The Maps of Us: Generational Trauma, Community Building, and Creative Resistance in Amman, Jordan

This research study focuses on the intersection of generational trauma, community-building, and creative resistance to observe the impacts of generational trauma on social-political progress and the role that communities and creativity in building social movements in Amman, Jordan. Understanding the implications of generational trauma can help bring understanding of its prevalence, what populations need to thrive in the face of generational trauma, and the political implications of generational trauma in Jordanian society. By conducting interviews with local Palestinian families, psychologists, community leaders, and creatives, the research study found that generational trauma plays a significant role in both motivating the need for political change and political action as a form of productive trauma release, yet feelings of fear, lowered resilience, community breakdown, mental/ physical health issues, and lowered communication skills as a result of the trauma pose as barriers to individual fulfillment as well as successful social-political change. Community and creative spaces can serve as places of open discussion, networks of care, resiliency, expression, self-preservation and solidarity for social change to combat the forces of generational trauma

Design, development and in vitro characterization of Pioglitazone loaded mucoadhesive buccal devices

Aim: The mucoadhesive buccal patches were developed and evaluated for systemic administration of Pioglitazone in the oral cavity. Pioglitazone belongs to a novel class of oral antidiabetic drugs known as Thiazolidinediones. Materials and Methods: The mucoadhesive buccal patches of Pioglitazone was formulated using Eudragit RS100 and HPMC K4M (mucoadhesive polymer) and were prepared by solvent casting method. Different patch formulations were evaluated for its physical parameters like thickness uniformity, swelling index, surface pH, uniformity of weight, folding endurance, mucoadhesive strength and in vitro parameters like drug content uniformity and drug release studies, and ex vivo parameters like mucoadhesion time. Results: Data for the parameters was found to be: thickness uniformity (0.27±0.45mm); uniformity of weight (40.81±0.66 mg), surface pH (6.5), folding endurance (>300), drug content uniformity (98.58±2.05%), swelling index (131±0.79%), mucoadhesive strength (38.20±1.75), in vitro drug release studies (95.18±1.98%) and ex vivo mucoadhesion, time of optimized formulation (4±1.26 h). The data was also fitted to different kinetic models to illustrate its anomalous (non-fickian) diffusion. Conclusions: The result revealed that Pioglitazone loaded buccal patches was most suitable mode of drug delivery for promising therapeutic action. Buccal patches of Pioglitazone can prove to be potential pharmaceutical dosage form for sustaining the drug release and reducing the dose frequency.Objetivo: Los parches de mucoadherente bucal fueron desarrollados y evaluados por la administración sistémica de la pioglitazona en la cavidad oral. Pioglitazona pertenece a una clase nueva de medicamentos antidiabéticos orales conocida como tiazolidindionas. Material y Método: los parches mucoadherente bucal de pioglitazona fue formulado con Eudragit RS100 y HPMC K4M (polímero mucoadherentes) y fueron elaboradas por el método de fundición solvente. Se evaluaron diferentes formulaciones de parches mediante parámetros físicos como uniformidad de espesor, índice de hinchazón, pH de la superficie, uniformidad de peso, resistencia al plegado, fuerza mucoadherentes y parámetros in vitro como uniformidad de contenido del fármaco y estudios de liberación y estudios ex vivo del tiempo de mucoadhesión del fármaco. Resultados: Los resultados obtenidos para los parámetros estudiados fueron: uniformidad de espesor, 0.27±0.45 mm; uniformidad de peso, 40.81±0.66 mg; pH superficial, 6.5; resistencia al plegado, > 300. Los ensayos in vitro dieron los siguientes resultados: uniformidad de contenido del fármaco, 98.58±2.05%; índice de hinchazón, 131±0.79%; fuerza mucoadherente, 38.20±1.75; y tiempo de liberación del farmaco (95.18±1.98%) y el ensayo ex vivo del tiempo de mucoadhesión del fármaco fue de 4±1.26 h. Los datos también se ajustaron a distintos modelos cinéticos para ilustrar su difusión anómala (no Fickian). Conclusiones: El resultado reveló que los parches bucales de pioglitazona fue el modo más adecuado de fármacos de acción terapéutica prometedora. Los Parches bucales de pioglitazona pueden resultar una potencial forma de dosificación farmacéutica para sostener la liberación del fármaco y reducir la frecuencia de la dosis.The authors are thankful to Panacia Biotec, Baddi (H.P.) India for providing the Pioglitazone as a gift sample. We are also thankful to the Board of Trustees, Bharat Institute of Technology, Meerut, India for providing necessary facilities to carry out this research work

