bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis and management of cases of ectopic pregnancy in a tertiary care centre: our experience
Authors: Mehta Anushka S. , Patel Riya R. , D. Shah Parav
Published: April 2024

Background: Ectopic pregnancy is a leading cause of maternal morbidity and mortality. With our study, we aim to highlight the importance of risk factors and effect of clinical presentation on the management modalities of ectopic pregnancy and study changing trends of modern management from radical surgical methods to medical and laparoscopic management of ectopic pregnancies.
Methods: This prospective study was undertaken at a tertiary care hospital between May 2021 and May 2022.
Results: The most common age group of presentation was 26-30 years. The most common risk factor was history of previous abortion. Amenorrhoea and abdominal pain were the most commonly encountered symptoms in this study. Cervical motion tenderness was significantly associated with ruptured ectopic pregnancy. Conservative medical management with injection methotrexate (Mtx), which was successful in 50% cases. Success rate was 100% for laparoscopic management and 100% for laparotomy in this study. No maternal mortality was observed during the present study.
Conclusions: Our hospital being a tertiary centre, had to manage a number of cases as surgical emergencies by laparotomy and not conservatively, as they brought in either diagnosed cases of ruptured ectopic pregnancy, or failure of medical management. It is important that in the face of this diagnostic dilemma, all physicians should be should maintain a high level of suspicion and be sensitive to the fact that in the reproductive age group any woman presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be considered irrespective of the presence or absence of amenorrhea or tubal sterilisation.
The study of the correlation between international ovarian tumour analysis classification, risk of malignancy index and clinicopathological findings of adnexal masses
Authors: Kelagade Mahadev , Thakur Ruchi N. , Deshmukh Sonali
Published: April 2024

Background: Adnexal masses of ovarian origin are of growing concern these days due to high fatality associated with ovarian malignancy because they are diagnosed at advanced stage due to vague symptoms and absence of recommended screening tests. The present study aimed to assess the prediction potential of IOTA classification and RMI to clinicopathological findings of adnexal masses and calculate the sensitivity and specificity of same.
Methods: This was a prospective observational study carried out on 96 non pregnant women presenting with adnexal mass to gynaecology OPD of a tertiary care hospital from 2020 to 2022. They were evaluated preoperatively with complete history, examination, ultrasound, and tumor markers. IOTA score and RMI was calculated for all patients. Following surgery, histopathology results were compared with preoperative evaluation. Statistical Analysis was done.
Results: Mucinous cyst adenoma was the most common benign ovarian tumour, serous cystadenocarcinoma being the most common malignant ovarian tumour. Patients with malignancy were older and mostly postmenopausal. IOTA was found better than RMI with higher sensitivity 98.5% and high PPV 98.5%. Similarly, IOTA had higher specificity 91.7% and higher NPV 91.7% for identifying and prediction of benign patients.
Conclusions: IOTA guidelines to describe sonographic features of adnexal masses have shown a high sensitivity and specificity for prediction of malignancy in adnexal masses and is a more reliable diagnostic tool over RMI tool for differentiation between benign and malignant adnexal masses.
Study of obstetric and fetal outcomes associated with maternal perception of decreased fetal movements in third trimester
Authors: Padore Ishaan S. , Jinturkar Anagha A.
Published: April 2024

Background: Prevalence of decreased fetal movement in third trimester has been reported as 4-15% in various studies. Association between maternal perception of decreased fetal movement and poor perinatal outcome like fetal growth restriction, oligohydramnios, fetal distress, preterm births, fetal congenital anomalies, and stillbirth are revealed in different studies. However, decreased fetal movements may sometimes cause unnecessary anxiety to pregnant women or clinicians leading to unnecessary interventions. Keeping this background, we planned to assess the significance of decreased fetal movement perception in third trimester of pregnancy and its correlation with the perinatal outcome.
Methods: A prospective observational study was carried out at a tertiary health care center B. J. Government Medical College, Pune for a period of 12 months (October 2021-October 2022). Study included 150 mothers with decreased fetal movement in the third trimester. These mothers were monitored till delivery by Repeat fetal movement count, cardiotocography (CTG), ultrasonography (USG), biophysical profile (BPP) and Doppler studies. Mothers were investigated for identification of ante-natal risk factors and their mode of delivery was noted. APGAR score of neonates at birth, birth weight and requirement of neonatal intensive care unit (NICU) admissions were also noted.
Results: Study observed that most of these females were primi-mothers belonging to lower socio-economic class. Oligohydramnios, obesity, gestational diabetes and anemia were observed as common risk factors. Emergency caesarean section was required in one out of five cases while one fourth of these mothers delivered pre-term. Most common neonatal complication observed was intra-uterine growth restriction. Mortality rate was 2%.
Conclusions: We thus conclude that mothers with reduced fetal movements are a risk group and should be referred immediately. Overall outcome was good in these babies, when given optimum institutional care.
Use of Panicker’s cannula in management of atonic postpartum hemorrhage
Authors: Rana Vaidehi , Patel Alpesh , Patel Vipul
Published: April 2024

