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To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections (CHIs). The skin tests including skin prick tests (SPT), intradermal tests (IDT) and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs, including ginkgolide injection, diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection. The results of the provocation tests were used as the “gold standard” to determine the sensitivity and specificity of the skin tests. The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests (P>0.05). The specificities of SPT and IDT were 0.976 and 0.797, respectively, and the sensitivities of both SPT and IDT were 0. Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs. (ChiCTR-CPC-15006921)

Introduction Magnitudes of change in endothelial function research can be articulated using effect size statistics. Effect sizes are commonly used in reference to Cohen’s seminal guidelines of small (d = 0.2), medium (d = 0.5), and large (d = 0.8). Quantitative analyses of effect size distributions across various research disciplines have revealed values differing from Cohen’s original recommendations. Here we examine effect size distributions in human endothelial function research, and the magnitude of small, medium, and large effects for macro and microvascular endothelial function. Methods Effect sizes reported as standardized mean differences were extracted from meta research available for endothelial function. A frequency distribution was constructed to sort effect sizes. The 25th, 50th, and 75th percentiles were used to derive small, medium, and large effects. Group sample sizes and publication year from primary studies were also extracted to observe any potential trends, related to these factors, in effect size reporting in endothelial function research. Results Seven hundred fifty-two effect sizes were extracted from eligible meta-analyses. We determined small (d = 0.28), medium (d = 0.69), and large (d = 1.21) effects for endothelial function that corresponded to the 25th, 50th, and 75th percentile of the data distribution. Conclusion Our data indicate that direct application of Cohen’s guidelines would underestimate the magnitude of effects in human endothelial function research. This investigation facilitates future a priori power analyses, provides a practical guiding benchmark for the contextualization of an effect when no other information is available, and further encourages the reporting of effect sizes in endothelial function research.

Coronavirus disease 2019 is threatening thousands of millions of people around the world. In the absence of specific and highly effective medicines, the treatment of infected persons is still very challenging. As therapeutics, neutralizing antibodies (NAbs) have great potential. Many NAbs have been reported, and most target various regions on the receptor-binding domain of the spike (S) protein, or the N-terminal domain. Several NAbs and NAb cocktails have been authorized for emergency use, and more are in clinical trials or are under development. In this review, considering the angle of binding epitopes on the S protein, we summarize the functions and the underlying mechanisms of a set of well-recognized NAbs and provide guidance for vaccine design and the combinatorial use of these antibodies. In addition, we review the NAbs and NAb cocktails that have been approved for emergency use and discuss the effectiveness of these NAbs for combating severe acute respiratory syndrome coronavirus 2 mutants.

The purpose of this review is to provide a comprehensive update on recent advances in heart transplantation in China. Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high, and many patients progress to endstage heart failure. Heart transplantation has become standard treatment for selected patients with end-stage heart failure, though challenges still exist. However, multiple advances over the past few years will improve the survival and quality-of-life of heart transplant recipients. This article elaborates on the specific characteristics of heart transplantation in China, the current issues, development trends, and related experiences with heart transplantation in Wuhan Union Hospital.

BackgroundTrigonella foenum-graecum(Methi) is a leguminous plant and botanically known asTrigonella foenum-graecumLinn, belong to the family Fabaceae.Trigonella foenum-graecumis used for a variety of health conditions, including digestive problems, bronchitis, tuberculosis, fevers, sore throats, wounds, arthritis, abscesses, swollen glands, skin irritations, diabetes, loss of appetite, ulcers, and menopausal symptoms, as well as in the treatment of cancer.Trigonella foenum-graecumseeds mainly contain Diosgenin [(3β,25R)-spirost-5-en3-ol], a plant-derived steroid sapogenin.ResultsThe identification and quantification results by HPTLC and HPLC studies ofTrigonella foenum-graecumseeds hydrolysedTrigonella foenum-graecumseeds, coded formulation, hydrolysed coded formulation extract with standard Diosgenin biomarker showed a significant highest peak in hydrolysedTrigonella foenum-graecumseeds and hydrolysed coded formulation. The standard Diosgenin is observed in the hydrolysed form of hydrolysedTrigonella foenum-graecumseeds and hydrolysed coded formulation. The literature onTrigonella foenum-graecumconfirms its activity as antidiabetic, and the peak of standard biomarker Diosgenin is seen after derivatization with anisaldehyde sulphuric agent, which possesses medicinal phytoconstituents value. Further related to future scientific aspects, more studies on its potent antidiabetic activity and multipurpose action need to be carried out with medicinal composition and its effects on the human body.ConclusionThis study aims to establish the qualitative and quantitative estimation of standard Diosgenin in reliable with coded ayurvedic formulation andTrigonella foenum-graecumseeds and its activity as antidiabetic by HPTLC and HPLC.

A diagnosis of drowning remains one of the most challenging issues in forensic science, especially for decomposed bodies. Diatom analysis is considered as an encouraging method for diagnosing drowning. In this study, we developed a drowned rat model using different diatom densities in water. A total of 120 adult Sprague-Dawley rats were used and divided into six groups, wherein experimental groups 1–5 were drowned rats (group A) and postmortem submersion rats (group B) that were submerged in water with five different Cyclotella sp. diatom densities, while the remaining group was used as a blank control. The combination of microwave digestion and vacuum filtration method was used to accomplish efficient tissue digestion and ascertain higher accuracy of diatom determinations within organs. The abundances of diatoms in the lungs, livers, and kidneys were significantly different. The diatom abundances in the lungs, livers, and kidneys were directly proportional to the water diatom densities, and specific quantitative relationships could be approximated by separate regression equations for each organ type. However, the trends associated with the diatom increases among organs slightly differed. In addition, the diatom abundances in the lungs, livers, and kidneys were all positively correlated. Diatoms were not observed in the postmortem submersion groups nor in the blank control groups. The results of this study provide valuable information for establishing a quantitative diatom framework for informing future forensic medicine efforts.

