bluuebunny/crossref_metadata_2025 huggingface dataset:
A reappraisal of Gaucher disease patients - Clinical presentation, and diagnosis in rare disease unit of central child teaching hospital in Baghdad province
Authors: Ali Ahmed Ikhlas , Abbas Fadhel Alaa
Published: May 2023

Introduction and Aim: Gaucher disease (GD) is an autosomal recessive ailment caused due to mutations in the GBA1 gene, encoding for the lysosomal enzyme, glucocerebrosidase. The aim was to evaluate the clinical, biochemical, and molecular parameters associated with this disease, as well as to identify symptoms and covariables thought to be most diagnostic of early GD presentation, allowing for early diagnosis and management.
 
Methodology: This cross-sectional study involved twenty-six patients diagnosed with GD at the Metabolic Department of Central Child Teaching Hospital, Baghdad, Iraq. Diagnosis depended mainly on history and physical examination and confirmed by beta-glucosidase enzyme assay of dry blood spot on filter paper and Lyso-GL-1 level. Amplification-based next generation sequencing approach was used in investigating the GBA1 gene at the molecular level.
 
Results: The mean age of the 26 (17 male and 9 female) patients was 9.13 years, with 100% consanguinity and 50% positive family history. The average number of years from the start of clinical manifestations to the diagnosis' validation was 3.82 years. The original age of presentation was 2.83 years, and the initial age of diagnosis was 6.65 years. Hepatosplenomegaly (85%), pallor (88%), splenomegaly (12%), splenectomy (12%), hemorrhage (19%), bone discomfort (23%), bone breakage (12%), and GD type III (19%) were observed. Among patients 65% exhibited radiological bone abnormalities, 54% had Erlenmeyer flask deformity, and 1.5% had osteopenia and fracture. Studies of GBA1 gene showed the mutation C.[1448T>c ](P.[ Leu483Pro] to be the most common. Hepatosplenomegaly and hematological deficiencies were effectively improved by enzyme replacement therapy.
 
Conclusion: In Gaucher disease, GBA1 gene mutation analysis could provide some predictive information about disease variance as well as severity. PCV%, platelet count, ferritin, and lyso-GL-1 levels could be employed as biomarkers for the diagnosis of GD. ERT proved effective in treating hematological and hepatosplenomegaly abnormalities.
A safety profile of Siddha formulation Karisalai Chooranam in Wistar albino rats
Authors: S. Mary Princess Sulekha , G. Dayanand Reddy , A. Muthuvel
Published: May 2023

Introduction and Aim: Karisalai Chooranam (KSC) is used in the traditional Siddha system of medicine for a long time to treat various ailments in the body. Its antistress and antioxidant properties were reported earlier. Investigating the acute and long-term toxicity of Karisalai Chooranam in Wistar albino rats was the goal of the current study.
 
Materials and Methods: For the acute toxicity investigation, Wistar rats were divided into four groups. For fourteen days, the animals were monitored for behavioural changes and toxicological complaints. For ninety days, a total of four categories of animal groups like control, forty mg/kg body weight, two hundred mg/kg body weight and thousand mg/kg body weight were utilized in a long - term toxicity study. The samples of blood were taken on the final day of the trial for biochemical and haematological examination. Animals were sacrificed for monitoring gross necropsy changes and histopathological examination of the liver, kidney and brain.
 
Results: There was no morbidity or death observed in the acute toxicity trial. In the research of long - term toxicity. KSC's haematological and biochemical parameters during analysis did not exhibit any appreciable changes. All the three doses of KSC, the renal and brain histology displayed normal architecture. When the medicine was given to the forty milligram and two hundred milligram dosage groups of animals for 90 days, no toxicity symptoms were present in the case of organ liver. After the medicine was given for 90 days to the thousand milligram dosage group, toxic signs such as programmed and localized cell death became apparent.
 
Conclusion: Toxicity studies proved the safety of KSC in animal models. If KSC is utilized clinically as prescribed in literature, it will not cause any adverse effects.
Müzik Eğitimi Anabilim Dallarında Keman Eğitimi Veren Akademisyenlerin Dört Keman İçin Orijinal/Aranje Edilmiş Eserleri Tanıma ve Kullanma Durumları
Authors: KAPÇAK Şeydagül , KAPÇAK IŞIKSUNGUR Beyzagül
Published: May 2023

Araştırmada Türkiye’deki Müzik Eğitimi Anabilim Dallarında keman eğitimi veren akademisyenlerin dört keman için orijinal/aranje edilmiş eserleri tanıma ve kullanma durumlarının ortaya konulması amaçlanmıştır. Araştırma nitel çerçevede gerçekleştirilen bir durum çalışmasıdır. Araştırmanın çalışma grubunu; Türkiye’deki her bir coğrafi bölgeden seçilmiş bir üniversitenin Müzik Eğitimi Anabilim Dalında görev yapan keman eğitimcileri oluşturmaktadır. Araştırmanın çalışma grubu; amaçlı tesadüfi örnekleme yöntemi ile belirlenmiştir. Amaçlı tesadüfi örnekleme yöntemi ile belirlenen çalışma grubuna ilişkin veriler yarı yapılandırılmış görüşme formu kullanılarak “Google Forms” aracılığıyla toplanmıştır. Görüşme formundan elde edilen veriler, içerik analizi yöntemi kullanılarak analiz edilerek elde edilmiştir. Elde edilen bulgular yorumlanmış ve sonuçlara ilişkin öneriler sunulmuştur.

