bluuebunny/crossref_metadata_2025 huggingface dataset:
PENENTUAN PRIORITAS INFRASTRUKTUR JALAN DENGAN METODE ANALYTIC HIERARCHY PROCESS (AHP) EXPERT CHOICE STUDI KASUS: JALAN RAYA DEMAK-GODONG
Authors: Yuliani Uppit
Published: May 2021

Proses penentuan proyek jalan pada pembangunan infrastruktur jalan, disusun berdasarkan skala kebutuhan dan kemendesakan seperti yang ada dalam Daftar Usulan Rencana Proyek (DURP). Pada penerapannya di lapangan ditemukan perbedaan antara DURP dengan rencana proyek yang telah disetujui seperti pada Daftar Isian Proyek (DIP). Studi penelitian menggunakan kasus jalan raya Demak – Godong Jawa Tengah yang dibangun oleh Dinas Bina Marga. Pendekatan ilmiah perlu dilakukan sebagai bahan untuk memutuskan penanganan proyek jalan sehingga dapat mengurangi unsur subyektivitas para pembuat kebijakan. Metode ilmiah yang digunakan adalah metode Analytic Hierarchy Process (AHP), metode yang cukup dikenal dan banyak digunakan dalam pengambilan keputusan dan manajemen. Melalui studi ini dapat dibuktikan bahwa metode AHP cukup handal dalam membantu para pembuat kebijakan dalam proses pengambilan keputusan yang obyektif. Metode AHP yang digunakan adalah Expert Choice untuk menentukan manakah prioritas jalan yang tepat, apakah beton atau aspal melihat dari beberapa faktor seperti daya tahan konstruksi serta dari segi penilaian kualitatif berupa perbandingan tingkat kenyamanan, dampak lingkungan, dampak sosial, ketersediaan bahan & peralatan dilokasi, serta metode & teknologi pelaksanaan. Dari hasil penelitian dapat diketahui faktor teknis yang mempunyai bobot tertinggi adalah faktor daya tahan terhadap cuaca sebagai prioritas dengan nilai 0,493, faktor non teknis yang mempunyai bobot tertinggi adalah faktor ketersediaan sumber daya dengan nilai prioritas 0,298 terhadap cuaca, 0,356 terhadap pergerakan tanah dan 0,363 terhadap perubahan lalu lintas. Konstruksi jalan beton unggul pada empat faktor yaitu daya tahan terhadap cuaca, daya tahan terhadap pergerakan tanah, daya tahan terhadap lalu lintas dan jangka waktu perawatan dengan tingkat keunggulan rata-rata enam kali dibanding konstruksi aspal. Keunggulan konstruksi aspal terdapat pada faktor-faktor kenyamanan permukaan jalan, kemudahan pelaksanaan pembangunan, ketersediaan sumber daya dan teknologi serta biaya dengan yang perbandingan keunggulannya dengan konstruksi beton adalah rata-rata empat kali. Dari berbagai aspek tersebut menunjukkan jalan beton rata-rata lebih unggul dibanding dengan jalan aspal.
HUBUNGAN SEJARAH DAN PENGARUH BUDAYA TERHADAP PROSES AKULTURASI ARSITEKTUR MASJID-MASJID TUA ABAD XVI-XX DI JAKARTA
Authors: Fitriandini Sumaiyah
Published: May 2021

Masjid-masjid tua di Jakarta, diketahui telah mengalami proses akulturasi arsitektur yang berasal dari kelompok masyarakat yang ada, atau datang ke Jakarta. Maksud dari penelitian ini adalah menganalisis sebaran masjid-masjid tua abad XVI-XX di Jakarta berdasarkan abad berdiri, lokasi, proses akulturasinya, dan menemukan hubungannya terhadap sejarah dan pengaruh budaya yang berkembang di Jakarta pada masa tersebut, melalui pendekatan kuantitatif, dengan teknik analisis deskriptif. Penyebaran agama islam yang sudah masuk ke Jakarta (Jayakarta-Batavia) mulai abad XVI, diiringi dengan keberadaan Suku Jawa di Jakarta pada abad XVI, menjadi simbol kuatnya pengaruh budaya Jawa pada bentuk arsitektur masjid di Jakarta. Masjid-masjid tua yang mengalami proses akulturasi arsitektur adaptasi Jawa paling banyak ditemukan pada abad XVIII-XIX. Terbentuknya komunitas muslim dan pemukiman warga pendatang di Jakarta pada abad XVIII-XIX telah menjadikan kawasan Jakarta Barat dan Jakarta Pusat sebagai kawasan yang paling banyak memiliki peninggalan bangunan masjid-masjid tua di Jakarta. Terbukanya pintu perdagangan maritim yang sedemikian luas, telah membuka peluang besar terjadinya akulturasi budaya di Jakarta pada abad XVIII-XIX. Masjid- masjid tua yang memiliki akulturasi bentuk arsitektur Jawa sebagian besar berada di Kawasan Jakarta Barat dan Jakarta Pusat. Proses akulturasi arsitektur yang mengadopsi bentuk arsitektur non lokal (Timur Tengah, Modern, dan Kolonial Belanda), juga mulai banyak muncul di abad XVIII-XIX, keberadaan masjid-masjid tua yang mengadopsi bentuk arsitektur Timur Tengah-Modern, juga ditemukan sebagian besar berlokasi di kawasan Jakarta Barat. Eksistensi masjid-masjid tua tersebut merepresentasikan simbol sejarah Islam yang tumbuh, berkembang dari masa ke masa sesuai dengan konteks ruang dan waktunya.
THE EFFECTIVENESS OF SCHOOLOGY ON TECHNOLOGY SKILLS: E-LEARNING INTEGRATION IN EDUCATION
Authors: Puji Rully Putri Nirmala , Priyanti Desi
Published: May 2021

