bluuebunny/crossref_metadata_2025 huggingface dataset:
Dieulafoy lezyonunda endoskopik tedavilerin zorlu seçimi
Authors: Öztürk Bengi
Published: January 2024

Sarıtaş ve arkadaşları tarafından yazılmış ve Akademik Gastroenteroloji Dergisinde yayınlanmış olan, “Dieulafoy lezyonu saptanan hastaların retrospektif analizi başlıklı çalışmayı ilgiyle okudum. Bu çalışmada Dieulafoy lezyonu nedeni ile üst gastrointestinal sistem kanaması geçirmiş olan hastalara uygulanan endoskopik tedavi yöntemleri ve tedavi sonlanımları değerlendirilmiş. Yapılan çalışmalar, Dieulafoy lezyonuna bağlı üst gastrointestinal sistem kanamalarında, hemoklip uygulamalarının akut kanama kontrolünde ve rekürren kanamayı önlemede skleroterapiye üstün olduğunu göstermiştir. Ancak, hemoklip uygulamasını monoterapide termal koagülasyon yöntemleriyle veya kombine tedavilerle karşılaştıran çalışma yoktur. Literatürde bu duruma dair az veri olması nedeniyle; bu çalışmada kanama nedenli exitus olan 3 hastada hangi endoskopik terapötik yöntemin uygulandığının, hastalarda rekürren kanama olup olmadığının ve oldu ise hangi yöntem sonrası olduğunun belirtilmesinin aydınlatıcı olması ve metodlar arasında kıyas yapabilmek adına fikir verici olması adına önemli bir katkıda bulunacağı görüşündeyim.
İnflamatuvar barsak hastalığında değişmeyen soru: İmmünmodülatör tedavi ne kadar güvenli?
Authors: Öztürk Bengi
Published: January 2024

Atay ve arkadaşlarının “İnflamatuvar bağırsak hastalığı olan hastalarda immünmodülatör tedaviler güvenli mi? 23 yıllık tek merkez deneyimi” çalışmasını ilgiyle okudum. Atay ve arkadaşları bu çalışmada immünmodülatör ajanların yan etkilerini 23 yıllık geriye dönük olarak değerlendirmişler. Bu çalışmada, halihazırda anti-tümör nekrozis faktör (anti-TNF) ajanlar veya anti-integrin ajan ile tedavi edilmekte olup geçmişinde immünmodülatör tedavi almış olan hastalar değerlendirilmiş. Bu çalışmada azatiyopürin kullanım süresini Crohn hastalarında 4.2 ± 3.5 yıl, ülseratif kolit olan hastalarda ise 3.0 ± 2.6 yıl olarak saptamışlar. Ayrıca azatiyopürin kullanmış olan hastaların 18’inde (%5.5), metotreksat kullanmış olan hastaların 6’sında (%7) ilaç kesilmesini gerektirecek yan etkiler geliştiğini ve bu yan etkilerin tamamının 2. derece yan etkilerden oluştuğunu göstermişler ve takip süresince tedavi ilişkili hematolojik veya solid organ malignitesi saptamadıklarını göstermişler (1). Yakın dönemde yapılan çalışmada da immünmodülatör tedavinin güvenli olduğuna dair benzer bulgular gösterilmiştir (2).
Azatiyopürin ile monoterapinin 8-9 yıla kadar uzayabildiği ve bu sürelerde dahi güvenli olduğu yönünde bilgiler sunulmaktadır (3,4). Bu çalışmada hastaların tedavi aldıkları süre literatüre kıyasla daha kısadır; sadece monoterapi alıp sonrasında kombine tedaviye ihtiyacı olan hastaları kapsaması nedeniyle, tedavi süresi bu çalışmada daha kısa gibi gözükmektedir. Yan etkilerin daha az görülmesi tedavi süresi kısalığına da bağlı olabilir.
Yapılan çalışmalarda, immünmodülatör tedavinin anti-TNF tedavi ile kombinasyonunda etkinliği ve yan etkileri değerlendirilmiş olup; yan etkiler monoterapi grubunda %29.4, kombinasyon grubunda ise %36.3 hastada gösterilmiş (5). Azatiyopürinin anti-TNF tedavi ile kombinasyonunda, azatiyopürinin yan etkileri nedeniyle çalışmanın erken aşamasında çalışmadan ayrılmayla sonuçlandığı gösterilmiştir (6). Bir başka çalışmada ise immünomodülatörlerle kombinasyon tedavisi özellikle immünomodülatör tedaviye biyolojik tedavinin başlamasından 30 günden daha uzun bir süre önce başlandığında, tedaviyi bırakma riskinin önemli ölçüde azaldığı gösterilmiştir (7). Yapılan çalışmalar incelendiğinde anti-TNF ajanla kombine immünmodülatör tedavinin yan etkilerine yönelik birbirinden farklı sonuçların olduğu dikkati çekecektir. Bu çalışmada da, anti-TNF veya anti-integrin ajanlar ile eş zamanlı immünmodülatör tedavi alan hastalar var ise bu hasta grubunun belirtilmesi ve immünmodülatör tedavinin kombine tedavideki yan etki profilinin değerlendirilerek alt grup analizinin ayrıca yapılmasının da literatüre katkı sağlayacağı görüşündeyim.
Mıknatıs ile neo-anastomoz: Mıknatısı nasıl itmeli?
Authors: Öztürk Bengi
Published: January 2024

