bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of silicon application on growth and yield of tomato (Lycopersicon esculentum Mill.) Var. Rajitha grown under water stress
Authors: Subhashini H. P. S. , De Silva C. S. , Silva N. R. N.
Published: July 2022

This experiment was aimed to determine the effect of application of silicon on the growth and yield of tomato (var. Rajitha) under water stress condition. Treatments of the experiment were 75 mg of Si and no water stress (T1), 75 mg of Si and 50% water stress (T2), 150 mg of Si and no water stress (T3), 150 mg of Si, and 50% water stress (T4), no Si and no water stress (T5), and no Si and 50% water stress (T6). A pot experiment was conducted at a plant house in Horticultural Crop Research and Development Institute, Gannoruwa in 2019. The experiment was conducted as a Complete Randomized Design with a factorial treatment structure. There were 5 replicates in each treatment. Water stress and silicon were taken as main factors. Silicon was added as magnesium silicate and water stress was imposed by maintaining a moisture level equivalent to 50% of field capacity. According to the results, the significantly highest (p ≤ 0.05) mean height of plants (132.6 cm) in (13 weeks after planting) was observed in plants of T3 treatment, and the lowest mean height (107cm) was observed in plants of T6 treatment. Among the water stress treatments, T4 treatment reported significantly highest (p ≤ 0.05) shoot/ root ratio followed by T2 treatment. The application of magnesium silicate had improved yield parameters such as number of flowers, number of fruits, fruit weight, and fruit yield. In water stress treatments, T4 plants showed the highest flowering. Among the water stress treatment plants T4 resulted in the highest number of fruits per plant (13.6). Water stress negatively affects fruit weight but compared to T6 treatment plants (54.4 g) T2 treatment plants (55.7 g) and T4 treatment plants (56.3 g) showed higher fruit weight, but the treatments were not significantly different from each other. Lower fruit yield was observed in T6 treatment plants (0.707 kg) but T2 treatment plants (0.77 kg) and T4 treatment plants (0.967 kg) have shown higher fruit yield. The results of this experiment showed that the water stress reduced the growth of tomato plant and yield. But the application of magnesium silicate has a positive influence on growth and yield by enhancing the water tolerance of tomato under water stress conditions.
Technical efficiency and its determinants: Paddy farming in Mahakanumulla cascade system
Authors: Perera K. L. P. A. , Hemachandra D.
Published: July 2022

Paddy farming is predominantly practiced in the dry zone of Sri Lanka. Most paddy lands in the dry zone belong to traditional hydrological cascade systems known as Village Tank Cascade Systems (VTCS) and paddy lands receive irrigation water from the tanks in VTCS. Land is a scarce resource for agriculture in Sri Lanka. Therefore, it is important to achieve high efficiency in paddy farming to increase paddy production in the country. A paddy farm is technically efficient if it is producing the maximum output using the minimum quantities of inputs, such as labour, capital, and technology. This study examines technical efficiency of paddy farmers in Mahakanumulla VTCS and its determinants. The technical efficiency of the farmers is estimated using parametric frontier technique; the Stochastic Frontier Analysis (SFA). In the first stage of the analysis a production function is estimated using the Maximum Likelihood Estimator. In the second stage, an inefficacy model is estimated with plot size, age, experience, household size, full time farming, and land ownership status as determinants of technical inefficiency. According to the results, the average technical efficiency of paddy farmers in Mahakanumulla VTCS is 92.3%. Only the plot size, experience, and household size are positively related to technical inefficiency and significant at 10%. According to the study findings, the technical efficiency of paddy farmers in Mahakanumulla VTCS does not vary significantly from the most efficient farmer in the area. This could be due to the fact that in the VTCS, farmers are operating under more homogenous conditions. However, it does not indicate that paddy farmers in Mahakanumulla VTCS are highly productive as results only reveal the technical efficiency level of paddy farmers in comparison to the most efficient paddy farmer in the area. Therefore, it is important that productivity improvements are continuously carried out.
Effect of gypsum application on yield performance of groundnut (Arachis hypogea L.) Varieties in Kilinochchi district, Sri Lanka
Authors: Thivakaran N. , Pradheeban L. , Nishanthan K.
Published: July 2022

Groundnut (Arachis hypogea L.) is an important oil crop grown in Sri Lanka. Application of fertilizer is substantially contributing to the yield increment; however improper management of fertilizer is the specific drawback in quality and quantity in groundnut. Therefore, the application of balanced fertilizer and minerals play an important role in the cultivation of groundnut. An experiment was conducted at the Department of Agronomy, Faculty of Agriculture, Kilinochchi to assess the effect of different rates of gypsum application on yield performance of groundnut varieties from January to May 2019. Two-factor factorial experiment was conducted in Randomized Complete Block Design (RCBD) with three replications. Four different rates of gypsum application such as 0 kg/ha (T1 - Control), 75 kg/ha (T2), l25 kg/ha (T3), and 175 kg/ha (T4) were used as the first factor and five groundnut varieties, namely Tissa (V1), Lanka Jumbo (V2), Tikiri (V3), Indi (V4), and ANK G1 (V5) were used as the second factor. All the agronomic practices were done according to the recommendations of the Department of Agriculture. The yield parameters were recorded, and the shelling percentage was calculated. Data were analyzed using SAS 9.1 package to perform ANOVA. The best treatment was identified through the means separation using Duncan’s Multiple Range Test (DMRT) at p = 0.05. The yield parameters of fresh and dry weight of pods / plant, hundred pods and seeds weight, number of mature and immature pods and total yield were higher in gypsum appliedtreatments rather than control and the highest in T4 (175 kg/ha gypsum) treatment. All the yield parameters were significantly different in Lanka Jumbo and ANK G1 from other varieties. However, the number of mature pods and shelling percentage were similar among the varieties. The highest shelling percentage (96 %) was recorded in Lanka Jumbo under 175 kg/ha gypsum application (T4). The highest yield parameters were recorded in Lanka Jumbo variety, whereas the lowest was in ANK G1. There was no interaction effect among gypsum application and varieties in the yield parameters. From this study, it can be concluded that the application of 175 kg/ha gypsum (T4) to the variety of Lanka Jumbo (V2) can be selected as suitable treatment combination to obtain the substantial yield from groundnut in Yala season.
Health economics in Africa from 1991 to 2020: A systematic review
Authors: Meng Xiao , Mu Gang , Tong Jiaxuan
Published: July 2022

