bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Democratic Way to Go?
Authors: van der Puil Roxanne , Spahn Andreas , Royakkers Lambèr
Published: October 2023

There are concerns amongst researchers and the general public that social media platforms threaten democratic values. Social media corporations and their engineers have responded to these concerns with various design solutions. Though the objective of designing social media democratically sounds straightforward, the concrete reality is not. The authors discuss what a democratic design for social media platforms could look like by exploring two classical conceptions of democracy, one in the liberal tradition and the other in the deliberative tradition. In particular, they discuss three concerns: 1) mis- and disinformation; 2) hate speech; and 3) the relations between filter bubbles, echo chambers, and public debate. By describing the underlying ideals of the two traditions and translating these into design guidelines, the authors make explicit how varied and contrary the implications of different conceptions of democracy can be for addressing public concerns and designing for democratic social media. With these things in mind, this article responds to a call, which is to raise awareness among social media corporations, engineers, and policymakers about varying democratic ideals and the implications that these may have for social media.
Multi-valve Libman-Sacks’s endocarditis-related multiple, massive and fatal systemic embolization. A case report and a review of diagnostic work-up
Authors: Parato Vito Maurizio , Belleggia Sara , Parato Andrea Giovanni , Ianni Umberto , Molisana Michela , Gizzi Germana , D'Agostino Simone , Dottori Melissa , Di Eusanio Marco
Published: October 2023

We reported a case of non-bacterial thrombotic endocarditis (NBTE) in a 37-year-old woman who presented with signs and symptoms of cardio-embolic cerebral stroke caused by a prothrombotic state due to underlying advanced uterine cancer. Multimodal imaging, including 3D-ecocardiography, as well as laboratory and cultural tests, were critical in making the diagnosis. After starting anticoagulation therapy with low molecular weight heparin (LMWH), the patient underwent surgical aortic valve replacement due to worsening aortic valve function, initial left ventricle enlargement, increasing dimensions, and mobility of vegetations. Unfortunately, vegetations relapsed on the aortic valve bio-prosthesis as well as the mitral leaflets, resulting in a final picture of multi-valve NBTE. The fatal outcome was due to a massive multiple limb embolism, which resulted in leg amputations and septical complications. Starting with the case, we present a brief overview of the pathology's presentation, treatment, management, and prognosis, as well as the diagnostic work-up.
Factors affecting the outcome of endoscopic sinus surgery: Our experience in a resource-constraint setting
Authors: Ngamdu Yusuf B , Adamu Auwal , Kirfi Abdullahi M , Edem Kingsley P , Abubakar Adamu , Shirama Yakubu B , Adebola Shofoluwe N , Ahmad Babagana M
Published: October 2023

Background:

Endoscopic sinus surgery (ESS) has recorded an excellent success rate, ranging from 80%–98% in the developed countries. However, the outcome in a resource-constraint setting may not be the same due to several factors associated with the patient, the clinical course, and the management of the disease.

Objective:

The aim of this study was to examine the factors that affect the outcome of ESS in a resource-constraint setting.

Materials and Methods:

Clinical, radiological, surgical, and outcome data of patients who had ESS at a newly established tertiary hospital from January 2018 to June 2022 were reviewed. Patients with complete resolution of symptoms and absence of disease on postoperative endoscopy were considered to have “satisfactory outcome.” Those with either recurrence or residual disease were considered to have “unsatisfactory outcome.” Chi-square and logistic regression analyses were carried out to determine the factors and predictors of outcome.

Results:

Fifty-three patients were evaluated, comprised of 29 (54.7%) males and 24 (45.3%) females. The age of the patients ranged between 11 and 67 years with a median of 33 years. The majority of the patients (67.9%) had satisfactory outcome, but 32.1% had unsatisfactory outcome. The complication rate was 26.4%, although the majority (24.5%) had minor complications. Factors associated with outcome were nasal allergy (P = 0.000), nasal polyps (P = 0.000), and anatomical variation (P = 0.045). However, only nasal allergy (P = 0.046) and nasal polyps (P = 0.004) were significant predictors of unsatisfactory outcome on logistic regression analysis.

Conclusion:

The outcome of ESS is also good in resource-constraint setting. However, a significant unsatisfactory outcome was recorded, factors such as the presence of allergy and nasal polyps may predict the unsatisfactory outcome. Therefore, allergy and nasal polyps should be evaluated thoroughly while preparing patient for ESS.
Knowledge of and attitude toward attention-deficit/ hyperactivity disorder (ADHD) assessed among primary schoolteachers of Makkah City in Saudi Arabia
Authors: Alshareef Hadeel H. , Elzahrany Suha R. , Alharthi Reem Abdullah , Alsulmai Amal A. , Aljabri Shuaa G. , Alamri Ghadeer E. , Alharbi Ibrahim , Alkhotani Amal M.
Published: October 2023

ABSTRACT

Background:

One of the most prevalent pediatric medical conditions is attention-deficit/hyperactivity disorder (ADHD). It is characterized by symptoms of hyperactivity, impulsivity, and/or inattention. The first people to notice a child’s ADHD symptoms are typically their teachers, who may then offer data that are typically helpful in its diagnosis. The purpose of this study was to assess teachers’ knowledge of ADHD, its causes and etiology, as well as the key demographic factors that influence said knowledge.

