bluuebunny/crossref_metadata_2025 huggingface dataset:
The Tibetan Renaissance and Tantric Buddhism
Authors: You Yalong
Published: June 2024

The renaissance of Tibetan Buddhism in the Middle Ages was a period of characterized by the unprecedented and fervent changes in religion and politics. This process is characterized by complexities of various kinds: first, the anachronisms and biases of the surviving primary sources: second, the multiplicity of Buddhist scriptures and practices that made their way to Tibet from surrounding regions, and, even more importantly, the subsequent innovations within Tibet, all of which contributed to an often fractious religious landscape; third, the extended political fragmentation, which presented challenges for Buddhist monks and teachers who needed to seek patronage through diplomatic means, as well as the opportunities for political powers to try to transcend their limited power by recruiting support from Buddhist communities.
Accelerating Aquaponics Adoption in Asia: Essential Technical and Policy Considerations
Authors: Joo James H. , Moses Andrew , Choo Sanghee , Lim Jinsook
Published: June 2024

The excessive exploitation of natural resources and the rapid industrialization of societies have led to severe ecosystem destruction and exacerbated climate change. Today, the global ecosystem faces significant threats. Consequently, consumer demand for safe and healthy food is steadily increasing while preserving the environment remains a priority. In response, agricultural science has evolved to develop a novel agricultural technology called “aquaponics”, which combines aquaculture and hydroponics, surpassing conventional hydroponic systems. However, the adoption of aquaponics remains relatively low compared to traditional farming methods. This study investigates the critical technical aspects that need to be developed in the aquaponics sector and proposes strategies to promote its wider adoption. By identifying key areas for improvement and addressing technical challenges, this research seeks to accelerate the deployment of aquaponics as a sustainable and efficient farming practice.
Türk fındığı (Corylus colurna)’nın doğal yayılışında yeni alanlar: Dağakça ve Çakallar (Bursa)
Authors: Kalkan Mehmet , Yılmaz Mustafa
Published: June 2024

Türk fındığının (Corylus colurna L.), Türkiye'de Karadeniz, Marmara, Ege ve İç Anadolu bölgelerinde çok sayıda birbirinden kopuk ve birçoğu tehlike altında olan popülasyonları bulunmaktadır. Türk fındığının Bursa ilinde Dağakça-Osmangazi ve Çakallar-Mustafakemalpaşa yörelerinde bulunduğu yeni doğal yayılış alanları ilk kez tespit edilmiştir. Osmangazi ilçesine bağlı Dağakça köyünün batı ve kuzey batı kısımlarında Türk fındığı yayılış yapmaktadır. Alacakaya tepesi, Çalpınar mevki, Kocakır tepesi, Topraklı tepelerinde meşcere kurduğu ve 800-1000 metre yükselti aralığında bulunan 590 hektarlık bir alanda doğal yayılış yaptığı belirlenmiştir. Mustafakemalpaşa ilçesine bağlı Çakallar köyünün kuzeyinde bulunan Kale ve Düdar tepelerinin yamaçlarında (650-900 m) ve güneyinde yer alan Küçükçal ve Sakarınbaşı tepelerinin yamaçlarında (800-975 m) münferit ve küme halinde Türk fındığı doğal yayılış göstermektedir. Türk fındığı, genellikle IUCN Kırmızı Listesi'nde "Düşük Risk" kategorisinde yer alsa da sınırlı yayılış alanları ve habitat kaybı nedeniyle bazı bölgelerdeki popülasyonları tehlike altındadır. Türk fındığının doğal yayılış yaptığı Bursa’daki popülasyonlarının gen kaynağı bakımından korunması ve çoğaltılması büyük öneme sahiptir. Bu yeni yayılış alanlarının koruma altına alınması ve sürdürülebilir orman yönetimi uygulamalarıyla desteklenmesi gerekmektedir.
Uses and Gratification Social Media X @Statsrawon to Fulfilment Information Needs of Followers
Authors: Nurfadila Amelia Putri
Published: June 2024

This study explores the effect of the @Statsrawon social media X account on follower satisfaction by meeting their information demands against the backdrop of an increasing dependency on social media for information consumption. The research, which is based on the Uses and Gratifications theory, attempts to investigate how particular content dimensions—reliability, assurance, empathy, and responsiveness—affect followers' satisfaction levels. A structured questionnaire was used to collect data from a purposive sample of 100 followers using a quantitative research methodology in order to examine the relationship between content features and satisfaction results. The results highlight a strong positive relationship between @Statsrawon content and meeting followers' information needs, highlighting the critical function that personalized matter plays in raising satisfaction levels. The study emphasizes the significance of producing pertinent and interesting content to favorably impact follower satisfaction and recommends for the enlargement of sample size and the addition of qualitative methodologies to enhance insights into follower engagement with social media content.
Strategi Komunikasi Pemasaran Umbati Coffee Di Media Sosial Instagram Dalam Menjaga Loyalitas Konsumen
Authors: Darmawati Chalik  , Harry Fajar Mulana  , Wa Nur Fida
Published: June 2024

