bluuebunny/crossref_metadata_2025 huggingface dataset:
FINITE ELEMENT ANALYSIS OF FEMORAL PROSTHESIS UNDER TRANSIENT LOADING FOR MULTIPLE ACTIVITIES OF DAILY LIVING
Authors: Patra Rabiteja , Jena Shreeshan , Das Harish Chandra , Rath Asita Kumar
Published: March 2022

The femoral prostheses experience versatile loading during the activities of daily living (ADL) and subsequently encounter a variety of stresses. This paper presents a detailed finite element analysis (FEA) of the femoral implant under transient loading. The distinct loading patterns corresponding to the most commonly occurring ADL are utilized for simulating the different scenarios. The CT reconstructed CAD model of the human femur bone assembled with a femoral implant is utilized for this study. The loading scenarios for walking, stair ascent, stair descent, standing up, sitting down, standing on one leg and knee bending are simulated by using the joint reaction forces and moments, corresponding to a body weight of 750 N, for the FEA. The results of this study are validated using a preliminary in-house built experimental setup comprising a fixture for a stainless steel femoral implant with sensors attached at three locations on the implant. The results indicate that the highest stresses are generated in case of the stair descent, stair ascent and standing on a single leg type of activities. These activities that generate high stresses on the implant surfaces are not suitable for the longevity of the implant and are therefore not advisable for post-operative patients.
Machine Learning in Computer Vision
Authors: Islam A. B. M. Rezbaul
Published: March 2022

Computer vision is a research field in computer science that provides the computer the ability of human perceptions. The goal of computer vision is to understand the image and its contents. Computer vision has evolved from simple pattern recognition to solving various complex real-world problems. Nowadays, computer vision has its application to the various domains of scientific areas not limited to Computer Science. It is widely used for medical science, biology, physics, and chemistry as well. The recent boost in computer vision is the due influence of machine learning (ML). ML is a subfield of artificial intelligence. Machine learning is a method that makes a computer learn from the provided data and improve its performance with time. Computer vision problems are complex, and they require a correct choice of algorithms. In this chapter, some machine learning algorithms that are widely used in computer vision will be discussed. The theoretical concepts are related to real-world computer vision problems such as human skin detection.
Risk factors for Herpes simplex virus and Cytomegalovirus infections in critically-ill COVID-19 patients
Authors: Fuest Kristina E. , Erber Johanna , Berg-Johnson Wiebke , Heim Markus , Hoffmann Dieter , Kapfer Barbara , Kriescher Silja , Ulm Bernhard , Schmid Roland M. , Rasch Sebastian , Lahmer Tobias
Published: March 2022

Background: To assess the prevalence of Herpes simplex and Cytomegalovirus infection in respiratory samples of critically-ill COVID-19 patients, its role in outcome and mortality and the influence of dexamethasone treatment in the early stage of SARS-CoV-2 infection.  Methods: All mechanically ventilated COVID-19 patients treated on ICU between March 2020 and January 2021 were included. Respiratory specimens were tested for Herpes simplex virus (HSV) type 1, 2 and Cytomegalovirus (CMV) by quantitative real-time PCR. Clinical parameters were compared in the cohort cohorts with and without HSV-1-infection.Results: 134 patients with a median age of 72.5 years (73.0% male, n=98) were included. HSV-1 reactivation occurred in 61 patients (45.5%), after median 9 (7-13) days of mechanical ventilation. The main factor for reactivation was length of stay on ICU (24 days vs 13 days, p<0.001) and duration of mechanical ventilation (417 vs 214 hours, p<0.001). Treatment with dexamethasone and a history of immunosuppression did not associate with HSV-infection in the univariate analysis (39 vs 41, p=0.462 and 27.9% vs 23.3%, p=0.561, respectively). Both ICU and hospital mortality were not significantly different in the cohorts with and without HSV-infection (57.4% vs 45.2%, p=0.219).Conclusions: Our study shows a high prevalence of HSV-infection in critically-ill COVID-19 patients which was unexpectedly higher than the prevalence of CMV-infections and unrelated to dexamethasone treatment. The main risk factors for HSV and CMV in the studied cohorts were the length of ICU stay and duration of mechanical ventilation. Therefore, we recommend routine monitoring of critically ill COVID-19 patients for these viral co-infections and consider treatment in those patients.
Body Anthropometric Characteristics and Rectal Temperature Cooling Rates in Women With Hyperthermia
Authors: Koenig Fallon S. , Miller Kevin C. , O'Connor Paul , Amaria Noshir
Published: March 2022

Context

Cold-water immersion (CWI) is the best treatment for patients with exertional heat stroke (EHS), and rectal temperature (Trec) cooling rates may differ between sexes. Previous authors have suggested that the body surface area (BSA):lean body mass (LBM) ratio is the largest factor affecting CWI Trec cooling rates in men with hyperthermia; this has never been confirmed in women with hyperthermia.

Objective

To examine whether the BSA:LBM ratio and other anthropometric characteristics affect Trec cooling rates in women with hyperthermia.

Design

Cross-sectional study.

Setting

Laboratory.

