bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of diuretics on sodium, potassium and chloride levels- a cross sectional study
Authors: Patel Varsha J. , Parikh Paresh C. , Vaghela Chirag
Published: October 2022

Background: Diuretics are one of the widely used class of drugs used in various cardiovascular and other disorders. However, they can cause various metabolic adverse effects, electrolyte imbalance being among important changes.Methods: A cross sectional study was conducted in which patients diagnosed with hypertension for at least one month were included. Over a period of 6 months patients were enrolled irrespective of whether they were taking diuretics or not. Demographic details, drug therapy and electrolyte levels were recorded in a proforma. Data was analyzed for difference in serum electrolyte levels between diuretic and nondiuretic groups as well as between different diuretic groups.Results: Out of total 177 participants, 71 were on diuretic therapy. There was significant difference in mean serum sodium (S. Na), potassium (S. K) and chlorine (S. Cl) levels between diuretic and nondiuretic groups (P<0.05). Hyponatremia, hypokalemia and hyperkalemia were observed. Thiazide diuretic group showed significantly greater hyponatremia compared to other diuretics (P=0.028). Hyperkalemia was observed in participants receiving K sparing diuretic or combination of loop and K sparing diuretics. Old age and number of comorbidities showed negative association with S. Na. Females had significantly more hyponatremia than male participants.Conclusions: The study confirms that diuretics cause various abnormalities in electrolytes namely Na and K levels. Old age, comorbidities and female sex are risk factors for hyponatremia.
A drug utilization study of topical corticosteroids in the department of dermatology in a tertiary care teaching hospital in upper Assam
Authors: Syiem Reuben P. , Chaliha Meghali , Talukdar Krishna
Published: October 2022

Background: Topical corticosteroids form an important group of drugs in dermatology and are among the most commonly prescribed medications. However, despite their efficacy, they are associated with various adverse effects and as majority of the skin conditions are chronic, there is a need to ensure that there is rationality in drug use. Thus, this study was conducted with an aim to analyze the drug utilization pattern of topical corticosteroids.Methods: The study was a hospital-based, prospective and observational study and conducted for a period of 12 months. The method of data collection was done based on one-on-one consultation with patients. Data collected were recorded prospectively in a specially designed proforma. Results were then entered and analyzed using Microsoft excel.Results: In the study, it was observed that 48% of the patients were males while 52% were females. Most patients belonged to the age group of 21-30 years (30%). Scabies (30%) was the most common dermatological condition. With regard to the prescribing frequency of different topical corticosteroids, mometasone furoate (31.4%) was the preferred choice in most patients. H1 antihistaminic drugs like levocetirizine (81.6%) were the most prescribed along with topical corticosteroids, followed by emollients (36.4%) and permethrin (29.2%). The average number of drugs per prescription was 3.6 and all drugs were prescribed by their generic names.Conclusions: Periodic monitoring of the drug utilization pattern in the form of prescription auditing is an effective tool to constitute guidelines for improving the utilization pattern.
Analysis of individual case safety reports of spontaneous reporting in adverse drug reaction monitoring centre at a tertiary care hospital
Authors: S. Gomathi , Devipriya Siddiraju , M. Sudha K. , C. Ramachandra Bhat
Published: October 2022

Background: In developing countries like India, the increased economic burden in healthcare system is due to adverse drug reactions (ADRs) related hospitalizations which in turn are related to polypharmacy associated with increased potential of ADRs. World Health Organization (WHO) started the program for international drug monitoring (WHO PIDM) in the year 1968. India is one of the member countries under WHO PIDM using the Vigibase for analysis of individual case safety reports (ICSRs). Aim of the study was to analyse the ICSRs by spontaneous reporting at ADR monitoring centre.Methods: The present study was focused on analyzing the ICSRs of spontaneous reporting using Vigiflow data from the ADR monitoring centre (AMC), Madras Medical College, Chennai.Results: A total of 541 ICSRs from the period between July 2017 and June 2018 were analysed. Among 541 ICSRs, 814 ADRs were analysed and found that the majority of the ADRs belonged to SOC of gastrointestinal disorders and the most of the ADRs were implicated by antimicrobial agents followed by non-steroidal anti-inflammatory drugs (NSAIDs). Among all the ICSRs, majority of the ADRs occurred in males (n=292) and the maximum number of ADRs were in the age group of 45-60 years (n=197). Of the 541 ICSRs, 313 were found to be of “serious” category and majority of the ICSRs outcome was found to be “recovered” (n=262). The causality assessment of the ICSRs were anlysed and found that the maximum number of ICSRs were under “probable” category as per WHO-UMC scale.Conclusions: Robust pharmacovigilance activities plays important role in minimizing the ADRs for better patient safety.
Rational use and cost variation analysis of antifungal drugs available in the Indian market: a pharmacoeconomic study
Authors: Manjhi Pramod Kumar , Kumar Chakrapani , Rana Akhilesh Kumar
Published: October 2022

