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NON- DISSECTING LARGE AORTIC ARCH ANEURYSM LEADING TO CHRONIC AORTIC INSUFFICIENCY PRESENTING AS ACUTE HEART FAILURE REVEALING MARFAN SYNDROME 非剥离性大主动脉弓动脉瘤导致慢性主动脉功能不全,表现为急性心力衰竭,显示马凡氏综合征
Pub Date : 2023-08-19 DOI: 10.47191/rajar/v9i8.02
Mariam EL Harrak
Introduction: Marfan syndrome is an autosomal dominant disorder of connective tissue which has many clinical symptoms and whose prognosis depends on associated cardiovascular complications, dominated by progressive aortic root dilation, which may lead to aortic dissection, rupture or aortic regurgitation. Prevention of these life threatening complications is of major importance. Case presentation: We report here a case of a 42-year-old man, with a history of two retinal detachments in 2015 and 2018, who presented with severe aortic valve regurgitation and severe heart failure secondary to significant aortic root dilatation revealing Marfan syndrome. Unfortunately, before referring the patient to the surgeon, the patient ended up dying from an unrecovered cardiac arrest. Conclusion: It is very important to recognize Marfan syndrome on time and the preventive actions should be undertaken in order to avoid life-threatening consequences of this disorder. Echocardiography and especially the angioscanner represent the main tools used for the diagnosis of gravity and the follow-up of this condition.
马凡氏综合征是一种常染色体显性结缔组织疾病,有许多临床症状,预后取决于相关的心血管并发症,以进行性主动脉根扩张为主,可导致主动脉夹层、破裂或主动脉反流。预防这些危及生命的并发症非常重要。病例介绍:我们在此报告一例42岁男性,2015年和2018年有两例视网膜脱离病史,表现为严重的主动脉瓣反流和严重的心力衰竭,继发于主动脉根明显扩张,显示马凡氏综合征。不幸的是,在将病人转诊给外科医生之前,病人最终死于无法恢复的心脏骤停。结论:及时认识马凡氏综合征,及时采取预防措施,避免发生危及生命的后果是十分重要的。超声心动图,特别是血管扫描仪是用于诊断重力和这种情况的随访的主要工具。
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引用次数: 0
An Interesting Case of Wellens Syndrome Dissimulating an Acute Coronary Sub-Occlusion 韦伦斯综合征伪装急性冠状动脉亚闭塞的有趣病例
Pub Date : 2023-08-08 DOI: 10.47191/rajar/v9i8.01
K. Alami, N. El Karroumi, L. Oukerraj, N. Fellat, R. Fellat
Wellens syndrome is an electric pattern highly specific of critical stenosis of the proximal LAD. It’s defined by abnormalities of T waves in V2-V3 : type 1 (biphasic T waves), type 2 (negative T waves). Wellens also does not show signs of infarction by definition. Our work is about a young man of 33 yo who accused quickly resolving chest pain. His EKG showed biphasic T waves in V2 V3 V4 and V5 and negative T waves in DI aVL with 0,3mm ST suspension. His T waves kept changing: disappearing in V5 and becoming less negative in other derivations. The cardiac catheterization showed tight lesion of the ostium of proximal LAD artery with a high thrombotic load. Patient was put under glycoprotein IIb/IIIa inhibitors and taken back to the cath-lab 1 week after for PCI (percutaneous coronary intervention) which was successful. First we want to discuss electrical findings. T waves inversion extended to V4 V5, which is uncommon. We have also to put forward the abnormalities we found in high lateral territory. Other particularity of our patient is the dynamic EKG showing he was threatening. Furthermore, definitive treatment typically involves cardiac catheterization with PCI to relieve the occlusion and there’s no place for stress tests. Wellens syndrome is a real challenge, which is underdiagnosed and needs more attention from emergency physicians. The interest of thrombolysis in this pre-infarction condition still needs to be substantiated.
