bluuebunny/crossref_metadata_2025 huggingface dataset:
KNOWLEDGE AND ATTITUDE BASED STUDY TOWARDS FAMILY PLANNING PRACTICE AND PREVALENCE OF SHORT BIRTH SPACING AMONG SUBURBAN POPULATION IN THE LIMITS OF GUNTUR GENERAL HOSPITAL, GUNTUR.
Authors: Tejkumar C. , Sravya Sravya , Srujitha Srujitha , Bhavadharani B.
Published: September 2023

Family planning programme was not as successful as expected, however, it has given an universal
knowledge about a concept of various family planning methods in the population. Besides these huge
knowledge of contraceptives, there is a large gap existing between practice of using contraceptive methods due to various
barriers like socioeconomic, geographical and territorial variations. The women who are married and who are requiring more
children, but not following any family planning techniques are known as unmet need or as KAP-GAP. It leads to the non practice
of reproductive intentions and contraception. As only two things like desire for more children and practice of contraception are
required for analyzing the data, many fertility studies have been carried out and the surveys are reported. The level of
knowledge of women and men on short gap births was assessed, in terms of grading which included good, average and poor,
the knowledge of wife falling under good are observed to be 27.77%, the average was observed to be in 31.74%, the poor was
reported in 40.47% of patients, the knowledge of husbands participated in the study was observed to be good among 29.36%,
average among 38.09%, poor among 32.53%, coming to the attitude scores among participants, it was assessed in terms of
satisfactory and unsatisfactory, among women, 28.7% fell under satisfactory and 71.42% fell under unsatisfactory scores, and
in husbands, 36.5% fell under satisfactory and 63.49% fell under unsatisfactory scores which are given in the table 2. It can be
concluded from the study on observations that, most of the study population are not with good compliance with the family
planning techniques and are not aware and in practice with giving appropriate gap between child birth.
IMMUNIZATION COVERAGE AND ITS DETERMINANTS AMONG CHILDREN AGED 12-23 MONTHS IN URBAN SLUMS OF GUWAHATI CITY- A CROSS SECTIONAL STUDY
Authors: Zeba Waferah , Goswami Kumaril , Hazarika Jhankar , Ojah Jutika , Chandra Baishya Achyut
Published: September 2023

Immunization is a process by which a person becomes
protected against a disease through vaccination. This term is
1
often used interchangeably with vaccination or inoculation.
In 1976, Dr Edward Jenner created the world's rst successful
vaccine against small pox. Subsequently, vaccine against
typhoid, rabies, diphtheria, inuenza, yellow fever, pertussis,
polio, hepatitis B, measles, mumps, rubella were discovered.
In 1974 the Expanded Programme on Immunization (EPI, now
the Essential Programme on Immunization) is established by
WHO to develop immunization programmes throughout the
world. The rst diseases targeted by the EPI are diphtheria,
2 measles, polio, tetanus, tuberculosis and whooping cough.
A COMPREHENSIVE NARRATIVE REVIEW OF ATRIAL FIBRILLATION: CURRENT INSIGHTS AND FUTURE DIRECTIONS
Authors: Lucia Julio Torres Karen
Published: September 2023

The exploration of risk factors in atrial brillation (AF) reveals hypertensive heart disease and coronary
heart disease (CHD) as major contributors. Rheumatic heart disease maintains a link, especially in
developing nations. Hypertensive heart disease's signicance is emphasized by a 1.42-fold AF risk increase in those with
hypertension history. CHD's connection emerges with acute myocardial infarction or heart failure. Valvular heart disease, mitral
valve prolapse, rheumatic heart disease, and obstructive sleep apnea correlate with AF. AF classication includes paroxysmal,
persistent, and long-standing persistent forms. Subclinical AF lacks symptoms. Valvular AF occurs in moderate-severe mitral
stenosis. Evaluation involves history, physical exams, ECGs, and echocardiograms. The Atrial Fibrillation Better Care pathway
guides initial management. Long-term care involves early follow-up, thromboembolism prevention, addressing AF recurrence,
rate or rhythm control, and regular follow-up
COOPERATIVE FEDERALISM IN INDIA: STRENGTHENING UNITY THROUGH COLLABORATION
Authors: Gautam Mukesh
Published: September 2023

This article delves into the concept of cooperative federalism in India, tracing its evolution, analyzing its
benets, and exploring notable achievements and initiatives resulting from this approach. India's federal
structure provides the backdrop for cooperative federalism, emphasizing collaboration between the central government and
state governments in policy formulation and implementation. The historical context highlights constitutional provisions
fostering shared decision-making and resource allocation. Benets encompass effective governance, intergovernmental
coordination, and streamlined resource sharing leading to improved development outcomes. Key achievements include GST
implementation, simplifying taxation, and successful centrally sponsored schemes in education, health, agriculture, and
infrastructure. Sustaining this approach becomes crucial to address emerging challenges and achieving inclusive and
sustainable development for all citizens.
DELIRIUM UNRAVELED: A NARRATIVE REVIEW ON ITS MULTIFACETED NATURE AND DIAGNOSTIC CHALLENGES
Authors: Cuellar Salazar Nicolaś
Published: September 2023

