bluuebunny/crossref_metadata_2025 huggingface dataset:
PATTERNS OF DEMOBILIZATION: A QUALITATIVE COMPARATIVE ANALYSIS (QCA) OF FAR-RIGHT DEMONSTRATION CAMPAIGNS
Authors: Zeller Michael C.
Published: September 2021

Scholarship on social movement lifecycles has focused on mobilization processes, with relatively less attention on the ends, demobilization. The intuitive connection between origins and ends has sometimes led to a conceptualization of demobilization as simply the failure to continue mobilizing, obscuring the distinct causal processes underlying demobilization. This article adds to recent studies foregrounding demobilization by studying the negative demobilization of large, far-right, demonstration campaigns. Using a subset from this population of cases—campaigns in Germany, England, and Austria between 1990 and 2015—the article applies qualitative comparative analysis (QCA) to this causally complex phenomenon. I find that demobilizing is conjunctural, with evidence of four patterns: closing opportunity, coercive state repression, civil countermobilization, and militant anti-far-right action. This article addresses an important—and conspicuously ubiquitous—population of cases, far-right demonstration campaigns and presents findings that reflect on critical issues in the study of far-right sociopolitics.
Electrocardiographic findings in COVID-19: analysis of tele-ECGs in Moscow ECG IT Center
Authors: Taskina Varvara Y. , Demkina Alexandra E. , Gazashvili Tamara M. , Shkoda Andrey S. , Vladzymyrskyy Anton V. , Morozov Sergey P.
Published: September 2021

BACKGROUND: Coronavirus disease (COVID-19) affects the cardiovascular system and the primary damage to the respiratory system involved in the pathological process. However, in the available literature, the electrocardiography (ECG) analyses are based only on small-sample studies and case reports, which determine the relevance of larger-scale studies to clarify the nature and prevalence of ECG abnormalities in subjects with confirmed coronavirus infection.
AIM: To determine the distribution of ECG changes in COVID-19 patients representing a non-selective population of Moscow residents.
MATERIALS AND METHODS: We performed a retrospective analysis of ECGs from 42,799 patients from March 10, 2020 to March 10, 2021 with a verified diagnosis of COVID-19 was performed. The study included patients admitted to Moscow clinical hospitals connected to the ECG IT Center. A standard 12-lead ECG was obtained and transmitted via an Internet connection to the server of the ECG IT Center, where the ECG interpretation was performed.
RESULTS: ECG changes were detected in 54% of patients. The most common cardiac arrhythmias were supraventricular extrasystole (12.6%) and atrial fibrillation (12.0%) reported in patients. Signs of the overloaded right heart were detected in 12.5% of cases, of which the ECG pattern of pulmonary embolism was confirmed in 485 patients (1.13%). Infarction ECG pattern was observed in 4.5% of patients, among which 3 cases of Brugada ECG pattern were reported. The incidence of ST-T changes was 2.2% of all study patients. Prolonged QT and QTc intervals were recorded in 540 patients (1.26%). In addition, individual cases of ventricular fibrillation, Frederick syndrome, and atrioventricular block of various degrees were reported.
CONCLUSION: The distribution of incidence of ECG changes in COVID-19 was shown based on the data obtained. The high incidence of atrial fibrillation, which is a risk factor for thromboembolic complications, was confirmed. Moreover, a significant prevalence of ECG patterns of overloaded right heart was shown, some are associated with pulmonary embolism. Other reported ECG changes were characterized by a significantly lower prevalence, which does not reduce their clinical significance. The data obtained may be used to improve COVID-19 patient management strategy in the future.
Diagnostic errors in subarachnoid haemorrhage
Authors: Schimrigk К. , Kaiser Т.
Published: September 2021

In this work diagnostic errors of subarachnoid haemorrhage have bun analyzed; the latter being caused by rupture of brain sacculated aneurysms. False diagnoses have been enumerated. Necessity of early hospitalizathion to neurology hospital of patients with signs of subarachnoid haemorrhage has been explained.
Rehabilitation after a cerebral stroke
Authors: Nau R.
Published: September 2021

In Germany, a cerebral stroke affects 2 out of 1000 inhabitants per year, which corresponds to 160 thousand strokes per year, according to other sources - up to 250 thousand. Currently, significant progress has been achieved in the treatment of acute strokes. The mortality rate for strokes in the early stages of the disease, which previously exceeded 50%, has significantly decreased.
Neuropsychological examination is an important component of diagnosing the consequences of traumatic brain injury
Authors: Salganik E.
Published: September 2021

Patient X., 39 years old, an actor by profession, had an accident on May 9, 1980. A car driven by another driver crashed into X's car from the right side. The patient was wearing a seat belt and was pushed to the left door of the car. He could not describe the details of the incident. He remembered how the police pulled him out of the car.
New approaches to the treatment of multiple sclerosis
Authors: Lowitzsch К.
Published: September 2021

Currently, multiple sclerosis (MS) is classified as an autoimmune disease with a specific genetic predisposition. T-lymphocytes play a leading role in its pathogenesis. The disease has a specific genetic predisposition.
Biorhythmostimulation in complex treatment of patients with initial forms of brain blood supply insufficiency
Authors: Belousova Т. Е. , Alekperov F. G. , Shvalev V. N.
Published: September 2021

