bluuebunny/crossref_metadata_2025 huggingface dataset:
A Lieu Sûr for the Fenians: France, the Fenians and the Irish Colony, 1848-1870
Authors: Watson Luke William
Published: December 2021

Every significant Irish nationalist organisation has depended on the international support of the Irish diaspora, never more so than in the 19th century. The Young Irelanders were scattered abroad in so many instances after the failure of the 1848 Rebellion, with many of their number fleeing to America, continental Europe and elsewhere. Though the Franco-Irish dimension of the Fenian movement is smaller in scale than Irish-American dimension, it is nonetheless worthy of investigation. This article seeks to address the lack of emphasis placed on the French element of Irish nationalism by providing a thorough examination of the influence of 19th-century France on the Fenians. It charts the direct influence of Paris and of the Irish diaspora in France on the movement and its exposure to organisations such as Young Italy, Young Poland and native French movements including La Société des Saisons. This paper concludes that France, French revolutionary spirit and French republican ideals were of significant importance to the Fenian movement, and played a direct role in shaping the development of Irish nationalism.
Ireland’s “Imponderable Dividends”: A Nascent Cultural Diplomacy Policy in the Postwar Years
Authors: Sablayrolles François
Published: December 2021

Focusing on Irish and French diplomatic archive material, this article analyses the conditions of the emergence of Ireland’s cultural diplomacy in the aftermath of the Second World War. From a diplomatic perspective, the Inter-Party government (1948-1951) marked a major turning point for Ireland. By passing the Republic of Ireland Act, the state officially became a Republic and withdrew from the Commonwealth. As the new Republic strove to achieve international recognition, the Cultural Relations Committee, an advisory board to the Department of External Affairs in charge of furthering the development of cultural relations with other countries was set up. The discussions among diplomats on membership of the Cultural Relations Committee and the topics to be addressed provide an insight into the competing visions of Irish culture and identity at a time of great political change. Finally, this paper gives an overview of the actions of the Committee in its first years of existence and explores the extent to which there was editorial independence in curating and commissioning work.
The Significance of the Táin in the Promotion of Cultural Nationalism with Particular Reference to Two Musical Compositions Inspired by Thomas Kinsella’s 1969 Translation
Authors: Horgan Goff Angela
Published: December 2021

This interdisciplinary discussion explores cultural nationalism across the creative arts in relation to the significance of the ancient saga, the Táin. Thomas Kinsella’s 1969 translation of Táin Bó Cuailnge [Brown Bull of Cooley] has proved to be a key post-Revival literary source from the ancient manuscripts of Ireland, as it has prompted renewed interest in the saga. Various creative artists have engaged with the Táin as a result of this translation, thereby contributing to a novel movement toward Irish cultural nationalism. The paper compares two Táin-inspired compositions by James Wilson and Aloys Fleischmann as each composer’s musical language yields insight into prevailing attitudes in Irish society towards the end of the 20th century.
“Beidh ár dTigh Hughes féin againn”: Music, Dance, and Overcoming the Disorientation of COVID-19 in Meadhbh Ní Eadhra’s “Cuairteoirí”
Authors: McCann Chris
Published: December 2021

This article examines the symbolism of music and dance in Meadhbh Ní Eadhra’s short story “Cuairteoirí” [“Visitors”], published in the October 2020 edition of Comhar. “Cuairteoirí” is set in a Connemara nursing home, where two residents come to terms with disorientation and isolation during the COVID-19 pandemic. The arrival of a band of musicians to perform a concert presents an opportunity for rejuvenation. Drawing on a multidisciplinary theoretical framework including social geography and music theory, this article examines Ní Eadhra’s employment of music and dance as narrative and symbolic devices. In particular, it explores the ability of these forms to function as praxis for reorientation in disrupted time and space. Literary parallels are examined, including Seán Ó Ríordáin’s experience of tuberculosis and Máirtín Ó Cadhain’s emigration fiction, to place Ní Eadhra’s text within the Irish literary lineage.
O DESENVOLVIMENTO DE HABILIDADES COGNITIVAS EM REGISTROS GRÁFICOS E ESCRITOS DE UM CLUBE DE CIÊNCIAS
Authors: Corrêa Almeida Willa Nayana , Coelho Antonia Ediele de Freitas , Malheiro João Manoel da Silva
Published: December 2021

O presente estudo analisa os níveis de Habilidades Cognitivas em registros gráficos e escritos desenvolvidos por estudantes deum Clube de Ciências, durante a etapa do Escrevendo e Desenhando de uma atividade experimental investigativa. A pesquisa caracteriza-se como qualitativa, sendo utilizada a Análise de Conteúdo para interpretação de 30 produções. O espaço analisado é considerado um ambiente não formal destinado ao ensino, pesquisa e extensão de ações didáticas voltadas às Ciências e Matemáticas. A atividade experimental investigativa aplicada foi intitulada “Problema da Água que não Derrama” e explorou as propriedades ligadas à tensão superficial da água. Durante as análises realizadas, identificamos que as Habilidades Cognitivas desenvolvidas pelos estudantes em seus registros relacionam-se diretamente à proposta almejada pela utilização da experimentação investigativa, sendo possível verificar níveis que variaram entre Baixa e Alta Ordem de Cognição, definidos entre N2 e N5 de Habilidades Cognitivas.
A PRESENÇA DO FOLCLORE E DA MÚSICA FOLCLÓRICA EM PROGRAMAS DE RÁDIO ESCOLAR
Authors: Ertel Daniele Isabel , Wolffenbüttel Cristina Rolim
Published: December 2021

