bluuebunny/crossref_metadata_2025 huggingface dataset:
Une approche génétique de la poésie de Pham Van Ky
Authors: Aubert-Nguyen Hoai Huong
Published: March 2023

Le présent article se propose de présenter le plurilinguisme littéraire qui caractérise le parcours de Pham Van Ky, en s’intéressant en particulier à son écriture poétique. Celle-ci sera abordée à travers l’étude de deux sonnets de son premier recueil de poèmes, Une voix sur la voie (Aspar, Saigon, 1936) : « Le Quena » et « Le Palanquin », en comparant un manuscrit autographe, daté du 24 avril 1934, avec la version publiée en recueil en 1936, en cherchant à comprendre ce qu’indiquent les évolutions d’un état du texte à l’autre. En effet, si l’auteur adopte les règles prosodiques de la poésie classique française et de la forme fixe qu’il a choisie, il conserve une liberté qu’on essaiera d’interroger et d’interpréter.
Métisse blanche de Kim Lefèvre, ou la rémanence des images
Authors: Yeager Jack A.
Published: March 2023

En 1989, Kim Lefèvre publie sa célèbre autobiographie Métisse blanche qui relate les difficultés d’être une enfant métisse pendant la période de la colonisation française. Quelques années avant son décès en 2021, elle écrit un nouveau volet de son panorama autobiographique inspiré de la vie qu’elle a menée à Paris pendant les premiers mois de son arrivée en France en 1960. Elle appelle son manuscrit « Le territoire du père ». Ce texte inédit peut se lire en miroir avec Métisse blanche. Par rapport à l’autobiographie, il peut être considéré comme une révision des représentations de la culture française de la protagoniste. Il peut également être interprété comme une reprise enrichie du texte publié. Le manuscrit peut également être lu indépendamment, comme un texte du « choc culturel », un nouveau roman qui révèle le courage et l’indépendance de l’autrice face aux épreuves. L’étude de certains épisodes repris du texte publié et celle de deux versions d’un passage inédit concernant un séjour en Suisse nous permettront de discerner l’évolution sentimentale et stylistique de Kim Lefèvre.
Noms de personnes et activités socioprofessionnelles : une identité nominale par le métier exercé
Authors: Yermeche Ouerdia
Published: March 2023

L’onomastique est un domaine de recherche qui étudie les différentes formes dénominatives, toponymiques, anthroponymiques et autres. Cet article étudie une catégorie particulière de l’anthroponymie (ou étude des noms de personne) en l’occurrence « la patronymie professionnelle », noms de personne construits sur des surnoms à base de métiers, pour en comprendre le fonctionnement et son impact sur l’identité nominale de l’individu.
Ester Troian Benvenutti
Authors: Dewes Elisangela , Souza José Edimar de , Giacomoni Cristian
Published: March 2023

Este estudo, com pressupostos teóricos na história cultural e metodológicos na análise documental histórica, a partir de documentos e transcrições de entrevistas, propõe investigar e compreender o percurso da professora Ester Troian Benvenutti junto às comunidades rurais de Caxias do Sul-RS. Para isso, considera que as representações sobre essa docente foram relevantes para o percurso de outras mulheres no campo da educação, nesta região. Com recorte temporal entre 1940-1960, busca-se evidenciar as ressonâncias de suas propostas na educação. Considerou-se que a sua atuação foi relevante, mediando as relações entre diferentes grupos sociais, e que suas propostas foram preponderantes para outras docentes e importantes para a transformação da cultura escolar local.
Public Private Partnerships as an Innovative Approach for Agricultural Sustainability in Sri Lankan
Authors: Kulatunga Janaka D. , Medis Ajith
Published: March 2023

Many countries identified the importance of Public Private Partnerships (PPP) in  agriculture in terms of a shared mechanism among partners for input, resources,  markets, technology, profitability, and associated risk. In addition, many studies  revealed that the partnership approach empowered rural farmers, youth, and  women regarding accessibility to the newly invented agriculture production and  marketing technology. Nevertheless, in Sri Lanka, PPP primarily focused on construction and manufacturing. This Paper attempts to identify whether the right partners are the crucial factor in planning a PPP model for better agriculture prospects in Sri Lanka. Establishing the right PPP in research and development and agricultural marketing will enhance the growth of the agriculture sector in Sri Lanka, thereby sustainability in agriculture and the livelihood of millions of poor farm families, youngsters, and consumers.
How Brand Preference Shapes Brand Loyalty of Milk Powder Through Young Consumers’ Eyes: The Moderating Role of Health Consciousness
Authors: Lakmali M. G. T. , Samaraweera G. C. , Narayana N. M. N. K. , Laksiri W. M. R.
Published: March 2023

Disputable information circulated through mass media on contamination of imported milk powder with hazardous chemical compounds is common at present that challenges consumer brand preference and brand loyalty. Though these two concepts seem highly correlated, adequate empirical studies have not yet explored with respect to the Sri Lankan market in young consumers’ health consciousness grounds to see the probable effect. Therefore, the present study aims to bridge this knowledge gap by focusing on the Sri Lankan milk powder market. Data were collected from Sri Lankan young consumer group (n= 100) via an online survey. The relationships among variables were tested using Structural Equation Modeling via SMART PLS 3 software. The analysis found that brand preference (T= 4.006, P=0.000) and health consciousness (T= 3.824, P=0.000) significantly and positively influenced consumer brand loyalty of milk powder while health consciousness (T= 2.158, P=0.031) significantly moderates the relationship between brand preference and brand loyalty. Hence, the study suggests manufacturers and marketers the importance of focusing on the health consciousness of young consumers to enhance and maintain brand loyalty while increasing the revenue of a particular milk brand.
Effects of endophytism by Beauveria bassiana (Cordycipitaceae) on plant growth, Fusarium (Nectriaceae) disease, and Sunn pest Eurygaster integriceps (Hemiptera: Scutelleridae) in wheat (Poaceae)
Authors: Torkaman Zahra , Talaei-Hassanloui Reza , Khorramnejad Ayda , Pashaei Mohammad Reza
Published: March 2023