Study of biorhythmostimulation efficiency in complex treatment of patients with initial forms of brain blood supply insufficiency was carried out. The obtained results are indicative of high efficiency of the given method of psychoemotional condition of patients. True reliable normalisation of arterial pressure, brain vascular tension, vegetative nervous system, cerebral cortex electrical activity took place. Biorhythmostimulatuion is a highly effective and pathogenically substantiated method of psychoemotional condition correction and can be widely used with medical purposes for patients with initial forms of brain blood supply insufficiency.
Hemodynamics changes in late manifestation of natal trauma of spinal cord’s cervical department
Authors: Prusakov V. F.
Published: September 2021

Hemodynamics of children with natal trauma of spinal cords cervical department was studied. It was determined, that among numerous manifestations of late complications of natal cervical traumas amyotrophy syndrome of shoulder girdle is widely spread, in which in 65% of cases hemodynamics insufficiency is determined in the carotid region, and in 37% - in vertebro-basilar region. Functional tests allowed to determine occult blood flow insufficiency in vertebro-basilar region in 80% of cases, thus confirming presence of chronic circulatory insufficiency in the system of vertebral arteries in patients with amyotrophy syndrome of shoulder girdle.
Recklinghausen neurofibromatosis variant
Authors: Zalyalova Z. A. , Yusupov F. Y. , Mukhametshina L. Y.
Published: September 2021

Neurofibromatosis is a hereditary disease characterized by the presence of many tumors located in the skin, along the peripheral nerves, in the central nervous system, skin pigmentation with bone anomalies, and damage to internal organs.
Manual therapy in patients with vertebrobasilar insufficiency
Authors: Sitel A.
Published: September 2021

According to WHO statistics, from 40 to 80% of the world's adult population suffer from clinical syndromes of osteochondrosis of the spine. As one of the most common causes of temporary disability, they lead to significant economic losses.
Import of Scientific Policy Instruments in Contemporary Russia
Authors:   Kemerovo State University, Kurbatova Margarita V. , Levin Sergey N. ,   Plekhanov Russian University of Economics,   Financial University under the Government of the Russian Federation, Sablin Kirill S. ,   Kemerovo State University
Published: September 2021

Characteristic features of contemporary scientific policy of Russia in the context of its instruments import are highlighted in the article. Instruments are analyzed as institutions according to the D. North interpretation. It was revealed that the main imports are the instruments those ensure the accountability of the academic community (academia). Grant funding system, scientometrics and academic excellence programs are these instruments. In the conditions of contemporary Russia the accountability of scientists and scholars to society turns into accountability to the vertical of power. The motivation of its representatives includes both the idea of public benefits as well as the task of private efficiency maximizing when to select the goals and instruments of scientific policy. It is shown that the selection process includes three main levels: political, governmental and departmental. Imported instruments are gradually transformed in accordance with the interests of the actors participating in the vertical administrative bargaining at all these levels. The goals set at the political level to strengthen economic and political positions of the country in the world are gradually being replaced with the tasks of maximizing the private efficiency of high-ranking participants in this bargaining. As a result, a qualitative modification of the sphere of science occurs. It is not just about the limitation of academic community autonomy, but about its incorporation into the vertical of power in the conditions of contemporary Russia. This fact leads to the changing of motivation and structure of academia. Academic researchers and scholars are gradually being replaced by politicized academic administrators and specific academic entrepreneurs. They are differ if compare them with the western academic entrepreneurs. The latter are focused on the competitive economic markets, while the first concentrate their attention on the redistribution of resources within the framework of vertical administrative bargaining.
Rural Child in the Polish Educational Discourse during the Interwar Period or about Less Known Roots of Regionalism at School
Authors: Mlekodaj Anna
Published: September 2021

The article is devoted to the process of discovering the specificity of life and development of a village child, initiated at the turn of the second and third decades of the 20th century. It was one of the consequences of the then developing educational discourse, supported by the achievements of child psychology, pedology, and the New Upbringing trend. In 1929, the first Polish research on the level of development of children from urban and rural environments was conducted. The results were very unfavorable for children from the countryside. This gave an impulse for further action. In 1930, in the pages of “Praca Szkolna” (“School Work”), a competition was announced among teachers to describe a rural child from various regions. Twenty-two papers were submitted, the best of which were published in the book Dziecko wsi polskiej (A Child of the Polish Countryside). These works allowed us to penetrate both the problems faced by rural children at school and the difficulties faced by teachers working in the countryside. To a large extent, they resulted from the lack of a proper diagnosis of the educational and upbringing needs of a rural child and from difficulties in cooperation between schools and villages. The perspective of changes in this area was opened only by regionalism, introduced to school curricula as a result of the education reform in 1932, which was to support the education of rural children and contribute to the integration of the school with the local community. Thus, the teaching characteristics of a rural child contributed, in a sense, to the introduction of regionalism in Polish schools.
To Traumatize or to Put under a Taboo? Holocaust Narratives in Children’s Literature
Authors: Rybak Krzysztof
Published: September 2021