This systematic review was conducted to identify, evaluate and characterize the overall progress of health economics research conducted for Africa. Health economics studies carried out from 1991 to 2020 for Africa were retrieved from the EconLit database using relevant searching strategies. According to the methodology of Preferred Reporting Items for Systematic Review and Meta-Analysis, qualified journal papers were included. Using bibliometrics, we ran a series of analyses on authorship, studied countries, affiliations, and countries of origin, journals, and research topics. A total of 2935 studies were screened, and 178 were included in this review. We observed that the determinants of illness is the most researched topics. The United States, World Bank, University of California Berkeley, are respectively the most influential countries, world organizations, and academic institutions in the field of health economics of Africa. HIV/AIDs is still the leading health issue in highly cited health economics studies in Africa. Health Policy and Planning is the most productive and academically influential journal, and Kenya is the most studied country by health economists among all African countries. African health systems are vulnerable compared to developed countries, as many of them are underfunded. The academic strength in Africa is much weaker than that of leading health economics countries. Even within the continent, the academic development and the attention it receives are uneven. More influential health economics studies of Africa should be published in addition to the disease focus of HIV/AIDS.
Self-medication against COVID-19 in health workers in Conakry, Guinea
Authors: Toure Abdoulaye , Camara Saidouba C. , Camara Alioune , Conde Mamoudou , Delamou Alexandre , Camara Ibrahima , Bangoura Salifou T. , Camara Alimou , Diallo Mamadou B. , Keita Mamadou B. , Kourouma Kaba , Camara Robert , Etard Jean-Francois , Keita Alpha-Kabinet
Published: July 2022

Data regarding the prevalence and consequences of self-medication during the COVID-19 pandemic in Africa are very limited. The study aimed to explore the frequency and risk factors of self-medication against COVID-19 by health personnel in this study. This cross-sectional study took place in June 2021, in Conakry, in the all three national hospitals and the six community medical centers, and five primary health centers. A multivariate logistic regression model was performed to identify factors associated with self-medication. A total of 975 health workers with a median age of 31 (IQR: 27-40) years, with 504 (51.7%) women were included. The majority were clinicians: physicians (33.1%) or nurses (33.1%). Of all, 46.2% reported having had at least one COVID-19 symptom during the 12 months preceding the survey. The proportion of self-medication was 15.3% among national hospital staff, 12.20% in municipality medical centers and 22.6% in primary health centers (p=0.06). More than two-thirds (68.7%) who selfmedicated did not have a test for SARSCoV- 2 infection. They took antibiotics including azithromycin, amoxicillin, ampicillin (42.2%), acetaminophen (37.4%), vitamin C (27.9%), hydroxychloroquine (23.8%) and medicinal plants (13.6%). The median duration of self-medication was 4 days. Fatigue or asthenia, sore throat, loss of smell and sore throat of a close person were independently associated with selfmedication. Health care workers largely practiced self-medication during the Covid pandemic and without diagnostic testing. The results suggest the need for training and sensitization of medical personnel to avoid the consequences of the molecules used, including hepatotoxicity and antibiotic resistance.
Induction of labour practices at Botshabelo District Hospital: Assessing the institutional guidelines
Authors: Benedict Matthew O.A. , Brits Hanneke
Published: July 2022

Induction of labour (IOL) is defined as an artificial stimulation administered to initiate the delivery process before the onset of spontaneous labour. Setting-adapted guidelines need to be developed to promote safe maternal and neonatal care in line with the needs of a specific institution. This study aimed to describe and assess the current IOL practices at Botshabelo District Hospital, focusing on incidence, indications, induction methods, complications, and outcomes. A retrospective-descriptive study included all relevant data from IOL cases over six months between July and December 2017. From 168 attempted inductions of labour, 153 files were retrieved. The majority of cases (69.7%) were for post-dates. Normal vaginal delivery (NVD) was achieved in most patients (69.3%), while one patient had an assisted delivery. Thus, 30.1% of inductions failed and required caesarean sections. The incidence, indications, methods of induction, complications, and outcomes of IOL in BDH are in line with international guidelines; however, including the sweeping of membranes at term and balloon catheters as methods could improve the current guidelines.
Latent tuberculosis infection in family members in household contact with active tuberculosis patients in Semarang City, Central Java, Indonesia
Authors: Karbito Karbito , Susanto Hardhono , Adi Mateus S. , Sulistiyani Sulistiyani , Handayani Oktia W.K. , Sofro Muchlis A.U.
Published: July 2022

