bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the breeding performance differ between solitary and colonial breeding Red-throated Loons Gavia stellata in the core area of the Swedish population?
Authors: Dahlén Börje , Eriksson Mats O. G.
Published: February 2021

Most Red-throated Loons Gavia stellata are solitary breeders in small pools and provide fish prey to the chicks from larger waters at a distance seldom exceeding 10 km. More rarely, several pairs nest together in colonies. We compared the breeding performance of solitary and colonial breeders in South-central Sweden during 2000–2016 (except for 2007). Annual productivity was 0.63 and 0.52 chicks per pair and year for solitary and colonial breeding pairs respectively, and mean percentage per year of broods with two chicks did not differ, 24% and 18% (no significant differences). Average hatching probability was the same, 0.576 and 0.581 over years. The average probability however, that at least one chick would be fledged was significantly higher among solitary pairs, 0.915 and 0.731 respectively, although the overall probability of successful breeding did not differ, 0.530 and 0.443. Thus, any benefit with reference to coloniality can be questioned. More likely, colonial breeding was a result of habitat selection, with a concentration of several nesting pairs within a relatively small area with a profitable foraging lake nearby.
Is early grass harvest for silage an overlooked reason for skylark Alauda arvensis population decline in Sweden?
Authors: Sondell Jan , Murray Julia , Persson Magnus
Published: February 2021

In 2015 we studied the relative importance of silage and cereal crops as breeding habitat for the skylark Alauda arvensis. In 2014 we had found that skylarks failed to breed successfully in grass silage fields. We compared skylark density between crops in one organic and one conventional farm, c. 100 ha each, at Kvismaren valley in south Sweden (approx. 59.2°N; 15.4°E). The densities were similar in all crops: 83 territories/km2 in silage and 75 (spring sown) or 80 (autumn sown) in cereal. However, silage harvest in early June and July destroyed, as in the previous year, almost all nests, effectively preventing skylarks from reproducing successfully in that habitat. Cereal fields are not harvested until after the young are fledged. Approximately 45% of the farmland area in Sweden is grass for silage, normally harvested in late May or early June. We suggest that this early harvest is an important and overlooked driver for population decline of birds nesting in such fields.
Habitat selection of Ortolan Buntings Emberiza hortulana on forest clear-cuts in northern Sweden
Authors: Percival Julianna Anne , Dale Svein
Published: February 2021

Ortolan Buntings Emberiza hortulana in Sweden used to occur mainly in farmland. Nowadays, a large proportion of the remaining population is found on forest clear-cuts in northern Sweden. Few studies have identified the types of clear-cuts that Ortolan Buntings prefer and whether these habitats are used for both breeding and foraging. We recorded presence and abundance of ortolan buntings on clear-cuts in Västerbotten County, northern Sweden. We sampled 123 clear-cuts (present N = 48, absent N = 75; total of 93–100 territories) and our results showed that clear-cut size, the number of remaining trees, bare soil percentage (≥10%) and narrow-leaved grass vegetation had a positive influence on ortolan bunting occupancy. The number of territories on clear-cuts was positively related to clear-cut size and number of remaining trees. Proximity to nearby farmland did not influence occupancy on clear-cuts. Behavioural observations indicated that the forest clear-cuts were used for both nesting and feeding. We discuss these results in relation to forest management policies and conservation of the ortolan bunting.
Bird fauna changes in a small urban park in South Sweden, over a period of 34 years
Authors: Ottosson Ulf , Ahlgren Magnus
Published: February 2021

The density of birds in urban landscapes, including parks, is poorly known. In this study we present surveys of a small city park in south Sweden. The surveys were conducted in April–June 1980 and in May–June 2014. The study plot has an area of 5.1 ha. We found 143 pairs of 22 species in 1980 and 151 pairs of 26 species in 2014 (2,800 and 2,960 pairs/km2). Turdus pilaris was the most common species in 1980 and Columba palumbus in 2014. Three species showed significant decline: T. pilaris 38 to 15 pairs, Fringilla coelebs 12 to 5 pairs and Carduelis chloris 18 to 12 pairs, while Turdus merula increased from 11 to 15 pairs. Two species, T. merula and Sylvia atricapilla, nesting both 1980 and 2014, showed increasing numbers that are consistent with these species’ population increase in Sweden. The bird densities in this study are considerably higher compared to what is generally observed in southern Sweden. Further study is required to establish whether the high densities are due to chance or edge effect.
Age and sex determination of Mallards Anas platyrhynchos in autumn
Authors: Andersson Stina , Bengtsson Daniel , Hellström Magnus , Waldenström Jonas
Published: February 2021

Male and female mallards Anas platyrhynchos are easily told apart, whereas ageing is problematic, due to individual timing of moult and lack of easily defined age criteria. From examination and photographic documentation of mallards caught at Ottenby Bird Observatory (56°12′N, 16°24′E), we describe nine characters of plumage and bare parts to be used for ageing in autumn. The reliability of these characters was tested by letting experienced bird ringers determine putative age of birds from photos. Age determination from any single character proved to be uncertain, as correctly assigned mallard photos of each character was in the range of 51–85% for males and 48–89% for females. For both sexes, the lowest figure represented post-humerals and the highest represented tertials. Rectrices, tertial coverts, and greater coverts had high scores (71–85%). Using all characters, 91% of the males and 95% of the females were correctly aged. As young mallards, with the progress of pre-breeding moult (completed from October onwards), acquire tail and tertials identical to adults, untypical individuals are better not assigned to an age category.
Survey of wintering Whooper Swans Cygnus cygnus in Sweden in January 2015, and habitat shift in 1995–2015
Authors: Nilsson Leif
Published: February 2021

