Prediction of visceral leishmaniasis incidence using the Seasonal Autoregressive Integrated Moving Average model (SARIMA) in the state of Maranhão, Brazil

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.

Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.

Prediction of visceral leishmaniasis incidence using the Seasonal Autoregressive Integrated Moving Average model (SARIMA) in the state of Maranhão, Brazil / Previsão da incidência da leishmaniose visceral usando o modelo de média móvel integrado autorregressivo sazonal (SARIMA) no Maranhão, Brasil

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.

Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.

E-learning among 2-year MBBS students in a Government Medical College in South India – A KAP study

Background: E-learning or electronic learning is a popular modality to address the educational needs of a population. In the context of medical education, E-learning is useful but has its limitations. Aim and Objectives: This study was conducted among 2-year MBBS students of a Government Medical College in South India to know their knowledge, attitude, and practice of E-learning and also to learn from their experiences during the COVID pandemic. Materials and Methods: After obtaining informed consent, students were asked to fill up a questionnaire containing 15 questions in Google Forms and submit it. Results: This study shows that more than 70% of students consider themselves capable of using computers for everyday activities. They also reported using search engines and online animations for updated medical information. However, they preferred their course content to be delivered through blended learning, a combination of classroom and E-learning. The students reported poor internet connectivity as a major limitation in E-learning. They also suggested having a separate website for each college where the teaching material can be uploaded by the faculty and can be accessed by all the students of the institution. Conclusion: From this study, it can be concluded that a majority of students have good knowledge and are already using E-learning modalities. They are also open to the idea of blended learning for clinical cases.

Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in Campos do Jordão State Park, São Paulo, Brazil / Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) no Parque Estadual de Campos do Jordão, São Paulo, Brasil

The aim of this paper was recording the occurrence of the species Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in lotic systems of the State of São Paulo. Specimens were collected in Sapucaí River, located in Campos do Jordão State Park. The mapping of geographical distribution of this species is of interest to public health since L. variegatus may be an intermediate host of Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), a parasite of recognized zoonotic potential. Distribution data serves as a basis for environmental monitoring and evaluation, being essential to map possible cases of the disease (Dioctophimosis) and provide information to health professionals.

O objetivo deste trabalho foi registrar a ocorrência de Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) em um sistema lótico do Estado de São Paulo. Os espécimes foram coletados no rio Sapucaí, localizado no Parque Estadual de Campos do Jordão. O mapeamento da distribuição geográfica desta espécie é de interesse para saúde pública uma vez que L. variegatus pode ser um hospedeiro intermediário de Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), parasito de reconhecido potencial zoonótico. Dados de distribuição servem de base para monitoramento e avaliação ambiental, sendo essenciais para mapear possíveis casos da doença (Dioctofimose) e fornecer informações para profissionais de saúde.

Gonadal characterization of the Amazonian fish Serrapinnus kriegi (Characidae: Cheirodontinae) / Caracterização gonadal do peixe Amazônico Serrapinnus kriegi (Characidae: Cheirodontinae)

The knowledge of the testicular and ovarian morphology of a particular fish species is of paramount importance. Such analyze enables the development of studies and techniques aiming the improvement of their reproduction, management, commercialization and even their conservation. This study performed the ovarian and testicular characterization of the ornamental Amazon fish Serrapinnus kriegi. A total of three males and three females had their gonads analyzed by optical microscopy. Females present ovaries filled with oocytes in asynchronous development, indicating partial spawning in the species. Moreover, the micropyle and micropilar cell formation was observed in primary growing oocytes, representing a precocious oocyte development; and the zona radiata in the final vitellogenic oocytes is thicker than other related species, evidencing the development of a better protection to the embryos in function of the waters’ turbulence that characterize it spawning sites in the Amazonian streams. The male specimens’ present anastomosed tubular testes with unrestricted spermatogonia spread along the entire seminiferous tubules. The present data elucidate the dynamic of spermatogenesis and oogenesis of an ornamental Amazonian species, through the description of the male and female germ cells development.

