bluuebunny/crossref_metadata_2025 huggingface dataset:
Global profile of individuals undergoing total knee replacement through the PROGRESS-PLUS equity lens: Protocol for a systematic review
Authors: Coetzee Marisa , Clifford Amanda M. , Jordaan Jacobus D. , Louw Quinette A.
Published: April 2022

Background: Osteoarthritis (OA) is a heterogenous degenerative disorder often causing destructive joint changes with severe pain and functional disability. Modifiable and non-modifiable risk factors, social context and psychological factors influence the development and progression of the disease. Total knee replacement (TKR) aims at reducing pain and improving function and is more successful with pre-operative and post-operative rehabilitation. However, most international research on rehabilitation interventions is conducted in high income contexts.Objective: The aim of our systematic review is to gain an overview of the demographic and social profiles of adults undergoing TKR for primary knee OA in lower, middle- and high-income countries through a health equity lens to inform the translation of intervention research in local contexts.Methods: A systematic review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Eligibility criteria include observational studies and grey literature (theses) since the beginning of the databases reporting on demographic data of adults awaiting or undergoing TKR surgery. The PROGRESS-Plus framework will be used to describe equity elements.Results: A narrative summary and description of the global profile of individuals undergoing total knee replacement for osteoarthritis.Conclusion: A snapshot of the global demographic and social profile of individuals receiving TKR for primary knee OA through an equity lens will shed light on the similarities and differences between individuals from different contexts. Global demographic profile information may inform or assist in the development of translational strategies for evidence-based rehabilitation.Clinical implications: Translation of existing rehabilitation interventions to local contexts could improve pre-operative and post-operative outcomes for individuals on our surgical waiting lists.
Paediatric minor head injury applied to Paediatric Emergency Care Applied Research Network CT recommendations: An audit
Authors: Du Plessis Jacques , Gounden Sharadini K. , Lewis Carolyn
Published: April 2022

Background: Traumatic brain injury (TBI) is a common cause of paediatric morbidity and mortality, with higher TBI rates in low- and middle-income countries. Non-contrast brain CT is the gold standard for diagnosing intracranial injuries; however, it exposes patients to ionising radiation. The Paediatric Emergency Care Applied Research Network (PECARN) clinical decision rule (CDR) aids clinicians in their decision-making processes whilst deciding whether a patient at very low risk of a clinically important TBI (ciTBI) requires a CT scan.Objectives: To establish whether the introduction of the PECARN CDR would affect CT utilisation rates for paediatric patients presenting with minor blunt head injuries to an academic hospital in Gauteng, South Africa.Method: This was an audit of paediatric patients who presented with minor blunt head injuries and were referred for CT imaging at an academic hospital in Gauteng, compared with PECARN CDR recommendations, over a 1-year period.Results: A total of 100 patients were referred for CT imaging. Twenty patients were classified as very low risk, none of whom had any CT findings of a TBI or ciTBI (p  0.01). A total of 61 patients were classified as intermediate risk and 19 as high risk. In all, 23% of the intermediate and 47% of the high-risk patients had CT features of a TBI, whilst 8% and 37% had a ciTBI, respectively.Conclusion: Computed tomography brain imaging may be omitted in patients classified as very low risk without missing a clinically important TBI. Implementing the PECARN CDR in appropriate patients would reduce CT utilisation rates.
Primary giant cell tumour of the breast with recurrence: A rare case report
Authors: Suleman Farhana E. , Vilakazi Moipone N. , Bida Meshack , Edwards Richard
Published: April 2022

Giant cell tumour (GCT) arising from the soft tissues of the breast is a rare disease with only eight cases previously reported in the literature. We present a case of histologically proven GCT of the breast, which demonstrated recurrence a few months after resection.
African contextual hermeneutics
Authors: Chukwuka Ebele C.
Published: April 2022

Hermeneutics is the science of textual interpretation and comprises a wide range of disciplines, which helps to control subjective influences in the study of the Old Testament and Hebrew Scriptures. It is imperative to consider the context of any given text, as well as the context of the receiver in the interpretive process. This consideration, from the African point of view, is what may be referred to as African contextual hermeneutics. To see the effect different contexts have on the interpretation of an encountered text, using as an example 1 Chronicles 21, it was discovered that the changes in culture, religion, tradition, text and language affected the presentation of the new text, so much so that the writer made a lot of additions and subtractions from the original story in 2 Samuel 24. The diversity of the Old Testament texts requires that each text be studied within its historical framework. This also reflects the reality of life expressed by people in the African society. However, with hermeneutics in the Old Testament, the reader should be brave enough to throw off cultural ties and focus only on what matters. It requires reading the controversy and polemic in the text and not being influenced by it. What matters in any text is the relationship between God and humans, and this is what the interpreter should translate into the African context, not the culture or the controversy. There is a need for reassessment of the ancient biblical tradition and the African worldviews, cultures and life experiences, to correct the effect of the extraneous cultural and ideological conditioning. African biblical hermeneutics can be understood as the rereading of the Old Testament from a premeditatedly African perspective. African biblical hermeneutics is the principle of interpretation of the Bible that could lead to transformation in Africa. Africa’s religious practice is mostly polytheistic. In the African religion, there are new allegories, images, figures of speech, ways of reasoning, etymologies, analogies and cosmogonies to gratify the intellect.Intradisciplinary and/or interdisciplinary implications: The African contextual ideas of mysticism, tradition and initiation advance new theological inductions, astrophysical tales and ways to hypothesise moral behaviour. Nevertheless, the ideologically motivated text of 1 Chronicles 21 can still be relevant for Africa today if the following options can be taken into consideration. Israel was a confused nation, seeking identity after the exile. An author like the Chronicler wanted to give them direction by telling them that they can find identity in their relationship with God. This can be translated into the African context as a relationship with God. This means that people who are feeling confused about their circumstances and identity today can find certainty in their relationship with God, regardless of how and where they worship.
The absence of urinary diversion in radical cystectomy avoids early complications in hemodialysis patients
Authors: Yang Yun-Ta , Liu Jui-Ming , Lin Cheng-Feng , Liu Kuan-Lin , Lin Cheng-Chia , Wu Chun-Te
Published: April 2022

Background:

Patients with end-stage renal disease who receive dialysis are considered a high-risk group for perioperative complications following anesthesia and surgery. However, for patients with anuria who will undergo radical cystectomy (RC), a urinary diversion is unnecessary. This study aimed to identify a safe surgical strategy by comparing oncologic outcomes and early complication rates in dialysis and nondialysis patients after RC.

