bluuebunny/crossref_metadata_2025 huggingface dataset:
Variaciones de la composición nutricional de la leche materna
Authors: Barrios Saavedra Luis Felipe
Published: August 2024

La complejidad de la composición de la leche humana es aún motivo de estudio, tanto a nivel de macronutrientes (carbohidratos, proteínas y lípidos), como de micronutrientes (minerales y vitaminas), así como de los elementos no nutricionales que cumplen un sinnúmero de funciones (anticuerpos, oligosacáridos, microbiota, otros). La evidencia demuestra que la composición varía a través del tiempo de forma tal que se reconocen etapas en la producción de leche materna. También se han establecido variaciones interindividuales entre las madres de neonatos prematuros o madres que acuden a ordeñarse en los bancos de leche cuando su hijo se encuentra hospitalizado. Estas variaciones son motivo de intensas investigaciones para determinar su impacto en la salud del lactante y determinar la necesidad de intervenciones como la fortificación o la suplementación de la nutrición durante la hospitalización. De igual importancia es reconocer factores epidemiológicos que permitan identificar madres en riesgo de presentar variaciones negativas de la composición de la leche que producen.
Evaluation of the Sofa Score in Predicating Outcome of Sepsis Patients Admitted to a Tertiary Care Center in Nepal
Authors: Khanal Sharad , Kumar Yadav Birendra , Subedi Aabishkar
Published: August 2024

Background Sepsis is a major health burden with life- threatening conditions, which leads to a high rate of mortality in patients. The Sequential Organ Failure Assessment (SOFA) score, which assesses organ dysfunction across multiple systems, has been considered a reliable indicator of the severity of critical illness. We have carried out this study to evaluate the predictive value of the SOFA score in assessing the mortality of patients with sepsis on admission.  Methods Our study was a cross-sectional, descriptive study carried out in patients with sepsis who were admitted to the medical ICU of Chitwan Medical College from December 15, 2021, to December 14, 2022. Patient sampling was done based on a non-probability convenience sampling technique.  Results In a study of 130 patients, 54.6% were male and 45.4% were female. The mean SOFA score was 7.1, with a median of 7. 38.5% (50 patients) died due to sepsis. The mean SOFA score was higher among deceased patients (9.3) than survivors (5.8). Higher SOFA scores were associated with increased mortality. 46% of patients required inotropes/Vasopressor support for shock. Patients requiring vasopressor support had a significantly higher mortality rate (53.3%) compared to those who did not need support (25.7%). 13.1% of patients required mechanical ventilatory support, and the majority of these patients (70.6%) had mortality.  Conclusion SOFA score is a valuable tool to assess organ dysfunctions and it can predict the outcome of patients admitted with sepsis.
Association of Platelet Count with Severity of Chronic Liver Disease
Authors: Thapa Bandan , Kumar Yada Birendra , Subedi Aabishkar , Joshi, M Bibek , Yadav Priya , Lamichhane Sharmila , Dahal Reshma
Published: August 2024

Introduction: Chronic liver disease (CLD) is a significant global health concern, encompassing a range of liver pathologies with varying degrees of severity. This cross- sectional study aims to investigate the relationship between platelet count and the severity of CLD. Platelet count is a readily available and cost-effective clinical parameter that may serve as a valuable prognostic marker for CLD progression.  Materials and Method: The study included 122 patients in Chitwan Medical College Teaching Hospital (CMCTH) diagnosed with CLD during one year starting from March 2022. Data were collected using the proforma specially designed for this study. Parameters like age and gender, as well as brief clinical data, including liver function tests, imaging findings, and platelet count, were collected. Patients were then classified into different stages of severity based on established criteria, i.e. child Pugh Score system (CTP score). Statistical analyses were performed using a statistical package for the social science (SPSS); statistical program version 20.0, to explore the association between platelet count and CLD severity.  Results: The majority of patients who had chronic liver disease were found to be high in the age group of 40-60 years. Thrombocytopenia was found in 72.1% of chronic liver disease patients. After classifying the severity of chronic liver disease, it was found that 55.7% of patients had a severe disease that was CTP-C, 36.1% were found to be CTP-B and 8.2% were CTP-A. In patients with normal platelet count, 44.1% had CTP-B, 41.2 had CTPC and 14.7% had CTP-A score. In patients with thrombocytopenia, 61.4% had CTP-C, 33.0% had CTP- B and 5.7% had CTP-A score.  Conclusion: This study provides a valuable snapshot of the potential association between platelet count and the severity of chronic liver disease. The prevalence of thrombocytopenia across different disease stages underscores its clinical relevance. The platelet count is decreased in chronic liver disease, however, it cannot be defined as the sole predictor for the severity of CLD.
Alginic Acid – A Traditional Pharmaceutical Biopolymer with Modern Applications in Novel Drug Delivery
Authors: Dhivya S. , Anandakirouchenane E.
Published: August 2024

Polymer is a class of natural or synthetic substance or material which composed of many repeated subunits of macromolecules. Polymers are basically classified into two groups namely natural polymers and synthetic polymers. Natural biopolymers play essential roles than synthetic due to its unique properties like biodegradability, biocompatibility, and safety. Alginic acid is a biopolymer which is extracted from seaweed- algae sources; mainly from Laminaria. Due to its excellent film formation, biodegradability and biocompatibility nature, alginic acid has a widespread of applications in the drug delivery system.
Representation of Vending Device using Finite State Automata
Authors: Pathak Lakshin , Shah Yashvi
Published: August 2024