As wintering Whooper Swans Cygnus cygnus have shifted their winter feeding habitats from water to terrestrial ones, the International Waterfowl Counts, covering only coastal and lake sites since its start in 1967, cannot monitor true population change. Therefore, special surveys covering also the terrestrial habitats have been organized in mainland NW Europe every five years since 1995. In January 2015, about 12,000 Whooper Swans were recorded in Sweden, an increase from 7,400 in 1995. On the national scale the use of terrestrial habitats shifted from about 30% in 1995 to about 80% in 2015. This shift came first in the southernmost province of Scania where 40% were feeding in terrestrial habitats already in 1995.
The Porteguese Perspective
Authors:   Universidade Lusiada, Pedreirinho José Manuel , Toussaint Michel ,   Universidade Lusiada, Guedes Pancho ,   Universidade Lusiada
Published: February 2021

ose Manuel Pedreirinho was born and educated in Lisbon, and has operated his own practice there since 1984. In addition to teaching the history of modern architecture and the theory of architecture at the universities of Lisbon, Coimbra, and Porto, Prof: Pedreirinho is also completing a PhD at the University of Bath (UK). The author of several articles and two books on Portuguese architecture and the teaching process, Prof: Pedreirinho is currently preparing a guide on the architecture of Porto. Michel Toussaint is an architect and educator in Lisbon, where he teaches the theory of architecture at the Universidade Tecnica de Lisboa and the Universidade Lusiada. Prof: Toussaint has published several essays, articles, and books on architectural topics, and has practiced in Portugal, Angola, and Macau. Pancho Guedes is an architect currently working in Lisbon ajler an extensive career in Mozambique and South Africa. A graduate of the University of Witwatersrand (South Africa), Prof: Guedes’ work is noted for it sculptural and expressionistic quality, influenced heavily by African art and the work of Gaudi. In addition to his academic career in Lisbon, Prof: Guedes has also taught at the Architectural Association in London. [Editor’s note: The text of these presentations was not available at the time of publication.]
The American City
Authors:   Tulane University, Stanton Michael
Published: February 2021

A city divides into forms and attitudes, into significances, in the most political of senses, into episodic impressions, grand narratives and great collective generalizations. Cities are the vehicles for vivid nostalgia and are often the victims of banal cliche, both in the making of their form and in the way they are perceived. They are collaborative works, and, like works of art, they are conceived passionately, formed imperfectly, understood and misread by a continually transforming and distracted collective. Cities embody myth and fact, blurring the border between the two. All this applies especially to the fraught history and troubled body of the American city.
From the Editors
Authors: Burkiewicz Łukasz
Published: February 2021

Silvestre de Sacy (1758–1838), a pioneer of Eastern Studies in Europe, supplied the European reader with many fundamental works about the Orient, in addition to translations, which are often still valid today. It was he who studied the Rosetta stone and interpreted the correspondence of Timur with the King of France, Charles VI. His accomplishments opened the mysterious and alluring Orient for Europe long before the publica­tion of Orientalism (1978), the widely discussed book by Edward W. Said. From our present perspective, the impact of the Orient on the culture of Europe is very obvious. Hence the interest in this issue among the authors of papers contained in this issue of Perspectives on Culture, most of whom refer to the main theme, The Orient: Now and Then.
Egypt in the Early 20th Century in the Light of Newspaper Essays of Tadeusz Smoleński
Authors: Zinkow Leszek
Published: February 2021

This paper brings to light the reports and analyses written by Tadeusz Smoleński, a forgotten source on the political history of the Middle East and particularly Egypt, in the first decade of the 20th century. Tadeusz Smoleński (1884–1909), the first Polish Egyptologist, was also a regular correspondent of the Lviv daily newspaper Słowo Polskie [‘The Polish Word’]. In his reports, he outlines a panoramic view of Egypt’s extraordinarily complex political situa­tion, determined by tensions between the European powers, i.e., the rivalry between Britain and France, and between Russia and Germany. Another fac­tor whose growing importance was noted by the Polish observer, is the rise of nationalist and Islamist movements in both Egypt and the Arab world as a whole. This takes place alongside the chronic political instability of the Otto­man Empire. While acknowledging all of the beneficial aspects of British rule (especially under the consulship of Sir Evelyn Baring), Smoleński does not hide his sympathies for Mus????t????afà Kāmil Bāšā, leader of the Egyptian national­ists. In his analysis, Smoleński also hints at some analogies between the situa­tion of the Egyptians and the Poles in their ambitions to set up an independ­ent nation-state.
A New Paradigm: “The Middle Ages without Catharism” and the Testimony of the Inquisitional Sources
Authors: Czarnecki Piotr
Published: February 2021

The article discusses the radical interpretation of Catharism which is getting more and more popular in the recent years. It’s adherents assume, that this heresy never existed for real in the regions of contemporary southern France, but was only a construct of the Catholic clergymen. In their opinion the image of well-organized and doctrinally consistent heresy was created by the Catho­lic polemists, basing on the ancient anti-heretical writings (mainly anti-man­ichaean scriptures of St. Augustine) and than it was imposed on the innocent people questioned during an inquisitorial procedure. The adherents of this interpretation (based on the interpretation of inquisitorial sources) propose a total change in the perception of Catharism, and writing it’s history anew, to fit a new paradigm—“Middle-Ages without Catharism.” The main aim of this article is to verify these revolutionary claims, basing on the analysis of the inquisitorial sources and to answer the following questions: Can we really say, that the image of Catharism in the inquisitorial sources is identical as in the Catholic polemics? Can we assume, that it was imposed on the interro­gated people by the inquisitors? And finally—is it really an image of the well‑organized counter-church?
Literary Representation of the Self in Medieval Arabic Autobiographies and the Cultural Barriers to Self‑Cognition. The Literacy Theory Perspective. Part 2
Authors: Prochwicz-Studnicka Bożena
Published: February 2021

