bluuebunny/crossref_metadata_2025 huggingface dataset:
MANUALINIO MASAŽO POVEIKIO GLABELOS RAUKŠLĖMS VERTINIMAS MERZ AESTHETIC SKALĖJE
Authors: Gerikienė Vitalija , Urbonienė Simona , Šulcaitė-Vasiljeva Mercedes , Letkauskaitė Kristina , Ozbinaitė Roberta
Published: November 2024

Tikslas. Įvertinti manualinio masažo poveikį glabellar raukšlėms Merz Aesthetic skalėje.

Metodika. Tyrime dalyvavo keturios 50–55 metų mote­rys (n=4). Tyrimas vyko dviem etapais. Pirmame etape visoms (A1, A2, A3, A4) tyrimo dalyvėms (n=4) buvo atlikti 8 masažai. Antrame etape masažas buvo pratęstas dviem (A3, A4) atsitiktinai atrinktoms tyrimo dalyvėms (n=2), kurioms buvo atlikti dar 8 masažai (iš viso šioms tyrimo dalyvėms buvo atlikta 16 masažų). Fotodoku­mentų analizei buvo naudojama Merz Aesthetic skalė.

Rezultatai. Įvertintas Merz Aesthetic skalėje, 8 masažų kursas turėjo teigiamą poveikį visų tyrimo dalyvių glabel­lar raukšlėms ramybės būsenoje ir dinamikoje. Visų ty­rimo dalyvių raukšlių būklė pagerėjo mažiausiai 1 balu.

Išvados. Tyrimo imtyje vertikalias kaktos raukšles for­muojančiam glabellar zonos raumenų kompleksui 8 ma­sažų kursas buvo efektyvesnis nei šešiolikos.
KLASIKINIO VEIDO MASAŽO SU ERŠKĖTUOGIŲ ALIEJUMI POVEIKIS BRANDŽIAI MOTERS VEIDO ODAI. ATVEJO ANALIZĖ
Authors: Stančaitytė Daiva , Ošurkovaitė Eglė
Published: November 2024

Odos senėjimas yra sudėtingas, ilgas biologinis proce­sas, kurį veikia genetiniai ir aplinkos veiksniai. Senstant odos struktūra keičiasi. Plonėja epidermio sluoksnis dėl keratinocitų atrofijos. Oda išsausėja, nes vyksta transepi­derminis vandens netekimas. Keičiasi odos elastingu­mas ir stangrumas dėl elastino ir kolageno sintezės lėtė­jimo. Senėjimo proceso padariniai yra odos suglebimas, raukšlės, pigmentacija, pilkšva odos spalva. Pasireiškus šiems požymiams, siekiama pirmuosius simptomus ma­žinti, naudojant įvairias natūralias priemones. Vienas iš senėjimą lėtinančių būdų žmonijos istorijoje yra masažas ir augaliniai aliejai. Masažo poveikis organizmui yra įvairialypis. Jo metu pašalinamos negyvos odos ląstelės, gerėja odos kvėpavimas, aprūpinimas deguonimi, page­rėja natūralus odos drėkinimas ir maitinimas, gerėja odos spalva, raumenų tonusas, gražėja veido ovalo kontūras. Augaliniai aliejai yra naudojami odai, nes turi daugybę teigiamų fiziologinių savybių. Erškėtuogėse randama vitaminų C, A ir E, karotinoidų, nepakeičiamųjų riebalų rūgščių, polifenolių, triterpeno rūgšties, galaktolipidų ir antioksidantų. Erškėtuogės yra augalas, kuris pasižymi išskirtiniu antioksidantų šaltiniu, turi įtakos raukšlėms, odos drėgmei ir elastingumui. Šio tyrimo tikslas − nu­statyti klasikinio veido masažo su erškėtuogių aliejumi poveikį brandžiai veido odai. Tyrimo rezultatai parodė senstančios veido odos būklės pagerėjimą, taikant kla­sikinį veido masažą su erškėtuogių aliejumi. Atlikus odos analizę prieš tyrimą ir po jo buvo pastebėti visų tirtų rodiklių pakitimai, kuriuos parodė aparatiniai bei manualiniai matavimai. Per visą tyrimo laikotarpį page­rėjo odos drėgmė, elastingumas, odos spalva, sumažėjo raukšlių gylis.
BENZODIAZEPINŲ, JŲ DARINIŲ IR PANAŠAUS VEIKIMO VAISTŲ VARTOJIMO PAPLITIMAS VYRESNIAME AMŽIUJE
Authors: Jaremko Inna , Liaudanskytė Gabija , Macas Andrius
Published: November 2024

Benzodiazepinai (BZD) yra vieni dažniausiai išrašomų vaistų visame pasaulyje ir naudojami dėl jų anksiolitinių savybių. Nors Lietuvoje suvartojimo rodikliai turi tenden­ciją mažėti, netinkamas šių vaistų paskyrimas lemia per didelį vartojimą, piktnaudžiavimą ir polifarmaciją, o tai tapo augančia visuomenės sveikatos problema. Kadangi vyresnio amžiaus žmonės yra pažeidžiamiausia populia­cijos grupė, vartojanti CNS veikiančius vaistus, šiame tyrime apžvelgėme šių medikamentų vartojimo indika­cijas, dažnį ir dažniausiai vartojamas preparatų grupes. Tyrimas buvo vykdomas Lietuvos sveikatos mokslų uni­versiteto ligoninės Kauno klinikų (LSMUL KK) Aneste­ziologijos klinikoje. Į tyrimą buvo įtraukti 283 tiriamieji, iš kurių 166 (58,7%) vartojo CNS veikiančius vaistus. Rezultatai atskleidė, kad daugiausia tiriamųjų vartojo BZD grupės vaistus, iš jų dažniausi buvo alprazolamas ir bromazepamas, o mažiausiai vartojo į BZD panašius medikamentus – zolpidemą. BZD vyresnio amžiaus žmo­nėms dažniausiai skiriami miego sutrikimų ir nerimo gydymui. Miego sutrikimams dažniausiai buvo vartoja­mas alprazolamas, o nerimo sutrikimams – bromazepa­mas. Beveik visi tiriamieji BZD, jų darinius ir panašaus veikimo vaistus vartojo ilgiau nei 4 savaites. Ilgalaikis BZD vartojimas vyresnio amžiaus žmonėms susijęs su didesniu nepageidaujamų reakcijų dažniu, o nesilaikant gydymo rekomendacijų – tolerancijos išsivystymu bei priklausomybės atsiradimu.
UŽPAKALINĖ TARPLAIPTINĖ BLOKADA: KLINIKINIS ATVEJIS
Authors: Stankutė Deimantė , Smolskaitė Ieva , Mikalauskis Alfredas , Valiuvienė Rūta , Gudaitytė Jūratė
Published: November 2024

