bluuebunny/crossref_metadata_2025 huggingface dataset:
“Life is about trying to find a better place to live”: Discourses of dwelling in a pro-recovery suicide forum
Authors: Alvarez Mike
Published: May 2022

In the two decades since the advent of Web 2.0, scholars of cybersuicide have identified many beneficial and harmful uses of the internet. However, the discursive meanings interactionally created by suicide website users have scarcely been attended to. The present study uses the theory and method of cultural discourse analysis (CuDA) to arrive at meanings about place that radiate from online communication among users of SuicideForum.com (SF), a pro-recovery website. Analyses of 2,119 posts across 131 threads reveal two overarching discursive themes. The first speaks to problematic discourses about place, including the role of placelessness and entrapment in the genesis of suicidality and its affective states, leading to further diminution of experiential worlds. The second theme taps into participants’ notions of what constitutes safe spaces, such as the presence of empathetic others who respect one’s timetable for personal disclosure, and the freedom to experiment with new ways of inhabiting the world. The study has numerous implications for clinical practice, including recasting psychological disturbances in terms of self-world relations and reconsidering involuntary psychiatric hospitalization in light of forum participants’ preoccupation with entrapment.
Evaluation of Smartphone usage as a Predictor of Social Jetlag in University Students
Authors: Mehta Karan V. , Mahajan Neeraj R. , Upadhyay Dishant B. , Jadeja Taxashil H. , Sevak Rajkumar J.
Published: May 2022

Background:

Individual sleep and activity patterns show large variations and are interfered considerably by social schedules. Social jetlag (SJL) is the difference between intrinsic circadian rhythm and extrinsically enforced sleep-wake cycle. However, little is known about the variables affecting the severity of SJL.

Methodology:

We evaluated whether sleep- or smartphone-related variables affected the severity of SJL among college students in India. A total of 1175 students from medicine, dental, engineering, paramedical, and other colleges in Gujarat, India, completed a web-based survey. The survey included demographic questions and questions from the Smartphone Addiction Scale-Short Version (SAS-SV), reduced Horne and Ostberg Morningness-Eveningness Questionnaire (rMEQ), and Munich Chronotype Questionnaire (MCTQ). The responses to the MCTQ determined SJL scores.

Results:

Outcomes from multiple linear regression analysis indicated that the sleep length on free-day (B = 0.42), chronotypes (B = 0.44, B2 = 0.40) maximum smartphone usage time after waking up (B = 0.92), smartphone addiction severity (B = –0.01) and free-day sleep onset range (B = –0.02) significantly predicted SJL scores (P < 0.03). The SJL severity was 0.42 and 0.40 units greater in individuals with morning-type and evening-type, respectively, compared to the neutral-type rMEQ category. The SJL severity was 0.92 units greater in individuals whose smartphone usage was maximum right after waking up compared to those whose usage was maximum during other times of the day. Every unit increase in SAS score decreased SJL by 0.01 units.

Conclusion:

These results indicate that SJL severity is affected by several factors, which can be targeted for developing interventions for reducing SJL among college students in India.
Effect of plateletpheresis on donor variables and platelet yield using three different cell separators: Experience from tertiary care hospital
Authors: Sharma Sarita , Bundas Sunita , Prinja Nippun , Sharma Amit , Narain Rachna
Published: May 2022

INTRODUCTION:

Platelet collection by apheresis is common nowadays. Many cell separators are available in the market for the same. This study was conducted to study the effect of various donor factors on platelet yield and the effect of different cell separator variables on platelet yield.

MATERIALS AND METHODS:

This cross-sectional study was done on 600 healthy apheresis platelet donors from April 2016 to March 2017 using three different cell separators. Donor variables, pre, and post-plateletpheresis hematological parameters, machine variables, platelet yield were observed.

RESULTS:

Postprocedural decline in hematological variables was seen. A positive correlation was seen with pre-apheresis platelet count, blood volume processed, and product volume. Product volume obtained was highest with COM. TEC. Mean platelet yield was maximally seen in Amicus.

CONCLUSION:

Main predictors of platelet yield are platelet count and volume processed. Donors with lower hemoglobin had better yields. Higher platelet counts lead to better product hence platelet increment in the patient.
Determinants of voluntary blood donation in the city of Bahir Dar
Authors: Feleke Berhanu Elfu
Published: May 2022

BACKGROUND:

In a normal adult, the volume of blood needed to maintain physiological needs ranges from 5 liters to 6 liters. Disease and traumatic conditions may decrease this volume. Medically, this condition can be treated safely by blood transfusion. However, residents of the city of Bahir Dar have a low rate of volunteering to donate blood. No study has examined this situation, and therefore, this study was designed to fill this gap.

AIM:

The aim of this study is to identify the determinants of voluntary blood donation in the city of Bahir Dar.

SETTING AND DESIGN:

An unmatched case–control study design was used.

METHODS AND MATERIALS:

The sample size was calculated using Epi-Info Software, 109 cases and 218 controls were included in the study. Data were entered into the computer using Epi-Info and were analyzed using SPSS.

STATISTICAL ANALYSIS USED:

Logistic regression was used. Adjusted odds ratios (AOR) and 95% confidence interval (CI) were used to identify the determinants.

RESULTS:

In this study, voluntary blood donation was more among male donors (AOR: 2.66; [95% CI: 1.03–6.88]), health professionals (AOR 18.56; [95% CI, 6.26–55.09]), negligence (AOR 0.12; [95% CI, 0.05–0.31]), lack of information (AOR 0.24; [95% CI, 0.1–0.58]), a convenient place (AOR 11.36; [95% CI, 3.61–35.73]), fear (AOR 0.26; [95% CI, 0.12–0.61]) and lack of opportunity (AOR 0.23; [95% CI, 0.1–0.52]).

