bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic and magnetocaloric properties of 0.5La0.7Ca0.2Sr0.1MnO3/0.5La0.7Te0.3MnO3 composite
Authors: AKÇA Gönül , KILIÇ ÇETİN Selda , EKİCİBİL Ahmet
Published: March 2020

In this work, the magnetic and magnetocaloric
properties of 0.5La0.7Ca0.2Sr0.1MnO3/0.5La0.7Te0.3MnO3
composite have been investigated. The 0.5La0.7Ca0.2Sr0.1MnO3/0.5La0.7Te0.3MnO3
composite has been composed by mixing the La0.7Ca0.2Sr0.1MnO3
and La0.7Te0.3MnO3 manganites with a ratio of
0.5:0.5, synthesized by using the standard solid state method. In order to investigate
the magnetic and magnetocaloric properties of the samples, magnetization
measurements dependence on temperature and magnetic field have been performed
by using physical property measurement system. The nature of the magnetic phase
transition for all materials has been identified by using Banerjee criterion
and Landau theory and according to both methods the magnetic phase transition is
second order. Magnetic entropy change values have been calculated by using
Maxwell relation and Landau theory. Based on Maxwell relation, the maximum
magnetic entropy change value of the composite has been calculated as 3.70 Jkg-1K-1
for 5 T.
Comparison of accelerator based radioisotope production potentials in medical imaging
Authors: AKÇAY Şeyda , KUDAY Sinan
Published: March 2020

Most recent production capabilities of highly demanded radoisotopes in
medical diagnosis and imaging is not as high as the increasing number of
patients worldwide. We studied radioisotope production efficiencies of 99m Tc, 111In,
18F, 11C, 125,124I, 67Ga, 64Cu
ve 86Y at medical accelerators through hadronic collision
simulations by Geant4. We considered to recent production parameters and
calculated the optimal values for parameters such as Q-value, cross section,
production energy and irradiation yields. This study also aimed to shed light
on the radionuclide production in the region.
Gamma radiation determination of absorption coefficients of cement sand block
Authors: ETUK Sunday , AGBASİ Okechukwu , EKPO Sunday , ROBERT Ubong
Published: March 2020

Three bands of cement with different trade names, Dangote, UNICEM, and Eagle cement were separately molded into cement-sand blocks at different proportions of cement sand ratio of 2:3, 3:7 and 1:4 by weight for each of the cement brand were prepared and allowed to cure. We exposed the blocks to gamma radiation for the determination of attenuation coefficient, half thickness, and mass absorption coefficient. We also determined density values for the blocks. The results for the cement samples show that the higher the cement content in the cement sand block, the higher the density value and the gamma attenuation coefficient, suggesting that cement sand block with a high proportion of cement content makes for a good shielding in gamma radiation exposed environment, Gamma radiation attenuation the method can equally be a useful technique for cement sand block quality control in building construction industry.
Production of lavender oil loaded antibacterial polymeric membranes
Authors: EĞRİ Özlem
Published: March 2020

Antibacterial polymeric membranes were produced within the context of this study. PCL polymer solution and PEG solution that was mixed with lavender oil (Oleum lavendula angustifolia) was electrospun concurrently from opposite directions. Thus lavender oil used as antibacterial agent was entrapped within PEG fibers. Antibacterial polymeric membranes were produced by collecting electrospun fibers on rotating mandrel. Interaction of the solvent with the polymer determined with Fourier Transform Infrared Spectroscopy (FTIR). Surface morphology of the membrane and fiber diameters were investigated by using Scanning Electron Microscopy (SEM) images. Mechanical strengths of the membranes were evaluated by standard tensile tests. Hydrophilicity of the membranes was characterized by contact angle measurements and water uptake capacity was characterized by swelling tests. In vitro controlled release of the lavender oil by dissolution of PEG fibers in aqueous medium was investigated under in vitro conditions. Antibacterial activity of the membranes on gram positive and gram negative bacteria species was observed by disk diffusion tests.
Map matching with kalman filter and location estimation
Authors: ERSAN Ziya Gökalp , ZONTUL Metin , YELMEN İlkay
Published: March 2020

Known as Global Navigation Satellite Systems, GNSS is a geolocation service. GNSS systems used in the world are known as GPS in America, GLONASS in Russia, GALILEO in Europe, BEIDOU in China and IRNSS in India. However, GPS is the only one that works decisively today. GNSS systems are used effectively in the navigation of all types of land, sea and air vehicles such as search and rescue, target finding, and landing and take-off of airplanes with or without limited visibility. However, when environmental and weather conditions are unfavorable, the accuracy of the GPS systems in the GNSS may vary. This study is presented as a solution to the map matching problem by minimizing the error deviation rates of GPS data from NOVATEL and UBLOX based vehicle tracking devices with the help of Kalman Filter Algorithm. In addition, the deviation rate between the GPS data from the vehicle tracking system and the estimated point coordinates is provided in meters.
Investigation of lactobacillus gasseri ma-2 as probiotic candidate
Authors: AŞAN ÖZÜSAĞLAM Meltem , GÜNYAKTI Ayşe
Published: March 2020