Postpartum hemorrhage (PPH) is leading cause of maternal mortality worldwide. Panicker’s cannula creates negative pressure inside the uterus that causes shrinking of the uterus which can assist the physiological process of contraction and retraction to stop atonic postpartum hemorrhage. It is safe and simple technique to prevent and treat PPH. It can be used in low-resource and primary care settings, where even para medical personnel can use this method effectively to prevent morbidity and mortality. This can also be used in non-PPH conditions. In this study total 20 women with singleton pregnancy (14 had vaginal delivery and 6 underwent cesarean section), who developed atonic postpartum hemorrhage were included in the study. Panicker’s cannula was used in the patients, in whom bleeding was not stopped despite using uterotonics. Cessation of complete bleeding was observed in all 20 women within 4 minutes, which was associated with contraction and firm retraction of the uterus. Amount of the blood in bottle ranged from 150-250 ml. Vacuum retraction of uterus assists in the normal physiological process of contraction and retraction. This simple and cost effective technique, takes very little time to stop bleeding. This lifesaving technique is useful in all settings especially in low resource settings.
Insights into neoadjuvant chemotherapy efficacy for stage 1B3 locally advanced cervical cancer: case series
Authors: Gupta Sumedha , Gupta Ratika , Shamsunder Saritha
Published: April 2024

Cervical cancer remains a leading cause of mortality among women worldwide, particularly in developing nations. While radical surgery is the established standard of care for early-stage disease, pelvic relapse post-surgery remains a concern. Neoadjuvant chemotherapy (NACT) preceding radical surgery has emerged as a promising approach, aiming to reduce tumor burden and improve surgical outcomes. We present three cases of stage 1B3 cervical cancer treated with three cycles of NACT repeated three weekly followed by radical hysterectomy. Post-operatively two patients received radiotherapy (External beam radiotherapy and brachytherapy) and one patient got lost to follow-up for 6 months and did not receive post-operative radiotherapy now under observation and regular follow-up. All the patients exhibited significant tumor reduction following chemotherapy, enabling successful surgical intervention. All patients remained in remission post-treatment. NACT showed effectiveness in reducing tumor size and facilitating successful radical surgery in patients with stage 1B3 cervical cancer. Our case series highlights the potential of NACT followed by radical surgery as a promising therapeutic strategy for stage 1B3 cervical cancer. NACT facilitated successful surgical intervention with favourable outcomes. Further research is warranted to elucidate the optimal patient selection criteria and the long-term benefits of this approach in improving survival rates and quality of life for cervical cancer patients.
Maternal near miss mortality: indication of maternal care
Authors: Ali Maryam , Prabhakar Manju , Sai Kuracha Anjani
Published: April 2024

Maternal mortality is one of the important indicators used for the measurement of maternal health. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death.  The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely haemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health. Here we are presenting case series of near miss mortality cases reported in Muzaffarnagar medical college.
The effect of hypokalemia in pregnancy on fetal heart rate
Authors: Febriani  , Nofiandi Riki
Published: April 2024

Hypokalemic myopathy can cause anything from weakness and numbness to total paralysis. The cause could be acquired or congenital. It is distinguished by low potassium levels (<3.5 meq/L) and severe muscle weakness. We present a case of 30-year-old multigravida at 31 weeks of gestation with malnourished condition, who came with acute onset of weakness of both legs. She was diagnosed to have hypokalemic paralysis with potassium levels of 1.5 meq/L. The medical profile remitted promptly on intravenous potassium replacement. Pregnancy was continued till 37 weeks with oral potassium supplements and regular monitoring of serum potassium levels.
Sertoli-Leydig tumor in a 17-year-old girl: a case report
Authors: Robergeau Fridjof S. G. , Massena Larry M. , Nazaire Maky-Kenson , Gilles Bernard , Millien Christophe
Published: April 2024

Sertoli-Leydig tumors of the ovary are rare. They can affect women in all age groups but are more frequent in the first three decades. No case of Sertoli-Leydig cells tumors has been reported in the Haitian literature. We present a case of a 17-year-old teenage who was seen in the outpatient clinic of the Mirebalais teaching hospital for: amenorrhea, change in voice and hair loss. After our evaluation and the completion of certain assessments, the clinical impression of a stromal and sexual cord tumor was retained, which guided us to perform a laparotomy. We conclude that in the management of this type of case, it is important to take into account the desire to preserve the patient's subsequent fertility and if there is one point that should not be overlooked, it is the psychosocial repercussions of the pathology before and after its treatment.
Open surgical retrieval of ovarian migrated intrauterine contraceptive device: a case report
Authors: Bobo Temidayo I. , Popoola Adetomilola K. , Duke-Aluko Gloria A. , Ano-Edward Gbemi H. , Bakare Tola Y.
Published: April 2024

