bluuebunny/crossref_metadata_2025 huggingface dataset:
État des lieux des soins non programmés en soins primaires. Une étude descriptive prospective dans le Vexin
Authors: Chambrion Cyril , Chevallier Frédéric , Vionnet Fuasset Joël , Senebier Bruno , de Smedt Sophie , Lebreton Julien , Boisnault Philippe
Published: September 2024

Introduction : Les soins non programmés (SNP) sont exclusivement étudiés en France par le prisme des consultations aux urgences. But de l’étude : Cette étude vise à quantifier les SNP sur un territoire en incluant les soins ambulatoires. Méthodes : Sur le territoire d’une CPTS, les SNP ont été explorés par une étude transversale descriptive prospective, pour les médecins généralistes (MG), infirmières (IDE), pharmaciens, kinésithérapeutes, ostéopathes, sages-femmes, service des urgences de l’hôpital de proximité. La définition du SNP pour l’enquête était un soin qui n’était pas prévu sur l’agenda du professionnel la veille de la séance ou un nouveau problème évoqué lors d’une séance déjà programmée pour un ou plusieurs autres problèmes de santé. Les soins prescrits ou adressés étaient exclus de l’enquête. Résultats : Rapportés à l’effectif du territoire, les SNP ont été réalisés par les médecins généralistes (41 %), les pharmaciens (20 %), les infirmières (15 %), les urgences (11 %), les kinésithérapeutes (5 %), les ostéopathes (4 %), les sages-femmes (4 %). Plus de 80 % des patients bénéficient d’un avis en ambulatoire. Dans une large majorité, les SNP sont pris en charge par le professionnel qui est en premier recours sur le SNP. Seules 8,5 % des réorientations ont lieu vers l’hôpital, ce qui correspond à 1,2 % des SNP réalisés. Conclusions : Les professionnels ambulatoires constituent un maillage du territoire en mesure de prendre en charge la majorité des demandes de SNP. Une plus grande coopération entre eux permettrait d’augmenter la qualité et la couverture des besoins de SNP.
L’impasse des étudiants gradués : entre l’inaccessibilité de la recension systématique et les biais de la recension narrative
Authors: Trudel Pierre , Duval-Brassard Pénélope , Trottier Christiane
Published: September 2024

La recension des écrits occupe une place importante dans le parcours des étudiants gradués et elle a un impact sur l’obtention d’un diplôme d’études supérieures dans les délais impartis. Malheureusement, les étudiants gradués ne disposent généralement pas des connaissances et des ressources nécessaires pour réaliser des recensions systématiques. En même temps, on leur dit que les recensions narratives ne sont pas rigoureuses et qu’elles sont plus susceptibles d’être biaisées. Cela leur laisse peu d’options pour réaliser des recensions des écrits crédibles. Cet article décrit comment une étudiante graduée (première auteure) a utilisé la procédure boule de neige pour accroître la rigueur d’une recension narrative. Il s’agit d’une procédure de recherche systématique qui repose sur l’analyse des références et des citations d’articles clés pour recenser la littérature. Des réflexions sur son expérience au doctorat et sur l’impact de la procédure boule de neige jusqu’à présent sont également présentées. Enfin, la contribution de l’article pour le cheminement des étudiants gradués et pour améliorer leur expérience en matière de recension des écrits est présentée.
Characteristics of educational experiences in STEM education in Medellin
Authors: Ángel-Uribe Isabel , Cano-Vásquez Lina , López-Molina Giovanni
Published: September 2024

STEM education seeks to respond to the challenges of the fourth industrial revolution and to prepare future generations of the city in 21st century skills and scientific and technological vocations. This article aims to identify the characteristics of the educational experiences lived in processes of partial and total implementation of the STEM approach. To this end, the article is located in the empirical-analytical paradigm, with a population of 2,511 teachers and 18,421 students from the 10th and 11th grades of 75 educational institutions in Medellin. The probabilistic random sampling (confidence level of 95% and margin of error of 5%) shows a sample of 390 teachers and 384 students. However, after filtering, data from 570 teachers and 3,262 students collected through a survey of 139 questions (Likert, dichotomous, polytomous, and multiple choice) were analyzed. The results allow identifying problem-based learning as the most implemented didactic strategy; the area of technology and information technology with the highest integration into the curriculum; the greatest uses of ICT are for communication and collaboration; the most implemented digital competencies are for surfing the internet and using email, and the partner with the most significant participation is the state, represented in different public and private organizations. Among the conclusions arises the need for a greater reflection and awareness of the processes and learning achieved by researchers and educational institutions to strengthen students' scientific and technological training.
Depression-induced changes in directed functional brain networks: A source-space resting-state EEG study
Authors: Jia Zhongwen , Tang Lihan , Lv Jidong , Deng Linhong , Zou Ling
Published: September 2024

