bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the “missing link” in speciesism development: How adolescents reason about animals
Authors: McGuire Luke , Faber Nadira Sophie
Published: July 2023

While many adults accept great harm being done to some non-human animals, like factory-farmed pigs, recent research suggests that young children have higher moral concern for animals. How do these concerned children develop into more indifferent adults? The present study aims to explore the “missing link” by examining adolescents. Combining quantitative and qualitative methods, we test adolescents’ (n = 103, M+-SD = 13.54 +- 1.87, 10 - 18-years-old, female n = 41, male n = 48) thinking about animals, with adults (n = 114, M+-SD = 43.73 +- 14.26, 19 - 78-years-old, female n = 54, male n = 59) as a comparison group. Like younger children in published studies, adolescents were less likely to categorise a farmed animal as food compared to adults. However, unlike children in recent research, adolescents were more speciesist, evaluated eating animals as more acceptable, and reported that farmed animals ought to be treated less well than adults did. The justifications that participants provided for their evaluations did not depend on their age. Those who saw eating animals as more ‘okay’ referenced social conventions to justify their evaluation. Taken together, this evidence points to adolescence as a period where there is a divide between knowledge of how animals are factually treated and moral cognitions, where concern for animals is diminished in preparation for an ‘adult’ view of animals – and the human-animal intergroup relations our society holds.
Positive aspects of caregiving in familial care for nonagenarians and centenarians : Findings from Hong Kong Centenarian Study
Authors: Lau Bobo Hi Po , Pat Lian Ying-Chun , Siu Joey Chung-Yue , Shum Eric Ngai-Yin
Published: July 2023

Caregiving is often filled with pains and gains. Family caregiving for the fast-growing but vulnerable population of near-centenarians and centenarians (NCCs) may contain distinct gratifying aspects. We analyzed quantitative and qualitative data from family caregivers of community-dwelling older adults aged 95 or above in Hong Kong. Quantitative analysis of data from 143 caregivers revealed that higher age and intact hearing ability of their NCC, lack of a domestic helper, higher dependence on basic activities of daily living, higher independence on instrumental activities of daily living, and better self-rated health were related to higher scores on positive aspects of caregiving. Qualitative analysis of data from 96 caregivers identified three themes regarding these positive experiences: (i) acquiring skills to render care; (ii) fulfilling family love and obligation, and (iii) preparing for own graceful aging. Our findings elaborated the nature and mechanisms of caregiving gains against the unique backdrop of exceptional longevity of the care recipients and the Chinese cultural expectations of filial piety.
Parental burnout and decreased sensitivity to context for mothers: A temporal network approach grounded in the family environment
Authors: Blanchard M. Annelise , Hoebeke Yorgo , Heeren Alexandre
Published: July 2023

Parental burnout, which includes emotional exhaustion, emotional distance, and feeling fed up with parenting, is a chronic and potentially debilitating stress condition that has become highly prevalent in Western countries. Yet uncertainty remains about parents’ daily experience of burnout and how their experiences interact with their family environment. In this study, we surveyed a sample of 40 parents (who felt overwhelmed and exhausted by parenting) daily for eight weeks about their experiences of parental burnout, interactions with their children, and family environment, yielding 1541 total observations; main analyses focus on 36 mothers. We estimated a multilevel vector autoregressive model and created three distinct graphical networks to best reveal the dynamics of these interactions. All models point to interactions with children as a key determinant in the parent’s daily experience of parental burnout—particularly predicting emotional distance and feeling fed up. At the temporal level, parental burnout symptoms were characterized by strong self-prediction (autoregression). In addition, the severity of parental burnout was negatively correlated with daily variation of parental burnout features. Together, these results suggest that mothers in a severe state of burnout are less sensitive to their context, with the exception of interactions with their children.
Infants' understanding of the causal power of agents and tools
Authors: Adibpour Parvaneh , Hochmann Jean-Rémy
Published: July 2023

Tools are objects that can be manipulated by agents with the intention to cause an effect in the world. We show that the cognitive capacity to understand tools is present in young infants, even if these produce arbitrary, causally opaque effects. In Experiments 1-2, we used pupillometry to show that 8-month-old infants infer an invisible causal contact to account for the –otherwise unexplained– motion of a ball. In Experiments 3, we probed 8-month-old infants’ account of a state change event (flickering of a box) that lies outside of the explanatory power of intuitive physics. Infants repeatedly watched an intentional agent launch a ball behind an occluder. After a short delay, a cube, positioned at the other end of the occluder began flickering. Rare unoccluded events served to probe infants’ representation of what happened behind the occluder. Infants exhibited larger pupil dilation, signaling more surprise when the ball stopped before touching the cube, than when it contacted the cube, suggesting that infants inferred that the cause of the state change was contact between the ball and the cube. This effect was canceled in Experiment 4, when an inanimate sphere replaced the intentional agent. Altogether, results suggest that, in the infants’ eyes, the power of the ball to cause an arbitrary state change must be inherited from an intentional agent. Eight-month-olds are thus capable of representing complex event structures, involving an intentional agent causing a change with a tool.
Behavioral bias for exploration is associated with enhanced signaling in the lateral and medial frontopolar cortex
Authors: Güldener Lasse , Pollmann Stefan
Published: July 2023