Background: Fungal infections are the 4th most common skin disease affecting 984 million people. Fungal infections are mostly associated with the use of broad-spectrum antibiotics, corticosteroids, anticancer/immunosuppressant drugs, indwelling catheters and implants, and the emergence of AIDS. The aim of this study was to analyze the rational use, cost ratio, and percentage cost variations in different brands of the commonly prescribed antifungal drugs available in the Indian market.Method: The maximum and minimum price of each brand of the drugs given in Indian rupees (INR) was noted by using ‘Drug Today’ (January to April 2021, volume II). The cost range, cost ratio, and the percentage cost variation for individual drug brands were calculated. The cost of tablets/capsule/injection was calculated and the cost ratio and percentage cost variation of various brands was compared.Results: After calculation of cost ratio and percentage cost variation for each brand of antifungal agents, tab Itraconazole 100 mg had a maximum percentage cost variation of 733.33% and a cost ratio of 8.33 while tab Griseofulvin 250 mg had a minimum percentage cost variation of 16.98% and cost ratio of 1.16.Conclusions: The present study shows there was a wide variation in the cost of the different brands of antifungal drugs manufactured by pharmaceutical companies which increases the economic burden. The clinicians prescribing these drugs should be aware of rational use and cost variation to reduce cost of drug therapy and improve patient compliance.
Occurrence of depression, anxiety and stress among medical students working during COVID Pandemic
Authors: Halvadia Devanshee R. , Bhavsar Harsh J. , Suthar Karan M. , Dumra Gurusharan H. , Patel Mayank J.
Published: October 2022

Background: Since the COVID-19 pandemic began, medical students have been allotted various duties like rapid antigen testing, Sanjivani corona ghar seva (service provided by the government for home quarantine people), RTPCR swab collection, and posting in wards and intensive care units (ICUs). While executing the COVID-19 duties, students had a significant degree of a significant degree of ambiguity and apprehension. The purpose of this study was to determine the psychological impact of COVID-19 on medical students performing COVID-19 duties.Methods: A questionnaire-based, cross-sectional observational study was conducted among undergraduate and postgraduate students of a tertiary care teaching hospital, who were deployed on COVID-19 duty during pandemic. A google form-based questionnaire was structured, encompassing demographic details, Depression, Anxiety and Stress Scale-21 (DASS-21) questionnaire and other (additional) COVID-19 duty related questions. The analysis of data was done by using unpaired t-test and chi-square test in Statistical package for social sciences (SPSS) version 20.0Results: In our research study, we found that occurrence of depression, anxiety, and stress was 40.46%, 48.37%, and 30.69% among the medical students during COVID -19 duty, respectively. Higher occurrence and more severity (p<0.01) of depression, anxiety and stress was seen in female medical students during COVID-19 duty in pandemic.Conclusions: We observed a higher occurrence of depression, anxiety, and stress among medical students while performing their COVID-19 duty in a pandemic. Medical students played a significant role in the COVID-19 pandemic. Therefore, measures should be taken to ensure the psychological wellbeing of medical students.
Evaluate the prevalence of risk factors among patients of myocardial infarction in our population: review of one hundred forty-seven cases
Authors: Bhavsar Tirth , Rana Devang
Published: October 2022

Background: CAD is disease of persons older than 45 years of age. In India, CAD in males, it manifests earlier than west European and North American males. This study is designed to study prevalence of risk factors (and angiographic profiles) amongst patients of Myocardial infarction in our population. Methods: Total of 147 consecutive patients of AMI were studied for risk factors.Results: Out of 147 patients, 116 (79%) were males and 31 (21%) were females. 11 (9.5%) of males and 01 (3.2%) of females were below 40 years of age. Whereas 34 (29.3%) of males and 06 (19.4%) females were of below 50 years of age. Median age for males was 54 years while that for females was 63 years. Smoking remains most prevalent amongst males while high LDL and HT remain most prevalent amongst young and overall females respectively. 108 patients had STEMI while 39 had NSTEMI.Conclusions: AMI occurs much frequently in males. Median age for males is almost one decade earlier than West European males and nearly 5 years earlier than North American males. Smoking is most common and hypertension second most common risk factors amongst males. In females median age for AMI is almost one decade later than Indian males. It is similar to North American females while nearly 5 years earlier than Western Europe females. HT and DM remain first and second common risk factors amongst females.
Cost variation analysis of commonly prescribed oral antipsychotic drugs available in India-a pharmacoeconomic perspective
Authors: R. Nivetha Raj , A. Geetha
Published: October 2022

Background: Antipsychotics are commonly prescribed for a variety of psychiatric disorders which require prolonged treatment. If a costly brand is prescribed, it reduces patient compliance, especially in the lower socio-economic groups. Awareness about the cost variation among different brands will guide an economically effective prescription by the treating physician.Methods: The cost of different brands of commonly used oral antipsychotic drugs available in the Indian market manufactured by different companies, in the same strength, number and dosage form was obtained from the latest CIMS, MIMS, and India drug Index. The cost ratio and percentage cost variation were calculated for each. The cost for the same drugs was also noted from the Jan Aushadhi generic medicines portal and a comparison was made. Results: The percentage variation in the cost was above 100% with most of the commonly used antipsychotic drugs like haloperidol (517%), trifluoperazine (504.12%), risperidone (485.27%), chlorpromazine (436.35%), aripiprazole (340.34%), flupenthixol (293.12%), olanzapine (245%), ziprasidone (176.02%), amisulpride (169.44%), quetiapine (163.16%). Percentage cost variation between branded and generic drugs ranged from 400-1050%.Conclusions: There is substantial cost variation among the various brands of antipsychotic drugs. Stigma surrounding generic prescription needs to be addressed. More psychiatric drugs need to be included under National list of essential medicines and DPCO (Drug price control order) so that there can be a ceiling on the maximum price.
Impact of extreme maternal age on neonatal outcomes
Authors: Rasamoelison Rina J. , Rambeloson Setra H. , Samena Hanitriniaina S. C. , Robinson Annick L.
Published: October 2022