Method:

The study was conducted among schoolteachers of primary schools located in different regions of Makkah City, Kingdom of Saudi Arabia. We used a stratified random sampling technique to collect our sample, with the inclusion criteria being teachers who were working in a primary school and who were directly involved in teaching students. Data analysis was performed using the IBM SPSS Statistics software version 21.

Results:

We received 335 responses to our questionnaire. The age of the participants ranged from 18 to 59 years, with the mean age being 40.2 ± 13.8 years. About 66.9% of teachers were women. Most of the teachers in this sample had a bachelor’s degree (73.4%), and only 21.8% had diplomas. Regarding the years of teaching experience, 34.6% had teaching experience exceeding 20 years, whereas 20.6% had less than five years of teaching experience. Regarding general knowledge of the teachers, (5.4%) of the teachers had a good level of knowledge. Only 63.6% of teachers were aware that ADHD students frequently struggled with task and activity organization, and only 7.5% of teachers had good knowledge of ADHD treatment, compared to 40.9% who had a good awareness of symptoms and diagnosis. Only the teachers’ education level was significantly associated with their knowledge level of ADHD: 25% of teachers with a postgraduate degree had an overall good level of knowledge versus 2.7% of those with a diploma (P = 0.006)

Conclusion:

The findings of this study lead to the conclusion that elementary school instructors have an inadequate understanding of ADHD. Some teachers misunderstand the signs and general facts associated with ADHD, thereby indicating the need for further training in this area.
Demographic and clinical characteristics of primary lung cancer patients in Kerala: Analysis of data from six teaching centers
Authors: Jose Nisha K. , Soman Biju , Thulaseedharan Jissa V. , Varghese Bipin T. , Thomas Shaji , Tom Jeremiah J. , Warrier Narayanankutty , Avaronnan Manuprasad , Jeemon Panniyammakal
Published: October 2023

Background:

Lung cancer continues to be the leading cause of cancer-related deaths in men and women. A breakdown by level of economic development shows no differences in cancer deaths in men but a higher rate of lung cancer deaths in women in industrialized countries as compared with developing nations. The risk factors for lung cancer most commonly include lifestyle, environmental, and occupational exposures. The role these factors play varies depending on geographic location, sex and race characteristics, genetic predisposition, as well as their synergistic interactions.

Materials and Methods:

It was a hospital-based registry, wherein hospitals were selected from three zones—north, central, and south zones of Kerala. The study was registered with clinical trial registry of India with Registration No. CTRI/2021/02/031299. Registry of lung cancer patients was prepared at all sites and institutional ethical clearance was received from all sites. All patients with primary lung cancer, histologically proven of all age groups were included in the study.

Results:

A total of 761 patients were registered from six teaching hospitals in Kerala who were diagnosed with primary lung cancer during the period 2017–2019. The mean age of the study population was 65.1 ± 10.2 years. Of all, 81.1% of them were males and 18.9% were females. Histologically, 56.4% had adenocarcinoma and 25.6% had squamous cell carcinoma.

Conclusion:

It was observed that the proportion of females diagnosed with primary lung cancer is increasing. Patients get diagnosed at a later stage of the disease, which calls for screening and early detection of lung cancer. As it accounts for the highest mortality among all other cancers, there is high scope for prevention and screening strategies.
A study to compare the performance of anganwadi workers in owned and rented anganwadi centers in a district of the western part of India
Authors: Somani Abhishek , Shah Sonal , Patel Maharshi , Parmar Piyushkumar C.
Published: October 2023

ABSTRACT

Introduction:

The Integrated Child Development Services (ICDS) scheme is one of the flagship programs, and under this, various activities like non-formal education on one hand and breaking the vicious cycle of malnutrition, morbidity, and mortality on the other hand are carried out by anganwadi worker (AWW). The aim of this study is to assess the AWWs performance and beneficiary participation in respect to the ICDS scheme.

Methodology:

This is a community-based, cross-sectional study done in two stages using a simple random sampling technique. Ahmedabad Municipal Corporation (AMC) area is divided into 10 parts called ghatak, and out of these 10 ghataks, 6 were chosen in the first stage, and in the second stage, 12 anganwadi centers were selected from these 6 selected ghataks using simple random sampling.

Result:

In this study, 58.3% of anganwadi workers were graduates. While talking about work related to “Home Visit” and “Immunization Sessions,” there was no statistically significant difference between owned and rented anganwadi center noted. While in “Nutrition & health education”-related work, there was a statistically significant difference between owned and rented anganwadi centers observed. Accuracy of weighing, plotting, and interpretation skill was more than 90% found in both the rented and owned anganwadi center. An almost similar level of nutritional status was observed in both owned and rented centers.

