Case Study Research Articles

CLINICAL EFFICACY OF ERAND SNEHA IN MANAGEMENT OF ACUTE NE-CROTISING PANCREATITIS: A CASE REPORT

Acute pancreatitis with local and systemic complications should be managed through a multi- disciplinary approach. Delays in assessment or mismanagement may lead to serious consequences. The existing treatment of this disease is mollifying and expensive. Cost-effective management of acute necrotizing pancreatitis with Ayurveda medicines within time constraintsand without any complications is encouraging. CASE PRESENTATION: In this case study, a 45-year-old male patient’s diagnosis of pancreatitis was established on the basis of the revised Atlanta classification. As per morphological classification, the patient was of necrotizingpancreatitis and severity grade was moderate as there were local complications. MANAGEMENT AND OUTCOME: The patient was hospitalized and prescribed Murchit Erand Sneha 100ml at 10 pm daily. The result was assessed by applying a numerical pain assessment scale to subjective and objective findings. On the 25th day patient was found free from signs and symptoms. DISCUSSION: In pancreatitis, Srotorodha is an important phenomenon, and Erand Sneha causes Sampraptivighatana by its Srotoshodhana effect. CONCLUSION: Management of acute necrotizing pancreatitis by using Erand Sneha within time constraints and without any complications is encouraging that needs to be further evaluated on a large number of subjects to bring some concrete conclusions and better treatment modality.

Vesicovaginal fistula post-vaginal delivery late revelation: A case report

Introduction: This study presents a compelling clinical case involving a 43-year-old woman who encountered a vesicovaginal fistula subsequent to vaginal delivery. The narrative encompasses the occurrence, diagnosis, and subsequent management of this rare postpartum complication. Case Report: A 43-year-old woman with an unscarred uterus experienced the conventional signs of postpartum recovery but developed hematuria and vaginal urinary leakage on the seventh postpartum day. Clinical assessment confirmed a vesicovaginal fistula due to partial uterine dehiscence. Diagnostic procedures and the subsequent successful surgical intervention are detailed, followed by the postoperative surveillance strategy and a one-month post-surgery evaluation. Conclusion: This case study demonstrates the successful management of a postpartum vesicovaginal fistula through surgical intervention, resulting in complete closure of the fistula and significant improvement in urinary symptoms. It highlights the importance of timely diagnosis and appropriate surgical intervention in managing such rare complications following vaginal delivery.

Determinants of last-mile travel mode choice under different COVID-19 alert levels: A case study of Batasan Hills, Quezon City, Philippines

The COVID-19 outbreak has led to remarkable changes in the transport sector and people’s travel behavior. The suspension of public transport leads to an increase in the number of private car users and the number of walking activities. The last mile, being one of the weakest links in the transport network, has become more challenging to manage with the imposition of different travel restrictions. Using the data collected from the households of Barangay Batasan Hills, Quezon City, Philippines, this study aimed to understand people’s travel behavior during the pandemic. Specifically, a binary logit model was used to determine the significant factors that affect the last-mile travel mode choice under different alert levels. Results showed that age during the pandemic, monthly household income, the purpose of travel, travel expense, travel time, departure time, origin, compliance with COVID-19 measures, and trip duration have significant factors in last-mile travel mode choice. In addition, risk perception on public transport was also a determinant of last-mile travel mode under alert levels 1 and 2. Analyzing travel behavior during the COVID-19 pandemic is deemed beneficial in devising strategies and interventions that will help mitigate the spread of the virus while still allowing economic activity and the movement of people to happen.

Ukrainian EFL Learners’ Perception towards the Use of Subtitles to Improve Their Listening Skills: a Case Study

Watching English videos is a powerful and popular tool for learning English as a foreign language, and teachers and researchers should pay close attention to it. The research paper investigates current EFL learners’ attitudes towards using subtitles when watching English audio-visual materials. The authors attempt to answer the following question: What are Ukrainian EFL learners’ perceptions of using subtitles to improve their listening skills? The significance of this study is that understanding the learners’ preferences and support for subtitles would help find effective teaching practices. We used a quantitative method to collect research data through online tools (Google Forms). The third-year students training in the BA program to become interpreters were under research. The findings suggest that students agreed on the importance of listening skills. Moreover, almost all participants are convinced that watching audio-visual materials with English subtitles improves their English proficiency. An area worth further investigation is the effect of subtitles on listening and reading skills, which is necessary as it would shed more light on using videos with and without subtitles in EFL acquisition.