Both ligament-advanced reinforcement system (LARS) and hamstring tendon autograft can serve as grafts for posterior cruciate ligament (PCL) reconstruction. However, few studies have compared the effectiveness of these two approaches. This study therefore aimed to compare the clinical efficacy of arthroscopic reconstruction of the PCL using either the LARS or hamstring tendon autograft.A total of 36 patients who underwent PCL reconstruction were retrospectively analyzed. Within this cohort, 15 patients received a reconstruction using the LARS (LARS group) and 21 using the hamstring tendon autograft (HT group).The pre- and post-operative subjective scores and knee stability were evaluated and the patients were followed up for a period of 2 to 10.5 years (4.11±2.0 years on average). The last follow-up showed that functional scores and knee stability were significantly improved in both groups (P0.05). Six months after operation, Lysholm scores and IKDC subjective scores were higher in the LARS group than in the HT group (P0.05). Nonetheless, the last follow-up showed no significant differences in the functional scores or the posterior drawer test between the two groups (P0.05). In the LARS and HT groups, 12 and 9 patients, respectively exhibited KT1000 values3 mm, with the difference being statistically significant (P0.05). In the HT group, the diameter of the four-strand hamstring tendon was positively correlated with height (P0.05), which was 7.37±0.52 mm in males and 6.50±0.77 mm in females (P0.05).Both LARS and hamstring tendon approaches achieved good efficacy for PCL reconstruction, but patients in the LARS group exhibited faster functional recovery and better knee stability in the long term. LARS is especially suitable for those who hope to resume activities as early as possible.

Einchecken mit Barcode wie am Flughafen, Aufzuge, die wissen, wohin man will, und selbstfahrende Roboter, die Material und Essen liefern. So konnte das Krankenhaus der Zukunft aussehen. In manchen Krankenhausern ist das schon heute so.

Obwohl das Zigarettenrauchen den grosten Risikofaktor fur die Entwicklung einer chronisch obstruktiven Lungenerkrankung (COPD) darstellt, spielen auch genetische Parameter eine wichtige Rolle. Bei angeborenem Alpha-1-Antitrypsinmangel ist das Risiko einer COPD aufgrund der reduzierten Menge an funktionsfahigem Alpha-1-Antitrypsin erhoht, das in seiner physiologischen Rolle die Lunge vor proteolytischen Enzymen und somit vor Zerstorung des Lungenparenchyms schutzt. Neben dem angeborenen Alpha-1-Antitypsin-Mangel wurden unterschiedliche Genome identifiziert, die die COPD-Suszeptibilitat masgeblich beeinflussen. Komplexe Erkrankungen wie die chronisch obstruktive Lungenerkrankung werden nicht durch einzelne genetische Varianten verursacht, sondern sind vielmehr das Ergebnis eines biologischen Konstrukts aus unterschiedlichen Genen und Proteinen. Die moglichst konkrete Bestimmung dieser genetischen Determinanten konnte neue Erkenntnisse und Ziele fur die medikamentose Therapie der COPD liefern. Seit die Kosten fur Gesamtgenomsequenzierungen gefallen sind, wird dieses umfassende Assessment auch fur die Untersuchung der genetischen Varianten der COPD verwendet, mit dem Ziel, einen Uberblick uber die genetische Architektur dieser Erkrankung zu erhalten.

Imaging of the neck is fascinating and challenging. This region includes air tracts and different structures as glandular parenchyma, muscles, vessels, bones, and nerves. The correct interpretation of neck calcifications, frequently encountered during daily practice, is essential to achieve a precise diagnosis. In this pictorial article, we illustrate and describe the most common neck calcifications, underlining in particular the pivotal role of CT.

Irritable bowel syndrome (IBS) is a common refractory disease. Chinese medicine (CM) has remarkable efficacy and advantages on the treatment of IBS. This review summarized the articles focusing on the treatment of IBS with CM to sum up the latest treatment methods for IBS and the underlying mechanisms. Literature analysis showed that prescriptions, acupuncture, and moxibustion are the primary methods of CM treatment for IBS. The potential mechanism centers on the regulation of the enteric nervous system, the alleviation of visceral hypersensitivity, the stability of intestinal flora, and the regulation of the immune system.

Purpose of Review This review describes lessons learned from longer acting contraception and employs a reproductive justice lens to inform expansion of emerging HIV prevention technologies. Recent Findings Reproductive justice is a framework that advocates for the promotion of universal sexual and reproductive freedoms, particularly among historically marginalized communities. This framework takes a holistic view of individuals and sees the interconnections between sexual health, reproductive health, and overall health. Employing a sexual and reproductive justice perspective is essential to understanding and helping to mitigate the role intersecting structural, sexual, and reproductive oppressions, including those demonstrated through promotion of longer acting contraception, and can critically inform rollout of future prevention technologies, such as longer acting HIV pre-exposure prophylaxis. Summary This review highlights the need for researchers, clinicians, and policymakers to apply lessons learned from contraception and specifically focuses on principles of reproductive justice to offer expanding HIV prevention options.

Background Angiogenic ocular diseases address the main source of vision impairment or irreversible vision loss. The angiogenesis process depends on the balance between the pro-angiogenic and anti-angiogenic factors. An imbalance between these factors leads to pathological conditions in the body. The vascular endothelial growth factor is the main cause of pathological conditions in the ocular region. Intravitreal injections of anti-angiogenic drugs are selective, safe, specific and revolutionized treatment for ocular angiogenesis. But intravitreal injections are invasive techniques with other severe complications. The area of targeting vascular endothelial growth factor receptors progresses with novel approaches and therapeutically based hope for best clinical outcomes for patients through the developments in anti-angiogenic therapy. Main text The present review article gathers prior knowledge about the vascular endothelial growth factor and associated receptors with other angiogenic and anti-angiogenic factors involved in ocular angiogenesis. A focus on the brief mechanism of vascular endothelial growth factor inhibitors in the treatment of ocular angiogenesis is elaborated. The review also covers various recent novel approaches available for ocular drug delivery by comprising a substantial amount of research works. Besides this, we have also discussed in detail the adoption of nanotechnology-based drug delivery systems in ocular angiogenesis by comprising literature having recent advancements. The clinical applications of nanotechnology in terms of ocular drug delivery, risk analysis and future perspectives relating to the treatment approaches for ocular angiogenesis have also been presented. Conclusion The novel ocular drug delivery systems involving nanotechnologies are of great importance in the ophthalmological sector to overcome traditional treatments with many drawbacks. This article gives a detailed insight into the various approaches that are currently available to be a road map for future research in the field of ocular angiogenesis disease management.