Araştırmanın sonucunda; repertuvarda bulunan, dört keman için orijinal/aranje edilmiş eserlerin toplam sayısı göz önünde bulundurulduğunda, katılımcıların yeteri kadar eser tanımadıkları ve tanıdıkları eserleri öğrencilerinin eğitiminde kullanan katılımcı sayısının da beklenenden az olduğu tespit edilmiştir. Sonuçlar doğrultusunda; Türk Müzik Kültürü’ne ve keman eğitimine katkı sağlayacak, eğitim niteliğinin yükseltilmesi amaçlı 4 Keman için Klasik Batı Müziği ve Türk Müziği'ne ilişkin basit, orta ve yüksek seviyede, küçük ve büyük ölçekli besteler veya düzenlemeler yapılarak kitaplaştırılması ve yeni eserlerin repertuvara eklenerek tanıtılmasına ilişkin konserler verilmesi önerilmiştir.
The Cool Island Effects of Green Spaces in Hot and Humid Cities: The Case Study of Antalya
Authors: Güldü Elif , Kuşçu Şimşek Çağdaş
Published: May 2023

In this study, cool island (CI) potentials as urban parks and green spaces of Antalya where it is in the Mediterranean climate belt were investigated by handling together with their peripheries’ urban morphology. Surface temperature data were obtained by remote sensing methods using Landsat 8 satellite images. In the study where the GIS techniques were used, the relationships between the cool islands and their surrounding urban texture were analyzed by statistical methods. The results indicate that while the density of adult trees in urban green spaces increases the cooling capacities and cooling distances of green spaces, the morphological characteristics of the peripheries of green spaces change their cooling distances. It is thought that these findings are constituted an important basis for the development of the climate-sensitive urban planning and urban design approach.
The Micro-district … A Smart, Sustainable Vision In The Architecture Of Headquarters Buildings
Authors: Almeamari B.A. Fajer Fareed
Published: May 2023

People spend about 70-80% of their time indoors. When it comes to employees who averagely start working from the age of 21 until the age of retirement, 60; more or less. Almost 8 to 9 hours per day is the average of working hours. According to Bahrain’s labour market regulatory authority, that makes it 40 to 45 hours per week (5 days of work). Thus, it exerts a significant impact upon the lives of a great number of people. Today the power that we must unleash is the power of innovation. Human beings, their ideas, inventions, dreams, and connections, are the capital of the future. Because where great minds go today, great things will happen tomorrow. “Micro smart district” is the point of the research that aims to introduce design guidelines for the smart workplace in headquarters’ buildings and create intimates and intelligent ways in a comfortable environment.
The Critical Period Hypothesis of Second Language Acquisition Theory of Eric Lenneberg's
Authors: Siahaan Frisca
Published: May 2023

In second language acquisition, The Critical Period Hypothesis (CPH) holds that there is a critical time period for a person to learn a new language with native proficiency. This time usually begins around the age of two and ends just before puberty. According to the hypothesis, learning a new language after this critical period will be more difficult and unsuccessful. The crucial phase is the stage of a person's development when their nervous system is primed and sensitive to environmental stimuli, according to developmental psychology. If a person does not receive the appropriate environmental stimuli during this time, their capacity to learn new skills will deteriorate, compromising a variety of adult social functions. If a child does not learn a language during this vital era, they are unlikely to achieve native fluency in their first language. Because of the adaptability of the brain, a person is poised to learn new abilities throughout the critical period. Synapses, or brain connections, are extremely receptive to information. Some researchers refer to the'sensitive period' or weak critical period' as a synonym for the critical period. The sensitive phase is comparable to thecritical period in that it is characterized by a high level of neuroplasticity and rapid formation of new synapses in the brain. The key distinction is that the sensitive phase is thought to endure longer than puberty, but there are no hard bounds.
Error Analysis on Reading Comprehension at Vocational School
Authors: Tamba Rani Juliana , Pardede Hilman
Published: May 2023

This research was conducted to know the students’ errors in reading comprehension from 25students as the sample, there are 15 students have difficulties in identifying main idea, 5 students havedifficulties in identifying name, 22 students have difficulties in identifying spesific word, 7 students havedifficulties in finding reference, and 22 students have difficulties in understanding the structure of thetext. It can be seen from the high number of percentage of participants who answered wrong on everyquestion of the test.This research is a case study and it uses descriptive quantitative method. The subjectsof the research are fifty fife students of the ten grade students at SMK SWASTA Palapa, Pancur Batu,Pancur Batu who are detected as having difficulties in understanding English reading descriptive textand an English teacher who handles the classes. The test were used as the instruments of this study. Thetest was used to obtain the data about the students’ difficulties in understanding English readingdescriptive text.The finding shows that the majority of the students find difficulties in identifying mainidea of the text, more than half of students made mistake in identifying specific word in the text andmany students cannot understand the structure of the text. Whereas, the factors causing the students’difficulties in understanding English reading descriptive text are learners’ background, teachingtechnique,.and the learners’ environment.
Teaching Speaking in Communicative Skills Through Snowball Throwing
Authors: Simanjuntak Hotnida Irawaty
Published: May 2023

