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Open Access September 09, 2025

Biopsy-Negative Giant Cell Arteritis Presenting as Stroke Mimic with Vision Loss and Complex Vascular Disease

Abstract A man in his 60s with multiple vascular comorbidities presented with sudden, painless vision loss in one eye. Although he had a high risk for atherosclerotic events, initial evaluation for stroke was negative for acute ischemia, but found to have markedly elevated inflammatory markers. Accordingly, giant cell arteritis was investigated and Ophthalmologic findings and fulfillment of the 2022 [...] Read more.
A man in his 60s with multiple vascular comorbidities presented with sudden, painless vision loss in one eye. Although he had a high risk for atherosclerotic events, initial evaluation for stroke was negative for acute ischemia, but found to have markedly elevated inflammatory markers. Accordingly, giant cell arteritis was investigated and Ophthalmologic findings and fulfillment of the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria supported the diagnosis of giant cell arteritis, despite a negative temporal artery biopsy. Management included high-dose glucocorticoids and delayed tocilizumab initiation due to the need for multiple vascular surgeries. Vision loss was irreversible, but systemic symptoms resolved and vascular interventions were successful. This case highlights the diagnostic and management complexities of biopsy-negative giant cell arteritis in patients with severe atherosclerotic vascular disease, emphasizing the importance of clinical judgment and established classification criteria when imaging and biopsy results are inconclusive.
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Case Report
Open Access January 15, 2025

Prevalence and determinants of mental health stress among nursing students in Bangladesh: A cross-sectional study

Abstract Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. [...] Read more.
Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. Methods: This cross-sectional study was conducted from December 2023 to February 2024 among 372 nursing students enrolled in selected nursing colleges in Bangladesh. A purposive sampling technique was used, and data was collected using a semi-structured questionnaire. The questionnaire assessed socio-demographic characteristics, academic challenges, and psychological symptoms, with mental health stress measured using a Likert scale. Descriptive statistics and Chi-square tests were used to analyze the data, with a 95% confidence interval applied to all analyses. Results: The findings revealed that 31.7% of nursing students experienced severe stress, 23.9% reported moderate stress, and 16.7% had mild stress. Age, academic semester, and course load difficulties were significantly associated with stress levels (p < 0.05). Psychological symptoms such as anxiety, difficulty concentrating, and loss of interest in activities were also significantly linked to higher stress levels. Notably, students in their first semester and those reporting harder course loads were more likely to experience stress. However, gender was not significantly associated with stress levels. Conclusions: This study underscores the high prevalence of stress among nursing students in Bangladesh, driven by academic and clinical challenges and psychological symptoms. The findings highlight the need for targeted interventions, such as stress management training, enhanced mental health support, and policies to alleviate academic pressures. Future research should explore longitudinal trends in stress and evaluate the effectiveness of interventions to support a resilient nursing workforce.
Article
Open Access November 16, 2024

Electrocution Cervical Myelopathy Presenting with Partial Brown Sequard Syndrome: A Case Report and Review of Literature

Abstract Background: Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. Aims and objectives: This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. Case report: We report the case of a 54-year-old housewife who presented [...] Read more.
Background: Electrical injuries are underreported in literature, but they can affect the peripheral and central nervous system causing permanent disability. Aims and objectives: This case report aims to highlight cervical spinal cord injury secondary to electrocution, a rare cause of spinal cord injury. Case report: We report the case of a 54-year-old housewife who presented with transient loss of consciousness and right sided hemiparesis following electrocution, while at home. Results: The patient met clinical critera for partial Brown- Sequard syndrome, which to our knowledge, has not been previously reported. She showed significant improvement over a month and is currently under monitoring. Conclusions: Electrical injury is a rare cause of normal MRI myelopathy and the potential for immediate, delayed, and long- term neurological disability.
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Case Report
Open Access March 08, 2024

Analysis of Toxic Contaminants in Agriculture: Educational Strategies to Avoid Their Influence on Food

