bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of a regional variant of botulinum toxin type A in the treatment of essential blepharospasm and hemifacial spasms: A retrospective study
Authors: Maneksha V , Chakrabarty Sabyasachi , Tanwar Meghana , Pillai Madhavi Ramanatha
Published: October 2021

Purpose:

The aim of this study was to report the outcomes of a regional variant of botulinum toxin type A (BtA) in essential blepharospasm and hemifacial spasm.

Methods:

The medical records of all patients with facial dystonias, who received at least one dose of BtA between May 2016 and April 2017 were retrospectively evaluated. The pre- and post-injection severity of symptoms, graded using the Jankovic rating system for essential blepharospasm and the Samsung Medical Center grading system for hemifacial spasm, the complications after each sitting, and the mean symptom-free interval were recorded. A correlation analysis was done to identify factors associated with longer symptom-free intervals. A P value < 0.05 was considered statistically significant.

Results:

The mean age at presentation was 56.62 ± 10.56 years. The mean duration of follow-up was 1.86 ± 2.06 years. The modal disease severity reduced from 5 to 0 in essential blepharospasm and from 2 to 0 in hemifacial spasm a week after injection of botulinum toxin. The mean symptom-free intervals with doses of 20, 22.5, 25, 30, and 50 units were 102.1 ± 44.7, 132.4 ± 35.3, 147.2 ± 61.6, 124.4 ± 55.1, and 142.4 ± 59.7 days, respectively. The commonest complication was lagophthalmos (26.3%; n = 20). Injections for primary dystonias were associated with longer disease-free intervals than those for secondary dystonias (P = 0.02). In nine sittings, the dose was increased for increased severity or presumed resistance, which resulted in a significant increase in the symptom-free interval (P = 0.004) without an increased incidence of complications (P = 0.48).

Conclusion:

BtA is safe and effective in the treatment of facial dystonias. The drug is more efficacious for primary facial dystonias.
Clinical profile and outcomes of neovascular glaucoma in the era of anti-vascular endothelial growth factor
Authors: Malgi Vishwesh Sirish , Gawas Lisika , Iyer Archana Suresh , Rao Aparna
Published: October 2021

Purpose:

To report the clinical profile and visual impairment in various stages of neovascular glaucoma (NVG) at a tertiary eye center in East India.

Methods:

The electronic medical records of the hospital database of patients with neovascular glaucoma seen between 2013 and 2020 were reviewed. Gonioscopic details were used to stratify patients into nonspecified NVG (Group 1), open-angle NVG (Group 2), and closed-angle NVG (Group 3). The clinical profile, angle features, cause of NVG, systemic associations, visual impairment, and blindness (defined as logarithm of the minimum angle of resolution, LogMar >1.3 at baseline and at final follow-up), and outcomes of medical/surgical interventions were compared between the three groups.

Results:

Of 846 eyes of 810 patients with NVG (Group 1, n = 564 eyes, Group 2, n = 61 eyes, and Group 3, n = 220 eyes), at baseline, the blindness rates in Groups 3 and 2 were 90 and 75%, respectively. The time from a previous intervention to the onset of NVG ranged from 3 to 5 months, while the median duration of NVG was about 4–4.5 months (0.03–120 months). Multivariate regression identified a longer duration of NVG as the only variable associated with poor final visual acuity.

Conclusion:

Visual morbidity by NVG remains as high as 75–90% in developing countries, even with the availability of anti-VEGFs and after improved management/investigative at all stages.
Identification of glaucoma from fundus images using deep learning techniques
Authors: Ajitha S , Akkara John D , Judy M V
Published: October 2021

Purpose:

Glaucoma is one of the preeminent causes of incurable visual disability and blindness across the world due to elevated intraocular pressure within the eyes. Accurate and timely diagnosis is essential for preventing visual disability. Manual detection of glaucoma is a challenging task that needs expertise and years of experience.

Methods:

In this paper, we suggest a powerful and accurate algorithm using a convolutional neural network (CNN) for the automatic diagnosis of glaucoma. In this work, 1113 fundus images consisting of 660 normal and 453 glaucomatous images from four databases have been used for the diagnosis of glaucoma. A 13-layer CNN is potently trained from this dataset to mine vital features, and these features are classified into either glaucomatous or normal class during testing. The proposed algorithm is implemented in Google Colab, which made the task straightforward without spending hours installing the environment and supporting libraries. To evaluate the effectiveness of our algorithm, the dataset is divided into 70% for training, 20% for validation, and the remaining 10% utilized for testing. The training images are augmented to 12012 fundus images.

Results:

Our model with SoftMax classifier achieved an accuracy of 93.86%, sensitivity of 85.42%, specificity of 100%, and precision of 100%. In contrast, the model with the SVM classifier achieved accuracy, sensitivity, specificity, and precision of 95.61, 89.58, 100, and 100%, respectively.

