bluuebunny/crossref_metadata_2025 huggingface dataset:
Pagtatasa Sa Kinalabasan Ng Perpormance Sa Assessment of Standards And Skills (Pass) Ng Mga Mag-Aaral Sa Asignaturang Filipino 9 Ng Junior High School, Pamantasan Ng Bohol
Authors: Kibir Carolite C.
Published: November 2022

Ang pag-aaral ay nakatuon sa Pagtatasa sa Kinalabasan ng Perpormans sa PASS ng mga mag-aaral sa asignaturang Filipino 9 ng UBJHS. Layunin nitong matasa ang perpormans sa iba’t ibang Kompetensi sa PASS, Summative, Akademik Perpormans batay sa mga kasanayang pampagkatuto sa makrong kasanayang pangkomunikasyon. Sa ginawang pagsusuri sa mga mga datos natuklasan ang sumusunod: Sa akademik perpormans, ang nakuhang mean ay Mas Mahusay. Sa PASS at Summative, ang nakuhang mean sa Pass ay Mahusay. Sa Summative batay sa antas ng Kompetensi ng mga makrong kasanyang pangkomunikasyon, ang nakuhang mean ay Mas Mahusay. Sa Kaugnayan sa pagitan ng Summative at akademik perpormans, at Kaugnayan sa pagitan ng Pass at akademik perpormans ang walang bisang hypothesis ay tinanggihan ito’y nangangahulugang mayroong makabuluhang antas ng ugnayan. Batay sa natuklasan inilahad ang sumusunod na konklusyon: ang kasanayan at kakayahan ng mag-aaral ng PASS, Summative, at Akademik Perpormans sa iba’t ibang kompetensi ng kasanayang pampagkatuto sa mga makrong kasnayang pangkomunikasyon ay Mas Mahusay, subalit may mag-aaral na hindi umabot sa inaasahan kaya kinakailangan na pagtuunan ng sapat na panahon sa pagtuturo upang maabot ang inaasahang perpormans. Ang mga sumusunod na rekomendasyon ay inilatag: Pagbisitang muli sa Gabay Kurikulum bilang pagsasakatuparan sa bawat markahan. Bubuo ng programang panlunas upang matugunan ang kakulangan sa pagkatuto sa makrong kasanayan sa pagsulat. Magsagawa ng aytem analisis upang masuri kung alin ang dapat iwaksi at manatili. Dapat ilahad sa mga kinauukulan ang resulta ng pag-aaral upang makagawa ng angkop na aksyon tungo sa mas lalong pagpapabuti.
Fourth Industrial Revolution and Curriculum Development
Authors: Tirol Ammon Denis R.
Published: November 2022

The Fourth Industrial Revolution (4IR) was built on the ICT and electronic transformations of the Third Industrial Revolution. This paper focuses on the 4IR’s impact on the educational sector, particularly on the academe’s role in the supply side of the future workforce. The educationist aims to design the learning program that would best equip the student for the workplace of the 21st century, and the success indicators of the learning program are responsiveness to job demands and curriculum contents relevance. How well the education strategist understands the workforce market and its required proficiencies would spell attainment of the key indicators. This researcher is tasked with the continued equipping of the university faculty and aims to share this critical need for educators to integrate into their learning objectives the acquisition of the required 21st-century skills by the students.
Effects of Bayluscide on Mitosis in Root Tip Cells of Allium cepa L.
Authors: Fudalan Emmanuel Rod V.
Published: November 2022

A common practice among farmers is to spray pesticides on crops in order to protect them from herbivores to have an abundant production of crops. The purpose of this study was to find out the effects of Bayluscide on cell division in root tip cells of onions (Allium cepa). The study uses the Randomized Complete Block Design (RCBD), consisting of one control group and four experimental groups that were replicated thrice. Fifteen healthy onion bulb roots were used and subjected to 0%, 2%, 6%, 10%, and 14% concentrations of Bayluscide and distilled water. Excised root tips were prepared for slides, and cytological changes were examined under the microscope. The cells counted and observed were subjected to Analysis of Variance (ANOVA), Duncan Multiple Range Test, and Mitotic Index. As reflected in the result, there was a significant decrease in cells undergoing cell division as the treatment concentration increased. Cells at the interphase stage increased in number as the concentration increased during the prophase, metaphase, anaphase, and telophase showed a marked decrease in number. Cytological abnormalities noted were shrunken and a broken nucleus.
Motivation and Commitment of the Non-Teaching Personnel of the Department of Education, Division of Bohol, Philippines
Authors: Namoc Frederick , Tirol Janice Aurora
Published: November 2022

Employees’ level of motivation and commitment plays an important factor in an organization. The effectiveness of an institution to maintain a quality team of employees links to its ability in managing the staff as well as recognizing the individual’s contributions. This study sought to determine the motivation and commitment of the non-teaching personnel of the Department of Education, Division of Bohol. Utilizing a quantitative method approach, the study used standardized tools on Motivation, Career Commitment, and Organizational Commitment. A total of 114 non-teaching personnel took part in the study, chosen using the complete enumeration method. The study revealed that non-teaching personnel was highly motivated regarding intrinsic motivation, while moderately motivated regarding extrinsic motivation as perceived by themselves and their administrative heads. Non-teaching personnel was moderately committed to their career, while they were highly committed to the organization. The level of motivation of the non-teaching personnel played a significant role in their level of commitment to their career and to the organization. Also, the level of commitment towards the career and organization of the non-teaching personnel showed a significant degree of difference. Lastly, the level of motivation among the non-teaching personnel differs between their intrinsic and extrinsic motivation.
Significant Life Events of Aging
Authors: Racines Maria Amy Fiel T
Published: November 2022