Schoology is an e-learning platform that offers several exciting features that can be optimized by educators and students in tandem with parents. This can be one of the media in optimizing strong communication between the three. Schoology is also able to be one of the pathways to improving the skills in utilizing the technology of students who have also become one of the demands of the 4.0 revolution. Schoology is able to be used by educators in particular types of education and in certain subjects. This study aims to identify the effectiveness of Schoology on the technology skills of students in higher education ranking. The research results have shown that Schoology poses an effect on improving technology skills in aspects of text formatting and searching the web.
Analisis evaluasi kebijakan publik bantuan tunai: studi kasus bantuan tunai di provinsi Lampung
Authors:   Universitas Lampung, Atika Supriadi Ratna , Widya Astuti Miranda ,   Universitas Lampung, Darina Siti ,   Universitas Lampung, Frediani Iga ,   Universitas Lampung, Nolince Pigai Theresia ,   Universitas Lampung
Published: May 2021

Purpose: This study aimed to see the extent to which the public policy of cash assistance in Lampung Province can be appropriately realized and on target. Research methodology: In analyzing the evaluation of cash transfer public policies in Lampung Province, it was carried out using descriptive analysis methods, with data collection applications using questionnaires and literature study. Result: The implementation of this policy is still not good, when viewed from public policy evaluation indicators. However, this policy has had a positive impact on the people who receive assistance. Limitation: The limitation of this study is the lack of data obtained. From the data obtained through the questionnaire, only 30 data were entered, while in the literature study the data obtained were only data in the form of the total amount of aid funds and the number of aid recipients. Contribution: This research is useful for Lampung and policy makers' people to see whether the implementation of the cash transfer policy has been implemented properly or not.
Pengaruh akuntabilitas dan budaya organisasi terhadap kinerja organisasi pada rumah sakit swasta kota Bandar Lampung
Authors:   Jurusan Akuntansi, Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung, Zaviera Azzahra Putri , Yuliansyah Yuliansyah ,   Jurusan Akuntansi, Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung, Nauli Pigo ,   Jurusan Akuntansi, Fakultas Ekonomi dan Bisnis, Universitas Lampung, Bandar Lampung
Published: May 2021

Purpose: This study aimed to provide empirical evidence of the effect of accountability and organizational culture on organizational performance at the private hospitals in Bandar Lampung. Research methodology: The population in this study were all employees at the head of a private hospital in Bandar Lampung, quantitative methods, SPSS applications, information retrieval techniques using questionnaires, and a sample of 93 respondent. Methods of data analysis using multiple regression with the T-test as a hypothesis test. Results: This study shows empirical evidence that the accountability variables and organizational culture positively influence organizational performance, either partially or simultaneously. Limitations: The sample of this study only includes about 93 employees who are equivalent to middle-level managers at private hospitals in Bandar Lampung Contribution: This research can provide important information on accountability and organizational culture towards the hospital and related organization or institutions.
Perioperative Ketamine Infusion is Effective in Reversing
Opioid-Induced Hyperalgesia
Authors: Candido Kenneth
Published: May 2021

Opioid-induced hyperalgesia (OIH) is a condition
of nociceptive sensitization caused by
exposure to opioids, which is characterized by a
paradoxical response whereby patients receiving
opioids for the treatment of pain actually become
more sensitive to pain as a direct result of opioid
therapy. There is increasing evidence showing
OIH presents a clinical challenge in acute,
chronic, and cancer pain settings. Both clinical
and animal studies have shown that glutamate
N-methyl-D-aspartate (NMDA) receptors may
play a key role in OIH, and pre-application of
ketamine, an NMDA receptor antagonist, or a
co-administration of ketamine and opioids, can
prevent OIH. However, no reports have shown if
ketamine can reverse OIH once it occurs.
We present a case of a 56-year-old male with a
past medical history of DM-2 with severe peripheral
neuropathy, recurrent osteomyelitis of the left
foot, hypertension, dyslipidemia, chronic neck
and right arm pain due to cervical spondylosis,
status post 4 times of cervical discectomy, and fusion
surgeries for cervical radiculopathy. He was
prescribed to high doses of opioids (morphine 60
mg, orally every 8 hours and hydrocodone/acetaminophen
10/325 mg, as needed up to 4 times
daily) for approximately 10 years. He underwent
left below-knee amputation due to uncontrolled osteomyelitis.
The patient had worsening stump pain
with an increasing dose of opioids and phantom
pain on post-operative day one, and he developed
OIH, diagnosed as escalating pain reports with
every opioid dose increase. A ketamine infusion
(loading dose of 10 mg IV bolus, then 20 mg/
hour IV infusion) was used after total cessation
of opioid use for post-operative analgesia for 3
consecutive days and the patient recovered from
his obvious OIH, with his stump pain and phantom
pain well-controlled by opioid administration on
post-operative day 5.
In our case, the blockage of NMDA receptors
by ketamine might quickly restore the balance
between opioid-dependent analgesic systems and
NMDA-dependent pronociceptive systems by deactivation
of the latter, which may help the patient
recover from OIH rapidly. While it is possible that
ketamine may help facilitate patients’ recovery
from OIH in addition to its ability to prevent OIH,
this clinical observation must be tested in future
prospective studies.
Key words: Opioids, ketamine, opioid-induced
hyperalgesia, phantom pain, post-amputation,
post-operative
Phrenic Nerve Stimulation in a Patient with a Dorsal Column
Stimulator
Authors: DuBose Daniel D.
Published: May 2021

