bluuebunny/crossref_metadata_2025 huggingface dataset:
Serial estimation of urinary trypsinogen-2 levels in patients of acute pancreatitis: a new prognostic indicator
Authors: Meena Rinki , Kumar Surender , Sonkar Abhinav Arun , Ahmad Faraz , Ali Wahid , Gaurav Kushagra , Parihar Anit , Singh Vijay Kumar
Published: December 2024

Background: Acute abdominal discomfort is a common symptom of acute pancreatitis (AP). However, because most clinics are unable to rapidly monitor pancreatic enzymes, early detection of AP is challenging. Therefore, the purpose of this study is to investigate the utility of serial urine trypsinogen-2 measurement as a prognostic indicator in individuals with AP.
Methods: A total of 60 patients with AP who presented to the surgical emergency department within 72 hours of symptom onset were included in the study, regardless of sex or age. AP was classified into mild, moderate and severe according to the revised Atlanta classification. Patient’s urine samples were collected at admission, day 3, day 5, and day 7 for determination of urine trypsinogen-2 level.
Results: The mean value of S. amylase (IU/l), S. lipase (IU/l), C-reactive protein (CRP) (mg/l), and urinary trypsinogen 2 were increased in severe compared with mild AP. The mean value of urinary trypsinogen 2 was significantly decreased from day 1 to day 7 after treatment in the mild, moderate, and severe AP groups. With these cut-off values, urinary trypsinogen 2 had a sensitivity of 92.3%, specificity of 42.9%, positive productive value (PPV) of 75%, and negative productive value (NPV) of 75% for diagnosing the severity of AP. These tests demonstrate the accuracy of urinary trypsinogen-2 to determine severity of AP.
Conclusions: In a cross-sectional study, urinary trypsinogen-2 can be used as both diagnostic and prognostic indicator for AP.
Comparative study of foley’s catheter and misoprostol versus mifepristone and misoprostol in induction of midtrimester abortions: a retrospective study
Authors: Manku Harpoonam
Published: December 2024

Background: To compare the efficacy and safety of intracervical Foley’s catheter and misoprostol versus mifepristone and misoprostol induction of midtrimester abortions.
Methods: I conducted a retrospective comparative study at a university affliated tertiary hospital at the postpartum unit of the department of obstetrics and gynaecology, Government Medical College, Amritsar from January 2022 to December 2023. Records were available for 80 patients who underwent midtrimester abortion. The enrolled women were allocated in two groups. Group A comprised women who underwent induction with combined intracervical Foley’s catheter and misoprostol (n=42). Group B included women who underwent midtrimester abortion with mifepristone and misoprostol (n=38). The procedure efficacy and safety of the procedure were assessed.
Results: There was complete foetal expulsion in all cases in Group A (100%) while the success rate was 89.47%in Group B. The induction to abortion (IAI) interval was significantly shorter in Group A than Group B (6.66±1.1 versus 9.42±2.69hours, p=.000). Group A had shorter insertion to balloon expulsion time (7.80±0.87). The women with nulliparity, longer interpregnancy interval (>22 months), smaller gestational age (just 14 weeks) and lower Bishop Score before insertion (<2) had poorer outcome.
Conclusions: The present results confirmed that a combined mechanical and pharmacological approach for midtrimester abortions has comparable efficacy and safety to induction with vaginal mifepristone and misoprostol and can be safely recommended. Further, it reduces the total dosage of misoprostol required for termination and shortens the termination interval, thereby increasing the patient comfort and is more affordable.
A study of acute pesticide poisoning in a tertiary care centre in South India
Authors: Bommineni Sashidhar Reddy , Alekhya K. , Chary Rallabandi Penta , Reddy Sai Bhargav , Sahithi
Published: December 2024

Background: Poisoning has been one of the common cause for mortality. According to WHO the incidence of poisoning has been increased. Poisoning can either be accidental exposure or suicidal in nature. In India pesticides  are commonly  used poisoning agents for suicide. This present study aimed to assess the incidence and outcome of acute poisoning presenting to our institute.
Methods: The study was conducted at RVMIMS for a period of one year from 2023-2024 in the deprtment of General Medicine. Retrospective data of the patients admitted with history of pesticide poisoning was collected and analysed. All patients who gave consent and >14 years were included in the study. Exclusion criteria were age <14 years, pregnant and lactating women and corrosive poisoning.
Results: Insecticide poisoning (53.6%) and herbicide poisoning (38.1%) were found to have high incidence. OP ompound is the most common poisoning out of the total cases studied which were 300. Male to female ratio was 3:2. Mortality rate is high due to paraquat poisoning (76.5%) and OP compound (17.6%) poisoning. Methemoglobinemia was seen in patients with plant protector poisoning.
Conclusions: We observed that in OP compound poisonings, early intubation with mechanical ventilator support in patients with very low serum pseudocholinesterase patients have good outcome.
A prospective, randomised double blinded comparative study of epidural ropivacaine with fentanyl and ropivacaine with dexmedetomidine in lower limb orthopaedic surgeries in epidural anaesthesia
Authors: Fultambkar Gajanan , Gayathri Racha , Vijayanand B.
Published: December 2024

