bluuebunny/crossref_metadata_2025 huggingface dataset:
Wage inequality of Mexican immigrants by type of job qualification in the United States
Authors: Rodriguez Perez Reyna Elizabeth , Valdes Martinez Daniela
Published: August 2022

The objective of this research is to analyze the characteristics of the labor market insertion of Mexicans by type of qualification and their wage differences in relation to native workers in the United States. The hypothesis is that there is a wage inequality between Mexican migrant workers and native workers, accentuated among skilled workers, due to a segmentation of the U.S. labor market. The methodology used to analyze each of the components that add up to the wage gap between Mexican and native workers is the Ñopo decomposition. The results showed the opposite of what is established by the human capital theory since the wage difference between Mexicans immigrants and natives by type of job qualification is mostly unexplainable from a statistical point of view and escapes modeling. This means that having citizenship and education does not eliminate the differences between Mexicans and natives. This allows us to accept the hypothesis, except in the case of low-skilled Mexican immigrants, since they have a wage differential in their favor.
Selección óptima de portafolios usando el modelo Black-Litterman con views difusas
Authors: Franco Gómez Yuly Andrea , Moreno Trujillo John Freddy , Zapata Quimbayo Carlos Andres
Published: August 2022

En este artículo se implementa un enfoque robusto para la selección óptima de portafolios de inversión, al incorporar los desarrollos del modelo Black-Litterman (BL) y la lógica difusa. Para ello, los retornos esperados, las opiniones del inversor (views) y la matriz de incertidumbre del modelo BL, se redefinen mediante la lógica difusa y se implementa un ejercicio de optimización para un portafolio constituido por acciones del mercado de valores colombiano. Los resultados muestran un desempeño favorable —fuera de muestra— del portafolio, en comparación con el modelo BL tradicional y el modelo media-varianza (MV), lo cual demuestra que el enfoque de lógica difusa permite incorporar información adicional para definir las views y medir la incertidumbre.
Evaluación de la sostenibilidad financiera en el Crédito de Desarrollo Humano Asociativo en la provincia de Tungurahua, Ecuador
Authors: Valencia Nuñez Edison Roberto , Valle Alvarez Alexandra Tatiana , Cruz Lascano Mary Elizabeth , Haro Sarango Alexander Fernando
Published: August 2022

El presente artículo tiene como objetivo analizar a los beneficiarios del crédito de desarrollo humano, modalidad asociativa en el marco de la sostenibilidad financiera. Este análisis se realiza mediante el planteamiento de una propuesta de evaluación que consta de una estimación general del entorno social, ambiental y de bienestar, adjuntado a una evaluación financiera. Dicho análisis se ajusta a métricas enfocadas en el endeudamiento, rentabilidad y gestión, donde la ponderación se realiza mediante el estadístico de efectos fijos y aleatorios ajustado a la prueba de Hausman. Asimismo, el contraste de la información general se justifica mediante un modelo logístico multinomial y con un análisis de correspondencia múltiple (ACM), los cuales permiten mostrar la influencia de las generalidades en la inducción de la sostenibilidad. Los resultados visualizados en un antes y durante el COVID-19 demostraron que la pandemia perjudicó a cerca de los 30 beneficiarios, quienes representan el 29,70% de la muestra. Adicional a esto, el ACM mostró que el bono variable, la educación secundaria y el rango etario de 30 a 45 años, son circundantes y coadyuvan a la sostenibilidad financiera.
On the evolution of manufacturing production concentration in Mexican states and its relationship to their level of economic complexity
Authors: Gómez-Zaldívar Manuel , Duran-Ruiz Jazmín Alejandra , Carrillo-Botello Jaime
Published: August 2022

We identify a link between the evolution of the concentration of manufacturing production among Mexican states and their level of economic complexity. Our results suggest that the concentration of manufacturing production among the country’s states evolved according to the predictions of standard models of international trade. However, the North American Free Trade Agreement (NAFTA) had a particular effect on each individual state, depending on its economic structure. More complex states, i.e., those more productively diverse and specialized in more sophisticated manufacturing goods, experienced a higher increase in their level of production concentration after NAFTA and were less affected by competition from Chinese exports to the U.S. In contrast, NAFTA had a less significant impact on the production concentration of less complex states, while competition from China halted their move towards greater specialization and even reversed it somewhat. These findings highlight the important role of international trade in shaping the development of the economic structure of Mexican states in the period under analysis
Exponential Transformed Inverse Rayleigh Distribution: Statistical Properties and Different Methods of Estimation
Authors: Banerjee Proloy , Bhunia Shreya
Published: August 2022

In this article a generalization of the inverse Rayleigh distribution has been addressed by using DUS transformation, named as Exponential Transformed Inverse Rayleigh (ETIR) distribution. Some of the statistical properties of this newly proposed distribution like mode, quantiles, moment, moment generating function, survival and hazard rate function have been studied comprehensively. To estimate the parameter of this distribution, four different estimation procedures, such as maximum likelihood estimation (MLE), maximum product spacing method (MPS), least square method (LSE) and weighted least square method (WLSE) are briefly discussed. Performance of these estimates are compared using extensive simulations. As an application point of view the model superiority is verified through two real datasets.
Independence of State Power: Problems of Strengthening and Anti-Corruption Security
Authors: Shamanskiy D. A.
Published: August 2022

