bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPREHENDING COVID-19: IMMUNOPATHOGENIC MECHANISMS OF CYTOKINE ACTION
Authors: AKANBONG Elisha , DEVRİM Alparslan Kadir , ŞENOL Ali , DEVRİM Tuba
Published: September 2021

Cytokine release syndrome (CRS) or cytokine storm is

as a result of the excess production of pro-inflammatory

cytokines which is due to the disproportionate response

of the immune system which can be instigated by

SARS-CoV-2. COVID-19 which is caused by SARSCoV-

2 has a correlation with cytokines. SARSCoV-

2 instigates the production of IL-1 by ubiquitous

macrophages and mast cells. IL-1 tends to influence

the production of IL-6 and TNF-α. The progression

of COVID-19 severity influences the level of certain

cytokines such as IL-6. IL-6 is the cytokine chiefly

responsible for the occurrence of CRS. CRS is the

cause of COVID-19-related complications and the

main cause of COVID-19-related deaths. Despite the

data reported in the literature so far, the relationship

between SARS-CoV-2 and cytokines has not been fully

elucidated. The aim of the present review is to examine

the relationship in question. Targeting cytokines during

COVID-19 treatment has the potential to increase

patient survival and reduce COVID-19-related deaths.

It is concluded that focusing on the mechanisms of

cytokine release and the effects of released cytokines,

especially examining the effects on T lymphocytes

and IFN-γ production in COVID-19 disease, may help

reduce the lethal effects of the disease.
BRICS - T ÜLKELERİNİN NÜFUS ARTIŞ HIZI İLE KALKINMA İLİŞKİSİ: YAPISAL KIRILMALI EŞBÜTÜNLEŞME ANALİZİ
Authors: KONAT Gökhan , FENDOĞLU Eda
Published: September 2021

Dünya nüfusu özellikle 1950’li yıllardan sonra hızla artmaya başlamıştır. Nüfus artışında doğum, ölüm oranları ve göç oranları temel itici güçlerdir. Nüfus artışı, ülkenin ekonomik kalkınmasında çok önemli bir rol oynamaktadır. Nüfus artış hızının ekonomik kalkınma üzerindeki etkisi, tartışmalı ampirik çalışmaların konusu olmuştur. Araştırmacılar, nüfus artışının ekonomik kalkınma üzerinde pozitif etkisi olabileceği gibi negatif etkilerinin de olabileceğini savunmuşlardır. BRICS-T (Brezilya, Rusya, Hindistan, Çin, Güney Afrika ve Türkiye) ülke grubu, son yıllarda yüksek büyüme hızı, artan ihracatı ve milli geliri, bol doğal kaynakları, jeopolitik konumu, lojistik olanakları ve gelişme potansiyeli olan ülkelere ev sahipliği yapması nedeniyle büyük önem taşımaktadır. Bu çalışmada dünya nüfusunun neredeyse yarısına sahip olan ve yükselen ekonomileri ile dikkat çeken BRICS-T ülkeleri için kalkınma ve nüfus artış hızı arasındaki ilişki araştırılmaktadır. Bu amaçla Birleşmiş Milletler Geliştirme Programı resmi veri tabanından insani gelişme endeksi verisi ile Dünya Bankası resmi veri tabanından yıllık nüfus artış hızı verisi kullanılmış olup 1990-2019 dönemini kapsamaktadır. Çoklu yapısal kırılmaları dikkate alan panel veri analiz yöntemlerinden faydalanılmıştır. Bunun için öncelikle iki değişkene 5 yapısal kırılmaya kadar izin veren Carrion-i Silvestre vd. (2005) tarafından önerilen kırılmalı panel birim kök testi uygulanmıştır. Ardından yapısal kırılmaları dikkate alan ve Banerjee ve Carrion-i Silvestre (2015) tarafından literatüre kazandırılan yapısal kırılmalı panel eşbütünleşme analizi gerçekleştirilmiştir. Elde edilen sonuçlar neticesinde iki değişken arasında uzun dönemli bir ilişkinin olduğu görülmektedir.
BABY BOOMERS, X, Y, Z KUŞAKLARININ SOSYAL MEDYA KULLANIM DÜZEYLERİ VE TERCİHLERİ
Authors: ALPTEKİN Gökhan , TÜRKMEN Deniz , ARSLANTAŞ Halis Adnan
Published: September 2021

Bu araştırma, Eskişehir İli Odunpazarı ve Tepebaşı ilçelerinde ikamet eden ve farklı kuşakları temsil ettiği kabul edilen bireylerin sosyal medya kullanım düzeyleri ve tercihlerini “süreklilik” ve “yetkinlik” boyutu açısından ele alan bir araştırmadır. Araştırmada tarama modeli kullanılmıştır. Tarama modeli, çok sayıda elemanın oluşturduğu bir evrende, evren hakkında genel bir kanıya varmak amacıyla evrenin tamamı yahut ondan alınacak bir grup üzerinde yapılan tarama kodifikasyonudur (Karasar, 2012). Araştırmanın çalışma grubunu kent merkezinde yaşayan 877 kişi oluşturmaktadır. Araştırmanın verileri Deniz ve Tutgun-Ünal (2019) tarafından geliştirilen “Sosyal Medya Kullanımı Ölçeği” kullanılarak çevrimiçi ortamda toplanmıştır. Araştırmada elde edilen bulgular; (1) Kuşaklar sosyal medya ağlarına erişimde en çok akıllı telefon kullanmaktadır. (2) BabyBoomer ve X kuşağı en çok Facebook’u kullanmayı tercih ederken, Y ve Z kuşağı ise en çok İnstagram’ı kullanmaktadır. (3) BabyBoomer, Y ve Z kuşakları sosyal medyada en fazla video ve müzik içeriklerini beğenirken, X kuşağı ise en fazla haber içeriklerini beğenmektedir.(4) Kuşaklar süreklilik ve yetkinlik boyutlarında sosyal medyayı orta düzeyde kullanmaktadır. (5) Y ve Z kuşağı, BabyBoomer ve X kuşağına göre sosyal medya kullanımında süreklilik sağlamakta ve kendilerini bu konuda daha yetkin bulmaktadırlar. (6) Z kuşağı kadınları aynı kuşakta bulunan erkeklere göre sosyal medya kullanımında süreklilik sağlayan cinsiyeti temsil etmektedir.
AHMET HAŞİM’İN ŞİİRLERİNDE MEKÂN
Authors: ABİÇ Taylan , SOLMAZ Vecihe
Published: September 2021