Should we keep doing what we know works for us or should we risk trying something new as it could work even better? The exploration-exploitation dilemma is ubiquitous in daily life decision-making, and balancing between the two is crucial for adaptive behavior. Yet, we only have started to unravel the neurocognitive mechanisms that help us to find this balance in practice. Analyzing BOLD-signals of healthy young adults during virtual foraging, we could show that a behavioral tendency for prolonged exploitation was associated with weakened signaling during exploration in central node points of the fronto-parietal attention network, plus the frontopolar cortex. These results provide an important link between behavioral heuristics that we use to balance between exploitation and exploration and the brain function that supports shifts from one tendency to the other. Importantly, they stress that interindividual differences in behavioral strategies are reflected in differences in brain activity during exploration and should thus be more in the focus of basic research that aims at delineating general laws governing visual attention.
Young Children’s Understanding of Affective Implications of Insight
Authors: Prenevost Mathilde Hallingstad , Haugen Josefine , Nilsen Ida Bekke Rønneberg , Bølstad Evalill , Pons Francisco , Reber Rolf
Published: July 2023

Insight includes a sudden understanding often followed by a characteristic set of epistemic feelings, including positive affect. As the first study of children’s understanding of insight, we investigate whether young children understand that having an insight for a solution in a problem-solving scenario leads to positive affect. Children aged 4-8 years old (N = 123) were presented with problem-solving scenarios and asked how the character in the story was feeling at different timepoints throughout the scenarios. We found that children aged 4-8 expected the story character to feel happy both when they had an insight and when a problem was successfully solved. However, after a failed solution attempt, the 4-year-olds expected the story character to feel less sad compared to the 5-8-year-olds. As a first study of children’s understanding of insight, we demonstrate that children understand that insight leads to positive affect already at a young age.
A study investigating the implementation of NICE recommended psychological interventions for people with psychosis following a psychiatric inpatient admission
Authors: Jacobsen Pamela Charlotte , Teale Ashley , Burgess-Barr Susanna
Published: July 2023

Background: The period of time following discharge from an inpatient setting presents a unique window of opportunity for people to engage in psychological treatment. In England, The National Institute for Health and Care Excellence (NICE) guidelines outline that every person with a schizophrenia diagnosis should be offered individual Cognitive Behavioural Therapy for psychosis (CBTp) and Family Intervention (FI). Objective: This study aimed to explore rates of offer and receipt of NICE recommended therapies for adults with a schizophrenia spectrum disorder diagnosis in the year following discharge from an inpatient unit. We then investigated possible predictors of therapy offer and receipt.
Intentionally awakening from sleep through lucid dreaming
Authors: Sandell Cameron , Stumbrys Tadas , Paller Ken A. , Mallett Remington
Published: July 2023

Standard treatments for nightmares focus on waking activities, with consequences for subsequent sleep. An alternative strategy may be to provide people with a novel way to learn to end a nightmare by waking up. People typically think of sleep as a state that they cannot control, but there are exceptions to this rule. For example, the ability to select dream content in a lucid dream might allow one to wake up deliberately, thus countering the typical helplessness of nightmares. However, documented evidence that this strategy can work is lacking. Therefore, we recruited healthy participants to complete a task during their next lucid dream; they were instructed either to attempt to wake up or to clench their fists. In the former case, we offered several options for how to wake up. After sleep, participants responded to a detailed survey about their dream and their subsequent awakening experience. Relative to those who clenched their fists, participants who attempted to wake up from the dream by closing their eyes reported waking up sooner after task completion. Furthermore, higher levels of lucidity and lucid-dream skills while dreaming were correlated with a quicker wake-up time and reduced negative emotions. This research showed that people can succeed in waking up from sleep intentionally while lucid dreaming. Because lucid dreaming is trainable, training for waking up in this way could constitute a viable therapeutic approach to relieve nightmare suffering.
Public Support for Gay Rights Across Countries and Over Time
Authors: Woo Byung-Deuk , Ko Hyein , Tai Yuehong Cassandra , Hu Yue , Solt Frederick
Published: July 2023

Support for gay rights has increased in the publics of many countries over recent decades, but the scholarship on the topic has been hindered by the limited available data on these trends in public opinion. To overcome this problem, we present the Support for Gay Rights (SGR) dataset, which combines a comprehensive collection of survey data with a latent-variable model to provide annual time-series estimates of public support for gay rights across 118 countries and over as many as 51 years that are comparable across space and time. We show these data perform well in validation tests and demonstrate their potential by replicating the influential but recently questioned finding of Andersen and Fetner (2008) that more income inequality yields less tolerant and supportive attitudes toward gay people. We anticipate that the SGR data will become a crucial source for cross-regional, cross-national, and longitudinal research that improves our understanding of the sources and consequences of public support for gay rights.
A study to evaluate the efficacy of instillation of ropivacaine with fentanyl, dexmedetomidine, or morphine through surgical drain for post-operative analgesia in patients undergoing modified radical mastectomy
Authors: Sumit Das  , Pritam Yadav  , Sanjay Johar  , Naveen Malhotra  , Irin Saha  , Ritu Rathee
Published: July 2023

