Rajesh Varma
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Anal adenosquamous carcinoma on perineal fistula: A case report
No full textIntroduction: Adenosquamous Carcinoma (ASC) of the anus presenting both glandular and squamous histopathologic features is a rare colorectal neoplasm.Case presentation: A 63-year-old man presented with a one-year history of intermittent rectal pain and bleeding on a perineal fistula. Pathological analysis of the surgical specimen revealed adenosquamous carcinoma of the anus, The patient received neoadjuvant treatment with chemotherapy and radiotherapy over a period of five weeks. then he underwent abdominoperineal resection and a permanent colostomy. Histology revealed invasive adenosquamous carcinoma on the resection specimen and the patient was started on adjuvant therapy with FOLFIRINOX.Discussion: Primary ASC of the colon and rectum are extremely rare clinical entities with poor prognosis. Most of the data come from individual case reports and a few small series, making it a challenge to understand the histogenesis of the disease. And the treatment modalities are not yet well codified, which has an impact on overall survival.Conclusion: Early diagnosis and radical surgery with other available therapeutic modalities can improve clinical outcomes.</p
The effect of dietary Aloe vera powder on growth performance and survival rate of Oreochromis niloticus fries
No full textThis study aimed to evaluate the impact of dietary Aloe vera on the growth performance parameters of Oreochromis niloticus fry. A feeding trial was conducted for a month at KMFRI Sang’oro Aquaculture station and 135 fish were randomly assigned to three treatments, including a Control group (C1), a group fed with 1% Aloe vera (A1), and a group fed with 2% Aloe vera (B1). The growth parameters, including Specific Growth Rate (SGR), Feed Conversion Ratio (FCR), Weight Gain (WG), and Survival were measured. The results indicated that the administration of Aloe vera at different concentrations significantly improved the growth performance of fish. The SGR, FCR, and WG were significantly higher in fish fed with Diet B (2% Aloe vera) followed by those fed with Diet A (1% Aloe vera) compared to the Control group. The results confirmed the Alternative hypothesis that there is a significant difference in the growth performance of fish fed with various incorporations of Aloe vera. Therefore, the study recommends the use of Aloe vera as a growth promoter in aquaculture, particularly at higher incorporation rates of 2%.</p
Primary paraspinal hydatid cyst with intraspinal extension. A rare case report
No full textHydatid cyst is a zoonotic disease caused by Echinococcus granulosus. It rarely presents in the musculoskeletal system. Primary hydatid disease in paraspinal muscles is very rare. It can be discovered as an incidental finding in radiological imaging. Symptomatic patients are presented with usually symptoms secondary to the compression effect. It can cause dreadful consequences like erosion of adjacent bones, myelopathy, and cauda equine syndrome if left untreated. We present such a case of Primary Paraspinal Cyst with Intraspinal Extension, and its radiological imaging findings, including X-ray, CT scan, and MRI. </p
Cystinosis - Pathophysiology
No full textCystinosis is a rare autosomal recessive lysosomal storage disorder affecting 1 in 100,000 – 200,000 live births. It is caused by a mutation in the Cystinosin (CTNS) gene, a cystine-proton cotransporter, the absence of which results in intra-lysosomal accumulation of cystine. Kidneys are affected first, presenting as Fanconi syndrome in infancy, followed by widespread involvement of the eyes, endocrine and neuromuscular system later in life. Cystinosis since being first described in 1903 to the discovery of CTNS gene defect a century later in 1998, has proven to be a complex disease. Clinical features are a manifestation of intra-lysosomal accumulation and interruption of cellular metabolic pathways in the affected organs. In this review, we explore the various pathophysiologic mechanisms underlying the manifestations of this complex disease.</p
Optical spectroscopic analysis, supercapacitance, photocatalysis of BaTi<sub>x</sub>Fe<sub>12-(4/3)x</sub>O<sub>19</sub> hexagonal nanoparticles
