bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant lipoma over the back
Authors: Vagholkar Ketan , Bhatnagar Isha , Vagholkar Suvarna
Published: February 2022

Lipoma is one of the most common soft tissue tumor arising from the mesenchyme. It is slow growing, encapsulated, and usually benign in nature. Tumors over the back, shoulder, and neck region have a high propensity to assume large size thereby getting redefined as a giant lipoma when they exceed 10 cm in width or weigh more than 1000 grams. MRI is the investigation of choice for evaluating giant lipomas. Fine needle aspiration cytology (FNAC) or frozen section may be pertinent in suspected cases of liposarcoma. Complete surgical incision is the treatment of choice. A case of a giant lipoma on the back of a 64-year-old lady is presented with a view to revisit conceptual understanding of the clinical evaluation, investigation, and management of giant lipomas.
Case report of breast implant-associated anaplastic large cell lymphoma and a call for increased awareness
Authors: Long Brittany , Dissanayake Thushara
Published: February 2022

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare but serious complication of breast implants. The incidence of BIA-ALCL varies between 1:9121 and 1:13745, and a recent meta-analysis found that countries where specific monitoring measures have been implemented have higher rates of cases. While a significant complication, there is no current evidence to support surgical risk management strategies to prevent BIA-ALCL. Many countries have adopted a model of surveillance, and in Australia the Therapeutic Goods Administration has endorsed data collection through the Australian Breast Device Registry (ABDR). We present a case of a 67-year-old woman who presented to her GP with 2 months of left breast swelling, on a background of a left breast implant in 2004. MRI of the left breast demonstrated a large peri-implant fluid collection, and cytology confirmed BIA-ALCL, CD30-positive and ALK-negative. She underwent a capsulectomy and final histology demonstrated a Breast Implant-Associated Anaplastic Large Cell Lymphoma with focal penetration of neoplastic cells beyond the capsule and into pericapsular fat (stage T4). While development of registries and national guidelines has ensured the safeguarding of health outcomes for patients moving forward, there is still a concern for women with pre-existing breast implants who are unaware of the risk of BIA-ALCL. This case highlights the importance of raising awareness and providing support to primary health care providers to ensure their patients are given the necessary information to avoid this rare, but serious complication.
A rare presentation of enterocutaneous fistula
Authors: Thirunavukkarasu Devi , Khanna Sriram , Swaminathan Shanthi Ponnandai , Kannan R.
Published: February 2022

Enterocutaneous fistula is an abnormal communication between two epithelialized surfaces, one of which is a hollow viscous organ. It most commonly occurs as a surgical complication. Other causes are trauma, malignancy, inflammatory bowel disease, ischemia. The great majority of enterocutaneous fistula are iatrogenic (75-85%) and rest (15-25%) occur spontaneously. Enterocutaneous fistula is the one of the most challenging conditions managed by General surgeon. The mortality rates vary in different series for patients, with enterocutaneous fistula and remains 5% to 15%.Here we report a rare presentation of enterocutaneous fistula.
A rare case of intrahepatic gallbladder in the setting of penetrating liver injury, a retrospective diagnosis: a case report
Authors: Kopperundevi V. , Prabhakar Joyce , S. L. Samarthan , Kannan R.
Published: February 2022

Intrahepatic gallbladder is a rare congenital variant among the ectopic gallbladder. Inadequate preoperative imaging studies might mislead the surgeon and most of the times can create unnecessary complications in the setting of cholecystectomy. Often these anomalies are either picked up intraoperatively or by retrospective diagnosis. Patients usually are at a high risk for developing cholelithiasis due to abnormality in the contractile ability of the gallbladder. The clinical symptoms can be misleading to many of the clinicians as recurrent dull aching right upper abdominal pain for many years, treated for acute peptic disease and dyspepsia.
Effect of face mask use on hearing impaired adult patients
Authors: Hussain Tanvir , Patil Anish , Munir Khalid , Choo Marcus
Published: February 2022

Background: In many countries, the increased use of face masks and other face coverings has been adopted as a response to the COVID-19 pandemic. The world health organization has given guidance that encourages the use of face masks in public settings as well as in settings where it is not possible to observe physical distancing.Methods: This research project was carried out from August 2021 to November 2021 in the ENT Department of Sligo University Hospital. The 100 patients with hearing impairment were randomly sampled from patients seeking health care services in the ENT clinic. Patients with normal hearing were excluded from the study. Data was collected with the help of questionnaire. The collected data was pre-coded for entry in SPSS and analyzed.Results: The respondents comprised 55 females and 45 males. Majority (80%) of the respondents generally agreed that the use of face masks has a negative impact on communication and hearing, especially for patients with hearing impairment. The 60% of respondents agree that the use of clear masks may provide the option to lip-read. The 80% of respondents agree that the use of face masks has a negative impact on communication and 50% of respondents agree that poor communication is likely to result in patient dissatisfaction.Conclusions: It was evident that most hearing-impaired patients are aware of the importance of facial expression in communication and most rely heavily on lip reading in addition to other facial features.
Effect of dolutegravir on plasma glucose among human immunodeficiency virus patients in a community health center setting
Authors: Bahamdain Foud O
Published: February 2022

