bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the Effectiveness of Elderly Gymnastics with Neuromuscular Tapping on Dynamic Balance and Spinal Flexibility in the Elderly
Authors: Melur Belinda  , Yuly Peristiowati  , Siti Farida Noor Layla
Published: December 2024

The elderly experience changes in physiological function and body structure, including decreased muscle mass, and joint stiffness. These changes lead to a decrease in the functional balance of the body. This study aims to analyze the difference in the effect of elderly gymnastics and the combination of elderly gymnastics with neuromuscular taping on dynamic balance and flexibility of the elderly. The design of this study was a quasi-experiment with two groups: group 1 elderly gymnastics, while group 2 elderly gymnastics and neuromuscular taping. The study population was the elderly in Karanglo Indah Elderly Gymnastics Group Malang City aged 60-74 years.
Correlation Compliance with the Implementation of Standard Operational Procedures Wound Treatment, Bundles Surgical Site Infection and Blood Sugar Levels with the Incident of Operative Site Infection in Sectio Ceasarea Patients
Authors: Slamet Djoko Sunarko  , Yuly Peristiowati  , Prima Dewi Kusumawati
Published: December 2024

Non-compliance with wound care SOPs can trigger surgical site infections that result in increased morbidity and mortality, as well as increased length of care. The purpose of this study was to determine the relationship between compliance with the implementation of wound care SOPs, surgical site infection bundles, and blood sugar levels with the incidence of surgical site infections. Correlation research with a cross-sectional approach design. The independent variables of compliance with wound care SOPs, KGD, and the implementation of SSI bundles used observation.
Subchronic toxicity of a drug based on D-cyphenothrin, pyriproxyfen and piperonyl butoxide
Authors: Arisov M. V. , Poselov D. S. , Poselova E. V. , Stepanov A. A. , Novik T. S.
Published: December 2024

The purpose of the research is to study the effects of a combined drug based on D-cyphenothrin, pyriproxyfen and piperonyl butoxide on the body of rats with repeated dermal application in a subchronic experiment.Materials and methods. The drug subchronic toxicity was studied in the vivarium of the VNIIP – FSC VIEV on 30 male rats divided into one control and two experimental groups of 10 animals each. The drug was applied daily for 7 days to the experimental rats at doses of 1/10 and 1/20 of the maximum possible dose for dermal application determined in an acute experiment when studying LD50. On the first day and at 10 days after the last application of the drug, half of the animals from each group were euthanized and blood samples were taken to determine morphological and biochemical parameters. A macroscopic examination of the organs was carried out; their mass was determined, and mass coefficients were calculated.Results and discussion. The drug based on D-cyphenothrin, pyriproxyfen and piperonyl butoxide applied dermally for 7 days in doses of 1/10 of LD50 (3071 mg/kg) and 1/20 of LD50 (1535.5 mg/kg) had no negative effect on the rats' organism, or its physiological state, and caused no changes in the morphological or biochemical blood parameters, as well as the mass coefficients of the internal organs. Doses of 3071 and 1535.5 mg/kg were inactive (safe). The threshold and toxic doses could not be determined
PENGARUH SELF-CONCEPT DAN SELF-EFFICACY TERHADAP KEMAMPUAN PEMECAHAN MASALAH MATEMATIS SISWA KELAS IX
Authors: Khesya Nurhaliza , Ananda Rusydi
Published: December 2024

Tujuan dari penelitiannini adalah supaya mengetahui apakah Self-concept dan Self-efficacy mempengaruhikkemampuan siswa dalammmemecahkannmasalah matematika. Penelitian kuantitatif ini menggunakan metode survei. Penelitian ini dilakukan di MTs TPI Sawit Seberang pada tahun ajaran 2024/2025, dan sampel terdiri dari 35 siswa kelas IX. Observasi, wawancara, kuesioner dan tes adalah metode pengumpulan data. Analisis statistik deskriptif dan inferensial, termasuk uji-prasyarat analisis data dan pengujiannhipotesis, digunakan. Temuan penelitian, berdasarkan uji hipotesis dengan taraf signifikans 5% (0,05), menunjukkan bahwa: 1) Self-concept dan Self-efficacy memiliki efek positif terhadap kemampuan memecahkan masalah matematis; 2) Self-efficacy dan self-concept memiliki efek masing-masing terhadap kemampuan memecahkan masalah matematis. dengan koefisien penentuan 0,535. Jadi, self-concept dan self-efficacy siswa berpengaruh sebesar 53,5%.
Neutrosophic fuzzy decision-making framework for site selection
Authors:   Department of Basic Science and Humanities, Greater Kolkata College of Engineering & Management, West Bengal, India, Biswas Aditi , Gazi Kamal Hossain ,   Department of Applied Mathematics, Maulana Abul Kalam Azad University of Technology, West Bengal, India, Bhaduri Prodip ,   Department of Applied Mathematics, Maulana Abul Kalam Azad University of Technology, West Bengal, India, Mondal Sankar Prasad ,   Department of Applied Mathematics, Maulana Abul Kalam Azad University of Technology, West Bengal, India
Published: December 2024