Patients or Other Participants

Sixteen women were placed in either a low BSA:LBM ratio (LOW; n = 8; age = 22 ± 1 years, height = 166.8 ± 6.0 cm, mass = 64.1 ± 4.5 kg, BSA:LBM ratio = 3.759 ± 0.214 m2/kg·102) or high BSA:LBM ratio (HIGH; n = 8; age = 22 ± 2 years, height = 162.7 ± 8.9 cm, mass = 65.8 ± 12.7 kg, BSA:LBM ratio = 4.161 ± 0.232 m2/kg·102) group.

Intervention(s)

On day 1, we measured physical characteristics using dual-energy x-ray absorptiometry, and participants completed a maximal oxygen consumption test. On day 2, participants walked at 4.8 km/h for 3 minutes and then ran at 80% of their predetermined maximal oxygen consumption for 2 minutes in the heat (temperature = ∼40°C, relative humidity = 40%). This sequence was repeated until Trec reached 39.5°C. Then they underwent CWI (temperature = ∼10°C) until Trec was 38°C.

Main Outcome Measure(s)

Rectal temperature and CWI cooling rates.

Results

The groups had different BSA:LBM ratios (P = .001), LBM (LOW: 45.8 ± 3.0 kg; HIGH: 41.0 ± 5.1 kg; P = .02), and body fat percentages (LOW: 25.7% ± 5.0%; HIGH: 33.7% ± 6.3%; P = .007) but not different BSA (LOW: 1.72 ± 0.08 m2; HIGH: 1.70 ± 0.16 m2; P = .40) or body mass index (LOW: 23.1 ± 2.1; HIGH: 24.9 ± 4.7; P = .17). Despite differences in several physical characteristics, Trec cooling rates were excellent but comparable (LOW: 0.26°C/min ± 0.09°C/min; HIGH: 0.27°C/min ± 0.07°C/min; P = .39). The BSA:LBM ratio (r = 0.14, P = .59), BSA (r = −0.01, P = .97), body mass index (r = 0.37, P = .16), and body fat percentage (r = 0.29, P = .28), LBM (r = −0.10, P = .70) were not correlated with Trec cooling rates.

Conclusions

Body anthropometric characteristics did not affect CWI Trec cooling rates in women with hyperthermia. Therefore, clinicians need not worry that anthropometric characteristics might slow CWI treatment in women with severe hyperthermia.
Montreal Cognitive Assessment: Exploring the impact of demographic variables, internal consistency reliability and discriminant validity in a South African sample
Authors: Kirkbride Elisabeth , Ferreira-Correia Aline , Sibandze Mlinganisi
Published: March 2022

The Montreal Cognitive Assessment (MoCA) is widely used to screen for cognitive impairment and has shown a good capacity to identify cognitive impairment. However, its psychometric properties have not been sufficiently studied in the South African context. Therefore, this study aimed to investigate (1) the influence of demographic variables (age, years of education, and gender) on total MoCA scores; (2) the internal consistency reliability of the test and (3) the discriminant validity of the total MoCA score. This study analysed secondary quantitative data, utilising a cross-sectional, between-subjects design. All participants completed the English MoCA version 8.1. The control sample (n = 89) included healthy South African adults who speak English as a second or third language and who have been educated in public schools. The clinical sample (n = 83) included patients with human immunodeficiency virus (HIV) and a comorbid disorder, either psychiatric (n = 70) or neurocognitive (n = 13). Total MoCA scores were significantly correlated with years of education (p 0.001) and age (p = 0.007) but not gender. Cronbach’s alpha was 0.64 revealing moderate internal consistency. The total MoCA score was not a significant predictor of diagnostic status, indicating poor discriminant validity of the MoCA in this sample. The MoCA appears not to be a useful screening or diagnostic tool in samples with similar characteristics.
The short-term effects of energy drinks on near visual performance
Authors: Hansraj Rekha , Xulu-Kasaba Zamadonda N.Q. , Tini Anoyolo , Naidu Dinalia , Hassim Fathima , Osman Faruk , Mbatha Slindile , Mtemeri Nyika
Published: March 2022

Background: Energy drinks have gained popularity amongst young adults in recent years. Widespread effects of its main ingredient caffeine have been observed on the nervous system; however, little is known about the effects of these drinks on the visual system.Aim: This research study investigated the effects of a chosen energy drink on near vision and near contrast sensitivity.Setting: The data were collected at a university optometry clinic in south eastern South Africa.Methods: A single-blinded, crossover study was conducted on 56 healthy subjects aged 18–30 years. Subjects were randomised, such that they consumed either the energy drink reboost or water (control) on separate days. Near visual acuity was measured using a near Logarithm of the Minimum Angle of Resolution (LogMAR) chart and contrast sensitivity using the MARS contrast sensitivity test. Near visual acuity and contrast sensitivity measurements were taken at baseline and again at 30 min, 60 min and 90 min intervals, following consumption. Data were analysed using repeated measures analysis of variance (ANOVA) and univariate analysis.Results: Both near visual acuity and contrast sensitivity, post-energy drink consumption, showed a marginal increase over the testing period. Near visual acuity increased from –0.13 LogMAR at baseline to –0.17 LogMAR at 90 min. Contrast sensitivity increased from 1.77 log units at 30 min to 1.78 log units at 90 min similar to that observed with the control. In both cases; however, the changes were neither statistically (p  0.05) nor clinically significant.Conclusion: The energy drink reboost had no short-term effect on near vision performance as measured with near visual acuity and contrast sensitivity.
Journey less travelled: Female nursing students’ experiences in providing intimate care in two nursing education institutions in Gauteng province, South Africa
Authors: Shakwane Simangele
Published: March 2022