Materials and Methods:

This study included 85 patients with primary urothelial cell carcinoma of the bladder who underwent RC at the Chang Gung Memorial Hospital, Keelung, Taiwan. Twenty-eight of these patients underwent regular hemodialysis. Overall survival and recurrence-free survival were compared to evaluate the oncologic outcomes. Complications at 3 months were graded using the Clavien–Dindo classification.

Results:

The overall survival and recurrence-free survival differences between dialysis and nondialysis patients were not significant (P = 0.686; P = 0.528). The degree of muscle-invasive disease was an independent factor affecting overall survival. The overall complication rates in the dialysis and nondialysis groups were 36% and 84%, respectively (P < 0.001). The major complication (Grades III–V) was 16% in the dialysis group and 28% in the nondialysis group (P = 0.241). The most common early complications were urinary tract infection and bowel kinetics change, and both were significantly lower in the dialysis group. A lower re-admission rate was also observed in the dialysis group.

Conclusion:

Lower rates of early complications and acceptable survival outcomes were observed in dialysis patients. Surgery can be conducted more aggressively, with confidence in suitable cases.
Pelvic splenosis in a patient with a 20-year history of splenectomy
Authors: Huang Wei-Lun , Chu Chun-Ting
Published: April 2022

Pelvic splenosis, also called ectopic pelvic spleen, is a rarely reported clinical condition. Pelvic splenosis refers to autotransplantation of splenic tissue resulting from seeding into the pelvic space that typically occurs after trauma. This report presents the case of a 39-year-old male with a rectal lesion. After a laparoscopic low anterior resection of rectosigmoid colon with colorectal anastomosis, the lesion was resected and diagnosed as an ectopic pelvic spleen. Pelvic splenosis requires no treatment in most cases. Surgery is considered only if it is accompanied with acute complications. When the diagnosis remains unclear, further biopsy or laparoscopy is recommended. If pelvic splenosis is confirmed, careful follow-up is beneficial. Finally, pelvic splenosis should be considered in the differential diagnosis of pelvic masses in patients with a history of splenectomy.
Hypertensive Phenotypes and Pattern of Ambulatory Blood Pressure in Patients of Diabetes Mellitus of Kashmir Valley
Authors: Bhat Tariq A. , Mir Mohammad R. , Naqati Shaariq , Naik Muzafar , Naqash Mubarik
Published: April 2022

Background:

Patients of diabetes mellitus (DM) with hypertension (HTN) have a fourfold increased risk of cardiovascular disease (CVD) as compared to normotensive nondiabetic controls. However, many patients of DM who are normotensive or have controlled blood pressure on office BP measurement (OBPM) may assume that they do not have increased risk of CVD but may be having HTN or uncontrolled blood pressure on ambulatory blood pressure monitoring (ABPM).

Study Design Objective:

A cross-sectional observational study to compare OBPM with ABPM and thus predict various hypertensive phenotypes like masked hypertension (MH) and white coat hypertension and pattern of blood pressure in diabetic patients of our population.

Materials and Methods:

Two hundred patients of DM with or without HTN were included in this study. The cases were subjected to detailed history, clinical examination, OBPM, and ABPM.

Results:

Out of 200 patients of DM, 32 were normotensives, 46 were hypertensives controlled on antihypertensive treatment, 22 were hypertensives not on anti-hypertensive treatment, and 100 were hypertensives uncontrolled on anti-hypertensive treatment. Among 32 normotensive diabetics, 17 (53%) patients hadMHon ABPM. Out of these 32 normotensive patients, 7 (21.8%) hadisolated nocturnal hypertension, 3 (9.3%) hadisolated day-time HTN (IDH)and 7 (21.8%) hadday-time and nocturnal HTN (DNH). Patients with MH had higher BMI, an observation that was statistically significant. Non-dipping pattern was found in 53% of patients of masked HTN. Out of 46 hypertensive diabetics with controlled OBPM on antihypertensive treatment, 26 (56.5%) hadmasked effect or masked uncontrolled hypertensionon ABPM. Out of 22 diabetics with treatment naïve HTN, 7 (32%) were found to havewhite coat hypertensionon ABPM. Fifteen (15%) patients out of 100 hypertensive diabetics with uncontrolled OBPM despite on anti-hypertensive were found to havewhite coat effecton ABPM. Patients with white coat effect had higher body mass index an observation that was statistically significant (p = 0.039). Non-dipping pattern was significantly associated with longer duration of diabetes (≥ 120 months), retinopathy and neuropathy.

Conclusion:

To rely exclusively on OBPM to diagnose HTN and monitor blood pressure may underestimate the CVD risk especially in diabetics. ABPM is a tool that may not only help clinicians in starting anti-HTN treatment perspicuously, but also may help in avoiding unnecessary anti-hypertensive treatment and/or withdrawing anti-hypertensive treatment as indicated and thus avoiding credulity.
Adrenal Incidentaloma Needs thorough Biochemical Evaluation – An Institutional Experience
Authors: Shah Akash N. , Saikia Uma K. , Chaudhary Bipul K. , Bhuyan Ashok K.
Published: April 2022

Context:

Adrenal incidentalomas (AIs) are seen in around 2% of apparently healthy individuals. These require careful evaluation for the hormone excess state and the presence of malignancy prior to intervention.