These days, the area of interest based on canteen location selection in the university campus is a prominent topic. This research work directly affects students' convenience, accessibility and the total campus experience. An ideal canteen site not only provides good food to the students and staff but also takes care of their health by providing a healthy environment. In this paper, we choose various criteria and sub-criteria to calculate the best site for a canteen in the university campus. Location, space and layout, infrastructure and Utilities, safety and compliance and environmental factors as criteria with their corresponding sub-criteria are chosen for this work. Here, the data sets used are provided by decision makers in linguistic words and then converted into crisp numbers. The criteria and sub-criteria weights are considered by a popular multi criteria decision-making (MCDM) method named Criteria Importance Through Intercriteria Correlation, i.e., CRITIC method. Therefore, the ideal location for the canteen in the university campus was determined by applying the complex proportional assessment method (COPRAS), which is basically a ranking method of MCDM. And finally, sensitivity analysis was conducted to make sure the outcomes were flexible and stable.
Large Language Models in Nonprofit and Public Good Sectors
Authors: song xinyuan , HSIEH WEI-CHE , Bi Ziqian , Jiang Chuanqi , Liu Ming , Wang Tianyang , Jing Bowen , Yang Junjie , Song Junhao , Chen Keyu , Chen Silin , Li Ming , Niu Qian , Liu Junyu , Peng Benji , Zhang Sen , Xu Jiawei , Pan Xuanhe , Wang Jinlang , Feng Pohsun , Wen Yizhu , Yan Lawrence K.Q. , Tseng Hong-ming , Ren Jintao , Zhang Yichao , Liang Chia Xin , Wang Yunze
Published: December 2024

Large Language Models (LLMs) represent a significant advancement in artificial intelligence, capable of understanding and generating human-like text based on extensive training data. These models are trained on vast datasets that encompass various topics, languages, and styles, enabling them to perform a wide range of language-related tasks, such as translation, summarization, content creation, and even complex question answering. Their versatility makes them invaluable tools across different industries, and recently, their application in non-profit and humanitarian sectors has garnered attention for its potential to make a significant positive impact.To understand the role of LLMs in these sectors, it is essential to first grasp the fundamentals of how they work. LLMs like GPT-3, BERT, and T5 operate using neural networks that mimic certain aspects of human cognitive processes. When given a prompt, these models analyze the input and generate responses based on learned patterns in language and context.
A Millimeter-Scale Change in Leaf Litter Placement Within Soil-Water Interfaces Alters Carbon Dioxide and Methane Emission
Authors: Liu Hao , Zhang Yi-Ning , Cai Yu-Jia , Liu Zi-Yan , Li Liang , Wang Ya-Qin , Shu Xiao , Goodacre Royston , Chen Zheng
Published: December 2024

Flooded soils play a critical role in global carbon cycling, serving as significant reservoirs of soil organic carbon and sources of carbon emissions. Leaf litter, particularly from local vegetation, is a major contributor to soil organic carbon formation in these ecosystems, with its decomposition driving the production of carbon dioxide and methane. While numerous studies have investigated the factors influencing leaf litter decomposition and the associated greenhouse gas emissions, the impact of millimeter-scale variations in leaf litter placement within the soil-water interface (SWI) remains underexplored. This study hypothesizes that such minor changes in burial depth can significantly alter the emission patterns of CO2 and CH4. To test this, a microcosm experiment was conducted, monitoring gas fluxes and profiles of physicochemical properties in treatments with leaf litter closely placed at two depths within the SWI. Results revealed that a sub-centimeter difference in leaf litter placement could lead to a substantial shift in CO2 and CH4 emissions, with important implications for modeling wetland carbon dynamics and predicting their climate impact. These findings underscore the sensitivity of greenhouse gas emissions to small-scale environmental variations, highlighting the need for more precise models in estimating wetland contributions to global carbon fluxes.
SAT in Polynomial Time: A Proof of P = NP
Authors: Vega Frank
Published: December 2024

The P versus NP problem is a cornerstone of theoretical computer science, asking whether problems that are easy to check are also easy to solve. "Easy" here means solvable in polynomial time, where the computation time grows proportionally to the input size. While this problem's origins can be traced to John Nash's 1955 letter, its formalization is credited to Stephen Cook and Leonid Levin. Despite decades of research, a definitive answer remains elusive. Central to this question is the concept of NP-completeness. If even one NP-complete problem, like SAT, could be solved efficiently, it would imply that all NP problems could be solved efficiently, proving P=NP. This research proposes a groundbreaking claim: SAT, traditionally considered NP-complete, can be solved in polynomial time, establishing the equivalence of P and NP.
Biased Bots: An Empirical Demonstration of How AI Bias Could Compromise Mental Healthcare
Authors: Timmons Adela , Feng Kexin , jduong@utexas.edu  , Carta Kayla , Walters Sierra , Jumonville Grace , Carrasco Alyssa , Freitag Gabrielle , Romero Daniela , Margolin Gayla , Narayanan Shrikanth , Comer Jonathan S. , Ahle Matthew , chaspari Theodora
Published: December 2024