Delirium is a complex medical condition that poses challenges for healthcare professionals. While no
single intervention completely prevents delirium, non-pharmacological approaches targeting
modiable risk factors show promise in reducing its incidence. These interventions include orientation protocols, cognitive
stimulation, sleep facilitation, early mobilization, and the use of assistive devices. Delirium management requires a
comprehensive approach, involving early recognition, multidisciplinary assessment, non-pharmacological interventions,
family involvement, and judicious use of pharmacotherapy when necessary. Regular reassessment and tailoring of treatment,
integration of palliative care, and ongoing education for healthcare providers are vital components. The long-term impact of
delirium on older adults' health is signicant, leading to extended hospital stays, cognitive decline, increased mortality, and
institutionalization. Addressing delirium with prevention, early intervention, and evidence-based practices is crucial for
improving outcomes in vulnerable populations, especially those with pre-existing conditions like Alzheimer's Disease.
OCCUPATIONAL HEALTH HAZARDS AMONG THE HEALTHCARE WORKERS DURING COVID-19 - A REVIEW
Authors: Biswas Gourab
Published: September 2023

SARS-CoV-2 or COVID-19 pandemic spread throughout the world and infected more than 750 million
people of different countries. According to WHO COVID-19 dashboard, near about 7 million deaths had
been recorded during this pandemic till date. Various preventive and control measures had been taken to ght against the
COVID-19. During the pandemic, healthcare workers (HCWs) played most crucial role. In spite of shortages of PPE kits, essential
consumables and emergency healthcare equipments, nearly 59 million healthcare workers had served the world with their
experience, knowledge and dedication, and saved millions of life throughout the globe. During that emergency situation, these
healthcare workers not only infected by the corona virus but also suffered from various types of occupational health hazards.
Several risk factors such as rapid transmission of infection, excessive workload, shifting duties, hazardous working
environment and psycho-social issues made them the most vulnerable group during COVID-19 pandemic. Advanced
healthcare system should ensure the occupation health-safety programme for every healthcare worker
A CASE REPORT BILATERAL GIGANTOMASTIA WITH CONGENITAL GUM HYPERTROPHY IN 12 YEAR- OLD - GIRL
Authors: Humnekar Akhilesh , Chandra kala Prakash
Published: September 2023

Introduction A benign disorder known as juvenile gigantomastia causes disproportionately large
breasts for a child's age, either unilaterally or bilaterally, during puberty. There are a number of
hypotheses that have been put forth, but the exact cause of gigantomastia is still unknown. The imbalance in endogenous
hormone production is included in the widely accepted notion. When gigantomastia develops in adolescence, it causes a
miserable condition, Physical and psychological issues result from it. physical issues including shoulder and back pain. Poorly
tting clothing, a bad body image, and difculty exercising are secondary social issues. Here, we describe the case of a 12-
year-old girl who underwent bilateral breast reduction surgery after being diagnosed with bilateral giagntomastia and
congenital gum hypertrophy. Report of the case In this case report, we provide a novel observation in a 12-year-old oid-giri with
congenital gum hypertrophy and juvenile gigantomastia (rapid and exaggerated growth in breast size during puberty in a
year, with consequent skin ulcerations). She had a BMI of 20.6 kg/m2. No auxiliary lymphadenopathy was present. Prolactin,
follicle-stimulating hormone, and serum estradiol levels were all within normal ranges. The results of the medical genetic
study did not link to any syndrome. The breast's radiological imaging revealed nothing neoplastic-looking. Debulking of the
gums was planned, and a reduction mammoplasty was performed. No recurrence has been documented following a follow-up
of 4 months. We conducted a thorough literature search but were unable to locate any cases that were similar. Discussion In the
unusual occurrence of gigantomasatia, breast development continues until adolescence. There are a number of theories that
have been put up, but the precise underlying aetiology for gigantism has not yet been fully understood. The following
techniques were used in the treatment of gignastomastia: (1) Surgical management, (2) preoperative or postoperative medical
therapy, (3) postoperative medical therapy alone, and (4) medical therapy. Conclusion Adolescents readily accept reduction
mammoplasty for gigantism, which can lead to better physical and psychological consequences. Since congenital gum
hypertrophy and gigantism have only sometimes been discussed in the literature, this case will add to our understanding and
aid future research into the best way to treat this crippling condition.
THE VITAL ROLE OF DIABETIC EDUCATOR IN PRIMARY CARE HEALTH CLINICS – SHARING THE EXPERIENCE FROM BUNTONG HEALTH CLINIC, PERAK, MALAYSIA
Authors: Ambigapathy Subashini , Niroshini Abdullah Nadia
Published: September 2023

Achieving and maintaining glycaemic control, optimising treatment, and ensuring patient adherence
continue to be major challenges in T2DM management globally. Diabetes mellitus is a major noncommunicable health problem globally, leading to multiple macro and microvascular complications, if not managed
appropriately. Structured Diabetic Resource Centers, led by trained diabetic educators to lead and provide organized and indepth management for Type 2 DM patients will be the way forward in ensuring comprehensive and holistic care for these
patients.
A COMPARATIVE EVALUATION OF INTRANASAL KETAMINE AND INTRANASAL DEXMEDETOMIDINE FOR PREMEDICATION IN PAEDIATRIC SURGERIES.
Authors: Mahendra Bharane Pranita , Gavali Yogesh
Published: September 2023