Trata-se, aqui, da presença do folclore e da música folclórica em programas de rádio escolar produzidos em uma escola de Ensino Fundamental. Esse é um estudo de abordagem qualitativa, que tem como método o estudo de entrevistas qualitativas realizadas com três alunas do 6º e do 8º ano do Ensino Fundamental, analisadas por meio da análise de conteúdo. O conhecimento pedagógico-musical e suas funções, com base em Kraemer (2000), e conceitos de folclore e música folclórica, de Wolffenbüttel (2019), consubstanciam o referencial teórico da pesquisa. Por meio desse estudo foi possível identificar as vivências folclórico-musicais, as identidades e as memórias das estudantes investigadas, conhecendo suas concepções de folclore e música folclórica.
RELIGIÕES DE MATRIZES AFRICANAS NO CONTEXTO ESCOLAR
Authors: Silva Sérgio Teixeira da , Soares Alexandre Gomes
Published: December 2021

Este texto tem como objetivo mapear produções científicas que abordam a religiosidade de matriz africana como fonte de segregação e silenciamento no contexto escolar. A metodologia utilizada é de natureza qualitativa, com triangulação de dados, permitindo observar o fenômeno de vários ângulos e comparar entre si dados de diferentes fontes. Como resultados, identificamos trabalhos que cujo foco foi a cultura e religiosidade de matriz africana no contexto escolar; o empoderamento feminino nas religiões de matriz africana; as tensões entre religiões de matrizes africanas e escola. O mapeamento aqui empreendido demonstra o compromisso da comunidade científica na reflexão do tema, evidencia, também, os empenhos de pesquisadores em divulgar a construção de novas práticas pedagógicas, novas matrizes curriculares, a busca pela transformação da sociedade o reconhecimento dos sujeitos e seus lugares de pertencimentos, inclusive com indicativos de novas análises a serem realizadas.
SABER HISTÓRICO NO CURRÍCULO PAULISTA
Authors: Barbosa Pedro Paulo Lima , Lastória Andrea Coelho
Published: December 2021

O presente artigo reflete sobre o recente currículo organizado pela Secretaria de Educação de São Paulo, no Brasil. Focamos a atenção sobre aspectos diretamente ligados ao saber histórico e como ele é exposto no componente curricular de História – Etapa Fundamental II, presente no Currículo Paulista. Interessa-nos, ainda, discutir a respeito de sua implementação. Para isso, o artigo está dividido em dois momentos. No primeiro, estudamos o processo de institucionalização do referido currículo e quais são os pontos de legitimação. Em um segundo momento, debruçamo-nos sobre o conteúdo de História e sua relação com a formação do alunado como cidadãos críticos e participativos na sociedade brasileira. Com abordagem qualitativa, nosso cenário de legitimação teórico-metodológica está pautado em autores da área educacional e da ciência histórica. Os resultados da investigação revelam, dentre outros, que há certo reducionismo do saber histórico à condição de conteúdos sobre valores morais.
GRAFIAS QUE ROMPEM SILÊNCIOS
Authors: Silva Luíza Cristina Silva , Cunha Marlécio Marknamara da Silva
Published: December 2021

Este artigo apresenta resultados de uma pesquisa que buscou empreender análises sobre grafias presentes no espaço da escola. Neste trabalho, as grafias produzidas por estudantes em sala de aula apresentam potencial de compreender as relações sociais, geográficas e discursivas do poder e do saber. Para isso, o objetivo deste trabalho foi analisar os modos de atuação do currículo insurgente na produção de discursos que constituem espacialidades. Trabalhamos em uma perspectiva pós-crítica de currículo e no viés da geografia cultural. O argumento defendido ao longo do desenvolvimento do trabalho entende que o currículo insurgente é constituído por grafias sobre sexualidades que transgridem limites espaciais e, assim, produz espacialidades a partir de tensionamentos discursivos. Metodologicamente operou-se com a observação participante e elementos da análise do discurso de inspiração foucaultiana. Neste artigo, o que nomeamos como currículo insurgente constitui o conjunto das produções discursivas das grafias realizadas por estudantes no espaço da escola. A partir das análises concluímos que as grafias, que constituem o currículo insurgente, e que são expressas no espaço escolar, evidenciam fissuras curriculares, ou seja, saberes silenciados, proibidos e não discutidos pelo currículo formal e oficial.
EDUCAÇÃO EMPREENDEDORA NA EDUCAÇÃO BÁSICA
Authors: Soares Tatiani Prestes , Luz Charlene Bitencourt Soster , Jung Hildegard Susana , Fossatti Paulo
Published: December 2021

Este artigo objetiva refletir sobre a percepção de pais com relação ao empreendedorismo na Educação Básica. Trata-se de um estudo exploratório de caráter qualitativo. Como recursos metodológicos, realizamos uma revisão de literatura e aplicamos 22 questionários a pais de alunos da Educação Básica escolhidos de forma aleatória no município de Canoas, na região metropolitana de Porto Alegre, RS. As respostas foram examinadas através da técnica de análise de conteúdo de Bardin. Observamos que todos os respondentes entendem a criatividade como algo positivo e inerente ao empreendedorismo. Além disso, percebem crescimento da inserção do empreendedorismo nas escolas de Educação Básica, como uma tendência a ser adotada na educação de crianças e adolescentes, principalmente em forma de projetos. São inúmeras as possibilidades de projetos de empreendedorismo no ambiente escolar, desde questões de desenvolvimento pessoal, até mesmo práticas como soluções de problemas da sociedade. Concluímos, portanto, que o tema empreendedorismo é um caminho viável para o desenvolvimento de sujeitos na sociedade contemporânea em contínua e rápida transformação. Também apontamos para a importância da participação dos pais na elaboração dos currículos escolares e nos processos de escolarização de seus filhos. Tais ações podem contribuir para o alcance de melhores índices de qualidade educacional.
DIREITO FUNDAMENTAL À EDUCAÇÃO E A MILITARIZAÇÃO DAS ESCOLAS PÚBLICAS NO PARANÁ
Authors: Duenha de Souza Carla Giselle , Espinosa de Mello Aguirre Lissandra
Published: December 2021

