bluuebunny/crossref_metadata_2025 huggingface dataset:
Tuberculosis Causing Infertility
Authors:   Department of Obstetrics & Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
Published: November 2023

Genitourinary tuberculosis was the second most common form (30%) of extrapulmonary tuberculosis after peripheral lymphadenopathy. We reported a case of tuberculosis of the cervix and endometrium presented with secondary amenorrhoea and infertility. The diagnosis was based on histological examination. Despite tuberculosis treatment, she did not gain back her menses.
Mapping Educational Pathways through Focus Groups: Children and Young People on the Impact of Inclusive Socio-Educational Practices
Authors: Lúcio Joana , Rodrigues Raquel , De Oliveira Rodrigues Marta
Published: November 2023

As school became a primary instance of socialization and acculturation, and school education expanded across practically every country in the world, and reached virtually all children/young people, during an increasingly longer period of the life cycle, school failure and dropout emerged as cross-cutting educational and sociopolitical issues. Nonetheless, the voices of the actors engaging in initiatives aimed at overcoming school failure and dropout are seldom heard. Project EDUPLACES (PTDC/MHC-CED/3775/2014) proposed to do just that, through interviews, questionnaires and focus groups with parents/families, children/young people, teachers/other staff and community representatives. This paper explores the outcomes of eight focus groups involving a total of 57 children/young people, with a particular emphasis on the discourses emanating from the participants in Mediation and Study Support practices. As we discuss how initiatives aimed at overcoming school failure and dropout address issues such as inclusion, participation, learning, empowerment and community development, focus groups emerge as a relevant tool for navigating the meaning(s) of educational success.
The European Green Deal Agenda After the Attack on Ukraine: Exogenous Shock Meets Policy‐Making Stability
Authors: Wendler Frank
Published: November 2023

The present article investigates how the EU climate and energy governance framework launched by the European Green Deal has been affected by the exogenous shock of the Russian war of aggression on Ukraine. Harnessing punctuated equilibrium theory, the theoretical approach applies its conceptual triad of policy images, venues, and feedback to the adoption of the current REPowerEU program as a critical test case of highly stable policy-making encountering a situation of exogenous shock. In the empirical part, a mixed-method content analysis of policy documents issued by the European Council and Commission from the adoption of the European Green Deal in 2019 to the current stage is presented to gauge the impact of the Russian attack on agenda-setting at the macro and meso-political levels of the EU. A second step evaluates how the expanded and more geopolitical policy image of the REPowerEU agenda is applied to extant governance processes. In this regard, the analysis identifies three factors limiting the impact of exogenous shock: the availability of three separate policy subsystems for the parallel processing of policy components, institutional safeguards for maintaining policy stability through supranational rules and provisions, and the critical function of the Commission in limiting revisions to a few targeted proposals. In conclusion, policy stability outweighs aspects of disruption and change, while the more diverse set of policy processes creates new challenges for the coherence of efforts to achieve decarbonization.
MUSTAFA RÂGIB IN MEVLİD-İ NEBÎ Sİ
Authors: KOYUNCU Fatih
Published: November 2023

Hz. Muhammed’in hayatı ve şahsiyetinin konu edildiği başta naat, mevlit, siyer ve hilye gibi türlerde kaleme alınan eserler Klasik Türk edebiyatının dinî muhtevalı metinleri arasında önemli bir yekûn teşkil etmektedir. Hz. Peygamber’e duyulan sevginin göstergesi olan mevlit, özellikle Hz. Muhammed’in doğumunu, bu vesileyle yapılan törenleri ve yazılan eserleri ifade eder. Mevlit metinlerinde genellikle Hz. Muhammed’in veladeti, bazı mucizeleri, peygamberliği, miracı ve vefatı konu edilir. Asırlardır Türk edebiyatında kaleme alınan yüzü aşkın mevlit türündeki metinler arasında özellikle Süleyman Çelebi’nin 812 / 1409-10 yılında yazımını tamamladığı Vesîletü’n-Necât isimli eseri ön plana çıkmıştır. İnsanların hem mutlu hem de hüzünlü günlerinde okunan bu eser birçok dile tercüme edilmiştir. Edebiyatımızda mevlit kaleme alan şairlerden biri de Mustafa Râgıb’dır. Şair hakkında kaynaklarda bir bilgiye rastlanmamıştır. Eldeki tek nüshada yer alan bilgilere göre Nakşibendi halifesi olduğu ve 1274 / 1857-58 yılında Manastır’da vefat ettiği bilinen Mustafa Râgıb’ın bu eseri 244 beyittir. Manzumede Allah ismini anmanın faziletini, Allah’ın varlığı ve birliğini, Hz. Peygamber’in nurunun yaratılışını, anne ve babasının evlenmesini, annesi Âmine Hanım’ın doğumu hakkında verdiği bilgileri, veladeti esnasında meydana gelen olağanüstü hadiseleri ve miracı anlatan şair, son olarak dua bölümüyle eserini tamamlamıştır. Bu çalışmada Mustafa Râgıb’ın eseri şekil ve muhteva açısından incelenmiş ve elde olan tek nüshadan hareketle Mevlid-i Nebî’nin metni okuyucuların istifadesine sunulmuştur.
Development of Basic Electricity and Electronics Practicum Jobsheet for Students of Electric Power Installation Engineering Expertise at SMK Negeri 3 Boyolangu
Authors: Septyawan Eggy Catur , Putranto Hari , Wibawanto Slamet
Published: November 2023

