bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Knee Arthroplasty in Patients with Spinal Cord Injury: Impact on Medical Complications, Hospital Costs and Length of Stay
Authors: Sambandam Senthil , Cheppalli Naga Suresh , Menedal Anil , Senthil Tejas , Sakthivelnathan Vishaal , Mounasamy Varatharaj
Published: April 2023

Introduction:

Patients with spinal cord injury (SCI) with degenerative joint disease of the knee may require total knee arthroplasty (TKA). This study examines the demographic and immediate postoperative outcomes of patients with SCI who undergo TKA.

Methods:

Admissions data for TKA and SCI were analyzed from the National Inpatient Sample database using International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes. An extensive array of preoperative and postoperative variables was compared among SCI TKA patients and non-SCI TKA patients. An unmatched and matched analysis using a 1:1 propensity match algorithm was conducted to compare the two groups.

Results:

Patients with SCI tend to be younger and have a 7.518 times greater risk of acute renal failure, 2.3 times greater risk of blood loss, and higher risk of local complications, including periprosthetic fracture and prosthetic infection. The average length of stay in the SCI cohort was 2.12 times greater, with a 1.58 times higher mean total incurred charge than the non-SCI group.

Conclusion:

SCI is associated with an increased risk of acute renal failure, blood loss anemia, periprosthetic fractures and infections, a longer length of stay, and greater incurred charges in TKA patients.

Study Design:

Retrospective study.
Tantalum Cementless Versus Cemented Total Knee Arthroplasty: A Meta-analysis of Level 1 Studies
Authors: Peddada Kranti V. , Delman Connor M. , Holland Christopher T. , Meehan John P. , Lum Zachary C.
Published: April 2023

Introduction:

Controversy exists on the ideal type of fixation in total knee arthroplasty (TKA). Noncemented fixation has been theorized to improve patient outcomes and longevity of implantation without increased risk of aseptic loosening or radiolucent lines. We sought to compare (1) patient-reported outcomes, (2) survivorship, and (3) revision rates for all-cause and aseptic loosening in a noncemented tantalum total knee with its cemented counterpart.

Methods:

Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were searched using a combination of keywords “trabecular metal,” “tantalum knee,” “total knee arthroplasty,” and “cementless trabecular.” Patient demographics such as age, sex, and body mass index were collected. Outcomes such as Knee Society Scores (KSSs), revisions, and radiolucent lines were recorded for analysis.

Results:

Four randomized controlled trials involving 507 patients with an average 5-year follow-up were eligible for meta-analysis. No differences were observed in any demographics such as age, sex, body mass index, nor preoperative KSS. Patients in the cemented cohort improved from preoperative KSS 46.4 to postoperative KSS 90.4 while the tantalum cohort improved from 46.4 to 89.3. No statistical difference was observed in postoperative KSS mean difference between groups. Six patients from the tantalum group underwent revision with one patient for aseptic loosening. Twelve patients from the cemented group underwent revision with four patients for aseptic loosening. No statistical difference was observed between rates of revision, aseptic loosening, or radiolucent line development.

Discussion:

Patient-reported outcomes improved postoperatively in both groups. No differences were detected between the cemented and noncemented TKAs in patient-reported outcomes, revision rates, or radiolucent line development. Noncemented tantalum fixation seems equivalent to cemented TKA survivorship. Longer term follow-up of these randomized controlled trials may provide a clearer understanding whether a difference exists.
Prolonged Time to Brake Following Lower Extremity Injuries
Authors: Alejo Andrew L. , Rascoe Alexander , Kim Chang-Yeon , Ren Bryan O. , Hoffa Matthew T. , Heimke Isabella M. , Vallier Heather A.
Published: April 2023

Introduction:

No guidelines exist for recommending return to driving. This study will examine time to brake (TTB) after lower extremity injuries versus in uninjured people. The potential effect of various types of lower extremity injuries on TTB will be measured.

Methods:

Patients with injuries to the pelvis, hip, femur, knee, tibia, ankle, and foot underwent testing using a driving simulator to assess TTB. Comparison was with a control group of uninjured people.

Results:

Two-hundred thirty-two patients with lower extremity injuries participated. The majority were in the tibia and ankle regions (47%). Mean TTB for control subjects was 0.74 seconds, compared with 0.83 for injured patients, noting a 0.09-second difference (P = 0.017). Left-sided injuries averaged TTB of 0.80 seconds, right-sided injuries averaged TTB of 0.86 seconds, and bilateral injuries averaged TTB of 0.83 seconds, all prolonged versus control subjects. The longest TTB was exhibited after ankle and foot injuries (0.89 seconds) while the shortest was after tibial shaft fractures (0.76 seconds).