Abstract A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and [...] Read more.
A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and fungicides is discussed due to their repercussions on health. In order to avoid the unhealthiness caused by the applications of these products, phytosanitary and educational control strategies are proposed; promoting the inspection of fruit and vegetable markets, and modifying the contents in higher professional and university education. To this end, we propose an active teaching methodology, through which the student acquires skills and responsibility for the use of chemical agents in agriculture, which serves to prevent the entry of these contaminants into the food chain. Of the different polluting chemical agents, in the case of herbicides we highlight Oxyfluorfen and Glyphosate with high toxicity and whose consumption is very high. In the case of pesticides and fungicides, among others are Organochlorine compounds, which have been detected in blood, and Carbon Tetrachloride and Chloroform, considered potent hepatotoxic and neurotoxic. The basic objective of this study is the awareness and acquisition of knowledge by future teachers about polluting agents, which will subsequently have an impact on society.
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Article
Open Access January 14, 2023

Searching for What You Can’t See - Evaluation of Pesticide Residues in Grain Sold at Selected Markets of Southwest Nigeria

Abstract Studies on the use of pesticides in southwest Nigeria have revealed a substantial rise in a variety of pesticide-related illnesses, including mental impairment and reproductive problems. Those who work in agriculture and are regularly exposed to pesticides are the most impacted. The World Health Organization (WHO) predicts that three million severe pesticide poisoning episodes occur globally each [...] Read more.
Studies on the use of pesticides in southwest Nigeria have revealed a substantial rise in a variety of pesticide-related illnesses, including mental impairment and reproductive problems. Those who work in agriculture and are regularly exposed to pesticides are the most impacted. The World Health Organization (WHO) predicts that three million severe pesticide poisoning episodes occur globally each year, with at least 300.000 deaths and 99% of cases occurring in low- and middle-income nations. The effects of longer-term exposure to pesticides on health are not yet precisely estimated. Objectives: To this end, the objective of this study is to assess the knowledge of pesticide residues and common pesticides in grain-based food (brown and white beans, yellow and white maize, brown millet and rice) about pesticide use in selected markets of Southwest Nigeria. Methods: A total of 240 respondents were selected from four states (Ado-Ekiti, Ibadan, Osun and Ondo) with the aid of structured questionnaire and interview guide using purposive sampling technique. The markets were Oja-titun (market) Ile-Ife, Osun; Alesinloye Market Ibadan, Oyo; Oja Oba, Ado-Ekiti, Ekiti; and Oja Oba, Akure Ondo State. The identification and quantification of pesticide residues was done using a Varian 3800/4000 gas chromatograph mass spectrometer while 60 structured questionnaires were administered to respondents including food merchants, buyers/consumers as well as food vendors. Data were analysed using descriptive statistics. Results: The experiment was conducted from November 2020 to November 2021. Up to 50.4% never read instructions on pesticide application while a shared 24.8% read them always and occasionally. The number of respondents who never read the instructions were particularly high in Ekiti and Ondo, up to 52.5% of the respondents in Ekiti do not know whether or not they are exposed to pesticides during application. Also, majority of the respondents never attended any professional training on pesticide application, this amounted to 79.3%. Most people were not aware that unsafe pesticide application is harmful to human health. Similarly, a wide variety of symptoms were reported by respondents following pesticide application or consumption of grains, these included headaches and dizziness, itching and redness of the eyes, skin allergy, diarrhea, and stomach disorder, vomiting and loss of appetite, weakness of the body, asthma, permanent skin patches, shortness of breath, excessive sweating. Millet recorded the highest number of OCP residues while maize had the lowest. On the contrary, maize had the highest number of OPP and carbamate residues while millet had the lowest number of OPP residues. Meanwhile, maize, rice and beans had only one carbamate pesticide residue. Conclusions: According to the study's conclusions, farmers who can only get information from agricultural extension officials should receive urgent and immediate attention for raising awareness. Additionally, extensive IPM training programs must be created with the intention of disseminating precautions for protecting human health and a healthy agro-ecosystem. In order to find more effective pest management methods that utilize less pesticides, it is crucial to reevaluate the pesticide residues and common pesticides found in grains in the targeted markets. To reduce farmers' exposure to pesticides, it is also required to establish personal protective measures, special educational initiatives, and legislation promoting the use of safer pesticides. Significance and novelty: This study gives policymakers a comprehensive understanding of the ways that may be utilized to close the significant knowledge gap on pesticide residues in grains and provides an insight into the knowledge of pesticide residues and common pesticides in grains.
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Article
Open Access January 06, 2023

