bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapunzel Syndrome in a Boy
Authors: Singh Kuldeep , Kapoor Pawan , Grover Nishu , Godara Surendra
Published: August 2023

Background:

Trichobezoar is a rare phenomenon where a ball of swallowed hair collects in the stomach. When its tail extends beyond the pylorus in to the small intestine, it is termed Rapunzel syndrome. The condition is most commonly seen in females with psychological disturbances, many of whom have trichotillomania and or trichophagia. We report Rapunzel syndrome condition in a young boy having no overt mental disturbances.

Clinical Description:

A 5½-year-old male child presented with complaints of vomiting for 20 days, associated with dull aching epigastric pain over 1 year. A lump had been noticed in the abdomen which was increasing in size for the past 5 months and decreased appetite for past 1 month. Besides pica, the child had no other significant medical or surgical illness. On examination, the child was underweight with pallor, with dry, lusterless, easily pluckable hair. His abdomen revealed a palpable lump in epigastrium, with ultrasonography showing a large gastric mass with air foci. Contrast-enhanced computed tomography abdomen revealed a large, well-circumscribed, nonhomogeneous lesion in the lumen of the stomach suggestive of bezoar. The patient underwent exploratory laparotomy, which confirmed trichobezoar with a long tail of hair extending through the pylorus into the small bowel. After successful removal of the trichobezoar, the patient was discharged with no postoperative complication and advised follow up in surgery, pediatrics, and psychiatry department.

Conclusion:

This case creates awareness of the possibility of the rare, bizarre entity of trichobezoar in a toddler presenting with nothing more than the usual common symptoms as seen in this age group. After ruling out common causes, when there is persistence of symptoms, with some clinical clues like pica, anemia, and behavior abnormalities, pediatricians may suspect an underlying atypical diagnosis like trichobezoar, even in a male child.
Hemolytic Disease of Newborn Following Anti-C and Anti-S Alloimmunization
Authors: Kar Shrutiprajna , Pradhan Monalisa , Som Tapas , Mohanty Pankaj Kumar
Published: August 2023

Background:

Non-Rhesus D antigen non-ABO, minor blood group alloimmunization in pregnant women is being increasingly recognized as a significant contributor to the development of the hemolytic disease of the fetus and newborn (HDFN). We report severe HDFN in a neonate born to an Rh-positive mother with sickle cell disease, following anti-C and anti-S alloimmunization.

Clinical Description:

A male baby born to a repeatedly transfused mother with sickle cell disease developed severe jaundice at 22 h of life. The baby was found to have severe anemia and indirect hyperbilirubinemia, but no encephalopathy, hepatosplenomegaly, or features of sepsis.

Management and Outcome:

His blood group was O positive and the direct Coombs test was 4+. Minor blood group typing showed the presence of anti-C and anti-S antibodies. The baby improved after receiving a double-volume exchange transfusion with matched blood and phototherapy.

Conclusion:

Severe hemolytic disease of the newborn (HDN) may be caused by minor blood group alloimmunization, especially seen in mothers with a history of multiple transfusions. Antenatal screening for alloimmunization in high-risk mothers can ensure timely diagnosis and treatment of HDN and prevent the harmful effects of neonatal hyperbilirubinemia.
Mutation in Methionyl-tRNA Synthetase 1 Causing Pulmonary Alveolar Proteinosis
Authors: Madhusudan Manoj , Chandra Tejaswi , Srikanta J. T.
Published: August 2023

Background:

A chronic history of exertional dyspnea, dry cough, and fatigue, associated with reticulonodular ground-glass opacity indicates an underlying interstitial lung disease (ILD). Pulmonary alveolar proteinosis (PAP) is a rare cause of ILD, in which there is abnormal accumulation of surfactant material in alveoli, thereby impairing gaseous exchange. In children, PAP is usually due to genetic mutations. We report a child with PAP due to mutation in methionyl-transfer RNA synthetase 1 (MARS) gene.

Clinical Description:

An 8-year-old boy presented with persistent dry cough, and exercise-induced breathlessness for 2 years of age, associated with failure to gain weight. He had multiple exacerbations in the past, requiring common symptomatic treatment, but with minimal improvement. On presentation to us, the child had tachypnea, hypoxia (oxygen saturation [SpO2]: 85%), and Grade 2 clubbing, with bilateral fine crepitation in bilateral lung fields.

Management and Outcome:

The child was stabilized by providing oxygen via high-flow nasal cannula. Blood investigations were largely normal. His chest X-ray and computerized tomography (CT) of the chest were suggestive of childhood ILD. A lung biopsy revealed periodic acid–Schiff-positive eosinophilic granular material in the alveolar spaces without any fibrosis, suggesting a diagnosis of PAP. Next-generation sequencing revealed a compound heterozygous mutation of the MARS1 gene resulting in PAP. Parental segregation analysis showed each one to be a carrier of one of the genes. Therapeutic whole-lung lavage (WLL) was carried out, following which symptoms improved markedly. SpO2 increased and the child was able to be weaned off oxygen and discharged. Three years, postdischarge, the child is asymptomatic and thriving well.

Conclusions:

PAP may be a cause of ILD in a child. Although the etiology can be ascertained by high-resolution CT of the chest and bronchoalveolar lavage, further genetic analysis should also be undertaken in children to identify the exact defect. WLL can provide a good outcome in children with PAP due to MARS mutation.
Early Onset Portal Hypertension Due to Silent Extensive Portal Vein Thrombosis Following Umbilical Vein Catheterization
Authors: Latawa Surbhi , Sharma Ritu , Rai Anuradha , Dhingra Dhulika
Published: August 2023

Background:

Umbilical vein catheterization is a routine procedure in neonatal intensive care units. This invasive procedure, though easy and useful, can result in disastrous complications.

