bluuebunny/crossref_metadata_2025 huggingface dataset:
Telecare in Parkinson’s disease: A nationwide survey among Hungarian neurologists
Authors: Pintér Dávid , Járdaházi Evelyn , Janszky József , Kovács Norbert
Published: July 2022

COVID-19 has made providing in-person care difficult. In most countries, including Hungary, telemedicine has partly served as a resolution for this issue. Our purpose was to explore the effects of COVID-19 on neurological care, the knowledge of neurology specialists on telemedicine, and the present state of telecare in Hungary, with a special focus on Parkinson’s disease (PD). Between July and October 2021, a nationwide online survey was conducted among actively practicing Hungarian neurology specialists who were managing patients with PD. A total of 104 neurologists were surveyed. All levels of care were evaluated in both publicly funded and private healthcare. Both time weekly spent on outpatient specialty consultation and the number of patients with PD seen weekly significantly decreased in public healthcare, while remained almost unchanged in private care (p<0.001); higher portion of patients were able to receive in-person care in private care (78.8% vs. 90.8%, p<0.001). In telecare, prescribing medicines has already been performed by the most (n=103, 99%). Electronic messages were the most widely known telemedicine tools (n=98, 94.2%), while phone call has already been used by most neurologists (n=95, 91.3%). Video-based consultation has been more widely used in private than public care (30.1% vs. 15.5%, p=0.001). Teleprocedures were considered most suitable for monitoring progression and symptoms of Parkinson’s disease and evaluating the need for adjustments to antiparkinsonian pharmacotherapy. COVID-19 has had a major impact on the care of patients with PD in Hungary. Telemedicine has mitigated these detrimental effects; however, further developments could make it an even more reliable component of care.
The peak latency prolongation of the blink reflex in a patient with trigeminal neuralgia of Meckel’s cave mass
Authors: Ku Bon D. , Shin Hyun Young
Published: July 2022

The blink reflex test of the trigeminal nerve can provide valuable information about lesions site. However it may not find small compressive lesions. We observed peak latency prolongation of the blink reflex test in a patient with trigeminal neuralgia caused by a small Meckel’s cave mass, in whom the onset latency was normal. Conclusion – We suggest peak latency of the blink reflex might be a valuable aid for discerning small mass in patients with trigeminal neuralgia. This is the first case report of compressive trigeminal neuralgia showing peak latency prolongation of the blink reflex test.
Combined heat pump heating and ventilation system using heat of soil, sewage water and ventilation emissions
Authors: BEZRODNY Mykhailo , OSLOVSKYI Serhii
Published: July 2022

ABSTRACT
Currently, one of the main energy consumers in many countries is the communal sector. In this case, the bulk of the energy is supplied by fossil sources. In this regard, studies in the field of alternative energy sources that can help solve not only the problem of energy saving, but also the problem of environmental pollution and prevent the approaching environmental collapse deserve special attention. One of the most promising sources of alternative energy in the field of communal utilities is heat pump that use the low-temperature heat of renewable sources and the heat of the upper layers of the soil. Soil, as an energy source, has an almost constant and sufficiently high temperature level, which determines the sufficient efficiency of using its heat. However, the widespread occurrence of this type of heat pump is hindered by the high cost of the ground heat exchanger and its installation. In this regard, the development of new heat supply schemes having higher energy efficiency is relevant. To solve this problem, a combined heating and ventilation scheme based on ground heat pump was developed. The feature of this scheme is the use of additional low-temperature energy sources, such as the heat of ventilation emissions and wastewater of a heat supply facility. On the basis of the scheme the thermodynamic model in which the equation of the basic balance of separate elements and the scheme as a whole found the defining parameters characterizing work of system is developed. An algorithm for determining parameters at the nodal points of the chain is proposed, on the basis of which a numerical analysis of the circuit is performed. The results of the analysis are presented in the form of graphical dependencies. Features of operation of the scheme depending on the set initial parameters and ambient temperature are shown. Conclusions are made on the possible reduction of capital and operating costs for heating and ventilation due to the proposed solution.
A critical re-examination of Reynolds analogy for micro-convective flow
Authors: KUMAR Rajan
Published: July 2022

The present research numerically investigates the validity of the Reynolds analogy for micro-convective water flow between Stanton number (St) and Fanning friction factor (ff), taking into account combined fluid properties variations such as temperature-dependent density, viscosity, and thermal conductivity. The Reynolds analogy is suggested to be valid when St increases for thermophysical fluid properties (TFP) with a decrease in ff. This analogy, therefore, helps to find the flow regime that increases heat transfer while shear stress decreases for TFP. Hence, the Reynolds analogy for TFP helps to design and improve the performance of the different devices, including micro-scale heat exchangers for electronics cooling, internal cooling passages of turbine airfoils, and many biomedical devices. Three modified non-dimensional parameters (ΠSρT, ΠSμT, and ΠSkT) appear from the non-dimensionalization of the governing conservation equations. Using dimensional analysis, the dependence of the friction factor on these parameters is examined.
The Success Factors of Conversion Process Using ADKAR Model: A Case Study of Islamic Savings Loan and Financing Cooperative
Authors: Yasid Mukhamad , Laela Sugiyarti Fatma
Published: July 2022