Aims:

To study the clinical, biochemical, and imaging characteristics of the patients with AI and correlate the diagnosis with the histopathology findings in patients undergoing surgery.

Settings and Design:

Retrospective observational study.

Methods and Material:

Patients with adrenal incidentaloma presenting between January 2017 and January 2021 were evaluated as per guidelines provided by the European Society of Endocrinology and the European Network for the Study of Adrenal Tumors. Patients were given final diagnosis on the basis of imaging impression, hormonal activity, and biopsy results (when applicable).

Results:

Forty-eight patients were evaluated, with 25 being male, the mean age being 40.9 years (8–71), and the mean size of the mass being 6.21 (1.4–13.7) cm. Thirty-five (72.9%) of them underwent surgical excision. The most common diagnosis was myelolipoma (16), followed by pheochromocytoma (10) and adenoma (9). Nineteen patients were found to have hormone-secreting masses. Two patients with pheochromocytoma were normotensive. There was discordance between imaging diagnosis and hormonal status in two patients, with final diagnosis of pheochromocytoma. One patient with extramedullary erythropoiesis of the adrenal gland was subsequently diagnosed with sickle cell anemia and adrenal insufficiency.

Conclusions:

The study highlights the rare possibility of discrepancy between non-contrast CT diagnosis and functional status of AI. There is also a rare possibility of extramedullary erythropoiesis presenting as AI with adrenal insufficiency. Specific evaluation for such rare possibilities should be considered in AI cases as per clinical scenario.
Medullary Thyroid Cancer: An Experience from a Tertiary Care Hospital of a Developing Country
Authors: Khan Sajjad A. , Aziz Abdul , Esbhani Umer A. , Masood Muhammad Q.
Published: April 2022

Background:

Medullary thyroid carcinoma (MTC) is a rare type of thyroid cancer that occasionally occurs as part of MEN2A. The universal treatment of MTC is total thyroidectomy with central lymph node dissection. For disease progression, carcinoembryonic antigen (CEA) and calcitonin (CTN) need to be followed. Our aim was to study the presence and patterns of the above-mentioned characteristics of MTC in our population.

Methodology:

This retrospective study was conducted in a tertiary care hospital of Pakistan in which data of thirty-two medullary thyroid cancer patients over the past 20 years were reviewed and analysed after fulfilment of inclusion criteria. Their clinical, pathological, biochemical and treatment modalities were recorded through a retrospective review of their medical record files.

Results:

The mean age of patients was 42.88 ± 2.67 years in our study, with a male-to-female ratio of 2:1. Patients with sporadic MTC were 68.8%, while 31.2% were familial. The rates of metastasis were highest in bones followed by lungs and liver. Total thyroidectomy was performed in 26 (81.2%) patients and among those chemotherapy and XRT were performed in one and two patients, respectively. Histologically, the mean tumour size was 7.62 ± 3.64 cm. Median pre-surgery calcitonin was 5756 pg/ml that decreased to 29.3 pg/ml post-surgery. Median pre-surgery CEA level was 246.5 ng/ml that decreased to 6.39 ng/ml post-surgery. Two patients were RET positive.

Conclusion:

MTC usually presents in the fourth decade of life with male predominance and mostly sporadic occurrence. Total thyroidectomy with subsequent serial calcitonin and CEA levels thereafter are the mainstay of treatment and follow-up.
Ultrasonographic Evaluation of Painful Joints in Rheumatoid Arthritis
Authors: Sultana Sadaf , Ahmad Mehtab , Ahmad Ibne , Usmani Hammad , Arif Mohammad
Published: April 2022

Context:

High-frequency ultrasound (US) of painful rheumatoid joints allows an increasingly refined analysis of the extent of joint involvement and disease activity.

Aims:

The aim of this study was to establish the role of the US in the evaluation of painful hand joints in patients with rheumatoid arthritis (RA) and its comparison with Conventional Radiography (CR) changes.

Settings and Design:

Cross-sectional study.

Subjects and Methods:

Patients diagnosed with RA were assessed by a thorough clinical examination and relevant laboratory investigations. After X-ray imaging, grayscale, and power Doppler US examination of the wrist, metacarpophalangeal, and proximal interphalangeal joints of both hands were performed using a high-frequency linear transducer.

Statistical Analysis Used:

SPSS version 20.0 (a statistical package for the social sciences) was used to collect, tabulate, and analyze all data. The results were presented as mean standard deviation or percentage. Differences in categorical data were compared using the Chi-square test and Fisher's exact test. A P < 0.05 was considered statistically significant.

Results:

Thirty-two of the 51 individuals studied had radiographic abnormalities, whereas 44 had abnormal findings in the US. The US can detect erosions in 37 patients, including all 15 of those who had radiographically visible erosions. A statistically significant difference was noted between the findings of radiography compared with US findings (P < 0.001).