Este artigo aborda o direito fundamental à educação, sua garantia e proteção no Brasil, a partir da análise constitucional e o processo de militarização em implementação na escola pública da educação básica por meio do Programa Nacional das Escolas Cívico-Militares do Governo Federal em parceria com os Estados. Com base no levantamento de legislações e documentos que regulamentam a implantação do Programa, demonstra-se a transformação pela qual passará 200 escolas públicas paranaense nos próximos anos. Este estudo tem como objetivo analisar o processo de militarização das escolas públicas da educação básica, as legislações que regulamentam o Programa e a sua implementação no Estado do Paraná. Justificando-se devido a relevância do tema e a escassez de pesquisas sob esta abordagem. Tem-se como metodologia utilizada a revisão bibliográfica. Por meio do estudo, demonstrou-se que apesar deste modelo ser denominado cívico-militar, a presença do militarismo é preponderante.
ALFABETIZAÇÃO CIENTÍFICA E A ABORDAGEM CIÊNCIA, TECNOLOGIA E SOCIEDADE ENQUANTO PRINCÍPIOS DA FORMAÇÃO INICIAL DE PROFESSORES/AS EM PEDAGOGIA
Authors: Terra de Oliveira Caroline , Gil Robledo
Published: December 2021

O artigo realiza um debate sobre o conceito de alfabetização científica com enfoque na abordagem curricular Ciência, Tecnologia e Sociedade (CTS) enquanto princípios fundamentais para a qualificação da formação inicial e continuada de professores e professoras em Pedagogia. Para tanto, busca apresentar os resultados e reflexões de um projeto de formação inicial na área de Ciências da Natureza, com foco na extensão universitária, realizado junto aos alunos e alunas do referido curso, da Universidade Federal de Pelotas, entre os anos de 2018 e 2019. A metodologia fundamenta-se em pesquisa bibliográfica, análise documental da Base Nacional Comum Curricular e reflexão crítica sobre os resultados da realização das ações de intervenção na escola, tendo como base o diálogo permanente entre a universidade e as instituições escolares públicas de educação básica. O debate possui como aporte teórico, especialmente, autores como Lorenzetti (2020), Chassot (2021), Bizzo (2009) e Pavão (2011).
AS PRÁTICAS DA AUTOGESTÃO NO CONTEXTO DA EDUCAÇÃO NÃO FORMAL: UMA ANÁLISE A PARTIR DA PRODUÇÃO DO CONHECIMENTO
Authors: Régis Oliveira Alysson André , Silva Luiz Brucelins Galdino da , Albuquerque Ryan Lins de , Cavalcanti Maria da Conceição Monteiro
Published: December 2021

A presente pesquisa buscou analisar a produção do conhecimento, de 2003 a 2020, no campo da economia solidária e as práticas para a autogestão no contexto da educação não formal. Assim, nos apropriamos, principalmente, das ideias Romanowski e Ens, Gohn e Singer. Para isso, foi realizada uma pesquisa do tipo Estado da Arte e, para a construção do corpus de dados, foram utilizados os resumos de artigos publicados em revistas científicas, dissertações e teses. Os resultados do presente estudo demonstram que a produção do conhecimento da economia solidária e das práticas para a autogestão no contexto da educação não formal ainda é um campo fértil para o desenvolvimento de novas investigações, indo ao encontro dos pressupostos elencados, pois se conjecturou que havia poucas pesquisas publicadas na área em função do resultado de outros estudos já publicados.
Acral perineurioma: a case report of a rare neoplasm successfully treated with autologous skin graft reconstructive surgery
Authors: Pierobon Elena , Cortelazzi Chiara , Dominici Michele Maria , Feliciani Claudio , Di Nuzzo Sergio
Published: December 2021

Soft tissues perineurioma is a rare nerve sheath tumor that affects most of all the subcutaneous tissue. Even if it could present as a large mass, it is a benign neoplasm for whom a complete surgical excision represents the gold standard treatment. Considering that it usually affects acral sites of young people, can be challenging to perform a reconstructive surgery that allows a full functional recovery. We report the case of a woman in her 20s presenting a perineurioma of the sole of the foot, a nodule of about 2 cm of diameter that compromised the support of the foot on the ground. We performed a radical surgical excision with no recurrence after 3 years of follow up and we obtained a full functional recovery thanks to an autologous full-thickness skin graft.
Evaluation of pediatric hydrocephalus: Clinical, surgical, and outcome perspective in a tertiary center
Authors: Singh Rahul , Prasad Ravi , Singh Ramit , Trivedi Adarsh , Bhaikhel Kulwant , Sahu Anurag
Published: December 2021