Umbati Coffee merupakan coffee shop yang telah menerapkan strategi pemasaran melalui media sosial seperti tiktok dan Instagram. Tiktok dengan jumlah followers 209 pengikut dan Instagram 1437 pengikut. Umbati coffee menggunakan kedua platfrom media sosial tersebut untuk meningkatkan daya tarik konsumen salah satunya dengan cara menyajikan beberapa konten seperti pengenalan produk baru, suasana umbati coffee dan live music. Tujuan penelitian ini adalah untuk mengetahui strategi komunikasi pemasaran dalam menjaga loyalitas konsumen umbati coffee. Penelitian ini dilakukan selama 2 (dua) bulan dimulai sejak bulan Januari hingga Februari 2024. Lokasi penelitian ini berada di Coffee Umbati Jl. Dr. Wahidin, Kota Baubau, Sulawesi Tenggara. Metode yang dIntagramunakan dalam penelitian ini yaitu kualitatif dengan pendekatan dIntagramital marketer model. Hasil penelitian ini adalah strategi komunikasi pemasaran yang dilakukan Umbati Coffee dimedia sosial instagram dalam menjaga loyalitas konsumen adalah salah satunya dengan menggunakan instagram Ads, dengan cara membuat konten-konten yang sedang viral atau for you page (FYP) yang kemudian di dibantu promosikan oleh kurir atau partnership, dengan begitu strategi ini bisa dikatakan cukup berhasil menarik perhatian konsumen.
Jejak Langkah Selebriti Arek dalam Yowis Ben: Cermin Budaya di Sinema Indonesia
Authors: Nimas Safira Widhiasti Wibowo
Published: June 2024

Penelitian ini berbicara mengenai representasi selebriti yang ditampilkan dalam Tetralogi Yowis Ben (2018, 2019, 2021) sebagai bagian dari budaya populer baru dalam dunia perfilman Indonesia. Fokus penelitian ini berusaha untuk menguraikan budaya selebriti yang digambarkan dalam kehidupan tokoh dalam konteks kultur Jawa Arek, sehingga meskipun telah terpengaruh modernisasi, namun kaitannya tetap erat dengan konsep kearifan lokal. Budaya selebriti dalam film ini menawarkan mimpi status (ketenaran), penampilan menawan, kekayaan, dan kekuasaan yang tidak bisa sembarang ditiru orang kebanyakan. Berdasarkan hasil pembacaan pada keempat film Yowis Ben menunjukkan bahwa tetralogi ini menawarkan contextual identity of celebrity, yakni penggambaran budaya selebriti berkonteks budaya Jawa Arek, tepatnya di Kota Malang, Indonesia. Konteks budaya Jawa Arek ini dilihat dari penggunaan bahasa hingga karakter tokoh dalam rangka celebrity production process. Penggambaran celebrity dan segala kehidupannya ini dapat diamati melalui narasi pembedahan mengenai alasan (reason why you want to be a celebrity), strategi (strategy become celebrity), menjaga citra baik selebriti (how to maintain celebrity image), hingga segala problematika yang dihadapi selebriti (celebrity dilema) dalam tetralogi Yowis Ben (2018, 2019, 2021).
Analisis Isi Konten Komersialisasi Kidfluencers pada Akun TikTok @abe_daily
Authors: Dyah Lestari Nastiti , Ayu Indahsari Dewi , Aji Ramadhan Ilham , Rica Khasanah Aliya , Zhurifa Alya , Gita Sukmono Filosa Gita Sukmono
Published: June 2024

Aplikasi TikTok merupakan aplikasi jejaring sosial dimana pengguna dapat berbagi video pendek lengkap dengan filter dan disertai musik sebagai pendukung. Aplikasi TikTok mulanya digunakan sebagai hiburan, kini berbagai macam ide konten dapat ditemukan hingga dapat menjual produk. Salah satunya adalah konten komersial yang melibatkan anak-anak hingga melahirkan kidfluencers. Penelitian ini bertujuan untuk mengetahui bagaimana proses komersialisasi kidfluencers. Metode penelitian yang digunakan dalam penelitian ini adalah analisis isi kualitatif dari Krippendorff. Analisis isi konten @abe_daily mencangkup lima video iklan produk pada periode bulan Februari 2024. Temuan penelitian ini yaitu proses komersialisasi pada konten @abe_daily yang terdiri dari Pre-Commercialization, Commercialization, dan Post-Commercialization. Pada semua tahapan tersebut terdapat peran orang tua khususnya Ayah dari Abe yang dominan dalam mengkomersialisasikan anaknya sebagai kidfluencers, dimana sejak awal tahapan proses pre-commercialization Ayah Abe berperan sebagai pengendali untuk mengajak Abe untuk promosi produk, lalu dilanjutkan saat proses commercialization peran Ayah Abe membuat Abe seolah-olah cocok dengan produk, dan tahap post-commercialization Ayah Abe mengajak audiens untuk membeli produk.
Pengaruh Motif Penggunaan Media Terhadap Kepuasan Pengguna (Survei Pada Pengakses Akun Instagram @ussfeed)
Authors: Aji Adam Kusumo , Prihatin Dwihantoro
Published: June 2024

