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Cutaneous angiosarcoma is a rare vascular tumour especially of elderly males. We present a rare case of elderly female who presented with scalp lesion, parotid swelling and posed a diagnostic challenge. Further work up including biopsy of the lesion revealed the diagnosis of cutaneous angiosarcoma. Rarity of the case due to presence of this rare tumour in a darkcolored female and wide spread presentation of the tumour prompted us to report the case. This case adds to the literature of few cases describing this rare tumour in Indian subcontinent. It attempts to alert the clinicians of this entity, as early diagnosis of the tumour may possibly improve the already known dismal prognosis!

This study has been done with intent to research the relationship between tendency to violance and gender role attitudes among the university students in terms of various variables. Tendency to violance of university students and their attitudes towards gender roles has been discussed in terms of various variables such as gender, average monthly income situation of family, parents’ educational level, perceived social support level from family ,exposure to domestic violance. The research sample consists of 300 students from Atatürk University studying geography,philosophy,science,French,Turkish teaching and psychological counseling and guidance. University students who set research sample “Individual Knowledge Form”, “Violence Tendency Scale” and “Gender Roles Attitudes Scale have been tested out. These analyses are made on the data obtained from the study; the frequency, percentage, t-test for independent groups, Kruskal-Wallis and Mann-Whitney U. From the result of the study it has been found that there is a significant difference between tendency to violence and gender roles. A significant difference is found between tendency to violence according as gender, perceived social support from family, exposure to domestic violence and attitude point average according as gender, average monthly income situation of family, mother’s educational level, witnessing to domestic violence.

Background: The epidemiology of the Coronavirus-disease associated mucormycosis (CAM) syndemic is poorly elucidated. We aimed to identify risk factors that may explain the burden of cases and help develop preventive strategies.Methods: We performed a case-control study comparing cases diagnosed with CAM and taking controls as recovered COVID 19 patients who did not develop mucormycosis. Information on comorbidities, glycemic control, and practices related to COVID-19 prevention and treatment was recorded. Multivariate regression analysis was used to identify independent predictors.Results: A total of 352 patients (152 cases and 200 controls) diagnosed with COVID-19 during April-May 2021 were included. In the CAM group, symptoms of mucormycosis began a mean of 18.9 (SD 9.1) days after onset of COVID-19, and predominantly rhino-sinus and orbital involvement was present. All, but one, CAM cases had conventional risk factors of diabetes and steroid use. On multivariable regression, increased odds of CAM were associated with the presence of diabetes (adjusted OR 3.5, 95% CI 1.1-11), use of systemic steroids (aOR 7.7, 95% CI 2.4-24.7), prolonged use of cloth and surgical masks (vs. no mask, aOR 6.9, 95%CI 1.5-33.1), and repeated nasopharyngeal swab testing during the COVID-19 illness (aOR 1.6, 95% CI 1.2-2.2). Zinc therapy was found to be protective (aOR 0.05, 95%CI 0.01-0.19). Notably, the requirement of oxygen supplementation or hospitalization did not affect the risk of CAM.Conclusion: Judicious use of steroids and stringent glycemic control are vital to preventing mucormycosis. Use of clean masks, preference for N95 masks if available, and minimizing swab testing after the diagnosis of COVID-19 may further reduce the incidence of CAM. [ABSTRACT FROM AUTHOR]

Background: In an inpatient setting, aspects of discharge planning are often left to the provider's memory, leading to errors, inefficiencies, and avoidable costs. Methods: A multidisciplinary team of oncology practitioners used process improvement methodologies to redesign the discharge planning process. Interventions: The primary intervention was an evidence-based discharge planning tool, called the discharge navigator, used from admission through discharge. Results: Thirty-day unplanned readmission rates decreased by 29.0% from preimplementation (March 2017 through August 2017) to postimplementation (September 2017 through March 2020). The percentage of patients discharged before noon increased 76.2%. A comparable service not utilizing the intervention saw lesser or no improvement in these measures. Conclusion: The tool provided a systematic approach to discharge planning. Key design elements included a centralized location within the electronic health record and an electronic shortcut to populate the tool. Although developed for a specialized population, most elements are applicable to any hospitalized patient. [ABSTRACT FROM AUTHOR]

