bluuebunny/crossref_metadata_2025 huggingface dataset:
Rancang Bangun Mesin Pencuci Kentang
Authors: Defrian Angga , Ginting Agus , Zulfakri Zulfakri , Amrizal Amrizal , Tarigan Sumatera , Febriamto Adi
Published: June 2024

Abstrak. Salah satu faktor penting dalam menjaga kualitas kentang adalah proses pasca panen yaitu pencucian. Proses pencucian kentang saat ini masih dilakukan secara manual oleh para petani, bahkan banyak tidak dicuci setelah proses pemanenan selesai. Hal ini mengakibatkan tampilan kentang kelihatan kurang menarik. Proses pencucian dengan cara ini mempunyai beberapa kelemahan dimana penggunaan air menjadi tidak terkontrol, juga membutuhkan ruang yang besar untuk perendaman yang banyak dan membutuhkan waktu yang lama. Oleh karena itu tujuan penelitian ini merancang dan membangun mesin pencuci kentang, dengan harapan pada pencucian kentang menjadi lebih efisien waktu dan lebih efektif.  [A1] Metode yang digunakan pada perancangan ini adalah analisa perancangan, rancangan struktural, fungsional dan hasil pengamatan. Hasil penelitian ini telah merancang bangun mesin pencuci kentang dengan ukuran panjang 78,75 cm, lebar 35 cm dan tinggi 58 cm. Dari analisa perancangan didapatkan kapasitas adalah 155,24 kg/jam. Hasil pengamatan yaitu pada 1 kg kentang dengan perbedaan waktu pencucian yaitu 0,[A2] 5, 1, 1,5, dan 2 menit.,  didapatkan waktu pencucian yang optimal  adalah 1 menit dan 1,5 menit pada beban 1 kg kentang. hasil dari 1 menit dan 1,5 menit masing-masing menghasilkan kentang yang bersih sebesar 76,92%, 84,61%, kotor 15,38%, 7,69%, dan kulit terkelupas 7,69%, 15,38%. Potato Washing Machine DesignAbstract Abstract One important factor in maintaining the quality of potatoes is the post-harvest process, namely washing. The current potato washing process is still done manually by farmers, many are not even washed after the harvesting process is complete. This results in the appearance of potatoes looking less attractive. The washing process in this way has several disadvantages where the use of water becomes uncontrolled, also requires a large space for a lot of soaking and takes a long time. Therefore the purpose of this study is to design and build a potato washing machine, with the hope that washing potatoes becomes more time efficient and more effective. The method used in this design is design analysis, structural, functional design and observation results. The results of this study have designed a potato washing machine with a length of78,75 cm, width of35 cm and height of58 cm. From the design analysis, the capacity is155.24 kg / hour. The results of the observation were on1 kg of potatoes with a difference in washing time of 0.5, 1, 1.5, and 2 minutes., the optimal washing time was 1 minute and 1.5 minutes on a load of1 kg of potatoes. The results of the observation were on1 kg of potatoes with a difference in washing time of 0.5, 1, 1.5, and 2 minutes., the optimal washing time was 1 minute and 1.5 minutes on a load of1 kg of potatoes. The results of 1 minute and 1,5 minutes resulted in clean potatoes of 76.92%, 84.61%, gross 15.38%, 7.69%, and flaky skin of 7.69%, 15.38%, respectively.
Pengaruh Kombinasi Vermikompos Dan Zeolit Terhadap Nitrogen, Fosfor, Dan Kalium Tanah Ultisol
Authors: Annisa Nur Rahma , Fikrinda Fikrinda , Zuraida Zuraida
Published: June 2024

Abstrak. Ultisol merupakan lahan suboptimal yang memiliki kendala ketersediaan hara. Penelitian ini bertujuan untuk mengetahui pengaruh kombinasi vermikompos dan zeolit terhadap nitrogen, fosfor, dan kalium tanah Ultisol. Penelitian ini menggunakan Rancangan Acak Kelompok dengan tujuh perlakuan dan tiga ulangan sehingga terdapat 21 satuan percobaan.  Faktor-faktor yang diuji yaitu kontrol (K0), 10 g pot-1 vermikompos (K1), 10 g pot-1 vermikompos+15 g pot-1 zeolit (K2), 20 g pot-1 vermikompos (K3), 20 g pot-1 vermikompos+15 g pot-1 zeolit (K4), 30 g pot-1 vermikompos (K5), 30 g pot-1 vermikompos+15 g pot-1 zeolit (K6). Hasil penelitian menunjukkan bahwa aplikasi vermikompos sebagai perlakuan tunggal maupun berkombinasi dengan zeolit meningkatkan kadar N total, P tersedia, dan K dapat dipertukarkan.  Kombinasi vermikompos dan zeolit efektif meningkatkan hara kalium sedangkan aplikasi vermikompos dalam dosis tinggi (30 g pot-1) memberikan pengaruh lebih baik terhadap hara nitrogen dan fosfor pada Ultisol. The Effect Of Vermicompost And Zeolite On Nitrogen, Phosphorus, And Potassium Of Ultisol Soil Abstract. Ultisol soil is a suboptimal land that has constraints on nutrient availability. This study aimed to determine the effect of the combination of vermicompost and zeolite on nitrogen, phosphorus, and potassium in ultisol soil. This study used a Randomized Block Design with seven treatments and three replications, so there were about 21 experimental units. The factors were control (K0), 10 g pot-1 vermicompost (K1), 10 g pot-1 vermicompost + 15 g pot-1 zeolite (K2), 20 g pot-1 vermicompost (K3), 20 g pot-1 vermicompost + 15 g pot-1 zeolite (K4), 30 g pot-1 vermicompost (K5), 30 g pot-1 vermicompost + 15 g pot-1 zeolite (K6). Results showed that the vermicompost as a single treatment or in combination with zeolite had increased exchangeable K significantly. The increase of vermicompost had effect on increasing available P and exchangeable K, while the increase of zeolit had increased the exchangeable K but decreased available P. In conclusion, the best application for ultisol soil is the use of vermicompost at 30 g pot-1 (K5).
PICU admission order set: a quality improvement initiative in a developing country
Authors: Aijaz Muhammad Sartaj , Shafiq Kiran , Faisal Urooj , Saeed Arsalan , Haque Anwarul
Published: June 2024

