Male Ratio Research Articles

Comprehensive Approach to Speech and Language Assessment in Recurrent Meningioma: A Case Study

Meningioma is a tumor that arises from the meninges - the membranes that surround the brain and spinal cord. It compresses the adjacent brain tissues, nerves and vessels, leading to changes in vision, loss of smell, headaches, hearing loss or ringing in the ears, memory loss, seizure and most importantly communication difficulty. It affects mainly the elderly above the age of 60, at a female: male ratio of 3:2. Recurrence and progression are well known and are frequent characteristics of meningiomas. The present study aimed to perform a comprehensive approach to speech and language assessment in a case with recurrent meningioma. A case reported following postsurgical recurrent meningioma in the left parietal temporal area, exhibiting symptoms of language, speech and swallowing difficulty associated with a weakness in the left upper and lower limb. The evaluation process from a speech and language perspective involved perceptual and instrumental assessment of cognition, communication and swallowing using tests and tools. The case was found to have comorbid disorders of nonfluent aphasia associated with neuro cognitive deficit, mild dysphagia, mild dementia and dysarthria of speech. Though the presence of language and speech disorders in case of recurrent meningioma is not common, the severity of the disorder may lead to severe communication deficit. Assessing and interpreting an individual's communication ability involves the integration of a variety of information collected in the evaluation process. Keywords: Recurrent meningioma, dysphagia, aphasia, dysarthria

From Beasts to Faulty Wiring: Metaphorical Images of Multiple Sclerosis as described by women

Multiple sclerosis (MS) is a disease affecting the brain and the spinal cord, in which the immune system attacks the myelin that protects nerve fibres, thus causing permanent damage resulting in various types of disabilities. As a (to date) incurable disease, the experience of the patient becomes central in coping with the many symptoms, especially in the way it is communicated, not only to treating physicians, but also to society at large. Over the last years MS, which a century ago seemed to affect women and men alike, has shown an increasing prevalence in the female to male ratio, both in small cohorts (Kotzamani et al., 2012; Krökki et al. 2011), and worldwide (Sellner et al., 2011). In view of this tendency, the study of MS has begun to include a gender approach, focusing on the potential explanatory factors, but also on the specific circumstances affecting women (Jobin et al., 2010). In our paper, drawing from a sample extracted from online testimonials, an analysis will be carried out of the various metaphorical imagery used by women to explain their symptoms to doctors, relatives, and society at large. Following the traditional classification by Lakoff and Johnson (1980: 14), we shall explore the framings used, which may lead to positive or negative experiences of the disease and may have an empowering potential when patients «fight» MS in the general framework of managing the condition.

Abstract 4140149: Differences in Interventional Treatment Outcomes of Peripheral Arterial Disease between African American Females, African American Males, and Caucasian Females

Introduction: Several recent publications demonstrated worse outcomes of interventional treatment of peripheral arterial disease (PAD) in patients of African American (AA) descent compared to Caucasians (C), and in female patients compared to male patients. However, studies addressing sex differences in outcomes, included predominantly white female patients. To our knowledge, there are no published studies specifically addressing outcomes of interventional treatment of PAD in female patients of African American descent. Aims: 1. To determine if the outcomes of interventional treatment of PAD in female patients of African American (FAA) descent differ from male African American patients (MAA), and Caucasian female patients (FC). If such differences exist, to identify factors associated with it. Methods: This study has a cross-sectional design with systematically retrospective data collection by the National Vascular Quality Initiative. Included in this study was data on patients treated with endovascular and open surgical options for symptomatic PAD. Statistical analysis was done using IBM Statistic SPSS V25. Results: 447,263 unique cases containing required data were available in the VQI database. Among them, 171,250 were female patients, of which 32,966 were FAA, 126,519 FC, and 39,461 MAA. This race and gender distribution is not significantly different from the US population structure (US Census Bureau 2023). 1 However, female to male ratio was higher in AA (0.83) compared to C (0.58, p<0.0001). FAA were younger (65.143+/-9.59) compared to FC (69.16+/-10.32, P<0.00001). Comparison of comorbidities, smoking rates, pre-interventional medications and post-interventional outcomes are listed in Table 1. Multivariate analysis confirmed higher amputation rate among FAA compared to FC and to MAA and showed no significant difference in mortality. Conclusions: FAA patients who require interventional treatment for PAD have significantly higher rate of hypertension and diabetes compared to FC and MAA patients and have higher amputation rates. It appears that differences in clinical outcomes of PAD treatment in FAA are related mostly if not entirely to poorly managed comorbidities existed prior to intervention.