This study aims to analyse the conversion-related issues from Savings and Loan Cooperative (SLC) into Islamic Savings Loan and Financing Cooperative (ISLFC) using a case study of Tunas Artha Mandiri (TAM) Cooperative, located in Nganjuk, East Java. Five main research questions include: exploring reasons for conversion, explaining the conversion process, assessing the level of conversion effectiveness, identifying obstacles during the conversion and analysing key success factors of conversion. This study applied a mixed method. A qualitative method was applied to answer the first four questions and a quantitative method with a structural equation model was used to answer the fifth question. Using 120 members of TAM as our respondents, this study found that the success of conversion depends on the awareness of human resources to emigrate and the reinforcement to emigrate, especially from the founders. In addition, this awareness indirectly affects the success of conversion through desire, knowledge, ability and reinforcement. In order to succeed, the cooperative management should provide socialization on how to run ISLFC effectively as well as gradual training.
Contextual Learning Innovations in Islamic Education Textbooks at Muhammadiyah Elementary School Grade VI
Authors: Mundzir Ilham
Published: July 2022

This article aims to analyze the instructional methods used in textbooks to increase understanding of Islam at the primary education level in Indonesia, namely Islamic Education for 6th grade of Muhammadiyah Elementary School published by Muhammadiyah Executive Board of Primary and Secondary Education. This textbook research was conducted using a qualitative method, with a content-analysis approach to the instructional methods used in the book. The results of the study showed that this Al-Islam Education textbook innovated by applying contextual teaching and learning (CTL) methods. In the end, this Islamic Education textbook published by Educational Council of Central Board of Muhammadiyah can serve as a good example of the openness of Islamic educational institutions to apply CTL-based instructional methods in Islamic education, in order to increase students' understanding and practice of Islam while at the same time improving the quality of Islamic religious education in Indonesia in general.
Determinants of Islamic Financial Literacy Index: Comparison Based on Ethnographic Studies in Yogyakarta, Indonesia
Authors: Khasanah Miftakhul , Aminullah Rizki , Setianingsih Dewi
Published: July 2022

This paper aims to determine the level of Islamic financial literacy (IFL) and identify factors that have a relationship and influence on the level of IFL in various communities. The research was conducted because there have been inconsistencies in previous studies regarding the factors that influence the level of financial literacy, both general and Islamic financial literacy. Demographic factors such as gender, education level, and income level are often used in this type of research. This paper is compiled in two steps with mixed method. The first calculates the IFL index level, and the second analyzes the factors affecting the IFL index level using ethnographic studies. Islamic financial literacy indicators consist of knowledge, skills, beliefs, attitudes, and behavior based on the aspects of religiosity and Maqasid al-Shari'ah. The factors that influence the Islamic financial literacy index are determined using ethnographic studies. The result is the education level affects the financial literacy index in one community. But the results will be different when different communities are compared. One of the influencing factors is the financial socialization agent, and this is very closely related to the political socialization theory. In this case, the Bank or Islamic financial institution acts as a potential agent.
The Urgency of Halal Tourism Literacy in Responding to Rejection of Halal Tourism in Indonesia
Authors: Rachman Abdul , Faluthamia Mayang Ayu , Said Muhammad , Haura Arie
Published: July 2022

Halal tourism has received a rejection from several people in Indonesia because it is understood as a form of Islamization of tourism. This rejection is evidence of the lack of literacy in Halal Tourism in the community regarding Halal Tourism. The purpose of this paper is to investigate the rejection of Halal Tourism in several regions of Indonesia and to discover the important role of Halal Tourism literacy in responding to the rejection of Halal Tourism from some communities. This study used a qualitative descriptive approach using document analysis as a data collection technique. The results of this study indicate that Halal Tourism literacy is very important to be able to increase public understanding of Halal Tourism that the concept of Halal Tourism is a universal concept that can be accepted by all religions, societies, cultures, and governments. Halal Tourism Literacy has an important role to socialize that Halal Tourism is not a form of Islamization of tourism but rather an extended service in the tourism industry in Indonesia.
High Integrity Low Publicity: Research Performance of Professors in Indonesian State Islamic Universities
Authors: Suntana Ija , Kania Dede , Nurfatoni Siti
Published: July 2022

This study aims to analyze the performance of the publihed research results by professors in three State Islamic Universities (UINs). By using the descriptive–qualitative analysis and quantitative data reading, this study analyzes research outputs of lecturers with a full professorship in the State Islamic Universities from January to October 2019. The research finds that most of the professor’s research results were not published whether in the forms of books or scientific journal articles. 60% of the professors have a lack of understanding of the open journal system, which causes a low level of publication among them. One program that is very effective in helping them to increase the productivity of the publications is a program of publication assistance.  The well-versed information technology assistants help the professors to get familiar with the information technology. This study adds to the existing literature regarding the research performance of university professors, especially in understanding what factors that hinder the publication performance of State Islamic University professors in Indonesia.
Spirituality as The Foundation of The Hierarchy of Needs in The Humanistic Psychology of Abraham Maslow and Sufi Psychology of Said Nursi
Authors: Ihsan Nur Hadi , Rahmadi Muhammad Alif , Jamal Jamal
Published: July 2022