Clinical Description:

A 28 day old baby boy presented with umbilical sepsis along with multiple skin abscesses. He had a history of double volume exchange transfusion for Glucose 6 Phosphate deficiency induced hyperbilirubinemia, during the postnatal period. Ultrasound whole abdomen done to look for intra-abdominal abscesses revealed extensive portal vein thrombosis including the main portal vein and its branches with cavernoma formation. Upper gastrointestinal endoscopy revealed Grade II esophageal varices suggestive of the development of portal hypertension.

Management and Outcome:

Baby was started on subcutaneous enoxaparin which continued for 3 months. Follow up ultrasound showed complete obliteration of portal vein, replaced by cavernomas with development of grade II esophageal varices seen on upper gastrointestinal endoscopy.

Conclusion:

This case highlights how umbilical vein catheterization in the neonatal period can lead to catastrophic complications such as obliteration of the entire main portal vein and its branches, formation of portal cavernoma, portal hypertension, and esophageal varices, all of which can develop silently, at a very early age.
Early-Onset Virilization May Rarely be Due to an Adrenocortical Neoplasm
Authors: Nanda N , Kaur Kirandeep , Kadian Kavita , Sridharan Kalyani
Published: August 2023

Background:

Adrenocortical tumors are rare neoplasms of childhood; most of which are functional in childhood, producing excess hormones. Virilization, precocious puberty, and Cushing's syndrome are common presenting features.

Clinical Description:

A 6-year-8-month-old girl presented with features of virilization, which started appearing at 2 ½ years of age. The mother gave a history of progressive enlargement of the clitoris with the development of pubic, axillary, and facial hair over the years. There was no history of perinatal complications, features of adrenal insufficiency, atypical external genitalia at birth, or family history of malignancy. On examination, she had features of heterosexual peripheral precocious puberty. The hormonal investigation was suggestive of cortisol and androgen excess. Radiologically, she had an adrenal tumor appearing like adrenocortical carcinoma (ACC)-large size, high noncontrast Hounsfield units, and poor washout.

Management and Outcome:

As virilization was not present since birth and there was no evidence of adrenal insufficiency, therefore, the possibility of congenital adrenal hyperplasia was unlikely. Investigations revealed that the testosterone levels were much higher than other adrenal androgen precursors like dehydroepiandrosterone sulfate. This was a clinical clue to the well-differentiated and benign nature of the tumor although radiologically it appeared like ACC. The child underwent en bloc resection of the mass, and histopathology was suggestive of a benign adrenocortical adenoma. Seven days after surgery, the serum testosterone had dropped substantially.

Conclusion:

This case creates awareness about the possibility of an adrenocortical neoplasm in a child with early-onset virilization, which can be diagnosed correctly by following a step-wise, logical sequence of investigations.
Awareness and knowledge of integrated counselling and testing centres (ICTC) counsellors about depression among people with human immunodeficiency virus (HIV): A descriptive study from Karnataka
Authors: Kumar P C Pradeep , John Soyuz , Cherian Anish V. , Pandian R Dhanasekara , Anand Nitin , Rao T S Sathyanarayana
Published: August 2023

Background:

Depression among people living with human immunodeficiency virus (PLHIV) is highly prevalent and it is associated with increased morbidity, poor adherence to antiretroviral therapy, and poor psychosocial outcomes. To address this, integrated counselling and testing centres (ICTC) counsellors provide psychosocial support to PLHIV.

Materials and Methods:

This descriptive study aims to assess the awareness and knowledge of ICTC counsellors about depression and its management. A total of 338 (n = 452) ICTC counsellors participated in the study. A demographic data sheet and a semi-structured questionnaire were used to collect data.

Results:

More than half of the participants reported that biochemical imbalances cause depression. 71.60% and 79.59% of participants reported that depression was common among PLHIV and required immediate attention. 92.60% of counsellors reported that a combination of counselling and medication would be effective to treat depression. 86.98% and 81.95% of counsellors were confident and actively screened for depression among PLHIV, and 78.11% of counsellors had access to a psychiatrist. In contrast. One-third of participants had difficulties working with PLHIV, and 55.56% of participants expressed that addressing issues of PLHIVs’ depression to be left to mental health professionals.

Conclusion:

ICTC counsellors had adequate knowledge about depression and its symptoms. However, lack of knowledge on intervention strategies, time constraints and work targets are significant barriers. These findings suggest that training on mental illness screening; brief intervention strategies may help counsellors to assist PLHIV in overcoming depression complications.
Stitch-induced caecal fecolith: An unusual long-term complication following laparoscopic appendicectomy
Authors: Subramaniyan S Sree , Gopal Sri Vengadesh
Published: August 2023

A fecolith is a mass of accumulated hardened faecal matter usually seen in patients with Chagas disease, Hirschsprung’s disease and inflammatory bowel disease. We report a 21-year-old female with chronic right lower abdominal pain post-appendicectomy. An abdominal computed tomography revealed a fecolith near the caecum and a right simple ovarian cyst. On diagnostic laparoscopy, a Prolene stitch in the previous appendicectomy site acting as a nidus and forming a fecolith was noted. It was excised by a small enterotomy and primary closure of the same. She had an uneventful post-operative course. This case highlights the danger of using a non-absorbable suture for appendicectomy and the rare phenomenon of fecolith formation post-appendicectomy after 4 years presenting with features of chronic recurrent abdominal pain.
Is the self-adhesive mesh a solution for chronic postoperative inguinal pain after TAPP: A single centre preliminary experience?
Authors: Kirov Kiril G. , Mihaylov Diyan M. , Arnaudov Stefan Svilenov
Published: August 2023

Background:

Minimally invasive surgery for groin hernia has expanded significantly over the last two decades and has demonstrated better outcomes in terms of pain and quality of life. A major contributing factor related to chronic post-operative inguinal pain (CPIP) is mesh fixation. An alternative to the standard fixation methods is the self-adhesive surgical mesh.