Background: The proliferation of artificial intelligence (AI) applications for mental health has advanced in recent years and shows promise to increase the reach, scope, and impact of mental healthcare. However, biases in algorithms designed to assess and treat mental health problems pose risk for equitable mental health. This cross-sectional study investigates the existence of bias in algorithms for detecting stress from mobile devices and its implications for mental health equity.Methods: A diverse sample of young adults (N = 212) carried smartphones, wore physiological sensors, and completed hourly surveys assessing their subjective stress for 24 hours. We then developed a Twin Neural Network machine learning (ML) model to detect hourly stress from smartphone and wearable data and evaluated model performance across gender and ethnic/racial status. Findings: The model performed moderately well overall yet showed significant variation in performance ranging from poor to good across gender and ethnic/racial groups. In particular, the model evidenced lower performance in women compared to men and overestimated the frequency of stress episodes for Hispanic/Latina women.Interpretation: Findings highlight the presence of bias in AI applications for mental health and underscore the need for cautious interpretation of ML outcomes in historically underrepresented groups. Discussion focuses on the implications of AI bias for mental health and the importance of developing methods that combine AI and social justice perspectives to ensure the implementation of equitable mental healthcare.Funding: This project is based on work supported by NIMH Grant No. R42MH123368 (Timmons, Comer, Ahle, Co-PIs), NSF GRFP Grant No. 1930019 (Timmons, PI), NSF Grant No. BCS-1627272 (Margolin, PI), SC CTSI (NIH/NCATS) Grant No. UL1TR000130 (Margolin, PI), NIH-NICHD Grant No. R21HD072170-A1 (Margolin, PI), NSF GRFP Grant No. DGE-0937362 (Timmons, PI), an APA Dissertation Award (Timmons, PI), NSF GRFP Grant No. DGE-0937362 (Han, PI), and NSF Grant No. 2046118 (Chaspari, PI).Keywords: Artificial intelligence; bias; equitable mental health; multimodal stress sensing
Limited effectiveness of psychological inoculation against misinformation in a social media feed
Authors: Wang Sze Yuh Nina , Phillips Samantha Cavanaugh , Carley Kathleen M. , Lin Hause , Pennycook Gordon
Published: December 2024

Psychological inoculation is a promising and potentially scalable approach to counter misinformation. The goal of inoculation is to teach people to recognize manipulation techniques, such as emotional language, commonly found in misinformation online. While there is substantial evidence that inoculation increases technique recognition when directly assessed, it is not clear if this effect transfers to spontaneous detection of techniques and disengagement with the associated content in real-life contexts. In particular, emotional appeals are abundant on social media and known drivers of attention and engagement. Therefore, we examined the effects of emotional language and emotional manipulation inoculation on attention and engagement in a simulated social media feed environment. Through five pre-registered studies, we found that inoculation only decreased engagement with emotionally presented content when we solely presented synthetic content relevant to the task of identifying emotional manipulation. Any addition of real tweets or even synthetic tweets containing other manipulation techniques (e.g., ad hominem attacks) into the feed appeared to nullify the effect. Our results highlight the importance of assessing misinformation interventions in ecologically-valid contexts to estimate real-world effects.
Decomposing Recruitment Elasticity in Job Matching
Authors: Kambayashi Ryo , Kawaguchi Kohei , Otani Suguru
Published: December 2024

This study estimates and decomposes recruitment elasticity, a key measure of employer market power, across job-matching stages using data from Japan's largest job-matching intermediary. On average, recruitment elasticity is negative but not statistically significantly different from zero. However, this masks heterogeneity across stages. The negative elasticity arises from lower-wage workers avoiding higher-wage vacancies during inquiry. Posted wages positively influence application, interview attendance, and offer acceptance decisions, with elasticity decreasing in that order. Other important patterns are also examined.
Awareness, perception and behavioral determinants associated with cancer prevention among adults: Results from a cross-sectional study in urban field practice area of a tertiary care hospital, Kolkata
Authors: Sarkar Paramita , Pallabi Dasgupta  , Sarkar Payel , Rivu Basu
Published: December 2024

Background: Cancer is emerging as a major public health problem. Two-thirds of cancer patients are in the advanced stage at the time of diagnosis. Public awareness plays a big role in cancer prevention.
Aims and Objectives: To assess awareness, perception, and behavioral determinants of cancer prevention of urban adults.
Materials and Methods: An observational, cross-sectional study was conducted in the urban slum of Kolkata. Four hundred fifteen respondents were interviewed using a pre-tested questionnaire after having consent.
Results: Though majority (72.3%) of respondents had satisfactory awareness but had limited awareness on screening tests (58.6%) and vaccination (1.6%). Half of them had a favorable perception on cancer prevention but the perceived barrier was more. The behavior score was poor among the majority of participants. The main source of information was T.V. (88.2%) and friends and relatives (80.2%). Only one-fourth of participants mentioned of health workers and health camps as sources of information indicating inadequate activities on cancer awareness programs. Age (OR 7.08, 95% CI=1.07–46.74), sex (OR 0.38, 95% CI=0.19–0.76) education (OR 4.81, 95% CI=2.50–9.27) were significant predictors of satisfactory awareness. Higher levels of education, younger age, and female gender were factors that shaped perception. Only education level (OR 0.29, 95% CI=0.15–0.59) had a significant association with cancer preventive behavior.
Conclusions: Though awareness on primary preventive measures was satisfactory but behavior was unsatisfactory among study participants. They had more perceived barriers while taking preventive measures. The finding indicates a need to promote health education and motivate people to recognize and modify cancer-related behavioral risk factors.
A prospective and retrospective observational study on residual gallbladder stones after cholecystectomy
Authors: Indranil Chakraborty  , Manojit Sarkar  , Arup Kumar Ghosh  , Amit Ray
Published: December 2024

