bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrocardiography signal processing method for effective assessment of a patient's heart rate using a convolutional neural network
Authors: Gordienko Daniel V. , Kravchenko Artem O.
Published: July 2024

BACKGROUND: The initial step in annotating an electrocardiogram is the evaluation of the patient's heart rhythm. In the presented study, a method has been developed to process the electrocardiographic signal and estimate the heart rhythm. The method is based on the application of a trained convolutional neural network, which will provide the physician with preliminary information about possible atrial fibrillation or the presence of other rhythm disturbances as soon as possible after receiving the electrocardiogram. Furthermore, such methodologies can be incorporated into telemedicine systems, thereby facilitating remote monitoring of cardiac status.
AIM: The aim of the study was to develop an electrocardiography signal processing method for the classification of a patient’s heart rhythm into three classes: sinus rhythm, atrial fibrillation, and other arrhythmias.
MATERIALS AND METHODS: The publicly available electrocardiograms of patients were selected for model training and testing. The software was written in the Python programming language using the TensorFlow framework. The training, validation, and test samples were formed with a ratio of 10:1:1:1, with a uniform distribution by classes. Three variants of data sets for each record were prepared: combining plots of all 12 leads of the electrocardiogram on one image, obtaining spectrograms of II and V1 leads using Gaussian wavelet, and representing the record as a vector cardiogram. The architecture of the convolutional neural network was based on the ResNet18 architecture, which was further modified, and a series of modifications were made for each of the input data representations.
RESULTS: A serialized model was obtained with the following accuracy metrics: accuracy=43% for matching 12 electrocardiographic leads in the image; accuracy=43% for vector representation of the electrocardiogram; and accuracy=69% for wavelet transform of the electrocardiogram. In the case of a two-class problem involving sinus rhythm and atrial fibrillation, the accuracy metric for the wavelet transform reaches 93% with metrics recall, precision, and F1-score values of 93%, 94%, and 93%, respectively.
CONSLUSIONS: The results demonstrate the potential of using convolutional neural networks to assess the heart rhythm of patients. Further development of the project involves the selection of the most effective machine learning algorithm, testing of this algorithm for the two-class problem, and expansion of the solution for other classes of rhythm disorders. Additionally, it is possible to improve classification results for the three-class problem by using a superior model and introducing additional clustering.
Radiomics for diagnosing clinically significant prostate cancer PI-RADS 3: what is already known and what to do next?
Authors: Tyan Alexandra S. , Karmazanovskij Grigoriy G. , Karelskaya Natalia A. , Kondratyev Evgeniy V. , Kovalev Alexander D.
Published: July 2024

BACKGROUND: Prostate cancer is currently the second most commonly diagnosed cancer in men. The second edition of the Prostate Imaging Magnetic Resonance Imaging Data Assessment and Reporting System (PI-RADS) was released in 2019 to standardize the diagnostic process. Within this classification, the PI-RADS 3 category indicates an intermediate risk of clinically significant prostate cancer. There is currently no consensus in the literature regarding the optimal treatment for patients in this category. Some researchers advocate for biopsy as a means of further evaluation, while others propose a strategy of active surveillance for these patients.
AIM: The aim of this study is to analyze and compare existing diagnostic models based on radiomics to differentiate and detect clinically significant prostate cancer in patients with a PI-RADS 3 category.
MATERIALS AND METHODS: A comprehensive search of the PubMed, Scopus, and Web of Science databases was conducted using the following keywords: PI-RADS 3, radiomics, texture analysis, clinically significant prostate cancer, with additional emphasis on studies evaluated by Radiology Quality Score. The selected studies were required to meet the following criteria: (1) identification of PI-RADS 3 according to version 2.1 guidelines, (2) use of systemic biopsy as a control, (3) use of tools compatible with the IBSI standard for analyzing radiologic features, and (4) detailed description of methodology. Consequently, four meta-analyses and 12 original articles were selected.
RESULTS: Radiomics-based diagnostic models have demonstrated considerable potential for enhancing the accuracy of detecting clinically significant prostate cancer in the PI-RADS 3 category using the PI-RADS V2.1 system. However, studies by A. Stanzione A. et al. and J. Bleker et al. have identified quality issues with such models, which constrains their clinical application based on low Radiology Quality Score values. In contrast, the works of T. Li et al. and Y. Hou et al. proposed innovative methods, including nomogram development and the application of machine learning, which demonstrated the potential of radiomics in improving diagnosis for this category. This indicates the potential for further development and application of radiomics in clinical practice.
CONCLUSIONS: Although the models developed today cannot completely replace PI-RADS, the inclusion of radiomics can greatly enhance the efficiency of the diagnostic process by providing radiologists with quantitative and qualitative criteria that will enable the diagnosis of prostate cancer with greater confidence.
Современный подход к диагностике и лечению Hallux valgus. Обзор литературы
Authors: Semenistyy Maksim N. , Ochkurenko Alexander A. , Semenistaya Oksana A. , Osmanov Daniil I.
Published: July 2024

Hallux valgus is a common deformity of the forefoot characterized by various clinical symptoms and reduces the quality of life of patients of various age groups. This literature review used the databases eLIBRARY.RU, Google Scholar, and PubMed and is a nonsystematic analysis. Studies describing various aspects of diagnosis, treatment, and development of complications of hallux valgus deformity of the forefoot were analyzed. The present article describes instrumental diagnostics, criteria for assessing the stage of the pathological process, and approaches and methods for surgical correction of deformity.
Current status and future directions of systemic therapy in high-grade bone sarcomas
Authors: Machak Gennady N.
Published: July 2024