Patients and Methods:

Prospective data analysis was performed of all patients undergoing laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair in a single centre for the period 1st January, 2022–15th December, 2022. A standardised surgical technique was used with a lightweight self-adhesive mesh without additional fixation. The analysis has encompassed early and late post-operative complications as well as the assessment of pain with an emphasis on CPIP.

Results:

The study enrolled 52 patients where a total number of 64 elective hernia repairs were performed: 92.2% (n = 59) primary and 7.8% (n = 5) recurrent. Fifty-one patients received post-operative follow-up: 100% at 1 month and 78.8% (n = 41) at 3 months. The incidence of early postoperative complications was 7.7% (n = 4): one patient developed a seroma, two patients – port site hematomas and one a transient subileus that were all managed conservatively. No patients suffered a recurrence. The average pain score according to the Visual Analogue Scale was 3.3 (0–8) at discharge, 0.6 (0–4) at 1 month and there was no incidence of CPIP after the 3rd month.

Conclusion:

Laparoscopic TAPP repair for inguinal hernia with a self-adhesive mesh is an adequate surgical technique with the potential to reduce CPIP, but more research is needed to evaluate this method.
Multidetector computed tomography evaluation of normal thymus and variations with age
Authors: Naik Suprava , Shri Aishvarya , Sidhu Simran , Lahre Yuvraj , Bag Nerbadyswari Deep , Bhoi Sanjeev Kumar , Mohakud Sudipta
Published: August 2023

Background:

Thymus is a T-cell-producing lymphoid organ that appears prominent in the paediatric population and involutes in size with ageing. The gland shows a wide variety of appearances across different age groups. The purpose of the study is to evaluate the computed tomography (CT) appearance of thymus gland in the normal population with a focus on size, CT attenuation and fatty infiltration in different age groups.

Patients and Methods:

This is a retrospective study done after taking approval from the Institutional Ethics Committee. Patients undergone CT scans of the thorax were identified from our database. All evaluations were done in non-contrast CT scans. Patients having underlying diseases that may have associated thymic abnormality were excluded. The appearance of thymus and the presence of fatty replacement were assessed. The size of thymus (length and thickness of right limb and left limb) and non-contrast CT Hounsfield unit (HU) value of thymic tissue were measured and compared in various age groups.

Results:

Four hundred and fifty patients were included, 262 (58.2%) were male. Mean age was 33.6 ± 17.1 years, range (3 months–80 years). The size of thymus was observed to decrease with increasing age. The mean age of complete fatty replacement in our study was 45 years. Complete fatty replacement was noted in all cases with an age of more than 60 years. The most common shape was arrowhead, and the most common location was pre-aortic and para-aortic location. Non-contrast CT HU value was maximum in infants and gradually decreased with advancing age.

Conclusion:

Even normal thymus can show varied appearance on CT which changes with the age of the patient being imaged. A comparison with normative data could help differentiate normal from abnormal glands to avoid unnecessary intervention.
Laparoscopic management of rare smoked dry pork bezoar in the stomach
Authors: Khanna Subhash , Barua Areendam , Choudhury Supriya
Published: August 2023

Medical literature recognise only 4 types of bezoar – phytobezoar, trichobezoar, lactobezoar and pharmacobezoar. Here, we discuss a new unique type of bezoar composed of undigested dry pork. A 58-year-old male patient from Nagaland, India, presented with intermittent symptoms of gastric outlet obstruction and pain abdomen. On clinical examination, he was found to have an epigastric lump. Upper gastrointestinal endoscopy showed an undigested ball of swallowed meat at the pylorus and later at the fundus on repeat endoscopy just before the surgical intervention. Endoscopic mechanical fragmentation was tried, but owing to the large size and hard sticky consistency of the bezoar, fragmentation was not feasible. Due to persistent pain abdomen and clinical gastric outlet obstruction, a decision for operative intervention was taken. He finally underwent laparoscopic anterior gastrotomy and evacuation of the bezoar. The post-operative course was uneventful, and the patient went home symptom free on the 5th post-operative day.
Effect of perioperative application of dexmedetomidine on post-operative stress reaction, pain and prognostic adverse effects in patients undergoing gynaecological laparoscopy
Authors: Wu Xing , Xing Yuhang , Pan Lili , Chai Mao
Published: August 2023

Introduction:

The aim of this study was to analyse the effect of perioperative dexmedetomidine (DEX) application on stress response, post-operative pain and prognosis in patients undergoing gynaecologic laparoscopy.

Patients and Methods:

One hundred and sixty-eight patients admitted for gynaecologic laparoscopic surgery from May 2020 to November 2022 were included in the study. The patients were randomly divided into pre-operative DEX group (n = 56), intraoperative DEX group (n = 56) and post-operative DEX group (n = 56) according to the application of DEX in the perioperative period. The visual analogue scale (VAS), time awake, extubation time, pneumoperitoneum time, post-anaesthesia care unit (PACU) stay time and Richmond agitation-sedation scale score (RASS) were recorded.