CONCLUSION:

Decision-makers in the area of blood collection should work hard to create awareness on voluntary blood donation. High-level decision-makers and the other partners should endeavor to make blood collection locations more convenient.
Type and screen method and Coombs crossmatch method for pretransfusion testing
Authors: Anu K. Devi , Pahuja Sangeeta , Sharma Geetika
Published: May 2022

BACKGROUND:

The aim of pretransfusion testing (PTT) is to prevent the immune-mediated hemolytic reaction by the transfusion of incompatible donor red cells. The methods of PTT have evolved over the years and a new method of type and screen (T and S) was introduced, in which only ABO grouping, Rh typing, and antibody screening would be carried out with omission of routine Coombs crossmatch. Although T and S is an accepted method for PTT in developed countries, only a few studies in literature have evaluated its efficacy in India.

AIM AND OBJECTIVE:

The aim of the study was to compare T and S method with conventional Coombs crossmatch method for PTT.

MATERIALS AND METHODS:

Two thousand and fifty samples were randomly selected from the samples received in blood bank for requisition of blood transfusion after taking informed consent. ABO blood grouping and Rh typing were performed for each recipient's sample. “T and S” and “Coombs crossmatch” were done simultaneously by two different persons without knowing the result of each test. A commercially available three cell panel was used for antibody screening, in which the recipient's plasma was reacted with red cells in the low ionic strength solution Coombs Gel card at 37°C by column agglutination technology.

RESULTS:

Antibody screening was positive in 29 (1.41%) patients and negative in 2021 (98.59%) patients. Out of 29 patients, 27 had alloantibodies and 2 had autoantibody. Most common alloantibody found in our study was anti-D. Other antibodies found were anti-K, anti-C + D, anti-E, anti-C, anti-c, anti-Jka, and anti-Mi (a). Crossmatch on first attempt was compatible in 2028 (98.93%) patients and incompatible in 22 (1.07%) patients. Out of 29 patients who were positive for antibody screening, crossmatch was incompatible in nine patients. Crossmatch was compatible in twenty patients, who had positive antibody screen. However, crossmatch compatibility in these patients, reflect either absence of corresponding antigen or antigen present in low dose (heterozygous) in donor blood. On the other hand, out of 22 patients incompatible on first crossmatch, antibody screening was negative in 13 patients and was positive in only nine patients. Hence, 13 patients with antibody would have been missed by antibody screen alone. Kappa statistics was used to compare the efficacy of “type and screening” and “Coombs crossmatch.” It showed κ =0.445 (P < 0.001) implying moderate agreement between the two variables of “T and S” and “Coombs crossmatch.”

CONCLUSION:

T and S is a scientifically better method but needs to be implemented with caution. We need to develop our own cell panels having adequate representation of indigenous antigen (including In, Mi (a), etc.,). Large-scale studies need to be done in India with indigenous screening cells to evaluate efficacy and safety of T and S method.
Passenger Lymphocyte Syndrome as a rare cause of hemolysis in a patient after small intestine transplantation, A case report and review of the literature
Authors: Zarei Edalat , Shafiekhani Mojtaba , Azadeh Nazanin , Shamsaeefar Alireza , Lotfi Mahnaz , Ahrami Mahbube , Rabbani Amirhassan , Nikoupour Hamed
Published: May 2022

Passenger lymphocyte syndrome (PLS) is a well-described phenomenon causing immune hemolytic anemia, mostly in non-ABO identical transplantations. The syndrome occurs when donor lymphocytes produce antibodies against the recipient's red blood cells. Although the syndrome is usually self-limited, further management with blood transfusions, immunosuppression, or plasmapheresis might be needed. A 23-year-old female with AB+ blood group underwent small intestine transplantation from a deceased donor with O+ blood group. She received rituximab, thymoglobin, and methylprednisolone as immunosuppressive induction. In the 9th postoperation day, she developed hemolysis which was primarily managed with blood transfusions and finally ceased by plasmapheresis and intravenous immunoglobulin. Few cases of PLS have been previously described in intestinal transplantation recipients. Correct diagnosis and management prevents severe hemolysis outcomes. Previous cases have been successfully treated with a combination of immune suppression, plasma exchange, and transfusions.
Assessing safety and efficacy of therapeutic plasma exchange in pediatric patients
Authors: Chowdhry Mohit , Mutjhukamaravel P. J. , Agrawal Soma , Gajulapali Shiva Prasad , Thakur Uday Kumar
Published: May 2022

INTRODUCTION:

Therapeutic plasma exchange has been widely employed by clinicians for removal of the toxic constituents from plasma by filtration of whole blood and subsequent removal of plasma and reinfusion of cellular components along with a replacement fluid. It has become an accepted therapeutic modality in paediatric patients for numerous indications including but not limited to renal transplant, haemolytic uremic syndrome and Guillain Barre Syndrome. But, data on safety and efficacy are mainly derived from studies in the adult population with very limited data available in the paediatric age group. However, it is technically challenging in children due to their small circulating volume. This study discusses the clinical indications, efficacy, and safety of therapeutic plasma exchange in paediatric population.

METHOD:

We retrospectively reviewed the data of children (up to 18 years of age) who underwent TPE between January 2017 and March 2019 at our Hospital. Main features of the TPE procedures i.e. frequency of TPE, site of vascular access, type of replacement fluid used, instrument used, plasma volume processed, priming of the circuit, adverse events if any and outcome of the patients were analysed.