Ahmet Haşim, Tük edebiyatının önemli isimlerinden biridir. Önceleri Tanzimat sanatçıları olan Abdülhak Hamit ve Muallim Naci’nin şiirlerinin etkisinde kalan şair daha sonra Servet-i Fünun sanat anlayışına uygun şiirler yazar. Fransız şiiri ise onun sanat anlayışını derinden etkiler. Şiiriyle bireysel sanat anlayışını kendi döneminde koruyan şair ilk şiir kitabı olan Göl Saatleri’ni 1921’de çıkarır. Daha sonra Piyale’yi 1926’da kaleme alır. Modern Türk şiirinin kurucularından biri olan Ahmet Haşim, kendisinden sonra Cahit Sıtkı Tarancı, Ahmet Hamdi Tanpınar, Ahmet Muhip Dıranas ve Necip Fazıl Kısakürek gibi birçok sanatçıyı etkiler Sanatçının şiirleri üzerine birçok çalışma yapılmış ve kitap çıkarılmıştır. Aynı zamanda onun bireysel odaklı sanat anlayışı dönemin sanatçıları ve kendisinden sonra gelen sanatçılar tarafından da tenkit edilmesine neden olur. Özellikle Haşim’in “hayal havuz”u gibi mekânsal çağrışımları bu eleştirilerin hedefidir. Genellikle mekân, daha çok roman ve hikâye unsurlarından biri olarak görülmektedir. Ancak mekân kavramı son yıllarda çeşitli çağrışımlarla yeniden anlam kazanmakla beraber şiirde de yerini bulur. Mekân ve insan karşılıklı bir etkileşime sahiptir. Dolayısıyla mekân ile şair de etkileşim içindedir. Ahmet Haşim’in şiirlerinde ise zaman kavramı öne çıkarılır. Hâlbuki zaman dışında ve zamanla birlikte şiirde vücut bulan, gerçek ve hayal ile iç içe geçmiş bir mekân meselesi Ahmet Haşim’in şiirlerinde mevcuttur. Çalışmanın amacı, Ahmet Haşim’in şiirlerinden hareketle mekân unsurlarını tespit etmek ve mekân unsurlarının sanatında nasıl kullanıldığını incelemektir. Mekânın şair için ne anlamlar ifade ettiğini -biyografisinden hareketle- ortaya koymak çalışmanın esas amacıdır.
Assessment of the Levels of ER and PR v1
Authors: Hari Sakti Dhimas
Published: September 2021

Measuring the level of estrogen receptor alpha, estrogen receptor beta, and progesteron receptor in meningioma tissue using quantitative real-time polymerase chain reaction.
ANALYSIS OF TACTICAL PROPERTIES OF MODERN GEOINFORMATIONAL MONITORING
Authors: Mikhno O. , Patrakeyev I. , Levinskova N.
Published: September 2021

Geoinformational monitoring of urban environment is a necessary component of modern military-geographical description of military operation theater. The polymorphism property of modern geoinformational monitoring can be attributed to tactical properties, since it significantly expands range of decryption features of territory to be studied. The essence of polymorphism property of geoinformational monitoring is as follows: the same object of monitoring or the same phenomenon or process can be represented by different models. This property of geoinformational monitoring allows to preserve the integrity of representation of monitoring objects due to the invariance of description of objects and to bring the study of tasks of one type of monitoring to tasks of another type. Consistency of disparate models of monitoring objects is carried out provided that they belong to a given category of models. A constructive approach to the integration of different types of models of monitoring objects in the system of geoinformational monitoring is using methods of categorical-functional analysis. The mathematical apparatus of category theory allows the formalization of structures of complex systems in the form of sets of morphisms and objects of category of structured sets. This allows us to preserve integrity of representation of monitored object, and the consistency of its disparate models based on the analysis of their belonging to a given category of models. The paper presents the mathematical apparatus of implementation of this method, which is the theoretical basis of properties of polymorphism of geoinformational monitoring. The property of polymorphism allows us to increase the efficiency of processes of observation, evaluation, control and management of urban environment on basis of a heterogeneous polymodel complex, which forms information space of object of monitoring. Specific models of practical implementation of the polymorphism properties of geoinformational monitoring on the example of anomalous zones of density of vehicles and thermal field of the city surface are considered.
Geleceğin Belirsizliğinde Beşeri Sermayenin Önemi: Savunma Planlayıcılarına Öneriler
Authors: Ünlü Oğuzhan , Begenirbaş Memduh
Published: September 2021