Results:

Patients in both the pre-operative and intraoperative DEX groups had substantially shorter wakeup and extubation times than those in the post-operative DEX group. Patients in the pre-operative DEX group had considerably shorter wakeup and extubation times than those in the intraoperative DEX group, and their pneumoperitoneum time was significantly shorter than that of the post-operative DEX group (P < 0.001). The RASS scores of the pre-operative DEX group and intraoperative DEX group were significantly lower than those of the post-operative DEX group at 1 h, 6 h and 12 h after surgery. Meanwhile, at all time periods, the RASS scores of patients in the pre-operative DEX group were considerably lower than those in the intraoperative DEX group (P < 0.01). The VAS scores of patients in the pre-operative DEX group and intraoperative DEX group were evidently lower than those in the post-operative DEX group at 0.5 h, 2 h and 12 h postoperatively, and the VAS scores of patients in the pre-operative DEX group were markedly lower than those in the intraoperative DEX group (P < 0.001). The incidence of nausea and vomiting was significantly lower in the pre-operative DEX group than in the intraoperative DEX group and the post-operative DEX group at 0–2 h, >2–12 h and >12–24 h postoperatively (P < 0.001). The incidence of nausea and vomiting in the intraoperative DEX group was significantly lower than that in the post-operative DEX group from 0 to 2 h after surgery (P < 0.05). The incidence of adverse reactions was not significantly different amongst the three groups of patients (P > 0.05).

Conclusion:

Pre-operative and intraoperative application of DEX can help reduce post-operative pain and stress responses, help patients recover quickly after surgery and improve patient prognosis, especially the pre-operative application of DEX.
Case report on laparoscopic management of congenital peritoneal encapsulation: A rare cause of small bowel obstruction
Authors: Dey Sumanta , Roy Sreetama , Guhathakurta Abhishek , Ghosh Debarchan
Published: August 2023

Peritoneal encapsulation (PE) is a rare congenital disorder described as an accessory peritoneal lining covering a part or whole of the small bowel. Some theorise the encapsulation is due to the formation of adhesion between the physiological hernia and the caudal duodenum. While others have stated it is a defect in the reduction of the physiological hernia. Patients usually present at different stages of intestinal obstruction at any point of time during life. There are also reports on post-humous diagnosis on autopsy. PE is a rare surgical entity, hence not much evidences are available on how to tackle this condition by minimally invasive approach. Here, we report a case of PE in a 43-year-old male who presented with features of intermittent sub-acute intestinal obstruction and was managed by laparoscopic surgery at our institute.
Management of type 2 diabetes: Self-management education and clinical findings
Authors: Türe Aysun , Demirsoy Nilufer , Gökalp Deniz
Published: August 2023

Aim:

The purpose of this study is to determine the effects of the self-management education provided to patients with type 2 diabetes under the leadership of a nurse on the perceptions of self-management and clinical findings of patients.

Materials and Methods:

The sampling of the research comprises 281 patients who received a diagnosis of type 2 diabetes and whose treatment is being conducted. The self-management perceptions, body mass index, preprandial blood glucoses, and glycolyzed hemoglobin levels of the patients were measured before and after the intervention and 3 months later.

Results:

It was determined as a result of the comparison of the scores before and after the nursing education provided to the patients that the patients’ self-management perception scale scores increased significantly and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels reduced significantly (P < 0.01).

Conclusions:

It is determined in research that the self-management education provided to patients with type 2 diabetes under the leadership of a nurse had a meaningful impact on the diabetes self-management skills and clinical findings of the patients.

Practice Implications:

It was determined that the average diabetes self-management education scores increased significantly when comparing before and after the self-management provided to patients and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels decreased at a statistically meaningful level.
Prevalence and risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam: A cross-sectional study
Authors: Dutta Suruj Jyoti , Dutta Pranjal Kumar , Dutta Anupam , Ahmed Sultana Jesmin , Sonowal Sarojmoni , Boruah Angshuman
Published: August 2023

Background:

Diabetic peripheral neuropathy (DPN), being the most common and early complication of diabetes mellitus, results in significant morbidity and debilitating sequelae in the form of foot ulcers, infection, and amputation. Due to the disease’s longevity, young type 2 diabetes constitutes a high risk for developing neuropathy, and screening of patients for DPN becomes crucial.

Objectives:

This study aimed to estimate the prevalence and identify the associated risk factors of peripheral neuropathy among young type 2 diabetes mellitus patients attending a tertiary care hospital in upper Assam.

Materials and Methods:

This cross-sectional study was conducted from July 1, 2022 to September 30, 2022 in the Department of Medicine. A total of 165 participants attending the outpatient Department and the Diabetic clinic, diagnosed with type 2 diabetes below the age of 45 years were recruited using non-random consecutive sampling. Patients were then interviewed using a pre-designed, pre-tested schedule. DPN was assessed by detection of vibration perception threshold (VPT) using a biothesiometer, the cutoff value for which was taken as 15 V.

Results:

The prevalence of DPN as assessed by VPT using biothesiometer was 13.9%. The prevalence of mild, moderate, and severe neuropathies was 9.1%, 3.6%, and 1.2%, respectively. DPN was found to have a significant association with the duration of diabetes and hypertension. Socio-demographic characteristics, smoking, alcohol intake, physical activity, anti-diabetic medication, and dyslipidemia were not found to have a significant association with DPN.