Background: Dolutegravir has become one of the initial backbone in antiretroviral therapy (ART) regimens for most patients with human immunodeficiency virus (HIV) in several recent clinical guidelines. However, dolutegravir has been associated with severe cases of hyperglycemia and new-onset of diabetes in multiple case reports and clinical trials. A community health center noticed an increasing number of new-onset hyperglycemia incidences in patients on dolutegravir.Methods: Retrospective chart review of patients who started on dolutegravir or dolutegavir combination regimen (Triumreq®, Juluca®) between the dates of 1 January 2013 to 1 January 2018 who have been treated in community healthcare centers. Baseline blood sugar and/or A1C before starting dolutegravir, at 3-6 months of treatment and at end of study were compared between subjects.Results: 422 subjects were enrolled. Dolutegravir had little effect on plasma glucose among 72% of the subjects (n=305). However, 7% of the subjects (n=28) on dolutegravir treatment with no glucose intolerance met criteria for prediabetes at 3-6 months of therapy. One subjects had developed diabetes at 3-6 months after dolutegravir was initiated. In addition, at the end of the study, thirteen percent of patients developed prediabetes (n=56) and 1.4% developed diabetes (n=6). Among the 24 subjects that had diabetes before dolutegravir was initiation, 83% required intensification of their diabetes regimen.Conclusions: Dolutegravir may cause a moderate increase in plasma sugar after 3-6 months of therapy. Further increase has been noticed up to 12%. Due to existence of confounding variables, patient with diabetes should not be switched from dolutegravir.
The experience of violence against women and girls in Southwest, Nigeria
Authors: Ibekwe Ogechukwu C. , Kareem Abiodun J. , Akpoti Okehi O. , Ogunromo Ayodele Y. , Oluwatuyi Korede O. , Ejiyooye Toluwalope
Published: February 2022

Background: Violence against women and girls is a universal malaise that involved all aspect of life irrespective of culture, status, religion, or age. Despite efforts in curbing the menace, women’s rights are still threatened. This study aimed to assess the experience of violence against women and girls in southwest, NigeriaMethods: A descriptive cross-sectional design was used for this study. Quantitative and qualitative data were collected using a semi-structured interviewer-administered questionnaire and a key informant interview guide from 413 women/girls with age >18 years. The data were analyzed using descriptive and inferential statistics. P value <0.05 was considered significant.Results: Physical violence 338 (81.8%) was the most common type of violence known while emotional violence 57 (98.1%) was the most common violence experienced. The prevalence of violence against women and girls was 15.5%. The factors associated with violence against women and girls were age (χ2=13.92; p=0.008) and marital status (χ2=67.62; p=0.001).Some of the causes of violence against women and girls were the weakness of the women and misunderstanding between the couples while the solution to the menace were the education of the women, and appropriate punishment for the perpetrators which should be enforced.Conclusions: Violence against women and girls is a malaise that can be curbed if appropriate measures are jointly taken by all and such imbibed into our culture.
Survey of effective factors in slow flow and no reflow in primary percutaneous coronary intervention patients
Authors: Babapoor Behzad , Sadeghieh-Ahari Saeid , Sadeghi Hariri Mehdi , Shahbazzadegan Bita
Published: February 2022

Background: The phenomenon of no reflow is a phenomenon that after angioplasty and the successful insertion of the stent, the blood flow rate is reduced again in the coronary arteries and there is no mechanical obstruction. The slow flow phenomenon is an angiogram that is associated with delayed progression of contrast media during coronary artery during angiography in the absence of coronary stenosis. The aim of this study was to investigate the prevalence and factors affecting these phenomenons in Primary percutaneous coronary intervention (PCI) patients.Methods: This cross-sectional study was performed. The statistical population of the patients is 340 people who were under the Primary PCI. After the patients 'data, information was collected through a questionnaire and patients' records.Results: 48 patients entered the PCI process more than 90 minutes after admission to hospital. The highest frequency is related to anterior MI and LAD was the most frequency based on type of vessel involvement, 12 of them died and 17.1% of patients had no reflow and 12.9% of patients had slow flow. The mean diameter of stents in patients was 2.98 and the mean balloon diameter in patients was 2.01 and there is a significant relation between stent diameter and balloon diameter with slow flow and no reflow (p<0.05).Conclusions: The results of this study showed that the prevalence of slow flow and no reflow after primary PCI in patients with heart attacks were at a high level with 12.9% for slow flow and 17.1% for no reflow.
Health seeking behavior among women diagnosed with breast cancer attending Kisii teaching and referral hospital in Kisii County
Authors: David Roselyne Nyakona , Araka Glenn Onsomu , Obare Obwocha Evans , Mong’are Samuel
Published: February 2022