Background: Local anesthetics have become vital part of multimodal analgesia approach. Instillation of local anesthetics through surgical drain is easier and safer method than conventional nerve blocks. Various local anesthetic drugs and adjuvants have been used for post-operative pain management through surgical drains.
Aims and Objectives: This study was conducted to evaluate the efficacy of instillation of ropivacaine with fentanyl, dexmedetomidine or morphine through surgical drain for post-operative analgesia and patient satisfaction in patients undergoing modified radical mastectomy.
Materials and Methods: A prospective, randomized, and double-blind study was conducted dividing 75 female patients aged 30–70 years who underwent modified radical mastectomy into three groups: Group (RM) received 40 ml 0.25% ropivacaine with 4.5 mg morphine, group (RD) 40 ml 0.25% ropivacaine with 1 mg/kg dexmedetomidine and group (RF) 40 ml 0.25% ropivacaine with 50 microgram fentanyl, instilled through surgical drains.
Results: Visual analog score for pain at rest and movement was significantly lower in group RM as compared to group RD and RF with no significant difference among group RD and RF at different time intervals postoperatively. Patient satisfaction at 24-h postoperatively was significantly better in group RM as compared to group RD and RF (P=0.01) with no significant difference among group RD and group RF.
Conclusion: Instillation of ropivacaine with morphine provides good pain relief, prolonged duration of analgesia, and good patient satisfaction in the post-operative period as compared to ropivacaine with dexmedetomidine or fentanyl.
A study of standard versus tubeless percutaneous nephrolithotomy: Our institutional experience
Authors: Rajkumar Ramakrishnan  , Senthil Kumar Poovathai  , Rajasekar Sundaram  , Gopu Rakesh Vamsi  , Gulakavarapu Sammohit  , Shravankumar Savadatti
Published: July 2023

Background: Percutaneous nephrolithotomy (PCNL) is considered to be the standard procedure in patients with large renal calculus. The purpose of this study is to analyze the evidence-based literature regarding the “nephrostomy-free” or “tubeless” PCNL and to assess the safety, efficacy, possibility, and benefits of tubeless PCNL over standard PCNL.
Aims and Objectives: The aim of the study was to review and compare tubeless PCNL with standard PCNL.
Materials and Methods: It is a retrospective study done between August 2021 and December 2022. 100 cases of stone disease with stone size more than 2 cm who underwent PCNL in the Department of Urology, Govt hospital, Salem. Patients are divided into two groups (Group A and Group B) of 50 each depending on date of surgery.
Results: In our study, we compared tubeless PCNL versus standard PCNL in patients with stone disease. Tubeless PCNL was performed with success in patients of age 13 years–65 years. 36 were female patients, whereas 64 were male patients in this study. All the results were presented in a tabulated form in our study.
Conclusion: Tubeless PCNL is a safe and effective technique and is associated with decreased pain, low analgesic requirement, less operating time, and faster recovery. However, it has its own limitation that precludes secondary procedure for the treatment, removal of internal stent, dysuria, and need to visit hospital for subsequent removal of internal stent.
Clinicopathological study of neck mass in pediatric age group
Authors: Ray Ritam , Sarkar Shaswata , Bhattacharyay Aditi
Published: July 2023

Background: Neck swellings are common in clinical practice and are of various types – congenital, acquired, inflammatory, neoplastic, and miscellaneous. The workup of a neck mass is different in children and adults, as the etiologies are different. Only 2–15% are malignant.
Aims and Objectives: To estimate the burden of neck mass in pediatric age group clinicopathological.
Materials and Methods: This prospective observational study was conducted in the Otorhinolaryngology Department of Burdwan Medical College and Hospital, Burdwan, a rural-based tertiary care hospital in Burdwan for 18 months from April 2021 to September 2022, and 50 patients in pediatric age group presented with neck swelling were included in this study after through history taking and meticulous clinical examination and after getting institutional ethics committee clearance.
Results: It was found that most of the patients presented with swelling over the right side (26 [52.0%]), but this was not statistically significant (P=68916) (Z=0.4). Few patients had (11 [22.0%]) 5 months of duration of symptoms, but it was not statistically significant (P=63836) (Z=0.4683). Some of the patients had fever and cough (13 [26.0%]) which was statistically significant (P<0.00001) (Z=4.8).
Conclusion: This study revealed the demographic and clinic-pathological profile of neck mass of various pathologies in pediatric age group.
The effects of two different doses of intravenous dexamethasone on blood glucose concentration intra-operatively and on postoperative pain and emesis in patients undergoing surgery under spinal anesthesia: A double-blind randomized clinical study
Authors: Titler Sanjiv , Gupta Suman , Ankita Gupta  , Goyal Shikha , Dilip Kothari
Published: July 2023

