bluuebunny/crossref_metadata_2025 huggingface dataset:
Pluriverse in science: Discourses of Amazonian land-use change and socio-environmental (in)justice
Authors: Tello Carlos , Neuburger Martina
Published: December 2023

In the Brazilian Amazon region, social, economic, and political changing structures have increased the pressure on land, generating inequalities for the region's most vulnerable residents. Simultaneously, scientific knowledge production has increased and documented the region's different realities. This document presents a scientific discourse analysis of land-use change in the Amazonian region and its interaction with socio-environmental (in)justice, considering the pluriversal perspective. We respond to the main questions: Do hierarchies in scientific knowledge production contribute to silencing subaltern voices and hiding a pluriverse approach when writing about Amazonia land issues? And if so, how? A systematic literature review was conducted using the scientific dissemination platforms Scielo, Scopus, and WoS. The results show a disproportionate representation of some stakeholders, and some states are used as near-total representatives for the Amazonia region. Furthermore, consideration of pluriversal perspectives in the articles does not guarantee high sensibility for heterogeneity of local contexts or for making subaltern voices heard.
Adaptation of deported peoples to Kazakhstan in the 20th century
Authors: Zhumatay Samat , Jiyenaliev Yerlan , Shintemirova Ainur , Ganibayeva Zhaidarman , Serkpaev Mukhtar , Yespenbetova Ainagul
Published: December 2023

This article is devoted to the history of the deportation of peoples to Kazakhstan in 1920s 1930s. The data on the stages of resettlement, on the number of deportees, on their places of settlement, on relations with the Kazakh population are given.
Preservation of natural resources and the traditional way of life of the indigenous population of the Khanty-Mansi Autonomous Okrug – Yugra in the 1990s – 2010
Authors: Prishchepa Alexander
Published: December 2023

The article analyzes the process of creating a legal basis for protecting the traditional way of life of the indigenous peoples of the KhMAO-Yugra and ensuring the environmental safety of the natural resources of the district during the years of its intensive oil and gas development. It notes the destructive technogenic impact of the production activities of energy facilities and construction enterprises on the ecological state of natural resources and the historical way of life of the indigenous population of the north of Western Siberia.
A review on smart robotic wheelchairs with advancing mobility and independence for individuals with disabilities
Authors:   Biju Patnaik University of Technology Rourkela, Odisha, India, Sahoo Sushil Kumar , Choudhury Bibhuti Bhusan ,   Department of Mechanical Engineering, Indira Gandhi Institute of Technology Sarang, Odisha, India
Published: December 2023

This research paper presents a comprehensive review of smart robotic wheelchairs and their impact on enhancing mobility and independence for individuals with disabilities. Traditional wheelchairs often impose limitations on users, resulting in reduced freedom of movement and limited accessibility. The emergence of smart robotic wheelchairs offers a promising solution to address these challenges. This paper provides an overview of wheelchair technology, identifies the specific challenges faced by individuals with disabilities, and explores the advantages and limitations of smart robotic wheelchairs through a review of previous research studies. The features and functionalities of smart robotic wheelchairs, including navigation and obstacle avoidance capabilities, autonomous and semi-autonomous modes, and customizable control options, are discussed. User experience and performance evaluation, along with the impact on mobility and independence, are examined. The paper concludes with future directions and recommendations to guide further research and development in this important field, aiming to empower individuals with disabilities and improve their quality of life.
An Evaluation of the Performance of Stopping Rules in AI-aided Screening for Psychological Meta-Analytical Research
Authors: König Lars , Zitzmann Steffen , Fütterer Tim , Campos Diego , Scherer Ronny , Hecht Martin
Published: December 2023

Several AI-aided screening tools have emerged to tackle the ever-expanding body of literature. These tools employ active learning, where algorithms sort abstracts based on human feedback. However, researchers using these tools face a crucial dilemma: When should they stop screening without knowing the proportion of relevant studies? Although numerous stopping rules have been proposed to guide users in this decision, they have yet to undergo comprehensive evaluation. In this study, we evaluated the performance of three stopping rules: the knee method, a data-driven heuristic, and a prevalence estimation technique. We measured performance via sensitivity, specificity, and screening cost and explored the influence of the prevalence of relevant studies and the choice of the learning algorithm. We curated a dataset of abstract collections from meta-analyses across five psychological research domains. Our findings revealed performance differences between stopping rules regarding all performance measures and variations in the performance of stopping rules across different prevalence ratios. Moreover, despite the relatively minor impact of the learning algorithm, we found that specific combinations of stopping rules and learning algorithms were most effective for certain prevalence ratios of relevant abstracts. Based on these results, we derived practical recommendations for users of AI-aided screening tools. Furthermore, we discuss possible implications and offer suggestions for future research.
The clinical biochemical and hematological profile of scrub typhus meningoencephalitis
Authors: Souvik Sarkar  , Soumya Sarathi Mondal  , Enamul Hossain  , Souvik Kumar Das  , Rahul Kumar  , Sanjay Kumar Mandal
Published: December 2023