Any surgical procedure and the preoperative phase is very stressful for both the parents and the children.
Premedication in children should aim at relieving this stress and anxiety. Several drugs have been used
to nd the best sedative agent and the best route of administration of these drugs in children. Both the drugs ketamine and
dexmedetomidine are effective for premedication in children undergoing surgery. Comparison of the efcacy of intranasal
ketamine (6mg/kg) and intranasal dexmedetomidine (1mcg/kg) as premedication in pediatric patients undergoing elective
surgeries was done. This was a randomized, comparative, double blinded, prospective, single center study conducted in a
tertiary care institute. It was found that Intranasal injection of ketamine (6mg/kg) as premedication proved better to relieve the
Parental separation anxiety and for better mask acceptance in pediatric patients between 2-9 years of age. Ketamine showed
signicantly better response than dexmedetomidine in context to no fear and anxiety and aggression to intravenous
cannulation, and good behavioral response, and children were calm during parental seperation while taking them to OR, and
also, parents were highly satised by this clinical outcome.
ABSTRACT
KEYWORDS : Pediatric patients, Premedicat
A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF LEVOBUPIVACAINE VERSUS ROPIVACAINE FOR POST OPERATIVE ANALGESIA UNDER SEGMENTAL SPINAL ANAESTHESIA IN LAPAROSCOPIC CHOLECYSTECTOMY.
Authors: Patel Pratik , Rathod Shalini
Published: September 2023

Laparoscopic Cholecystectomy is normally performed under general anaesthesia, but regional
techniques like Segmental spinal have been emerging and found benecial. Now adays laparoscopic
surgeries are commonly performed on a day care basis. Although of less intensity, laparoscopic surgeries do have some
amount of pain. This post-operative pain, to some extent, limits early post operative recovery and extends hospital stay.
Segmental spinal provides excellent post operative analgesia. Materials and methods: Total 60 patients aged between 18
and 60 years of either sex, with American Society of Anaesthesiologist status(ASA) I/II and body mass index >18.5 to <25,
scheduled to undergo elective laparoscopic cholecystectomy were enrolled for the study. Patients were randomized into two
groups with 30 patients in each group. Segmental spinal was given at T9-10 space using 27 gauge spinal needle, Group L
received 1.5ml Levobupivcaine(0.5%) + Inj Fentanyl (25mcg) while Group R received 1.5ml Ropivacaine (0.5%)+ inj
Fentanyl(25mcg) intrathecally. Results : The demographic details and the preoperative hemodynamic were comparable in
both the groups. Duration of postoperative analgesia observed from the time of spinal injection to rst demand of rescue
analgesia in the recovery room was more in group L(154.73 ± 19.74) as compared to group R(121.40 ± 22.22). Intraoperative
hemodynamics were comparable and stable in both the groups. Conclusion: In comparison to the Ropivacaine group, the
duration of postoperative analgesia was signicantly prolonged in the Levobupivacine group. Both Levobupivacaine and
Ropivacaine provide good hemodynamic stability intraoperatively.
RARE CASE OF MALROTATION OF GUT IN AN ADULT PRESENTING WITH VAGUE CHRONIC ABDOMINAL PAIN
Authors: Praveen Pallam , Jain M Bhavesh , Bhanuprakash Reddy Manchuri
Published: September 2023

Malrotation is a midgut developmental anomaly. Normally intestinal rotation occurs around Superior
Mesenteric Artery. In case of Malrotation there is failure of rotation and xation of intestine. Usually it is seen
in children. It is seen rarely in adulthood. It is usually asymptomatic but in symptomatic cases surgical intervention may be required.
While it is difcult to diagnose, prompt diagnosis and surgical intervention lead to a positive outcome. In the present report, a case of
incidental intestinal malrotation with clinical ndings of vague chronic abdominal pain is discussed with a literature review.
AN INFERENTIAL APPROACH TO AGENTS OF RADICALIZATION OF TERRORISM
Authors: Oxley Mark , Collins Mary , Lyons Joe , Schootman Mario , Heidbreder Bill , Higgs Gary , Higgs Melissa
Published: September 2023

Predicting the behavior of individuals and institutions in society is an important and complex task, this is
especially critical in the case of potential terrorism. This importance is due to the fact that terrorism
behavior is destructive to civilized societal function. The difculty associated with terrorism is that it is the result of the interplay of
invisible obscure forces & energy operating in the virtual background on the constellation of societal entities. GIS has become a
major tool of visualizing the physical artifacts of the rituals and behaviors on the landscape. This paper introduces a framework
for systematizing the visualization of the causes of behaviors through inferential GIS in a space time and phase space structure
through Oxley's General Model operating an iterative classier.
ICHTHYOSIS PREMATURITY SYNDROME: A RARE CASE REPORT
Authors: Kumar N T Mohan , Hulman Manjunath
Published: September 2023

Ichthyosis prematurity syndrome (IPS) is a rare autosomal recessive disorder of cornication
characterized by the clinical triad of premature birth, thick caseous desquamating epidermis, and
neonatal asphyxia. It is caused by mutations in the SLC27A4 gene or FATP4 gene encoding fatty acid transport protein 4 (FATP4)
leading to defective lipid homeostasis, affecting keratinocyte differentiation and skin barrier formation. The IPS babies are
most commonly born premature and at gestational weeks 30 to 34. Immediately after birth asphyxia is typically noted probably
due to aspiration of amniotic debris. At birth, the skin is covered by a thick, caseous, desquamating epidermis. Later in the
course of the disease, the child's health improves rapidly, changing to follicular hyperkeratosis, dryness of the skin, and ne
white scaling at the scalp that persists into adulthood. Overall, IPS is recognized rarely, and only a few cases have been
reported. Diagnosis is essential in order to reassure parents about the benign course of the disease after complications in the
perinatal period and to offer genetic counselling.
SUDDEN CARDIAC DEATH RISK ASSESSMENT AND SPORTS INVOLVEMENT AMONG ATHLETES: A COMPREHENSIVE REVIEW
Authors: Sebastiań Zinho Salazar Zuń ĩga Juan
Published: September 2023

