bluuebunny/crossref_metadata_2025 huggingface dataset:
A study to determine the severity based outcome of pediatric patients with dengue spectrum disorders in a tertiary care hospital
Authors: M. Vijaysuryakiran K. , Pattar Mounesh , Paida Sanjay
Published: December 2019

Background: Dengue Fever (DF) has become a major global public health problem. The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. Dengue infection ranges from mild illness to a severe form of haemorrhagic fever and shock syndrome which may prove fatal. Objective of the study was to determine severity-based outcome in children with dengue spectrum disorder in a tertiary care centre in Mumbai.Methods: It was a prospective, non-interventional, observational, surveillance study conducted over 14 months (from September 2016 till October 2017). Children aged <18 years admitted to Nanavati Super Specialty Hospital, Mumbai diagnosed with dengue spectrum disorders according to WHO 2009 classification with clinical features and laboratory investigation confirming dengue were enrolled as study participants.Results: Out of 127 patients, 57(44.9%) were females and 70(55.1%) were males. 81(63.8%) were ward patients, 46(36.2%) required PICU admission. 17(13.4%) patients had dengue with warning signs, 100(78.7%) had dengue without warning signs and 10(7.9%) had severe dengue according to WHO 2009 case classification of dengue. 122(96.1%) were discharged home, 4(3.1%) died of dengue and dengue related complications all four deaths occurred in children with severe dengue.Conclusions: This study showed that commonest inpatient admission category among children with dengue according to WHO 2009 classification was dengue without warning signs Overall mortality in patients with dengue fever without warning sign as well those with warning sign remains very low. Children presenting with severe dengue associated with either organ failure or refractory shock are at increased risk of mortality.
Clinical study of cutaneous infections in children
Authors: Chandrasekaran Manikandan Natarajan , Mariappan Vairaprabha Devi
Published: December 2019

Background: Dermatological ailments contribute to one third of outpatient visits in paediatric clinics. Among these, cutaneous infections are found to be the commonest as per various studies. This study was conducted to find out the commonest cutaneous infections in children. Aim was to find out the prevalence of various cutaneous infections in children.Methods: In this study 200 children aged between 1- and 12-years attending outpatient clinic with signs and symptoms suggestive of cutaneous infection were included in the study. History, physical examination and appropriate tests were done to arrive at the diagnosis.Results: Here, 133 children were male and 67 were female. Viral infections were found to be the commonest cutaneous infections and were found in 85 children followed by bacterial infections in 52, fungal infections in 42 and infestations in 21. The presence of high humidity and hot climate in our coastal city along with the prevalent clothing pattern, overcrowding and socio economic factors play a significant role in the type of cutaneous paediatric infection found in that geographical area.Conclusions: Proper hygiene, education and clothing along with avoidance of overcrowding and early medical attention will help to prevent peadiatric cutaneous infections.
Knowledge, attitude and practices regarding breastfeeding and infant milk substitutes among mothers of upper middle-class society in a baby friendly hospital initiative accredited hospital of New Delhi, India
Authors: Gangwal Maansi , Nair Bindu T. , Singh Varun Kumar
Published: December 2019

Background: Exclusive breastfeeding is considered a major public health intervention to promote both child and maternal health. Introduction and awareness of infant milk substitutes among mothers appear as a threat to this important practice.Methods: The study is an observational cross-sectional study using a questionnaire containing socio-demographic variables. The study was conducted among 300 mothers who reported to immunization clinic and paediatrics OPD of a BFHI accredited hospital in Delhi. Data collected in the study has been analysed using SPSS version 21.0 and MS-Excel. Student ‘t’ test for quantitative variables and ‘chi square test’ for categorical variable have been used for statistical significance. p-value <0.05 was considered to be significant.Results: In this study 78.7% mothers intended to breastfeed. 71.3% knew that breastfeeding should be continued up to 2 years and 96.3% knew exclusive breastfeed should be given till 6months. Major source of knowledge were doctors and elders of society. However, 49.6% mothers started breastmilk substitutes before 6 months of age. Major causes that appeared as barriers against exclusive breastfeeding were insufficient quantity of milk (23.4%), child refusal (61%) and maternal health problems (15.6%).Conclusions: Despite good knowledge about breastfeeding among upper middle-class mothers, practice of exclusive breastfeeding remains suboptimal. There is a need for more reinforcement upon importance of breastfeeding, its benefits for both mother and baby so as to foster the practice.
Mortality profile in pediatric malignancies: a 11 year retrospective study
Authors: Joshi Vaishali M. , D’Sa Lorraine A. C. F.
Published: December 2019

