scholarly journals Prurigo Pigmentosa: A Clinicopathological Report of Three Middle Eastern Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
N. Almaani ◽  
A. H. Al-Tarawneh ◽  
H. Msallam
Keyword(s):  
Middle Eastern ◽  
Sudden Onset ◽  
Clinicopathological Features ◽  
Inflammatory Disorder ◽  
Histological Features ◽  
The Third ◽  
Strict Diet ◽  
Postinflammatory Hyperpigmentation ◽  
High Index Of Suspicion ◽  
Distinct Features

Prurigo pigmentosa is a unique cutaneous inflammatory disorder characterized by a sudden onset of pruritic and erythematous macules, urticarial papules, and plaques that may coalesce to form a reticulated pattern. Lesions typically heal within weeks leaving a reticulated and mottled postinflammatory hyperpigmentation. The majority of reported cases originate from Japan with much fewer cases described worldwide without predominant ethnicity. The histopathological features of prurigo pigmentosa can be nonspecific; however, distinct features exist for each stage of the disease. The aetiology of prurigo pigmentosa is not fully understood. However, ketoacidosis has been implicated in the pathogenesis and indeed prurigo pigmentosa has been associated with ketoacidotic states such as diabetes mellitus, fasting, dieting, and anorexia nervosa. In this report, we present 3 Jordanian patients with prurigo pigmentosa and describe their clinicopathological features. One patient developed prurigo pigmentosa while fasting during the month of Ramadan and another was undertaking a strict diet. No associations were identified in the third patient. In view of the largely nonspecific clinical and histological features, a high index of suspicion is required as many cases of prurigo pigmentosa are probably undiagnosed.

A New Ancient Middle Eastern Chronological Model

2019 ◽  
Vol 28 (2) ◽  
Author(s):  
Willem McLoud
Keyword(s):  
Middle Eastern ◽  
Total Period ◽  
The Third ◽  
Primary Focus

In this paper, I argue for a new ancient Middle Eastern chronology in which the Mesopotamian “high” chronology is used in correlation with K. A. Kitchen’s “low” chronology for the Egyptian Twelfth Dynasty. Although my primary focus is on the Akkadian empire and the Fifth and Sixth Dynasties in Egypt, I also show that this chronological reconciliation obtains widespread consistency with data over the total period of Egyptian and Mesopotamian civilisation throughout the third and second millennia B.C. I also discuss the Hebrew chronology in the framework of this new ME chronology.

Abdominal apoplexy during pregnancy

2020 ◽  
Vol 13 (10) ◽  
pp. e235946
Author(s):  
Jasmeet Kumari ◽  
Rosemary Harkin
Keyword(s):  
Iliac Fossa ◽  
Unknown Origin ◽  
Breech Presentation ◽  
Sudden Onset ◽  
Left Iliac Fossa ◽  
Safe Delivery ◽  
Uterine Contractions ◽  
Early Labour ◽  
Increased Risk ◽  
High Index Of Suspicion

We report a case of idiopathic spontaneous intraperitoneal haemorrhage (ISIH) in a 31-year-old patient at 37 weeks gestation in her second pregnancy. The patient presented to the labour ward with abdominal pain and uterine contractions. The initial complain was of sudden onset, severe sharp pain in left iliac fossa. She started having uterine contractions within 30 min of her presentation. Examination confirmed early labour with a footling breech presentation. Urgent caesarean section was performed that confirmed peritoneal bleeding of unknown origin with safe delivery of the baby. Mother and baby were safely discharged on day 5. ‘Abdominal apoplexy’ (ISIH), is a rare obstetric emergency with increased risk of fetal and maternal morbidity and mortality. With various clinical presentations as a possibility, diagnosis is challenging. High index of suspicion with prompt management of suspected cases can be pivotal life saving measure for the fetus and mother.

Relational key account management: insights from the Middle Eastern context

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nada Saleh Badawi ◽  
Moustafa Battor ◽  
Saeed Badghish
Keyword(s):  
Social Capital ◽  
Relationship Quality ◽  
Middle Eastern ◽  
Key Account Management ◽  
Content Type ◽  
The Third ◽  
Account Management ◽  
Key Account ◽  
Multiple Case ◽  
Key Accounts

Purpose The purpose of this study is to explore relational aspects of key account management (KAM) in terms of social capital and relationship quality. The second objective was to identify the main dimensions that shape social capital and relationship quality within the KAM context. Finally, the third objective was to explore how relational KAM is practiced in the Middle Eastern context. Design/methodology/approach This study used a qualitative methodology and a multiple case design. Semi-structured interviews were carried out with a sample of senior executives from large Saudi firms. Findings The results highlight the importance of relationship quality and social capital to KAM implementation. A multiple case study was used to build a relational framework for KAM in the Middle Eastern context. Practical implications Three strategies were identified for use within the context of KAM in the Saudi market. The first strategy consisted of a means of attracting potential customers. The second strategy involved communication, aimed at maintaining frequent contact with key accounts. Finally, the third strategy was concentrated in maintenance to help sustain the relationship with key accounts. Originality/value This study extends understanding and the application of KAM to the Middle Eastern context, contributing to social capital, relationship quality and the KAM literature.

scholarly journals Hypomelanosis of Ito: Case report of a rare neurocutaneous syndrome in a neonate and review of the literature.

