bluuebunny/crossref_metadata_2025 huggingface dataset:
RETRACTED: Open Innovation in R&D
Authors: Maamari Bassem E. , Osta Alfred
Published: February 2022

Breakthrough innovations are crucial drivers of economic progress, often depending on external knowledge sources to complement internal knowledge. Co-patenting is one way to achieve this by implementing open innovation within research and development. The purpose of this paper is to explore the impact of co-patenting on breakthrough innovations in the pharmaceutical industry. A research question is tested empirically using an archival dataset comprising 866 patents in pharma. The findings show that co-patenting has a significant positive impact on breakthrough innovations. Short of previous investigation, this paper provides new empirical insights on the open innovation and co-patenting levels, leading to both academic and practical implications on the field.
Using Knowledge Management to Improve the Effectiveness of Data Fusion Centers
Authors: Willman Logan , Jennex Murray Eugene , Frost Eric G.
Published: February 2022

Data fusion centers have been around since the 9/11 terrorist attacks but have been shackled with an underperforming label. Products from fusion centers often do not support the mission of the organizations supporting the centers. This paper addresses the questions of the historical barriers to information sharing and how fusion centers can become more efficient and effective in this role. The research and experience of the authors are viewed through a knowledge management lens to propose using structured analytic technique exercises coupled with applying knowledge management tools and concepts to improve knowledge flow and the relevance and quality of the intelligence products produced.
RETRACTED: Gender Differences in Virtual Community Knowledge Sharing
Authors: Wang Xuan , Li Yaojie , Stafford Thomas , Khasraghi Hanieh Javadi
Published: February 2022

Over the years, Web 2.0 and Web 3.0 have promoted and prospered user-generated content, ease of use, interoperability, and virtual communities. Indeed, a growing number of online platforms and virtual communities contribute to our society and economy by maximally sharing knowledge among numerous participants. Hence, it is necessary to understand the participation-motivation of knowledge sharing in various virtual communities. Using a sample of American virtual communities of interest, this study examines a model of knowledge sharing based on social capital theory and social cognitive theory. This research echoes prior studies with similar and even stronger evidence. Also, the results suggest a significant moderating effect of gender difference on knowledge sharing in virtual communities when participants share a common language and vision.
Critical Success Factors for ERP Implementation
Authors: Idilbi Muradallah , Abu-Shanab Emad Ahmed
Published: February 2022

Due to the high failure rate of enterprise resource planning (ERP) systems, implementation issues have been highly addressed in the literature. Two major directions were followed in the literature focusing on technology adoption theories, and focusing on the critical success factors (CSF) of ERP implementation from organizational perspectives. However, few studies covered both directions in one study. This study extended the TAM with computer self-efficacy (CSE), and explored the major CSF that influence the implementation process of ERP systems in a Qatari environment. 321 valid responses were collected from employees working in 40 different organizations with varied business lines in Qatar. Results indicated that perceived usefulness, perceived ease of use and computer self-efficacy were significant predictors of behavioral intention (R2 = 0.56). Major findings of the descriptive analysis related to the CSF concluded that top management support, followed by users’ training, and project management process are the major ones perceived by the sample.
Silent Hypoxia in COVID-19 Pneumonia: State of Knowledge, Pathophysiology, Mechanisms, and Management
Authors: Cajanding Ruff Joseph Macale
Published: February 2022

Patients with COVID-19 often present with life-threatening hypoxemia without dyspnea or signs of respiratory distress. Termed silent or happy hypoxia, it has puzzled clinicians and challenged and defied our understanding of normal respiratory physiology. A range of host- and pathogen-related factors appears to contribute to its development, including SARS-CoV-2’s ability to produce different COVID-19 phenotypes; induce endothelial damage and elicit a vascular distress response; invade cells of the central nervous system and disrupt normal interoception and response; and modulate transcription factors involved in hypoxic responses. Because hypoxemia in COVID-19 is associated with increased mortality risk and poorer survival, early detection and prompt treatment is essential to prevent potential complications. Interventions to prevent hypoxemia and improve oxygen delivery to the blood and the tissues include home pulse-oximetry monitoring, optimization of patient positioning, judicious use of supplemental oxygen, breathing control exercises, and timely and appropriate use of ventilatory modalities and adjuncts.
Evaluation of the law relating to medical negligence in Sri Lanka
Authors: Chandrasiri H.L.N.S.
Published: February 2022