The article investigates the ways of representing the Holocaust in children’s literature published in Poland in the 21st century (e.g. Joanna Rudniańska’s Kotka Brygidy and Smoke by Antón Fortes and Joanna Concejo). Phenomena such as anti-Semitism or death of the main character, called by researchers and critics inappropriate for a young audience, are analyzed with the use of the research on taboo in children’s literature (Bogusława Sochańska and Justyna Czechowska) as well as confronted with the threat of “traumatization” of the young reader (Małgorzata Wójcik-Dudek). The analysis proves that the Shoah only appears to be well-represented in children’s literature as many topics are still omitted.
Youth’ Educational Problems During Distance Learning
Authors: Araszkiewicz Aleksandra
Published: September 2021

The article is based on the distance learning experience in the second half of the 2019/2020 school year. The author focuses on the students’ perspective and points out that the youth’ educational dilemmas compared to traditional education have not so much changed, but have become acute. In order to understand different student attitudes during distance learning, it is necessary to understand their reasons, therefore, the author analyzes the learning conditions, students’ time management skills and the impact of technology on the health and social development of their students.
Gestión sostenible de plásticos: análisis regulatorio y técnico en el marco de la iniciativa de economía circular en la Alianza del Pacífico y Ecuador
Authors: Cifuentes Luis Abdón , Cerda Gho Viviana , Bohaud Ausset Anne - Lise , Alarcón González María Teresa , Cabrera Castro Camila , Parra Arias José Luis , López Gómez Iván , Ochoa Herrera Valeria , Cevallos Daniela Flor , Flores Rendón Camila , Scheel Mayenberger Carlos , Cantú Garza Andrea , Galarza Contreras Elsa , Galarza Contreras Christian
Published: September 2021

En la Declaración sobre Gestión Sostenible del Plástico (2019), los países miembros de la Alianza del Pacífico (AP), Colombia, Chile, México, y Perú, junto a Ecuador, tomaron la decisión de enfrentar la gestión de plásticos de manera sostenible, con un enfoque de economía circular. Insertado en este contexto, el presente estudio analiza y compara el escenario regulatorio y los incentivos fiscales y financieros implementados en la AP y Ecuador, en relación con la gestión del plástico. Asimismo, este estudio identifica las mejores prácticas y las brechas existentes en esta materia, establece un índice que permite comparar el carácter sostenible de la gestión de los plásticos en esos países, y entrega recomendaciones para que los incumbentes tomen informadas decisiones de políticas públicas para el uso y gestión sostenible de los plásticos.
Effects of Innovation on Employment: An Analysis at the Firm Level in Bolivia
Authors: Foronda Carlos , Beverinotti Javier
Published: September 2021

This study quantifies the impact of process and product innovation on employment growth in Bolivia by using microdata from a survey on innovation conducted in Bolivia in 2016. Following the model of Harrison, Jaumandreu, Mairesse, and Peters (2008) and the adaptations for Latin America of Crespi and Tacsir (2013) and Elejalde, Giuliodori, and Stucchi (2015), we demonstrate that employment growth is explained by product innovation. On the other hand, we find no evidence of a displacement effect due to process innovation. With respect to innovation and work composition, we observe that the reation of qualified employment is slightly favored over that of unqualified employment.
PREVALENCIA DE FRACTURAS ORBITO CIGOMATICA EN EL HOSPITAL DE ESPECIALIDADES DE LAS FUERZAS ARMADAS No 1-QUITO EN DOS ESCENARIOS DISTINTOS
Authors: León Pachano Luis , Unda Jaramillo Patricio Marcelo
Published: September 2021

Presentamos una investigación aplicada y comparativa, relacionada con dos escenarios de la vida del Ecuador, ocurridos en octubre del 2019 y marzo del 2020. Donde se presentaron pacientes con traumatismos faciales. El objetivo de la investigación fue establecer la prevalencia de las fracturas faciales en los pacientes de estos dos eventos. Se encontraron similitudes en los dos casos y se comparó con los datos mundiales, sacándose como conclusión que los traumatismos orbito-cigomáticos fueron los más comunes, lo que nos obliga a estar preparados para atender estos pacientes que seguramente se presentarán con mayor regularidad en las salas de emergencia de nuestros hospitales.
Performance Analysis of NOMA Downlink for Next- Generation 5G Network with Statistical Channel State Information
Authors: Kumar Indrajeet , Mishra Manish Kumar , Mishra Ritesh Kumar
Published: September 2021

Non-orthogonal multiple access (NOMA) is a compelling strategy that helps wireless networks of the fifth-generation (5G) to fulfill the diverse demands of increased fairness, high reliability, extensive connectivity, low delay and superior performance. Traditionally, NOMA network presumes perfect transmitter-side channel state information (CSI), which is almost impossible for a number of communication scenarios. Furthermore, this paper contemplates the realistic NOMA downlink method in the Rayleigh fading networks, where the statistical CSI linked with each user is known to the transmitter. We evaluate the outage probability of the proposed model and obtain a closed-form framework of the probability of outage for each user. Besides, the source can optimize the network’s achievable sum-rate for different users based on statistical CSI. The precision of our outage probability analysis and the optimum power allocation algorithm proposed are both verified by the analytical and simulation results.
Clinical Presentation and Management of Patients with Peptic Ulcer Perforation in Kashmir - A Prospective Study
Authors: Ganaie Abdul Rashid , Banoo Zuneera , Hela Aamir Hussain , Hakeem Ishfaq Ahmad , Khandwaw Haseeb Mohammad
Published: September 2021

