Isolated Aortitis with multiple Aortic aneurysms and widespread venous, arterial and intracardiac thrombosis: A challenging Vascular Behcet’s Disease case management
In 1937, Hulusi Behcet’s brought to our attention the existence of a disease characterized by recurrent oral aphthae and any of several systemic manifestations including genital aphthae, ocular disease, skin lesions, gastrointestinal involvement, neurologic disease, vascular disease, or arthritis [1-3]. He became the first physician to describe this and the disease was henceforth named after his name. The aetiology of this disease remains unclear however it has been noticed that Behcet’s syndrome is remarkable for its systemic vasculitides which include its ability to involve blood vessels of all sizes (small, medium, and large) on both the arterial and venous sides of the circulation with occlusive nature . This makes Vasculitis the major cause of the clinical manifestations of the disease with the involvement of almost any organ. We herein report an unusual case of a thirty-year-old Syrian man with no past medical illnesses. On presentation, he suffered from a sudden onset of shortness of breath and a history of hoarseness of voice for less than a week, and drastic weight loss of about thirty kgs within a month. Imaging confirmed the presence of pulmonary embolism, bilateral deep venous thrombosis, intracardiac thrombosis, popliteal artery thrombosis with thoracic, and abdominal aortic aneurysms. This case highlights the importance of having a high suspicion of the possibility of Behcet’s disease when multiple thrombi and aneurysms manifest in a patient on the silk root country. Thereby, stressing the importance of familiarizing ourselves with such unusual presentations of Behcet’s disease and the course of this unusual presentation with some learning points with a good literature review included below.
The Impact of COVID-19 Pandemic in Psychiatric Outpatient Visits in Abu Dhabi – A Retrospective Study
Introduction: Coronavirus pandemics has affected mental health services around the globe. A marked reduction in psychiatric admission and emergency visits were reported recently. With regards to outpatient services, there was an adoption of tele-psychiatry in mental health facilities in many countries. Objectives: To examine the impact of COVID-19 pandemics on the psychiatric outpatient visits in the largest Psychiatric Hospital in Abu Dhabi, UAE, during the month of April 2020. Methodology: A descriptive retrospective study of medical records of all patients attended the general adult psychiatry clinic in the month of April 2020. Results: 1,050 patients were included in the analysis. The sample consists of 55.9% males. The mean age was 40.7 years. The predominant ethnicity was Arab (88.3%). The most prevalent diagnosis was depressive disorder 32.7%. Only 1.6 % patients attended the clinic as new appointments. Tele-assessment was conducted in 64% (N=672) visits. 9.3 % reported to be in relapse during April. Patient with schizophrenia showed the lowest relapse rate 5.7%. Only 8.5% had taken PCR COVID test, with two patients tested positive. Conclusion: The great shift to tele-assessments and the service of medications home delivery were the main reason for maintaining the service in the psychiatric outpatient settings.
Gendered Inequalities in HIV/AIDS: Investigating Linkages between Degradation, Disenfranchisement, Unemployment and Disease
The purpose of this paper is to examine the social, political, economic, and environmental forces that shape disproportionate HIV rates among women in less-developed countries. Specifically, we analyze how environmental degradation and women’s property rights condition female unemployment rates in poor nations and ultimately, patterns of disease. Using data from 105 less-developed nations, we construct a structural equation model to analyze influences on the proportion of HIV cases among women. We find that environmental degradation is an important, though often overlooked factor contributing to the female HIV burden across nations, through mechanisms such as female unemployment, disenfranchisement, and poor access to socio-health services. We also find that restrictions on property rights for women impact female unemployment and access to health services. Conclusions point to the efficacy of incorporating ecofeminist frameworks that emphasize ecological conditions alongside political, economic, and social forces to explain global health and gender inequalities in HIV/AIDS.
In this COVID-19 lockdown Survey Monkey study, as many as 75% of 260 respondents reported feeling fatigued. Correlation analyses suggested that feeling fatigued was significantly correlated with demographic variables and virtually every item on every scale of the survey. The demographic correlations suggested that fatigue occurred more frequently in younger participants, in males, and in those not working from home during the lockdown. The significant correlations for the scales suggested that those feeling fatigued engaged in fewer health activities including exercise and self-care; they spent more time on social media including gaming and Facebook; they engaged in less cooking and creative projects; they scored higher on the Stress Scale including worrying more about the virus and their finances; they reported feeling more isolated, lonely, bored and touch deprived; they did more snacking and napping and expressed more “cabin fever”; they had lower scores on connecting and activities at home; and they had higher scores on anxiety, depression, sleep disturbances, and PTSD scales. A regression analysis suggested that 51% of the variance in the fatigue scores was explained by the depression (37% variance), sleep disturbances (12%) and anxiety (1%) scores. These results are limited by their being self-reported data from a non-representative, cross-sectional sample. Nonetheless, they highlight the negative effects of feeling fatigued during a COVID-19 lockdown.
In-Vitro protein digestibility, physico-chemical properties and nutritional quality of sorghum-green gram cookies supplemented with mango powder
Ready to Eat (RTE) sorghum cookies were prepared by incorporating green gram flour at 10%, 20%, 30%, dried mango powder at 10% and evaluated for their physico-chemical and nutritional properties. Protein, fat, fiber and ash increased with increase in green gram flour substitution as carbohydrate content decreased significantly. Significant differences (p ≤ 0.05) in protein content were seen in cookies ranging from 9.52% to 13.60%. Fiber increased significantly from 9.40% to 10.90%. In vitro protein digestibility ranged from 67.75 ± 0.01% to 90.05 ± 0.10 %. Vitamins analysed increased with addition of green gram flour. Thiamine content ranged from 0.22±0.02 to 0.61±0.02 mg/100g, riboflavin from 0.09±0.00 to 1.39±0.04 mg/100g and ascorbic acid from 13.87±0.79 to 19.31±0.94 mg/100g. Value addition of under-utilized crops like sorghum and green grams can play a vital role in development of high nutritional quality RTE products.
