bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug-Resistant Long RP Tachycardia in the Emergency Department (ED): A Challenging Entity
Authors:   Consultant, Department of Emergency Medicine, Sir H N Reliance Foundation Hospital, Mumbai 400004, India., Pavrey Renaldo , Vajifdar Farzin ,   Specialist, Emergency Medicine, Doctors without Borders-India, Mumbai 400088, India. Corresponding Author:
Published: January 2024

Long RP tachycardia is an uncommon form of supraventricular tachycardia (SVT) that exhibits a longer RP interval than PR interval on 12-lead electrocardiograms (ECG)1. The differential diagnosis of a long RP tachycardia includes the uncommon form of AV nodal reentrant tachycardia (AVNRT), the permanent form of reciprocating tachycardia (PJRT), and atrial tachycardia (AT). Drug responses vary markedly from patient to patient in uncommon SVT. Few small patient cohorts have been studied involving uncommon SVT whose attacks could not be adequately controlled by antiarrhythmic agents2. We present the case of a 47-year-old woman with stable long RP tachycardia refractory to first and second-line treatment in the Emergency Department, who rapidly destabilized to transient heart failure and hemodynamic compromise, ultimately requiring synchronized electrical cardioversion. In our report, we highlight the presentation of long RP tachycardia in the Emergency Department; its management in the acute setting and dealing with its ECG interpretational challenges. Our reasons for highlighting this case are: 1. This is a relatively uncommon ECG presentation to the Emergency Department, which poses its own analytical dif culties. 2. The dynamic nature of drug-resistant tachyarrhythmia in the acute setting makes this case clinically relevant to the Emergency Physician.
Predictors of Mortality among Non Traumatic Non COVID Emergencies during Early COVID-19 Outbreak: An Observational Study on Clinical Profile and Outcome of Patients in North India
Authors:   Assistant Professor, Department of Emergency Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India., Verma Alka , Sanjeev Om Prakash ,   Assistant Professor, Department of Emergency Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India., Srivastava Divya ,   Associate Professor, Department of Anesthesiology,Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India., Singh Ratender Kumar ,   Professor, Department of Emergency Medicine,Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India., Yadav Priyank ,   Assistant Professor, Department of Urology,Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India., ... Rahul ,   Assistant Professor, Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India.
Published: January 2024

Context: Severe acute respiratory distress corona virus 2 (SARS COV 2) unleashed an unprecedented medical emergency and led to exemplary global containment response to limit the Corona Virus disease (COVID-19). These responses began in the initial phase of the pandemic itself and came at the cost of non-COVID hospital services. Aims: The aim of this study was to highlight the profile of patients, their outcomes and predictors of mortality in non-traumatic emergencies presenting to the non-Covid section of a north Indian tertiary care center during the early phase of COVID outbreak. Settings and Design: Single center observational study. Methods: After obtaining Institute ethics committee approval, data of patients presenting in emergency from February 1, 2020 to April 30, 2020 were obtained retrospectively. Patients coming with trauma related emergencies were excluded. Statistical analysis used: The data was categorized as survivors and non-survivors. Student t test/Mann Whitney test was used to compare continuous variables and Chi square test was used to compare categorical data. Univariate and multivariate binary logistic regression analysis were used to identify the predictors of non-survival. Results: Out of 800 patients admitted in emergency, 2 were found to be SARS COV2 positive. Of the remaining 798 patients, 27 (3.4%) patients expired. On multivariate analysis, greater age, hemoptysis, oxygen or ventilatory requirement and need of vasopressors at admission were predictors of non-survival. Conclusions: Greater age, need for oxygen, ventilator and vasopressors at time of admission are harbingers of mortality among non-Covid patients presenting in emergency.
Supra Ventricular Tachycardia in Pregnancy
Authors:   Resident, Department of Emergency Medicine, Max Hospital, Shalimar Bagh, New Delhi-110088, India., Uzma Khanam Uzma
Published: January 2024

The physiological changes during pregnancy predispose female of new-onset or recurrent arrhythmia. Supraventricular arrhythmia is that the commonest sort of arrhythmia during pregnancy and, although often benign in nature. We describe a complex case of supraventricular arrhythmia during pregnancy and review the currently available literature. In pregnancies complicated by arrhythmia, a follow-up and both maternal and fetal monitoring during pregnancy, delivery and post partum should be made. Diagnostic modalities should be used as in non-pregnant women. All antiarrhythmic drugs cross the placenta, but when necessary, medical treatment should be used. Electrical cardioversion is safe during pregnancy, and electrophysiological study and catheter ablation sometimes performed in selected patients, preferably with zero-fluoroscopy technique. Sometimes, delivering the fetus (if viable) is that the best therapeutic option.
Pipelle Endometrial vs Hysteroscopic Endometrial Sampling in Abnormal Uterine Bleeding
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College, Keezhakasakudy, Karaikal 609609, Pondicherry, India., Krishnamoorthy Geetha , V C Veena ,   Post Graduate, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College, Keezhakasakudy, Karaikal 609609, Pondicherry, India., Hercules Aroshime ,   Post Graduate, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College, Keezhakasakudy, Karaikal 609609, Pondicherry, India., P Amutha ,   Professor, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College, Keezhakasakudy, Karaikal 609609, Pondicherry, India.
Published: January 2024