Straipsnyje aprašomas klinikinis atvejis, kai po periferi­nės regioninės blokados pasireiškė paralyžius ir sąmonės praradimas. 49 m. pacientui, prieš planuojamą peties akromioplastikos operaciją, buvo atlikta interskaleninė peties nervinio rezginio blokada užpakaliniu būdu. Ada­tos dūrio vieta ir nervinis rezginys identifikuoti remiantis anatominių orientyrų ir neurostimuliatoriaus duomeni­mis. Po vietinių anestetikų mišinio injekcijos pacientui stebėtas kvėpavimo funkcijos praradimas ir sąmonės netekimas. Labiausiai tikėtina, kad simptomų priežastis buvo vietinių anestetikų intratekalinė injekcija. Pacientas buvo intubuotas ir pradėta dirbtinė plaučių ventiliacija. Po operacijos pacientas perkeltas į intensyviosios tera­pijos skyrių, kuriame taikant simptominį gydymą, gyvy­binės funkcijos atsikūrė. Šis klinikinis atvejis parodė, kad periferinė regioninė blokada gali sukelti gyvybei pavojingas komplikacijas, kurios gali tapti iššūkiu visai medikų komandai. Literatūroje nurodoma, kad siekiant sumažinti komplikacijų dažnį, šią blokadą rekomenduo­jama atlikti kontroliuojant ultragarsu.
INCIDENCE OF SPHENOIDAL EMISSARY FORAMEN IN A SAMPLE OF DRY SKULLS FROM LITHUANIA
Authors: Berškys Ignas
Published: November 2024

Sphenoidal emissary foramen (SEF) or foramen of Vesa­lius is an opening located medially and anteriorly to the foramen ovale in the base of the skull. Curiously, it can also be absent. This study aimed to investigate the inci­dence of SEF in a sample of dry skulls from Lithuania and to compare the findings with those published pre­viously. For this, 72 dry skulls (51 male and 21 female) were examined for the presence of SEF. The patency of SEFs found was confirmed. The data gathered was statis­tically analyzed, and a literature review was performed. SEF was present in 59.7% (N = 43/72) of the skulls. It presented unilaterally (37.5%, N = 27/72) more often than bilaterally (22.2%, N = 16/72), but the difference was not statistically significant. No statistically signifi­cant difference could be observed between SEF incidence in the left (19.4%, N = 14/72) and the right (18.1%, N = 13/72) antimere in case of unilateral occurrence. Fe­male skulls were more likely to possess SEF (71.4%, N = 15/21) than male skulls (54.9%, N = 28/51) but not statistically significantly so. The findings of this study agree with the description of SEF as an inconsistently found foramen and add to the anatomical knowledge of it. Awareness of SEF is of paramount importance if sur­gical manipulations are performed in close proximity to it to reduce the risk of potential complications.
LĖTINIS HEPATITAS B: EPIDEMIOLOGIJA, TRANSMISIJA, DIAGNOSTIKA, GYDYMAS
Authors: Rožankevičiūtė Emilija
Published: November 2024

Lėtinė hepatito B infekcija yra sunki našta sveikatos sistemai pasauliniu mastu. Beveik trečdalis milijardo gy­ventojų yra arba buvo paveikti ligą sukeliančio patogeno. Nors daugelis pasaulio šalių į valstybines imunoprofilak­tikos programas yra įtraukusios vakciną nuo hepatito B viruso, vis dar yra tam tikrų regionų, kuriuose skiepijimo aprėptys išlieka pernelyg mažos, o naujų atvejų skaičius didėja. Dažniausiai tokie regionai apima besivystančias šalis, kuriose infekcija perduodama perinataliniu būdu arba ankstyvoje vaikystėje. Toks viruso plitimo kelias kasmet didina mirčių skaičių. Lėtinio hepatito B įtarimas, ankstyva diagnostika ir priešvirusinių medikamentų sky­rimas gali sulėtinti ligos eigą. Nors taikant šiuolaikinius gydymo metodus neįmanoma pasiekti viruso eliminaci­jos ir visiško pasveikimo, vaistų vartojimas gali pagerinti pacientų gyvenimo kokybę, prailginti išgyvenamumą bei atitolinti sunkių ligos komplikacijų, įskaitant cirozę ar hepatoceliulinę karcinomą, pasireiškimą. Siekiant padi­dinti funkcinio pasveikimo, apibrėžiamo kaip hepatito B paviršiaus antigeno (HBsAg) paciento kraujyje neaptiki­mas, dažnį, kuriami nauji gydymo metodai ar taikomos esamų vaistų kombinacijos.
GELEŽIES STOKA: EPIDEMIOLOGIJA, ETIOLOGIJA, SIMPTOMAI, DIAGNOSTIKA, GYDYMAS
Authors: Gužytė Eglė
Published: November 2024