Background: A small number of post-cholecystectomy syndrome cases result from residual stones in a lengthy cystic duct or recurrence of lithiasis in a remaining gallbladder (GB) tissue. In laparoscopic procedures, up to 13.3% may involve incomplete GB removal due to surgical complexities and anatomical variations such as adhesions or challenging morphology.
Aims and Objectives: (1) To assess the incidence of retained stones in patients undergoing cholecystectomy, (2) to compare incidences among open and laparoscopic cholecystectomies, (3) to study various presenting ways and different investigational methods helping in early diagnosis and proper management, and (4) to study different operative interventions for different cases.
Materials and Methods: This was a prospective and retrospective observational study. After getting ethical committee approval and informed consent, 35 patients were included in the study. The study was carried out in the Department of General Surgery at I.P.G.M.E.R./S.S.K.M. Hospital, Kolkata.
Results: Most patients were post-open cholecystectomy cases. The incidence of retained GB stones was 4.48%, with females affected 2.8 times more than males. Common symptoms were pain abdomen (80%) and fever (25%). Ultrasonography diagnosed stump calculi in 85.71% of cases; magnetic resonance cholangiopancreatography (MRCP) was preferred when ultrasound was inconclusive.
Conclusion: Cases underwent subtotal cholecystectomy or had long cystic duct stumps in rural hospitals, referred to tertiary hospital for further management. Symptoms included pain abdomen, fever, and sometimes jaundice. MRCP confirmed diagnoses before open re-exploration; completion cholecystectomy addressed residual stones for symptom relief and cure.
Umbilical port versus epigastric port for gallbladder retrieval in laparoscopic cholecystectomy: An intervention study
Authors: Shakil Jawed  , Shaikh Md Nafis Jahangir  , Imdadul Haque
Published: December 2024

Background: Open cholecystectomy as a routine operation once for cholecystitis and cholelithiasis is no more a routine practice. Laparoscopic cholecystectomy (LC) is one of the most common surgeries done these days and has become the gold standard for the treatment of symptomatic cholelithiasis.
Aims and Objectives: The aim of the study was to compare the retrieval of gallbladder (GB) between epigastric port and umbilical port as two approaches of LC in terms of the time taken to remove GB, pain, and other complications postoperatively.
Materials and Methods: An intervention study was conducted in the general surgery department between June 2022 and May 2023 among 73 patients who were admitted for cholecystectomy recruited by a total consecutive sampling method. Patients were put into two modalities of retrieval of GB by performing the two methods alternately. Templates were generated in MS Excel sheet and analysis was done. Appropriate statistical tests were used and the P<0.05 was taken as significant.
Results: There was no significant difference in the mean age (P=0.21) of patients as well as the mean duration of surgery (P=0.07) through epigastric port as compared to umbilical port. Patients who had undergone retrieval of GB through epigastric port (P=0.04) had significantly lesser pain at 6 h post-operation as compared to epigastric port. The overall pain scores were lesser when extraction of GB was done through epigastric port in comparison with umbilical port. The post-operative complications in terms of infection, hernia was lesser in patients undergoing extraction of GB through epigastric port.
Conclusion: Epigastric port could be better as compared to umbilical port for retrieval of GB with respect to mean duration, post-operative pain and herniation from port site, and also surgical site infection.
Effect of kangaroo mother care in low-birth-weight babies in reference to breastfeeding in NICU at a tertiary care centre - An observational study
Authors: Kalita Dulal , Sarma Sumana
Published: December 2024

Background: Kangaroo mother care (KMC) is described by the WHO as early, ongoing, and prolonged skin-to-skin contact between a mother and her preterm infants.
Aims and Objectives: (1) The aim of the study was to study the effect of KMC in growth of newborn and (2) to study the effect of KMC in prevention of hypothermia, apnea, and requirement of prolonged hospital stay.
Materials and Methods: In this prospective, hospital based, observational study, 241 neonates who were hospitalized to the neonatal intensive care unit in Gauhati Medical College and Hospital, Guwahati between April 2023 and March 2024 were assessed. Every potential mother was trained for KMC and given exclusive breastfeeds, and contrasted with a control/(conventional method of care) group of mothers.
Results: The KMC babies had better breastfeeding rates as compared to the control group (76% vs. 53.8%). The weight gain (14.9±4.7 vs. 10.5±4.1 g/day), increase in length (0.97±0.67 vs. 0.69±0.63 cm/week), chest circumference (0.73±0.35 vs. 0.49±0.19 G/week), and head circumference (0.74±0.52 vs. 0.50±0.31 g/week), was also better in the KMC group. The incidence of apnea and hypothermia was significantly less in the KMC group, and the duration of stay in hospital was less in the KMC group than the control group (10±5 vs. 16±8 days).
Conclusions: KMC improves breastfeeding rates, improves growth, reduces morbidities, and decreases duration of hospital stay.
Radiological approach for early diagnosis of liver parenchymal disease
Authors: Rachna Chaurasia  , Sunil
Published: December 2024