Background: Opioids as epidural adjuvants have been used with local anaesthetics since long and now, α-2 agonists are being used for same purpose. Current study aims to compare the effects of ropivacaine combined with dexmedetomidine versus ropivacaine combined with fentanyl in patients undergoing lower limb orthopaedic surgeries.
Methods: Total of 90 American society of anaesthesiologists (ASA) I, ASA II patients scheduled to undergo lower limb orthopaedic surgeries under epidural anaesthesia were randomly divided into 2 groups. Group RF (n=45) received 20 ml of 0.75% ropivacaine with 1 µg/kg fentanyl and group ropivacaine with dexmedetomidine RD (n=45) received 20 ml of 0.75% ropivacaine with 1µg/kg dexmedetomidine as adjuvants. Onset of action, duration of analgesia, adverse effects and hemodynamic were monitored.
Results: Results show that age, sex, ASA grade did not differ significantly between two groups. Mean duration of sensory block (426.6 vs 520.43 mins; p<0.01), motor block (412.0 vs 503.37 mins; p<0.01) and analgesia (451.43 vs 552.93 mins; p<0.01) was significantly faster in RD group. No difference was observed between the study groups in hemodynamic parameters during and after the procedure. Incidence of nausea was significantly higher in RF group (15.6% vs 0%).
Conclusions: Administration of dexmedetomidine as adjuvant in epidural anaesthesia for orthopaedic surgical procedures reduces the onset time of sensory, motor block and extends duration of analgesia. Sedation with dexmedetomidine found superior to fentanyl in terms of efficacy, with lower incidence of adverse effects and greater effectiveness as a pre-emptive analgesic.
Comparative study conventional incision and drainage versus primary closure with negative suction drainage of soft tissue abscess
Authors: Katamsetti Siva Sandeep , Bhoir Lata
Published: December 2024

Background: An abscess refers to a confined collection of pus within tissues, organs, or specific body spaces, arising from tissue breakdown within the dermal and deeper skin layers. It is a hallmark of infection, identified as an inflammatory lesion containing purulent material, which commonly occurs as a response to a range of biological, chemical, or physical injuries to host tissues. The typical signs of an acute abscess include redness, tenderness, warmth, and swelling, often presenting a fluid-like consistency when pressed. While the overlying epidermis remains intact, the dermis hosts inflammatory cells and degraded tissue. Distinguishing an abscess from similar conditions is essential; erysipelas affects the upper dermis, while cellulitis involves loose connective tissue beneath the dermis, often mimicking an abscess.
Methods: This comparative hospital-based study evaluated wound healing time and scarring between two treatment approaches: conventional incision and drainage versus primary closure with a negative suction drain. Fifty patients were randomly divided into two groups: Group A: 25 patients treated with conventional incision and drainage; Group B: 25 patients receiving primary closure with suction drainage following incision and drainage.
Results: Primary closure with suction drainage showed faster wound healing, reduced postoperative pain, shorter hospital stays, and a lower recurrence rate compared to the conventional approach.
Conclusions: Incorporating primary closure with suction drainage is advantageous over traditional methods, suggesting a need for wider adoption among surgeons as it provides faster recovery, less pain, and improved cosmetic outcomes.
Determination of clinical target volume to planning target volume margins and set up errors in image guided radiotherapy for head and neck and prostate cancer patients treated in helical tomotherapy: an institutional study
Authors: Bora Ghritashee , Goswami Smriti , Baruah Rheetwik , Das Kaustav , Goswami Bibhash C. , Paul Moumita , Penumur Manasa
Published: December 2024

Background: Appropriate immobilization and accurate target delineation is imperative in radiotherapy planning and treatment. To achieve optimum target volume coverage with reduced dose to organs at risk, variability in set up should be minimized. This study was an attempt to determine the translational errors and corresponding planning target volume margins in head and neck and prostate cancer patients treated with helical tomotherapy.
Methods: This is a retrospective observational study of a total of 29 patients of head and neck cancer and 7 patients of prostate cancer treated in helical tomotherapy with image guided radiation therapy. The shifts in the translational directions were recorded and the systematic and random errors were calculated to obtain the corresponding clinical target volume (CTV) to planning target volume (PTV) margins using Van Herk formula.
Results: A total of 945 CBCT images were acquired for the head and neck region and 237 images for the pelvic region. The corresponding CTV-PTV margins in the X, Y and Z directions were 3.5 mm, 3.7mm and 3.4mm respectively for the head and neck region and 4.4mm,8.7mm and 5.8mm in the prostate cancer patients.
Conclusions: Image guided radiation therapy is an effective method for ensuring adequate coverage of the target in IMRT technique. Thus, proper imaging will lead to less chances of geographic miss.
Study of feasibility and acceptability of screen and treat approach for cervical cancer prevention
Authors: Kaur Kirandeep , Kaur Amrit Pal , Bagga Permeet Kaur , Jyothi
Published: December 2024

