bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammatory Hematological Ratios in Adolescents with Mental Disorders: A Scoping Review
Authors: Popov Mikhail , Popov Yuri , Kosterin Dmitry , Lepik Olga
Published: June 2024

BACKGOUND: Inflammatory hematological ratios (IHRs), such as neutrophil to lymphocyte, monocyte to lymphocyte, and platelet to lymphocyte ratios, are associated with mental disorders, symptoms severity, and the disease phase. Evidence from the studies in adult patients has been summarized in systematic reviews and meta-analyses. The results of the studies in adolescents remain poorly systematized.
AIM: To summarize the findings from the studies that investigated the relationship of IHRs with mental disorders in adolescent patients.
METHODS: This scoping review included studies of IHRs in patients aged 10–19 years with mental disorders (other than anorexia nervosa), published in English by December 31, 2023. The search for relevant papers was performed in MEDLINE. The studies were categorized into two groups: studies with external controls (healthy adolescents) and studies with internal controls (patients in different phases of mental disorder, with or without self-harm/suicidal behaviors).
RESULTS: A total of 11 studies were included in the review (all cross-sectional ones). The results of these studies demonstrate that 1) adolescents with mental disorders (major depressive disorder, psychotic disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, substance use disorders) have higher IHR values than individuals of the same age without corresponding disorders (5 studies); 2) IHR values are positively correlated with the severity of psychopathological symptoms (1 study); 3) higher IHR values are associated with the phase of the mental disorder — manic episode in bipolar disorder (1 study) and exacerbation of psychosis in psychotic disorders (1 study); and 4) higher IHR values are associated with self-harm/suicidal behaviors — suicide attempts (1 study) and non-suicidal self-injury (1 study).
CONCLUSION: IHRs are associated with mental disorders in adolescents, and higher IHR values are associated with a more severe/acute clinical presentation (severity of symptoms, mania, acute psychosis, self-harm/suicidal behaviors). Further studies of higher methodological quality are needed to evaluate the diagnostic and prognostic value of IHRs as biomarkers of mental disorders in adolescence.
Approaches to the compilation of a list of pharmaceuticals and their metabolites subject to state regulation
Authors: Shpachuk Arkady Yu. , Vilisova Maria A. , Sklyarova Natalia A.
Published: June 2024

The main sources of entry of pharmaceutical drugs and their active metabolites into drinking water are the pharmaceutical products consumed by the population, which are discharged through the sewage system, the effluents from pharmaceutical and medical organizations, as well as the by-products of agriculture, which ultimately form wastewater that passes through insufficiently effective treatment systems. The study is devoted to the development of approaches to the formation of a list of pharmaceutical products and their metabolites subject to state regulation. The importance of strengthening control over the use of such substances and conducting additional assessments of their negative impact on the environment is emphasized. In the course of the work, a comparative analysis of the active components in the top 20 best-selling pharmaceutical products on the Russian market was carried out using Russian and international literature sources. Regulatory legal acts regulating the classification of antibiotics and hormones by the degree of danger have been studied. Based on this, a preliminary list of medicinal substances that can potentially have a negative impact on the environment has been formed, mainly in accordance with the requirements of SanPiN 1.2.3685-21. The results of the study can be used for further assessments of the harmful effects of these substances and the development of measures for their regulation.
The evaluation of the caudal block performance in 0–8-year-old children using FLACC scale
Authors: Turan Akar Evrim Burcu , Üzümcügil Filiz , Akça Başak
Published: June 2024

Purpose: The evaluation of postoperative pain in pediatrics is a true challenge. We aimed to evaluate the immediate postoperative pain management using FLACC (Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Pain Scale) scale after caudal block.
Material and Methods: The anesthesia records of children aged 0–8 years who underwent caudal block under general anesthesia prior to surgery were evaluated. The intraoperative and postoperative use of opioids were obtained, as well as, the FLACC scores.
Results: Seventy-eight children were included and evaluated in two groups according to ages of 1-24 (n=37) and 24-96 months (n=41). Intraoperative requirement for opioid was observed in 7.7% (n=6) of patients. Nine patients (11.5%) required fentanyl in the immediate postoperative period with FLACC ≥4. Only 1 patient required opioids both intraoperatively and in the immediate postoperative period, suggesting a success rate of 98.7%. The patients were observed to receive single dose opioid, despite FLACC ≥4 in the following postoperative 1st,2nd and 3rd hours. The subgroups of age were similar in terms of FLACC scores and the changes in these scores within the postoperative 3 hours. There were no urinary retention or motor block. However, paresthesia was recorded in 4 patients at age of 24-96 months, whereas, in none of the patients at age of 1-24 months. The uncomfortable numbness, which could not be described at age of 1-24 months may have caused the difference, as well as, leading to high FLACC scores without any opioid use.
Conclusion: Our study supported that anesthetists consider FLACC scale as a part of pain assessment to administer opioid, not as a sole indicator.
Ventricular tachycardia as a rare and fatal cause of recurrent dizziness in emergency department
Authors: Tekin Fatih Cemal , Demirel Ece
Published: June 2024

Dizziness is a non-specific complaint often used by patients to describe many symptoms. The incidence of dizziness is estimated to be between 20-30%. The life-threatening rates of diseases that cause dizziness are quite low. However, missing underlying fatal causes such as Ventricular Tachycardia will have very serious consequences. Therefore it should be kept in mind that the etiology of dizziness may include malignant and life-threatening causes such as VT. ECG should not be neglected in patients.
Where are the broken needle fragments? Are they intra-articular or not? Case report
Authors: Kaya Onur
Published: June 2024

