bluuebunny/crossref_metadata_2025 huggingface dataset:
Lean Approach to Social Entrepreneurship
Authors: Ertemel Adnan Veysel
Published: December 2022

This chapter proposes an alternate view to social entrepreneurship emphasizing that for-profit and non-profit entrepreneurship are in essence indifferent. It then discusses the latest trends in commercial entrepreneurship world together with implications on social entrepreneurship. In doing so, the lean startup phenomenon and closely related concepts, namely customer development philosophy, business model innovation, value proposition design, and jobs-to-be-done theory are explored with implications on social entrepreneurship.
From Social Sustainability to Social Entrepreneurship
Authors: Toker Kerem
Published: December 2022

Despite the discussion of social sustainability, which has been a crucial component of sustainable development for decades, unfortunately, the desired successful outcomes have not been realized in practice. This failure caused the need to examine the concept of social sustainability differently than ever before. Social entrepreneurship is a valuable tool to meet this need. Concordantly, this chapter purposes to evaluate the relations between social sustainability and social entrepreneurship by comprehensively analyzing them. Discussing this relationship and proposing a new perspective will support overcome theoretical dilemmas and practical struggles. Therefore, the concept of sustainability was explained in detail through a wide literature review, and then the concept of social entrepreneurship was examined, and links, similarities, and gaps were revealed between the two concepts. As a result, the effective implementation of social sustainability policies depends on the social impact and value created by social entrepreneurship.
Social Entrepreneurship and Sustainable Development
Authors: de los Ríos-Sastre Susana , González-Sánchez Víctor M.
Published: December 2022

There is no doubt about the relevant role of social entrepreneurs as social transformers and there seems to be broad consensus on the factors that characterize it, such as: a sustainable social orientation, the intensive use of innovation, and the aim of creating social value. This chapter offers an updated vision of social entrepreneurship around the world, showing the main advances made in recent years and analyzing the main challenges and opportunities for the near future. It includes a reflection on the concept of social entrepreneurship, since today there's not a single definition of that term, and a review of the evidence on good practices in this field, which could serve as a model for future initiatives.
Social Entrepreneurship for Sustainable Economic Growth
Authors: Bayarçelik Ebru Beyza , Taşel Fulya
Published: December 2022

The purpose of this study is to explore the link between social entrepreneurship and economic growth. For nations' economic development there are several influencing factors that can be listed. Entrepreneurship has been an interest to academics and practitioners for a few decades and accepted as one of the important factors that are playing an essential role in advancing economic development. Social entrepreneurship (SE) is a new area of entrepreneurship, which focuses on creating social value initially for individuals. Thus, it is possible to say that social entrepreneurship should improve the wellbeing of individuals by generating social value. Hence, satisfying social needs embraces both social and economic aspects, which will also affect economic wellbeing in a positive manner. The argument of this research is social entrepreneurship is an important catalyzer of economic wellbeing and economic growth.
Native American Approaches to Social Entrepreneurship
Authors: Harrington Charles , Clarkson Gavin S.
Published: December 2022

Few groups face more significant, complex, and difficult economic and social problems than those confronted by American Indians. Economic impoverishment, unemployment, exploitation of natural resources, a failing educational system, insufficient housing, inadequate healthcare, and loss of cultural identity all threaten the wellbeing of native communities. Social entrepreneurship has proven an effective avenue for the pursuit of tribal economic development, sustained economic independence, and sovereignty of Native American people. Native American social entrepreneurs have specific and unique characteristics which impact business decision making, strategy, and enterprise growth. American Indian entrepreneurs can leverage knowledge of their distinct history, institutions, indigenous culture, and local economic resources in order to add value to their social entrepreneurial ventures.
Social Entrepreneurship Activities in the Tourism Sector
Authors: Sirkintioğlu Yildirim Şükran , Esen Ülkühan Bike
Published: December 2022

Social entrepreneurship is a frequently encountered and increasingly popular concept. Although there are some differences and difficulties in defining the concept, the main reason why it has become such a frequently heard concept today is the social purpose inherent in it. The ability of social entrepreneurship activities to find a place in the tourism sector will make it easier for both social entrepreneurship activities and the tourism sector to achieve their goals. Therefore, in this study, it is aimed to reveal the required fields of study by determining how the concept of social entrepreneurship is handled in the field of tourism with bibliometric analysis. In line with the purpose, 43 studies including the determined keywords were reached. When the methodologies of the articles were examined, it was concluded that empirical studies were in the majority and most of these empirical studies were prepared by using the qualitative research method.
Understanding Social Entrepreneurship in the African Context
Authors: Wale-Oshinowo Bamidele A. , Uba Chijioke Dike , Adeyeye Mercy M. , Omobowale Ayotunle Olumuyiwa
Published: December 2022

