Case Of Series Research Articles

Early Identification of Risk of Child Abuse Fatalities: Possibilities and Limits of Prevention.

(1) Background: The aim of the study was to analyse the structure of registered fatal violent crimes against children under 5 years of age and to identify the main characteristics and risk factors of fatal violence against children in order to discuss the possibilities and limits of prevention of these crimes. (2) Methods: Mixed-method design: 1. retrospective statistical analysis of data extracted from Czech statistics about crime. 2. qualitative analysis of autopsy reports and construction of serial case study. The data were pooled from two different sources: 1. Statistics about crime against children aged 0 to 5 (n = 512). 2. Autopsy reports (n = 52) of children up to the age of five. (3) Results: The following indicators and risk factors were identified: mental disorder or cognitive deficits in parents, parents’ immaturity, poor parenting skills, inadequate parenting practices, absence of a deep emotional bond with the mother, lack of parents’ interest in catering to the children’s needs, parents’ addiction, an unprotected, hazardous environment and surroundings, household falling apart, incidence of suspected domestic violence, incidence of multiple bruises and untreated injuries, aggressively dominant parents, poverty, absence of adequate health care, medical neglect of a child, poor health of the child and failure to thrive. (4) Conclusions: The task for the state is to make effective use of all accessible mechanisms to improve the situation in families. Particularly in the context of the newly emerging situation of increasing uncontrolled violence in families in the context of the restrictions of the COVID-19 pandemic, this demand is more than urgent. Close attention should be paid to children who are not registered with pediatricians and fail to attend regular medical examinations. It is also vital to follow families in which violence has already been suspected in the past.

Women and Crime: Exploring the Role of Gender, Sexuality, and Race in Constructions of Female Criminality

This roundtable on women and crime was inspired by a discussion at a CUNY Dissections Seminar in April 2021, where Gülhan Balsoy presented her work in progress on Ottoman crime fiction in the early 20th century. The focus of her paper was a popular murder mystery series called The National Collection of Murders, which had been published in Istanbul in 1914. The protagonists of this fictional crime series were a mother and daughter known as the Dark Witch and the Bloody Fairy, who led an underground criminal gang living in a secret subterranean world beneath the city of Istanbul. While reading her paper the night before the seminar, I could not help but notice striking parallels between this fictional Ottoman murder mystery and the sensationalized media coverage of a 1921 Egyptian serial murder case, popularly known by the name of its alleged perpetrators, Raya and Sakina. In both the fictive Ottoman story and the Egyptian media coverage of a real crime, two sets of female relatives were presented as the respective leaders of a criminal gang that stole luxury goods from respectable families and turned their homes into human slaughterhouses. In both cases, the female gang leaders used “superstition” to deceive and trap their victims while continually outwitting the police, all against a backdrop of illicit sex.

Anesthesia Management in Patient with Uncorrected Double Outlet Right Ventricle Underwent Cesarean Section: Serial Case Report

Background: Double outlet right ventricle (DORV) is a rare cardiac condition in which the heart demonstrates single ventricle physiology. Pregnancy complicates cyanotic heart disease as the decrease in systemic vascular resistance (SVR) worsens the right-to-left shunt. The effect worsens by neuraxial anesthesia for cesarean delivery. Anesthesia for these patients needs understanding for the physiology of DORV in order to maintain stable hemodynamics. Heart defect still become non obstetric main factor causing morbidity and mortality in pregnant woman. Case: We present three case of parturients with DORV scheduled for cesarean section. Elective caesarean section was scheduled using spinal anesthesia hyperbaric bupivacain combined with fentanyl. Hemodynamic during operation was stable. Conclusion: Low dose spinal anesthesia performed in this patient did not cause hypotension and minimal hemodynamic changes because the intensity of the sympathetic block was lower.