Conclusion:

In terms of performance and participation, there was not much difference between corporation own and rented anganwadi centers, although there were shared concerns related to frequent changes of place of rented anganwadi centers affecting the participation of beneficiaries.
Giant mandibular osteoma, CT findings for the primary care provider
Authors: Sharma Rajaram , Dey Amit Kumar , Udmale Prasad , Priyamvara Aditi , Alam Shah , Dey Debashish , Thakkar Hemangini
Published: October 2023

We report a very rare case of 35-year-old female with a giant mandibular osteoma in the angle of the mandible. We highlight the importance of CT in diagnosing as well as defining the extent of this rare case so that proper management can be undertaken. We also showcase the importance of angiography to show relationship of this mass with the surrounding vessels.
Thyrotoxicosis: A paradox
Authors: Bawaskar Himmatrao S. , Bawaskar Pramodini H.
Published: October 2023

Incidence of thyroid dysfunctions including hypo- or hyperthyroidism is significantly increased. Hyperthyroidism is common in males, and hypothyroidism is often seen in females. Here, we report two female patients suffering from hyperthyroidism, but their signs and symptoms are totally opposite to each other.
Facility assessment of the best functioning facility providing emergency obstetric care in the selected blocks of Varanasi, Uttar Pradesh
Authors: Singh Arun K. , Kumari Kalpana , Pandey Pallavi
Published: October 2023

ABSTRACT

Background:

UP has the 2nd highest MMR which is 197 compared with national average of 113 (RGI-SRS-2016-2018).Although institutional deliveries in India has been increased from 78.9% (NFHS-4) to 89% (NFHS-5) [ UP from 67.8% to 83.4%] but still we are far away from SDG -3 target. It reflects that there may be increase in crude coverage but not in effective coverage.

Materials and Methods:

It is a cross sectional study conducted in May – June 2017. Out of 8 blocks of rural Varanasi, 4 blocks were selected randomly. Best functioning facility for EmOC services in each selected block were assessed using Facility Gap Assessment Schedule of IPHS.

Result:

None of the facility met the recommended standard for BEmOC .Tracking of drop out of ANC and PNC services, use of Partograph, treatment of abortion-related complications, were not found at all the 4 facility. Blood grouping and RH typing was also not functional at 2 of the 4 centers. Caesarean section and availability of blood bank were also lacking in CHC (FRU).

Conclusion:

If condition of best functioning facility in a block is not according to the recommendation then how can we expect to provide a good maternal health service to public.
Clinico-epidemiological profile of non-survivors of COVID-19 during the last two waves in a tertiary care hospital of North India: A retrospective descriptive study
Authors: Husaini Syed H. M. , Waseem Shah M. A. , Siddiqui Zia , Ali Wasif M. , Nasreen Farah , Athar Manazir , Ahmad Manzoor , Khan Haris M.
Published: October 2023

Background:

SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection.

Method:

Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a P value<0.05 was taken as significant.

Results:

60.94% and 39.06 % were males and females, and 26.57% & 73.43 % of patients had moderate and severe disease, respectively. Fever, cough, and dyspnea were the most common presenting symptoms. 78.12% and 21.88% had pre-existing (diabetes and hypertension were most common) and no co-morbidities, respectively. 65.62 & 17.19 % of patients had bilateral and unilateral ground glass opacities, respectively. Thrombocytopenia, lymphopenia, neutrophilia, elevated monocytes, and neutrophil-lymphocyte ratio (NLR) of 7.52 were hematological findings. D dimer was elevated. ABG showed low PaO2 and SPO2 %. ALT and AST were elevated. Tachycardia was also present. Compared to the first wave, no significant association of gender with severity was found. However, the percentage of male patients was higher. The association of the duration of stay and co-morbidity with disease severity was significant in both the first and subsequent waves of COVID-19.

Conclusion:

Co-morbidity, disease severity, and radiological lung opacities play a role in the outcome of COVID-19. The associated findings are hematological, renal, liver, cardiovascular, and arterial blood gas derangements.
An observational analysis of profile and outcome of children with malnutrition admitted at malnutrition treatment centre
Authors: Gupta Ajay , Grover Somya , Kumar Abhishek , Kumawat Pragya , Meena Sadhana
Published: October 2023

ABSTRACT

Introduction:

Nutritional status is an important health indicator and children bear maximum burden of it. Poor nutrition during first thousand days of a child’s life can lead to stunted growth. Comorbid condition adversely affects treatment outcome of malnutrition. This study is aimed to describe the profile and treatment outcome of malnourished children.

Materials and Methods:

This record-based retrospective, analytical observational study was conducted from October to December 2020. Data of severe acute malnourished children who were admitted in malnutrition treatment centre during August 2017 to September 2020, collected. Totally, 264 eligible children were enrolled in the study. The data were collected through medical records of patients. Data were entered in excel spreadsheet and analysed.

Results:

Most of the children belonged to 6-24 months of age, almost equal proportion of male and female, and more than three-fourth of children were from rural area. The mean length of stay in hospital was 15.19 ± 6.64 days and average weight gain of children was 7.6 ± 6.7 gm/kg/day. There was significant increase in Z-score (Weight/Height) and MUAC at the time of discharge (P value <0.05). There was no significant association of treatment outcome with the presence of comorbidities (P value >0.05).