Foreign body penetrations often occur in the lower extremities and childhood foreign body penetrations inside the knee are very rare. In this case, as a result of the examinations and tests we carried out after detecting two separate foreign bodies in the anterior and posterior part of the knee we present a childhood injury where we removed foreign bodies that we couldn’t be sure if they were really inside the knee joint by arthroscopic intervention, which is an easy, safe and minimally invasive technique.
Investigation of the protective effect of selenium supplementation on renal function in cisplatin-administered rats
Authors: Altunkaya Melek , Abuşoğlu Gülsüm , Ozturk Bahadir
Published: June 2024

Purpose: Selenium is an important antioxidant and anticarcinogen with the ability to protect cells from oxidative stress, a significant marker of cisplatin-induced toxicity. This study aimed to reveal the effect of selenium on free radicals in cisplatin-induced nephrotoxicity by examining changes in creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and galectin-3, which are associated with kidney damage.
Materials and Methods: Twenty-four Wistar albino rats, aged 60 days, were equally divided into four groups: control, cisplatin, selenium, and cisplatin+selenium. The experiment started on the 39th day after the rats were born. Controls were intraperitoneally administered a single dose of physiological saline. Rats in the selenium and cisplatin+selenium groups were administered 1 mg/kg of selenium by gastric gavage per day for 21 days. The rats in the cisplatin and cisplatin+selenium groups were intraperitoneally administered 7.5 mg/kg of cisplatin on the 57th day. The experiment was terminated 3 days after single-dose administration. Tissue samples were analyzed using the ICP-MS method for selenium, the biochemical method for plasma creatinine, and the ELISA method for NGAL and galectin-3.
Results: Kidney tissue selenium levels were significantly higher in the selenium-supplemented groups (control;146.8 ± 10.8 ng/dl, selenium;520.2 ± 31.2 ng/dl, cisplatin;140 ± 6.4 ng/dl; cisplatin + selenium; 363.4 ± 33.6 ng/dl). Plasma creatinine levels were statistically significantly higher in the cisplatin-administered groups (control; 0.32 ± 0.01 mg/dl, selenium; 0.32 ± 0.01 mg/dl, cisplatin; 0.47 ± 0.02 mg/dl; cisplatin + selenium; 0.45 ± 0.04). There was no difference in kidney tissue NGAL levels; however, galectin-3 levels were significantly increased in the cisplatin group compared with the other groups. This increase was lower in the cisplatin+selenium group than in the cisplatin group. Heart tissue NGAL and galectin-3 levels were higher in the cisplatin group.
Conclusion: Selenium supplementation may have a healing effect on the nephrotoxicity and cardiotoxicity caused by cisplatin, as indicated by changes in creatinine, NGAL, and galectin-3 levels.
Cognitive behavioral therapy in an adolescent with trichotillomania partially responding to medical treatment
Authors: Çelikkol Sadıç Çağla
Published: June 2024

Trichotillomania is a psychiatric disorder characterized by recurrent hair pulling resulting in hair loss. Pharmacological agents and psychotherapy methods have been used in the treatment of trichotillomania. However, controlled studies on the efficacy of these methods in the child and adolescent population are very limited. Since there is no gold standard treatment for trichotillomania, disease management becomes challenging. In this article, we present a 13-year-old girl diagnosed with trichotillomania, who partially responded to medical treatment and cognitive behavioral therapy (CBT) was added to her treatment. After the addition of CBT, there was a significant improvement in the patient's symptoms, and this improvement continued even though the patient suddenly stopped using the medication during the treatment process. This case demonstrates that an adolescent with trichotillomania who responded partially to medication may have significant improvement in her symptoms with CBT that includes components of habit reversal training.
Clinical characteristics and factors associated with functional outcome in patients with Guillain Barré syndrome
Authors: İyigündoğdu İlkin , Derle Eda , Kaya Zeynep , Girgin Güven , İkbali Afşar Sevgi , Ümit Yemişçi Oya , Alkan Berna , Kibaroglu Seda , Benli Ülkü Sibel
Published: June 2024

Purpose: We aimed to evaluate the clinical characteristics of Guillain Barré syndrome (GBS) patients retrospectively and identify the prognostic factors associated with worse outcome at discharge and at the end of the first month in patients with GBS.
Materials and Methods: Patients who were followed up with the diagnosis of GBS were evaluated retrospectively. Demographic characteristics of the patients, cerebrospinal fluid examinations, treatment regimens, Medical Research Council (MRC) and Hughes Motor Scale (HMS) scores were recorded and HMS ≥3 was accepted as associated with poor prognosis in patients. SPSS version 25 program was used in the statistical analysis of the data. p
In vitro evaluation of emulgel formulation for topical application of diclofenac potassium
Authors: Demirtürk Esra
Published: June 2024