Abraham Maslow’s theory discredits the existence of religion and substitutes it with secular spirituality. It provides a space for anthropocentrism and materialism philosophy, freedom, authorization, and a single human potentiality. On the other hand, Said Nursi’s Sufi Psychology sets religious teachings as the radiance of spirituality. It identifies the genuineness of human beings as creatures who are obedient to God. This study aims to reveal how humanistic psychology and Sufi psychology perceive the need for spirituality by referring to Abraham Maslow and Said Nursi. Researchers identify, select, and formulate relevant and constructive narratives to support each theory stated. They then conducted a deductive content analysis of the references using the available variables, categories, and content tabulations. This research finds that Maslow's spirituality relies on subjective human experience, and life satisfaction can be achieved by maximizing one's potential. On the other hand, Nursi's spirituality is based on the Shari'a and leads to fundamental happiness. For Maslow, the existence of God has been alienated from the human mind, and religion has become a secondary component. At the same time, Nursi has a Tauhidic perspective on reality and believes that religion is the primary guidance of life. Meanwhile, secular spirituality promises nothing but illusory pseudo-happiness. This concept originated from the confusion of Modern Western Psychology on the nature of God, religion, and human psychology. This confusion will vanish if it refers to religious teaching as the ultimate truth. Although both have differences in their ontological nature and conceptual psychological foundations, they both present a similar understanding of recognizing a Higher Entity capable of controlling human life. This entity is called God. In conclusion, Nursi's concept of Tawhid-based spirituality offers a solution to modern man's anxiety, emptiness, and powerlessness of their life problems.
Oral itraconazole combined with local isoconazole in the treatment chronic candida vulvovaginitis
Authors: Elsayed Mostafa Abdulla
Published: July 2022

Background: Chronic vulvovaginal candidiasis is a major problem and common with poor quality of life from itching and discharge and it is difficult to treat because fungi are slow growers.Methods: Two hundred cases recruited from JAM clinic in Benha city, Egypt divided into two groups to study combination of oral itraconazole and local isoconazole in comparison with the use of local isoconazole only in chronic monilial vulvovaginitis and main outcome was relief of symptoms and signs with absent laboratory evidence of monilial infection by culture. Group one included 100 cases treated with combined oral itraconazole with three alternate days dose of local isoconazole (gynotrazonagen) and group two (local isoconazole only) included 100 cases treated with local isoconazole ovules on alternate days for 3 doses and week period.Results: Regarding the cure rate there were 90 clinically cured rate in the combined group compared to 70 in the local treatment group with p value of 0.0004 which was a very high statistically significant difference. Clinical cure included alleviation of the symptoms of discharge dysuria dyspareunia burning itching with also by clinical examination cure and disappearance of redness erythema edema fissures with absent pseudomycelia by microscopic examination. Usually, a symptom score of less than 2 is a positive one. Regarding the laboratory cure which means absent or negative candida culture on Sabaraud agar medium there were a laboratory cure rate of 84 out of 100 in the combined treatment group compared to 65 out of 100 in the local treatment group with p value of 0.002 and a high statistically significant difference.Conclusions: Oral itraconazole combined with local isoconazole is highly effective in treating chronic monilial vulvovaginitis.
Epidemiological study of uterine fibroids: our experience from urban Maharashtra
Authors: Ngorili Goldy S. , Yadav Bhaurao B. , Takalkar Anant A.
Published: July 2022

Background: Uterine fibroids or myomas or leiomyoma of uterus are the most common type of benign tumour of uterus and also most common pelvic tumour in women. Exact etiology is not known but the cause estimated to be is oestrogen and progesterone which proliferate tumour growth as fibroid rarely occur before menarche and reduces after menopause.Risk factors for developing fibroids are age, early age at menarche, reduced fertility, frequent alcohol and caffeine consumption, obesity, hypertension, diabetes mellitus, and previous pelvic inflammatory disease.  Objective of the research was to study the epidemiological factors associated with uterine fibroids.Methods: This present cross sectional descriptive observational study carried at Vilasrao Deshmukh Government Medical College (VDGMC), Latur from October 2019 to October 2021 among all cases of fibroid admitted at our tertiary care hospital. Data was analysed by using statistical package for the social sciences (SPSS) 24.0 version IBM United States of America (USA) and results are mentioned in percentages.Results: Out of 166 women, majority were from 31-40 years age group i.e. 58 (34.9%). Majority of the women were from urban area i.e. 57.2%. 13.2% were nullipara and 14.5% were multipara and grand multipara. 19.3% women were not practicing any contraceptive method. Abdominal lump complained by 41%, abnormal uterine bleeding 24.1%, metrorrhagia in 21.7%. Ultrasonography (USG) findings of the study population revealed submucosal fibroids in 64(38.6%), and intramural fibroids in 32 (19.3%).Conclusions: Incidence of fibroids is most common in 31-40 years of age i.e. 34.9%. Commonly observed symptom was abdominal lump (41%) and abnormal uterine bleeding (24.1%). Prevalence of submucosal fibroids was 38.6%, intramural fibroids 19.3%, submucosal polyp 14.5%, seedling fibroid 13.9% and subserosal fibroid 10.2%.
A study on micronucleus frequency in cervical smear as biomarker for genetic damage in polycystic ovarian syndrome
Authors: R. Showri , T. Rajini
Published: July 2022