Intraovarian migration of intrauterine contraceptive device (IUD) is a rare complication, only few cases have been reported. Arguably any reported case in Nigeria to best of knowledge. The patient was Mrs. S.I, a 29-year-old primiparous presented with a 6-hour history of abdominal pain, the pain was said to be sudden in onset pain associated with vomiting. She used an IUD for contraception for about 2 years prior to her presentation. The physical examination showed a patient with good hemodynamic and ventilatory status. Abdominal and vaginal examination revealed marked tenderness at suprapubic and left iliac region, with positive cervical excitation and left adnexal tenderness respectively. Provisional diagnosis of acute pelvic inflammatory disease was made, empirical broad spectrum antibiotic therapy commenced, pelvic scanning done revealed a hyperechoic structure, likely intrauterine device, perforating the uterine fundus and extending into the left ovary. Subsequently, she had laparotomy and the removal of the device. She did well post-surgery and was discharged home to follow in the clinic on the third day after surgery. Intraovarian migration of IUD is one of the rare complications of the device. High index of suspicion with radiological imaging support is necessary in making the diagnosis in a woman of reproductive age group with IUD in- situ regardless of the visible IUD string or not.
De novo late postpartum preeclampsia: a case report with review of literature
Authors: Hota Basanta Manjari , Anusha N. S. Sai , Sneha Guguloth , Devisri Yallamandala
Published: April 2024

De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertension of ≥140/90 mmHg with features of organ system malfunctioning during 48 hours to six weeks of delivery following a normotensive pregnancy and labor. Though a lesser studied condition it is responsible for more number and increased severity of maternal morbidity, mortality, and cause of post-delivery hospital admission. Its exact cause is not yet clearly defined. The incidence is 0.3-27% as noted by many authors. Patients usually present on day 7-10 with severe headaches, neurological symptoms like visual disturbances; symptoms of other organ involvement, and high blood pressure. High suspicion leads to diagnosis. Primary investigations include that for preeclampsia. The principle of management is the reduction of blood pressure, prophylactic anticonvulsants, and diuretic is considered if there are features of fluid overload. She needs constant monitoring. Post delivery women, after discharge, do not avail of home blood pressure monitoring and even the symptoms, to start with are treated with over-the-counter medication. This leads to worsening of the condition. Our patient, a primipara reported to this hospital on the 38th day of normal vaginal delivery following a normotensive pregnancy and delivery, with features of preeclampsia. The aim of publishing this case is for statistical records and create awareness of the condition. Every postpartum woman on discharge from the hospital following a normotensive pregnancy and delivery must be counseled on the significance of home BP monitoring and must consult an obstetrician on developing any new symptoms.
Successful outcomes of a monoamniotic twin pregnancy discordant for anencephaly
Authors: Swain Sujata , Jena Paresh Kumar
Published: April 2024

Mono amniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence. 29-year-old primi gravida was diagnosed with mono amniotic twin one baby anencephaly and other baby normal at 14 weeks of gestation during NT scan. Patient was counselled regarding selective termination & expectant management outcomes. They wanted to continue the pregnancy with expectant management. She developed pregnancy induced hypertension around 30 weeks which was managed by oral labetolol. Caesarean section was performed at 36 weeks of gestation, with first baby normal & second baby Anencephaly. The normal newborn infant was discharged from SNCU without any complications. Expectant management of a mono amniotic twin gestation discordant for anencephaly diagnosed at the first trimester is associated with a favourable outcome for the unaffected foetus.
A rare presentation of caesarean scar pregnancy: a case report
Authors: Manku Harpoonam , Nivetha B. , Jyothi
Published: April 2024

Caesarean scar pregnancy (CSP) or retained products of conception is a rare but life-threatening complication. It is an abnormal implantation of the gestational sac or retained products of conception into the myometrium and a fibrous scar after a previous caesarean section. The incidence of such cases is on the rise due to the increase in caesarean sections worldwide. A 37-year-old P2L2A1 (two previous caesarean sections and one spontaneous abortion followed by dilation and curettage) presented with complaints of vaginal bleeding and lower abdominal pain. She was diagnosed as a case of CSP with retained products of conception by ultrasonography and confirmation of the diagnosis was done by magnetic resonance imaging. An exploratory laparotomy was performed and the patient was successfully managed. Treatment must be individualized depending on the patient's hemodynamic profile, size, extent, depth, and vascularity, caesarean pregnancy, future fertility wishes, and compliance for follow-up.
Female sexual dysfunction: a review
Authors: Kaundal Asmita , Renjhen Prachi
Published: April 2024

Sexual health is an important aspect of human life and to maintain a healthy and happy sexual life a positive integration of physical, social as well and psychological domains is very important. Any alteration in any of these domains can lead to sexual dysfunction which can significantly affect the quality of life of a couple. Many couples live with the problem and suffer silently due to shyness, stigmas, and social norms related to the issue. Many times even the treating medical professionals also do not screen for the sexual issues due to inadequate knowledge and training related to sexual dysfunction further increasing the burden of the disorder which remain undiagnosed. Sexual dysfunction can affect both men and women. Since the sexual cycle is complex in women both diagnosing and treating the female sexual dysfunction can often be challenging. Routine screening, meticulous workup and multidisciplinary approach is usually required to diagnose and mange sexual disorders.
Comparison of response and toxicity of induction chemotherapy with cisplatin and 5-fluorouracil versus cisplatin and paclitaxel followed by concurrent chemoradiotherapy in advanced head and neck cancer
Authors: Islam Towhidul , Alam S. M. Nazmul , Robbi M. Fazle
Published: April 2024