Background: Cervical cancer is the fourth most prevalent cancer among women globally, with approximately 604,000 new cases and 342,000 deaths reported Worldwide according to GLOBOCAN 2022. In India, cervical cancer ranks as the second most common cancer cervical cancer accounts for 6-29% of all malignancies in women in India. Most patients with cervical cancer in India are diagnosed at an advanced stage. Cervical cancer is both preventable and curable if detected early through proper screening.
Methods: The present study is a prospective study of 1 year which included 500 patients between age 30-50 years, selected after verifying inclusion and exclusion criteria. All the women were screened using VIA and underwent treatment with thermocoagulation. Immediate side effects and side effects at 3 and 6 monthly follow up visits were noted.
Results: In this study, a total of 500 women participated. The VIA positivity rate was 11.4%., 94.7% women underwent thermocoagulation. The mean VAS score for pain was 3.815±0.772. During 3 monthly followup visit, 25.92% females reported discharge per vaginum. No side effects were reported at 6 month follow up visit. The case detection rate was 6.4%. The positive predictive value (PPV) was 59.2%.
Conclusions: VIA is an excellent alternative to cytology and other expensive screening methods in resource-limited settings like ours. Similarly, thermocoagulation is a quick and straightforward procedure to perform. Utilizing VIA for screening and thermocoagulation as a treatment method has high acceptability among patients, with no significant side effects, making it a safe treatment option.
A study to assess the clinical probability of deep vein thrombosis among patients admitted in Maharishi Markandeshwar institute of medical sciences and research, Mullana, Ambala, Haryana
Authors: Rathore Ghanshyam , Saklani Manisha
Published: December 2024

Background: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality worldwide, with an estimated yearly prevalence of 1 in 1,000 and about 350,000 new cases in the USA annually. DVT involves a blood clot in deep veins, primarily in the legs or pelvis. Its significance lies in clot migration, which can lead to life-threatening pulmonary embolism (PE). The development of DVT is summarized by Virchow's Triad: venous stasis, endothelial injury, and hypercoagulability.
Methods: The current study approach was the quantitative approach and descriptive design. The study sample included patients admitted in the ward of MMIMSR, Ambala, Haryana
Results: In the study, 72.1% of participants were in the "no special risk" category. The "average desirable" category had 65.6% of participants. For mobility, both "limited (uses aids, self)" and "complete bed rest" categories had 27% each. The "no injury" category included 58.1%. Swelling was noted in 81.9%, and warm skin in 65.6%. Significant associations with DVT were found for age, ward, and illness duration (p<0.05). The highest risk levels for DVT were "moderate risk" (41.4%) and "high risk" (34%), with "no risk" and "low risk" categories being smaller.
Conclusions: This study concludes that hospitalized patients may risk developing DVT. Screening should be performed using Dr. Ricky Autar’s DVT risk assessment tool. Preventive interventions and personalized risk stratification are crucial for moderate and high-risk DVT categories. Timely surveillance, education, AI diagnostics, wearable tech, and policy changes can improve early detection, treatment, and management of DVT.
A comparison of extra-mucosal single layer interrupted repair vs conventional double layer repair of intestinal anastomosis: a hospital-based study
Authors: Baruah Alfred , Choudhury Dhirendra Nath , Patowary Kamal Krishna
Published: December 2024

Background: Intestinal anastomosis is a critical surgical technique used to resect and reconnect segments of the gastrointestinal tract. Traditional double-layered techniques using both absorbable and non-absorbable sutures have been widely used. However, single-layer anastomosis is gaining interest due to its simplicity, cost-effectiveness, and reduced operating time. This study aims to compare the outcomes between extra-mucosal single-layer interrupted repair and conventional double-layer repair.
Methods: A prospective, randomized controlled study was conducted over six months with 42 patients undergoing intestinal resection and anastomosis. Patients were randomized into two groups: single-layer anastomosis (Group A) and double-layer anastomosis (Group B). Both groups were monitored for key outcomes such as anastomotic leak, return of bowel function, surgical site infection, and hospital stay.
Results: The single-layer technique showed a significantly shorter operative time (23.8±2.5 minutes) compared to the double-layer technique (33.1±2.6 minutes). There were no statistically significant differences in anastomotic leak rates, re-interventions, or surgical site infections between the two groups. The cost of materials was lower for single-layer anastomosis.
Conclusions: Single-layer anastomosis offers a time-efficient, cost-effective alternative to double-layer anastomosis with comparable clinical outcomes. The findings support the broader adoption of the single-layer technique, particularly in resource-limited settings.
Combined clinical and surgical strategies for advanced colorectal cancer with hepatic metastases: impact on survival and quality of life-a systematic review
Authors: Villarreal Guillermo Olaya , Castellanos Camila Montes , Bolívar Sánchez Mariant Karolyn , Rivera Gastelum Jorge Luis , García Noriega David Bernardo , Zuluaga Mauricio Zuluaga , Ordosgoitia Mora Jose Carlos , Massé Ponce Alfonso Joan
Published: December 2024