Background: Multiple studies have shown that standardized admission order sets (AOSs) in general as well as specific clinical diseases improved adherence to evidence-based patient management, minimized variability, improved workflow, and augmented patient safety. These order sets are intended to provide a framework for treating patients and planning a course of care. The objective of this study is to assess the implementation of SAOS in a Pediatric Intensive Care Unit (PICU) of a new public-sector hospital in Pakistan.
Methods: A descriptive, cross-sectional study was conducted on all children (age: 1 month to 15 years) admitted to PICU from October to December 2022. All admission orders were paper-written based on the mnemonic "AD CAVA DIMPLS". All data were collected on Microsoft Excel and descriptive statistics were applied.
Results: A total of 932 admissions were done during the first three months. The most common age and admitting diagnosis were one-year-old and lower respiratory tract diseases respectively. The overall adherence to AOS was 71.68%. Nine components of AOS [AD CAVA DIM] had 90.77% appropriate utilization.
Conclusions: We observed a very high rate of implementation of AOS in our PICU.
Prevalence, risk factors and outcomes of acute kidney injury in critically ill children with hematological malignancies
Authors: Tariq Rabeea , Haq Anwar U. , Ahmed Abdul R. , Saeed Arsalan , Khan Mohammad R.
Published: June 2024

Background: Limited data is available on acute kidney injury (AKI) in critically ill children with hematological malignancies. The aim of this study is to assess the rate, risk factors and outcome of AKI in children with hematological malignancies admitted in the pediatric intensive care unit (PICU) of a large tertiary-care pediatric oncology referral center in Karachi.
Methods: We conducted a retrospective, cross-sectional study on critically ill children with hematological malignancies who developed AKI and were admitted in PICU from July 2017 to June 2019. Demographic data, clinical profile, and outcomes were included. AKI was defined according to the kidney disease: improving global outcomes (KIDGO) criteria.
Results: Of 399 critically ill children with a hematological malignancy, 85 (21.33%) patients developed AKI. The mean age was 7.8±3.8 years and 66% were male. The most common diagnosis was acute lymphoblastic leukemia (ALL) (50%). Dialyitc therapy was initiated in 9 patients (2.3%) only. The risk factors for AKI were tumor lysis syndrome (p=0.001), exposure to nephrotoxic drugs (p<0.001), septic shock (p<0.001), use of mechanical ventilation (p<0.001), need of vasoactive drugs (p<0.001) and age (p<0.001). Kaplan-Meier survival analysis showed that median survival time in children with AKI was 11 days (95% CI 7.6–14.4) while median survival time in children without AKI is significantly higher (log rank test p<0.001). By multivariate analysis, AKI is an independent risk factor for mortality [OR 20.02; 95% CI 8.14-49.28; p<0.001]. The mortality rate was 63.5% in patients with AKI and 8.6% in patients without AKI (p<0.001).
Conclusions: AKI occurred in 21.3% of critically ill children with hematological malignancies and is associated with age, organ dysfunction, sepsis, tumor lysis syndrome and exposure to nephrotoxic drugs. AKI is an independent risk factor for high mortality rate in this population.
Pattern of changes in hepatic aminotransferases level during dengue infection in children aged 1-12 years
Authors: Swamy Satyawathi , Ukkali Sadashiva B. , Kulkarni Nagamani , Thobbi Achyut N.
Published: June 2024

Background: Dengue fever is a pandemic viral disease carried by mosquito-borne flavivirus. Dengue infection is the most common arthropod infection in humans. The study is done with the aim to establish a relation between hepatic dysfunction and outcome in patients with dengue fever. It was found that hepatic transaminases were significantly deranged in dengue with warning signs indicating poor prognosis and need for early initiation of supportive treatment which can reduce mortality and morbidity in these children. Liver function tests can be of profound benefit in indicating the prognosis of children with dengue fever in resource-limited settings.
Methods: Cohort prospective observational study in Al-Ameen children hospital over 2 years. Patients aged 1-12 years fulfilling WHO case definition of fever and ≥2 of following: nausea/vomiting, rashes, aches and pains, tourniquet test positive, thrombocytopenia or any warning sign and serologically confirmed NS1Ag positive were studied. Once serologically positive, a blood sample was taken while establishing an intravenous line.
Results: Dengue with warning signs and dengue without warning signs were the classifications given to the patient. Both AST and ALT were found to be higher in groups having dengue with warning signs, with AST higher than ALT. 
Conclusions: In dengue infection, hepatic dysfunction was common. Enzymes were significantly deranged in dengue with warning signs indicating prolonged illness and poor prognosis and need for early initiation of supportive treatment for better outcomes.
Safety and efficacy of a fixed dose combination of oral drops of paracetamol, phenylephrine hydrochloride, and chlorpheniramine maleate in the symptomatic treatment of common cold in children: an active post-marketing surveillance study
Authors: Dewan Bhupesh , Shinde Siddheshwar , Motwani Nisha
Published: June 2024

