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BACKGROUND: The Angio-invasive Rhino-orbito-cerebral mucormycosis (ROCM) producing strokes is a less explored entity. Our hospital, a stroke-ready one, had an opportunity to manage mucormycosis when it was identified as the nodal center for mucormycosis management. We are sharing our experiences and mistakes in managing the cerebrovascular manifestations of ROCM. METHODS: We conducted a prospective observational study during the second wave of the COVID-19 pandemic from 1st May 2021 to 30th September 2021, where consecutive patients aged more than 18 years with microbiologically confirmed cases of ROCM were included. Clinical details (timing of stroke onset after ROCM symptoms, GCS, NIHSS), imaging findings (ASPECTS, the territory of stroke, the pattern of infarct, hemorrhagic transformation, cavernous sinus thrombosis), angiogram findings, management details (IV thrombolysis), and outcomes (mRS at discharge and duration of hospital stay) were documented. We also compared the demographics, clinical features (NIHSS), radiological findings, treatment details, duration of hospital stay, and functional outcome at the discharge of the ROCM stroke patients with stroke patients without ROCM. RESULTS: Stroke developed in 42% of patients with ROCM, predominantly anterior circulation border zone ischemic infarcts. Strokes occurred after a median of five days from the onset of ROCM symptoms. The most common vessel involved was the ophthalmic artery, followed by the cavernous ICA. We could not thrombolyse ROCM stroke patients. ROCM patients who developed stroke compared with patients without stroke had a more infiltrative fungal infection and higher inflammatory markers. Mucormycosis associated stroke patients had higher in-hospital mortality and poor functional outcomes. T CONCLUSION: Due to delayed recognition of stroke symptoms, none received reperfusion strategies, leading to poor functional outcomes. For early stroke detection, ROCM cases need frequent monitoring and education of patients and their relatives about the ALS acronym (loss of ambulation, limb weakness, and loss of speech).
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COVID-19 , Mucormicosis , Pandemias , Accidente Cerebrovascular , Humanos , Antifúngicos/uso terapéutico , COVID-19/complicaciones , Curva de Aprendizaje , Mucormicosis/diagnóstico , Mucormicosis/epidemiología , Mucormicosis/terapia , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/epidemiologíaRESUMEN
Academic success is a multifaceted achievement that depends on a myriad of factors, spanning personal, environmental, and institutional dimensions. The intricate interaction of numerous factors, such as how effective and interested a student is in their own academic performance, shapes their potential for academic achievement. This study's goal is to examine the effects that diversity, colour, and immigration status have on the academic accomplishment of 109 college students in Chinese province of Fujian. The main objective of the study to infer on how self-efficiency, self-interest, and stress affect academic achievement in particular. The researcher devised a survey tool in order to determine the degree of academic self-efficiency, academic self-interest, and stress connected to academic activities. The method of data collection that was used was called purposive sampling, and the participants were students in their primary year of university. The findings suggest that the scales that were used in the research have a high degree of reliability and exhibit very little inverse connection. "A Structural Equation Model (SEM) was created in order to examine the relative effects of stress and self-efficiency in predicting three aspects of academic performance: fresher man grade point average, credits earned, and persistence in studies beyond the first year (Considine and Zappala, 2002) [16]". According to the data, self-efficiency is a stronger and more reliable predictor than the pressure connected with academic achievement. In conclusion, this study's originality lies in its holistic approach to understanding academic success, and its research implications extend to policy development, intervention strategies, equity and inclusion efforts, future research directions, and teacher training, all aimed at improving the academic success of diverse student populations.
