St. Martinus University

Visual impairment among school-aged children in low-resource settings can significantly impact their quality of life and education due to limited access to comprehensive eye care. This study reports outcomes of a school-based vision screening program using the Peek Capture smartphone app for vision screening and patient referral in two districts of Punjab, Pakistan. This was a retrospective, observational study. We analyzed primary programmatic data collected from children undergoing vision screening by School Health and Nutrition Supervisors in the districts of Chakwal and Layyah in Punjab, from January 2022 to September 2024. The Peek Capture platform enabled real-time tracking of program data, including referrals and follow-ups. Primary outcome measures included referral rates and follow-up adherence rates, which were analyzed by age group and gender. Statistical comparisons were made using the z-test for proportions and the Chi-squared test of independence. Among 151,456 children screened (54% female), 5.7% (n = 8,682) were referred to Rural Health Centers (RHCs), with higher referral rates in females (6.3% vs. 5.0%, p < 0.001) and older children aged 12–18 (7.9% vs. 4.2%, p < 0.001). Follow-up was completed by 47.1% (n = 4,091), with no significant gender difference but lower rates in older children (45.6% vs. 49.2%, p = 0.001). Among those who followed up, 73.3% (n = 2,999) were confirmed to have an eye condition. Glasses were prescribed in 71.5% of diagnosed cases. Hospital referrals were rare (1.8%) and did not vary by gender. This study demonstrates the feasibility of high-volume, school-based vision screening using a smartphone-based platform in low-resource settings, with strong diagnostic yield among those who followed up. However, the 47.1% follow-up rate highlights a critical implementation challenge. Modest age- and gender-related differences point to areas for targeted programmatic strengthening. Further research is needed to assess the cost-effectiveness and long-term impact of such programs.

Nowadays humans are increasingly worried about the increasingly serious condition of the earth due to pollution on land, sea and air as well as massive damage to forests, valleys, mountains, rice fields and springs. It is sure that natural conditions have a very dangerous impact on human lives. That is why the ecological crisis and the social crisis are two things that cannot be separated. In the face of the ecological crisis, the Church must provide a prophetic response. Ecopastoralism is one of the Church's responses to ecological problems. This research aims to explain ecopastoralism as a response to environmental problems in the Parish of St. Maximilianus Kolbe, Wukir. The method used in this research is a qualitative method and a case study approach to pastoral programs in the environmental sector and the concrete work of Wukir Parish people in the environmental sector. Data was collected through observation, interviews, and document analysis of various reports. The results of this research show that ecopastoralism in Wukir Parish is carried out with a basic pattern that refers to the duties of the Church, namely liturgy, kerygma, koinonia, and diakonia. The tasks of the Church are always connected with ecology in order to raise awareness among the people about the important role of the natural environment and other creations for human life in the world. Ecopastoralism in the Wukir parish contributes to strengthening the environmental Christian community. This community strives to live out an ecological perspective, develop ecological spirituality as an inner spirit to care for and preserve other creations, and culminates in ecopraxis, namely concrete actions in the environmental sector.

Introduction and importance: Candy Cane syndrome (CCS) is a rare condition in which the proximal gastrojejunal attachment’s afferent blind limb is elongated. This can lead to different symptoms, including nausea and vomiting, with less commonly described reflux and regurgitation symptoms. Case presentation: A 38-year-old female presented with a chronic complaint of postprandial pain, discomfort, and reflux lasting for about 2 years after a previous Roux-en-y gastric bypass (RYGB) surgery. Upper endoscopy was done and raised suspicion for CCS. The patient underwent an exploratory laparoscopy, which confirmed the diagnosis. Surgical resection of the afferent limb was done, and all symptoms were completely resolved at the postoperative follow-up. Clinical discussion: CCS is considered a rarely described complication that can occur after RYGB gastric bypass surgery. Diagnosing this condition includes performing upper gastrointestinal (GI) studies and endoscopy, which reveal a redundant afferent limb. Laparoscopy serves as a dual-purpose tool, confirming the diagnosis of CCS and providing a definitive curative intervention. Surgical resection has a high success rate, with evidence supporting its efficacy in relieving symptoms. Conclusion: As the popularity of Bariatric surgeries rises, it is crucial to consistently consider CCS, despite its rarity, as a potential complication. Although diagnosing CCS can be challenging, physicians should maintain a high index of suspicion, especially in patients presenting with upper GI symptoms following metabolic surgeries.

