bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of shorter MDR tuberculosis regimen drugs on heart rate variability in MDR tuberculosis patients at tertiary care hospital
Authors: Patel Disha S. , Acharya Chetankumar R.
Published: June 2021

Background: Tuberculosis is major cause of death in India. Analysis of heart rate variability is one of the most popular methods of autonomic nervous system evaluation. Shorter MDR-TB regimen drugs affect both central nervous system as well as peripheral nervous system. Existing research suggests that active pulmonary tuberculosis causes ANS dysfunction. So, by HRV measurement impact of shorter MDR-TB regimen drugs on autonomic dysfunction can be correlated. Aim of the current investigation was to evaluate effect of shorter MDR-TB regimen drugs on cardiac autonomic regulation in MDR-TB patients with respect to heart rate variability as a parameter.Methods: Fifty newly diagnosed MDR-TB patients of either gender on shorter MDR- TB regimen were enrolled in this study after taking consent. After 20 minutes rest, ECG was taken by “physiopac digital polygraph” software for 5 minutes. Two follow-up HRV assessments were done on 2nd month and 4th or 6th month of treatment. HRV was calculated by root mean square deviation of successive differences between adjacent RR intervals (RMSSD) and low frequency and high frequency ratio.Results: Repeated measures ANOVA showed no statistically significant difference in HRV parameters between baseline, 2 months and 6 months groups. So, sympathetic and parasympathetic modulation in terms of HRV remains unchanged during treatment of MDR-TB with shorter MDR-TB regimen drugs.Conclusions: Shorter MDR-TB regimen drugs don’t have any significant impact on HRV in MDR- TB patients, No correlation was observed between HRV and heart rate in MDR-TB patients.
Automation in pharmaceutical sector by implementation of artificial intelligence platform: a way forward
Authors: Shinde Amol , Pawar Dilip , Sonawane Kunal
Published: June 2021

Worldwide, there are technological advances that swift automation in several aspects of the pharmaceutical industry such as pharmacovigilance, clinical research, medical affairs, and marketing. Innovative technology like artificial intelligence (AI) emphasizes the massive use of the internet for drug development, drug safety, data analytics, communication marketing, and customer engagement to achieve the goal of pharmaceuticals and patient-centric healthcare. Presently, escalating the number of individual case safety reports (ICSRs) necessitate the support of AI in the transformation of drug safety professional. AI can be transformed and evolve the clinical trial process from the conventional method alongside benefited the cutting cost, enhancing the trial quality, and alleviate trial time by almost half. Today, AI may be efficiently implemented to lower the cost of medical information requests, besides the online chatbots to communicate with health care professionals (HCPs) and consumers. There are numerous forthcoming uses of AI which need to be executed for renovation in the field of pharmaceuticals.
Effect of metformin on serum level of vitamin B12 and folate in patients of type-2 diabetes mellitus
Authors: Meena Rajesh , Kumar Ramesh , Meena Atul , Meena Om Prakash , Meena Lokesh , Meena Arun
Published: June 2021

Background: Several types of DM are caused by a complex interaction of genetic and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycaemia include- reduced insulin secretion, decreased glucose utilization, and increased glucose production.Objective of the current study was to study the effect of metformin on the level of vitamin B12 and folate in patients of type 2 DM.Methods: This is hospital based study before and after metformin therapy randomized controlled trial was conducted in medicine ward of M. B. hospital, Udaipur. Baseline serum vitamin B12 and folate level of all patients were measured and treatment with metformin 500 mg twice a day was given for 6 months. After 6 months serum vitamin B12 and folate level of all patients were re-evaluated.Results: There was a significant positive correlation (r=0.824, p<0.001) between decrease in vitamin B12 and decrease in folate level after metformin treatment. When analysis for change in vitamin B12 is compared with change in MCV values after 6 months, negative correlation (r=-0.08, p>0.05) was obtained. A non significant correlation (r=-0.08, p>0.05) with change in level of serum folate and change in MCV values or haemoglobin level was obtained.Conclusions: Low serum vitamin B12 level is associated with longer duration and higher dose of metformin use. Routine determination of vitamin B12 level in patients with type 2 DM on high dose of metformin and those with prolonged use of metformin might help in identifying patients that would benefit from vitamin B12 supplements.
Correlation of neutrophil lymphocyte ratio with HbA1c in patients of type 2 diabetes mellitus
Authors: Varma Sanjay , Khande Manisha , Gupta Preeti , . Archana , Khare Rajeev Lochan , Malhotra Yogendra , Lakra Devpriya
Published: June 2021