Background: Head and neck cancer poses a prevalent oncological challenge in Bangladesh, often diagnosed in advanced stages. Standard treatment for inoperable cases involves concurrent chemo-radiotherapy, but induction chemotherapy has shown significant benefits. This study aimed to compare the response and toxicity of induction chemotherapy with cisplatin and 5-fluorouracil versus cisplatin and paclitaxel followed by concurrent chemo-radiotherapy in advanced head and neck cancer.
Methods: From January 2019 to June 2020, a multicenter study enrolled 150 cases with inoperable squamous cell carcinomas in the head and neck. Ethical approval was obtained from Bangabandhu Sheikh Mujib Medical University. Divided into two arms, Arm A had 75 patients receiving cisplatin and 5-fluorouracil, while Arm B had 75 patients receiving cisplatin and paclitaxel for three cycles.
Results: After 24 weeks of treatment, complete response rates were 53.33% in Arm A and 56.0% in Arm B, with partial response rates of 29.33% and 32.0% respectively. Overall response was 82.66% in Arm A and 88.0% in Arm B, showing no statistically significant difference (p>0.05). Arm A exhibited more anemia, oral mucositis, skin toxicity, and hand- foot syndrome, while Arm B had higher neuropathy. Hematological and non-hematologic toxicities during concurrent chemo-radiotherapy were similar in both arms.
Conclusions: Induction chemotherapy with cisplatin and paclitaxel, followed by concurrent chemo-radiotherapy, is equally effective as induction chemotherapy with cisplatin and 5-fluorouracil, followed by concurrent chemo-radiotherapy, in treating advanced head and neck squamous cell carcinoma. However, the former regimen demonstrates significantly fewer toxicities, indicating a safer treatment option.
Effect of neoadjuvant concurrent three-dimensional conformal chemoradiotherapy with conventional two-dimensional chemoradiotherapy in locally advanced rectal cancer
Authors: Alam S. M. Nazmul , Islam Towhidul , Robbi M. Fazle , Rahman M. Mahmudur , Ferdos Jannatul , Maruf M. Abdullah Al
Published: April 2024

Background: Rectal carcinoma is a prevalent clinical condition, and treatment hinges on factors like tumor specifics, staging, grading, and histopathological characteristics. While surgery remains the primary treatment, neoadjuvant chemoradiotherapy, particularly using 3D-CRT, has proven effective in reducing local recurrence rates for locally advanced cases. Alternatively, 2D-RT is considered for neoadjuvant treatment. This study aimed to compare the impact of neoadjuvant concurrent three-dimensional conformal chemoradiotherapy with conventional two-dimensional chemoradiotherapy in the context of locally advanced rectal cancer.
Methods: In this multicentre quasi-experimental study, 60 patients with biopsy-proven adenocarcinoma and clinically confirmed locally advanced rectal cancer, were divided into Group A (receiving oral capecitabine with three-dimensional conformal radiotherapy) and Group B (receiving the same capecitabine dose with 50 Gy two-dimensional radiotherapy). After surgery within 6-12 weeks, outcomes were analysed.
Results: After neoadjuvant chemoradiotherapy, clinical complete response rates were 16.7% in Group A and 10.0% in Group B, with a higher pathological complete response in Group A (10.0% vs. 3.3%). Tumor downsizing occurred in 83.3% of Group A and 73.3% of Group B, and sphincter-sparing surgery was achieved in 73.3% of Group A and 56.7% of Group B. Grade 2 toxicities included anemia (10.0% vs. 13.3%), leucopenia (13.3% vs. 20.0%), diarrhoea (10.0% vs. 16.7%), proctitis (13.3% vs. 40.0%), and urinary toxicity (10.0% vs. 20.0%). Grade-1 toxicities were nausea (20.0% vs. 40.0%), vomiting (20.0% vs. 36.7%), mucositis (56.7% vs. 60.0%), hand-foot syndrome (33.3% vs. 40.0%), and urinary toxicity (43.3% vs. 56.67%), with significant proctitis in Group A (p=0.012). Other toxicities showed non-significant p-values (>0.05).
Conclusions: Tumour response was not statistically significant between the patients of concurrent 3D-CRT and 2D-RT Arms. But the patients of 3D-CRT arm showed better response arithmetically. Also, there was an observable significant reduction of toxicities (lower gastrointestinal) in the 3D-CRT arm.
Assessing the acceptability and usability of digital interventions for pregnancy health
Authors: Damse Sneha , Gupta Manvi
Published: April 2024

Background: Despite the promising potential of digital interventions to enhance maternal health outcomes, there is a lack of comprehensive exploration into their real-world acceptability, usability, and effectiveness among pregnant women. This study was conducted to evaluate the acceptance and usability of digital interventions among pregnant women to gain insights into real-world applications.
Methods: The study enrolled fifteen pregnant women (ages 20 to 40 years) using an online application between November 2022 and May 2023. Data collection comprised a usability survey, and statistical analysis employed descriptive statistics and Chi-square tests.
Results: Significant variations in age (mean 29.33 years) and gestational age (mean 13.80 weeks) were observed (p<0.001). Ease of use received positive ratings (73.3% found it easy; p=0.071), with no participants finding it difficult (p<0.001). The introduction to the application was well-received (p=0.004). Monitoring utilities were deemed helpful by 73.3% (p=0.071), with strong agreement from 26.7%. App engagement was high, with 86.7% disagreeing it was boring and 13.3% strongly disagreeing with the same (p=0.020). Motivational impact for a healthy diet was endorsed by 80% (p=0.091), and medication adherence support by 93.3% (p=0.015). Recordkeeping ease was significant (80% agreement; p=0.247). Notably, 86.7% remained active users after 30 days, with no dropouts (p<0.001).
Conclusions: This pilot study suggests that digital interventions can positively influence maternal health, offering valuable insights for their integration into healthcare strategies.
Prominent early adulthood hyperferritinemia in scrub typhus
Authors: Naskar Sayan , Chaudhuri Bhaskar Narayan , Basak Amrita , Guchhait Partha , Das Satadal
Published: April 2024

