London Journal of Medical and Health Research
London Journal of Medical and Health Research London Journal of Medical and Health Research is focused on publishing groundbreaking ideas on theoretical and experimental research in all domains relating to medicine, diseases, advances in pharma and instruments. As a flagship scholarly journal, It is a peer-reviewed, international, indexed journal. The journal publishes high-quality research papers that are double-blind refereed. The journal has a dedicated team for reviewing articles of COVID-19 to make sure the research is valid and published first. It provides practical, theoretical, and managerial implications useful for further research development. The journal publishes high-quality research papers that are double-blind refereed. Authors and readers include academic researchers and educators, as well as scientists. SUBMIT MANUSCRIPT
Phrenic Nerve Paralysis: Effects on Diaphragm Mobility
Phrenic nerve paralysis is a severe clinical condition with significant repercussions on respiratory mechanics and patient quality of life. It results from the interruption of diaphragmatic innervation, compromising the physiology of the muscle, reducing pulmonary expansion, and leading to alveolar hypoventilation. The phrenic nerve originates from the cervical roots C3 to C5, following a complex anatomical pathway that makes it vulnerable to iatrogenic injury during cervical or thoracic surgeries or anesthetic blocks. This study reviewed scientific evidence from the past decade, without language restrictions, using databases such as PubMed and SciELO and search terms including "phrenic nerve paralysis," "iatrogenesis," and "neurotization." The analysis integrated data from prospective studies and systematic reviews, highlighting diagnostic techniques such as dynamic ultrasonography and electroneuromyography. Therapeutic strategies ranged from conservative approaches to surgical interventions, including neurotization with autologous grafts and diaphragmatic plication. The findings conclude that preventing iatrogenic injuries requires standardized protocols, intraoperative monitoring, and equitable access to therapies. These measures are essential to reduce morbidity and mortality and improve clinical outcomes, particularly in vulnerable populations such as the elderly and patients with neuromuscular comorbidities.
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Newborn Survival Analysis: between 2019 and 2021 in Burundi
Progress towards the fourth Millennium Development Goal - to reduce child mortality under the age of 5, to which all countries are committed - has been slow in several countries in the Central African region in recent years. This study includes 2,886 observations from Burundi between 2019 and 2022. Early neonatal mortality (0 - 6 days) accounts for 50% of neonatal deaths in the country. Through survival analysis, I identified several key risk factors�Caesarean section, malaria, and fetal distress�as the primary causes of early neonatal mortality. Contrary to conventional wisdom, most of these health problems can be managed with cost-effective, evidence-based interventions that do not require sophisticated skills or technologies in countries with high infant mortality. By improving the health of the mother, through adequate nutrition during pregnancy, correct management of childbirth and appropriate care of the newborn, 32.9% of infant deaths can be avoided. These results further argue in favor of an appropriate prevention policy focused on the mother-child pair: better monitoring of pregnancies among mothers, ensuring good vaccination coverage and improving health infrastructure.
Unhealthy Diets and Menarche: Association between Ultra-Processed Food Consumption, BMI, and Menstrual Health in Adolescent Girls
Background: The increasing reliance on ultra-processed foods (UPFs) among adolescents has emerged as a global nutritional concern. UPFs are typically energy-dense, rich in unhealthy fats, sugars, and additives, while being poor in micronutrients. Excessive intake of such foods has been linked to obesity, metabolic dysfunction, and early pubertal onset. Menarche, a critical milestone in female reproductive development, is influenced by nutritional and environmental factors. However, evidence from Indian contexts, particularly rural and semi-urban regions, remains limited. Objective: This study aimed to examine the relationship between dietary fat intake from UPFs, body mass index (BMI), and menstrual health indicators�specifically age at menarche and the occurrence of early menarche�among school-going adolescent girls in the Midnapore district of West Bengal, India. Methods: A cross-sectional survey was conducted among adolescent girls (N = 232) using a structured questionnaire covering socio-demographic characteristics, dietary habits, anthropometric measurements, and menstrual history. Nutrient intake, with a focus on fat consumption from UPFs was estimated and BMI was computed using WHO criteria. Descriptive statistics, linear regression, and binary logistic regression analyses were employed to assess associations. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for early menarche (< 12 years). Results: The mean age at menarche in the study population was 12.45 � 0.98 years. Nearly one in five participants (?22%) experienced early menarche. High dietary fat intake (? 75th percentile, proxy for UPF consumption) was significantly associated with early menarche (OR = 1.64, 95% CI: 1.10�2.46). Linear regression analyses indicated that dietary fat intake was inversely related to monarchical age (? = -0.003, p < 0.05), independent of BMI. Furthermore, BMI exhibited a significant negative association with age at menarche (? = -0.020, p < 0.01), suggesting that overweight girls tended to attain menarche earlier. Conclusion: The findings highlight a strong association between ultra-processed food consumption, elevated BMI, and earlier onset of menarche in adolescent girls. Given the potential long-term implications�such as increased risk of menstrual irregularities, metabolic disorders, and reproductive health challenges�public health interventions promoting nutritional literacy, healthier dietary alternatives, and lifestyle modifications are urgently warranted in school and community settings.
