bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical and Micro Faces for Almonds Limited Limits
Authors: Ahmed Inas  Khaled , Jassem Mohamed Ahmed
Published: July 2022

This study was conducted with the aim of manufacturing four types of milk, they are yogurt (T1) and almond milk fermented with starter yoghurt bacteria (Lactobacillus delbruckiisb bulgaricus and Streptococcus thermophiles) treated (T2) and almond milk fermented with bacteria (L. bulgaricus and Lactobacillus acidophilus) treated (T3) And almond milk fermented with bacteria (Bifidobacterium longum and L. acidophilus) treated (T4). The results of the chemical analysis showed that the percentage of moisture in the milk of the treatments (T1, T2, T3, T4) had a significant decrease when stored at refrigerator temperature after 14 days of storage. A significant increase in the percentage of fat and protein was observed after 14 days of storage for the different treatments compared to the first day of manufacturing. The pH values ​​of the milk of the above treatments had a significant decrease during storage at a temperature of 5 ± 2 °C for 14 days. As for the percentage of acidity, as the storage period progressed, a significant increase occurred in its peaks. The results of the microorganisms numbers examinations showed that the total number of aerobic bacteria increased after 14 days of storage in the refrigerator, and no growth of colon bacteria, yeasts and molds appeared in almond milk and yoghurt during the 14-day storage period. The sensory evaluation results showed that the treatments for almond milk and yogurt were acceptable, and the sapphire milk got the highest scores throughout the 14-day storage period.
Food’s Fortification: A Solution for Vitamin D Deficiency
Authors: Jaiswal Ranjana , Sharma Smriti , Pedhekar Sunannda K
Published: July 2022

Vitamin D is a fat-dissolvable nutrient expected for avoidance of various sicknesses combined with bone related immune system illnesses for instance rickets, osteoporosis and osteomalacia. Lack of vitamin D is seen in both the sexes and among all the age groups. Micronutrient lacks are consistently adding to the rising weight of wellbeing related co-morbidities with low dietary calcium and magnesium intake in Indian populace. Regardless of loads of daylight, vitamin D inadequacy is far and wide in India as well as everywhere. The expansiveness of broadly utilized food varieties, including milk, cheddar, margarine, dairy items, and different breakfast drinks, can work on the state of lack of vitamin D. There is prerequisite of advancement of effective systems which can diminish lack of vitamin D in everybody as well as in various age groups.
Shops, Markets (Food, Ingredients or Condiments) and Street Food Places in the Precarious Neighborhoods of Port-Bouët in Abidjan
Authors: Beugré Gnakon  Flora Carenne , Bouafou Kouamé Guy Marcel , Amani Yao Célestin
Published: July 2022

This work is part of the realization of our doctoral thesis whose theme is "Problem of the food and nutritional practices of the urban populations of the precarious districts of Port-Bouët, in Abidjan (Ivory Coast). This study aims to present the characteristics, food and hygiene of shops, markets and street food places in precarious neighborhoods of the municipality of Port-Bouët in Abidjan.The methodology is based on (1) direct observation of the environment of these shops and street food places (2) surveys of the supporters of these shops (questionnaires). In the 65 precarious neighborhoods of Port-Bouët, grouped into seven zones, there are many street food places and they are mostly “open air”. Most of the shops, markets and street food places are located along dusty roads or gutters containing sewage. They open from morning to evening and are generally run by women of foreign origin and some Ivorians. It sells foods for breakfast, lunch, snack and dinner, of African types. Vendors, utensils, cutlery are “relatively good” cleanliness. Some shops and street food places do not have handwashing points. Others give customers the same container filled with water to wash their hands. In short, shops and street food places have poor hygiene that can impact the health of consumers.
Radiological Predictors for Difficult Single Incision Laparoscopic Cholecystectomy
Authors: Chaudhary Amita , Chauhan Rohit , Jhobta R. S.
Published: July 2022

Background: Single-incision laparoscopic cholecystectomy (SILC) has been developed to further minimize the invasiveness of laparoscopic cholecystectomy by reducing the number of incisions. Knowledge of preoperative clinical factors to predict difficult SILC may be used for the preoperative counselling of the patients regarding the successful outcome of the surgery as well as to predict the risk of conversion preoperatively for selected patients, prepare the patient psychologically and minimise the procedure related cost. Objective: The present study was conducted to know about radiological predictors for difficult SILC. Methods: The study was a hospital based prospective observational study where 50 patients undergoing elective laparoscopic cholecystectomy due to gall stone diseases were included in the study. Multiple logistic regression analysis was done to predict difficult single incision laparoscopic cholecystectomy. Results: Out of 50 patients 15 patients underwent difficult SILC, while 35 patients had undergone easy single incision laparoscopic cholecystectomy independent risk factors in multivariate logistic regression analysis for difficult SILC were: contracted or distended gall bladder on ultrasound, longer umbilicus to Calot’s triangle distance (UCD) on MRI. Conclusion: Radiological Factors associated with difficult SILC contracted or distended gall bladder on ultrasound and longer umbilicus to Calot’s triangle distance on MRI.
Is Conventional Laparoscopy Better Than the Single Incision Laparoscopy for Cholecystectomy: A Narrative Review
Authors: A Chaudhary , R Singh
Published: July 2022