Background: Most women with breast cancer are diagnosed at an advanced stage of the disease leading to poor treatment outcomes. Therefore, this study aimed at determining the socio-economic and cultural factors that influence health seeking behavior among women diagnosed with breast cancer in Kisii County.Methods: 96 breast cancer women who were attending the Kisii Teaching and Referral hospital in Kisii County were purposively sampled. A descriptive study design was used. Structured and open-ended questionnaires were the data collection tools. Collected data was analyzed using Chi square and correlation analysis through SPSS.Results: 84.4% of the respondents were rural dwellers, 56.3% of the respondents were Protestants while 69.79% of the respondents were married. Majority (53%) of the respondents had attained a secondary level of education, 54.2% were self-employed while 80.2% of the respondents had a monthly income of KShs 10,000. There was no association between breast cancer treatment and an individual’s level of income (χ2=2.773, p=0.597). 2.1% of the respondents agreed that breast cancer is a curse. Witchcraft was not associated with health seeking behaviour (χ2=9.907, p=0.624). 67.7% of the respondents agreed that breast cancer is a killer disease that metastases fast within the body.Conclusions: The respondent’s education, employment status and level of income are the socio-economic factors that determine health seeking behaviour among women diagnosed with breast cancer in Kisii County. Majority of the victims use traditional medicine as a treatment option for breast cancer because it is cheaper than modern cancer therapy.
Self-care among medical professionals: a cross sectional study
Authors: Sathiarajan Dhanya , Chandrashekarappa Smitha M. , Anil Deepak , Robin Roshna S. , Narayana Murthy M. R.
Published: February 2022

Background: High rates of burnout, moral distress, anxiety and depression and suicide tendencies are found among medical professionals who continue throughout their career. It can lead to personal crisis as well as suboptimal patient care. Self- care strategies among medical professionals can minimize harm due to these burnouts. Self care have multiple dimensions including nutrition, interpersonal relations, health responsibility, physical activity, spiritual growth, and stress management to promote and maintain emotional and physical well being. This study was aimed to assess the self-care among medical professionals in Mysuru. To assess self –care among medical professionals.Methods: It’s a cross sectional study conducted using pretested semi structured questionnaire on self-care among 376 medical students, both undergraduates and postgraduates. Questionnaire included various domains of self care. Data was entered in Microsoft Excel and analysed using SPSS version 25 (Licensed to JSS AHER). Descriptive statistics like mean, median and interquartile range and inferential statistics like Mann-Whitney Test were used.Results: Among 376 participants, social well-being among undergraduates were found to be better than post graduate students. No other domain had differences in the self-care scores with respect to year of study or with respect to gender.Conclusions: Markedly decreased self-care practices among medical professionals calls for urgent attention and strategies multilayered at the individual, institutional, and national levels need to be promoted.
A cross-sectional study on impact of online classes among undergraduate students of Shimoga institute of medical science, Shivamogga due to COVID-19
Authors: B. P. Anitha , Kumar N. Praveen , R. Darshitha , Kiran G. M. Shashi
Published: February 2022

Background: The COVID-19 has resulted in shutdown of all the schools all over the world. This has led globally, over 1.2 billion children to remain out of classroom. As a result, education has changed from classroom teaching to e-learning, whereby teaching is on digital platforms. Although online classes have several advantages but there are disadvantages also. In this regard the study aims to explore whether the online classes effect on both physical and mental health of students along with the effect on education.Methods: A cross-sectional study was done from October-November 2020 (2 months). A pre-designed questionnaire was given to phase-III, part-I and part-II students (253) in Google forms. The database was created in MS-excel sheet and results were expressed in percentages.Results: Out of 253 students 166 students responded, which was 65.6% out of whom physical health impact like eye problems due to online-classes was most for dry eyes (54.8%) and least for double vision (13.9%). Impact on mental health was most for headache (54.8%) and least for depression (36.7%). Impact on education was most for lack of practical based learning (97.6%) and was less for difficulty in understanding subject (63.9%).Conclusions: Students had more negative impact on education with online-classes. So, except during crisis period offline classes are preferred.
COVID-19 restrictions: impact on lifestyle and social behaviour among adults of 18-40 years in Kurnool town
Authors: Deepthi Kommula , Pasha M. A. M. , Fatima Afsar
Published: February 2022

Background: With the unprecedent spread of COVID-19, lockdown had been implemented in the country as a preventive strategy to reduce transmission. This pandemic born lockdown has affected the lifestyle and social behaviours of individuals.Methods: A web based cross-sectional study was conducted among adults of 18-40 years in Kurnool town through snow ball sampling method. Data was collected using pre-tested, pre-designed, semi-structured questionnaire through google forms and the data was analysed using SPSS version 22.Results: The 53.8% of the participants were not doing any physical exercises. Only 47.8% had changed to a healthy diet during lockdown. The 38.3% perceived an increase in their weight during lockdown. The 12.6% had decreased or tried to cut-down alcohol consumption.Conclusions: Overall there was a negative impact on the lifestyle behaviour in our study. There is a need for health education and lifestyle behaviour programmes.
Sleep quality and its associated factors among elderly population in a rural area of West Bengal
Authors: A. Inba Raja , Sardar Jadab C.
Published: February 2022

