bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Ethanol Blending on the Reactivity and Laminar Flame Speeds of Gasoline, Methanol-to-Gasoline, and Ethanol-to-Gasoline Surrogates
Authors: MacDonald James , Lopez Pintor Dario , Matsubara Naoyoshi , Kitano Koji , Yamada Ryota
Published: April 2024

Ethanol blending is one method that can be used to reduce knock in spark ignition engines by decreasing the autoignition reactivity of the fuel and modifying its laminar flame speed. In this paper, the effects of ethanol blending on knock propensity and flame speed of petroleum and low-carbon gasoline fuels is analyzed. To do so, surrogate fuels were formulated for methanol-to-gasoline (MTG) and ethanol-to-gasoline (ETG) based on the fuels’ composition, octane number, and select physical properties; and 0-D and 1-D chemical kinetics simulations were performed to investigate reactivity and laminar flame speed, respectively. Results of MTG and ETG were compared against those of PACE-20, a well-characterized surrogate for regular E10 gasoline.

Similarly to PACE-20, blending MTG and ETG with ethanol increases the fuel’s research octane number (RON) and sensitivity. The trends of the ethanol blending effects were slightly stronger with PACE-20 and MTG than with ETG, with 13.6% volume of ethanol necessary to reach a RON of 98 for MTG and 18.4% volume necessary for ETG. 1-D modeling of the flame speed showed that while ethanol has a faster flame speed than gasoline at pressures below 2.4 bar, the flame speed decreases at increasing pressure, with regular gasoline having a higher flame speed at pressures representative of combustion. Sensitivity analyses to identify the reactions and species relevant in controlling laminar flame speed showed that for ethanol, the active radicals in the flame decreased as pressure increased due to increasing methyl recombination leading to a decrease of the flame speed. For regular gasoline, the formation of active radicals increased with pressure due to increasing HCO decomposition leading to an increase in the flame speed.
Streamlining Hybrid Vehicle Control Development with an Efficient MATLAB/Simulink Simulation Platform
Authors: Venkataramu Achyut , Wang Yue , Patel Nadirsh , Berger Daniel , Huo Shichao , Şenoğlu Onur
Published: April 2024

Automotive hybrid vehicle controls development is an increasingly complex and challenging task. Therefore, to adequately verify and validate the control algorithms prior to its deployment onto real world testing platforms a robust, scalable, low-maintenance simulation platform is most necessary. The currently available test properties pose major challenges in setup, accessibility, maintenance, complexity, and reusability. The aim of this paper is to present a systematic approach of the initial setup, the adaptation to a vehicle program, and the maintenance of a purely MATLAB/Simulink based simulation platform that alleviates the concerns highlighted above. The platform follows the approach of a level 1 virtualization platform for production intent application software components - without the Run-Time Environment (RTE), Basic Software (BSW), and Microcode Abstraction (MCAL) layers. The application layer interacts with a plant model and multiple soft controllers as necessary to form an integrated closed-loop environment. The scale of the application layer to be included within the simulation can be varied based on the nature of the development intent and could be expanded to include additional software components. Additionally, the work involves developing a toolchain to automate the creation of the framework necessary to run the simulation, which significantly reduces the human effort required to adapt the simulation to extended platforms. The benefits include the optimization of the performance of the central processing unit (CPU) running the simulation, while reducing the dependency on the need for expensive licenses and equipment. The results show this process has a quick turnaround time in adapting to different platforms while simulating a large-scale simulation without the need for a high-performance machine.
Predictive Maintenance of a Ground Vehicle Using Digital Twin Technology
Authors: Eddy Conner William , Castanier Matthew P. , Wagner John R.
Published: April 2024

The safety and reliability of ground vehicles is a motivating factor for periodic maintenance which includes fluids, lubrication, cleaning, repairs, and general observation of key subsystems. The scheduling of maintenance activities can occur at different rates such as daily, weekly, or perhaps operating time based on collected historical data and general guidelines. The availability of a digital twin (DT), which offers a virtual representation of the vehicle behavior, enables virtual system simulations for different operating cycles to explore the dynamic behavior. When field operating fleet data can be integrated with the digital twin estimates, then this supplemental information can be combined with the existing maintenance plan to provide a more comprehensive approach. In this paper, a digital twin with a statistical based predictive maintenance strategy is investigated for a wheeled military ground vehicle. The underlying models and mathematics are presented to establish a basis for this engineering tool. A case study is examined in which a DT is utilized in a computer simulation mode as a physical vehicle was unavailable to generate numerical data for signal features and condition indicators. Representative results show a high validation accuracy and reasonable training times can be achieved in support of predictive maintenance classification models. The steady progression towards a virtual engineering design and product support framework for transportation systems relies on the presence of digital twin technology and prognostic-diagnostic methodologies.
Lower Ionospheric variations during the intense tectonic activity in the broader area of Greece on October of 2020
Authors: Contadakis Michael E. , Arabelos Dimitrios M. , Pikridas Christos , Bitharis Stylianos , Scordilis Emmanuel M.
Published: April 2024

