bluuebunny/crossref_metadata_2025 huggingface dataset:
Conditional Ground-Motion Models for Horizontal Peak Ground Displacement for Active Crustal Regions
Authors: Sung Chih-Hsuan , Abrahamson Norman A. , Huang Jyun-Yan
Published: April 2021

Ground-motion models (GMMs) are developed for peak ground displacement (PGD) and for bandlimited PGD based on strong-motion data that has been filtered as part of standard processing and the total PGD that includes the tectonic deformation as well as the vibratory ground motion. For the bandlimited PGD, we develop conditional ground-motion models (CGMMs) using subsets of the Pacific Earthquake Engineering Research Center Next Generation Attenuation-West2 Project (NGA-W2) database and the National Center for Research on Earthquake Engineering Taiwan Senior Seismic Hazard Analysis Committee level 3 project database. The CGMM approach includes the observed pseudospectral acceleration (PSA(T)) as an input parameter in addition to magnitude and distance. The period of the PSA(T) is used as an input parameter; it is magnitude dependent and is based on the period for which there is the highest correlation between the ln(PGD) and ln(PSA(T)). Two CGMMs are developed: a global model based on the NGA-W2 data and a region-specific model for Taiwan. The conditional PGD models are combined with traditional GMMs for PSA(T) values to develop GMMs for both the median and standard deviation of PGD without the dependence on PSA. A second set of PGD GMMs are developed to correct for two factors: the effect of the high-pass filtering from standard record processing and the stronger large magnitude (M>6.5) scaling due to tectonic deformation. For magnitudes greater than 7, the PGD values from the total PGD GMMs are 2–5 times larger than the bandlimited PGD values based on the strong-motion data sets, but the increase is at very long periods. The appropriate PGD model to use, bandlimited PGD or total PGD, depends on the period range of interest for the specific engineering application.
lsforce: A Python-Based Single-Force Seismic Inversion Framework for Massive Landslides
Authors: Toney Liam , Allstadt Kate E.
Published: April 2021

We present an open-source Python package, lsforce, for performing single-force source inversions of long-period (tens to hundreds of seconds) seismic signals. Although the software is designed primarily for landslides, it can be used for any single-force seismic source. The package allows users to produce estimates of the three-component time series of forces exerted on the Earth by a landslide with postprocessing options to estimate the trajectory of its center of mass. Green’s functions for a user-selected 1D Earth model are obtained automatically from the Incorporated Research Institutions for Seismology Synthetics Engine webservice or can be computed for custom 1D Earth models using Computer Programs in Seismology. lsforce implements the two most commonly used source parameterizations: a fully flexible, high-resolution approach and a more stable but lower-resolution method of overlapping triangle sources. Regularization options include a blended zeroth-, first-, and second-order semiautomated Tikhonov regularization scheme, as well as additional optional constraints on start times, end times, and on the sum of forces. Uncertainty due to data selection can be assessed using either a leave-one-out approach or a modified jackknife technique that randomly excludes subsets of the data for multiple re-inversions. Numerous built-in plotting methods allow for easy quality control and assessment of results. In this article, we briefly outline the theory and methodology, describe our implementation, and demonstrate the usage of lsforce using the well-studied 28 June 2016 Lamplugh rock avalanche in Alaska. Despite the rapidly increasing prevalence of landslide single-force inversions in the landslide and seismology literature over the past decade, to our knowledge this is the first open-source code for performing such inversions.
El difícil equilibrio entre la crisis del sector aéreo y los derechos de los pasajeros en la era del COVID-19
Authors: Fassiaux Sébastien
Published: April 2021

Como consumidores, los pasajeros aéreos han sido unos de los más afectados por la pandemia de la COVID-19. Frente a duras restricciones de viaje y una caída repentina de la demanda, las aerolíneas han tenido que cancelar miles de vuelos. A nivel de la Unión Europea, el Reglamento (CE) 261/2004 otorga importantes derechos sustantivos a los pasajeros aéreos que sufren perturbaciones de vuelos, entre ellos las cancelaciones. Sin embargo, durante la pandemia se han violado esos derechos a gran escala. Este artículo estudia la medida en que los derechos de los pasajeros aéreos han resistido, en España, al choque exógeno provocado por la pandemia. En particular, el artículo presenta los remedios contractuales disponibles para los pasajeros aéreos tanto en virtud de la legislación española como de la UE. Además, explica que los derechos sustantivos se han mantenido formalmente a nivel nacional y europeo, a pesar del incumplimiento masivo por parte de las compañías aéreas. Por último, el artículo examina una reforma prevista de las normas procesales que afectan a los pasajeros aéreos en España, a la luz del derecho fundamental a la tutela judicial efectiva garantizado por el art. 47 de la Carta de Derechos Fundamentales de la Unión Europea.
Genealogía de la noción de constitución en Portugal: Las «leyes fundamentales» y la «constitución civil»
Authors: Domingues José , Moreira Vital
Published: April 2021

