Corneal Ulcers (Infectious Keratitis)

2022 ◽  
pp. 137-252
Keyword(s):  
Early Recognition ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Microbial Keratitis ◽  
Tissue Destruction ◽  
Infectious Process ◽  
Corneal Ulcers ◽  
Before And After ◽  
Immediate Surgery ◽  
Almost All

Microbial keratitis is an infectious process that occurs due to the proliferation of microorganisms (bacteria, fungi, viruses, and parasites) and associated inflammation and tissue destruction. Smears and cultures are indicated for the isolation of microorganisms and for making the correct diagnosis and immediate initiation of antimicrobial therapy, especially in cases where corneal infiltrate is chronic, large, deep, or atypical. Microbial keratitis is considered a vision-threatening ocular emergency. Therefore, this chapter, which consists of almost all cases studied before and after treatment, highlights the importance of early recognition, isolation of specific microorganisms, and sensitivity-based therapy. Also, the evaluation of these cases helps to show the appearance of the eye after the therapeutic treatment and demonstrates the emergency of immediate surgery to save the eyeball in cases where medical treatment is ineffective. The authors have summarized the treatment options they have used for bacterial, fungal, acanthamoeba, and herpetic keratitis cases.

scholarly journals Open surgery of complex long segment (giant) glomus spinal arteriovenous malformation

2020 ◽  
Vol 17 (1) ◽  
pp. 56-58
Author(s):  
Alok Deo ◽  
Sameer Aryal ◽  
Gopal Raman Sharma
Keyword(s):  
Arteriovenous Malformation ◽  
Early Recognition ◽  
Pediatric Population ◽  
Correct Diagnosis ◽  
Previous History ◽  
Stable Condition ◽  
Spinal Arteriovenous Malformation ◽  
Ct Angiogram ◽  
Long Term Result ◽  
Almost All

Spinal arteriovenous malformation occurring in the pediatric population (under 15 years) initially complain of pain as the first symptom which is often over looked. In almost all, diagnosis is delayed resulting in weakness. Angiogram provides correct diagnosis in all cases. Radical microsurgical excision tends to offer best long-term result. Here we present a 7-year-old girl referred to us for lumbar puncture with provisional suspicion of meningitis. She had history of fever for two days and signs of meningism were present. On examination, she was stable and had complains of headache. Her previous history suggested she had continuous backache since childhood and had visited multiple centers previously for the problem. A detailed work up revealed a long segment spinal space occupying lesion. CT angiogram showed spinal arteriovenous malformation. Laminoplasty and open microsurgical excision of arteriovenous malformation was performed. Her hospital stay was uneventful and was discharged in stable condition. Early recognition, accurate diagnosis and prompt surgical treatment may result in significant improvement of neurological function.

A Brief Review on Dual Target of PARP1 and STAT3 for Cancer Therapy: A Novel Perception

2020 ◽  
Vol 16 (2) ◽  
pp. 115-134
Author(s):  
Kaviarasan Lakshmanan ◽  
Gowramma Byran ◽  
Manal Mohammed
Keyword(s):  
Signaling Pathways ◽  
Single Molecule ◽  
Treatment Options ◽  
Poor Response ◽  
Cytotoxic Agents ◽  
Acquired Drug Resistance ◽  
Single Target ◽  
New Strategy ◽  
Cancer Multiple ◽  
Almost All

Background: Cancer is a disease characterized by the uncontrolled growth and spread of abnormal cells. Around the world, over 10 million cancer cases occur annually. Half of all men and one-third of all women will develop some form of cancer during their lifetime. It is one of the most feared diseases, primarily because half of those diagnosed with cancer die from it. There are several treatments available for cancer. Almost all traditional cytotoxic agents suffer from severe toxicities and other undesirable side effects. Objective: In recent years, the development of targeted medicines has made significant achievements. Unfortunately, though these agents can block key regulators of signaling pathways in cancer, multiple compensatory pathways always attenuate pharmacological effect of single-target drugs. In addition, poor response rates and acquired drug resistance also represent a significant barrier to widespread use of targeted medicines. More recently, a number of combinatorial therapies have expanded treatment options, which can directly block several key signaling pathways and create a synergistic effect. Conclusion: Therefore, in order to overcome these barriers, the present investigation aims to develop a new strategy for designing a single molecule with inhibition of two receptors (PARP1 and STAT3) simultaneously and producing enhanced anti-cancer activity with less and/or null toxicity.

scholarly journals Glioblastoma and MiRNAs

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1581
Author(s):  
Swalih P. Ahmed ◽  
Javier S. Castresana ◽  
Mehdi H. Shahi
Keyword(s):  
Brain Tumors ◽  
Human Body ◽  
Diagnostic Tool ◽  
Poor Prognosis ◽  
Treatment Options ◽  
Diagnosis And Treatment ◽  
Therapeutic Success ◽  
Knowing That ◽  
Almost All ◽  
Cell Signaling Pathways