In the realm of sports cardiology, denitions are pivotal in evaluating sudden cardiac death (SCD) risk.
Athlete categories young, masters, competitive, and recreational- provide contextual frameworks.
Optimizing participation necessitates balancing the intricacies of cardiovascular conditions. Structural anomalies like
hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy mandate judicious approaches. The
enigmatic interplay of exercise and inherited arrhythmia syndromes necessitates cautious engagement. Amidst these
complexities, the symphony of cardiac health and athletic pursuit unfolds, with each note representing a nuanced facet of
prevention and well-being.
ABSTRACT
MPV, A SIMPLE MARKER TO PREDICT COVID-19 REL
Authors: Fatih Sari M. , Ozan Gokuc A.
Published: September 2023

Background: Mean platelet volume (MPV) is a simple and cheap blood parameter which is widely
available all around to world. Previously it was showed that MPV may be a good predictor for the
underlying systemic inammation. Thus, in the current study, we aimed to analyze whether it is a useful biomarker to predict the
mortality among the subjects over 60 years old. Material- Method: We included 119 subjects over 60 who were admitted to
intensive care unit due to COVID-19 infection and 26 healthy controls who were matched based on gender, age and the
presence of diabetes mellitus and hypertension. Results: Baseline demographic features of thesubjects and healthy controls
were similar. MPV level in serum were found to be elevated among the subjects with COVID-19 infection compared to health
controls. Among COVID-19 infected subjects, MPV were also higher in deceased subjects than that in recovered group. Linear
regression analyses revealed that elevated MPV level increased the risk of mortality 8 times (p value 0.005). Conclusion: A
widely available parameter of complete blood count analyses, MPV, could be a simple, accurate predictor for mortality among
COVID-19 infected subjects over 60.
PANDEMICS AND THE ETHNOGRAPHER'S DILEMMA
Authors: Paul Satyaki , Chatterjee Sabatini
Published: September 2023

Pandemics are real-time catastrophe that necessitates a rapid reaction, reducing reliance on culturalist
interpretations of illness and health that impede traditional anthropological investigations.
Ethnographers' responsibilities shift from raising awareness of indigenous beliefs about health and sickness to addressing
problematic customary rules of practice and enhancing patient-physician trust. The roles have also been expanded to
incorporate the cultural appropriateness of disease containment strategies and explain the local beliefs about pandemic
events. In this vein, while conventional ethnography has become a semi-illegal practice with the institutionalization of the 'New
Normal', ethnographers are negotiating this particularly entangled scenario with strategies to create a critical space to
interrogate the varied nature of social impacts of outbreak response particularly different forms of social exclusion in different
cultures
ASSESSMENT OF EXTRA PANCREATIC MANIFESTATIONS OF ACUTE, SUBACUTE AND CHRONIC CALCIFIC PANCREATITIS
Authors: Reddy Suresh , S C Sanjay , Bansal Shivam , S Srinivas
Published: September 2023

Introduction: Pancreatitis accounts for 6-10 per cent of all cases of abdominal pain among patients
admitted to hospitals in India. Pancreatitis may sometimes involve multiple organ systems and place
demands on the surgeon beyond his or her skills. Patients with systemic complications should be managed by a
multidisciplinary team that includes intensive care specialists. It is important to determine the presence and degree of
association of these intra-abdominal conditions with acute/subacute/chronic calcic pancreatitis. Aim &objective: To analyze
the various systemic manifestations of pancreatitis, including both gastrointestinal and extra-intestinal features. Methods And
Materials: It is a prospective and retrospective observational clinical study in patients who are more than 18 years of age, have
typical symptoms like epigastric pain, nausea, vomiting with serum amylase and/or lipase levels elevated 3-4 times above
normal and proven imaging diagnosis of acute/subacute/chronic calcic pancreatitis. Contrast Enhanced Computed
Tomography (CECT) imaging protocols for abdomen and pelvis with GE 16 Signa Channel were followed. P Results:- atients
with pancreatitis can have a wide range of other features like ascites, pleural effusion, liver features like fatty hepatomegaly ,
portal hypertension, chronic liver parenchymal changes, hepatic infarct, gall bladder or biliary tract pathologies like calculous
or acalculous cholecystitis, choledocholithiasis, cholangitis, renal changes like pyelonephritis, calculi, cysts, vascular changes
like splenic/superior mesenteric/portal vein thrombosis, splenic pathologies like splenomegaly, splenic infarct, lung
involvement etc. Pancreatitis is one of the leading causes of abdominal pain as well as hospital ad Conclusion: mission due to
gastrointestinal disease and thus amounts to a signicant health burden. It can have widespread systemic (both visceral and
vascular) associations. These extra-pancreatic features may have important implications for the treating surgeon as they may
be able to anticipate the possibility and frequency of these associated manifestations and treat with a more wholesome
approach, thus reducing signicant morbidity and mortality.
A COMPREHENSIVE REVIEW OF HYPERTENSIVE DISORDERS IN PREGNANCY: CURRENT PERSPECTIVES AND FUTURE DIRECTIONS
Authors: Eduardo Millan Julio Alejandro
Published: September 2023