Wellens综合征是一种高度特异的前冠状动脉近端严重狭窄的电征。通过V2-V3的T波异常来定义:1型(双相T波),2型(负T波)。根据定义,韦伦斯也没有表现出梗塞的迹象。我们的工作是关于一个33岁的年轻人,他声称迅速解决了胸痛。他的心电图显示V2、V3、V4和V5的双相T波和DI aVL的负T波,ST悬浮0.3 mm。他的T波一直在变化:在V5中消失,在其他衍生中变得不那么负。心导管检查显示前冠状动脉近端口病变紧密,血栓负荷高。患者给予糖蛋白IIb/IIIa抑制剂治疗,1周后行PCI(经皮冠状动脉介入治疗)成功。首先,我们想讨论一下电的发现。T波反演扩展到V4 V5,实属罕见。我们还必须提出我们在高外侧区域发现的异常。我们病人的另一个特点是动态心电图显示他有威胁。此外,最终的治疗通常包括PCI心导管插入术来缓解闭塞,没有地方进行压力测试。韦伦斯综合征是一个真正的挑战,它的诊断不足,需要急诊医生更多的关注。在这种梗死前的情况下进行溶栓治疗的兴趣仍然需要证实。
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引用次数: 0
Challenges for the Development and Use of Marine Natural Products 开发和利用海洋天然产品的挑战
Pub Date : 2023-07-29 DOI: 10.47191/rajar/v9i7.11
Matilde Machado, Pedro Sousa, T. Gudz, G. Teixeira
Marine environments are known to be difficult and complex. To survive in hostile environments, living organisms have developed functional and metabolic adaptive mechanisms, which we are still far from knowing and taking full advantage of. Many compounds of marine origin are structurally complex and have unique functionalities, whose potential goes beyond pharmaceuticals, reaching cosmeceuticals, nutraceuticals, biomaterials and energy. Based on knowledge and technical development, cooperation between academia and industry allows for the sustainable use of marine resources. The present survey does not aim to be exhaustive, we intend to have an idea of the present situation and of future prospects.
众所周知,海洋环境是困难和复杂的。为了在恶劣的环境中生存,生物已经发展出功能和代谢的适应机制,我们还远远没有了解和充分利用这些机制。许多海洋来源的化合物结构复杂,具有独特的功能,其潜力超越了药物,达到药妆,营养保健,生物材料和能源。在知识和技术发展的基础上,学术界和工业界之间的合作使可持续利用海洋资源成为可能。这次调查的目的并不在于详尽无遗,我们只是想了解一下目前的情况和未来的前景。
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引用次数: 0
ACUTE CORONARY SYNDROME REVEALING AN ECTATIC CORONARY NETWORK: THE CHALLENGES OF MANAGEMENT (CASE REPORT) 急性冠状动脉综合征显示冠状动脉网络扩张:管理的挑战(病例报告)
Pub Date : 2023-07-27 DOI: 10.47191/rajar/v9i7.10
Asmae Benatmane
Coronary ectasia is relatively a rare pathological entity, whose pathophysiological mechanisms and management principles are still poorly understood. Atherosclerosis is the predominant etiology with other causes that can be incriminated at lower percentages. These abnormalities expose to a major risk of intracoronary thrombosis by blood stasis, especially since they are most often associated with stenotic lesions conditioning the prognosis of patients. We report the case of a patient admitted to the emergency room for the management of an acute coronary syndrome without ST segment elevation with on coronary angiography an aspect of diffuse coronary ectasia affecting the 3 main coronary arteries, and we discuss a review of the literature concerning this type of condition and specifics of management.
冠状动脉扩张是一种相对罕见的病理实体,其病理生理机制和治疗原则尚不清楚。动脉粥样硬化是主要的病因,其他原因也有可能在较低的百分比。这些异常暴露于由血瘀引起的冠状动脉内血栓形成的主要风险,特别是因为它们最常与影响患者预后的狭窄病变相关。我们报告一例因急性冠状动脉综合征入院急诊的患者,无ST段抬高,冠状动脉造影显示弥漫性冠状动脉扩张影响3条主要冠状动脉,我们讨论了有关这类疾病的文献综述和具体的处理方法。
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引用次数: 0
COMMUNICATION SKILLS EDUCATION THROUGH GAMES FOR ELEMENTARY SCHOOL STUDENTS 通过游戏对小学生进行沟通能力教育
Pub Date : 2023-07-22 DOI: 10.47191/rajar/v9i7.09
Trần Thị Thúy Lan, Dam Thi Hoa
In Vietnam, implementing the new general education curriculum focuses on nurturing students' competencies and character development. A significant emphasis does place on fostering communication and collaboration skills among students. Consequently, the role of communication skills education within schools is paramount. This article presents various strategies for imparting communication skills through engaging games designed for elementary school students.
