bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Tsallis entropy measures in concomitants of generalized order statistics under iterated FGM bivariate distribution
Authors: Husseiny I. A. , Nagy M. , Mansi A. H. , Alawady M. A.
Published: July 2024

Shannon differential entropy is extensively applied in the literature as a measure of dispersion or uncertainty. Nonetheless, there are other measurements, such as the cumulative residual Tsallis entropy (CRTE), that reveal interesting effects in several fields. Motivated by this, we study and compute Tsallis measures for the concomitants of the generalized order statistics (CGOS) from the iterated Farlie-Gumbel-Morgenstern (IFGM) bivariate family. Some newly introduced information measures are also being considered for CGOS within the framework of the IFGM family, including Tsallis entropy, CRTE, and an alternative measure of CRTE of order $ \eta $. Applications of these results are given for order statistics and record values with uniform, exponential, and power marginals distributions. In addition, the empirical cumulative Tsallis entropy is suggested as a method to calculate the new information measure. Finally, a real-world data set has been analyzed for illustrative purposes, and the performance is quite satisfactory.
Éducation dans et par la nature et écoformation, évolution des pratiques et des conceptions éducatives des acteurs
Authors: Martin Émilie
Published: July 2024

Cet article présente les principaux constats d’une recherche qui interroge les enjeux sous-jacents aux formes d’éducation par la nature et dans la nature, en s’intéressant aux pratiques pédagogiques mises en place et aux motivations d’enseignants et d’éducateurs à l’environnement. À partir d’une règle de vie collective - « je fais attention à moi, aux autres et à la nature » - rencontrée dans différents dispositifs éducatifs (classe dehors, forest school, école alternative en nature), cette recherche interroge les pratiques d’éducation par la nature et dans la nature au prisme des principaux éléments de réflexion apportés par la notion d’écoformation. L’évolution des conceptions de l’éducation et des postures pédagogiques des acteurs est ici questionnée en portant un regard sur la place laissée aux enfants et celle accordée au milieu dans les apprentissages, et sur les formes éducatives étudiées.
Enhancing Rural Governance in Zimbabwe
Authors: Kaponda Tendai
Published: July 2024

Zimbabwe's rural governance involves coordination across different government levels, with distinct roles and responsibilities. The chapter highlights the historical evolution of rural governance in Zimbabwe, which has shifted towards greater decentralisation. The RDDC serves as a platform for coordination across government entities at the district level, but issues such as inadequate participation and conflicting authorities have been noted. Political dynamics, economic constraints, and social traditions influence intergovernmental coordination. Ansell and Gash's collaborative governance model offers insights for stakeholders. Intergovernmental coordination is crucial for facilitating collaboration and communication. There is a need for enhanced information sharing, clarified roles, improved leadership, adequate resources, and better communication mechanisms. Leveraging the lessons from Ansell and Gash's model can significantly contribute to promoting effective intergovernmental collaboration and improving rural governance and development outcomes in Zimbabwe.
Incidence of falls and fall-related characteristics in hospitalized children in South Korea: a descriptive study
Authors: Park Hyeyeong , Kang Hyunju
Published: July 2024

Purpose: With the recent increase in interest in patient safety, prevention of falls in hospitalized children has become important. This study aimed to identify the incidence rate of falls among hospitalized children and explore fall-related characteristics.Methods: This retrospective descriptive study analyzed the medical information of 18,119 patients aged <18 years admitted to a general hospital in South Korea from electronic medical records and fall event reports between January 1, 2018, and September 30, 2023. The study variables included the general and clinical characteristics of the fall group and fall-related characteristics of the fall events. This study employed descriptive statistics and a chi-square test using IBM SPSS version 26.0.Results: Among the patients, 82 fall events were identified. Therefore, the fall incidence rate was 4.5 falls per 1,000 patients. Furthermore, a statistically significant difference was found concerning the type of injury sustained between children >1 year old and those <1 year old, and most cases had no damage or bruises. More cases were found in which falls occurred two days after hospitalization in winter and summer than on the day or the day after hospitalization, which was a statistically significant difference. In addition, fall prevalence was higher between 8 am and 4 pm, and when no caregiver was present. Conclusion: Based on the results of this study, education and interventions to prevent fall events in infants and toddlers should persist throughout hospitalization, and it is necessary to guide continuous management and observation of the caregivers.
Evaluation of a child abuse prevention program for unmarried mothers in South Korea: a single-case experimental design
Authors: Park Il Tae , Oh Won-Oak
Published: July 2024

