bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of the Number of Hidden Layers on The Performance of Deep Q-Network for Traveling Salesman Problem
Authors: Hanif Benzfica , Larasati Aisyah , Nurdiansyah Rudi , Le Trung
Published: November 2023

The Traveling Salesman Problem (TSP) effectively represents the complex distribution issues encountered by couriers, who must carefully plan a route that includes all customer addresses while minimizing the distance traveled. As the magnitude of deliveries and the range of destinations expand, the courier's responsibility becomes progressively challenging. In this particular context, the objective of our research is to expand the existing knowledge and explore the complete capabilities of Deep Q-Network (DQN) models in order to achieve the most efficient route determination. This endeavor can potentially bring about significant changes in the courier and delivery service sector. The foundation of our unique methodology relies on an empirical inquiry, utilizing a comprehensive dataset including 178 observations obtained from motorcycle-based package delivery agents. Our research is carefully planned and executed using a comprehensive factorial experimental design. This design incorporates three crucial factors: the number of hidden layers, episodes, and epochs. The hidden layer parameter is set to a singular level, while the episode parameter is configured to explore five levels, and the epoch parameter is designed to travel four levels. The evaluation of our DQN models' performance is conducted utilizing the MSE metric as a measure. This assessment is carried out at every iterative cycle, ensuring thorough scrutiny. The central focus of our research centers on the intricate connection between episodes and epochs, and their influence on MSE. The findings of our study reveal that the association between episodes, epochs, and errors is not statistically significant although different level of episodes and epochs produces slightly different level of error.
Stacked LSTM-GRU Long-Term Forecasting Model for Indonesian Islamic Banks
Authors: Sujatna Yayat , Karno Adhitio Satyo Bayangkari , Hastomo Widi , Yuningsih Nia , Arif Dody , Handayani Sri Setya , Kardian Aqwam Rosadi , Wardhani Ire Puspa , Rere L.M Rasdi
Published: November 2023

The development of the Islamic banking industry in Indonesia has become a significant concern in recent years, with rapid growth in the number of banks operating based on Sharia principles. To face emerging challenges and opportunities, a deep understanding of the long-term financial behavior of Islamic banks is becoming increasingly important. This study aims to predict the share price of PT Bank Syariah Indonesia Tbk, over 28 days using the LSTM-GRU stack. The observation stage includes importing the dataset, data separation, model variations, the training process, output, and evaluation. Observations were conducted using 10 model variations from 4 stacks of LSTM and GRU. Each model performs the training process in four epochs (200, 500, 750, and 1000). The results of observations in this study show that long-term predictions (28 days ahead) using four stacks of LSTM-GRU and daily training accumulation techniques produce better accuracy than the general method (using multiple outputs). From the observations we have made for predictions for the next 28 days, the model with the LGLG stack arrangement (LSTM-GRU-LSTM-GRU) produces the best accuracy at epoch 750 with an MSE LSTM-GRU 63.43762863. This study will undoubtedly continue in order to achieve even better precision, either by utilizing a new design or by further improving the technology we are now employing.
Comparison of Machine Learning Algorithms for Species Family Classification using DNA Barcode
Authors: Riza Lala Septem , Rahman M Ammar Fadhlur , Prasetyo Yudi , Zain Muhammad Iqbal , Siregar Herbert , Hidayat Topik , Samah Khyrina Airin Fariza Abu , Rosyda Miftahurrahma
Published: November 2023

Classifying plant species within the Liliaceae and Amaryllidaceae families presents inherent challenges due to the complex genetic diversity and overlapping morphological traits among species. This study explores the difficulties in accurate classification by comparing 11 supervised learning algorithms applied to DNA barcode data, aiming to enhance the precision of species family classification in these taxonomically intricate plant families. The ribulose-1,5-bisphosphate carboxylase-oxygenase large sub-unit (rbcL) gene, selected as a DNA barcode locus for plants, is used to represent species within the Amaryllidaceae and Liliaceae families. The experimental results demonstrate that nearly all tested models achieve accurate species classification into the appropriate families, with an accuracy rate exceeding 97%, except for the Naïve Bayes model. Regarding computational time, the Random Forest model requires significantly more time for training than other models. Regarding memory usage, the Least Squares Support Vector Machine with a polynomial kernel, and Regularized Logistic Regression consume more memory than other models. These machine learning models exhibit strong concordance with NCBI's classifications when predicting families using the test dataset, effectively categorizing species into the Amaryllidaceae and Liliaceae families.
A Case Study of Energy Balance of Castor Bean Cultivation in Iran
Authors: Jahannavard Sharareh , Ghorttapeh Abdollah Hassanzadeh
Published: November 2023

The production of biofuel from farm products has been promoted as a replacement for fossil fuels. Castor bean (Ricinus communis L.) is one of the best crops used to produce biodiesel. The first step toward the introduction and widespread cultivation of the crop is to investigate the energy balance and economic analysis for its production in the field. To do so, we studied the comparison of the energy balance sheet on three different planting dates and plant densities of Castor beans in the Urmia. All data, such as input and output, were converted to equal values of the consumed and produced energy, by using special formulas and indexes, after which the energy efficiency was calculated. The results of analysis of variance showed that the effect of different planting dates on energy output of biomass, grain, oil, protein yield, and their energy efficiency was significant. Energy efficiency of oil and protein yield was also affected by plant density per unit area. The interaction effect of planting date and plant density was also significant on biomass energy output and its efficiency, energy efficiency of oil, and protein yield. According to the results, in order to achieve maximum energy efficiency, it is suggested that the most desirable planting date is May 20 and the most suitable density of 16,000 plants per hectare in West Azerbaijan.
Maternal and perinatal outcome in Rh negative mothers
Authors: Sharma Mamta , Raigar Kiran , Sisodiya Jyoti
Published: November 2023