In this paper, we investigate the Lower ionospheric variations from TEC observations during the intense seismic activity of October 2020 in the area of Greece. The data were analysed using both, statistical analysis of TEC variations in order to detect uneven gross variations and Discrete Fourier analysis in order to investigate the TEC turbulence. The results of this investigation indicate that the High-Frequency limit fo of the ionospheric turbulence content, increases as aproaching the occurrence time of the earthquake, pointing to the earthquake epicenter, in accordance with our previous investigations. We conclude that the Lithosphere Atmosphere Ionosphere Coupling, LAIC, mechanism through acoustic or gravity waves could explain this phenomenology. In addition, the statistical analysis shows an excess greater than 3𝜎 from the mean TEC values, one and seven days before the earthquake. Since no major disturbance of the geomagnetic field occured during these days, we conclude that we probably observed precursory ionospheric variations in accordance to analogous findings from the variation of VH/VHF electromagnetic wave propagrations over strong earthquake areas.
Multi-parametric study of seismogenic anomalies during the 2021 Crete earthquake (M=6.0)
Authors: Sasmal Sudipta , Chowdhury Swati , Kundu Subrata , Ghosh Soujan , Politis Dimitrios , Potirakis Stelios , Hayakawa Masashi
Published: April 2024

It is well established that pre- and co-seismic irregularities in the earth’s atmosphere highly depend on a set of parameters. According to the Lithosphere-Atmosphere-Ionosphere Coupling (LAIC) mechanism, these parameters are associated with various channels (thermal, chemical, acoustic, electromagnetic, etc.) through which an earthquake (EQ) preparation process can have its anomalous phenomena. In this research, we perform a multi-parametric observation using various channels during a strong EQ (M = 6.0) on September 27, 2021, on Crete Island in Greece. We investigate the acoustic and electromagnetic channel using ground and satellite-based observation. We present the Atmospheric Gravity Wave (AGW) in the acoustic channel using the temperature profile computed from the SABER/TIMED instrument. In the electromagnetic channel, ionospheric Total Electron Content (TEC) is recorded by the GNSS-IGS station DYNG in Greece. This TEC information is also used in the acoustic channel anomaly by computing the wave-like structures in the small-scale fluctuation of the TEC profile. We compute energetic (30 to 100 keV) electron precipitation in the inner radiation belt from the NOAA satellite. We also investigate the outcomes of the SWARM satellite to compute the magnetic field and electron density profile. All the parameters show significant seismogenic anomalies (mostly enhancement) before the EQ. To understand each parameter’s temporal and spatial sensitivity, we present a comparison using the anomalies in each parameter.
Semi-mechanized planting of saplings: pivotal results on the efficiency of a new method
Authors: Schönauer Marian , Hoffmann Stephan , Breinig Lorenz , Wagner Thilo , Guerra Filippo , Jaeger Dirk
Published: April 2024

Large clear-cut areas as a consequence of drought and bark beetle infestations necessitate extensive replanting efforts in German forests, leading to an increased interest in efficient planting systems. In addition to manual planting, mechanized and semi-mechanized systems utilizing surplus forest machine capacities available after completion of salvage logging operations are likely required for timely reforestation of the clear-cut areas. A semi-mechanized system utilizing a standard forwarder with a grapple-actuated soil borer for both, the transport of planting material and the preparation of planting pits, combined with two workers carrying out manual planting, was investigated in a time-and-motion study. The frequency method was used after video recording of a planting operation that covered an area of approximately 1.2 hectares. A total of 815 alder saplings (Alnus glutinosa L.) with heights of 1.2–1.5 m were planted. Observed productivity was 93 saplings per system work hour (SWH). With additional placement of stakes for stabilizing the plants, the productivity decreased to 42 saplings per SWH. While directly comparable results were not found in the literature, available productivity figures of purely manual planting systems do not suggest an increased productivity of this semi-mechanized system. Considering ergonomics, however, forwarder utilization provides reduced workload not only in plant hole preparation but also with material transport and clearing of planting spots. Both the ergonomic aspects of the system and, in particular, the suitability of the soil borer for different soil textures should be further investigated.
Keywords: time studies; forwarder; stand regeneration; windthrow; forest operations
Humanismo y secularización (consideraciones sobre la modernidad)
Authors: Ordóñez García José
Published: April 2024