Background: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder with metabolic and reproductive consequences. Genomic damage and susceptibility to cancer are noteworthy concerns in PCOS. Relationship between PCOS and endometrial and ovarian cancer has already been established. The presence of high body mass index, excess triglycerides, oxidative stress and occurrence of metabolic syndrome is a frequent occurrence in PCOS. This may succeed into genetic damage and susceptibility to cervical cancer as they are also known risk factors of the same. The aim of the study was to estimate the frequency of micronuclei in cervical smear and to determine if it can be used as a biomarker of genomic instability and susceptibility to cervical changes in the future in PCOS.Methods: This observational case control study included 38 subjects diagnosed with PCOS by Rotterdam’s criteria and 38 controls and was conducted between September 2018 to March 2020 in VIMS and RC. Data regarding age and anthropometric details and cervical smear samples was collected from all the subjects. The frequency of micronuclei in cervical smears was expressed as mean±standard deviation (SD). Differences between the PCOS group and the control group were examined for statistical significance using two-sample independent t-test. A p value of ≤0.05 denoted statistically signifi­cant difference.Results: The mean±SD of micronuclei frequencies in cervical smears was observed to be 1.69±0.69 and 0.33±0.18 (p value <0.0001) in the subjects with PCOS and control group, respectively.Conclusions: Micronuclei frequency was found to be elevated in cervical smears of women with PCOS when compared to controls indicating genetic instability and probable susceptibility to cervical cancer in the future in women with PCOS.
Antioxidants containing selenium impact on unexplained oligohydramnios
Authors: Elsayed Mostafa A.
Published: July 2022

ABSTRACTBackground: Oligohydramnios is a significant morbidity during pregnancy that may affect fetal growth and functions and the presented work was an effort to test the addition of selenium for the correction and regaining normal liquor.Methods: Cases recruited from those attending Zinat al-Hayat hospitals and diagnosed with unexplained oligohydramnios after exclusion of prom postdates pregnancy induced hypertension Then final 100 cases divided into two groups group one control: 50 controls that followed healthy diet and a positive mindset only group two cases: 50 who followed healthy lifestyle plus adding selenium ace tablets once daily. Cases and controls followed by ultrasound evaluation with calculation of AFI and fetal weight.Results: Regarding improvement in amniotic index to be more than 5, there were 40 cases out of 50 in cases compared to 25 in controls with p=0.001 a high statistical difference that signified positive impact on the amount of amniotic fluid, regarding amniotic fluid particle diameter it was present in 22 out of 50 in controls compared to 8 only in cases with p=0.002,Regarding birth weight of, more than 2500 gm. there were 20 out of 50 in controls compared to 35 out of 50 in cases with intervention and p=0.002. Regarding APGAR score below 6 there were 15 in controls compared to only 3 in cases with p=0.001, regarding neonatal incubation there were 10 in controls compared to one in selenium group with p=0.004.Conclusions: adding selenium ace tablets in cases of unexplained oligohydramnios had a promising result and a positive impact on amniotic fluid index and neonatal outcomes
Study of correlation between age of menarche and body mass index in adolescent
Authors: Agrawal Megha , Agrawal Anshul
Published: July 2022

Background: Younger age at menarche is associated with higher body mass index (BMI) for adolescents. Obesity has a strong association with infertility and menstrual irregularities. Higher BMI at menarche is associated with an earlier occurrence of menarche.  The timing of menarche was associated with the BMI, waist circumference, thickness of skin fold, but more strongly so with the BMI.Methods: This cross-sectional study was conducted at Durgapur (West Bengal), where total 600 adolescent girls aged 12-17 years from DAV Model School, Durgapur and GMPS High School, Durgapur were selected.Results: In studied girls, maximum girls 267 (44.5%) attained menarche at age of 13 years. 129 girls (21.5%) had menarche at age of 12 years. 87 girls (14.5%) had menarche at age of 11 years. 77 girls (12.8%) had menarche at age of 14 years. 39 girls (6.5%) had menarche at age of 15 years. Only 1 girl (0.2%) had menarche at age of 10 years. 119 girls with BMI of <18.5 kg/m2 had mean age of menarche 12.92±1.03 years. 357 girls with BMI of 18.5-24.99 kg/m2 had mean age of menarche 12.74±1.07 years. 124 girls with BMI of >25 kg/m2 had mean age of menarche 12.60±1.07 years.Conclusions: Mean age of menarche in adolescent girls was 12.75±1.06 year. Mean BMI was found 21.6±3.64 kg/m2. High BMI girls had earlier menarche, comparatively to normal BMI girls and underweight girls.
Knowledge and practices about family planning among women attending the Obstetrics Outpatient Department of a newly established tertiary care center
Authors: Mohapatra Ipsita , Samantaray Subha R. , Soma Hage , Pun Shital K. , Halder Barsha
Published: July 2022