Chemotherapy combined with radical surgery is the gold standard treatment for high-grade bone sarcomas. The number of cured patients has remained unchanged over the past decades. Approximately 30% of patients with stage IIB tumors, 70% with stage IIIB tumors, and more than 80% of recurrent bone sarcomas are resistant to currently used chemotherapy regimens and ultimately die from the disease. Currently available targeted therapies, mainly multiple tyrosine kinase inhibitors, are not curative, but a significant proportion of patients with advanced sarcomas achieve disease stabilization. This opens up the possibility of combining local and systemic treatments to consolidate clinical response, reduce tumor burden, and prolong progression-free interval. The optimal combination of systemic and local treatment methods (surgery, radiation therapy, radiosurgery) makes it possible to impact metastatic lesions, transforming an advanced tumor process into a chronic disease in responding patients. Early detection of relapse may improve the effectiveness of systemic treatment due to low tumor burden and lack of established resistance mechanisms. Future directions in the field of advanced sarcoma include the development of personalized treatment approaches and further studies of tumor biology based on “omics” technologies.
İntrakraniyal anevrizma cerrahisi sırasında kan akımının geçici olarak durdurulması yöntemleri
Authors: Güneş Yasemin , Laflı Tunay Demet
Published: June 2024

Yüksek morbidite ve mortalite oranına sahip serebral anevrizmaların tek etkili tedavisi endovasküler veya cerrahi onarımdır. Bu girişimler, anevrizmaya sekonder subaraknoid kanamayı (SAK) tedavi etmede, daha fazla morbiditeyi engellemede ve aynı zamanda henüz rüptüre olmamış anevrizmalarda SAK’ı önlemede kullanılır. Serebral anevrizmaların, mikrocerrahi teknik ile anevrizmanın boynuna bir klip yerleştirilerek uygulanan cerrahi tedavisi etkili ve güvenli prosedürler olmakla birlikte belirli zorlukları da içerir. Özellikle de büyük yapılı, kritik serebral ve vasküler yapılara yakın ve derin yerleşimli anevrizmalarda klipaj aşaması oldukça kritiktir. Cerrahi anevrizma tedavisiyle ilişkili riskler arasında beyin retraksiyonu, geçici arteriyel tıkanıklık ve intraoperatif kanamanın neden olduğu yeni veya kötüleşen nörolojik defisitler yer alır. Bu riskleri azaltmak için, anevrizma boynunun klipajı aşamasında kan akımını geçici olarak durdurmada veya azaltmada kullanılan çeşitli yöntemler tanımlanmıştır. Bunlar arasında, hızlı ventriküler pacing (RVP), derin hipotermik kardiyak arrest (DHCA) ve adenozin kaynaklı hipotansiyon ve asistoli yer almaktadır.
Anahtar sözcükler: Adenozin-ilişkili kardiyak arrest, intrakraniyal anevrizma cerrahisi, geçici kalp durması, kan akımı
Farmakovijilansın Önemi: Sahte ve Standart Altı İlaçlar
Authors: Karataş Yusuf
Published: June 2024

The scope of pharmacovigilance has expanded dramatically in recent years. In addition to the need of monitoring adverse drug reactions, it also involves counterfeit/substandard drugs, drug efficacy issues, misuse, and drug abuse. It is documented that among the drugs used for the treatment of patients with a high demand are counterfeited. All healthcare professionals (medical doctor/physicians, pharmacists, dentists, nurses, midwives, and paramedics) must raise awareness about counterfeit/substandard pharmaceuticals, as well as promote preventive measures in this area. The purpose of this review was provide information about counterfeit and substandard drugs that may lead to an increase morbidity and mortality in humans. This article emphasizes the importance of a pharmacovigilance system to combat hazardious effects of counterfeit/substandard drugs on public health.

Farmakovijilansın kapsamı son yıllarda önemli ölçüde genişlemiştir. Advers ilaç reaksiyonlarının önemi ve izlenmesine ilaveten sahte/standart altı ilaçları, ilaçların etkinliğinin eksikliğini, yanlış kullanımı, ilacın kötüye kullanımını da içermektedir. Hastaların tedavisi kullanılan ilaçlardan yüksek oranda talep edilen pahalı ilaçların sahtelerinin yapıldığı belirtilmektedir. Tüm sağlık çalışanları (tıp doktorları, eczacılar, diş hekimleri, hemşireler, ebeler, ve paramedikler), sahte/standart altı ilaçları vd. farkındalıkların artırılması ve bu konuda önleyici çalışmaların artırılması gerekmektedir. Bu derlemenin amacı, insanlarda morbidite ve mortalitede artışa yol açabilecek sahte ve standart altı ilaçlar hakkında bilgi vermektir. Bu derleme, sahte/standart altı ilaçların halk sağlığı üzerindeki zararlı etkileriyle mücadele etmek için farmakovijilans sisteminin önemini vurgulamaktadır
Hamilelikte Bitkisel Ürün Kullanımının Etkinliği ve Güvenliği
Authors: Ertuğ Peyman , Gidener Sedef
Published: June 2024