Celebrando el bicentenario del constitucionalismo en Portugal (1822), este artículo pretende ser una contribución al estudio de la genealogía del término y del concepto de «constitución» en este país, que comenzó a formarse en la época del preconstitucionalismo, mucho antes de la Revolución Liberal de 1820. En realidad, el concepto moderno instituido desde las revoluciones liberales de los siglos xviii-xix tuvo sus antepasados constitucionales, que no siempre son notorios y de fácil comprensión. En general, el más conocido y estudiado de todos ellos sigue siendo el de las llamadas «leyes fundamentales», concepto que aún hoy es vulgarmente usado como sinónimo de constitución. A partir de 1772, en Portugal, surgió un nuevo concepto, el de «constitución civil». Por lo tanto, sin dejar de lado la comparación con lo ocurrido en otras latitudes constitucionales, para entender el proceso de formación del concepto de «constitución» en Portugal, centramos nuestra investigación especialmente en torno a las nociones de «leyes fundamentales» y de «constitución civil», que son el fondo etimológico más cercano del moderno concepto portugués de constitución, formado a partir de 1820-‍1822.
La gestión de las crisis en el marco de la Ley de Seguridad Nacional: La pandemia por covid-19 y la necesidad de una urgente reforma
Authors: Herbón Costas Juan José
Published: April 2021

La aprobación de la Ley 36/2015, de 28 de septiembre, de Seguridad Nacional, ha dotado al Gobierno de una competencia de coordinación sobre las capacidades de las comunidades autónomas y las entidades locales para abordar la gestión de grandes crisis transversales. Este artículo pretende abordar el estudio de tan novedosa competencia, así como analizar sus posibilidades de aplicación a las grandes crisis padecidas recientemente por España, y más concretamente a la producida por la covid-19.
Insultos en el Tribunal Constitucional (sobre un requisito para el ejercicio de las libertades de expresión e información)
Authors: Urías Martínez Joaquín
Published: April 2021

A la hora de ejercer las libertades de expresión e información, la jurisprudencia constitucional española ha introducido un único límite absoluto: la prohibición de insultos. Se configura así como un requisito negativo para la validez constitucional del ejercicio del derecho. El trabajo analiza qué significa ese carácter. Más allá, ahonda en la definición de un concepto operativo de insulto, tomando en cuenta tanto la doctrina española como experiencias comparadas.
La suspensión del Parlamento por Boris Johnson: Una sentencia entre el derecho y la historia
Authors: Díaz Rico Javier Carlos
Published: April 2021

El 27 de agosto de 2019 el primer ministro británico Boris Johnson propuso a la reina la suspensión del Parlamento durante cinco semanas, duración anormalmente prolongada según la práctica de este Estado. Fue decretada el día siguiente. El Reino Unido se adentraba en dos meses de discusiones trascendentales, ya que la fecha de salida de la Unión Europea acordada era el 31 de octubre. Sin embargo, la Corte Suprema declaró el 24 de septiembre la nulidad de la suspensión y de la propuesta de Johnson. El poder de suspensión del Parlamento es una prerrogativa regia reconocida por el common law cuyos límites deben ser fijados por los tribunales. Para ello la Corte Suprema emplea los principios constitucionales de soberanía parlamentaria y control del Gobierno. La ausencia de una codificación de estos principios otorga a la interpretación de la historia del derecho británico un extraordinario papel.
How Perception-Based Decisions can Negatively Shape your Leadership Performance (Decision-Making and Behavior)
Authors: Jemison Vincent
Published: April 2021

In the present day, one of the most subtle means political leaders use to influence their base of supporters is through verbal communication. With this in mind, research shows that over the past two years, some political leaders have increasingly relied on “transferring their perception onto their base of followers, which often negatively stimulates, arouses and shapes an individual’s performance” (decision-making and behavior). In addition, to the detriment of our society, when political leaders transfer their perception onto their base of followers, they often misjudge the sensitive consequences of their prospective outcomes. Here for the first time, research now shows that a displaced thought process is attributed to the underlying stimulation used to arouse the transfer of one’s perception onto others. Therefore, because the “Dangerous behavior” following the transfer of one’s perception has become so prevalent in our society, such performance warrants immediate exploration.
Peran Konsultan Pajak Terhadap Kepatuhan Wajib Pajak
Authors: Nugraheni Agustina Prativi , Sunaningsih Suci Nasehati , Khabibah Nibras Anny
Published: April 2021

Taxpayer compliance has always been an interesting topic in research. Previous research has often analyzed factors that have an impact on taxpayer compliance. This study aims to raise other factor that may have an impact on taxpayer compliance. The research method used a qualitative approach, namely descriptive research. The data used in this study are from journals and documents. Furthermore, the observation was carried out with data collection techniques through surveys. The results show that consultants play a role in influencing taxpayer obedient behavior and helping taxpayers carry out their tax obligations.Keywords:   Tax Consultant; Tax Compliance; TaxpayerAbstrak: Kepatuhan wajib pajak selalu menjadi topic menarik dalam penelitian. Penelitian sebelumnya sering menganalisis factor yang memiliki dampak pada kepatuhan wajib pajak. Tujuan penelitian ini untuk mengangkat faktor lain yang kemungkinan berdampak pada kepatuhan Wajib Pajak. Metode penelitian menggunakan pendekatan kualitatif yaitu penelitian deskriptif. Data yang dipergunakan pada penelitian ini adalah dari jurnal dan dokumen. Selanjutnya dilakukan obseravasi dengan teknik pengumpulan data melalui survey. Hasil penelitian menunjukkan bahwa konsultan berperan dalam mempengaruhi perilaku taat wajib pajak serta membantu wajib pajak melaksanakan kewajiban perpajakan. Kata Kunci:  Konsultan Pajak, Kepatuhan Pajak, Wajib Pajak
Sistem Kontrol Pesawat Tanpa Awak Untuk Menentukan Waypoint Berbasis Ardupilot
Authors: Rachmawati Putri , Asyam Muhammad Haydar
Published: April 2021