Significant life events are bound to happen at any phase in life. The aging process alone reveals recognizable life events that are inevitable, which the different biological and social theories tried to come up with explanations for. Amid the changes, which one seemed to dominate? Understanding this phenomenon is essential not only for the elderly to prepare but as well as for the significant others and people in the health care arena to understand. This study aimed to assess the significant life events that affected change among elderlies. This research is qualitative and employed interpretative phenomenology, utilizing the Hermeneutic approach in the data gathering process. The informants were the seven elderlies from the first district of Bohol, aged 60 years old and above chosen through purposive sampling. An in-depth interview was conducted to gather the data which focused on the life events experienced by the informants and how they affected change. The data were transcribed, interpreted, and analyzed to come up with the common meaning of the lived experience. The findings of the study pointed out four themes; a.) Advancing age, declining health, and vanishing resources, b.) Retirement: the inevitable moment and uncertainty of what lies ahead, c.) the loss of a loved one and the accompanying pain, and d.) The moment of change and living with life’s changes. These four themes explain the conclusion that the aging process brings about significant events such as the decline in health, uncertainty in Retirement, and the possible loss of loved ones. These events affected changed the individuals’ lives.
E-LITERACIA EM SAÚDE EM ESTUDANTES UNIVERSITÁRIOS E CONSUMO DE INFORMAÇÕES SOBRE NUTRIÇÃO
Authors: Santos Luciana Figueiredo dos , Souza Eliana Carla Gomes de , Kiepper Bhreendda Hary Dy Luar Prates
Published: November 2022

OBJETIVO: Observar a presença de e-literacia em saúde em estudantes universitários e analisar o consumo de informações sobre nutrição nas mídias sociais pelos mesmos.

MÉTODOS: Estudo transversal, realizado com estudantes universitários, por meio de um questionário online auto preenchível. As questões compreendiam informações de cunho sociodemográfico, acadêmico e a escala de e-literacia em Saúde (eHEALS).  As análises foram realizadas em softwares estatísticos visando a correlação entre as variáveis. O cálculo da escala eHEALS foi efetuado através do somatório das respostas das questões, logo, quanto maior o valor observado, maior será a percepção de competência de e-literacia em saúde dos estudantes.

RESULTADO: O estudo contou com a participação de 241 graduandos com mediana de idade de 22,7 anos, 73,1% dos respondentes eram do sexo feminino, apenas 39,3% eram estudantes dos centros de saúde e 55,4% estavam entre o primeiro e o sexto período da graduação. Cerca de 92,1% acessam as redes sociais diariamente, com tempo de tela variando de 2 a 3 horas/dia. Dentre aqueles com maior acesso as mídias digitais, percebeu-se  procura significativa por informações ligadas a nutrição e saúde, como hipertrofia, dietas e emagrecimento. Os estudantes apresentaram e-literacia em saúde favorável, sendo a média dos estudantes dos centros da saúde maior que dos demais cursos.

CONCLUSÕES: Os estudantes universitários apresentam e-literacia em saúde satisfatória. Os alunos dos cursos das ciências biológicas e saúde demonstraram possuir maior letramento digital em saúde que os graduandos dos demais cursos.
UNDERSTANDING THE OPTIMIZED EFFECT OF MULTIPLE REINFORCEMENT ON IMPACT STRENGTH AND HARDNESS FOR AA6061/AL2O3/SIC REINFORCED COMPOSITE USING TAGUCHI TECHNIQUE AND GREY RELATION ANALYSIS
Authors: Srivastava Nitin , Anas Mohd.
Published: November 2022

Aluminium matrix composite with the reinforcements of Al2O3 and SiC were fabricated by using stir casting together with the application of squeeze casting. The percentage of the volume fractions of both the reinforcement varied between 2% to 4% and the combinations were made for the experiments. It is a novelty because less work is required for the combination of the above reinforcements and their effect on the properties. The presence and uniform distribution of Al2O3 and SiC are confirmed by microstructural analysis. Hardness as well as tests were carried out as per ASTM standards for the Charpy test and hardness test by Brinell hardness tester. ANOVA analysis found the effect of the two reinforcement agents. The effect of the varied reinforcement combinations was analyzed and the optimum value of hardness and impact strength is predicted by the use of Taguchi technique. Impact strength and hardness show an increasing trend up to level 3 having impact strength = 17.1 kJ/m2, and a hardness of 79.2 BHN.
EQUIVALENT FATIGUE OF CRANKSHAFT STRUCTURE BASED ON RESIDUAL STRESS FIELD AND ITCD APPROACH
Authors: Wu Chang , Sun Songsong
Published: November 2022