Background: Common cold often accompanied by mild fever and systemic symptoms in children, poses a significant social burden. Scientific evidence suggests that the pathogenesis of colds involves the activation of multiple inflammatory pathways, rendering single-molecule treatment ineffective against the symptoms. This active post-marketing surveillance study evaluated the safety and efficacy of a fixed-dose combination containing paracetamol, phenylephrine hydrochloride, and chlorpheniramine malate in treating common cold in children aged 2 to 5 years.
Methods: In this clinical study, 200 children with common cold symptoms were enrolled. Maxtra® P oral drops, a fixed-dose combination containing paracetamol (125 mg), phenylephrine hydrochloride (2.5 mg), and chlorpheniramine maleate (1 mg) per ml drops, were administered as 1 ml every 4 to 6 hours for 5 days. Safety was assessed using the global tolerability assessment based on responses from parents and investigators. Efficacy was evaluated based on symptom severity scores categorised as absent, mild, moderate, severe, or very severe.
Results: Complete remission from common cold symptoms was achieved in 82% (164 patients) of 200 patients. Statistically significant reductions (p<0.001) in symptom severity scores were observed for all common cold symptoms from day 1 to day 5. No adverse events were observed. Maxtra® P oral drops were regarded as good to excellent for treating common cold symptoms by 92.5% of parents and 97.5% of investigators.
Conclusions: The observations of study indicate that Maxtra® P oral drops are efficacious and well- tolerated for treating common cold in children aged 2 to 5 years.
Study of serum ferritin as diagnostic and prognostic biomarker for severity of sepsis: a hospital-based study
Authors: Thapar Vayom , Khinchi Yograj , Saini Susheel Kumar , Agrawal Garima , Saini Ajay Kumar
Published: June 2024

Background: The objective of the study was to evaluate serum ferritin levels to define it as a diagnostic and prognostic biomarker for severity of sepsis.
Methods: In this hospital-based descriptive type of observational study, conducted at the Department of Pediatrics, NIMS Medical College; 80 children of age group 6 months to 18 years with diagnosis of pediatric sepsis were included. Children were divided into grades of sepsis (sepsis, severe sepsis, septic shock, MODS). Progress of sepsis, severe sepsis, septic shock, and sepsis with MODS was followed with serum ferritin levels on day 1, day 3, day 7, or more than 7 days and one week post recovery.
Results: Pneumonia was identified as the most common source of infection. The blood culture positivity rate was 32.5%. E. coli was the most common organism grown on blood culture. Median serum ferritin levels increased as sepsis severity worsened. A significant association was discovered between sepsis severity and CRP levels at the time of admission.
Conclusions: There is a consistent pattern of Serum ferritin levels with increasing severity of pediatric sepsis. Routine use of serum ferritin levels in diagnosis and prognostication is both feasible and simple. CRP level correlate well with serum ferritin level for diagnosis of sepsis.
Platelet count and its indices as diagnostic markers of neonatal sepsis: a cross-sectional study
Authors: Goyal Sweety , Sharma Chandra M. , Kumar Ravish , Mohan Nitesh
Published: June 2024

Background: Neonatal sepsis is a critical condition posing a significant threat to newborns globally, particularly in developing countries. The non-specific symptoms and time-consuming traditional diagnostic methods highlight the need for rapid and reliable biomarkers. Recent studies suggest platelet count and indices such as mean platelet volume (MPV) and platelet distribution width (PDW) as potential indicators for early diagnosis of neonatal sepsis. This study aimed to assess the correlation between platelet count and its indices and neonatal sepsis.
Methods: A hospital-based cross- sectional study was conducted at NICU of tertiary care hospital involving 80 neonates with suspected sepsis. Platelet count, PDW, and MPV were measured and correlated with neonatal sepsis. Statistical analyses were performed using SPSS software, with a significance set at p<0.05.
Results: Of the 80 neonates studied, 22.5% exhibited thrombocytopenia. There was a noteworthy inverse relationship discovered between platelet count and sepsis, while MPV and PDW were higher. Gram-negative organisms were the most common cause of sepsis, out of which E. Coli (63.64%) was the most common.
Conclusions: The study confirmed a significant association between platelet count and indices with neonatal sepsis. Platelet count, MPV, and PDW can serve as effective, rapid diagnostic markers, potentially improving early detection and outcomes in neonatal sepsis.
Magnetic resonance imaging findings in acute febrile encephalopathy in children
Authors: Hirekerur Vikram L. , Gaikwad Shahaji Y. , Kolewad Aparna B.
Published: June 2024

Background: This prospective observational study aims to study magnetic resonance imaging (MRI) findings in the setting of acute febrile encephalopathy in children between 1 month to 18 year of age group.
Methods: This study was conducted in patients of acute febrile encephalopathy admitted in pediatric intensive care unit (PICU) at tertiary care centre during January 2019 to December 2019 in age group one month to 18 years. 32 patients satisfied the inclusion criteria.
Results: Of the 32 patients included in the study MRI was done in 28 patients. MRI brain was normal in 17 patients and abnormalities were found in 11 patients. Majority findings were cerebral enema and restricted diffusion 3 (10.5%). Other findings were T2 hyperintensity and FLAIR hyperintensity lesion in basal ganglia and thalami region 2 (7%), T2 and FLAIR hyperintensity hippocampal lesion in hippocampus 2 (7%), haemorrhagic lesion 1 (3.5%).
Conclusions: Acute febrile encephalopathy is a life-threatening condition. It is important to identify the possible aetiology for directing specific treatment. Amongst others MRI is one modality that has the potential to identify possible aetiology. Paediatric intensive care physicians are not always updated regarding utility of MRI and its findings in acute febrile encephalopathy. The main reason being non-inclusion of this subject in curriculum. This study was intended to understand all the possible MRI findings in acute febrile encephalopathy, correlate it with clinical findings and ultimately aid in management of these cases.
Late-onset maple syrup urine disease triggered by human herpesvirus-6 mediated encephalopathy in a toddler
Authors: Panchal Ashini , Watterson Christopher T. , Green Jack
Published: June 2024