The purpose of writing this paper is to describe teaching speaking in the communicative skill subject throughsnowball throwing method. In speaking, many students still get some difficulties, because probably, they worriedabout their grammar mistakes. The teacher can use snowball throwing method to make students enjoyable to learnspeaking. This method provides an efficient way of getting students to share their different ideas or perspective andcan help students master spoken english. It is suitable for the students because it helps the students to understandhow to speak well. It is usually used a ball and it is made from a paper or rubber and the ball will be thrown torandom student and once the student get the ball, he or she will have a chance to speak in the classroom. When theteacher conducts teaching and learning speaking through snowball throwing method, the students will be enjoyablein learning process. And it is recommended that the teachers consider to use snowball throwing method as one ofthe teaching speaking methods in the class.
EVALUATION OF NASOLABIAL ANGLE IN SOUTHERN PUNJAB AND ITS RELATION TO FACIAL AND NASAL MOLDING
Authors: SHAGUFTA KANWAL  , MUHAMMAD ILYAS ANJUM  , MUHAMMAD IKRASH ANJUM  , FATIMA ALTAF  , RAMAL FATIMA  , ZUBAIR HASSAN AWAISI
Published: May 2023

Head and facial molding has been carried out as a cultural practice in southern Punjab to enhance facial features. This molding can affect the nasolabial angle which is an important parameter for diagnosis and treatment planning of orthodontic patients. The purpose of our study is to evaluate the nasolabial angle of southern Punjab belt. Nasolabial angle was evaluated from the cephalometric radiographs of 60 patients. Mean and standard deviation were calculated and had the following results, (104.27±10.84 in males and 100.30±12.19 in females). Our value is in accordance with other Asian countries where facial and nasal molding is practiced.
DEEP NECK SPACE INFECTIONS A RETROSPECTIVE STUDY
Authors: MUHAMMAD ILYAS  , MAZHAR IFTIKHAR  , MUHAMMAD IQBAL  , GHULAM DASTAGIR  , SHEHBAZ HUSSAIN  , NAJAM UL HASNAIN KHAN
Published: May 2023

Background: Deep neck space infections (DNSI) mostly present a true clinical challenge. Though the use of antibiotics has decrease the incidence but DNSI remain a leading public health problem. Objective: To evaluate deep neck space infections among patients.

Method: It was retrospective study in which 50 patients with DNSI admitted in ENT Department of Lahore General Hospital, Lahore, from June 2016 to April 2019 were included. All the parameters such as gender, age, symptoms, etiological factors and location of abscess were studied.

Results: Among 50 patients, 66.0% were males. 90.0% patients had neck pain, 86.0% neck swelling, 82.0% dysphagia and 76.0% fever. Among these patients, 36.0% had odontogenic infection and 50.0% had ludwig’s angina.

Conclusion: Deep neck space infections were more prevalent among males and the most common symptoms were neck pain, neck swelling, dysphagia, fever and odynophagia. Odontogenic infections were most frequent etiological factor and Ludwig’s angina was very common presentation of DNSI.
A STUDY ABOUT INCLINATION OF PEOPLE TOWARDS ORGAN DONATION
Authors: PERVAIZ ZARIF  , MUHAMMAD ASIF  , ZUBIA IQBAL
Published: May 2023

Objective: People with nonfunctioning organs waiting for donation are increasing but provision of viable organs is not meeting the need. As many of the Pakistanis are poor who sell their organs for money. This has led to illegal transplants. Now a legal way has been adopted by the Government to prevent this illegal trafficking of human organs. This study was carried out to know the willingness of peoples about organs donation.

Material Methods: From general population by convenience nonprobability method 130 subjects both males and females of age 18 years and above were requested to answer the questionnaire. Results: 130 subjects included 102 males and 28 females.59.8% males 32.1% females were willing for organ donation. 55.26% of educated and 31.25% of uneducated were willing for organ donation. Conclusion: To prevent illegal donation of organs and to alleviate present level of organ donation it is pertinent to improve health education levels in general people0.
ROLE OF ASPIRIN AS PROPHYLAXIS AGAINST COLORECTAL CANCER
Authors: UMAR FAROOQ QURESHI  , MUHAMMAD NAVEED ASLAM  , MUHAMMAD NADEEM ANSARI  , MOHSIN KHAN
Published: May 2023

Introduction: Colorectal cancer (Bowel Cancer) is cancer of colon and rectum that are the parts of large intestine. [1] Symptoms are pain on defecation, blood and mucus in feces.[2] Risk factors of colon cancer are certain diet that is red meat, alcohol, and meat that is processed, obesity, smoking, and lack of physical activity.[3, 4]. Others factors are old age, type three personalities and usage of spicy foods. People with inflammatory bowel disease (ulcerative colitis and Crohn's disease), familial adenomatous polyposis are at high threat of cancer of colon and rectum. This can be prevented by using aspirin usage in long term.[5,6,7]. In high danger families, cancer of colon can be prevented by using aspirin and colonoscopies are recommended in these families.[8,9] Colorectal cancer can be diagnosed by sigmoidoscopy or colonoscopy.[10,11,12] .Most of people (50 %) do not report any signs and symptoms of colon cancer.[13,14]. Streptococcus gallolyticus is associated with colorectal cancer.[15, 16]

Objective: To find out the role of aspirin as prophylaxis against colorectal cancer.

Methodology: This descriptive retrospective study was conducted in the Ibnae –Sienna Hospital Multan from January 2016 to August 2017. 100 patients of each group between 50-65 years of age were included in the study; all were male whose were taken aspirin for pain killer and for fever as routine since long term and 100 male patients of same age not used aspirin. Date analysis was carried out using SPSS version 19 Software. Results: All were male patients 100 (100 %) 50-65 years of age. Most of the patients (98) 98 % who used aspirin in the past have no colorectal cancer as compared to patients (18) 18 % who not taken aspirin in the past have colorectal cancer.