Purpose: For superficial pain, nonsteroidal anti-inflammatory medications (NSAIDs) offer sufficient analgesia, particularly in cases of mild to severe dull pain. Diclofenac potassium is one of the most preferred drugs in this group, but its low water solubility and high permeability due to its BCS II class classification makes it a challenging active substance in the formulation process. The aim of this study was to develop and evaluate in vitro of emulgel formulations containing diclofenac potassium.
Materials and Methods: All substances used in the formulation development process were substances in conformity with pharmacope specifications. Emulgel formulations containing diclofenac potassium were prepared and evaluated in terms of pH, conductivity, rheological properties, viscosity, drug release rate and stability.
Results: The method developed and validated for the determination of the active ingredient resulted in a good linear relationship that was established between the peak areas and the concentrations (2.5-40 μg /mL) of diclofenac potassium with the determination coefficient (R2) which equals to 0.9999. F1, F2, F3 and F4 formulations were found to be stable at the end of the 1st and 3rd month when evaluated with the amount of active substance, pH and rheological properties at different temperatures and conditions. Formulations F2 and F4 are more viscous than other formulations F1 and F3. The initial pH values of all prepared formulations were found to be compatible with the skin. When the reological properties of the formulations were studied, they were determined by examining the calculated R2 values of the Herschel-Bulkley reological type (R2 values of F1, F2, F3 and F4 formulations respectively were 0.999045, 0.999301, 0.999650, 0.999631). In the drug release rate studies, the release of active substance from F2 and F4 formulations continued until the 6th hour and reached plateau values.
Conclusion: Diclofenac potassium emulgel can be used as an antiinflammatory analgesic agent for topical drug delivery.
Blood management in total knee arthroplasty: an exploratory study regarding the use of drain and tranexamic acid in two types of instrumentation
Authors: Dias Pedro Alexandre , Caldeira-Dantas Sofia , Carvalho Maria Miguel , Marreiros Ana , Fontes Ana Paula , Sousa João Paulo
Published: June 2024

Background: This study investigates how presence or absence of drain or tranexamic acid (TXA) in 2 different types of instrumentation with invasion/sparing femoral canal affects hemoglobin drop after total knee arthroplasty (TKA).
Methods: This was a retrospective observational study that included 736 individuals divided in five groups, regarding conventional instrumentation (CI) or patient specific instrumentation (PSI), presence or absence of drain and TXA. Mean percentage of hemoglobin drop after the first postoperative day was compared for each group.
Results: Patients submitted to CI using drain and no TXA revealed the highest value (21,3%±9,1; p<0,001). Groups who received TXA and drain was not used, presented the lowest blood loss. Moreover, with the introduction of TXA PSI lost its advantage over CI.
Conclusions: TKA using CI, without drain and with TXA administration showed better results, reducing mean percentage of hemoglobin drop after surgery.
Surgical and functional outcome of management of anterior column with posterior hemitransverse fracture of acetabulum
Authors: Chatrashali Shivaraj A. , Patil Alok C. , Nataraja Chetan M. , Gaddi Rakshith A.
Published: June 2024

Fractures of acetabulum are relatively uncommon, but as they involve the major weight bearing joint in lower extremity, they assume great clinical importance. The displaced acetabular fracture fragments result in hip joint incongruity which in turn leads to abnormal pressure distribution over the articular cartilage surface. This may lead to accelerated breakdown of the articular cartilage, resulting in disabling irreversible arthritis of hip joint. The aim of treatment of these difficult acetabular fractures is concentric reduction of femur head under the weight bearing dome of acetabulum resulting in anatomic reduction and followed by a stable fixation. This can be achieved only by adequately exposing the acetabulum and by rigid internal fixation. In our series 20 patients were included. Majority of the patients were males with mean age of 43.85±16.88 years. Most common mechanism of injury was road traffic accident. Right side was most affected. Most of the cases were isolated injuries. Majority of the cases had no complications. At the final follow up, most of the cases had Excellent follow-up according to Modified Merle d’Aubigne and Postel score. Surgical management of Anterior column with posterior hemitransverse fracture of acetabulum gives excellent outcomes with least number of complications.
Primary chondrosarcoma of bone: a clinicopathological and oncological outcome analysis
Authors: Subbiah S. , D. Priya
Published: June 2024

Chondrosarcomas are a heterogenous group of cartilaginous matrix-producing malignant neoplasms. They have varied morphological features and different clinical behaviors. The tumors usually range from benign low-grade tumors or intermediate atypical cartilaginous tumors (ACTs), to malignant, aggressive high-grade tumors. A multidisciplinary team at a tertiary sarcoma centre allows for optimal management of these patients. To determine the clinicopathological and survival outcomes of patients of chondrosarcoma, we report a total of 20 cases in the last 10 years at our institution. Our results have shown that chondrosarcomas occurred in different age groups and most common location was in axial skeleton. Most common histological type was conventional chondrosarcoma and majority were high grade tumors. All patients had undergone surgery and majority of the patients were alive after many years of treatment with an overall survival of 85%. Long term survival of patients is attributed to completeness of surgical resection.
Medial open wedge high tibial osteotomy: an effective procedure for varus malunited neglected proximal tibial plateau fractures: a case series
Authors: Sarkar Aruddha , Sen Biswarup , Sahni Saurabh
Published: June 2024

