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The metallic endoscopic clip was first described for hemostasis in 1975. [1] Endoscopic clips are now frequently used in non-variceal upper gastrointestinal bleeding, and have many different indications. [1] Most clips are not magnetic resonance imaging [MRI]-safe, and are contraindications to MRI. [2] The hemostatic clips usually spontaneously dislodge within 1 to 3 weeks after placement, but some case reports have shown that they can be retained for up to 2 years. [5] Hemostatic clips retention until ulcers healed could promote permanent endoscopic hemostasis of both severe ulcer hemorrhage and very severe hemorrhage related to inpatient ulcer bleeding. [3] Given the short retention time, most physicians rarely advise their patients to abstain from diagnostic procedures that would be contraindicated with a hemostatic clips placed, such as magnetic resonance imaging. [5] Two cases will be reported for retained clips more than 2 years with a review about risks for clip retaining, MRI compatibility, and retrieving retained clips.

Age-related macular degeneration (AMD) is a disease leading to severe visual loss and legal blindness in the elderly population overall in cold countries. Its pathogenesis, likely multifactorial, involving a complex and dynamic interaction of metabolic, functional, genetic, and environmental factors, remains poorly understood. For these reasons currently used therapeutic approaches are way beyond to be effective. Two types of AMD are distinguished: the dry and the wet form. Main risk factors include advanced age, genetic predispositions, environmental determinants, history of exposure to intensive light and smoking. Till now, there is no approved therapy for dry AMD, although several agents/treatments are currently in clinical trials. Since upregulated vascular endothelial growth factor (VEGF) is a predominant proangiogenic factor in CNV. the wet AMD can be treated with intra-vitreous application of “anti-VEGF” agents; however, their clinical results are disappointing. In this article, we report clinical results of a novel approach, based in our discovery of the unsuspected intrinsic capacity of human being to transform the power of the sunlight into chemical energy, throughout the dissociation of the water molecule, like plants do it.

Transportation infrastructure promotes the interconnection of production factors between regions and enhances the efficiency of land use, while land use patterns also have an impact on transportation development patterns and mixes. Although the development of different regions within megacities tends to be integrated, different transportation mixes and land inputs still bring differentiated dynamics to the development of the blocks. In order to explore the relationship between regional traffic conditions and land use efficiency, this paper investigates the traffic development conditions and land use efficiency of each district in Shanghai by using the traffic dominance degree model and the three-stage Super-SBM model, and explores the relevant role relationship between them by using the coupled coordination degree model. The results show that: (1) the central city has the highest traffic dominance, and the suburban areas, especially the distant suburban areas, have low traffic dominance; (2) the land use efficiency of the eastern area of Shanghai is significantly higher than that of the western area, and the land use efficiency of the southern area is higher than that of the northern area; (3) in terms of coupling coordination, the traffic development and land use efficiency of most districts are coordinated, but the degree of coordination varies greatly, with Huangpu District, Yangpu District, Pudong New Area, and Hongqiao District. Yangpu District, Pudong New Area and Hongkou District are at a high level of coordinated development, Chongming District and Changning District are at an uncoordinated development, and the rest of the districts are at a medium level of coordinated development.

Introduction: The elderly, because they are more susceptible to develop chronic diseases, seek health services and medications more often, which predisposes this population to the problems related to them. Add to this the possibility of illiteracy, which may compromise understanding and lead to incorrect use of the drug. Objective: To evaluate the understanding of drug therapy by the elderly who are in a situation of polypharmacy. Methods: A quantitative, cross-sectional and descriptive study was carried out with individuals ≥ 60 years old who used 2 or more drugs in two communities in Recife-PE, from August to October 2016. The method used followed the principle of analysis, which verifies the agreement between the respondent’s response and the information contained in the medical prescription, and classifies the users through scores: less than six points – level of insufficient understanding; from six to eight – regular; above eight points, good level. Results: The elderly had low levels of schooling, 28% were illiterate. The two communities are made up of 72% and 48% of the elderly with insufficient understanding. Conclusion: The importance of the pharmacist as a member of the multidisciplinary team, who should guide and ensure that information is passed on to the user in a safe and efficient manner, through educational actions that promote knowledge about the use of medicines.