Conclusion: Patients used aspirin since long have very least possibilities of colorectal cancer
LOCAL AUDIT OF PRACTICES OF NG FEEDING IN ACCORDANCE TO THE NICE-NUTRITIONAL SUPPORT GUIDELINES 2006 & BSG 2003
Authors: MUHAMMAD IMRAN HASAN KHAN  , FATIMA KHALID
Published: May 2023

OBJECTIVES:

To compare practice of NG feeding in our hospital with standard protocols & suggest improvements. AIM:

1. To promote a clear, consistent and evidenced based approach to the placement, care and management of nasogastric tubes. 2. To promote the safety and well-being of all patients who require a nasogastric tube. SAMPLE:

Health care professionals (staff nurses, House Officers , Medical Officers, Post graduate Trainees) working in Ward, ICU & HDU of LGH during the month of June 2015, were recruited to participate in this study. DATA SOURCE:

Performa based AUDIT TYPE:

Health care professionals Surve
SİMÜLASYON DESTEKLİ ÖRNEK BİR TASARIM İLE DÖKÜM HATALARININ ENGELLENMESİ VE MALİYETLERİN DÜŞÜRÜLMESİ
Authors: ÖZKAN Erhan
Published: May 2023

Bu makalede enerji sektöründe yaygın olarak kullanılan bir komponente ait kum kalıba döküm prosesinde yolluk tasarımına bağlı olarak hatasız bir ürün elde edilmesine yönelik döküm simülasyon işlemleri ve bu işlemlerin gerçek döküm uygulamasına ait çalışmalar gerçekleştirilmiştir. Döküm ürünü geometrisinin ihtiyaçlarına uygun olan tahliye ve yolluk sistemlerinin tasarımı yapılmıştır. Solidworks ile tasarım simülasyonları gerçekleştirilmesini takiben Anycasting simülasyon programı kullanılarak katılaşma, dolum-zaman-sıcaklık analizleri ile mikro ve makro çekintilerin simülasyon çalışmaları gerçekleştirilmiştir. Simülasyon sonuçları ele alınarak yolluk-tahliye mekanizmaları yenilenmiştir. Farklı yapıda tasarlanan tahliye-yolluk sistemleri için gerçekleştirilen simülasyon çalışmaları araştırılarak mukayese yapılmış ve prototip imalat sonuçları değerlendirilmiştir. Simülasyon sonuçları döküm prosesinde yolluk tasarımının ürün kalitesine doğrudan etkili olduğunu ortaya koymaktadır. Yolluk tasarımlarının yenilenmesi neticesinde makro-mikro çekinti ile birlikte dolum süresi ve akış hızları değerlerinde de azalma görülmüştür. Simülasyon çalışmaları neticesinde döküm esnasında oluşması muhtemel hatalı parçaların üretimi ve kusurlu kalıp tasarımının önüne geçilmesi mümkün olacak ve parça başına düşen üretim maliyetleri azalacaktır.
Analisis Pengaruh Profitabilitas, Ukuran Perusahaan Dan Leverage Terhadap Nilai Perusahaan
Authors: Heliani  , Nur Hidayah K Fadhilah  , Meutia Riany
Published: May 2023

Penelitian ini dilakukan dengan tujuan untuk mengetahui bagaimana pengaruh profitabilitas, ukuran perusahaan, dan leverage terhadap nilai perusahaan pada Perusahaan Sektor Industri Dasar dan Kimia yang terdaftar di Bursa Efek Indonesia periode 2018-2020. Metode pengambilan sampel dalam penelitian ini menggunakan metode purposive sampling. Secara parsial profitabilitas berpengaruh signifikan terhadap nilai perusahaan, ukuran perusahaan tidak berpengaruh terhadap nilai perusahaan, leverage berpengaruh signifikan terhadap nilai perusahaan. Secara simultan profitabilitas, ukuran perusahaan, dan leverage berpengaruh terhadap nilai perusahaan Perusahaan Sektor Industri Dasar dan Kimia yang terdaftar di Bursa Efek Indonesia periode 2018-2020.
Relato de experiência sobre a participação em um Grupo de Trabalho da Comissão Nacional de Ética em Pesquisa
Authors: Batista e Silva Martinho Braga
Published: May 2023

Trata-se de um relato da participação do autor no Grupo de Trabalho da Comissão Nacional de Ética em Pesquisa (Conep), no período de 2017 a 2021, encarregado de elaborar a Resolução sobre a tipificação da pesquisa e a tramitação dos protocolos de pesquisa no Sistema CEP/Conep (Resolução CNS Nº 674/2022). O artigo está dividido em quatro partes: prévia, proteção, participação e pendência. Uma perspectiva antropológica sobre as instituições estatais sustenta a reflexão sobre a aplicação da noção de vulnerabilidade na avaliação ética de pesquisas.
The Path of Constructing a Platform of Academic Affairs System based on Continuing Education in Universities - Taking Zhejiang Open University as an Example
Authors: Lin Yufan
Published: May 2023