Background: Neutrophil lymphocyte is an indicator of subclinical inflammation. Type 2 diabetes mellitus is associated with chronic low-grade inflammation. One of the novel inflammatory markers is hemogram derived neutrophil to lymphocyte ratio. There are very few studies which are directly accessing the relation between NLR and HbA1c, so in the present study our aim to correlate neutrophil lymphocyte ratio with glycemic control in patients having type 2 diabetes.Methods: Hospital based observational cross section study was carried out at department of medicine, Pt JNMMC and Dr BRAM Hospital, Raipur, between September 2018 to August 2019. 105 patients with type 2 diabetes mellitus according to ADA criteria who were aged more than 18 years were included in the study. Relevant investigation and complete blood count were performed. Microsoft excel and SPSS version 25 were used for collection and analysis of the data, p<0.05 was considered as significant.Results: Out of 105 patients who were given the consent for the study, the ration of male is to female was 1:0.98, mean age of all the patients was 51.77±10.56 years, mean neutrophil lymphocyte ratio among the patients was 6.30±2.646, HbA1c count more than ≥9 was 54 (51.27%). NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitus.Conclusions: Increased NLR is associated with elevated HbA1c and poor glycemic control. Type NLR should be used as a marker of diabetic control level in addition to HbA1c in type 2 diabetic subjects.
Study of electrocardiographic changes in patients with acute cerebrovascular accidents
Authors: Bhasme Sanjay , Dakre Abhieet , Jagtap Pranjal
Published: June 2021

Background: Stroke is “a focal (or at times global) neurological impairment of sudden onset, and lasting more than 24 hours (or leading to death), and of presumed vascular origin. A variety of cardiovascular events like cardiac arrest, arrhythmias, and severe hypotension can be seen in stroke victims. The purpose of this study is to investigate the prevalence and characterization of ECG abnormalities in patients of cerebrovascular accidents.Methods: Study was carried out in Dr. PDMMC and tertiary care hospital Amravati, Maharashtra, India. All acute cerebrovascular accidents patients were the study subjects. The diagnosis of ischemic stroke was confirmed by CT scanning. Pre-validated questionnaire was used for data collection. At the end of the study all the ECG were compared to approach towards the result. Study was carried out over a period of three months from October to December 2020.Results: We have recruited 90 stroke patients, most of them were males. Major type was ischemic stroke. In total 62 (68.89%) stroke patients had some form of ECG change. Majority i.e. 35 (38.89%) patients had QTc prolongation followed by 32 (35.56%) patients had T wave changes. QTc prolongation and Atrial fibrillation were significantly more among hemorrhagic stroke patients (p<0.05) and T wave changes and ST changes (elevation or depression) were significantly more among ischemic stroke patients (p<0.05).Conclusions: Prevalence of ECG abnormalities among stroke patients was more i.e. 68.89%. QTc prolongation and T wave changes were the commonest ECG abnormalities.
Pattern of adverse drug reactions and serum level of maintenance lithium treatment in patients with bipolar affective disorder: a cross-sectional study in Eastern Nepal
Authors: Sarraf Deependra Prasad , Nepal Suraj
Published: June 2021

Background: Benefits of lithium maintenance therapy in bipolar affective disorder (BPAD) are restricted by adverse drug reactions (ADRs) and low therapeutic index. The same dose of lithium has sub-therapeutic, therapeutic and supra-therapeutic serum level in different patients. The objective of this study was to describe the pattern of ADR and serum concentration of maintenance dose of lithium in patients with BPAD.

Methods: A cross-sectional study was conducted in patients diagnosed with BPAD and taking lithium monotherapy 900 mg daily at least for 6 months at outpatient department of psychiatry, B. P. Koirala institute of health sciences. Sociodemographic profile and relevant laboratory investigations were recorded on a self-designed proforma. Chi square test, ANOVA test and student’s t test were used for analysing the data at p value <0.05.

Results: Out of 123, 64 (52.0%) were female. Serum concentration ranged from 0.31 to 1.51 mmol/l with mean of 0.803 mmol/l and was in therapeutic range in 104 (84.6%) patients. At least one ADR was seen in 81 (65.9%) patients and hand tremor (43.6%) was the commonest ADR. Hypothyroidism and hyperthyroidism were seen in 9 (6.8%) and 6 (4.5%) patients, respectively. Occurrence of ADRs were more in female and was significantly significant (P value <0.05).

Conclusions: The serum level of lithium 900 mg/day varied widely and was in therapeutic range in majority of the patients. Prevalence of ADRs was 65.9%. Occurrence of ADRs were significantly more common in female patients and supra-therapeutic serum concentration of lithium. A prospective long-term study should be conducted to validate the study findings.
Otorhinolaryngological manifestation in COVID-19
Authors: Sachdeva Kavita , Saji Tinnu Anna , Rawat Mukesh , Shukla Amrita , Chandrakapure Deepankar , Sharma Diksha
Published: June 2021

Background: Coronaviruses (CoV) disease caused by the seventh member of enveloped RNA coronavirusdisease. The COVID-19 is presented mainly by lower respiratory tract related symptoms such as fever, cough, dyspnea and chest tightness that could progress rapidly to acute respiratory distress syndrome (ARDS) whereas the different upper respiratory tract related symptoms include nasal congestion, sore throat and smell dysfunction. The aim of this study is to contribute to current knowledge about COVID-19 and to study about the otorhinolaryngological manifestations and its effects in COVID-19 patients.

Methods: This prospective observational study was done on 644 patients who got admitted to COVID suspect ward of a tertiary care centre in middle India. The patients were assessed for the signs and symptoms and the findings were analysed.