RESULTS AND CONCLUSION:

A total of 114 procedures were performed on these 24 patients. Fifteen patients with Category I indication showed good clinical outcome in terms of attainment of target ABO titre and/or decrease in the donor specific antibody. TPE is an effective therapeutic option in selected paediatric disorders. Our series of data on TPE procedures from paediatric perspective has shown safety and efficacy of the therapy.
Factors associated with vasovagal reactions in whole blood donors
Authors: Shivhare Aaditya , Basavarajegowda Abhishekh , Harichandrakumar K. T. , Silwal Pragya , Raj Pruthvi
Published: May 2022

BACKGROUND:

Vasovagal reactions to blood donation though generally mild and account for about 1% of donations, causes embarrassment/injury to the donors, lower likely return rates for future donations etc. The workforce hours devoted to attending to those who reacted can also affect the efficiency of the blood centre. There are various factors, both modifiable and nonmodifiable, involved in the causation of such reactions.

OBJECTIVES:

This study sought to identify the factors associated with vasovagal donor reactions in a case–control study.

MATERIALS AND METHODS:

This was a descriptive comparative study between donors who had VVRs (cases) and those who did not (controls) during or after blood donation from a single center in southern India. All the biophysical and demographic variables were collected from the donor records. In addition, a questionnaire was administered to the donors after donation within half an hour, addressing the psychosocial variables. All the data were captured in Microsoft Excel and analyzed using SPSS for Windows version 20.

RESULTS:

A total of 178 donors who had donor reactions were included in the study with an equal number of controls who were age and sex-matched. Donors who had VVRs had an odds of 4.1 (95% confidence interval [CI]: 2.4–7.7) of admitted anxiety for blood donation. They also had an odds of 4.4 (95% CI: 2.8–6.9) of disturbed sleep the night before blood donation. Having an accompanying person to the blood center was detrimental, with an odds of 0.32 (95% CI: 0.2–0.6). Donors with local complications such as hematoma, double prick, or delayed collection had an odds of 21.2 (95% CI: 1.8–159.8) of developing VVR.

CONCLUSION:

The psychosocial factors such as fear of the needle, the sight of the blood, state of mind, and quality and duration of sleep seem to have an association, adversely impacting the donors resulting in VVRs after/during blood donation.
Calcaneal-stop procedure for treatment of pediatric flexible flatfoot
Authors: Abd Al-Masseih Emiel S.A. , Mashhour Mohsen A. , Farag Hossam Alsayed , AbouZied Mahmoud S.
Published: May 2022

Background

Flexible flatfoot is a common problem of premature patients. There are different procedures described for the treatment of this condition. The calcaneal stop is an easy and simple procedure for its treatment. In this study, we evaluate this technique as a valuable one.

Patients and methods

This study was performed on 20 feet in 12 patients (seven males and five females) with flexible flatfeet (eight bilateral and four unilateral cases) who were treated with a calcaneal-stop procedure. They had the following inclusion criteria: (a) skeletal-immaturity patients; (b) symptomatic flexible flatfoot deformity (pain, function, and activity limitations) not responsive to conservative treatment. The evaluation was done clinically by American Orthopedic Foot and Ankle Society Ankle–Hindfoot score, and hindfoot valgus angle. Radiological evaluation was done by calcaneal-pitch angles, Kite’s angle, talar-declination angle, lateral Meary’s angle, and talonavicular-coverage angle.

Results

Clinical and functional outcomes of all patients were evaluated, before surgery, and at 3 and 6 months after surgery. The American Orthopedic Foot and Ankle Society score mean increased from 70.6 (SD 4.8) to 88.4 (SD 7.4) at the end of the study. Heel valgus improved from 11.45 (SD 3.02) to 2.7 (SD 1.3) at the end of the study. The calcaneal-pitch angle increased from 13.4 (SD 1.1) to 16.1 (SD 1.4) at the end of the study. Talar-declination angle decreased from 41.9 (SD 5.0) to 32.8 (SD 4.5) at the end. Kite angle changed from 29.6 (SD 3.1) preoperatively to 26.7 (SD 2.7) finally. Talonavicular-coverage angle improved from 22.4 (SD 5.4) to 11.2 (SD 5.68) at the end. Lateral Meary’s talocalcaneal angle decreased from 20.55±6.9 to 14.3±4.73 at 6 months after surgery. There was significant satisfaction of 11 (91.6%) patients with one patient who showed some pain at the site of operation with no need for screw removal.

Conclusion

There was significant improvement (P<0.00001) of all clinical and radiological parameters. The changes were mainly after surgery. There was an increased improvement with time, however, it was not statically significant. The main problem of flatfeet is patient dissatisfaction, which requires intervention. The calcaneal-stop procedure is an easy and simple procedure, with a minimal complication for the management of flexible flatfeet.
Correction of multiplanar deformities around the knee with monolateral external fixator
Authors: Fadel Mohamed Hussein , Taha Hossam El din El Amir
Published: May 2022

Introduction

duction Angular deformities around the knee are common during childhood and most cases are a variation in the normal growth pattern. Uncorrected deformities change the biomechanics by disturbing stress distribution on the knee joint weight-bearing surface. Monolateral external fixator with osteotomy has shown better results being simple, and offers accurate correction, a low complication rate, the ability to correct valgus, varus, and rotational deformities, with early mobilization of the patient.

Patient and methods

A multicenter study case series prospective study was conducted from January 2020 to January 2021. A total of 30 patients with coronal plane deformities were included in the study. Of them, 15 patients (all cases were unilateral, 9 left limbs and 6 right limbs) presented with genu valgum with an age range between 10 and 16 years, and mean age was 10.5 years. Eight patients presented with genu varum only and six cases presented with genu varum and internal tibial torsion (all cases were unilateral, seven right limbs and eight left limbs) with an age range between 10 and 16 years and a mean of was 12.4 years.