Background: Spinal anesthetic techniques are relatively safe and associated with quick and uneventful recovery, but post-operative pain and postoperative nausea and vomiting (PONV) are major concerns after the effect weans off. Steroids by virtue of their anti-inflammatory effect are expected to reduce pain as well as PONV.
Aims and Objectives: The study was conducted to evaluate the efficacy of two different doses of intravenous dexamethasone on blood glucose concentration intra-operatively and on post-operative analgesia and emesis for different surgeries under spinal anesthesia.
Materials and Methods: This double-blind randomized clinical study was performed on 120 patients aged 20–60 year posted for surgery under spinal anesthesia who were randomly allocated into three groups to receive either normal saline (Group A: 40 pts), intravenous 4 mg dexamethasone (Group B: 40 pts), or iv 8 mg dexamethasone (Group C: 40 pts) immediately after spinal anesthesia. Hemodynamic parameters, respiratory rate, intraoperative blood glucose concentration., severity of post-operative pain, and incidence of PONV was compared among the groups.
Results: Patients in Group C had significantly less severe post-operative pain and incidence of PONV (P<0.05). Furthermore, less post-operative rescue analgesia was required in Group C (P<0.05). There was a highly significant rise in intraoperative blood glucose level in Group C as compared to other groups, but it was well below the recommended guidelines (<180 mg/dL).
Conclusion: Our study concluded that i.v. dexamethasone 8 mg was more effective, although it caused raised blood glucose concentration intraoperatively, but it also provided prolonged post-operative analgesia, increased time of first rescue analgesic, less incident of post-operative nausea and vomiting, and better patient satisfaction.
Trends in hospitalization and mortality in COVID-19 admitted patients after a single dose of vaccine
Authors: Tirumala Bukkapatnam Ramakrishna  , Uma Pokala  , Sasikala Kanapalli  , Naveen Pokala  , Uday Kumar P
Published: July 2023

Background: Several types of vaccines are available across the world. Efficacy in preventing disease or reducing severity in terms of hospitalization, morbidity, and mortality needs to be studied in vaccinated patients, as most of them fail to prevent COVID-19 infections.
Aims and Objectives: We aimed to correlate the disease severity and impact of a single dose of vaccine in COVID-19 breakthrough infections.
Materials and Methods: The present study included 348 COVID-19 patients admitted to a tertiary hospital in Telangana, India, from March to August 2021 (and divided into an elderly group as Group 1 and a middle-aged group as Group 2 according to the vaccination protocol). Data were taken from the medical records of patients retrospectively regarding demographic and clinical details, as well as vaccination status during their hospital stay.
Results: Diabetes mellitus and hypertension were found to be prevalent together as comorbidities (40%) in patients with prolonged hospitalization and 36% in those with severe disease (assisted ventilation). In vaccinated groups, irrespective of age, prolonged hospitalization was drastically halved (PR=0.418 for Group 1 and PR=0.416 for Group 2). Overall mortality in Group 1 is 2 times more frequent than in the Group 2 (odds ratio=2.12). Overall, prolonged hospital stays need for ventilatory support and deaths were also 2 times more common in men than in women.
Conclusion: Older age, male gender, and more than one comorbidity are the most important factors determining poor clinical outcomes in persons with breakthrough severe acute respiratory syndrome coronavirus 2 infection, whereas vaccination is associated with a strong protective effect.
Comparative evaluation of magnetic resonance arthrogram with arthroscopy in knee pathologies
Authors: Harish Deepak P  , Prem Chand Paladugu  , James Boblee
Published: July 2023

Background: Magnetic resonance arthrogram (MRA) has emerged as a supplement to non-contrast magnetic resonance imaging (MRI), especially in the identification of meniscal and chondral pathologies. It has increased the diagnostic efficacy of MRI in the evaluation of knee pathologies.
Aims and Objectives: The present study was carried out to evaluate the role of MRA in the diagnosis of various knee pathologies and to correlate its findings with arthroscopy.
Materials and Methods: A total of 56 patients with knee pain scheduled to undergo arthroscopic evaluation were enrolled in the study and were assessed using MRA before arthroscopy. MRA findings were correlated with arthroscopic findings. The level of agreement was measured using kappa statistics. Diagnostic efficacy was assessed in terms of sensitivity, specificity, positive predictive value, and negative predictive value.
Results: Cartilage involvement (48.2%), anterior cruciate ligament (ACL) tear and medial meniscus tear (37.5% each), bony injury (n=12; 21.4%), chondral defect (n=11; 19.6%), posterior cruciate ligament tear (n=10; 17.9%), and lateral meniscus tear (n=8; 14.3%) were the knee pathologies confirmed by arthroscopy. MRA had a sensitivity and specificity of 100% for pathologies such as ACL tear, lateral meniscus tear, medial meniscus tear, and bony injury. It was 100% specific for all the pathologies with no false positive detection. There was a strong to perfect agreement between MRA and arthroscopic findings for different knee pathologies.
Conclusion: The present study found MRA to be a highly specific diagnostic tool for the diagnosis of different knee pathologies and it is useful in reducing the burden of undesired invasive arthroscopies.
Histomorphological features and IHC expression in endometrial and endocervical adenocarcinoma
Authors: Ann Maria Sunny  , Saji Mary Varghese  , Letha V  , Sankar S
Published: July 2023