We present a case of a 76-year-old female who
developed recurrent left-sided muscle spasms
resembling hiccups after permanent dorsal column
stimulator (DCS) implantation. The patient
had a cardiac resynchronization device with
defibrillating capabilities (CRT-D) in place, which
was interrogated before and after the permanent
DCS placement with no interference reported.
Due to the timing of the event with the placement
of the DCS, it was presumed that the spasms
were related to the DCS implantation, and removal
of the DCS was considered. However,
further evaluation by a cardiology consultant
revealed that a lead from her CRT-D was most
likely stimulating the phrenic nerve and causing
diaphragmatic contractions. The patient was sent
to the electrophysiology clinic where the voltage
on her left ventricular lead was reduced, and her
symptoms resolved completely. Due to the time,
risks, and expense of implanting a DCS, it is
imperative to consider all other possible causes
of diaphragmatic contractions prior to removing
a DCS system.
Key words: Dorsal column stimulator, cardiac
resynchronization therapy device, phrenic nerve
stimulation, hiccups, muscle spasms, diaphragmatic
contractions, interference
Ultrasound-guided Transmuscular Quadratus Lumborum Block with
Depot Steroids in the Management of Abdominal Myofascial Pain
Syndrome
Authors: Niraj Gopinarth
Published: May 2021

Background: Trigger point injection is the current
standard in the management of abdominal myofascial
pain syndrome (AMPS). However, multiple
trigger point injections can cause significant
discomfort and there is a possibility of missing
trigger points resulting in a reduced efficacy of
trigger point treatment. Recently, abdominal wall
blocks have been reported in the management
of chronic abdominal wall pain. Transmuscular
quadratus lumborum block (TQLB) is a novel
abdominal wall block.
Objective: The report describes the role of the
ultrasound-guided TQLB with depot steroids in
the management of AMPS.
Study Design: Prospective case series.
Setting: Tertiary pain medicine clinic in a University
Hospital.
Methods: Adult patients with AMPS under the
care of a single physician were offered TQLBs
with a mixture of local anaesthetic and depot
methylprednisolone instead of multiple trigger
point injections as a part of an on-going prospective
longitudinal audit into the management of
AMPS. Patients completed brief pain inventory
questionnaire at baseline and at 12 weeks postprocedure.
Results: Thirty patients underwent TQLB. All patients
reported complete absence of pain within 15
minutes of the block and sensory testing revealed
extensive hypoaesthesia extending from thoracic
T6 to T12 anteriorly. Clinically significant benefit at
12 weeks was reported by 36% of patients, with
60% (18/30) of the patients preferring to receive
the novel intervention instead of multiple trigger
point injections. None of the patients reported
post-procedural flare up.
Limitations: Open label case series in a small
cohort.
Conclusion: The prospective series in a limited
cohort suggests that TQLB with depot steroids
could play a role in the management of AMPS.
Key words: Abdominal myofascial pain syndrome,
transmuscular quadratus lumborum block,
trigger point treatment, nonspecific abdominal
pain, viscerosomatic convergence
Prolongation of Lumbar Facet Joint Nerve Block Duration with 10%
Lidocaine Neurolysis: A Retrospective Cohort Study
Authors: Kim David D.
Published: May 2021

Background: Neural blockade of the facet medial
branch/L5 dorsal rami with local anesthetic
with or without corticosteroid has been used to
both diagnose and treat low back pain. Higher
concentration lidocaine has been shown to be
neurolytic in multiple in vivo, in vitro, and some
clinical studies. This may make 10% lidocaine a
possible neurolytic agent to prolong pain relief
from facet blocks.
Objective: Compare neurolytic effects of 10%
lidocaine to prolong pain relief compared to bupivacaine/
methylprednisolone (BM) in facet medial
branch/L5 dorsal rami blocks (MBB).
Methods: Retrospective review of 77 patients
who received a 10% lidocaine MBB from after
short term relief from MBB with BM. Comparison
was made in visual analog scale (VAS) and duration
of relief using Wilcoxon signed rank matched
pairs test.
Results: There was no significant difference
between baseline median VAS prior to MBB with
BM and 10% lidocaine and median days VAS
recorded post each MBB ((P = 0.477). Median
VAS immediately after BM MBB (17.5 mm) was
not significantly different than after 10% Lidocaine
MBB) of 18 mm (P = 0.341). Median duration of
relief with 10% lidocaine was greater at 14 days
versus BM at 3.5 days (P = 0.001). There was
no significant correlation between the volume
of 10% lidocaine at each level and performance
measures: % change VAS post lidocaine MBB (P=
0.529), duration lidocaine MBB (P = 935), VAS
pre-RFTC (P = 0.683).
Limitation: Retrospective, small study.
Conclusion: Ten percent lidocaine was moderately
effective neurolytic agent with longer duration
than BM.
Key words: Lidocaine, facet joint, neurolysis,
low back pain
A CASE REPORT ON STERNOCLEIDOMASTOID SYNDROME - A TRUE PAIN IN
THE NECK
Authors: Chauhan Gaurav
Published: May 2021

The Sternocleidomastoid (SCM) muscle may
develop myofascial trigger points and the physical
manifestation of pain and signs and symptoms
due to these trigger points is commonly referred
to as SCM syndrome. The diagnosis of SCM
syndrome can be onerous as non-specific signs
and symptoms associated with SCM syndrome
may vary in presentation. The subject in this
case report had post-acceleration-deceleration
induced injury to SCM with hypertrophy of sternocleidomastoid
muscle on the left side. The patient
reported pain over the left SCM muscle, forehead,
around the ipsilateral eye, over the cheek, the
tip of the chin, sternoclavicular joint and deep in
the throat upon. The patient was ascribed various
diagnosis before a definitive diagnosis was
made. The patient underwent three trigger point
injections under ultrasound guidance, last one
with BOTOX, and reported long-lasting pain relief.
Overall with intensive physical therapy and trigger
point injections the acute symptoms resolved.
Key words: Sternocleidomastoid syndrome,
myofascial pain syndromes, trigger points, ultrasound,
Botox
How an Elite High-performance Weightlifter with Spine Pain Became
a Silver and Gold Olympic Winner: A Case Report
Authors: Ramirez Jorge Felipe
Published: May 2021