Objectives: Determine the eclampsia prevalence and factors associated with eclampsia and recurrent seizures in Suriname and evaluate quality-of-care indicator 'magnesium sulfate (MgSO4) coverage'.Study Design: A two-year prospective nationwide cohort study was conducted in Suriname and included women with eclampsia at home or in a healthcare facility.Main Outcome Measures: We calculated the prevalence by the number of live births obtained from vital registration. Risk factor denominator data concerned hospital births. Descriptive statistics and multivariate regression analysis were performed.Results: Seventy-two women with eclampsia (37/10.000 live births) were identified, including two maternal deaths (case-fatality 2.8%). Nulliparity, African-descent and adolescence were associated with eclampsia. Adolescents with eclampsia had significantly lower BPs (150/100 mmHg) than adult women (168/105 mmHg). The first seizure occurred antepartum in 54% (n = 39/72), intrapartum in 19% (n = 14/72) and postpartum in 26% (n = 19/72). Recurrent seizures were observed in 60% (n = 43/72). MgSO4 was administered to 99% (n = 69/70) of women; however 26% received no loading dosage and, in 22% of cases MgSO4 duration was <24 h, i.e. guideline adherence existed in only 43%. MgSO4 was ceased during CS in all women (n = 40). Stable BP was achieved before CS in 46%. The median seizure-to-delivery interval was 27 h, and ranged from four to 36 h.Conclusion: Solely 'MgSO4 coverage' is not a reliable quality-of-care indicator, as it conceals inadequate MgSO4 dosage and timing, discontinuation during CS, stabilization before delivery, and seizure-to-delivery interval. These other quality-of-care indicators need attention from the international community in order to reduce the prevalence of eclampsia. [ABSTRACT FROM AUTHOR]

A team of ICU specialists, paediatricians, palliative care physicians and family together decided to make a shared decision. Response to: 'Medical consent; striking the right balance between shared decision-making and shared responsibility': a win-win scenario if done well We share our experience of a challenging situation in COVID intensive care unit (ICU) when a 14-year-old girl with osteosarcoma bone with lung metastasis was transferred to ICU for severe COVID-19 infection. [Extracted from the article]

1983 yılında Kayseri'nin Felahiye ilçesine bağlı Çukur bucağının 3 km. kuzeydoğusunda, Kağnı deresindeki kum ocaklarından kum alınırken bulunduğu bildirilen 29 adet tunç eser Müzemize getirildi. Ele geçirilen bu eserlerin yanında değişik malzemelerden yapılmış, değişik türde başka eserlerin de bulunup bulunamadığı anlaşılamadı. İlk bakışta bu eser grubunun bir defineyi temsil ettiği anlaşılmaktadır. Ancak bu defineyi oluşturan eserlerden bir kısmının eksik olduğu izlenimi edinilmiştir. Yerinde yaptığımız araştırmalarda, buluntu yeri olarak işaret edilen kesimde herhangi bir eski kalıntıya rastlanmamıştır. Yalnız bugünkü köyün dışında, kum ocaklarının bulunduğu yere 1 km. uzaklıktaki tarlada, Eski Tunç Çağı'na ait kaba seramik parçaları ele geçirilmiştir. Bu araştırma sırasında köylüler, sözkonusu tarlada daha önceleri küçük bir tepenin bulunduğunu, sonradan bu tepenin sürülerek düzleştirildiğini ifade etmişlerdir. Bu bilgilerin ışığında üzerinde duracağımız eserlerin, ait oldukları çağda, bu iskan yerinin yakın çevresine depo edilmiş, saklanmış olabilecekleri gibi, tamamen ayrı bir bölgeden, özellikle Orta Anadolu'nun kuzeyinden Müzemize getirilmiş olabilecekleri ihtimali de düşünülebilir. Kağnı deresindeki kum ocağından elimize geçmeyen irice kahverengi bir kap içerisinde bulundukları yolundaki ifade, bu eserlerin bir define, bir depo oldukları görüşüne ağırlık kazandırmaktadır. Define, teber biçimli onbir balta, sap delikli üç balta, bir kabza veya asa başı ile onüç çalparadan oluşmaktadır.