We aim to evaluate in this systematic review the impact of combined clinical and surgical strategies on survival and quality of life in patients with advanced colorectal cancer and hepatic metastases (CRLM). We designed and followed our search on PubMed, Cochrane Library, Embase, and Google Scholar for studies published between 2010 and 2024. Inclusion criteria encompassed studies reporting survival rates and quality of life outcomes in patients who went through clinical or surgical management for CRLM and our data extraction and quality assessment were performed using standardized tools and risk of bias of included RCTs was accessed using Cochrane risk of bias tool. We found liver-first approach demonstrated improved 3-year overall survival (69%) for synchronous CRLM compared to combined or classic approaches with 54.4–60.4%. Neoadjuvant chemotherapy facilitated tumor downstaging but was associated with liver injury when prolonged beyond five cycles and those patients with metachronous CRLM, surgical resection come with maximum survival rate with five-year survival rates reaching 60% in selected cases and quality of life outcomes was improved in patients achieving curative resection. After all research, it can be can conclude that combined clinical and surgical strategies and tailored sequencing of treatment can enhance survival and quality of life for CRLM patients. Early multidisciplinary interventions and optimized chemotherapy regimens are critical in balancing oncologic outcomes and treatment-related risks.
Severe hypoalbuminemia in patient with pulmonary edema and pleural effusion: a case report
Authors: Wulandary Martika Esty , Sofandi Aditya Azwar
Published: December 2024

Hypoalbuminemia is a recognized risk factor for mortality and poor outcomes in various clinical contexts. This case report aims to discuss the case and management of severe hypoalbuminemia in a 30-year-old female patient with pulmonary edema and pleural effusion at RSUD Bima. A 30-year-old female with a history of tuberculosis was admitted with worsening shortness of breath, nosebleed, abdominal and breast enlargement, hair loss over the past 2 months, tired, joint pain, swelling in both legs, ulcers on the oral mucosa, and butterfly rash. She exhibited signs of anaemia, hypoalbuminemia, and ascites. X-ray thorax showed cardiomegaly, pulmonary edema, and bilateral pleural effusion. Diagnoses included dyspnea due to pulmonary edema, severe hypoalbuminemia, anaemia, thrombocytopenia, and suspected SLE. Treatment involved oxygen, IV octalbin 25% 100cc, medications, and an extra protein diet. After three days, her albumin levels improved. Hypoalbuminemia can cause pleural effusion by reducing oncotic pressure, leading to fluid buildup. In SLE, it may result from inflammation, malnutrition, or protein loss. Management includes addressing causes, nutritional support, and careful albumin administration.
Neonatal dengue: a case report and literature review
Authors: Gitari Ni Made , Windiyanto Romy , Swandewi Gusti Ayu Sri Ari
Published: December 2024

Dengue fever is a viral infectious disease that remains a health problem worldwide. Neonates mortality and morbidity have been linked to vertical transmission of the dengue virus. Infants born to mothers with dengue infection before the days of delivery require suspicion and tracing of dengue infection, particularly in dengue-endemic areas. This case report describes the possibility of vertical transmission of dengue in an infant with a dengue-infected mother near delivery. The baby had clinical improvement during treatment and was discharged at 11 days of life. Prompt diagnosis, appropriate treatment, and close monitoring are needed to improve neonatal dengue outcomes.
Fahr’s syndrome with hypoparathyroidism in a 65 year old: a case report
Authors: Sirohi Parmendra , Vishwakarma Manaswi , Gupta Rahul , Sharma Peeyush , Verma Abhishek
Published: December 2024

Fahr’s syndrome also known as idiopathic basal ganglia calcification (IBGC) is a notably rare neurological disease with an autosomal dominant pattern of inheritance and genetic heterogeneity, resulting from symmetric bilateral calcification commonly in basal nuclei and cerebellum. Regardless of being a rare disorder, Fahr's can have a dramatic effect on patients, and is characterized by spectrum of metabolic, biochemical, neuro-radiological, and neuro-psychiatric alterations leading to cognitive dysfunction, motor impairment and neurological manifestations. Our case of a 65-year male, deals with array of varied clinical symptoms and diagnostic difficulties of Fahr’s associated with hypoparathyroidism. The case report contributes to the expanding comprehension of the Fahr’s highlighting its genetic aspect and clinical heterogeneity and developing avenues for appropriate diagnostic and imaging modalities as-well-as intervention techniques. The motives of this article extend beyond the clinical case, influencing future research, diagnostic and prevention strategies.
Bradycardia secondary to autonomic involvement by small cell lung cancer
Authors: Sharma Vishnu , Bagrodia Vansh , Gupta Shraddha
Published: December 2024

We present a case of a male in late 50s with Small Cell Lung Cancer (SCLC) who came with near-fainting episodes and was found to have unexplained bradycardia despite thorough evaluation ruling out common causes. Autonomic testing revealed involvement of both sympathetic and parasympathetic nervous systems, likely due to tumor encasement of cardiac nerve supply. This case illustrates an unusual etiology for bradycardia in SCLC cancer patients, developing from secondary effects due to physical extension of tumor.
Atypical case of mycoplasma pneumoniae presenting as Stevens-Johnson syndrome
Authors: Sharma Kalpana , Das Sinthiya , Basumatary Phoebe Sarah
Published: December 2024