Background The ability to inhibit oxidative stress has been established as the prime mechanism in treatment of several disease conditions. In view of this, two new series of coumarin–chalcone hybrid molecules (5a–o and 6a–o) were synthesized using various aromatic aldehydes. The structures of the compounds were confirmed using IR, 1HNMR and mass spectral analyses. The compounds were evaluated for their antioxidant potential against 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydroxyl radicals in scavenging assays. Results Compounds 5o and 5k exhibited significant antioxidant potential as compared to the standard drug (ascorbic acid). Conclusions It can be concluded that the coumarin–chalcone treatment have the potential to be optimized further to generate scaffolds capable to treat many pathological conditions.

Background Reinforcement corrosion and the concrete strength reduction are critical problems that resulted from crack creation in concrete. Very expensive and hazardous technologies based on chemical materials have been provided for repairing the cracks. Recently, crack repair using bio-catalysis precipitating bacteria has been developed as a viable and ecofriendly alternative technique. The main target of this study was to select and identify bacterial isolates with high urease activity to use in filling the cracks by the precipitation of CaCO3. Results Two endospore-forming and alkali-resistant ureolytic bacteria were combined with concrete to tolerate the mechanical stresses generated by mixing. The two isolates designated as (B1 and B2) were selected and identified as Bacillus wiedmannii strain FSL W8-0169 and Bacillus paramycoides strain MCCC 1A04098, respectively, using 16SrDNA gene sequencing. Both bacterial species completely heal cracks in fully destructed concrete and significant enhancement in compressive strength was illustrated. The calcite filling of cracks and CaCO3 crystals that were screened using a scanning electron microscope may explain the crack healing and the enhancement in concrete strength. Conclusions Bacillus wiedmannii strain FSL W8-0169 and Bacillus paramycoides strain MCCC 1A04098 can be inserted with the concrete to improve the compressive strength and the self-healing of cracks. The two ureolytic bacterial strains can be used to protect water buildings from exposure to frequent cracks.

Medikamente sind eine relativ haufige Ursache einer interstitiellen Lungenerkrankung. Eine medikamenteninduzierte interstitielle Lungenerkrankung („drug induced interstitial lung disease“, DIILD) kann dabei nahezu jedes morphologische Muster der bekannten interstitiellen Pneumonie wie nichtspezifische interstitielle Pneumonie (NSIP), organisierende Pneumonie (OP), diffusen Alveolarschaden (DAD) oder gewohnliche interstitielle Pneumonie (UIP) induzieren. Die Diagnose einer medikamenteninduzierten Lungenschadigung ist dabei von weitreichender Bedeutung, da sie eine kausale Therapie durch Absetzen der nebenwirkungsauslosenden Medikation erlaubt. Ein gesteigertes Risiko fur eine Medikamentennebenwirkung kann entstehen durch vorhergehende Reaktionen auf das betreffende Medikament, Medikamenteninteraktionen, berufsbedingte Faktoren und genetische Polymorphismen. Die Identifikation einer pulmonalen Medikamentenreaktion stellt eine schwierige, haufig nur interdisziplinar zu losende Aufgabe dar, zu der in seltenen Fallen auch die Durchfuhrung einer Lungenbiopsie notwendig ist. Die Aufgabe der Pathologie ist es in diesen Fallen, die vorliegenden Reaktionsmuster zu benennen. Es muss entschieden werden, ob eine mogliche Medikamentenschadigung infrage kommt. In diesem Entscheidungsprozess ist ein medikamentos ausgeloster Lungenschaden immer eine Ausschlussdiagnose.

Acute ischemic stroke (AIS) in teenagers occurs infrequently and is a real emergency with serious consequences for patients and their families. Both thrombectomy and thrombolysis are well tolerated, but they are still debated. Nowadays, there are not sufficient data concerning the outcome of these treatments and only a few studies and case reports proved their efficacy and safety. Herein we present two reports of AIS in adolescents, for which different therapeutic approaches were performed, achieving a successful outcome in both cases without short or long-term complications. The early recognition of teenage stroke is not always easy, due to the variability of causes and symptoms, but a good outcome can be achieved with reperfusion treatments performed as quickly as possible.

OBJECTIVE Previous study suggested that estradiol (E2) plays an important role in otolith shedding by regulating the expression of otoconin 90 (OC90). The purpose of this article is to provide further data on the effect and mechanism of E2 on the morphology of otolith. METHODS The rats receiving bilateral ovariectomy (OVX) were used as animal models. Co-immunoprecipitation was used to observe the relationship between estrogen receptor (ER) and estrogen-related receptor α (ERRα). The morphology of otolith was observed under the scanning electron microscopy. Western blotting and qPCR were used for quantitative analysis of the roles of ER and ERRα in regulating OC90 expression. RESULTS The looser otoliths were observed in rats receiving bilateral OVX, which could be reversed by supplementation with E2. The level of ERRα was decreased in bilateral OVX rats. ER and ERRα interacted with each other on the regulation of the expression of OC90. CONCLUSION Our results suggest ER and ERRα are both important downstream receptors involved in regulating OC90 expression in utricles of rats, and ERRα probably functions by interacting with ER. This provides evidence for the mechanism of otolith shedding. And it may be significant for future studies of targeted prevention and therapies for benign paroxysmal positional vertigo.