Characterization of lactic acid bacteria in human milk has become an interesting field for developing new probiotics. Therefore, some probiotic properties of Lactobacillus gasseri MA-2 strain isolated before from human breast milk were screened in vitro. MA-2 strain exhibited safety aspects with no hemolytic activity (γ-hemolytic activity) and sensitivity to penicillin G, cloxacillin and chloramphenicol. The remarkable tolerance to various acid, bile, pepsin and pancreatin conditions was determined with high survival rate. The strain also presented significant auto-aggregation (93%) as well as co-aggregation activity with pathogenic microorganisms. L. gasseri MA-2 originated from human milk exhibited promising probiotic properties.
Long-chain diesters of fattyy alcohols as novel phase change materials for thermal energy storage
Authors: KAHRAMAN DÖĞÜŞCÜ Derya
Published: March 2020

In this study, long chain diesters of fatty alcohols were synthesized for use in thermal energy storage applications. Long-chain diesters of adipic acid were proposed for the first time in this study to be used as phase change material (PCM). For this purpose, ditetradecyl adipate (DTA) and dioctadecyl adipate (DOA) were synthesized as novel solid-liquid PCMs by means of the direct esterification reaction of adipic acid with 1-tetradecanol and 1-octadecanol. The reaction was yielded at around 90% as an average at the end of 6 hours. The DTA and DOA were characterized chemically using FT-IR and 1HNMR techniques as the energy storage properties, total enthalpy, and specific heat (Cp) capacity values were determined by DSC analysis. Melting temperatures and enthalpies of DTA and DOA were measured as 44 and 60 C respectively; and 142.4 and 186.2 Jg-1 respectively. Total enthalpy calculation showed the latent heat storage capacity along with sensible heat capacity of fatty alcohols and long-chain diesters between 0 and 80 C. Cp values of fatty alcohols and long-chain diesters also calculated for solid and liquid phase separately. TGA analysis was performed to determine thermal stability of the esters. DTA and DOA compounds were found stable up to 248.3 and 342.5 C respectively. Thermal cycling test was applied to the materials and it was found that DTA and DOA are both found stable after 1000 times accelerated thermal cyclings. According to the results obtained, DTA and DOA with high energy storage capacity are promising to be used as new solid-liquid PCMs in thermal energy storage applications for medium temperature applications.
Workplace Safety: A Necessity or a Luxury in the Micro, Small and Medium Enterprises of Bangladesh?
Authors: Al Amin Mohammed Nafeez
Published: March 2020

Following the deadliest accidental structural failure in modern human history, Bangladesh Government has been getting external pressure to amend and properly implement its “Workplace Safety Laws”. Garment factories like the ones in Rana Plaza (the collapsed building in Savar) are large organizations. Along with the large companies, there are a significant number of micro, small and medium-sized enterprises in Bangladesh which are employing more than 31 million people. Obviously, workplace safety should be a matter of concern for their employers, or is it? Why are they reluctant about it? What is being done to ensure safety? Are they getting pressures or motivated by externalities? Safety measures if taken, is it enough? What else can be done to improve workplace safety? The purpose of this research paper is to find out and analyze the answers to the above questions concerning workplace safety in the MSMEs of Bangladesh. A blend of secondary sources and primary sources (survey amongst a significant number of owners of various MSMEs and observation of a few organizations) of data were used from which both quantitative and qualitative analyses were carried out for the purpose of exploring the unknown. The results show a rather reluctant approach by the owners regarding this issue. However, it was also found that the government has taken a lot of initiatives to minimize workplace safety hazards and is on the verge of implementing them.  Thus, a few alternatives that involve lobbying and use of marketing activities to create greater awareness were recommended.

JEL Classifications Code: J81, J88
Composición florística, estructura y diversidad del bosque pluvial tropical de la subcuenca del río Munguidó, Quibdó, Chocó, Colombia
Authors: Mena-Mosquera Víctor Eleazar , Andrade C. Hernán J. , Torres-Torres Jhon Jerley
Published: March 2020

Se caracterizó la composición florística, estructura horizontal y diversidad del bosque primario de la subcuenca del río Munguidó, Chocó, Colombia. Se estableció una parcela de muestreo de 1000 x 1000 m en donde se marcaron cuatro parcelas temporales de muestreo (PTM) de 500 x 10 m. En estas PTM se registraron los individuos con diámetro a la altura del pecho ≥ 10 cm. Se calculó el índice de valor de importancia (IVI) con base en la abundancia, dominancia y frecuencia relativas. Se encontró una abundancia promedio de 441 individuos/ha, pertenecientes a 71 especies de 63 géneros y 32 familias. Las familias mejor representadas fueron: Moraceae, Faboideae y Apocinaceae. Las especies de mayor importancia ecológica, según IVI, fueron: Virola reiidi, Chrysophyllum argenteum y Protium veneralense. El bosque de estudio presentó una alta diversidad de especies, con valores en los índices de Equidad de Shannon, Dominancia de Simpson y Diversidad de Margalef 3,6, 0,03 y 10,3, respectivamente. Este ecosistema se caracteriza por poseer una alta riqueza y diversidad de especies y poca presencia de individuos de la familia Arecaceae.
Fog harvesting potential for domestic rural use and irrigation in San Cristobal Island, Galapagos, Ecuador
Authors: Echeverría P. , Domínguez Ch. , Villacís M. , Violette S.
Published: March 2020