Hamilelik sırasında bitkisel ürünlerin çok yaygın kullanımına rağmen, bu tedavilerin spesifik olarak değerlendirilmesine yönelik çok az çalışma bulunmaktadır. Hiperemezis gravidarum için zencefil takviyesi dışında, aslında hamile kadınlarda başka herhangi bir bitkisel tedavinin kullanımı için klinik bir endikasyon yoktur. Aksine, vaka raporları ve epidemiyolojik çalışmalardan elde edilen kısıtlı sayıdaki veriler, bazı bileşiklerin kullanımına ilişkin uyarılara sahiptir. Bitkilerin hamilelik veya doğum üzerinde etkileri olabilir, reçeteli ilaçlarla etkileşimleri olabilir ve fetüs için potansiyel olarak ciddi komplikasyonlara neden olabilir. Bu nedenle özellikle hamilelikte bitkisel ilaç öyküsü almak önemlidir.
The genetics of autoimmunity in the rat
Authors:   , Martin Anne-Marie , Blankenhorn Elizabeth P
Published: June 2024

Multiple sclerosis (MS) and insulin dependent diabetes mellitus (IDDM) are complex autoimmune diseases, where both genetic and environmental factors contribute to disease etiology. Because of the complex nature of both diseases, identification of non-MHC-linked genes has been difficult. The identification of non-MHC-linked genes in autoimmune diseases is the focus of this dissertation. Lewis (LEW) rats are susceptible to the induction of experimental allergic encephalomyelitis (EAE), the rodent model for MS. The histocompatible Lewis-resistant (LER) is a sub-strain of LEW and is resistant to EAE induction. We have investigated genetic differences between these two rat strains. We conducted microsatellite analysis to identify polymorphisms between the two strains on a whole genome scale. Using microsatellite analysis, we have shown that the LER rat strain is derived from LEW rats and Buffalo rats. The linkage on chromosome 4 encompasses the [special characters omitted] gene locus and is linked to disease severity. This is of interest to us, given the fact that there are allelic differences in the TCR [special characters omitted] gene between LEW and LER and that one of the LER-specific-clusters is also found in this region on chromosome 4. The diabetic-prone Bio-breeding (DP-BB) rat is an excellent model for studying IDDM. DP-BB rats spontaneously develop IDDM at approximately 60-80 days of age. The Wistar Furth (WF) rat is MHC-compatible with DP-BB, but does not spontaneously develop IDDM. One of the genes controlling IDDM in the DP-BB rat is the lymphopenia (lyp) gene, which causes depletion of a regulatory (RT6+) subset of T cells in the periphery of DP-BB rats. Lyp is recessive, so to create homozygous lyp/ lyp progeny, previous genetic crosses have been generated in the direction of the susceptible DP-BB parent. Using an induction protocol that depletes peripheral RT6+ T cells, we have mimicked the activity of lyp and can induce IDDM in otherwise resistant F1 animals. We generated a (DP-BB x WF) F1 x WF backcross, and we show that IDDM segregates among the backcross progeny following the induction protocol. This has enabled the identification of novel genes that contribute to phenotypes related to IDDM. To investigate the role of iddm4 and to determine that it is a different gene to lyp, we generated a backcross between the diabetic-resistant (DR)-BB rat and WF rat strain. DR-BB rats are a histocompatible sub-strain of the DP-BB rat. DR-BB rats share 85% of their genomic markers with DP-BB, but they express the wild type lyp gene and do not spontaneously develop IDDM. However, following the RT6+ T cell depletion protocol for IDDM induction, DR-BB rats develop diabetes. (Abstract shortened by UMI.).
DCAS supports cell polarization and cell-cell adhesion complexes in development
Authors:   , Tikhmyanova Nadezhda , Golemis Erica
Published: June 2024

Oncogenes or tumor suppressors have been found to play critical roles in cancer and organismal development. However, It is frequently difficult to assess their developmental roles in humans and other mammals, because of the complexity of signaling pathways. The human Cas protein family has 4 members in mammals (BCAR1/p130Cas, NEDD9/HEF1/Cas-L, EFS/Sin1, and CASS4/HEPL), some of which are known to function as oncogenes in inducing metastasis and providing other growth advantages to tumors. To understand if there is a Cas role in development, we created a new genetic Dcas model in Drosophila, which has only a single Cas family member. Loss of Dcas causes 10% of flies to die as embryos from a prominent morphogenic defect affecting dorsal closure. However, Dcas is an important modulator of the phenotypic severity of mutations affecting integrins (If and mew) and their downstream effectors Fak56D or Src42A. Fak56D-Dcas double mutant embryos were embryonal lethal, and had extensive cell polarity defects, including mislocalization and reduced expression of E-cadherin. Further genetic analysis established that loss of Dcas intensified the embryonal lethal phenotypes of mutations in E-cadherin (Shg) or its signaling partners p120- and [beta]-catenin (Arm). Dcas also specifically inhibits the ability of Shg to localize to cell-cell junctions, influencing cell morphology and polarity. These results support an important role for Cas proteins in cell-cell adhesion signaling in development and suggest that human Cas genes may act as important modifiers in human development. We also performed mammalian genetic studies of the role of NEDD9 in mammary tumor development, and a companion study aimed at identifying proteins governing resistance to EGFR-targeting drugs, which identified NEDD9 as one hit from a screen. We found that loss of NEDD9 delays mammary tumor formation, and that together with BCAR1, NEDD9 contributes to the survival of cells treated with EGFR inhibitors. The molecular mechanisms supporting Cas-dependent tumor growth and drug resistance implicate activation of its mammalian and Drosophila partners FAK and Src, translating our finding from Drosophila to other in vivo systems, and indicating Cas function in fruit fly provides important clues to Cas-dependent regulation of tumor growth and drug resistance.
Longitudinal cocited author mapping and intellectual structure
Authors:   , McCain Katherine Wootton
Published: June 2024