Context: Pediatric hydrocephalus (PH) results in significant clinical and psychosocial morbidity in pediatric population. Aims: The aims of the study are to evaluate clinical, surgical, and outcome perspective of PH patients of age <12 years. Settings and Design: This is a retrospective cohort study. Materials and Methods: This study includes 117 pediatric patients (age ≤12 years) of hydrocephalus due to various etiology admitted in our department between September 2018 and December 2020. Demographic profile, etiology, clinical presentation, management, complications and postoperative outcome characteristics were evaluated. Survival analysis was done with respect to etiology and age group. Statistical Analysis Used: P < 0.05 was considered statistically significant. Unpaired t-test and Chi-square test were used. Kaplan–Meier curve plotting and survival analysis were also done. Results: Male-to-female ratio was 1.3:1. Most frequent etiology of PH was postinfectious (35%). Posterior fossa pilocytic astrocytoma (34.2%) was the most common neoplastic etiology. Surgical procedure performed for PH was ventriculoperitoneal shunting (n = 103), Ommaya reservoir (n = 2) placement, and endoscopic third ventriculostomy (ETV) (n = 8). Mortality was significantly (P = 0.0139) more in patients of neoplastic etiology. Cognitive deficits and delayed developmental milestones were significantly (P < 0.05) more in congenital hydrocephalus etiology. There was a nonsignificant difference in survival between age groups (P = 0.1971). However, a significant survival difference was evident (P = 0.0098) for etiology. Conclusions: Disease-specific mortality is main cause of mortality in PH. Neoplastic etiology PH has poor survival when compared to others. Life-long routine controls are required to avoid future possible complications and enhance better rehabilitation of the child.
Adult coagulase-negative staphylococcal meningitis in Qatar: Clinical characteristics and therapeutic outcomes
Authors: Khan Fahmi
Published: December 2021

Background and Objectives: Coagulase-negative staphylococci (CoNS) have emerged as a major pathogen in nosocomial meningitis. This study was designed to describe the clinical profile, laboratory parameters, treatment, and outcomes of CoNS meningitis in patients admitted to Hamad General Hospital, Qatar. Materials and Methods: This retrospective hospital-based study described the patients with CoNS meningitis from 2009 to 2013. Results: Twelve patients were recruited for the study, of which there were 10 (83.3%) males and 2 (16.7%) females with a median age of 39 years (interquartile range [IQR]: 29–46 years). Fever was the most common presenting symptom being present in all patients, followed by mental alterations 7 (58.3%). All CoNS meningitis cases in this study were nosocomially acquired after neurosurgery and in most cases after external ventricular drain (EVD) insertion. The median time between the procedure and acquisition of infection was 13 days (IQR: 10–15.7 days). The isolated species include 8 (66.7%) Staphylococcus epidermidis, 2 (16.7%) Staphylococcus capitis, and 2 (16.7%) Staphylococcus haemolyticus. All CoNS isolates were sensitive to vancomycin while 75% of them were oxacillin resistance. In the eight patients with EVDs, the infected EVDs were removed, while all patients received empirical antibiotics involving mainly vancomycin and ceftriaxone that were modified upon receipt of culture results. All patients were cured, and no mortality was reported. Conclusions: CoNS meningitis is a recognized complication related to the introduction of neurosurgical devices. Because of its nonspecific clinical presentation, treating physicians should have a high suspicion index. If CoNS meningitis is highly suspected, vancomycin is the empirical treatment of choice while awaiting results of sensitivity.
Hydatid cyst of dorsal spine masquerading as tubercular infection: A case report and review of literature
Authors: Das Gurudip , Nanda Saurav , Sahu Nabin , Kumar Doki , Patro Bishnu
Published: December 2021

Hydatid cyst disease of the spine is rare, and only a few are reported in the scientific literature. This infection is caused by the larvae of Echinococcus granulosus cestode. The presentation is usually late because the patient remains asymptomatic for a longer duration after the infection. The initial form of treatment is always surgical in a symptomatic patient for excision of the diseased tissue. A 35-year-old male presented in the outpatient department with a chief complaint of mid-back pain and intermittent history of fever following his back surgery for 4 years. The patient has taken presumptive treatment for tuberculosis before presenting it to us. Radiological investigations dictate the presence of hydatid cyst in the D4 vertebra. Intact cysts were excised with perioperative albendazole coverage. The patient was mobilized on postoperative day-1 with Taylor's brace, and the brace was continued for 6 weeks. The patient was followed up at regular intervals for 1 year, and no recurrence was found. Hydatid cyst disease in the spine is a rare disease but associated with high morbidity despite significant advances in diagnostic imaging techniques and surgical treatment. For a provisional diagnosis, magnetic resonance imaging is the investigation of choice. Surgical decompression is the main stray of treatment along with antihelminthic therapy. A close follow-up is required after the initial treatment to find the recurrence at the earliest.
Pituitary apoplexy following severe diabetic ketoacidosis, with two uncommon complications of supraventricular tachycardia and acute limb ischemia, in a patient with neglected pituitary adenoma and undiagnosed diabetes mellitus: A rare clinical association
Authors: Pattankar Sanjeev , Chauhan Phulrenu , Kapadia Farhad , Sankhe Milind
Published: December 2021

Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea-vomiting, visual impairment, ophthalmoplegia, altered sensorium, and panhypopituitarism. Though diabetic ketoacidosis (DKA) is an established complication of uncontrolled diabetes mellitus, its association with PA is extremely rare. Likewise, supraventricular tachycardia (SVT) and Acute limb ischemia (ALI) have rare, reported association with DKA. We present one such case of rare associations seen in our clinical practice. A 20-year-old woman was brought to our emergency room with headache, breathlessness, and altered sensorium. Clinical and biochemical evaluation revealed SVT, DKA, and right lower limb ALI. On enquiry, the patient was found to be diagnosed with pituitary adenoma 2 years ago and lost to follow-up. PA was detected on neuroimaging and confirmed histopathologically. Possibility of PA presenting as DKA and its sequelae exists.
The effects of temperature and prothrombotic conditions on cerebral venous sinus thrombosis frequency: An institutional experience
Authors: Mustansir Fatima , Inam Maha , Darbar Aneela
Published: December 2021