Fungi living within a plant (i.e., endophytic fungi) can directly affect the growth of the host plant or have indirect effects by affecting levels of damage to the plant caused by insect herbivory or plant pathogens. Greenhouse and field trials were conducted to investigate the endophytic effects of the fungus Beauveria bassiana on wheat, on the wheat-feeding Sunn pest, Eurygaster integriceps (Hemiptera: Scutelleridae), and on the wheat pathogen, Fusarium culmorum (Nectriaceae), which causes root and crown rot disease. Conidia of B. bassiana were applied to wheat either by foliar spray, soil drench, or seed treatment. Seed treatment with conidia provided the highest re-isolation percentages: 91.7% in leaves, 95.8% in stems, and 91.7% in roots. Inoculated plants were taller and had greater wet and dry weights compared to control plants. In both greenhouse and field studies, E. integriceps that were fed inoculated plants laid eggs that were less likely to hatch. Inoculations reduced the incidence of root and crown rot disease by 42% under greenhouse conditions. These results document the potential of using endophytic infections of B. bassiana in wheat as a control measure for Sunn pest and root and crown rot disease.
A semiquantitative representation of uncertainty for the 3D Paleozoic bedrock model of Southern Ontario
Authors: Bunn M I , Carter T R , Russell H A J , Logan C E
Published: March 2023

The southern Ontario bedrock model is a valuable resource for researchers and practitioners, but its application is subject to uncertainty. To address this issue a semi-quantitative approach to visualize the relative effects of data sparsity for each layer,
identify regions where a lack of data support reduces model confidence, and quantify potential errors in data collection and model construction is presented. This analysis summarizes several sources of error, including cartesian position error, error in the vertical position of the formation
contact, error between the modelled topographic surface and recorded collar elevations, and error between the modelled formation top surface and formation top picks. Where data is present, these errors are added to provide an approximation of total uncertainty. Where data are not present,
uncertainty is approximated as 50% of the range in formation top variation, with an average value of 27.5 m across all layers. The results show that data availability strongly influences the average total error for each layer, with deeper layers exhibiting higher total error due to lower data
density. However, this analysis also suggests that the modelled surfaces likely carry errors of less than 5 to 10 m in most regions.
Carotid cavernous fistula
Authors: Krothapalli Neeharika , Fayad Mohamad , Sussman Eric , Bruno Charles , Ollenschleger Martin , Mehta Tapan
Published: March 2023

Carotid cavernous fistulas (CCFs) are a rare but debilitating entity that may present with orbital or cerebral venous hypertension. CCFs may pose diagnostic and management pitfalls for clinicians as they can initially be misdiagnosed as primary orbital pathology or nonarteriovenous shunting-related cavernous sinus pathology. Furthermore, the resolution of pulsatile tinnitus could be an ominous sign in patients with untreated dural arteriovenous fistula. We describe a case of a 56-year-old male who presented with progressive right eye proptosis, congestion, decreased visual acuity, limited duction, exophthalmos, and pulsatile tinnitus. The patient had poor response to antibiotics and steroids. Magnetic resonance imaging brain showed significant inflammation involving the right orbit and atypical enhancement of the basal frontal lobe adjacent to the orbit. Cerebral angiography revealed an indirect right CCF and right sigmoid sinus thrombosis with stenosis of the right internal jugular vein. No clear predisposing factor was identified. Given the rapidly progressive nature of the condition, the patient successfully underwent endovascular treatment with transvenous approach to preserve flow in the internal carotid artery while ensuring occlusion of the fistula. A triad of proptosis, eye congestion, and signs of turbulent flow such as tinnitus or orbital bruit should raise suspicion for CCF. An interesting feature in this patient is that CCF may have occurred secondary to sigmoid sinus thrombosis with accompanying small cortical vein drainage. Our case highlights the importance of early recognition and timely intervention to ensure the resolution of orbital hypertension-related symptoms in rare cases of CCFs.
Mental stress, meditation, and yoga in cardiovascular and cerebrovascular diseases
Authors: Fayyaz Aminah I. , Ding Yuchuan
Published: March 2023

It is well known that stress can increase the risk of heart attack and stroke although the exact way it does this is unknown. This information is particularly more relevant in a post COVID-19 era where healthcare workers are increasingly facing more stressful working conditions. Thus, it is important to look into alternative methods to deal with stress including meditation and yoga which have shown potential.
Where are we heading in post-China angioplasty and stenting for symptomatic intracranial severe stenosis era?
Authors: Xue Fang , Yun Ho Jun , Peng Liwei , Wu Chuanjie
Published: March 2023

Symptomatic intracranial atherosclerotic disease (ICAD) is a globally challengeable disease. In the past 20 years, people have made a huge effort to deal with the problem including using endovascular technology and aggressive medical therapy. However, the efficacy of these methods seemed to be limited. The recent China angioplasty and stenting for symptomatic intracranial severe stenosis (CASSISS) did not support the addition of percutaneous transluminal angioplasty and stenting to medical therapy for the treatment of patients with symptomatic severe ICAD. So where are we heading in the post-CASSISS era?
Risk factors for multiple recurrent ischemic strokes
Authors: Uzuner Nevzat , Uzuner Gulnur Tekgol
Published: March 2023

BACKGROUND:

Cardiovascular diseases, hypertension, diabetes mellitus, dyslipidemia, and atrial fibrillation are the most common modifiable risk factors for recurrent ischemic stroke. In this study, we aimed to find the risk factors associated with more than two recurrent ischemic strokes after the first-ever stroke.

