bluuebunny/crossref_metadata_2025 huggingface dataset:
Deteksi Dini Buta Warna pada Anak dengan Mainan Color Vision Busy book
Authors: Prasetya Rahmawan Dwi , Salsabillah Salsabillah , Susanto Endro Tri , Jayadi Nor
Published: March 2023

Perancangan mainan Color Vision Busy book ini bertujuan menghasilkan desain mainan anak yang dapat memudahkan orangtua dan guru dalam mendeteksi dini atau menemukan indikasi buta warna pada anak usia 3-6 tahun melalui pendekatan permainan. Metode perancangan yang digunakan adalah Design Thinking Method oleh Sheila Pontis berdasarkan Stanford Design School 2010. Metode ini memiliki enam tahapan yakni understand, empathise, define, ideate, prototype, dan test. Konsep perancangan konten serta sistem bermain, menghindari meminta anak untuk mengidentifikasi warna dan menyebutkan angka, karena  hal tersebut membutuhkan keterampilan verbal atau kognitif yang lebih maju. Permainan color vision busy book mangarahkan anak untuk mencocokkan, mencari kesamaan, dan mengelompokan sesuai warna serasi. Berdasarkan hasil uji coba produk mainan terhadap anak usia 3-6 tahun dengan kondisi penglihatan normal dan orang dewasa dengan kondisi penglihatan buta warna merah-hijau, diketahui bahwa produk mainan Color Vision Busy book dapat mendeteksi buta warna merah-hijau dan sesuai dengan kemampuan anak usia 3-6 tahun
Bentonite and polymeric support fluids used for stabilization in excavations
Authors: AKHTAR Muhammad Shahbaz
Published: March 2023

Bentonite is a natural and finite mineral resource. Dilute suspensions of sodium montmorillonite clay in water represents bentonite slurries. Suspension and orientation of colloidal clay particles define rheological properties in bentonite slurry (BS). The BS has been used about seventy years to temporarily support the excavations. More recently, polymer support fluids (PSF) gained much popularity and are widely used compared to bentonite support fluids. The PSF are categorized into natural (pure) and synthetic polymers. Physico-chemical properties of PSF are different than BS irrespective of the quite similarity in the mode of action. Synthetic polymer fluids are molecularly engineered fluids that can be a popular alternative of conventional BS deployed as excavation support fluids in different foundation applications such as diaphragm wall panels and pile bores. The synthetically engineered fluids of polymers (water-soluble) are different from conventional BS. The PSF offer additional benefits because their use is cost effective, eco-friendly, and these polymers need smaller site footprint as well as easy preparation, mixing, handling, management and ultimately the final disposal. Nevertheless, synthetic polymers have advantage over bentonite, however, foundation engineers and scientists have also certain concerns about their use because of their performance related issues. For an efficient use of polymers, specific properties and in situ behavior of polymers as well as their sorption onto the soils must be recognized because the polymer concentration in the solution is decreased with time during their use. The present manuscript reviewed the relative performance of excavation support fluids and displayed an arranged marriage of physicochemical and rhelogical properties of natural and synthetic excavation support fluids used in the foundation industry. This information will be highly useful to scientific community for their future ventures and will lay a foundation to understand the mechanisms of stabilization in open and deep excavations.
Ideas of jadidism and attempts to implement them in Karachay and Balkaria (1870s-1920s)
Authors:   Kabardino-Balkarian State University named after Kh.M. Berbekov, Muslim Barazbiev , Rustam Begeulov ,   Karachay-Cherkess State University named after U.D. Aliyev
Published: March 2023

The article examines the public-educational views and activities of supporters of Jadidism in Ka-rachay and Balkaria in the second third of the XIX–first third of the XX century. The data on spe-cific personalities who tried to carry out some reforms in the system of Muslim education and en-lightenment within the framework of this cultural and educational movement are given. Their ef-forts to modernize the local education system and introduce gender equality in this area, the de-velopment of the press, introducing the native language in spiritual and secular schools, etc. are highlighted. The activities of a significant part of the Karachay-Balkarian Jadids continued in the Soviet era, when many of them contributed significantly to the formation of a new school system in their native language. One of the key places in the article is occupied by the personality of Ef-fendi, teacher, public figure Ismail Akbayev, who shared the ideas of the Jadids, tried to put them into practice and contributed significantly to the development of Karachay-Balkar culture, espe-cially education. It is concluded that, thanks to the innovation of the Jadidids, advanced educa-tional ideas for their time were embodied in the Karachay-Balkar ethno-cultural environment.
Anti-bolshevik statehood in the North Caucasus and Transcaucasia in 1918-1921: comparative analysis of modern historiography
Authors:   Kabardian-Balkarian Scientific Center of the Russian Academy of Sciences, Arsen Kambiev
Published: March 2023

