Introduction: Social distancing and wearing a face mask are highly recommended to mitigate the transmission of coronavirus disease 2019 (COVID-19). However, the success of these strategies relies on individuals’ adherence and public compliance. This study was conducted to assess the level of belief in social distancing and face mask practices in communities in low- and middle-income countries (LMICs) and to identify their possible determinants. Methods: A cross-sectional study was conducted in ten LMICs countries in Asia, Africa, and South America from February to May 2021. A questionnaire was used to assess the belief, practice, and their plausible determinants. Identification of the associated determinants was performed using a logistic regression model. Results: Our data revealed that only 62.6% and 66.9% of the participants had good beliefs in social distancing and good face mask practices, respectively. Residing in the Americas, having a healthcare-related job, knowing people in immediate social environment who are or have been infected and exposure to information of COVID-19 cases on social media or TV were factors significantly associated with good belief in social distancing. Residing country, gender, monthly household income, type of job and exposure to information of COVID-19 cases were significantly associated with face mask wearing practice. Conclusion: The proportion of participants having good beliefs in social distancing and good face mask practices is relatively low (<75%). Hence, sustained health campaigns regarding social distancing benefits and face mask-wearing practices during COVID-19 are critical in LMICs.
Sjögren's syndrome is a long-standing autoimmune condition that predominantly affects the body's exocrine glands, most notably the eyes and mouth, leading to ocular and oral dryness. Neurological involvement, particularly affecting the central nervous system, is infrequently encountered, and the occurrence of stroke as an initial clinical manifestation remains exceptionally uncommon. We report a 42-year-old diabetic male who presented with an acute onset of right hemiplegia and aphasia, and was subsequently diagnosed with primary Sjögren's syndrome. Evaluation revealed multiple acute infarcts in the left middle cerebral artery territory with apical clot and ischemic heart disease. Positive antinuclear antibody by immunofluorescence, Ro-52 recombinant antibody positivity, and raised inflammatory markers suggested an autoimmune vasculitic process secondary to Sjögren's syndrome. The patient improved significantly after pulse methylprednisolone and hydroxychloroquine therapy. This case highlights the importance of considering autoimmune etiologies like Sjögren's syndrome in young stroke patients with systemic features.
BACKGROUND:Isolated greater tuberosity (GT) fractures constitute approximately 20% of proximal humeral fractures and predominantly affect younger, active individuals. While minimally displaced fractures respond well to conservative treatment, displacement exceeding 5 mm often results in subacromial impingement and rotator cuff dysfunction, necessitating surgical intervention. Despite various fixation techniques available, optimal management remains debated. This study evaluates the functional and radiographic outcomes of a low-profile anatomical locking plate specifically designed for GT fractures. METHODOLOGY:This prospective study, conducted from June 2023 to November 2024, included 30 patients with displaced isolated GT fractures treated surgically using a low-profile anatomical proximal humerus GT plate via a deltoid-splitting approach. Patients were followed clinically and radiographically at regular intervals up to 6 months. Functional outcomes were assessed using the Constant-Murley Score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) score, and Visual Analog Scale (VAS) for pain. Range of motion and complications were documented. RESULTS:The mean patient age was 42.6 ± 10.3 years with male predominance (60%). Mean fracture displacement was 6.7 ± 1.5 mm superiorly and 7.9 ± 1.8 mm posteriorly. Surgery was performed at a mean of 4.6 ± 1.2 days postinjury with an operative time of 65.2 ± 8.5 min. At final follow-up (mean 17.2 ± 4 months), the mean ASES score was 81.3 ± 9.4, constant score improved from 41.6 at 1 month to 75.8 at 6 months, DASH score decreased from 48.5 to 14.2, and VAS reduced from 5.8 to 1.8. All fractures achieved union. Complications included restricted abduction in 10% and superficial infection in 3.3%, with no implant failures. CONCLUSION:Low-profile anatomical locking plates provide excellent functional outcomes, reliable fracture healing, and minimal complications in displaced GT fractures, representing a dependable surgical option facilitating early mobilization and functional recovery.
Embryo culture is a critical determinant of success in assisted reproductive technology (ART). Conventional incubation (CI) systems have long been the standard for supporting embryo development. Still, their reliance on periodic morphological assessments disrupts stable culture conditions and limits embryo evaluation to static observations. The introduction of time-lapse incubation (TLI) has addressed these challenges by enabling uninterrupted monitoring, providing continuous morphokinetic data, and supporting algorithm-driven embryo selection. This narrative review compares CI and TLI approaches, examining their principles, strengths, limitations, and reported clinical outcomes. While TLI has demonstrated advantages in laboratory workflow efficiency and embryo assessment, evidence regarding its impact on live birth rates remains inconsistent. Moreover, challenges related to high costs, accessibility in resource-limited settings, and ethical considerations warrant careful evaluation. Future directions point toward integrating artificial intelligence, non-invasive molecular profiling, and personalized embryo culture strategies to further enhance reproductive outcomes. A balanced appraisal of current evidence is essential to guide the responsible adoption of TLI within clinical practice.
Calcium Pyrophosphate Dihydrate (CPPD) deposition disease, also known as pseudogout, is a crystal-induced arthropathy that primarily affects larger, weight-bearing joints such as the knees, hips, and shoulders. CPPD can present with a wide spectrum of clinical manifestations, ranging from asymptomatic chondrocalcinosis to acute inflammatory arthritis. CPPD in the spine is rare and can lead to calcification of the ligamentum flavum, potentially causing spinal cord compression, myelopathy, and significant neurological impairment. The absence of chondrocalcinosis on imaging does not rule out the diagnosis of spinal CPPD. On microscopy, CPPD is characterised by rhomboid-shaped, positively birefringent crystals, in contrast to the needle-shaped, negatively birefringent crystals observed in gout. The present case report of a 78-year-old female highlights a rare and isolated clinical presentation of CPPD causing lumbar spine myelopathy, which was discovered incidentally on histopathology after spinal decompression and discectomy surgery. Although imaging modalities may raise suspicion for CPPD by revealing chondrocalcinosis, they often lack the specificity to differentiate it from other degenerative or inflammatory conditions. Histopathological analysis and polarised microscopic examination remain the cornerstones in diagnosing CPPD, even in atypical clinical presentations or ambiguous imaging findings. This underscores the importance of including pseudogout in the differential diagnosis of lumbar myelopathy, particularly in elderly patients, to provide early, targeted treatment and prevent severe irreversible neurological deficits.
