SARS-CoV 2 was designated a pandemic by WHO on March of 2019. There have been over 120 million confirmed cases of COVID-19 globally with greater than 4 million hospitalizations in the US alone. These cases can range from asymptomatic disease to multi-organ dysfunction resulting in death. The spectrums of complications stemming from COVID-19 are much broader and can include other autoimmune disorders. Here we present a case of a woman who developed autoimmune hemolytic anemia from COVID-19 infection and was successfully treated with high dose corticosteroids.
Successful treatment for bladder rupture after explosion during transurethral resection of prostate: a case report
Extra or intraperitoneal bladder explosion is a rare complication of transurethral resection of the prostate (TURP) or bladder tumor resection associated with high morbidity. There were just over 25 reports of bladder explosion described in the literature until 2015. We report the case of a 56-year-old black man, diagnosed with prostatic adenocarcinoma and scheduled for tunneling by transurethral resection of prostate (TURP). His medical history included diabetes mellitus, hypertension, retinopathy with bilateral amaurosis, ischemic stroke, and myocardial infarction. He was successfully submitted to a continuous spinal technique and sedation. During the hemostatic phase of the procedure, a loud “pop sound” was heard in the operating room and the patient presented sudden arterial hypotension and abdominal distention. An exploratory laparotomy was done to manage the bladder explosion. The adequate resolution of this adverse event requires awareness and high clinical suspicion for prompt intervention.
Background: Craniopharyngioma is a benign tumor of the sellar region that is typically characterized by a maldevelopment tumor with a high recurrence rate, as well as substantial morbidity and mortality in the long term. Signal transducers and transcription activators have been identified as critical components of cytokine signaling pathways that have previously been documented in craniopharyngioma-related literature. Purpose: The primary goal of this investigation is to examine transcription factor expression in craniopharyngiomas. In addition, a clinical-pathological and immunohistochemistry correlation will be sought. The current study enlisted the participation of forty patients. AdaCPs exhibited: β-catenin STAT2, STAT3, STAT6, and HDAC1 expression. While, STAT4, HDAC2, and GATA 3 were all negative. TTF1 was found in proteinaceous substances within the cyst formation (OMF). β-FGR, DPGR, TNFa, and Nrf2 were found to be associated with inflammation, OMF presence, and finger protrusion in brain surrounding tissue or brain invasion. Conclusions: Tumor recurrence was associated with increased expression of STAT3, STAT6, HDAC, β-catenin, and TNFα in WLA when compared to no recurrence. Coexpression of β-catenin, STAT2, STAT3, and STAT6 with TNFα was also shown using double fluorescence merge stains. There was no association between HDAC1 and HDAC2 coexpression and β-catenin, notably in the WLAs. Discussion: Histologically complicated features include cystic and solid components, the latter of which is made up of diverse morphological cell types. HDAC1 and HDAC2 regulate the enhanced expression of inflammatory genes during inflammation and macrophage response.
Acute limb ischemia(ALI) in a paediatric patient is a rare condition but may result in limb loss and life long complications. We present here a case of a 34 weeks premature infant, with birth weight 1530 grams, who was having respiratory distress at time of birth. Infant was referred to advanced pediatric center for further management, where he was kept in neonatal ICU. He was put on C-PAP and oxygen support and an infant feeding tube for feeding. On 21st day infant developed ischemia of the right upper limb. Color Doppler flow study was done which revealed thrombosed right radial and ulnar artery and biphasic flow in brachial artery. He was put on low molecular weight heparin and was advised referral to higher center for further management. Patient developed dry gangrene of right hand and wrist resulting in the autoamputation of the hand and wrist after a period of 15 day from development of gangrene. In order to prevent such complications there should well trained staff to detect early ischemic changes in the limb so that timely treatment can be started and the long term chronic complications can be prevented.
DIAGNOSTIC INDEXES FINDINGS IN EARLY STAGES OF APPENDICITIS (DIFESA STUDY): A REANALYSIS FROM THE POSAW STUDY DATABASE
Purpose: The resection of a normal-looking appendix during laparoscopic appendicectomy (LA) remains a dilemma. The optimal approach requires reliable macroscopic judgment by the surgeons. The aim of this study is to assess the surgeon’s ability to laparoscopically diagnose acute appendicitis (AA) in its initial uncomplicated grades. Method: Subgroup analysis from the POSAW study, 2016. Patients diagnosed with initial grades of AA (0 – 1) who underwent LA were included (n=718). The median age was 29.4 years, and 52% were female. The accuracy of the macroscopic intraoperative diagnosis was assessed with the histopathological examination of the resected specimens, and the agreement between the surgeon’s and the pathologist’s judgment was established. Results: Of the 79 appendices classified intraoperatively as normal-looking, 18 (22.8%) had some inflammation degree. Of the 639 appendices classified intraoperatively as inflamed, 101 (15.8%) were normal. The intraoperative surgeon’s judgment had an accuracy of 83.4% and a moderate to low agreement (Kappa 0.42). The sensitivity and specificity values were 96.8% and 37.7%, and the positive and negative predictive values were 84.2% and 77.2%, respectively. Conclusion: The surgeon’s intraoperative diagnosis of uncomplicated AA’s initial grades is not sufficiently accurate to establish good reliability for appendicectomy. The surgeon overestimates the presence of appendicular inflammation.