Background: Scrub typhus is a zoonotic infectious disease caused by the Gram-negative coccobacillus Orientia tsutsugamushi. Meningoencephalitis occurs in two-thirds of all the infected cases.
Aims and Objectives: The study of these cases was conducted to study the clinical, biochemical, and hematological features of scrub typhus meningoencephalitis.
Materials and Methods: We included 12 patients who were admitted in the General Medicine Ward of Medical College and Hospital, Kolkata, between May 2021 and July 2022. The serum scrub typhus immunoglobulin M (IgM) test was used to diagnose the cases after ruling out dengue, malaria, leptospirosis, bacterial, tubercular, and viral meningoencephalitis.
Results: A triad of fever, altered sensorium, and meningeal signs were present in all of the cases. 2 patients had seizures, 1 patient had lateral rectus palsy, 1 patient had a generalized maculopapular rash, and eschar was seen in only 2 cases. The most common laboratory abnormalities were hyponatremia, anemia, and transaminitis (each 83.33%). 8 cases (66.7%) had a combination of anemia, hyponatremia, and transaminitis. Cerebrospinal fluid abnormalities included protein elevation (75%) and lymphocytic pleocytosis (83.33%). Scrub typhus IgM was positive in all of them. All the cases showed excellent response to doxycycline.
Conclusion: A high degree of clinical suspicion is required to diagnose scrub typhus meningoencephalitis. The eschar is detected in very few cases and it may be difficult to recognize the same among the dark-skinned Indian population. However, as per our study, any case of meningoencephalitis with a combination of anemia, hyponatremia, and deranged liver function tests should always raise the possibility of the aforementioned disease and doxycycline therapy must be started promptly.
Study of cerebrospinal fluid adenosine deaminase activity for differential diagnosis of tuberculous and non-tuberculous meningitis
Authors: Seema Agarwal  , Varma Santosh , Agarwal Akhil
Published: December 2023

Background: Diagnosing a case of tuberculous meningitis (TBM) has always been challenging. Numerous previous studies have demonstrated that cerebrospinal fluid-Adenosine deaminase (CSF-ADA) estimation is useful in the diagnosis of TBM and can differentiate TBM from other types of meningitis.
Aims and Objectives: The current study aims to look for a simple, rapid, cost-effective, and specific test to differentiate tubercular etiology from other causes of meningitis.
Materials and Methods: A total of 80 patients admitted to the hospital with signs and symptoms of meningitis were selected and divided into two groups: Group 1 (Cases): 40 patients of TBM, Group 2 (Control): 40 patients of pyogenic and viral meningitis. The CSF ADA was estimated by enzymatic method, CSF Protein by turbidimetric method, and CSF Glucose by Glucose oxidase (GOD) and Peroxidase (POD) method.
Results: CSF ADA levels (mean ± SD) in the TBM and non-TBM groups were 10.874+7.72 IU/L and 2.44+1.757 IU/L, respectively (highly significant, P<0.001). With the CSF ADA cut off as >6 IU/L, the sensitivity of the test was 95%, and the specificity of 92.5%. On comparison of the values of CSF ADA in the two groups, the t value is −6.75, and the difference in these two values was found to be highly significant (P<0.01).
Conclusion: ADA estimation in CSF is a simple, inexpensive, rapid, and specific method for making a diagnosis of tuberculous etiology in TBM. As a screening test, the determination of ADA activity in CSF can help the physician diagnose TBM early and reduce irreversible brain damage and neurologic sequelae by early administration of anti-tuberculous medications.
A study of complications and their associated factors in the management of high-energy tibial plateau fractures treated by open reduction and internal fixation
Authors: Lawrence Mathias  , Aravind Shanbhag  , Varsha Shankar
Published: December 2023

Background: Tibial plateau fractures are one of the leading causes of joint dysfunction in major weight-bearing joints. Maintained articular surface, uniform plateau level, and a near-normal range of knee joint motion can all be preserved following the appropriate surgical guidelines.
Aims and Objectives: The objectives of the study are as follows: (1) To study the complications and their associated factors in the management of high-energy tibial plateau fractures treated by open reduction and internal fixation. (2) To assess radiological parameters pre-operative and post-operative and their relation to fracture pattern. (3) To assess factors, such as fracture patterns, those influence the loss of reduction.
Materials and Methods: Statistical analysis was done by expressing the data in frequency, percentage, mean, and standard deviation. Repeated measures ANOVA test or Friedman test or Wilcoxon signed-rank test will be used to compare radiological parameters from pre-operative to opposite side of the limb, and immediate post-operative to 6 weeks and 3 months.
Results: Thirty-one cases of proximal tibial plateau fractures were studied between January 2021 and September 2022. The joint width has reduced in the immediate post-operative and has almost remained the same at 45 days and 3 months. The articular step off was noted to have a reduction of 0.3 mm in particular depression which is not significant. In the comparison of tibial offset preoperatively to the immediate post-operative and the 45-day and 12-week follow-up values, there was decrease in the values from the pre-operative to immediate post-operative radiographs and the reduction in the values noted in the further follow-ups is not significant.
Conclusion: There was statistical significant difference noted between the pre-operative and immediate post-operative radiological parameters such as joint space width, tibial offset, and medial tibial plateau angle. Further radiological assessment done at 6-week and 3-month post-operative, there was no statistically significant loss of reduction.
Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries
Authors: Suman Sarkar  , Debarati Goswami  , Sujan Sarkar  , Sandesh Rathod
Published: December 2023