Purpose: The purpose of this study is to apply and evaluate the effectiveness of a child abuse prevention program based on the Nursing Model of Resilience and Coping Skills Training Model for unmarried mothers during pregnancy and puerperium.Methods: This study had a prospective single-case, AB design with four repeated self-questionnaire measures and three observational measures. Seven unmarried mothers were provided with 10 sessions child abuse prevention program through individual visits from 32 to 34 weeks of pregnancy to 6 weeks after childbirth. The questionnaire was composed related to resilience, maternal stress, maternal attitude, parent-child interaction, child abuse potential. The observation was measured by video recording (total 16 times) the interaction of parent-child during feeding and analyzing it by three experts. Data were analyzed by Wilcoxon signed-rank test and Friedman’s test.Results: Maternal attitude and parent-child interaction were statistically significantly improved after intervention compared to before intervention. However, maternal stress decreased after intervention compared to before intervention, but it was not statistically significant. Also, resilience and child abuse potential were not statistically significant. This program is partially effective in preventing child abuse by promoting parenting attitudes and parent-child interactions.Conclusion: This study focused on individual resilience and applied systematic intervention as coping skills training to prevent child abuse. This study is meaningful in that interventions were conducted through individual visits to unmarried mothers at high risk of child abuse, and the program was applied, including pregnancy and postpartum periods, to prevent child abuse early.
Safety and Efficacy of Injection Tenecteplase in 4.5 to 24 Hours Imaging Eligible Window Patients with Acute Ischemic Stroke (EAST-AIS) - Study Protocol
Authors: Pandit Awadh Kishor , Jatwani Arti , Tangri Poorvi , Srivastava Madakasira Vasantha Padma , Bhatia Rohit , Kale Shashank Sharad , Gaikwad Shailesh , Srivastava Achal Kumar , Garg Ajay , Joseph Leve Sebastian , Vibha Deepti , Vishnu Venugopalan Y. , Singh Rajesh Kumar , Radhakrishnan Divya M. , Das Animesh , Agarwal Ayush
Published: July 2024

Background and Aims:

Tenecteplase is used as the standard of care treatment for thrombolysis in acute ischemic stroke (AIS) patients within 4.5 h of symptom onset. Documented reports were less certain to claim the benefits of it in an extended window period. EAST-AIS (CTRI/2022/03/040718) trial is designed to determine the success rate of thrombolysis in an extended window period for good clinical outcomes.

Study Design:

It is a randomized, placebo-controlled trial of tenecteplase administered within 4.5–24 h of stroke onset (with or without large vessel occlusion) based on evidence of salvageable tissue through baseline computed tomography perfusion (CTP) or magnetic resonance imaging (MRI) scan. Criteria of patient inclusion are as follows: patients of both genders (male and female), age >18 years, pre-stroke modified Ranking Scale (mRS) <2, baseline NIHSS >5, CTP showing penumbra–ischemic core ratio >1.8, absolute difference in volume >10 ml, and ischemic core volume <70 ml. The sample size for the study is 100 patients: 50 in the tenecteplase arm (0.25 mg/kg body weight; maximum- 25 mg) and 50 in the placebo arm (controls).

Study Outcomes:

The study’s primary objective is safety endpoints along with the efficacy of tenecteplase assessed using the mRS score at 90 days of stroke onset.

Conclusion:

The result obtained from EAST-AIS will determine the safety and efficacy of tenecteplase injection administered 4.5–24 h following the symptom onset for AIS patients within the territory of Internal Carotid Artery (ICA), Middle Cerebral Artery (MCA), or Anterior Cerebral Artery (ACA) occlusion.
A Gender-based Study on the Morphometry of Cotyloid Cavity of the Coxal Bone in South Indian Population
Authors: Soman Meril Ann , Bhat Shivarama , Nallathamby Rani
Published: July 2024

Background and Aim:

The cotyloid cavity (acetabulum) is a cup-shaped hollow on the lateral aspect of the coxal bone. The head of the femur articulates with cotyloid cavity to form the hip joint. The cotyloid cavity varies in size, shape, and depth among individuals. Any deviation from the normal range of parameters of the acetabulum may result in arthrosis-related pathologies.

Materials and Methods:

The present study was conducted on 200 dry human hip bones. The bones were collected from the department of anatomy of a medical college in Mangalore. The following morphometrical parameters of the cotyloid cavity were measured: (a) transverse diameter of acetabulum, (b) acetabular height, (c) acetabular depth, (d) acetabular volume, (e) distance from the pubic tubercle to the anterior rim of the acetabulum, and (f) ratio between distance from the pubic tubercle to the anterior rim of the acetabulum and acetabular height. Range, mean, standard deviation, and standard error of mean were determined for each parameter. P value was also calculated. Gender-wise comparison of the results was done.

Results:

The independent t-test was done, and the P value was calculated for each parameter. All the parameters showed significant differences between the male and female hip bones.

Conclusion:

In this modern era, total and partial hip replacement surgeries are very commonly performed. Therefore, knowledge regarding the various morphometrical parameters of the cotyloid cavity may be of great help in the preoperative planning period. It would also be of great help in the fields of forensic anthropology, osteology, and anatomy.
Jeavons syndrome mimicking head nodding tic- A case report
Authors: Sheetal S. , Gladson Nikhil , John Rakesh , Kurup Yamuna P.
Published: July 2024

Jeavons syndrome is an uncommon generalized epilepsy syndrome characterized by a triad of eyelid myoclonia with or without absences, as indicated by epileptiform discharges on electroencephalography (EEG) precipitated by eye closure and photosensitivity. Eyelid myoclonia is an ictal phenomenon manifested as repeated fluttering or trembling of the eyelids or eyelid blinking, often precipitated by eye closure and light exposure. It has often been mistaken for eye-blinking tics. Myoclonic jerks involving the head, resembling a head shaking movement, may be observed in Jeavons syndrome, which may be misdiagnosed as a head nodding tic. Many case reports of this syndrome have incorrectly diagnosed eye blinking tics; however, misdiagnosis as head nodding tics is rarely reported. We report the case of a 10-year-old girl, referred to us for evaluation of head nodding tics, who was observed to have eyelid myoclonia and upward gaze deviation during photic stimulation. The patient’s EEG showed bursts of polyspike and wave discharges. She was diagnosed with Jeavons syndrome and was initiated on anti-epileptic agents.
Gedunin attenuates streptozotocin-induced diabetic hepatopathy in rats
Authors: Mazumdar Suchismita , Marar Thankamani M , Patki Jyoti M
Published: July 2024

Objective:

To examine the hepatoprotective effects of gedunin in streptozotocin (STZ)-induced diabetic rats.