Abstract 4136159: Determinants of Exercise Intolerance in Postural Orthostatic Tachycardia Syndrome: a Systematic Review

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a syndrome of an exaggerated heart rate (HR) response with standing, disproportionately affecting young women associated with exercise intolerance due to dizziness, palpitations, and/or chest pain. Research question: How does the exaggerated increase in HR with standing translate into impaired exercise tolerance in subjects with POTS? Aims: To systematically analyze determinants of exercise intolerance in subjects with POTS. Methods: We searched the National Library of Science and identifed 11 cohorts with a diagnosis of POTS and an assessment of exercise capacity. We abstracted the information including type of exercise testing, hemodynamics and gas exchange parameters (peak oxygen consumption [VO 2 ]) with exercise, and effect of interventions (if present). Results: We identified 849 subjects with POTS, female:male ratio of 8.5:1, 25±8 years, and 365 age-and sex-matched controls. A cycle ergometer was used in 8 studies (574 subjects, 68%) and a treadmill in 3 (275 subjects, 32%). Peak VO 2 was measured in 10 studies (836 subjects, 98%), and exercise hemodynamics in 9 (593 subjects, 70%). All 11 (100%) studies described a higher HR at rest and during submaximal exercise in subjects with POTS, with a similar slope of HR/load, and shorter time to peak HR. Of the 9 studies with hemodynamics, 6 (67%) reported a reduction in stroke volume (SV) with standing and with exercise, but only 1 (11%) documented a reduction in cardiac output (CO). Two studies (22%) enrolling teenagers showed a variable increase in SV and CO in POTS. Peak VO 2 was reduced in 8 (80%) studies when compared with predicted values, but only in 4 (40%) when compared with controls matched for deconditioning. Intravenous fluid administration in two studies did not affect HR, SV, CO or peak VO 2 . Exercise training in one study (19 subjects) and propranolol 20 mg in another study (11 subjects) led to improving peak VO 2 . Conclusions: An exaggerated HR response with standing and with exercise is a hallmark of POTS, a mechanism by which subjects reach a higher HR at lower workloads. While the increase in HR is associated with a reduction in SV, CO is typically maintained and occasionally increased, therefore making it an unlikely mechanism responsible for the peculiar exertional symptoms of POTS. Strategies that result in a reduction in HR may, on the other hand, translate in improved exercise capacity in subjects with POTS.

Five years of emergency keratoplasty at a tertiary eye hospital.

The aim of this study is to present the results of patients who underwent emergency keratoplasty for tectonic or therapeutic reasons. Medical records of 33 patients who underwent tectonic or therapeutic keratoplasty at Ege University Department of Ophthalmology between January 2019 and January 2024 were retrospectively evaluated. Demographic characteristics, ocular and systemic findings, indications of keratoplasty, size of grafts, need for re-keratoplasty, preoperative treatment modalities, need for additional surgical interventions, and prognosis of the patients were investigated. During this period, 450 penetrating keratoplasty (PK) surgeries were performed and 34 (7.55%) were emergency PK (34 eyes of 33 patients). The mean age of the patients was 65.30 ± 15.40 (40-91). Female to male ratio was 18/15. 17 (50.00%) emergency PKs were performed for tectonic and 17 (50.00%) were performed for therapeutic purposes. Mean follow up time was 24.85 ± 26.62 (2-120) months. A total of 20 (58.82%) eyes required additional surgery, 9 (26.47%) of which required re-keratoplasty with different indications during follow-up. Graft rejection or failure developed in 17 (50.00%) of the eyes in an average of 12.05 (1-45) months. Evisceration was needed in 2 (5.88%) eyes. Despite limited access to donor cornea and high complication rate, emergency keratoplasty is one of the most important options that retain ocular integrity in the treatment of corneal infections and non-traumatic corneal perforations unresponsive to conventional treatment.

Pulmonary hypertension in patients carrying FLNA loss-of-function variants.