The Galapagos Archipelago is a semiarid zone scarce of superficial water resources. Due to its geographic location and the presence of oceanic currents, these islands are covered by fog during seven months along the year which could represent a potential source of water supply. In this study, the feasibility of fog collection for domestic rural use and irrigation was investigated using two Standard Fog Collectors (SFC) of 50% and 35% shade coefficient of 1 m2 and a cylindrical fog net (CFN) of 0.15 m2 at 600 m of elevation in the windward side of San Cristobal Island (Galapagos). The methodology applied consists in the quantification of the monthly and annual water balance at different altitudes in an average and dry years, using the orographic gradients of rainfall, evapotranspiration and cloud water interception. The latter was used to estimate the fog water availability to satisfy any water deficit. Fog water interception was estimated using a geometric model and the use of different climatic variables. On the other hand, water demand in the rural zone for domestic consumption and livestock was estimated with the quota method, and the water demand for agriculture was estimated through the water balance. Results show that the amount of fog captured reaches 7.9, 5.9 and 3.4 mm/d with 50-SFC, 35-SFC and CFN, respectively. Comparing these results with other locations in the world, fog water collection in Galapagos is above the average. A fog gauge system of 50-SFC was designed at different elevations to cover the 25% and 15% of the water deficit in the average and dry year, respectively.
Prospective observational study to evaluate the efficacy of labetalol versus nifedipine in the management of preeclampsia
Authors: D. Sarulatha , M. Menaga
Published: March 2020

Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. It has effects both on expectant mother and fetus. Pre-eclampsia is a pregnancy specific multisystem disorder of unknown etiology, and accounts for 12-18% of maternal mortality. There is general consensus that maternal risk is decreased by antihypertensive treatment that lowers very high blood pressure. Objective of this study was to study the efficacy of oral labetalol versus oral Nifedipine in the management of preeclampsia in the antepartum and intrapartum period.Methods: The present study was conducted in a tertiary care centre, Chennai from October 2013 to September 2014. It was a prospective observational study done in antenatal ward and labor ward. All antenatal women diagnosed to have pre-eclampsia, irrespective of gestation are included in this study.Results: Age distribution of PIH patients and the maximum number of patients were 20-25 years of age. maximum patients of severe preeclampsia were primigravida. Both systolic and diastolic BP in the two groups (oral labetalol and oral Nifedipine groups) were not statistically significant as the p value is >0.005.Conclusions: From this study, authors found that both oral labetalol and oral nifedipine are effective and well tolerated when used for rapid control of blood pressure in severe hypertension of pregnancy.
A sonographic assessment of previous caesarean section scar: is a reliable safeguard for trial of labour?
Authors: Dhama Vandana , Gupta Sonam , Chaudhary Rachna , Singh Shakun
Published: March 2020

Background: Over the time the caesarean delivery rate has significantly increase worldwide from 18.2% in 2002 to 30.3% in 2012. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. The purpose of this study was to assess the usefulness of sonographic measurement of the lower uterine segment scar before labour for deciding whether it is a reliable safeguard for trial of labour or not in a woman having previous one caesarean delivery.Methods: This study was a prospective observational study, carried out on 108 pregnant women having previous one CS, gestational age >37, singleton pregnancy, cephalic presentation. Trans-abdominal USG was done to measure scar thickness. Trial of labour was given to each patient irrespective of scar thickness. Pregnancy outcome were noted in terms of successful VBAC or emergency LSCS and compared with scar thickness. Correlation between sonographic and intra-operative finding of scar were noted.Results: Result shows strong correlation between scar thickness and successful trial of labour. Scar thickness increases chances of successful vaginal deliveries.Conclusions: Sonographic assessment of previous scar has a practical application to predict the thickness and thinness of previous scar and can be taken as a reliable safeguard for trial of labour after previous cesarean but cut off value above which vaginal delivery could be considered safe is yet to be identified.
Clinicohaematological study of anaemia in antenatal patients
Authors: Gupta Veena , Sharma Karishma , Chaurasia Amrita
Published: March 2020

Background: According to WHO, approximately 75% of pregnant women in developing countries and 18% in developed countries are anaemic. In India prevalence of anaemia is reported to be 33%-89% and is one of the important causes of maternal morbidity and mortality. The present study was done with the objective to study the socio-demographic factors related to anemia and the distribution of different types of anaemia in antenatal patients.Methods: A prospective analytical study was done on 205 pregnant females who presented with anemia (Hb <11 gm/dl) in 1st, 2nd and early 3rd trimester (up to 30 weeks of gestation) in the department of obstetrics and gynecology of Swaroop Rani Nehru Hospital, Prayagraj from September 2017 to September 2018.Results: The rural background with lower socio-economic status comprised majority of the anemic patients (65.9%) with the major cause being iron deficiency anemia (68.8%). The patients mainly presented with anemia at late second or early third trimester (82.4%). Clinical signs like pallor, oedema and symptoms like palpitations and dyspnoea were more associated with severe anemia than mild and moderate anemia.Conclusions: Anemia prevention and prompt detection is the need of the hour with effective management. In India, major cause of anaemia are nutritional deficiencies which can be treated by proper diet and medications. The advises of routine iron supplementation during pregnancy, regardless of whether the mother is anemic or not, is strongly recommended by this study.
Shortened versus standard post-partum maintenance therapy of magnesium sulphate in severe pre-eclampsia: a randomised control trial
Authors: Orisabinone Idowu B. , Onwudiegwu Uche , Adeyemi Adebanjo B. , Oriji Chibuzor P. , Makinde Olakunle I.
Published: March 2020