Current research confirms abnormalities in resting-state electroencephalogram (EEG) power and functional connectivity (FC) patterns in specific brain regions of individuals with depression. To study changes in the flow of information between cortical regions of the brain in patients with depression, we used 64-channel EEG to record neural oscillatory activity in 68 relevant cortical regions in 22 depressed patients and 22 healthy adolescents using source-space EEG. The direction and strength of information flow between brain regions was investigated using directional phase transfer entropy (PTE). Compared to healthy controls, we observed an increased intensity of PTE information flow between the left and right hemispheres in the theta and alpha frequency bands in depressed subjects. The intensity of information flow between anterior and posterior regions within each hemisphere was reduced. Significant differences were found in the left supramarginal gyrus, right delta in the theta frequency band and bilateral lateral occipital lobe, and paracentral gyrus and parahippocampal gyrus in the alpha frequency band. The accuracy of cross-classification of directed PTE values with significant differences between groups was 91%. These findings suggest that altered information flow in the brains of depressed patients is related to the pathogenesis of depression, providing insights for patient identification and pathological studies.
Unravelling Technology Acceptance: Lessons Learnt from Teacher's Experience During COVID-19 for Post-Pandemic Systemic Education
Authors: Peiris Manesha
Published: September 2024

The COVID-19 pandemic presented a unique environment to understand education technology acceptance and adoption. The pandemic acted as a catalyst, encouraging higher education (HE) institutions to rapidly transition from traditional learning environments to technology-driven learning environments. While the motivation for this transition at an institutional level was driven by the need for operational continuation and survival, this rapid transition transferred an increased responsibility to the teacher. Extant research in the context of education technology acceptance and adoption during the COVID-19 pandemic gives substantial emphasis to the learner’s experience since the learner is often seen as being on the receiving end of this transformation. However, in this narrative, the teacher is often overlooked. Through a systematic literature review of technology acceptance and adoption during the COVID-19 pandemic, we examine themes surrounding the teacher’s experience to address the research questions. When the teacher or instructor is the subject of the study, how have learning technologies influenced their role? and What factors encourage or influence teachers’ acceptance of learning technologies? Key findings from this study reveal that the role of the teacher in this technology-driven learning environment shifts from instructor to facilitator, positioning them as an extension of technology. As a result, the teacher determines how the educational technology is perceived by the learner as useful or easy to use. The findings of this study recognise considerations for HE institutions in this age of digital transformation while also presenting new avenues for research in the domain of technology acceptance and adoption.
Exploring a Mobile Technology-Driven Model for Intercultural Communication Education
Authors: Chen Huajie , Mei Kehan
Published: September 2024

In the context of accelerating globalization, intercultural communication competence has become a crucial element for the success of individuals and organizations. The frequent international interactions have underscored the importance of enhancing methods for improving intercultural communication skills within the educational sector. The rapid advancement of mobile technology offers unprecedented opportunities for educational innovation. Its convenience and widespread use have made mobile device-based learning models highly attractive. Particularly, advancements in real-time speech processing technologies have provided new tools and methods for intercultural communication education. By leveraging mobile real-time speech detection and synthesis technologies, a more interactive and personalized learning experience can be achieved, thereby enhancing the efficiency and effectiveness of language learning. This study aims to explore a mobile technology-based model for intercultural communication education and is divided into three main parts: firstly, the investigation of mobile real-time speech detection technologies aimed at intercultural communication education to provide instant feedback and improvement suggestions; secondly, the exploration of mobile real-time speech synthesis technologies to generate high-quality speech samples for learners to practice against; and thirdly, the integration of the aforementioned technologies to develop a flexible, efficient, and highly interactive learning system based on mobile technology. This study is expected to not only improve the effectiveness of intercultural communication education but also provide significant references for the innovative application of educational technologies.
COVID-19 Pandemic Effects on Angler Effort and a Brown Trout Population in a Driftless Area Stream in Southeast Minnesota
Authors: Dieterman Douglas J.
Published: September 2024

Early opinions of the COVID-19 pandemic included equivocal notions of whether the pandemic would result in more or less angler effort and harvest in recreational fisheries. Early papers also suggested using changes in angling license sales to infer changes in angler effort but expressed concern about adequate assessment of pandemic effects on fisheries because of interruptions to routine assessment programs. To assess pandemic effects on angler effort at a stream trout fishery, a trail camera was installed immediately prior to implementation of a statewide stay-at-home order, at a representative stream trout angling site that is part of a long-term fish monitoring program. The trail camera was deployed through the trout harvest angling season from the peak pandemic year of 2020 through cessation of most restrictions in 2022. Statewide sales of angling licenses and trout stamps were assessed through this time to compare with angler effort measured with the trail camera. Annual trout population assessments were examined for pandemic effects in conjunction with angler effort. Anglers were present on 84% of days in 2020, 66% in 2021, and 69% in 2022. Following the pandemic peak of 603 angler-hours in 2020, angler-hours declined by 23% between 2020 and 2021 and by –16% between 2020 and 2022, whereas statewide sales of licenses and trout stamps only declined by 4% between 2020 and 2021 and 11% between 2020 and 2022, suggesting more angler pressure at the study site than could be inferred by changes in license or trout stamp sales. Higher pressure during the pandemic was due in part to more anglers younger than 20 years old. Despite higher angler pressure in 2020, there was no long-term effect on the Brown Trout population, as adult abundance in 2021 and 2022 exceeded abundance in every year from 2017 to 2020. These data add to a limited number of similar field-based pandemic studies coupling changes in angler use with fish population responses and should provide further insight into the broader assessment of COVID-19 pandemic effects.
Behavior Problems in the School Community
Authors: Glymitsa Efi , Zafiriadou Eleni , Zafiropoulou Maria , Galanaki Evangelia
Published: September 2024