Methods:

Rats were divided into 4 groups: control, STZ, gedunin, and STZ+gedunin. Biochemical parameters for liver function and liver histology were studied. The molecular interaction of gedunin with the liver glucose transporters GLUT2 and SGLT1 was examined using AutoDock Vina.

Results:

Gedunin attenuated STZ-induced increase in the levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, lactate dehydrogenase and gamma-glutamyl transferase in the serum and liver tissue, reduced lipid peroxidation, and enhanced antioxidant activity. Histopathological studies showed considerable restoration of liver architecture in gedunin-treated diabetic rats. In silico studies revealed stable binding of gedunin with GLUT2 and SGLT1.

Conclusions:

Gedunin exerts hepatoprotective effects in STZ-induced diabetic rats by reducing liver enzymatic activities and oxidative stress. Further studies are warranted to verify the mechanism of its hepatoprotective action.
C-phycocyanin shows neuroprotective effect against rotenone-induced Parkinson’s disease in mice
Authors: Rathod Hritik , Soni Ritu M. , Shah Jigna S.
Published: July 2024

Objective:

To investigate the neuroprotective effect of C-phycocyanin in a mouse model of rotenone-induced Parkinson’s disease.

Methods:

C-phycocyanin (50 mg/kg, i.p., daily) was administered to rotenone (30 mg/kg, p.o., daily) treated mice for 28 days. Behavioral studies (Y-maze, rotarod, round beam walk, and wire-hang tests) were carried out to assess neurobehavioral deficits. Glutathione and malondialdehyde were determined in both serum and striatal tissue. Molecular proteins (AKT, AMPK, NF-κB, BDNF, and alpha-synuclein) in the striatum were estimated using ELISA. Histopathological analyses (hematoxylin and eosin stainning as well as Nissl staining) were carried out to assess structural abnormalities in the striatum.

Results:

C-phycocyanin significantly increased BDNF levels and decreased alpha-synuclein levels. It also slightly upregulated AMPK and AKT levels without significant difference compared with the rotenone group. Additionally, rotenone-induced elevated oxidative stress and structural abnormalities in the striatum were markedly mitigated by C-phycocyanin.

Conclusions:

C-phycocyanin might have potential neuroprotective effects against Parkinson’s disease. Further studies are warranted to verify its efficacy and to understand the molecular mechanisms behind the neuroprotective effects of C-phycocyanin in Parkinson’s disease.
Participatory Security as Form of Control: Kaziranga National Park, India
Authors: Fanari Eleonora
Published: July 2024

‘More security, more conservation’ is the mantra utilised by the Indian forest service to ensure the protection of flora and fauna. Aligned with international agreements aiming at securing wildlife and preserving forests, the Union and the State governments of India have adopted a series of green measures to ensure both the securitisation and participation of local communities in conservation efforts. This research article illustrates how participatory forms of conservation are employed to complement the securitisation of conservation, serving as a means to indirectly control people’s lives and create new environmental subjects. It does so through a case study of Kaziranga National Park, a biodiversity conservation hotspot in the northeastern state of Assam, renowned for the successful conservation of the Greater One-horned Rhino Rhinoceros unicornis. This ‘success’ emerges amidst critiques of its violent and militarised anti-poaching conservation measures and the efforts deployed to protect the rhino ‘at any cost’. The research article analyses the participatory protection mechanisms supported by state and non-state agencies to ensure the conservation of Kaziranga, primarily carried out through the revitalisation of two bodies: the eco-development committee and the voluntary defence organisation. The results demonstrate how soft forms of violence complement hard forms, thereby supporting a broader process of structural violence and national building in Assam. It shows how participatory mechanisms are used as ‘counterinsurgency practices.’

Abstract in Hindi: rb.gy/rhcrzz
Psychological Health and Coronavirus Disease 2019-related Knowledge, Attitude, and Behavioral Practices among Industrial Workers: A Cross-sectional Study
Authors: Mohammadiyan Mahdi , Kangarlou Marzieh Belji , Chamani Abbasali , Mohammadi Saeed
Published: July 2024

Aim:

The spread of the coronavirus disease 2019 (COVID-19) pandemic has imposed a high threat on the health of industrial workers as the most crucial source of the workforce in maintaining business and the community economy. The present study was conducted toevaluate the levels of psychological health and knowledge, attitude, and behavioral practice (KAP) relating to COVID-19 and to investigatethe individual and occupational risk factors associated with them.

Materials and Methods:

A cross-sectional study was conducted among 603 randomly selected workers from Tehran industrial city, Iran. Data collected through an online self-reporting questionnaire consisted of demographic variables, Depression, Anxiety, and Stress Scale (DASS-21), and items about KAP. Kruskal–Wallis, Mann–Whitney U-tests, and regression model analyses were performed to determine the factors associated with DASS-21 and KAP scales.