Background: Pre-eclampsia is a pregnancy-associated multi-organ disorder caused by altered trophoblastic invasion and endothelial cell dysfunction. It is associated with significant maternal and perinatal morbidity and mortality, especially in developing countries. Magnesium sulphate (MgSO4) is effective in the management of severe pre-eclampsia/eclampsia. Objective of this study was to compare the effectiveness of a shortened course of MgSO4 to the Pritchard regimen in patients with severe pre-eclampsiaMethods: This study was carried out at the obstetrics and gynecology department of the Obafemi Awolowo University Teaching Hospital, Ile-Ife. It was a randomised control study of 116 patients, 58 in each group. Group A received the standard Pritchard regimen: a loading dose of MgSO4 4g slow IV bolus plus 10 g IM (5 g in each buttock), followed by maintenance dose of 5g MgSO4 IM 4-hourly into alternate buttocks until 24 hours after delivery. Group B received same loading dose, but the maintenance dose was limited to three doses of 5g MgSO4 IM four hours apart after delivery. In both regimens, 2g MgSO4 was given IV for breakthrough fit. Data were analyzed using SPSS version 20.Results: This study revealed that twelve-hour postpartum MgSO4 was as effective as the Pritchard regime with no statistically difference in occurrence of seizures (X2 = 0.341, df = 1, p = 0.514). The average total dose of magnesium sulphate used was lower in the study Group B.Conclusions: Twelve-hour postpartum MgSO4 is as effective as the standard 24-hour Pritchard regime.
Study of anemia in hypothyroid pregnant patients
Authors: Singh Nidhi , Mani Poonam , Yadav Lalita , Naresh Neha
Published: March 2020

Background: Hypothyroidism and anemia in pregnancy causes significantly high maternal and fetal morbidity and mortality. Aim of this study was to determine the prevalence of anemia, grade and type of anemia in hypothyroid pregnant patients.Methods: This prospective study was conducted at department of obstetrics and gynecology, CSSH, Meerut, Uttar Pradesh over a period of 2 years from August 2017 to August 2019. Patients who attended the OPD during the study period were included in the study according the inclusion criteria and were studied for the clinical profile, obstetric history and detailed examination. Investigations were done including hemoglobin, blood grouping, urine routine, HbsAg, Anti-HCV, HIV, RBS and serum TSH. The women with raised serum TSH, indicating hypothyroidism, test for free T3, free T4 and anti-TPO was done, and the hypothyroid females with anemia were further investigated with GBP for the type of anemia, data evaluated with adequate statistical analysis.Results: A total 223 patients, enrolled in the study, prevalence of anemia in hypothyroid patients was 69.95%. Most patients with overt hypothyroidism had mild anemia 26 (68.4%), while in sub-clinical hypothyroid patients’ group most of the patients had moderate anemia. In the overt hypothyroid and subclinical hypothyroid group dimorphic anemia was the most prevalent form of anemia with 52.6% and 74.6% respectively.Conclusions: Prevalence of anemia in hypothyroid pregnant patients is 69.95%. Dimorphic anemia is most prevalent; hence it is important to study anemia in antenatal patients with hypothyroidism and appropriate strategies should be used to prevent and treat anemia.
Spontaneous uterine rupture of an unscarred uterus in primigravida: case report
Authors: Bansode Minakshi D.
Published: March 2020

A spontaneous rupture of the unscarred uterus in a primigravid patient is extremely rare and is associated with high perinatal and maternal morbidity and mortality. Study report a case of spontaneous rupture of an unscarred uterus at 36 weeks of gestation in a 22-years primigravid woman. Ultrasonography showed posterior low-lying placenta praevia with lower margin touching internal OS. Operative findings during emergent caesarean section revealed e/o 2 L of hemoperitoneum, uterus was bicornuate and pregnancy was in the right horn. There was fundal rupture of right horn measuring approximately 6-7 cm anteroposterior. Incision was taken on the lower part of right horn and placenta was seen on anterior wall. Baby delivered as breech after incising placenta. Postoperative recovery was uneventful. In, conclusion, bicornuate uterus may be an independent risk factor for uterine rupture, which can occur in primigravid patients and at any gestation.
Comparison of performance statistics of CT scan and ultrasonography in complicated appendicitis: experience in a tertiary care centre
Authors: Majhi Harekrishna , Panigrahi Pramit Ballav , Mohapatra Abinasha
Published: March 2020

Background: This study is conducted from November 2018 to November 2019 in this institute, where comparison of performance statistics is done between CT scan and Ultrasonography in patients with complicated appendicitis scheduled for conservative management, elective or emergency surgery.  Aim of the study was to evaluate and compare the performance statistics of CT scan and Ultrasonography in complicated appendicitis.Methods: The CT scan or USG findings of 87 patients were reviewed. The patients were divided into two groups i.e. CT scan group (group-1/18 patients), USG group (group-2/69 patients). Satistical analysis Student”s t-test, Fischer”s test, p-value, k-value.Results: Clinical signs, CT findings, USG findings, complications at surgery and histological examinations were noted. 2, 3, 13, patients presenting with CT features and 5, 13, 51 patients presenting with USG features of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass respectively. No clinical signs showed a significant association with the presence of appendicular perforation, peri-appendicular abscess, inflammatory appendicular mass or the complication encountered at surgery.Conclusions: In this study, by comparing CT scan group and USG group in complicated acute appendicitis, CT scan can change the plan of management in doubtful cases, decrease length of hospital stay and expenses, reduce the complication rate and negative laparotomy rate, and reduce the episodes of conversion to open surgery.
Does microneedling with 5% minoxidil offer added advantage for treatment of androgenetic alopecia in comparison to use of topical 5% minoxidil alone?
Authors: Malhotra Karan , Herakal Kallappa C.
Published: March 2020