As a consequence of the field's constant expansion year after year, the path of developing the academic affairs system platform, which is directly linked to college continuing education, has received increasing attention. Using Zhejiang Open University as a starting example, this study discusses the challenges with existing academic affairs administration in colleges and universities. It discovers that the primary concerns are the large workload of class schedule management, the lack of data support for teaching inspection& teaching quality assessment, the redundant construction of multiple systems & multiple entrances, teachers' workload accounting is unclear, student safety issues and student mental health. We handle the difficulties one at a time as we create the platform, by establishing the institutional assurance system, integrating information service entrances and so on. Simultaneously, we focus on recommendations as exploring additional features, evaluating the effectiveness in various educational contexts, and adapting the platform to different institutions. As a consequence, those actions can make contributions such as improved top-level design, data effectiveness and scientific decision-making.
Prognostic and Predictive Markers for Immunotherapy in Non Small Cell Lung Cancer
Authors:   Department of Infectious Diseases, Clinical Hospital for Infectious Diseases, Cluj-Napoca, Romania, Filip Petru Vladimir , Farcaș Marius ,   Department of Clinical Hematology, Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
Published: May 2023

n the last decade, lung cancer patients have benefited from novel and efficient therapies such as immunotherapy. However, currently, there is no standardized method for predicting the success of immunotherapy. We review the potential immune markers such as the tumor mutational burden (TMB), the presence of intratumor infiltrating lymphocytes (TIL), the neutrophils/ lymphocytes ratio (NLR) and microsatellite instability (MSI), providing a summary of their reported utility, prognostic and predictive value.
Radiomics Breakthrough Could Spark the Head and Neck Cancer Radiotherapy Revolution
Authors:   ", Mireștean Camil Ciprian ,   1 University of Medicine and Pharmacy Craiova, Department of Oncology and Radiotherapy, Craiova 200349, Romania,   2 Railways Clinical Hospital Iasi, Department of Surgery, Iași 700506, Romania", Iancu Roxana Irina ,   "3 “Gr. T. Popa” University of Medicine and Pharmacy, Faculty of Dental Medicine, Oral Pathology Department, Iași 700115, Romania; 4 “St. Spiridon” Emergency Universitary Hospital, Department of Clinical Laboratory, Iași 700111, Romania", Iancu Dragoș Petru Teodor ,   "5 “Gr. T. Popa” University of Medicine and Pharmacy, Faculty of Medicine, Oncology and Radiotherapy Department, Iași 700115, Romania; 6 Regional Institute of Oncology, Department of Radiation Oncology, Iași 700483, Romania"
Published: May 2023

Radiomics, the method by which digital images could be transformed into mineable data, opens new horizons for biomedical research and in particular in oncology, for diagnostic, predictive and prognostic purposes. The use of artificial intelligence (AI) algorithms in the radiomics algorithm makes radiomics and AI two inseparable, intricate domains. AI defined as machine capability of imitating human intelligence, has already been implemented on a large scale in oncology and radiotherapy. One of the two main branches (the virtual one) of machine learning depending on the application, artificial intelligence is involved both in the diagnostics processes as well as treatment planning, – dose delivery and radiotherapy quality assurance (QA). Head and neck cancer (HNC), although it is the 6th malignancy in incidence worldwide, is redoubtable due to the high rate of therapeutic failures, especially of loco-regional recurrence. Although intensity-modulated treatment techniques have brought benefits especially in limiting the toxicities associated with irradiation, AI and especially radiomics, due the possibility to extract data from high-resolution medical imaging in order to build predictive diagnostic and prognostic models, could upgrade the technological revolution in HNC radiotherapy at a higher level. Beyond the already intensively studied diagnostic applications, radiomics could be useful for predicting the response to radio-chemotherapy, anticipating treatment related toxicities and for pre-therapeutic evaluation of the need for adaptive radiotherapy (ART). Clinical-radiomic models have superior predictive power and the delta variation of radiomic features could be a biomarker still less evaluated. Due to characteristics of modern radiotherapy which includes as standard the image guided radiotherapy (IGRT) concept using the computer tomography (CT) simulator and Cone Beam CT (CBCT) to ensure the accuracy of the patient’s positioning during the treatment, radiomics in radiotherapy could be the spearhead of the translation radiomics in daily clinical routine and of the HNC RGRT concept development.
"Pharyngolaringeal Neoplasm Treated with Surgery and Radiotherapy – Squamous Cell Carcinoma with Sarcomatoid Dedifferentiation – Clinical Case"
Authors:   Colțea Clinical Hospital, Medical Oncology Department, Bucharest, Romania, Croitoru Bianca Elena , Pîrvu Edvina Elena ,   Colțea Clinical Hospital, Medical Oncology Department, Bucharest, Romania
Published: May 2023

"Sarcomatoid carcinoma is a rare and aggressive form of squamous cell carcinoma (SCC). It is a biphasic tumor that has been shown to be a dedifferentiated monoclonal form of classic squamous cell carcinoma. The factors that contribute to proliferation of SCC to sarcomatoid carcinoma are not precisely known but some studies revealed the importance of anterior radiation therapy. This case report describes a 62-year-old man, heavy smoker and alcohol drinker diagnosed with laryngeal neoplasm. The pathological diagnosis was well-differentiated SCC of the piriform sinus. Surgery was performed and the pathology report revealed medium differentiated SCC, pT4aN1M0. The patient underwent external radiotherapy (RT) with 66Gy/tumour bed in 33 fractions. At 4 months post RT the clinical exam revealed tumor recurrence near the tracheal stoma. A second surgery was performed and the pathology diagnosed a recurrence of SCC with sarcomatoid-looking areas, with two surgical margins being invaded by the tumor. Postoperative computer tomography (CT) of the neck showed no evidence of macroscopic disease. The next treatment used was chemotherapy with 4 cycles of carboplatin paclitaxel but soon after, an inoperable locoregional recurrence was diagnosed and he started treatment with Nivolumab followed by rapid locoregional progression. Squamous cell carcinoma with sarcomatoid dedifferentiation is a rare histology of laryngeal cancer, with an aggressive behavior that requires intense treatment and follow-up."
Techniques of Maxillary Sinus Floor Elevation
Authors: Sharma Manish Kumar , Sharma Archna
Published: May 2023