Metabolic crisis should always be on the differential diagnosis of a toddler presenting with focal neurologic signs and refractory ketoacidosis. Maple syrup urine disease (MSUD) is an autosomal recessive metabolic disorder caused by an enzyme deficiency in the branched-chain α-ketoacid dehydrogenase (BCKDH) complex that leads to toxic buildup of the branched-chain amino acids (BCAA) leucine, isoleucine, and valine. Classically diagnosed in the neonatal period (especially with the advent of newborn screening), our patient is a rare case of a previously healthy toddler with late-onset or intermittent MSUD triggered by human herpesvirus-6 and a fasting state. Though MSUD as a diagnosis is incredibly rare beyond the neonatal period, prompt recognition and treatment can be life-saving and lead to good outcomes.
Tropical pulmonary eosinophilia-mimicking acute severe asthma: a case report
Authors: Roy Poulomi , Verma Shalini , Bhatnagar Shrish
Published: June 2024

Tropical pulmonary eosinophilia (TPE) is a rare but serious infection characterized by wheezing, fever, and eosinophilia, with clinical features such as paroxysmal cough, wheezing, and dyspnoea. TPE is diagnosed by a history of filarial endemic regions and peripheral eosinophilia >3,000/mm3. It can be easily missed but can be a differential for bronchial asthma and tuberculosis. A 15-year-old male with cough and breathlessness for three years was diagnosed with TPE after laboratory investigations showed leucocytosis with eosinophilia. A provisional diagnosis was considered, and diethylcarbamazine (DEC) was started at a dose of 6 mg/kg body weight for 21 days, with improvement in the patient's symptoms. TPE affects 51.4 million people globally and is often misdiagnosed as other conditions like bronchial asthma, military tuberculosis, and interstitial lung disease. The diagnostic criteria for TPE include a history of residence or travel to a filarial endemic region, paroxysmal and nocturnal cough with dyspnoea, leucocytosis with peripheral blood eosinophilia>3000/mm3, elevated serum IgE and filarial antibody titres, pulmonary infiltrations in chest X-ray, and clinical improvement with DEC.
A case report on CREST syndrome with acrodermatitis
Authors: S. L. Adithya , D. P. Anfi , Dharan Shaiju S. , Dharman Dhanya
Published: June 2024

Acrodermatitis enteropathica (AE) is an autosomal recessive disorder, which is characterized by mutation affecting intestinal zinc absorption, subsequently leading to hypozincemia. In 20% of the cases, occurs the triad comprising dermatitis, alopecia and intractable diarrhoea as its diagnostic hallmark. The major manifestations include dermatitis, diarrhoea, alopecia, mood changes, anorexia, neurological disturbances, growth retardation, weight loss and recurrent infections. It is caused by mutations in the gene that encodes a membrane protein that binds zinc. Zinc is an essential coenzyme in metal enzymes (like ALP), which is important structural component of gene regulatory proteins and gene expression. Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome is a variant systemic sclerosis characterized by the presence of calcinosis, Raynaud’s phenomenon, oesophageal motility abnormalities, sclerodactyly and telangiectasia antinuclear antibodies recognizing chromosomal centromere proteins are characteristic of CREST syndrome and are present in more than 50% cases. Circulating antibodies against anti-nucleolar antigens are present in most patients with systemic scleroderma. Alterations of the blood vessels and induction of fibroblasts by potent mediators plays an important role in the early phase of scleroderma. Here, we present a case of 12-year-old girl child with insidious onset gradually progressive symptoms of dryness in both lower limbs, bluish discoloration of the fingers on exposure to cold, skin tightening over the face and hands, whitish pigmentation over the scalp and neck, whitish nodules progressing to ulceration over the posterior aspects of both elbows and difficulty in eating- both solids and liquids for 1-year duration.
Diabetic cystopathy due to detrusor muscle dysfunction in a child with type Ⅰ diabetes mellitus
Authors: Parmar Ankita , Kavthekar Saiprasad O. , Kulkarni Suhas P. , M. Sundharavel , Kulkarni Shradha K. , Pawar Ravindra S. , Patil Nivedita B.
Published: June 2024

The word diabetic cystopathy (DC) refers to lower urinary symptoms due to diabetic neuromyopathy and is common in adults while very unusual in children with diabetes mellitus. This case report seeks to delineate a distinctive case concerning a 9-year-old boy who was diagnosed with DC due to detrusor muscle dysfunction confirmed by urodynamic studies, induced by type 1 diabetes mellitus of four years duration. DC should be considered in children with long standing urinary symptoms without urinary tract infection in type 1 diabetes mellitus even if it is rare condition.
Infantile fibromatosis colli: torticollis with auspicious outcome
Authors: Sharma Prasidutt , Agarwal Shubhi , Choudhury Khurshed A. , Udagi Sharanaprabhu
Published: June 2024

Among the various causes of infantile torticollis fibromatosis colli (FC) is a scarce one. Although it’s a benign condition it causes momentous disquiet in parents. Neck swelling with history of difficult instrument delivery is a classical allusion towards FC. Proliferation of sternocleidomastoid (SCM) muscle is the major cause. Presentation is commonly at 2-6 weeks of age with complaints of swelling or torticollis mostly unilateral, rarely bilateral. A 5-week-old male baby presented with swelling on the right side of neck and diagnosed with FC. We evaluated potential diagnostic modalities in this patient and concluded their usefulness and importance in various presentations.
Chronic urticaria with thyroid auto-antibodies linked to urticarial vasculitis
Authors: Gowda Mahesh K. O. , Doddabasappa Prathiba N.
Published: June 2024