Background: Androgenetic alopecia is the most common cause of chronic hair loss. The FDA approved treatment for male androgenetic alopecia are Finasteride and Minoxidil. But many patients do not respond to these medications. Microneedling is a recent modality that releases several growth factors and enhances penetration of minoxidil, thereby promoting hair growth.Methods: 60 patients, aged 21-40 years, with androgenetic alopecia were divided into 2 groups. In group A, patients were subjected to microneedling twice monthly, immediately followed by application of topical 5% minoxidil solution over the scalp and then 1 ml twice daily. In group B, patients were treated with application of 1ml of topical 5% minoxidil solution over the scalp twice daily. The results were evaluated based on patient’s and physician’s assessment based on the standardized 7-point evaluation scale.Results: Patients in group A showed statistically significant improvement (p value<0.05) compared to group B. Headache and erythema were the most common side effects encountered in both the groups.Conclusions: Microneedling with 5% minoxidil is a safe, simple and cost-effective modality and is a promising treatment option for patients with androgenetic alopecia. It showed much better results when compared to use of topical 5% minoxidil solution alone.
Evaluation of vitamin-D status in premenopausal and postmenopausal type-2 diabetic women and its relation to glycemic control
Authors: Kotwal Shivwani D. , Bhat Anjali N. , Yograj Sabita , Kotwal Suresh
Published: March 2020

Background: Vitamin D deficiency is a public health problem around the world. In 2008, it was estimated that 1 billion persons present with vitamin D insufficiency or deficiency. Vitamin D is obtained through exposure to ultraviolet B (UVB) sunlight as well as nutritional sources. Despite the high UVB sunlight exposure in tropical countries, studies suggest Vitamin D deficiency is highly prevalent. Vitamin D is believed to help improve the body’s sensitivity to insulin, the hormone responsible for regulating blood sugar levels, thus reducing the risk of insulin resistance, which is often a precursor to Type-2 diabetes. Aim and objective of the study was to evaluate and compare the Vitamin-D levels in Premenopausal and Postmenopausal Type-2 Diabetic women and to evaluate if their Vitamin-D levels have any co-relation with their glycemic control.Methods: The study was conducted in Government Medical College Jammu and its associated hospital on 60 Type-2 Diabetic women, 30 premenopausal and 30 postmenopausal. Vitamin-D [25(OH) Vitamin D] levels were assessed by Chemiluminescence method in the Biochemistry Lab. of Govt. Medical College Jammu. Blood sugar levels, both fasting and postprandial, were assessed by Glucose oxidase-peroxidase method in the same Lab.HbA1C was assessed by HPLC [High Performance Liquid Chromatography] assay.Results: Vitamin-D deficiency [Vitamin-D levels <20 ng/ml] was seen in 16.67% of premenopausal type-2 diabetics and in 36.67% postmenopausal type-2 diabetics. This was not related to the glycemic control as HbA1C was increased in both the groups.Conclusions: Vitamin-D deficiency is more prevalent in postmenopausal Type-2 diabetics, as compared to premenopausal type-2 diabetics.
A prospective study to evaluate the effects of acute normovolemic hemodilution on perioperative homologous transfusion requirements in patients undergoing major surgery
Authors: Kumar Ajay , Singh Shalendra , Bhatia Parmeet , Hooda Bhavna , Taank Priya
Published: March 2020

Background: Acute Normovolemic Hemodilution (ANH) and autologous transfusion can mitigate the harmful effects of banked blood intraoperatively. This study was planned to evaluate its effects on perioperative transfusion requirement, hemodynamic stability and safety profile.Methods: Hundred patients were randomized to Group 1, where assigned patients received ANH and autologous transfusion after hemostasis; and Group II where assigned patients received homologous transfusion. In group I, 350 to 700 ml of patient's blood was collected before induction of anaesthesia and was kept in the operation theatre at room temperature. This was followed by rapid infusion of calculated Hetastarch. Intraoperative blood loss, amount of transfused blood, serial haemoglobin (Hb) assessment, and change in hemodynamics were carefully monitored. The blood was reinfused once hemostasis was secured at the end of surgery.Results: It was observed that hemodynamic stability was maintained in both the groups during and after haemodilution. There was no significant change in bleeding and clotting time due to haemodilution. The mean intra-operative blood loss in both groups was comparable. 350 mL and 700 mL blood withdrawn in 27 and 23 patients and 500mL and 1000 mL HES infused respectively. There was an average fall in the mean Hb level by 1.74 gm % and in the mean haematocrit (Hct) level by 6.4 % after haemodilution. The mean 12th and 24th hour Hb and Hct levels were comparable. The requirement of homologous blood transfusion in group I was significantly low (p<0.0001). Need for homologous transfusion was 0.72 per patient treated in the Group I.Conclusions: Acute normovolemic hemodilution is a simple, safe and effective modality to reduce perioperative transfusion of banked blood and should be considered in patients undergoing surgical procedures where major blood loss is expected.
A study of histopathological spectrum of central nervous system lesions at a tertiary health care center of South Gujarat, India
Authors: Shihora Nidhi V. , Patel Himanshu U. , Patel S. M. , Ramani Pankaj R. , Nandasana Bhumika N.
Published: March 2020