This research presents: (1) a description of the changing intellectual structure in two subject areas-macroeconomics and Drosophila genetics; (2) a validation of those observations using judgments collected directly from subsets of citing authors. Cocitation data on forty-one authors in macroeconomics and forty-nine authors in Drosophila genetics are collected over two consecutive time periods. The authors' names, representing cited bodies of work, are the units of analysis. Non-metric multidimensional scaling of cocitation profile data is used to create two-dimensional maps of authors in each time period. Authors with similar profiles are clustered using Johnson's "smallest diameter" method. Changes in structure are evaluated using canonical correlation of map coordinates and inspection of cluster membership. In the validation study, independent judgments of inter-author similarity are used as a metric of perceived intellectual structure. These data, collected from fourteen macroeconomists and fifteen Drosophila geneticists via a single card sort technique, are similarly mapped and clustered. In each field, congruence between a two-dimensional map of author clusters (deriving from the aggregate similarity judgments) and the more recent cocitation map and clusters is assessed using canonical correlation. Cocited author mapping is a valid representation of the intellectual structure in both macroeconomics and Drosophila genetics. In macroeconomics, differences between maps and clusters represent the influence, on judgments, of individual authors' perceived policy orientation. In Drosophila genetics, differences result from a time lag between the knowledge of authors' recent work and the incorporation of that work into the formal literature. The nature of author clusters is field-specific: author clusters in macroeconomics represent primarily schools of thought; almost all the author clusters in Drosophila genetics represent research specializations. Maps in both fields consistently display one dimension corresponding to subject orientation of authors. The other dimension corresponds to a field-specific aspect of scholarly "style". Cocited author structure is remarkably stable from one time period to the next. Movement of authors is interpretable: spatial relocation and cluster reassignment of individual authors represents "active migration" (resulting from authors' changed research interests) or "passive migration" (resulting from changes in the use of previously published work).
Caracterización y función del concepto jurídico de familia en la jurisprudencia de la Corte Suprema chilena
Authors: Turner Saelzer Susan , Zúñiga Añazco Yanira
Published: July 2024

El trabajo aborda las dificultades de conceptualizar jurídicamente la familia considerando la confluencia actual de diversos órdenes normativos (civil, constitucional e internacional), que inciden en la materia y que, además, operan en un contexto de cambios sociales. Ahonda en la comprensión que la Corte Suprema de Chile ha hecho de la familia en su jurisprudencia, concluyendo que, al igual que el Tribunal Europeo de Derechos Humanos, ella ha optado por una interpretación dinámica y funcional a las particularidades del caso concreto, a la materia del conflicto y a la persona que solicita el amparo jurisdiccional. Con ello se aleja de la pretensión de fijar un concepto único y omnicomprensivo de familia.
Childbirth experience of mothers attending selected secondary hospital
Authors: Moni Mahfuja Khatun , Tripty Nabila Nusrat , Sarmin Tanjina , Joty Afroza Tasnim , Suchona Sadia Haque , Tamanna Tanjeemay , Begum Fakrunnesa , Biswas Gayatree
Published: June 2024

Background: Childbirth experience is an important event in every woman’s life but there is lack of current research in this area in Bangladesh. For improving quality of care for pregnant women during childbirth, clinical care modalities should be designed to improve the experience of care by the mothers. The aim of the study was to assess the childbirth experience in regards to respectful maternity care, effective communication, companionship during childbirth and continuity of care.
Methods: A cross-sectional study was conducted between January to December 2020 among 98 mothers during facility-based childbirth in one model district hospital and one existing district hospital situated in northern part of the country.
Results: Mean age of the respondents was 23.2 years (+SD 5.0). Majority completed secondary education (53.1%), and their average monthly family income was 12081.63 taka (+SD 5469.08). Childbirth experience was not associated with socio-demographic status and educational background (P>0.05). This study presents data on physical abuse prevalence and consent refusal rates among respondents, stratified by age groups, educational levels, and monthly family income. Despite variations observed across demographics, statistical analysis, including chi-square tests with continuity correction, revealed no significant differences (P<0.05) in these outcomes based on demographic factors.
Conclusions: More than half of the mothers experienced non consented care and around one fourth of mothers being physically abused during childbirth.
Correlation of axial length and corneal power with refractive status of patients with refractive error in Kano, North-Western Nigeria
Authors: Mahmud Muhammad U. , Ibrahim Umar F. , Isyaku Mohammad , Hassan Sadiq , Ebisike Philips I. , Sani Rabi Y.
Published: June 2024