Background: Scrub typhus is an acute infectious disease, caused by Orientia tsutsugamushi. It is endemic to a geographically distinct region of Japan, Taiwan, China, and South Korea, known as the tsutsugamushi triangle, as well as in Nepal, Pakistan, and Papua New Guinea. In India, the incidence of this disease varies from 4-46% with high morbidity and mortality.
Methods: In this cross-sectional study at a tertiary care hospital in Kolkata, India we analysed ferritin blood levels along with different demographic and laboratory test parameters of 60 suspected scrub typhus patients who were also scrub typhus IgM antibody positive during a one-year study period.
Results: It was found that serum ferritin levels were unusually high in 21-40 years age group patients along with mildly increased urea and creatinine levels. Other important findings were below 40 years of age males were mostly affected, but above 40 years of age, females were generally affected. Haemoglobin and platelet levels were normal in all age groups. Although WBC count and neutrophils were normal in the 21-40 years age group, in other age groups increased levels were observed.  CRP, SGPT, and SGOT levels were uniformly high above 20 years of age. Electrolytes were mildly decreased.
Conclusions: It appears that oxidative stress-induced acute kidney injury may be an important reason for the rising ferritin levels in the 21-40 years age group. These important findings may be helpful to clinicians in management of these patients.
Clinical disease activity index versus disease activity score (28 joints) for assessment of disease activity in obese patients of rheumatoid arthritis
Authors: Saxena Sarthak , Kundu B. K.
Published: April 2024

Background: Measurement of disease activity by Disease Activity Score 28 joints -Erythrocyte Sedimentation Rate (DAS28-ESR), Disease Activity Score (28 joints)-C-Reactive Protein (DAS28-CRP), and Clinical Disease Activity Index (CDAI) has become an integral part of management of Rheumatoid Arthritis (RA), by ‘Treatment to Target’ approach. With the exception of CDAI, the other two use inflammatory markers ESR and CRP to measure disease activity. Obesity is also known to increase inflammatory markers like CRP. We undertake this study to examine if obesity confounds the disease activity measurement in RA leading to overestimation of disease activity.
Methods: A cross-sectional observation study was conducted on one hundred patients of RA (40 obese and 60 non obese) in remission or low disease activity as defined by CDAI. They were divided into obese and non-obese groups based on Indian standards (BMI>25kg/m2). ESR and CRP were measured in both the groups. DAS28-ESR and DAS28-CRP were calculated and compared using relevant statistical tests.
Results: DAS28-ESR and DAS-28-CRP scores were significantly higher in the obese subjects, despite both groups having comparable CDAI scores. Similar findings were also observed with inflammatory markers ESR and CRP, both being higher in obese patients.
Conclusions: We conclude that indices incorporating inflammatory markers, like DAS28 overestimate disease activity in obese RA patients. Treatment decisions regarding escalation or addition of DMARDs should be taken after considering the same. CDAI appears to be better suited for disease activity measurements in obese RA patients as compared to DAS 28.
A study of potency determination of 3C antimuonium crudum in the treatment of corn
Authors: Kumar Rekha , Prajapati Aarti , Prajapati Pooja
Published: April 2024

Background: Planter skin is anatomically different from the normal skin of the body due to prominence of keratin filaments such as k6, k7, k9, k16 and k17. As per Hahnemann statement in chronic disease, Antimuonium crudum is basically the native ore (persulphuric of antimony) found in blocks of parallel block needle with a metallic lustre and are composed of twenty-eight parts of sulphur combined with 100 parts of metallic antimony.
Methods: An observational comparative prospective open label study was conducted from September 2019 to September 2020. 32 patients were included in the study. Follow up of the cases were done after every 15 days where the size of the corn was measured using a vernier caliper. Height, width and diameter of the corn was also measured pre and post-treatment to analyse the results.
Results: A total of 32 patients were studied. The size of the corn was considerably reduced after taking the medication. There was a significant reduction in the intensity of the pain due to corn after medication as well.
Conclusions: There is a significant reduction of disease intensity score, after the homoeopathic treatment. Which shows the efficacy and potency of 3C Antimuonium crudum in the treatment of corn.
Robotic intersphincteric resection of low rectal cancer versus laparoscopic intersphincteric resection of low rectal cancer
Authors: Alotaibi Ahmed Z.
Published: April 2024