Acute on Chronic Limb Ischemia Treatment: Case Series

ABSTRACT
 
 BACKGROUND: Acute on chronic limb ischemia is a condition caused by acute disruption in chronic vessel disease. The major cause is peripheral arterial disease or embolism. Treating the acute phase while considering the origin of disease is important to treat acute on chronic limb ischemia.
 CASE DESCRIPTION: 3 cases were described on this serial case report. The first and second case represent acute on chronic limb ischemia conditions with history of intermittent claudication (IC) and signs of acute limb ischemia (ALI) upon arrival. They were both treated with surgical intervention for ALI. Despite of adequate surgical intervention, both cases showed suboptimal limb recovery. Both patients were referred for further evaluation of chronic vessel disease with angiography. Third case represent chronic limb ischemia as end point of treatment from the first and second case. Patient with worsening IC despite adequate medical and exercise treatment underwent angiography examination. Angiography result found two sites of total occlusion of right common iliac artery and superficial femoral artery. Angioplasty and primary stenting were done on common iliac artery. Drug coated balloon and stenting was also performed on superficial femoral artery.
 CONCLUSION: Patients with acute on chronic limb ischemia need to be treated during acute phase and the remaining chronic vessel disease. Consideration and care should be taken when managing similar cases for optimal treatment.
 
 KEYWORDS: Acute on chronic limb ischemia, Thrombectomy, Angioplasty, Drug-coated Balloon.

Uterine Perforation as a Complication After Unsafe Abortion: Serial Case

The demand for abortion and the incidence of unsafe abortion are still very high. About 45% of all abortions worldwide are unsafe abortions. Unsafe abortion is still a public health problem and one of the causes of maternal morbidity and mortality. In this article, we report 2 cases of uterine perforation after provocation or induced abortion due to unwanted pregnancy. The diagnosis of uterine perforation was established by clinical suspicion and exploratory laparotomy. Many factors affect access to abortion and one of them is the law regarding abortion. Countries with almost no deaths from unsafe abortions are countries that allow abortion on demand without restrictions. Meanwhile, unsafe abortion can be prevented through prevention and controlKeywords: unsafe abortion, uterine perforation.

The performances of singularity-avoidance CMA equalizers in real-time system

In this paper, we compare the performances of conventional CMA, two-stage CMA and constrained CMA, from cases of fixed-point, parallelization and delay periods which are necessary in real-time system. We implement an 112Gbit/s dual polarization channel model to simulate conventional CMA and other modified CMAs. When OSNR (Optical Signal to Noise Ratio) and PDL do not vary, compared with float-point case, reducing bit width of input data can worsen singularity problem of these three equalizers. Besides, when OSNR and PDL do not vary, compared with serial case, increasing parallels number can reduce singularity probabilities of these three equalizers. Then, when PDL does not change, increasing delay periods can deteriorate singularity problem. Furthermore, in float-point case, fixed-point case, serial case, parallels case and delay periods case, compared with other two equalizers, constrained CMA all shows best performances to decrease singularity probabilities. Therefore, among these three equalizers, constrained CMA is the most suitable to be employed in real-time system.

C48. How to handle VT storm in ICD patient : serial case report

Abstract Background Ventricular tachycardia (VT) storm can cause sudden death in patients with trans-venous implantable cardioverter-defibrillator (ICD) and adversely affects prognosis in survivors. Patients with recurrent shocks have a poor quality of life and increased mortality rates. The purpose of this case series was to discuss the available treatment option for VT storm in ICD patients. Case Summary We reported two patients with VT storm on ICD. Both patients had palpitation, clinical heart failure, and recurrent shocks from ICD with appropriate rhythms. The first case had hypokalemia with ICD recording showed 45 episodes of VT, 45 antitachycardia pacing (ATP), and 5 shocks therapy. The second case had hypomagnesemia with ICD recording showed 195 episodes of VT, 42 ATP, and 3 shocks therapy. Management approaches to these patients include ICD reprogramming, correcting electrolyte abnormalities, treating heart failure and administering anti-arrhythmic drugs (AADs). Discussion VT storm on ICD refers to three or more appropriate therapies for ventricular tachyarrhythmias, including ATP or shocks, within 24 hours. The known triggers must be treated, such as electrolyte disturbance and worsened heart failure. AADs therapy could suppress VT and increased the tachycardia cycle length (TCL) so that the response to ATP is better. ICD reprogramming include higher heart rate treshold, longer detection period, and improving ATP programming. Catheter ablation and cardiac sympathetic denervation (CSD) may be an option if VT storm persists.

