bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Directed Learning Readiness among Undergraduate Nursing Students in a Nursing Campus
Authors: Suyal Sunita , Pandey Apsara
Published: January 2025

Background: Self-directed learning is an instructional strategy, in which learners exercise a great deal of independence in setting learning goals and deciding what is worthwhile learning as well as how to approach the learning task within a given framework. The dynamic and complex patient care environment requires nurses to embrace the concept of self-directed learning. The study aimed to identify the readiness for self-directed learning among undergraduate nursing students.
Methods: A descriptive cross-sectional study design was used to conduct the study among 151 undergraduate nursing students. The stratified proportionate random sampling technique was used to select the sample from the total population. Self-Directed Learning Readiness Scale which is a self-administered, validated standard tool for Nursing Education was used to collect data. The duration of data collection was 2nd February 2023 to 24th February 2023. Data were analyzed by using descriptive statistics such as frequency, percentage, and mean, and inferential statistics such as chi-square.

 

 

Results: The mean age of the respondents was 22.4 years and almost all (97.4%) were female. Likewise, 62.9% were from Bachelor of Science in Nursing and 37.1% from Bachelor of Nursing Science. Most (81.5%) had heard about Self-directed learning. The majority of the respondents (66.9%) had a high level of self-directed learning readiness and 33.1% of respondents had a low level of self-directed learning readiness. Similarly, among the three domains, self-control has the highest mean score 58.66 ± 6.61. The level of self-directed learning readiness was significantly associated with age (p=0.029), academic program (p=0.002), and academic year (p=0.010).
Conclusions: The nursing students have self-directed learning readiness. Age, academic year and academic program were statistically significant with the readiness level for self-directed learning.
UNLOCKING CREATIVITY THROUGH COMICS ENHANCING STORY RETELLING SKILLS AMONG ISLAMIC UNIVERSITY STUDENTS USING ENGLISH COMICS
Authors: Mukhlisin
Published: January 2025

This study explores the use of English comics as a tool to enhance story retelling skills among Islamic university students. The research employs a mixed-methods approach, combining quantitative and qualitative data to assess the effectiveness of comics in improving students' language proficiency. Sixty undergraduate students from an Islamic university participated in the study, with 30 students in the experimental group using English comics and 30 students in the control group following traditional text-based methods. Results revealed that the experimental group exhibited a significant improvement in their story retelling skills, as measured by pre-test and post-test assessments. The use of comics fostered higher engagement, creativity, and motivation, with students reporting that the visual and textual elements of comics facilitated better comprehension and narrative recall. Observations and interviews further highlighted the positive impact of comics on students' participation and their ability to construct coherent, creative retellings. This study underscores the cognitive and affective benefits of comics as a multimodal learning tool, providing valuable insights for educators seeking innovative methods to enhance language learning. The findings suggest that integrating comics into language curricula can significantly improve language skills, particularly in the areas of storytelling and narrative construction, while offering an engaging and culturally relevant learning experience. Future research is encouraged to explore the long-term effects and broader applications of comics in language education.
Storage Optimization at PT XY Using Class Based Storage and FSN Analysis Methods
Authors: Aditya Septian , Dahda Said Salim
Published: January 2025

This research aims to make the process of picking goods according to their type easier, so that the distance of transporting materials is shorter than the previous distance. FSN Analysis classifies goods based on the frequency of demand, and Class Based Storage groups goods based on their category (FSN) and places them in strategic locations in the warehouse. In this research, changes to the warehouse layout were made manually based on the results of the FSN analysis and the application of the Class Based Storage method. The results of the FSN Analysis are 7 types of Fast moving category goods, 6 types of Slow moving category goods, and 2 types of Non-moving category goods. FSN analysis is made by sorting all frequencies of goods from the highest value, as well as cumulative calculations and frequency percentages. By comparing the initial layout with the proposed layout, data processing results in a total decrease from IDR 6.558.992,00/ month to IDR 3.825.480,00/ month, or 41,7% more efficient by using the proposed layout based on the Class Based Storage method and FSN Analysis reduce moment material handling 42%. Therefore, it can be concluded that the problem of storing goods in PT XY's warehouse will be solved if using a storage optimization policy that uses the Class Based Storage method and FSN Analysis as a review and reference material in arranging future storage layouts.
Regulatory Analysis Of Renewable Energy Use Strategies In Indonesia: A Review
Authors: Purba Ester Nugraheny Natalia , Irianto Chairul G.
Published: January 2025

This article discusses developments in the use of renewable energy in Indonesia, identifies the obstacles faced, and offers innovative solutions for managing renewable energy in this country. The aim of the research is to increase awareness of researchers, policy makers and investors about Indonesia's great potential in the field of renewable energy, as well as increasing capabilities in its use. This research seeks to provide new insights to policy makers for future decision making, in achieving the target of renewable energy use of up to 31% by 2050 in accordance with the General National Energy Plan (RUEN). This research uses a qualitative descriptive method to analyze conditions for the use of renewable energy, readiness, obstacles, and solutions that support the achievement of RUEN goals. By referring to the latest scientific literature, government poli-cies, and regulations, this article seeks to explain the relationship between renewable energy sources, energy policies, and relevant strategies to advance the use of renewable energy in Indonesia. The findings indicate that the government faces a significant challenge in aligning the energy mix target by 2050 with the current realization. Insufficient regulations and lack of research and development of renewable energy technology may also contribute to this challenge.
Evaluation of Flexible Pavement Using the 2017 Bina Marga Method Study on Darul Hikmah Street, Terong Tawah, Labuapi District
Authors: Fariyadin Adiman , Efendy Anwar , Silviana Salwa
Published: January 2025