Conclusion:

Most vulnerable age group for malnutrition was 6 months to 2 years. Majority of children with malnutrition improve with standard treatment protocol of malnutrition. We can improve the ability of community health workers to significantly reduce child malnutrition at the primary care level and in the community by equipping them with the required knowledge, tools, and assistance.
Demographic predictors of central sensitization in patients of knee osteoarthritis
Authors: Jain Shweta , Anand Vijender , Gupta Ajay , Khorwal Bhawna
Published: October 2023

Context:

Evidence suggests that central sensitization (CS) may contribute to pain in osteoarthritis (OA) knee patients, which cannot be treated by locally directed treatment strategies.

Aims:

The aim of this study was to examine differences in demographic profile of patients with and without central sensitization in osteoarthritis knee.

Settings and Design:

Observational cross-sectional study at tertiary care hospital.

Materials and Methods:

The study was conducted in the Department of Physical Medicine and Rehabilitation, VMMC and Safdarjung Hospital in 345 OA knee patients. Demographic profiles including age, gender, education, occupations, type of family, marital and socioeconomic status and central sensitization were assessed. The association between CS and various demographic parameters was investigated.

Statistical Analysis Used:

Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, version 21.0. For statistical significance, P value of less than 0.05 was considered statistically significant.

Results:

Ninety out of 345 (26%) of study subjects had CS; out of which 96% were females. Younger homemaker and those with unskilled/semiskilled type of job had higher chances of having CS in comparison with those with skilled and professional job (P < .001).

Conclusions:

Elicitation of specific demographic factors that can predict CS in people with knee OA may help in early identification and management of CS in OA knee patients.
Seroprevalence with epidemiological determinants of hepatitis C virus and Treponema pallidum infection in blood donors of a teaching hospital in southwest Punjab, India: A 5-year study
Authors: Bansal Nidhi , Gupta Anshul , Sidhu Tanvir K. , Maharishi Ram Niwas , Gupta Saurabh , Roychoudhury Arnav K.
Published: October 2023

ABSTRACT

Background:

A high seroprevalence of various transfusion-transmitted infections (TTIs) in donated blood is the main safety concern, especially in low- and middle-income countries. As per the World Health Organization (WHO) recommendation, all blood donations must be tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum infection, and malaria, which mainly comprises the major bulk of TTIs.

Aims:

The purpose of this study is to observe the seroprevalence of hepatitis C virus and Treponema pallidum infection over the period of 5 years in blood donors of our blood center along with their epidemiological determinants with respect to age, sex, residence, occupation, and type of donors

Materials and Methods:

Retrospective study was conducted for the period of 5 years, from 1st January 2017 to December 2021, estimating the seroprevalence of hepatitis C and Treponema pallidum infection in the blood donors along with their epidemiological determinants

Results:

Out of 19,689 donations in 5 years, 690 (3.50%) units were positive for transfusion-transmissible infections with 1.67% donors seropositive for HCV, 1.23% for Treponema pallidum infection, 0.42% for HBV, and 0.18% for HIV. The prevalence of TTIs was found to be highest in 2020 (4.52%) and least in 2017 (2.57%). Out of a total of 330 HCV cases detected in 5 years, 84.85% of cases were seen in voluntary donors. Rural donors constituted 71.21% of cases. The majority of cases were seen in the age group of 18–30 years, i.e., 61.82%, and a maximum number of cases were seen in the farmers (31.21%), followed by laborers and construction workers (21.21%). Out of a total of 242 cases of Treponema pallidum infection, 84.29% were seen in voluntary blood donors. Demographic data showed 70.24% of cases in rural donors. Occupational data revealed a maximum number of cases in farmers (34.29%), followed by laborers (21.90%).

Conclusion:

Higher seroprevalence of HCV and Treponema pallidum infection in our region as compared with other areas is a matter of great concern about the growing infection rate of these in our area. Stringent use of donor selection criteria and more vigorous donor screening is utmost need of the hour for reducing the burden of TTIs in blood transfusion services.
Persistent symptoms and functional health status among Covid-19 patients after discharge from a Covid hospital
Authors: Kulkarni Meenal V. , Nayse Vedant J. , Bansod Chetan M.
Published: October 2023

Background:

After recovery from acute Covid infection, many patients are found to be experiencing persistent symptoms.

Objectives:

To find out the proportion of patients with persistent symptoms after discharge from a Covid hospital and to assess post-Covid-19 functional status.

Materials and Methods:

A descriptive cross-sectional study was conducted among patients discharged from a Covid hospital. Records of patients were obtained from the medical records department. Data were collected by using a prevalidated close-ended questionnaire. The questionnaire consisted of information regarding the socio-demographic status, history of persistent symptoms, and functional status of patients. Patients were contacted and interviewed telephonically. History regarding common persistent symptoms and functional status was asked. Statistical analysis was done by using Epi info statistical software.

Results:

Out of 133 patients, persistent symptoms after discharge were reported among 92 (69%) patients. The common symptoms reported by the patients were fatigue (48.12%), weakness (42.10%), dyspnea (27.82%), and myalgia (12%). Loss of taste was reported by 10 (7.5%) and loss of appetite by 8 (6.01%). Seventy-four (55.63%) patients reported functional limitations.