Chronic urticaria is a common disorder of unknown origin, which is often associated with normal routine laboratory values and no evidence of systemic disease. Cutaneous vasculitis is one of the rare presentation of chronic urticaria. We reported a 13-year-old female child, who presented to us with tender urticarial wheals all over the body, who on further evaluation was found to have positive anti-thyroid peroxidase antibodies and was diagnosed to have urticarial vasculitis.
Functional outcome of transforaminal epidural steroid injection in lumber disc herniation with radiculopathy
Authors: Rafi Abdullah A. , Roy Liton K. , Hossain Kazi Shahadat , Rahman Mohammed Mahfoozur , Alam Khorshedul , Kadir Mohammed A. , Mahdee Mujtaba T. A.
Published: June 2024

Background: Transforaminal epidural steroid injection (TFESI) is a useful therapeutic tool for lumber disc herniation with radiculopathy. TFESI reduce inflammation and edema around herniated disc and nerve root, thus alleviating pain and accelerating the natural history of the herniated disc by shrinkage. This study aims to determine the effectiveness of TFESI in lumber disc herniation with radiculopathy.
Methods: In this prospective observational study, 273 patients were included considering inclusion & exclusion criteria. All subjects received TFESI for lumber disc herniation with radiculopathy. The primary outcome was assessed with a Bengali version of Oswestry disability index (ODI) score and Roland-Morris disability questionnaire (RMDQ) scores at 2 weeks, 1 month, 3 months and 1 year.
Results: From baseline (18.6±3.6), mean RMDQ score was significantly reduced at 2 weeks (14.4±3.7), at 1 month (13.8±3.8), at 3 months (11.6±3.6) and at 1 year (7.8±3.7) respectively. 69.2% patients had severe disability at baseline according to disability rank of ODI score; after procedure during follow up severe disability was found in 21.6% cases at 2 weeks, 9.1% at 1 month, 5.0% at 3 months and 1.2% at 1 year. The reduction of severe disability from baseline in subsequent follow up was significant. From baseline (45.7±10.0), mean ODI score was significantly reduced at 2 weeks (36.4±9.0), at 1 month (28.2±8.9), at 3 months (24.3±8.9) and at 1 year (18.9±10.5) respectively.
Conclusions: Transforaminal epidural steroid injection significantly reduced disability and provide improved functional outcome in patients with lumber disc herniation with radiculopathy.
Incidence of K-wire fixation of upper limb fractures for road traffic accidents in Bangladesh
Authors: Amin M. Mahamudul , Asaduzzaman M. , Khatun Shamima , Al-Maruf M. Abdullah , Khalequzzaman A. K. M.
Published: June 2024

Background: Road traffic accidents (RTAs) are a significant public health issue globally, particularly in developing countries like Bangladesh. This study focuses on the epidemiological and clinical aspects of upper limb fractures resulting from RTAs, with an emphasis on the treatment modalities employed.
Methods: This retrospective observational study analyzed hospital records of 40 patients with upper limb fractures due to RTAs at Chakaria Unique Hospital, Cox’s Bazar, Bangladesh, within the period of 1 year, from February 2023 to January 2024. The study included cases with comprehensive documentation of fractures resulting specifically from RTAs. Excluded were injuries not related to upper limb fractures and those not caused by RTAs. The focus was on patient demographics, the nature of the fractures, treatment methods (particularly K-wire fixation), and documented outcomes.
Results: The majority of the patients were young males, with the highest incidence in the 21-30 age group (40.00%). Two-wheeler vehicles were the leading cause of these injuries (57.50%). Treatment modalities varied, with open reduction and internal fixation (ORIF) combined with K-wire fixation being the most prevalent (35.00%). Other methods included ORIF alone and ORIF with plate-screw, each accounting for 25.00% of cases. Right-sided injuries were more common (57.50%) than left-sided (42.50%).
Conclusions: The study highlights the predominance of upper limb fractures in younger males due to two-wheeler accidents. The preference for combined ORIF and K-wire fixation in treatment reflects the complexity of these injuries. The findings call for enhanced road safety measures and further research into optimized treatment protocols for upper limb fractures in Bangladesh.
Comparison between malleolar locking plate and metaphyseal locking plate for the management of the distal tibial fracture
Authors: Mustofa M. Gulam , Bhadra Avishek , Saha Sushmoy , Ahmed Sabbir
Published: June 2024

Background: A pilon fracture is a distal tibial metaphyseal fracture that involves the ankle joint. Distal tibia fractures include extra-articular fractures of the metaphysis and the more severe intraarticular tibial plafond or pilon fractures. Several treatment methods have been recommended for the treatment of these injuries, with a recent emphasis on minimally invasive techniques. This research studies the outcome of a malleolar locking plate (M) versus a metaphyseal locking plate (P) in the management of distal tibial (Pilon) fracture.
Methods: Distal tibial M and P were used to treat 80 cases of tibial pilon fracture. The study examined the use of anterior/ anteromedial approach for tibia and posterolateral/ lateral fibular fixation.
Results: The male to female gender ratio was 2.63 in M and 1.35 in P. Mean age was 57.03±15.93 (M) and 52.1±12.788 (P). Surgeries were mostly done within 1 day to 1 week. Mean hospital stay was 6.43±4.545 (M) and 4.93±4.676 (P). The mean lower extremity functional score (LEFS) was 66.55 (M) and 67.15 (P) with 83.56% maximal function. 3 P cases had infections. No infections were seen in M group at the end of the 12th week follow-up.
Conclusions: The results of the study indicate that there is no significant difference in terms of LEFS criteria, union, fracture alignment, range of motion (knee and ankle), infection, and other outcome measures between M fixation and P in the treatment of distal tibia fracture in adults.
From incision to outcomes: a comparative dive into the functional outcomes of arthroscopic all-inside and outside in meniscal repair techniques
Authors: Malhotra Ashu , Srivastav Shekhar , Singh Harjoban , Sen Biswarup
Published: June 2024