Conclusions:

US is more sensitive than CR for the detection of erosion and can complement the CR in the evaluation of these patients.
Exploring the Efficacy of Ultrasound-Guided Lumbar Erector Spinae Plane Block for Perioperative Analgesia in Percutaneous Nephrolithotomy
Authors: Dey Samarjit , Mujahid Omer Mohammed , Nagalikar Suresh , Arora Prateek
Published: April 2022

Erector spinae plane block (ESPB) is used to a great extent for perioperative analgesia. The ease of administering it, safety and the perioperative analgesia achieved make it a good addition to anesthetic plans. The reduction in opioid usage with the usage of regional analgesia techniques may aid in enhanced recovery; in addition, regional analgesia with this block provides excellent analgesia and better postoperative outcome as seen here in two cases who underwent percutaneous nephrolithotomy (PCNL). Single-shot ESPB was performed in two cases undergoing PCNL. We achieved stable hemodynamics throughout the procedure and a mean NRS of 1.8 for a duration of 18 h postsurgery in both cases, with faster mobilization and early discharge of the patients.
Intraoperative Ultrasound-Guided Serratus Anterior Plane Catheter for Postoperative Analgesia after Breast Surgery in a Morbidly Obese Patient
Authors: John Annie Sheeba , Sivashanmugam T. , Nahar Afreen , Paul John
Published: April 2022

Inter-fascial plane blocks play a great role as part of the multimodal analgesic regimen for breast surgery. Fascial plane blocks are effective for immediate analgesia, but their use for prolonged postoperative analgesia is not yet explored. We present a hybrid technique of successful placement of intraoperative ultrasound-guided deep serratus anterior plane (SAP) catheter for continuous postoperative analgesia in a morbidly obese patient undergoing breast surgery. A sexagenarian morbidly obese female patient with left carcinoma breast was posted for modified radical mastectomy. The deep serratus anterior fascial plane was more than 9 cms deep and was poorly visualized. Hence, intraoperative catheter was placed under ultrasound guidance and used effectively for 5 days. The static and dynamic pain scores were <4 at all-time points with local anesthetics and nonopioid systemic analgesics. We observed that intraoperative ultrasound-guided SAP catheter can be effectively used for continuous postoperative analgesia in morbidly obese patients undergoing breast surgery.
Utility of Ultrasound-Guided Erector Spinae Plane Block in Patients Presenting to the Emergency Department with Rib Fractures
Authors: Srinivasarangan Madhu , Prasad Shetty Bellipady Shyam , Patil Akkamahadevi , Sivasankar Abhijith
Published: April 2022

Context:

Alleviating significant pain and enhancing lung function in patients with multiple rib fractures presents a formidable challenge to all emergency physicians (EPs). Conventional pharmacological measures and traditional thoracic regional analgesia techniques are not always feasible or safe in the emergency department (ED). Therefore, an effective, feasible, and safe method for providing analgesia in such patients will be extremely advantageous to all patients and EPs alike. Here, we describe the utility of a regional block technique that can be applied in patients suffering from multiple rib fractures in the ED.

Aims:

The aims of this study were as follows: (1) to determine the effectiveness of an ultrasound-guided erector spinae plane block (ESPB) in ameliorating pain and improving lung function in patients presenting to the ED with multiple rib fractures and (2) to assess the safety and the feasibility of the ESPB in the ED.

Setting and Design:

This was a retrospective observational clinical study conducted in the ED of a tertiary care hospital over a period of 12 months.

Subjects and Methods:

Data regarding all patients with rib fractures who had undergone an ESPB in the ED were extracted from the ED procedure register, and the inpatient case sheets were obtained from the medical records department for review and analysis. The data included, but were not limited to, the Numerical Rating Scale (NRS) for pain and respiratory parameters, i.e., respiratory rate and peak expiratory flow rate (PEFR) at 30 min post procedure and subsequently after every top-up dose up to a period of 48 h.

Statistical Analysis:

Descriptive statistics such as mean, standard deviation, frequency, and percentage were used. Inferential statistics such as repeated-measures ANOVA were done using SPSS software version 22 (IBM).

Results:

The mean NRS was significantly reduced by >50% at 30 min and by 72% over a 48-h period (P < 0.001). Meaningful improvements in the respiratory parameters were also observed during the same period with significant increments in the PEFR values (49% increase [P < 0.001]) as well as a decrease of 36% in the respiratory rate (P < 0.001). The mean time for performing the procedure was 16.27 min, and no adverse events were observed as a consequence of the block.

Conclusion:

The study demonstrates the efficacy of USG-guided ESPB in ameliorating pain as well as improving lung function for multiple rib fracture patients. This procedure can be performed in a short time making it suitable for application in the ED. No adverse events as a consequence of the ESPB were noted.
Increased skin reactions with hydroxychloroquine during breast radiotherapy
Authors: Yıldırım Halil Cumhur , Şahin Merve , Engin Burhan , Öksüz Didem Çolpan
Published: April 2022

With the advances in radiation technology, skin reaction due to postoperative radiotherapy (RT) in breast cancer patients is generally mild and tolerable. However, certain drugs may increase the radiation effect. In literature, only few cases of adverse reactions in the radiation field have been reported with the use of Chloroquine. This report describes the case of a 30-year-old young female who had enhanced skin reactions with hydroxychloroquine (HCQ) treatment during breast RT. HCQ should be used with caution in patients undergoing RT due to its potential radiosensitizer effect.
Primary pulmonary T-cell lymphoma
Authors: Vemuri Mahesh Babu , Rajaram Manju , Malik Archana , Toi Pampa CH
Published: April 2022

Primary pulmonary lymphoma (PPL) is a rare clonal proliferation of lymphoid tissue involving one or both lungs. It is of two types, B-cell and T-cell lymphomas among which T-cell lymphoma is a rare entity and it is sparsely considered as a differential diagnosis in neoplastic lesions of the lung. Here, we are reporting a case of primary pulmonary T-cell lymphoma. PPL is a rare disease and can present with nonspecific symptoms. Radiologically, it can easily be confused with more common malignancies such as bronchogenic carcinoma with or without metastases. PPL carries different therapeutic and prognostic implications. Therefore, physicians should make every effort to achieve histopathological diagnosis before prognosticating a patient presenting with lung cancer.
Role of rapid arc-image-guided radiotherapy in hepatocellular carcinoma with portal vein tumor thrombosis: A study from tertiary care center in Punjab, India
Authors: Sidhu Manjinder Singh , Ramandeep  , Sood Sandhya , Aggarwal Ritu , Singh Kulbir , Sood Divyanshi
Published: April 2022

Background and Objectives:

Treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is very challenging with poor outcome. In this situation, radiotherapy has become an alternative treatment modality, more precisely due to advances in radiation techniques. The goal of our study is to do analysis of these patients treated with rapid arc image-guided technology (RA-IGRT) at our institution.