This article addresses the problems associated with the relationship between the influence of writing on cognitive processes and the features of the cul­ture within which writing appears. Classical literacy theory, with the modi­fications that were introduced over the course of time, was embraced as the research perspective. According to these modifications, the change in the cog­nitive processes and content which occurs under the influence of writing is not automatic. Every culture has at its disposal a specific array of factors which influence writing and literacy and which determine the extent to which the potential of writing will be used. The aim of this article is to demonstrate the most important cultural norms and values which, by being practiced socially, could have limited the influence of writing on self-cognitive processes—the consequences of such processes can be found in the literary representation of the self in medieval Arabic autobiographies of the 12th–15th centuries. These features were referred to as traditionalism, the domination of collective aware­ness over individual awareness, the acceptance of social hierarchical structure, and a Quranic vision of the limits to man’s freedom.
The Turkish Republic of Northern Cyprus as an Example of a Non-Recognized State
Authors: Osiewicz Przemysław
Published: February 2021

The issue of Cyprus remains one of the longest unregulated international dis­putes. For nearly half a century of the island’s de facto division, it has been one of the factors destabilizing the situation in the eastern Mediterranean. It has periodically led to tensions, not only between members of the two Cypriot communities, the Greek and Turkish Cypriots, but also between Greece and Turkey, and finally, Turkey and the European Union. The purpose of this article was to present the Turkish Republic of Northern Cyprus as an exam­ple of a so-called unrecognized state and to assign it to an appropriate type of unrecognized states. The selected case was examined on the basis of the attributes of an unrecognized state, formulated by a leading researcher of this issue, Nina Caspersen, and a selected typology of unrecognized states.
Recepcja Orientu w ujęciu socjologicznym
Authors: Switat Mustafa
Published: February 2021

Artykuł prezentuje refleksje socjologiczne nad recepcją „arabskiego” Orientu w kulturze polskiej. Jego podstawą są pierwsze wyniki analizy transferu pomiędzy kulturą arabską a kulturą polską: średniowiecznego srebra i innych elementów kultury materialnej, wartości religijnych i innych elementów kul­tury niematerialnej, koni oraz przedstawicieli arabskiej społeczności w Pol­sce. Przyswajanie i przyjęcie ww. arabskich elementów kulturowych (przed­miotów transferu) oraz podmioty tego transferu zostały przedstawione przez pryzmat wybranych teorii i pojęć socjologicznych, jak np. transnarodowość, naśladownictwo, percepcja oraz dyskurs.
Polska a imperium mongolskie oraz Złota Orda w latach 1241–1502
Authors: Bojko Krzysztof
Published: February 2021

W związku z najazdem w 1241 roku armii Batu-chana na Europę Środkową i Wschodnią doszło do pierwszego, bardzo niefortunnego dla Polski spotka­nia z ówczesnym imperium mongolskim. Klęska pod Legnicą, śmierć księ­cia Henryka II Pobożnego, upadek państwa Henryków na Śląsku nie tylko odsunęły o kilka dekad proces zjednoczenia ziem polskich, ale też w praktyce wyeliminowały Piastów śląskich ze skutecznej rywalizacji o przyszłe zjed­noczenie Polski. Jedynie śmierć wielkiego chana Ugedeja skłaniająca Batu­-chana do powrotu wraz z armią do Mongolii uratowały Polskę i Węgry od długotrwałego zniewolenia, które spotkało księstwa ruskie. Kolejne mongol­skie najazdy na Polskę z lat 1259 na 1260 oraz z przełomu roku 1287 na 1288 jedynie pogłębiły proces upadku gospodarczego i zniszczeń ziem polskich. Klęski poniesione przez Mongołów w walkach z egipskimi Mamelukami oraz upadek Królestwa Jerozolimskiego w 1291 roku spowodowały, że Zachód stracił zainteresowanie nawiązywaniem politycznych układów z Mongołami. W Europie Wschodniej umocniła się natomiast zachodnia dzielnica impe­rium mongolskiego, tzw. Złota Orda, która zaczęła odgrywać znaczącą rolę w życiu politycznym całego regionu. Szczyt jej potęgi przypadał na pierw­szą połowę XIV wieku za rządów chanów Uzbeka i Dżanibeka. Od drugiej połowy XIV wieku widoczne jest osłabienie Złotej Ordy. W wieku XV prze­kształciła się ona w tzw. Wielką Ordę. Powstrzymanie chana Wielkiej Ordy Ahmeta w 1480 roku nad Ugrą przez księcia moskiewskiego Iwana III było triumfem Moskwy. Polska natomiast traciła jednego z nielicznych sojusz­ników na wschodzie. Nieudzielenie zaś przez króla polskiego Aleksandra Jagiellończyka w 1502 roku wsparcia ostatniemu chanowi Wielkiej Ordy Szach-Achmadowi umożliwiło zniszczenie Wielkiej Ordy przez sojusznika Iwana III, władcę Chanatu Krymskiego, chana Mengli Gireja. Upadek Wielkiej Ordy dla Polski oznaczał symboliczne zakończenie wspólnej historii zapoczątkowanej jeszcze najazdem Mongołów z 1241 roku. Dla Rosji był ostatecznym potwierdzeniem zrzucenia przez nią zwierzchno­ści tatarskiej. Dla Chanatu Krymskiego, który niszcząc Wielką Ordę, de facto zrywał dotychczasowe związki z dawnym imperium mongolskim, oznaczał natomiast, iż stawał się on częścią nowego, kształtującego się wówczas ładu polityczno-gospodarczego w Europie Wschodniej.
Podtrzymywanie polskiej kultury przez Polonię w Nowej Zelandii po II wojnie światowej
Authors: Zdziech Dariusz
Published: February 2021