C48. How to handle VT storm in ICD patient : serial case report

Abstract Background Ventricular tachycardia (VT) storm can cause sudden death in patients with trans-venous implantable cardioverter-defibrillator (ICD) and adversely affects prognosis in survivors. Patients with recurrent shocks have a poor quality of life and increased mortality rates. The purpose of this case series was to discuss the available treatment option for VT storm in ICD patients. Case Summary We reported two patients with VT storm on ICD. Both patients had palpitation, clinical heart failure, and recurrent shocks from ICD with appropriate rhythms. The first case had hypokalemia with ICD recording showed 45 episodes of VT, 45 antitachycardia pacing (ATP), and 5 shocks therapy. The second case had hypomagnesemia with ICD recording showed 195 episodes of VT, 42 ATP, and 3 shocks therapy. Management approaches to these patients include ICD reprogramming, correcting electrolyte abnormalities, treating heart failure and administering anti-arrhythmic drugs (AADs). Discussion VT storm on ICD refers to three or more appropriate therapies for ventricular tachyarrhythmias, including ATP or shocks, within 24 hours. The known triggers must be treated, such as electrolyte disturbance and worsened heart failure. AADs therapy could suppress VT and increased the tachycardia cycle length (TCL) so that the response to ATP is better. ICD reprogramming include higher heart rate treshold, longer detection period, and improving ATP programming. Catheter ablation and cardiac sympathetic denervation (CSD) may be an option if VT storm persists.

Ultrasound-guided Perineural Dextrose Injection for Treatment of Superior Cluneal Nerve Entrapment: Serial Case Report

Background: Superior cluneal nerve entrapment is a neuropathic condition caused by the inclusion of the superior cluneal nerve that contributes to one of the causes of lower back pain leading to high morbidity. Several therapeutic modalities are available for superior cluneal nerve entrapment, including medications, physiotherapy, perineural injection, and surgery. Perineural injection with 5% dextrose has become therapeutic alternative in many cases of neuropathy, but its long-term effectiveness is unknown. Case Presentation: This study described four patients with superior cluneal nerve entrapment with severe pain intensity treated with ultrasonography guided perineural 5% dextrose injection, resulting in significant clinical improvement during the 6-month evaluation. Conclusion: Perineural injection can be considered as long-term therapy in patients with superior cluneal nerve entrapment who have failed other conventional therapies.

High D-dimer Level in Fracture Patient with Asymptomatic Covid-19: Dilemmatic Surgery Decision - A Serial Case Report

Introduction: SARS-CoV-2 is highly transmittable virus. D-dimer associated with high fatality rate in COVID-19 with pneumonia and fractures. COVID-19 make surgical decision more challenging. Thrombosis plays an important mechanism in severity of COVID-19 and could be measured through D-dimer level. Case illustrations: We report 4 fracture cases with asymptomatic COVID-19. 1st case diagnosed close fracture in right 1/3 distal cruris without pneumonia, D-dimer 2420 ng/dl. Surgery 20 days after trauma with decreased D-dimer level. 2nd case, was diagnosed with close fracture in the left cruris and right 1/3 middle of clavicle with pneumonia, D-dimer level 6670 ng/dl, decision obtained in 27 days after hospitalization with decreased D-dimer. 3rd case diagnosed open fracture in left 1/3 distal humerus with pneumonia, D-dimer level 1020 ng/dl. Surgery 32 days after trauma with decreased D-dimer. 4th case diagnosed open fracture in left 1/3 proximal humeral and left medial phalanx index finger with pneumonia. The D-dimer level 2830 ng/dl. Surgery was obtained 17 days after trauma with decreased D-dimer. Discussion: Pandemic creates gray zone in orthopedic surgery. D-dimer found increased in COVID-19 and fracture patients. Asymptomatic case can be operated on 10th day post positive result as long as the general condition is optimal. D-dimer also important in making the decision to perform surgery. D-dimer over 2500 ng/mL have greater risk for being VTE in fracture patients. Conclusion: The pandemic has creates a large gray zone. The strategies for decision making includes general condition and severity COVID-19 also D-dimer level. Keywords: D-dimer, COVID-19, Fracture, Surgery.

