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Post Blast Tympanic Perforations, Clinical and Paraclinical Study at Six Yaounde Hospitals

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 126-134页

作者： Andjock Nkouo Yves Christian Lekassa Pierrette Meva’a Biouele Roger Christian Moboung Prudence Mindja Eko David Djomou Francois Njock Richard Ndjolo Alexis ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Omar Bongo Ondimba Military Teaching Hospital Libreville Gabon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon

Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.

关键词： Tympanic Perforation Blast Yaounde

Outcome of patients with traumatic cranial nerve palsy admitted to a university hospital in Nepal

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中华神经外科杂志(英文) 2024年第2期10卷 1-7页

作者： Kumari Khusbu Gautam Naveen Parajuli Monika Singh Shreejana Pradhananga Amit Sedai Gopal Shilpakar Sushil Sharma Mohan Raj Maharajgunj Medical Campus Institute of Medicine Tribhuvan University Maharajgunj Kathmandu Nepal Department of Research Institute of Medicine Maharajgunj Kathmandu Nepal Department of Neurosurgery Tribhuvan University Teaching Hospital Maharajgunj Kathmandu Nepal

Background Cranial nerve palsy (CNP) is a common complication of traumatic brain injury (TBI). Despite a high incidence of TBI in Nepal (382 per 100,000), literature on the specific management and outcome of CNP is lacking. This study aimed to examine the outcomes of TBI patients involving single versus multiple *** A retrospective chart review of 170 consecutive TBI patients admitted to the tertiary neurosurgical center in Nepal between April 2020 and April 2022 was conducted. Demographic, clinical, and etiological characteristics; imaging findings; and management strategies were recorded, compared, and analyzed using descriptive statistics. The Glasgow Outcome Scale Extended (GOSE) was used to measure the outcomes in two groups of patients (single and multiple CNP) at 3 *** Out of 250 eligible patients, 80 were excluded and CNP was noted in 29 (17.1%) of the remaining 170. The median age was 34.9 years, and falls (60.6%) were the most common cause of trauma. TBI severity was categorized based on GCS: mild (82.4%), moderate (15.9%), and severe (1.8%). Cranial nerve involvement was seen in 29 (17.05%) patients: single cranial nerve involvement in 26 (89.65%) and multiple nerve involvement in 3 (10.34%). The most common isolated cranial nerve involved was the oculomotor nerve (37.9%). CT findings revealed a maximum of skull fractures with no significant association between CNP and CT *** CNP is a common consequence of TBI with the most common etiology being falls followed by RTA. Single CNP was more common than multiple CNP with no significant difference in the outcome in the 3-month GOSE score. Further research is needed to determine the burden of traumatic CNP and establish specific management guidelines for different types of CNP.

关键词： Cranial nerve palsy Nepal Outcome Traumatic brain injury

Hematological Malignancies in Sickle Cell Disease Patients: Report of Four Cases in Togo and Literature Review

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Open Journal of Blood Diseases 2024年第1期14卷 31-41页

作者： Padaro Essohana Guedenon M. Koffi Magnang Hèzouwè Womey M. C. Kodzovi Layibo Yao Kalaissi Mandjamana Agate R. Pikiliwè Department of Hematology Campus Teaching Hospital University of Lomé Lomé Togo Department of Pediatrics Sylvanus Olympio Teaching Hospital University of Lomé Lomé Togo National Center of Research and Treatement of Sickle Cell Disease Patients (CNRSD) Lomé Togo Department of Hematology Sylvanus Olympio Teaching Hospital University of Lomé Lomé Togo