Background: The distinction of endometrial adenocarcinoma (EMA) from endocervical adenocarcinoma (ECA) has great significance preoperatively, since the therapeutic plan depends on the primary site of tumor. Immunohistochemistry (IHC) is an ancillary method in distinguishing primary EMA and ECA, especially in cases of histomorphological overlap.
Aims and Objectives: Primary objective of this study was to describe the expression of IHC markers–estrogen receptor (ER), vimentin, monoclonal carcinoembryonic antigen (CEA), P16 in EMA and ECA. Secondary objective of this study was to describe the histomorphological features of EMA and ECA.
Materials and Methods: This is a descriptive study done at the Department of Pathology, Government Medical College, Kottayam between November 2019 and May 2021. The sample size was 54 which included primary adenocarcinoma diagnosed on curettage biopsies. IHC was performed using ER, Vimentin, P16, and mCEA. A semiquantitative scoring was done using the German IHC scoring system.
Results: Histomorphological features and IHC expression in EMA and ECA were studied. Percentage of cases with expression of IHC markers is as follows. In endometrioid EMA-ER in 100% of cases, Vimentin 83.3%, P16 0%, and CEA in 7.3% cases. About 80% of serous carcinomas showed P16 and vimentin positivity with negative staining for ER and CEA. In ECA-ER in 0% cases, vimentin 16.7%, P16 80%, and CEA in 66.7% of cases. Based on histomorphologic appearance, the common histologic subtype of EMA was endometrioid EMA followed by serous carcinoma. In ECA, the usual type was more common than gastric type.
Conclusion: IHC markers-ER, vimentin, P16, and CEA are useful in distinguishing endometrioid EMA and ECA.
Efficacy of intravenous ketamine as premedicant for prevention of intraoperative hypotension after spinal anesthesia in parturients posted for elective cesarean section
Authors: Manjula BP  , Sudeepta Sambrekar  , Girish BK
Published: July 2023

Background: Hypotension following spinal anesthesia (SA) in lower segment cesarean section can be deleterious to the parturient and to fetus. Ketamine acts by stimulating the cardiovascular system leading to high blood pressure and increase in heart rate (HR) and cardiac output.
Aims and Objectives: This study aimed to assess the efficacy of 15 mg of prophylactic intravenous ketamine in elective cesarean section for prevention of hypotension after SA.
Materials and Methods: This double-blinded randomized controlled study was conducted on 98 participating parturients who were American Society of Anesthesiologists term pregnant women. The parturients were randomly divided into two groups (n=49 in each). All the parturients received SA. Ketamine group - Group K received 15 mg of ketamine IV bolus in 3 mL saline and control group - Group C received the same volume of normal saline IV bolus. HR and systolic blood pressure (SBP) were recorded at baseline at 5, 10, 15, and 20 min after the injection and then every 15 min till the end of the operation. Incidences of hypotension were recorded. The total number dose of ephedrine used, APGAR score, and Visual Analog Scale scores were recorded. The Ramsay Sedation Score was also recorded at baseline, then 5, 10, 15, 30, and 45 min after injection, and then at the end of the operation.
Results: This study showed a statistically significant increase in the incidence of hypotension and higher use of intravenous ephedrine 6 mg boluses in the control group when compared to the ketamine group. Forty-two parturients in the control group developed hypotension compared to 23 parturients in the ketamine group with P<0.001. The total ephedrine dose was significantly lower among the ketamine group. Sedation was observed for the first 15 min intraoperatively in the ketamine group with P=0.001. There was no statistically significant difference in APGAR score between the two groups.
Conclusion: There was significantly higher hemodynamic stability in the ketamine group with regard to SBP, diastolic blood pressure, and HR. Hence, low-dose ketamine, when used as a premedicant, is an effective agent that can be used in preventing post-spinal intraoperative hypotension in parturients undergoing cesarean section delivery.
Immunohistochemical analysis of cytokeratin 7 and 20 expression in colorectal carcinoma and its correlation with histopathological grading of tumour
Authors: Santanu Nandy  , Vandana Maroo  , Gopinath Barui
Published: July 2023

Background: Colorectal carcinoma is a malignant epithelial tumor originating in the large bowel. More than 90% of colorectal carcinomas (CRC) are adenocarcinomas. This being graded morphologically at H&E stain in histopathology as well-differentiated, moderately differentiated, and poorly differentiated.
Aims and Objectives: The aim of this study is to assess any association with different histopathological types and extent of differentiation of CRC with change in expression of CK 7 and Cytokeratin 20 (CK20).
Materials and Methods: In the present study, total 59 patients has been selected by the predetermined sampling techniques. The specimen was collected and the necessary processing was done for H&E stain and for immunohistochemistry for CK 20 and CK 7 profile.
Results: This study showed that most of the well-differentiated colorectal carcinoma are CK20 (+ve)/Cytokeratin 7 (CK7) (-ve) and poorly differentiated CRC are CK20 (+) and/CK7 (+) and also CK20 (−ve)/CK7 (+ve).
Conclusion: Hence, from this study, it is evident that the expression of CK 20 positivity decreasing and CK7 positivity increasing in respect of progression of well differentiated to poorly differentiated colorectal carcinoma, that is, there is a relationship of expression of CK20 and CK7 profile with the histological grading of colorectal carcinoma. Furthermore, the expression profile of CK20 and CK 7 may be of helpful while searching for unknown primary in cases of metastatic deposit.
Comparative evaluation of the effectiveness of nebulized dexmedetomidine V/S intravenous dexmedetomidine in blunting hemodynamic response to intubation – A prospective and randomized study
Authors: Gandhi Monika , Singh Swati , Agrawal Arpit , Arora KK
Published: July 2023