Materials and Methods:

Thirteen patients were included in the study. As per intuition policy, patient set up, contouring, and treatment plans were generated. Radiological response assessment was done 1-month post-radiotherapy. Survival analysis curve along with Chi-square test for prognostic factors assessment was done using SPSS.

Results:

With median dose of 45 Gy in 20 fractions, we were able to achieve 27.3% objective response rate with median survival of 5 months in eligible patients.

Conclusions:

One-year overall survival up to 30% can be achieved in HCC with PVTT, especially in patients with objective response to radiotherapy with Japan Integrated Staging score 2, provided it is precisely hit by RA-IGRT.
Subjective and perceptive assessment of speech/voice and swallowing function before and after radiation therapy in patients of head-and-neck squamous cell cancer
Authors: Aggarwal Vasundhara V. , Waghmare Chaitali Manohar , Lolage Saroj N. , Pawar Hemant J. , Ravichandran Meenakshi , Bhanu Arya
Published: April 2022

Aim:

To prospectively assess subjective and perceptive speech/voice and swallowing function before and after radiation therapy (RT) in patients of head-and-neck squamous cell cancer (HNSCC).

Materials and Methods:

The study cohort comprised eligible consecutive HNSCC patients planned for curative RT from April 2018 to July 2018 who consented for the study. Prospective evaluation of speech/voice and swallowing function was done before and after RT. For subjective and perceptive evaluation of speech/voice, speech handicap index (SHI) and Grade, Roughness, Asthenia, Breathiness, and Strain (GRABS) Scale was used, respectively. For subjective and perceptive evaluation of swallowing, M D Anderson Dysphagia Inventory (MDADI) and Performance Status Scale for head and neck (PSSHN) were used, respectively. All patients were taught speech/voice and swallowing exercises before RT. Statistical analysis was performed using SYSTAT version-12 (Cranes software, Bengaluru).

Results:

The study cohort comprised 30 patients of HNSCC with a median age of 57 years and male-to-female ratio of 4:1. The most common subsite was the oral cavity (43.33%) and a majority (76.66%) presented in the locally advanced stage. Post-RT there was significant improvement in speech/voice function (SHI P = 0.0006, GRABS score P = 0.003). Perceptive assessment of swallowing function by PSSHN showed significant improvement (P = 0.0032), but subjective assessment by MDADI showed no significant (P = 0.394) improvement until the first follow-up.

Conclusion:

Speech/voice function improved significantly after radiotherapy when combined with rehabilitation exercises. Swallowing function did not improve till the first follow-up. Future studies with the large number of patients and long-term follow-up are needed to document the changes in organ function.
Efficacy and safety of hydroxychloroquine for managing glycemia in type-2 diabetes: A systematic review and meta-analysis
Authors: Dutta D , Jindal R , Mehta D , Kumar M , Sharma M
Published: April 2022

Aims:

No Cochrane meta-analysis with grading of evidence is available on use of hydroxychloroquine (HCQ) in type-2 diabetes (T2DM). This meta-analysis evaluated the efficacy and safety of HCQ in T2DM.

Methods:

Electronic databases were searched using a Boolean search strategy: ((hydroxychloroquine) OR (chloroquine*)) AND ((diabetes) OR (“diabetes mellitus”) OR (glycemia) OR (glucose) OR (insulin)) for studies evaluating hydroxychloroquine for glycemic control in T2DM. The primary outcome was a change in glycated haemoglobin (HbA1c). The secondary outcomes were changes in other glycemic/lipid parameters and adverse effects.

Results:

Data from 11 randomized controlled trials (RCTs) (3 having placebo as controls [passive controls] and 8 having anti-diabetes medications as controls [active controls]) involving 2,723 patients having a median follow-up of 24 weeks were analyzed. About 54.54% of the RCTs were of poor quality as evaluated by the Jadad scale. The performance bias and detection bias were at high risk in 63.64% of the RCTs. The HbA1c reduction with HCQ was marginally better compared to the active (mean differences [MD]-0.17% [95%, CI:-0.30–-0.04;P=0.009;I
2=89%; very low certainty of evidence, VLCE]), and passive (MD-1.35% [95%CI:-2.10–-0.59;P=0.005;I
2=74%]) controls. A reduction in fasting glucose (MD-16.63mg/dL[95%, CI: -25.99 – -7.28mg/dL;P<0.001;I
2=97%;VLCE]) and post-prandial glucose [MD -8.41mg/dL (95%CI: -14.71 – -2.12mg/dL;P=0.009;I
2=87%;VLCE]), appeared better with HCQ compared to active controls. The total adverse events (risk ratio [RR]0.93 [95% CI:0.68–1.28]; P=0.65;I
2=66%) were not different with HCQ compared to the controls.

Conclusion:

The routine use of HCQ in T2DM cannot be recommended based on the current evidence.
Utility of CD200 Expression by Flow Cytometry in Lymphoproliferative Disorders and Plasma Cell Dyscrasias
Authors: Divya Pavuluri , Vangala Navatha , Uppin Megha S. , Uppin Shantveer G. , Gundeti Sadashivudu , Bacchu Srinivas , Radhika K. K. , Parvathi A , Paul Tara Roshni
Published: April 2022

ABSTRACT

Background:

The cluster of differentiation 200 (CD200) is a recently introduced marker, used to differentiate various lymphoproliferative disorders (LPDs) and is a potential target for chemotherapy.

Objective:

The objective is to study the utility of CD200 expression by flow cytometry (FC) in various LPDs and plasma cell disorders.