Artykuł dotyczy zachowania elementów polskiej kultury przez diasporę Pola­ków w Nowej Zelandii na przestrzeni ostatnich siedemdziesięciu lat. Kon­centruje się na utrzymaniu wiary katolickiej w protestanckim społeczeństwie, podtrzymaniu języka przodków, wiedzy o Polsce, jej tradycjach, strojach, tańcach, pieśniach oraz kuchni. Badania prowadzone zarówno na źródłach zastanych, jak i wywołanych podczas czterech pobytów na antypodach, dopro­wadziły autora tekstu do wniosku, który w artykule został poparty wieloma przykładami, że Polonia w Nowej Zelandii na przestrzeni siedemdziesię­ciu lat działała bardzo prężnie w różnych dziedzinach, szczególnie w dwóch głównych ośrodkach miejskich: Wellington i Auckland. Obecnie dzięki naj­nowszej emigracji do wspomnianych dwóch głównych ośrodków dołączyły skupiska Polonii w Christchurch i Dunedin.
Drugorzędny drugi obieg. W trzydziestą rocznicę zniesienia cenzury w Polsce
Authors: Okoński Krzysztof
Published: February 2021

Literatura podziemna istnieje obecnie tylko w archiwach historycznych lub w zbiorach prywatnych i nie ma szansy wpłynąć na współczesny dyskurs. Któż byłby dziś naprawdę zainteresowany prezentowanymi w niej liberal­nymi poglądami, jej różnorodnością tematyczną i estetyczną, kiedy radykalne siły, fake newsy i trolle w coraz większym stopniu kształtują komunikację w przestrzeni publicznej? Czy eskalacja konfliktów ideologicznych w Polsce może prowadzić do instrumentalizacji mitu literatury i prasy dysydenckiej przez uczestników życia politycznego? Jaki potencjał dla badań literaturo-i kulturoznawczych oraz dydaktyki tkwi w podziemnej literaturze i prasie? Czy digitalizacja druków drugoobiegowych ułatwia kultywowanie pamięci o tych publikacjach? I wreszcie – czy nadszedł czas demitologizacji niektó­rych aspektów kultury niezależnej? 30 lat po zniesieniu cenzury nadal aktualne jest pytanie o nieobecność w popularnych formach pamięci bohaterów polskiej historii – drukarzy, kol­porterów i autorów.
COMPARATIVE STUDY OF LIPID PROFILE BETWEEN ISCHEMIC AND HAEMORRHAGIC STROKE AT MEDICINE DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR
Authors: Singh Amrendra Kumar , Sourav Kumar , Choudhary Rajkamal , Jana Debarshi
Published: February 2021

Background: Stroke is one of the major global health problems. Stroke is the most common clinical manifestation of cerebrovascular disease of which more than 99% are due to arterial involvement and less than 1% due to venous involvement in the form of Cerebral Venous Thrombosis (CVT). Among arterial causes 85% are due to infarction and 15% due to haemorrhage. There is difference in serum lipid levels in subtypes of strokes to guide lipid-lowering therapy which can reduce incidence of stroke and stroke related mortality by adapting primary and secondary preventive measures. Authors have endeavoured to correlate severity of lipid derangement and stroke.
Methods: In this study 64 consecutive eligible ischaemic stroke cases and 64 eligible hemorrhagic stroke cases would be included. Cases of strokes will be divided into ischaemic and hemorrhagic as per clinical features and with help of brain imaging by CT scan and MRI at the time of admission and 8 hour fasting lipid profile was collected from all cases. All this information will be filled in preformed format.
Results: Serum lipid profile of two categories of stroke showed raised serum total cholesterol in 39.1% patients of ischaemic stroke in contrast to 18.8% patients with haemorrhagic stroke (p=0.019).
Stroke patients showed raised in LDL cholesterol in 29.7% patients of ischaemic stroke in contrast to 9.4% patients with haemorrhagic stroke, (p=0.007).
Conclusions: Based on the finding of our study we conclude that ischemic stroke patient had higher lipid derangement as compare to haemorrhagic stroke in terms of raise total cholesterol, LDL cholesterol and decrease HDL cholesterol.
ROLE OF VIRECHANA KARMA (THERAPEUTIC PURGATION) IN PSORIASIS: A CLINICAL STUDY
Authors: Meenu Mishra , Ankita Sharma , Shwetal Shivhare , Vivek Sharma
Published: February 2021

Background: The skin or the integument is the external organ that protects against mechanical trauma, UV light and infections. The prevalence of skin diseases in India is 10 to 12% of the total population with psoriasis being the major contributor, in India it ranges from 0.44% to 2.8%. In Ayurveda all skin diseases come under the concept of Kushta. Psoriasis has a high resemblance with Ekkushta, which is the type of Kshudrakushta (less severe form of the Kushta). Skin diseases considered as Pitta Doshaja and Rakta Dhatu Pradoshaja Vikara. Acharya Charaka stated that Virechana is the great treatment for Pitta predominance diseases. Aim: To study the role of Virechana Karma in the management of Ekkushta (Psoriasis). Material and Methods: A single group of 5 diagnosed patients of Ekkushta (Psoriasis) were registered at the Kayachikitsa OPD of Pt. Khushilal Sharma Govt. (Auto.) Ayurvede Hospital Bhopal. The patients were treated with Virechana Karma. Duration of study is 21 days and follow up after completion of trial every week for 1 month. Assessment was done on the basis of symptomatic relief after treatment. Observation: The overall effect of the Virechana Karma in all patients suggested that, complete cure was not in any patient. One patient was mild improved, one patient was markedly improved and three patients were moderately improved. None of patients remained unchanged. Conclusion On the basis of this clinical trial it can be concluded that Virechana Karma works effectively in the management of psoriasis.
ROLE OF TLC NLR & SERUM CREATININE IN DIAGNOSING ACUTE APPENDICITIS: A PROSPECTIVE STUDY IN A TERTIARY CARE CENTRE
Authors: S Madhu B , Shenoy Shraddha
Published: February 2021