Spine pain affects athletes’ performance and
is a common reason for missed playing time.
Return-to-play is the main concern for patients;
for this reason, treatment must be evaluated
under these criteria. Nonsurgical treatment and
specific physical rehabilitation should be the first
option. There are few reports using endoscopic
spine surgery in high-performance weightlifters.
We report a successful case of a 33-year-old
elite high-performance weightlifter with cervical
and lumbar intervertebral disc hernias, who, after
anterior cervical endoscopic discectom in 2009
and then a transforaminal lumbar endoscopic
discetomy and percutaneous interspinours space
in 2014, won silver and gold Olympic medals,
set an Olympic record, and won a weightlifting
world championship after. We concluded that
return-to-play after 2 endoscopic spine surgeries
was possible for a high-performance weightlifter.
Endoscopic spine surgery is an alternative to treat
spine pain in elite high-performance athletes.
Key words: Intervertebral disc hernia, weightlifter,
endoscopic spine surgery, gold medal, silver
medal, Olympic games, case report.
NEUROFIBROMATOSIS TYPE 2: A REVIEW OF PAIN MANAGEMENT OPTIONS
Authors: Padalia Devang
Published: May 2021

Neurofibromatosis is a chronic and painful disease
process that can cause significant morbidity.
The development of central and peripheral lesions
is the primary source of acute and chronic
pain. The pain associated with this condition is
difficult to treat, but there are a number of options
to make the lives of these patients more
comfortable.
A review of current literature and research data
was used to compile a detailed list of treatment
options for patients with neurofibromatosis type
2 (NF2). Key points on physiology and pain, as
well as current and potential treatment options,
are discussed.
There are a number of articles, case reports, and
studies regarding the treatment options for pain
in patients with NF2. However, there is a lack of
well-controlled randomized trials that demonstrate
the superiority of one treatment modality. There
are novel treatment plans being tailored to work
at a genetic level, but these still require further
research before implementing in daily practice.
The management of chronic pain in NF2 is a difficult
challenge for the medical community. Novel
treatment options are currently being researched
to improve the quality of life in these patients.
Using a multimodal approach to pain control will
improve the chances of a successful outcome.
Key words: Neurofibromatosis type 2, schwannomatosis,
neurofibromatosis type 1, chronic pain,
pain management, neurofibroma, analgesics
Intracranial Hypotension for Anesthesiologists: What We Should
Know
Authors: Calvo Maria Eugenia
Published: May 2021

The common denominator of spontaneous intracranial
hypotension (SIH), postsurgical cerebral
spinal fluid (CSF) leaks, and postpuncture headache
(PPH) is a decrease in CSF volume. The
typical presentation is orthostatic headaches, but
atypical headaches can be difficult to diagnose
and challenging to treat. Management is based
on clinical suspicion and characterization of the
headache, followed by imaging (noninvasive or
invasive). Treatment ranges from conservative
to different modalities of epidural blood patches,
fibrin glue injections, or surgical exploration and
repair.
We report 5 cases with great variation in clinical
and radiological presentations. Two cases of
SIH involved difficult diagnosis and treatment, 2
others featured postsurgical high-flow CSF leaks,
and one case presented with a low-flow CSF
leak that needed closer evaluation in relation to
hardware manipulation.
In all cases, recommendations for diagnosis and
management of intracranial hypotension were followed,
even though in 3 cases the mechanism of
trauma was not related to spontaneous hypotension.
All cases of headache were resolved.
The actual recommendations for SIH are very
effective for PPH and postsurgical CSF leaks.
With this case series, we illustrate how anatomical
and clinical considerations are paramount in
choosing appropriate imaging modalities and
clinical management.
Key words: CSF leak, epidural blood patch,
intracranial hypotension, postural headaches,
subdural hematomas
Misdiagnosing Abdominal Myofascial Pain Syndrome as Anterior
Cutaneous Nerve Entrapment Syndrome: Are we Failing Patients with
Nonspecific Abdominal Pain?
Authors: G Niraj
Published: May 2021

Background: Chronic abdominal wall pain
(CAWP) is often undiagnosed and results in
significant health care use as well as patient
suffering. There are two main types: abdominal
myofascial pain syndrome (AMPS) and anterior
cutaneous nerve entrapment syndrome
(ACNES). Although the 2 conditions share clinical
similarities, they have subtly distinct unique
features.
Objectives: To highlight the current practice,
elucidate the characteristics of the 2 types of
CAWP, and direct the spotlight on abdominal
myofascial pain.
Study Design: Prospective case series.
Setting: Tertiary pain medicine clinic in a university
hospital.
Methods: As a part of a prospective audit of
management of chronic abdominal pain, patients
completed brief pain inventory-short form
questionnaires at baseline and at 3 months posttrigger
point treatment.
Results: All 3 patients were misdiagnosed with
ACNES. Patient 1 was attending the emergency
department once every 5 days prior to being correctly
diagnosed with AMPS. Following trigger
point treatment, there was a significant reduction
in emergency department attendance. Patient 2,
with a 10-year history of lower abdominal pain that
resulted in severe disability, was able to mobilize
following trigger point treatment. Patient 3, with
a high opioid use (360 mg per day), was able to
discontinue opioids following ultrasound-guided
trigger point injection with depot steroids.
Limitations: Open label case series in a small
cohort.
Conclusions: AMPS is as common as the various
visceral inflammatory diseases. Lack of awareness,
ignoring its existence, and misdiagnosing it
may not benefit patients with chronic abdominal
pain.
Key words: Chronic abdominal wall pain, abdominal
myofascial pain syndrome, anterior cutaneous
nerve entrapment syndrome, viscerosomatic
convergence
Methylprednisolone Dosage in Lumbar Epidural Steroid
Injections: A Retrospective Analysis of Efficacy in Pain
Relief
Authors: Rong Chen Calvin
Published: May 2021