Materials and Methods:

This is a retrospective study done over a period of 2 years. The study group included 52 cases with a clinical suspicion of LPD (n = 40) or plasma cell disorder (n = 12). Clinical data, morphological data on peripheral blood, and/or bone marrow examination were analyzed and correlated with the final results on FC.

Results:

Out of 40 LPDs, chronic lymphocytic leukemia (CLL) accounted for a majority of the cases accounting for 57.5% (23 cases). Plasma cell myelomas (PCM) were the most common plasma cell disorders accounting for 75% (nine cases). All cases of CLL showed CD200 expression and the two cases of mantle cell lymphoma (MCL) were CD200 negative. Splenic marginal zone lymphomas (MZL) involving marrow showed dim CD200 expression. Bright CD200 expression was also observed in all cases of hairy cell leukemia (HCL) and 67% of cases diagnosed as PCM.

Conclusion:

CD200 is a very useful marker in the diagnosis of various LPDs especially CLL, HCL, and PCMs. It can be used as an additional marker particularly in distinguishing CLL/small lymphocytic lymphoma (SLL) from MCL and atypical CLL from other CD5+ B-cell neoplasms and extranodal MZL.
Impacto da ocorrência de árvores ocas no rendimento da colheita de madeira na Floresta Nacional de Saracá-Taquera, Pará
Authors: Almeida Vivian Barroso , Silva José Natalino Macedo , Steinbrenner Maximilian Klemens Albert
Published: April 2022

No manejo de florestas tropicais, a ocorrência de ocos nos troncos e seu impacto sobre a produção volumétrica têm sido pouco abordados na literatura científica nacional. Esta questão é tratada no presente trabalho, por meio de um estudo de caso em uma unidade de produção anual (UPA) localizada na Floresta Nacional de Saracá Taquera, PA. Foram selecionadas, para a colheita, 3.190 árvores de 25 espécies comerciais, perfazendo um volume de 24.020 m³. Destas, foram extraídas 3.079 árvores, das quais 1.227 (39,8%) eram árvores que substituíram as que foram encontradas ocas. Durante a derrubada, 1.175 árvores (36,4%) estavam ocas. De um modo geral, foram verificados 53,5% de árvores ocas na UPA, representando, aproximadamente, duas árvores ocas por hectare manejado. Os resultados revelaram que, apesar desse número muito expressivo de árvores com esse defeito, o rendimento volumétrico (80,7%) da colheita não foi afetado de maneira significativa, devido à possibilidade de substituir as árvores ocas por outras sãs, por ocasião da derrubada. Como mais da metade das árvores selecionadas para o corte estavam ocas, a substituição garante a viabilidade econômica da exploração atual de projetos de manejo florestal.
AN EXPERIMENTAL DETERMINATION AND NUMERICAL ANALYSIS OF A LOITER MUNITION UNMANNED AERIAL VEHICLE SYSTEM
Authors: SARAÇYAKUPOĞLU Tamer , DELİBAŞ Heyzem Doğukan , ÖZÇELİK Ahmet Devlet
Published: April 2022

This paper experimentally determinates the calculation of an Unmanned Aerial Vehicle (UAV) and analyzes the design criteria within four different scenarios. The UAV to be designed is a loiter munition UAV system. A mobile or equipment such as a parachute and/or airbag. The UAV may be operable day and night conditions, capable of 2-3 hours of flight hours, and will be launched from a catapult. The UAV navigation system is compact and easily controlled by a personal Global Positioning System (GPS). The mentioned UAV will have a vast operational capability, especially for defense and border security activities since it is equipped with advanced avionics and a small physical footprint for covert operations. As a consequence of this research, it can be claimed that the UAV's mid-wing, twin-tail, and relatively light body will have three axis stability and offer numerous benefits, particularly in terms of operational cost.
Quantitative Analysis of Solid Waste Generation from Tanneries in Kano State
Authors: I. U. Haruna , M. Kabir , S. G. Yalo , A. Muhammad , A. S. Ibrahim
Published: April 2022

Tanning industries have been so important since ancient times because it helps to produce essential goods such as garment and footwear. However, these industries have been polluting the environment, so there was a need for investigations, observations, and analysis by researchers for better management and environmental sustainability. In this study, solid wastes from tanning industries in Kano State, Nigeria were quantitatively analyzed. Both questionnaires and physical measurements were used in the Bompai, Sharada, and Challawa industrial areas. The average weight of raw skin was 0.96 kg and the generation rate was 27.5% of the total weight of processed skin. It was found that 85% of the generated waste was organic, while only 15% was inorganic. The peak season for a solid waste generation was the holy season of the Muslim-majority communities, known as "Eid al-Adha", (10th-13th Zulhajj of the lunar calendar). While the off-peak generation season was during the rainy season, generated solid wastes from the tanning industries could have the potential for sustainable utilization in terms of renewable energy generation and some agricultural applications. It was therefore recommended that future researches should analyze the potentiality of these industries for the benefit of Kano State.
A Comprehensive View on the effects of Hyperautomation in Business and in Employment of Humans
Authors: Begum B.Rasina , Rahman A.Abdhur
Published: April 2022

We, at present, are witnessing a severe and faster change in the field of intelligence than in any other period in the history of human evolution and it is most likely to evolve at the same pace or even much faster in the coming years. What was once considered ‘physical involvement of humans’ is becoming obsolete with technology advancement, global unexpected disasters like climate change, viral diseases and even political issues which in turn causing an unprecedented turmoil of larger magnitude as well as opportunity for both society and businesses alike. All these technology advancements need to be filtered down into a perfect system which leads to the evolution of new field called Hyperautomatin.This hyperautomation, still in its early stage of adaptation, impacts the lives of millions of ordinary people and businesses. This paper is about the impact of this technology and how it is impacting in varying scales.
Perancangan Sistem Informasi Penjualan Baju Secara Online (E-Commerce) pada Toko Hermanto Jakarta
Authors: Aini Setyawati Nur , Fadholi Arief
Published: April 2022