Gallstone disease is one of the most common problems affecting digestive tract. The prevalence of gallstones is related to factors like age, gender and ethnic background. The prevalence of gallstone varies widely from place to place. It is estimated that approximately 20-25 million people in the United States have gallstones and that approximately 1 million new cases of cholelithiasis develop each year. Cholelithiasis is 10-15% prevalent in India and approximately 1-2% of asymptomatic patients will develop symptoms and require cholecystectomy each year. Its occurrence has been found to be at least 7.4% in adult population of North India. There has also been a remarkable shift in the trend of gall stone disease from middle aged, fertile, fat, females to young asthenic females in their twenties. Changing incidence in India is mainly attributed to westernization of diet, change in socioeconomic structure and availability of ultrasound as investigation in both rural and urbanareas. The current review was done to determine the efficacy of conventional laparoscopic cholecystectomy in comparison to single incision laparoscopic cholecystectomy.
Bear Bite Injuries in the Hilly Areas of District Sirmaur, Himachal Pradesh
Authors: Sharma Uma , Sharma Manish
Published: July 2022

Bear attacks are rare but widely publicized incidents. Degradation in form of overgrazing, deforestation, fire, reclamation of forest land for other uses and over extraction of forest resources essential for bear survival is occurring throughout the bear range. For those living nearby forest areas, bear presents a considerable danger worse than the tigers and leopards.
Postoperative pain and other complications due to spillage during laparoscopic cholecystectomy: A cross sectional study in a tertiary care hospital
Authors: Sharma Uma , Sharma Manish
Published: July 2022

Background: Present study was done to evaluate the postoperative pain and other complications due to spillage during laparoscopic cholecystectomy. Material and Methods: This prospective study was conducted in the Department of General Surgery, IGMC, Shimla. 100 consecutive patients of symptomatic gallstones with the documented gallstones undergoing laparoscopic cholecystectomy between July 2011 to March 2012 were included in the study and a study of gall bladder perforation was done. Results: Majority of patients in this study were females and were in age group of 31- 40 years. The difference in post-operative pain in patients without spillage and with spillage was significant on the day of surgery (p value=0.015). The difference in the pain was insignificant on 1st post-operative day (p value= 0.101) and on 2nd post operative day (p value= 0.567). Post-operatively fever was present in 3.09% of patients and ileus in 2.06% of patients. The difference in fever and ileus for patients without spillage and with spillage was insignificant (p value= 0.567 and 1 respectively). Port site infection at one week follow up was present in 1.03 % of patients and serous discharge from port site was present in 2.06 % of patients. The difference in port site infection and serous discharge from port site in patients without spillage and with spillage was insignificant (p value= 0.412 and 1 respectively). On post-operative USG collection in Morrison’s pouch was present in 2.06% of patients which settled without any intervention. The difference in patients without spillage and with spillage was insignificant (p value= 1). Conclusion: It was concluded the difference in post-operative pain was significant on the day of surgery while it was insignificant on 1st and 2nd post operative day. Post-operatively fever, ileus, Port site infection and serous discharge from port site was present as post operative complication.
Incidence of perforation of gall bladder during laparoscopic cholecystectomy and its associated factors: A cross sectional study in a tertiary care hospital
Authors: Sharma Uma , Sharma Manish
Published: July 2022

Background: Present study was done to evaluate the incidence of perforation of gall bladder during laparoscopic cholecystectomy and its associated factors. Material and Methods: This prospective study was conducted in the Department of General Surgery, IGMC, Shimla. 100 consecutive patients of symptomatic gallstones with the documented gallstones undergoing laparoscopic cholecystectomy between July 2011 to March 2012 were included in the study and a study of gall bladder perforation was done. Results: Majority of patients in this study were females and were in age group of 31- 40 years. . Gall bladder perforation was present in 27.83% of patients. Gall bladder perforation was more common in males and in age group of 61- 70 years. Gall bladder perforation occurred during grasping in 44.4 % patients and during dissection from liver bed in 37.04% patients. Gall bladder perforation was more common in case of distended gallbladder with omental adhesions (9 out of 22 patients) and in patients with partly intrahepatic gallbladder (4 out of 8 patients). Conclusion: Gallbladder perforation is common intra-operative phenomenon, more common in males and in older age group. Perforation is more common in gallbladder having adhesion with omentum and if gallbladder is partly intra-hepatic.
Diabetic Foot Push
Authors: C Jain Amit   Kumar
Published: July 2022

The use of spinal anesthesia in obstetrics is justified by the advantages it has over general anesthesia. It is a simple and easy technique. However, the possibility of serious complications or even death with this technique during cesareans leads to questions about its place. We report a case of totalization of spinal anesthesia during a cesarean section, that had a favorable evolution for both mother and child.
The development of nomogram for predicting thyroid cancer in subject with single thyroid nodule in Bali, Indonesia
Authors: Aryanti Citra , Sudarsa I Wayan , Adiputra Putu Anda Tusta , Setiawan I Gede Budhi
Published: July 2022