A case study of bowel prolapses after induced abortion

Induced abortion, the intentional termination of pregnancy, is among the most common of gynaecological procedures. Depending on country-specific abortion laws, where abortion laws are highly restrictive, abortion is unsafe leading to maternal morbidity and mortality. This is a case study of unsafe abortion. In this case a 25-year-old G3P2L2 with previous 2 normal vaginal delivery had uterine perforation with bowel prolapse through the vagina following an dilatation and curettage of a missed abortion of 7 week and 6 days in a private hospital. Following the procedure patient had severe abdominal pain and bleeding from vagina, magnetic resonance imaging (MRI) was done. Patient came to our hospital with MRI. Patient was taken for exploratory laparotomy with uterine repair, bowel resection and anastomosis. Even though MTP Amendment act 2021 in India is liberal and government provides free contraception and abortion services by trained personnel, due to ignorance and misinformation, female often undergoes unsafe abortion. Unsafe abortion causes mild discomfort to grave injury like bowel prolapse leading to maternal death. Best preventive measure is awareness and easy accessibility

Approximation of durrmeyer type operators depending on certain parameters

Motivated by a number of recent investigations, we consider a new analogue of Bernstein-Durrmeyer operators based on certain variants. We derive some approximation properties of these operators. We also compute local approximation and Voronovskaja type asymptotic formula. We illustrate the convergence of aforementioned operators by making use of the software MATLAB which we stated in the paper

Occupational COVID-19 exposure among health care workers in obstetric unit in a Central Government Hospital in India: initial experience

Background: Health care workers (HCW) are the frontline warriors who are at a high risk of acquiring the COVID-19. HCW in obstetrical department are at high-risk due to their close proximity with the patient for examination, giving treatment and in delivery. The objectives of this study were to evaluate the positivity rate of COVID-19 in the initial 3 months of pandemic in health care personnel working in obstetric unit in a tertiary care hospital.Methods: Prospective cohort study was conducted in department of obstetrics and gynecology at tertiary care hospital in Delhi from 10 April to 10 June 2020. Predesigned questionnaire was used to record data of HCWs exposed to COVID-19 patients.Results: In a period of 3 months (April-June 2020), 152 health care workers were exposed to 30 COVID-19 patients.  Out of this, 10 HCW were found to be positive on testing, showing a positivity rate of 6.58%. Positivity ratio was 6:3:1 among nurses, auxiliary workers and doctors respectively. Labor room was area of high infection as 80% of HCW were infected in the labor room .80% HCW acquired infection during patient care in hospital and 20% were infected in contact with asymptomatic COVID-19 positive HCW.Conclusions: Positivity rate in obstetric department is comparable to that of general population. Appropriate infection prevention measures like use of PPE, handwashing and maintain safe distance from the patient is the key to prevention of infection. Gloves and N95 masks have been shown to provide superior protection as compared to triple layer masks. Nursing staff and auxiliary workers should be reinforced the importance of use of PPE, hand hygiene and physical distancing

Incidence Patterns and Outcomes for Hodgkin Lymphoma Patients in the United States

Hodgkin lymphoma (HL) demonstrates heterogenous histologic findings, clinical presentation, and outcomes. Using the United States Surveillance, Epidemiology, and End Results (SEER) data we examined relationships between patient characteristics, clinical features at diagnosis, and survival in HL patients. From 2000 to 2007, 16,710 cases were recorded in 17 SEER registries. Blacks and Asians had low incidence (black/white incidence rate ratio (IRR) 0.86, P < .01; Asian/white IRR 0.43, P < .01). The bimodal pattern of incidence was less prominent for black males. Asians and Blacks presented at a mean age of 38 years compared to 42 years for Whites (P < .001). Race was a predictor for survival with HR of 1.19 (95% CI 1.11–1.28) for Blacks. Age was the most important predictor of survival (HR for patients ≥45 years 5.08, 95% CI 4.86–5.31). These current patterns for presentation and outcomes of HL help to delineate key populations in order to explore risk factors for HL and strategies to improve treatment outcomes