No full textObviously, BaTixFe12-(4/3)xO19 Hexagonal nanocrystals are excellent candidates as photocatalysts in water purification, as well as using them as electrode materials for supercapacitors and energy storage applications. M-Type Hexagonal nanoparticles (BaTixFe12-(4/3)xO19, 0 ≤ x ≤ 1) with the magneto-plumbite structure were formerly synthesized by co-precipitation procedure and investigated by several techniques such as XRD, FT-IR, Raman, Photoluminescence and UV-VL. XRD and FT-IR confirmed the structure, and Raman spectra showed 12 characterizing summits. Photoluminescence emission spectra indicated two summits at 448 and 501 nm. Optical UV-VL spectroscopic analysis parameters showed dependence on λ and x. Obviously, BaTi0.75Fe11O19 nanocrystals as a sort of M-Type Hexagonal Ferrites showed excellent Photocatalytic activity on the Degradation of Organic Dyes like; Crystal Violet, Methyl Orange, … etc. Furthermore; these nanocrystals possess excellent electrochemical performance; which in turn introduces these materials for Supercapacitors Applications. Thus, the Photo-catalytic activity of BaTi0.75Fe11O19 nanocrystals for the decolorization of Crystal Violet (CV) dye (1 × 10-5 M) illuminated excellent photocatalytic efficiency reaching ≈ 85%. On the other hand; BaTi0.75Fe11O19 nanoparticles exhibited a specific capacitance of 1858 mF/g at 50 mV/s. The current study introduces promising applications of BaTi0.75Fe11O19 nanoparticles as electrode materials for super capacitance and energy storage. </p
How to anticipate and control possible future health crises through foresight approaches using the COVID-19 pandemic crisis?
No full textProspective studies have evolved towards a more integrated, complex, and diachronic way of thinking about the future. What is the future? It is a set of possibilities, delimited by what we think is impossible (limits of plausibility) and by the difficulty of estimating the degree of plausibility of an event in a V.U.C.A. period. The term V.U.C.A. refers to the four characteristics that reflect the world according to military thinking: Volatility; Uncertainty; Complexity; Ambiguity. The COVID-19 crisis is an example of V.U.C.A with an uncertain situation. Foresight is a discipline that allows us to understand the forces at work in the construction of the future. Resolutely oriented towards action, it aims to enlighten the choices of the present by exploring possible futures. Strongly linked to strategy, it allows the determination of a desirable future, a vision, and the implementation of the means to achieve it. Foresight is exploratory (of possible futures), normative (creating a chosen future), quantitative (using statistical data), and qualitative (using survey data). Foresight does not foresee, it anticipates. Prospective approaches could be used more in particular in the field of health to define more or less pessimistic scenarios in order to define strategies of anticipation of futures that we do not want to see happen. The foresight for pandemics and epidemics initiatives can create a space for dialogue and bring together diverse perspectives and lived experiences. We emphasize in this communication the potential benefits and outcomes of foresight thinking, such as improved resilience, better resource allocation, and effective response strategies.</p
Antimicrobial prescription pattern in the Deido health district, Douala, Cameroon
No full textInappropriate antimicrobial prescriptions are among the highest contributing factors to Antimicrobial Resistance (AMR). Most low and middle-income (LMICS) countries with high AMR burdens like Cameroon, seldom document information on prescription patterns, whereas this information is crucial in addressing inappropriate antimicrobial prescriptions. This study was therefore designed to elucidate antimicrobial prescription patterns in order to tailor interventions to mitigate AMR in Cameroon. The study adopted a multicentre cross-sectional design. Information on antimicrobial prescriptions was collected from four hospitals within the Deido Health District, between October 2019 and March 2020. Of the 1398 participants that were enrolled in the study, the most presented age group were participants aged 15-45 years 913(65.3%) and prescriptions were higher amongst females (923,53.6%). The highest number of antimicrobial prescriptions was made in the outpatient department 592(42.3%) followed by the pediatric unit, 344(24.6%). Most of the prescriptions were for patients with respiratory tract infections 436 (31.2%), followed by those with digestive tract infections 248 (17.7%). The most frequently prescribed class of drugs were the Penicillins 690 (40.3%, 37.8 – 42.6), with Amoxicillin clavulanic acid accounting for 27.8% of the overall prescriptions followed by Cephalosporins 392 (22.7, 20.6 – 24.7), with Ceftriaxone being the most prescribed in the class (13.3%). The need for prescription was mainly determined by clinical judgement (61.1%), while only 9.5% of prescriptions were based on antimicrobial sensitivity test. In the struggle to mitigate AMR, there is a great need to exploit data on prescription patterns and develop stewardship programs in order to optimise antimicrobial use in Cameroon. We emphasize in this communication the potential benefits and outcomes of foresight thinking, such as improved resilience, better resource allocation, and effective response strategies.</p