An unmanned Aerial Vehicle (UAV) is a type of unmanned aerial vehicle which is controlled by a remote system. This type of aircraft is usually controlled by remote control from outside the plane and can also move automatically based on a program that has been programmed on the computer system. In this study, a control system with autopilot and remote control is used. This study aims to apply the ardupilot system to the super heavy model aircraft with a long-range flight mode control system using the Futaba T8J (8 channel) radio control. The results of this study took a flight time of 15.02 minutes with an altitude of 30 meters, a waypoint radius of 20 meters with a speed of 10 m / s.
A comparative study of glycopyrrolate and dexamethasone in the control of postoperative nausea and vomiting after intrathecal fentanyl and bupivacaine for caesarean section
Authors: Okonkwo Ikemefuna P. , Onyekwulu Fidelis A.
Published: April 2021

Background: Postoperative nausea and vomiting (PONV) is an undesirable outcome that parturient who undergo caesarean section experience. We compare the efficacies of IV glycopyrrolate and IV dexamethasone as prophyaxis against PONV in these paturient.Methods: This was a prospective, randomized, double blind placebo-controlled study of seventy six (76) ASA II patients aged 18-40 years who underwent elective caesarean section under spinal anaesthesia. Patients were randomly allocated to three groups, group G (glycopyrrolate): n=26, group D (dexamethasone): n=25 and group C (control; normal saline): n=25. Data collection was with the aid of a proforma which included the biophysical profile, Belville scoring scale for PONV, Likert scale was used for patient satisfaction and side effects were also documented. The data were analyzed using SPSS version 17 and presented in tables and figures.Results: The demographic characteristics and mallampati scores of patients in all 3 groups were similar. The results showed that the incidence of PONV in group D was 8%, in group G 19.2% and in group C 32% (p= 0.048, OR= 0.185, 95% C.I for OR= 0.035 – 0.983). All patients expressed satisfaction in the care they received as assessed using the Likert scale and only patients who received IV glycopyrrolate experienced side effects in the form of dryness of the mouth. There were no side effects reported in patients who received IV dexamethasone.Conclusions: The study demonstrated that IV dexamethasone 8mg was more effective in controlling PONV after intrathecal fentanyl and bupivacaine for caesarean section when compared to 0.2 mg IV glycopyrrolate.
Active case finding and evaluation of IL-6 production among household contacts of pulmonary tuberculosis patients in a high disease setting
Authors: Chukwuanukwu Rebecca C. , Onyenekwe Charles C. , Anyabolu Arthur E. , Onwunzo Maria C. , C. Okonkwo Robert , O. Okeke Chizoba , O. Manafa Patrick , A. Eze Ukpai , M. Omigie Ngozi
Published: April 2021

Background: Tuberculosis (TB) is a top infectious disease killer worldwide and remains a huge public health concern. However, most TB case findings are limited to self-referral (passive case finding), when individuals develop symptoms of TB. Only 15% of disease burden in Nigeria are reported. In view of this, it is important to assess the latent and active disease burden amongst HHC of TB patients suffering from pulmonary TB. In addition, it has been suggested that IL-6 levels could be used as a prognostic marker in exposed individuals. IL-6 levels were assessed in this cohort.Methods: A total of 205 subjects participated in this study, comprising 62 pulmonary TB index cases and 143 of their household contacts. Also, 54 apparently healthy subjects were recruited to serve as controls. Active case finding was performed amongst the HHC, using sputum and blood samples; they were tested for active TB. Blood samples were also collected for measuring IL-6 levels.Results: Findings reveal 6.3% previously undiagnosed active TB among the HHC of the TB patients and a significantly higher number of latently infected TB cases compared to the control population (p=0.0078). There were significant differences when comparing HIV co-infected index group to their HIV negative counterparts (P=0.032). Significantly different IL-6 levels were found among the study groups and sub-groups (p<0.0001), with significantly higher levels in TB mono-infection compared to in TB/HIV co-infection (p=0.031).Conclusions: These results demonstrate the importance of active TB case finding for TB control and the possible role of IL-6 as a diagnostic marker in TB control.
Uptake of long-acting reversible contraceptives in north central Nigeria: a five-year review
Authors: Jumbo Caroline H. , Muhammad Rafat B. , Adewole Nathaniel D. , Isah Dennis A. , Offiong Richard A. , Abdullahi Habiba I.
Published: April 2021