METHODS:

We collected the ischemic stroke patients in our stroke registry data bank, and the eligible patients were followed for recurrent ischemic stroke after 2008. Our study consisted of 927 patients who were followed up for 9 years after the first-ever stroke.

RESULTS:

We found that 185 (20%) patients had a recurrent ischemic stroke, and another 32 (3.5%) patients had more than one recurrence after the first-ever ischemic stroke. The mean time for the first stroke recurrence was 1 year, and the mean time for the multiple stroke recurrences was 3 years. Significant risk factors for multiple recurrences were congestive heart disease (P < 0.015) and diabetes mellitus (P < 0.006).

CONCLUSIONS:

We concluded that even with the appropriate treatments, patients with congestive heart disease and diabetes mellitus have a higher rate of multiple recurrences for ischemic stroke after the first-ever ischemic stroke, indicating that more attention should be paid to this issue.
Importance of multiplanar reformation angiographic images for the detection of carotid web
Authors: Zelada-Ríos Laura , Barrientos-Imán Danny , Simbrón-Ribbeck Lourdes , Argomedo Carlos Abanto , Ramírez-Quiñones Jorge , Rosa Pilar Calle La , Chávez Ana Valencia , Otiniano-Sifuentes Ricardo
Published: March 2023

Carotid web (CW) is considered a variant of intimal fibromuscular dysplasia. CW represents between 9.4% and 37% of ischemic strokes that were initially misclassified as “cryptogenic.” However, in Latin America, there is a lack of detection. We present 5 cases of ischemic stroke due to CW and discuss the usefulness of multiplanar reformatting (MPR) imaging in computed tomography angiography. The identification of CW with the use of tridimensional (3D) reconstructions and maximum intensity projection was 20%, the rest was misdiagnosed as atherosclerotic plaque. With the MPR, the identification of typical CW findings was improved, such as a thin septum, a shelf-like image, and a mountain shadow-like image. However, one must be alert to changes in the 3D disposition of the carotid bifurcation, as they may mask the typical CW findings. A good practice is to align the internal carotid artery exactly posterior to the external carotid artery in the sagittal plane.
Common obstetrics and gynecologic topics in critical care
Authors: Ritchie Julia , Birsner Meredith L. , Zighelboim Israel , Taylor Nicholas P.
Published: March 2023

The fields of Obstetrics and Gynecology and Critical Care often share medically and surgically complex patients. Peripartum anatomic and physiologic changes can predispose or exacerbate certain conditions and rapid action is often needed. This review discusses some of the most common conditions responsible for the admission of obstetrical and gynecological patients to the critical care unit. We will consider both obstetrical and gynecologic concepts including postpartum hemorrhage, antepartum hemorrhage, abnormal uterine bleeding, preeclampsia and eclampsia, venous thromboembolism, amniotic fluid embolism, sepsis and septic shock, obstetrical trauma, acute abdomen, malignancies, peripartum cardiomyopathy, and substance abuse. This article aims to be a primer for the Critical Care provider.
Comparison of adjuvant therapy with midazolam, paracetamol, tramadol, or magnesium sulfate during intravenous regional anesthesia with ropivacaine
Authors: Modir Hesameddin , Moshiri Esmail , Khamene Mohsen Parsi , Komijani Davood
Published: March 2023

Background:

Intravenous (IV) regional anesthesia is an easy, safe, reliable, and efficient option for inducing anesthesia during surgeries but with tourniquet-related pain. This study aimed to evaluate midazolam, paracetamol, tramadol, and magnesium sulfate administration as adjuvants with ropivacaine on pain relief and hemodynamic changes in IV regional anesthesia.

Methods:

A randomized, double-blind, placebo-controlled trial was conducted in subjects undergoing forearm surgery with IV regional anesthesia. The block randomization method was used to assign eligible participants to each of five study groups. Hemodynamic parameters were assessed before applying the tourniquet, at prespecified time points (5, 10, 15, and 20 min), then and every subsequent 10 min until surgery completion. A Visual Analog Scale was used to assess pain severity at baseline followed by every 15 min until completion of the surgery, and after tourniquet deflation every 30 min to 2 h, and at 6, 12, and 24 h postoperative. Data were analyzed using Chi-square and analysis of variance with repeated data testing.

Results:

The shortest onset and the longest duration of sensory block were observed in the tramadol group and the shortest onset of motor block in the midazolam group (P < 0.001). Pain score was estimated to be significantly lower in the tramadol group at the time of tourniquet application and release, and 15 min to 12 h after tourniquet release (P < 0.05). In addition, the lowest dose of pethidine consumption was observed in the tramadol group (P < 0.001).

