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Background: Inflammatory bowel disease (IBD) is associated with multiple factors that influence bone metabolism. This study aimed to compare the clinical manifestations and diagnostic parameters of patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis, as well as to assess their relationship with subsequent bone disorders. Methods: Blood tests (including calcium–phosphate metabolism) and fecal tests (including calprotectin) were performed in eighty children recently diagnosed with IBD. Additionally, the bone densitometry results were evaluated in 25 of them. Results: Diarrhea (p = 0.02) and bloody stools (p < 0.001) were more frequent in patients with UC, whereas fever was more common in patients with CD (p = 0.003). Laboratory tests revealed anemia in 62.5% (50/80) and thrombocytosis in 36.3% (29/80). Higher calprotectin levels in the feces were found in girls at the time of diagnosis (p = 0.02). Osteopenia was detected in almost half of the examined patients (12/25), and 20% (5/25) met the criteria for osteoporosis. Low calcium levels at diagnosis were correlated with subsequent bone disorders (p = 0.005). Insufficient levels of vitamin D were detected in 77.8% (56/80). Conclusions: Early disease detection and the appropriate monitoring of children with IBD may decrease the risk of serious consequences, including osteoporosis. [ABSTRACT FROM AUTHOR]

Vestibular schwannoma (VS) is a benign peripheral nerve sheath tumor involving the vestibulocochlear nerve. Affected patients typically experience a gradual emergence of episodic imbalance and unilateral hearing loss, tinnitus, and headache. Less often, VS may be associated with facial pain; ocular, otic, and taste disturbance; paresthesia of the tongue and face; and temporomandibular disorder-like presentations. There is limited information in the dental literature relating the myriad of oral and maxillofacial manifestations of VS. The objective of this article is to underscore the importance for dental clinicians to seek clinicopathologic correlations with VS-related symptomatology, potentially resulting in a timelier diagnosis and improved patient outcomes. To convey this clinical challenge, a detailed narrative of a 45-year-old patient with an 11-year delay in diagnosis has been reported. In addition, the typical radiographic appearance of an implanted cranial device placed following VS resection has been provided. [ABSTRACT FROM AUTHOR]

This narrative review delves into the intricacies of hemangiomas and vascular malformations (VMs), exploring their characteristics, diagnostic approaches, and therapeutic interventions. Hemangiomas, characterized by an abnormal growth of blood vessels, and VMs, arising from developmental abnormalities in blood vessels, present multifaceted challenges in clinical practice. The review navigates through the clinical manifestations and classifications of these vascular anomalies, emphasizing the importance of accurate diagnosis based on clinical evaluation, imaging techniques, and histopathological assessment. Variations in presentation, ranging from asymptomatic lesions to severe complications impacting vital organs, underscore the necessity for comprehensive understanding and tailored management strategies. Moreover, this review examines current therapeutic modalities encompassing medical, interventional, and surgical interventions. It synthesizes the evolving landscape of treatment options and highlighting the benefits, limitations, and potential adverse effects associated with each approach. In addition, the review underscores the significance of a multidisciplinary approach, integrating expertise from dermatology, radiology, and surgery, to optimize patient care and outcomes. The challenges posed by these vascular anomalies necessitate ongoing research endeavors aimed at refining diagnostic criteria and advancing therapeutic innovations. This review amalgamates existing knowledge and providing clinicians and researchers with a comprehensive understanding of hemangiomas and VMs, thereby fostering continued exploration and innovation in this complex field.

Abstract Background Healthcare corruption poses a significant threat to individuals, institutions, sectors, and states. Combating corruption is paramount for protecting patients, maintaining the healthcare system's integrity, and preserving public trust. As corruption evolves, takes new forms, and adapts to changing socio-political landscapes, understanding its manifestations is critical to developing effective anti-corruption strategies at individual and institutional levels. Objective The aim was to comprehensively collate the manifestations of different types of corruption in healthcare to illustrate prevailing patterns and trends and to provide policymakers, practitioners, and researchers with practical insights to inform research agendas, regulatory and governance strategies, and accountability measures. Method We conducted a narrative review of scientific articles published between 2013 and 2022 using keyword searches in SCOPUS and EBSCO. We utilized the corruption typology proposed by the European Union and Thompson's Institutional Corruption Framework to systematically identify manifestations across different corruption types. The Prisma scheme was employed to document the selection process and ensure reproducibility. Findings Bribery in medical service provision was the most frequently investigated form of corruption, revealing rather uniform manifestations. Misuse of high-level positions and networks and institutional corruption also received considerable attention, with a wide range of misconduct identified in institutional corruption. Extending the analysis to institutional corruption also deepened the understanding of misconduct in the context of improper marketing relations and highlighted the involvement of various stakeholders, including academia. The pandemic exacerbated the vulnerability of the healthcare sector to procurement corruption. Also, it fostered new types of misconduct related to the misuse of high-level positions and networks and fraud and embezzlement of medical drugs, devices, and services. Conclusions The review spotlights criminal actions by individuals and networks and marks a notable shift towards systemic misconduct within specific types of corruption. The findings highlight the necessity of customized anti-corruption strategies throughout the healthcare sector. These insights are crucial for policymakers, practitioners, and researchers in guiding the formulation of legal frameworks at local and global levels, governance strategies, and research priorities.

Human immunodeficiency virus/Acquired immunodeficiency virus (HIV/AIDS) is well known to be a major public health problem globally. On the other hand, HIV/AIDS is associated with various otorhinolaryngological manifestations. On the other hand, there has been a global reduction in the burden of otorhinolaryngological manifestations since the introduction of highly active antiretroviral therapy though there are limited studies on otorhinolaryngological manifestations among HIV/AIDS patients in Tanzania. A hospital based descriptive cross-sectional study was conducted at Ilala District in Dar es Salaam from November 2022 to March 2023 where 380 study participants were recruited using convenience sampling technique. Data was collected using pre-tested semi-structured questionnaires and analysis was done by means of Statistical Package for Social Sciences (SPSS) version 23. Of all the 380 patients recruited in this study, 22 (5.8%) had otorhinolaryngological manifestations. Most of the patients with otorhinolaryngological manifestations were males (6.1%) in the age group 0–9 years (23.1%) followed by those aged 10–19 years (18.8%). The commonest otorhinolaryngological manifestations were allergic rhinitis (22.7%) and otitis externa (22.7%) followed by hearing loss (18.2%), Kaposi's sarcoma (13.7%), tonsillitis (9.1%), chronic suppurative otitis media, (4.5%) sinusitis (4.5%) and adenoid hypertrophy (4.5%). Otitis externa predominated in males (23.1%) while allergic rhinitis predominated in females (33.3%). Similarly, a significant association was found between the occurrence of otorhinolaryngological manifestations with CD4 counts (p-value = 0.001) and viral load (p-value = 0.000). Otorhinolaryngological manifestations among patients living with HIV/AIDS and on highly active antiretroviral therapy were less prevalent. Males outnumbered females in terms of being affected by otorhinolaryngological manifestations. Allergic rhinitis and otitis externa were the commonest otorhinolaryngological manifestations and most of participants with otorhinolaryngological manifestations had viral load of greater than 100 copies and CD4 counts of less than 200cells/mm3. [ABSTRACT FROM AUTHOR]