Background: Intimate care is not facilitated in South African nursing education and training. Nursing students encounter it for the first time in clinical practice, where they see and touch the naked bodies of patients. The societal segregation of gender roles has led to the feminisation of the nursing profession, suggesting that women are more caring and maternal and that intimate care implementation comes more easily to them than to their male counterparts.Aim: This study explored female nursing students’ experiences of intimate care for diverse patients.Setting: The study was conducted in two nursing education institutions in Gauteng province, South Africa.Methods: Descriptive phenomenology was used to describe the lived experiences of participants. Seventeen female nursing students were purposively sampled. Data were collected using semi-structured interviews and analysed using Moustakas’ (1994) eight steps.Results: Four themes emerged: intimate care comprehension, preparedness for providing intimate care, reactions in providing intimate care and coping mechanisms when providing intimate care to diverse patients.Conclusion: Intimate care forms a basis on which nursing students prioritise the physical needs of patients by providing care that exposes their bodies and requires touch. The students were taught to provide care with respect, maintaining patient autonomy and nursing professionalism. Unfortunately, age and gender barriers create feelings of discomfort and embarrassment. More needs to be done to support and empower nursing students in providing intimate care to diverse patients competently, confidently and comfortably.Contribution: Understanding the experiences of participants in providing intimate care to diverse patients will assist nurse educators in intimate care facilitation and support. The female nursing students will be empowered and trained to execute intimate care in a manner that is culturally, religiously and ethically acceptable.
Theological education and the COVID-19 pandemic in Sub-Saharan Africa: A Malawian perspective
Authors: Mawerenga Jones H. , Knoetze Johannes J.
Published: March 2022

The coronavirus disease 2019 (COVID-19) pandemic has brought a unique disruptive moment of unprecedented proportions in world history affecting all spheres of life. Theological education in Malawi, Sub-Saharan Africa, has not been spared in experiencing the effects of the COVID-19 pandemic. This study argues that the effectiveness of theological education in Africa contributes towards the future of Christianity on the continent, because it serves as a foundation for a vibrant missional church. Nevertheless, the COVID-19 pandemic has provided opportunities for creativity and innovation which could ensure the survival and sustainability of theological education in Africa. It is therefore crucial to critically reflect on how the provision of theological education in Malawi in particular, and in Sub-Saharan Africa, in general, can be sustained during the uncertain and challenging times when the COVID-19 pandemic is devastating the African continent and the entire world. This article investigated the challenges and opportunities for theological education in Malawi in view of the ongoing COVID-19 pandemic. In view of this, the following five objectives emerged: (1) to evaluate the Malawi government’s response to the COVID-19 pandemic; (2) to discuss the history and importance of theological education in Africa; (3) to examine the challenges of theological education in Malawi in view of the ongoing COVID-19 pandemic; and (4) to assess the prospects of theological education in Malawi in view of the ongoing COVID-19 pandemic. A qualitative research methodology was used, namely a literature review and interviews with members of the faculty of theological institutions in Malawi. Six main findings were established: First, the COVID-19 pandemic has presented both challenges and opportunities for theological education in Africa. Second, the effectiveness of theological education in Africa has contributed towards the future of Christianity on the continent. Third, the COVID-19 pandemic has challenged the dominant models of theological education in Africa. This entails a shift from face-to-face teaching to online teaching and learning. Fourth, the COVID-19 pandemic has provided opportunities for the sustainability of theological education in Africa. Fifth, theological education has encountered misleading theologies regarding the COVID-19 pandemic. Sixth, theological education has the opportunity of constructing life-giving theologies in Africa. This study has two implications: (1) navigating the changing terrain of theological education in Malawi; and (2) theological education’s employment of digital technologies during and post the COVID-19 pandemic.Contribution: This study has contributed to the discourse of theological education in Africa by providing solutions to the challenges posed by the COVID-19 pandemic.
Memoire of a momentous intellectual journey
Authors: Kruger P.P.
Published: March 2022

No abstract available.
A South African study on antecedents of intention to quit amongst employees in bed and breakfast establishments in the Free State province
Authors: Monyaki Lebohang , Chipunza Crispen , Mashavira Nhamo
Published: March 2022

Background: The continued growth in employment creation by small businesses in the hospitality sector necessitates research in organisational behaviour concepts such as turnover intentions that, for a long time, have been associated only with large organisations.Aim: This study investigated the impact of selected individual and organisational factors on turnover intentions amongst employees in bed and breakfast (BB) establishments in a district in the Free State province of South Africa.Setting: There is limited research within the South African context on antecedents of intention to quit amongst employees in BB establishments.Methods: The study was purely quantitative. An ex post facto design was adopted. One hundred and forty four (144) employees were chosen using convenience sampling. Data were collected using a structured questionnaire and data analysis was done by way of structural equation modelling (SEM).Results: Human resource practices, quality of work environment and organisational structure, all explained variance in intentions to quit. Human resource practices had a strong relationship with job satisfaction, and the quality of work environment was related to organisational commitment, while organisational structure explained employees’ job stress.Conclusion: The effectiveness of BB establishment owners’ interventions to reduce intentions to quit amongst employees is dependent on the implementation of excellent human resource management (HRM) practices and creating a conducive work environment that promotes employees’ long-term commitment to the business.
Decolonising medical causality in the COVID-19 pandemic
Authors: Visser Adele
Published: March 2022

