Hereditary Hemochromatosis: an Inherited Abnormality of Iron Regulation

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Hereditary Hemochromatosis (HH) is an autosomal recessive genetic disease characterized by abnormalities in iron regulation, mostly due to mutations in the HFE gene, leading to increased iron absorption due to hepcidin deficiency. The classification of HH is based on the type of mutated gene, which must be distinguished from non-genetic conditions that cause secondary elevations in serum iron levels such as multiple transfusions and increased iron supplementation. Pathophysiological mechanisms of HH include increased absorption of iron in the upper intestine, decreased expression of the iron regulatory hormone hepcidin, altered function of the HFE protein, and tissue damage and fibrogenesis caused by iron overload. The human body is physiologically unable to excrete excess iron load so excess iron in serum will be deposited in various organs, causing organ dysfunction. The clinical manifestations of hemochromatosis vary widely depending on the location of iron deposition in the organ. The classic clinical triad of hemochromatosis is liver cirrhosis, skin pigmentation, and diabetes mellitus. Hemochromatosis can be screened for and diagnosed by examining serum ferritin levels, transferrin saturation, unsaturated iron-binding capacity, total iron-binding capacity, liver biopsy, magnetic resonance imaging, and genetic testing. The main treatment for hemochromatosis at this time is phlebotomy although other therapeutic methods can also be used to help lower iron levels and improve the patient’s clinical course, such as therapy with chelating agents, erythrocytopharesis, and liver transplantation. If hemochromatosis is not treated, the patient can experience progressive liver damage leading to cirrhosis and hepatocellular carcinoma, and complications due to damage to various tissues and organs.

Immediate Results of Surgical Treatment for “Difficult” Duodenal Ulcers

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For the period from 2001 to 2020, 1567 patients were operated on for duodenal ulcers (DU) on the basis of the Department of Surgical Diseases and Urology of the Andijan State Medical Institute. At the same time, “difficult” DU was diagnosed in 494 (31.5%) patients. Of these, 364 (73.7%) patients were operated on in a planned manner and 130 (26.3%) – in an emergency. The subject of our study were only 262 patients with “difficult” DU who were admitted to the clinic in a planned manner. At the same time, the control group consisted of 114 (43.5%) patients and the main group – 148 (56.5%) patients.

Thus, the analysis of the causes of undesirable consequences and the revision of surgical tactics, taking into account the omissions made in patients of the control group and the widespread use of improved methods and techniques of operations, made it possible to reduce the frequency of postoperative complications associated with surgical intervention on the stomach – by 12.6% (from 19 .3 to 6.7%), as well as mortality by 5.4% (from 6.1 to 0.7%). All this allowed us to achieve the desired goal.

Prevention of Iron Deficiency Anaemia in Pre-School Children

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The article is devoted to the role of iron, vitamins and minerals in the development of iron deficiency anaemia in children of early and pre-school age. Iron deficiency (ID) is one of the most common nutritional-dependent states in the world, which, according to WHO [1], affects more than 1.5 billion people. Iron deficiency is in the form of iron deficiency anaemia (IDA) [1, 2] in about half of the cases (over 700 million of the world’s population). ID is mostly due to nutritional reasons, but age and socio-economic factors are also important.

Situation of Professional Development via Self-Directed Learning of Social Work Students in Hanoi National University of Education

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This article focuses on the current situation of professional development (PD) capacity through self-directed learning (including knowledge, awareness, intervention skills, professional attitudes) of social work students in Hanoi National University of Education (HNUE). To achieve this goal, we conducted a random survey of 135 students by observation methods, and questionnaires. Self-directed learning (SDL) is one effective tool to enhance professional learning (which is a key component of professional development, in addition to professional identity and professional practice) because it oriented a process for students to achieve the desired results. Research results show that students’ awareness, attitudes, and skills of professional development via self-directed learning are weak. Students are not aware of and understand how to develop their profession. The activities they did are just according to their intuition and do not have the necessary skills for PD. This leads to the recommendation for an educational group social work. This suggested group work aims to enhance awareness, attitudes, and skills of professional development through SDL of Social Work students in HNUE by providing knowledge, skills, and the way how to apply them to actual activities, promoting the capacity of the individual.

Radiofrequency Ablation for Lower Limb Pain

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Radiofrequency Ablation (RFA) can be used to remove or change unwanted elements. Radiofrequency (RF) has been treating various pain-producing components for over 50 years. However, not all pain syndromes have been treated with it because of understanding or technical limitations. This review paper will focus on how RFA is used to treat lower limb pain for new indications.

Lower Extremity PainPost- surgery pain: herniorrhaphy, cesarean section, appendectomy, Pudendal neuralgia, Recalcitrant neuropathic pelvic pain, Meralgia paresthetica.

Knee Pain Syndromes: Subchondral insufficiency fractures of the knee, Knee osteoarthritis

Ankle Pain Syndromes: Achilles tendinosis, Insertional Achilles tendinosis.