Introduction: Alzheimer’s disease is a more common neurodegenerative disease, affecting 25 million people worldwide, or accounting for about 60 to 70% of all dementia cases. There is currently no exact mechanism to explain the pathophysiology of Alzheimer’s disease, however, cascading metabolic amyloid and post-translational review of tau protein are used as major hypotheses. Objective: To demonstrate in the literature new approaches in the development of Alzheimer’s disease modifiers. Methodology: This is a literature review study with a 5-year time frame, developed from the research of scientific articles published in international journals, through online databases such as “PubMed” and “Science Direct”. Results: Alzheimer’s disease-modifying drugs are not yet available, but many patients may, however, develop phase III clinical trials and are intended to modify as pathological stages leading to the disease. As disease-modifying therapies under study, these changes also affect Aβ and tau protein and also cause inflammation and oxidative damage. The results obtained in the clinical trials performed were positive and promising and are still under study. The results show that there is still a long way to go in the development of Alzheimer’s disease modifying drugs. Conclusion: The results demonstrated that there is still a long way to go in the development of Alzheimer’s disease modifying drugs, but nevertheless levels at the research level should be continued in order to improve the pathophysiology of the disease and find an effective treatment for this disease the same.

Objectives: Studies have suggested that the prevalence of Internet Gaming Disorder (IGD) is higher among Asian populations. This study compared the prevalence and severity of IGD between English-speaking gamers and Chinese-speaking gamers. Correlates of IGD were investigated in the global sample. Methods: A total of 101 English-speaking gamers and 130 Chinese-speaking gamers were recruited via a social marketing campaign and participated in an online questionnaire. Results: The prevalence of IGD was 0.0% and 0.8%, respectively, among English-speaking gamers and Chinese-speaking gamers. Chinese-speaking gamers were more likely to deceive family members, therapists, or others because of the amount of gaming activity, and were more likely to have jeopardized or lost an important relationship, job, or an educational or career opportunity because of gaming activity. English-speaking gamers were more likely to own a dedicated gaming device, started video gameplay at a younger age, spent more hours weekly on gameplay, and were more likely to play games to escape or relieve a negative mood. Among the global sample, correlates of a higher level of IGD were: being males, being current students, spending more hours weekly on gameplay, having experienced anxiety in the past year, having a higher level of violence, and having less real-life social support. Conclusions: These results suggested that the prevalence of IGD is low and comparable between English-speaking and Chinese-speaking gamers. The two populations differed in certain diagnosis criteria of IGD and behavioral factors relating to gameplay. Psychosocial factors of IGD were observed among the global sample adjusting for the cultural background.

Population of older person are growing globally, in Africa and Nigeria. The WHO stated that this demographic change has implications on health care systems and on achieving sustainable development goals (SDGs) and universal health coverage (UHC). However, programs to adjust to population aging is still lacking in countries like Nigeria. This project proposal aims to implement and evaluate, with goal of scaling up, community geriatric program on achieving SDGs and UHC among older persons in Nigeria. Intervention approach will include home based management of older persons through seven geriatric case management processes, service provisions by trained case managers across four intervention domains, instituting and supporting health geriatric clinics and drug banks, enrollment of beneficiaries into national health insurance program and supporting system strengthening (on geriatric care) for service providers and hospitals. Data collection and entry will be done using expert data capturing tools and geriatric data management information system (GDMIS), while data analysis will be done through comparison of pre and post intervention indices. Review of literatures and anecdotal data show paucity of geriatric projects for care of older persons whose population is exponentially increasing in Africa. This project proposal that aims to implement and evaluate effect of a novel and innovative community health programs on achieving SDGs and UHC goals among older persons in Nigeria will share its result, conclusion, and recommendations, which will be disseminated for adaption and adoption for geriatric programing in the African context.

