bluuebunny/crossref_metadata_2025 huggingface dataset:
Zinc(II) and Cadmium(II) Salphen Catalyzed Alkylation Reactions to Form α-Alkylated Ketones
Authors: GÜNNAZ Salih
Published: December 2022

The zinc (II) and cadmium (II)-salphen catalyzed α-alkylation of ketones with primary alcohols is reported. Various α-alkylated ketones were obtained in good yields through a borrowing hydrogen strategy by using 1 % of catalysts and a catalytic amount of NaOH (10 mol%) as the base under air atmosphere. All synthesized compounds were characteized by 1H and 13C NMR.
Clinical characteristics and treatment modalities of vulvovaginal atrophy in genitourinary syndrome of menopause
Authors: Cho Hae Jung , Seo Jong Wook , Yoon Ji Sun , Chung Jae Eun
Published: December 2022

Background: Genitourinary syndrome of menopause (GSM) causes symptoms such as vaginal dryness, dysuria, repetitive urinary tract infection and urinary urgency may affect daily activities, sexual relationships, and overall quality of life. The aim of the study was to provide the clinical characteristics of VVA patients in South Korea and the effectiveness as well as complications of the currently used low dose estrogen vaginal suppository.Methods: 52 women who has visited the outpatient gynecology clinic of the National Health Insurance Service Ilsan Hospital from January 2018 to December 2019 were recruited as study subjects. For the analysis of the clinical characteristics, subjective symptoms described by the patient’s own words such as vaginal dryness, pain, dysuria, dyspareunia, or no symptoms at all were included. Objective signs such as thinning of vaginal rugae, mucosal dryness, and mucosal fragility and the presence of petechiae were recorded.Results: Vaginal dryness was the most common complaint (92.3%). Thinning of the vaginal rugae was the most commonly noted objective sign (73.1%). Of the 52 subjects, 31 (59.6%) refrained from using the low dose estrogen vaginal suppository. The most common reason for not being able to use the suppository was the inability to insert the suppository (32.3%).Conclusions: Although patient-reported symptoms and clinical objectivity through physical examination are two components in diagnosing VVA, further study is warranted for a more objective and discriminatory diagnosis criteria for VVA. As the only available treatment modality was low dose vaginal estrogen suppository, comparison with other treatment modalities were not available.
A study illustrating the risk factors, clinical presentation and management of ectopic pregnancy in a secondary hospital in Bahrain
Authors: Shaltout Ola , Deen Fatema Waheed Akbar Mohammed Akbar Nawab , Mustafa Nawal Usman , Desouky Marawan Mohamad ElSayed Mohamed , Gupta Alka , Jeddy Rafiea
Published: December 2022

Background: Assess the risk factors, clinical presentation and type of intervention indicated in ectopic pregnancies at American mission hospital in Bahrain. Methods: This is a retrospective cohort study conducted from August 2021 to April 2022 at American mission hospital in Bahrain. All patients (n=205) who attended the hospital from January 2017 to June 2021 with a presentation suggestive of ectopic pregnancy were extracted from the electronic medical record database and reviewed. Data was recorded on Microsoft Excel version 16.61.1 and numerical data was extrapolated into graphs and tables via IBM SPSS Statistics version 28.0.0.0 (190). Data was subjected to descriptive and stratification analysis. Results: The leading risk factor for ectopic pregnancy was previous pelvic surgery (40.4%). The most reported symptom was amenorrhea (65.9%). Risk of rupture was tripled when serum B-hCG level was elevated, rendering it the strongest predictor of rupture according to our data (95% CI=1.25, 7.19; p-value 0.0139). Majority of patients (56.4%) were treated with methotrexate with a success rate of 88.7% and 8.5% of cases were managed expectantly. Those who failed medical management or presented with rupture were treated surgically.Conclusions: Our study found B-hCG levels to be the most sensitive predictor of rupture and need for surgical intervention. Therefore, management was largely, but not exclusively, based on B-hCG levels. Majority of cases were treated medically and patients undergoing expectant management experienced no complications.
Analysis of endometrial biopsy reports from adult women with abnormal uterine bleeding, a cross-sectional descriptive study
Authors: Keshta Mohamed S. , Keshta Ahmed S. , Husain Manar , Gomaa Hoda N. , Ehiwario Jennifer , Gupta Alka , Jeddy Rafiea
Published: December 2022

Background: Abnormal uterine bleeding is a common complaint in most women of different ages that prompts seeking gynecologic care. This study aimed to analyze and age-classify the prevalence of endometrial pathologies in women with abnormal uterine bleeding.Methods: This is a cross-sectional and a descriptive study, conducted at the obstetrics and gynecology department of the American Mission Hospital in the Kingdom of Bahrain on 88 patients who presented with abnormal uterine bleeding between January 2019 and January 2020.Results: Eighty-eight women with abnormal uterine bleeding demonstrated a fluctuating pattern of twenty endometrial pathologies distributed among five age groups in the range of 30-71. The mean age of the study cohort was 44.9±7.65 years; 55% of which were reported in the 41-50 age group. Benign endometrial polyp was reported as the most common pathology, accounting for 47.8% of the cohort. Although benign endometrial polyp was significantly the highest overall finding in all three age groups younger than 60, disordered proliferative endometrium was the highest reported single pathology in the age group 41-50, (N=10, p≤0.0001).Conclusions: This study demonstrated that benign endometrial polyp was the most common finding in women with abnormal uterine bleeding. This information could be essential for patient guidance and awareness of the benefits of endometrial biopsy. Eventually, the prediction of the potential endometrial pathology in women with abnormal uterine bleeding is vital for early disease management.
Clinical features of endometriosis: a review of literature
Authors: Thatikonda Rajashree , Palve Tushar , Shaikh Soheil , Bulchandnani Priya , Kulkarni Sejal , Devnikar Komal
Published: December 2022