Sürekli değişen dünya, bilgi donanımını artırmayı gerektirirken, sürdürülebilir performansa yönelik talepler, kurumları; yeni teknolojileri kullanma, kurumsal yapılarını uyarlama, iş yönetimlerini yeniden tasarlama, işgüçlerini yeniden konumlandırma ve iş süreçlerini iyileştirme yeteneklerini incelemeye ve yeniden değerlendirmeye zorlamaktadır. Geleceğin dış çevresi çok daha kırılgan, dengesiz ve daha az öngörülebilir bir hale gelmesi sebebiyle insan kaynağının önemi daha da değer kazanmaktadır. Örgütlerin etkin bir şekilde görev yapabilmesi iş süreçlerinin ve yöntemlerin her seviyede liderler ile uyum içerisinde geliştirilerek kesintisiz ve sürekli devam eden bir beşeri sermaye programı oluşturmak ile mümkündür. Oluşturulan programla hem örgütler etkin bir şekilde görev yapacak hem de kendine güvenen, kendisinden beklenen sabır, azim ve dayanıklılığı sergileyen bir insan kaynağını elinde bulunduracaktır. Bu doğrultuda geleceğin belirsizliği ve rekabet ortamına dikkat çeken ABD Savunma Departmanı 2030 Yılı Personel ve Hazırlık Stratejisi de göz önünde bulundurularak Savunma Planlayıcılarına geleceğin öngörülemez koşullarında insan kaynağının sahip olması hedeflenen özelliklere yönelik Beşeri Sermaye Geliştirme Programı yol haritası oluşturulmuştur. Oluşturulan Beşeri Sermaye Geliştirme Programıyla; teknoloji öngörüsüne sahip, iyi eğitimli, dinamik ve sürekli öğrenen personelin, yüksek aidiyet duygusuyla doğru yerde, doğru zamanda ve her an harbe hazır olmasını hedeflenmektedir.
ALINSKYISM AND TACTICAL DEXTERITY: BUILDING THE TEXAS CHICANO MOVEMENT, 1965–1978
Authors: Venegas Mario
Published: September 2021

This article examines internal processes that helped Alinskyism become a hegemonic style of organizing among Chicanos in Texas over New-Left and Marxist styles. I argue that Alinskyite Chicanos outmaneuvered rival activists through what I call tactical dexterity. Tactical dexterity illuminates how actors transpose cultural schemas with organizational knowledge to craft tactics that build political power, negotiate status, and expunge rivals to control resources. The Mexican American Youth Organization (MAYO) and Raza Unida Party illustrate the political maneuverings of activists to organize Chicanos in Texas. Sewell’s framework of structuration illuminates how activists use creative flexibility in adopting tactics to prevail over rivals. This article illustrates the creativity of Alinskyite organizers in leveraging cultural schemas and institutional knowledge to force recognition of Chicanas and to remove Marxists from conventions. These moments provide an opportunity to reveal processes through which one style of organizing prevailed over others.
Outpatient treatment of patients with amyotrophic lateral sclerosis in a neurological clinic
Authors: Osterhage J. , Prudlo I. , Dielmann U. , Schimrigk К.
Published: September 2021

And myotrophic lateral sclerosis (ABS) is a rapidly progressive degenerative disease of the motor nervous system, so patients with this diagnosis need intensive monitoring and treatment.
Hemodynamics disorders in vertebra-basilar region in patients with vibration disease, caused by local vibration (data of rheography and transcranial dopplerography)
Authors: Ilyina M. I. , Obraztsova R. G. , Nesterova М. V. , Filatova R. I. , Samokhvalova G. N. , Granovskaya М. А.
Published: September 2021

Brain hemodynamics was studied in vertebra-basilar region in patients with vibration disease, resulting from local vibration. High percentage of clinical and roentgenologic manifestations of cervical octeochondrosis was revealed, as well as incidence increase of cephalgia syndrome while vibration disease progressing. Analysis of rheographic curves (deviation by E.Enin) and transcranial dopplerosonograms showed cerebral circulation dificiency in vertebrabasilar region. The highest level of hemodynamic disorders was marked in vertebral arteries. It is not excluded, that one of the factors, enfluencing hemodynamics disorders, is pathology of the vertebral column.
Inhibitory interactions in the system of functionally connected muscles of the shin in patients with the cerebral palsy
Authors: Pleschinsky I. N. , Guselnikova G. G. , Bikmullina R. H. , Novikova Е. V.
Published: September 2021

In 10 able-bodied individuals and 8 patients with the cerebral palsy reciprocal and non-reciprocal inhibitions of soleus motoneurones were investigated by means of the H-reflex conditioned by electrical stimulation of the tibialis and gastrocnemius medialis nerves, respectively. In normal individuals short- and long-latency periods of both reciprocal and non-reciprocal inhibitions were found. The cerebral palsy patients showed the increased inhibitory influence with more enhanced short-latency components of inhibition. A possible role of inhibitory systems in limitation of patologically activated antigravitant soleus motoneurones was discussed.
Significance of diphtheria toxin in neuropathy development and protective effect of nerves growth factor
Authors: Sorokina М. N. , Davydovskay М. V. , Romanjuk А. V. , Chalisova N. I. , Skripchenko N. V. , Nasyrov R. А. , Aksenov О. A. , Markova О. А.
Published: September 2021

In experiments in vitro and in vivo competitive relationships of diphtheria toxin and nerves growth factor were shown: in organotypical culture (300 sensor ganglions) and in model of experimental diphtheria neuropathy in 66 white rats. There were given evidences of protective action of nerves growth factor, inhibiting the toxic effect of diphtheria toxin. Contents of free toxin and specific immune comlexes was studied in 25 children with diphtheria polyneuropathy. Favourable outcome of disease was observed in children with high presence of nerves growth factor in blood serum, thus giving new approach in treatment of nervous system diseases.
Some aspects of the pathogenesis of multiple sclerosis
Authors: Matveeva Т. V. , Arleevskaya М. I. , Demin Т. V.
Published: September 2021

The key mechanism of the pathogenesis of multiple sclerosis (MS) is demyelination and the associated impairment of axonal impulse conduction. This disease is genetically determined to a certain extent.
Immune response and localization of focal brain lesions
Authors: Gorbunov V. I.
Published: September 2021