The Differences of Night Eating Syndrome, Sleeping Pattern, and Sugar-Sweetened Beverage Consumption Habit based on Metholic Type in Obese Students
Background: The prevalence of obesity in students is currently increasing and it can lead to� metabolic syndrome at such a young age. The habit of students who have bad sleeping pattern, night� eating syndrome, and excessive SSB consumption can increase the risk of metabolic syndrome in� obese students.� Purpose: The purpose of this research was to analyze the differences of night eating syndrome,� sleeping pattern, and consumption habit of sugar-sweetened beverage based on metabolic types in� obese students.� Method: The research was conducted in July-September 2020 with female students in Semarang� City as subjects. This research used a case-control design, as many as 52 subjects aged 19-24 years� were selected by consecutive sampling method. The collected data included: body weight using� digital scales, height using a microtoise, waist size using a medline, blood pressure using a� tensimeter, and a laboratory tests was conducted to check triglyceride levels, HDL cholesterol,� fasting blood glucose, as well as insulin. The used instruments were The Night Eating Questioner� (NEQ) to assess the night eating syndrome, Pittsburg Sleep Quality (PSQI) to assess sleeping� pattern, and Semi-Quantitative Food Frequency Questionnaire (SQFFQ) to see the subject's� consumption of sugar-sweetened beverage during the last one month. The data were analyzed using� Chi-Square test.� Result: The research showed that majority of the subjects who experienced night eating syndrome� (46,2%) and bad sleeping pattern (61,5%) were subjects with Metabolically Unhealthy Obesity� (MUO). Meanwhile, for sugar-sweetened beverage consumption in Metabolically Healthy Obesity� (MHO) and Metabolically Unhealthy Obesity (MUO) were still within the normal range (86,4%). A� difference between night eating syndrome (p=0,006) and sleeping pattern (p=0,012) on� Metabolically Healthy Obesity (MHO) and Metabolically Unhealthy Obesity (MUO) was also� observed.� Conclusion: Students with Metabolically Unhealthy Obesity (MUO) type were experiencing more� night eating syndrome and bad sleeping pattern compared to the students with Metabolically Healthy� Obesity (MHO) type.�
Arthroscopic Fixation and Ligament Reconstruction in Tibial Plateau Fracture: A Case Report
Introduction: Tibial plateau fractures account for approximately 1% of all fractures; however, they are associated with high morbidity due to a wide spectrum of soft tissue injuries and a significant incidence of concomitant ligamentous and meniscal lesions. Among these, anterior cruciate ligament (ACL) injuries are particularly relevant, as delayed diagnosis or inadequate management of these injuries can compromise joint stability and long-term functional outcomes. Case presentation: We present the case of a 33-year-old male patient with a lateral tibial plateau fracture (Schatzker type I) associated with a complete anterior cruciate ligament tear and a fibular head fracture in the right knee following a traffic accident. The patient underwent ACL reconstruction using hamstring tendon autograft, along with open reduction and internal fixation of the tibial plateau and fibular head fractures. Postoperative evolution has been satisfactory, with full recovery of range of motion, a stable, pain-free knee, and favorable functional outcomes. Discussion: Tibial plateau fractures are complex articular injuries with a high incidence of associated ligamentous damage, particularly involving the anterior cruciate ligament. Treatment should be individualized based on the fracture pattern and associated injuries. Arthroscopy-assisted techniques represent a viable option for reduction, fixation, and simultaneous management of intra articular lesions, contributing to joint function preservation and showing satisfactory functional outcomes. Conclusion: This case highlights the importance of maintaining a high index of suspicion for associated ligament injuries in tibial plateau fractures, regardless of the fracture pattern. Additionally, the arthroscopy-assisted approach is emphasized as a valuable tool for achieving precise anatomic reduction and simultaneous anterior cruciate ligament (ACL) reconstruction in a single surgical procedure. The case presented, along with the available evidence, supports the combined approach as a safe, effective, and minimally invasive strategy that promotes early functional recovery and favorable clinical outcomes.
Neurological Manifestation of Chikungunya Virus and its Implication in the Pathogenesis of Guillain-Barr頓yndrome: A Systematic Review of Clinical and Mechanistic Evidence
Chikungunya virus (CHIKV) infection has been linked to severe neurological outcomes, notably Guillain-Barr� Syndrome (GBS). This systematic review highlights clinical and mechanistic evidence associating CHIKV with autoimmune polyradiculoneuropathies. Findings reveal the virus�s neurotropism and support its role as a triggering factor for GBS. Despite methodological heterogeneity among studies, the evidence underscores important implications for diagnosis, clinical surveillance, and patient management. Deeper understanding of this relationship is essential to improve preventive and therapeutic health strategies.