Conclusion:

Tramadol appeared to be able to effectively relieve pain, shorten the onset of sensory block, prolong the duration of sensory block, and achieve the lowest consumption of pethidine.
Comparison of the effects of tranexamic acid, nitroglycerin, and remifentanil on the prevention of bleeding during herniated lumbar intervertebral disc surgery
Authors: Modir Hesameddin , Moshiri Esmail , Shakeri Aidin , Khalatbari Mohamad
Published: March 2023

Background:

Surgery is a well-known and effective method of treating lumbar intervertebral disc herniation. The present study aimed to compare the effects of administering tranexamic acid (TXA), nitroglycerin (NTG), and remifentanil (REF) on hemorrhage prevention during herniated lumbar intervertebral disc surgery.

Methods:

A double-blind clinical trial was conducted on 135 participants undergoing lumbar intervertebral disc surgery. A randomized block design was used for subject assignment to three groups including TXA, NTG, and REF. The hemodynamic parameters, bleeding rate, hemoglobin level, and the amount of infused propofol were measured and recorded after surgery. Data were then analyzed in SPSS software using Chi-square test and analysis of variance.

Results:

The mean age of participants in the study was 42.12 ± 7.93 years, and all three groups were equal in terms of demographic characteristics (P > 0.05). The mean arterial pressure (MAP) of the TXA and NTG groups was notably higher than the REF group (P < 0.008). The mean heart rate (HR) of the TXA and NTG groups was notably higher than the REF group (P < 0.05). The propofol dosage used in the TXA group was higher than the two groups of NTG and REF (P < 0.001).

Conclusion:

Among participants undergoing lumbar intervertebral disc surgery, the greatest MAP variability was observed in the NTG group. Higher mean HR and propofol consumption was observed in the NTG and TXA groups when compared to REF. No statistically significant differences were noted between groups in oxygen saturation or bleeding risk. Based on these findings, REF may be considered a preferred surgical adjunct over TXA and NTG during lumbar intervertebral disc surgery.
Clinicoradiographic Aspects of Arteriovenous Malformations Involving the Orofacial Region
Authors: Parikh Shilpa J , Patel Harmi P. , Shah Jigna S , Kothiya Sadhana
Published: March 2023

Vascular malformation consists of a group of tumors that emerge from the vascular origin caused by vascular or lymphoproliferation. Arteriovenous malformations (AVMs) contribute high-flow, creating direct vein artery contact without regular capillary network. AVMs are present at birth or in congenital. Acquired AVMs occur later in life due to hormonal changes or trauma. AVM of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease and an incomplete resection frequently leads to recurrence of the lesion. Here, we present a series of three cases of AVM reported during 2019–2022 involving the orofacial region.
Successful Management of Abdominal Aortocutaneous Fistula Following Emergency Endovascular Aneurysm Repair for Aortoenteric Fistula in a Patient with Takayasu Arteritis
Authors: Sima Rahul Ralph , Sekar N , Gopalamurugan AB , Rajan Archana , Sebastian Jithin Jagan
Published: March 2023

Aortocutaneous fistula is an extremely rare complication after aortic endograft infection. We report on the management of a patient who presented with aortocutaneous fistula following emergency endovascular aneurysm repair (EVAR) of an aortoenteric fistula (AEF). A 50-year-old female with Takayasu arteritis who had undergone thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm, 23 years ago presented with a spontaneous abdominal AEF and another contained ruptured descending thoracic aortic aneurysm distal to the previous endograft. She underwent emergency bridge EVAR and redo-TEVAR. Thirteen months following EVAR, she presented with endograft infection and a spontaneous aortocutaneous fistula. She was successfully managed with an axillo-unifemoral bypass followed by EVAR endograft explantation. She was discharged on long-term antibiotics and has been symptom free for 12 months.
Isolated Giant InfraRenal Abdominal Aortic Aneurysm with Dissection
Authors: Jayant Divij , Behera Arunanshu , Tandup Cherring , Nagaraj Satish Subbiah , Yadav Saroj
Published: March 2023

Although abdominal aortic aneurysm (AAA) is common in the atherosclerotic aorta in the elderly, isolated AAA (IAAA) is a rare entity. Only few case reports of IAAA associated with concomitant dissection are reported in the literature. Here, we present a case of a middle-aged male who presented with abdominal pain with stable hemodynamics. Abdominal examination revealed a pulsatile mass in the left paraumbilical region. CT angiography of the abdomen revealed an isolated infrarenal AAA with dissection extending into the bilateral common iliac arteries and an eccentric partial thrombosis of the false lumen. The patient underwent successful open aneurysmorrhaphy with PTFE graft. Postoperative course was uneventful, and the patient was discharged to follow up in clinics.
Comparative Study of Cardiac Risk Indices to Predict Perioperative Cardiovascular Outcome in Patients with Peripheral Vascular Diseases
Authors: Singh Vivek Kumar , Rai Sudhir , Anand Vembu , Singh Nitu
Published: March 2023

Introduction:

Existing methodologies and risk stratification indices for predicting peri-operative cardiac complications in vascular surgery patient lack sufficient predictive value and therefore cannot be recommended for risk stratification. There are no Indian studies for preoperative cardiac risk scores for patients who undergo vascular and endovascular procedures. Therefore, an attempt was made to risk stratify and compare two existing cardiac risk indices (i.e., Detsky's modified cardiac risk index vs. Revised cardiac risk index [RCRI]) to predict peri-operative morbidity and mortality due to cardiac causes. The aim of this study: (a) To compare Detsky's modified cardiac risk index and RCRI to predict perioperative cardiovascular outcome in patients with peripheral vascular disease undergoing surgical intervention. (b) To predict perioperative cardiovascular outcome based on cardiac risk index in patients with peripheral vascular disease undergoing surgical intervention.

