bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous Immunoglobulin for Treatment of Patients with COVID-19: A Case-control Study
Authors: Khodashahi Rozita , Naderi Hamid Reza , Sedaghat Alireza , Allahyari Abolghasem , Sarjamee Soroush , Eshaghi Soudabe , Fazeli Farzaneh , Hoseini Benyamin , Dadgarmoghaddam Maliheh , Khodashahi Mandana
Published: March 2021

Background: It seems that the risk of developing complications associated with coronavirus disease 2019 (COVID-19) is higher among individuals with weakened immune systems. Objectives: Therefore, this study was carried out to determine the effectiveness of intravenous immunoglobulin (IVIG) for the treatment of patients not entering the intubation phase compared to those entering the intubation phase. Methods: This descriptive case-control study was performed on 26 patients with COVID-19 referring to Imam Reza hospital in Mashhad, Iran, in March 2020. For subjects with COVID-19 not responding to the standard three-drug protocol (i.e., ribavirin, hydroxychloroquine, and lopinavir/ritonavir), three doses of IVIG (0.4 g/kg/day) were added to the protocol. The patients were divided into two groups of subjects not entering the intubation phase and those entering the intubation phase and compared in terms of different variables. Results: The comparison of laboratory findings showed a significant difference before and after receiving IVIG regarding oxygen saturation (P < 0.005), white blood cell (P = 0.001), hemoglobin level (P = 0.0002), lymphocyte count (P = 0.03), and C-reactive protein (P = 0.001). In general, 53.8% and 46.2% of the patients were discharged and expired, respectively. All the subjects not entering the intubation phase were recovered; nevertheless, only one case entering the intubation phase was recovered, and 92.3% of the patients expired. A significant difference was observed between the patients not entering the intubation phase and those entering the intubation phase in terms of mortality (χ2 = 22.28; P < 0.005). Conclusions: In summary, the obtained results of the current study confirmed the therapeutic effects of IVIG on patients with COVID-19. Moreover, better treatment results, shorter hospital stay, and lower mortality rates were observed among COVID-19 patients who did not enter the intubation phase in comparison with those entering the intubation phase.
Physical Activity Based on the BASNEF Model Constructs in Women with a Child Less Than Two Years of Age
Authors: Faghih Solaymani Parshang , Rahimzadeh Ardeshir , Rahmani Khaled , Masodi Azita
Published: March 2021

Background: Lack of physical activity plays an important role in increasing blood pressure, diabetes, elevated lipids, and obesity. Postpartum women are at risk for low physical activity. Objectives: The aim of this study was to determine the status of physical activity based on beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model constructs at the postpartum period in women attending the centers of comprehensive health services. Methods: This cross-sectional study was performed on 217 randomly selected mothers who had a child less than 2 years of age in Sanandaj, Kurdistan Province, northwest of Iran. A researcher-made questionnaire including demographic information and BASNEF model components was used to collect the data. Data were analyzed in SPSS software version 22 and using Pearson’s correlation coefficient, multiple linear regression, and logistic regression. Results: Results showed that 89% of mothers had low or no physical activity. According to the findings, despite the fact that all three components of knowledge, attitude, and subjective norms somewhat predicted the intention to engage in physical activity, the predictive ability of the subjective norms with a correlation coefficient of 0.34 was statistically significant (P < 0.001) in predicting the mother’s physical activity. Conclusions: The results of this study showed that the level of physical activity of studied women after childbirth was undesirable. Designing and implementing interventions by health managers and providers to change women’s behavior and encouraging them to do physical activity is necessary.
An Investigation of Mental Health and Its Association with Demographic and Clinical Variables in Psoriasis Patients Referred to the Rheumatology Clinic of Golestan Hospital in Ahvaz
Authors: Nazarinasab Masomeh , Negahban Saeedeh , Rajaei Elham , Ahmadi Shima
Published: March 2021

Background: Psoriasis is a relatively common inflammatory skin disease characterized by red, scaly plaques in different parts of the body. Although the etiology of the disease is not fully understood, psychological stress is mentioned as a potential factor in developing the disease. Objectives: In this study, in response to the lack of sufficient information obtained from assessing the influence of psoriasis on mental health, an attempt has been made to evaluate the prevalence of mental health problems in a sample of patients with psoriasis. Methods: This study was conducted following an applied, descriptive-correlational study design. A total of 104 patients with psoriasis were selected using the census sampling method. Data were collected using the standardized Symptom Checklist-90 (SCL-90) questionnaire. This self-administering questionnaire contains 90 items. The reliability and validity of the questionnaire were confirmed. Results: The mean score of mental health was 177.51 ± 69.35, which indicates moderate psychiatric disorders. The positive symptom distress index (PSDI) was 0.22 ± 0.08. There was a significant association between all dimensions of mental health and the total score of mental health with gender (P < 0.05). Also, a significant association was found between paranoid ideation and marital status (P = 0.024). There was no significant association between obsessive-compulsive, anxiety, and the total score of mental health with income level (P > 0.05), but there was a significant association between other dimensions of mental health and income level (P < 0.05). Conclusions: Although in the present study, psychiatric disorders in patients with psoriasis were moderate, psychological counseling and psychiatric consultation are key to reduce the consequences of the disease and its progression.
Vertical Transmission of COVID-19: A Systematic Review
Authors: Fathi Najafi Tahereh , Dashti Sareh , Bahri Narjes
Published: March 2021