Serial case of HIV associated neurocognitive disorder

HIV Associated Neurocognitive Disorder (HAND) divides into three severity categories, which include asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD). This case report aims to present and compare the serial case of two patients' clinical manifestations that are diagnosed and treated for HAND.

Imaging of Acute Stroke patient with Covid-19: A serial case

Background: Coronavirus Disease 2019 (COVID-19) has been declared as a pandemic in March 2020 by WHO. Apart from respiratory symptoms, COVID-19 is also associated with various neurological manifestations, one of which is stroke. We reported three cases with diagnosis of stroke in confirmed COVID-19 patients.
 Case Presentation: Head CT scan without contrast in the three reported cases showed different types of strokes. The first case showed ischemia in the right insular lobe and right parietal lobe. The second case showed intracerebral hemorrhage in the left thalamus and intraventricular hemorrhage, whereas the third case showed acute infarction in right frontotemporal lobe, right lentiform nucleus, right insular cortex, that supports prelenticulostriate segment I MCA embolism.
 Conclusion: CT scan is an important imaging modality in stroke cases both in COVID-19 and non-COVID-19 cases. CT scans are good at detecting the presence of bleeding, widely available, faster to operate, and less expensive than MRI. The types of stroke in COVID-19 patients can appear as different types of stroke. Generally, it appears as ischemic stroke, but hemorrhagic stroke can also occur with a less frequent occurrence. Further research is needed to explain the exact correlation between stroke and COVID-19.

Oral candidiasis and the risk factors: a serial case reports

Oral candidiasis (OC) is also referred as ‘thrush’ is caused by the infections of the tongue and other oral mucosal sites and characterized by fungal overgrowth and invasion of superficial tissues. The main causative agent of 95% OC cases is Candida albicans. The prevalence of fungal oral infection was increased due to the increasing use of antibiotic and immunodeficiency condition. However, many factors have been suggested as risk factors for oral colonization. These predisposing factors are divided into local and systemic factors. We present two cases of patient with oral candidiasis that have admitted at Wangaya Regional Hospital, Denpasar, Bali, Indonesia with different precipitating factors in order to remind health provider that oral candidiasis does not only occur in people living with HIV/AIDS (PLWHA).

Qualitative Perfusion Assessment of Myocardial Viability Study in Patients Who Cannot Stop Long-acting Nitrate: Serial Case Reports

The information of myocardial viability status is important to decide the management of CAD. Myocardial viability study (VS) with short-acting nitrate (SAN)-added is recommended to perform inpatient with CAD before revascularization therapy. This study aims to determine whether there are differences in the perfusion results of myocardial viability studies with Long-acting nitrate (LAN) and those with added SAN. Three patients with CAD were referred to our department for myocardial VS to determine the treatment choice. Long-acting nitrate (LAN) was consumed regularly every day and not allowed to be stopped due to the symptomatic chest pain. Patients underwent two myocardial perfusion VS, the first study with continuing the daily routine LAN only and the second one with SAN-added to the daily routine LAN. VS was analyzed qualitatively. The result of this study, no significant perfusion difference between LAN treatment only and SAN-added studies, it is possible the LAN regular dose alone is sufficient to create a vasodilating effect on the arteries without the need for addition of SAN. Conclusion, patients who take LAN routinely, VS might be performed without the need to take additional vasodilator prior to radiopharmaceutical injection.Keywords: coronary artery disease; myocardial perfusion imaging; revascularization therapy; viability study