Conclusion:

These results demonstrate the ability of the deep learning model to identify glaucoma from fundus images and suggest that the proposed system can help ophthalmologists in a fast, accurate, and reliable diagnosis of glaucoma.
The confusion is killing Public Health, Community Medicine and Family Medicine; all critical to India's healthcare delivery system
Authors: Raina Sunil Kumar , Kumar Raman
Published: October 2021

The clarity on the structure and functioning of academic Public health, Community Medicine and Family Medicine appears to missing to a large extent. The confusion appears more visible now than ever before. The dichotomy in regulating medical training by India's regulators, the National Medical Commission (NMC) and National Board of Examination (NBE) does not seem to be helping the situation either. Added to it is the confusion created by academic institution not directly regulated by the NMC.
A cross-sectional study on health-seeking behavior in relation to reproductive tract infection among ever-married rural women in Kancheepuram district, Tamil Nadu
Authors: Surya B , Shivasakthimani R , Muthathal S , Prakash B , Loganathan S , Ravivarman G
Published: October 2021

Introduction:

Reproductive tract infection (RTI) is the infection of the reproductive tract. Due to the hesitation in reporting the symptoms and receiving the treatment from the health centers, there is a significant dropout. The health care-seeking actions of the women reflects the attentiveness of the disease in that community and the inadequacy of the health care facility. Since the women from the rural area belongs to high-risk group for RTI, this study was conducted with the objective to assess the health care-seeking behavior about reproductive tract infection among rural women in the reproductive age group in Kancheepuram district, Tamil Nadu. Primary care physicians play a vital role in improving health care system, assessing the health-seeking practice helps in improvement and decision making and implementing.

Methods and Material:

A community-based cross-sectional study was conducted in the rural field practice area of Chettinad hospital. A sample size of 330 was arrived by multi-stage random sampling and population proportion to size method. Data was collected using a standardized questionnaire of DLHS- 4 on RTI/STI. Data entered in MS-EXCEL and analyzed using SPSS version 21 and results interpreted.

Results:

The prevalence of RTI was found to be 50.3%. 60.8% of the affected females received treatment with majority of them in the group following home remedies. Significant association was noted between treatment seeking behavior, age, and the socioeconomic status (P- < 0.05).

Conclusions:

The women in the reproductive age group in the rural areas should be provided with regular health education regarding the symptoms of the RTI and also motivate them to seek appropriate treatment.
Assessment of Health-promoting Lifestyle Profile in Undergraduate Medical Students of a Medical College
Authors: Tapare Vinay Shridhar , Borle P. S. , Parande Malangori Abdulgani , Sakore Deepika , Ingole Sandhya , Salunke Jayshree , Gajbhiye Sandhya
Published: October 2021

Introduction:

According to the available statistics, 53% of deaths are related to lifestyle. The aim of this study was to evaluate health-promoting lifestyles in medical students of a medical college of Western Maharashtra, India. Objectives: To determine the health-promoting lifestyle behaviours among undergraduate medical students and to find out sociodemographic determinants of HPLP.

Material and Methods:

This cross-sectional study was performed on 307 undergraduate medical students. Health Promotion Lifestyle Profile Proforma (HPLP)was prepared which consists of two parts, Part I deals with the sociodemographic characteristics of the participants and Part II of the proforma deals with Health-promoting lifestyle information which was a modified version of HPLP II. It consists of 46 items divided into 7 subscales. Permission of Institute Ethical Committee was taken. Data was analyzed by using analysis of variance (ANOVA) and Mann Whitney test and predictors were determined by multiple linear regression analysis.

Results:

Medical students of this Institute showed good level of health-promoting lifestyle in total HPLP II score. The overall HPLP-II mean score and all subscales of HPLP except interpersonal relations were significantly more among the first and third year students than 2nd year students. Female students practiced significantly better food practices while Male students showed a significantly higher level of physical activity and self-concept. Income was the significant predictor of overall HPLP; age was the significant predictor of Health responsibility, sex and income were the significant predictor of physical activity, sex, living with family and income were significant predictor for food practices; sex, living with family were predictors of spiritual growth; BMI and income as a predictors for Interpersonal relations; and age was a predictor for stress management.

Conclusion:

The study results showed that Medical college students in Pune had reasonably good orientation towards health promoting practices.
Bone Marrow Failure Disease and Head-and-Neck Squamous Cell Carcinoma in King Faisal Specialist Hospital and Research Center in Riyadh
Authors: Jebreel Alaeddin , Alayed Rawan Salem , Al-Soufi Rahaf M. Bashar , Farahat Rana Hani
Published: October 2021

Objective:

This study aims to look at bone marrow failure disease patients who presented to our center, as to analyze the presentation and possible ways to improve the survival outcome in these cases.

Methods:

This was a retrospective chart review study.

Results:

In our series, most of the head-and-neck squamous cell carcinomas (HNSCCs) were found in Fanconi anemia (FA) patients, and most are located within the oral cavity, most frequently at the tongue margins and the gingival areas. These tumors arise in both male and female bone marrow failure disease patients without a prior history of excessive tobacco and alcohol use. Even if a patient presents at an early stage, there are frequent relapses. The highly aggressive nature of the tumors is reflected by poor survival, amounting to <2 years. FA is a rare but well-studied inherited disorder that is clinically characterized by progressive bone marrow failure, congenital malformations, and increased incidence of malignancies, especially acute myeloid leukemia and squamous cell carcinomas (SSCs) of the head and neck. Greatly improved protocols for stem cell transplantation increasingly save the lives of these young patients. However, in both transplanted and not transplanted patients, the emergence of aggressive SSC represents a major medical challenge. Noninvasive screening options, including frequent self-examination and inspection by a medical team, should lead to early detection and treatment. Standard platinum-based chemotherapy in combination with radiotherapy cannot be used in FA patients due to therapy-associated toxicities and mortalities even with reduced dosing. Therefore, surgery is the most important treatment option for HNSCC in bone marrow failure disease patients and requires an early and efficient detection of malignant lesions.