Automata theory predominates in a number of applications derived using the technique of a finite state machine . In the paper, we study the representation of a vending machine (VM) that enhances the academic institution’s book delivery service using the concepts of the computation theories. The effectiveness regarding the virtual machine(VM) is viewed as a problem. Automata theory relies on the finite state machine (FSM) design to increase efficiency. The different components of a vending machine are examined at, and it is determined how they can be modelled as finite state machines. We go over the architectural considerations for vending machines, such as the selection of components, the layout of the machine, and the selection of input and output approaches. We use the theory of computation to examine the constraints and difficulties in vending machine design. The paper will design an FSM with fewer states in the end. As a result, we will learn how to increase the VM’s design effectiveness and cost.
Real-Time Human Profiling: Unveiling Age, Gender and Emotions Using Deep Learning
Authors: Kotadia Akshat , Kalavadiya Ekta , Pathak Lakshin , Patel Tvisha
Published: August 2024

This paper introduces the development of a real-time system, which deploys an integrated use of Flask, deep learning, Convolutional Neural Networks (CNNs) and cascade classifier approach to detect age, gender, and emotion from facial images. While its numerous applications—ranging from marketing and medical services to security surveillance—immediately catches the eye, the facial recognition technology is fast becoming the hot topic. Our suggested system aims at absolutely determining the age, gender or emotional state of a person instantaneously in real life. Flask, Python micro web framework, is at the basis of the software, providing the desired functionalities for the exchange of information between the processing engine and the front end. Convolutional Neural Networks (CNNs) which are a part of deep learning for tasks involving feature extraction and classification are the main tool used by most learning algorithms. CNNs are widely used in face recognition systems mainly due to the fact that they perform very well at such tasks as image processing. On the one hand, the model uses cascade classifiers for superior face detection, thereby finding and separating face regions in input images or video streams. Unlike some of the approaches that require heavy computation, these classifiers are computationally light solutions that can run in real-time even on resource- limited devices. The system capacity to identify age, gender, and emotion accurately in real-time is exemplified through: performance evaluation. We have used various means to stress the system and ensure that it is precise and offers timely results over the given period. By means of varied testing stages, we have discovered that the system usually brings high levels of precision and validity for the numerous data sets and trial situations. In this regard, be it differentiating between individuals’ age or readily identifying the exact gender or recognizing nuanced emotional clues, the system performs at the optimum level.
The Effect of Green Human Resource Management and Green Innovation on Environmental Performance with Employee Green Behavior as a Mediating Variable: A Case Study of PT. PLN (Persero) Distribution Jakarta Raya
Authors: Adi Chandra Rachmat , Pendrian Okder
Published: August 2024

Global warming and other environmental issues have become a major focus on the global agenda. Indonesia, as a developing country with a significant industrial sector including the electricity industry, faces significant challenges related to carbon emissions and environmental impacts. This study aims to investigate the influence of Green Human Resource Management (Green HRM) and Green Innovation on company Environmental Performance, considering the role of Employee Green Behavior as a mediator at PT. PLN Distribution Jakarta Raya. The research adopts a quantitative descriptive approach with a cross-sectional design. The research sample consists of employees from PT. PLN Distribution Jakarta Raya selected through purposive sampling. Data were collected via questionnaires and analyzed using Structural Equation Modeling (SEM) with Partial Least Squares (PLS). The analysis results indicate that Green Human Resource Management (H1) significantly and positively influences Employee Green Behavior and Environmental Performance at PT. PLN Distribution Jakarta Raya. Furthermore, Green Innovation also has a significant positive effect on employees' green behavior and Environmental Performance in the company. Employee Green Behavior has been shown to contribute significantly to Environmental Performance. However, the influence of Green Innovation on Environmental Performance is not significant. Moreover, Employee Green Behavior can act as a mediator linking the influence of Green Human Resource Management on Environmental Performance, but not in the case of Green Innovation. This study contributes to the fields of environmental management and human resources by highlighting the importance of integrative strategies to achieve better Environmental Performance in companies. The next step involves implementing these practices on a broader scale to support environmental sustainability in the future.
Quantum-Accelerated Flight Selection: Probing Grover's Algorithm and Quantum Device Efficiency
Authors: Hire Jayesh , Gawande Vaidehi , Dhande Sagar
Published: August 2024

Current flight search platforms primarily consider four essential factors when planning a trip: departure/arrival dates, as well as the origin and destination locations. However, when additional parameters are added to this search, the problem shifts from a simple to a complex search, as the engine must sift through a massive dataset of flights, including information on airlines, flight routes, fees, and more. To address this challenge and improve flight search efficiency amidst data-intensive and resource-demanding environments, this paper proposes the use of Grover's search algorithm. This algorithm is demonstrated as the optimal solution for searches with increased constraints. The paper highlights the practical application of Grover's search algorithm across three datasets of assorted sizes, as well as various quantum hardware and simulators available in the NISQ era. Furthermore, this paper provides an in-depth understanding of the complexity of quantum circuit design, including the key phases of state encoding and amplitude amplification. The effectiveness of these approaches is evaluated through analysis of execution times and quantum measurement results. The aim is to showcase the potential of quantum computing in revolutionizing real-world search tasks, particularly in the realm of flight selection.
KEDİ VE KÖPEK DAVRANIŞ BOZUKLUKLARINA FARMAKOLOJİK YAKLAŞIM
Authors: Çelen Tekedereli Şükran , Baydan Emine
Published: August 2024