Background: Uncorrected refractive errors are a major cause of blindness and low vision. Determination of the etiology is essential in planning appropriate treatment modalities. Aim of this study was to determine the correlation between axial length and corneal power with refractive status of patients with refractive error in Kano, Nigeria.
Methods: Observational cross-sectional study in which 385 eligible patients were recruited. Relevant history was obtained from the patients and ocular examination was done. Objective and Subjective refraction were performed. Spherical equivalent was calculated for patients with astigmatism. Keratometric readings (k1 and k2) and measurement of axial length were taken. Data was analyzed using the statistical package for the social sciences (SPSS) version 22.
Results: Statistically significant inverse association (r=-1.7, r2=56.8%, p<0.0001) was found between Spherical equivalent objective refraction and axial length of right eye. Statistically significant inverse association (r=-1.2, r2=53.3%, p<0.0001) was found between Spherical equivalent subjective refraction and axial length of right eye. Statistically significant inverse association (r=-0.5, r2=8.5%, p<0.0001) was found between spherical equivalent objective refraction and corneal power of the right eye. Statistically significant inverse association (r=-0.3, r2=6.4%, p<0.0001) was found between spherical equivalent subjective refraction and Corneal power of right eye. Negative correlation   existed between axial length and corneal power but was not statistically significant (r=-0.0, p<0.4).
Conclusions: The study established that axial length and corneal power are the determinants of refractive status and that axial length is a stronger determinant.
Assessment of lead augmented vector left (aVL on surface electrocardiogram) for confirming atrioventricular nodal reentrant tachycardia
Authors: Hamid M. Abdul , Ahmed Mohsin , Islam A. F. M. Rezaul , Aktar M. Shameem , Rahman Atikur , Sonali Tahmina Alam
Published: June 2024

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) stands as one of the most common forms of paroxysmal supraventricular tachycardia (PSVT), encompassing a wide spectrum of clinical presentations and diagnostic challenges. The aim of this study was to evaluate the assessment of lead aVL (surface ECG) for confirming AVNRT.
Methods: This was a prospective observational study and was conducted at the Department of Cardiology and Electrophysiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh during the period from February 2019 to January 2020.
Results: In our study 41 patients (66.1%) had AVNRT and 21 patients (33.9%) had AVRT on the final evaluation. Total 33.9% of patients had aVL notch on ECG. Among patients who had AVNRT, 46.3% had an aVL notch and among patients who had AVRT, 9.5% had an aVL notch on ECG. The difference was statistically significant (p=0.004). Among 21 patients who had aVL notch on ECG, 6 (31.6%) male patients had AVNRT, 13 (64.8%) female patients had AVNRT, 1 (50%) male patients had AVRT and 1 (50%) female patient had AVRT.
Conclusions: In conclusion, the interpretation of electrocardiographic criteria, including the aVL notch, plays a pivotal role in confirming the diagnosis of AVNRT and guiding therapeutic interventions.
Correlation of diagnostic accuracy of computed tomography with magnetic resonance imaging in local staging of carcinoma rectum at tertiary care center
Authors: Danish Mozaffar , Bhat Shreya , Sharma Sachin , Ahmad M. Shamim
Published: June 2024

Background: Rectal cancer is third most common cancer related death worldwide. Cross sectional imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI) play a major role in preoperative staging. En-bloc resection of mesorectum and preoperative neoadjuvant chemoradiotherapy has significant role to reduce postsurgical recurrence.
Methods: A cross-sectional observational study was conducted in the department of radiology, Narayan medical college and hospital Sasaram over a period of 12 months from August 2022 to September 2023. A total of 40 patients with biopsy proved rectal carcinoma were included, Local staging of carcinoma rectum was performed using MRI pelvis, MDCT abdomen and pelvis, the results were analysed and correlated.
Results: The current study is aimed to correlate the diagnostic accuracy of CT with MRI in local staging of carcinoma rectum. Rectal cancer was more common in elderly mostly above 50 years of age. 65% of the cases showed irregular circumferential wall thickening and 35% showed polypoidal growth. On correlating with MRI, CT showed an overall good sensitivity, specificity, and accuracy in diagnosing tumor staging, mesorectal fascia (MRF) involvement and extramural vascular invasion (EMVI). CT can be considered as a reliable imaging modality for local staging of rectal cancer.
Conclusions: MRI and MDCT both are complementary imaging modalities in preoperative staging of rectal cancer. MRI is the best available imaging modality for the local staging of patients and has the potential to play an important role in accurately differentiating which patients should receive preoperative chemoradiation prior to total mesorectal excision. CT can be considered as a reliable imaging modality for assessing local staging of rectal cancer.
Prediction of esophageal varices in cirrhosis by using splenic stiffness measurement
Authors: Behera Sanatan , Behera Manas Kumar , Jena Sushanta Kumar , Mahapatro Arupam
Published: June 2024

Background: Predicting esophageal varices in cirrhosis using the measurement of splenic stiffness is an exciting area of study. Vein enlargement in the lower esophagus, known as varices, is a common symptom of cirrhosis caused by portal hypertension. These varicose veins are potentially fatal since they bleed easily. The present study aims to predict the OV in cirrhosis patients by splenic stiffness in and around this region.
Methods: After receiving permission from the Institutional Ethics Committee, the study was performed. The present study authors measured splenic stiffness and liver stiffness by using FibroScan in 112 consecutive cirrhotic patients who met the inclusion criteria. Patients were also assessed by hepatic venous pressure gradient (HVPG), upper gastrointestinal endoscopy, liver stiffness, liver spleen diameter to platelet ratio score, and platelet count to spleen diameter ratio.
Results: Among 112 patients enrolled, 64 patients had valid liver stiffness and splenic stiffness measurement, and 64 patients had EV (small, n=23 and large n=42). There was a significant difference in median liver stiffness (54.2 vs. 21.3 kPa, p<0.05), splenic stiffness (56.1 vs. 30 kPa, p<0.05), liver spleen diameter to platelet ratio score (6.3 vs. 2.7, p<0.05), and platelet count to spleen diameter ratio (798 vs 1,241, p<0.05) between patients with OV and those without OV.
Conclusions: Non-invasive markers, such as splenic stiffness, may help identify individuals with cirrhosis who are at risk of having esophageal varices, especially large ones, and who are at risk of bleeding, the study's authors conclude.
Clinical spectrum of hypocalcaemia in children
Authors: Ramdasi Aboli V. , Wade Minal , Inamdar Nusrat R.
Published: June 2024