Background: There were many cases of thyroid cancer proven from histopathology test after lobectomy from single thyroid nodules, which were not being predicted in advanced. The challenge for the clinician is thus to predict the malignancy preoperative to prevent unnecessary second completion thyroidectomy. Objective: This study aimed to determine the cancer probability risk of a single thyroid nodule by using preoperative parameters. Methods: This cohort study was conducted in Sanglah General Hospital, from 2016 to 2021. All data was obtained by Cancer Registry and electronic medical records. There were nine variables that being analyzed in this study, such as age, gender, side, size, consistency, vascularization, node, and cytology. The data was pooled and analyzed in SPSS and R studio. Smart phone application was developed using Android studio. Data were analyzed by logistic regression multivariate analysis. Results: From 2016-2021, there were 198 subjects with single thyroid nodules underwent surgeries in Sanglah General Hospital, Denpasar, Bali, Indonesia. As many as 98 subjects were histopathology proven cancer (follicular, papillary) after surgery. From multivariate analysis, the only left significant variables were vascularization, calcification, age, consistency, and cytology. Further, nomogram was developed to plot the probability of cancer from significant variables. By using only cytology parameter, the cancer predictive value was only less than 10%. Even age and consistency parameter by physical examination gave a higher value of 30% predictive value. The ultrasound parameters, combining the presence of calcification and vascularization, had a good predictive value of 60%. Conclusion: The combination of the ultrasound characteristics, age and physical examination able to accurately predict thyroid cancer.
Profile of Urology Patients at the Covid-19 Isolation Ward in Dr. Moewardi General Hospital Surakarta Periode June 2020 – May 2021 (A Retrospective Descriptive Study)
Authors: Anggreini Meily , . Wibisono .
Published: July 2022

Objective: Coronavirus disease firstly discovered in December 2019, has caused many changes in patient management in the hospital, including in urology department. Several studies have demonstrated an increased rate of delayed care, with urology surgery having a delay of more than 8 weeks (Amota, O. et al., 2020). The medical workers are trying to reduce the spread rate by reducing of transmission (Amota, O. et al., 2020;and Sanyaolu, A. et al., 2020). The spread of this infectious disease is continuously increasing, hence the declaration of a pandemic (Cucinotta D). The COVID-19 status in the Solo city was updated to the red zone since the first year of the pandemic which makes the author interested in sharing information about COVID-19 in urology inpatients in the isolation ward (Tanggap Covid 19 Jawa Tengah, 2020). Materials and Methods: This study is a retrospective descriptive study that used secondary medical records data to determine the profile of urology patients in the COVID-19 isolation ward in dr. Moewardi General Hospital Surakarta for 1 year from May 2020 – June 2021. Results: This study found the urology patients in the COVID-19 ward were 26 patients, which was 4% of the total urology inpatients in the dr. Moewardi General Hospital in the first year of pandemic. Male patients consisted 85% of the total patients, with a mean age of over 50 years. The most frequent diagnosis was urinary retention. The mean duration of hospitalization was 2 weeks. The management in ward were urinary catheter insertion, closed cystostomy, prostate biopsy with local anesthesia, and emergency debridement surgery in isolated operating room. Delayed diagnostic procedures consisted of USG and BNO, while the delayed elective surgery consisted of cystoscopy, nephrectomy, direct visual urethrotomy (DVIU), and DJ stent insertion. Conclusions: The urology inpatients in the COVID-19 ward treated by multiple departments, in which the treatment of COVID-19 was prioritized before the definitive management from the urology department.
The Impact of Covid on The Survival Rate of Cancer Patients. Single Center Study At Moewardi Hospital Indonesia
Authors: Soewoto Widyanti , Adnyana Ida Bagus Budhi Surya , Salafuddin Muhammad Fahmi , Putra Muhammad  David Perdana , Putra Galih Santoso , Septiani Rizka Vinkan , Muamar Muhamad , Saadhi Ikhdin Radiamin , Ardianti Meirisa , Setiawati Dea Alberta , Hutabarat Rico Alfredo , Prasetyo Dinar Kukuh
Published: July 2022

Background: The novel coronavirus known as SARS-CoV-2 has spread worldwide and caused the COVID-19 pandemic. In September 2020, more than 32 million confirmed cases of COVID-19, with a death toll of more than 990,000. Among COVID-19 patients, those with cancer had worse outcomes than those without malignancy, but in some studies, the mortality rates differed significantly, ranging from 3.7% to 61.5%. Method: In this descriptive study, survival analysis with the Kaplan Meier curve was used to determine the healing rate of patients with cancer exposed to COVID-19 and undergoing treatment at dr. Moewardi General Hospital Surakarta-Indonesia from February to December 2020, and the Log Rank test was used to analyze data on two related groups. Results: The analysis using the Kaplan Meier method, female patients were found to have a higher survival rate than females, paged less than 50 years had a higher survival rate than those aged > 51 years, breast cancer had the lowest survival rate, and comorbidity of anemia had a higher survival rate than those with other comorbidities. The Log Rank test found a significant difference in the cumulative survival rates of cancer patients with COVID-19 with a p-value of 0.010 for comorbidity types. Meanwhile, from gender (p = 0.632), age (p = 0.672), type of cancer (p = 0.472), there was no significant difference. Conclusion: COVID-19 female patients aged less than 50 years with types of malignancy other than breast cancer and comorbidity of anemia have a higher survival rate..
Total Spinal Anaesthesia in Obstetrics, Case Report and Literature Review
Authors: Khalid Ouahmane , Ziani Hicham , Ettaje Ayoub , Tazi Anas Saoud
Published: July 2022