This chapter presents strategies that teachers can use for preventing and dealing with students' behavior problems in the school community. These strategies are based on behavioral, cognitive behavioral, ecosystemic, and humanistic approaches. The basic premise of this chapter is that the effectiveness of prevention and intervention is enhanced when strategies from all these approaches are used by educators. The basic principles of behavioral, cognitive behavioral, ecosystemic, and humanistic models are briefly presented based on which, management strategies are described that teachers can implement to prevent and deal with children's behaviour problems as well as to increase desirable behaviours. These prevention and intervention programs are delivered at the individual, classroom, whole school, and family levels. Specific examples are given for all these strategies. Finally, two case studies or scenarios are presented with the aim of illuminating the effective use of these strategies in real situations within the school community.
Mindfulness in Education
Authors: Reppa Glykeria , Michael Katerina
Published: September 2024

In recent years there has been an increasing amount of research on the practice of mindfulness in education. There are several studies that examine the practice of mindfulness and its effectiveness in various aspects of the lives of both students and teachers. The purpose of the chapter is to mention the different practices that have already been implemented in different educational levels, either in pupils/ students or teachers/ tutors and their effectiveness in different aspects of their lives, through literature. It is also discussed mindfulness as a quite promising practice, which is likely to be a pedagogical practice that serves educational purposes that have long been part of the tradition of education.
Abstracts of Oral and Poster Presentations at the 83rd Annual Academic Sessions of the Galle Medical Association on 26th & 27th September 2024 at the Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
Authors: Waidyarathne Eisha I. , Liyanage Gayani
Published: September 2024

NA
Cervical myelopathy as an atypical presentation of antineutrophil cytoplasmic antibody-associated vasculitis in a patient affected by silicosis: a case report and literature overview
Authors: Grazzini S. , Terribili R. , Conticini E. , Bartalini S. , Cantarini L. , Frediani B.
Published: September 2024

We describe the case of a 73-year-old man affected by pneumoconiosis, secondary to silica dust exposure, who was diagnosed with antineutrophil cytoplasmic antibody (ANCA)-positive microscopic polyangiitis (MPA)-related cervical myelitis. Pneumoconiosis is reported to trigger autoantibody production and the onset of different autoimmune diseases, including ANCA-associated vasculitis (AAV). MPA is an AAV of the small vessels that can often affect the nervous system, although involvement of the spinal cord in the form of myelitis is described as an anecdotal occurrence. Our experience suggests that an autoimmunity workup should be considered for patients with pneumoconiosis who present with neurological symptoms consistent with AAV.
Assessment of liver and kidney function in patients with ankylosing spondylitis on long-term non-steroidal anti-inflammatory drug therapy
Authors: Sülükcü S. , Uslu S.
Published: September 2024

Objective. This study aimed to analyze the status of liver [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and kidney (serum creatine) function in ankylosing spondylitis (AS) patients assuming continuously non-steroidal anti-inflammatory drugs (NSAIDs) alone over a long period.
Methods. Between 2013 and 2022, there were records of 385 AS patients. Of them, 56 were receiving only NSAIDs, and the files of these patients were retrospectively analyzed. Demographic and clinical characteristics were collected. Blood tests, including serum creatinine, AST, and ALT, were assessed at each visit.
Results. Of the 56 patients, 39 were male. The mean age was 45.30 years, and the follow-up period was 9.80 years. Of them, 44.6% used indomethacin, 26.8% naproxen, 17.9% diclofenac, 5.4% acemethazine, 3.6% meloxicam, and 1.8% celecoxib. The mean baseline serum creatinine was 0.71 mg/dL. The mean baseline serum AST and ALT were 19.6 u/L and 22.9 u/L, respectively. Baseline creatinine, AST, and ALT were not statistically significantly different between sexes. There was a statistically significant difference between mean creatinine concentrations at baseline and at year 3. One patient on naproxen discontinued treatment due to elevated creatinine. The creatinine level decreased during the patient's follow-up. Liver enzymes above 3 times the normal value were not seen in any patient.
Conclusions. Based on real-world data, long-term use of NSAIDs has generally not led to acute liver and kidney injury or progressive impairment of hepatorenal function requiring discontinuation of treatment.
New range record for Campbell’s monkeys (Cercopithecus campbelli) in West Africa
Authors: Mirghani Nadia , Dotras Laia , Llana Manuel , Barciela Amanda , Renelies-Hamilton Justinn , Hernandez-Aguilar R. Adriana , Galbany Jordi
Published: September 2024