Background: Hypocalcaemia is a biochemical abnormality commonly seen in paediatric population with a multi-factorial etiology having varied presentation ranging from acute emergency to chronic diagnostic dilemma. We studied the clinical profile of infants and children presenting with hypocalcaemia from 0 to 12 years of age.
Methods: Clinical features, risk factors, precipitating factors, feeding/dietary practices of all children (0-12 years) visiting our tertiary care centre, from January 2019 to March 2020, diagnosed with hypocalcaemia were recorded and a correlation with serum calcium levels was studied.
Results: Out of 92 patients having hypocalcaemia majority 57 (62%) were males. Majority of participants belonged to age group of 6 months-2 years i.e. 40 (43.48%). The commonest presentation was convulsions present in 39 (42.39%) participants affecting more children less than 2 years of age; whereas majority of children above 2 years of age presented with growth impairment. Risk factors identified were perinatal risk factors, faulty feeding practices in infants, inadequate dietary calcium intake in children, inadequate sun exposure. Amongst the biochemical factors precipitating hypocalcaemia, alkalosis showed significant association (p value 0.016) with degree of hypocalcaemia; most common etiology was vitamin D deficiency and nutritional rickets.
Conclusions: Hypocalcemia plays vital role in infants and growing children because of its various implications on growth and development. Exposure to sunlight, vitamin D and calcium supplementation during pregnancy and lactation and infancy with good dietary calcium intake for children during their growth spurts can prevent complications. Health education and awareness of common risk factors for hypocalcaemia can prove helpful.
Central venous catheter related blood stream infection in tertiary care hospital
Authors: Sawant Ankita R. , Paritekar Anita A.
Published: June 2024

Background: Central venous catheter-related bloodstream infections (CRBSIs) are associated with significant morbidity and mortality in hospitalized patients. Understanding the incidence and risk factors associated with CRBSIs is crucial for implementing effective preventive strategies. The study aimed to examine the incidence and risk factors associated with central venous CRBSIs in a tertiary care hospital setting.
Methods: A prospective observational study was conducted at a tertiary care hospital to investigate the incidence and risk factors of CRBSIs. Patients aged >18 years with a central venous catheter inserted for >48 hours were included. Clinical and microbiological data were collected, and CRBSI rates were calculated. Statistical analysis was performed using SPSS V 23.0.
Results: A total of 50 patients were recruited, with 11 diagnosed with CRBSIs. The incidence of CRBSIs was 8.1 per 1000 central line days and 5.7 per 1000 inpatient days, with a Device Utilization Ratio (DUR) of 0.7. Male gender and older age (>40 years) were significantly associated with CRBSIs (p<0.05). Gram-negative microorganisms were the most commonly isolated pathogens (63.63%), followed by Gram-positive organisms (27.27%) and Candida species (9.09%). Immune system status (p=0.0372) and duration of catheterization (P=0.0035) were found to have a significant association with CRBSI. Mortality was higher in patients with CRBSIs compared to those without (45.45% vs. 28.21%).
Conclusions: CRBSIs remain a significant concern in tertiary care hospitals, with Gram-negative organisms being the predominant pathogens. Male gender and older age were identified as risk factors for CRBSIs. Effective infection control measures targeting high-risk populations are warranted to reduce the incidence of CRBSIs and improve patient outcomes.
Effect of health education on knowledge regarding cervical carcinoma among the female college students of Nadia district, West Bengal
Authors: Debnath Priya , Pal Jayita , Halder Tanudipta , Ghosh Manoj
Published: June 2024

Background: Cervical cancer, the second most common cancer among women globally, causes significant deaths in low- and middle-income countries, including India. This study aims to assess the effectiveness of health education on cervical cancer knowledge among female college students in Nadia district, West Bengal, highlighting the importance of awareness in this priority group.
Methods: A quasi-experimental study was conducted at two government colleges in the Nadia District. It involved three steps: initially, a baseline survey was performed using a pretested questionnaire and checklist to gather socio-demographic data and assess students' knowledge of cervical cancer. This was followed by a three-week intervention phase at the study college. Finally, knowledge scores were reassessed post-intervention at both the study and control colleges.
Results: Baseline comparisons of socio-demographic characteristics and median knowledge score showed no significant difference between the study and control groups (median scores: 4.50 versus 9.00, p=0.431), indicating comparability. Post-intervention, the study college exhibited a significant increase in knowledge scores (median 19, IQR 9.00-24) compared to the control college (median 8, IQR 2.00-12.75). The control college showed no significant change in median knowledge scores post-intervention (pre-test median 9.00, IQR 3-12; post-test median 8.00, IQR 2-12.75, p=0.320).
Conclusions: Structured health education programs with regular reinforcement significantly enhance college students' knowledge of cervical cancer. An integrated approach involving both education and health departments is essential for effective implementation.
Awareness and perception regarding the e-waste management among a population in northern Kerala
Authors: Cheruvalappil Jamaludheen , Suresh Atul , Rajeev Krishnaraj , Manzil Nidha Rafee Zubaida
Published: June 2024