This development research aims to develop printed teaching materials in the form of practicum job sheets to assist the learning process of basic electricity and electronics by the 2013 curriculum. Research and Development is a research model used to develop existing products. The development model in this study is the Sugiyono model. This development stage begins with looking for potential problems, collecting data, designing products, validating designs, product trials, design revisions, product testing, product revisions, usage trials, and product revisions, and ends with mass production. The development of this teaching material has met the criteria for proper use with the results obtained from experts with a validation expert value of 93.8 percent; product trial results with an average value of 90.4%, and usage trial results with an average value of 93.6 percent.
Educational Game-Based Learning Media to Grow Learning Motivation in Computer and Basic Network Subjects in Vocational High Schools
Authors: Faiz Yoga Hanif , Kurniawan Wendy Cahya
Published: November 2023

The use of technology in the learning process requires educators to be able to adapt to technology in the learning process. Based on the observations that have been made, in the Subject of Computers and the basic network of computer assembly shows that students are less motivated. To foster motivation to study computer assembly material, media was developed to discuss basic competencies regarding computer assembly tools. Researchers make Educational Game-Based Learning Media as Learning Media that adapts to digital technology. This media has many advantages, including being easy to operate, not limited by distance and space, not boring, and easy to understand. The purpose of this development research is to develop and determine the feasibility of Educational Game-based learning media to foster motivation to learn basic subjects of Computers and Networks in TKJ. The research and development method used is Design Thinking with the following stages: 1) Empathize; 2) Define; 3) idea; 4) Prototype; 5) Test. The types of instruments used are game test questionnaires and student learning motivation tests. The type of data in this study is quantitative and quantitative with data collection methods using questionnaires. The results of the research and development carried out produced educational game learning media for computer subjects and basic network computer assembly materials. Feasibility analysis on material validation 96.45%, media expert validation 96.46%, product trial 84.23%, and learning motivation test 84.38%. Based on the results of the feasibility analysis of Educational Game learning media it is said to be "Valid" or Decent Enough. The results of the analysis of learning motivation are said to be high and can foster learning motivation. It can be concluded that Educational Game learning media can be used as a complement to the learning process and can foster student learning motivation.
Mechanical Characterization of NaOH-Treated Agel Fiber-Cotton Composites
Authors: Santhiarsa IGN Nitya , Kusuma I Gusti Bagus Wijaya , Negara I Gede Artha
Published: November 2023

Composites comprising two or more distinct materials are fabricated to enhance the mechanical properties of the constituent materials. A common approach for generating composites is vacuum infusion. This technique enables the infusion of two materials utilizing a vacuum. In the field of composite science, textile composites have emerged as an important new development. Agel rope, derived from twisting agel fibers, exhibits inferior bending strength and elongation compared to ropes fabricated from synthetic fibers. Moreover, agel rope is susceptible to bacterial decay. This study aims to characterize the mechanical properties of textile composites comprising woven agel rope subjected to NaOH treatment. Specimens in the longitudinal (warp) shows maximal load bearing capacity, as determined by experimental results. Samples treated with 5% NaOH tolerated peak loads of 51.12 N prior to failure, with an associated deflection of 3.18%. Specimens in the transverse (weft) of the woven cotton demonstrated maximum load of 40.75 N at 0.9% deflection. The maximum stress was 25.67 MPa. Similar to agel rope, NaOH treatment removes adhering contaminants from cotton fibers, thereby enhancing their strength. However, NaOH concentrations exceeding 7.5% extract cellulose, damaging the fiber ultrastructure.
Inter-Frame Video Compression based on Adaptive Fuzzy Inference System Compression of Multiple Frame Characteristics
Authors: Putra Arief Bramanto Wicaksono , Malani Rheo , Suprapty Bedi , Gaffar Achmad Fanany Onnilita , Voliansky Roman
Published: November 2023

Video compression is used for storage or bandwidth efficiency in clip video information. Video compression involves encoders and decoders. Video compression uses intra-frame, inter-frame, and block-based methods.  Video compression compresses nearby frame pairs into one compressed frame using inter-frame compression. This study defines odd and even neighboring frame pairings. Motion estimation, compensation, and frame difference underpin video compression methods. In this study, adaptive FIS (Fuzzy Inference System) compresses and decompresses each odd-even frame pair. First, adaptive FIS trained on all feature pairings of each odd-even frame pair. Video compression-decompression uses the taught adaptive FIS as a codec. The features utilized are "mean", "std (standard deviation)", "mad (mean absolute deviation)", and "mean (std)". This study uses all video frames' average DCT (Discrete Cosine Transform) components as a quality parameter. The adaptive FIS training feature and amount of odd-even frame pairings affect compression ratio variation. The proposed approach achieves CR=25.39% and P=80.13%. "Mean" performs best overall (P=87.15%). "Mean (mad)" has the best compression ratio (CR=24.68%) for storage efficiency. The "std" feature compresses the video without decompression since it has the lowest quality change (Q_dct=10.39%).
Round-Robin Algorithm in Load Balancing for National Data Centers
Authors: Sudiatmika I Kadek Wahyu , Indrawan Gede , Sariyasa Sariyasa
Published: November 2023