Background: Brachial plexus block (BPB) is widely used nowadays in patients undergoing upper limb surgery. Levobupivacaine is one of the best local anesthetics in the current scenario in this field. Both dexmedetomidine (DM) and dexamethasone (DX) are commonly used local anesthetic adjuvants in BPB to enhance blocking effects. In anesthesiology, there is always a search for a better alternative.
Aims and Objectives: In this study, we investigated the effect of DM and DX as adjuvants to levobupivacaine on the quality of supraclavicular BPB.
Materials and Methods: A prospective, double-blind, randomized controlled intervention study (superiority trial) was done involving 60 patients aged 20–60 years, randomly allocated into two equal groups (group S-DM group-Patients were received Injection 0.25% Levobupivacaine 2 mg/kg body weight+Inj. DM 1 mcg/kg body weight+distilled water [total volume 30 mL] and group C-DX group-Patients received Inj. 0.25% Levobupivacaine 2 mg/kg+Inj. DX 0.1 mg/kg body weight+Distilled water [total volume 30 mL]). The scores of the modified Gormley and Hill scale and the modified Bromage scale were recorded along with hemodynamic parameters. Pearson’s Chi-square test, Mann-Whitney U-test, one-way ANOVA, Kaplan–Meier survival analysis, and Z-test were used for statistical analysis.
Results: The onset of motor block was shorter in group-S patients (14.2667±1.0807 [min]) compared to group-C (15.9333±1.5742 [min]), and the duration of motor block was higher in group-S (708.5667±4.2644 [min]) compared to group-C patients (682.3667±20.0095 [min]) (P<0.001).
Conclusion: DM is a better alternative to DX when added to levobupivacaine for decreasing the onset of sensory and motor block and increasing the duration of supraclavicular BPB.
Study of Mannheim peritonitis index for predicting morbidity and mortality in patients of hollow viscous perforation: In a tertiary care hospital of Eastern India
Authors: Parikshita Dalai  , Akshay Chawla  , Sumit Ranjan Samal  , Swapnarani Behera  , Dharma Niranjan Mishra
Published: December 2023

Background: Peritonitis is the inflammation of peritoneum, the serosal membrane that lines the abdominal cavity and organs inside. The hollow viscous perforation (HVP) is one of the most common surgical emergencies encountered by surgeons on a daily basis. Mannheim Peritonitis Index (MPI) is a simple and effective method in predicting the morbidity of patients with HVP.
Aims and Objectives: This study attempts to evaluate the prognostic value of MPI scoring system in patients with peritonitis due to HVP.
Materials and Methods: This is a clinical, prospective, and observational study. There were 50 patients with HVP (stomach, duodenum, ileum, and appendix) admitted in Srirama Chandra Bhanja Medical College and Hospital from March 2021 to October 2022 included in the study. Necessary data were collected; MPI score was calculated for each patient and analyzed.
Results: The number of post-operative complications, duration of intensive care unit, and hospital stay proportionately increased with the MPI score. Out of the eight variables used in this scoring system, duration of pain, intraperitoneal fluid and organ failure on admission carried more significance in predicting the morbidity in the post-operative period than the other variables.
Conclusion: MPI is a simple and effective method in predicting the morbidity of patients with HVP and to assess it as a clinical tool in stratifying these patients according to individual surgical risk.
Clinico-etiological and histopathological correlation in erythroderma: In a tertiary care hospital of Eastern Odisha
Authors: Dharmendra Kumar Sahu  , Purna Chandra Singh  , Jayashree Mohanty  , Dharma Niranjan Mishra
Published: December 2023

Background: Erythroderma, or “exfoliative dermatitis,” is a generalized inflammatory disorder of the skin manifesting with erythema and scaling affecting more than 90% of the skin surface. Primary erythroderma develops in normal skin, and etiological factors include drug reaction, lymphomas, and hematological malignancies, which may be idiopathic.
Aims and Objectives: The present study is to evaluate the clinico-etiological and histopathological correlations in erythroderma.
Materials and Methods: This prospective observational study was done in the Department of Dermatology, S.C.B. Medical College, Cuttack, from 2021 to 2022. Erythema and scaling involving more than 90% of the body surface area were calculated by Wallace’s rule of nine. A detailed demographic profile and history were recorded with a thorough clinical examination for each patient, involving type of scales, sizes of scales, color of scales, associated lichenification or fissuring, pedal edema, examination of the scalp for scales, hair loss, examination of the nails and mucosa, and associated arthritis.
Results: The most common disease was psoriasis (16), Idiopathic (7), followed by atopic and drug-induced dermatitis 6 patients each. Seborrheic dermatitis showed 3 cases, followed by contact dermatitis, Reiter’s disease, Pemphigus foliaceus, Ichthyosis (congenital), Dermatomyositis, and malignancy-induced 2 cases each, whereas contact dermatitis and Dermatophyte infection were found to be one patient each.
Conclusion: Though some of the etiology remains unknown, repeated investigations and continued follow-up are necessary to determine long-term complications. The role of alternative medicines and the injudicious use of steroids by quacks or untrained practitioners should be discouraged, and proper awareness should be given to patients with erythroderma.
Relationship between dermatoglyphics and blood group of male and female first-year medical students at Rama Medical College, Kanpur
Authors: Hamid Ansari  , Mohammad Faizan Ansari  , Medha Das
Published: December 2023