Background: The problems with sleep increases sharply with age and can have profound effects among the elderly. The present study was done to assess the prevalence of sleep quality and its associated risk factors among the elderly people in a rural area of West Bengal.Methods: Cross-sectional study was done at Arkhali village, West Bengal, among 80 elderly individuals of 60 years and above age during February and March 2020. Face to Face interview was conducted using self - designed general socio-demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI), 7 – Item General Anxiety Disorder (GAD) Scale and 5 – Item Geriatric Depression Scale (GDS). Chi-square test was done to test association using SPSS 20 software.Results: The mean age of the respondents was 70.1 ± 6.9 years and majority (60%) were females. Prevalence of poor sleep quality (GPSQI≥5) was 75%. The mean GPSQI of the study was 8.33±4.272.  Increasing age category (p=0.001), marital status (p=0.003), present living status (p=0.006), health problems (p=0.014), help for daily activities (p=0.030), mosquitoes disturbing sleep (p=0.001), generalised anxiety (p=0.001) and Geriatric depression (p=0.001) had a significant association with poor sleep quality.Conclusions: Healthcare providers should regularly provide sleep health education, encourage participation in family activities, sharing of ideas and making of compromises within the family.
Study of profile and factors associated with high-risk pregnancies among PMSMA beneficiaries visiting block Barwala, district Hisar of Haryana
Authors: Kumar Amit , Sharma Seema , Sindwani Pooja , Jakhu Paramjeet , Pandey S. M. , . Diksha
Published: February 2022

Background: Any pregnant woman can develop life-threatening complications with little or no advance warning, so all pregnant women need access to quality antenatal services to detect and prevent life-threatening complications during childbirth. The Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is thus being introduced to ensure quality antenatal care to pregnant women in the country. Under the campaign, a minimum package of antenatal care services would be provided to the beneficiaries on the 9th of every month at the PMSMA clinics. The objectives of study were to study profile and identify high risk pregnancies and associated factors of PMSMA beneficiaries.Methods: It was a retrospective study. Information was collected from hospital records of antenatal beneficiaries attending monthly PMSMA clinic in block Barwala. Maternal characteristics such as age, gravida, parity, trimester at time of first visit were noted. High risk factors were also noted. Data was collected & analysed by using SPSS version 20 software.    Percentage & Chi-square test are used to analyse the data.Results: The records of total 401 antenatal beneficiaries were analysed. Out of total beneficiaries 26.9% were detected as high-risk pregnancy. Most common medical condition was anaemia. Majority of beneficiaries were belonged to age group 21-30 years. Percentage of Rh-ve beneficiaries were found to be 7.7%. Out of total 4.2% beneficiaries were having twins’ pregnancies. Maximum number of high-risk pregnancies belonged to blood group A.Conclusions: Detecting High-risk pregnancies in an effective measure to reducing maternal and infant mortality.
Health seeking behaviour and its socio-demographic determinants among menopausal women in Lucknow
Authors: Gupta Ginic , Kumari Reema , Mishra Prabhaker
Published: February 2022

Background: Menopausal women are those who have not experienced regular menstrual bleeding for 12 months or more. It is a physiological event, but its psychological, physical and sexual consequences will prevail throughout post-reproductive years. Some women are silently suffering without knowing what is happening to their own body and they don’t know about where to get help. Aim of the study was to estimate the health seeking behaviour among menopausal women in Lucknow and to find the association of Health Seeking behaviour among menopausal women with the various socio-demographic parameters.Methods: A community based cross sectional study was conducted from August 2020 to January 2021, among 206 Menopausal women of 46-65 years in rural and urban field practice areas of Community Medicine Department, KGMU, Uttar Pradesh, Lucknow.Results: (42.7%) of the total study participants went to the health facility for menopause related symptoms. (14.6%) had heard about HRT and (1%) were current user of HRT. (43%) responded that they will be fine with time, (29%) responded that they didn’t need to go to the health facility, (21.8%) had financial constrains. Literacy, residential status and category was found significantly associated with health seeking behaviour among menopausal women.Conclusions: Poor health seeking behaviour was observed among women for menopausal symptoms. Majority of them responded that they will be fine with time, other common reason for not going to health facility was that they were not aware about menopausal symptoms, they think that they don’t need to go to the health facility.
Assessment of nutritional status in relation to socio economic determinants among Sabar tribes of Jhargram district of West Bengal, India
Authors: Mandal Anindita , Roy Debasmita
Published: February 2022

Background: This cross-sectional study was undertaken to assess the nutritional status in relation to socio-economic determinants among sabar tribes of Jhargram district, West Bengal.Methods: Nutritional status of 169 children, adolescent and adult male and female tribal people was taken to measure body height, body weight and BMI. Socio economic status including family income, occupation, family size, educational status, source of drinking water, use of sanitary latrine, smoking habit and prevalence of diseases among sabar tribal people was recorded by questionnaire study.Results: Undernutrition is prominent among sabar children and adolescent. The people of this area were relatively underprivileged to access to safe drinking water and sanitary latrine. The health status of sabar people of this locality was associated strongly with family income and educational status. Although other factors like safe drinking water ,use of sanitary latrine, occupation , no of children in a family, smoking habit showed insignificant association. Besides, occupation and life style related diseases were very common among adult sabars.Conclusions: Percentage prevalence of undernourished people especially children and adolescent in this study is large, they required a variety of interventions to improve quality of life like- assessment of nutritional status, causes of nutritional deficiencies and imbalance, formulation of diet plan and its implementation where required.
The use of safety practices to reduce occupational injury among solid mineral miners in Southwest, Nigeria: an examination of the health belief model
Authors: Kareem Abiodun J. , Kareem Adesola O. , Owoeye-Lawal Oluwatosin T. , Aro Adewale J. , Lawa Opeyemi A. , Ibekwe Ogechukwu C. , Ogunromo Ayodele Y. , Oluwatuyi Korede O. , Ejiyooye Toluwalope
Published: February 2022