The article deals with the problems associated with state construction on the territory of the for-mer Caucasian viceroyalty of the Russian Empire in 1918-1921. The analysis of state formations is given according to several criteria by which one or another new formation on the territory of the Russian Caucasus could or could not be considered a state. Based on the results of a brief study, conclusions are drawn that some of the limitrophe could be called states, and some did not fit this definition well enough. The emphasis is on insufficient internal resources to build a full-fledged state. It is pointed out that the new statehood could not exist without decisive external support, initially from the German and The Ottoman Empire, and then Great Britain. Ultimately, it is con-cluded that the external side, in this case Great Britain, was not sufficiently interested in preserv-ing and merging the new statehood in the Caucasus, unlike the same situation in the Baltic States.
The socio–political situation in the Vedensky district of the Chechen autonomous region in 1925
Authors:   Kh. Ibragimov Complex Institute of the Russian Academy of Sciences, Abbaz Osmaev , Petimat Osmaeva ,   A.A. Kadyrov Chechen State University
Published: March 2023

On the eve of the centenary of the Chechen Autonomous Region creation on the 12th November, which existed for 12 years, issues related to its formation, development, socio-political processes that occurred found its relevance. The strengthening of Soviet power in the whole country, and, in particular, in the North Caucasus, Chechnya, and other national entities, was associated with cer-tain difficulties, despite the victory in the civil war. Life in Chechen villages proceeded as before, there were no profound changes, especially in mountainous areas, except that the elders were re-placed by the conveners of village executive committees, who in Chechen in both cases were called yurt-da/the owner of the village. Sheikhs and mullahs enjoyed absolute authority and not all of them supported the new government. The population had weapons in their hands, which some of them used to resolve contradictions both in relations with their fellow tribesmen and with the authorities. The analysis of the questionnaires compiled by the OGPU on the eve of the disarma-ment of 1925, when compared with other data, gives a lot of valuable information about the socio-political situation in the regions of the republic.
To the problem of personal history study Krasnodar employees pedagogical institute
Authors:   Kuban State University, Oleg Matveyev
Published: March 2023

The author researches the personal history of the Krasnodar Pedagogical Institute, turning to the example of its director I.N. Bagov in 1935–1937. Relied upon by the party documents, the author shows the director efforts to manage the educational life of the university, difficult relationships with colleagues in the atmosphere of universal suspicion and denunciations, the desire to preserve professional personnel, and save students and teachers. Through the mirror of party documents, the actions of the director of the Institute for Improving the Life and Culture of Students, the level of research work of the university, the fight against laziness and mismanagement are traced. From ideologically biased texts, I.N. Bagov’s human traits, through the assessments of people guided by both political and personal motives in the conditions of a nationwide atmosphere of suspicion. The author shows the feasibility of applying the contextual approach, when the historical biography acts simultaneously as the reconstruction of the unique fate of the university’s 1930s head, as well as a vehicle for knowing the historical society in which he acted. Ibrahim Nagozhevich Bagov shared with his people both the bright pages of his dramatic story, associated with the construction of new life and good expectations, and hardship that fell into the country and society in that con-flicting era. The author believes that a considerable part of the work by the director I.N. Bagov contributed to the successes achieved by Kuban and Adygea in the prewar years in the training of qualified specialists for public education and economic work.
Grave monuments of the adygs in the 14th – 16th centuries: general characteristics and the problem of cultural and ethnic belonging
Authors:   Kabardian-Balkarian Scientific Center of the Russian Academy of Sciences, Timur Zagazezhev
Published: March 2023

The funeral and memorial rites of the Adygs are one of the fundamental, structure-forming elements of the spiritual culture of the people. Starting from the late middle ages and up to the present time, the burial practices of the Adygs have been transformed under the effect of external and internal factors. In the late middle ages, when the predominant part of the Adygs adhered to paganism, under-barrow rite of the dead was dominated at the entire historical space of their residence. Barrows of the XIV-XVI centuries are represented by earth, stone or mixed mounds about a meter high, erected above the buried in a wooden block, usually oriented along the line W - E. Late medieval Adyghe mounds are on the plane and in the foothills. Adyghe mounds can be divided into three local groups: The Eastern Black Sea, Zakubansk (Belorechensk), Kabardino-Pyatigorsk. Each of these groups has its own specifics. The late medieval barrow burial grounds by Adyghs occupies the area from the Northern Black Sea region in the west to the borders of modern plain Chechnya in the east; from the Kuma River in the north to the foothills of the Rocky and Caucasian Ranges in the south (except for burial grounds in the mountains of the North-Western Caucasus, near the modern Karachay villages of Kart-Dzhurt, Uchkulan and Khurzuk). The belonging of the the North Caucasian barrows of the 14th – 16th centuries to the Adygs is confirmed by archeological data, narrative sources and folklore materials.
Gender asymmetry in traditional culture turkic peoples of Dagestan in the 19th – early 20th centu-ry
Authors:   Dagestan Federal Research Center of the Russian Academy of Sciences, Madina Gimbatova
Published: March 2023

