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Delayed splenic rupture 4 months following minor blunt abdominal traumaChatzipetrou Maria, Tzanakis Nickolaos, Giannopoulos George and Kornaropoulos Michail*
Get PDFSplenic rupture, no matter what the cause is, is associated with significant mortality. It can present either acutely after trauma, or days to weeks later, a situation known as ‘’delayed splenic rupture (DSR)’’. On the other hand, splenic rupture without trauma history occurs mainly in a pathologically altered spleen, a rare situation called atraumatic splenic rupture (ASR). Cases of ASR of normal spleen have been reported in literature with various cause as far as trauma is concerned.</p
The World Cannot say anymore that Children are not the face of COVID-19 The Urgency to Detect, Respond to MICS, and Care for children in 2021
Get PDFCovid 19 pandemic has been showing disastrous effects across the world, since December 2019, affecting 220 countries, over 197 million cases and 4.2 million deaths by end July 2021, and huge economic loss, Political blame games and vaccine diplomacy and many social security measures. The pandemic also has exposed the limitation of Public Health capacities across the world.By now we know that Children of all ages can be affected. The fact that exact data of number of children affected or their proportion of the total infections or deaths, is not readily available even at subnational levels, indicates that they have not been the face of the Pandemic. In the initial months the symptoms and signs of the disease were very mild in children, until in May 2020, when a few cases of critical illness called Multisystem inflammatory syndrome in children were first reported in UK/USA. Very few cases of mucor mycosis a fungal infection after recovering from Covid 19 are also being reported among children across the world. As of now available data indicates that children under the age of 18 years represent about 8.5% of reported cases and the symptomatic children are fewer and usually mild, and deaths were negligible compared to other age groups. The complications of MICS and lack of vaccine are the two major hurdles in protecting the lives of the children as of now. The indirect impact is the Orphanhood due the death of millions of COVID-19-associated deaths of the parents, poverty due to diminished earning by the parents losing jobs or working for low wages, interruption in education due to closure of schools, increase in malnutrition in poor countries due to disruption of nutrition programs and mental health of the children for want of peer interactions and the tensions of online learning.After about one and half year analysis of the available data indicates that the Covid 19 Pandemic affects the world’s children in three ways through: 1. infection with the virus and its complications like MICS and Mucor mycosis 2. the socioeconomic effects of the virus and related public health measures to suppress transmission and control the pandemic by the national and provincial Governments and 3. the risk that the virus and its response poses to the longer-term efforts to achieve the economic revival, efforts for Sustainable Development Goals (SDGs) and ensuring the realization of the rights of all children as committed by the national governments.Working with UNICEF India, for over 17 years, the author in this article tries to look at the data available and assess the impact of covid 19 pandemic on the children in short and long terms.Materials & methods: The author has reviewed the Covid 19 pandemic world dash boards, Periodical press and TV media reports, sub-national data of age and sex distribution of cases, small studies on the cases and deaths of Covid 19and it’s complications and reports on the various development partners on the issue of child related SDGs.</p
An insight of mucormycosis (black fungus) in ayurveda
Get PDFMucormycosis, commonly known as black fungus, is a rare but serious fungal infection caused by a fungus called Mucormycete, which is abundant in the environment. It mainly affects people with preexisting diseases or people taking medications that reduce the body’s ability to fight infections and disease. It is detected relatively frequently in COVID19 patients in several states of India. The disease usually manifests on the skin and also affects the lungs and brain. People who are suffering from COVID- 19 and who are in recovery stage have a poor immunity and take the prevalence of disease higher and hence the immune system won’t develop sufficient antibodies to fight against them. People hospitalized with severe COVID19 illness who were prescribed with steroids to reduce the infection. Steroids work by reducing inflammation in the lungs and reducing the body’s immune response to prevent it from attacking healthy cells in the body, resulting in a decreased ability to monitor immune responses. These patients are very sensitive to the effects of Mucormycete. This infection will not spread from person to person. This infection starts first in the nose and spreads to the eyes, then to the lungs and brain. This black fungus is now seen more frequently in post COVID19 Patients in India specifically. The present review is based over the ayurvedic treatment under AYUSH used for the black fungus infection.</p
New in the etiology, pathogenesis, prevention and treatment of atherosclerosis. The two different types of cholesterol plaques have nothing to do with each other