Background: Healthcare corruption poses a significant threat to individuals, institutions, sectors, and states. Combating corruption is paramount for protecting patients, maintaining the healthcare system's integrity, and preserving public trust. As corruption evolves, takes new forms, and adapts to changing socio-political landscapes, understanding its manifestations is critical to developing effective anti-corruption strategies at individual and institutional levels. Objective: The aim was to comprehensively collate the manifestations of different types of corruption in healthcare to illustrate prevailing patterns and trends and to provide policymakers, practitioners, and researchers with practical insights to inform research agendas, regulatory and governance strategies, and accountability measures. Method: We conducted a narrative review of scientific articles published between 2013 and 2022 using keyword searches in SCOPUS and EBSCO. We utilized the corruption typology proposed by the European Union and Thompson's Institutional Corruption Framework to systematically identify manifestations across different corruption types. The Prisma scheme was employed to document the selection process and ensure reproducibility. Findings: Bribery in medical service provision was the most frequently investigated form of corruption, revealing rather uniform manifestations. Misuse of high-level positions and networks and institutional corruption also received considerable attention, with a wide range of misconduct identified in institutional corruption. Extending the analysis to institutional corruption also deepened the understanding of misconduct in the context of improper marketing relations and highlighted the involvement of various stakeholders, including academia. The pandemic exacerbated the vulnerability of the healthcare sector to procurement corruption. Also, it fostered new types of misconduct related to the misuse of high-level positions and networks and fraud and embezzlement of medical drugs, devices, and services. Conclusions: The review spotlights criminal actions by individuals and networks and marks a notable shift towards systemic misconduct within specific types of corruption. The findings highlight the necessity of customized anti-corruption strategies throughout the healthcare sector. These insights are crucial for policymakers, practitioners, and researchers in guiding the formulation of legal frameworks at local and global levels, governance strategies, and research priorities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to provide a holistic view of the emergence of shareholder activism (SA) in India. However, specifically, this study aims at fulfilling the research gap by discussing the policy and legal advancement in the area of SA and investigating the chronological evolution of SA, manifestations of SA, motives of SA, outcome of SAs and impact of SA on the financial performance of the firm. Design/methodology/approach: This study used a mixed methodology (both qualitative and quantitative) to draw inferences, including content analysis, descriptive statistics, independent sample t-test and paired sample t-test. The data has been collected from the annual reports of the sample companies and the Prowess database. Return on assets and return on equity have been used as measures of financial performance while investigating the difference in financial performance between firms subjected to SA and firms not subjected to SA. Findings: The findings of this study suggest that there has been significant growth in the occurrence of SA incidents in India in the past decade, with shareholders prominently manifesting by opposing the proposals at annual general meetings/extraordinary general meetings, mostly involving governance-related demands. The findings from the independent sample t-tests revealed that there has been a significant difference in the financial performance of the sample subjected to SA and firms not subjected to SA. Furthermore, the results of the paired sample t-test provide strong evidence of significant improvement in the financial performance of firms' post-SA. Practical implications: The findings of this study have implications for various stakeholders. The findings of this study suggest that SA has been relatively more successful in the Indian context and may encourage minority shareholders to follow active participation through shareholder proposals and votes rather than a passive strategy to trade and exit. For firms, it can provide valuable inferences about the emergence of SA and how it has a positive impact on the financial performance of the firm, which can lead to a change in the perception of investors and promoters who perceive SA as a threat (Gillan and Starks 2000; Hartzell and Starks, 2003). For policymakers, it can act as a tool to investigate whether the regulatory changes have been able to bring the intended transparency, accountability and enhanced shareholder participation. This will encourage policymakers to be more agile, as their efforts are bearing fruit. This will also act as a guide to formulating future policies and regulations. Originality/value: This study is an effort to provide a holistic view of SA scenarios in a developing economy setting like India, where SA is a very recent phenomenon. Although there are studies in the area of SA, there is a dearth of studies that have investigated the various dimensions of SA in the Indian context in a very systematic and extensive manner, investigating all the different dimensions of SA. Furthermore, this study also intends to investigate the impact of SA, which is normally perceived as a threat to financial performance and provide valuable contrasting evidence. [ABSTRACT FROM AUTHOR]

Introduction: Varicella zoster virus (VZV) causes infection of the central nervous system, which manifests as various neurological syndromes. In this case series, we discuss three different clinical presentations of VZV reactivation (herpes zoster). The main clinical feature of herpes zoster is a pruritic vesicular rash, present in a dermatomal distribution, which occurs after reactivation of the virus because of immunosuppression. Patients presentation: We report on three individual cases of complicated herpes zoster that resulted in various neurological pathologies. The patients described in this case series each received a lumbar puncture with cerebrospinal fluid analysis, which showed a positive varicella zoster polymerase chain reaction test (VZV PCR). Management and outcome: All three patients received intravenous acyclovir as their core component of treatment. In addition to this, some received other adjunctive treatments, mainly corticosteroids. Two patients achieved disease resolution while one patient demised. Conclusion: The case series highlights the various ways in which VZV can affect the central nervous system (CNS) such as meningitis, encephalitis, myelitis and arteritis. Contribution: This is a brief overview of the clinical manifestations of VZV affecting the CNS in patients presenting to a regional hospital within the Western Cape province in South Africa.

Freezing of gait (FOG) is an episodic and highly disabling symptom of Parkinson’s disease (PD). Although described as a single phenomenon, FOG is heterogeneous and can express as different manifestations, such as trembling in place or complete akinesia. We aimed to analyze the efficacy of deep learning (DL) trained on inertial measurement unit data to classify FOG into both manifestations. We adapted and compared four state-of-the-art FOG detection algorithms for this task and investigated the advantages of incorporating a refinement model to address oversegmentation errors. We evaluated the model’s performance in distinguishing between trembling and akinesia, as well as other forms of movement cessation (e.g., stopping and sitting), against gold-standard video annotations. Experiments were conducted on a dataset of eighteen PD patients completing a FOG-provoking protocol in a gait laboratory. Results showed our model achieved an F1 score of 0.78 and segment F1@50 of 0.75 in detecting FOG manifestations. Assessment of FOG severity was strong for trembling (ICC=0.86, [0.66,0.95]) and moderately strong for akinesia (ICC=0.78, [0.51,0.91]). Importantly, our model successfully differentiated FOG from other forms of movement cessation during 360-degree turning-in-place tasks. In conclusion, our study demonstrates that DL can accurately assess different types of FOG manifestations, warranting further investigation in larger and more diverse verification cohorts.