Background: Diffuse liver parenchymal disease (LPD) encompasses a wide range of liver disorders characterized by extensive involvement of liver tissue, often resulting in significant morbidity and mortality. Early detection and accurate assessment of these diseases are crucial for effective management and improved patient outcomes.
Aims and Objectives: This study aims to evaluate the efficacy of various imaging modalities in the early detection and monitoring of diffuse LPDs, specifically focusing on non-invasive techniques such as ultrasonography (USG), computed tomography (CT), and Fibroscan.
Materials and Methods: A prospective observational study was conducted involving 362 patients presenting with clinical signs and symptoms of liver disease at Maharani Laxmi Bai Medical College, Jhansi. Patients underwent standardized imaging protocols, including US, CT, and Fibroscan, along with laboratory tests to confirm liver function abnormalities. Imaging findings were correlated with clinical and laboratory data to assess diagnostic accuracy and efficacy.
Results: The study found that ultrasound, elastography, and CT provide a reliable, non-invasive method for assessing diffuse LPD at the early stage ultrasound along with Fibroscan and CT both have comparable diagnostic capabilities in assessing diffuse LPD. Ultrasound and Fibroscan being non-invasive and radiation-free should be used as initial investigations whereas CT further contributes to the detailed characterization of liver parenchyma. Integration of these imaging modalities significantly enhanced early diagnosis and disease monitoring.
Conclusion: Integrating advanced imaging modalities, especially elastography, into routine diagnostic protocols for diffuse LPDs enables early detection and effective management. Non-invasive techniques such as US and CT improve patient outcomes by allowing timely intervention and continuous monitoring of disease progression, thus reducing the need for invasive procedures such as liver biopsy.
An observational study of clinico-pathological characteristics of gynecological tumors and mode of treatment
Authors: Ashwini R  , Ravi N Patil  , Shiny Varghese  , Nalini Arun Kumar  , Sathyavani C
Published: December 2024

Background: Gynecological malignancies are a group of various malignancies of the female reproductive system which included cancers of the ovary, cervix, uterus, vulva, vagina, and also gestational trophoblastic neoplasia.
Aims and Objectives: The aim of this study was to study the clinical profile, different histopathological types of gynecological tumors, and mode of treatment.
Materials and Methods: Study was conducted on 94 patients from June 2022 to December 2022.
Results: Mean age of study population was 49.54±14.54 years. On radiological examination, out of total 52 ovarian cancers, cysts were present in 14 (14.89%) women, solid cysts in 16 (17.02%), papillary projections in 9 (9.57%), vascularity in 11 (11.70%), and lymphadenopathy in 2 (2.12%) women. The Pipelle biopsy results showed complex hyperplasia with atypia in 6 women (6.38%), endometrial carcinoma in 2 women (2.12%), focal atypia in 3 women (3.19%), and simple hyperplasia with atypia in 7 women (7.44%). On Pap smear/liquid based cytology, 1 (1.06%) woman each had atypical squamous cells, HSIL cannot be excluded, atypical squamous cells of undetermined significance, high-grade squamous intraepithelial lesion, and low-grade squamous intraepithelial lesion. No intraepithelial lesion or malignancy was found in 82 (87.23%) women. Present study showed that cervix cases was 10 (10.63%), endometrium 30 (31.91%), and vaginal 1 (1.06%). Majority of women in the present study, that is, 53 (56.38%) had ovarian tumors. In endometrial cancer, endometrioid adenocarcinoma, that is, 15 (50%) followed by simple endometrial hyperplasia without atypia and complex endometrial hyperplasia with atypia, that is, 4 (13.33%) each.
Conclusion: Maximum number of patients having various gynecological tumors presented with stage II disease and above but maximum women with ovarian cancer reported with stage III and stage IV. These results clearly explained that ovarian cancer usually had non-specific or misleading symptoms as compared to cervical cancer which reported few specific symptoms.
Evaluation and comparison of disability and functioning of low-risk pregnant women in 2nd and 3rd trimester using the world health organization disability assessment schedule 2.0
Authors: Nirmal Shivangi Ravindrakumar  , Shishram Saini  , Rizwana Shaheen  , Asmita Arun  , Neetu Gehlot
Published: December 2024

Background: Pregnancy is a physiological phenomenon where there is progressive anatomical, physiological, and biochemical change not only confined to the genital organs but also to all the systems of the body. There is a lack of knowledge in the field of functioning and disability among women with low-risk pregnancy without severe complications, and the condition that can lead to limitation in activity and restriction of participation. Considering the lack of research and the fact that the physiological changes of pregnancy can impact negatively on women’s functioning, the purpose of this study was to evaluate disability and functioning of low-risk pregnancy and its associated factors using a specified diagnosed tool developed by the World Health Organization (WHO).
Aims and Objectives: The aim of the study was to evaluate disability and functioning of low risk pregnancy using the WHO disability assessment schedule 2.0 (WHODAS 2.0).
Materials and Methods: This is an observational hospital-based prospective study, 140 women aged 18–35 year with low-risk pregnancy were interviewed first in 2nd trimester using WHODAS 2.0 questionnaire which was followed by 2nd interview in 3rd trimester with a minimum gap of 8 weeks and comparison was done between both trimester.
Results: Higher level of disability observed in cognition in 2nd trimester (P=0.009) while mobility and life activities domain were high in 3rd trimester (P=0.01 and P=0.027). Self-care domain had P=0.008 which was statistically significant with increasing level of difficulty in self-care as pregnancy advances. Getting along (P=0.005), participation (0.042) indicating greater difficulty as pregnancy progresses.
Conclusion: The findings showed that even in a low risk pregnancy, functioning can be affected in different domains. The identification of impairments to functioning could enable improvement in care. Longitudinal studies involving the first trimester and postpartum are necessary to gain insight into women’s disability and functioning during the pregnancy puerperal period.
Combination of ultrasound-guided pectoral nerve block I and serratus anterior plane block for attenuation of surgical stress response during modified radical mastectomy: A prospective interventional randomized controlled trial
Authors: Monotosh Pramanik  , Shalini Chaudhuri  , Sandipan Banerjee  , Uddalak Chattopadhyay  , Syed Sadaqat Hussain  , Nikhil Kumar Singh  , Jyotirmay Kirtania
Published: December 2024