Results: Within the included 664 cases, 423 (64%) were males and 241(36%) were females. The maximum number of patients in 50 to 60 years of age ,128(19%). Among which 97% (646) from urban area and 3% (18) from rural area. 564 (85%) were symptomatic with 459 patients had symptoms for 1-4 days,112 patients for 5-10 days,4 patients between 11-15 days. The most common symptoms with which these patients presented were cough (68%), fever (62%), signs of breathlessness (61%). The most common ENT manifestations were sore throat 333 (59%), nasal discharge 120 (12%), anosmia 65 (12%), ear discharge 46 (8%).

Conclusions: Even though the most common manifestations of COVID-19 were cough, fever, breathlessness significant proportions of patients do manifest with ENT symptoms like sorethroat, nasal discharge, anosmia, ear discharge which may go unnoticed. Recognizing the cases and addressing them properly is important for curbing the rapid spread of COVID-19 pandemic.
Awareness of typical speech-language development among parents of children with hearing impairment
Authors: Pallavi Pooja , Waknis Aarti P.
Published: June 2021

Background: Parents of children with hearing impairment who are aware of normal speech-language development play an effective and active role in the early detection, diagnosis, and habilitation of these children. Hence this study was aimed to explore the level of awareness about normal speech and language milestones in parents of children with hearing impairment.

Methods: Questionnaire assessing the parents’ awareness of speech-language development in children from birth to 3 years was administered on 80 parents of children (birth to 5 years) with hearing impairment. These included 40 parents of children recently diagnosed with hearing impairment (group 1 HI-R) and 40 parents of children with hearing impairment who were fitted with appropriate hearing devices and enrolled in a speech and language habilitation program (group II HI-T).  

Results: Results indicated that the level of awareness was moderate for both the groups for semantic and morphosyntax domains as well as total scores, but was low to moderate for the pragmatic domain. There was no statistically significant difference in the level of awareness between the two groups.

Conclusions: Moderate awareness levels indicates that parents of children with hearing impairment need to be made aware about the normal speech and language development so that it can guide them in the habilitation process. This information although important does not appear to have been provided to the parents of children already undergoing habilitation. Thus, there is need of including this as a goal in parental counseling.
Screening: a unique study of otorhinolaryngeal manifestations in 400 patients of pulmonary tuberculosis being diagnosed and treated under revised national tuberculosis control programme
Authors: . Rupali , Sharma Karan , Kajal Nirmal Chand
Published: June 2021

Background: Tuberculosis (TB) is primarily a disease of lungs but can affect any part of the body. Among extrapulmonary TB, tuberculosis of otorhinolaryngeal region is uncommon but not rare. Despite the best efforts of the RNTCP, tuberculosis is still a major health problem in India. In our study screening of the pulmonary tuberculosis patients was done to know the incidence and pattern of otorhinoloryngeal manifestations and also to know the treatment outcome after follow up of patient till completion of DOTS therapy under RNTCP.

Methods: This study included 400 pulmonary tuberculosis patients, both sputum positive and sputum negative (200 patients in each group) of newly treated (ND) and previously treated (PT) categories. After complete history, physical and local examination, suspected patients were evaluated for otorhinolaryngeal manifestations of tuberculosis. The diagnosis was confirmed after culture swabs, fine needle aspiration cytology (FNAC) and biopsy for histopathological examination (HPE).

Results: Out of total 400 patients majority of patients belong to 21-30 years age group. Out of total 400 patients, 5 (1.25%) patients were having laryngeal tuberculosis, 1 (0.25%) patient of tubercular otitis media and 2 (0.5%) patients were having nasal TB. Results of our study are consistent with previously done studies despite RNTCP treatment. The treatment outcome was good after completion of ATT.

Conclusions: Every patient of pulmonary TB with complaint related to otorhinolaryngeal region should be examined and followed up with high suspicion of ENT related tuberculosis.
Post COVID-19 acute invasive fungal rhinosinusitis caused by Scedosporium apiospermum: a covert pathogen
Authors: Singla Sonam , Singh Vyoma , Bansal Atmaram , Sharma Jai Prakash , Wadhwa Teena , Sarma Smita
Published: June 2021

Immune dysregulation caused by COVID-19 and the presence of risk factors such as diabetes, steroid therapy and immune-modulatory drugs significantly increase the risk of secondary invasive fungal infections. Scedosporium apiospermum is an emerging pathogen and is rarely reported as a cause of fungal rhinosinusitis. This was a previously unreported case of post COVID-19 acute invasive fungal rhinosinusitis caused by S. apiospermum with rare complications of cranial nerve palsies and ruptured mycotic intracranial aneurysm.
Laryngeal lipoma: case series- successful microlaryngeal surgery
Authors: Manohar M. Babu , Rao Soorya A.
Published: June 2021