Background: Birth spacing and appropriate family planning is the milestone for long term good health of both the mother and the child and in turn the betterment of the whole society. Before starting the Family Planning clinic, we wanted to have a thorough understanding of the levels of awareness and acceptance of various family planning methods among the women attending the outpatient department of this tertiary care hospital. This preliminary data would be helpful in planning suitable programs which would be helpful in enhancing the family planning acceptance and modifying the existing steps of approach.Methods: A cross-sectional descriptive study was done in the department of Obstetrics and Gynecology of the tertiary care hospital. The study group included 200 women within the reproductive (18-45 years) age group.Results: 88% of the participants were aware of some or the other methods of contraception. According to the participants, the main source of information was health care workers, friends, family members (mother and sisters) and various social platforms and television. 37% of women were not using any method despite being aware of contraceptive methods. Maximum women (65) were following coitus interruptus as a natural method of contraception.16.5% of women were using barrier method of contraception. Unawareness about contraceptive methods was the major reason behind not using any method of contraception. Though knowledge about contraception was reported by 88% of the study population, only 63% of them were actually using some method of contraception.Conclusions: The study shows that there is a gap between the level of awareness about various family planning services and the actual practice of any method of contraception by the study population. So, the main aim of starting of the family planning clinic at our institute would be to bridge this gap.
Sigmoid volvulus complicating pregnancy: a case report
Authors: Panwar Megha , . Rajkumar , Ahuja Nidhi , Sangwan Anubhav , Arora Jainendra
Published: July 2022

Sigmoid volvulus in pregnancy is a rare, but devastating pathology owing to its adverse effects on the mother as well as the foetus. It can lead to maternal mortality in 5-50% cases and foetal mortality in up to 30% cases. A high index of suspicion is necessary and timely surgical intervention is the key to improving feto-maternal outcomes. We present a case of a 32-year-old pregnant woman who presented with sigmoid volvulus at 28 weeks of gestation. The patient was taken up for an emergency laparotomy, where the sigmoid colon was found to be extremely dilated and twisted. Bowel resection and primary anastomosis was done. An anastamotic leak occurred postoperatively, due to which re-exploration and colostomy was done. The patient had a spontaneous abortion after the surgery. She was discharged after five days with a functional stoma and elective colostomy closure was done after six weeks.
An episiotomy scar site endometriosis: a rare case report and review of literature
Authors: Thirupathi Kalaivani , Rengaraj Nithya
Published: July 2022

Endometriosis can be defined as the presence and growth of functioning endometrial tissue (glands and or stroma) outside the endometrium. Occasionally, surgical scars are the sites of endometriotic implantation particularly perineal scars (episiotomy). Perineal scar endometriosis is a very rare condition, its incidence rate was about 0.03-0.15%. Perineal scar endometriosis mainly affects young females at the episiotomy site following a previous vaginal delivery. A 29 years old patient presented with swelling at the site of episiotomy which was associated with pain during menstruation. On examination a palpable mass was revealed without induration at close proximity to episiotomy scar site during menstruation. MRI pelvis is the most commonly used imaging technique for the diagnosis of perineal endometriosis as well as to assess the deeper extent of the lesion. Mass excised and sent for histopathological examination. Wide local excision is the definitive treatment for surgical site endometriosis. Follow up is recommended for recurrence. The rare possibility of malignant transformation, can be excluded by histopathological examination of excised tissue.
Symphysio-fundal height measurement as a tool in antenatal care: current understanding: narrative review
Authors: Papa Dasari
Published: July 2022

Symphysio-fundal height (SFH) measurement during pregnancy was recognized as a simple clinical indicator for monitoring fetal growth since decades. However, its significance and validity are questioned in recent era of Sonography. This is a narrative review of the topic published. Conclusions of systematic reviews, meta-analysis as well as studies which compared SFH and ultrasound for fetal growth monitoring were included. The review revealed SFH has poor sensitivity as a tool for screening and diagnosing fetal growth restriction and inter-observer variations are high and hence fallacious. However multiple measurement model incorporating standard international guidelines may be useful in resource poor settings. Limitations of SFH include that it is not useful in hydramnios, multiple pregnancies and pregnancies with uterine or ovarian masses and fetuses in transverse lie. For screening and early diagnosis of growth restriction, estimation of gestational age and fetal weight estimation USG is the standard tool.
Meigs’ syndrome: how we mistook the diagnosis in a tertiary oncology centre in India; an opinion piece on the surgeon’s responsibility in minimizing the stress of the cancer patient and family
Authors: Ray M. D. , Josephin J. R. Jeena , Kapila Shivani , N. Premanand
Published: July 2022