Aim: To know the clinical features and prevalence of infertilityin endometriosis.Objectives: 1. to discuss clinical features of endometriosis2. to know the prevalence of infertility in endometriosisMaterial and methods:Background: The study shows the clinical features of endometriosis, common laparoscopic findings of endometriosis, and incidence in a particular age group. Objectives of current study were to discuss the clinical features of endometriosis and to know the prevalence of infertility in endometriosisMethods: Cases of infertility, chronic pelvic pain, dysmenorrhoea, and laparoscopically diagnosed endometriosis were considered for this study.Results: Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, dysmenorrhoea, dyspareunia, and infertility.Conclusions: This study show typical clinical features and prevalence of infertility in patients with endometriosis in a tertiary care centre.Cases of infertility, chronic pelvic pain, dysmenorrhoea, and laparoscopically diagnosed endometriosis were considered for this study. Results and conclusion: Endometriosis is a disease in which the endometrium (the tissue that lines the inside of the uterus or womb) is present outside of the uterus. Endometriosis most commonly occurs in the lower abdomen or pelvis, but it can appear anywhere in the body. Symptoms of endometriosis include lower abdominal pain, dysmenorrhoea, dyspareunia, and infertility. This study is to know the common clinical features and prevalence of infertility in patients with endometriosis in a tertiary care centre.
Analysis of outcome of vaginal hysterectomy and pelvic floor repair by POPQ system
Authors: Devnikar Komal , Palve Tushar , Shaikh Soheil , Bulchandani Priya , Kulkarni Sejal , Thatikonda Rajashree
Published: December 2022

Background: To assess the relief of symptoms and efficacy of vaginal hysterectomy and pelvic floor repair surgeries in patients with pelvic organ prolapse.Methods: A total of 55 women participated in the study. Vaginal hysterectomy with or without anterior and posterior colporrhaphy and fothergills surgery were done in all cases. Patients were followed postoperatively about symptom relief and the anatomical correction was analyzed at 6 months using Pelvic Organ Prolapse-Quantification (POP-Q) System.Results: The highest incidence of POP was between 41 to 50 years of age and in multiparous women with parity 2 and more than 4. 36.36% had stage III prolapse when measured using the POPQ classification. Something coming out per vaginum was the commonest complaint seen in 100% of the patients. The improvement of all symptoms was significant (p value <0.05).Conclusions: There is significant anatomical restoration and symptom relief after surgery by POPQ.
A cross sectional study on COVID-19 vaccination during pregnancy and its safety, perinatal and neonatal outcomes in a tertiary care hospital
Authors: Sitimani Anita , P. Achala K. , S. Bandamma N.
Published: December 2022

Background: Pregnant women are more likely to suffer severe COVID-19 illness, during the second wave of the COVID-19 pandemic in India, there were increased pregnant cases of severe COVID-19. Following first wave due to the wild alpha variant, the vaccine efficacy was questioned during second wave caused by beta and omicron. When compared to receiving only two doses, a third dose (booster dose) that was given at least five months following the second dose significantly decreased the rate of COVID-19 symptoms and severe COVID-19 caused by all variants.Methods: A prospective hospital based cross-sectional study was undertaken at SSIMS AND RC, Davangere. This study was conducted on pregnant women visiting antenatal clinics and delivering at the department of OBG at S. S. hospital, Davangere.Results: The data was collected from Feb 2022 to April 2022 at our institute in women undergoing delivery with history of COVID 19 vaccination during pregnancy. A total of 188 cases were studied in the following duration, majority of the women belonged to the age group of 26 to 35 years. 54.8% of the cases were multiparous followed by 45.2% of the cases who were primigravida’s. The mean gestational age during admission and delivery of the patients involved in the study was 37.33 weeks, ranging from as early as 27 weeks of gestation to 40 weeks of gestation. There was no significant correlation between the neonatal and maternal complications seen in the study to the number of doses, gestational age and type of vaccine.Conclusions: Vaccinating everyone is the most effective method of battling the current COVID-19 outbreak. Despite the lack of sufficient clinical data on long-term side effects, the decline in the number of new cases, critically sick patients, and mortality in many nations suggests that vaccines will put an end to the pandemic.
A study of caesarean section rate by using Robson's ten group classification system at tertiary care hospital, Ahmedabad, India
Authors: Patel Maurvi V. , Jivani Bhoomi D. , Patel Swati N.
Published: December 2022