Flexible pavement utilises asphalt as a binding agent. The pavement layer transmits and distributes the weight from the road or flexible pavement uniformly onto the compacted subgrade. Damage to flexible pavement results from a confluence of multiple connected factors. The purpose of the study is to ascertain the thickness of flexible pavement layers and the various forms of flexible pavement. This research employs the 2017 Bina Marga approach, utilising predicted LHR data over the design life or LHRT, to ascertain the kind and thickness of flexible pavement layers, considering the CESA4 and CESA5 values. The 2044 LHRT value for Passenger Cars and Other Light Vehicles is 33,358.7; Class 5A is 6.2; Class 5B is 4.1; Class 6A is 17.1; Class 6B is 39.1; and Class 8 or non-motorized vehicles is 280.1. The CESA4 value derived from the LHRT value was 4021566.47, whereas the CESA5 value was 469755.421. The most preferred type and thickness of flexible pavement is asphalt with a granular foundation layer, namely AC – WC pavement type at 4 cm thickness, AC – BC at 6 cm thickness, and LFA Class A at 40 cm thickness.
Cotton Industry Reform in Uzbekistan: Implications of Textile Clusters
Authors: Asfaw Etenesh
Published: January 2025

• The current government of Uzbekistan is open to major reforms in the cotton sector. An important one is introduction of cotton-textile clusters.
• Cotton clusters are expected to attract investments from private sectors and modernizations. This in return will increase productivity and resource use efficiency and speed-up value-addition.
• Clusters are also expected to improve linkage with farmers, create decent working conditions for cotton pickers, phase-out subsidies and reduce the responsibility of the state.
• An assessment of cotton-textile clusters points out that clusters improve productivity and quality of raw cotton. They provide agronomic advice to farmers and promote adoption of modern technologies.
• Nevertheless, cotton pickers continue to be mobilized through district farmers’ councils and the old state-ordered production target continues.
• The enforcement of unrealistic and overestimated production quotas is a hindrance for performance of the textile clusters.
• If the cluster approach is to be encouraged, State production targets should be eliminated and clusters themselves should manage cotton harvest in a socially responsible manner, without forced labor.
Examine the Effects of Climate Change on Forage Quality and its Subsequent Impact on Milk Yield and Composition
Authors: Mukhtar Ahmad  , Muhammad Jamil  , Saeed Ullah  , Shakirullah  , Mubarik Ali
Published: January 2025

Background: Climate change is a major threat to animal productivity because it lowers the quality of fodder, which in turn lowers milk yield and changes its composition. The connection between cow and buffalo dairy output, environmental variables, and pasture quality is explored in this research. Methods: From July 2023 through June 2024, a cross-sectional study was conducted carrying 400 animals, including 200 cows and 200 buffaloes. The mineral composition, digestibility, crude protein and fiber content of the forage were evaluated to determine its quality. The analysis focused on milk production and its constituent parts, such as fat, protein, lactose, and solids-not-fat (SNF). There was a log of feed consumption habits and environmental data (rainfall, humidity, and temperature). Findings: We found a lot of variation in the nutritional composition of the forages we looked at. Berseem had the highest levels of crude protein (17.5%) and digestibility (80.2%), whereas wheat straw had the lowest. Even while buffaloes had a higher protein and fat content (6.8% and 3.4%, respectively), cows produced more milk (12.1 ± 1.8 L/day) than buffaloes (9.8 ± 1.6 L/day). There was a positive correlation between crude protein and milk protein (r = 0.72, p < 0.001), although digestibility and yield were significantly impacted by lignin and neutral detergent fiber (NDF) (p < 0.05). Dairy output was affected by changes in fodder quality and consumption habits brought about by environmental variables. Conclusion: Climate change and forage quality have a major impact on milk production and composition. Low-quality diets restricted the performance, whereas forages like berseem and maize silage, which are high in protein and easy to digest, increase output. Sustainability of dairy output in the face of changing environmental circumstances requires adaptive measures such as climate-resilient pasture systems and precision feeding.
Penafsiran Asas Judicial Pardon Dalam Kitab Undang-Undang Hukum Pidana Baru
Authors: Robi Assadul Bahri
Published: January 2025