Reasonable competent and skilled medical practitioners owe a duty of care to their patients. Medical negligence and malpractice are expressions that are used in the medical community very often. It is hard to collect a handful of successful Sri Lankan case law documents that reached the Supreme Court. However, an exception exists from the landmark case of Priyani Soyza v. Rienzie Arseculerathe for the Recovery of Damages for the Death of a Person prior to enacting Act No.2 of 2019. This case law is just a tip of an iceberg. Many more merits have still been under-reported. Prevailing tort liability of medical negligence in Sri Lanka is neither the best nor certain. The professionally skilled staff owe a huge debt of gratitude to their clients to perform a reasonable duty of care. However, when it comes to human health, the professional relationship becomes livelier and more sensitive. Negligence is a common terminology in any profession, occupation, business, or trade where a prudent person would not reasonably omit or commit, resulting in ultimate physical, mental, or economic loss. The growth of science and technology and free health policy in Sri Lanka have been taking an immense struggle through legislative, international conventions case laws, and eminent legal commentaries to fulfill the patient-oriented medical system. This paper aims to analyse and evaluate the ups and downs of the Sri Lankan legal system regarding medical negligence while comparatively introducing successful sources from other jurisdictions. Primary and secondary data collected were analysed using the qualitative research approach in this study. In this study, the qualitative research approach was used and data for analysis were gathered from both primary and secondary sources. In conclusion, admire the hypothesis and recommendations of the successful green pasture oasis used in consumer protection law, professional insurances, and non-fault redress for prevailing tort-based Medical Negligence.
Modelling the Use of Traditional Family Planning by Women in Sri Lanka
Authors: Peiris T.S.G. , Karunarathne H.V.V.M.P.
Published: February 2022

Family planning plays a crucial role in enhancing the health of the mother and the child. Contraceptives are used by most women in the reproductive age span (15-49 years). Sri Lanka has been named as one of the countries with high usage of traditional family planning (TFP) methods than the other Asian countries. However, the reasons for that have not been investigated. Therefore, this study is carried out to identify the significant factors influencing on usage of TFP by using data from Sri Lanka Demographic and Health Survey in 2016 with a sample size of 10835. The percentages of women using TFP is 16.3% compared to 83.7% of using modern family planning (MFP). Among TFP users, the withdrawal method and the rhythm method are 35% and 57% respectively. The balance 8% uses both methods. A binary logistic regression model was developed to capture the factors influencing the use of TFP by considering all variables simultaneously. The fitted model was invariant on the type of selection method and selection criteria. The overall predictive power is 82.9%. The knowledge on family planning, having advice from public health midwives, attendance to well-women clinics, religion, ethnicity, decision to use family planning, husband’s occupation, women’s age, women’s occupation, women’s education level, number of children, and wealth quantile are the significantly associated factors with the usage of TFP. The odds of the usage of TFP among the women having no children and women having 1 or 2 children are respectively 1.4 and 4.0 times higher than the women having 3 or more children. The factors identified are geared towards providing robust evidence based on data driven decision making (DDDM) and therefore the key population groups in need of contraceptive services can be targeted more effectively and efficiently. Organizing counselling programmes and promotions on family planning and conducting media awareness programmes to avoid some myths on modern contraceptives can be suggested.
La salute riproduttiva
Authors: Fiori Angelo
Published: February 2022

Non disponibile
Bioetica e nursing, Codice deontologico infermieristico francese
Authors: Fiori Angelo
Published: February 2022

Nel febbraio 1993 è stato approvato in Francia il nuovo Codice deontologico infermieristico. Esso riguarda, infatti, i doveri cui il personale infennieristico deve attenersi verso i pazienti ed i colleghi.
Extranodal presentation of a lymphoma with precursor B-cell phenotype and translocation t(8;14) in South Africa
Authors: Hodkinson Katherine E. , Perner Yvonne , Glencross Deborah K. , Wiggill Tracey , Botha Adam , Poole Janet
Published: February 2022

Introduction: A rare entity of a B-cell malignancy with precursor B-cell phenotype and concomitant translocation t(8;14) or variant MYC translocation exists. These cases show clinical, pathological and molecular overlap between precursor B-lymphoblastic leukaemia or lymphoma and Burkitt leukaemia or lymphoma (BLL).Case presentation: We report a case from February 2019 at the Charlotte Maxeke Johannesburg Academic Hospital, South Africa, of a 9-month-old infant with a predominantly extracranial soft tissue mass showing extradural extension. There was no involvement of the peripheral blood or bone marrow. Fine needle aspiration and Tru-Cut biopsy of the soft tissue scalp mass showed the tumour to be of precursor B-cell phenotype. Contrastingly, an immunophenotypic assessment revealed a high S-phase fraction and raised concern for BLL. This prompted testing for the translocation t(8;14) by fluorescence in-situ hybridisation analysis, which confirmed this aberration.Management and outcome: Based on the published experience of other centres, the patient was initiated on a BLL protocol. Despite an excellent clinical response, the patient succumbed to neutropenic sepsis six months after diagnosis.Conclusion: Leukaemia or lymphoma with translocation t(8;14) or variant MYC translocation and precursor B-cell phenotype is a rare entity with a varied clinical presentation. This poses a challenge for diagnosis and classification and a clinical dilemma for the choice of treatment.
Factors that Master of Nursing students associate with study progress in higher education institutions in Gauteng province
Authors: Mudzi Patricia Y. , Jiyane Priscilla M. , Sepeng Nombulelo
Published: February 2022