BACKGROUND Around 4 million people are affected by peptic ulcer diseases worldwide annually. The incidence of around 1.5 % to 3 % has been estimated. Peptic ulcer perforation presents with an overall mortality of 10 %. The management is also associated with significant post-operative morbidity and mortality regardless of whether laparoscopic or open repair is performed. In this study, we wanted to find out the incidence of peptic ulcer perforation and its management. METHODS Our study was a prospective observational study conducted in post graduate Department of Surgery, Government Medical College Srinagar, from October 2018 to November 2020. All patients were evaluated properly with all baseline investigations followed by X-ray chest and abdomen and ultrasonography (USG). RESULTS In our study, 136 patients were diagnosed as cases of peptic ulcer perforation. The maximum number of patients were in age group of 41 - 50 years (27.20 %). The male : female ratio was 14.1 : 1. Abdominal pain was present in all patients as presenting symptom followed by abdominal distension. In this study, 124 patients (91.2 %) had perforation in first part of duodenum, 9 patients (6.6 %) had perforation in prepyloric region and 3 (2.2 %) patients had perforation in body of stomach. Graham’s Patch repair was done in 133 patients, 1 patient underwent primary closure, and 2 patients underwent distal gastrectomy with gastrojejunostomy. CONCLUSIONS Our study shows that young people with perforated peptic ulcer have fewer coexisting medical illness, a lower complication rate and a more favorable outcome as compared to elderly patients with perforated peptic ulcer. A majority of such perforations are in 1st part of duodenum with male preponderance. A plain chest radiograph is sufficient to make diagnosis in the classic case of sudden onset epigastric pain. KEYWORDS Perforation Peritonitis, Management of Peptic Ulcer Perforation, Graham’s Repair, Clinical Presentation of Peptic Ulcer Perforation
Clinical Profile and Short-Term Outcome of Neonatal Seizures in a Tertiary Care Hospital, Kuppam – A Retrospective Study
Authors: Kancherla Poojitha , P.J. Harsha , R. Gowtham , Basha Dowlath Anwar , G.P Chandran , Golluri Raghuveer
Published: September 2021

BACKGROUND Neonates presenting with seizures require long term stay in hospital and have higher chances of neuro-developmental delay later. Seizures in neonates are mostly subtle and difficult to diagnose. We wanted to study the clinical profile and short-term outcome on term and later pre-term neonates presenting with seizures. METHODS The study was a retrospective observational study done from November to December 2020 at PES Hospital, Kuppam. Retrospective data of neonatal seizures from May 2019 to April 2020 was considered for study. Details from the case records of neonates with seizures was collected. RESULTS Neonatal seizures (NS) were most common in females (53.8 %, 72/134). Subtle seizures were most common form of seizures in neonates which was seen in 64.2 % (86/134) babies followed by tonic seizures in 22.4 % (30/134). Neonatal seizures were most commonly seen in babies with hypoxic ischemic encephalopathy in 63.4 % (85/134) followed by metabolic disturbances in 15.6 % (21/134) and meningitis in 13.5 % (18/134). In babies with hypoxic ischemic encephalopathy, metabolic and meningitis subtle seizures were observed to be more common. Seizures were seen most commonly in first 72 hours of life (82.85 %, 111/134). Seizures in babies with hypoxic ischemic encephalopathy, metabolic causes most commonly occurred within first 24 hours of birth. Seizures in babies with meningitis most commonly occurred after 7 days of birth. Babies with neonatal seizures with sequelae was seen in 17.96 % (24/134) and 11.94 % babies died (16/134). CONCLUSIONS Subtle seizures were most common form and hypoxic ischemic encephalopathy was most common risk factor. Most neonatal seizures present within 72 hours of birth. Babies with meningitis presented with seizures most commonly after 72 hours of birth. KEYWORDS Hypoxic Ischemic Encephalopathy, Neonatal Seizures, Newborn, Aetiology, Outcome
Prevalence and Symptomatology of Laryngopharyngeal Reflux Disease in a Medical College Hospital in Kerala
Authors: George Binu Raju , P.V Ajayan , Samad Saify
Published: September 2021

BACKGROUND Laryngopharyngeal reflux is a common clinical condition encountered in Otolaryngology practice. It is one of the major causes of laryngeal inflammation. It presents with a constellation of symptoms making the diagnosis difficult. Reflux Symptom Index and Reflux Finding Score are two tools which aid in diagnosis of Laryngopharyngeal reflux. The main objective of this study was to study the agent, host and environment factors of epidemiology of patients with laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score. METHODS A descriptive study was conducted on 100 patients attending the Department of Otorhinolaryngology, Government Medical College and Hospital, Thrissur, Kerala. The study period was for one year from December 2017 to December 2018. Demographic data of the patients was recorded, and patients were evaluated for Laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score using 70 degree / flexible nasopharyngolaryngoscopy. The clinical data collected was then tabulated and analysed. RESULTS From the study conducted in 100 patients, 59 % were females and 41 % males. Most common symptom noted was frequent clearing of throat which was present in 88 % cases. Least frequent symptom was choking episode (in 5 %). CONCLUSIONS The prevalence of Laryngopharyngeal Reflux Disease was commonest in the 31 to 40 years age group with mean age was 37.8 ± 2.35 years. The male to female ratio were 1:1.43. The disease was common in labourers and housewives. Risk factors were consumption of tea/coffee, inadequate sleep of less than 6 hrs. Lower socioeconomic group populations were more vulnerable than higher income group. The RSI score was between 13 and 15 in 53 % of the patients. KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score
Cross-Sectional Study on Stigma among Care Givers of Patients with Mental Illness in Kanchipuram District, Tamil Nadu
Authors: G Umesh , T.V. Asokan , V Roselin , V Sri Santhanakrishnan V
Published: September 2021