Motif penggunaan media sosial dan kepuasaan pengguna media sosial merupakan satu hal yang berkaitan. Penelitian ini, bertujuan untuk membahas tentang pengaruh motif penggunaan media sosial instagram @ussfeed terhadap kepuasan pengakses akun. Teori yang digunakan dalam penelitian ini adalah teori Uses and Gratifications. Penulis menggunakan metode kuantitatif dengan menggunakan teknik purposive sampling. Pengumpulan data melalui kuisioner kepada pengguna instagram yang pernah mengakses atau mencari konten pada akun instagram @ussfeed. Rumus ‘Lemeshow’ digunakan untuk menentukan ukuran sample dengan margin of error sebesar 10% dari 100 responden. Hasil dari penelitian menunjukan bahwa penggunaan media berpengaruh secara signifikan terhadap kepuasan pengguna akun instagram @ussfeed. Hasil ini menegaskan bahwa pengguna Instagram @ussfeed cenderung mencari dan menggunakan akun @ussfeed untuk mendapatkan informasi yang relevan, baik tentang peristiwa dan kondisi lingkungan sekitar, maupun informasi yang berkaitan dengan keadaan dunia. Dominasi motif informasi dalam mempengaruhi kepuasan pengguna menunjukkan bahwa konten yang disajikan oleh @ussfeed telah memenuhi kepuasan pengakses akun tersebut.
Comparative Analysis of Gulen Movement and Muhammadiyah: Their Internationalization Strategies and Integration with Governmental Systems
Authors: Muttaqien Audi Izzat , Surwandono Surwandono
Published: June 2024

This study examined how the Gulen movement and Muhammadiyah spread their influence to achieve their global vision and relations with the government. Both the Gulen movement and Muhammadiyah are Islamic-based non-governmental organizations and some of the largest in their respective countries and the world. This study employed a descriptive qualitative method to analyze the data and a literature study to collect the data. The analysis revealed that, first, by using the new transnational activism approach, the international role of the Gulen movement and Muhammadiyah brought benefits to both governments of origin. Muhammadiyah had a significant role in providing an excellent image for the Indonesian government. Meanwhile, despite the dispute and the Gulen movement’s independence, the public has viewed the movement as identical to a representative of the Turkish government with its international role and media use. Second, the approach of transnational Muslim NGOs has explained that both the Gulen movement and Muhammadiyah were oriented toward helping fellow Muslims with a focus on Muslim groups and countries. The Gulen movement built many educational institutions in Muslim-majority countries, such as Azerbaijan and Senegal. In contrast, Muhammadiyah accommodated and provided full scholarships for students from Muslim-majority areas, such as Southern Thailand and Mindanao, Phillippines. Muhammadiyah also helped mobilize humanitarian aid for Rohingya Muslims.
Boosting Indonesia’s Economy Through Hajj and Umrah: Opportunities and Diplomatic Avenues
Authors: Saripudin Mohamad Hery , Juned Mansur
Published: June 2024

In the last 50 years, the number of Hajj pilgrims has surged from 200,000 to 3 million. The organization of Hajj and Umrah not only impacts the economy but also serves as a diplomatic tool for both the host country, Saudi Arabia, and the countries of origin of the pilgrims, such as Indonesia. While the economic impact on Saudi Arabia as the destination country has been extensively studied, the effects on the pilgrims’ countries of origin, particularly Indonesia, are less well-documented. Therefore, this paper seeks to explore how Hajj and Umrah, as forms of religious tourism, can generate economic benefits for Indonesia within the Saudi Arabian context. Utilizing a qualitative method, including literature review and observation, this paper explores and elaborates on how Hajj and Umrah can present economic opportunities for Indonesia. The findings suggest that these religious events could benefit Indonesia through various channels: services related to preparation and departure, transportation, export opportunities for Micro, Small, and Medium Enterprises (MSMEs), and as a means of economic diplomacy with Saudi Arabia and other pilgrim-originating countries. There is significant potential to develop these economic opportunities further to enhance Indonesia’s economic diplomacy and directly benefit its people.
The Multi-Level Governance Dilemma in Mandalika Special Economic Zone: A Bargaining and Cooperation Approach
Authors: Affandi Roseno Aji , Putri Salsa Nabila , Mursitama Tirta Nugraha , Yani Yanyan Mochamad , Bainus Arry
Published: June 2024

This study’s background is based on the social and political tension in developing the SEZ in Indonesia. The research concluded that the main problems in SEZ development stemmed from three main factors: (1) lack of comprehension of multi-level governance, both from the central and local governments; (2) too-centralized government imposing top-down regulation; (3) lack of skills from the local government and local community to negotiate and collaborate with the multi-stakeholders. This study disclosed that Mandalika SEZ has encountered the same problem, specifically the lack of the role of local government and local communities in participating in Mandalaika SEZ sports tourism development. This study is crucial in terms of its contribution to theory and fieldwork investigation. This study investigated the political economy impacts of Mandalika SEZ by employing the integration of Multi-Level Governance (MLG) and Bargaining and Cooperation (BNC) theories. The integration of these theories is novel and differentiates them from previous research. This study employed a qualitative research approach, utilizing stakeholder interviews as the primary data source, complemented by secondary data obtained from prior research.
Surgical versus non-surgical intervention in endometriosis with infertility: a patient preference trial
Authors: Ishrat Shakeela , Rupa Shamima Bashar , Hossain Marufa , Anwary Shaheen Ara , Deeba Farzana , Banu Jesmine
Published: June 2024