Este artículo es un breve aviso de un proyecto de investigación más ambicioso, aún en curso, sobre la relación entre nihilismo y postmodernismo. Recoge algunas ideas de Heidegger y de sus comentaristas más recientes, muy especialmente del llamado "pensamiento débil", buscando una respuesta al nihilismo contemporáneo en una sociedad que se caracteriza por secularizar todo lo trascendente. Por lo tanto, este ensayo puede considerarse como un intento de definir el contexto del problema desde un punto de vista "postnihilista"
"Vino nuevo en odres nuevos". El P. Bernard Häring y la renovación de la Teología Moral
Authors: Colombo Roquette Jesús
Published: April 2024

Este artículo fue bom como lección inaugural del curso académico 1996-1997 en el Instituto de Estudios Teológicos de Sevilla (C.E.T). Se parte de una serie de notas biográficas del Padre Haring necesarias, según el autor, para comprender el desarrollo intelectual del personaje y la evolución de su enseñanza moral. En la segunda parte. La contribución del Padre Haring a la TeologíaMoral renovada se revela: una moral fundada sobre el Custodio de Dios; un nuevo destinatario, es decir, el paso del confesionario al "cristiano adulto": paso de la ley y del mandamiento a la "ley del Espíritu que da la vida en Cristo": diálogo con el hombre de hoy: diálogo ecuménico: cultura continua, que implica renovación continua: moral de tendencia comunitaria (ni individualista, ni perfeccionista), de la solidaridad salvífica; moral que libera al hombre, que no lo aprisiona ni lo encorseta. En conclusion. se muestra claramente la gran aportación del Padre Haring a la Teología Moral: el paso de una moral centrada en el objeto a una moral centrada en el hombre libre, responsable y fiel a Cristo
A MOTIVAÇÃO NO E-LEARNING
Authors: Lôbo Ítalo Martins , Silva Dirceu da , Tesch Adriana da Conceição , Zatti Marta Cristiane Kraemer , Ferreira Patrícia Alves
Published: April 2024

A motivação tem despertado interesse em diversos campos da Psicologia, e as Teorias da Aprendizagem têm desempenhado um papel especialmente relevante nesse contexto. Essas teorias estabelecem uma conexão significativa entre motivação e o processo de aprendizagem, juntamente com outros processos cognitivos fundamentais, como a atenção e a memória. Ao considerar a motivação como uma variável essencial, essas teorias buscam compreender como os estímulos podem influenciar as respostas dos indivíduos, por que certos estímulos evocam respostas específicas em vez de outras possíveis, quais estímulos têm valor de recompensa e por que algumas respostas parecem ocorrer sem um desencadeador externo aparente. A motivação é reconhecida como um fator crucial para o sucesso do processo de aprendizagem, tanto em ambientes de ensino tradicionais como em modalidades de aprendizagem virtual. Ao explorar as interações entre motivação, cognição e aprendizagem, as teorias da área fornecem um arcabouço teórico importante para entender como a motivação pode impulsionar e direcionar os esforços das pessoas em busca de objetivos educacionais. Na modalidade e-learning a motivação é crucial para todo o desenvolvimento e curso do processo de aprendizagem. Objetiva-se com esta produção identificar e compreender os aspectos motivacionais neste contexto assim como compreender os desafios ligados a este fator tanto para docentes quanto para discentes através da metodologia da revisão de literatura.
Analysis of Parking Characteristics in Rest Area Km 726 B in Planning Parking Space Needs at Rest Area Facilities STA 19+600 Manjungan Klaten Village Solo-Yogyakarta-Nyia Kulon Progo Toll Road Section I Package 1.1 Solo Klaten (STA 0+000 – 22+300)
Authors: Rahayu Yayuk Sri , Widyaningsih Nunung
Published: April 2024