BACKGROUND Stigma experienced by caregivers of patients with mental illnesses remains unnoticed. This study was conducted to evaluate the stigma perceived by the care givers of patients with various mental illnesses and the factors associated with stigma. METHODS This cross-sectional study was conducted among the care givers of patients with mental illnesses who accompanied the patients to the outpatient department (OPD) of Psychiatry in Meenakshi Medical College Hospital and Research Institute, from January 2017 to March 2017. A total of hundred care givers were included in the study. All care givers aged between 18 - 50 years of age in both sexes were included in the study. Care givers of substance abuse cases were excluded from the study. A total of hundred care givers with fifty care givers of neurosis patients and another fifty care givers of psychosis were included in the study. Family interview schedule (FIS) stigma scale was used to assess the stigma perceived by care givers. Data was entered in Microsoft excel and data analysis was done using statistical package for social sciences (SPSS) version 17. RESULTS Mean perceived stigma score was 12.27 ± 9.43. High, low and zero stigma was noted among 44 %, 36 % and 20 % of care givers, respectively. Also, it was found that care givers of psychosis patients had more stigma than the care givers of neurosis patients (P = 0.0008). Statistically significant association was found between patient’s duration of illness (P = 0.003), patient’s diagnosis (P = 0.000) and care givers burden (P = 0.000) with severity of stigma perceived by the care givers. CONCLUSIONS Proportion of stigma prevailing among the care givers is high and it depicts only the cases which were reported to the health care center, whereas a larger proportion of cases remains not seeking the health care. An early intervention by conducting routine assessments of the mental status of caregivers is necessary. KEYWORDS Stigma, Care Givers, Mental Illnesses, Family Interview Schedule
Beta Thalassemia Trait among Antenatal Mothers and Those with Microcytic Anaemia
Authors: Kashinkunti Mohan D. , Acharya Radhika
Published: September 2021

BACKGROUND Among microcytic hypochromic anaemias, the most common disorders are iron deficiency anaemia (IDA) and co-pathological conditions such as α- or βthalassemia (α- or β- thalassemia) traits. Thalassemia minor is often an asymptomatic carrier state but exhibit marked microcytosis that can be mistaken for iron deficiency. About 1.5 % of the global population (80 to 90 million people) are carriers of thalassemia and more than 200 mutations are described in thalassemia, the only effective way to reduce burden of thalassemia is to prevent birth of homozygotes. The purpose of this study was to estimate the prevalence of beta thalassemia trait (BTT) in adult individuals with microcytic hypochromic anaemia and among antenatal mothers visiting the Obstetric Department of SDMCMSH. METHODS In this prospective descriptive study, 101 adult patients between 18 and 40 years who were in in-patient department (IPD) or attending out-patient department (OPD) from department of general medicine and department of haematology were studied during a period of one year from October 2018 to October 2019 and their blood sample was sent for complete blood count (CBC), iron studies and haemoglobin electrophoresis. All the data was entered in Microsoft Excel software and analysis was done using Minitab software. P value of less than 0.05 was considered statistically significant. RESULTS Out of the 101 microcytic hypochromic anaemia patients analysed, 7 patients have beta thalassemia trait. 4 of the 7 are females. Their haemoglobin electrophoresis report showed high HBA2 value of > 3.8. There were no carriers among the pregnant individuals tested. A regression model was fitted for predicting HBA2 based on values of serum iron, serum ferritin, and mean corpuscular volume (MCV). CONCLUSIONS In conclusion, identification of thalassemia gene mutations in our population is necessary because of the country’s multiracial population. This will prevent unnecessary treatment with iron supplements in thalassaemic patients and also helps in pregnant women to prevent thalassemia major children. Molecular genotyping provides a rapid and reliable method for identification of common, and unknown α - and β - gene mutations, which help to diagnose unexplained microcytosis and thus prevent unnecessary iron supplementation. We conclude that microcytosis due to thalassemia is common in north Karnataka. This illustrates the importance of adequate prenatal and laboratory investigation for these abnormalities. KEYWORDS Beta Thalassemia Trait, Microcytosis, Haemoglobin Electrophoresis, Antenatal Screening, Thalassemia
A Cross-Sectional Study of Microcirculatory Transit Time as a Risk Stratification Method in Cardiac Syndrome X Conducted in a Tertiary Hospital at Hyderabad, Telangana
Authors: Parvathareddy Krishna Malakondareddy , Kolli Jagadeesh Reddy , Ravi Srinivas , Nagula Praveen , Imamuddin Syed , Chamarti Venkata Arunavalli
Published: September 2021