Abiyev A. ve arkadaşları tarafından yazılmış, 2023; 22, 3. sayıda yayınlanmış olan, post-transplant biliyer darlığın tedavisinde manyetik kompresyon anastomoz ile ilgili vakayı ilgiyle okudum. Burada sağ karaciğer nakilli bir hastanın anastomotik tam obstrüksiyonunun perkütan-endoskopik kombine bir işlemle ilerletilen 10 f çapında mıknatıslarla açılması ve başarılı re-anastomozu tarif edilmiş. İşlemin tekniğinde 10 f mıknatısların darlık bölgesine ilerletilmesi için 10 f stent iticinin kullanıldığı söylenmiş; yazıdan anlaşıldığı kadarıyla mıknatıslar stent iticinin içinden darlık bölgesine ilerletilmiş (1). Bilindiği gibi manyetik kompresyon anastomozun biliyer kullanımı 1998 yılında Yamanouchi ve arkadaşları tarafından tarif edilmiş ve özellikle Uzakdoğu ülkelerinde sıklıkla kullanılmıştır (2). Bu yazılar okunduğunda 4-5 mm çapında mıknatıslar kullanıldığı görülecektir (3). Bu yöntemin zorluğu endoskopun çalışma kanalından geniş mıknatısın kanaldan ilerletilememesi, endoskoptan gönderilen bir stent tutucu ile darlığa ilerletilmeye çalışılmasıdır. Bu durumun yaratabileceği zorluk nedeniyle, darlığa ilerletilebilmesi için safra kanalına tam kaplı metal stent konulması tarif edilmiştir (3). 4-5 mm’lik mıknatısların perkütan olarak safra kanallarına ilerletilebilmesi için bundan daha geniş bir kılıfın safra yollarına gönderilmesi gerekir ki, oldukça travmatik bir işlemdir. Bu zorlukları aşmak için Parlak ve arkadaşları “over the wire, through the scope” mıknatıslarını üretmiş ve yöntemini tarif etmişlerdir (4). Buna göre 0.035 inch kılavuz telin üzerinden ilerletilmeye uygun iç deliği olan ve endoskopun kanalından sığacak kadar ince (5-10 f) mıknatıslar kullanılmaktadır. Bu yöntemle teknik başarının daha yüksek olduğu ile ilgili vaka serileri de yayınlanmıştır (5,6).
Standards for Review of the Concept of a “National Court” in EU Law
Authors: Grądzka Ilona , Krzysztofik Edyta
Published: January 2024

The aim of the article is to demonstrate the evolutionary approach of the Court of Justice to the criteria for review of the concept of a court within the meaning of EU law. It has been shown that there are three basic standards used by the Court in this area. The first one is an examination of the premises developed as part of the procedure of a question referred to for a preliminary ruling, which includes functional and systemic premises. The second one is based on Article 47 of the Charter of Fundamental Rights of the European Union, which specifies three premises: independence, impartiality and establishment of a court by statute. The third standard of control indicated by the Court of Justice in the judgment in case C-64/16 is of a different nature. It has been applied to reforms of the justice system in the Member States and is based on the combined interpretation of three provisions: Article 2, Article 4 (2) and Article 19 (1) of the Treaty on European Union. The indicated standard was the cause of a lively discussion initiated by the constitutional tribunals of the Member States (the case of Poland and Romania). In principle, they do not question the right of the Court of Justice to review the concept of a court under the first and second standard. However, in relation to the reforms of the justice system, they emphasize their own competence, which is granted to them by their national constitutions. It should be noted that the fundamental problem that appears in the jurisprudence of both the Polish Constitutional Tribunal and the Court of Justice is the protection of primacy of the constitution and irrefutability of the judgments of constitutional tribunals by the Court of Justice.
Airbnb as an Accommodation Platform and Tax Aspects
Authors: Janovec Michal
Published: January 2024

Airbnb has long been one of the leaders in providing accommodation worldwide, but there are still a few tax issues related to Airbnb without clear interpretation. The article aims to research, from the taxation point of view, the activity of providing temporary accommodation using the internet platform Airbnb. To evaluate such a taxation area, it is necessary to analyze the current legal regulation in the field of tax law with some possible legal recommendations de lege ferenda. For this article, the prime source of law is the Czech Republic tax law, but some of the research is also valid internationally, based on commonly used tax principles. The central point of the article, still relatively unclear in everyday practice, is the tax obligations (income tax and value-added tax) of accommodation providers using this platform. The article also includes some comparisons with foreign legislation. The author wants to point out possible facts that need to be considered when regulating Airbnb in the field of tax law.
Comments on the Implementation of the Sale of Goods Directive into the Polish Legal Order
Authors: Jurczyński Paweł
Published: January 2024

The purpose of the article is to examine the effects of the entry into force of the Act of 4 November 2022 amending the Consumer Rights Act, the Civil Code Act and the Private International Law Act, being a result of the implementation of the so-called Sale of Goods Directive. The author analyses the issue using the formal-dogmatic method, focusing on the impact of the changes introduced by the above-mentioned Act on the standard of consumer protection and the manner in which entrepreneurs conduct their business activities. Moreover, he identifies the most significant problems related to the implementation of the Sale of Goods Directive into the Polish legal order, drawing attention to the legal and economic consequences of the choices and solutions adopted by the Polish legislator. He also assesses both the content of the Act in question and the content of the Sale of Goods Directive, formulating de lege ferenda conclusions.
Institutional and Performance Effects of Administrative Decentralization in Croatian Territorial Governance Setting
Authors: Lopižić Iva , Manojlović Toman Romea
Published: January 2024