The coronavirus disease 2019 (COVID-19) pandemic has irrevocably changed every aspect of social, medical and economic life globally. Although our traditional Western consideration of the underlying causes have led to massive strides in prevention and control of spread, a wider more inclusive approach, including principles of African and non-Western causality may facilitate our ability to prevent future outbreaks. Decolonising our traditional thoughts on medical causality may compliment the practice of medicine and enrich our understanding of health.
Sustaining pastoral work and welfare in Zimbabwe: Case study of pastors in Masvingo urban
Authors: Tagwirei Kimion
Published: March 2022

A growing number of pastors in Zimbabwe are adversely affected by the economic crisis that has been caused by the lockdown measures imposed by the government to tackle the coronavirus disease 2019 (COVID-19) pandemic. Only some pastors who are financially supported by their churches and donors and others who have adopted tent-making ministry are getting through this difficult situation. There is very little study on the subject of economic sustainability of Zimbabwean pastors. The majority of the available literature is limited to a few denominations. This article applies ‘theonomic reciprocity’ theory, which integrates divine action and human participation for ecclesiastic sustainability. In this respect, tent-making was reviewed. In the context of economic volatility, this study examined the economic sustainability gap that needs to be bridged between pastoral ministry and welfare. The article discusses sustainability of congregational support for pastors and tent-making ministry in the Zimbabwean economic context. Very few pastors in Masvingo have embraced self-sustaining initiatives. Most of them are yet to integrate faith and business due to fear of diverting their attention from ministry. The study recommends pastors to consider contextually needful tent-making towards sustaining their work and welfare.Intradisciplinary and/or interdisciplinary implications: Exploring the economic sustainability of congregational support and consideration of tent-making is a contextually crucial research that features Pastoral Theology, Ecclesiology and Economics.
The ‘lived experiences’ of the love of God according to a prayer in the letter of Ephesians
Authors: Van der Merwe Dirk G.
Published: March 2022

The epistle to the Ephesians is regarded as a circular letter, yet it also contains two specific intercessory prayers (1:15–23; 3:14–21) in which the Trinity concept features persuasively. On the one side, this research tends to point out how the divine attribute of love relates to all three the divine persons in cooperation and how the trinity concept features in the prayer in Ephesians 3:14–21. On the other side, the article also aims to identify conceived spiritualities (lived experiences of the divine trinity) that the hearers (readers) could have perceived and experienced when hearing this prayer or even praying this prayer themselves. Methodologically, the ‘hermeneutic research approach’, as proposed and developed by Waaijman and Iser, has been deductively applied for the investigation in this research. Firstly, the dynamic and relational character of the trinitarian God is briefly discussed. Secondly, an exploration of the appearance and inclusion of trinitarianism in Ephesians has been conducted. Thirdly, the focus falls on trinitarian spirituality (the divine attribute of love) in Ephesians 3:14–21. Mechanisms proposed by Waaijman and Iser, which could foster spiritualities in the reading of texts, have been applied to Ephesians 3:14–21 to contribute towards a validation for a trinitarian spirituality of prayer.Intradisciplinary and/or interdisciplinary implications: This research challenges believers to experience divine presence in the reading of biblical texts, how the reader can become involved in the text. This spirituality will certainly prepare them to experience the divine involvement in their personal life every day. The magnificent methodology proposed by Waaijman has been applied to guide the believers in accomplishing this.
Intraoperative Chertsey Test, is it a Reliable Alternative to Computed Tomography Scan for Diagnosing Syndesmotic Injuries of the Ankle?
Authors: Sayyadi Shahram , Omidian Mohammad Mahdi , Pourmojarab Ali , Khodayi Abouzar , Baroutkoub Mojtaba , Salimi Sohrab , Rasi Alireza Manafi
Published: March 2022

Background:

The present study aims to evaluate the diagnostic exactitude of the intraoperative Chertsey test in tibiofibular syndesmotic injuries in patients with malleolar fractures, in comparison with a computed tomography (CT) scan.

Materials and Methods:

In this study, patients with malleolar fractures operated between 2018 and 2020 were examined. Thirty-nine patients were enrolled in the study. A three-dimensional preoperative CT scan was obtained. The opposite unfractured ankle was also scanned and considered as the control group. The Chertsey test was performed during the operation to assess the syndesmosis injury. Then, patients were partitioned into two distinct groups, considering the condition of their ankle, namely the Chertsey positive (unstable syndesmosis) group and the Chertsey negative (stable syndesmosis) group.

Results:

The outcomes of the present survey illustrated that the Chertsey test was positive in 16 patients (41.03%) and negative in 23 patients (59.07%). The median of all CT scan parameters (anterior tibiofibular distances (TFD), middle TFD, posterior TFD, and maximal TFD and volume) before surgery in the group of patients with a positive Chertsey test was significantly higher, measured against the unfractured control group (P < 0.001 for all parameters). Furthermore, a comparison of CT scan parameters and syndesmosis space volume before surgery between the two groups of patients with positive and negative Chertsey test results showed that the measurement of parameters in Chertsey-positive patients was significantly higher than the Chertsey-negative patients (P < 0.001).