The problem of traffic jams continues to increase, the government is designing an alternative road connecting Surakarta to Yogyakarta. The increasing volume of vehicles on the Solo - Yogyakarta toll road makes accidents prone due to driver negligence. To reduce the risk of accidents and relieve fatigue after traveling, one of the policies taken is to build rest areas and facilities. The method used in the research is a direct survey to obtain primary data in the form of incoming and outgoing vehicle data, the number of existing parked vehicles, facilities in rest areas and secondary data in the form of daily traffic on the Solo - Yogyakarta toll road obtained from PT. JMM. Based on the condition of the existing rest area, it is necessary to analyze the parking facilities to get an idea of ​​parking capacity and parking space requirements. The guideline used in the research is "Guidelines for Planning and Operation of Parking Facilities for the Directorate of City Transport Traffic System Development 1998", as well as references related to parking analysis. The conclusion of the analysis results is that the parking space needed for the Solo-Yogyakarta toll road in the 2024 planning year is 271 SRP, the volume of incoming vehicles is 2751, the accumulation is 206 vehicles, the parking index is 75.99%, the turnover is 10.15, and in 2033 there are parking spaces. What is needed is a capacity of 541 SRP, a volume of incoming vehicles of 5495, an accumulation of 411 vehicles, a parking index of 76.07%, and a turnover of 10.16.
Conductas de riesgo para enfermedades cardiometabólicas en funcionarios del Hospital General Docente Riobamba. Julio a diciembre del 2019
Authors: Muquinche Usca Maria de Lourdes , Reyes Corral Francisca Rocío , Maldonado Ibarra Richard Vicente
Published: April 2024

Introducción: Las Enfermedades cardiometabólicas constituyen un serio problema de salud pública para la población mundial por ser una de las principales causas de morbimortalidad. Objetivo: Identificar las conductas de riesgo para enfermedades cardiometabólicas en los  Funcionarios del Hospital General Docente  de Riobamba. Metodología: Se realizó un estudio de tipo descriptivo de corte  transversal, la información se recabo a través de una encuesta que fue validada por expertos, la muestra fue de 44 funcionarios de la Unidad Administrativa. Resultados: El promedio de edad es 47 años, la mayoría es de sexo femenino 55%, referente a su estado civil el 64% son casados. Existe un alto consumo de tabaco 55%, en relación al consumo de comida rápida se identifica que  el 100% posee esta conducta, Sólo el  36% de los funcionarios realiza actividad física en promedio 2 horas a la semana. El tiempo que dedican a ver televisión es de 5 horas diarias en el 46% de los investigados. Conclusiones: Se puede establecer que este grupo de funcionarios posee conductas de riesgo para enfermedades cardiometabólicas debido a sus patrones de consumo de comida rápida y substancias tóxicas como el cigarrillo, así como como se evidencia sedentarismo puesto que una cantidad muy reducida de los investigados practica actividad física s dos horas a la semana, siendo necesario realizar a acciones de promoción y prevención de salud en este grupo.
Efecto de la adición de distintos niveles de extracto proteico de quinua (Chenopodium quinoa wild) en la composición de la  mortadela tipo I
Authors: Pino Falconí Paúl Roberto , Zambrano Núñez Telmo Marcelo , Romero Machado Efraín Rodrigo , Villamar Manrique Sonia Andrea
Published: April 2024

Introducción: la quinua es fuente de proteínas de muy buena calidad, importante por su contenido en número y tipo de aminoácidos, posee los 8 aminoácidos esenciales para el humano. Objetivo: identificar si la adición de extractos de quinua modifica las características nutricionales, microbiológicas y sensoriales en la mortadela tipo I. Métodos: la investigación fue desarrollada mediante el diseño de 3 tratamientos (2.5, 5.0 y 7.5%) más un tratamiento control (0.0%), los tratamientos estuvieron constituidos por los diversos porcentajes de adición de extracto de quinua. Se realizaron determinaciones químicas, microbiológicas y sensoriales en los productos finales. Resultados: en los porcentajes de humedad, fibra, proteínas y carbohidratos, identificamos diferencias estadísticas significativas entre tratamientos, mientras los porcentajes de cenizas y grasas no se ven modificados estadísticamente. Microbiológicamente se analizaron en el producto final, Bacterias aerobias, E. coli y Coliformes totales, observando resultados no mayores a lo que exige el Servicio Ecuatoriano de Normalización (INEN), no se encontró presencia en el contenido de Salmonella. En la evaluación organoléptica realizada con 30 jueces consumidores, observamos que, empleando hasta 7.5% de adición de extracto de quinua, los evaluadores no identifican cambios sensoriales perjudiciales en el producto cárnico, y finalmente, en la prueba de determinación de aceptación general, los 30 evaluadores indican su mayor aceptación en la mortadela tipo I con 5.0% de adición de extracto de quinua. Conclusiones: el extracto de quinua en la mortadela tipo I aumenta favorablemente la cantidad de nutrientes, especialmente proteínas, no modifica las características microbiológicas y no disminuye las características sensoriales del alimento
Elizabeth, simulador neonatal para  auscultación de ruidos cardíacos
Authors: Baltodano Ardón Franklin , Pineda Grillo Indira José , Andrade Cuadrado Carlos Eduardo
Published: April 2024