Conclusions:

The proportion of persistent symptoms among Covid-19 patients after discharge was found to be high. More than half of the patients reported functional limitations. Patients should be screened for persistent symptoms and health care services should be provided.
Awareness of risk factors, symptoms and screening of breast cancer: A cross-sectional survey among 35–65-year-old women in Alappuzha district, Kerala, India
Authors: Mohan Reshmy , Thulaseedharan Jissa Vinoda
Published: October 2023

Background:

Breast cancer awareness is vital to enhance early detection and treatment, thus improving women’s quality of life and reducing the breast cancer burden in a country. This paper describes breast cancer awareness among women in the Alappuzha district, Kerala.

Methods:

A community-based cross-sectional survey was conducted among 320 women aged 35–65 using a multi-stage cluster-sampling method. The data were collected using a structured interview schedule and analysed using IBM SPSS Statistics-25. The Chi-square test was used to test associations, and binary logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results:

The most reported risk factor and symptoms were unhealthy food habits (29.6%) and breast lumps (91.7%), respectively. Nearly half of the women spoke about at least one risk factor (53.8%), and 39.8% mentioned at least two symptoms of breast cancer. Awareness of breast self-examination and mammography were 85.7% and 39.5%, respectively. Compared to women with a primary level of education, women with a higher secondary or above level of education were more likely to report at least one risk factor (AOR = 8.96; 95%CI: 3.44-23.36), more than two symptoms (AOR = 4.73; 95%CI: 1.82-12.27) and mammogram as a screening method (AOR = 61.1; 95%CI: 6.56-394.63). Women detected with breast cancer (n = 6) were excluded from the analysis.

Conclusion:

Women are unaware of most of the risk factors and symptoms of breast cancer, and breast cancer awareness are highly associated with women’s education. Breast cancer awareness creation is essential to improve the early detection of breast cancer among women, especially in the low socioeconomic strata.
Impact of school start time and sleep pattern of adolescents on their mood and sleep quality
Authors: Singh Ruchi , Roy Moutrisha M. , Chouhan Sunil , Joshi Ankur , Rai Nirendra K.
Published: October 2023

Objective:

The physiological delay in bedtime among adolescents, compounded with the early start of school, results in insufficient sleep, especially on school days. The present study compared the sleep pattern and moods of students attending two schools with different start timing.

Materials and Methods:

The study involved adolescents from two schools with different start times: School A (7 am) and School B (8 am). Pittsburgh Sleep Quality Index, Depression Anxiety Stress Scales-21, and Pediatric Daytime Sleepiness Scale questionnaires were used to assess students’ mood, sleep duration, sleep quality, and daytime sleepiness. The clinical trial registry number is CTRI/2022/06/043556.

Result:

A total of 640 students (mean age 13.7 ± 2.0 years; 47.5% male) participated in this study. Students from School B had longer sleep duration, with 72.9% reporting sleep deprivation compared to 87.1% of School A (P = 0.00001). School A students reported having (P ≤ 0.001) higher daytime sleepiness, higher daytime dysfunction (P = 0.023), and poorer sleep quality. Students at School A scored higher for all mood derangements, with significantly higher scores for depression (P = 0.041).

Conclusion:

The study illustrates that though not much differences are observed in the bedtime of adolescents of the two schools, however, due to the early school start time of School A, students have to compulsorily wake up early, leading to higher sleep deprivation and greater mood derangements among them.
Taylor Spatial Frame versus Ortho SUV for Correction of Lower Limb Deformities: A Comparative Study
Authors: Dhawan Manish , Sharma Anant , Chauhan Ravi , Vig Varun , Prasad Manish
Published: October 2023

Background:

Deformity of long bones of lower limb leads to frequent gait and joint problems, in addition to the esthetic problems. Correction of such deformities proves to be a challenge due to spatial and soft-tissue considerations. Taylor Spatial Frame (TSF) and Ortho-SUV Frame (SUV) are two six axis correction devices which utilize the Ilizarov methods and allow easier correction of complex deformities. This study was performed to compare the efficacy of TSF and SUV for correction of lower limb long bone deformities.

Materials and Methods:

The Study was held at Sir Ganga Ram Hospital, New Delhi between January 2015 and November 2019. Twenty patients were included for each correction group. Assessment of correction was done in terms of rate and accuracy of deformity correction, lengthening index, total lengthening achieved, time in frame, assessment of ability to perform Activities of Daily Living, functional outcome using Association for the Study and Application of the Method of Ilizarov (ASAMI) score, and complications during treatment.

Results:

Both groups showed excellent correction of deformity in all planes and good functional outcomes. TSF group showed lesser incidence of joint stiffness as well as a shorter time in Frame. Pin site infection was the most common complication followed by major residual deformity.