Conclusion:

Chertsey test could be used to diagnose syndesmosis injuries in patients with malleolar fractures due to its high importance in the outcome of patients.
Evaluation of Cognitive and Psychomotor Functional Changes in Anesthesiology Residents after 12 hours of Continuous Work in Operation Theater
Authors: Prasad R. Varun , Gupta Suman Lata , Swaminathan Srinivasan
Published: March 2022

Background:

Prolonged working hours in operation theater may impair cognitive and psychomotor function.

Aims:

This study was done to evaluate the changes in cognitive and psychomotor changes in the anesthesia residents after 6 and 12 h of continuous work in operation theater.

Settings and Design:

Sixty anesthesia residents whose working hours were expected to be longer than 12 h were recruited for this prospective, observational study.

Methods:

The study consisted of a set of five tests used for assessing the cognitive and psychomotor functions. The tests were conducted for the participants at 0, 6, and 12 h of work and the total scores at the respective time period were noted. The tests were manual dexterity test using purdue peg board, finger tapping test, visual spatial capacity memory test, digit symbol substitution test (DSST), and frontal assessment battery.

Statistical Analysis:

The observations of the purdue peg board test, finger tapping test, and digit symbol substitution test at 0, 6, and 12 h were tested using the repeated measures analysis of variance and paired t-test. The observations of visual spatial capacity memory test and frontal assessment battery were tested using the Chi-square test.

Results:

In the purdue peg board test, there was significant reduction in the mean number of pins assembled by the participants over 12 h of work. There was a significant difference in the number of finger taps by the dominant hand between 0 and 12 h and also between 6 and 12 h. In the visual spatial memory test, there was no significant difference in the performance of the participants with incorrect response at 0 and 12 h of duration. There was a significant decrease in the number of correct response among the participants in the digit symbol substitution test at 0 and 12 h of work. There was no significant difference in the scores obtained in frontal assessment battery test which was used to assess the cognitive function.

Conclusion:

There was a significant reduction in the psychomotor functions of the anesthesiology residents after 12 continuous hours of work in the operation theater and there was no significant reduction in cognitive function observed during that period.
Effect of Injection Speed of Heavy Bupivacaine in Spinal Anesthesia on Quality of Block and Hemodynamic Changes
Authors: Jacob Ann Riya , Paul Jerry , Rajan Sunil , Ravindran Greeshma C. , Kumar Lakshmi
Published: March 2022

Background and Aims:

Spinal anesthesia is a technique widely used for gynecological, lower abdominal, pelvic and lower limb procedures. Even though it causes a profound nerve block, it is associated with profound hypotension.

Aims of the Study:

To assess the effect of the speed of injection of heavy bupivacaine on quality of block and hemodynamic changes in patients undergoing gynecological surgeries under spinal anesthesia.

Methods:

This was a prospective randomized study conducted on 40 patients. Group F patients were given 3.2 mL of 0.5% heavy bupivacaine intrathecally in 15 s and Group S patients were given the same drug over 60 s. The time to achieve T10 dermatomal block, maximum block height, block height at 5 min were recorded. Heart rate (HR), systolic, diastolic blood pressures, and mean arterial pressures (MAP) were also recorded at different time points.

Results:

HR, systolic BP, diastolic BP, and MAPs and mean block height at 5 min were comparable between the two groups at all time points. The time to achieve T10 dermatome block was significantly faster in Group F (1.85 ± 1.14 min) as compared to Group S (3.98 ± 1.58 min). Majority of patients in Group F (65%) had a maximum block up to T6 and those in Group S (45%) had a block upto T4. The usage of vasopressors was found to be significantly higher in Group F compared to Group S with P = 0.041.

Conclusion:

Using faster speed of injection of heavy bupivacaine during spinal anesthesia can lead to faster achievement of blockade but with significantly higher usage of vasopressors.
Clinical Profile of New-Onset Seizures in the Elderly
Authors: Malge Mahadev Hanmantappa , Nagaraja B. S. , Rajanna Avinash Hanbe
Published: March 2022

Aim:

The aim of the study is to determine the etiology of seizures in the elderly and types of seizure in elderly populations.

Materials and Methods:

This was a cross-sectional study carried out on patients of age more than 60 years with seizures and who satisfied inclusion and exclusion criteria, admitted in Bangalore Medical College and Research Institute (BMCRI) attached hospitals, Bengaluru, between November 2016 and October 2018. After obtaining ethical clearance and approval from the institutional ethics committee of BMCRI, written informed consent was taken from the patients. Detailed history was taken from all patients, and all patients underwent thorough clinical examination and investigations. The diagnostic probability was based on the clinical data obtained from the patient charts and the results of electroencephalography (EEG) and computed tomography (CT) scans. The etiology of seizures was determined on the basis of medical history, neurologic examination, EEG, and CT scans.

Results:

A total of 58 patients of new-onset seizure included in the study out of which 30 were male and 28 were female. Majority of the patients were aged between 60 and 70 years. Male-to-female ration was almost equal. GTCS was the major type of seizure. Cerebrovascular infarct was the most common etiology. Diabetes and hypertension (HTN) were the most common comorbid conditions.