Davranış bozukluklarının tedavisinde öncelikli olarak davranış terapileri kullanılmaktadır. Tedaviye başlamadan once ilk olarak temelde yatan nedenin tespitinin yapılması ve gerekiyorsa bu terapilere destek amaçlı ilaç kullanımı yapılmalıdır. Davranış bozukluğuna neden olan etkenler fizyolojik ya da psikolojik etkenlerdir. Bazen davranış terapisi, çevrenin düzenlenmesi, hasta sahibinin pozitif yönlendirilmesi ile belirli bir düzeye ve belirli bir noktaya kadar davranış bozukluğu tedavi edilebilmektedir. Özellikle fizyolojik nedenlere bağlı davranış bozukluklarında vücutta salınım mekanizması bozulan ya da olmayan bazı biyolojik faktörlerin yerine konması ile tedavi mümkün olabilmektedir. Bununla birlikte, davranış bozukluklarını doğru teşhis edebilmek amacıyla öncelikle normal hayvan davranışlarını anlamak gerekmektedir. Bu derlemede, normal hayvan davranışları anlatılarak, davranış bozukluklarında kullanılan farmakolojik tedavi unsurları ele alınmıştır.
Graph-based two-level indicator system construction method for smart city information security risk assessment
Authors: Yang Li , Zou Kai , Zou Yuxuan
Published: August 2024

The rapid development of urban informatization has led to a deep integration of advanced information technology into urban life. Many decision-makers are starting to alleviate the adverse effects of this informatization process through risk assessment. However, existing methods cannot effectively analyze internal and hierarchical relationships because of the excessive number of indicators. Thus, it is necessary to construct an indicator's dependency graph and conduct a comprehensive hierarchical analysis to solve this problem. In this study, we proposed a graph-based two-level indicator system construction method. First, a random forest was used to extract the indicators' dependency graph from missing data. Then, spectral clustering was used to separate the graph and form a functional subgraph. Finally, PageRank was used to calculate the prioritization for each subgraph's indicator, and the two-level indicator system was established. To verify the performance, we took China's 25 smart cities as examples. For the simulation of risk level prediction, we compared our method with some machine learning algorithms, such as ridge regression, Lasso regression, support vector regression, decision trees, and multi-layer perceptron. Results showed that the two-level indicator system is superior to the general indicator system for risk assessment.
Some properties of weaving $ K $-frames in $ n $-Hilbert space
Authors: Wang Gang
Published: August 2024

$ K $-frames are more generalized than ordinary frames, particularly in terms of their weaving properties. The study of weaving $ K $-frames in Hilbert space has already been explored. Given the significance of $ n $-Hilbert spaces in functional analysis, it is essential to study weaving $ K $-frames in $ n $-Hilbert spaces. In this paper, we introduced the notion of weaving $ K $-frames in $ n $-Hilbert spaces and obtained some new properties for these frames using operator theory methods. First, the concept of weaving $ K $-frames in $ n $-Hilbert spaces is developed, and examples are given. By virtue of auxiliary operators, such as the preframe operator, analysis operator, and frame operator, some new properties and characterizations of these frames are presented, and several new methods for their construction are given. Stability and perturbation results are discussed and new inequalities are established as applications.
Voluntary turnover of high achievers: A systems psychodynamics analysis with CIBART
Authors: McComb Calum B. , Barnard Antoni
Published: August 2024

Orientation: Voluntary turnover is a costly and frequently disruptive organisational phenomenon, particularly when it involves high achievers.Research purpose: The study aimed to develop a psychodynamic exposé of voluntary turnover by applying the conflict, identity, boundaries, authority, roles and task (CIBART) model to the lived experiences of high achievers.Motivation for the study: The research primarily focusses on voluntary turnover as an individual, rational decision-making process. It recognises the contribution of unconscious systems psychodynamics to voluntary turnover. Research conducted from this perspective is necessary to gain a more comprehensive and in-depth understanding of the topic.Research approach/design and method: Seven case studies of individual voluntary turnover were conducted in a large private retail company. Data were collected using free association narrative (FANI) interviews. The analysis of the data was guided by hermeneutic phenomenology, and the interpretive frame used was the CIBART model.Main findings: Six themes were constructed to describe the conflict dynamics along each of the six CIBART dimensions. Within each theme, the conflict dynamic is exposed, revealing the subsequent anxiety and defences that accumulate leading to the decision to leave. Ultimately, the six themes synthesise to propose that voluntary turnover is a conscious manifestation, yet an unconscious defence against system-wide conflict.Practical/managerial implications: Facilitating leaders’ understanding and processing of the conflict dynamics that occur across the CIBART dimensions, and which contribute to voluntary turnover, create opportunities for both transformation and prevention.Contribution/value-add: The research offers insights into the psychodynamics of voluntary turnover, which consulting psychologists and organisational leaders can utilise to address this phenomenon within their work groups.
Feeding Behavior among Health-care Workers in a Tertiary Health Institution Southeast Nigeria
Authors: Nnadozie Ugochukwu Uzodimma , Asouzu Nwabumma Cynthia , Asouzu Nonso Christian , Anekwu Emelie Moris , Obayi N. Okwudiri K. , Maduba Charles Chidiebele , Anamazobi Adaobi Esther , Anikwe Christian Chidebe , Nnolim Ikenna Bede , Nnadozie Adaobi Azuka
Published: August 2024

Background:

Feeding behavior is an important factor in the prevention and management of noncommunicable diseases, which are the leading cause of death globally.