1970 ◽  
Vol 42 (3) ◽  
pp. 231-233
Author(s):  
M Mukhtar-yola ◽  
LI Audu ◽  
AT Otuneye ◽  
AB Mairami ◽  
EC Otubelu ◽  
...  
Keyword(s):  
Case Report ◽  
High Index ◽  
Review Of The Literature ◽  
Cutaneous Lesions ◽  
Hypomelanosis Of Ito ◽  
The Third ◽  
Neurocutaneous Syndrome ◽  
Paediatric Practice ◽  
High Index Of Suspicion

Hypomelanosis of Ito (HI) though said to be the third most common neurocutaneus disorder, is rarely reported in paediatric practice in Africa. A high index of suspicion must be maintained in children with cutaneous lesions as a seizure may be the first symptom that may bring the child to attention. A case of HI in a neonate is hereby reported to sensitize clinicians about this relatively uncommon disorder

scholarly journals Carpometacarpal Dislocation of the Third to Fifth Fingers and an Associated Fracture of the Hamate in a Military Paratrooper

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Georgios Kalinterakis ◽  
Emmanouil Antonogiannakis ◽  
Arezoo Abdi ◽  
Georgios Demetriades ◽  
Alexandros Koulouktsis ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Functional Results ◽  
Concomitant Injuries ◽  
Military Hospitals ◽  
The Third ◽  
Carpometacarpal Joints ◽  
Orthopedic Surgeons ◽  
Term Basis ◽  
Great Force ◽  
High Index Of Suspicion

Multiple carpometacarpal dislocations with a simultaneous fracture of the hamate represent less than 1% of all injuries to the hand and wrist regions, with a scarcity of published cases. These injuries usually require a great force, and diagnosis can be missed or delayed because of the high likelihood of other severe concomitant injuries. We report a case of acute closed dislocation of the third through fifth carpometacarpal joints and an associated fracture of the hamate in a military paratrooper. The injury was caused by a wrong landing technique during parachuting. The patient was managed with primary surgical repair, and after a six-month follow-up, he has excellent functional results. The fact that both this clinical entity and the mechanism of injury are very unusual a high index of suspicion is needed, especially for orthopedic surgeons working in military hospitals. Additionally, given that there is a paucity of published cases and optional treatment is controversial, this study corroborates the superiority of surgical repair in a long-term basis.

scholarly journals Optimal Thermal Characteristics of the Courtyard in the Hot and Arid Climate of Isfahan

Buildings ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. 166 ◽  
Author(s):  
Roya Hasehzadeh Haseh ◽  
Mehdi Khakzand ◽  
Morteza Ojaghlou
Keyword(s):  
Thermal Comfort ◽  
Middle Eastern ◽  
Thermal Characteristics ◽  
Arid Climate ◽  
Second Step ◽  
Traditional Architecture ◽  
Optimal Form ◽  
The Third ◽  
Simulation Process

The courtyard is a common and traditional architectural concept in Middle Eastern countries, especially Iran. This study presents practical solutions to arrive at the optimal form and features of a courtyard based on this traditional architecture to cope with the hot and arid climate of Isfahan, Iran. A model using the ENVI-met 3.1 software was used to simulate the courtyard orientation, the height of the wall enclosure, the albedo of the materials and the vegetation level in Isfahan. As the first step of the simulation, different orientations were simulated. Based on the results, the northern courtyard is recommended as the optimum orientation for the remainder of the simulation process. A high wall enclosure is recommended in the second step of simulation to ensure cool temperatures at noon and warmth at night. In the third step, it is advised to use low-albedo material in the courtyards to avoid the extra reflected radiation of used materials on the inhabitants. The final step suggests that more than 50% of the courtyard plan should be covered by greenery to ensure thermal comfort in the courtyards. Based on these suggestions, designers can create more sustainable courtyards that are better suited to the hot and arid climate of Isfahan.

scholarly journals Proximal peroneal artery traumatic pseudoaneurysm following a compound proximal tibial shaft fracture managed with an external fixator: A case report

2019 ◽  
Vol 27 (1) ◽  
pp. 89-92
Author(s):  
Malinda Rasith Ileperuma ◽  
Badra Hewavithana
Keyword(s):  
External Fixator ◽  
Rare Complication ◽  
Shaft Fracture ◽  
Sudden Onset ◽  
Peroneal Artery ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Artery Pseudoaneurysm ◽  
Initial Injury ◽  
High Index Of Suspicion