Lipoma of the larynx is a very rare entity. In this study, we report two cases of lipoma of the larynx. The first case presented to us with hoarseness of voice and choking sensation and was diagnosed using a flexible fibreoptic video laryngoscopy and a computerised tomography (CT) of the neck. The lesion was excised surgically using microlaryngoscopic method. The diagnosis was confirmed histopathologically. Follow-up after 2 years showed no residual or recurrent lesions. The second case was a middle aged man with change in voice, burning sensation and foreign body sensation in throat. Flexible fibreoptic videolryngoscopy showed a small ventricular swelling on the right side in the anterior part. We considered the provisional diagnosis of a benign tumor and proceeded with microlaryngoscopic excision without any radiological investigation. Diagnosis of Lipoma was revealed after the histopathologic examination. We are reporting this case to highlight the rare location of the lesions and the successful use of microlaryngoscopic surgery.
Basal cell papilloma of the external auditory canal: a case report
Authors: Anuar Khairullah
Published: June 2021

Basal cell papilloma are benign neoplastic lesion affecting skin, oral mucosa, trunk and genital organs. However it is uncommon to originate in the external auditory canal.We present a 32-year old female presented with otalgia, reduced hearing and bleeding intermittently from the left ear. Clinically it showed multilobulated, blackish mass obliterating the external auditory canal. The mass was friable and bleed to touch. Excision biopsy was done under general anaesthesia and she had uneventful recovery. The histopathology reported as seborrhoeic keratosis or Bbasal cell papilloma. No dysplasia or malignancy seen. In conclusion, basal cell papilloma of the external auditory canal is rare and complete excision of the lesion ensures good outcome and recovery.
Traumatic spinal fractures: presentation and prognosis
Authors: Maloth Ramdas
Published: June 2021

Background: The bulk of spine injuries that result in permanent injury happen as a result of vehicle accidents. Objective of the study was to estimate the incidence, outcome, and causes of spinal fractures.

Methods: From January 2018 to December 2019, data were obtained from the trauma register database of all traumatic spinal injuries admitted to the section of trauma surgery, department of Meenakshi medical college hospital and research institute, Kanchipuram, Tamil Nadu. Demographic information as well as injury severity Ratings were gathered. SPSS (trial version 24) was used for analysis.

Results: A total of 513 (14%) of the 3665 patients referred to the trauma surgery section had spinal injuries, with an average age of 34.2 11 years. The leading causes of cervical injuries (p0.05) were motor car collisions (38.5%) and accidents from great heights (20.3%). The injury level scale ranged from 4 to 70. In 25% of cases, lumbar injury was linked with thoracic injury (p<0.001). A mixture of thoracic and Lumber injuries is associated to a cervical injury in 35% of cases (p<0.001). A total of 4.4 percent of injuries were linked to neurological deficits. Fifty-nine cases of spine fractures were surgically treated, with 12 of them having neurological deficits. The overall mortality rate was 3%.

Conclusions: In these areas, spinal fractures are rare. The most common neurological deficits are caused by cervical and thoracic spine injuries. Young males are the most vulnerable group, and accident prevention services in the workplace and enforcement of traffic laws should be prioritized for them.
Evaluation of functional outcome of diaphyseal fractures of shaft humerus treated with closed interlocking nail in adults
Authors: Naser M. Abdul , Vare Sunil Asaram , Shah Abbas Shakir
Published: June 2021

Background: Humeral shaft fractures are those fractures of the diaphysis of the midshaft that do not involve the proximal or distal articular joints. Humerus fractures have a substantial impact on personal function and well‐being and are one of the causes of excessive mortality among the elderly. The aim and objective of the study was to study the functional assessment after interlocking nailing in fractures of shaft humerus.

Methods: A retrospective clinical study was done on 20 patients with shaft humerus fractures treated with intramedullary nailing by orthopaedic surgeons at a tertiary care centre in the Department of Orthopaedics, Indian Institute of Medical Science and Research, Noor hospital, Jalna between January 2020 to July 2020 (DASH Score being calculated till January 2021). The DASH score was assessed 6 months post-operative day of surgery.

Results: For all the operated patients clinical, physiological and ortho-radiological assessment were performed to observe and evaluate fracture stabilization, reduction, fracture healing and callus formation, functional evaluation done with DASH scoring system.

Conclusions: Closed intramedullary nailing is safe and reliable technique to fix humeral shaft fracture. It provides early fracture consolidation, with high union rate, with advantage of early mobilization of the involved limb.

 
Comparative study between Blair’s procedure of ankle fusion and arthroscopic ankle arthrodesis
Authors: Krishna Daya , Upadhyay Gunjan , Kumar Alok , Singh Rawat Chandra Mohan
Published: June 2021

Background: Our objective was to perform a comparative study in terms of functional outcome of Blair’s procedure of ankle fusion versus arthroscopic methods of ankle fusion.

Methods: 25 patients that underwent arthroscopic ankle arthrodesis versus Blair’s procedure of ankle fusion were taken for study at government medical college, Srinagar (VCSGGIMS and R) from the duration 2015-2021. Clinical assessment was done foot and ankle disability index and visual analog scale score for pain. Radiological assessment was done by serial X-rays. Regular follow-ups were taken till one year.