The paper explains the main problems of anti-corruption security in public authorities. The lack of and disorganization of the state system of personnel selection and recruitment is the main determinant factor that contributes to the emergence, development and growth of corruption in public authorities. The author came to the conclusion that the lack of control and state monopoly in the state system of selection and recruitment of personnel has led to the situation when individuals (groups of individuals) have the opportunity to carry out activities for the selection and recruitment of state personnel pursuing their personal interests. In fact, this type of activity exists in parallel with legitimate state authorities. State personnel selection activities are carried out under the influence of shadow structures or individuals integrated into the system of state power, who have corrupt views and antisocial attitudes. The actual absence of a unified, effective state system of personnel selection creates corruption risks that directly affect the independence of state power. As a result, a partizan official does not seek to carry out socially useful activities or achieve socially useful results or social justice and equality. The main motive for staying in power for such officials is meeting their unfair personal needs, interests, and ambitions. The very fact that an official has an internal selfish motivation or other interest inevitably leads to the destruction of the public administration system. This is confirmed by the fact that the internal motivation of such an official (egoism, self-interest) does not allow him to achieve a socially useful result in his activities because his driving force is personal ambitions or other interest.

The author substantiates the need to distinguish between legal and illegal protectionism at the legislative level and to establish a state monopoly over this type of activity.
Special Grounds for Exemption from Criminal Liability for Criminal Bankruptcy: Critical Assessment of a Legislative Novel
Authors: Subachev A. K.
Published: August 2022

One of the consequences following the legislator’s attempts to radically improve the effectiveness of the norms on criminal liability for criminal bankruptcy in July 2021 was the addition of Article 195 of the Criminal Code of the Russian Federation. It came with a note the made it possible for the nominal head of the bankrupt organization to be exempt from criminal liability if they contributed by their actions to compensation for the damage caused by the crime. After analyzing this novel, the author paid attention to the fact that it accumulated not only statutory concepts common for the Russian criminal law, but also certain provisions inherent in competition law. Meanwhile, such a reception was of a shambolic nature, since the legislator did not use the concept of a person controlling the debtor (which, obviously, he assumed), but only one of the presumptions of control over the debtor — extracting benefits from illegal or unscrupulous behavior of the debtor, which does not seem quite correct. In addition, the comment does not imply any encouragement for the fake manager for disclosing information about the debtor’s property that was hidden by his controlling persons, although this approach is present in the bankruptcy law and increases the chances of creditors to restore their violated rights. Moreover, the exemption of the guilty person from criminal liability is for the most part dependent on the actions of third parties, and not the nominal value itself. The key conclusion of the study is that the considered norm is unlikely to be applied in practice both due to the lack of a proper incentive for the nominal value, and due to the uncertainty of the procedural mechanism of its application. Following the critical evaluation, the author proposes the optimal, in his opinion, revision of the analyzed norm.
Inter-play of trauma and disease ― a case report
Authors: Hosahally Jayanth S , Singh Ankita , Girish Chandra Y.P.
Published: August 2022

Determining cause and manner of death in medico legal cases is of paramount importance in forensic practice. A 29 year old woman was brought by the police for medico legal autopsy with history of assault by her boyfriend. As per the initial police investigation and crime scene visit by the police, the case was registered as culpable homicide amounting to murder. Autopsy revealed that the deceased had acute on chronic meningitis, a natural disease incompatible with life if left untreated. It was also observed that there was a faint ligature mark around neck and multiple contusions at places over the body. There were no features suggestive of asphyxia or other findings which could alone cause death. The deceased was alive for some time after the assault. Considering these facts, cause of death was attributed to meningitis and further it was opined that the assault could have expedited the death.
Alcohol and children: clinical and forensic study
Authors: Plis Semyon S. , Kovalenko Liliya A. , Veselkina Olesya V. , Dolginov Dmitry M. , Ostapenko Yury N. , Vlassov Vasily V. , Klevno Vladimir A.
Published: August 2022

