Lupine Publishers Group

Divyan Chopra, Chenghui Li, Jacob T Painter, Jonathan P Bona, Intawat Nookaew, and Bradley C Martin*

DOI : 10.32474/GJAPM.2021.04.000187

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Background: About 38% of U.S. adults use prescription opioids. Opioid-related overdoses have risen in the last decade. Studies suggest that duration and type of first opioid prescribed play a significant role towards risky and chronic opioid use. Objective: The primary objective was to identify key players involved with initiation of patients on opioids. This study also identified patient characteristics most likely to receive care from influential opioid providers as opioid initiation interventions could be directed to such physicians. Design/Participants: A cohort of patients with incident opioid use were identified using Arkansas All-Payer Claims Database from 2013-2018. A social network comprising provider as nodes and referrals as edges was constructed based on healthcare utilization 180 and 90 days preceding incident opioid u..... ReadMore

Yasser Mohammed Hassanain Elsayed1*

DOI : 10.32474/GJAPM.2021.04.000186

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Rationale: A novel COVID-19 with severe acute respiratory syndrome had emerged in Wuhan, China in December 2019. The presence of takotasobo cardiomyopathy in COVID-19 patients is an extremely rare and commonly recognized post severe stress. The changeable bifascicular block is also very rare to be present after COVID-19 with the severe acute respiratory syndrome. Interestingly, the combination of COVID-19 pneumonia with an apical takotasobo cardiomyopathy and changeable bifascicular block has a worthy risk impact on both morbidity and mortality of COVID-19 patients. Patient concerns: An elderly carpenter male COVID-19 pneumonic patient was admitted to the critical care unit with dyspnea and tachypnea post-severe emotional stress with evidence of acute myocardial infarction, cardiomyopathy, and changeable bifascicular block. Diagnosis: Api..... ReadMore

Atroune L*, Bouaita K, Benhafri A, Habchi N, Bennaleg S and Djaffer M

DOI : 10.32474/GJAPM.2021.04.000184

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Awake craniotomy is today a common and effective practice worldwide and in Algeria, however it remains a rare surgical procedure in children due to age and psychological aspects that hinder with its feasibility and limits its application. Despite extensive literature in the adult population awake brain surgery remains poorly reported in the pediatric population. The aim of this article is to report a case of a 15 years old child who was treated in our department with excellent outcome...... ReadMore

Andrew Hague*

DOI : 10.32474/GJAPM.2021.04.000183

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This is your death plan. Choose the easy options. Go with the flow. Do what you want to do. This will get you off the endless conveyor. No more effort and it’s all downhill. Be advised by advertisers, doctors who know nothing about food or exercise, a government that wants to squeeze you and business intent on profit. If you are reading this thinking you can do the opposite, think again. You will be fighting powers you did not know exist. Perhaps you should be in a cave without money, friends or help. Survival in a civilised society is difficult. Only the brave can go against the grain. There are three sectors: food, exercise and lifestyle. All three are waiting for you like monsters of the deep to suck you in and kill you. You think you are being looked after. Beware!...... ReadMore

Wang Jun, Yin Jichao*, Hu Xing lV and Lei Chengxiang

DOI : 10.32474/GJAPM.2021.04.000182

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Background and objectives: Superior cluneal nerve entrapment syndrome is one of the causes of low back pain. Explore new treatment methods for the treatment of Superior cluneal nerve entrapment syndrome. Case Report: A 44-year-old man with severe pain in the right lower waist for 3 days, pain in the right iliac crest, accompanied by throbbing pain in the right hip, restricted waist movement, increased pain during forward bending and rotation his straight-legraising tests were negative on both sides. Check the sacroiliac joints and spine without obvious abnormalities. Result: Manipulative therapy can relax the tension of the waist and hip muscles, and comprehensively obtain better treatment results for the compression of the buttock epithelial nerve; ultrasound examination can well describe the damage of the buttock epithelial nerve...... ReadMore

José Francisco Cravo*, Ionut Tabolcea and Turgay Tuna

DOI : 10.32474/GJAPM.2021.04.000181

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Cervical epidural blood patches (CEBP) remain an unfamiliar domain for most anesthesiologist as they fear the possible neurological complications related with the procedure. The injection of autologous blood as close as possible to the dural leakage site has shown to be the most effective approach for symptom resolution in case of spontaneous cervical dural tears. This case report describes in detail a feasible and effective technique to perform an epidural blood patch at the cervical level...... ReadMore

Castro Diez, Laura*, García Jiménez, Maria Lourdes, Juncal Díaz, Jorge Luis, López Álvarez Servando, Noguera Aguilar and Jose Francisco

DOI : 10.32474/GJAPM.2021.04.000180

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Objectives: Abdominal wall pathology, such as inguinal and umbilical hernias, is one of the most prevalent pathologies in the field of General Surgery, with interventions being carried out more and more within outpatient Major Surgery programs. Nevertheless, this pathology is not free from postoperative morbidities or complications, such as postoperative pain, which sometimes requires a longer hospital stay. We present our initial experience using incisional anesthetic catheters in patients who underwent an inguinal or umbilical hernia and analyze various postoperative parameters related to pain and the functional limitation it causes in the patient. Material and Methods: We intervened a consecutive series of 20 patients with an average age of 60 years with abdominal parietal defects, 15 with a diagnosis of inguinocrural hernia, an..... ReadMore