The electromagnetic induction quenching approach has been widely applied in the engine industry, especially in relation to parts made of metal materials, such as crankshafts. To this end, the reinforcing effect of this technique has been quantitatively studied. Using this approach, we first performed multi-physics simulations to obtain key information, such as the temperature and residual stress distributions. Then, the fatigue limit load was predicted according to the simulation results and the indirect-defined theory of critical distance (ITCD) model. Finally, the feasibility of this prediction method was verified by standard bending fatigue experiments. The results of the prediction method were accurate and consistent with the experimental results, with wide popularization and application prospects.
Protecting Fido, protecting the family: Developing domestic violence law to include companion animals
Authors: Swemmer Sheena
Published: November 2022

This article argues that by developing domestic violence laws to include and protect individual companion animals in the home, it might be possible to prevent violence against other victims in the home. Protecting a companion animal from persistent violence by, for example, having properly integrated reporting systems between government departments, could protect various vulnerable members of the family. The article briefly sketches the status of intimate partner violence in South Africa and explores the current implementation of the Domestic Violence Act. The status of companion animal abuse in South Africa and other jurisdictions is briefly explored. The article then shows that an intersection of violence exists in the home between women, children and companion animal and that protecting specific victims of violence (such as companion animals) can potentially act as a mechanism that can protect all victims from future or persisting violence.
Methodologies for measuring the quality of urban infrastructure for pedestrian mobility: A systematic literature review
Authors: Marangão Glaucia Hellen de Freitas , Magagnin Renata Cardoso , Fontes Maria Solange Gurgel de Castro , Azambuja Maximiliano dos Anjos
Published: November 2022

The spatial quality of urban infrastructure for pedestrian mobility, influenced by the physical aspects of space and the elements perceived by pedestrians, can induce the behavior of people in order to encourage or inhibit the use of some routes. Therefore, identifying methods and techniques to evaluate this infrastructure's quality is important to contribute to the analysis and diagnosis, which are fundamental for urban management. Given this context, this article aims to identify, through a systematic literature review , the main methods and techniques for evaluating the spatial quality of sidewalks from the micro, meso and macro scales. The Scopus platform database was used and the search delimited the period from 2016 to 2020 for scientific articles. The analysis of 42 articles allowed us to identify: (1) their main characteristics (most relevant authors evaluating this theme, countries where the study was carried out, year of the research´s development and journals with the highest number of publications on this theme, among other general aspects), (2) the main methodologies and techniques for the evaluation of spatial quality, and (3) the importance of the scale of analysis to evaluate urban infrastructure for pedestrian mobility and its influence on the analyses of the results.
Формирование профессиональных компетенций будущего учителя по активизации познавательной деятельности школьников
Authors: Раимкулова Ажарбубу
Published: November 2022

В монографии раскрывается проблема формирования профессиональных компетенций будущего учителя по активизации познавательной деятельности школьников, которая рассматривается как одна из важнейших направлений, подлежащих всестороннему анализу, как в теории, так и в практике высшего педагогического образования. Рассмотрены научно-педагогических условий профессионального роста, саморазвития и реализации творческих способностей студентов педагогических направлений.
Una aproximación a las fuentes: La regla de reconocimiento en la teoría de Herbert L. A. Hart
Authors: Diaz  Romero Ubaldina
Published: November 2022

El artículo se ubica en el escenario iusfilosófico de mitad del siglo XX. Tiene como objetivo rastrear fuentes de la Regla de Reconocimiento de Herbert Lionel Adolphus Hart tomando como partida la tesis que hace de dicha regla una respuesta ponderada al debate entre el formalismo kelseniano y la teoría utilitarista de Bentham y Austin en primera instancia. Esto se explora en las fuentes reconocidas y no reconocidas por el propio autor, por cuanto el artículo sostiene la presencia decisiva en lo metodológico de ascendientes directos en dicho trabajo como Hobbes, Hume, Malinowski, entre otros, los que otorgan a dicha regla de reconocimiento no un mero afán conciliador de las tradiciones anteriores, sino que definen su naturaleza propia y la necesidad de abordarla desde ámbitos interdisciplinarios, porque es desde la exploración del habla en contexto como ella puede rendir frutos para el análisis de los principios subyacentes en la práctica judicial.
Analysis and hydraulic improvement of a maturation pond using Computational Fluid Dynamics
Authors: Velázquez-Araque Luis , Chica Johan
Published: November 2022

Especially in small communities, little attention is paid to the hydraulic characteristics of wastewater treatment systems. Motivated by this problem, and using the ANSYS fluid dynamics software, the hydrodynamic evaluation of the residual water flow in a rural plant maturation pond was carried out. For the stationary modeling of the velocity and turbulence fields, the standard k-ε model was used; and for transient modeling of virtual tracer transport, the species transport model without chemical reaction was used. Subsequently, the analysis of the distribution of retention times was carried out, in order to obtain the flow patterns that govern the hydrodynamics of the pond. The results revealed the presence of hydraulic short circuits, stagnant zones, and recirculations, due to design deficiencies and operating conditions over the years. Given this situation, and by bibliographic recommendation, new modified geometries were proposed with longitudinal and transverse baffles at 70 and 90% in relation to the width and length of the pond. As a result, the hydraulic characteristics improved notably in all cases; however, the models configured at 90% achieved higher efficiency.
Is Property an Insurance or an Additional Burden? Financial Stress Among Homeowners in Europe
Authors: Heidenreich Martin , Broschinski Sven
Published: November 2022