Asas Judicial Pardon sebagaimana diatur dalam Pasal 54 ayat (4) KUHP Baru merupakan inovasi penting dalam sistem hukum pidana Indonesia yang memberikan hakim kewenangan untuk mengesampingkan hukuman atas dasar kemanusiaan dan keadilan. Namun, ketidakjelasan kerangka penafsiran terhadap Asas Judicial Pardon memunculkan risiko penyalahgunaan kewenangan dan disparitas putusan, sehingga diperlukan panduan interpretasi yang komprehensif dan berbasis pada prinsip hukum modern. Penelitian ini bertujuan untuk menganalisis konsep, landasan hukum, dan kerangka penafsiran Asas Judicial Pardon guna memastikan penerapannya sesuai dengan keadilan substantif dan restoratif. Penerlitian ini merupakan penelitian hukum normatif dengan pendekatan peraturan perundang-undangan, konseptual, dan penafsiran hukum, yang didukung oleh analisis literatur dan dokumen hukum terkait. Hasil penelitian menunjukkan bahwa Asas Judicial Pardon memiliki dasar filosofis yang kuat dalam keadilan distributif dan restoratif, serta potensi besar untuk mendukung sistem hukum yang lebih humanis dan inklusif. Pendekatan sistematis dan kontekstual diperlukan untuk menjaga konsistensi Asas Judicial Pardon dengan prinsip hukum lain dalam KUHP Baru, sementara pendekatan preskriptif menyediakan pedoman praktis yang dapat digunakan hakim untuk menilai setiap kasus secara objektif, akuntabel, dan transparan. Implikasi penelitian ini adalah perlunya penyusunan pedoman interpretasi resmi oleh Mahkamah Agung dan pemahaman komprehensif bagi hakim untuk mengoptimalkan penerapan Asas Judicial Pardon. Selain itu, transparansi dalam putusan pengadilan yang melibatkan Judicial Pardon serta pemantauan dan evaluasi penerapan Asas Judicial Pardon perlu dilakukan secara berkala. Dengan langkah-langkah ini, Asas Judicial Pardon dapat berfungsi sebagai instrumen penting dalam reformasi hukum pidana, mendukung terciptanya sistem peradilan yang responsif terhadap nilai-nilai kemanusiaan, dan mendorong harmoni sosial yang berkelanjutan.
Pemanfaatan Limbah Cangkang Telur Sebagai Pupuk Organik Pada Tanaman Berbuah Di Desa Kuranji Kabupaten Lombok Barat
Authors: Nikhla Fitriyah  , Nining Purwati  , Meilinda Pahriana Sulastri
Published: January 2025

People often underestimate egg shell waste, even though egg shell waste contains many benefits, one of which is that it can be used as organic fertilizer for plants. Egg shells contain the nutrients calcium, magnesium and phosphorus which are really needed by fruit-bearing plants so that the fruit is healthy, dense and does not rot quickly. The aim of implementing this community service is to provide understanding to the community about the importance of processing egg shell waste into useful products such as organic fertilizer to increase environmental awareness. The method for implementing community service activities located in Kuranji Village, Labuapi District, West Lombok Regency is by explaining the process of making organic fertilizer from egg shells. The results achieved are that people become more concerned about the environment by starting to collect egg shell waste and use it as fertilizer and can find out the contents and benefits of egg shells. There are 3 ways to make fertilizer from egg shells that can be useful for fruit-bearing plants, namely the first is using egg shells that have been mashed using a blender, then the second way is to use boiled water from eggs, and the last is mashed egg shells mixed with vinegar. along with water and then sprinkle it on the plants. The plants used as examples are tomatoes, chilies and bananas.
Penguatan Literasi Sebagai Bagian Gerakan Literasi Perpustakaan Masjid Pada Masjid Haramain Desa Tratak Lombok Tengah
Authors: Draditaswari Silka Yuanti , Hairul Hidayah  , Baiq Rofina Arvy  , Anjar Aprillia Kristanti  , Liska Novianti Paramitaswari
Published: January 2025

The low reading interest in Indonesia presents a significant challenge, particularly among children. The National Literacy Movement (GLN) initiated by the goverment, aims to foster a culutre of literacy across various domains, including mosques. Mosques, as centers of Islamic community activites, hold substantial potential to support literacy movements through their libraries. This community engagement program was conducted at the Haramain Mosque Library in Tratak Village, Central Lombok, which demonstrates considerable potential to become a hub for childrens literacy. Initial observations revealed limited book collections and a lack of literacy activites in the library. The program aimed to establish structured literacy development by providing engaging reading materials, organizing the library environment, involving literacy ambassadors, and implementing a 15-minute reading program before Qur’anic lessons. The program outcomes showed an increase in children’s reading interest, despite challeenges such as prioritizing Qur’anic lessons. The program outcomes showed ann increase in children’s reading interest, despite challenges such as prioritizing Qur’anic learning time. This initiative had a positive impact on fostering reading habits and enhancing the mosque’s role as a community literacy center. The sustainability of the literacy program requires improvement htrough reading materials, optimizing technology, and fostering collaboration with relevant stakeholders.
Peningkatan Motivasi untuk Melanjutkan Pendidikan Melalui Pengabdian Berbasis Service Learning di SMAN 8 Mataram
Authors: Muhamad Farhan Maulana  , Inaz Putri Kamila  , M. Sagos  , Qomari Auliyah  , Istiqomah Virginia  , Ahmad Dani  , Agus Kurnia
Published: January 2025

Quality education is one of the important sustainable development goals in the progress of a region. Statistical data shows that the participation rate of 7-24 years old in Mataram City in higher education is 12.99%. This figure is still far below the national gross participation rate that continues to higher education, which is 31.45%. To increase students' motivation in continuing their education, role models are needed for them to share their experiences. Therefore, this activity aims to support efforts to improve the quality of inclusive and equitable education in Mataram City to ensure lifelong learning opportunities for all students and motivate them to continue to higher education. This service program is carried out with a service learning approach through counseling, training, and mentoring to students at SMAN 8 Mataram. The implementation method includes several stages, namely: preparation of materials, inclusive learning implementation training and introduction of learning technology for students to encourage independent and collaborative learning. The results of this activity show an increase in students' understanding of the concept of inclusive education as well as an increase in student motivation to participate in lifelong learning activities.
Distribusi Temporal Aves dan Kualitas Perairan di Daerah Persawahan Jempong Barat, Kota Mataram
Authors: Muhamad Zulhariadi  , Riri Septia Hariyani  , Baiq Nita Diniati  , Baiq Nita Diniati
Published: January 2025