Objective: Today, with the availability of direct-acting antivirals (DAAs), the value of therapeutic patient education (TPE) in chronic hepatitis C needs to be redefined, as these drugs have made treatment simple. The study presented here in sought to define what role TPE plays today in hepatitis C management along with what factors are associated with such programs being used. Methods: We included 786 patients mono-infected with hepatitis C virus (HCV) who underwent treatment with DAAs. 284 of whom benefited from a TPE program (36.1%). The characteristics of HCV and how it was treated were compared retrospectively between TPE+ and TPE- patients. The TPE program was overseen by a nurse. Results: The following factors were associated with TPE on multivariate analysis: migrant status (OR=3.63, 95%CI: 2.24-5.96, p

Objective: to identify the main digestive manifestations related to SARS-CoV-2 in Togo and to determine their impact on the prognosis of the disease. Patients and method: This was a cross-sectional study with retrospective and prospective collection, with descriptive and analytical aims, conducted from May 1, 2020 to April 30, 2021 at the national center for the management of infectious diseases of Lome. Patients of both sexes and of any age, tested positive for SARS-CoV-2 by PCR on nasopharyngeal and oropharyngeal samples and hospitalized at the national center for infectious disease management of Lome were included in this study. Digestive manifestations were divided into gastrointestinal manifestations and hepatobiliary manifestations. The threshold of significance of the tests was retained for a p value less than or equal to 0.05. Results: out of 876 patients hospitalized during the study period, 215 presented with digestive manifestations, corresponding to a prevalence of 24.54%. the predominance was male, with a male/female sex ratio of 1.74. the mean age was 46.07+/-16.14 [02 months – 82 years]. gastrointestinal manifestations were found in 11.98% of cases. abdominal pain was the most frequent digestive symptom (15.35%). hepatobiliary manifestations were represented by cytolysis syndrome (44.19%) and cholestasis syndrome (36.28%). digestive manifestations were associated with renal failure (p=0.03) and thrombocytosis (p

Background: Acne vulgaris of infants is a well-recognized medical and cosmetic problem as it may cause severe scarring of the face. Hence medical treatment is essentially needed. Objective: To record all patients with infantile acne vulgaris and to do full demographic and clinical evaluation. Patients and methods:This is case series clinical descriptive study with interventional therapeutic trial that included all patients with infantile acne vulgaris that were seen during the period from Jan 2021 – September 2021 years. All demographic and clinical features were recorded. The clinical scoring of acne severity was done as follow:mild when the rash was mainly comedones,moderate mainly papules and pustules and severe mainly nodules and scarring. Any triggering factors were recorded including hormonal changes. Therapy was started by giving topical 2% clindamycin twice a day and oral trimethoprim-sulfamethoxazole suspension one teaspoonful twice a day for 1-2 months. Results: This study included 28 patients with infantile acne, with 19(67.86%) males and 9(32.14%) females with male to female ratio;2.1. The age of patients ranged from 1-24 months, with a mean 14.6 ±6.1.The duration of rash was ranged from 4-8 weeks. The commonest sites affected were cheeks in 27(96.4%) cases, followed by forehead in 8 (28.6%), then chin in 6 (23.1%), and nose 6 (23.1%) of the cases. Scoring of severity of acne showed moderate in 13(46.4%), followed by mild in 9 (32.1%), and sever in 6 (21.4%). The response to treatment was complete clearance in 15(53.6%) and partial response in 13(46.4%) of the patients while no adverse effects were observed. Conclusions: Infantile acne is not uncommon disease among infants where medical therapy is essentially needed especially in severe cases as to prevent facial scarring. Early diagnosis and treatment with oral trimethoprim-sulfamethoxazole suspension and topical 2% clindamycin lotion is an effective mode of therapy.