Background The successful use of PRP in regenerative medicine has led investigators to study its effect in the treatment of conditions like decreased ovarian reserve, poor responders, and premature ovarian insufficiency. Objective To review the uses of intraovarian PRP in reproductive medicine. Methods A literature search for English articles related to the uses of intraovarian PRP in reproductive medicine, including articles published in PubMed, from 2000 to April 2021. Results Seventeen studies: No RCT. Studies were classified according to indication. (1) For diminished ovarian reserve: 6 studies including 369 patients. (2). For poor responders: 3 case series studies including 41 patients with an improvement in ovarian response. (3) For premature ovarian insufficiency: 8 studies including 373 patients. Ovarian reserve markers were the outcome of all studies with conflicting results. LBR was not determined in the majority of studies. Conclusion Intraovarian PRP for diminished ovarian reserve, poor ovarian response, or POI is still experimental. Well-designed, large RCTS to confirm its efficacy and safety are required.

Background The emergence of high resistance and toxicity of the existing anti-breast cancer drugs have demanded the need to design new drugs with improved activities against breast cancer. A computational technique incorporating quantitative structure–activity relationship and virtual template-based design was carried out to evaluate thirty-four compounds from derivatives of thiophene, pyrimidine, coumarin, pyrazole and pyridine with anti-breast cancer activities. The chemical structures of the compounds were drawn with chem draw v.12.0.2 and they were optimized using Spartan 14 software. The molecular descriptors were calculated with the aid of PaDel descriptor software. The dataset was curated and then divided into training and test set that was used to generate and validate the model. Results The first out of the four models generated was chosen as the paramount model with statistical validations of R2 = 0.9847, $$R_{{{\text{adj}}}}^{2}$$ R adj 2 = 0.9814, $$Q_{{{\text{cv}}}}^{2}$$ Q cv 2 = 0.9763, min expt. error for non-significant LOF (95%) = 0.0679, an external validation $$R_{{{\text{test}}}}^{2}$$ R test 2 of 0.8240 and coefficient of Y-randomization ($${\text{cR}}_{{\text{p}}}^{2}$$ cR p 2 ) = 0.8200, which confirm the robustness of the model. Conclusions The high predictive power of the generated model describes the models’ reliability and the designed compounds pointed out compound 2 with pGI50 = 4.2504 as the best designed compound to inhibit breast cancer, compared to its co-designed compounds and the template. The results of this research provide vital information to the pharmaceutical chemists and the pharmacologist in the course of developing new breast cancer drugs.

The decline in birth rates has become a very serious problem in various parts of the world. Many countries have implemented national programs for increasing birth rates, one of which involves the use of traditional medicine as an alternative solution. Among the fast-growing traditional medicines, traditional Chinese medicine (TCM) and traditional Indonesian medicine (TIM) have attracted a lot of demand globally. Here, we analyzed and compared the herbal medicines from TCM and TIM that must be avoided by pregnant women for preventing miscarriage and maintaining safety during pregnancy and the postpartum period. This review uses data from official reports from the respective government and national and international electronic databases for analysis. Although TCM and TIM have their own characteristics of treatment, they also have some similarities in concept and treatment, especially those related to herbal medicines. This review can be used as a reference base to help pregnant women consume herbal medicines at appropriate conditions and doses.

Extracorporeal membrane oxygenation (ECMO) plays an important role as a life-saving tool for patients with therapy-refractory cardio-respiratory failure. Especially, for rare and infrequent indications, scientific data is scarce. The conducted paper focuses primarily on our institutional experience with a 19-year-old patient suffering an acute chest syndrome, a pathognomonic pulmonary condition presented by patients with sickle cell disease. After implementation of awake ECMO therapy, the patient was successfully weaned off support and discharged home 22 days after initiation of the extracorporeal circulation. In addition to limited data and current literature, further and larger data sets are necessary to determine the outcome after ECMO therapy for this rare indication.

In den vergangenen Monaten hatten Fuhrungskrafte der Pflege verscharft durch die Corona-Pandemie einen raschen Wandel zu bewaltigen. Dies nahm das Karl Landsteiner Institut fur Human Factors & Human Resources im Gesundheitswesen zum Anlass und fuhrte im Marz und April mit EUCUSA, dem Spezialisten fur Feedbacksysteme, eine Befragung durch, an der aus ganz Osterreich annahernd 1.600 Fuhrungskrafte teilnahmen. Dabei wurde der 2016 durchgefuhrte Fuhrungsbarometer (vgl. Qualitas 04/16) in modifizierter Version wiederholt. Die Ergebnisse konnen osterreichweit Grundlagen fur zukunftige Masnahmen und Strategien aus Sicht des Pflegemanagements und datenbasierte Informationen fur Entscheidungstrager fur gezielte Weiterentwicklung des Handlungsfeldes „Fuhrung“ in der Pflege bieten.

Die enorme Beschleunigung der DNA-Sequenzierung durch die Entwicklung der Next-Generation-Sequencing-Technologien eroffnet dem Fach Pathologie nicht nur vollig neue Moglichkeiten in Forschung und Diagnostik, sondern stellt es auch vor grose Herausforderungen. Der Nachweis zahlreicher genomischer Alterationen (Punktmutationen, kleine Insertionen und Deletionen, Fusionstranskripte, Tumormutationslast [TMB]) wird bereits zuverlassig in der molekularpathologischen Routinediagnostik eingesetzt. Diese werden in absehbarer Zeit durch zahlreiche weitere Anwendungen (Genamplifikationen, Mikrosatelliteninstabilitat, genomische Signaturen wie homologe Rekombinationsdefizienz (HRD), mRNA-Profile, B‑ und T‑Zellklonalitat, DNA-Methylierung) erganzt werden. Herausforderungen in der Praanalytik, der Beurteilung der Assaysensitivitat und -spezifitat sowie der Bewertung der identifizierten Aberrationen (Variantenbewertung), die die Ausbildung und den Einsatz neuer Fachkrafte erfordern, werden dargestellt und diskutiert.