BACKGROUND Cardiac syndrome X (CSX) is not benign, and it needs long-term follow up and risk factor modification. In this study, we wanted to calculate microcirculatory transit time on coronary angiography in patients with cardiac syndrome X (CSX), compare microcirculatory transit time in patients with and without CSX and to see whether microcirculatory transit time can be proposed as a risk stratification method in CSX. METHODS Cross sectional study of 52 patients. The angiogram was taken at 15 frames per second. The left coronary artery was injected with 7 ml of contrast approximately. Microcirculatory transit time (MCTT) was obtained offline. The microcirculatory transit time in seconds is calculated as last frame count minus first frame count/15. Microcirculatory transit time was compared and analysed in both groups. RESULTS A total of 52 subjects were analysed. There were 26 cases in the angina group with a mean age of 49.96 years and 26 cases in the control group with a mean age of 50.32 years. Dyslipidemia, smoking and statin use were more common in the angina group, which was statistically significant (P < 0.05). The mean MCTT of the group with angina and positive treadmill test (TMT) was 6.76 seconds, whereas the negative TMT group was 6.39 seconds. The mean frame count was 58.1, and the mean MCTT was 3.8 seconds in the control group, whereas the mean frame count and mean MCTT were 98.1 and 6.5 seconds in the angina group, which was statistically significant (P < 0.001). CONCLUSIONS CSX patients had longer MCTT than patients without chest pain and normal coronary arteries. MCTT can be used to assess the risks of CSX. Long-term followup studies with a large sample size should be conducted. KEYWORDS Cardiac Syndrome X, Angina, Coronary Artery Disease, Microcirculation
A Cross-Sectional Study of Sociodemographic Profile of Blood Donors and Their Knowledge about Blood Donation in a Rural Area of Kerala
Authors: Kumaran Indu Pachampully , K.A Archana , Dharmadas Meena , Nadanganan Sasikala , B Anu Kumar , Vilambil Sajith
Published: September 2021

BACKGROUND Even in the presence of sufficient voluntary blood donors, the need of blood is not met yet. We wanted to evaluate the causes that hinder the smooth functioning of well-maintained blood transfusion services (BTS). METHODS This is a population based cross-sectional study conducted among blood donors from voluntary outreach blood donation camp for period of one year. Total 1536 blood donors from 32 blood donation camps were subjected to study for the sociodemographic characteristic and their knowledge of blood donation. Statistical analysis of data was done using Microsoft Excel, analysed using statistical package for social sciences (SPSS) ver.16 software. RESULTS A total of 32 blood donation camps were conducted during the study period that provided 1536 donors. In most of the camps, male donors (75 %) were more than female donors. Donors of age group of 30 to 39 years (43.9 %) were more when compared to others. Donors those who were married accounted for 79.9 %. Blood donors of Hindu religion (53 %) were more. CONCLUSIONS The main hindrance for blood donor motivation is lack of knowledge. Literacy and chance to mingle in society have a positive effect on blood donor motivation. Targeting of effective donor motivation, recruitment, and retention were attained by conducting awareness classes, seminars, workshops, and visual communication modalities. KEYWORDS World Health Organization, Altruistic Blood Donor, Blood Transfusion Services, Transfusion Transmitted Infections, Blood Components and Plasma Derivatives, Director General of Health Services (DGHS), National Blood Transportation Council (NBTC)
A Retrospective Descriptive Study on Death Due to Cyanide Poisoning Over a Period of 20 Years in Government Medical College, Thiruvananthapuram
Authors: K Sasikala , Fernz Vitni , B.T Abitha Raj , Asok Ajith V. , Mathew Amritha , P.R. Karthika Thirunal , Pratheep Neethu , R Srijith , R Aaditya
Published: September 2021

BACKGROUND Cyanide is a rapidly acting poison which has been the suicidal agent of choice since time unknown. Its notoriety also extends to homicide, and it has often been used by serial killers. It is found in nature and is used in various industries, but is difficult to obtain nowadays as a result of strict policy implementation. METHODS All cases of cyanide poisoning over a period of 20 years from 2000 to 2019 were studied. Samples were sent for identification and quantification by GC-MS to the chemical examiner’s laboratory. Data was collected in pro forma and entered into Microsoft Excel and analysed using statistical package for social sciences (SPSS). RESULTS A total of 84 cases were studied over a period of 20 years. The majority of cases were recorded in the first decade of the study period. Most common age group involved was 31 to 40 years. Males comprised 84.9 % of the total. Majority were suicidal in nature, and 22.6 % were suicide pacts. The reason for committing suicide could not be found in 59.3 %. 67.9 % were found dead or brought dead to the hospital. In 24 % cases, the typical smell of bitter almonds was identified. Police were able to make out the presence of poison in 83.3 % during the preliminary investigation. CONCLUSIONS Males were the commonly affected. Ingestion of poison was the method of administration in all cases. Majority were suicides, and occurred in the residence of the victims. In majority of cases, police could identify the cause of death as poisoning. The characteristic smell could be identified only in a few cases. KEYWORDS Cyanide, Corrosion, Poisoning, Suicide
Relation between Retinal Arterial Occlusions in the Eye and Carotid Artery Occlusion - A Retrospective Study in a Tertiary Care Hospital in Kottayam in Kerala
Authors: Thankamani Himasree , Ankan Shaji , Sudhakaran Sunil Maruthivila , Hyder Naina Jabeen
Published: September 2021