Since the discovery of the functional asymmetry of the cerebral hemispheres, interhemispheric lateralization and intrahemispheric organization of the brain have been a leading problem in clinical neurology.
Literature as an Auxiliary Science in Teaching Geography
Authors: Gielata Ireneusz
Published: September 2021

The article discusses the status of literature in teaching geography. Like cartography, literature maps the space and assigns proper names which allow us to see the places of “condensed, multiplied time” (Claudio Magris). Literary maps bind topography with history and thus realise a geopolitical project of “thinking of place, time and action as coherent unity” (Karl Schlögel). Such literary names as Conrad’s “heart of darkness” or mare nostrum, mare monstrum from Dariusz Czaja’s essay, in geography didactics can reveal the drama of “building up of land and history” (Magris) and thanks to this, a map used in the didactic process can lead to cathartic experience, i.e. it can sharpen, activate and sensitize the pupils’ eye.
Students' Behavioral Intention to Use Learning Management System: The Mediating Role of Perceived Usefulness and Ease of Use
Authors:   College of Teacher Education and Senior High School Department, Laguna State Polytechnic University, San Pablo City, Laguna 4000, Philippines, Panergayo Albert Andry E. , Aliazas John Vincent C.
Published: September 2021

This paper investigates the mediating role of perceived usefulness and perceived ease of use on the effect of online learning self-efficacy factors: learning in an online environment, time management, and technology use to the students' behavioral intention to use learning management system. A cross-sectional explanatory research design was employed to collect and interpret the data gathered from 470 senior high students. Mediation analyses were initiated using PROCESS v3.5 following the procedure of Hayes (2013). Findings revealed that the three online learning self-efficacy factors, perceived usefulness, and perceived ease of use could explain the variation of students' behavioral intention to use. The results further showed that perceived usefulness and ease of use are both significant mediators in the relationship between online learning self-efficacy factors and student's behavioral intention to use. These results suggest that the future intention to use is higher when the students' perception of LMS found it valuable and easy to use. Development and adoption of LMS in educational institutions should consider the usefulness and manageability features to increase usage, fostering successful LMS-based course implementation.
Streamed Video Reconstruction for Firefox Browser Forensics
Authors: El-Tayeb Mahmoud , Taha Ahmed , Taha Zaki
Published: September 2021

In criminal investigations, the digital evidence extracted from social media may provide exceptional support. Reviewing the history or cache of the web browser may provide a valuable insight into the activity of the suspect. The growing popularity of Internet video streaming creates a risk of this technology misuse. There are a few published research on video reconstruction forensics on the Chrome browser. There is a difference in the methods applied to reconstruct cached video on Chrome from the methods applied to Firefox or any browser. Our primary focus in this research is to examine the forensic procedures required to reconstruct cached video stream data using Twitter and YouTube on the Firefox browser. Some work has been done to reconstruct a cached video on the Chrome browser, but we need more work on the rest of the browsers, most notably the Firefox browser used in this research. Both examination strategies and contemplations displayed are approved and suitable for the forensic study of various streaming platforms as well as the web browser caches.
Blind Image Quality Assessment Using a CNN and Edge Distortion
Authors: Movva Rajesh Babu , Kontham Raja Kumar
Published: September 2021

The present paper introduces a Convolutional Neural Network (CNN) for the assessment of image quality without a reference image, which comes under the category of Blind Image Quality Assessment models. Edge distortions in the image are characterized as input feature vectors. This approach is in justification of the fact that subjective assessment focusses on image features that emanate from the edges and the boundaries present in the image. The earlier methods were found to use complex transformations on the image to extract the features before training or as a part of the training. The present work uses Prewitt kernel approach to extract the horizontal and vertical edge maps of the training images. These maps are then input to a simple CNN for extracting higher level features using non-linear transformations. The resultant features are mapped to image quality score by regression. The network uses Spatial Pyramid Pooling (SPP) layer to accommodate input images of varying sizes. The present proposed model was tested on popular datasets used in the domain of Image Quality Assessment (IQA). The experimental results have shown that the model competes with the earlier proposed models with simplicity of feature extraction and involvement of minimal complexity.
Classification of Rigid and Non-Rigid Objects Using CNN
Authors: Gullapelly Aparna , Banik Barnali Gupta
Published: September 2021

Classifying moving objects in video surveillance can be difficult, and it is challenging to classify hard and soft objects with high Accuracy. Here rigid and non-rigid objects are limited to vehicles and people. CNN is used for the binary classification of rigid and non-rigid objects. A deep-learning system using convolutional neural networks was trained using python and categorized according to their appearance. The classification is supplemented by the use of a data set, which contains two classes of images that are both rigid and not rigid that differ by illuminations.
Isolation and well-being in the time of lockdown
Authors: Bourdeau Lepage Lise , Kotosz Balázs
Published: September 2021

In response to the Covid‑19 health crisis, the French government has imposed various measures, referred to as social-distancing measures, including a lockdown with the primary objective of reducing face-to-face interactions between people in order to limit the spread of the virus. This paper seeks to determine if the social-distancing measures and lockdown lead to social isolation for certain people and have an impact on French people’s well-being. First, it reveals that the feelings of social isolation have substantially increased in France during this lockdown.  Second, it explores the factors that help to explain these changes by developing a predictive model and reveals that living alone, being a woman, being young are factors that explain this increase in felling of social isolation. Third, the estimation of the effects of changes in feelings of social isolation on changes in the reported level of well-being of French respondents during lockdown shows that people who reported feeling more socially isolated than others has the lowest levels of well-being among the French population; and that the increase in people’s feelings of social isolation during lockdown is a factor that has a negative impact on their level of well-being.
A Cross Sectional Study of Chronic Liver Disease with Reference to Portal Hypertension and Endoscopic Finding at Down Town Hospital, Guwahati, Assam
Authors: Nayak Manabendra , Pradeep Ghodke Chinmoy
Published: September 2021