Background: Inflammatory bowel disease (IBD) is associated with multiple factors that influence bone metabolism. This study aimed to compare the clinical manifestations and diagnostic parameters of patients with Crohn’s disease (CD) and ulcerative colitis (UC) at the time of diagnosis, as well as to assess their relationship with subsequent bone disorders. Methods: Blood tests (including calcium–phosphate metabolism) and fecal tests (including calprotectin) were performed in eighty children recently diagnosed with IBD. Additionally, the bone densitometry results were evaluated in 25 of them. Results: Diarrhea (p = 0.02) and bloody stools (p < 0.001) were more frequent in patients with UC, whereas fever was more common in patients with CD (p = 0.003). Laboratory tests revealed anemia in 62.5% (50/80) and thrombocytosis in 36.3% (29/80). Higher calprotectin levels in the feces were found in girls at the time of diagnosis (p = 0.02). Osteopenia was detected in almost half of the examined patients (12/25), and 20% (5/25) met the criteria for osteoporosis. Low calcium levels at diagnosis were correlated with subsequent bone disorders (p = 0.005). Insufficient levels of vitamin D were detected in 77.8% (56/80). Conclusions: Early disease detection and the appropriate monitoring of children with IBD may decrease the risk of serious consequences, including osteoporosis.

Purpose: We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts. Methods: This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case. Results: A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30–39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001). Conclusion: Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections. [ABSTRACT FROM AUTHOR]

Defects in the mitochondrial DNA (mtDNA) cause mtDNA depletion syndrome (MTDPS), a subclass of mitochondrial disorders that are genetically and phenotypically heterogeneous. MTDPS is a rare autosomal recessive disease caused by a mutation of a nuclear gene named FBXL4 (F-box and leucine-rich repeat protein 4), located on chromosome 6. This nuclear-encoded mitochondrial protein plays a vital role in mitochondrial bioenergetics, mtDNA maintenance, and mitochondrial dynamics. Pathogenic variants in the FBXL4 gene reduce mtDNA synthesis, resulting in a large decrease in the mtDNA content in cells, which is essential for normal energy production. These pathogenic variants in the FBXL4 gene are associated with an encephalomyopathy MTDPS type 13 (MTDPS13), a rare and severe mul­tisystemic disorder mainly characterized by infant-onset encephalomyopathy and lactic acidosis, developmental delay, hypotonia with feeding difficulties and failure to thrive. Other features may include the central nervous system and the ophthalmologic, cardiac, gastrointestinal, genito­urinary, and immunological systems. Herein, we report the case of an infant born to consanguineous Pakistani parents with an early onset of severe lactic acidosis, hypotonia, feeding difficulties, hypertro­phic cardiomyopathy, supraventricular tachycardia, and transient neutro­penia harboring a homozygous variant in the FBXL4 (c.370C>T [p.Q124*]) gene. This variant was identified in the patient’s parents in heterozygosity. He started medical treatment (with coenzyme Q10, propranolol, and sodium bicarbonate) and multidisciplinary support. As a result, a progressive improvement in postural tone and feeding autonomy was observed during the first months of life. Therefore, encephalomyopathy MTDPS13 should be suspected when dealing with patients with severe congenital lactic acidosis and developmental impairment.

Introduction: Coronavirus Disease-2019 (COVID-19), has caused, nearly 18 million deaths worldwide, many more hospitalisations, and severe economic and social disruption, as of March 2022. Malnutrition and electrolyte imbalance can lead to immune system dysfunction, which can increase the risk of infection. Aim: To evaluate the electrolyte imbalance and other biomarkers in COVID-19 patients and also, to compare these parameters with healthy individuals. Materials and Methods: A retrospective case-control study was conducted in the Department of Medical Laboratory Sciences at European Gaza Hospital, Southern Gaza Strip, Palestine. The duration of the study was four months, from February 2022 to May 2022. A total of 200 participants were included in the study, out of which 100 patients were diagnosed with COVID-19 infection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test and 100 healthy individuals were recruited from blood bank donors and comprehensive Screening Department. Biochemical profile; Fasting Blood Glucose (FBG), urea, Creatinine (Cr), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total Creatinine Kinase (CK-total), Creatine Kinase (CK) isoenzyme CK and electrolytes (Na, K, phosphorous, and Mg, ionised calcium, total calcium, and Cl) were assayed. Data were statistically analysed using Student’s t-test and Chi-square test. Results: The mean age of the study participants was 54.1±12.2 years for cases and 54.3±12.4 years for controls. A total of 200 subjects, both the groups had 34 (34.0%) males and 66 (66.0%) females, which was not statistically significant (p-value>0.05). COVID-19 patients had significantly higher values of Na (141.9±4.6 vs 139.7±3.1; p

Introduction: To date various oral manifestations in patients with coronavirus disease 2019 (COVID-19) have been reported. Objectives: In the present study, we investigated the relationship between Polymerase Chain Reaction (PCR) positivity and oral signs in patients with suspected COVID-19. Methods: A total of 383 patients who presented to the emergency department for the first time with any symptoms associated with COVID-19 were included in the study. Oral examinations were performed and the findings, PCR status, and thorax computerized tomography (CT) reports were recorded. Results: Oral mucosa was involved in 246 (64.2%) patients. 175 (78,4%) of patients with COVID-19 confirmed the diagnosis with PCR test or CT results had oral manifestation. Dry mouth, microvesicles on the tonsils or pharynx, and petechiae in the oropharynx were significantly higher in patients with positive PCR tests (P = 0.001, P < 0.001, P < 0.001, respectively). The ratio of intact oral mucosa was statistically significantly higher in patients with negative PCR tests compared to those with positive PCR tests (P < 0.001). Microvesicles on the tonsils or pharynx were most associated with PCR positivity in patients without lung involvement (P < 0.001). Dry mouth, erythema of the tonsils and pharynx, petechiae in the oropharynx, and primary/secondary herpes infection are more related to PCR positivity in patients without lung involvement (P < 0.05). Lung involvement in patients with PCR positivity is related to only cheilitis (P = 0.034). Conclusions: Our study revealed that especially microvesicles, petechiae, erythema on the tonsils or pharynx, and some other oral lesions such as dry mouth, oral aphthae, and primary/secondary herpes infection are associated with PCR positivity.

Background. The study of the of state’s activities and local authorities in the im-plementation of confessional policy in region, by the example of the North-Western Territory of the Russian Empire, is an integral part of the measures of the tsarist government to ensure public security in the western outskirts of the state. The purpose of the study is to consider the main activities of the tsarist administration in the 1860s to solve the confessional issue and eliminate contradictions in the region on religious grounds on the example of the policy pursued by the Governor-General of the North-Western Territory M.N. Muravyov. Materials and methods. To achieve this goal, an analysis of unpublished documents from the funds of the State Archive of the Russian Federation, as well as published materials, was carried out. The work uses retrospective, problem-chronological, historical-comparative, as well as gen-eral scientific research methods. Results. The main directions and characteristic features of the confessional policy pursued by the administration of M.N. Muravyov in the specified region were identified. Conclusions. The religious policy of M.N. Muravyov made it possible to temporarily stabilize the intensity of sectarian contradictions in the North-West Territory, showing an effective way to solve this issue. It became an important area of his activity during the years of the administration of the region, significantly weakening the position of the Catholic Church and strengthening the influence of Orthodoxy on the inhabitants of the region, which contributed to the further integration of the region into the Russian Empire.