A quarter of the world’s population is infected with Mycobacterium tuberculosis (M.tb), 10% of cases develop active tuberculosis (TB), and 90% have a latent TB infection. Family members of TB patients have the highest potential for latent TB infection. This study aims to identify latent TB infection and risk factors in family members within the household contacts of active TB patients. This study used a crosssectional study design with a contact tracing method. The selected subjects were 138 people from 241 total family members of 112 active TB patients. Subjects underwent a tuberculin skin test (TST), using 2 units of tuberculin (TU) purified protein derivative (PPD) 0.1 mL (PT. Bio Farma Persero, Bandung, Indonesia). Data risk factors were collected during home visits. Data were analyzed using the chi-square test and multiple logistic regression. A total of 63.8% (88/138) of family members of active TB patients’ household contacts had latent TB infection. The type of occupation of laborers/ farmers/fishers is the most dominant risk factor associated with latent TB infection (AOR: 7.04; 95% CI: 1.70–29.02), followed by unqualified bedroom density (8 m2/2 people) (AOR: 5.33; 95% CI: 2.44– 12.71) and contact duration ≥5 hours/day (AOR: 4.70; 95% CI:1.33–16.66). Latent TB infection in family members of active TB patients’ household contacts was quite high. Occupation type, contact duration, and bedroom density were simultaneously confirmed as the main risk factors related to latent TB infection. Therefore, it is recommended to identify and prevent latent TB infection in family members in household contact with active TB patients.
Identifying malignant nodules on chest X-rays
Authors: Mahboub Bassam , Tadepalli Manoj , Raj Tarun , Santhanakrishnan Rajalakshmi , Hachim Mahmood Yaseen , Bastaki Usama , Hamoudi Rifat , Haider Ehsan , Alabousi Abdullah
Published: July 2022

Background:

Three and half million anonymous X-rays were gathered from 45 locations worldwide (in-hospital and outpatient settings). qXR was initially trained on this massive dataset. We used an independent dataset of 13,426 chest X-rays from radiologists’ reports. The test data set included 213,459 X-rays chosen at random from a pool of 3.5 million X-rays. The dataset (development) was developed using the remaining X-rays received from the remaining patients.

Methods:

qXR is a deep learning algorithm-enabled software that is used to study nodules and malignant nodules on X-rays. We observed moderate to a substantial agreement even when observations were made with normal X-rays.

Results:

qXR presented a high area under the curve (AUC) of 0.99 with a 95% confidence interval calculated with the Clopper–Pearson method. The specificity obtained with qXR was 0.90, and the sensitivity was 1 at the operating threshold. The sensitivity value of qXR in detecting nodules was 0.99, and the specificity ranged from 0.87 to 0.92, with AUC ranging between 0.98 and 0.99. The malignant nodules were detected with a sensitivity ranging from 0.95 to 1.00, specificity between 0.96 and 0.99, and AUC from 0.99 to 1. The sensitivity of radiologists 1 and 2 was between 0.74 and 0.76, with a specificity ranging from 0.98 to 0.99. In detecting the malignant nodules, specificity ranged between 0.98 and 0.99, and sensitivity fell between 0.88 and 0.94.

Conclusion:

Machine learning model can be used as a passive tool to find incidental cases of lung cancer or as a triaging tool, which accelerate the patient journey through standard care pipeline for lung cancer.
Relationship between Age, Sex, and Anthropometric Factors with the Distance of L4-L5 Interspace from Tuffier's Line
Authors: Tantri Aida Rosita , Satoto Darto , Natassa Stesy
Published: July 2022

Background:

The anatomical marker used in spinal anesthesia is L4-L5 interspace. The L4-L5 interspace is thought to be right on the Tuffier's line, which connects the two highest points on the iliac crest. The location of L4-L5 interspace from the Tuffier's line varies greatly because of the influence of several factors such as differences in race, sex, age, and anthropometric factors. This study aimed to examine the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier's line using ultrasound guidance at Cipto Mangunkusumo National General Hospital.

Materials and Methods:

This was an observational analytic study with a cross-sectional design in 93 subjects at Cipto Mangunkusumo National General Hospital recruited for the study. Statistical analysis was performed to find the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier's line and to continue with multivariate analysis to obtain the prediction formula of the distance between L4-L5 interspace and the Tuffier's line.

Results:

This study found that the distance of L4-L5 interspace to the Tuffier's line is −2.59 ± 1.58 cm. Correlation analysis showed a significant relationship between height and sex to the distance of L4-L5 interspace and the Tuffier's line. The distance prediction formula obtained in this study is 4.921 + [0.536 × (1 for male or 2 for female)] + (−0.052 × height in cm).