BACKGROUND Cirrhosis is a progressive clinical condition associated with considerable mortality and morbidity. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension.1 In cirrhosis, primary diagnostic test for evaluation of upper-gastro-intestinal bleeding (UGIB) is endoscopy.2 The present study attempts to find out different clinical patterns of the chronic liver disease (CLD) with portal hypertension along with the endoscopic profile of the patients. METHODS It was a cross sectional study conducted in Down Town Hospital, Guwahati, Assam. RESULTS A cross sectional study was conducted at Downtown Hospital, Guwahati, Assam on patients diagnosed with chronic liver disease from 01 January 2017 to 31 January 2018. Male predominance was observed in this study with 84 % males and 16 % females. Male to female ratio was 5.25 : 1. Maximum patients (58 %) were observed in the age group of 40 to 60 years followed by 30 % in the age group of 60 to 80 years. The average age was 53.6 years. Most common aetiological factor was alcohol (66 %) followed by non-alcoholic steatohepatitis (NASH) (16 %). Other aetiologies were hepatitis-B, hepatitis-C and cryptogenic. 88 % cases were recorded in model for end stage liver disease (MELD) score range of 10 to 29. Ascites was noted in 88 % cases, of which 20 % had grade-1 and grade-2, 48 % had grade-3. Splenomegaly was noted in 70 % cases. Child-Pugh class-C consisted of 26 % cases (13) with grade-III varices followed by 18 % cases (9) with grade-II varices while Child-Pugh Class-B had 24 % cases (12) and 8 % cases (4) with grade-III and grade-II varices respectively. Child-Pugh class-A had all the cases with grade-I varices. CONCLUSIONS Alcoholism was the leading cause for cirrhosis followed by hepatitis-B, hepatitis-C, NASH and cryptogenic. Class-C had maximum number of cases with grade-III varices followed by class-B. MELD score ranged between 10 - 29 in majority. Severe anaemia was noted in 10 % cases. Thrombocytopenia a non-invasive indicator of oesophageal varices was noted in 70 % with different grades of oesophageal varices. KEYWORDS Endoscopy, Portal Hypertension, Chronic Liver Disease
Ectopic Pregnancy - A 1 Year Clinical Study in King George Hospital, Visakhapatnam
Authors: Mudadla Vamsi , Kaitala Shyamala , Nandigama Satyavani
Published: September 2021

BACKGROUND Ruptured ectopic is a life threatening obstetric emergency. Obstetrician must have a high index of suspicion for ectopic pregnancy and should be aware of importance of early diagnosis and early intervention. The present study was undertaken to evaluate the incidence, clinical presentation, risk factors, treatment and morbidity associated with ectopic pregnancy. METHODS Retrospective analysis of ectopic pregnancy was done in King George Hospital, Visakhapatnam from January 2020 to December 2020 in the department of OBG. The following parameters: Age, risk factors, clinical presentation, site of ectopic, diagnostic methods, mode of treatment were noted. RESULTS A total of 63 cases were reported during this time frame. It is a tertiary care centre getting referrals from nearby districts and other hospitals. Incidence of ectopic pregnancy in the present study is 0.89 %. 41.26 % of patients belonged to age group between 26 to 30 years. Out of 63 cases 49.20 % were multigravida. 28 % of the cases were associated with previous H/O abortions and 23 % of the cases were associated with PID and in 17.4 % of the cases there was no predisposing factors. 96.82 % the patients presented with pain abdomen. Shock in 34.92 % of the cases. Ampulla is the most common site of ectopic. In 76 % of the cases there was hemoperitoneum > 500 ml. Salpingectomy was done in 79.3 % cases. 84 % of cases required blood transfusion > 1 unit. There was no mortality. CONCLUSIONS Ectopic pregnancy is one of the obstetric emergency with significant morbidity and mortality. PID and post abortal sepsis are one of the important risk factors for ectopic pregnancy. As many patients may not have recognizable risk factors, a high index of suspicion is critical for early diagnosis. Early USG diagnosis of ectopic pregnancies reduces mortality and enables us to offer the patient conservative medical and surgical treatment. KEYWORDS Ectopic Pregnancy, TVS, Ampulla, Salpingectomy
A Prospective Study of the Clinical Profile of Pilonidal Sinus Disease at a Tertiary Care Centre in North India - Comparison of Limberg Flap Closure and Z-Plasty in Treatment
Authors: Yadav Gulab Dhar , Varshney Ashish , Deb Adiveeth
Published: September 2021

BACKGROUND Sacrococcygeal pilonidal sinus disease is defined as a hair-filled cavity in the subcutaneous fat of the natal cleft (postsacral intergluteal region). This study was done to investigate the prevalence, clinical presentation, body mass index (BMI) as a risk factor; and complications of Limberg flap and Z-plasty, for the reconstruction of defects after excision of sacrococcygeal pilonidal sinus in terms of the incidence of seroma, wound infection, wound dehiscence, flap necrosis, recurrence, duration of hospital stay and time taken for complete wound healing after the procedure. METHODS This was a prospective study done on 50 patients from January 2018 to October 2020 at a tertiary care hospital in 15 to 50 years of age group presenting with pilonidal sinus disease. Statistical analysis was done using SPSS (Statistical Package for Social Sciences) version 15.0 statistical analysis software. Significance was assessed at 5 %. RESULTS The mean age of presentation was 25 years with chief complains of swelling, discharge and pain, the mean BMI was 24.39 kg/m2 . Anaerobic infection is more common in the sinus (40 %), and among aerobic organisms, Staphylococcus was the most common organism (19 %). In Limberg flap closure, only one 1 developed wound infection and this same patient had partial wound dehiscence, while in Zplasty group, 3 developed seroma, 2 wound infections and 2 partial flap ischemia. CONCLUSIONS The goals of management of pilonidal sinus diseases include conservative management along with definitive surgical treatment of the disease. Pilonidal abscess is managed by incision and drainage and is followed by definitive treatment, later on. Flap procedures are effective ways to treat the disease, of which Limberg flap is the most reliable flap with minimum complications, lesser hospital stay and faster wound healing. KEYWORDS Pilonidal Sinus, Limberg Flap, Z-Plasty
Transfusion Transmissible Infections among Voluntary Blood Donors in a Tertiary Care Hospital, Kerala - A Cross Sectional Study
Authors: T.K Raji , Narayanan Deepa
Published: September 2021