Objectives: The pathogenesis of cerebral venous sinus thrombosis (CVST) is complex and involves the interplay of underlying provocative factors. Upon observing a higher frequency of CVST cases presenting to our hospital in summer, we hypothesized that CVST may be influenced by variations in climate. Materials and Methods: A retrospective review of all patients who were diagnosed with CVST at a tertiary care hospital in Pakistan between January 2010 and December 2019 was conducted. After dividing patients into groups based on the type of risk, the frequency of CVST in these groups between four seasons (spring, summer, fall, and winter) was compared. Results: A total of 256 patients diagnosed with CVST were included, of which 129 were female and 127 were male. The mean age was 41.7 ± 15.2 years. Of the total patients, 91.4% had some sort of risk factor, either systemic (162 patients) or local (72 patients), while 22 patients did not have any identifiable risk factor. The number of patients with more than one known risk factor was 93 (36.3%). Of the total number of patients, 96 (37.5%) patients had hyperhomocysteinemia, followed by 85 patients (33.2%) with a prothrombotic risk factor other than hyperhomocysteinemia and 44 (17.2%) patients with central nervous system infections. The most commonly affected sinuses were a combination of the transverse sinus and sigmoid sinus (21%), There was a statistically significant seasonal variation in CVST cases among all patients (P = 0.03) and in the systemic risk factor group (P = 0.05), with the highest number of cases occurring in the summer season. Conclusions: CVST may be influenced by seasonal changes in atmospheric temperatures and humidity, especially in patients with underlying prothrombotic risk factors.
Early exposure of the dorsal surface of M1 segment via the distal transsylvian approach for clipping of anteroinferior-projecting middle cerebral artery bifurcation aneurysms
Authors: Sriamornrattanakul Kitiporn , Akharathammachote Nasaeng , Wongsuriyanan Somkiat
Published: December 2021

Background: Middle cerebral artery bifurcation (MCAB) aneurysms are common intracranial aneurysms. Anteroinferior-projecting MCAB aneurysms, with the M1 segment usually embedded into the deep part of the Sylvian fissure, cause some surgical challenges. The distal transsylvian approach (DTSA) allows M1 exposure from the dorsal surface for proximal control in the early step. Therefore, this study aimed to demonstrate the efficacy and safety of DTSA for clipping anteroinferior-projecting MCAB aneurysms. Materials and Methods: Among 97 patients with MCA aneurysms, 13 with anteroinferior-projecting MCAB aneurysms who underwent aneurysm clipping via the DTSA between June 2018 and January 2021 were retrospectively evaluated for the aneurysm obliteration rate, surgical complications, and outcomes. Results: Ten patients (76.9%) had ruptured MCAB aneurysms and three (23.1%) had incidentally discovered unruptured MCAB aneurysms. Favorable outcome was achieved in 100% of patients with good grade. The complete aneurysm obliteration rate was 100% without intraoperative lenticulostriate artery injury. Twelve (92.3%) patients had early identified distal M1 segment for proximal control, and one (7.7%) patient had premature rupture of aneurysm that achieved favorable outcome at 3 months postoperatively. Difficult M1 exposure and premature rupture occurred in the patient with MCAB located above the Sylvian fissure line. Permanent postoperative neurological deficit was detected in one patient due to severe vasospasm. Conclusions: DTSA, which simplify the early exposure of the dorsal surface of distal M1, is safe and effective for clipping anteroinferior-projecting MCAB aneurysms without extensive Sylvian fissure dissection. High-positioned MCAB requires careful dissection of the aneurysm neck with consideration of tentative clipping preparation.
Purely suprasellar (Hypothalamic) atypical teratoid rhabdoid tumor presenting with diabetes insipidus and panhypopituitarism in an adult male: A case report and review of literature
Authors: Shaaban Ahmed , Al Hajali Amro , Elaiwy Orwa , El Sotouhy Ahmed , Al-Bozom Issam , Ayyad Ali
Published: December 2021

Atypical teratoid rhabdoid tumor (ATRT) is a rare primary malignant tumor of the central nervous system. Little knowledge is available about natural history, behavior, prognosis, and best management guidelines of such tumor. Its occurrence in adults is very rare and more predominant in females. Locations in adults are mainly cerebral hemispheres, but recently, more cases are reported in sellar/suprasellar cisterns. We are reporting a case of purely suprasellar ATRT of a middle aged male who presented initially with diabetes insipidus (DI).
Transfalcine approach for the resection of a bilateral falx meningioma: Technical nuances and review of literature
Authors: Boissonneau Sebastien , Beucler Nathan , Graillon Thomas , Farah Kaissar , Fuentes Stephane , Dufour Henry
Published: December 2021