Conclusion:

So far, no uniform treatment protocol for the management of HNSCCs in FA patients exists. Therefore, we propose that the information on affected FA patients should be collected worldwide, practical therapeutic guidelines developed and national treatment centers established.
Retrospective Review of Outcomes of Thyroid Surgeries Performed Over 4 Years at a Single Center
Authors: Alghamdi Thamer , Alabidi Abdulaziz , Aly Mohammed Gamal
Published: October 2021

Context:

Thyroid surgery may have severe postoperative complications; however, there is a lack of national data on its outcomes in Saudi Arabia.

Aims:

The aim of this study was to improve practice and develop efficient pre- and postoperative data.

Settings and Design:

A retrospective review of the medical files of 277 patients undergoing thyroidectomy, including total thyroidectomy, hemithyroidectomy, and completion thyroidectomy, for various indications at a single center from January 2016 to December 2019 was performed.

Materials and Methods:

The demographic and histopathological data and surgical outcomes were recorded.

Statistical Analysis:

Only descriptive statistics were used.

Results:

A total of 198 (71.4%) patients were female and 79 (28.5%) were male. Benign lesions were observed in 65.6% of the patients, while 34.4% of the patients had malignant lesions. Papillary thyroid carcinoma was the most common malignant pathology, followed by follicular thyroid carcinoma, medullary carcinoma, and mucosa-associated lymphoid tissue lymphoma. The total complication rate was 17.3%, and 81.2% of the complications occurred in females. Temporary hypocalcemia developed in 9% of the patients and permanent hypocalcemia in 2.9%. A postoperative hematoma occurred in 1.1%. Temporary and permanent recurrent laryngeal nerve injuries were recorded in 2.9% and 1.4% of the patients, respectively.

Conclusions:

Thyroidectomy is a safe and effective surgical procedure, and the results obtained in this study were similar to data in the literature. Auditing and reporting of the surgical outcomes of thyroidectomy at our institute and other national centers could help establish national guidelines that will improve these outcomes and ensure patient safety.
Development of white common beans for the processing industry in East Africa: Adaptability, resistance to selected diseases, cooking time and canning quality
Authors: Amongi W. , Kato F. , Male A. , Musoke S. , Acam C. , Kabwama A. , Nakyanzi B. , Sebuliba S. , Williams M. , Mbiu J. , Baguma G. , Mukankusi C.
Published: October 2021

Common bean (Phaseolus vulgaris L.) provides dietary protein, energy, fiber and micronutrients especially, iron and zinc to over 800 million people in Africa and Latin America. The crop has various seed types, but white beans are very popular in the processing industry. This study aimed to investigate agronomic and canning quality, cooking time and the response of white beans to root rots and angular leaf spot (ALS) that cause significant yield losses in bean production eastern Africa. Small and large seeded beans improved for drought tolerance were evaluated from 2013 to 2018. Significant (P<0.001) differences existed among the 151 genotypes for response to three pathogens (Fusarium cuneirostrum, Pythium ultimum and Pseudocercospora griseola), cooking time and canning quality traits. It was possible to select for single, dual and triple disease resistance. Resistance to each of the pathogens was expressed in 24-75% of the genotypes; while dual resistance to any two pairs of the pathogens occurred in 10-44% of the genotypes. The four genotypes; ICNBunsixSxB405/4C-1C-1C-88, RAZ-11, ETSNAP18 and ETSNAP3 that expressed resistance to three pathogens were cooked in 46-56 minutes, and are recommended as sources of resistance for breeding, but could be further improved for fast cooking and canning quality since a general below average canning quality was exhibited. Sixty-eight genotypes were cooked in <50 minutes while 24 expressed good to excellent visual canning quality. The genotypes like RAZ-120, RAZ36-Caballero, NavyLine-60, NavyLine-25, ZABR16573-25F22, ZABR16575-60F22, ETSNAP33, Bifortsmallseeded-15 and ZABR16574-37F22, that cooked in less than 45 minutes, exhibited good to excellent canning quality and resistant to intermediate response to the evaluated diseases were recommend for breeding purpose and for further evaluation for possible promotion.
ESTUDO RADIOGRÁFICO DA QUALIDADE DA OBTURAÇÃO ENDODÔNTICA POR ALUNOS DE GRADUAÇÃO EM ODONTOLOGIA
Authors: Tonelli Stéphanie Quadros , Lafetá Thatyana Maldonado Nicácio , Tonelli Barbara Quadros , Tonelli João Vitor Quadros , Brito-Júnior Manoel
Published: October 2021