Conclusion:

Seizure was the dominant manifestation of various underlying disorders in the elderly, of which cerebrovascular disease was the most common cause, followed by metabolic cause. Comorbidities such as diabetes and HTN also had an important role in seizure activity. GTCS was the most common type of seizure in the elderly.
Ambulatory blood pressure monitoring and its utility in management of hypertension in a clinic setting in South India
Authors: Hegde Subhashchandra B , Aroor Shivaramakrishna , Anupama Yedabettu Janardhana , Hegde Shrikanth N.
Published: March 2022

Introduction:

High blood pressure (BP) is an important risk factor for cardiovascular diseases. The association of short-term BP variability (BPV) with target organ damage (TOD) is not clearly established. We conducted this observational study to evaluate the degree of concordance between Office BP measurements (OBPM) and ambulatory BP monitoring (ABPM) and to study the association of ABPM parameters on TOD.

Materials and Methods:

Patients attending clinics of the authors between January 2018 and August 2019 were enrolled. Their BP status was determined by OBPM and ABPM and the degree of concordance analyzed. ABPM parameters between those with TOD and without TOD were compared using appropriate statistical measures.

Results:

Data from 968 subjects (males 61.5%, mean age 59.39 ± 14.86 years) were analyzed. Masked hypertension (HTN) and white coat HTN were seen in 138 (14.3%) and 50 (5.2%) participants, respectively. There was moderate concordance between ABPM and OBPM readings (Cohen's κ =0.571, 95% confidence interval [CI]: 0.445, 0.595,P< 0.001). There were 530 (54.8%) nondippers and 189 (19.5%) reverse dippers. High morning surge (MS) was seen in 193 patients (19.9%) and TOD was seen in 378 patients (39%). Among all the ABPM parameters which were significantly associated with TOD on univariate analysis, only BPV (P = 0.04, odds ratio [OR]: 1.04, 95% CI: 1.00, 1.08) and systolic BP in active phase (P = 0.01, OR: 1.02, 95% CI: 1.00, 1.04) were found to be predictors of TOD after multiple logistic regression analysis. Dipping status and MS were not associated with TOD.

Conclusions:

ABPM is a useful tool for diagnosis and accurate categorization of HTN. The analysis of ABPM parameters helps to identify the patients with BPV which has important implications for the prevention of TOD. ABPM is recommended in all individuals with cardiometabolic risk profile or with established TOD even with normal office BP readings.
Fine-Needle Aspiration Cytopathology Correlation Study of Thyroid Nodule with the Postoperative Histopathological Reporting in a Rural Medical Setup
Authors: Vargis Rufus K. Sam , Peechatt Tony Joe , Raghuveer C. R. , Sharada M. S. , Chacko Arun Mathew , Vijayan Arya
Published: March 2022

Background:

Fine-needle aspiration cytology (FNAC) is the examination of cells that are obtained through a fine needle under vacuum. Due to the superior diagnostic reliability and cost-effectiveness of FNAC, American thyroid association had setup some guidelines stating that FNAC must be used as a diagnostic test initially before the ultrasonography and thyroid scintigraphy. This present study was undertaken to categorize and correlate all the thyroid FNAC samples according to the Bethesda system and for assessing the efficacy of the Bethesda reporting system in the preoperative evaluation of thyroid lesions. The major aim of study is to identify the nodules which require surgery and those benign nodules that can be observed clinically, thereby reducing the overall rate of thyroidectomy among patients with benign disorders.

Materials and Methods:

The present prospective study was conducted among 428 patients with thyroid lesions at a tertiary care rural medical set up. All the specimens were fixed in 10% formalin, and detailed gross examination was done. 3–10 tissue bits were selected from representative areas and all the bits were processed and stained with H and E stain. Cytological diagnoses were correlated with histopathology and the efficacy of The Bethesda System for Reporting Thyroid Cytopathology for reporting FNAC was estimated.

Discussion:

Out of 428 patients with thyroid lesions, 96 cases of histopathological specimens were collected. The histopathology lesions were divided into benign nonneoplastic, benign neoplastic, and malignant to study the gender, age group affected with these lesions and to calculate the association of malignancy with gender and age. The result showed that diagnostic tests are not significantly different with respect to sensitivity. Hence, FNAC is a reliable test for histopathology in diagnosis of thyroid lesions. In the present study, although the malignancy rate was higher among males, no association of gender and malignancy was not significant (P > 0.05).

Conclusion:

The Bethesda standardized system for reporting cytopathology improved the communication between pathologists and clinician promoting an interlaboratory agreement.
Avascular Necrosis of Bilateral Femoral Head in a HIV Patient
Authors: Kamat Vivekanand R , Pastapur Murugesh , Biradar Sangram
Published: March 2022