O conhecimento da morfologia testicular e ovariana de uma determinada espécie de peixe é de suma importância, pois através destas análises é possível o desenvolvimento de estudos e técnicas visando o melhoramento de sua reprodução, manejo e comercialização e até mesmo auxiliar em sua conservação. Este estudo realizou a caracterização ovariana e testicular do peixe Amazônico ornamental Serrapinnus kriegi. Um total de três machos e três fêmeas tiveram suas gônadas analisadas através de microscopia óptica. As fêmeas apresentam ovários preenchidos por oócitos em desenvolvimento assincrônico, indicando desova parcelada da espécie. Além disso, observou-se a formação de micrópila e célula micropilar em oócitos em crescimento primário, representando o desenvolvimento precoce do oócito; a zona radiata nos oócitos vitelogênicos finais é mais espessa em comparação a outras espécies relacionadas, evidenciando o desenvolvimento de uma melhor proteção aos embriões, em função das águas turbulentas que caracterizam seu local de desova nos córregos amazônicos. Os machos apresentam testículos do tipo tubular anastomosado com espermatogônias irrestritas, espalhadas por todo o túbulo seminífero. Os dados apresentados elucidam a dinâmica da espermatogênese e oogênese de uma espécie de peixe ornamental amazônica, por meio da descrição das células germinativas masculinas e femininas.

Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in Campos do Jordão State Park, São Paulo, Brazil

Abstract The aim of this paper was recording the occurrence of the species Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in lotic systems of the State of São Paulo. Specimens were collected in Sapucaí River, located in Campos do Jordão State Park. The mapping of geographical distribution of this species is of interest to public health since L. variegatus may be an intermediate host of Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), a parasite of recognized zoonotic potential. Distribution data serves as a basis for environmental monitoring and evaluation, being essential to map possible cases of the disease (Dioctophimosis) and provide information to health professionals.

Resumo O objetivo deste trabalho foi registrar a ocorrência de Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) em um sistema lótico do Estado de São Paulo. Os espécimes foram coletados no rio Sapucaí, localizado no Parque Estadual de Campos do Jordão. O mapeamento da distribuição geográfica desta espécie é de interesse para saúde pública uma vez que L. variegatus pode ser um hospedeiro intermediário de Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), parasito de reconhecido potencial zoonótico. Dados de distribuição servem de base para monitoramento e avaliação ambiental, sendo essenciais para mapear possíveis casos da doença (Dioctofimose) e fornecer informações para profissionais de saúde.

Gonadal characterization of the Amazonian fish Serrapinnus kriegi (Characidae: Cheirodontinae)

Abstract The knowledge of the testicular and ovarian morphology of a particular fish species is of paramount importance. Such analyze enables the development of studies and techniques aiming the improvement of their reproduction, management, commercialization and even their conservation. This study performed the ovarian and testicular characterization of the ornamental Amazon fish Serrapinnus kriegi. A total of three males and three females had their gonads analyzed by optical microscopy. Females present ovaries filled with oocytes in asynchronous development, indicating partial spawning in the species. Moreover, the micropyle and micropilar cell formation was observed in primary growing oocytes, representing a precocious oocyte development; and the zona radiata in the final vitellogenic oocytes is thicker than other related species, evidencing the development of a better protection to the embryos in function of the waters turbulence that characterize it spawning sites in the Amazonian streams. The male specimens present anastomosed tubular testes with unrestricted spermatogonia spread along the entire seminiferous tubules. The present data elucidate the dynamic of spermatogenesis and oogenesis of an ornamental Amazonian species, through the description of the male and female germ cells development.