Materials and Methods:

This is an observational, prospective, longitudinal, controlled cohort study, which assessed 103 patients admitted at vascular centre for a period of 2 years. All patients undergoing vascular surgical procedure and evaluated by a cardiologist in the preoperative period were included in the study.

Results:

Eighteen patients (17.4%) had cardiac complications. The Detsky's index was found to be a satisfactory predictor of postoperative cardiac events (P < 0.001) as compared to RCRI which had a P < 0.003. There were a total of 10 mortalities (9.7%). Detsky's model and RCRI had positive predictive value (PPV) of 73.3% and 31.4%, specificity of 94.1% and 72.7%, respectively.

Discussion:

The overall sensitivity, specificity, PPV, negative predictive value of the Detsky's risk index, and RCRI in the prediction of cardiac events were 31.4%, 94.1%, 73.3%, 72.7% and 73.3%, 72.7%, 31.4%, 94.1%, respectively. In our study, the area under ROC for Detsky class was 0.76 versus 0.75 and superior to C statistic. However, the area under ROC for RCRI class was 0.72 versus 0.75 and inferior to C statistic. One important inference from the study was that 77.6% patients were smoker in the study group which emphasize the direct relation of peripheral vascular disease with smoking.

Conclusion:

The study concluded that patients with good surgical risk and profile undergoing minor vascular procedures can be operated without further testing. For other patients, the next step would be to incorporate the Detsky index. A Detsky score of 20 or more is comparable to a major clinical predictor in the American College of Cardiology/American Heart Association scheme.
Kite String Vascular Injuries
Authors: Singh Devender , Kottilliyil Aruna Sree , Anurshetru Basavarajendra
Published: March 2023

Introduction and Objectives:

Vascular injuries due to kite string are uncommon but are associated with significant morbidities and mortality. With the increase in the sharpness of the string, the incidence of these injuries is on the rise not only to flyer but also to the innocent other people. We present our experience as there is a relative paucity of data and literature on this subject and suggest measures to control.

Methods:

Between January 2016 and January 2022, six patients suffered vascular injuries due to kite string (manja) and were admitted to the vascular unit of tertiary care center. The medical histories of the patients were reviewed retrospectively and analyzed. Initial treatment included hemorrhage control by direct pressure or packing and fluid resuscitation and airway establishment by intubation (if required). Neck injuries were divided into three zones. All patients were subjected to computed tomography angiography followed by emergency exploration and repair.

Results:

Males are most commonly affected. The most common age group affected was 3050 years. Majority of these patients were travelling on a two wheeler. The neck was most commonly involved with primarily venous injuries. Four patients had injuries in Zone II and one patient in Zone I. One patient had a deep laceration around the ankle with vascular and significant soft-tissue injuries. The injuries were of the jugular veins, external carotid artery, trachea and tibial artery, nerve, and tendoachilles (complete tear). All the major vascular injuries were either repaired or ligated. There was no major morbidity or mortality.

Conclusion:

Kite flying is a popular sport in the Indian subcontinent. Vascular injuries due to sharp string can lead to grievous injuries or may be fatal. This study attempted to enlighten these dangers and emphasize that potential threats have to be understood and addressed adequately.
Outcomes Following Spliced Vein Graft and Composite Graft as Conduit for Infrainguinal Bypass
Authors: Prasath S Arun , Viruthagiri Arunagiri , Mandjini Nedounsejiane
Published: March 2023

Background:

Peripheral arterial disease is a significant health care burden globally. Treatment options for limb salvage include open surgical bypass or endovascular revascularization. One of the vital prerequisite for successful infrainguinal bypass is the availability of good conduit. Not all patients have good quality great saphenous vein of adequate length to facilitate bypass. In these scenarios, splicing of available autologous veins and synthetic graft with vein cuff are alternate options.

Aim:

To compare the outcomes of infrainguinal bypass done for patients with chronic limb threatening ischemia in two groups In Group I, non spliced GSV was the conduit used. In Group II, either spliced vein graft or synthetic graft with vein cuff was used.

Materials and Methods:

This is a retrospective study done in a tertiary care centre over a period of 40 months. Ipsilateral Great Saphenous Vein (GSV) was our preferred conduit. In the absence of good calibre GSV, splicing of available autologous veins were done. Only when autologous veins were not available synthetic graft was used with distal vein cuff.

Results:

A total of 52 patients have undergone bypass during the study period of which 15 patients (28.8%) did not have good calibre GSV. Splicing of autologous veins were done for 10 patients (19.2 %) and synthetic graft with vein cuff was used for 5 patients (9.6%). One year graft patency in group I was 81% and in group II was 66.6%. Limbs were salvaged in 86% of patients in either groups. The mortality rate was 8.1% and 6.6% in groups I & II respectively.