Results

There is a statistically significant decrease of tibiofemoral angle (TFA) and mechanical axis deviation (MAD) after surgical correction of genu valgum among the included children with P value=0.001, and there is a statistically significant increase of lateral distal femoral angle (LDFA) after surgical correction of genu valgum with P value=0.001. There is a statistically significant increase of TFA, medial proximal tibial angle (MPTA), and MAD after surgical correction of genu varum among the included children with P value=0.001.

Conclusion

Correction of multiplanar deformities around knee using monolateral external fixator has good results in genu valgus with the improvement of LDFA and TFA, and with the improvement of MPTA and TFA in genu varum and with correction of MAD in both of the deformity after surgical correction, with rotation correction using the ability of direction of Schanz placement.
Management of oblique and spiral metacarpal fractures with mini plate and screw versus screws only
Authors: Saleh Mohamed R.A. , Toreih Ahmed A.
Published: May 2022

Background

Fractures involving the tubular bones of the hand are the most frequent of all skeletal injuries. The choice of treatment depends on a variety of clinical and radiological factors. The goal of treatment is restoration or preservation of the hand function.

Objectives

To compare the results of mini plate plus screw versus screw only in oblique and spiral metacarpal fractures.

Patients and methods

This is a randomized clinical trial that included 40 patients with oblique and spiral metacarpal fractures who divided into two groups according to management: either fixation by mini plate and mini screws (20 patients) or fixation by mini screws only (20 patients). Quick-DASH and total active motion (TAM) scoring systems were used to evaluate all patients on 4th, 12th, and 24th weeks postoperative.

Results

The mean value of TAM score in the mini plate group was significantly higher than screws only group at 4th week postoperative (P=0.007) while it was nonsignificantly higher at 12th and 24th week postoperative. Also, the mean value of DASH score in the mini plate group was significantly lower than screws only group at 4th week postoperative (P=0.0001) while it was nonsignificantly lower at 12th and 24th week postoperative. The total number of complicated patients in the mini plate group was 2 patients (10%) while it was 5 patients (25%) in the screw only group with significant difference between both groups (P=0.0001).

Conclusion

Although mini plate and screw group showed early mobilization of the affected hand and has significant Quick-DASH and TAM scores at 4th week postoperative, both groups revealed the same functional outcomes at the end of follow-up.
Hepatic Arterial Infusion Chemotherapy for Liver Tumor Control in a Patient with Liver Metastasis from Lung Small Cell Carcinoma, a Case Report and Discussion
Authors: Su Po-Hsu , Wu Chun-Feng
Published: May 2022

Hepatic arterial infusion (HAI) chemotherapy was now used in the treatment of liver metastasis in the patients with colorectal cancer and in the treatment of hepatocellular carcinoma. The blood supplies of cancer cells were from hepatic artery instead of portal system which mainly supply normal liver cells. By delivering chemotherapeutic agents directly to cancer cells through catheter in hepatic artery, it provided much more selective treatment and better local tumor control. The feasibility of liver tumor excision was increased after HAI chemotherapy. Theoretically, HAI chemotherapy may be applied to any tumors that mainly get blood supply from hepatic arteries. However, there were few reports of HAI chemotherapy for metastatic liver tumors from other solid tumors. Our report provided a case treated by HAI chemotherapy for liver metastasis from lung small cell carcinoma. This may give us an idea of extended application of HAI chemotherapy to more solid tumors with liver metastasis.
Intramuscular Metastasis in Carcinoma of the Cervix
Authors: Bachheti Yamini , Nair Sharanya R. , Durgapal Prashant , Gupta Sweety
Published: May 2022

Cervical carcinoma is the second most common malignancy among Indian women. It spreads mainly through the regional lymphatics to nodes in the pelvic and para-aortic regions. If distant metastasis occurs, it is typically in the lung, bone, and liver. Melanoma, renal, lung, thyroid, lymphoma, and leukemia malignancies frequently metastasize to muscles. Subcutaneous and intramuscular metastasis from carcinoma of the cervix is a rare manifestation. The reported incidence for subcutaneous metastasis ranges from 0.1% to 2%, and only 19 cases of intramuscular deposits have been reported. Here, we discuss the occurrence of subcutaneous and intramuscular metastatic lesions in a patient with carcinoma of the cervix.
Degenerative occipitocervical dislocation – Uncommon entity at extreme of Life
Authors: Diyora Batuk D , Dhall Gagan , Patel Mehool , Chhajed Rahul , Devani Kavin , Purandare Anup
Published: May 2022

Traumatic occipitocervical dislocation (OCD) has been reported numerous times both in children and adults. Nontraumatic OCD is rare. An 85-year-male referred with 2 months history of motor and sensory complaints in all four limbs. There was no history of trauma. Neck movements were restricted. A lateral radiograph of the cervical spine was suggestive of extensive degenerative changes in the cervical spine. Computed tomography scan of the cervical spine revealed posterior OCD with degenerative changes. Magnetic resonance imaging revealed compressive myelopathy at the cervico-medullary junction. Posterior occipitocervical fixation was performed. His neurological symptoms significantly improved. The procedure resulted in an excellent immediate and long-term clinical outcome.
Diaphragm sparing mini open thoracotomy with standalone expandable cage
Authors: Swamy Narayan , Basantani Neeraj
Published: May 2022

Objective:

An ideal surgical procedure to any vertebral fracture with cord compression produces maximum decompression, without producing additional deficits, achieve fixation by fusion of minimum number of motion segments and maintain the corrected kyphosis without any long-term deterioration. Although conventional posterior approach provides three column fixation, it invariably devitalizes the strong paraspinal muscles and posterior ligamentous complex of the involved vertebra and the adjacent segments necessary for maintaining erect posture. The lateral approach too, damages the strongest portion of the vertebra, the pedicle and sometimes the diaphragm has to be cut open and re-sutured. Conventional anterior approaches are mainly used either as a part of combined approach where in, there is extensive destruction of anterior longitudinal ligament and crus of the diaphragm and have the limitation that they cannot address the T11 and T12 fractures without cutting open the diaphragm. The anterior approach is not usually attempted as it is not a familiar approach to the neurosurgeon and literature reports increased morbidity. The main aim of this study is to encourage the reader to employ a new anterior approach toward thoracolumbar fracture management.