Objetivo: Avaliar a qualidade de obturações endodônticas executadas por alunos em atividades laboratoriais da Disciplina de Endodontia de curso de graduação em Odontologia. Métodos: Foram avaliadas 80 obturações de canais radiculares em 35 dentes, por meio de radiografias padronizadas de dentes molares e pré-molares birradiculares. A qualidade da obturação foi criteriosamente avaliada em três parâmetros: i) limite apical, ii) homogeneidade e iii) conicidade, que foram estratificados em escores (E) 0, 1 e 2. E0 e E1 corresponderam a acentuado e suave desvio da normalidade, respectivamente; enquanto E2 correspondeu ao padrão-ouro. Em função da combinação dos escores atribuídos, a obturação foi classificada em perfeita (PF), satisfatória (ST) ou deficiente (DF). Assim, com três escores E2: obturação PF; dois escores E2: obturação ST; e um ou nenhumescore E2: obturação DF. As associações entre as variáveis foram analisadas através do teste quiquadrado de Pearson (p<0,05). Resultados: As frequências de escores E2 (condição ideal) para homogeneidade, limite apical e conicidade foram 97,5%, 87,5% e 73,8%, respectivamente (p>0,05). Obturações PF, ST e DF ocorreram em 63,8%, 33,8% e 2,5% dos casos, respectivamente. Não houve, portanto, associação estatisticamente significativa entre a distribuição dos escores dos parâmetros bem como da qualidade de obturação entre os grupos de dentes (p>0,05). Conclusão: As obturações realizadas apresentaram adequado padrão de qualidade, sendo a conicidade o parâmetro mais crítico, principalmente nos molares superiores.
KNJIŽEVNOST U NASTAVI STRANOG JEZIKA
Authors: Simović Vesna
Published: October 2021

Mesto, funkcija i značaj književnog teksta u nastavi stranih jezika menjali su se kroz istoriju u zavisnosti od postavljenih ciljeva učenja jezika. U tradicionalnoj, gramatičko- prevodnoj metodi književnost ima povlašćeno mesto i služi za sticanje jezičke, prvenstveno gramatičke i leksičke kompetencije. On je primer upotrebe gramatičkih struktura koje se uče, kao i rečnika bogatijeg od onog korišćenog u govornom kodu. Književnost se u ovoj metodi izjednačava i sa kulturom, pa se tako književni tekst, uz druga umetnička dela, vidi kao izraz najviših dometa ljudskog duha. Iako će u potonjim metodama druge vrste nastavnog materijala dobiti primat (tekstovi i dijalozi iz pera autora udžbenika, kasnije i tekstovi namenjeni izvornim govornicima, nazvani autentični dokumenti), književni tekst će biti uvek prisutan u nastavi stranog jezika zahvaljujući svojim specifičnostima. To je vredan dokument koji ima višestruke funkcije i može se koristiti u različitim fazama u procesu učenja jezika. U savremenoj glotodidaktici, književni tekst ne samo da pomaže u ovladavanju jezičkom kompetencijom (za šta je tradicionalno bio korišćen), već se pokazuje kao adekvatan predložak za sve komunikativne, receptivne i produktivne, usmene i pisane aktivnosti. Njegova upotreba na času omogućava stvaranje autentičnih komunikativnih situacija, na čiju važnost je ukazao komunikativni pristup; one motivišu učenike na rad i učenje jezika.
O PRONAĐENOM I IZGUBLjENOM SEĆANjU I IDENTITETU U ROMANU „AUSTERLIC“ VINFRIDA GEORGA ZEBALDA
Authors:   Univerzitet u Novom Pazaru, Mančić Emilija
Published: October 2021

Der Zusammenhang von Erinnerung und Identität ist ein zentrales Thema in den zeitgenössischen literatur- und kulturwissenschaftlichen Diskussionen. In An- lehnung an theoretische und methodische Ansätze, die vor allem Astrid Erll, Marion Gymnich und Ansgar Nünning im deutschsprachigen Raum vertreten, ist das Ziel dieser Arbeit, am Beispiel von W. G. Sebalds Roman Austerlitz (2001) die Möglichkeit der Literatur aufzuzeigen, die unterschiedlichen (Erinnerungs-) Medien zusammenführt. Literatur generiert Erinnerungsräume die auf komplexe Weise lesbar werden und plädiert somit für eine vielseitige Erinnerungspraxis. Dabei wird die Unzulänglichkeit der Möglichkeiten einer Nacherinnerung im Roman eine zentrale Rolle zukommen. Die Untersuchung verweist auf verschiedene Verfahrensweise des Textes, in dem kein Medium für sich allein steht und in dem Formen der Zeugenschaft thematisch und problematisch werden. Auf dieser Weise werden die begrenzten Möglichkeiten der narrativen Übertragung der traumatischen Vergangenheit aufgezeigt.
A Descriptive Study of Intraoperative Complications in Manual Small Incision Cataract Surgery
Authors: Khatwani Dr. Divya , Tammewar Dr. Ajay , Murade Dr. Sneha , Naik Dr. Roopa
Published: October 2021