Background: Endotracheal intubation stimulates sympathetic system causing transient increase in heart rate and blood pressure which may be detrimental in patients with cardiovascular and cerebrovascular comorbidities. Intravenous dexmedetomidine given preoperatively prevents these unfavorable changes caused by endotracheal intubation.
Aims and Objectives: The aims of this study were to compare effectiveness of nebulized dexmedetomidine and intravenous dexmedetomidine given preoperatively in blunting hemodynamic response (HR) to intubation.
Materials and Methods: One hundred and twenty ASA I and II patients (either gender between 18 and 60 years) undergoing elective surgeries under general anesthesia were randomized into two equal groups in this prospective and comparative study. Thirty minutes before induction, Group IV received dexmedetomidine 0.50 μg/kg (diluted with normal saline [NS] to 50 mL) as slow IV infusion and nebulization with 5 mL NS, while Group N received nebulization with dexmedetomidine 1 μg/kg mixed with NS up to 5 mL along with 50 mL NS given as slow IV infusion. HR and mean arterial pressure (MAP) were noted at different intervals until extubation. Sedation score using Ramsay Sedation Scale (post-administration of drug) and adverse effects were noted. Comparison of HR and MAP was done using unpaired “t” test (P=0.05).
Results: IV dexmedetomidine and nebulized dexmedetomidine given pre-induction were comparable in reducing stress response to intubation. The sedation score in both groups was comparable post-administration of drug. The incidence of hypotension was significantly more in IV group.
Conclusion: Nebulized dexmedetomidine was equally efficacious in blunting HR to intubation as IV dexmedetomidine with fewer side effects making its administration safer for maintaining hemodynamic stability.
Study of clinical and biochemical profile of scrub typhus in a tertiary care hospital of West Bengal
Authors: Mandal Rakesh , Guha Banerjee Sarmila , Sinha Arunima , Bandyopadhyay Ujjwal , Sinha Arijit
Published: July 2023

Background: Humans are accidental hosts in the zoonotic disease Scrub typhus. The disease though widespread in our county, it remains grossly underdiagnosed because of its non-septic clinical manifestations and lack of access to specific laboratory facilities.
Aims and Objectives: The objective of present study is to evaluate the clinical presentations of Scrub Typhus among the study group. Furthermore, to assess the various laboratory findings in Scrub Typhus cases among the study group is the other objective of this study.
Materials and Methods: The present study is an Institution-based, observational, and cross-sectional study conducted for 18 months with the admitted patients having 14–70 years of age. Data collected regarding patients’ demographic profile, symptoms, clinical findings, laboratory, and radiological findings. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables.
Results: In our study, we found that most of the patients were 14–20 years old and female population was higher. It was found that 34.3% of patients had Eschar, 42.9% of patients had Rash, and 91.4% of patients had Pallor, 8.6% of patients had Ascites, 25.7% had Edema, 8.6% of patients had Jaundice, 11.4% had shock, and 57.1% had pneumonia/pneumonitis. The present study showed that 65.7% of patients had drug response (Doxycycline).
Conclusion: Knowledge of geographical distribution, evidence of exposure to vector, clinical features such as fever, rash, eschar, headache, and myalgia along with high index of suspicion are crucial factors for early diagnosis and that helps in timely treatment of the cases.
Utility of automated cell counter histogram in diagnosis of thrombocytopenia and pseudothrombocytopenia
Authors: Hariom Meena  , Suresh Kumar Sutrakar  , Rifat Q Usmani  , Rashmi Jain  , Aayushi Guru  , Rakesh Gupta  , Vinod Kumar Shakya  , Parul Singh Rajput  , Shambhavi Sharma
Published: July 2023

Background: Automated hematology analyzers have become mainstream of complete blood count (CBC) during the past two decades; they are potential, more accurate to produce results of CBCs. However, often automated analyzers can give false results too, specially, falsely low platelet count due to platelets aggregates, which have to be confirmed on peripheral smears.
Aims and Objectives: The aim and objective of the study was to diagnose thrombocytopenia (TCP) cases and differentiate them from pseudothrombocytopenia (PTCP) cases by analyzing platelet histogram and to determine the sensitivity and specificity of platelet histograms for diagnosing TCP and PTCP.
Materials and Methods: The present study was conducted in the Department of Pathology at Shyam Shah Medical College, Rewa, M.P., after obtaining ethical clearance from the Institutional Ethics Committee. It was prospective study conducted for a period of 15 months from January 2021 to May 2022 on 1000 samples.
Results: The sensitivity and specificity of platelet histogram flags and presence of multiple peaks to diagnose TCP and PTCP cases were calculated as 73.60% and 93.60%, respectively. The present study also interpret that mean platelet volume and platelet distribution width cannot use as indicator to differentiate between TCP and PTCP.
Conclusion: The present study concludes that analysis and interpretation of histogram more specifically platelet histogram flagging provide clue for early detection of PTCP cases prior peripheral smear examination and also helpful in differentiating them from true TCP cases. These platelet histogram flagging can be used as a screening parameter for the detection of PTCP and these are helpful in preventing unnecessary stress for clinician, patients, and their relatives. However, the peripheral smear examination will remain the gold standard to differentiate TCP from, PTCP.
Significance of levels of serum proteins and serum lipids as prognostic indicators in mortality of burn patients
Authors: Pruthviraj CS  , Gaharwar APS  , Saxena Saurabh , Guru Aayushi , Dhakad Sachin , Deepak Kumar , M Anaswara
Published: July 2023