Role of Yoga Prana Vidya (YPV) system in the successful management of metabolic diseases: A Review

Metabolism is the complicated chemical reaction in the body's cells that changes food into energy. Nutrition and metabolism are correlated. Metabolic syndrome, a spectrum of metabolic disorders such as obesity, diabetes, cholesterol, blood pressure, etc., is a significant public health problem in India. Prevention and control of metabolic disorders is the focus of healthcare systems. This paper presents a review of recent research on how the Yoga Prana Vidya(YPV) System of Healing protocols have successfully resolved metabolic issues.This study uses a literature review method to identify relevant research articles and synthesize the results. A total of 9 eligible research articles meeting the criteria were selected and the combined sample was 257 people. 2 papers have case studies with a sample of 3 and the remaining 7 have a sample of 254 people who improved metabolic well-being. In 4 out of the 7 studies, the sample of 207 patients experienced statistically significant improvements in body weight, BMI, and waist size within 1 to 7 days of healing camp. Results from the remaining 3 studies with a sample of 47 show marginally significant improvements.The evidence gathered from this study validates the YPV system as a performing therapy to effectively prevent and manage metabolic disorders. Further research with appropriate samples and methodologies is recommended.

Features of Intergovernmental Consultations.The case of Germany

The article explores interstate dialogue focusing on the contacts of highest state bureaucrats and to diplomatic missions. The author analyzed the format of intergovernmental (interstate) consultations and presents the key features of its functioning. The case study is Germany, which has developed a rather comprehensive system of the interstate formats. The difficulties of the creation of Germany’s interstate dialogue with the US, the UK, Anglo-Saxon states as a whole are presented. The article explains the reduction (2019‒2023) in the frequency of German-French interministerial meetings and the ability of the format to overcome the crisis of trust in tandem. The securitization of the negotiation agenda in 2013‒2023 of Germany-Netherlands (as the closest ally of Germany) dialogue is highlighted. The paper determined the causes of the long-term interruption of intergovernmental consultations with NATO member-states and Israel as an increasingly common phenomenon in German foreign policy. Rather illustrative is Germany’s approach to the formats with Russia and China as the key objects for containment by the West. “Bottle necks of the formats used by Germany in Euro-Atlantic community and in the world is underlined.

Critical Care Nursing Response to the Maui Wildfire Disaster: Narrative Review and Case Study.

Climate change has increased the frequency and severity of natural disasters, including the 2023 wildfires in Maui, Hawai'i. The no-notice disaster affected hospital operations at the sole acute care hospital that serves the community, requiring immediate interventions and reallocation of resources. The purpose of this article is to explore the role that critical care nurses play in responding to wildfires. Literature related to the nursing role in managing wildfire injuries and the events on Maui are explored and a case study presented. Results are organized into themes: environmental limitations, disaster response and code triage activation, no-notice preparation for critical care nurses, preparation to increase patient capacity and maintain patient safety standards, hospital staffing and staff affected by the disaster, management of patient care and hospital system operations, and disaster medical tent. Preparation for no-notice events requires critical care nurse involvement to effectively facilitate care for patients affected by disasters.

Enhancing Indigenous Cropping Systems under Climate Change: A Case Study of Maize (Zea mays L.) and Groundnut (Arachis hypogea) in Northern Ghana