Background: Senile cataract is the most common cause of reversible blindness in India and other developing countries. It is one of the significant social problem. Though phacoemulsification has become a routine procedure for cataract extraction in most parts of the developed world, it is not always appropriate either for its cost or the density of cataract involved in developing nations like India. Small incision cataract surgery is commonly performed surgery in developing countries. This procedure is safe, effective to increase the surgical outcome, reduces surgical time, easier to maintain instrumentation and at the same time affordable. The present study is undertaken to study the intraoperative complications and how best these complications can be minimized and managed. Methods: A total of 50 cases were studied from October 2020-January 2021. It is a hospital based, descriptive cross sectional study. Results: Intraoperative complications occurred in 10 cases (20%). It included iris prolapse in 3 cases (6%), tunnel related complications in 3 cases which included premature entry in 2 cases (4%) and button holing in 1 case (2%), Descemet membrane detachment in 1 case (2%), intraoperative miosis in 1 case (2%), intraoperative hyphema in 1 case (2%), capsule related complications in 1 case (2%) and PC rent in one case (2%). Conclusion: Over all the intraoperative complications of manual small incision cataract surgery are less and the procedure is well suited in our country, where there is a large number of backlog of cataract cases.
Clinical Profile of Polycystic Ovarian Syndrome Patients In Tertiary Care Hospital
Authors: Gavali Dr. Urmila , Pawar Dr. Mayuri , Aher Dr. Gautam , Shinde Dr. Suhas
Published: October 2021

ABSTRACT:

Background: Polycystic ovarian syndrome (PCOS)is common gynecological endocrinopathy characterized by chronic anovulation and hyperandrogenism affecting 5-10% of women worldwide.  It is a heterogenous, multifactorial, complex genetic disorder with uncertain etiology and is one of the most common treatable cause of infertility.

AIM: To study the various clinical presentations in polycystic ovarian syndrome.

MATERIALS AND METHODS: Present study is cross sectional observational study carried out in tertiary care centre. This study was performed in the Out Patient Department of Obstetrics and Gynecology.

RESULTS: The mean age of 41 patients in the study was 23.6 years. Most common presenting symptom in patients is menstrual irregularities (89%) followed by infertility and hirsutism. USG (abdo+pelvis) showing polycystic ovarian syndrome ovaries. Around 39% patients with PCOS developed insulin resistance.

KEYWORDS: - Amenorrhea, Infertility, Oligomenorrhea, Polycystic Ovarian Syndrome.
A Cross Sectional Study to Evaluate Cutaneous Manifestations in Diabetic Patients and their Correlation with Sugar Control at Tertiary Care Center in Western Maharashtra
Authors: Chate Dr. Ashutosh , Swami Dr. Amrut , Rane Ms. Sakshi , Gosavi Dr. Ramesh
Published: October 2021

Introduction: Diabetes is a leading chronic disease in world and number of cases are significantly increasing each year in India also. Out of many associated conditions, skin involvement in diabetes also needs to be evaluated. We conducted this study to study relation between the sugar control and skin manifestations in diabetic patients. Methodology: We studied total 100 diabetic patients visiting our dermatology OPD over a period of 1 year from January to December 2020. All skin diseases in diabetic patients were studied. We studied association of these diseases with sugar control in our study participants. Results: Mean age of our study participants was 63.48 ± 18.12 years, Majority of the males were from the age group of 61 and above, 34 (62.96%) while majority of the females were from the age group of 41-60 years 25 (54.35%). Majority of the patients had diabetes for 5-10 years (52%) followed by more than 10 years (36%) and less than 5 years in 24% cases. Out of 100 participants, 44% had controlled diabetes while rest 56% had uncontrolled diabetes with HbA1c > 6. We observed a significant difference in skin manifestations of controlled and uncontrolled sugars in diabetic patients. (p = 0.007). Conclusion: From this study, we conclude that the skin is involved in diabetes quite often. Early diagnosis and treatment of skin manifestations in diabetic patients is important to reduce unwanted morbidity and further complications in the diabetic patients.
Primary Autoimmune Hemolytic Anemia Due To Warm Reactive Autoantibodies: A Rare Case Report
Authors: Shinde Dr. Abhijit , Shinde Dr. Sonal , Dr. Sushrut Kumar  , Kothari Dr. Ramesh , Mhaske Dr. Sneha
Published: October 2021

Autoimmune hemolytic anemia (AIHA) is an acquired form of hemolytic anemia in which autoantibodies target red blood cell (RBC) membrane antigens, inducing cell rupture (lysis).  It affects both pediatric and adult populations, although its presentation in childhood is relatively rare, with the annual incidence estimated to be approximately 0.8 per 100,000 individuals under 18 years old [3]. Here we report  one such a rare case of autoimmune hemolytic anemia due to primary warm reactive autoantibodies in a 3 year old female child. As there was presence of hemolysis in peripheral blood smear &  other investigations also,  Direct coomb’s test was done & it came out to be positive which was suggestive of autoimmune hemolytic anemia, as following lab reports are suggestive of continuous destruction of RBC & after introduction of steroids parameters of  hemolysis came out to be normal suggestive of warm reactive autoantibodies type of AIHA. Clinically also patient improved & her urine colour also became normal after when prednisolone started. Patient also did not have any features of secondary causes of warm autoantibody like Systemic lupus erythematous, immunodeficiency disorders, ulcerative colitis & lymphoproliferative disorders so it was considered primary or idiopathic. W-AIHA tends to have a chronic course and is not expected to subside without treatment. It can be a fatal disease, with a mortality rate of up to 4% in children, either because of the acuity of the presentation or because of being refractory to treatment and requiring multiple lines of therapy with frequently associated toxicity [14]. Fortunately our patient responded to steroid therapy.
Measurement of noise in a service center of the automotive sector
Authors: Solarte Andersson Alexander Diaz , Holguin Jhon Hamilton Urrego , Alzate Diego Alejandro Ruiz , Lopez Fernando García , Zapata Julian Andres Estrada
Published: October 2021