Objective:

This study is aimed to investigate the feeding behaviors among health-care workers in a tertiary hospital in southeast Nigeria.

Materials and Methods:

The study was a cross-sectional survey. A total of 418 participants (186 males and 232 females) were involved in the study. The instrument is a sociodemographic questionnaire and a modified form of the British Heart Foundation's questions to assess the nutritional value of individuals. The participants were consecutively recruited from their workstations. Data were collected using self-administered questionnaires, which were hand distributed and collected back on the same day after completion.

Results:

The study showed that health workers in the teaching hospital had an overall “fair” feeding behavior (86.13 ± 8.52 out of 140). It also showed that females had a significant (P < 0.05) overall better feeding behavior (88.15 ± 9.00) compared to males (83.62 ± 7.18). The studied participants had poor feeding behavior in carbohydrates and fats and oil consumption and just fair behavior in fruits and vegetables, salt intake, and water consumption. The feeding behavior was inadequate, and there was no significant gender or profession-related differences in the overall behavior of the participants.

Conclusion:

The health-care workers in the tertiary health institution in southeast Nigeria have inadequate feeding behavior. They should join in the global call and awareness on healthy feeding behavior to prevent and reduce the burden of noncommunicable diseases.
Tuberculosis Stigma
Authors: Junaid Salamah Abimbola , Kanma-Okafor Oluchi Joan , Olufunlayo Tolulope Florence , Odugbemi Babatunde A. , Ozoh Obianuju Beatrice
Published: August 2024

Context:

Tuberculosis (TB), though preventable and curable, remains a global health problem, ranked one of the top causes of death worldwide, despite the World Health Organization's strategies. This may be due to the stigma surrounding the disease.

Aim:

This study assesses TB stigma in light of knowledge, attitudes, and preventive practices among individuals in an urban community.

Settings and Design:

This was a descriptive, cross-sectional study among 317 residents of Surulere, Lagos, Nigeria, selected by multi-stage sampling.

Subjects and Methods:

Data were collected using a pretested, semi-structured, interviewer-administered questionnaire and analyzed using Epi InfoTM version 7.2.2.6 2018 (Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA).

Statistical Analysis Used:

Descriptive variables were summarized as frequencies, and the Chi-square test was used to test the associations. The level of significance was predetermined at P ≤0.05.

Results:

Most participants were between the age group of 21 and 40 years. Approximately 9 out of every 10 respondents (91.8%) were aware of TB. Overall, only 2.4% of respondents had good knowledge of TB, more than half (59.1%) had positive attitudes toward TB, about one-third (37.1%) had good preventive practices and 22.7% of respondents expressed TB stigma, 63.6% would show no compassion or desire to help people with TB while 64.3% would rather people with TB were never employed. However, good knowledge translated into less stigma (P <0.001).

Conclusions:

Most participants were aware of TB, although knowledge, attitude, and practice levels were poor. Knowledge was found to reduce TB stigma, reinforcing the need for improved community literacy regrading TB. This has the potential to influence health-seeking behavior and promote better TB prevention, detection, and treatment outcomes.
An Unusual Presentation of Sarcoidosis: The Great Mimicker
Authors: Kumar Sunil , Garg Ajay , Taneja Sheena , Chander Ayushi , Vyas Harsh
Published: August 2024

ABSTRACT

Sarcoidosis is a very well-known disease for its variable clinical and radiological presentation. Thoracic involvement is the commonest manifestation of sarcoidosis followed by skin. We present here an interesting case report of an old-age patient with an unusual presentation of sarcoidosis. He was previously treated for leprosy based on skin biopsy with partial relief only. The unusual things in this patient were clinical and radiological findings. Clinically, he had only complaints of weight loss which had not been reported earlier; second, the skin lesions were not typical. The unusual radiological things were a disproportionate distribution of radiological lesions and predominant consolidation. Lower lobe consolidation in sarcoidosis is rarely reported, which was present in this patient. The perilymphatic micronodules were more concentrated on the right upper lobe as compared to the left upper lobes. Based on this case report we cannot deny the wrong diagnosis of leprosy because both diseases share common clinical and histopathological features.
“COVID-19 vaccination and the mentally ill” – A comparative study on knowledge and attitude toward COVID-19 vaccine between patients with mental illness and their caregivers from Southern India
Authors: Pushpalal Gargi , Muruganandam Partheeban , Subramanian Karthick , Balasundaram Sivaprakash
Published: August 2024

Background:

Patients with mental illness are at an increased risk of contracting COVID-19 infection. Hence, there is a need to understand their awareness, attitude, and willingness to accept the novel COVID-19 vaccine as well as of their caregivers. Our study aimed to find the differences in knowledge, attitude, and perceptions of patients with mental illness and their caregivers toward the COVID-19 vaccine.