Background: Hormonal suppression decrease pain and reduce endometrioma size in women with endometriosis. There are medications like cabergoline which reduce inflammation associated with endometriosis but do not prevent ovulation. Hormonal suppression followed by cabergoline may allow pregnancy in women with endometriosis. The objective of the study was to assess and compare the efficacy of medical versus surgical management in infertile women with endometriosis.
Methods: A patient preference clinical trial was carried out on 20 women who wish pregnancy and has sonographic evidence of endometrioma and pain. They were counseled adequately about the advantages and disadvantages of surgical and medical management of endometriosis with infertility and were asked to make a choice. The interventions were applied according to patient preference. The interventions were i) dienogest for 3 months when cyst size ≤5 cm and letrozole plus norethisterone for 6 months when cyst size > 5 cm followed by cabergoline 0.5 mg twice weekly for 6 months, plus timed intercourse and ii) laparoscopic surgery followed by expectant management or ovarian stimulation with or without intrauterine insemination. The women were followed up for results.
Results: A total of 18 participants opted for medical management and only 2 participants for surgery. All participants given medical management had reduction of pain, and all except one had reduction of cyst size. Pregnancy occurred in 2 out of 14 (14.3%) participants given medication. One woman with surgery had persistence of pain and recurrence of cyst. No one having surgery got pregnant during the study period.
Conclusions: The infertile women with endometriosis prefer medical management over surgery. The medical management may be a better option for infertile women with endometriosis who do not plan in vitro fertilization in near future.
Unsafe abortion: journey from unmet needs to denial for contraception
Authors: Singh Reeta , Shukla Pankhuri , Aditya Vani , Sarkar Ruma
Published: June 2024

Background: Easy over the counter availability of abortion pills leads to unsupervised rampant use of the pills which further results in physical and mental health complications and social and financial burdens for women, communities and health systems.  Aims and objectives were to study the sociodemographic, obstetric and clinical profile of the women presenting with unsupervised intake of abortifacient, and to study the acceptance of post abortal contraception and also the method of contraception accepted.
Methods: This present study was carried out in women with history of unsupervised self-intake of abortifacient and presenting with complain of bleeding per vaginum and various other complications in the emergency or outpatient department of obstetrics and gynaecology between October 2022 to September 2023 at Nehru Hospital, BRD Medical college, Gorakhpur. Complete personal, sociodemographic and obstetric history was obtained. Complete general and systemic examination was done and all routine investigations were sent.
Results: A total of 197 women were enrolled in this study. In our study majority 39.48% (n=77) of women were between 25-30 years age. 56.34% (n=111) belonged to low socioeconomic strata and 69.54% (n=137) resided in urban area. 42.63% (n=84) were gravida 3 or more. 22.8% cases took abortifacient pills beyond 9 weeks of gestation. All patients procured the contraceptive from local practitioner, quacks, medical stores and chemists without any consultation from gynecologist. Most frequent complain was Chronic bleeding per vaginum with RPOC (n=112, 56.85%). Majority patients had moderate to severe anemia and 53.8% (n=106) required blood transfusion. 2.03% (n=4) presented with features of sepsis and 2.03% (n=4) presented with ruptured ectopic. Majority (n=160, 81.21%) didn’t opt for post abortion contraception.
Conclusions: One major contributor to unsafe abortions is the easy availability of abortion pills. These pills should be restricted from over-the-counter sales and made available to the public only through authorized MTP centres with a proper prescription.
Histopathological features of ovarian mass among patients attending a tertiary care hospital in South India
Authors: Logeswari B. M. , Banupriya P. , Amirtha C. , Veena R. , Kasiraj Radhika
Published: June 2024

Background: First of all, globally, ovarian tumors are becoming a more common source of morbidity and death. The goal of the current investigation was to ascertain the incidence of different ovarian tumor histological and morphological variants in a tertiary healthcare center in southern India.
Methods: The study, which took place in a tertiary healthcare facility in Chennai, involved 89 ovary specimens that were obtained over the course of 18 months (from August 2021 to December 2022) from patients in the obstetrics and gynecology department. The specimens underwent both histological and critical gross examination. Standard H&E-stained paraffin slices were observed. After being organized on proforma, the histology results were examined.
Results: A total of 89 patients, ranging in age from 16 to 90, were enrolled in the study. The majority of patients (30.3%) were in the age range of 31 to 40 years. The majority of ovarian tumors were benign, accounting for 58 (65.2%) of the total, while malignant tumors accounted for 25 (28.1%). The most prevalent type of tumors, according to the World Health Organization (WHO) classification, were surface epithelial tumors (76.12%), followed by germ cell tumors (18.46%). In the current investigation, one case of metastatic tumors to the ovaries was also identified. Serous cystadenoma 29 (32.6%) was found to be the most prevalent subtype among the many known subtypes of ovarian tumors, followed by papillary serous carcinoma 14 (15.7%).
Conclusions: Compared to malignant or borderline tumors, benign ovarian tumors are more common. Surface epithelial tumors are the most prevalent histological subtype of ovarian cancers, followed by germ cell tumors. It's critical to distinguish between benign and malignant tumors in order to ensure appropriate treatment and healing. Future research of this kind with a larger sample size is advised.
Novel technique for repairing episiotomy incisions to achieve optimal vaginal and perineal anatomy
Authors: Shobhane Hema J. , Sharma Diksha
Published: June 2024

Background: Episiotomy is one of the most commonly practiced obstetric procedures done to enlarge the diameter of the vulval outlet to facilitate the passage for the fetal head and prevent an uncontrolled tear of the perineal tissues in the second stage of labor. The study compared the effectiveness of the new technique with the standard technique in promoting proper tissue healing, reducing discomfort and minimizing the risk of complications.
Methods: The prospective comparative study was conducted for duration of 15 years. Women who were primigravida, with singleton pregnancy, at term gestation, with vertex presentation were included in the study and women with multigravida, multiple pregnancy, preterms were excluded from the study. Episiotomies were performed either novel technique or traditional technique by random allocation and results were compared.
Results: At 6 weeks and 1 year, 80% and 95% patients had no pain who had episiotomy repaired by novel technique. At one year follow up 1% patients had vaginal discharge who had episiotomy repaired by novel technique while 6% who had episiotomy repaired by traditional technique. 78% patients were psychologically satisfied with episiotomy repaired by novel technique.
Conclusions: Novel technique of episiotomy suturing is recommended for less postoperative complications, cosmetic pleasing aesthetic outcome and psychological satisfaction.
A study to estimate the knowledge and practice regarding safe sex among teenage girls attending a rural hospital
Authors: Haldar Sanjana , Akhtar Selim , Chowdhury Srijoni , Chatterjee Shiv S. , Dan Utpal
Published: June 2024