Geležies stoka itin plačiai paplitusi visuomenėje. Skai­čiuojama, kad geležies stoką patiria penktadalis pasau­lio gyventojų, ypač vaikai iki 5 metų, vaisingo amžiaus, nėščios ir krūtimi maitinančios moterys bei vyresnio amžiaus žmonės. Dažniausiai geležies stoka vystosi palengva, pirmiausia geležies atsargos sumažėja kaulų čiulpuose, tada jos išsenka ir išsivysto geležies stokos anemija. Priežastys, dėl kurių išsivysto geležies stoka, gali būti skirstomos į keturias grupes: sumažėjęs geležies suvartojimas, padidėję fiziologiniai poreikiai, sutrikusi absorbcija arba lėtinis kraujavimas. Ankstyvieji gele­žies stokos simptomai nespecifiniai: nuovargis, silpnu­mas, fizinio krūvio netoleravimas, sunkumas susikaupti, mažas darbo produktyvumas. Geležies stoka gretutinių ligų neturintiems žmonėms diagnozuojama, kai feritino koncentracija <30 μg/l, o vyresniems ar gretutinėmis li­gomis sergantiems žmonėms, kai feritino koncentracija <100 μg/l arba transferino saturacija <20 proc. Nustačius geležies stoką, skiriamas pirmo pasirinkimo gydymas peroraliniais geležies preparatais.
IŠMANIOJO TELEFONO SUKELIAMAS LAIKINASIS MONOKULINIS AKLUMAS: SIMPTOMAI IR PRIEŽASTYS, DIAGNOSTIKA, PREVENCIJA
Authors: Svirskaitė Kamilė , Budreckis Kasparas
Published: November 2024

Išmaniaisiais telefonais naudojasi vis didesnė žmonių populiacija – tiek vaikai, tiek pagyvenusieji. Vis dažniau aprašomi atvejai, kai pacientai atvyksta į gydymo įstaigą dėl laikino regos sutrikimo viena akimi, nurodę, kad prieš tai naudojosi išmaniuoju telefonu. Diagnozuoti išmaniojo telefono sukeltą laikiną aklumą galima iš anamnezės, ta­čiau labai svarbu pacientą, kuris nurodo tokius simpto­mus, ištirti, atmesti kitas monokulinio aklumo priežastis bei pasiūlyti prevencines priemones.
CycleGAN-based Data Augmentation for Enhanced Remaining Useful Life Prediction Under Unsupervised Domain Adaptation
Authors: Joubaud Dorian , Zotov Evgeny , Bektaş Oğuz , Kubler Sylvain , LeTraon Yves
Published: November 2024

Predictive maintenance is crucial for enhancing operational efficiency and reducing costs in Prognostics and Health Management (PHM). One of the key tasks in predictive maintenance is the estimation of Remaining Useful Life (RUL) of machinery. In practice, the data for different machines is not always accessible in sufficient quantity or quality, therefore the machine learning models trained on machines in one domain often perform poorly when applied to other domains due to covariate shifts. As a solution, Domain Adaptation (DA) aims to tackle domain shifts by extracting domain-invariant features. However, traditional methods often fail to adequately address the complexity and variability of real-world data. We propose to address this challenge, using a Wasserstein CycleGAN with Gradient Penalty (W-CycleGAN-GP) to learn mappings between domains and generate augmented data in the target domain from data in the source domain. We use our approach to generate realistic augmented data that bridge domain gap coupled with recent work on adversarial-based and correlation alignment-based DA models to improve the performance of RUL prediction models in target domains without having access to labeled data. The experimental results on the C-MAPSS dataset demonstrate a significant improvement in the RUL prediction score and accuracy within the target domain.
Data-driven Detection of Engine Faults in Infrequently-driven Ground Vehicles
Authors: Kohrt Ethan , Moon Matthew , Sullivan Matthew , Das Sri , Thurston Michael , Nenadic Nenad G.
Published: November 2024

We investigated the detection of engine faults in infrequently driven ground vehicles using data-driven methods based on neural network autoencoders. Multivariate time-series data from the infrequently driven vehicles under investigation had limited coverage of operating conditions. Hence, a considerable part of this work focused on identifying suitable vehicles, relevant signals, and pre-processing the data. We trained autoencoder models on eight vehicles with known faults and detected faults in six. Four of the faults were detectable under idle conditions and four were detectable under driving conditions. Model evaluations required human inspection to distinguish fault detections from other anomalies. We detail our procedures for pre-processing, model development, and post-processing, and we include a discussion on our interpretations of the model results.
Global-Local Continual Transfer Network for Intelligent Fault Diagnosis of Rotating Machinery
Authors: Li Jipu , Yue Ke , Liao Jingxiao , Wang Tao , Zhang Xiaoge
Published: November 2024

Existing fault diagnosis methods face three fundamental challenges when deployed in the dynamic environment, including insufficient continuous diagnostic capability, poor model generalization performance, and inadequate data privacy protection. To address these problems, we develop a novel continual fault diagnosis framework named Global-Local Continual Transfer Network (GLCTN) for fault classification of unlabeled target samples under different working conditions without any source samples. Specifically, a consistency loss and a mutual information loss are introduced in the proposed GLCTN to transfer the learned diagnostic knowledge. Moreover, a dual-speed optimization strategy is utilized to preserve the acquired diagnostic knowledge and to endow the model with the ability to acquire new knowledge. Validation experiments conducted on an automobile transmission dataset demonstrate that the proposed GLCTN achieves satisfactory diagnostic performance on multiple continuous transfer diagnostic tasks.
Remaining Useful Life Prognostics of Rolling Element Bearings Based on State Estimation Techniques
Authors: Li Zhen , Gryllias Konstantinos
Published: November 2024