Background: Malignancy is one of the leading causes of childhood deaths in developed nations while diarrheal and respiratory infections continue to compete in many developing nations. Since the state of Goa, has health statistics comparable to the western world, an attempt has been made to look at the childhood cancer mortality in proportion to overall deaths in the only tertiary care hospital in the stateMethods: In the absence of a population registry, information was obtained from the hospital mortality statistics during the period from January 2007 to December 2017.Results: A total of 118 cancer deaths were seen over a period of 11 years with a male/female ratio of 1.34:1. The proportion of cancer deaths to total deaths due to any cause, per year was 11.9%. Most of the deaths were noted in the 1-10 years age group (53.4%) with maximum deaths seen  in hematological malignancies (50.8%).Though sepsis was the immediate cause of death in 42(35.6%), a significant drop was noted in last 5 years wherein it was observed to fall from 22.8% in the initial 6 years to 12.7% in the latter 5 year period.Conclusions: Proportion of cancer related deaths were seen to reduce over the study period with a significant drop, in sepsis, as the major cause. Simple measures to control sepsis may help to reduce cancer mortality.
Severity of thrombocytopenia and its outcome in preterm and term neonates admitted in neonatal intensive care unit in a rural tertiary care hospital
Authors: Reddy P. Krishnakanth , Kondle Vamshi Krishna
Published: December 2019

Background: Detection of thrombocytopenia is a useful initial assessment for sick neonates, and it is considered as one of the complications of the disease process.Methods: The present study was a prospective hospital based observational study done in 60 neonates in the department of Paediatrics, KIMS, Narketpally during the period of October 2016 to September 2018.Results: The proportion of babies with thrombocytopenia admitted to the NICU was 10.9%. out of the sixty newborns with thrombocytopenia, 31(51.7%) were term babies and 29(48.3%) babies were preterm. Out of 29 preterm babies 3 (5%) were extremely preterm, 5 (8.3%) were very preterm and 21(35%) babies were moderate to late preterm. 32 babies (53.3%) had mild thrombocytopenia, 14 babies (23.3%) babies had moderate thrombo cytopenia and 14 babies (23.3%) had severe thrombocytopenia. The most common etiologic association with thrombocytopenia was septicemia (60%) followed by birth asphyxia (23.3%), maternal Pregnancy induced Hypertension (18.3%), both Disseminated intravascular coagulation and Meconium aspiration syndrome were 6.6% and Necrotizing enterocolitis was 3%. Among the 60 babies admitted with thrombocytopenia, the most frequently seen symptom was not feeding well (35%) and lethargy (33.3%) in all three groups that is babies with mild, moderate, and severe thrombocytopenia. Mortality rate among severely thrombocytopenic neonates was significantly higher (57.14%).Conclusions: Low platelet count was an independent risk factor for poor outcome in our study. Hence it could be used as a prognostic indicator in thrombo- cytopenic neonates.
Neonatal outcome of a giant placental chorioangioma in a late preterm newborn
Authors: Nigri Daniel , Dabaja Hicham , Smolarski Alyosha , Cohen Lourdes
Published: December 2019

Chorioangioma, the most common benign placental tumor, is found in 1% of placental pathology. Tumors greater than 4 cm are classified as giant and associated with multiple maternal and fetal complications. Authors are presenting a case report of a rare 16 cm giant chorioangioma, discovered at time of delivery, complicated with pregnancy induced hypertension and presenting with minimal fetal complication. This patient exhibited eventually a satisfactory perinatal outcome, complicated by severe anemia and thrombocytopenia requiring transfusion of blood products and bilateral, self-resolved spontaneous cephalohematomas. Chorioangiomas should be considered in the differential diagnosis of any newborn that presents with anemia.
Parapagus dicephalus conjoined twin: a case report
Authors: Mahajan Shalaka , Chauhan Urmila , Gholap Siddhant , Yelam Bapu
Published: December 2019

A conjoined twin is a rare event. As per recent literature, 60% of conjoined twins are aborted spontaneously and hence true incidence of conjoined twin is approximately 1 in 200,000 live births. Classification is based upon site of attachment out of which parapagus with dicephalic variety is extremely rare (0.5% amongst reported cases). Author report a case of dicephalic twin born at 36 weeks of gestation to a multigravida mother in central India.
Case report of a male child with lupus nephritis
Authors: . Richa , Sharma Shashi , Abrol Pankaj
Published: December 2019

Systemic lupus erythematosus is a chronic autoimmune inflammatory disease of unknown etiology that affects various organs, most frequently the skin, joints, kidneys, nervous, hematologic and cardiovascular systems. It affects females more often as compared to males. The kidneys are one of the most serious organs involved. Lupus nephritis may present as hypertension, proteinuria, and renal failure or it may also be asymptomatic. The recent reports suggest that childhood-onset lupus nephritis could be more severe than the late-onset disease. The occurrence of SLE in pediatric patients is very rare, especially in a male child. Here author report a case of an 8-year-old male child clinically misdiagnosed as a case of henoch schonlein purpura, who was thoroughly investigated and finally confirmed as a case of lupus nephritis.
A study of etiological profile of acute confusional state
Authors: Kaur Jaspreet , Mohan Gurinder , Nayyar S. B. , Kaur Ranjeet
Published: December 2019