The current distribution of Campbell’s monkeys Cercopithecus campbelli extends from southwestern Gambia to the western Ivory Coast. In Senegal, it has only been confirmed in the western part of the country. Here, we report for the first time its presence in southeastern Senegal. We obtained camera trap footage of a Campbell’s monkey individual in the Dindefelo Community Nature Reserve located in Kedougou region, 174 km away from its known distribution range. In the footage, a single Campbell’s monkey appears alongside a group of at least nine green monkeys Chlorocebus sabaeus. We discuss different hypotheses that could explain the presence of the Campbell’s monkey in Dindefelo, and conclude that this individual may be a single migrant.
Current state of coastal change monitoring and mapping in Canada: towards a national framework
Authors: Carter J. , Hastings N. L.
Published: September 2024

Les populations et les établissements côtiers du Canada exigeront des planificateurs de l'utilisation des sols et des autres décideurs qu'ils comprennent les risques et l'instabilité potentielle des environnements côtiers au Canada. Les variations naturelles des environnements côtiers seront exacerbées par les impacts continus du changement climatique - élévation du niveau de la mer et augmentation des tempêtes. En réponse à cette situation, des chercheurs de Ressources naturelles Canada ont procédé à un examen approfondi des pratiques existantes dans tout le pays pour détecter et surveiller les changements côtiers afin d'élaborer un cadre pancanadien. Par le passé, la Commission géologique du Canada a mené des recherches sur les changements côtiers et la sensibilité au niveau de la mer, en partenariat avec des agences provinciales lorsque cela était possible. Cependant, les programmes de surveillance sont actuellement ponctuels, bien que des efforts soient en cours pour rassembler les informations historiques dans une seule base de données SIG qui sera accessible au public. Compte tenu de l'évolution du climat et de l'augmentation des risques pour la société, il est nécessaire de redynamiser un cadre national pour l'étude des changements côtiers. Cette étude donne un aperçu de la méthodologie la plus récente et de la compréhension du changement côtier au Canada et documente les ensembles de données provinciales et territoriales qui utilisent une variété de formats, de méthodes et d'approches. C'est dans le Canada atlantique que les données sur le changement côtier au Canada sont les plus complètes. Les côtes de l'Arctique et de la baie d'Hudson souffrent d'un manque de couverture, tandis que la côte du Pacifique manque de données quantitatives sur le changement côtier (mais est décrite en détail dans les données qualitatives). Les deux principales méthodes utilisées dans la recherche sur les changements côtiers sont le suivi des changements à partir de l'imagerie aérienne et les enquêtes sur le terrain utilisant soit des mesures de distance à partir de points fixes, soit des traces GPS différentielles. Cependant, certaines sources décrivent l'utilisation de relevés par drones aériens et de la photogrammétrie comme des techniques émergentes. Divers systèmes de classification des données sur les changements côtiers sont utilisés par différentes institutions ; une comparaison de ces systèmes a permis de produire trois prototypes pour un éventuel système national unifié de classification des changements côtiers. Cette étude met en lumière l'état actuel de la recherche sur les changements côtiers au Canada, en indiquant les méthodes utilisées et les domaines nécessitant des améliorations. Les données quantitatives concernant la côte pacifique permettront d'égaler les recherches effectuées dans le secteur atlantique, tandis que la côte de la baie d'Hudson et l'intérieur de l'archipel arctique canadien semblent être collectivement sous-étudiés.
Clinical learning of nursing students during the COVID-19 pandemic in Limpopo province, South Africa
Authors: Nchabeleng Linda , Bopape Mamare A. , Manamela Ledile E. , Ntho Tshepo A.
Published: September 2024

Background: The Nursing Education Programme was affected during the coronavirus disease 2019 (COVID-19) pandemic, resulting in nursing students being unable to participate in the clinical experiential learning required by the South African Nursing Council.Objectives: The study seeks to explore and describe nursing students’ experiences of clinical experiential learning during the COVID-19 pandemic.Method: A qualitative, explorative and descriptive, research design was used in the study. A non-probability purposive sampling method was used, and 55 nursing students participated in the study. Data were collected through six focus group discussions, consisting of 8–12 nursing students in each group. Data were analysed following Tesch’s open coding method.Results: Three themes emerged from the study’s findings: The impact of COVID-19 on the clinical experiential learning of nursing students, the effects of COVID-19 on the mental well-being of nursing students, and nursing students’ experiences of support during the COVID-19 pandemic. Notably, 11 sub-themes emerged.Conclusion: The findings of this study reveal that the COVID-19 pandemic severely disrupted the Nursing Education Programme, highlighting the challenges of inadequate clinical hours, restricted clinical access and the significant psychological impact on students.Contribution: This study adds to the literature on students’ experiences during clinical experiential learning in South Africa during the COVID-19 pandemic.
Pioneering family medicine: A collaborative global health education partnership in Ethiopia
Authors: Woldeyes Meseret Z. , Makhani Leila , Ephrem Nitsuh , Rodas Jamie , Andoniou Ellena , Rouleau Katherine , Ghavam-Rassoul Abbas , Janakiram Praseedha
Published: September 2024