Resumo O conhecimento da morfologia testicular e ovariana de uma determinada espécie de peixe é de suma importância, pois através destas análises é possível o desenvolvimento de estudos e técnicas visando o melhoramento de sua reprodução, manejo e comercialização e até mesmo auxiliar em sua conservação. Este estudo realizou a caracterização ovariana e testicular do peixe Amazônico ornamental Serrapinnus kriegi. Um total de três machos e três fêmeas tiveram suas gônadas analisadas através de microscopia óptica. As fêmeas apresentam ovários preenchidos por oócitos em desenvolvimento assincrônico, indicando desova parcelada da espécie. Além disso, observou-se a formação de micrópila e célula micropilar em oócitos em crescimento primário, representando o desenvolvimento precoce do oócito; a zona radiata nos oócitos vitelogênicos finais é mais espessa em comparação a outras espécies relacionadas, evidenciando o desenvolvimento de uma melhor proteção aos embriões, em função das águas turbulentas que caracterizam seu local de desova nos córregos amazônicos. Os machos apresentam testículos do tipo tubular anastomosado com espermatogônias irrestritas, espalhadas por todo o túbulo seminífero. Os dados apresentados elucidam a dinâmica da espermatogênese e oogênese de uma espécie de peixe ornamental amazônica, por meio da descrição das células germinativas masculinas e femininas.

Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in Campos do Jordão State Park, São Paulo, Brazil / Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) no Parque Estadual de Campos do Jordão, São Paulo, Brasil

Abstract The aim of this paper was recording the occurrence of the species Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) in lotic systems of the State of São Paulo. Specimens were collected in Sapucaí River, located in Campos do Jordão State Park. The mapping of geographical distribution of this species is of interest to public health since L. variegatus may be an intermediate host of Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), a parasite of recognized zoonotic potential. Distribution data serves as a basis for environmental monitoring and evaluation, being essential to map possible cases of the disease (Dioctophimosis) and provide information to health professionals.

Resumo O objetivo deste trabalho foi registrar a ocorrência de Lumbriculus variegatus (Müller, 1774) (Oligochaeta, Lumbriculidae) em um sistema lótico do Estado de São Paulo. Os espécimes foram coletados no rio Sapucaí, localizado no Parque Estadual de Campos do Jordão. O mapeamento da distribuição geográfica desta espécie é de interesse para saúde pública uma vez que L. variegatus pode ser um hospedeiro intermediário de Dioctophyme renale (Goeze, 1782) (Nematoda, Dioctophymatidae), parasito de reconhecido potencial zoonótico. Dados de distribuição servem de base para monitoramento e avaliação ambiental, sendo essenciais para mapear possíveis casos da doença (Dioctofimose) e fornecer informações para profissionais de saúde.

Gonadal characterization of the Amazonian fish Serrapinnus kriegi (Characidae: Cheirodontinae) / Caracterização gonadal do peixe Amazônico Serrapinnus kriegi (Characidae: Cheirodontinae)

Abstract The knowledge of the testicular and ovarian morphology of a particular fish species is of paramount importance. Such analyze enables the development of studies and techniques aiming the improvement of their reproduction, management, commercialization and even their conservation. This study performed the ovarian and testicular characterization of the ornamental Amazon fish Serrapinnus kriegi. A total of three males and three females had their gonads analyzed by optical microscopy. Females present ovaries filled with oocytes in asynchronous development, indicating partial spawning in the species. Moreover, the micropyle and micropilar cell formation was observed in primary growing oocytes, representing a precocious oocyte development; and the zona radiata in the final vitellogenic oocytes is thicker than other related species, evidencing the development of a better protection to the embryos in function of the waters' turbulence that characterize it spawning sites in the Amazonian streams. The male specimens' present anastomosed tubular testes with unrestricted spermatogonia spread along the entire seminiferous tubules. The present data elucidate the dynamic of spermatogenesis and oogenesis of an ornamental Amazonian species, through the description of the male and female germ cells development.