Glioblastoma (GB) is one of the most common types of lethal brain tumors. Although several treatment options are available including surgery, along with adjuvant chemo and radiotherapy, the disease has a poor prognosis and patients generally die within 14 months of diagnosis. GB is chemo and radio resistant. Thus, there is a critical need for new insights into GB treatment to increase the chance of therapeutic success. This is why microRNA (miRNA) is being potentially considered in the diagnosis and treatment of glioblastoma. The objective of our review is to provide a holistic picture of GB up-regulated and down-regulated miRNA, in relationship with the expression of other genes, cell signaling pathways, and their role in GB diagnosis and treatment. MiRNA treatment is being considered to be used against GB together with radiotherapy and chemotherapy. Moreover, the use of miRNA as a diagnostic tool has also begun. Knowing that miRNAs are isolated in almost all human body fluids and that there are more than 3000 miRNAs in the human genome, plus the fact that each miRNA controls hundreds of different mRNAs, there is still much study needed to explore how miRNAs relate to GB for its proliferation, progression, and inhibition.

scholarly journals Effect of Integrated Neuromuscular Exercise in Physical Education Class on Health-Related Fitness in Female Children

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 312
Author(s):  
Marijana Sinđić ◽  
Draženka Mačak ◽  
Nikola Todorović ◽  
Bianka Purda ◽  
Maja Batez
Keyword(s):  
Physical Education ◽  
Muscular Fitness ◽  
Female Children ◽  
Before And After ◽  
Health Related ◽  
The Republic ◽  
Almost All ◽  
And Control ◽  
Cardiorespiratory Endurance ◽  
Health Related Fitness

Integrated neuromuscular training (INT) showed benefits for improving fundamental movement skills (FMS). However, the INT health-related fitness (HRF) effects are lacking. The current study aimed to determine the effects of INT implemented during physical education (PE) in a primary school in the Republic of Serbia on HRF in female children. The sample consisted of 72 healthy girls who were divided into the intervention (EG: n = 37; mean ± SD: age = 8.17 ± 0.31) and control (CG: n = 35; age = 8.11 ± 0.31) groups. The EG and CG performed the INT program and traditional PE activities two times per week within the first ~15 min of PE class, respectively. The Fitnessgram battery tests assessed the HRF (body composition, cardiorespiratory endurance, muscular fitness, and flexibility) before and after the program. After eight weeks, the EG significantly reduced all fat measures, while the CG decreased only triceps skinfold but to a smaller extent (F = 5.92, p < 0.02, ŋ2 = 0.09). Both groups significantly improved the performance of almost all muscular fitness tests (curl-ups, trunk lift, push-ups); however, the EG increased the push-ups more than the CG (F = 9.01, p < 0.01, ŋ2 = 0.14). The EG additionally improved the modified pull-ups (F = 14.09, p < 0.01, ŋ2 = 0.19) and flexed arm hang (F = 28.82, p < 0.01, ŋ2 = 0.33) tests. The flexibility and cardiorespiratory endurance of both groups did not significantly change after eight weeks. This approach of exercise showed positive acceptance and relatively good results after only eight weeks.

scholarly journals The Demerger Impact upon Sustainable Development of Economic Entities: Evidence from Romania

2021 ◽  
Vol 13 (15) ◽  
pp. 8316
Author(s):  
Camelia Mirela Baba ◽  
Constantin Duguleană ◽  
Marius Sorin Dincă ◽  
Liliana Duguleană ◽  
Gheorghița Dincă
Keyword(s):  
Sustainable Development ◽  
Business Strategies ◽  
The Sustainable Development ◽  
Ex Post ◽  
Before And After ◽  
Almost All ◽  
The Impact ◽  
Profitability Ratios ◽  
Positive Effect

The Covid-19 induced economic crisis has significantly affected almost all businesses from nearly every sector, causing severe financial problems, lack of cash assets, and decrease of revenues. In this context, the economic entities were forced to look for adjustment and rescue solutions of their activities. One possible solution for the recovery and reorganization of economic entities’ activities is demerger. This paper evaluates the impact of demerger upon the sustainable development of economic entities in terms of economic efficiency and financial performances. To achieve this goal, a statistical analysis of profitability ratios before and after the demerger, as well as a structural analysis of 268 demerger projects for the April 2012–April 2021 period, were performed. The results attest there are no significant differences between the ex-ante and ex-post financial performances. However, demerger seems to have a positive effect upon analyzed companies helping them to overcome economic hardships, rethink their business strategies, and continue their activity in the medium and long-term time horizon.

scholarly journals Nonvascular Complications of Injectable Fillers—Prevention and Management

2020 ◽  
Vol 53 (03) ◽  
pp. 335-343
Author(s):  
Kuldeep Singh ◽  
Shahin Nooreyezdan
Keyword(s):  
Early Recognition ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Vascular Complications ◽  
Physical Characteristics ◽  
Clear Understanding ◽  
Type Iv ◽  
Acute Infections ◽  
Tyndall Effect ◽  
Delayed Complications