Background: Caesarean delivery rate is rising continuously worldwide and is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries thereby helps to optimise caesarean section rates. Methods: This study was conducted at GMERS medical college and hospital, Sola, Ahmedabad, Gujarat, India. All patients who delivered between November 2021 and May 2022, were included in the study and were classified in 10 groups according to modified Robson’s classification system. The CS rate and contribution to the overall CS rate was calculated within each group.Results: Total number of deliveries was 836, out of them 242 was CS. The CS rate was 28.94%. The main contribution to overall caesarean rate was 39.67% by group 5, followed by 17.77% by group 1, 10.33% by group 2. CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 88% in nulliparous breech (group 6), 84.95% in previous CS (group 5), 40.62% in multiparous breech (group 7) and least 3.57% in multipara spontaneous labour (group 3).Conclusions: The Robson groups 1, 2, 5 and 6 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be a few effective strategies.
Effect of elective cerclage versus rescue cerclage in pregnancy and its pregnancy outcome
Authors: Gupta Surbhi , Kumari Gitanjali , Taralekar Vaishali
Published: December 2022

Prolongation of the pregnancy in cases of incompetence of cervix or short cervix can be done by prompt diagnosis at the correct time with a decision on encirclage taken at the right time. An observational retrospective study conducted over a period of 6 months in a tertiary care centre enrolling 14 pregnant women who had various risk factors like multiple gestation, short cervix, cervical incompetence, bad obstetric history, anomalous uterus, in vitro fertilization technique, history of primary infertility ,recurrent abortions and mid-trimester losses or preterm delivery, and the results were interpreted with various tables and charts showing the benefits of elective versus emergency encirclage. Through the study, it was found that there wasn't any significant difference in the incidence of a patient who underwent cervical encirclage whether the patient had a prior antenatal registration or not. 71% of the patients enrolled for encirclage were primigravida and the most common gestation age was between 12-24 weeks. The most common age group was 21-30 years of age. Cervical incompetence and short cervix were the most important risk factor needed for cervical cerclage. Most of the patients delivered at around 34-37 weeks of gestation. 21.4% patient underwent rescue cerclage and delivered between 34-37 weeks of gestation. 57.14% underwent elective cerclage and delivered near term. Elective cerclage has a better outcome of pregnancy to reach near term than rescue cerclage.
Caesarean section with breech presentation and shaft femur fracture in newborn: a rare case report
Authors: Tiwary Rimple , Tiwary Manish Kumar
Published: December 2022

Vaginal delivery for breech presentation is always associated with a higher risk of injury to the newborn as compared to caesarean delivery. A male infant was delivered by elective caesarean section at 40 weeks of gestation for breech presentation. During extraction, the newborn sustained a right femur shaft fracture. A simple splint with immobilization along with leg raise led to complete healing without complication. Caesarean delivery is associated with a reduced risk of newborn birth injuries as compared to vaginal and instrumental delivery but rare accidental complication can be possible.
A rare case of Nabothian cyst presenting as mass per vagina
Authors: N. Sunanda , Goulay Jyothi C.
Published: December 2022

Nabothian cysts are benign non neoplastic disorder rarely of any clinical significance usually appear as bumps on the surface of the cervix which may be single or in groups and they appear as a sequalae to chronic cervicitis, are asymptomatic unless they are sizeable presenting with rare and varied symptoms. Generally, Nabothian cysts do not require any therapy. The therapy is recommended when a patient becomes symptomatic with pain or when the lesion character is not clear and malignancy cannot be ruled out. Here we reported a case of 23-year young unmarried girl nulligravida with complaints of mass per vagina. On local examination an irregular polypoidal mass was seen protruding outside the introitus measuring about 4×4 cm soft to cystic in consistency. Ultrasound revealed a well-defined anechoic cyst of 3.6×5.7 cm noted in the right ovary with no evidence of internal septation/solid component and wall calcification suggestive of right ovarian simple cyst with left ovary and uterus being normal. Surgical management was planned. Diagnostic laparoscopy was performed which revealed right ovarian simple cyst of 6×4 cm which was punctured using cautery and drained. Following this vaginal exploration revealed a polypoidal structure of 5×4 cm cystic consistency seen arising from right upper anterolateral lip of cervix. Polyp was resected with cautery and haemostasis achieved. Post operative period was uneventful. Such rare presentations do pose a diagnostic dilemma and hence it should be kept in mind to ensure adequate treatment.
A case of degenerated cervical fibroid polyp
Authors: Bhavanam Nandini , Munisamaiah Munikrishna
Published: December 2022

Cervical fibroids are often solitary. It may be either interstitial, subserous, submucous or polypoidal. Cervical fibroid usually develops in the wall of the cervix, supravaginal portion. They can change the shape of the cervix or lengthen it, grow rapidly and obstruct the cervix. As fibroids enlarge they may outgrow their own blood supply leading to various types of degeneration. Cystic degeneration is observed in 4% is considered an extreme sequelae of oedema. However atypical appearances that follow degenerative changes can cause diagnostic confusion. Hence misdiagnosis of adenomyoma, hematometra, pyometra, uterine sarcoma and ovarian masses is common.
Isthmocele: emerging emergency
Authors: Todani Ashok Kumar , Todani Kiranlata
Published: December 2022