Rice field areas that are the habitat of several types of water birds that make up the ecosystem continue to decline in several urban areas including Mataram City. Therefore, it is important to conduct routine observations every year on the diversity of birds that inhabit the rice field areas of Mataram City and its surroundings. This study aims to calculate the temporal distribution of birds in the Jempong Barat Rice Field Area, Mataram City along with its environmental parameters. This type of research is descriptive explorative with a roaming method to observe birds and measure environmental parameters of water quality in rice fields. The results of the study showed that there were 7 species of rice field birds and 3 of them were aquatic birds (wetland). The time most often found birds was in the morning. The Bird Diversity Index is in the medium category (H '= 1.68) and the quality of rice field waters generally meets water quality standards.
Analisis Karakteristik Morfologi Famili Zingiberaceae di Desa Segara Katon, Kecamatan Gangga Kabupaten Lombok Utara
Authors: Moh. Fauzan Azima  , Sofiyatur Rahmah  , Firman Ali Rahman
Published: January 2025

Zingiberaceae is a long-lived terna, the characteristic of this family is the rhizomes that have an aromatic odour, have rhizomes that enlarge like tubers and have thick roots, and usually have spaces filled with volatile oils. Zingiberaceae is better known to the public as ginger-ginger plants and has been used as a spice and traditional medicine. This study aims to inventory the Zingiberaceae family in Segara Katon Village, North Lombok Regency, NTB. The methods used in this study were observation and exploration methods with data collection techniques using simple random sampling. This type of research is descriptive qualitative. The results found as many as 3 genus namely Curcuma, Kaemfperia, and Zingiber which include Curcuma zeodaria, Curcuma longa, Curcuma xhantorhiza, Kaempferia galanga, and Zingiber officinale. Ginger-ginger plants are also able to treat several diseases such as flu, indigestion, asthma, wounds and others. Apart from being a medicine, ginger-ginger plants are also often used as a spice.
Keanekaragaman Tumbuhan Paku Di Kawasan Twa Kerandangan Kabupaten Lombok Barat
Authors: Hidiyatul Fithi  , Siti Diana Fathia  , Hasan Basri  , Ervina Titi Jayanti
Published: January 2025

Taman Wisata Alam Kerandangan adalah salah satu kawasan konservasi yang terletak di desa Senggigi, Lombok Barat. Lanskap eksotis dan beragam flora maupun fauna menjadi ciri khas yang membedakan taman wisata ini. Jenis penelitian yang digunakan adalah penelitian deskriptif kualitatif, bertujuan untuk mendapatkan data dan informasi yang berisi penjabaran terkait keanekaragaman tumbuhan paku di kawasan TWA Kerandangan. Teknik pengambilan sampel menggunakan metode jelajah kombinasi dengan plot, yaitu dengan menjelajahi kawasan TWA dari halaman depan menuju air terjun Goa Walet dan membuat plot ukuran 5m x 5m untuk setiap stasiun tempat pengambilan data tumbuhan paku. Teknik analisis data menggunakan metode deskriptif kuantitatif, yaitu menghitung INP dan H´ tumbuhan paku yang didapatkan, and documentation. Hasil penelitian menunjukkan bahwa terdapat di kawasan TWA Kerandangan. Hasil penelitian menunjukkan bahwa terdapat13 jenis tumbuhan paku antara lain Adiantum raddianum C. Presl, Christella dentata (Forssk.) Brownsey & Jermy, Cystopteris fragilis (L.) Bernh., Elaphoglossum crassifolium (Gaudich.) W.R. Anderson & Crosby, Microsorum pustulatum (G.Forst.) Copel., Nephrolepis biserrata, Odontosoria chinensis (L.) J.Sm., Platycerium bifurcatum C.Chr, Polypodium vulgare, Pteridium aquilinum (L.) Kuhn, Pteris biaurita L., Pteris ensiformis Burn., Selaginella sp. Berdasarkan hasil analisis data didapatkan INP stasiun 1 didominasi oleh C. fragilis (63,17%), C. dentata (51,03%), dan A. raddianum (45,95%). INP stasiun 2 didominasi oleh jenis P. aquilinum (56,14%), dan INP pada stasiun 3 didominasi oleh E. crassifolium (97,57%) dan Selaginella (53,22%). Nilai indeks keanekaragaman tumbuhan paku di TWA Kerandangan membuktikan bahwa keanekaragaman jenis tumbuhan paku dari setiap stasiun termasuk ke dalam kategori sedang dengan nilai 1,0 < H´ < 3 dimana H´ pada stasiun 1 ialah 1,70, stasiun 2 yaitu 1,69, dan stasiun 3 yaitu 1,24.
Non-Clinic Blood Pressure Measurement – More Light, Less Darkness
Authors: Vinay Kapur
Published: January 2025