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Background: As Industry 4.0 debuted roughly a decade ago, it is now necessary to examine how it affects various aspects of the discipline. It is the responsibility of the education sector to guarantee that the next generation is equipped mentally, physically, and cognitively to face unforeseen challenges. Numerous educational institutions are outfitted with Industry 4.0 technology-based learning. Industry 4.0 fosters advancements in learning methodologies, especially for language enhancements. Learners may gain knowledge at their base, providing them an opportunity for independent study. The majority of subjects have been acquired through Industry 4.0. This research chapter explores the intersection of Industry 4.0 and education, specifically focusing on the SmallTalk AI tool. It investigates how technological and digital innovations within the context of Industry 4.0 can serve as powerful tools to enhance language learning outcomes. Methods: This article presents a comprehensive analysis of statistical data and empirical evidence to support the positive impact of Industry 4.0 technology of SmallTalk on language acquisition particularly speaking. The study also determines the relationship among participants' usage through the technology acceptance model (TAM). Furthermore, it examines the challenges and opportunities associated with integrating these innovations into language learning pedagogies, offering insights for educators and policymakers to harness the potential of Industry 4.0 in fostering language proficiency. The research employs quantitative analysis. The data obtained from educational institutions has been analyzed using the SPSS and AMOS software. Results: The results indicate that Industry 4.0 has had an important effect on English language acquisition. This self-supported adaptable system of education facilitates effective student learning. This study also suggests that future research into the utility of Industry 4.0 be conducted elsewhere internationally.
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During this period in history, the advancement of technology is developing at a fast pace, and it is becoming more important to every normal person. In particular, the smart phone, which is quickly becoming one of the most frequently used gadgets in ordinary life, is no longer considered a luxury commodity. Because of the COVID-19 epidemic, students are not required to utilise textbooks while studying. Beyond textbooks, there are numerous other media that may be used to advance an individual's education and development. The purpose of this research study is to investigate the effect of social media, namely Blogs, on the vocabulary acquisition of ESL students. A questionnaire was adopted for data collection from 60 people from different universities, and the results were analysed using a descriptive method. Following the responses given by the respondents, it was noticed that a lot of ESL learners believed that using Blogs to improve vocabulary development is beneficial since it raises the degree of involvement in studying. The current research investigates the use of social constructivist theory in the teaching of ESL learners. The purpose of this study report is to demonstrate the statistically significant impact of the use of Blogs on the growth of learners' vocabulary. Finally, the article concluded that, in light of the descriptive study, the social constructivist method is very significant in English language learning, particularly in vocabulary development. The following objectives were established for the study through Descriptive Method of Social Constructivist Theory of Learning Vocabulary:â¢To explore the relationship between the use of Blogs and an interest in ESL learners' vocabulary knowledge.â¢To identify the effect of Blogs on the development of English vocabulary among ESL learners by using social constructivist theory.â¢To examine the effect of using Blogs on students' capacity to improve their vocabulary usage.
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The study of medicinal plants with their traditional uses and related pharmacological studies has received more attention during the past several decades around the world. The Malayali tribes of the Javadhu Hills in the Eastern Ghats rely heavily on a system of traditional medicine for healthcare. A qualitative ethnographic method with a semi-structured questionnaire was used to interview 52 people across 11 localities in the Javadhu Hills. In the data analysis, descriptive statistics such as Use reports (UR), frequency of citations (FC), relative frequency of citations (RFC), informant agreement ratio (IAR), fidelity level (FL), and informant consensus factor (FIC) were studied. In the current investigation, 146 species from 52 families and 108 genera were discovered to treat 79 diseases. Leguminosae and Apocynaceae were the dominant families (12 species each). The most frequently used life form was the herb and the plant part were the leaf. The majority were being harvested from natural resources. Most medicines were taken orally. The most frequently cited species are Moringa oleifera and Syzygium cumini. The illnesses were divided into 21 categories. The majority of the plants mentioned are utilised to increase human immunity and health. The principal ailment (general health) was revealed by two-way cluster analysis and PCA. The species Litsea decanensis, Phoebe paniculata, Commiphora caudata, etc., were new records for the Javadhu hills according to a comparison between the current study and previous local and regional research. Documenting novel ethnomedicinal species and their therapeutic applications will encourage more phytochemical and pharmacological research and may even result in the creation of new medications. Furthermore, the study's significant novelty is that principle component analysis and two-way cluster analysis clearly revealed that the species that are used to treat various diseases, as well as species that are closely associated with treating specific ailment categories, are distinct. Significantly, species recorded in this study rely on maintaining and improving general body health of humans.