The article indicates gender roles in the traditional culture of the Turkic–speaking peoples of Da-gestan in the 19th – early 20th century, defines the daily responsibilities of men and women in the household, their gender-marked occupations, stereotypes and behaviors, their participation degree in social production, and also defines the individual opportunities of men and women in everyday and public life, in education, in access to governance, in the family law system, their place and role in public life and spiritual culture. The materials point to the asymmetry of the gender system of the Turkic-speaking peoples of Dagestan, where everything male (masculine) was primary, sig-nificant and dominant, and everything female (feminine) was defined as secondary, insignificant, and subordinate. It was found that the gender distribution in the family among the Turkic-speaking peoples of Dagestan occurred under gender, according to which the man performed professional roles, the woman's family roles, which corresponded to the accepted ideas about the masculine and feminine type. Against the background of globalization processes, when the traditional family institution is on the verge of extinction, and gender-neutral education is broadly promoted in for-eign media, the study of gender roles and features of gender behavior and education in traditional culture is of great scientific and practical importance.
The problem of the little man in the works of V. Mamishev
Authors:   The Institute for the Humanities Research – Affiliated Kabardian-Balkarian Sci-entific Center of the Russian Academy of Sciences, Madina Hakuasheva , Elena Betuganova
Published: March 2023

The article examines the main thematic and substantive aspects of the modern Russian-speaking Kabardian writer V. Mamishev, the structure, the dominant direction of his poetic and prose works. The relevance of the study is determined by most of the author’s works have not yet be-come the object of research. Meanwhile, Mamishev’s work reflects the original modern type of artistic consciousness, a close connection with the modern literary process and its features. The problems of ordinary people, a «small» person with antisocial tendencies, are at the center of V. Mamishev’s creativity. The article examines the national identity of the Russian-speaking author, the peculiarities of poetics, composition, style. The dominant direction in which artistic discourse is realized is postmodernism. The author is characterized by a funny entrance, mainly humorous and ironic perception. The research uses the method of artistic analysis. The results obtained can be used in preparing special courses on Adyghe literature, national literatures of the North Cauca-sus, Russia.
Online JIC Students Attendance Monitoring System in Classroom Using Radio Frequency Identification Technology
Authors: Sehar Amna
Published: March 2023

Online JIC Students Attendance Monitoring System in Classroom UsingRadio Frequency Identification Technology
Nigeria’s Compliance with the Yaoundé Code of Conduct in the Cases of Piracy and Armed Piracy of the Nigerian State in the Gulf of Guinea in 2016-2021
Authors: Arifin Jessika Ami , Juned Mansur
Published: March 2023

Through adherence to the Yaoundé Code of Conduct and its execution in eradicating piracy and armed piracy instances that happened in the Gulf of Guinea from 2016 to 2021, this study evaluates Nigeria's history, progress, and response to piracy. The goal of this study is to examine Nigeria's compliance with the Yaoundé Code of Conduct as shown in its papers and historical development in accordance with the documentation from the literature review. The data was processed using qualitative approaches, namely research on descriptive research, which focuses on employing analysis to provide an overview or description of a scenario. The information received is analyzed utilizing non-reactive research methods after being gleaned from pertinent literature investigations. This approach will process information from reliable sources, including primary and secondary data, which will then be examined in accordance with predetermined theories and concepts to provide a response to the problem formulation. According to the study's findings, from 2016 to 2021, Nigeria adhered to the Yaounde Code of Conduct in situations of piracy and armed piracy. Nigeria is actively creating and putting into effect a national maritime security strategy to safeguard its marine affairs from all kinds of illegal activity. In compliance with the Yaounde Code of Conduct, Nigeria enacted the POMO ACT which made Nigeria the first country with an anti-piracy law and cooperated in the protection of vessels in accordance with the articles contained in the Yaounde Code of Conduct. However, Nigeria's strict emphasis on adhering to the Yaounde Code of Conduct hasn't worked to stop piracy because it doesn't deal with the underlying issues.
The Zero Delusion
Authors: Rives Julio
Published: March 2023

Zero signifies absence, or an amount of no magnitude, and allegedly exemplifies one of humanity's most splendid insights. Nonetheless, it is a questionable number. Why did algebra embrace zero and dismiss infinity despite representing reciprocal concepts? Why is zero exceptional in arithmetic? Is zero a "real" point? Has it a geometrical meaning? Is zero naturalistic? Zero is elusive in thermodynamics, quantum field theory, and cosmology. A minimal fundamental extent is plausible but hard to accept because of our acquaintance with zero. The uniform distribution is unreachable in statistical mechanics. Digit 0 is unnecessary in positional notation (e.g., bijective numeration). Transmitting nil bits of information is impossible, and communication is never error-free. Mathematical zeroes are semantically void (e.g., empty set, empty sum, zero vector, zero function, unknot). Because "division by zero" and "identically zero" are uncomputable, we advocate for the nonzero rational numbers to build rings and new physics that reflects nature's countable character. In a linear scale, we must handle zero as the smallest nonzero rational or the limit of an asymptotically vanishing sequence of rationals. Zero, as such, is a logarithmic scale's pointer to a being's property via log(1). The exponential function, which decodes the logarithmically encoded data back to the linear scale, is crucial to understanding the Lie algebra-group correspondence, the Laplace transform, linear fractional transformations, and the notion of conformality. Ultimately, we define a "coding space" as a doubly conformal transformation realm of zero-fleeing hyperbolic geometry that keeps universal relationships of structure and scale through the cross-ratio.
A Teaching Note on Negligence: Palsgraf Revisited
Authors: Hunter Richard J. , Shannon John H. , Amoroso Henry J.
Published: March 2023