Materials and Methods:

The chief author has devised a novel, safe, mini open, diaphragm sparing approach to address all these issues, exploring a corridor between medial margin of psoas and left crus of the diaphragm which is sufficient enough for good decompression of the cord and that even a standalone broad foot plated expandable cage for stabilization is effective in correction of kyphosis without posterior supplementation or potential respiratory complications.

Results:

All 37 operated patients recovered well and their kyphotic angles were maintained on follow up. All patients improved neurologically without any respiratory complications potentially associated with thoracotomy.

Conclusion:

This prospective study proved that kyphotic corrections were better, no subsidence rates observed, and were maintained at 1 year follow-up with this novel approach.
Computed tomography perfusion (CTP) in primary lung cancer: Results from a tertiary care centre
Authors: Arimbrakkunnan Mufeed , Garg Pawan K. , Khera Pushpinder S. , Sureka Binit , Elhence Poonam , Pareek Puneet , Chauhan Nishant Kumar , Yadav Taruna
Published: May 2022

Context:

Lung cancer is the leading cause of cancer-related deaths in the world. Computed tomography perfusion (CTP) parameters can be used to evaluate the vascular flow dynamics of lung tumours. We set out to evaluate the CTP parameters in lung cancer and correlate them with histopathological subtype and other characteristics of patients with Lung Cancer.

Settings and Design:

This prospective study was conducted at a tertiary care referral hospital in western India.

Methods:

Between January 2019 and July 2020, CTP was performed in 46 patients of lung cancer with histopathological confirmation. The CTP parameters were evaluated in detail and correlated with histopathological subtypes, staging and immunohistochemistry (IHC) markers. Analysis of variance (ANOVA) test, receiver operator characteristic (ROC) curve, Box and whiskers plot graph and Pearson correlation tests were used for statistical analysis.

Results:

The most common subtype was adenocarcinoma (AC) in 21 patients, followed by squamous cell carcinoma (SCC) in 15 patients and others in 10 patients. Statistically significant difference in blood flow (BF) (f = 5.563, P = 0.007), blood volume (BV) (f = 3.548, P = 0.038) and permeability/flow extraction (FE) (f = 3.617, P = 0.036) were seen in different histopathological subtypes of lung cancer. BF is the main perfusion parameter for differentiation of AC from SCC. P63 positive lesions showed statistically significant lower BF, BV and FE parameters compared to P63 negative lesions (P = 0.013, 0.016 and 0.014, respectively). Different T stages showed statistically significant differences in BF (f = 3.573, P = 0.037), BV (f = 5.145, P = 0.010) and in FE (f = 4.849, P = 0.013).

Conclusion:

CTP is a non-invasive imaging method to assess the vascular flow dynamics of the tumours that may predict the histopathological subtypes in lung cancer. It can be used to target large-sized lesions during biopsy and to predict the chemotherapy response.
Role of low-dose tissue plasminogen activator in patients with refractory hypoxia due to presumed microthrombi in pulmonary vasculature in coronavirus disease 2019: A case series and review of the literature
Authors: Hashim Zia , Ghatak Tanmoy , Nath Alok , Singh Ratender Kumar
Published: May 2022

Severe hypoxia due to coronavirus disease 2019 (COVID-19) is challenging in the intensive care unit (ICU). It is often unresponsive to mechanical ventilation at high positive end-expiratory pressure and the fraction of inspired oxygen combination. The cause of such worsening hypoxia may be microvascular thrombosis in the pulmonary vascular system because of the procoagulant nature of COVID-19 infection. Confirming the diagnosis with computed tomographic pulmonary angiography is not always possible, as the patients are too sick to be shifted. Tissue plasminogen activator (tPA) is recommended for pulmonary thromboembolism with hypotension and worsening hypoxia, as confirmed by computed tomography pulmonary angiography. However, its role in worsening hypoxia because of presumed microthrombi in the pulmonary vasculature in COVID-19 is unclear. We present six cases from our ICU where we used low-dose tPA in COVID-19 refractory hypoxia with presumed microthrombi in the pulmonary vasculature (oligemic lung field, refractory hypoxia, increased D dimer, electrocardiographic features of pulmonary embolism, and right ventricular strain on echocardiography). Oxygenation improved within 6 h and was maintained for up to 48 h in all patients. Therefore, there is a possible role of microthrombi in the mechanism of hypoxia in this setting. An early decision to start low-dose tPA may improve the outcome. However, all patients finally succumbed to sepsis and multiorgan failure later in their course. A systematic review of the literature has also been performed on the mechanism of thrombosis and the use of tPA in hypoxia due to COVID-19.
Comparison of clinical, biochemical, and polysomnographic parameters between obese and nonobese obstructive sleep apnea
Authors: Reddy Sekhar , Koul Parvaiz A. , Bhat Moomin Hussain , Shah Sanaullah , Ganie Mohd Ashraf
Published: May 2022

Background:

Obstructive sleep apnea (OSA) occurs in both obese and nonobese individuals. This study was designed to compare clinical, metabolic profile, and polysomnographic parameters among obese and nonobese OSA patients.