The tendency to reduce invasive surgeries is gaining more adepts, and the primary goal in meningioma surgery is the maximal safe resection. Falx meningioma is common location for intracranial meningioma, and according to their deep localization, falx meningioma represents a neurosurgical challenge. The objective of the study is to report the feasibility of a transfalcine nontumor dominant side approach for a bilateral falx meningioma. We report a technical note about the surgical approach of a 44-year-old female suffering from an evolutive meningioma of the middle third of the falx. According to the venous drainage anatomy, and the tumor conformation, a contralateral transfalcine approach was done. We described with details this surgical approach, and a reflection about transfalcine approach is proposed, which is a variant of the interhemispheric approach. It permits a good exposure of the medial surface of the contralateral hemisphere thanks to a falx incision. Moreover, a literature review is proposed about 278 articles with a special emphasis on transfalcine approach in meningioma surgery. We report an original minimal invasive approach for an intracranial meningioma, with a complete resection (Simpson I) without any technical complication. This contralateral transfalcine approach brings new technical nuances for the resection of falx or midline intracranial tumors.
Functional outcome of surgically treated patients of ossified posterior longitudinal ligament of cervical and dorsal spine in Indian population – A single center retrospective analysis of 40 patients
Authors: Srivastava Sudhir , Gaddikeri Manojkumar , Bhosale Sunil , Raj Aditya , Naseem Atif , Marathe Nandan
Published: December 2021

Aims: The aim of the study was to retrospectively evaluate the neurological outcome in operated patients of ossified posterior longitudinal ligament (OPLL) of cervical and/or dorsal spine using modified Japanese orthopedic association (mJOA) score and find out the factors affecting the outcome. Settings and Design: The study design was a retrospective study. Materials and Methods: Forty operated patients of cervical and/or dorsal spine OPLL were included in the study. Neurological examination was conducted and analyzed using mJOA score pre- and postoperatively at 1, 6, and 12 months. Improvement in the mJOA score based on age, sex, type of OPLL, duration of symptoms, type of surgical procedure, and radiological parameters were calculated, analyzed, and compared with previous records of the patient. Results: Significant improvement in mJOA scores with mean preoperative being 12.27 ± 1.95 with 1-year postoperative 13.85 ± 2.02 (P < 0.0001) noted. There is a significant difference in mean mJOA scores in posterior approach with instrumentation (P < 0.0001) as compared with laminoplasty group (P < 0.005). Patients with occupancy ratio <60% had better results (P < 0.0001) as compared to those with occupancy ratio of >60% (P = 0.003). Patients with duration of symptoms >1 year had poorer results compared to those of <1 year duration. Mean ossification kyphosis angle was 19.4° ± 5.73°. Conclusion: OPLL is a progressive disease which causes severe neurological deficit if left untreated. OPLL in a young patient with short duration of symptoms, low occupancy ratio, and low ossification kyphosis had better chances of neurological recovery. Type of OPLL and sex of patient do not affect the recovery. OPLL managed early and surgically has better results irrespective of anterior or posterior approach with significant improvement in mJOA score. Decompression with fusion has better results than decompression alone.
Metastatic colon cancer in the pituitary: A case report with review of literature
Authors: Karia Kishan , Price Sally-Ann , Soon Wai , Chowdhury Yasir , Thant Kyaw , Batra Ruchika , Meade Sara , Karavitaki Niki , Tsermoulas Georgios
Published: December 2021

We report a rare case of metastatic colonic adenocarcinoma to the pituitary gland in a 58-year-old who presented with visual decline and panhypopituitarism. He underwent urgent transsphenoidal endoscopic surgery with significant improvement of his vision, followed by adjuvant fractionated radiotherapy to the resection cavity. He made a satisfactory recovery, but regrettably died from COVID-19 9 weeks after completion of radiotherapy. A multidisciplinary approach is essential for optimal management of this condition due to its rarity and complexity.
Performing awake surgeries in times of COVID-19 – A Singapore experience
Authors: Jain Swati , Loh Will , Chan Hui-Minn , Lam Calvin , Yeo Tseng , Sein Lwin , Nga Vincent , Teo Kejia
Published: December 2021

Introduction: It has been 17 years since the severe acute respiratory syndrome outbreak and Singapore is facing yet another daunting pandemic – the novel coronavirus (COVID-19). To date, there are 57,607 cases and 27 casualties. This deadly pandemic requires significant changes especially in the field of awake surgeries for intra-axial tumors that routinely involve long clinic consults, significant interactions between patient and multiple other team members pre, intra, and postoperatively. Materials and Methods: A retrospective review of all awake cases done during the COVID-19 pandemic from February to June 2020 was done. In this article, we outline the rigorous measures adopted during the COVID-19 pandemic that has allowed us to proceed with awake surgeries and intraoperative mapping at our institution. Results and Discussion: We have divided the protocol into various phases of care of patients planned for an awake craniotomy. Preoperatively, teleconsults have been used where possible thereby limiting multiple hospital visits and interaction. Intraoperatively, safety nets have been established during asleep-awake-asleep phases of awake craniotomy for all the team members. Postoperatively, early discharge and teleconsult are being employed for rehabilitation and follow-ups. Conclusions: Multiple studies have shown that with intraoperative mapping, we can improve neurological outcomes. As the future of the pandemic remains unknown, the authors believe that surgical treatment should not be delayed for intracranial tumors. Awake craniotomies and intraoperative mapping can be safely carried out by adopting the described protocols with combination of multiple checkpoints and usage of telecommunication.
Minimally invasive surgery for traumatic high-grade lateral spondylolisthesis of L1 with multiple spinal fractures: Closed reduction and internal fixation using percutaneous pedicle screws
Authors: Sasagawa Takeshi
Published: December 2021