Varus malunited tibial plateau fracture is a disabling condition causing varus thrust gait, instability, and secondary osteoarthrosis. There are few evidence-based guidelines for the management of symptomatic varus malunion in young patients. Our case series aims to review outcomes of open wedge high tibial osteotomy for varus malunited tibial medial plateau fractures. We present case series of three patients who presented with symptomatic varus malunion of proximal tibia with Kellgren-Lawrence stage II or less arthritic changes. All presented with varus thrust. Exclusion criteria for the procedure would be complex intra-articular step malunions and severe arthritic changes. Medial open wedge high tibial osteotomy was performed and stabilized with locking plate and tricortical autograft. Patients were followed up for 12 to 20 months. All achieved deformity correction, reported significant improvement in varus thrust and were satisfied with their improvement in stability and knee function. There was no complication related to wound healing and no delayed loss of correction. The osteotomy led to correction of the coronal deformity and ensured that the collateral balance is restored benefiting the overall gait of the patient. Also, if such a patient undergoes total knee replacement in future, the bone stock will be significantly better with this procedure. Medial open wedge high tibial osteotomy for varus malunited tibial plateau fractures is effective procedure that provides excellent functional and radiologic outcomes, and carries minimal complications.
Metachronous osteoid osteoma in adjacent proximal phalanges: a case report and literature review
Authors: Kortbawi Rabih , Aouad Dany , Kunegel Edouard , Sattari Azadeh , Kazzi Wissam El
Published: June 2024

Osteoid osteoma (OO) is a benign bone tumor commonly affecting long bones, and in rare cases, involves small bones such as hand phalanges. The presenting symptom is usually nocturnal inflammatory pain. OO is in the majority of cases a solitary lesion, with very rare reported cases of metachronous lesions in different locations. We present a case of a 31-year-old female patient who presented for severe pain and swelling over her fourth finger proximal interphalangeal joint (PIPJ) of the right hand. After thorough radiological investigations, a presumptive diagnosis of OO was made and the patient underwent surgical excision and curettage with resolution of her symptoms post-operatively. Six years after remission, the patient presented again to our clinics with the same clinical picture in the third finger PIPJ of the right hand. Clinical and radiological investigations revealed a metachronous OO in the adjacent phalanx of the previous surgical site. Similar management consisting of excision and curettage was performed, resulting in a symptom-free follow up. To our knowledge, this is the first case of metachronous OO in adjacent proximal phalanges of the hand. This case highlights the importance of considering metachronous OO in the differential diagnosis of patients previously diagnosed and treated for OO and presenting with a similar clinical and radiological picture.
Bilateral simultaneous neck of femur fractures from a single injury in a high-risk patient
Authors: Roy Mainak , Das Deepanjan , Bhavani Prashant , Dwidmuthe Samir , Sah Saurabh , Sadar Amey S.
Published: June 2024

Simultaneous bilateral neck of femur fractures resulting from a single traumatic event are exceptionally rare. Often these patients have underlying metabolic bone disorders like renal osteodystrophy, osteomalacia, long term steroid intake, osteoporosis, hyperparathyroidism etc. We present a unique case of bilateral neck femur fractures in a patient with no history or objective proof of metabolic bone disease. This case underscores the significance of recognizing atypical presentations and the need for individualized management. A 70-year-old male patient presented with altered sensorium, disorientation, and bilateral hip fractures following a self-fall at home. The absence of metabolic bone abnormalities, along with pre-existing systemic hypertension and coronary artery disease, made this presentation remarkable. Diagnostic workup revealed hyponatremic encephalopathy, further complicating the high-risk surgical status of the patient. A two-stage approach with bipolar uncemented hemiarthroplasty was chosen, and early mobilization was initiated. Remarkably, the patient returned to pre-injury mobility soon after surgery, illustrating the successful outcome. This case highlights the rarity of simultaneous bilateral neck of femur fractures in patients even without metabolic bone disease, emphasizing the need for careful evaluation and customized management. The collaborative efforts of surgeons, physicians, and anesthetists were pivotal in achieving a positive outcome, demonstrating the remarkable potential of multidisciplinary teamwork in challenging medical scenarios. This case serves as a testament to the dedication and expertise of the medical community in the face of extraordinary challenges.
Terrible triad of elbow: a case managed with radial head prosthesis
Authors: Sanikop S. T. , Bhuti Gangadhar , Jain Sarthak , Chandra Rellu Sarath
Published: June 2024

The terrible triad of elbow consists of radial head fracture, coronoid process of ulna fracture, and posterior or posterolateral humero-ulnar joint dislocation. Favorable outcomes are expected in cases with early surgical intervention. Here we present a 48-year-old male patient with terrible triad of elbow injury following road traffic accident who underwent radial head replacement with temporary ulno-humeral transfixing K-wire. We came to a conclusion that planned and staged anatomical restoration of ligamentous and bony structures of the elbow with combative rehabilitation will give the best possible outcome.
Comparative trichoscopic analysis of efficacy of combination therapy versus monotherapy of platelet rich plasma and topical minoxidil in the treatment of androgenetic alopecia
Authors: Annamreddy Leepika , Kode Sridevi , John Akhila Merin , Rajakamal Chinta
Published: June 2024