BACKGROUND: This study aimed to evaluate the differences in the clinical pictures in the group of alcohol intoxication (without the loss of conscious) and alcohol poisoning (with the loss of conscious).
AIMS: This study aimed to investigate the clinical differences in the groups of alcohol intoxication (without loss of consciousness) and alcohol poisoning (with loss of consciousness) and determine the level of blood ethanol concentrations in children and adolescents from alcohol intake that causes a loss of consciousness, which means ethanol poisoning occurrence, and finally, offer practical recommendations for forensic doctors in cases of alcohol poisoning in children.
MATERIALS AND METHODS: The total amount of data was a combination of two studied populations: population No. 1 from the archive of the Bureau and population No. 2 from the Childrens Clinical Hospital No. 13 named after N.F. Filatov. The study is a retrospective population-based and prospective (observational) cross-sectional study. Data were grouped as (1) persons whose alcohol intake did not cause significant health disorders (alcohol intoxication) and (2) persons whose alcohol intake caused the onset of coma, respiratory arrest, or death (alcohol poisoning). Urine screening for psychoactive and narcotic substances was conducted using liquid chromatography-tandem mass spectrometry.
RESULTS: The data set included 67 minors aged 1117 years. Blood and urine ethanol levels of males and blood of females were significantly higher than in patients with alcohol intoxication. The objective status of patients was the same. No differences were found in alcohol pharmacokinetics (resorption and elimination), as well as the instrumental parameter readings. The present study revealed that alcohol intoxication and poisoning were not associated with dangerous changes in such parameters as systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate.
CONCLUSION: The results showed that ethanol poisoning in children aged 1117 years old developed at an ethanol concentration of 2.61 g/L in the blood and 3.01 g/L in the urine. Additionally, no significant differences were found in the instrumental parameters.
Skull injury due to atypical firearm: a case report
Authors: Siamionau Viachaslau V. , Tsiatsiuyeu Andrei M.
Published: August 2022

BACKGROUND: Injuries from atypical firearms are highly variable in their morphology and often differ from typical gunshot injuries. This can lead to problems in forensic diagnostics. Knowledge of the atypical weapons design and discovery of atypical projectiles inside a body or at crime scene allows proper injury nature assessment.
CASE PRESENTATION: The morphological features of the entrance and exit gunshot wounds of the occipital and frontal bones caused by an atypical projectile ― a concrete nail 4.560 mm are described. The entrance gunshot injury had typical morphological features associated with the specific action of the projectile (a tissue defect, internal beveling of wound). The exit wound was atypical due to the incomplete exit of the concrete nail from the cranial cavity, as well as the anatomical features of the damaged area.
CONCLUSION: Atypical firearms and projectiles are diverse and their samples may have many unique designs and technological features knowledge of which may be crucial for forensic examination of gunshot injuries. A comprehensive medico-legal assessment of the injury gunshot nature and the number of shots is traditionally based on the injury morphology and revealing the gunshot residues. However, the presence of projectiles and/or their fragments in the body facilitates the solving of expert tasks. In our case the key to the correct interpretation of the wounds nature was the presence in the skull of an atypical projectile ― a concrete-nail.
International congress: “Topical issues of forensic medicine and expert practice-2022”
Authors: Maksimov Aleksandr V.
Published: August 2022

On April 2021, 2022, the International Congress: Topical Issues of Forensic Medicine and Expert Practice-2022 was held in Moscow based on the Moscow Regional Research Clinical Institute named after M.F. Vladimirsky. The International Congress has once again gathered a pool of leading experts in the field of forensic medicine from different countries. The International Congress was attended by leading practitioners and prominent scientists, department heads, and heads of forensic medical expert institutions. Specialists from Germany, Italy, Portugal, Japan, Turkey, the Czech Republic, Slovakia, Belarus, Kazakhstan, Turkmenistan, Kyrgyzstan, and other countries expressed a desire to share their experiences with colleagues and discuss the most pressing problems of forensic medicine. The scientific program of the congress was compiled, emphasizing the latest achievements in various fields of forensic medicine and related disciplines. Program reports on trends and ways of world forensic medicine development in the XXI century were presented at the plenary sessions, and the most promising areas of expert research in the field of thanatology, laboratory diagnostics of pathological processes, experts, and law enforcement practice of harm caused to human health were discussed at specialized sections.
Comparative analysis of risk factors for hip fracture in patients of different nationalities living in Kazakhstan
Authors: Issayeva Samal M. , Lesnyak Olga M. , Issayeva Bakytsholpan G. , Dilmanova Dina S. , Bissembay Meruyert A. , Burakhanova Gaukhar A.
Published: August 2022

BACKGROUND: Osteoporosis is a multifactorial systemic skeletal disease characterized by a decrease in bone strength leading to an increased risk of fractures. Hip fracture is a serious complication of osteoporosis. It is expected in Kazakhstan by 2050 the annual number of hip fracture will increase by 140% compared to 2015 data and will amount to 28,048 cases. There are differences in the incidence of fractures and low bone mineral density in different ethnic groups. However, low bone mineral density is only one of many risk factors for osteoporotic fractures.
AIM: To study the risk factors of osteoporosis and related osteoporotic fractures in patients with hip fracture living in Kazakhstan.
MATERIALS AND METHODS: The case-control study included 98 patients with hip fracture of Kazakh (main group, n = 49) and other nationalities (control group, n = 49). In the registration card, risk factors for osteoporosis and osteoporotic fractures from the Fracture Risk Assessment (FRAX) model were distinguished, and the Find cases Assess Confirm Severity algorithm (2019) was used to diagnose sarcopenia. Statistical analysis was carried out using the Statistics 26 (IBM SPSS, США).
RESULTS: The groups were comparable in terms of gender, disability, fracture location and functional activity, surgical treatment. An increase in cases of hip fracture at an older age was found in the main group than in the control group (р = 0.035).
There were no differences in the groups for clinical risk factors for osteoporotic fractures (body weight, height, history of fractures, family history of fractures, medication, comorbidity), except for smoking (lower in Kazakhs than in the other group) (р = 0.033). Differences in 10-year probability of major osteoporotic fracture and hip fracture between groups (р = 0.34 and р = 0.74) were not found. The proportion of patients who entered the intervention threshold and at low risk did not differ in the groups (р = 0.623).
The average SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) score was lower among Kazakhs (р = 0.011), there is a difference between the groups when walking (р = 0.044), climbing stairs (р = 0.003). A decrease of grip strength was noted in the main group (р = 0.008), especially in men (р = 0.011), but low grip strength (р 0.001) and signs of sarcopenia (р 0.001) were determined only by age, not nationality.
CONCLUSIONS: The Fracture Risk Assessment (FRAX) model and intervention threshold can be applied to all residents of Kazakhstan.
Beta-blockers in elderly patients: neuroprotective effect or risk of cognitive decline?
Authors: Bogdanova Tatyana A. , Turusheva Anna V.
Published: August 2022