Discussion:

Any lower extremity injury caused a prolonged TTB compared with control patients. Left, right, and bilateral injuries all had longer TTB. Ankle and foot injuries experienced the longest TTB. Additional investigation is warranted to develop safe guidelines for return to driving.
Implementation of Peri-Operative Strategies for Prevention of Surgical Site Infection
Authors: Fayyaz Maria , Akram Fazeelat , Muneer Bushra , Naeem Usra , Islam Beenish , Shahzadi Mubashara , Shahzadi Uzma
Published: April 2023

Surgical site infection (SSI) is also known as nosocomial or health acquired infection which is increasing day by day and augmenting morbidity and mortality rate. The presence of the SSI shows the signs and symptoms including redness, pain, heat, presence of pus, and many more. Despite improvements in operational practice and contamination control strategies, SSI plays a major role in high morbidity and mortality and places a heavy burden on the resources of medical services. The purpose of this review article is collection of data that already exists about the pre-operative, intra-operative and post-operative strategies for prevention of the SSIs. The data about the SSI has been collected from the different review articles and research papers. Different keywords like prevention of SSI, cure from SSI, epidemiology of SSI, causes of SSI, and peri-operative strategies for prevention of SSI were used for data collection. Implementation of the pre-operative, intra operative and post-operative strategies can reduce or completely eliminate the surgical site infection. The morbidity and mortality rates that are directly linked with the SSI can be decreased by the alteration of different factors including operation theatre environment, treatment related factors and patient related factors. A proven and thorough strategy to lower the incidence of SSIs is SSI surveillance. Maintaining operation theatre quality is also essential for SSI reduction. But more research is still needed to improve the standards for regular infection control and surveillance in hospitals.
Effect of Skills Competency-Based Orientation on Clinical Performance Among Nursing Interns at University of Lahore Teaching Hospital
Authors: Parveen Razia , Ali Afsar , Sarwar Hajra , Aziz Zunaira
Published: April 2023

The competencies of nursing interns have direct effects on the wellbeing and health of patients, and lack of it can result in severe problems for the patients. Thus, the clinical performance and competence of nursing interns are the main professional and corporate problems for nurses and patients. Furthermore, it is needed that the nurses show the capability to supply quality care for patients and to collaborate with other nurses and colleagues. Objective: To determine the effect of skills Competency- based orientation on clinical performance among nursing interns at University of Teaching Hospital Lahore. Methods: A quasi experimental study design was used to conduct this study at University of Lahore Teaching Hospital among nursing interns. A simple random sample of n=40 participants was recruited. The educational intervention consisted of 12 sessions of 40 to 50 minutes each, from June, 2022 to August 2022.To collect data, permission was granted from the Research Ethical Committee (REC) and then Medical superintendent of University of Lahore Teaching Hospital. To assess the performance among nursing interns, an observational checklist was used. Data of the study participants were entered in statistical software SPSS 21.0 and was analyzed accordingly. Results: Findings revealed a significant effect of the educational intervention program on performance of nursing interns (Pre interventional performance score 21.00 +5.088and post interventional performance score 38.00+4.481among the nursing interns (p- value <0.001). Conclusion: It is concluded that nursing education program has effect on performance among nursing interns.
Comparison of RPM (Re-positioning Maneuver) & Liberatory maneuvers vs Betahistine on BPPV (Benign Paroxysmal Positional Vertigo) for improving functional ability and quality of life
Authors: Talha Muhammad , Asif Somiya , Shahid Hamza , Nazir Syeda Maria , Haq Kiran
Published: April 2023

BPPV is a vestibular disease which arises due to positional changes of head. Objective: To compare the efficacy of CRP & Liberatory maneuvers collectively in contrast to Betahistine alone for improving quality of life oof BPPV patients. Methods: After getting the approval from ERC of RIHS (Rawal Institute of Health Sciences) Islamabad, this study was conducted at Rawal General & Dental Hospital Islamabad from 20th September 2022 to 19th Jan 2023. 30 patients between age of 20-50 years with first episode of vertigo were included in this study. Two groups were formulated. Group A patients were given CRP (Epley’s maneuver) & Liberatory maneuver (Semont’s) whereas group B patients were given just Betahistine 16mg. Both techniques were used twice a day for one week. Tools used for assessment were DHI & SF-36. SPSS version 21 was employed for analysis. Results: Mean+SD of age was 32.40+10.91 in group A and 29.93+11.67 in group B. The frequency of age between 20-30 years old patients was 07(46.4%) in group A and 11(73.7%) in group B. The frequency in age group 31-40 & 41-50 was 04(26.8%) & 04(26.8%) in group A whereas in group B it was 04(26.3%) & 0(0%) respectively. within group analysis of both groups showed significant improvement (p<0.05) on. Between groups Analysis revealed insignificant difference (p>0.05). Conclusion: Both maneuvers in combination are equally effective as Betahistine is in improving the quality of life of BPPV patients.
Spontaneous resolution of ‘glue ear’ in children- An experience at a tertiary care teaching hospital of Khyber Pakhtunkhwa.
Authors: Anwar Khurshid , Yar Mohammad Adnan , Khan Saeed
Published: April 2023

Otitis media with effusion (OME) is a common cause of treatable hearing impairment in children. As OME is a recurrent problem, a ‘wait and see’ policy is therefore worthwhile before embarking on treating it surgically. Objective: To determine the frequency of cases having spontaneous resolution of otitis media with effusion in the first 3 months after acquiring the disease. Methods: This study was conducted in ENT Department of Hayatabad Medical complex, Peshawar during the period from July 1, 2021 to Sep 3, 2022. Children aging 3-13 years diagnosed with recent onset OME were followed upto 3 months. Children were categorized into two categories; “Resolved” and “Persistent OME” on the basis of pure tone audiometry and tympanometry at the end of 3 months. Using this data, the frequency of spontaneous resolution of otitis media with effusion (glue ear) was calculated. Results: A total of 185 patients were included in the study. The male: female ratio was of 1.28: 1 with mean age of 7.71 ± 2.75years. The 6-9 years comprised 88(47.57%) & was the commonest age group involved by OME and it was in the same group where maximum percentage of spontaneous resolutions of disease occurred. Overall 148(80%) of children with glue ear achieved spontaneous resolution. Statistically this number has been highly significant (p=0.001). Conclusion: OME resolves spontaneously in a significant proportion of children in first 3 months of illness. A close follow up is recommended before embarking on surgery which is best reserved for persisting cases.
Clinical Presentation, Complications and Outcome of Measles in Pediatric Population at Tertiary Care Hospital
Authors: Kulsoom Shazia , Soomro Shazia , Junejo Sadaf , Anjum Misbah , Waseem Hira , Akram Marium
Published: April 2023