Background: Globally, the unsatisfactory progress of postgraduate students registered for a master’s degree is a cause for concern. It affects graduation numbers and completion time.Aim: This study aimed to determine the perceived supervisory-researcher community support, research writing, work–life balance, and research conceptions factors that Master of Nursing students associate with study progress.Setting: The study was conducted in three selected higher education institutions (HEIs) in the Gauteng province.Method: A correlational cross-sectional research design was utilised. A self-administered questionnaire adapted from the Cross-Country Doctoral Experience Survey was e-mailed to a total sample of 136 Master of Nursing students who were at least in their second year of study, of which 122 (89.7%) responded. Descriptive statistics, factor analysis, the Mann-Whitney U test, and the Kruskal-Wallis test were used to analyse the responses.Results: Most of the students’ perception was greater regarding supervisory-researcher community support and research conceptions. Despite a high mean composite score of 4.134 (SD-1.452) on work–life balance, some respondents found it difficult to balance work and life. Respondents with a source of income perceived greater supervisory-researcher community support (p = 0.022) while those studying full-time had better research writing perceptions (p = 0.002).Conclusion: There is need for HEIs to develop or strengthen interventions targeting research writing and work–life balance factors that were perceived to result in less support. Funding remains a concern for Master of Nursing students.Contribution: This study contributes to knowledge on factors that Master of Nursing students associated with study progress.
Pauline and Johannine Theosis
Authors: Ferries Ryan A.R.
Published: February 2022

This article looks at Colossians 2–3:17 and John 17:13–26 as the base texts to see the commonalities between Johannine and Pauline conceptions of Theosis. First, the article looks at indwelling and participation as the methods of Theosis in the two traditions. Second, the role of mimesis is seen to be integral in these texts’ concepts of Theosis. Third, the article looks at hope and glory that believers have and look forward to as indicative of their deification. The study begins by defining the term Theosis and its cognate terms – deification and divinisation – properly, within an Orthodox Christian context.Contribution: The goal is to see and detail the concept of Theosis in Pauline and Johannine literature, looking at Colossians 2–3:17 and John 17:13–26 specifically. As such, the present study will broaden the discussion the doctrine of Theosis as it appears in the Christian scriptures.
Begging enterprise: A growing trend among Igbo Christians in Nsukka Urban
Authors: Ugwu Ndidiamaka V. , Okoye Kanayochukwu M.
Published: February 2022

It is obvious that the practice of begging is growing exponentially and changing into various forms mostly among the Christians in the Nsukka area. Although begging has long been in existence in the Nsukka area, it has never been encouraged. Financial assistance from family and relatives usually prevents an indigent person from begging in the street. Giving alms to the poor is regarded as a religious duty by many people. But, some beggars take advantage of people’s sympathy and thus the practice of begging is encouraged. Many scholars have written about the increase in the number of beggars in Igboland and attributed it to a number of factors such as poverty and ill health. Some see it as an indictment on government. However, this present study attributes the increase in the number of beggars in Nsukka’s cultural area to religion, laziness as against hard work, individualism as against communalism, social disorganisation because of urbanisation. These beggars who do nothing other than to beg are less productive, and consequently contribute nothing to the nation’s economy. They are a nuisance in the society, as some engage in all kinds of immoral activities that degrade human society. This study therefore attempts to explore the growing trend of begging among Igbo Christians in Nsukka Urban. It aims to identify the different dimensions of begging and the reasons behind this practice. A qualitative phenomenological method was employed in this study.Contribution: The findings of this study revealed that poverty is not the cause of begging among Christians in Nsukka but rather laziness, individualism, and religious mendicancy, among others. It recommends that the Igbo people should go back to the values that bind them together.
Mannose inhibits the growth of prostate cancer through a mitochondrial mechanism
Authors: Deng Yu-Lin , Liu Ren , Cai Zhou-Da , Han Zhao-Dong , Feng Yuan-Fa , Cai Shang-Hua , Chen Qing-Biao , Zhu Jian-Guo , Zhong Wei-De
Published: February 2022

The limited treatment options for advanced prostate cancer (PCa) lead to the urgent need to discover new anticancer drugs. Mannose, an isomer of glucose, has been reported to have an anticancer effect on various tumors. However, the anticancer effect of mannose in PCa remains unclear. In this study, we demonstrated that mannose inhibits the proliferation and promotes the apoptosis of PCa cells in vitro, and mannose was observed to have an anticancer effect in mice without harming their health. Accumulation of intracellular mannose simultaneously decreased the mitochondrial membrane potential, increased mitochondrial and cellular reactive oxygen species (ROS) levels, and reduced adenosine triphosphate (ATP) production in PCa cells. Mannose treatment of PCa cells induced changes in mitochondrial morphology, caused dysregulated expression of the fission protein, such as fission, mitochondrial 1 (FIS1), and enhanced the expression of proapoptotic factors, such as BCL2-associated X (Bax) and BCL2-antagonist/killer 1 (Bak). Furthermore, lower expression of mannose phosphate isomerase (MPI), the key enzyme in mannose metabolism, indicated poorer prognosis in PCa patients, and downregulation of MPI expression in PCa cells enhanced the anticancer effect of mannose. This study reveals the anticancer effect of mannose in PCa and its clinical significance in PCa patients.
Prognostic Value of Baseline White Blood Cell Count and Neutrophil–Lymphocyte Ratio in Carcinoma Cervix
Authors: Bhogadi Amani , Singareddy Rohith , Bajwa Harjot Kaur , Raju Alluri Krishnam
Published: February 2022

Aims:

To evaluate the impact of baseline white blood cell (WBC) count and neutrophil–lymphocyte ratio (NLR) in carcinoma cervix patients treated with definitive chemoradiotherapy.