The case of Palsgraf v. Long Island Railroad (1928) provides an opportunity to engage students in a study of the cause of action termed negligence. The article explores issues relating to proof of negligence, defenses to negligence, and more directly, to the views of two American jurists, Benjamin Cardozo and William Andrews, relating to the issues of duty and causation—critical elements of proof.
Imprecision and Unconscious Moralism in Public Health Risk Communication
Authors: Deonandan Raywat
Published: March 2023

Risk communication is a foundation of the practice of public health. It is traditionally based on a carefully considered epidemiological computation of the likelihood of experiencing a condition given the presence of a particular exposure or behaviour. The extent to which numerical precision is important in such communication is a function of the availability of good statistics, the ability of the target audience to appreciate the meaning of the statistics, and the emotional heft represented by the chosen statistic. There is an inherent danger, however, in overweighting the latter consideration at the expense of the former two. When emotional impact and behavioural change become goals to the exclusion of complete scientific credibility, we risk brushing against the realm of propaganda in service of unexplored unconscious societal moralism. In this era of heightened distrust of state authority, it behooves public health communication to avoid the suggestion of data misrepresentation in service of behaviour change, regardless of how socially desirable that change might be.
Art, Meditation and Cognitive Science: A Framework for Museum-based Community Meditation Programme during the COVID-19 Pandemic in Singapore
Authors: Chan Russell Weili , Chen Sharon Peiling , Chia Dee Yu Teng
Published: March 2023

In 2020, the COVID-19 pandemic caused mandatory lockdowns around the world, which exacerbated mental health issues created by social isolation. To improve museum visitors' mental health and maintain engagement despite the physical closure of museums, the Singapore Art Museum (SAM) rapidly deployed an online programme called Unwind with SAM to engage the public with the museum's contemporary art collection through meditation and contemplation. The programme focused on the positive effect of arts on mental health and well-being, combined with cognitive benefits of meditation by “slow looking” at different artworks. The programme was completed in a steadfast manner; therefore, this practice-based report allows for consolidation of the processes to explore the intersectional potential between art, contemplation and cognitive sciences in a publicly accessible way. The first section provides a brief overview of the current landscape of art and wellness approaches in museums. The second section outlines a philosophical framework which explores the intersection of art, meditation and cognitive science to guide the programme, alongside a breakdown of components and their design rationale. The final part provides a critical reflection and concludes with recommendations for other museum practitioners, managers and scientists to utilise the framework for designing future programme with diverse organisations.
Evolution of linguistic markers of agency, centrality and content during metacognitive therapy for psychosis
Authors: Nikzad Amir Hossein , Lysaker Paul H. , Minor Kyle S. , Leonhardt Bethany , Liberman Mark Y. , Vohs Jenifer , Wiesepape Courtney N. , Tang Sunny X.
Published: March 2023

Recovery from psychosis involves deep and subjective personal changes such as regained sense of agency and purpose. Metacognitive Reflection and Insight Therapy (MERIT) is a form of person-centred psychotherapy that promotes recovery-oriented outcomes by enhancing metacognitive capacity, i.e. one’s ability to monitor and regulate cognition and behavior. Previous research has shown the feasibility, acceptability and clinical benefits of MERIT. However, it is not clear whether and how the subjective outcomes of MERIT are objectively manifested in the patient-therapist communications during therapy sessions. In this study, we used natural language processing (NLP) to detect and quantify objective markers of change in the psychotherapy transcripts of five participants diagnosed with psychosis across 24 sessions of MERIT. As hypothesized, analyses detected shifts in specific speech signals over time within psychotherapy transcripts including: 1) changes in patterns of pronoun usage with more active and central first-person plural pronoun (We); 2) transition in temporal focus of speech from past-focus towards present- and future-focus; and 3) increased words representing perceptual and cognitive processes. Our findings suggest that the speech of participants over MERIT reflected increasingly complex ways of thinking about themselves and others such as an increased sense of agency and a more goal-oriented mode of thinking. Results also suggest NLP can objectively quantify meaningful signals consistent with expected changes during psychotherapeutic interventions.
Infants’ visual attention to own- and other-race faces is moderated by experience with people of different races in their daily lives
Authors: Arnold Sophie , Burke Nicole , Leshin Rachel , Rhodes Marjorie
Published: March 2023

Infants sometimes differentially attend to faces of different races, but how this tendency develops across infancy and how it may vary for infants growing up with different exposure to racial diversity remain unclear. The present study examined the role of experiences with racial diversity on infants’ visual attention to different racial groups (specifically own-race vs. other-race groups) in the first year of life via a large-scale study of infants (N = 203; Mage: 6.9 months, range: 3-14 months; 70% White, 8% Asian, 5% Black, 12% Multiracial, 4% unreported; 14% Hispanic, 86% Non-Hispanic) from across the United States. We tested the role of two forms of racial diversity: that of infants’ social networks (reported by parents) and that of infants’ neighborhoods (obtained from U.S. Census data). Regardless of age, infants looked longer at other-race faces than own-race faces, but this tendency was moderated by the racial diversity of infants’ social networks. Infants with more diverse networks looked equivalently long at own-race and other-race faces, whereas those with less diverse networks looked longer at other-race faces. In contrast, infants’ looking behavior was not moderated by the diversity of their neighborhoods. Together, our research suggests that exposure to racial diversity in infants’ immediate social networks predicts how infants look to faces of different races, illustrating the context-dependent nature of the development of infants’ attention to race.
Targeting Behavioral Interventions Based on Past Behavior: Evidence from Vaccine Uptake
Authors: Brody Ilana , Dai Hengchen , Saccardo Silvia , Milkman Katherine , Duckworth Angela Lee , Patel Mitesh , Gromet Dena
Published: March 2023