Background: Hair is a pivotal facet of physical visage and cultural identity. Since time immemorial hair has been considered as a sign of vitality, beauty and health. Hair loss complaint is encountered by at least 50% of men and women in their lives. Androgenetic Alopecia is one of the most common causes of hair loss among youth which often leads to psychological stress. This underscores the need for early detection and treatment of androgenetic alopecia. Hence a comparative trichoscopic analysis of the efficacy of combination therapy vs monotherapy of platelet rich plasma (PRP) and topical minoxidil in the treatment of androgenetic alopecia was done.
Methods: Sixty untreated cases of androgenetic alopecia were enrolled in this randomized prospective interventional study. Patients were randomly allotted into three groups. Group I (PRP with minoxidil), Group II (Minoxidil), Group III (PRP). Patients were assessed by trichoscopic evaluation, clinical photographs, physician assessment and patient self-assessment at the end of three months and six months of treatment.
Results: Among group 1 (PRP+Minoxidil), a total of 55% of patients had improvement in the grade of alopecia while in group 2 (Minoxidil), 25% of patients had improvement in the grade and 40% of patients had improvement in group 3(PRP). By trichoscopic analysis, 58.6% of patients had improvement in group 1, 36.5% of patients had improvement in group 2 and 44.025% of patients improved in group 3.
Conclusions: Combination therapy with both PRP+Minoxidil shows significant results when compared to individual therapies which was confirmed by trichoscopic analysis.
The role of methylcobalamin in managing neuropathic pain: Addressing challenges and exploring solutions for improved patient outcomes
Authors: Dave Yatri A , Dhande Keshini S , Maurya Dimpal D
Published: June 2024

The escalating global diabetes burden, particularly in India, where 77 million cases exist, is exacerbated by factors such as obesity and unhealthy habits, with an anticipated rise to 134 million by 2045. Diabetic neuropathy affects 29.2% of the Indian population, with majority experiencing vitamin B12 deficiency. Challenges in B12 absorption arise from acid-suppressing medications, metformin use and increased reverse osmosis (RO) water consumption. Methylcobalamin, a bioactive B12 form, shows promise for neuropathy management, with subcutaneous administration preferred for its efficacy and convenience over intramuscular injections. The methodology involved a thorough search of PubMed and Google Scholar using relevant keywords, with articles screened based on specific criteria. In our study, we surveyed physicians, diabetologists, orthopaedics and neurophysicians using a questionnaire. We focused on the usage of vitamin B12 injections in patients with diabetic neuropathic pain and gathered feedback on their efficacy. It focused on comparative studies of SC (Subcutaneous) and IM (Intramuscular) administration of vitamin B12 in diabetes-related neuropathic pain. Methodological quality assessment and data synthesis summarized key findings on bioequivalence, pharmacokinetics, clinical outcomes and practitioner preferences for SC versus IM administration. Intramuscular administration is often avoided due to discomfort and frequent clinic visits. About 50% of practitioners prefer subcutaneous vitamin B12 injections. Metformin therapy may cause vitamin B12 deficiency. Despite some reluctance, a regimen of five vitamin B12 injections alternated every other day is recommended. Compliance with injections is moderate. Two-thirds of practitioners are aware of the subcutaneous route for vitamin B12 administration, but few know about comparative trials. Patient compliance could improve with self-administered pre-filled syringes (PFS). The conventional IM method of administering methylcobalamin may lead to patient non-compliance due to injection site discomfort. However, subcutaneous PFS of methylcobalamin provide a solution to this issue. PFSs offer a practical option for diverse patient groups, including those on long-term metformin therapy, individuals with low adherence to vitamin B12 supplements and recently diagnosed cases of vitamin B12 deficiency. The convenience of at-home PFS administration reduces the necessity for frequent clinic visits.
A holistic approach to acute pain in trauma: From assessment to intervention
Authors: Shetti Akshaya N
Published: June 2024

Effective management of acute pain in trauma situations demands a comprehensive and holistic approach that encompasses various aspects ranging from initial assessment to intervention strategies. Meticulous assessment of pain severity, characteristics, and underlying etiology is essential for tailoring individualized treatment plans. This involves utilizing validated pain assessment tools, considering patient-reported pain scales, and integrating clinical judgment to accurately gauge pain intensity and quality.

Subsequently, intervention strategies must be multifaceted, integrating pharmacological and non-pharmacological modalities to address pain effectively while minimizing adverse effects and promoting patient safety. Pharmacological interventions may include analgesics such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and adjuvant medications, administered judiciously based on pain severity and patient factors. Meanwhile, non-pharmacological approaches encompass techniques like regional anaesthesia, physical therapy, cognitive-behavioural therapy, and integrative therapies to augment pain relief and enhance overall well-being.
Economic assessment of convulsive status epilepticus: Investigating socioeconomic correlations in hospitalization costs and outcomes in Northern India
Authors: Ansari Ahmad Ghayas , Nasar Ariba , Nasar Hiba
Published: June 2024

Convulsive Status Epilepticus (CSE) poses a considerable health challenge globally, especially in resource-limited regions like Northern India. Despite its medical implications, the economic impact of CSE remains understudied in these settings.

This study aimed to evaluate the socio-economic impact of CSE by examining hospital costs and the financial strain experienced by patients in Northern India.

Patients who presented with CSE were included in the study. Their demographic parameters, socioeconomic parameters and expenditure during the hospital stay were noted and outcome was assessed. Statistical analyses were conducted to identify associations between economic factors and clinical outcomes.

The study comprised a total of 110 patients. Out of the total sample size of 110 individuals, 50.9% (n =56) were residents of rural areas, whereas 49.1% (n = 54) were from urban areas. A significant association with poor outcomes was observed between the education score of the family head (p=0.001), the Modified Kuppuswamy socio-economic class V (p=0.038) and the length of hospital stay (p=0.012). However, on performing a univariate logistic regression analysis to determine independent risk variables for poor outcome, it was observed that patients with an education status score of less than 4 (p=0.036, OR 65.405 95% CI 1.322 - 3235.454) and belonging to Modified Kuppuswamy socio-economic class IV or class V (p=0.045, OR 1.198 95% CI 1.013 - 1.305 and p=0.022, OR 2.156 95% CI 1.235 - 9.307 respectively) were significantly associated with poor outcome.