Background: This work was planned to assess knowledge about sexually transmitted diseases (STDs), contraceptive methods available and the practice of use of contraceptives and personal hygiene among teenage girls attending the outpatient department (OPD) of a rural medical college.
Methods: Consenting, non-pregnant teenage girls (14-19 years) attending the gynaecology and obstetrics OPD with minor ailments were asked to respond to a questionnaire and blinded data collection was done by two lady counsellors. Statistical analysis was performed.
Results: Knowledge of STI, unwanted pregnancy and family planning was significantly higher in teenage girls with sexual exposure, and in those who had completed standard 12 education (p<0.001). 
Conclusions: Our work suggests that in this particular rural setting knowledge level of STD, HIV and unwanted pregnancy is high but practice of safe sex and contraceptives are low. We suggest implementation of age-appropriate gender based, culturally sensitive sex education curriculum in schools to cope up the increasing vulnerability of young girls. Additionally, community participation, health care institutions and media can raise awareness in teenage girls and their families and remove the taboo regarding family planning practices.
Evaluating the efficacy of Dfrag tablets on human sperm DNA fragmentation - insights from a prospective clinical study
Authors: Raj Mala , J. Roobini , Kasturiraj Aarathy
Published: June 2024

Background: Infertility affects approximately 8-10% of couples worldwide. Sperm deoxyribonucleic acid (DNA) fragmentation index (DFI) has emerged as a significant factor in infertility research, highlighting its importance in understanding reproductive health.
Methods: This prospective clinical study aimed to assess the impact of Dfrag® tablets, a unique nutraceutical combination containing vitamin D3 (600 IU), selenomethionine (40 mcg), coenzyme Q10 (100 mg), and astaxanthin (8 mg), on high sperm DFI over a 3-month period. The study utilized the sperm chromatin dispersion test (SCD) to measure DFI and examined semen parameters before and after the intervention.
Results: Dfrag® tablets were found to significantly improve semen volume, total sperm count, sperm concentration, and progressive motility within the 3-month treatment period. The study reported an average reduction of 36% in DNA fragmentation levels post-treatment with Dfrag® tablets. However, no significant changes were observed in total motility or sperm morphology.
Conclusions: This study demonstrates the potential of Dfrag® tablets in reducing sperm DNA fragmentation and improving key semen parameters associated with fertility.
Silent ovarian ectopic pregnancy: a case report
Authors: Rafiq Sophia , Shakeel Shazia , Tanveer Neha , Pervaiz Zainab , Khan Taleah
Published: June 2024

In clinical practice, an ovarian pregnancy is considered one of the most challenging diagnoses faced by an obstetrician/gynecologist. In this article, we report a 31-year-old Asian-Pakistani female, who presented to the ObsGynae clinic with 8 weeks of amenorrhea, a positive urine pregnancy test, and very high serum β-hCG levels. Transvaginal ultrasonography ruled out a tubal pregnancy, and the patient was sent for repeat β-hCG levels. The patient was hemodynamically stable and displayed no characteristic signs and symptoms of an ectopic pregnancy. Upon repeat scans and β-hCG levels, a diagnosis of ovarian ectopic pregnancy was made. The patient was managed on medication; a single dose of I/M 50 mg/m2 methotrexate was administered and the resultant decline in β-hCG levels proved the success of conservative treatment in this case. An ovarian ectopic can present as a life-threatening condition, and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy, without any alarming signs despite very high β-hCG levels, as reported in this case, is one of the rarest clinical cases observed.
Postpartum inferior vena cava thrombosis: a case report
Authors: Jagadeesan Nithya , Kaviyarasu Sri Vigni
Published: June 2024

Inferior vena cava thrombosis (IVCT) is an important cause of morbidity and is one of the direct causes of maternal death after delivery in developed countries. The risk of venous thromboembolism (VTE) is present throughout the pregnancy and is maximal during postpartum, especially after twin delivery. Most of the signs and symptoms of deep vein thrombosis (DVT) overlap those of normal pregnancy causing difficulty in diagnosis. We report a case of 32-year-old primigravida who developed IVCT in postoperative period following caesarean section for twin delivery at term gestation. This was diagnosed by ultrasound on evaluation for her leg pain. She was initiated on anticoagulation that was continued for a period of six months. She is on regular follow up. IVCT is rare but recognition of signs and symptoms is fundamental to start adequate therapy and avoid potential serious sequelae.
A rare case on ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy
Authors: . Neha , Chauhan Madhubala , Chaudhary Divya
Published: June 2024