Conclusion:

When good caliber GSV is not available, splicing of available autologous veins provide comparable patency and should be preferred over synthetic graft. Synthetic graft provides acceptable limb salvage rate when used with an adjunctive procedure like vein cuff for tibial bypasses and should be used when autologous veins are not available or when the patient carries a high risk for major surgery.
Arterial Thoracic Outlet Syndrome - Clinical Presentation, Surgical Management, and Outcome
Authors: Ayyavoo Harish Kumar , Duraichi B. Vella , Sritharan Narayanan , Jayachander K , Ilayakumar Paramasivam , Kumar S. Prathap , Babu R. Ranjith , Ramya M. , Sujith P. Jan
Published: March 2023

Objective:

The main objective of this study was to review the clinical presentations, surgical management, and outcome of surgical procedures for arterial thoracic outlet syndrome (TOS).

Methodology:

This is a retrospective analysis of arterial TOS patients admitted in our department (Institute of Vascular Surgery, Madras Medical College, Chennai) from August 2012 to July 2022.

Results:

This study enrolled 81 patients, with mean age of 41.13 (12-65 years) and 50.61% male (41) and 49.39% female (40), associated with distal arterial lesions - 63 (77.77%), among which 50.61% - occlusion in the brachial artery (33), 24.69% in forearm arteries (15), and 24.69% in the axillary artery (15). About 95.06% of patients had cervical rib (77), 2.46% - first rib abnormality (2), 2.46% - soft-tissue compression (2), 59.25% was SCHER Stage III (48), 33.33% SCHER stage I (27), and 7.40% SCHER stage II (6). All patients had undergone a supraclavicular approach. The most common arterial lesions were subclavian artery (SCA) thrombus in 53.08% (43), occlusion in 17.28% (14), and dilatation in 29.62% (24) cases. The cervical rib excision with anterior scalenectomy in 95.06% (77), and 1st rib excision with anterior scalenectomy 2.46% (2) and soft tissue resection with anterior scalenectomy 2.46% (2) of patients. SCA intervention/reconstruction was done in 88.88% (72) of cases. Two patients had underwent above elbow amputation (2.46%) and no mortality and SCA patency was 100%.

Conclusion:

Cervical rib excision with anterior scalenectomy with or without thrombectomy is an effective procedure for arterial TOS cases.
Comparing Endovascular Revascularization to Open Surgical Revascularization for Chronic Mesenteric Ischemia
Authors: Alqahtani Saeed Saad , Albilasi Bader Menwer N , Alenzi Osama Mohammed , Almoallem Saleh Abdullah S , Alruwaili Ali Nuwaysir S , Alkhaldi Mohammed Hamoud , Alruwaili Abdullah Mohammad G , Alkhaldi Mohammed Amid S , Almassaeed Raid Jawdat
Published: March 2023

Although the incidence of chronic mesenteric ischemia (CMI) is uncommon, it could become life threatening. With improvements in diagnostic imaging and endovascular therapy over the past few decades, the treatment of CMI has evolved. Even though endovascular revascularization for CMI is prominent, it is unclear if the early advantages outweigh the long-term patency rates. This study conducts a systematic review and meta-analysis to present comprehensive insights into the validity of endovascular revascularization versus open revascularization as effective therapeutic modalities. Studies up to 2022 were searched in MEDLINE, Cochrane Database of Systematic Reviews, Scopus, and Embase. Additionally, references from earlier studies and review papers were manually searched for additional relevant reports. At least two authors examined all the results, making sure they fit the inclusion and exclusion criteria. In the event of disagreement, the authors were able to reach an understanding. Open revascularization is superior to endovascular approaches in maintaining vessel patency and reducing symptoms over the long term. Perioperative problems are more common in patients undergoing open procedures. Each patient's anatomy and physiology call for a different revascularization approach to be applied in treating this condition.
Assessment of Clinical Awareness of Cardiopulmonary Resuscitation Among Dental Undergraduate Students in the Vidarbha Region
Authors: Patel Shraddha
Published: March 2023

Background:

Cardiopulmonary resuscitation (CPR) is an important link in the chain of survival during the early minutes of cardiac arrest. Prompt identification and immediate help increase the chances of survival for victims. As dental students start working on patients from their 3rd year of professional life, important life-threatening situations and lifesaving skills should be known to them.

Aims and Objectives:

The aim of the present study was to assess the awareness of CPR among dental students from 3rd and final year.

Materials and Methods:

In this study, students of 3rd year and final year of dental colleges of the Vidarbha region were included to access the basic knowledge regarding basic life science skills while performing CPR through a questionnaire that consisted of 20 questions. The questionnaire was circulated among students in Google forms and responses were noted. After excluding the incomplete response, the results were then analyzed.

Results:

The results were expressed in appropriate graphs and tables. It was observed that the participants included were lacking about complete knowledge of CPR. Among 206 students who responded, a large number of them (around 94%) had not heard of basic life support (BLS)/CPR. Rescue breathing in infants was not known to around 85% of students, chest compression and ventilation ratio in a child was known by only about 11% of students, and the first response in suspected foreign body obstruction was not known to about 90% of the students. The overall result was not favorable and the students had low confidence in performing BLS/CPR.

Conclusion:

The result of the current study indicates a strong need for emphasis on both theoretical and practical training in CPR for undergraduate dental students. This might prove beneficial to save more lives while avoiding medicolegal complications which may occur in the dental clinic also, thus benefiting both the patient and the dental practitioners as well.
Effectiveness of Education Program on Knowledge about Organ Donation
Authors: Jabade Mangesh Vilinikaran , Upendra Sheelas
Published: March 2023

Background:

Organ donation is when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead. To understand organ donation, it is first important to understand organ transplantation. A transplant is a medical procedure where one person's dysfunctional organ or tissue is replaced by that of a healthy person, thus restoring its function. The organ donation and transplantation system strive to honor the gift of donated organs by fully using those organs to save or improve the quality of the lives of transplant recipients.