The Provincial Government of Bali assumes a crucial role in administering various public service applications to meet the requirements of its community, traditional villages, and regional apparatus. Nevertheless, the escalating magnitude of traffic and uneven distribution of requests have resulted in substantial server burdens, which may jeopardize the operation of applications and heighten the likelihood of downtime. Ensuring efficient load distribution is of utmost importance in tackling these difficulties, and the Round Robin algorithm is often utilized for this purpose. However, the current body of research has not extensively examined the distinct circumstances surrounding on-premise servers in the Bali Provincial Government. The primary objective of this study is to address the significant gap in knowledge by conducting a comprehensive evaluation of the Round Robin algorithm's effectiveness in load-balancing on-premise servers inside the Bali Provincial Government. The primary objective of our study is to assess the appropriateness of the algorithm within the given context, with the ultimate goal of providing practical and implementable suggestions. The observations above can optimize system efficiency and minimize periods of inactivity, thereby enhancing the provision of vital public services across Bali. This study provides essential insights for enhancing server infrastructure and load-balancing strategies through empirical evaluation and comprehensive analysis. Its findings are valuable for the Bali Provincial Government and serve as a reference for other organizations facing challenges managing server loads. This study signifies a notable advancement in establishing reliable and practical public service applications within Bali.
MINERALOGICAL AND GEOCHEMICAL PROPERTIES OF THE MIOCENE ROCKS OUTCROPPING AROUND TUZLUCA (IĞDIR-TÜRKİYE)
Authors: YAKUPOĞLU Türker , KARASU Enver
Published: November 2023

In this study, Miocene lithostratigraphic units (Turabi, Çincavat and Tuzluca formations) outcropping in the Neogene Kağızman-Tuzluca Basin in the west of Iğdır province were studied. The units are represented by evaporatic, carbonate and clayey rocks. The study aims to determine the mineralogical and geochemical properties of these rocks and to interpret the paleoenvironmental conditions. XRD (X-ray diffraction) whole rock and clay fraction analyzes, OM (Optical Microscope) studies, element determination with XRF (X-ray fluorescence) and, FE-SEM / EDS (Field emission scanning electron microscopy-energy dispersive X-ray spectrometry) studies of rock samples taken along the sections measured in the field were carried out for this purpose. Quartz, feldspar, mica, calcite, gypsum and halite minerals were determined in whole rock compositions of the samples. Smectite, illite, chlorite and paligorskite minerals were found in the clay fractions. It has been determined that feldspars altered to smectite by SEM and EDS studies. Optical microscopy and paleoenvironment studies indicate that the origins of gypsum, halite and palygorskite minerals are authigenic. It was also determined that calcite was authigenic and detritic, while chlorite, illite, quartz, feldspar and mica were detrital. The predominance of smectite, as well as the presence of chlorite, illite and palygorskite indicate that the basin developed under alkaline conditions, mostly hot and humid, and occasionally arid and cold conditions. In geochemical analyzes, the positive correlation of SiO2 with other major oxides (excluding CaO, MgO and SO3) is the input of clay and clastic materials, while the negative correlation of SiO2 with SO3 and CaO is associated with the decrease in the rate of CaSO4 sediments as a result of shallowing of the basin due to evaporation of water.
KAOLIN FORMATION IN YATAĞAN (MUĞLA) LIGNITE DEPOSIT
Authors: BÜÇKÜN Zeynep , ÇOLAK Mümtaz
Published: November 2023

The 30-km-long and 10-km-wide, coal-bearing Yatağan Basin is located in SW Anatolia, close to the eastern coast of the Aegean Sea, Türkiye. The basement consists of Menderes Massif metamorphics in the NW part of this intermontane basin, c. 80-km2-large area (Turgut lignite deposit). The Neogene and Quaternary sedimentary filling comprises fluvioterrestrial, limnic and telmatic sediments which contain a mineable coal seam up to 15 m thick, unconformably overlain the basement. Two fresh and six weathered samples were picked up from the Menderes Massif gneiss outcrops of the catchment area. Eight sedimentary rocks, inorganics over and underlying the coal seam, were obtained from four borehole cores. All samples were examined under the optical microscope; XRD, SEM-EDX and ICP-MS analyses were later performed. This study aims to examine the mineralogical content and geochemical processes of the sedimentary rocks from different formations, namely Sekköy and Turgut Formations, which are over- and underlying the lignite horizon, to assess the clay mineral formations and transformations. Gneiss samples contain mainly quartz, plagioclase, K-feldspar, muscovite and biotite with a lesser amount of tourmaline, chlorite, garnet, apatite, zoisite, zircon and Fe-oxides. The -2 µm fraction consists mainly of illite, with fewer smectite and kaolinite. Sericitizitation of feldspar is the main product in gneisses. Coal over-and underlying sedimentary rock samples contain mainly quartz, plagioclase, K-feldspar, muscovite, and biotite with less pyrite and iron oxides. The -2 µm fraction of the sedimentary rock samples consists of variable clay mineral contents. Kaolin content is higher in acidic conditions with an opposite correlation to smectite occurrences. The geochemistry of Menderes Massif gneisses shows that it gave felsic material to the catchment area, whereas the geochemistry of sedimentary rocks is not coherent in all cases. Geochemical parameters like CIA and PIA proved that weathering processes of the source materials prevailed during the generation of these sedimentary units.
The quest for better outcomes: a randomized controlled trial comparing letrozole versus clomiphene citrate in polycystic ovarian syndrome related infertility
Authors: Hasnat Fahmida , Ferdousi Mahmuda A. , Hasan M. Mahboob , Islam Mohammad T.
Published: November 2023