Yasser Mohammed Hassanain Elsayed*

DOI : 10.32474/GJAPM.2021.04.000179

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Rationale: Iatrogenic substance-inducing disease is an occasionally clinical entity. Alcohol is a common illicit and abused substance. Inhaling alcohol vapor and mists have common occupational health and safety risks including both respiratory and hepatic hazards. Patient concerns: An elderly-aged married male patient presented to the physician’s outpatient clinic with tachypnea, sinus tachycardia, and chest pain post-alcohol inhalation. Diagnosis: Iatrogenic alcohol inhalation inducing sinus tachycardia and coronary spasm in an asthmatic and cirrhotic patient. Interventions: Electrocardiography, oxygenation, monitoring for vital signs, and echocardiography. Outcomes: The dramatic normalization of clinical and electrocardiographic coronary artery spasm with sinus tachycardia after oxygenation had happened. Lessons: The identificat..... ReadMore

Paul T E Cusack*

DOI : 10.32474/GJAPM.2021.04.000178

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In this paper, we consider the logical basis for ethical acts based on sound moral arguments. We consider the authority of the Church over the course since the Enlightenment. We show that virtue is the logical outcome using AT math. We show mathematically that there is such a thing as soul energy (SE) that makes up part of the total energy of the universe. Human beings have a soul and science proves it. It is important because many people today have no faith in religion; their faith is in science. Nothing could be more stunted and costly to their wellbeing temporally and eternally. We also consider why there are 16 personality types in Jungian Psychology. We see that the personality is based on stress tolerance. Some seek pleasure; others avoid pain. This is the underlying force beneath the various personality types. It is important..... ReadMore

Andrew Hague*

DOI : 10.32474/GJAPM.2021.04.000177

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The ease with which cancer is stopped by CellSonic surprises oncologists and delights patients. Cancer is an electrical fault. The behaviour of the cells is corrected by changing the voltage to that of healthy cells, a process called electroporation. There is no surgery and no drugs. This is biophysics, not biochemistry. There are no side effects, and the replication of mutating cancer cells is stopped immediately. Then starts the healing of the damage caused by cancer and the usual problems in patients unfortunate to have been treated with chemotherapy and radiation. The cancer in the lungs has special difficulties because the tissues converted from malign to benign must be removed. Lung surgery is seldom an option. CellSonic sells to specialist clinics where the patients pay for treatments. These clinics are too busy to tell CellS..... ReadMore

Mercedes Benítez Jiménez*

DOI : 10.32474/GJAPM.2020.04.000176

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Citrullinemia is an autosomal recessive genetic condition that falls under the spectrum of urea cycle disorders. The defective genes reduce the activity of enzymes needed to process nitrogen effectively. Two types exist: type I (neonatal onset) occurs when the defective arginosuccinate synthase enzyme fails to complete the third step of the urea cycle by converting citrulline and aspartate to L-argininosuccinate...... ReadMore

Raden Theodorus Supraptomo*, Suroto, Bambang Purwanto and Ari Natalia Probandari

DOI : 10.32474/GJAPM.2020.03.000175

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Background: Labor pain is the most painful experience. The use of neuraxial intrathecal labor analgesia (ILA) in standard delivery is increasing with lower maternal pain scores and higher levels of satisfaction. This study was aimed to demonstrate that neuraxial ILA mechanisms decrease endothelial nitric oxide synthase (eNOS), and decrease interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Methods: This randomized controlled trial was conducted in 100 pregnant patients, aged <35 years old, who will be in labor within 2017 and were a patient in obstetrics and gynecology at six hospitals and six primary health centers in Surakarta. Subjects were randomized and divided into two groups. Group ILA (n = 50) received 2.5 mg bupivacaine + 50 µg clonidine +0.1 mg morphine and the control group (n = 50) did not receive any treat..... ReadMore

João Abrão, Antoine Louis Jacques M, Álvaro Dowling and Kai-Uwe Lewandrowski*

DOI : 10.32474/GJAPM.2020.03.000174

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Background: Providing adequate anesthesia that caters to rapid turn-over in an outpatient ambulatory surgery center setting is sometimes as much of an art as it is a science. Outpatient spine surgery is characterized by shorter simplified versions of their inpatient counterparts carried out in a hospital setting. Objective: The monitored anesthesia care (MAC) and deep sedation with a laryngeal mask airway (LMA) in the prone position have received little attention in the anesthesia and spine surgery literature. The authors reviewed their clinical outcomes with the outpatient endoscopic spinal surgery in conjunction with these two types of anesthesias. Methods: We performed an analysis of perioperative anesthesia and clinical outcomes in 184 patients who underwent lumbar endoscopic spinal surgery in two outpatient ambulatory surgery ..... ReadMore