Aim- To assess the role of TLC and NLR and serum creatinine in diagnosing acute appendicitis. Background-Acute appendicitis being the most common surgical emergency globally can lead to varied consequences if not detected and treated accurately. Early and precise biochemical detectors affect the severity of acute appendicitis. Materials and methodology- A prospective study was conducted in K R Hospital, Mysore from 2019-2020. All cases of acute appendicitis during this period were assessed for severity. TLC, NLR and serum creatinine were assessed and correlated with severity of acute appendicitis. Results- A total of 96 patients were included in the study, 72 patients had SAA and 24 had CAA. This was classified in accordance to the cut off values. TC cut off point was 15,050 cells/cumm ,Sn 91.7 %, Sp 74.6%. The NLR cutoff value was 4.56, Sn of 83.3%, Sp of 66.2%. The cutoff value for neutrophil count was 77.6%, Sn 91.7% , Sp 71.18%. The cutoff value for lymphocyte count was 18.2%, Sn was 91.7%, Sp 65.8%. The cutoff value of creatinine was 0.73, Sn of 83.3%, Sp 80.03%. Conclusion- TC, TLC, NLR and Serum creatinine combinedly help distinguishing between the simple acute appendicitis and complicated acute appendicitis and is a very economical measure for the prediction
A COMPARATIVE STUDY OF VOLAR LOCKING PLATE VERSUS EXTERNAL FIXATION FOR DISPLACED INTRAARTICULAR DISTAL END RADIUS FRACTURES AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR
Authors: Shankar Kunal , Harinandan Vikash M. , Chaudhary Laljee , Jana Debarshi
Published: February 2021

Background: Distal radius fracture is more common accounting for 1/6th of the all fractures. With this background, this study was carried out to compare the functional outcome of volar locking plate and external fixator to the displaced intra-articular distal end radius fractures using Modified Mayo Wrist Score (MMWS).
Materials and methods: This study included those patients with distal radius fracture attending the Orthopaedic Department of DMCH, Laheriasarai, Bihar, during January 2019 to December 2019. Patients were randomised based on - even and odd day of the week. This included two set of group with twenty patients in each group- one with volar locking plating and other with external fixation. Patients were followed up at 6 months and 1 year. At each follow up, the pain and range of movements were assessed by MMWS score which was entered in Microsoft excel and analysed in SPSS 20.
Results: At the end of one year after surgery, we observed that external fixation technique was superior for treating displaced intra-articular comminuted distal end radius fractures than volar locking plate.
Conclusion: External fixator showed more advantageous than volar locking plates after 1year of follow up.
A SYSTEMATIC NON-INVASIVE APPROACH FOR REHABILITATION OF TRAUMATIZED MAXILLARY LATERAL INCISOR – A CASE REPORT.
Authors: Karunakar P , Rangareddy M.S. , Karteek Basa Srinivas , Reddy Chavva Lakshmi Charan , Akshara Gandikota
Published: February 2021

Coronal fractures of permanent anterior teeth by trauma are the most common type of injury. Many factors are considered in the attempt to provide optimal mechanical properties, aesthetic, and longevity. Discomfort, serious psychological, esthetic, functional, and phonetic problems are related with anterior crown fracture, this may also affect social communications and it poses a challenge for the dentist, to save these teeth. The restoration of traumatically injured teeth with substantial loss of coronal structure necessitates endodontic treatment followed by post insertion into canal space so that foundation restoration can be strengthened to receive the crown. In this case report, such case is described with fiber-reinforced post and core system.
HIGH RESOLUTION COMPUTED TOMOGRAPHY FINDINGS OF TEMPORAL BONE IN PATIENTS WITH UNSAFE CHRONIC SUPPURATIVE OTITIS MEDIA.
Authors: Shami Sakshi , Raunaq Raunaq , Chumber Shishir , Vani Kavita , Prasad Akhilandeswari
Published: February 2021

CSOM is defined as chronic inflammation of mucoperiosteal lining of middle ear cleft, i.e. eustachian tube, middle ear and mastoid. Unsafe CSOM is associated with marginal/ attic perforations and cholesteatoma, which may produce multiple complications. It is a potentially serious condition as it can progressively enlarge and cause erosion into neighbouring structures, giving rise to serious complications. HRCT provides information regarding the extent of disease and depicts anatomical variations, which may lead to complications during surgery. The aim of this study was to assess the usefulness of HRCT imaging of temporal bone in cases of unsafe CSOM. In an IRB approved cross-sectional observational study of consecutive 50 patients with clinically diagnosed unsafe CSOM, HRCT of temporal bone was performed. Patients not fit for CT scan e.g., pregnant patients were excluded. HRCT was performed on Philips Brilliance 40 slice CT. Collimation was set at 190mm with scan time of 4.79 seconds with kVp of 140 and mAs of 350. HRCT findings of these patients were compared with the intraoperative findings of those patients who underwent surgery. Standardised statistical methods were used. It was found to be male predominant disease with a mean age of 25.5 years. The most common finding on HRCT was soft tissue density involving the middle ear cleft. Cholesteatoma caused ossicular erosion with the incus being most commonly affected. This study concludes that HRCT should be done in all patients of unsafe CSOM to know the extent of disease which guide in surgical approach and treatment plan.
THE EFFICACY OF FRACTIONAL CO2 LASER WHEN COMBINED WITH PLATELET-RICH FIBRIN MEMBRANE FOR FACIAL REJUVENATION
Authors: Chauhan Vasim F , Patel Krina B , Vora Nitin S
Published: February 2021