Background: Traumatic high grade lateral spondylolisthesis at the thoracolumbar junction is an extremely severe injury caused by high-energy trauma, commonly resulting in polytrauma. The treatment of this pathology is challenging, and even death following surgery has been reported. Therefore, it is necessary to focus on making surgical invasion minimal. Methods: A 53-year-old female fell from a height and presented with severe back pain and complete paralysis below L1. Computed tomography (CT) showed a Grade 4 traumatic lateral spondylolisthesis and severe comminution of L1, and mild compression fractures at T9 and L3. Results: First, we performed posterior surgery on the day of the injury to reduce the fracture and stabilize the spinal column using percutaneous pedicle screws (PPS). Twelve days later we resected the L1 vertebral body and inserted a cage with an iliac bone graft using an anterior approach. The estimated blood loss from posterior and anterior surgeries was 320ml and 200ml, respectively. Bony fusion was achieved as seen on CT at the 1-year follow-up. Conclusion: A 2-stage combined posterior-anterior approach using PPS can be performed less invasively, enabling adequate reduction, internal fixation, and anterior reconstruction for patients with high grade traumatic lateral spondylolisthesis without spinal shortening or facet interlocking.
Papillary tumor of Pineal Region in a 5-year-old male child: A rare entity
Authors: Gupta Kanika , Khursheed Sumat , Nayil Khursheed , Khursheed Sumaira , Makhdoomi Rumana
Published: December 2021

Papillary tumor of the pineal region (PTPR) is a rare grade II to III pineal lesion. These tumors mostly occur in adults, only rarely in children, with six cases in children under the age of 16 years (10.2%) up to now. We report the case of a 5-year-old male child presenting with worsening headaches, abnormally enlarged head since birth and visual disturbances. Imaging reveals a mass in the region of the pineal gland. The third and lateral ventricles were enlarged. The patient underwent a gross-total surgical resection of pineal mass through a suboccipital supracerebellar approach and tissue sent for histopathological examination and an available immunohistochemical workup has been done which confirmed the diagnosis of papillary tumor pineal region. This case highlights the histopathological features, imaging along clinical presentation similar to those in the original description of this rare entity PTPR. More studies are required to determine the prognosis and standard treatment protocol of this rare entity.
Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial
Authors: Vadhanan Prasanna , Kalyanasundaram Cheran , Sundaram Subbulakshmi , Rajendran Iniya , Rajasekar Preethipriyadarshini
Published: December 2021

Background and Aims:

Various pharmacological and non-pharmacological strategies have been employed to minimise hypotension during obstetric spinal anaesthesia. We compared a prophylactic combination of glycopyrrolate, ondansetron, and ephedrine in terms of total vasopressor consumption, with standard treatment in this randomised controlled trial.

Methods:

One hundred patients undergoing elective caeserean sections were randomly divided into two groups of 50 each, the study group received prophylactic ondansetron and glycopyrrolate boluses followed by an infusion of ephedrine, while the control group received ephedrine boluses as required. The total ephedrine consumption (primary objective), incidence and degree of hypotension, heart rate variations, and neonatal APGAR scores (secondary objectives) were analysed.

Results:

The median ephedrine requirement was lesser in the study group compared to the control group [13.2 mg (10--15.75) vs. 27.7 mg (12--24)], with aPvalue of 0.02. Fewer participants experienced hypotension in the study group before baby delivery compared to the control group (12 vs. 36,P= 0.004). Heart rate was higher in the study group. No significant differences were observed in neonatal APGAR scores and incidence of adverse events.

Conclusion:

A combination of glycopyrrolate, ondansetron, and ephedrine might offer better haemodynamic stability and reduce vasopressor consumption in obstetric patients undergoing spinal anaesthesia as opposed to standard treatment.
Epidemiology and factors associated with all-terrain vehicle accidents in children
Authors: Al Mutari Mohammed , Alasmari Bushra , Aldosari Lama , Alluhaidan Rahaf , Aljohani Reham , Hijazi Shahd Omar , Othman Fatmah
Published: December 2021

Background:

All-terrain vehicle (ATV) accidents have a substantial impact on the pediatric population in Saudi Arabia; however, few local studies are available. An in-depth study of this issue and adequate implementation of regulations are required to prevent additional casualties. The aim of this study was to describe the epidemiology of ATV injuries in the pediatric population and the outcomes associated with the injuries.

Methods:

We conducted a retrospective chart review at a Level 1 trauma center in Riyadh. All patients, aged ≤14 years and admitted due to an ATV accident, from 2004 to 2018 were included in this study. Demographic information, hospital course, and injury outcomes were extracted from the King Abdulaziz Medical City trauma registry. Each medical record was reviewed for short-term complications and the mechanism of injury. The primary outcome measure was the type of injury associated with ATV accidents; the secondary outcomes were injury site and mechanism of injury, and the association between the impact of injury and the clinical and demographic variable.

Results:

In total, 165 patients were involved in ATV accidents and met our inclusion criteria. The mean age was 8 ± 4 years, and 79% (131/165) were boys. Over 50% (84/165) of the sample had lower limb injuries. The majority of patients had fracture injuries (37%, 61/165), followed by amputations (30%, 50/165). Of the amputation group, the majority (86%, 43/50) was from 1 to 5 years compared to the no amputation group (P < 0.001). For the amputation group, 67% (33/50) had a limb trapped in the chain of the vehicle as to the mechanism of injury.

Conclusion:

The majority of patients had lower-extremity injuries, specifically fractured (37%) or amputated (30%) with children from age 1–5 years having a significantly higher proportion of hospital admission compared to the rest of the study population. Despite the existing legislation for ATV use in children, they are not enforced. The finding of this study recommends urgent implementation of these regulations for both ATV retailers and users and promotes public awareness about the severity of such injuries.
Surgeons' re-operative valve replacement practices in patients with endocarditis due to drug use
Authors: Aultman Julie M. , Dziadkowiec Oliwier , McCallister Dianne , Firstenberg Michael S.
Published: December 2021

Background:

This study discerns surgeons' attitudes and practices in the determination of heart valve replacement for patients with infectious endocarditis (IE) due to intravenous drug use (IVDU). We aimed to identify the factors contributing to surgeons' decision-making process for initial and recurrent surgical heart valves and the availability of institutional guidance.