Background: Meniscal repair has been associated with superior outcomes, including enhanced knee function, increased activity levels, reduced osteoarthritis progression, cost savings, and improved long-term functional outcome scores compared to partial meniscectomy. This study aimed to evaluate and compare the functional outcomes of meniscal repairs performed using the outside-in and all-inside techniques, utilizing the International Knee Documentation Committee (IKDC), Tegner Lysholm (TL) scores and comparing our results with previous studies.
Methods: This prospective study included 53 patients with traumatic meniscal tears and associated ligamentous injuries that underwent arthroscopic meniscal repair. Details of investigations were recorded, and knee functional assessment was performed using the 2000 IKDC score and TL scores.
Results: The mean age of the patients was 28±8.41 years, with 41 (77.36%) males and 12 (22.64%) females. At the final follow-up of 1 year, the IKDC scores in the all-inside group and outside in group were 93.26±4.45 and 94.31±2.63. The TL scores in the all-inside and outside in groups were 95.33±2.45 and 96±1.00. No statistically significant difference was noted between the two groups (p value >0.005).
Conclusions: Meniscal repairs in the two groups in our series demonstrated favourable clinical outcomes, as evidenced by significant improvements in IKDC score with averages increasing from 25.31 to 93.26 and from 25.91 to 94.31 in all-inside and outside-in groups respectively. The TL sores showed an improvement from 21.07 to 95.33 and from22.43 to 96.00 in all-inside and outside-in groups respectively. In conclusion, short-term results of traumatic meniscal tears with repair are promising, leading to significant improvements in knee function irrespective of concomitant injuries and the type of repair.
A rare case of a floating knee concomitant with an ipsilateral floating hip and a bimalleolar fracture
Authors: Pires Joao , Inês Ana , Miraldo Leonardo , Gameiro Diogo , Peixoto Daniel
Published: June 2024

An ipsilateral floating knee and hip is an extremely rare condition that is associated with a life threatening condition. So its correct management, is essential to mantain a stable hemodynamic condition. We reported our management for this fracture in order to underline the rareness, the severity of this entity and highlight the importance of damage control to respond to this. A 71-year-old female referred to our hospital after motor vehicle accident. At arrival, the patient was hemodynamically unstable and went directly to the emergency room, which was reverted. In physical examination there was a swollen thigh, without neurovascular deficits. X-rays reveal a LC type 1 fracture with sacrum, superior and inferior pubic ramus compression fracture, a wedge extra-articular distal femur fracture, a transverse tibial shaft fracture and a bimalleolar fracture. Then in the operation room the patient become unstable hemodynamically, and it was decided to do a reduction and fixation with an external fixator in the femur shaft and in the tibiotarsi joint, which enable the patient recovery. After 7 days, the patient still stable hemodynamically and a retrograde femoral nailing and an anterograde tibial nailing was made. Due to lack of skin conditions, the bimalleolar fixation was postponed to thirteen days after when its osteosynthesis was performed. The LC type 1 fracture underwent osteosynthesis with two percutaneous partially-threaded screws. Then the patient underwent to a rehabilitation protocol. Follow-up appointments showed good radiologic and clinically evolution. At 6 months revealed a complete return to normal daily life, without limitation or pain. In our work, we highlight the rareness and the severity of this injuries and the need of the damage control approach due to the hemodynamic unstableness of this kind of patients.
A rare presentation of intramuscular ganglion cyst in gastrocnemius muscle: a case report
Authors: Bhushan Ravi , Madan Harnam S. , Goel Siddharth , Nupoor
Published: June 2024

Ganglion cyst is a common benign cystic lesion but its presence at intramuscular region is rare. There are very few such reported cases in literature which are confirmed by histopathology. Here we are reporting a rare case of ganglion cyst in medial head of gastrocnemius muscle in a 20 year old male who presented with complaints of swelling in proximal aspect of left leg associated with occasional pain. The diagnosis was made on the basis of MRI and was confirmed histopathologically.
Isolated traumatic hip dislocation along with ipsilateral femur shaft fracture: rare case report with review of literature
Authors: Tukade Sandeep Marotirao , Sheth Binoti A. , Akhade Nagesh , Laldas Sourav
Published: June 2024

Hip dislocation accompanied by an ipsilateral fracture of femur shaft is an uncommon injury usually seen after high-velocity trauma and often coincides with multiple systemic injuries. This case report describes a 27-year-old male who suffered a posterior hip dislocation and ipsilateral fracture of femur shaft following a motorcycle-car collision accident with no associated fractures of the acetabulum and femoral neck. He was treated with fixator-assisted hip reduction and intramedullary femur interlock nailing in lateral position in a same setting. The advantage of this method is that the rate of AVN of femoral head is decreased by decreasing the overall timing of surgery and it also allow early successful reduction of the hip. The risk of AVN should be explained to the patient beforehand even if the surgery is done within 6 hours. This case highlights the importance of timely intervention and effective surgical techniques in managing such complex injuries and also aims to share our experience in managing such rare injuries and review the existing literature on this rare injury.
Musculoskeletal ultrasound as a diagnostic tool in quadriceps tendon rupture
Authors: Kaur Depinder , Choudhary Amit K. , Singh Rana P.
Published: June 2024