Conclusion:

There was a significant relationship between height and sex to the distance of L4-L5 interspace from the Tuffier's line.
Severe Hyponatremia and Cerebral Edema after Laparoscopic Salpingectomy, Hysteroscopy Myomectomy, and Adenomyosis Resection
Authors: Nugroho Alfan Mahdi , Omega Andy , Danneto Christian
Published: July 2022

The usage of hypotonic irrigation solution during hysteroscopy and laparoscopy can cause systemic fluid absorption and complications such as hyponatremia, fluid overload, and cerebral edema. Moreover, Trendelenburg position on gynecologic laparoscopy with a long duration can increase intracranial pressure and decrease cerebral perfusion pressure. A woman, 39 years old, suffered from severe hyponatremia and cerebral edema after hysteroscopy myomectomy, laparoscopic salpingectomy, adenomyosis resection, and adhesiolysis procedure. Water for injection was used as an irrigation solution during the procedure, totaling 20 L. The position of the procedure was supine, Trendelenburg, with a procedure duration of 4 h 50 min. A spontaneous respiratory trigger was not found for about 1 h during extubation. We found anisochoric pupil 5/4 mm without direct and indirect light reflex on physical examination. From the laboratory result, the sodium level was 118. Brain CT scan with contrast showed cerebral edema. Sodium correction was given using NaCl 3%, 500 mL/24 h IV drip. Sodium was corrected slowly and cautiously to prevent cerebral pontine myelinolysis. In the ICU, the sodium level was increased to a normal level. But, the light reflex was still absent, and the pupil was anisochoric. Brain MRI showed diffuse cerebral edema.
Amniotic Fluid Embolism with Cardiac Arrest and Coagulopathy During Cesarean Section
Authors: Lim Lan Fern Michele , Sim Xiu Ling Jacqueline , Sng Ban Leong
Published: July 2022

Amniotic fluid embolism (AFE) is a rare but potentially fatal condition of pregnancy. It is a diagnosis of exclusion and its management largely supportive. We present a case of a 36-year-old patient who was admitted at 32 weeks gestational age with an acute abdomen. She underwent an emergency Cesarean section for fetal distress secondary to possible placental abruption. This was complicated by post-delivery cardiac arrest and respiratory failure from suspected AFE, disseminated intravascular coagulation and severe postpartum hemorrhage. She was managed with vasopressors, point-of-care coagulation testing, massive transfusion, anti-fibrinolytics, fibrinogen concentrate and eventual hysterectomy. Post-operatively, she was treated for acute respiratory distress syndrome in the intensive care unit. She and her neonate survived with good outcome. We discuss the practical constraints faced in the diagnosis and management of AFE, due to a lack of specific diagnostic tests and the need for prompt high-quality resuscitation, simultaneous management of coagulopathy and massive hemorrhage, timely activation of senior personnel and the involvement of a multi-disciplinary team in a crisis situation.
A study of demographic, attitudinal, and clinical factors associated with adherence to treatment in schizophrenia
Authors: Parkar R. Shubhangi , Behere Nilam Shivajirao , Elvin L , Angane Amey Yeshwant
Published: July 2022

Background/Objectives:

Schizophrenia is a severe mental disorder requiring prolonged treatment, and adherence to the treatment is an important factor. The reasons for nonadherence vary according to disease severity, treatment, local perceived problems, environment, and sociocultural factors. It is necessary to understand the pattern and factors related to adherence. This study aims at understanding adherence to treatment in the patients of schizophrenia and associated psycho-social and disease-related factors. It also analyzes the change in adherence over a period of the last 35 years.

Methods:

A review of past psychiatry records and nonadherence to the treatment of patients of schizophrenia that followed up in outpatient department was done over the last 35 years. For the evaluation of psychotic symptoms, positive and negative syndrome scale (PANSS) and for attitude toward medicine, drug attitude inventory-10 (DAI-10), and clinician rating scale (CRS) were used. Statistical analysis was done using SPSS-20 software.

Results:

Sixty-five percent of the patients were adherent to the treatment. Sociodemographic factors such as age, gender, family type, marital status, education as well as factors related to accessibility to medicines were not significantly associated with adherence. Adherence had significant positive correlation with CRS scores and negative correlation with PANSS positive and general score. Adherence of ≥80% for current year was found to be associated with the cross-sectional positive DAI score. Patient perceived causes such as social, financial, unwillingness, and lack of insight, side-effect profile had a significant association.

Conclusions:

Attitude and willingness toward treatment, insight into illness, and side-effect profile play a pivotal role in adherence.
Uropathogens and the Antibiogram Profile from a Tertiary Care Hospital
Authors: Kashyap Bineeta , Singh NP , Nirmal Kirti , Meena Manoj Kumar
Published: July 2022

Background:

Urinary tract infections (UTIs) are one of the most common bacterial infections in humans, both in the community and the hospital settings. The distribution of antimicrobial susceptibility data of UTI-causing microorganisms changes from time to time and from place to place. The susceptibility data provided by regional microbiology laboratories helps to choose the empirical antimicrobials to treat UTI.

Aim and Objectives:

To determine the prevalence and antimicrobial drug susceptibility pattern of the bacterial uropathogens isolated from a tertiary care hospital.

Material and Methods:

A retrospective analysis over a period of two months (Jan-Feb 2021) was performed in the Department of Microbiology of a tertiary care hospital, East part of Delhi. These two months were immediately following conversion of this facility to a non COVID centre from a dedicated COVID centre. Culture results of the urine samples received during the study period were analyzed. The samples were processed according to standard guidelines. The data were entered into micro soft excel for analysis.