Spontaneous form of ovarian hyperstimulation syndrome in pregnancy (OHSS) is extremely rare and characterized by gastro-intestinal symptoms and complication of shift of fluid in the third space. It is often associated with multiple gestations, hypothyroidism, polycystic ovarian syndrome and molar pregnancy. Treatment depends on the patient’s clinical condition. The aim of this case report is to bring into light a case of spontaneous OHSS in a healthy Indian pregnant woman that presented with pain abdomen, abdominal distension and vomiting at 14 weeks of gestation without any of the above-mentioned risk factors. Ultrasonography showed a single viable intrauterine pregnancy along with bilateral enlarged cystic ovaries, ascites and raised CA-125 levels. There was no history of ovulation induction in present and previous pregnancy. We successfully managed the patient conservatively with Dopamine agonist Cabergoline and she delivered a healthy baby at 33 weeks. Although spontaneous OHSS is a rare entity, it should be included in differential diagnosis of acute abdomen in pregnant women. OHSS can lead to life threatening complications, early diagnosis is required for proper management.
Dysgerminoma: a case report on rare malignant tumor
Authors: Rajmane Shantanu H. , Anand Mamta Neelesh , Senapati J. B.
Published: June 2024

Dysgerminoma is a malignant germ cell tumour (GCT) accounting for less than 1% of ovarian neoplasm. It is analogous to seminoma in males. It is a tumour of young age, affecting women of reproductive age group. In most of the cases, due to its clinical features of it is often, misdiagnosed as abdominal tuberculosis. It is one of the rare tumours, which have excellent response to chemotherapy and radiotherapy. It is tumour in whom, surgery followed by radiotherapy and chemotherapy gives excellent prognosis even in advanced stage. This is a rare case report of 16-year-old girl with primary amenorrhoea, abdominal mass and pleural effusion, when undergone staging laparotomy – had ovarian tumour with torsion which histopathologically came out to be, dysgerminoma.
Clinical spectrum of obstructed inguinal hernia and its clinical outcome
Authors: Shah Rabin Pratap , Adhikari Shashi Shekhar , Gautam Khagendra
Published: June 2024

Background: Obstructed inguinal hernia is an emergency surgical condition the world over. The study was aimed to study the clinical spectrum of obstructed inguinal hernia and its management.
Methods: This cross-sectional study was conducted at Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal. In this study, we included all cases, aged above 12 years, with obstructed inguinal hernia admitted in our department. Excluded cases were patients suffering from comorbid conditions predisposing to development of groin hernia and those who were unfit to undergo surgical intervention.
Results: During the study duration, we included 60 consecutive patients fulfilling the study criteria. Mean age of the patients was 49.5±6.24 years, ranging from 12 to 78 years. The most common presenting symptoms were pain and irreducible swelling, observed in all patients. The onset of symptoms was less than 6 hours in 58% of the patients. The most common contents of the hernial sac was small intestine (47%). Herniorrhaphy was done in 73%. In our study, post-operatively there were wound infections in 5% cases, seroma in 4%, post-operative hematoma in 3% and paralytic ileus was present in one case. At 30 days post-operatively, one cases died (2%).
Conclusions: Obstructed inguinal hernias continue to be a source of morbidity and mortality in Nepal. Wound infection rate was 6% and one case expired in the 30 day follow up period.
Variations in origin and relation of the posterior cutaneous nerve of the thigh with piriformis muscle
Authors: Bansal Rimple , Goyal Ruchi , Chhabra Usha , Kaushal Subhash
Published: June 2024

Background: The gluteal region includes a disproportionate number of nerves of all sizes, both motor and sensory. The piriformis is the uppermost of the small muscles of the gluteal region and the key to the arrangement of nerves and vessels in the buttock. The posterior cutaneous nerve of the thigh usually supplies the posterior aspect of the thigh and, according to literature the nerve terminates at the popliteal region or proximal leg. The study was undertaken to record the variations in emergence of the posterior cutaneous nerve of the thigh and its relation to piriformis muscle.
Methods: Comprised of 60-lower extremities with gluteal region from 30 embalmed adult human cadavers (52 male and 8 female specimens). Any variation in the emergence of the posterior cutaneous nerve of the thigh in relation to piriformis was noted.
Results: In the present study piriformis consisted of one belly in 55 specimens (91.67%) and two bellies of piriformis were observed in 5 specimens. In present study the posterior cutaneous nerve of thigh was emerging below the piriformis in 56 specimens (93.33%) and in 4 specimens (6.67%), the relation of posterior cutaneous nerve of thigh with piriformis was found variable which were grouped as type A, type B and type C.
Conclusions: Knowledge of variant relation of posterior cutaneous nerve of thigh with the piriformis is important as entrapment of this nerve may lead to pain in the area innervated by posterior cutaneous nerve of thigh.
A study in patients of median arcuate ligament syndrome undergoing laparoscopic management
Authors: Patel Sahil M. , Nathani Prakher B. , Dholariya Meet V. , Kuswaha Manoranjan R.
Published: June 2024