Hypertensive disorders during pregnancy encompass various conditions, including preeclampsia,
gestational hypertension, chronic hypertension, and preeclampsia superimposed on chronic
hypertension. Accurate diagnosis is crucial for management decisions, timing of delivery, and assessing maternal prognosis.
Healthcare providers must consider other medical disorders with similar features. PlGF-based tests can aid in ruling in or ruling
out preeclampsia between 20+0 and 36+6 weeks of gestation, offering improved prediction capabilities. Differentiating
between these disorders can be challenging, but careful examination of blood pressure trends, proteinuria, and end-organ
dysfunction signs can help. Recurrence rates of preeclampsia in subsequent pregnancies are signicant, and it is associated
with long-term maternal cardiovascular risks and diseases. Personalized management strategies and biomarkers hold
promise for future research in preeclampsia, providing better prediction and intervention strategies for improved maternal and
offspring outcomes.
FREQUENCIES OF HYPERTENSION, DIABETES MELLITUS, AND CHRONIC KIDNEY DISEASE AMONG CORONARY ARTERY DISEASE PATIENTS
Authors: Kumar Pandey Abhay , Pandit Abha
Published: September 2023

Background: Coronary artery disease (CAD) is becoming a major cause of mortality and morbidity in
developing and developed countries now. Hypertension, diabetes mellitus as well as chronic kidney
disease (CKD) are treated as some major comorbidities for coronary artery disease patients. We have very limited researchbased information regarding the frequency of hypertension, diabetes mellitus and chronic kidney disease among coronary
artery disease patients. The aim of the study was to assess the frequencies of hypertension, Aim of the study: diabetes mellitus
and chronic kidney disease among coronary artery disease patients. This was a prospective ob Methods: servational study
and was conducted in the Department of Medicine, Index Medical College and Research Centre, Indore, India from June 2020
to May 2021. A total of 83 patients with coronary artery disease (CAD) were included in this study as the study subjects. A
convenient purposive sampling technic was used in sample selection. All the clinical as well as demographic information of the
participants was recorded. A predesigned questionnaire was used in data collection. All data were collected, processed and
analyzed by using the MS Ofce program. In analyzing the frequencies of hypertension, diabetes and Results: CKD among
our total participants, we observed that only hypertension, diabetes and CKD were in 10%, 7% and 6% cases, respectively. On
the other hand, hypertension with diabetes, hypertension with CKD and diabetes with CKD were present in 11%, 8% and 6%
cases, respectively. Among our total participants, in 5% of cases, all the 3 diseases, hypertension, diabetes and CKD, were
present and 47% were free from those diseases. Hypertension is the most frequent comorbid Conclusion: ity in patients with
coronary artery disease patients as a single comorbidity. More than 50% of CAD patients have any one or more types of
comorbidities among hypertension, diabetes mellitus and CKD.
CORONARY ARTERY BYPASS SURGERY IN ELDERLY PEOPLE A INSTITUTIONAL RETROSPECTIVE STUDY
Authors: Senthil V. , Sanjeev Pandian R.
Published: September 2023

Objective: To Study the prognosis and outcome in elderly people present with coronary artery disease
under going coronary artery bypass surgery in our institute. Methods: 134 elderly patient who are 65
years and more than 65 years who underwent coronary artery bypass surgery between January 2017 to December 2022 who's
datas are collected from our computer stored data and from medical record department in our college and from Tamilnadu
chief minister comprehensive health insurance scheme institutional Web site data base. Results: 1184 cases of coronary artery
bypass surgery done in our institute from January 2017 to December 2022 from this 134(11.3%) cases are elderly patient, mean
age 67. 6 years (range 65-75 years) highest of 85 years old female operated in this period. The indication for surgery was triple
vessel disease in 65 patient(48.5%) ,double vessel disease in 40 patient(29.8%),single vessel disease in 5 patient, single vessel
disease with ventricular septal rupture in 1 patient, left main coronary artery stenosis in 44 patient(32.8%),12 patient with post
coronary stent. Surgical procedure Off pump coronary artery bypass surgery in 108 patient(81%), On pump beating heart
coronary artery bypass surgery in 5 patient (3.7%),On pump arrested heart coronary artery bypass surgery in 6 patient(5.35%)
with mitral mitral mechanical valve replacement in 1patient, with aortic mechanical valve replacement in 4 patient. A total of
320 grafts were constructed(mean 2.4 grafts per patient),35 (26%) of them being arterial only left internal mammary artery
harvested and other grafts were great saphenous vein. Post operative average ventilation time18hrs (range 18hrs to 24hrs),
There were 21(15.7%)hospital death and 15(11%) late death in follow up, total 36 (26.8%) death till now. Conclusion: intra
operative, post operative mortality and morbidity is high in patient present with severe left ventricular dysfunction, coronary
artery diseases induced complication and additional comorbidity, however most of patient recovered from post operative
cardiovascular lethal or morbid event and on regular clinical follow up
DO WE LIVE IN A SICK SOCIETY?
Authors: Manika . A . M . G Habeeba
Published: September 2023

t's no measure of health to be well adjusted to a profoundly
sick society – Jiddu Krishnamurti
ALOPECIA: AN EXTENSIVE NARRATIVE REVIEW OF TYPES, CAUSES, AND MANAGEMENT STRATEGIES
Authors: Pinzon Luna Juliana
Published: September 2023

Hair biology is a complex process involving the interaction of hair follicles, dermal papilla, and hair shaft
components. Hair loss disorders encompass various conditions, such as cicatricial (scarring) and
nonscarring alopecia, along with structural hair disorders. A thorough patient interview, physical examination, and trichoscopy
aid in diagnosing hair loss forms. Management involves addressing underlying causes, and initial treatments include topical
minoxidil and oral nasteride/dutasteride for androgenetic alopecia. Corticosteroids and platelet-rich plasma may be used for
inammatory alopecia. Treatment outcomes may vary, necessitating a tailored approach for each patient. Ongoing research
and clinical trials offer promise for more targeted and effective therapies in the future. Patients should collaborate with
healthcare providers to determine suitable treatment strategies.
A STUDY ON CSOM (CHRONIC SUPPURATIVE OTITIS MEDIA) AND ITS PREDISPOSING FACTORS IN A TERTIARY CARE HOSPITAL, PATNA, BIHARCROSS SECTIONAL
Authors: Vardhan Bhardwaj Harsh , Mishra Deepshikha , Priya Prachi
Published: September 2023