Methodology:

A cross-sectional comparative study was conducted among patients with clinically stable psychiatric illness and their age-matched caregivers at a tertiary hospital. A validated questionnaire was used to check their knowledge, attitude, perception, and motivation toward the COVID-19 vaccine. Assessment of functioning was made using the global assessment of functioning scale.

Results:

Four hundred and sixteen individuals were included (208 in each group). There was no statistically significant difference between patients and caregivers regarding knowledge scores. Patients with anxiety disorders showed higher mean knowledge scores, and those with substance use disorders showed lower mean knowledge scores. Majority of the patients were not aware of the name of the vaccine (60%) but were willing to take the vaccine (76%), felt vaccination to be safe (69%), agreed that the vaccine will be protective (71%) and believed that despite vaccination, COVID precautions have to be followed (89%).

Conclusion:

The knowledge, attitude, and willingness toward the COVID-19 vaccine were similar across patients and caregivers in contrast to expectations. Patients with substance use disorders must be given more information, with emphasis on vaccination implementation. Importantly, improving the caregivers’ awareness can further improve the vaccination rate among this vulnerable population.
Fetal and neonatal outcomes of pregnancies with antenatal ultrasound findings
Authors: John Elizabeth Mary , Pournami Femitha , Prithvi Ajai Kumar , Panackal Anila V. , Prabhakar Jyothi , Jain Naveen
Published: August 2024

Background:

Detection of variations or abnormalities in antenatal fetal ultrasound scans helps in planning further follow-up and intervention. Sometimes, finding soft markers could alarm anxious families. Systematic studies on clinically relevant outcomes would aid in prognostication, allay anxieties and help in designing reporting templates.

Methodology:

This retrospective study included pregnancies that were flagged with any fetal ultrasound finding by the high-risk obstetrics department during the study period. We studied the proportion of those with any one of adverse fetal/neonatal outcomes (AFNO): (a) fetal loss (b) neonatal death; or who required (c) surgical intervention (d) neonatal intensive care support (e) periodic follow-up related to the finding. A descriptive analysis of findings and specific AFNO were also conducted.

Results:

Of 1495 scans, 495 had at least 1 ultrasound finding. Complete details of primary outcome were available for 360 pregnancies; 60 (16.7%) had AFNO. Most common were cardiac echogenic focus (19.5%), prominent cavum vergae (12.6%), urinary tract dilatation (9.3%), and choroid plexus cyst (8.9%). The above-isolated findings had good outcomes (AFNO in 4.6%). Overall, AFNO were noted in 12.7% of those with single findings. Brain anomaly, omphalocele, and hydrops had poor outcomes. With 2 and 3 findings in combinations, 22.1% and 44.4% had AFNO, respectively.

Conclusions:

AFNO were noted in 16.7% of those with any fetal ultrasound finding. When expectant families are informed about specific isolated soft markers (echogenic cardiac focus, cavum vergae, echogenic bowel, hypoplastic nasal bone, choroid plexus cyst, single umbilical artery) clinicians may also reassure the low association of AFNO.
A comparative study to see the outcome in patients suffering from fissure-in-ano following modified closed lateral internal sphincterotomy, closed lateral internal sphincterotomy, and fissurectomy
Authors: Ghose Sivaji Sankar , Chowdhury Mili Das , Dharmamer M. Y.
Published: August 2024

Background:

The present study was undertaken to evaluate the comparative results of “Modified Closed Lateral Internal Sphincterotomy (LIS), Closed LIS, and Fissurectomy” technique in treating fissure-in-ano in terms of relief of symptoms, healing of wound, postoperative hospital stay, recurrence rate, and postoperative complications.

Materials and Methods:

A total of 120 cases with definite history of fissure and clinically diagnosed cases of fissure-in-ano were selected for the study. A final diagnosis was made after proctoscopic examination under anesthesia during operation. The type of procedure which was to be undertaken was done by letting patient pick up slips randomly where the name of the procedure was written. Total 120 slips were made with 40 slips of each procedure written in them. Postoperative period was closely monitored, and all the cases were meticulously followed for a variable period of time.

Results:

In the present study, 68% of the patients were male and 32% were female. It was more prevalent in the age group of 18–40 years. Forty patients underwent modified closed LIS, 40 underwent closed LIS, and remaining 40 patients underwent fissurectomy. Postoperative pain, operative time, duration of hospital stay, and recurrence rate were compared.

Conclusion:

Fissure-in-ano is a very painful condition and may cripple the daily activity of the patient. Encouragingly, high success rates were achieved in our patients with the modified closed LIS technique.
Erroneous display of inhalational agent..!
Authors: Agnihotri Anamika , Mali Minal C. , Valasareddy Sunil Kumar
Published: August 2024

A well-equipped anesthesia workstation is a boon for better anesthesia practice. Advancement in technical aspects such as respiratory gas analysis made perioperative care better and safer. Any kind of equipment troubleshoot can contribute to morbidity and mortality; however, the magnitude of these is not established.
Pattern of adverse events following immunization of COVID vaccination among adolescents in Union Territory of Puducherry, India
Authors: Maharani B. , Jafrin A. Lourdu , Babu L. N. , Mathiyalagen Prakash
Published: August 2024

Background:

Adolescents’ COVID-19 vaccination (15–18 years) was advised by the Ministry of Health and Family Welfare to protect the vulnerable group against COVID-19 infection and reduce the severity of the illness. The information on the pattern of adverse events following immunization (AEFI) following COVID-19 vaccination among adolescents is not available in the Indian population. This study aimed to assess the pattern of AEFI following COVID-19 vaccination among 15–18-year adolescents in the Union Territory of Puducherry and identify the various remedial measures to manage the encountered AEFIs and their impact on the AEFI.