Context: Evidence regarding the vertical transmission of COVID-19 from infected pregnant women to the fetus are not sufficient. Methods: The current study intended to systematically assess the possibility of vertical transmission of COVID-19 in published literature. We systematically searched international bibliographic databases, including PubMed, SCOPUS, and Google Scholar, to identify relevant studies from the time of inception of these databases until July 2020. The search strategy was finalized based on the results of the primary search in PubMed. All observational studies, including cross-sectional, cohort, case-control, case reports, and case series, published in peer-reviewed journals in any language. Editorials, commentaries, and letters to editors were excluded. Twenty articles (6 retrospective studies, 2 prospective, one cohort, 9 case reports, and 2 case series) with a total of 145 subjects were eligible for the review. Data were collected based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. Results: Methods of assessing COVID-19 included polymerase chain reaction (PCR) analysis of naso/oropharyngeal, vaginal, rectal, urine secretions and gastric and amniotic fluid samples, and serum immunoglobulin (Ig) assays. Vertical transmission was reported in 6 neonates (< 10%), based on PCR, and three were positive based on Ig assays. Conclusions: According to the evidence, the possibility for vertical transmission of COVID-19 is rare.
“Self-Affection” and “Temporal Thickness” in Phenomenology of Perception
Authors: Hotanen Juho ,   Chiasmi International
Published: March 2021

In the “Temporality” chapter of Phenomenology of Perception, Merleau-Ponty refers to the Kantian notion of “self-affection.” The subject has an affective self-relation through time because the subject is of time. Merleau-Ponty shows that it is crucial that self-affection is not understood as an immediate self-coincidence. According to him, the idea of an immediate self-possession renders self-relation impossible. Instead, temporal self-relation should be understood as a paradox of connection and difference: the contact of the self to itself always also implies distance. The temporal subject is not transparent to itself but has a connection to its past and its future through the temporal thickness of the present.
Mutual Determination, Concrescence and Transition. Whitehead’s Speculative Conception of Temporal Subjectivity Interpreted from a Merleau-Pontyan Standpoint
Authors: Vanzago Luca ,   Chiasmi International
Published: March 2021

The interpretive approach adopted in this paper is influenced by Merleau-Ponty’s philosophy and in particular by his understanding of Nature, which in turn takes into consideration Whitehead’s work. Whitehead’s philosophy of organism is seen by its author as the metaphysical generalization of problems found in his investigation of natural knowledge. Whitehead admits that a speculative approach is necessitated by the very questions arising from the mathematical concepts of the material world and the revolutions undergone in logic, mathematics and physics at the turn of the century.Whitehead’s understanding of nature is framed from the beginning in terms of a processual approach. However, this notion of process is not fully worked out in the epistemological works and requires a metaphysical deepening. This is due to the fact that the notion of duration adopted in the epistemological works is not sufficient to convey the notion of process. This lack of adequacy is coupled by Whitehead with the need to interpret process in terms of experience. In turn, this notion of experience is wider than the usual one, for it implies that there is experience from the lowest levels onwards. Matter itself experiences. Seen in this perspective, reality is thus conceived in terms of a whole in constant change, whose parts are in mutual connection. This conception derives from Whitehead’s criticism of Aristotle’s substantialism and from his preference for a relationist ontology. The outcome of this approach is a speculative conception of reality in terms of a twofold notion of process: concrescence and transition, which Whitehead sees as the two faces of the creative advance of nature. This dual notion of process is interpreted in this essay in a merleau-pontyan perspective.
La riflessione impossibile e il rispecchiamento nel mondo. Dall’esperienza infantile alla surréflexion
Authors: Amoroso Prisca ,   Chiasmi International
Published: March 2021

This essay builds on two questions: the relation of the child with the other and the child’s way of knowing, in which the resistance of the unreflected is not yet problematized. Through a reconstruction of Merleau-Ponty’s critique of Piaget’s idea of the child’s linear intellectual progression toward reflexive abstraction, I highlight the moment of unreflection by taking up the notion of ultra-thing, which Merleau-Ponty borrows from Henry Wallon. These ultra-things are entities with which the child entertains a vague relation and which always remain at the horizon of her perception without yet being possessed in a representation or grasped in a concept. They include, for example, the sun, the sky, the Earth, the body as an object, existence before the birth of the child – uninhabitable dimensions or, to the contrary, ones that are necessarily inhabited. The concept of ultra-thing has not been sufficiently explored in Merleau-Pontian studies and its importance remains underappreciated. This essay thus formulates a hypothesis about the relation between ultra-things and hyper-reflection.
La telepatia e la macchia. Mirror neurons e monadologie merleau-pontyane
Authors: Leoni Federico ,   Chiasmi International
Published: March 2021