An isthmocele, a caesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicating to the uterine cavity, at the site of a previous cesarean section scar. With rise of caesarean sections, incidence of isthmocele and scar ectopics is on rise, being 19 to 88% in caesarean delivery patients. As there are no definitive criteria for diagnosing an isthmocele, several imaging methods can be used to assess the integrity of the uterine wall and thus diagnose an isthmocele. However, transvaginal ultrasound and saline infusion sonohysterography emerge as specific, sensitive and cost-effective methods to diagnose isthmocele. When cervix is encroached as well by ectopic placentation, situation becomes much more alarming and grave. Timely diagnosis and active management of the entity is a must to save life of patient. Area of isthamocele bearing ectopic gestation sac has to be excised whatever be the method, by endoscopy or conventional open method. Previous gestation scar dehiscence or rupture of uterus repair leads to more weakness and impaired integrity of uterine wall. If patient refuses to undergo simultaneous sterilization, recurrence of isthmocele formation and ultimate scar ectopic will be even higher. Here we presented a case of ectopic gestation in isthmocele complicated by its extension to cervix with an associated posterior wall cervical fibroid at same level.
A case report of scar endometriosis with bladder endometriosis
Authors: Ramanidevi T. , Deepika A. , Sangavi D.
Published: December 2022

Endometriosis is a common gynaecological condition which occurs in 10-15% women of reproductive age group. It can occur in pelvic and extra pelvic regions like urinary tract, abdominal wall, nervous tract, gastrointestinal tract, nose, lungs, umbilicus and sciatic nerve tract.  Previous abdominal wall surgery can lead to scar endometriosis based on implantation theory which is very rare and this is hormone dependent. Here we are presenting a case of recurrent scar endometriosis along with bladder endometriosis which is extremely rare. The common cause for scar endometriosis is caesarean section and hysterotomy. Rarely it can occur following laparoscopy and amniocentesis. The diagnosis is based on the symptoms which are cyclical. USG and MRI can help in the pre-operative diagnosis and FNAC can confirm the diagnosis. Management of scar endometriosis is mainly wide excision of the lesion. Medical management can only be temporary. COCs, progesterone, dienogest and GnRH analogues are the drugs for medical management. Recurrence of scar endometriosis is also rare and association with bladder endometriosis is still rare. Malignant changes are almost less than 1%. This patient had scar endometriosis, bladder endometriosis and adenomyosis, fimbrial endometriosis and ovarian endometrioma. All were excised and post-operative suppression with GnRH was given for 3 months and LNG-IUS was inserted for prevention of recurrence as well as for management of adenomyosis.
Prospective study of management of unstable intertrochantric femur fractures in elderly: hemiarthroplasty vs. osteosynthesis by proximal femoral nail
Authors: Murkute Kishor G. , Jadhav Shivsagar V. , Tonde Jeevan , Badgujar Omprakash Kumar
Published: December 2022

Background: A prospective study was done to compare the outcomes of management of unstable intertrochantric femur fractures in elderly by hemiarthroplasty and osteosynthesis by proximal femoral nail.

Methods: This was an interventional prospective study. The study was carried out over 3 years from 2019 to 2022 at PCMC’s PGI YCMH, Pimpri, Pune, Maharashtra, India. The study was carried out over 3 years from 2019 to 2022;50 Patients were randomly divided into two groups; Group A (unstable intertrochanteric femur fracture patients treated by bipolar hemi-arthroplasty) and Group B (unstable intertrochanteric femur fracture patients treated by proximal femoral nailing) with 25 patients in each group. Outcomes were evaluated based on functional outcomes, mean surgical time, mean blood loss during surgery, post-operative length of stay, post-operative complications. Harris hip Score was used to assess clinical functional outcomes.

Results: The PFN group showed a better Harris Hip score at 1, 3, and 6 months follow ups. Mean surgical time was more in bipolar hemiarthroplasty group. Mean blood loss during surgery was more in bipolar hemiarthroplasty group. Post-operative length of stay was more in bipolar hemiarthroplasty group. Post-operative complications like infections, limb length discrepencies were more in bipolar hemiarthroplasty group, whereas 2 implant failures occurred in PFN group compared to a single one in bipolar hemiarthroplasty group.

Conclusions: Both PFN and bipolar-hemiarthroplasty appear to produce satisfactory outcomes in surgically treated unstable IT fractures, bipolar-hemiarthroplasty has the advantages of early mobilization and early weight bearing, no risk of non-union but PFN group is superior when it comes to functional outcomes, mean surgical time, Mean blood loss during surgery, post-operative length of stay, post-operative complications.
Double-plating approach in the management of isolated distal femoral fractures
Authors: Kulkarni Sunil , Supare Saurabh R. , Nadange Anjan , Garimella Rohith , Pawaskar Pranit
Published: December 2022

Background: Fractures above 9 cm of the articular surface of distal femur are defined as distal femoral fractures which accounts for an estimated 4%-6% of all femur fractures. Stable fixation can be achieved by dual plating of distal femoral fracture. The indications of a dual- lateral and medial plate medial are comminuted distal femur fractures (AO type C3), medial supra-condylar void and bone loss of more than 3 cm, medial Hoffa fracture, inter-condylar comminuted bicondylar fractures, non-union after failed fixation with single lateral plate, poor bone quality.