Understanding and planning for heterogeneous treatment effects is critical to developing nuanced theories of human behavior and offering more useful guidance to organizational leaders and policymakers. We introduce past behavior as a systematic source of heterogeneity in the effectiveness of interventions that either target insufficient intentions as a barrier to behavior change or combat the intention-action gap. In online and field experiments (total N=17,362), an information intervention designed to enhance intentions to receive the flu shot by correcting misconceptions only led to a detectable increase in vaccination intentions and uptake for those who had not been vaccinated in the prior flu season. In contrast, an intervention designed to encourage follow-through by increasing the salience and convenience of vaccination only detectably improved vaccine uptake for those who had been vaccinated against the flu in the prior season. This work paves the way for a theoretically-informed approach to customizing interventions.
Comparative study between digital breast tomosynthesis plus digital mammography and digital mammography alone in symptomatic women using BI-RADS score
Authors: Syeed Aalishan Fatima  , Majid Jehangir  , Aijaz Ahmad Ganai  , Masrath Quyoom
Published: March 2023

Background: Digital mammography (DM) is the only screening modality that has been proven to reduce mortality from breast cancer through early detection. However, to reduce false positive results and improve the sensitivity of DM, we undertook a study to compare the impact of digital breast tomosynthesis (DBT) to DM in the evaluation of symptomatic women using the breast imaging reporting and data system (BIRADS) score.
Aims and Objectives: The aim of the study was to compare the impact of DBT to DM in the evaluation of symptomatic women using BIRADS score.
Materials and Methods: This cross-sectional study of 100 symptomatic patients in the age group of 35–85 years who underwent DM and DBT was included in the study and was analyzed using the American College of Radiology-BIRADS score. Patients with a palpable breast lump, pain, nipple discharge, skin dimpling, or skin changes over breast and nipple inversion or other nipple abnormalities were included in the study.
Results: Comparison based on the diagnostic accuracy of mammography alone and mammography plus DBT based on BIRADS score revealed DM had a sensitivity of 96%, specificity of 40.6%, a positive predictive value (PPV) of 72.9% and negative predictive value (NPV) of 86.7% with an accuracy of 75.3% while DM plus DBT had a sensitivity of 98.1%, specificity of 46.9%, the PPV of 75.4%, and NPV of 78.8%. There was no significant increase in sensitivity (P=1.000), specificity (P=0.614), PPV (0.734), and accuracy (0.584).
Conclusion: DM plus DBT does not change the BIRADS scoring but its addition increases the diagnostic confidence while there is no significant increase in sensitivity/specificity/PPV/NPV or diagnostic accuracy using DM plus DBT.
Thoracic segmental spinal anaesthesia for laparoscopic cholecystectomy in a case of birt-hogg-dube syndrome
Authors: Tushar Kanti Ghosh  , Roy Purbasha
Published: March 2023

Birt-Hogg-Dube syndrome is an extremely rare genetic disorder featuring multiple lung cyst or bulla which lead to recurrent spontaneous pneumothorax. Laparoscopic cholecystectomy poses a significant challenge in such cases from anesthetic point of view. Thoracic segmental spinal anesthesia (TSS) is a relatively new and beneficial alternative to general anesthesia to avoid post-operative complications. In this report, we used thoracic segmental spinal successfully in a known case of Birt-Hogg-Dube syndrome to avoid post-operative pneumothorax and discussed the technique and anatomical and physiological consequences. We can conclude that thoracic segmental spinal anesthesia can be used safely and successfully in laparoscopic cholecystectomy specially in cases where general anesthesia is better avoided as in Birt-Hogg-Dube syndrome.
Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study
Authors: Sowmya Madihalli Janardhan Iyengar  , Surekha Kumar  , Shankar Kantharaju
Published: March 2023

Background: Ivabradine is an effective drug to prevent abnormal increase in heart rate (HR).
Aims and Objectives: The aims of this study were to determine if a pre-operative oral dose of ivabradine (2.5 mg) reduces intraoperative bleeding during functional endoscopic sinus surgery (FESS) and improves visualization of operative field.
Materials and Methods: A prospective, randomized, and placebo-controlled study was carried out in 30 patients of ASA grade I and II, aged between 18 and 60 years undergoing FESS surgeries. The patients were randomly allocated into two groups. Group I – received 2.5 mg of tablet ivabradine and Group P – received a placebo (vitamin tablet) 1 h before surgery. Blood loss and hemodynamic parameters (HR, systolic, diastolic, and mean blood pressure) were assessed perioperatively. Surgical field was graded by operating surgeon using Fromme – Boezaart score (FBS) at the end of procedure. Post-operative monitoring for any complications was also done.
Results: Mean final blood loss in Group I was 165.73±43.48 mL and in Group P was 246.25±30.76 mL. There was a significant difference in mean final blood loss (mL) between two groups with P<0.001. In Group I – 13.33% had FBS 1 and 86.67% had FBS 2, whereas in Group P – 6.67% had FBS 2, 86.67% had FBS 3, and 6.67% had FBS 4. Thus, Group I had lower FBS scores than Group P and was statistically significant.
Conclusion: Pre-operative oral ivabradine helps in reducing intraoperative bleeding in FESS surgery and provides good surgical field compared to placebo.
Unexpected diagnosis in not so usual clinical scenarios: Acute promyelocytic leukemia – A tertiary care hospital experience
Authors: Gautam Rashmi , Singh Sarika , Dhar Lity , Balhara Kirti , K Sahi Puneet , Gupta Sangeeta
Published: March 2023