Non-clinic blood pressure measurements are very important in confirming diagnosis of hypertension and they give us an idea of associated cardiovascular risk more precisely than clinic BP measurements. It can detect masked hypertension and white coat hypertension & ABPM especially can monitor night-time BP diagnosing individuals with nocturnal hypertension.  Masked hypertension and nocturnal hypertension are strongly related with target organ damage along with enhanced morbidity and mortality due to cardiovascular causes. ABPM can also measure early morning rise of BP, mean 24 hour BP, diurnal variation as well as average real variability. Home BP monitoring by patients themselves leads to their greater involvement in maintaining BP records and in achieving treatment goals. The purpose of this review is to preferentially discuss role of non-clinic BP monitoring in making accurate diagnosis and deciding treatment of hypertension that might help a great deal in reducing morbidity and mortality associated with it.       
Asian Journal of Medical Sciences Vol.10(1) 2019 13-18
Clinicoradiological profile of interstitial lung disease in rheumatoid arthritis
Authors: Paramita Bhattacharya  , Susmita Ghosh  , Sarbani Sengupta  , Angira Dasgupta  , Kaushik Ghosh  , Bhaskar Ghosh
Published: January 2025

Background: The burden of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients in resource limited countries like India is often under-reported. This study was conducted to find out the clinicoradiological profile of ILD in patients with RA in India.
Aims and Objectives: (1)To find out the frequency of Interstitial Lung Disease (ILD) in Rheumatoid Arthritis (RA) (2) To correlate the clinical findings with those of radiological(Chest x-ray & HRCT Thorax) and pulmonary function tests including Spirometry, TLCO (Diffusing capacity of the Lung for Carbon monoxide/DLCO Corrected for alveolar volume i.e., DLCO/V) Estimation.
Materials and Methods: Thirty consecutive patients of RA (with or without pulmonary symptoms or signs) who fulfill the American Classification of Rheumatology criteria1987 were selected from the patients attending the General Medicine OPD (Rheumatology Division) of B.R. Singh Hospital during the study period regardless of being on any medications for RA. This was a cross-sectional, descriptive study. Results were tabulated in Microsoft office excel worksheet and descriptive statistics were expressed as means, standard deviations (SD) mean for continuous normally distributed data and as percentages. Statistical software SPSS version 19.0 was used for data analysis. Unpaired t test (for continuous data)/Chi square test (for proportion) was used for comparing cases and controls.
Results: The frequency of ILD in RA was 60%. Female patients with a positive rheumatoid factor had a greater chance of development of ILD.The frequency was found to be increased after the age of 40 years. Though in this study 60% of patients had restrictive pattern, 31% had obstructive and 3 % had mixed pattern on Spirometry. The patients with deforming RA had greater frequency of restrictive or mixed pattern on Spirometry. 22.22% patients had a decreased TLCO despite having normal CXR. Despite being asymptomatic12 patients had restrictive lung disease and reduced TLCO with HRCT evidence of ILD. Overall, Spirometry & TLCO are the most appropriate tests to detect restrictive lung disease in patients with RA. In fact, HRCT can show evidence of ILD even when clinical parameters and Chest X-ray are normal.On HRCT of thorax reticular pattern and sub-pleural fibrosis (UIP-Usual interstitial pneumonia) are the predominant pattern.
Conclusion: The frequency of ILD in RA is quite high. It may be recommended to use Spirometry & TLCO as screening test for detection of restrictive lung disease in patients with RA who should undergo HRCT of chest to confirm presence of ILD in a resource limited setting.
Acute abdomen due to epiploicappendagitis
Authors: Robin George Manappallil  , Della Harigovind  , Unnikrishnan Vijayamukundan
Published: January 2025

No abstract available.
Primary spinal peripheral primitive neuroectodermal tumor with acute presentation: A case report and review of literature
Authors: Abta Bachchan  , Kaushik Roy  , Suniti Kumar Saha  , Debajyoti Pathak  , Partha Ghosh  , Abhishek Nadkarni
Published: January 2025

Primary spinal primitive neuroectodermal tumors (PNET) is a rare occurrence and carries a poor prognosis. A 13-year old female patient acutely presented with pain in the thoracic region, bilateral lower limb weakness, bladder and bowel dysfunction. Clinically paraplegia with truncal weakness, lower limb deep tendon reflexes of both side were absent and planter reflexes equivocal bilaterally. Preoperative MRI of thoracic spine revealed D4-D6 extradural SOL. A D4-D5 Laminectomy and left Cortico transversectomy done. Pathological findings were consistent with PNET. The clinical, histopathological, and radiological findings of the patient are presented.
The ‘Ivy Sign’ of Moyamoya disease
Authors: Ummer Karadan  , Robin George Manappallil
Published: January 2025

Stroke is uncommon in pediatric age group. Moyamoya is a rare idiopathic disease characterized by progressive vaso-occlusion of the main blood vessels to the brain. We report a case of 13 year old female who presented with recurrent headache and transient left hemiparesis and was diagnosed to have Moyamoya disease. The ‘ivy sign’ is a characteristic magnetic resonance image finding seen in patients with Moyamoya disease.
Gentamicin induced acute hypereosinophilia
Authors: Robin George Manappallil  , Mele Chelakkoth Sabir
Published: January 2025