A crucial function of wealth is to protect individuals from the consequences of adverse life events. However, sometimes wealth also implies additional financial risks. In addition to the insurance function of homeownership (the most common form of wealth), we therefore also examine financial squeezes that reflect the indebtedness and social embeddedness of homeowners and limit their options for dealing with social risks. A third hypothesis expects a trade‐off between social protection and homeownership. Taking the example of unemployment, we examine the effects of short‐term unemployment on the perceived financial situation of households based on data derived from EU‐SILC for 27 European countries. It can be shown that debt‐free homeownership reduces financial stress in the case of unemployment compared to tenants and indebted owners. A debt‐free home thus offers an additional buffer and insurance against the financial consequences of unemployment. However, indebted homeowners are particularly hard hit by unemployment because they have to use all their financial resources to pay off their mortgages. Finally, we did not find a trade‐off but a cumulation of advantages due to homeownership and generous unemployment benefits in countries with high net replacement rates.
Opportunities and Challenges of Municipal Planning in Shaping Vertical Neighbourhoods in Greater London
Authors: Cerrada Morato Lucía
Published: November 2022

Production of housing in London is driven by three factors: a housing crisis that requires the construction of more than 1.6 million homes by 2025, a model of social housing production mainly delivered through private developers’ contributions, and a metropolitan governance structure through which housing targets are allocated to municipalities with highly unequal pressures, being inner London boroughs the ones with the highest targets to meet. In the context of a non-prescriptive and liberalised planning system, this threefold scenario has resulted in the construction of unprecedented residential landscapes, dominated by high-density and high-rise buildings. Tower Hamlets Council is at the forefront of this challenge both in the UK and Europe and is trying to develop planning tools to shape them. This article discusses three innovative supplementary planning documents (SPDs) produced by the policy team that have had unequal success in shaping different aspects of this form of development: the South Quay Masterplan SPD, the High Density Living SPD, and the soon-to-be-adopted Tall Building SPD. A comparative analysis of these planning documents and the perception of urban planners working at different stages of the planning process on the effectiveness and limitations of these SPDs in shaping vertical neighbourhoods shed light on the key factors influencing the role municipal planning can have in delivering a built environment that supports residents’ quality of life. By doing so, this case study illustrates the limitations of municipal planning and planners in local government, pointing to more structural and strategic issues of metropolitan governance.
Earthquake Stress Drop for a Circular Crack in an Anisotropic Medium
Authors: Tang Shuhang , Zheng Yingcai , Zhou Hua-Wei , Hu Hao
Published: November 2022

The circular-crack model has been widely used in seismology to infer earthquake stress drop. A common assumption is that the background medium is isotropic, although many earthquakes occur in geologically anisotropic settings. In this article, we study the effect of anisotropy on stress drop for a circular crack model and present explicit formalism in both static and kinematic cases. In the static case, we obtain the relationship between stress drop and slip for a circular crack model in an arbitrarily anisotropic medium. Special attention is given to the transversely isotropic (TI) medium. The static formalism is useful in understanding stress drop, but not all quantities are observables. Therefore, we resort to the kinematic case, from which we can infer stress drop using recorded far-field body waves. In the kinematic case, we assume that the crack ruptures circularly and reaches the final displacement determined by the static solutions. The far-field waveforms show that the corner frequency will change with different anisotropic parameters. Finally, we calculate the stress drops for cracks in isotropic and anisotropic media using the far-field waveforms. We find that in an isotropic medium, only shear stress acting on the crack surface contributes to shear slip. However, in a TI medium, if the anisotropy symmetry axis is not perpendicular or parallel to the crack surface, a normal stress (normal to the crack surface) can produce a shear slip. In calculating stress drop for an earthquake in an anisotropic medium using far-field body waves, a large error may be introduced if we ignore the possible anisotropy in the inversion. For a TI medium with about 18% anisotropy, the misfit of inferred stress drop could be up to 41%. Considering the anisotropic information, we can further improve the accuracy of stress-drop inversion.
Rupture Scenarios for the 3 June 1770 Haiti Earthquake
Authors: Hough Susan E. , Martin Stacey S. , Symithe Steve J. , Briggs Richard
Published: November 2022

The 2010 M 7.0 Haiti earthquake provided the impetus to reconsider historical earthquakes in Hispaniola (Bakun et al., 2012). That earthquake also shed new light on complex fault systems along Haiti’s southern peninsula (Douilly et al., 2013; Saint Fleur et al., 2015). Recently, the 2021 M 7.2 Nippes earthquake (Calais et al., 2022; Douilly et al., 2022), and a recent study reconsidering the 1860 sequence (Martin et al., 2022) further underscored the complexity of fault systems and large earthquake ruptures along the peninsula. Motivated by these studies and recent geological investigations (Prentice et al., 2010; Saint Fleur et al., 2020), we reconsider the 3 June 1770 Haiti earthquake to explore the conventional assumption that it was the last major (M ≥7.5) earthquake along the Enriquillo–Plantain Garden fault (EPGF). Accounts provide compelling evidence for substantial liquefaction in the Cul-de-Sac plain, one or more likely landslide-driven tsunami in Gonaïves Bay, and extensive landsliding that created at least three documented landslide dams. We consider three end-member rupture scenarios that are consistent with available constraints: two scenarios with M 7.7 and rupture lengths of 150–170 km, and one scenario with a ∼90 km rupture and M 7.5. Absent future work to identify and date paleoevents along the southern peninsula, none of these scenarios can be ruled out. Our preferred rupture model extends from the Miragoâne pull-apart to near la Selle mountain, with a rupture length of 127 km, M 7.6, and a high stress drop. Rupture could have been on the EPGF or on an oblique thrust fault associated with overthrusting of the Massif de la Selle. The results do support the conclusion that the 1770 earthquake was the last major earthquake in southern Haiti, with a magnitude upward of M 7.5 and significantly more severe shaking in southern Haiti than during the 2010 earthquake.
Isocyanides
Authors:   , Altundas Abdullah Bilal , Fleming Fraser F.
Published: November 2022

