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  • Alston Mohamad posted an update 2 days, 9 hours ago

    Neurogenic tumors of the tracheobronchial tree are extremely rare, and these include neurofibroma and schwannoma. The rare schwannoma most frequently is reported in adults. We will report an endobronchial schwannoma in an 11-year-old boy. © 2020 The Authors. Published by Elsevier Ltd.Background Oral Sub Mucous Fibrosis (OSMF) is a clinical entity, well known since the time of Sushruta as ‘Vidari’. OSMF is a chronic subtle disease that is associated with significant functional morbidity and an increased risk for malignancy. Generally, OSMF is considered as an adult disease, but recently Indian suburb area has reported incidence of 0.2-1.2 percent in pediatric age group as well. The pathogenesis of the disease is not well established, but is believed to be multifactorial. Areca nut chewing is considered as the major etiology amongst all. Children indulge in habit of chewing areca nuts due to its easy availability of different forms of multicolored attractive areca nut pouches in markets. Other factors involved in the consumption of Areca nut are levels of awareness, household environment, peer pressure, low cost, etc. Case presentation A 5-year-old boy reported with the complaint of restricted mouth opening since 3-4 months. He had habit of chewing betel nut, a minimum of 2-3 sachets daily since one and a half years. He also complained of intolerance to spicy food. The oral mucosa was pale, opaque, blanched with a reduced mouth opening of interincisal width being 06 mm.Palate was fibrotic with shrunken uvula. Conclusion This Case of OSMF in a 5-year-old boy is reported to be the first incidence of OSMF in a child with least interincisal opening of 06 mm. © 2020 Craniofacial Research Foundation. Published by Elsevier B.V. All rights reserved.The United States government has identified the health care sector as part of the critical infrastructure for homeland security to protect citizens against health risks arising from terrorism, natural disasters, and epidemics. Citizens also have expectations about the role that health care plays in enjoying a good quality of life, by providing response systems to handle emergencies and other illness situations adequately. Among the systems required to support desired performance levels is a robust and resilient pharmaceutical supply chain that is free of disruption. Shortages of drugs place undue pressure on healthcare providers to devise alternative approaches to administer patient care. With climate change expected to result in increasingly severe weather patterns in the future, it is critical that logistics engineers understand the impact that a catastrophic weather event could have on supply chain disruption to facilitate the design of supply systems that are robust and resilient. Immunology inhibitor This study investigates the main causal and intermediate events that led to risk propagation in, and disruption of, the U.S. pharmaceutical supply chain following Hurricane Maria. A causality Bayesian model is developed to depict linkages between risk events and quantify the associated cumulative risk. The quantification is further examined through different advanced techniques such as predictive inference reasoning and sensitivity analysis. The general interpretation of these analyses suggests that port resilience is imperative to pharmaceutical supply chain performance in the case of Puerto Rico. © 2020 Published by Elsevier Ltd.Market reforms have been given much of the credit for China’s spectacular growth performance. This paper looks at China’s reform process systematically with India’s and argues that the Chinese state has played a key role in transforming China into a modern economic state, deploying unlimited supplies of labor and combining it with a variety of initiatives in a pragmatic, nonideological way to promote public and private investment and create productive employment in agricultural, manufacturing, and service sectors. India’s reforms have been sporadic and are still a work in progress. The record-breaking expansion of China’s financial system in fostering investments was overlooked, but has attracted considerable attention in recent years. Is China unique, or are lessons from the Chinese experience for public policy and its sequencing transferrable for agricultural and structural transformation in countries lagging behind, including India? © 2020 Published by Elsevier B.V.Smart technologies present numerous opportunities for enhancing mobile health care. However, some concerns regarding the viability of smart technology applications must be addressed. This study investigated these concerns by reviewing the current practices of smart technology applications to mobile health care. As a result, five factors critical to the applicability of a smart technology to mobile health care are identified, and the fuzzy geometric mean-fuzzy analytic hierarchy process (FGM-FAHP) approach is proposed to assess the relative importance levels of the identified factors. The experimental results showed that the three most critical factors identified include (a) the relaxation of the related medical laws; (b) unobtrusiveness; and (c) the precise need and situation of a user. Accordingly, approximately 44%, 26%, and 15% of the budget should be allocated to the realization of the three critical factors, respectively. In addition, the challenges involved and opportunities for enhancing the effectiveness of existing applications are discussed. © 2020 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.Immunosuppression after solid-organ transplantation can lead to opportunistic infections as cryptococcosis. A 69-year-old female, cadaveric renal-transplant recipient, manifested with ulcerative lesions on the 7th month of immunosuppression. Histological examination confirmed the diagnosis of cryptococcosis. Treatment with systemic and topical antifungal therapy for 7 months concluded in significant cutaneous improvement. This case presentation encourages high clinical suspicion of opportunistic pathogens such as Cryptococcus spp. and highlights the necessity of appropriate management. © 2020 The Authors.

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