Background: Long-acting reversible contraceptives (LARC) are methods used in the prevention of pregnancy that are long lasting. They are effective and efficacious methods of contraception and return to fertility after removal is prompt. Objectives was to determine the uptake of long-acting reversible contraception and assess the characteristics of acceptors of these methods in the area.Methods: This was a retrospective study of clients’ who visited the family planning unit of the University of Abuja teaching hospital over a 5-year period, from 01 January 2015 to 31 December 2019. Information on socio-demographic characteristics and specific methods selected were extracted from their records and represented on simple tables, graphs, and charts.Results: A total of one thousand eight hundred and ninety-one (1,891) clients accepted available methods of contraceptives during the five-year study period. One thousand seven hundred and twenty-four (1,724) accepted LARC (91.1%) while only one hundred and sixty-seven (167) accepted non-LARC (8.9%). Majority 946 (54.9%) of the clients that accepted LARC were aged between 30-39 years and clients less than 20 years were 22 (1.3%). Clients with parity 3 and above were 1162 (67.7%), and majority of LARC acceptors wanted more children 1145 (66.4%). Amongst the LARC acceptors, most of the clients opted for subdermal implant either Jadelle or Implanon 940(49.7%). Three hundred and ninety-eight (23.1%) discontinued a form of LARC during the study period while 1127 (65.4%) continued with one form of LARC or another.Conclusions: The uptake of LARC in this region is very high. Teenagers and low parity rarely attended the family planning clinic.
Post colonoscopic acute bacterial prostatitis: a case report
Authors: Rashid Rahim A. , Karthikeyan Ramalakshmi
Published: April 2021

Colonoscopy is a common procedure for diagnosing a wide range of conditions and symptoms affecting the large bowel. Research has shown that the examination itself may induce transient bacterial infections. Specifically acute bacterial prostatitis (ABP) has little mention in medical literature as a recognized complication of this procedure. Here we discuss a 37 year old male presenting with symptoms suggesting lower urinary tract infection after having undergone colonoscopy followed by recurrent episodic haematuria and lower urinary tract symptoms (LUTS). Physicians and endoscopists should be aware of the risk of acute bacterial prostatitis as a potential complication of colonoscopy in order to minimize misdiagnosis as well as the complications associated with the delayed treatment of it. In addition male patients and the immunocompromised should be fully counselled regarding this risk prior to undertaking this procedure.
Management of penile emergencies- one year observation
Authors: Sarker Ashok Kumar , Babu Tarafdar Habibullah , Ahmed Abul Bashar Shahriar
Published: April 2021

Background: Penis is a very sensitive organ and even minor injury or discomfort may cause a patient to seek emergency evaluation. Penile emergencies and their management often rely on the results of imaging examinations. But most of the time the traumatic emergencies require urgent exploration to ensure a fair outcome. Objective was to present different types of penile emergencies and to determine the overall outcome of their managements.Methods: It was an observational study conducted at surgery department of Enam Medical College and Hospital, for one year. All patients with penile emergencies were included by selective sampling technique. The main outcome variables were type of penile emergencies, etiology of trauma, grading of trauma, types of surgical intervention, postoperative erectile function. Data processing and analysis were done using SPSS v (23). Statistical significance was determined by Students t test for quantitative data.Results: Total 33 patients admitted with emergencies. 18 (54.5%) belonged to traumatic category, 10 (30%) belonged to infective and one patient (3%) belonged to vascular (ischemic priapism) and others consist of 4 (12%). 40% of trauma was of grade III variety. Seven were victim of sharp cut injury. One who presented with ischemic priapism after 3 days underwent emergency distal shunt procedure with an acceptable functional penis post operatively. Timing of surgical intervention was compared with erectile function on the basis of International Index of Erectile Function (IIEF). A p value <0.05 was considered to be significant.Conclusions: Penile emergencies require prompt, accurate diagnosis. Early surgical intervention can save the organ.
Comparative study between outcome of noncemented and cemented total hip replacement
Authors: Hossain M. Tofayel , Asaduzzaman M. , Rahman M. Wahidur , Hossain Subir
Published: April 2021

Background: To resolve the damage and pain in the joint in the hip, total hip replacement (THR) is used. There are some methods used to give THR, but cemented and noncemented THR are common to improve the result of the cemented THR as patients face some complications after replacement. In this study we compared the outcome of the noncemented and cemented THR. The aim of this study was to compare the outcome of noncemented and cemented THR and find out the favorable outcome.Methods: This was a randomized, comparative type of observational study and was conducted in the Department of Orthopedics of National Institute of Traumatology and Orthopaedic Rehabilitation, Bangladesh during the period from 2019 to 2020 on 60 patients, of which 2 groups were made with 30 patients in each group. The age range was less than 50 to more than 70. In group-A cemented THR was done and in group-B noncemented THR was done. Percentage was calculated to find out the proportion of the findings. Further statistical analysis of the results was done by computer software devised in the statistical packages for social scientist (SPSS-23) and MS excel.Results: After comparing outcomes, we saw that most of the patients get better result at the 2nd revision conducted in 6th months. There was no significant difference between the results of the two groups.Conclusions: Though noncemented THR had better result in pain and infection occurrence after treatment, the instability is higher comparing cemented THR. Besides, patients cemented THR also had many complications after treatment.
Comparison of various diagnostic and therapeutic modalities of undescended testis
Authors: Swami Ganesh Ashok , Bansod Himanshu
Published: April 2021