Background: Infertility is a widespread concern, particularly among individuals with polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) has been a primary treatment for PCOS-related infertility, despite suboptimal pregnancy rates. Letrozole, an aromatase inhibitor, presents an alternative with potential advantages for improving pregnancy outcomes. This study aimed to rigorously compare letrozole and CC in the context of PCOS-related infertility, focusing on Bangladeshi women, adopting incremental dosing protocols, and examining endpoints to contribute valuable insights.
Methods: A randomized controlled trial was conducted at a tertiary care center in Bangladesh from July 2021 to June 2023. Participants included women aged 18-35 with anovulatory infertility due to PCOS. They were randomized into two groups: letrozole and CC. Treatments were administered following incremental dosing protocols, and outcomes included endometrial thickness, ovulation rate, mono-follicular development, pregnancy rate, and time to pregnancy.
Results: Out of 187 patients assessed for eligibility, 102 were enrolled, with 51 in each group. Demographics were comparable between groups. While endometrial thickness did not significantly differ between the groups, letrozole demonstrated a higher rate of mono-follicular development (72.55% versus 50.98%), a significantly higher pregnancy rate (47.06% versus 23.53%), and a shorter time to pregnancy (9.23 weeks versus 11.7 weeks) compared to CC.
Conclusions: This study suggests that letrozole may be a preferred option for ovulation induction in PCOS patients due to its superior pregnancy rates and shorter time to pregnancy compared to CC. However, limitations such as a relatively small sample size and variations in dosages should be considered. Further research is needed to validate these findings and address the evolving needs of patients with PCOS-related infertility.
Practice of ovarian stimulation among poor responders in a country with limited resources: case of the Paul and Chantal Biya human reproduction center, Yaoundé, Cameroon
Authors: Vanina Ngono Akam Marga , Etienne Belinga , Pascale Mpono , Robert Nyada Serge , Nsahlaie Christiane , Michele Mendoua , Marie Kasia Jean
Published: November 2023

Background: Approximatively 2 to 30% of women who undergo ovarian stimulation have a poor response. The management is not clearly defined, constituting a challenge for clinicians and biologist.
Methods: This was a longitudinal descriptive study with prospective data collection that took place at Paul and Chantal Biya Gynecological Endoscopic surgery and Human Reproductive Teaching Center, during a period of 1 year and 6 months, from June 2020 to November 2021. Our objective was to describe the practice of ovarian stimulation of patients judged to be poor responders in CHRACERH. We highlighted the numbers, percentages, averages and their standard deviations. Statistical analyzes were carried out using SPSS v15.0 software.
Results: Out of 159 cycles included, we identified 55 patients considered possible poor responders, i.e. a prevalence of 34.6%; the average age was 36.36±6.2 years with extremes ranging from 33 to 44 years, mainly overweight in 81.8% of cases. The average AMH level was 0.9±0.4 ng/ml, the average CFA 6.15±3.7. 87.3% of patients were on their first stimulation attempt, the long-delay agonist protocol and the short agonist protocol were used in 58.2% and 41.8% respectively. The maximum daily dose in patients was 300 IU with an average total dose of gonadotropin used of 3371.8±874 IU. At the end of the ovarian stimulation, the average number of follicles collected and mature oocytes were respectively 5.6±3.6 and 4±2.9 with an average maturity rate of 70.7±31% as well as an average fertilization rate in ICSI of 45.2±32%. The pregnancy rate was 12% among poor responders.
Conclusions: Poor responders constitute a large proportion of patients stimulated at CHRACERH; their still low pregnancy rates prompt an improvement in care.
Comparison of conventional pap smear with liquid based cytology, and assessment of the effectiveness and feasibility of liquid-based cytology over conventional pap smear in rural tertiary care centre
Authors: Sharma Sheela , Singh Neetu , Sinha Amrita , Jain Smriti
Published: November 2023