Methods: The retrospective research study of 35 cases of distal femoral fractures which were treated with lateral and medial plates in post graduate institute Swasthiyog Pratishthan, Miraj (G. S. Kulkarni Hospital, Miraj). The study period was from September 2020 to May 2022. The average follow-up was 8 months.

Results: 1 year after operation, knee function was evaluated by Oxford knee score along with Mean EQ-5D-5 L score. Functionally the mean oxford knee score was 41.53±1.69, with a maximum Oxford Knee Score of 48. Mean EQ-5D-5 L score was 83.8 (72-82). Average time to union was 9 months (6-12 months). Four (17.4%) cases needed autologous bone graft.

Conclusions: Double incision dual-plating approach for distal femoral fractures is effective and provides stable construct without reduction loss allowing early rehabilitation. Single lateral plating of distal femur fractures was associated with relatively higher failure rate. Addition of medial plate along with lateral plate reduces chances of fixation failure.
A comparative study between dynamic hip screw and proximal femoral locking plate in the management of unstable pertrochanteric fracture femur
Authors: Parshuramkar Atul N. , Jain Pramod A. , Patond Kisan R. , Jagdale Aditya S.
Published: December 2022

Background: Pertrochanteric fracture represent perhaps the most important public health problem facing the orthopedic surgeon today. The purpose of the present study is to compare dynamic hip screw with proximal femoral locking plate (PFLP) in pertrochanteric fracture femur.

Method: During the period from December 2019 to August 2021, 50 patients with pertrochanteric fracture femur who were admitted in the orthopaedics department were selected. The 25 patients treated with PFLP and 25 patients treated with dynamic hip screw according to the standardized protocol. Patients were followed up for the 1 year. 

Results: The mean operative time and average intraoperative blood loss was more in PFLP group when compared with DHS group it was statically significant.  PFLP group has marginally better functional than DHS group. There was no difference in the radiological outcome between two group.

Conclusions: PFLP can be feasible alternative to treatment of complex comminuted pertrochanteric fractures. It can be use in old age patients with osteoporotic bone which provide stable fixation.
Is novel “PGI technique” worth considering for closed reduction of posterior hip dislocations?
Authors: Aslam Marouf , Sultan Asif , Khan Mohammad Ashraf , Bhat Mudasir Nazir , Nabi Dar G.
Published: December 2022

There are numerous approaches for closed reduction of posterior hip dislocations, but the most call for strong and prolonged traction, help stabilizing the pelvis, and difficult placement of the doctor and/or patient. A novel closed reduction procedure that only requires one surgeon to complete safely and effectively the hip reduction and does not require traction-counter traction or unique posture of patient.  The 11 patients, with a mean age of 34.1 years, underwent reduction. Five type I, five type II, and one type III dislocations consisted our study. Closed reduction was accomplished in 11 hips (100%), with all requiring just one try. This innovative method is an easy, secure, and efficient replacement of other techniques for closed reduction of posterior hip dislocations. It can be performed by a single surgeon, requires no traction, and can be very helpful for patients with polytrauma as well as those patients who have pelvic fractures and ipsilateral lower limb injuries.
Neurological deterioration after spinal anaesthesia: a rare mode of presentation of spinal tumours
Authors: Oyemolade Toyin A. , Adeolu Augustine A. , Akinwonmi Olugbenga D. , Ekanem Inwonoabasi N.
Published: December 2022

Spinal anaesthesia is a safe and widely performed mode of anaesthesia with low complication rate. It may however be complicated infrequently with neurological deterioration as a result of injury to nerve root and spinal cord or epidural haematoma. Rarely neurological deterioration may occur following spinal anaesthesia in the presence of spinal tumours. We presented a case of neurological deterioration following spinal anaesthesia for caesarean section in a patient with previously undiagnosed thoracic spinal tumour.
Stiff hip managed with capsular incision in adolescent girl: a case report
Authors: K. S. Rao Shreekantha , A. S. Jasmal
Published: December 2022

Idiopathic chondrolysis is an uncommon condition defined by the complete loss of femoroacetabular articular cartilage in a child with no previous trauma, slipped capital femoral epiphysis, infection, or extended immobilisation. Because of the gradual onset of symptoms, escalating radiographic abnormalities, and the lack of a diagnostic laboratory test, diagnosis is sometimes delayed. Localized osteoporosis, subchondral erosions, femoral head alterations, and a reduction in joint space are all common radiographic findings. We report a case of Idiopathic chondrolysis of the hip in a 14‑year‑old Indian girl who presented with pain and stiffness in her right hip with an MRI differential diagnosis of avascular necrosis/ tuberculosis of right hip joint.
Single-stage contralateral total hip and knee arthroplasty: a report of two cases with literature review
Authors: Tomar Lavindra , Govil Gaurav , Dhawan Pawan
Published: December 2022

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) have been performed for end stage degenerative arthritis of hip and knee respectively, with reliable functional outcomes. A single joint arthroplasty has wide acceptance, and presents less complications than a staged or simultaneous bilateral joint arthroplasty. Any contralateral or ipsilateral staged or simultaneous two joint arthroplasty have been infrequently performed and occasionally described. We present two cases where contralateral hip and knee arthroplasty were performed in single-stage simultaneously for an end-stage degenerative arthritis. Hip was operated first than knee in both the cases. The clinical, radiological, and functional recovery was graded good in both. There were no complications, or an extended stay in hospital, and blood transfusion requirements were insignificant. The contralateral two joint arthroplasty needs meticulous preoperative work-up, dedicated high volume joint arthroplasty unit, and use of meticulous standard surgical techniques to achieve the desired functional outcomes. 
To compare the short-term efficacy and safety of combination therapy with standard fluence and reduced fluence PDT in polypoidal choroidal vasculopathy
Authors: Iqbal Sameer , Manoj S  , Meel Narendra , Nair Unnikrishnan
Published: December 2022

To evaluate and compare the efficacy of reduced-fluence photodynamic therapy (PDT) with standard-fluence photodynamic therapy in treating polypoidal choroidal vasculopathy.