Non-alcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease globally. Despite the increased demand placed on health-care systems, little attention has been given to the design and implementation of efficient and effective models of care for patients with NAFLD. In many health-care settings, no formal pathways exist and, where pathways are in place, they are often not standardized according to good practices. We systematically searched the peer-reviewed literature with the aim of identifying published examples of comprehensive models of care that answered four key questions: what services are provided? Where are they provided? Who is offering them? How are they coordinated and integrated within health-care systems? We identified seven models of care and synthesized the findings into eight recommendations nested within the ‘what, where, who and how’ of care models. These recommendations, aimed at policy-makers and practitioners designing and implementing models of care, can help to address the increasing need for the provision of good practice care for patients with NAFLD. There is a need for effective models of care for patients with non-alcoholic fatty liver disease (NAFLD). In this Expert Recommendation, Lazarus et al. discuss seven examples of comprehensive NAFLD models of care and produce eight recommendations aimed at policy-makers and practitioners.

Unicystic ameloblastoma (UA) is an uncommon odontogenic tumor derived from odontogenic apparatus and comprises 6% of all ameloblastomas. We report a case of a forty-nine-year-old male presented with a chief complaint of bleeding from gums, pain, and difficulty in eating of one-year duration. The lesion was excised and diagnosed as unicystic ameloblastoma (type 1.2.3) with extensive granular cell change in all components. Granular cell variant of unicystic ameloblastoma appears to be a rare variant of unicystic ameloblastoma with only five satisfactory cases reported till date. As reported, this variant may show late recurrence as solid ameloblastoma hence a strict close follow-up is warranted.

Baground: Health promoting university (HPU) is a place to create a context of promoting health that is common in universities. This research aims to know the general picture of perception of education personnel FK-KMK UGM about the development of health promoting university. Method:This type of research is quantitative with cross sectional study design. Bivariate analysis of research results using chi square and multivariate using logistic regression. Results: The benefits of HPU according to tendik is to have policies relevant to the development of HPU, namely the prohibition of smoking, the availability of access to clean drinking water, the availability of bicycle routes to support physical activity, the environment supports physical activity, the availability of healthy canteens. HpU barriers according to tendik, namely the number of unhealthy foods and KTR policy has not been effective. Tendik FK-KMK UGM has a high intention to support the development of HPU. There is a significant relationship between benefits, with the intention of supporting the development of HPU with a value of p = 0.00. There is a significant relationship between obstacles and the intention of supporting the development of HPU with a value of p = 0.005. Conclusions:The perception of FK-KMK UGM education staff about hpu development requires a domain of improvement on less effective policy barriers and facilities on campus are underutilized. Keywords: health-promoting university, perceptions, benefits, barriers, intentions, education staff Pendahuluan: Health promoting university (HPU) adalah tempat untuk menciptakan konteks mempromosikan kesehatan yang bersifat umum di universitas. penelitian ini bertujuan mengetahui gambaran umum persepsi tenaga kependidikan FK-KMK UGM tentang pengembangan health promoting university. Metode: Jenis penelitian adalah kuantitatif dengan rancangan cross sectional study. Analisis hasil penelitian secara bivariat menggunakan chi square dan multivariat menggunakan regresi logistik. Hasil: Manfaat HPU menurut tendik adalah memiliki kebijakan yang relevan dengan pengembangan HPU, yaitu larangan merokok, tersedianya akses air minum bersih, tersedianya rute sepeda untuk penunjang aktivitas fisik, lingkungan mendukung aktivitas fisik, tersedianya kantin sehat. Hambatan HPU menurut tendik, yaitu masih banyaknya makanan tidak sehat dan kebijakan KTR belum efektif. Tendik FK-KMK UGM memiliki intensi yang tinggi mendukung pengembangan HPU. Terdapat hubungan yang signifikan antara manfaat, dengan intensi mendukung pengembangan HPU dengan nilai p = 0.00. Terdapat hubungan yang signifikan antara hambatan dengan intensi mendukung pengembangan HPU dengan nilai p = 0.005. Kesimpulan: Persepsi tenaga kependidikan FK-KMK UGM tentang pengembangan HPU membutuhkan domain perbaikan pada hambatan kebijakan yang kurang efektif dan fasilitas yang ada di kampus kurang dimanfaatkan. Kata kunci: health promoting university, persepsi, manfaat, hambatan, intensi, tenaga kependidikan

We describe 101 EoE patients with dysphagia, with food impaction (EoE-FI) and without food impaction (EoE-NoFI). Compare clinical features, endoscopy, histology and 10 additional histological features (AHF), and outcomes. Clinical features, dysphagia score, and endoscopic findings were captured. Eosinophils and 10 AHF at diagnosis and follow-up were done. Two hundred seven patients were seen with EoE, 101 patients with dysphagia enrolled; Follow period was; EoE-FI, and 71 EoE-NoFI and mean ages of 10.9 and 10.4 years, respectively (p = 0.27). Clinical features, EGD, and biopsies were almost similar in both groups. EoE-FI, 1.7 years (mean), range 1/12–8 years, and EoE-NoFI, 1.1 years (1/12–7 years). Dysphagia score improved from 3 to 1.25 in EoE-FI and 1.21 to 0.71 in EoE-NoFI (p < 0.001). Composite score improved from 3.3 to 1.45 and 2.49 to 1.48 (p < 0.001) in EoE-FI and EoE-NoFI; 15/30 (EoE-FI) and 45/71(EoE-NoFI) patients had repeat EGD. Peak eosinophils in EoE-FI improved from 60 to 27 (p = 0.03), and in EoE-NoFI from 47.6 to 33 (p = 0.001). Mean eosinophils in EoE-FI improved from 42 to 27.5 (p = 0.03), and EoE-NoFI from 39.3 to 22.1(p < 0.001). Comparison of the 10 AHF at diagnosis and follow-up showed minimal numerical (%) differences, and none were significant. During follow-up, none had recurrence or occurrence of FI in both groups. There were no significant differences in the clinical features and outcomes of dysphagia in EoE-FI and EoE-NoFI groups. Endoscopy including strictures and histologic findings of eosinophils and the 10 AHF were similar in both groups at diagnosis and follow-up.