Settings and Design:

Retrospective cohort study, original research article in Department of Radiation Oncology, Basavatarakam Indo American Cancer hospital.

Materials and Methods:

Patients of squamous cell carcinoma cervix treated with radical chemoradiotherapy from January 2017 to August 2017 were included in the analysis. All patients had baseline blood counts, local imaging, and metastatic workup at diagnosis. Patients received external beam radiotherapy to a total dose of 50 Gy in 25 fractions along with weekly cisplatin (40 mg/m2) and brachytherapy (21 Gy in 3 fractions). Baseline WBC counts and baseline NLR were correlated with outcomes using chi square test and receiver operating characteristic curves.

Statistical analysis used:

The patients were divided into two groups based on high-baseline WBC count and normal-baseline WBC count. Baseline WBC counts and baseline NLR were correlated with patterns of recurrence using chi square test. The sensitivity and specificity of prognostic factors for recurrence were computed using ROC curves.

Results:

The NLR cut-off value of 3.47 had high sensitivity and specificity for predicting recurrence in these patients. Majority of the recurrences in patients having high WBC count and high NLR were distant recurrences.

Conclusions:

A high-baseline WBC count and high NLR resulted in higher rates of recurrence and inferior survival in carcinoma cervix patients in our study. These biomarkers can be used as predictors of outcomes in carcinoma cervix.
Atypical Herpes Zoster Reactivation in an Elderly Gentleman with Advanced Oral Cancer
Authors: Kukreja Divya , Chakrabarti Deep , Resu Abigail Veravolu , Verma Mranalini , Bhatt Madan Lal Brahma
Published: February 2022

Background: Varicella-zoster virus (VZV) causes varicella in children and reactivation zoster in adults. A 79-year-old gentleman with an old history of varicella infection receiving methotrexate for advanced tongue cancer presented with multiple vesiculo-papular lesions in axillae and chest wall. The lesions were multidermatomal in distribution, painless, indurated, and nontender. A Tzanck smear confirmed the diagnosis of herpes zoster. His lesions resolved on antiviral therapy. Dermatologic side effects of methotrexate are otherwise rare and occur in 1%–10% of patients. Nevertheless, advanced cancer or cancer chemotherapy may cause immunosuppression leading to reactivation of VZV in some patients.
Dosimetric Feasibility and Clinical Outcome of Image-Guided Interstitial Brachytherapy Using Two Different Fractionation Schedule in Carcinoma Cervix
Authors: Basu Abhishek , Mandal Bidyut , Mondal Janmenjoy , Ghosh Debjit , Chakraborty Ipsita
Published: February 2022

Methods and Material:

Overall, 60 patients were accrued between 2014 and 2017 and treated with ISBT by using Syed–Neblett Template by iridium 192 with Gamma Med plus HDR after the loader unit. They were allotted in two arms (n = 30) and received nine Gy ×2# and 7 Gy ×3 # respectively. All patients received 50Gy/25# whole pelvis EBRT by Theratron 780C. Coverage Index (CI), dose homogeneity index (DHI), overdose index (OI), dose non-uniformity ratio (DNR), D90Target, and 2cc EQD2 of OARs were calculated and correlated with toxicity, locoregional control, and survival.

Statistical Analysis Used:

Unpaired t-test and chi-square test were used to compare numerical and categorical variables, using IBM SPSS, V23. PFS and OS were calculated by using Kaplan–Meier analysis, and a log-rank test was used for comparison. A p-value ≤ 0.05 was considered significant.

Results:

Mean EQD2 for bladder (77.33 vs. 80.24 Gy) and rectum (69.12 vs. 69.87) along with D90 (9.12Gy vs. 7.20Gy) were comparable. With a median follow-up period of 38 months, three-year local control rate was 56.6% vs. 46.60% (P = 0.72) and three-year OS was also similar, 83% vs. 80% (p=.8). Dosimetric parameters and toxicity profile between two groups were comparable.

Conclusions:

9Gy ×2 # is a reasonably good alternative for treating the locally advanced carcinoma cervix.
Demographic Profile and Clinicopathological Patterns of Colorectal Cancer in Subhimalayan North India
Authors: Gupta Nitin , Verma Shalini , Negi Muninder , Devi Soma
Published: February 2022

Background:

Despite colorectal carcinoma being one of the common cancers with an increasing incidence over the past few decades, there are only a few studies that have assessed its demographic, clinical, and pathological profile in the north Indian population.

Objective:

To assess the demographic and clinicopathological patterns of colorectal cancer (CRC) among patients in the subhimalayan region of North IndiaMaterials and Methods: This retrospective cross-sectional study analyzed the data of 244 patients with CRC who were referred to a state-owned medical college in Himachal Pradesh, India, between January 2016 and April 2020. Demographic, clinical, and pathological information was extracted from patient record files.