Results: Both modalities proved to be equally effective in terms of patient’s functional outcome. Our analysis showed that Blair’s procedure ankle fusion was associated with a lower fusion rate (OR 0.26, 95% CI 0.13-0.52, p=0.0002), longer tourniquet time (MD 16.49, 95% CI 9.46-23.41, p<0.00001), and longer length of stay (MD 1.60,95% CI 1.10-2.10, p<0.00001) compared to arthroscopic ankle fusion; however, there was no significant difference between two groups in terms of infection rate (OR 2.41, 95% CI 0.76-7.64, p=0.14), overall complication rate (OR: 1.54, 95% CI 0.80-2.96, p=0.20), and operation time (MD 4.09, 95% CI 2.4910.66, p=0.22).

Conclusions: We found no significant difference between two groups in terms of infection rate, overall complication rate, and operation time. Further high quality randomized controlled trials that are adequately powered are required.
Analytic study of functional outcome of retrograde intramedullary nailing for distal femoral fractures in adults
Authors: Kommera Srujith , Reddy Pradeep , Khaleel Saba
Published: June 2021

Background: The purpose of this Study was to evaluate the clinical and functional outcome of retrograde intramedullary nailing for distal femur fractures.

Methods: This 2 years observational study was done between December 2018 to January 2021, 60 patients with distal femoral fractures were surgically treated at our hospital using retrograde intramedullary nail. The patient was placed supine on fracture table with affected limb flexed to 60 degrees. Through a Transpatellar approach, the nail was introduced in retrograde method after serial reaming. Postoperatively knee range of motion was started immediately and weight bearing was progressed after signs of fracture union were noted on x-rays. The outcome was evaluated for time taken for fracture union, complications and functional outcome with various types of fractures.

Results: All the fractures in the present study healed at an average of 13 weeks. However 25 to 40% of these patients underwent bone grafting primarily with reports of delayed union and non-union. Shortening occurred in two patients (3.33%) did affect the final functional outcome. average range of motion is 120 deg. for all fractures, 119 deg. for extra-articular fractures and 118 deg. for intra-articular fractures. Infection rates are low (0% to 8%).

Conclusions: The study shows distal femoral fractures were common due to high velocity injuries, retrograde nailing is an excellent technique for management of distal femoral fractures as it promotes high rate of fracture union with less complications.
Short term outcome of radial head arthroplasty in Mason type 3 and 4 fractures
Authors: Ganai Mudasir Rashid , Khan Shahid Shabir , Rahim Inayat , Maajid Saheel , Dar Tahir Ahmed
Published: June 2021

Background: Radial head arthroplasty provides a suitable treatment in Mason type 3 and 4 3 fractures. Arthroplasty produces consistent results with a shorter learning curve than ORIF and prevents the late complications associated with radial head excision.

Methods: After seeking approval from local institutional ethical committee 30 patients with Mason type 3 and 4 radial head fractures were admitted from outpatient department (OPD) of SKIMS MC and Hospital Bemina, Srinagar. The study was conducted from February 2019 to June 2020 in department of Orthopaedics SKIMS MC and Hospital Bemina, Srinagar. 30 patients with mean age of 25 years comprising of 9 females and 21 males underwent radial head arthroplasty and were followed up to a minimum of 1 year post-operatively.

Results: Outcome was evaluated by assessing elbow functional performance using Mayo elbow performance (MEPI). No revisions were performed during the study. Two patients had implant backout and 6 patients had elbow stiffness.

Conclusions: Radial head arthroplasty can be used successfully with most of excellent results for treatment of comminuted radial head fracture (Mason type III and IV radial head fractures). Over all radial head arthroplasty is a demanding option in type 3 and type 4 fractures which are not amenable to reconstruction.
Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series
Authors: Rao Shreekantha Koteshwara Surendra , Mulla Mahammad Aseem Mahammadgous , Malik Deepak , Usman Mohammed
Published: June 2021

Tibial plateau fractures accounts for about 1% of injuries. Various mechanisms have been described, resulting in milder form to serious injuries depending upon force of impact.  High velocity injuries resulted from valgus or varus impacted forces combined with axial loading such as in Schatzker type 6. The ideal method of treatment for these fractures is always a matter of debate. As all intra-articular fractures necessitate anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation, which can be achieved very well by open reduction and internal fixation (ORIF) with dual plating. To study the functional and radiological outcome of Tibial plateau fractures treated surgically with dual plate osteosynthesis. 15 patients in the age group 18-60 were included. Rasmussens criteria was used to assess the functional and radiological outcomes with follow up period of 1 year prospectively. The outcome assessment using Rasmussens score concluded good results. The average duration for union was ­6 months. ROM achieved in these patients were to be at least 124 degrees. The infection rate in this study was accounted as 13.3%. Open reduction and internal fixation of tibial plateau fractures, by dual plating has good functional and radiological outcome. This is an effective method of treatment even with moderate soft tissue injury if meticulous surgical technique, appropriate soft tissue handling and adequate healing period given. All these have shown to decrease the postoperative complications such as infection.
Medial patellofemoral ligament reconstruction using autologous hamstring graft for recurrent patellar dislocation: a clinical and functional outcome evaluation
Authors: Ghosh Sanjib , Das Ayon , Baid Mahak , Das Arijit
Published: June 2021