The Serotonin Hypothesis for Depression: A Comprehensive Study
It has been observed a sharp growth in the number of diagnoses of depression (under the MDD [Major Depressive Disorder] spectrum) in the last decades, accompanied by a similarly increase in sales of antidepressants in several societies, leading to depression being currently considered an epidemic (WHO). The predominant understanding of the cause for depression, the serotonin hypothesis, conveyed by 80% of the population, dates back to the 1960s, when the first antidepressants were being developed. This article sought to verify this state of affairs from the main literature available, starting from the original pharmacological development of antidepressants and their implication in the body�s physiology. Most of the literature gathered for this study did not validate the hypothesis as the most plausible main cause for depression, while nonetheless, this continues to be widespread by pharmaceutical industries and most medical practitioners as such.
Optimizing Patient Flow and Resource Utilization: Transfer Centers as Strategic Command Hubs in Multi-Hospital Healthcare Systems
Healthcare systems face unprecedented operational challenges including capacity constraints and financial pressures, exacerbated by workforce shortages and shifting care delivery models. Optimized transfer centers emerge as a strategic solution, functioning as centralized hubs that coordinate inter- and intra-facility patient transfers while integrating clinical decision-making with logistics and bed management. This article explores how such centers serve as catalysts for enhancing access, efficiency, and cost control across a ten-hospital health system in the DMV region. Through a performance transformation framework, the article examines the structural and technological components contributing to effective transfer center operations, including centralized communication platforms, real-time data integration systems, standardized triage protocols, bed management visualization technologies, and interdisciplinary staffing models. Key outcomes demonstrate significant improvements in transfer times, emergency department boarding, resource utilization, and financial performance. The implementation framework focuses on improving performance and lowering costs for outbound BLS ambulance and wheelchair van services for acute patient transport, while simultaneously reducing administrative burden on clinicians who were previously arranging outbound transportation and decreasing overall length of stay. Optimized transfer centers represent a high-impact intervention for healthcare systems seeking to improve resource allocation while enhancing quality and equity of care across distributed networks.
Effect of using a Composition of 4 Essential Oils on Self-Esteem, Training Quality and Pain Score in Athletes from the Moroccan National Poomsae Team
During training and competitions, athletes face physical factors, including pain, fatigue and exhaustion, added to psychological factors, including negative vibes and mental pressure. Recovery is a key function; it is a step aimed at restoring athletes' physical condition to its normal pre-competition state. Essential oils have shown their positive effect in improving sports performance by modulating psychological states, improving alertness and reducing pain, physical and mental fatigue. This study aims to determine the effect of using a mixture of 4 essential oils on training quality, self-confidence, fatigue and pain in athletes of the Moroccan national poomsae team. Other factors were studied: self-esteem, depression, insomnia and back pain. The results showed a significant effect of using Essential oils on all factors studied.
A Vascular Benign Lesion in a Perilous Location
Background: Hemangioblastomas arehighly vascular grade 1 tumors arising sporadically or, more rarely, in the context of Von Hippel-Lindau disease.Cystic brainstem hemangioblastomas are rare with only few cases reported in literature. Even though they are benign, their surgery is challenging in view of their eloquent location and vascularity.Thorough perioperativemanagement is required. Case presentation: We report the case of a 47-year-old female patient with progressive weakness, difficulty in swallowing and ataxic gait.The brain MRI showed a cystic lesion occupying the caudal part of the fourth ventricle and the dorsal medulla oblangata. We performed a subtotalexcision of the tumor that was challenging due to its adherence to the floor of the 4th ventricle and its high vascularity. The pathology exam concluded to a hemangioblastoma. The patient presented a good evolution with no tumor progression in 6 months follow-up. Clinical discussion: The cystic brainstem hemangioblastoma is a rare seemingly innocuous lesion but highly challenging to neurosurgeons. MRI is the investigation of choice, regularly sufficient for preoperative evaluation. Still, some authors recommend the performance of a cerebral angiography or a CTA preoperatively. In literature, manystrategies, such as the use of preoperative embolizationor radiosurgery were described, aiming for a better-quality surgery and prognosis. Conclusion: Cystic brainstem hemangioblastoma is a scarce histologically benign but challenging lesion with surgical difficulties.Through our case and literature review, we concluded that surgery is the mainstay treatment for brainstem hemangioblastomas mainly cystic ones and that a thorough study of its vascularization via angiography or CTA with a preoperative tumor embolization can help achieve a total tumor resection with good functional outcome andlow mortality.