Rolling element bearings (REBs) are key components in rotating machines. 40% of the failures in electrical motors occur due to bearing faults. Consequently, monitoring the health stage and estimating the remaining useful life (RUL) of the REBs is essential. Additionally, maintenance of rotating machines can be scheduled based on the RUL estimation, which will mitigate potential time wasting, economic losses and hazards. In this summary, several issues that exist in current research are highlighted. Then a series of preliminary explorations have been performed, and some results have been already obtained. Finally, a systematic methodology is expected to be proposed by combining the state estimation techniques and physical models to facilitate the development of the PHM.
Implementation of Wastewater Monitoring System using Low-Cost Water Sensor and IoT-based SCADA
Authors: Soetedjo Aryuanto , Abdilah M. Rifqi , Limpraptono F. Yudi , Hendriarianti Evy
Published: November 2024

Wastewater monitoring is crucial for ensuring the wastewater quality is in the allowable range. This paper presents the implementation of a wastewater monitoring system using low-cost water sensors and Internet of Things (IoT)-based Supervisory Control and Data Acquisition (SCADA). The low-cost water sensor comprises the pH, temperature, turbidity, and Dissolved Oxygen (DO) sensors. The sensors are connected to the ESP32 microcontroller that is equipped with the WiFi module for communicating with the master unit, namely the Haiwell CBOX. Since the Haiwell CBOX is an IoT-based device, it is connected to the IoT cloud server. Thus, it can be accessed remotely through the Internet. The experimental results show that the user-friendly graphical interface is easy to develop and provides the user with useful and helpful information for monitoring and analyzing wastewater parameters. Further, the communication time interval of four seconds between the ESP32 and CBOX achieves a stable connection.
DOMESTIC VIOLENCE PREVALENCE AND PERCEPTION OF PREGNANT WOMEN VISITING ANTENATAL CLINICS IN GARRI HOSPITAL -KHARTOUM STATE, SUDAN 2019
Authors: Ali Abacker Tayba Mohammed , Ali Nasr Abubakr Mohammed , Taha Faiza
Published: November 2024

Background: Pregnant women who experience domestic abuse are at heightened risk for bleeding preterm labor, and
psychosis. Violence is a serious public health concern. Objective: to investigate the occurrence of domestic violence
among clients and their perception in prenatal clinics. A convenient sample of 236 clients, intervie Methods: wed in a cross-sectional hospitalbased study in 2019. Data were analyzed and suitable statistic was used. Results: 113 (47.9%) of pregnant women were reported exposure to
domestic violence (Physical 10.7%, economic constrain 21.2% and psychological 16%.). Women believed that spouse and the family were
responsible for domestic violence. links between husband's substance used alcohol and violence (P = 0.002), verbal abuse and adverse pregnancy
outcomes, p <. 05 were found. Occurrence of domestic violence among mothers was high. Associations Conclusion: identified in this study shed
light on complex social factors that need to be addressed.
SURGICAL AND ANESTHETIC MANAGEMENT OF A CERVICAL PENETRATING WOUND: A CASE REPORT WITH LITERATURE REVIEW
Authors: Nabil Mehdi , Khallikane Said , Monsif Salek , Qamouss Youssef , Abou ElHassan Taoufik
Published: November 2024

Cervical penetrating injuries have the potential to negatively impact the essential and practical outlook for the injured
person. The difficulties of handling emergencies and subsequent corrective procedures call for a comprehensive
understanding of the seriousness of the situation, life-saving measures, and surgical reconstruction techniques. We report the case of a 24-year-old
male who presented with a penetrating neck injury. It was a postero-lateral stab wound near the cervical spine. CT angiography confirmed the
knife's path through muscles without vascular injury or contrast leakage. The patient underwent successful surgical exploration with thorough
preoperative preparation and advanced anesthetic management. Management of penetrating neck injuries has evolved from routine exploration to
a selective approach utilizing cervico-thoracic CT angiography, which reduces unnecessary procedures and improves outcomes. The neck is
divided into three zones for assessment: Zone I (supraclavicular to cricoid), Zone II (cricoid to mandible), and Zone III (mandible to skull base).
FUNCTIONAL HYPOTHYROIDISM IN PATIENTS RECEIVING CONCURRENT CHEMORADIATION FOR HEAD AND NECK SQUAMOUS CELL CARCINOMA.
Authors: Yasar Syed , Manam Surendra
Published: November 2024

Introduction: Head and neck cancers are the fth most common globally and second most prevalent in India, with 77,000 annual cases.
Radiotherapy, often combined with chemotherapy, is a standard treatment but frequently results in radiation-induced hypothyroidism (RIHT), with
incidence rates ranging from 4% to 79%. RIHTsignicantly impacts quality of life, yet thyroid function testing is rarely routine. Hypothyroidism, a
common late effect, is irreversible and requires lifelong hormone replacement. Preventive strategies are crucial to minimize this complication in
patients undergoing radical radiotherapy with concurrent chemotherapy for head and neck squamous cell carcinoma. Aim & Objectives: This
study examines the incidence of radiation-induced hypothyroidism in patients with HNSCC receiving chemoradiation and explores preventive
strategies to reduce its occurrence and associated morbidity. Materials and Methods: This prospective study, conducted at GSLMedical College
from October 2019 to April 2021, involved patients with head and neck squamous cell carcinoma receiving radical radiotherapy. Eligible patients
underwent thyroid function tests before, after treatment, and six months post-radiotherapy. Dose-volume metrics were analyzed, and statistical
assessments were performed using SPSS 22.0 and R version 3.2.2. Signicance was set at p < 0.05. The study aimed to evaluate the incidence of
radiation-induced hypothyroidism and explore preventive strategies. Results: In our study, 17 out of 31 patients (54.8%) developed radiationinduced hypothyroidism (RIHT) at 6 months post-radiotherapy, with 13 (41.9%) showing clinical hypothyroidism (mean TSH 7.77 ± 2.93, p <
0.001). T4 and T3 levels showed no signicant difference between hypothyroid and euthyroid patients. Cold intolerance occurred in 12.9%, weight
gain in 16.1%, dry skin in 29%, and constipation in 35.5% of patients. The mean thyroid dose was similar between hypothyroid (6570.29±587) and
euthyroid groups (6541.35±601.13), with no statistically signicant difference. Long-term follow-up is crucial, as RIHT incidence increases over
time. Conclusion: Radiation-induced hypothyroidism (RIHT) is a common complication of head and neck radiotherapy, with our study reporting a
54.8% incidence at 6 months. While no clear dose-response relationship was identied, smaller thyroid volumes increased the risk of
hypothyroidism. Early detection and long-term follow-up are essential to prevent progression from subclinical to clinical hypothyroidism. Further
research is needed to improve predictive models and minimize thyroid exposure during treatment.
COMPARATIVE EFFECTIVENESS OF MEDICATED SETON VERSUS INFANT FEEDING TUBE IN MANAGING COMPLEX HIGH ANORECTAL FISTULAS: A
PROSPECTIVE STUDY
Authors: Bhat Nitish , Singh Sanjay , Yadav Akhilesh
Published: November 2024