Introducción: La creación de simuladores surgió como un método de enseñanza enfocado en el área de médica puesto que las personas se negaban a ser sujetos de práctica para los estudiantes. Objetivo: Elaborar un simulador electrónico neonatal que permita la auscultación de ruidos cardíacos normales y patológicos con materiales económicos y de fácil acceso, proporcionando una herramienta para que los estudiantes de medicina adquieran habilidades y conocimientos. Metodología: Estudio exploratorio, con una metodología inductiva, en el cual se elaboró en la primera fase un simulador pediátrico de ruidos cardiacos, posteriormente se realizó la validación con expertos y una evaluación de conocimientos y habilidades a 52 estudiantes de la carrera de medicina. Resultados: El simulador construido demostró ser eficaz para reproducir ruidos cardíacos normales y patológicos y permitió entrenar y desarrollar habilidades de auscultación cardíaca en estudiantes de medicina. Conclusiones: Es necesario desarrollar simuladores de bajo costo y fácilmente manipulables como herramienta de práctica enfocados en mejorar la atención a pacientes reales.
Kockázati tényezők a gazdaságban 2023 közepén
Authors: Belyó Pál
Published: April 2024

A világgazdaságban hosszabb ideje zajló kritikus folyamatok alapvetően befolyásolhatják Magyarország gazdasági-társadalmi folyamatait is. Kedvező folyamat, hogy 2023 első félévében a korábbi kockázatok bekövetkezésének esélye csökkent. A másfél éve tartó és súlyosbodó orosz – ukrán háború mellett egyéb jelentős geopolitikai feszültségek is kialakultak. Általános probléma, hogy négy évtizede nem tapasztalt magas infláció alakult ki még a fejlett gazdaságokban is. Szinte valamennyi ország küzd a magas államháztartási hiány csökkentésével, és az elmondottakkal együtt járó szigorú monetáris és fiskális politika megvalósításával. A recesszió elkerülésére hozott intézkedések jelentősen befolyásolják a keresletet és kihatnak a gazdasági növekedés élénkítésére. Kedvező folyamat, hogy az Európai Unió országai érezhetően csökkentették az orosz energia importtól korábbi függőségüket. Érezhető az a folyamat is, hogy lassul a világkereskedelem, és a geopolitikai feszültségek is jelzik, hogy átértékelődnek a kereskedelmi kapcsolatok, így pl. Kína szerepe is. Élénkül egy folyamat az eddigi függőségek lazítására, alternatív megoldások felkutatására.
Impact of maternal anaemia in different trimesters on newborn weight: A hospital-based observational study
Authors: Dr Susanta Kumar Behera  , Dr Sandeep Kumar Tripathy  , Dr Om Avishek Das  , Dr Akshaya kumar Sethi
Published: April 2024

Anaemia is an extremely significant nutritional disorder throughout the world. Anemia in pregnancy is widely reported in India. The majority of the studies have highlighted a poor pregnancy result linked to anaemia. Other than that, the timing of the haemoglobin taken into consideration for analysis lacked consistency. As a result, we designed this hospital-based observational research to investigate these factors. Methods: The study was carried out at Maharaja Krushna Chandra Gajapati Medical College and Hospital Brahmapur, Ganjam, Odisha where 1000 pregnant women were selected, and their haemoglobin levels were assessed. It was observed in their antenatal record that the haemoglobin levels in earlier trimesters. We monitored these mothers till the babies were born and assessed the gestation and birth weight of the infants. For the baseline characteristics, descriptive statistics were employed. Results: In our study, 56.4% of mothers were anaemic. The second trimester showed a higher percentage of anaemia, while the third trimester showed the lowest percentage. Through all three trimesters, 394 (39.4%) mothers remained anaemic. The second trimester showed a higher percentage of anaemia (65.4%), while the third trimester showed the lowest rate (44.8%). Only 23 mothers were classified as having severe anaemia (Haemoglobin less than 7 gm/dl), out of which 15 were in 1st trimester, 6 were in 2nd trimester and only 2 were in the 3rd trimester. Conclusions: Mothers who were anaemic in the third trimester had a considerably higher prevalence of low birth weight infants. Mothers who were anaemic in their second and third trimesters had a higher rate of preterm births. In our investigation, higher haemoglobin levels had noimpact on either birth weight or gestation.
Emerging Role of Nutraceuticals in Covid 19
Authors: Naaz Huda  , Dawar Rajni  , Rani Anita  , Kaur Charanjeet
Published: April 2024

