeletal dysplasia, and to date there are no reports of this condition in Australia. This is a case of a lady who presented with dull arm pain with a pathognomonic radiological findings. The plain radiographs obtained of the limb demonstrated a characteristic candle wax appearance in a monomelic distribution. The natural history, presentation, and management are discussed in detail.

    Keywords

    Melorheostosis; Skeletal dysplasia; Central Australia.


  • 2019, December

    editorial

    Why HALO 301 Failed and Implications for Treatment of Pancreatic CancerOpen Access

    Nausheen Hakim, Rajvi Patel, Craig Devoe and Muhammad W. Saif*
    DOI:
    PDF365.50 KB 365.50 KB
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    Abstract [+]

    Survival rates for pancreatic cancer (PC) remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops leading to poor outcomes. PC is a relatively chemoresistant tumor and one of the explanations for this is attributed to desmoplasia that impedes drug delivery. Based on this, stromal modifying agent such as Pegvorhyaluronidase alfa (PEGPH20) was developed and investigated in phase I-III studies. Although phase I-II studies showed promising results in patients with high hyaluronic acid (HA) expressing tumors, the phase III HALO 301 study failed to miss it’s primary endpoint and further development of PEHPH20 is halted. This failure implies that targeting desmoplasia alone is not sufficient and other intrinsic factors such as lack of significant neoantigens, low tumor mutational burden, and epithelial to mesenchymal transition may be at play. It is also important to consider that although the tumor stroma may be a physical barrier hampering drug delivery, it may also have protective effects in restraining tumor growth and progression. Further studies in molecular biology to better characterize the complex interaction between the microenvironment and cancer cells are warranted.

    Keywords

    Pegvorhyaluronidase alfa (PEGPH20); Desmoplasia; Pancreatic cancer; Chemoresistance; HALO.


  • 2019, December

    editorial

    PARP Inhibitors in Pancreatic Cancer: From Phase I to Plenary SessionOpen Access

    Rajvi Patel, Daniel Fein, Carolina B. Ramirez, Kevin Do and Muhammad W. Saif*
    DOI:
    PDF397.94 KB 397.94 KB
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    Abstract [+]

    Survival rates for pancreatic cancer remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops. Tumors deficient in deoxyribonucleic acid (DNA) damage repair mechanisms such as BRCA mutants show better responses to platinum based agents, however, such tumors can utilize the poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP) pathway as a salvage mechanism. Therefore, inhibition of PARP pathway could lead to tumor destruction and synthetic lethality in presence of BRCA mutation. Various PARP inhibitors have been approved for treatment of patients with germline or somatic BRCA mutant breast and ovarian cancer. This provides basis of using PARP inhibitors in patients with pancreatic cancer that harbor BRCA mutation. A recent phase III Pancreas Cancer Olaparib Ongoing (POLO) study showed impressive results with near doubling of progression free survival compared to placebo (7.4 vs 3.8 months). These results highlight the importance of germline testing for all patients with pancreatic cancer and inclusion of additional deficiencies in homologous recombination repair (ATM and PALB2) including BRCA variants of uncertain significance should be further explored.

    Keywords

    Pancreatic cancer; Chemoresistance; DNA damage repair; Synthetic lethality; BRCA1/2; Germline mutations; Genomics.


  • 2019, December

    case report

    Spontaneous Resolution of Pituitary Cystic LesionOpen Access

    Alice Willison, Avinash K. Kanodia*, Kirit Singh, Graham Leese, Douglas Allan, and Kismet Hossain-Ibrahim
    DOI:
    PDF413.59 KB 413.59 KB
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    Abstract [+]

    Differentiating between cystic lesions of pituitary gland may be challenging. Usual differentials are cystic pituitary adenoma (cPA) and Rathke’s cleft cyst (RCC). Diagnostic certainty of magnetic resonance imaging (MRI) is limited in the absence of usual suggestive features. Furthermore, RCC can co-exist with approximately 2% of pituitary adenomas. Over time, these cystic lesions may remain static, resolve spontaneously, or result in symptomatology relating to mass effect and/or hormonal disruption. In cases of an asymptomatic lesion being found incidentally, little is known about how it may progress, raising question whether to proceed with surgical management or follow-up. We a present case of a spontaneously resolving pituitary cystic lesion with imaging features more suggestive of cPA than RCC, for which watchful waiting proved a successful treatment strategy. The current case serves as a reminder that small cystic lesions can be followed-up with spontaneous resolution and should be offered active treatment only when clinically required.

    Keywords

    Pituitary gland; Pituitary cystic lesion; Cystic pituitary adenoma (cPA); Magnetic resonance imaging (MRI).


  • 2019, December

    case report

    A Rare Case of Gemcitabine-Induced Pulmonary HypertensionOpen Access

    Janice Shen, Su Yun Chung, Elham Azimi-Nekoo, Jyothi Jose and Muhammad W. Saif*
    DOI:
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    Context

    Gemcitabine is the backbone of systemic treatment of locally advanced and metastatic intrahepatic cholangiocarcinoma. In recent literature, gemcitabine has been linked to various pulmonary side effects.

    Case Report

    We report a case of an 82-year-old male who developed acute pulmonary hypertension after receiving one cycle of gemcitabine for metastatic cholangiocarcinoma. His symptoms began with fatigue associated with shortness of breath and cough that worsened despite dose reduction. He developed new onset bilateral pulmonary effusions and an echocardiogram revealed findings consistent with pulmonary hypertension. A computed tomography (CT) angiogram was negative for pulmonary thromboembolism. Although he was promptly treated with diuretics and steroids, the patient could not tolerate any further therapy.

    Conclusion

    Gemcitabine-induced pulmonary hypertension is rare and can be challenging to diagnose, as it remains a diagnosis of exclusion. However, physicians should be vigilant of new pulmonary symptoms, as delayed treatment can cause significant patient morbidity and mortality.

    Keywords

    Cholangiocarcinoma; Gemcitabine; Pulmonary hypertension.

    Abbreviations

    CT: Computed Tomography; PE: Pulmonary Thromboembolism; GIPT: Gemcitabine-Induced Pulmonary Toxicity.


  • 2019, December

    case report

    The Importance of Enzyme Substitution Therapy in Early Pancreas Exocrines of InsufficiencyOpen Access

    Biljana Petrovic*
    DOI:
    PDF257.68 KB 257.68 KB
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    Introduction

    Functional disorders of the digestive tract are a common occurrence in the doctor’s office. In addition to functional dyspepsia, 35% of dyspepsia are unresolved dyspepsia, which are a symptom of the early stage of pancreatic exocrine insufficiency.

    Aim

    Based on clinical experience, we can suspect and detect chronic pancreatic insufficiency at an early stage, which is the aim of this paper.

    Method

    To demonstrate the efficacy of enzyme replacement therapy in the early stage of pancreatic exocrine insufficiency using the case report of the patient.

    Results

    Results confirms significance and effectiveness of creon as an enzyme replacement therapy in the treatment of malabsorption and maldigestion.

    Conclusion

    Creon (pancreatin) showed great effect in the treatment of dyspepsia and anorexia nervosa, body mass index (BMI) for 30 days increased from 15.9 to 17.4, which leads us to the conclusion that unrecognized chronic pancreatic insufficiency can be expected in long-term dyspepsia.

    Keywords

    Chronic pancreatic insufficiency; Enzyme; Body mass index (BMI); Digestive tract.