Complex anorectal stulas pose a signicant clinical challenge, often requiring surgical intervention to prevent recurrence and mitigate
complications such as incontinence. This study aimed to compare the efcacy of medicated setons and infant feeding tubes (IFT) as drainage
procedures in treating complex high anorectal stulas. A total of 54 patients were divided into two groups, with 27 patients in each group. Group A
used infant feeding tubes, and Group B employed medicated setons. The analysis was conducted to assess pain, weekly tie, cost, and durability of
the treatments. The results showed that medicated seton provided better pain relief, while IFT offered advantages in terms of cost and durability.
Both methods exhibited similar outcomes in the frequency of weekly tie adjustments.
FUNCTIONAL OUTCOME OF DIAPHYSEAL FRACTURES OF LONG BONES IN CHILDREN WITH TENS SYSTEM
Authors: Hussain Md Muzammil , Patil M. S
Published: November 2024

Background: The diaphyseal fractures of pediatric long bones are very commonly encountered in orthopedic practice. Previously conservative
treatment was considered ideal for these fractures and is treated by spica. Because of nonunion, unacceptable angular deformities, fracture
instability, joint stiffness or the failure of conservative management, some diaphyseal fractures require osteosynthesis. Hence surgical procedure of
choice for diaphyseal fractures in children is an intramedullary xation with titanium elastic nails. To examine the union rates, clinical Objectives:
results, and functional outcomes of TENS-treated pediatric diaphyseal fractures of long bones. This Methods: prospective study was carried out at
Al-Ameen Medical College and Hospital, Vijayapura. Thirty patients aged between 6-16 years with diaphyseal fracture of long bones were
included in our study. Patients were treated with closed reduction and internal xation with TENS. They were followed up for 6 months both
clinically and radiologically. The functional outcome evaluated using Flynn's scoring system. The me Result: an age of the patients was 10.3 years.
There was male preponderance (66.66%). In our study, RTA was observed to be the main cause of fracture (50%) whereas (33%) fractures were due
to self-fall and (16%) were due to fall from height. In our study, (33.33%) patients had fracture of femur, followed by fracture of tibia (30%), radius
& ulna (26.67%), and humerus (10%). The mean time to union was 12.1 weeks. TENS in diaphyseal fractu Conclusion: res of long bones provides
early union early mobilization, deformity correction and minimal intervention.
ASSESSMENT OF AGE AND SEX IN REMS SCORES AMONG TRAUMA PATIENTS IN A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL CROSS-SECTIONAL STUDY
Authors: Palepu Raghu , C. Sada Elizabeth
Published: November 2024

Trauma causes significant global morbidity and mortality, with over 5 million annual deaths, particularly in low- and middle-income countries.
Effective trauma care requires early, accurate assessment. The Rapid Emergency Medicine Score (REMS) uses variables like Glasgow Coma Scale
(GCS), blood pressure (BP), respiratory rate (RR), pulse rate (PR), peripheral oxygen rate (SpO2), body temperature (BT), and patient age to
predict outcomes. This study correlated the age and sex with REMS scores among trauma patients to enhance clinical decision-making and patient
care. Material And Method: This cross-sectional observational study included 100 trauma patients > 18 years of age, presented to the emergency
medicine department. After taking consent demographic data was collected and REMS was calculated. Results: Out of a total of 110 trauma
patients, 78% were males and 22% were females, with a mean age of 37.86 years. The major age group was 21-30 years (25%), with a
predominance of RTAs in most cases (51%). The initial REMS of the study population was 4.52 ± 4.43, which decreased to 3.25 ± 3.56. There was a
weak correlation between gender and follow-up score (r=0.09); however, males showed a weak positive correlation with the initial score (r=0.21).
Conclusion: There was a strong positive correlation between initial and follow-up scores, indicating that initial health assessments are strong
predictors of subsequent health outcomes. There was a weak correlation between gender and follow-up score, suggesting minimal gender influence
on follow-up scores.
A COMPARATIVE STUDY OF ULTRASONOGRAPHY AND MRCP IN DIAGNOSING OBSTRUCTIVE JAUNDICE
Authors: C R Varun , Sharma Gaurav , Patel Ankit
Published: November 2024