Background: Incidence of Rh negativity in India is 5-10%. Rh negative pregnancy poses a risk only when there is incompatible mating, leading to antigen-antibody reaction, and hemolysis. However, it can be prevented by adequate measures.
Methods: This prospective observational study conducted at Government Medical College hospital and J.K. Lon hospital Kota 100 women with Rh negative blood group admitted for delivery were enrolled.
Results: Mean age of study participants was 26.87 years with SD of 3.62 years and the prevalence of Rh-negative pregnancy was around 2.9. Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality.
Conclusions: Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality. Routine antenatal screening and timely management with intrauterine transfusion are lifesaving method which should be incorporated in daily obstetrics practice.
The role of carbohydrate antigen 19-9 in the clinical evaluation of mature cystic teratomas: an observational study at a tertiary care centre
Authors: Manohar Sumana , S. Shanaz Nazeen
Published: November 2023

Background: Carbohydrate antigen (CA) 19-9 is a tumour marker mainly used in the evaluation of gastrointestinal tract malignancies including pancreas, colon and biliary tract. Cases of ovarian tumours such as mucinous neoplasms have been reported to have high levels of CA 19-9. However, its role in the management of cystic teratomas (MCT) which are the most common benign ovarian tumours encountered in gynaecology, is not studied in depth in literature.
Methods:  In our study, we observed the levels of CA 19-9 in 40 patients presenting with MCT. Its association to the cyst size, contents, laterality and torsion or rupture were documented.
Results: The various clinical parameters evaluated in our study such as larger cyst size, presence of torsion and tooth as a content had a positive association with elevated CA 19-9 levels (p<0.05).  However, CA 19-9 had no significant relationship with the laterality of the cyst. Thus, CA 19-9 may serve as an important adjunct tool to ultrasonography in the management of dermoid cysts (MCT), particularly in those with larger sizes and at risk of torsion.
Conclusions: High levels of CA 19-9 can be observed in benign ovarian tumors like mature cystic teratoma (MCT) and it need not always be associated with malignancy or malignant transformation of benign tumors. Levels more than 100 IU may warrant further imaging studies to rule out gastro-intestinal pathologies. Unnecessary medical investigations or patient anxiety can be avoided in cases of moderate elevation in CA 19-9 levels.
A study on prevalence and determinants of postpartum depression among mothers: a cross-sectional study
Authors: H. Nisarga , Preethimol  , Siddiq Abubaker
Published: November 2023

Background: Postpartum depression (PPD) is a common affective disorder. It remains unrecognized and affects the health of mothers and the interpersonal relationships, mother infant bonding as well as emotional and cognitive behavior of baby. It occurs immediately or 2 to 6 weeks after delivery and may last for a year. This study aims at determining the prevalence of PPD among mothers, its associated factors and to correlate mothers age and parity in PPD.
Method: It is a cross sectional study conducted in department of obstetrics and gynecology (OBG) in a tertiary care hospital. we have enrolled one seventy-two (172) postpartum women within six months of their delivery after obtaining informed consent. Edinburgh postnatal depression scale was used for determining the prevalence. Sociodemographic and obstetrics questionnaire were given to identify associated factors and correlation between mothers age and parity.
Results: Out of 172 enrolled patients, we collected information about PPD, in our study the prevalence of PPD was 44%. Age, marital status, education of mother, occupation of mother, Occupation of husband, wealth index, social support by family, husband substance abuse, type of family, gender of baby, parity, mode of delivery, present pregnancy, sex preference of mother, infant illness, are the factors associated with PPD. Age and parity have no correlation with PPD.
Conclusions: The high prevalence rate of PPD and associated risk factors imply the need for strengthening and improving of postpartum care.
Prevalence of ecosapentaenoic acid and docosahexaenoic acid deficiency in pregnant women: a prospective observational study
Authors: Mishra Vishwa J. , Nayar Sakshi , Mansukhani Chandra , Kumar Sunita , Gujral Kanwal
Published: November 2023