In 2020, the deconcentrated model of the performance of state administration tasks in Croatian territorial units was replaced with the model of administrative decentralization. The new State Administration System Act abolished the county state administration offices as first-instance state administration bodies and transferred their tasks to the delegated scope of competence of counties as second-level self-government units. The paper explores the effects of administrative decentralization. Based on theoretical assumptions on decentralization effects, comparative experience with administrative decentralization ex-ante evaluation of county state administration offices abolition, five hypotheses about the effects of administrative decentralization in Croatian territorial governance setting are formulated. The hypotheses are tested by analysis of the legal and institutional framework of the performance of delegated tasks, empirical data gathered through the questionnaires, nine interviews, and secondary data. The results show that administrative decentralization strengthened the role of Croatian counties, strengthened their administrative role, strengthened the role of county governors, increased the horizontal and weakened vertical coordination, improved some aspects of service delivery but not uniformity in service provision across the state territory, and improved the transparency but not led to the democratization of county government. Five national-specific factors are analyzed as possible explanations for such results: general societal trends, external pressures, characteristics of Croatian public administration, general features of the Croatian local self-government system, and adopted organizational design.
Białowieża Primaeval Forest – a Conflict between the Polish Government and the European Commission
Authors: Kmiecik Zbigniew R. , Furtak-Niczyporuk Marzena , Grzywaczewski Grzegorz , Kitowski Ignacy
Published: January 2024

The article describes the natural background, the origin, the course and the outcome of the dispute between Poland and the European Commission which was going on in the years 2016–2018 regarding the forest management performed in the Białowieża Forest. The dispute took place on two interrelated levels: natural and legal. The main axis of the dispute between the Polish government and the European Commission was the difference of views as to what actions would prove effective in the fight against the latest gradation of the bark beetle, which occurred with exceptional intensity in the Białowieża Forest in 2015, and what actions would be most beneficial in the context of preserving rare species of birds and insects that make up the fauna of the Białowieża Forest. The article presents extensively the arguments raised by both parties to the conflict in the proceedings before the Court of Justice of the European Union, which were initiated by a complaint filed by the European Commission. As a commentary on these arguments, the views expressed in the scientific literature as to the proper reaction in response to a recurrent infestation of the bark beetle, usefulness and efficacy of the active forest management operations questioned by the European Commission, as well as an impact of these operations on the conservation of natural habitats, insects and birds are presented. The legal dimension of the dispute boiled down to the question of what actions in the situation were allowed, required or prohibited under Polish and EU law.
The Impact of Online Media on Legal Discourse
Authors: Kotowski Artur
Published: January 2024

This article examines the methodological challenges and difficulties created by the emergence of new forms of legal discourse. These are provided by the new channels of communication, collectively found within the “mass media” and concerns online media: portals, blogs, social networking applications, etc. Since analytical theories of legal discourse were developed before the IT revolution, it is important to consider to what extent existing theories of legal discourse are adequate, given the contemporary picture of the phenomenon. The article is scientific but also contains some reflexions in the field of legal methodology due to its subject. There are formulated two research theses. The first concerns the assumption that due to the expansion of mass media, legal discourse is losing its previous hermetic character. The second assumes that the research programme of analytical jurisprudence, within which previous theories of legal discourse have been developed, requires appropriate modifications to capture the new forms in which it is conducted. The paper concludes by formulating possible directions for the development of a methodology for creating theories of legal discourse.
Axiology of Law and Human Rights: A Few Theoretical Remarks in the Perspective of Internal Integration of Legal Sciences
Authors: Liżewski Bartosz
Published: January 2024

The aim of the article is to link two research problems. The first of them concerns the determination of the relationship between the axiology of law and human rights. The task of the second is a presentation of this relationship from the perspective of the internal integration of legal sciences. The article explains the mutual relations between the axiology of law and human rights. The following theses are proposed. The first is that human rights, due to their axiological character, are an integral part of the axiology of the entire legal system. At the level of the Constitution of the Republic of Poland, these are included in the rules of the state system. In essence, they contribute to building an integrated value system. The second thesis materializes in the statement that human rights integrate not only the branches of law, but also legal sciences. They are present in every branch of law, i.e. in constitutional, criminal and civil law, labour law, legal theory and international law. They become the subject of scientific reflection in various legal sciences. For these reasons, human rights perform very important functions in the internal integration of legal sciences. The third thesis concerns the level of international law. Human rights, through the European protection system, integrate the European legal space. The protection standards of the European Court of Human Rights play the main role. They contribute to building a common European axiological dimension of human rights.
Intergovernmental Coordination in Portugal
Authors: Ruel Teresa , Vilela Noémia Bessa , Silva Natacha Jesus , Oplotnik Zan Jan
Published: January 2024