Background: For Endometrial biopsy Pipelle sampling can be done as an office procedure. In this study Pipelle is being studied in terms of specificity and sensitivity for diagnosis and for replacing other methods of sampling. Methods: 60 patients underwent pipelle endometrial sampling on OPD basis followed by hysteroscopic evaluation and endometrial sampling in the same menstrual cycle . Histopathology report of both the pipelle and hysteroscopic endometrial samples were compared and statistical analysis done. Results: In subjects with proliferative Endometrium in Hysteroscopy 93.9% were diagnosed by pipelle sample, In Secretory Endometrium in Hysteroscopy, 83.3% were diagnosed by pipelle sample, Out of 33 subjects with Disordered Endometrium in Hysteroscopy, 100% were diagnosed by pipelle sample. In the sample Hyperplasia in hysteroscopy, 100% were diagnosed by pipelle sample. In samples without simple Hyperplasia in Hysteroscopy, 98.3% were negative in pipelle sample and 1.7% were positive in pipelle sample (False Positive). In Adenomatous Polyp in Hysteroscopy 20% were diagnosed by pipelle sample and 80% were negative (False Negative). In Cystoglandular Hyperplasia in Hysteroscopy, 100% diagnosed by pipelle sample. Conclusion: Pipelle is 100% sensitive in diagnosing premalignant changes in the endometrium. Hence pipelle, a cost effective non-invasive procedure, can be used as a first line method to diagnose endometrial pathology in abnormal uterine bleeding.
A Study Comparing Efficacy of Morning Dosage versus Evening Dosage of Oral Micronised Progesterone Sustained Release SR 300mg in Prevention of Preterm Labour
Authors:   Professor and HOD, Department of Obstetrics and Gynecology, Dr D Y Patil Medical College, (Affiliated to Dr D Y Patil Vidyapeeth, Deemed to be Uniersity), Pimpri, Pune 411018, Maharashtra, India., G Deshpande Hemant , S Madkar Chandrakant ,   Professor,  Department of Obstetrics and Gynecology, Dr D Y Patil Medical College, (Affiliated to Dr D Y Patil Vidyapeeth, Deemed to be Uniersity), Pimpri, Pune 411018, Maharashtra, India., J Shinde Madhukar ,   Associate Professor, Department of Obstetrics and Gynecology, Dr D Y Patil Medical College, (Affiliated to Dr D Y Patil Vidyapeeth, Deemed to be Uniersity), Pimpri, Pune 411018, Maharashtra, India., Gulati Chetan ,   Junior Resident, Department of Obstetrics and Gynecology, Dr D Y Patil Medical College, (Affiliated to Dr D Y Patil Vidyapeeth, Deemed to be Uniersity), Pimpri, Pune 411018, Maharashtra, India.
Published: January 2024

Objectives: To assess the efficacy of oral micronized progesterone SR 300 in preventing preterm labour after arresting it, with changes in dosage timing. The main purpose of this study is to find out whether there is a clinico pharmacological correlation if same drug is given at different timings Materials and Methods: Prospective randomized study was done at our institution. Total sample size of 130 women who came in preterm labour and process of preterm labour was arrested with Tocolytics were included in the study group. Sample was divided into 2 groups of 65 womens in each group in view of prevention of preterm labour. One group was given MNP SR 300 at 9am and 2nd group was given MNP SR 300 at 9pm by oral route. They were studied for the difference in maternal outcomes like prolongation of gestational age at delivery and neonatal outcome like birth weight, maturity, morbidity and mortality. Results: Both the group were comparable with respect to age and parity. Our study showed that there was no statistically significant difference with respect to maternal and fetal outcome with changes in timings to two groups who were given MNP SR 300 orally at 9am and 9pm. Conclusion: More studies on big samples are recommended to further analyse our results, since this the only study till date.
Evaluation of Modified Biophysical Profile in Pre-Eclamptic Patients and Measure its Impact on Perinatal Outcome
Authors:   Assistant Professor, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India., Patel Priyanka , Majumdar Anamika ,   Associate Professor, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India., Vaghela Rajnikant ,   Resident, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India., Patel Komal ,   Resident, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India., Patel Dhaval ,   Resident, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India., Damor Chetana ,   Resident, Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat 395010, India.
Published: January 2024

