bluuebunny/crossref_metadata_2025 huggingface dataset:
BUREAUCRAT-ASSISTED CONTENTION IN CHINA*
Authors: O’Brien Kevin J. , Li Lianjiang , Liu Mingxing
Published: October 2020

Bureaucrat-assisted contention in China is a type of collective action in which native-born local officials help socioeconomic elites launch or sustain popular action against outsider party secretaries by leaking information and sabotaging repression. Bureaucrats who assist local influentials are neither elite allies nor institutional activists. Instead, they unleash or support collective action as a weapon in a power struggle against ambitious, heavy-handed or corrupt superiors. Unlike mass demonstrations that are mobilized as a bargaining chip, bureaucrat-assisted contention hinges on a partnership with local elites who have their own grievances and pursue their own goals. Because it combines bureaucratic politics and popular action, this type of contention can help us understand underexplored aspects of political opportunities, framing, and mobilizing structures. In particular, it shows how participants in contention sometimes span the state-society divide, and how collective action can influence (and be influenced by) power struggles within a government.
The effect of the distance from the pyloric sphincter and size of the calibration tube on ­postoperative outcomes of the laparoscopic sleeve gastrectomy
Authors: Omarov T I , Bayramov N Yu , Huseynova M R , Zeynalov N A
Published: October 2020

Aim. To study of the effect of the diameter of the calibration tube and the distance from the pyloric sphincter on the outcomes of the laparoscopic sleeve gastrectomy.

Methods. The study included 945 (915 women) patients with a body mass index 51.59 kg/m2. The average age of the patients was 53.58.5 years. The patients were divided into 2 groups by the type of laparoscopic surgery: in the first group (n=463), a 36 Fr calibration tube was used, the distance from the pyloric sphincter was 46 cm; in the second group (n=482), a 32 Fr calibration tube was used, the distance from the pyloric sphincter was 23 cm. The main comparison criteria was the percentage of body weight loss in the first 6 and 12 months, and an additional comparison criteria was the of concomitant diseases progress in postoperative and the existence of complications.

Results. A comparative analysis showed that the first group in the first 6 months lost 593% of its initial body weight, while in 12 months 714%; in the second group, 733 and 873% of the initial weight, respectively. Concomitant diseases in the first group decreased by 7080% by the 6th month after surgery and by 8596% by the 12th month. In the 2nd group, similar remission with improvement was between 84 and 94% at the 6th month, and remained the same at the 12th month.

Conclusion. The results of the study show that in laparoscopic sleeve gastrectomy with a calibration tube diameter 32 Fr and a distance of 23 cm from the pyloric sphincter, compared to a calibration tube diameter 36 Fr or more and a distance of 46 cm from the pyloric sphincter, a body weight loss faster and more effective with earlier remission of concomitant diseases, while the number of complications is comparable.
Slc6a4, Tph2, Htr1b, Htr2a genes expression in the mouse spinal cord after microgravity exposure simulation on earth
Authors: Kuznetsov M S , Lisyukov A N , Davleeva M A , Izmailov A A
Published: October 2020

Aim. To determine the level of gene expression of the serotonergic neurotransmission system (Slc6a4, Tph2, Htr1b, Htr2a) in the cervical and lumbar enlargement of the spinal cord for mice after 30-day microgravity exposure simulation by using the antiorthostatic unloading model by Morey-Holton et al. and a subsequent 7-dayrecovery period.

Methods. The experimental animals were divided into three groups: Unloading group with mice undergoes hindlimb-unloading procedure for 30 days (n=5); Recovery group with mice undergoes hindlimb-unloading procedure for 30 days, followed by readaptation within 7 days (n=5); Control group with mice kept at standard vivarium conditions (n=5). The expression level of genes encoding synaptic proteins in the central nervous system was estimated by a real-time polymerase chain reaction.

Results. There were no statistically significant differences between the studied groups regarding the Tph2, Htr1b, and Htr2a expressions in the cervical and lumbar enlargement of the spinal cord. Compared to the Control group, a statistically significant increase (6.3 times) in the level of Slc6a4 expression in the lumbar spinal cord was revealed after microgravity exposure simulation (Unloading group), followed by a 3-fold decrease during the readaptation period (Recovery group ).

Conclusion. The expression level of the Slc6a4 gene, which encodes carrier protein involved in the function of serotonergic synapses, may indicate the potential involvement of this neurotransmitter system in the pathogenesis of movement disorders after microgravity exposure simulation on earth.
Medical and social indicators of the reproductive potential of the female population of the region (on the example of the Republic of Tatarstan)
Authors: Khabriev R U , Mingazova E N , Shigabutdinova T N , Sadykova R N
Published: October 2020

Aim. To analyze the dynamic changes in medical and social indicators of the reproductive potential of the female population, markers of trends in the formation of the medical and demographic process in the region.

Methods. The study was conducted on the basis of an analysis of literary sources that determine the general trend in the demographic situation in the country, as well as information from statistical collections of the Federal State Statistics Service and the Ministry of Health of Russia and Tatarstan. The analytical and statistical methods (descriptive statistics, student criterion, trend analysis) were used in the study.