From Algorithms to Outcomes: Transforming Modern Healthcare through Artificial Intelligence
Artificial Intelligence (AI) refers to the utilisation of computers and advanced technologies to simulate intelligent behaviour and critical thinking comparable to that of humans. The term was first described by John McCarthy in 1956 as the science and engineering of creating intelligent machines. [1,2]. Previously considered a concept of science fiction, AI is now a tangible reality and is widely represented within academic discussion and mainstream applications. Machine Learning (ML), which is a subset of AI, enables machines to learn from patient data and generate predictions by pattern recognition, thereby empowering healthcare providers in delivering better care through accurate diagnosis and treatments. Although current technologies and AI models have not yet advanced to a stage where they may replace a doctor, they hold considerable promise as valuable diagnostic tools in healthcare. [1,3] While the likelihood of AI assuming a significant role in healthcare seems imminent, its evolution is currently tempered by concerns regarding ethical challenges and patient safety. This literature review aims to examine the contemporary applications of AI in healthcare, its potential advantages for both patients and healthcare professionals, and the existing challenges and limitations that may hinder its continued progression. [1,2]
Renal Leiomyoma as a Bosniak IV Lesion: A Case Report
Leiomyoma is a benign neoplasm originating from mesenchymal cells, affecting the smooth muscle of the genitourinary tract. These tumors can occur in various places throughout the urinary tract, mainly in the bladder, but renal involvement is less frequent and is usually in the renal capsule. They are generally asymptomatic, and diagnosis is frequently incidental through imaging studies. When symptomatic, flank pain, palpable abdominal mass or hematuria can be present. This report describes a patient with lower back pain whose computed tomography(CT) revealed a complex Bosniak IV renal lesion. Later, the patient was submitted to a partial robotic nephrectomy and diagnosed with leiomyoma through immunohistochemistry.
Prevalence and Determinants of Hearing Loss in Patients with Chronic Rhinosinusitis in a Tertiary Hospital in Nigeria
Background: Chronic rhinosinusitis is a common otorhinolaryngologic condition that is often encountered in daily practice. Nasal obstruction has been found to be the most disturbing symptom in patients with chronic rhinosinusitis which could predispose them to otologic pathologies. Aim: to assess the prevalence and determinants of hearing loss among patients with chronic rhinosinusitis in the Lagos State University Teaching hospital. Method: an analytical cross-sectional study which was conducted among 256 patients diagnosed with chronic rhinosinusitis in Lagos State University Teaching Hospital. Participants� audiological profiles was assessed by conducting Pure Tone Audiometry and tympanometry. Data obtained were analyzed with SPSS software version 27.0. Result: The participants aged 40-49 years constituted the largest age group (30.1%) and most of them were female (69.5%). The prevalence of hearing loss among the participants was 40.2%. There was reduced odds for hearing loss among participants aged 20-29 years (AOR= 0.043, 95% C.I= 0.012- 0.157), 30-39 years (AOR= 0.042, 95% C.I= 0.010- 0.171) and 40-49 years (AOR= 0.075, 95% C.I= 0.027- 0.209). Also there was reduced odds for hearing loss in male (AOR= 0.142, 95% C.I= 0.057- 0.357), but those with facial pain had increased odds for hearing loss (AOR= 5.814, 95% C.I=1.742- 19.231) and those that with nasal polyp had increased odds for hearing loss (AOR= 2.134, 95% C.I= 1.023- 4.451). Conclusion: the prevalence of hearing loss was high in chronic rhinosinusitis and its determinants were age group, gender, facial pain and nasal polyps.
Morbidity and Mortality of Percutaneous Endoscopic Gastrostomies Performed Over A 9-Year Period. Experience of the Pasteur Hospital Endoscopic Center
Enteral nutrition is the first method to be considered in patients with nutritional risk and disorders that preclude the oral route. Endoscopic gastrostomy is a fast and safe procedure with a low rate of complications. The aim of this study was to determine the morbidity and mortality of PEG performed at the Endoscopic Center of the Pasteur Hospital from January 1, 2013 to December 31, 2021.� The total number of gastrostomies performed was 241. The most frequent indications were neoplastic and neurological. The frequency of complications observed was 17 %, similar to what is described in the literature (0.4% to 22.5%). The most frequently observed complication was accidental exit (8.9 %), of which the majority managed to recover the trajectory. Among the most important complications were buried dumping syndrome or incarceration (1.6 %) and hemorrhage (1.2 %). Infections accounted for 2.4%. One patient presented implantation of laryngeal neoplasm in the abdominal wall, a rare but described complication. Six patients died within the first 30 days, which is equivalent to 2.4 %, less than that described in the literature. Of these, 4 were due to causes associated with their underlying pathology.��
Prevalence and Corneal Morphometry of Pediatric Keratoconus: A Two-Year Cross-Sectional Study in Ukraine
This study aimed to assess the prevalence and corneal morphometric characteristics of pediatric keratoconus in children aged 6�16 years in Ukraine, using data collected over a two-year period. Participants were stratified by age group (6�10 and 10�16 years) and keratoconus diagnosis status based on corneal topography. Significant differences in corneal thickness and curvature were observed across groups. These findings highlight the need for early screening and morphometric monitoring in children during puberty to facilitate timely diagnosis and intervention. Observations: Significant improvements in corneal parameters and Omega-3 indices were observed in children after supplementation. Conclusions and Importance: Nutritional support may serve as an accessible therapeutic option in resource constrained setting.