BACKGROUND: Due to the fact that the number of elderly people with cognitive disorders is steadily increasing worldwide, there is an increased interest in studying the effects of drugs of different pharmacological groups on cognitive function.
For many years, beta-blockers have been one of the main groups in the therapy of cardiovascular diseases. The effect of beta-blockers on cognitive function has been studied for a long time, and there is different, sometimes contradictory data on this issue.
AIM: To evaluate the incidence of cognitive impairment in elderly and to determine the associations between cognitive impairment and the beta-blockers use.
MATERIALS AND METHODS: Cross-sectional study included all patients aged 60 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 at the polyclinic No. 78 in Saint Petersburg.
Measurements: the Montreal cognitive assessment (MoCA) test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, a medication review and questionnaire.
RESULTS: The prevalence of cognitive impairment among the study participants was 71.1% (n = 138). Сognitive impairment was associated with high blood pressure and a history of stroke (p 0.05). Beta-blockers use was associated with decreased in total MoCA score, fluency (p = 0.0115), thinking (p = 0.0012), and memory (p = 0.0040). The identified association remained statistically significant after adjusting for gender, age, high blood pressure, a history of stroke, level of education, and decreased emotional background with odds ratio 2.245 (95% confidence interval 1.1564.358) for the fluency test and coefficient of regression 0.781 (95% confidence interval [1,233][0,328]) for delayed memory.
CONCLUSIONS: Memory impairment (coefficient of regression 0.781, 95% confidence interval 1.233 to 0.328) and decreased fluency (odds ratio 2.245; 95% confidence interval 1.1564.358) were observed in the study in the outpatient elderly patient population taking beta-blockers. The beta-blockers may lead to memory impairment. When choosing hypotensive therapy, all possible effects of beta-blockers should be considered, including the effect on cognitive status.
Deep neck infections in children and adults: from diagnosis to treatment a clinical study
Authors: Sizer Bilal , Yılmaz Ümit , Sırma Enes , Topçu İsmail
Published: August 2022

Background: Although deep neck infections (DNI) are less common today with the use of antibiotics and oral care, they carry a serious risk of morbidity and mortality, especially when complications develop. These infections spread in potential cavities created by the layers of the deep neck fascia. In this study, it is aimed to review the diagnosis, follow-up and treatment processes for patients with DNI.

Methods: The medical files of 166 patients aged 1-78 years, who were diagnosed with DNI, were scanned retrospectively. In our study, when the differences between adults and children were taken into account in relation to DNI, the 9 most common diagnoses were compared in terms of age, complaints, examination findings, radiological imaging reports, complete blood count, C-reactive protein, erythrocyte sedimentation rate, surgical procedures, medical treatment, hospitalization time and mortality rates.  

Results: The three most common causes of DNI were dental problems, lymphadenitis and tonsillitis. When the imaging methods requested for diagnosis were examined, it was seen that 52.4% (n=87) of those performed were computed tomography and 43.4% (n=72) ultrasonography. During treatment, all patients received prophylactic antibiotherapy. Tracheostomy was performed in 9 of 15 patients who developed respiratory distress during follow-up.

Conclusions: Although the decreasing frequency of DNI, technological developments and increasing awareness, it still carries a serious risk of mortality and morbidity due to its potential and important complications. Due to the inadequate dental and oral care, dental problems are still the most important factor in etiology of DNI The reduction of morbidity and mortality depends on rapid diagnosis and appropriate treatment selection.

 
Risk factors of acute otitis media among infants in a tertiary care hospital in Rawalpindi: a descriptive cross-sectional study
Authors: Mumtaz Khan Tayyab , Akram Jehanzeb , Muneer Fahad , Ilyas Daniyal , Ahmed Hafiz Muhammad , Khan Asghar , Naeem Muhammad Ahsan , Hafeez Umair , Nawab Fareena , Nasir Muhammad Waleed
Published: August 2022

Background: Acute otitis media (AOM) is the second most common disease of childhood. Many factors play role in the causation of AOM. However, the research-based data on risk factors for AOM in infants is still inadequate. Objective were this study aimed to determine the risk factors for AOM in infants with AOM.