In this article, the apprentices of the IDAMA Research Seedbed (Research in Automotive Development and the Environment) of the SENA Automotive Mechatronics Maintenance Technology training program of the Advanced Manufacturing Technology Center of the Antioquia Region, intend to outline the project of noise measurement in a service center of the automotive sector  with the purpose of qualifying  the operating environment of the technicians involved in the corrective and preventive maintenance processes of vehicles of all types.

 

En este artículo,  los aprendices  integrantes del semillero  de investigación IDAMA (Investigación en Desarrollo Automotriz y Medio Ambiente) del programa de formación de Tecnología en Mantenimiento Mecatrónico de Automotores del SENA del Centro de Tecnología de la Manufactura Avanzada de la Regional Antioquia, pretenden esbozar el proyecto de medición de ruido en un centro de servicios del sector automotriz con el propósito de cualificar el ambiente de operaciones de los técnicos involucrados en los procesos de mantenimiento correctivo y preventivo de vehículos de todo tipo.
Life Cycle Assessment Applied to Railway Infrastructure: A Proposed Method
Authors: Ribeiro Filipe Batista , Da Silva Marcelino Aurélio Vieira
Published: October 2021

Based on mitigation strategies for the rational use of resources and conscious consumption of inputs, it is important to develop tools that allow the measurement of environmental impacts and greenhouse gas emissions, for better decision-making in the planning of railway infrastructure activities. Therefore, this article presents a method for evaluating railway infrastructure projects, having as a parameter the potential impact of global warming when different materials are used in the sub-ballast, to improve the support capacity of the railway pavement. As a technical criterion for evaluation, the mechanical behavior of the subgrade was considered in a condition of moisture above the optimal level, with a sub-ballast composed of sandy material as a baseline for comparison. The results, considering the environmental impact, clearly indicated that the use of a soil-cement mixture in the sub-ballast was the best option. Furthermore, even in the face of more frequent renovation of the permanent way, the reference scenario was more attractive than those with use of a combination of soil-emulsion and hot mix asphalt.
Assembly method in GIS INTEGRO and its usage for solving of gravitational inverse problem
Authors: Mitsyn Sergey , Bolshakov Egor
Published: October 2021

Various methods based on growing bodies are lately gaining attention in a context of inverse gravity problem that we call a family of “assembly methods”. A variant of method was adopted for GIS INTEGRO in original formulation that is fit for the problem of multiple bodies incorporated in an environment of varying density, in absolute densities (not density contrasts) that are however have to be a priori specified. Such formulation allowed the implementation of the method that is suitable for territory modeling in the regional scale. To workaround method’s instability a number of changes are proposed that consist of introduction of priority on atomic modifications, modification queue and assessment of model evolution instead of just the final result. The developed software allows processing of large grids (tens of millions of tiling elements) even on 5–8 year old desktops. Based on method approbation experience some insights and practice methods are presented. An application example is presented as part of work on modeling of Enisei-Khatanga regional depression territory.
Triangle of Triangular Numbers
Authors:   Independent Research Scholar California Public University, USA, Sivaraman Dr. R.
Published: October 2021

Among several interesting number triangles that exist in mathematics, Pascal’s triangle is one of the best triangle possessing rich mathematical properties. In this paper, I will introduce a number triangle containing triangular numbers arranged in particular fashion. Using this number triangle, I had proved five interesting theorems which help us to generate Pythagorean triples as well as establish bijection between whole numbers and set of all integers.
Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence
Authors: Bera Om Prakash , Shah Vandana , Bhattacharya Sudip , Saleem Sheikh Mohd
Published: October 2021

Type 1 diabetes mellitus (T1DM) is an autoimmune ?-cell destruction, usually leading to absolute insulin deficiency, insulin resistance, or by a combination of both. Both the incidence and prevalence of diabetes T1DM is suspected to be high in India, but in the absence of nation-wide registry, the possibility of exact numbers is unsure. Till date, studies done among the population have seen prevalence more than the incidence of the disease, which has led to late screening and diagnosis of the disease within the community settings. India is already suffering from the burden of type 2 DM, in the process of screening those, patients with T1DM are somewhat getting ignored. Furthermore, cost associated with the treatment expenditure and social status of the people suffering from the disease too have a role to consider which has been totally side-lined in national programmes like National Program for Control of Diabetes, Cardiovascular disease, and Stroke (NPCDCS). There is also scarcity of data on the incidence of T1DM which could aid in formulating better policy avenues for the patients suffering from the disease.  Reports on trends in T1DM are more commonly available from countries with better established public health surveillance systems and diabetes research infrastructure. From India, due to scarcity of data on T1DM, we had to rely on published literature of some major centers across the country. Results from the Indian Council of Medical Research (ICMR) first phase, till July 2011 which included 5546 patients found T1DM among 63.9% cases and predominately among children; at registration 11.1% had already developed chronic complication of T1DM. As India is already suffering from the burden of type 2 DM, during current management and treatment, the problem lies at various levels which needs to be addressed. We propose a setting based, life course approach for T1DM where every age group will have access to the health care system either directly or indirectly from intra-natal life till elderly age group through health approach based on scientific methods delivered through health system. In this regard a central registry having enumeration and provisioning of mandatory Insulin to all through a national policy being implemented by NPCDCS is what policy makers must take up at urgent bases if we want to bend the curve of rising T1DM and prevalence of overall diabetes in India.
A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city
Authors: Prajapati Arpit Chelabhai , Patel Mansi Maulik , Khanpara Hardika Jamanadas , Shukla Rujul Pankajbhai , Christian Donald Shailendra , Solanki Ashaben kacharabhai , Geriya Disha Rajeshbhai
Published: October 2021