Get PDFThe article is presented in the form of a review and analysis of the literature, which additionally helps to reveal the mechanisms of the pathogenesis of the development of atherosclerosis. This article provides a completely new understanding of the stages and sequence of atherosclerosis development. The modern vision is refuted, which states that all types of lesions in atherosclerosis are developed successively, one after another. The article sheds a light on a significant difference between type IV atherosclerotic lesions and between types V and VI atherosclerotic lesions. Type IV atherosclerotic lesions consists of one lipid core with molten extracellular lipid. Stretches the middle and outer layers of an artery from one side and protrudes beyond the anatomical artery dimensions over the years. In contrast, type V atherosclerotic lesions type is a long, concentric, soft, strong, elastic, yellow, uniform structure, in the form of a tube with a hole in the middle, located in the lumen, which is easily removed from the artery. This types V and VI atherosclerotic lesions - the author suggests calling “cylindrical cholesterol plaque”. Type V atherosclerotic lesions (cylindrical cholesterol plaque) has nothing to do with types I-V atherosclerotic lesions. There are many “coincidences” that make it impossible to see the difference between them. Type V atherosclerotic lesions (cylindrical cholesterol plaque) is an independent pathological structure that appears in a short period of time (few minutes) in the lumen of a healthy artery in case of artery spasm and appearance of a strong obstruction to blood flow. Low density lipoproteins are retained within the wall, in front of the site of arterial narrowing, and quickly create a CCP in the form of a hollow cylinder. All subsequent forms of types V and VI atherosclerotic lesions - concentric and eccentric, are the result of the destruction of the original concentric structure of the type V atherosclerotic lesions (cylindrical cholesterol plaque).</p
Assessing Storage Insect Pest infestations and Faecal dropping of Rodent in Stored Grains from two districts of Southwestern Ethiopia
Get PDFThis study was designed to assess the occurrence of major insects and rodent pest infestations in stored grain from two districts of Southwestern Ethiopia. Omo Nada and Bako Tibe districts were purposively selected because they are potential maize and sorghum growing regions with high postharvest losses. A total of 160 farmers’ stores from both the districts were randomly selected. The grain samples used in the present study were stored for five different time periods, ranging from 1 to 5 months and from the same farmers’ stores, to identify storage insect pest, determine grain weight loss and insect damage. The results showed that the dominant insect species in maize and sorghum grains were weevils (Sitophilus spp.) followed by the Angoumois gelechiid (Sitotroga cerealella Olivier) and flour beetles (Tribolium spp.). High number of insects were recorded from both plastered and un-plastered gombisa and polypropylene bags. Additionally, the amount of every insect pest in each storage container recorded per 100 g grain increased because the duration of grain storage increased. There have been 0.33-1.29g and 0.44-1g of rodent droppings per 100g sample of maize and sorghum grains, respectively. This showed that faecal dropping per 100 g grain increased along with increase in storage period. Grain damage showed significant (P<0.05) differences over the storage periods across the studied districts. A similar trend was observed for weight loss in each of the grains all districts. These results indicated that farmers are incurring a substantial grain loss to insects and rodent pests. Hence, there is an urgent need to devise appropriate tactics for protecting the losses in farm-stored maize and sorghum in Ethiopia.</p
A survey on the impact of the coronavirus disease 2019 pandemic in Portuguese physical and rehabilitation medicine departments
No full textIntroduction: The pandemic Coronavirus Disease 2019 (COVID-19) strongly affected the organization and functioning of Physical and Rehabilitation Medicine (PRM) departments in Europe, posing specific challenges in the management of diseases and their consequences.We aim to evaluate the changes suffered by Portuguese PRM departments in the scope of assistance, organization, training and research.Methods: A self-administered, cross-sectional online questionnaire was sent to 41 Portuguese PRM departments, regarding the assistance provided to patients with COVID-19, organizational changes and difficulties experienced on team management, training and research. Results: The survey had a response rate of 82.9%. The majority of the PRM departments assisted patients with COVID-19, mainly in the context of inpatient general ward care and intensive care units. Changes in the assistance activity and accessibility were reported by almost all PRM departments, mainly affecting the outpatient consultation. There was a reduction on the number of healthcare professionals reported, especially by transfer to other areas, and almost all used remote procedures, especially for patient reassessment, counseling, and monitoring. The majority of PRM departments highlighted the pandemic’s impact on the training availability, as well as in the applied research and publications.Conclusions: The pandemic triggered a complete overhaul of rehabilitation departments with significant changes in assistance activity, changing routines and programmed procedures, with a strong negative impact on scientific research and training. Outpatient consultations was the most affected area, while support for hospitalization and internal consultations remained mostly operational. The use of remote procedures was high, particularly in follow-up and counseling. </p
Massive use of tattoos and psychopathological clinical evidence