Dengan kemajuan teknologi terutama pada bidang teknologi informasi, website salah satu media yang tepat untuk memberikan layanan informasi. Dengan membanguni sebuahi perangkati lunaki layanan informasii berbasisi mediai website, tentunyai segala layanani informasii yangi hendaki diberikani terhadap masyarakati ataupuni sekedari mengenalkani identitas perusahaani itui sendirii dapati menggunakani media websiteo tanpai adai keterbatasani ruangi informasi karenai websitei bersifati dinamisi sehinggai dapat berubah-ubah isi website itu sendiri sesuai dengan kebutuhan. Perancangan sistem informasi ini diharapkan menjadi metode alternatif dalam melakukan promosi dan transaksi pembelian yang lebih mudah, efektif dan efisien. Sistem ini terfokus pada user (pembeli) dan admin. Fitur yang dapat diakses oleh pembeli setelah melalukan pendaftaran dan login yaitu melakukan proses pemesanan. Pembuatan sistem penjualan ini memudahkan pelanggan dalam melakukan proses pembelian serta memudahkan pemilik toko dalam melakukan promosi produknya agar lebih efektif dan efisien.

Kata kunci : Perancangan, sistem informasi dan penjualan pakaian.
Evaluasi Kenyamanan Mahasiswa Terhadap Penggunaan Seragam STIKES Yayasan RS Dr. Soetomo
Authors: Masyfufah Lilis , Rose Mawati Aprilia , Novitasari Dyah , Indah Puspitasari Devi
Published: April 2022

Sekolah Tinggi merupakan Perguruan Tinggi yang menyelenggarakan pendidikan akademik dan dapat menyelenggarakan pendidikan vokasi dalam satu rumpun Ilmu Pengetahuan atau Teknologi tertentu dan jika memenuhi syarat, sekolah tinggi dapat menyelenggarakan pendidikan profesi. Hal ini tidak hanya berdampak pada penampilan mahasiswa melainkan jugaakan berpengaruh dalam konsentrasi belajar mahasiswa. Oleh karena itu peneliti melakukan penelitian tentang kenyamanan penggunaan seragam pada Stikes Yayasan Rs Dr Seotomo. Penelitian ini adalah untuk mengembangkan desain seragam di kampus STIKES Yayasan  Rs DR. Soetomo Surabaya. Penelitian ini merupakan jenis penelitian dan pengembangan atau Research and Development (R&D). Penelitian ini menggunakan kerangka konsep teori SDLC untuk pengembangan model seragam  di STIKES Yayasan Rs Dr Soetomo.  Pada penelitian ini peneliti melakukan penelitian dan pengembangan pada seragam kampus. Tingkat kenyamanan penggunaan seragam yang dapat mempengaruhi proses belajar mahasiswa di kampus. Rancangan penelitian menggunakan cross sectional untuk mempelajari korelasi antara faktor-faktor risiko dengan efek, dengan cara pendekatan observasi atau pengumpulan data sekaligus pada satu waktu. Dengan menggunakan populasi sebanyak 100 mahasiswa STIKES Yayasan Rs. DR Soetomo. Sampel dari penelitian ini menggunakan Quota Sampling yaitu teknik sampling dengan mengambil jumlah sampel sebanyak jumlah yang telah ditentukan yakni 40 mahasiswa mengisi kuesioner untuk identifikasi awal beberapa permasalahan di Stikes Yayasan Rs. Dr. Soetomo. Indicator yang digunakan dalam penelitian ada 3 yaitu menganalisis kebutuhan, identifikasi penggunaan dan ketentuan seragam, dan pengembangan desain seragam. Instrument penelitian ini menggunakan checklist sehingga peneliti membuat dan menyebarkan kuisioner dalam bentuk online yaitu google form yang akan diisi oleh mahasiswa sehingga data yang diperoleh dalm bentuk data primer.

Kata kunci : SDLC, pengembangan dan tenaga kesehatan.
MENGATASI PERILAKU MEMBOLOS MELALUI KONSELING INDIVIDUAL MENGGUNAKAN PENDEKATAN BEHAVIOR DENGAN TEKNIS SELF MANAGEMENT
Authors: Komariah
Published: April 2022

Fenomena membolos  terjadi di SMA Negeri Astanajapura. Menurut data yang diperoleh peneliti bahwa di sekolah tersebut fenomena membolos banyak terjadi pada kelas XII.IIS.4. Dari data diketahui yakni pada tahun ajaran 2019/2020 terdapat 4 siswa yang membolos dalam setiap harinya. Apabila dihitung secara kasar maka per-minggunya jumlah siswa yang membolos ialah 24 siswa. Sementara setiap bulannya jumlah siswa yang membolos ialah 144 siswa. Berdasarkan data peneliti diketahui bahwa siswa tersebut merupakan siswa yang mempunyai persentase membolos paling tinggi dibanding siswa yang lain. Fenomena yang ada pada siswa kelas XII.IIS.4 SMA Negeri 1 Astanajapura menunjukkan terdapat beberapa siswa yang melakukan perilaku membolos yang tinggi. Tujuan dari penelitian ini yaitu untuk mengetahui konseling individual menggunakan pendekatan behavior dengan teknik self management dapat mengatasi perilaku membolos pada siswa kelas XII.IIS.4 SMA Negeri 1 Astanajapura. Jenis penelitian adalah PTK kualitatif eksperiment dengan desain penelitian one group pre test-post test design. Subyek penelitian ini adalah siswa kelas XII.IIS.4 SMA Negeri 1 Astanajapura yang memiliki tingkat perilaku membolos yang tinggi. Pemilihan subjek dilakukan melalui rekomendasi dari guru pembimbing dan terjaring 4 siswa, diantaranya adalah AS, MR, RM, dan SR. Hasil pre test menyatakan terdapat 4 siswa yang mempunyai perilaku membolos dengan kategori tinggi. Setelah dilaksanakan konseling menggunakan pendekatan behavior dengan teknik self management, 4 siswa tersebut menunjukkan hasil pos test yang menurun yakni perilaku membolos berada pada kategori rendah. Berdasarkan hasil pre test serta post test yang ada menunjukkan adanya perubahan perilaku siswa kelas XII.IIS.4 SMA Negeri 1 Astanajapura yang mengalami penurunan perilaku membolos setelah dilakukan konseling individual menggunakan pendekatan behavior dengan teknik self management.
PENINGKATAN KETERAMPILAN MENULIS EKSPOSISI MELALUI MODEL PEMBELAJARAN INVESTIGASI KELOMPOK
Authors: Supaidi
Published: April 2022