Relations between political units – levels of government – in a multilevel structure can be organized according to a range of institutions and processes. Intergovernmental relations suggest that the different levels of government interact with their political actors, namely executives, parliaments, or political parties. The research studies on this topic have concentrated attention on federal systems, and unitarian systems have been neglected. Next to that it must be stressed, that to exercise the competences of the decentralised levels there must be some sort of fiscal autonomy. Without fiscal autonomy, there can be no autonomy for subnational level of governments. Portugal illuminates this landscape. The intergovernmental relation or coordination between the Portugal mainland and the regional governments (Azores and Madeira) are mainly informal, so far. In this paper, we intend to explore and understand the role of political actors in such intergovernmental coordination and the institutional mechanisms they promote to that coordination.
The Role of the Principle of Proportionality in Identifying Legal Capacity to Fundamental Rights
Authors: Pozsár-Szentmiklósy Zoltán
Published: January 2024

The legal capacity to fundamental rights gives the right-holder the ability to exercise and enforce fundamental rights. In the absence or questionable status of the legal capacity of a right-holder, there is a need to justify such a position. In this regard, no general standards based on legal doctrine and jurisprudence can be identified. The paper focuses on the question of whether the principle of proportionality could play a role in identifying and justifying the legal capacity to fundamental rights. Based on a review of the literature, two functions of the proportionality analysis can be identified as relevant in this regard: it supports the justification of the decision to restrict fundamental rights and it precludes arbitrary decisions in relation to the limitation. The author argues that, based on its justificatory function, proportionality can play a role in identifying the legal capacity to fundamental rights in the case of human persons. In the case of autonomous organizations, in addition to its justificatory function, its function related to the exclusion of arbitrary decisions can be taken into account when using it as a standard for identifying legal capacity. In the case of human persons and autonomous organizations, there is a need for a negative justification of the limitation of legal capacity, based on proportionality. In the case of new challengers in fundamental rights disputes (such as future generations), a positive justification is required to determine legal capacity. The proportionality analysis does not play a role here, but rather other standards that require a rationality-based justification.
How Can Be Increased the Accessibility and Effectiveness of Advance Directives?
Authors: Tőkey Balázs , Hoffman István
Published: January 2024

One or more forms of advance directives are regulated in the majority of legal systems. However, people generally do not create advance directives. The main reason for this problem is that people do not have enough information about this legal institution, and it is too difficult or expensive to create one. Furthermore, it is also questionable if someone has an advance directive whether it will be able to achieve the aimed legal effect. Similarly, the enforcement of the advance directives could be problematic, especially if litigation is required to enforce these wills. The situation of advance directives is more or less the same in the majority of legal systems. Our aim is to show that these problems could be solved using the already existing, e.g. in Austria or Hungary, digital health databases and by introducing a non-litigation legal dispute framework.
The Significance of the Judgment of the Supreme Administrative Court of 4 November 2021 in case no. III FSK 3626/21 as a Judgment of the National Court, European Judges for the Status of Assessors and Judges of Courts of First Instance and for the So-called Conditionality Mechanism
Authors: Skwarzyński Michał
Published: January 2024

The commentary essentially endorses the considerations of the Polish Supreme Administrative Court judgment of 4 November 2021 in case no. III FSK 3626/21. The author indicated a possible way of resolving the dispute over the National Council of the Judiciary (NCJ) and the composition of the Supreme Court without destructive, automatic undermining of the status of judges selected in the procedure with the newly appointed NCJ. The standard defined by the Supreme Administrative Court applies to all assessors and all judges of first instance. Ignoring by the European Court of Human Rights in the case of Advance Pharma Sp. z o.o. v. Poland, the judgment of the Supreme Administrative Court of 4 November 2021 does not alter the rules of the test from the case of Guðmundur Andri Ástráðsson v. Iceland. The Supreme Administrative Court’s ruling binds both the European tribunals and is necessary for the correct determination of the status of both first-instance judges and assessors. Moreover, in relation to the judgment of the Court of Justice of the European Union of 16 February 2022 in case C-157/21 Poland should be paid funds from the National Reconstruction Program, because the dispute over the rule of law concerns courts other than administrative, and in relation to these courts the issue of the rule of law is resolved by the judgment of the Supreme Administrative Court of 4 November 2021.
Employment as a Part of Rehabilitation: A Review of Similarities and Differences between Female and Male Criminals
Authors: Felczak Joanna
Published: January 2024

In this review article, the latest knowledge in the area of the importance of employment in the process of rehabilitation is presented. The goal is a literature review and an analysis of the similarities and differences between female and male criminals in the context of employment during the prison sentence and the chances of finding employment after release. Also, the relationships between employment and later recidivism are analyzed. To present the relationship between employment and recidivism holistically, the following points were referred to: the role of work in rehabilitation and adaptation to freedom; differences between males and females in employment experiences and peculiarities in social background affecting their labour force attachment; the employment of prisoners before, during and after punishment; opportunities and barriers in finding a job by former prisoners; bidirectional relationship – employment as a way to reintegrate ex-offender with the society and as a way to prevent recidivism. Different phases of rehabilitation (being in prison, leaving prison) were distinguished and labour force attachment prior to imprisonment spell were also discussed. Also, the article consists of a discussion section where conclusions and recommendations are presented. The indications for further research were also listed, one of which is to examine the real benefit of the work of convicts – whether it provides the possibility of subsistence. In the article, study results from various countries, and consequently, various judicial systems, are referred to.
Sosialisasi AISIRE bagi guru sekolah dasar sebagai pendukung pembelajaran pendidikan jasmani
Authors: Ginanjar Agi , Mubarok Mochamad Zakky , Mudzakir Dicky Oktora , Syifa Ahmad , Suherman Dias , Sari Indah Purnama , Arroihan Mohammad , Rahayuda Rahayuda , Wahyuni Tri
Published: January 2024