  • 2020, January

    brief report

    The Skinny on Moisturizers: A Brief ReportOpen Access

    Sreeja R. Kuppam*
    This work is done by a high school student and we are publishing this as it fits into our mission of promoting and encouraging studies in science, technology, engineering and mathematics (STEM) field for our next generation. – Editor-in-Chief, DRMTOJ
    DOI:
    PDF407.59 KB 407.59 KB
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    Objective

    To compare the effectiveness of 5 different skin moisturizers using JELL-O® as a model for the human skin.

    Methods

    In this study five different moisturizers (Equate®, Burt’s Bees®, Suave®, Aveeno® and Vaseline®) were applied to equivalent samples of JELL-O®. Observations were made over a 12-day period and data was collected at 15 different time intervals. The primary outcome was the height (cm) and weight (g) of the JELL-O® sample at each time interval. The study was an ex vivo experiment conducted in a home laboratory. No Institutional Review Board (IRB) approval was required since the research does not involve living organisms.

    Results

    Overall, the JELL-O® sample that had the Vaseline® applied on it had the lowest loss of height and weight. The height stayed at 100% of its original value and the weight only decreased to 97.2% of the original value by the end of the observation period. In contrast, the sample which had Suave® applied to the surface its height and weight decrease the most (42% and 28% respectively). The other moisturizers had effects intermediate between these two extremes.

    Conclusion

    Based on this ex vivo head to head study using JELL-O® as a model for the human skin the 5 moisturizers examined had widely differing levels of effectiveness with Vaseline® appearing to be the most protective against evaporative losses and Suave® appearing to be the least.

    Keywords

    Moisturizers; Dry skin; Different moisturizers; Skin lotions; Vaseline® effectiveness.


  • 2020, January

    letter to the editor

    Squamous Melanocytic Tumour at an Unusual Site: An Uncommon Case and Literature ReviewOpen Access

    Barbara Barbosa*, Salvador J. Diaz-Cano, FRCPath and Alexandre Abramavicus
    DOI:
    PDF478.58 KB 478.58 KB
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    We herein present a case report of a 60-year-old male patient diagnosed with squamous-melanocytic tumour (SMT) in his anal region, comprised of two intermingled different phenotypic lesions. This dual tumour is quite uncommon and could potentially be challenging on both diagnose and also management. It is the first case reported on this location, moreover, the lack of consensus for these lesions makes it difficult to classify them. We reviewed the literature of similar SMT’s and discussed its histogenesis. As they are rare, their biological behavior and potential metastasis remain unclear. Therefore, close follow-up is advised.

    Keywords

    Combined neoplasia; Squamous-melanocytic tumour; Uncertain; Anal canal.


  • 2020, January

    Case Illustration

    Graves Disease: Successful Cesarean Section and SalpingectomyOpen Access

    Ryan Sanni* and Kinal Bhatt
    DOI:
    PDF267.42 KB 267.42 KB
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  • 2020, January

    illustration

    Necrotizing Fasciitis: Fatal Evolution of Acral MelanomaOpen Access

    El Marfi Abdelhafid*, Samia Mrabat, Kaoutar Laamari, Mohammed El Idrissi, Abdelhalim El Ibrahimi, Abdelmajid El Mrini, Zakia Douhi, Sara Elloudi, Hanane Baybay and Mernissi F. Zahra
    DOI:
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  • 2020, January

    original research

    Characteristics of Effective and Safe Methods of Treatment for Fresh Fracture-Dislocations of the Proximal HumerusOpen Access

    Pavel Kogan*, Dmitrii Chugaev and Leonid Solomin
    DOI:
    PDF452.58 KB 452.58 KB
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    Abstract [+]

    Aim

    The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics.

    Patients and Methods

    This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis.

    Results

    Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s) exceeding 10 mm had an average score of 49.5±19.5 points (Mean=44). Analysis of the results of treatment showed that the delay in restoring normal anatomy of the PH or avoiding surgical interventions at all led to functional disorders of the shoulder joint. It was also demonstrated that neither patients, nor doctors were satisfied with the outcomes of the unipolar shoulder replacement (USR). Based on the results of the study, we proposed an algorithm for determining the tactics of surgical treatment in cases when a fracture-dislocation of the PH with complete dislocation of the fragment involving the articular surface of the humeral head is diagnosed.

    Conclusion

    The present study demonstrated some factors affecting the outcomes of treatment for fracture-dislocations of the PH. Current approaches for endoprosthesis replacement in these cases remain debatable and require further investigation.

    Keywords

    Trauma; Fracture; Shoulder joint; Fracture-dislocation of the proximal humerus.


  • 2020, February

    review

    Better Together: Evolving Social Process between Bystanders and First Responders is a Force Multiplier for Effective Emergency ResponseOpen Access

    Carmit Rapaport* and Isaac Ashkenazi
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    PDF433.98 KB 433.98 KB
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    Bystanders are an integral part of an emergency scene. Their presence on site makes them the immediate potential responders, who can provide life-saving assistance as well as various rescue actions. Research has shown that bystanders are willing to and are capable of helping, especially (but not limited to) when a leader emerges, as the help is rooted in a collective action. In this article, we suggest a new framework for understanding the effectiveness of bystanders help, based on the evolving social process between bystanders and first responders. As we show, the transition from no help, at the very first moment right after the emergency has occurred, to an effective coordinated response where first responders and bystanders act together, goes through engagement of bystanders. Further, first responders should acknowledge the social organization of bystanders, utilize and leverage it in order to optimize their efforts. This framework has important insights for policy makers when managing emergency and disaster situations with limited resources.

    Keywords

    Bystanders; First responders; Mass casualty incident; Help; Emergency; Cardio-pulmonary resuscitation (CPR).


  • 2020, February

    Case Illustration

    Dynamic Shape Change of an Aortic Valve Cusp Perforation on 3D Transesophageal EchocardiogramOpen Access

    Maedeh Ganji, Jose Ruiz, Robert Percy, Emil Missov and Srinivasan Sattiraju
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  • 2020, February

    case study

    Gender, Creativity and Insanity: From an Anthropologist’s NotebookOpen Access

    Meenakshie Verma*
    DOI:
    PDF315.96 KB 315.96 KB
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    This essay has emerged through my research engagements with life history as a research method in anthropology. It is based on the life events of a woman artist. The past few decades have brought an explosion of cultural criticisms and also explorations of women’s creative expressions across cultures. Some of the queries addressed are, how do external forces shape the creativity of female artists. Also, how do creative women respond to such forces? Creative women, then, have a unique relationship to their cultural contexts, as well as to the creative genre to which they respond. This essay also delves into myths related to insanity and women. It discusses creativity, as a mode of engagement with rigid social structures.

    Keywords

    Life history; Women; Creativity; Body psyche; Insanity; Myths; Anthropology.