Background: Central nervous system lesions can have varied aetiology like infectious, inflammatory and neoplastic. Establishing an accurate aetiology is essential for timely diagnosis and neurosurgical intervention. The annual incidence of tumours of CNS ranges from 10 to 17 per 100,000 people for intracranial tumours and 1 to 2 per 100,000 people for intraspinal tumours; the majority of these are primary tumours, and only one fourth to one half are metastastic. The present study attempts to provide preliminary data on morphological patterns of intracranial lesions and to study clinicopathological spectrum.Methods: The present study was carried out at a tertiary care center from January 2015 to September 2017. A total of 65 cases of CNS lesions were analyzed. In case of CNS tumours reporting were done according to WHO criteria for classification and grading.Results: Out of 65 cases studied, 51 cases (78.46%) were of neoplastic lesions and 14 cases (21.54%) of non-neoplastic lesions. Among 14 cases of non-neoplastic lesions 2 cases were of reactive/cystic lesions, 4 cases  were of infective lesions, and 8 cases were of congenital lesions. In the present study, out of 51 neoplastic cases most common cases were of astrocytoma.Conclusions: The exact histopathological diagnosis of Central Nervous system lesions is essential to predict the prognosis and treatment. Management strategies and prognosis of tumours depends on the correlation of factors like the types, grades of tumours, its location, size and stage of development.
A study to evaluate the adequacy of pelvic lymph node coverage in carcinoma cervix patients in Indian population by conventional four field box technique using computerized tomography simulation based pelvic lymph node contouring
Authors: Ghosh Tanmoy , Basu Joydeep
Published: March 2020

Background: Traditionally pelvic External Beam Radiotherapy is delivered with four field box technique in carcinoma cervix patients. The primary aim of this prospective observational study is to determine the adequacy of pelvic lymph nodal coverage by conventional Four Field Box Technique with the help of pelvic lymph node contouring by CT simulation.Methods: Between January 2013 and August 2015 sixty patients with biopsy proven Carcinoma Cervix were enrolled in this study. Of these fifty-three patients were available for final analysis. CT simulation based Pelvic lymph node contouring was done for each patient. Then two External Beam Radiotherapy plans were generated, one contoured based and the other based on bony landmark based Four Field Box Technique. The number of patients whose contoured lymph nodes lies partly outside the field borders of the bony landmark-based plan and also its extent was determined. D90 of various groups of pelvic lymph nodes obtained from both the plans were compared using ‘paired sample t - test’.Results: It was seen that with Four Field Box Technique there is inadequate coverage of common iliac lymph nodes in 34/53 patients. The difference between the mean D90 of common iliac lymph nodes in two sets of plans was found to be statistically significant.Conclusions: Pelvic field planning should be individualized. CT simulation-based radiotherapy planning should be done for each individual patient to adequately cover the nodal microscopic disease.
Artificial intelligence in critical care: prediction of sepsis in patients in intensive care from first initial laboratory parameters
Authors: Mitra Samrat , Sangwan H.
Published: March 2020

Background: Sepsis is a leading cause of morbidity and mortality in the critical care setting. The analysis of hemostatic parameters at admission have been proven to be a predictive marker for development of sepsis in the ICU. The present study aims to develop a machine learning model which can predict the development of sepsis after 72 hours of ICU admission, from initial assessment of hemostatic parameters.Methods: A total of 170 ICU admissions over six months (May 2018 - Dec 2018) period were included in the study. Hemostatic parameters including platelet counts, prothrombin time and Sonoclot assay were assayed at time of admission. The patients were followed up for development of sepsis. The data was split in two sets: training (100) and test (70). A machine learning model was developed using the linear discriminant analysis (LDA) model, in the R programming environment. The statistical parameters employed were sensitivity, specificity, positive and negative predictive value.Results: A comparison of incidence of development of clinical sepsis and predicted sepsis by the model showed 74.19% sensitivity and 84.61% specificity over the testing set. 06 false positives and 08 false negative predictions were encountered.Conclusions: The model shows potential to be used as a predictive tool for development of sepsis in the critical care ward. Moderate sensitivity and good specificity were achieved by the model, highlighting the role of hematologic assessment at admission in prediction of development of sepsis. However, further studies with larger datasets are required before implementation in clinical practice.
Our management in vascular Behçet patients with ascending aorta aneurysm: 6 years’ experience
Authors: Ata Emin C. , Beyaz Metin O.
Published: March 2020