The use of spinal anesthesia in obstetrics is justified by the advantages it has over general anesthesia. It is a simple and easy technique. However, the possibility of serious complications or even death with this technique during cesareans leads to questions about its place. We report a case of totalization of spinal anesthesia during a cesarean section, that had a favorable evolution for both mother and child.
A Comparative Study of Single Clip Laparoscopic Cholecystectomy (SCLC) and Conventional Laparoscopic Cholecystectomy (CLC)
Authors: Attri Anshu , Sharma Parul , Chandel UK , Devkaran Bhavash , Kaundal Ashok , Syal Kartik
Published: July 2022

Background: Theoretical benefits for use of one clip laparoscopic cholecystectomy are Less operative time, Less bleeding, Early post operative recovery, Cost factor , Less spillage of stones, Less chances of converting into open cholecystectomy , Less pain post operatively and Less amount of CO2 used. Thus, a study was undertaken to compare the advantages of Single clip laparoscopic cholecystectomy (SCLC) over conventional laparoscopic cholecystectomy (CLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30th june 2020. In this study 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group 1 patients underwent CLC and Group 2 patients underwent SCLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO2 used , post operative pain , conversion into open cholecystectomy and post operative complications. Results: Out of 100 patients 15 were males and 85 were females. Among them, 5 males and 45 females underwent CLC using electrocautery while 10 males and 40 females underwent SCLC. Mean age of males were 47.60 ± 3.36 and females were 45.20 ± 15.82 in CLC group and mean age of males were 48.50 ± 14.49 and females were 46.73 ± 16.16 in SCLC group . Present study showed that there was significant less Operative Time, Less Mean CO2 used, less Approx. Blood Loss, less Average pain score at 6 and 24 hours, less Average Length of hospital stay, less Intra Op. Stone spillage, less Use of Drain and Post op. Complications in SCLC as compared to CLC but there was no significant difference in Conversion to Open Cholecystectomy in both groups. Conclusion: Study showed clear cut benefits of SCLC over CLC in terms of operative time , intra operative stone spillage , intra operative blood loss , amount of CO2 used , post operative pain and post operative complications
Advantages of Two Clips Laparoscopic Cholecystectomy (TCLC) and Conventional Laparoscopic Cholecystectomy (CLC): A Comparative Study
Authors: Attri Anshu , Sharma Parul , Chandel UK , Devkaran Bhavash , Kaundal Ashok , Syal Kartik
Published: July 2022

Background: Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips. Thus, a study was undertaken to compare the advantages of Two Clips Laparoscopic Cholecystectomy (TCLC) over conventional laparoscopic cholecystectomy (CLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30th june 2020. In this study 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group 1 patients underwent CLC and Group 2 patients underwent TCLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO2 used , post operative pain , conversion into open cholecystectomy and post operative complications. Results: In the present study among 100 patients, 19 were males and 81 were females. Among them,5 males and 45 females underwent CLC using electrocautery while 14 males and 36 females underwent TCLC.Mean age of males were 47.60 ± 3.36 years and females were 45.20 ± 15.82 years in CLC group and mean age of males were 45.36 ± 14.53 and females were 45.25 ± 15.97 in TCLC group. Present study showed that there was significant less Operative Time, Less Mean CO2 used, less Approx. Blood Loss, less Average pain score at 6 and 24 hours, less Average Length of hospital stay, less Intra Op. Stone spillage, less Use of Drain and Post op. Complications in TCLC as compared to CLC but there was no significant difference in Conversion to Open Cholecystectomy in both groups. Conclusion: Study concluded that TCLC had advantage over CLC in terms of operative time ,intra operative stone spillage , intra operative blood loss , amount of CO2 used , post operative pain and post operative complications
Arterio-Venous Brain Malformation Rupture during Pregnancy, About a Case
Authors: Abidi Asmae , Hadlousi Abdelziz   El , Nabil Noussaiba , Doumiri Mouhcine , Amor Mourad , Maazouzi Wajdi
Published: July 2022

AVMs are abnormalities of the intracranial vessels that constitute a connection between the arterial and venous systems and lack an intervening capillary bed. Hemorrhagic presentation of AVM is associated with significant morbidity and mortality; it is an independent predictor of future hemorrhage. AVM rupture is one of the most frequent and important causes of hemorrhagic stroke during pregnancy and puerperium. Whether the risks of AVM rupture increases during pregnancy and puerperium is controversial, but maternal physiological changes in hemodynamics, blood volume, and hormonal effects on the vessel walls could potentially increase the risk of hemorrhage from AVMs during pregnancy and in the postpartum period. For AVM during pregnancy and puerperium, previous studies have demonstrated histologic changes in arteries and arterioles of pregnant women, thought to be mediated by progesterone; the changes included fragmentation of reticular fibers and loss of normal corrugation of elastic fibers, which might play a role in the increased risk for AVM hemorrhage during pregnancy. However, there is insufficient evidence to guide management decisions for ruptured AVMs during pregnancy, and further well-designed, multicenter, perspective clinical trials are needed. We report the case of a young woman, who had an emergency ceasarean surgery for a headeck and consciousness disorder witch evoked eclampsia, while in fact; she had a rupture of arteriovenous malformation following the rupture of a cerebral Arterio-venous malformation in cerebral imaging.
A Rare Case of Synovial Sarcoma with Bone Metastasis Mimicking Multiple Myeloma – Challenges of Management in a Nigerian Resource Constrained Setting
Authors: MO Nkpozi , G Eyichukwu . , BO Ayogu  .
Published: July 2022