Social enterprises are organizations created with the aim of applying entrepreneurial skills and innovations to solving social problems. They are managed by individuals who combine pragmatic and result-oriented methods of a business entrepreneur with the goals of a social reformer. Such enterprises combine resources in innovative ways to create social value in and for the society. However, social enterprises may face challenges that impact their ability to accomplish social goals. For instance, when confronted with the harsh realities of economic recession, teaming poor population, and the need to profit for social intervention, social enterprises existing in hostile economic environment in developing countries may face possibilities of shutdown. This chapter examines the concept of social entrepreneurship in a subsisting economy in Africa. Specifically, it draws from relevant primary and secondary data to explore the nature of social entrepreneurship in the Nigeria context and the potential role that social entrepreneurship can play in addressing social problems.
Are There Really Differences Between Social and Commercial Entrepreneurship in Developing Countries?
Authors: Hidalgo Luis F. , Rialp Josep , Urbano David
Published: December 2022

The objective of this chapter is to determine the probability of starting social or commercial entrepreneurship in developing countries using the institutional approach as the theoretical framework. The study tests the hypotheses through a binomial logistic regression based on a sample of 10,598 entrepreneurs obtained from the Global Entrepreneurship Monitor (GEM). The main findings demonstrate that a higher level of education (formal institution) and a positive perception of personal values (informal institution) increase the probability of being a social entrepreneur. Also, the study shows that the interaction between informal institutions causes changes in the likelihood of being a social or commercial entrepreneur. This research advances the discipline by providing new information on the institutional environmental factors that influence social entrepreneurial activity.
Water Crisis in Tunisia During the Anthropocene and Great Acceleration Wetlands as Key Sites of Hydrogeological Modifications
Authors: Essefi Elhoucine , Hajji Soumaya
Published: December 2022

Due to overexploitation, anthropogenic pollution, and climatic change during the Anthropocene and Great Acceleration, Tunisia has already witnessed a severe water crisis. Since they are the natural outlets of their hydrological and hydrogeological basins, wetlands are candidates to obviously display the radical change in water cycles related to anthropogenic activities. This chapter provides efficient methods to investigate water cycle modifications through the study of the water budgets within wetlands (Sidi El Hani Discharge Playa, Eastern Tunisia was taken as example). As concrete manifestation of this change, the dryness of in water springs or the decrease of their flows are concrete indicators of a real water crisis in Tunisia. In addition, salt consumption leads to a decreasing salinization.
High Resolution Cyclostratigraphy During the Last Two Millennia Based on the Clayey Fraction Within the Mhabeul Wetland (Southeastern Tunisia)
Authors: Essefi Elhoucine
Published: December 2022

High-resolution proxy-based paleoenvironmental records derived from wetlands provide important insights into climate changes over centennial to millennial timescales. This work aims to study the climatic cyclicity of the clayey fraction along a 78 cm core from the saline system of Mhabeul, located in Southeastern Tunisia. Based on the age model of Essefi et al., the core covers the last two millennia (»2100 yr). A high-resolution sampling of 2mm was carried out to obtain 380 samples evenly distributed along the core. In terms of analyses, the cumulative curve of the grain size distribution carried out by Fritsch laser apparatus percentages of the Clayey fraction underwent the spectral analysis. Based on the spectral analysis, millennial cycles of » 2500 yr, and 1000 yr are related to solar forcing. Solar irradiation is most likely responsible for the cyclic characteristics at 500 yr (600 yr) frequency.
Knowledge Mobilization for Agri-Food Supply Chain Decisions
Authors: Zhao Guoqing , Liu Shaofeng , Elgueta Sebastian , Manzur Juan Pablo , Lopez Carmen , Chen Huilan
Published: December 2022

The current world business environment is characterized by increasing uncertainties, complexities, and risks, which require agri-food supply chain (AFSC) managers to respond and act quickly in a context full of instability and unpredictability. Increasing pressure placed on AFSC managers intensifies the need to combine knowledge management (KM) and decision support that rapidly overcome knowledge boundaries. It has been recognized that the research issue related to the knowledge mobilization crossing boundaries in the AFSC needs to be addressed. This paper investigates knowledge boundaries and boundary-spanning mechanisms by collecting data from experienced AFSC practitioners. Empirical results verify that knowledge boundaries such as syntactic boundaries, semantic boundaries, and pragmatic boundaries could be effectively tackled by four specific boundary-spanning mechanisms: boundary spanners, boundary objects, boundary practices, and boundary discourses.
A Decision Support System for Improving the Inconsistency in AHP
Authors: Escobar María Teresa , Aguarón Juan , Moreno-Jiménez José María , Turón Alberto
Published: December 2022

This paper presents a DSS aimed at helping decision makers reduce and improve their inconsistency in eliciting their judgements when using the analytic hierarchy process (AHP). The DSS is designed for revising the judgements of a pairwise comparison matrix when the row geometric mean (RGM) is used as the prioritisation procedure and the geometric consistency index (GCI) as the inconsistency measure. The procedure employed guarantees that both the judgements and the derived priority vector will be close to the initial values. The DSS allows different degrees of participation of the decision maker in the review/modification of the judgements: no participation (automatic mode); prior participation (semi-automatic mode); and ongoing participation (interactive mode). The DSS also includes options to incorporate other requirements of the decision maker, such as limiting the modified values to an interval or improving inconsistency by modifying the lowest number of judgements, among others.
Crowdfunding for Entrepreneurial Education
Authors: Denner dos Santos Carlos , Moreira Marina , Panis Amanda , Alves Dyego
Published: December 2022