Results:

A total of 1650 urine samples from suspected UTIs were analyzed retrospectively for isolation and identification of bacteria and antimicrobial susceptibility testing. 271 (16.4%) grew significant microorganisms including fungus. In both male and female patients E. coli (n = 46, 17%) was the most commonly isolated microorganism, followed by Staphylococcus spp. (n = 45, 16%). Isolated resistance to uropathogens was common with Cotrimoxazole (60%), Nitrofurantoin (50%), ciprofloxacin (50%), tetracycline (45%), Imipenem and cefotaxime (35%)

Conclusions:

UTI is one of the most common infectious diseases that clinicians are dealing with. Increasing antimicrobial resistance among uropathogens implicated in UTI is a matter of concern. Periodic monitoring of etiology and drug susceptibility is recommended.
Evaluation of analgesic effects and hemodynamic responses of epidural ropivacaine in laparoscopic abdominal surgeries: Randomised controlled trial
Authors: Jayadevan Dipti , Kumar Lakshmi , Varghese Rekha , Balakrishnan Sindhu , Shyamsundar P , Kesavan Rajesh
Published: July 2022

Background and Aims:

The role of epidural analgesia in laparoscopic surgeries remains controversial. We evaluated intraoperative analgesic effects of epidural ropivacaine versus intravenous fentanyl in laparoscopic abdominal surgery and assessed postoperative analgesic requirements, hemodynamic changes, time to ambulation, and length of stay (LOS) in the ICU.

Material and Methods:

Seventy-two American Society of Anesthesiologists physical status I–III adult patients undergoing elective laparoscopic abdominal surgeries were randomized to either 0.5 mg/kg/h intravenous fentanyl (Group C) or 0.2% epidural ropivacaine at 5–8 mL/h (Group E) infusions intraoperatively and 0.25 m/kg/h fentanyl and 0.1% epidural ropivacaine infusions respectively postoperatively. Variations in mean arterial pressure (MAP) of 20% from baseline were points of intervention for propofol and analgesia with fentanyl or vasopressors. The number of interventions and total doses of fentanyl and vasopressors were noted. Postoperative analgesia was assessed at 0, 6, 12, and 24 h and when pain was reported with numerical rating scale and objective pain scores. Chi-square test and Student’s t-test were used for categorical and continuous variable analysis.

Results:

Intraoperatively, 14 patients versus 4 needed additional fentanyl and 26 versus 14 needed additional propofol in groups C and E respectively (P = 0.007, P = 0.004). MAP at 0, 6 and 18 h was lower in Group E. Pain scores were better in Group E at 6,18, and 24 h postoperatively. Time to ambulation was comparable but LOS ICU was prolonged in Group E (P = 0.05)

Conclusion:

Epidural ropivacaine produces superior intraoperative analgesia and improved postoperative pain scores without affecting ambulation but increases vasopressor need and LOS ICU in comparison with intravenous fentanyl in laparoscopic abdominal surgeries.
Analgesic efficacy of programmed intermittent epidural bolus vs patient-controlled epidural analgesia in laboring parturients
Authors: Meena Anuradha , Mitra Sukanya , Singh Jasveer , Saroa Richa , Takker Navneet
Published: July 2022

Background and Aims:

Programmed intermittent epidural boluses (PIEB) may produce more extensive spread of epidural bolus rather than continuous epidural infusion (CEI). Previous studies compared PIEB with CEI and concluded that PIEB shows better outcome when combined with patient controlled epidural analgesia (PCEA), but these studies lack any comparison between PCEA and PIEB in the absence of CEI.

Material and Methods:

In this open labeled, prospective, randomized, controlled study 50 parturient were randomly assigned to two groups of 25 each.Group 1 received PCEA bolus of 5 ml (0.1% levobupivacaine plus 2mcg/ml fentanyl) with 15 min lockout interval with provision of rescue clinician bolus of 5 ml of same drug for breakthrough pain. Group 2 received physician-administered PIEB with same parameters as Group 1. The primary outcome was to assess total consumption of levobupivacaine plus fentanyl mixture, in PIEB vs. PCEA group, corrected for duration of labor (ml/h) and secondary outcomes included pain score, maternal satisfaction, maternal, and neonatal characteristics.

Results:

The hourly mean drug consumption in the PCEA group was significantly lower as compared with the physician-administered PIEB group (5.46 ml/h, SD 2.01 vs. 6.55 ml/h, SD 1.28; P = 0.03). The median total number of rescue boluses consumed were less in the PCEA group when compared with the PIEB group (0 vs. 1; P < 0.001). There was no significant difference between groups with regard to pain scores, maternal hemodynamics, maternal and fetal outcome and adverse effects.

Conclusion:

PCEA may be better than physician-administered PIEB in providing effective labor analgesia with comparable safety.
The effect of type 2 diabetes mellitus on perioperative neurocognitive disorders in patients undergoing elective noncardiac surgery under general anesthesia. A prospective cohort study
Authors: Ntalouka Maria P. , Arnaoutoglou Eleni , Vrakas Spyridon , Staikou Chryssoula , Angelis Fragkiskos A. , Papadopoulos Georgios , Tzimas Petros
Published: July 2022

Background and Aims:

Preliminary evidence suggests a possible relationship between type 2 diabetes mellitus (T2DM) and perioperative neurocognitive disorders (NCD). We sought to investigate whether patients with T2DM, undergoing elective noncardiac surgery under general anesthesia, are at increased risk of perioperative NCD.

Material and Methods:

A prospective cohort study was designed. One-hundred and forty-four patients with T2DM and 144 healthy controls were recruited. Controls were matched for sex, age, type of operation, and educational background. Postoperative delirium (POD), delayed neurocognitive recovery and postoperative NCD were evaluated.