Background: Synovial sarcoma (SS), a rare carcinoma of soft tissues (including ligaments and muscles) around the big joints of the body, poses significant diagnostic and management challenges in low and middle income countries especially if it presented when metastasis had occurred. When there is metastasis to the bones, it mimics multiple myeloma on radiological skeletal survey. The objective of this report is to draw attention to this rare carcinoma which, usually, presents as a small painless nodule within the first three decades of life. We report this rare case of SS in a middle aged Nigerian lady who presented initially at National Orthopaedic Hospital (NOHE) with chronic severe right hip pain in which the initial radiological skeletal survey strongly suggested multiple myeloma. Definitive diagnosis and management of this case of synovial sarcoma was very challenging to the patient and managing unit. Conclusion: Early diagnosis of SS is critical at which point surgical excision or radiotherapy may be the preferred treatment option to achieve a favorable outcome. When metastasis is extensive, chemotherapy becomes the therapy of choice and it does not come cheap or easily available.
Peripartum Management of Vonwildebrand Disease: A Case Report
Authors: Abdelaziz El Hadloussi , Hajar El Hamdouchi , Mohammed Afrikh , Youness N'joumi , Abidi Asmae . , Salma Jebli , Tazi Anas Saoud
Published: July 2022

Understanding coagulation disorders is essential, especially for obstetricians and intensive care providers managing parturients, as these disorders can have significant consequences for the mother and child during the peripartum period. Von Willebrand-Jürgens syndrome or von Willebrand disease is the most common congenital bleeding disorder. It is subject to autosomal inheritance with variable penetrance and expressivity. The cause of the disease lies in quantitative (type 1, type 3) or qualitative (type 2) abnormalities of vonWillebrand factor (vWF). vWF has two important functions in coagulation. On the one hand, it circulates in plasma as a carrier protein for factor VIII and thus has a protective function; on the other hand, it is responsible for platelet adhesion to the subendothelium of injured vessels and platelet aggregation . The risk of bleeding varies according to the severity of the injury. The therapeutic management strategy depends on the type of disease. In this paper, we report the observation of two patients with von Willebrand disease who had vaginal deliveries.
The Role of Focused Assessment with Sonography for Trauma (FAST) in Children with Stable Hemodynamics after Blunt Abdominal Trauma:the Spleen and Hepatic Rupture Case Series
Authors: Muamar Muhamad , . Suwardi
Published: July 2022

Introduction: The most prevalent type of abdominal trauma in children is blunt abdominal trauma (BAT). Traffic accidents and falls are the most prevalent causes of trauma. In this case, a CT scan is the gold standard for detecting BAT. However, there are several limits to this examination, particularly in terms of availability, cost, and radiation exposure. In BAT, FAST assists in the detection of intraabdominal free fluid. Case Description: Three pediatric patients with stable hemodynamics underwent BAT in this case series. All three patients were below 17 years old and had stomach discomfort due to a traffic accident. All three patients tested positive for FAST. Then, a contrast CT scan of the abdomen revealed a splenic rupture in the three patients and a splenic rupture and liver rupture in one of them. All the patients were hemodynamically stable before being treated with symptomatic medicines in a conservative (non-surgical) manner. All of the patients had satisfactory outcomes and could return home without undergoing surgery. Conclusion: Both FAST and CT scans do not affect therapeutic care, that were conservative management in these patients with stable hemodynamics. As a result, FAST may be a less expensive examination alternative, reducing radiation exposure and lowering the risk of cancer in children in the future.
The Effect of Progesterone Levels Changes in the Blood on the Progressivity of Luminal a Breast Cancer
Authors: Asli Uray Yessika Bianthi Sugiat , Soewoto Widyanti , Surya A Ida Bagus Budhi
Published: July 2022