Results. It was revealed that the fertility rate of women living in rural areas decreased by dynamics (between 1991 and 2017, from 79.9 to 42.3 per 1000 women aged 1549; p 0.05). Before 2014, the indicator for rural residents was higher than that for urban women. Since 2015, the trend has been reversed: among urban women it has become higher than among those living in rural areas, which correlates with the birth rate in urban and rural areas. Percentage of live births from 1991 to 2017 in women of early reproductive age (up to 20 years) decreased among urban women from 11.3 to 3.7% (p 0.05), among rural women from 10.0 to 5.8% (p 0.05); among urban women in the age group 2024 years from 35.4 to 27.1% (p 0.05), among rural women of the same age from 40.9 to 34.2% (p 0.05). In the observed period, percentage of live births among women of the older reproductive age increased both among residents of cities and in rural areas. Percentage of births by birth order was changed: in urban areas accounted for 55.9% of the first child, in rural areas 44.3%; for the second child 35.1% and 34.2%, respectively; for third and more children 9 and 21.5%.

Conclusion. The analysis of medical and social indicators of the reproductive potential of the female population and markers of trends in the formation of the medical and demographic process in the region suggests a decrease in fertility rate (fertility) with an increase in the mean age of women at childbirth.
Neuroimmune predictors of outcome after aneurysmal subarachnoid hemorrhage
Authors: Ermakov S V , Karpov S M , Вaturin V A , Belokon O S , Mozheiko R A
Published: October 2020

Aim. To determine the possibility of predicting the course and outcomes of aneurysmal subarachnoid hemorrhage (aSAH) by using the detection of autoantibody level to neurospecific proteins.

Methods. The autoantibody level to neurospecific proteins was detected in 65 people: 30 healthy volunteers and 35 with a confirmed diagnosis of aneurysmal subarachnoid hemorrhage. Autoantibodies to myelin basic protein (MBP), peripheral myelin, dopamine receptors, myosin, N-methyl-D-aspartate (NMDA) receptors and S100 protein detected by using an enzyme immunoassay. The severity of illness in dynamics was defined in all patients by using the following scales: Rivermead mobility index, HuntHess, Graeb and others. Statistical analysis was performed using Statistica 10.0, with the consistent use of descriptive statistics methods, the MannWhitney, KruskalWallis and Pearson tests, Spearman coefficient.

Results. At the first stage, neurospecific proteins characterized by a large increase in autoantibody titers were identified. Further, based on the data obtained, a statistically significant correlation between autoantibody titers to S100 protein (360.4340.35 g/ml, p 0.05), MBP (145.9112.43 g/ml, p 0.05), NMDA receptors (66.176.42 g/ml, p 0.05) and aSAH outcome was established.

Conclusion. The study revealed an increase in autoantibody level to neurospecific proteins in the blood plasma of patients, depending on the severity of subarachnoid hemorrhage and the development of delayed cerebral ischemia due to cerebral vasospasm; high antibodies titers to S100 protein in subarachnoid hemorrhage are associated with cerebral vasospasm and the development of secondary (delayed) ischemic changes in the brain.
Evaluation of Seismic Hazard Models with Fragile Geologic Features
Authors: Stirling Mark W. , Oskin Michael E. , Arrowsmith J. Ramon , Rood Anna H. , Goulet Christine A. , Grant Ludwig Lisa , King Tamarah R. , Kottke Albert , Lozos Julian C. , Madugo Chris M. , McPhillips Devin , Rood Dylan H. , Sleep Norman H. , Wittich Christine E.
Published: October 2020

We provide an overview of a 2019 workshop on the use of fragile geologic features (FGFs) to evaluate seismic hazard models. FGFs have been scarcely utilized in the evaluation of seismic hazard models, despite nearly 30 yr having passed since the first recognition of their potential value. Recently, several studies have begun to focus on the implementation of FGFs in seismic hazard modeling. The workshop was held to capture a “snapshot” of the state-of-the-art in FGF work and to define key research areas that would increase confidence in FGF-based evaluation of seismic hazard models. It was held at the annual meeting of the Southern California Earthquake Center on 8 September 2019, and the conveners were Mark Stirling (University of Otago, New Zealand) and Michael Oskin (University of California, Davis). The workshop attracted 44 participants from a wide range of disciplines. The main topics of discussion were FGF fragility age estimation (age at which an FGF achieved its current fragile geometry), fragility estimation, FGF-based evaluation of seismic hazard models, and ethical considerations relating to documentation and preservation of FGFs. There are now many scientists working on, or motivated to work on, FGFs, and more types of FGFs are being worked on than just the precariously balanced rock (PBR) variety. One of the ideas presented at the workshop is that fragility ages for FGFs should be treated stochastically rather than assuming that all share a common age. In a similar vein, new studies propose more comprehensive methods of fragility assessment beyond peak ground acceleration and peak ground velocity-based approaches. Two recent studies that apply PBRs to evaluate probabilistic seismic hazard models use significantly different methods of evaluation. Key research needs identified from the workshop will guide future, focused efforts that will ultimately facilitate the uptake of FGFs in seismic hazard analysis.
#Hashtag: How Selected Texts of Popular Culture Engaged With Sexual Assault In the Context of the Me Too Movement in 2019
Authors: Oleszczuk Anna
Published: October 2020