Quadriceps tendon ruptures are relatively rare injuries, particularly in young adults, and their diagnosis can be challenging. This case report presents a case of traumatic quadriceps tendon rupture in a young adult and highlights the use of ultrasound Imaging as a diagnostic tool. Quadriceps rupture is uncommon in young adults in contrast to patellar tendon rupture but in this case young patient presented with acute knee pain and an inability to extend the leg after a sudden H/o fall, leading to a loss of continuity between the quadriceps muscle and the patella. Musculoskeletal Ultrasound examination revealed a complete tear of the quadriceps tendon, confirming the diagnosis. The patient underwent surgical repair and achieved a favorable outcome with appropriate rehabilitation. This case report emphasizes the importance of considering quadriceps tendon rupture in the differential diagnosis of acute knee injuries and highlights the value of ultrasound in making an accurate and timely diagnosis.
Synovial hemangioma: an unusual cause of chronic anterior knee pain in children
Authors: Lingaiah Purushotham , Abraham Vineet Thomas
Published: June 2024

Synovial hemangioma is an uncommon cause of chronic anterior knee pain. The non-specific clinical presentation leads to delay in diagnosis. MRI is diagnostic and should be considered early in evaluation to plan treatment and prevent functional disability. We present a case of unilateral synovial hemangioma of the knee in a child with pain, swelling and restricted knee mobility. Arthroscopy can be diagnostic and therapeutic in such cases.
Non-tuberculous mycobacterial infection over abdomen: an interesting case report
Authors: Velapati Sai Teja Reddy , Gopal K. V. T. , Raju P. V. Krishnam , Bulla Rekha Rani
Published: June 2024

Non‐tuberculous mycobacteria (NTM) are Mycobacterium species other than M. tuberculosis and M. leprae. - referred to as ‘atypical’. They are acid-fast bacilli residing in soil and water that cause cutaneous infections primarily after trivial trauma, surgery and cosmetic procedures. Skin and soft tissue infections (SSTI) caused by NTM species are increasing in incidence. They have a wide spectrum of clinical manifestations. NTM SSTI should be suspected when the skin infection does not respond to empirical antibiotics; Although, even with a sound clinical suspicion, the relatively low sensitivity of AFB & Fite staining as well as non-specific histopathology findings, the diagnosis is difficult. Optimal therapy is not well established, but usually is species dependent and includes use of multiple antibiotics for several months and potential use of adjunctive surgery. We report a case of 40-year-old female presented with chief complaint of multiple painful swellings over abdomen for 2 years not subsiding with standard antibiotic and surgical management. Investigations were done to rule out cutaneous tuberculosis, mycetoma and septic panniculitis; Automated mycobacterial culture on Modified Middlebrook 7H9 broth showed growth of NTM after 13 days of aerobic incubation. Though species could not be identified due to lack of resources, she was treated with combination of Rifampicin, Clarithromycin and Minocycline for 6 months; Good response was seen within 3 weeks and complete clearance of abscess was seen after 2 months of follow-up.
Hair dye allergies: available alternatives
Authors: Gurusamy Sukanya , Danny Celestin Geo , S. Gayathri , Sundarara Divyabharathi
Published: June 2024

P-phenylenediamine (PPD) is a well-known sensitizer of skin which forms a major component in permanent hair dyes. Allergic contact dermatitis induced by PPD is a major concern for hairdye industry and the population using hair dyes. To reduce the burden of contact dermatitis due to PPD in hair dyes, various alternative hair dye molecules have been developed over the years which include two-methoxymethyl-p-phenylenediamine (ME-PPD) molecule and hydroxyethyl-p-phenylenediamine (HE PPD) molecule. These both molecules have shown reduced sensitization to skin and much lower skin permeability which makes them as safer alternatives to PPD hair dyes in the market.
Cardiac complications of systemic drugs used in dermatology
Authors: Palaniswami Saranya , Saminathan Praveen Vasanthi , Ramasamy Sri Vaishnavi
Published: June 2024

Within the realm of dermatology, the use of systemic drugs carries implications beyond skin health, often intersecting with cardiovascular outcomes. From antihistamines to biologics, medications prescribed for dermatological conditions may pose varying degrees of risk to the heart. Understanding these potential cardiac side effects is paramount in the comprehensive management of dermatologic patients. This journal article delves into the intricate relationship between systemic dermatologic drugs and cardiovascular health, elucidating the mechanisms underlying cardiotoxicity, identifying patient-specific risk factors, and offering insights into optimizing therapeutic regimens while safeguarding cardiac well-being. Through this exploration, we aim to equip dermatologists with the knowledge necessary for delivering safe and effective care, ensuring the holistic health of their patients.
Beta initiated advanced closed loop D B S devices in achieving movement in Parkinson`s
Authors: Sanagala Siva Skandha , Raju V Rama
Published: June 2024

In Parkinson disease there is a normal physio- logical reduction of STN-β-band power, shorter smoothing period could have the advantage of being more sensitive to changes in β power, which could enhance motor performance. Objective: In this study, we addressed this question by evaluating effectiveness of STN-β-triggered ACL-DBS by a standard 400ms and a shorter 200ms smoothing-window during reaching movements.