Posterior maxillary region is often limited for standard implant placement because of reduced residual vertical bone height. An elevation of the maxillary sinus floor is one option in solving this problem. This article describes the various surgical techniques that can be used to enter the sinus cavity, elevating the sinus membrane and placing the bone grafts for placement of dental implants in the resorbed posterior maxillary region.
Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome
Authors: Akther Ummay Sufia , Kabir Jakaria , Ali Liaquat , Setu Nazia Haque
Published: May 2023

Background: Pregnancy is associated with various complications such as pre-eclampsia, SGA, preterm birth etc. Low dose aspirin is a possible medication to minimize these adverse outcomes. The aim of this study was to evaluate the use of low dose aspirin for primary prevention of adverse pregnancy outcome. Material Methods: This cross-sectional study was conducted in department of Gynaecology, North Bengal Medical College Hospital, Mirjapur Bkash Hospital, Mirjapur, Tangail, Bangladesh, during the period from June 2021 to August 2022. Total 200 pregnant women were included in this study. Results: In this study, the mean (±SD) age of the study subjects were 25.12 ± 5.49 years and 25.00 ± 4.83 years in LDA group and control group, respectively. There was no statistically significant (p>0.05) difference in age between the groups. The rate of caesarean section was higher in control group (68%) compared to LDA group (59%) but there was no statistically significant (p>0.05) difference among the groups. In our study, 8% pregnant women in LDA group and 19% pregnant women in control group had gestational hypertension, pre-eclampsia was seen in 6% and 13% pregnant women in LDA group and control group, respectively, preterm birth was seen in 8% and 17% pregnant women in LDA group and control group, respectively, SGA was seen in 19% and 32% pregnant women in LDA group and control group, respectively, and fetal distress was seen in 2% pregnant women in both LDA group and control group. There were statistically significant (p<0.05) differences in complications except fetal distress. Mean (±SD) neonatal birth weight was 2.88±1.03 kg and 2.74±0.85 kg in LDA group and control group, respectively and there was no statistically significant (p>0.05) difference. Conclusion: We found that low dose aspirin could significantly reduce the risk of adverse outcomes, especially for pre-eclampsia, SGA and preterm birth.
Assessment of Knowledge and Attitude Toward Antibiotic Use and Resistance among 4th Year Students of Shaheed Monsur Ali Medical College
Authors: Alima Fouzia , Moon kawsar Jahan , Afrin Samantha , Noor Sarah Binte , Amin Mohammed Ruhul , Afroz Rumana , Ferdouse Faria , Noor Syeda Fateha
Published: May 2023

Background: The misuse and overuse of antibiotics can lead to antibiotic resistance. Thus, it is important to have adequate knowledge and attitude toward antibiotic use and resistance for all specially the medical students who are the future healthcare practitioners. The aim of this study was to assess the knowledge and attitude toward antibiotic use and resistance among 4th year students of Shaheed Monsur Ali medical college. Material Methods: This cross-sectional study was conducted in Shaheed Monsur Ali medical college, Dhaka, Bangladesh from October 2022 to December 2022. A structured questionnaire was administered to 126 randomly selected undergraduate medical students. Results: In our study, the percentage of male and female was same. Majority of the participants (55.56%) always get a prescription before starting antibiotics. Most of the participants (60.32%) never stop taking the prescribed antibiotics after their symptoms improved. Majority of the participants (54.76%) sometimes completed the course of the prescribed antibiotic treatment. In our study, majority of the participants (54.76%) sometimes take the correct dose of their antibiotics at the right time for the full duration. In this study, majority of the participants (47.62%) never save the remaining antibiotics for next time they get sick. Majority of the participants (73.02%) sometimes give leftover medication to friends or family if they get sick. For cough or sore throat, majority of the participants (48.41%) sometimes prefer taking an antibiotic. Most of the participants (69.05%) never buy the same antibiotics if they are sick that helped them get better when they had the same symptoms before. Most of the participants (96.03%) always check the expiry date of the antibiotic before using it. Knowledge level of antibiotic in majority of the participants (47.62%) was very good. Knowledge level of antibiotic resistance in majority of the participants (54.76%) was very good. Attitude level of antibiotic usage in majority of the participants (34.13%) was average, followed by 32.54% had bad, 32.54% good attitude level. Conclusion: From the findings of the study, it can be concluded though the knowledge level of the medical students is adequate, they are not careful about the usage of antibiotics and often misuse it. The students tend to not follow the rules of the usage guideline of antibiotics which ultimately results in antibiotic resistance. They should be more conscious to follow the guidelines of antibiotic usage.
Functional Outcome of Unstable Intertrochanteric fracture Treated with Proximal Femoral Nail Anti-Rotation
Authors: Mazumder Md Abu Abdullah Hossain , Hossain Md.Sazzad , Paul Sujit , Suzon Md Jahangir Alom , Hosen Md. Sazzad , Mahsin Mohammad
Published: May 2023