The paper seeks to explore recent shifts within the popular culture with regard to oppression involving gender, class, race, and ethnicity that can be traced back to the #MeToo movement which was revived as a social media hashtag in October 2017 and has since spread all over the world. The paper starts with a brief overview of Western popular culture that “has recently been seen as a champion for feminism . . . with many high-profile female musicians and actresses visibly promoting the movement in their work” (Woodacre 2018, 21). Next, the paper discusses the origins of the Me Too Movement and the way it approaches the meaning of gendered oppressions as well as individualized and collective experiences of survivors of sexual abuse. This is later explored in the examination of the impact of the hashtag-led movement on three works of popular culture: Amazon’s TV series Lorena (2019), Nancy Schwartzman’s documentary Roll Red Roll (2019), and We Believe: the Best Men Can Be (2019) advertisement by Gillette. The entire case study is informed primarily by feminist theory understood as inseparable from feminist activism, following bell hooks’ Feminist theory from margin to center (1984).
De Anima I e II: o movimento nos âmbitos vegetativo e sensitivo
Authors: Alonso André
Published: October 2020

Movement is a key concept in Aristotle’s physics and is largely used to explain changes in the sublunary sphere. It is especially investigated in the Physics and, as a concept, depends intrinsically on notions like actuality and potentiality. In this paper, I focus first on the theory of movement found in Physics III and V, then I analyze the ways it is used to define the soul itself and to explain the different vital phenomena – vegetative and sensitive activities – described in De Anima I and II.
El pensamiento no intelectualista como síntesis entre metafísica del acto y la metafísica de la representación
Authors: Gutiérrez Pozo Antonio
Published: October 2020

La metafísica del acto define la realidad como dinamismo y ejecutividad. La metafísica de la representación concibe el ser como objeto identificado por la conciencia. Establecer un puente entre estas dos metafísicas, o en otras palabras entre diferencia e identidad, proceso y objetivación, equivale a integrar acción y pensamiento. Para conseguirlo, consideramos necesario defender la existencia de una conciencia no intelectualista ni objetivadora que posea un pensar que forme parte del propio devenir.
Visualizing the knowledge domain of multimodal discourse analysis (2009-2019): A bibliometric review
Authors: Chen Chunlei
Published: October 2020

Different from traditional discourse analysis, multimodal discourse analysis (MDA), a systematic analysis of different semiotic modes, utilizing language, images, sounds in a discourse, emphasizes the coordination of both dynamic and static semiotic resources. This study presents the status quo and development trend of the research field through an objective, systematic, and comprehensive review of relevant publications available from the Web of Science Core Collection. Analysis techniques including a descriptive statistical method and a bibliometric method are used. The study quantitatively analyzes the publications in terms of general characteristics, geographical distribution, high-cited representatives, and topic discovery and distribution to illustrate the development and trend of MDA. The research findings are as follows: (1) In the past 10 years or so, international MDA research has presented a significant growth trend, with flourishing research output, interest and diversification of presented subjects; (2) New topics are constantly emerging, with research topics mainly focusing on the development of visual grammar, gesture, digital technologies, conference presentations, metonymy and metaphor, etc.; (3) Research focuses mainly on multimodality, semiotics, conversation analysis, critical discourse analysis etc.; (4) The article also listed a series of important and highly influential literature, countries, journals and authors on MDA during different periods. It is hoped that this paper can provide a reference for the further study of MDA.
Book Review
Authors: Sun Xinghong
Published: October 2020

An abstract is not available for this content.
Eutrophication Bifurcation Analysis for Tasik Harapan Restoration
Authors:   the School of Mathematical Sciences, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia, Tay Chai Jian , Teh Su Yean , Koh Hock Lye
Published: October 2020