Background: Electronic waste, or e-waste, refers to all items of electrical and electronic equipment (EEE) and its parts that have been discarded by its owner as waste without the intent of re-use. Improper e-waste management can lead to adverse human health effects and environmental pollution. The aim of our study was to assess the knowledge, attitude and practice regarding e-waste management and the factors affecting it.
Methods: This cross-sectional study was conducted from December 2023 to February 2024 in three block panchayats of Malappuram district in Kerala with a sample size of 266 selected using multistage sampling. Data was entered in Microsoft Office and was analysed using statistical package for the social sciences (SPSS) software. Factors affecting the outcome variables was assessed using Chi-square test or Fisher exact test depending on the sample distribution.
Results: Study results showed that 28.9% of the participants had good awareness, 27.1% had average awareness and 44% of the population had poor awareness and on e-waste management. 89.5% of population had a very good perception towards e waste management. Age, gender, type of family they come from, educational factors, occupational factors and socioeconomic class were the factors affecting e-waste management.
Conclusions: Increasing public awareness and educating stakeholders about the hazards of e-waste is crucial. Promotion of campaigns and programs to inform individuals about the proper disposal methods, recycling options, and the importance of reducing e-waste generation through responsible consumption can significantly improve the management of e-waste.
Knowledge, attitude and practice pattern among intensive care nursing staff on eyecare practices in ICU patients
Authors: Thomas Retty Ann , Raghavan Remya , Mahadevan K.
Published: June 2024

Background: Eyecare forms a major part of the care provided to all patients in ICUs. Critical care nurses limited knowledge about anatomy and physiology of eyes and ocular manifestations in critically ill patients can delay the identification and delivery of proper eyecare.
Methods: A hospital based descriptive study among 74 ICU nursing staff was conducted using a well-structured questionnaire. Basic demographic data including age, gender, education, experience in ICU, type of ICU and previous eye training were collected. Questionnaire had 3 parts-knowledge, attitude and practice with 7 MCQs in each. Knowledge assessment was on different ocular signs in patients, their risk factors and management with 2 or more correct responses and a score of 3, 2, 1 or 0 was given. Attitude assessment was regarding the importance of early detection, treatment and prevention of eye diseases. Positive response was given score1, negative response 0. Practice assessment was based on methods and techniques of eyecare followed in ICU.
Results: 54% had 1-5 years experience in ICU. 20.3% were from NSICU. 78% had average knowledge. 86.8% answered the question on high risk for exposure keratopathy correctly. 50% showed good attitude, maximum positive attitude was for the question on the effect of eye care on preventing eye disorders. No correlation was found between attitude and knowledge score. Average practice pattern was shown by 54%. Practice patterns followed included assessment of lid closure in their last duty by 66.2%, eyelid closure assessed hourly by 59.5%, eyedrops instilled 3 hourly and 6 hourly by 36.5% and method of cleaning eyes using distilled water by 41.9%. 50% of nurses cleaned the eyes hourly. 60% staffs did taping for incomplete eyelid closure and 61% followed fixed eyecare protocol.
Conclusions: ICU nurses level of knowledge concerning eye care of mechanically ventilated develop a fixed protocol for eyecare in ICU which will help in systematic management.
Modified Bentall procedure with mitral valve replacement in a patient with Marfan syndrome: a case report
Authors: Raha Sanjay K. , Barua Sumit , Kamrul Hasan M. , Shafiqul Islam M. , Jobaid Hasan M. , Faisal N. Majumder N. , Al-Faraby Mahmodul H. , Roy Kaushik , Sorower Hossain M. , Biswas Smriti K. , Jahan Hosne
Published: June 2024

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder characterized by fibrillin-1 protein abnormalities, predisposing individuals to cardiovascular complications such as aortic root dilation and mitral valve prolapse (MVP). Management often requires surgical intervention, with the modified Bentall procedure being a standard approach for aortic root replacement. However, managing concomitant mitral valve pathology poses additional challenges due to the complex anatomical relationship between the two valves and the prolonged nature of the procedure. We present a case report of a 35-year-old male with Marfan syndrome who underwent a successful simultaneous modified Bentall procedure and mitral valve replacement for concurrent aortic root aneurysm and mitral valve prolapse. Surgical interventions involved meticulous attention to detail to mitigate risks associated with malpositioned coronary ostial sutures, debridement of the severely calcified mitral valve, and achieving hemostasis. Following surgery, the patient exhibited favorable postoperative outcomes, with evidence of optimal valve function and improved systolic and diastolic parameters, indicative of a successful recovery.
Empyema associated with Lemierre syndrome: case report and literature review
Authors: S. Gomez Ulises , Valdez Gustavo A. H. , M. Rojas Jorge , C. Escamilla Juan A. , Q. Melendez Jocelyn N. , G. Villar Marco A. , M. Jimenez Ivan A.
Published: June 2024