Two methods for determining combinatorial identities
No full textTwo methods are presented for determining advanced combinatorial identities. The first is based on extending the original identity so that it can be expressed in terms of hypergeometric functions whereupon tabulated values of the functions can be used to reduce the identity to a simpler form. The second is a computer method based on Koepf's version of the Wilf-Zeilberger approach that has been implemented in a suite of intrinsic routines in Maple. As a consequence, some new identities are presented. </p
Determinism and chaos – a story about Big Bang, singularity and the future of mankind
No full textPeople have always tried to understand and tame the nature around them. It is a well-known fact that the sanest and safe approach from a psychological point of view is to focus on the present moment, the here and now. Nevertheless, we keep looking and living in the past or daydreaming and making predictions about what the future will bring. This paper is looking at this topic trying to unify several perspectives, stemming from a very diverse set of disciplines: biology, genetics, economics and cryptography, which are apparently working in parallel to solve the same problem. They all aim to find a theory of everything, one that can make sense out of chaos, light out of darkness and that can accurately predict the future based on present and past events. The current paper is supposed to inspire researchers to ask themselves tough questions, sometimes completely outside of their comfort zone, that can lead to discoveries with a huge positive impact on us all.</p
Increase in the number of consultations for early telarche and the subsequent diagnosis of early or early puberty in pediatric endocrinology in Alava, after the confinement suffered during the COVID-19 pandemic
No full textIntroduction: Due to the COVID-19 pandemic and home confinement measures, many of our routines and daily habits have been both affected and modified. Have these factors conditioned a real increase in precocious (PP) and accelerated puberty (AP)?Objectives: This is an observational and retrospective study in which the incidence of medical consultations due to premature thelarche is compared between March to December 2019 and 2020. The medical consultations occurred in the Pediatric Endocrinology (PE) consultation of our hospital.Patients and methods: The analysis involved 75 cases of young girls consulted with premature thelarche in 2019 and 97 girls which were consulted in 2020. From each patient, different variables were analyzed, such as somatometry, hormones, eco, and treatment.Results: In 2019, 75 first visits of PE were due to premature thelarche in young girls (accounting for 2.46% of the total number of first visits carried out in Pediatrics Outpatient Clinics (POC) and 16.77% of PE first visits). However, in 2020, 97 first visits were due to PE (3.52% of the total first-time visits of OC and 23.3% in PE). It was found that in 2020 the number of first-time visits due to premature thelarche increased by 28% compared to 2019 (p: 0.0001 mean comparison).In 2019, out of the 75 consultations due to premature thelarche, 40% were diagnosed with an earlier physiological puberty. Conversely in 2020, out of the 97 consultations, 61.77% had normal physiological puberty. These figures represent an OR of 1.54 (p: 0.02 t Student for independent samples). It was evaluated whether the patients had experienced > 3kg weight gain above 6 months prior to the medical visit. In 2020, 31.57% of patients experienced weight gain, whereas 68.42% did not. In 2019 patients who experienced weight gain accounted for 12.16% and 87.83% did not experience significant weight gain (p: 0.01 t Student for independent samples).Conclusion: Our data demonstrates there has been an increase in the incidence of referrals from Primary Attention to Pediatric Endocrinology to examine advanced thelarche during the period of lockdown measures (2020), in addition to an increase in the number of diagnostics of PP and AP in young girls in our hospital when compared to figures for 2019.Furthermore, in 2020 there was a greater number of patients who experienced a weight gain increase 6 months prior to the medical consultations.We hypothesize that the lockdown inflicted sedentary lifestyles together with changes in dietary habits, promoting weight gain in patients. This effect could have caused a body fat mass increase in girls, suggesting a “trigger effect” in the activation of the gonadal axis, causing a rise in the number of early puberty cases.IRB: CIEC 01/2017.</p