Avascular necrosis (AVN) is due to ischemic death of the bone involving typically the femoral heads. Its incidence rate is higher in HIV-infected patients and is multifactorial. The factors such as dyslipidemia, alcohol use, steroid use, protease inhibitor in highly active anti-retroviral therapy (HAART) regimen and HIV infection itself increases the incidence of AVN. Here, we report the case of 52-year-old female with a history of pain in bilateral hip joint with no history of trauma. She was a known case of retroviral disease since 9 years and was on HAART. On examination, her vitals were stable, and she had restriction in both passive and active movements around bilateral hip joint, and they were painful. There was no obvious swelling, and other joints were normal. General and systemic examinations, including neurological and musculoskeletal, were normal. Laboratory parameters showed hematological renal and liver functions to be normal, but total cholesterol was 285 mg/dl and triglycerides were 231 mg/dl. Magnetic resonance imaging showed STIR hyperintense band sign corresponding to T1 hypointense rim suggestive of bilateral AVN of head of femur (FICAT and ARLET Classification Stage 1). The aim of this case report is to alert the clinicians involved in HIV care regarding AVN as a subtle yet frequent complication in a HIV-infected patient with known predisposing factors when presenting with acute spontaneous nontraumatic bilateral hip joint pain.
Low-dose (7.5 mg/kg) bevacizumab may be a viable option in recurrent ovarian cancer: A retrospective study
Authors: Demirkiran Aykut , Eryilmaz Melek Karakurt , Karaagac Mustafa , Araz Murat , Korkmaz Mustafa , Koçak Mehmet Zahid , Artac Mehmet
Published: March 2022

Objective:

Bevacizumab (BEV) is a humanized monoclonal antibody of vascular endothelial growth factor receptors and, as a result of clinical trials, was approved for the treatment of recurrent ovarian cancer (ROC). The aim of this study was to assess the clinical utility of BEV in patients with ROC in real-world practice beyond clinical trials.

Materials and Methods:

In this single-center retrospective cohort study, we evaluated the medical data of all patients with ROC who were treated with BEV between October 2013 and March 2020.

Results:

A total of 76 females were evaluated. Forty-nine (64.5%) patients were platinum sensitive and 27 (35.5%) patients were platinum resistant. BEV was used in combination with chemotherapy agents in all patients, and the most preferred combinations were gemcitabine/carboplatin (GC) (78.9%) and carboplatin/paclitaxel (14.5%). In all patients, the BEV dose was 7.5 mg/kg every 3 weeks. The median progression-free survival (PFS) was 11.1 months (95% confidence interval [CI]: 9.6–12.6), and the median overall survival (OS) was 22.3 months (95% CI: 17.5–27.2). In multivariate analysis, serous histological type (P = 0.01), maintenance BEV administration (P = 0.001), and combination of GC-BEV (P < 0.001) were associated with better PFS, while serous histological type (P = 0.016) and good performance status (P = 0.006) were associated with prolonged OS.

Conclusions:

Low-dose (7.5 mg/kg) BEV was found to be effective in the second-line treatment of patients with ROC in our real-life study. In addition, the combination of BEV with GC was shown to be a viable option, especially in the treatment selection of platinum-resistant patients.
The feasibility of thoracoscopic-guided intercostal nerve block during uniportal video-assisted thoracoscopic lobectomy of the lung
Authors: Kang Do Kyun , Kang Min Kyun , Woon Heo , Hwang Youn-Ho
Published: March 2022

Background:

Uniportal thoracoscopic surgery has become widely accepted for its favourable outcomes with regard to pain. However, post-operative pain is still a concern associated with thoracic surgery. The objective of this study was to evaluate the post-operative pain of patients undergoing uniportal video-assisted thoracoscopic surgery (VATS) lobectomies using an intra-operative intercostal nerve block.

Methods:

All consecutive patients undergoing uniportal VATS lobectomies between October 2018 and October 2019 were reviewed retrospectively. Twenty consecutive patients in Group A underwent uniportal VATS lobectomies without intra-operative intercostal nerve blocks. The other 20 consecutive patients in Group B underwent uniportal VATS lobectomies with intra-operative intercostal nerve blocks. Numeric Pain Rating Scale (NRS) scores were recorded at 1, 12 and 24 h postoperatively. The number of anti-inflammatory drugs (non-steroidal anti-inflammatory drug [NSAIDs]) consumed until the time of chest tube removal was also recorded.

Results:

There was no difference between the groups with regard to sex, age, chest tube duration, length of stay, operative time or laterality. There was a significant difference in post-operative NRS scores at 1 h (P < 0.001) and 12 h (P = 0.014) between the groups. The NSAID consumption was significantly lower in Group B than in Group A (P = 0.038).

Conclusion:

Intra-operative intercostal nerve blocks with bupivacaine provided immediate post-operative pain relief and reduced post-operative opioid consumption in patients who underwent uniportal VATS lobectomies.
Health Profile and Nutritional Status of Rural Primary School Children in Western Maharashtra. Is School Absenteeism Associated with Undernutrition?
Authors: Singh Basant , Kansara Nikunj Kumar , Bansal Ankur , Teli Prabhakar , Yadav Arun Kumar
Published: March 2022

Background: Healthy adulthood thrives on the foundation of a healthy childhood. Earlier studies show different morbidity patterns and prevalence of under-nutrition in children studying in Government primary schools. The present study was undertaken to explore the morbidity pattern and nutritional status of children studying in a government primary school in the field practice area of Rural Health Training Centre of a medical college in Pune, Western Maharashtra.

Methodology:

A cross-sectional study was done in a Government Primary School during January–February 2019. A total of 134 school children studying in classes 1st to 7th underwent anthropometric measurements, medical examination, dental examination, and haemoglobin estimation to bring out the common morbidities present in children of school-going age. School records of the past 6 months of the academic year 2018–19 were used to know the prevalence of absenteeism among the subjects studied, and an attempt was made to find any association between absenteeism and under-nutrition among school children.