Objective. To investigate the effect of sex on the clinical characteristics, prognoses, and therapeutic selection of eosinophilic granulomatosis with polyangiitis (EGPA). Methods. We retrospectively enrolled 170 hospitalized patients with EGPA who were managed at our hospital between 2007 and 2020. Detailed clinical data were reviewed. Manifestations, prognoses, treatments, and outcomes were compared between female and male patients. Cumulative survival rates were calculated using Kaplan-Meier curves. Results. In this cohort, the male to female ratio was 1.4:1. Renal involvement was more frequent in male patients, including serum creatinine elevation, and proteinuria > 1 g/24 h. Severe gastrointestinal (GI) involvement occurred more commonly in male patients. Female patients had longer allergy duration and higher ratios of allergic rhinitis and asthma. Sex differences in proteinuria > 1 g/24 h, serum creatinine > 150 mmol/L, severe GI involvement, and weight loss were more significant in patients aged ≤ 55 years than those in patients aged > 55 years. Overall, male patients had a higher Birmingham Vasculitis Activity Score and a worse prognosis assessed at diagnosis, with a lower proportion of 1996 Five Factor Score = 0 than females. Regarding treatment selection, methylprednisolone pulse and cyclophosphamide were administered more frequently to male patients. All-cause mortality and cumulative survival rates were comparable between the sexes. Conclusion. In this Chinese EGPA cohort, male and female patients showed distinct disease phenotypes. Male patients with EGPA had a higher disease activity at diagnosis and required more aggressive treatment for remission induction. [ABSTRACT FROM AUTHOR]

Abstract Background Patients with congenital aural atresia (CAA) can present with concomitant temporomandibular joint (TMJ) retroposition, implying that even with a high Jahrsdoerfer score, canaloplasty and tympanoplasty cannot be performed. Therefore, this study aimed to summarize the clinical manifestations and share our diagnostic and treatment experience of this rare entity, which has not been described previously. Methods Thirty patients (30 ears) with CAA and TMJ retroposition without maxillofacial dysplasia were included. Diagnosis was based on patient history, physical examination, pure-tone average test results, and temporal bone high-resolution computed tomography (HRCT) findings. Their Jahrsdoerfer scores and interventions were also recorded. Results Twenty-four and six patients among the 30 patients (males, n = 15) had CAA and TMJ retroposition on the right and left sides, respectively. Seventeen ears had a normal auricle; most had an enlarged cavum conchae and a large tragus. Twelve ears had an accessory auricle, and two had a preauricular fistula. All external auditory canals had complete atresia, including four with a shallow concavity and four with a small orifice in the cavum conchae. Temporal bone HRCT revealed poor or undeveloped tympanic temporal bone in the diseased ears, atresia in the external auditory canals, and partial/complete occupation of the mandibular condyle with or without soft tissue. The average Jahrsdoerfer score was 8.17. Thirteen patients opted for different surgeries, three wore a bone-conduction hearing aid, and fourteen chose no intervention. Conclusions CAA with TMJ retroposition was often unilateral, typically on the right side. Most patients had normal auricles, with an enlarged cavum conchae and a large tragus (“mirror ear”). Even with a high Jahrsdoerfer score, traditional hearing reconstruction surgery could not be performed. Patients can undergo Vibrant Soundbridge or Bonebridge implantation or wear bone-conduction hearing aids to improve hearing levels, or refuse intervention because of mild hearing loss. The TMJ location can be used as a Jahrsdoerfer Grading System supplement for preoperative evaluation. Graphical Abstract

From the après‐mai 1968 through the end of the 1970s, successive groups of French radicals legitimized revolutionary violence and developed a militant protest culture that challenged the state's monopoly on violence. Most scholars have presented political violence in 1970s France as bound to the trajectories of organized Maoist and Trotskyist groups and as the product of revolutionary ideology that was overcome by experience. This article traces how a cohort of radicals continued to articulate discourses of self‐defense, counterviolence, and violence as revolution of the self well into the 1970s. Activists did so because their experiences of conflict confirmed the salience of violent struggle. The article contributes to the historical study of violent phenomena by tracing an approach that integrates the analysis of understandings of violence and experiences of conflictual politics. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19), has caused, nearly 18 million deaths worldwide, many more hospitalisations, and severe economic and social disruption, as of March 2022. Malnutrition and electrolyte imbalance can lead to immune system dysfunction, which can increase the risk of infection. Aim: To evaluate the electrolyte imbalance and other biomarkers in COVID-19 patients and also, to compare these parameters with healthy individuals. Materials and Methods: A retrospective case-control study was conducted in the Department of Medical Laboratory Sciences at European Gaza Hospital, Southern Gaza Strip, Palestine. The duration of the study was four months, from February 2022 to May 2022. A total of 200 participants were included in the study, out of which 100 patients were diagnosed with COVID-19 infection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test and 100 healthy individuals were recruited from blood bank donors and comprehensive Screening Department. Biochemical profile; Fasting Blood Glucose (FBG), urea, Creatinine (Cr), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total Creatinine Kinase (CK-total), Creatine Kinase (CK) isoenzyme CK and electrolytes (Na, K, phosphorous, and Mg, ionised calcium, total calcium, and Cl) were assayed. Data were statistically analysed using Student's t-test and Chi-square test. Results: The mean age of the study participants was 54.1±12.2 years for cases and 54.3±12.4 years for controls. A total of 200 subjects, both the groups had 34 (34.0%) males and 66 (66.0%) females, which was not statistically significant (p-value>0.05). COVID-19 patients had significantly higher values of Na (141.9±4.6 vs 139.7±3.1; p<0.001), K (4.6±0.9 vs 4.3±0.5; p-value=0.001), Cl (108.7±5.3 vs 101.1±4.0; p<0.001), P (4.6±0.6 vs 4±1.4; p<0.001), and Mg (2.1±0.2 vs 1.7±0.3; p<0.001). However, they had lower Ca ionised (1.0±0.1 vs 1.1±0.1; p<0.001) and total Ca (8.4±0.9 vs 9.1±1.1; p<0.001). Furthermore, COVID-19 patients had significantly higher levels of biomarkers of other biochemical profiles compared to healthy controls. Conclusion: As compared to healthy individuals, patients hospitalised with COVID-19, exhibited alterations in their electrolyte balance and other biochemical markers. Management of these parameters to get homeostasis, could that warrant opportunities to reduce morbidity and mortality of disease. [ABSTRACT FROM AUTHOR]