This systematic review evaluated and compared the two currently available intersphincteric resection techniques (robotic and laparoscopic intersphincteric resection) for low rectal cancer, with the final aim of comparing associated factors between the two techniques. The assessed factors included surgical duration, hospital stay, complications, overall survival, local recurrence, and low anterior resection syndrome (LARS). A literature search of the search engines “PubMed”, “SCOPUS”, and “Web of Science” was conducted, with a time interval set between 2015 and 2023. The initial search yielded 57 studies, of which 10 met the inclusion and exclusion criteria. Hence, data was extracted from only these 10 studies. The average reported robotic surgery time varied between 197 and 472 mins, while the laparoscopic surgery time varied between 240 and 325 mins. Conversely, the overall survival and local recurrence rates were 89.7% and 6.7% for robotic and 87.9% and 6.2% for laparoscopic resection, respectively. In addition, complications were reported in 16.5% and 18.2% of robotic and laparoscopic resection cases, respectively. This systematic review showed that although the surgery duration is longer in robotic resection compared to laparoscopic resection, the former technique is associated with lower rates of complications and local recurrence, and improved overall survival. In addition, few studies have reported on the prevalence of LARS; therefore, we recommend that this field be studied and included in the reported data of the upcoming studies to allow more conclusive evidence regarding prevalence of LARS among the two groups of intersphincteric resections.
Hepatitis A and cryptogenic cirrhosis of liver: a case series
Authors: Narang Nisha , Dhanju Avtar S. , Rikhye Rishabh , Kaur Manavdeep , Singh Adab Alwinder , Jassal Pankaj
Published: April 2024

We are discussing a case series of 12 patients that presented with either compensated or decompensated chronic liver disease that were labelled as cryptogenic cirrhosis of liver after ruling out most of the known causes of chronic liver disease. They were found to be positive for hepatitis A IgG antibody. Cryptogenic cirrhosis has been attributed to various possible causes like non- alcoholic fatty liver disease, various metabolic disorders or occult viral infections. Hepatitis A virus is known to cause acute viral hepatitis. Presence of hepatitis A IgG antibodies in serum of patients with chronic liver disease may act as a clue to fill the voids in our understanding of cryptogenic cirrhosis of liver. Possibility of hepatitis A and various other viruses as potential causes of chronic liver disease needs to be explored.
A rare case of acquired hemophilia A
Authors: Gulati Shipra , Dessai Rishikesh , Chawla Kunal , Pandey Anjali
Published: April 2024

Acquired hemophilia A (AHA) is a rare bleeding disorder characterized by IgG autoantibodies directed against circulating coagulation factor (F) VIII neutralizing its coagulant function. The usual clinical presentation of AHA is spontaneous or provoked bleeding in a person with a negative personal or family history of a coagulopathy and can lead life threatening bleeding especially in older patients. Here we report a case of 54-year-old male patient presenting with blood and passage of clots in urine. He was treated with recombinant factor VII and VIII with steroid as eradication therapy. Underlying cause remained unclear in this case.
Lower limb lymphedema mimicking as elephantiasis in intravenous drug user
Authors: Aryan Shubham , Singh Mandeep , Sharma Chavi , Khutan Himanshu , Chahal Jasmeen , Kumar Naveen
Published: April 2024

India been the population of over a billion, it is estimated that 62.5 million people use alcohol, 8.75 million use cannabis, two million use opiates, and 0.6 million use sedatives or hypnotics. Intravenous (IV) drug abuse is fairly spreading throughout the country. Rapid urbanization and migration to metro cities have led to disturbance in the social life render an individual more vulnerable to stresses and strain of modern life and with easy availability of drugs, sharing needle, peer pressure are also among the commonest reason for exponential rise of intravenous drug user (IVDU) especially among the young generation. IV drug abuse is one of most serious and social evil, prevailing in our society that leads to number of infections from local cutaneous infections to dreadful like human immuno-deficiency virus (HIV) which in turn not only increase the morbidity but mortality as well. Here we have patient who had history of IV drug injection to lower limb that led to chronic lower limb swelling which on further investigation turns out to be grade IV lymphedema.
Acute mercury poisoning complicated by gastrointestinal bleeding
Authors: Bhattacharjee Manna , Mahawar Ashok K. , Paghdar Harshkumar
Published: April 2024

Mercury poisoning is a rare but potentially serious condition that can result from environmental exposure to elemental mercury. We present a case of a 22-year-young male who presented to the emergency department (ED) with symptoms of mercury poisoning after his family members brought home a vial of elemental mercury. The patient experienced nausea, anxiety, abdominal pain, diarrhea, and fever. Despite normal initial laboratory tests and imaging studies, a presumptive diagnosis of mercury poisoning was made based on the patient's history of exposure and clinical presentation. Although his hospital stay was complicated by passage of blood in stool, possibly lower GI bleed, but treatment with N-acetylcysteine (NAC) was initiated empirically, leading to resolution of symptoms and a favorable outcome. This case highlights the importance of considering mercury poisoning in patients with appropriate exposure history and the effectiveness of NAC in the treatment of acute mercury poisoning. Public education on the hazards of mercury and the importance of prompt recognition and treatment are essential in preventing severe complications associated with mercury exposure.
Tackling carbapenem resistance: ceftazidime - avibactam in contemporary clinical scenarios
Authors: Maladkar Manish , Patil Shrikant , Anchan Namita
Published: April 2024