Patellofemoral instability is a painful and often recurring disorder with many negative long-term consequences. Surgical treatment for patellar dislocation has evolved from the initial medial reefing to the present-day anatomical reconstruction of medial patellofemoral ligament (MPFL) which is thought to be the most appropriate treatment. MPFL reconstruction successfully addresses patellofemoral instability by restoring the deficient most important static primary soft tissue restraint. This prospective case series was conducted at a Tertiary care Govt. Hospital in Kolkata between January 2019 to August 2020 on 15 patients who underwent MPFL reconstruction for recurrent patellar dislocation. All patients were followed up at an interval of 2 weeks, 6 weeks, 3 months and 6 months. Kujala score was used to assess the functional outcomes of the patients. Out of 15 patients, 13 (86.7%) showed good to excellent results whereas 2 (13.3%) had Fair outcome and none of the patients demonstrated Poor surgical result. The mean Kujala score improved from 49.6 pre-operatively to 92.7 post-operatively. By the end of 6 months follow-up, 13 (86.7%) patients achieved almost full range of motion. Majority (80%) of patients did not have any complications. Only 2 patients had a post-operative recurrence (13.3%). Reconstruction of MPFL using autologous hamstring graft showed excellent results over the short term with a low re-dislocation rate and acceptable complication rates. It greatly helps in preventing further episodes of patellar subluxations or dislocations and in improving quality of life.
Bone versus implant: an atypical presentation of a typical complication of forearm fractures
Authors: Vatsya Pulak , Gupta Anupam , Mittal Samarth , Trikha Vivek
Published: June 2021

Both bone forearm fractures are one of the most common upper limb fractures operated by orthopedicians. Although the primary surgery is usually relatively straight forward and simple, but we present a case where the primary surgery failed and the patient presented with a deformed hand after 5 months, even though there were signs of union on radiographs. When operated upon, although the ulna had undergone primary bone healing and a peri-implant fracture had occurred, whereas radius had refractured from the fracture site and the plate was bent giving the deformed appearance. We discuss this unique complication, the planning, difficulties and scope of errors in such a situation, where the race to union is won by ulna but lost by radius.
Detection of osteoporosis in lumbar spine [L1-L4] trabecular bone: a review article
Authors: Patil Kavita Avinash , Prashanth K. V. Mahendra , Ramalingaiah A.
Published: June 2021

The human bones are categorized based on elemental micro architecture and porosity. The porosity of the inner trabecular bone is high that is 40-95% and the nature of the bone is soft and spongy where as the cortical bone is harder and is less porous that is 5 to 15%. Osteoporosis is a disease that normally affects women usually after their menopause. It largely causes mild bone fractures and further stages lead to the demise of an individual. This analysis is on the basis of bone mineral density (BMD) standards obtained through a variety of scientific methods experimented from different skeletal regions. The detection of osteoporosis in lumbar spine has been widely recognized as a promising way to frequent fractures. Therefore, premature analysis of osteoporosis will estimate the risk of the bone fracture which prevents life threats. This paper focuses on the advanced technology in imaging systems and fracture probability analysis of osteoporosis detection. The various segmentation techniques are explored to examine osteoporosis in particular region of the image and further significant attributes are extracted using different methods to classify normal and abnormal (osteoporotic) bones. The limitations of the reviewed papers are more in feature dimensions, lesser accuracy and expensive imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and DEXA. To overcome these limitations it is suggested to have less feature dimensions, more accuracy and cost-effective imaging modality like X-ray. This is required to avoid bone fractures and to improve BMD with precision which further helps in the diagnosis of osteoporosis.
The Impacts of Remote Learning in Secondary Education: Evidence from Brazil during the Pandemic
Authors: Lichand Guilherme , Dória Carlos Alberto , Neto Onicio Leal , Cossi João
Published: June 2021

The goal of this paper is to document the pedagogic impacts of the remote learning strategy used by an state department of education in Brazil during the pandemic. We found that dropout risk increased by 365% under remote learning. While risk increased with local disease activity, most of it can be attributed directly to the absence of in-person classes: we estimate that dropout risk increased by no less than 247% across the State, even at the low end of the distribution of per capita Covid-19 cases. Average standardized test scores decreased by 0.32 standard deviation, as if students had only learned 27.5% of the in-person equivalent under remote learning. Learning losses did not systematically increase with local disease activity, attesting that they are in fact the outcome of remote learning, rather than a consequence of other health or economic impacts of Covid-19. Authorizing schools to partially reopen for in-person classes increased high-school students test scores by 20% relative to the control group.
Las medidas de salvaguardia en la Comunidad Andina
Authors: Gómez Apac Hugo
Published: June 2021

El presente capítulo tiene por objeto explicar el desarrollo jurisprudencial llevado a cabo por el Tribunal de Justicia de la Comunidad Andina (en adelante, el Tribunal o el TJCA) con respecto a las medidas de salvaguardia comercial previstas en el capítulo XI del Acuerdo de Cartagena.
El principio de subsidiaridad empresarial del Estado
Authors: Guzmán Napurí Christian
Published: June 2021