This paper applies the concept of a crowdsourcing campaign in the context of entrepreneurial education, and reports the perception of participants in such application in a large business school. The classroom task is to prepare a crowdfunding campaign for their university in a freely available digital platform, having identified a relevant problem on campus. The problem identification is based on market research, where problems disrupting the school are found. To implement student's developed “solutions”, crowdsourcing campaigns are created to expose ideas to market validation, and nudge students to communicate with customers and suppliers. The ‘successful' perceptions of participants signal a large potential for this ‘exercise', as campaigns can be successful, leading to the creation of micro-organizations to run these projects and impact communities positively. Of course, future research should establish correlation between crowdsourcing campaigns and likelihood of starting businesses and social ventures.
Regression Predictors for Porosity in Degraded Cladding Based X-Bandmicrowave Non-Destructive Evaluation: A Case Study of Tetra-Boroncarbide
Authors: Roshan Ali Ali Ameen , Al-Barody Sadeem , Ahmed Faiz , Albarody Thar M. Badri , Hussein Alaa Raad , Direa Mohammed Mahmmud
Published: December 2022

Tetra-Boron Carbide (B4C) are an excellent material for industrial applications in the nuclear, aerospace, and military. It is an excellent neutron absorber for use as a radiation shield. Using B4C as thermal barrier coating reduces the metal surface temperature, shields the substrate metal alloy from excessive heat, and increases system efficiency. In this degraded has been evaluated using non- destructive techniques that are appropriate for the predicament. To track the thermal barrier coating’s integrity over time, a microwave non-destructive technique was used to predict the porosity of the topcoat. Network analyzer (ENA5701C) in X-band (12–18 GHz) was utilized for this investigation. Detection was based on the changes in the electromagnetic properties, such as permittivity . A set of samples contained varied filler ranging of 5, 10, 15, 20 percent particle reinforcement. Most tested samples shows that porosities have maximum permittivity in the range of 15.4 – 16.7 GHz where some resonance occurred when real primitivity represent the capability of B4C to store and dissipate energy. This study suggesting that the proposed methodology could be a valuable aid technique for evaluating degraded on composite material systems in a non-destructive and accurate manner with complex pore morphology
Investigation of Microwave Sintering of B-Type Carbonated Hydroxyapatite Bioceramics
Authors: Petit Clémence , Le Tiec Arnaud , Pancrazi Louis , Douard Nathalie
Published: December 2022

B-type carbonated hydroxyapatite (CBHA) is potentially an excellent biodegradable bioceramic for bone repair. However, conventional sintering results in formation of undesired phases. Therefore, microwave sintering of CBHA was investigated to assess the possibility to reduce formation of unwanted phases. Pellets with 0.8 mol% of B-type carbonate were sintered in a multimode instrumented cavity under static air with short thermal cycles. They were prepared from a CBHA powder alone and from a mixture of CBHA and carbon powder to generate a local in-situ CO2 atmosphere. XRD, FT-IR, SEM and BET analyses indicated that CBHA densification with increase temperature lead to decomposition into apatite. The addition of carbon powder to the CBHA that generate a CO2-rich atmosphere around the samples did not prevent the decomposition. Efficient control of temperature and atmosphere composition is required to improve microwave sintering of CBHA bioceramics.
Perceptions and attitudes toward the use of telemedicine for the postoperative outpatient urological care during the COVID-19 pandemic in an Academic Hospital in Southern Italy
Authors: Mirone Vincenzo , Celentano Giuseppe , Collà Ruvolo Claudia , Cirillo Luigi , Fusco Giovanni Maria , Abate Marco , Morra Simone , Di Bello Francesco , Califano Gianluigi , Mirone Claudia , Cacace Gianluigi , Morgera Vincenzo , La Rocca Roberto , Capece Marco , Longo Nicola , Napolitano Luigi , Creta Massimiliano
Published: December 2022

Introduction: Telemedicine is a most used tools in various medical and surgical scenarios. The aim of the present study was to explore attitudes and perceptions by urologic patients toward the use of telemedicine in the context of patient-physicians communication during the post-operative follow-up in a large academic tertiary urology referral department in Italy. Materials and methods: An anonymous questionnaire consisting of 15 multiple choice questions was designed including three sections: respondents’ demographics, attitudes, and perceptions towards the use of telemedicine. Invitations to participate to this anonymous questionnaire was given to outpatients attended at Urology Department, University of Naples Federico II. Results: In total 697 responses were received (participation rate 73%). The frequency of telemedicine use was described as frequently, occasional, rarely, and never by 41.6%, 30.4%, 15.1%, and 12.6% of respondents, respectively. WhatsApp messenger used by 59.5% of respondents and telephone call (34.3%) were the most common type of tools. Satisfaction in using telemedicine was reported as very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied by 39.6%,41.4%,10%,7% and 2% of respondents respectively. Overall, 43.7%% of participants individuated limited interaction and risk of misdiagnosis as the major limit of telemedicine. Conclusions: Telemedicine represents the future of medical practice due to several benefits as well as convenience, increased access to care and decreased healthcare costs.
The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy
Authors: Pikramenos Konstantinos , Zachou Maria , Apostolatou Eleftheria , Papadopoulos Dimitrios , Mitsogianni Maria , Papatsoris Athanasios , Varkarakis Ioannis , Mitsogiannis Iraklis
Published: December 2022