Introduction: Hypertensive disorders in pregnancy are a major cause of maternal and perinatal morbidity and mortality worldwide. Modified biophysical profile (MBPP) combines Non stress test as a short term marker of fetal status and the amniotic fluid index as a marker of long term placental function which is easier to perform and less time consuming. Aim: To study the antepartum fetal surveillance with modified biophysical profile and perinatal outcome in pre-eclamptic women. Materials and Methods: Prospective descriptive study of perinatal outcome included 150 ANC patients gestational age between 34 to 40 weeks both primi gravida and multigravida with pre-eclampsia admitted in SMIMER hospital during January 2017 to June 2018. Patients were treated in line with standard protocol and perinatal outcome were then studied. Results: Of the 150 NST’s in MBPP, 77% were reactive and 23% were non-reactive. When the MBPP was abnormal with respect to both parameters 60% of the cases had LSCS and 40% of them had vaginal delivery. When both parameters were normal there were only 3.63% cases were MSL. When NST was abnormal and AFI normal 45.45% cases were MSL and when NST was normal and AFI abnormal 42.8% cases were MSL. When both the parameters were abnormal 63.6% of the cases had APGAR <7 `whereas when NST was normal and AFI was abnormal 2(28.5%) the cases had APGAR <7. When AFI was normal and NST was abnormal 36.3% of the cases had APGAR <7. Conclusions: Modified biophysical profile (MBPP) is easier, less time consuming, cost effective and patient compliant test.
Emergency Obstetric Hysterectomy: A Retrospective Analytical Study Over 2 Years at District Hospital Tamilnadu
Authors:   Senior Civil Surgeon, Department of Obstetrics and Gynecology, Government Headquarters Hospital, Virudhunagar 626001, Tamilnadu, India., Uma Maheshwari B
Published: January 2024

Aim: Present study was undertaken with an aim to evaluate the incidence, maternal profile, indications, type, no. of transfusions, matenal outcome and how they are behaving over past 2 years (2018 – 2020) in our Government headquarters hospital virudhunagar. emergency obstetrics hysterectomy remaining an essential weapon in any obstetrics armoury. Methods: Case sheets of emergency hysterectomy for there major indications (resistant atomic PPH, Rupture uterus, adherent placenta) were taken and analyzed. Conclusion: Initially atomic PPH being the commonest indication for peripartum hysterectomy. According to present study rupture uterus being the commonest indication for peripartum hysterectomy, increasing no. of cs nowadays should be the reason for this change.
A Prospective Study on Prevalence of Anemia in Pregnant Women
Authors:   Assistant Professor, Department of Obg, Dr Patnam Mahender Reddy Institute of medical sciences, Chevella 501503, Telangana, India., G Bhavya , Patil Madhu ,   Associate Professor, Department of Obg, Melmaruvathur Adhiparaskthi institute of medical sciences, Melmaruvathur 603319, Tamilnadu, India.
Published: January 2024

Background: India being one of the developing country and wide importance have been given to take care of maternal health but still anaemia plays a major public health problem and also one of the most commonest nutritional diseases in the world. Anemia being more prevalent in women of reproductive age and more so rampant during pregnancy. Anemia also increases maternal morbidity and mortality.The requirement of nutrients increases during pregnancy and many causes like lack of proper education, poverty, early marriage, teenage pregnancy and poor nutritional supplementation increases the risk of anemia in pregnancy. Methods: This prospective observational study was conducted by the Department of OBG at Dr Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Telanganafrom November 2018 to October 2019. A total of 120patients were included in the study on the basis of inclusion criteria. Results: Themaximum cases 65(54.2%) were in the age of 21-25 yrs followed by 43(35.9%) in the age group 26-30years. The mean age of the patients was 24.24 (SD12.66) years. The maximum incidence of anemia were present in multigravida 78 cases (65%) when compared to primi 42cases(35%).The majority of the cases presented with moderate anemia 62 cases (51.7%), 38 cases (31.7% )presented with mild anemia, 20 cases (16.6%) had severe anemia. Severity of anemia was classified as ICMR classification. Keywords: Anemia; Pregnancy; Nutritional
A Study of Feto-Maternal Outcome in Cases of Vaginal Birth after Cesarean SectionA Study of Feto-Maternal Outcome in Cases of Vaginal Birth after Cesarean Section
Authors:   Senior resident, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39, Shah Aena , Majumdar Anamika ,   Associate professor, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39, Shah Jitesh ,   Professor, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39, Naik Aishwarya ,   Senior resident, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39, Ramani Nidhi ,   Senior resident, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39, Agarwal Yash ,   Senior resident, Department of Obstetris and Gynecology, Surat Municipal Institute of Medical Education & Research Medical college, Surat 39
Published: January 2024

Introduction: Pregnancy with a previous cesarean section(CS) may lead to several concerning maternal, fetal, and neonatal complications in subsequent pregnancies such as placenta accreta and uterine rupture.Trial of labour after cesarean (TOLAC) and Vaginal Birth After Cesarean (VBAC) has a quantifiable effect on decreasing total cesarean deliveries. Aim: To assess maternal and fetal outcome of vaginal birth after one lower segment cesarean section in selected cases. Materials And Methods: Prospective observational study of maternal and fetal outcome included 100 ANC patients with singleton pregnancy of more than 34 weeks gestation and one previous lower transverse cesarean delivery admitted in SMIMER hospital between January 2018 to June 2019. Results: 57% patients had vaginal delivery without any assistance, while 18% patients required vacuum assistance and 25% patients required repeat LSCS after failure of TOLAC. Among successful VBAC none had any complications, while among repeated CS patients, 4% patients had PPH, 2%had intraoperative finding of uterine dehiscence and 1%had intraoperative finding of uterine scar rupture.67% had interval of ≤ 3 years between current and previous pregnancy. Bishop’s score of less than 8 resulted in 100% CS whereas Bishop’s score of more than 9 resulted in 100% VBAC.Among VBAC, 5.3% babies required NICU admission, while among repeated CS, 16% babies required NICU admission. Conclusion: This study has found a high success rate of VBAC (75%). Keywords: Vaginal birth after cesarean section; trial of labour after cesarean section.
Rare Case Report of Acute Infract in Left Caudate Nucleus: A Post-Partum Catastrophe
Authors:   Consultant, Department of Obstetrics and Gynecology, District Hospital, Dharwad, Karnataka 580001, India., Shetty Satish , Somkuwar Suchitra ,   3rd Year Post Graduate, Department of Obstetrics and Gynecology, District Hospital, Dharwad, Karnataka 580001, India.
Published: January 2024