Methods: This descriptive cross-sectional study was conducted among 189 infant patients with AOM in the otorhinolaryngology outpatient department of allied hospital of Rawalpindi medical university, Rawalpindi. Established inclusion and exclusion criteria and non-probability convenience sampling technique were utilized for the selection of patients. After taking informed consent, data were collected through a self-adapted questionnaire. Descriptive analysis was accomplished through SPSS version 25.

Results: AOM was more common among patients who had, an age group with a range of 9-12 months (41.28%), male gender (55.02%), lower birth order (49.73%), mothers with illiterate educational status (53.96%), mothers with the job (57.14%), lower socioeconomic status (59.25%), used bottle-feeding (46.56%), supine position during feeding (61.37%), used a pacifier (67.73%), poor feeding hygiene (58.21%), unvaccinated pneumococcal status (57.15%), and large family (63.50%). In the case of family ear infection and passive smoking, AOM incidence was more frequent among infants whose family had no history of ear infection (69.85%) and no smoking exposure (53.44%).

Conclusions: In short, the age group with a range of 9-12 months, male gender, low birth order, illiterate mothers, mothers with the job, lower socioeconomic status, bottle-feeding, supine feeding position, pacifier use, poor feeding hygiene, unvaccinated pneumococcal status, and large family size, all raise the risk of AOM incidence in infants.
Judicious management of pinna keloids: our experience with combination therapy
Authors: Mathews Sunil , Jose Asha T. , Gangwar Varun , Vadivu Arumugam S. , Nandhan Raghu
Published: August 2022

Background: Keloids occur as a result of overgrowth of fibrous tissue following healing of a cutaneous injury and they cause aesthetic issues when they appear on the exposed parts of the body, especially the face. Keloids are difficult to treat, with a high recurrence rate. There are several treatment modalities for management of keloids, though no single modality is completely effective. Most commonly used treatment modalities are intra-lesional steroids, surgical excision, pressure application, silicone gel sheets, 5-fluorouracil (5-FU), cryotherapy, radiation therapy, laser therapy or a combination of these modalities. The aim of the study was to analyse the causes of development of keloids on the pinna and evaluated the outcomes of various treatment modalities applied. It focused on assessing the clinical efficacy of combined surgical excision of pinna keloids with serial steroid injections to prevent recurrence, in comparison to monotherapy with intra-lesional steroid injections alone.

Methods: A retrospective review based on medical records was done for 18 patients with keloid of pinna, who were treated with either monotherapy or combination therapy.   

Results: Satisfactory low recurrence rates were observed with meticulous surgical excision followed by serial steroid injections (18.2%), as compared to monotherapy with serial steroid injections alone (71.4%), and these comparative results were statistically significant at p<0.05 in the cohort.

Conclusions: A judicious plan for management for pinna keloids is necessary in order to achieve the best functional and cosmetic outcomes, while reducing the recurrence rates to a minimum. Following a combination of interventions has proved safe and effective for managing this challenging entity.
Neonatal facial palsy without forceps use: report of two cases and review
Authors: Boussaadni Yousra E. L. , Attaellah Rabab , Oulmaati Abdallah
Published: August 2022

Neonatal facial palsy is a very rare diagnosis with only a few previously published cases of newborns, it can have varying etiologies apart from traumatic causes. The congenital, infectious, inflammatory, neoplastic causes must be eliminated before making the definitive diagnosis of traumatic facial paralysis. A multidisciplinary approach is recommended to differentiate various causes and initiate treatment in a timely manner. Corticosteroids have been used to minimize nerve damage and hasten recovery in the most of studies. We report in this work two cases at 2 and 3 days old of congenital unilateral facial palsy in newborns without history of obstetrical trauma with a good prognosis after corticosteroids with complete resolution.
Case study of a hydrostatic pressure-induced traumatic chronic tympanic membrane perforation with purulent otorrhea and spontaneous closure
Authors: Kress Gavin T. , Kress Tyler A.
Published: August 2022

Tympanic membrane (TM) perforations are ruptures of the membrane separating the middle and outer ear which heal spontaneously in 78.7-94% of cases. However, with large perforations and infection, the spontaneous closure rate diminishes.Chronic TM perforations are thought to rarely close spontaneously and are often treated with a myringoplasty which has a variable success rate, potential risks, and a significant recovery period during which patient activity is notably limited. Significant controversy exists over the indication for surgical intervention in the case of grade 3, chronic TM perforation with a history of infection. The aim of this case study is to provide insight into the typical progression and potential spontaneous resolution of such cases. Moreover, there is a lack of publicly available reference images outlining the progress of TM perforation healing, so detailed time-stamped photos are included. The investigators imaged, at regular intervals, a 23-year-old male’s mid-anterior chronic grade 3 TM perforation who presented with an outer and middle ear infection with purulent otorrhea. The result indicates that chronic grade 3 TM perforations with a history of infection still have potential to spontaneously close. Given the risks and inconvenience of a myringoplasty, further consideration should be taken before recommending this procedure in these cases.
Superior nasolabial flap in reconstruction of the tongue: case report
Authors: Munjal Manish , Garg Ramneesh , Rishi Porshia , Sidhu Harjinder , Munjal Shubham , Talwar Shivam , Sharma Salony , Kaur Hardeep
Published: August 2022