Background: The mining industry requires measures at reducing the increasing incidence of occupational injury. The behavioural change towards the use of preventive and safety measures are required. The health belief model concept analyses behavioral change towards the use of preventive measures required to reduce occupational injury. The aim of the study was to use the health belief model to describe miners safety practices in Southwest, Nigeria.Methods: A descriptive cross-sectional study using a structured survey was employed. The consenting staff of the mining industry completed a pretested self-administered questionnaire. Data were analysed using descriptive and inferential statistics. The level of significance was taken as p≤0.05.Results: A total of 73 (60.8%) of the respondents had various forms of occupational injury. The self-efficacy (χ2=4.232; p=0.040) had a statistically significant association with occupational injury and was also a predictor (OR=2.3; p=0.042; 95% CI=1.03-4.97) of injury. The factor that positively affects workers use of personal protective equipment was one health belief model component: self-efficacy (χ2=9.509; p=0.009). The socio-demographic factors associated with self-efficacy were age (χ2=4.135; p=0.042) of the respondents, gender (χ2=5.720; p=0.017) and monthly income (χ2=6.047; p=0.014).Conclusions: The conviction to successfully use the personal protective equipment have a better effect on increasing the rate of preventive behaviour among miners.
Body mass index as a predictor of quality of life of patients with chronic obstructive pulmonary disease: a cross-sectional study
Authors: Kushwaha Sonam , Singh Ankita , Bage Rowanti Neha , Swaroop Vibha
Published: February 2022

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem with increasing mortality worldwide. Obesity is well known to be associated with increased morbidity and mortality in the general population but in the case of COPD, a phenomenon known as the “obesity paradox” is observed. Nutritional status is a good prognostic indicator in patients with COPD.Methods: A cross-sectional study was conducted in a tertiary care hospital of Lucknow with 250 COPD patients to assess their body mass index (BMI) using Quetelet’s formula. Study subjects were selected using a systematic random sampling method.Results: The mean BMI was observed to be 24.93±4.0. Health-related quality of life of undernourished patients was most affected. A statistically significant relation was seen across all the components of SGRQ.Conclusions: The results of the study indicated that the malnourished COPD patients had poor health-related quality of life and severe limitation in airflow.
India’s path towards better mental health in a pandemic
Authors: Andhale Avanti , Venkatesan Nanditha , Zadey Siddesh
Published: February 2022

COVID-19 has wide-ranging effects on population health including mental health, particularly in low-and-middle-income countries (LMICs). Outbreak and interventions such as quarantine and isolation against it have contributed to psychosocial adversities. We aimed to review the state of India’s mental healthcare planning, identify the gaps in the health systems and policies, and present cost-effective and scalable solutions. Necessary background information was triangulated through an iterative literature review of the policy, preprint, and peer-reviewed research literature. We focused on the following themes-a) health system capacity, policy, and law for India, b) psychological impact of COVID-19 outbreak in India, c) psychological impact of interventions against COVID-19, and d) best practices across countries for mental health management during the pandemic. We used qualitative synthesis to identify health systems and policy gaps to generate short- and long-term solutions supported by high-grade evidence for effectiveness, cost-effectiveness, and adaptation feasibility in India. The Indian health system has several shortcomings in its mental health care that became pronounced during the current COVID-19 pandemic. To overcome these, long-term goals should include increased public financing, increased human resources production, integration of health emergency and mental health policies and legislation. Immediate needs could be met by scale-up of task-shifting initiatives and telepsychiatry services in rural regions. In the ongoing pandemic, employing school-based psychosocial interventions, public awareness campaigning, subverting misinformation through broadcast legislations, and stigma reduction for general mental illnesses are pertinent. These solutions can help bridge the gaps in mental health care in India.
Impact of COVID-19 pandemic on Indian economy
Authors: Narayanappa Sharada , Boyanagari Vamsi Krishna , Uthkarsh Pallavi Sarji
Published: February 2022

The Coronavirus disease 2019 (COVID-19) pandemic has emerged as the most challenging biological disaster of the 21st century. The sudden onset of pandemic in the background of unpreparedness and the lockdown and social distancing measures has impacted the economies of not only the less developed but also the well-developed countries. The objective of this paper is to examine the economic impact of the COVID-19 pandemic on the various sectors of the Indian economy. The data has been collected from the start of the pandemic till the second week of May 2021. The results of the study show that the policy measures taken to contain the pandemic resulted in a severe crunch in the Indian economy. The GDP growth rate recorded a negative figure, the manufacturing sector and contact- intensive hospitality service sectors, domestic and international trade had to shut down and suffered losses like never before. Agriculture, Information technology and software services sector remained resilient and sustained the economy. Migrants had to revert back to their hometowns in search of alternate jobs, unemployment was at its highest during the lockdown in 2020. Continued policy measures and monetary support are needed to cope with the economic impact of COVID-19 in the backdrop of an unprecedented forecast.
Association between HBA1C and NIHSS score in stroke
Authors: Ambresh Ayyali , K R Madhu
Published: February 2022