Gentamicin, an aminoglycoside, has been used for the treatment of severe infections by both Gram positive and negative organisms. Nephrotoxicity and ototoxicity are the common adverse effects. The patient being described had urinary tract infection for which he received gentamicin, and developed hypereosinophilia. To the best of our knowledge, this is an unreported event.
Reliability assessment of pre -post test questionnaire on the impact of a daylong clinical pharmacology workshop among medical professionals
Authors: Arunava Biswas  , Sukanta Sen  , Krishnangshu Ray
Published: January 2025

Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of a program on the participants. However, the reliability of such data collection ‘tool’ is not often judged. There is lack of evidence supporting the authentication of such research instrument.
Aims and Objective: This study was conducted to assess the reliability of prepost test questionnaire comprising MCQs, on participants attending a one-day workshop on clinical pharmacology at a teaching hospital in eastern India.
Materials and Methods: Pre and post test questionnaire comprising 15 MCQs covering different aspects of ‘Good Clinical Practices’ on which several presentations were later delivered by experts were distributed to (n=42) participants in a one-day oriented workshop within stipulated time period and their feedback were collected and statistically analyzed after the workshop was over.
Results: The average number of MCQs attempted in the pretest questionnaire was 12.42 and in posttest were 14.44 by the participants. The workshop participants increased their percentage of correct answer score from an average of 48.4 in pretest to a statistically significant 88.73 in posttest (p<0.0001).
Conclusion: Pre/post questionnaire could be effective and reliable tools in meeting stipulated learning objectives and help in assessing the aftermath of an educational program.
Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery
Authors: Indra K. Shrestha  , Yong Yu Si  , Jian Ping Tao
Published: January 2025

Tranexamic acid is widely used as an antifibrinolytic drug to reduce blood loss intraoperative and postoperative time periods as well as to reduce transfusion of allogeneic blood. After releasing in the market, multidisciplinary surgeries have wide use of tranexamic acid due to its antifibrinolytic effect to reduce bleeding and transfusion of blood. In literature, there were mentioned a few adverse effects like thromboembolism, seizure, anaphylactic reaction, etc which are still unsolved questions to date. The aim of this review to minimize the blood loss from acute bleeding in different situations by updating the doses used in a different clinical scenario,since the release of tranexamic acid. It also gives an idea about appropriate doses to reduce blood loss, need for blood transfusion, minimize adverse effects and to understand the wide scope of application of TXA to date.
Investigation of Borrelia burgdorferi antibodies in patients with multiple sclerosis
Authors: Nilay Ildız  , İbrahim Halil Özerol  , A. Cemal Özcan  , Hamit Çelik
Published: January 2025

Background: Lyme is a disease that is non-compulsory in our country and whose seroprevalence data is less studied.
Aims and Objective: Recent studies have shown that bacterial and viral infections are risk factor for various neurodegenerative diseases such as multiple sclerosis and Alzheimer’s disease. Herein, we aim to determine the seroprevalence of Lyme in multiple sclerosis (MS) patients. For this purpose, 100 MS patient’s serums were investigated for Borrelia burgdorferi IgM and IgG positivity.
Materials and Methods: The results identified with ELISA as positive antibody was confirmed by Western Blot (WB) test. The correlation between ages, gender, occupation, tick history, existence of erythema chronicum migrans (ECM), antibody positivity, pain, year with MS results were investigated using Kolmogorov-Smirnow and Kruskal-Wallis statistical test.
Results: B. burgdorferi IgM and IgG antibodies were positive in 8% patients when using ELISA method, but that were found to be 2% by WB. ELISA IgM antibody test gave a 5 negative result in WB. These results were considered false positive in the ELISA test. So, altogether 5 patients were positive by WB method. None of syphilis positive samples detected that B. burgdorferi positive serum. A significant difference between the parameters in terms of IgM positivity was not detected (p> 0.05). B. burgdorferi IgG antibodies were found significant differences between the MS disease duration (p = 0.03). MS in the group of less than 10 years had higher titers of IgG antibodies to B. burgdorferi.
Conclusion: Although a small number of patients with MS is positive with Lyme antibodies. Lyme disease is a treatable.Also, If the patient is MS, clinician should be considered Lyme in the differential diagnosis. This is the first study that the correlation between Lyme and MS from Turkey.
Determining the angle of femoral torsion and association with shaft length and mid circumference
Authors: Subodh Kumar Yadav  , Sanjenbam Arun Chandra Singh  , Renu Yadav
Published: January 2025

Background: Angle of femoral torsion has an anatomical variation based on sex, geography, ethnicity and occupation and concludes various impact factor on determining the angulation as well as the length of the bone.
Aims and Objective: Thus, present study is aimed to determine the angle of femoral torsion in Nepalese population.
Materials and Methods: This is a cross-sectional study carried out at the Department of Anatomy, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Of the total 60, unpaired and unknown gender, dry femora were collected during one year period and separated as right sided (n=30) and left sided (n=30) according to the standard anatomical landmarks. Measurement of angle was done by Kingsley Olmsted method and the length, mid-circumference by measuring tape.
Results: The angle of torsion in dry femora (n=60) for right (16.73± 3.095) and left (16.67± 2.963) side were recorded. The mean shaft length, mid circumference for right sided femora were recorded as 39.367±0.9185 and 7.933 ± 0.6661cm respectively. The mean shaft length and mid circumference were 38.917± 0.8914 and 7.933 ± 0.5833cm respectively for left sided femora. Differences (ATF, p=0.932, LF, P=0.059, MCF, P=1) of variables between right and left femora were analyzed and correlation of angle of femoral torsion with shaft length and midshaft circumference (ATF vs MCF, p= 0.571 and LF, p=0.153) was done.
Conclusion: Documenting the femoral angle of torsion with shaft length, midshaft circumference in normal dry femora of cadaver is of great importance for Orthopedic surgeons since it provides a knowledge for planning the hip surgeries.
Strategic lockdown and blessing variation – potential success keys against COVID-19
Authors: Koutilya Bhattacharjee  , Suvajit Saha  , Emili Banerjee  , Partha Ganguly
Published: January 2025