Results:

In this study, a prevalence of moderate to extremely severe symptoms was 30.2% for depression, 35.7% for anxiety, and 15.6% for stress. 89.9%, 95.3%, and 66% of the workers had moderate knowledge, attitude, and good behavioral practice, respectively. Home appliance industry (adjusted odds ratio [aOR] = 0.84, P = 0.002), work experience over 16–20 years old (aOR = 0.38, P = 0.031), and having an associate’s degree (aOR = 0.82, P = 0.02) were positively associated with worker’s attitude, depression, and knowledge, respectively.

Conclusion:

The findings indicated a considerable proportion of psychological health problems, particularly depression, anxiety, and stress among workers across industries. Occupational health services should provide interventions to improve knowledge, particularly in disease transmission, increase awareness, and emphasize appropriate preventive measures to reduce workplace chronic stressors and improve psychological health.
An Overview of Clinical Trials on the Duration of Dual Antiplatelet Therapy and the Scope of Novel Oral Anticoagulants Following Percutaneous Coronary Intervention
Authors: Singh Ambukeshwar , Gupta Alka , Sharma Jayesh , Anand Vishal , Narain Varun Shankar
Published: July 2024

ABSTRACT

After percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is an important therapy for preventing thrombotic events. Numerous clinical trials have been conducted to determine the ideal length of therapy in relation to the duration of DAPT. Similar to this, various clinical trials have investigated the use of novel oral anticoagulant (NOAC) medication in conjunction with DAPT following PCI. In this review, we sum up the findings from various significant clinical studies that have influenced the duration of DAPT and the scope of NOAC therapy following PCI.
Determinants of multimorbidity among elderly population in maharashtra, India: Logistic regression analysis
Authors: Santhosh Reshma , Kakade Satish V. , Durgawale PM
Published: July 2024

BACKGROUND:

Population aging is an emerging global trend. Because of decreasing fertility rates and improved healthcare, the lifespan of elderly population increased. Consequently, proportion of elderly population is increasing at an alarming rate. This is accompanied by an increased recognition of the occurrence of multimorbidity and associated mortality risks. So, the purpose of this study was to determine the prevalence and predictors of multimorbidity among elderly population in Maharashtra with its variation among socio-demographic spectrum, functional health and health behaviors.

MATERIALS AND METHODS:

Sample of elderly population aged > 60 years were selected to examine multimorbidity and its associated risk factors. Statistical methods such as Chi-square test were used to show the association between multimorbidity and other covariates. Binary logistic regression analysis was used to understand the effects of predictor variables on multimorbidity. Receiver Operating Characteristic (ROC) Curve Analysis was carried out to improve the performance of the classification model by using a modified cut-off probability value. Z scores were calculated to compare model performance in training data and test data.

RESULTS:

The prevalence of multimorbidity in Maharashtra in training data and test data was found to be 32.8% and 32.9%. Residence, living arrangement, MPCE Quintile, marital status, work status, education, tobacco consumption, physical activity, Instrumental Activities of Daily Living (IADL), Activities of Daily Living (ADL) and self-rated health of elderly population were important determinants that exert a significant adverse effect on multimorbidity.

CONCLUSION:

Prediction percentages indicate that appropriate actions should be undertaken to ensure good quality of life for all the elderly in Maharashtra.
Endoscopic transcanal facial nerve decompression in traumatic facial nerve palsy: A case series
Authors: Bandyopadhyay Arjyama , Rout Khageswar
Published: July 2024

Temporal bone fractures contribute to 7%–10% of patients suffering from facial nerve (FN) palsy.Traumatic facial paralysis is the most common cause of lower motor neuron facial paralysis, accounting for about 17% of its incidence. Temporal bone fractures contribute to 7%–10% of patients suffering from facial nerve (FN) palsy. The proximal tympanic segment of FN is most commonly affected in such cases. The classical microscopic surgeries for pathologies involving the FN, such as transmastoid approach, middle cranial fossa approach, and translabyrinthine approach, are associated with several disadvantages. The endoscopic transcanal approach is a minimally invasive surgery that can be used mostly for a lesion limited to the tympanic segment of the FN. It provides sufficient exposure for nerve decompression as compared to other approaches. Clear endoscopic vision of the tympanic cavity is also achieved, which is beneficial to ossicular chain reconstruction. Moreover, it causes minimal surgical trauma. Operating time and postoperative hospital stay are also reduced. This technique is cosmetically more acceptable to the patient. In this article, we report three cases of posttraumatic FN palsy where we performed endoscopic transcanal nerve decompression. It resulted in dramatic improvement of the facial palsy from House–Brackmann Grade IV or Grade V to Grade II immediately following surgery. The outcome of FN decompression through this approach was found to be comparable to conventional approach.
Role of traditional Chinese medicine-based acupuncture in the resolution of ovarian torsion
Authors: Shubha R. , Silwal Karishma , Nair Pradeep M. K.
Published: July 2024