The study underscores the substantial economic burden imposed by CSE on patients in Northern India, emphasizing the urgent need for targeted interventions to mitigate financial strain and enhance access to healthcare services.
SWOT of a Non-Communicable Diseases (NCD) care program in western India – lessons learned
Authors: Roy Kallol , Swati A Roy  , Amol R Dongre
Published: June 2024

: Shree Krishna Hospital Program for Advancement of Rural and Social Health (SPARSH), it means “touch” in Hindi) aims to address the NCD burden through community-based service delivery.

: We carried out SWOT analysis to understand the Strengths, Weaknesses, Opportunities, and Threats of SPARSH for further strategic planning.

: Exploration of items for SWOT with staff was done. Salient items (items with more frequency) for each domain were selected to develop a five-point Likert type scale. Consensus score of each item was calculated and a score above 75% was considered salient.

: Major strength was door to door medicine service & delivery worked. Weakness was communication gap while working in a large team. Staff felt that in era of emerging pandemics, NCD care must be strengthened and financial stability to run such a program was perceived as a threat.

: SWOT explored the strengths which need to be strengthened. Weaknesses and opportunities to be addressed in future planning and program development.
Assess perimenopausal symptoms among women
Authors: Soumya. A , Nageswaran Karpagavalli , Purohit Nisha
Published: June 2024

Change is inevitable in human life; it brings benefits, challenges and rebeginning. In women's lives, Perimenopause is the transitional time around menopause, and it is a regular transient change with challenges, like physiological, psychological and other changes. The women aware of these changes will help to cope with them in a better way and reduce their anxiety and stress. In this view, researchers felt a need to assess perimenopausal symptoms among women and associate the findings with baseline data.

The data was collected using the quantitative research approach, the non-experimental exploratory, descriptive survey method. Two hundred samples met the sampling criteria from selected areas by the non-probability convenience sampling method.

The significant findings of this study reveal that 58.5% of the sample had moderate perimenopausal with different somatic, psychological and uro-genetic symptoms. All variables are statistically significant in association with baseline data as the P value is less than 0.05.
Quality of life of elderly in old age home and in the community
Authors: Singh Rajendra , Singh Pranesh , Singh Reena , Singh Hutesh
Published: June 2024

: Old age is a period of transition when one has to deal not only with the physical wellbeing, but also with the challenges of mental, social and economic wellbeing. The elderly essentially require understanding, compassionate care, unconditional love and support with human touch. Family is the basic unit of the society and our elderly are its roots, they need tender care, respect and regards.

To find out the difference in old person’s quality of life, living in a old age home & in the community.

This was an observational studyconducted at Government run old age home, Araji bag, Azamgarh and at the OPD of Government SDJH Medical College & Hospital, Chandeswar, Azamgarh, Uttar Pradesh. For assesment OPQoL (WHO) questioner was used.

This study shows that mean of OPQoL in group 1 (at community/at Home) was 60.20±6.94 and Mean of OPQoL in group 2 (At Old age Home) was 53.83±8.24. Paired T-test also shows that senior citizens living with family members were happier than senior citizens living at old age home.

This study suggests that senior citizens living with family members were happier than senior citizens living at old age home.
Prevention and reduce the complications of chronic kidney diseases: A holistic health care approach
Authors: Panda Ashok Kumar
Published: June 2024

The high incidence of chronic kidney diseases (CKD) and lifelong expensive treatment, diagnosis and dialysis drown the acceptance of Ayurveda as holistic care. The incidence of renal diseases is increasing two-fold in Ayurveda hospital in past one decade. The commonest patients are CKD, renal calculus and nephritis. Holistic approach is personalised and treating cause than symptom through diet, Yoga, Panchakarma(detoxification), Herbo-mineral remedies, meditation and modulation/correction of daily lifestyle. Optimum sugar and blood pressure control along with reno protective medicines can prevent the progression of CKD to end stage renal diseases and reduce renal dialysis and replacement therapy. Ayurveda physician should not ignore nephrotoxic plants and heavy metal containing medications. Fifteen single drugs, seven Ayurveda formulations and nephrotoxic Ayurveda herb/compound are described with evidences. In this review, holistic health care approach through Ayurveda medicine, diet Panchakarma, practice of yoga , pranayama , life style modifications to prevent and reduce the complications of chronic renal diseases are discussed with evidences.
Siddha makardwaja and bhumiamalaki (Phyllanthus niruri) can reverse the progression of Non Alcoholic Steato-hepatitis(NASH): Case study
Authors: Panda Ashok Kumar , Kar Sarbeswar
Published: June 2024

A 45-year male, a business man came to our general OPD with elevated liver enzyme with elevated fasting blood glucose report in his hand. The patient was further advised for fibro scan and his Liver stiffness measurement (LSM) was 11kPa with CAP score 264dB/m with negative virus panel. The patient was diagnosed as Non-Alcoholic Steato-hepatitis (NASH) based on his overweight and biochemical and radiological findings 3000mg (Phyllanthus niruri) aqueous extract tablet (500mg) in two divided dose after food with luke warm water along with one tablet special Rasa 125mg twice daily before food triturate with honey for 10 minutes for six months. The symptom of dyspepsia and constipation were relieved in 1 month of treatment whereas mild change in liver fibrosis (LCM &CAP score) was observed in 1 three month of therapy and marked regression in liver stiffness was observed in after six months of therapy. The patient has no relapse of the liver fibrosis even after three years of observation. The patient had no adverse sign or symptom during medication and observed period. Rasa and (Phyllanthus niruri) combination therapy can reverse the Progression of Non-Alcoholic Steato-hepatitis (NASH) in six months of therapy and sustain the amelioration liver tissue even after discontinuation of medication in long term follow up.
Micropropagación de maracuyá y curuba a partir de segmentos nodales y foliares
Authors: Caicedo Molina Sara Ximena , Medina Ospina Giomar , Manjarrés Hernández Elsa Helena
Published: June 2024