Objective: The aim of this study is to determine if patients undergoing radical retropubic prostatectomy with localized prostate cancer under combined (epidural-spinal) anaesthesia have any benefit over patients undergoing the procedure under general anaesthesia.Material and Methods: Patients with clinically localised prostate cancer, scheduled for radical retropubic prostatectomy, were allocated to undergo the operation under either general anaesthesia (GA) or under combined (epidural-spinal) (CESA) anaesthesia. Several parameters were recorded both preoperatively (medical history, biometric data, PSA, biopsy Gleason score) and postoperatively (blood pressure, heart rate, haemoglobin levels, operation time and total hospital stay). In addition, mean arterial pressure, change in heart rate, total blood loss, blood transfusions, SAS score, intravenous fluid administration and operation time were also noted down intraoperatively. Patient pain levels and total satisfaction were evaluated using appropriate questionnaires. At the 12-month follow-up, biochemical recurrence using PSA levels and urinary continence status were evaluated. Results: A total of 60 patients were included (30 in each group). Intraoperatively, mean MAP and heart rate change was higher in the GA group (MAP+7,46, HR+27) and mean SAS was higher in the CESA group (+0.93). The time needed for patients’ recovery was faster (-3.5 min) and hospitalization was shorter for patients in the CESA group (-0.6 days). Intraoperative blood loss, time for induction and duration of operation were not significantly different. Mean postoperative drop of haemoglobin was greater in the GA group (+0.56) while blood transfusions, VAS pain scores and amount of intravenous fluids did not differ significantly between the two groups. No complications were reported. Patient satisfaction and urinary continence were comparable between the groups and there were no cases of biochemical recurrence. Conclusions: Radical retropubic prostatectomy can safely be performed under combined (spinal epidural anaesthesia, with possible benefits of lower blood loss, less post-operative complications and earlier discharge. Both procedures have equal oncological and functional outcomes at the 12-month follow-up.
Could we safely omit a Repeat Transurethral Resection of the Bladder (re-TURB) after Hexaminolevulinate Photodynamic Diagnostics (PDD)-TURB?
Authors: Lorusso Vito , Doisy Laure , Granata Antonio Maria , Gregori Andrea , Manfredi Celeste , Spirito Lorenzo , Sciorio Carmine , Ciancimino Luca Giuseppe Maria , Molteni Samuele , Morelli Michele , Cirillo Luigi , Napolitano Luigi , Walz Jochen , Pignot Geraldine
Published: December 2022

Objective: Bladder cancer (BC) is considered one of the malignancies with moderate-high incidence, high rate of recurrence and costly management. Diagnosis and staging are thus important for therapeutic purposes. Considering the risk of residual tumour and understaging, in specific cases, international guidelines recommend performing a second transurethral resection of the bladder (reTURB). Our study aimed to evaluate the impact of hexaminolevulinate Photodynamic Diagnostics (PDD) at first TURB on the rate of residual tumour. Materials and Methods: We retrospectively analysed patients undergoing TURB in our centre between 2012 and 2020. Eightytwo patients had a re-TURB after a first complete TURB with a delay < 3 months. Patients who had an incomplete first resection were excluded. We compared patients who underwent standard white light cystoscopy/TURB and then hexaminolevulinate PDDguided reTURB (group A, n = 49) and patients with PDD-cystoscopy/ TURB at the first procedure then white light cystoscopy/reTURB (group B, n = 33). The residual tumour rate at reTURB as well as median recurrence-free survival (RFS) were compared between the two groups. Results: Residual tumour at reTURB was detected in 48.8% of cases in our cohort, with a significant difference between the two groups (71.4% in group A versus 12.5% in group B, p < 0.001). After a median follow-up of 22 months, the median RFS was 15 months in Group A and 32 months in Group B, but this difference was not significant (p = 0.7). Conclusions: Using PDD at the time of the initial TURB had a statistically significant impact on the rate of residual tumour at the reTURB. Nevertheless, the percentage of residual tumour even with the use of PDD does not allow for safely omitting second resection. Performing a reTURB with PDD for patients who did not have it initially, provides the same benefit in terms of recurrence-free survival.
Confluent and reticulated papillomatosis with eruptions on the trunk and extremities
Authors: Fukumoto Takeshi , Oka Masahiro
Published: December 2022

Dear Editor, Confluent and reticulated papillomatosis (CRP) is a rare skin disorder in young individuals. It is clinically characterized by slightly hyperkeratotic or verrucous grayish-brown papules coalescing to form a reticulated pattern peripherally with confluent plaques centrally. Sites of predilection are the neck, interscapular, intermammary regions, and abdomen. CRP commonly arises during puberty or in early adulthood. Herein, we describe an atypical case of CRP in which the skin lesions developed not only on the abdomen, as a site of predilection, but also on broad areas of the extremities.
Voacanga grandifolia (Miq.) Rolfe protects against alcohol-induced liver toxicity in rats
Authors: Pal Lal Chand , Agrawal Shivankar , Gautam Arti
Published: December 2022

Objective:

To evaluate the ethanol extract of Voacanga grandifolia for hepatoprotective and antioxidant potential against ethanolinduced liver toxicity in rats.