Methodology:

A questionnaire-based cross-sectional study was conducted in government, government-run, and private schools after obtaining necessary approval from the concerned in Pondicherry. A pretested and content-validated questionnaire consisting of demographic details of the participants, name of the COVID-19 vaccine, number of doses taken, various AEFI, onset of symptoms and its duration, various remedial measures employed, and details of AEFI reported was utilized for the study. Responses were obtained either through Google Forms or by administering the questionnaire in person. Data were entered in MS Excel, and analysis was performed using SPSS. Frequency and percentage were used to represent the categorical data. Mean and standard deviation were used to represent the quantitative data. The Chi-square test/Fisher’s exact test was used to find the association between the categorical data. P <0.05 was considered as statistically significant.

Results:

About 75.7% of recipients received Covaxin, 22.4% received Covishield, and 1.9% received other vaccines. About 96.9% said that they encountered adverse events following vaccination. The most common adverse event reported was pain at the injection site, tiredness, fever, myalgia, headache, hypersomnia, and joint pain. Less common adverse events, such as insomnia, vertigo, giddiness, nausea, and vomiting, were also reported by the participants. Fever (P < 0.001), headache (P < 0.001), joint pain (P < 0.05), and giddiness (P < 0.01) were significantly more among Covishield recipients than Covaxin recipients. There was a statistically significant absence of AEFI and also fewer symptoms among boys when compared to girls. Duration of AEFI among girl participants was 2.43 ± 1.799, which was significantly (P < 0.001) more than the boys 2.03 ± 1.798. None of the study participants reported AEFI to the health-care authority.

Conclusion:

Information obtained in the study shows that COVID-19 vaccination is relatively safer in the adolescent population also with minimal adverse events similar to adults.
A case of enteric fever complicated by hemophagocytic lymphohistiocytosis probably induced by ChAdOx1 nCoV-19 COVID-19 vaccine
Authors: Cherian Mathew , Thampi Siddhant Jeevan
Published: August 2024

Although enteric fever is a relatively common disease in countries mainly belonging to South Asia (incidence of around 100/100,000 persons per year) where there is poor hygiene, its complications in the form of hemophagocytic lymphohistiocytosis (HLH) are rare but have been documented before. Here, we present the case of a 19-year-old boy diagnosed with enteric fever with secondary HLH possibly induced by the COVID-19 vaccine (COVISHIELD ChAdOx1 nCoV-19 coronavirus vaccine [Recombinant]). Although there is no proof that the vaccine could have induced secondary HLH, its possibility cannot be ruled out simultaneously. Early identification and diagnosis of HLH are of extreme importance. If not treated correctly, mortality can reach up to 40%. In this article, we would like to press upon the clinical presentation, diagnosis, and management of such a case and the possibility of this presentation being induced by the COVID-19 vaccine.
Plasma cell periodontitis: A rare disease entity with unique clinical and histopathological features
Authors: Yasmine Hanine , Maryam Chaddadi , Reda El Ochi Mohamed , Amine Cherkaoui
Published: August 2024

Plasmacytoid mucositis is a rare form of periodontal disease characterized by the infiltration of plasma cells into the gingival tissues. This case report highlights a unique case of plasmacytoid mucositis with periodontal involvement in a young woman. A 32-year-old female presented with gingival hyperplasia and cheilitis. The clinical examination revealed the presence of deep periodontal pockets, severe gingival inflammation, and bone loss. The patient was treated with a combination of nonsurgical periodontal therapy, systemic antibiotics, and oral hygiene instructions. After 2 months of the treatment, the patient showed significant improvement in the clinical parameters. This case report adds to the existing literature on this condition, emphasizing the importance of early diagnosis and prompt treatment. It highlights the need for a multidisciplinary approach involving periodontists, histopathologists, and microbiologists. The lesson to be learned from this case report is that plasmacytoid periodontitis should be considered and a biopsy should be performed to confirm the diagnosis.
Impact of periodontal phenotype on the outcome of subgingival instrumentation in Stage II and III, Grade A and B periodontitis
Authors: Kant Krishan , Sharma Rajinder Kumar , Tanwar Nishi , Tewari Shikha , Sangwan Aditi
Published: August 2024

Background:

The influence of periodontal phenotype (PP) has been documented in the outcomes of various surgical periodontal interventions such as crown lengthening, mucogingival surgery, implant restoration, and open flap debridement. Previous studies with smaller sample sizes have assessed the role of PP on the outcome of nonsurgical periodontal therapy with inconsistent results.

Aim:

The aim of the current interventional study is to estimate the influence of PP on the outcome of subgingival instrumentation in Stage II and III, Grade A and B periodontitis.