Regime shift is characterized by large, abrupt and persistent changes in ecosystem structure and dynamics. Bifurcation analysis is commonly used to identify regime shift equilibrium states and to distinguish their stability characteristics. Eutrophication in lake, a regime shift from clear-water oligotrophic state, is a stable equilibrium state that can persist for long duration. Characterized by undesirable turbid water condition, eutrophication has been known to impair valuable ecosystem services provided by lakes worldwide. The high incidence of eutrophication in Malaysian lakes (62%) mandates urgent need for lake restoration. The three-fold objectives of this paper are (1) to develop a mathematical model for analysing bifurcation criteria in regime shift, (2) to identify regime shift thresholds and (3) to propose effective ecosystem management strategy for shallow tropical lakes such as Tasik Harapan. A mathematical model consisting of four compartments: algae, phosphorus, dissolved oxygen and biochemical oxygen demand is formulated to analyse the eutrophication dynamics in the highly eutrophic Tasik Harapan (TH), a small shallow lake in Universiti Sains Malaysia (USM). Bifurcation analysis is performed by means of XPPAUT to identify the regime shift thresholds and to determine the type of lake response. Identified as irreversible, the eutrophication state of TH mandates an urgent lake restoration program to remove nutrients in the lake. Two restoration methods for reducing nutrients are assessed: (1) flushing of lake water and (2) hypothetical application of the invasive water hyacinth. Bifurcation analysis indicates that a flushing rate exceeding 0.042 day-1 is needed to restore TH to oligotrophic state. A complicated strategy of water hyacinth application would reduce the algae concentration from 300 μg/l to 120 μg/l after 9.6 years. A severe shortfall is the complicated and uncertain process of frequent removal of water hyacinth to prevent the lake from being overwhelmed by the invasive plants. The feasibility and sustainability of these two lake restoration methods are discussed. The insights gained would be useful to the relevant authorities in determining and implementing the best remediation measures for TH.
Utilizing Graphical Elements for Concept Map Analysis to Design Teaching and Learning Assessment
Authors:   Mahidol University, Thailand, Chuechote Suparat , Laosinchai Parames
Published: October 2020

The graphical elements as parts of concept map construction are employed to assess both learning and teaching. Augmenting the use of concept maps, this study examines the graphical elements, such as, nodes, edges, cliques, diameters, travelling paths and structures of the graphs to relate to ones’ understanding to a topic, in this case, polynomials for middle school. In the aspect of teaching assessment, the teacher’ concept map drawn according to the lesson plan is served as the master map, which echoes the teacher’s expectation of students’ learning. On the other hand, students’ maps also reveal their understanding through the nodal relationship, which can be the definitions of terms, related examples, graph representation and algebraic manipulation. Data collection includes a focus group of 10 students and 1 teacher undergoing the concept map assessment task with restricted node terms. Graphically analyzed, students’ concept maps reveal some common elements as in the teacher’s map. In addition, the interview with the teacher also suggests that concept map as the assessment tool is an effective teaching reflection for which the teacher can see what to fulfill for future classes.
Helping People with Language Learning Disabilities Using Native Mobile Voice Recognition — Exploring Its Limits and Advantages
Authors:   the Department of Statistics, Computer Science and Mathematics, Public University of Navarre (UPNA), 31006 Pamplona, Spain, Alonso C. , Read T. , Astrain J. J.
Published: October 2020

This article presents an intelligent system for people with language learning disabilities called MarLuc. MarLuc aims to improve people’s skills in their native language rather than a second language. The system was born as a tiny Computer Assisted Language Learning (CALL) web-based application targeted to improve pronunciation. Later it became a Mobile Assisted Language Learning (MALL) application and has therefore incorporated some powerful native resources such as voice recognition present on mobile devices. Working with personal mobile devices has brought new exciting possibilities, including but not limited to easy access to native voice recognition and the utilization of bots. In this study, we will show the advantages and some limitations of using native Siri or Android based voice recognition.
Examination of the relation of localization of placenta at 18-24 weeks of gestation by ultrasonography with the development of preeclampsia later in pregnancy
Authors: Pundir Seema , Namdeo Neelam , Jain Sandhya
Published: October 2020

Background: The aim of the study was to examine the relation of localization of placenta at 18-24 weeks of gestation by ultrasonography with the development of preeclampsia later in pregnancy.Methods: Hospital based Prospective observational Cohort study at department of Obstetrics and Gynecology, Dr. BSA Hospital Delhi. 150 pregnant women of gestational age18-24 weeks attending ANC clinic were enrolled for ultrasound examination and on the basis of ultrasonography (USG) findings placenta was classified as Group-A (patient found to have laterally located placenta). And Group-B (patients found to have centrally located placenta). All women in both the group were followed up regularly till term. Study duration was 1 year, June 2017-June 2018.Results: The overall risk of developing Preeclampsia with a late rally located placenta was 8.5(odds ratio) with 95% confidence interval (4.0339 to17.9108). This difference was highly statistically significant (p<.0001). Placental laterality has a sensitivity of 77.27%, beside that it has a good specificity of 71.43% and negative predictive value of 80%. Lateral localization of placenta by ultrasonography at mid trimester can be used as a screening test. The presence of urine albumin in group A was found in 70.67% as compared to 13.33% in group B. This difference was statistically significant. (p=0.0001). Around 72% of total complications were seen in Group-A as compared to 28% in Group-B. This difference was found to be statistically significant (p=0.028).Conclusions: Significant correlation exists between placental laterality and the development of preeclampsia and thus placental localization by ultrasonography in midtrimester (at 18-24 weeks) can be used for prediction of development of preeclampsia later in pregnancy.
A hospital based retrospective study of thyroid disorders on obstetric and perinatal outcomes
Authors: Patel Sagar R. , Yadava Pushpa A. , Mehta Shital T. , Raval Bina M. , Sisodiya Viditsinh P. , Parikh Riya A. , Viraja Mital R.
Published: October 2020

Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients.
A missed cornual ectopic pregnancy: a case report
Authors: Prah James K. , Derkyi-Kwarteng Leonard
Published: October 2020

Ectopic pregnancies continue to be among the leading causes of maternal mortality globally. Cornual pregnancies are types of ectopic pregnancies that occur in the interstitial part of the fallopian tube and invades the uterine wall. We report a case of cornual ectopic pregnancy at 26 weeks that was missed and only diagnosed at autopsy following rupture and death of the pregnant woman. This case emphasizes the importance of a detailed carefully performed ultrasonography in the first trimester for all pregnant women.
Postpartum atypical haemolytic uremic syndrome: a rare case report
Authors: Khatod Neha , Mukharjee Shubhra , Malviya Vijay
Published: October 2020

Hemolytic uremic syndrome (HUS) is characterized by triad of microangiopathic hemolytic anaemia, Thrombocytopenia and Acute renal failure. Genetically predisposed women develop HUS and may be triggered by pregnancy. The diagnosis is challenging due to overlapping clinical features of other diseases in pregnancy. The long-term prognosis is guarded. We are presenting a case of a young primigravida who underwent emergency lower (uterine) segment caesarean section (LSCS). She developed progressive anaemia, thrombocytopenia and renal failure postoperatively. Aggressive management with plasmapheresis, blood transfusions and hemodialysis saved her life. She is currently in remission.
A case of natural conception after uterine artery embolization
Authors: Dharmarha Noor , Hajari Anju , Konda Anuradha , Reddy Venkatesa Muni
Published: October 2020

Our objective of this case report is to highlight the value of uterine artery embolization as a means of conservative management of uterine arteriovenous malformation in patients wanting preservation of fertility. A 24 years old woman, P1L1A2 presented with complaints of heavy menstrual bleeding for two months. She had a previous term caesarean section in 2014, followed by curettage twice, in 2016 and 2017. The first episode of heavy bleeding occurred two months after the last curettage. Previous menstrual cycles were regular with moderate flow. The patient was started on combined oral contraceptive pills but she did not respond to medical treatment. Transvaginal scan and Doppler showed uterine AVM and endometrial thickness of 7.7mm. Beta hCG was less than 1.2. Digital subtraction angiography and bilateral uterine artery embolization was done. Patient conceived spontaneously a year after the procedure and delivered a healthy baby at term by elective caesarean section. Angiography and uterine artery embolization has revolutionized the management of AVM and contrary to popular belief, the pregnancy outcome after UAE was good.
Pure gonadal dysgenesis misdiagnosed as Mayer Rokitansky Kuster Hauser Syndrome: a case report
Authors: Singh Preeti B. , Purwar Roli , Kumar Pawan
Published: October 2020

Gonadal dysgenesis is a group of heterogeneous disorders with very rare presentation. The spectrum of disease not only includes primary amenorrhoea but also secondary amenorrhoea. Herein, we are reporting a case of 16-year-old phenotypic female who presented with amenorrhoea with 46, XX karyotype with hypoplastic uterus with absent ovaries (on imaging), with high gonadotropins level and low estradiol. Suspecting Mayer–Rokitansky–Küster–Hauser syndrome (due to hypoplastic uterus) with gonadal dysgenesis she was started on cyclic hormones for development of secondary sexual characters and to prevent bone loss. But, during follow up, after giving estrogen for 8 months, her hypoplastic uterus again starts reappearing with attainment of cyclic menses on estrogen and progesterone withdrawal. We concluded that, in the presence of rudimentary or hypoplastic uterus, straightforward diagnosis of MRKH is to be avoided without seeing peripheral estrogenisation, hormone profile and karyotype analysis.
Evaluation of Ilizarov technique in the treatment of open fractures of tibia
Authors: Debnath Debdulal , Islam Jihadul , Huda Nazmul , Shameem M. A. A.
Published: October 2020

Background: Now a day, open fracture of tibia is a common occurrence in the orthopedic treatment arena. Fundamentally, open fractures of tibia are classified into type I, II, IIIA, IIIB and IIIC. The aim of this study was to evaluate the Ilizarov technique in the treatment of open fractures of tibia.Methods: This was an observational prospective study conducted in the Department of Orthopedic Surgery, Northern International Medical College& Hospital, Dhaka, Bangladesh during the period from January 2017 to December 2017. Thirty-six (36) patients with tibial fractures were selected as the study population. This study was approved by the ethical committee of the respective medical college.Results: Out of total 36 participants, 65% were males and 35% were female. In analyzing mode of injuries, we found the highest 80.56% participants were from road accidents followed by 11.11% from sports injury and rest only 8.33% from general falls. The duration of treatment with the fixator was 12-23 weeks (average 16 weeks). In our study total 36 cases were debrided on the same day and stabilized with Ilizarov ring faxator after a period of 5 to 12 days from the date of injury. The operation time ranged from 90 minutes to 120 minutes (Mean 102±4 minutes).  Conclusions: In this study no case developed deep infection, non-union or unacceptable mal-union. The construct through Ilizarov is stable and enables the patient to bear weight on the affected limb a short time after the surgery, even in cases of comminuted fractures.
Clinical study and surgical management of acute intestinal obstruction in the adults
Authors: Gadhavi Jaydeep M. , Charpot Rahul
Published: October 2020