Typical Meigs syndrome may mislead the surgeon as advanced ovarian cancer. CECT can identify the huge ovarian mass, ascites and pleural effusion. Mostly Surgeon’s mind focuses towards the pleural effusion with elevated CA 125 as stage IVa ovarian cancer because of the rarity of this syndrome. But it is Surgeon’s responsibility to diagnosis of Meigs syndrome beforehand to alleviate the pain of the patient and her family. Meigs’ syndrome typically presents with the triad of an ovarian mass, ascites and pleural effusion. The latter two resolved after removal of the mass. As this syndrome is a rare entity, this presentation of an ovarian mass may mislead the surgeon, biasing his or her mind towards advanced ovarian malignancy. Along with these if the CA-125 is also raised, the patient is usually labelled as stage IVa ovarian cancer, causing immense distress to the patient and family. This makes it even more imperative that the surgeon diagnoses this syndrome beforehand to avoid the pain of the patient and family.
Pulmonary functions in sewage workers
Authors: Karande Shilpa P. , DeSouza R. , Asagaonkar D. S. , Dhokar Sudhir , Pose Meghna , I. Vasanthi
Published: July 2022

Background: Occupational lung diseases in sewage workers have not received sufficient attention, despite chronic exposure to noxious material. We aimed to describe the pulmonary function testing pattern of sewage workers with special emphasis on estimated lung age.Methods: We included sewage workers who came for health check-up. We excluded patients who had respiratory infection/any other respiratory ailments. Socio-demographic profile, history and examination were noted. Routine haematological investigations, chest radiograph, PFT were done. Basal and predicted measurements FVC, FEV1, PEFR, FE F25-75%, MVV and estimated lung age were noted.Results: Average age was 43.48±7.96 years on presentation and no one was symptomatic, everyone had normal X-ray chest findings. Of these 82 participants,36 had normal pattern on PFT. Out of 46 abnormal patterns, 28 had obstructive,5 restrictive and 13 had mixed patterns. In Obstructive pattern, mean FEV1/FVC ratio was 78.15 + 4.42 %, FEV1% was 89.26+10.27 %. In restrictive pattern, mean FVC % was 71%±5.72. In mixed pattern mean FVC % was 71.83+10.7%, FEV1 % was 70.98+6.43%.FEF (25-75%) was 62±10.85% in the obstructive pattern and 93±11.49% in the restrictive pattern. Estimated lung age was found to be 45±10.71 years, 55±11.36 years and 67±7.54 years in normal, obstructive and restrictive pattern which was high.Conclusions: There is a considerable burden of occupation lung diseases in the form of reduced lung functions among sewage workers, which often goes undiagnosed. Periodic assessment and appropriate measures in reducing the exposure should be considered.
Glycopenic endometrium in infertility
Authors: Shivappa Prateek , Isaacs Roma , Mandrelle Kavita , Goyal Sunita
Published: July 2022

Background: Infertility is a global health problem affecting 8-10% couples worldwide. Endometrium is considered to be sensitive indicator of ovarian, pituitary and hypothalamic function. The endometrium, which fails to produce adequate amount of glycogen is termed as ‘glycopenic uteri’. Glycopenic endometrium is said to be unfavourable for early blastocyst implantation leading to infertility in spite of ovulation. Endometrial aspiration/biopsy can be histologically dated based on the Dallenbach-Hellweg criteria which forms an essential part of histopathological examination of endometrium for infertility work-up. The aim of the study was to study the correlation of glycogen content with endometrial histomorphology in infertility.Methods: Cross-sectional observational study in which one hundred twenty-two endometrial specimens sent as curetting/ biopsy were studied. The Glycogen content of endometrium was graded from + to ++++ as given by Arzac and Blanchet. Statistical analysis was done on SPSS version 26.0. The categorical variables were represented by count (percentage) and the continuous variables were represented by mean±SD. The Chi-square test was used to find the association of glycogen content with infertility, the various phases of the endometrium and age.Results: Glycopenic endometrium was seen in 36.9% cases of infertility. Out of which, glycopenic endometrium was much more prevalent in patients with secondary infertility (47%) as compared to patients with primary infertility (35.1%).  Conclusions: Glycogen depletion in secretory phase results in inadequate preparation of endometrium at the time of implantation. Assessment of glycogen is considered to be an essential part of histopathological examination.
Prevalence and risk factors of bone disease in patients with chronic pancreatitis: a cross sectional study
Authors: Kaidabettu Nithin Ramesh , Ramasamy Akilandeswari Alagan , Rathod Vivek , Mohamed Kani Shaikh , A. Anand , N. Arun
Published: July 2022

Background: Osteopenia and osteoporosis is a highly prevalent condition and presents a tremendous public health burden. The association of bone disease has been recognized in several diseases of the git, resulting in established guidelines for screening in patients with malabsorptive disorders such as inflammatory bowel disease (IBD) and celiac disease.  Increasingly, the risk of bone disease has been recognized in patients with chronic pancreatitis, who share similar risk factors as patients with other gastrointestinal disorders.Methods: This single-centre study was carried out in Kilpauk medical college. This study population consisted of 47 patients who were image confirmed cases of chronic pancreatitis. History of smoking, alcohol use was taken, body mass index, fecal elastase was measured. Dual-energy X-ray absorptiometry scan was used to examine bone mineral density (BMD) for the lumbar spine and bilateral femoral neck.Results: Of the 47 patients, 19 patients were chronic smokers and 28 patients had history of significant alcohol use. The prevalence of osteoporosis in patient group was 29.8% in patients with CP compared to Indian prevalence of 18.3% in previous studies. The prevalence of osteopenia was 48.9% in patients with CP compared to Indian prevalence of 49.9% in previous studies.Conclusions: Bone disease in CP can be attributed to several risk factors which act synergistically in propagating abnormal bone metabolism. Osteoporosis and osteopenia are underappreciated sources of morbidity in patients with chronic pancreatitis. Bone health management guidelines are urgently required in patients with chronic pancreatitis.
Carotid cavernous fistula with retrograde flow to cortical veins successfully treated with endovascular detachable balloon
Authors: Ramadhoni Pinto Desti , Nuraini Minda
Published: July 2022