In 2013, Ethiopia launched its first Family Medicine (FM) residency programme at Addis Ababa University (AAU). The University of Toronto’s Department of Family and Community Medicine (DFCM) was invited to support Addis Ababa University’s Department of Family Medicine’s (AAU-FM) educational programme activities forming the Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM). This paper describes the TAAAC-FM partnership, a capacity-strengthening initiative that focuses on four key levers of academic engagement and transformation: education offerings for AAU-FM trainees, partnership preparation of DFCM faculty, fostering AAU-FM faculty development and leadership, and lastly scholarship, knowledge sharing and mentorship. Toronto Addis Ababa Academic Collaboration in Family Medicine operates on principles of respect, flexibility and cultural sensitivity. Monthly virtual meetings and annual in-person faculty visits fostered curriculum support, teaching and leadership training, ensuring that the programme remained responsive to evolving needs. The partnership has contributed to a Community of Practice (CoP) to advance FM in Ethiopia, promoting shared learning. Addis Ababa University’s Department of Family Medicine faculty leads in various roles, engages with global FM communities, and contributes to policy development, demonstrating significant progress in FM education and leadership. Looking ahead, TAAAC-FM aims to adapt its efforts based on the capacity built with AAU-FM, continue faculty development, and strengthen linkages within the global healthcare community. The partnership’s success underscores the importance of collaborative, culturally informed high-low resource setting approaches to FM training and healthcare system strengthening, offering valuable insights for similar initiatives.
Evaluation Recovery of Ulcerative Colitis with a Lactobacillus Cocktail Derived from Traditional Dairy Products: In vivo Study
Authors: Rezai Shaghayegh , Ghorbani Elnaz , Khazaei Majid , Nazari Seyedeh Elnaz , Rahmani Farzad , Naimi Hamideh , Afshari Asma , Avan Amir , Ryzhikov Mikhail , Soleimanpour Saman , Mehr Seyed Mahdi Hasanian
Published: September 2024

Background:

This investigation investigates the anti-inflammatory and fibrinolytic effects of a cocktail of probiotics derived from traditional dairy products in a murine model of ulcerative colitis (UC).

Materials and Methods:

A mix of newly isolated probiotics containing L. plantarum, L. brevis, L. delbrueckii, and L. helveticus was characterized and orally administered to inbred eight-week-old C57BL/6 male mice (n = 6). Clinical symptoms, pathohistological changes, and inflammatory and fibrosis markers were analyzed in the existence and absence of probiotics in colitis mice.

Results:

Dairy lactobacillus probiotics potently attenuated colitis symptoms by decreasing dextran sulfate sodium (DSS)-induced body weight loss, colon shortening, rectal bleeding, and rectal prolapse. Consistently, a cocktail of probiotics could significantly improve histopathological grading by suppressing crypt loss, mucosal damage, and inflammation scores in colitis tissues. Moreover, the mix of probiotics suppressed pro-inflammatory genes including interleukin (IL)-1β, IL-6, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ), and increased anti-oxidant markers and activity such as superoxide dismutase and catalase in colon tissue. Furthermore, compared to the no-treated group, the administration of probiotics reduced fibrosis by decreasing collagen deposition in tissue sections and down-regulating levels of pro-fibrotic genes including alpha-actin-2 (Acta2), collagen (Col) 1a1, and Col 1a2 in colitis tissue homogenates.

Conclusions:

The results show the newly isolated cocktail of probiotics elicits a potent protective effect on UC symptoms in mice model. Further study on these probiotics is required to fully explore their effectiveness, strength, and safety considerations.
Primary Anterior Sagittal Anorectoplasty Shift from Staged to Single-stage Procedure for Low Anorectal Malformations in Female Children: Our Initial Experience in Single Centre
Authors: Wani Ab. Hamid , Singh Narinder , Singh Gurbir , Parihar Satish
Published: September 2024

Background:

Anorectal malformation (ARM) is a common congenital anomaly found in the paediatric age group. Previously, the repair of the vestibular fistula (VF) was performed as three-stage procedure with initial colostomy followed by a definite procedure and, lastly, colostomy closure. At present, a single-stage procedure is preferred, especially in lower anomalies owing to the convenient and time-saving approach.

Objective:

The clinical profile and outcome of ASARP for treatment of ARM in females (vestibular anus and perineal fistula).

Methods:

A retrospective analytical study was conducted at Government Medical College, Jammu. A total of 60 patients were included in the study.

Results:

Most of the patients were in the age group of 1–5 years (30%), followed by 6 months–1 year age group (25%). Forty-five (75%) females had VF while 15 (25%) had perineal fistula. Intraoperative complication was vaginal tear seen in 6 (10%) patients followed by rectal tear seen in 3 (5%) patients. Early post-operative complications were seen in 9 (15%) patients. Wound infection was the most common complication seen in 5 (8.3%) patients, wound dehiscence in 3 (5%) patients and retraction of rectum in 1 (1.6%) patient. Late post-operative complications were seen in 24 (40%) patients. Perineal excoriation was the most common complication seen in 6 (10%) patients, constipation seen in 5 (8.3%) patients, anal stenosis in 4 (6.6%) patients and mucosal prolapse in 4 (6.6%) patients.