Variations in the level of origin and the branching pattern of the ilio-lumbar artery (ILA) are often under-reported due to the difficulty in the dissection of the posterior division of the internal iliac artery and its branches. We report a variant right ILA where it had a supernumerary branch that went on to supply the iliacus muscle and the ilium bone. Such anatomical variations in the ILA are of importance to the surgeons while choosing a better pedicle for the iliac bone graft.

Background Nanomaterials of curcumin with hyaluronic acid have gained a lot of attention for potential therapeutic applications of curcumin and hyaluronic acid with or without other additional drugs. Overall studies of curcumin and hyaluronic acid show that nanomaterials of curcumin with hyaluronic acid accelerate the efficacy of curcumin in the treatment of various disorders like arthritis, cancer, hepatic fibrosis, neural disorders, wound healing, and skin regeneration, it is largely due to the combined effect of hyaluronic acid and curcumin. However, due to limited clinical trials and experiments on humans and animals, there is a substantial gap in research for the safety and efficacy of nanomaterials of curcumin-hyaluronic acid in the treatment of curcumin and hyaluronic acid targeted diseases and disorders. Main body of the abstract In this current review, we have first described various reported synthetic nanomaterials of curcumin-hyaluronic acid, then in the next section, we have described various fields, disorders, and diseases where these are being applied and in the final section of this review, we discussed the research gap, and future research directions needed to propose the fabricated nanocurcumin-hyaluronic acid biomaterials. Short conclusion There are substantial gaps in research for the safety and efficacy of nanomaterials of curcumin with hyaluronic acid due to limited available data of clinical trials and experiments of nanocurcumin-hyaluronic acid biomaterials on humans and animals. So, it entirely requires serious and committed efforts through the well-organized system of practical and clinical trials which provide results, data, and detections that lead to the formulation of the best drug from curcumin with hyaluronic acid for the treatment of curcumin and hyaluronic acid targeted diseases and disorders.

There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery (MIS) for hypertensive intracerebral haemorrhage (ICH), and little is known about the relationship between satellite sign on computed tomography (CT) scans and postoperative rebleeding after MIS. This study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic MIS. We retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following admission. Postoperative rebleeding occurred in 14 of 65 (21.5%) patients with the satellite sign on baseline CT, and in 5 of the 40 (12.5%) patients without the satellite sign. This difference was statistically significant. Positive and negative values of the satellite sign for predicting postoperative rebleeding were 21.5% and 87.5%, respectively. Multivariate logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative rebleeding. In conclusion, the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.

Background Present work describes a fast, simple, and sensitive procedure for the simultaneous determination of cetirizine in the presence of quinolones using diclofenac sodium as an internal standard. The present work was designed to analyze these compounds in pharmaceutical and clinical labs being economical for use. Results The mobile phase consisted of the simple composition of methanol, acetonitrile, and water in a ratio of 50:20:30 with a pH adjusted to 3.1 at a flow rate of 1 mL min−1. The UV detection was performed at 225 nm. The linearity was assessed over the range of 2.5–50 μg mL−1 for all drugs. The parameters such as accuracy, precision, linearity (>0.999), and sensitivity were satisfactory. Conclusion The method was equally applicable for formulation and human serum with recovery values between 95 and 105%. The results of the method were validated statistically according to ICH guidelines.

Background Cancer is a global health challenge, it impacts the quality of life and its treatment is associated with several side effects. Resistance of the cancer cells to the existing drugs has led to search for novel anticancer agents. Pyrimidine, a privileged scaffold, is part of living organisms and plays vital role in various biological procedures as well as in cancer pathogenesis. Due to resemblance in structure with the nucleotide base pair of DNA and RNA, it is recognized as valuable compound in the treatment of cancer. Main text Many novel pyrimidine derivatives have been designed and developed for their anticancer activity in the last few years. The present review aims to focus on the structure activity relationship (SAR) of pyrimidine derivatives as anticancer agent from the last decade. Conclusion This review intends to assist in the development of more potent and efficacious anticancer drugs with pyrimidine scaffold. Graphical abstract

Biopsy of medial wall acetabular lesions pose a unique challenge as access to the area is limited, as it requires wide incision to approach deep-seated area. We describe here minimal access approach for such acetabular lesions. This case report describes an innovative minimal access approach to this complex situation. A 12-year-old girl with an osteolytic lesion in the inferior medial acetabular wall was treated with biopsy and curettage through a laparoscopic-assisted minimal access approach. The technical details of the procedure as well as outcomes of treatment are described. This case highlights ease of access to medial wall acetabular lesions through a laparoscopic-assisted approach.

To report novel ocular findings in unique Marinesco-Sjögren syndrome (early-onset cataracts, cerebellar ataxia, and a progressive myopathy), review literature, and discuss causes of vision decrease in this rare entity. A 3-year-old girl diagnosed with Marinesco-Sjögren syndrome underwent uneventful cataract surgery in both eyes within 1 week of her 2nd birthday. This was exactly similar to her sister and other two related family members. Additionally, she had prominent corneal nerves and subtle corneal subepithelial deposits in both eyes. Cataracts are one of the primary diagnostic criteria for the Marinesco-Sjögren syndrome, and their early diagnosis and treatment are important for prevention of additional permanent visual loss. Prominent corneal nerves and mild corneal subepithelial defects are described in this report and may occasionally be helpful in making the diagnosis.