Copyright of Inonu University Journal of the Faculty of Education (INUJFE) is the property of Inonu University Journal of the Faculty of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pamukkale University Journal of Education is the property of Pamukkale University Journal of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

REFERENCES 1 Niyas VKM, Arjun, R. Breakthrough COVID-19 infections among health care workers after two doses of ChAdOx1 nCoV-19 vaccine. Dear Editor, We read with interest article by Niyas I et al. i [1] on-breakthrough infections after COVID vaccine. [Extracted from the article]

Abstract: Cardiovascular disease (CVD) continues to account for a very high percentage of deaths in patients with ESRD. An entire gamut of risks factors-some well known, some still being understood and yet more putative are operational in patients with renal disease. CVD assumes enhanced importance in the wake of its disproportionate effect on patients with uremia. Some studies have reported an upto 15 fold higher cardiovascular death rate in patients on PD when compared to non-uremic cohorts. Thus it follows that the longevity of patients on PD is directly related to improvements in the recognition, management and prevention of CVD. While the conventional risk factors like age/diabetes/hypertension/hyperlipidemia/smoking etc need no elaboration, factors unique to renal failure like calcium/phosphorus/Vitamin D abnormalities, anemia, dialysis related chronic inflammation etc add to the burden and pathogenesis of CVD. Specific to PD, certain abnormalities like hypoalbuminemia and attendant malnutrition, metabolic abnormalities and even high transporter status (speculative) are thought to propagate the progression of CVD. A review of CVD in PD is incomplete without a referral to non-atherosclerotic disease-volume overload, congestive heart failure and LVH. This review looks into the spectrum of CVD in PD patients, its pathogenesis, and factors unique to PD, and possible therapeutic and preventative measures. [Copyright &y& Elsevier]

Abstract: In this study it is aimed to investigate whether university students’ attitudes toward the use of PowerPoint as a supporting teaching tool in the lectures change according to variables such as gender, academic units attended. For this purpose, the sample consisted of total 653 students who enrolled, Faculty of Education (N=287), Faculty of Engineering (N=125), School of Economics and Administrative Sciences (N=92) and Vocational School (N=149) in Bayburt University. Data was collected using “attitude toward the use of PowerPoint” scale. Additionally, students’ opinions of the use of PowerPoint as a supporting teaching tool was collected from their responses to a questions form developed by researchers, then written documents analyzed to reveal their opinions with respect to the use of PowerPoint. The data obtained was statistically analyzed (ANOVA). It was found that there is no any statistically meaningful difference in the participants’ attitude toward the use of PowerPoint in respect to gender, but there was significant difference in the participants’ attitude toward the use of PowerPoint according to academic units attended. Recently, the findings were discussed in terms of the use of PowerPoint as a supporting tool in the lectures and its importance. [Copyright &y& Elsevier]