Materials and Methods:

Fifty-two patients (n = 27 thick PP and n = 25 thin PP) underwent subgingival instrumentation using ultrasonic scalers and curettes under local anesthesia in a single sitting, and periodontal parameters were recorded at baseline, 2, 4, and 6 months. The McNemar and Chi-square tests were applied for categorical data, whereas the Wilcoxon signed-rank test and Mann–Whitney U-test were applied for continuous data in intra- and intergroup comparisons, respectively.

Results:

Significantly better improvements in deeper pockets (>5 mm) with thick PP were observed. Loss of attachment was found in thin, bleeding on probing (BOP)-negative sites with an initial probing depth of ≤3 mm. However, BOP-positive sites belonging to both groups exhibited higher improvements in terms of clinical parameters.

Conclusion:

Probing depth, PP, and periodontal inflammation recorded in terms of BOP influence the gain in clinical attachment following subgingival instrumentation.
Assessment of nutritional status in chronic periodontitis patients: A cross-sectional study
Authors: Bhatsange Anuradha , Kamble Sanika Prakash
Published: August 2024

Background:

This cross-sectional study compared the nutritional status of chronic periodontitis (CP) patients who presented with various degrees of severity with systemically healthy individuals using the Mini Nutritional Assessment (MNA®) tool along with laboratory analysis of macro- and micronutrients.

Materials and Methods:

This research enrolled a total of 84 participants, of which 63 belonged to the CP group while 21 served as healthy controls. The CP patients were divided into three groups of 21 each, based on severity as mild, moderate, and severe. Clinical periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment level/loss, total number of teeth present [NOT-P], furcation involvement, pathological migration, and tooth mobility), biochemical parameters (lipid, protein, iron profiles, and Vitamin D3 and B12), and the MNA® tool were used to assess the nutritional status of all the participants. The results were analyzed statistically.

Results:

NOT-P, MNA score, lipid profile (except very-low-density lipoprotein), iron profile (except total iron-binding capacity), and Vitamin D3 showed high significant differences (P < 0.001) among the groups. However, Vitamin B12 and protein profile except for total protein revealed significant differences (P < 0.05).

Conclusion:

CP can be a contributing risk factor for the development of malnutrition. MNA® tool can be used for assessing the nutritional status of CP patients.
Predictive Effect of Methylene Tetrahydrofolate Reductase Variants on Vascular Related Crisis
Authors: Patel Suprava , Nanda Rachita , Hussain Nighat , Mohapatra Eli , Patra Pradeep Kumar
Published: August 2024

BACKGROUND:

Homocysteinemia is regarded as potential predictor for vaso-occlusive phenomenon often observed in sickle cell hemoglobinopathy. The objective was to determine the relationship of these genotypes with homocysteinemia and the predictive coefficient of these polymorphisms on the vascular-related crisis in the presence of sickle cell gene.

MATERIALS AND METHODS:

The case-control study comprised 89 children diagnosed with sickle disease with features of vascular crisis, 160 children without crisis and 252 apparently healthy children as the control group. The genotypes were assayed for C677T and A1298C variants and their association and predictor effect for homocysteinemia of different grades were analyzed. Sequential multiple regression model was used to assess the predictive effect.

RESULTS:

Homocysteine levels were significantly higher in the crisis group (P < 0.001). When compared to the wild genotype the variants depicted significantly raised homocysteine levels (P < 0.001). The prevalence of C677T was 29.9% and that for A1298 was 66.3% in the study population. The odds for crisis was 2.3 times for crisis in TT677 and 1.34 times in CC1298 variants. The genotypes revealed a significant association with different grades of homocysteinemia (P < 0.001). Plasma homocysteine depicted significant negative correlation with weight, height, body mass index and hemoglobin levels. None of the TT variants reported normal homocysteine values. Shift toward the variant form showed an increase of homocysteine levels by 7.3 units and 6.9 units for C677T and A1298C single-nucleotide polymorphisms respectively.

CONCLUSION:

Co-presence of methylenetetrahydrofolate reductase C677T and A1298C polymorphisms could be important predictor for homocysteinemia and thus contribute toward vascular crisis in sickle cell patients.
Challenges in the Diagnosis of Gaucher Disease with Multiple Splenic Lesions
Authors: Alshomar Ahmad
Published: August 2024

The progressive nature, multisystem involvement, and delayed diagnosis of Gaucher disease (GD) make it a challenging disorder. Herein, we report the clinical and genetic findings of a patient with GD of Saudi-Arab ethnicity. In this case, a young patient was discovered to have hepatosplenomegaly and whose radiological image revealed an unusual presentation of multiple nodular lesions in the spleen that were initially thought to represent benign hemangiomas. He had a splenectomy with a liver biopsy, which revealed features consistent with GD. The activity of β-glucocerebrosidase in dry blood spots was below its cutoff value. Molecular genetic analysis of the glucosylceramidase beta gene confirms the diagnosis. Enzyme replacement therapy was initiated.
Molecular Alterations in IDH 1/2 Genes among Iraqi Adult Acute Myeloid Leukemia Patients
Authors: Jaleel Al-Shammari Haider Hasan , Al-Rubaie Haithem Ahmed , Al-Badran Ihsan Mardan
Published: August 2024

BACKGROUND:

The recurrent somatic variations in IDH1/2 genes in AML play imperative roles in epigenetic dysregulation and the pathogenesis of AML, which could be useful prognostic markers for risk stratification.

AIM:

The aim of the study was to detect the frequency of R132 mutations in the IDH1 gene and R140Q mutation in the IDH2 gene with their treatment outcomes.