No full textPurpose: This research aims to identify any recurrent psychopathological profiles in individuals who abuse tattoos and that, for this reason, the tattoo itself could be the manifestation of a specific symptom.Methods: Clinical interview and administration of the MMPI-II and PICI-1.Results: The research on a population sample of 444 people has shown a strong psychopathological tendency in the MMPI-II that is confirmed in the PICI-1 (TA version); in fact, the data are even more significant and expressive a precise psychopathological diagnosis of personality. In the male group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and antisocial disorder emerged individually. In the male group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, narcissistic, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 51% and 75%, at least 5 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 76% and 100%, at least 6 dysfunctional traits of borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and bipolar disorder emerged individually. In the female group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, borderline, anxiety, phobic, obsessive, somatic, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 51% and 75%, at least five dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 76% and 100%, at least 6 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually.Conclusions: On the basis of these data, it is reasonable to argue that as the percentage of body surface area covered by tattoos increases, so do the dysfunctional traits of a specific main disorder. In particular, the recurrent dysfunctional traits are anxious, phobic, obsessive, somatic and bipolar in subjects with less than 25% of the body surface covered by tattoos, while borderline, narcissistic, antisocial, sadistic and masochistic traits are more frequent in subjects with more than 26% of the body surface covered by tattoos. Comparing the data with the control group we reasonably come to the conclusion that the use of tattoos is not directly related to the presence of one or more psychopathologies, but if the use is massive this is a fairly robust indicator of the likely presence of a significant number of psychopathological traits of the same morbid condition.</p
Bezoars: An unusual cause of intestinal obstruction in children
No full textIntestinal obstruction in children are mostly caused by congenital anomalies of the gastrointestinal tract. Ingested foreign bodies can cause GI disturbance including obstruction. Bezoars are concretions of human or vegetable fibers that accumulate in the gastrointestinal tract. The most common type of bezoar in human is the trichobezoar, which is mostly made of hair, followed by bezoars made of vegetable or fruit fiber (phytobezoars), milk curd (lactobezoars), or any indigestible material. Intestinal obstruction due to bezoars is an uncommon cause of intestinal obstruction among children and adolescents. We present seven cases of intestinal obstruction in children and young adults caused by bezoars between 2012 and 2019. The age ranged from 11 months to 16 years. There were four females to three males. One adolescent girl had trichobezoars, another had tricho-phytobezoars, three had phytobezoars and two had lactobezoars. The presentations were epigastric discomfort, nausea, intestinal obstruction, chronic malnutrition, recurrent vomiting and abdominal distension. One adolescent girl with Rapunzel syndrome, required psychiatric treatment following removal of the trichobezoar. All the children except one required surgery. A child with lactobezoar improved with conservative treatment and passed the bezoar after enema. All the operated patients had uneventful recovery. The mean follow up was 83.5 months. </p
Functional outcomes of ulnar nerve neurotization by anterior interosseous nerve in high level injury
No full textBackground: The ulnar nerve injury induce sever hand malfunction due to intrinsic muscle paralysis. The ulnar nerve repair in proximal area (high ulnar nerve injury) seldom leads to intrinsic muscle function because of long distance of nerve return. Therefore, the best techniques to restore intrinsic hand function in patient with high ulnar nerve injury is distal nerve transfer to minimize the regeneration time and distance. Objective: The aim of this study is to describe the surgical results obtained with the transfer of the motor branch of the anterior interosseous nerve destined to the pronator quadrates muscle to the motor division of the ulnar nerve (the deep branch of ulnar nerve).Methods: It is a retrospective study of thirty elderly patients with high ulnar nerve injury underwent a transfer of distal branch of anterior interosseous nerve to deep branch of ulnar nerve, and end to end suture of the ulnar nerve at the site of injury in Sohag microsurgery unit. Results: The mean postoperative follow-up period was 22 months (range from 12 to 38 months). At the final follow-up, twenty-seven (90%) patients showed good results according to the Highet-Zachary scheme (M3 or M4, S3+, and negative Froment’s sign). The other three patient (10%) showed a poor result (M1, S2, positive Froment’s sign).Conclusion: This technique of transfer of distal branch of anterior interosseous nerve to deep motor branch of ulnar nerve and primary repair of ulnar nerve at site of injury is effective for motor and sensory recovery of distal ulnar innervated side of the hand.</p
How and what we eat impact our environment
No full textOur dietary choices are one of the leading global causes of environmental degradation and decline in human health. The increasing consumption of fossil fuels, the emission of greenhouse gasses, deforestation and the extraction of fresh water by the food industry have triggered worldwide concern about the western lifestyle and our future in this world. Although modernization and new technologies in agriculture have helped end hunger, the lack of communication with environmental development promotes water and consequently food insecurity around the world, as well as malnutrition and an increase in chronic diseases. This mini-review summarizes the environmental and health impacts caused by the Western food industry and shows that we need to promote the development of food science together and in a communicative way with health and environmental sciences.</p