Background: Apart from the flexion crease and secondary folds, dermatoglyphics is the scientific study of naturally existing epidermal ridges and their arrangement on the digits, palms, and soles. In medicolegal cases, fingerprints can be used to identify suspects, victims, and other people who touch a surface as well as to diagnose inherited diseases. ABO blood group is divided into A, B, AB, and O. ABO type is determined by two antigens and two antibodies. Due to the presence or absence of the D antigen, it is further divided into Rh-positive and Rh-negative.
Aims and Objectives: This study aimed to find correlation between ABO and Rh blood group with dermatoglyphic pattern in human beings.
Materials and Methods: The study was conducted among 107 medical students studying at RMCHRC, Kanpur, UP, India. Rubber stamp ink pads were utilized to smear each finger. Imprints were obtained, and each fingerprint pattern was inspected and documented using a strong hand lens on a sturdy white piece of paper.
Results: Among 1070 fingerprint patterns studied, the most common pattern observed was whorl. This pattern was present in 226 male’s digits (49.23%) and 233 female’s digits (50.26%), totaling to 459 forming 42.89% of the total patterns observed. B + blood group was the most common blood group present with whorl pattern, seen in 92 males and 99 females.
Conclusion: This study shows the association between the distribution of dermatoglyphics, ABO, Rh blood group, and gender.
Rapid immunochromatographic test: An evolving tool for diagnosis of scrub typhus
Authors: Saha Sabyasachi , Sanjit Kumar Patra  , Mrinmoy Pathak  , Jayanta Bikash Dey  , Ghosh Tapashi , Chakraborty Sohanjan
Published: December 2023

Background: Scrub typhus is prevalent in many districts of South Bengal throughout the year where an average temperature of 20–35°C, which contributes to the spread of Leptotrombidium deliense. However, its diagnosis remains complicated by the lack of readily available and validated assays, the non-specificity of clinical symptoms on admission, and even non-availability of the pathognomonic eschar in most of the cases.
Aims and Objectives: This study was carried out to evaluate the rapid immunochromatographic test (RICT) for early detection of scrub typhus for using it as an early diagnostic tool at the field level.
Materials and Methods: This cross-sectional study in which 181 serum samples from clinically suspected cases (after excluding dengue, malaria, Japanese encephalitis, and typhoid fever) collected over 13 months were processed for the detection of immunoglobulin M (IgM) antibodies for scrub typhus by enzyme-linked immunosorbent assay (ELISA) and rapid test.
Results: Considering IgM ELISA for scrub typhus as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value for RICT were found to be 100%, 86.87%, 50%, and 100%, respectively.
Conclusion: RICT is a simple, rapid, and reliable assay for diagnosis of scrub typhus, capable of providing accurate results quickly and is highly suitable for field deployment in remote areas with limited medical support.
Study of exercise-induced desaturation in chronic obstructive pulmonary disease patients visiting tertiary care center in Bangalore
Authors: G Anjali , Deepak Kumar R  , Sivasankari R  , Puneet Komarla Nagendra
Published: December 2023

Background: Chronic obstructive pulmonary disease (COPD) patients often have a lower ability to exercise and muscle weakness, both decreasing their quality of life. The 6 min walk test (6MWT) offers insightful data on the functional capacity of respiratory variables on exercise performance. A significant reduction in oxygen saturation (SpO2) throughout the test signifies a lower tolerance for exercise or additional oxygen requirement.
Aims and Objectives: This study focuses to investigate desaturation in COPD patients with normal resting oxygen levels (normoxemic) employing the 6MWT. The objective of the study defines to analyze different clinical parameters such as smoking behavior, 6MWT, and clinical parameters of COPD patients to diagnose respiratory performance.
Materials and Methods: Between June 2019 and May 2020 study was conducted on patients presenting to our OPD, who were above 40 years and diagnosed with COPD, with baseline SpO2 ≥90%. 6MWT was performed on them as per American Thoracic Society guidelines. Noting their distance covered and desaturation if present.
Results: The study group included 60 patients; the group was divided into 35 desaturators (DS) and 25 Non-DS (NDS) based on fall in SpO2 during 6MWT, all current smokers were in the DS group and had low body mass index values, DS group covered less distance when compared to NDS, DS had low mean forced vital capacity and forced expiratory volume 1 second values.
Conclusion: This study established the relationship between COPD risk variables and 6MWT. The 6MWT was identified as a useful method to examine respiratory performance by noting exercise-induced desaturation and in turn the respiratory capacity among COPD patients.
Surgical site infections - A threat to the health-care system: An observational study from a tertiary care hospital of Bihar
Authors: Kunal  , Kumar Ashutosh , Kumar Manish , Amaresh Kumar , Ali Hassan Ashif , Anupama Anjoo
Published: December 2023