Background: ACS (Acute confusional states) are on the rise taking the shape of an epidemic. These states are common among the elderly, but young individuals are also not spared. Prompt diagnosis and management of these states can decrease the associated morbidity and mortality.Methods: In this prospective observational study, etiological profile of ACS was evaluated in a total 100 patients, selected over a period of one year, after they fulfilled the CAM (Confusion Assessment Method) criteria.Results: Among 100 patients of ACS, mean age was 54.77±18.50 years, males were 66% and 34% were females. The most common diagnosis provisionally made on the basis of history and clinical examination was metabolic encephalopathy in 37% patients, meningoencephalitis (24%), CVA (Cerebrovascular accident) (18%), seizures (9%), sepsis (6%), poisoning (6%). Whereas the final diagnosis made after subjecting the patients to relevant investigations, was metabolic encephalopathy in 37% of patients, meningoencephalitis (20%), CVA (18%), sepsis (12%), unprovoked seizures (6%), poisoning (6%) and undetermined in 1%. The final diagnosis matched the provisional diagnosis in most of the patients except sepsis as a provisional diagnosis was underdiagnosed. The mean duration of hospital stay was 7.6±3.67days and the hospital stay was most commonly complicated by aspiration pneumonia and acute kidney injury.Conclusions: This study emphasizes that the ACS is an emergency medical situation, where prompt identification, workup and treatment should be done parallelly and urgently to prevent the morbidity and mortality.
Awareness regarding self care among diabetics in urban slum of Kolkata: a community-based, cross-sectional study
Authors: Ray Samir Kumar , Pattnayak Ujjwal , Madhwani Kishore P. , Singh Jitendra Kumar
Published: December 2019

Background: Diabetes mellitus is a disease associated with significant morbidity and mortality. Patients with diabetes have higher rates of coronary artery disease, peripheral vascular disease, retinopathy, neuropathy and nephropathy. Many of these complications can be prevented with appropriate medical care that often requires significant alterations in lifestyle and strict adherence to self-care tasks to obtain good control of disease. Awareness regarding the complications of this disease will play a vital role in its prevention and control. While lack of adherence to the treatment and self-care leads to poor glycemic control, thereby, increasing hazardous complications. Objective of the study was the present study was conducted to assess the knowledge of diabetic patients regarding the disease and its complications, and to estimate the knowledge and adherence to self-care practices concerned with Type 2 diabetes mellitus.Methods: The study was conducted in Tangra an urban slum of Kolkata from July 2018 to December 2018. A house to house survey was conducted to identify the known diabetics in the community and data of 362 patients were collected.Results: A total of 362 diabetic patients consented and participated in the study of whom 191(52.76%) were male and 171(42.74%) female. Majority of the respondents (26.52%) between the age of 50-59 years, 140(38.67%) belonged to upper middle class. Though 332(91.71%) respondents were aware regarding diet control but only 170(46.96%) were actually practicing the recommended diet schedules. Knowledge of the respondents regarding eye, foot, skin and dental care was very low, only 67(18.51%), 102(28.28%), 62(17.13%) and 46(12.71%) respondents were aware respectively and practices were still lower.Conclusions: Overall the level of self-care activities among diabetic patients in our study was quite low.  Government policies should help in creating guidelines on comprehensive diabetes management within the primary health care setting including availability of medicines and diagnostic services and creating public awareness.
Perception of type 2 diabetes mellitus clients on applications in Bima Regional General Hospital
Authors: . Syaiful , Haris A. , . Julhana
Published: December 2019

Background: Repeat hospitalization is a process for a patient who needs to return to hospital as a result of inability to control and take care of their disease. The objective of study is to gather deeper understanding about the meaning experience of repeat hospitalization process among diabetes mellitus type 2 patients. The study is qualitative research within phenomenology method by using deep interview instruments. In this study, the research seeks the experience of diabetes mellitus type 2 patients who are being treated with repeat hospitalization process.

Methods: The study applies descriptive phenomenology approach. By using the method, the subject could be explored, analyzed, and explained directly about their experience of repeat hospitalization. The size of sample, in descriptive study, is essential in order to reveal the saturation data. The participants collecting procedure is using the snowball sampling technique.  

Results: The age of participants are ranging from 40-79 years old. The level of education among participants are varies, from elementary schools to senior high schools. The occupation type are housewife, farmers or merchants. The participants’ income is ranging between 750.000-2.000.000 rupiah/month.

Conclusions: The result reveals four findings among 10 participants: 1) the characteristics of participants 2) the lack of knowledge from diabetes mellitus (DM) management, 3) quality of service, 4) hope of recovery.
Assessment of analgesic and neuropharmacological activity of leaves of Bixa orellana (Family: Bixaceae)
Authors: Aktary Nahida , Sultana Sharmin , Hossain M. Lokman
Published: December 2019

Background: Bixa orellana Linn, (Family: Bixaceae) commonly known as “Lipstick tree” have been extensively used traditional medicine in India and others part of the world to cure laxative, cardiotonic, hypotensive, expectorant, antibiotic, antipyretic, aphrodisaic etc. It has been found that B. orellana contains different phytochemical groups such as phenolic compounds, glycosides, tannins, steroids, alkaloids, saponins. The project work has been designed to investigate the phytochemical nature (group determination of plant constituents), analgesic and neuropharmacological activity of B. orellana leaves extract.

Methods: Analgesic activity of B. orellana was determined by acetic acid induced writhing, hot plate, tail immersion and paw tickling test/formalin induced nociceptor test. Open field, hole cross, tail suspension and light/dark box test were employed for the assessment of neuropharmacological activity of B. orellana.  