Background: Intertrochanteric fractures are one of the most disabling injuries, most commonly observed among the elderly, and shows a challenging problem for orthopedic surgeons. Nowadays, intertrochanteric fractures are being treated with different extramedullary and intramedullary devices. Among them, intramedullary fixations show the best outcome, and are widely used for different treatment of unstable intertrochanteric fractures (type 31A2, 31A3). A new device designed by AO/ASIF, the Proximal Femoral Nail Anti-Rotation (PFNA) represents a unique intramedullary nail system for improved management, with decrease in the number of complications. Material Methods: This prospective hospital based clinical trial was conducted at the Department of Orthopaedic Surgery, Chittagong Medical College Hospital, Chattogram, Bangladesh. The study duration was 2 years, from January 2018 to December 2019. During this period, a total of 48 patients who were admitted in the study place with unstable intertrochanteric fracture of femur were included in the study. Patients were followed up for 24 weeks, and overall outcome was measured using Kyle’s Criteria. Results: 48 patients were treated for unstable intertrochanteric fractures. The majority were between 50-80 years old (62.5%), with a mean age of 58.38. Gender distribution was even, with 50% male and 50% female. 75% of fractures were caused by a fall from height and 25% by a road traffic accident. 68.75% of fractures were type 31A3 and 31.25% were type 31A2. 68.75% of patients did not have comorbidities. The mean time interval for fixation was 12.6 days, and the majority of operations lasted between 45-90 minutes. 87.5% had a closed reduction and 12.5% had an open reduction. 64.58% of patients had radiation time between 2.5-3.3 minutes. At 2 weeks follow-up, 21.28% had poor functional outcome, 78.72% had fair functional outcome, and none had good or excellent outcomes. At 6 months follow-up, 2.17% had poor outcomes, 8.70% had fair outcomes, 34.78% had good outcomes, and 54.35% had excellent outcomes. 16.67% of patients experienced complications such as infection, varus, delayed union, and lateral migration. Conclusion: Most patients achieved good to excellent functional outcomes after treatment, with minimal complications.
Menstrual Abnormalities Among Adolescent Females Attending a Tertiary Care Hospital in North India
Authors: Fayaz Farhana , Khurshid Nadia , Ismail Haamid
Published: May 2023

Background: To study the menstrual abnormalities among adolescent females attending a gynaecolocial outpatient department (OPD) in a tertiary care hospital. Material Methods: It was a cross sectional study which was carried at outpatient department (OPD) of obstetrics and gynaecology, Government medical college Srinagar over a period of 6 months. A total of 90 adolescent females in the age group 10-19 years were included in the study. Along with the demographic profile, menstrual abnormalities were evaluated with the help of self-structured questionnaire. Results: The mean age of the study population was 15.6 ± 2.8 years. Majority of the adolescent females were in the age group of 16-19 years (44.4%), literate with formal education above 10th class (37.8%) and from rural background (56.7%).Dysmenorrhea was the most common menstrual morbidity in 64.4% of adolescent females followed by menorrhagia (26.7%). Pain abdomen was the most common premenstrual symptom encountered by 62.2% of females. Conclusion: Menstrual abnormalities are common in the adolescent females with dysmenorrhea being the commonest.
Maternal Characteristics of Full-Term Birth Asphyxia Neonates
Authors: Prodhan MD Shamsuzzaman , Azad Abu Zafur Md , Sultana Ayesha , Islam MD Monwarul , Hossian Shah MD Moazzem , Zaman Mostafa , Sultana Ummey Wahida
Published: May 2023

Background: In developing countries, perinatal hypoxia is still a leading cause of mortality and disability. In 2011, the infant mortality rate dropped from 92 per 1000 live births in 1991 to 43 per 1000 live births. However, neonatal mortality in Bangladesh remains high, accounting for more than half of all deaths under the age of five and more than two-thirds of infant mortality. As a result, any qualities that can operate as a risk factor for prenatal asphyxia can be quite beneficial. The aim of the study was to observe the maternal characteristics of perinatal asphyxia in full-term pregnancies. Material Methods: This cross-sectional descriptive study was conducted at the Department of Obstetrics and Pediatrics, Rangpur Medical Collage, and Hospital, Rangpur, Bangladesh. The study duration was 2 years, from January 2012 to December 2013. The study was conducted with a total of 60 cases of birth asphyxia, who were delivered or admitted into the study hospital. Results: In 70% of cases, the mother was Primipara. Among the neonates, 61.67% were male, and 38.33% were female. Only 33% of the case neonates had received regular antenatal check-ups, while 55% had irregular check-ups, and 11.67% had no antenatal checkups. According to the grading of asphyxia, 51.67% of neonates had moderate asphyxia, 20% had mild asphyxia, and 28.33% had severe asphyxia. The mean serum sodium value in mild, moderate, and severe asphyxia were 135.33, 123.42, and 121.53 mmol/L respectively. Mean serum potassium values were 4.11, 4.86, and 5.51 mmol/L respectively. Mean serum creatinine 0.72, 1.00, and 1.83 mg/dl respectively. Mean blood urea levels were 36.17, 58.97, and 88.06 mg/dl respectively. A significant difference was observed between the mean values of serum electrolytes and patients’ asphyxia grade. Conclusion: The study findings revealed that birth asphyxia was more common among vaginal deliveries and irregular or no neonatal care cases. Primipara patients had a higher likelihood of neonatal asphyxia. Serum electrolyte levels varied significantly based on the grade of asphyxia.
Association of Clinical Presentation at Different Stages of Carcinoma Cervix
Authors: Akhter Hachina , Begum Ferdousi
Published: May 2023