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.
Post COVID-19 Symptoms: A Neglected Domain
Authors: Mittal Chhaya , Mishra Abhishek , Jain Seema , Gautam Neelam S
Published: October 2021

Background: COVID -19 is the most important public health problem of recent time. Most people who have COVID-19 recovers completely within a few weeks but some people continue to have symptoms after initial recovery. Objective: To assess the prevalence of Post COVID symptoms, to assess requirement of treatment and to make recommendation for Post COVID care. Methods: Present cross sectional study was done among patients who recovered from COVID-19 in Meerut district. Mobile numbers of COVID patients were obtained from records, Total 100 randomly selected patients were contacted using google form and information regarding post covid symptoms in between 6 weeks to 12 weeks after recovery from COVID was obtained. Result: 87%patients developed one or more post covid symptoms. Weakness was reported to be most common problem (55%), followed by body ache (26%) and neuropsychiatric symptoms such as difficulty in concentration and insomnia (22%). Every fifth patient reported that symptoms persisted for more than 1 month. Though most of the respondents classified their symptoms as mild and moderate (52.5% and 37.9% respectively), 47% of the symptomatic patients have to take some treatment for these symptoms. Conclusion: Post COVID symptoms are common but usually less severe . Some form of treatment was required to deal with problem. Almost one in five patients reported that symptoms persisted for more than one month. The results highlight the need for post Covid care for COVID recovered patients.
Serosurveillance among COVID-19 Cases in Ahmedabad Using SARS-COV2 IgG Antibodies
Authors: Prakash Om , Solanki Bhavin , Sheth Jay , Maitrak Daxa , Kadam Mina , Vyas Sheetal , Shukla Aparajita , Tiwari Hemant
Published: October 2021

Background: Serosurveillance study focusing on antibodies against SARS-CoV2 among the Covid19 cases can add value in the scientific knowledge & help in formulating valid predictions regarding immunity status in the post-covid period. Objectives: To estimate seropositivity among covid19 cases and to identify various factors affecting seropositivity. Methods: During second half of October 2020, a population based serosurvey on Covid19 cases was carried out in Ahmedabad. Covid-Kavach test kits were used and estimated seroprevalence was compared with available demographic and covid19 case related parameters to identify factors affecting seropositivity in the post-covid period. Simple proportions and Z-test were used as appropriate. Results: As on October 2020, the sero-positivity among Covid19 cases in Ahmedabad was 54.51% [95% Confidence Interval (CI) 52.14-56.86%]. Females have higher positivity (54.78%) as compared to males (54.30%) but the difference was statistically not significant (Z=0.19, P=0.84). Among children and elderly, the positivity is high and from young adults to elderly the seropositivity has an increasing trend. Severity of clinical illness and longer duration of hospitalization are associated with higher seropositivity. Conclusion: With 54.51% seropositivity among covid19 cases, it is clear that all the covid19 cases may not have developed IgG antibodies, have undetectable level or might have disappeared during the post-covid period. Comparison of seropositivity with age group and clinical case details clearly suggest close correlation with the severity of clinical symptoms. The seronegative cases indicate the need for further in-depth scientific research to identify the factors affecting immunity and to uncover the reasons behind the same.
Doctors on duty: the real-life heroes during pandemic: Your opinion matters!!!
Authors: Begum Jarina , Ali Syed Irfan , Lalitha D Laxmi , Panda Manasee , Avinash Bhagyalaxmi , Thalanjeri Padmini
Published: October 2021