False Beliefs about Contracting Avian (Bird) Flu from Processed Poultry Products

Abstract Avian influenza (bird flu) occurs sporadically in American poultry flocks, decimating these flocks and causing substantial economic losses. Avian influenza also impacts the beliefs of food handlers and preparers in the home (home cooks). Although those who properly handle and prepare processed poultry products cannot succumb to avian influenza, there is a widespread belief that one can contract [...] Read more.
Avian influenza (bird flu) occurs sporadically in American poultry flocks, decimating these flocks and causing substantial economic losses. Avian influenza also impacts the beliefs of food handlers and preparers in the home (home cooks). Although those who properly handle and prepare processed poultry products cannot succumb to avian influenza, there is a widespread belief that one can contract the bird flu from these foods. Beliefs about getting avian influenza from poultry products and intentions to avoid consuming poultry products are the focus of this study of 285 home cooks. False beliefs about getting avian influenza from handling, preparing, and consuming poultry products are apparent in this sample. Correlational analysis also shows that those holding the false beliefs intend to act upon those beliefs by planning not to consume poultry products. Moreover, the false beliefs about contracting avian influenza from poultry products are correlated with a bias to see oneself as less likely to produce food that contains foodborne diseases. These findings are consistent with, and contribute to, the research literatures on belief formation and change, behavioral intentions, and with research showing how guilt by association thought processes underlie false beliefs related to food safety. This research has important implications for poultry and other food processing industries, and for campaigns to persuade the public about real and imaginary risks associated with particular food products.
Article
Open Access August 24, 2022

Epidemiological and Clinical Profile of Deaths due to COVID-19 among Hospitalized Patients in Sidama Region, Ethiopia

Abstract Novel corona virus disease (COVID-19) pandemic, which started in China's Hubei province in 2019, has caused a significant loss of human lives globally. This study describes the epidemiologic and clinical profiles of COVID-19 related deaths among patients admitted to treatment centers in Sidama region, Ethiopia. A cross-sectional study of 186 in hospital COVID-19 related deaths that occurred from [...] Read more.
Novel corona virus disease (COVID-19) pandemic, which started in China's Hubei province in 2019, has caused a significant loss of human lives globally. This study describes the epidemiologic and clinical profiles of COVID-19 related deaths among patients admitted to treatment centers in Sidama region, Ethiopia. A cross-sectional study of 186 in hospital COVID-19 related deaths that occurred from July 2020 to December 2021 in Sidama region were analyzed. Data was extracted from regional emergency operation center death report. Data was entered using Epidata v3.1 and analysis was done using SPSS v.20. Categorical data was summarized using frequency and percentage while continuous data was summarized using median and interquartile range. Association between variables was assessed using chi-square test. More than two-third of the deceased patients were male (135; 72.6%) and median age at death was 60. The majority of deaths (151; 81.1%) occurred in 2021, while April 2021 had the highest death records. Cough and shortness of breath were the main presenting symptoms occurring in 89.2% and 85.5% of deceased patients respectively. Most of the COVID-19 related deaths (64.5%) had associated comorbidities. Diabetes (50%) and Hypertension (39.2%) were the most prevalent comorbidities. Significant proportion of patients (74.73%) presented on severe end of disease spectrum (critical/ severe). Of the deceased patients, around two-third required Intensive care unit (ICU) admission and 111 of them were put on mechanical ventilator. Moreover, the median ICU stay was 4 days. Around half of the death (48.4%) occurred in the first 5 days. The median survival time from symptom onset was 11.5 days with most (43.5%) of the deaths occurring within the first 14 days of symptom onset. Age category was significantly associated with the number of days from onset to death (p=0.006). The case fatality rate was 1.87% which is lower than national and global reports. Unlike previous studies, the prevalence of asthma among deceased patients was low and there were no patients with documented COPD.
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Article
Open Access October 22, 2021