Conclusion:

This study has stressed the importance of screening for hypertension even in the younger age groups as well as the need for early detection of DPN, which can aid in taking necessary actions to impede the disease’s progression.
Comparison of efficacy between canagliflozin and teneligliptin as add-on therapy to metformin and glimepiride on plasma glucose levels along with blood pressure and lipid levels in patients with type 2 diabetes mellitus
Authors: Gautam Ashish , Singh Shoor Vir , Gupta Ankit , Sharma Anupam , Gupta Saurabh , Pursnani Nikhil , Agrawal Prabhat
Published: August 2023

Background:

Despite of several guidelines metformin and glimepiride remains the first prescribed drug in most people with diabetes. Very often canagliflozin and teneligliptin remain the third prescribed OHA. Efficacy of teneligliptin and canagliflozin as solo drug or in combination with other single OHA’s on glycaemic parameters, lipid profiles & blood pressure is already established. But their efficacy on above parameters when used as third drug next to metformin and sulfonylurea is still not investigated.

Aims and objectives:

Aim of this study is to compare glycaemic and non-glycemic effects of canagliflozin and teneligliptin as third line drug. Objective is to establish their multiple pleotropic effects at this position.

Methods:

Subjects with uncontrolled glycaemic parameters with hypertension and diabetic dyslipidaemia already on half maximal doses of metformin and glimepiride were enrolled in the study. Out of 87 selections, 45 were prescribed canagliflozin 100 mg/d and to 42 subjects, teneligliptin 20mg/d, each for 24 weeks. Effects over HbA1c, fasting and post prandial plasma glucose, systolic and diastolic blood pressures, HDL’c and triglycerides were observed pre and post intervention.

Results:

As a third drug both canagliflozin and teneligliptin show significant reduction in HbA1c (1.5 versus 1.6%), fasting (-20.2 versus -28.8 mg %), and post prandial (-39.9 versus – 58.5mg %). Effects over systolic (4 mmHg versus 1.1 mmHg) and diastolic BP (3.1 mmHg versus 0.2 mmHg) was clinically and statistically significant (p = 0.3 and 0.1) respectively in both groups. A statistically insignificant (9.6 versus 4.1 mg%; p =) reduction in Triglycerides but significant (7.6 versus 1.2; p <0.0001) increase in HDL’c was observed.

Conclusion:

Canagliflozin and teneligliptin, both retains their glycaemic and non-glycaemic benefits even when used as third OHA for diabetes management. Canagliflozin scores better for comorbid hypertension and diabetic dyslipidaemia.
Cavernosal abscess and primary scrotal calcinosis in the diabetic patient: A case report and review of literature
Authors: Pandiaraja Jayabal
Published: August 2023

A cavernosal abscess is a rare urological condition to occur. It is classified as primary and secondary. The primary is mostly idiopathic, whereas the secondary is associated with some precipitating factors. Most of the cases were diagnosed clinically. In some cases, imaging such as an ultrasound of the local region or magnetic resonance imaging may be required. Cavernosal abscesses can be treated using a minimally invasive procedure such as image-guided drainage or incision and drainage along with systemic antibiotics. A 52-year-old uncircumscribed uncontrolled diabetic patient presented with a complaint of swelling in the penile region for the 1-week duration. He also complains of pain in the penile region for a 5-day duration. He is a known case of type 2 diabetes on oral hypoglycemic drugs for the past 2 years. Clinical examination confirmed the diagnosis of cavernosal abscess. The patient underwent circumcision with incision and drainage of abscess under higher antibiotic coverage (vancomycin and metronidazole). The patient underwent local excision of primary scrotal calcinosis after 1 month. The patient is followed up for more than 2 years without any evidence of recurrence or impotence. The cavernosal abscess is one of the rare urological conditions, which needs immediate surgical intervention to reduce future complications such as erectile dysfunction and recurrent abscess. Uncontrolled diabetes has a high chance of developing cavernosal abscesses even without precipitating factors.
An update on the role of antihyperglycemic agents in diabetoporosis
Authors: Sharma Nidhi , Nayak Amit Kumar
Published: August 2023

Diabetes mellitus is a chronic disorder that progresses globally at an alarming rate. The impact of this disorder is severe as it deteriorates the quality of life due to its associated diseases such as kidney disease, cardiovascular disease, obesity, and neurological disorders and also disturbs bone metabolism. One of the major complications of diabetes is osteoporosis, which is frequently brought on by diabetes. Bone abnormalities and a higher risk of fractures are linked to both type type-1 diabetes and type-2 diabetes and hence diabetes is regarded as one of the risk factors for the occurrence of osteoporosis. In view of this, there is a need to assess the therapeutic role of hypoglycemic agents in the treatment of osteoporosis. Glucagon-like peptide-1 (GLP-1) agonist, a hypoglycemic class could be a novel and promising drug target in the management of osteoporosis due to its additional role in the bone remodeling process. It has also been reported that GLP-1 agonists can increase bone mineral density, improve bone quality, and prevent fractures in diabetic patients. This review highlights the recent findings by which antidiabetic medications are used in the treatment of diabetes-induced osteoporosis and also gives an insight into its pathophysiology and possible mechanisms that are involved in the treatment of diabetes-induced osteoporosis. However, more research is required to fully understand the therapeutic role and unique mechanism of GLP-1 agonists in the bone remodeling process.
A qualitative study on the perceived benefits of back to basics-diabesties session among individuals with type 1 diabetes mellitus and caregivers in India
Authors: Sethi Jazz , Natarajan Lakshmi , Dev Deeksha , Kothapalli Sanjana R , Dhagia Sumeet , Mohan Viswanathan , Subrahmanyam Ayyalasomayajula S , Bhale Yash , Shah Hetansh S , Bommathula AnuHasini , Aravindakshan Pramodkumar T
Published: August 2023

Aim:

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that makes self-care challenging for T1DM individuals and their caregivers. This qualitative study aimed to explore the perceived benefits of the Back to Basics-Diabesties (B2B) session among T1DM individuals and their caregivers in India.