Pulmonary hypertension (PH) is an unusual complication of X-linked disease caused by loss-of-function (LOF) variants in the filamin A (FLNA) gene. Patients with FLNA LOF may also present dysmorphic facial features, aortic dilation, thrombopenia, and periventricular nodular heterotopia (PVNH). We reported clinical, functional, radiologic, and hemodynamic characteristics of patients with FLNA LOF variants and PH from the French PH Network. Nine patients were identified with a female to male ratio of 8:1. PH was diagnosed at a median age of 36 [0-69] years. Associated conditions included epilepsy (n=5), PVNH (n=7), valvular heart disease (n=8), congenital heart diseases (n=4), thrombocytopenia (n=4), and hyperlaxity (n=4). Right heart catheterisation confirmed moderate-to-severe precapillary PH with a median mPAP of 33 [22-49] mmHg and PVR of 4.7 [2.4-8.0] WU. The DLCO was markedly decreased (48 [22-64] %pred) and five patients had obstructive ventilatory disorder. High-resolution CT showed heterogeneous parenchyma (n=8), emphysema (n=3), presence of a peripheral hyperclear band (n=3) and aortic ectasia (n=4). Pathologic assessment available in one patient revealed significant remodelling of small pulmonary arteries, interstitial edema, and irregular alveoli shapes. During follow-up, three patients died, including two from right heart failure. No patient died from aortic rupture. Precapillary PH, likely due to multiple mechanisms, may complicate the course of patients with LOF FLNA variants and may be the presenting symptom leading to diagnosis. The combination of PH with parenchymal involvement and extrapulmonary symptoms (epilepsy, congenital heart diseases, valvular and aortic involvement, thrombocytopenia) should prompt genetic screening for FLNA.

Assessment of Biology and Fertility Life Table of Coccinella septempunctata Linnaeus Predating on Mustard Aphid, Lipaphis erysimi Kaltenbach

Lipaphis erysimi (Kalt.), commonly known as the mustard aphid (Homoptera: Aphididae), is the most notorious, globally distributed, and obligatory ectoparasite of many field crop including rapeseed and mustard. An investigation was carried out to assess the biology and fertility life table of Coccinella septempunctata in Bio-control lab, Department of Entomology at CCS Haryana Agricultural University, Hisar following the standard protocol at the laboratory condition of temperature (T) 25±2°C, relative humidity (RH) 65±5% RH, and 16:8 light:dark (L:D). Biological studies revealed that Coccinella septempunctata (L.), predatoryfemale laying eggs either singly or in masses (546.90 eggs/female) were vibrant yellowand spindle shape with an incubation period of 3.50 days. Hatchability was 86.00±5.62 per cent. There were four grub instars followed by pre-pupal stage, mean grub duration of 1st, 2nd, 3rd and 4th instar was 1.68±0.47, 3.18±0.60, 3.08±0.65 and 5.02±0.73 days. Total grub duration extended for 12.97±0.61 days. Larval survival was 74.44 per cent, followed by a pre-pupal period of 1.05±0.18 days and pupal duration of 5.93±0.86 days. Total grubs and pupal period were computed to be 18.90 ± 1.16 days with adult emergence 77.22 per cent. Total developmental period, from egg to adult was 23.45±1.20 days. Adult became darker in colour and have seven spots, three on each wing and one in the middle, near the head and act as predator to control mustard aphid. Females of beetle survived longer than the males with ovipositional period of 23.10 days and preponderance of female has been noticed with female: male ratio of 1.62: 1 in the study.

Sun protection strategies of young children and their parents: A comparative, cross-sectional study from Türkiye

This study aimed to investigate the frequency of sun protection measures used by young children and their parents and evaluate the possible effect of parental knowledge and behavior on their children’s sun safety practices. A sun safety awareness test and a self-reported questionnaire survey regarding sun protection strategies, reasons and barriers for using these methods were conducted on parents of children aged 3-5 years between June and December 2023. One hundred fourty parents (median age: 35, female:male ratio=4:1) were included. Parents who sought advice from their physicians (14.0) had a higher median awareness score than those who did not (12.0) (p

Foix-Alajouanine syndrome: a comprehensive overview of rare but relevant diagnosis.