BACKGROUND Central retinal artery occlusion (CRAO) was first described by Van Graefe in 1859 as an embolic event to the central retinal artery in a patient with endocarditis. CRAO has various causes, but patients typically present with sudden, severe, and painless loss of vision. Retinal arterial occlusions are a cause for profound visual loss in the population. Carotid atherosclerosis is common in elderly people. Dyslipidaemia, hypertension, and diabetes mellitus are factors which accelerate the development of carotid atheromatous plaques. Embolism from the carotid bifurcation is the most common cause of retinal artery occlusions. In retinal arterial occlusion carotid arterial occlusion is usually assessed using radiological techniques. The purpose of this study was to evaluate carotid atherosclerotic disease in patients with arterial occlusions in the eye and determine the relation between arterial occlusions in the eye & carotid artery occlusive disease. METHODS This retrospective study included patients aged thirty and above, who had come with symptoms suggestive of arterial occlusions in the eye and carotid doppler was done. The inclusion criteria included patients diagnosed with the following conditions CRAO, branch retinal artery occlusion (BRAO), ophthalmic artery occlusion, anterior ischaemic optic neuropathy (AION) and cilioretinal artery occlusion. Patients usually present with sudden loss of vision in one eye. After taking a detailed history, all patients were subjected to a thorough ocular examination. Patient’s vision is assessed using Snellen’s visual acuity chart, pupillary assessment done, and fundus examination to look for retinal arterial occlusion is also done. Fundus imaging is also done. Carotid doppler was done to rule out carotid artery occlusive disease. RESULTS Patients presenting with retinal arterial occlusion should be investigated thoroughly for both systemic and local causes of CRAO. The risk of developing arterial occlusions were 1.7 - 9.15 times more in patients with carotid artery occlusion than in patients with normal carotids. Arterial occlusion was more found in patients with 70 % occlusion of the carotid artery. CONCLUSIONS There was a strong association between retinal arterial occlusions and carotid artery occlusion. KEYWORDS Central Retinal Artery Occlusion (CRAO), Carotid Artery Occlusive Disease, Carotid Doppler
Evaluation of Functional Outcome of Patients with Transverse Fracture of Patella Treated with Tension Band Wiring - A Prospective Study Conducted at Trichur, Kerala
Authors: Ponnan Prakash , Kunjappan Manoj Murungodiyil
Published: September 2021

BACKGROUND Patella is the largest sesamoid bone in the human body, which plays important role in biomechanics of the knee. It is one of the few bones without periosteal surrounding. Fracture of patella constitute almost 1 % of all skeletal injuries with high prevalence in age group of 20 - 50 years. Fracture of patella may be due to direct/indirect force. Direct force often results in displaced or comminuted fractures. Fracture caused by indirect mechanisms result from a violent contraction of quadriceps muscle with knee flexion. Most of the patella fractures are combination of direct and indirect forces. Most significant effects of fracture patella are loss of continuity of the extensor mechanism of the knee and potential incongruity of the patellofemoral articulation. Treatment option includes reconstruction of entire patella or partial patellectomy and tendon repair or total patellectomy with extensor mechanism repair. Advancement in surgical techniques treatment option being shifted from patellectomy to reconstruction, preservation, and restoration of extensor mechanism. The purpose of this study was to evaluate the functional outcome of transverse fracture of patella treated with tension band wiring. METHODS This prospective study was done among 35 patients, who sustained transverse patellar fractures and were admitted in Department of Orthopaedics, Government Medical College, Thrissur from 01 October 2019 to 01 October 2020. Functional and clinical outcome was assessed at 2 weeks, 4 weeks, 3 months, and 6 months using Goodfellow’s scoring system. RESULTS The mean age was found to be 43 years, males were predominant. In 62.86 % of study population, right side was involved. In 63 % of study population, fracture occurred due to road traffic accidents (RTA). Average union was achieved in 11 - 13 weeks. Functional outcome was excellent to good in 85.71 % of study population. CONCLUSIONS Transverse fracture of patella can be treated with modified tension band wiring without much complications and early weight bearing is possible with good functional outcome. KEYWORDS Transverse Fracture Patella, Prospective Study, Tension Band Wiring, Good Fellows Score
A Prospective Study of Patients with Pseudoexfoliation Glaucoma and Its Management in a Tertiary Care Centre in South India
Authors: Sultana Nishat , Gupta Priyam
Published: September 2021