Angina pectoris (AP) is the most common symptom of cardiovascular diseases, which seriously affects the quality of life in cardiovascular patients. Kuanxiong (KX) Aerosol (), a compound preparation that consists of 5 traditional Chinese medicines: Herba Asari , Rhizoma Alpiniae Officinarum, Lignum Santali Albi, Fructus Piperis Longi, and Borneolum, has been used in the treatment of AP for many years, exhibiting a significant curative effect and less side-effect. For the convenience and comprehensive understanding of KX Aerosol, this review systematically summarizes evidence on KX Aerosol in the treatment of AP including the pharmacological effects of its composition, clinical research, animal experiments, and network pharmacology prediction. Meanwhile, we highlight the research limitation of KX Aerosol at present. This review may guide the clinical application of KX Aerosol and further provide a reference for the research of AP.

Ectopic ACTH (adrenocorticotropic hormone) syndrome, EAS, is extremely rare, accounting for only 10–20% of all ACTH-dependent Cushing’s syndromes, and only 5–10% of all types of Cushing’s syndromes. Given the extremely aggressive behavior of malignancies, EAS is typically associated with significantly higher levels of ACTH and cortisol, the difference being 100–1000-fold greater than in Cushing’s disease. Consequently, clinical symptoms and manifestations of EAS can be more severe and rapid in onset. In this case report, we describe the course of EAS-induced malignant hypertension in a 40-year-old patient who was subsequently diagnosed with high-grade poorly differentiated large cell neuroendocrine carcinoma (NEC).

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin’s lymphoma (NHL). Usually, it presents as expanding mass in the neck or abdomen but can present in unusual ways as an extranodal disease, with multiorgan involvement. Appropriate suspicion and workup can lead to early diagnosis to initiate early treatment, but it comes with multiple challenges, in case of older frail population. Herewith, we are reporting our patient, a 63-year-old frail older woman presented as multiple cranial nerve palsy and renal impairment at presentation.

Background The knowledge and the beliefs of people could affect the fertility of women and men all over the society. According to gender, the aim of this study was to describe knowledge level and attitude of Moroccan young people about infertility in Marrakesh-Safi region in Morocco. Results We selected 355 Moroccan young people by a simple random sampling method, during 2019 and using a previously validate questionnaire. Both of female and male had a low level knowledge about the meaning, causes, and treatment of infertility (only 20, 8% of female and 25, 6% of male were aware). Almost, half of them (41, 6% of female versus 51, 9% of male) had reported that it is easier to conceive if the couples had already their first baby. However, 92% of female and 86% of male had confirmed that the lifestyle is a factor that may affect the infertility. The results showed that there was a difference between male and female attitude if the fertility treatment fails, the percentage of male who had proposed the polygamy as solution was higher than female (22.5% versus 6.6%). Besides, the minority had accepted divorce as alternative. The adoption was another solution proposed and accepted by both male and female. Conclusion The result of our study reflects the fact that it is important to investigate on education and a public awareness about fertility in order to upgrade the level of knowledge and attitudes of Moroccan young people.

Patient partners can be described as individuals who assume roles as active members on research teams, indicative of individuals with greater involvement, increased sharing of power, and increased responsibility than traditionally described by patient participants who are primarily studied. A gap still remains in the understanding of how to engage patients. The objective of this commentary is to describe the involvement of four patient partners who worked with researchers during a scoping review.We describe approaches to meaningfully engage patient partners in conducting a scoping review. Patient partners were recruited through existing patient networks. Capacity development in the form of the training was provided to these four patient partners. Engagement strategies were co-designed with them to address potential barriers of involvement and acquiring the necessary skills for the successful completion of this scoping review.Involving patients partners early in the project established the foundational relationship so patient partners could contribute to their fullest. We witnessed the success of working alongside patient partners as members of the research team with a clear and mutually agreed upon purpose of the engagement in health research activities and how this seemed to contribute to an effective and rewarding experience for both researcher and patient partner.Patients have taken on roles as members of research teams, often involved in a wide range of activities, such as members of advisory committees. Despite these important new roles for patients, broadly, researchers are still challenged with identifying opportunities of benefit to all involved. We describe the involvement of four patient partners who worked with researchers to complete a scoping review. We detail the approaches used to support the project and the benefits and challenges we experienced while involving patients in this review. Co-designing engagement approaches assisted in gaining the support and buy-in necessary from patient partners for the successful completion of this scoping review. Involving patients partners early in the project established the foundational relationship for patient partners to contribute to their fullest. We witnessed the success of working alongside patient partners as members of the research team with a clear and mutually agreed upon purpose of the engagement in health research activities and how this seemed to contribute to an effective and rewarding experience for both researchers and patient partners.

Robotertechniken werden im Rahmen der Herzchirurgie in den Subdisziplinen der koronaren Bypass- und Mitralklappenchirurgie sowie ihrer assoziierten Operationsverfahren angewendet. Bisher werden diese nur an wenigen, hochspezialisierten Zentren durchgefuhrt. Standardisierte Ausbildung und kontinuierliches Training sind zur fehlerfreien Bedienung des Roboters erforderlich. Der Patientenselektion und dem perioperativen Monitoring kommt besondere Bedeutung zu. Neben dem an der Roboterkonsole tatigen Chirurgen ist ein weiterer geschulter Chirurg, der patientenseitig positioniert ist, erforderlich. Die klinischen Ergebnisse bei selektionierten Patienten sind hervorragend. Bisher ist ein Robotersystem klinisch verfugbar. Zukunftig werden weitere, innovative Modifizierungen der Robotersysteme die Akzeptanz der Roboterchirurgie im Rahmen der Herzchirurgie beeinflussen.