Material and Methods:

This cross-sectional retro-prospective study involved 148 OSA patients. OSA patients were classified as nonobese (body mass index [BMI] <27.5 kg/m2) and obese (BMI ≥27.5 kg/m2) to determine the influence of BMI on its risks, clinical, metabolic, and polysomnographic parameters. For statistical comparisons, continuous variables were analyzed by Student’s t-test and categorical variables by Chi-square.

Results:

Of 148 patients, 106 patients were of a retrospective group and 42 in the prospective group. 116 patients were obese and 32 were nonobese with a mean BMI of 33.66 ± 5.3 versus. 25.17 ± 2.2 kg/m2 respectively. Female sex (70.7% vs. 43.4%), larger neck circumference (37.99 ± 3.93 vs. 33.67 ± 5.5 cm), loud snoring (94.8% vs. 81.3%), excessive daytime sleepiness (53.4% vs. 9.4%), fatigability (94.8% vs. 75%), high Epworth Sleepiness Scale score (16% vs. 8%), and hypertension (77.6% vs. 46.9%) were significantly (P < 0.05) more common among obese OSA patients while as smoking and sedative use was more prevalent among nonobese OSA group. However, no significant difference in median apnea-hypopnea index and severity of OSA between obese and nonobese group was observed. At the same time, the median oxygen desaturation index was significantly higher in obese patients (26.1 vs. 12.7, P = 0.005).

Conclusion:

Nonobese OSA patients depicted less severe disease symptoms and thus require high index of suspicion for early identification due to associated cardiovascular risk.
A study of the diagnostic utility of the complement activation product C4d in bronchoalveolar lavage fluid of patients with bronchogenic carcinoma
Authors: Rashash Nadia E. , El-Kolally Reham M. , Ahmed Amira Y. , Farahat Amgad Abd-El Raoof
Published: May 2022

Background

Molecular markers may improve the diagnosis of lung cancer. In the past few years, multiple biomarkers have been detected in bronchial lavage fluids and tissues of patients with lung cancer.

Aim

The present prospective case–control study aimed to evaluate the role of complement activation product (C4d) as a diagnostic aid for bronchogenic carcinoma and to predict its diagnostic levels in bronchoalveolar lavage fluid (BALF) and in sputum supernatant of patients diagnosed with lung cancer.

Patients and methods

The study included 40 patients. They were classified into two groups: group 1 represented lung cancer group (which was diagnosed in this study by histopathological examination), which consisted of 25 patients and group 2 represented control group with nonmalignant chest diseases, which consisted of 15 patients. Clinical assessment, bronchoscopy, measurement of C4d in BALF and in sputum supernatant, and measurement of total protein in BALF were performed for all studied participants.

Results

C4d in bronchoalveolar lavage (BAL), C4d in sputum supernatant, and total protein in BAL were significantly higher in the lung cancer group compared with the control group.

Conclusion

C4d in BAL and sputum as well as total protein in BAL can be used as a diagnostic aid in patients with bronchogenic carcinoma compared with other lung diseases with moderate sensitivity and specificity.
Assessment of subfoveal choroidal thickness after uneventful phacoemulsification in diabetic patients
Authors: Eldeep Tasneem F. , Nawar Amin E. , Atef Mohammed S. , Abo El-Enin Mostafa A.
Published: May 2022

Background

Phacoemulsification is an intraocular surgery that may worsen preexisting retinal diseases by inducing inflammation in the posterior segment of the eye. It is related to interleukin-1β expression and genes’ upregulation in both retina and choroid. Choroid imaging with enhanced depth imaging (EDI) facilitated choroidal thickness measurement.

Aim

The aim was to assess the changes in subfoveal choroidal thickness following uncomplicated phacoemulsification in diabetic patients − without retinopathy − using EDI of spectral-domain optical coherence tomography.

Patients and methods

This prospective observational study included 60 eyes of 60 patients who underwent cataract extraction by phacoemulsification, subdivided into two groups, the first group was 30 eyes of patients had diabetes with no retinopathy, the second one was 30 eyes of nondiabetic healthy patients as a control. Using EDI-spectral-domain optical coherence tomography, subfoveal choroidal thickness (SFCT) was evaluated 1 week preoperatively and 1 month postoperatively.

Results

The mean age of both groups was 59.033±9.072 and 58.200±8.235, respectively. In group I, mean preoperative SFCT was 194.600±27.523 µm and 1 month postoperatively was 207.100±27.530 µm. In group II, mean preoperative SFCT was 191.233±17.520 µm and 1 month postoperatively was 193.133±17.085 µm. Regarding operative time and phaco power, in group I, mean time was 12.583±2.051 min and mean power was 28.900±12.645%, whereas in group II, mean time was 11.667±1.845 min and mean power was 22.333±7.849%.

Conclusion

Phacoemulsification induces nonsignificant nonpathological increase in SFCT with the presence of diabetes as a systemic disease but without local diabetic changes in the eye; however, a significant difference was observed between patients with and without diabetes as regards SFCT.
A study of diagnostic utility of annexin A1 in bronchoalveolar lavage fluid of patients with bronchogenic carcinoma
Authors: Shepl Samar S. , Ganna Salwa A. , Hodeib Hossam A. , Abd El-Zaher Ayman H.F.
Published: May 2022

Background

Annexin A1 is implicated in multiple types of cancer, but few researches have studied its job in lung cancer.

Aim

The aim of the study was to enumerate annexin A1 levels in bronchoalveolar lavage fluid (BALF) and sera of lung cancer patients and patients with benign lung diseases and to evaluate its role as a diagnostic aid for lung cancer.