Antimicrobial resistance poses a formidable challenge in treating severe infections, with the prevalence of extended-spectrum beta-lactamase (ESBL) - producing, Klebsiella pneumoniae carbapenemase (KPC) - producing, and multidrug-resistant (MDR) organisms on the rise. This necessitates careful consideration of various factors, including local resistance patterns, patient-specific characteristics, and drug properties, in treatment decisions for critically ill patients. Ceftazidime-Avibactam demonstrates efficacy against aerobic Gram-negative bacteria and offers a crucial advancement against carbapenem-resistant organisms (CRO) with its effectiveness against key pathogens, including ESBL, AmpC, KPC, and OXA-48-producing Enterobacteriaceae and drug-resistant P. aeruginosa. Ceftazidime-Avibactam emerges as a valuable option for critically ill patients with limited treatment choices. The drug's excellent safety profile demonstrated in clinical trials, further positions it as a crucial addition to antimicrobial treatment options. As the global threat of drug-resistant bacteria grows, Ceftazidime-Avibactam plays a pivotal role in addressing this challenge and offers a promising solution for critically ill patients facing infections caused by antimicrobial-resistant pathogens. The article delves into therapeutic efficacy and the prospective role of Ceftazidime-Avibactam in managing MDR Gram-negative organisms, underscoring the critical role of appropriate antibiotic administration in reducing mortality associated with Gram-negative infections.
A review on importance of forensic photography in investigation of drowning deaths
Authors: ali Mohammed sufiyan
Published: April 2024

Forensic photography plays an important role in solving the cases related with drowning, a proper photography of crime scene or victim/deceased helps in proper investigation, ruling out doubts and also in court room presentation. A recent report of the World Health Organization (WHO) labels drowning as one of the world's leading causes of death As police investigation continues, parallel public investigations also start which can spread rumours, misinformation and speculation. The onlookers on crime scene (including Local Media) may misinterpret the visible post mortem changes of the body of drowned victims as antemortem injuries. A clear photography using correct lighting, accurate angling, and different viewpoints of the characteristic external features like (Bluish Skin, Froth and foam, Washerwomen’s Hand, Cutis anserina, Cyanosis, Keratin loss, Cadaveric spasm) of drowned body and evidences around the crime scene will help in avoiding possible misinterpretation and public pressure on officials and also helps the medical officer in autopsy findings and in preparation of report. This article discusses the importance of Photography of drowning cases.
Discharge against medical advice (DAMA) in patients with long bone fractures at YEC: Epidemiological, clinical, evolutionary and medico-legal aspects
Authors: Ngongang Gilbert Frank Olivier , Loic Fonkoue , El Hadj Oumar Ndoye , Saidou Arabo , Conde Namoudou , Mahamed Soumah , Jean Bahebeck
Published: April 2024

Discharge against medical advice (DAMA) is a term used in healthcare establishments when a patient leaves a hospital against the advice of their doctor.

The aim of this study was to describe the epidemiological, clinical, evolutionary and medico-legal aspects of patients with long bone fractures discharged against medical advice at the Yaoundé Emergency Centre (YEC).

This was a retrospective descriptive and analytical study conducted between January 2016 and December 2022 at the YEC. All patients aged 18 years or older with at least one long bone fracture and discharged against medical advice from our study site during the study period were included. Patients were then contacted to collect the reasons for DAMA, the therapeutic itinerary, the type of treatment undertaken, direct costs, and evolutionary data. Statistical analyses were performed using SPSS version 26 software.

Six hundred and forty-seven patients were enrolled during the study period, representing a prevalence of DAMA of 45.7%. The mean age of the patients was 35.47 (± 13.86) years, and 475 (73.4%) were men. Socioeconomic status was low in 72.4% of cases. All religions and ethnic groups were represented. Road traffic accidents (RTA) were the cause of trauma in 83% of cases. The main site of injury was the tibia, in 253 (39.1%) cases. Open fractures accounted for 38.8% of cases. The median time to discharge against medical advice was 16 [6-26], , , hours, with 73.4% of DAMA within 24 hours. Lack of financial resources, the choice of traditional treatment and the preference for another hospital were the three main reasons.

In our setting, 45.7% of patients with long bone fractures initially admitted to hospital were discharged against medical advice. The type of injury was varied, with 38.8% open fractures, some of which were complex.
Формирование карьерной траектории студентов с ограниченными возможностями здоровья и инвалидностью на этапе образовательного учебного процесса в вузе
Authors: Колтунова Татьяна Владимировна , Ладыгина Ирина Александровна , Рашина Екатерина Леонидовна
Published: April 2024

Рассмотрены механизмы содействия трудоустройству выпускников образовательных организаций с инвалидностью и ограниченными возможностями здоровья, реализуемые в вузах; описаны основные мероприятия по обеспечению маршрутизации карьерного сопровождения выпускников с инвалидностью при трудоустройстве в субъектах Российской Федерации. Авторы подчеркивают значимость и необходимость карьерной поддержки выпускников с ограниченными возможностями здоровья и инвалидностью.
Социальная профилактика экстремизма в студенческой среде (по материалам социологического исследования)
Authors: Мозговая Елена Ивановна , Долженков Илья Олегович
Published: April 2024