Background: Pregnancies at extreme ages of reproductive life are considered to be at high risk for mother and neonate. The aim of the study was to determine neonatal risks associated with extreme maternal age.Methods: A retrospective cohort study was conducted at Befelatanana Maternity covering the period from 1 January to 31 December 2018. Data was collected from neonate’s medical files.Results: Of 789 neonates from mothers with extreme age included, 64.7% were from mothers under the age of 18, and 35.3% from mothers aged 40 and over. They were compared to 519 neonates from mothers aged 20-30. Maternal age under 18 was a risk factor for Apgar index below 7 at the 5th minute RR 1.69 (95% CI 1.17, 2.44), preterm birth RR 2.19 (95% CI 1.70, 2.80), low birthweight RR 2.03 (95% CI 1.53, 2.53) and admission to neonatalogy RR 2.64 (95% CI 2.20, 3.16). Also, the neonatal risks of pregnancy after 40 years were fetal death in utero RR 2.97 (95% CI 1.51, 5.85), low birthweight RR 2.47 (95% CI 1.97, 3.10), preterm birth RR 2.85 (95% CI 2.21, 3.68), and admission to Neonatalogy RR 3.06 (95% CI 2.54, 3.68).Conclusions: The extreme age of the mother is therefore a risk of neonatal adverse outcomes. Rigorous prenatal follow-up is needed for these high-risk pregnancies.
Study of endocrinological complications in children with beta thalassemia major
Authors: Jain Jigar K. , Vaishnav Jolly G. , Vohra Arif S. , Shah Mansi , Goyal Anika , Kansagara Mit , Gohil Priya
Published: October 2022

Background: Thalassemia is the commonest hemoglobinopathy in our country of which β thalassemia is most common. More and more endocrinological complications are seen in current scenario in children usually more than 10 years of age with significant iron overload due to inadequate iron chelation. Aim of the study is to understand the common endocrinological complications and the key factors for their prevention.Methods: A prospective analytical study was done at a tertiary care centre, civil hospital, Ahmedabad in children between 9-18 years of age over period of 1 month to determine the prevalence of endocrinological complications and their correlation with mean serum ferritin levels in beta thalassemia patients.Results: Total 48 children enrolled during study period. Mean serum ferritin level 3179±788 ng/ml. Out of 48, 20 children (41.66%) having endocrinological complications. Most commonly observed endocrinological complication was growth retardation in which 17 children (35.41%) were undernourished and 13 children (27%) found to have stunted growth. Delayed puberty was observed in 7 children (14.58%). Hypothyroidism observed in 4 children (8.33%). Five patients (23.8%) with mean serum ferritin level <2500 ng/ml and 15 patients (55.5%) with mean serum ferritin level beyond 2500 ng/ml developed endocrinological complications which statistically significant (p=0.02).Conclusions: Endocrinological complications in adolescent children with thalassemia major were mild in severity in our study and observed when the serum ferritin went beyond 2500 ng/ml. Thus, these children should be managed at a tertiary care centre. Early identification and multidisciplinary treatment are necessary for early treatment as well as prevention of endocrinological complications.
A study to assess knowledge regarding identification of neonatal danger signs among primipara mothers in selected hospital in Siliguri
Authors: Das Mamata , Kumar Primi , Saha Mallika , Purbey Baishali , Sarkar Debolina , Mahata Tithi , Mahanta Mou , Tarfdar Maya , Sarkar Magnolia , Roy Tandrima , Sur Brotati , Layla Runa , Paul Priti , Sarkar Susmita , Sharma Sanjana , Roy Riya , Sarkar Sayantani , Singha Priyanka , Owasti Alabida Rahman , Poddar Anita , Sarkar Gargi , Sultana Diya
Published: October 2022

Background: Newborn mortality is one of the most neglected health problems in the developing world, there are estimated 4 million neonatal deaths worldwide each year. Moreover, it is estimated to account for 40% of under five deaths and two-third of infant deaths.Methods: A descriptive cross-sectional study included 120 primipara mothers of newborn from 2 to 28Day of life admitted in postnatal ward in Siliguri District hospital during the year 2022 in the month of June. Data was collected using face to face interview method.Results: The study showed majority of the mothers were having good knowledge 85.83% regarding neonatal danger signs followed by Fair knowledge 9.16% and only 5% of mothers were having Poor knowledge.Conclusions: Good knowledge of the mothers indicates that mother can identify the danger signs and early treatment makes the good prognosis.
Role of point of care lung ultrasound in neonatal respiratory distress in comparison with chest X-ray-a clinico-radiological evaluation
Authors: . Manusha , Bhushan Shashi , Aneja Satinder , Gupta Amit , Sabhikhi G. S.
Published: October 2022