Conclusion:

Both TSF and SUV provide excellent outcome in correction of complex spatial deformities of lower limb with high accuracy and good functional outcome. The TSF provides an advantage over SUV with reduced time in Frame, lesser joint stiffness and increased patient compatibility due to smaller frame size and reduced bulk as compared to SUV.
Prospective Audit of Requisitions for Transfusion at a Rural Tertiary Care Hospital in Central India as a Step to Improve Transfusion Practices
Authors: Vaidya Vihanka Devchand , Deshmukh Abhay Vilas , Shivkumar Vitaladevuni Balasubramanyam , Meshram Manish Arun
Published: October 2023

Introduction:

A blood requisition form is the sign of final clinical decision for the transfusion. It provides all the clinical details of the patient. The missing and incorrect information in blood request form can be the cause of error and transfusion reactions. This study was aimed to evaluate blood transfusion request form for its correctness and completeness. Based on its findings and results, the clinicians will be asked to take corrective measures.

Methods:

The blood requisition forms were evaluated in the blood centre at central India during the period of October 2019 to June 2021 and were analysed.

Results:

15022 blood requisition forms were received for 19904 units of blood and blood products during the study period. Majority of the requisitions were for single unit. 10.75% forms were without demographic details, 14.58% were without priority, 18.91% were without mentioning of blood group, 32.69% were without mentioning of indication, 24.23% forms were without history of previous transfusion and 23.47% forms were without proper clinical history.

Conclusion:

The requests for whole blood was much more than packed red cells. More than 60% forms were not properly filled and without proper clinical information. The indication for transfusion of blood and blood components were not mentioned in 33% of the forms. The forms in which indications were mentioned, more than 30% had inappropriate indications. Thus, it is important to sensitize the clinicians about the importance of correctness and completeness of blood transfusion request forms to ultimately improve the clinical practices.
Novel versus Traditional Serum Biomarkers in Predicting the Response to Anti-tubercular Therapy in Pulmonary Tuberculosis Patients: A Prospective Study
Authors: Mangal Vishal , Singhal Anuj , Vohra Gaurav , Karade Santosh , Menon A S , Kaur Kaminder Bir
Published: October 2023

Background:

India ranks first in the global share of tuberculosis (TB). Active TB is also associated with elevated levels of B-Cell growth factors like B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL). We aimed to study the circulating levels of ferritin, high-sensitivity C-reactive protein (hsCRP), BAFF, and APRIL in sputum-positive and sputum-negative active pulmonary TB (PTB) patients.

Materials and Methods:

We enrolled 90 sputum positive and 90 sputum-negative newly diagnosed PTB patients. All the patients underwent estimation of serum ferritin, hsCRP, BAFF, and APRIL before initiation of f Anti-Tubercular therapy (ATT), after 1 month of ATT, and after 2 months of ATT. We compared the change in the cytokines mentioned above in PTB subjects at baseline, after 01 and 02 months of the intensive phase of standard anti-tubercular therapy.

Results:

There was a significant difference between the serum BAFF levels at all times between the sputum-positive and sputum-negative groups (P < 0.001). There was a considerable increase in the APRIL level 2 months after initiation of ATT in both the groups (sputum positive group P = 0.004) (sputum negative group P < 0.001). There was a significant decrease in serum ferritin level and hsCRP after 2 months of ATT compared to baseline (P < 0.001) in both sputum positive and negative groups.

Conclusion:

Serum ferritin, hsCRP, and APRIL levels can be used to assess the treatment response in both sputum-positive and sputum-negative cases. Serum BAFF levels >587 pg/ml at baseline implies high probability of sputum smear positivity in a patient with PTB.
Assessment of Peripheral Vestibular Apparatus in Patients with Peripheral Vestibular Symptoms using Videonystagmography in Tertiary Care Center
Authors: Reddy Lakku V. Manohar , Naga Rahul , Gupta D K , Mathews Sunil
Published: October 2023

Introduction:

Vertigo, dizziness, giddiness, and unsteadiness are all quite frequent symptoms that affect a large proportion of the population. Due to the challenges associated with effectively diagnosing and documenting vestibular illnesses, figures on their prevalence, frequency of occurrence, and social impact vary greatly. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo of vestibular origin. Positional nystagmus is most frequently seen in benign paroxysmal positional vertigo (BPPV) associated with peripheral vestibular diseases. Videonystagmography (VNG) tests are an excellent diagnostic tool for distinguishing peripheral from central vestibular abnormalities, provided they are conducted and interpreted by doctors rather than technicians. The current study utilized VNG to evaluate vestibular apparatus function in patients with peripheral vestibular symptoms (dizziness/imbalance/giddiness/vertigo).

Methods:

Prospective observational study comparing efficacy of assessment of vestibular apparatus using clinical vestibular assessment versus VNG in patients having vestibular symptoms.

Results:

With clinical vestibular assessment test, 13 out of 50 symptomatic patients had no nystagmus. When VNG was performed on these patients, 10 out of these 13 patients had shown positive findings, whereas only three patients had negative findings. Our study finds that VNG along with clinical evaluation is more effective in diagnosing vestibular disorders when compared with clinical evaluation alone and this was statistically significant.