Results:

The mean age of patients in the study was 51.2 years, with an age range from 19 to 81 years. Approximately 48% of the patients were aged between 40 and 60 years, 15% were younger than 40 years, 56% of the patients were male, and 44% of the patients were female. Rectal bleeding (~46%), change in bowel habits (~41%), and abdominal pain (39%) were the common clinical symptoms. Overall, 73% of the patients were diagnosed at a mean duration of five months after the onset of their symptoms, and approximately 36% of the patients were in stage II and 48% were in stage III at the time of diagnosis. Colon carcinoma accounted for 76% of the patients, 17% had rectal carcinoma, 5% had carcinoma of recto-sigmoid, and 2% of the patients were diagnosed with ano-rectal carcinoma. Histopathologically ~ 81% patients had adenocarinoma, 14% had mucous carcinoma, 3% had signet ring carcinoma, and 2% had NET.

Conclusions:

In the subhimalayan region in North India, CRC has a higher male gender predominance, with a substantial number of patients younger than 40 years. Most of the cases are diagnosed after a mean duration of five months of the symptoms. Colon carcinomas are more common than rectal carcinomas, with left-sided colon carcinomas being more common than right-sided colon carcinomas. The majority of tumors are adenocarcinomas, whereas mucinous carcinomas are less common and signet ring carcinomas are rare. A greater number of patients with right-sided colon carcinomas have a higher stage and a more aggressive tumor grade at the time of diagnosis. The study also shows that there is a need to be more vigilant for colorectal carcinoma in patients with lower GIT symptoms and it lays emphasis on a colorectal screening program in such patients, to enable early detection of this tumor.
Comparison of Setup Variations and Defining a CTV-PTV Margin in Fractionated Radiotherapy of Brain Tumor Using Novalis Tx Orthogonal OBI (kv) Versus Brain Lab ExacTrac (kv) Imaging Systems with Brain Lab Mask
Authors: Pandey Hemant K. , Bhadauria Mano , Jadhav Ganesh Kishan Rao , Manocha Sapna , Masodkar Renuka , Piyushi Divya , Raut Sanjay , Goswami Brijesh , Chauhan Sunil Kumar
Published: February 2022

The objective of this study is to evaluate the setup discrepancy between Brain Lab ExacTrac (kv) and Orthogonal Novalis Tx (kv) imaging systems and to obtain an optimal CTV-PTV margin. We recruited 35 consecutive brain tumor patients, immobilized with non-invasive thermoplastic BrainLab mask, between August 2016 and August 2017. The position verification done by ExacTrac, Infrared Positioning System was followed by a set of images by OBI at 0° and 90° position. The images were autofused and compared with DRR generated by TPS. The extent of translational and rotational shift was then applied and documented. The translational inter-fractional setup error (mean ± SD) in X-axis detected by OBI and ET was 0.002 ± 0.227 and −0.042 ± 0.084, respectively. In Y-axis, the error detected was −0.01 ± 0.176 and 0.075 ± 0.079, respectively, whereas in Z-axis the error with OBI and ET was 0.329 ± 0.521 and 0.051 ± 0.091, respectively. The P-value of inter-fractional errors in X, Y, and Z axes was 0.294, 0.013, and 0.004, which is statistically significant in Y- and Z-axes. Rotational inter-fractional setup errors (mean ± SD) for OBI and ET were −0.101 ± 0.257 and −0.076 ± 0.102, respectively. The rotational setup errors detected by ET in pitch and roll dimension are −0.003 ± 0.084 and −0.085 ± 0.073, respectively. The data obtained were put in Van Herk’s formula (PTV margin = 2.5 ∑ + 0.74 σ), and CTV-PTV margin was calculated. CTV-PTV margin for ET was 2.70, 2.72, and 2.94 mm and 3.38o, 2.84o, and 2.51o in lateral, longitudinal, vertical and pitch, roll, yaw dimension, respectively. The CTV-PTV margin for OBI was 7.40, 6.20, and 5.30 mm and 7.27o in lateral, longitudinal, vertical, and yaw dimension, respectively. Daily setup verifications that use the Brain LAB Exac Trac 6D image-guided system are very useful for brain tumor treatment; nevertheless, OBI kv imaging can be used for FRT of brain tumor with extended margin.
Trajectories of General Movements in Very Preterm Infants
Authors: John Hima B. , Oommen Samuel Philip , Kumar Manish
Published: February 2022

Background and Objectives:

The assessment of general movements (GMs), particularly fidgety movements, helps identify preterm infants likely to suffer from Neurodevelopmental deficits; less is known about preterm GMs. This study evaluates the predictive value of preterm GMs for normal fidgety movements.

Methods:

This prospective cohort study included 131 very preterm infants (gestational age - M (standard deviation) - 29.7 (1.3) weeks) who underwent 3 GM assessments in the preterm period (31–37 weeks postmenstrual age [PMA]), term age (38–44 weeks PMA) and fidgety movement age (48–58 weeks PMA).

Results:

The sensitivity of preterm GMs in predicting fidgety movements was 67.21%, the specificity was 44.4%, the positive predictive value was 94.25% and negative predictive value was 9.09%. The proportion of abnormal GMs decreased with increasing age, with 33.8% in the preterm age, 20% in the term age, and 7% in the fidgety movement age.