Diabetes Mellitus is a very common metabolic disorder and it is an independent risk factor for stroke and is associated with 2 to 6 fold increased risk compared with non-diabetic subjects and worsens survival of patients with acute stroke. Glucose intolerance or even fasting hyperglycemia may follow an acute vascular event, and ensuing physical inactivity and poor food intake may lead to continued glucose intolerance. Glucose intolerance in a stroke patient may or may not reflect glycemia prior to the event. Measurement of HbA1C rather than glucose as an indicator of prior glycemia offers a new perspective. Hence this study is to find out association between HbA1c levels with NIHSS score in stroke.

To find out association between HbA1c levels with NIHSS score in stroke.

This a cross sectional descriptive study.

In this study well controlled Diabetes has moderate stroke severity, fairly controlled Diabetes has moderate to severe stroke severity and poorly controlled Diabetes has severe stroke. It is observed that severity of the presenting complaints worsened from well controlled Diabetes to poorly controlled Diabetes. The NIHSS score correlates with the HbA1C, with increase in severity of the stroke from well controlled Diabetes to poorly controlled Diabetes.

Severity of the score increases as the infarct size increases. Poorly controlled Diabetes has more severe stroke as per NIHSS score with large sized infarcts. Stroke is a medical emergency and can cause permanent neurological damage, complications and death. National Institutes of Health Stroke Scale (NIHSS) is a well-validated, reliable scoring system for use specifically with stroke patients. The National Institutes of Health Stroke Scale (NIHSS) can be used as a standard measurement instrument by physicians to evaluate the severity of a patient and outcome.
No-Reflow phenomenon in the perspective of endovascular neurosurgery
Authors: Yadav Kuldeep , Singh Deepak Kumar , Kaif Mohd. , Shankar Diwakar
Published: February 2022

Concept of No-Reflow (NR) phenomenon is largely studied in cardiological intervention characterised by the failure of myocardial reperfusion despite the absence of mechanical obstruction of large and medium sized vessels. NR negatively affects outcome of procedure, so there is great importance of prediction and management. The objective was to introduce concept of NR in neuro-intervention and have an idea of incidence and independent predictors of NR in patients with post intervention no-reflow in large and medium sized brain arteries.

This was a single-centre prospective case– control study between march 2017-march 2021 in the department of Neurosurgery, Dr. R.M.L.I.M.S., Lucknow, India. Cases were subjects who suffered NR, and the control comparators were those who did not. Clinical outcomes were documented. Salient variables relating to the patients and their presentation, history and angiographical findings were documented.

Of 153 consecutive patients, 11(7.2%) suffered from NR, with all cases occurring post intervention in the form of coiling with or without stent/balloon support or flow diverter placement with or without coiling. Patients with NR had increased risk of in-hospital death and disability (1 patient/9.1% death, 8 patients/72.72% with one or multiple neurological dysfunction with varying severity) in comparison to patients without NR (4 patients/2.8% deaths and 12 patients/8.5% disabilities, out of 142 patients). From baseline variables available prior to neuro-endovascular surgery, the independent predictors of NR were increased complexity of pathology, admission systolic hypertension, weight of more than 75 kg and history of hypertension, history of DM, history of ischaemic vascular disease/dissection/aneurysm in the brain or elsewhere, history of systemic arteritis, history of autoimmune disease and atherosclerosis, history of smoking, female gender, elderly.

Patients with NR have a higher rate of morbidity and mortality following ischaemia and embolism. Predictors of NR include lesion complexity, systolic hypertension and high body weight, female gender, elderly, dyslipidaemia and preexisting arterial disease. Further validation of this risk model is required with lager number of patients and multicenter studies.
An advance of complex multifaceted root learning for parkinson behavior using subthalamic nucleus biomarkers
Authors: Raju Venkateshwarla Rama , Rani Balmuri Kavitha , Srinivas Konda , Madhukar G.
Published: February 2022

Though DBS is suiting well to Parkinson`s still its current version being modified now and often as suggested by the neuroscientists. The technique has gained an effectual management surgical therapy concerned to PD, explicitly whilst growing idea as an effectual method to alleviate Parkinson’s disease and other movement disorders. The present ver.1 indirect DBS is an open loop based and its parameters are changeable manually and there is no provision to adjust automatically or online based on Parkinson diseased behavior and performance. Hence, supervised classification of patient behavior is a major and significant step towards the design of next generation DBS systems which are adaptive closed loop based. The work in this study demonstrates a supervised classification machine learning (CML, i.e., multiple kernel learning M-K-L) method to distinguish such cognitive behavioral tasks by using the subthalamic nuclei (STN) biomarkers, i.e., biomedical data of microelectrode recording (MER) bio signals (or local field potential LFP). We applied the time domain and frequency domain representation spectrograms of the raw data acquired from right and left hemisphere brain`s STNs as the feature vectors. Following the feature extractions, we combined those features via support vector machines (SVMs) with complex multifaceted root learning, i.e., C-M-L or multi kernel learning (M-K-L) formulation. The C-M-L based classification techniques were applied to a class and categorize different tasks such as switch (push-pull button), movement of jaws, vocalizations, plus movement of arm due to the tremor. Our experiments show that the l - n o r m C-M-L/M-K-L radically smash distinct kernel SVM-based classifiers in classifying behavioral tasks of five subjects even using signals acquired with a low sampling rate of 10 Hz. This leads to a lower computational cost.
A rare variant of chronic inflammatory demyelinating polyneuropathy with autonomic dysfunction
Authors: K Jayaraj , C V Shaji , K A Kabeer , S R Prashanth
Published: February 2022