Keterbatasan sarana dan prasaran pembelajaran pendidikan jasmani sering menjadi masalah klasik dalam proses pembelajaran pendidikan jasmani yang berakibat materi kebugaran jasmani pada aspek kecepatan reaksi menjadi terabaikan bahkan tidak pernah dilakukan sama sekali dalam pembelajaran pendidikan jasmani. Dengan menggunakan media pemebelajaran AISIRE dapat mengurangi permasalahan keterbatasan sarana dan prasarana dalam proses pembelajaran pendidikan jasmani pada aspek kecepatan reaksi. Tujuan dari kegiatan ini ingin memberikan sosialisasi pembuatan, penggunaan, dan penilaian AISRE untuk mendukung pembelajaran pendidikan jasmani materi kebugaran jasmani pada aspek kecepatan reaksi. Metode dalam kegiatan ini menggunakan persiapan, pelaksanaan, evaluasi dan refleksi, dan tindak lanjut. Peserta kegiatan ini adalah guru pendidikan jasmani ditingkat Sekolah Dasar dan Madrasah Ibtidaiyah di wilayah Kabupaten Indramayu dan Kabupaten Cirebon sebanyak 10 orang. Hasil kegiatan ini memberikan dampak berupa peningkatan pengetahuan, pemahaman, pembuatan, penggunaan, dan penilaian pada AISIRE untuk mendukung pembelajaran pendidikan jasmani materi kebugaran jasmani pada aspek kecepatan reaksi.
Considerations on Format Protection in Chinese TV Programs
Authors:   The Legal Studies Institute of Chosun University, f f , LEE Chang Jae
Published: January 2024

A broadcast format can be thought of as the framework, containing elements that distinguish it from other programs with fixity and identifiability, such as the program name, stage setting, and background music. There is some debate as to whether program formats can be legally protected under traditional copyright principles based on the idea-expression dichotomy.
According to China's copyright law, for an intellectual product to be legally protected as a work, the following three conditions must be met: (1) the work must be an intellectual achievement in the field of literature, art, and science; (2) it must have originality; and (3) it must be expressible in a certain form. Given these principles, there are practical limitations to how broadcast program formats can be included in the category of copyrighted works to provide protection under the existing legal order. One way to overcome these limitations is to consider the approach method, which focuses on the substantial similarity of the two broadcast programs at issue.
On the other hand, in the broadcast program market, subsequent programs created by copying and plagiarizing an existing successful broadcast format may constitute unfair imitation under the Unfair Competition Law and should be sanctioned under the law. If a format creator trades in format rights or attracts investment based on a format, it is an obvious commercial activity. Therefore, if a broadcast program format is in competition, it is reasonable for the format creator's behavior to be regulated by the Anti-Unfair Competition Law. However, there are certain limitations to the ability of the Unfair Competition Act to regulate infringement of broadcasting formats.
In the future, as trade between Korea and China in the cultural content industry expands, it is expected that the number of broadcast program formats produced in China will increase as in the past. In light of this, the discussion on broadcast program formats in China and the study on how to legally protect the rights of authors is also relevant to Korea.
Evaluation of Demirjian stage of the third molar as a reliable predictor of 18 years age
Authors: Kumar Pramod , Kumari Soni , Priya Nimisha , Shekhar Arpita , Kumar Krishna , Kumar Ashish
Published: January 2024

Background: In accordance with section 3(1) of the 1875 Indian majority act, any individual residing in India must reach the majority age when they reach the age of 18 and not before. Third molar formation begins approximately the age of 18. This study aims to distinguish the third molar Demirjian stage(s) indicate that the individual is under the age of 18, and which do not, we will be able to determine the person's age.
Methods: In this research, 202 patients' OPG radiographs aged 14-25 years were obtained. Their radiographs revealed 742 third molars in total. Third molar development was examined using Demirjian's eight-stage method, and average age was then calculated for each step of third molar growth. Stages under the age of eighteen and stages over the age of eighteen were analyzed.
Results: Data revealed that a person was in stage C most likely under the age of 18 (minor) and at stage H, a person was most likely over the age of 18 (major). Stages A and B were not evident in the age range studied. The age associated with stage C was less than 18 years, while the age associated with stage H was greater than 18 years.
Conclusions: Assessing third molar growth stages is a reliable non-invasive method for estimating an individual's age. Stage H indicates a likely age over 18 with completed root development, while stage C suggests an age under 18 with ongoing root development, making it a quick and useful approach.
Clinical validation of artificial intelligence-based cataract screening solution with smartphone images (Logy AI cataract screening module)
Authors: M. Mano Aarthi V. , Tiwari Nivedita , Khobragade Vinay , Pareek Mitali , Panchbhai Anand , Ghosh Priyanjit , Saravanan Jayachandhran
Published: January 2024