  • 2020, February

    case report

    Blighted Ovum: A Case ReportOpen Access

    Aqsaa N. Chaudhry, Frederick M. Tiesenga, Sandeep Mellacheruvu and Ryan R. Sanni
    DOI:
    PDF275.49 KB 275.49 KB
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    Presenting in her late twenties, this case report examines a G6P2 patient at 11-weeks gestation that was diagnosed with a blighted ovum, as well as the subsequent outcome and methods of additional management. A blighted ovum refers to a fertilized egg that does not develop, despite the formation of a gestational sac. The most common cause of a blighted ovum is of genetic origin. Trisomies account for most first trimester miscarriages, while consanguineous marriages result in recurrent miscarriages due to a blighted ovum. Additionally, a higher percentage of deoxyribonucleic acid (DNA) damage in sperm carries a higher rate of miscarriage. Nutritional factors that may lead to a blighted ovum include low-levels of copper, prostaglandin E2, and anti-oxidative enzymes. High body mass index (BMI), especially in women with a BMI≥30 kg/m2 has been shown to be linked to a blighted ovum. Globally, it has been shown that a blighted ovum is a serious adverse event related to vaccination against dengue fever.


  • 2020, March

    editorial

    Pathology Hiding in Plain Sight: The NF1 Plasma MembraneOpen Access

    Vincent M. Riccardi*
    DOI:
    PDF287.00 KB 287.00 KB
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  • 2020, March

    Case Illustration

    Hidradenoma PapilliferumOpen Access

    Kaoutar Laamari*, Hanane Baybay, Samia Mrabat, Zakia Douhi, Sara Elloudi and Fatima Z. Mernissi
    DOI:
    PDF394.66 KB 394.66 KB
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  • 2020, March

    case report

    Advanced Heart Failure Exacerbated by Discreet Left Ventricular Lead Non-CaptureOpen Access

    Jon Krathen*, John Costello, Mark Moshiyakhov, Raphael Corbisiero and Kulpreet Barn
    DOI:
    PDF698.54 KB 698.54 KB
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    Abstract [+]

    This case report illustrates a challenging case of worsening heart failure in a previously well-compensated patient with unclear etiology. Further workup revealed the patient’s cardiac resynchronization therapy-defibrillator (CRT-D) left ventricle (LV) lead was losing capture during positional changes. This case demonstrates the importance of device optimization, as well as electrocardiogram (ECG) monitoring to elucidate possible causes of acute systolic heart failure.

    Keywords

    Cardiac resynchronization; cardiac resynchronization therapy (CRT); Systolic heart failure; Lead positioning;
    Advanced heart failure.


  • 2020, March

    brief research report

    Awareness of Ototoxicity among Medical Doctors in AssamOpen Access

    Writisha Bora, Himanshu K. Sanju*, Vijay Kumar, Prasanta Borah and Tushar Jain
    DOI:
    PDF444.04 KB 444.04 KB
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    Introduction
    Previous literature has reported ill-effect of ototoxic drug on hearing and balance. Present study investigated awareness among medical doctors for the same.
    Method
    A total of 55-medical doctors of multiple specialties from Assam, India participated in the present study. A total of 14 questions with Likert Scale based scoring pattern were framed and validated for the present study.
    Results
    Outcome of the present study showed high awareness percentage about side effect ototoxic drugs was obtained, which was a satisfying outcome.
    Conclusion
    While low audiological referral and consultation awareness was identified as an area of concern.

    Keywords
    Ototoxicity; Doctors; Assam; Awareness.


  • 2020, April

    case report

    Pseudo Metabolic Acidosis in the Setting of Hypertriglyceridemia: A Case ReportOpen Access

    Atul Bali* and Roopa Naik
    DOI:
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    Low serum bicarbonate, with or without an elevated anion gap, can indicate metabolic acidosis. High anion gap metabolic acidosis is due to the unmeasured anions. Hypertriglyceridemia can also be associated with spuriously low serum bicarbonate levels due to lab interference. We present a 44-year-old woman who presented with anion gap metabolic acidosis in the presence of severe hypertriglyceridemia.

    Keywords

    Hypertriglyceridemia; Acid-base disorders; Low serum bicarbonate; Metabolic acidosis.


  • 2020, April

    clinical study

    A Case Study Exploring Pre-Service Teachers’ Programming Difficulties and Strategies when Learning Programming LanguagesOpen Access

    Fatih Gok and Kyungbin Kwon*
    DOI:
    PDF368.66 KB 368.66 KB
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    Understanding the importance of training young people, this study sought to explore the early experience of pre-service teachers in their computational practices in terms of the difficulties they faced and the strategies they used while learning how to program. Based on convenience sampling, four participants were recruited from an undergraduate course focusing on computer science education in K-12. The literature on novice programmers’ difficulties and their strategies was used to establish the conceptual background for this study. We collected four semi-structured interviews with pre-service teachers, a total of five hour-long classroom observations, and 19 class activities (archival data). After conducting a content analysis, findings showed four categories in which pre-service teachers face difficulties: (a) understanding the computational concepts (semantic); (b) using the concepts inappropriately (syntax); (c) developing a program (algorithmic thinking), and (d) identifying problems (debugging). We also found five categories in which pre-service teachers overcome their difficulties: planning, using resources, seeking support, guessing and checking, and looking for visual assistance. This study emphasized that pre-service teachers encounter several difficulties in learning computational concepts through programming languages, which should be considered in pre-service teacher education.

    Keywords

    Computational Thinking; Computer science education; Pre-service teachers; Problem solving strategies.


  • 2020, April

    observational study

    Micropulse Transscleral Cyclophotocoagulation: Our ExperienceOpen Access

    Syed S. Ahmad*, Shuaibah A. Ghani, Ghuncha Khatoon, Sumera Sagheer and Juwairiya Ilyas
    DOI:
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    Introduction

    Traditionally, ciliary body destruction has been used to treat uncontrolled intraocular pressure (IOP) following maximally tolerable medical therapy. This is due to the large number of complications seen with this procedure. However, recently a new technique of sub-threshold laser or micropulse laser, is able to provide selective destruction of the ciliary body in a controlled manner. This avoids most of the complications seen with other modalities. We have performed a small case descriptive pilot study to assess the effectiveness of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in lowering IOP.

    Methods

    This pilot study was conducted on four patients in the age range 55-70-years with intractable glaucoma. Two patients had primary angle closure glaucoma, one-each had steroid-induced glaucoma and neovascular glaucoma. Mean baseline IOP was 32±2.4 mmHg. Mean number of glaucoma medications were 2.5±1.5. All patients underwent 180° MP-TSCPC. Absolute success was defined as IOP<20 mmHg without acetazolamide.

    Results

    Following the procedure the patients were followed-up at days 1,7,30 and 90. At the last follow-up of the study, mean IOP was 18.2±1.2 mmHg in all four patients. Mild anterior chamber inflammation was the only complication noted. Mean number of glaucoma medications reduced to 1.5±1.0 following the procedure. Thus, absolute success was achieved in all patients.

    Conclusion

    This small pilot study validates other studies which show effectiveness of MP-TSCPC as an efficient and safe procedure to lower IOP. This procedure can be used over a wide variety of cases, though the indications for such procedures are still evolving. More extensive and long-term studies will clarify the position of this procedure in our glaucoma management practices.

    Keywords

    Glaucoma; Micropulse laser; Cyclophotocoagulation.