Hemiglossectomy with functional rehabilitation using a rotational superior nasolabial flap as a single stage procedure and its outcome has been described. Nasolabial sulcus and nasofacial was the donor site for the nasolabial flap. This hairless area except for the lower cheek in males, is an important consideration in oral cavity reconstruction. The flap constituted by skin, subcutaneous tissue and the underlying musculature has a subdermal plexus is supplied by feeder vessels from the branches of the facial artery and provides the blood supply to the nasolabial muscle and skin. Usually, the choice of pedicle is based on the site of the defect and any need for rotation or advancement of tissue to the site of the defect. In our patient the superior nasolabial flap based on alar and lateral nasal artery was utilized.

 
A rare presentation of extra pulmonary tuberculosis in neck (isolated level-VI cervical lymph node tuberculosis)
Authors: Bhatt Chandani D. , Shah Ishita , Odedara Ramde , Modi Niral
Published: August 2022

One of the most common varieties of extra pulmonary tuberculosis is tuberculosis lymphadenitis. This was the case report of a 40-year-old female who presented with complaint of neck swelling and voice change and was later diagnosed with an isolated extra-pulmonary level-VI cervical lymph node tuberculosis. The diagnosis was made by histopathology and PCR and patient was then started with anti-tuberculosis therapy.
Extra-oral approach to iatrogenic temporomandibular joint dislocation-case report
Authors: Munjal Manish , Munjal Shubham , Sharma Salony , Kaur Hardeep , Chawla Deeksha , Sandhu Loveleen , Gupta Dhruv , Sawhney Mehneet , Pillai Anjana
Published: August 2022

We discuss an intriguing patient whose temporo-mandibular joint got dislocated following, a per oral sialodochotomy. The reduction was undertaken using an external approach rather than the conventional internal without sedation. The approach is quick, painless, easy to perform, reproducible and least expensive. This technique is based on the following principles i.e., in the anteriorly dislocated mandible, the coronoid process and anterior border of the ramus can be palpated easily over the cheek on the affected side and thus steady pressure application on the cheek over the coronoid process and anterior aspect of the mandibular ramus, easily reduce the dislocation. In the undislocated mandible, the coronoid process and anterior border of the ramus are not palpable as they are located posterior to the body of the zygoma  
Orbital tuberculosis an interesting case report
Authors: Gunasekar Kalpana , Shaan Manohar
Published: August 2022

Tuberculosis can affect any organ. Orbital tuberculosis is very uncommon. The involvement of adnexa of orbit especially the eyelid is very rare even in endemic region. Many of the patients with orbital Tuberculosis doesn’t have concomitant involvement of any other system by tuberculosis. We report a 13-year-old girl presented with complaints of painless progressive swelling on right upper eyelid for six months. The child didn’t have any other septic foci. The child was planned for excisional biopsy which confirmed the diagnosis of Koch disease by histopathology and RTPCR and child responded well with ATT. The case being reported to insist on earlier diagnosis and prevent further morbidity.
Osteophyte compression mimicking a pharyngeal pouch!
Authors: Krishnan Ragitha B. , Krishnan Binu
Published: August 2022

Dysphagia is a broad term encompassing various symptoms due to any condition affecting the normal mechanism of swallowing. The symptoms are often varied like inability to swallow solids and/or liquids, cough on taking liquids, recurrent episodes of aspiration pneumonia and so on. Zenker‘s diverticulum is a not so common condition in which the patient usually presents with hallitosis, delayed regurgitation of feeds in an unchanged manner and foreign body sensation in the throat. Another rare condition is an osteophyte indenting onto the esophagus and causing dysphagia. A 63 year old male presented to the laryngology out patient department with symptoms of food sticking in his throat and regurgitation of feeds in unchanged form which occurred hours after the initial meal. As clinical evaluation and flexible endoscopic evaluation of swallowing were unremarkable he was subjected to a fluoroscopy. Fluoroscopy showed prominent osteophytes at fourth cervical vertebra (C4) and seventh cervical vertebra (C7); the higher one obliterating the apex of right pyriform fossa thereby leading to occasional stagnation of barium in the right pyriform fossa which mimicked a pouch. A computed tomography confirmed the finding of an osteophyte compressing on the lower end of the hypopharynx and giving rise to symptoms similar to that of a pharyngeal pouch. He consequently underwent an osteophyte excision via anterior cervical approach following which he was relieved of his symptoms.
General health and functional improvement among patients with unstable extracapsular proximal femoral fractures managed with proximal femoral nail by using SF-36 score
Authors: Verma Amit Kumar , Dhiman Priyanka , Sharma Vipin
Published: August 2022

Background: Proximal femoral nail is emerging as the treatment of choice for unstable extra capsular proximal femoral fractures. This study comprises of functional evaluation of the treated patients by using SF 36 score.

Methods: This was a prospective hospital-based study done on 54 patients with unstable proximal femoral fractures classified according to the AO/ASIF classification system and were treated by using PFN in the department of Orthopaedics DRPGMC, Tanda. Functional outcome was assessed by using SF-36 score on, 14th postoperative day, at three months and six months.