Background: A surgical site infection (SSI) is any infection occurring after a medical intervention. It is the most common nosocomial infection in low- and middle-income countries. It has raised both mortality and morbidity. Resistance to antibiotics due to irrational use has further added to the severity of the problem.
Aims and Objectives: The current study was designed with the aim of determining the incidence of SSIs among patients operated on a tertiary care hospital, along with their antibiogram.
Materials and Methods: An observational study with a cross-sectional design was conducted on 150 patients with suspected SSI were included in this study over a period of 1 year, from August 2021 to July 2022. An adult patient with pus, serous, or seropurulent discharge from the surgical wound was included in the study. Information was obtained using a pre-designed and pre-tested schedule. Identification of the colony was done by gram staining and inoculation on 5% sheep blood agar and Mac Conkey agar plates. Antimicrobial sensitivity testing was done. The data was analyzed using Microsoft Excel.
Results: A total of 152 patients were included in the study. The incidence of SSI was found to be 38.2%. The mean age of the participants was 47.7 ± 21.6 years. The maximum incidence of SSI was noted in the 5th decade of life. Among the 58 patients’ samples, 65 aerobic bacterial colonies were isolated. Out of which Staphylococcus aureus and Escherichia coli were the commonest organisms. On performing an antibiogram, a higher degree of resistance was observed among Gram-negative organisms.
Conclusion: SSI adds to the mortality as well as the morbidity of the patients. Not only this, but it also adds to the expenses. A more stringent surveillance system and reinforcement of the guidelines was the need of the hour to overcome this problem of hospital-acquired infections.
Evaluation of the diagnostic accuracy of microalbuminuria in predicting mortality among elderly patients with sepsis
Authors: Bar Mita , Mukhopadhyay Prianka , Biswas Atanu , Sarkar Manisha
Published: December 2023

Background: Sepsis is a common cause of morbidity and mortality among geriatrics.
Aims and Objectives: The objective of study was to find the clinicomicrobiological profile of elderly inpatients (≥60 years) with sepsis and to evaluate the diagnostic accuracy of urine albumin to creatinine ratio (ACR) or microalbuminuria in predicting mortality.
Materials and Methods: A prospective observational study was conducted among 50 geriatric patients admitted with sepsis in the ward or intensive therapy unit under medicine department of a tertiary care center for a period of 1 year. Baseline clinicomicrobiological profile was noted. Urine ACR values were measured at admission, day 4, and day 7 and geriatrics were followed up for 28 days to see the outcome. Receiver operator characteristic curve analysis was performed to evaluate the area under the curve for microalbuminuria on the 3 days and to determine the optimum cut-off points to predict mortality.
Results: The mortality rate within 28 days was 64%. Urine microalbuminuria on day 1, day 4, and day 7 of admission was significantly higher among the non-survivors compared to survivors (P≤0.001, P≤0.001, and P=0.006, respectively). Microalbuminuria levels (in mcg/mg) of 143.0, 60.05, and 42.6 on day 1, 4, and 7 of admission, respectively, can be used as the cut-off to predict the death of geriatric sepsis inpatients with overall diagnostic accuracy of 83.0%, 83.4% and 86.1%, respectively, sensitivity as 93.75%, 87.50%, and 100.0%, respectively, and specificity as 44.44%, 72.22%, and 72.22%, respectively.
Conclusion: Microalbuminuria can be a potential biomarker to predict death among geriatric septic inpatients, which can further help in improving the treatment strategy.
Transthoracic ultrasonography in the assessment of interstitial lung disease in patients with systemic sclerosis
Authors: Shasanka Sekhar Das  , Saubhik Kanjilal  , Mridul Kanti Das  , Avas Chandra Ray  , Kausik Munsi  , Parasar Ghosh
Published: December 2023

Background: Transthoracic ultrasonography was considered, sometimes in the past as unsuitable for the assessment of lung but it eventually emerged as an important tool in the diagnosis and in guiding treatment of various lung and pleural diseases. Several studies in the past proved it to be a useful complementary tool in the detection of interstitial pulmonary fibrosis.
Aims and Objectives: This study aims to assess the utility of transthoracic uultrasonography (TUS) in comparison to high-resolution computed tomography (HRCT) thorax in the detection of interstitial lung disease (ILD) in systemic sclerosis (SSc) patients.
Materials and Methods: SSc patients with HRCT proven ILD were identified and classified according to Warrick’s score. Sonographic evidence of ILD in these patients were judged by the presence of B-lines or ultrasonic lung comets (ULCs). Each procedure was studied and interpreted by two independent examiners blinded about the patient’s clinical and radiological features. Standard spirometric measurements were performed in all patients.
Results: A highly significant positive linear correlation between ULCs and Warrick’s score was found in this study (r=0.83, P≤0.001). ULC score had moderate negative correlation with forced expiratory volume in 1 s (FEV1) % p (r=−0.60, P=0.001) and weak negative correlation with forced vital capacity (FVC) % p (r=−0.45, P=0.01) and FEV1/FVC % (r=−0.42, P=0.02).
Conclusion: USG lung can be suggested as a useful non-invasive tool in the detection of ILDs in scleroderma patients.
Comparative study of the diagnostic power of full outline of unresponsiveness score and Glasgow coma scale in patients with traumatic brain injury in an emergency department
Authors: Raaj Vishnu R  , Dhilipan K  , Prakash PS  , Selvarajan N
Published: December 2023

