Introduction: Paraneoplastic hypoglycemia unrelated to insulinoma is a rare cause of hypoglycemia and is due to paraneoplastic secretion of either IGFI, IGFII, or more rarely insulin Observation: We report a case of paraneoplastic hypoglycemia in a patient with metastases of an unknown primary. This is a 60-year-old patient admitted to the ward for recurrent hypoglycemia, the first of which was discovered following an apyretic coma. He has a history of hepatic and gluteal metastases from an undifferentiated carcinoma, the primary of which is unknown, followed in the oncology department and treated by chemotherapy. The biological assessment shows microcytic hypochromic anemia, hypoinsulinism <0.1mIU / l associated with a collapsed C peptide <0.15ng / ml (RV: 1.1- 4.4) with a concomitant glycemia of 21 mg/l. In view of the clinical context and the paraclinical explorations, the diagnosis of paraneoplastic hypoglycemia was retained after the elimination of the factitious origin and the insulinoma. The patient was put on diet, infusion of 5% glucose serum from which he was weaned after the introduction of prednisolone corticosteroid therapy: 60 mg per day with good tolerance and disappearance of hypoglycemia. Discussion/Conclusion: Paraneoplastic hypoglycemia is hypoglycemia most commonly caused by the overproduction of insulin-like growth factor 2 (IGF-2) and its precursors which can activate the insulin receptor. In general, large mesenchymal and epithelial tumors may be the cause. The diagnosis is confirmed by the discovery of an elevated IGF-2 / IGF-1 ratio. The basic treatment is surgical excision. Glucocorticoids are among the drugs that can be used in cases where surgery is not possible as a first line followed by other alternatives in case of failure.

International result-oriented performance in sports requires systematic scientific training. A proper pedagogical approach is required for systematic loading of the athletes in order to record-breaking performance. The performance of an athlete largely depends upon a progressive training load for a relatively long period of time. The degree of mechanical tension, subcellular damage, and metabolic stress can all play a role in exercise-induced muscle adaptations. The process of adaptation largely depended upon the ratio of load and recovery stimulus. Thus the load dynamics and proper adaptation is reflected in the achievement of an athlete. The present research review-based article discussed systematically the procedure of training load, importance of recovery, and adaptation of load.

Scar pregnancy is a rare but serious form of ectopic pregnancy that is life-threatening and functional. Its actual incidence remains undetermined, but the increase in published cases over the past ten years testifies to the increased vigilance of obstetrician-gynecologists on ultrasound diagnosis, which remains the first-line examination. To date, there is no consensus on a reference treatment. We report our experience of a case of pregnancy on caesarean section scar in a 36-year-old patient treated in our department. The diagnosis was suspected in the presence of metrorrhagia associated with pelvic pain in the first trimester of pregnancy. Ultrasound confirmed the diagnosis and treatment consisted of surgical cure by laparotomy. The objective was to discuss the epidemiological, physiopathological, diagnostic aspects, the therapeutic and evolutionary modalities of this rare pathology.

This update reviewed the effects of VR complementary therapy in breast cancer patients regarding physical symptoms such as the common triad of pain, lymphedema and upper limb impairment following treatment. The results revealed weak but consistently positive, significant effect in physical symptoms. Findings, however, were limited by poor methodological quality, small sample sizes and low statistical power in studies. Future recommendations include better designed studies with large sample sizes and acceptable power to investigate the effects of VR interventions in women with breast cancer, during and after cancer treatment.

Streptococcus constellatus is a microorganism that lives commensally in the oropharyngeal region, urogenital region, and intestinal tract. However, it can cause infection in patients with certain predisposing factors. We present a rare case of a right-sided frontal abscess caused by Streptococcus constellatus in a 47-year-old male with well-controlled type 2 diabetes mellitus patient who was injured by shrapnel pieces in the head and who was malnourished. The patient was successfully treated by surgical evacuation and antibiotherapy. Very few cases of brain abscesses caused by S. Constellatus have been reported in the literature. Only four cases in an immunocompetent patient have been reported to date.

Squamous Cell Carcinoma (SCC) is an epithelial neoplasm arising from the malignant proliferation of keratinocytes and it is the second most common type of skin cancer behind basal cell carcinoma (BCC). SCC presents with a wide variety of clinical manifestations including erythematous patches and nodules although its most usual presentation includes indurated well demarcated ulcerative lesions. We present historical case of SCC of the scalp who made the extension and invasion the brain after eroding the vault.