  • 2020, April

    opinion

    The Catalytic Framework: Africa’s Weapon to End Acquired Immune Deficiency Syndrome by 2030Open Access

    Benjamin Djoudalbaye*
    DOI:
    PDF280.21 KB 280.21 KB
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  • 2020, April

    commentary

    Measurement of Women’s Leg Edema Using UltrasonographyOpen Access

    Eri Ikuta, Yumiko Watanabe, Nami Yanagisawa, Miwa Nakagawa, Ayumi Ono, Keiko Seki, Makiko Oowaki, Masafumi Koshiyama* and Shin-ichi Sakamoto
    DOI:
    PDF337.16 KB 337.16 KB
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  • 2020, May

    systematic review

    Optimizing Cardiovascular Outcome in Type 2 Diabetes Mellitus with Better Control of Diabetes Mellitus with Empigliflozin and Hypertension with Renin Angiotensin System Inhibitors and Manidipine Preferably of the DihydropyridonesOpen Access

    Kulvinder Kochar Kaur*, Gautam Allahbadia and Mandeep Singh
    DOI:
    PDF555.43 KB 555.43 KB
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    Aim: Obesity is increasing globally by leaps and bounds and thus the incidence of type 2 diabetes mellitus (T2DM) along with it so much so that the term diabesity had to be coined. Earlier we had reviewed how to treat the both together and the role of empagliflozin to improve cardiovascular outcome trials (CVOT). Similarly T2DM and hypertension are pathophysiologically-related diseases which co-exist with a broader complex of metabolic diseases which co-exist possessing similar set of risk factors. Hence it is important to consider which antihypertensives are suitable that possess a positive effect on metabolic factors in cases of T2DM who require an antihypertensive.

    Method: A systematic review was carried out using the PubMed search engine with the MeSH terms: “T2DM”; “essential hypertension; “cardiovascular (CV)”; “Complications of diabetes mellitus (DM) and antihypertensive”; “Antihypertensive preferred in T2DM subjects”; “Renin-angiotensin–aldosterone system inhibitors”; “Angiotensin converting enzyme inhibitors (ACEi)”; “Angiotensin receptor blockers (ARBs)”; “Dihydropyridine calcium channel blocker”; “β2 blockers”; “Diuretics”.

    Discussion: Most diabetes mellitus (DM) subjects need a minimum of two antihypertensive drugs, combining a renin-angiotensinaldosterone system (RAS) inhibitor with a dihydropyridine calcium channel blocker seems to be the most indicated approach. But not all dihydropyridine calcium channel blockers have equivalent effects on metabolic parameters. Hence manidipine that causes positive effect on insulin resistance (IR) seems to be an effective option. We have reviewed how manidipine is superior to amlodipine with regards to improving IR, not seen with amlodipine, along with not causing excessive sympathetic nervous system (SNS) activation, pulse pressure and ankle edema or to much lesser extent than amlodipine. Therefore, manidipine needs to be the first addition to RAS inhibitors in case of DM’s having hypertension of the dihydropyridines calcium channel blockers. Further good blood pressure (BP) control been correlated with good CVs outcomes.

    Conclusion: A RAS inhibitor is the first line of choice of drugs in a subject with T2DM who needs to be treated with empagliflozin for better CVOT outcome, and when a 2nd drug has to be added it is manidipine that is preferred over amlodipine. Plant products are proving to be having a lot of beneficial effects in DM, obesity and hypertension. Thus need for developing agents from plants will prove to be more cost effective in these chronic diseases where compliance is difficult to achieve with the use of common antiDM drugs and antihypertensives with the cost factor along with their side effects.

    Keywords

    Type 2 diabetes mellitus (T2DM); Diabesity; Antihypertensives; Renin-angiotensin-aldosterone system (RAS) inhibitor; Dihydropyridines calcium channel blockers; Plant products.


  • 2020, May

    editorial

    A New Mindset: Artificial Intelligence in Digital Hearing AidsOpen Access

    Neha Taneja*
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  • 2020, May

    Preparing for an In vitro Fertilization CycleOpen Access

    Connie Stark*
    DOI:
    PDF287.93 KB 287.93 KB
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  • 2020, May

    editorial

    Neurofibromatosis 1 Somatic Mutation Triggering Cellular Apoptosis to Prevent Neurofibromatosis 1 ProgressionOpen Access

    Vincent M. Riccardi*
    DOI:
    PDF278.33 KB 278.33 KB
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  • 2020, May

    opinion

    Cancer DynamicsOpen Access

    Daniel Gandia* and Cecilia Suárez
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    PDF298.99 KB 298.99 KB
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  • 2020, May

    case report

    An Unusual Case of Nausea and Vomiting in Pregnancy: A Case ReportOpen Access

    Babu Karavadra*, Medha Sule and Christine-Antoinette Portelli
    DOI:
    PDF299.70 KB 299.70 KB
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    Malrotation of the gut is rare in adults. We discuss the case of a 30-year-old primiparous woman who presented to the acute gynecology ward at 19-weeks’ gestation with ongoing nausea and vomiting throughout pregnancy. She attended on a number of occasions with the same symptoms and was trialed on a number of different antiemetics. Initial biochemical investigations were unremarkable, however, the patient started to develop signs of ‘abdominal obstruction’. A magnetic resonance image (MRI) of the pelvis showed evidence of duodenal obstruction secondary to malrotation which may be secondary to a fibrous (Ladd’s) band. She was treated laparoscopically via a Ladd procedure and had an uneventful recovery. Interestingly, the patient presented again in her second pregnancy with very similar symptoms and underwent another Ladd procedure, but via a laparotomy. This is an interesting, rare and unusual case of nausea and vomiting in pregnancy.

    Keywords

    Ladd bands; Pregnancy; Nausea; Vomiting; Hyperemesis; Volvulus.


  • 2020, May

    systematic review

    Pre-Debridement and Post-Debridement Culture in Open Fractures of the Extremities: A Comparative StudyOpen Access

    Mohamed A. Abdi, Vidmi T. Martin, Sayid O. Mohamed, Zhaozhen Wang, Leila E. Abdulle and Bo Yu*
    DOI:
    PDF421.75 KB 421.75 KB
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    Background

    Due to contamination, open fractures are considered to be dangerous and thereby require proper management. Through a systematic review and meta-analysis, this study compares the literature on pre-debridement and post-debridement cultures derived from such fracture sites.

    Methods

    Data for this review was collected through various online sources such as dataBASE (EMBASE), medical literature analysis and retrieval system online (MEDLINE) and different citations provided the relevant data.

    Results

    Twenty articles were included. The desired timing to examine the debridement was six hours post-injury (according to the six-hour rule). Antibiotics including ampicillin, penicillin, cefazolin, cefuroxime, and flucloxacillin were used in some patients. The use of Ancef I as an antibiotic during the starting hours of fracture helps to reduce the chances of infection in 1.4% of the infected patients. The infection rate was 3% in pre-debridement culture, while a 2% infection rate was found in post debridement culture. Gram-negative bacteria were responsible for pre-debridement infection, while gram-positive bacteria were responsible for post-debridement.

    Conclusion

    The pre-debridement infection rates are reduced as compared to post-debridement when treatment is initiated within a strict time interval and limited to the specific use of antibiotics. Treatment of gram-negative bacteria helps to reduce the bulk of infectious material and thereby reduces the infection rate.

    Keywords

    Open fractures; Debridement; Pre-debridement; Post-debridement; Meta- analysis; Systematic review.