Mycoplasma pneumoniae causes atypical pneumoniae in children and adolescents. M. pneumoniae associated Stevens-Johnson Syndrome (SJS) is also known as atypical SJS. SJS is characterized by generalised exanthema associated with fever, mucositis and history of numerous medications and certain agents of atypical pneumonia. We describe the case of a 7-year-old boy with bilateral atypical pneumonia along with multiple skin and mucosal exanthema that required intensive care unit admission due to respiratory distress. He was diagnosed with SJS associated atypical pneumonia caused by Mycoplasma pneumoniae confirmed by serological test. Since, there are few similar cases in literature; a treatment protocol is yet to be established. Our case is an example evidence-based treatment and hopefully in future there might be a definite protocol for Atypical Stevens-Johnson Syndrome.
Giant gallstone in the gallbladder: case report of an uncommon surgical challenge
Authors: Wani Ab Hamid , Singh Gurbir , Mehak Shireen , Iqbal Javid
Published: December 2024

Giant gallstones are an uncommon presentation of cholelithiasis, typically defined as gallstones measuring more than 5 cm in diameter. Though gallstones are a frequent clinical finding, stones of this size are rare and pose unique challenges in diagnosis and management. We present a case of a 45-year-old female who was found to have a giant gallstone during the evaluation of abdominal pain. This case report highlights the clinical presentation, diagnostic approach, and surgical management regarding giant gallstones.
Oral health status and treatment needs of children with sensory deficits: a narrative review
Authors: Katkam Pallavi , Puranik Manjunath P. , Shanbhag Namita
Published: December 2024

Oral health is an inescapable component of overall health. Oral health care and maintenance is an essential component of overall growth and development of children. Inculcating and following good oral hygiene practices with appropriate diet modification is a prerequisite to achieving sound oral health. Oral health is an important aspect of health for all children, and is more important for children with special health needs. Children with sensory deficits deserve the same opportunities for oral health and hygiene as those who are healthy. Unfortunately, oral health care is one of the greatest underserved health needs of disabled people. Inadequate dental care or poor dental public health measurements may have negative influence on their oral health status. Hence this review discusses the types, epidemiology, classification, etiology, clinical features, oral health status, treatment needs and dental management of children with sensory deficits.
Correlation between disease knowledge and health related quality of life in patients with chronic obstructive pulmonary disease
Authors: Sushma  , Sikka Gitanjali , Singh Pawan K. , Meetu
Published: December 2024

Chronic obstructive pulmonary disease (COPD) is a growing global health concern, with approximately 10% of individuals over 40 affected by this debilitating condition. In India alone, an estimated 30 million people live with COPD. The disease significantly impairs health-related quality of life (HRQoL), with acute exacerbations leading to physical disability that limits daily activities and further deteriorates HRQoL. This study aims to assess the correlation between COPD knowledge and HRQoL among COPD patients, with specific objectives to evaluate the level of disease knowledge and HRQoL in this population. Patients' awareness and understanding of COPD are critical for managing the disease effectively and maintaining a better quality of life. Treatment strategies must prioritize enhancing HRQoL by reducing exacerbations, improving lung function, and promoting smoking cessation. However, lower health literacy and insufficient knowledge about COPD are strongly associated with poorer HRQoL, increased disease severity, and a higher risk of hospitalizations and emergency department visits. Educational interventions focused on improving health literacy, particularly within COPD self-management programs, have the potential to significantly enhance HRQoL, decrease healthcare utilization, and improve medication adherence. This study underscores the importance of targeted education and self-management support in improving outcomes for COPD patients.
Correlation between knowledge of type II diabetes mellitus and glycaemic control
Authors: Hemlata  , Sikka Gitanjali , Shaveta  , Meetu
Published: December 2024

Effective glycemic control in type II diabetes mellitus (T2DM) is crucial but challenging, with patient knowledge playing a key role in successful management. Observational cross-sectional analytical study. A review of recent studies was conducted, focusing on the impact of diabetes knowledge on glycemic outcomes. There is a positive correlation between increased type II diabetes mellitus knowledge and improved glycemic control. Patients who had better disease knowledge of T2DM could effectively manage their disease condition, including regular monitoring and lifestyle changes, and had improved glycemic outcomes, while those with less knowledge had poorer control. Improving patient education is essential for better glycemic control in Type II diabetes mellitus. Healthcare systems should implement targeted educational programs to address knowledge gaps, especially in areas with limited healthcare access.
Impact of lateral positioning and soft tissue manipulation on oxygenation and haemodynamic parameters in paediatric patients on mechanical ventilation
Authors: Nishant  , Sikka Gitanjali , Mittal Kundan , Yadav V. S.
Published: December 2024

Acute respiratory failure remains an important cause of morbidity and mortality in pediatric patient in last few years. Great attention was paid to the effect of changes in pediatric patient position other than the supine position during mechanical ventilation. Respiratory tract infection is one of the major prevailing respiratory illnesses in pediatric population. Soft tissue manipulation and positioning have been recommended for several decades to have a positive effect on hemodynamic, better sleep-wake cycle, enhanced neuromotor development, reduced rate of nosocomial infection and thereby reduces mortality in hospitalized patient. There is no study done to date which has seen the combined effect of right and left lateral positioning and soft tissue manipulation on oxygen saturation (SaO2) and hemodynamic parameters in Paediatric patients with respiratory failure.  Hence to form an evidence-based protocol by combining positioning and soft tissue manipulation present study needed to be conducted.
The effect of body position on oscillometric blood pressure readings in young adults: narrative review
Authors: Nimar Rahul , Sikka Gitanjali , Yadav Vikram Singh
Published: December 2024