Background: The use of ultrasound for immediate management of life-threatening conditions is one among the main changes of these last decades. Lung ultrasound has become more and more popular in the first decade of the 21st century, both in neonatal and in paediatric age groups. The lung ultrasound may be tool in differential diagnosis of respiratory distress in newborns. Aims and objectives: To assess diagnostic role of point of care lung ultrasound in neonates presented with respiratory distress and analyse the possibility of initiating management protocol based on lung ultrasound finding.Methods: Present non-randomized study-a hospital based analytical cross-sectional study was carried out in 60 patients with respiratory distress for a period of 18 months (January 2020-30 June 2021). Neonates suffering from respiratory distress (Pulmonary cause with Downe’s score >4) were included.  Routine investigations, lung USG and chest x-ray examination was recorded. Detailed perinatal history were obtained.Results: Mode of delivery was LSCS among 38.3% and vaginal delivery among 61.7% subjects. The mode of respiratory support was CPAP among 33.3% and ventilator among 66.7% subjects. Mean birth weight of the study population was 2003.51±767.35 grams. Final diagnosis of the present study shows that majority of neonates had respiratory distress syndrome (38.33%) followed by birth asphyxia with respiratory distress (28.33%) followed by TTNB (11.66%). A total of 25.0% neonates had Downes score 4, 16.7% had 5, 25.0% had 6, 26.7% had 7 and 6.7% neonates had 8 score. X-ray findings showed sensitivity 56.67% and positive predictive value 100% were observed. On the basis of USG findings, 93.22% sensitivity and positive predictive value 98.21% were observed.Conclusions: Lung ultrasound is a non-invasive, bedside and repeatable method that could improve the management of neonatal respiratory distress. Neonatal lung ultrasound is a useful predictor of the need for intubation over chest x-ray. Combined lung consolidation, pleural line abnormalities and absence of A line findings were the most specific lung ultrasound findings in RDS which were present among majority of the patients.
Missed foreign body-buccal space
Authors: Garg Manish , Arora Shilpi , Arora Shilpi
Published: October 2022

Foreign bodies may get embedded in the maxillofacial region as a result of penetrating trauma in the maxillofacial region.  The ensuing complications and sequelae of these occult foreign bodies can pose a diagnostic challenge to an oral and maxillofacial surgeon. Diagnosis of these foreign bodies can be achieved by the use of plain radiographs, ultrasonography, computed tomographic scans, and magnetic resonance imaging. Once diagnosed and located, these foreign bodies should be removed for definitive management. I report a case of a persistent sinus of the cheek caused by an occult wood splinter and discuss its diagnosis and clinical management
A case of Ebstein’s anomaly
Authors: Goswami Sourabh , Deora Surender , Kumar Shubham , Mohanty Vivek , Gudhage Rahul
Published: October 2022

Ebstein’s anomaly (EA) is a rare congenital heart disease. It has varied clinical presentation depending upon the spectrum of deformation and function of the tricuspid valve and other structures. A comprehensive evaluation by non- invasive modalities is required for optimal decision making regarding the approach to surgical correction of the disease.
Alarmingly high prevalence of addictive screen use behaviour among under thirteen children: a cross sectional study in Mumbai
Authors: Paranjape Raghav M. , Raul Shreeya K. , Rao Shirish R. , Mhatre Pauras P. , Adarkar Shilpa A.
Published: October 2022

Increasing amount of discretionary (non-homework) screen time (DST) has raised significant concerns over the addictive potential of screen-based media and psychiatric dimension children’s health. This study was undertaken to find the prevalence of addictive screen use behaviour in children under the age of 13 years, and its association with the type of content consumed. A cross-sectional study was conducted in Mumbai metropolitan region (MMR) in which 154 parents from 4 schools were interviewed using a pre-validated questionnaire. Data was analyzed using SPSS v26.0, chi-square test and unpaired t test were used at significance level of p<0.05. 18% of the children were found of have addictive screen use behaviour and it was found to be significantly associated with playing shooting and fighting games (p<0.05). Prevalence of addictive screen use behaviour is alarming among under 13 children. Interventions to tackle this concern must be urgently undertaken.
Version reckoning of variant glenoid levels: a radiological study on dry human scapulae
Authors: Elshahhat Amr , Abdel Aziz Aya Mohammed , Basyoni Yehia , Nour Khaled Ayman
Published: October 2022

Background: Preoperative glenoid version measurement can guide base plate implantation and directing screws positioning. Glenoid vault depth affects guide-wire insertion with accurate inclinations towards maximum bone stock. No consensus exists regards the precise glenoid level for version assessment, whether at midaxial or coracoid tip level, and if those values are identical or not. Additionally, there is not much data in literature concerning the deepest point of glenoid vault and its proximity to anterior and inferior glenoid surfaces. Thus, we aimed in this study to report glenoid version values at all levels utilizing two different methodologies (Freidman method, vault version method). Additionally, detecting deepest vault point and how much distant from anterior and inferior glenoid aspects.

Methods: Sixty dry, unpaired scapulae were scanned with 1.25mm-thick slices. Version was measured at all levels and compared. Axial and coronal slices with greatest vault depth was determined and distance from anterior and inferior glenoid rims were determined.

Results: Version method showed significant difference in version at coracoid tip and midaxial levels (p<0.001). Mean versions were 18.2±10.6º and 8.9±6.8º respectively. Also, significant difference was noted between version of upper, middle, and lower thirds, except between middle and lower thirds. A significant difference was evident between both methodologies on comparing version at coracoid tip level (p<0.001).