Conclusion:

This study confirms findings of other studies-specificity values of preterm GMs are poor, implying a high rate of false positives. Preterm GMs may be inadequate in predicting future Neurodevelopmental outcomes.
Computed Tomography-Based Angiographic Evaluation of Circle of Willis and Its Variations. First Documented Evidence from Northern India
Authors: Jan Shah Sumaya , Shah Bashir Ahmad , Bhat Shabir Ahmad , Faisal Syed Shah , Saleem Sheikh Mohd
Published: February 2022

Background:

The circle of Willis (CW) encircles the pituitary stalk and is considered an anastomotic vascular system that links the forebrain and hindbrain. Because morphology varies between races, it was reasonable to do research on the anatomy of the CW. The purpose of this study was to determine the anatomical variations in the arteries composing the CW on computed tomography (CT angiography) in the adult Kashmiri population.

Materials and Methods:

This was a cross-sectional descriptive study conducted to assess the structural characteristics of CW and to estimate the prevalence of anatomical variations of CW in the adult Kashmiri population among those who were permanent residents of Kashmir Valley, aged 20 years or older, and who were referred for CT angiography from the Department of Medicine or Surgery with the diagnosis of CW.

Results:

A total of 50 (23.1%) studied CT angiography were having the presence of any anatomical variations, while 166 (76.9%) had normal anatomical origins. Arteries forming the CW (polygon) were found to be absent among 9 (4.16%) and 5 (2.3%) had fetal origin of arteries forming the CW. Trifurcation of arteries was found among only 2 (0.9%), hypoplastic arteries were found among 34 (15.7%), and complete circles were present in 207 (95.8%) CT angiographs. Right and left internal carotid artery, right and left anterior cerebral artery, the right middle and left middle cerebral artery, and the anterior communicating artery were all present.

Conclusion:

Hypoplasia was more prevalent in a posterior circle, absent arteries in the anterior circulation, while accessory vessels were common in the anterior portion of the circle.
A Study to Compare the Correlation of Perceived Stress and Insomnia between Health Professionals and other Employees in a Government Medical College of Eastern India
Authors: Mukherjee Anjan , Chaudhuri Arunima , Chakraborty Shibaditya , Adhya Debasis
Published: February 2022

Background:

Perception of higher stress may lead to insomnia which can adversely affect the mental and physical well-being of health professionals and patient care. The aim of the study was to compare the correlation of perceived stress and insomnia among health professionals and other employees in a Government Medical College of Eastern India.

Materials and Methods:

This online survey was conducted using two Google forms in a span of 18 months. In the first section of the document, the relevance was explained, and informed consent was taken. In the second part of the form, participants were asked to fill up demographic details and relevant history. In the third part of the form, participants had to fill up the following four scales: Perceived Stress Scale (PSS) of Sheldon Cohen, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Job Satisfaction Scale (JSS).

Results:

Participants were divided into two groups: Group A: Health Professionals and Group B: Other Employees. JSS scores were significantly higher among Group A (38.29 ± 6.34) as compared to Group B (35.47 ± 6.98) with a P = 0.0008**. Participants having higher JSS scores also had higher PSS scores (Group A with an r = 0.12; Group B with an r = 0.007). ISI scores were significantly higher in Group A (10.53 ± 3.43) as compared to Group B (6.21 ± 2.77) with a P < 0.001**. Participants having higher PSS scores also had higher scores for ISI (Group A with an r = 0.167 and Group B with an r = 0.333). PSQI scores were significantly higher among Group A (11.52 ± 2.05) as compared to Group B (6.37 ± 2.69) with a P < 0.0001**. PSS scores also positively correlated to PSQI scores (Group A, r = 0.963 and Group B r = 0.959). Participants having higher PSS scores also had higher scores for PSQI (Group A with an r = 0.963 and Group B with an r = 0.959).

Conclusions:

Perceived stress scores positively correlated to both severities of insomnia and poor quality of sleep among study participants. This suggests that higher perceived stress levels may be a significant contributor to insomnia and poor sleep quality among health professions as they are constantly exposed to higher professional stress in the present health-care system.
Expanding the use of Computer-Based Assessments in Medical Education
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: February 2022

The employment of computers for facilitating learning in the field of medicine is a known identity. The purpose of the current review is to explore the role of computer-based assessment in medical education and the potential challenges and strategies that need to be adopted to overcome them. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 15 articles were selected based upon their suitability with the current review objectives and analyzed. The keywords used in the search include computer-based assessment and medical education. The mode of use of computers in assessment can be decided based on the purpose of the intended assessment and play an important role in helping predominantly the students to expedite their learning. Computer-based assessments offer a good option for the students to assess their knowledge and learning progression in a nonthreatening and noncompetitive environment. In conclusion, computer-based assessments can be acknowledged as an exciting prospect and have the potential to bring about reforms in the assessment in medical education. This calls for the need that each and every medical institution should gradually aim for the introduction of the same within their set-up and thus prepare students better for their future medical career.
Managing blisters in minor burns
Authors: Garg Ramneesh , Rakesh Devika , Mittal Rajinder K , Kathpal Sheerin Shah , Kaur Amandeep , Singh Karan
Published: February 2022

Introduction:

Management of burn blister has always been controversial. The options available are deroofing the blister, aspiration of fluid or leaving the blister intact. There is no set dressing protocol for managing blisters.

Aims and objectives:

To compare two treatment modalities i.e. deroofing and keeping the burn blister intact for the optimal management of minor superficial 2nd degree burns.