Postanginal septicemia, also called Lemierre syndrome, is a metastatic infection that can have multiple complications, including empyema. Therefore, the natural history of the disease begins with an infection of the oropharynx by microbiota from the digestive system, which causes a thrombophlebitis of the jugular vein with septic infiltrations, including into the lungs causing pneumonia, which in turn can generate parapneumonic effusions and/or empyemas. Furthermore, it is a syndrome that was thought to have been forgotten by the era of antibiotics, but with resistance to these antibiotics it has begun to re-emerge. Next, we will talk about a case of a 41-year-old man with no significant pathological history, who entered secondary to a peritonsillar abscess which turned into Lemierre syndrome with a treatment based on broad-spectrum antibiotics and then performed of lung decortication by thoracotomy. Empyema as a complication of Lemierre syndrome is rare and even more so in this post-antibiotic era, so health personnel should have a high clinical suspicion since adequate and timely treatment will help reduce the complications of this disease, as well as like his mortality.
Left site perforated appendicitis associated to midgut malrotation in a patient in the third decade of life: a case report
Authors: Hernandez-Licona Jennifer , Martin Hernández Jesus Antonio , Cutipa-Flores Gainsborough Gonzalo
Published: June 2024

Acute appendicitis represents the most common surgical emergency in the world.  Clinically, it presents with pain in the right iliac fossa. One third of patients presents with pain in another location, secondary to the variability of the anatomical position of the appendix. Acute left appendix is a very rare pathology, and it is commonly associated with congenital anomalies such as intestinal malrotation or situs inversus. The patient in this case, a 30-year-old male, presented with abdominal pain in the epigastrium which later radiated to the hypogastrium. Initially with a diagnosis of suspected gastroenteritis, with no improvement with treatment, it was decided to perform an abdominal tomography, where the left cecal appendix was observed, with increased diameter, associated with signs of midgut malrotation. Diagnostic laparoscopy was performed, and no appendix was identified. It converted to open surgery, revealing small intestine on the right side, colon on the left side and perforated left cecal appendix. Acute left appendicitis it should be suspected early to avoid delay in diagnosis and treatment, and to avoid future complications. Abdominal tomography is a highly sensitive diagnostic tool in the case of acute appendicitis associated with intestinal malrotation. Laparoscopy is the first choice in suspected left appendicitis, but the surgeon must take into account the difficulties that may arise during the procedure, the time of evolution and not delay definitive treatment; it must also decide when open surgery is necessary.
Metachronous multiple primary malignancies: a case report of colon and thyroid cancer
Authors: Bojorquez Kimberly O. , Camacho Leonel , González Mariana , Medina Luis F. , Geraldo Laura M. , Chávez Jesús A. , Vidaurri Karla P. , García Roberto , Bojórquez Dylan A. , Macedo Ricardo , Garibay Leobardo D.
Published: June 2024

Cancer remains a challenging disease for our profession despite the medical and technological advances achieved in recent years. This challenge increases when we encounter multiple primary tumors that significantly modify the prognosis of our patients.
A case study of post traumatic meningitis after a road traffic accident
Authors: Satalkar Durgesh J. , Jaju Madhusudan R. , Jaya B.
Published: June 2024

In road traffic accident cases one of the main reasons for hospitalization is traumatic brain injury (TBI) with subdural hematomas (SDH). The in-hospital course is further complicated by variety of infections including meningitis. A significant concern in the field of bacterial resistance is the multidrug-resistant strain of K. pneumoniae. Due to the dearth of therapeutic options, treating K. pneumoniae infections can be difficult and have an adverse impact on morbidity, mortality, and healthcare-related expenses. Here, we present the case of a 34-year-old polytrauma patient who was in good physical health prior to the road traffic accident. The patient sustained right fronto temporo parietal SDH, frontal contusion, frontal bone fracture, multiple facial bone fracture and CSF rhinorrhoea. He underwent bifrontal craniotomy and ACF repair on the following day. His in-hospital course was complicated by Klebsiella meningitis. He was discharged from the hospital after 25 days of successful treatment of meningitis. In the present study, effective and satisfactory results were achieved through antibiotic therapy which included Colistin IV and intrathecal, Fosfomycin IV, and Tigecycline IV, for a post-operative K. pneumoniae infection. On review day, the CSF analysis had revealed total leucocyte count of 9 and CSF showed no growth.
Non-Hodgkins lymphoma of bilateral eyelids with basal cell carcinoma of nose: a rare case report
Authors: Swer Dorafiona , Mahawar Rahul , Sobita Devi Yumkhaibam , Sangtam Dangtila
Published: June 2024

Malignant tumours affecting the eyelid mainly include basal cell carcinoma. Non-Hodgkin’s lymphoma may occur in almost any part of the body and should be considered in the differential diagnosis of extra lymphoid tumours. Non- Hodgkin’s lymphoma of the eyelid is rare. Rare diseases should be considered in differential diagnoses because they have the tendency for rapid systemic involvement and they may require treatments that are different from the other common diseases. Basal cell carcinoma occurs most frequently at sun-exposed sites, most commonly in the head and neck regions. The aim of any therapy selected for BCC treatment involving the head and neck is to ensure complete removal, functional preservation, and a good cosmetic outcome. Here, we reported a case of a 70-year-old female with non-Hodgkin lymphoma of eyelids followed by basal cell carcinoma of the nose treated with multimodality approach.