Measles is highly contagious infection with person-to-person transmission through droplet infection in developing countries, which can lead to death in complicated cases. Bronchopneumonia, encephalitis, gastroenteritis with renal failure and electrolyte imbalance are common complications in pediatric age group. Objective: To determine complications of measles in hospitalized children at Tertiary Care Children Hospital. Methods: This cross-sectional study conducted at inpatient medical wards of National Institute of Child Health from July-Dec 2022. All patients hospitalized in study duration with the diagnosis of measles from 6 months till 12 years of age were enrolled. History, examination, laboratory tests, treatment and outcome were recorded and analyzed. Results: Children enrolled were 185, the mean age ± SD of presentation was 26.7 ± 27.1 months, with 56.8% males. Mean weight of patients was 10.48 ± 9.7kg. Common measles complications were bronchopneumonia 160(86.5%), acute diarrhea 64(34.6%) encephalitis 24(13%), myocarditis 16(8.6%), acute kidney injury 11(5.9%), and otitis media 18(9.7%). Conclusions: Most common clinical features were fever, maculopapular rash, cough and coryza.  Bronchopneumonia was the main reason of hospitalization in majority of patients and leading cause of death in 13.5% of patients along with encephalitis and myocarditis. Additional strategies are required by government for elimination of vaccine preventable measles from Pakistan.
Knowledge Assessment Regarding Nasogastric (Ng) Tube Insertion Guidelines Among Nurses in District Headquarters Hospital Toba Tek Singh
Authors: Akhter Shamshad , Ali Amjad , Rehman Khursheed
Published: April 2023

Inserting a nasogastric tube in most countries, is the responsibility of the nursing profession. To ensure patient safety and avoid complications, nurses must first understand what they know and do when inserting nasogastric tubes into sick patients. As a result, the nurse must have the necessary knowledge and abilities for tube insertion and verification. Objective: To assess the knowledge regarding Nasogastric (NG) Tube insertion guidelines among nurses. Methods: Descriptive cross-sectional research design was utilized in the current study. A total of 105 nurses were selected for this study. Modified form of questionnaire were utilized to collect data. Data was analyzed by using (SPSS) version-22. Frequency distribution tables and graphs were used to describe the results of study. Results: The result finding shows that knowledge for all nurses in this study as regards Nasogastric (NG) Tube was unsatisfactory 65.7% while only 34.3 % with a satisfactory knowledge. The educational level is directory co-related with the knowledge level. Those who have a degree level education score more than diploma level with a p equal to 0.01. Conclusions: Knowledge level of nurses regarding NG tube insertion guidelines was found unsatisfactory. It is the most important thing for nurses to know the nasogastric tube guidelines because then they can provide effective care to the patients, and by following the nasogastric tube guidelines nurses can improve their everyday practice.
Prevalence of Left Ventricular Hypertrophy in End Stage Renal Disease Patients on Maintenance Hemodialysis
Authors: Naz Afreen , Das Bhagwan , Memon Sughand , Sanjay . , Memon Rafia , Kumar Kishor
Published: April 2023

Among the hemodialysis population, left ventricular hypertrophy (LVH) is becoming a major cause of cardiovascular death, mainly due to myocardial infarction, heart failure, and arrhythmias. Objective: To determine the frequency of left ventricular hypertrophy in ESRD patients on maintenance hemodialysis. Methods: The Descriptive Cross-sectional study was conducted at Department of Nephrology, Liaquat University of Medical and Health Sciences Jamshoro. All patients above 18 years of age and below 65 years of age of both gender having end stage renal disease on maintenance hemodialysis with 3 months or more of maintenance hemodialysis were consecutively enrolled. On dialysis free day patients meeting inclusion criteria was sent for Trans Thoracic Echocardiography. Measurements was taken as inter-ventricular septal thickness, left ventricular end-diastolic diameter and left ventricular posterior wall thickness through parasternal long axis or short axis just distal to the tip of mitral valve leaflet. Results: The mean age of the patients was 53.54 ± 11.63 years. There were 72 (61.5%) males and 45 (38.5%) females. The mean duration of hemodialysis was 5.61 ± 0.97 months. The mean duration of ESRD was 7.23 ± 0.78 months. Type 2 diabetes mellitus was found in 73 (62.4%) and hypertension in 71 (60.7%) patients. The frequency of left ventricular hypertrophy was found in 53 (45.3%) patients. Conclusions: The frequency of left ventricular hypertrophy was found to be 45.3% in ESRD patients on maintenance hemodialysis
Psychological Well-Being and Care Giver Burden of Parents Having Child with Leukemia
Authors: Ghaffar Robina , Ali Afsar , Sarwar Hajra
Published: April 2023