Background:
Facial rejuvenation is different from other aesthetic procedures in that it directly restores a younger appearance in patients. Demand for a youthful and attractive appearance has increased recently and mass media have promoted the desire for beauty. Fractional-CO2 laser one of the most utilised modality for this purpose nowadays but there are few drawbacks of this method which can be reduced and efficacy can be increased by the addition of autologous blood components.

Objectives:
We evaluated the synergistic efficacy and safety of combined use of fractional-CO2 laser and topical application platelet-rich fibrin membrane for facial rejuvenation.

Methodology:
Total of 12 patients (M:5, F:7) was included in the study.
All patients were treated once with fractional-CO2 laser followed by topical application of platelet-rich fibrin membrane application over face for 30 minutes.
Patients were evaluated at baseline, one, four, and eight weeks after the session.

Result: PRF when applied after fractional-CO2 laser showed additive effects on facial rejuvenation with lesser downtime.
A COMPARATIVE STUDY OF ATTENUATION OF HYPERTENSIVE RESPONSE WITH ESMOLOL AND LABETALOL IN LOW DOSES IN OROTRACHEAL INTUBATION
Authors: Singh Praveen Kumar , Krishan Rajeev , Choudhary Chandeshwar , Jana Debarshi
Published: February 2021

Background: This was a prospective, randomized, double blind, comparative, clinical study to assess the efficacy of Esmolol and Labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation.
Materials and Methods: This study was conducted on 50 ASA 1 patients of either sex undergoing elective surgeries under general anaesthesia. Patients were randomized into two groups; group E who received intravenous Esmolol (0.5 mg/kg) or group L who received intravenous Labetalol (0.25 mg /kg) prior to induction and hemodynamic parameters were recorded as per designed protocol to assess stress response to laryngoscopy and intubation.
Results: Both the study groups had similar demographic profile. Instat version 3.10 was used for statistical calculations. The study data were analyzed using statistical methods of mean, standard deviation. Esmolol (0.5 mg/kg), abetalol (0.25 mg/kg) significantly attenuated the rise in heart rate, systolic blood pressure, and RPP during laryngoscopy and intubation. However, the difference was not statistically significant among the values for DBP and MAP.
Conclusion: From our clinical study it can be concluded that in lower doses, intravenous Labetal ol (0.25 mg/kg) is a better agent than intravenous Esmolol (0.5 mg/kg) in attenuating the sympathomimetic response to laryngoscopy and intubation. Usual dose of esmolol used to obtund intubation response is 2-4mg/kg, while labetalol has been tried in all doses ranging from 0.25, 0.5, 0.75, and 1 mg/kg.
SNAKE BITE PRESENTING AS INTRACRANIAL BLEED WITH NORMAL COAGULATION PARAMETERS
Authors: Waingankar Harsh , Kaushik Prashant , Sinha Shruti , Ghanekar Jaishree
Published: February 2021

Snakebite being commonly encountered emergency in our country and most dreaded one too. It has been estimated that as many as 2.8 million people are bitten by snakes, and 45 900 people die from snakebite every year in India1. The most common coagulopathy associated with snake-bite envenoming is Venom Induced Consumptive Coagulopathy. Venom contain enzymes like proteases, phospholipase A2, hyaluronidase and arginine ester hydrolase. Phospholipase A2 is the factor responsible for hemolysis secondary to the esterlytic effect on the red cell membranes The hyaluronidase causes spread of the venom in the subcutaneous tissue by disrupting mucopolysaccharides. In majority of cases there is disruption in coagulation profile causing increase in PT, INR, aPTT, thrombocytopenia and increase in FDP, which suggests DIC as the probable cause for intracerebral hemorrhage . But always it is not true there are some cases in which there is hemorrhagic risk without alteration in coagulation profile. All my 3 cases present to us with normal coagulation profile , One 26 year old male present within one hour of snake bite and died within 3 days of the bite, while other two presented lately that is 2and 6 day of the snake bite ,of which both survived and had no residual focal deficit at time of discharge. This delayed clinical, laboratory manifestation of vasculotoxic snake due to the delayed seepage of venom from deeper reservoirs in the bite site or due to disassembly of the antigen-antibody complex with reinstitution of circulating unbound venom constituents. Intracranial hemorrhages are poorly understood in case of snake bite and can occur later complication also even after treatment with ASV. Still use of FFP is not advocated in much studies, there is immense need to investigate this area. Use of ASV and FFP without increased WBCT to avoid later complication is to be studied.
A COMPARITIVE EVALUATION BETWEEN COMBINED SPINAL EPIDURAL BLOCK AND EPIDURAL BLOCK FOR LOWER ABDOMINAL SURGERIES
Authors: Choudhary Chandeshwar , Singh Praveen Kumar , Jana Debarshi
Published: February 2021