The Role Impact of Corporate Social Responsibility (CSR) In Building Small and Medium Enterprises (SMEs) Brand Image in Ghana

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This study investigates the need for SMEs to practice corporate social responsibility (CSR) in building their brand image in Ghana. The study aims at exploring the role impact of Corporate Social Responsibility (CSR) in building small and medium enterprises (SMEs) brand image in Ghana. Evaluating the role of CSR in building the brand image of SMEs adopted research designs/methods and approached to solicit both secondary and primary data. To identify the perceptions held by SMEs, motives for CSR practices, benefits associated with CSR practices, and the impact of Corporate Social Responsibility on SMEs’ Brand Image, questionnaires and interviews were conducted with SMEs operators and Environmental Protection Agency officials in the Kumasi metropolis. The findings show that SMEs perceived CSR as a means of paying back to society what has been received as profit and also as a means of protecting and improving the quality of the natural environment as well as spending revenue to the state. It was noted that organizations practice Corporate Social Responsibility (CSR) to project the right corporate image, used as a marketing strategy, and to make employees happy and satisfied Benefits from CSR regarding customer loyalty, gaining goodwill from the community, enhanced government relations, and building client relations was also ascertained. Despite the numerous benefits associated with CSR activities, other challenges were also identified as free giveaway products and the high cost of CSR programs. Some suggestions such as the honest provision of accurate information about the SMEs products, organizing programs to suit students, a regular donation to the societies, and total collaboration between SMEs and their communities were made to promote firms’ image through CSR practices.

Proposed Marketing Strategy to Fight Market Uncertainty for Indonesia Paper Company

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The paper industry has faced pressures from the digitalization process and climate change over the past five years. Currently, the war in Europe is adding to the pressure. Companies from the paper industry, such as Indonesia Paper Company, must review their business strategies in facing this global market uncertainty. Using the Scenario Planning approach, this study finds two possible scenarios that companies can prepare for: the economy deteriorates into a world economic crisis, or the economy improves. Both scenarios show significant changes in market segmentation that can impact business and marketing strategies. The company has a Competitive Advantage in the source of raw materials. Therefore, the company can apply the Cost Strategy in facing a crisis. The advantage can also help companies carry out a Focused Differentiation Strategy when the economy improves. When uncertainty is still high, like today, companies can make internal improvements to adapt to rapid technological changes and optimize performance.

MRI-Guided Focused Ultrasound, an Emerging Minimally Invasive Technique in Neurology

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MRI-guided Low Intensity Focused Ultrasound has a wide range of applications in neurological disorders and is superior to other minimally invasive neuromodulation techniques in terms of a better spatial resolution and stimulating deeper brain structures. Parkinson’s disease, Alzheimer’s disease, essential tremor, brain malignancy, epilepsy, nerve block, medication delivery, and stroke are among the neurological disorders which benefit from MRI-guided Low-Intensity Focused Ultrasound. In addition, the safety profile of this minimally invasive neurostimulation technique is also well studied and approved. Therefore, the clinical application of Focused Ultrasound in neurologic disorders should be the focus of future clinical trials.

Integrated Management System Based on Risk Process Implementation in Start-Up Company (Superspring) To Maximize the Cost Efficiency

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Risk and opportunity always come like two sides of a coin. The greater the risk, the higher the possibility of return obtained, or even the possibility of failure if it is not anticipated from the start. So the risk must be managed so as to minimize the impact that will be experienced. This research aims to explore the implementation of risk management in start-up company cost efficiency. Start from the business processes identification, risk and opportunity identification, risk analysis, and risk treatment. The risk and opportunity for improvement will be converted into financial conversion or calculated by the financial impact (on value). And finally, the cost comparison of existing costs with the implementation of risk control and implementation of improvement opportunities will be carried out. Using the process approach ISO 9001, risk approach ISO 31000, and FMEA, the company is ideal to implement risk management to make it cost-efficient. Based on the calculation done from the core process (the sales process, the IT process, the technical process, the warehouse and logistic process, and the customer service process) analysis, is shown that all over the risk decrease is about 65.54% (from inherent risk to residual risk) and the cost efficiency is about 315%.

SGLT2 Inhibitors and the Associated Risk of Genito Mycotic Infections – A Narrative Review

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The increased prevalence of Diabetes mellitus, the comorbid associations and complications among the global population has led to a dependency for treatment options with multiple modalities. One such option is the SGLT2 inhibitor (SGLT2i) class of drugs. SGLT2i have been demonstrated to improve glycemic control while providing cardiovascular (CV) and renal benefits in patients with T2DM. SGLT2 inhibitors comprising of canagliflozin, dapagliflozin, empagliflozin, ertugliflozin and remogliflozin are indicated in T2DM individuals with CV complications or chronic kidney disease (CKD). Although generally well tolerated, they pose some important safety concerns. The most common side effect of SGLT2i administration being Genital Mycotic Infections (GMI) and Symptomatic Volume Depletion. Meta-analysis and large clinical trials have reported an incidence of 2.5% to 6.5% of GMI, and a 4-6-fold increased risk of GMI among patients on SGLT2i.

This narrative review evaluates the recent literature on SGLT2i and the incidence and severity of GMI. The review aims to help guide health care professionals involved in clinical care for patients on SGLT2 inhibitors.

The existing literature evidence suggests that the GMI associated with SGLT2i therapy are generally mild and respond well to the conventional treatment. Major risk factors of infection are female, poor hygiene, prior infection, and uncircumscribed men. Perineal hygiene and treatment with standard antifungal agents could effectively decrease the incidence of such infections and may not warrant strict discontinuation of SGLT2i therapy. Active patient participation and awareness during treatment initiation is helpful in early recognition of symptoms and timely interventions.