En realidad, la doctrina maneja dos conceptos de subsidiaridad en el ámbito del derecho público económico. El primero, que es más amplio, está dirigido a comprender el accionar del Estado como subsidiario de la actuación de los particulares, de tal forma que él mismo interviene cuando estos no pueden obtener por sí mismos el resultado más eficiente, dada la existencia de distorsiones en el mercado como pueden ser los costos de transacción o las externalidades.
Fundamentos para otorgar autonomía constitucional al Instituto Nacional de Defensa de la Competencia y de la Protección de la Propiedad Intelectual (INDECOPI)
Authors: López Raygada Pierino
Published: June 2021

En el presente artículo abordaremos diversos aspectos que revelan la relevancia constitucional del mandato funcional del Instituto Nacional de Defensa de la Competencia y de la Protección de la Propiedad Intelectual (en adelante, Indecopi), que además es la entidad administrativa investida como la autoridad nacional de protección del consumidor en el país.
Supervision of Academic Supervisor and Quality of ‎Education in Madrasah Ibtidaiyah
Authors: Hasanah Nur
Published: June 2021

Supervisors are one of the most important elements in ensuring the quality of madrasah education. Therefore, the duty of the supervisor have to be in accordance with the work program about the quality of education in the madrasah is in accordance with the standards set by the madrasah. The maximum implementation of supervisory to the academic supervision will help the quality of madrasah education to be achieved. This study aims to determine the academic supervisory competence of madrasah supervisors, the quality of madarasah education, and the relation of academic supervisory competence and the quality of Madrasah Ibtidaiyah education in the Sub-district of West Ungaran Barat, Semarang District.This study used the method of observation, interviews, and documentation. And the data analysis used flow flows. The conclusion of this study was that the academic supervision competence of the Madrasah Ibtidaiyah supervisor has been carried out but has not been maximally in accordance with the supervisor's work program. While, the education quality of MI Nyatnyono 2 and MI Lerep in the process standards and results have not been maximized. And the relations of the supervisors' academic competency supervision and MI (Madrasah Ibtidaiyah) quality education are associative relations in the form of cooperation, accommodation and supervisory associations in conducting academic supervision in the MI so that the quality of MI education in standard processes and results can be carried out even though it is not maximized.
Student Worksheet Based on Scientific Approach to ‎Improve Learning Outcomes and Creative Thinking Ability ‎of Elementary Student
Authors: Nurkholis Akhmad
Published: June 2021

The scientific approach is an approach that is much highlighted in the implementation of the 2013 curriculum with learner-centered learning. Learning steps with this approach is designed so that learners are actively building concepts, principles or laws through the stages which includes observing, asking, reasoning, trying, and forming networks. The aims of this study are to develop student worksheets with a scientific approach to ecosystem balance learning material, describe the effect of student worksheets based on a scientific approach toward creative thinking skills, and explain the effect of student worksheets with a scientific approach to student learning outcomes. The method used in this study was pre-experimental design with the research design of one-group pretest-posttest design. Subjects in this study were learners VB class Madrasah Ibtidaiyah Negeri/MIN (Islamic Elementary School) 1 Magelang which numbered 26 people. The data collection techniques used are interviews, observation and written tests. The results of the study show that the student worksheet based on the scientific approach can improve student learning outcomes of 4.50 from an average of 70.00 to 74.50, and increasing the number of students completeness by 8 from 14 to 22 students who completed, the percentage of completed students increased by 30.76%, from 53.85% to 84.61%, the class completeness percentage of 84.61% exceeded the class completeness criteria was set at 80%, and a positive effect on creative thinking skills of learners.
"That’s my Auntie"
Authors: McCracken Krista , Hogan Skylee-Storm
Published: June 2021

The Truth and Reconciliation Commission of Canada called for increased access to archival material documenting the history of Residential Schools. What does this access and associated programming look like? How can archives approach sharing Residential School history in an ethical and culturally appropriate way? This project report provides examples of reciprocal approaches to archival work by drawing on a case study of the community-guided work undertaken by the Children of Shingwauk Alumni Association (CSAA) and the Shingwauk Residential Schools Centre (SRSC).
Dah Dzāhge Nodesidē/We Are Speaking Our Language Again
Authors: Thompson Edōsdi/Judy
Published: June 2021

As a member of the Tahltan Nation, I carried out research that centred on community experiences of language reclamation. The investigation focused on how language reclamation is connected to health and healing, as well as what has been done and what still needs to be done to revitalize and reclaim the Tahltan language. Language reclamation is the start of a process in which our people heal from the impacts of colonization and assimilation by reclaiming our language, culture, and identity, thereby allowing our voices to become stronger and healthier. From what was learned from community co-researchers, scholars who have worked with our communities, Indigenous community language revitalization experts, and international language revitalization scholars, I developed a Tāłtān Language Reclamation Framework focusing on governance; language programming; documentation; training and professional development; and resiliency, healing, and well-being. This report will discuss the ways in which this framework has been implemented in community over the last decade, highlighting examples such as the formation of a language governing body, Dah Dẕāhge Nodeside (Tahltan Language Reclamation Council); the implementation of language nests; the development of a Tāłtān language school K–8 curriculum; the creation of learning materials based on old and new recordings of first language speakers (e.g., digital apps and videos, websites, alphabet book, grammar resources); post-secondary fluency/proficiency community programming; and documentation training. Finally, we continue to focus on the relationship between language reclamation, intergenerational trauma, and healing, resiliency, and well-being. This will be done through community-based immersive programming that focuses on the nurturing of relationships with first language speakers in order to create not only learning resources, but safe and supportive environments for all speakersーlearners, second language speakers, silent speakers, and first language speakers.
Evolving Knowledge
Authors: Pottle Barry , Walsh Andrea N.
Published: June 2021