A meditation on specularity as paradigms of a theory of experience which informs every field of philosophy and human sciences, including contemporary neurosciences. And a meditation, starting from neurosciences and mirror neurons, on the different readings of this paradigm of specularity and specularization. In particular, on that “second” reading of specularization, which suggests that the mirror is not an instrument of representation but of expression, not a device of adaquation but of creation. It is an hypothesis that Merleau-Ponty, facing the very same problems contemporary neurosciences are confonted to, reactivates in an increasingly systematic way in his later years, drawing from a tradition which we try here to reconstruct. From Merleau-Ponty to Bergson, from Bergson to Leibniz, this second reading of specularity contains a possibility which is still fruitful and which neurosciences themselves could adopt in order to reconsider in a new perspective the evidences they have considered until now from the point of view of a first reading of specularity. This second reading of specularity suggests that it is not so much necessary to explain how one subject comprehends the other, but how both subjects are comprehended within the transcendental space of what we could call an event. Empathy is not so much a syntonization among subjects, but subjects are a partial and local desyntonization of that empathic system we should place as the beginining and not at the end of the process. Consciousness does not represent the other consciousness, but they express in a simultaneous and specular diffraction the fundamental unity of an event which is every time unique and impersonal.
Merleau-Ponty e Cézanne
Authors: Fugali Edoardo ,   Chiasmi International
Published: March 2021

The aim of this article is to demonstrate the intrinsically technical nature of visual perception and pictorial performance through their common anchorage in the corporeity that brings them into existence. As with any other artistic technique, painting reveals itself to be the natural extension of a technological attitude already rooted in the sensorimotor devices of the body in action; painting is led to inhabit a world that is of the same nature as corporeal agents, because the objects that populate it share with it the ontological element of the “flesh”. Through Merleau-Ponty’s analyses of Cezanne’s pictorial works, I demonstrate that the main purpose of painting is, analogically with the descriptive analyses made possible by the phenomenological reduction, to render intersubjectively evident the hidden work of vision before its sedimentation in an accomplished perceptual scene. As the experiments of contemporary neuroscience also demonstrate, perception is by and large a reconstructive process of “image-making” rather than an allegedly accurate reproduction of the spectacle of the world. Painting, on the other hand, both in terms of creation and for the observer, employs the same sensorimotor resources as instruments.
L’essere grezzo della tecnica
Authors: Zoppis Andrea ,   Chiasmi International
Published: March 2021

Through a reading of Merleau-Ponty’s late courses on Nature, this essay presents a new reflection on technique and makes explicit the ontological significance of a rethinking of technique in this period. After an analysis of the historical sense of the notion of Nature and of animal behavior, we turn to cybernetics. The need to rethink man on the basis of his contingency, that is, on the basis of his relationship with the world and with the technical objects through which this relationship is structured, arises in the essay. Merleau-Ponty’s course on Nature has thus allowed us to investigate the ontological significance of the notion of technique by considering technical objects that Merleau-Ponty himself references. Technique, by prolonging Nature, becomes the keystone to the contact between man and Being, thus illustrating the necessity, for philosophy and for culture, of a return to the contact with brute being that founds and inhabits it.
“Frange” del concetto di informazione: natura e tecnica in Merleau-Ponty e in Simondon
Authors: Macrì Saverio ,   Chiasmi International
Published: March 2021

This paper investigates how Merleau-Ponty and Simondon conceived the theory of information and, in particular, assessed its validity as an instrument of analysis in multiple fields of knowledge. Specifically, the comparison will analyze the relationship between organism and environment, which is central both to Merleau-Ponty’s philosophy of nature and to Simondon’s theory of individuation. For both authors, the analysis of processes of interaction between organism and environment is characterized by the search for a type of causality that distinguishes itself from mechanism, which reduces these interactions to a sum of independent parts occasionally tied by a causally determined relation. However, while Merleau-Ponty views the categories introduced by the theory of information as a mere reconstruction of the mechanistic perspective, Simondon revises these categories to overcome mechanism and move towards the construction of a model of experience based on relation.
Deformation of the Human Body
Authors: Okui Haruka ,   Chiasmi International
Published: March 2021

In the Sorbonne lectures on the philosophical and psychological inquiry of child development, Merleau-Ponty offers a fundamental insight about imitation. Denying the representation-based explanation of imitation, he proposes that gestures occur without representation through the body-object relation, such as “precommunication” based on the works of body schema. Merleau-Ponty’s thought could be examined by way of more practical examples of body techniques. This paper describes the experience of object manipulation, in particular, Bunraku puppetry. Because three puppeteers manipulate a single puppet together in Bunraku, this example might be a challenge to an ordinary assumption that a body is owned by an individual and that inner thoughts control the body. Merleau-Ponty’s insight suggests that the puppeteers share another type of body schema that is not internalized to their individual bodies but emerges afresh in each performance through collaborative movement.
Updates
Authors: Reynolds Stephanie
Published: March 2021

Freedom to Read Foundation Report to CouncilIntellectual Freedom Committee Report to CouncilSummary of Comments from Facial Recognition SurveyResolution in Opposition to Facial Recognition Software in LibrariesResolution on the Misuse of Behavioral Data Surveillance in LibrarieCommittee on Professional Ethics Report to CouncilCommittee Information Update (CIU)
Censorship Dateline
Authors: Reynolds Stephanie
Published: March 2021