Background: Ascending aortic involvement in Behçet’s disease is very rare, and often accompanied by aortic root dilatation. In cases with aortic valve insufficiency without valve structure impairment, valve-sparing surgery can be performed. This study aimed to investigate the mid-term results of patients with ascending aortic involvement and selected surgical procedures according to the valve structure among those vascular Behçets disease.Methods: A total of 13 Behçet’s disease with aortic involvement operated at our center from January 2012 to 2018 was retrospectively investigated. Bentall or david valve-sparing operations were preferred according to the aortic valve status. Postoperative echocardiography and computed tomography imaging was performed periodically for aortic valve competence and pseudoaneurysm formation.Results: Bentall procedure was performed in 7 (54%) patients, and 6 (46%) patients were undergone valve-sparing David procedure. Operative mortality was 7.7%, one patient died of major gastrointestinal bleeding 3 months after the operation. After 51±23 (ranged 23 to 94) months of follow-up, no other mortality occurred, overall survival rates were 84.6%, two patients had minimally aortic regurgitation and one patient had mild regurgitation in David procedure. In Bentall procedure, no paravalvular leakage was found during follow-up.Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.
Timing of hypocalcemia after total or near total thyroidectomy: a prospective observational study
Authors: Benkhadoura Mohamed O. , Elbarsha Abdulwahab M. , Elgazwi Khaled K. , Elshaikhy Akrem I. , Elkhweldi Talal K. , Tajoury Othman H. , Alsharif Jamal A. , Abdulrahman Abdulgadir M.
Published: March 2020

Background: Hypocalcemia after thyroidectomy is the most common metabolic complication that prolongs the hospital stay. The aim of this study was to determine timing of hypocalcemia postoperatively and determine the safest day to discharge post-total or near-total thyroidectomy patients based on serum calcium level.Methods: From October 2012 to January 2017, the medical records of 117 consecutive patients who underwent a total or near-total, completion or redo thyroidectomy for benign and malignant thyroid diseases in two university hospitals were prospectively analyzed. The serum calcium was measured preoperatively, on the morning on the first, second, third and fourth postoperative days and the postoperative day on which hypocalcemia developed was identified.Results: Of the 117 patients who underwent a total or near thyroidectomy, 36 (30.7%) developed hypocalcemia, which was transient in 34 (29%) and permanent in two (1.7%) patients. The postoperative hypocalcemia was mild in 10 (8.5%) patients, and 26 (22.2%) patients developed significant postoperative hypocalcemia. Of the 36 patients who developed hypocalcemia postoperatively, the peak incidence of hypocalcemia (72.2%) was on the first postoperative day, and by the third day serum calcium measurement detected 97.3% of patients who developed hypocalcemia.Conclusions: Postoperative serial serum calcium levels may be useful for identifying patients suitable for early discharge following total/near total thyroid surgery in hospitals that lack the facilities. Hypocalcemia peaked on the first postoperative day. However, based on serum calcium levels alone, the third postoperative day is the crucial day for deciding whether to discharge the patients.
Treatment outcome of hepatolithiasis: Nepalese experience
Authors: Pandit Narendra , Awale Laligen , Yadav Tek Narayan , Deo Kunal Bikram , Adhikary Shailesh
Published: March 2020

Background: Hepatolithiasis is a rare disease with high rate of treatment failure and recurrence. This study aims to review the burden, management and outcome from an endemic region.Methods: A retrospective review of database of patients with hepatolithiasis managed surgically from 2015 to 2019 was performed. Diagnosis was based on the clinical findings and radiological investigations. Demographic data, clinical presentation, extent of disease and type of surgical management were evaluated. The outcome measures included immediate stone clearance, postoperative complications and follow-up.Results: Hepatolithiasis was seen in nine (0.34%) out of 2,600 patients being evaluated for gallstone disease. Three patients were young, while the remaining six were in the middle-age group. The presenting symptoms were pain abdomen (78%) and jaundice (22%). Hepatolithiasis was located in the left, right and both ductal systems in 5, 1 and 3 patients respectively. Liver resection for unilateral disease was done in 3 patients: left hepatectomy (n=2) and left lateral segmentectomy (n=1). High bile duct exploration and bilio-enteric drainage was done in 5 patients. One patient required hepatolithotomy and T-tube drainage due to cholangitis. Complete stone clearance was achieved in 78%. Complications included surgical site infection and cholangitis in 2 patients. There was no operative mortality. Histopathology revealed recurrent pyogenic cholangitis. At median follow-up of 28 months, 7 patients are symptom-free.Conclusions: Hepatectomy is an effective treatment when disease is confined to the left lobe. Combined surgical procedure is an acceptable option for bilateral or right-sided hepatolithiasis.
Management of complex genital fistula: experience in a tertiary sub-Saharan hospital
Authors: Agwu Ngwobia P. , Ahmed Abdullahi A. , Muhammad Abubakar S. , Mungadi Ismaila A. , Oyibo Emmanuel U. , Hassan Mairo
Published: March 2020