Background: Acute promyelocytic leukemia (APL) is a distinct subtype of Acute myeloid leukemia (AML) with arrest in maturation of cells of myeloid series in bone marrow. PML-RARA fusion resulting from t(15;17) translocation forms the genetic basis of this haematological malignancy. Introduction of specific differentiating targeted therapy i.e. All-trans retinoic acid (ATRA) have remarkably improved the outcome of this previously dreaded AML.
Aims and Objective: The current study presents five cases of Acute promyelocytic leukemia with unusual presentations followed by effective treatment to revert their adverse outcome.
Materials and Methods: In this retrospective evaluation of Acute Myeloid leukemia cases, five cases were included from duration of November 2019 to November 2021. The diagnosis of AMLs was made according to EGIL 1998/WHO 2016 guidelines. Peripheral blood (PB) and bone marrow aspirate (BMA) were stained with Giemsa and cytochemistry included myeloperoxidase (MPO) and periodic acid-schiff (PAS).
Results: Five color flowcytometric analyses were performed on BMA and PB samples. Chemotherapy was administered in the patients and follow-up was done. 03/05 patients faced mortality due to rapid disease progression.
Conclusion: The fast track clinical course from presentation to the outcome of APL is dreadful for the treating clinician and the heamatopathologist. Cytomorphology and Cytochemistry are as important in rapid recognition of APL as Immunophenotyping and Cytogenetics for establishing accurate diagnosis.
Effect of addition of intrathecal preservative free magnesium sulfate with 0.5% bupivacaine heavy and fentanyl with 0.5% bupivacaine heavy on post-operative pain relief in patients undergoing hysterectomy
Authors: Gupta Ankita , Neelima Tandon  , Namrata Jain  , Manmohan Jindal
Published: March 2023

Background: Spinal anesthesia is the most common neuraxial anesthesia for infraumblical surgeries. The use of various adjuvants has become popular in today’s scenario to enhance its quality.
Aims and Objectives: The aim of this study was to evaluate the onset, duration of sensory and motor block, hemodynamic effects (if any), duration of post-operative analgesia, and adverse effects of fentanyl or magnesium given intrathecally with 0.5% bupivacaine heavy in patients undergoing hysterectomy.
Materials and Methods: This prospective randomized double-blinded study was conducted in total sixty patients undergoing hysterectomy, divided into two groups of 30 patients each. Group F received 25 μg fentanyl with 3 mL 0.5% bupivacaine heavy and Group M received 100 mg magnesium sulfate with 3 mL 0.5% bupivacaine heavy. The onset and duration of sensory and motor blockade, duration of analgesia, hemodyamics, and side effects were assessed.
Results: The mean time of onset of sensory and motor block was less in fentanyl (P<0.001). Duration of sensory, motor block, and duration of analgesia was more in fentanyl group (P<0.001), whereas incidence of side effects such as bradycardia, hypotension, and shivering was less in magnesium.
Conclusion: Our study concluded that addition of fentanyl as adjuvant effectively augmented the quality of spinal anesthesia, but magnesium provided stable hemodynamics and lesser side effects as compared to fentanyl.
Evaluation of triglyceride-glucose index, triglyceride to high-density lipoprotein cholesterol ratio, and other lipid ratios in hypertension
Authors: Kiro Jyotsna , Acharya Madhusmita , Bhoi Sumitra , Bhoi Sanghamitra , Tirkey Neelam B
Published: March 2023

Background: Hypertension is one of the most common diseases with increasing morbidity and mortality. HTN is associated with cardiovascular risk factors such as insulin resistance (IR) and hyperlipidemia. Recently, triglyceride-glucose (TyG) index has been proposed as a marker for insulin resistance.
Aims and Objectives: This study aimed to assess TyG index, triglyceride to high-density lipoprotein ratio, and other lipid ratios in HTN patients.
Materials and Methods: The present study was conducted on 200 subjects and was categorized into two groups. 100 hypertensive patients were considered as cases and 100 healthy individuals as controls. Serum sample of the subjects was used for the estimation of total cholesterol, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Low-density lipoprotein (LDL) cholesterol was calculated. TyG index and TG/HDL ratio and other lipid ratios were calculated. Blood pressure (BP) was recorded.
Results: In this, BP, total cholesterol, TG, LDL, Very low-density lipoprotein cholesterol, Non-HDLC, TC/HDL ratio, TG/HDL ratio, and TyG index were increased in cases and HDL and HDL/LDL ratio were decreased. Study parameters were positively correlated with TyG index and TG/HDL ratio, except HDL, and HDL/LDL ratio.
Conclusion: The study concludes that significantly increased TyG index and TG/HDL ratio in hypertensive cases and their correlation with blood pressure.
Skin and soft-tissue coverage for limb salvage in extensive diabetic foot ulcers: An institutional experience
Authors: Petkar Kiran , Gourav Prasad
Published: March 2023