  • 2020, May

    mini review

    Effect of Statins Therapy in DiabetogenesisOpen Access

    Abolaji S. Olagunju*, Olayinka A. Adebayo, Samson O. Kosemani and Toluwanimi P. Iroko
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    PDF325.64 KB 325.64 KB
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    Abstract [+]

    Statins are widely used in the management or inhibition of several processes that lead to the development of cardiovascular diseases. Increased statin therapy has been related to the induction of type II diabetes (DM), a state which predisposes to cardiovascular disease (CVD). Statins are well-known to possess anti-inflammatory properties and the ability to disrupt de novo biosynthesis of cholesterol and lipid homeostasis has been implicated in the induction of inflammatory responses within pancreatic β-cells. Inhibition of β-hydroxy β-methyl glutaryl-CoA (HMG-CoA) results an increased level of low-density lipoproteins (LDL) receptors. Increased LDL receptor numbers will replenish exhausted intracellular supplies, resulting in higher levels of intracellular cholesterol. Therefore, stimulating immunological response and inflammatory reactions, disrupt the functional integrity of the β-cell via oxidation of the plasma-derived low-density lipoprotein. Despite the pleiotropic effects of statins on the pancreatic β-cell, they have also been reported to affect a number of other cell types associated with the development of diabetes. Inhibition of the biosynthesis of isoprenoid by statins has been associated with the down-stream regulation of glucose transporter (GLUT 4) in adipose tissues, which facilitates the uptake of glucose. This effect resulted in increasing resistance to insulin in the liver, muscle, and adipose tissue. Adiponectin, a plasma protein released by adipocytes, alters fatty acids and carbohydrate metabolism both in the muscle cells and liver. This process indirectly influences resistance to insulin by the attendant decrease in hepatic gluconeogenesis and to upregulate muscular β-oxidation and glucose uptake.


  • 2020, June

    original research

    Clinical and Ultrasonographic Evaluation of the Pelvic Floor in Primiparous Women after Normal Vaginal Delivery with Episiotomy and without EpisiotomyOpen Access

    Nora H. K. Elabady*, Ahmed M. Awara, Amr M. El-Badry and Nareman El-Hamamy
    DOI:
    PDF391.81 KB 391.81 KB
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    Abstract [+]

    Objective

    The aim of this prospective study is clinical and ultrasonographic evaluation of the pelvic floor in primiparous women after normal vaginal delivery with episiotomy and without episiotomy.

    Methods

    This is a cross-section study of primiparous women with a history of delivery at Tanta University Hospital from August 2018 to August 2019. The sample power was calculated based on avulsion (major and minor) in two groups (vaginal delivery with episiotomy and without episiotomy) of total forty-primiparous women with an interval after delivery (20 cases after normal vaginal delivery with episiotomy and 20 cases after normal vaginal delivery without episiotomy).

    Results

    Twenty-four hours of delivery there was a highly significant difference between group A (with episiotomy) and group B (without episiotomy) regarding to ultrasound abnormalities, degree of tear, blood loss, hemoglobin concentration and clinical findings, while no difference regarding levator ani weakness. Two months later from delivery there was no significant difference between group A and group B regarding to ultrasound abnormalities and levator ani weakness while there was a difference between the two groups in regarding with clinical findings.

    Conclusion

    Normal vaginal delivery without episiotomy in primiparous women is better than normal vaginal delivery with episiotomy as there is no perineal tenderness, no dyspareunia. Low incidence of urinary, rectal incontinence, tear and perineal infection.

    Keywords

    Clinical and ultrasonography; Primiparous; Normal vaginal delivery; Episiotomy.


  • 2020, June

    systematic review

    The Use of Artificial Intelligence in Computed Tomography Image Reconstruction: A Systematic ReviewOpen Access

    Theresa Lee* and Euclid Seeram
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    Background

    Current image reconstruction techniques in computed tomography (CT) such as filtered back-projection (FBP) and iterative reconstruction (IR) have limited use in low-dose CT imaging due to poor image quality and reconstruction times not fit for clinical implementation. Hence, with the increasing need for radiation dose reductions in CT, the use of artificial intelligence (AI) in image reconstruction has been an area of growing interest.

    Aim

    The aim of this review is to examine the use of AI in CT image reconstruction and its effectiveness in enabling further dose reductions through improvements in image quality of low-dose CT images.

    Method

    A review of the literature from 2016 to 2020 was conducted using the databases Scopus, Ovid MEDLINE, and PubMed. A subsequent search of several well-known journals was performed to obtain additional information. After careful assessment, articles were excluded if they were not obtainable from the databases or not available in English.

    Results

    This review found that deep learning-based algorithms demonstrate promising results in improving the image quality of low-dose images through noise suppression, artefact reduction, and structure preservation in addition to optimising IR methods.

    Conclusion

    In conclusion, with the two AI-based CT systems currently in clinical use showing favourable benefits, it is expected that AI algorithms will continue to proliferate and enable significant dose reductions in CT imaging.

    Keywords

    Computed tomography (CT); Artificial Intelligence (AI); Image reconstruction (IN); Machine learning (ML); Deep learning (DL); Dose reduction.

    Abbreviations

    AI: Artificial intelligence; CT: Computed tomography; ML: Machine learning; DL: Deep learning; FBP: Filtered back-projection; IR: Iterative reconstruction; MBIR: Model-based iterative reconstruction; LDCT: Low-dose computed tomography; FDA: U.S Food and Drug Administration; ANN: Artificial neural network; DNN: Deep neural network; CNN: Convolutional neural network; CNR: Contrast-to-noise ratio; SNR: Signal-to-noise ratio.


  • 2020, June

    commentary

    Towards a More Sustainable Response: Strengthening the Social Agenda in the Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome EpidemicOpen Access

    Jennifer Knight-Johnson*
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  • 2020, June

    case report

    Agenesis of the Thyroid Isthmus: A Case ReportOpen Access

    Ivan P. Mani* and Niharika Raju,
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    Agenesis of the thyroid isthmus is a rare entity with a incidence rate of 0.5 and 10%. Thyroid isthmus agenesis could be associated with ectopic thyroid tissue or agenesis of the thyroid lobes. We discuss a case of a multinodular goitre which presented with morphological variations which was not detected on ultrasonography of the neck.

    Keywords
    Thyroid; Head and neck; Isthmus.


  • 2020, June

    original research

    A System or Method of Analysis for Injury Prevention in Sports, Youth Fastpitch Softball Pitchers: A Pilot StudyOpen Access

    Rebecca L. Fahey*, Karen L. Fahey, Michael D. Fahey†, Peter D. Ehn and Robert R. Schweyer
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    Background

    The prevalence of softball injuries in young pitchers is increasing with more injuries in the upper extremity in the beginning of the season.

    Research Question

    Calculate the forces generated during the pitching motion of female youth pitchers at four main areas: the stride, hips, shoulder, and wrist for 2 groups. R1: u1≠u2.

    Study Design

    Pilot study, Cross-sectional design.

    Level of Evidence

    Level-2, Strength-B.

    Methods

    This study included a total of 15 female youth fastpitch softball pitchers (mean age, 14.33-years; mean weight, 59.01 kg) recruited to participate during the Fall Softball League (2014). Divided into two groups: 270° hip rotation group vs. a projected 360° hip rotation group.

    Results

    A paired sample t-test showed that the 2 groups (270° hip rotation and projected 360° hip rotation) were strongly and positively correlated (r=0.993, p<0.001). There was a significant average difference between 270° hip rotation and the projected 360° hip rotation forces (t14=12.996, p<0.001). On average, the projected 360° hip rotation forces were 580.68 N higher than 270° hip rotation forces (95% CI [676.51, 484.84].