Hasil observasi awal menunjukkan yakni keterampilan menulis eksposisi siswa kelas VII MTsN Ponorogo reltif rendah. Rerata prasiklus masih di bawah nilai KKM. Tujuan yang hendak dicapai dari penelitian ini ialah meningkatkan kemampuan siswa dalam menulis eksposisi melalui pembelajaran investigasi kelompok. Penelitian ini yakni penelitian tindakan kelas terdiri atas dua siklus. Penelitian tindakan kelas yaitu sebuah perencanaan terhadap aktivitas belajar berupa suatu tindakan, yang sengaja diproksikan serta terjadi dalam suatu kelas secara menyeluruh. Tindakan tersebut dilakukan dengan arahan dengan guru yang dilaksanakan oleh siswa. Lebih lanjut dijelaskan bahwa PTK mencakup empat tahapan model penelitian tindakan, yaitu perencanaan, pelaksanaan, pengamatan, serta refleksi. Teknik pengumpulan data yang dilaksanakan pada penelitian tindakan kelas ini diambil dengan beberapa teknik diantaranya dengan menggunakan observasi, wawancara, tes, dan dokumentasi. Peneliti menggunakan pedoman penilaian untuk menentukan tingkat keberhasilan keterampilan menulis eksposisi. Penilaian penulisan eksposisi ini mencakup 5 aspek, yaitu (1) isi dengan skor maksimal 30, (2) organisasi dengan skor maksimal 20, (3) kosakata dengan skor maksimal 20, (4) penggunaan bahasa dengan skor maksimal 20, dan (5) mekanik dengan skor maksimal 10. Hasil penelitian menunjukkan yakni terdapat peningkatan produk bisa terlihat dari skor rata-rata kelas yang diperoleh mulai dari tahap pratindakan hingga periode II. Pada tahap pratindakan diperoleh skor rata-rata sebesar 70,18 meningkat menjadi 77,85 pada tahap periode I. Selanjutnya, terjadi peningkatan skor rata-rata menulis eksposisi pada periode II menjadi 91,61. Hal tersebut menunjukkan terdapat peningkatan 21,43 dari tahap pratindakan hingga periode II. Hasil dari tindakan yang dilaksanakan hingga periode II sudah terpenuhi indikator keberhasilan produk yaitu 75% siswa mendapatkan skor lebih dari atau sama dengan 75 dari skor maksimal 100 setelah diberikan tindakan. Secara keseluruhan pada siklus II semua aspek dan kriteria menulis eksposisi mengalami peningkatan yang signifikan. Dari hasil penelitian di atas terbukti bahwa penggunaan model pembelajaran investigasi kelompok dinilai berhasil dan dapat meningkatkan kemampuan menulis eksposisi siswa kelas VII MTsN Ponorogo.
PENGARUH PERATURAN PRESIDEN NOMOR 21 TAHUN 2016 TENTANG BEBAS VISA TERHADAP KEAMANAN NEGARA DAN KESEJAHTRAAN DALAM PERSPEKTIF KEIMIGRASIAN
Authors: Syakir
Published: April 2022

Dalam Peraturan Presiden Republik Indonesia nomor 21 tahun 2016, ada 2 (dua) dasar pertimbangan yang mendasari terbentuknya peraturan ini, adapun pertimbangan itu adalah untuk meningkatkan hubungan Negara Republik Indonesia dengan negara lain, perlu diberikan kemudahan bagi orang asing wargannegara dari negara, pemerintah wilayah administratif khusus suatu negara,  untuk masuk ke wilayah negara Republik Indonesia yang dilaksanakan dalam bentuk pembebasan dari kewajiban memiliki visa kunjungan dengan memperhatikan asas timbal balik dan manfaat dan juga untuk memberikan manfaat yang lebih dalam peningkatan perekonomian pada umumnya, dan peningkatan jumlah kunjungan wisatawan mancanegara pada khususnya, perlu untuk menyesuaikan jumlah negara, pemerintah wilayah administratif khusus suatu negara tertentu yang diberikan fasilitas pembebasan dari kewajiban memiliki visa kunjungan. Melihat dari tujuan awal pembentukan Peraturan Presiden nomor 21 tahun 2016 yang mendasari diberikannya fasilitas bebas visa kunjungan kepada 169 negara yang tercantum dalam pertimbangan peraturan presiden ini dibuat, tentang peningkatan perekonomian dan jumlah wisatawan yang datang ke Indonesia, namun ada hal penting yang harus segera di laksanakan demi terjadinya keseimbangan antara kesejahteraan negara dan keamanan negara dalam rangka menjaga tegaknya kedaulatan negara Republik Indonesia dalam sisi keimigrasian dan banyaknya permasalahan yang terjadi, dan juga belum tercapainya tujuan awal pemberian bebas visa kunjungan ini.