Sonographic and Anatomical Evaluation of the Liver and Portal Vein Reference Values / Evaluación Ecográfica y Anatómica de los Valores de Referencia del Hígado y la Vena Porta

SUMMARY: This paper's aim is a morphometric evaluation of liver and portal vein morphometry using ultrasonography in healthy Turkish population. This study was carried out with 189 subjects (107 females, 82 males). The demographic data and the body surface area were calculated. The longitudinal axis of the liver for two lobes, diagonal axis or liver span, anteroposterior diameter of the liver and portal vein, portal vein transverse diameter, caudate lobe anteroposterior diameter, and portal vein internal diameters as well as longitudinal liver scans in an aortic plane, sagittal plane, transverse plane, and kidney axis were measured. All measurements were analyzed according to age, sex, body mass index, obesity and alcohol consumption. The mean values of the age, height, weight and body mass index were calculated as 44.39 years, 167.05 cm, 74.23 kg, and 27.06kg/m2 in females, respectively. The same values were 44.13 years, 167.70 cm, 75.93 kg and 26.71 kg/m2 in males, respectively. There was significant difference between demographic characteristics, gender, and alcohol consumption in terms of anteroposterior diameter of the liver, portal vein transverse diameter of the right side and liver transverse scan. Also, some measurements including portal vein transverse diameter, liver transverse scan and at kidney axis longitudinal scan of liver showed significant difference between the age groups. There was significant difference in diagonal axis and anteroposterior diameter of liver, portal vein internal diameter, and longitudinal liver scans of the aortic plane parameters between obesity situation. The findings obtained will provide important and useful reference values as it may determine some abnormalities related liver diseases. Also, age, sex, obesity and body mass index values can be effective in the liver and portal vein morphometry related parameters.

El objetivo de este artículo fue realizar una evaluación de la morfometría del hígado y la vena porta mediante ecografía en una población turca sana. Este estudio se llevó a cabo en 189 sujetos (107 mujeres, 82 hombres). Se calcularon los datos demográficos y la superficie corporal. Se midió eleje longitudinal del de dos lóbulos del hígado, el eje diagonal o la extensión del hígado, los diámetros anteroposterior del hígado y de la vena porta, el diámetro transversal de la vena porta, anteroposterior del lóbulo caudado y los diámetros internos de la vena porta, así como las exploraciones longitudinales del hígado en un plano aórtico. Se midieron el plano sagital, el plano transversal y el eje del riñón. Todas las mediciones se analizaron según edad, sexo, índice de masa corporal, obesidad y consumo de alcohol. Los valores medios de edad, talla, peso e índice de masa corporal se calcularon como 44,39 años, 167,05 cm, 74,23 kg y 27,06 kg/m2 en las mujeres, respectivamente. Las mismas variable fueron 44,13 años, 167,70 cm, 75,93 kg y 26,71 kg/m2. Hubo diferencias significativas entre las características demográficas, el sexo y el consumo de alcohol en términos de diámetro anteroposterior del hígado, diámetro transversal de la vena porta del lado derecho y exploración transversal del hígado. Además, algunas mediciones, incluido el diámetro transversal de la vena porta, la exploración transversal del hígado y la exploración longitudinal del hígado en el eje del riñón, mostraron diferencias significativas entre los grupos de edad. Hubo diferencias significativas en el eje diagonal y el diámetro anteroposterior del hígado, el diámetro interno de la vena porta y los parámetros de las exploraciones hepáticas longitudinales del plano aórtico entre situaciones de obesidad. Los hallazgos obtenidos proporcionarán valores de referencia importantes y útiles ya que pueden determinar algunas anomalías relacionadas con enfermedades hepáticas. Además, los valores de edad, sexo, obesidad e índice de masa corporal pueden ser eficaces en los parámetros relacionados con la morfometría del hígado y la vena porta.

Dynamic changes in cytoskeletal elements following acute cerebral ischemia and reperfusion in rats / 中国药理学通报

Aim To investigate the dynamic time-course changes in neuronal cytoskeleton after acute ischemia and reperfusion in rats. Methods Reperfusion was performedin rats by blocking the middle cerebralarteryfor 90 min, then therats wereobserved and collected at different time points. The brain damage wasobserved by Nissl staining,and neurobehavioural function was evaluated with neurological deficit score and forelimb placement test. The cellular changes in the alternations of cytoskeletal elements including microtubule associated protein 2 (MAP2) and neurofilament heavy chain (NF-H) were observed by immunohistochemistry staining and Western blot. Impaired axons, dendrites and cytoskeletal alternations were detected by electron microscope. Results Brain damage and neurobehavioural function were gradually aggravated with the prolongation of reperfusion. Brain damage appeared earlier and more severe in striatum than in cortex. Moreover, decreased MAP2-related and increased NF-H-related immunoreactive intensities were found in the ischemic areas. Impaired cytoskeletal arrangement and reduced dense were indicated. Damaged cytoskeletal components such as microtubules and neurofilament arrangement, decreased axonal filament density, and swelled dendrites were observed after cerebral ischemia reperfusion by ultrastructural observations. Conclusions Different brain regions have diverse tolerance to ischemia-reperfusion injury. Major elements of neuronal cytoskeleton show dynamic responses to ischemia and reperfusion, which may further contribute to brain damage and neurological impairment following MCAO and reperfusion.