Background: Undescended testes (UDT), which are defined as the failure of testes to descend in scrotum. It is the most common developmental defect in male infants. It is recorded in 30% of preterm infants compared with 3% of term infants.Methods: Convenient sampling method for data collection, clinical palpation, ultrasound, magnetic resonance imaging (MRI), endoscopic ultrasound, laparoscopic methods for detection and therapeutic management.Results: Laparoscopy has proven to be the only diagnostic modality where the findings provide a clear dependable direction for the definitive management of impalpable testes, so it allows an accurate diagnosis and definitive treatment in the same sitting.Conclusions: Diagnostic imaging has no role in the routine evaluation of boys with undescended testes. Laparoscopy in impalpable testes is the procedure of choice and allows definitive management, even when conversion to open procedure is necessary.
Acute gangrenous appendicitis and acute gangrenous cholecystitis in a pregnant patient, a difficult diagnosis: a case report
Authors: Lew David , Tian Jane , Louis Martine A. , Shah Darshak
Published: April 2021

Abdominal pain is a common complaint in pregnancy, especially given the physiological and anatomical changes that occur as the pregnancy progresses. The diagnosis and treatment of common surgical pathologies can therefore be difficult and limited by the special considerations for the fetus. While uncommon in the general population, concurrent or subsequent disease processes should be considered in the pregnant patient. We present the case of a 36 year old, 13 weeks pregnant female who presented with both acute appendicitis and acute cholecystitis.
Trans-duodenal migration of pancreatic duct stent into liver
Authors: Bakhshi Girish D. , D. Samprathi , Mishra Akshat , Chanap Mahesh
Published: April 2021

Endoscopic retrograde Cholangio-pancreatography (ERCP) is the one of the modalities for treating symptomatic pancreatic duct obstruction with dilation. A plastic stent placement is the standard technique followed. Complications after a plastic stent placement commonly found in the biliary tract in the form of migration into the duodenum with or without perforation have been widely described. Although complications of pancreatic duct stents are relatively rare, duodenal perforation secondary to pancreatic plastic stent migration into liver has not been described. Duodenal perforation results in perforative peritonitis when the intestinal contents leak into peritoneal cavity. However, stent migration resulting in duodenal perforation is a slow process where the inflammation results in adherence of surrounding organs, thereby preventing leak of intestinal contents into free peritoneal cavity. We present a case of contained duodenal perforation due to migration of pancreatic stent into liver. It is important to note that the chronic inflammatory process around the migrated pancreatic duct stent led to the asymptomatic nature patient in present case.
Lateral aberrant thyroid having papillary carcinoma: a case report
Authors: Parab Saurabh Subhash , Ghatage Mansing N. , Kulkarni Sharang S. , Patil Aniket P. , Phatak Pallavi S. , Hendre Apurva P.
Published: April 2021

Aberrant thyroid is a mass of tissue having the structure of a pathological thyroid gland situated at some definite distance from the normal thyroid gland. In all the variants of carcinoma of thyroid the papillary variant is the most common. Predominantly seen in females ranging in the age group of 25-45 years. It is often well differentiated, slow growing and localised. Here we report a case of a 35-year-old lady with a swelling in the right anterior triangle of the neck with normal thyroid gland. Histopathological report was suggestive of papillary carcinoma of thyroid. The origin of lateral ectopic thyroid tissue is not fully understood and controversial. The lateral localisation is a rare entity and debated extensively in the literature. Though rare, the possibility of an ectopic thyroid carcinoma must always be considered by the surgeon in cases of a pathological mass in the neck. This case report demonstrates that a normal thyroid gland on clinical examination does not exclude the presence of thyroid carcinoma in an ectopic tissue.
Faith, social prestige and violence against surgeon in India and subcontinent: a narrative review
Authors: Yagnik Karan J.
Published: April 2021

Violence against surgeons is universal problem but unique in India. It is reported on a daily basis across India. A lot of literature is available. Analysis and review are required. This article is about the best solutions to violence’s against surgeon. Various books, conference presentation and proceedings, workshop lectures, various electronic databases, symposium lectures, research papers and talks have been selected. Selected full articles were reviewed (total-13 article). This review is conducted for the practical knowledge to prevent violence against surgeon and hence patient-doctor satisfaction. Poor patient surgeon communication and lack of faith in medical system are major reasons for violence. There are more reasons which are discussed in details. Poor image of surgeons, cost of healthcare, poor quality of healthcare and poor communication is major factor for violence against surgeons. Low health literacy and lack of faith in the judicial procedure are also important factor. Media can explain all these things but they are not interested. Surgeon should understand the nature of patient and their relatives and act accordingly. Proper explanation in people’s language can change things in tremendous way.
A prospective observational study on assessment of types of shock in children and requirement of inotropes in treatment of shock in tertiary care hospital
Authors: Kotha Jhansi Rani , Kothapally Hari Krishna , Pinnoju Sai Chand , Kumar Sudheer
Published: April 2021