Conclusion:

The single-staged ASARP procedure resulted in satisfactory outcomes. It is an excellent procedure for females with VF and perineal fistula. Appropriate selection, preparation of patient, optimal correction with minimal sphincter damage and needful post-operative care of wound give excellent cosmetic and functional outcomes in terms of continence. It also decreases the burden on treating the surgeon, family and psychological stress on the patients and parents.
Firearm Injuries in Children: Four-year Experience from a Rural Tertiary Care Centre of Northern India
Authors: Chaudhary Amit , Rahman Rafey Abdul , Alim Muniba , Gupta Umesh Kumar , Gupta Survesh Kumar
Published: September 2024

Background:

Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing.

Aim:

The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India.

Materials and Methods:

This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed.

Results:

Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%).

Conclusion:

The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children.
Clinical, Histologic, and Therapeutic Pattern of Posterior Fossa Tumors in Children in Cameroon: A Cross-sectional Study
Authors: Figuim Bello , Nassourou Oumarou Haman , Nchufor Ndouh Roland , Nicaise Ewane Khadije Gael , Orlane Ndome Toto , de Paul Djientcheu Vincent
Published: September 2024

Introduction:

Posterior fossa tumors are significant in pediatric neurooncological populations due to their frequency and morbimortality. We convey a 10-year experience managing pediatric posterior fossa tumors at two reference centers in Cameroon.

Materials and Methods:

We conducted a cross-sectional study with data collected retrospectively in the Neurosurgery Department of the Central and General Hospitals of Yaounde from January 2010 to December 2019. Included in the study were all patients aged 0–15 years who underwent surgery for posterior fossa tumors.

Results:

We retained 43 pediatric posterior fossa tumor files, representing 47.89% of pediatric brain tumors. The male/female sex ratio was 0.86, with a mean age of 6.93 ± 4.345 years. The predominant clinical presentations were headaches + vomiting (97.7%), visual impairment (67.4%), and altered consciousness (14%). The vermis was the most frequent site affected (46.5%). Hydrocephalus was found to be associated with the tumor in 30 patients (69.8%). Tumor excision was total in 90.7% of cases, with cerebrospinal fluid diversion performed within the surgery in 83% of cases. Pilocytic astrocytomas represented 37.2%, medulloblastomas 30.25%, ependymomas 6.9%, and brainstem gliomas 4.6%. The postoperatory mortality rate was 20.9%. The survival rate at 5 years for medulloblastomas was 43%.

Conclusion:

Pediatric posterior fossa tumors are frequent. Pilocytic astrocytomas are the most common histologic type, followed by medulloblastomas. Radical surgery is the leading standard of care. Adjuvant treatment remains limited.
Patent Urachus with Patent Vitellointestinal Duct: A Rare Simultaneous Occurrence
Authors: Dudhani Shreyas , Bachagala Keerthana , Suman Bijay Kumar , Rashi Rashi , Sinha Amit Kumar
Published: September 2024

A large number of congenital anomalies often involve the umbilicus. This is a report of two such anomalies together in an infant. The child had a mass protruding from the umbilicus since birth. The urachus was noted to be patent on voiding cystourethrogram. On exploration, a patent vitellointestinal duct was also noted. Resection and anastomosis was done for the vitellointestinal duct, and the urachus was excised close to the dome of the bladder. Histopathological examination confirmed a tube lined by intestinal epithelium and the urachal remnant showing a dense fibrous tube-like structure. The omphalo-mesenteric vessels are located between the urachus and the patent vitellointestinal duct, and care should be taken while incising or dissecting in this region to prevent bleeding.
An Unusual Variant of Mid-penile Hypospadias with Intact Prepuce and Patulous Urethra – Addition of a Drop to the Sea of Hypospadias Variants
Authors: Prakash Divya , Singh Sunita , Kapoor Rohit , Dixit Rini
Published: September 2024

Hypospadias is one of the most common and extensively studied pathology of paediatric surgery. Although a plethora of research articles describing hypospadias and its variants exist, new variants are often encountered and they never cease to surprise us. We, in our case, are trying to add a drop to the sea of variants of hypospadias. A 2-year-old boy was brought with an abnormally large and patulous urethral opening at the mid-penile region with intact prepuce and chordee. In this case report, we will review the available literature on this rare variant and discuss its management.
Combined Upper Fornix Transconjunctival and Endoscopic Transnasal Approach for Frontoethmoidal Osteoma with Orbital Extension - A Case Report
Authors: Suwa Takahisa , Kitaguchi Yoshiyuki , Maeda Yohei , Morimoto Takeshi , Nishida Kohji
Published: September 2024

Rationale:

Intraorbital osteomas are incidentally found and occasionally require surgical treatment. Depending on their localisation, a single technique may not provide a sufficient surgical field.

Patient Concerns:

We report a 16-year-old male with a left upper medial palpable mass.

Diagnosis:

Computed tomography revealed a dense bony mass extending from the ethmoid sinus to the superior wall of the frontal sinus, with protrusion into the orbital cavity.

Treatment:

The combination of upper fornix transconjunctival and endoscopic transnasal approaches was chosen for the surgical removal procedure.