PTEN May Involve in Regulation of PD-L1 Expression in Triple Negative Breast Carcinoma

Abstract Triple negative breast carcinoma (TNBC) is a rapid progressive tumor and has a poor overall survival. Therefore, it is crucial to find out effective molecular targets and develop optimal therapeutic strategies for TNBC. In this study, immunohistochemical staining was used to detect expressions of programmed death-ligand 1 (PD-L1) and phosphatase and tensin homolog (PTEN) in 136 breast carcinomas including 50 TNBC. The effect of PTEN on regulation of PD-L1 expression was assessed in vitro in the PTEN knockdown TNBC cells. We found that PD-L1(SP142) positive rate in TNBC (48.0%) was significantly higher than non-TNBC (23.3%). PTEN negative rate was 42% in TNBC. The inverse correlation between PTEN and PD-L1(SP142) expression in TNBC was statistically significant (P [...] Read more.
Triple negative breast carcinoma (TNBC) is a rapid progressive tumor and has a poor overall survival. Therefore, it is crucial to find out effective molecular targets and develop optimal therapeutic strategies for TNBC. In this study, immunohistochemical staining was used to detect expressions of programmed death-ligand 1 (PD-L1) and phosphatase and tensin homolog (PTEN) in 136 breast carcinomas including 50 TNBC. The effect of PTEN on regulation of PD-L1 expression was assessed in vitro in the PTEN knockdown TNBC cells. We found that PD-L1(SP142) positive rate in TNBC (48.0%) was significantly higher than non-TNBC (23.3%). PTEN negative rate was 42% in TNBC. The inverse correlation between PTEN and PD-L1(SP142) expression in TNBC was statistically significant (P<0.05). After PTEN knockdown, PD-L1 expression in TNBC cells increased significantly, and the expression level of AKT increased simultaneously. PTEN knockdown promoted cell proliferation, viability and G1/S switch of TNBC cells. These results suggested that PTEN may involve in regulation of PD-L1 expression, because PTEN loss can upregulate PD-L1 expression in TNBC. Antitumor immunity of PD-L1 could be enhanced in TNBC when targeting PTEN at the same time.
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Communication
Open Access January 31, 2026

Management of Placenta Accreta Spectrum Disorders: A Prospective Single-Centre Experience of 236 Cases in Riyadh, Saudi Arabia (2018–2024)

Abstract Objective: To evaluate maternal and neonatal outcomes of women with placenta accreta spectrum (PAS) disorders managed by a dedicated multidisciplinary team at a tertiary referral centre in Riyadh, Saudi Arabia. Methods: We conducted a prospective case series of all women with antenatally suspected and intraoperatively or histopathologically confirmed PAS managed at King Fahad Medical [...] Read more.
Objective: To evaluate maternal and neonatal outcomes of women with placenta accreta spectrum (PAS) disorders managed by a dedicated multidisciplinary team at a tertiary referral centre in Riyadh, Saudi Arabia. Methods: We conducted a prospective case series of all women with antenatally suspected and intraoperatively or histopathologically confirmed PAS managed at King Fahad Medical City between April 2018 and December 2024. Women with high suspicion of PAS were electively admitted at 31+6 weeks’ gestation for optimisation when feasible and delivered by midline laparotomy and fundal or classical caesarean incision with the placenta left in situ. Definitive management consisted of hand-assisted retrograde caesarean hysterectomy or segmental uterine resection with reconstruction. Outcomes included operative time, quantified blood loss, transfusion requirements, intra- and postoperative complications, intensive care unit (ICU) admission, hospital stay, and neonatal morbidity. Results: A total of 236 women with confirmed PAS were managed. Median maternal age was 36 years and placenta previa coexisted in 86.9%. Elective caesarean delivery at 34+0–35+6 weeks occurred in 72.0%, whereas 28.0% required emergency delivery for haemorrhage or labour. Caesarean hysterectomy was performed in 85.2% and conservative segmental uterine resection in 14.8%. Median operative time was 135 minutes and median blood loss 4.3 L; the median transfusion requirement was six units of packed red blood cells. Intraoperative complications occurred in 27.1%, most commonly bladder injury (14.8%). One woman (0.4%) died intraoperatively from disseminated intravascular coagulation with intracardiac thrombosis. ICU admission was required in 66.0%. Neonatal intensive care unit admission occurred in 53.0%, mainly because of prematurity; there were no neonatal deaths. Conclusion: Centralised multidisciplinary management of PAS with planned delivery at 34–35 weeks, avoidance of placental removal, and use of retrograde hysterectomy or segmental resection can minimise haemorrhage and maternal mortality while maintaining acceptable neonatal outcomes in a high-volume referral centre.
Article
Open Access January 19, 2026