Resumo O conhecimento da morfologia testicular e ovariana de uma determinada espécie de peixe é de suma importância, pois através destas análises é possível o desenvolvimento de estudos e técnicas visando o melhoramento de sua reprodução, manejo e comercialização e até mesmo auxiliar em sua conservação. Este estudo realizou a caracterização ovariana e testicular do peixe Amazônico ornamental Serrapinnus kriegi. Um total de três machos e três fêmeas tiveram suas gônadas analisadas através de microscopia óptica. As fêmeas apresentam ovários preenchidos por oócitos em desenvolvimento assincrônico, indicando desova parcelada da espécie. Além disso, observou-se a formação de micrópila e célula micropilar em oócitos em crescimento primário, representando o desenvolvimento precoce do oócito; a zona radiata nos oócitos vitelogênicos finais é mais espessa em comparação a outras espécies relacionadas, evidenciando o desenvolvimento de uma melhor proteção aos embriões, em função das águas turbulentas que caracterizam seu local de desova nos córregos amazônicos. Os machos apresentam testículos do tipo tubular anastomosado com espermatogônias irrestritas, espalhadas por todo o túbulo seminífero. Os dados apresentados elucidam a dinâmica da espermatogênese e oogênese de uma espécie de peixe ornamental amazônica, por meio da descrição das células germinativas masculinas e femininas.

Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.

Aspects épidémiologiques, cliniques, thérapeutiques et évolutifs des maladies thyroïdiennes à Bouaké (Côte d'Ivoire) / Epidemiological, clinical, therapeutic and evolutionary aspects of thyroid deseases in Bouake (Ivory Coast)

Contexte : la maladie thyroïdienne représente la plus fréquente endocrinopathie dans le monde après le diabète sucré. En Afrique, elle constitue un véritable problème de santé publique et sa prise en charge est souvent entravée par les moyens d'investigations. Le but était d'étudier le profil des affections thyroïdiennes à Bouaké. Méthodes : il s'agissait d'une étude rétrospective, descriptive, menée dans le service de consultation de Médecine Interne du Centre Hospitalier Universitaire de Bouaké du 1er janvier 2020 au 31 décembre 2021. Elle a porté sur les dossiers de 104 patients suivis pour une pathologie thyroïdienne. Résultats : Sur 2560 patients reçus, la pathologie thyroïdienne concernait 104 patients ; soit une fréquence de 4,1%. Il s'agissait de 93 femmes et 11 hommes avec un sex-ratio (H/F) de 0,12 L'âge moyen était de 42,03 ans ±15 ans. Dans plus de la moitié des cas (55,8%), le délai de consultation était supérieur à 06 mois. Sur le plan fonctionnel, 58 patients (55,8%) présentaient une hyperthyroïdie avec comme principales étiologies la maladie de Basedow (60,3%, n=35) et le goitre multinodulaire toxique (24,1%, n=14). L'hypothyroïdie était retrouvée chez 10 patients (9,6%), le plus souvent post thyroïdectomie (60%). Les goitres et nodules euthyroïdiens étaient retrouvés chez 36 patients (34,6%) dominés par le goitre multinodulaire euthyroïdien (36,1%, n=13) et le goitre simple (27,8%, n=10). Le traitement des hyperthyroïdies reposait essentiellement sur les antithyroïdiens de synthèse dans 96,7%. Seulement 1 patient hyperthyroïdien avait subi une thyroïdectomie. La majorité des patients (82,2%) étaient perdus de vue. Conclusion : La pathologie thyroïdienne au CHU de Bouaké est une maladie fréquente de la femme jeune. Les hyperthyroïdies dominent le tableau des thyréopathies avec comme principale étiologie la maladie de Basedow. On note un taux élevé de perdu de vue, d'où l'intérêt d'une éducation de nos patients.