Pulmonary vein thrombosis (PVT) is a potentially life-threatening condition that is often underdiagnosed or undetected. PVT resulting from a non-surgical cause has been rarely reported, especially in patients without any risk factors. Here, we present a case of an elderly patient with a ventricular permanent pacemaker (PPM) who was found to have features suggestive of PVT on contrasted-enhanced computed tomography pulmonary angiogram (CTPA). We hypothesize that a ventricular PPM could alter flow dynamics in the pulmonary vein predisposing to PVT. This case highlights the importance of atypical presentations and considering broad differentials, particularly in the elderly. A high index of suspicion is necessary for an early diagnosis to prevent further deterioration of the patient.

Eine Groszahl der chirurgischen Eingriffe bei chronisch entzundlicher Darmkrankheit (CED) ist minimal-invasiv durchfuhrbar. Die Vorteile des laparoskopischen Standardvorgehens gegenuber dem offenen Vorgehen sind hinsichtlich fruher und spater Outcomeparameter fur die Ileozokalresektion beim Morbus Crohn mit Level-I-Evidenz adaquat belegt. Fur viele andere Indikationen liegen zumindest grosere Register- oder Fall-Kontroll-Studien vor, die Vorteile fur die Laparoskopie zeigen. Fur die roboterassistierte Chirurgie ist die prinzipielle Machbarkeit gezeigt worden, wobei die limitierte Datenlage zumindest bei Colitis ulcerosa eine Vergleichbarkeit der Ergebnisse zum laparoskopischen Standardvorgehen suggeriert. Single-Port-Ansatze haben bisher keine relevanten Vorteile in der CED-Chirurgie zeigen konnen. Die transanale minimal-invasive Chirurgie zur Durchfuhrung der restaurativen Proktokolektomie hat in zwei groseren Fall-Kontroll-Studien keine eindeutigen Vorteile zeigen konnen, hat sich aber zumindest als gleichwertige Alternative erwiesen. Insgesamt erscheint es unwahrscheinlich, dass es durch die neuen beschriebenen laparoskopischen Techniken wesentliche messbare Vorteile fur den Patienten im Vergleich zum laparoskopischen Standardvorgehen geben wird, da das Zugangstrauma nicht relevant verandert wird. Generell mussen bei der Indikationsstellung zum minimal-invasiven Vorgehen immer die Grundprinzipien der CED-Chirurgie und auch die Kontraindikation im Einzelfall berucksichtigt werden, denn im Langzeitverlauf relativieren sich die Vorteile des laparoskopischen Vorgehens.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought an unprecedented upheaval in our health-care systems. Amongst the many challenges posed by the disease, increased risk of thromboembolism has presented a distinct new front for increased mortality and morbidity. While there are multiple documented evidences for the same, the exact mechanism, knowledge of groups at-risk, and mitigation strategies are evolving. We present a case of a young individual who was diagnosed with acute lymphoblastic leukemia (ALL), was started on appropriate chemotherapy, and subsequently developed severe COVID-19 pneumonia. He was treated for COVID-19 pneumonia and recovered from the illness. However, his recovery from COVID-19 was further complicated by cortical venous sinus thrombosis (CVT). Contrast enhanced magnetic resonance imaging (CEMRI) brain and magnetic resonance venography (MRV) revealed the diagnosis of CVT with hemorrhagic parenchymal changes. He was managed with therapeutic anticoagulation and cerebral decongestants and was subsequently shifted to oral anticoagulant therapy. While the case was managed at a tertiary care setting, it opened up the question of identifying the high-risk groups and to formulate guidelines for extended thromboprophylaxis in these patients.

We present a case of an extensive multilevel and concurrent spinal subdural (SSA) and spinal epidural abscess (SEA) extending from C2 to S3 caused by methicillin-resistant Staphylococcus aureus (MRSA), which was evacuated via two selective laminectomies using a ventriculostomy catheter intradurally. Extensive SEA and SSA can be resolved through selective laminectomies with subsequent insertion of a fluoroscopically guided catheter to aid in evacuation and irrigation of the abscesses. As demonstrated by our case, this option avoids complications of long segment decompressions and potential iatrogenic instability and should be considered in the treatment plan to reduce morbidity and achieve the best possible patient outcomes.

In the elderly, a significant decline in the liver and renal function was observed with increasing aging. This study aims to identify the characteristics of elderly with acute poisoning and analyzed the difference between Asia and non-Asia. We gathered works of literature from the Google Scholar database and PubMed with limits in human, English, MEDLINE, age above 65 years old, and title or abstract of “acute poisoning in the elderly” from the year 1983 to 2019. During the 36 years, 11 articles from Google Scholar (including 9 articles in PubMed) with 34,593 patients were included to study. Data of age, gender, etiology, poisoned substance, outcome, length of stay (LOS), and mortality rate were collected, and we divide them into two groups: Asia and non-Asia, to compare the diversities and discussion were made. The mean ± SD (standard deviation) in age is 72.3 ± 4.5 years old. Of these patients, 57.8% were male. Accidental poisoning was more common in elderlies. Of the types of poisoning, drugs were the most common substance (40.4%). Among all the cases in this study, 60.2% were admitted to the hospital after poisoning. Of them, 26.2% were admitted to an intensive care unit (ICU). The mortality rate of the study participants was 13.2%. Most of the poisoned elderly patients are unintentional, and drug (BZDs) is the most common agent poisoned. Asia group of poisoned elderly patients are older, male predominant, more intentional, and having a higher rate of mortality than the non-Asia group.

Stem cell transplants, and neural stem cells (NSCs) in particular, hold tremendous potential in recreating axonal relays that bridge traumatic spinal cord injuries (SCIs). While currently there is no standardized transplant methodology, common themes emerge from reviewing recent studies. Current research focuses on injecting NSCs without damaging existing tissue, overcoming common hurdles such as glial scarring, immune reaction, and tumorigenesis and inducing proper differentiation into sensory and motor neurons. Notably, scaffolding holds promise in improving outcomes. Although animal trials have demonstrated NSC ability to improve motor function, human trials are mostly limited to verification of safety instead of efficacy. While controversy and debate surround the use of stem cells, NSCs for SCI merit further exploration.