Background: Burn mortality is significant because of the higher metabolic and physiological abnormalities; it causes more so than because of the actual injury. Since these abnormalities persist throughout the clinical course of burns, it is believed that both the trend of change and absolute values of the serum proteins and serum lipids have an impact on the prognosis and outcome.
Aims and Objectives: This study aimed to find whether serum albumin, globulin, total protein, cholesterol, and triglyceride levels are clinically relevant to determine the mortality of a burn patient and thereby the patient’s outcome.
Materials and Methods: The current prospective analytical study was carried out in patients who were admitted to the burn unit, Department of Surgery, Shyam Shah Medical College, and associated Sanjay Gandhi Memorial Hospital, Rewa (M.P.), during the period of April 1, 2021–June 30, 2022 (15 months), and the results were analyzed.
Results: In the present study, a total of 112 patients were studied and followed up. Among them, 86% (96/112) of total patients were survivors who were discharged/DOR in stable condition and 14% (16/112) of total patients expired during the course of treatment. It could be statistically inferred that the increase in values of albumin, globulin, total protein, and cholesterol during the clinical course reduces mortality with serum albumin acting as the best predictor with the highest sensitivity of 100% and specificity of 100% and cholesterol the least.
Conclusion: It could be statistically inferred that the increase in values of albumin, globulin, total protein, and cholesterol during the clinical course reduces mortality with serum albumin acting as the best predictor and cholesterol the least.
Delay in healthcare seeking, diagnosis, and treatment of patients with tuberculosis: A cross-sectional study
Authors: Mahendra Chouksey  , Arya Vimal , Nilima Takhelchangbam
Published: July 2023

Background: One of the greatest challenges in the fight against tuberculosis (TB) is the delay in seeking medical care among those who are sick. This can be complemented by delays in providing prompt health-care services.
Aims and Objectives: The aims of this study were to estimate the number of patients facing delays and to understand the various reasons for individual and health system delays.
Materials and Methods: In this cross-sectional study, new sputum positive cases of >18 years registered at the two TB Units of two community health centers of a district in Uttar Pradesh from March 2018 to April 2019 were included. The primary outcome was patient delay and health system delay. They were assessed from patient interviews as well as through records.
Results: A total of 120 patients were included in the study of which, 76 had been subjected to one or the other form or a combination of delay. The factors such as age, education level, occupation, socioeconomic condition, and the walking duration to the nearest health center were found to be significantly associated with delay. The patient delay was seen in 37 (30.8%) with median delay of 45 days (interquartile range [IQR] 37–53). The health system delay was observed in 48 (40.0%) patients with median delay of 24.5 days (IQR 12.0–47.2).
Conclusion: In spite of robust program implementation, patient factor delays continue to prevail which contributes to the total delay. Addressing delay in Tb is of utmost important so as to progress to TB elimination.
Clinical, radiological, and functional evaluation of surgical treatment in degenerative lumbar canal stenosis
Authors: Jeswani Mayank , Vivek Kumar Kankane  , Avdhesh Shukla  , Avinash Kumar  , Avinash Sharma
Published: July 2023

Background: Low-back pain (LBP) is extremely prevalent and is the one of the most common causes for people to seek medical attention. As life expectancy continue to increase, prevalence of symptomatic spinal stenosis will increase. Although lumbar stenosis is not life-threatening, it can cause chronic and sustained pain and can limit activity severely. Early, accurate diagnosis, and treatment of lumbar stenosis is important in preserving activity in elderly population.
Aims and Objectives: The study was conducted to find the incidence of degenerative lumbar canal stenosis (LCS) among patients of LBP, to evaluate clinicoradiological profile and to evaluate the outcome and complications in the surgically treated patients of degenerative LCS.
Materials and Methods: This prospective study included all patients admitted with LCS under department of neurosurgery, GR medical college and associated J.A. group of Hospitals from December 2021 to December 2022 who underwent surgery. No randomization done.
Results: Out of total 48 patients, 58% were males while 42% were females, 62.5% of patients were of more than 40 years of age, all patients were having LBP and 64.5% of patients were having LBP for the past 1 year. After surgical management, 87.5% of patients shows improvement in symptoms in Oswestry disability index and Visual analog scale scales.
Conclusion: Overall good surgical outcome is obtained and better surgical results in degenerative LCS compared to other studies. Patients with degenerative LCS presenting with back pain and associated neurological deficit are successfully managed with surgical treatment in this study.
Clinical profile and outcome of COVID-19-positive pregnant mothers admitted in a tertiary care center: A retrospective cohort study from Mizoram, India
Authors: Vanremmawii  , Lalrinfela  , Lalduhchhungi  , Vanlalpeka Harvey , Lalramhluna PC  , Anusuya Ganesh Shanmugasundaram
Published: July 2023