Colleges and UniversitiesSchools
Study of antioxidant activity of selected monocarbohydrazone derivatives
Authors: Mrđan Gorana , Matijević Borko , Vlaisavljević Sanja , Vaštag Đenđi , Apostolov Suzana
Published: March 2021

Many of carbohydrazone derivatives have shown a wide range of biological activities. In previous studies, these compounds have proven to be excellent anti-cancer, antitumor, antibacterial, antimicrobial and antioxidant agents. Monocarbohydrazones, as one of the carbohydrazone derivatives, have been slightly explored. Due to that reason, in this study, eight newly synthesized monocarbohydrazones were subjected to examinations by the use of three antioxidant tests. To determine the effectiveness of monocarbohydrazone as potential radical scavengers, DPPH (2,2-Diphenyl-1-picrylhydrazyl), ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) and FRAP (Ferric Reducing Antioxidant Power) assays were used. The obtained results could open the door for further studies of these compounds as biologically active substances.
Sample analysis of organically produced honey and conventionally produced honey in Western Serbia
Authors: Ivanović Marina , Galonja-Coghill Tamara , Janković Saša , Rajković Miloš , Stanković Veroslava , Paunović Dušanka , Zlatanović Snežana
Published: March 2021

Conventional method of honey production is widely spread in the area of western Serbia. Despite the advantages of honey production in an organic manner, beekeepers are still hesitant to take this step, regardless of the difficulties with placement of such honey on the foreign market, so their products are mainly sold on the domestic market. Besides the undeniable nutritional value, honey produced in the conventional way with proper use of agro technical measures and implementation of the wide range of products in the treatment of bee diseases, in its composition very often contain residues of hazardous chemical compounds, pesticides, antibiotics. Research on four qualitative differences of the content of certain substances between the conventional and organic honey producers has been conducted in western Serbia. The research obtained five manufacturers, out of which two were engaged in organic manner of production, while the remaining three dealt with the conventional honey production. After examining the area and the apiaries in question, interviews with honeybee producers, the sampling of honey took place. Upon performed analysis, it was concluded that one conventionally produced sample of honey was not safe for human consumption, due to presence of pesticides.
Characterization of deposited plasma spray NiCrAlCoY2O3 coating layers on AlMg1 alloy substrates
Authors: Mrdak Mihailo , Lačnjevac Časlav , Rakin Marko , Janaćković Đorđe , Veljić Darko , Bajić Darko
Published: March 2021

In this paper, analyzed are the effects of the plasma spray distance on the microstructure and mechanical properties of the NiCrAlCoY2O3 coating layers deposited at atmospheric pressure. The microstructure and mechanical properties of the coating layers are under the influence of the interaction of plasma particles (ions and electrons) with powder particles, providing the transfer of velocity and temperature of the plasma particles onto the powder particles. The effect of the interaction is directly dependent on the time the powder particles were present in the plasma which is defined by distance of the plasma gun from the substrate, depending on the granulation of the powder, the melting point and specific gravity. In order to obtain homogeneous and denser coating layers with high adhesion, in the experiment three distances from the substrate were used: 95 mm, 105 mm and 115 mm. The layers were deposited on thin sheets of AlMg1 aluminum thickness of 0.6 mm. Evaluation of mechanical properties of the layers was carried out by examining microhardness using the HV0.1 method and the bond strength by tensile testing. The morphology of the powder particles was examined on the SEM, while the microstructure of the layers was evaluated under a light microscope in accordance with the Pratt Whitney standard. The results of the experiment showed that the distance from the substrate substantially influenced the structure and mechanical properties of the coating layers. The best deposited layers were examined in the system with the ZrO224%MgO ceramic coating, which have proved to be reliable protectionfrom high temperature and abrasive rocket jet fuel.
Detailed characterization of the Ti-O based thin films obtained by cathodic arc evaporation
Authors: Jokanović Vukoman , Bundaleski Nenad , Čolović Božana , Ferarra Manuela , Jokanović Bojan , Nasov Ilija
Published: March 2021

Physicochemical properties of thin films on the base of titanium oxides, obtained by a cathodic arc evaporation on the surface of glass substrate are analysed in details. The analysis of these films was made by using XRD, FTIR, SEM, XPS analysis and ellipsometry. On the basis of these analyses, particularly analysis obtained by XPS, the oxidative state Ti and corresponding phases are determined through various film layers from the surface to the substrate. The depth of the various levels and their extinction coefficients and refractory indexes are estimated by ellipsometry.
Old English Syntax and Its Relation to German
Authors: Lauridsen Freja Bang
Published: March 2021

At first glance, the syntax of ancient Old English appears reminiscent of the syntax of the Present-Day German language. A number of shared syntactic traits such as Subject Object Verb constituent order, Verb Second, and a complicated inflectional system have caused the two languages to be compared by scholars, who often have referred to German as simply a present-day version of the now far-gone Old English. Exploring both similarities and dissimilarities of the two languages, this article examines the relationship between the two languages’ syntax to show that although structurally similar once, modern-day English has lost most of the syntactic traits linking it to the German language and their common Proto-Germanic roots. These syntactical differences not only show that Old English was never just a modern-day variant of German but also show that the two languages are developing in separate directions – or at least in separate paces.
The Zoopoetics of Les Murray
Authors: Feddersen Merle Marianne
Published: March 2021