We present a rare case of multiple infections coexisting together. This is one of the rarest cases of four infections which coexisted together in our patient. It is an alarming for the physicians to be aware of such infections as early prompt diagnosis can be lifesaving. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) continues to be one of the deadliest infectious diseases over the centuries, killing more people worldwide than any other single infectious disease. There is an urgent need for additional strategies which can expedite efforts to combat TB including a preventive vaccine. In this endeavour, we have developed a protocol for a multisite, double-blind, placebo-controlled clinical trial in India that aims to evaluate the efficacy and safety of two TB vaccines; namely, VPM1002 and Immuvac ( M.w ) ( Mycobacterium Indicus Pranii ) (MIP) among healthy household contacts (HHCs) of sputum smear-positive pulmonary TB (PTB) patients., Methods and Analysis: In the three-arm randomised double-blind placebo-controlled trial study protocol, a total of 12 000 HHCs (aged 6-99 years) of sputum smear-positive PTB patients will be randomised to receive either of the two vaccine candidates VPM1002 and MIP or placebo. The primary efficacy endpoint is the prevention of microbiologically confirmed TB. Secondary endpoints will include (1) prevention against Latent TB infection, (2) incidence of adverse events and serious adverse events in study participants, (3) efficacy of vaccine in prevention of PTB/extra PTB in different age groups (6-18 years, 19-35 years, 36-60 years and above 60 years) and (4) immunogenicity of VPM1002 and MIP at month 2 and month 6 after first vaccination in terms of flow cytometric analysis of M.Tb specific CD4+ and CD8+ T cells secreting cytokines and Luminex assays for the presence of different cytokines in the sera and supernatants of peripheral blood mononuclear cells cultures stimulated with whole cell lysates of M.Tb and subsequently similar analysis for the cases who develop TB postvaccination during the follow-up period., Ethics and Dissemination: Ethics committees' approvals have been granted by the Institutional Human Ethics Committees of all participating centres in this study and the names of the ethics committees and approvals are as follows: (1) National Institute for Research in Tuberculosis (NIRT)-Chennai (including subsites): ECR/135/Inst/TN/2013/RR-19, Approval No. 390/NIRT-Institutional Ethics Committee (IEC)/2018 dated 5 December 2018 (NIRT-Madurai-ECR/1365/Inst/TN/2020; approval dated 8 June 2020; NIRT, Vellore: ECR/1215/Inst/TN/2019; approval dated 26 September 2020); (2) All India Institute of Medical Sciences (AIIMS), Delhi (including subsites)-Institute Ethics Committee, ECR/547/Inst/DL/2014/RR-17 ECR/538/Inst/DL/2014/RR-20; approval No.IEC-385/06-07-2018, approval OP-28/05.04.2019 and SFH- ECR/593/Inst/DL/2014/RR-20 IEC/VMMC/SJH/project/2019-05/25 ; 23 May 2019; (3) National Institute of Tuberculosis and Respiratory Diseases (NITRD), Delhi: ECR/315/Inst/DL/2013/RR-19; approval IEC-No-NITRD/EC/2019/9004; 8 January 2019; (4) Pune-National AIDS Research Institute (NARI) and subsite-ECR/23/Inst/MH/2013/RR-19; IEC-NARI/EC/approval/2018/196; 29 May 2018; (5) Regional Medical Research Centre-Bhubaneshwar-ECR/911/Inst/OR-2017/RR-21; approval, dated 25 April 2018; Subsites- AIIMS, Bhubaneshwar ECR/534/Inst/OD/2014/RR-17 and 20 approval No. T/EMF/Pulm. Med/19/01 dated 13 May 2019; SCB, Cuttack No. No.ECR/84/Inst/OR/2013/RR-20; approval no.186 dated 7 February 2020; (6) NTI-Bengaluru: Ethics Committee-No-ECR/1819/Inst/KA/2019; approval No NTI-IEC/1.2019/principal investigator, dated 31 January 2019; (7) BMMRC, Hyderabad- ECR/450/Inst/AP/2013/RR-16 approval No. 779/BMMRC/2018/IEC, dated 11 June 2018 (Subsite Share India- Mediciti Ethics Committee-ECR/283/Inst/AP/2013/RR-20; Approval no. EC/11/VII/2K20(1) dated 11 July 2020) and (8) SJMC-Bengaluru: ECR/238/Inst/KA/2013/RR-19; approval IEC/1/491/2020; 7 August 2020.The trial findings will be published in accordance with the Consolidated Standards of Reporting Trials guidance. The results of this clinical trial will be presented at scientific conferences and disseminated through publications in peer-reviewed journals, conference presentations and shared with Ministry of Health and Family Welfare, policy-makers and other stakeholders., Trial Registration Number: CTRI/2019/01/017026., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: There are studies available on the prevalence of coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) in hospitalized patients but not on the incidence of CAM in post-discharge patients. The aim of our study was to find the incidence of CAM in the patients discharged from a COVID hospital., Material and Methods: Adult patients with COVID discharged between March 1, 2021 and June 30, 2021 were contacted and enquired about sign and symptoms of CAM. Data of all included patients were collected from electronic records., Results: A total of 850 patients responded, among which 59.4% were males, 66.4% patients had co-morbidities, and 24.2% had diabetes mellitus. Around 73% of patients had moderate to severe disease and were given steroids; however, only two patients developed CAM post discharge., Conclusion: The incidence of CAM post discharge was low in our study, which could be attributed to protocolized therapy and intensive monitoring., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Community Medicine.)