Conclusions: Glenoid version at coracoid tip and midaxial levels are not the same. Correlation of preoperative version values with intraoperative situations might be studied in future studies.

 

 
Comparison of functional outcomes and complications of conservative management verses surgical fixation with a locking compression plate in the treatment of displaced middle third clavicular fracture
Authors: Sakharkar Nilesh S. , Atram Vikas A. , Arora Chandan A. , Bhurre Rohit K. , Atilkar Akshay J. , Sakhare Kuber
Published: October 2022

Background: About 3 to 5 percent of all fractures are clavicle fractures, which account for 45 percent of fractures at the shoulder. While fractures of the lateral and medial thirds of the clavicle account for 15% and 5% of all clavicle fractures, respectively, middle third fractures account for 80% of all clavicle fractures.

Methods: patients were divided into two groups at random. Patients selected for conservative treatment with figure of eight Clavicle Brace and arm sling/pouch were treated with the brace immediately and for surgical intervention with locking plating. Constant and Murley's scoring system was used to check for signs of healing and functional improvement

Results: The 40 patients in the current study include 20 with a new fracture of the mid-third clavicle who underwent surgical treatment with clavicular locking compression plate and screws and 20 who underwent conservative treatment with a figure-eight clavicle brace and arm pouch/sling. There was a statistically significant difference in the Constant and Murley score between the surgical group and the conservative group.

Conclusions: According to the present study, patients with a displaced mid-third clavicle fracture may benefit more from surgery than from conservative treatment.

 
New classification of S1 pedicle morphometry impacting pedicle screw insertion technique
Authors: Tiwari Atit , Sonone Sandeep V. , Jaiswal Nishant P.
Published: October 2022

Background: The conventional entry point for the S1 pedicle screw insertion has been described as ‘at the base of and lateral to the superior S1 superior facet’. However, many orthopaedic surgeons complain that this technique is extremely demanding and is faced with many challenges in execution. Therefore, alternative entry points and modifications of existing techniques are explored for a greater convenience.

Methods: We conducted a survey amongst 136 spine surgeons on the technical difficulties faced during insertion of the S1 pedicle screw. We also classified the S1 pedicles based by measuring their geometric parameters on 100 random computed tomography (CT) images.

Results: The S1 pedicle entry technique was considered to be the most difficult and challenging by the orthopaedic surgeons in our survey due to an inadequate medial angulation due to paraspinal muscle mass tension and an overhanging iliac crest. This could be explained by the hourglass shaped pedicle (type 3) with a desired medial angle more 50 degrees (type III) observed as the most common S1 pedicle in the study population. To overcome this limitation, most of them preferred a tri-corticate approach.

Conclusions: A more lateral entry point and a longer screw might be considered as solutions for a better and safer S1 pedicle entry. Also, the use of pre-operative CT can be considered to visualize the type of S1 pedicle and hence, decide on the most appropriate technique of screw insertion.

 
The management of complex periprosthetic femoral fractures: a case series of plating with wire augmentation, and a review of the literature
Authors: Mahajan Neetin P. , Chaudhari Kunal , Patel Ravi , Bagimani Pramod , Gund Akshay
Published: October 2022

Periprosthetic fractures continue to increase in frequency. This is due, in part, to the increasing number of primary and revision arthroplasties performed annually and to the increasing age and fragility of patients with such implants. All types of periprosthetic fractures can present unique and substantial treatment challenges. Here we present a case series of 3 elderly patients who came to us with periprosthetic hip fractures in previously operated case of hip hemiarthroplasty/total hip replacement done. The injuries were managed with splintage and operative procedures. Postoperatively mobilization was challenging. But patients were successfully mobilized with the help of relatives and physiotherapists. Periprosthetic fractures are becoming quite common in elderly and difficult to treat as the number of hip joint arthroplasty operative has increased in developing countries. the correct procedure is very challenging as every case needs to be treated very individualistically. A good plan always results in much reduction in the operating time and better patient post operative outcome. Postoperatively mobilization of patient and functional outcome is hampered. Proper counselling by operating surgeon, physiotherapy and postoperative rehabilitation with the help of relatives and assisting devices provides good outcome. So that early appropriate treatment and mobilization can be done with good functional outcome.
Vascular injuries associated with total knee arthroplasty
Authors: Hulse Narayan , Naik Prashanth , Dilip Naveen , K. N. Nagabhushan , Bhat Adarsh Krishna K.
Published: October 2022