Leukemia is one of most prevalent type of cancer among the children with age less than 15 years. Worldwide, Leukemia represents 32.5% of all types of cancer among the children. In Pakistan, 46.5% child with cancer diagnosed with leukemia. Both the mother and father are involved in the direct and indirect care of their child with leukemia Direct care is the tasks with the care of the child with leukemia and indirect care is the financial support and the facilities provided to the patients. Objective: To determine the psychological wellbeing and Care burden among parents having Children with Leukemia. Methods: A cross-sectional study designed was used. A sample of n=81 participants was recruited from Sadiq Abbasi Hospital Bahawalpur, through convenient sampling. The psychological wellbeing and care burden questionnaires were used to measure care burden and psychological wellbeing among parents having children with leukemia. Filled questionnaires were entered and analyzed through SPSS version-21. Results: Findings revealed that 71.60% participants had poor psychological wellbeing, 18.51% had fair and only 38.27% had good wellbeing during their children leukemia care. Similarly, 12.34% had low care burden, 38.27% had moderate and majority 49.38% were having high care burden. Conclusions: Majority of the parents of children with leukemia in this study were having high care burden and poor psychological wellbeing while taking care of their children
Changes and challenges in higher education services after COVID-19 pandemic (The case of Israel & The Republic of Moldova)
Authors: Levkovich Lavan Limor
Published: April 2023

The COVID-19 crisis that broke out all over the world in March 2020 has influenced all life areas and economy, including higher education. The transition to online distance learning in a very short time for organization, and the social and economic emergency, had significant implications on the higher education system and those who study. A quick and effective organization of higher education institutions and research institutes promoted higher education in some of the countries to the front of pedagogic competition and progress, which attracted international students and brought academic prosperity of the institutions. The transition to distance learning, which was forced due to health-social constraints, changed the higher education systems’ perception and promoted innovative ideas in placing higher education as an economic-social factor in each country. This article, which is part of a doctoral thesis that discusses the position of higher education as a factor of competitiveness and student mobility, will try to map what was done in both countries, Israel and Moldova.
Reducing eating disorders through experiential psychotherapy: a case study of anorexia nervosa
Authors: Caranfil Narcisa Gianina
Published: April 2023

Over the last decades, the prevalence of eating disorders has increased dramatically. In the current psychiatric nomenclature of the DSM-5 [2], the eating disorders consist of three clearly defined syndromes, i.e. anorexia nervosa, bulimia nervos and binge-eating disorder. The onset of the most clinical cases occurs in adolescence or young adulthood. Data provided by psychiatric practice reveal that eating disorders occur more frequently in women, compared with men. These disorders appear to be multidetermined. Thus, the risk for (or protection against) the development of eating disorders resides in several factors, i.e. genetic, neurohormonal, family, psychological and sociocultural. Negative life events can also play a triggering role. Anorexia nervosa is a debilitating mental disorder with profound biological, psychological and social consequences. Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among adolescents has increased. Different types of psychotherapeutic interventions (e.g., family-based therapy, cognitive-behavioral therapy, dialectical behavior therapy, interpersonal therapy, etc.) are used to treat eating disorders. However, the benefits of experiential techniques (e.g., emotion-focused therapy or gestalt therapy) have been less explored. This paper focuses on a 19-yearold adolescent girl presenting with symptoms of anorexia nervosa. The complaints, results of the initial assessment, goals of the therapeutic sessions, working techniques as well as gains of the intervention based on experiential methods (e.g., the empty chair technique, metapositions, cognitive reframing, etc.) are reviewed. Practical implications are discussed considering the potential of experiential psychotherapy in assisting clients with eating disorders.
Psyhosocial factors of adaptation potencial
Authors: Dzic Ilona
Published: April 2023

The article describes the role of factors promoting or letting adaptation, which are conditionally divided into two large groups: external (social) and internal (personal). External factors included a set of criteria that are most associated with social determinants, as opposed to internal ones, which are associated with individual properties of personality.
Growing on a Solid Ground: The Training Needs of Library Paraprofessional Staffs in Landscaping Information Service
Authors: De La Cruz Fe Nangcas Jalon , Wasil Ellene Clemente
Published: April 2023

This study aimed to determine the training needs of library paraprofessional staff in landscaping information service. Qualitative method employing phenomenology as a research design were used. Library and information science education (LIS) emerged as major theme with core ideas on no formal education occurred. Knowledge and skills that resulted to lack of technological know-how in organizing library materials and insufficient information literacy appeared to be essential in the service delivery. Also, strengthening administrative planning transpired as another major theme while no training plan and inadequate information and instruction to newly hired contractual workers were emphasized. On-the-job training for technical and mechanical processing of library materials was another suggestion. In-service training for seminars and workshops, library materials circulation and information services were given emphasis as well as vestibule training and benchmarking activity. The results pointed out that there is a need to conduct trainings to paraprofessional staffs to provide quality services to clients.
Preparation and Conductivity of Polymer-Modified Graphene Films
Authors: Rana Md Jewel , Hossain Khan Rajib , Jami Marzan Mursalin , Shyeed Md Abu , Hasan Md Kamrul
Published: April 2023