Conclusion:

Based on our results, VNG is the better modality for the assessment of vestibular apparatus in patients with peripheral vestibular symptoms for diagnosis and treatment.
Quiz in PG Teaching: Are we Adapted to New Methods in Learning?
Authors: Shukla Rajat , Singhal Anuj , Shaw Subash Chandra , Manthene Mahesh , Sahoo Shrimukta , Singhal Aditya
Published: October 2023

Introduction:

Traditional methods of teaching residents in medicine are lectures, symposiums, case presentations and CMEs. Students have different levels of attitude about learning and responses to specific environments. A sound understanding of the changing trends in medical education is crucial to the accurate implementation of adequate training protocols which helps in good perception of subject by students. Novel ideas and concepts must pave way for modern methodologies of teaching.

Methodology:

We administered the peer validated questionnaire to 30 Junior residents(JRs) who participated in the quiz on Diabetes. JRs were informed about quiz 10 days prior and adequate material was shared with them.

Results:

More than half of the students (56.7%) responded that the quiz was better enjoyed than discussing the similar topic in class room teaching, maximum students (86.7%) responded that the quiz should be inculcated in postgraduate curriculum.

Conclusion:

This kind of novel methods helps the students to have good understanding and perception of the subject rather than routine teaching methods and helps to make an impact.
Minimally invasive surgery for gastro-oesophageal junction adenocarcinoma: Current evidence and future perspectives
Authors: Bîrlă Rodica , Hoara Petre , Achim Florin , Dinca Valeriu , Ciuc Diana , Constantinoiu Silviu , Constantin Adrian
Published: October 2023

Minimally invasive surgery is increasingly indicated in the management of malignant disease. Although oesophagectomy is a difficult operation, with a long learning curve, there is actually a shift towards the laparoscopic/thoracoscopic/ robotic approach, due to the advantages of visualization, surgeon comfort (robotic surgery) and the possibility of the whole team to see the operation as well as and the operating surgeon. Although currently there are still many controversial topics, about the surgical treatment of patients with gastro-oesophageal junction (GOJ) adenocarcinoma, such as the type of open or minimally invasive surgical approach, the type of oesophago-gastric resection, the type of lymph node dissection and others, the minimally invasive approach has proven to be a way to reduce postoperative complications of resection, especially by decreasing pulmonary complications. The implementation of new technologies allowed the widening of the range of indications for this type of surgical approach. The short-term and long-term results, as well as the benefits for the patient - reduced surgical trauma, quick and easy recovery - offer this type of surgical treatment the premises for future development. This article reviews the updates and perspectives on the minimally invasive approach for GOJ adenocarcinoma.
Role of inositol polyphosphate-4-phosphatase type II in oncogenesis of digestive system tumors
Authors: Han Le , Chen Shuo , Du Shi-Yu
Published: October 2023

Minimally invasive surgery is increasingly indicated in the management of malignant disease. Although oesophagectomy is a difficult operation, with a long learning curve, there is actually a shift towards the laparoscopic/thoracoscopic/ robotic approach, due to the advantages of visualization, surgeon comfort (robotic surgery) and the possibility of the whole team to see the operation as well as and the operating surgeon. Although currently there are still many controversial topics, about the surgical treatment of patients with gastro-oesophageal junction (GOJ) adenocarcinoma, such as the type of open or minimally invasive surgical approach, the type of oesophago-gastric resection, the type of lymph node dissection and others, the minimally invasive approach has proven to be a way to reduce postoperative complications of resection, especially by decreasing pulmonary complications. The implementation of new technologies allowed the widening of the range of indications for this type of surgical approach. The short-term and long-term results, as well as the benefits for the patient - reduced surgical trauma, quick and easy recovery - offer this type of surgical treatment the premises for future development. This article reviews the updates and perspectives on the minimally invasive approach for GOJ adenocarcinoma.
Factors Contributing to the Pre-Elimination of Malaria from Hainan Island, China, 1986–2009
Authors: Sun Dingwei , Jiang Hongwei , Wang Guangze , Hu Ximin , Wang Shanqing , Chen Yan
Published: October 2023

Malaria was endemic in Hainan Island, China, for a lengthy period before its elimination. Here, we aim to gain a better understanding of malaria elimination by assessing and quantifying the relative effects of longitudinal changes in specific antimalarial interventions, socioeconomic development approaches, and malaria vectors on malaria prevalence in Hainan during the 1986–2009 pre-elimination period. Annual data were collected on the incidence of malaria, the number of residents protected by drugs (RPD), the number of residents protected by vector control, the presence of Anopheles minimus and Anopheles dirus, the annual per capita income of rural residents, major cash crop (rubber plantation) areas, the literacy rate of adult rural residents, and the rate of reinforced concrete house construction in rural areas. Backward stepwise multiple linear regression models were developed to identify the factors associated with the annual malaria incidence (AMI). The AMI declined from 20.3 to 0.8 per 10,000 population from 1986 to 2009; this decrease was significantly associated with an increase in the number of RPD and improved literacy rate among rural adults. The results of this study implied that the sustained distribution of antimalarial drugs and increase in education levels in risk areas significantly impacted the reduction and elimination of malaria infection in Hainan. We suggest that these findings could be applicable to malaria-endemic areas in Southeast Asia with similar natural and socioeconomic environments to Hainan and where malaria incidence has decreased to a low level.
EVALUATING THE PERCEPTION OF MARKETING COMMUNICATION IN POLITICAL MARKETING FROM A GENERATIONAL PERSPECTIVE
Authors: AKBIYIK Ferdi , ÇAĞLAR Nedret
Published: October 2023