Background: Docosahexaenoic acid (DHA), ecosapentaenoic acid (EPA) and alpha lineoloic acid (α-LA) are essential fatty acids of the long chain polyunsaturated fatty acid (LC-PUFA) or omega-3 fatty acid. These fatty acids are not synthesized by our body. Diets rich in LC-PUFA reduces the incidence of - preeclampsia, intrauterine growth restriction, preterm delivery, in utero fetal death and placental abruption. Objectives of the study were: to estimate the prevalence of EPA and DHA deficiency in pregnant women by omega-3 index test (O3I), and also to correlate blood levels of EPA and DHA with various socio demographic parameters.
Methods: All enrolled subjects were assessed with a pre-defined performa for their demographic and socio-economic characteristics, personal history, obstetric history, body mass index (BMI), education, diet and blood samples were tested for O3I.
Results: Result of the study indicated that 98% of pregnant women had EPA and DHA deficiency as indicated by O3I levels. This was regardless of age, parity, BMI, and socio economic status. Women consuming vegetarian diet had statistically significant lower mean and median levels of O3I as compared to the women having a non-vegetarian diet, p value <0.001, 0.004 respectively. In our entire cohort of 150 women, only 2 non-vegetarian women had sufficient O3I.
Conclusions: 98% of pregnant women across various socio economic classes had EPA and DHA deficiency as measured by O3I levels. Vegetarians had statistically significant lower levels of O3I as compared to the non-vegetarians.
A study of prevalence of anaemia in pregnant women among rural population in Rajasthan
Authors: Chaturvedi Nidhi , Verma Ashwani , Pratiksha  , Chaudhary Sakshi
Published: November 2023

Background: Anaemia in pregnancy is a major contributor in morbidity seen in pregnancy and childbirth. Prevalence of anaemia in India is still as high as 52%. Aim of the present study is to study the prevalence of anaemia and its socio demographic variables in rural population of Rajasthan.
Methods: This study was done in our tertiary care teaching institute in obstetrics and gynecology department in Rajasthan. 2384 women who came to the ANC clinic were screened for anaemia. 1442 women found anemic were enrolled for study. They were interviewed through a structured questionnaire and data thus obtained was analyzed.
Results: Prevalence of anaemia was found to be 60.4% in the study. Out of these 58.8% had mild anaemia, 39.8% had moderate anaemia, 1.04% severe anaemia and 0.2% had very severe anaemia. Maximum women were in the age group 20-24years (48.8%). A large proportion of women were from the lower socioeconomic strata 58.9%. Maximum anemic women had received primary education (63%), while 25% were illiterate and 12% received more than primary education. Prevalence of anaemia was almost similar in both primigravidas 49.1% and multigravidas 50.9%. Regular iron intake was seen in 56% women, 27.7% took iron folic acid (IFA) tablets but irregularly and 16.3% had not taken any supplements.
Conclusions: Anaemia is still highly prevalent among pregnant women in rural Rajasthan. So, there is a need for effective implementation of the existing programmes for prevention and treatment of anaemia for healthy future generation.
Interstitial ectopic pregnancy: a case series
Authors: Gnanavel Gitanjali
Published: November 2023

Interstitial ectopic pregnancy is very rare with incidence of 2-5%. Their presentation is not uniform and hence may go unrecognized till complications develop. We present three cases of interstitial ectopic pregnancies presenting in our hospital in a span of 1 year. Only one of them had pain in the abdomen at the time of presentation. All cases presented at around five to six weeks of gestation. Ultrasonography confirmed the diagnosis. One case was managed medically while in other two cases, there was a need of surgical management. There were no complications in all the cases. Thus, early presentation of cornual ectopic pregnancy results in satisfactory outcome.  Hence, all pregnant women should undergo regular antenatal checkups with early scans once the urine pregnancy test come positive to confirm whether it is an intra uterine pregnancy or not.
Urethro-cutaneous fistula: a rare complication in anti-incontinence surgery with trans-obturator tapes sling
Authors: Treviño Cavazos Omar , Guerrero Reyes Guadalupe , Gutiérrez González Adrián , Hernández Velázquez Ricardo , Loya Maldonado Karen M. , Leyva Vázquez José I. , Reyes Alcaraz Jennifer E. , Robledo Torres Alejandra , Saca Cuevas Sara Y. , Herrera Morales Juan C.
Published: November 2023

This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.
Supraventricular tachycardia at 37 weeks with electro cardioversion therapy
Authors: S. Donel , Adhar L. Munawar
Published: November 2023

The health of both the mother and the fetus is at risk when symptomatic maternal arrhythmias occur during pregnancy. Sustained symptomatic arrhythmias should be managed, much like in the non-pregnant population. The specific arrhythmia that has been identified or is suspected must be treated. Electrical cardioversion (ECV) is used to treat supraventricular arrhythmias when medication therapy and physical therapy, such as sinus carotid massage or Valsalva movements, fail or in life-threatening conditions where the patient is hemodynamically unstable. A 27-year-old primipara came to Bengkalis hospital at 37 weeks of gestation due to complaints of palpitations. palpitations felt since 4 hours before admission to the hospital. The patient had experienced the same complaint and was examined by a cardiologist who said that the patient had a tendency to arrhythmia and was given bisoprolol. An ECG examination was carried out in the emergency room, the impression was supraventricular tachycardia with HR 185 bpm, an abdominal termination of pregnancy was carried out, and the cardiologist performed electro-cardioversion (ECV) in the operating room 3 times, and the mother's HR returned to sinus rhythm. The outcome was a baby girl born with a birth weight of 3200 grams, an Apgar score of 8/9. Mother was treated and went home on the 3rd post-operative day in good condition. Provided that a multidisciplinary approach, continuous fetal heart rate monitoring and the possibility to perform a caesarean section are applied, it can be concluded that cardioversion is a safe and effective treatment for maternal tachycardia in pregnancy.
A rare case of live unruptured ovarian ectopic pregnancy
Authors: Khandhedia Parth , Sharma Karan , Joshi Ashka
Published: November 2023