A young hypothyroid female with history of chronic inflammatory small joint arthralgias presenting with distal sensory motor symptoms of 8 weeks duration and prominent disturbances of bladder sensations was found to have symmetric motor and distal large fibre sensory loss and blunting of perineal sensations. On evaluation was found to have a normal nerve conduction study at presentation and imaging showing hypertrophic and enhancing cervical and lumbosacral nerve roots with a positive marker of mixed connective tissue disorder on ANA profile, fitting into a diagnosis of Chronic Immune Sensorimotor Polyradiculopathy in the background of a connective tissue disorder.
Organisational membership and professional excellence among medical practitioners
Authors: Mukhopadhyay J
Published: February 2022

Professional organizations play indispensible role among medical practitioners ensuring gold standard medical care and treatment. Organisational membership effectuates expression of clinical work, scientific understanding and ardour for distinction. Considering ever-exceeding scientific unfurling in clinical horizon and organisations’ role in upholding therapeutic excellence, it was decided to construe membership status among certain doctors inter-alia, reckoning allied benefits, if any.

Study was conducted among 72 doctors selected semi-purposively from certain consenting medicos connected to scholar through various links during August’ 19 - October’ 19 incorporating medicos from diverse age-groups, specialities and functional domains. Sample size was calculated on basis of membership percentage observed in pilot study. Structured pre-tested questionnaire was formulated including participants’ personal attributes and parameters related to their membership in professional organisations with benefits ensued there-by. Questionnaires were circulated online, collected, analysed and tabulated.

Majority (44.4%) belonged to 41-50 years and overall 59.7% availed organizational membership. Most were male (66.7%), post-graduate (52.7%), private practitioner (30.6%) with 47.2% harbouring 21-30 years expertise. Many benefitted by ‘relevant information’ (74.4%), ‘professional acquaintance’ (55.8%) and publication (51.1%). Personal reason (27.9%), scarce time, routine commitments (23.2% each) represented common pretexts for missing membership errands. Post-graduate, middle aged, experienced, male, private practitioners found significantly endowed with wealth of clinical information, publications, clinical acquaintances, professional knowledge and interactive confidence being associative.

Study elicited precious information about elite professionals elucidating orientation towards model clinical society. Further research is recommended to explore factors that could play important role in professional lives to achieve excellence.
Epithelioid Sarcoma: An overview with emphasis on its differentiation from morphologic mimics
Authors: Kulkarni Medha P , agdale Rakhi V J , Pol Jaydeep N
Published: February 2022

Epithelioid sarcoma (ES) is a malignant mesenchymal neoplasm that exhibits epithelioid cytomorphology and a predominantly epithelial phenotype. The principal types based on histopathological features and location; include the classic or conventional type (CES) and the proximal type (PES).

The aim of the study was to analyze our cases of ES regarding clinical, pathological and immunohistochemical features.

This is a retrospective study. Seven cases of ES were included in the study. Clinical and pathological details were retrieved from patient records. Details like site, size, histopathological type and IHC features of the tumors were studied.

Out of seven, five were PES and two were CES. There were six males and one female; with age ranging from 12 to 68 years. Total five tumors involved extremities. One was noted at a rare site, paratesticular region. Three tumors were larger than 5 cm in greatest dimension. On immunohistochemistry (IHC), all the tumors were reactive for CK, EMA, Vimentin, Ca 125 and showed loss of nuclear expression of INI1. CD 34 was expressed in 6 out of 7 cases.

ES is a rare aggressive malignant tumor with dismal prognosis. It is often misdiagnosed because of nonspecific clinical features at presentation. Helpful clues in diagnosis are tumors in young males with epithelioid and/or spindle cell morphology, Rhabdoid cells and granuloma like central necrosis. Co-expression of epithelial and mesenchymal markers along with reactivity for CD34 and Ca 125 and loss on INI1 expression on IHC substantiate the diagnosis of ES.
US Policy towards ASEAN: the Impact on Regional Economic Relations
Authors: Chudinova Ksenia
Published: February 2022