A case of post-traumatic proximal peroneal artery pseudoaneurysm following a proximal tibial shaft fracture, complicated by acute compartment syndrome, fixed using an external fixator, in a 22-year-old female is presented. She was investigated for sudden-onset bleeding from the external fixator pin site, 6 weeks after the initial injury, was anaemic and diagnosed with a pseudoaneurysm at lower limb angiography. Contrast leak from the site of pseudoaneurysm was noted and open surgery with ligation of the pseudoaneurysm was performed. This rare complication of a proximal tibial shaft fracture has to be considered in patients presenting with acute bleeding from the surgical site or from pin sites after a significant lag period and requires a high index of suspicion.

scholarly journals Postmoderne epistemologie en postkoloniale hermeneutiek

2004 ◽  
Vol 60 (3) ◽  
Author(s):  
Andries G. Van Aarde
Keyword(s):  
South Africa ◽  
Third World ◽  
Middle Eastern ◽  
Postcolonial Studies ◽  
Biblical Studies ◽  
The Third ◽  
Biblical Texts ◽  
The Third World

Postmodern epistemology and postcolonial hermeneuticsPostcolonial hermeneutics is concerned with linguistic, cultural and geographical transfer. Within the framework of biblical studies it explores strategies of interpreting texts from the situation of previously colonised people who are accommodated in a new liberated context, but find themselves both included and excluded. Biblical texts are historically considered to be both the products of people who were subjected to the exploitation of Middle-Eastern and Graeco-Roman super powers and interpreted today in the third world by people who also were subjects of modern colonial powers. Postcolonial studies represent a postmodern epistemology which implies a deconstructive approach to hermeneutics. The article consists of five “preludes”, introducing postmodern epistemology, postcolonial hermeneutics, postcolonial biblical studies, and unlocking potential biblical research in South Africa.

A study of Xianbei tombs

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Zheng Wei
Keyword(s):  
Lake Baikal ◽  
Inner Mongolia ◽  
River Valley ◽  
The West ◽  
Fourth Group ◽  
Liaohe River ◽  
The Third ◽  
Western Side ◽  
Northern Wei ◽  
Distinct Features

AbstractThe present paper divides the generally recognized Xianbei tombs into five groups. The first group is in the Hailar River valley; the second group, in the West Liaohe River valley; the third group, in the Chaoyang area; the fourth group, along the boundary between Inner Mongolia and Shanxi; and the fifth group, in northern Shanxi, middle Inner Mongolia and the zone a little west of them. In cultural aspect, the tombs of the second group present Xianbei features in pottery but distinct difference from the already affirmed Xianbei graves in burial manner. Referring to literature records, it may be reasonable to attribute them to the Wuhuan rather than to the Eastern Xianbei. The tombs of the third group centering on Chaoyang belong to the Murong Xianbei and present distinct features related to the second group tombs, which suggests that the Murong Xianbei culture may have partly inherited the Wuhuan culture. The fifth group tombs are the closest to the Northern Wei burials so far excavated, so they may represent the source of the Tuoba Xianbei culture. The first group of remains can hardly be taken as the direct forerunner of the fifth group graves and Northern Wei tombs, so they may have belonged to the Eastern Xianbei rather than to the Tuoba Xianbei. As the fifth group tombs show certain similarity in grave goods to the fourth group that may have belonged to Tan Shihuai’s reign, to speak in temporal terms, it was hardly possible that the Tuoba Xianbei entered the Datong area through the route on the western side of the Greater Khingan Mountains. Moreover, as the fifth group tombs are related to a certain extent to the Xiongnu tombs near Lake Baikal, it can be inferred that the Tuoba Xianbei originated in the northern Greater Khingan Mountains, then went into the zone near Hulun Buir, from there migrated southwestwards, and later, turning eastwards, entered the middle area of present-day Inner Mongolia.

scholarly journals Clonidine Toxicity: One or More Tablets can be Dangerous in Toddlers

2019 ◽  
Vol 39 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Sandesh Kini ◽  
Ramesh Bhat Y ◽  
Phalguna Kousika ◽  
Chennakeshava Thunga
Keyword(s):  
Respiratory Failure ◽  
Attention Deficit ◽  
Healthy Child ◽  
Ventilatory Support ◽  
Sudden Onset ◽  
High Index ◽  
Case Scenario ◽  
Attention Deficit Hyperactive Disorder ◽  
Hypertensive Drug ◽  
High Index Of Suspicion

Clonidine was a popular anti-hypertensive drug during the 1970s but is less commonly used now. In children clonidine is used to treat attention deficit hyperactive disorder (ADHD). We report a toddler who accidentally ingested 0.3 mg of clonidine and developed respiratory failure with hypotension requiring ventilatory support and inotropes but recovered completely within one week. In any case scenario, when a previously healthy child presents with sudden onset respiratory failure, we should keep a high index of suspicion of clonidine use by anyone at home and its easy accessibility to the child.   

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