Barbaric Women: Race and the Colonization of Gender in Interwar Egypt

AbstractThis article analyzes the sensationalized media coverage of a serial murder case during the Egyptian revolution of the early interwar era. Despite conflicting evidence, the media blamed the murders on two sisters from southern Egypt named Raya and Sakina. Through a close reading of Egyptian editorials and news reports, I argue that middle-class nationalists constructed Raya and Sakina as barbaric women who threatened to pull the nation back in time in order to legitimize their claim to power. Borrowing from Ann Stoler's analysis of the relationship between race and sexuality and Maria Lugones's concept of the modern/colonial gender system, this article maintains that race was as central to nationalist conceptions of female barbarism as gender, sexuality, and class. The enduring depiction of Raya and Sakina as the quintessential barbaric Egyptian women symbolizes the way in which the modern woman was constructed at the intersection of race and sexuality.

Surgical Technique for Complex Syndactyly in Apert Syndrome : A Serial Case

Abstract: Complex syndactyly in Apert syndrome, especially complicated with synonychia and synostosis, is a surgical challenge. The incidence of Apert Syndrome is reported to be approximately 1 per 100.000 to 160.000 live births and its incidence in Indonesia is not yet known. It is practically symmetrical causing significant dysfunction and infection if not treated properly. The goals in the treatment are separation of independent digits without disturbing function and growth, creation of a lined commissure, provision of skin cover for the denuded nail edge and exposed bone, and to create aesthetically pleasing individual fingertips with proper nails, nail folds and adequate pulp fullness. Many variations of surgical release of the first web space and of the remaining syndactyly have been described. Various approaches to the bony deformity of the thumb have also been described. All previously described techniques advocate releasing a single side of a digit at any given surgery to maintain the vascularity of that digit. This is due to the unreliability of the vascular branching pattern to the digits. In this serial case, we reported 5 cases of Apert syndrome. We described the clinical findings, incision design, immediate and post-surgery follow ups. The results were uneventful, with satisfying function and aesthetic appearance.

Serial Intervals and Case Isolation Delays for Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.

BackgroundEstimates of the serial interval distribution contribute to our understanding of the transmission dynamics of coronavirus disease 2019 (COVID-19). Here, we aimed to summarize the existing evidence on serial interval distributions and delays in case isolation for COVID-19.MethodsWe conducted a systematic review of the published literature and preprints in PubMed on two epidemiological parameters namely serial intervals and delay intervals relating to isolation of cases for COVID-19 until 22 October, 2020 following predefined eligibility criteria. We assessed the variation in these parameter estimates by correlation and regression analysis.ResultsOf 103 unique studies identified on serial intervals of COVID-19, 56 were included providing 129 estimates and of 451 unique studies on isolation delays, 18 studies were included providing 74 estimates. Serial interval estimates varied from 1.0 to 9.9 days, while case isolation delays varied from 1.0 to 12.5 days which were associated with spatial, methodological and temporal factors. In mainland China, the pooled mean serial interval was 6.2 (range, 5.1-7.8) days before the epidemic peak and reduced to 4.9 (range, 1.9-6.5) days after the epidemic peak. Similarly, the pooled mean isolation delay related intervals were 6.0 (range, 2.9-12.5) days and 2.4 (range, 2.0-2.7) days before and after the epidemic peak, respectively. There was a positive association between serial interval and case isolation delay.ConclusionsTemporal factors, such as different control measures and case isolation in particular led to shorter serial interval estimates over time. Correcting transmissibility estimates for these time-varying distributions could aid mitigation efforts.