Background: Epidural injections have been used
for pain relief since the 1880s. Corticosteroids are
antiinflammatory medications that can alleviate
pain, but also have harmful systemic adverse
effects. Literature regarding methylprednisolone
dosage efficacy is limited.
Objectives: To determine the lowest effective
dose of methylprednisolone in a lumbar epidural
steroid injection (LESI) for maximal pain relief
without exposing patients to adverse events
caused by steroid use.
Study Design: Retrospective chart review.
Setting: Outpatient interventional pain clinic at
an academic center.
Methods: Adults (n = 133), aged 18 to 85 years,
with low-back pain and radicular symptoms
treated with LESI from August 2011 to November
2015. Patients who received prior cervical
epidural steroid injections were excluded. Interventions
were
LESI with methylprednisolone 40 mg, 80 mg,
or 120 mg. Main outcome measures showed
change in pain score using a numeric pain scale
(NPS; 0 = no pain, 10 = excruciating pain), and
patient’s self-reported reduction in pain (percentage),
pre- and postprocedure. The primary endpoint
measurement was 2 weeks postinjection.
Adverse effects were recorded.
Results: The number of patients who received
each dose varied: n = 88 received 120 mg, n = 30
received 80 mg, and n = 13 received 40 mg. The
NPS pain scores pre- and postprocedure for 120
mg were 8.89 ± 1.32 and 4.08 ± 3.74, (mean ±
standard deviation), respectively; for 80 mg: 9.06
± 1.00 and 3.75 ± 4.00; and for 40 mg: 9.00 ±
1.00 and 4.00 ± 0.00. Percentage of pain relief for
120 mg, 80 mg, and 40 mg was 57.26%, 50.74%,
and 57.26, respectively (P = 0.3347). n = 4 experienced
adverse effects, all received 120 mg.
Conclusions: All 3 dosage groups had similar
efficacy in pain relief, but only patients who received
120 mg experienced adverse effects. This
demonstrates that lower dosages can be used for
pain relief with less potential harm to the patient.
Key words: Methylprednisolone, interlaminar
epidural, radiculopathy
ABNORMAL UTERUS A CAUSE FOR MISCARRIAGE
Authors: Peter Stella , Peter Supriya
Published: May 2021

Some women have a congenital uterine abnormality, which is a womb/uterus that is formed in an unusual way before
birth. Uterine malformations occur due to a birth defect. In the womb, female infants develop two separate halves of their
uterus that merge together before birth. If the two halves fail to merge completely, the woman may be born with a malformed uterus. Uterine
malformations make up a diverse group of congenital anomalies that can result from various alterations in the normal development of the
Mullerian ducts. It has been found that the prevalence of uterine abnormality is estimated to be 6.7% among general population. About 18% of
women who have recurrent miscarriages have some type of uterine abnormality. Uterine conditions don't always show signs or symptoms until
one tries to conceive. When a baby girl is developing in the womb, two small tubes call Mullerian ducts come together to form her uterus. For
some baby girls, the Mullerian ducts don't come together completely. Symptoms range from amenorrhea, infertility, recurrent pregnancy loss, and
pain, to normal functioning depending on the nature of the defect. A uterine malformation that does not usually cause symptoms does not usually
require treatment. However, if the malformation if causing problems, then surgery will be considered. Surgical intervention aims to x the
malformation and can often be performed laparoscopically with a hysteroscope.
A COMPARATIVE STUDY TO EVALUATE THE OUTCOME OF PONSETI'S TECHNIQUE AND ACCELERATED PONSETI'S TECHNIQUE FOR CORRECTION OF CLUBFOOT
Authors: Vidhyarthi Ashok , Varma H.S. , Singh Rajeev , Thakur Rajendra , Thakur Darwin Kumar
Published: May 2021

Introduction: Clubfoot is a common congenital deformity with incidence of1-6.8/1000 live births. Ponseti method is currently the gold standard for treatment of clubfoot which conventionally involves weekly plaster changes. A prospective comparative study was carried out at our hospital where we compared one group with weekly plaster change to other group with twice weekly plaster change, using the classical Ponseti protocol of manipulation. A total 50 feet (36 children ), divided into two Methods: groups, were randomly allocated to either Group 1 – 25 feet(accelerated Ponseti) or Group 2 – 25 feet (standard Ponseti). Group 2 underwent serial manipulations and casting once a week and Group 1 received manipulations and castings twice a week. Pirani score was documented at the time of presentation, after each cast, and at the time of removalof nal cast to assess the success of treatment ( Pirani score ≤1). A tota Results: l 43 feet (29 patients) underwent the entire course of treatment, while 7 patients discontinued the treatment during the course of the study. 14 patients, i.e, 21 feet were treated with Accelerated Ponseti Protocol (APP),i.e Group -1, and 15 patients, i.e, 22 feet were treated with Standard Ponseti Protocol (SPP), i.e Group-2. Mean duration of treatment from the rst cast to tenotomy in the accelerated ponseti protocol group was 20.57 ± 4.5 days (ranging from 12 to 29 days), and in standard ponseti protocol group was 39.66 ± 6.9 days (ranging from 29 to 51 days). Conclusion: Both the methods proved to be equally efcacious for the management of clubfoot in our study. However, the accelerated method had an overall shorter treatment duration making it convenient for the parents. As the patient is under direct observation of surgeons, complications, in any, are detected early and easily. Overall, the accelerated technique is more practical, benecial, and equally efcacious as standard ponseti technique, providing a more rapid correction of the deformity.
CYTOPATHOLOGICAL SPECTRUM OF NON NEOPLASTIC AND NEOPLASTIC THYROID LESIONS AT TERTIARY CARE CENTRE, GWALIOR
Authors: Dhakad Sapna , Sharma Shailendra , Kaur Diljeet
Published: May 2021