    Conclusion

    The Current Method (CM) of pitching clearly uses the shoulder as the driving force of the pitch, as pitchers created 467.96 N of force at the shoulder. Pitchers who used 270° hip rotation produced an average of 147.33 N at the hip while these same individuals can create an average of 589.30 N with full hip rotation.

    Clinical Relevance

    Pitchers using the CM of pitching generated an average of 468 N of force at the shoulder. Identifying interruptions in the kinetic chain is the key to reducing injuries. This is accomplished by creating the ideal kinetic chain and teaching it through a certified pitching coach program. Once identified, interruptions can be modified and changed through exercises to strengthen and improve the kinetic chain.

    Keywords

    Softball injury prevention; Fastpitch softball; Windmill pitch; Female youth pitchers; Windmill biomechanics.


  • 2020, June

    original research

    Challenges and Practices in the Implementation of Coaching Manuals in Selected Youth Handball Coaching Program in Addis Ababa, EthiopiaOpen Access

    Abate S. Wasihun*
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    Objective

    The aim of this study was to assess challenges and current practices in implementation of coaching manuals in selected Addis Ababa city, Ethiopia youth handball coaching program.

    Methods

    The study was employed a descriptive survey research method. Ten sample youth projects were selected, from twenty-four youth handball projects using stratified and purposive sampling technique. Thus, the samples of this study were 50 players, 10 coaches and 32 sport administrative officials. The data was collected through questionnaire and observation checklist and thus, analyzed using both quantitative and qualitative methods by describing statements and frequency counts and percentages.

    Results

    The findings of the study indicated that, lack of coordination work among the concerned stakeholders, due to financial scarcity; unavailability of adequate training materials and equipment, and the selection of trainees conducted just randomly without clearly stated criteria. Lack of suitable and standardized handball courts in the area and less emphasis given to maintain even the existing ones, the existed manual was not well designed and modified based on the trainee’s age level since similar manual for both sex. Due to monitoring were limited to certain sport expertise, here were no concerned bodies in charge of finding immediate solutions to the problem that were faced by the coaches and trainees. Furthermore, due to lack of awareness of communities, trainee families did not support the training program.

    Conclusion

    This kind of implementations revealed that was exposed to failure to solve the confronted challenges. Therefore, attention must be paid to the availability of sport infrastructures and qualified human resources should be employed. In addition, special attention must be given to acquiring and developing resource material such as manuals and coaching kits, which may assist in improving knowledge and advancing the technical skills of sport experts and coaches.

    Keywords

    Handball; Program; Trainee; Coaching manual; Challenges; Coach; Implementation.


  • 2020, June

    short communication

    Proteinuria: A Guide to Diagnosis and AssessmentOpen Access

    Sasha-Kay D’Aguilar and Amith Skandhan*
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    Proteinuria is a common incidental finding that physicians face in the inpatient and outpatient setting. Proteinuria may represent a benign pathology in asymptomatic patients, or it can be a sign of significant renal or systemic disease. The latter is usually associated with persistent proteinuria or other clinical findings such as renal failure. This article will focus on the mechanisms, causes and diagnostic approach of proteinuria. Proteinuria is a common incidental finding that physicians face in the inpatient and outpatient setting. Proteinuria may represent a benign pathology in asymptomatic patients, or it can be a sign of significant renal or systemic disease. The latter is usually associated with persistent proteinuria or other clinical findings such as renal failure. This article will focus on the mechanisms, causes and diagnostic approach of proteinuria.
    Keywords
    Proteinuria; Glomerular; Tubular; Nephritic; Nephrotic.


  • 2020, June

    case report

    A Rare Case of Giant Cell MyocarditisOpen Access

    Althea C. G. Neblett*
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    Giant cell myocarditis is a rare condition first described in 1905. It has a reported incidence range from 0.007% to 0.051%. It affects female and male individuals, equally, and usually occurs in young and middle-aged persons. The underlying aetiology of giant cell myocarditis is unknown but it is thought to be mediated by T-lymphocytes. Diagnosis is made via histological examination of myocardial tissue and is characterized by a mixed inflammatory cell infiltrate with multinucleated giant cells and cardiomyocyte necrosis, predominantly affecting the ventricles. The following report describes a rare case of giant cell myocarditis in a 71-year-old man with a history of hypertension and heart failure, who died while waiting to be seen in the emergency department. Autopsy findings revealed an enlarged, dilated heart with histologic features in keeping with giant cell myocarditis, along with features of heart failure. Diagnosis of giant cell myocarditis is less common in the elderly age group, possibly due to a less severe disease process in this age group and it may be misdiagnosed because older individuals may have other cardiovascular diseases (CVDs).

    Keywords

    Myocarditis; Giant cell myocarditis; Autopsy; Elderly, Cardiovascular.


  • 2020, June

    brief research report

    Contributions to Global Self-Esteem: Domain Specific Self Perceptions in Athletes Vs. Non-AthletesOpen Access

    Jason P. Willow*
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    Objective

    The objective of the present study was to examine the influence of social self-concept and physical self-worth on global self-esteem in college athletes compared to their non-competing peers. It was hypothesized that the unique contribution of each variable on self-esteem would be markedly different between the groups.

    Methods

    In a population of 146 undergraduate students, regression analyses revealed significant relationships between the domain-specific self-perceptions and global self-esteem in both groups. It was determined, however, that athletes and non-athletes differed in the distribution of variance explained by the variables. Specifically, the variance in self-esteem in athletes was attributed exclusively to physical self-worth while non-athletes revealed unique contributions from both social self-concept as well as physical self-worth.

    Results and Conclusion

    The results of the present study may be meaningful from the perspective of athletic identity and retirement from sport. Further investigation is warranted, both qualitatively and quantitatively, that may assist in developing strategies to ease the transition from participating athlete to non-competitive participation. An additional area of interest may be in examining the relationship between the domain-specific self-perceptions and psychological risk for, and impact of, athletic injury.

    Keywords

    Self-esteem; Athletes; Social self-concept; Physical self-worth; Non-athletes.


  • 2020, June

    review

    Photobiomodulation in Cells’ RepairOpen Access

    Yvona Zivic*
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    Photobiomodulation is a non-invasive treatment modality acting at different biological levels through the non-thermal transfer of photons to the living matter via a photoelectric effect, inducing photochemical reactions in treated cells. The objectives of this article is to review the literature on Photobiomodulation, its different fields of application and mechanisms of action, for establishing a comprehensive summary of evidence. The search strategy initially run searches in scientific databases MEDLINE,
    PubMed, EMBASE and Cochrane registries from 1990 up to March 2020, with entries Photobiomodulation, LLLT-LEDT, PDT, Photobiology, Cytochrome c Oxidase. Selection criteria was based on preferably inclusion of randomized clinical trials (RCTs), systematic reviews (SR) and studies providing qualitative and quantitative data with the best consistency, in a field where heterogeneity of light parameters is often a difficulty to comparison of findings. Publised expert opinions were also considered. A total of 80 publications were reviewed out of a thousand obtained from databases, among which were retained 9 RCTs, 6 systematic reviews, 3 meta-analysis and 2 case-reports. Differences were found in treatment parameters as wavelength, dosage, energy output, treatment length, performances of light-sources, quantity of diodes and single power of these, which may explain the paucity of high-level body of evidence in Cochrane databases. However, numerous state-of-the- art researches are also found, led by dedicated research teams paving the way to standardized methods of evaluation and comprehension of light-biological-tissues interaction and optimization of outcomes in a promising field.
    Keywords
    PhotoBioModulation; Low-Level-Laser-Therapy (LLLT); Light emitting diodes (LED); Biophotons-mitochondria; Adenosine-triphosphate (ATP); Inflammation-pain-skin rejuvenation; Photo dynamic therapy (PDT); Photobiology.