Cooperation with the Association of Southeast Asian Nations (ASEAN) is one of the important elements of the Biden administration’s Indo-Pacific strategy.
The United States plans to expand its participation and capital investment in infrastructure building in the region, in renewable energy sources and in new technologies development, especially digital commerce. However, since the United States is not a member of neither the CPTTP nor the RCEP, US companies may be at a disadvantage compared to those from other countries. At the same time, ASEAN economies are actively cooperating with the PRC, including cooperation within the framework of the Belt and Road and the Digital Silk Road project. One of the most important tasks of US economic diplomacy in the Asia Pacific is to create with allied countries a system of technological standards, as an alternative to the one lobbied by China.
The changing situation in the region provides many new opportunities for Russian enterprises. For example, Russian companies have the potential to cooperate with the ASEAN economies in the production and trade of science-intensive products.
Estimativa das propriedades do biodiesel metílico produzido a partir da pupunha e aspectos biotecnológicos
Authors: Oliveira Anne Caroline Defranceschi , Graziani Ana Claudia , Schultz Caroline , Mariano André Bellin
Published: February 2022

Dentre as diversas matérias-primas viáveis para a produção de biodiesel, a pupunheira (Bactris gasipaes) apresenta-se como uma promissora fonte de óleo, a partir do mesocarpo e amêndoa. Essa palmeira natural da América Central e do Noroeste da América do Sul apresenta também um grande potencial agroindustrial e biotecnológico, devido às características do palmito e composição dos seus resíduos: bainha, folhas e frutos. Os resíduos da agroindústria podem ser utilizados como suplementos alimentares para ruminantes, devido ao alto teor de proteínas, na fabricação ou elaboração de biofertilizantes e na produção de etanol, bebidas alcoólicas e outros produtos. Esse aproveitamento dos resíduos consiste de grande importância, tendo em vista o aumento recente da área cultivada no país. A viabilidade técnica da produção de biodiesel da pupunha depende, entre outros aspectos, da qualidade dos lipídios obtidos para produção de combustíveis líquidos. Assim sendo, este trabalho apresenta a relação entre a composição do óleo do mesocarpo da pupunha e a qualidade do biodiesel, com foco na estimação do Número de Cetano e do Ponto de Entupimento a Frio. Aspectos biotecnológicos e agroindustriais são discutidos, e processos integrados são sugeridos com objetivo de viabilizar a produção de biocombustível com maximização dos ganhos e diminuição dos impactos ambientais.
Espécies de leveduras do gênero Malassezia identificadas em recém-nascidos prematuros: revisão integrativa
Authors: Silva Davi Porifirio da , Calumby Rodrigo José Nunes , Santos Fabianny Torres de Oliveira , Bastos Maria Lysete De Assis , Moreira Iramirton Figueiredo , Moreira Rossana Teotônio de Farias
Published: February 2022

Este estudo teve por objetivo identificar e descrever as espécies de leveduras do gênero Malassezia relatadas em recém-nascidos prematuros. Trata-se de uma Revisão Integrativa da Literatura, desenvolvida em seis etapas, com resgate de estudos nas bases de dados Medline, Lilacs, BEDENF e nas bibliotecas Science Direct e Portal de Periódicos CAPES, por meio da combinação dos descritores premature infant e Malassezia. Como resultados, foram incluídos 20 estudos, publicados entre os anos de 1987 e 2020 em inglês, alemão e francês, originados de países dos continentes americano, europeu e asiático. No período relatado, somente quatro espécies do gênero Malassezia foram identificadas como colonizadoras e agentes infecciosos de recém-nascidos prematuros, sendo elas M. furfur, M. pachydermatis, M. globosa e M. synpodialis. É importante considerar a identificação limitada de Malassezia spp. Assim, a caracterização e monitoramento dessas leveduras são importantes para nortear a prática clínica.
Desempenho de leguminosas para adubação verde na Amazônia Meridional
Authors: Lima Rogerio Fogaça , Rabelo Hudson De Oliveira , Silva Hitalo Queiroz da , Pereira Pablo Rodrigues , Carvalho Marco Antonio Camillo de , Yamashita Oscar Mitsuo
Published: February 2022

A adubação verde proporciona a melhoria dos aspectos físicos, químicos e biológicos dos solos, por meio do cultivo e incorporação de espécies com grande produção de biomassa e ciclagem de nutrientes, auxiliando na conservação dos solos. Em vista dessas considerações, este trabalho teve por objetivo avaliar o desempenho de leguminosas para a adubação verde nas condições climáticas da Amazônia Meridional, no Mato Grosso. As espécies crotalárias (Crotalaria breviflora, C. ochroleuca, C. spectabilis), a mucuna-cinza (Mucuna pruriens) e o feijão-de-porco (Canavalia ensiformis) foram avaliadas em delineamento de blocos casualizados com quatro repetições, parcelas de 3 m x 4 m, com linhas espaçadas de 0,5 m. As variáveis altura de planta, comprimento de raiz, massas de parte aérea e de raiz (base seca), índice SPAD (Soil Plant Analysis Development) e teor e produção total de N, P e K foram avaliadas. O feijão-de-porco e a C. ochroleuca se destacaram quanto ao comprimento de raiz e produção de massas secas de parte aérea e de raiz. Para o índice SPAD, os maiores valores foram observados em plantas de C. ochroleuca e feijão-de-porco. Essas, juntamente com a mucuna-cinza, apresentaram os maiores acúmulos de N e P. Os adubos verdes avaliados apresentam bom desenvolvimento nas condições climáticas da Amazônia Meridional, do Norte de Mato Grosso.