Background: Shock is a state of impaired tissue perfusion which result in an imbalance between oxygen demand and supply. This reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients. There is sparse date regarding epidemiology of shock in paediatrics. In this study we were aimed to assess the types of shock and treatment of shock with Inotropes.Methods: Children of age 1 month to 12 years with a clinical diagnosis of shock were included.Results: Out of 155 children admitted with shock 72.2% had septic shock, 25.8% had hypovolemic shock, 1.2% had cardiogenic shock, 0.6% had dengue shock. In this study the mortality rate was 8.39% of total patients. The mortality rate of septic shock, hypovolemic shock, cardiogenic shock was 84%, 7.69%, 7.69% respectively. 74.33% of patients were treated with two Inotropes, 5.3% were treated with more than two Inotropes, 11.5% were treated with single Inotropes and 0.88% was treated with no inotrope.Conclusions: In the present study, among all types of shock the prevalence and mortality rate was more with Septic shock. As shock has high mortality rate in children the early recognition and patient education is required.
Relative bradycardia- indicator of severe dengue fever: a comparative study between PICU and ward patients
Authors: Tripathi Priyasha , Gogia Priya , Raghuwanshi Surendra Singh
Published: April 2021

Background: Mortality due to dengue fever during epidemics is very high with all the four serotypes actively found in India. It is very difficult to distinguish and manage illness of viral aetiologies based on initial clinical features. Bradycardia can be seen as notable clinical finding in severe dengue fever. Clinical features that can be used in the initial assessment of febrile patients are essential tools for physicians in limited resource settings. Awareness of bradycardia as an early indicator of severe dengue fever could help in the early recognition and potentially reduce morbidity and mortality.Methods: This is an observational comparative study of 40 dengue fever positive paediatric patients admitted in PICU and general ward. The study was conducted at Atal Bihar Vajpayee Govt Medical College, Vidisha from 20 August to 20 November 2020 (3 months).Results: Bradycardia, as a significant clinical feature was present in almost all PICU patients as compared to ward patients. It can be taken as a clinical marker of severity to prevent life threatening complications of dengue like shock and haemorrhage.Conclusions: With specific WHO guidelines to classify and treat dengue fever, we try to prevent its deadly consequences but in resource limited settings like ours, initial clinical judgement can prevent much causality and prepare us to foresee and timely manage the complications.
Retrospective analysis of disease profile and percentage of COVID positivity among patients presenting to paediatric triage of a tertiary care hospital during COVID pandemic lockdown period
Authors: Pathak Gargi H. , Chauhan Anuya , Beniwal Sunita
Published: April 2021

Background: Currently, limited reports analyze pediatric patients infected with SARS-Covid-19. We conducted this study with the purpose of assessing the disease profile and percentage of COVID positivity among pediatric patients presenting to our triage area.Methods: A retrospective quantitative observational study was conducted in the pediatric triage area, department of pediatrics, Civil hospital campus, Ahmedabad, India. Patients aged 0-12 years were included with the study period from 1stApril to 30th June, 2020. Patients fulfilling the ICMR testing criteria were considered as suspected COVID patients and tested for COVID. Remaining patients were triaged and managed either on OPD basis or admitted in PICU, NICU or pediatric ward. Also, data of OPD attendance rate and immunization rates of 3 months (April, May and June) of 2019 and 2020 were collected from pediatric OPD and vaccination center.Results: A total of 709 patients presented in the triage out of which 35.5% were neonates, 28.6% were between 1-12 month, 23.2%were between 1-5 years and 12.6% were between 5-12 years. 12 out of 97 suspected patients tested positive for COVID 19. Among COVID positive patients, 50% had uncomplicated illness or mild pneumonia, while 50 % had critical illness and were admitted in COVID ICU. Mortality among non COVID patients was 22.7%, and among COVID patients was 16.6%. A sharp fall was noted in the OPD attendance (10 times) and immunization rates (3 times) this year compared to last year.Conclusions: Incidence of COVID positivity was comparable to the studies done in other countries. Even during the pandemic peak, the major chunk of pediatric admissions still belonged to the non COVID conditions. The drastic fall in immunization rates can have implications in the form of re-emergence of vaccine preventable diseases in the coming times.
Level of awareness of the benefits, socio-demographic and cultural factors influencing exclusive breastfeeding among mothers attending MCH clinic in Tudor sub county hospital
Authors: Machila Consolata Mandi , Karonjo Jane , Mogere Dominic , Kariuki Peterson
Published: April 2021

Background: Knowledge of exclusive breastfeeding (EBF) among women is essential when promoting optimal breastfeeding practices. Breastfeeding is recommended for the first six months of life and continuation of breastfeeding and adequate complementary foods for up to two years of age or beyond.Methods: A descriptive cross-sectional study design was used. This study utilized a mixed method approach (qualitative and quantitative).Results: The prevalence of exclusive breastfeeding was low at 33.6%. Data revealed that 60.9% of respondents were knowledgeable on the benefits of EBF, while 38.6% were not knowledgeable, the rest of the respondents did not respond or their answers were not valid.Conclusions: Women's knowledge on benefits EBF and intention to practice it is still low. There was significant difference in the participants place of residence (rural versus urban).
Basic first aid and life support: are the schools prepared? a descriptive study
Authors: Verma Mayuri , Agrawal Sunil , Agrawal Palack
Published: April 2021