Background: The clinical profile of COVID-19-positive pregnant mothers and their outcome has not been studied in Mizoram.
Aims and Objectives: The objectives was to study the clinical profile of COVID-19-positive pregnant mothers and also to study the positivity rate among the babies born to those pregnant mothers.
Materials and Methods: This study was a retrospective cohort of COVID-19-positive pregnant mothers who were admitted in a tertiary care center in Mizoram from July 2020 to September 2021. The data were collected from the case sheets of the patients retrospectively. The babies were also tested for COVID-19 after 24 h after birth by rapid antigen test (RAT). P<0.05 was considered statistically significant. Data analysis was done by coGuide Statistics software, Version 1.0.
Results: Out of 81 COVID-19-positive pregnant mothers, majority 56 (69.14%) were in the age group 19–25 years. Only 6 (7.41%) were vaccinated. The most common symptoms observed were fever 35 (43.21%) followed by cough 28 (34.57%). Sixty-five (80.25%) were full term at the time of admission and 36 (44.44%) were primigravida. The mode of delivery was full-term cesarean section 55 (67.90%), term normal vaginal delivery 21 (25.93%), hysterotomy 3 (3.7%), abortion 1 (1.23%), and pre-term vaginal delivery 1 (1.23%). The mortality among pregnant mothers was 3 (3.70%). The positivity rate for babies tested by RAT was 2 (2.47%).
Conclusion: The mortality among pregnant mothers was 3.70% and the COVID-19 positivity rate among newborn babies was 2.47%.
Challenges and lessons from COVID-19
Authors: Om Saswat Sahoo  , Dhar Ruby , Arun Kumar  , Subhradip Karmakar
Published: July 2023

In this review, we elaborate the post-COVID-19 challenges, and also, the lesson learned out of this crisis. With over 700 million people affected worldwide and nearly 6 million deaths, COVID-19 pandemic is of unprecedented nature ever witnessed by the human race. Besides health-care challenges, there were socioeconomic consequences that still have its footprints affecting life of the citizens. We summarized these challenges, addressing the lacunae in terms of enhancing our infrastructure, logistics, and knowledge, not only about this disease, but also to adequately prepare for future pandemic of this proportion.
FLEXURAL BEHAVIOR OF RC BEAMS CONTAINS RUBBERIZED PIECES AND STRENGTHENED WITH CFRP SHEETS
Authors: Abdullah Adday Adnan , Sultan Ali Ahmed
Published: July 2023

When rubberized, concrete beams lose some of their flexural strength. Conversely, flexural strengthening accounts for a sizeable portion of the structural applications for external carbon fiber reinforced polymers (CFRP) sheets that strengthen reinforced concrete beams. In this study, externally bonded sheets of (CFRP) were used to compensate for the flexural strength loss brought on by using rubberized concrete in constructing the beams. The study's reinforced concrete beams were split into two groups, each with three beams. In the first group, waste tire rubber (WTR) replaced (5 and 10) % of the fine and coarse aggregate, respectively. The reference group is the second group of typical concrete-mixture beams without used tire rubber. Each beam measured (2.1 m ×0.3m × 0.2m) has the same tensile, compression, and shear reinforcement. Every group of concrete beams contained a beam without any external reinforcement, a beam with a single layer, and a beam with double layers of (CFRP) sheet, where the beam soffit was externally strengthened. ABAQUS' finite element analysis software was used to represent the third external strengthening layer numerically. The mechanical properties of the two groups have been tested; additionally, the flexural response of the beams was examined using a monotonic two-point loading. The outcomes denote that strengthening with one and two layers of (CFRP) sheet increases the first crack load (FCL) and failure load (FL) by (8.57 and 17.64) with (17.14 and 34.27) %, respectively. The first crack deflection (FCD) also increased by (58.64) and (78.19) %, while the failure deflection (FD) decreased by (13.25) and (5.42) %, respectively.
AUTOMATIC MODULATION CLASSIFICATION USING DEEP LEARNING POLAR FEATURE
Authors: H. Shah Ali , H. Miry Abbas , M. Salman Tariq
Published: July 2023

The automatic modulation classification of signals is of great importance in modern communications, especially on cognitive radio. Several methods have been used in this field, the most important of which is the classification of modulation automatically using Deep Learning, where the methods depend on the convolution neural network, which is one of the Deep Learning networks, achieved high accuracy in classifying the modulation, so the proposed network depends on the type of deep learning CNN consisting of four blocks, each block contains a set of symmetric and asymmetric filters. The network also contains Max Pool. In this paper, the features extracted in phase-squaring and polar have been combined for the input, which helps in extending the input, that is, an increase in the features inside the network. It also contributes to improving the accuracy of classifying the higher-order modulation through the Polar plane. The dataset RadioML 2018.01A was adopted, which is used in the most recent research, where 11 types of modulation normal-class: (FM, GMSK, QPSK, BPSK, 0QPSK, AM-SSB-SC, 4ASK, AM-DSB-SC, 16QAM, 8PSK,00K) were taken. A simulation of which can be found in Matlab 2021. The proposed network achieved 100% classification accuracy when the signal-to-noise ratio is greater or equal to 2 dB for 11 types of modulation. The results of the paper were compared with modern networks Baseline network, Visual Geometry Group network, and Residual Neural network. The comparison showed the superiority of the proposed network over these networks, as the proposed network achieved an accuracy equal to   100% at SNR 2 dB while BL achieved an accuracy equal to 72% at SNR 2 dB, RN, and VGG almost reach 93% at SNR 2 dB.