Objectives: Breast cancer is the most common type of cancer in Indonesia, accounting for 28% of all cancer diseases. This number increases annually (Departemen Kesehatan RI, Statistik morbiditas dan mortalitas di rumah sakit; 2005-2010). Breast cancer in women is associated with progesterone hormone, which is a female reproductive hormone (DeVita, V. T. et al., 2011). Both in-vivo and in-vitro researches on the effect of progesterone on breast cancer progression has been carried out in other studies. However, clinical research on this topic is rarely done. Therefore, the authors were interested in doing this research (Sobri, F. B. et al., 2018). Material and Methods: This was cross-sectional research. This was a follow-up study from research conducted five years ago in The Department of Surgical Oncology Dr. Moewardi Hospital Surakarta between March to May 2015. Subjects of this study were Luminal A breast cancer patients carried out for progesterone examination in the blood and assessed for TNM stage. Evaluation of progesterone levels in the blood and TNM stage were performed in November to December 2020. Statistical analysis: In this study data, bivariate and multivariate analyses were carried out. Logistic regression test for ordinal data was used for bivariate analysis, whereas Chi-square/Fisher exact test was performed for data with nominal dichotomy scale. Multivariate analysis was done using logistic regression with a significance p-value less than 0.05 in the bivariate analysis to determine the odds ratio. Data was significant if p less than 0.05. Results: Based on bivariate analysis with logistic regression test and multivariate analysis, progesterone levels in the blood of Luminal A breast cancer patients influence the breast cancer progression, with p-value = 0.037 on bivariate analysis and p-value = 0.031 on multivariate analysis. Increased progesterone levels in the blood of Luminal A breast cancer patients multiplied the risk of breast cancer progression by 12 times. Conclusions: This study showed that blood progesterone levels had a significant effect on the progression of Luminal A breast cancer patients..
Association between Blood Eosinophil Count and Tissue Eosinophil Grading Among Patients Suffering From Sinonasal Polyposis Attending Tertiary Care Hospital
Authors: Singh Devender Pal , Dogra S. S. , Saroch Munish , Chander Bal , Kumar Sudesh , Sharma Ankush
Published: July 2022

Background: Present study aimed to evaluate the association between blood eosinophil count and tissue eosinophil grading among Patients suffering from Sinonasal Polyposis attending routine ENT OPD in Dr. RPGMC Tanda. Material and Methods: The present study was done as a hospital based cross sectional study in the department of ENT and Head and Neck Surgery, in Dr. RPGMC Kangra at Tanda. It was done in 30 patients of chronic rhinosinusitis with nasal polyposis (CRSwNP) from June 2018 to June 2019 who met the inclusion criteria. Data regarding Blood and Tissue eosinophil count was retrieved. Results: in the present study,there were a total of 30 patients out of which there were 16 males and 14 females. The mean age observed of patients was 42.47±13.68. Among the total, 17 patients were classified as Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (ECRSwNP) while 13 were classified as Non-Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (NECRSwNP). There were 9 cases of ECRSwNP where tissue eosinophils were >10/HPF while 8 cases had less than 10 tissue eosinophils/HPF. Similarly 9 cases of NECRSwNP had less than 10 tissue eosinophils/HPF while 4 cases had tissue eosinophils were >10/HPF. The association between blood eosinophil count and tissue eosinophil grading was not significant with p value of 0.225. Conclusion: Present study concluded that there was no significant association of blood eosinophil count between NECRSwNP and ECRSwNP with tissue eosinophils.
Ocular Surface Disorders and Their Association with SocioDemographic Variables among Patients Admitted In Adult Intensive Care Unit Of A Tertiary Care Hospital
Authors: Sharma Ankush , Tuli Rajeev , Sharma R. K. , Kumari Usha , Singh Devender Pal
Published: July 2022

Background: Present study was done to evaluate the ocular surface disorders and their association with Socio-demographic variables among Patients admitted in Adult Intensive Care Unit. Material and Methods: It was a prospective observational study carried in AICU over period of one year by Department of Ophthalmology, Dr. RPGMC Kangra at Tanda. All the patients who were admitted in AICU greater than 48 hours between ages of 18-65 years were included and evaluated for socio-demographic information like age, gender etc. Thorough ophthalmic examination was also done for ocular surface disorders and analyzed using epi info v7 software. Results: A total of 126 patients were included in the study. Mean age of the study participants was 41.8 years. Maximum patients, 23.8% of the patients were in age group of 51 and 60 years followed by 23% between 21 and 30 years and 41 and 50 years each. 64.3% of the patients were males while 35.7% were females. 101(80.2%) patients belonged to rural areas while 25(19.8%) belonged to urban areas. 73.8% of the patients belonged to lower upper Socioeconomic class followed by 11.2% patients in lower middle class. For 78.6% of the patients, duration of stay in AICU was up to one week followed by 12.7% had the hospital stay was between 1 week and 2 weeks. 74 (58.7%) of the patients had ocular surface disorders. Longer duration of stay in AICU was associated with significantly increased number of patients having ocular surface disorders (Pless than 0.0001). Presence of ocular surface disorders was not related with age (P=0.153) and gender (P=0.359). Conclusion: The present study concluded that there is a close association of ocular surface disorders with longer duration of stay of these critically ill AICU patients. Eye care should be an integral part of management of these patients.
Risk Factors of Abnormal Testosterone Levels in Liver Cirrhosis
Authors: Sharma Shubham , Shad Roha .
Published: July 2022