Iatrogenic vascular injuries are rare but potentially devastating complications of total knee arthroplasty (TKA). This retrospective study analyzes vascular injuries associated with total knee arthroplasties in an urban, tertiary level referral hospital between 01 April 2010 to 31 March 2020 consisting of 6548 TKAs. Six patients sustained vascular injuries which included five primary, and one revision TKAs. Three patients were bilateral, and two were unilateral primary TKAs. The mean age-adjusted Charlson’s comorbidity index was two (range 1-3). Only two injuries were recognized intraoperatively. They underwent successful vascular repair. The third patient was diagnosed and underwent a vascular repair on the first postoperative day but experienced a permanent foot drop. Two other patients underwent thrombectomy on the fifth postoperative day; one required above-knee amputation, and the other continued to suffer from vascular claudication and paraesthesia. Another patient developed a pseudoaneurysm, which was identified and repaired five months after the primary TKA. The site of vascular injury was popliteal artery in five and superficial femoral artery in one patient. The mechanism of injury was a direct laceration in three, posterior Hohman's retractor in one, the effect of tourniquet on calcified vessels in one, and unknown in one patient. Early recognition was the only factor that significantly altered the functional outcome and limb salvage. Bilateral simultaneous total knee arthroplasties had no higher risks. A mandatory institutional protocol to recognize the early signs of vascular injuries is necessary for successful vascular repair.
Management of skin and soft-tissue infections and acne with topical nadifloxacin: a comprehensive review
Authors: Muchhala Snehal , Sarkar Rashmi , Lahiri Koushik , Kharkar Rajendra D. , Rathod Rahul
Published: October 2022

Skin and soft tissue infections (SSTIs) and acne are multi-factorial skin conditions that involve microbial invasion of the skin and underlying soft tissues; though, both have different pathogenesis. Most of these infections are caused by bacteria, affecting all age groups. Early diagnosis and appropriate antimicrobial therapy remain the cornerstone of management of SSTIs and acne. Over the years, an increase in antibiotic resistance has been reported with mupirocin and fusidic acid that makes the management of SSTIs and acne increasingly challenging. Further, these antibiotics are unable to penetrate biofilms and show their action on the microorganisms embedded deep in the polymeric matrix. In this review, we have discussed the current evidence on the efficacy and safety profile of nadifloxacin compared to other currently available antimicrobial agents. An extensive search was performed through PubMed and Medline using relevant key words. This article has highlighted nadifloxacin’s broad antimicrobial spectrum, unique dual mechanism of action, distinct characteristics like ability to retain efficacy in acidic pH, low antibiotic resistance and superior action against biofilms. This review concludes that nadifloxacin, could be a potential empirical therapy in the management of SSTIs and acne.
A rare case of elephantiasic pretibial myxedema with secondary cutis verticis gyrata
Authors: Aung Phyo Zaw , Simsamer Pacharee , Nararatwanchai Thamthiwat
Published: October 2022

A 61-year-old man with a history of thyrotoxicosis, diabetes mellitus, hypertension, and dyslipidemia presented to the dermatology outpatient clinic with bilateral non-pitting edema, asymmetrical yellowish-brown plaques, and nodules associated with some areas of hyperpigmentation, Peau’d orange appearance and elephantiasis-like skin lesions over both low legs. It was diagnosed as pretibial myxedema attributed to thyrotoxicosis. Additionally, convoluted folds and deep furrows similar to the cerebral cortical surface were seen on the forehead suggesting secondary cutis verticis gyrata (CVG) and our approach to the patient will be discussed in this case report.

 
Kaposi`s varicelliform eruption in a case of pustular psoriasis
Authors: Rao Naveen Netaji , Toor Sharanjit Singh
Published: October 2022

Kaposi`s varicelliform eruption (KVE) is a disseminated cutaneous infection with herpesvirus type 1 or 2, vaccinia virus, or coxsackievirus A16 in a patient with another underlying dermatosis. When herpesvirus type 1 or 2 is the pathogenic virus, the term ‘‘eczema herpeticum’’ (EH) is used, independent of the underlying dermatologic diagnosis that preceded the eruption. Presenting a case of generalised pustular psoriasis who while on immunosuppressant therapy cyclosporine developed KVE on the 3rd week of therapy. Based on the nature of cutaneous eruption and the bed side Tzanck smear test he was diagnosed as Psoriasis herpeticum. He was treated with oral acyclovir for 15 days with complete resolution of the lesions. KVE rarely occurs in psoriasis. It is more often in those patients who are on immunosuppressant therapy like oral methotrexate, cyclosporine etc. A high index of suspicion is needed while managing skin eruptions in a known case of psoriasis.
Cutaneous sarcoidosis: a marker of underlying systemic disease
Authors: Satyanka L. , Gopal K. V. T. , Raju P. V. Krishnam , Rani B. Rekha
Published: October 2022

Sarcoidosis/Mortimer’s malady is a multisystem disease defined by presence of epithelioid cell granulomas without caseation in various organs.It involves mainly the lungs, eyes, skin, lymph node etc. We reported a 40 year old female who presented with multiple plaques over different regions of the body with past history of ulcerated lesion of scalp which healed with cicatricial alopecia. On thorough evaluation she was found to have involvement of multiple internal organs. Based on the clinical features and histopathological findings, a diagnosis of cutaneous sarcoidosis (plaque type) was made. Patient treated with systemic and topical corticosteroids resulting in marked improvement in her skin lesions were seen and pulmonary complaints also resolved.
Knowledge regarding breast self examination among adolescent girls
Authors: Thakur Manjula , Thakur Reena , Chicholkar Jitendra
Published: October 2022

A breast exam is a self-inspection of the breasts. During a breast exam, eyes used to see and hands to observe the appearance and feel the breast. Breast exams allow becoming more familiar with girls breasts.