Осуществлена попытка анализа проблемы распространения экстремистских настроений в среде студенческой молодёжи и обоснована значимость социальной профилактики как деятельности по устранению и снижению влияния факторов, способствующих формированию и проявлению экстремизма среди студентов. Установлено, что низкий уровень правовой информированности молодых людей, недостаточный жизненный опыт, неспособность проводить критический анализ ситуации, свободный доступ к системным ресурсам интернет-пространства способствуют вовлечению студентов в экстремистскую деятельность. Проведённое исследование позволило обозначить способы повышения эффективности профилактики экстремизма в студенческой среде. Вовлечение студенческой молодёжи в волонтёрскую (добровольческую) деятельность расширит сферу социального общения молодых людей, создаст возможности для усвоения положительных социальных ценностей, позволит осуществить переоценку мотивов и потребностей, что станет важным ресурсом в системе социальной профилактики экстремистских проявлений в студенческой среде.
Особенности развития спорта слепых в Белгородской области на современном этапе
Authors: Никулин Игорь Николаевич , Малахов Роман Евгеньевич , Войкина Дарья Владимировна
Published: April 2024

Целью исследования является выявление особенностей развития спорта слепых в Белгородской области на современном этапе. Выявлены основные детерминанты развития спорта слепых в Белгородской области на современном этапе. Спорт слепых в Белгородской области представлен в следующих спортивных дисциплинах: лёгкая атлетика, армрестлинг, плавание, шахматы, шашки. Определены ведущие спортсмены и команды. Установлена доля занимающихся спортсменов с нарушениями зрения в 2022 году в разрезе этапов спортивной подготовки. Наибольший процент занимающихся представлен в учебно-тренировочных группах – 34,6%. Установлена положительная динамика по количеству занимающихся адаптивной физической культурой и спортом в Белгородской области слабовидящих спортсменов после спада в 2019 и 2020 годах. Показатели 2023 года – 430 человек, впервые превысили данные 2018 года. Установлены основные проблемы, сдерживающие темпы развития спорта слепых в Белгородской области. Среди которых: отсутствие федерации спорта слепых, сложность сбора спортсменов одновременно в местах проведения тренировочных занятий; дети с серьёзным нарушением зрения обучаются в специализированных интернатах; взрослые, по окончании учебных заведений, слабо мотивированы к занятиям спортом.
Первичная заболеваемость и инвалидность вследствие болезней органов пищеварения среди взрослого населения Белгородской области в сравнительном аспекте с Российской Федерацией в динамике за 2008−2022 гг.
Authors: Урусова Марина Анатольевна , Андреева Наталья Александровна , Дмитриева Татьяна Владимировна , Чаплыгина Ольга Николаевна , Крючкова Ирина Владимировна
Published: April 2024

Представлены результаты сравнительного анализа показателей первичной заболеваемости и инвалидности вследствие болезней органов пищеварения (БОП) среди взрослого населения в Белгородской области в сравнительном аспекте с Российской Федерацией (РФ) за 15 лет (2008−2023). Определены ранговые места БОП в структуре первичной заболеваемости и инвалидности. Уровень первичной заболеваемости и инвалидности вследствие БОП за период наблюдения в Белгородской области и в целом по стране характеризовался положительной тенденцией к снижению. Контингент инвалидов формировался преимущественно за счет лиц трудоспособного возраста, инвалидов III группы.
Первые 3 ранговые места в структуре первичной инвалидности вследствие БОП занимали болезни печени, воспалительные заболевания кишечника и болезни поджелудочной железы. Выявленные особенности возрастной структуры и тенденции в динамике показателей инвалидности вследствие БОП с учетом установленных признаков регрессивности популяции позволяют прогнозировать рост уровня инвалидности, что свидетельствует о необходимости дальнейшей оптимизации оказания медико-социальной помощи и поддержки данного контингента инвалидов.
Исследование уровня удовлетворенности клиентов социальными услугами на муниципальном уровне
Authors: Жанатұлы Кенжебай Темірлан
Published: April 2024

Удовлетворенность клиентов является важнейшим показателем для оценки эффективности и качества социальных услуг. В ходе пилотажного исследования проводились замеры уровня удовлетворенности клиентов следующими видами социальных услуг: здравоохранение, включая доступность медицинских услуг, качество медицинского обслуживания и время ожидания; социальное обеспечение, (включая пособия и поддержку): оценка удовлетворенности услугами социального обеспечения, в том числе доступностью и эффективностью мер социальной поддержки; жилищные услуги, включая доступность жилья, удовлетворенность условиями проживания и государственную поддержку в решении жилищных вопросов. Для изучения удовлетворенности клиентов был проведен социологический опрос методом стандартизированного интервью (выборка типологическая по категориям получателей социальных услуг n=50, г. Кокшетау, Казахстан, 2023 г.). Из проведенного исследования удовлетворенности клиентов социальными услугами были получены следующие основные результаты: в области здравоохранения респонденты высоко оценили доступность медицинских услуг, то время как в жилищной сфере респонденты отметили недостаточность существующих мер, и бюрократизированность процедур получения социальной поддержки. По результатам исследования было сформулировано несколько ключевых рекомендаций, направленных на повышение удовлетворенности клиентов социальными услугами.