Ectopic pregnancy is the implantation of embryo anywhere outside the uterus. The commonest location is fallopian tubes followed by previous scar, abdomen and ovary. Most of them terminates with rupture in first trimester and usually have an intricate diagnosis through surgery and histopathology. A lady in her early-thirties presented with brownish discharge per-vaginally with LMP 2 months ago and UPT positive 15 days ago. The scan revealed a good chorio-decidual reaction without any gestational sac in the uterus which was found live and unruptured along with the heartbeats in right adnexa. She was managed with emergency laparoscopic removal of the ectopic where the Gestational sac was not visualised in right tubes but astonishingly it was found in the right ovary. There were no complications post-operatively and patient was discharged in a stable condition. The overall increase in the incidence is admitted to IUCD, STI, ART, PID and many others. However, the actual factor remains unclear. The diagnosis is often made during surgery but histopathological confirmation is required. Spiegelberg Criteria defines the ovarian ectopic. Hence, it becomes peremptory to identify the cases early for complication prevention and the related deaths.
Navigating mixed connective tissue disease in pregnancy: a rare case report
Authors: Nannaware Dipika , Kamath Anusha , Gangane Neha , Yadav Anita
Published: November 2023

Autoimmune connective tissue diseases (CTDs) in pregnancy present a complex interplay between maternal health and fetal outcomes. While historically discouraged due to potential complications, proper preconception counselling and disease control offer the prospect of safe pregnancies. This case report focuses on mixed connective tissue disease (MCTD), a rare condition combining features of SLE, systemic sclerosis, rheumatoid arthritis, and polymyositis, presenting during pregnancy. A 29-year-old woman, gravida 2, para 1, with a history of rheumatoid arthritis, was referred at 31+4 weeks with a deranged coagulation profile, fetal growth restriction (FGR), and oligohydramnios. Extensive laboratory and imaging investigations confirmed MCTD diagnosis. Treatment involved LMWH, aspirin, hydroxychloroquine, and prednisolone. Comprehensive monitoring and multidisciplinary care were maintained throughout. Despite initial improvement, the patient faced complications at 35+3 weeks, leading to an emergency caesarean section at 36 weeks due to preterm FGR, oligohydramnios, and breech presentation. A male infant weighing 2.1 kgs was delivered, requiring neonatal intensive care due to prematurity and respiratory distress. Postoperatively, the mother resumed medication and was discharged with her baby. This case highlights successful MCTD management during pregnancy through meticulous monitoring and a multidisciplinary approach. The risk of complications necessitates informed preconception counselling, emphasizing the importance of disease remission, close surveillance, and prompt intervention in disease relapse. Comprehensive care, including medications and careful planning, contributes to improved maternal and neonatal outcomes in this rare and challenging scenario.
Caesarean scar pregnancy: diagnostic dilemma
Authors: Rajeswari K. S. Raja , M. Anushri , Shaunthani Priya
Published: November 2023

Caesarean scar pregnancy is a rare but life-threatening type of ectopic pregnancy if not accurately diagnosed on time. With increasing caesarean section rates, caesarean scar pregnancy is bound to increase. We presented a 34-year-old gravida 2 para 1 live 1, last child birth 8 years, conceived with first cycle of follicular study without ovulation induction. Patient was a known case of fibroid uterus with adenomyosis. Pregnancy confirmed with baseline serum beta HCG and small gestational sac in USG at 6 weeks 4 days. At 7 weeks 3 days in dating scan there was two tiny sac within endometrium? early intrauterine pregnancies? early pregnancy failure? pseudo gestational sacs hence serum beta HCG done. Serum beta HCG levels were suggestive of ectopic pregnancy but and feta medicine centre ultrasound was suggestive of twin gestation. Repeat transvaginal ultrasound with inhouse sinologist confirmed the diagnosis of caesarean scar pregnancy with adenomyotic changes (which probably could have been misinterpreted as multifetal gestation) and fibroid uterus. We report this case to highlight the high suspicion of CSP in previous caesarean scar pregnancy.
Case report on interstitial pregnancy in a post adenomyomectomy woman
Authors: Srivastava Archita , Gahlaut Renu S.
Published: November 2023

Intramural pregnancy is a rare form of ectopic pregnancy with early diagnosis essential for prevention of severe hemorrhage and uterine rupture. We report a rare case of an interstitial ectopic pregnancy at 09 weeks gestation in a woman 3 year post laparoscopic adenomyomectomy. 3D transvaginal ultrasound was utilized as diagnostic aids in this case. Due to the size and location of the gestational sac, and early diagnosis made this case undergo conservative surgical management saving her uterus for future pregnancy.
Role of multi-biomarkers and algorithms for diagnosis of early-stage ovarian cancer
Authors: Upadhyaya Anupama , Singh Priti
Published: November 2023