Results: Phytochemical screening revealed the presence of reducing sugar, alkaloids, glycosides, gum, terpenoids, tannins, steroids and flavonoids. In analgesic activity test, the sample showed significant analgesic activity. The dose-dependent neuropharmacological activity is shown in neuropharmacological activity test.

Conclusions: Our exploration suggests that B. orellana contains bioactive compounds and it should be studied further for isolation and purification of such novel compounds.
Utility of serum gamma glutamyl transferase activity among hypertensive patients
Authors: Kunwar Saroj , Maharjan Luniva , Chaulaigai Bimal , Sah Sanjay Kumar
Published: December 2019

Background: Hypertension, a chronic medical condition of elevated blood pressure in the arteries. It is an emerging problem worldwide and one of the identifiable cause of kidney disease. Gamma glutamyl transferase (GGT) plays essential role in the metabolism of glutathione which is reported as major antioxidant. More recently increased GGT is associated with pathogenesis of hypertension. This study was aimed to determine activity of gamma glutamyl transferase in hypertensive patients.

Methods: All together 150 participants were recruited from Department of Medicine, Star Hospital for this hospital based cross-sectional study. Among which 50 were normotensive, 50 were pre-hypertensive and 50 were hypertensive. Blood sample were collected and analyzed in autoanalyser by enzymatic method.  

Results: Mean serum gamma glutamyl transferase activity is significantly different among normotensive, prehypertensive and hypertensive groups (i.e., 10.3 IU/l, 26.8IU/l and 37.2 IU/l respectively). Serum gamma glutamyl transferase activity is significantly higher in prehypertensive patients than normotensive group (p=0.001). Similarly GGT activity is significantly increased in hypertensive patients than prehypertensive patients (p=0.001).

Conclusions: Serum gamma glutamyl transferase activity is raised in prehypertensive and hypertensive participants as compared to normotensive. Thus Serum gamma glutamyl transferase level can have potential role on management of hypertension.
Inadequate vitamin D level: association with low energy fractures of distal radius in young patients and its predictors in Karachi, Pakistan
Authors: Muzzammil Muhammad , Kumar Ranjeet , Minhas Muhammad Saeed , Kumar Vinod , Jahanzed Syed , Qadir Abdul
Published: December 2019

Background: The objective of the study was to determine association of inadequacy of vitamin D level with low energy fractures of distal radius and its predictors in young patients in Karachi Pakistan.

Methods: Cross-sectional study was conducted on 220 young patients, visited hospital with low energy fracture of distal radius. A questionnaire was designed and filled after taking consent includes details regarding age, gender, occupation, area of skin and sun exposure duration, dietary habits, type of clothing and residence used. Serum Vitamin D3 levels were determined and compared with serum calcium levels, serum phosphorus and alkaline phosphatase levels.  

Results: Among 220 patients ranging from 12-45 years, mean 28±23.33 SD. Female were 172 (78.18%). Mostly have history of fall 127 (57.72%) and RTA 63 (28.63). Sun exposure duration in majority of participant was 1-2 hour/day 132 (60%). Variable coloured clothes used by majority participant 135 (61.36%) and variable fabric 102 (46.36%). 202 (91.8%) patients had deficiency of vitamin D and correlated with duration of sunlight exposure significantly, also with exposure of large skin area, dietary consumption of vitamin D rich food and worn variable clothing colours. Serum phosphorus level and serum alkaline phosphatase level were negatively correlated with vitamin D significantly whereas positively correlated with serum calcium.

Conclusions: Prevalence of vitamin D deficiency is very high in low energy fracture of distal radius in young population and sun exposure duration found to be most common predictor of inadequate D levels. A national food fortification program and campaign of public awareness to increase sunlight exposure and increase intake of vitamin D rich food are urgently needed.
Comparative study of the efficacy of oral caroverine versus oral Gingko biloba in the treatment of cochlear synaptic tinnitus
Authors: Jain Sachin , Chatterjee Kinshuk , Aftab M. , Kumar Dinesh , Singh Ramsiya , Upadhyay Ved P.
Published: December 2019

Background: Cochlear synaptic tinnitus (CST), also referred to as sensorineural type III tinnitus, is a type of transformation tinnitus, resulting due to aberrant signal transduction between Inner hair cells and afferent nerve fibres owing to excessive and pathologic glutamate release and subsequent spontaneous receptor depolarization (NMDA and AMPA receptors). Of the various pharmacologic agents used for treatment for CST, Gingko biloba and Caroverine have stood the test of time.

Methods: A total 48 selected patients of CST, otherwise free from any medical or surgical co-morbidity, were included in the study and divided randomly in two groups, one group receiving oral formulation of Caroverine and the other group receiving oral Gingko biloba in appropriate doses. Both the groups were followed up for 12 weeks. Treatment outcomes were measured in terms of improvement in subjective symptoms (tinnitus grading) and psycho-acoustic measure (tinnitus matching).

Results: Although oral caroverine yielded promising results in the initial month of treatment in terms of improved tinnitus matching, long term effect was found to be dissatisfying. Oral Gingko biloba, at the completion of 12 weeks of therapy was found to be more effective in terms of improvement of mean tinnitus grading and matching (p<0.05). Side effects of the test drugs were not noted in either group.