BACKGROUND Blood transfusion is a common life-saving medical procedure, but it may cause acute and delayed complications. A transfusion transmissible infection (TTI) is any infection that is transmissible from person-to-person through parenteral administration of blood or blood products i.e. packed red blood cells (RBC), platelets, plasma and other blood products. This study was undertaken to assess the prevalence of transfusion transmissible infections among blood donors in blood bank connected to a tertiary care hospital in Kerala and evaluate the safety of the blood donations. METHODS Samples of 13,262 donors from January to June 2018 were taken. All the donors who were accepted for donation as per criteria by national acquired immunodeficiency syndrome (AIDS) control society were included in the study. Consent was obtained from blood donors to conduct testing for transfusion transmitted diseases. Donors were screened by 4th generation enzyme linked immuno sorbent assay (ELISA) test kits for HIV-1/2, 3rd generation ELISA test kits for HBsAg and hepatitis C virus (HCV), rapid immunochromatographic test for malaria and rapid plasma reagin (RPR) test for syphilis. Tests were performed as per manufacturer instructions. All the reactive samples were discarded as per the guidelines. RESULTS Among 13,262 donors, 13,014 (98.12 %) were males and 248 (1.8%) were females within the age group of 18 - 60 years. Out of these, 7 (0.052%) donors were HBsAg positive and 3 (0.02%) were HIV positive. RPR reactivity was seen in 2 donors (0.01%) only. None of the blood donors tested showed positivity for HCV or malarial parasite. In this study, prevalence of hepatitis B was highest (0.052) followed by HIV (0.02%) and syphilis (0.02%). CONCLUSIONS Hepatitis B virus (HBV) is the most common transfusion transmissible infection among apparently healthy donors, followed by HIV and syphilis. TTI’s can be eliminated or reduced by implementing an integrated strategy for blood safety, like effective selection of blood donors, avoiding unnecessary transfusions, and early detection of TTIs. KEYWORDS Transfusion-Transmitted Infections, HIV, HBV, HCV
Functional Outcome of Antibiotic Impregnated Nail in Infected Non-Union of Tibia and Femur - A Prospective Observational Study, Trichur, Kerala
Authors: Palakandy Arjun Dev Naroth , Kunjappan Manoj Murungodiyil , Francis Jose
Published: September 2021

BACKGROUND Infected non-union is a complex, debilitating and challenging disorder affecting orthopaedic surgeon and patient in terms of cost and time.1 Antibiotic impregnated nail has been a cheap and effective method used for treatment of infected nonunion. Factors that may lead to infected non-union are many.2,3 High local concentrations of antibiotics with minimal systemic levels and without systemic side effects make local antibiotic therapy a very useful technique in treating infected non-union. 4 Buchholz and Engelbrecht were the first to use antibiotic impregnated cement.5 Major advantage of using antibiotic impregnated cement is, it provides high concentration of antibiotics locally with less systemic side effects.6 The purpose of this study was to determine the functional outcome of antibiotic impregnated nail in treatment of infected non-union of femur and tibia. Antibiotic cement impregnated intra-medullary nail can provide stability, help in control of infection,7 is easy to remove, and also provides all the advantages of the cement beads.8,9 METHODS This prospective study was done on 25 cases at Government Medical College Thrissur from 01 September 2016 to 01 April 2018. Functional results were evaluated with regard to control of infection, bony union, deformity, limb leg discrepancy and complications (both intra and post-operative complications). RESULTS Most of the cases had type 2 open injury initially, accounting for 49 %. Staphylococcus aureus was reported in 56 % of cases. Infection control was achieved in 23 cases. Bony union was visualised in 18 cases, remaining 5 cases united following bone grafting. In 2 cases there was no control of infection and no bony union was achieved, later antibiotic nail removal and Ilizarov fixation was planned. Bone grafting was done in 10 cases. CONCLUSIONS Antibiotic impregnated cement nailing is a simple, economical and very effective procedure with less complication and shorter duration of treatment when compared with other conventional procedures. KEYWORDS Infected Non-Union, Long Bones, Antibiotic Impregnated Cement Nail
Prevalence and Causes of Infertility in Overweight and Obese Women in a Tertiary Care Hospital Setup in Mangalore - A Retrospective Secondary Data Analysis
Authors: Dhandapani Keerthana , Kodavanji Bhagyalakshmi , N.A Vinodini , N.J Priyadarisini , Deshpande Shripad B.
Published: September 2021