Introduction: Chronic Suppurative Otitis Media is a long-term inammation of the middle ear cavity and
mastoid antrum which is caused by a plenty of factors. Clinically, CSOM is classied into two types,
namely the tubotympanic and the atticoantral. The etiology and pathogenesis of otitis media are multifactorial and include
genetic, infections, allergy, environmental, social and racial factors and Eustachian tube dysfunction. So this study was
conducted to asses the prevalence of CSOM types and to evaluate the predisposing factors in ENT OPD of a tertiary care
hospital. Materials And Methods: A cross-sectional observational study was conducted among 100 patietns of CSOM
attending ENT OPT, of a tertiary care hospital in Patna district, Bihar, India. A pre-designed and pre-tested questionnaire was
developed , with a consent form attached to it for voluntary participation, through which data were collected and the
distributions of responses were presented as frequencies, percentages and chi-square for evaluating predisposing factors.
Results: The tubotympanic disease was present in 93% of CSOM cases while 7% had atticoantral disease.Around 83%
participants had CHL and 17% had MHL in CSOM .Around 45% had mild hearing loss ,39% had moderate hearing loss and
10% had severe degree of hearing loss.
Conclusion:
1. Duration >4 years was found signicant for tubotympanic and CHL with p value<0.05
2. Agricultural base was also found to be signicant factor for tybotympanic type of CSOM p value being <0.05.
AUTISM SPECTRUM DISORDER AND GENETIC ASSOCIATIONS IN A TERTIARY PRIVATE HOSPITAL IN NORTHERN MEXICO
Authors: Antonio Infante Cantú José , Lucila Rodríguez Rivera Sofía , Neurologist Pediatric
Published: September 2023

Background: Autism spectrum disorder (ASD) consists of a group of heterogeneous genetic
neurobehavioral disorders associated with developmental impairments in social communication skills
and stereotypic, rigid or repetitive behaviors. Aims: To review behavioral, psychiatric and genetic associations related to ASD.
Methods: Descriptive, prospective, observational and longitudinal study. Inclusion criteria were patients with ASD from July
2022-July 2023 in a tertiary private hospital. Study variables were age, gender, clinical features, level of autism, type of epilepsy,
comorbidities, genetic syndromes, epileptic syndromes and type of treatment. Information was captured in Excel and analyzed
in SPSS. Results: We review 36 patients with ASD from July 2022-July 2023. Age: 2-31, 10±24.7. Clinical features: self -injurious
behaviors 40%, aggression 35%, sleep disorders 25%. Levels of autism 1 (17- 47.2%), 2 (12- 33.3%) and 3 (7- 19.4%).
Comorbidities 27 (75%): intellectual disability 15 (41.6%), attention decit hyperactivity disorder (ADHD) 2 (5.5%), Tourette's
syndrome 1 (2.7%), global developmental delay 3 (8.3%), developmental language disorder 4 (11.1%), cerebral palsy 1 (2.7%),
migraine 1 (2.7%). Genetic syndromes 12 (33.3%): Prader Willli, Angelman, Lafora, Down, Noonan, Usher, fragile X,
lissencephaly, callosum corpus dysgenesia, neurobromatosis, tuberous sclerosis, Type II Chiari malformation. Epileptics
syndromes 4 (11.1%): West 1 (2.7%), Lennox Gastaut 1 (2.7%), atypical absences 2 (5.5%). Association was found between
severe autism and genetic syndromes with statistical signicance (p<0.05). Conclusion: Autism characteristics in genetic
syndromes demand attention across time and circumstance, to evidence and support related changes in need.
MANAGEMENT OF FORGOTTEN DJ STENT IN A TERTIARY CARE CENTER; A FORGETTABLE
MORBIDITY
Authors: Hasan Arshad , K. Das D. , Singh Rohit , K. Sinha S. , K. Malviya A.
Published: September 2023

Introduction and Objective:-In modern days and person`s busy life, forgotten and retained Double J stents are
becoming common problem in our society. Double J stents are placed in the management of various kind of urological
diseases but forgotten and retained stents causes another significant morbidity. This study focus for Proper education
and public awareness to avoid severe complications. There also need of early and universal introduction of absorbable
double j stent which can tackle this challenge. We retrospectively analysed the records of patients Methods:- presented
to the our department with forgotten or long term retention of DJ stents from January 2018 to December 2022 . All cases
were reviewed for age, gender, clinical features & surgical procedures performed. During these time Results:- period,
total 28 patients reported to our department with history of forgotten DJ stents. . Out of which 22(78.6%) were male and
06(21.4%) were females. Age ranged from 15 years to 60 years. Duration with stent in situ ranged from 6 months to 4
years. Presenting complaints of flank pain 87.5%, dysurea 50%,haematuria 35.7% LUTS 35.7% and renal failure in 14.7%
were noted. A combination of stent removal under local anaesthesia , cystolithotripsy, percutaneous nephrolithotripsy(
PCNL), ureteroscopy and open surgeries were done to clear the stones and extract the DJ stent. For Conclusion:- gotten
or retained double j stent is a source of severe morbidity due to its complications . It increases psychological and
financial burden of the patients.
WOMEN EMPOWERMENT: AN INTEGRAL TO SUSTAINABLE DEVELOPMENT
Authors: Mishra Avantika
Published: September 2023