Outcomes:

The two-pathway approaches resulted in the clear removal of the mass. Post-operative recovery was rapid, although a slight restriction of the inferomedial duction remained at three months.

Take-away Lessons:

This combination of techniques can provide a wide surgical field for the resection of frontoethmoidal osteomas with orbital extension.
Quality of sleep in doctors posted in rural areas
Authors: Bhardwaj Vibhuti , Gohri Jay , Sharma Dhruv Kodan , Sahana K. S. , Hegde Saurish , Doddaiah Sunil Kumar
Published: September 2024

Introduction:

Among medical students, sleep is subjected to various obstacles such as curriculum and postings. Sleep is also influenced by sociodemographic factors but the intersectionality theory shows that multiple social factors within a person can influence health and behavior. Rural postings are another factor. We aim to explore the above in the study.

Materials and Methods:

It is a cross-sectional study done among 199 medical students across the country. We used a standardized Pittsburgh Sleep Quality Index questionnaire and analyzed the data using SPSS software. The Chi-square test for associations between various demographic factors and sleep indicators.

Results:

About 71.9% of the participants were interns. Only 37.2% of the participants reported good sleep in rural areas. There was a statistical significance between sleep quality and the duration it takes to fall asleep, waking up in the middle of the night, and duration of stay in rural areas.

Conclusion:

Good sleep is a crucial factor in keeping the human body working efficiently and functioning well. The main issues such as hectic academic schedules, lack of infrastructure, and flexibility in their allowances, especially during their residency, training will help to improve their sleep and in turn their quality of work.

The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.
Silicosis presenting as progressive massive fibrosis: A case series
Authors: Deivasigamani Mohanakrishnan , Nagesh Manikandan , Shanthalingam Balamurugan , Chokalingam Chandrasekar
Published: September 2024

Progressive massive fibrosis (PMF) is a severe form and late-stage chronic pneumoconiosis defined by the clustering of silicotic nodules fused with connective tissue in silicosis and coal macules surrounded by fibrous tissue in coal workers’ pneumoconiosis. High levels of exposure to silica and coal mine dust are important risk factors for the development of PMF. A thorough occupational history and radiological investigation would help in the diagnosis and prevention of this condition, as there is no effective treatment. Hence, primary prevention is important as it has high mortality and morbidity. Newer health strategies, including periodical screening, evaluation, treatment, and awareness, are needed among workers who are exposed to these health hazards.
Primary mediastinal small cell neuroendocrine carcinoma in a young man: a rare case report
Authors: Mallik Sonali , Kaur Amanpreet , Kar Sonali , Goyal Amit
Published: September 2024

A mediastinal small cell neuroendocrine carcinoma (MSCNEC) is a rare form of neuroendocrine tumor (NET). Due to its aggressive nature, it often recurs after treatment and has a high tendency to metastasize or spread to other parts of the body, such as the lymph nodes, lungs, liver, bones, or brain. Because of its rarity and aggressive behavior, managing MSCNEC can be challenging. However, the prognosis for this type of cancer is generally poorer compared to some other types of NETs, highlighting the need for early detection and aggressive treatment strategies. Here, we report a case of a 28-year-old nonsmoker man with small cell carcinoma of the lung presenting as a mediastinal mass with superior vena cava syndrome.
A study on the relationship of dyspnoea score, high-resolution computed tomographic scan, and pulmonary function tests in the evaluation of connective tissue disease-related interstitial lung disorders
Authors: Kundu Somenath , Chatterjee Surajit , Haldar Ranjit Kumar , Mukhoti Krishanu
Published: September 2024

Background: Connective tissue diseases (CTDs) are one of the most common causes among the known etiologies of interstitial lung disorders (ILDs). Parenchymal involvement in CTDs confers a significant risk of mortality as well as morbidity with serious consequences. The present study aims to correlate dyspnoea scores with high-resolution computed tomography (HRCT) changes, spirometry, diffusing capacity for carbon monoxide (DLCO), and 6-Minute Walk Test (6MWT) among different types of CTD-ILDs. Methodology: The hospital-based observational, cross-sectional study was performed over 1 year among 60 patients with CTD-ILDs. The dyspnoea score (modified Medical Research Centre grade), HRCT thorax pattern with a percentage of involvement, and functional parameters (forced vital capacity (FVC), DLCO, 6-Minute Walking Distance (6MWD)) were compared among different CTD-ILD groups. Results were computed using Microsoft Excel. Results: Systemic sclerosis (SSc) was the most common cause of CTD-ILDs (43%) with a predominant nonspecific interstitial pneumonia pattern (71% of all SSc-ILDs), followed by rheumatoid arthritis (RA) (30%) with a predominance of usual interstitial pneumonia (55% of all RA-ILDs). Other cases included dermatomyositis (6%), mixed connective tissue disease (6%), and Sjögren disease (3%). Three percent of the patients remained unclassified. The difference in the HRCT pattern was seen between RA- and SSc-ILDs, which was statistically significant (p = 0.00035). The mean FVC was 1.68L and the mean 6MWD was 316 m. 6MWD showed a positive correlation with FVC and DLCO (r = 0.67 and 0.78). The percentage of the HRCT thorax involvement showed a negative correlation with FVC and 6MWD but not in linear regression (p = 0.000281 and 4.27e–08, r = –0.45 and −0.67, confidence interval (CI) 95%). DLCO had a negative linear regression with HRCT thorax involvement (r = –0.93, CI 95%) showing superiority over other functional parameters. Conclusion: The integration of clinical data, the extent of involvement in HRCT thorax, and physiological parameters, especially DLCO, provide a holistic approach to better understand CTD-ILDs.
Skin Rash with Acute Respiratory Distress Syndrome in Chronic Miliary Tuberculosis: The Role of HRCT Thorax and Bronchoscopy as Diagnostic Tools
Authors: Malhotra Priyanka , Unni Mahesh , Vairagade Abhishek , Shital Patil
Published: September 2024