Accurate measurement of blood pressure (BP) is crucial for diagnosing hypertension and evaluating cardiovascular risk. Although office BP readings are generally consistent with 24-hour ambulatory measurements, their accuracy can be influenced by various factors. Elements such as environmental conditions, participant behaviour, device calibration, and measurement methods can lead to variations in readings, ranging from 1-2 mmHg to as much as 20-50 mmHg. Studies show that room temperature, noise, recent physical activity, and dietary choices affect BP measurements. Additionally, differences between BP readings from the right and left arms and variations due to body position (sitting versus supine) add complexity. Demographic factors, including age and sex, also contribute to variability, highlighting the need for standardized measurement procedures. This study seeks to analyse how arm side, body position, and measurement sequence influence BP variability and its effect on hypertension prevalence, aiming to improve the precision of clinical and epidemiological assessments. Thereby findings of these studies limit the generalizability of the results to hypertensive and normotensive patient population. Previous studies have also shown that there is difference in reading of blood pressure between right arm and left arm with readings of left arm are higher than right arm with oscillometric and sphygmomanometer blood pressure measuring device. Therefore, need to develop a definitive protocol for accurately measuring oscillometric blood pressure in young adults across eight different positions of the right and left arms.
Navigating the complexities of hypertension: guidelines, screening and treatment approaches
Authors: Zaidi Insia , Nag Riya , Srivastava Sanchita , Raza Syed T. , Eba Ale , Rizvi Saliha , Fatima Naseem , Khan Farheen
Published: December 2024

Hypertension or high blood pressure, is a prevalent condition and a leading cause of cardiovascular morbidity and mortality worldwide. This review provides an in-depth analysis of the current epidemiology, diagnosis and management of hypertension, with a focus on integrating guidelines from major health organizations such as the American College of Cardiology (ACC), American Heart Association (AHA) and European Society of Hypertension (ESH). Key factors contributing to primary and secondary hypertension are discussed, along with their respective diagnostic strategies. The review highlights the importance of accurate blood pressure measurement and the challenges posed by resistant hypertension. Moreover, it examines the disparities in hypertension management across various populations, underscoring the need for individualized care. A unique aspect of this review is the inclusion of telemedicine and digital healthcare solutions in the management of hypertension, particularly in the wake of the COVID-19 pandemic. Telehealth services, which have been increasingly integrated into primary care, offer significant potential for improving blood pressure control, especially in underserved and high-risk populations. The review concludes with a discussion on future directions in hypertension management, including advancements in remote monitoring and personalized treatment strategies. By synthesizing guideline-driven approaches and exploring innovative healthcare solutions, this review aims to provide healthcare professionals with a comprehensive understanding of the evolving landscape of hypertension diagnosis and management.
The effect of sleep hygiene training given to epilepsy patients on seizure frequency and sleep quality: pre-test post-test control group experimental study protocol
Authors: Gelin Dilek , Oğuz Sıdıka
Published: December 2024

Background: Epileptic seizures develop with hyper-synchronization of neuronal networks, causing insomnia, and sleep quality decreases with drug treatment. Insomnia, which occurs with decreased sleep quality, increases epileptic seizure discharges. This study/trial aims to determine the effect of sleep hygiene education given to epilepsy patients on seizure frequency and sleep quality.
Methods: It is non-pharmacological clinical research and was conducted experimentally with a pretest-posttest control group experimental model. Randomization was done using simple random selection. The routine treatment of the first experimental group (n=80 people) continued. Patients were provided with sleep hygiene training, a sleep hygiene training booklet, and an educational video for those who requested it. In the three-month follow-up, sleep hygiene training was repeated in the monthly meetings. The second group, the control group (n=80), continued routine treatment, and no intervention was made for three months. In the planned monthly meetings, sleep quality was evaluated using the PSQI (Pittsburgh sleep quality index). In the monthly meetings, the seizure schedule recorded by the patients and the frequency of seizures were evaluated together with the patients.
Results: In this study, data collection began on June 1, 2023, and the data collection process ended on May 21, 2024, while the data analysis process is ongoing.
Conclusions: With this trial/study, the evidence-based use of sleep hygiene education's effectiveness on the seizures and sleep quality of epilepsy patients will be evaluated.
Trial registration: The trial was registered in clinical trials: (ClinicalTrials.gov Identifier: NCT06352476). Registered on: 10881-669.
Human immunodeficiency virus infected patient with cerebral infarction without non-infectious comorbidities
Authors: Shavitri Ogek Dwi , Suryana Ketut
Published: December 2024

