Rajesh Varma
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Risk factors and incidence rate of complications originated as a consequence of the acute SARS-CoV-2 infection or the treatments performed. A longitudinal study in general medicine from March 15, 2020 to October 31, 2022 in Toledo, Spain
No full textBackground: The epidemiological data on complications originated as a consequence of the acute infection of COVID-19 or the treatments performed are not well known.Objectives: To estimate the incidence rate and the risk factors of complications originating as a consequence of the acute infection of COVID-19 or the treatments performed in general practitioner consultation.Methodology: A prospective study of patients with COVID-19 in a general practice setting in Toledo, Spain, from March 15, 2020, to October 31, 2022.Results: 687 positive cases of acute COVID-19 were diagnosed. Of these, 36 (36% were women and 39% had >=65 years old) presented complications, which represents a gross incidence rate of 5%. In >=65 years old, the incidence rate was 23%. The incidence rate of complications was much higher in 2020 vs. 2021 and 2022 (21%, 5%, and 1% cases, respectively). The only statistically significant risk factors were aged > = 65 years (RR = 2.46), having presented moderate-severe severity of primary infection (RR = 14.54) having chronic diseases (RR = 3.11), and specifically of the circulatory system (RR = 1.98).Conclusion: In the context of general medicine in Toledo (Spain) incidence rate of complications originated as a consequence of acute infection of COVID-19 or the treatments performed, was higher in cases with acute infection in 2020, and in >=65 years old, and are risk factors having presented moderate-severe severity of primary infection, having chronic diseases, and specifically of circulatory system, and being >= 65 years old.</p
Muscle strength, level of pain and balance in women with knee osteoarthritis after a sensory-motor exercise program associated to photobiomodulation therapy via cluster: a single-blinded randomized with placebo control trial
No full textIntroduction: Osteoarthritis (OA) is the most common chronic condition of the joints that leads to pain, stiffness and disability. Aim: The aim of this study was to determine the effectiveness of a sensory-motor exercises program and the photobiomodulation on pain, muscle strength, severity of the injury and dynamic balance of women with knee osteoarthritis. Method and Materials: Thirty-two women were randomized in sensory-motor exercises associated with the placebo photobiomodulation group (SMAG) and sensory-motor exercises with the active photobiomodulation group (SMPG). The pain, knee flexor and extensor peak torque, severity of the injury and dynamic balance were evaluated with the numeric pain rating scale, cell roll, Knee Injury and Osteoarthritis Outcome Score and timed up and go, respectively. Subjects were administered sensory-motor exercises, strengthening exercises and photobiomodulation via cluster applied at the end of each training session for 8 weeks, 2 times/week. Results: There was no significant improvement in the knee flexor and extensor peak torque, meantime, there was a significant linear positive correlation in the sensory-motor exercises program associated with the placebo photobiomodulation group (p = 0.002) at the end of treatment. A significant improvement in the severity of injury (p = 0.002) and dynamic balance (p = < 0.001) was observed in both groups. Furthermore, the level of pain showed a significant improvement in the sensory-motor exercises program associated with the placebo photobiomodulation group (p = 0.043). Conclusion: Sensory-motor exercise program promotes beneficial effects on the severity of the injury and dynamic balance and its association with photobiomodulation was able to produce an extra effect in pain relief. However, adding photobiomodulation to routine exercise regimes for subjects with knee osteoarthritis should be investigated.</p
The pathological technical and tactical movements of a soccer player during return to sport predicts a second anterior cruciate ligament injury