Mitos is always understood as a story, inherited from the old generation. Claude Levi Strauss, underlined that mitos is not only a story telling about the experience in the past among the deities but contained also different precious values for the new generation. This article is written based on the research done among the people in Tanalein, a village found in Solor Island, East Flores. There are different clans and tribes living together in this area. Each tribes have different mitos formulated in different oral tradition. Based on the problems among the young people in this area, I have been trying to study the old mitos of Suku Lein. One of the old tribe came to this area, analysing and trying to find the didactic values for the formation of the young people. Education as a way of preparing the young generation for the future must be based on the values of local culture. Mitos selalu dipahami sebagai sebuah kisah atau cerita yang diwariskan dari generasi terdahulu. Mitos tidak sekadar sebuah kisah yang menceritakan pengalaman masa lampau di kalangan para dewa-dewi tetapi sekaligus berisikan berbagai nilai yang berharga untuk generasi masa kini. Artikel ini ditulis berpijak pada penelitian lapangan yang dilaksanakan di Desa Tanalein, sebuah desa yang ada di Pulau Solor, Larantuka, Kabupaten Flores Timur. Dalam desa ini terdapat banyak suku yang hidup bersama. Setiap suku memiliki mitos yang berbeda, yang diungkapkan dalam berbagai bentuk tradisi lisan. Merujuk pada permasalahan yang sedang dihadapi generasi milenial di kawasan ini, penulis berusaha untuk mempelajari mitos suku Lein, salah satu suku penghuni pertama dari kawasan ini. Penulis berusaha membuat analisa dan menumukan pesan didaktis demi pembentukan generasi milenial. Pendidikan sebagai salah satu jalan mempersiapkan generasi milenial pada masa yang akan datang hendaknya berpijak pada nilai-nilai kebudayaan lokal.

Background: Diabetes mellitus is a prevalent chronic disease that significantly increases the risk of complications from infections such as influenza and pneumococcal disease. Despite established recommendations for vaccination, coverage rates among adults with diabetes remain suboptimal. This study aims to analyze trends in influenza and pneumococcal vaccination rates among adults with diabetes using the United States Diabetes Surveillance System (USDSS) database. Methods: This retrospective database study utilized data from the USDSS from 2000 to 2022, which provides comprehensive nationwide data on diabetes care. The study population included adults aged 18 and above with a documented diagnosis of diabetes. Data were extracted on demographic variables (age, sex, race/ethnicity), clinical characteristics (type of diabetes, duration of diabetes, comorbid conditions), and vaccination records. Descriptive statistics summarized demographic and clinical characteristics, while temporal trends in vaccination rates were analyzed using graphical representations. Results: Over the past two decades, influenza vaccination rates among adults with diabetes increased from 41.4% in 2000 to 56.7% in 2019, reflecting improved awareness and healthcare practices, though slightly dipping to 54.2% in 2022. In contrast, pneumococcal vaccination rates showed more variability, starting at 29.3% in 2000, peaking at 39.4% in 2018, and declining to 30.2% in 2022, indicating challenges in maintaining high coverage. Influenza vaccination rates showed an overall increasing trend across all demographic groups: rates among Hispanic individuals increased from 32.1% in 2000 to 55.4% in 2022, non-Hispanic Whites from 43.4% to 52.7%, and non-Hispanic Blacks from 39.2% to 44.5%. Pneumococcal vaccination rates also increased but displayed more variability; Hispanic rates peaked at 33.3% in 2016, non-Hispanic Whites at 45.6% in 2019, and non-Hispanic Blacks at 41.7% in 2017. Higher educational attainment was consistently associated with higher vaccination rates for both vaccines. Conclusions: This study highlights significant improvements in influenza and pneumococcal vaccination rates among adults with diabetes over the past two decades. However, disparities remain, particularly among racial and educational groups. Targeted strategies are necessary to address these disparities and enhance vaccination coverage, ultimately reducing the risk of severe infections in this vulnerable population.

Utilized in the healthcare sector, social media offers numerous benefits. However, its drawbacks encompass the variable quality of unregulated and unsupervised content. Thus, we aimed to evaluate the information in content related to chest pain found across Instagram and analyze the quality and reliability of chest pain-related content via Instagram posts. Instagram posts with content related to chest pain were analyzed with the help of a structured questionnaire that included the Global Quality Scale (GQS) and DISCERN score (DS). To collect Instagram posts, several distinct hashtags were employed: #chestpain, #chestpains, #angina, #anginatreatment, #heartattack, #heartattacksurvivor, #heartattackprevention. A total of 262 posts were included, of which 29.7% of the total posts (n=78) contained information that describes the etiology of the disease. 27.8% of the total posts (n = 73) enclosed promotional content. Posts were found to be uploaded by doctors (18.7%), hospitals (15.6%), patients (17.9%), dieticians (11.1%), healthcare organizations (9.2%), and others (27.5%). Both Global Quality and DISCERN scores were statistically significant with a p-value of 0.001. The findings of this study revealed that most of the Instagram content on chest pain posted via physicians were highly reliable and had a better global quality score. Information regarding various causes, symptoms and preventive measures on Instagram can be considered as an acceptable source for patients to surf on. A major limitation is that only English content was analyzed. In the future, the use of higher quality posts produced by healthcare professionals could potentially contribute to enhancing patient education via Instagram.