Introduction: Most of the lower abdominal surgeries are conducted under spinal or epidural anaesthesia. The purpose of this study is to evaluate combined spinal epidural anesthesia and epidural block in terms of efficacy, surgical analgesia and muscle relaxation in patients undergoing lower abdominal surgeries.
Material and methods: This prospective randomised study was conducted at SKMCH, Muzaffarpur, Bihar where 60 patients of ASA I and II, aged 20-60 years of both sexes scheduled for elective lower abdominal surgeries were randomized into two groups.
Group A – receiving epidural anaesthesia. 20ml of 0.5% plain bupivacaine was injected epidurally.1.5-2ml of 0.5% Bupivacaine was injected epidurally for every unblocked segment after the maximum height of block is reached so as to get the required T6 level.
Group B – receiving combined spinal epidural anaesthesia. (2.5 ml) of 0.5% Bupivacaine (heavy) was deposited in the subarachnoid space.1.5-2ml of 0.5% bupivacaine was injected epidurally for every unblocked segment after 10 minutes to get required T6 height of block.
Results: The changes in hemodynamic parameters observed between the two groups are statistically not significant. The time to achieve T6 sensory block was significantly shorter in CSE group when compared to epidural group. CSEA provided more degree of motor blockade and significantly good quality of analgesia compared to epidural anesthesia alone. The amount of bupivacaine required to produce the desired level of T6 blockade is 2.5 times less in CSEA compared to epidural anesthesia.
Conclusion: Combined spinal epidural technique is effective, safe, with stable hemodynamics and superior to epidural anaesthesia in patients undergoing lower abdominal surgeries.
STUDY TO EVALUATE THE ROLE OF HIGH TIBIAL OSTEOTOMY (HTO) FIXED WITH ANGLE STABLE PLATE IN TREATMENT OF OSTEOARTHRITIS OF KNEE AT NMCH, ROHTAS, BIHAR
Authors: Kumar Sandeep , Rashmi Kumari , Anshuman Kumar , Jana Debarshi
Published: February 2021

Background: Osteoarthritis is more common in females. It is because osteoarthritis in post-menopausal women is associated with higher body weight, higher subcutaneous fat, calcium deficiency and weaker muscles linked to hormonal changes. The purpose of this study was to evaluate the role of high tibial osteotomy fixed with angle stable plate in treatment of osteoarthritis of knee. Material and Methods: In our study 10 cases were operated by modified coventry technique, 10 cases were operated by open wedge osteotomy with non locking plates and bone graft and 104 cases were operated by medial open wedge osteotomy and iliac graft secured by locking plate. In these cases full weight bearing was allowed at 8 week, 6 week and 3rd post operative day respectively. Radiographical analysis include post operatively change in tibio-femoral angle. Mean follow up of these cases was 2 year. Results: In our study thee knee pain and function score were significantly improved (p value <0.001). The average pain score preoperatively was 1 8± 7(the maximum pain score for pain is 50) and post-operatively was 44±5. According to the grading used for functional assessment in knee scores there was definite improvement in the function of cases 122 (98.38%) at 2 yrs. The preoperatively mean functional knee score in of 110 cases (88.7%) cases was 28.86 (the maximum functional knee score is 100) and postoperatively was 70.45. There is correction in tibiofemoral angle (mean preoperative and postoperative tibiofemoral angle was 5.2±1.5 degrees varus and 5.8±1.3 degrees valgus respectively). Conclusion: There was definite improvement in the pain and function of the knee after the correction of the deformity (P value <0.001). The results of high tibial osteotomy in 88.23 percentage knees were rated as excellent. 104 out of these 124 cases were fix by locking plates. 2 cases had poor results due to excessive over correction and associated comorbidities. There is a definite correlation between the postoperative valgus obtained and relief in the pain.
A PROSPECTIVE STUDY OF COMPARISON OF EPIDURAL BUPIVACAINE, FENTANYLAND THEIR COMBINATION FOR POSTOPERATIVE ANALGESIA IN LOWER ABDOMINALAND LOWER EXTREMITY SURGERY
Authors: Choudhary Chandeshwar , Singh Praveen Kumar , Jana Debarshi
Published: February 2021

BACKGROUND
Epidural analgesia with local anaesthetics and opioids provide good control of postoperative pain in lower abdominal and lower extremity surgery.
AIM
To evaluate and compare the analgesic action and adverse effects of epidural bupivacaine, fentanyl and their combination in postoperative period.
METHODS
75 patients undergoing elective infraumbilical surgery were allocated in three groups in a randomized double blinded fashion. Postoperative analgesia was maintained with continuous infusion of epidural drug in the following manner: Group B: Injection Bupivacaine 0.125% @ 0.1mL/kg/hr through epidural route; Group F: Injection Fentanyl 4µg/mL @ 0.1mL/kg/hr through epidural route; Group BF: Injection Bupivacaine 0.0625% and Fentanyl 2µ/mL @ 0.1mL/kg/hr through epidural route.
RESULTS
VAS score were almost similar in all three groups at 00, 04, 08hrs and not clinically significant at that point of time. VAS score showed significant difference at 12, 20 and 24 hrs, being persistently lower in Gr BF than Gr B and Gr F. According to VRS Scale Score at 04 hrs majority of patients of all three groups had mild-to-moderate pain (p=0.278). At 08 hrs, 24% (p=0.082), 12 hrs 60% (<0.001), 16 hrs 68% (<0.001), 20 hrs 88% (<0.001) and 24 hrs 84% (<0.001) of Gr BF patients were pain free which are clinically significant. At the end of 08, 12, 16, 20, 24 postoperative hours, no patients of any groups had residual motor paralysis. Rescue analgesic needed in Gr BF patients were significantly less than other two groups.
CONCLUSION
Combined bupivacaine and fentanyl infusion through an epidural route provides better analgesia in comparison to bupivacaine and fentanyl alone. Total drug, rescue analgesic requirement and adverse effects are much lower in combined group.
COMBINED DEXAMETHASONE AND DICLOFENAC VS SINGLE DICLOFENAC BASED ANALGESIC REGIMEN IN PATIENTS UNDERGOING MAXILLOFACIAL SURGERY: COMPARISON OF POST OPERATIVE ANALGESIA
Authors: Banerjee Priti , Hajra Bimal Kumar , Mukhopadhyay Soma , Chatterjee Joydeep
Published: February 2021