Mature Cataract, A Veil Concealing, A Pachychoroid Spectrum: About Two Cases

Abstract The pachychoroid spectrum is a new entity grouping pathologies with common choroidal features. First described in 2013 by American ophthalmologist Bailey Freund and his team [1]. It is defined by a diffuse or focal increase in choroidal thickness with dilatation of choroidal vessels adjacent to Bruch's membrane, associated with retinal pigment epithelial dysfunction, loss of the choriocapillaris [...] Read more.
The pachychoroid spectrum is a new entity grouping pathologies with common choroidal features. First described in 2013 by American ophthalmologist Bailey Freund and his team [1]. It is defined by a diffuse or focal increase in choroidal thickness with dilatation of choroidal vessels adjacent to Bruch's membrane, associated with retinal pigment epithelial dysfunction, loss of the choriocapillaris and thinning of Sattler's layer [1, 2]. At present, the pachychoroid spectrum includes well-known pathologies such as central serous chorioretinitis (CSCR) and polypoidal choroidal vasculopathy (PCV), as well as pathologies of more recent description such as epitheliopathy or type 1 neovessels secondary to pachychoroid, pachydrusen, choroidal excavation and peripapillary pachychoroid. The morphological changes of the lens which is a cataract can be unilateral or bilateral and occur symmetrically or not over variable durations. A cataract is said to be mature when the opacification occupies the entire lens, it induces a complete loss of vision. It makes the visualization of the fundus reflection impossible, which explains the impossibility of visualizing hemorrhages and other lesions of the eye with the possibility of concealing a pachychoroid spectrum during the ocular examination in patients. The aim of our study is to describe the symptomatology and therapeutic approach of SPC.
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Case Report
Open Access January 07, 2026

Pre-eclampsia’s Hidden Risk: Sudden Postpartum Bilateral Serous Retinal Detachment with Complete Visual Recovery

Abstract Introduction: Severe pre-eclampsia is a multisystem disorder associated with various ocular complications, however postpartum bilateral serous retinal detachment is uncommon and may threaten vision if not early recognized, thus requiring prompt management in order to prevent permanent visual loss. Clinical Description: A case of a 31-year-old woman, G3P0 with an in vitro [...] Read more.
Introduction: Severe pre-eclampsia is a multisystem disorder associated with various ocular complications, however postpartum bilateral serous retinal detachment is uncommon and may threaten vision if not early recognized, thus requiring prompt management in order to prevent permanent visual loss. Clinical Description: A case of a 31-year-old woman, G3P0 with an in vitro fertilization and previous miscarriages, developed severe pre-eclampsia at 34 weeks of gestation. She underwent an emergency cesarean section for maternal indication. On the second postoperative day, she develops sudden unilateral blindness and blurred vision in the contralateral eye. Ophthalmological examination showed normal optics discs while MRI revealed bilateral serous retinal detachment. She was managed conservatively with strict blood pressure control, magnesium sulphate therapy and anticoagulation with full recovery of vision over 3 weeks without need of surgical intervention. Discussion: Postpartum retinal detachment is uncommon, most often serous and reversible. This case highlights that conservative management focusing on strict blood pressure control and supportive care was sufficient to avoid surgical intervention. Timely diagnosis and coordinated multidisciplinary management ensured complete visual recovery. Conclusion: Bilateral serous retinal detachment is a rare but reversible postpartum complication of severe pre-eclampsia. With early recognition, close monitoring and conservative management can lead to complete restoration of vision.
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Case Report
Open Access December 28, 2025