Material and Methods:

This prospective study was done on 27 patients who presented with minor superficial 2nd degree burns of upper limbs. Total of 50 blister wounds were randomly split into two categories of 25 each. One subset of blisters (Category 1) was deroofed and dressed every alternate day with silver alginate dressing. The other subset of blisters was left intact (Category 2) and dressed every alternate day. The parameters assessed and compared were pain at burn site, soakage of dressing and time to complete healing

Statistical Analysis:

Student t –test and Chi square (χ2) test. SPSS 21 software

Results:

The mean age of patients was 36 years. Category 1 wound patients had more pain (as assessed by Visual Analogue Scale) in comparison to Category 2 wounds. The time to wound healing was less by mean of 1.7days in Category 1 wounds compared to Category 2 wounds. Wound soakage was comparable in both subsets.

Conclusion:

De roofing a burn blister results in statistically significant decrease in time to wound healing and is recommended for management of minor superficial 2nd degree burns.
Prevalence of mental health disorders among health-care providers of COVID-19 positive and suspected cases
Authors: Das Subhash , Harish Dasari , Tyagi Shikha , Rohilla Ravi , Domun Ira , Garg Apoorva , Pandargiri Mallikarjun A , Singh Shaminder
Published: February 2022

Background:

Health-care providers (HCP) engaged in demanding work like being involved in the care of COVID-19 positive and suspected cases are likely to have a lot of stress, anxiety, depression, and other mental health issues. It will be noteworthy to have an idea about the magnitude of the mental health problems in them to formulate effective intervention strategies for their well-being.

Aims and Objectives:

The aim of this study is to determine whether frontline HCP engaged in the treatment and care of COVID-19 positive and suspect cases experienced increased mental health problems.

Methodology:

Two hundred and fifty-one frontline HCPs engaged in COVID-19 duty and 97 nonfrontline (controls) HCP were assessed and compared using tools like General Health Questionnaire 12, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale. Appropriate statistical tools such as analysis of variance and Chi-square were used.

Results:

Frontline HCP who were directly involved in COVID-19 duty had a higher proportion (28.3%) of psychological morbidities as compared to 19.6% among controls; HCP-frontline had significantly 2.17 times chances of having psychological distress compared to HCP controls. Among, HCP-frontline 13.1% had clinical depression, whereas in the HCP control, this was 6.2%. Further, 20.3% of HCP frontline and 10.3% of HCP control had clinical anxiety, and the difference between the two groups was statistically significant (P = 0.0011).

Conclusion:

Frontline HCPs working in demanding work such as COVID-19 patient care are susceptible to psychological distress, anxiety, and depression which warrant urgent attention.
Kimura's disease involving the conjunctiva
Authors: Yadav Sonal P. , Patil Swapnil , Puntambekar Anirudha , Deshpande Rahul
Published: February 2022

A 50-year-old female presented with gradually increasing, pink nodular lesion on the temporal bulbar conjunctiva of the left eye, noticed in the past 15 days. She denied any history of trauma or similar episodes in the past or concurrent systemic illness. The lesion did not change after a 2-weeks long topical steroid course. It was then surgically excised. Histopathological analysis revealed lymphoid follicles with proliferating blood vessels lined up by plump endothelial cells with mixed infiltrate containing numerous eosinophils. Based on these findings, diagnosis of Kimura's disease (KD) was established. KD is a rare, chronic inflammatory disorder of possible allergic or autoimmune etiology which has been rarely described in conjunctiva.
Fungal seeding of bandage contact lens with no underlying corneal invasion of boston keratoprosthesis
Authors: Siddharthan K. S. , Agrawal Anushri , Reddy Jagdeesh Kumar
Published: February 2022

Infectious keratitis develops in 13.6% of eyes after keratoprosthesis (Kpro) implantation, with a similar rate of culture-positive bacterial and fungal keratitis. We report a case of 73-year old man who underwent Boston Kpro implantation in the left eye 2 years back. He presented with conjunctival discharge and a whitish growth over the bandage contact lens (BCL) for the past 2 weeks. Slit-lamp examination showed a whitish elevated growth with surrounding diffuse brownish feathery seeding all over the BCL. The BCL which was sent for culture grew fungus. The underlying Kpro was clear with no evidence of any active infiltrate. The patient was started on topical antifungal eye drops and was followed up for 12 months with no recurrence of infection. Educating the patient to be sensitive and to report immediately if they note any abnormality is as important as cleaning or replacing the BCL on a regular basis.
The oxidative and inflammatory nature of age-related macular degeneration
Authors: de Almeida Torres Rogil José , de Almeida Torres Rogerio João , Luchini Andrea , Anjos Ferreira Ana Lucia
Published: February 2022

The understanding of the effects of oxidation and inflammation on age-related macular degeneration (AMD) genesis has been of utmost importance for the advancement of preventive and therapeutical measures adopted in this disease. Several studies have been conducted on lifestyles, dietary antioxidants, expression of antioxidant enzymes, naturally found in the retina, as well as expression of cytokines, enzymes, and growth factors, with an ultimate goal to prevent or mitigate the visual damage induced by AMD. This article details the disruption of redox homeostasis associated with the increase of cells and inflammatory markers, major factors in triggering and/or aggravating the degenerative macular disease. The data sources used in this review study include Cochrane Database of Systematic Reviews, PubMed, MedlinePlus Health Information, and Elsevier Science.
Mega Coronary Arteries with Obstructive Coronary Artery Disease in Hypertrophic Obstructive Cardiomyopathy
Authors: Das Debasish , Acharya Debasis , Das Tutan , Pramanik Subhas
Published: February 2022