Due to the continuous cropping of maize and groundnuts on the same land in northern Ghana for livelihood, production yields have declined significantly below potential levels. The purpose of this study was to evaluate the ecological limitations affecting maize and groundnut productivity in northern Ghana and also to analyze the socioeconomic constraints impacting the livelihoods of smallholder farmers. Five cropping systems (viz. sole continuous maize (SCM), sole continuous groundnut (SCG), maize-groundnut intercrop (MGI), groundnut/maize rotation (GMR) and maize/groundnut rotation (MGR)), each with or without fertilizer were established under RCBD at Nyankpala during the 2021 and 2022 cropping seasons. For the fertilized rotation treatments, the maize crop received 60-N, 40-P2O5, and 40-K2O, kg/ha, while the groundnut crop received 20-N, 40-P2O5, and 40-K2O, kg/ha using NPK 11, 22, 21, kg/ha with trace elements S, Zn and B. The cropping systems were characterised on grain yields, yield related parameters, resource use and economic returns on investments. The results showed that intercrop and rotation treatments gave better yields. Their land equivalent ratios (LER) were 1.2 and 1.09 respectively, in the two seasons. Maize grain yield under the rotation increased from 2.5 to 3.8 t/ha while groundnut pod yield increased from 0.6 to 0.9 t/ha. The system with highest economic returns was recorded for the rotation systems either with or without fertilizer application. To improve livelihoods and productivity, smallholder farmers in northern Ghana should adopt intercrop and rotation systems, incorporate fertilizer application, and consider soil fertility management practices. Policy support and extension services can facilitate the adoption of these sustainable agricultural practices.

A stochastic analysis and bibliometric analysis of COVID-19

COVID-19 a novel Corona Virus Disease which was caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2) continues to pose a critical and urgent threat to global health. When an infected person comes in contact with a normal individual or when the infected person sneezes or coughs, the virus that triggers COVID-19 spreads.The spread of novel SARS-CoV-2 was increasing, and the threats caused by it were becoming more severe in 2021. To counter the disease and save countless lives in danger, it is necessary to predict the trend of the number of cases and deaths and then implement the policies accordingly. In this paper, the trends of the growth rate of worldwide cases and deaths were studied, and the future growth for 100 days was predicted using the Neural network model and Polynomial Regression model. For efficient planning, the countries were grouped using Principal Component Analysis and the predictions were made. The cases and deaths in different countries and states were related through the Pearson coefficient, and the heat maps were studied. Additionally, in this paper, a case study to predict the trend of cases, number of deaths and recoveries in India was also performed. The Indian states were grouped into four groups based on the Principal Component Analysis (PCA) results, and relevant remarks and trends were suggested. The growth of cases and deaths was studied, and the peaks were predicted for the next 200 days. In recent months, COVID-19 has generated a significant deal of anxiety as a global pandemic, and an increasing number of studies have been published in this area. Consequently, a bibliometric examination of these papers may offer insight into current research hot subjects and trends. We are the first to join stochastic analysis of COVID-19 effects with bibliometric analysis of COVID-19. This prediction, if taken into consideration strategically during the planning of preventive measures of COVID-19 can help to reduce the cases to a great extent.

Salmonella Paratyphi B wound infection in a diabetic foot a rare case presentation

This case study presents a rare instance of a diabetic foot wound infection caused by Paratyphi B in a 44-year-old male with type 1 diabetes mellitus. Though species are typically associated with enteric fever and gastrointestinal manifestations, some species like Paratyphi B can rarely cause wound infection as presented in this case. The patient underwent antibiotic treatment and eventually required surgical amputation of the affected toe due to the infection's chronic nature. This case underscores the importance of unusual pathogens in diabetic wound infections and highlights Paratyphi B's potential as an agent in such cases.

Timely identification and treatment of uterine artery pseudoaneurysm after hysteroscopic procedures

Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection. This article discusses the case study by Kakinuma et al , which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman. Utilizing advanced imaging techniques such as ultrasound and computed tomography (CT), the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition. The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases. This article aims to expand on the study’s findings, discuss the clinical implications, and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery.

Restoring with flowables: An injection moulding technique – A report of two cases

This case report showcases the conservative management of aesthetic anterior restorations for patients seeking to enhance their smiles using the highly filled flowable composite resin injectable moulding technique. This efficient method resulted in optimal, aesthetically pleasing outcomes, leading to high patient and dentist satisfaction. Direct veneers made from injectable flowable resin composites provide a minimally invasive treatment option, given that the case selection criteria are appropriately followed. Furthermore, this approach can be viewed as a more cost-effective alternative. However, additional follow-ups are essential to thoroughly assess the clinical longevity of both the restorations and the materials utilised.