In the concerted journey towards sustainable development, women empowerment has surfaced as a key area that cannot
be overlooked. Despite various patriarchal shackles that have timelessly bound half of the world's population, a
significant shift has gradually taken root in all corners of society. Women empowerment is not just about bestowing rights
for women; it intermeshes gender equality, women's health and safety, female education, women's rights, and economic
independence. It has now become an intrinsic goal for any society that aspires for holistic progress.
EFFECTIVENESS OF GYANKUNJ PROJECT IN GOVERNMENT PRIMARY SCHOOLS OF
GANDHINAGAR CITY
Authors: Tarunkumar Balabhai Kuvad
Published: September 2023

The Gyankunj project is the initiative of Government of Gujarat to boost the education through technology.The Gujarat
government launched the Gyankunj project as a means of advancing education.The main goals of this research report
were to evaluate the facilities, learn about the academic standing of the students, and gauge how they felt about the
Gyankunj initiative.With the use of the survey approach,the researcher discovered the outcomes of a quantitative study
with a sample of 10 schools and 97 students.The hypotheses based on variables are the academic performance of the
children in the schools where the Gyankunj programme is implemented and the schools where it is not implemented
differs significantly.Additionally,there is a strong association between academic success and students' opinions at the
school where the Gyankunj programme is offered. For evaluating the tested hypotheses, there was the Reaction Scale,
the Achievement Test and Checklist. The Achievement test comprises 40 questions that are based on Gyankunj
programme elements. The results finds that the Correlation Between Achievement Scores and Reactions of Students
related to the Gyan Kunj Project was 0.435959. which shows a partial positive correlation. The significant difference
between the mean scores of students studying in Schools running the Gyankunj Project and Schools not running the
Gyankunj Project in Gandhinagar City was found 5.503 at 0.1 level. The result shows that the achievement score of
students in schools without the Gyankunj project is comparatively less. Students who got more scores on the
Achievement test gave more positive reactions to Gyankunj Project.And it is also remarkable to note is the most of the
schools,the equipment provided in this project is working properly and care is taken by the school staff
PREOPERATIVE SERUM ALBUMIN AS A PREDICTOR OF POST OPERATIVE MORBIDITY
AND MORTALITY IN PERFORATION PERITONITIS
Authors: Thakur Tapsh , Sharma Aabha , Thakur Naqsh , Bhansali Yogita
Published: September 2023

Introduction: Peritonitis due to perforation of the gastrointestinal tract is one of the most common surgical emergencies
all over the world. Wound healing requires energy and is a catabolic process. Patients who are severely malnourished
demonstrate impaired wound healing and predisposition to infection. In humans, albumin is the most abundant plasma
protein, accounting for 55-60% of the measured serum protein. The association between hypoalbuminemia and poor
outcomes has long motivated clinicians in administering exogenous albumin to hypoalbuminemic patients. Hence there
is a need for such a study which would assess risk factors contributing to adverse post-operative outcomes and hence
assess whether early correction of albumin levels can prevent complications. To study and Aim And Objectives:
evaluate the correlation between the preoperative serum albumin levels and postoperative morbidity and mortality in
diagnosed cases of perforation peritonitis. All the patients undergoing Exploratory Material And Methods :
Laparotomy due to the any cause of Perforation Peritonitis will be included in the study. Assessment and repair of
perforation was done. Patient will be observed for minimum 7 days for post-operative period to observe any morbidity
or mortality for the study. Exlusion and inclusion criteria were made accordingly. The serum albumi Results: n was
significantly decreased in patients between the age of 41 to 60 years, whereas serum albumin was significantly
increased in the patients of younger age group. Patients living in the rural area had serum albumin < 3.5 g/dl, whereas
those living in the urban area had serum albumin more >3.5 g/dl. The findings were statistically significant. (p=0.006).
Wound complications were significantly more in patients in which serum albumin was less than 3.5 g/dl. (p=0.001).
Duration of stay in the hospital was found to be more than 7 days if serum albumin was less than 3.5 g/dl. Conclusion:
Preoperative Albumin levels can be used as single indicator to predict the mortality and morbidity in patients of
Perforation peritonitis and can help in early prediction of complications and managing them accordingly.
ASSESSING THE ORAL MANIFESTATIONS AMONG CHRONIC RENAL FAILURE PATIENTS
IN CHENGALPATTU DISTRICT TAMILNADU – A CASE-CONTROL STUDY
Authors: Priyalakshmi A Deepika , B Ravisankar , M Deivanayagi , M Preethy , E Ramji
Published: September 2023

Aim:To determine the nature,incidence,and severity of oral manifestations that occur in chronic renal failure patients in
Chengalpattu district Tamilnadu. Methods: A total of 100 people participated in the study—50 CRF patients and 50
controls.The control group was chosen from the same age range as the case group,had a normal GFR,and seemed to be
disease-free.The case group was chosen at random from a population of CRF patients with GFR values between 15 and
30 mL/min. To rule out any signs, the patients underwent an intraoral examination. The outcomes of the investigation
were then contrasted with those of several other comparable studies. Results:The most prevalent oral conditions in CRF
patients were halitosis (34%),changed taste (42%),pallor (88%),and dry mouth (90%).CRF patients had much greater
oral alterations than individuals in the control group. These alterations could be attributable to metabolic problems
brought on by renal failure. Conclusion: Significant oral alterations in the individuals who were the subject of the study
provided evidence of the influence of CRF on the oral cavity and suggested a connection between CRF and oral health. To
link the severity of such alterations to disease progression, more research is needed.
A STUDY OF THE FACTORS AND BARRIERS FOR GREEN SANITARY PRODUCT USAGE
Authors: Das Chatterjee Arundhati
Published: September 2023