The global pandemic of SARS-CoV-2, claiming thousands of lives each day has brought the world to a standstill. Such devastating and great impact of Coronavirus disease (COVID-19) is due to unexpectedly rapid spread, which did not allow for much preparedness. The scientists are working hard to come up with a vaccine, but nothing fruitful has been produced so far due to the rapid spread of the virus. Multiple drugs have been tried to target the virus, but no specific drug is there to prevent the spread of virus. Hence, we analysed the role of non-pharmacological substances such as nutraceuticals, probiotics and dietary supplements in reducing the susceptibility and mitigating the symptoms of COVID 19. In current scenario, when there is dearth of specific antiviral agents, theses substances could prove to be great importance due to their easy availability and no known side effects if administered in large doses. Scientific evidence has also suggested the beneficial role of bacterial and molecular products on immune response against the viruses. They could also regulate the inflammatory response and prevent endothelial damage. However, due to lack of specific data, rigorous clinical trials should be conducted to confirm the beneficial role of these supplements, probiotics and nutraceuticals in this period of crises.
A Study of Management of Fistula in Ano at a Tertiary Health Care Centre
Authors: DR Amrutha M  , DR Rajeshwara K.V.
Published: April 2024

A Fistula is an abnormal communication between any two epithelial-lined surfaces. Fistula in Ano is an abnormal communication between the anal canal and the perineal skin. Fistula in ano denotes the chronic phase of anorectal sepsis and is characterized by chronic purulent drainage or cyclical pain associated with abscess reaccumulation followed by intermittent spontaneous decompression.
Amit Jain’s System of Practice: From Modern to Super Modern Diabetic Foot Surgery
Authors: Dr. Amit Kumar C Jain
Published: April 2024

One of the known diseases that have been neglected for decades is the diabetic foot. No wonder why it was called Cinderella of complications and often it was rendered as an orphan disease. However, over last one decade, one can notice development of various new concepts in this field. This article aims to highlight one such developments being the Amit Jain’s principle and practice for diabetic foot, which is the modern diabetic foot surgery system and with introduction of various new concepts recently, it has taken a leap to super modern diabetic foot surgery system, This system was aimed at standardizing and improvising the practice of diabetic foot.
Clinical Prediction of outcomes in Acute Pancreatitis with Various Prognostic Indicators and Modified CTSI
Authors: Dr. Girish S.P.  , Dr. Sainani Rahul Raju
Published: April 2024

Introduction: Acute pancreatitis is the most common cause of patients presenting to the emergency department with pain abdomen. It is an inflammatory process of the pancreas that can range from mild inflammation to severe extensive pancreatic necrosis and multi-organ failure with mortality rates of 20% to 30%. Diagnosis can be difficult, because there is no pathognomic clinical presentation and no diagnostic gold standard. Material and Methods: It was a prospective cross-sectional descriptive study conducted in the Department of Gastroenterology at Sapthagiri Institute of Medical Sciences and Research Center from December 2019 – August 2020 among 100 patients. Results: The total patients studied in this study were 100, which comprises of 93 males and 7 females. Among the male population the maximum age group is 41-50. Next comes the 31-40 which includes 30 patients. Among the female population the maximum age group is 41-50 which includes about 4 patients. In our study distribution of the SAP within and above the cut off value of the different prognostic scores. 11 patients with SAP had RANSONs score < 3 and 10 with SAP had RANSON score ≥ 3. 11 patients with SAP had APACHE II score of ≥8 whereas 10 had APACHE II score < 8. But only 8 patients with SAP had BISAP score < 3 and 13 SAP patients had BISAP score ≥ 3. MCTSI score in 11 SAP was < 4 and 10 patients with MCTSI had ≥ 4. Conclusion: BISAP score is simple and it is the better scoring system in predicting the prognosis when compared to other scores & MCTSI. BISAP score has many advantages when compared to other scoring systems.
Pathophysiology and Spectrum of Neuro-COVID
Authors: Finsterer J, MD, PhD
Published: April 2024