Results:

Two hundred twenty-eight patients were analyzed. Compared to controls, patients with T2DM were diagnosed with higher rates of NCD preoperatively (n = 96 vs. n = 26, P < 0.05) and higher POD up to 4 days postoperatively (n = 204 vs. n = 68, P < 0.05). Increased rates of delayed neurocognitive recovery and postoperative NCD were recorded in patients with T2DM up to 9 months postoperatively (n = 473 vs. n = 192, P < 0.05). Insulin-dependent patients had higher rates of POD on the second (n = 38 vs. n = 24, P < 0.05) and third day (n = 27 vs. n = 16, P < 0.05) when compared to noninsulin-dependent patients. Logistic multivariable analysis revealed that patients with T2DM are at increased risk for postoperative cognitive disorders.

Conclusion:

Patients with type 2 diabetes mellitus appear to be at a higher risk of perioperative NCDs up to 9 months after elective noncardiac surgery under general anesthesia.
Code blue: Predictors of survival
Authors: Hazra Darpanarayan , Nekkanti Ankita Chowdary , Jindal Anmol , Sanjay M , Florence Irene , Yuvaraj S , Abhilash Kundavaram Paul Prabhakar
Published: July 2022

Background and Aims:

Code blue is a rapid response system developed for emergency resuscitation and stabilization of any sudden cardiac arrest (SCA) within a hospital. Literatures on outcome and factors predicting mortality from SCA in the Emergency departments (EDs) of India is scant.

Material and Methods:

This retrospective cohort study included all patients above the age of 15 years who had a code blue declared in the ED between the months of January 2018 and June 2019. Factors related to the sustained return of spontaneous circulation (ROSC) and mortality were analyzed using descriptive-analytic statistics and logistic regressions.

Results:

This study included 435 patients with a male predominance of 299 (69%). The mean age was 54.5 (SD - 16.5) years. Resuscitation was not attempted for 18 patients because of the terminal nature of the underlying disease. The majority were in-hospital cardiac arrests (74%). The nonshockable rhythm included pulseless electrical activity (PEA) (85.5%) and asystole (14.5%) cases. Shockable rhythms, that is, pulseless ventricular tachycardia/ventricular fibrillation were noted in only 10% (43/417) of cases. ROSC was attained in 184 (44.1%) patients, among which 56 (13.4%) were discharged alive from the hospital. Multivariate logistic regression analysis showed CPR >10 min (odds ratio [OR]: 13.58; 95% CI: 8.39–22.01; P < 0.001) and female gender (OR: 1.89; 95% CI: 1.13–3.17; P = 0.016) to be independent risk factors for failure to achieve ROSC in ED.

Conclusion:

The initial documented rhythm was nonshockable in the majority of the cases. CPR duration of more than 10 min and female gender were independent risk factors for failure to achieve ROSC in the ED. Nonshockable rhythms have a poorer outcomes than that of shockable rhythms.
Effects of intra-operative infusion of lidocaine on postoperative pain and quality of recovery in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial
Authors: Awal Shikha , Bhalotra Anju Romina , Sharma Saurabh
Published: July 2022

Background and Aims:

Early recovery is desirable after day care surgery. Intravenous lidocaine has anti-inflammatory, anti-hyperalgesic, and analgesic effects and by reducing postoperative pain, nausea, vomiting, and duration of postoperative ileus and hospital stay, might be a useful adjuvant to improve recovery after gynecological laparoscopic surgery.

Material and Methods:

Fifty female patients, aged 18–55 years, undergoing gynecological laparoscopic surgery were randomly allocated to two groups. In Group L, patients received intravenous lidocaine 1.5 mg/kg at induction of anesthesia followed by infusion of 2 mg/kg/hour until the completion of surgery and in Group NS, patients received normal saline infusion. The Global QoR-40 score at 24 hours, pain score in PACU and at 24 hours, nausea/vomiting, PADSS score in PACU and analgesic consumption over 24 hours were assessed and data were analyzed using SPSS version 17 software.

Results:

Demographic data were comparable in both groups. The mean Global QoR-40 score in Group L was 197.30 ± 2.3 versus 178.74 ± 6.02 in Group NS (P < 0.001). The mean time to attain PADSS ≥9 was 50 min shorter in Group L than in Group NS (P < 0.001). Nausea, vomiting, and anti-emetic requirement were also significantly reduced in Group L as compared to Group NS (P = 0.005) as was the mean pain score over 24 h (P < 0.001) and the total analgesic consumption over the first 24 h after surgery (P < 0.005).

Conclusion:

Intraoperative intravenous lidocaine infusion resulted in an improved overall Quality of Recovery in patients undergoing ambulatory gynecological surgery.
Full-text publications of presentations at neuroanesthesia meetings of India: A 5-year audit and analysis
Authors: Krishnakumar Mathangi , Sundaram Mouleeswaran , Chakrabarti Dhritiman , Sriganesh Kamath
Published: July 2022

Backgroud and Aims:

Conference presentations provide an opportunity to rapidly share findings of new research despite limitations of details and reach. Earlier studies have examined publication rates of conference presentations in anesthesia. However, conversion rate of neuroanesthesia meeting presentations to publications is unknown. We assessed the publication rate of neuroanesthesia conference presentations from India over a 5-year period and identified factors contributing to subsequent publications.

Material and Methods:

Conference abstracts of the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) from 2014 to 2018 were studied with regard to conversion to full-length publications. Details of presentations were obtained from abstracts published in the journal of ISNACC and details of publications were collected by searching Google and PubMed using title and author details.

Results:

Only 17.5% (40/229) of the abstracts presented at ISNACC conferences over a 5-year period resulted in subsequent full-text publications in peer-reviewed journals. Prospective cohort studies (OR [95% CI] 2.84 [1.05–8.56], P = 0.048), randomized trials (OR [95% CI] 2.69 [1.04 to 7.9], P = 0.053), and abstracts from public institutions (OR [95% CI] 3.44 [1.4 to 10.42], P = 0.014) were significantly associated with publications after conference presentations.