Methods:

An IRB-approved, anonymous mixed-methods, open survey instrument was designed and validated with 24 questions. A convenience sample of cardiothoracic surgeons in the United States and globally resulted in a total of 220 study participants with 176 completing every question on the survey.

Results:

A cluster analysis revealed that although surgeons can be divided into subgroups based on their previous experience with valve replacements, these groups are not perfectly homogenous, and the number of identified clusters is dependent on technique used. Analysis of variance revealed the variables that most clearly divided the surgeons into subgroups were, in order of importance, years of practice, number of valve replacements, and geography.

Conclusions:

Our analysis showed heterogeneity among cardiothoracic surgeons regarding how they make clinical decisions regarding re-operative valve replacement related to IE-IVDU. Therefore, an opportunity exists for interprofessional teams to develop comprehensive guidelines to decrease variability in surgical decision-making regarding valve replacement associated with IE-IVDU.
An assessment of measures to reduce injuries and mortality among motorcyclists
Authors: Fadaei Hadi , Ainy Elaheh , Paydar Roghayeh
Published: December 2021

Background:

Motorcyclists are one of the most vulnerable groups in road accidents. This study aimed to investigate the effective measures to reduce injuries and deaths in the most vulnerable road users' motorcyclists in 2020.

Methods:

The study was a cross-sectional study. In this study, 147 motorcycles were randomly selected from the list of all motor courier units in Tehran, which was prepared through an internet search. The required information was collected through questionnaires and interviews. The inclusion criteria had a minimum high school education and an age range of 18–65 years. The trained questioners referred to the selected courier offices and after obtaining consent to participate in the study, project questionnaire were completed.

Results:

The mean age of subjects was 31.4 ± 8.0 years. All subjects were male. The purpose of the trip was going to work (84.4%). The highest percentage of leaving home time (94.6%) was observed in the morning. More than half of the subjects had a history of accidents (54.5%), and also more than half of the subjects (54.0%) had a history of an accident in their 2nd degree relatives' families. Forth-fifths of the studied motorcyclist (89.5%) wore helmets. Nearly half of the subjects (48.3%) always fastened their helmets strap. The highest action (72.0%) was suggested to separate the motorcycle lanes.

Conclusion:

In the viewpoint of the motorcyclist, separating the motorcycle lines could be one of the most effective measurements to injury reduction. Hence, officials and planners need to pay more attention to the logical demands of motorcyclists.
Epidemiology and patterns of road traffic fatalities in India pre- and post-motor vehicle (Amendment) act 2019
Authors: Sahu Manas Ranjan , Mohanty Manoj Kumar , Sasmal Prakash Kumar , Radhakrishnan Rakesh Vadakkethil , Mohanty Chitta Ranjan , Shaji Ijas Muhammed , Naveen Alagarasan , Parida Madhusmita
Published: December 2021

Background:

Road traffic accidents (RTAs) are a preventable cause of death. The government of India enacted the motor vehicle amendment (MVA) act on September 01, 2019, to curtail the alarming trend of RTAs and their associated fatality. The study objective was to compare the epidemiology and pattern of fatal RTAs before and after the MVA Act 2019 of India.

Methods:

An autopsy-based cross-sectional study was conducted at the Department of Forensic Medicine and Toxicology (FMT) of a tertiary-care hospital from March 2019 to February 2020. The sample comprised 75 fatal RTA victims who underwent postmortem at FMT. Patients were studied in two groups: One pre-MVA group (n = 47) and one Post-MVA group (n = 28). The data were obtained from medical records and inquest reports with autopsy correlation. Data pertaining to sociodemographic profile, mechanism, injury profile including injury-severity-score (ISS) and survival-time was recorded.

Results:

There was a 40.4% decline in mortality among RTA victims (P = 0.057) in the post-MVA group. The case fatality rate also declined during post-MVA implementation months compared to pre-MVA months (1.61 vs. 1.96). A significant correlation was noted between the ISS and survival-time of victims (P < 0.001, r = −0.522). The mean age of patients was 39.87 ± 17.44 years. Heavy motor vehicles along with motorized two-wheeler were the most common offending-vehicle. The median ISS of all victims was 41 (33–57). Head injury was the most common cause of death (60%).

Conclusion:

Study results signal-toward early triumph of the new MVA act, probably due to enhanced adherence to safety gears and constructive behavioral change.
Oral manifestations of white blood cell dyscrasias with emphasis on their management
Authors: James Amritha , Ahmed Sahanaz Praveen , Arunachalam Preethi , Mahalingam Ramya , Mohan Vaddadi Krishna
Published: December 2021

White blood cell (WBC) dyscrasias refer to a group of disorders that affect the WBCs or their precursors. Oral manifestations are often the first identifiable signs of such disorders. A clear knowledge about these manifestations is necessary for both the dentist and the general physicians to initiate treatment at the earliest which could prove as a matter of life or death for the patient in certain malignancies. There is no comprehensive review on the oral manifestations of WBC dyscrasias till date. Hence, the aim of this review is to present the oral manifestations of the most commonly encountered WBC dyscrasias and their treatment modalities with an emphasis on dental management.