Background: The aim of this study was to evaluate the treatment protocol of intestinal obstruction in adults.Methods: A total of 60 patients diagnosed with intestinal obstruction were included in the study. All the patients with the provisional diagnosis of the intestinal obstruction were assessed clinically after the admission. Appropriate surgical procedures were implemented on the patients with clear signs and symptoms of acute abdominal obstruction. Surgery adopted and criteria for deciding the procedure were noted.Results: For the management of small bowl obstruction. Adhesiolysis was done in 14 patients, resection and anastomsis was done in 8 patients, in 4 patients the band release procedure was performed, hernia repair was done in 8 patients, followed by resection, hernia repair, volvulus derotation and Mekels diverticulectomy was done in 2 patients respectively. For the management of large bowl obstruction the Colostomy was done in 8 cases, resection and anastomosis in 4 cases, intussusception milking in two cases, volvulus derotation was done in 2 cases and right hemicolectomy was done in 4 cases of CA ascending colon.Conclusions: Success in the treatment of acute intestinal obstruction depends largely upon early diagnosis skilful management and treating the pathological effects of the obstruction just as much as the cause itself. Postoperative adhesions are the common cause to produce intestinal obstruction. Clinical radiological and operative findings put together can diagnose the intestinal obstruction. Mortality is still significantly high in acute intestinal obstruction.
Stapled versus open haemorrhoidectomy: a prospective study
Authors: Mohammed Serbin , Balachandran Kavitha Jayanthi , Vineed S. , Chisthi Meer M.
Published: October 2020

Background: In this era of staplers and advanced techniques in surgery Milligan Morgan technique of open haemorrhoidectomy is still considered as gold standard procedure for symptomatic haemorrhoids. Stapler haemorrhoidectomy, even though it is practiced in many centres has not become common due to various factors. The present study was done to compare the efficacy, safety and advantages, if any, of the stapled haemorrhoidectomy to open procedure.Methods: This prospective study was performed in the department of general surgery, Government medical college, Thiruvananthapuram, Kerala over a period of 12 months from March 2015 to March 2016. Symptomatic patients with grade 3 and4 haemorrhoids were selected for the study. The patients were randomized into two equal groups of 20 each. Group A underwent conventional open haemorrhoidectomy and group B, stapled haemorrhoidectomy.Results: Mean operative time period for group A was 39.25 ±5.5 minutes and group B was 26.75±4.7 minutes. There was significant difference in the pain score between these procedures on first 3 post-operative days. There was also significant difference in group A and group B which was 6.55±1.099 and 3.55±0.759 days respectively for mean hospital stay and 9.90±1.651 and 5.70±0.865 days respectively for return to normal work.Conclusions: Stapler haemorrhoidectomy is associated with lower pain scores postoperatively and shorter duration of hospital stay with early return to work when compared to conventional open haemorrhoidectomy.
A rare extensive clinical presentation of calciphylaxis due to primary hyperparathyroidism
Authors: A. Mohamad Safwan , Vijayan K. N. , S. Akash , T. Ashwini , K. P. C. Muhammed Irfan
Published: October 2020

Calciphylaxis is a dreadful condition predominantly seen in chronic kidney disease patients on haemodialysis or following renal transplant. Calciphylaxis occurring in patients with normal kidney function is extremely rare. Here we present 53-year-old women presented with painful, extensive eschar-like skin lesions involving bilateral lower limb of 3 months of duration. She had hypercalcemia, high serum parathyroid hormone (PTH) levels and elevated alkaline phosphatase. Ultrasound neck and sestamibi scan demonstrated left inferior parathyroid adenoma. Lower limb radiographic studies showed subcutaneous calcification. Cutaneous biopsy confirmed calciphylaxis. Cinacalcet to control hypercalcemia, antibiotics and pain control medications were started. Left inferior parathyroidectomy and debridement of gangrenous lesions of lower limbs were performed. Histopathology was consistent with parathyroid adenoma. Lower limb wound started granulating with Vacuum-assisted closure (VAC) dressing and skin graft was planned. Unfortunately, she succumbed 11 weeks from surgery due to proximal myopathy, aspiration pneumonitis, sepsis and multiorgan failure.
Robotic surgery in Nigeria: an uncertain possibility
Authors: Oyebamiji Tunde A.
Published: October 2020