Ticks are obligatory hematophagous arthropods that harbor and transmit infectious pathogens to humans and animals. Tick species belonging to Amblyomma, Ixodes, Dermacentor, and Hyalomma genera may transmit certain viruses such as Bourbon virus (BRBV), Dhori virus (DHOV), Powassan virus (POWV), Omsk hemorrhagic fever virus (OHFV), Colorado tick fever virus (CTFV), Crimean- Congo hemorrhagic fever virus (CCHFV), Heartland virus (HRTV), Kyasanur forest disease virus (KFDV), etc. that affect humans and certain wildlife. The tick vectors may become infected through feeding on viraemic hosts before transmitting the pathogen to humans and animals. Therefore, it is vital to understand the ecoepidemiology of tick-borne viruses and their pathogenesis to optimize preventive measures. Thus this review summarizes knowledge on some medically important ticks and tick-borne viruses, including BRBV, POWV, OHFV, CTFV, CCHFV, HRTV, and KFDV. Further, we discuss these viruses' epidemiology, pathogenesis, and disease manifestations during infection. [ABSTRACT FROM AUTHOR]

Reticular Oral lichen planus (OLP) is a chronic autoimmune disease that presents as fine, white, linear and lace like lesions of the oral cavity referred to as Wickham striae. The clinical characteristics of 30 patients with reticular oral lichen planus is presented so that cases are not missed/misdiagnosed by ENT surgeons. The clinical records noted for each patient were gender, age and clinical presentation of reticular OLP (site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages). Twenty patients were females (66.7%) and 10 (33.3%) were males giving a female to male ratio of 2:1. Majority of patients (50%) among both males and females were in the age group of 31–40 years followed by 41–50 years (20%). Oral discomfort/burning sensation was the chief symptom in 24 (80%) patients followed by asymptomatic oral white patches in 5 (16.6%).The buccal (cheek) mucosa was the site most affected (76.8%) followed by the buccal mucosa plus retromolar trigone mucosa (10%) and tongue (6.6%), Extraoral lesions were observed in 2 (6.6%) of patients at presentation with oral lesions and were on the nails in 1 patient and wrist in 1 patient. Tobacco smoking, alcohol use, diabetes and hypertension were reported in 3 (10%), 0%, 2 (6.7%) and 4 (13.3%) patients respectively. ENT surgeons routinely see patients with oral discomfort/oral ulcerations and as such they should be well versed with classical clinical characteristics of reticular oral lichen planus. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts. Methods: This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case. Results: A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30–39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001). Conclusion: Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections.

Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns.

Tourism is one of the world-leading businesses that represent a major generator of socio-economic development in many countries, even underdeveloped ones. The events are activities that belong to a group of formed activities, which should be a part of every tourist destination that aims to have successfully developed tourism. Trips that are primarily focused on visiting certain manifestations are portrayed as tourism of manifestations or event tourism. The manifestations are spatio-temporal phenomena, each unique due to the mutual interaction of place, domiciled inhabitants, tourists, and the managing system, including program and concept. The events that bring tourists to a certain destination can be related to culture, art, sports, entertainment, business, and even politics. This paper aims to emphasize the importance of ethnographic manifestations in Serbia as indeed a priceless intangible cultural heritage that has a huge influence and significance on the development of the local environment, as well as on the positioning of the entire country as a manifestational tourist destination with over 2500 events per year.

Abstract Background Cow’s milk is known to be the most frequent food allergen in infants in the first years of life. Eliminating cow milk protein from diets and reintroducing it with a challenge test are the main methods for sure diagnosis. Cow’s Milk-related Symptom Score (CoMiSS) has been developed for primary health care providers to improve their knowledge about CMPA. Objective This study was conducted to prescribe clinical presentation of cow’s milk allergy among infants. Methods A cross-sectional study was conducted at Gastroenterology and Nutrition Unit, University Children Hospital, from the 1st of January 2020 to the 31st of December 2020. Forty infants, complaining of recurrent or persistent gastrointestinal manifestations, were included in our study (28 males and 12 females). Those infants were subjected to detailed medical and social patient history, comprehensive physical exam, and CoMiSS scoring as an awareness tool to suspect underlying cow milk allergy. Infants with a CoMiSS of more than 12 points and positive elimination rechallenge test were regarded as eligible to be part of our study. Results This study showed that the most frequently occurring gastrointestinal manifestations associated with CMPA were regurgitation (92%), diarrhea (80%), colic (75%), vomiting (67.5%), and lastly constipation which represents only (5%). Conclusion Regurgitation and diarrhea are the commonest presentations for infants proved to have cow milk allergy with CoMiSS score and elimination rechallenge test, where constipation is the least common presentation for those infants.

The paper analyses the slogans of “Monstration”, a manifestation that was held for the first time in Novosibirsk in 2004 and has become an important social and cultural event in many other Russian cities as well as in some other countries. The corpus compiled by the author includes about 4000 slogans and allows, basing on the theory of speech genres, to highlight the main topics and structural features of this type of texts and to identify their similarities and differences with the slogans of political manifestations. The study proves that Monstration may be considered as a form of “linguistic self-defense” and could be compared with the linguistic resistance that existed in the Soviet Union: the totalitarian language that dominated the public sphere was opposed by the anti-totalitarian language used in the sphere of personal communication; and one of the main instruments of the anti-totalitarian linguistic self-defense was irony. It seems that in 2019, the totalitarian language in Russia was yet at such a stage of development that language resistance was relevant; however, it was feasible not only in private space (and the Internet), but also manifested itself in public space from time to time.

Coronavirus emerged from Wuhan China, which has been a global challenge for healthcare authorities and individuals. Patients are presenting to clinicians with neurological symptoms caused by coronavirus disease-2019 (COVID-19) or with preexisting neurological conditions with fear of contracting the virus. This is a literature review of COVID-19 patients and patients with underlying neurological conditions affected by the pandemic encompassing December 2020 to March 2021. We searched multiple databases including PubMed, Google Scholar, EBSCO, Semantic Scholar, and Wiley Online for information on neurological manifestations of patients suffering from coronavirus. Clinical data and co-morbidities of the patients were examined. Headache, dizziness, hyposmia, and stroke symptoms were reported. According to recently published literature, some of the patients with coronavirus who have respiratory symptoms also develop neurological symptoms. Certain medical emergencies such as stroke require immediate treatment to ensure better clinical outcomes for the patients. Neurologists and clinicians need to recognize these acute symptoms in order to timely manage and treat the affected patients.