Median arcuate ligament syndrome (MALS), a rare disease characterized as a result of extrinsic compression by diaphragmatic fibers arching on the celiac artery. This syndrome presents a challenging diagnostic workup due to its various clinical presentations and incomprehensible pathophysiology, requiring various investigations to exclude other causes. Laparoscopic surgery is gaining popularity. The aim was to study presenting age, sex, clinical symptoms, postoperative symptom relief and re-establishment of celiac artery blood flow after laparoscopic surgery. The prospective study was carried out in a tertiary care hospital for 10 cases of MALS over 24 months. All patients underwent extensive evaluation with no definitive diagnosis and persistent symptoms. Radiologically proven cases were operated laparoscopically and post-operative celiac artery Doppler was done on 6 months follow-up. All demographic data, clinical characteristics, diagnostic studies, management and outcomes were reviewed. 70% cases of MALS present between 3rd to 5th decades with 85% female preponderance. Postprandial epigastric pain, most common presenting symptom in 60% cases. Laparoscopic surgery is extremely effective and considered to be safe, having substantial reduction in symptoms in 90% patients and re-establishment of celiac artery blood flow (PSV) in 100% patients on 6 months follow-up. Surgeons evaluating patients with chronic abdominal pain should consider MALS as a differential diagnosis. Prompt diagnosis and treatment are critical for resolving symptoms and improving patients’ quality of life. Radiological investigations are pivotal in diagnosis and post-operative evaluation. Laparoscopic management is recommended due to its shorter postoperative stay, less post-operative pain and cosmetic suture line.
Cleft palate: historical treatments and current management
Authors: Hernandez Daniel Fernando Narvaez , Flores Alexis Andrei Granados , Escobar Daniela Fernanda Carpio , Salazar María Idalia Padilla , Meza Luis Fernando Ochoa , Orozco Manuel Fonseca , Serrano María Isabel Sixtos , Correa Daniela Medina , Castañeda José Fernando Montiel
Published: June 2024

The soft palate is an indispensable anatomical component that serves crucial functions such as airway maintenance, swallowing facilitation, and speech enablement. Significant morbidity results from excisional surgery that disturbs the functional architecture of the soft palate; furthermore, the intrinsic velar musculature cannot be adequately restored with prosthetic or flap reconstructions. When managing oral malignancies that affect the soft palate, achieving oncological control and reducing the incidence of complications and adverse effects are the principal goals. In the contemporary era of microsurgical practice, research groups are not solely focused on achieving successful flap procedures and oncological excision, but also on improving functional outcomes. A suprafascial ALT flap was surgically constructed in this instance to optimize the functionality of the remaining velar muscles and provide additional volume. The method of treatment is determined by the defect's dimensions and the anatomical components that are extracted. It is advisable to perform direct repair for full-thickness injuries. However, nonanatomic reconstruction is employed for full-thickness injuries that are "near-total to total," or exceeding 70%, with the addition of a fascial splint to restrict the velopharynx. A two-layer closure technique, the use of a fascial sling, the positioning of the skin vessel/perforator, the incorporation of the vastus lateralis muscle, the maintenance of a minimal distance between the point of entry into the muscle and the point where the perforator branches off, and the verification of the muscle's vitality prior to finalizing the closure are all recommended approaches for managing velopharyngeal constriction. In summary, the utilization of an anterolateral thigh (ALT) free flap technique in palate reconstruction yields advantageous functional outcomes while minimizing donor site complications.
Expert perspectives on the clinical use of high-dose amoxicillin with clavulanic acid in pediatric practice in Indian settings
Authors: S. Manjula , Kumar M. Krishna
Published: June 2024

Background: This study was conducted to gather expert opinion regarding the clinical use of a high dose of amoxicillin 600 mg + clavulanic acid 42.9 mg in pediatric practice in Indian settings.
Methods: This cross-sectional study comprised 19 questions and gathered perspectives from pediatricians across India regarding the prescription practices of amoxicillin (600 mg) and clavulanic acid (42.9 mg) for various bacterial infections in pediatric patients. Data were analyzed using descriptive statistics.
Results: Majority (85.65%) of clinicians opined that the high dose of amoxicillin (600 mg) and clavulanic acid (42.9 mg) was very effective in treating bacterial infections in pediatric patients. About 54% of the respondents reported prescribing 600 mg amoxicillin + 42.9 mg clavulanic acid as the high dose for pediatric patients, while 41% of them prescribed 400 mg amoxicillin + 57 mg clavulanic acid as the high dose for pediatric patients. According to 51% of clinicians, the benefits of prescribing the higher-strength formulation of amoxicillin (600 mg) + clavulanic acid (42.9 mg) compared to the standard-strength formulation of amoxicillin (500 mg) + clavulanic acid (125 mg) include increased effectiveness against resistant bacteria, reduced risk of adverse effects, and reduced frequency of dosing.
Conclusions: This study highlighted the clinicians' preference for the high dose of amoxicillin (600 mg) and clavulanic acid (42.9 mg) as an effective treatment for bacterial infections in pediatric patients.  The respondents preferred the high dose over other doses of amoxicillin and clavulanic acid due to the lower percentage of adverse effects.
Clinical profile of thrombocytopenia in pediatric patients
Authors: Chauhan Anuya V. , Mehta Disha A. , Patel Urvi
Published: June 2024

Background: Thrombocytopenia is often asymptomatic and may present as an incidental finding during routine evaluation or during laboratory investigations performed for other reasons. Most common immune mediated cause of thrombocytopenia in children is immune thrombocytopenic purpura. Early diagnosis and treatment is guided by the severity and specific cause of the disease.
Methods: This prospective study included all the admitted patients between >1 month to <12 years of age confirmed as having thrombocytopenia with platelet count <1,50,000/micro-litre by laboratory methods. Detailed history regarding various symptoms of onset and progression was recorded. Data of this study was recorded in Microsoft Excel and analyzed using statistical method.
Results: This study included 120 patients with thrombocytopenia. Incidence of thrombocytopenia among hospital admission was 4.3%. Male to female ratio was 1.6:1. 55 (45.8%) patients were more than 5 years, 26 (21.67%) patients were between 3-5 years, 28 (23.33%) patients were between 1-3years, 11 (9.17%) were infants. 112 (99.2%) patients presented with fever while 81 (67.5%) patients had vomiting. Bleeding from any site and petechiae, purpura as a presenting complaint was seen only in 7 (5.8%) and 6 (5%) respectively. 24 patients received blood products.
Conclusions: Infectious diseases were the most common cause of thrombocytopenia in children particularly moderate thrombocytopenia in present study. Thrombocytopenia is a common hematological finding in many febrile illnesses like dengue, malaria. Fever, vomiting were more significant symptoms. Symptomatic and supportive treatment in form of intravenous fluids and antipyretics were required in most of the children. Very few patients required platelet rich concentrate (PRC) for treatment.
Clinico-etiological profile of neonates with neonatal hyperbilirubinmemia treated with double volume exchange transfusion
Authors: Mir Naseer Y. , Irtika  , Zaman Bashir U.
Published: June 2024