Mechanisms of Cypermethrin-Induced Reproductive Toxicity
Cypermethrin, a pyrethroid insecticide, is known for its effectiveness against pests but has raised concerns about reproductive toxicity, fertility issues, and developmental issues in offspring. This review explores cypermethrin's reproductive toxicological effects, identifying biological and molecular mechanisms, evaluating in vitro and in vivo studies, and highlighting potential long-term consequences on subsequent generations. A systematic literature review was conducted, focusing on peer-reviewed articles, toxicological reports, and relevant studies that explore the impact of cypermethrin on reproductive health. Databases such as PubMed, Scopus, and Google Scholar were searched using keywords related to cypermethrin, reproductive toxicity, endocrine disruption, and developmental effects. Studies selected for inclusion had to meet stringent criteria regarding experimental design, exposure levels, and outcome measures. Cypermethrin, an insecticide, has been found to disrupt reproductive health through various mechanisms. It interferes with hormone synthesis, leading to hormonal imbalances and sexual development issues. Cypermethrin exposure also results in oxidative stress, compromising gamete quality and reproductive function. Increased apoptosis in germ cells can lead to reduced sperm quantity and quality, impacting male fertility and female fertility. Cypermethrin exposure during critical growth periods can cause malformations and impaired development in offspring, posing risks to population viability and biodiversity. These mechanisms highlight the need for cautious regulation and deeper understanding of cypermethrin's impact on reproductive health. Cypermethrin, a common pest in agriculture and residential areas, poses significant reproductive health risks through endocrine disruption, oxidative stress, and cellular apoptosis, necessitating further research for safe exposure levels.
Chronic thromboembolic pulmonary hypertension
Developing RNase P Ribozymes for Therapy of Herpes Simplex Virus 1
RNase P ribozymes, derived from the M1 RNA of Escherichiacoli, have shown great promise as a novel nucleic acid-based gene interference approach to modulate gene expression. When the M1 RNA component of RNase P is covalently linked with a guide sequence (GS), it can be engineered into a sequence-specific endonuclease M1GS ribozyme. As the GS base-pairs with target mRNAs, it forms a structure that mimics a pre-tRNA-like substrate, allowing for M1 RNA�s structure-based recognition mechanism. These M1GS constructs function catalytically and irreversibly, capable of cleaving target mRNA substrates without relying on host proteins. M1GS activity enhancement has been achieved through an in vitro selection process that introduced mutations in the catalytic core of M1 RNA. This process generated ribozyme variants with greatly improved cleavage efficiency and substrate affinity. M1GS ribozymes have been successful in inhibiting herpes simplex virus 1 (HSV-1) by targeting genes critical for viral infection. HSV-1 is the causative agent of cold sores and may lead to severe morbidity and mortality in neonates and immunocompromised individuals. HSV-1 establishes lifelong latent infection, and novel anti-HSV-1 strategies are needed to block and eliminate viral latency and reactivation. Using HSV-1 infection as an example, this review will summarize the function of RNase P and its catalytic RNA, the enhancement and engineering of M1GS ribozymes, and their potential as a gene-targeting agent for therapeutic applications against HSV-1.
Canine Chronic Inflammatory Enteropathy with Special Reference to Immunological Markers for Diagnosis
A study on Chronic Inflammatory Enteropathy (CIE) in dogs was conducted at Madras Veterinary College Teaching Hospital. Out of 40 dogs with persistent gastrointestinal signs, 16 were diagnosed with idiopathic CIE. The condition was more prevalent in 2-5 year-old male dogs, particularly in mongrel breeds. Clinical signs included chronic diarrhoea, vomiting, and weight loss, with disease duration of 1-3 months. Gastroduodenoscopy revealed hyperemia, friability, and granularity in the stomach and duodenum, while colonoscopy showed friability, hyperemia, ulceration, and discoloration of colonic mucosa. Histopathology of duodenal biopsies showed villous stunting, mucosal fibrosis, and lymphoplasmacytic infiltration. Immunohistochemistry indicated upregulation of CD3+ cells and Ki67 antigen. A positive correlation was found between the Canine Chronic Enteropathy Activity Index (CCECAI) and endoscopic and histopathological scores.
Primary Tokophobia Rooted in Developmental Trauma: A Case Study of Reproductive Fear in Adulthood
This case study explores a rare presentation of tokophobia�an intense, pathological fear of childbirthin a 38-year-old Togolese woman named Afi, situated within a highly pro-natalist cultural context. Unlike the normative expectations in Togo, where motherhood is celebrated and socially reinforced from an early age, Yawadeveloped a persistent fear of pregnancy and childbirth following early developmental trauma and using an integrative therapeutic approach�including cognitive-behavioral therapy, imagery desensitization, psychoeducation, and observational exposurethe intervention aimed to reframe traumatic associations and restore autonomy in reproductive decision-making. The treatment was framed within a solution-focused and brief therapy model and culturally adapted to fit collective values. The findings underscore the importance of trauma-informed, culturally sensitive interventions in underrecognized mental health conditions such as tokophobia, particularly in African contexts where such cases are seldom documented. While the results are not generalizable, this case contributes to the emerging literature on reproductive trauma in non-Western settings.