  Twenty-eight eyes (27 patients) with polypoidal choroidal vasculopathy were retrospectively analysed; 14 eyes received Indocyanine green angiography-guided standard-fluence (SF) PDT (50 J/cm) and 14 eyes received Indocyanine green angiography-guided reduced-fluence (RF) PDT (25 J/cm). Primary outcome measured after 6 months of treatment were the changes in mean BCVA, polyp regression, polyp PED height, central choroidal thickness (CCT), post PDT intravitreal anti VEGF injection need and complications.

Results of both the groups were comparable at 6 months follow up. Mean change in log mar visual acuity at 6 months for the SF PDT group was 0.12 compared to 0.13 for the RF PDT group (p = 0.919).  Mean change in PED height at 6 months for the SF PDT group was 159 μm compared to 172 μm for the RF PDT group (p = 0.06). Mean change in CCT at 6 months for the SF PDT group was 45μm compared to 10μm for the RF PDT group (p = 0.96). While the SF PDT group needed a mean of 2 injections post PDT, the RF PDT group required a mean of 3 injections during the course of 6 months follow up. Neither of the group reported any adverse effects following the procedure.

 Our study demonstrated that reduced-fluence PDT is at least on par with standard-fluence PDT in management of PCV.
A study of posterior reversible encephalopathy syndrome as a cause of sudden transient vision loss during pregnancy
Authors: Bussa Manjula , Ganta Nihitha , Morsa Sai Nikhita , Teja Sri Rama Ravi , Bitragunta Chandrasekhar
Published: December 2022

To emphasize the importance of Posterior Reversible Encephalopathy syndrome (PRES) as the cause of sudden vision loss during pregnancy in patients with acute haemodynamic instability like preeclampsia, eclampsia, severe PIH.

: In this prospective observational study pregnant women within age group of 25-40 years presenting with acute onset of visual, neurological symptoms to the emergency department were examined. Blood pressure recorded. Patients vision was recorded using snellens chart at the time of presentation and after the recovery. Slit lamp examination, fundus examination, pupillary reactions were noted to rule out other causes of vision impairment. MRI was done to detect PRES. Patients were stabilised and their blood pressure was monitored and treated with intravenous anti hypertensives.

: 8 out of 10(80%) of the pregnant women presented with sudden vision impairment were preeclamptic and 2 out of 10(20%) were with features of eclampsia. Majority were in third trimester. All the patients were diagnosed early with PRES on MRI and regained vision within 2 days with immediate treatment with intravenous antihypertensives.

Posterior Reversible Encephalopathy syndrome has to be kept in mind as one of the differential diagnosis while examining the pregnant women with eclampsia, preeclampsia, PIH coming with sudden visual impairment.
Comparison of pain perception caused by aligner and conventional fixed orthodontic treatments
Authors: Bicakci Ali Altug , Çelebi Fatih , Duran Melike
Published: December 2022

The aim of this study was to compare the pain perceived in fixed orthodontic and aligner treatments during the first seven days of treatment.

Forty patients who had 3–6 mm maxillary dental crowding and a non-extraction treatment plan were included in this study. The subjects were randomly divided into two groups: the fixed orthodontic group and the aligner group, with ten females and ten males in each. In the fixed orthodontic group, treatment was started with 0.014-inch round nickel-titanium archwire, and a 0.018×0.025-inch preadjusted edgewise appliance was used. In the aligner group, treatment was started with a polyurethane aligner. Throughout the study, teeth in the upper jaw were treated in both groups. The pain scores of the subjects were measured with the visual analog scale at the second and sixth hours and on the first, second, third, and seventh days of treatment.

The pain scores of the fixed orthodontic group were significantly higher than those of the aligner group at the sixth hour, on the first, second, and third day. The differences at the second hour and on the seventh day were not statistically significant.