Acute Right Ovarian Torsion with Six Twists: Successful Ovarian Preservation Following Detorsion

Abstract Introduction: Ovarian torsion is a rare gynecological emergency that can result in permanent ovarian loss if not promptly recognized and managed. Cases involving multiple rotations of the ovary are highly unusual and pose a significant risk for ovarian viability. Clinical Description: A 33-year-old P2 woman presented with sudden severe lower abdominal pain. Imaging showed a complex [...] Read more.
Introduction: Ovarian torsion is a rare gynecological emergency that can result in permanent ovarian loss if not promptly recognized and managed. Cases involving multiple rotations of the ovary are highly unusual and pose a significant risk for ovarian viability. Clinical Description: A 33-year-old P2 woman presented with sudden severe lower abdominal pain. Imaging showed a complex midline adnexal mass, more towards left and mild free fluid with suspected torsion. Emergency laparotomy showed a sixfold torsion of the right ovary with a dermoid cyst. Detorsion and cystectomy were performed with preservation of the ovary. Postoperative recovery was uneventful and histopathology further confirmed a benign dermoid cyst. Discussion: Ovarian torsion with multiple rotations is extremely rare so early recognition and timely surgical intervention enable ovarian salvage even in severe cases. Moreover, Dermoid cysts are the most common predisposing factor. Conclusion: This case highlights the importance of prompt diagnosis and immediate management of ovarian torsion to prevent complications, preserve ovarian integrity and fertility.
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Case Report
Open Access October 04, 2025

Unequal Burden of Loss of a Loved One in Non-Hispanic Black and White Californians

Abstract Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR [...] Read more.
Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs.
Article
Open Access August 20, 2025

A Comparative study of visual narrative in Chekhov's misery and Lu Xun's the New Year's sacrifice

Abstract This article is a comparative analysis of the short stories «Longing» by Anton Chekhov and «Prayer for Happiness» by Lu Xun, exploring the themes of social exclusion, grief and the impossibility of communication in society at the end of the XIX – beginning of the XX century. The article examines how both authors portray the struggle of the main characters to connect with other people in the face [...] Read more.
This article is a comparative analysis of the short stories «Longing» by Anton Chekhov and «Prayer for Happiness» by Lu Xun, exploring the themes of social exclusion, grief and the impossibility of communication in society at the end of the XIX – beginning of the XX century. The article examines how both authors portray the struggle of the main characters to connect with other people in the face of personal tragedy and the indifference of society. The author analyzes the narrative techniques, symbolic images and character development used by Chekhov and Lu Xun to convey universal human experiences of loss, loneliness and the search for meaning in an indifferent world.
Article
Open Access July 12, 2025

Nodal Marginal Zone Lymphoma with IgG and IgM Secretion of Kappa Light Chain: Case Report

Abstract Nodal marginal zone lymphomas are indolent and rare non-Hodgkin lymphomas, most often diagnosed at an advanced stage. Their clinical presentations are typically insidious, which can lead to delayed diagnosis. The concomitant secretion of IgM and IgG immunoglobulins with kappa light chains constitutes an exceptional feature in this type of lymphoma, as illustrated by our case. We report the case of [...] Read more.
Nodal marginal zone lymphomas are indolent and rare non-Hodgkin lymphomas, most often diagnosed at an advanced stage. Their clinical presentations are typically insidious, which can lead to delayed diagnosis. The concomitant secretion of IgM and IgG immunoglobulins with kappa light chains constitutes an exceptional feature in this type of lymphoma, as illustrated by our case. We report the case of a 62-year-old man with a history of treated syphilis and inferior vena cava thrombosis managed with rivaroxaban, who presented with a left inguinal mass evolving over three months, accompanied by fever, night sweats, and weight loss. Clinical examination revealed non-inflammatory left inguinal lymphadenopathy without other abnormalities. Laboratory tests showed non-regenerative anemia, leukopenia, and elevated LDH levels. Protein electrophoresis revealed a monoclonal peak in the gamma region, confirmed by serum immunofixation showing two monoclonal bands of IgG kappa and IgM kappa types. Biopsy of the inguinal lymph node revealed histological and immunohistochemical features consistent with a small B-cell marginal zone lymphoma, staged as IV based on the extension workup. A chemotherapy regimen consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was initiated, resulting in a partial response after four cycles. The coexpression of IgM and IgG kappa light chains in nodal marginal zone lymphomas, which are already rare, is an unusual finding. This particularity warrants multicenter studies to better assess its diagnostic, prognostic, and therapeutic implications.
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Case Report
Open Access December 22, 2023