Ameliorative effect and mechanism of Sanwei ganlu on hepatic fibrosis in rats / 中国药房

OBJECTIVE To investigate the ameliorative effects and mechanism of Sanwei ganlu on hepatic fibrosis in rats. METHODS The rats were randomly divided into normal group， model group， silibinin group （positive control， 50 mg/kg）， and Sanwei ganlu low-dose， medium-dose， and high-dose groups （80， 250， 800 mg/kg）. Except for normal group， hepatic fibrosis rat models were established by intraperitoneal injection of CCl4 in the other groups of rats. Starting from the 6th week of modeling administration， they were given normal saline or corresponding drugs intragastrically at the same time. At the end of the ninth-week experiment， liver and spleen indexes of rats were calculated； the pathological structure and fibrosis changes of liver tissue were observed by HE， Masson and Sirus Red staining. The contents of alanine transaminase （ALT）， aspartate transaminase （AST）， procollagen type Ⅲ （PC Ⅲ）， collagen type Ⅳ （COL-Ⅳ）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） and IL-1β in serum， and hyaluronic acid （HA） and laminin （LN） in liver tissue were all detected. RESULTS Compared with the model group， the liver injury and collagen fiber deposition of rats were improved to different extents in Sanwei ganlu groups and silibinin group； the contents of ALT， AST， PC Ⅲ， COL-Ⅳ， IL-6， TNF-α and IL-1β in serum as well as the contents of HA and LN in liver tissue significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS Sanwei ganlu can alleviate the progression of hepatic fibrosis in rats， possibly by inhibiting the synthesis of collagen fiber， reducing transaminase content， down-regulating the levels of HA， LN， PC Ⅲ and COL-Ⅳ， and reducing the inflammatory response.

Research status of ocular changes in beta-thalassemia major / 国际眼科杂志(Guoji Yanke Zazhi)

Beta-thalassemia major(β-TM)is an inherited disease caused by a defect in the synthesis of globin. The disease requires long-term blood transfusion and iron chelator treatment, which can cause various secondary changes in the body and eye tissues. Compared with normal peers, β-TM patients will show changes in the eye such as steeper corneal curvature, shallower anterior chamber, increased lens thickness, shorter axial length, and reduced tear secretion. At the same time, nutritional deficiencies and the use of iron chelator drugs will increase the risk of complicated cataract and retinal degeneration, thus affecting the quality of life of β-TM patients.This article combines relevant domestic and foreign literatures to explore and review the changes in the eye of β-TM patients, with a view to providing valuable insights for clinical practice.

Advances in the effect of ocular hypertension on ocular refraction / 国际眼科杂志(Guoji Yanke Zazhi)

Ocular hypertension(OH)can cause a variety of ocular structural and functional damage, among which the effect on ocular refraction has long been recognized in the clinic. The effect of OH on ocular refraction is related to the transparency and shape of refractive media, as well as the changes of the axial length. Due to the different speed and degree of intraocular pressure(IOP)elevation, the changes of refraction are reversible or irreversible. Irreversible changes in refraction are often accompanied by visual transmission impairment, and have a certain reference value for the evaluation of the latter condition. IOP changes lead to changes in the axial length, which are related to scleral remodeling and choroidal perfusion changes, and have a certain impact on the development of myopia and refractive error after cataract surgery. In this paper, the research progress of the changes of refractive media and axial length caused by OH, as well as the characteristics of the effects on ocular refraction are summarized, hoping to deepen the understanding of the effect of OH on ocular refraction, and provide reference for preventing irreversible ocular refractive changes, guiding the assessment of visual transmission damage and preventing or controlling the development of axial myopia.