No full textBackground: Return to sport after Anterior Cruciate Ligament (ACL) reconstruction remains a difficult decision-making process that is not structured on shared and homogeneous assessments. This greatly elevates the risk factors for second injuries.Objective: Highlight football-specific gestural, pathological, technical-tactical patterns that contribute to new ACL injuries (ipsilateral graft rupture or contralateral rupture of the native ACL).Material and method: For the purpose of this literature review, peer-reviewed and nonpeer-reviewed indexed journals were consulted from 1979 to the present. Studies were identified by searching them on PubMed/MEDLINE databases. The following search terms were used: “second ACL injury,” “cutting maneuver and ACL”, “sidestep cutting technique and ACL” “Valgus knee in sport” “change of direction and ACL injury” “pressing soccer” tackle in soccer”. The literature search was directed, also, to the Gray Literature.Result: An immediate pressing or re-aggression on the adversary, tackle, or cutting maneuver is clinically read as moments of risk factors, injury, or re-injury, for both the ball bearer and the defender. We found how a good deal of literature emphasizes how side-to-side gestural asymmetries, during technical and tactical movements, present during return to sport can elevate risk factors for second ACL injuries. During ball recovery, 4 main game situations have been found to elevate the risk factors of knee capsular ligament injuries: (1) during tactical moments of collective pressing or individual pressure; (2) in the postural rebalancing phase after moments of instability following the kicking of the ball; (3) dysfunctional moments from gestural instability, in landing, after a header in single-pedal support; (4) during a tackle by direct contact or indirect contact on the joint.Conclusion: Residual pathological movement’s side-to-side asymmetries and postural-dysfunctional pictures related to specific gestures after ACL reconstructive surgery are predictive factors of second ipsilateral ACL injury or injury to the contralateral limb. Given, however, the subjective interpretation of movement quality assessments, their relative reliability and validity in the diagnostic and therapeutic use of complex sports gestures, pressing, and cutting maneuvers, during the process of return to sport should be analyzed together and clinical assessments to identify other and consistent predictors of second ACL injuries.</p
Restoration of sinus rhythm in a late presentation of inferior STEMI complicated by complete heart block with percutaneous coronary intervention
No full textAn 87-year-old female patient presented with a two-day history of the chest and epigastric pain associated with generalized fatigue. She was diagnosed with late presentation inferior ST-elevation myocardial infarction complicated by complete heart block. Given her late presentation, she was not taken to the catheterization laboratory immediately. She was admitted to the cardiac care unit. Transthoracic echocardiography showed an ejection fraction of 55% - 60% with wall motion abnormalities involving the posterior and inferior walls. A coronary angiogram the next day showed a total occlusion of the proximal segment of the RCA. Despite the uncertain benefit, taking into account the complete heart block, the artery was re-canalized with stent placement. She remained in complete heart block with stable hemodynamics. The heart team took the decision with the family to delay the insertion of a permanent pacemaker to maximize the chance of spontaneous recovery. Indeed, three days after coronary revascularization, her rhythm evolved into atrial fibrillation and two days later reverted to sinus rhythm with first-degree AV block and LAFB. She remained in normal sinus rhythm and first-degree AV block at her six months follow-up clinic visit. Data regarding the role of percutaneous intervention in patients presenting with late inferior STEMI and complete heart block is lacking. Our case illustrates the possible therapeutic role of late intervention in restoring sinus rhythm and avoiding the insertion of a permanent pacemaker.</p
Boundary value problem for the third-order equation with multiple characteristics
No full textThe article constructs a unique solution to a tertiary-order equation with multiple characteristics with boundary conditions that include all possible local boundary conditions. The uniqueness of the solution of boundary value problems is proved by the method of integral equations using the sign-definiteness of quadratic forms. When proving the existence of a solution to the problem, Green's function method, the theory of integral equations and potentials are used.</p
Calculation of the magnetic field of the asteroid 4 Vesta parent body (Application of SK theory)
No full textThe SK theory provides a deeper insight into the magnetic properties of celestial bodies. In this study, the magnetic field calculated of the parent body of asteroid 4 Vesta, could facilitate deeper insight into the formation of planets or the Universe. </p
Parkinson’s disease dementia and dementia with lewy bodies differences and similarities