Anthrax is a deadly disease for animals and humans, which occurs mainly acutely - in a septicemic form, with inflammatory-necrotic processes in different organs. It is caused by Bacillus anthracis. The disease is widespread in Asia, Africa, Central and South America and southern Europe. In our country, until the end of the 20th century, anthrax in animals was a serious problem, but with the implementation of systematic, annual vaccinations of susceptible animals in stationary outbreaks and strict diagnostic control in the National Reference Laboratory (NRL), the incidence dropped sharply and now only single cases. The article presents the most important characteristics of the causative agent, epizootological features of the infection, pathogenesis and clinical manifestations of the disease. The diagnostic methods used and the possibilities for immunoprophylaxis and control of anthrax in animals were reviewed, in accordance with the requirements of Ordinance No. 6/October 5, 2020. Modern molecular methods for detection and identification of B. anthracis are indicated. The application of B. anthracis produced lethal factor (LF) and protective antigen (PA), as an alternative in cancer therapy is described. Anthrax is discussed in the context of the One Health concept. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer diagnosis and treatment have been shown in studies to have a negative impact on patients' physical, psychological, and social wellbeing, as well as overall quality of life. Psychologically, it's linked to sadness, anxiety, and demoralisation. Stigma contributes to the hidden burden of breast cancer as a chronic illness. Research on the elements that breast cancer survivors encounter as influences on stigma associated to the disease is lacking. Based on the lived experiences of breast cancer survivors, this study sought to investigate the factors that lead to the manifestations of both self- and public breast cancer stigma. Methods: Individual semi-structured interviews with 24 patients diagnosed with breast cancer were performed, followed by five focus groups with 25 patients diagnosed with breast cancer. Interviews were verbatim transcribed and analysed using thematic framework analysis. Results: Two major themes have emerged from the data: a) Breast cancer stigma among breast cancer survivors, highlighting the various manifestations of stigma and the variables that influence them; including disease-related factors, patients' views of cancer, public perceptions of breast cancer, family and interpersonal dynamics, and b) Stigma resilience and empowerment, emphasising the necessity of sociocultural transformation and coping strategies to preserve resilience. Conclusions: To improve the well-being of breast cancer survivors, practitioners and health policymakers should be aware of the breast cancer stigma that underpins patients' emotional and behavioural outlooks and its potential consequences on patients' quality of life. They need to develop interventions to address the different stages of cancer stigma taking into consideration sociocultural influences, norms, and beliefs. [ABSTRACT FROM AUTHOR]

Background: Patients with congenital aural atresia (CAA) can present with concomitant temporomandibular joint (TMJ) retroposition, implying that even with a high Jahrsdoerfer score, canaloplasty and tympanoplasty cannot be performed. Therefore, this study aimed to summarize the clinical manifestations and share our diagnostic and treatment experience of this rare entity, which has not been described previously. Methods: Thirty patients (30 ears) with CAA and TMJ retroposition without maxillofacial dysplasia were included. Diagnosis was based on patient history, physical examination, pure-tone average test results, and temporal bone high-resolution computed tomography (HRCT) findings. Their Jahrsdoerfer scores and interventions were also recorded. Results: Twenty-four and six patients among the 30 patients (males, n = 15) had CAA and TMJ retroposition on the right and left sides, respectively. Seventeen ears had a normal auricle; most had an enlarged cavum conchae and a large tragus. Twelve ears had an accessory auricle, and two had a preauricular fistula. All external auditory canals had complete atresia, including four with a shallow concavity and four with a small orifice in the cavum conchae. Temporal bone HRCT revealed poor or undeveloped tympanic temporal bone in the diseased ears, atresia in the external auditory canals, and partial/complete occupation of the mandibular condyle with or without soft tissue. The average Jahrsdoerfer score was 8.17. Thirteen patients opted for different surgeries, three wore a bone-conduction hearing aid, and fourteen chose no intervention. Conclusions: CAA with TMJ retroposition was often unilateral, typically on the right side. Most patients had normal auricles, with an enlarged cavum conchae and a large tragus ("mirror ear"). Even with a high Jahrsdoerfer score, traditional hearing reconstruction surgery could not be performed. Patients can undergo Vibrant Soundbridge or Bonebridge implantation or wear bone-conduction hearing aids to improve hearing levels, or refuse intervention because of mild hearing loss. The TMJ location can be used as a Jahrsdoerfer Grading System supplement for preoperative evaluation. [ABSTRACT FROM AUTHOR]

Background: Acute rheumatic fever (ARF) with carditis can lead to the development of rheumatic heart disease in children and young adults. Objective: This study aimed to investigate the manifestations of rheumatic carditis, clinically significant regression of valvular regurgitation as assessed by echocardiography, and the independent predictors of mitral regurgitation (MR) improvement after rheumatic carditis in Thai children. Method: Children diagnosed with rheumatic carditis during 2005–2020 at Siriraj Hospital (Bangkok, Thailand) were retrospectively enrolled. Trivial, and mild regurgitation were grouped as non-clinically significant (NCS) regurgitation. Valvular regression was defined moderate-severe regurgitation improving to NCS regurgitation. Results: Eighty-one patients (mean age: 10 years, range: 8–12 years) were included. At presentation, 59 (72.8%) patients had combined mitral regurgitation (MR) and aortic regurgitation (AR), 20 (24.6%) patients had MR alone, and 2 (2.4%) patients had AR alone. Concerning severity, 28 (34.6%) and 30 (37%) patients presented with severe and moderate MR, respectively. Severe and moderate AR was found in 9 (11.1%) and 16 (19.8%) patients, respectively. At the one-year follow-up, 43.4% of moderate-severe MR, and 41.7% of moderate-severe AR improved to NCS regurgitation. Multivariate analysis revealed high erythrocyte sedimentation rate (ESR) (p = 0.01) and severe carditis (p = 0.05) at presentation to be independent predictors of MR improvement. Conclusion: Thai children with rheumatic carditis had a high incidence of valvular regurgitation; however, the valvular damage was improved in most patients. High ESR and severe carditis independently predict MR improvement.

Purpose – The purpose of this study is to evaluate rice farmers’ perceptions on the manifestations of the climate change and identify efficient strategies and determinants of adoption of these strategies in the Republic of Benin. Design/methodology/approach – Surveys were conducted using participatory research appraisal tools and techniques, such as direct observation, individual interviews and field visits through a questionnaire for data collection. A total of 418 rice farmers across 39 villages located in the three climatic zones of the Republic of Benin were interviewed. Farmers’ perceptions, temperature from 1952 to 2018 and rainfall from 1960 to 2018 data obtained from meteorological stations were analysed using descriptive and inferences statistics. Findings – All the surveyed farmers were aware of climate change and perceived diverse manifestations including the delay in rainfall regarded as the most important risk. They perceived that deforestation, no respect for the laws of nature and desacralization of morals, no respect for cultures and the traditional rainmakers are the main causes of climate change. The disruption of agricultural calendar and the reduction in rice yield were perceived as the main impacts of climate change in rice production. They used various approaches to adapt and mitigate climate change effects. The adoption of adaptation strategies was influenced either negatively or positively by the household size, land size, education level, membership to rice farmer’s association, training in rice production, access to extension services, use of improved varieties and the location in climatic zones. Research limitations/implications – For each climatic zone of the Republic of Benin, weather data were collected in only one meteorological station. Practical implications – The study showed that it is important to educate rice farmers on the scientific causes of climate change for better resilience. There is an urgent need to train rice farmers in irrigation and water management techniques to cope with climate variability. To promote irrigation, the authors suggest the establishment of a subsidy and credit mechanism by the government. Factors that influenced adoption of efficient adaptation strategies to climate events must be taken into account for future adaptation policies in the Republic of Benin. Originality/value – This study provided an overview of the perceptions and adaptations of rice farmers along the climatic gradient in the Republic of Benin. Therefore, the knowledge of the determining factors of the adaptation strategies used by rice farmers could be used in the setting up of effective climate change resilience policies in Benin.