Patients and methods

This prospective analytic controlled case study was performed in Chest Department, Tanta University Hospitals, on 40 patients. The patients were split into two groups: group 1 included 20 patients with bronchogenic carcinoma, group 2 included 20 patients having nonmalignant lung diseases of known etiologies. Clinical assessment, demographic data, and routine investigations were done to all patients. Annexin A1 expression in BALF and serum was examined using enzyme-linked immunosorbent assay.

Results

Annexin A1 levels were higher in BALF and sera of lung carcinoma patients than those of the control group. Positive correlation was present between annexin A1 level in BALF and serum and advanced clinical stages of lung cancer and between BALF annexin A1 level and its level in serum.

Conclusion

High annexin A1 level in BALF was related to advanced clinical stage of lung carcinoma and in a positive correlation with serum annexin A1. High sensitivity and specificity of BALF annexin A1 for detection of lung carcinoma showed that it deemed to be a molecular biomarker for lung cancer prognosis and diagnosis.
Hemostatic system changes among diabetic foot ulcer patients
Authors: Zamzam Mohamed L.H. , Hodeib Hossam Abd El-Mohsein , Elbedewy Tamer A. , EL-Ahwal Loai M.M.
Published: May 2022

Background

There are many reports about hemostatic changes in patients with diabetic foot ulcer (DFU). There are some reports about changes in the platelet morphology in patients with DFU. The goal of this research was to see whether platelet indices and hemostatic status might be used as predictors of DFU.

Aim

We aimed to assess the changes in the hemostatic system (hemostatic state and platelet indices) among patients with DFU.

Patients and methods

A total of 80 individuals were included in the study. They were divided into three groups: group 1 represented 20 diabetic patients without diabetic ulcer, group 2 represented 40 patients with known DFU, group 3 represented 20 normal healthy individuals. Laboratory investigations included fasting blood glucose level, kidney function tests (urea and creatinine), glycosylated hemoglobin, complete blood count including platelet count and platelet indices (platelet distribution width, mean platelet volume, plateletcrit, and platelet larger cell ratio), prothrombin time, international normalized ratio, activated partial thromboplastin time, and FVIII.

Results

Platelet indices (platelet distribution width, mean platelet volume, plateletcrit, and platelet larger cell ratio) were significantly greater in patients with DFU compared with other groups (P=0.0001), and FVIII was also significantly higher in patients with DFU compared with other groups (P=0.0001).

Conclusion

Diabetes is linked to a prothrombotic propensity as well as a hypercoagulable condition. Platelet indices indicate that patients with DFU have extra-reactive and aggregable platelets. Platelet indices could be used as an easy and cheap method for prediction and progression of DFU.
Choroidal assessment in diabetic maculopathy
Authors: Wasef Lilian S.F. , Wasfy Tamer El-Sayed , El-Koddousy Mona S. , El-Koumy Hamdy Abd El-Azim
Published: May 2022

Background and aim

Diabetic maculopathy is a leading cause of visual loss in diabetic patients. The choroid is the outer retina's primary source of oxygen and nourishment and the only blood supply to the avascular fovea. Angiopathy of the choroid seems to have a role in the pathophysiology and progression of diabetic maculopathy. It has been theorized that unexplained visual acuity loss in diabetic patients might be linked to diabetic choroidopathy. The aim of this study was to evaluate choroidal changes in eyes with diabetic maculopathy using optical coherence tomography.

Patients and methods

In all, 20 eyes of 10 normal individuals and 94 eyes of 50 diabetic patients suffering from diabetic maculopathy were recruited in this study. The diabetic patients were categorized according to the type of maculopathy as demonstrated by fluorescein angiography into four subgroups: the focal edema group, the diffuse edema group, the ischemic maculopathy group, and the mixed maculopathy group. Choroidal thickness was measured subfoveally, 1 mm away from the fovea nasally, temporally, superiorly, and inferiorly using optical coherence tomography.

Results

There was a significant difference among the different groups in all the measured regions (P=0.001). The more severe the maculopathy, the thinner the choroid in all the measured regions.

Conclusion

The results of this study suggest a negative relationship between macular choroidal thickness and severity of diabetic maculopathy.
Замечание о гипотезе Шеня для групп
с заданным типом одинаковых порядков
Authors: Kumar Pradeep
Published: May 2022

Пусть $G$ - группа. Определим отношение эквивалентности $\sim$
на $G$ следующим образом: $x\sim y$, $x,y\in G$, если $x$ и $y$
имеют одинаковый порядок. Множество размеров
классов эквивалентности по этому отношению называется
типом одинаковых порядков группы $G$. Пусть $s_{k}(G)$ и
$\pi_{e}(G)$ - число элементов порядка $k$ и множество порядков
элементов конечной группы $G$ соответственно. Шень (2012)
выдвинул следующую гипотезу: пусть $G$ - группа порядка $p^{l}$
с типом одинаковых порядков $\{1,m,n\}$, и пусть $|\pi_{e}(G)|>3$.
Если $p=2$ и $s_{2^{i}}(G)\neq0$ при $i\geqslant2$,
то $s_{2^{i}}(G)=2^{l-2}$. Если $p>2$, то такой группы
не существует. В данной статье мы даем частичный ответ
на эту гипотезу. Точнее, для $p=2$ мы строим
опровергающий гипотезу контрпример, а для $p>2$ показываем,
что гипотеза верна для конечных $p$-групп
класса нильпотентности меньше $p$.
Библиография: 7 названий.
Построение частных решений с помощью специальных функций
для уравнений с дробной производной
Authors: Irgashev Bakhrom Yusuphanovich
Published: May 2022