Methods:

Sprague-Dawley rats were administered ethanol (7 g/kg) and then treated with 100 and 200 mg/kg of Voacanga grandifolia extract. The phytochemical constituents and antioxidant potential of Voacanga grandifolia extract were evaluated by GC-MS and in vitro antioxidant assays. Biochemical indicators for liver damage and proapoptotic and antiapoptotic gene expression were determined using biochemical kits, ELISA, and qRT-PCR, respectively. Additionally, histopathological study of the liver was performed.

Results:

GC-MS identified propanoic acid, meso-erythritol, D-pinitol, myo-inositol, and hexadecanoic acid in Voacanga grandifolia extract. Voacanga grandifolia extract (100 and 200 mg/kg) increased the concentration of enzymatic antioxidants while diminishing the levels of inflammatory cytokines and biochemical indicators. qRT-PCR assay showed that Voacanga grandifolia extracts upregulated antiapoptotic gene expression while downregulating pro-apoptotic gene expression. Furthermore, the plant extract improved the hepatic architecture of ethanol-intoxicated rats.

Conclusions:

Voacanga grandifolia extract demonstrates hepatoprotective activity against alcohol-induced liver injury in rats and could be a potential hepatoprotective agent.
Role of microtubules in neuro-electrical transmission
Authors: Zhu Bao Ting
Published: December 2022

Unlike man-made electronic devices such as computers, the nervous system never suffers from “overheating” due to its massive neuro-electrical activities. This paper proposes a new hypothesis that neuronal microtubules (neuro-MTs), which are major structural components of axons and dendrites, are vacuum cylindrical nanotubes that can mediate electrical transmission with a unique form of quasi-superconductivity. It is speculated that hydrolysis of guanosine triphosphate catalyzed by the a-/ß-tubulin subunits would supply cellular energy to relocate electrons to form the conduction electrons inside neuro-MTs. Owing to the consecutive dipole ring structures of neuro-MTs, the moving speed of the conduction electrons inside neuro-MTs is expected to be very slow, and this feature would enable physiological neuro-electrical transmission with super-high energy efficiency. Further, the dipole ring structures of a neuro-MT would help terminate the electron conduction with high efficiency. The proposed neuro-MT-mediated electrical transmission offers a new mechanistic explanation for the saltatory conduction of action potentials along the axons. Lastly, it is speculated that owing to its unique consecutive dipole sheet structures, the myelin sheath which wraps around large axons and some dendrites, may functionally serve as an effective shield for the electromagnetic fields generated by the conduction electrons inside the axonal neuro-MTs.
Blood analysis by Raman spectroscopy for laser stimulation on mouse prefrontal cortex
Authors: Li Shu-Yang , Xia Yu-Dan , Tian Jing , Shan Chunlei , Zhang Heng , Chen Na , Liu Shu-Peng
Published: December 2022

Low-level laser therapy, a noninvasive physical therapy, is applied to a wide range of conditions and has many effects including anti-inflammatory, analgesic, and anti-allergic effects. Some reports show that low-level laser therapy improves memory for patients. In this study, we explored the effect of laser stimulation on the prefrontal cortex of Alzheimer’s disease model mice. Ten 4-month-old APP/PS1 double-transgenic Alzheimer’s disease model mice were selected for prefrontal cortex stimulation by an 808-nm laser for 40 minutes every day. The peak intensities of blood Raman spectroscopy at 675, 747, 1124 (P < 0.05), 1223 (P < 0.05), 1305, 1340, 1372, 1540, and 1637 cm-1 were different between the laser stimulation group and the control group. The results indicated that laser stimulation of the mouse prefrontal cortex may induce some changes in blood components, such as porphyrins and glucose. Laser stimulation could play a role in the neurophysiological activity, thereby triggering the changes in blood components that could be detected by Raman spectroscopy.
Conservative Approach for Managing Complicated Crown-root Fracture in a 4-Year-Old Child
Authors: Kariya Pratik B. , Singh Sweta , Deshpande Anshula Neeraj , Desai Arohi
Published: December 2022

Traumatic dental injuries (TDIs) are of great concern when it comes to a child. Crown-root fracture is the most complicated type as both crown and root are affected by trauma. Complicated crown-root fracture seldom occurs in deciduous dentition. It is a tragic experience and requires immediate attention and quick functional and esthetic repair. Appropriate and early diagnosis leads to successful treatment, for which knowledge on types of TDIs, classification, and management is necessary. Complete restoration of teeth affected with trauma will restore function and esthetics and preserve occlusal harmony. The objective of the present case report is to discuss the appropriate diagnosis and conservative treatment of this unusual and rare case of complicated crown-root fracture in a 4-year-old child using tooth fragment reattachment. This case will focus on the options to restore the uncommon trauma and normalize the function and esthetics of the patient, which will lead to improvement of speech, increase in self-confidence and protection of successors, and describe the treatment and aspects concerning follow-up of the patient.
The Triad of Denial, Neglect, Behavioral Disorder Causing to Habitual Multiple Foreign-Body Ingestion – A Surgeon's Nightmare
Authors: Verma Roshan K.
Published: December 2022