Background: Purpose of the study was to clinically assess the accuracy of Logy AI cataract screening solution, an artificial intelligence-based module, which works through WhatsApp and also as a separate smart phone application, that can detect cataracts using images taken by a smartphone camera, by comparing with slit lamp based diagnoses made by ophthalmologists.
Methods: A prospective clinical study was conducted in an eye clinic of a tertiary care hospital in the southern part of India with 437 patients. Smartphone images taken were sent to the Logy AI cataract screening solution which predicted if the patient had cataract or not. It graded cataracts as immature and mature. Patients were examined by ophthalmologists with slit-lamp and diagnosis was documented. Both were compared.
Results: 794 eye images were included in the study. The overall accuracy of the AI screening solution for cataract detection was computed to be 90.08%. Further, the accuracy was 88.02% for immature cataract, 97.16% for mature cataract, and 90.08% normal category. The sensitivity was 90.38%, the specificity was 89.87%, and the F1 score was 87.98%. The positive predictive value was 85.71% and the negative predictive value was 93.29%. Logy AI cataract prediction module’s AUC (0.8946) falls under the good category.
Conclusions: Logy AI cataract screening module could work as an effective cataract screening tool at the community level in remote areas where there is no expensive equipment and ophthalmic health care workers considering the accuracy and efficiency to work in low resource settings. It can also be a good home screening tool suitable for the post-COVID era.
Intraoperative haemofiltration during on-pump cardiac surgery at Queen Alia Heart Institute
Authors: Awamlah Ahmad A. , Hadidi Abdallah A. , Shobaki Wael A. , Qudah Bashar A. , Badaren Mutaz A. , Mohd Ashraf F.
Published: January 2024

Background: Objective of the study was to determine the frequency, indications and benefits of utilizing haemofiltration during cardiopulmonary bypass in adult cardiac surgical patients.
Methods: This is a prospective observational analysis of data of adult cardiac surgical patients presented for on-pump cardiac surgery in the period between September 2023 and December 2023 at Queen Alia Heart Institute. Data was collected using Google Forms online and was subsequently recorded on Excel sheaths. Patients were divided into two groups: the haemofiltration group and the non-haemofiltration group. Both groups were compared according to perioperative laboratory and clinical variables. Statistical analysis of results using Microsoft excel followed data collection. Ethical committee approval was obtained.
Results: Data from 130 adult cardiac surgical patients (105 males and 25 females) enrolled in this analysis showed that haemofiltration was used in 25 patients (19.2%). The most frequent indication for intraoperative haemofiltration was haemodilution in 14 patients (56%). Blood transfusion was needed in 17 (68%) of patients who had haemofiltration and in 35 (33.4%) of patients who did not need haemofiltration. Patients from the haemofiltration group were extubated 5 hours earlier than patients from the non-haemofiltration group, as the duration of mechanical ventilation in the ICU was 17.9 hours in the haemofiltration group versus 24.9 hours in the non-haemofiltration group. The average overall hospital stay was 3 days less in the haemofiltration group.
Conclusions: Haemofiltration during cardiopulmonary bypass main indications were severe haemodilution, hyperkalaemia and preoperative renal impairment. The use of haemofiltration during CPB was associated with earlier tracheal extubation and shorter hospital stay.
Role of dermoscopy in hyperpigmented skin disorders: A tertiary care centre experience
Authors: Oza Rutu Harsh , Agrwal Shreya , Tank Jaydipkumar , Sutaria Amita , Parmar Kirti S , Shah Bela J , Chaudhary Navin R , Saini Kriteeka , Vyas Harshita , Shah Shikha R , Mistry Deval
Published: January 2024

Dermoscopy, performed with a handheld instrument called dermatoscope, is a non-invasive and in-vivo technique for the evaluation of various skin lesions in clinical practice. Although many studies have shown the importance of dermoscopy in diagnosing skin lesions by supplementing naked-eye evaluation, Indian data on its usefulness is scarce. We aimed to describe dermoscopic findings in various pigmented conditions in skin of colour.

A retrospective observational study was carried out in a tertiary care hospital in western India for the period of two years- October 2015 to September 2018. Patients were selected from the available records by using pre-specified selection criteria. Detailed demographic and clinical parameters were recorded. The dermoscopic examination was done using Dermlite DL3 polarised device. The histopathological findings, when available, were also evaluated.

A total of 352 patients were identified, 181 males and 171 females. Out of the total number, 272 patients had melanocytic and 80 had non-melanocytic lesions. Benign melanocytic nevi (100 out of 272) and seborrheic keratosis (58 out of 70) were the most common observations for melanocytic and non-melanocytic lesions respectively.

The study provides real-world data on a large scale for dermoscopic findings in hyperpigmented lesions in Indian patients. This study corroborates with observations from previous studies to suggest quick and non-invasive use of dermoscopy for reliable diagnosis. Larger studies in future may obviate the need for biopsy while managing these patients.
A clinico-epidemiological study of breast eczema sparing nipple and areola from a tertiary care hospital in western Rajasthan
Authors: Awake Praneet , Verma Manjulata , Waghmare Swagat , Kachhawa Dilip , Sharma Deepak
Published: January 2024

Nipple eczema can be a local manifestation of atopic dermatitis/eczema when it arises with classic age-related patterns of eczema on other body sites, or it can occur in isolation. In our study, breast eczema sparing nipple and areola, was observed in females of western Rajasthan.

This study reports the demography, clinico-morphological patterns and factors causing it.

After due informed consent, thirty consecutive female patients of breast eczema were undergone a detailed history, clinical examination and patch testing. Hamilton Anxiety Rating Scale was used for anxiety severity assessment.