Association between Self-Esteem and Dietary Changes among Cancer Patients: A Cross-Sectional Study

@#Introduction: Cancer diagnosis may shift an individual’s food choices as well as self-esteem mainly due to the side effects of treatment, which will influence their nutritional status and perception about themselves. The aim of this study was to explore the association between dietary changes and self-esteem among cancer patients. Methods: A cross-sectional study was conducted among 113 cancer patients in Hospital Universiti Sains Malaysia. Among the data collected were socio-demographic background, clinical characteristics, Karnofsky Performance Status Scale, dietary changes questionnaire before and after cancer diagnosis, self-esteem. Spearman correlation was employed for determining the relationship between dietary changes and self-esteem. Results: Out of 113 subjects, 98 subjects (86.7%) made changes in their dietary intake after being diagnosed with cancer. A total of 58.4% and 45.1% of the subjects reported a decrease in their intake of sugar and condensed milk, while 52.2% stopped consuming red meat. The mean self-esteem score was reported to be average (29.33 ± 3.52). However, no statistically significant association was found between socio-demographic, clinical parameters, and self-esteem with dietary changes. Conclusion:The findings of this study demonstrated that cancer patients had made drastic dietary changes following cancer diagnosis especially consumption of red meat and food high in sugar. Most cancer patients had average self-esteem level. Although no association had been found between dietary changes and self-esteem level, it is suggested for more studies should be carried out to provide clear understanding of the factors affecting dietary changes among cancer patients.

Long-term auditory monitoring in children with Alport syndrome based on different degrees of renal injury / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate long-term auditory changes and characteristics of Alport syndrome（AS） patients with different degrees of renal injury. Methods:Retrospectively analyzing clinical data of patients diagnosed AS from January 2007 to September 2022, including renal pathology, genetic detection and hearing examination. A long-term follow-up focusing on hearing and renal function was conducted. Results:This study included 70 AS patients, of which 33（25 males, 8 females, aged 3.4-27.8 years） were followed up, resulting in a loss rate of 52.9%.The follow-up period ranged from 1.1to 15.8 years, with 16 patients followed-up for over 10 years. During the follow-up, 10 patients presenting with hearing abnormalities at the time of diagnosis of AS had progressive hearing loss, and 3 patients with new hearing abnormalities were followed up, which appeared at 5-6 years of disease course. All of which were sensorineural deafness. While only 3 patients with hearing abnormalities among 13 patients received hearing aid intervention. Of these patients,7 developed end-stage renal disease（ESRD）, predominantly males （6/7）. The rate of long-term hearing loss was significantly different between ESRD group and non-ESRD group（P=0.013）. There was no correlation between the progression of renal disease and long-term hearing level（P>0.05）. kidney biopsies from 28 patients revealed varying degrees of podocyte lesion and uneven thickness of basement membrane. The severity of podocyte lesion was correlated with the rate of long-term hearing loss（P=0.048）, and there was no correlation with the severity of hearing loss（P>0.05）. Among 11 cases, theCOL4A5mutationwas most common （8 out of 11）, but there was no significant correlation between the mutation type and hearing phenotype（P>0.05）. Conclusion:AS patients exhibit progressive hearing loss with significant heterogeneity over the long-term.. THearing loss is more likely to occur 5-6 years into the disease course. Hearing abnormalities are closely related to renal disease status, kidney tissue pathology, and gene mutations, emphasizing the need for vigilant long-term hearing follow-up and early intervention.

Assessment of land use cover changes, carbon sequestration and carbon stock in dry temperate forests of Chilas watershed, Gilgit-Baltistan

Abstract Land use and land cover change are affecting the global environment and ecosystems of the different biospheres. Monitoring, reporting and verification (MRV) of these changes is of utmost importance as they often results in several global environmental consequences such as land degradation, mass erosion, habitat deterioration as well as micro and macro climate of the regions. The advance technologies like remote sensing (RS) and geographical information system (GIS) are helpful in determining/ identifying these changes. In the current study area, changes in carbon stocks, notably in forest areas, are resulting in considerable dynamics of carbon stocks as a result of climate change and carbon sequestration. This study was carried out in the Diamer district of the Gilgit Baltistan (GB) Pakistan to investigate the change in cover change/land use change (particularly Forest Land use) as well as carbon sequestration potential of the forests in the district during almost last 25years. The land cover, temporal Landsat data (level 1, LIT) were downloaded from the USGS EROS (2016), for 1979-1989, 1990-2000 and 2001-2012. Change in land uses, particularly forest cover was investigated using GIS techniques. Forest inventory was carried out using random sampling techniques. A standard plot of size 0.1 ha (n=80) was laid out to determine the tree density, volume, biomass and C stocks. Simulation of C stocks was accomplished by application of the CO2FIX model with the data input from inventory. Results showed a decrease in both forest and snow cover in the region from 1979-2012. Similarly decrease was seen in tree volume, tree Biomass, dynamics of C Stocks and decrease was in occur tree density respectively. It is recommended we need further more like project such as BTAP (Billion Tree Afforestation Project) and green Pakistan project to increase the forest cover, to control on land use change, protect forest ecosystem and to protect snow cover.