Background: Management of complex genital fistulae is challenging due to the cost and technical skill required. This study reports our experience in the management of patients with complex genital fistulae and to highlight the crucial role of the reconstructive urologists.Methods: This was a retrospective review of female patients managed at a tertiary hospital in Nigeria from 2006 to 2017 for complex urinary fistulae. Data were extracted from patient case notes and the data analysed using the SPSS software.Results: Twenty-four female patients mean age 28.9±11.1 years. Fistulae resulted from prolonged obstructed labour 10 (41.6%), caesarean hysterectomy 7 (29.2%), caesarean section and abdominal hysterectomy 2 (8.4%) respectively. The fistulae were vesicovaginal 16 (66.7%), ureterovaginal 3 (12.5%). Others were vesicocutaneous, urethrovaginal and rectovaginal. Prior attempts at repair were done in 7 (29.2%) and the number of attempts ranged from 1 to 4. Surgical procedures included direct closure in 9 (37.5%), closure and uretero-neocystostomy 7 (29.2%), uretero-neocystostomy only 3 (12.5%) closure and abdominal hysterectomy 2 (8.3%), closure and continent catheterizable neo-bladder 2 (8.3%) and 1 (4.2%) closure, abdominal hysterectomy and uretero-neocystostomy. Post-operative complications were noted in 2 (8.3%) and consisted of gynaeatresia and recurrent RVF. Repair was successful in 70.8% of patients while failed repair was recorded in 16.7% and while stress incontinence was present in 12.5%.Conclusions: Complex genital fistulae in our practice are of obstetric origin involving the bladder, ureters and rectum. The reconstructive urologist has a crucial role the management for a favourable outcome.
Comparative study of closed versus open lateral internal sphincterotomy in the management of chronic anal fissure
Authors: Bansal Anand R. , Bansal Manish , Bhardwaj Ankit
Published: March 2020

Background: Anal fissure is a painful tear in distal anal canal extending from just below the dentate line to anal verge. Patient presents with pain during or after defecation and passage of bright red blood per anus. Various studies investigating chronic anal fissures show a large variation in healing rates for different modalities. The present study was carried out to evaluate effectiveness of closed versus open lateral internal sphincterotomy in treatment of patients with chronic anal fissure.Methods: A prospective study was conducted in the Department of Surgery, Pt. B.D. Sharma PGIMS, Rohtak. Group A and group B included 20 patients each with chronic anal fissure and managed by closed and open lateral internal sphincterotomy respectively and effectiveness was evaluated with regards to fissure healing, pain reduction, recurrence and incontinence after surgical treatment.Results: The mean pain scores on visual analogue scale at end of 1 week in group A and group B was not found to be statistically significant, whereas it was found to be statistically significant at 3 week and at 6 weeks. Delayed healing was seen in 1 patient of group B, whereas no patient in group A had delayed healing or absence of healing postoperatively.Conclusions:There was a significant difference between closed and open methods of lateral internal sphincterotomy in terms of relief in post-operative pain but as a whole both techniques did not show any statistically significant difference in terms of fissure healing, postoperative complications or recurrence at 3 months.
Cell cannibalism: a diagnostic and prognostic marker of breast cancer
Authors: Mohsin Mir , Zargar Haroon Rashid , Khan Mohammad Amanullah , Sherwani Rana
Published: March 2020

Background: Cell cannibalism (cytophagocytosis) is defined as a tumor cell within a tumor cell, such that smaller tumor cells are found in the cytoplasm of larger tumor cells with crescent shaped nuclei. Aims and Objectives were to study the cytomorphological characters of cell cannibalism in primary and metastatic breast cancer, to correlate the histologic type and grade of tumors with positive rate of cannibalism and to study the role of Cannibalism as an independent prognostic factor in breast cancer.Methods: The study was conducted during the period of July 2003 to June 2005 in the Department of Surgery and Pathology, JNMCH, Aligarh. A total of 42 cases were included in the study. A minimum of 3 FNAC smears per case were assessed for cytophagocytosis. Presence of metastasis was also noted to establish the cytological grade and aggressiveness of the tumor.Results: Out of 42 cases, significant cannibalistic activity was noted in 30 (71.42%) cases. All grade III (33.4%) breast tumors were found positive for cytophagocytosis (4.28/smear), while the rate was much lower (2.33/smear) in grade II and (1.63/smear) in grade I tumors. LN metastasis was confirmed by histopathological examination in all high grade tumors showing significant cannibalistic activity.Conclusions: Cannibalism in breast carcinoma is an indicator of both the anaplastic grade and invasiveness. The rate of cytophagocytosis may have a prognostic significance.
Modified retrorectus procedure for repair of midline incisional hernias
Authors: Mir Javed A. , Masoodi Sanober M.
Published: March 2020

Background: Incisional hernias develop after abdominal operations. Primary closure procedures carry high recurrence rates. Prosthetic repairs with different modifications have reduced the recurrence rates and are the procedures of choice for incisional hernia repair.Methods: Our study is a prospective study conducted on 30 patients of midline incisional hernia. Hernia repair was done by modified retrorectus technique with in which the mesh is placed between the rectus abdominis muscle and the posterior rectus sheath.Results: In our study, the hernia defect ranged from 25-40 cm2.The mesh size used ranged from 15×15 to 30×20 cm. Mean duration of hospital stay was 9.9±2.3 days. Operative time ranged from 90-150 minutes. Follow up period ranged from 3-15 months. There were no post-operative complications in 73.3% cases. Seroma formation occurred in 10% cases and wound infection was seen in 10% cases. One patient developed mesh infection which required partial removal of mesh. There was no recurrence, no mortality, no bowel injury or adhesion obstruction. Wound related complications and morbidity was higher in patients with risk factors and comorbidities like diabetes, obesity, anaemia, COPD, hypoalbuminemia and patients on steroids.Conclusions: The retrorectus technique for the repair of midline incisional hernia using polypropylene mesh is a safe and durable procedure with excellent long-term results, minimal comorbidities and least recurrence rates and is an open procedure of choice for the repair of large incisional hernias.