Results:

Out of 134 children, 26 (19.4%) were stunted, 51 (38.64%) were underweight, and 2 (1.49%) were found to be obese. Dental caries was found in 73 (54.48%) pupils, and it was the commonest morbidity found. Eighty-six (64.18%) of the examined school children were anemic. Thirty-five (26.12%) had ear problems, skin problems were found in 35 (26.12%), 6 (4.48%) had refractive errors, and 2 (1.49%) were having Tachycardia. An association was found between abesentism and underweight (P = 0.02).

Conclusions:

The present study found that under-nutrition is present among children studying in a rural Government school despite the mid-day meal programme being implemented in the school. Targeted interventions may be planned for undernourished children to improve their nutritional status, and more studies are required to assess their health needs and problems.
Effect of Suboccipital Release Technique in Forward Head Posture
Authors: Aggarwal Amita , Nair Ashwani , Palekar Tushar J. , Bhamare Dhammapal
Published: March 2022

Background:

Forward head posture is a postural malalignment. It can lead to increased neck pain and decreased neck mobility.

Objective:

The purpose of this study was to find added effect of suboccipital release technique with conventional treatment on neck pain, disability, mobility, and craniovertebral angle (CVA) in forward head population.

Materials and Methods:

Fifty subjects with forward head posture and neck pain were randomly allocated in two groups. Experimental group (Group A) was given myofascial release to suboccipital group of muscles along with conventional treatment and control group (Group B) received conventional treatment. Subjects received treatment three times a week, for 2 weeks. By the end of session, pre- and post-comparison was done for neck pain, disability, range of motion, and CVA.

Statistical Analysis:

Data were analyzed with Winpepe software and Primer software using Wilcoxon signed-rank sum test, Paired t-test, and Mann–Whitney rank sum test.

Results:

Statistical significance was found between and within the group with respect to pain, disability, and cervical range of motion (P < 0.05). CVA had shown significant results only for within the group.

Conclusion:

This study concluded that suboccipital release technique along with conventional treatment significantly improve neck pain, disability, and range of motion in forward head posture.
Geological, geochemical and fluid inclusion investigations on the Duna Pb-Ba-(Ag) deposit, Central Alborz, North Central Iran
Authors:   Department of Earth Sciences, Islamic Azad University, Science and research Branch, Tehran, Iran, Sadeghi Alireza , Nezafati Nima ,   Islamic Azad University, Department of Geology, Science and research branch, Tehran, Iran, Hakimi-Asiabar Saeid ,   Islamic Azad University, Lahijan branch, Department of Geology, Lahijan, Iran, Ganji Alireza ,   Islamic Azad University, Lahijan branch, Department of Geology, Lahijan, Iran
Published: March 2022

The Duna Pb-Ba-(Ag) mine is located ca. 155 km north of Tehran in the central Alborz structural zone, northern Iran. The ore mineralization occurs as stratabound, epigenetic, E-W and WSWENE trending veins and veinlets in fracture-controlled as well as massive and open-space filling textures within a Permian dolomitic limestone host rock. Field observations as well as mineralogical and petrographic studies show dolomitization, silicification and possibly haematisation in the host rock. In the mineralization zone, galena and barite are the main minerals, followed by pyrite, quartz, chalcopyrite, tetrahedrite, sphalerite, calcite and supergene minerals such as covellite, malachite, azurite, cerussite, anglesite, and Fe-oxides. The chemical analyses of the highgrade ore samples show an average grade of 18.66 wt. % for Pb, 19.99 wt. % for Ba, and 120 ppm for Ag together with substantial quantities of Zn (0.15 wt. %), As (690 ppm), Cu (0.86 wt. %), Sb (0.25 wt. %), and Sr (0.56 wt. %). The amount of silver in some samples from the tunnel and discordant layers is up to 7030 ppm. The positive Eu/Eu⃰ ratio and the weak negative Ce/Ce⃰ anomaly in the ore samples were most likely inherited from magmatic water. The presence of minerals such as pyrite and chalcopyrite together with the co-precipitation of sphalerite and chalcopyrite suggest a high-temperature for mineralizing fluids. The homogenization temperatures of fluid inclusions from barite in concordant layers span between 135 and 165 ºC with salinities between 18.54 and 23.65 wt. % NaCl equivalent, while the homogenization temperatures of fluid inclusions from barite of discordant layers span between 113 and 285 ºC with salinities between 7.34 and 23.65 wt. % NaCl equivalent. The structural, geological, geochemical, and mineralogical studies together with the paragenesis of the ore minerals and fluid inclusion data allow consideration of the Duna Pb-Ba-(Ag) mine as a two stage mineralization scenario; 1st stage /older/MVT-type (Early Cimmerian tectonic phase), and the second stage/younger/Irish-type (Laramide orogenic movements). The structural data, high temperature of the fluid inclusions, positive Eu/Eu⃰ ratio and high silver content, especially in the discordant layers, indicate the involvement of a magmatic water mixed with meteoric and connate fluids comparable to the Irishtype mineralization in the second stage, which formed along brecciated zones of the thrust faults. The second stage of mineralization was most likely influenced by the Akapol granitoid intrusive mass, which overprinted the 1st stage/older/MVT-type.