Materials and Methods:

The B2B session is a structured intervention provided through telephonic peer counseling, aimed at enhancing the understanding of T1DM that provides practical knowledge of diabetes management, insulin administration, blood glucose monitoring, diet, exercise, and psychosocial aspects of living with T1DM. Overall, more than 1560 participants (T1DM/caregivers/family/friends) have opted for B2B session. A qualitative telephonic interview was conducted (n = 96) using a semistructured open-ended questionnaire to collect data on the perceived benefits of B2B session. The information obtained was then coded, and grouped to form themes.

Results:

According to T1DM individuals, B2B sessions enhanced diabetes knowledge and confidence, self-management abilities, increased sense of community and peer support, and easy accessibility. Caregivers reported that the B2B session provided emotional support, disease knowledge, shared experiences, practical ideas, and coping strategies. Most widely appreciated salient feature of B2B session was the peer counselors were themselves with T1DM or caregivers of T1DM, which created unbreakable trust among the study participants. Clinical evidence after B2B session showed a 23% of improvement in the glycated hemoglobin (<8%) and nearly 8% of drop in hypoglycemic events and 17% of drop in hyperglycemic episodes.

Conclusion:

This study shows the benefits of peer counseling, which could help healthcare professionals and policymakers improve diabetes education and support programs for T1DM patients and their caregivers in India.
Analysis of anti-slip control system and dynamic performance of mechanical engineering drive based on improved social engineering algorithm
Authors: Liu Jiangbo , Liang Wei , Wang Chunyan
Published: August 2023

INTRODUCTION: The field of mechanical engineering technology is an emerging technology field with many research directions, and there are many directions of intersection with other disciplines, among which the field of mechanical engineering has outstanding research advantages. With the continuous development of mechanical engineering technology, the research direction of mechanical engineering applied to the field of mechanical engineering is also continuously enriched and developed. Mechanical engineering research focuses on realizing the monitoring and control of the dynamic performance of mechanical systems, as well as realizing the integration of design and system control.
OBJECTIVES: In order to improve the disassembly efficiency, reduce the disassembly cost and disassembly energy consumption, it is optimized using social engineering methods to achieve better results and reduce the disassembly cost and energy consumption.
METHODS: Aiming at the drive and anti-skid control strategy of four-wheel hub motor, it was simulated using improved social engineering algorithms, and based on this, three road recognition algorithms were selected for low, medium, and high adhesion road verification.
RESULTS: Through the study of automobile anti-skid control system, the basic structure of automobile anti-skid control system is summarized and some solution measures are proposed. A new type of drive anti-skid control system is proposed for the problems of high vibration and noise of automobile brake. The drive anti-slip control system is characterized by simple structure, easy maintenance, simple control and reliable operation, and high operation efficiency.
CONCLUSION: This study shows that the system not only has excellent drive anti-slip effect, but also has good control performance. In addition, this drive anti-slip system is able to ensure the safe and reliable operation of mechanical brakes in various harsh environments. This new drive anti-slip control system is a new type of drive device that can be widely used for driving force on various mechanical brakes and drive wheels, and the study of this device is of great significance.
Construction Schedule of Medium Voltage Overhead Distribution Network Optimization Based on Neural Network Algorithm
Authors: Xu Mengfan , Pan Junyang
Published: August 2023

INTRODUCTION: The medium voltage overhead distribution network is a complex planning problem, and monitoring the construction progress of the medium voltage overhead distribution network is an important aspect of the planning problem. Regarding the structure of the medium voltage overhead distribution network, it is one of the important components in China's distribution network system. If the construction progress of the medium voltage overhead distribution network is optimized, it will affect the normal operation of the entire power grid system in a certain region. Optimizing the construction progress of medium voltage overhead distribution networks using modern development related technologies or algorithms is one of the practical research topics.
OBJECTIVES: To better predict various issues that may arise during the construction progress of the distribution network. Complex geographical conditions lead to construction difficulties, and lack of technology leads to frequent stoppages of construction, further leading to frequent power outages in various regions. In terms of the overall power supply system, the reliability of power supply is not high.
METHODS: By comparing the BP neural network algorithm with the CNN network algorithm, the actual operation effect is evaluated by experts.
RESULTS: This article predicts the implementation progress of the medium voltage overhead distribution network, and the results show that the accuracy of the BP model for predicting the construction progress of the medium voltage overhead distribution network can reach 88%; The accuracy of the CNN medium voltage overhead distribution network construction progress prediction model reaches 77%.
CONCLUSION: The use of neural network algorithms to optimize the construction schedule of medium voltage overhead distribution networks has been evaluated by experts in practical applications, and the medium voltage overhead distribution network in power supply systems has potential application value.
Case Report: Hemophagocytic Lymphohistiocytosis Secondary to Plasmodium ovale wallikeri Infection
Authors: Novella-Mena María , Cantudo-Muñoz Purificación , Tallón-Pérez José David , Gómez-Rodríguez María del Mar , Rojo-Marcos Gerardo
Published: August 2023