DNA strands and their bases are in the cells in every creature. They essential for growth, metabolism regulation and carrying genetic information bases to new generations. The bases of DNA are working with 0 and 1 system. In this theoretical research, first, by using Gaussian program, NMR susceptibility of DNA bases and their C2Fe+ attached varieties are determined. In the next step, with effect of magnetic field (H) and NMR susceptibility of these compounds, their resulted Magnetization (M) is calculated. These resulted magnetizations not only can be considered as a method to make a new (0) and (1) system for DNA bases but also can be used as creating certain signals to mark of DNA bases and their compounds which are attached to C2Fe+.

The purpose of this study is to analyze the weakness of the role of the Notary Official of Land Deed Maker in determining the Sales Value of Tax Objects to increase current regional original income and reconstructing the role of the Notary/PPAT in determining the Sales Value of Tax Objects to increase regional original income based on the value of justice. The approach method used in this research is socio-legal, namely by conducting joint research between law and non-doctrinal institutions that are empirical/social in examining the legal rules that apply in society. This research is descriptive-analytical. The results of this study shows that the Weaknesses in the regulation of the determination of the sale value of tax objects to increase the current local revenue. Based on article 6 paragraph (3) of the Law on Customs for the Acquisition of Land and Building Rights, therefore, the Reconstruction of the regulation on the determination of the Sales Value of Tax Objects to increase regional original income based on the value of justice, namely that the Regional Head in determining the amount of the sale value of the tax object is obliged to establish it as instructed by Law The Law on Regional Taxes and Levies and Regional Regulations truly reflects the actual value, which is the selling value of tax objects based on the value of justice and by changing several related articles including Article 24 paragraph (1) of the Law of the Republic of Indonesia Number 20 of 2000 concerning Amendments to Law Number 21 of 1997 concerning Customs on Acquisition of Land and Building Rights and Article 79 paragraph (3) of Law Number 28 of 2009 concerning Regional Taxes and Regional Levies.

Leprosy is an infectious disease that is brought on by the rod-shaped, acid-fast bacteria Mycobacterium leprae. The illness mostly affects the skin, eyes, peripheral nerves, and mucosa of the upper respiratory tract. Leprosy is curable, and prompt medical attention can help avoid disability. Multidrug therapy can be used to treat leprosy (MDT). Droplets from the lips and nose are prone to spread leprosy during frequent and intimate contact with untreated people. For the disease to be completely eradicated as a public health problem, early detection and treatment with multidrug therapy (MDT) are necessary. If leprosy is not treated, it can result in long-term harm to the skin, nerves, limbs, and eyes. There were 208 619 new leprosy cases worldwide in 2018, according to official data from 159 countries in six different WHO regions. Based on statistics, the prevalence rate is 0.2/10 000.

Hodgkin Lymphoma is rarely diagnosed as spinal cord compression syndrome. Caused by an epidural mass, this complication is often encountered in a late stage of the disease. We report the case of a 52-year-old woman presenting with symptoms of low thoracic spinal cord compression due to an epidural tumor on the MRI. Emergent surgery was undertaken on this patient, consisting in laminectomy and tumor resection. After surgery, pain relief and mild neurological improvement were noticed. The histological study revealed a Hodgkin Lymphoma and the patient was referred to chemotherapy and radiotherapy. Though chemotherapy is the gold standard treatment for Hodgkin Lymphoma, surgical spinal decompression may be required in epidural involvement of the disease. Diagnosis may be suspected in the presence of lymphadenopathy and general health decay.

Intracranial meningiomas continue to challenge our best clinical efforts to eliminate them once discovered and deemed appropriate for treatment. Malignant meningiomas constitute 10% to 15% of all meningiomas and limited information exists regarding adjuvant treatment. The external whole brain irradiation is recommended. Traditional chemotherapy has proven ineffective; thus, new chemotherapeutic agents and new methods of delivery should be developed. Immunotherapy may be considered for patients with malignant meningiomas when all others previous treatment have failed. We report a case of anaplastic papillary meningioma. A 60-year-old woman presented with a 10-year history of gradually decreasing olfactory function. A magnetic resonance image demonstrated a large Olfactory groove meningioma. The tumor and the infiltrated dura were radically removed. Postoperatively, the patient remained neurologically intact. The treatment was complemented by external whole brain radiation.