Results: Our study has mean scores of short form-36 subscales as physical function 70.6, role limitation due to physical health 68.1, role limitation due to emotional health 90, energy/fatigue 66, emotional wellbeing 78, social functioning 67.7, pain 75 and general health 73.3.

Conclusions: The results of this study confirm that intramedullary nailing with the use of a PFN in unstable proximal femoral fractures is a safe method. A significant change was seen in quality of life postoperatively as evidenced by various scores used in present study. Weaknesses of this study include a short follow-up period and the inclusion of a small study group.
Functional results of minimally invasive cheap fixation technique for all types of intertrochanteric femoral fractures using enders nail and cannulated cancellous screws
Authors: Aziz Ansari Muqtadeer A. , Patel Altamash A. , Rathod Pratik P.
Published: August 2022

Background: The objective was to study functional results of fixation of intertrochanteric fractures of femur using enders nail and cannulated cancellous screws.

Methods: This was a prospective observational study. The study was conducted on 30 patients of intertrochanteric femoral fractures who underwent fixation by enders nailing and cannulated cancellous screws in Department of Orthopaedics, GMCH, Aurangabad from January 2018 to January 2021. Patients were assessed functionally using Harris hip score, visual analogue score, and radiological assessment at 3, 6, and 12 months.

Results: All patients showed radiological union within 3 months. Functional assessment was done with Visual analogue scale (VAS) in which mean VAS score was 0.9 (range 0-3), mean Harris hip score which was 86 (range 81-90). One patient developed superficial infection at incision site which was treated by giving appropriate antibiotics and one patient complained of prominent nail on medial side of knee which was treated by implant removal after union of fracture.

Conclusions: Fixation of intertrochanteric femur fractures using enders nailing and cannulated cancellous screws achieves good stability with minimal complications and improved patients’ outcome in terms of less intraoperative blood loss, less chances of infection, less operative time with minimal patient morbidity and good functional outcome.
Clinical practice for the management of atopic dermatitis (eczema) patients attending dermatology outpatient department at a tertiary health care centre
Authors: Sirisha N. L. , Kareemulla Shaik , Charitha K. , Reddemma S. , Kumar B. Veera , Sreeja A.
Published: August 2022

Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin condition that affects all age groups. It is one of the most common skin disorders in developed countries. Symptoms are eczematous papules, itch and associated consequences, like sleep disturbances that significantly have an impact on quality of life of the patients. The standard therapies for AD consist of the use of topical corticosteroids, topical applications of emollients, and oral formulations. The present study was undertaken with a view to find out the treatment patterns for AD in patients visited dermatology outpatient department (OPD) in a tertiary care teaching hospital.

Methods: A prospective observational study conducted for a period of three months at OPD of dermatology in tertiary care hospital (GGH-RIMS), Kadapa. A total of 45 prescriptions were collected after obtaining a proper informed consent from recruited patients.

Results: In a total of 45 prescriptions analysis, it was found that there was a female predominance with a female to male ratio of 2:1. AD was more prevalent in the age group of 20-29 years. Topical preparations were highly prescribed i.e., 90 utilizations when compared to oral formulations having 60 utilizations. Levocetirizine was the most commonly prescribed drug.

Conclusions: This study provides prescription patterns of AD in a tertiary care hospital. Cost can be minimized by generic prescribing. Treatment strategies to be individualized having strong emphasis on patient education. Self-management strategies also optimize outcomes and reduces unnecessary costs associated with management of AD.
The role of hematological biomarkers, coagulation profile and CRP (c-reactive protein) in COVID-19 patients in private health care sector
Authors: Aditi Sneha , Kumari Roushni , Aziz Abdul
Published: August 2022

SARS-CoV-2 causing corona virus disease 2019 (COVID-19) is the most common infection in recent days worldwide. Rapidly evolving from the epidemic outbreak in Wuhan, China on 29 December 2019, SARS-CoV-2 is the third known corona virus that causes fatal respiratory diseases in humans.

The roles of biomarkers from a blood sample in the diagnosis of COVID-19 patients who have visited the hospital with history of fever has been evaluated.

A retrospective study was carried out in a private sector hospital at Panipat where the patients having history of fever were admitted during 1st May 2020 to 15th August 2020. A total of 100 patients were included who were suspected cases of corona. All the blood parameters, systemic inflammatory index (SII), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) Coagulation factor (prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and C-Reactive protein (CRP) are compared between negative and positive COVID-19 cases according to RT-PCR. Result: Out of 100 patients, 65% were RTPCR covid positive. In patient with RTPCR negative test results, it was found that total leukocyte count, neutrophils, platelet, NLR and SII values were higher. However, haemoglobin, lymphocytes and PLR was found to be elevated in patients with positive test results.

COVID-19 positive patients presented with leukopenia, neutropenia, thrombocytopenia and lymphocytosis. SII and NLR were reduced. PLR and CRP were increased. PT and APTT were within normal limits. Lymphocyte count and PLR showed strong significance in this study.