Isocyanides are powerful functionalities by virtue of the carbene-like terminal carbon that imparts unique reactivity. Capable of functioning as electrophiles, nucleophiles, radical acceptors, and in transition metal-catalyzed insertions, isocyanides engage in a plethora of methodologies that generate complex molecules from relatively simple starting materials. Despite their reactivity, only a handful of isocyanides are commercially available. Relatively few methods access isocyanides with even less providing di- or tri-substituted isocyanides. The challenge has been to develop a general method to prepare variously substituted isocyanides through a simple general method. The focus of this dissertation is to address the deficiency of methods to rapidly, generate complex isocyanides and to demonstrate their unique chemistry through the synthesis of highly functionalized cyclohexadienes. As such, the thesis is a collection of six published articles focused on different aspects of isocyanide chemistry. As a prelude to much of the chemistry, the first chapter describes the formation, structure, and reactivity of metalated isocyanides. The summary provides the broad reactivity patterns to understand the isocyanide chemistry of Anisylsulfanylmethylisocyanide (Asmic) that features in chapter 2. Initially developed as an isocyanide building block, chapter 2 describes the discovery of the first-ever low-temperature isomerization of isocyanides to nitriles from Asmic. Asmic has proven to be a particularly valuable precursor, not only to complex isocyanides, but also to a variety of heterocycles which has led to the development of a large-scale synthesis, the subject of chapter 3. The demonstrated utility of Asmic was summarized as a useful reagent for building functionalized isocyanides and nitriles in chapter 4. Rapid access to diverse Asmic derivatives led to the discovery and development of a novel dearomatization method that rapidly assembles complex cyclohexadienes which is described in detail in chapter 5. The dearomatization was rigorously explored through both computational and experimental investigations that have shed light onto a new avenue for isocyanide chemistry. The concluding chapter describes a practical synthesis and purification of sulfonium salts that was developed during the development of the dearomatization of Asmic derivatives. Collectively, the thesis demonstrates the highly versatile nature of isocyanides and their excellent potential for accessing complex scaffolds that are otherwise extremely challenging to prepare.
“Senggol Bestie” as Media Promotion Among Muhammadiyah Universities
Authors: Fadillah Dani , Farihanto Muhammad Najih , Anggesa Dwi Setiawan Resdika
Published: November 2022

This paper aims to discuss the emergence of the phenomenon of mutual flexing carried out by Muhammadiyah universities on TikTok social media. So far, every business entity that carries out promotions for its agency tends to avoid offending other agencies and only focuses on discussing the advantages of its products, even if it has to touch other institutions. This has never been done openly. This research was conducted using a qualitative approach with phenomenological analysis. The author collected data with participant observation to find out the participants’ essential phenomena in their life experiences. In this case, the author managed the content of official social media creators of Muhammadiyah Universities who created TikTok publication content. Then based on the data obtained from the resource persons, the author draws a research conclusion. The conclusion of this study shows that flexing activities carried out by content creators of Muhammadiyah Universities have the potential to become a new form of publication style that has never existed before among universities.
Correction of velopharyngeal insufficiency secondary to palatal gunshot wound: case presentation and review of the literature
Authors: Martínez-Wagner Rogelio , Cardenas-Cruz Cristopher , Ortiz-Monasterio Iván , Vargas Edgar , Cabrera María M. , Ysunza Pablo A. , Pamplona M. Del Carmen , Campos-Lopez Diana E.
Published: November 2022

Reconstruction of midfacial traumatic defects secondary to a gunshot wound (GSW) is one of the most challenging head surgeries. The high impact on the functional and aesthetic quality of life, and the small margin of error to achieve a successful outcome are significant hurdles in the surgical treatment of these cases. Here we report a 33-years old patient who suffered a GSW with an entrance wound penetrating between the soft and hard palate and an exit wound on the right malar region. A description of the case and a systematic review of the literature were conducted. The treatment depends on the type of weapon used, deforming characteristics of the bullet, kinetic energy, place of impact, and general conditions of the patient. GSW generate a particular injury due to their special trauma kinematics. In this case, our patient required extensive reconstructive surgery with interposition of costal cartilage to recover velopharyngeal structure and function, patients treated with this surgical strategy develop fewer complications such as infection, shrinkage, scarring. As demonstrated by this case report, the result can be satisfactory. In order to provide the most beneficial results for the patient, surgical techniques are evolving continuously, improving both structure and function, and increasing the quality of life of the patients. Free flaps are preferred because of the good results reported. Patients treated with this surgical strategy develop fewer complications such as infection, shrinkage, scarring. As demonstrated by this case report, the result can be satisfactory.
The study to understand management of constipation and prescription pattern of laxative therapy
Authors: Shilpi Kajal , Jain Amit B. , Patel Dixit
Published: November 2022