Background: Extensive diabetic foot ulcers (DFUs) with skin and soft-tissue defects need prompt coverage of the defect using plastic surgical means. The indication, timing, and techniques of wound coverage in DFUs are not adequately understood by all. Hence, an institutional experience of providing skin and soft-tissue coverage to extensive DFUs is reported.
Aims and Objectives: The aims of this study were to study the various types of DFU that needs surgical wound coverage and to understand the types of wound coverage surgeries, their timings, success rates, and final outcomes.
Materials and Methods: A retrospective-prospective study of all the DFUs managed using skin and soft-tissue coverage was conducted. Surgical and medical management and their outcomes were studied.
Results: Sixteen patients underwent skin graft or flap surgery for their DFU. All the limbs were salvaged and all wounds were covered with two reports of ulcer recurrences.
Conclusion: For optimal care of DFUs, the possible need for wound coverage, it’s timing, and aftercare are to be understood by all involved.
Microbiological blood profile among COVID-19 patients hospitalized in a tertiary care hospital: An observational study
Authors: Meena Mamta , Priyanka Singh  , Mittal Arvind Kumar , Deepti Chaurasia
Published: March 2023

Background: Bacterial coinfection contributes to increase morbidity and morbidity of viral respiratory infections and may lead to fatal outcome during its course of illness.
Aims and Objectives: The main objective of this study was to determine the bacteriological profile of COVID-19 patients admitted in hospital, their antibiotic susceptibility, and their association with severity.
Materials and Methods: The present study was retrospective observational cross-sectional study of all patients admitted for COVID-19 at Gandhi Medical College and Hamidia Hospital, Bhopal (MP) between (March 2020 and December 2020). Demographic, comorbid conditions, and microbiological data were compared HBD and intensive care unit (ICU) admissions and role secondary coinfection in severity and mortality.
Results: Thirty percentages of percent of patients showed bacterial growth, Staphylococcus aureus was most common, followed by Pseudomonas aeruginosa. Mean±SD of age was 43.6±21.6. Antibiotic resistance of cefoxitin, cotrimoxazole, and azithromycin was seen in maximum Gram-positive growth, whereas sensitivity for linezolid and gentamicin was present in 10–16% cases. Highest antibiotic resistance in Gram-negative growth was seen for ceftozidime, amikacin, imipenem, and meropenem, whereas sensitivity of colistin antibiotic was highest in Gram-negative growth.
Conclusion: Coinfection rates increase in patients admitted to the ICU, despite frequent prescription of broad-spectrum antibiotics. Infectious diseases practitioners carry the burden of life-saving and provide for societal trust that is effective antibiotic therapy in the face of these changes. With a growing body of evidence supporting short-course, antimicrobial therapy “Shorter Is Better” should be the new mantra.
A cross-sectional study on the role of hematological and inflammatory biomarkers as predictor of mortality at the time of admission among COVID-19 patients
Authors: Totade Sanjay Kumar , Daheria Chanchlesh , Morya Rajesh Kumar , Bhagwan Singh Yadav  , Varma Amit , Toppo Neelam
Published: March 2023

Background: Whole world experienced COVID-19 pandemic with more than 155 million cases and >3.4 million deaths. Vasculitis and immune system activation plays a critical role in pathogenesis, especially in severely ill and non-survivors COVID-19 patients.
Aims and Objectives: The aim of the study was to establish the role of hematological indices and inflammatory biomarker as predictors of mortality among non-survivor and survivor COVID-19 cases at the time of admission.
Materials and Methods: The cross-sectional study was conducted at a dedicated COVID-19 referral hospital from July 2020 to August 2020, among 300 real time-polymerase chain reaction confirmed COVID-19 cases. Demographic, clinical, comorbidity, laboratory investigation, and outcome data were collected from patient’s medical record. Outcome variables – discharged (survived) or death (non-survived) were considered for comparison of various hematological indices and inflammatory biomarkers. Data are represented as median, IQR (Q1-Q3) and difference between median and proportions were calculated by Mann–Whitney U-test and χ² test. A predictive power of laboratory parameters between survivors and non-survivors was evaluated using receiver operant curve (ROC) analysis and area under the ROC curve (AUC).
Results: The median age of non-survivors was significantly higher than survivors. Hypertension was significantly associated with non-survivors. Hematological parameters such as total leukocyte count, absolute neutrophil count, Neutrophil: Lymphocyte ratio were significantly increased with lymphocytopenia (P=0.001), and Inflammatory biomarkers such as C-reactive protein (CRP), lactate dehydrogenase, D-dimer, ferritin, procalcitonin, and NT-Pro BNP, all were significantly increased in non-survivors patients (P=0.001). CRP and neutrophil lymphocyte ratio (NLR) showed “Good” predictive value for mortality with cutoff value of 74.0 mg/l (AUC=0.841, Sensitivity=80.4%, Specificity=73.0%) and 5.65 (AUC=0.805, Sensitivity=76.1%, Specificity=73.0%), respectively. Pro-BNP showed “Fair” predictive value for mortality with cutoff value of 330.5 pg/ml (AUC=0.726, Sensitivity=73.9%, Specificity=58.2%).
Conclusion: We suggest that CRP, NLR, and Pro-BNP can be used as a screening tool to predict mortality in COVID-19 patients for timely intervention to save valuable life, especially when sensitivity toward severity of COVID-19 among medical health professionals and general public is on decline.
Efficacy of local infiltration analgesia in post-operative pain management following total knee replacement
Authors: Avinash TP  , Mithun Shetty  , Shamana Shetty
Published: March 2023