BACKGROUND Obesity has become an epidemic worldwide. Several mechanisms are involved in the relationship of fertility and obesity, including metabolic and reproductive functions. In light of the fact that most of the causes of infertility are treatable, there is a need to document the diagnostic findings in overweight and obese infertile women. The causes of infertility prevalent in a particular region can be provided by hospital-based studies. So, the present study is designed to find out the common causes of infertility in overweight & obese women and to gain knowledge regarding the prevalence of primary and secondary infertility among these infertile women. METHODS The data of 115 infertile women (18 to 45 years) were collected from hospitals under Kasturba Medical College (KMC), Mangalore retrospectively. Data of history of previous conception, body mass index (BMI), type of infertility, duration of infertility, age and the causes of infertility were collected. The prevalence of each cause was evaluated. RESULTS Among 115 infertile women, 92 (80 %) were pre–obese and 23 (20 %) were obese (P - .001). Primary infertility was most common in pre obese women and secondary infertility in obese women which was statistically significant (P < .05). Ovulatory dysfunction was the most common cause in obese infertile women (P - .004), whereas in pre obese women, it was uterine and adnexal causes. CONCLUSIONS Comparatively, maintaining a healthy lifestyle can avoid fertility problems in pre obese women, because the effect of BMI on hypothalamic–pituitary-gonadal (HPG) axis is higher in obese women in whom ovulatory disorders were the leading cause. The significance of weight reduction before pregnancy should be informed to overweight and obese patients and should be aided to lose weight. Treatment of anaemia itself may resolve the infertility issues and should be taken as a first line treatment in all cases. KEYWORDS Female Infertility, Adipose Tissue, Obesity, Infertility Causes, Ovulatory Dysfunction
Immediate Sequential Bilateral Cataract Surgery in Covid-19 Pandemic - A Prospective Study in a Tertiary Eye Care Centre of Eastern India
Authors: Priya Aanchal , Kumar Sunil , Singh Seema
Published: September 2021

BACKGROUND Immediate sequential bilateral cataract surgery (ISBCS) is the procedure in which both eyes are simultaneously operated in a single hospital visit. The onset of corona virus disease-19 (COVID-19) pandemic has raised the interest among ophthalmic surgeon in considering immediate sequential bilateral cataract surgery to reduce hospital visit of patients. This study was done to assess the intraoperative and post-operative complications and average number of hospital visits required after performing immediate sequential bilateral cataract surgery in COVID-19 pandemic. Also, the post-operative visual outcomes were evaluated. METHODS Patients with visually significant bilateral cataract with best corrected visual acuity ≤ 6/18 in better eye, axial length within range of 21 - 25 mm and age >18 years with no ocular and systemic co-morbidity were included in the study. All patients underwent immediate sequential bilateral cataract surgery from July 2020 to September 2020. Strict intraoperative protocols were followed in all cases. Intracameral injection of 0.1 ml moxifloxacin 0.5 % (vigamox / Novartis health care Pvt Ltd. Texas, USA) was given at the end of surgery in all cases. Intraoperative and post-operative complications, visual and refractive outcomes were analysed. RESULTS Sixty-four eyes of 32 patients with mean age 55 ± 2.82 years (range: 48 - 71 years) were included in the study. The mean pre-operative best corrected visual acuity was 0.64 ± 0.08 logarithm of minimum angle of resolution which improved significantly to 0.03 ± 0.03 at the end of second follow up on day 14 (P < 0.0001). The mean post-operative spherical equivalent was -0.22 ± 0.48 D. The target refraction within ± 0.50 D was achieved in 56 eyes (87.50 %) and within ± 1.0 D in all eyes. No vision threatening complications such as endophthalmitis, cystoid macular oedema, retinal detachment or corneal decompensation occurred in any of eyes. Total hospital visits were reduced to four per patients for both eye surgeries. CONCLUSIONS Immediate sequential bilateral cataract surgery may be considered as preferred practice in selected cases to reduce the risk of cross infection of COVID-19 by short hospitalization and less follow up visits. KEYWORDS Bilateral Cataract Surgery, COVID-19, Endophthalmitis
A Cross Sectional Study to Assess Morphometry of Upper End of 80 Cadaveric Tibiae in a Tertiary Care Centre of Central India
Authors: Agichani Sonali Rajesh , Medhi Bandita , Harioudh Satish Kumar
Published: September 2021

BACKGROUND Osteoarthritis of knee joint is one of the major health problems, due to the evolution of erect posture. Upper weight bearing end of tibia is most vulnerable to damage in such patients. Total knee arthroplasty and unicompartmental arthroplasty are the most frequently done procedures, which require the use of adequate knee prosthesis. So, the present study was focused at providing morphometric data of upper articular end of tibia for designing the tibial component of prosthesis. METHODS The present study has been conducted in SAMC & PGI, Indore in the Department of Anatomy. 80 dry tibia bones were studied, of which 33 were right sided and 47 were left sided. Maximum anteroposterior (AP) length and width of upper surface of medial and lateral condyles and intercondylar area were measured with digital vernier caliper. RESULTS The average anteroposterior diameter was found to be greater than the transverse diameter for both the condyles and the intercondylar area, irrespective of side. Furthermore, the anteroposterior diameter and the transverse diameter of medial condyle was more than that of lateral condyle on both the sides. In intercondylar area, the anteroposterior diameter was found to be more on right side while transverse diameter was more on left side. CONCLUSIONS The present study demonstrates the accurate complete comparative measurements of all the parameters of upper surface of medial and lateral condyles and intercondylar area. The morphometric data obtained will provide guidelines for designing tibial component of knee prosthesis in central Indian population. Apart from clinical significance, the study has anthropological and medicolegal importance as well. KEYWORDS Morphometry, Upper End of Tibia, Knee Joint
Prevalence of Low Circulatory Vitamin D Levels in Patients with Acute Myocardial Infarction - A Cross Sectional Study from a Tertiary Care Centre in Kozhikode, Kerala
Authors: Kunnath Nasreen Edavanam , Kayakkal Muhammed Ashraf , Sreedhar Shaji , Panarkandy Geetha , Appunni Sandeep
Published: September 2021