According to the study outcomes, less pain was felt during the aligner treatment compared to the fixed orthodontic treatment. However, it should be considered that the force activation interval is shorter in the aligner treatment, and the cumulative pain score may be higher.
Orthodontic miniscrew supported correction of partially impacted mandibular 2nd molar- A case report
Authors: Rao Sushmita Batni , Shetty Vikram , Manasawala Taher , Mujumdar Devashree
Published: December 2022

A wide range of clinical procedures have been introduced and practiced to correct mesially inclined mandibular molars which is a common situation among young adults, occurring usually due to inadequate space in the arch for its eruption. There are two major treatment options available for the correction of impacted / partially impacted molars and this depends on several factors. The objective was to treat a 15-year-old male patient having a lower right partially impacted 2nd molar using skeletal anchorage system. The lower right 3 molar was surgically excised, and the partially impacted 2 molar was uprighted using an orthodontic miniscrew which was placed between lower right 1 and 2 premolars on the mesial side. The use of skeletal anchorage system has an excellent advantage over conventional methods since there is prevention of unwanted movement of anchor teeth leading to successful correction without any delay in the treatment duration.
Inflammatory dentigerous cyst management in paediatric patient followed by management of impacted maxillary canine with 1 year follow up: A rare case report
Authors: Gupta Gaurav , Gupta D K , Gupta Neelja , Gupta Priyanka , Gupta Richa , Sankhla Devanshi
Published: December 2022

Cysts of jaw present as swellings of jaws and midface. Of different varieties, dentigerous cyst is most common type of noninflammatory odontogenic cyst. Dentigerous cysts are generally associated with crowns of impacted or unerupted permanent teeth. Here we present a case of dentigerous cyst in 13‑year‑old female child, which was successfully treated with conservative therapy. Patient also reported after one and half year with protruding teeth and retained deciduous right upper canine & impacted permanent canine. This case report also presents orthodontic management of retained deciduous canine and impacted permanent canine.
Authoritarianism: Is There a Future?
Authors: Malashenko Aleksei V.
Published: December 2022

Author analyzes the role of authoritarian regimes in the contemporary world, he characterizes their specific features in the first place determined by their historical traditions and political culture. The author pays attention to post-communist, post-soviet as well as Muslim authoritarian models. Also, he estimates perspectives of authoritarianism for the future, its capacities for the survival in conditions of the modern world. How great is the potential of authoritarianism, how limited is it by its conservatism, and how open is it to innovation? What is the effectiveness of an authoritarian system in the context of global changes taking place in the world, which are largely determined by scientific and technological progress, communication technologies? The author tries to consider these issues on the example of the countries of the East.
On the one hand, some authoritarian regimes are ready to adapt to ongoing transformations, including in the political sphere, for the sake of their survival. In their practice, they use democratic norms, allow the activities of parliament, opposition parties, while striving, however, to fully maintain their own control over the state. They are aware that the softening, liberalization of the authoritarian system can lead to its elimination. And therefore, on the other hand, authoritarians use any situation, especially its aggravation, to tighten their rule.
Authoritarianism has existed in various forms at almost all times. It was formed on the basis of the political culture in which the title role belonged to the state, and therefore to those who were currently in power. In this context, current authoritarianisms have direct analogies with their predecessors.
Some analysts tend to view each variant of illiberal government as a unique, "competitive" democracy, as a "hybrid" authoritarianism. Whatever definitions are offered, the essence of authoritarianism does not change from this. Taking into account the national specifics in each individual country, authoritarianism remains a global, one might say, inevitable phenomenon that will continue to exist in different versions, and may even strengthen its position, which is the case today.
The Arab Spring in the Syrian Arab Republic and Russian Interests
Authors: Gutenev Yuriy
Published: December 2022

The article examines the dynamics of political processes in the Middle East after the beginning of the Arab Spring at its various stages, how the foreign policy changes of recent years in the Middle East reflected important events in the international arena and influenced the Syrian crisis. Using the example of the Syrian Arab Republic (SAR), the author analyzes the relations of the main actors of political processes whose interests were affected by the Arab Spring, as well as the approaches of the Russian Federation to ensuring collective security in the region. Special attention is paid to the complex relations between the Russian Federation, the United States and the Republic of Turkey. The differences in the sphere of regional interests are analyzed. The author also examines the confrontation between the State of Israel and the Islamic Republic of Iran as one of the imbalances that hinder the settlement of the Middle East conflict. A brief analysis of the imbalances that are the driving force in international relations and aggressive actions of the actors, such as military intervention and the struggle for regional influence, are the main subject of the study in this article. The author relies in the analysis mainly on the works of domestic orientalists who gave a tentative assessment of the driving forces of the Arab Spring, paying special attention to the change in the position of the Russian Federation from expectant observation at the beginning of the events under consideration to subsequent active intervention and transition to influencing the situation in the region at the present time.
From the Delta to the Delta: Natural Conditions and Settlers on the Main Nile in the Fifth Millennium BC. Part I (Introductory)
Authors: Proussakov Dmitry
Published: December 2022