Background: Hemopathies were rarely observed in major sickle cell disease patients some thirty years ago, probably due to the high mortality rate among the latter as a result of progressive complications. Thanks to advances in the management of sickle cell disease, patients' life expectancy has increased considerably, exposing them more frequently to neoplasia, including hematological malignancies. The increased risk of leukemogenesis is multifactorial and linked to the pathophysiological mechanisms of the clinical manifestations of sickle cell disease. Study Setting: The clinical haematology department of campus teaching hospital and the paediatric onco-haematology unit of Sylvanus Olympio teaching hospital in Lomé were used as study settings. Observations: Four hematologic malignancies were collected in a cohort of 5847 major sickle cell syndromes. The median age of the patients was 31.25 years (extremes: 14 and 58 years) and they were predominantly female (sex ratio M/F = 0.25). Two were on background therapy with hydroxyurea. Among the four patients, there were two cases of acute lymphocytic leukemia, including ALL3 in a 58-year-old SS woman and T-ALL2 in a 12-year-old SC. Then, a case of lymphocytic lymphoma in a 20-year-old SS man was reported and finally a case of chronic myelocytic leukemia in a 33-year-old woman of Sβ+ thalassaemia phenotype. Conclusion: To further report this coexistence, it is therefore essential to systematically consider hematological malignancies during major sickle cell syndromes even if there are similarities in the symptomatology of these two serious pathological situations.

关键词： Hematological Malignancies Sickle Cell Disease Lomé-Togo

Distinct but correct: generating diversified and entity-revised medical response

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Science China(Information Sciences) 2024年第3期67卷 94-113页

作者： Bin LI Bin SUN Shutao LI Encheng CHEN Hongru LIU Yixuan WENG Yongping BAI Meiling HU College of Electrical and Information Engineering Hunan University School of Mathematics Sun Yat-sen University JD Technology National Laboratory of Pattern Recognition Institute of AutomationChinese Academy of Sciences Xiangya Hospital of Central South University teaching and Research Section of Clinical Nursing Xiangya Hospital of Central South University

Medical dialogue generation(MDG) is applied for building medical dialogue systems for intelligent consultation. Such systems can communicate with patients in real time, thereby improving the efficiency of clinical diagnosis. However, predicting correct entities and correctly generating distinct responses remain a great challenge. Inspired by actual doctors’ responses to patients, we consider MDG a two-stage task: entity prediction and dialogue generation. For entity prediction, we design an ent-mac post pre-training strategy by leveraging external medical entity knowledge to enhance the pre-trained model. For dialogue generation, we propose an entity-aware fusion MDG method in which predicted entities are integrated into the dialogue generation model through different encoding fusion mechanisms, using information from different sources. Because the diverse beam search algorithm can produce responses with entities that deviate from the predicted entities, an entity-revised diverse beam search is proposed to correct the entities entailed in the generated responses and make the generated responses more distinct. The experimental results on the China Conference on Knowledge Graph and Semantic Computing 2021(A/B tests) and the International Conference on Learning Representations 2021(online test) datasets show that the proposed method outperforms several state-of-the-art methods, which demonstrates its practicability and effectiveness.

关键词： medical entity prediction ent-mac post pre-training strategy entity-aware fusion medical dialogue generation encoding fusion mechanism entity-revised diverse beam search

Adjuvant Rectal Diclofenac for Post Operative Analgesia after Caesarean Section—A Randomized Controlled Study

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 591-609页

作者： Eziaha Eric S. Ede Ayodele A. Olaleye John C. Irechukwu Uchenna Nelson Nwaedu Borniface N. Ejikeme Vincent Chidiebere Ali Bartholomew I. Olinya Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

BACKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can be used for postoperative analgesia. It is available and affordable. OBJECTIVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P CONCLUSION: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.

关键词： Pain Caesarean Section Diclofenac Placebo Suppository

Prognosis Factors of Urinary Quality of Life in Parkinson Disease

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Open Journal of Therapy and Rehabilitation 2024年第1期12卷 10-17页

作者： Ngor Side Diagne Sakhi Othman Ababacar Mamadou Gueye Marie Jeanne Sakho Fatou Dialo Mboup Amélie Ndeye Makarame Sy Papa Ndiouga Lo Ba Seydina Ousmane Anna Modji Basse Maouly Fall Adjaratou Dieynaba Sow Moustapha Ndiaye Amadou Gallo Diop Physical Médicine and Rehabilitation Department Fann Teaching Hospital Dakar Senegal Neurology Department Pikine Hospital Dakar Senegal Physical Médicine and Rehabilitation Department Ibn Rochd Teaching Hospital Casablanca Morocco Physical Médicine and Rehabilitation Department Military Hospital Dakar Senegal Neurology Department Fann Teaching Hospital Dakar Senegal

Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD. Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann teaching Hospital, Dakar and included patients followed for treatment of PD. Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale. Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45. Mean duration of PD was 3.1 ± 2.9 years. Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%. Quality of life was impaired in 88.88% of cases. Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered. Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042). Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.

关键词： Urinary Quality of Life Parkinson Disease Dakar

A Discussion of Artificial Intelligence in Visual Art Education

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Journal of Computer and Communications 2024年第5期12卷 71-85页

作者： Joanna Black Tom Chaput Department of Curriculum Teaching and Learning Faculty of Education University of Manitoba Winnipeg Manitoba Canada

Since ChatGPT emerged on November 30, 2022, Artificial Intelligence (AI) has been increasingly discussed as a radical force that will change our world. People have become used to AI in which such ubiquitous technologies as Siri, Google, and Netflix deploy AI algorithms to answer questions, impart information, and provide recommendations. However, many individuals including originators and backers of AI have recently expressed grave concerns. In this paper, the authors will assess what is occurring with AI in Visual Arts Education, outline positives and negatives, and provide recommendations addressed specifically for teachers working in the field regarding emerging AI usage from kindergarten to grade twelve levels as well as in higher education.

关键词： Visual Art Education Art Education Artificial Intelligence AI Generative Artificial Intelligence GAI Art teaching and Learning Art Pedagogy Art Curriculum Development Digital Art Education Art Art Education Critical Literacy

Potential efficacy and mechanism of medicinal plants on chronic kidney disease-associated vascular calcification:a review

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Traditional Medicine Research 2024年第9期9卷 21-31页

作者： Han-Qing Zhang Shuang Wu Xin Chen Ya-Xuan Fang Qiu-Mei Lan Zi-Jun Zhou Yan-Heng Qiao Jie Li Yan-Ru Zhao Ming Pei Bo Yang Department of Nephropathy First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin 300381China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion Tianjin 300381China

Vascular calcification is a crucial risk factor that affects the incidence and mortality of cardiovascular disease in chronic kidney disease *** medicine relies on calcium-phosphorus binding agents,calcium mimetics,active vitamin D,and hemodialysis to prevent and treat vascular calcification,however,their efficacy is unsatisfactory and adverse reactions often *** plant therapy can act as an integrative regulator in patients with chronic kidney disease-associated vascular calcification,which can significantly improve patients’symptoms,but its specific mechanism has not been fully elucidated *** this paper,we reviewed the domestic and international theoretical studies on the pathogenesis mechanism of chronic kidney disease-associated vascular calcification in recent years,summarized eight active ingredients of medicinal plants as well as four compound formulas for improving chronic kidney disease-associated vascular calcification,and explored the mechanism of action of herbal medicine,which will provide a new strategy for promoting the prevention and treatment of vascular calcification.

关键词： chronic kidney disease chronic kidney disease-mineral and bone disorder(CKD-MBD) vascular calcification medicinal plants herbal monomers

The diagnostic conundrum in necrotizing otitis externa

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 59-65页

作者： Abiya A.Ahmed Shaan Rashid Vinay K.Gupta Neil C.Molony Keshav K.Gupta Bradford Royal Infirmary Bradford Teaching Hospitals NHS Foundation TrustWest BromwichWest YorkshireUK Sandwell and West Birmingham Hospitals NHS Trust West BromwichUK Russells Hall Hospital DudleyUK

Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory *** diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and treatment are *** is a notoriously challenging diagnosis to *** is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive *** review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations,thus,providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.

关键词： diagnostic malignant otitis externa necrotizing osteomyelitis skull base osteomyelitis temporal bone osteomyelitis