Recent Articles

  • Complex Incisional Hernia – Easy To Diagnose But What To Do After?

    Introduction. Loss of domain represents a defect in abdominal wall or loss of continuity of fascial closure, with more than 20% of the peritoneal cavity content under the skin in a serous sac, where the reconstruction involves additional reconstructive techniques. Clinical Case. A 63-year-old active smoker with multiple comorbidities such as COPD severe form with the need for oxygen at home (may be an absolute contraindication) and surgical history of open umbilical hernia repair with a rapid development of loss of domain hernia (2 weeks after surgery) was prepared preoperatively with Botulinum Toxin type A and Preoperative Progressive Pneumoperitoneum. Discussion. Despite comorbidities, by optimizing the abdominal wall with Botulinum Toxin type A and Preoperative Progressive Pneumoperitoneum with the intraoperative use of the Rives-Stoppa technique or posterior separation of components, Abdominal Wall Strength Score improves significantly in a short time, with quick socio-economic reintegration and low-rate of complications. Conclusions. By preoperative preparation, with augmentation techniques of the abdominal wall, thus, even the barriers given by comorbidities (absolute contraindications) are overcame, with low postoperative risks, offering the patient a normal quality of life.

  • The emergence of bladder dysfunction secondary to lupus cystitis in a patient with established lupus nephritis: the first case from Pakistan

    Lupus cystitis is an uncommon manifestation of systemic lupus erythematosus (SLE). We describe the case of a 23-year-old woman with lupus that complained of abdominal pain, vomiting, and diarrhea for one week. Two years back, she was brought with an affirmative history that satisfied the clinical criteria of SLE which was renal biopsy-proven (class V membranous lupus nephritis). On radiologic workup, she was found to have bilateral hydronephrosis and a thick-walled bladder with diverticula. Immunosuppressive therapy was commenced however augmentation cystoplasty had to be opted for as the symptoms did not subside with medical therapy alone.

  • VARIATIONS IN KNEE RANGE OF MOTION DURING REPEAT KNEE EXTENSION WITH AN AMPUTATED LOWER LEG AT DIFFERENT CONTRACTION RHYTHMS OVER 8 CONSECUTIVE DAYS IN A PATIENT WITH SEVERE DIABETIC NEUROPATHY: A CLINICAL STUDY

    Background: This clinical study sought to understand the knee range of motion (KROM) in an amputated stump during repeat voluntary knee extension with or without a 0.5 kg weight in the acute/early phase after amputation can vary between different target knee extension rhythm frequency (KER) levels in the amputated lower leg of a patient with severe diabetic sensory disorder and leg ischemia. Case Presentation: A 51-year-old male patient with severe diabetic neuropathy had a right lower leg amputation due to necrosis and ulcer lesion following a burn injury to the first toes and severe ischemic peripheral vascular disease. In a sitting position with the base of the foot of the non-amputated left leg on the ground, he performed repeat knee extension of the resected stump (knee active extension and passive flexion without a target KROM) for 1 min with both self-controlled free KER and different target KERs (30, 40, 50, 60, and 80 contractions per minute [cpm] using a metronome), with or without a 0.5 kg weight placed on the resected stump over 8 consecutive days. The KROM was measured using a goniometer placed between the resected stump and the thigh muscle with a continuous data acquisition system. The mean values achieved for KER, KROM, and angle rate during a 1 min session was determined during each daily session, and consecutively average values over sessions on 8 consecutive days was also evaluated. The achieved mean KER at all target KERs corresponded closely with the target KER. The average KROM was approximately 60 degrees over a range of targets between 30 and 60 cpm, but the value was lower at approximately 50 degrees at 80 cpm. The angle rate increased consistently with the increase from a target of 30 to 60 cpm, but it was reduced at 80 cpm. The mean…

  • Loneliness in Adults During a COVID-19 Lockdown

    Loneliness has been frequently reported in the COVID-19 literature but rarely in the context of potential comorbidities including depression, fatigue, and sleep problems. The present study assessed the relationships between self-reported loneliness, and the potential comorbidities based on an archival database called the COVID-19 Lockdown Activities Survey (N= 260 participants). Loneliness was endorsed by 67% of the participants. Greater loneliness was related to greater depression, fatigue, and sleep problems. A regression analysis revealed that depression contributed to 47.1% of the variance in loneliness. These results highlight the multidimensionality of loneliness. The generalizability of these results is limited by the homogeneity of the sample (predominantly non-Hispanic white females). Nonetheless, they highlight the importance of designing interventional protocols that address loneliness and the associated depression, fatigue, and sleep problems rather than loneliness alone.

  • Impact of Logistics Strategy on Projects’ Success: A Field Study of Residential Complexes in Khartoum State

    There is considerable growth in the construction projects in Khartoum State. That growth makes progressive organizations, in the construction sector, embark on a journey of applying concept and principles of executing project management. Based on that, there is great increase in the number of residential complexes in Khartoum State. These housing projects have been executed by companies adapting project management philosophy. And to obtain the best results from the process of executing construction projects, many factors should be given a huge consideration. One of these factors is logistics services. Logistics services play a significant role in the success of any construction project. All construction projects materials are obtained through logistics channels. Therefore, any issue in logistics process will seriously affect the output of the construction projects. And these issues have been affecting many construction projects and seriously affect the quality, cost and time of the final outputs of the construction projects. This research found that logistics strategy plays a significant role in the successful execution of the construction projects. Moreover, this research tested the moderator role of lean logistics in the relationship between logistics strategy and the successful execution of the construction projects.