Our reviews intend to provide a comprehensive update for the diagnosis of ovarian cancer using biomarkers (CA125) and ultrasonography algorithm RMI and ROMA and how to improve our approaches to identify and diagnose ovarian cancer in early stage and improve the survival rate This meta-analysis done in the Department of Obstetrics and Gynaecology Swaroop Rani hospital Prayagraj, Uttar Pradesh. Source of literature was all the standard online articles available in last 3years and also the departmental records of the last 1year following criteria CA125, HE4, RMI, ROMA for screening or diagnosis. Our result on the basis of ODDS ratio and confidence interval (CI) of tumour marker like CA125, HE4, RMI, ROMA from different study. Overall estimation and pooled estimation determined by forest plot and our pooled estimation is present between the 0.8 OR to 1.0 OR and 95 % of confidence interval of the result. Our study concludes that RMI has comparatively good OR ratio and pooled effect of forest plot is in favour of RMI 0.8 OR to 1.0 OR and had good opportunity to identify early-stage ovarian cancer. Our study concludes that RMI score has comparatively good OR ratio and it can be used to identify early-stage ovarian cancer which can help in on time intervention and improved outcomes in such patients.
Perceived sources of stress and anxiety among Senegalese dental students
Authors: Lecor Papa A. , Gadiaga Rokhaya , Dieng Seynabou , Soumboundou Sankoung
Published: November 2023

Background: Dental studies are stressful and anxiety-provoking. The aim of this study was to assess the stress and anxiety levels of dental students at Cheikh Anta Diop university in Dakar, Senegal.
Methods: A descriptive cross-sectional study was conducted among 133 students. A general stress self-questionnaire (Perceived stress scale 14), another specific to dentistry studies and a final Spielberger anxiety questionnaire were distributed manually or electronically to students regularly enrolled in master’s 1 and 2 at the institute of odontology and stomatology of Cheikh Anta Diop university in Dakar.
Results: A total of 121 students responded, giving a response rate of 90.97%. The average stress level was 20.8±1.08. Of these, 14 students (11.6%) had mild stress, 75.2% had moderate stress and 13.2% had high stress. The most commonly reported stress factors specific to dentistry studies were examinations and ongoing tests (67.7%), the pre-clinical transition to the clinic (70.3%), patient delays or missed appointments (83.5%), fear of making mistakes (67%, i.e., perforation, medical contraindications, etc.), the availability of equipment (70.3%), and conservative odontology and endodontics procedures (71.6%). Concerning anxiety, 113 students (93.4%) had a moderate level of anxiety and 2 students (1.6%) had a high level of anxiety.
Conclusions: This study showed that stress and anxiety are frequently found among dental students. Intervention strategies based on raising awareness and promoting psychological well-being in the educational context should be adopted for these students.
Medication pattern and adherence to type II diabetes treatment at university hospital of Central India
Authors: Shamkuwar Chetna A. , Meshram Sushant H. , Kumari Nalini
Published: November 2023

Background: The estimated number of diabetics in India was 62.4 million in 2011 projected to rise 101.2 million by 2030. Rational medication pattern and adherence to treatment are key components of diabetes control. Study purpose is to evaluate medication pattern and assess adherence to treatment.
Methods: Prospective, observational and questionnaire-based study. Medication pattern evaluated from prescriptions and adherence assessed with Morisky medication adherence scale.
Result: Total 200 prescriptions were studied. 98 (49%) and 102 (51%) were male and female respectively. Majority were above 60 years of age. Co-morbid conditions were found in 175 (87%) patients with hypertension (72%), being more common. Patients were prescribed 1216 medications. The average number of drugs per prescription was 6.20. Oral hypoglycemic drugs were 22.69%. Commonly prescribed drugs were anti-hypertensive (15.70%), drugs for coronary artery disease (10.36%), antibiotics, NSAID, PPI, vitamins and minerals (31.99%). High, medium and low adherence were observed in 47%, 38% and 15% of patients. Males (61%) adherence more than females in high adherence group.
Conclusions: This study demonstrates the variability of drug utilization in diabetics. More than fifty percent patient have medium and low adherence which affects control of diabetes. Factors leading to poor adherence should be studied for better control of diabetes.
Study of breast lesions in cytology and its histopathological correlation
Authors: P. Balamanikandaraja , S. Rajarajan , P. Visalakshi , M. Anusuya , Nifra Fathima
Published: November 2023

Background: Breast cancer is commonly diagnosed malignancy in females and is leading cause of death. Malignant lesions mostly occur after menopause. Fine needle aspiration cytology is minimally invasive technique, used in triple test and produces speedy results. It can able to differentiate between benign and malignant lesions of breast lump. Our study aims to categorize the breast lesion and to correlate FNAC with histopathological studies.
Methods: This retrospective study was done in department of pathology from July 2021 to May 2023.107 cases were undergone FNAC and slides were examined and lesions were categorized. Tissue biopsies were obtained, processed and histological sections were made and examined. The FNAC findings were correlated and analyzed with histological findings.
Results: Right breast lesions (55%) were more in our study than left breast lesions (42%). Totally 77 cases were diagnosed as benign lesions by FNAC of which 37 cases were biopsied and histological diagnosis of all cases shown as benign category. 6 cases were diagnosed as proliferative breast disease with atypia of which only one case was received for biopsy and diagnosed as atypical ductal hyperplasia. 12 cases were diagnosed as malignancy and 6 biopsies were received with 5 cases were diagnosed as malignant lesions. Sensitivity and Specificity of FNAC in breast lesions were 100% and 97.43% respectively.
Conclusions: FNAC is rapid and valuable tool with high sensitivity, specificity and low false positivity. It is useful in preoperative evaluation and avoids unnecessary surgical intervention.
Correlation of anthropometric indices by cardio vascular index in young adult having obesity
Authors: Jee Kanhaiya , Dhoot Mahesh , Sharma Ankit , Singh Anand Kumar
Published: November 2023