Background: Data for front-line health-care workers, risk of disease is limited so as the resources available. Although inspiring stories on doctors fighting against COVID-19-19 were covered we are still unaware of the challenges at ground level. The present study throws light on it and provides way through towards resolving the issues. Objectives:1. To assess the perceptions of the doctors towards the process of COVID-19-19 crisis management. 2.To identify the challenges and recommend solutions based on their views, suggestions. Methods: A cross sectional study on perception of doctors (94) involved in COVID-19 duty was conducted during July to September 2020, with the help of pre-validated semi-structured questionnaire through online google survey form. The questionnaire had demographic details, views on before, during and after the COVID-19 duty along with 4 open ended questions on their good and bad experiences, problems & suggestions. Descriptive statistics for quantitative & thematic analysis for qualitative data was used. Results: Nonresponse rate was 26%, mean age 27.55 year. Majority were from clinical departments (78%). 42% felt that training was proper, 60% adequate PPE kit, 52.6% were aware of management strategy, 86% stressed,82% found difficulties in communication. 42% were provided proper quarantine facility yet, 58% faced discrimination. Few themes emerged under challenges like lack of resources & training, stress & burnout, for which patient sensitization, refresher training, psychological & administrative support was suggested. Conclusion: Although COVID-19 pandemic has impacted life of doctors in either way, the challenges could easily be tackled by the recommended simple solutions.
Assessment of relationship between Hemoglobin and BMI levels in female college students and influence of diet and physical activity on these parameters
Authors: Aluri Sai Padma , Davuluri Rajani , Nomula Chandan Babu
Published: October 2021

Anaemia and nutritional status through Body Mass Index (BMI) are two key indicators in National Family Health Survey of India. The objective of the study is to determine the correlation between Hemoglobin (Hb) and BMI values and to understand the effect of diet and physical activity on these two parameters amongst college girl students. A questionnaire covering food habits and physical activity of 200 female students (18-22 years age) was used for data analysis along with Hb and BMI values of the same subjects. No significant association was found between Hb and BMI values, but a significant association was found between physical activity and BMI. Diet consumption which included leafy and other vegetarian diet, eggs and meat has shown significant contribution for high Hb levels. The present study strongly provides evidence based conclusion for the relationship between diet, nutrition and Hb levels as well physical activity and BMI. A multiple regression model was developed to estimate Hb levels based on their food habits.
The genesis of the second wave and the probable way forward for India
Authors: Aravindakshan Rajeev , Srivastava Siddharth
Published: October 2021

An unprecedented pandemic affecting 210 countries emerged in the watershed year of 2020 and involved India as well (1). We mined the number of daily cases of three equal periods of importance during the evolution of the pandemic in India, namely 1) initial lockdown (March-April 2020), 2) early days of unlocking (June-July 2020), and 3) second wave (March April 2021). Notice the March 2020 series in [Figure 1] and country-wise cases in [Figure 2], and we can observe that India was able to sustain itself against the first wave of the SARS Coronavirus-2 in a much better way compared to other developed countries. Social lockdown and other preventive strategies paid off even in the face of criticisms regarding lack of preparedness and economic slowdown due to strict enforcement of harsh measures. Soon, there were demands of decentralized control measures with more testing and local containment measures than the centrally dictated regimen. Lockdown was suggested for only local clusters with high positivity rather than a general clampdown (2). The June-July series in [Figure 1] represents the increasing numbers of cases resulting from suspicions, fear-mongering, and resultant relaxation in social restrictions as part of the phase-wise unlocking across the country.
Peer Pressure of Publishing or Perishing (PPPP)
Authors: Gupta Divya
Published: October 2021

Researchers create or improvise knowledge by innovating concepts, methods and/or interpretations. Scientific research and scientific writing seem to be inseparable in this modern world for professional existence. Publications are important to give a thrust and positive boost up in your career. Since last decade, research has taken a new horizon. Medical schools and universities frequently use the quantification of publication as the measure of a scholar’s academic competency. Publications are an essential and sometimes the sole criteria considered during recruitments. The numerical value of the published work is taking a leap step ahead of the quality of research.  Scholars, who do not have the aptitude of publishing frequently or who focus more on their clinical work and teaching activities to shape up the undergraduates’ and postgraduates’ future, may find themselves out of this professional race. Each individual faculty of the medical institutions is unique research scholar. There is an upcoming trend that unless they pen down their research, they will be undervalued in the academic workplace. This undue “Peer Pressure of Publishing or Perishing” is floating as the new “Catch Phrase” of the professional era.
Linfoma no Hodgkin. 593 autopsias en el Hospital Clínico-Quirúrgico “Hermanos Ameijeiras”. 1983-2020.
Authors: Alvarez Santana Reynaldo , Flores Choque Sheila Zulma , Gutierrez Rojas Angela Rosa , Hurtado de Mendoza Amat José
Published: October 2021

Los linfomas son el quinto tipo de neoplasia maligna más común en el mundo y el tercer tipo de cáncer más frecuente en la infancia y adultos jóvenes. Por año, mueren aproximadamente 200 000 pacientes y se diagnostican 350 000 nuevos casos. En Cuba, constituyen la quinta causa de muerte, con una incidencia de 1041 casos por año. Se realizó una investigación descriptiva, longitudinal, retrospectiva y no experimental para conocer las características de 593 pacientes fallecidos con linfoma no Hodgkin en el Hospital Clínico Quirúrgico “Hermanos Ameijeiras”, en autopsias realizadas en el periodo de 1983 a 2020, ambos inclusive. Se identificaron variables sociodemográficas, causas directa de muerte funcionales y morfológicas, básica y contribuyente, recogidas en el protocolo de autopsia y procesadas mediante el Sistema Automatizado de Registro y Control de Anatomía Patológica. Se identificaron los sitios de origen, de metástasis y las variedades histológicas de los linfomas no Hodgkin.