Las pasifloras en Colombia están presentes en 24 departamentos y 422 municipios, con más de 15 000 hectáreas cultivadas en su mayoría por pequeños y medianos productores. Dentro de las especies más representativas se destacan el maracuyá y la curuba. Las mayores limitantes del sector productivo de estas especies son las técnicas de propagación convencionales, la carencia de adaptación y la climatización de especies. Por lo tanto, el objetivo de esta investigación fue realizar micropropagación in vitro de estas dos especies a partir de segmentos foliares y nodales, evaluando diferentes concentraciones de bencilaminopurina (BAP). La investigación se desarrolló en tres etapas: 1) selección y obtención del material vegetal; 2)evaluación del protocolo de desinfección de explantes de segmentos nodal y foliar, y 3) estandarización de la micropropagación in vitro. El protocolo de desinfección en el que se empleó NaCLO al 1,0 % y al 1,5 % fue el más adecuado para la propagación de la curuba y el maracuyá, sin embargo, es la concentración de 1,0 % la más apta para controlar la contaminación por hongos, bacterias, y factores asociados con necrosis, lo cual favoreció el desarrollo de los explantes. El segmento nodal fue el más adecuado para la propagación y más reactivo que el segmento foliar, bajo la incidencia con BAP. Se pudo comprobar que para la obtención de callos, hojas y brotes, la mejor concentración es la de BAP 1,0 mg/l o el control, mientras que para la obtención de hojas es la BAP 2,0 mg/l. El maracuyá se caracterizó por ser la especie más sobresaliente en el establecimiento in vitro con respecto a la curuba.
أغراض الكناية بـ "كذا وكذا" في الصحيحين
Authors: İsa Najmeddin
Published: June 2024

تنوَّعت الأساليب النَّبوية في التَّربية والتَّوجيه إلى مكارم الأخلاق والنَّهي عن سفاسفها، فأحياناً نرى الكناية في البيان النَّبوي عن بعض الألفاظ بالإشارة، وغالباً ما نرى التَّصريح والبيان؛ لأنَّه الأصل الذي أرسل به النَّبي عليه الصَّلاة والسَّلام، وتبع هذا الأسلوب الصَّحابة ومن بعدهم في رواية الحديث وتبليغه، ومن مقاصد استعمال هذا الأسلوب الاختصار في الأمر إذا تعذَّر التَّطويل، أو أن يكون التَّلميح أولى من التَّصريح للإبهام في أمر يستحب ستره رحمة بمن تعلَّق به، أو أن يكون الأمر ممَّا يستحيا من ذكره والإفصاح عنه، أو أن يكون في الأمر شكٌّ بين الرُّواة، أو أن يكون عدم ذكر الأمر لتعظيمه أو تحقيره، وتعدُّ الإشارة بألفاظ الكناية أحد الإشكاليات التي تحتاج إلى إيضاح في الحديث النَّبوي لإزالة الإبهام عن الأمر الذي كنَّى به، لذا تناول هذا البحث لفظ "كذا وكذا" في الحديث النَّبوي لبيان الدَّلالات المتولدة عن هذا النوع من الكنايات، وما يترتب عليها من آثار متعلقة بسلوك المخاطبين من أفراد هذه الأمة، وما يترتب عليه من مقاصد بغية بيانها وتعيين المراد منها وفق منهج المحدثين وأهل اللغة. وقد نهج البحث المنهج الوصفي التَّحليلي في جمع مفرداته، وبيان مقاصده توصيفاً وتحليلاً ودلالة.
Alter-hegemonía por delegación y diplomacia infraestructural: configuraciones institucionales entre China y Colombia
Authors: Niño César , Hernández Jessika , Yepes-Lugo Cristian
Published: June 2024

Este artículo tiene por objetivo analizar las configuraciones institucionales en la agenda diplomática entre la República Popular China y Colombia en el siglo XXI. Desde el rastreo de procesos, el análisis de literatura y la construcción de conceptos, este trabajo realiza aportes novedosos al utilizar el modelo de alter-hegemonía por delegación y la diplomacia infraestructural. La investigación se distancia de los clásicos lentes de la política exterior ligados a las relaciones hegemónicas entre Estados, encontrando que la agenda Colombia-República Popular China se conforma según el modelo alter-hegemónico por delegación a partir de la diplomacia infraestructural, en el cual los Estados buscan expandir su influencia mediante proyectos de inversión. Se examina en específico la configuración institucional en las relaciones diplomáticas, evidenciando el papel de entidades no gubernamentales, como la Asociación Colombo China. Este enfoque ofrece una perspectiva alternativa y relevante para comprender las dinámicas contemporáneas de la diplomacia internacional.
Physical Memory
Authors: Trivedi Nripesh
Published: June 2024