Background: The aim of this study is to correlate anthropometric indices with hemodynamic vascular changes in young adult obese patients.
Methods: It is case-control study, 140 patients were recruited. Which were divided into two group i.e., study group=70 and control group=70. Anthropometric measurement waist circumference (WC) and total body fat percentage (TBF%) of each patient is compared with right brachial pulse wave velocity (PWV) (dominant hand).
Results: Obese individuals had high levels of PWV as compared with non obese patients. Study suggested that cardiovascular parameter levels were significantly increased in obese patients, these same patients gradually progress towards the hypertensive condition.
Conclusions: Changes in cardiac function are common in obese patients, hence, there is need for periodical assessment of the cardiac function and anthropometric measurement and PWV as cardiac markers in obese patients proves to be an early and simple tool to give warning signal for the patients to take early preventive measures.
Rhino-ocular and rhino-oculo-cerebral mucormycosis; two extremes of clinical spectrum complicating COVID-19 disease: two case reports
Authors: Fotedar Sanjay , Mahapatra Sarthak , Supragya Kunj
Published: November 2023

Corona virus disease 2019 is associated with wide spectrum of clinical features and secondary events complicating the natural course of disease, including infectious and noninfectious complications. As pandemic is evolving wide range of secondary infections including bacterial and fungal infections complicating the clinical course of COVID-19 disease are being reported, authors report two cases of rhino-orbital and rhino-orbito-cerebral mucormycosis in a patient of COVID-19 pneumonia. Mucormycosis is caused by saprophytic fungi involving nasal passages, sinuses, oral cavity and brain commonly. It is usually seen immunocompromised host and in diabetics with poorly controlled blood sugar level at times normal host though rare. High index of clinical suspicion is needed to suspect and diagnose mucormycosis to maximize the survival as disease is highly fatal because of its angio-invasive pathology.
Treatment of orbital floor fractures in a reference center in Mexico city
Authors: Heftye-Sánchez Brandon , Prieto-Vargas Valentina , Fattel-Servin Omar , Chávez-Serna Enrique , Felemovicius-Hermangus Jacobo
Published: November 2023

Background: Orbital trauma accounts for approximately 3% of all emergency department visits, with approximately 4.4 million annual visits in the United States alone. We aim to describe the treatment of adult patients with orbital floor fractures between 2016 and 2021.
Methods: A retrospective, descriptive, cross-sectional, and observational study was conducted on the medical records of adult patients with orbital floor fractures between 2016 and 2021 in a referral center in Mexico city.
Results: The study included 53 patients, 5 females (8%) and 48 males (92%), with a median age of 37 years at the time of diagnosis. Among the reported trauma mechanisms, falls and violence were the most common. 4 patients (7.5%) had impure right unilateral fractures, 4 patients (7.5%) had impure left unilateral fractures, 18 patients (33.9%) had pure left unilateral fractures, 22 patients (41.5%) had pure right unilateral fractures. Five patients (9.4%) had pure bilateral fractures. Six (11.3%) received non-surgical treatment, while 47 (88.6%) underwent surgical treatment. The most common surgical approach was the transconjunctival with lateral extension.
Conclusions: There was a predominance of male patients and physical aggression as the primary trauma mechanism. Automated vehicle accidents were associated with more complex fractures. The most common type of orbital floor fracture was pure right unilateral. Most patients underwent open reduction with internal fixation.
A comparative study of short-term post caesarean section complications in normal versus gestational diabetic mothers
Authors: Hossain M. Muktar , Rahman Sadia , Sufian M. Mir , Islam M. Saiful , Gaffar M. Abu Jar , Ahmed Mirza Shakil
Published: November 2023

Background: There are variegated complications following caesarean section that may compel the mothers to stay longer in hospital with sufferings or to carry a long period of morbidity at home. Unfortunately, these complications are more in gestational diabetes mellitus (GDM). This study was designed to compare post-operative complications following caesarean sections in normal and GDM Mothers.
Methods: This study was conducted in the Department of Obstetrics and Gynecology, 250 bedded general hospital, Naogaon, Bangladesh, from January 2022 to June 2023. In this study 74 participants were included consecutively. Among these, 37 mothers had GDM and 37 had normal pregnancies as control. After caesarean section, data regarding sociodemographic, obstetric and surgical profile were recorded and analyzed.
Results: The mean age of the participants in GDM group was 31.32±5.56 years and in normal pregnant group was 29.24±5.56 years. Post-operative pain were almost same in both groups. Mean time of PO mobilization was 25.2 hours in GDM group and 20.2 hours in normal group. 16 patients in GDM group had PO complications and 6 in normal mothers. Among the complications SSI and UTI were more common in GDM group. No mortality was recorded. Average hospital stay were 5.9 days and 4.9 days in GDM and normal patients.
Conclusions: Some post-operative complications are more common in GDM mothers. So, good glycemic control, appropriate surgical technique and proper post-operative care are needed to reduce post-operative morbidity and hospital stay.
Predictors of febrile urinary tract infection after ureterorenoscopy for urinary stones
Authors: D. H. Jayanth , Paul R. Fredrick , Gopi Rayidi , Singh Ravinder
Published: November 2023