Background and aim: Liver diseases are associated with low testosterone. However, little is known about risk factors of changes in testosterone. This study determined testosterone levels in liver cirrhosis and associated risk factors with the abnormal testosterone levels. Methods: In this descriptive hospital-based study, 50 patients with evidence of liver cirrhosis diagnosed on history, imaging and investigations were included for a period of 12 months. Testosterone levels were measured by enzyme chemiluminescence immunoassay (ECLIA)and value less than 249 ng/dl was taken as cut-off for decreased levels. Results: 84% of the patients had abnormal testosterone levels. Age, SGOT, SGPT, serum albumin, PT, and INR were not significantly associated with abnormal testosterone levels. Testosterone levels were decreased in majority of the patients but testosterone levels in CTP class B and C were higher, signifying that testosterone levels are related with severity of liver disease. Conclusion: There is a significantly higher prevalence of abnormal testosterone levels in liver cirrhotic patients in this region.
Comparison of Quality of life in patients of chronic pelvic pain after pulsed radiofrequency ablation versus thermal radiofrequency ablation of Ganglion Impar
Authors: Verma Madhav , Syal Kartik , Verma Rajesh Kumar , Maitan Manoj , Bhardwaj Akshu
Published: July 2022

Background: The present study was done to compare the Quality of life in patients of chronic pelvic pain after pulsed radiofrequency ablation versus thermal radiofrequency ablation of Ganglion Impar. Material andMethods: The present study was prospective, randomized, single blinded study and was based on series of 30 patients presenting with chronic pelvic pain , having already failed conservative medical management, presenting in Pain clinic if IGMC Shimla. The patients were divided into 2 groups of 15 patients. Patients in Group A(n=15) were given thermal radiofrequency ablation where as patients in Group B were given pulsed radiofrequency ablation.Results: Mean 24 Hours Post Procedural American Chronic Pain Association Quality Of Life Scale Score(ACP) of the patients in Group A was 6.20 ± 0.414 where as mean 24 Hours Post Procedural ACP Score in patients of group B was 7.07 ± 0.704.(P=0.000). The mean 1 week Post Procedural ACP Score of the patients in Group A was 6.00 ± 0.000 where as mean 1 week Post Procedural ACP Score in patients of group B was 6.73 ± 0.704.( P=0.000). Mean 2 week Post Procedural ACP Score of the patients in Group A was 5.53 ± 0.516 where as mean 2 week Post Procedural ACP Score in patients of group B was 6.47 ± 0.743.(P =0.000). Mean 3 week Post Procedural ACP Score of the patients in Group A was 5.20 ± 0.414 where as mean 3 week Post Procedural ACP Score in patients of group B was 6.27 ± 0.458.(P=0.000). Conclusion: Present study showed that mean Post Procedural ACP Score (24 Hours, 1,2and 3 week) was significantly lower in group A as compared to group B. we can conclude that thermal radiofrequency ablation of ganglion impar for chronic pelvic pain produces Quality of Lifeand Functional Capacity in the patients as compared to patients who were treated with pulsed radio frequency ablation.
Comparison of Satisfaction Level Using Likert Scale among Patients of Chronic Pelvic Pain in Pulsed Radiofrequency Ablation versus Thermal Radiofrequency Ablation of Ganglion Impar
Authors: Verma Madhav , Syal Kartik , Verma Rajesh Kumar , Maitan Manoj , Bhardwaj Akshu
Published: July 2022

The present study was done to compare the Satisfaction level using Likert Scale among patients of chronic pelvic pain in pulsed radiofrequency ablation versus thermal radiofrequency ablation of Ganglion Impar. Material and Methods: The present study was prospective, randomized, single blinded study and was based on series of 30 patients presenting with chronic pelvic pain , having already failed conservative medical management, presenting in Pain clinic if IGMC Shimla. The patients were divided into 2 groups of 15 patients. Patients in Group A(n=15) were given thermal radiofrequency ablation where as patients in Group B were given pulsed radiofrequency ablation.Results: Mean age (in years) in group A and B was found to be 47.60± 6.833 and 42.67±7.807 years respectively. The p value was calculated to be 0.76 which was found to be statistically non significant. According to Post 24 Hours Likert scale, in Group A, 2(13.3%) patients were satisfied and 13(86.7%) were very satisfied while in Group B, 1(6.7%) patient was neutral , 10(66.7%) were satisfied and 4(26.7%) patients were very satisfied. (P= 0.004). According to Post 1 week Likert scale, in Group A, 2(13.3%) patients were satisfied and 13(86.7%) were very satisfied while in Group B, 1(6.7%) patient was neutral , 9(60.0%) were satisfied and 5(33.3%) patients were very satisfied.(p=0.011) Similarly 100% of the patients of group A were satisfied with the procedure as compared to patients of group B 3 weeks after the procedure.( p =0.011). Conclusion: Present study showed that mean Post Procedural satisfaction level using Likert Scale (24 Hours, 1,2 AND 3 week) was significantly more in group A as compared to group B. we can conclude that thermal radiofrequency ablation of ganglion impar for chronic pelvic pain produces better satisfaction level in the patients as compared to patients who were treated with pulsed radio frequency ablation.
Management of Incarcerated Inguinal Hernia Associated with Abdominal Tuberculosis in Muhammadiyah Babat Hospital, Indonesia
Authors: Putra Muhammad David Perdana , Putra Doddy Setya Adi , Hermawan Muhammad  Dony
Published: July 2022