Since its introduction about 2 decades ago, surgical robots are becoming increasingly used in many surgical operations. The emerging technology has increased the efficiency, reliability and precision of surgical procedures. It has minimized overall post-operative complications and led to faster patient recovery. Although there are some limitations to robotic surgery, its many advantages have generated great excitement within the surgical community. Thus, there is an exponential growth in the use of the surgical robot across numerous surgical specialties and in many developed nations of the world. In Africa, the robotic surgical system has only been adopted in South Africa and Egypt for limited surgical cases. However, there has been no documented use in Nigeria. The implementation of robotic surgery in Nigeria is been hampered by low budget allocation to health, a regressive health care financing model, epileptic power supply and most of all, poor leadership make the implementation of robotic surgery in Nigeria challenging. The cost of acquiring and maintaining the surgical robot will gradually become cheaper as more robotic surgical manufacturers enter the marketplace, thereby making it more affordable and accessible in low- and middle-income countries. Effective leadership and critical investment in health care systems and human capital, will increase the possibility of implementing a robotic surgical program in the future.
Surgery in the COVID-19 pandemic
Authors: Kumar Satish , Pal Sanjay , Kalyanasundar Suresh
Published: October 2020

The world is going through a difficult time with the COVID-19 pandemic for the last five months and has affected more than 200 countries. Wuhan in China was the first place and then this has spread all over the globe. The virus affects the respiratory tract predominantly leading to death more so in the elderly and those with comorbid conditions. All routine and planned surgical services had to be stopped in view of the very rapid spread of the virus compounded by the lack of a proper treatment. It has been nearly 90 days and surgical services need to restart. There are various protocols being practiced and we have also put up a protocol which is simple and wherein the disease has been triaged into three groups and accordingly treatment is executed. All surgical emergencies are treated considering them as COVID positive till proved by a negative test.
An observational study to determine the effectiveness of treatment of dental caries in management of non-specific recurrent/chronic pharyngitis
Authors: U. Jagadeeswaran V. , Marthandam Jagadeesh , Kumar Sathish
Published: October 2020

Background: Chronic pharyngitis is a common inflammatory condition of the pharynx, which has long duration and various etiological factors attributed to it. The most common local constant source of infection causing chronic pharyngitis are rhinitis, sinusitis and laryngopharyngeal reflux. The management for the above etiology is mostly symptomatic. In majority of the cases in spite of symptomatic treatment there is no relief for the patient and the non- specific conditions have to be considered in those cases. One such non-specific condition is chronic dental caries due to poor oral dental hygiene.

Methods: A prospective observational study was carried out in the ENT and dental department for over a period of one year at our tertiary care hospital after obtaining institutional ethical committee clearance.  

Results: 50 out of the 67 patients who had chronic dental carries and who were on chronic medication for non-specific chronic pharyngitis benefitted from dental treatment.

Conclusions: Patients with long duration medication for symptomatic treatment of non-specific chronic pharyngitis, if presented along with chronic dental carries, it’s recommended to do initial treatment for dental caries management. Awareness has to be created among all individuals about oral dental hygiene.
Endoscopic endonasal pituitary adenoma surgery: our surgical experience in 116 patients
Authors: Potdukhe Krishna Vikas , Patel Kalpesh , Vishwakarma Rajesh
Published: October 2020

Background: The primary objective of this study was to evaluate the outcome of excision in terms of gross and partial resection rates compared to the grades of pituitary adenoma (based on Hardy-Vezina classification). We also evaluated the post-operative complications and the effect of resection on visual outcomes and endocrinological remission.

Methods: We retrospectively analysed 116 patients who underwent surgical resection of pituitary adenoma via endonasal trans-sphenoidal approach at Civil Hospital (Ahmedabad) between March 2013 and March 2019 and collected pre-operative and post-operative data in terms of imaging, endocrine function and vision.  

Results: According to the postoperative imaging data and endocrine examination results, gross-total resection (GTR) was achieved in 79.3% (92 patients), and partial (PR) in 20.6% (24 patients) which was significant (p<0.05). Improvement in vision was seen in 62% (40 patients out of 64 patients). Out of 44 patients having endocrine dysfunction, endocrinological remission was achieved in 32 patients with functional adenomas (72.7%). Sinusitis followed by headache was the most common minor complication seen in the study.

Conclusions: Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for patients having grade 3 or lower pituitary adenomas, which leads to gross total resection in comparison to patients having grade 4 adenoma. It also results in high rate of surgical decompression and better visual outcome. Partial resection may result in endocrinological response in functional tumors.
A rare case of pediatric intranasal lobular capillary hemangioma
Authors: Schild Sam D. , Irizarry Rachel , Plum Ann
Published: October 2020