Background: Cervical cancer is the second most common cancer in women in India. So, detection of its premalignant lesions is of utmost importance, which can be easily done by screening methods. Screening programmes for cervical cancer using the conventional pap smear (CPS) technique have been in place since decades. However, CPS technique has many limitations. To overcome these limitations liquid-based cytology (LBC) was introduced in the mid 1990 as a better tool for processing cervical samples. The aim of present study is to compare CPS with LBC and to assess the diagnostic accuracy and cost effectiveness of LBC in rural tertiary care centre.
Methods: The study was conducted over a period of 2 years at Rama medical college, Mandhana, Kanpur. All women presenting to gynaecological OPD with symptoms and signs suspicious of cervical malignancy were selected for paired samples of conventional pap and LBC. Colposcopy and biopsy were sought which correlated with cytologic findings. 
Results: A maximum number of cases were in the reproductive age group, most common age of presentation being 40-49 years (27.3%) followed by 30-39 years (25.3%). A majority of patients were presented with a complaint of discharge per vagina 176 (58.7%), followed by pelvic pain 154 (51.3%). Only 4 patients were found to have unsatisfactory smear in LBC (1.33%) while 22 patients had unsatisfactory smear in conventional PAP (7.33%). LBC showed presence of endocervical cells in almost all patients 290 (97.97%). Candida bodies were not evident in LBC smears while the CPS showed presence candida bodies in 4 cases.
Conclusions: Both the screening methods are very effective and sensitive in the detection of premalignant lesions with slight discordance of grade on histology. Thus, we conclude that cervical cytology is very effective in the detection of premalignant lesions with the sensitivity of almost 100%. In developing countries such as India, where finances pose a major problem, conventional method is as good as LBC.
Study on assessment of knowledge, attitude and practice towards prevention and screening of cervical cancer among couples
Authors: Devi Lukram M. , Lucksom Pesona G.
Published: November 2023

Background: Cervical cancer (CC) is caused by Human Papilloma Virus which is sexually transmitted. With the rise in its incidence, it is necessary to know if couple awareness is important to increase uptake of screening. Thus, this study was undertaken to analyze if knowledge, attitude and practice towards prevention and screening of CC in male partners has influence in female counterparts.
Methodology: Questionnaire based cross sectional study from August 2022 to August 2023, done in the department of Obstetrics and Gynecology, Sikkim Manipal Institute of Medical Sciences. 340 couples (680 participants), ≥18years of age, attending the outpatient department who consented for the study were enrolled.
Results: Only 48% of the study population (142 couples) had heard about cervical cancer. There was no significant difference in the knowledge between males and females among couples who had heard about CC. However, there was significant difference in the female counterpart’s knowledge when males had or lacked knowledge on CC (p<0.00001). Assessment of preventive practice showed that only 17% women had done screening test and only 33% of couples used barrier contraception. More than 80 % couples had a positive attitude towards screening and vaccination against the disease.
Conclusions: Though the population exhibited positive attitude towards CC prevention but the lack of knowledge led to less preventive practices. Male partner’s knowledge also showed influence on awareness about CC among females. Hence, to increase screening uptake, educational programs should include couples rather than females.
Study of lipid profile in polycystic ovarian syndrome: a case control study in tertiary care hospital
Authors: Marbaniang Racheal Sweet , Yanglem Ajitkumar Singh , Kshetrimayum Victoria , Naorem Sangeeeta , Laithangbam Rosyka , Ashem Florida
Published: November 2023

Background: Polycystic ovarian syndrome (PCOS) is one of the most common causes of endocrine dysfunction in women of reproductive age. Dyslipidaemia plays an important role in the development of PCOS. Lipid abnormalities which include elevated low-density lipoprotein and triglyceride levels and reduced high-density lipoprotein levels are often found in women with PCOS and thus they are associated with long-term risk of coronary heart disease. The study aims to estimate lipid profile levels in patients with polycystic ovarian syndrome (PCOS) taken as cases and normal healthy subjects taken as controls.
Methods: This is a case control study conducted in the Department of Biochemistry in collaboration with Department of Obstetrics and Gynaecology, RIMS, Imphal. Fasting blood samples were collected from cases and controls and lipid parameters were estimated. Forty-five cases of PCOS patients in the age group of 18-44 years diagnosed according to Rotterdam criteria and forty-five age-matched healthy women with regular menstrual cycle taken as controls were recruited.
Results: The mean±SD of age in cases was 26.38±4.85 years and control was 28.23±3.99 years. However, the difference was found to be statistically insignificant. The majority of cases were from urban areas which comprised of 62% and only 55.6% were from rural areas. The mean±SD for cholesterol, TG, LDL were 203.40±54.20 mg/dl, 163.26±69.49 mg/dl, 132.82±50.39 mg/dl respectively and was higher in cases compared to controls and the difference was statistically significant. However, the mean±SD of HDL in cases 24.81±2.31mg/dl was lower as compared to controls and the difference was statistically significant with p<0.05.
Conclusions: PCOS is found to be associated with atherogenic lipid profile. Thus, it may be suggested that dietary control and improvement of living style to control dyslipidaemia should be taken up early in PCOS to prevent development of cardiovascular disease.
A rare case report: unruptured ovarian pregnancy
Authors: Sarkar Shipra , Ghosh Somenath , Mitra Priyanka
Published: November 2023

Ovarian pregnancy is a rare form of ectopic pregnancy. Its incidence is 0.5-1% of all ectopic gestations or 1 in 7000 to 40000 live births. The diagnosis is intricate and based on surgical and histopathological observations. In our institute in last 10 years, we have seen a single confirmed case out of 189 ectopic pregnancies. It was a spontaneous pregnancy with no history of contraception failure and diagnosed as tubal ectopic by ultrasound imaging. Laparotomy findings and histopathology confirmed it to be an Ovarian Pregnancy.
Challenges in conservative management of placenta increta with methotrexate in nulliparous woman
Authors: Anitha A. , Usha N.
Published: November 2023