  • 2020, July

    short communication

    Looking Back, Moving Forward: Reflection on Race and RacismOpen Access

    Abi Canepa-Anson*
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    This paper addresses the history of racism, its manifestation and its impact. It recognises that racism is both interpersonal and structural. It is embedded in the way society and organisations are structured, through policies and practices that disadvantage black people. It is important now to work towards racial justice for the sake of a better and shared future.
    Keywords
    Racism; Race; Black lives matter; Psychotherapy; Belonging; Identity and black identity; Internalised racism; White racism.


  • 2020, July

    brief research report

    How Self-Reflection Influences Use of Cognitive and Analytical LanguageOpen Access

    Sheila Brownlow*, Emily L. Fogleman and Sophie Hirsch
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    Objective
    We examined cognitive processes and analytic expression according to emotional prime, hypothesizing that negative affect may increase rumination as seen in analytic language (that is, lead to language of “explaining”), as well as insight and causality, reflecting language focused on specific reasons.
    Method
    Sixty-four participants were assigned randomly to write about either “positive aspects of myself ” or “aspects of myself that I would like to change”. These narratives about positive and negative characteristics were subjected to the linguistic inquiry and word count (LIWC) in order to examine how the manipulations influenced expression.
    Results
    More insight and causation in language was seen in participants’ language that focused on positive (rather than negative) aspects of themselves, but more discrepancy was seen when writing about negative qualities. These findings were not a function of wordiness.
    Conclusion
    Causality and insight were prevalent in language after positive prompting, perhaps because people were providing rationale and support for positive self-talk. Discrepancy suggests counterfactual thought and was common in writing from a negative prompt.
    Keywords
    Language use; Analytical language; Sex differences in linguistics.


  • 2020, July

    original research

    Combining Ability Analysis in Sweet Corn (Zea Mays Saccharrata L.) Using Line by Tester DesignOpen Access

    Abdullah Khan, Hidayat Ur-Rahman*, Ashfaq Ahmad, Muhammad Iqbal, Sajid Kamal, Sohail Khan and Junyao Bu
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    Aim

    The purpose of this study was to investigate the different combination of testcrosses for morphological and yield relating traits and to investigate general combining ability of the inbred lines.

    Materials and Methods

    This research was conducted at The University of Agriculture Peshawar, Pakistan during 2016. Line x-tester analysis was used to test general combining ability (GCA) effects of 24 S4 lines of sweet corn. Alpha lattice design with two replications and two checks was used during the experiment. Research data were recorded on various flowering, morphological and yield parameters.

    Results

    Highly significant variations were recorded among the testcrosses for the studied traits except anthesis silking interval (ASI), 100-kernel weight. Minimum days to tasseling (48-days) and silking (53.5-days) was exhibited by pop-syn-swt (9-4)×synthetic sweet. GCA effect was -2.14 for tasseling and -2.00 for silking. Maximum value (3.5-days) for ASI was recorded for Pop-synswt 1(8-3)×synthetic sweet, while GCA effect for ASI was -0.71. Lowest plant height (129.8 cm) was recorded for pop-syn-swt 1(3-3)×synthetic sweet, while GCA effect for plant height was observed to be -14.79. Maximum cob length (16.6 cm) was revealed by pop-syn-swt 1(12-2)×synthetic sweet. For cob length GCA effect of 1.01 was recorded. Maximum 100 kernel weight (31.3 g) was estimated for pop-syn-swt 1(2-1)×synthetic sweet. GCA effect of 1.85 was recorded for 100-kernel weight. Highest mean (7143.9 kg ha-1) for grain yield was recorded for pop-syn-swt 1(9-4)×synthetic sweet. GCA effect for grain yield was found to be 1370.93.

    Conclusion

    Generally a low GCA value, either positive or negative indicates that the mean of a parent does not largely vary from its offsprings. In contrast, high GCA value suggests that parent is either superior or inferior to the general mean and it has high heritability and less environmental effects. Based on the findings in this research, the above mentioned testcrosses can be included in future sweet corn breeding programs where early flowering and yield attributes is desired.

    Keywords

    Sweet corn; General combining ability; Inbred lines; Line by tester; Yield; Flowering.


  • 2020, July

    book review

    Enlightment in Darkness: United Nations and Behavioral Sciences Global ContributionOpen Access

    Jose R. Rodrigues-Gomez*
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  • 2020, July

    original research

    Cross-Sectional Associations between Physical Activity and Internet Addiction among Undergraduate Students in TaiwanOpen Access

    Yen-Jung Chang* and Jia-Ji Sun
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    Purpose

    Internet addiction is a major health concern among undergraduate students; however, few studies have addressed modifiable behavioural factors associated with internet addiction in the context of Taiwan. This study aimed to investigate associations between physical activity and the risk of internet addiction among undergraduate students in Taiwan.

    Methods

    In 2017, we recruited 320 undergraduate students from Northern Taiwan to participate in a cross-sectional questionnaire-based survey. Physical activity was measured by the Taiwanese short-form version of the International Physical Activity Questionnaire, which evaluates an individual’s weekly levels of vigorous-intensity aerobic physical activity (VPA) and moderate-intensity aerobic physical activity (MPA). Internet addiction was measured by the Chen Internet Addiction Scale (CIAS).

    Results

    For the 320 surveyed students, the average CIAS score was 53.3, and 18.13% of participants were at risk for internet addiction (defined as CIAS score >64). The results of the multiple regression analysis indicated that a routine of at least 150 min of MPA per week was negatively associated with risk for internet addiction (β=−4.39, 95% CI=[-8.10, -0.66]). No significant associations were observed between internet addiction and 75 min of VPA or 150 min of total physical activity per week. Among the 5 dimensions of the CIAS scale, MPA was negatively associated with tolerance symptoms, time-management problems, and interpersonal and health-related problems when a routine of 150 min per week was adopted.

    Conclusion

    A routine of 150 min of MPA per week was associated with a lower risk for internet addiction. Intervention efforts aimed at reducing undergraduate students’ problematic internet use should promote recommended levels of MPA. We also recommend longitudinal research on the effects of engaging in physical activity on the risk of internet addition.

    Keywords

    Physical activity; Internet addiction; Undergraduate students.


  • 2020, July

    case report

    Lupus Erythematosus Affecting the Genitalia: An Unusual SiteOpen Access

    Dahhouki Sara*, Jihane Ziani, Khadija Issoual, Zakia Douhi, Sara Elloudi, Hanane Baybay, Fatima Z. Mernissi, Elbaraka Yassine, Errarhay Sanae, and Banani Abdelaziz
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    Cutaneous lupus erythematosus classically affects sun-exposed areas. It’s rarely affects the genitalia, and there are few cases reported in the literature. Thus, we report the different genital manifestations observed in a patient with lupus erythematosus affecting the genital area.
    Keywords
    Genitalia; Cutaneous lupus erythematosus; Systemic lupus.