Objectives:

The objectives are as follows: (1) to assess the knowledge regarding organ donation among nursing students studying at selected nursing colleges in Pune City and (2) to evaluate the effectiveness of education program on knowledge regarding organ donation, among nursing students studying at selected nursing colleges in Pune.

Methodology:

The design of the study is quantitative-one group pre-test and posttest design. The data of this study were collected by a self-structured questionnaire using the purposive sampling method. The questionnaire had two sections, namely to gather information regarding demographic variables and knowledge on organ donation.

Results:

Assessed the knowledge and perception regarding organ donation and result were found as follows: the pretest knowledge score of the students includes 16% had good, 70% had average, and 14% had poor score. The posttest knowledge score of the students includes 57% had good knowledge, 40% had average, and 3% had poor knowledge score.

Conclusion:

This study revealed that education program is effective to increase the knowledge on organ donation among nursing students.
A Case Series on Imperforate Hymen Causing Hematometra and Hematocolpos with Unusual Presentations
Authors: Patwa Prerna Anup , Rathi Rajkiran , Chaudhary Konika , Charan Ashutosh , Singh Rohan Kumar , Mishra Gaurav Vedprakash
Published: March 2023

Obstruction of the uterine or vaginal outlet causes hematometra or hematocolpos. The uterine or the vaginal cavity is distended with blood and its products causing abdominal pain, obstructive symptoms, and discomfort in adolescent patients. A proper diagnosis aids inadequate management through various surgical techniques and not only prevents any further complications but also preserves fertility in such individuals. In this article, we are presenting three cases of hematometra and hematocolpos, discussing their clinical presentations and imaging findings.
Effect of Yoga Therapy Module on Lumbosacral Radiculopathy
Authors: Muley Parikshit , Mandlik Vishwas , Deshpande Vidya , Muley Pranjali
Published: March 2023

Lumbosacral (L-S) radiculopathy is one most common reasons for low back pain occurring due to etiologies of discopathies and lumbosacral disc herniation. The treatment which is used for radiculopathies is pain killers, physiotherapy, and spine surgeries. Many of the patients opt for conservative treatment and one of the better conservative treatments is through yoga therapy. The case study reveals electrodiagnostic findings before and after completion of yoga therapy module given for 3 weeks duration. Electrodiagnostic findings show improvement in the nerve conduction study parameters after the yoga therapy was given. The result of the case study reveals that yoga therapy module may be used as a complementary tool for conservative treatment purpose of L-S radiculopathy.
Oral Mucosal Lesions in Moderate-to-Severe COVID-19 Disease – An Indian Critical Care Unit Experience
Authors: Sircar Keya , Popli Deepika Bablani , Jha Onkar Kumar , Sircar Mrinal , Hasan Shamimul
Published: March 2023

Severe acute respiratory syndrome coronavirus 2 is a widespread worldwide public health malady due to a viral COVID-19 infection. The World Health Organization has affirmed this malady as a pandemic and Public Health Emergency of International Concern. A wide array of oral lesions has been reported in patients with COVID-19. Oral lesions can be an initial sign of COVID-19 or an alarming sign of peripheral thrombosis. However, there is a scarcity of published literature on the oral manifestations of COVID-19 in hospitalized patients. We present four different types of oral lesions in hospitalized patients with moderate-to-severe COVID-19 disease. This article proposes that a detailed examination of the oral cavity in patients admitted to COVID-19 intensive care unit/high dependency units will help to understand the significance of the oral lesions in the management of the disease. Dental professionals should be a part of the multidisciplinary treatment protocol, thus, emphasizing a detailed and meticulous oral examination and oral health amelioration of COVID-19 patients.
A Cross-Sectional Study on Knowledge, Attitudes, and Practices of Hand Hygiene in Medical and Dental Undergraduate Students of Central Indian Region Amid COVID-19
Authors: Meshram Rishikesh K. , Patel Aditya , Amburle Rohit , Gaware Snehal , Patel Shradhdha
Published: March 2023

Context:

Effective hand hygiene (HH) is one of the most important measures to prevent the cross-transmission of infectious diseases such as COVID-19, especially among health professionals. There are very limited studies that have aimed at investigating HH practices among medical and dental students in the period of their professional formation.

Aims:

This study aim's to measure the quality of HH practices, attitudes, and knowledge among the medical and dental students during the corona pandemic in health science institutes of Maharashtra.

Settings and Design:

A cross-sectional study through Google Form-based closed-ended questionnaires where options were given.

Materials and Methods:

All students associated with patient clinics during their academic learning were eligible for inclusion in the study. The knowledge, attitudes, and opinions regarding HH practices were collected through an online Google Form questionnaire.

Statistical Analysis Used:

Chi-square and “t” tests were used to find out the statistical difference between the two groups.

Results:

Both medical and dental undergraduate students showed a moderate level of HH knowledge, whereas dental students have a lower level of attitudes and practices of HH as compared to the medical undergraduates.