Placenta increta is a severe complication of pregnancy normally diagnosed during the second trimester. Early detection could reduce the risk of hemorrhage during abortion or miscarriage; however, guidelines on first‐trimester diagnosis are lacking. We describe a case of placenta increta during the second trimester with retained products of conception and its consequences followed by effective management with methotrexate.
Associating factors in postmenopausal women with pelvic organ prolapse
Authors: Daniyal Laraib
Published: November 2023

I have reviewed with deep interest the publication "the evaluation between vitamin D level and pelvic organ prolapse in postmenopausal women." As a medical student, I appreciate all authors on their dedicated work and would like to express my gratitude for their findings. This study investigated the association between vitamin D levels and pelvic organ prolapse in postmenopausal women.
Prevalence, practice, and determinants of self-medication among the common public in a village of Northern Kerala, India
Authors: G. Narayanan Namboothiri , K. C. Lamees , Latheef Tamanna , M. M. Thasleema , Muhammed N. Thameem , R. Swathi
Published: November 2023

Background: Self-medication, managing health issues without professional guidance, poses significant risks to individuals and public health. Prevalence rates vary globally, often higher in low-income countries due to limited healthcare access. While self-medication offers cost-effective solutions for minor ailments, it may lead to misuse, adverse effects and financial burdens. Identifying factors driving self-medication is crucial for tailored interventions. This study aims to assess self-medication prevalence, practice, and influencing factors in a Kerala village.
Methods: A community-based cross-sectional study included 212 participants (≥18 years) selected via convenient sampling. A pre-tested questionnaire collected socio-demographic data, self-medication prevalence, and influencing factors. Self-medication was defined as OTC drug use without consulting a medical graduate. Data were analyzed using SPSS 26, with chi-square tests for bivariate analysis (p≤0.05).
Results: Participants (mean age: 38.13±15.56) reported 53.8% self-medication. Acute illness individuals self-medicated more (80.7% purchased from independent pharmacies). Time constraints (24.5%) and expired prescriptions (42.1%) drove self-medication. Medication choice was influenced by cost (54.3%), brand reputation (21.1%), and both (24.6%), with pharmacist recommendations (36.0%) playing a role. Self-medication was common among ages 41-60 (64.3%) and those with lower education levels (77.8% primary, 70.5% middle). Acute illness individuals self-medicated more (66%) than chronic cases (34%).
Conclusions: This rural Kerala study identifies a 53.8% self-medication rate, affected by age, education, and healthcare preferences. Targeted interventions are needed for ethical self-medication and improved healthcare practices.
BERA in the detection of hearing loss in high risk children: an observational study in two tertiary care teaching hospitals in upper Assam region
Authors: Mili M. K. , Sarma Debajit , Sarmah Monikuntal , Goswami Suhanee , Pegu Krisna , Talukdar Linkan , Talukdar Sharmistha , Siddique Mohsina
Published: November 2023

Background: Significant hearing loss affects children globally (1-3/1,000 infants at birth). Early diagnosis (<6 months age) and subsequent early intervention facilitates normal development of language, regardless of the severity of hearing loss.
Methods: A hospital-based, descriptive, retrospective study was done in two tertiary-care centres of Upper Assam region, upon total (55 + 46 =) 101 high risk children (<15 years) during a study period of 1 year. Patients were subjected to a questionnaire, and hearing tests (BERA/OAE) were performed.
Results: Majority of the cases were <5 years of age, with male preponderance (66.30% cases). NICU graduates with history of ototoxic medications/mechanical ventilation, neonatal hyperbilirubinemia and caregiver concern were the common presenting risk factors identified.
Conclusions: 49.50% cases (n=50) suffered from hearing loss [most common was severe degree of hearing loss, n= 24].  75% cases in AMCH and 63.6% in LMCH with caregiver concern, 55.55% cases in AMCH and 50% in LMCH with past neonatal hyperbilirubinemia; 50% cases with positive family history; and 46.66% NICU graduates tested positive for hearing loss. Ideally, all high risk children <15 years should be screened for hearing loss with earliest intervention and rehabilitation, to enable them to lead a normal life and reduce the burden of handicap in the community.
Comparison between intraoperative and postoperative surgical outcomes of laparoscopic partial nephrectomy and open partial nephrectomy: laparoscopic versus open partial nephrectomy
Authors: Sharma Sachin , Swain Samir , Panda Sabyasachi , Tripathi Abhilekh , Yash Manharlal Tilala , Behera Kishore Kumar , Anshuman Jatin
Published: November 2023