Today, the Western world is extensively centred around human language and the natural sciences. The transformative powers of poetry, such as they can bring forth the presence of nonhuman animals, have thus been marginalized in several respects. This article investigates how the animal poems of Presence, a poetic sequence in the poetry collection Translations from the Natural World by the Australian poet Les Murray, re-sensitizes the reader to the expressive bodies of nonhuman animals and establishes the notion of a more-than-human world. By introducing Aaron M. Moe’s concept of zoopoetics, a theory and practice that links the nonhuman animal as a maker, subject and individual to the art of writing and reading poetry, Murray’s animal poems can be understood as deeply attentive texts that use human language to explore how nonhuman bodies and minds exist outside of anthropocentric binaries, and shape not only our physical realities, but also our imagination.
Post-Intensifying
Authors: Bengtson Jonas
Published: March 2021

Language is a “moving target”; the meaning and use of elements of a language can change so that former understandings and explanations become insufficient. The contemporary, American English colloquial use of the ass-intensifier, such as in “a grown-ass man”, is an example of that. This article is an examination of the ass-intensifier and a comparison with its Danish counterpart røv, exploring the similarities and dissimilarities. It will be argued that the English intensifier is post-intensifying and has two distinct meanings; furthermore, that intensification by a grammaticalized version of a lexical item for posterior is not exclusively an English phenomenon, showing a cross-linguistic link.
The Malthusian Alternative and Overpopulation in Avengers: Infinity War and Avengers: Endgame
Authors: Kragsbjerg Trine Mærsk
Published: March 2021

This article examines the depiction of the environmental problem of overpopulation in the two Marvel films Avengers: Infinity War and Avengers: Endgame through the analysis of the character Thanos and his Malthusian theory and his cornucopian thinking counterpart, The Avengers. The article investigates how these two theories affect and form the subject of overpopulation in the two films and what signal the films send in relation to environmental alternatives. It suggests that the films hinder the contemplation of all environmental alternatives through their depiction of the Malthusian alternative as a villainous and unwarranted ideology.
What Do You Meme?
Authors: Holm Cille Hvass
Published: March 2021

Users of the Internet have established a unique form of communication tool commonly used on social media platforms; these are referred to as Internet memes. The term meme, however, was conceived many years before its appropriation into an Internet sphere. Where memes are units of cultural information propagated like a virus from brain to brain, Internet memes are dynamic digital artifacts that can easily be created and quickly distributed to a large social group with the intention of communication. Internet memes are not static; rather their format inspires social interactions that allow them to be modified and reworked with an infinite amount of communicative outcomes. This paper offers an exploration of the different features of Internet memes, which are identified as creational/distributional, social, as well as communicative. When combined, these features in relation to each other constitute a sociolinguistic potential.
The Ambiguous Portrayal of Nature in Annihilation
Authors: Kjærulff Caroline
Published: March 2021

This article examines how Alex Garland’s science fiction horror film Annihilation (2018) works as a form of eco-media, and how it has potential to influence its audience in a positive direction. I argue that the portrayal of nature in the film, from the different horror genres at play, to the themes of disease, destruction and renewal, and the stunning but eerie visuals, challenge the conceptions we have of the environment and climate change, and invites the audience to rethink the relationship between nature and humans.
Linguistic Profiling and Discrimination in The Witcher 3: Wild Hunt
Authors: Troelsen Thor Nordfeld
Published: March 2021

This article examines the linguistic profiling in the video game The Witcher 3: Wild Hunt with an interest in its possible useful appliance for a large gaming community with little knowledge of a fantasy world such as The Witcher’s. I work with the phenomenon of linguistic profiling as proposed by John Baugh, which will be used in conjunction with the dialects and accents used in The Witcher 3. Besides this, I use an interview of the translation and adaptation team from the game developers (CD Projekt Red) to showcase what considerations they made when choosing and distributing accents and dialects in the English version of the game. This paper concludes with detailing the problematic uses of accents and dialects in the game, while also highlighting the benefits to new players when orienting them in the Witcher world, which is the overall advantageous result from the accent distribution in the game.
The Impact of Fasting on Metabolic and Anthropometric Parameters in Type II Diabetic Patients: A Prospective Observational Study
Authors: Yazdanyar Tayebeh , Sohrab Mehrnoush , Ramezani Atena , Aliabadi Parastoo Karimi , Bahar Adele , Shirzad Mahboobeh , Abdolmaleki Elham Yousefi , Aarabi Mohsen
Published: March 2021