Background: Cancer cervix is the most common cancer in women in developing countries where screening facilities are inadequate. The incidence of cervical cancer is steadily declining in the developed world. The rate of cervical cancer is decreasing day by day due to their awareness of cervical cancer, especially its risk factors, and undertaking measure like routine screening tests. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stage. This study aimed to analyze the association of clinical presentation at different stages of carcinoma cervix. Material & Methods: This descriptive study was conducted in Chittagong Medical College Hospital, taking 100 randomly selected patients of carcinoma cervix over one year (July 2019 to June 2020). The research protocol was approved by the research committee (Local Ethical committee). Informed written consent was taken from each patient. Results: Among the study subjects, most of the respondents (32, 32.0%) belonged to 51-60 years old followed by (24, 24.0%) 41-50 years and >60 years of age. Most (76, 76.0%) of the patients presented with blood-stained vaginal discharge. Significant numbers of the patient presented with foul smelling per vaginal discharge (72, 72.0%) and post-coital bleeding (68, 68.0%). Only 8% of the patients had haematuria signifying the advanced stage of the disease. Most of the patients about 72.0% sought medical advice within one year of developing symptoms. 56.0% of patients were menopausal, only 20.0% of patients had regular menstruation, and 24.0% of patients had irregular menstruation. 24.0% of patients had metrorrhagia and 2.0% of patients had dysmenorrhoea. Some degree of anemia was present in almost all patients. Only 16.0% of the patients had severe anemia 6.0% of the patients had dependent edema and 4.0% had lymphadenopathy. Most of the patients had cauliflower-type (54.0%) lesions in the cervix followed by 36.0% of patients who had the ulcerative type of growth in the cervix. Among the respondents, 96.0% of the patients had squamous cell carcinoma and only 4% had adenocarcinoma. Most (44, 44.0%) of the patients presented in the hospital with stage II ca cervix, followed by stage III (40, 40.0%). Conclusion: Most common presentation was blood-stained per-vaginal discharge, followed by foul-smelling per-vaginal discharge and post-coital bleeding. All the patients were clinically anemic, some showed severe anemia. The majority of the patient in this series showed a cauliflower-like lesion, followed by an ulcerative lesion. Among all patients majority (96.0%) had squamous cell carcinoma and the remaining had adenocarcinoma. Most of the patients presented in the hospital with stage II ca cervix, followed by stage III.
The Clinical Outcome of Brolucizumab in the Treatment of Neovascular Age-Related Macular Degeneration – A Prospective Observational Study
Authors: Mukta Ziaul Ahsan , Khatun Dilara , Khanom Tasnim , Bashir Mashrur Al , Nawaz Al , Dutee Nabila Noor
Published: May 2023

Background: Neovascular age-related macular degeneration (nAMD), also known as wet AMD, is a chronic eye disease that affects the macula, which is the central part of the retina responsible for sharp, central vision. Brolucizumab is a type of anti-vascular endothelial growth factor (VEGF) drug, which works by blocking the activity of a protein called VEGF that promotes the growth of abnormal blood vessels under the macula in neovascular AMD. The aim of this study was to evaluate the clinical outcome of brolucizumab in the treatment of neovascular age-related macular degeneration. Material & Methods: This prospective observational study was conducted in Department of Ophthalmology, Bangladesh Eye Hospital & Institute Ltd, Dhaka, Bangladesh, during the period from February 2022 to February 2023. Total 60 patients with neovascular AMD were included in this study who were treated with brolucizumab. Results: The mean age of the patients was 74.3 (SD±9.8) years. Majority of the study subjects were (51.7%) female patients in the study. In our study, majority (38.3%) of the patients had only their right eye affected. In optical coherence tomography (OCT) findings, we found that a high percentage of patients had subretinal fluid (85%), intraretinal fluid (61.7%), and sub-RPE fluid (83.3%). The BCVA showed a significant change after 12 weeks of treatment, as indicated by the P-value of 0.0007. Here improvement of vision was seen in patients with AMD with active Choroidal neovascularization (CNV). But in case of AMD with macular scar, no improvement of vision was seen. In addition, the SRT, FCP, and CMT parameters also showed a statistically significant (P<0.001) improvement after brolucizumab treatment. In our study, 4 patients (6.7%) experienced intraocular inflammation, which is inflammation within the eye, 2 patients (3.3%) reported cloudy vision, and 3 patients (5%) experienced eye redness as a complication of the treatment. The majority of the patients, 51 (85%) did not experience any complications from the treatment. After treatment, improved vision was seen in most of the study patients (70%) and 30% had no improvement. Conclusion: From the findings of our study, it can be concluded that brolucizumab may be an effective treatment for neovascular AMD, as it can improve the best-corrected visual acuity and structural outcomes of the retina such as subfoveal retinal thickness, foveal center point, and central macular thickness. There was also a tolerable complication rate after treatment.
Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report
Authors: Ferdausi Munira , Adhikary Alpana , Rashed Begum Sultana Hasina , Yasmin Mehbuba
Published: May 2023

Uterine inversion is a condition in which the interior surface of the relaxed uterus protrudes through the vaginal entrance. Its causes are divided into two categories: puerperal and non-puerperal, with puerperal uterine inversion being more common than non-puerperal uterine inversion. The most common variety is acute inversion, which occurs immediately or within 24 hours after delivery. Chronic Uterine Inversions (CUI) that occur more than four weeks after delivery are uncommon. In this study we discuss a case of a 30-year-old woman who came with the complaints of feeling of a mass in the vagina after her last confinement which was gradually coming down through the vagina and remain outside the introitus for 5 years. Based on clinical and sonographic evaluation, she was diagnosed with CUI and developed post partum haemorrhage. We adopted Haultain’s method for correction of CUI. Since, CUI as a painless vaginal mass in the delayed post-partum period is uncommon and hence documented.