Background: The aim of the study was to compare intraoperative and postoperative surgical outcomes of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN).
Methods: We did prospective retrospective study on 33 cases of renal mass operated as partial nephrectomy (PN) (15 LPN and 18 OPN) in department of urology and renal transplant SCB medical college Cuttack Odisha from 1 may 2019 to 1 may 2023. Surgical outcome of both approaches compared based upon intraop time, estimated blood loss, ischemia time, hospital stay, complications and rise in creatinine.
Results: Mean intraop time 140.66 min in OPN vs 172.8 min in LPN (p<0.05-significant), mean estimated blood loss was 453 ml in OPN vs 345 ml in LPN (p=0.113-not significant), mean ischemia time was 15.88 min in OPN vs 20.53 min in LPN (p<0.05-significant), mean post op hospital stay was 7.5 days in OPN vs 6.3 days in LPN (p=0.184-not significant). Intra-op complications was 2 (11.11%) in OPN vs 2 (13.33%) in LPN and postop complications was in 5 (27.7%) in OPN vs 4 (26.66 %) in LPN. Mean rise in creatinine was 0.25 in OPN vs 0.29 in LPN (p=0.642-not significant).
Conclusions: LPN is a feasible and safe alternative to OPN with comparable surgical outcomes but operating time and ischaemia time is significantly more in LPN as compare to OPN.
Retroperitoneal abscesses: a diagnostic dilemma – case series, review of the literature and practical guide for the management of iliopsoas abscessess
Authors: Kumar Deeksha , Byrne Hannah , Gurung Ganga , Airon Nitin , Rao Milind
Published: November 2023

Retroperitoneal abscesses are uncommon clinical conditions which can pose a notoriously difficult diagnostic dilemma. This paper focuses on the management of secondary iliopsoas abscesses (IPA). We aim to review the literature for the diagnosis and management of IPA, as well as present our IPA pathway, which we believe will reduce the difficulties clinicians may encounter when treating patients with IPA. Our three IPA cases are of colorectal, orthopaedic and urological origin. All patients underwent percutaneous drainage of the IPA, with one proceeding to open drainage. No mortalities were reported. IPA is a condition that presents diagnostic and therapeutic challenges to clinicians. The classical triad of IPA comprising of fever, abdominal/back pain and a limp is reported in just 5 – 30% of cases. Computed tomography remains the gold standard for diagnosis and radiologically guided drainage should be attempted in the first instance. The literature emphasizes the importance of maintaining a high index of suspicion for IPA, as it can be easily misdiagnosed within a wide range of differentials. Empirical treatment consists of broad-spectrum antibiotics, which should be adjusted when blood/aspirate cultures are available. Open drainage should be reserved for cases where percutaneous attempts are not appropriate, unsuccessful, or a patient clinically deteriorates. In a practical sense there is often confusion as to which specialties should best manage IPA. In recognising these difficulties, an IPA pathway would act as a concise guide for clinicians and ultimately optimise patient care.
Variability in presentation and management of gastric volvulus: report of 3 cases
Authors: Peña-González Ricardo-Raziel , Huerta-Pérez Ramón-Guillermo , Hernández Erick-F. , Higuera-Hidalgo Francisco , Etchegaray-Dondé Agustin
Published: November 2023

Gastric volvulus is a pathology of acute or subacute presentation. Depending on the type, a gastric volvulus can present as an emergency if there is vascular compromise with necrosis and high risk of perforation and its surgical resolution is mandatory. Subacute gastric volvulus does not compromise the organ or organism urgently but is associated with high morbidity and should be resolved when the patient is in optimal conditions to offer definitive treatment. Depending on the torsion axis, it is classified as axial or mesenteroaxial organ, both merit reduction according to their presentation and the clinical context of the patient.
Uterine arteriovenous malformations: a life threatening emergency in women
Authors: Oraon Bullu Priya
Published: November 2023

Arteriovenous malformation (AVM) refers to an anomalous, non-functional connection between uterine arteries and veins, potentially posing life-threatening risks due to profuse bleeding. AVM involves the growth of arterial and venous channels, fistula formation, and a combination of capillary-like vessels. This case series sheds light on our institution's experience in diagnosing and managing women with this rare gynecological condition. This retrospective study examined cases of uterine arteriovenous malformation in the Department of Obstetrics and Gynecology at RIMS, Ranchi. All three cases presented with heavy vaginal bleeding. One case had a history of medically induced abortion followed by suction and evacuation. Ultrasound color Doppler confirmed the diagnosis. One patient underwent uterine artery embolization using selective coil and foam agents, while two patients opted for hysterectomy. Two of the cases had a history of previous caesarean sections. Uterine AVM should be considered as a potential differential diagnosis in cases presenting with bleeding after abortion or curettage. The aim of reporting these cases is to highlight the common presentation of this condition and aid in its diagnosis and management.
Acute diarrhoea with severe dehydration and complications in a 1-year-old child: a case report in a hospital with low resource setting
Authors: Putri Dessy Natasha A. , Ongo Maria Rupertha D. , Andriany Stephany
Published: November 2023

Diarrhea remains a leading cause of child morbidity and mortality because can lead to complications such as hypovolemic shock, electrolyte disturbances and metabolic acidosis. In this case study, the author would like to demonstrate management of diarrhea in a hospital with limited resources. A 1-year-old boy presented with complaints of watery stools 6 times/day, vomiting 3 times/day and fever. Child appeared weak, refused to drink, experience rapid and heavy breathing, and a loss of consciousness. Physical examination revealed heart rate about 156 per min, peripheral pulse was not palpable, respiratory rate 44 per min, oxygen saturation 98% and temperature about 36.7°C. When crying, the face appeared haggard, the eyes sunken, and there were no tears, reduced bowel noise, longer skin turgor and the capillary refill time increases. Laboratory findings showed leucocytosis (23,600/µl), hyponatremia (127 mmol/l) and hypokalemia (2.66 mmol/l). He was treated with resuscitation fluid administration, Ringer lactate 20 cc/kg BW in 20 min continue with 30 ml/kg BW in 30 min and 70 ml/kg BW 2 hrs 30 min later. The patient was then administered with D5% 500 cc±28 cc sodium bicarbonate, 27 cc+KCL 7.4% within 24 hour. The patient was also given oxygen therapy, antibiotic, probiotics and zinc. The patient was discharged home on hospitalization day 5 with a significant improvement condition. Diarrhea can lead to complications that cause of death in diarrhea cases. This case report highlighted to recognize signs and symptoms and manage severe diarrhea in a hospital with limited resources.
Orthodontic treatment using segmental T loop for correction of ectopically erupting canine: a case report
Authors: Nandeshwar Nivedita A. , Shenoy Usha , Hazare Ananya , Karia Himija , Khorgade Pritam , Bhattacharaya Sangita
Published: November 2023