Introduction: A prospective study was carried out, with the aim of establishing the clinical manifestations of cholelithiasis in the population of Quito, Ecuador. Methods: During the period from January 2012 to October 2017, 534 patients were referred from different outpatient clinics of the Ecuadorian Institute of Social Security to the Batan Medical Center with the diagnosis of cholelithiasis after a clinical assessment and abdominal ultrasound, to be treated surgically. Results: Sixty-nine percent of patients were female with a male-female ratio of 1:2.21. Mean age was 44.9 years. Pain was the most common symptom in our study: 95.7%. Among these patients, pain was located in the epigastrium in 49.8%, in the right hypochondrium in 45.1% and only 0.8% had low back pain. Pain ranged from moderate and even severe. The remaining 4.3% of patients had dyspepsia or were asymptomatic. Conclusions: This finding highlights the fact that epigastric pain must be always considered as a clinical manifestation on cholelithiasis.
Femoral neck fractures are common fractures in the elderly, especially in elderly women. There are many mature treatment methods for femoral neck fractures. However, which option is better is still controversial. In order to allow clinicians to better develop treatment plans for elderly patients with femoral neck fractures, this article summarizes the diagnosis and treatment status of elderly femoral neck fractures from the aspects of epidemiology, etiology and diagnosis, treatment methods and progress of elderly femoral neck fractures.
The social and economic diversity of the coffee-banana farming system and technology uptake in Central Uganda
Food systems of the future that will guarantee food and nutrition security of millions of poor farming households will have to be both economically and socially diverse. Diversity of farming systems acts as a catalyst for innovation, commercialisation as well as technology adoption. This study sought to find farm typologies and explore the social, enterprise and economic diversity of the various farm types based on a promoted Growing Bananas with Trees and Livestock (GBTL) technology system that was implemented by National Agricultural Research Organisation and Bioversity International in three districts of Central Uganda, Kiboga, Nakaseke and Ssembabule. Using Principal Component Analysis (PCA) and Cluster Analysis (CA), typologies were created in which two distinct clusters of farming households were revealed. Further analysis of the clusters through Food Consumption Scores, food classes, and other descriptive statistics indicated that the two clusters were socially and economically diverse. Findings indicated that Cluster 1 is made up of smaller farms with high crop diversity. Families in Cluster 1 sell more of their produce and subsequently have lower food security compared to the land-abundant, off-farm earning and more food secure Cluster 2. We failed to reject the hypothesis that socially and economically diverse farmers adopt technologies more given that the level of GBTL adoption was about 25% and about 70% for Banana + Goats within both clusters.
At the current moment, there is no single approach regarding diagnostics and after-treatment of compression stenosis of the celiac axis. This work aims to study the state of the vasculature of the stomach and intestinal tract during compression stenosis of the celiac axis. Compression stenosis of the celiac axis is a disease caused by extravasal pressure of the celiac axis of the abdominal aorta applied by the arcuate ligament of the diaphragm, diaphragmatic peduncle, or neurophibromatic tissue of celiac plexus. It presents in chronic abdominal pain, dyspeptic events, and neurovegetative disorders. This work aims to study the state of the vasculature of the stomach and intestinal tract during compression stenosis of the celiac axis. Materials and methods. Intraorgan vasculature has been studied – 18 specimens of stomachs and intestinal tracts, gathered during autopsies of dead bodies with compression stenosis of the celiac axis. Autopsie material has been studied sensu L. Reiner. Research has been conducted with angiology, roentgenologic and histologic methods. To achieve the set goal a universal method has been developed, based on classical impregnation methods: intravascular – Ranvier-Goyer, and immersional – Belschowsky-Gros. Results. The conducted research has allowed locating significant changes of histostructure of microcirculation vessels’ vascular wall: wall shredding, edema of basal membrane, swelling of perivascular connective tissue. Overall the stomach and intestinal tract looked paralytically dilated. The most prominent morphologic changes of microvasculature have been revealed in the pyloric part of the stomach and first intestinal segment of dodecadactylon. In addition to diffuse atrophic changes of the stomach lining and intestinal lining, observed during stenosis of the celiac axis, these changes take the form of helcoid process in separate parts of it. As a result, the conducted research has allowed exposing prominent changes of histostructure of vascular walls of stomach and intestines during compression stenosis of…
Adult Learning Theory: Reflections on the role of mentoring as a key to success in advanced degree programs
Vital to completing advanced educational and training programs beyond the undergraduate degree level is realizing specific dispositions and traits. In this paper, the role of mentoring as a critical contributing factor to student success is examined through critical reflection as a form of qualitative inquiry. Traditionally utilized in professional settings to improve practice, critical reflection provided an emergent methodological approach for close examination of personal experiences with mentoring during the learning process in pursuit and subsequent completion of a professional degree (Fook, 2013). This in-depth examination of personal experience derived lessons learned from individuals that successfully navigated the rigor of advanced educational programs to expose mentoring’s role as the key to success.