Conclusions: Gingko biloba is thus found to be more effective treatment modality for CST for long term basis and is also readily available in the market, cost effective and free of side effects as well.
Correlation between diagnostic endoscopy, computed tomography and operative findings in patients with chronic rhinosinusitis
Authors: Bagewadi Satish , Ankle N. R. , Patil R. N. , Havaldar Rajesh Radhakrishna
Published: December 2019

Background: The varied symptomatology and diagnostic difficulties pose a great challenge to the Otorhinolaryngologists in treating chronic rhinosinusitis. Both diagnostic nasal endoscopy and computed tomography (CT) has been used to analyse the pathological/anatomical changes associated with chronic rhinosinusitis. Various studies have been done to evaluate the efficacy of both these methods to analyse the changes associated with chronic rhinosinusitis. In this study, the authors contemplate to determine which one is better as a preoperative diagnostic tool.

Methods: In this study 30 patients (60 sides) suffering from chronic rhinosinusitis underwent functional endoscopic Sinus Surgery after being thoroughly evaluated by diagnostic endoscopy and CT scan. The various factors affecting the sinus drainage were analysed and compared between each modality.  

Results: The findings of diagnostic endoscopy correlated very well with the operative findings except for conditions where there was severe anatomic or pathologic obstruction which hampered visualisation. Extent of disease in each sinus is very well recognised on CT.

Conclusions: Both diagnostic endoscopy and CT are important preoperative evaluation tools in detecting anatomic variations or pathologic changes within sinuses, although for the surgeon, the operative findings remain the gold standard in the management of the disease.
External auditory canal stenosis due to isolated fibrous dysplasia of temporal bone: a case report
Authors: Silu Manju , Gupta Gaurav
Published: December 2019

Benign disease of bone marrow in which marrow is reorganize into fibrous tissue and immature woven bone, is known as fibrous dysplasia. Involvement of temporal bone is rare and can be isolated or in monostotic or polystotic form with various otologic manifestations. We are here reporting a case of fibrous dysplasia of the unilateral temporal bone who presented with hearing loss and stenosis of the external auditory canal. External auditory canal stenosis due to fibrous dysplasia was managed with canalplasty and patient was free of recurrence till last follow up. Fibrous dysplasia of isolated temporal bone is a rare entity which requires high grade of suspicion in a patient who presents with unusual bony swellings in the ear. Its management usually includes resection of the most affected part of temporal bone in order to achieve auditory canal patency and restoration of hearing. After surgery, a close follow up is warranted due to its propensity of recurrence.
Impact of magnetic resonance imaging on arthroscopic surgeries of knee joint
Authors: Sasnur Prakash , Patwegar Abdul Qadeer , H. M. Adarsha
Published: December 2019

Background: Though magnetic resonance imaging (MRI) is popular as a diagnostic tool, questions arise regarding imaging when clinical diagnosis of most internal derangements of knee can be done. Treatment of meniscal and anterior cruciate ligament (ACL) injuries usually involves arthroscopic surgery after MRI. But accurately performed examination with positive signs alone will be justified for arthroscopy directly without MRI. The aims and objectives of this study are to assess the impact of MRI in selecting or excluding cases which genuinely require an arthroscopic surgery. To know whether routine MRI is required pre-operatively in all cases with positive clinical findings.

Methods: 60 cases underwent clinical examination of affected knee and a preliminary diagnosis was made. Further they were subjected to MRI. Results of arthroscopy were considered as definitive diagnosis and results of clinical examination and MRI were judged accordingly.

Results: Of 60 patients, examination revealed 85% accuracy, 82% sensitivity, 89% specificity for ACL injuries. For medial meniscus 58% accuracy, 66% sensitivity, 48% specificity. For lateral meniscus 55% accuracy, 58% sensitivity, 50% specificity. MRI revealed 73% accuracy, 82% sensitivity, 63% specificity for ACL injuries. For medial meniscus 63% accuracy, 90% sensitivity, 39% specificity. For lateral meniscus 62% accuracy, 79% sensitivity, 50% specificity.
Conclusions: Clinical examination is more sensitive, specific and accurate in diagnosis of ACL. MRI is more sensitive but less specific for meniscal injuries. Clinical examination for cruciate injuries can surpass the MRI findings. Arthroscopy can be performed without MRI in single lesion injuries. However, MRI will play a role in meniscal injuries or doubtful cases.
Analysis of challenging reconstruction of soft tissue defects around the knee joint and evolving a treatment algorithm
Authors: J. J. Lankaram , Begum U. Rasheedha , G. Karthikeyan , V. Ramadevi
Published: December 2019

Background: The soft tissue defects around knee joint give a challenging experience to reconstruct. There are various ways to reconstruct soft tissue defects around knee joint. In this study, a reconstructive algorithm is formed for soft tissue defect around knee joint using pedicled flaps.

Methods: Reconstructive procedures were done for 15 cases of soft tissue defects around knee joints following different etiologies during the tenure of January 2017 to December 2018 in the Department of Burns, Plastic and Reconstructive Surgery, Kilpauk Medical College, Chennai.