This study made use of an evaluative approach with one group pretest and post test design. The sample for the study sample comprised of 60 adolescent girls. A disproportionate purposive sampling technique was used to select 60 adolescent girls. The tool and STP were validated by 7 experts. Pre testing and reliability of the tool was established prior to pilot study. Pilot study was conducted among ten adolescent girls. this gave basis for the invigilator to conduct the actual study .the actual study was conducted among 60 adolescent girls .following the pretest, STP Was administered and post test was conducted seven days after the administration of STP. The obtained data was analyzed in terms of the objectives and hypothesis using descriptive and inferential statistics.

The finding of the study showed that STP is an effective teaching strategy to increase knowledge of adolescent girls.

The finding of the study proved that adolescent girls lacked knowledge about breast self examination. The STP given by the investigator helped the adolescent girls to improve their knowledge and the finding showed that it is statistically significant at 0.05 level of significance.
Thrombectomy using aspiration catheter- An effective first line approach for resistant thrombi in patient of acute myocardial infarction
Authors: Tamakuwala Krunal Krishnakant , Bhavsar Masum , Nanda Vivek
Published: October 2022

Acute myocardial infarction is caused by the rupture or erosion of an atherosclerotic plaque, initiating intra-luminal thrombosis resulting in partial or complete occlusion of a coronary artery. Primary percutaneous coronary intervention (PCI) is the preferred treatment and is effective in opening the infarct-related artery. These results can be further improved with thrombus aspiration which reduces stent thrombosis and improves myocardial blush. In acute presentation, there is a high load of thrombus in the infarct-related artery and stent placement in such a case increases the chances of the thrombus shifting both proximally and distally in the microvasculature. In such patient, deferred stenting along with the attempt of thrombus aspiration has the potential for complete thrombus removal with improvement in TIMI flow which eliminates the need of stenting. Here, we present an interesting case report pertaining to the feasibility of multiple thrombus aspiration attempts (>25) as first approach in young patient (Male/32 years/no co-morbidities) with late presentation of STEMI and a large resistant thrombus load on an angiogram. We also re-assessed the need of stenting after 5 days of thrombus aspiration attempt along with continued anticoagulation from the first contact with patient.
The Reality and Policy Implications of U.S. Green Jobs
Authors: H. Bezdek Dr. Roger
Published: October 2022

Green jobs are of intense interest in the USA but heretofore have not been rigorously estimated.  While green jobs are desirable and are increasing rapidly, consistent time series estimates and forecasts of these jobs are not available.  This has impeded research and policy development.  We analyze the importance of green jobs and estimate the green jobs created by the USA economy 1970 – 2030 by industry, occupation, skill, and salaries.  Here we show that:  1) jobs generated by the USA green economy have increased from 1% of total jobs in 1970 to 6% 2020, and are forecast to comprise 14% of jobs in 2030; 2) most persons in these jobs do not realize that they owe their livelihood to the green economy; 3) jobs generated by the green economy are at least 3 or 4 times larger than realized; 4) most green jobs are not attractive, well paid, or unionized; 5) there about 25 times as many jobs currently being created by the U.S. green economy than by the U.S. coal industry; 6) advocates can be their own worst enemies by misrepresenting the reality of green jobs.   The significance of green jobs is not appreciated and this has serious economic, environmental, and policy implications that must be remedied.
Introduction
Authors: Suárez Castiñeira María Luz , Zhang Xiaotong
Published: October 2022

Beyond trade, investment, geostrategic and security challenges, as well as issues of connectivity and governance, the European Union-Asia Pacific dialogue has also boosted the involvement of civil society in international politics. The involvement of civil society can contribute to enhancing mutual trust and knowledge as well as democratization processes and channels for citizen participation in social issues that have an impact on people’s lives. However, in the last decade, internal crises both in the EU and in the Asia-Pacific region, as well as a lack of political will on both sides to support the discussion of issues in non-official processes, seem to have slowed down the intensity of interregional interaction and cooperation between civil society organizations. This special issue of Cuadernos Europeos de Deusto (CED) / Deusto Journal of European Studies on “European Union-Asia Pacific social and cultural dialogue: involving civil society in interregional relations” aims to make a contribution to the knowledge and understanding of some of the major actors and factors that determine the evolution of social and cultural interregional dialogue.
Evaluation of Cryoprotective, Cryocapacitation Inhibitory and Fertility Enhancing Potential of RU-486, Sericin and Taurine in Cattle and Buffalo Semen
Authors: Chaturvedi Devangana , Dhami A.J. , Chaudhari D.V. , Patel A.C.
Published: October 2022