The definitive diagnosis of COVID-19 was made by RT-PCR analysis, but this is a time-consuming and less accessible test. Low values of NLR and SII and high value of PLR and CRP are indicative of COVID-19 and can be used in its diagnosis.
Changing faces and habitat of mucormycosis epidemic in sequential COVID waves
Authors: Tyagi Aarti , Grover Shweta , Bansal Rani
Published: August 2022

The Corona virus poses a greater challenge in the form of the deadly fungal infection, mucormycosis.

 To study the histopathological features giving emphasis on the varying presentation of mucormycosis in sequential covid waves.

A prospective study comprising 31 patients histopathologically diagnosed with mucormycosis were included in the study. Demographic features, predisposing conditions, and clinical features were obtained from medical records. Tissue sections were reviewed with hematoxylin and eosin (H and E), and special stains like Gomori's methenamine silver (GMS), and periodic acid Schiff (PAS) potassium hydroxide (KOH) examination and fungal culture.

 The study included 21 males and 10 females with age ranging from 35-75 years. On histopathological examination, inflammation, granulomas, foreign body giant cells along with necrosis was seen. Invasion into soft tissues, muscles, and adipose tissues along with Angioinvasion, perineural spread was identified. Fungal balls, round to ovoid mature sporangia with column-shaped columella, presence of proliferating hyphae in tissues like skeletal muscle, cartilage etc which are supposed to be relatively resistant for inflammatory pathology got noted as one of our astounded histopathological findings insinuating how a human body acts as a culture media exhibiting diversity of a human makeup. The trend of presentation and severity kept changing with successive covid wave.

 Diagnosis of mucormycosis is gruesome and more difficult as compared to other infectious organism. In addition, like any malignant pathology, perivascular and neural infiltration is one of the important histological features of invasive mucormycosis as it indicates the severity and prognosis. There is drastically different trend of presentation in covid and its different mutant waves.
Cytomorphological study of cervical Pap smear based on the Bethesda system 2014
Authors: Sinchana KM  , Jadhav Meena N , Kittur Shreekant K
Published: August 2022

: The Papanicolaou (Pap) smear used worldwide for cervical screening was developed by Dr George Papanicolaou in 1940s. The Pap smear is a simple, safe and effective test to detect cervical cancer at an early stage.

: To study the spectrum of lesions in cervical Pap smear based on The Bethesda System(TBS) 2014 and to determine frequency of premalignant and malignant lesions.

: The present prospective study included 200 cases above 20 years of age. The cytological interpretation of smears were made according to TBS 2014. When there was difficulty in differentiating HSIL from other lesions p16 immunostaining was done and evaluated according to the criteria proposed by Wentzensen et al.

: Chi – square test was used to see the association between different attributes. Statistical analysis was performed using SPSS version 22. P value <0.05 was considered significant.

: The most common lesion was NILM with 175 cases (87.5%) followed by 7(3.5%) SCC, 4(2%) HSIL, 2(1%) cases each of ASCUS, AGC-NOS, LSIL and 1(0.5%) case of ASC-H. Among 200, 7(3.5%) cases were unsatisfactory for evaluation. The subjects were not uniformly distributed (P <0.001). The p16 marker was used in 6(3%) doubtful cases of HSIL among which 2(33.33%) cases were positive.

Cervical Pap smear is a useful technique to detect the inflammatory, premalignant and malignant lesions of cervix which helps the clinician to plan further management.
Fore-arm rhabdomyosarcoma in neurofibromatosis type 1: A unique case
Authors: Makkar Dheeraj , Kakkar Vikas
Published: August 2022

Rhabdomyosarcoma (RMS) is the commonest soft sarcoma in kids, with alveolar and embryonal variants distinguishable by histopathology and, more significantly, molecular biology. RMS occurs intermittently in a substantial proportion of cases without a predisposing condition. Nevertheless, it is well established that certain hereditary factors enhance the likelihood of developing RMS. Beckwith–Wiedemann syndrome, Gorlin syndrome, Costello, NF1, and Li Fraumeni syndromes are some of them. These syndromes present with RMS during childhood.

A 47-year-old female with NF 1 discovered a lump in her right forearm one year prior to presentation. When the patient noticed ulceration on the swelling, she sought medical attention. A tumor was detected in the center of the right forearm via MRI, and it was suspected to be a cystic or myxoid soft-tissue tumor, rhabdomyosarcoma or a peripheral neural tumor.

We classified the tumor as stage 4 due to axillary lymph node involvement and lung metastasis. Histopathology confirmed rhabdomyosarcoma.   The patient then received radiotherapy and chemotherapy, and her tumor went into remission.

After confirming NF1 syndrome, we advise patients to adhere to the standard cancer screening protocol. The screening would assist in the earlier diagnosis of tumors, leading to a reduction in complications.
Melanocytic nevus presenting as perianal skin tag
Authors: Aboud Khalid Al , Malki Ahmad Al , Solami Hasan Al , Idrees Nasser
Published: August 2022

This is a concise case report about the observation of an old patient with perianal skin tag found on pathological examination to be a melanocytic nevus.