Background: First aid is the immediate assistance provided to a sick or injured. Children spend most of their daytime in schools and are at greater risk of accidents and injuries. National disaster management guidelines 2016 recommends that school teachers and students be trained in first aid and basic life support (BLS). This study was undertaken in schools to assess the awareness of high school students and teachers about first aid and BLS, accompanied by demonstration and hands-on training.Methods: This was a descriptive cross sectional study. All students of class 11th and 12th and teachers of three cantonment schools in New Delhi were included. Knowledge was assessed using a questionnaire comprising 20 multiple choice questions. 377 questionnaires were analyzed.Results: Mean knowledge score=10.96, SD=2.87. 67.6% participants had a score <12 (60%), 29 (7.7%) had good knowledge, 214 (56.8%) average (11-15) and 107 (35.5%) poor (≤10).Conclusions: There was low level of awareness about correct first aid and BLS. First aid training should be incorporated as a part of school curriculum. Repeated reinforcement of knowledge and skills is essential.
Comparison between body mass index and mid upper arm circumference for classifying nutritional status of pregnant women: a prospective cohort study
Authors: Chhillar Ekta , Puri Manju , Sinha Rajesh Kumar , Kumar Praveen
Published: April 2021

Background: BMI is used to assess nutritional status of pregnant women however weight gain during pregnancy confounds the nutritional status later in pregnancy. Unlike weight, MUAC does not undergo significant change as the pregnancy advances. We aim to compare the changes in BMI and MUAC in pregnant women over various trimesters to assess whether change in MUAC is less compared to weight.Methods: In this prospective observations study, BMI and MUAC measurements were taken of 300 pregnant women during different trimesters. Chi-square tests were conducted to assess associations between socio-demographic indicators and nutritional status. Correlation coefficients were calculated between BMI and MUAC over three trimesters. ANOVA tests were conducted on BMI and MUAC to assess their respective mean differences over three trimesters.Results: Mean difference of 0.43 cm (3.2%) was noted in MUAC compared to 5.32 kg/m2 (23.14%) in BMI from first to third trimester. No significant differences were observed in mean MUACs between first and second (p=0.326) and second and third trimesters (p=0.143) but, it was significantly different between first and third trimesters (p=0.003). Significant differences were observed in mean BMIs between first and second (p=0.05), second and third (p<0.001) and first and third trimesters (p<0.001). Correlation between BMI and MUAC were positive and significant in all three trimesters.Conclusions: Positive correlations were found between BMI and MUAC. Less change was observed in MUAC than BMI over three trimesters. MUAC seems to be a reliable tool for assessing nutritional status of antenatal women.
Symptoms and perceptions of risk factors among cancer patients attending a tertiary care hospital in Chandigarh, North India
Authors: Kumar Dinesh , Goel Naveen K. , Sharma Munesh K. , Pandey Awadhesh K.
Published: April 2021

Background: With growing incidence of cancer, it is of prime interest to study views of cancer patients regarding their perceptions regarding cancer cure and its risk factors. The objective of the study was to explore opinions of cancer patients regarding the disease and perceived risk factors of various cancers.Methods: Results of present study are based on part of detailed findings of ICMR sponsored project wherein perceptions and beliefs of cancer patients were explored by interview method.Results: Study included 1117 new cancer patients including 501 (44.9%) males and 616 (55.1%) females representing different socio-economic classes. Spectrum of cases showed breast cancer (18.3%), head and neck cancer (10.2%) and cervical cancer (9.1%) as three major types of cancers. About 43% respondents were of the opinion that cancer can be curable and 15.0% thought it was due to displeasure of God. Symptoms of cancer perceived by them included mainly weakness and fatigue, loss of appetite and weight loss, indigestion or difficulty in swallowing as reported by 729 (65.3%), 568 (50.9%), 341 (30.5%) patients, respectively. Varied perceptions of patients regarding risk factors for different types of cancers were also reported.Conclusions: The study reported several misconceptions regarding cancer and risk factors perceived by cancer patients. There is an urgent need of health education to be made an integral part of cancer cure to avoid those misconceptions of patients prevent the disease and for better treatment outcomes. More in-depth studies are required to explore further opinions and to ascertain the findings.
Short versus long video-based lectures as a tool for faculty development during COVID-19 pandemic
Authors: Elsamanoudy Ayman Z. , Aboukamer Rasha A. , Hassanien Mohammed A.
Published: April 2021

With emerge of the COVID-19 pandemic, video-based lectures (VBLs) was widely used as an effective online faculty development tool. VBLs varies from short videos (5-minute) to the long one (1-2 hours). So, the current study aims to evaluate the effectiveness of long VBLs versus short VBLs. A total of 21 short (9) and long (12) VBLs were produced, in 2020, by the authors. The metadata for all of VBLs was downloaded from YouTube [VBLs overview data, audiences’ engagement data, and audience retention (AR) report]. The viewership data included the number of views (4800), watch time by hours (173.6), males to females’ ratio (79/21), the number of the subscribers (157), the video length (2.9±1.2 minutes), number of viewers (241.1±157.8), and the watch time (5.1±3.3 hours). The audience retention is presented as average view duration (1.1±0.4 hours) and average percentage view (42.8±7.9%). Lastly, audience engagement is represented by the number of subscribers (6.4±7.4), likes (9.7±8.0), and dislikes (0.3±0.7). The comparison of the mean audience retention and engagement between short and long VBLs showed that short VBLs had significantly higher number of subscribers and likes as well as the average percentage views in comparison to long VBLs. We could conclude that short VBLs are more effective and efficient as a regard audience retention and engagement. Moreover, the more use of advanced technology for video development makes it more engaging.
Continuing COVID vaccination will break the chain of virus transmission: myth or reality
Authors: Pasi Achhelal R.
Published: April 2021