The most common cause of portal hypertension is liver cirrhosis. Portal hypertension causes many complications in cirrhotic patients; a significant complication is the formation of varices and the subsequent life-threatening variceal bleeding due to elevated portal venous pressures. Hepatic venous pressure gradient (HVPG) is the gold standard for measuring portal hypertension and guides management. Pharmacological treatments lower the HVPG, preventing the progression of varices and subsequent variceal bleeding. The pharmacological treatments frequently used in primary and secondary prophylaxis of a variceal bleed are nonselective beta (β)-adrenergic blockers. Propranolol was the first nonselective β-adrenergic blocker used for lowering HVPG and has been well studied. However, in the past decade, clinical trials have shown that carvedilol has been more effective. This study aims to establish whether carvedilol is more effective than propranolol in reducing the hepatic venous pressure gradient and decreasing the risk of variceal bleeding in adult cirrhotic patients. A systematic review has been conducted to gather relevant clinical trials comparing drugs and their effects on HVPG. Four databases: PubMed (Medical Literature Analysis and Retrieval System Online (MEDLINE)), Google Scholar, the Cochrane Library, and ScienceDirect, were analyzed, and records from January 1, 1999, to January 1, 2023, were chosen. There were a total of 1,235 potentially eligible records across the four databases. Using the eligibility criteria for this systematic review, seven studies of 533 patients were included. Across all seven clinical trials, it was found that carvedilol reduced HVPG more than propranolol and decreased the risk of variceal bleeding in adult cirrhotic patients.

Multiple sclerosis is a neurological disorder categorized by inflammatory processes with a high prevalence worldwide. It affects both motor and sensory pathways and is also associated with the visual pathway.Fingolimod is a commonly used drug for relapsing-remitting multiple sclerosis. It is a sphingosine 1-phosphate modulator acting on its receptors for immune cell accumulation, neuronal function, embryological development, vascular permeability, smooth muscle cell function, and endothelial barrier maintenance.This review aims to understand the processes, mechanisms, risks, and management of fingolimod-associated macular edema. Due to the anti-inflammatory properties of fingolimod, it decreases various cytokines, including interleukin (IL)-1B and IL-6, spike wave, and spike amplitude, in electrophysiological activities and decreases insoluble receptors for advanced glycation end productligand. A daily dosage of 0.5 mg of fingolimod has an increased association with macular edema. The serious adverse events of fingolimod are lymphopenia, cardiovascular events, ocular events, and carcinoma. Fingolimod decreases brain volume and increases vascular permeability, resulting in increased macular volume and damage to the blood-retinal barrier, which causes an increased risk for macular edema. Cystoid macular edema is more common in older individuals suffering from comorbidities affecting the retina, such as diabetes, or those undergoing ophthalmological surgeries. This review also highlights the importance of regular ophthalmology examinations on patients consuming fingolimod both in the initial stages and chronic use. The treatment options for macular edema include nonsteroidal anti-inflammatory drugs, acetazolamide, triamcinolone, ketorolac, corticosteroids, and intravitreal procedures.

Fracture nonunion remains a great challenge for orthopedic surgeons. Some bone fractures don't heal promptly, resulting in delayed unions and nonunions, and there is a need for an additional surgical procedure. Previous research has shown that teriparatide, a type of synthetic parathyroid hormone, can promote the formation of callus and lead to healing in individuals with delayed or non-healing bone fractures. Limited systematic reviews exist that examine the use of teriparatide in cases of delayed healing or non-healing bone fractures, which have their limitations. In this review, we overcome those limitations by including prospective studies, retrospective studies, case reports, and case series together. A systematic search of theliterature was conducted in both PubMed and Google Scholar up to September of the year 2022. The studies included in our research included adult patients (over the age of 16) diagnosed with delayed union or nonunion of any bone in the body (flat bone, long bone, short bone, or irregular bone). The studies were limited to those written in English. The outcomes that were tracked and recorded include the healing of the fracture and any negative side effects or adverse events. The initial search yielded 504 abstracts and titles. After reviewing these, 32 articles were selected for further analysis, which included 19 case reports, five case series, two retrospective studies, and six prospective studies. Studies included daily (20 micrograms) or weekly (56.5 micrograms) subcutaneous administration of teriparatide. The duration of follow-up for these studies varied from three to 24 months. Based on the available research, it appears that administering teriparatide subcutaneously is a safe treatment option for delayed healing and non-healing bone fractures, with very few to no reported negative side effects. Using teriparatide for induction of callus formation and treating delayed and nonunions is highly safe and effective.

Mission of the church today should and foremost be characterized as an exercise of dialogue.Just as the interior life of God is a perfect communion of gift and reception,identity and openness to the other, communion in relationship and communion in mission, so the church that is called into being by that mission must be a community that not only gives of itself in service to the world and to the peoples of the world,s cultures but learns from its involvement and expands its imagination ot the depths of God unfathomable riches.And just as the ways about persuasion and freedom - respecting love, mission can no longer proceeds in wys that neglect the freedom and dignity of human beings. Nor can a church that is rooted in a God that saves through self-emptying think ofitself as culturally superior to the peoples among whom it works.Mission,as participation in the mission of the triune God can only proceed in dialogue and can only be carried out in humility.