We report a rare case of hypertrophic obstructive cardiomyopathy (HOCM) presenting with mega coronary arteries with obstructive coronary artery disease. Interestingly, the patient had large septals, large diagonals, large obtuse marginal with a large left atrial branch, and a large conus almost mimicking a duplicate right coronary artery. Because of massive left ventricular hypertrophy, to overcome the supply-demand mismatch, coronary arteries may become large or with more arborization in hypertrophic cardiomyopathy but the same is rarely encountered in routine clinical practice. Our case is a rare illustration of the simultaneous presence of mega coronary arteries and critical obstructive coronary artery disease in HOCM in a young male of 38 years of age.
Multimodality Imaging Clues for Restrictive Cardiomyopathy
Authors: Adhyapak Srilakshmi M. , Thomas Grace A. , Gupta Anuraag , Shaikh Jabraan U. , Jose Tivlin , Kramadhari Harshith , Varghese Kiron
Published: February 2022

Restrictive cardiomyopathy is an entity that can be mistaken for several mimicking conditions, including hypertrophic cardiomyopathy. These patients present with heart failure, which is essentially due to left ventricular diastolic dysfunction, with preserved left ventricular ejection fraction. Conditions associated with hypereosinophilia and diastolic dysfunction with restrictive heart disease are called Loeffler's syndrome. There is also associated left ventricular thrombus formation and fibrosis. Here, we present a case of restrictive cardiomyopathy associated with rheumatoid arthritis presenting clinically with heart failure. The clues pointing toward hypereosinophilic endocarditis were a high absolute eosinophil count and a large left ventricular thrombus. We discuss the multimodality imaging findings to differentiate the different types of restrictive cardiomyopathy.
Analytical and Post Analytical Phase of an ISO 15189
Authors: Chandra Smita , Kusum Anuradha , Gaur Dushyant Singh , Chandra Harish
Published: February 2022

Objective:

Analytical and post analytical phase are integral part of total quality management system and include steps from submission of slides till reports are dispatched. The present study was conducted to analyze the analytical and post analytical phase of the ISO15189:2012 certified cytopathology laboratory. It was also intended to study the various errors which were encountered and steps taken to reduce these discrepancies.

Methods:

The study included all documents of quality program from 1 November 2014 till 31 Oct 2019 in medical institute situated in north Himalayan region of India. All the data was recorded and analyzed for analytical and post analytical phase.

Results:

The number of samples received in cytopathology lab was 21,566 with total quality errors of 5.19%. Out of these pre-analytical errors were 55%, analytical 10.5% and post analytical errors constituted 34.4%. The maximum errors detected were due to typographical errors followed by delayed turnaround time. Cyto-histopathological discordance was 10.5% in non-gynecological cases and 2.2% in gynecological cases.

Conclusion:

Analytical and post analytical phase analysis is essential to minimize the errors and improve the quality of cytopathology lab. Cyto-histopathological correlation is valuable for continuous data tracking in the cytopathology with analytical errors analysis. Maintenance of external, internal quality program, turnaround time with documentation, continuous training and communication with clinician is fundamental for quality improvement in any cytopathology lab. Acknowledgement of nonconformance with root cause analysis and sincere efforts to minimize them is the basic key for successful quality management.
Benign Megalencephaly
Authors: Hambire Chaitali , Hambire Umesh
Published: February 2022

Macrocephaly and megalencephaly are clinical entities characterized by the presence of head circumference more than two standard deviations than the mean. It is important to distinguish them from one another for appropriate management. There is no specific etiology for macrocephaly, whereas megalencephaly is caused by the developmental or postnatal anomalies of brain.
Prevalence and Distribution of Tobacco Intake in Various Districts of the Union Territory of Ladakh, India
Authors: Singh Malvika , Jamwal Manju
Published: February 2022

Background:

India is one of the top three tobacco burden countries in the world. Tobacco intake causes loss of health and environment and increases financial burden of an individual.

Aims:

The aim of this study was to assess the prevalence and distribution of tobacco intake among individuals of more than 15 years of age in the union territory of Ladakh, India.

Subjects and Methods:

District-wise data from National Health Survey-5, Ministry of Health and Family welfare 2019–2020, were collected, analyzed, and measured. Data collected were entered and statistically analyzed using the Statistical Package for the Social Sciences version 24.0 software (IBM, Armonk, NY, USA). Various districts were diagrammatically color coded and described.

Results:

Out of all the districts in the union territory of Ladakh, the prevalence of tobacco smoking was highest in Leh district and lowest in Kargil district.

Conclusions:

People should be made more aware of the ill effects of tobacco usage. Although the Government of India enacted various legislations to control tobacco use, its reduction lies in our hands and the same should be discussed with general masses by making them aware of the menace of tobacco on the mental, environmental, and health of an individual.