Pediatric nasal cavity vascular tumors express a wide variety of pathologies. Lobular capillary hemangioma (LCH) is an acquired benign vascular growth of skin and mucosa whose etiology remains unknown, though trauma and hormonal influences are implicated. Although well documented in the head and neck literature for children age five or less, it is a rarity within the nasal cavity and has yet to be documented in the mid-septum. We describe a unique case of intranasal LCH and review the current literature. A nine-year-old male presented with one week of profuse intermittent unilateral epistaxis and no history of nasal trauma. Rhinoscopy revealed a pink, pedunculated mass of the right mid-nasal septum at the bony-cartilaginous junction. CT and MRI imaging were consistent with an expansile vascular lesion receiving prominent bilateral sphenopalatine artery supply. Following embolization, en bloc endoscopic surgical excision of the lesion using cold dissection was performed with no bony or cartilaginous involvement noted. The epistaxis resolved following resection. Final histology confirmed the mass as a lobular capillary hemangioma. Paediatric intranasal LCH is a rare entity, yet warrants consideration in our differential diagnosis of pediatric vascular tumors. Our study indicates these lesions can develop in the mid-septum despite the absence of a vascular plexus. Preoperative embolization should be considered for pediatric nasal cavity tumors due to concern for hemorrhage. Endoscopic wide local excision is an appropriate and effective treatment.  
Rhinosporidiosis-an atypical presentation as a facial swelling in left cheek
Authors: Kumar E. Siva , Swapna C. A. , Karanam Lavanya , Kumar Ram
Published: October 2020

Rhinosporidiosis is a chronic granulomatous disease of mucous membranes caused by Rhinosporidium seeberi. Most frequently affected sites are nose and nasopharynx followed by eye. Report a rare case of 13-year-old female with rhinosporidiosis in a bizarre way of presentation as a cyst in left cheek. A 13-year-old female child hailing from West Bengal presented to ENT OPD with complaints of swelling in the left cheek for 6 months gradually increasing in size. On examination left side of cheek a cystic swelling extending from angle of mouth to lateral side of face was seen. Magnetic resonance imaging (MRI) neck plain and contrast showed large well defined T2 hyperintense cystic lesion in subcutaneous plane measuring about 5.7 cm (transverse)×6.0 cm (cephalocaudal)×5.5 cm (anteroposterior) with post contrast wall enhancement. Patient planned for excision and histopathological examination was consistent with rhinosporidiosis. Rhinosporidiosis continues to be a conundrum necessitating further literature and research on this. The difficulty in culturing the organism and its preternatural presentations add up to difficulties in diagnosing. Emphasise the quaint feature of its presentation as a cyst in cheek as primary site without any focus of infection in the respiratory tract and with negative history of traumatic inoculation.
Successful paediatric tympanoplasy – An overview
Authors: Thantry Deepalakshmi , Raj K Vishnu , S G Mahesh , P Devan P , Bhandary Rukma
Published: October 2020

Paediatric tympanoplasty is regarded by many as being less successful than in adults due to higher incidence of otitis media. In our study, we are trying to determine the pre-operative conditions that influence the success of paediatric tympanoplasty and construct a prognostic index for the same.

To determine which pre-operative conditions or surgical technique may influence the success of pediatric tympanoplasty and to construct a prognostic index for the same.

40 children between 8-15 years were included in this prospective study between June 2018- August 2019 in Department of ENT, in our institution. Pure Tone Audiograms were recorded pre and post operatively.

The positive outcomes measured were integrity of tympanic membrane, minimum of 10decibel gain in auditory threshold and air filled space in middle ear. Higher success rate was observed in cases with elder age group (12-15 years), shorter duration of ear discharge, longer period of dry ear and small size of perforation.

Tympanoplasty in children is a current and controversial theme. We have made a novice attempt to define factors that predict success or failure in paediatric tympanoplasty.
Anti-Windup FOPID-Based DPC for SAPF Interconnected to a PV System Tuned Using PSO Algorithm
Authors: Boudechiche Ghania , Sarra Mustapha , Aissa Oualid , Gaubert Jean-Paul , Benlahbib Boualam , Lashab Abderezak
Published: October 2020

This paper deals with a shunt active power filter (SAPF) integrated in a photovoltaic (PV) system, which is interfaced to the grid via a double-stage configuration, for simultaneously improving the power quality in the existence of non-linear loads and injecting the PV harvested power to the power grid. The direct power control (DPC) based on the conventional Proportional-integral (PI) suffers from some shortcomings in the transient state, such as large overshoots and undershoots in the voltage. Long response time is another disadvantage when using such a controller. To overcome this situation, the proposed control method is equipped by an anti windup fractional order proportional-integral differentiator (AW-FOPID) regulator, replacing the standard PI or PID regulators to maintain the DC link voltage at its desired value with small overshoots and undershoots in the voltage, while maintaining a short response time. The AW-FOPID controller, however, has five parameters, which makes it troublesome to tune. Accordingly, to adjust this AW-FOPID parameters, the Particle Swarm Optimization (PSO) algorithm is employed by minimizing the Integral Time Absolute Error (ITAE). Furthermore, an intelligent algorithm for tracking the maximum power point (MPPT) based on fuzzy logic has been applied to eventually resolve the drawback of the rapidly changing weather conditions. The overall control scheme is examined by simulation using MATLAB/Simulink software. The obtained simulation results and comparative study demonstrate the feasibility and performance of this control strategy.