Cloud Based Payment Processing and Merchant Services: A Scalable and Secure Framework for Digital Transactions in a Globalized Economy

Abstract In today’s world of a globalized economy and ubiquitous digital transactions, businesses are hungry for ways to increase transaction efficiency and security. In the real economy, solutions that scale to fit transaction volume or velocity are equally valuable. This is true for clearing and settlement and for the day-to-day needs of buyers and sellers alike. Clever observers of both cash and digital [...] Read more.
In today’s world of a globalized economy and ubiquitous digital transactions, businesses are hungry for ways to increase transaction efficiency and security. In the real economy, solutions that scale to fit transaction volume or velocity are equally valuable. This is true for clearing and settlement and for the day-to-day needs of buyers and sellers alike. Clever observers of both cash and digital transactions can spot cases where technology that supports transaction security or safety can strengthen consumer-borrower ties, mitigate default risks, and reduce recidivism. In general, a cloud solution for payment processing and merchant services solves two major barriers to optimum business technology: lack of scalability and lack of security [1]. The extension of current practice has its advantages, but new solutions unlock significant opportunities for both consumers and financial institutions [2]. The focus of this work is on the provisioning of cloud-based payment processing and merchant services to financial institutions and established global organizations, although the options available with these services mean they are potentially applicable to a wide range of group entities, including non-trading organizations, pension administrators, and group treasurers. With the increased attention to cybersecurity, a mass of data is available to assist the IT departments of the major payment processors, merchants, and acquirers to get cybersecurity on the radar of C-level executives [3]. The case is put forward for the increased targeting of and reporting to the Board’s Audit, Risk, and Liability Committees of publicly held payment processors and merchants to reduce fraud losses and mitigate the reputation and class action lawsuit risk due to data breaches. The progress of technology in the payment sector requires all stakeholders to have a collective approach in order to mitigate fraud and cybersecurity-related risks in new products and services to enhance consumer confidence and the proportion of retail cashless transactions [4].
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Review Article
Open Access January 22, 2025

Tech Transformations: Modern Solutions for Obstructive Sleep Apnea

Abstract Recent advancements in the screening, diagnosis, and management of obstructive sleep apnea (OSA) have significantly improved patient outcomes. For screening, the use of home sleep apnea testing (HSAT) has become more prevalent, offering a convenient and cost-effective alternative to traditional in-lab polysomnography. HSAT devices have shown good specificity and sensitivity, particularly in [...] Read more.
Recent advancements in the screening, diagnosis, and management of obstructive sleep apnea (OSA) have significantly improved patient outcomes. For screening, the use of home sleep apnea testing (HSAT) has become more prevalent, offering a convenient and cost-effective alternative to traditional in-lab polysomnography. HSAT devices have shown good specificity and sensitivity, particularly in patients with a high pre-test probability of OSA. In terms of diagnosis, advancements in wearable technology and mobile health applications have enabled continuous monitoring of sleep patterns and respiratory parameters. These tools provide valuable data that can be used to identify OSA more accurately and promptly. Additionally, machine learning algorithms are being integrated into diagnostic processes to enhance the accuracy of OSA detection by analyzing large datasets and identifying patterns indicative of the condition. Management of OSA has also seen significant progress. Continuous positive airway pressure (CPAP) therapy remains the gold standard, but new developments include auto-adjusting CPAP devices that optimize pressure settings based on real-time feedback. Mandibular advancement devices and hypoglossal nerve stimulation are emerging as effective alternatives for patients who are CPAP-intolerant. Furthermore, lifestyle interventions such as weight management, positional therapy, and exercise have been shown to complement medical treatments, leading to better overall outcomes. This review article highlights these advancements that collectively contribute to improved patient adherence, reduced symptoms, and enhanced quality of life for individuals with OSA.
Review Article
Open Access May 22, 2024