Foix-Alajouanine syndrome (FAS) is an uncommon neurological disorder marked by the gradual development of spinal cord congestion. First documented by Foix and Alajouanine in 1926. Although it is infrequent, delayed or misdiagnosis is nonetheless prevalent, resulting in inadequate therapy and unfavorable results. Using the PubMed database, MEDLINE, and EMBASE, we collected data on FAS patients and conducted a pooled analysis. The term 'FAS' was used to search for related articles. Our search was restricted to previous clinical case reports or series that were published in English. Non-English articles were excluded. We included the articles in the period from 1974 to 2024. Articles were eligible if the radiographic and clinical findings were indicative of FAS. A thorough research analysis was performed, examining case reports that specifically addressed this issue. This study examines the clinical symptoms, difficulties in diagnosis, methods of treatment, and outcomes related to FAS. FAS predominantly impacts the elderly population. A total of 26 patients were diagnosed with FAS. The median age of affected individuals was 53 (SD ±15.96). The ratio of males to females is roughly 5:1. The clinical manifestations encompass gradual muscle weakness and sensory impairments. The diagnosis is dependent on radiological evaluations, specifically MRI and digital subtraction angiography. Possible treatments include endovascular therapy, surgical closure of arteriovenous fistula, or a combination of the two. Significant improvements in neurological impairments can be achieved by early intervention. The diagnosis of FAS continues to be difficult due to its infrequency and varied clinical manifestations. Prompt and precise diagnosis is essential for proper intervention, typically utilizing endovascular or surgical methods. Additional research is required to determine prognostic markers and enhance long-term care techniques for this rare neurological condition.

Associations of Phthalate Exposure with Adiposity and Metabolic Syndrome in US Adolescents and Adults, NHANES 2013-2018

Abstract Background/Objective Phthalates are ubiquitous endocrine-disrupting chemicals and suspected obesogens. However, the associations with fat distribution and associated cardiometabolic complications remain unclear. Therefore, we examined the associations between phthalate exposure, body fat (total and distribution patterns), and metabolic syndrome (MetS) among US adolescents and adults. Methods We analyzed cross-sectional data from 829 adolescents and 3905 adults in the 2013-2018 National Health and Nutrition Examination Survey. Total percent body fat (%BF), visceral adipose tissue (VAT) mass, and android to gynoid (A/G) ratio were determined using dual-energy x-ray absorptiometry. Associations between molar sums of low molecular weight (∑LMW), high molecular weight (∑HMW), and di(2-ethylhexyl) phthalate (∑DEHP) metabolites, and adiposity indicators and MetS were analyzed with multivariable linear and logistic regressions. Models included sex interaction terms, were stratified by age group, and adjusted for relevant covariates. Results ∑HMW and ∑DEHP exposures were positively associated with %BF in males, and all phthalate groups were associated with greater VAT mass and A/G ratio in adolescent males. Five-fold increases in ∑HMW and ∑DEHP metabolites were associated with 21.7% (95% CI: 10.5-33.9) and 18.0% (95% CI: 7.72-29.2) greater VAT mass among adolescent males, respectively. Sex modified the relationship between ∑HMW exposure and A/G ratio among adolescents (interaction p-value = 0.0185). Phthalates were not associated with odds of MetS. When assessing individual MetS components, phthalates were associated with hyperglycemia in adult males. Conclusion Greater exposure to phthalates was associated with greater %BF in all males, and with fat distribution in adolescent males; however, phthalates were not linked to MetS.

Impact of Climate Deviation on Reproductive Profile of Nile Tilapia, Oreochromis niloticus (Linnaeus, 1758) from the Tons River, India

Nile tilapia, Oreochromis niloticus is among the leading farmed species around the world as well as a powerful invader in many countries globally. Studies were undertaken during the period from February 2019 to January 2020 from the lower stretch of the Tons River at Prayagraj, Uttar Pradesh, India. During the sampling period, 683 fish specimens of Nile Tilapia, Oreochromis niloticus (336 males and 347 females) were collected and studied for evaluation of sex ratio and sex structure. The sex ratios of male and female fishes were very close and reported 1.0:1.03 in the stock. The male ratio was higher in the small size group of fish with 81 to 200 mm size groups and 411 to 470 mm size group. The sex structure of males and females was observed at 49.19% and 50.81%, respectively in the case of stock. The female proportion was recorded as a minimum with 37.50% in the 441-470 cm size group and highest with 54.84% in the 381-410 mm size group. However, the male proportion was reported lowest at 45.16% in the 381-410 mm size group and highest at 62.50% in the 441-470 mm size group. In the present findings, O. niloticus was found to reach maturity starting below 138 mm of total length, taking individual fish. The fishes breed in the months of March to June and September to November of the year. The number of eggs per individual ranged from 393 to 4338 in the size of fish varied from 138-452 mm. The reported fecundity and sex ratio of O. niloticus indicated that the climatic condition or environmental condition of the Tons River was most suitable. The environmental condition (especially temperature) of the Tons River at Prayagraj is slightly warm compared to the Ganga River which is very favourable for O. niloticus. The water current velocity of the Tons River is very poor. Both parameters are very helpful for the stability of O. niloticus in the Tons River at Prayagraj. The high fecundity of O. niloticus in the Tons River at Prayagraj could probably be a result of a combination of different causes such as climatic conditions, habitat structure, food abundance, water quality, and quality of food. Therefore, the present study aimed to update the information on the sex ratio, sex structure, and fecundity of O. niloticus with respect to climate from the Tons River, India.