BACKGROUND Pseudoexfoliation syndrome is the most common identifiable cause of open angle glaucoma worldwide. Pseudoexfoliation glaucoma develops in 50 % of patients with pseudoexfoliation syndrome. The purpose of this study was to assess the clinical profile, intraocular pressure (IOP), gonioscopic findings, disc changes and need for medical or surgical line of management for the control of pseudoexfoliation glaucoma. METHODS It was a prospective hospital based interventional study of 68 consecutive patients diagnosed with pseudoexfoliation glaucoma, who presented to the glaucoma clinic at a tertiary care centre from Nov 2017 to Mar 2019. RESULTS 68 patients diagnosed with pseudoexfoliation glaucoma were evaluated during the study period from November 2017 to March 2019. Male predominance of 43 (63 %) was noticed. Mean age group of study population was 68 years with 44 (65 %) of patients in age group of 61 – 75 years. 55 cases had bilateral pseudoexfoliation. 85 (69 %) eyes had a pressure of > 21 mm of Hg. 97 (79 %) eyes had open angles, 4 (3 %) occludable angles, 22 (18 %) had closed angles. 4 (3 %) of eyes had cup disc ratio < 0.5, 49 (40 %) eyes had cup disc ratio of 0.5 - 0.7, 64 (52 %) had > 0.7 cupping. 38 (31 %) eyes were controlled on medical therapy with topical antiglaucoma medications. In 14 (11 %), eyes were treated with Nd: YAG PI (neodymium-doped yttrium aluminium garnet peripheral laser iridotomy) with medical treatment, 59 (48 %) eyes were taken up for triple procedure. 10 (8 %) eyes could not be controlled using medical therapy and had to be taken for surgical treatment. CONCLUSIONS Pseudoexfoliation glaucoma leads to irreversible visual loss if high IOP is not treated leading to glaucomatous optic nerve damage and visual field loss. The response to medical therapy is poor and needs surgical intervention. KEYWORDS Pseudoexfoliation Glaucoma, Intraocular Pressure, Optic Nerve Damage, Dandruff Like Material
Inter-Basal and Septal Connections of Papillary Muscles - An Anatomical Rationale for Rhythmic Opening of AV Valves - A Multicentric Medical College Based Cross Sectional Study
Authors: Shenoy Praveen Mulki , Ramos Amith , Pai Narasimha , Shetty Bharath , Rao Aravind Pallipady
Published: September 2021

BACKGROUND The papillary muscle basal connections have significant clinical implications. Variety of studies done on its morphology and function by various specialists in different departments. A close look on these revealed the interconnections of papillary muscles to one another and to the interventricular septum of both ventricles is related to uncoordinated contractions of papillary muscles, leading to hyper or hypokinesia or prolapse or even its rupture. METHODS Our study done in 25 formalin soaked hearts revealed after the deep and meticulous dissection, reflecting the walls of ventricles laterally the numerous interconnections of papillary muscles at its bases and IVS. Ventricles are opened by inverted ‘L’ shaped incision and its reflected more laterally till all the papillary muscles is visible in one frame after incising the moderator band. The connections were noted, measured, photographed, tabulated, compared with similar studies and analysed with experts with respective fields. RESULTS Almost all the specimens did have the interconnections. Further the post mortem findings of the cardiac related deaths with involvement of papillary muscles suggest damage to such ‘bridges’. The moderator band extensions to the base of right APM, and its extension to the posterior groups is noted in all the specimens. The bridge from the IVS to bases of both the groups of papillary muscles is noted in left ventricle. In90% of specimens the one PPM is found to be loosely connected, more so in left ventricle. CONCLUSIONS We are of a conclusion that such basal interconnections and to the interventricular septum are responsible for rhythmic contractions of papillary muscles of both ventricles. Since the AV valves have to open simultaneously, interconnections becomes mandatory as the impulse has to reach it before it reaches the trabeculae carniae. One of the Posterior papillary muscles is loosely connected to other papillary muscles, may be the reason for its rupture, more so in left ventricle. KEYWORDS Papillary Muscle, Interbasal Connection, Moderator Band, Valvular Prolapse, AV Valves
Effect of Iron Supplementation in Anaemic Children with Breath Holding Spells at a Tertiary Care Hospital (KGH - Visakhapatnam) in Southern India
Authors: Devagudi Ramadevi , Pedada Ramu , Dumpala Annapurna
Published: September 2021

BACKGROUND Breath holding spells (BHS) are common, non-epileptic paroxysmal events that occur in children below 6 years, whose diagnosis is made many times clinically. Exact aetiology is not known, but iron deficiency was one among many proposed aetiological factors. Very few studies were published till date to determine role and effect of iron supplementation in children with breath holding spells. Hence the present study was taken up to assess the presence of iron deficiency and the effect of iron supplementation in children with breath holding spells. METHODS This prospective interventional study was performed from May 2012 to April 2017. 125 children below six years of age brought with the complaint of breath holding spells were screened for presence of anaemia and other systemic illnesses. Ten children were excluded with other organic causes and only 85 children were found to have anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months and followed up for a total period of 6 months. Response to iron supplementation was assessed in these children by measuring total number of attacks of BHS before starting iron supplementation, after supplementation of iron for three months and also at the end of follow-up period. The results were analysed by using Microsoft Office Excel. RESULTS 76.52 % (85/115) of patients had anaemia and were supplemented with 6 mg/kg/day of ferrous sulphate for 3 months. The remaining 27 cases had normal Hb % & red blood cells (RBC) indices and were not included. Response to iron therapy was assessed in anaemic children with breath holding spells and we found complete response in 78.41 %, partial response in 15.91 % and no response in 5.7 %. CONCLUSIONS This study proved the role of iron therapy in anaemic children with breath holding spells. KEYWORDS Breath Holding Spells (BHS), Iron Deficiency, Anaemia, Haemoglobin