A carotid-cavernous fistula (CCF) is an abnormal vascular connection, which allows blood to flow either directly or indirectly from the carotid artery into the cavernous sinus. The classic triad of ocular symptoms mostly seen in direct CCFs but less common without ocular symptoms. This difference in symptoms depends on the draining venous flow from the fistula, whether it affects the ophthalmic veins or affects the cortical veins. We presented a case of a 32-year-old man with decreased consciousness, seizures, vomiting, a history of long-standing headache, ringing in the ears and double vision, without ptosis, opthamoplegia and without proptosis. Head CT showed a sulcal and perimesencepalic type of subarachnoid hemorrhage. Digital subtraction angiography (DSA) results obtained arterial vein fistula from the right internal carotid artery to the cavernous sinus with the dominant vein draining into the cortical vein, accompanied by dilatation and elongation of the cortical veins. No disturbances in ophthalmic venous outflow were found. Endovascular therapy was performed to close the fistula with detachable balloon embolization modality, with the result of complete fistula closure. The symptom pattern of CCF depended on flow velocity, location of CCF venous drainage, inflammation and pressure within the venous sinuses. Cerebral catheter angiography is the gold standard imaging modality used in the diagnosis and classification of CCF and embolization using a detachable balloon is one of the treatment options for direct CCF.
Docetaxel induced subacute interstitial lung disease in a patient with prostate cancer
Authors: Sanghai Rishav , Ghosh Shantanu , Saraf Saiyam , Mittal Stuti
Published: July 2022

Interstitial lung disease (ILD) is a collective term for a group of disorders that result in inflammation and scarring of the lung interstitium. Although majority of the cases of ILD are idiopathic, some of the etiologies can range from viral infections; connective tissue disorders or drug injury. Docetaxel is an anticancer agent of taxoid family that can rarely cause pulmonary toxicity.  It can be occasionally used for the management of advanced prostate cancer. The adverse effects of the medication are mediated by type I and type IV hypersensitivity reactions.  Here, we reported a case of 68-year-old man with advanced prostate cancer who completed six cycles of chemotherapy with docetaxel and presented with shortness of breath, low-grade fever and cough two weeks after completion of scheduled regimen. Clinical examination revealed diffuse wheeze and decreased air entryon auscultation, oxygen desaturation and an ulcerative lesion on the left forearm. All his routine serum, sputum and autoimmune profile were inconclusive. The inflammatory markers (CRP, ESR) were raised but procalcitonin was in normal range. Pulmonary function tests were indicative of restrictive lung disease. Digital chest X-ray revealed diffuse opacification with prominent bronchovascular markings and HRCT of thorax reported bilateral scattered honeycomb appearance, subpleural opacities, centrilobular nodules with air trapping. Docetaxel induced interstitial lung disease (DILD) was diagnosed and the patient was advised with high dose systemic and inhalational steroids along with external oxygen support.  Rapid clinical improvement was seen and the patient was eventually discharged with tapering doses of oral steroids, physiotherapy and close follow-up.
Audiovestibular manifestations during pregnancy: a review
Authors: Swain Santosh Kumar
Published: July 2022

Pregnancy is nine-month duration physiological process with psychological, cardiovascular, and hormonal changes that affects different organs of the pregnant women. Any organs of the body can be affected during pregnancy due to hormonal changes so as in audiovestibular system. There are several audiovestibular manifestations occur during pregnancy such as hearing loss, otosclerosis, tinnitus, autophony, facial nerve palsy, and vertigo manifested as first time or get exacerbated during pregnancy. Majority of the changes during pregnancy are harmless to the mother and fetus, whereas some may cause pathological manifestations. The hormonal changes during pregnancy can cause alteration in the homeostasis of the inner ear fluids and hamper the inner ear functions. The changes of estrogen and progesterone levels during pregnancy can affect the audio-vestibular system. These changes in the inner ear may manifest with symptoms like vertigo, tinnitus, fullness in the ear, and hyperacusis. These symptoms in the pregnancy directly affects the quality of life both physically and emotionally. There are no standard guidelines for the management of audiovestibular manifestations. However, there are very little data available for audiovestibular manifestations during the pregnancy period. The objective of this review article is to discuss the prevalence, etiopathology, and clinical presentations, diagnosis and treatment of audiovestibular manifestations during pregnancy.
Evaluation of efficacy and outcome of retroperitoneal laparoscopic pyelolithotomy and open pyelolithotomy in patients with renal stones
Authors: . Vitrag , Saraf Aakansha
Published: July 2022