Most common site of breast eczema was the upper-outer quadrant (15/30) followed by upper-inner quadrant (9/30). The cell-phone was the most common object which was kept in close contact with the breast followed by purse (26/30) and money (11/30). Total 20 positive patch tests were seen in 17 patients. Fifteen patch tests were relevant to the current dermatitis. Mild anxiety cases were significantly more in acute type whereas moderate-severe type was more with chronic type (p value=0.021).

Larger study is required to establish the exact cause of this type of breast eczema.

Breast eczema seems to have diverse etiology, supplemented by various factors such as anxiety, perspiration in hot arid weather, traditional loosely-fit inner clothing of women in this region of western Rajasthan and friction produced by the objects (cell phones) that are kept in contact with breasts, work together to produce dermatitis.
A case control study of risk factors in chronic urticaria
Authors: Godse Kiran , Tiwari Kritika , Patidar Vatsal , Patil Sharmila , Nadkarni Nitin
Published: January 2024

Urticaria presents as erythematous, often pruritic, raised transient wheals. The aetiology of Chronic Urticaria (CU) is not well understood. Autoimmunity, chronic infections, allergens and metabolic syndrome are some known implicated factors. But the role of life style factors like diet, smoking, alcohol, occupation, family

history etc is relatively unknown. This study aims to uncover the role of these modifiable factors in causation of CU.

Data from 20 individuals with chronic urticaria (duration <1 year) and 20 age and sex matched Controls (healthy/patients without chronic urticaria) was collected using questionnaires to assess lifestyle and risk factors like diet, alcohol consumption, smoking, medications, stress, sleep etc in the implication of CU.

Our study revealed notable if not significant associations. Out of these, 6 cases (30%) had a family history of CU, while 10 cases (50%) had a prior history of acute urticaria episodes. Additionally, 6 cases (30%) reported food allergies, and 10 cases (50%) had a documented medical history. Furthermore, 7 cases (35%) reported insect bites as a factor, while 1 case (5%) was linked to H. Pylori infections. Notably, 12 cases (60%) showed a lower consumption of fruits, while 9 cases (45%) exhibited a relatively higher intake of foods containing dyes and additives. These findings collectively suggest some potential connections in the development of CU.

This study underscores the intricate connections between risk factors, lifestyle choices, and CU. Differences in sleep quality, food allergies, dietary habits, and seafood consumption provide potential insights into associations. This investigation may contribute to improved CU management approaches.
Correlation of photopatch positivity with clinical profile in patients with photoallergic dermatitis
Authors: Nirmaladevi P , Kayalvizhi V A , Sivayadevi P , Kalyanakumar P , Sivasankari R Vidhya
Published: January 2024

Photopatch test (PPT) is designed to diagnose Photoallergic Contact Dermatitis (PACD) using specific dose and wavelength of irradiation. This study is a retrospective analysis of patients with photosensitivity who have undergone photopatch testing.

To find the Correlation of photo patch positivity with clinical profile in patients with photoallergic dermatitis.

Photo patch testing helps in determining the sensitizing potentials of commonly used day to day agents containing the allergen. Thirty-seven patients who had patch tested between July 2022and June 2023 were analyzed. The patch test antigens comprising 20 common photoallergens from Indian Standard Series were photopatch tested. Of all the patients tested the overall positivity rate was (67.56%). All patients had a characteristic clinical picture of photodermatitis for an variable duration. All patients were engaged in various occupations that involved working outdoors. The exacerbating factors were summer season in 15 (40.54%) patients, insecticides spraying in three (8.1%) and exposure to plant in ten (27%). History of contact with cement was present in six (16.21%) patients. The patients who showed positivity after irradiation was 5 (13.51 %), before and after irradiation was 7 (18.91%), and exacerbated grading after irradiation was 13 (35.13%). The commom allergen showing positivity were parthenium (29.72%), potassium dichromate (13.51%), PPD (10.81%). Apart from these allergens’ fragrance mix, paraben, neomycin sensitivity was also noted in few patients.

Significant number of cases belongs to photodermatitis, thereby, finding the cause and the measures to alleviate the symptoms are paramount important. For proper diagnosis, photopatch test is essential and our study emphasis the same which can aid in appropriate management. Cosmetics, sunscreens and drugs like NSAID are found to be the emerging cause for PACD and photopatch series with relevence to above allergen is the need of the hour.
Lamotrigine induced toxic epidermal necrolysis in an epileptic child: A wrath of polypharmacy? - A case report
Authors: Kaviarasan P K , EJ Divya , B Poorana , S Chidambaranathan
Published: January 2024

Toxic Epidermal Necrolysis (TEN) is a severe form of adverse drug reaction (ADR) characterized by extensive areas of necrotic blisters, erosions of the skin and mucosal membranes. Antiepileptics are the leading cause of TEN. We report a five and half year old male child, a known case of seizure disorder "Juvenile myoclonic epilepsy" since 2 years. The child was treated with sodium valproate (VPA), levetiracetam and lamotrigine(LTG). This triple combination therapy dramatically controlled the seizures. But within three weeks, there were extensive urticarial rashes, which rapidly become necrotic, haemorrhagic, vesiculobullous suggestive of TEN involving more than 40% body surface area (BSA). The child was managed successfully, by conservative measures, without IVIG or biologics, simply by stopping the AEDs, corticosteroids, and wound care with wet collagen dressings, in a rural set up, was a challenging scenario. Hence we report this case. Conclusion: Childhood TEN is rare but preventable. VPA inhibits LTG clearance, cause TEN and can worsen the prognosis.
Dengue convalescent rash
Authors: Pursnani Nikhil , Agrawal Prabhat , Gupta Nimish , Gautam Ashish
Published: January 2024

