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Intravenous leiomyomatosis of the uterus: still discovered on anatomopathological examination
No full textBackground: Leiomyomas beyond the uterus are defined by benign smooth muscle cell tumors outside of the uterus. Intravenous leiomyomatosis is a rare type of uterine leiomyoma and is characterized by the formation and growth of benign leiomyoma tissue within the vascular wall. Herein, we present a case of Intravenous leiomyomatosis successfully treated by surgical removal and a review of actual medical recommendations.Case presentation: A 49 - year-old woman, maghrébin, G3 P2, no family history of uterine myomas mentioned, having systemic arterial hypertension, presented to our department with hypogastric pain and abnormal uterine bleeding in the prior five months resulting in anemia which required iron supplementation. On physical examination the vital signs were normal. A palpable mass in the hypogastrium was noted. The rest of the exam was unremarkable. Pelvic ultrasound showed a huge uterus with multiple heterogeneous leiomyomas, including at least one intracavity. Computed tomography scans and magnetic resonance imaging were not done initially due to the unaffordability of the patient. The initial diagnosis was leiomyoma. The decision to perform a total abdominal hysterectomy and bilateral salpingo-oophorectomy was taken. The abdomen was opened by a midline vertical incision. During surgery, multiple subserosal, intramural and submucosal fibroids ranging from 2 cm × 3 cm to 10 cm × 10 cm were seen. On pathological examination, the uterus measured 19 cm in the largest diameter and weighed 1.3 kg. The cut section showed white nodular myometrial masses. Microscopically, intravascular growth of benign smooth muscle cells is found within venous channels lined by endothelium. The diagnosis of Intravenous leiomyomatosis of the uterus without malignant transformation was retained. The patient was monitored for 14 months and subsequent computed tomography did not reveal any evidence of tumor recurrence. The follow-up will be performed annually till the age of menopause.Conclusion: Intravenous leiomyomatosis is a benign, rare and potentially lethal pathology. It especially affects premenopausal women with a history of uterine myoma, whether operated on or not. They require close and prolonged follow-up because of the high risk of recurrence
The central role of desire in mediating bullying behavior in schools
No full textNumerous studies of bullying in schools have identified aspects of the environment (E) and aspects of the person (P) as contributing to the prevalence of bullying in schools. It is proposed that the concept of desire can play a central role in explaining how bullying in schools arises and how it can be effectively addressed by schools by promoting social and emotional learning, mindfulness, and problem-solving techniques such as the Method of Shared Concern. The article identifies a need for further research to confirm the hypothesized relationships and assess the utility of the concept of desire as a variable in research and the practice of bullying prevention in schools
Chronic Lyme disease presented with gastroparesis
No full textWe present a case of a 54-year-old White man who was admitted to our clinic for evaluation of gastroparesis. His gastroparesis was severe and unresponsive to previous treatments. Darkfield microscopy revealed the presence of spirochetes and corkscrew-shaped bacteria; although Lyme immunoglobulin M (IgM) and immunoglobulin G (IgG) Western Blot testings were negative. The patient was diagnosed with Chronic Lyme disease and recovered with antibiotherapy. We outline a rare case of dysmotility syndrome; a unique presentation of cChronic Lyme disease and emphasize the limitation of tools necessary in diagnosing Lyme diseas
Shoulder recovery for head and neck cancer patients after unilateral neck dissection: a pilot exploratory study
No full textAn established side-effect of neck dissection (ND) for head and neck (HNC) tumour management includes shoulder dysfunction (SD), which can impact quality of life (QOL). Shoulder strength and range of movement (ROM) are key parameters to be monitored in SD. However, such evaluations are not routinely conducted in the clinical setting. The aim of this study was to evaluate objectively the impact of ND on shoulder functions. Methods: This is a pilot exploratory study in a tertiary cancer centre. Five participants with unilateral ND and advanced HNC, completed the study. Outcome measures consisted of self-reported QOL questionnaires, C2–T1 dermatomes and shoulder ROM and strength testing. Data was collected at baseline, 1.5-months after surgery and 6-months after diagnosis (after adjuvant treatment completion). Results: Most outcome measures on the surgically affected side were negatively impacted post-operatively, with varied recovery seen at follow-up. Sensory loss was noted at C3–4 dermatome levels. Shoulder ROM and strength was reduced on the surficial side for all participants, with some recovery after six months except for two participants.Conclusion: Results of SD after ND are diverse and unique to each patient. Findings from this pilot study indicate that regular rehabilitation/exercise may facilitate recovery of shoulder function post HNC surgery. However, customised rehabilitation may yield better outcomes. Future studies with a larger sample are indicated to validate the findings of this study
Is the informed consent form only a symbolic document in clinical trials?