Relationship between grey scale sonographic grades of fatty liver and shear wave elastographic values: an observational study

Background: Due to the growing public health menace of metabolic syndrome, the Non-Alcoholic Fatty Liver Disease (NAFLD) has been recording a burgeoning global rise. The prognosis of NAFLD is largely depends upon its histological stage. Simple steatosis has a fairer prognosis, while Non-Alcoholic Steatohepatitis (NASH) has a poorer prognosis with tendency to progression into fibrosis and end stage liver disease. Until now, the diagnosis of varying grades of NAFLD has been dependent upon liver biopsy, which is indisputably the most reliable tool to distinguish between simple steatosis, steatohepatitis, and end stage liver disease. The sonographic grading of NAFLD is primarily based on subjective findings, the results of which may vary between different observers. Hence, there is a need to identify a reliable non-invasive objective substitute. To compare the sonographic grades of fatty liver on gray scale with liver stiffness (Kpa) values of shear wave elastography. Also, an attempt to establish objective criteria for grading of fatty liver with improved accuracy and increased specificity.Methods: Cross sectional, observational study comprising of 240 adults referred for routine abdominal sonography. All patient underwent gray scale sonography and shear wave elastography and results were analysed.Results: A significant positive correlation was found between various grades of NAFLD as assessed subjectively on grey scale sonography to the liver stiffness in kilopascal (Kpa) using shear wave elastography.Conclusions: Shear wave elastography being an objective imaging tool is a reliable modality compared to grey scale sonography in diagnosis of NAFLD and has the capacity to carry out quantitative evaluation of liver parenchyma in vivo

Observational study of vaginal culture in symptomatic and asymptomatic non pregnant female patient in tertiary care hospital

Background: Vaginal miroflora plays an important role in maintaining healthy microenvironment. Lactobacilli are the dominant flora responsible for this. Any disturbance in balance of normal and abnormal flora leads to different types of vaginal infections like, vulvo-vaginal candidiasis, and bacterial vaginosis. Most common organisms causing vaginitis is Gardnerella vaginalis which causes bacterial vaginosis. Other organisms responsible for infections are, candida, trichomonas, and viruses. Abnormal growth of pathogenic bacteria during pregnancy can lead to various adverse pregnancy outcomes. Methods: This is an observational study conducted in a tertiary care hospital over a period of 6 months (January 2023 to June 2023). Overall, out of 135 women, sample of 120 women were taken and treated accordingly. Results: Among 120 women, 52 (43.3%) women had no growth on culture, while 20 patients (16.6%) showed growth of Klebsiella and 20 (16.6%) patient shows Candida and rest shows growth of other pathogen. Conclusions: In our study, half of the women were found to be with positive culture report, who shown improvement after treatment

Clinical, Molecular, and Environmental Risk Factors for Hodgkin Lymphoma

Epidemiological studies suggest unique occurrence patterns of Hodgkin lymphoma (HL) worldwide. In most Western countries there is a clear bimodal age distribution with an early peak in young adults followed by a second peak in older adults, particularly among males. In the Middle East and Asia, HL is more common in early childhood. There also are marked racial differences in the presentations of HL and HL subtypes, and particular single nucleotide polymorphisms (SNPs) have been identified as etiological factors suggesting that gene-gene and gene-environment interactions are involved. Personal health choices such as exercise and smoking may modify an individual's chances of developing HL. Numerous studies highlight the impact that exposure to Epstein-Barr virus and other environmental factors have on HL risk. Understanding the relative importance of each of these findings and their links to HL development and survival will help clinical researchers expand curative therapies and create preventative strategies for HL