Background: Pain Management is one of the most important aspects in maxillofacial surgery. This study was conducted to compare post-operative analgesic effect of combination of Dexamethasone and Diclofenac with Diclofenac only, in patients undergoing maxillofacial surgery under GA.
Materials and Method: Sixty adult patients of both genders of ASA physical status I and II undergoing maxillofacial surgery were randomly allocated in two groups. In Group C (n=30) patients received combination of injection dexamethasone (8 mg IV) and injection diclofenac sodium (75 mg) in 1st bottle of NS. In Group D (n=30) patients received injection diclofenac sodium (75 mg) in 1st bottle of NS and 2 ml NS IV (placebo). Intensity of post- operative pain was assessed by VAS score at 0,1,4,8,12,24 hours after surgery. Duration of analgesia was noted from time of 1st administration of rescue analgesic and total amount of rescue analgesic needed in 1st 24 hours was also calculated.
Results: Both the groups were comparable with respect to mean age, gender, body weight. VAS score of Group C was significantly lower than Group D with p <0.05. Mean duration of analgesia in Group C was significantly higher than Group D with p <0.001. Consumed dose of rescue analgesic (injection paracetamol) was higher in Group D than Group C with p <0.05. Lesser Cumulative VAS scores were observed in Group C at 0,1,4,24 hours with p value < 0.05.
Conclusion: Combination of injection diclofenac and dexamethasone is superior analgesic regimen than single diclofenac in maxillofacial surgery with lesser VAS score, prolonged duration of analgesia and lesser dose of rescue analgesic.
THALAMIC TUBERCULOMA AND HEMICHOREA.
Authors: Moorthy Moses P. , Srinivasan A. V. , Balasubramanian S. , Mohanty Shraddha laxmidhar
Published: February 2021

25 years old female diagnosed to be having retro viral infection for past six months developed subacute onset of involuntary movements of left upper and lower limb in the form of flowing movements from proximal to distal parts of the limb. On examination vitals were stable, routine blood investigations were normal. CXR and ECG were normal. Patient CD4 count is 179. Neuro-imaging revealed T2 and flair hyper intensity and T1 hypo intensity with out any evidence of diffusion restriction noted in right thalamus. Possibility of TUBERCULOMA in right side of thalamus.
MEDICAL NEGLIGENCE: CURRENT SCENARIO IN INDIA
Authors: Kumar Binay , Kumar Avinash , Kumari Vinita , Rastogi Ashok Kumar , Himanshi Himanshi , Singh Nawal Kumar
Published: February 2021

Medical profession, one of the noblest professions, but not immune to negligence due to lack of reasonable degree of care and skill or willful negligence, which causes injury or death of the patient. There is no proper guideline in India to tackle the issues related to the medical negligence. So, interpretation of law by the different court and law enforcing agencies along with the circumstantial evidence related to negligence cases, sometimes becomes misleading and lead to wrong conviction and punishment. So, doctors are always afraid of its impact on them. Many landmark judgments have been passed by various courts and consumer forums in civil and criminal negligent cases, against doctors and health institutions, to award compensation in alleged negligence cases. Now a days, people are more aware of their rights and health, so cases of medical negligence have significantly gone up over the past few years. A basic knowledge of how medical negligence is adjudicated in the various judicial courts of India will help a doctor to practice his profession without undue worry about facing litigation for alleged medical negligence.
The present article aims at discussing the various aspects of negligence, and current scenario in India and discussion with different landmark judgements of cases related to medical negligence.
A PROSPECTIVE CROSS SECTIONAL OBSERVATIONAL STUDY OF CHRONIC PELVIC PAIN IN ADOLESCENTS TRANSVAGINAL ULTRASOUND VERSUS LAPAROSCOPY
Authors: Kumari Supriya , Narayan Surya , Jha Kumudini , Jana Debarshi
Published: February 2021

Background: Chronic pelvic pain (CPP)is cyclic or noncyclic, intermittent or constant discomfort in the pelvic region for at least 6 months. It is a common complaint in female adolescents that may be overlooked.
Objective: To evaluate CPP in adolescents using transvaginal ultrasound (TVS) and laparoscopy.
Study design: This is a prospective cross sectional observational study conducted at Obstetrics and Gynaecology Department of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. A total of 100 adolescents with CPP were evaluated by TVS and laparoscopy and findings were analyzed.
Results: The mean age of adolescents was 17 ± 3.5 the majority were parous (51%), rural (69%) and low social class (65 %). Diffuse pelvic pain was present in (62%), Dysmenorrheain (61%), deep abdominal and pelvic tenderness in (55% and 80% respectively).
TVS was normal in (40%) andabnormalin (60%). Laparoscopic evaluation was normal in (29%)and abnormal in(71%) in the form of tubo- ovarian masses (19%),endometriosis (18%) ovarian cysts (9%), adenomyosis (8%), Adhesions (6%), PID and RVF uterus (4% for each), subserous fibroid and pelvic congestion (1% for each). sensitivity and specificity of TVS were (81.7% and 93.1% respectively). Positive and negative predictive values were 96.7% and 67.5% respectively. Kappa test between TVS and laparoscopy showed good agreement (kappa = 0.67).
Conclusions: Good agreement was found between TVS and laparoscopy, however, laparoscopy is considered as a gold standard tool in evaluating adolescent CPP because of distinct advantages in terms of sensitivity and negative predictive value.