No full textBeing one of the basic principles of clinical research, informed consent is definitely a legal responsibility and ethical duty for health professionals
Planococcus citri (Risso) (Hemiptera: Coccomorpha: Pseudococcidae) on Strawbery (Fragaria vesca L., Rosaceae) in Silifke, Mersin, Turkey
No full textFragaria vesca L. (Rosaceae), called “wild strawberry”, “woodland strawberry”, “Alpine strawberry”, “Carpathian strawberry” or “European strawberry” is grown naturally throughout much of the Northern Hemisphere and produces fruits. The plant can be spread mostly by stolons as well as by the seeds to establish new populations
Prevalence of performance-enhancing drug use among gym members in Saudi Arabia, Riyadh: A cross-sectional survey
No full textContext: Illicit and performance-enhancing drug (PED) use is prevalent among athletes.Aims: We examine the prevalence of PED use among amateur athletes, identify the common characteristics and associated risk factors for illicit PED use and measure the perception and awareness among gym members regarding the safety and effects of illicit drug use.Settings and design: This cross-sectional study was conducted among adult male and female gym center attendees in Riyadh, Saudi Arabia.Methods and materials: Self-administered Arabic and English questionnaires were used for data collection. Statistical analysis used: SPSS version 26 was used to perform t- and chi-square tests.Results: This study included 379 participants, of whom 59.6% were male, 52.8% were between 26 and 35 years of age, and a majority of the participants had normal (47.5%) or overweight (40.9%) body mass index. Our study revealed a high prevalence (48.5%) of PED use among gym athletes in Riyadh, Saudi Arabia. Moreover, the true prevalence might have been higher due to the possibility of underreporting by some participants because of the sensitivity of the subject. Protein powder was the most commonly used type of PED. Of all the participants, 22.3% reported anabolic androgenic steroid use. Side effects of PEDs were observed in 19% of the study participants.Conclusion: The results of this study should encourage public health researchers and health advocates to design and implement behavioral interventions to educate the public on the benefits, risks, and contraindications of dietary supplements used by athletes to enhance their body performance.Key messages• Performance-enhancing drug (PED) use is prevalent among both professional and amateur athletes.• Gym athletes in Riyadh, Saudi Arabia, report increasing PED use.• Side effects and negative health impacts are associated with illicit PED use.• Misinformation on the risks and benefits of PEDs is a major public health concern.• More efforts should be implemented in public awareness about the risk of using PED targeting younger populations
Post-vaccine immunity against hepatitis B in Moroccan children
No full textBackground: Hepatitis B is a major public health issue worldwide. Immunization of infants against this disease has been effective in Morocco since 1999. However, evaluation of post-vaccination response is rarely performed in our setting. The purpose of this study was to evaluate immunity against HBV in fully vaccinated children in the city of Marrakech in Morocco and to investigate the factors influencing the level of post-vaccination immunity. Methods: A descriptive cross-sectional study was conducted on fully vaccinated children who have medical and vaccination records, from three primary healthcare centers in Marrakech. Children with anti-HBs antibody levels between 10 and 100 IU/L were considered moderately immune, and those with antibody levels above 100 IU/L as highly immune, while those with antibody levels below 10 IU/L were considered non-immune. Results: Of the 123 children recruited, 114 (92.7%) had protective anti-HBs antibody titers, of which 37 (30%) were moderately immunized and 77 (62.7%) were highly immunized, and nine (7.3%) were non-immune. Age, birth weight, vaccine type, and time since the previous dose have all been significantly associated with the degree of post-vaccination immunity. Anti-HBs antibody levels were not significantly related to factors potentially linked to post-vaccination non-response, such as chronic disease, immunosuppressive medication and others.Conclusion: Our findings denote that the HBV vaccine used in The Moroccan Expanded Program on Immunization (EPI) is effective against HBV. Nevertheless, in non-responders, corrective actions such as re-vaccination and monitoring of post-vaccination anti-HBs antibody levels should be implemented