在越南,实施新的通识教育课程的重点是培养学生的能力和性格发展。一个重要的重点是培养学生之间的沟通和协作技能。因此,沟通技巧教育在学校中的作用是至关重要的。本文介绍了通过为小学生设计的引人入胜的游戏来传授沟通技巧的各种策略。
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引用次数: 0
ANALYSIS OF PREY PREDATOR INTERACTION WITH HARVESTING SYSTEM ON MATHEMATICAL MODELLING 捕食者与收获系统相互作用的数学建模分析
Pub Date : 2023-07-21 DOI: 10.47191/rajar/v9i7.08
Tulu Leta Tirfe
In the Modern World, everything will be systematically developed by using best modelling. In our article we will prepare and analyzed in the area of Dynamics of System of Two Prey and One Predator by using Holling Type – II Functional Response, and we designed the model such as First Prey and the Second prey a ratio – dependent response, where harvesting of each prey species is taken into consideration. And also, the model is used to study the Ecological Dynamics of the Fox – Antelope – Rabit (FAR) in a given habitat. We also focus the effect of harvesting on prey species. We discussed Local and Global Stability Analysis of the system were carried out, and also we analyze numerical simulation for particular variables and then, we conclude and show that the Result of Analysis of our model that the Three Species would co – exist if the Antelope and Rabbit were not harvesting beyond their Intrinsic Growth Rate (IGR).
在现代世界,一切都将通过使用最好的模型来系统地开发。在本文中,我们将利用Holling Type - II型功能响应在两食一食系统动力学领域进行准备和分析,并设计了第一食和第二食比例依赖响应模型,其中考虑了每种食饵的收获情况。并利用该模型研究了狐羚羊兔(Fox - Antelope - rabbit, FAR)在特定栖息地的生态动态。我们还关注了收获对猎物物种的影响。对系统的局部稳定性和全局稳定性进行了分析,并对特定变量进行了数值模拟分析,结果表明,如果羚羊和兔子的收获量不超过其内在生长速率(IGR),则三种物种将共存。
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引用次数: 0
SOCIAL STOCK EXCHANGE IN INDIA – TIME TO TAKE CAPITAL MARKET TO SOCIAL WELFARE OBJECTIVES 印度的社会证券交易所,是时候把资本市场的目标转向社会福利了
Pub Date : 2023-07-17 DOI: 10.47191/rajar/v9i7.07
DR. J. Gayathiri
With major transformations happening in the National Stock Market it comes up with the new launch idea of Social Stock Exchange after decades in the upcoming months. This paper focuses on the framework and the various regulations fixed for listing in the social stock exchange. The concept was down for discussion from the year 2019 but the final nod for the launch of social stock exchange was announced in the month of February 2023 by SEBI. With its discussion and approval process going on various charitable organizations started their talks on the listing process in the social stock exchange. After decades a great transformation and introduction of new sector into the stock market making the investors meet the growth of the social enterprise. Will this be leverage in building a newer network or an added challenge with more intermediaries involving.
随着国家股票市场的重大变革,在接下来的几个月里,它提出了几十年后社会股票交易所的新推出理念。本文重点研究了社会证券交易所上市的框架和各项规定。这个概念从2019年就开始讨论,但印度证券交易委员会在2023年2月宣布了启动社会证券交易所的最终同意。随着讨论和审批程序的进行,各种慈善组织开始讨论在社会证券交易所上市的问题。经过几十年的大转型和新板块的引入,使投资者满足了社会企业的成长。这是建立一个新的网络的杠杆,还是一个涉及更多中介机构的额外挑战?
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引用次数: 0
EXISTENCE OF SEISMIC WAVE DUE TO TALL BUILDING 高层建筑引起的地震波的存在
Pub Date : 2023-07-14 DOI: 10.47191/rajar/v9i7.06
Abebe Mekuria Mamuye
In this article, we proposed and analyzed a mathematical model for the so – called city – effect in what in which an earthquake can be locally disturbed by the collective response of tall buildings in the large city. We use a set of equations c0upling vibrations buildings in buildings to motion under the ground. These equations were previously studied by different authors the existence of the seismic wave was ensured by a method of Numerical solutions. None those authors do not consider differential methods to show the existence of earthquake due to tall buildings. Furthermore, we show how we can solve for the wavenumber in a non – linear equation and we are able to find resonant frequencies coupling seismic waves and vibrating tall building which ensure the existence seismic wave due to building.