Background: General anesthesia with multimodal analgesia is the standard anesthetic management during modified radical mastectomy. In this study, a combined ultrasound-guided pectoral nerve block (PECS I) and serratus anterior plane (SAP) block were used for surgical stress response attenuation and post-operative analgesia.
Aims and Objectives: This study aimed to compare the efficacy of combined PECS I and SAP block to intravenous (IV) multimodal analgesia in attenuating surgical stress response and post-operative analgesia in patients who underwent modified radical mastectomy with axillary clearance. The primary objective was to estimate the intraoperative fentanyl requirement to reduce autonomic response due to surgical stimulus. The intraoperative vitals, post-operative numeric rating scale pain score, post-operative analgesic use in the recovery room, and incidence of post-operative nausea vomiting were the secondary objectives.
Materials and Methods: Thirty-six consenting patients were randomized into two groups. After induction of general anesthesia, Group B patients received ultrasound-guided PECS I and SAP block whereas Group C patients received IV analgesics only. Intraoperative fentanyl dosage to keep the systolic blood pressure (SBP) and heart rate (HR) within 20% of baseline were noted in the both groups. Intraoperative vitals, post-operative pain score, analgesic requirement, and incidence of post-operative nausea, and vomiting were also recorded in the both groups.
Results: Surgical stress response attenuation was achieved with a lower dosage of fentanyl in Group B compared to Group C (intraoperative fentanyl [mean±SD], 116.11±25.70 μg vs. 134.44±20.07 μg, P=0.023). Compared to Group C, intraoperative reduction in SBP and HR was higher in Group B (SBP reduction [mean±SD], 24.03±12.5 mm of Hg vs. 15.2±13.05 mm of Hg, P=0.045 and HR reduction [mean±SD], 18.61±6.6 beats/min vs. 10.73±10.03 beats/min, P=0.009, respectively). The apparently higher pain scores in the control group were statistically insignificant.
Conclusion: A combined PECS I and SAP block attenuates intraoperative autonomic stress response due to the surgical stimulus with significantly less opioid requirement.
Clinical profile of female patients with chronic telogen effluvium and its association with serum ferritin level
Authors: Minu Sunil  , Meriya Zacharia
Published: December 2024

Background: Diffuse hair loss persisting longer than 6 months without any cause is referred to as chronic telogen effluvium (CTE). The role of iron deficiency without anemia in causing chronic diffuse hair loss is unclear. Some studies have reported a critical threshold of 40 mcg/mL of serum ferritin, below which increased telogen shedding was observed. Screening all patients with CTE for iron deficiency will aid us in finding a possible cause and help in its management.
Aims and Objectives: To study the clinico-epidemiological profile of female patients with CTE and its association with serum ferritin levels.
Materials and Methods: Cross-sectional study on 263 female patients aged 13–60 years with CTE attending the Department of Dermatology at Government Medical College, Kottayam.
Results: The mean age of patients with CTE was 28.92 years. Trichodynia was reported by 20% among which 70% reported associated mental stress which was statistically significant. Bitemporal thinning was noted in 57% and 68% had short growing hairs in the frontal/bitemporal region. The hair pull test was positive in 37.6%, high visual analog grade of hair loss in 92%. Only 32% had anemia (Hb <12) but 86% had S. ferritin <40 mcg/L with the mean S. ferritin being 23.93 ng/mL and the majority were in the age group of 20–29 years.
Conclusion: The majority were found to have low serum ferritin levels without clinical anemia, which could indicate an association between low iron stores and CTE. Additional case–control studies are needed to establish the role of iron deficiency in causing hair loss.
Effectiveness of 8 weeks of Panchakshari mantra chanting on cognitive and psychological parameters in young adults
Authors: Anitha Lakshmi  , Bhargavi SK  , Shashikumar SD  , Yashica Gowda R  , Sai Sailesh Kumar Goothy  , Mukkadan JK
Published: December 2024

Background: It was reported that those who practice chanting of the Shiva panchakshari mantra can overcome stress, attain prosperity, and get stability in life. However, there are no research studies in this area in the PubMed literature to support scientific evidence.
Aims and Objectives: The present study was undertaken to observe the effectiveness of 8 weeks of Panchakshari mantra chanting on cognitive and psychological parameters in young adults.
Materials and Methods: A total of 60 young adults were part of the study after obtaining the written informed consent. After recruiting, they were randomly assigned to two groups, control and experimental groups with 30 participants in each group. After recording the baseline, the participants in the experimental group were trained in chanting the panchakshari mantra for a week under the supervision of Vedic teachers. The participants in the control group were not allowed to chant during the study period. All the parameters were recorded in both groups after 8 weeks of the intervention.
Results: There was a significant decrease in the depression, anxiety, and stress scores of the participants of the experimental group after the intervention. There was a significant improvement in the scores of spatial and verbal memory in the participants of the experimental group followed by the intervention.
Conclusion: There was a significant improvement in the verbal memory scores in the participants of the experimental group. There was a significant decrease in the depression, anxiety, and stress scores of the participants followed by the chanting. The study recommends further detailed studies in this area to provide further scientific evidence.
Comparison of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment intensive care unit scoring system as mortality predictors in intensive care unit patients with sepsis
Authors: Lokesh SB  , Latha V
Published: December 2024