Introduction: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is therefore, necessary for patients to receive proper instructions about their physical activities, eating habits, blood glucose monitoring and medications. Aim: To investigate the effects of fasting on metabolic and anthropometric indices in type II diabetic patients. Materials and Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of 40 type II diabetic patients (33 females and 7 males) who wished to fast. They started to follow given instructions on their physical activity, eating habits, blood glucose monitoring, and medications before Ramadan. Anthropometric variables were measured pre and post-Ramadan. Fasting Blood/Plasma Glucose (FBG/FPG), Glucose 2 Hour Postprandial (2h PPG), glycosylated haemoglobin (HbA1c), and the lipids profile were assessed before and after Ramadan. FPG and 2h PPG were also evaluated on the fifteenth day of Ramadan. Data were presented as mean±SD. Paired t-test was employed and a p-value of <0.05 was considered statistically significant. Results: After completion of the study, anthropometric variables of patients, including weight (74.9±12.7 vs. 73.0±13.1 kg, p<0.001), BMI (29.9±5.2 vs. 29.0±5.1 kg/m2, p=0.042), waist circumference (106.2±11.8 vs. 105.3±11.6 cm, p<0.001), conicity index (9.94±0.96 vs 9.80±0.99, p=0.085), systolic blood pressure (118.5±10.6 vs. 113.8±9.4 mmHg, p=0.018), Diastolic blood pressure (72.0±7.9 vs. 68.3±7.0 mmHg, p=0.02) and FPG (125.1±27.4 vs. 105.2±21.4 mg/dL, p<0.001) decreased significantly. However, serum triglyceride increased significantly (127.5±45.5 vs. 166.5±53.5 mg/dL, p<0.001) after fasting compared to pre-Ramadan measurements. Changes in other variables were not statistically significant. Conclusion: The results of this study indicate that fasting had beneficial effect on fasting blood glucose level and anthropometric parameters in type II diabetic patients.
A Curious Case of Acute Pancreatitis in Pregnancy
Authors: Kalani Karan Rajgopal , Kathuria Vaishali , Pandit Sanjay , Bhadoria Dharam Pal
Published: March 2021

Hypercalcaemia is rare in pregnancy and is under diagnosed owing to its non-specific presentation which is frequently attributed to the pregnancy itself. Severe hypercalcaemia presents a therapeutic challenge, especially during pregnancy. The present case of a 26-year-old primigravida who presented with acute pancreatitis is described here. The pancreatitis was found to be secondary to parathyroid adenoma- induced hypercalcaemia. After initial conservative medical management with subcutaneous and intranasal calcitonin, she underwent a small-incision adenoma excision. This unusual cause and presentation of hypercalcaemia and its management is reviewed thereof.
Correlation of Anaemia and Restless Legs Syndrome in Elderly: A Cross-sectional Study
Authors: Agrawal Abhijit , Bhagawati Jahnabi , Kumar Sunil
Published: March 2021

Introduction: Restless Legs Syndrome (RLS) also known as Willis Ekbom Disease (WED) which manifests as a neurologic disorder among patients with anaemia, particularly with iron deficiency anaemia. Aim: To find the association of anaemia with RLS in the elderly population. Materials and Methods: In this cross-sectional study, 100 patients of age ≥60 years were enrolled and categorised into mild, moderate, and severe anaemia as per World Health Organisation (WHO) criteria. Every participant was enquired about RLS via a questionnaire based on the International RLS Study Group Rating Scale (IRLSSGRS) for its Severity and for the diagnosis (Essential clinical criteria for the diagnosis of RLS). Results: The study showed that patients with anaemia had a statistically significant correlation with RLS (p=0.04) and severity of RLS (p=0.032). Serum ferritin levels too showed a statistically significant correlation with RLS (p=0.032). Conclusion: Patients with severe anaemia and lower serum ferritin levels were more prone to RLS and had more RLS severity.
Co-existing Tubercular Pleural Effusion and Visceral Larva Migrans in a Patient with Hypereosinophilia: A Rare Case
Authors: Kaur Taranpreet , Bansal Nitin Kumar , Goyal Kuldeep , Chaudhary Jaykrat
Published: March 2021

Eosinophilic pleural effusions accounts for 5-16% of all the cases of pleural effusion. Here the authors present a case of 21 years old male patient, with right-sided chest pain in whom peripheral blood eosinophilia along with eosinophilic pleural effusion were found after a series of relevant investigations and two causative factors were found for same i.e., Visceral Larva Migrans (VLM) and tubercular pleural effusion. Both of them individually can cause hypereosinophilia, but presence of them together makes this case rare and interesting.
SARS-Coronavirus Disease-19 and Comorbidities: A Systematic Review
Authors: Shankar Mythri , Nishanth KR
Published: March 2021

Introduction: Coronavirus-19 (COVID-19) pandemic is evolving rapidly worldwide. It has led to a worldwide research to identify the people who are at more risk for developing the infection, increasing severity and mortality. Aim: The aim of this systematic review was to evaluate the risk of some of the common and major comorbidities on the outcome of the disease. Materials and Methods: A literature search was conducted using EMBASE, PUBMED, Web of science, SCOPUS and Cochrane database. Medical Subject Headings (MeSH) used were “COVID-19” or “SARS CoV 2” or “Coronavirus disease 19” and “Comorbidities” or “Risk factors”. Individual risk factors were also used as keywords such as “Diabetes”, Hypertension”, “Obesity”, “Chronic kidney disease”, “Elderly”, “Cardiovascular disease”, “Lung disorders” and “Malignancy”. Two researchers conducted the search independently. Results: After extensive search, 57 articles were shortlisted for complete review. It was found that patients with comorbidities had more severe disease than those without comorbidities. Patients with more number of comorbidities had more severe disease than patients with single comorbidity. Initial reports suggested that elderly were at more risk than the younger population. The most common comorbidity was hypertension followed by diabetes and obesity. Conclusion: A meticulous triage of patients should be carried out after acquiring proper medical history because this will help to identify patients who are at an increased risk of poor outcome of the infection. Also, they should be given more aggressive treatment upon diagnosis of infection.
Lung: Another Victim of the Silent killer Diabetes- A Cross-sectional Study
Authors: Mukherjee Tirthankar , Sneha SR , Vinayaka NS
Published: March 2021