Human immunodeficiency virus (HIV) has been proven to increase the risk of stroke. The annual incidence rate of ischemic stroke in HIV was 216 per 100,000. Multiple factors, linked to HIV infection, could increase the susceptibility of developing cerebrovascular diseases (CVD), such as opportunistic infections, coagulation abnormalities, dyslipidemia, and toxicity of antiretroviral therapy (ART). HIV is thought to contribute to the incidence of stroke through both HIV-associated and traditional stroke risk factors. ARTs, namely protease inhibitors and nucleoside reverse transcriptase inhibitors, can increase the incidence of stroke.
Effects of Research Evaluation on Balkan Post-Socialist Countries
Authors: Lambovska Maya
Published: December 2024

Research evaluation (RE) strongly affects actors in higher education nowadays. Accordingly, this article unveils the effects of RE on Balkan post-socialist countries (BPSCs). Stakeholder theory, systematic literature review, K-means cluster analysis, a sample of 25 papers, expert evaluations and synthesis/analysis underpin it. Main results: 1. Data was found for Bosnia and Herzegovina (BIH), Bulgaria, Croatia, Serbia, Romania, and Slovenia. 2. The negative RE effects outnumbered the positive (30 vs. 22). They were also more frequently cited (65 vs. 53). 3. The most cited negative effects were unfair evaluation in some disciplines and the rise of authors per publication, while enhanced collaboration was the most cited positive. 4. Specifics of RE effects on BPSCs were elucidated. 5. BPSCs 3-cluster maps were created for the positive, negative, and all RE effects. The maps of negative and all RE effects were the same, covering BIH and Romania in cluster 1 (titled ‘least positive, mid negative’), Bulgaria and Serbia in cluster 2 (‘mid positive, least negative’), Slovenia and Croatia in cluster 3 (‘most positive, most negative’). The positive map differed only for Serbia, assigned to the ‘least positive’ cluster. The primary role of this article is as a landmark for BPSCs research evaluation effectiveness.
Simplified models for describing multitasking modes in living recognition systems
Authors:   National Research Lobachevsky State University of Nizhny Novgorod, Russia, Golovina Alina , Yakhno Vladimir ,   National Research Lobachevsky State University of Nizhny Novgorod, Russia
Published: December 2024

The purposeof this study is to explore the possibilities and create versions of simplified languages that describe the variety of dynamic modes during the alternating execution of multiple tasks. These languages can be used for an adequate description of experimentally recorded variants of behavior in living systems under such conditions.

Methods. The study was conducted using a physical methodology based on qualitative analysis of possible solutions and confirmed by the results of computational experiments. To qualitatively describe the versions of possible mechanisms for switching between dynamic
modes of operation of living systems in situations presented by the environment for these systems (expressed through changes in emotional or energy states), the simplest basic model was used. This model includes two balance equations corresponding to either the first or the second solvable problem. For this system, a two-dimensional phase space is constructed, allowing for tracking characteristic changes in the trajectories of the representing points in the ’null-isocline’ system, which depend on the control parameters. Various trajectories of representing points are considered depending on the initial conditions, visually demonstrating the main modes of transitional processes in the developing system.

Results and discussion. Classification of dynamic modes in the system has been conducted, depending on control parameters. Such dynamic modes form the basis for simplified language descriptions. The proposed simplified mathematical model allowed for the examination of a wide range of states and various types of its evolutionary changes in full accordance with known examples of behavior modes in living systems.
Joint Comprehensive Plan of Action for Occupational Health
Authors: Mosadeghrad Ali Mohammad , Monazzam Ismailpour Mohammad Reza , Shahtaheri Seyed Jamaleddin , Zakerian Seyed Abolfazl , Mazloumi Adel , Khadem Monireh , Abbasi Mahya , Karimi Ali , Karimi Asan , Golbabaei Farideh
Published: December 2024

Introduction: The purpose of occupational health is to maintain and improve the health of employees and improve their physical, mental and social well-being through the prevention, control and elimination of occupational hazards. It is necessary to integrate educational, research and health service activities to prevent and control potential occupational health hazards in the community. This study aimed to develop a Joint Comprehensive Plan of Action (JCPOA) for occupational health at Tehran University of Medical Sciences (TUMS).
Material and Methods: In this participatory action research, a strategic planning committee was established, whose members were professors of the occupational health department in the school of public health and managers of the occupational health department in the health deputy of TUMS. The strategic planning committee carried out a strategic evaluation of the internal and external environments of both occupational health deprtments of TUMS and identified the strengths, weaknesses, opportunities and threats. Then, the strategic direction of JCPOA including the vision, mission, values, goals and objectives was determined. Also, the strategies and actions to achieve the goals and objectives were identified. Finally, the action plan to achieve these objectives was developed.
Results: This applied research led to the strategic evaluation of the internal and external environments of the occupational health depratment of the School of Public Health and the occupational health depratment of the Health deputy of TUMS, determining the strategic direction, and finally, developing an action plan to achieve the goals and objectives.
Conclusion: The JCPOA for occupational health was developed using a collaborative and systemic approach. The proper implementation of this plan can lead to the improvement of occupational health indicators in the community. Cooperation between university and industry is necessary for the sustainable development of society
The Effect of Virtual Self-Management Training in Communication Skills on The Level of Violence and Occupational Stress of Emergency Technicians at Shahid Beheshti University of Medical Sciences In 2021
Authors: Dastur Sara , Zandi Mitra , Karimian Masoumeh
Published: December 2024