Ovarian torsion (OT) is a gynecological emergency that affects females of childbearing age and usually requires surgical management. Here, we present a 30-year-old female who presented with an ultrasonographically confirmed OT along with an ovarian cyst and severe pain in the lower abdomen. She was treated at a private acupuncture clinic as an outpatient. She underwent one acupuncture session per week for 11 weeks. St 40, Sp6, Sp9, Lv3, Li4, CV4, St 29, K6, Lu7, Sp4, and Pc6 were selected and punctured based on traditional Chinese medicine diagnosis. The patient reported mild relief from pain immediately after the first session. A complete relief of pain was reported by the patient by the end of the third session. A follow-up ultrasound revealed no significant ovarian abnormality. This report indicates the possibility of using acupuncture in emergency conditions like OT.
A rare case of chronic headache
Authors: Miriyala Srinivas , Challagulla Madhubabu , Agarwal Pooja , Mohanty Lalatendu , Rao Bangam Rajendra Prasad
Published: July 2024

Cerebral venous thrombosis (CVT) is a relatively uncommon and rare condition worldwide, affecting approximately 1 in 100,000 individuals annually and comprising about 0.5% of all strokes. It is more prevalent in women of childbearing age due to hypercoagulable states. We present a case report of a 19 years old female exhibiting symptoms, including headache, occasionally associated vomiting, blurring of vision and one generalised seizure. On general examination and neurological, there were no significant abnormality found, Fundoscopy revealed blurred disc margins and the presence of papilledema. An emergency non-contrast computed tomography (NCCT) scan of the brain showed normal findings. Subsequently, a magnetic resonance imaging (MRI) scan of the brain indicated partial loss of flow void in the posterior part of the superior sagittal sinus and straight sinus, along with the formation of collateral channels, suggestive of possible subacute dural sinus thrombosis. Additionally, a contrast-enhanced MRI (CEMRI) scan with MR venogram showed filling defects in the posterior part of the superior sagittal sinus and straight sinus, with non-visualization of the left transverse sinus, indicative of subacute to chronic dural venous thrombosis, Beta 2 glycoprotein IgM and Cardiolipin IgM were positive and titres were high. This case with history of headache for 4 years underscores the need for early diagnosis, which could have alleviated suffering and further prevent grave consequences, with an insight to such problems and accessibility to high end imaging diagnosis tools for early recognition and management.
Ocular hypertension in a child of acute lymphoblastic leukemia
Authors: Sen Saswati , Das Matuli , Parida Shrutakirty
Published: July 2024

To highlight the case of ocular hypertension in a 9-year-old male who came with fever and swelling in the left eye (LE) for 3 days. He was a known case of acute lymphoblastic leukemia (ALL) on treatment with oral steroids. His best-corrected vision was 6/6 in both eyes (BES). The anterior segment was normal in BES except for mild periorbital edema in the right eye (RE). On applanation tonometry (AT), intraocular pressure (IOP) was 42 mmHg in RE and 36 mmHg in LE. Gonioscopy showed open angles in BEs. Fundoscopy and optical coherence tomogram–retinal nerve fiber layer were normal in BES. He was diagnosed with steroid-induced ocular hypertension in BES and was started on both topical and oral antiglaucoma medications (AGMs). IOP was normal after 2 weeks of treatment. He came after a month of discontinuation of AGMs against medical advice but was still on oral steroids. He was asymptomatic, but his IOP was 28 mmHg in RE and 26 mmHg in LE. Parents were counseled about the disease and need to restart AGMs. Regular follow-up was also emphasized.
Histomolecular subtyping of periampullary adenocarcinoma and its correlation with pathological prognostic factors
Authors: Goyal Namisha , Pradhan Prita , Giri Ranjana , Sahoo Subrat Kumar
Published: July 2024

Introduction:

Periampullary adenocarcinoma (PAC) is a less frequent tumor accounting for approximately 0.5%–2% of all gastrointestinal malignancies. Histologically, PAC subtyped into intestinal and pancreaticobiliary adenocarcinoma which is further confirmed by immunohistochemistry (IHC). Subtyping of PAC has emerged as an important prognostic factor with potential therapeutic implications.

Aim:

The aim of the study was to assess morphology and IHC expression of CK7, CK20, and CDX2 to subtype PAC and correlate the subtype predicted on histomorphology with the immunohistochemical expression.

Materials and Methods:

This was a cross-sectional study done from January 2018 to July 2023. A total of 28 pancreaticoduodenectomy specimens were assessed and further classified into intestinal and pancreaticobiliary subtypes after correlating both histological and immunohistochemical features. Statistical analysis was performed using the standard statistical software. P <0.05 was considered statistically significant.

Results:

Histomorphology and IHC (CK7, CK20, and CDX2) expression was studied in 28 cases having an age range from 41 to 74 years including 18 males. Based on histomorphological findings, they are categorized into intestinal (n = 15) and pancreaticobiliary (n = 13) subtypes. The use of only morphology showed a sensitivity, specificity, and diagnostic accuracy of 63.6%, 52.9%, and 53.16%, respectively, for the intestinal subtype and 50%, 57%, and 57%, respectively, for the pancreaticobiliary subtype. With the use of combined histomorphology and IHC the sensitivity, specificity, and diagnostic accuracy was >90% with a significant reduction in false-positive diagnosis.