  • 2020, July

    original research

    Determinants of Non-Insurance in A-Duiem Administrative Unit, White Nile State, Sudan 2018Open Access

    Samia Y. I. Habbani, Egbal A. B. A. Karaig*, Elfatih M. Malik, Sumaia M. Al-Fadil, Maisa El-Fadul, Siddik M. A. Shaheen, Nahid A. A. Gadir and Hashim Al-A. S. AbuZaid
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    Background

    Population knowledge and attitudes toward health insurance are important factors that facilitate health insurance coverage. National studies on these parameters are limited.

    Aim

    This study aims at assessing determinants of non-insurance in A-Duiem Administrative Unit and calculating as a secondary objective the household’s health insurance coverage.

    Methods

    The study was a descriptive cross-sectional community-based conducted in A-Duiem Administrative Unit, Sudan. It collected quantitative data from non-insured households and qualitative data by interviewing community leaders and conducting focus group discussions with community organizations members. Quantitative data analyzed using the Statistical Package for Social Sciences (SPSS) version 20, and the thematic analysis for the qualitative data.

    Results

    The study interviewed 419 non-insured households’ heads and thirteen community leaders and conducted eight focus group discussions with sixty community organizations members. Around 37.9% (95% CI: 33.4-42.7) of the heads of the non-insured households did not know the health insurance, while only 2.4% (95% CI: 1.5-4.7) had good knowledge. The knowledge of non-insured community leaders and members of the community organizations was moderate. The study participants showed positive attitudes towards health insurance, as 97% (95% CI: 95.1-98.4) of the heads of the non-insured households wanted to join the health insurance and 65% (95% CI: 59.2-70.1) of them stated that they could pay its premium. Most of the community leaders and members of the community organizations had health insurance cards. Those who were not enrolled, have limited knowledge about health insurance while almost all believe they should join it. The study identified 52.4% of non-insured households (95% CI: 48.9-55.8). The study showed low health insurance coverage among families, despite their positive attitude. This is mostly attributed to poor awareness of the heads of the non-insured households about health insurance. The National Health Insurance Fund (NHIF) should address this gap through effective communication strategies using motivated community institutions.

    Keywords

    Health insurance; Non-insured; Population coverage; Knowledge; Attitudes; Sudan.


  • 2020, July

    case report

    Cosmetic Tail Docking – An Option for Severely Injured Tail in Dog: A Case ReportOpen Access

    Haben Fesseha*
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    Tail docking is usually performed on those dogs whose tail or associated structures have been injured. A two-year-old male dog was presented Veterinary Teaching Hospital (VTH) with complain of injury on the tail due to bite by another dog. The injured site of the tail was contaminated with the debris on presentation and the dog was in severe pain. Amputation of the tail at the level above the injury site of the tail was taken. Care for surgery, oxytetracycline wound spray was applied on the incision site of the tail; Pen Strep and Meloxicam were given for three-days. The suture material was removed 10th-day post-surgery and the tail stump healed uneventfully. Hence, tail amputation is the best option of treatment for severing traumatic tail and successful management of the injured tail was presented in the present case report.
    Keywords
    Dog; Injured tail; Cosmetic tail docking.


  • 2020, July

    mini review

    The Time is Now for Disruptive Innovation in Pre-Exposure Prophylaxis Adherence MonitoringOpen Access

    Giffin Daughtridge*, Elijah Kahn-Woods, Casper Enghuus and Shane Hebel
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    Monitoring adherence to pre-exposure prophylaxis is a critical component of reaching ending the human immunodeficiency virus infection (HIV) epidemic goals in the US. Currently, providers still depend on “self-report” pre-exposure prophylaxis (PrEP) adherence, whereby providers ask their patients about their recent pill taking habits. There appears to be growing consensus across the HIV prevention community that “self-report” is an inadequate method of identifying that is in-need of additional adherence support services. In a recent survey, 97% of providers report utilizing self-reported adherence because it is convenient, but only 10% of these providers believe it is accurate. While “self-report” is convenient, evidence and testimonials from diverse stakeholders across the HIV prevention landscape indicate that there is a desire for more accurate, effective adherence monitoring methods. In this mini-review, we will briefly synthesize the emerging evidence and propose a solution to ensure all patients receive the support needed to protect them from HIV acquisition.
    Keywords
    Pre-exposure prophylaxis; HIV; Adherence; Prevention; Self-report.


  • 2020, July

    review

    The Potential of Amniotic Fluid-Derived Extracellular Vesicles to Treat Severe Acute Respiratory Syndrome Coronavirus 2 Infection Versus Hydroxychloroquine in Human PatientsOpen Access

    Ian A. White*
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    Recently a lot of attention has been focused on fast-tracking repurposed drugs for the treatment of a novel coronavirus; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent leading to the devastating coronavirus disease-2019 (Covid-19). One of the first and most well-known examples is hydroxychloroquine (HCQ), which has been used for years as a treatment for malaria, rheumatoid arthritis and lupus. HCQ was rolled out as a miracle treatment for Covid-19, which was inexpensive, effective and causing few side-effects. However, its effectiveness in treating Covid-19 has recently been questioned leaving doctors and patients confused and desperate. Here the proposed mechanisms of action of HCQ are discussed and compared with an inexpensive, safe and effective alternative, which is derived from natural, healthy amniotic fluid.
    Keywords
    Covid-19; SARS-CoV-2; Amniotic fluid; CytoSomes.


  • 2020, August

    scoping review

    Scoping Review and Expert Reflections: Coronavirus Disease 2019 – Preparedness and Response in Selected Countries of East Africa, West Africa, and Southeast AsiaOpen Access

    Ednah Madu*, Elfatih M. Malik, Sharath B. Nagaraja, Renu Tyagi and Gregory Fant
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    Background

    The coronavirus disease 2019 (COVID-19) outbreak, started in the Hubei province of China in December 2019. On January 31, the World Health Organization (WHO) declared COVID-19 a worldwide pandemic. We wondered what countries in Africa and South-East Asia had done to prevent infectious disease, specifically, COVID-19, from impacting the population of specific countries in that region, and what disease control measures were successful. Expert reflections on findings could guide continued successful public health approaches in managing this complex infectious disease pandemic.

    Method

    Using a scoping review, published papers, or program descriptions for specific geographic regions (i.e., Africa or Southeast Asia) were searched using specified key terms. Three targeted countries classified by World Bank as lower-middle-income in the two WHO selected regions [Africa (Sudan and Nigeria); Southeast Asia (India)] were reviewed with respect to COVID19 preparedness and response. Findings were organized, highlighting key points that seem particularly useful for regional learning. The evidence from each region was summarized in the aggregate to determine some common, noteworthy themes. COVID-19 epidemiologic data for these regions were also reviewed.

    Result

    Our findings indicate experience from prior infectious disease outbreak seems to have prepared the selected countries in their preparedness for COVID-19 outbreak on various levels. Incidence of COVID-19 increased across the selected countries. WHO recommended basic public health strategies to reduce disease transmission was initiated by the selected countries at different levels. However, feasibility and lockdown practices raise public health concerns and questions across the target regions reviewed.

    Conclusion

    This scoping review and expert reflections uncovers important preparedness and responses to the COVID-19 pandemic in the selected WHO regions. Further exploration and possible public health strategic plans may be needed.

    Keywords

    COVID-19 Pandemic; Health system; Preparedness and response; Sub-Saharan Africa; Southeast Asia; Developing countries.


  • 2020, August

    original research

    Fingerstick Plasma Drug Testing of Chronic Pain Patients: Comparison of Paired Fingerstick Plasma and Urine Specimens