Competing Interests: None

Background: Strongyloides stercoralis (S. stercoralis) , a unique parasite, can cause mortal disease even years after the exposure. Iatrogenic use of steroids can complicate asymptomatic infections to a life-threatening hyperinfection and/or disseminated infection. Data regarding seroprevalence of strongyloidiasis remains scarce and this knowledge gap needs due attention in many endemic countries including India., Aim: The present study is aimed at assessing the seroprevalence of Strongyloides infection and the need for routine screening among individuals receiving steroid therapy., Methodology: Eighty patients receiving steroid therapy and thirty healthy volunteers who had not received any immunosuppressive drugs and/or anthelminthic therapy in last six months were enrolled as cases and controls respectively and they were screened by Strongyloides IgG ELISA., Results: Among the 80 patients on steroids, the mean cumulative prednisolone equivalent dose received was 8.2 g (±11.2 g) for a mean duration of 184 days, 16 patients (20%, 95% CI 11.9-30) had a positive Strongyloides IgG serology. Only 4 controls (4/30, 13.3%, CI 3.8-30.7) tested positive (p=0.4)., Conclusions: Our study demonstrated a Strongyloides seroprevalence of 20% in the study population emphasizing the need for screening for Strongyloides infection prior to immunosuppressive therapy in order to prevent hyperinfection or possible dissemination., Competing Interests: Conflict of interest None

Background: BBV152 is a whole-virion inactivated SARS-CoV-2 vaccine that has been deployed in India. The results of the phase 3 trial have shown clinical efficacy of BBV152. We aimed to evaluate the effectiveness of BBV152 against symptomatic RT-PCR-confirmed SARS-CoV-2 infection., Methods: We conducted a test-negative, case-control study among employees of the All India Institute of Medical Sciences (a tertiary care hospital in New Delhi, India), who had symptoms suggestive of COVID-19 and had an RT-PCR test for SARS-CoV-2 during the peak of the second wave of the COVID-19 pandemic in India between April 15 and May 15, 2021. Cases (test-positives) and controls (test-negatives) were matched (1:1) on the basis of age and gender. The odds of vaccination with BBV152 were compared between cases and controls and adjusted for level of occupational exposure (to COVID-19), previous SARS-CoV-2 infection, and calendar time, using conditional logistic regression. The primary outcome was effectiveness of two doses of BBV152 (with the second dose received at least 14 days before testing) in reducing the odds of symptomatic RT-PCR-confirmed SARS-CoV-2 infection, expressed as (1 - odds ratio) × 100%., Findings: Between April 15 and May 15, 2021, 3732 individuals had an RT-PCR test. Of these, 2714 symptomatic employees had data on vaccination status, and 1068 matched case-control pairs were available for analysis. The adjusted effectiveness of BBV152 against symptomatic COVID-19 after two doses administered at least 14 days before testing was 50% (95% CI 33-62; p<0·0001). The adjusted effectiveness of two doses administered at least 28 days before testing was 46% (95% CI 22-62) and administered at least 42 days before testing was 57% (21-76). After excluding participants with previous SARS-CoV-2 infections, the adjusted effectiveness of two doses administered at least 14 days before testing was 47% (95% CI 29-61)., Interpretation: This study shows the effectiveness of two doses of BBV152 against symptomatic COVID-19 in the context of a huge surge in cases, presumably dominated by the potentially immune-evasive delta (B.1.617.2) variant of SARS-CoV-2. Our findings support the ongoing roll-out of this vaccine to help control the spread of SARS-CoV-2, while continuing the emphasis on adherence to non-pharmacological measures., Funding: None., Translation: For the Hindi translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)