Behavioral disorders in children can sometimes lead to habitual and deliberate ingestion of multiple foreign bodies that may be neglected for long periods and require a multidisciplinary team approach to remove them successfully.
Evaluation of Serum Ferritin and D-Dimer Levels in COVID-19 Patients of an Indian Tertiary Care Setting
Authors: Raja Sangeetha , Periasamy Deepa , Periyasamy Bagavathiammal , Narayanasamy Dheebalakshmi , Periaswamy Panneerselvam , Vajiravelu Suganthi
Published: December 2022

Background and Aim:

Because COVID-19-affected individuals with severe disease are more susceptible to develop acute respiratory distress syndrome, metabolic acidosis, and septic shock, it is currently widely accepted that severe COVID-19 cases have a higher fatality rate than mild instances. Hence, it is very critical to identify between severe and mild disease among the COVID-19-affected individuals at the earliest to prevent the fatal sequelae. The study was done using serum ferritin and D-dimer levels as biomarkers to find a correlation between the severity of lung involvement among COVID-positive patients.

Materials and Methods:

A cross-sectional study has been conducted between June 2021 and November 2021 for 6 months among the patients who are positive for COVID-19 at the Government Erode Medical College. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was detected in all of the patients using a real-time reverse transcription–polymerase chain reaction assay.

Results:

One hundred and eight COVID-19-affected individuals with lung involvement and 102 COVID-19-affected individuals without lung involvement were included in the current study. Groups A and B had mean ages of 61.72 ± 10.6 years and 54.78 ± 12.4 years, respectively. COVID-19 infection was studied in patients who were both mildly unwell and severely ill, where the findings revealed a link between serum ferritin and D-dimer levels and lung involvement among COVID-positive patients. The group with lung involvement had considerably higher D-dimer levels than the group without the involvement.

Conclusion:

The levels of D-dimer and ferritin are linked to serious involvement of the lung as indicated by the computed tomography scan. Both these markers of inflammation are useful in determining the severity of SARS-CoV-2 infection among the infected patients.
Medical Students' Perspective on Working in a Health-Care Team - Revealed by Thematic Analysis
Authors: Shetty Archana
Published: December 2022

Implementation of Competency-Based Medical Education in 2019 has brought significant changes in the delivery of medical education in India. Attitude, ethics, and communication module has been introduced in to focus on the much-overlooked soft skill aspects and real-life scenarios that will be encountered during future medical practice. The present study has used thematic analysis to understand the effect of this newly implemented module on undergraduates. Qualitative data analysis of thematic type was performed for gaining in-depth perceptions. Analysis revealed that students observed the importance of various roles and their hard work involved in hospital functioning. Students felt they would practice attributes of collaborative work, enhanced communication, and respect for all support systems in future practice. Students perceived the module positively and got to know the facets of under-recognized roles of health-care workers other than medical professions, whose role is crucial for delivering quality health-care services.
Spinal Intramedullary Tumors
Authors: Menon Girish , Srinivasan Siddharth , Nair Rajesh , Hegde Ajay , Nair Suresh
Published: December 2022

Intramedullary spinal cord tumors constitute an uncommon group of central nervous system neoplasms which pose considerable diagnostic and management challenges. Often low grade, these tumors have an insidious onset and slow progression, which makes early diagnosis a challenge. Advances in magnetic resonance imaging technology have greatly aided the diagnosis and preoperative planning of intramedullary tumors. Yet, radiological diagnosis can be difficult in the presence of several tumor mimics. The introduction and advancement of microsurgical techniques have made surgery the preferred treatment modality. Timing of intervention, however, is contentious. Eloquence of the surrounding tissue and the unforgiving nature of the spinal cord adds to the surgical challenge. Their treatment and prognosis is largely dependent on tumor histology and patient functionality. Well-demarcated tumors like ependymomas and hemangioblastomas can be resected completely with good outcome. Infiltrative tumors such as high-grade astrocytomas are best managed with biopsies or limited resections. Postoperative deficits can be crippling and the use of intraoperative neurophysiologic monitoring and other adjuncts is mandatory. Subtotal resection carry a high risk of recurrence and gross total resection carries a high risk of operative morbidity. With the availability of newer imaging modalities and intraoperative adjuncts, the earlier pessimistic conservative approach has been replaced by an aggressive surgical approach. This review provides an overview on the entire spectra of spinal intramedullary tumors with particular focus on management strategies.
A 5-year analysis of admissions, seasonal variation, and patient outcomes in rural Nigeria
Authors: Ibrahim Azeez Oyemomi , Agbesanwa Tosin Anthony , Aremu Shuaib Kayode , Agboola Segun Matthew , Shabi Olabode Muftau , Afolabi Babatunde Adeola
Published: December 2022

Introduction:

In low- and middle-income countries like Nigeria, there is an observed paucity of data on the admission pattern and patient outcomes in health facilities. Few related studies were conducted in the urban centers, but none from the rural areas where the majority of the populace resides. This study is to ascertain the demographic profile, seasonal variations, yearly distribution, admission pattern, and treatment outcomes at the accident and emergency department (AED).