Background: The objective of this study was to evaluate demographic profile and prescription pattern of laxative therapy in chronic constipation (CC) patients.Methods: This real-world, retrospective, SMART-2 study was conducted at various centres in India between April 2021 and March 2022.Results: Data of a total 12,080 patients diagnosed with CC were analysed. The mean age of patients was 53.84 years and majority (63.62%) were males. Most reported influencing lifestyle parameters included ‘not very active’ or ‘lightly active’ lifestyle (78%) and non-vegetarian diet (67%). Squatting (56.89%) was the common mode of defecation. As per the Bristol stool criteria, the most common stool consistency observed was type 2 (sausage-shaped but lumpy) (25.49%) followed by type 1 [separate hard lumps, like nuts (hard to pass)] (22.92%). As per the Rome IV diagnostic criteria, straining (44.62%) was the most common symptom. Faecal evacuation disorder was present in 52% of the patients. Common associated conditions were diabetes (35%) and hypothyroidism (12.9%). Antihypertensive drugs (23.7%), iron supplements (13.5%) and opiates (10.7%) were the most commonly prescribed drugs in patient’s medication history. Lactulose solution (65%) was the most prescribed drug for CC. Quality of life was adversely impacted in every one out of five patients.Conclusions: Chronic constipation is more common among males and is influenced by lifestyle parameters. It is associated with comorbidities like diabetes and hypothyroidism. Antihypertensives, iron supplements and opiates are commonly noted in medication history for CC patients. Lactulose solution is the most common prescribed pharmacotherapy for the relief from constipation. Chronic constipation increases distress level among the patients.
Severe epistaxis and pregnancy ''about two cases'' and review of the literature
Authors: Baba Sacko Hamidou , Dicko Bagayoko Hawa , Dicko Abdoul Razak , Aminata Kodio
Published: November 2022

Epistaxis is a health ENT problem which is still current, this is one of the commonly encountered emergencies in Rhinology. The nasal mucosa suffered influence systemic, local, metabolic or hormonal disorders causing a slowdown of muco-ciliary function during pregnancy. These observations relate the clinical and therapeutic particularities of the management for severe epistaxis in women during the last trimester of pregnancy. The woman's hormonal system is unique in its kind due to cyclic changes during pregnancy, the menstrual cycle and menopause. Our clinical observations confirm the effects of these metabolic, endocrinological and physiological alterations related to pregnancy. In a tropical environment with the inadequacy of ENT specialists, base medical personnel is often confronted with delicate clinical situations in the evolution of ENT diseases. Management for epistaxis during pregnancy is special because of its context, well evident diagnosis requires vital gestures as evidenced by our observations. The ear, nose and throat specialist must necessarily be well warned of its physiological changes during pregnancy to better understand the clinical evolution of certain common throat diseases as epistaxis. Epistaxis during pregnancy is a subject that remains topical in the field of care, it is promoted directly or indirectly by hormonal changes. Multidisciplinary management in coordination must be done in a timely manner because the risks are not negligible for the health of the mother and the child.
Study to compare the effect of Dexmedetomidine vs MgSo4 (50%) intrathecally as an adjuvant with bupivacaine (0.5%) for lower limb orthopedic surgery under subarachnoid block
Authors: Pathak Meha , Doshi Shilpa M
Published: November 2022

Lower limb surgeries may be performed under local, regional (spinal or epidural) or general anesthesia, but neuraxial blockade is the preferred mode of anesthesia. Sub-arachnoid block or Spinal anaesthesia is the most common central block used in a surgical setting, which is being the most versatile and commonly used regional block. With increasing use of hyperbaric bupivacaine for sub arachnoid block, their limitations like prolongation of onset of sensory and motor blockage effect, short duration of action and early postoperative requirement of an analgesic agent, require an intrathecal adjuvant to these local anaesthetic agents for a complete satisfactory period of anaesthesia and patient satisfaction.

The aim of this study was to compare and evaluate the effect of Dexmedetomidine with MgSO4 (50%) intrathecally as an adjuvant for the characteristics of sensory and motor blockage for lower limb orthopedic surgery under subarachnoid block along with bupivacaine (0.5%).

: Participants were randomly divided into two groups of 40 participants each. Group D (n=40) received Bupivacaine + dexmedetomidine, Group M (n=40) received Bupivacaine + MgSO4. Under strict aseptic and antiseptic precaution subarachnoid block was performed. Mixture of drugs according to group assign was injected. Assessment of sensory and motor characteristics was done.

Inj. Dexmedetomidine as an adjuvant in spinal block, seems to be superior to intra-thecal MgSO4 as it has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate without significant hemodynamic alterations.