CHALLENGES TO BREASTFEEDING DURING THE FIRST FOUR WEEKS POSTPARTUM AMONG MOTHERS AGED 18 – 29 YEARS, WHO ATTEND SELECTED CLINICS IN ELEUTHERA, THE BAHAMAS
The present study seeks to investigate the breastfeeding challenges mothers on the Bahamian island of Eleuthera face, and propose strategies to improve the situation. Purposive sampling was utilized to recruit mothers from selected health centers in Eleuthera, the Bahamas (N=51). The study utilized a cross-sectional, quantitative research design wherein a forced choice, closeended survey questionnaire using Likert Type scale to elicit data from the research participants. Demographic data was analyzed using descriptive analysis, while ANOVA (Analysis of Variance) was used to determine the relationship between demographic variables (independent variable) and breastfeeding knowledge, attitudes and practices (dependent variables) using the Statistical Package for the Social Sciences (SPSS) Version 26. The findings demonstrated that the relationship between breastfeeding knowledge, attitudes and practices and demographic variables such as educational level, marital status, maternal parity and religion was not statistically significant. The implications of the finding are that health centers can enable mothers to overcome breastfeeding challenges, by improving breastfeeding knowledge through advocacy, education and awareness. Important recommendations pertaining to nursing interventions and social support programs for initiating and continuing breastfeeding among Bahamian mothers and focusing on erasing the social stigma associated with breastfeeding to improve breastfeeding rates were also made.
Exploration of explanatory factors underlying teachers’ perception of learning difficulties in mathematics in interaction with student performances
This study project contributes to documenting the subject of learning difficulties in mathematics [1-4]. In this research, we aimed to verify what are the main explanatory factors underlying teachers’ perception of learning difficulties in mathematics and in relation to student performance in a problem-solving test. To meet the objectives of the study, we implemented a correlational quantitative data analysis devise with the participation of 262 primary school students. Regression analyzes were performed. The results of the analyzes show that the performance in solving a written mathematics questionnaire is explained mainly by socio-demographic variables associated with the students and by factual variables relating to the conditions for taking the questionnaires. Moreover, the teacher’s perception of student performance in mathematics is mainly explained by variables directly related to the student or to the teacher’s vision of the student’s potential for success at school.
Typology of Customer Retention Schemes in the Private Sports Sector During COVID-19: Analyzing the Behavior of Martial Arts Instructors Using Latent Class Analysis
The COVID-19 pandemic brought new challenges in all aspects of life. It largely brought the sports sector to a halt: major events were postponed or canceled, while gyms and training centers were closed due to repeated lockdowns and social distancing rules and regulations. In the private sports sector, some instructors adopted technological means of maintaining contact with their students in an attempt to retain customers and maintain a high volume of cash flow. Our work focuses on the martial arts (MA) sector in Israel during two crucial periods in 2020: The first lockdown of March through June, when all sports activities were banned, and the period following it, when trainers were allowed to commence training under some regulations. Using data collected from 199 MA instructors, we test for their level and means of engagement with trainees during the lockdown, and the impact these had on customer retention in the period that followed. Using latent class analysis, we establish an empirically based typology of retention schemes (low contact, high contact, and maverick), and test whether these influenced the financial performance of MA studios. Our findings show that the financial damage and the return rate of trainees do not vary between the three types. We offer some insights into the uniqueness of the MA field, and how this may explain these counter-intuitive results.
This longitudinal case study conducted at a private University in the northeastern United States explored the impact of the edTPA assessment and preparation process as an embedded component of the University’s educator preparation program. The study tracked 59 graduate level candidates from entry into the program through candidate licensure. The researchers examined the impact of the edTPA preparation process on teacher candidates’ perceptions of their readiness to teach in comparison to their actual readiness to teach as indicated by their edTPA portfolio passing score. The University’s School of Education has an estimated 30% ethnic diversity population, thus a second research question compared perceptions of readiness to teach of candidates of color to those of Caucasian peers. Framed by Bandura’s (1977) self-efficacy theory, this study contributes to the research on the edTPA as an efficacious and inclusive evaluation tool, particularly within diverse schools of education.
My research is a result of accumulated provocation of obsolete and paralyzing education that has been frozen since the middle ages. We have to admit that before the pandemic, education was already in crisis. Governments have been ignoring to adopt any comprehensive plan to reform the educational systems till it has been unprecedently disrupted by COVID-19. I try through this paper to make a global call for governments to immediately start cooperating together for setting international qualifications framework that best suit future competencies. This call should be prioritized on the world agenda. It would be more plausible for governments, UNESCO and other education stakeholders to seize the opportunity of the 2020 disruption of life cycle for the maximum benefit of humanity. For this to happen we need exceptional leaders with extraordinary vision to transform education instead of ensuring children can keep learning and that every single child returns to school after the pandemic. Another challenge to be expected is the reduction in education budgets being under pressure as governments shift spending towards the health and economic response to the pandemic. The impact of schools closing on a generation of children will be immense on the long term. We must act now to save the education and life chances of generations of youth. At this time of unprecedented crisis, the world must come together to protect education and put it at the very heart of the global recovery effort. Recovery, not as before but as convenient and sustainable with the perspective requirements. It is time to expose youth to real life experiences; we need our children to learn about finance from characters like Jef Bezos or Bill Gates or Mukesh Ambani; to learn about psychology from John Anderson, Eliot Aronson and Ahmed Ukasha; to know approaches of math and physics as…