Limb Salvage Surgery of Osteosarcoma Usingliquid Nitrogen at Rsup Dr. Moh. Hoesin Palembang: A Case Series

The five-year survival rate of osteosarcoma has gradually increased to 60% from 20% with Limb Salvage Surgery (LSS) combined with chemotherapy. Limb salvage surgery involves two main steps, wide resection of the bone tumor, followed by reconstruction of the defect. Reconstruction can be achieved with Cryosurgery.
 In this study, we presented a serial case of four patient at RSUP Dr. Moh. Hoesin Palembang with ages between 13-19 years old, 2 male and 2 females and diagnosed with Osteosarcoma Enneking stage IIB at the Lower Extremity Region that treated with Cryosurgery from October 2020- February 2021.
 The cryosurgery procedure on RSUP dr. Moh Hoesin Palembang, started with the bone soaked into liquid Nitrogen for 20 minutes. The bone than thawed at room temperature for 15 minutes and then soaked with normal saline in room temperature for another 15 minutes. The used of Cryosurgery for limb salvage surgery shown a good result for inducing osteosarcoma necrosis with all Histopathology results shown 50-90% to 91-99% post cryosurgery (Huvos grade II-III).
 The followed up however shown mixed results, with the patients have mixed knee flex ranged from 40o to 1100, but The LLD could still be preserved at 1-2 cm. During Followed up at 1-2 month postoperative, we found complication such as failure of fixation and skin necrotic. The followed-up research also still needed for long termed results, complications and for assessing the recurrency rated of the Osteosarcoma for these cases.

Predator or Prey Who Do You Think You Are?

In the Japanese animation PSYCHO-PASS, the setting is a future Japan where every citizen’s mental health is monitored and analysed, and where they can sometimes be terminated according to the state of their mental health. In such a dark and dystopian setting, the motifs from the many bloody quotations of Shakespeare’s bloodiest play Titus Andronicus are used in the three-episode multiple murder case of young schoolgirls. The animation shows how Shakespeare is used to stylise and elaborate the serial murder case. This article discusses how Titus Andronicus is used to give relevance and sophistication to serial murder, and how the bloodiness of a serial murder can give a different impression to audiences by the use of literature.

Frequency of Immediate Neonatal Complications (Hypoglycemia and Neonatal Jaundice) in Late Preterm and Term Neonates.

BackgroundEvidence suggests that neonates born at 34-36 weeks should not be considered full-term neonates, given the magnitude of morbidities they experience compared with term infants. Neonates born at 34 to 36 weeks are at increased risk for early illness such as hypoglycemia and hyperbilirubinemia compared to term infants.ObjectiveThis study's objective was to determine the frequency of immediate neonatal complications (hypoglycemia and neonatal jaundice) in late preterm and term neonates.Subjects and methodsA serial descriptive case study was conducted at the private tertiary care hospital. Random samplings were taken, and the sample size was calculated on Epi Info software (Centers for Disease Control and Prevention, Atlanta, GA). All the eligible samples were taken into confidence following approval by the College of Physicians and Surgeons Pakistan's institutional review board. A structured questionnaire was used in which demographic information of the patient was collected, and all neonates were closely observed for early targeted morbidities (hypoglycemia, hyperbilirubinemia)ResultsA total of 215 neonates were born during the study period, of whom 108 (50.2%) were term babies and 107 (49.8%) late preterm babies. There were 122 (56.7%) male infants and 93 (43.3%) female infants. Jaundice was observed in 6.5% (n=7) of term neonates and 22.4% (n=24) of late preterm neonates (p<0.0). Similarly, hypoglycemia was observed in only 4.6% (n=5) of term neonates and 15.9% (n=17) of late preterm neonates (p<0.01).ConclusionThere is a significant association between gestational age and immediate neonatal complications of jaundice and hypoglycemia. Compared with term neonates, late preterm neonates are at a higher risk of neonatal jaundice and hypoglycemia. Gender and mode of delivery did not correlate to complications rate.