Conclusion:

Undergraduate health-care students need to be increased emphasis on HH education and improvement in their current primary training and also there is an urgent need for educational and motivational intervention particularly targeted at dental students.
Challenges in the Diagnosis of Neonatal Septicemia
Authors: Mudey Gargi , Mudey Abhay
Published: March 2023

Clinical diagnosis of septicemia in neonates is challenging as symptoms and signs are vague. Blood culture, the gold standard test takes at least 48–72 h to get a positive culture report and 5–7 days for reporting negative results. Blood culture may give false negative results in about 30% cases due to blood specimen being collected after antibiotic therapy or low volume of specimen or fastidious and slowly growing organisms. There is a need of rapid, sensitive, specific, diagnostic test for neonatal septicemia that can detect all relevant microorganisms in a low blood sample and is not affected by maternal antibiotics. In view of all the above mentioned facts this article focuses on the laboratory methods evaluated for the diagnosis septicemia in neonates.
Biomarkers Association and their Predictive Value in SARS-CoV-2-Infected Hospitalized Patients at a Tertiary Health Care Center
Authors: Ali Saood , Wagh Pankaj , Aurangabadkar Gaurang , Adwani Sameer , Kadukar Juhi
Published: March 2023

This study investigated the association and predictive value of biomarkers in hospitalized patients with SARS-CoV-2 infection. Coronavirus disease (COVID) infection has been linked to a significant hyperinflammatory immune response described as a “cytokine storm,” which results in organ deterioration and damage. Several studies have shown that cytokine levels, notably interleukin 6, can be used as indicators of COVID-19 disease severity. This hospital-based cross-sectional study was conducted in DMIMS Medical College, Sawangi-Meghe, Wardha, from March 2020 to April 2020. The study population was confirmed adult cases of COVID-19 admitted to the hospital during the study period. A positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction or rapid antigen test from a nasopharyngeal swab or other respiratory sample was defined as a confirmed SARS-CoV-2 case. A purposive sampling technique was used and a total of 100 study subjects were enrolled for the study. Our study discovered a link between hematological, coagulation, and inflammatory indicators and infection severity. However, whether these indicators have a mechanistic or causative role in illness progression has to be investigated further.
A Survey of Anemia Burden and its Predictors Among the Undergraduates Enrolled in a Government Medical College of Delhi
Authors: Rustagi Ruchir , Sharma Pragya , Basu Saurav , Rao Shivani , Sharma Nandini
Published: March 2023

Background:

Anemia in developing countries is a major public health challenge whose burden is influenced primarily by dietary factors, physiological characteristics, and cultural practices.

Objectives:

The objectives of this study were to estimate the prevalence of anemia among medical students and find its associated sociodemographic, dietary, or clinical correlates, if any.

Methods:

A cross-sectional study was conducted among 665 medical undergraduate students, who were screened for anemia via a camp-based approach, with estimation by an automated hemoglobinometer and participant recruitment by an opt-in option. Analysis was done using IBM SPSS version 25.0.

Results:

The prevalence of anemia was 19.8%, with a significantly higher prevalence among females (40.9%) compared to males (5.6%). All males and majority of female anemics (56.4%) belonged to mild category. On bivariate analysis, female sex, hostel residence, and frequent consumption of meat or poultry were significant predictors of anemia. On adjusted analysis, female students were 11 times more likely to have anemia compared to male students (P < 0.001). Furthermore, menstrual irregularities were more frequently reported by the female students with anemia.

Conclusions:

A high burden of anemia exists among female medical students. These findings emphasize the need for regular and periodic screening activities, supplemented with health education activities for awareness generation to control this neglected public health problem.
Effect of Intranatal Gentle Birthing Care on Labor Outcome
Authors: Vishnupriya P. , Salunkhe Jyoti Avinash , Salunkhe Avinash H. , Kakade Satish V. , Patange R. P. , Kshirsagar N. S.
Published: March 2023

Background:

Birth companionship, and continuous support during labor and delivery, can improve women's childbirth experience and birth outcomes.

Aims and Objective:

To assess the effect of Intra-natal Gentle Birthing Care (IGBC) on Labor Outcome.

Material and Methods

: The post-test only control group design and a evaluate approach was used on 30 parturient mothers who were admitted in the Krishna Hospital & Medical Research Centre, Karad. The Intra-Natal Gentle Birthing Care was administered in separate unit and post test for labor outcomes of parturient mothers was assessed. The informed consent was obtained from mothers. All calculations were carried out using SPSS V20.

Results:

Out of 30 (100%) mothers only 2(6.6%) mothers were administered injection Oxytocin and 2(6.6%) mothers' injection Drotin / Epidosin. Rest all 26(86.66%) mothers were not administered any type of analgesia and anesthesia. There was statistically significant difference found between Mean ± SD coping(with labor pain) score of the mothers who completed labor process within 6hrs, 8hrs, 10hrs and 12hrs (P<0.0001). Majority parturient mothers, 27(90%) completed 1st stage within 10 hours. Intra natal gentle birthing care was having significant effect on decent of fetal head and dilatation of cervix (P<0.0001). The Bonferroni multiple comparison test, 1st stage Vs 2nd and 4th stage, 2nd stage Vs 3rd and 4th stage, 3rd stage Vs 4th stage among all comparison showed significant difference(P<0.001) except 1st stage Vs 3rd stage (P>0.05).

Conclusion:

The mean coping score of parturient mothers was more and there was significant difference in mean score of duration of labor stages, cervical dilatation and decent of fetal head after administration of “Intra-natal gentle birthing care” thus the Intra-natal gentle birthing care was effective.