在本文中,我们提出并分析了一个所谓城市效应的数学模型,在这种模型中,大城市高层建筑的集体反应可以局部干扰地震。我们用一组方程将建筑物内部的振动与地下的运动耦合起来。这些方程以前被不同的作者研究过,地震波的存在是用数值解的方法来保证的。所有这些作者都没有考虑用微分方法来表明高层建筑引起的地震的存在。此外,我们还展示了如何求解非线性方程中的波数,从而能够求出地震波与振动的高层建筑耦合的共振频率,从而保证了由于建筑物引起的地震波的存在。
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引用次数: 0
ACADEMIC ACHIEVEMENT AND ACADEMIC FRAUDULENT BEHAVIOR: EFFECTS OF CAMPUS CULTURE, INFORMATION TECHNOLOGY IMPLEMENTATION, AND ACADEMIC ACHIEVEMENT 学业成绩与学业欺诈行为:校园文化、信息技术实施与学业成绩的影响
Pub Date : 2023-07-13 DOI: 10.47191/rajar/v9i7.05
S. Slamet
Academic fraud is an act committed by students to get maximum results by committing bad and prohibited acts such as cheating, discussing with friends during exams or other ways. The problems formulated in this study are: 1) does campus culture influence fraudulent academic behavior?; Does the use of information technology influence academic fraud behavior?; and 3) does academic achievement influence academic fraud behavior? This type of quantitative research is an ex post facto model with 118 students at Ivet University Semarang as subjects. Data collection techniques used documentation and questionnaires with instruments that met the requirements of validity and reliability. The data analysis technique was used with the help of SPSS data processing, with the results that: 1) based on descriptive statistical analysis, the academic fraud variable was high, while campus culture was relatively high, while the use of information technology was included in the high criteria and the academic achievement score was relatively high; 2) based on hypothesis testing only campus culture variables have a positive and significant effect on academic cheating, while the variables of information technology use and academic achievement are found to have no significant effect on academic cheating.
学术欺诈是指学生为了获得最大的成绩而做出的不良行为和被禁止的行为,如作弊、考试时与朋友讨论或其他方式。本研究提出的问题是:1)校园文化是否影响学术欺诈行为?信息技术的使用是否影响学术造假行为?3)学业成绩是否影响学术欺诈行为?这种定量研究是一种事后模式,以三宝垄伊维特大学118名学生为研究对象。数据收集技术使用文件和问卷调查的工具,满足效度和可靠性的要求。运用数据分析技术,借助SPSS软件对数据进行处理,结果表明:1)基于描述性统计分析,学术造假变量较高,校园文化变量较高,而信息技术的使用被纳入高标准,学业成绩得分较高;2)通过假设检验发现,只有校园文化变量对学业作弊有正向显著影响,而信息技术使用和学业成绩变量对学业作弊没有显著影响。
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引用次数: 0
LITERATURE REVIEW: FACTORS AFFECTING CHILDREN'S ANXIETY WHEN VISITING THE DENTIST CLINIC IN THE COVID-19 PANDEMIC ERA 文献综述:新冠肺炎大流行时期影响儿童牙科就诊焦虑的因素
Pub Date : 2023-07-08 DOI: 10.47191/rajar/v9i7.04
Eko Prastyo
The influence of the spread of COVID-19 in the world has caused changes in regulations in society, including in dentistry, which have a negative impact on the psychology of pediatric patients. This change can cause an increase in children's anxiety without exception when visiting a dentist's clinic. This study aims to examine what factors can affect children's anxiety when visiting a dentist clinic in COVID-19 pandemic era. Type of research used is Narrative Review by searching for data through Google Scholar database, PubMed, Wiley and ScienceDirect using the keywords of dental anxiety AND child/Pediatric AND COVID-19 and obtained 6 scientific articles relevant to the research objectives. There is an increase in anxiety in children when visiting a dentist clinic in COVID-19 pandemic era which is influenced by lockdown regulations, the presence of parents at home and the age of the child himself.
新型冠状病毒感染症(COVID-19)在世界范围内扩散的影响,引起了包括牙科在内的社会规制的变化,这对儿科患者的心理产生了负面影响。这种变化会导致儿童在看牙医时毫无例外地增加焦虑。本研究旨在研究在新冠肺炎大流行时期,哪些因素会影响儿童在看牙医时的焦虑。使用的研究类型为Narrative Review,通过Google Scholar数据库、PubMed、Wiley和ScienceDirect检索数据,以dental anxiety and child/Pediatric and COVID-19为关键词,获得与研究目标相关的6篇科学文章。在新冠肺炎大流行时代,受封锁规定、父母在家、儿童年龄等因素的影响,儿童在牙科诊所就诊时的焦虑情绪有所增加。
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引用次数: 0
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RA JOURNAL OF APPLIED RESEARCH
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