Background: Artificial insemination with frozen semen is of great value for livestock breeding and improvement. However, the procedure of cryopreservation leads to varying degree of oxidative and cryodamage to sperms deteriorating its quality, capacitation status and fertility. Hence, a variety of protocols, cryoprotectants and additives have been tried to protect sperms from such damages. This study was aimed to evaluate the antioxidant and cryocapacitation inhibitory potential of Mifepristone, Sericin and Taurine in routine extender on cryopreserved bull semen including in vivo fertility. Methods: Semen ejaculates of 3 Gir and 3 Murrah bulls with greater than 75% initial motility were split-diluted @ 100 million spermatozoa ml-1 using TFYG extender without and with Mifepristone (10 µg/ml), Sericin (5 mg/ml) and Taurine (4 mg/ml) and frozen in LN2 using a programmable biofreezer. The freshly diluted as well as frozen-thawed samples were assessed for sperm motility, viability, plasma membrane integrity, CTC (chlortetracycline) fluorescence assay and seminal plasma oxidative markers. The straws frozen as above were used to inseminate 100-375 cows and/or buffaloes with each treatment involving well trained field AI technicians. Conception rates were determined based on confirmation of pregnancy per-rectum 45-60 days after first AI in non-return cases. Result: The mean percentages, on dilution and at post-thaw stage in particular, of motile, live, HOS reactive and non-capacitated sperm were significantly (p less than 0.01) higher with reduced lipid peroxidation (MDA, SOD and GPx) whereas capacitated and acrosome reacted sperm were lower in Mifepristone supplemented extender than in control extender and the values for Sericin and Taurine fortified extender were intermediary in both the species. The first AI conception rates obtained for Gir and Murrah bull semen cryopreserved in control extender and extender supplemented with Mifepristone, Sericin and Taurine were 44.48, 51.11, 47.22 and 48.72% in cattle and 44.44, 55.40, 51.57 and 52.05% in buffaloes, respectively, suggesting that all additives used and Mefipristone in particular can be advantageously incorporated in the semen extender for cryopreservation of both cattle and buffalo semen.
Damage of the Egyptian Fruit Bat (Rousettus aegyptiacus) at El-Dakhla Oasis, New-Valley Governorate, Egypt
Authors: Rizk A.M. , Ahmed H.A.A. , El-Bakhshawngi M.I.A.
Published: October 2022

Background: The Egyption fruit bat, Rousettus aegyptiacus, is considered a harmful pest that attacks agricultural crops, especially ripe fruits, causing economic losses. It is widespread in African sahara desert, Egypt, Pakistan and Northern India. This pest causes damage to many vegetables and fruits. The measuring of damage percentage will aid in the protection of these crops from bats attacking. Methods: The losses caused by Egyptian bats were estimated during two years (2019 and 2020) in many fruit orchards (date palm, citrus, apricot and mango) in reclaimed lands at Butt village, Dakhla Oasis, New-valley Governorate, to achieve integrated management of bat populations. Result: Only one species the Egyptian fruit bat, R. aegyptiacus, has been recorded with 167 individuals attacking fruit orchards. The highest average losses (11.1%) were found in date palms, from August to Oct., while the lowest (4.7%) were found in Apricot, during June and July. The second-highest losses were 7.6% in mango from June to August. The damage began from December to March in citrus with an average loss percent of 7.0%. Therefore, bat dens must be monitored and dealt with to limit their populations and reduce their losses to these value crops in El-Dakhla Oasis.
A review of microfinance and women empowerment in Ethiopia
Authors: Malela Ismael Hussein
Published: October 2022

Microfinance has a positive impact on the living standard of the poor people in particular and alleviates poverty in their households in general. It is not only undermining poverty in the city but also empowering women through surviving and making their life prosperous with dignity and self-reliance by providing financial services. This study aims to provide information for a better understanding of the constraints of women to access microfinance institutions (MFIs) in Ethiopia and establishes a knowledge base that helps to make a sound decision by providing information for policymakers and identifying research gaps, MFIs, and other lending institutions, and stakeholders. The study uses the literature review methods. From the findings of the study, Ethiopian Microfinance is facing different challenges in empowerment such as lack of collateral assets, lack of information, work burden, production failures, verbal abuse, lack of infrastructure and low institutional capacity.
Keywords: Collateral, empowering women, microfinance, poverty eradication
Little Circle Arabic Learning (LCAL) To Improve Arabic Language Skills And Confidence/ Little Circle Arabic Learning (LCAL) Untuk Meningkatkan Kemampuan Berbahasa Arab Dan Kepercayaan Diri
Authors: Mauludiyah Lailatul , Syarofah Alfiatus , Fauzi Moh. Fery
Published: October 2022

Learning Arabic at the university level for non-language majors was still a problem, and it was still being developed. This research aimed to see how well the Little Circle Arabic Learning (LCAL) learning model worked in practice. Students majoring in Islamic Religious Education who are learning the native language at the University of Muhammadiyah Malang's Arabic Language Development Program (PPBA) were the subject of this study, which used a quantitative approach. The method of data collection were questionnaires and tests. While the data analysis used is descriptive quantitative to process the results of the questionnaire. The sample t-test is related to processing the test results. Based on the t-test results, this research indicates that the Little Circle Arabic Learning (LCAL) model effectively taught Arabic at the university level. There was also an increase in competence in students in terms of kalam, vocabulary, and translation. This LCAL learning model can also improve the ability to interact with teams in groups and the student's self-confidence. These components support students being able to speak Arabic.
Tackling ragweed: The International Ragweed Society held its 2022 world conference in Budapest
Authors: Makra László
Published: October 2022

The International Ragweed Society held its current conference in Budapest on September 8-9, 2022. The conference is the highest-level international event in the field. The paper, in connection with the event, gives a brief overview of the beginnings of palynology, which is a relatively new science. The paper reports a Hungarian example of the rapid spread of ragweed. It presents the damage caused by ragweed and its pollen, which happens in all areas of life, based on which it is said a serious natural, economic, human, and environmental health problem. Based on model results, the problem will continue to worsen with global climate change. All of this proves the attention paid to the topic and the fact that the conference provides insight and solutions to the environmental and social challenges posed by ragweed and its pollen.