As countries roll out vaccines that prevent COVID-19, many scientists are reluctant to say with certainty that the vaccines prevent person to person transmission. All the vaccines authorised for emergency use do this,however there are no conclusive evidence that the COVID-19 vaccine prevents the infection. The limited data available suggests that the vaccines will at least partly reduce transmission, and the studies to determine this with more clarity are underway. One should wait for more data and conclusive evidence to make a statement like “ongoing COVID vaccination will break the chain of transmission”. A vaccine that is highly effective at preventing people from acquiring infection would help to reduce transmission, and till then we need to follow the COVID prevention measures. The best way to prevent infection from COVID-19 is to avoid exposure to the virus.aCOVID-19 is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose main mode of transmission between people, is when an infected person is in close contact with another person, apart from fomite and airborne transmission. Infection occurs when virus enters in the body and begin to multiply while disease occurs when the cells in the body are damaged — as a result of the infection — and signs and symptoms of an illness appear. Approximately 40% to 45% of those infected with SARS-CoV-2 remain asymptomatic and asymptomatic persons can transmit SARS-CoV-2 to others. Asymptomatic SARS-CoV-2 infections have been demonstrated to present with viral loads similar to symptomatic infections. Contact tracing and modelling studies suggest presymptomatic and asymptomatic patients are responsible for approximately 50% of all COVID-19 transmission events.
Effectiveness and safety of a combination of sun protection and depigmentation agent in the treatment of epidermal hyperpigmentation
Authors: Chandrashekar B. S. , N. Vinay
Published: April 2021

Background: Medication adherence is recognized as a worldwide public health problem. As a multi-modality approach with sun protection and depigmentation is quintessential in patients with epidermal hyperpigmentation, a combination of day and night cream may be prudent for long-term improvement and compliance. Aim of the current investigation was to assess treatment outcomes and medication compliance in patients with epidermal hyperpigmentation using day and night cream in a combi-kit packaging (Melaglow day and nightTM combi-kit).

Methods: Sixty patients (18-45 years) with epidermal pigmentation were enrolled in this 12-week study. Treatment effectiveness was determined by melanin index/erythema measure (dermacatch), extent, depth and density of pigmentation (fotofinder), and clinical/dermoscopic aspects (grade-1: <25%; grade-2: 25%-50%; grade-3: 50%-75%; grade-4: >75% reduction in the amount of epidermal pigment), safety, satisfaction, and compliance were assessed.

Results: Out of 60 patients, 52 completed the study. The overall percentage of melanin and erythema improvement was 22.51% and 13.85%, respectively. Based on fotofinder images, 36.54% had grade-2, 34.62% had grade-3, 15.38% had grade-1, and 13.46% patients had grade-4 improvement. Based on the photographic images, 40.38% had grade-2, 32.69% had grade-3, 17.31% had a grade-1, and 9.62% had grade-4 improvement in skin color. All patients agreed that combi-kit helped in remembering and adhering to treatment. Most patients were satisfied with the treatment (84.62%), with compliance rate of 97.72%. No adverse events were reported.

Conclusions: Combi-kit containing day and night cream (Melaglow day and nightTM combi-kit) was safe and effective in the treatment of epidermal pigmentation, ensuing treatment compliance, and patient satisfaction.
The enigma of adult onset Henoch Schoenlein purpura and leucocytoclastic Vasculits: a case report
Authors: Belgaumkar Vasudha A. , Chavan Ravindranath B. , Deshmukh Nitika S. , Gowda Ranjitha K.
Published: April 2021

Leukocytoclastic vasculitis (LCV), also known as hypersensitivity vasculitis is a small vessel inflammatory disease which mainly involves the postcapillary venules. It can be idiopathic or secondary to connective tissue diseases, infection, malignancy. A 39 year old male presented with a recurrent episode of multiple palpable purpurae over the legs, trunk, back and upper limbs with diffuse abdominal pain, bloody diarrhoea and arthralgia. Anti-nuclear antibodies (ANA) were positive, but ANA profile was equivocal. Histopathological examination confirmed leukocytoclastic vasculitis. A final diagnosis of Henoch Schoenlein purpura (HSP) was reached based on EULAR Criteria. He was treated with tapering doses of prednisolone, hydroxychloroquine and bed rest with limb elevation. All symptoms and lesions gradually resolved. Various sub-types of cutaneous small vessel vasculitis may mimic each other, warranting a meticulous evaluation. Adult onset HSP though rare must be considered in the differential diagnosis of LCV, which might be the presenting manifestation of an underlying connective tissue disease. Hence long-term follow-up with stringent clinical and laboratory monitoring is recommended.