Results of endoscopic electrode removal surgery in patients with cardiovascular implantable electronic devices

Introduction: The increasing popularity of permanent pacemakers and implantable cardioverter defibrillators (ICDs) has improved the quality of life and long-term prognosis of cardiovascular patients. However, there is also an increase in infections of cardiac implantable devices (CIEDs). The infection rate after the first implant is 4.82/1000 people, and after the device replacement is 12.12/1000. With the development of endoscopic techniques, a method of thoroughly treating infections of cardiac implantable devices is opened without increasing the severity of the patient’s condition. Method: Cross-sectional study, 08 patients with pacemaker infection underwent endoscopic surgery at the Cardiovascular Center, E Hospital from January 2020 to July 2024. Result: In 08 patients, the male ratio is mainly 06 patients, the oldest age was 85 years old and the youngest is 25 years old. There are 07 cases with permanent pacemaker implantation, 1 case of ICD placement Brugada syndrome. All cases have bacterial cultures: 05 patients have Staphylococcus aureus and 03 cases have cultured Staphylococcus epidermidis. All patients have pacemaker examination and underwent endoscopic surgery to remove the electrode. The average surgical time is 68,71± 18.3 minutes (97-40), in which 01 case has only electrode probe infection, the remaining cases has both the pacemaker and electrode probe infection. Most stable cases are discharged from hospital with an average time of 16,2± 7,8 days (11-30), 01 severe case due to sepsis in a patient with heart failure EF: 30%, kidney failure, diabetes, hypertension has to stay in treatment for additional 30 days. Conclusion: Endoscopic electrode removal surgery in patients with pacemaker infection initially achieved good results, with low complications and mortality, but a larger number of patients and long-term follow-up and evaluation are needed.

Healthy plasma lipidomic signatures depend on sex, age, body mass index, and contraceptives but not perceived stress.

Perceived stress is thought to contribute to the pathogenesis of metabolic, vascular, mental, and immune diseases, with different susceptibilities in women and men. The present study investigated if and how perceived stress and/or demographic variables including sex, age, body mass index, regular prescription drugs, occasional analgesics, or dietary supplements manifested in plasma lipidomic profiles, obtained by targeted and untargeted mass spectrometry analyses. The study included 217 healthy women and 108 healthy men, aged 18-68 years, who were recruited in a 2:1 female:male ratio to account for women with/without contraceptives. As expected, dehydroepiandrosterone sulfate (DHEAS) and ceramides were higher in men than women, and DHEAS decreased with age, while ceramides increased. Contrary to expectations, neither DHEAS nor ceramides were associated with perceived stress (PSQ30 questionnaire), which was however, associated with BMI in men, but not in women. None of the lipid species or classes showed a similar "age X sex X BMI" interaction, but the endocannabinoid palmitoylethanolamide (PEA) correlated with BMI and hypertension. Independent of perceived stress, lysophosphatidylcholines (LPCs) were lower in women than men, whereas LPC metabolites, lysophosphatidic acids (LPAs), were higher in women. The LPA:LPC ratio was particularly high in women using oral contraceptives suggesting a strong hormone-induced extracellular conversion of LPCs to LPAs, which is catalyzed by the phospholipase D, autotaxin. The results reveal complex sex differences in perceived stress and lipidomic profiles, the latter being exacerbated by contraceptive use, but perceived stress and lipids were not directly correlated.