Resumo O uso e as mudanças na cobertura da terra estão afetando o meio ambiente global e os ecossistemas das diferentes biosferas. O monitoramento, relatório e verificação (MRV) dessas mudanças são de extrema importância, pois muitas vezes resultam em várias consequências ambientais globais, como degradação da terra, erosão em massa, deterioração do hábitat, bem como micro e macroclima das regiões. As tecnologias avançadas, como sensoriamento remoto (RS) e sistema de informações geográficas (SIG), são úteis para determinar / identificar essas mudanças. Na área de estudo atual, as mudanças nos estoques de carbono, principalmente em áreas florestais, estão resultando em uma dinâmica considerável dos estoques de carbono como resultado das mudanças climáticas e do sequestro de carbono. Este estudo foi realizado no distrito de Diamer de Gilgit Baltistan (GB), Paquistão, para investigar a mudança na mudança de cobertura / mudança de uso da terra (particularmente uso de terras florestais), bem como o potencial de sequestro de carbono das florestas no distrito durante quase os últimos 25 anos. A cobertura da terra, os dados temporais do Landsat (nível 1, LIT), foram baixados do USGS EROS (2016), para 1979-1989, 1990-2000 e 2001-2012. Mudanças nos usos da terra, particularmente na cobertura florestal, foram investigadas usando técnicas de SIG. O inventário florestal foi realizado por meio de técnicas de amostragem aleatória. Um lote padrão de 0,1 ha (n = 80) foi estabelecido para determinar a densidade das árvores, volume, biomassa e estoques de C. A simulação dos estoques de C foi realizada pela aplicação do modelo CO2FIX com a entrada de dados do inventário. Os resultados mostraram uma diminuição na cobertura florestal e de neve na região de 1979 a 2012. Da mesma forma, diminuição foi observada no volume da árvore, biomassa das árvores, dinâmica dos estoques de C e diminuição na densidade das árvores, respectivamente. É recomendado que precisemos de mais projetos como o BTAP (Billion Tree Afforestation Project) e o projeto Green Pakistan para aumentar a cobertura florestal, controlar as mudanças no uso da terra, proteger o ecossistema florestal e proteger a cobertura de neve.

Excesso de peso pré-gestacional e ácidos graxos poli-insaturados no leite humano: modelo teórico de causalidade / Pre-gestational overweight and polyunsaturated fatty acids in human milk: theoretical causality model

Resumo Inúmeros estudos têm se detido na avaliação da associação entre o excesso de peso pré-gestacional e os ácidos graxos poli-insaturados no leite humano. Todavia, diante da complexidade de fatores de risco potencialmente confundidores, é recomendável a utilização de ferramentas gráficas para identificar possíveis vieses. O objetivo deste artigo é propor um modelo teórico de causalidade utilizando o gráfico acíclico direcionado entre o excesso de peso pré-gestacional e os ácidos graxos poli-insaturados no leite humano. Foi realizada ampla revisão da literatura para identificar as variáveis com relações causais com a exposição e/ou desfecho. A escolha das variáveis para ajuste seguiu o algoritmo gráfico que compreende seis critérios para a seleção de um conjunto mínimo de variáveis potencialmente confundidoras. Condições socioeconômicas, intervalo interpartal, idade materna e padrão de consumo alimentar foram as variáveis ajustadas a fim de se estimar o efeito total do excesso de peso pré-gestacional sobre o conteúdo dos ácidos graxos poli-insaturados no leite humano. O conjunto mínimo de variáveis encontrado pelo presente estudo pode ser utilizado na análise de outros estudos que avaliem essa associação.

Abstract A number of studies have focused on the evaluation of the relationship between pre-pregnancy overweight and polyunsaturated fatty acids content in human milk. However, given the complexity of potentially confounding risk factors, the use of graphical tools is recommended to identify possible biases. This article aims to propose a theoretical model of causality using the directed acyclic graph between pre-pregnancy overweight and polyunsaturated fatty acids content in human milk. Methods: An extensive literature review was performed to identify variables with causal relationships with exposure and/or outcome. The choice of variables for adjustment followed the graphic algorithm that comprises six criteria for selecting a minimum set of potentially confounding variables. Socioeconomic conditions, interpartum interval, maternal age and food consumption pattern were the variables that would have to be adjusted in order to estimate the total effect of pre-pregnancy overweight on polyunsaturated fatty acids content in human milk. The minimum set of variables found in the present study can be used in the analysis of other studies that evaluate this association.

Manejo anestésico para cirugía tiroidea. Una revisión no sistemática / Anesthetic management for thyroid surgery. A non-systematic review

Resumen: Las hormonas tiroideas forman parte fundamental del mantenimiento de la homeostasia, se encuentra particularmente relacionado con la función cardiovascular. Los estados distiroideos clínicos o subclínicos pueden comprometer este sistema en forma significativa durante los procedimientos quirúrgicos. Existen múltiples fármacos que pueden modificar la patología tiroidea en mayor o menor medida, disminuyendo el riesgo de complicaciones en la eventualidad de una cirugía. La utilización de anestesia general, ya sea balanceada o total endovenosa, se ha convertido en el estándar de oro, por la menor tasa de complicaciones asociadas. Durante el período perioperatorio se debe mantener un monitoreo estricto de la función cardiovascular para detectar alteraciones en forma temprana e iniciar las correcciones necesarias.