Prevalance of Hpv Infection in Women Living with HIV Attending Waibargi Specialist Hospital
Cervical cancer remains a significant public health concern, particularly for women living with HIV (WLWH), due to their increased susceptibility to persistent human papillomavirus (HPV) infections.� This study aims to assess the prevalence of high-risk HPV (hrHPV) infections in WLWH attending Waibargi Specialist Hospital in Myanmar in the year 2024. The cross-sectional analysis involved 234 WLWH, tested with Cobas 4800 system HPV DNA test. Colposcopy directed biopsies were conducted among the participants to detect the presence of cervical intraepithelial neoplasia (CIN) and invasive carcinoma. The results revealed a high HPV prevalence of 29.9% among the study population, with 70 women tested positive for one or more high-risk HPV types.� Among those, single infection with HPV 16 was found in 9 women (3.8%), HPV 18 in 8 (3.4%) while 35 (15%) of them were infected with other high-risk HPV types. Additionally, 18 women (7.7%) had mixed infections involving multiple hrHPV types.�� The study also identified that women on ART for more than three years exhibited significantly lower HPV infection rates, as did those with undetectable viral loads, suggesting that effective HIV management can mitigate HPV-related cervical cancer risk. In this study, 41 women (70.7%) out of 58 HPV-positive cohort diagnosed with CIN I or more severe histological abnormalities after colposcopy directed biopsy. Notably, 86.7% of patients with HPV 16, 18, or mixed infections had positive histology results, compared to 53.6% in those with other hrHPV. In conclusion, this study highlights the high prevalence of hrHPV infections and the association between specific HPV genotypes and the development of cervical pre cancer and cancer among WLWH. The study also emphasizes the need for integrated cervical cancer screening and vaccination programs within HIV frameworks along with the importance of proper HIV treatment. However, since it is a hospital-based study, further research is required to cover the broader populations, particularly in rural and underserved areas of Myanmar.
Long-Term Anamnesis of Chronic Thromboembolic Pulmonary Disease. Does it Predict the Results of Pulmonary Thromboendarterectomy?
Introduction: Pulmonary thromboendarterectomy (PEA) is the main method of treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The residual pulmonary hypertension (PH) after CTEPH surgical treatment is a risk factor with increasing of hospital mortality. Objective: To analyze and evaluate the results of PEA in patients with different persistent time of medical history as a possible prognostic factor of residual PH and outcome. Methods: Retrospective and prospective analysis of the PEA results in 87 patients operated on from April 2012 to February 2022 was conducted. The patients were divided into 3 groups. The 1st group - 45 patients with a medical history from 3 months to 1 year, the 2nd - 20 patients from 1 year to 3 years and the 3rd - 22 patients with long-term history more than 3 years. Results: The average age of the patients was 48.7 � 13.5 years, including 56.7 % males and 43.3 % females. Due to New York Heart Association (NYHA), 7 (8.0%) patients preoperatively belonged to class II, 60 (69.0%) to class III and 20 (23.0%) to class IV. Postoperatively the mean pulmonary artery pressure (mPAP mmHg) and� pulmonary vascular resistance (PVR dyn�s�cm??) significantly decreased in all groups (mPAP :1st group from 45�13 to 23�6, 2 nd � from 49�14 to 25�6 and 3 rd � from 58�12 to 31�7; PVR: 1st group from 797�262 to 290�135, 2 nd � from 925�383 to 376�159 and 3 rd � from 1248�332 to 505�189). Hospital mortality after PEA was 0 in patients with medical history less than 1 year, 5% from 1 to 3 years and 31% in patients with long- term anamnesis. Conclusions: PEA is an effective surgery with mPAP and PVR decreasing in the early postoperative period. However, long-term medical history and PVR &gt;1000 dyn�s�cm?? are very important risk factors with increasing of hospital mortality.
Impact of the Transplant Acceleration Program (PAT-MA) Phase I on Transplant Indicators in Maranh㯬 Brazil: A Retrospective Study
Introduction: In the context of public health, the efficiency of transplant programs is crucial to improving outcomes for patients on waiting lists. This study evaluated the impact of implementing the Transplant Acceleration Program (PAT-MA) at the Transplant Center of Maranh�o, Brazil. Objectives: The aim of this study was to assess the impact of PAT-MA implementation on key performance indicators of the Maranh�o Transplant Center, with a focus on improving the organization and effectiveness of the regional transplant system through structured management methodology. Methods: We conducted a retrospective observational study analyzing data from the Maranh�o Transplant Center before and after the first phase of PAT-MA as a quality improvement initiative, comparing the years 2022 and 2023. The indicators collected included: number of transplants performed, waiting list size, notifications per million population, effective donors per million, organ transplants per million, corneal transplants per million, and number of active CIHDOTTs and OPOs. Results: Following PAT-MA implementation, there was a reduction in the family refusal rate (from 67% to 63%), a decrease in the rate of cardiac arrests before procurement completion (from 28% to 26%), an increase in notifications per million (from 172 [24/million] to 327 [46/million]), effective donors per million (from 12 [1.7/million] to 28 [3.9/million]), organ transplants per million (from 27 [3.9/million] to 62 [8.7/million]), corneal transplants per million (from 133 [18.6/million] to 255 [35/million]), and number of active CIHDOTTs and OPOs (from 3/0 to 10/1). These findings demonstrate marked growth and improvement in the regional transplant system. Conclusion: This study demonstrates that the implementation of the Transplant Acceleration Program (PAT-MA) had a positive impact on key performance indicators at the Maranh�o Transplant Center. The results underscore the importance of strategic management approaches to optimize transplant program outcomes.