Materials and Methods:

A retrospective survey was used to review the data of patients admitted to the AED of the institution between January 2015 and December 2019. The data obtained were analyzed using SPSS Version 20.0. The results were presented in descriptive and tabular formats.

Results:

Five thousand nine hundred and forty-four patients were studied with a mean age of 49.8 ± 19 years. There were 53.9% males and 46.1% females. Many (60.1%) were admitted from April to October. There were 58.9% medical and 41.1% surgical cases. Among the medical cases were 18.6% noncommunicable and 18.5% communicable diseases. Out of 5944 patients, 9435 disease patterns were diagnosed with infectious diseases 15.5%, and orthopedic 14.4% being the most frequently diagnosed medical and surgical cases, respectively. The treatment outcome revealed that the mortality rate was 3.7%.

Conclusions:

The number of admissions increased over 5 years. Although most patients were treated and discharged successfully, the number discharged against medical advice was high. Therefore, appropriate hospital and community interventions should be implemented to improve admission outcomes.

The following core competencies are addressed in this article:

Patient care and procedural skills, Medical knowledge, and Systems-based practice.
Prevalence of Coexistent Allergic Rhinitis in Schoolchildren with Bronchial Asthma and Its Association with Asthma Control
Authors: Shanmuganathan Aruna , Gopalakrishnan Kumaran , Ganga Nisha
Published: December 2022

Introduction:

Bronchial asthma (BA) is a common chronic respiratory disease in children with a wide variation in global prevalence due to differences in environmental and genetic factors as well as differences in diagnostic criteria. Allergic rhinitis (AR) is one of the major risk factors associated with childhood asthma, with coexistent AR reported in 60%–70% of children with asthma in India. According to the one airway hypothesis, with evidence from epidemiological and clinical studies, the upper and lower airways share the same pathophysiological changes. This similarity results in inflammatory changes in either airway to have an effect on each other. Very few Indian studies have reported on increasing prevalence of childhood BA. Hence, it is essential to diagnose and treat concomitant AR in patients with BA to achieve good asthma control.

Aim:

To study the prevalence of coexistent AR in schoolchildren with BA and its association with asthma control.

Materials and Methods:

This prospective cross-sectional study was done during 3 months period from June to August 2018 in five randomly selected schools from a semi-urban area. A total of 1417 students of both genders belonging to 8–14 years of age were included. Demographic details were noted and spirometry was done. BA was diagnosed and control of asthma was assessed based on the Global Initiative for Asthma guidelines. Children diagnosed with BA were administered AR and its Impact on Asthma (ARIA) questionnaire to determine the prevalence and severity of AR. Data were analyzed using SPSS Version-20 and the severity of ARIA was correlated with asthma control using Pearson's correlation test.

Results:

The prevalence of BA among 1417 schoolchildren was 5.86% and majority of the asthmatic children were not well controlled (95%). 97.5% of children with BA had coexistent AR. There was a significant (P < 0.001) correlation between the severity of AR with asthma control.

Conclusions:

Our study showed a high prevalence of coexistent AR in children with BA. Children with greater severity of AR were found to have poor asthma control.
Comparative Evaluation of Transverse Dental Arch Width Changes with Conventional and Self-ligating Brackets
Authors: Balakrishnan Nivethigaa , Subramanian Aravind Kumar
Published: December 2022

Aim:

This study aims at comparing the transverse width changes during leveling and aligning phase with conventional and self-ligating brackets.

Materials and Methods:

The study consisted of twenty samples. The sample was split into two groups. Group 1 consisted of ten samples treated with conventional brackets and ten samples treated with self-ligating brackets. Pretreatment and leveling aligning cast were used for the study. Measurement of transverse dimension was taken at two different regions, premolar and molar. Reference points were chosen according to the Pont's model analysis. In the premolar region, measurements were made from the distal pit of the first premolar on either side, and in the molar region, measurements were made from the mesial pit on either side. The overall values are compiled and compared among both the bracket groups.

Results:

The results of the study showed that there were changes in the interpremolar and intermolar arch width during leveling and aligning phase in both the bracket types.

Conclusion:

Since the arch width changes can affect the stability in the posttreatment phase, an orderly use of custom-made archwires from the very beginning is advised. The amount of arch width changes that occur with the treatment is irrespective of the bracket type, provided that other factors are maintained to be constant. Both conventional metal-ligated brackets and dual-activation self-ligating brackets provide an equal amount of changes in the dental arch transverse dimensions.
Role of Open Laparostomy in Severe Abdominal Sepsis and Other Acute Abdominal Conditions
Authors: Danvath Kishan , Pokala Praveen Kumar
Published: December 2022

Introduction:

Laparostomy or open abdomen is defined as intentionally leaving the abdomen open following laparotomy and closed once condition of the patient becomes stable. The exposed abdominal contents are protected with a temporary cover. This is performed in severely where repeat access to the peritoneal cavity is needed in the postoperative period. This allows free drainage from the peritoneal cavity and prevents the development of complications due to immediate closure of abdomen, such as abdominal compartment syndrome. However, this is a morbid procedure and is associated with many complications.