Most of the patients approach the orthodontist with their prime issue being their appearance. The patient expects the treatment to improve their overall appearance which in turn increases the acceptance by their peers. A 14 year old female report with a chief complain of irregularly placed teeth in upper and lower front region of jaw. After detailed diagnosis her treatment was planned wherein over retained 53 was extracted followed by correction of buccally erupting 13 and correction of crowding and improvement in airway was achieved. Titanium molybdenum (TMA) segmental T loop was used to retract 13. Post-treatment records revealed that treatment objectives were achieved and patient was satisfied with the treatment.
Extensive ileocaval and renal vein thrombosis mimicking acute pyelonephritis
Authors: Khiste Saurabh D. , Avinash Ignatius , Khan Mohammed F.
Published: November 2023

Renal vein thrombosis (RVT) is a rare clinical diagnosis which is the presence of thrombus in the major renal veins or its tributaries. Major causes include nephrotic syndrome, trauma, malignancy, hypercoagulable states. Presentation could be unilateral or bilateral flank pain and/or haematuria. Symptoms could be confused with nephrolithiasis. A normal ultrasonography (USG) in the initial stage could delay the diagnosis and hence propensity for dreaded complications such as loss of renal function and pulmonary embolism. Anticoagulation is the mainstay of therapy for RVT. Review of the literature reveals that thrombolytic therapy can also be used in patients with the most severe disease. Here we present a case of a young male, who initially suspected to have acute pyelonephritis, turned out to have extensive Iliocaval and unilateral RVT secondary to factor V leiden mutation who underwent catheter directed thrombolysis and mechanical thrombectomy.
Anticipated difficult airway management in a case of hemifacial microsomia
Authors: Mutha Sandeep , Pandit Shrirang , K. Sushmitha , Phalgune Deepak
Published: November 2023

Airway management in paediatric patients with facial abnormalities is challenging for an experienced anaesthesiologist. Both mask ventilation and intubation can be difficult or impossible, especially with associated congenital facial anomalies. Hemifacial microsomia (HFM) is linked with mandibular hypoplasia and temporomandibular joint anomalies. These abnormalities may cause problems for direct laryngoscopy and endotracheal intubation.  A case report of a two-year-old child having HFM with a history of failed intubation in the past is presented here. We did manoeuvres for proper fitting of mask and to prevent air leak during mask ventilation. As there was a history of failed intubation, we kept difficult intubation kit including fiberoptic bronchoscopy, video laryngoscopy and ultrasound ready.
Named cells and inclusion bodies in bacterial and viral infections associated with oral cavity
Authors: Dhume Manjeeta S. M. , Dias Clarence P.
Published: November 2023

An oral pathologist can explore the world of intricate features in complicated tissues thanks to this visual speciality. Because our eyes are more accustomed to seeing normal morphology in cells and structures, we can become stuck in a state of flux when we encounter specific ill cells or bodies. Although they may appear to be deceiving, they aid the pathologist in making a diagnosis because they are pathognomonic for numerous diseases and conditions. With a focus on pathogenesis, microscopic features, and stains used to highlight features of the same, the current article is an attempt to compile various histopathological bodies seen in various diseases associated with bacterial and viral diseases associated with the oral cavity.
Variations in fingertip dermatoglyphic pattern in congenitally deaf and mute subjects
Authors: Kaur Harsimarjit , Goyal Ruchi , Bansal Rimple , Chhabra Usha , Kalyan Gurdeep Singh
Published: November 2023

Background: Dermatoglyphics, the scientific study of the origin, development and variation on dermal ridges and patterns on the fingers, palms and soles have been employed to observe association with many congenital defects and genetic diseases. Development of dermal ridges and congenital deafness seems to be interlinked as they develop at about the same time.
Methods: The material for the study consisted of finger and palm prints of congenitally deaf and mute children of 100 subjects with congenital deafness and muteness between 5-21 years of age and 50 control of similar age group with normal hearing and speech were chosen. Digital patterns, triradii, total ridge count were noted.
Results: Overall fingertip pattern of subjects and control when right and left hands were considered together showed significant results in which there was maximum percentage of ulnar loops followed by whorls, carpal arches, composites and least were the tented arches in the subjects. Mean ridge count of all the digits comes out to be less in subjects in comparison to control but it was not statistically significant.
Conclusion: Dermatoglyphics can serve as a simple, inexpensive screening tool but further preliminary investigations are needed to come to a conclusive finding.