Background: COVID-19, a respiratory illness, has become a pandemic originating from the Wuhan city of China. Earlier, similar diseases like Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome had caused mass mortality in different parts of the globe. Therefore, a similar new disease was of great concern for the humankind. However, it is observed that COVID-19 has a differential rate disease prevalence and mortality among the countries.
Aims and Objective: This disease has already affected 2.4 million people globally, leading to healthcare disasters, financial meltdowns due to worldwide lockdowns. Our objective was to evaluate the effect of lockdown in India and to characterize the functional implications of genetic variations of SARS-CoV-2 (the causative virus).
Materials and Methods: Epidemiological data for COVID-19 was taken from WHO and other national or international bodies to evaluate the prevalence of the disease in different countries. A statistical modeling was done to estimate the probable number of COVID-19 affected persons with or without lockdown. Bioinformatic analyses were done to identify mutational variations of SARS-CoV-2 and their functional implications.
Results: Statistical modeling predicted that number of COVID-19 case could be much higher without lockdown in countries. Countries with malaria and dengue prevalence are less affected by COVID-19. Bioinformatic analyses revealed presence of an Indian SARS-CoV-2 SP1 variant with lesser capability of human receptor binding.
Conclusion: Lockdown and deliberate testing has played key important role in prevention of disease transmission. Indian variant of SARS-CoV-2 with less affinity towards human receptor may have a role for lesser virulence.
Henoch-Schonlein Purpura with hematochezia in an adult patient
Authors: Robin George Manappallil  , Pradeep Kumar  , Thushara Anand
Published: January 2025

Henoch-Schönlein purpura (HSP) is a self-limiting vasculitic disease, commonly seen in children. It is characterized by palpable purpura, arthritis, hematuria and abdominal pain. Hematochezia is an uncommon symptom. The patient being reported is an adult male who presented with vomiting, abdominal pain and hematochezia, followed by appearance of palpable purpura and arthritis. He was diagnosed to have HSP. Hematochezia as one of the initial presentations of HSP in adults is an uncommon scenario.
Pre-analytical, analytical, and post-analytical considerations while processing samples of COVID-19 patients: Perspective from a clinical chemistry laboratory in India
Authors: Saswati Das  , Bidhan Chandra Koner
Published: January 2025

Background: Since its detection in December 2019 in the city of Wuhan, China, the COVID-19 pandemic has grappled the world. Laboratories have been central in the diagnosis, prognosis and therapeutic monitoring of COVID-19 patients. With this pandemic spreading, laboratory personnel have become vital in the efforts to halt the advance of the virus.
Aims and Objective: In this article, we will address various concerns in all the three phases of testing of the COVID-19 blood and serum samples in a clinical chemistry laboratory and discuss the issues pertaining to a resource-limited setting.
Materials and Methods: International, national and regional guidelines on bio-safety and operational management available at the time of preparation of this manuscript were analyzed. Additionally, literature search through PubMed was done on the keywords “bio-safety”, “pre-analytical”, “analytical”, “post-analytical” and “COVID-19”.
Results: The pre-analytical, analytical, post analytical, general management problems we faced in our laboratory and the best practices that we followed to address the same has been included in this paper.
Conclusion: Some unprecedented challenges the laboratories have encountered during this outbreak are maintaining the lab safety of highest standards, management of human resource while sustaining the quality of testing. Laboratories will have to constantly innovate in order to meet the demands of this outbreak.
Direct genital manipulation is rare a manifestation of childhood gratification behaviour below 5 years of age: A case series
Authors: Biswajit Biswas  , Sumanta Laha  , Archan Sil  , Mousumi Das  , Shibnath Mondal  , Raveesh Kumar  , Priyanka Biswas  , Santi Sarkar
Published: January 2025

Childhood masturbation/self-gratification behaviour means self-stimulation of the genitals by an immature child. Literature on this topic is scarce and scattered. Though most of the paediatricians seem to know about this entity, precise knowledge on spectrum of different behavioural patterns these children may show is lacking. Masturbatory activity in infants and young children is difficult to recognise because it often does not involve manual stimulation of the genitalia at all. We hereby report a series of 3 cases of childhood masturbation where direct genital manipulation, a very rare manifestation, was evident during gratification spells.
The New Normal in Dentistry after COVID-19 Outbreak
Authors: Amit Tirth  , Md Nazamuddin Tafadar  , Ravishankar Lingesha Telgi  , Monika
Published: January 2025