Objective: To compare the height, weight and BMI of Chinese children aged 2-4 years between urban and rural areas, and to provide some references for the study of early childhood health. Methods: A total of 1361 rural and urban children (721 boys, 640 girls) aged 2-4 years who met the criteria of the China Family Panel Studies (CFPS) in 2018 were selected as subjects, to analyze and compare the physical development of children in rural and urban areas. Results: The height of urban children aged 2-4 years was higher than that of rural children (p < 0.05), the weight of urban and rural children aged 2-4 years had no significant difference (p > 0.05), and the BMI of rural children aged 2-4 years was higher than that of urban children. Conclusions: The physical development of children in China is different between urban and rural areas, so we should pay attention to the problem of obesity in rural children.

Background: Functional results after low anterior resection for rectal cancer are an issue of increasing attention among colorectal surgeons and others interested in this subject. The aim of the study to compare the nocturnal bowel movement and frequency of bowel movement between TCP & SA groups after low anterior resection. This study also compare the urgency of bowel movement between two groups and the incontinence of flatus & loose stool between two groups. Methods: This prospective observational study was carried out in the Department of Surgery Bangabandhu Sheikh Mujib Medical University Shahbag, Dhaka, during 1st January 2016 to 30lh June 2017. For this purpose, a total of 40 patients with low rectal cancer undergoing low anterior or ultra-low anterior resection with TCP or straight anastomosis in the above mentioned hospital were both male & female patients and age group (18-75 years) were enrolled in this study. Data was expressed as mean with standard deviation (Mean±SD). Collected Data were statically analyzed applying student‘t’ test and chi-square test using SPSS-24. P value of <0.05 was considered statically significant. Results: The mean age was 45.9±13.29 years in group-I and 47.55±10.86 years in group-II. Male female ratio was 1.2:1 in TCP group and 1.5:1 in SA group. Anal tone on 3rd month 1(5.0%) in group-I and 10(50.0%) in group-II. Anal tone was significantly (p<0.05) improve in group I at 3rd month. Finger grip on 3rd month 18(90.0%) in group-I and 19(95.0%) in group-II. Finger grip was almost alike between two group, no statistical significant (p>0.05) was found between two groups. Conclusion: Most of the patients were in 5th and above decade and male predominant. Transverse coloplasty pouch anastomosis provided not only better functional results than straight anastomosis, but also improved quality of life, thus may be the better choice.

The activities of the terror group named “Boko haram” whom earlier joined alliance with the Islamic State of west African Province (ISWAP), has endangered the lives of many Nigerians and by large, the lives of many Africans, hence the heinous crimes perpetuated by the proscribed group has negatively affected the peaceful coexistence of the people of Niger republic, Mali, Chad, Cameroun Central African republic, and of recent the people of Burkina Faso. This paper investigated the pitiful state and agony of the families that lost their members due to such terror activities in Gwoza, Borno state, which was once the headquarters of the boko haram insurgents. The researchers utilised qualitative method to arrive at their results, using face-to-face interview and focus group discussion (FGD). Participants were sampled through purposive sampling method. The results revealed that so many families has lost their bread winners which forced them to the street finding food and shelter, while others remain in the refugees camp. The paper posits that the federal government and other relevant agencies local and international should endeavour to create an avenue to find out the missing persons, and take care of the families wandering on the street.

Eclampsia is a serious obstetric complication that, especially in developing countries, is linked to high rates of maternal and perinatal morbidity and mortality. The study's goal is to assess the clinical characteristics of eclampsia, the maternal and perinatal outcomes and proffer suggestions for improvement. The cases of eclampsia managed at the University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria, for over 5 years (from 2015 to 2019) were the subjects of the study. The medical records library, special care infant unit, labour ward, theatre, postnatal wards, and emergency room records were retrieved. SPSS version 23 was used to analyze the generated data. Eclampsia occurred in 16.7 out of every 1000 deliveries. The majority (66.9%) of eclampsia cases included women; between the ages of 20 and 35, who were unbooked (98.1%), and nulliparous (61.3%). 73.8 percent of the cases involved antepartum eclampsia, and 71.9 percent of deliveries were emergency caesareans. Eclampsia contributed to 31.7% of all maternal deaths, had a case fatality rate of 18.97%, and had a mother mortality ratio of 316/100,000 births. Eclamptic deliveries had a 149/1000 perinatal death rate. Pulmonary oedema, renal failure, HELLP syndrome, cerebrovascular accident, and disseminated intravascular were determinant factors in maternal mortality. Eclampsia remains a significant factor in maternal morbidity and mortality, particularly in resource-limited countries. Risk factors such as nulliparity and unbooked status were linked to increased prevalence. It also shows the need for early referral and timely management of the disease.