The Hummers method was used to make graphite oxide, and ultrasonic exfoliation at 25°C and 90°C was used to make graphene oxide (GO). At a low temperature, polyethyleneimine (PEI) was used as a reducing and changing agent for graphene oxide (GO) to make dispersions of graphene that were modified with PEI. Optoelectronics’ electron and infrared spectroscopy showed how temperature affected PEI’s ability to break down GO. The results show that PEI can partially reduce GO at 25°C. At 90°C, the grafted PEI gradually dissociated from the GO sheet. The graphene dispersion was filtered and assembled into a PEI-GO film, and its conductivity was found to be 117S.m-1, hopefully conductive material for graphene.
ANALYSIS OF MULTIVARIATE GOITRES: RETROSPECTIVE STUDY IN A TERITIARY CARE CENTRE
Authors: Kotennavar Manjunath , Benakatti Rajendra , Patil Aravind , Kumar Jeevan , Savant Manjunath , Jaju Pradeep , Gutta Santhan
Published: April 2023

Objectives : To evaluate demographic profile, risk factors, clinical presentation, pathological features of thyroid swellings diagnosed and managed at our tertiary care hospital. The purpose of the study was to compare the following parameters pre and post surgery. The following parameters were noted Type of Goitre, clinical symptoms, Biochemical status (thyroid profile), surgical complications, post-op status-comparison between FNAC and histopathological report.
Materials and Methods :
A total of 127 cases of thyroid swellings on examination from March 2018 to May 2020 in BLDE(DU) Shri BM Patil Medical College Hospital and Research Centre, Vijayapura were included. The medical records were retrieved, studied and analysed retrospectively with regards to type of goiters, clinical symptoms, Biochemical status (thyroid profile), at the time of presentation and surgical complications. Histopathological details were analyzed.
Results : The most number of cases were noted in 41-60yrs age group, with female predominance, solitary nodules being most common. Hemithyroidectomy being the predominantly done surgery and nodular goitre was seen in the final histopathogical report in most of the cases.
Conclusions : In our study we concluded that USG and FNAC findings of the thyroid goiters had higher sensitivity and specificity in detecting thyroid tumors but it has low sensitivity for follicular carcinoma as observed in our study, discrepancy between FNAC and HPR.
Gall bladder perforation: a case-series & proposal of the algorithm to a management plan.
Authors: II Ashok , Ghosh Nalinikanta , Victor Alister , Behari Anu , Sharma Supriya , Singh Rajneesh , I Ashok
Published: April 2023

Introduction: Gallbladder perforation (GBP) is a rare & life-threatening complication of both benign & malignant diseases of the gall bladder which requires aggressive supportive management and sepsis control in the initial phase. Follow by further evaluation to know the pathology of GBP and definitive surgical management. Hence, the aim of this study is the describing an algorithmic approach based on our case series.
Material and Methods: A retrospective study of GBP patients between 2016 and 2020 in a tertiary care centre. Comparisons were made between xanthogranulomatous cholecystitis (XGC) vs. chronic cholecystitis (CC) & benign vs. malignant disease.
Results: 81 patients with GBP were included. The mean age was 54 years. Male: Female ratio was 1.13. Mortality was 3.7% (n=3). The most common clinical presentation was a combination of pain in the right upper quadrant of the abdomen & fever with chills or rigours in 61(75.3%) cases. Surgery was performed in 62 patients (76.5%) out of which, open cholecystectomy 23 (37.7%) was the most common. 7 had the malignant disease in the final histopathology. The most common aetiology was XGC – 32 (51.61%).
Conclusions: GBP is a complex problem, requiring multidisciplinary aggressive management in the initial phase followed by meticulous evaluation before definitive surgery.
A Prospective study of Preoperative sonographic and Doppler parameters as predictors of improvement in semen analysis parameters after varicocelectomy
Authors: KUMAR ROHAN , SALIM MOHAMMED , RAO MOHD , SINGH RAMANDEEP
Published: April 2023

TITLE:-A Prospective study of Preoperative sonographic and Doppler parameters as predictors of improvement in semen analysis parameters after varicocelectomy
OBJECTIVE:-To assess correlation between preoperative size of varicoceles, presence of reflux on sonogprahy and colour Doppler and improvement in semen analysis parameters after varicocelectomy.
METHODS:-This is a prospective comparative study and was carried out between November 2021 to September 2022. During the study period, 40 consecutive patients (Patients with 16-40 years of age) presented to surgical outdoor with clinical presentation and eventual radiological diagnosis of varicocele were included. Preoperative and post operative samen anlysis was done and comparision done between semen parameters and usg color doppler findings.
RESULTS: In this study, a total of 40 patients were evaluated. There was a signifificant positive correlation between the degree of reflux preoperatively and the improvement index i.e. P < 0.001 in group with reflux >2sec, also there was a positive correlation between the vein diameter and the improvement index i.e. P=/<0.001 in group with vein size >3mm.
CONCLUSION: The best preoperative sonographic parameters of success of unilateral varicocele repair are the presence of normal-sized testes, high grade reflux, and large vein diameter.
A clinical study of Diabetic foot patients who underwent amputations in tertiary care center- An observational study.
Authors: SURYAWANSHI DR , MAHEY DR , BAKALE DR , ALVA DR
Published: April 2023