Introduction: Diabetes is a multisystem disorder with well known complications involving various organs in the body. The presence of abundant connective tissue and microvasculature raises the possibility that lung may also be affected in diabetes. Aim: To evaluate the pulmonary function parameters in patients with diabetes mellitus and to determine their correlation with glycaemic control, duration of diabetes and other microvascular complications. Materials and Methods: This is a cross-sectional study done between September 2018 and March 2019. A total of 300 type 2 diabetic patients, aged 30-70 years, with duration of diabetes more than 1 year, were included in the study. Thorough history was taken regarding the duration of diabetes and symptoms of the complications. All of them were evaluated for diabetic microangiopathies: nephropathy (by 24 hour urinary protein excretion), retinopathy (by direct ophthalmoscopy) and neuropathy (by clinical examination). Glycosylated Haemoglobin (HbA1c) was measured as an indicator of glycaemic control. Spirometry and single breath diffusion capacity for carbon monoxide were performed on all the subjects. Pulmonary Function Test (PFT) parameters of each subject were compared with the normal values. Unpaired t-test and one-way analysis of variance (ANOVA) were used. Correlation and regression studies were used to find out the strength of association between Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) and the following: the duration of disease, HbA1c and presence of other microvascular complications. Results: Pulmonary function parameters like Forced Expiratory Volume in first second (FEV1), Forced Vital Capacity (FVC), Peak Expiratory Forced Rate (PEFR) and DLCO were below the normal values in 53% of diabetic patients included in the study. Majority of them had a restrictive ventilation pattern. The diffusion capacity corrected for Alveolar Volume (VA) as measured by DLCO/VA was significantly reduced in those with longer duration of diabetes and in those with other microvascular complications. However, the poor lung functions had no correlation with the HbA1C values. Conclusion: This study demonstrated that lungs are indeed affected in patients with type 2 diabetes. The presence of extrapulmonary microangiopathy and duration of the disease may predict the incidence and the severity of the lung function abnormality.
N-Terminal Pro-Brain Natriuretic Peptide Levels in Patients Presenting with Acute Breathlessness in Emergency Department
Authors: Bahulikar Arun , Patel Sunil , Phalgune Deepak Sadashiv
Published: March 2021

Introduction: Breathlessness is one of the most common symptoms in patients presenting to the emergency department. Differentiating Congestive Heart Failure (CHF) from other causes of dyspnea is of extreme importance. N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) levels may be valuable for the diagnosis of Heart Failure (HF) in patients with acute breathlessness when used in combination with other clinical information. Aim: To find the utility of NT-proBNP levels in patients presenting with acute breathlessness. Materials and Methods: This cross-sectional study was conducted on 255 patients presenting with acute breathlessness. Details of clinical history, clinical examination, laboratory tests, Electrocardiogram (ECG), X-ray chest, and 2D echocardiogram were collected from each patient. A 5 mL sample of peripheral venous blood was taken from the patients for the quantitative determination of NT-proBNP levels. Mann-Whitney U test was used to compare medians of continuous variables. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy were determined for NT-proBNP levels. Results: The mean age of the patients was 58.9 years. The median NT-proBNP level was significantly higher in patients who had HF compared to respiratory failure and Hyperventilation Syndrome (HVS). The sensitivity and specificity of NT-proBNP level >450 pg/mL was 76.9% and 90.0%, respectively for patients <50 years of age. The sensitivity and specificity of NT-proBNP level >900 pg/mL was 82.9% and 92.3%, respectively for patients 50-75 years of age. The sensitivity and specificity of NT-proBNP level >1800 pg/mL was 61.5% and 100.0%, respectively for patients >75 years of age. Conclusion: NT-proBNP measurement is a useful biochemical tool for the emergency room physician in the rapid and reliable diagnosis of HF in patients with acute breathlessness.
Clinical Improvement with Pirfenidone in Two Patients of COVID-19
Authors: Firdaus Huma , Razak Nader Abdul , Reza Maqsumi , Khan Nafees Ahmad , Shameem Mohammad
Published: March 2021