No full textThe second most common neurodegenerative disease causing dementia in the population over 65 years is Parkinson´s Disease Dementia (PDD), sharing many clinical, genetic, pathophysiological, imaging, and morphological features with Dementia with Lewy Bodies (DLB). There is an ongoing debate whether these two diseases are separate diseases, just different phenotypes on the basis of the same Lewy Body pathology or the same disease. The differences are rather few and many authors tend to believe that PDD and DLB may be manifestations of the same neurodegenerative disorder.Based on a single examination, without regard to the temporal sequence of events, it is difficult or impossible to differentiate a single patient with parkinsonism as PDD or DLB. The relative timing when cognitive and motor symptoms appear, applying the 1-year rule, could be helpful in clinical practice in distinguishing the diseases. The subtle differences are hard to observe with more executive problems in PDD and a tendency of more easily triggered psychotic problems in DLB. Eventually, PDD and DLB might be the same disease - as long as unquestionable biomarkers definitely distinguishing both entities are not found.</p
Comparison of the performances between the gray and non-gray media approaches of thermal transport in silicon-tin
No full textWe have compared the performances of the gray and non–gray media approaches of thermal transport in Silicon – Tin using Monte Carlo Simulation. The Boltzmann Transport Equation (BTE) for phonons was used to describe the heat flow and ballistic conduction in semiconducting alloy systems. In this work, we have attempted solving the BTE using Monte Carlo (MC) simulation Computational domains for both gray and non-gray media approaches are modeled and the geometry and dimensions of unit cell and sub-cells in the domain are determined. In addition, the computational performances of the gray and non-gray media approaches are compared. The results revealed that when compared to non- gray approach, the gray media approach has more errors in the sub-cells. The maximum relative error is about 3.5%. The results also show that the non–gray media approach of thermal transport in Silicon – Tin exhibited numerical predictions with a very close match to experimental data.</p
Comparative evaluation of platelet indices in Preeclamptic and Non-Preeclamptic patients in the Enugu Metropolis
No full textPreeclampsia (PE) is one of the most common causes of maternal mortality and morbidity. It complicates 5% - 6% of all pregnancies globally and up to 15% of pregnancies in Sub-Saharan Africa. The present study was designed to determine the values of platelet indices in preeclamptic patients compared to non-preeclamptic controls. A total of 70 patients comprising 35 preeclamptic cases and 35 non-preeclamptic controls aged 18-40 years were recruited for the study. Blood samples (3mls) were collected from patients for the estimation of platelet indices using the Mindray 530 BC automated hematology analyzer, Mindray, Japan. The data were analyzed by SPSS version 22 using T - test and Pearson correlation. The level of significance was set at p < 0.05 and the result was presented as mean + SD. The result revealed a significant increase in the MPV (13.5 + 0.18 vs. 09.4 + 0.20), PDW (16.2 + 0.037 vs. 06.0 + 0.19) and PLCR (38.0 + 1.19 vs. 26.2 + 1.19) between the preeclamptic patients and non-preeclamptic controls. There was a significant decrease in the PLT (174.1 + 15.5 vs. 231.1 + 15.05), PCT (1.9 + 0.14 vs. 3.3 + 0.75), and PLCC (60.7 + 3.24 vs. 69.4 + 3.17) for the preeclamptic cases compared to non-preeclamptic control. These findings may be useful in the management of the adverse outcomes of preeclampsia for the Enugu population.</p
Orca reproduction in captivity: A review of the science, ethics and welfare concerns
No full textOrca whales, also known as killer whales, are highly social and intelligent animals that have captured the public’s fascination for decades. However, the use of orca whales in marine parks and aquariums for human entertainment has sparked controversy about their welfare and ethical considerations. Captive breeding programs have been developed for several marine species, including orca whales, to ensure their survival. However, captive orca reproduction is a contentious topic due to the potential health and welfare concerns for the animals. In this scientific essay, we review the reproductive biology of orca whales in captivity, the health and welfare concerns associated with captivity, and the ethical considerations of keeping these intelligent and social animals in captivity for human entertainment. Our review highlights the need for continued research to improve the welfare of captive orcas and the conservation efforts of wild populations.</p