Background: Ureterorenoscopy is a frequently used technique for the treatment of urolithiasis which provides high success rates when used under proper indications. Febrile urinary tract infection (FUTI) and urinary sepsis is the most frequent among its scarce complications. It often results secondary to urinary tract obstruction associated with urolithiasis, but also may occur after urinary tract manipulation such as ureterorenoscopy, clinical presentation varies from self-limited fever to the development of septic shock with the need for vasoactive agents or even to the patient’s death. This study has been designed to determine our rate of postoperative FUTI and sepsis after ureterorenoscopy, as well as to identify those factors that have been associated with its development.
Method: Prospective study done on 219 patients who underwent ureterorenoscopy for urinary lithiasis in government medical college, Kottayam from February 2021-March 2022. Personal, clinical, surgical and microbiological data were collected. Patients who develop FUTI, urinary sepsis during 30 days following intervention were identified. Statistical analysis will be performed by chi squared test/fishers exact test; logistic regression as appropriate.
Results: Our studies show incidence rates of postoperative FUTI in 11% and sepsis in 1.3%. Following statistical analysis, it was discovered that double J urinary diversion, a positive preoperative urine culture, diabetes, prolonged operational time, and intraoperative dilatation were all high-risk factors for the development of UTI after instrumentation.
Conclusions: Ureteroscopy-associated urosepsis is a nosocomial infection. With the increasing popularity of ureteroscopic procedures, it is imperative that patients with increased risk are addressed appropriately, and suspected sepsis must be speedily and aggressively managed.
A descriptive study on urethral catheter removal on 2nd versus 4th day after transurethral resection of prostrate
Authors: P. Ravi Teja , Krishnaprasad Kiron , Chandra K. Ravi , Nazar M. Nazar
Published: November 2023

Background: BPH refers to the benign age-related growth of the prostate. A number of treatment methods for BOO have been proposed over the years, but transurethral resection of the prostate (TURP) remains the standard by which all others may be judged. This study is intended to explore the feasibility and safety of catheter removal on day 2 after TURP as compared with 4-5th day catheter removal. Aims and objectives: To find percentage of patients who are able to void and compare duration of hospital stay in 2nd vs 4th day catheter removal after TURP.
Methods: It is a descriptive study on 52 patients who underwent TURP in the department of urology, GTDMCH, Alappuzha. Post operatively depending on surgeon’s choice catheters are removed on 2nd /4th POD. Patients who void satisfactorily will be discharged after a 24 hour observation period.
Results: Mean age of study is 66.26. Patients who are able to void after catheter removal on POD 2 is 90.39% vs POD 4 is 91.18. Mean hospital stay in POD 2 is 3.87 vs POD 4 is 5.5, percentage of patients who had transient incontinence after surgery in POD 2 is 4.8 vs 5.8 in POD 4.
Conclusions: There is no difference in percentage of patients who are able to void in both groups. There is no difference in POD 2 and POD 4 groups in terms of complication. Whereas hospital stay reduced in POD 2 group, thus reducing cost burden to the patient and family.
Random pattern sub-clavicular flap in digital degloving injuries: an alternative in the reconstructive ladder
Authors: Azcárate-Varela José A. , Prieto-Vargas Valentina , Chavez-Serna Enrique , Fattel-Servin Omar S. , Martínez-Wagner Rogelio
Published: November 2023

Degloving soft tissue detachment injuries occur when the skin and subcutaneous tissue detach from the underlying structures, affecting the skin coverage. The hand is usually the most frequent affected site. In digital lesions, the best results are obtained by revascularization; nevertheless, this procedure is challenging for the surgeon. Random pattern flaps represent an effective alternative for the treatment of these devastating lesions. We present two clinical cases with digital degloving injury from the proximal phalanx. Both cases required reconstructive surgery in 2 stages, using a successful random pattern sub-clavicular flap. This article aims to share the results of using this method as another reconstructive option with good results. After an average follow-up of 8 months in both cases, adequate skin coverage and functionality of the finger treated with the described flap was observed. Patient A presents a finger with proper healing and functionality. Patient B at 10 months, presents a thumb with adequate length for clamping and opposition. Sub-clavicular flap is an excellent reconstructive alternative for digital degloving injuries where revascularization is unattainable, providing good skin coverage and functionality and being a reproducible outpatient procedure.
Review of: Sokolov B. V. Baron Ungern and Civil War in the East. Moscow: Veche, 2022; ISBN: 978-5-4484-3355-9. 448 p.
Authors: Kuzmin Sergius
Published: November 2023

This review considers the book by philologist, publicist, literary critic, and historian B. V. Sokolov “Baron Ungern and the Civil War in the East”, published in 2022. The book is positioned as a “portrait” of Baron R. F. von Ungern-Sternberg, participant in the Civil War in the East of Russia and in military operations in Mongolia, who restored the independence of the latter country in 1921. The book contains some excerpts from documents and memoirs designed to substantiate the author’s assessment of the historical events of that time, the activities of Ungern and some other personalities participated in these events. Analysis of this book revealed a number of significant mistakes and inaccuracies discussed in this review.
DIVERSIDAD DE MACROINVERTEBRADOS ACUÁTICOS EN UN NACIMIENTO DE RÍO EN EL PÁRAMO DE SANTURBÁN, NORTE DE SANTANDER
Authors: Castellanos Pablo Manuel , Serrato Clemencia
Published: November 2023