Abstract:
Introduction: Amputation in Diabetic foot patients though lifesaving, has a negative impact on a patient’s quality of life. This study aimed to identify various clinical presentations and risk factors associated with amputation in diabetic foot patients. Methods: This prospective observational study was conducted at a tertiary care center for one year from August 2013 to July 2014. In total, 60 patients with diabetic foot ulcers admitted and operated on for amputation were included. Detailed history and clinical examination were performed. Routine blood examination, wound swab for culture and antibiotic sensitivity, and appropriate radiological examination were performed, and Grading of diabetic foot wound was done by using Wagner’s classification. The above data was recorded and analyzed. Results: Most common age group was 50- 59 years (34%) with a mean age of presentation was 56.31 years. Males were more predominantly affected than a female with male to female ratio is 2:1. Gangrene was the commonest mode of presentation (67%) followed by an ulcer in (20%). Most patients (45%) underwent Ray’s amputation, followed by Trans-metatarsal (34%), and (21%) required a higher level of amputation. Most amputations were noted in patients with a combination of risk factors (76.5%) such as sepsis, poor glycemic control, ischemia, neuropathy, and osteomyelitis as compared to a patient with solitary risk factors (23.5%). Conclusion: Gangrene was a commonest clinical presentation in a patient with a diabetic foot undergoing amputation. The highest incidence of amputation was observed in patients with multiple risk factors such as sepsis, poor glycemic control, ischemia, neuropathy, and osteomyelitis compared to patients with a solitary risk factor. This factor acts synergistically and concurrently, rather than independently and sequentially.
Three-dimensional reconstruction
of the congenital cleft of the ear lobule with lipo-dermal flap.
Authors: Singh Anupama , Bhatnagar Ankur
Published: April 2023

Objectives-Because of the variable amount of deficit of tissue in cleft ear lobule,
Reconstruction of Congenital clefts of ear lobule is challenging so treatment of congenital
clefts of ear lobule needs customization to deal with the deficient volume of tissue in three
dimensions (thickness, length, and width). In this series, we describe the three-dimensional
reconstruction of the congenital cleft of the ear lobule with lipo-dermal flap and the
evaluation of clinical outcomes in terms of the aesthetic expectation of the patient. Materials
and methods- Patients of all age groups and gender who presented with fresh congenital cleft
of ear lobule underwent Three-dimensional reconstruction with lipo-dermal flap from 2017 to
2022 were included. We used customized repair for deficient tissue of the congenital cleft of
the lobule by de-epithelizing skin of all cleft surfaces and raising lipo-dermal flap. Results-
Out of (06) cases, one case was male and 5 cases were females, with an average age group of
20.16 years. 33.33% of the congenital cleft of lobule was presented with three lobes and
66.6% of cases presented with two lobes. The aesthetical appearance was assessed as per
criteria and was found good in 83.3% and very good in 16.6% of cases. Conclusions- Three-
dimensional reconstruction of the congenital cleft of the ear lobule with lipo-dermal flap is a
simple and effective technique to correct lobule deformities in proportion to the extent of the
cleft and yields an aesthetically good pleasing ear lobule which matches with opposite side
ear without complications.
Comparison of Perinatal and Neonatal Outcomes of Very Advanced Maternal Aged Pregnants and Early Adolescent Pregnant Women
Authors: lmaz Mehmet , Aksin Serif , Balsak Deniz , Avc Faz , Aboalhasan Yasmin , Bala Mesut , Sar ahabettin
Published: April 2023

Aims: In recent years, very early pregnancies and very advanced pregnancies have increased. In our study, we aimed to compare these groups in terms of maternal and fetal risks.
Materials and Methods: This study retrospectively were compared the perinatal outcomes of women of reproductive age in 80 early adolescent pregnant (16 years and younger) and 67 older pregnant women (45 years and older) followed in Siirt Training and Research Hospital between 2017 and 2021 in Siirt Training and Research Hospital (Siirt, Turkey). In cases gravida, parity, hemogram, biochemistry, urine, week of birth, fetal weight, gender, APGAR 1-5. min, mode of delivery (vaginal delivery/ cesarean section), miscarriage, neonatal death, premature rupture of membranes (PROM), premature birth, placental ablation, fetal distress, intrauterine death, gestational diabetes mellitus (GDM), preeclampsia, surmaturation, polyhydramnios , oligohydramnios, presentation anomaly, multiple pregnancy, intrauterine growth retardation (IUGR), postpartum hemorrhage, placenta previa, maternal and fetal outcomes in three pregnant groups were evaluated.
Results: Normal spontaneous vaginal delivery (NSVD)/Cesarean section (C/S)" parameter was found to be significantly higher in pregnant women aged 45 and above, while it was found to be significantly lower in the group aged 16 and below(p<0.0001). Spontaneous abortion, on the other hand, was not found significantly in the 16-year-old and younger group compared to the other groups, while it was significantly higher in pregnant women aged 45 and above(p<0.0001).The incidence of GDM was significantly higher in pregnant women aged 45 and over, but it was not determined in pregnant women aged 16 and younger (p=0.003). The incidence of preeclampsia was also found to be significantly higher in pregnant women aged 45 and over (p<0.0001). The incidence of polyhydramnios was significantly higher in the risky pregnant group than in the control group (p=0.015). The incidence of presentation anomaly was found to be significantly higher in pregnant women aged 45 and over (p=0.012). No statistically significant difference was found in other parameters.
Conclusion : Both early adolescent pregnancies and very advanced age pregnancies have their own problems. The obstetrician should be aware of these in his approach to both groups.
CLINICOPATHOLOGICAL STUDY ON CARCINOMA OF ESOPHAGUS
Authors: Bagada Jayeshkumar , Kotadiya Kuldeep , C Raghunandan , Rathod Jignesh
Published: April 2023

Background: Oesophageal cancer is among the most severe gastrointestinal cancers in the world due to its quick progression and often fatal prognosis. There is a lack of available information on oesophageal cancer in India, especially in the research area. This research was performed to outline the clinicopathological as well as endoscopic patterns of oesophageal cancer in this area of the globe. The research offers local data as a baseline for future comparisons.