Conclusion:

The conversion rate of conference presentations of neuroanesthesia society of India into journal publications is significantly low. There is need for neuroanesthesia community of India to work together to improve the translation of presentations into publications.
Assessment of Professional Nursing Governance on Nurses in a Multi-Cultural Setting in the Kingdom of Saudi Arabia
Authors: Qasim Abdiqani , Alghamdi Khalid Suhail , Lalithabai Diana Selvamony , Hababeh Mohamad Omar , Ammar Wael Mohamad
Published: July 2022

Background:

Health-care institutions constantly strive to enhance the care environment and promote staff satisfaction. Engaging nurses through shared governance helps achieve these institutional goals.

Aim:

This Saudi study aimed to assess the current status of professional nursing governance on nurses at King Fahad Medical City, Saudi Arabia.

Methodology:

A cross-sectional study was conducted with 247 nurse participants chosen by the convenience sampling technique. Data were collected using the Index of Professional Nursing Governance tool.

Results:

Staff nurses practiced the first level of shared governance with a mean score of 196.9 ± 49.7, showing they had primary decision-making responsibilities. The dimension with the lowest score was 'goal-setting and conflict resolution' (19.6 ± 6.12). Years of nursing experience was a statistically significant (P = 0.002) factor in governance.

Conclusion:

Nurse participants practiced shared governance in their given setting. However, their below-par score for “goal-setting and conflict resolution” underscores the need for professional development.
Nonalcoholic Steatohepatitis-Induced Hepatocellular Carcinoma
Authors: Hakami Abdulrahman Mohammed , Elmakki Erwa
Published: July 2022

The incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)-related cirrhosis is globally increasing, especially among communities with sedentary lifestyles. NASH-related liver cirrhosis is an emerging etiology of liver cancer. Given the increasing rates of obesity and the other risk factors of NAFLD/NASH such as diabetes mellitus, dyslipidemia, hypertension, and metabolic syndrome, NASH-related liver cancer will remain a challenging disease in the coming decades. Recent reports have shown that NASH also can cause hepatocellular carcinoma (HCC) directly without causing liver cirrhosis, the so-called noncirrhotic liver cancer. Furthermore, the pathogenicity of noncirrhotic HCC caused by NASH is not well understood and needs more future research. In the present time, NASH-related HCC has become one of the leading indications of liver transplantation. However, as the major risk factors of NASH are controllable, NASH-related HCC is a potentially preventable condition.
Surgical Management of Complex Odontoma Associated with Impacted Tooth
Authors: AlAhmari Manea Mousa
Published: July 2022

Odontomas are a type of mixed odontogenic tumor made up of mineralized ectomesenchymal tissue. Odontomas are divided into two categories by the World Health Organization: complex and compound. They are commonly observed in regular radiography tests and can be caused by a variety of factors. They are, however, rarely linked to impacted teeth. Through a clinical case report, this study attempts to highlight the clinical and histological aspects of this rare dental tumor. In the present case report, a 28-year old male patient visited with a complaint of impacted anterior tooth and swelling. After a thorough clinical and radiological examination, it was decided to excise the growth by curettage. On histological investigation, the tissue was diagnosed with complex odontoma. One-year follow-up of the case revealed excellent healing with no sign of recurrence.
Educational intervention to improve knowledge, attitude, and practice of pharmacovigilance among resident doctors at a tertiary care hospital
Authors: Hingorani Sadhana Keshav , Shah Awani Yogesh , Mehta Chaitali Dharmendra
Published: July 2022

Background:

Physicians, residents, interns, pharmacists, and nurses, as major health-care providers, bear a great deal of responsibility for reporting adverse drug reactions (ADRs). Resident doctors are the backbone of health-care system; hence they play a significant role in detecting and reporting ADR, particularly for hospitalized patients, as they are in contact with a patient and available round the clock.

Aims and Objective:

Hence, the purpose of this study was to assess the knowledge, attitude, and practice (KAP) regarding Pharmacovigilance among resident doctors and to improve reporting of ADR by training resident doctors for filling the ADR reporting form. Material: This was a prospective, cross-sectional, questionnaire-based study.

Materials and Methods:

A prevalidated, structured KAP-relatd questionnaire was given to resident doctors before and after the educational intervention at a tertiary care teaching hospital. Pre- and post test questionnaires were then compared and statistical analysis was applied using McNemar’s test and paired t-test.

Result:

A total of 151 resident doctors submitted the pre- and post questionnaires. The study result depicted that resident doctors lacked the knowledge in reporting the ADRs. Post educational training, resident doctors inclined a positive attitude toward reporting ADRs. KAP among resident doctors has improved significantly as a result of the educational intervention.

Conclusion:

The present requirement in India is to motivate the residents through continuous medical educations and trainings in order to enhance the importance of Pharmacovigilance practice.
Changes of lower urinary tract function after robot-assisted radical prostatectomy: An urodynamic follow-up within 1 year
Authors: Jiang Yuan-Hong , Kuo Hann-Chorng
Published: July 2022

ABSTRACT

Objectives:

This study investigated the changes of lower urinary tract function after robot-assisted radical prostatectomy (RaRP) with 1-year urodynamic follow-up.