Abstract: Thyroid hormones are a fundamental part of the maintenance of homeostasis, it is particularly related to cardiovascular function. Clinical or subclinical dysthyroid states can significantly compromise this system during surgical procedures. There are multiple drugs that can modify the thyroid pathology to a greater or lesser extent, reducing the risk of complications in the event of surgery. The use of general anesthesia, whether balanced or total intravenous, has become the Gold standard, due to the lower rate of associated complications. During the perioperative period, strict monitoring of cardiovascular function must be maintained to detect alterations early and initiate the necessary corrections.

Radiological and Anatomical Evaluation of the Tracheal Morphology and Morphometry in Turkish Adults / Evaluación Radiológica y Anatómica de la Morfología y Morfometría Traqueal en Adultos Turcos

SUMMARY: The trachea is a tubular organ lying between larynx and lungs containing smooth muscle, membranes, and cartilage. This paper evaluated the dimessions of the trachea and main bronchi morphometry in healthy adults using Computed Tomography. This retrospective observational study was performed with 170 healthy adult subjects (89 females, 52.35 %; 81 males,47.65 %). The length of the trachea, the anteroposterior and transverse diameter of the trachea and the right and left main bronchi were measured. From these measurements, the trachea shape were calculated and four types of trachea were identified as circular, oval, horseshoe-shaped, and rectangular. All measurements were significantly higher in males than females (excluding tracheal bifurcation angle). According to the value obtained by dividing the anteroposterior by the width of the trachea, tracheal shapes are considered; the circular shape was seen 104 subjects (61.2 %), followed by oval type (34 subjects), horseshoe type (24 subjects) and rectangular type. (8 subjects). Also, the most frequently seen was circular type in both females and males. Hovewer, there was no significant difference between sex in terms of trachea shape. Additionally, a striking finding was that trachea morphometry and morphology showed the significance according to age dependent changes. Trachea measurements were affected several reasons such as used methods, age, sex, or race. This study has many clinical importance as it may reduce the risk of accidental damage to these area by clinicians such as cardiothoracic surgeons, anesthetist, or radiologist.

La tráquea es un órgano tubular que se encuentra entre la laringe y los pulmones y que contiene músculo liso, membranas y cartílago. Este trabajo evaluó las dimensiones de la tráquea y la morfometría de los bronquios principales en adultos sanos mediante Tomografía Computarizada. Este estudio observacional retrospectivo se realizó con 170 sujetos adultos sanos (89 mujeres, 52,35 %; 81 hombres, 47,65 %). Se midió la longitud de la tráquea, el diámetro anteroposterior y transversal de la tráquea y los bronquios principales derecho e izquierdo. A partir de estas mediciones, se calculó la forma de la tráquea y se identificaron cuatro tipos de tráquea: circular, ovalada, en forma de herradura y rectangular. Todas las mediciones fueron significativamente mayores en hombres que en mujeres (excluyendo el ángulo de bifurcación traqueal). Según el valor que se obtiene al dividir el anteroposterior por el ancho de la tráquea, se consideran las formas traqueales; la forma circular fue observada en 104 sujetos (61,2 %), seguida del tipo ovalado (34 sujetos), tipo herradura (24 sujetos) y tipo rectangular (8 sujetos). Además, el tipo más frecuente fue el circular tanto en mujeres como en hombres. Sin embargo, no hubo diferencias significativas entre sexos en términos de forma de la tráquea. Además, un hallazgo sorprendente fue que la morfometría y la morfología de la tráquea mostraron importancia según los cambios dependientes de la edad. Las mediciones morfométricas de la tráquea se vieron afectadas por varios motivos, como los métodos utilizados, la edad, el sexo o la raza. Este estudio tiene importancia clínica ya que puede reducir el riesgo de daño accidental por parte de médicos como cirujanos cardiotorácicos, anestesistas o radiólogos.

Actividad física durante el embarazo y su relación con la ganancia de peso gestacional / Physical activity during pregnancy and its relationship with gestational weight gain / Atividade física durante a gestação e sua relação com o ganho de peso gestacional

Objetivo: describir los patrones de actividad física de una cohorte de gestantes de nuestro medio y explorar su asociación con la ganancia de peso en cada uno de los trimestres del embarazo. Método: estudio descriptivo longitudinal sobre una muestra de 151 mujeres. Se utilizó el Cuestionario Internacional de Actividad Física para evaluar la actividad física durante el embarazo en función del volumen, intensidad y ámbito de realización. Se llevaron a cabo diferentes modelos de regresión lineal múltiple para analizar la asociación entre actividad física y ganancia de peso gestacional. Resultados: la actividad física disminuyó durante el embarazo, tanto en tiempo como en intensidad. El índice de masa corporal pre-gestacional fue el principal factor asociado con una menor ganancia de peso a lo largo de todo el embarazo. La influencia de la actividad física sobre la ganancia de peso gestacional se limitó al tercer trimestre del embarazo en el que se observó una asociación inversa entre ambas variables. Conclusión: los resultados de este estudio muestran un importante descenso de la actividad física en la época del embarazo y sugieren una influencia limitada de ésta sobre la ganancia de peso gestacional.

Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy. Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables. Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain

Objetivo: descrever os padrões de atividade física de uma coorte de gestantes em nosso meio e explorar sua associação com o ganho de peso em cada um dos trimestres de gestação. Método: estudo descritivo longitudinal com uma amostra de 151 mulheres. O Questionário Internacional de Atividade Física foi utilizado para avaliar a atividade física durante a gestação de acordo com o volume, intensidade e escopo do desempenho. Diferentes modelos de regressão linear múltipla foram utilizados para analisar a associação entre atividade física e ganho de peso gestacional. Resultados: a atividade física diminuiu durante a gestação, tanto em tempo quanto em intensidade. O índice de massa corporal pré-gestacional foi o principal fator associado ao menor ganho de peso ao longo da gestação. A influência da atividade física no ganho de peso gestacional limitou-se ao terceiro trimestre de gestação, no qual foi observada associação inversa entre ambas as variáveis. Conclusão: os resultados deste estudo mostram uma diminuição significativa da atividade física no momento da gravidez e sugerem uma influência limitada desta no ganho de peso gestacional.

Distance and near vision changes after intravitreal anti-vascular endothelial growth factor injection in eyes with center-involving diabetic macular edema

Purpose: To elucidate distance and near vision changes after intravitreal injections in center?involving diabetic macular edema (CIDME) in phakic and pseudophakic groups. Methods: A retrospective study was done on 148 eyes (72 phakic and 76 pseudophakic) with center?involving DME. All eyes were treated with intravitreal anti?vascular endothelial growth factor (VEGF) injection. All patients underwent distance best?corrected visual acuity (BCVA) testing, near BCVA testing, dilated fundus examination, and optical coherence tomography (OCT) at baseline and follow?up visits. Eyes that could not improve after the first injection were given 2nd, 3rd, and more injections in the subsequent visits. Results: On follow?up, post injections in the phakic group (n = 72), there were 65 eyes (90.3%) with stable/improved near vision and 59 eyes (81.9%) with stable/improved distance vision, whereas in the pseudophakic group (n = 76), 63 eyes (82.9%) and 60 eyes (78.9%), respectively. Both in phakic and pseudophakic eyes, 7.7%–13% of the cohort showed only near vision improvement. Conclusion: In DME, besides the changes in distance vision, there are also changes in near vision. These changes should be taken into account while determining the response to anti?VEGF in DME treatment.

BIOMEDICAL WASTE MANAGEMENT IN INDIA - A CONSORIOUS APPROACH

The duty of all people supporting and ?nancing healthcare activities is to manage safely and sustainably biomedical waste (BMW), so that it does not adversely affect the environment and society. In order to maintain a healthy and clean environment, effective management of Biomedical Waste is very crucial. This study has made an extensive review on the recent Biomedical Waste Management Rules,2016, practical problems w.r.t effective implementation of rules and regulations with respect to Biomedical Waste (BMW), addressing major hindrances with respect to applying appropriate techniques and methods to be adopted for ejecting Biomedical Waste (BMW). The new rules and regulations are framed and structured in order to: 1. Improving the process of segregation, transportation, and disposal method. 2. Reducing level of environmental pollution and degradation thereby making dynamic change in the disposal of BMW and its process of treatment in India. Collaborative teamwork should be done with government support in order to develop from the perspective of: 1. Finance 2. Infrastructure 3. Providing facilities for healthcare workers for their safety 4. Continuous Monitoring of Biomedical Waste Disposal Practices

Acute abducens nerve palsy with acute disseminated encephalomyelitis-like presentation following COVID-19 vaccination

We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.

A-review-the-elderly-patients-in-dentistry

The aim of this review is to determine the factors that cause oral and dental health problems in the elderly. Maintenance of a natural, healthy and functional dentition is as important for healthy aging as maintaining physical and mental abilities. Over the past century, scientific progress has significantly increased life expectancy, people's living standards are improving and people are paying more attention to hygiene conditions. The role of oral and dental health on the general health status of the elderly population is too great to be ignored. In a number of cases, in addition to the effects of Aging on the orofacial region, acquired systemic diseases and the medications used in their treatment cause unpleasant changes in the oral cavity. Tooth loss, abrasions, periodontal diseases, dental caries, lesions in the oral mucosa, etc. cause elderly patients to be unable to perform oral functions well enough. Speech difficulties, muscle atrophy and changes in taste can also be observed. Elderly people need to be treated in cooperation with medical doctors and dentists who monitor the general health of the elderly and ensure good dental care