We report the first known case of hemophagocytic lymphohistiocytosis (HLH) secondary to imported Plasmodium ovale wallikeri infection in a 58-year-old white woman. A delayed diagnosis of malaria and HLH was made after protracted fever and pancytopenia failed to respond adequately to antimalarial treatment, which required intravenous methylprednisolone and gamma-globulin therapy to resolve.
IMPLIKASI TEORI KONSTRUKTIVISME VYGOTSKY DALAM PENERAPAN MODEL PEMBELAJARAN KELOMPOK DENGAN SUDUT PENGAMAN DI TK ANAK MANDIRI SURABAYA
Authors: Amahorseya Michaela Zebada Faustina Agrippine , Mardliyah Sjafiatul
Published: August 2023

Penelitian ini mengulas tentang Implikasi Teori Konstruktivisme Vygotsky dalam Penerapan Model Pembelajaran Kelompok Dengan Sudut Pengaman di TK Anak Mandiri Surabaya. Penelitian ini bertujuan untuk mendeskripsikan implikasi teori konstruktivisme Vygotsky dalam penerapan model pemebalajran kelompok dengna sudut pengaman di TK Anak Mandiri Surabaya. Jenis penelitian ini adalah deskriptif-kualitatif Adapun instrument penelitian yakni menggunakan observasi, wawancara serta dokumentasi dan peneliti sebagai instrument kunci. Sumber data penelitian ini adalah kepala sekolah dan pendidik. Adapun hasil yang menunjukkan bahwa implikasi teori konstruktivisme dalam pembelajaran kelompok dengan sudut pengaman sesuai dengna penerapan kurikulum merdeka yang saat ini tengah digencarkan oleh Kementrian Pendidikan. Proses pelaksanaannya dengan menerapkan metode inkuiri yang mana nilai-nilai berakhlak mulia, berkebinekaan global, mandiri, bergotong royong, bernalar kritis dan kreatif sesuai dengan apa yang dikatakan Vygotsky bahwa anak dapat belajar dan membelajari teman sebayanya melalui pembelajaran kelompok dengan sudut pengaman berbasis proyek.
ANALISIS PENERAPAN METODE MONTESSORI PADA ASPEK KEMANDIRIAN ANAK MELALUI KEGIATAN PEMBELAJARAN PRACTICAL LIFE
Authors: Kamil Nurhusni , Asriyani Solatiyah
Published: August 2023

Sikap  mandiri merupakan suatu hal   yang paling mendasar  yang perlu diterapkan  kepada anak usia dini  dari orang dewasa. Penanaman sikap kemandirian  kepada anak  dapat dilakukan  melalui berbagai kegiatan  dan hal yang sangat disukai oleh anak. Ada banyak cara dan metode yang  digunakan salah satunya  melalui penerapan metode  Montessori melalui kegiatan  practical life. Kegiatan pembelajaran ini bermaksud  mengajarkan anak tentang  aspek kemandirian  melalui hal-hal sederhana dalam hidupnya. Metode penelitian yang  digunakan  dalam bentuk kualitatif  dengan menggunakan tinajuan pustaka (library research). Adapun tujuan dari penelitian ini adalah  untuk mengetahui analisis  penerapan metode Montessori pada aspek kemandirian anak melalui kegaiatan pembelajaran paractical life. Temuan baru dalam penelitian ini adalah informasi kepada  semua orang tua dan guru sebagai praktisi PAUD.
STRATEGI MANAJEMEN KELAS PEMBELAJARAN PENGUCAPAN KATA DALAM BAHASA INGGRIS PADA PESERTA DIDIK USIA DINI DI TK AL FITIYAN ACEH BESAR
Authors: Sariakin  , Faizah Cut , Fitria Nora
Published: August 2023

Penelitian ini bertujuan: (1) untuk mengkaji bagaimana guru TK Alfitiyan menyiapkan strategi manajemen kelas pada proses bembelajaran pengucapan, (2) untuk mengkaji bagaimana guru TK Al fitiyan melakukan strategi manajemen kelas dalam proses pembelajaran pengucapan, dan (3) untuk mengkaji bagaimana guru TK Al fitiyan mengevaluasi hasil strategi manajemen kelas dalam proses pembelajaran pengucapan.  Penelitian ini termasuk penelitian kualitatif karena hanya menggambarkan situasi dan kondisi pelaksanaan proses pembelajaran pengucapan hanya dua orang maka guru tersebut diambil sebagai subyek penelitian dan dinamakan sumber data. Instrumen yang digunakan untuk mengumpulkan data adalah observasi, wawancara, dan dokumentasi. Data yang diperoleh dianalisis dengan prosedur narasi. Hasil kajian menunjukkan bahwa guru menyiapkan silabus dan bahan ajar persemeter. Guru menggunakan satu metode dalam proses belajar mengajar metode latihan. Selanjutnya dalam mengevaluasi hasil proses belajar mengajar, guru mengevaluasi peserta didik dengan menggunakan satu macam tes yaitu tes proses berjalan. Tes yang dilakukan berupa secara individual. Berdasarkan hasil penelitian dalam proses belajar mengajar, guru harus menekankan pengajaran cara atau metode yang cukup sesuai untuk tingkat siswa dalam belajar pengucapan.
PSIKOEDUKASI BERBASIS KETAHANAN KELUARGA PADA IBU DALAM MENINGKATKAN KAPASITAS PENGASUHAN PADA ANAK PRASEKOLAH
Authors: RAZAK ALIFAH INDALIKA MULYADI
Published: August 2023