  • Use of item response theory in marketing research

    There are three purposes of this paper. The first is to present a brief introduction to item response theory in conjunction with marketing research. The second is to present a review of the current uses of item response theory in representative marketing research journals. The third is to present an example that illustrate and contrasts classical test theory and item response theory approaches to item and scale analysis. Several item response theory relevant papers were recently published in various marketing research journals. Because models under item response theory, from simple to complex, were used without any systematic introduction in marketing research, this paper briefly presents the main concepts in item response theory. A content analysis was done for the second purpose with 30 item response theory relevant articles in marketing research journals. Articles were sorted based on the taxonomy of item response theory models. Many articles reviewed relied on some type of unidimensional dichotomous item response theory models. Articles published recently within the past 10 years used more complicated item response theory models, both mathematically and statistically, than other previously published articles in marketing research journals. Lastly, data from a scale with three Likert-type items of four response categories were analysed using a traditional approach based on item statistics and coefficient alpha as well as using an item response theory approach by employing the graded response model. Main concepts of item response theory were explicated with figures.

  • Determination of Business Sustainability Probability for Leading Industrial Products in Tasikmalaya City

    The leading industrial products of Tasikmalaya City are facing competition from similar products and synthetic products. It is feared that this could threaten the business sustainability. This study aims to examine the determinants of the sustainability of the leading industrial products of Tasikmalaya City. Primary data were obtained through focus group discussions (FGD), interviews and questionnaires in five locations. The analytical tool used is an ordered logit model which used to estimate equations with dependent variables that are qualitative. There are five variables were obtained that explained the three aspects of the probability for the sustainability of the leading industry in Tasikmalaya City. This research find that the biggest determination of business sustainability probability is online product promotion. The more promotion efforts from off-line to online, probability of turnover development increase by 365 times. Interestingly, the chance of business success only rose by 0.682 given the factors that determine the supply product such as certification, product development cooperation, awareness of the importance of green industries, access to financing sources, patents, technical guidance, marketing training and product promotion, price stability of raw materials, assistance of tools and machinery also determines the sustainability of the business.

  • COMPARATIVE STUDY OF OPEN CHOLECYSTECTOMY IN ACUTE AND CHRONIC CHOLELITHIASIS IN RURAL CENTRE OF INDIA

    The incidence of cholecystitis with cholelithiasis is increasing day by day either acute or chronic cases. Gall stones are the most common cause of acute cholecystitis in 90-95% of the cases. The management of acute cholecystitis is still laparoscopic cholecystectomy in urban area of India but in rural area open cholecystectomy is still preferred method of surgery for acute as well as chronic gall stone. Our study was conducted on 100 patients divided into two groups of 50 of each to compare the results of open cholecystectomy between acute and chronic cases. The overall post-operative morbidity was more in acute cases. But there was significant difference in the total hospital stay and total cost of the therapy in both the groups. drain output was also high in first three days in acute case so, acute case cholecystectomy was found to be more expensive overall and higher length stay and more co morbidities than chronic cases.

  • ROLE OF MESENCHYMAL STEM CELLS IN CARDIOVASCULAR DISEASE

    In recent years, globally there is an incredible boost in stem cell research has kindled the expectations of both patients and physicians. Mesenchymal stem cells (MSCs) seem to represent a future powerful tool in regenerative medicine, owing to their availability, ease of manipulation, and therapeutic potential, therefore they are particularly important in medical research. Mesenchymal stem cells (MSCs) are capable self-renewing, multipotent progenitor cells with multilineage potential to differentiate into cell types, such as adipocytes, cardiomyocytes, endothelial cells and vascular smooth muscle cells, although the relative contribution of trilineage differentiation and paracrine effectors on cardiac repair. MSCs shows to have the beneficial effects of MSC-based therapies offers most attractive options to treatment of wide range of diseases from cartilage defects to cardiac disorders. Cardiovascular diseases (CVDs) are an important cause of death and disease worldwide. Because injured cardiac tissue cannot be repaired itself, it is urgent to develop other alternate therapies. Stem cells can be differentiated into cardiomyocytes, endothelial cells, and vascular smooth muscle cells for the treatment of CVDs. In addition to cardiac stem cells, mesenchymal stem cells represent another multipotent cell population in the heart; these cells are located in regions near pericytes and exhibit regenerative, angiogenic, antiapoptotic, and immunosuppressive properties.

  • SAFETY SNACKS: IMPROVING QUALITY IN LONG-TERM CARE

    Falls among residents in the long-term care setting adversely affect resident health with potential for serious injury and quality of care provided. Nurses at the long-term care facility recognize the need to reduce falls. The nurses propose the intervention and name the initiative Safety Snacks. The research questions are: in a long-term care facility, does the practice of additional rounding while providing snacks twice daily, decrease the incidence of falls and falls with serious injury as compared to not providing Safety Snacks over a three-month period? Will unintended weight loss change by additional rounding during which nourishment and fluids are given to residents twice daily over a three-month period? The study examines the number of falls, falls with serious injury, and unintended weight loss before and after the Safety Snacks intervention. Poissons Means Test and odds ratio are used for fall data analysis. A two-proportion z-test is used for weight loss data. The results demonstrate a reduction in falls and falls with serious injury. The odds ratio demonstrates a medium effect in falls with serious injury. The two-proportion test on unintended weight loss yields a significant difference of 0.09 with a 95% confidence interval of (0.015, 0.17). One implication is the increase in rounding while providing nutrition and hydration may reduce falls and falls with serious injury. The second implication is the more significant effect on unintended weight loss with providing Safety Snacks. The third implication is the empowerment of nurses to recommend and execute a change in practice to improve quality.