Context: Thyroid disease is the most common endocrinopathy observed in the world. In Africa, thyroid diseases remain a real public health problem and their care is often hampered by the means of investigation. The purpose of this work was to study the profile of thyroid affections in Bouake. Methods: This was a descriptive study with retrospective data collection, carried out over the period from 1 January 2020 to 31 December 2021 at the Internal Medicine consultation at the University Hospital of Bouake. All epidemiological, clinical and therapeutic and evolutionary data from patients followed for thyroid pathology were collected. It focused on the records of 104 patients followed for thyroid disease. Results: Out of a total of 2560 consultations, 104 patients were involved in thyroid pathology, prevalence of 4.1%. They were 93 women and 11 men with a sex ratio of 0.12. The average age was 42.03±15.64 years. In more than half of the patients (55.8%) the evolution of the clinical symptomatology was more than six months. A total of 58 patients (55.8%) had hyperthyroidism. The etiologies of hyperthyroidism were dominated by Grave's disease and toxic multinodular goiter, with 60.3% and 24.1% of hyperthyroidism respectively. Hypothyroidism was confirmed in 10 patients (9.6%), among then 6 (60%) had undergone total thyroidectomy. The multinodular goiter was found in 36 patients and was dominated by multinodular goiter (36.1%) and single goiter (27.8%). The treatment of hyperthyroidism was exclusively with synthetic antithyroid drugs. Hypothyroidism was treated with hormone replacement therapy. The majority of patients (82.2%) were lost in view. Conclusion: The thyroid pathology at the University Hospital Center of Bouake is a frequent illness of the young woman. Hyperthyroidism were frequently found with as main etiology Grave's disease The majority of patients (82.2%) were lost in view hence the interest of patient's education.

Impact of Habitat on the Development of Coprophagous and Xylophagous Coleopteran Insects in the Park of Bamimgui-Bangoran (Central African Republic)

Coprophagous and Xylophagous Coleopterans are equally impacted by the fragmentation of ecosystems and are recognized for their character as indicators of certain ecosystem functions, such as the recycling of organic matter and pollination. Thus, as part of the program to restore degraded ecosystems in protected areas and others sectors of the Bamingui-Bangoran Prefecture in the Central African Republic (CAR), an inventory of insect species according to their ecological profile is needed. Insects were collected over 8 hectares corresponding to 6 different habitats in the Bamingui-Bangoran park. Sixty different traps were installed in each habitat with 100 meters of distance between the traps. The measured parameters are the number of individuals collected per week. As results, 8 coleopteran families (4 Coprophagous families and 4 Xylophagous families) were identified. The Coprophagous and Xylophagous Coleopterans were much abounded in grassy savannahs with much mixing trees with Imperata cylindrica and in grassy and shrubby savannas with many flowering plants (Melliferous) and less abounded in grassy and shrubby savannahs domined by Imperata cylindrica. However, repartitions of individuals fit uniform distribution in all coleopteran families belonging to Xylophagous group whereas in Coprophagous, uniform distribution fit was established only for one family.

Bite Marks: Indispensable Forensic Evidence

Introduction: Forensic odontology involves the collection, management, interpretation, evaluation, and presentation of dental evidence for criminal or civil legal proceedings, a combination of various aspects of the dental, scientific and legal professions. Bite mark analysis is an essential aspect of it that can significantly impact the courtroom or when considering the care of children and women deemed at risk. Materials and Methods: Data were obtained and analyzed from previously published literature and electronic database searches of relevant published literature from PubMed and Google Scholar. Forensic odontologists examine, interpret, analyze, and prepare reports on bruises or marks thought to be caused by teeth and, on occasion, are cross-examined in a court of law. Hence, they are considered essential in forensic dentistry in solving crimes to find either suspects or even victims in self-inflicted injuries as they are caused either by humans or animals that reveal biting edges, spacing, restorations, missing teeth, broken teeth, or supernumerary teeth unique to that individual. The main reasons for causation are sexual crimes, homicides, child abuse, and violent fights. There are many methods to analyze, that are classified into manual, semi-automatic, and automatic methods. Objectives: This review highlights the bite marks in detail about their characteristics, methods of collection and different methods of analysis and its applications in forensic odontology. Conclusion: This review shows different methods of analyzing bitemarks and explains the advantages, disadvantages, and limitations, and identifies which method is better advisable and adaptableforanalysis.