Acerca de lo virtual y sus implicancias para la vida psíquica / About virtuality and its implications for psychic life / Au sujet du virtuel et de ses consequences pour la vie psychique / Sobre a virtualidade e suas implicações na vida psicológica

¿A qué llamamos lo virtual? En camino a su mejor definición nos encontramos con los nuevos desarrollos conceptuales sobre el tema que dan cuenta de la trascendencia antropológica y subjetiva que va teniendo y cobrando cada vez mayor relevancia. Así pues, distintos teóricos ponen de relieve los cambios que se van produciendo a nivel psicológico y social, de lo que cabe referirnos en particular a la constitución psíquica en niñes y adolescentes. Podemos pensar al psicoanálisis como al juego en tanto espacios virtuales posibilitadores de una elaboración y una recreación subjetivas AU

What do we call the virtual? On the path to its best definition, we encounter new conceptual developments on the subject that account for its anthropological and subjective transcendence, which is increasingly gaining relevance. Different theorists highlight the changes that are occurring at the psychological and social levels, particularly in relation to the psychic constitution of children and adolescents. We can think of psychoanalysis as a game, as virtual spaces that enable subjective elaboration and recreation AU

Qu'appelle-t-on le virtuel? En cheminant vers sa meilleure définition nous trouvons les nouveaux développements conceptuels sur le sujet, qui rendent compte de la transcendance anthropologique et subjective qui devient chaque jour plus importante.Ainsi, différents théoriciens mettent en relief les changements qui se produisent au niveau psychologique et social, et nous nous référons ici tout particulièrement à la constitution psychique des enfants et des adolescents.Nous pouvons penser la psychanalyse ainsi que le jeu comme des espaces virtuels qui rendent possible une élaboration et une re création subjectives AU

O que chamamos de virtualidade? Em direção à sua melhor definição nos encontramos com novos desenvolvimentos conceituais sobre o tema que abrange a transcendência antropológica e subjetiva que vai adquirindo cada vez mais relevância. Assim, diferentes teóricos colocam em destaque as mudanças que são produzidas a nível psicológico e social, do qual podemos nos referir particularmente a constituição psicológica em crianças e adolescentes. Podemos pensar al psicoanálisis como a o jogo en tanto espacios virtuales posibilitadores de una elaboración y un re creación subjetivas. Podemos pensar na psicanálise como um jogo nos diversos espaços virtuais possibilitando uma elaboração e uma recriação subjetiva AU

Does L-carnitine prevent cadmium-induced damage in gastrointestinal contractility and histological changes in prepubertal rat / ¿La L-carnitina previene el daño inducido por cadmio en la contractilidad gastrointestinal y los cambios histológicos en ratas prepúberes?

SUMMARY: Cadmium (Cd) is the industrial and environmental toxic heavy metal which is found in air, water and soil. Cd, adversely affects many organs in humans such as kidney, intestine, liver, testis and lungs. L-carnitine (LC) is an important agent that plays essential role in energy metabolism. In our study, we aimed to work out whether LC application has any protective effect on intestinal contractility and morphologic damage of prepubertal rat duodenum on Cd-induced toxicity. Twenty eight prepubertal female Wistar rats were divided into four groups. The first group is control (C), second group; Cd group; Cadmium chloride was given 2 mg/kg 28 days with a one-day break by i.p. The third group; Cd+LC, which cadmium chloride was given 2 mg/kg i.p. and LC was given orally by gastric lavage. The LC dose was given as 75 mg/kg. The fourth group; LC, which only LC was given orally. The intestinal segments were isolated and suspended in tissue bath. Contractile responses were induced by acetylcholine (ACh) and relaxation was achieved with phenylephrine. Also the segments were examined for histological changes by light microscopy. Ach-induced contractions were higher in Cd+LC, LC, and control group compared to the Cd group in duodenal segments. The phenylephrine-induced relaxations were lower in Cd groups as compared with Control, Cd+LC and LC group in duodenal segments. In Cd group intestinal morphology was observed to be severely damaged whereas in Cd+LC group the damage was noticeably lower. Cd administration caused severe cellular damage and decreased gastrointestinal motility. Treatment with the LC has affected the gastrointestinal contractility and reduced the damage in intestinal morphology, which occured after Cd application.