Objectives: To know the occurrence of Squamous Cell Carcinoma (SCC ) and Adenocarcinoma (AC) of the esophagus in patients visiting Shree Krishna Hospital, Karamsad, to know the etiological factors of carcinoma esophagus, to identify disease presentation, prognosis, and progression, and to study the distribution of tumors in relation to age, sex, site of occurrence, and treatment.

Study Design: Retrospective, observational study

Methodology: This is a retrospective observational analysis of 150 histologically verified cases of oesophageal cancer treated at “Pramukhswami Medical College” (PSMC) and “Shree Krishna Hospital” (SKH), Karamsad between august 2020 to July 2022. Data were obtained and examined from the computer database of medical records.

Results: Out of 150 patients,which accounts for 25 percent of all malignant gastrointestinal tract tumors at our hospital. The majority of patients (52 percent) came from rural regions and had poor socioeconomic positions. 43.33 percent of patients had smoking and 41.33 percent had drinking records, respectively. The middle 3rd esophagus (32.17%) was the most prevalent anatomical location for esophageal cancer followed by the cervical esophagus (18.88%) & gastro-oesophageal junction (13.99%). The most frequent histological form was SCC (86.33 percent).
Conclusion Lack of awareness of the disease, poor accessibility to healthcare facilities, lack of diagnostic and staging facilities, lack of screening programs and the high cost of care are among the hallmarks of the disease in this region and pose a great challenge in the management of these patients. Addressing these challenges will help reverse this trend.
ESTRATÉGIAS DE INOVAÇÃO EM ESCRITÓRIOS DE CONTABILIDADE NA CIDADE DE DIANÓPOLIS (TO) EM TEMPOS DE PANDEMIA
Authors: Lôbo Daiane Gomes , Da Rocha Maria Regina Teixeira , Santos Gabriel Machado , Pôrto Júnior Francisco Gilson Rebouças , Leão Gilmar Teixeira , Dozza Marcos Antonio
Published: April 2023

Tendo em vista que a Pandemia do COVID-19 gerou mudanças culturais, políticas, econômicas e sociais que implicou na necessidade de empresas mudarem suas rotinas e práticas e se ajustarem à realidade da doença que suscitou na necessidade de inovar, esta pesquisa acerca das estratégias de inovação, em escritórios de contabilidade do município de Dianópolis (TO), teve como objetivo mapear os processos de inovações desenvolvidos por Empresas de Contabilidade localizadas no município. O método de pesquisa utilizado foi o de estudo de caso do tipo exploratório com abordagem qualitativa cuja operacionalização foi conduzida por um questionário aplicado por meio do uso da ferramenta Google Forms, enviado através do correio eletrônico aos gestores e funcionários dos escritórios de contabilidade anteriormente mapeados. Realizamos a sistematização e a análise dos dados qualitativos; geramos gráficos e quadros com a análise dos dados com as seguintes categorias de análise: inovação, mudanças e pandemia. Os resultados obtidos revelaram que os escritórios desenvolveram estratégias inovadoras, para lidar com o isolamento social e a crise econômica, diferentes daqueles usados até então. Conclui-se que seus gestores desenvolveram estratégias de inovações, não apenas em tecnologias digitais, mas também em serviços e nos processos de atendimento ao cliente.
MONITORING AND CONTROL OF A VARIABLE FREQUENCY DRIVE USING PLC AND SCADA
Authors: Soleh Uddin  , Alia Diana , Suharso Didik
Published: April 2023

Motor induksi (atau motor asinkron), yang merupakan motor Arus Bolak-balik (AC) yang paling banyak digunakan di industri, selalu bergantung pada perbedaan kecil dalam kecepatan antara medan magnet stator yang berputar dan kecepatan poros rotor yang disebut untuk menginduksi arus rotor pada belitan rotor. Dengan demikian, motor induksi tidak dapat menghasilkan torsi pada kecepatan sinkron, di mana slip tidak lagi ada. Sebuah motor bila diizinkan, akan memberikan torsi hingga batas maksimumnya untuk memutar bebannya; terutama di bawah rotor yang terkunci atau berat beban peralatan yang dimuat. Nilai batas torsi maksimum berbeda untuk setiap motor induksi AC dan berbanding lurus tergantung pada karakteristik motor. Dalam beberapa kasus, seperti konveyor, mesin bubut bermotor, atau penggerak motor langsung, jika motor dibiarkan menjalankan torsi maksimum, itu dapat menyebabkan kerusakan permanen pada peralatan. Penelitian ini menyajikan desain sistem Variable Speed Drive (VSD) yang memiliki kemungkinan untuk mengukur kecepatan rotor dan mengendalikan torsi motor asinkron berada dalam batas torsi yang ditentukan.
OBJECT DETECTION AND ESTIMATING THE DISTANCE BETWEEN DETECTED OBJECTS USING DEEP LEARNING ALGORITHMS
Authors: CHANDU VUNNAM ESWAR , HARSHITHA CHAGARLAMUDI , SREE VENNA NAVYA , GANESH ELURI
Published: April 2023