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Objective Despite the technological advancement in imaging, digital subtraction angiography (DSA) remains gold standard imaging modality for spontaneous subarachnoid hemorrhage (SAH). But even after DSA, around 15% of SAH remains elusive for the cause of the bleed. This is an institutional review to solve the mystery, "when is second DSA really indicated?" Methods In a retrospective review from January 2015 to December 2017, we evaluated cases of spontaneous SAH with initial negative DSA with repeat DSA after 6 weeks to rule out vascular abnormality. The spontaneous SAH was confirmed on noncontrast computed tomography (NCCT) and divided into two groups of perimesencephalic SAH (PM-SAH) or nonperimesencephalic SAH (nPM-SAH). The outcome was assessed by a modified Rankin's score (mRS) at 6 months postictus. Results During the study period, we had 119 cases of initial negative DSA and 98 cases (82.3%) underwent repeat DSA after 6 weeks interval. A total of 53 cases (54.1%) had PM-SAH and 45 cases (45.9%) had nPM-SAH. Repeat DSA after 6 weeks showed no vascular abnormality in 53 cases of PM-SAH and in 2 (4.4%) out of 45 cases of nPM-SAH. At 6 months postictus, all cases of PM-SAH and 93% of nPM-SAH had mRS of 0. Conclusion We recommend, a repeat DSA is definitely not required in PM-SAH, but it should be done for all cases of nPM-SAH, before labeling them as nonaneurysmal SAH. Although the overall outcome for nonaneurysmal spontaneous SAH is better than aneurysmal SAH, nPM-SAH has poorer eventual outcome compared to PM-SAH.
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Galactomannan (PSP001) isolated from the fruit rind of Punica granatum was demonstrated as an excellent antioxidant, immunomodulatory and anticancer agent both in vitro and in vivo models. Since the most lethal and debilitating attribute of cancer cells is their ability to evolve to a state of malignancy, with key features like increased angiogenesis, invasion, migration, colony formation, and metastasis, the present study focused on evaluating the effects of the galactomannan on tumor and malignancy. PSP001 effectively reduced the neovascularization in chick embryos highlighting its potential as an angiogenic inhibitor. Furthermore, the invasion, migration and clonogenic capacity of human and murine cancer cells were dramatically inhibited by PSP001. Evaluation of the molecular mechanism of its unique potential revealed the down regulation of key players including VEGF, MMP-2, and MMP-9 with marked elevation of TIMP-1 and TIMP-2. The anti-metastatic potential of PSP001 tested in pulmonary metastasis C57BL/6 mice model deciphered the combinatorial administration with vincristine deliberated better survival rates and decreased metastatic index. The angiogenic inhibition potential of PSP001 was further proved with peritoneal angiogenesis assay in BALB/c mice ascitic tumor model. The outcomes of the current investigation highlight the mode of action of antitumor galactomannan in the reduction of tumor malignancy.
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Antineoplásicos/farmacología , Lythraceae/química , Polisacáridos/farmacología , Animales , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Masculino , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Ratones , Invasividad Neoplásica , Metástasis de la Neoplasia , Neovascularización Patológica/tratamiento farmacológico , Inhibidor Tisular de Metaloproteinasa-1/metabolismo , Inhibidor Tisular de Metaloproteinasa-2/metabolismo , Regulación hacia Arriba/efectos de los fármacos , Factor A de Crecimiento Endotelial Vascular/metabolismo , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
INTRODUCTION: Since Glycated Albumin (GA) reflects short term variations and glycated protein shows degrees of hyperglycaemia, the objective of this study was to find GA and microalbuminuria as a early risk markers along with the duration of Uncontrolled Diabetes Mellitus in type 2 diabetic nephropathy. MATERIAL AND METHODS: The present cross-sectional study included randomly selected Uncontrolled Type 2DM (n = 75), controlled Type 2DM (n = 75) and healthy controls (n = 75). Their fasting venous blood samples were obtained for GA and serum creatinine, while their morning urine samples were obtained for detection of microalbuminuria. Statistical analysis was done by using SPSS, version 16.0. One-Way ANOVA was performed. All p-values which were ≤ 0.05 were considered as statistically significant. RESULTS: The mean GA, microalbuminuria and serum creatinine were the highest in Uncontrolled DM as compared to those in Controlled DM respectively. Microalbuminuria and GA had a significant correlation with the duration of diabetes (p<0.0001). CONCLUSION: The present study identified that the risk of microalbuminuria increased with a poor glycaemic control. A persistent increase in GA and microalbuminuria may be considered as risk markers in diabetic nephropathy. Therefore, a regular screening for microalbuminuria and estimation of GA can help in the clinical management, to prevent complications.