Background: The Glasgow coma scale (GCS) is the most commonly used scale, and the full outline of unresponsiveness (FOUR) score is new validated coma scale as an alternative to GCS to measure the level of consciousness and evaluate the severity of the injury in traumatic brain injury (TBI) patients.
Aims and Objectives: The present study compared the performance of FOUR scores and GCS in outcome predictions of TBI cases.
Materials and Methods: This prospective and cross-sectional study was conducted over a year by the Emergency Department of a tertiary care hospital, Kovai Medical Center and Hospital, Coimbatore, India. Of 159, 123 patients were recruited from intensive care unit (ICU), and 36 from the ward were included in this study. Data were collected using an observation checklist to determine the similarities and differences in predicting outcomes using the two assessment scales (GCS and FOUR).
Results: Most patients were 51–60 years (38%), with a mean age of 41.57. About 82% were male, 18% were female, and 31% had comorbidity of hypertension. Data analysis showed a significant statistical difference in mean FOUR and GCS scores between ICU and ward admission. A multivariate logistic regression study revealed that the probability of ICU admission in trauma patients from the emergency department was associated with a decline in GCS and FOUR scores. The range of predicted ICU admission was similar in both GCS and FOUR score models.
Conclusion: Although both scores are good predictors of TBI patients, we concluded that the FOUR score is a recommended predictive model for patients admitted to the medical ICU.
A study of morbidity and mortality pattern of pre-term neonates in neonatal intensive care unit of a tertiary care hospital of North East India
Authors: Kalita Dulal , Rahman Mahibur , Barman Diganta
Published: December 2023

Background: Pre-maturity is one of the major health problems and associated with high morbidities and mortality. According to the WHO every year, an estimated 15 million babies are born pre-term and this number is rising.
Aims and Objectives: The objectives of the study were to know the various morbidity pattern developed during the clinical course and to identify the cause of mortality of pre-term babies admitted in neonatal intensive care unit (NICU).
Materials and Methods: This prospective, observational study was conducted in the Neonatal Intensive Care Unit of Gauhati Medical College and Hospital, Assam, over a period of 1 year. A sample size of 150 pre-term babies selected randomly as per inclusion and exclusion criteria.
Results: The total number of cases studied in the present study were 150 pre-term babies admitted in NICU. Male pre-term babies were 82 (54.6%) and female pre-term babies were 68 (45.3%). The various morbidities observed among the pre-term babies during the study period were neonatal hyperbilirubinemia (48%) followed by respiratory distress syndrome (RDS) (30%), neonatal sepsis (22%), hypocalcemia (16%), hypothermia (14.7%), necrotizing enterocolitis (NEC) (5.3%), and intraventricular hemorrhage (4.7%). The overall mortality among the studied cases was 12.6%. Out of 150 cases, 19 cases were expired (12.6%). The present study shows that RDS (36.8%), neonatal sepsis (26.3%), birth asphyxia (21.1%), and NEC (15.7%) were the major causes of mortality among pre-term babies.
Conclusion: The survival rate increases significantly with increase in birth weight and gestational age. RDS, birth asphyxia, and neonatal sepsis were the leading causes of death.
A prospective audit to assess the feasibility of sentinel lymph node biopsy and/or low axillary sampling in clinicoradiologically node-negative axilla for early breast carcinoma
Authors: Abasaheb Madhukar Tidake  , Anagha S Varudkar  , Balaji Shankarrao Mane
Published: December 2023

Background: Sentinel lymph node (SLN) dissection was designed to minimize side effects of lymph node surgery but still offer outcomes of axillary lymph node dissection.
Aims and Objectives: Our study is designed to determine whether SLN resection achieves the same therapeutics outcome as complete axillary dissection but with fewer side effects for node-negative axilla in clinicoradiologically operable breast cancer patients.
Materials and Methods: Duration-based prospective observational study was carried out at the General Surgery and Surgical Oncology Department at Government Medical College and Hospital, Aurangabad with a duration of 2 ½ years from July 2019 to January 2022. A total of 36 patients of breast cancers with stages T1-T2, N0 with clinically and radiologically negative axilla from July 2019 to January 2022 duration were included in our study.
Results: When the histopathological status of axillary lymph nodes was compared to the histopathology of SLNs it was seen that out of 36 patients, the histopathology of sentinel node was positive in 10 patients (10/36) however the rest of the axilla was positive in 6 cases and negative in 4 cases and the histopathology sentinel node was negative in 26 patients out of 36 cases (26/36) however the rest of the axilla was also negative in 24 cases and positive in 2 cases.
Conclusion: SLN biopsy using methylene blue dye alone is a highly reliable and predictable technique to stage the axilla in breast cancer patients as this study shown a low false-negative rate (7.69%). This technique may help to avoid complete axillary lymph node dissection in sentinel node-negative patients thereby minimizing the morbidity of axillary lymph node dissection. This study demonstrates that sentinel node localization is possible with methylene blue dye alone.
Case of triple extradural hematoma in a single patient: A rare case report
Authors: Jolly Sinha  , Avdhesh Shukla  , Vivek Kumar Kankane  , Avinash Sharma  , Sutradhar Sridham
Published: December 2023

Epidural hematoma (EDH) is found in 1–4% of traumatic brain injury cases. Acute triple extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5–1% of all extradural hematomas. Here is a case report of a 36-year-old female patient who presented to us with a head injury due to fall from a bike due to collision with a stray animal. The patient had a Glasgow Coma Scale of 9 (E2V2M5) with bilateral sluggishly reacting pupil to light. Computed tomography showed asymmetric bilateral posterior fossa EDHs along with an extradural hematoma in the right frontal region with multiple small contusions with mass effect. The surgical evacuation was performed first of the posterior fossa in the prone position and then right frontal hematoma evacuation in the supine position in the same sitting. The patient recovered well and was discharged on the 10th post-operative day with no neurological deficit. Early drainage of hematomas has been demonstrated to be an effective technique that soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage.
Influence of sleep patterns on hormonal regulation and metabolic biomarkers: A cross-sectional observational study
Authors: Banpur Rajini  , Mudassir Mirza  , Shareefa M  , Syeda Samina
Published: December 2023