Results: Soft tissue defects around knee joint need flap to have a durable cover, to protect the underlying structures – bones, vessels, tendon, and to enable ease of free movement of knee joint without producing contracture. There are various etiologies for soft tissue defects around knee joint-post traumatic injuries, post total knee replacement, post electric burn injuries, post burn scar contracture release of knee joint. 15 cases of soft tissue defects around knee joint were reconstructed using various pedicled flaps-medial thigh rotation flap, gastrocnemius muscle and myocutaneous flap, reverse anterolateral thigh flap, propeller flap. In this retrospective study, reconstructive algorithm for soft tissue defects around knee joint is provided.

Conclusions: The reconstruction of soft tissue defects around knee joint is difficult one. In this study, a simple reconstructive algorithm is provided based on the experience in Department of Burns, Plastic, and Reconstructive Surgery, Kilpauk Medical College, Chennai.
Treatment of subtrochanteric fracture femur by open reduction and internal fixation by long proximal femoral nailing
Authors: Munavalli Prabhu P. , G. Gururaj N.
Published: December 2019

Background: Subtrochanteric fractures are devasting injuries that most commonly affect the elderly population and also in young.

Methods: This is a prospective study of 20 cases of subtrochanteric fracture admitted to KIMS, Huballi between November 2008 to August 2010 treated with left proximal femoral nail (LPFN) by open method. Cases were taken according to inclusion and exclusion criteria, i.e., fresh subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. Objectives of this study were to study subtrochanteric fractures and to determine effectiveness of LPFN in tretment of subtrochanteric fractures by open reduction and internal fixation (ORIF).

Results: In our study of 20 cases, there were 16 male and 4 female patients with age ranging from 17 years to 75 years with most patients in between 21-40 years. 65% of the cases admitted were road traffic accidents, 25% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IA fracture accounted for 40% of cases. Mean duration of hospital stay was 24 days and mean time of full weight bearing was 14 weeks in our patients. Good to excellent results were seen in 85% of cases in our study.

Conclusions: Subtrochanteric fractures of femur can be successfully treated by ORIF by LPFN resulting in proper anatomical reduction and hence alignment and high rate of bone union.
Functional outcome of non-vascularized fibula in gap non union
Authors: Yadav Amit Kumar , Pawar Eknath , G. S. Prasanna Kumar , Mane Akash , Harssor Abhishek , Shet Vipul , Bansal Sagar
Published: December 2019

Background: Gap non-union is one of the most perplexing problems facing the orthopedic surgeon today. Fibula is the preferred site of non-vascularized bone graft due to its easy accessibility to surgical resection and minimal donor site complications.

Methods: The study comprised 11 patients of gap non-union between 13 to 80 years (mean=34.9 years). The fibular graft was harvested from the mid shaft and cortico-cancellous bone graft taken from the iliac crest was applied at both ends of the fibular graft to aid in union.

Results: The average bone gap was 7 cm (4-13 cm). 64% of the patients achieved bone union after the first procedure, of the remaining 4 patients, 1 patient showed union after secondary cortico-cancellous bone grafting, while two are planned for the same. The remaining one patient has only completed 16 weeks follow-up at present and is not showing signs of union at present. Functional range of motion was achieved in both the proximal and distal joints in all cases.

Conclusions: Non-vascularized fibular bone grafting is a simple and effective treatment option which does not require any special skill, has a very low complication rate and has very high patient compliance.
Curettage and bone grafting for simple bone cyst of humeral head in a young woman: arthroscopic approach and step towards minimal invasive surgery
Authors: Soni Nirav G. , Jesalpura Jaimeen P.
Published: December 2019

The simple bone cyst (SBC) also called unicameral bone cyst is a tumor-like lesion of unknown cause, attributed to a local disturbance of the bone growth. Although the pathogenesis is still unknown, the lesion appears to be reactive or developmental . Traumatic etiology of simple bone cysts remains an enigma up to now. We present a case of 44 year old woman who came with c/o pain in right shoulder due to fall from vehicle 5 months back with X-ray and MRI both suggestive of cystic lesion over greater tuberosity humeral head . Patient was treated with arthroscopic curettage and bone grafting. In the last decade, however, there has been an exponential growth in the use of minimally invasive surgical techniques. This is particularly seen in the shoulder, where multiple arthroscopic and procedures have been described in the treatment of intra- and extra-articular pathologies.
Pycnodysostosis with recurrent long bone fractures
Authors: Chetia Naba Pallab , Rajan Aswin Deepak , Medhi Himashis
Published: December 2019

Pycnodysostosis is a rare autosomal recessive sclerosing bone disorder characterized by generalized diffuse osteosclerosis. Patients usually have a large head with separated sutures, open fontanels, aplasia of frontal sinuses, obtuse mandibular gonial angle and acroosteolysis of distal phalanges and multiple long bone fractures. We report this case of a 30-year-old female with repeated multiple long bone fractures and other clinico-radiological pathognomonic features of pycnodysostosis.
Post biologic scenario in pemphigus patients at a tertiary care institution
Authors: A. Ramesh , V. Sampath , A. Shabari
Published: December 2019

Background: Rituximab is increasingly used for the treatment of pemphigus. Data derived from single center studies following a uniform treatment protocol are limited. The effect of demography and disease type on treatment response is poorly characterized. Aim of this study was to assess the efficacy, adverse effects of rituximab, adjuvants and follow up in pemphigus patients.