Clinical, Histopathological, and Immunophenotypic Spectrum of Hepatic Epithelioid Hemangioendothelioma: Eight Years’ Data of a Tertiary Care Center from North India

BackgroundEpithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor that commonly affects the liver. Hepatic EHE (HEHE) presents with variable clinical and histopathological features. We describe detailed clinico-histopathological features, differential diagnosis, and treatment outcomes of the cases of HEHE. Materials and methodsAll cases of HEHE diagnosed in our institute in the last eight years (2016-2023) were reviewed (n=8) (total 36 cases of EHE; 22.2%). The clinical features, radiology, histopathology, immunophenotype, molecular features, and treatment outcomes of all cases were evaluated. ResultsThe median age of presentation was 49.5 years with a female: male ratio of 7:1. Abdominal pain was the commonest presentation. Approximately two-third of the patients had multifocal lesions. Histopathology showed purely epithelioid, predominantly epithelioid, and predominantly spindle-cell morphology in 50%, 25%, and 25% respectively. All cases showed typical myxohyaline/ fibrous stroma and organized thrombi of the portal/ central veins. CD31 was the most commonly used immunostain with positivity in all cases. CAMTA1 break-apart FISH was positive in 75% of cases while none showed TFE3 immunopositivity. Chemotherapy was the most commonly employed therapy (n=5) followed by surgery (n=2). The median duration of follow-up was 26 months. Five patients were alive with disease (two patients ≥3 years), one patient died of sudden cardiac death, and two patients were lost to follow-up. Two patients developed metastatic disease at follow-up. ConclusionWe describe the clinico-histopathological features and differential diagnosis of HEHE. This appears to be the largest case series of HEHE from India.

Paradoxical Psoriasiform Skin Eruption in Pediatric Patients with Inflammatory Bowel Disease Treated with TNFα Inhibitors.

Tumor necrosis factor α inhibitors (TNFαI)-induced psoriasiform eruptions are a well-known phenomenon among adults. However, data are limited regarding this reaction in children. To describe in pediatric patients with inflammatory bowel diseases (IBD), the clinical characteristics of TNFαI-induced psoriasiform eruptions and the outcomes of various therapeutic options. We reviewed the medical charts of pediatric patients (aged <18 years old) with IBD who developed TNFαI-induced psoriasiform eruptions during 2006-2022. Among 454 patients with IBD treated with TNFαI, 58 (12.8%) were diagnosed with TNFαI-induced psoriasiform eruptions, of whom 51 were included in the study. The female to male ratio was 1:1.3. The median age at skin eruption was 14.1 [interquartile range, 12.11-16.05] years. The median elapsed time to eruption appearance was 15 [interquartile range, 7-24] months after initiation of the treatment. All the patients were treated with topical steroids and 17 (33%) needed systemic treatment (phototherapy, methotrexate or acitretin). Sixteen patients (31%) needed to stop TNFαI treatment due to an intractable eruption. Female patients, patients with inflammatory alopecia and patients who were treated with methotrexate or phototherapy were more prone to stop TNFαI. TNFαI-induced psoriasiform eruptions are common in pediatric patients with IBD. The eruption may appear months or even years after treatment initiation. Almost one-third of the described patients had to replace their treatment due to a recalcitrant cutaneous eruption. This indicates that a multidisciplinary approach is required for effective management.

Effectiveness of Soleus Muscle Flap for The Coverage of Wound in Open Tibia Fracture in The Mid Shaft

Introduction: An open fracture of the tibia has been one of the most common long bone injuries. Soleus muscle flap supply can be a remedy for this kind of soft tissue difficulties. The soleus muscle flap’s blood supply may help in the construction of a longer, safer, and more functional flap. When the incision is clinically fit for covering, the flaps from the same leg are elevated between 0 and 14 days following the damage. In the majority of these cases, the flaps are covered with a split-thickness skin graft taken from the anterior aspect of the thigh in the same sitting. This can be a great solution. Aim of the study: The study aimed to assess the effectiveness of soleus muscle flap for the coverage of wound in open tibia fracture in the mid shaft. Methods: This prospective interventional study aimed to evaluate the outcomes of early coverage using the soleus muscle flap in the management of Gustilo type-IIIB fractures of the mid-shaft tibia. The study followed a quasi-experimental design and was conducted over an 18-month period from January 1, 2010, to June 30, 2011. The research took place in the Department of Orthopaedics and Traumatology at Dhaka Medical College Hospital (DMCH) and the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) in Dhaka. The study population included all 15 patients admitted to the hospitals with clinical and radiological evidence of open Gustilo type-IIIB fractures of the mid-shaft tibia followed by the inclusion and exclusion criteria. Informed written consent was taken before data collection and confidentiality was maintained. The analysis was done by SPSS version 15. Result: Among 15 patients most (12) were male, 3 were female. Mean age was 38 ± 12 years. Majority were in 31-45 years. Male female ratio was 4:1. The selected study subjects were predominantly motor driver (26.66%), followed by day labor, housewife, service holder, farmer, and businessman (each was-13.33%), and student was 6.66%. ...