El cadmio (Cd) es el metal pesado tóxico industrial y ambiental que se encuentra en el aire, el agua y el suelo. El Cd afecta negativamente a muchos órganos humanos, como los riñones, los intestinos, el hígado, los testículos y los pulmones. La L-carnitina (LC) es un agente importante que juega un rol esencial en el metabolismo energético. El objetivo de este estudio fue determinar si la aplicación de LC tiene algún efecto protector sobre la contractilidad intestinal y el daño morfológico del duodeno de rata prepuberal sobre la toxicidad inducida por Cd. Veintiocho ratas Wistar hembras prepúberes se dividieron en cuatro grupos. El primer grupo control (C), segundo grupo; grupo cd; Se administró cloruro de cadmio 2 mg/kg durante 28 días con un descanso de un día por vía i.p. El tercer grupo; Cd+LC, al que se administró cloruro de cadmio 2 mg/kg i.p. y LC se administró por vía oral mediante lavado gástrico. La dosis de LC se administró como 75 mg/kg. El cuarto grupo; LC, al cual solo LC se administraba por vía oral. Los segmentos intestinales fueron aislados y suspendieron en baño de tejido. Las respuestas contráctiles fueron inducidas por acetilcolina (ACh) y la relajación se logró con fenilefrina. También se examinaron los segmentos en busca de cambios histológicos mediante microscopía óptica. Las contracciones inducidas por Ach fueron mayores en Cd+LC, LC y el grupo control en comparación con el grupo Cd en los segmentos duodenales. Las relajaciones inducidas por fenilefrina fueron menores en los grupos Cd en comparación con el grupo Control, Cd+LC y LC en los segmentos duodenales. En el grupo Cd se observó que la morfología intestinal estaba severamente dañada mientras que en el grupo Cd+LC el daño fue notablemente menor. La administración de Cd causó daño celular severo y disminución de la motilidad gastrointestinal. El tratamiento con LC afectó la contractilidad gastrointestinal y redujo el daño en la morfología intestinal, que ocurría después de la aplicación de Cd.

Comparative study to evaluate retinal changes using spectral-domain optical coherence tomography in diabetics without diabetic retinopathy

Purpose: To elucidate changes in the neuro?sensory retina at the macula, using spectral?domain optical coherence tomography (SD?OCT) in type 2 diabetics without clinical signs of diabetic retinopathy, and compare with healthy subjects. Methods: This was a cross?sectional observational study, conducted at a tertiary eye institute from November 2018 to March 2020. Type 2 diabetics visiting the outpatient department with normal fundus (without any clinical signs of diabetic retinopathy) were taken as Group 1, and healthy subjects as Group 2. Both underwent recording of visual acuity, intraocular pressure (non?contact tonometry), slit?lamp anterior segment examination, fundus examination using an indirect ophthalmoscope, and macular SD?OCT. SPSS (Statistical Package for Social Sciences) version 20 [IBM SPSS statistics (IBM corp. Armonk, NY, USA released 2011)] was used to perform the statistical analysis of the data entered in the excel sheet. Results: Our study included 440 eyes of 220 subjects, divided equally into two groups. The mean age of patients with diabetes was 58.09 ± 9.42 years, and of controls 57.25 ± 8.91 years. The mean BCVA in group 1 and group 2 was 0.36 ± 0.37 and 0.21 ± 0.24 logMAR, respectively. SD?OCT showed thinning in all areas in group 1 compared to group 2, but statistically significant thinning was seen only in the central subfield (P = 0.0001), temporal parafoveal (P = 0.0001), temporal perifoveal (P = 0.0005), and nasal perifoveal areas (P = 0.023) in group 1. There was a significant inter?eye difference noted between the right and left eyes in nasal and inferior parafovea only in group 1 (P = 0.03). No significant difference was noted between males and females. Conclusion: There was significant macular thinning in diabetics compared with controls, which denotes the occurrence of neuronal damage in these eyes before clinical evidence of diabetic retinopathy.

Evaluation of Structural and Compositional Changes on the Root Surface Exposed to Diode Laser (810 nm): An In?vitro Study

Background: The laser therapy has been used as an adjuvant for conventional periodontal disease as they exhibit a bactericidal effect on scaling and root planning by its thermal and photo disruptive effects on the pathogens. This study focuses on the structural and compositional changes induced on the root surfaces of teeth following diode laser (DL) application with increasing quantum of exposure time. Objective: The objective of this study was to evaluate the structural and compositional changes on the root surface of extracted human permanent teeth after application of DLs (810 nm) with varying time interval. Materials and Methods: Twenty samples of single?rooted periodontally compromised extracted teeth were utilized for this study. Root planning was done and the roughness caused by the instrumentation was measured using profilometric analysis. Then, the samples were divided into four groups, with DL application time: Group 1 – laser application for 15 s, Group 2 – laser application for 30 s, Group 3 – laser application for 45 s, and Group 4 – laser application for 60 s. A scanning electron microscope was used to examine the cemental surface and energy?dispersive X?ray analysis software assesses the compositional changes of the teeth in each group. Results: This study reveals that on exposure of DL (810 nm) on the root surface when time of exposure increases, there were relative increases in surface irregularities and charring. There were significant changes in the chemical composition of the tooth surface.