Kelvin Wang BSE, Krishna B Shah and Suman Rajagopalan*

DOI : 10.32474/GJAPM.2020.03.000173

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Airway management of a patient with penetrating facial trauma is often anticipated to be difficult. However, due to the variation in presentation of penetrating facial trauma, there are no consensus guidelines established for securing the airway. We present a case of penetrating facial trauma with an impaled screwdriver, describe the anatomical significance of the embedded foreign object, and suggest an approach to airway management. Ultimately, a skilled provider must use his or her clinical judgement and have a clear understanding of anatomy to best approach these unique scenarios..... ReadMore

Polukhov RSh, Nasibova EM*, Polukhova AE, Rustamkhanly AM, Sultanova MJ and Nasibov FG

DOI : 10.32474/GJAPM.2020.03.000172

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The novel coronavirus infection (COVID-19) pandemic, caused by the highly contagious severe acute respiratory syndrome coronavirus (SARS-CoV-2), is still at its peak, causing thousands of deaths every week. Since the beginning of the coronavirus (just a few months ago), our understanding of the disease has grown rapidly. While there are several large, randomized drug trials currently underway, current survival from severe COVID-19 is entirely dependent on providing the best supportive care possible...... ReadMore

Metin Tas and Ayse Veyhurda Dikmen*

DOI : 10.32474/GJAPM.2020.03.000171

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A 71 year-old male patient, who was diabetic and hypotensive, was admitted to emergency room with the complaints of high fewer, shortness of breath and general malaise. He was diagnosed to have acute renal failure, signs of uro-sepsis and emphysematous pyelonephritis with pathognomonic computerized tomography (CT) scans. After 7 days of follow-up with meropenem and teicoplanin treatment and hemodialysis, the patient was externed. This case was an emergent case of emphysematous pyelonephritis, which is a rare entity with a high incidence of mortality in modern clinical practice...... ReadMore

Azza Ahmed Ameen Hafez*

DOI : 10.32474/GJAPM.2020.03.000170

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Fluid therapy is an essential component part management of critically ill patients. Proper estimation of the amount of needed fluids is of great importance due to the well-established adverse effects of marked negative and positive fluids balance. Central venous pressure has been widely used by ICU physicians for volume status assessment. Several methods have been postulated for volume status assessment, among which is the inferior vena cava collapsibility index. As the inferior vena cava is a thin-walled capacitance vessel that adjusts to the body’s volume status by changing its diameter depending on the total body fluid volume. Giving the fact that bedside ultrasonographic measurement of inferior vena cava diameters is an available, non-invasive, reproducible, and quiet easy-to-learn technique, it can provide a safe and quiet re..... ReadMore

Behzad Saberi*

DOI : 10.32474/GJAPM.2020.03.000169

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There are common abnormalities which can be seen due to occlusion in the anterior or posterior circulation of the brain in the Cerebrovascular accident which can be helpful to localize the lesion at the bedside Aphasia, Amaurosis fugax, Hemisensory loss, Hemianopic visual loss and Hemiparesis are common abnormalities which can be seen in the occlusion of the anterior circulation which would be the territory of the carotid and comprise about 80 percent of the cases Hemianopic visual loss, Syncope, Tetra paresis, Transient global amnesia, Ataxia, Diplopia, Dysarthria, Chocking, Hemisensory loss, Vertigo and Vomiting are common abnormalities which can be seen in the occlusion of the posterior circulation which would be the territory of the vertebrobasilar and comprise about 20 percent of the cases...... ReadMore

Shiv Charan Navriya*, Satish Kumar Ranjan, Sunil Kumar, Ashwani Kumar Kandari, Tushar Aditya Narain and Kim Jacob Mammen

DOI : 10.32474/GJAPM.2020.03.000168

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COVID-19 disease was first reported in Wuhan city of China, since then this is spreading with alarming speed and had already affected more than 213 countries around the world. The COVID-19 pandemic has had a global impact on all sectors of public health and hospital services. Naturally, urology services have been affected too with several patients, suffering from urological malignancies and renal stone disease, left to their fate. Present records hint towards this pandemic continuing at least till the end of this year and it is only prudent that we come up with strategies to re-initiate urological services in a phased and a safe manner to tackle both, the urological diseases and the COVID-19 infection. This review aims at providing recommendations for resumption of urological services in a phased manner, based on the available evide..... ReadMore

Mohit Kumar, Bhavna Gupta* and Suresh Kumar

DOI : 10.32474/GJAPM.2020.03.000167

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A 15 year old American Society of Anaesthesiologist class 1 male, was, posted for modified radical mastoidectomy under general anaesthesia. On the day of the surgery, routine standard monitors were attached. The ECG on the monitor showed normal sinus rhythm with a heart rate of 88/min, blood pressure of 100/70 mmHg, peripheral saturation of 99% on room air.He was pre-medicated with 1mg intravenous Midazolam, 80 micrograms fentanyl and induced with 100 mg propofol and vecuronium 5 mg.Trachea was intubated with 6 mmID cuffed endotracheal tube and connected to anaesthesia workstation. Anaesthesia was maintained on 50:50 O2 :N2 O and Sevoflurane...... ReadMore