В работе строятся частные решения с особенностью, выраженные через
функции Райта, для уравнений с дробной производной Римана-Лиувилля.
Библиография: 6 названий.
О $Z$-множествах пространства идемпотентных вероятностных мер
Authors: Kholturaev Kholsaid
Published: May 2022

В работе показана гомеоморфность пространств вероятностных мер
и идемпотентных вероятностных мер
на одном и том же метризуемом компактном пространстве.
Приведен пример, согласно которому конструкции взятия пространства
вероятностных мер и пространства идемпотентных вероятностных мер
образуют различные друг от друга функторы. Далее, применяя функтор
идемпотентных вероятностных мер, установлен критерий метризуемости
компактного хаусдорфово пространства. Выделено подпространства
идемпотентных вероятностных мер, являющиеся $Z$-множествами в нем.
Библиография: 23 названия.
Об аппроксимативных свойствах рядов Фурье
по полиномам Якоби $P_n^{\alpha-r,-r}(x)$,
ортогональным по Соболеву
Authors: Gadzhimirzaev Ramis Makhmudovich
Published: May 2022

В статье рассматривается задача об отклонении от функции $f$
из пространства $W^r$ частичных сумм ряда Фурье по системе полиномов
$\{\varphi_n(x)\}_{n=0}^\infty$, ортогональной относительно
скалярного произведения типа Соболева.
Здесь $\varphi_n(x)=(x+1)^n/n!$
при $0\leqslant n\leqslant r-1$ и
$$
\varphi_n(x)=\frac{2^r}{(n+\alpha-r)^{[r]}
\sqrt{h_{n-r}^{\alpha,0}}} P_n^{\alpha-r,-r}(x)\qquadпри\quad
n\geqslant r,
$$
где $P_n^{\alpha-r,-r}(x)$ - полином Якоби степени $n$.
Основное внимание уделено получению оценки сверху для функции
типа Лебега частичных сумм ряда Фурье
по системе $\{\varphi_n(x)\}_{n=0}^\infty$.
Библиография: 2 названия.
Case Report: Plantar Cyst Caused by Phaeoacremonium inflatipes in an Immunocompetent Male, Resolving with Combination Potassium Iodide and Itraconazole Therapy
Authors: Sandhu Jaspriya , Kohli Jaismine Kaur , Gupta Sunil Kumar , Gupta Veenu
Published: May 2022

Phaeohyphomycosis is a subcutaneous mycosis presenting as verrucous or ulcerated plaques/nodules/cysts. We report here, a case of cystic plantar phaeohyphomycosis in a 72-year-old immunocompetent male. On examination, an asymptomatic, skin colored, firm-to-soft, fluctuant, cystic lesion was seen over the left forefoot. Aspirate of lesion yielded velvety grayish–brown colonies on fungal culture, with septate, branched, phaeoid hyphae with lateral and terminal conidiophore noted on microscopic examination, and identified as Phaeoacremonium inflatipes. Due to the ongoing pandemic and advanced age, the patient declined surgical intervention and we started him on a supersaturated solution of potassium iodide (SSKI) (starting at 5 drops thrice a day and gradually increasing 1 drop per day to 20 drops thrice a day) and itraconazole (100 mg twice daily) in combination. An encouraging response was seen at 6 weeks, with complete resolution at 6 months follow-up. We report this case for the unusual fungus isolated (i.e., P. inflatipes) as well as a robust response to a combination of SSKI and itraconazole. In cases where patients refuse or are unfit for surgical excision, this combination maybe an effective therapeutic alternative.
CC-circuits and the expressive power of nilpotent algebras
Authors: Kompatscher Michael
Published: May 2022

We show that CC-circuits of bounded depth have the same expressive power as
circuits over finite nilpotent algebras from congruence modular varieties. We
use this result to phrase and discuss a new algebraic version of Barrington,
Straubing and Th\'erien's conjecture, which states that CC-circuits of bounded
depth need exponential size to compute AND.
Furthermore, we investigate the complexity of deciding identities and solving
equations in a fixed nilpotent algebra. Under the assumption that the
conjecture is true, we obtain quasipolynomial algorithms for both problems. On
the other hand, if AND is computable by uniform CC-circuits of bounded depth
and polynomial size, we can construct a nilpotent algebra in which checking
identities is coNP-complete, and solving equations is NP-complete.
Efektivitas Token Economy Dalam Meningkatkan Ketahanan Duduk Pada Anak ADHD
Authors: Syukria Elgo , Rahmahtrisilvia Rahmahtrisilvia
Published: May 2022

Siswa yang dikategorikan Attention deficit hyperaktivity disorder (ADHD) memiliki masalah ketahanan duduk dalam proses pembelajaran yang ditunjukan dengan serinya meninggalkan kursi tempat duduknya. Pada penelitian ini, dilakukan modifikasi perilaku menggunakan metode token economy dalam meningkatkan ketahanan duduk anak dengan kategori ADHD. Jenis penelitian menggunakan Single Subject Research dengan subjek anak ADHD dengan gejala hyperaktive. Penelitian ini menerapkan desain A1-B-A2 untuk mengetahui durasi ketahanan duduk anak sebelum diberi intervensi, saat diberi, dan setelah diberi intervensi menggunakan token economy dalam waktu 30 menit proses pembelajaran. Dari penelitian menggunakan desain A1-B-A2, didapatkan (A1) sebanyak empat kali diperoleh skor 0%, (B) sebanyak enam kali diperoleh skor 66,66%, dan  (A2) sebanyak lima kali dan diperoleh skor 60%. Dengan demikian, konsep A1-B-A2 menggunakan token economy efektif  dalam meningkatkan ketahanan duduk anak ADHD kelas I di MI No. 41/E3 SEMERAP.