Background: Obstructive jaundice, caused by bile flow obstruction, presents significant clinical challenges. While ultrasonography (USG) is
widely used for initial diagnosis, it has limitations in visualizing deep structures like the distal common bile duct and pancreas. Magnetic
Resonance Cholangiopancreatography (MRCP), introduced in 1991, offers a non-invasive, radiation-free alternative for detailed visualization of
the biliary and pancreatic systems. Aims & Objectives: This study aimed to compare the diagnostic effectiveness of USG and MRCP in
identifying the cause of obstructive jaundice. Additionally, the study sought to evaluate the role of both modalities in detecting post-surgical
complications, with an emphasis on diagnostic accuracy, sensitivity, and specificity. Methods: A cross-sectional study of 90 patients with
suspected obstructive jaundice was conducted at the Department of Radiodiagnosis, Heritage Institute of Medical Sciences, Varanasi, from
November 2022 to May 2024. Patients underwent USG followed by MRCP. Data were analyzed using SPSS version 26.0, and the chi-square test
was applied to assess statistical significance (p < 0.05). Results: MRCP showed higher diagnostic accuracy (95.56%) and sensitivity (81.82%)
compared to USG's detection rate of 65.5% for obstructive pathologies. MRCP identified more cases of bile duct injuries (13.3%) and bile leaks
(41.1%). USG, though useful for initial screening, was less effective in detecting complications. Most participants were female (68.89%) and aged
51-60, with yellowish discoloration of the skin as the most common symptom (76.67%). Conclusion: MRCP is superior to USG for diagnosing
obstructive jaundice and post-surgical complications, offering greater sensitivity, specificity, and diagnostic accuracy. While USG is a costeffective screening tool, MRCP is essential for confirming findings, assessing biliary obstructions, and planning surgery, leading to better patient
outcomes.
A PROSPECTIVE OBSERVATIONAL STUDY OF DRUG UTILIZATION FOR COMPARATIVE ANALYSIS OF EFFICACY OF SUMATRIPTAN, NAPROXEN AND A FOUR COMPONENT ERGOTAMINE BASED COMBINATION IN MIGRAINE WITHOUT AURA
Authors: Dixit Madhumita , Singh Abhishek Kumar , Chaurasia Rakesh Chandra , Kumar Nim Dwividendra
Published: November 2024

Background: Migraine is primary headache disorder characterized by recurring attacks of pain and associated symptoms. Ergotamine has been
considered very effective preparations for aborting acute attacks of migraine without aura but in recent times Triptans have proven to be very
promising as well. The aim of our study was to compare the efcacy of Sumatriptan, Naproxen and Erg Objective: otamine based four-component
drug combination in the treatment of moderate to severe acute attacks of migraine without aura. Stud Materials and Methods: y was designed as
prospective, observational, randomized, parallel arm and unicentric conducted in neurology department of a tertiary care hospital of North India.
The enrolled patients having migraine without aura were randomised in four treatment groups. Group 1(n=49) received Sumatriptan (100 mg),
Group 2(n=46) received a combination of Sumatriptan (85 mg) and naproxen (500 mg), Group 3(n=50) received Naproxen (500 mg) and Group
4(n=44) received a combination of Ergotamine (1 mg) + Caffeine (100 mg) + Paracetamol (250 mg) + Prochlorperazine (2.5 mg). In the Results:
rst part of the study, combination of sumatriptan and naproxen worked signicantly better than sumatriptan alone in higher dose in terminating the
Migraine attack within 2 hrs. In the second part combination of Sumatriptan (85 mg) and naproxen (500 mg) worked signicantly better in ensuring
sustained pain relief at 24 hours as compared to Naproxen (500 mg) alone. Conclusion: Combination therapy with Sumatriptan and Naproxen
remains a promising approach for treating acute migraine and achieving sustained pain-free outcomes, making it a potentially preferable option in
clinical practice for migraine management.
EARLY VS. CONVENTIONAL STOMA CLOSURE POST-BOWEL SURGERY: A RANDOMIZED CONTROLLED TRIAL
Authors: Kanojiya Rajkamal , Goyal Rajat , Sharma Dhruv , Purohit Aman
Published: November 2024

Background/Aim: This study aims to evaluate early stoma closure versus conventional stoma closure following defunctioning diversion stoma
surgery. The focus is on complications frequency, health-related quality of life (QoL), and length of hospitalization (LoH). Patients and Methods:
We conducted a prospective, parallel-arm, randomized controlled trial including patients who underwent temporary stoma surgery from December
2022 to November 2023. We assessed postoperative complications, QoL, and LoH. Results: A total of 80 patients participated, with 40 in each
group. Postoperative complications showed laparostoma rates of 5% in the early closure group versus 2% in the conventional group, wound
infections at 36% versus 20%, intra-abdominal collections at 16% versus 22%, and anastomotic leaks at 6% versus 10%. Medical complications
were comparable between the groups (26% vs. 30%). The hospital stay duration and overall mortality and morbidity rates were similar (62% vs.
46%). However, the early closure group experienced a signicant reduction in stoma care costs (90% vs. 6%) and a notable improvement in QoL.
Conclusion: Early stoma closure does not increase the risk of postoperative complications, reduces stoma care costs, and signicantly improves
QoL.
MATERNAL NEAR MISS PATIENTS IN RURAL TERTIARY CARE CENTER - CLINICALAND SOCIAL FACTORS
Authors: Chaturvedi Pragya , Kagne Swati , Tondge Ganesh
Published: November 2024