Pulmonary tuberculosis (TB) is a leading cause of mortality and morbidity in India, presenting with diverse clinical and radiological manifestations such as consolidation, cavitation, lymphadenopathy, pleural effusion, miliary TB, and endobronchial TB. While acute miliary TB presenting as Acute respiratory distress syndrome (ARDS) is documented, the association with a skin rash mimicking viral exanthematous fever is not. This case report describes the case of a 41-year-old male patient with acute dyspnea, a maculopapular rash, and lung infiltrates on chest radiograph, initially diagnosed with acute hypoxic respiratory failure and later confirmed as ARDS. High-resolution computed tomography (HRCT) thorax revealed consolidation with nodules and a characteristic butterfly pattern sparing the apices and bases. Bronchoscopy confirmed TB etiology through MTB genome in BAL samples. The patient improved significantly with intravenous antibiotics, steroids, and HFNC, leading to a documented cure after 6 months of anti-tuberculosis treatment. This report highlights the importance of considering TB in cases with nodular consolidation and positive limiting signs and recommends ICU bronchoscopy as a reliable diagnostic tool. The Kigali modification for ARDS definition was instrumental in managing this case. Use of Kigali modification for defining ARDS in resource limited setting guided management in our case.
Efficacy of Shirodhara and Nasya karma in the management of post-stroke dystonia
Authors: Sindhu Bommidi , Madikonda Praveen Kumar , Bura Johar
Published: September 2024

Dystonia is the second most common movement disorder after stroke. Occurrences of involuntary movements have been reported in 1%–4% of patients with ischemic and hemorrhagic strokes affecting the basal ganglia, thalamus, and/or their connections. The time course for the development of movement disorders varies considerably from the day of the onset of stroke to several years later and it also depends on the type of movement disorder. At the moment, for many of these disorders, the knowledge of pharmacological treatment is still inadequate. Deep brain stimulation is the surgical treatment option for dystonia; however, its therapeutic mechanism is poorly understood. A 50-year-old male patient with complaints of uncontrolled involuntary movements of the right upper limb associated with pain and fatigue for more than a month, with a history of cerebrovascular accident three months back, was admitted at Government Ayurvedic Hospital. The case was diagnosed as dystonia and correlated with Akshepaka (~clonic convulsions) explained in Ayurveda. This case of poststroke dystonia is managed with Shirodhara (~therapeutic oil-streaming over the head) and Nasya (~medication through nasal route) for a period of 21 days. The patient was assessed based on the Fahn–Marsden Rating Scale, with a score of “12” before and “0” after the management. The patient got complete relief within a span of 21 days, which is worth reporting. This case study demonstrates that dystonia (~Akshepaka) in acute phase can be managed by Ayurvedic Panchakarma (~five internal bio-cleansing therapies) procedures. This protocol may be utilized in various other movement disorders with an extended period for efficient results.
Efficacy of dexamethasone as adjunctive therapy in the treatment of parapneumonic pleural effusion in children
Authors: Hassan Hala M. , El-Razik Ahmed M.A. , El-Tomey Mohamed A. , Harkan Ahmed I.
Published: September 2024

Background

Parapneumonic effusion (PPE) occurs as a complication in around 13% of instances of community-acquired pneumonia.

Aim

To assess the effect of dexamethasone as an adjunctive therapy in the treatment of PPEs in children.

Patients and methods

This is a double-blinded, parallel-group, placebo-controlled, randomized clinical trial carried out on 60 children aged from 1 to 13 years with pneumonia complicated by PPEs. Patients were randomly divided into two equal groups (with the usual treatment in the form of double antibiotics given to all) and either intravenous dexamethasone at a dose of 0.25 mg/kg every 12 h for 3 days (group A) or intravenous saline every 12 h for 3 days as placebo (group B).

Results

Duration of hospitalization, chest tube insertion, and number of patients referred to the pediatric intensive care unit were significantly lower in group A than in group B (P=0.007, P<0.001 and P=0.025, respectively). Normal PPE was significantly higher in group A than in group B (P=0.025) after 2 weeks, and small PPEs were significantly higher in group A than group B (P=0.008) on the 7th day. Fluid thickness by chest ultrasound on the 7th day was significantly lower in group A than in group B (P=0.016).

Conclusion

Dexamethasone was an effective adjunctive therapy for PPEs in children.