AbstractInjectable filler treatments have increased in popularity because of enhanced safety profile and improved physical characteristics. ISAPS (International Society of Plastic Surgery) put out global data showing 3.7 million hyaluronic acid (HA) filler procedures in 2018, making it the second most often performed procedure in the world, after botulinum toxin. And these are only ‘those’ performed by qualified plastic surgeons. There was a concomitant increase in both the nonvascular and vascular complications, which coincided with the number and type of filler procedures performed. Filler complications were reviewed from existing literature, and an attempt was made to understand etiology, elucidate clinical features, and clarify optimum treatment strategies for each. Complications can be early or delayed in presentation, early consisting of injection site complications like bruising, edema, and hypersensitivity, Tyndall effect, and intravascular injection. Delayed complications included hypersensitivity type IV, acute infections like cellulitis, abscesses, and herpes and delayed ones like granulomas, biofilms, and atypical mycobacterial infections. These were analyzed and treatment options, protocols, and consensus guidelines were suggested. A clear understanding of facial anatomy, physical characteristics of all fillers used, early recognition, and treatment options of complications will ensure optimum outcomes.

Can a Short Intensive Course Affect Entrepreneurial Ability, Knowledge and Intent, or Further Entrepreneurial Study?

2015 ◽  
Vol 29 (5) ◽  
pp. 397-404 ◽  
Author(s):  
Jon Cornwall ◽  
Jodyanne Kirkwood ◽  
Gavin J. Clark ◽  
Stephen Silvey ◽  
Ruth D. Appleby ◽  
...  
Keyword(s):  
Small Group ◽  
Boot Camp ◽  
Business Development ◽  
Formal Study ◽  
Entrepreneurial Ability ◽  
Entrepreneurial Development ◽  
Before And After ◽  
Business Course ◽  
Almost All ◽  
Intensive Course

The SEED (Student Enterprise Experience in Dunedin) programme was developed as a four-week, intensive entrepreneurial ‘boot camp’ to provide a small group of participants with a highly experiential business course. Using pre-course and post-course surveys, the authors measured the entrepreneurial ability, knowledge and intentions of the sixteen SEED participants to determine whether the programme was successful as an educational format. The results showed that perceived entrepreneurial ability and knowledge significantly improved, while intent increased but not significantly. Almost all participants intended to start a business both before and after the course, while twice as many (six) indicated that they would undertake further formal study in entrepreneurship after the course compared to before. The data suggest that SEED is filling a niche in entrepreneurial development and support for budding entrepreneurs, with the course also facilitating local business development.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

Discontinuation of Medication Overuse in Headache Patients: Recovery of Therapeutic Responsiveness

Cephalalgia ◽  
2006 ◽  
Vol 26 (10) ◽  
pp. 1192-1198 ◽  
Author(s):  
P Zeeberg ◽  
J Olesen ◽  
R Jensen
Keyword(s):  
Drug Withdrawal ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Frequency ◽  
Female Ratio ◽  
Headache Centre ◽  
Before And After ◽  
Male Female Ratio ◽  
Few Data ◽  
Almost All

It is generally accepted that ongoing medication overuse nullifies the effect of prophylactic treatment, although few data support this contention. We set out to describe the treatment outcome in patients withdrawn from medication overuse and relate any improvement to a renewed effect of prophylaxis. For patients with probable medication-overuse headache (pMOH), treated and dismissed from the Danish Headache Centre in 2002 and 2003, we assed, from prospective headache diaries, the headache frequency before and after withdrawal of offending drugs and compared these frequencies with the headache frequency at dismissal. Among 1326 patients, 337 had pMOH. Eligible were 175, mean age 49 years, male/female ratio 1: 2.7. Overall, there was a 46% decrease in headache frequency from the first visit to dismissal ( P < 0.0001). Patients with no improvement 2 months after complete drug withdrawal ( N = 88) subsequently responded to pharmacological and/or non-pharmacological prophylaxis with a 26% decrease in headache frequency as measured from the end of withdrawal to dismissal ( P < 0.0001). At dismissal, 47% were on prophylaxis. Former non-responders to medical prophylaxis had a 49% decrease in headache frequency from first visit to dismissal ( P < 0.0001), whereas those who had never received prophylaxis had a 56% reduction ( P < 0.0001). This difference was not statistically significant ( P = 0.22). Almost all MOH patients benefit from drug withdrawal, either just from the withdrawal or by transformation from therapeutic non-responsiveness to responsiveness. According to the International Classification of Headache Disorders, 2nd edn, the MOH diagnosis requires improvement after drug withdrawal. Our data suggest that these diagnostic criteria are too strict.

Risk factors of postthrombotic syndrome before and after deep venous thrombosis treatment

2016 ◽  
Vol 32 (6) ◽  
pp. 384-389 ◽  
Author(s):  
Rob HW Strijkers ◽  
Mark AF de Wolf ◽  
Cees HA Wittens
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Treatment Options ◽  
Postthrombotic Syndrome ◽  
Factor X ◽  
Catheter Directed Thrombolysis ◽  
Before And After ◽  
Patient Selection Criteria ◽  
The Moment

Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.

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