Dexmedetomidine, as an adjuvant to Inj. Bupivacaine intra-thecally in sub-arachnoid block, has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate.
To compare the efficacy of USG guided central venous catheterisation at internal jugular vein (IJV) and at the Pirogoff’s confluence
Authors: Princee Akanksha , Sachdev Sudhir , Jain Ashish , Verma Kalpana , Jethava Durga
Published: November 2022

: To compare the efficacy of USG guided central venous catheterisation at internal jugular vein (IJV) and at the Pirogoff’s confluence [IJV, subclavian vein (SCV), Brachiocephalic Vein (BCV)].

: A prospective, comparative, randomized, hospital based study was conducted on 100 patients requiring central venous access. After explaining the study to the selected patients, they were randomized into two groups with the use of sealed envelope method i.e. group A (Central venous cannulation of IJV) and group B (central venous cannulation of Pirogoff’s confluence of IJV, SCV, BCV). Data was collected with respect to the efficacy of USG guided cannulation on the basis of time for visualisation, access time, number of attempts, time to CVC, total time of procedure, length of catheter inserted. Any complications encountered were recorded.

: There was no difference between number of attempts in either of groups, mean visualization, access time and time to CVC was longer in group B with statistically significant difference. Mean length of catheter inserted was shorter in group B with statistical significant difference. Procedure time required was comparatively more in group B.

: The results indicated that Ultrasound guided cannulation of group A is efficacious than group B in terms of time required to culminate the procedure as well as complications but cannulation of Pirogoff’s confluence is a novel approach giving easier access, better visualisation and length of catheter inserted is lesser than IJV.
Clinical evaluation of perfusion index (PI) as a predictor of post spinal hypotension in lower segment caesarean section (LSCS)
Authors: Karasala Varalakshmi , Kumar Upendra , Tripathi Archana , Somvanshi Mukesh
Published: November 2022

Hypotension is a common complication, subsequently spinal anaesthesia in lower segment caesarean section, which can cause adverse maternal & foetal outcomes. A new decisive research area in obstetric anaesthesia is prevention & early treatment of spinal hypotension to improve maternal & foetal outcomes. A novel parameter, Perfusion index (PI) is tried during sub arachnoid block for predicting hypotension in lower segment caesarean section (LSCS).

In this study, 60 parturient belonging to ASA status 1 or 2 with apparent pregnancies scheduled for elective LSCS received spinal anaesthesia with 2ml of 0.5% heavy bupivacaine by using an orange (25G) Quincke needle at L3-L4 or L4-L5 interspinous space. Haemodynamics & perfusion index were recorded at regular intervals. Baseline perfusion index was correlated with degree of hypotension by using Receiver Operative Characteristic curve. Baseline perfusion index & other parameters were correlate by Karl Pearson correlation method.

: In our study 34.5% incidence of hypotension among study theme & momentous correlation between fall in systolic blood pressure from baseline & baseline perfusion index (r = 0.436; P < 0.05). The optimal utmost point for perfusion index was found to be 3.5 with a sensitivity of 37% & specificity of 97%.

A higher incidence of hypotension was found in Parturient having baseline perfusion index more than 3.5 following sub arachnoid block in elective LSCS.
Comparison of intravenous dexmedetomidine alone versus dexmedetomidine ketamine combination on sedation intubation response safety profile and patient satisfaction during awake fiberoptic nasotracheal intubation
Authors: Magnani Vandana R , Lalchandani Kavita S
Published: November 2022

Awake fiberoptic intubation requires adequate airway anaesthesia along with good sedation to achieve patient cooperation during intubation without respiratory depression and hypoxia.

The purpose of this study was to compare dexmedetomidine alone and dexmedetomidine with ketamine in order to achieve an ideal regimen during awake fiberoptic intubation by providing sedation, good intubating conditions, better hemodynamic stability, and patient satisfaction.

This prospective, randomised, double-blind clinical trial included 60 patients who were scheduled for elective surgery under general anaesthetic and required nasotracheal intubation. Patients were randomly assigned to two groups of 30 each, with ages ranging from 18 to 65 years and ASA grades I and II. All patients received an inj. dexmedetomidine bolus at 1 mcg/kg over 10 min. followed by a study drug depending on the group. In Group A, patients will receive an inj. ketamine 15 mg bolus and a 20 mg/hr ketamine infusion, whereas those in Group B will receive a normal saline bolus and infusion till completion of intubation. Sedation by Ramsay sedation scale (RSS), intubation response (by coughing score and grimace score), hemodynamic stability was observed during awake fiberoptic intubation, and patients' satisfaction by visual analogue score (VAS) and recall of events were assessed post operatively at 24 hours.

In Group A with greater hemodynamic stability compared to Group B, RSS and Post-Operative Vas Score were more successfully attained.