Some neurological manifestations may not be specific for COVID-19 and due to other causes but that COVID-19 must be considered as a differential of all acute neurological conditions. The following neuropathological abnormalities were found: acute microscopic thrombotic ischemic infarcts; microscopic haemorrhagic infarcts; petechial haemorrhage; focal perivascular parenchymal Tcell infiltrates; diffuse perivascular parenchymal T-cell infiltrates; leptomeningeal inflammation; interstitial brainstem inflammation with neuronal loss; capillary endothelium expression of ACE2 receptors; microglial nodules; and hypoxicischemia changes and neuronal loss.
A Rare Case Report of Waugh Syndrome in an Eight Months Old Male
Authors: Pielly Hanna, MD  , Kamal Kanso, MD  , Wafaa Dia, MD  , Nada Wazne MD  , Fadi Iskandarani, MD  , Imane Hassan, MD  , Farah Beih, MD  , Rouwayda Dana, M.D.  , Bassem Abou Merhi, MD  , Ounssi Hammoud  , Chawki Hammoud, MD
Published: April 2024

The author reports a case of Waugh syndrome in an 8-monthold baby boy. Although Waugh's Syndrome is rare, most of thedocumented cases are in children. Waugh syndrome, first described in 1991 by Georges Waugh, is an intussusception associated with abnormal bowel rotation (Behera, C. R., & Mohanty, S. K. 2014; & Henderson, A. A. et al., 2013). Less than 100 cases have been described so far worldwide. Intussusception is one of the most common causes of bowel obstruction in pediatrics. Although this intussusception is idiopathic in 81% of cases, it can sometimes be secondary to various etiologies such as Meckel's diverticulum, congenital bridles, gastroenteritis, polyposis and intestinal lymphomas. The authors discuss treatment options and discussthe probability of Waugh's Syndrome during any intussusception in children (Behera, C. R., & Mohanty, S. K. 2014).
Non – Invasive Ventilation in Patients with Type 2 Respiratory Failure
Authors: Dr Sarang Patil, MD
Published: April 2024

Non-invasive positive pressure ventilation (NIPPV) as an alternative to the endotracheal intubation is associated with less infectious complications and injury to the airways. In a study cohort which included 50 patients with type 2 respiratory failure with the commonest diagnosis of copd exacerbation with or without associated co-morbidities, mechanical ventilation with nippv was applied and the response was observed. There was significant improvement with nippv in form of increase in pH, pao2 and decrease in paco2 and hco3 after one hour of nippv application which also persisted after successful weaning. This is a prospective and Observational study was carried out during April 2018 to March 2019. In a BiPAP mode inspiratory pressure (IP) is kept 8-10 cm above the end-expiratory pressure (EP). If PSV mode used for NIPPV the IP to start with was kept on 15-20 cm H2O with a small PEEP of 4-5 cm H2O. Nippv was successful in 84 patients in our study cohort with 62 patients weaned successfully off Nippv. Use of NIPPV was associated with lesser risk of nosocomial infections, less antibiotic use and lower mortality as compared to patients who are equally ill and do not received Nippv. Nippv is a METHOD of providing ventilatory support using a noninvasive interface with the patient and thus circumvents the complications of invasive mechanical ventilation like ventilatorassociatedpneumonias (vap), injury to airways, barotrauma and post intubation laryngeal and tracheal stenosis.The study, demonstrated that nippv is not only a feasible ventilatory modality but also a treatment that is associated with significant improvements in clinical outcomes.
Blood Pressure Changes during Initial and Relapsing Episodes in Children with Nephrotic Syndrome: A Comparative Study
Authors: Dr Poulomi Roy MBBS, MD  , Dr. Subhasis MukherjeeMBBS,MD, DCH
Published: April 2024

Hypertension is an important feature arising from altered homeostasis related to the disease process in nephrotic syndrome. It indicates the disease state and response to therapy as well as dictates the treatment plan.The present study aims to detect changes in diastolic and systolic blood pressure during the initial and relapsing episode of nephrotic syndrome and compare them for future guidance in therapy.This observational, cross-sectional study was conducted between October 2016 and January 2019 with patients attending the pediatric clinic with either initial episode or relapse of nephrotic syndrome. A total of 100 patients with 50 patients in each group were included. The blood pressure was recorded and blood, and urine samplesof each subject analyzed.The present study indicates that though the majority of the patients in both the groups have normal systolic and diastolic pressure, diastolic blood pressure was significantly high in the relapse group. There was alsoa significant reduction in serum albumin and spot protein creatinine ratio in the relapse group.Blood pressure measurement needs to be part of the routine examination of any child attending a nephrology consultation clinic or admitted to the hospital. Children who developed hypertension during treatment or relapse indicate that nephrotic syndrome should be followed up over a long duration. Altered blood pressure may necessitate encouragement for regular follow up in nephrology clinic for early recognition and treatment of long term complications.
Laser Management for Anal Fistulas: A Prospective study
Authors: Dr. Roopa Bhushan  , Dr Manish Joshi
Published: April 2024