The caudate nucleus is important in the modulation of motor functions and may influence cognitive and mental functions. However, cases of cognitive and behavioral disorders caused by caudate stroke are rare in practice. We report a case of 26 year-old female patient who presented with abrupt onset of cognitive and behavioural dysfunctions in post partum period on 4th day of elective caesarean section. Her prominent symptoms include fever, abnormal behaviour in form screaming, not identifying family members and not feeding baby. Computed tomography revealed no significant abnormality and magnetic resonance imaging of the brain revealed an acute infarction in the head of the left caudate nucleus in post portum period. Keywords: Cerebral venous thrombosis; Caudate nucleus; Reversible cerebral vasoconstriction syndrome.
Uterine Rupture: A Rare Case and its Successful Management
Authors:   Professor, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College and Hospital, Karaikal, Pondicherry 609609, India., krishnamoorthy Geetha , G Saranya ,   Post Graduate, Department of Obstetrics and Gynecology, Vinayaka Missions Medical College and Hospital, Karaikal, Pondicherry 609609, India.
Published: January 2024

Misoprostol is a commonly preferred drug for induction of labor but it should be strictly avoided in scarred uterus because of high chances of uterine rupture. Here presented a 31 year old female with intrauterine death of twin pregnancy at 20 weeks of gestation who had uterine rupture probably due to vaginal misoprostol. This report elaborates about the uterine rupture, a rare presentation and its successful management.
A Study of Level of C-reactive Protein in Preterm Labor and Preterm Premature Rupture of Membranes
Authors:   Professor and HOD, Department of Obstetrics and Gynaecology, JJM Medical College, Davangere 577004, Karnataka, India., S Shetty Shukla , Anjum S Sabaa ,   Senior Resident, Department of Obstetrics and Gynaecology, JJM Medical College, Davangere 577004, Karnataka, India.
Published: January 2024

Context: Preterm delivery is one of the most important causes of perinatal morbidity and mortality. Early detection of infection is most important during the conservative management of patients with preterm labor. CRP is one of the sensitive markers of systemic inflammation and hence, a suitable marker for predicting risk of preterm delivery. This study was thus planned with an aim to establish the association between maternal plasma CRP levels in pregnancy and risk of preterm delivery. Aims: To study the association between the level of CRP and preterm labor and PPROM. Methods and Materials: The study included 150 women with singleton pregnancy with gestational age between 28-36+6 weeks who experienced PTL and PPROM. The study was conducted over a period of 24 months from November 2018 – October 2020. Venous blood samples were drawn from these patients and Serum CRP level was estimated. Results: 103 (68.7%) out of 150 patients enrolled in the study had elevated levels of Serum CRP >/=7 mg/L thus showing a significant statistical relation between S.CRP and PTL, PPROM. The mean S.CRP value being 12.0 ± 5.9 mg/L. The relation between S.CRP and its variation with gestational age was also found to be highly significant, showing the mean value of S.CRP to be highest among gestational age between 28-30 weeks and lowest among 35-36 weeks. Conclusions: CRP can thus be established as a biochemical marker for prediction of PTL and can be used as a non-invasive screening tool to detect cases that are at risk of PTL and PPROM.
Role of Closed Incision Negative Pressure Therapy in Scar Management
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Reddy K Sriharsha , Chittoria Ravi Kumar ,   Professor and Registrar (Academic), Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., K Nishad ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Thomas Neljo ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

In recent years, there has been a greater emphasis on providing high-quality medical treatment to ensure patients’ safety through improving recovery after surgery (ERAS), reducing postoperative stress, and restoring normal function quickly. Negative pressure wound care has revolutionized the way acute and chronic wounds are treated. The incision site is usually covered with an occlusive or semiocclusive covering after primary wound closure. It is thought that using closed incisional negative pressure therapy on surgical wounds improves wound healing by better distributing shear stresses on wound edges and promoting the evacuation of wound fluids such subcutaneous seroma and hematoma.
Role of Indigenous Cost Effective Two Layer Regenerative Scaffold in Wound Bed Preparation
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Reddy K Sriharsha , Chittoria Ravi Kumar ,   Professor and Registrar (Academic), Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., K Nishad ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Thomas Neijo ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