Object detection is a computer vision technique that allows us to identify and locate objects in an image. Computer vision is a field of artificial intelligence that trains computers to interpret and understand the visual world. Object detection involves a bounding box around each object in the image and distance should be estimated between objects. It is used to identify the objects in a given image like person, bicycle, dog etc. With this kind of identification and localization, object detection can be used to count objects in a scene and determine and track their precise locations, all while accurately labeling them. In our project we are using the COCO dataset and YOLOv3 using a deep learning method. Key Words: Deep learning-YOLO, a monocular camera, distance calculation, and object identification
Smart Voting System
Authors:   Dept. of IT Engineering, Vasantdada Patil Pratishthan’s College Of  Engineering, Sion, Maharashtra ,India, Shaikh Jabbar , Mhaske Pallavi , Khan Tabassum , Patil Pranay , S.Mane Dr.Pradip
Published: April 2023

The electoral system in India has undergone several changes in recent years. The current system involves either Secret Ballot Voting (SBV) or Electronic Voting Machines (EVM), both of which are costly, labor-intensive and inefficient. The current system only verifies identification proof, which increases the likelihood of fraudulent voting. This study proposes the use of an electronic voting system that incorporates fingerprint and face recognition technology. The online system enables voters to cast their votes from anywhere, minimizing the chances of voting fraud. The proposed system has three levels of security: verification of unique id number, election id number, and face recognition. The use of voter identity number and fingerprint can prevent fake and duplicate registrations, leading to a higher success rate during voting. This method significantly enhances the security level of the voting process. Key Words: identification proof, face recognition, protect, security level, success.
Urban Storm water management through bioretention swales in Institutional campus for Green Environment - A Case Study
Authors:   Dept. of Civil Engineering, Ramaiah University of Applied Sciences, Bangalore, C Dr. Lakshmi , R Ms Sushma , K.J Mr Vijaykumar
Published: April 2023

Nature uses vegetated depressions, wetlands, marshes, etc. to clean storm water runoff by removing sediments, turbidity, heavy metals, and other pollutants. Some pollutants are removed by vegetation uptake, some by natural flocculation from decomposing vegetation, some by just slowing the flow down enough for sedimentation to occur, and some by biota consumption and ionic attraction around the root structure. Many pollutants migrate attached to soil particles and soil particles in themselves are considered a pollutant. When storm water runoff leaves a site, unless there is effective erosion protection such as vegetation, soil also leaves the site, in the forms of sediment, suspended solids, and microscopic soil particles called colloidal suspension, dissolved solids, or turbidity. The soil particulate can be clay, minerals, organic material, heavy metals, etc. Sediment usually will readily settle out.A biological filtration canal is a shallow depression created in the earth to accept and convey stormwater runoff. A biological filtration canal uses natural means, including herbaceous vegetation and soil, to treat stormwater by filtering out contaminants being conveyed in the water.
“Mudra” (Text to Speech Conversion with Hand Gestures)
Authors:   Pillai HOC College of Engineering & Technology, Rasayani., Lad Prof. Poonam , Katkar Rohit Pralhad , Bochare Vishal Balasaheb , Jampal Srikant Santosh , Tambe Hrushikesh Dhanaji
Published: April 2023

One of the non-verbal communication techniques utilized in sign language is the hand gesture. Deaf persons who struggle with speech or hearing most frequently use it to converse with each other and hearing people. Several makers around the world have created various sign language systems, but they are neither adaptable nor cost-effective for end users. The majority of programs only provide text- based results. So, we are going to offer a system prototype in an application that solves the aforementioned issue. Hand gestures can be translated into text and then spoken by the system. Several algorithms will be used by the system, including CNN for classifying hand movements and SVM for detection of hand movement & TTS for conversion of Text To Speech.
Validating Big Data through Software Testing
Authors:   Hyderabad Institute of Technology and Management, Hyderabad, Telangana, India., Akshaya Gangula , Reddy Bandi Thanu Sathwik , Bandi Assoc Prof. Surendra
Published: April 2023

Big data has become an indispensable part of many industries due to its numerous benefits, which range from statistical analysis to predictive systems and smart cities. With an overwhelming amount of data generated daily from multiple sources such as the internet, mobile phones, and websites, big data presents a unique set of challenges for testing, as the data is frequently unstructured and highly volatile. To handle the massive amounts of data, complex data combinations, and functional errors that can affect performance and degrade application quality, the testing process for big data applications necessitates specialized knowledge and skills. This poses a significant challenge for organizations that rely on big data for various activities, particularly from a business standpoint. Unlike testing for other types of data, big data testing necessitates a thorough understanding of the technical details and minute changes that occur in seconds during data processing. Big data testing differs from other types of testing due to its complexity.[1] This paper explores the characteristics of big data, as well as various testing methodologies used for big data, and the challenges that accompany it. Keywords: Big Data, software testing.