Research on Procrastination During Exams, Mental Health Care, ADHD and its Preventions
When students put off preparing for an exam despite knowing they have a deadline and should do so, this is known as procrastination by examination. Students who are anxious about failing the test may put things off. They may put off doing it if they are having trouble understanding the topic. Students who have bad study habits may put off tasks. Depression, anxiety, low self-esteem, and ADHD (Attention Deficit Hyperactivity Disorder) have all been related to procrastination. A neurological condition known as ADHD can impact both adults and children. Hyperactive tendencies, difficulty focusing on activities, and an inability to regulate impulses are all possible symptoms of ADHD2. The disease does, however, also have several advantages and strengths. The primary aim of this study in the exam environment is the integration of procrastination findings by examination. The findings can be used to promote improvements in exam scores, writing techniques, academic performance indicators, and the entire exam and learning experience for students. We also expect that our work will encourage more research using materials connected to tests and other texts to help candidates avail themselves of excellent exam-related activities, which are essential to avoiding and are required to receive higher scores on their exams. The investigators chose the ICSE board schools in the sub-urban areas of Mumbai. In 2024, the researchers distributed 1400 questionnaires to the 12 ICSE Board Schools. 624 students, 227 teachers, 228 parents, and 232 guardians from these participating schools93.64% of respondents were answered. The research reflects that every government must take care of the students and provide effective counseling centres through national, and state representatives it will be required in these digital environments to take care of the future generation because based on necessity everyone procrastinates using mobile phones for their related studies. The usage of mobile also caused procrastination from elementary to research.
Attention Deficit Hyperactivity Disorder ADHD
Relationship between Triple X Trisomy and ASD in A 2-Year-Old Child in Bom Despacho/Mg
This study describes the case of a female child diagnosed with Triple X Syndrome and Autism Spectrum Disorder (ASD). The pregnancy was complicated, culminating in delivery at 36 weeks following medical recommendation due to vasa previa and umbilical cord insertion issues. Initial low food intake was observed, requiring intensive nutritional monitoring. During the first months of life, signs of developmental delay and atypical behaviors, such as lack of interaction and sensitivity to sensory stimuli, emerged, prompting the mother to seek specialized evaluation. The initial diagnosis suggested ASD; however, a second neuropediatrician requested genetic tests and additional clinical observations, leading to the discovery of X chromosome trisomy (47,XXX). This condition is associated with variable phenotypic characteristics and, in the described case, contributed to the autistic presentation. Multidisciplinary treatment, including equine therapy, speech therapy, swimming, and specific therapeutic interventions, resulted in significant improvements in the child's social interaction and development. The use of Risperidone helped control some behavioral symptoms. This case highlights the importance of genetic testing in underexplored diagnoses, as well as the essential role of early intervention in improving the quality of life for children with trisomies and ASD.
Homo Sapiens is the most dangerous species ever to live on earth. Compared to other animals, its communications skills are inferior being dependant on speaking but can record language which helps it to make tools most of which are weapons. These skills could be diverted to peaceful purposes. This article describes the behaviour of the species and shows how it can save itself from self-inflicted extinction.�
Clinical and Histological Findings Following a Single Session of Recombinant Enzymes Applied to the Abdomen of Patients with Fibrosis Sequelae from Liposuction
Introduction: Liposuction is the most commonly performed plastic surgery, aimed at improving both the physical appearance of patients and their self-esteem. However, like any surgical intervention, it can present complications. One of the most frequent is contour irregularity, which, although not usually severe, has both physiological and aesthetic implications for the patient. Objective: The general objective of the research is to observe the histological and clinical changes in the abdominal skin of five women who developed fibrosis as a complication of an abdominal liposuction performed more than two years ago, following a single application of recombinant enzymes. This will be done by describing these changes, analyzing the relationship between clinical and histological findings, and comparing the results before and after the enzyme application. Methods: The study is a descriptive longitudinal one, conducted on 5 women between the ages of 33 and 60 with post-liposuction fibrosis, without previous treatments except for massages and radiofrequency. The cases were selected through simple random sampling. Both photographic records and biopsies were taken before and after the enzyme application. Results: The results showed significant clinical improvement in skin quality and texture, with a reduction in lumpiness and contour regularization. Histologically, a decrease in collagen basophilia and inflammatory response was observed, as well as a decrease in fragmented elastic fibers and an increase in intact elastic fibers. Regarding collagen fibers, greater integrity and homogeneity were noted. Conclusion: The application of recombinant enzymes resulted in significant clinical and histological improvements. This treatment proved to be safe, reliable, and easy to apply, with high patient satisfaction, suggesting its potential to replace more invasive treatments in the management of post-liposuction fibrosis.