Methods: Author undertook a retrospective review of records of 26 pemphigus patients (pemphigus vulgaris 25 and pemphigus foliaceus 1) who had received rituximab infusion. Oral prednisolone was administered in doses up to 0.5 mg/kg of body weight after infusion and tapered over the next 3-4 months according to the disease activity. However, other immunosuppressive agents such as cyclophosphamide and AZT were continued for one year after clinical remission was achieved.

Results: Complete remission was observed in 23 (88.5%) patients. The mean time to disease control and complete remission was 1.10 and 4.36 months, respectively. Three patients experienced relapse after a mean duration of 26 months. Infectious complications like candidiasis and furunculosis developed in two patients. Two patients had hypotension during infusion.

Conclusions: Rituximab is an effective agent in the treatment of pemphigus and also for a long duration of remission with a lower initial dose of oral prednisolone. Severe side effects were rare.
Generalized pigmentation with nutritional deficiency
Authors: Naskar Snahasish , Kharkar Vidya
Published: December 2019

Vitamin B12 deficiency is one of the most underdiagnosed causes of hyperpigmentation. It is known to cause Addisonian pigmentation. We describe a case where a patient presented with hyperpigmentation on the aesthetically significant areas of the body for which he presented to the clinic. Diagnosis was confirmed on histopathology and serum vitamin B12 levels. The hyperpigmentation reversed significantly on treatment.
Improving functional density of time-critical applications using hardware-based dynamic reconfiguration and bitstream specialisation
Authors: Le Roux Rikus , Van Schoor George , Van Vuuren Pieter
Published: December 2019

The dynamic reconfiguration of an FPGA has many advantages, but the overhead from the process reduces the functional density of applications. Functional density is an indication of the composite benefits a reconfigured application obtains above its generic counterpart and measures the computational throughput per unit hardware resources. Typically, only quasi-static applications obtain a functional density advantage by dynamically reconfiguring its parameters. Contributing to the functional density reduction of applications with tight time constraints is the overhead to generate a new configuration, and the time it takes to load it onto the device. Normally these applications have to reuse their hardware numerous times between configurations before obtaining a functional density advantage. The most promising reconfiguration method to improve functional density with minimal hardware reuse was one that extracts certain characteristics from the bitstream and then implements a bitstream specialiser that generates new hardware at bit-level while the device is being reconfigured. While it was shown that this method allows reconfiguration of an application in real-time, its effect on functional density was not determined. This paper will show that a significant increase in functional density can be achieved for applications where reconfiguration is required before the next execution cycle of the application.
THE MYTHOLOGICAL DISCOURSE OF THE ITELMEN POETRY (BASED ON THE WORKS OF G. POROTOV)
Authors: G. Khazankovich Yulia
Published: December 2019

Purpose of the study: The authors review the Itelmen poetry based on works written by Georgii Porotov. Mythological discourse analysis helps us reveal the Itelmen worldview.

Methodology: The poet focuses on the mythological character of the creator of Kamchatka, Kutkh the Big Raven, the main character of the poems composed by G. Porotov, in particular, the poem “The Winged Kutkh, or a Love Song”. Discourse analysis is used on the material of the Itelmen poetry for the first time in order to study the manifestation of the epic in the artistic thinking of the peoples of Kamchatka. The subject of the study was the mythological story of Kutkh Raven's marriage.

Main Findings: Within the framework of the study, the authors base their research on the works of the famous mythologist and folklorist E. Meletinsky, which are focused on identifying the specifics of the mythology in the mentality of the Paleo-Asiatic peoples in the Far East.

Applications of this study: The article will be of interest to a wide circle of readers and researchers of the indigenous peoples of the world.
ZOOMORPHIC LEXIS AS A FRAGMENT OF THE CHINESE LINGUISTIC WORLDVIEW (BASED ON CHINESE PHRASEOLOGICAL UNITS)
Authors: Daulet Fatimabibi , Orazakynkyzy Farida , Anuar Saule , Nurkassym Ashimbay , Zeinolla Zhanat , Zhunisbek Gulnaz
Published: December 2019

Purpose: The purpose of this study is to identify the ethnocultural features of the functioning of Chinese phraseological units with zoomorphic components by describing their lingo cultural properties. The Chinese phraseological units with a zoomorphic component from the liuchu (六畜) group — six domestic animals, whose images occupy a special place in Chinese linguoculturology — were used as linguistic material.

Methodology: In order to describe the internal form of zoomorphisms, the authors used the following methods: semantic identification, providing the possibility to identify individual phraseological meaning with the lexical structure; cognitive interpretation, which is involved in the "decoding" of cultural codes enclosed in phraseological units; The etymological approach is used to determine the primary sources of zoomorphisms, which are figurative dominants of the studied phraseological units.

Main Findings: The authors found that zoonyms as animal names are anthropocentrically oriented and have connotative properties, acting as a means of secondary nomination, they represent an ethnospecific worldview. The authors determined that the ethno specific features of the considered phraseological units are due to the specificity of the linguistic system of the Chinese language, as well as the specifics of the influence of animals on the life of the Chinese ethnos.