BACKGROUND Vitamin D deficiency continues to be an unrecognized health disorder globally while ischemic heart disease (IHD) is the leading cause of premature mortality. Many recent studies have found high rates of cardiovascular diseases among patients with low vitamin D levels. Due to limited randomized control trials, it is reasonable to screen acute myocardial infarction (AMI) patients for vitamin D deficiency. Thus, the study aims to find out as to whether vitamin D deficiency is a risk factor for AMI and evaluate the association between their troponin I and vitamin D levels. METHODS In this cross-sectional study, cases included patients admitted with myocardial infarction in the medicine wards or ICU while controls were age and sex matched apparently healthy subjects. Detailed history was taken about duration of the illness and other significant medical illness. Serum troponin I (Trop I) levels and electrocardiogram (ECG) reports were assessed. Serum samples for 25- hydroxyvitamin D [25(OH)VitD] estimation by electrochemiluminescence method, were collected from both cases and controls. Statistical analysis was performed using SPSS version 22.0 software. RESULTS The mean 25(OH)VitD levels were found to be significantly lesser in cases [20.98 ± 6.29 ng/ml] as compared to controls [27.13 ± 10.50 ng/ml], further decreased in ST-elevation myocardial infarction (STEMI) (17 %) subjects [15.70 ± 4.43 ng/ml] as compared to non-ST elevation myocardial infarction (NSTEMI) (83%) [22.06 ± 6.10 ng/ml]. There exists a significant moderate negative correlation [ρ = -0.46] between troponin I levels and 25(OH)VitD levels in AMI. CONCLUSIONS Vitamin D deficiency hence can be a risk factor for development of myocardial infarction. But already established risk factors confounds to state it as an independent risk factor. KEYWORDS Acute Myocardial Infarction, 25-Hydroxyvitamin D, Troponin I, ST-Elevation myocardial infarction, Non-ST Elevation myocardial infarction
A Retrospective Study of Symptom Profile of Psychiatric Complications in Alcohol Dependence Patients Admitted in Psychiatric Ward in Chennai
Authors: D Vijayanand , S Dhanya Dedeepya , L Lavanya
Published: September 2021

BACKGROUND Alcohol dependence is a psychiatric diagnosis in which an individual is physically or psychologically dependent on alcohol. It includes the presence of alcohol tolerance, physical dependence, and an inability to control alcohol intake. Alcohol dependence is a severe mental health problem associated with health issues, social and financial burden not only for the patient but also for the family members. The purpose of this study was to analyse the psychiatric complications in patients with alcohol dependence syndrome (ADS) admitted in psychiatry ward. METHODS A retrospective review of records of patients admitted in male psychiatry ward at a tertiary care center was done. The data was collected among 200 male patients admitted in the psychiatry ward from January 2019 to December 2019. Patient's' demographic details like their age, gender, socioeconomic status, locality, religion, marital status, and psychiatry comorbidity were noted. RESULTS Secondary data was collected from 200 patients admitted in the psychiatry ward. Percentage analysis was done. The patient's demographic details like their age, gender, socioeconomic status, locality, religion, marital status and their psychiatry complications were considered. Complications like sleep disturbances, tremors and seizures were mainly observed in this study. Major findings of the study were anxiety, depression, psychosis, cognitive impairment, cravings and relapses which were common symptoms among alcohol dependence patients admitted in psychiatric ward. CONCLUSIONS Alcohol dependence can lead to severe psychiatric disorders. Heavy consumption of alcohol can affect brain function and alter various chemical and hormonal systems in brain known to be involved in the development of many common mental disorders. The intoxicating effects which result due to intake of alcohol can result in temporary impairment of judgment and motor skills.1 Alcohol addiction can lead to development of tolerance and dependence, as well as abnormal social and occupational functioning.2 People who are married in the age group between (30 to 49) years from rural areas with low socioeconomic status are mostly found to be dependent on alcohol. KEYWORDS Alcoholism, Addiction, Behaviour, Drinking
Solitary Thyroid Nodules - Validity of Ultrasonography, Fine Needle Aspiration Cytology and Sestamibi in Detecting Thyroid Malignancies - A Cross-Sectional Study in Kerala
Authors: Suresh Shilpa , Menon Riju R. , Jacob Pradeep , C Gopalakrishnan Nair
Published: September 2021

BACKGROUND The diagnosis of thyroid malignancies continues to remain a challenge, due to lack of specificity with various modalities, and intrinsic variability with clinical examination. Although histopathological diagnosis is confirmatory, there is a need for pre-surgical assessment and confirmation, which will prove to be useful in decision making regarding the course of management. The present study was carried out to evaluate the validity of various modalities for detection of thyroid malignancies. METHODS This cross-sectional study was carried out among 40 patients who presented to the outpatient clinic with thyroid nodules. All the participants were evaluated by ultrasound, fine needle aspiration cytology (FNAC) and sestamibi scintigraphy. All the participants were taken up for surgery and the resected specimen was sent for histopathology for confirmatory diagnosis. RESULTS Ultrasound and FNAC detected malignancy in 25 % of the participants, while sestamibi scintigraphy detected malignancy in 30 % of the participants. Based on histopathology, the gold standard confirmatory test, malignancy was detected in 35 % of the participants. It was observed that the sensitivity was highest for FNAC (75 %) followed by TC methoxyisobutylisonitrile (TC MIBI) (50 %). Specificity was highest for FNAC (95 %) followed by ultrasound (88 %) (P < 0.0001). CONCLUSIONS FNAC has the highest sensitivity and specificity while ultrasound and sestamibi have comparable specificity. There is a high probability of malignancy when the delayed image in sestamibi scintigraphy shows retention. MIBI may prove to be useful in differentiating benign and malignant follicular lesions. KEYWORDS Papillary Carcinoma, Histopathology, Thyroid Nodule, Sestamibi, FNAC