Background: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. The aim of the study was to determine the clinical profile and etiology in neonates who were treated with double volume exchange transfusion (DVET).
Methods: This was a hospital based prospective observational study in neonates ≥35 weeks of gestation who were treated with DVET for severe hyperbilirubinemia in a tertiary care centre over a period of six months.
Results: In our study 110 neonates with severe hyperbilirubinemia were treated with DVET. Majority of the neonates were males (59.1%). Lower segment caesarean section (LSCS) was the common mode of delivery observed in 66.4% of the study subjects. Rh incompatibility (36.4%) was the commonest cause of exchange transfusion followed by ABO incompatibility (20%). The mean age of neonates at admission and mean age at DVET in days were 4.03±2.46 and 4.25±2.44 respectively. The mean birth weight of neonates treated with DVET was found to be 2.81±0.57. The mean total serum bilirubin at pre-exchange and post exchange were 26.13±6.58 mg/dl and 11.63±3.24 mg/dl respectively.
Conclusions: Rh incompatibility was the most common cause in neonates with severe hyperbilirubinemia requiring double volume exchange transfusion.
Probable case of autosomal dominant myotonia congenita (Thomsen disease) seen in Sokoto, Nigeria
Authors: Isezuo Khadijat O. , Sani Usman M. , Garba Bilkisu I. , Waziri Usman M. , Ahmad Murtala M. , Ahmed Hadiza K. , Inoh Ikemesit I. , Ogunkoya Olubusola B. , Jangebe Mikailu A. , Alimi Saheed
Published: June 2024

Myotonia congenita is a rare heritable disease of skeletal muscles characterized by muscle stiffness (myotonia) and hypertrophy. We report a child with features of autosomal dominant type of myotonia congenita seen at our hospital. A 4-year-old boy admitted for an acute febrile illness was observed to have generalized muscular hypertrophy said to be present since he was 7 months old. It was associated with painless generalized muscle stiffness and slow initiation of movements after period of rest which gradually subsided following a few minutes of activity. He also had history of frequent falls while running, but no difficulty climbing stairs or muscle weakness. Pregnancy and delivery were uneventful. He had normal developmental milestones and was doing well in school. No history of similar problem in any family member and his parents were not consanguineous. On examination he had generalized muscular hypertrophy with a Herculean build. He had demonstrable stiff movements and gait after rest with percussion myotonia. Gower sign was negative. Serum creatinine kinase was normal at 79.2 U/L (Up to 130 U/L) and CK-MB was 24.8 U/L (Up to 24 U/l)). Electromyography (EMG) showed myotonia as sharp waves in a waxing and waning pattern. Muscle biopsy and genetic test were not done due to non-availability. A diagnosis of myotonia congenita most likely autosomal dominant type (Thomsen disease) was made based on strongly suggestive clinical features and EMG in the patient. He was since discharged as acute febrile illness resolved but still has symptoms of myotonia. This is the first reported case of myotonia congenita in our environment supported by clinical and EMG features. Genetic diagnosis should be made available in resource limited settings.
Comparison of OpenSim and AnyBody modeling system™ predictions in biomechanical modeling of upper extremities
Authors: Gautam Kamal , Hefzy Mohamed S. , Mustapha Abdul A. , Kyle Behrens
Published: June 2024

Background: The study of muscle forces in upper extremities is pivotal for advancements in biomechanical modeling, contributing significantly to the field of orthopedics, rehabilitation, and sports science. Despite the prominence of OpenSim and AnyBody modeling system™ in this domain, a gap persists in comparative analyses specifically targeting muscle force predictions in upper extremity motions.
Methods: This study compares the predictions of muscle forces in static elbow flexion, shoulder flexion, and shoulder abduction using OpenSim and AnyBody modeling systemTM, hypothesizing significant differences in predictions attributable to their distinct modeling methodologies and assumptions. This work utilized generic models without subject-specific data and conducted simulations in both software environments, focusing on the magnitude and activation of major muscle forces under predefined kinematics.
Results: OpenSim and AnyBody modeling systemTM produced similar results when simulating elbow flexion, with both software predicting forces in the major muscles required to maintain the posture. However, discrepancies were observed between the two software for muscle force predictions during the shoulder flexion and abduction movements. AnyBody modeling systemTM appeared to be more robust as it included all the upper extremity muscles and predicted the major muscles forces required for these movements more accurately compared to OpenSim.
Conclusions: The results of this study show significant differences in muscle force predictions between OpenSim and AnyBody modeling systemTM, attributed to the unique modeling approaches, especially in representing muscle-tendon complexes and joint dynamics.