Conclusion:

The correlation of histomorphology and IHC findings can aid in better subtyping of PAC.
Cystoscopic extraction of a wired earphone from male urinary bladder
Authors: Wani Umer Hamid , Pasha Mahaboob , Najar Firdous Ahmad , Ansari Shakeel , Alam Saiyad Shah , Fatimah Mehjabeen , Taslim Mohd
Published: July 2024

A foreign body in the urinary bladder is an uncommon urological emergency, resulting from scenarios such as iatrogenic injuries, self-insertion for pleasure, sexual abuse, assault, and migration from the adjacent sites. Self-inserted urinary bladder foreign bodies for sexual enjoyment pose a substantial issue for clinicians due to their difficulty in the diagnosis and therapy. Most patients were admitted late owing to embarrassment, resulting in severe short-and long-term consequences. This case study describes the intriguing presentation of a 57-year-old male who came to the surgery outpatient department 17 days after experiencing burning when urinating along with blood and dysuria. Wire-like radiodensities in the soft tissues of the pelvis were seen on an X-ray; their morphology was described as that of an earphone wire. The wired earphone foreign body was removed using a cystoscopy procedure. The patient’s hospital stay was minimal, and he was discharged with antibiotics and analgesics.
Rhabdomyosarcoma of prostate presenting as prostatic abscess in young adult – Rare presentation of a rare disease
Authors: Mishra Sumanta Kumar , Raman Sarojini , Boaz Ranil Johann , Panda Sumit Kumar
Published: July 2024

Rhabdomyosarcoma (RMS) of the prostate in adults is a rare but highly malignant tumor and often metastatic at diagnosis. RMS of the prostate in adults has been reported in isolated case reports in the literature. Timely diagnosis and multimodal treatment give the best survival chance to the patient. The varied presentation of RMS of the prostate in adults mimicking multiple other pathologies of the prostate and lack of pathognomic radiological findings makes its diagnosis difficult and delays in treatment. Transrectal biopsy of the prostate with immunohistochemistry panel at histopathological examination confirms the diagnosis. A 27-year-old man diagnosed as prostatic abscess and treated with antibiotics was referred to our center. Adequate suspicion of malignancy with proper evaluation and biopsy leads to correct diagnosis of RMS of the prostate. Multimodality treatment was initiated as the disease was not metastatic at diagnosis.
Mental health on the frontlines: Disaster psychiatry perspectives from Odisha
Authors: Panda Udit Kumar , Pattnaik Jigyansa Ipsita , Samantray Swayanka , Ravan Jayaprakash Russell
Published: July 2024

Disasters can have a profound impact on mental health, leading to stress, posttraumatic stress disorder (PTSD), depression, anxiety, grief, substance abuse, and suicidality. These issues can persist for years, affecting 30%–60% of survivors, and risk and resilience depend on factors such as socioeconomic status, cultural background, health, trauma exposure, age, sex, and community support. Early interventions and long-term interventions, such as skills building, communal practices, cooperative livelihood programs, clinical therapies, and addressing health-care disparities, can help in recovery. Trauma can lead to neurobiological changes, and culturally sensitive mental health care is essential. Climate change accelerates extreme events, and disaster response systems must integrate such care to enhance resilience and mitigate trauma to disrupted communities such as Odisha and broadly affected populations worldwide.
New targeted pharmacotherapy and experimental therapies for inflammatory bowel disease
Authors: Sahu Saroj Kanta , Giri Suprabhat , Nath Preetam , Mallick Bipadabhanjan , Praharaj Dibyalochan , Anand Anil Chandra
Published: July 2024

“Inflammatory bowel diseases (IBDs)” are idiopathic inflammatory disorders of the gastrointestinal tract. The natural course of “IBD” may be chronic, progressive, or relapsing–remitting. The goal of IBD therapy is currently based on a “target-to-target” approach. “Moderate-to-severe IBD” patients often require long-term treatment with biologics to attain therapeutic targets. Although biologics work well, the primary and secondary nonresponses are still quite high. IBD patients experiencing biological failure led to progressive disease burden; development of complications; and poor physical, mental, and social health. The unmet therapeutic paradigm in IBD includes novel treatments that target distinct immunoinflammatory pathways with improved therapeutic response, safety, and tolerability. A deeper understanding of the pathophysiology of the disease and the reasons underlying treatment failure helps guide IBD therapy. In addition, various experimental treatments are beginning to be developed, such as stem cell therapy, vagus nerve stimulation, novel small-molecule medications, and gut microbiome modification. This paper reviews the most recent medicines added to the treatment arsenal for IBD, prospective new medications shortly, and experimental therapies that could provide physicians with various alternatives for managing patients clinically.
Stress-Induced Diabetic Ketoacidosis Due to Transient Beta Cell Stunning in a Youth with Type 2 Diabetes Mellitus: A Case Report
Authors: Sriraam Manoharan , Sri Lekha Sadagopan , Unnikrishnan Ranjit , Anjana Ranjit Mohan , Mohan Viswanathan
Published: July 2024