Background: Sleep duration and quality play a critical role in health, impacting hormonal regulation and metabolic functions.
Aims and Objectives: This study aimed to investigate the complex interplay between sleep patterns, hormonal regulation, and metabolic biomarkers.
Materials and Methods: A cross-sectional observational study was conducted involving 100 individuals. Demographically, participants averaged 35.2 years, with 45% males and 55% females and an average body mass index (BMI) of 25.9 kg/m² (ranging 18.7–32.5). Sleep assessment revealed an average duration of 7.2 h (range: 5.5–9.0 h) and a mean sleep quality score of 6.8 (range: 3–11).
Results: Correlation analyses spotlighted significant associations between sleep duration and hormonal markers. Negative correlations emerged for cortisol and leptin, while insulin showed non-significance. Sleep duration exhibited both a positive correlation with fasting glucose and non-significant negative and positive correlations with total cholesterol and high-density lipoprotein cholesterol. Incorporating age, gender, and BMI, multivariate regression underscored sleep duration’s enduring impact on cortisol (Coefficient=−0.23, SE=0.09, P=0.021, 95% CI [−0.42, −0.04]). However, the sleep duration-fasting glucose relationship lost significance post-adjustment (Coefficient=0.09, SE=0.06, P=0.128, 95% CI [−0.03, 0.21]).
Conclusion: This study illuminates intricate links between sleep, hormones, and metabolism. Sleep duration influences cortisol, and fasting glucose associations involve multifaceted factors. These insights offer direction for future research and clinical approaches in managing sleep-related health aspects.
A clinical, comparative, prospective, and observational study of two different ratios of ketamine and propofol in short surgical procedures at a tertiary care hospital
Authors: Muralidhara KS  , Shivakumar G  , Santhosh MCB  , Shashwatha N Gowda
Published: December 2023

Background: Ketamine and propofol are two medications commonly used for procedural sedation because they possess many of the desired characteristics including rapid induction and recovery. The opposing physiologic effects of ketamine and propofol suggest the potential for synergy, and this has led to an interest in their combined use, commonly termed “Ketofol.” The purpose of this study is to compare two different proportions of ketamine and propofol, 1:2 and 1:3 in short surgical procedures.
Aims and Objectives: The aim of the study was to compare the quality of analgesia, level of sedation, and respiratory and hemodynamic parameters of two different proportions of ketamine and propofol in the ratio of 1:2 and 1:3 in short surgical procedures.
Materials and Methods: After obtaining approval from the institutional ethics and scientific committee, with IEC no.MIMS/IEC/2021/474 dated February 23, 2021, 86 consenting patients of 18–60 years categorized under American Society of Anesthesiologists Category I and II undergoing elective short surgical procedures lasting for about 20 min were selected. The study patients were divided into two groups of 43 each by convenient sampling method. In Group A, 43 patients received 1 mL of ketamine (50 mg/mL) mixed with 10 mL of 100 mg propofol (10 mg/mL). In Group B, 43 patients received 30 mg of ketamine mixed with 9 mL of 90 mg propofol (10 mg/mL). Non-invasive blood pressure, heart rate, oxygen saturation, Ramsay Sedation Score, Modified Aldrete Score, and any incidence of side effects were recorded.
Results: The quality of analgesia and level of sedation was achieved better in Group A compared to Group B. No significant difference was observed between the two groups with respect to hemodynamic and respiratory parameters.
Conclusion: The combination of propofol and ketamine has several benefits such as hemodynamic stability, lack of respiratory depression, good recovery, and potent procedural analgesia. Ketofol 1:2 proportion is comparatively better and can be used safely in short surgical procedures.
Visual benefits and complications following neodymium-doped yttrium aluminum garnet (Nd: YAG) capsulotomy
Authors: Ajay R Kamath  , Gundapaneni Ramya
Published: December 2023

Background: The incidence of posterior capsule opacification (PCO) noted at the end of 5 years following cataract extraction is 33%. With the advent of phacoemulsification various materials and designs of intraocular lenses, the incidence of PCO has been reduced. Following pediatric cataract surgery, the incidence of PCO was found to be 100%. Nd: YAG capsulotomy is considered a safe, effective, and non-invasive technique to treat PCO.
Aims and Objectives: The aim of the study was to evaluate the visual acuity among the patients with PCO and to assess the complications following Nd: YAG capsulotomy.
Materials and Methods: A total of 100 eyes of 100 patients with study period being 2 years from October 2015 to July 2017. The study was prospective study, and sampling was purposive sampling. After recruiting, the participants were divided into 2 case groups - pseudophakia and aphakia. A complete ophthalmological evaluation was done which included best-corrected visual acuity, torchlight and slit-lamp examination, and measurement of IOP which was followed by a fundus examination.
Results: The minimum and maximum age of the patient observed in our study was 34 and 88. Most of the study population was in the age group of 51–60 years. Majority of patients presented with PCO with an interval of 25–36 months following cataract surgery and were noted in about 52% of study population. Majority of the patients had visual acuity 6/36-6/18 and observed in 36% of study population. Comparison between pre-YAG and post-YAG day 1 visual acuity was done using significance test and P=0.000 which was highly significant, visual acuity at 4th week was compared to that of 6th week, and it was significant.
Conclusion: The loss of vision due to PCO is a distressing complication for a patient who has spent time and money getting their surgery done and finds that their vision is dropping again. YAG laser capsulotomy is a simple, outpatient solution that will bring the smile back on the patient’s face instantly. Capsulotomy improves visual acuity immediately after the procedure and more after 4 or 6 weeks with least complications.
Incidental precancerous and cancerous neoplasms in routine cholecystectomy specimens – A fascinating series of cases in a tertiary care center
Authors: Meghadipa Mandal  , Debajyoti Singha Roy  , Vandana Maroo  , Sanghamitra Mukherjee
Published: December 2023