Background: Post-operative pain and prosthetic joint infections are two crucial impediments in providing a good quality of life after surgery.
Aims and Objectives: In this study, we evaluated the efficacy of local infiltrative anesthesia (LIA) in total knee arthroplasty (TKA) and to study associated complications.
Materials and Methods: The present study was conducted over 2 years. All patients who underwent total knee replacement for degenerative arthritis of the knee were considered for the study. Questionnaire consisted of three sections, first section: Demographic profile, second one: Laterality of knee, duration of surgery, final section: Consisted of pain evaluation by visual analog score. Pain assessment in post-operative period was done for 3 days (72 h) and was estimated using visual analogue score (0–10). Assessment was done at 6 h, 24 h, 48 h, and 72 h after surgery during rest and movement. Data collected were entered and analyzed using SPSS. Association between different variables was done using Chi-square test/Fishers exact test.
Results: Visual analog score was 3.4±1.31 in first 6 h. Visual analog scale scoring was significantly less 48 h of post-surgery. There were no postoperative surgical wound problems in any of the cases and no clinical signs of infection were identified at the end of 3-month post-surgery.
Conclusion: LIA can be considered a safe and effective modality for pain control in knee arthroplasties.
Comparison between transdermal buprenorphine and intravenous paracetamol for post-operative analgesia after major plastic reconstructive surgery under general anesthesia – A randomized double-blind controlled trial
Authors: Arghya Maity  , Rajasree Biswas  , Suchismita Mallick  , Ghosh Sujata , Sarbari Swaika
Published: March 2023

Background: Adequate pain management is an essential entity in reconstructive surgery to prevent adverse physiological and psychological outcome. Transdermal buprenorphine has been mostly studied in chronic pain and cancer related pain but hardly studies in acute pain are available.
Aims and Objectives: The aims of this study were to compare post-operative pain relief achieved by transdermal buprenorphine and IV paracetamol in terms of safety and efficacy. Sedation and adverse effects were also studied.
Materials and Methods: This is a prospective, parallel group, double-blind, and randomized trial. After ethics, clearance and consent from 46 patients undergoing major reconstructive surgery were allotted into Group B, (n=23) who received transdermal buprenorphine and Group P (n=23) who received m IV paracetamol 6 hourly. IV Paracetamol was taken as active control. Standard institutional protocol for general anesthesia was followed. Visual analog scale (VAS) score was measured postoperatively for 48 h. Diclofenac sodium was the rescue analgesic. Sedation was assessed by Ramsay Sedation score.
Results: Transdermal buprenorphine patch (TDB) gave superior pain relief in comparison to intravenous paracetamol 48 h postoperatively, P≤0.0.5 pin VAS score. The total amount of rescue analgesic required was high in Group P than Group B (P=0.034). Hemodynamic stability was better maintained with TDB with minimal sedation and side effect.
Conclusion: TDB (20 μg/h; 20 mg) can be safely used for post-operative analgesia with greater efficacy and minimal side effects when compared to intravenous paracetamol.
A study on cancer awareness among people attending a tertiary level care hospital in West Bengal
Authors: Sen Gupta Debjani , Soma Chakrabarty  , Swati Majumdar  , Subhadip Dutta  , Spandan Mandal
Published: March 2023

Background: A cross-sectional observational study conducted in the outpatient registration counter among people seeking registration ticket in a government Medical College. Sample size was 214 with equal representation of each sex.
Aims and Objectives: (1) The study’s aims at assessing the knowledge quotient about the occurrence, site presenting symptoms risk factors and outcome of various cancers. (2) Sex specific cancer screening program self-breast examination, mammography, pap smear awareness, and usage among females of study population have been investigated.
Materials and Methods: A cross-sectional observational study. Predesigned pretested questionnaire was administered to consenting participants among those registering for outpatient tickets at Calcutta National Medical college Hospital. Statistical analysis Used: Descriptive statistics was used with MS Excel.
Results: Awareness was 69.8% with 69% stating gastrointestinal tract to be the most common site, Of the population 70% stated pain was to be the most common presenting symptom, tobacco was said to be the most common causative agent by 72% and 70% stated it to be non-treatable. Among sex specific cancers 40% women identified breast as site of cancer presenting with nipple discharge and 34% stated the presenting feature to be lump. Screening method of self-breast examination and PAP smear was said by 5% and 2%, respectively.
Conclusion: The awareness regarding site cardinal signs outcome and risk factors was not good among study population. Much effort is to be given to address the state of things.