Background: Sepsis is a life-threatening organ dysfunction caused by a deregulated host response to infection. It is one of the leading causes of in-hospital mortality and morbidity among patients. It also results in significant morbidity and financial burden.
Aims and Objectives: (1) To study the etiological profile of patients admitting with sepsis to ICU. (2) To compare between APACHE II and SOFA ICU scoring system of patients with sepsis at admission and at 24 h in predicting the 5th-day mortality.
Materials and Methods: This was a single center hospital based prospective, observational, study conducted in patients in ICUs of ESICMC PGIMSR and Model Hospital Rajajinagar, Bangalore. Patients over age 18 years admitted in ICU who have fulfilled the criteria for sepsis were included in our study. Their clinical profile, APACHE II and SOFA scores were evaluated and followed up to 5th day of admission and data were compared with respect to patients’ outcome in the form of survival.
Results: In this study, out of 53 patients the maximum number of patients belong to the age groups of >60 years (23 patients). Male-to-female distribution in this study noted was 30 and 23 patients, respectively. Aspiration Pneumonitis (17%) and Community-Acquired Pneumonia (17%) were the most common causes of septic. Out of 53 patients, 31 patients did not survive. In this study, it was observed that the SOFA scoring had the highest specificity (87.10%) and APACHE II had the highest sensitivity (96.77%) at admission. However at 24 h of admission, both the highest sensitivity and highest specificity was more for APACHE II score. The most area under the Receiver-operating characteristic curve was better for SOFA score (AUROC=58.0%) at admission than APACHE II score with AUROC of 53.7%, however AUROC of both SOFA and APACHE II score calculated at 24 h of admission were equally good in predicting 5th-day mortality.
Conclusion: We found that the SOFA score outperformed APACHE II scores in predicting survival in septic shock patients at admission. SOFA and APACHE II calculated at 24 h of admission and both scores provided equal efficacy in predicting 5th-day mortality in patients with sepsis.
Demographic profile and clinical spectrum of gallstone disease in a rural tertiary care center: A retrospective observational study
Authors: Ajender Singh  , Mukesh Kumar  , Sanjeev Singla  , Pushpendra Malik  , Chanderbhan
Published: December 2024

Background: Gallstone disease is a major public health problem worldwide irrespective of age. The incidence of gallstone disease shows considerable geographical and regional variations.
Aims and Objectives: The aim and objectives are to study the correlation between demographic profile and clinical spectrum of gallstone disease and to study the clinical spectrum of gallstone disease at a rural tertiary care hospital to assess the demographic profile of gallstone disease patients.
Material and Methods: The present retrospective observational study was conducted in the Department of General Surgery, BPS Medical College for Women, Khanpur Kalan, District, Sonipat. A total of 342 patients with gallbladder disease were included.
Results: Out of 342 patients, 294 were female and 48 were male. The most common presenting symptoms among gallstone diseases were right hypochondrium pain in 307 (89.8%) patients, followed by epigastric pain in 24 (7%) patients, and nausea in 11 (3.2%). Ultrasonography suggests that the highest number of patients were associated with multiple gallstones in 203 (59%) patients out of which 170 were females and 33 were males; single stones were associated with 139 (40.6%) patients out of which 124 were females and 15 were male followed by double calculi in 5 (1.5%) patients.
Conclusion: Gallbladder stone disease is more common in females. It can affect any age group. The maximum number of gallstone disease patients present with pain in the right hypochondrium and nausea. Maximum patients had multiple calculi gallbladder disease. Gallstone disease with chronic symptoms affects the liver function and anatomy of the Calot’s triangle that may affect the surgical procedure outcomes and hospital stay.
A comparative study of efficacy of 0.5% intrathecal isobaric ropivacaine, ropivacaine heavy, and bupivacaine heavy for lower abdomen and lower limb surgeries
Authors: Archana Singh  , Ashish Mathur  , Umesh Prasad Yadav  , Preeti Goyal
Published: December 2024