Childhood Hypertension And Obesity In a Developing Country Setting: A Survey Among School Age Children In Calabar, Nigeria

Background Childhood hypertension is silently rising and gradually becoming a serious public health burden and concern due to its attendant significant morbidity and mortality. It is oftenneglected and rarely reported.Also, childhood obesity is increasingly assuming epidemic proportion with a consequent predisposition to cardio-metabolic diseases. Aim To determine the prevalence of childhood hypertension in association with obesity among apparently healthy school age children in Calabar Study Design/Setting A cross-sectional descriptive study conducted among randomly selected school-age children, in Calabar, Nigeria. Methods/Subjects This cross-sectional study was conducted among children, aged 6 – 12 years old who were selected from public and private primary schools through multi-stage sampling. Blood pressure and body mass index (BMI) were categorized based on the updated 2004 fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents and International Obesity Trust Fund (IOTF) respectively. Results A total of 374 children were enrolledwith a male to female ratio of 1.0: 1.3 and mean (SD) age of 9.48 (1.42) years. Mean (SD) systolic blood pressure was 95.9 ±8.8mmHg and the mean (SD) BMI was 16.6 ± (2.6) kg /m2. Hypertension was observed in 9 (2.4%) out of 374 children. Hypertension occurred more in the adolescents 6(3.2%) than in the preadolescents 3(1.6%). Similarly, hypertension was higher in females 8(3.7%) than in males 1(0.6%) With regards to obesity,15 (4%) were obese with a female: male ratio of 1.5: 1. Obesity was higher in adolescents [11 (5.8%)] than in pre-adolescents [4(4%)] Conclusion The prevalence of hypertension was 2.4% and it was commoner in females than in males who were more obese. Obesity was strongly associated with increasing BP. Awareness should be created among health care professionals to regularly check for hypertension and overweight among school children for early diagnosis and treatment.

Beauty Re-defined: A Comparative Analysis of Artificial Intelligence-Generated Ideals and Traditional Standards.

Background Traditional methods for assessing facial beauty rely on subjective measures like averages or "golden ratios." However, artificial intelligence (AI) offers a data-driven approach to analyzing attractiveness. This study explores how AI-generated beauty criteria compare to established ideals, considering cultural influences and the evolving concept of beauty. Methods To explore how AI-generated beauty ideals compare to traditional standards, we used three AI text-to-image generation tools (Dezgo (Dezgo SAS LLC, France), Freepik (FreePik Company, Malaga, Spain), and ImagineArt (Vyro, Islamabad, Pakistan)) to create images from a specific prompt. The first four generated images for each gender that met our criteria were included in this study. A single researcher used MediaPipe Studio software to identify ten key facial landmarks on each image. Landmark distances were measured twice in Adobe Photoshop 2023 (Adobe, San Jose, California, United States) and averaged for each measurement. The average values were then used to calculate 23 facial proportion ratios based on established neoclassical canons and golden facial ratios. We then compared these AI-generated ratios to the ideal values using one-sample t-tests in IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States), p < 0.05 significance, to assess alignment with traditional beauty standards. Results AI-generated faces displayed statistically significant differences, p < 0.05, from established beauty standards in both neoclassical canons and golden ratios for both males and females. Differences were seen in facial width, upper and lower face proportions, and eye symmetry. Conclusion AI-generated faces deviated from traditional beauty standards of neoclassical canons and golden ratios for both genders. This suggests AI incorporates factors beyond established ideals, potentially reflecting contemporary preferences, cultural biases, or emerging trends.

Result of consistent use of hearing aid in speech and language development.