Pirfenidone has been approved for the treatment of idiopathic pulmonary fibrosis due to its anti-fibrotic activity. It has been shown to have anti-inflammatory and antioxidant properties apart from being an anti-fibrotic agent. Cytokine storm, severe inflammation and oxidative stress leading to acute respiratory distress syndrome and multiorgan failure are factors causing mortality in patients of COVID-19. This article reports two cases of 35 years and 60-year-old male patients of COVID-19, those were diagnosed by real time Polymerase Chain Reaction (PCR) using nasopharyngeal samples. They were started on pirfenidone 400 mg BD, later increased to 600 mg TDS along with empirical antibiotics, dexamethasone, supplemental oxygen and non-invasive ventilator support. Both the patients improved and were discharged. Both the patients were followed by telemedicine after one week, did not require oxygen at rest and were comfortable at rest in contrast to earlier complaints. Thus, the authors conclude that pirfenidone can be a possible cure for COVID-19 patients, larger trials are required to confirm its efficacy.
Heat Intolerance and Hyperhidrosis as the only Presenting Manifestations of Acromegaly: A Case Report
Authors: Kamalesh TN , Sarathy HA Vijaya , Sreedevi NT
Published: March 2021

Acromegaly is a state of Growth Hormone (GH) excess characterised by coarse facial features, acral enlargement, hyperhidrosis, headache, visual disturbances and visceromegaly. The most common cause of acromegaly is pituitary adenoma. The average delay between onset of symptoms and diagnosis is about six years in acromegaly owing to its subtle clinical features at the disease onset.Early diagnosis is important to reduce the morbidities and mortality associated with acromegaly. Familiarisation of physicians with the signs and symptoms of the disease is an effective strategy for the early diagnosis of acromegaly. Here, the authors report a case of 38year-old female patient. After proper clinical examination, history and series of relevant investigations, the serum GH level was estimated and was found to be elevated (40 ng/mL). GH secreting pituitary macroadenoma presenting with heat intolerance and hyperhidrosis without the classical manifestations of acromegaly.
A Longitudinal Study on Comparison of Haematocrit, Glasgow Score and Computed Tomography Abdomen as Prognostic Markers in Assessment of Severity in Acute Pancreatitis
Authors: Chitrambalam Tharun Ganapathy , Rajasekhar Sidhu , Sundaraj Jeyakumar , Panicker Koshy Mathew , Paladugu Ramyasree
Published: March 2021

Introduction: Acute Pancreatitis (AP) can present from a mild self-limiting process that requires only supportive care to severe disease that can cause multiple Organ Failure (OF) and high mortality. It is therefore important to identify such patients at increased risk of OF and mortality at the earliest. Aim: To evaluate and compare the efficacy of three prognostic markers namely Haematocrit, Glasgow scoring and Computed Tomography (CT) abdomen in assessing the severity of AP. Materials and Methods: A prospective longitudinal study was done on 120 patients diagnosed with AP, over a period of 18 months. Haematocrit was done at admission and at 48 hours. A fall in haematocrit of more than 10% was considered sensitive. Modified Glasgow score was assessed at admission and after 48 hours. Other variables include blood glucose level, white blood count, blood urea nitrogen, serum calcium, partial oxygen pressure (PaO2), decrease in haematocrit, serum Lactate Dehydrogenase (LDH), serum aspartate aminotransferase (AST) and serum albumin. A score of ≥3 was considered sensitive. CT of abdomen was done at 72 hours and a Computed Tomography Severity Index (CTSI) score of ≥4 was considered sensitive. The results of each prognostic marker were graphed and compared to assess Length of Hospital Stay (LOHS), need for Intensive Care Unit Admission (ICUA), OF and mortality. Results: The mean LOHS was six days. Haematocrit was sensitive in 23 of 79 patients that stayed in hospital for >6 days. Modified Glasgow scores were sensitive in 35 of 79 patients. CT of abdomen was sensitive in 59 out of 79 patients. Total 29 of 120 patients were admitted in the ICU, out of which difference in haematocrit was sensitive in 14 patients, Modified Glasgow coma score of ≥3 was seen in 14 patients and CTSI scores were sensitive in 22 patients. Twelve out of 120 patients developed OF. All 12 patients showed a sensitive Modified Glasgow scores of ≥3 and CTSI ≥4, whereas only five patients were sensitive for fall in haematocrit. Five patients died during the study. All five patients were sensitive for fall in haematocrit Glasgow coma scores and CT abdomen. Among the prognostic markers, haematocrit showed 100% sensitivity, specificity and Positive Predictive Value (PPV) than the other prognostic markers making haematocrit the better prognostic marker. Conclusion: CT of abdomen is a reliable prognostic marker in terms of assessment of LOHS, need for Intensive Care Unit (ICU) care and mortality. Modified Glasgow score is accurate in assessing OF. Haematocrit is specific in assessing the need for ICU care and mortality.
Pulmonary Nocardiosis in Immunocompetent Patient: A Rare Case Report
Authors: Shah Kusum V , Kumar Saket , Rana Yash , Shah Arti D
Published: March 2021

Pulmonary nocardiosis is a rare bacterial infection that may lead to severe disease in immunodeficient patients and usually not so common in immunocompetent patients. The report is about a 57-year-old male with Norcardiosis. His sputum and Bronchial Alveolar Lavage (BAL) were negative for acid-fast bacilli. Nocardia species was isolated in BAL culture. He was started on Trimethoprim/Sulfamethoxazole and Clarithromycin, which was later continued for six months.