Konsep ketahanan keluarga merupakan kondisi keluarga yang memiliki ketangguhan, kemampuan fisik material dan psikis mental spiritual guna hidup mandiri, mengembangkan diri, dan keluarganya untuk mencapai keadaan harmonis dalam meningkatkan kesejahteraan lahir dan batin. Ketahanan keluarga perlu dimiliki oleh setiap keluarga agar setiap anggota keluarga dapat terpenuhi hak dan kewajibannya, yang ditandai dengan sikap melayani sebagai tanda kemuliaan, keakraban antara suami-istri menuju kualitas perkawinan yang baik, orangtua yang mendidik anaknya, suami-istri yang memimpin dengan penuh kasih, serta anak-anak yang menaati dan menghormati orangtuanya. Strategisnya tujuan dan konsep ketahanan keluarga didukung dengan data Badan Pusat Statistik yang menunjukkan terdapat sekitar 81.210.230 keluarga di Indonesia berdasarkan Survei Penduduk Antar Sensus di tahun 2015. Tujuan penelitian ini adalah memberikan pelatihan pada ibu meningkatkan kapasitas pengasuhannya pada anak prasekolah yang diujikan melalui instrument dimensions of parenting capacity focus pada stimulation. Efektivitas program diuji melalui metode penelitian eksperimen the-before-after study design, berdasarkan dimensi kapasitas pengasuhan yang terdiri atas : (1) child’s cognitive development and potentional through interaction; (2) communication, talking and responding to the child’s language and questions; (3) encouraging and joining the child’s play; (4) promoting educational opportunities; dan (5) facilitating child to meet challenges of life. Strategi pelatihan disusun menggunakan psikoedukasi berbasis ketahanan keluarga yang dikemas melalui blended training pada ibu selama 10 hari dengan melibatkan 50 orang ibu di Kota Cimahi, Jawa Barat. Hasilnya menunjukkan bahwa kemampuan ibu dalam mengasuh anak efektif meningkat setelah mengikuti program psikoedukasi berbasis ketahanan keluarga.
ON BECOMING A PROFESSIONAL ENGLISH TEACHER
Authors: Syakira Sitti , Abdullah Fuad , Anwari M. Rifqi Romdoni , Andriani Agis , Hidayati Arini Nurul , Anwar Dede
Published: August 2023

In teacher identity studies, limited attention has been generally paid to how the pre-service teachers constructed their identity by conveying various emotions in their practices. Most scholars identified the pre-service teacher's emotions during the teaching practices program. However, identifying these emotions during online teaching practices remains under-researched. Given this fact, this study probed how an English pre-service teacher’s emotions constructed his professional identity during online teaching practices. This study employed a narrative inquiry of an English pre-service teacher during online teaching practices in one of the senior high schools in Tasikmalaya, West Java, Indonesia. The data were collected from an English pre-service teacher’s reflective journals and analysed with narrative analysis (Labov, 1972). The findings revealed that the English pre-service teacher met various emotions manifested in his professional identity construction. There were five emotions experienced during online teaching practices, namely worrying, challenging, empathetic, enjoyable, and determined explored in seven critical activities of the professional practice process. During learning to teach, he could manage his negative emotions (i.e., worrying, challenging, empathetic) into positive emotions (i.e., enjoyable, determined). Therefore, his emotions experienced during online teaching practices implied that his professional identity commenced constructing in the seven activities of his professional construction process.
TEACHING MATERIALS FOR BAHASA INDONESIA READING SKILLS BASED ON LOCAL WISDOM WITH A QUANTUM APPROACH
Authors: Saota Erlina , Rasyid Yumna , Pujiati Hanip
Published: August 2023

This study aimed at developing teaching materials for Bahasa Indonesia reading skills for Grade IV Elementary School students based on local wisdom using a Quantum approach in South Nias District. By applying Borg and Gall's R&D design, this study involved 92 random samples of students. Data was collected through questionnaires and tests. The results of the study using the t-test obtained tcount of 23.40 higher than ttable of 2.63. In other words, there was a significant difference after using the developed teaching material product. It can be concluded that the developed teaching materials for Bahasa Indonesia reading skills based on local wisdom with a Quantum approach was very effective for teaching reading in grade IV, Public Elementary School, South Nias District. The implications of this study regarding reading achievement, local wisdom, and teacher's strategies are also discussed.
ANALISIS LITERATUR REVIEW PENERAPAN MODEL DISCOVERY LEARNING PADA PEMBELAJARAN IPA DI SEKOLAH DASAR
Authors: Sudewiputri Padmarani , Dharma I Made Aditya , Dewi Komang Ayu Krisna , Dewi Ni Putu Artila
Published: August 2023

Penelitian ini merupakan penelitian kualitatif berupa studi pustaka (literature review) atau tinjauan pustaka, penelitan ini dilakukan karena guru kurang memahami model-model pembelajaran yang telah ada termasuk model Discovery Learning pada pembelajaran IPA di Sekolah Dasar. Metode Penelitian menggunakan metode studi pustaka. Berdasarkan studi literatur yang telah dilakukan terhadap 15 jurnal penelitian mengenai studi pustaka penerapan model Disecovery Learning pada pembelajaran IPA di Sekolah Dasar maka dapat disimpulkan bahwa model Disecovery Learning dapat memberikan pengaruh baik pada kelas tinggi (93%), pada kelas rendah (7%).Berdasarkan hasil penelitian dapat disimpulkan Penerapan model Discovery Learning Pada pembelajaran IPA di Sekolah Dasar memberikan dampak positif diantaranya yaitu: meningkatkan hasil belajar (54%), meningkatkan keaktifan belajar (13%), meningkatkan berpikir kritis (20%), dan yang terakhir meningkatkan kompetensi pengetahuan IPA (13%)