Physical Memory.
Users
Authors: Trivedi Nripesh
Published: June 2024

Users
Lipomatosis of the Ileocaecal Valve: A Case Report
Authors: Hasan Mizanul , Rahman Meher Angez , Alshantti Khalil
Published: June 2024

The lipomatosis of ileocecal valve is characterized by a diffuse infiltration of fatty tissue, most often in the submucous layer. The ileocecal valve becomes enlarged. Lack of distinct capsule differentiate the fat in this condition from a true lipoma. As lipomatosis of the ileocecal valve is a rare condition, with doubtful pathogenesis and somewhat controversial therapy the case is reported. It must be recognized and differentiated from true tumours.
Garrido, María Belén. 2022. Rupturas presidenciales: las acciones de la fuerza pública ante movimientos noviolentos del Ecuador en 1997, 2000 y 2005. Sevilla: Universo de letras. 382 p.
Authors: Bravo Allaica Christian Danilo
Published: June 2024

La reseña expone los principales aportes teóricos, metodológicos y empíricos del libro Rupturas presidenciales. María Belén Garrido analiza a profundidad la relación entre los principales factores que incidieron en la fuerza pública para aplicar un mínimo grado de represión a los movimientos noviolentos en las rupturas presidenciales de Abdalá Bucaram (1997), Jamil Mahuad (2000) y Lucio Gutiérrez (2005) en el Ecuador. La reseña muestra las variables y factores clave utilizados en la investigación, las estrategias aplicadas en el trabajo de campo, la organización del libro en capítulos y los principales hallazgos de la investigación. La reseña muestra como el libro en mención ofrece un conjunto de herramientas para el estudio de la fuerza pública y sus relaciones con los gobiernos de turno y la sociedad.
Ríos Vega, Luis Efrén e Irene Spigno, dirs. 2001. Estudios de casos líderes interamericanos Vol. XXI, A diez años de la sentencia de “Campo Algodonero”: reflexiones sobre el desarrollo de la jurisprudencia interamericana en materia de violencia de género.
Authors: Niño Soto Larissa Lizbeth
Published: June 2024

El pronunciamiento de la Corte IDH en la sentencia titulada González y otras (“Campo Algodonero”) vs. México, se convirtió en un criterio jurisprudencial de gran relevancia por la inclusión de la perspectiva de género. La presente reseña expresa una valoración sobre la obra A diez años de la sentencia de “Campo Algodonero”: reflexiones sobre el desarrollo de la jurisprudencia interamericana en materia de violencia de género, a través de la cual se ofrece un panorama sobre la situación jurisprudencial de la Corte IDH del luego de cumplir diez años desde su primera sentencia sobre perspectiva de género, además de un análisis sobre diversos casos de violencia de género que han sido abordados por el tribunal interamericano. El texto permite concluir que el libro, a través de las valiosas aportaciones de sus autorías, es un apreciado objeto de estudio sobre las sentencias de la Corte IDH en casos de violencia contra las mujeres.
The Concept of a Personal Mobility Device
Authors:   Postgraduate Student of the Department of Civil and Entrepreneurial Law of the Ulyanovsk State University, Vlasenko Georgy D.
Published: June 2024

For a long time, one of the controversial issues in the legal literature is the generic name of the entire set of technical devices equipped with an electric motor and providing an increase in the speed of movement in an urban environment. The authors of publications devoted to the topic under consideration use a wide variety of phrases. In the article, based on the analysis of judicial practice and subordinate regulations, the author of the article develops his own version of this concept. An adjustment of the current legislation is proposed.
Legal Regulation of a Carsharing Agreement: Qualification Issues
Authors:   Attorney of the Chamber of Lawyers of Ulyanovsk Region, Postgraduate Student of the Department of Civil and Entrepreneurial Law of the Ulyanovsk State University, Kurganov Vadim V.
Published: June 2024

The concept of carsharing is not fixed in Russian legislation. The absence of a legally fixed concept of carsharing and its regulation entails legal uncertainty. There are different opinions among scientists and practicing lawyers regarding the legal nature of the carsharing agreement. The article examines the legal structure of the carsharing agreement and qualification issues. It should be concluded that currently a carsharing agreement is a legal constructor that includes elements of various agreements enshrined in the Civil Code of the Russian Federation.
On the Establishment of the Legal Framework for the Start of Product Transportation Across the EAEU Customs Border by Highly-Automated Vehicles
Authors:   Associate Professor of the Department of Commerce and Trade Regulation of the Moscow State Institute of International Relations (University), Kozhankov Anton Yu. , Vlasenko Darya S. ,   Lecturer of the Department of Public Law of the Russian Foreign Trade Academy, PhD (Law), Rybin Aleksandr I. ,   Chief Specialist of the Administrative and Legal Department of the Directorate of International Transport Corridors
Published: June 2024

The article discusses the prospects for the development of cross-border cargo transportation using highly automated vehicles. The authors analyze the main normative legal acts in the field of cargo movement across the border of the Eurasian Economic Union and develop recommendations for amending them to start using highly automated vehicles in cross-border transportation.
Marriage by Proxy in Private International Law
Authors:   Associate Professor of the Department of Private International Law of the Russian Foreign Trade Academy, PhD (Law), Tarikanov Dmitry V.
Published: June 2024

In a number of jurisdictions exists a possibility to be united by wedding when one or both of the individuals are not physically present, being represented by other persons (proxies). Whether such a wedding is valid in the jurisdictions in which that possibility does not exist, if spouses are their citizens, depends on classification of that rule.