The quality of skin wound healing can be improved by the application of collagen scaffolds as biological dermal substitutes. Dermal extract helps to improves wound healing and quality of the scars. They serve as a scaffold into which cells can migrate and repair the injury. In the current scenario where in many biological and cellular engineering skin substitutes are available, wound management is a multimodality treatment with use of multiple available methods to augment wound healing at various levels. An excellent dermal substitute should be affordable, long-lasting, ready-to-use, analgesic, durable, flexible, non-antigenic, stops water loss, conforms to uneven wounds, anti-microbial, and may be applied in one sitting. In this study, we attempted to mimic the same technique in our two-layered regenerative scaffold, which is created locally and is cost-effective.
Early Detection of Common Bile Duct Injury Post Cholecystectomy, What are the Options?
Authors:   Professor and Head,Department of General Surgery, Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India., Gosh Yatin , Seth Sunil ,   Associate professor, Department of Radiodiagnosis, Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India., Hastir Ankur ,   Associate professor,Department of General Surgery, Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India., .. Shivani ,   Junior Resident, Department of General Surgery, Punjab Institute of Medical Sciences, Jalandhar 144001, Punjab, India.
Published: January 2024

In the present scenario, laparoscopic cholecystectomy remains the most common surgery performed by the general surgeons but there is constant fear of the common bile duct injury associated with it. We have moved from the era of open to laparoscopic cholecystectomy with a long initial learning curve for surgeons.2,3 During this period, the most vulnerable structure to injury is the common bile duct1,4 which can lead to serious complications like biliary peritonitis, hepatic failure and death. 22 Majority of the patients are identified later with the progression of jaundice and a few are recognized on table as requiring immediate repair. Our study is focused on the role of ultrasound in the postoperative period as a tool for detecting common bile duct injury within 72 hours of cholecystectomy.
Rare Case of Gall Bladder Perforation following acute Calculus Cholecystitis in a Elderly Male: A Case Report
Authors:   Senior Divisional Medical Officer, Department of Surgery, B.R. Singh Hospital and Centre for Medical Education and Research, Kolkata, West Bengal 700014, India, Pradhan Dipanjan , Basu Rohit ,   3rd year DNB trainee, Department of Surgery, B.R. Singh Hospital and Centre for Medical Education and Research, Kolkata, West Bengal 700014, India, Karamakar Saurav ,   Post Doctoral Trainee, Department of Urology, NRS Medical College and Hospital, Kolkata, West Bengal 700014, India.
Published: January 2024

Perforation of the gallbladder is a rare but dreaded complication following cholecystitis.1 Spontaneous perforation is most commonly seen in the elderly, and in patients suffering from diabetes mellitus.2 The most common site of perforation is the fundus of gall bladder.3 The gall bladder distension and edema associated with acute inflammation leads to venous and arterial obstruction. Subsequently, this leads to ischaemia and necrosis of the gall bladder wall. The fundus is most susceptible to this injury due to maximum distance from the cystic arterial supply. Aggravating factors include atherosclerosis, focal vasospasm and localized vasculitis. If diagnosed and treated late, perforation of gallbladder may be associated with high chances of morbidity and mortality.4-6 Here, we report a case of a 66-year-old male with perforation of gallbladder following acute calculous cholecystitis.
Clinical Prospective Study of Post-Operative Morbidity and Mortality After Low Anterior Resection with Preventive Diverting Loop Ileostomy in Patients of Rectal Cancer
Authors:   Postgraduate Final Year Student, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India., Halam Irene , Kumar Samriddh ,   Postgraduate Final Year Student, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India., Chhabra Abhishek ,   Assistant professor, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India., Dawan M.L. ,   Professor, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India., Kishor Sundar ,   Assistant professor, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India., Khadda Sandeep ,   Professor, Department of Surgery, Sadar Patel Medical College and PBM Hospital, Bikaner, Rajasthan, India.
Published: January 2024

Background: Rectal cancer continues to be devastating malignancy worldwide. Faecal diversion is an important tool in the surgical management of rectal cancer. The presence of stoma may also increase the risk of complications related to stoma itself (high stoma flow, retraction, prolapse, kidney failure, skin excoriation etc.). Aims: To measure postoperative morbidity and mortality after low anterior resection with preventive diverting loop ileostomy in patients of rectal cancer Material and methods: This is a prospective study and was carried out between december 2021 to November 2022. Total 28 patients who underwent LAR with Diversion stoma were included according to pre-defined inclusion and exclusion criteria. Results: Male to female ratio was 1.8:1.Mean age was 57.92±15.85 years. 1 (3.57%) patient had anastomotic leak, 3 (10.71%) had wound infection, 6 patients (21.42%) had chest infection, 1 (3.57%) patients pelvic collection, 9(32.15%) patients had electrolyte imbalance, 2(7.14%) patients had ileus. Mean hospital duration during primary surgery of patients was 11.46±2.47. Mean Post stoma closure hospital stay was 5.84 (±1.57) days. Out of total 28 patients 1(3.57%) patient died, 25 (89.29%) patients underwent subsequent stoma closure. Rest 2(7.14%) patients had their ileostomy as a permanent stoma. Conclusions: Decision to create or not to create diversion stoma should be on case to case basis upon operating surgeon’s discretion with shared information to patient and his/her family with their involvement in decision making.
Surgical Outcome of Free Flap Surgery in a Tertiary Referral Center in Maharashtra
Authors:   Final year resident, Department of Plastic Surgery, Grant Medical College & Sir J.J. Group of Hospitals, Mumbai 400008, Maharashtra, India., Samant Apurva Nayan , Gundewar Sagar ,   Assistant Professor, Senior Consultant, Department of Plastic Surgery, Grant Medical College & Sir J.J. Group of Hospitals, Mumbai 400008, Maharashtra, India., Jaiswal Yogesh ,   Consultant, Department of Plastic Surgery, Grant Medical College & Sir J.J. Group of Hospitals, Mumbai 400008, Maharashtra, India., Kapoor Rajat ,   Assistant Professor, Senior Consultant, Department of Plastic Surgery, Grant Medical College & Sir J.J. Group of Hospitals, Mumbai 400008, Maharashtra, India.
Published: January 2024