Findings of Parkinson`s with advanced idiopathic Parkinson’s disease showed that reducing the smoothing-window for quantifying β did lead to shortened β-burst-durations by increasing number of β-bursts <200ms and more frequent switching “ON/OFF” of the stimulator but had no behavioral effects. Both ACL-DBS, COL-DBS improved motor performance to an equivalent extent compared to no DBS. Also, there were indemarkerdent effects of a decrease in β power and an increase in gam- ma power in predicting faster movement speed, while a decrease in β event-related-desynchronization (ERD) predicted quicker movement initiation. COL-DBS blocked both β and gamma (γ) more than ACL-DBS, whereas β ERD was reduced to a similar level during COL-DBS and ACL-DBS compared with no DBS, which together explained the achieved similar performance improvement in reaching movements during COL-DBS and ACL-DBS.

Results suggesting STN-β-triggered ACL-DBS is effective in improving motor performance during reaching movements in people with Parkinson’s disease, and that shortening of the smoothing window does not result in any additional behavioral benefit. When developing ACL-DBS systems for Parkinson’s disease, it might not be necessary to track very fast β dynamics; combining β, gamma, and information from motor decoding might be more beneficial with additional bio- markers needed for optimal treatment of tremor.

This research is not just fundamentally designed to expand knowledge of basic mechanisms and principles of health and care problems. This is generally longer-term research with broad applicability and involves strategic, applied, developmental and implementation.
A story of thundeclap headache and stroke
Authors: Puri Sakshi , Aleena Insha , Chakroborty Debabrata
Published: June 2024

Giant cell arteritis causes large and medium vessel vasculitis that can involve the aorta and great vessels. We report a case of a 59-year-old female with no known comorbidity who presented with complaints of sudden onset, sharp, severe right-sided headache for 15 days which was gradually progressive and not responding to any painkillers followed by acute onset left-sided weakness. On examination, she had reduced power in the left upper and lower limb, right temporal, parietal scalp tenderness, and low-volume temporal artery pulsation. MRI and MRA of the brain revealed a subcortical infarct in the right frontal subcortical region with normal cerebrospinal fluid findings. His ESR and CRP levels were raised and her hemoglobin level was low (vasculitis markers and other stroke workups were non-contributory). VEP showed moderate to severe retino-optic pathway dysfunction predominantly demyelinating type. We started aspirin, atorvastatin, and prednisolone as we suspected Giant cell arteritis (GCA). GCA is an unusual cause of ischaemic stroke (stroke prevalence is around 1.5% - 11% in GCA cases). In our case, the patient with no history of headache or stroke presented with ischaemic stroke in her very first presentation and was diagnosed with Giant Cell Arteritis. The headache was acute at onset and the stroke was in the anterior circulation, which is relatively uncommon. We need to consider the possibility of GCA, especially in this age group, and, after ruling out other possibilities, should not delay starting corticosteroids in these patients to avoid catastrophic consequences, including blindness.
A comparative study of Triphala Kashaya and standard treatment (Allopurinol) in the management of Vatarakta (Gout)
Authors: Joshi Mrudula Vinayak , Deshmukh Pooja Gopalrao , Joshi Vinayak Nilkanth
Published: June 2024

Ayurveda is a life science with prime goal of promotion of health and prevention of disease. Vatarakta is one of the main articular diseases. As the name suggests, vyadhi produced by conjugation of vitiated Vata and Rakta is called Vatarakta. The vitiated rakta causes margavarodha and dushti of Vata. Vatarakta is very similar to Gout from etiology and symptomatology.

In this study 66 patients fulfilling the diagnostic criteria of Vatarakta based on Sandhishoth, Sparshasahatva, Stambha and Sandhitoda were selected. Triphala Kashaya 80 ml with 5 gm of Madhu was given orally in two divided doses at morning and evening in group A and group B was given tablet Allopurinol 100 mg for 28 days and effect on the symptoms was evaluated.

Symptomatic improvement was observed with statistically significant results p<0.05 in group A, along with attainment of normal serum uric acid levels followed by feeling general wellbeing. From the present study it can be concluded that the Triphala Kashaya showed promising results in the management of Vatarakta.
Effect of Percussion and vibration therapy in Musculoskeletal disorders: A short review
Authors: Sheeba Kauser Mohammed , Manjula Kumari V V. , Venkateshwara prasanna G.
Published: June 2024

The utilization of percussion theory with the help of (hand held massager or prominently known as hand gun) has become progressively well known as of late. In spite of the fact that their utilization is increasingly normal, both in a clinical and sports setting, there is still little data to direct the experts. This survey planned to decide the impacts of percussion therapy in as pre-and post-action or part of a treatment.

Information sources utilized were Pub Med, PEDro, Scopus, Claviate, Medline, Web of Science and Google Researcher. At first, 170 records were screened, out of which 16 could be incorporated with considerate inclusion and exclusion criteria. Fifteen had a moderate gamble of predisposition and one a high gamble of inclination.

In strength, balance, speed increase, endurance, it either didn't have upgrades or it even showed a decline in execution. In the recuperation related results, percussion gun were demonstrated to be practical instruments for firmness decrease.
Catolicismo social y levantamiento religioso en Chihuahua: del pacifismo a la defensa
Authors: Machado Márquez Jorge Arturo
Published: June 2024

La Diócesis de Chihuahua promocionó, a inicios del siglo XX, la Rerum Novarum: sus tres primeros obispos impulsaron un catolicismo social exitoso, se distinguieron por su orientación pacífica, durante la etapa porfirista respetaron las autoridades políticas y fueron ajenos a la resistencia armada. Sin embargo, en la segunda mitad de los años veinte adoptaron una actitud defensiva que incluso los motivó a elegir la opción bélica. El 23 de enero de 1927, la Revista Católica publicó, en El Paso, Texas, un plan de levantamiento armado, cuyo objetivo era derrocar al gobierno federal de Plutarco Elías Calles. ¿Qué originó el cambio y motivó a la opción armada, qué pasó con dicho plan?