The objective of this study is to examine whether there are disparities in the perception of marketing communication in political marketing among female voters based on different generations. This research distinguishes itself from previous studies in the field by focusing on assessing the perceptions of female voters according to their generational cohorts. To achieve this aim, a research model was proposed using a scale derived from existing literature, aligning it with the study's objective. The collected data was analyzed using the SPSS 22 statistical package, employing descriptive statistics to ascertain the socio-demographic characteristics of the participants. Various statistical analyses, including reliability testing, the KMO test, factor analysis, correlation analysis, ONEWAY ANOVA, and post hoc tests, were conducted on the dataset. The results of the factor analysis revealed the presence of three distinct factors, consisting of different sets of items, labeled as “Marketing Communication,” “Advertisement,” and “Political Product.” Based on the conducted analyses, it was concluded that the Baby Boomer generation may exhibit a higher sensitivity compared to other generations towards various advertising channels such as print and digital media, political leaders, and party rallies.
Did Leo Tolstoy Become Don Quixote? Half a Century of Dispute Between Two Geniuses
Authors: Obolenskaya Yu. L.
Published: October 2023

This article for the first time examines Leo Tolstoy’s interpretation of two «Don Quixotes»: the greatest creation of M. de Cervantes Saavedra and the famous article by Ivan Turgenev «Hamlet and Don Quixote». On the basis of L. Tolstoy’s diaries and letters, the memoirs of his contemporaries, the article analizes the motives of Tolstoy’s contradictory assessments of Cervantes’ work and his immortal creation. These assessments offer a deeper understanding of both the character of L. Tolstoy and his aesthetic, ideological and moral priorities in different periods of his life. A detailed analysis of the writer’s dialogue-polemic with these two authors and with the texts themselves fits into the broad context of Russia’s spiritual life in the second half of the 19th century. L. Tolstoy had an important episode in his youth that became crucial for his work: the spiritual mentoring of another genius of Russian literature, Ivan Turgenev, during the meeting of two writers in 1857, the so-called «Dijon solitude», when Turgenev, proving the high social significance of the ideals of quixotism for the new era, attempted to turn a young Hamlet-type writer (L. Tolstoy) into a selfless Don Quixote type. The title of the novel «Don Quixote», as well the names of Cervantes and his characters are mentioned in Tolstoy’s diaries, articles and letters about 20 times. The novel seems to «test» him until the end of his life: the high assessments of his contemporaries, their perception of Don Quixote as a new Messiah capable of saving humanity, contradict Tolstoy’s understanding of serving good, therefore working on the most important treatise for him, which is the manifesto «What is art?», Tolstoy changes the estimates of «Don Quixote» several times. Firstly, he mentions among his favorite poets, composers and painters the only novel — «Don Quixote», then he indicates its «poor contents». In 1905, Tolstoy finally became convinced of the importance of the idea of self-sacrifice for the sake of high ideals and of the educational significance of the novel, and besides, he admitted that all his sons were «Don Quixotes». More than half a century of Tolstoy’s dialogue with Cervantes and his heroes invariably continued in his mind, and the knight errant will be most vividly reflected in one of the most autobiographical and close to Tolstoy characters — Levin from «Anna Karenina». The circumstances of Leo Tolstoy’s farewell to the Yasnaya Polyana estate and the last journey of the knight of the sad image, as well as the circumstances of their demise, tragically echo.
Spanish-American Relations in the 1890s in the Context of the Monroe Doctrine
Authors: Volosyuk O. V.
Published: October 2023

The Monroe Doctrine, proclaimed in 1823, was successfully used by the United States throughout the 19th century to protect US territorial and political interests in the Western Hemisphere. One of the most obvious examples of its application in international relations was the Spanish-American War of 1898. The Russian ambassador in Madrid, Dmitry Shevich, was an unbiased witness of the application of the Monroe Doctrine by the Americans to Spain and Cuba in the 1890s. Based on his reports, we analyze the stages of the escalation of the conflict, examine the evolution of the aggressive US policy towards Madrid under the pretext of protecting the interests of Spain from Cuban «insurgents», we address the role and participation of Russia in the conflict. The Monroe Doctrine was applied where and when the position of the US government was absolutely strong. Whereas in the 1870s the situation in Cuba, and even in the United States itself, was not very appropriate, it is in the 1890 that the position of the United States in the international arena, the stabilization of the situation in the country as a result of the Reconstruction era and the chaos in the domestic political situation in Spain served as key factors for Washington’s confidence in the success of its enterprise. The United States used various methods of pressure on Spain in order to squeeze it out of Cuba and get the island into its undivided possession. At the same time, whereas in 1896–1897 the relations were dominated by diplomatic rhetoric about the need to «pacify» the situation in Cuba and the willingness to act as an intermediary between the metropole and the insurgents, the relations with Spain turned into threats and ultimatums after the explosion of the battleship Maine. Washington openly voiced its right to decide the fate of the states and nations of the Western Hemisphere.