Materials and Methods:

Clinically localized prostate cancer patients receiving RaRP were prospectively enrolled. We analyzed their clinical symptoms, stress urinary incontinence (SUI) and urge urinary incontinence (UUI) status, and videourodynamic studies (VUDSs) during the postoperative 1st year.

Results:

In total, 74 patients were enrolled with a mean age of 69.4 ± 8.1 years, a mean total prostate volume of 34.7 ± 15.9 mL, a ≥pT3 stage proportion of 37.8%, and a positive surgical margin rate of 18.9%. The International Prostate Symptom Score significantly reduced from 7.3 ± 6.0 before surgery to 4.1 ± 4.1 at postoperative 1 year. Significantly increased full sensation, reduced detrusor voiding pressure, increased maximal urinary flow rate, and decreased bladder outlet obstruction index were noted at 1-year VUDS follow-up. The changes of VUDS parameters were significantly different between the patients with and without preoperative bladder outlet obstruction. At postoperative 1 year, 8.1% and 6.8% of patients experienced SUI and UUI, respectively. In multivariate analysis, the factors of T stage ≥3, preoperative detrusor overactivity (DO), and positive surgical margin were the independent predictors of immediate SUI and SUI at 3 and 12 months, respectively.

Conclusion:

During the 1st year after RaRP, patients experienced significant changes of lower urinary tract function demonstrated in VUDS with the improvement in clinical symptoms. Factors of T stage ≥3, preoperative DO, and positive surgical margin were the predictors of postoperative SUI.
Fine properties of solutions to the Cauchy problem for a fast diffusion equation with Caffarelli–Kohn–Nirenberg weights
Authors: Bonforte Matteo , Simonov Nikita
Published: July 2022

We investigate fine global properties of nonnegative, integrable solutions to the Cauchy problem for the fast diffusion equation with weights (WFDE)

u_t=|x|^\gamma\operatorname{div}(|x|^{-\beta}\nabla u^m)

posed on

(0,+\infty)\times\mathbb{R}^d

, with

d\ge 3

, in the so-called
good fast diffusion range

m_c<m<1

, within the range of parameters

\gamma, \beta

which is optimal for the validity of the so-called Caffarelli–Kohn–Nirenberg inequalities.

It is natural to ask in which sense such solutions behave like the Barenblatt

\mathfrak{B}

(fundamental solution): for instance, asymptotic convergence, i.e.

\|u(t)-\mathfrak{B}(t)\|_{\mathrm{L}^p(\mathbb{R}^d)}\xrightarrow{t\to\infty}0

, is well known for all

1\le p\le \infty

, while only a few partial results tackle a finer analysis of the tail behaviour.
We characterize the maximal set of data

\mathcal{X}\subset\mathrm{L}^1_+(\mathbb{R}^d)

that produces solutions which are pointwise trapped between two Barenblatt (global Harnack principle)
, and
uniformly converge in relative error
(UREC), i.e.

\mathrm{d}_\infty(u(t))=\|u(t)/\mathcal{B}(t)-1\|_{\mathrm{L}^\infty(\mathbb{R}^d)}\xrightarrow{t\to\infty}0

. Such a characterization is in terms of an integral condition on

u(t=0)

.

To the best of our knowledge, analogous issues for the linear heat equation,

m=1

, do not possess such clear answers, but only partial results. Our characterization is also new for the classical, nonweighted FDE. We are able to provide
minimal rates of convergence
to

\mathcal{B}

in different norms. Such rates are almost optimal in the nonweighted case, and become optimal for radial solutions. To complete the panorama, we show that solutions with data in

\mathrm{L}^1_+(\mathbb{R}^d)\setminus\mathcal{X}

, preserve the same “fat” spatial tail for all times, hence UREC fails and

\mathrm{d}_\infty(u(t)) = \infty

, even if

\|u(t)-\mathcal{B}(t)\|_{\mathrm{L}^1(\mathbb{R}^d)}\xrightarrow{t\to\infty} 0

.
A variational approach to frozen planet orbits in helium
Authors: Cieliebak Kai , Frauenfelder Urs , Volkov Evgeny
Published: July 2022

We present variational characterizations of frozen planet orbits for the helium atom in the
Lagrangian and the Hamiltonian picture. They are based on a nonlocal Levi-Civita regularization
in Barutello, Ortega and Verzini (2021) with different time reparametrizations for the two electrons
and lead to nonlocal functionals. Within this variational setup, we deform the helium problem to
one where the two electrons interact only by their mean values and use this to deduce the existence
of frozen planet orbits.
The impact of gender diversity on digital reporting in the USA
Authors:   University of Petra, Shehadeh Esam , Alkayed Hani ,   University of Petra, Aly Doaa ,   University of Gloucestershire
Published: July 2022

This study aims to examine the impact of gender diversity on the digital reporting practices of non-financial U.S. firms listed on the S&P 500 index. Our results confirm the proposed hypothesis, indicating that the presence of female board members improves the levels of digital reporting. This could relate to the thought that gender diversity may correspond to more extensive discussions within the boardroom, which leads to better-informed decisions based on greater levels of information exchange both between the board and other stakeholders and amongst board members themselves. Our findings provide evidence for policy makers that gender diversity enhances online disclosure and thus, the transparency of the firm. The findings can be used, also, by corporate governance institutions to raise awareness of the advantages of having female members on the board. Our study contributes to the body of literature on both gender diversity and corporate online disclosure by providing new evidence that gender diversity on the board can improve digital reporting.