Objective: To determine the benefits of proper guidance and proper use of hearing aid in language development age. Study Design: Descriptive Cross-sectional study. Setting: Department of ENT, Abbasi Shaheed Hospital and Karachi Medical and Dental College. Period: January 2022 to December 2023. Methods: In this study those cases were included which came with hearing loss. Both sexes were included in this study. After informed consent complete history and examination was done. Also relevant investigations were performed where required. Results: In this study, male were 72 (60%), male female ratio was 1.5:1. Highest number of patients were between the age of 6-8 years 60 (50%). Between 1.5 to 3 years, 51 children were properly guided and followed the proper instruction of use of hearing aid while 9 children were not properly guided and not properly used of hearing aid. 92 patients (76.6%) used hearing aid consistent with proper guidance, in which 79 (85.8%) children developed good speech and language. while 13 (14.1%) children were found poor in speech and language development while 28 (23.33%) children did not use hearing aid properly and all found poor in speech and language. Conclusion: Proper use of hearing aid which may be beneficial in improvement of word recognition and speech development in hearing impaired child under proper guidance and training from otologist and audiologist.

8032 Clinical And Laboratory Characteristics Of Patients With Primary Hyperparathyroidism Followed At A Brazilian University Hospital

Abstract Disclosure: G. Koga: None. D. Amorim: None. L.M. dos Santos: None. D. Calixto: None. M. Ohe: None. J.G. Vieira: None. M. Lazaretti-Castro: None. Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by hypercalcemia due to hyperfunction of parathyroid glands. Its clinical presentation has been changing, becoming mostly asymptomatic. However, there are few data on developing countries.Objective: to describe clinical and biochemical features of primary hyperparathyroidism in a Brazilian population of a tertiary hospital. Methods: 259 individuals with PHPT are followed in a school-hospital in Sao Paulo in the last 2 years and this preliminary analysis included 161 of them. Clinical and laboratorial data were obtained by reviewing medical records. Data are presented as median [min-max] and statistical differences were considered if p&amp;lt;0.05. Results: 133 (82.6%) were women (3.7:1 female:male ratio) with a median age at diagnosis of 63 years [24-88]. There was higher prevalence of Caucasian (62.7%) then among Afro-descendants and Asians/indigenous: 35.4% and 1.9%, respectively. 99 (61.5%) patients were asymptomatic. Symptoms were observed in 38,5% (nephrolithiasis, fractures, bone pain, hypercalcemic crisis). Target organ involvement was evaluated: 48.4% had osteoporosis, and 47.2% kidney stones. At diagnosis, median total calcium (tCa) was 11.2 mg/dL [10.0-19.1], ionized calcium (iCa) 1.48 mmol/L [1.30-2.48], PTH 277.7 pg/mL [51.4-2374.0] and 25OHD 23.5 ng/mL [5.0-54.2]. Symptomatic patients were diagnosed younger (61 [24-83] vs 64 [31-88]; p=0.036), had higher tCa (11.4 [10.2-19.1] vs 11.2 [10-16]; p=0.049) and greater prevalence of 25OHD&amp;lt;20 ng/mL (50.0 vs 30.4%; p=0.03) than asymptomatic. Patients with severe hypercalcemia (&amp;gt;14 mg/dL) were diagnosed younger than those with non-severe hypercalcemia (52 [41-54] vs 63 [24-88] years; p=0.002). Patients with osteoporosis had older age at diagnosis compared to those without (64.0 [42-86] vs 61.5 [24-88]; p=0.018). Histological data were obtained from 94 individuals out of 104 submitted to surgery: 59.6% had single adenoma, 39.3% hyperplasia or multiple adenomas and 1.1% parathyroid carcinoma. Patients with single adenoma had higher levels of tCa and iCa than those with multiglandular disease (median of 11.4 [10.0-19.1] vs 10.9 [10.3-13.4]; p=0.042 and 1.52 [1.32-2.48] vs 1.43 [1.30-1.59]; p=0.02, respectively). Conclusion: Our preliminary data showed that most of the patients were Caucasian women presenting with asymptomatic disease. Compared with other countries, we still have a greater proportion of symptomatic presentations (38.5%) and multiglandular diseases (39.3%) than the reported in literature. Severe forms were diagnosed earlier, in younger patients and with a single adenoma, suggesting that they may have a different disease from the asymptomatic ones. These aspects demonstrate that there may be ethnic and environmental influences interfering with the presentation of this disease. Presentation: 6/2/2024