Introduction: Reconstruction with a free flap is routinely done at site especially head and neck and oral because of better surgical and functional outcomes, improved esthetics results, and overall higher success rates. Aim & Objective: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions and tudy various demographic and pre-operative factors associated with it. Methods: This was a retrospective study of 45 patients undergoing reconstructions with free flaps from January 2020 to December 2022. Different types of free flap were performed like Anterolateral thigh, Free fibula osteocutaneous flap (FFOCF), free functioning muscle transfer (FFMT), Free radial artery forearm flap (FRAF), The medial sural artery perforator (MSAP), latissimus dorsi (LD), myocutaneous flap, superficial circumflex iliac artery perforator (SCIP). Results: The patients included total 45 participants, with 35 men and 10 women, with a mean age of 45.56 years. Oral malignancy was the most common cause. Squamous cell carcinoma represented the majority of the diagnosed tumors (31.1%) followed by ameloblastoma. The most common recipient vessels were the internal jugular vein (91.4%), the facial artery (77.4%) followed by superior thyroid artery. The overall flap success rate was 93.33%. Venous thrombosis was the most common cause for re-exploration. The majority of patients had satisfactory cosmetic and functional results of both donor site and recipient site on 1 month follow up. Conclusion: Microsurgical free flap seems to be a valuable and successful method in head and neck surgery. The reconstruction can be done by skilled surgeons with post-op monitoring.
A Case Series on Hydatid Cyst Disease: Usual and Unusual Sites with Different Approaches and Management
Authors:   Second year resident, Department of General Surgery, Pandit Deendayal Upadhyay Medical College & Hospital, Rajkot 360001, Gujarat, India., Behera Binoy Kumar , G.M. Muruganandam ,   Third year resident, Department of General Surgery, Pandit Deendayal Upadhyay Medical College & Hospital, Rajkot 360001, Gujarat, India., Bhatt J.G. ,   Professor and hod, Department of General Surgery, Pandit Deendayal Upadhyay Medical College & Hospital, Rajkot 360001, Gujarat, India., Vagadia J.G. ,   Assistant Professor, Department of General Surgery, Pandit Deendayal Upadhyay Medical College & Hospital, Rajkot 360001, Gujarat, India.
Published: January 2024

Hydatid disease is a cyclo zoonotic parasitic infection caused by Echinococcus granulosus. This disease is commonly found in the liver and lungs but no organ of the body is immune. When found at unusual sites in the body they show atypical presentations and pose a diagnostic challenge. In such conditions, a high index of suspicion, radiological investigations as well as histopathological examination are necessary in establishing the diagnosis. We present a review of the occurrence of hydatid disease at common as well as unusual sites and our experience with clinical presentation and management of hydatid disease.
Rare Case of Appendicitis in Hernial Sac-Amynad’s Hernia Type 2 Case Report
Authors:   Post Graduate, Department of General Surgery, Amrita Institute of Medical Sciences, Kochi 682041, India, Devanarayan V , Venugopal P R ,   Professor, Department of General Surgery, Mount Zion Medical College, Adoor, Kerala 679556, India.
Published: January 2024

Amynad’s hernia is the term used for hernia with content as Appendix and part of caecum. This can be presented as incarcerated hernia and rarely with acute appendicitis. Here we are presenting a case acute abdomen with appendicitis in the inguinal hernia. This case is reported in a 68 yr old man with long standing hernia presented as acute pain and vomiting. This case report is reported due to its rarity.
Neonatal Severe Hyperparathyroidism: A Case Report
Authors:   Postgraduate student, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India., U. Manikandan , Sundari S. Meenakshi ,   Professor, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India., N. Karuppasamy ,   Associate professor, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India., R. Srinivasakumar ,   Assistant Professor, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India., C. Aravindan ,   Assistant Professor, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India., G. Selvakumar ,   Assistant Professor, Department of Pediatric Surgery, Madurai Medical College and Hospital, Goripalaiyam, Tamil Nadu 625106, India.
Published: January 2024

Background: Neonatal severe hyperparathyroidism is an extremely rare condition that presents in the first few months of life. Recognition at the early stage followed by prompt surgical intervention are of vital importance for survival. Hypotonia, respiratory distress, lethargy and delay in growth and development occur in association with the elevated serum parathormone levels and hypercalcemia. Definitive therapy involves total parathyroidectomy. Case Description: We are presenting a case with Neonatal severe hyperparathyroidism, who underwent total parathyroidectomy. The patient had been followed up with medical therapy until. Parathormone levels rapidly declined following total parathyroidectomy and the patient was discharged with full recovery. Literature Review: Sestamibi scintigraphy might fail to show an ectopic parathyroid gland. In such conditions, on table confirmation of parathyroid glands by frozen section and Intraoperative parathormone monitoring is vital at this point. Persistently elevated parathormone levels might suggest a remnant parathyroid tissue at the surgical site or an ectopic parathyroid gland that should be excised. Clinical Relavance: Neonatal severe hyperparathyroidism is a life-threatening disease. In the present case surgery performed at the early is life-saving due to the failure of medical therapy to control the disease.
Acute myocardial infarction complicated with anterior spinal artery syndrome:a case report
Authors: Han Song , Wang Lin , Zhang Wei , He Junwei , Duan Yanli , Yan Tao , Pan Jing
Published: January 2024