Emphysematous pancreatitis: Diagnosis, treatment, and prognosis

BACKGROUND Emphysematous pancreatitis (EP) is a rare, severe form of acute necrotizing pancreatitis characterized by gas in pancreatic or peripancreatic tissue, with a high mortality rate. AIM To assess the diagnosis, treatment, and outcomes of EP through a series of case studies. METHODS This case series was conducted in intensive care units at the Second Affiliated Hospital of Anhui Medical University. Patients were included if they were diagnosed with pancreatic necrosis and gas via computed tomography from June 2018 to June 2024. Patients were categorized into early and late EP groups based on the timing of the appearance of the bubble sign and into extensive and common types based on the distribution range of the bubble sign. The data recorded included sex, age, aetiology, Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, Bedside Index for Severity in Acute Pancreatitis score, subtype, gas distribution extent, aetiological diagnostic basis, pathogen categories, intervention measures, and prognosis. RESULTS Among the 15 patients, 66.7% had a biliary aetiology and extensive type of EP, 47.1% had early-onset EP, and 73.3% had confirmed aetiological evidence [6 based on bacterial culture, 4 based on both routine culture and next-generation sequencing (NGS), and 1 solely based on NGS]. The common pathogens were Escherichia coli and Klebsiella pneumoniae . Six patients survived. Among the 2 patients who did not undergo percutaneous drainage or surgical treatment, 1 survived. Of the 6 patients who underwent percutaneous drainage, 2 survived, 2 survived after subsequent surgery, and 2 died without surgery. Among the 6 patients who underwent surgery alone, 5 died and 1 survived. Among the early-onset EP patients, 4 survived; among the late-onset EP patients, 2 survived. Among the common EP types, 4 survived; among the extensive EP types, only 1 survived. CONCLUSION The mortality rate among patients with EP is considerable, and NGS enhances pathogen identification accuracy. Despite the debate on conservative vs surgical management, the STEP-UP strategy remains viable. Aggressive antimicrobial therapy, early percutaneous catheter drainage, and other minimally invasive interventions, along with delayed surgical intervention, may improve patient prognosis.

Case study of a potential West Polynesian variant of von Hippel- Lindau disease

Case study of a potential West Polynesian variant of von Hippel- Lindau disease

Resonance of literati spirit and space: investigating the cultural atmosphere within traditional Chinese academy architecture

ABSTRACT Traditional Chinese academies have historically played a vital role in nurturing intellectual elites and preserving the literati spirit, with their architectural remnants continuing to imbue contemporary settings with a distinct cultural essence. This research aims to revisit and reinterpret the “literati ambiance” through a multidisciplinary lens, integrating literature research and case studies. It explores the nature and generative mechanisms of the cultural atmosphere inherent in traditional Chinese academy architecture, providing a new interpretation of constructing and experiencing this unique ambiance. By drawing on atmospheric aesthetics and the concept of Genius Loci, the study analyzes the interplay between the physical environment, human emotions, and cultural contexts in generating the literati ambiance. The findings enhance comprehension of this ambiance and offer insights into its conservation and dissemination. The research also addresses potential constraints and suggests areas for further study, including verification through case studies, cross-cultural comparisons, and detailed examinations of specific locations.

Strategies for activating youth film education: focusing on the achievements and limitations of the Korea Film Council (2018–2022)

This article proposes possible directions for the long-term development of film education based on an analysis of the achievements and limitations of the Korean Film Council’s Youth Film Education Activation Project from its seventh (2018–21) and eighth (2021–2) terms, as well as the background and nature of the project and its budgetary trends. Since 2018, the Korean Film Council has reviewed the discourses about film education that have arisen from various fields, and, in particular, it has conducted research into overseas film education case studies. Furthermore, it has supported film education teacher research groups, directly operated a pool of film education practitioners, and taken active steps to publicise the importance of film education. However, due to the freezing of the Film Council’s budget from 2021, and the extent to which its 2022 budget was allocated for the operation of pilot schools, overarching visions for the activation of Korean film education have yet to be realised. The article adopts a reflective, critical perspective on the council’s activities during this period, while considering the future of film education in South Korea more generally.