Background: Thyroid lesions are the important clinical problems encountered in most of patients coming to the tertiary care centre. Fine Needle Aspiration Cytology (FNAC) is the widely accepted diagnostic technique in thyroid lesions. A solitary thyroid nodule is dened as a palpable, single, clinically detectable nodule in the thyroid. They cause more concern because of high probability of malignancy in them, which can range from 5-35% of all solitary thyroid nodules. Nodular lesion comprises those disorders that produce a clinical nodule and consists of non-neoplastic hyperplasia as well as benign and malignant tumors. Aims and Objectives:To study the spectrum of clinical presentation of individuals with thyroid lesions and cytomorphological features. Material and methods: A retrospective study was carried out in cytopathology section in Department of Pathology from January 2015 to December 2017. Total 212 patients with palpable thyroid swelling referred from the OPD of J.A hospital for FNAC were included in the study. The smears made from the aspirate were air dried and stained with May-Grunwald-Giemsa (MGG) stain. Result: The present study was carried out in the Department of Pathology from January 2015 to December 2017. Out of 212 cases most common thyroid lesion was Colloid goitre 35.38%(n=75) followed by Colloid goitre with cystic changes 19.81%(n=42), Follicular Neoplasm 19.34%(n=41), Hashimoto thyroiditis 7.55%(n=16), Colloid cyst 6.13%(n=13), Infected cystic lesion 2.83%(n=6), Benign hyperplasia of thyroid 2.36%(n=5), Adenomatoid goitre 1.89%(n=4), Thyroglossal cyst 1.89%(n=4), Granulomatous thyroiditis 1.41%(n=3), Papillary thyroid carcinoma 0.94%(n=2) and least common was Lymphoma of thyroid 0.47%(n=1). Conclusion: FNAC is almost an accurate technique in diagnosis of palpable and overt thyroid lesions. Thyroid lesions are more common in females than males. Colloid goitre is the commonest thyroid lesion.
A COMPARATIVE STUDY OF CLINICAL AND BIOCHEMICAL PROFILE AMONG SURVIVORS AND NON SURVIVORS OF PATIENTS WITH COVID-19 INFECTION - A RETROSPECTIVE STUDY.
Authors: N Tilak. , Yergolkar Abhijna Vithal , Kulkarni Ashwin , Kumar T. Anil , K.J Sujatha. , Khandre Guruprasad
Published: May 2021

BACKGROUND: The pandemic caused by SARS-Corona Virus-2 (COVID-19) is far from over. There has been
ongoing new infections across the globe. The clinical course of the disease is varied among different individuals. The
prediction of severity and mortality is very difcult but quite essential for timely escalation of the treatment. This is a comparative study of
clinical, biochemical parameters among the survivors and non survivors of COVID-19 infection. METHODOLOGY: This is a retrospective
study conducted in a tertiary care hospital in South India. This study was an audit of 39 survivors and 39 non survivors of COVID-19 infection.
These patients were matched with age and gender. The clinical prole, Biochemical parameters and the clinical course among the two groups
were compared and analyzed. RESULTS: 39 survivors and 39 non survivors were included in the study. The two groups were age and gender
matched. The symptoms were fever, cough, breathlessness, fatigue, myalgia, body ache, diarrhea. Breathlessness was more common among
patients who did not survive. Pneumonia severity index was class 1 and class 2 among patients who survived. PSI was class 4 and class 5 among
the patients who did not survive. This difference was statistically signicant. It was seen that there were signicant number of comorbidities and
inammatory markers like CRP, D DIMER, LDH, S. Ferritin seen among non survivors compared to the survivors. The study CONCLUSION:
shows that presence of comorbidities has an adverse impact on the outcome of the patients with COVID-19 infection. The elevated inammatory
markers like CRP, D Dimer and LDH predicted poor outcome. Pneumonia severity index was a useful marker to predict the outcome among
patients of COVID.
STUDY ON OUTCOME OF TREATMENT OF NONUNION LONG BONE FRACTURE
Authors: Kumar M. Ganesh , Sivakumar M.
Published: May 2021

The aim of the study is to analyze the outcome of treatment of infected Nonunion of long bones using limb reconstruction
system and to reveal its real usefulness Nonunion is diagnosed, until clinical or radiographic evidence shows healing has
ceased and that union is highly improbable. Nonunion is dened as “established when a minimum of 9 months has elapsed since injury and the
fracture shows no visible progressive signs of healing for 3 months This is a prospective and retrospective study which consists of 30 cases in the
age range from 20 yrs to 65 yrs Patients who were lost to follow up were not included in this study. Our institution approved our treatment
protocols and all patients gave written informed consent. ASAMI' criteria were used to analyze the results in our study. In this study we conducted,
we could achieve a success rate of 80%, giving good encouraging results to most of our patients. Hence we conclude that the Indian version of the
Limb reconstruction system is effective and convenient method for the treatment of infected nonunion of long bones. This can also be used to
correct the limb length discrepancies simultaneously, which can arise during the course of the treatment.
Bioactive secondary metabolites produced by the emerging pathogen Diplodia olivarum
Authors: DI LECCE Roberta , MASI Marco , LINALDEDDU Benedetto Teodoro , PESCITELLI Gennaro , MADDAU Lucia , EVIDENTE Antonio
Published: May 2021

A new cleistanthane nor-diterpenoid, named olicleistanone (1), was isolated as a racemate from the culture filtrates of Diplodia olivarum, an emerging pathogen involved in the aetiology of branch canker and dieback of several plant species typical of the Mediterranean maquis in Sardinia, Italy. When the fungus was grown in vitro on Czapek medium, olicleistanone was isolated together with some already known phytotoxic diterpenoids identified as sphaeropsidins A, C, and G, and diplopimarane (2-5). Olicleistanone was characterized as 4-ethoxy-6a-methoxy-3,8,8-trimethyl-4,5,8,9,10,11-hexahydrodibenzo[de,g]chromen-7(6aH)-one. When D. olivarum was grown on mineral salt medium it produced (-)-mellein (6), sphaeropsidin A and small amounts of sphaeropsidin G and diplopimarane. Olicleistanone (1) exhibited strong activity against the insect Artemia salina L. (100% larval mortality) at 100 μg mL-1 but did not exhibit phytotoxic, antifungal or antioomycete activity. Among the metabolites isolated (1-6), sphaeropsidin A (2) was active in all bioassays performed exhibiting strong phytotoxicity on leaves of Phaseolus vulgaris L., Juglans regia L. and Quercus suber L. at 1 mg mL-1. Sphaeropsidin A (2) also completely inhibited mycelium growth of Athelia rolfsii, Diplodia corticola, Phytophthora cambivora and P. lacustris at 200 μg per plug, and was active in the Artemia salina assay. Also in this assay, diplopimarane (5) and sphaeropsidin G (4) were active (100% larval mortality). Diplopimarane also showed antifungal and antioomycete activities. Athelia rolfsii was the most sensitive species to diplopimarane. Sphaeropsidin C (3) and (-)-mellein (6) were inactive in all bioassays. These results expand knowledge on the metabolic profile of Botryosphaeriaceae, and embody the first characterization of the main secondary metabolites secreted by D. olivarum.
Neocosmospora spp. associated with dry root rot of citrus in South Africa
Authors: GUARNACCIA Vladimiro , VAN NIEKERK Jan , CROUS Pedro , SANDOVAL-DENIS Marcelo
Published: May 2021