Clinical evaluation of periodontitis types affected cumulative and annually radiographic periodontal alveolar bone loss using the treatment of Sandwich’s technique

Abstract The aim of the present study was to assess the cumulative radiographic periodontal attachment loss (CRPAL) and annually radiographic periodontal attachment loss (ARPAL) of different disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with separated periods of 5 years or more in teaching hospital during 1981-2001, [...] Read more.
The aim of the present study was to assess the cumulative radiographic periodontal attachment loss (CRPAL) and annually radiographic periodontal attachment loss (ARPAL) of different disease groups over 5 years or more. A total of 53 subjects, who had taken two sets of full-mouth standarized paralleling radiographs with separated periods of 5 years or more in teaching hospital during 1981-2001, were collected for the past 20 years. The radiographic periodontal attachment levels at mesial and distal surfaces of teeth were assessed by measuring the distance between cement-enamel junction and the bone crest using an electronic digital caliper (EDC) under a 10X magnified radiographs. The results revealed that mean CRPAL was highest in the generalized aggressive periodontitis (GAgP) group (-5.523.27 mm), then the chronic periodontitis (CP) group (-4.823.47 mm), and the localized aggressive periodontitis (LAgP) group (-4.473.47 mm) followed, and lowest in the periodontal healthy (PH) group (-1.050.59 mm). The mean ARPAL was highest in the LAgP group (-0.260.25 mm/yr.), then the GAgP group (-0.200.13 mm/yr.), and the CP group (-0.120.09 mm/yr.) followed, and lowest in the periodontal healthy group (0.070.06 mm/yr.). Conclusions showed that mean CRPAL was highest in the generalized aggressive periodontitis group, then the CP group, and the LAgP group followed, and lowest in the periodontal healthy group. In addition, there existed a strong statistical significance (p<0.0001) in both CRPAL and ARPAL (mm) among individuals affected GAgP, LAgP, CP, and PH groups among mild, moderate, and severe periodontitis using paired t-test.
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Open Access February 20, 2023

Response of Three Cucumber Cultivars to the Application of Sulphate of Ammonia as top Dressing with Respect to Fruit Yield and Shelf Life

Abstract The experiment was conducted in the experimental field of the Horticulture Department, University for Development Studies (UDS), Nyankpala campus with the aim of determining the response of three cucumber cultivars (Marketer, Nandini, Pointset) to the application of sulphate of ammonia as top dressing with respect to fruit yield, and shelf life. It was a 3 x 3 x 2 factorial arranged in a [...] Read more.
The experiment was conducted in the experimental field of the Horticulture Department, University for Development Studies (UDS), Nyankpala campus with the aim of determining the response of three cucumber cultivars (Marketer, Nandini, Pointset) to the application of sulphate of ammonia as top dressing with respect to fruit yield, and shelf life. It was a 3 x 3 x 2 factorial arranged in a randomized complete block design with three replications. Data was collected on total fruit yield, shelf life and percentage fruit decay in storage. Their effect on the varieties differed significantly to a varying degree. The factors, however, had no significant impact and caused no difference in the fruit yield and fruit weight. 15:15:15 NPK effect on the cucumbers caused a high decay incidence when applied alone or in combination with (NH4)2SO4. Therefore, the application rate may be revised or reduced to experiment if decay incidence would decline in storage. Further studies may extensively be carried out to note if varying the rate of NPK would impact positively on the shelf life of cucumber. (NH4)2SO4 effect increased weight loss in cucumbers hence, better storage techniques should be considered by controlling high temperatures. Complete fertilizer; 15:15:15 NPK and (NH4)2SO4 had a positive impact on protein and fibre. Hence, their application is recommended for increasing protein and fibre level in cucumbers.
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