A combination of dexmedetomidine and ketamine provides the optimum sedation, hemodynamic stability, and patient satisfaction during awake fiberoptic intubation.
The comparative efficacy of two different doses of fentanyl on hemodynamic response to laryngoscopy and tracheal intubation: Prospective, randomized control trail
Authors: Patel Neel Vishnubhai , Patel Vidhi Vishnubhai , Patel Darshna Dharmendra , Patel Priyanka Jagdishchandra , Kotecha Hetal Girishkumar , Mendpara Urvisha Avchar
Published: November 2022

General anaesthesia with muscle relaxants using controlled ventilation involves laryngoscopy and tracheal intubation, which is associated with haemodynamic changes in the form of tachycardia and hypertension due to increased sympathoadrenal activity and are probably of no consequence in healthy individuals, but they may be hazardous to those with Myocardial Insufficiency and cerebrovascular disease. The objective of the present study was to compare the effect of two different doses of fentanyl with etomidate as an induction agent in attenuating haemodynamic stress response during laryngoscopy and endotracheal intubation. A randomised control trial was carried out on 60 adult patients (ASA I, II, III) undergoing elective surgery under general anaesthesia requiring endotracheal intubation. The patients were randomly allocated into two groups of 30 each i.e. group F2.5 and group F5 receiving fentanyl 2.5μg/kg and 5 μg/kg intravenously five minutes before intubation respectively. The pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded at various time intervals up to ten minutes after intubation. The study showed that both the doses were equally effective in blunting the pulse rate response, but the 5μg /kg proved significantly effective in blunting the blood pressure response. The rate pressure product, a measure of cardiac O2 consumption was found to be significantly lower in fentanyl 5μg/kg compared to fentanyl 2.5μg/kg. Hence, we conclude that fentanyl in 5 mcg/kg dose is more effective in attenuating hemodynamic responses to intubation as compared to 2.5 mcg/kg.
A prospective, randomised, double blind study comparing dexamethasone and dexmedetomidine as adjuvants to 0.2% ropivacaine for post-operative analgesia in ultrasound guided brachial plexus block
Authors: Gulati Niti , Garg Ishita , Arora Divesh
Published: November 2022

The Adjuvants added to local anaesthetic increases the duration of post-operative analgesia and decreases the analgesic requirement in post-operative period. The study was conducted with the intent of comparing post-operative analgesic effect of Dexamethasone and Dexmedetomidine in ultrasound guided Brachial Plexus Block.

A prospective, randomised, double blind study to compare post-operative analgesic effect of Dexamethasone and Dexmedetomidine as adjuvant to 0.2% Ropivacaine in Ultrasound Guided Brachial Plexus Block. 60 patients belonging to ASA I and ASA II scheduled for upper limb surgeries were included in the study after taking informed consent. Group A received 20ml of 0.2% Ropivacaine with 8mg of Dexamethasone. Group B received 20ml of 0.2% Ropivacaine with 50 µg of Dexmedetomidine. Our primary objective was to compare the time to first request for analgesia in both the groups. Secondary objective was to compare duration of sensory and motor block in post-operative period and to compare overall requirement for analgesia in 24 hours in both the groups.

The mean duration of motor block in Dexamethasone group was 635.47 ± 26.29 minutes and in Dexmedetomidine group was 827.47 ± 54.62 minutes. Similarly, mean duration of sensory block was 681.5 ± 27.19 minutes in Dexamethasone group and 877.17 ± 52.85 minutes in Dexmedetomidine group. The mean duration of time to first rescue analgesic was 709.67+18.47 minutes in dexamethasone group and 910.2 ± 51.66 minutes in Dexmedetomidine group. Total analgesia given had significant statistical difference of 0.004 between the two groups, with mean of 1.23 ± 1.17 in Dexamethasone group and 0.4 ± 0.56 in Dexmedetomidine. However, at 2hr, 4hr, 8hr, 12hr, 18hr and 24 hr the difference in VAS scores was significant (p value <0.0001).

Dexmedetomidine is better than Dexamethasone in prolonging duration of analgesia of the Brachial plexus block.
Subarachnoid block in parturients with mild COVID-19 disease for Caesarean delivery- A case series
Authors: Wadhwa Rachna , Chilkoti Geetanjali T , Maurya Prakriti , Mohta Medha , Gupta Anju
Published: November 2022

The obstetric population has been most vulnerable in this COVID-19 pandemic. We could not retrieve any study evaluating the safety and efficacy of anaesthetic techniques in parturients with COVID-19 undergoing caesarean delivery (CD) from South Asian Sub-continent. We, herein present the detailed clinical analysis and anaesthetic management of a case series of seven parturient with COVID-19 undergoing CD under subarachnoid block (SAB) in a tertiary care designated COVID hospital in the city of Delhi between June and December 2020.

Herein, we report 7 parturients with mild COVID-19 disease undergoing CD under SAB. Our observations are that the use of SAB was associated with transient haemodynamic perturbations in terms of hypotension in 3 patients and bradycardia in one patient. The neonatal outcome was observed to be favourable.

To conclude, our experience is that SAB is safe and effective for parturient with mildly symptomatic COVID-19 disease; however, was found to be associated with transient haemodynamic changes exclusively in parturients with anaemia.
Succinylcholine induced Masseter spasm in a young male with frontal sinus abscess
Authors: Loya Shilpa Jagdish , Sreekumar Ashik , Kulkarni Sanhita
Published: November 2022

We report a case of frontal sinus abscess posted for FESS, a chronic ghutka chewer with MPC IV and restricted mouth opening. Following induction with propofol and succinylcholine we noticed lockjaw when intubation was attempted, he was ventilated and anesthesia was deepened using propofol and dexmedetomidine, after a few minutes the masseter spasm had improved and miller’s blade was used for endo tracheal intubation & the procedure was uneventful.