Applications: The collected empirical material can be used in classes in linguoculturology and intercultural communication; it can be used while writing textbooks, methodological manuals; to create thesauri, phraseological dictionaries, as well as to clarify the national-cultural specificity and functioning of zoononyms in the linguistic worldview.

Novelty/Originality: The scientific novelty of the work is due to the insufficient study Chinese phraseological units with the zoonym component. The work makes a certain contribution to solving the problem of the functioning of zoononyms in phraseological units, in particular, the study made it possible to trace the influence of extralinguistic factors, such as geographical and biological, as well as globalization processes.
DETERMINANTS OF INTERCULTURAL EDUCATION
Authors: Bystray Yelena , Вaronenko Elena , Belova Larissa , Raisvich Julia , Shtykova Tatiana
Published: December 2019

Purpose of the study: The article aims to identify the determinants of intercultural education and describe their essence.

Methodology: The authors used the cluster of methods: the diagnostics of cultural identity and a foreign cultural-reflexive position in communication with representatives of other cultures, the analysis of activity-related products, rapid assessment questionnaire "Tolerance index", questionnaire. The study comprised 135 students of the South Ural State Humanitarian-Pedagogical University (Chelyabinsk, Russia).

Main Findings: The authors have determined typical features and target-oriented aspects of intercultural education and presented them in the form of a matrix. The authors have also developed and tested the course "Basics of intercultural communication", considered the formation of the cultural self-identity and foreign culture-reflexive position of students, as well as their tolerance index and types of ethnic identity.

Applications of this study: The study results can be used in teaching courses concerned with problems of intercultural communication to students of foreign language faculties, international faculties, and other humanities faculties. The research materials are of scientific significance for undergraduate and graduate students working on their dissertations.

Novelty/Originality of this study: The study novelty is as follows.: At the theoretical level, it determines the typical features and determinants of intercultural education. At the practical level, it introduces and tests the course "Fundamentals of intercultural communication". It analyzes the formation of the cultural self-identity and foreign cultural-reflexive position of students, as well as their tolerance index and types of ethnic identity.
TO THE PROBLEM OF STUDYING THE ETHICAL CHARACTERISTICS OF THE PERSON
Authors: R. Ismagilova Regina , R. Sibaeva Gulnaz , I. Ishmuradova Izida , A. Khayrullin Bulat
Published: December 2019

Purposes: The crisis in modern humanitarian science testifies to the need to search for a new approach that goes beyond the boundaries of the natural-science approach, which in its turn involves addressing to the origins of our culture, expanding the categorical apparatus and methodological basis of psychology. In individual consciousness, the spiritual crisis is expressed in the loss of the ideals of life. Therefore, at the present stage of the development of society, the need for a philosophical and psychological analysis of spiritual and moral ideas and their role in the formation of the individual is felt with particular severity.

Methodology: In the framework of the activity approach embodied in the works of S. L. Rubinstein, the main provisions were formulated, which are of special methodological importance for the solution of this problem. In particular, these are provisions on the study of the human psyche through its manifestations in the main types of activity and the influence on the activities of external causes, not directly, but indirectly, through its internal, psychological conditions.

Results: This article is devoted to the description of the results of an empirical study carried out from the position of the activity approach and aimed at revealing the level of ethical behavior of adolescence and youth ages. The urgency of the study is due to the fact that the tendency of the transition from the theoretical-descriptive to the experimental-developing technology of research of ethical characteristics is clearly manifested in the work.

Implications/Applications: This article could be practical in predicting the problems regarding the study of Ethical Characteristics of person and help the audience to broaden their information in this vein.

Novelty/Originality: In one case, the individual in the process of communicating with other people, assimilates universal values, the experience of moral relations, develops beliefs and moral ideals, in the other can under the influence of communication become attached to completely opposite values, degrade morally
MAJOR AREAS OF FOREIGN LANGUAGE SPEECH ACTIVITY OF UNIVERSITY STUDENTS IMPROVEMENT
Authors: A. Valeev Agzam , G. Kondrateva Irina , R. Sabirova Diana , F. Plotnikova Nailya
Published: December 2019

Purposes: Increased international activity in Russia leads to a steady claim of foreign language knowledge. The list of professional characteristics of a university graduate includes the ability to adapt to new information realities in the professional community, where foreign language speech activities become highly demanded, when not only language skills, but also social and cultural arrangements of the country. Thus, innovative approaches to foreign language teaching are required. The article explored the following aspects of foreign-language speech activity of university students. Methodology: methodology of teaching foreign-language speech activity; principles of development of foreign language speech activity of students; realization of educational resources for this activity development; model of pedagogical technology of formation of foreign language speech activity, etc. Result:  The results of the pilot work showed the validity of using the principles of the development of foreign language speech activities in the organization of the educational process. Implications/Applications: This article will help the student to promote the ability to give a speech. Novelty/Originality: At the same time, being a type of speech activity, foreign language communication in the process of training solves, in turn, educational and development tasks by means of a foreign language sign system, where the whole set of speech actions of the individual is actually present.