A 15-year-old boy was admitted to the intensive care unit of our hospital with complaints of increased urination, extreme tiredness, and nausea for the past 15 days. He had also lost 6.5 kg of weight (almost 10% of total body weight) in 1 month. On admission, his plasma glucose was 780 mg/dL, glycated haemoglobin (HbA1c) 11.6%, serum ketones >10.0 mmol/L, osmolality 346 mosm/kg, arterial pH 7.28, and bicarbonate 9 mEq/L. The C-peptide report initially indicated poor pancreatic beta cell reserve (fasting: 0.41 pmol/mL and stimulated: 0.46 pmol/mL). He was diagnosed with diabetic ketoacidosis and responded well to treatment, after which time he was switched to subcutaneous insulin. Ten days later, in the outpatient clinic, his fasting blood glucose was 132 mg/dL, postprandial blood glucose was 183 mg/dL, and C-peptide had improved to fasting: 0.89 pmol/mL and stimulated: 1.42 pmol/mL. Considering the presence of acanthosis nigricans on the neck, a body mass index in the overweight range, a positive family history of diabetes, and negative tests for pancreatic autoantibodies, an early onset diagnosis of type 2 diabetes mellitus was considered. Insulin was gradually withdrawn, and he was switched to metformin. Sustained recovery of C-peptide in this case indicates that lack of insulin at admission was due to beta cell stunning, rather than a total and irreversible loss of beta cells as expected in type 1 diabetes mellitus. Beta cell stunning is often reversible, as shown in this case.
Biodiversity and Diabetes: Is There a link?
Authors: Mohan Viswanathan , Uma Sakthy Gunasekaran , Shobana Shanmugam , Thomson Jacob Chelladurai
Published: July 2024

India is rich in agrobiodiversity and is considered to be one of the important countries for production of food, oilseed and horticultural crops, spices, and medicinal plants. However, the prevalence of noncommunicable diseases (NCDs) such as type 2 diabetes (T2D) and obesity has been rapidly increasing in India due to unhealthy food habits, for example, changing from healthy unpolished brown rice to highly polished white rice. Bringing back our traditional foods such as millets and making use of India’s rich biodiversity could help improve the health of its population and help in preventing and control of NCDs such as T2D.
Sun Exposure Characteristics among the Indian Population Who Are at Risk for Type 2 Diabetes Mellitus: A Population-Based Cross-Sectional Study
Authors: Binna Sunita , Kodali Prakash Babu , Sharma Hemanshu , Nair Pradeep M. K.
Published: July 2024

Background and Aim:

Evidence suggests a beneficial effect of sun exposure on type 2 diabetes mellitus (DM). However, little is known about the characteristics of sun exposure among DM patients or individuals at risk of developing DM. The aim of this study was to analyze the sun exposure behaviors of individuals diagnosed with DM and those susceptible to developing DM within a semi-urban community in North India.

Materials and Methods:

A population-based cross-sectional study was conducted in northern India with 494 participants aged 25–60, with or without DM. The participants’ sun exposure characteristics were assessed through a sunlight exposure questionnaire, and total sun exposure in a day was computed using the veritable sun exposure (VSE) index. Fasting blood sugar, anthropometric measurements, and demographic details were also collected.

Results:

The study had 56.5% female participants, and 9.1% of the participants had DM. The VSE of the study participants ranged from 0.01 to 0.81, with a mean of 0.15 (±0.14) and a median of 0.10, indicating that more than half of the study samples had less than 10% h/day of sunlight exposure. The use of sunscreen, gender, and disease status all influenced VSE. Our data suggest that the characteristics of sun exposure among Indians significantly deviate from standard recommendations.

Conclusion:

Our results propose a need for evidence-based guidelines and policies that promote awareness about sun exposure among DM patients as well as those at risk of developing DM. Nevertheless, these findings need to be validated through large-scale observational studies.
Demographic and Socioeconomic Determinants of Noma (Cancrum Oris) and Strategies to Reverse the Trend
Authors: Bala Mujtaba , Sulaiman Amidu Omotayo , Taiwo Abdulrazaq Olanrewaju , Braimah Ramat Oyebunmi , Ibikunle Adebayo Aremu , Bello Abubakar Abdullahi , Abdulazeez Shafiu Isah , Olayemi Lukman Adeniran , Jaafar Rufai , Kaura Abubakar Mohammad
Published: July 2024

Background:

Noma is a major cause of mortality and morbidity in Nigeria and other sub-Saharan African countries with dire far-reaching consequences on the precarious health system and socioeconomic situation of the vulnerable population of the region.

Aim:

This study aimed to describe the demographic and socioeconomic determinants of noma patients and proffer workable strategies to check the trend.

Materials and Methods:

Relevant clinical data of the subjects such as demographics, socioeconomic factors, clinical outcome, and length of hospital stay were recorded and analyzed using SPSS version 25.

Results:

A total of 178 case records of patients managed with noma were included and there were 76 (42.7%) males and 102 (57.3%) females. The age range of the study subjects was 1-33 years with mean±SD of 6.23±4.63. The majority of the subjects 172 (96.6%) were from rural communities, farming 126 (70.8%) was the main source of income of the study subjects. All the subjects were from poor households with low socioeconomic status and most of the subjects 175 (8.3%) were not enrolled in formal education. Measles 81 (45.5%) and malnutrition 78 (43.8%) were the most common risk factors identified. Good clinical outcome was recorded with 23 days average length of hospital stay.

Conclusion:

Demographic and socioeconomic determinants play a crucial role in the occurrence of noma and attention to vulnerable age groups by removing health inequities, fair distribution of resources, and poverty alleviation and improving the living conditions of the affected people would lead to the eradication of the scourge.
Effect of HIV-Integrated Care on Uptake of Maternal Health and Routine Childhood Immunization Services at Primary Health Care Facility in Northern Nigeria: An Interrupted Time Series Analysis
Authors: Lawan Umar Muhammad , Akparibo Robert
Published: July 2024

Background:

This study assessed the effect of HIV-integrated care delivered within routine primary health care (PHC) in Kano, Nigeria, on the uptake of maternal health and routine childhood immunization services.