Citrus is one of the most important fruit crops cultivated in South Africa. Internationally, citrus dry root rot is a common disease in major citrus production areas. Several abiotic and biotic factors are involved in disease development, in which Neocosmospora species are important biotic agents. The diversity of Neocosmospora species associated with dry root rot symptoms of Citrus trees cultivated in South Africa was evaluated using morphological and molecular analyses. Multi-locus analysis was conducted, based on fragments of seven loci including: ATP citrate lyase (acl1), calmodulin (cal), internal transcribed spacer region of the rRNA (ITS), large subunit of the rRNA (LSU), RNA polymerase largest subunit (rpb1), RNA polymerase second largest subunit (rpb2), and translation elongation factor 1-alpha (tef1). A total of 62 strains representing 11 Neocosmospora species were isolated from crowns, trunks and roots of citrus trees affected by dry root rot, as well as from soils sampled in affected citrus orchards. The most commonly isolated taxa were N. citricola, N. ferruginea and N. solani, while rarely encountered taxa included N. brevis, N. crassa, N. hypothenemi and N. noneumartii. Furthermore, four Neocosmospora species are also newly described, namely N. addoensis, N. citricola, N. gamtoosensis and N. lerouxii.
Virulence and diversity of Puccinia striiformis in South Russia
Authors: VOLKOVA Galina V. , KUDINOVA Olga A. , MATVEEVA Irina P.
Published: May 2021

Puccinia striiformis causes wheat yield losses in all countries where wheat is cultivated. Virulence and diversity of the P. striiformis were assessed in 2013–2018 in South Russia, and this showed that the North Caucasian population of the pathogen was diverse. One hundred and eighty two virulence phenotypes were identified in 186 P. striiformis isolates. Among isolates collected in 2014, 2015, and 2018, all phenotypes were unique. In the 2013 and 2017 populations, phenotypes with few (one to eight) virulence alleles prevailed. In the 2014, 2015, and 2018 populations, most of the phenotypes contained greater numbers (nine to 19) of virulence alleles. Over the 5 years of research, the pathogen population lacked isolates virulent to the host Yr resistance genes 3, 5, 26, and Sp. Single (from 1 to 5%) occurrences of isolates virulent to host lines with Yr genes 3a, 17, 24, 3b + 4a + H46, and 3c + Min were identified. Differences in frequencies of virulence alleles between years in the P. striiformis populations (Ney indices, N) were generally non-significant (N = 0.11 to 0.23), with the exception of the populations in 2013 and 2017 (N = 0.37). The minimum N values was found for the populations of 2015 and 2018 (N = 0.10). Over the five years of this study, the dynamics of the virulence of the population and jumps in the frequency of isolates with respect to many Yr genes were identified. This feature of the P. striiformis populations in South Russia, combined with high phenotypic diversity, indicates the ability for rapid race formation and morphogenesis in response to changes in biotic and abiotic factors.
Educação continuada e metodologias ativas em cursos a distância em enfermagem: revisão integrativa da literatura
Authors: Takaki Cavichioli Flávia Carla , Martins do Nascimento Filho Hélio , Tinti Moreira Borges Daniela , Blanes Leila , Masako Ferreira Lydia
Published: May 2021

Objetivo: Verificar e discutir as metodologias ativas de ensino adotadas na educação de enfermeiros em cursos í  distância. Método: A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo. Realizou-se revisão integrativa da literatura em bases de dados utilizando os seguintes descritores e suas combinações: Educação a Distância, Enfermagem e Metodologias ativas. Resultados: Observou-se que 33,3% dos estudos promoviam aprendizagem por meio de ambiente virtual de aprendizagem, 30,3% usavam o formato e-learning e 12,1% utilizavam método hí­brido. Considerações finais: As metodologias ativas de ensino têm sido empregadas em cursos de capacitação de profissionais de saúde, inclusive enfermagem, e têm contribuí­do positivamente na qualidade da assistência prestada aos pacientes.
Promoção da saúde no contexto da tecnossocialidade: revisão integrativa da literatura
Authors: Favero Alves Thais , Martins Ferreira Juliana , De Amorim Busana Juliano , Oliveira da Silva Hoffmann Ana Cristina , Gonçalves Nistchke Rosane , Dutra Tholl Adriana
Published: May 2021