Distributed Reinforcement Learning for IoT Security in Heterogeneous and Distributed Networks

The explosive growth of the Internet of Things (IoT) has significantly increased networked devices within distributed and heterogeneous networks. Due to these networks’ inherent vulnerabilities and diversity, the proliferation of IoT devices presents substantial security challenges. Traditional security solutions face challenges in keeping up with the constantly changing threats in dynamic situations. This article reviews the application of distributed Reinforcement Learning approaches to enhance IoT security in dispersed and heterogeneous networks. This paper provides a comprehensive overview of the fundamental theories reinforcing IoT security. We also explore the basis of Distributed Reinforcement Learning and discuss its benefits and drawbacks for IoT security. Then, we focus on how Distributed Reinforcement Learning might address these issues and offer details on the design factors to consider when implementing Distributed Reinforcement Learning-based solutions into practice. We outline case studies and experiments that show how Distributed Reinforcement Learning may enhance IoT security. We also address performance analysis and evaluation measures to compare Distributed Reinforcement Learning-based approaches with conventional security methods. Finally, we highlight the possible uses of Distributed Reinforcement Learning in IoT security and suggest future directions, emerging trends, and unresolved challenges.

‘Caution will get us nowhere’: manifesto writing as collective practice with a diverse film-making class

This article puts forth a number of ideas on co-creation with film-making students, which can both enhance their own practice and critically situate it within the wider film, television and creative industries. In the case study presented here, students on a second-year module called Independent Filmmaking Practices at the University of Greenwich in 2021 wrote a collective manifesto, titled the ‘Dismantle-festo’. The case study presented here is partly for educators seeking in-class exercises which depart from mainstream thinking about the film and television industries. However, in presenting and analysing both the exercises which led to the manifesto, and the manifesto itself, this article is also partly a record of the concerns and hopes of this cohort, condensed within the radical format of the manifesto.

Crafting an urban restorative model from bibliometric analysis of neuro-urbanism literature

PurposeNeuro-urbanism is an emerging field focused on addressing global urban challenges by examining the impact of urban living on stress levels and mental well-being. The restorative environment approach has been widely applied to measure stress and mental health outcomes. Although there is a recognised relationship between neuro-urbanism and restorative environments, further exploration of literature is needed. This paper aims to propose a conceptual urban restorative model that leverages neuro-urbanism to explore the potential of various urban space typologies and their associated urban design qualities in fostering restorative environments.Design/methodology/approachThis review article utilised VOSviewer to conduct a bibliometric analysis of data from Scopus and PubMed, focusing on neuro-urbanism and restorative environments. Our study explored the intersection of neuroscience and urbanism in designing environments that enhance mental well-being by mapping keyword co-occurrences and analysing citation networks. It identified research clusters, emerging trends and literature gaps, offering a detailed overview of how these fields intersect and influence each other.FindingsOur findings have revealed significant links between these fields, paving the way for the proposed restorative model. This model, derived from the literature, outlines the types of restorative environments, managing domains and theories integrating intangible and tangible urban design qualities using features and variables.Research limitations/implicationsThis study has limitations, as the proposed urban restorative model was developed using data from a literature review of databases such as Scopus and PubMed without testing its application in a real-world case study. Nevertheless, the urban restorative model provides valuable insights that can support urban designers, planners and public health organisations in evaluating restorative environments, which may enhance mental well-being and reduce stress in urban settings.Originality/valueThis research contributes to the broader understanding of how urban design can influence mental well-being and provides actionable keys for improving the quality of life in urban settings.

The AHEAD leadership development program: an illustrative case example in a unique healthcare context

Purpose Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to retain them. The purpose of this paper is to describe a perspective on practice by illustrating a case example that showcases a pilot LDP for newly promoted healthcare leaders. The details about how it was developed and implemented collaboratively by a healthcare consortium and higher education institution (HEI) to address shared healthcare leadership talent pipeline and retention challenges are provided. Design/methodology/approach This perspective on practice describes how a consortium of competitive healthcare organizations, a type of branded Inter-organizational Relationship referred to as “Coopetition,” contracted with a HEI to design, develop and launch a pilot LDP, referred to as the Academy for Healthcare Education and Development program, using the analyze, design, develop, implement and evaluate model. Findings The significance of this illustrative case example is discussed along with some initial lessons learned based upon this pilot LDP that 24 program participants completed. Implications for research, theory and practice are presented, followed by limitations and a conclusion. Originality/value Inter-organizational relationships, particularly coopetition, are relatively new in the healthcare sector, along with collaboration with HEIs to develop interventions to solve compelling industry problems. This illustrative case example offers insights that address scholars’ calls and practitioners’ needs to explicate different approaches for LDPs to build the healthcare leadership talent pipeline.