Materials and Methods:

In this retrospective study, a total of 25 patients were included. Data were obtained from case records from the emergency and elective surgical departments of patients who had laparostomy in the last 3 years. Analysis of data was done with regard to indications, surgical procedure, timing of return to theatre, fascial closure, and complications including death.

Results:

In all cases, temporary abdominal closure (TAC) done using a plastic cover or silo bag. Out of 25 patients, 10 patients had gross peritoneal contamination due to gastrointestinal perforation, pancreatic necrosis in 2 cases, bowel gangrene in 2 cases, and abdominal trauma with intraperitoneal bleeding in 3 cases. Two patients died within 48 h of initial surgery. Fascial closure was achieved between 3 and 7 days, with an average of 3.8 days. Only skin closure without fascial closure was performed in 3 cases.

Conclusions:

Laparostomy is a very useful procedure in severely ill and unstable patients with multiple intra-abdominal injuries, gross peritoneal contamination, and severe bowel edema, where repeat access to the peritoneal cavity is required in the postoperative period. Fascial closure rates are similar to other TAC closure techniques. Wound infections and inability to close fascia are important complications.
Idiopathic Necrotizing Fasciitis of the Breast
Authors: Dubhashi Siddharth Pramod
Published: December 2022

Necrotizing fasciitis of the breast is extremely rare. This is a report of a 41-year-old woman with idiopathic necrotizing fasciitis of the breast, who was managed successfully with a good index of clinical suspicion, early surgical intervention, parenteral antibiotics, and nutritional support. This helped in further spread of local infection, minimizing the damage to the breast parenchyma.
Determination of Serum Procalcitonin and Total Antioxidant Capacity in Patients of Sepsis before and after Treatment, in a Tertiary Care Hospital
Authors: Jain Divya Anand , Sontakke Ajit V. , Pawar Vaishali S. , Jain Ashutosh
Published: December 2022

Introduction:

Sepsis is a medical emergency, occurring due to the body's systemic immunological response to an infection. It is among the most common reasons for intensive care unit admissions worldwide and is one of the top 10 leading causes of death worldwide. Procalcitonin (PCT) is the marker of sepsis, and total antioxidant capacity (TAC) is a marker of oxidative stress and gives a mirror image about patient's antioxidant status. The purpose of the study was to estimate serum PCT and TAC levels in sepsis patients, before and after treatment, and to find the correlation between them.

Materials and Methods:

In this observational follow-up study, 60 sepsis patients were recruited using purposive sampling method, and samples were taken before and after treatment. Separated serum was used to measure PCT and TAC. PCT was measured by a rapid quantitative test using a sandwich immunodetection method based on fluorescence immunoassay technology, on a Finecare FIA system. Values over 0.5 ng/ml were considered significant. TAC was measured using the ferric-reducing antioxidant power method based on reduction of a colorless Fe3+-TPTZ on interaction with a potential antioxidant, into an intense blue Fe2+-TPTZ complex.

Results:

The mean PCT in subjects before treatment was as high as 40.62 ± 12.02 ng/ml, and the difference between before and after treatment values was highly significant (P = 0.000). For TAC also, before treatment value was higher (485.64 ± 106.53 μm/l) than the after treatment (277.79 ± 74.17 μm/l) value with a significantly high difference (P = 0.000). Furthermore, a strong positive correlation between PCT and TAC (r = 0.754, P = 0.000) was observed.

Conclusion:

It was concluded that in sepsis, there is a concomitant existence of inflammation and oxidative stress. Since TAC values correlate with values of PCT, TAC could be a reliable prognostic marker and may be helpful in evaluating interventions on follow-up of patients.
Dysphagia in the Elderly
Authors: Gupta Manish , Gupta Monica , Gupta Akanksha
Published: December 2022

The process of eating and swallowing is a complex physiologic process requiring volitional as well as reflexive activities and involving multiple structural and functional elements. Dysphagia is a geriatric syndrome resulting in multiple negative health consequences. Dysphagia can have profound adverse influences, including malnutrition, dehydration, aspiration pneumonia, and depression poor quality of life in the elderly. With the aging of the population across the globe, health-care providers are encountering older patients with dysphagia either due to oropharyngeal or esophageal disease. Barium swallow remains a low-cost initial alternative for luminal and esophageal motility assessment. A variety of emerging modalities can help detect anatomical and functional deficits. These include fiberoptic endoscopic evaluation of swallowing, videofluoroscopic swallow study, high-resolution pharyngeal manometry, and esophagogastroduodenoscopy. This review provides a comprehensive review of diagnostic modalities and addresses several issues regarding the collaborative management of elderly persons with dysphagia, including a brief discussion on how swallowing mechanisms are affected by the aging process.