Defluoridation of water by the Homa* method, a co-precipitation technique using wood ash leachate and alum
No full textHigh fluoride level in drinking water is an endemic public health concern in East Africa. Unlike in Kenya where it is absent, the Nalgonda technique, a defluoridation method that uses two chemicals, alum, and CaO, has seen mixed results in its application and adoption in Ethiopia and Tanzania. This has been due to the low capacity of communities to manage the process and the breakdown in the supply chain of chemicals used in the technique. In the present study, we attempted to bridge the gap in the chemical deficit by investigating the possible substitution of CaO with leachate from wood ash, a by-product of wood combustion commonly found in Kenya. The leachate was prepared from one part of wood ash mixed with two parts of distilled water and stirred for 24 hours followed by decantation. The new technique, the Homa method, using alum and wood ash leachate was then tested on H2O samples from three areas in Kenya with high F- concentrations ranging from 5.1 mg L-1, 9.1 mg L-1 to 91.0 mg L-1. The determination of F- concentration by SPADNS Spectrophotometry was applied throughout the experiment. Four levels of alum i.e. 1%, 2%, 3%, and 4% were dosed on five volumes of water i.e. 100, 200, 300, 400, and 500 ml raw water at 5.1 and 9.1 mg L-1 F-. For water samples at 91.0 mg L-1 F-, the same volumes were treated with 5 higher alum levels i.e. 5%, 6%, 7%, 8%, and 9%. The final pH was then adjusted to 7 with ash leachate for defluoridation. The set-up was a factorial design experiment where the final F- concentration was the dependent variable and the volume of raw water, the percentages, and volume of alum and wood ash leachate constituted the different factors. A fitted multivariate regression model of the general form; where Y = Residual fluoride, X = wood Leachate volume, W = alum Concentration, X*W = Interaction α, β, γ were regression coefficients, ε = error term, showed that only in the Baringo area did we have an interaction between wood ash leachate and alum concentration significant (p < 0.05). Defluoridation occurred (p < 0.05) at as low as 10% and as high as 99%, depending on the initial F- content. Total coliform decreased from 310, 290 and 270 count/l respectively to zero. Unfortunately, high chemical and TDS (from 558 mg L-1 to more than 9,000 mg L-1) enrichment were recorded in addition to the mixed data on turbidity. The overall results show that wood ash can substitute CaO in the Nalgonda process. Further investigation is however required to make it applicable for potable water production
Evaluation of long antigen exposition dendritic cell therapy (LANEX-DC®) in the adjuvant treatment of pancreatic cancer – results of a single center analysis
No full textIntroduction: Even after surgical resection and adjuvant chemotherapy in pancreatic cancer the 5-year disease-free survival times (DFS), as well as overall survival rates (OS), are still low and median survival times are below 2 years. Here we retrospectively analyzed the outcome of immunotherapy in the additional adjuvant treatment of pancreatic cancer with long antigen exposition dendritic cell therapy (LANEX-DC®) in 28 patients who were treated at our institution. Patients: Data were available from 28 patients. Dendritic cells (LAEX-DC®) were produced according to a recently published protocol.Results: Therapy was well tolerated and no serious side effects were observed. The median disease-free survival times and the median survival times were 16,9 months and 29,4 months respectively. Five-year DFS and OS were 14,3% and 17,9%. Conclusion: We were able to show in a small cohort of patients that additional treatment with dendritic cells (LANEX-DC®) is highly effective and extends the median disease-free survival times as well as the median survival in the adjuvant treatment of pancreatic cancer, whereas the five-year overall survival still remains unsatisfactory