Background: Lower abdomen and lower limb surgeries can be performed under spinal anesthesia. Ropivacaine is a local anesthetic, belonging to the amino amide group. It is a pure S-enantiomer and is considered to have a better safety profile than bupivacaine.
Aims and Objectives: The aim of the study is to compare the efficacy of intrathecal isobaric ropivacaine (IR) 0.5%, ropivacaine heavy 0.75% and bupivacaine heavy 0.5% for lower abdomen and lower limb surgeries.
Materials and Methods: This prospective randomized study was conducted in 120 patients scheduled for lower abdomen and lower limb surgeries under spinal anesthesia belonging to ASA Grade I or II. Patients were randomized into three groups of 40 each. Group IR-received 3 mL of 0.5% IR, Group hyperbaric ropivacaine (HR)-received 3 mL of 0.75% heavy Ropivacaine and Group Hemoglobin received 3 mL of 0.5% heavy bupivacaine. The parameters studied were the onset and duration of sensory and motor block, duration of analgesia, hemodynamic parameters, and side effects.
Results: The onset of sensory and motor block was significantly faster in HR followed by hyperbaric bupivacaine (HB) followed by IR. The duration of sensory and motor block was significantly shorter in HR followed by IR followed by HB. Duration of analgesia was longest in HB.
Conclusion: HR produced a rapid onset of the sensory and motor block with a shorter duration. HB produced a longer duration of motor and sensory block.
Comparison of ease of endotracheal intubation with fixed height pillow versus pillow height attained by alignment of external auditory meatus to sternal notch
Authors: Priyanka Bansal  , Pulkita Kataria  , Kirti Kshetrapal  , Hemant Kamal  , Renu Bala  , Geeta Ahlawat
Published: December 2024

Background: Endotracheal intubation is considered to be the “Gold Standard” for airway management during the administration of general anesthesia and in critical care setting because of its advantages, which allows delivery of anesthetic gases and oxygen through positive pressure ventilation without inflation of stomach, permits access to tracheobronchial tree for pulmonary hence minimizing the risk of gastric content aspiration, and improves surgical access to head and neck. The major determinants of easy tracheal intubation are optimal laryngoscopy and a good visualization of the glottis.
Aims and Objectives: The aims and objectives of the study are to seek the optimal pillow height that gives the best direct laryngoscopic view and can be recommended as the starting head position before direct laryngoscopy in adults.
Materials and Methods: The present study was conducted in a prospective randomized comparative manner in the Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma University of Health Sciences, Rohtak after obtaining approval from the institutional ethical committee (approval number: No. BREC/Th/20/Anaesth.../034). Patients included were scheduled for elective surgery under general anesthesia requiring endotracheal intubation. The inclusion criteria were patients aged 18–50 years of either sex of ASA I and II.
Results: A total of 50 subjects, 25 in each group, were included in the final analysis. Following observations and results were drawn from the present prospective and randomized study using appropriate statistical tests. The various observations were out of 50 patients in the study population, and the mean age in years of patients in Group 1 was 38.48±11.77 years and 39.36±11.64 years in Group 2.
Conclusion: To conclude, alignment of external auditory meatus to sternal notch offers better conditions for endotracheal intubation than conventionally used sniffing position when assessed in terms of Cormack–Lehane grading and time taken for laryngoscopy and intubation.
THE ADMISSIBILITY OF CRIMINAL EVIDENCE OF BATTERED WOMAN SYNDROME IN MALAYSIA UNDER THE PENAL CODE AND EVIDENCE ACT 1950
Authors: Mohd Safri Mohammed Na’aim  , Ramalinggam Rajamanickam  , Rohaida Nordin
Published: December 2024

Battered woman syndrome (BWS) is a syndrome that presents after long-term abuse of domestic violence’s case. The evidence is presented in court to explain why some women remain in abusive relationships. In Malaysia, the evidence on BWS is not a defence by itself, but rather given to support any relevant defence such as provocation under Exception 1 to s. 300 of the Penal Code (Act 574) and private defence under ss. 96 to 106 of the Penal Code. The case of Pheh Boon Kheang v. Peh Boon Wang [2007] 2 MLJ 785 shows that evidence related to BWS can be submitted through expert witness under s. 45 of the Evidence Act 1950 (Act 56). The principle of it was affirmed in Nisalma binti Saat v. Public Prosecutor [2018] MLJU 880 where the High Court accepted expert evidence proffered by a psychiatrist which resembled BWS in support of private defence. This research employed doctrinal research consisting of legal analysis of the Penal Code, the Evidence Act 1950, case law, and other scholarly writings in this area. The research found that although BWS evidence has been accepted in court, it is not free from criticism thus the admissibility of it may be challenged. The research therefore aims to analyse the relevancy of BWS and its evidential weight to be admitted by the criminal court.
Entre a angústia e o gozo
Authors: Alves Fernandes Diêgo , De Oliveira Moreira Jacqueline
Published: December 2024

Partimos da problemática: será que a angústia pode ser o afeto que não deixa o sujeito enganar-se sobre o engodo subjacente à racionalidade neoliberal vinculada ao discurso capitalista na contemporaneidade? O objetivo fulcral de nosso trabalho de fundamentação teórica esteve às voltas de compreender de que modo o discurso capitalista pautado pela racionalidade neoliberal tem reverberado sobre o sujeito e sua relação com o outro no laço social. Destacamos que há uma primazia do discurso capitalista no estabelecimento do laço social. Ao passo que isso nos levou a indicar que uma das reverberações implícitas ao discurso capitalista envolto pela racionalidade neoliberal está em fundamentar as relações entre o sujeito e o outro no laço social por meio do imperativo tautológico do gozo mútuo. Assim, na contemporaneidade, a norma passa pelo outro especular só ter utilidade para que o sujeito goze ilimitadamente. Por fim, destacamos que a angústia é a “voz” que grita em convocação ao sujeito para uma insurgência aos engodos próprios do discurso capitalista, simulacro contemporâneo da racionalidade neoliberal.