Acute myocardial infarction is a common disease with high mortality, which is mainly manifested as acute chest pain and ST segment elevation in ECG, and few patients may also experience lower limb weakness. Anterior spinal artery syndrome, on the other hand, is a less frequent ischemic disease characterized by superficial sensory disturbances below the level of damage as well as limb dyskinesia, sometimes accompanied by severe chest pain. We report a case of acute myocardial infarction complicated with spinal cord infarction. Hopefully, it will be a wake-up call that anterior spinal artery syndrome is a rare complication of acute myocardial infarction.
Virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic
Authors: Cha Jae-Ryong , Ko Sang-Hun , Jeon Young-Dae , Kim Sang-Gon , Park Ki-Bong
Published: January 2024

Background
During the COVID-19 pandemic, large in-person conferences were mostly cancelled to avoid further disease contagion. Physicians continued to demand changes in form to enable participation in lifelong medical education programs, and the traditional model of in-person conferences needed to be rethought. As such, a regional branch of the national orthopedic association tried to move in-person conferences onto a virtual platform. This study aimed to investigate the effect of transitioning large in-person conferences to a virtual model during the COVID-19 pandemic, especially examining any differences in the attendance of each type of conference.
Methods
In this retrospective observational study, 776 participants in virtual conferences and 575 participants in in-person conferences were analyzed. Institutions were classified based on their location in a central city and two neighboring cities. Affiliated institutions were divided into resident training hospitals, general hospitals, and private clinics. The change in the number and proportion of participants between the virtual conference year and in-person conference year was calculated.
Results
The number of virtual conference participants was significantly greater than that of in-person conference participants (P = 0.01). Although the highest number of participants was from central city for both years, the proportion of participants from the two neighboring cities increased. Although the proportion of participants from resident training hospitals and private clinics decreased, the proportion of participants from general hospitals increased.
Conclusions
We implemented a virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic. The virtual platforms can be helpful for organizations that must hold regular lifelong medical education programs for members spread across a wide geographic region.
Analysis of autophagy-related gene signature associated with clinical prognosis and immune microenvironment in colorectal cancer
Authors: Miao Dazhuang , Song Yushuai , Liang Guanying , Wang Yan , He Wei , Huang Luyu , Lu Hongnan , Jiang Shixiong , Jia Yunhe , Li Zhiwei , Tong Jinxue
Published: January 2024

Purpose: Autophagy has a critical involvement in the initiation and progression of various cancers, including colorectal cancer (CRC). The feasibility of using autophagy-related genes as prognostic tools for CRC patients is yet to be determined.
Methods: We gathered RNA sequencing data and clinical details for colorectal cancer (CRC) from TCGA as our training set and used the GSE39582 dataset from the GEO database for validation. Autophagy-related genes (ARGs) were obtained from the Human Autophagy Database. Using the R limma package, we identified differentially expressed ARGs (DAGs) in TCGA's CRC samples. Prognostic DAGs signatures were established via Cox and LASSO Cox regression analyses. CRC patients were divided into high-risk and low-risk groups based on median risk scores, with their prognosis assessed through Kaplan-Meier, ROC, and calibration curve analyses. The CIBERSORT algorithms were employed to examine the association between immune status and the signature. Immunohistochemistry assays were conducted to evaluate the prognostic significance of these DAGs in CRC samples.
Results: Our study developed a signature consisting of 11 key prognostic DAGs (CANX, NRG1, WIPI1, EIF2AK3, WDR45, PELP1, ULK1, WIPI2, DAPK1, ULK3, MAP1LC3C), revealing that high-risk patients had markedly reduced overall survival compared to low-risk ones. This signature, independently predictive after adjusting for clinical factors, was validated using the GSE39582 dataset and showed a strong correlation with immune status in TCGA CRC samples.
Conclusion: The autophagy-related signature independently predicts CRC prognosis and guides immunotherapy strategies.
COMPOSICIÓN FLORÍSTICA DE LAS RIBERAS DE LA CUENCA DEL RÍO TAURA, GOLFO DE GUAYAQUIL, ECUADOR
Authors: Bonifaz Carmita
Published: January 2024