Methods:

A retrospective cohort design was used to review and collect anonymized data from medical records of women and children who accessed health care from the PHC facility between January 2009 and December 2016. Data were analyzed using SPSS version 22. Interrupted time series analysis (ITS) was performed to estimate changes in maternal and childhood immunization service usage over time following the delivery of the integrated care.

Results:

Uptake of maternal health services increased over time: antenatal care attendance (effect/month [95% confidence interval (CI)]: 6.6 [44.55–8.65], P = 0.0001), family planning (effect/month [95% CI]: 1.3 [0.26–2.26], P = 0.014), and delivery (effect/month [95% CI]: 0.9 [0.39–1.45], P = 0.0009). Uptake of routine immunization also increased over time with the integrated care: Bacille Calmette Guerin (BCG) (Effect/month [95% CI]: 1.8 [0.64–2.88], P = 0.002), and diphtheria, tetanus, and pertussis 1 (DPT1)/Penta 1 vaccinations (Effect/month [95% CI]: 1.0 [0.20–1.73], P = 0.013) also showed a moderate increase over time, but DPT3/Penta 3 vaccination dropped gradually over time (Effect/month [95% CI]: −0.1 [−0.74–0.46], P = 0.649).

Conclusion:

The integrated care resulted in increased uptake of both maternal health and childhood routine immunization services. This suggests that the reorganization and restructuring of the HIV-integrated care in the Kumbotso Comprehensive Health Centre has had a positive impact on non-HIV services provided at the center. There are still opportunities for further research to refine and elaborate on the novel findings of this study.
Intimate Partner Violence among Antenatal Women of Rural Area: A Cross-sectional Study
Authors: Sharma Arvind , Patel Sunita , Lilhare Anant Kumar , Yadav Kuldeep Singh , Dhakar Jagmohan Singh
Published: July 2024

Background:

“Domestic violence” is defined as “a pattern of behavior in any relationship that is used to gain or maintain power and control over an intimate partner.” Intimate partner violence during the phase of pregnancy enhances the risk of abortion, preterm birth, low birth weight babies, and intrauterine death.

Aim & Objective:

To assess the prevalence of intimate partner violence among antenatal women and its association with various sociodemographic and obstetric factors.

Materials & Method:

This was a cross sectional community based study which was carried out in the rural area of district Jabalpur (M. P.) among 230 pregnant women for period of 1 year (March 2021–February 2022) Intimate partner violence was assessed by using HURT, INSULT, THREATEN, and SCREAM scale.

Results:

Prevalence of intimate partner violence was 29 (12.6%) among antenatal women. Strong correlation was found between age of respondents with intimate partner violence (P = 0.026). Physically hurt, insult or talk down, threaten with physical harm, and scream or curse were reported by 29.6%, 51.3%, 33.9%, and 54.8% antenatal women, respectively.

Conclusion:

Health care workers at ground level are most important personnel to screen out antenatal women for intimate partner violence due to multiple contacts during the course of pregnancy and it should be included in routine antenatal care.
Knowledge and Attitude of Homeopathy Doctors Attending the Modern Pharmacology Bridge Course toward Psychiatry – A Cross-sectional Study
Authors: Saka Deepti , Ransing Ramdas , Nanaware Sagar Subhash , Pevekar Krishna , Padma Kumari
Published: July 2024

Aim:

The aim of the study is to assess the knowledge and attitude of homeopathy doctors attending modern pharmacology course toward psychiatry. This is the first ever course approved by the state government of Maharashtra in India for registered homeopathy practitioners. We have considered them as our study group because they work at a grassroots level and are the first level of contact between the individual and the health system.

Methodology:

One hundred subjects were included in the study. A semi-structured questionnaire was used to assess their knowledge and attitude toward psychiatry. Informed consent was obtained from all the participants.

Results:

Of the 48 participants included in the study, most belonged to ages 44–53 years, with 83.4% of males. All had completed a degree before 2000 AD with about 50% of the sample having completed a bachelor’s degree. Of these, 74.5% had more than 20 years of homeopathic practice. Based on the Attitudes Toward Psychiatry-30 questionnaire, majority of the sample had a negative attitude toward psychiatry.

Conclusion:

Most of the traditional homeopathy doctors carry a negative or neutral attitude toward the field of psychiatry and its therapeutic interventions.
Trevor’s Disease Managed by Epiphyseal Osteotomy and Excision: Novel Surgical Technique
Authors: Regmi Anil , Garg Varun , Gowda Rohan , Maheshwari Vikas K. , Sharma Cury , Singh Vivek
Published: July 2024

A number of treatment options for Trevor’s disease based on the patient’s symptoms have been mentioned in the literature. An epiphyseal osteotomy, however, has not yet been covered in any publication report. We report a rare case of Trevor’s illness affecting the fifth metatarsal head, presenting as a painless fifth toe valgus deformity. At 1-year follow-up, treatment options such as osteochondroma excision and medial closing wedge epiphyseal osteotomy produced satisfactory clinical and radiological results. Trevor’s disease can be safely managed with the aforementioned approach, although it does require follow-up until the patient reaches the age of fusion of the epiphysis.