Laparoscopic cholecystectomy is one of the most commonly performed surgeries for benign gall bladder pathologies. Pre-cancerous and malignant gall bladder neoplasms often have overlapping non-specific clinical manifestation in their early stages. Radiological findings are also non-specific in the early stages with the presence of cholelithiasis in a significant proportion of cases. Cholelithiasis is said to be one of the important comorbid risk factors for gall bladder carcinoma (GBC) as a source of constant irritation to biliary mucosa. In such cases, cholecystectomy done for benign indications may lead to a histopathological diagnosis of incidental gall bladder carcinomas. Pancreaticobiliary type of adenocarcinoma is the most common subtype of GBC with two described cases in this series. Invasive foci need to be ruled out in. All cases of high-grade biliary intraepithelial neoplasia as were seen in the third case. Intracholecystic papillary neoplasm is a recently described entity with one reported case in this series that was associated with invasive adenocarcinoma. Signet ring adenocarcinoma is a rarely encountered adenocarcinoma in gall bladder with worse outcome. One such case has been described here where the patient has succumbed to death within 3 months of surgery and during the course of adjuvant therapy.
Assessing adherence to hypertension medications and its impact on blood pressure control: A community-based observational study
Authors: Sandhya Rani M  , Ramesh Palabindela  , Penupothu Sree Nagamani  , Naveen Choudary G
Published: December 2023

Background: Hypertension is a prevalent cardiovascular condition requiring effective medication management for blood pressure control.
Aims and Objectives: The aim is to explore the relationship between adherence to hypertension medications and its impact on blood pressure control among a diverse population.
Materials and Methods: A participant cohort of 500 adults, with a mean age of 56 years, was examined for their adherence to hypertension medications and blood pressure control outcomes. Adherence was assessed through self-report questionnaires and pill count analysis, while blood pressure control was defined as systolic blood pressure below 140 mmHg and diastolic blood pressurebelow 90 mmHg. The statistical analysis included logistic regression with adjustments for potential confounding variables.
Results: The participant cohort displayed a balanced gender distribution and predominantly managed hypertension through multi-drug regimens. Around 65% reported high medication adherence, confirmed by pill count analysis. Notably, 55% achieved the defined blood pressure control target, indicating effective management. A robust association was observed between high adherence and improved blood pressure control (adjusted odds ratio=1.65, 95% confidence interval: 1.28–2.12, P<0.001). Participants with high adherence were 1.65 times more likely to attain target blood pressure control than those with lower adherence, with a high level of statistical significance.
Conclusions: This study highlights the crucial link between medication adherence and blood pressure control in hypertensive individuals. High adherence increases the likelihood of optimal blood pressurecontrol, underscoring patient commitment. Tailored interventions and support mechanisms are essential for enhancing adherence and improving hypertension management outcomes.
Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in patients of hydrocephalus in eastern India: A prospective observational study
Authors: Anurup Saha  , Gitanjali Dutta  , Shahid Iftekhar Sadique  , Sibaji Dasgupta
Published: December 2023

Background: Hydrocephalus is a disorder of cerebrospinal fluid (CSF) physiology, resulting in an abnormal enlargement of the ventricles due to excessive accumulation of CSF. Although neurosurgical treatment has evolved over time with ventriculoperitoneal shunt (VPS) as the standard of care, procedure-related complications and poor long-term cognitive and motor milestone outcomes are still considerable, justifying the need for safer alternatives. Endoscopic third ventriculostomy (ETV) has emerged as a promising prospect especially in non-communicating hydrocephalus (NCH).
Aims and Objectives: To compare the beneficial effects of ETV versus ventriculoperitoneal shunt in patients of NCH.
Materials and Methods: The present prospective study was conducted at the Department of Neurosurgery, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Kolkata from July 2021 to December 2022 among 60 patients admitted with NCH. Out of 60 patients; 30 patients underwent ETV and the remaining 30 patients VP shunting. All included patients had their history taken and relevant clinical and radiological examination done pre-operatively. They were discharged on the third post-operative day or later depending on their clinical condition and recovery.
Results: Aqueductal stenosis was the most common etiology for NCH in both the groups. Post-intervention, complications and reoperation rate were reported more in VP group as compared to ETV group. Overall 3 subjects died, out of which 2 belonged to VP group and 1 to ETV group. Success was found in 70% and 86.67% of the subjects in VP and ETV group respectively.
Conclusion: In patients with non-communicating or obstructive hydrocephalus, ETV was reported to be superior to VPS in terms of reoperation and complication rate at 4th, 12th, and 24th weeks after the treatment.