RESUMEN
Moyamoya disease is a cerebrovascular condition characterized by progressive occlusion of the cerebral vessels, particularly in the circle of Willis. This report describes the case of a 12-year-old boy presenting with a history of recurrent right-sided weakness over a period of seven years. Magnetic resonance imaging revealed evidence of both old and recent infarcts, as well as encephalomalacic changes. The diagnosis was confirmed by magnetic resonance angiography, which demonstrated severe stenosis in both internal carotid arteries and the presence of significant collateral formation. In Bangladesh, surgical revascularization for Moyamoya disease had not been previously attempted, and due to financial constraints, the patient's family opted for conservative management with anti-platelet therapy and regular follow-ups. Although a hereditary component is often presumed in Moyamoya disease, no such familial history was identified in this case. Additionally, no associations with immunological, infectious, hematological, vascular, or congenital syndromes were found. Mortality rates for Moyamoya disease are approximately 10% in adults and 4.3% in children, with a significant proportion of affected individuals experiencing cognitive decline. However, the patient in this case maintained intact cognitive function, and with diligent follow-up and anticoagulation therapy, it was anticipated that his functional capacity would remain stable.
RESUMEN
BACKGROUND: Mobile apps have been shown to play an important role in the management, care, and prevention of infectious diseases. Thus, skills for self-care-one of the most effective ways to prevent illness-can be improved through mobile health apps. OBJECTIVE: This study aimed to design, develop, and evaluate an educational mobile-based self-care app in order to help the self-prevention of COVID-19 in underdeveloped countries. We intended the app to be easy to use, quick, and inexpensive. METHODS: In 2020 and 2021, we conducted a methodological study. Using the ADDIE (analysis, design, development, implementation, and evaluation) educational model, we developed a self-care management mobile app. According to the ADDIE model, an effective training and performance support tool is built through the 5 phases that comprise its name. There were 27 participants who conducted 2 evaluations of the mobile app's usability and impact using the mobile health app usability and self-care inventory scales. The study design included pre- and posttesting. RESULTS: An Android app called MyShield was developed. The results of pre- and posttests showed that on a scale from 0 to 5, MyShield scored a performance average of 4.17 in the physical health dimension and an average of 3.88 in the mental well-being dimension, thereby showing positive effects on self-care skills. MyShield scored highly on the "interface and satisfaction," "ease of use," and "usefulness" components. CONCLUSIONS: MyShield facilitates learning self-care skills at home, even during quarantine, increasing acquisition of information. Given its low development cost and the ADDIE educational design on which it is based, the app can be helpful in underdeveloped countries. Thus, low-income countries-often lacking other tools-can use the app as an effective tool for fighting COVID-19, if it becomes a standard mobile app recommended by the government.
RESUMEN
Cancer is a global health issue that disproportionately kills based on stage of disease, cellular pathology, and genetics, to name a few. Another variable to consider in this ongoing fight is treatment machine complexity that leads to elevated development and purchasing cost, leading to a reduced use. Reducing the complexity (in hopes of lowering costs) would benefit underdeveloped, low- and middle-income countries by introducing newer treatment technology, as their currently accepted standards do not meet standards of more advanced, developed countries. In this study, unilateral head and neck (H&N), and prostate cases using volumetric modulated arc therapy (VMAT) were tested with multiple segment widths of 5, 10, 15, and 20mm to create treatable plans. Pinnacle 9.10v was used for planning purposes. A total of 12 cases were planned with varying multileaf collimator (MLC) widths. Treatment plans were evaluated retrospectively. Results show that altering the MLC widths from 5 through 20mm produces both comparable and treatable plans up to 99% and 98% target coverage for H&N and prostate, respectively, albeit clinically significant hot spots were shown to increase with increasing segment width. Furthermore, the results show that increasing widths can produce comparable treatment plans as measured against our current Food and Drug Administration (FDA)-approved treatment devices-leading to an increase in treatment efficacy in economically underdeveloped countries.