Introdução: Na contemporaneidade, o uso de tecnologias pode se configurar como empecilho ou potência para a promoção da saúde. Este estudo tem como objetivo conhecer o que tem sido publicado sobre as redes sociais no quotidiano das pessoas no processo de saúde e adoecimento para a promoção da saúde. Materiais e Métodos: Revisão integrativa de literatura em cinco bases de dados, no recorte histórico de 2015 a 2019. Resultados: 12 artigos foram analisados, resultando em três categorias: "˜Tecnossocialidade: Rede Social no engajamento terapêutico"™; "˜Tecnossocialidade: Rede Social como ferramenta de empoderamento"™; "˜Tecnossocialidade: A produção de conhecimento"™. Discussão: Destaca-se a necessidade de avaliação para validação das informações socializadas, e debate sobre a efetividade da aplicação prática dos conhecimentos adquiridos pelo usuário. Conclusões: O enfoque do empoderamento em debate nas redes sociais volta-se majoritariamente para a perspectiva individual, ficando aquém do incentivo í  participação comunitária sugerida na Polí­tica Nacional de Promoção da Saúde.
Como melhorar a qualidade da saúde da equipe de enfermagem mediante ao COVID-19
Authors: Lemos de Souza Botelho Joyce , Macedo Santos Solange , Fiuza Aquino Carolaine , Oliveira de Melo João Marcos , Gimenes Cassimiro de Freitas Ingred
Published: May 2021

Objetivo: Identificar estratégias que podem ser inseridas ou já utilizadas, para promover a saúde dos trabalhadores de enfermagem no enfrentamento do Sars Cov 2 e melhorar a rotina de trabalho. Métodos: Este estudo se afigura como uma revisão integrativa de literatura, este trabalho versa sobre artigos em lí­ngua portuguesa, espanhol e inglês, do perí­odo de março de 2020 a outubro de 2020. Os critérios de inclusão foram: Texto completo de acesso gratuito, ensaio clí­nico, meta-Análise, ensaio controlado randomizado e revisão sistemática. Resultados: Foram encontrados ao todo 133 produtos nas bases de dados PubMed, Lilacs e SciELO. Sendo estes 3 duplicados e após a leitura foi deduzido que 120 destes trabalhos não preenchiam os critérios estabelecidos. Conclusão: Foi possí­vel perceber com este estudo, que a maioria dos fatores que afetam a saúde do trabalhador de enfermagem, está diretamente relacionado í s questões psí­quicas, que devem ser trabalhadas com investimento de apoio psiquiátrico e psicológico frequentemente. A inclusão de tecnologias que mantém o profissional distante a alguns casos, se mostra satisfatório
Evolução temporal da pandemia do COVID-19 e letalidade em profissionais de saúde no Brasil
Authors: Soares Lisboa Cinthia , Rodrigues Almeida Leila Magda , Silva Santos Paula , Da Mota Santana Jerusa
Published: May 2021

Objetivos: Analisar a evolução temporal do COVID-19 e identificar a taxa de letalidade por Sí­ndrome Respiratória Aguda Grave em profissionais de saúde no Brasil. Métodos: Estudo ecológico transversal, com dados secundários no ano de 2020. Foram coletadas informações relacionados aos números de óbitos, casos confirmados e em investigação da COVID-19. Resultados: De janeiro a agosto foram confirmados 1.241.685 casos de COVID-19 e 4.615 de Sí­ndrome Respiratória entre os profissionais. Destes, 991 foram óbitos, o que resultou em taxa de letalidade de 0,79/1.000. Houve um aumento de 28,7% no número de casos, entre junho e agosto, enquanto, em agosto, houve uma redução de 33,16%. Na análise de Pearson detectou-se que as correlações significantes foram entre os óbitos por COVID-19 e Sí­ndrome Respiratória. Conclusões: Os resultados além de revelar a real magnitude dos riscos em que se encontra este grupo, apresenta a alerta ao poder público, em todas as suas esferas.
Manutenção do tratamento oncológico frente í pandemia de COVID-19: revisão de literatura
Authors: Amandula Santos Aliana , Oliveira de Freitas Cati Lanne , Barcellos da Silva Alves Ingrid , Alves de Sousa Lydio Zaira Andressa , Moreira da Silva Soeiro Vanessa , da Silva Viana Lucian
Published: May 2021

Objetivo: Identificar na literatura brasileira as estratégias adotadas nos serviços de saúde para manutenção do tratamento oncológico durante a pandemia de COVID-19. Métodos: Trata-se de uma revisão da literatura realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval Sistem on-line, PubMed e na biblioteca eletrônica Scientific Electronic Library Online, que incluiu produções do ano de 2020, nos idiomas inglês e português, desde que abordassem o contexto nacional sobre a temática proposta. Resultados: Foram selecionados quatro artigos que auxiliaram na construção de duas categorias, a saber: enfrentamento da manutenção do tratamento oncológico pelos pacientes e organização dos serviços de saúde oncológicos brasileiros para manutenção do tratamento. Conclusão: Pode-se considerar que há um número ainda restrito de artigos no cenário nacional sobre a temática abordada e que tal lacuna interfira diretamente no curso de tratamento do paciente com câncer.
A saúde coletiva na articulação da educação e empoderamento de mulheres Kalunga: uma revisão sistemática
Authors: De Fátima Silva Sonilda Aparecida , Rincón Afonso Lúcia Helena , Andrade Peres Vannúzia Leal , Xavier Rodovalho José , Santos do Nascimento Alda Nazaré
Published: May 2021

Objetivo: Sistematizar, mapear e reconhecer as produções por meio de aspectos metodológicos e evidências identificando temáticas e abordagens dominantes e emergentes. Método: realizou-se uma busca no Portal de Periódicos da Capes, com os descritores "quilombos e Kalunga, educação, saúde e empoderamento", com recorte temporal de 2001 a 2019, elegendo no total 41 artigos para leitura. Resultados: apontaram crescimento significativo de produções acadêmicas elaboradas sobre as comunidades quilombolas - Kalunga, porém a quantidade de achados é pouco expressiva, frente ao povoado, em especial, as mulheres. Conclusão: notou-se que nas diferentes abordagens dadas pelos trabalhos analisados, que as comunidades remanescentes dos quilombolas têm empreendido lutas pelos direitos í  educação, saúde, cidadania, igualdade e territorialidade. Houve um avanço significativo na autonomia das mulheres Kalunga, porém ainda é necessário que o sistema polí­tico intervenha com maior atenção a essa população, pois as discussões acerca do processo de empoderamento das mulheres Kalunga ainda são incipientes.