La cuenca del río Taura se encuentra conformada por el río del mismo nombre, el cual, con 1 962 Km2 de recorrido, llega hasta el mar desembocando por el Golfo de Guayaquil al Océano Pacífico, en la costa de Ecuador. Dicha cuenca alberga un gran desarrollo humano que, en mayor o menor grado, podría incidir en la flora de la misma. El objetivo de esta investigación fue registrar la composición florística de dicha cuenca, caracterizando florísticamente los estuarios y riberas de la misma, a fin de contribuir al conocimiento florístico del Golfo de Guayaquil, el más grande de Sudamérica. Se establecieron once estaciones a lo largo de la ribera de la cuenca, con ecosistemas de manglar; y formaciones de herbazal lacustre de tierras bajas de bosque seco tropical, en las mismas se evaluaron las especies vegetales presentes en base a un estimado poblacional, mientras que la abundancia del estrato herbáceo fue evaluada en función del área de su cobertura respecto a 100 m2. El monitoreo se realizó tanto en régimen de lluvia como sin ella durante los años 2006, 2012, 2018, 2020. Un total de 42 especies, 37 géneros y 23 familias fueron registradas en las once estaciones muestreadas. El 55% son monocotiledóneas, 40% eudicotiledóneas y 5% helechos. En las Monocotiledóneas la familia Poaceae está mayormente representada con 12 especies. La fitocenosis en la cuenca del río Taura se ha visto influenciada por la época de mayor o menor precipitación dentro del mismo año, caracterizándose principalmente por las comunidades de plantas de bosque ribereño (BR) y matorral herbáceo (MH) y de bosque hidrófilo de manglar (BH-M).
Sistematização da assistência de enfermagem e as potencialidades na área da enfermagem sob a utilização do software Tasy
Authors: Pissaia Luís Felipe , Costa Arlete Eli Kunz , Oliveira Eniz Conceição
Published: January 2024

O objetivo deste estudo é identificar as potencialidades da aplicação da Sistematização da Assistência de Enfermagem (SAE) por meio do software Tasy para a área da enfermagem. Trata-se de uma pesquisa qualitativa, descritiva e exploratória, tendo como participantes doze estudantes regularmente do curso de graduação em enfermagem da Univates. Os instrumentos de pesquisa foram entrevista individual e diário de itinerância do pesquisador. A análise dos dados seguiu aproximações com a Análise de Conteúdo de Bardin. Os resultados indicam os benefícios de realização da SAE no Tasy para o fortalecimento da relação entre teoria e prática. Outro ponto abordado é a potencialidade para a assistência de qualidade em prol da população atendida e por fim, a gestão dos indicadores e metas da equipe, além do gerenciamento da saúde dos pacientes. Dessa forma, considera-se que a realização da SAE no Tasy possibilita várias potencialidades para a melhoria das ações desenvolvidas pelos enfermeiros.
Tingkat Pemahaman Arti Leksikal pada Leksem yang Berkonsep Abstrak dan Emosi oleh Penyandang Tunarungu
Authors: Lintangsari Alies Poetri , Widodo Wahyu
Published: January 2024

Mahasiswa Tunarungu menghadapi kesulitan penguasaan bahasa, khususnya memahami leksem yang berkonsep Abstrak dan Emosi. Hal ini dikarenakan tunarungu sangat mengandalkan referent (acuan) dalam memahami makna kata. Penelitian ini bertujuan untuk mengetahui (1) bagaimanakah tingkat pemahaman tunarungu terhadap leksem yang berkonsep emosi dan abstrak, (2) Apakah latar belakang pendidikan mahasiswa tunarungu (SMA atau SMA LB) berperan dalam membentuk pemahaman arti abstrak dan emosi? Pengumpulan data dilakukan dengan mengadakan tes tertulis yang berisikan soal leksem berkonsep abstrak dan emosi dengan acuan dan tanpa acuan (gambar). Analisis dilakukan dengan mempertimbangkan dua hal, yaitu pemahaman tunarungu terhadap arti leksem dan ketepatan konteks penggunaan leksem dalam kalimat. Hasil penelitian menunjukkan bahwa pada kata abstrak acuan tidak terlalu berpengaruh pada pemahaman tunarungu, sedangkan pada leksem emosi acuan berpengaruh dalam membantu tunarungu memahami makna leksem.
ESTUDOS DE CASO COMPARADOS SOBRE PRIMEIROS CONCURSOS PARA INGRESSO NAS CARREIRAS DA JUSTIÇA E DO MINISTÉRIO PÚBLICO NO BRASIL, ENTRE OS ANOS 1930 E 1950.
Authors: Axt Gunter
Published: January 2024

o artigo procura comparar dados históricos sobre os primeiros concursos públicos para ingresso na carreira do Ministério Público do Rio Grande do Sul, realizado em 1941, do Ministério Público de Santa Catarina, realizado em 1952, e do Ministério Público Militar, realizado entre 1956 e 1959. Tais eventos são comparados com exemplos de iniciativas pioneiras, como os concursos para ingresso na Magistratura no Estado do Rio Grande do Sul, durante a chamada Primeira República, isto é, antes de 1930. O texto baseia-se em um conjunto de fontes primárias, como entrevistas, matérias jornalísticas de época, correspondências e livros de registros dos primeiros concursos. Os eventos são analisados no contexto da inovação gerencial da modernidade, no sentido da construção burocrática racional-legal. O Brasil conheceu experiências pioneiras na realização de concursos públicos, os quais, inicialmente, ainda se viam expostos à clássica indistinção entre espaço público e privado, que caracterizou a formação social brasileira.