Background: Urolithiasis has affected humans since antiquity. The aim of the study was to evaluate the efficacy and outcome of retroperitoneal laproscopic pyelolithotomy and open pyelolithotomy in patients with renal stones.Methods: The present prospective randomized clinical study was carried out in department of surgery from June 2017 to April 2021 in patients with renal stones. A total of 100 patients with solitary renal pelvic stone were properly assessed radiologically and clinically before planning the surgical intervention.Results: The overall mean age of presentation among patients undergoing pyelolithotomy was 41.9±12.30 years (χ2=5.14, p≤0.001). Minimum number of patients were 41-60 years age group i.e.; 58 patients. 70 patients were males while 30 patients were females with male to female ratio 2.33:1. The mean stone size among patients undergoing LP and OP was 1.9±0.5 cm. The mean operative time (min) among patients undergoing LP group (123.9±9.5 minutes) was more as compared to OP group was 80.1±17.5 min. The mean duration of return to work was 3.86±1.39 days. The mean duration of return to work in LP group was 3.87±1.37 days, while in OP group was 5.87±1.34 days (χ2=18.56, p<0.02).Conclusions: Retroperitoneal laproscopic pyelolithotomy proved to be safer in all the aspects than open pyelolithotomy.
Urethral stricture disease: a qualitative survey to assess mental status of the patients
Authors: Bhattacharyya Kali Sankar , Paul Pritama , Paul Sritama , Chowdhury Piyali Dutta , Paul Uttam Kumar
Published: July 2022

Background: Urethral stricture patients are often associated with general anxiety disorders. So, our objective was to gather the data of manifestation of anxiety disorder in urethral stricture patients.Methods: We had measured the anxiety level of these patients after two weeks of insertion of catheters (with catheter) and again two weeks after removal of catheter (without catheter) by using the ‘7-item generalized anxiety disorder’ (GAD-7) tool.Results: During the data analysis we have found that amongst the 56 patients included in the study 24 patients had minimal, 12 patients had mild, 11 patients had moderate and 9 patients had severe level of anxiety after 2 weeks of insertion of catheter. Later on, two weeks after removal of catheter 32 patients had minimal, 14 patients had mild, 7 patients had moderate level and 3 patients had severe level of anxiety.Conclusions: So, it can be concluded that urethral stricture disease with an indwelling catheter is an important cause of moderate to severe anxiety and proper intervention plan is crucial for all patients before and after inserting catheter.
Pancreatectomy for metastatic renal cell carcinoma: twenty years of experience at a tertiary centre
Authors: Chou Richard Y. , Daly Daniel , Wong Pearl , Gaszynski Rafael , Apostolou Christos , Merrett Neil
Published: July 2022

Renal Cell Carcinoma (RCC) accounts for approximately 90% of primary renal malignancies, of which the clear cell subtype is most common. While metastatic disease is common at the time of diagnosis and generally confers a poor prognosis, metastatic RCC may demonstrate relatively indolent behaviour and present many years after resection of the primary tumour, including to the pancreas. The available literature suggested that surgical resection was appropriate for select patients, including those with a solitary pancreatic metastasis, minimal comorbidities and uncomplicated progress from initial treatment of their primary renal malignancy. A retrospective case series of patients presenting with RCC metastases to the pancreas, managed via surgical resection at a tertiary teaching hospital was reviewed. Analysis of patient demographics, investigations, management and outcomes were performed, with a focus on post-operative morbidity and overall survival. Between 2000 and 2020, 7 patients underwent pancreatic resection of RCC metastases at our tertiary teaching hospital with curative intent. Median age at time of resection was 66 years. No post-operative mortality or major morbidity was experienced by the 7 patients, although 4 patients developed some degree of pancreatic insufficiency. Four patients experienced recurrent metastatic RCC, with median time to recurrence of 3.5 years. This was the largest local study to describe an Australian experience of the surgical management of RCC pancreatic metastases. These patients are frequently afforded prolonged survival following pancreatic resection, but often develop other distant sites of disease and second renal tumours.
A case report of large adult sacrococcygeal teratoma with literature review
Authors: Akhtar Aisha , Ruiz-Vega Karla M. , Apostolides George Y.
Published: July 2022

Sacrococcygeal teratomas rarely present in adulthood. Due to its rarity, accurate diagnosis is a clinical dilemma in adults. The patient was a 41-year-old female who presented with pelvic pain, low back pain radiating to the legs and chronic constipation.  The patient underwent a CT scan which demonstrated a 6 cm presacral multiloculated mass compressing rectum. Prior to presentation at our clinic, she had an EUS and biopsy by gastroenterology, followed by diagnostic laparoscopy due to her past medical history of endometriosis.  Her workup was negative for gynaecologic pathology which led to a surgical referral. We evaluated the images and took her to the operating room for posterior paracoccygeal retrorectal mass resection with coccygectomy and intraoperative flexible sigmoidoscopy. She had complete excision for pathologically proven mature 9 cm teratoma. Sacrococcygeal teratoma is rare in adults. A high index of suspicion is required for diagnosis. It should be in the differential diagnosis when dealing with presacral masses in adults. Complete excision is the treatment of choice.