The 5th millennium BC is marked by the transition to agriculture in the Egyptian Nile valley, rather late for the Fertile Crescent. This was preceded by the Quaternary epic of discovery of the Nile banks by hominids, from the Olduvian Pithecanthropus of the lower Palaeolithic to the Neolithic settlers of the Predynastic period, who laid the socio-economic foundation of the Pharaonic civilization. In the Pleistocene geological epoch, the Main Nile underwent a complex evolutionary transformation from palaeo-rivers with such powerful watercourses as the Prenile to the much inferior in volume Neonile on which, at the 2nd marine isotope stage (27.8–14.7 ka) when the Sahara was a hyperarid desert, comparatively frequent Paleolithic sites of gatherers, fishermen and hunters arose in Upper Egypt and Lower Nubia (the archaeological cultures Halfa, Fakhuri, Qadan, Ballana, Silsila, Afia, Makhadma et al.). Warming and humidification of the climate with the onset of the 1st marine isotope stage was accompanied by an “abrupt return” of the summer monsoon rains to East Africa and an episode of the “Wild Nile” with the incision of the River, which probably made its Egyptian valley unsuitable for settlement by the beginning of the Holocene (11700 ± 99 ka); thus, the Epipalaeolithic is represented here by rare industries of Elkab in Upper Egypt and Karun in the Fayum oasis. At the same time, from the 9th millennium BC there was an increase in the population of the Sahara, where during the African humid period of the early Holocene grassy and woody savannahs were spreading. The Nile Delta with its “historical” network of branches had not yet formed and represented a barren sandy plain which (as well as the Valley) was unsuitable for life and the establishment of the food-producing economy. Simultaneously in Sudan, in the Gezira region at the confluence of the White and Blue Nile, an inner delta was formed, which may have been the cause of the later Neolithization of the lower reaches of the Main Nile.
Historiography of the Liu Song Empire (420-479 AD)
Authors: Prass Vladislav
Published: December 2022

The Liu Song empire was the first South Chinese state during the Northern and Southern Dynasties period. Although it existed for just 59 years, the Liu Song, with a shift to authoritarian military rule and a rise to power of the “new nobility”, marked the beginning of a new era in Chinese history. Nevertheless, despite its importance, the Liu Song, as well as the period of 3rd to 6th centuries in general, remains relatively unstudied by sinologists. This article is an attempt to consider and briefly describe the main sources about the Liu Song.
The Chinese Folk Woodcut and Court Culture
Authors: Pistsov Konstantin M.
Published: December 2022

In this article on the example of a folk woodcut the connections between folk and court culture in Later Medieval China are considered. It is noted, that the same plots were used in the festive decoration of the imperial palace as in the folk woodcuts that adorned the houses of the townspeople and peasants. The examples of the mutual influence of folk and court cultures are given. As one of the main sources, the notes of the court eunuch Liu Ruoyu (1584–?) are involved. The author analyzed a number of published pictorial sources from Chinese collections. The close connection between folk and court culture in later medieval China within the framework of the general cultural context is confirmed. Assumptions are made regarding specific ways of interpenetration between folk and court culture.
Między starą a nową ojczyzną – muzyczna aktywność cymbalistów na Dolnym Śląsku w latach 50. XX wieku
Authors: Gacek Gabriela
Published: December 2022

W artykule omówiono zagadnienie muzycznej aktywności cymbalistów, którzy zmuszeni byli do migracji z przedwojennych kresów wschodnich (Wileńszczyzny, Galicji Wschodniej) na Dolny Śląsk po II wojnie światowej. Będąc nowymi osadnikami na tzw. Ziemiach Odzyskanych, otoczeni ludnością o różnym pochodzeniu regionalnym, cymbaliści próbowali w nowych warunkach kontynuować muzyczną działalność. W tekście ukazane są różne sposoby adaptacji do nowej sytuacji wykonawczej w nowym miejscu zamieszkania: budowanie kolejnych instrumentów, granie w kapelach ludowych składających się z członków o różnym pochodzeniu regionalnym, próby indywidualnego muzykowania oparte na wykonywaniu muzyki tanecznej z regionu pochodzenia czy założenie zespołu składającego się z uczniów szkoły średniej uczących się wykonywać aranżację melodii pieśni ludowej z Dolnego Śląska i repertuar z Wileńszczyzny. Za bazę źródłową służą archiwalne przykłady muzyczne nagrane w latach 50. XX wieku przez Józefa Majchrzaka (1909-1985), polskiego folklorystę, muzykologa i redaktora radiowego pracującego w Polskim Radiu Wrocław.
Testing processing algorithms for seismic data from laboratory modeling
Authors: Petrochenko T. A. , Zadoev A. Yu. , Duchkov A. A. , Mitrofanov G. M.
Published: December 2022

In this paper, we consider an example of obtaining data similar to seismic surveys in the process of conducting physical modeling. It is shown that the features of the data are close to those observed in a real experiment. This is proof of the possibility of testing the processing methods used in the practice of seismic exploration on the data of laboratory modeling of seismic surveys. In particular, the application of a certain set of processing procedures for the considered data related to the simulated environmental object showed that the resulting time sections contain all the inherent structural features of the model.
Tem signal transformations to frequency domain for fast data inversion
Authors: Nikitenko M. N.
Published: December 2022

The paper presents a new data inversion technique for the transient electromagnetic method (TEM) by converting the measured signals into the frequency domain. The inversion involves a search for such earth model parameters that there is a consistency between the synthetic and field data. We use an optimization method, where through numerical simulation at each iteration the synthetic data are determined in accordance with the changing model parameters. Numerical simulation of TEM signals is a computationally expensive procedure, since the time-domain signal is usually calculated via the inverse Fourier transform of the frequency signal. Consequently, compared to the frequency signal, the time needed to calculate the time signal increases hundreds of times. It is proposed to transform the measured signals into the frequency domain and perform inversion therein, which significantly reduces the time expenditures. Transition into the frequency domain by the Fourier transform includes the extraction of the primary field from the signal, calculated by means of a special algorithm. This fact makes it possible to employ for the transformation a relatively small time interval actually used in TEM instead of an infinite one.