Dengue is one of the common causes of fever in tropical countries like India. It is self-limiting fever with recovery in almost all cases unless patient develop hepatic failure or haemorrhagic fever. Few of the patients developed convalescent rash during the recovery phase. We are reporting convalescent rashes in dengue which are very common but very few published literatures are available so we are reporting this case.
Verrucous lesion mimics- A case series
Authors: Sudhana M Madhu , Sara S Sannidhi , S Vathsala , Shrikantaiah Megha M , YB Somashekar
Published: January 2024

Cutaneous lesions with wart like growth pattern are referred as verrucous lesions. Few lesions clinically look like warts but they are associated with different conditions, pathology, prognosis and treatment. Histopathology plays a very important role in such cases to diagnose the condition. In this article we present 5 different cases, with verrucous morphology.

Our first case was a 70 year old man, with verrucous growth over hyperpigmented plaque on left leg. Biopsy showed Squamous cell Carcinoma overlying Lichen Simplex Chronicus. Second case was a 65yr old man with verrucous growth over right thigh diagnosed as well differentiated Squamous cell carcinoma on histopathology. Third case was a 22year old man, with multiple erythematous verroucous growth over left thigh. Biopsy showed syringocystadenoma papilliferum. Fourth case was a 9 year old female, with verrucous lesion over left side of forehead. Biopsy suggested chondroid syringoma. Fifth case was a 25year old female with multiple verrucous lesions over nose, diagnosed as sebaceous hyperplasia.

Difficulty in diagnosing verrucous lesions can be resolved with knowledge and awareness of different diseases with verrucous morphology and histopathological examination.
A comprehensive case study on vitiligo: Navigating challenges and treatment strategies
Authors: Mir Javaid Ahmad , Mushtaq Bushra , Mushtaq Onaisa Aalia
Published: January 2024

This in-depth case study examines the complex terrain of vitiligo and the difficulties that thirty-year-old Mrs. A. must overcome. The storey is told via a thorough analysis of her clinical appearance, which includes the emergence of distinct, symmetrical white spots on several body regions. Given Mrs. A's medical history of general health and her elevated stress levels prior to the depigmentation, the diagnostic procedure is carefully broken down, including physical examinations, medical history evaluations, and pertinent laboratory testing. Examining the epidemiology of vitiligo, the study clarifies its worldwide frequency, age at start, genetic predispositions, autoimmune correlations, and subtle effects on people from various ethnic origins. This case study stands out for its examination of the discrepancy between traditional textbook representations and the dynamic, Mrs. A's emotional and psychological reactions to vitiligo require individualised care. A multidisciplinary approach guides the development of treatment strategies that include photo therapy, topical corticosteroids, and specialised psychological support. The storey ends with a discussion of the follow-up procedure, an assessment of the effectiveness of the treatment, emotional healing, and the continued difficulties of long-term care. This case study provides insightful information about the comprehensive care of vitiligo sufferers, highlighting the significance of customised, team-based approaches in addressing the complex aspects of this skin disease.
From single DNA adducts measurement to DNA adductomics in molecular epidemiology of cancer
Authors: Baer-Dubowska Wanda , Szaefer Hanna
Published: January 2024

ABSTRACT
Environmental carcinogens exert their carcinogenic effects by forming DNA adducts. This type of DNA damage can also be formed endogenously as a result of, e.g., oxidative damage. Unrepaired  DNA adducts may induce mutations in critical genes, leading to the initiation of chemical carcinogenesis. Therefore,  detection, identification, and quantification of DNA adducts is essential for cancer risk assessment. Over the last 50 years, the major DNA adducts formed by different classes of environmental carcinogens were characterized. With the development of techniques such as 32P-postlabeling, their measurement was implemented into molecular epidemiology. Advances in liquid chromatography-tandem mass spectrometry (LC-MS ) made the measurement of adducts more precise  and allowed to gain knowledge about their identity and structures. Therefore,  opened the way to  DNA adductomics, the  “omics” approach investigating DNA adducts comprehensively, similarly to proteomics. This review presents the historical perspective of DNA adducts research and the emerging field of adductomics.
APPLICATION OF ANIMAL ASSISTANCE AT THE UNIVERSITY OF DEBRECEN FACULTY OF EDUCATION FOR CHILDREN AND SPECIAL EDUCATIONAL NEEDS
Authors: Lovas Kiss Antal
Published: January 2024

Animal assistance used among university students is not unknown, numerous foreign examples prove its valid existence. The application aimed at university students appeared in the United States of America, but nowadays it is used in many countries around the world. The emergence of assistance dogs in higher education is related to the scientific interest aimed at discovering and measuring the causes of the positive effects experienced during the use of assistance animals. Simultaneously with the introduction of animal assistance training at the University of Debrecen Faculty of Education for Children and Special Educational Needs, the university student sensitization program began in 2021, within the framework of which students can meet the assistance dog serving on the university campus on a daily basis. The first university student sensitizer dog of the country has a multifaceted task, it not only performs tasks in the field of animal-assisted activity but also fulfills a socialization role with its presence, helping many to rethink their ideas about keeping animals. The study presents this socialization program.