Introduction: Emergency technicians face workplace violence and increasing occupational stress. Thepurpose of this study was to investigate the impact of a virtual self-management training in communicationskills on occupational stress and the degree of aggression among emergency technicians.
Material and Methods: This study involved 60 emergency technicians randomly assigned to either theintervention or control group. They completed surveys on workplace violence and occupational stress.The intervention group received six weeks of a virtual self-management training in communication skills.Data was collected after two months and analyzed using SPSS software.
Results: The findings showed that there was no statistically significant difference between the controlgroup (110.08±11.92) and the two intervention groups (114.39±11.25) in terms of the averageoccupational stress before the intervention; The average job stress score between the intervention(94.0±12,70) and control (98.81± 20,81) groups significantly differed following the intervention (p=0.034);After the intervention, the intervention group had lower verbal and physical abuse frequencies comparedto the control group.
Conclusion: The virtual self-management communication training demonstrated the potential to reduceoccupational stress but did not significantly decrease the violence towards the emergency technicians.A comprehensive training program addressing violence factors and communication techniques,implemented over a longer period, is recommended
Risk Analysis of The Steel Erection Process Using The Functional Resonance Analysis Method
Authors: Roveshti Mehran Maleki , Naghavi-Konjin Zahra , Etemadinezhad Siavash , Charati Jamshid Yazdani
Published: December 2024

Introduction: Steel erection is known as one of the most hazardous construction activities. From an occupational health and safety perspective, this process carries high risk. Therefore, this study aims to conduct a qualitative risk analysis of steel structure assembly and model it using the Functional Resonance Analysis Method (FRAM).
Material and Methods: In this cross-sectional study, the construction site of a high-rise building steel structure was first visited to identify the main processes involved. Then, semi-structured and open-ended interviews were conducted with 33 workers partaking in this process. Data from the interviews and process identification were entered into FRAM Model Visualiser (FMV) software to investigate and model complex relationships and interactions between daily tasks.
Results: Of the 19 major system component functions identified, four functions had potential instability and defects due to complex human, organizational, and technological function interactions. By intensifying the FRAM graphic model, risks may be imposed on the system if the interactions of these four functions are neglected. These include coordination with the experienced rigger, preparation of the tower crane, attachment of parts at the installation site, and execution of the rescue rope.
Conclusion: The findings demonstrate that conducting qualitative risk assessment and modeling the steel frame construction process using FRAM allows for an in-depth understanding of nonlinear conditions and dynamics resulting from escalating technical-social interactions. This approach enables a comprehensive analysis of system safety status.
El rol de la excepción de minerías de datos en la inteligencia artificial (IA) generativa – perspectiva europea
Authors: Contardi Magali
Published: December 2024

Los avances en las tecnologías de inteligencia artificial (IA) han impulsado el desarrollo de la IA generativa, capaz de producir una amplia gama de contenidos. No obstante, el entrenamiento de estos sistemas plantea importantes interrogantes sobre la salvaguardia y el ejercicio de los derechos de autor de los contenidos utilizados para estos fines. En este contexto, este artículo se propone analizar el rol y la idoneidad de la excepción de minería de datos (‘Text and Data Mining’) en el ámbito de la IA generativa, centrándose en el marco legislativo de la Unión Europea (UE). El artículo concluye argumentando que, aunque la minería de datos posee un potencial considerable en el desarrollo de la IA y su incorporación en el marco legislativo de la UE es crucial, tanto la estructura misma de la excepción como la diversidad de enfoques nacionales no ofrecen un cuadro normativo que permita una aplicación armonizada en la UE y ello podría socavar su uso en el campo de la IA generativa.
Digital Technologies as a Factor of Transformation of Learning in the University Education
Authors: Kharchenko Andriy , Nalyvaiko Oleksii , Kreydun Nadiya , Sheiko Anastasiia , Ptushka Anastasiia , Khatuntseva Svitlana , Zotova Liliya
Published: December 2024

This article investigates the transformative impact of digital technologies on university education, particularly in light of the accelerated adoption driven by the COVID-19 pandemic. The study aims to explore how these technologies have reshaped teaching and learning processes, focusing on their effectiveness, the challenges they present, and their future potential. The research is grounded in a thorough literature review, coupled with empirical data gathered from interviews with university teachers and students, and enhanced by insights from AI systems. The findings reveal a generally positive reception of digital tools, with significant benefits in enhancing student engagement, providing flexible access to educational resources, and supporting diverse learning modalities. However, the study also identifies key challenges, including the digital divide, the need for continuous faculty training, and the rapid pace of technological change. Additionally, the potential of emerging technologies such as artificial intelligence (AI), virtual reality (VR), and augmented reality (AR) to further personalize and enrich the educational experience is highlighted. The article concludes that while digital technologies offer substantial opportunities for innovation in higher education, their successful integration requires strategic planning, robust policy frameworks, and sustained investment in infrastructure and professional development.