Entre septiembre del 2005 y febrero del 2006, se realizó un estudio para determinar la diversidad de macroinvertebrados acuáticos en un nacimiento de río ubicado en el Páramo de Santurbán, Norte de Santander. La comunidad de macroinvertebrados encontrada estuvo conformada por 63 taxones, pertenecientes a 30 familias y 12 órdenes, siendo el Orden Diptera el más diverso. La estación 3 presentó la mayor riqueza y abundancia de organismos. Los taxones colectados más abundantes fueron el microcrustaceo Hyalella sp.  y el Ephemeroptera Prebaetodes sp. En general, el nacimiento presentó una diversidad biológica moderada y una dominancia baja. Adicionalmente, los valores de similitud indicaron una alta variabilidad en la composición de especies entre estaciones.
ESTUDIO DE EMERGENCIA DE INSECTOS ACUÁTICOS EN LAS ZONAS DE BOSQUE RIPARIO, BOSQUE PLANTADO Y PASTOS, ABEJORRAL (ANTIOQUIA, COLOMBIA)
Authors: Rúa-Rivillas Juan Camilo
Published: November 2023

Entre marzo-agosto del 2004, se realizaron muestreos quincenales de insectos acuáticos emergentes en quebradas con riberas cubiertas de bosque ripario, plantado y pasto respectivamente, en un área de protección-producción hídrica, en el municipio de Abejorral, con el fin de analizar las influencias de las coberturas y las épocas climáticas sobre la comunidad de la fauna béntica emergente. El mayor número de individuos emergió entre los meses que corresponden a la sequía (julio-agosto). La “zona de bosque ripario” fue la de mayor diversidad pero menor abundancia, seguida por la “zona de bosque plantado” y en tercer lugar la “zona de pastos”con menor diversidad y mayor dominancia. En esta zona se presentaron las mayores abundancias de familias emergentes y temperaturas del agua. Entre la comunidad de insectos emergentes predominaron los dípteros. Las familias Anthomyiidae, Ceratopogonidae, Dixidae, Noctuidae, Pyralidae, Sciomiydae y Stratiomyiidae, emergieron solamente en tiempo de lluvia; Sarcophagidae, Leptoceridae, Braconidae y Muscidae, emergieron en tiempo de sequía. En las tres zonas las familias Cecidomyiidae, Dolichopodidae y Tipuliidae emergieron continuamente durante el tiempo de estudio.
GEOPHYSICAL MODELLING OF AN AREA OF CERRITOS, PEREIRA (RISARALDA)
Authors: Serna Lina María , Montes Luis , Vargas Carlos
Published: November 2023

A geophysical project was developed in Cerritos area, near  Pereira city, where gravity, magnetic, electrical and seismic data were acquired over a 210.75 km 2 area. The data were processed and interpreted according the geological information acquired and also available; as result a free to confined aquifer was defined in the Plio-Pleistoce Pereira formation (Tqp), that is characterized by non-homogeneous lateral layers and constituted by a superior sequence of volcanic ashes and an inferior of volcano-clastic flows which reaches 750 m thick. The Pereira fm is controlled by the tectonic controlled Cartago and Barroso formations, with inverse faults that indicate uplift of the basement and variations of the Pereira formation thick, affecting the underwater circulation system and expressed by variations in the electric resistivity of the subsoil.
NANOMATERIALES: ¿QUO VADIS? UNA AGENDA PROSPECTIVA PARA EL CENTRO DE EXCELENCIA DE NUEVOS MATERIALES –CENM–
Authors: Reyes Alvarado Alfonso , Pedraza Camargo Gustavo , Prieto Pedro
Published: November 2023

Por sus propiedades particulares, y potencial aplicabilidad, los nanomateriales han sido objeto de estudio en los laboratorios desde hace más de dos décadas. Para comprender cómo llegó la investigación en estos materiales artificiales a generar una de las industrias de mayor crecimiento en el mundo, se presenta una retrospectiva de su desarrollo histórico. Posteriormente se presenta una descripción breve del impacto actual, de estos materiales, en la investigación, la innovación y la tecnología. Lo anterior se describe en término de publicaciones, patentes, recursos invertidos en su desarrollo, y empresas creadas en torno a su producción. Dado el poco conocimiento que se tiene sobre los efectos de estos materiales sobre los seres vivos, son muchas las legislaciones que también han debido adaptarse a estas nuevas tecnologías, las cuales realizan un control ético y de seguridad sobre la manipulación y fabricación de nanotecnología. Se presenta un futuro cercano en el desarrollo de la nanotecnología con base en los factores de cambio identificados por la Fundación de la Innovación Bankinter. Finalmente se presentan las líneas estratégicas a través de una agenda prospectiva desarrollada desde la academia con proyección a la industria nacional, planteada por el CENM con base en estos factores de cambio que podrían delinear el desarrollo de la nanotecnología a futuro en Colombia.