Importance and Utility of Trisutra in Teaching, Research and Clinical Practice

The aim of Ayurveda is to maintain the health of individuals. It is accomplished through the two objectives; curing disease in the diseased and preventing disease in the healthy. For this purpose Ayurveda, the science of life is presented in the form of Trisutra (three aphorisms). They are Hetu (etiological factors), Linga (symptomatology) and Oushadha (therapeutics). The causative factors for the derangement of health and its reversal are coming under the purview of Hetu. Generally, excess, deficient and wrong union of sense objects, action and time result in diseases and health is the outcome of their proper union. Linga represents the clinical features of health and disease. Oushadha include drugs, therapies, wholesome diet and lifestyle which are intended to cure the disease and promote health. The entire Ayurveda is coded in these three aphorisms, hence it is known as Trisutra Ayurveda. The term Triskanda (three pronged) is synonymously used with Trisutra. The present knowledge of Ayurveda was evolved by the decipherment and elaboration of Trisutra through continuous research processes. Ayurveda compendia were designed in the order of Trisutra, Hetu, Linga and then Oushadha for the effective teaching and learning. Trisutra forms the ground for research in Ayurveda. Fundamental and applied researches in Ayurveda are primarily based on these three principles. Thorough understanding of Trisutra is essential for the accurate diagnosis of diseases and planning of effective management for them

A Review on Ayurvedic Perspective of PCOS

Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. It is characterized clinically as a combination of ovulatory dysfunction, hyper androgenic state and abnormal ovarian morphology. Women with PCOS are at increased risk of presenting with menstrual irregularities, hirsutism, obesity, insulin resistance, impaired glucose tolerance, Type 2 Diabetes mellitus, dyslipidemia and cardiovascular problems. PCOS being a syndrome cannot be correlated with any particular disease in Ayurveda. Hence for the better comprehension of this disease in terms with Ayurveda, the diseases mentioned in Ayurveda classics manifesting with signs and symptoms of PCOS have been studied in detail in relation with Nidana, Dosha, Srotas involved and their management. Diseases like Vandhya, Arajaska, Nashtarthava, Arthavakshaya and Pushpagni jathaharini shows resemblance in signs and symptoms and to some extend these can be related with PCOS

The Phytosociology of Weeds in Agroforestry Systems in Different Types of Amazonian Forest Cover

Agroforestry systems are examples of soil exploration that is closer to the natural form of the forest, with intercropping of several species within an area, thus being sustainable alternatives. Therefore, the objective of this work was to evaluate the weed community in agroforestry systems in two ecosystems: solid ground and floodplain in the state of Pará. Such collections were made in eight areas, with about one hectare each, cultivated in agroforestry systems, four of which are on dry land and four on floodplains, in the rural area of Cametá-PA. Four plots of one square meter per area were randomly sampled, where the species were identified, counted, and taken to weigh to evaluate the weed community. Among the evaluated environments, the species that stood out the most in the solid ground environment was Kyllinga brevifolia, leading most of the evaluated indices. In the lowland ecosystem, the Brachiaria species purpuracens were the most relevant.

SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.

Dietary Diversity and its Association with Anaemia among Adolescents of Central India: Findings from Baseline Cross Sectional Study

Background: Anaemia continues to be a major public health concern in the country owing to varied dietary practices, socio-demographic and cultural influencers. Poor nutrition as a principal underlying factor is less explored among the adolescents among the high focus states in India. Objectives: To study the dietary diversity i.e., food habits, preferences, frequency of food consumption among adolescents and its association with anaemia. Material and Methods: This cross-sectional study, from a baseline adolescent health survey (November 2017 – March 2018) included 3213 adolescents (10-19 years). The participants were selected using multi-stage stratified random sampling technique from 6 districts of Madhya Pradesh. Data collection was done by filed investigators through paperless real time method that included sociodemographic details, anthropometric measurements, haemoglobin food frequency questionnaire. Results: The most common daily consumed food items were cereals, tea and pulses by adolescents. Overall prevalence of anaemia was 1715 (53.4%). Those consuming occasional fruits, green non leafy vegetables, red and yellow vegetables, roots and tubers and milk products were at higher risk of developing anaemia compared to other food items regularly. Conclusion: Although association exists between occasional consumption of certain food groups, their temporal relationship needs to be established.