The rate of tuberculosis is expanding around the world, particularly in creating nations. The prevalence of abdominal tuberculosis has been found to be as high as 12% in individuals with extrapulmonary tuberculosis. Peritoneal thickening and intestinal attachments can happen in patients with stomach tuberculosis. Inguinal hernias are greatly uncommon in individuals with stomach tuberculosis; as it were 11 cases have been detailed within the English-language writing, half of which involved pediatric patients. No authoritative rule on the administration of such cases is accessible. In this report, we depict the abnormal finding of an imprisoned inguinal hernia in an grown-up with abdominal tuberculosis and propose a treatment to treat this complicated illness based on our successful encounter.
Socio-demographic and Clinical Characteristics of Patients with Acute Intestinal Obstruction at Tertiary Care Institute of North India
Authors: Sharma Rohit , Chandel U. K. , Kaundal Ashok
Published: July 2022

Background: Acute intestinal obstruction continues to be one of the commonest surgical emergencies. Present study was done to evaluate the Socio-demographic and Clinical Characteristics of patients with acute intestinal obstruction at IGMC Shimla. Material and Methodology: This cross sectional study was done among total of 50 patients admitted with features of acute intestinal obstruction in the general surgery department of Indira Gandhi Medical College Shimla, randomly selected during the period from 15 June 2019 to 15 June 2020. Data regarding Socio-demographic and Clinical Characteristics was extracted and analysed using Epi Info Software v7. Results: Intestinal obstruction occurs in all age groups, the age spectrum in our clinical study was 14 years to 85 years. The study showed the peak incidence in the age group 51-60 (11) and 61-70(10) years .Mean age in our current study was 53 years and male to female ratio was 3:1. Most common symptoms in present study were Abdominal pain (100%) followed by Vomiting (80%). Most common signs in present study were Distension (72%) and abdominal tenderness (64%). Conclusion: Our study concluded that most of the cases of acute intestinal obstruction were male, aged above 50 years. Abdominal pain was the most common symptom while abdominal distension was the most common sign among patients.
Etiology of Acute Intestinal Obstruction and its Association with Socio-demographic among Patients at Tertiary Care Institute of North India
Authors: Sharma Rohit , Chandel U. K. , Kaundal Ashok
Published: July 2022

Background: The etiology of acute intestinal obstruction, which is one of the commonest surgical emergencies, varies between countries and has also changed over the decades. Present study was done to evaluate the etiology of acute intestinal obstruction and its association with Socio-demographic among patients at IGMC Shimla. Material and Methodology: This cross sectional study was done among total of 50 patients admitted with features of acute intestinal obstruction in the general surgery department of Indira Gandhi Medical College Shimla, randomly selected during the period from 15 June 2019 to 15 June 2020. Data regarding etiology of acute intestinal obstruction and Socio-demographic Characteristics was extracted and analysed using Epi Info Software v7. Results: The study showed the peak incidence of Intestinal obstruction in the age group 51-60 (11) and 61-70(10) years .Mean age in our current study was 53 years and male to female ratio was 3:1. Most common etiology was Adhesive intestinal obstruction (40%), followed by tuberculosis (28%), Malignancy (16%), Obstructed hernia (6%),Volvulus (6%) and Perforated appendix (4%). 76% of small bowel and 24% of large bowel accounts to intestinal obstruction.In the present study Adhesions due to previous surgeries, Obstructed hernia, Malignancy and Volvulus occurred mostly in patients above 50 years of age while there were equal number of Koch abdomen and Perforated appendix among below 50 years and above 50 years patients .Adhesions due to previous surgeries nearly equally affected male and female but obstructed hernia affected males only. Interestingly, Tuberculosis affected females more than males in this study mainly because of low socioeconomic status. Obstructed umbilical and epigastric hernia affected 8.1% males. Colonic and rectosigmoid malignancies affected 21.6% males. Conclusion: Our study concluded that most of cases were of small bowel obstruction. Adhesions due to previous abdominal surgeries and tuberculosis were the commonest cause of intestinal obstruction and occurred mostly in patients above 50 years of age and in males.
Evaluation of Site of Perforation among Secondary Peritonitis Cases and its Association with Outcome in a Tertiary Care Hospital
Authors: Thakur Preet , Chandel U.  K. , Kaundal A. K.
Published: July 2022

Background: The present study was carried out to evaluate the Site of Perforation among Secondary Peritonitis cases and its association with outcome in a tertiary care Hospital. Material and Methods: This cross sectional study was conducted by Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 among patients with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: A total of 250 individuals with a diagnosis of perforation peritonitis were assessed in the current study. Males made up 205 (82%) of the total while females made up 45 (18%). The patients' average age was 47.28 17.34 years, ranging from 18 to 87. In the study, 99 (39.6%) of the total patients were under the age of 40, while 151 (60.4%) were beyond the age of 40. Of the total, 32 (12.80%) passed away while 218 (87.20%) were discharged after receiving treatment. The Most common cause was Duodenal perforation among 91 patients (36.4%), Gastric perforation among 83 patients (33.2%), Ileal perforation among 32 patients (12.8%), Jejunal perforation among 16 patients (6.4%) and Other among 28 patients (11.2%). Among the patients who expired due to Secondary Peritonitis, maximum 12(37.5%) had Gastric Perforation followed by Duodenal Perforation in 9 (28.1%) patients. Conclusion: The study concluded that most of patients of secondary peritonitis had Duodenal perforation followed by Gastric perforation. The most common type of perforation among patients who died from secondary peritonitis was gastric followed by duodenal.