PATIENTS, MATERIALS AND METHODS:

IDH molecular alterations were detected by high-resolution-melting (HRM)-based real-time PCR assay in 56 newly diagnosed AML patients.

RESULTS:

IDH molecular alterations were identified in 39.3% of AML patients; IDH1 R132 and IDH2 R140Q mutations were present in 32.1% and 12.5% of patients, respectively. The mean age of patients with mutant IDH (52±14.87 years) is higher than in wild type (41.68±20.4 years), P = 0.041. Females were seen in 53% of mutant IDH patients while in the wild-type 73.3% were males (P = 0.038). There were significantly lower mean levels of hemoglobin, absolute neutrophil count, and platelet count in mutant IDH than in wild-type (P = 0.015, 0,.03 and 0.01, respectively). After induction remission therapy, 68.2% of mutated IDH and 64.7% of unmutated IDH patients didn't achieve complete remission (P > 0.05). After 6 months; 59.1% of mutated IDH and 64.7% of unmutated IDH had unfavorable outcomes (P > 0.05).

CONCLUSIONS:

IDH mutations are common in Iraqi adult AML patients and present in older age and females predominance with lower Hb level, WBC count, absolute neutrophil count, platelet count, and less extramedullary involvement. There is an insignificant association with treatment outcomes.
Ramifications of Pancytopenia in Children in a Tertiary Care Center in North Indian
Authors: Gupta Nikhil , Chalotra Sonam , Parihar Ravi Kumar , Sharma Preeti
Published: August 2024

BACKGROUND:

Pancytopenia generally suggests the likelihood of bone marrow failure syndromes or leukemias. However, other easily treatable entities can also cause pancytopenia. To know the underlying cause of pancytopenia is essential for definite management and prognosis.

AIM:

The aim of this study is to study the prevalence, clinico-hematological profile, and etiology of pancytopenia in hospitalized children of 1 month to 18 years of age.

METHODS:

Descriptive study conducted in a tertiary care center included children of age 1 month to 18 years hospitalized with pancytopenia. Sociodemographic data, presenting complaints, and detailed history were noted. Detailed clinical examination and relevant investigations were done.

RESULTS:

The prevalence of pancytopenia was 2%. Majority of the patients were >10 years of age. Female: Male ratio was 1.15:1. The most common presentation was progressive pallor, followed by fever, icterus, and bleeding manifestations. The most common clinical examination finding was pallor, followed by splenomegaly, hepatomegaly, icterus, and lymphadenopathy. Macrocytic blood picture was most common, followed by microcytic, atypical cells, and normocytic picture. Mean serum ferritin (ng/ml) was 374.77 ± 1662.64. Mean serum B12 (pg/ml) was 117.72 ± 64.71. In bone marrow aspirate examination, megaloblastic erythropoiesis was most common, followed by normoblastic erythropoiesis, dual deficiency, malignant cells of lymphoid series, hypocellular marrow, and malignant cells of myeloid series. Megaloblastic anemia was the most common etiology, followed by dimorphic anemia amid acute leukemia.

CONCLUSION:

The study showed that megaloblastic anemia and infections (tuberculosis, dengue fever, and enteric fever) both of which are eminently treatable, cause nearly 65% of pancytopenia cases in pediatric patients.
Enhancing Communication with ChatGPT: A Guide for Academic Writers, Teachers, and Professionals
Authors: Giray Louie
Published: August 2024

ChatGPT has the potential to improve communication. ChatGPT can help with the 7Cs of effective communication: clarity, coherence, conciseness, concreteness, correctness, completeness, and courtesy. ChatGPT can make complex ideas simple for clarity. It can suggest transitions for coherence and provide concise responses. It offers concrete details and examples, making information relatable. ChatGPT generates grammatically correct and thorough information, contributing to correctness and completeness. It also maintains a courteous tone and suggests polite language choices. However, ChatGPT has limitations. It can sometimes lack accuracy, struggle with understanding context, or miss empathy. It may also give incomplete or generic answers. Academic writers, teachers, and professionals should use ChatGPT carefully. They need to verify information independently and evaluate suggestions critically. By combining ChatGPT with human judgment and editing, they can improve their communication. Responsible use of ChatGPT as a support tool can enhance communication in professional settings.
An unexpected culprit of haemoptysis: Bronchial varices and review of literature
Authors: Bansal Avdhesh , Sharma Priya
Published: August 2024

Bronchial varices, characterized by dilated and tortuous vessels within the bronchial tree, are a rare entity often presenting as massive or recurrent haemoptysis. Multiple aetiologies have been described in the literature including congenital or acquired pulmonary vein stenosis secondary to surgical or radiofrequency ablation or other cardiac interventions. We present a case of a 60-year-old female with a history of systemic hypertension, hypothyroidism and sick sinus syndrome, who presented with intermittent episodes of dry cough and haemoptysis. A diagnostic workup revealed circumferential bronchial thickening and pulmonary vein stenosis on contrast-enhanced chest computed tomography (CT). Bronchoscopic findings confirmed the presence of bronchial varices, which was secondary to the Radiofrequency ablation she underwent 7 years ago. This case highlights the diagnostic challenge posed by bronchial varices and underscores the importance of a comprehensive approach in managing such rare presentations.