The outbreak of SARS-COV2 responsible COVID-19 disease created a worldwide health emergency. After its first case was accounted for in 2019, 31st December by World Health Organization in Wuhan city of china, and afterward spreading in different nations, with India surpassing cases even the inception nation as on twentieth of May 2020. The WHO declared the disease as pandemic way back and countries over the world adoptinglockdown and contact tracing to limit the contagion. The virus transmits person-to-person predominantlythrough respiratory routes through direct contact, droplets and possibly aerosols. Because of the unique nature of practice in dentistry, most procedure generate significant amount of aerosols and droplets, posing a possible risk of infection transmission. Understanding the concern of risk of transmission in dental practice, this literature is aimed to discuss the possible risk associated with practice and aim to raise awareness of the same with preventive measures especially after the lockdown end in day to day practice.
Knowledge, attitude and preventive practices related to novel Coronavirus Infection (COVID-19) among patients attending dental hospital in Dharwad
Authors: Hema Tyavanige Shekarappa  , Kruthika Satyabodh Guttal  , Varuni Iyer  , Vani Gupta  , Preeta Shetty
Published: January 2025

Background: The Novel Coronavirus Disease 19 (COVID-19) is one of the deadly diseases declared as pandemic by WHO. The managing strategies include prevention of spread of the infection and awareness regarding the preventive practices, which are very vital in preventing the exponential spread of the disease. Despite the rolling commentary over telephone calls and advertisements at every desk, public is too negligent over this global threat.
Aims and Objectives: The present questionnaire based study was aimed to assess the knowledge, attitude and preventive practices existing among the public to face the pandemic.
Materials and Methods: The present study was a cross-sectional questionnaire based study using a convenience sampling method. The patients attending the outpatient section of the Oral Medicine department of a Dental Hospital for various dental complaints were interviewed by telephonic conversation. Patient’s knowledge and awareness regarding the prevailing situation created by the media was assessed.
Results: Seventy-seven point seven percent of the participants were following the preventive practices. They had an average attitude towards the prevention of spread of infection (52.4%) and considering COVID-19 as a serious infection (51.8%). Younger population, professionals and females had an overall better Knowledge, Attitude and Practices.
Conclusions: Majority of the assessed population had a sound knowledge about the pandemic. Certain key issues like visiting the hospitals only for emergencies needs to be emphasised by health care professionals to prevent the spread of the disease.
A rare consortium of functional neurological disorder and Fahr’s disease - a herald of extensive calcification
Authors: Alka Chauhan  , Sunny Garg
Published: January 2025

Fahr’s disease is also known as familial idiopathic basal ganglia calcification affecting the cerebral microvessels and presenting with numerous neuropsychiatric manifestations. Functional neurological disorder (FND), a pure neuropsychiatric phenomenon occurs rarely in Fahr’s disease. Herein, we have presented a case of 17 year old female presenting neuropsychiatric symptoms like pseudoseizure, left sensorineural deficit and mild headache for last 4 months. Mental status examination revealed impaired attention and concentration. Laboratory examinations were within normal limits except CT scan and MRI Brain which revealed bilateral and symmetrical basal ganglia calcification. This is a rare case of FND associated with Fahr’s Disease, never reported in the literature. This case highlights the need for evaluating the biological factors in causation of FND where psychological factors were not assessed.
Epidemiology of traumatic spinal cord injury in Nepal: A systematic review
Authors: Bikash Parajuli  , Khagendra Acharya  , Dipak Shrestha
Published: January 2025

Spinal cord injury (SCI) leads to disabling condition. In Nepal the nationwide statistics of incidence and prevalence of SCI is still unclear which demands a systematic examination of crucial epidemiological aspects of SCI. An electronic search was conducted on PubMed, Ovid EMBASE, Cochrane Library and Google Scholar. Clinical studies investigating epidemiology of spinal cord injury were included. A narrative synthesis of the data that comprised 1796 patients was conducted. Males comprised 73%, and the mean age varied from 32 to 47 years. The two leading causes of SCI were falls (60%) and accidents (17%). Most patients had incomplete neurology (AIS grade B, C and D = 42%) followed by AIS A grade (36.3%). Cervical injury (37.4%) was the most common level of injury. Mortality during hospital stay was low (1.98%) whereas after rehabilitation was high (24.32%). The review contributes in understanding epidemiology of SCI in Nepal which is expected to help in planning for prevention and management.
The Use of ACE inhibitor/ARB in SARS-CoV-2 Patients: A Comprehensive Narrative Review
Authors: Timotius Ivan Hariyanto  , Karunia Valeriani Japar  , Vika Damay  , Felix Kwenandar  , Novia Lauren Sieto  , Andree Kurniawan
Published: January 2025

The three most common comorbidities that are associated with increased mortality in COVID-19 patients are Hypertension, Diabetes, and Cardiovascular disease, Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARB) are the drugs most commonly prescribed for the management of these diseases. Recent experimental study in animals and humans have found that SARS-CoV-2 uses ACE2 as the receptors for entry. Moreover, in an animal study, the use of ACE inhibitor/ARB increases the level of ACE2 expression that can lead to increased SARS-CoV-2 infectivity. On the other side, some evidences suggest that the ACE2 receptor is not necessary for SARS-CoV-2 entry into the cell and suggested that there is a cofactor that play part. Experimental studies in humans also showed that there is no association between ACE inhibitor/ARB with SARS-CoV-2 infectivity and mortality. In conclusion, there is still insufficient data to stop the use of inhibitor/ARB in SARS-CoV-2 patients. Therefore, we suggested that in line with the recommendations from ESC and AHA/ACC, the use of these two drugs in SARS-CoV-2 patients with cardiovascular comorbidity should still be continued.