Maternal deaths are merely the tip of the iceberg. The broad base of this iceberg represents the maternal near miss patients. This has emerged as an
adjunct to investigation of maternal deaths as the two have similar pathological and circumstantial factors. These cases help us analyse and prevent
obstetrical catastrophes. Aim: To assess the various complications leading to maternal near miss at rural tertiary care center in Maharashtra, to
evaluate the socio-economic and clinical characteristics involved in these patients. Objective- To record the condition of the near-miss patients
during admission, their mode of delivery, the primary cause and the key interventions used. Method: A prospective observational type of Study
Design used and we conducted a study in a tertiary care centre of Maharashtra for 19 months from December 2022 to June 2024. All pregnant
women of reproductive age group attending Obstetrics and gynaecology department of our hospital with diagnosis of near miss according to the
WHO maternal near miss criteria and who followed up were included. Results: A total of 102 cases of near miss & 14 maternal deaths were
observed. The Maternal near miss Mortality ratio was 7.3:1. 47% cases were between age 21 - 25 years. 47% were primigravida. 86.3% reside in
rural areas. Majority cases were from lower or lower middle socioeconomic classes. 21.6% were illiterate while 60.8% were educated up to
primary level. 72.5% were referred cases. 40% of mothers had inadequate antenatal checkups. Major socio-economic factors for Probable MNM
seen in present study were: lack of accessibility of hospital (71%), Inability of understand the problem (67%). Most common etiology for maternal
near miss was hypertension disorders (40.2%) followed by hemorrhage and medical complication (22.5%). LSCS was required in 58.8%. Most
cases had hospital stay between 7 to 14 days (84.3%). ICU stay was seen for 1 to 3 days in 90.2% cases. Blood Transfusion was done in 62.7% cases.
Conclusion: Present study showed the common etiologies, interventions, common socio-economic factors of near-miss cases. The addition of
near-miss audits allows the care of critically ill women to be analyzed, deficiencies in the provision of care to be identified, and comparisons within
and between institutions and countries to be carried out over time. This will improve the quality of obstetric care and further reduce maternal
morbidity and mortality.
A STUDY TO ASSESS THE EFFECTIVENESS OF EDUCATIONAL TEACHING PROGRAM ON MISSION NIRAMAYA BY U.P. GOVERNMENT FOR SKILL COMPETENCY ENHANCEMENT AMONG NURSING STUDENTS AT SCHOOL OF NURSING SCIENCE AND RESEARCH, SHARDA UNIVERSITY, GREATER NOIDA.
Authors: Arora Nirvaan , Bhawna Bhawna , Kumari Kajal , Kaur Manjot , Kena Ringam , Kumari Subhadra
Published: November 2024

Background : The landscape of healthcare is continually evolving, guided by initiatives aimed at improving public health and ensuring equitable
access to healthcare services. Among these initiatives, Mission Niramaya stands out as a signicant effort to promote holistic health and preventive
care practices. Mission Niramaya is a bold initiative that was launched on October 2022 by Uttar Pradesh's Honorable Chief Minister, Shri Yogi
Adityanath, with the primary goal of revolutionizing medical education and improving the quality of nursing and paramedical staff in the state.
Material and method : A pre experimental study was conducted to nd out the effectiveness of structured teaching programme on knowledge
regarding Mission Niramaya by U.P. Government for skill competency enhancement among Nursing Students. On 1st day pre test was done by
using structured questionnaire and on the same day structured teaching programme was conducted for 158 nursing students to make them aware
about the initiative taken by uttar pradesh government for revolutionizing medical education and improving competency, skills for healthcare
professionals and on 7th day the post test was conducted. Results : It has been found that the majority of nursing students have inadequate
knowledge about Mission Niramaya 41.5 % and after structured teaching programme 84.8% of the nursing student were found to have adequate
knowledge about mission Niramaya the mean difference between the pre-test and post-test score was statistically signicant (The mean pre-test
score was 14.91 (SD = 4.2), indicating moderate initial knowledge. After the intervention, the mean post-test score rose to 18.07 (SD = 2.5),
showing substantial improvement. A paired t-test revealed a statistically signicant t-value of -8.4 (p < 0.01), with a mean difference of 3.16,
highlighting the program's positive impact on the students' understanding of Mission Niramaya. Conclusion : The study evaluated the
effectiveness of an educational teaching program on Mission Niramaya among nursing students. The demographic prole showed that most
participants were aged 18-20 (62.7%), rst-year students (97.5%), B.Sc. Nursing students (94.3%), and from urban areas (77.2%), with 53.8%
having some prior knowledge of Mission Niramaya. Pre-test assessments indicated that 6.3% had poor knowledge, 38.6% had average knowledge,
and 55.1% had good knowledge. Post-test results showed signicant improvement, with no students in the poor knowledge category, 15.2% with
average knowledge, and 84.8% with good knowledge. The mean pre-test score was 14.91 (SD = 4.2), which increased to 18.07 (SD = 2.5) postintervention.
The ontogenetic development of Rana dalmatina Bonaparte 1840 species (Amphibia: Ranidae) in the context of climate change
Authors: Cozari Tudor , Gherasim Elena
Published: November 2024

Globally, amphibians represent one of the main objects of study in the context of climate change, because the temperature variations recorded and in the Republic of Moldova also represent a major threat to their development and sustainability. For this purpose, a complex ecological study was carried out regarding the embryonic and larval development strategies of the Rana dalmatina Bonaparte, 1840, species and the main particularities related to its population structure and dynamics were described. This research allowed us to evaluate the degree of ecological plasticity of natural populations of Rana dalmatina in relation to the plurality of environmental factors, which allows us to develop suitable and safe measures for monitoring and conservation of the species.
Autisme op school: ASS en ATO in basis- en voortgezet onderwijs
Authors: Delfos Martine F.
Published: November 2024

Dit is een complete herziening van twee boeken, verschenen onder de titel Autisme op school (ISBN 9789088504433 en 9789088504440). De mogelijkheden van kinderen en jongeren met autismespectrumstoornissen worden onvoldoende benut. In het voortgezet onderwijs wordt de jongere geconfronteerd met een heel team aan docenten. Autisme vergt een andere benadering op school, maar ook een andere houding van de docent. In het voortgezet, secundair onderwijs betekent het dat het team ook onderling op elkaar moet afstemmen, wat op zich al een grote klus is. Het grootste probleem is dat de jongere met autismespectrumstoornissen over een heel scala aan mentale leeftijden beschikt (MAS1P, Mental age Spectrum within 1 person). Op vijftienjarige leeftijd kan hij vijftien zijn in biologisch opzicht en midden in de puberteit zitten, terwijl zijn sociaal-emotionele leeftijd twee jaar is. Hij kan in de wiskundeles zijn leraar soms voorbij zijn en tegelijk geen schoolrijp gedrag vertonen. In 'Autisme op school' legt Martine Delfos in heldere, praktische taal uit wat autisme op school betekent, hoe je een probleem herkent en hoe je ermee om kunt gaan.
Handboek Participatief Actieonderzoek. Samen bouwen aan een betere wereld
Authors: Eelderink Madelon
Published: November 2024