Menstruation products are crucial elements in a woman's life as it helps in collecting menstrual fluids hygienically.
Reasons behind women choosing a particular menstrual product are myriad and complex, factors often been
interrelated. Since prehistoric times there had been a mute struggle of young girls and women folks to carry on their
daily chores smoothly along with menstruation. However, at present the sanitary products available in the market are
detrimental for the environment because of the usage of hidden plastic. Hence the rising trend of using green or
menstrual products.This study explores the factors and barriers for a consumer in choosing a green sanitary product.
This involves a systematic literature review relating to the usage of menstrual product and a case study based on one of
the states of India,West Bengal with a sample of 142 females. Study reveals a significant difference in green sanitary
product usage with respect to its awareness,income and education of the sample.
FUNCTIONAL AND RADIOLOGICAL OUTCOME OF LOCKING COMPRESSION PLATE FOR
DISTAL TIBIA FRACTURES USING MIPPO TECHNIQUE – A PROSPECTIVE STUDY
Authors: Ramij Raja Mijajuddin Hanfi Sheikh , Wagh Aniket
Published: September 2023

Background: Distal Tibia fracture is one of the most substantial therapeutic challenges that confronts an orthopaedic
surgeon. Numerous features are responsible for this, but perhaps none are as difficult as the accompanying soft tissue
injury that is frequently present. They are only 1-10% of all lower extremity fractures. Plating has been the conventional
management strategy for such fractures. However, restoration of the osseous anatomy while ignoring the oftentraumatized soft tissue envelope, frequently led to poor postoperative outcomes and high complication rates. This
prompted for more research into the treatment strategies. The conventional plating techniques are thus rapidly being
replaced by low profile Locking Compression Plates (LCP). They give higher degree of stability and provide better
protection against primary and secondary loss of reduction. Since open reduction in lower end tibial fractures often
jeopardizes vascularity of the fracture fragments, minimally invasive percutaneous plate osteosynthesis (MIPPO) is
slowly becoming the best possible option permitting adequate fixation in a biological manner. Materials And
Methods: This is a prospective study for a period of 2 years from 1ST June 2015 to 31st May 2017 done under the
guidance of the ethical committee of the hospital. It includes 36 cases of fractures of lower end tibia in adults. Patients
were evaluated as per the history, mode of injury and clinical findings pre-operatively, duration of surgery, time for
fracture union, complications, and functional outcome post-operatively. Clinical and radiological follow-ups were taken
at intervals of three weeks. OLERUD-MOLANDER scoring system was used to analyse functional outcome at the end of 6
months. According to OLERUD-MOLANDER scoring system, at the end of 6 months, 28 out of 36 patients Results: (78%)
had excellent outcome, 5 (14%) had good results, 1 (3%) patient had fair outcome and 2 (5%) patients had poor results.
The average duration of surgery was 77 minutes. Average time of fracture healing was 12 weeks with three cases of
delayed union i.e., 20 weeks. There were no intra-operative complications. Post-operatively 3 patients had superficial
wound infection and 6 patients had ankle stiffness. The present case series concludes that MIPPO wi Conclusion: th LCP
is an effective treatment modality in terms of union time and complication rate for distal third tibia fractures. The outcome
is evidently better than the open reduction and internal fixation technique with conventional plates.
OUTCOMES OF IVOR-LEWIS AND MINIMAL INVASIVE MCKEOWN ESOPHAGECTOMY FOR
LOWER AND MIDDLE ESOPHAGEAL CANCER.
Authors: Ryul Park Chang , Kyu Kim Dong
Published: September 2023

Background: Ivor-Lewis esophagectomy and Mckewon esophagectomy are used to treat esophageal cancer, and minimally
invasive technique is increasingly adopted to lower morbidities and complications after operation. Surgical approaches to
esophageal cancer are not standardized however. This study compares results of Mckeown esophagectomy as minimally
invasive technique with the conventional Ivor-Lewis esophagectomy. Data of patients underwent Ivor-Lew Methods: is
esophagectomy (ILE) or minimally invasive Mckeown esophagectomy (MIME) operation from January 2009 to December 2019
were retrospectively collected. Preoperative conditions, cancer characteristics, and operative outcomes were selected as
variables for analysis. Total 125 patients undergone surgery for esophagus, 54 got ILE for esophageal cancer and 65 got MIME.
Results: Despite minimally invasive approach, Mckeown esophagectomy tend to get more complications than Ivor-Lewis
esophagectomy. Postoperative arrhythmias and vocal cord palsy occurred significantly higher in MIME group than ILE. Fatal
complications like pneumonia, bronchoesophageal fistula, stenosis or leakage of anastomosis site also appeared more
frequent in MIME group with low significance. Short term mortalities showed no difference. When comparing total survival and
disease-free survival at middle to lower esophageal cancer, MIME group seemed better survival and lowerer cancer
recurrence than ILE group, although significance was low. Surgical methods should be thoroughly consid Conclusions: ered in
managing esophageal cancer due to possible postoperative morbidities. MIME tend to have higher postoperative
complications than ILE, but short-term mortalities showed no differences. When managing middle and lower esophageal
cancer MIME can be an option to lower cancer recurrence and better survival.