Background/aim. Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2. Although the main symptoms of this virus are in the respiratory system, neurological clinical manifestations in the form of the central nervous system (CNS), peripheral nervous system (PNS) and musculoskeletal system are often found. This study aims for data on the characteristics of neurological manifestations in COVID-19 patients. Research methods. A retrospective cohort study with medical record from June 2020 to June 2021 which was analyzed descriptive, Chi-Square test and survival using SPSS program. Research result. There were 136 patients with PCR swab results (+), 80 (58.8%) male and 56 (41.2%) female, age > 50 years 92 (67.6%), 47 (34.6%) died. Neurological manifestations in the CNS that stroke 72 (52.9%) RR 4.8 (CI 95% 2.1-10.6; p

Résumé : À la faveur d’une politique linguistique qui assure la promotion du bilinguisme au Tchad et au Cameroun, le français est reconnu langue officielle. Dans ces deux pays, il partage son statut linguistique respectivement avec l’arabe et avec l’anglais. À cet effet, le français s’utilise comme une des deux langues de travail dans le domaine : administratif, scolaire, médiatique entre autres. Mais, par sa prédominance sur le secteur formel, celui-ci devient source des conflits linguistiques qui influent sur l’unité nationale et la cohésion sociale. En ce sens, l’objet de cette recherche est d’explorer des pistes qui pourraient conduire à une paix linguistique et sociale. Inscrite dans une perspective sociolinguistique, cette étude prend appui sur une enquête documentaire et une enquête de terrain. Comme telle, elle se penche sur les facteurs, les formes de ces conflits, leurs conséquences et aboutit à des suggestions

Introduction Coeliac disease is a genetic autoimmune disease of the digestive system. It is caused by permanent intolerance to gluten (a protein contained in wheat, rye, barley), which results in the atrophy of the intestinal villi in the small intestine and deficiency of nutrients in the body. It can also manifest itself with various pathologies within the teeth and oral mucosa. Aim of the study The purpose of the study is to present the symptoms of coeliac disease in oral cavity. Materials and methods PubMed and Google Scholar medical databases were analyzed, operating with the following keywords: coeliac disease, oral cavity, manifestations, lesions, symptoms, oral health in as many configurations as needed. Twenty-eight related articles published during the last five years (2018-2023) were selected. Results In addition to the classic intestinal symptomatology, coeliac disease can also manifest itself in the oral cavity in the form of delayed tooth eruption, enamel defects, MIH, recurrent aphthous stomatitis or xerostomia. The etiology of the changes is still not clear, but studies show that they most likely arise as a result of impaired absorption of vitamins and minerals in the small intestine. Conclusion The variety of symptoms of celiac disease makes it a significant diagnostic challenge. It is important to raise awareness among dentists about the symptoms of the disease because a quick diagnosis can prevent many complications.

IntroductionBreast cancer diagnosis and treatment have been shown in studies to have a negative impact on patients’ physical, psychological, and social well-being, as well as overall quality of life. Psychologically, it’s linked to sadness, anxiety, and demoralisation. Stigma contributes to the hidden burden of breast cancer as a chronic illness. Research on the elements that breast cancer survivors encounter as influences on stigma associated to the disease is lacking. Based on the lived experiences of breast cancer survivors, this study sought to investigate the factors that lead to the manifestations of both self- and public breast cancer stigma.MethodsIndividual semi-structured interviews with 24 patients diagnosed with breast cancer were performed, followed by five focus groups with 25 patients diagnosed with breast cancer. Interviews were verbatim transcribed and analysed using thematic framework analysis.ResultsTwo major themes have emerged from the data: a) Breast cancer stigma among breast cancer survivors, highlighting the various manifestations of stigma and the variables that influence them; including disease-related factors, patients’ views of cancer, public perceptions of breast cancer, family and interpersonal dynamics, and b) Stigma resilience and empowerment, emphasising the necessity of sociocultural transformation and coping strategies to preserve resilience.ConclusionsTo improve the well-being of breast cancer survivors, practitioners and health policymakers should be aware of the breast cancer stigma that underpins patients’ emotional and behavioural outlooks and its potential consequences on patients’ quality of life. They need to develop interventions to address the different stages of cancer stigma taking into consideration sociocultural influences, norms, and beliefs.

The Municipality of Zaječar has quality cultural and tourist potentials that only with proper and quality valorization can enable sustainable development of tourism that will have a long-term effect. Cultural tourism in this municipality represents a real chance for its long-term development. In this paper, the manifestation values will be analyzed, which in combination with cultural monuments, archeological sites, sacral objects and other values, using the storytelling method, can fit into one complex tourist product. By creating such a product, it would influence the improvement of the destination's image and form an umbrella brand that would include all cultural values, which would make the municipality of Zaječar recognizable. [ABSTRACT FROM AUTHOR]

Monkeypox is a zoonotic disease, endemic in central and west African regions, and has re‐emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of mucocutaneous, as well as systemic symptoms of the disease. We searched four main online databases with the keywords "monkeypox" and "Orthopoxvirus". A total of 46 articles were included, with a cumulative number of 1984 confirmed cases. Patients were predominantly men who have sex with men, who were mostly in their 30s, with a history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular, pustular or pseudo‐pustular, vesicular‐umbilicated and papular lesions were the most common, mainly presenting asynchronously, with less than 10 lesions on each patient. Almost all patients also reported systemic manifestations, namely fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis, and proctitis. Sexual contact is the main pathway of transmission in the current outbreak, with viral shedding in bodily fluids playing a key role. We've compared these idiosyncratic findings of the new outbreak with previous outbreaks. We've also gathered and categorized images from our included studies to make a "clinical atlas" for this "new" face of monkeypox, which can be of utmost importance for clinicians to be familiarized with, and have a clear picture of monkeypox for their differential diagnoses. [ABSTRACT FROM AUTHOR]

Azim Murtaza, in his most isolated place, has gently cut the curve of his possibilities along with his age. The imitation of the poets begins to show its colors. In the art of Azim Murtaza, the whole evolution is slowly unfolding and one can feel that he hates the terms of wearing a belt and a clock. He is not just a good lion. He say good ghazals, his poems are not prisoners of his loneliness, his poems are prisoners of the group of his companions, and they fly in the direction of the thoughts. The greatest sorrow of Azim Murtaza, the seeker of the original grief, is that the manifestations of grief are not ready to leave him. It should be that this failed attempt of Azim Murtaza is the most powerful part of his personality and this is the point where he seems to repeat the steps taken by modern poets. [ABSTRACT FROM AUTHOR]

Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns. [ABSTRACT FROM AUTHOR]

Purpose: Lateral ventricle meningiomas (LVM) in children are very rare. The current research is mostly limited to adults, and there are very few related studies on children. The purpose of this study was to analyze the clinicopathological and imaging features of lateral ventricle meningiomas in children. Methods: A retrospective analysis of five children with pathologically confirmed lateral ventricle meningioma was performed, and we collected clinical data, including clinicopathological data, treatment prognosis data, and imaging features (including tumor location, signal intensity, enhancement degree, intratumoral cyst, calcification, peritumoral edema, and associated hydrocephalus). Results: Among the 5 patients with LVM, 4 were male and 1 was female with an average age of 7.6 years (range 2 to 12 years). All CT scans showed slight hyperintensity or isodensity, and only 1 patient had calcification. Two patients demonstrated cyst changes. Four patients had varying degrees of peritumoral edema. The average tumor volume was 164.1 cm3 (1.4–314.9 cm3). All 5 patients with LVM were iso- or hypointense on T1WI. The T2WI signals had no obvious features. Four patients had a high signal on DWI (80%). The contrast-enhanced signals were mostly homogeneously strong (80%). MRI showed hydrocephalus in 3 patients. All patients underwent gross total resection, and they were followed up regularly after the operation. The average follow-up time was 47.4 months. No recurrence was found in any of the children. All patients were pathologically confirmed to have meningiomas, and WHO grades were all grade I. Conclusion: Lateral ventricle meningiomas in children are very rare, and the imaging manifestations of the tumor have certain characteristics, but the clinical diagnosis is still difficult, and the diagnosis still requires pathological analysis. [ABSTRACT FROM AUTHOR]

Systemic sclerosis (SSc) is a progressive autoimmune connective tissue disease. Platelets to lymphocytes (PLR) and platelets to haemoglobin ratios (PHR) are emerging biomarkers used in the assessment of activity and severity of various autoimmune diseases. This study was designed to clarify the association of PLR and PHR with SSc disease activity and its different manifestations. A cross-sectional study involved sixty SSc patients. Demographic, clinical data and investigations were done. PLR and PHR were correlated positively with ESR (r = 0.351, p = 0.003*), (r = 0.620, p = 0.000**), CRP (r = 0.417, p = 0.001*), (r = 0.305, p = 0.018**) and SSc activity index (r = 0.292, p = 0.024*), (r = 0.359, p = 0.005*). PLR and PHR were highly significantly related to digital ulcerations, musckeloskeletal, and pulmonary manifestations. Also, they had a significant relation to ground glass abnormalities on HRCT, mild restriction in pulmonary function tests and anti-scleroderma-70 antibodies. The cutoff value for PLR was 107.8 with high sensitivity 97.9% and specifity 92.3%, area under the curve (AUC = 0.723, P 0.015) on receiver operating characteristic curve (ROC). PHR AUC (0.799, P.001), cut value was 23.5 at 95.7% sensitivity and 84.6% specifity. PLR and PHR were significantly related to digital ulcerations, musculoskeletal, and pulmonary manifestations and can be considered as predictive biomarkers for the assessment of SSc disease activity and severity. [ABSTRACT FROM AUTHOR]

Aim. The main aim of the research is to identify and evaluate the quality of life of patients with an eating disorder - anorexia nervosa. In an analytical and descriptive way, the authors determine the level of various areas of life of patients who suffer from anorexia nervosa. Methods. The subjects of the study were participants suffering from anorexia nervosa. Based on qualitative research through unstructured interviews, the authors carried out causal case individual investigations, which they classified according to anamnesis, diagnostic tools and areas, which they evaluated based on the statements of the participants. Results. The analysis shows that anorexia nervosa affects different areas of life. It is a lifelong problem that has a huge impact on the physical, psychological, and spiritual side of a person. Conclusion. The study deals with the various elements of anorexia nervosa, which ultimately affects a person for life. Through definitions and interpretations of the authors' research results, we can confirm that it has multi-problematic consequences for the categorised areas of an individual's life, for the family and the groups in which they live. [ABSTRACT FROM AUTHOR]

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Professional learning communities (PLC) have increasingly attracted attention in research on teachers' professional development. The aim of this study is to identify contradictions that can occur and be manifested in PLCs in mathematics. Identifying contradictions in PLCs are important, as the identification and resolution of contradictions are crucial to developing PLCs. We have conceptualized PLCs and contradictions within the Cultural Historical Activity Theory. Our data consist of two iterations of interviews with four teacher leader coaches with extensive experience of coaching teacher leaders of PLCs in mathematics. The study distinguishes 26 manifestations of contradictions, taking the overall forms of dilemmas and conflicts. Our results can be used in designing PLCs in mathematics: they can be used to make visible and increase participants' awareness of contradictions involved in PLCs and thereby increase the possibility that the contradictions serve as sources of support rather than obstacles in the development of PLCs in mathematics. [ABSTRACT FROM AUTHOR]

Plain English summary Polycystic ovary syndrome (PCOS) is a global health problem associated with significant drawbacks during reproductive life. Few published studies have been conducted in Africa (including Sudan) addressing the clinical manifestations and phenotypic presentation of the disease. Therefore, we aimed to evaluate the clinical and biochemical presentation of the different PCOS phenotypes among infertile Sudanese women. A total of 368 infertile women with PCOS from a fertility center in Khartoum, Sudan, participated in the study. Clinical, hormonal, and ultrasonographic characteristics were described and compared between the four phenotype groups of PCOS. In this regard, Sudanese women uniquely expressed phenotype D as the most prevalent, and this does not match with the global distribution of PCOS phenotypes. Moreover, women with phenotype A were older and had high mean blood pressure, and a higher waist/hip ratio was observed among women with phenotype D. More epidemiological studies on this subject are needed in the region due to geographical, ethnic, and genetic variations.

Scabies is a common skin disorder, caused by the ectoparasite Sarcoptes scabiei. The scabies mites burrow is highly diagnostic but illegible by the naked eye, because it is tiny and may completely be obscured by scratch and crust. The classic technique is opening the end of an intact mite burrow with a sharp instrument and inspecting its contents in the light microscope under loupe vision. Dermatoscope is a new method to diagnose scabies, with the advantages of non-invasive and more sensitive. This study verified the characteristic manifestations of scabies under dermoscopy. Under the closer examination of the curvilinear scaly burrow, the scabies mite itself may be seen as a dark equilateral triangular structure, which is often referred to as a “jet with contrail.” Besides, this study found that the positive detection rate of microscopic characteristic manifestations under the dermoscopy ordered by the external genitals, the finger seams and the trunk, which were statistically different (P-value < 0.05). Of note, this is the first study to explore the regional distribution of the characteristic dermoscopic manifestations of scabies. We are the first to propose to focus on examining the external genitalia and finger seams with dermoscopy.