“For twenty years we've been struggling to find a solution and to come to an agreement. Nobody has ever accomplished this, not even the experts. Now we have done it ourselves in just 7 weeks!” - Sabaanse visser en PAO-deelnemer Participatief Actieonderzoek (PAO) is een benadering die ons in staat stelt complexe problematiek aan te pakken met datgene wat we in overvloed hebben op aarde: mensen. Wanneer al die mensen vanuit intrinsieke motivatie bijdragen aan een betere wereld op een manier die bij hen past, kunnen we enorme sprongen vooruit maken. Met PAO onderzoeken we waar die energie in de samenleving zit en laten we mensen ontdekken hoe ze met die energie kunnen samenwerken. Zij maken hun eigen actieplannen en voeren die samen uit. Het 'Handboek Participatief Actieonderzoek' biedt praktische handvatten voor het uitvoeren van PAO, of dat nu is op het gebied van gezondheidszorg, natuurbescherming, sociale problematiek of een ander domein. Het is gebaseerd op de nieuwste inzichten en ervaringen uit de praktijk. Diverse PAO-methoden worden stap voor stap toegelicht en het is aan de lezer om er een combinatie van methoden uit te halen, die het best aansluit bij de lokale context. Madelon Eelderink is koploper in de toepassing van Participatief Actieonderzoek (PAO). Met haar bedrijf SevenSenses streeft ze naar wereldwijde toepassing van PAO voor het versneld behalen van de Sustainable Development Goals. Met PAO faciliteert zij de ‘community-up’ co-creatie van innovaties en oplossingen die passen bij de behoeften en belangen van alle betrokkenen. Sinds 2013 voeren Madelon en haar team wereldwijd PAO uit op diverse onderwerpen, zoals duurzame ontwikkeling, natuurbescherming, gezondheid en gezondheidszorg, het sociale domein en de energietransitie. Daarnaast is Madelon veelgevraagd trainer, begeleider en spreker op het gebied van PAO. Momenteel voert Madelon een PhD-onderzoek uit aan de Universiteit Utrecht naar de manier waarop PAO ingezet kan worden om complexe duurzaamheidsproblematiek aan te pakken.
Chondroblastoma of Bone in Children: A Study of 3 Cases
Authors: Fettah Meryem , Mimouni Mohammed , Charki Mohamed Tazi , Abdellaoui Hicham , Atarraf Karima , Afifi Moulay Abderahmane
Published: November 2024

Chondroblastoma is a benign bone tumor arising most often in the epiphyses of long bones. Nearly 90% occurred in patients between the ages of 5 and 25 years, but tumors were found in later adulthood and even in old age. A few chondroblastomas were predominantly cystic, and some contained zones that were indistinguishable microscopically from aneurysmal bone cysts. Conservative surgical removal, nearly always effective, should be thorough so as to minimize the risk of the occasional troublesome recurrence. Late sarcomatous change has been reported in a few cases whether radiation therapy was employed or not. We report a series of 3 boys with chondroblastoma, with an average age of 12 years. All our patients underwent biopsy for confirmation and then surgical treatment consisting of curettage of the lesion followed by bone autograft filling. The aim is to discuss the anatomoclinical and evolutionary aspects of this rare tumour, to evaluate the results of surgical treatment and to identify the factors influencing the rate of recurrence after treatment.
Health Related Quality of Life (HRQoL) Following APER: Early Effects on Ano Rectal Cancer Patients
Authors: Hossain Dr. Md. Tahir , Hasan Dr. Ahmed Sami Al , Shakir Dr. Washif , Shil Dr. Rajib , Kabir Dr. Sakib
Published: November 2024

Background: Colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. Treatment of rectal cancer had been primarily focused on oncologic outcome, with detailed assessment of survival and local recurrence. Less attention has been given to functional outcome and quality of life (QoL). Methodology: This prospective study was conducted in the Department of Surgical Oncology, National Cancer Research Institute & Hospital, Dhaka from July, 2019 – March, 2021. Total 33 patients who fulfilled the inclusion and exclusion criteria were included in this study by purposive sampling. The scoring formulas supplied by EORTC was used for both the questionnaires (QLQ-C30 and QLQ-CR29) and in accordance to the scoring manual, the questionnaire items were grouped into scales in the categories – global health status QOL, functional scales and symptoms scales and then compiled. The p value was set as significant if p<0.05. Results: Mean age of the patient was 45.1±13.9 years. Physical function, role function, emotional function, cognitive function, social function and global health status were significantly (p=0.001) decreased after treatment group than before treatment group. Fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea and financial difficulties were significantly increased after treatment group than before treatment group. Conclusion: Surgical oncologist can improve the quality of life of patients by saving the neurovascular structures while performing anterior/posterior/lateral dissection of rectum. Multidisciplinary approach including “Tumour Board” as well as performing sphincter saving procedures (AR) rather than APER could drastically improve the quality of life of cancer patients. Preoperative counselling, taking time to explain and understand patients’ concern results in decreased stress and improve ......
Chronic Idiopathic Non Puerperal Uterine Inversion: Case Report
Authors: Nisrine Benaouicha , Khadija Errmili , Youssef Essabagh , Amina Lakhdar , Baydada Aziz
Published: November 2024

We present the case of a 50-year-old patient with type 2 diabetes, who had two late abortions on a cervical insufficiency and a premature delivery at 34 weeks of amenorrhea following a cervical cerclage The patient was referred to our clinic for chronic pelvic pain and a mass in the vagina that had been present for one year. Upon examination, we noted a mass externalised at the vulva, with no visualisation of the external foramen of the cervix and no palpation of the uterine fundus. A suprapubic ultrasound confirmed the absence of the uterus in pelvic position, leading to a diagnosis of complete uterine inversion. The patient underwent a total vaginal hysterectomy with simple postoperative management. An anapathological examination confirmed the diagnosis of idiopathic uterine inversion.