Bilateral Thalamic Stroke in a Young Adult: A Rare Presentation of Artery of Percheron Infarction
Artery of Percheron (AOP) infarcts are rare ischemic strokes resulting from occlusion of a solitary arterial variant supplying the paramedian thalami and rostral midbrain. We present the case of a 26-year-old previously healthy female who presented with acute altered consciousness and vertical gaze palsy. MRI brain revealed symmetric bilateral thalamic diffusion restriction, consistent with AOP infarction. This case underscores the importance of considering this rare stroke subtype in young patients presenting with unexplained coma or altered mental status.
Analysis of the Surgical Treatment Results of Large Idiopathic Macular Holes using Tamponade with Internal Limiting Membrane Flaps and Platelet-Rich Plasma
BACKGROUND: Penetrating macular holes of the retina remain today one of the main reasons for a significant loss of central vision, especially in working age patients. At the same time, the mainstream problem are the validity and effectiveness of treatment of large and giant macular holes with a diameter of more than 500�1000 �m. AIM: to optimize the treatment method for patients with large and long-standing macular holes. To analyze the results of treatment of patients with this condition. MATERIALS AND METHODS: In 2023, 56 patients were operated on for idiopathic large macular hole. During vitrectomy, a new surgical technique was used for the macular hole bed tamponade with flaps of the internal limiting membrane in combination with the introduction of platelet-rich plasma. RESULTS: After the resorption of the gas-air mixture (1�1.5 months after surgery), ophthalmoscopically and according to optical coherence tomography data, closure of the macular hole was observed in 51 of 56 operated patients, which amounted to 91.1%. CONCLUSIONS: The surgical treatment technique used allows for closure of large macular holes in 91.1%.
Atrial Flutter with 1:1 Atrioventricular Conduction
Introduction: Generally, atrial flutter leads 2:1 to the ventricles. It rarely leads 1:1, with states of cardiogenic shock. Due to the very fast ventricular rate. Objetives: To present patients with atrial flutter, with 1:1 atrioventricular conduction. Explain diagnostic methods. Review production mechanisms. Define the causes of presentation in exposed. patients. Mention the behavior and treatment. Methods: The following were taken in to account: Electrocardiogram with heart rate greater tan Identification of atrial flutter waves. Determination of 1:1 atrioventicular conduction. Typing of heart disease. Evaluation of hemodynamic status. Age and sex. Then we proceded to treatment and behavior. Results: Ten patients were observed. Average age 57 (22-72). Ischemic heart disease 4; chronic rheumatic 2; chronic cor pulmonale 2; dilated cardiomyopathy 1 and pre-excitation syndrome 1. Average atrial rate 257 (240-270). Hemodynamic instablity 6. Treatment: electrical cardioversi�n 5; Amiodarone 2; Digoxin 1; descontinuation of Digoxin 1 and spontaneous 1. Vagal maneuver was performed in 5. Digoxin precipitated the arrhythmia in 1,in the rest it was triggered spontaneously. Conclusion: The mayority of cases had heart disease. The arrhythmia can be confused with ventricular tachycardia and paroxismal supraventricular tachycardia. Vagal maneuvers help in the diagnosis. Depending on the state of hemodynamic stability, it card be treated with antiarrhythmics or electrical cardioversi�n.
(Re) Assessing the (in) Efficacy of Traditional Medicine among the NSO and Bakweri of Cameroon: Historical and Contemporary Perspectives
Traditional Medicine (TM) which was pioneer in satisfying man�s health needs posed as one of those cultural aspects of centrality to the social and political economies of most communities in Africa South of the Sahara. Conventional medicine has its roots in traditional healing practices, as many early medical discoveries were derived from traditional herbal knowledge. Otherwise, the base of conventional medicine was first laid by TM. The question of efficacy looms over TM as a serious debate ensues among scholars for example: in Cameroon, as to its effectiveness which have been sustained for more than a century. So, though TM among the Nso and Bakweri was widely known for its effectiveness in the nineteenth and twentieth centuries, it seems as though sparsely and at times administration of herbal treatment did not meet up to expectations as diseases it was intended to treat or heal persisted despite administration of herbal concoctions. Reasons account for this backdrop which are pinpointed and analysed herein. Inter-disciplinarity and content analysis form the methodological blocks of this manuscript, meanwhile primary and secondary sources will be used for data collection. The findings reveal that TM was effective but the activities of some practitioners had/has tempered with the efficacy of TM in one way or the other; deontological concerns/(in)adherence has its paw on the question as far as the efficacy/inefficacy of TM is concerned, the nature of certain illnesses, among others. Overtime, this practice has also evolved with significant improvement in packaging and hygienic conditions. The findings also revealed the fact that though TM failed to treat some illnesses does not demonstrate inefficacy, since individual traditional healers at times failed to respect the norms of treatment.