Interview with Inuk artist Barry Pottle from Nunatsiavut in Labrador (Rigolet). Photographs are selected from ten years of photography based on his experiences and observations as an urban Inuk. This conversation provides insight into Pottle’sphotographic practice, particularly the artist’s process of learning the art and technical processes of photography and why his photographs matter in the process of Canadians facing their complicities in Canada’s ongoing colonialism. Pottle’s practice produces unique knowledge about Inuit culture and history through his eyes as an urban Inuk photographer.
Engaging Respectfully with Indigenous Knowledges
Authors: Callison Camille , Ludbrook Ann , Owen Victoria , Nayyer Kim
Published: June 2021

This paper contributes to building respectful relationships between Indigenous (First Nations, Métis, and Inuit) peoples and Canada's cultural memory institutions, such as libraries, archives and museums, and applies to knowledge repositories that hold tangible and intangible traditional knowledge. The central goal of the paper is to advance understandings to allow cultural memory institutions to respect, affirm, and recognize Indigenous ownership of their traditional and living Indigenous knowledges and to respect the protocols for their use. This paper honours the spirit of reconciliation through the joint authorship of people from Indigenous, immigrant, and Canadian heritages. The authors outline the traditional and living importance of Indigenous knowledges; describe the legal framework in Canada, both as it establishes a system of enforceable copyright and as it recognizes Indigenous rights, self-determination, and the constitutional protections accorded to Indigenous peoples; and recommend an approach for cultural memory institutions to adopt and recognize Indigenous ownership of their knowledges, languages, cultures, and histories by developing protocols with each unique Indigenous nation.
Grease Trail Storytelling Project
Authors: Sam Johanna , Schmeisser Corly , Hare Jan
Published: June 2021

Background: Indigenous learners and community members are often excluded from online learning environments, as both consumers and producers of knowledge, resulting in an educational digital divide. Further, Indigenous knowledges represented through digital practices and online spaces risk misrepresentation and appropriation, which leads to stereotypes and deficit thinking about Indigenous people, their histories, and their current realities. There is a need for educational approaches that give space, voice, and agency to Indigenous people. Aim: This article is a reflection on a teaching enhancement project that weaved together local land-based learning, Indigenous storytelling, and digital media. Project Overview: Indigenous pre-service teachers created an open educational resource, the Grease Trail Digital Storytelling Project, to enhance the preservation and accessibility of Indigenous histories, stories, and memories embedded in local landscapes. Their approach to Indigenous digital storytelling uses the principles of respect, relevance, responsibility, and reciprocity to document and curate their digital storytelling practices and Indigenous knowledgetraditions. Discussion: The Grease Trail Digital Storytelling Project may serve as a helpful resource for those interested in learning how Indigenous digital storytelling could be approached for the preservation of Indigenous intellectual traditions that bring together land, story, and memory in online spaces and integrated as a tool for teaching and learning in school and community settings.
HASAN ONAT’IN GÜNÜMÜZ DİNİ GRUPLARI ÜZERİNE DÜŞÜNCELERİ
Authors: ARIKAN Adem
Published: June 2021

Hasan Onat İslam mezhepleri tarihi ve çağdaş İslam akımları alanında dersler vermiş, kitaplar, makaleler yazmış, tebliğler sunmuş, televizyon, radyo ve gazetelerde yayınlar yapmıştır. O Türkiye’deki mevcut dinî anlayışın tarihini Osmanlı’nın son dönemi ile ilişkilendirerek ele almaktadır. Hasan Onat’a göre Cumhuriyet’in ilk döneminde aydınlar dinden uzak durmuştur. Din alanında boşluk, tarikatlar ve cemaatler tarafından doldurulmuştur. Gelenek din gibi görülmüştür. Sömürge ülkelerinde yazılmış kitaplar tercüme edilmiş ve Türkiye'deki din dili siyasallaşmıştır. İran devrimi sonrası, devrimin Şiî ideologlarının kitapları tercüme edilmiş, Türkiye’de geleneksel Sünnî anlayışta çözülme hızlanmıştır. Selefi-Şii kutuplaşması, Şii İran ve Vehhabi Suudi Arabistan siyasi rekabetiyle ilgilidir. Selefilik bir mezhep değil, bir zihniyettir. Hasan Onat aklın önemine vurgu yapmaktadır. O Kur’ân merkezli, araştırmaya dayalı din anlayışını önemsemektedir. Geleneğin muazzam birikimi sağlıklı bir şekilde eleştiriye tabi tutularak değerlendirilmelidir.