Introduction: Laser treatment for fistula-in-ano, also known as FiLaC (fistula laser closure) or LAFT (laser ablation of fistula tract), has gained increasing attention in the last decade. The procedure consists of delivering laser energy at 360° within the lumen of fistulas by means of a radial fiber which is slowly withdrawn from the external orifice. Material & Methods: The study analysed 40 patients treated for anal fistulae in Sapthagiri Institute of Medical Sciences, Bangalore between November 2020 to June 2021. Fistulae were classified in accordance with the Parks’ classification system, and all patients were preoperatively assessed by clinical examination and proctosigmoidoscopy and classified using three-dimensional (3D) endoanal ultrasonography performed by a sonographer experienced in endoanal ultrasound. Results: Of the 40 patients, 26 were female and 14 were male (overall median age 46 years; range 17–82 years). The median period of follow-up was 11 months, follow up was scheduled in the outpatient at 1 and 2 weeks and 1, 3, 6 and 11 months postoperatively. However, patients were instructed to return to the outpatient at any time should symptoms recur. In the cohort, 39 fistulae (97.5%) were cryptoglandular in origin and 1 (2.5%) were Crohn’s related. 97.5% had previously undergone surgery including abscess drainage and prior fistula operations. The mean number of operations before FiLaC treatment was 2.4 (±1.7) with a range of 1–9 previous operations. Discussion: The use of FILAC for the treatment of anorectal fistula has shown encouraging. The technique is easy to learn and fast to perform, allows exploration of curved paths and any size since the fiber is very flexible and long. The destruction of the epithelialized path and sealing is carried out by laser emission radially 360◦, thereby allowing the application of energy across the path homogeneous in a controlled manner. Conclusion: The FILAC, sphincter preservation minimally invasive surgery in the treatment of anal fistulas, looks promising although prospective and long-term follow-up studies should be conducted.
A study to evaluate the functional and radiological outcome of proximal femoral nail Anti rotation 2 in inter trochanteric fractures of femur
Authors: Dr. M Venu Gopal Reddy
Published: April 2024

Introduction: Fractures around the trochanteric area of the femur are among the most frequent fractures encountered in orthopaedics, especially in geriatric population and increasing life expectancy has resulted in increase in these type of fractures. Aim: The aim of this study was to analyze the functional and radiological outcome of patients treated with PFN A-II. Methods: Patients presenting with unstable intertrochanteric femur fracture (AO classification) and Singh’s index ≤ 3 were included. The study included 70 patients (30 males and 40 females), at our institution during the period of July 2019 to December 2020. Clinical outcome was measured in terms of procedure time, clinical function at each follow-up and mortality. Radiographic evaluation was measured by quality of reduction, Cleveland Index, tip-apex distance (TAD), and time for the union. Complications including delayed union, non-union, screw backing out , screw cut through into the joint, infection, osteonecrosis of the femoral head, and implant breakage were also investigated. Results: All the 70 patients included in the study were treated with PFN A-2. The average age of the patients included was 74.4 years . The TAD was more than 25mm in 8 patients. 11 patients has sub optimal position of the implant as per cleveland index. Outcome was excellent in 45, good in 15, fair in 7,poor in 3, and this is based on modified Harris hip score with the minimum follow-up period being 6 months. The difference between the neck shaft angle of the operated side when compared with the un-injured side is more than 10 * in 11 patients. The average union time was 5.6 weeks, average modified Harris hip score was 86.5. Conclusion: The result of our study shows that PFNA2 is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation in the osteoporotic patients , which allows early full weight bearing mobilization of the patient.
A Study On Clinical Profile of Urinary Tract Infection in Diabetes Mellitus in a Tertiary Care Hospital
Authors: Dr. Jason Andrade  , Dr. Leo F Tauro  , Dr. Reshmina Chandni Clara Dsouza  , Dr. Shubha N Rao
Published: April 2024

Background: Diabetic Patients are at high risk of developing various infections especially if the diabetes is uncontrolled. Urinary tract infections (UTI) are one of the common infections in diabetics. Knowledge about the clinical and microbiological profile of UTI in diabetic patients will not only aid in early diagnosis but also helps in early initiation of appropriate empirical antibiotic therapy ensuring early recovery. Material & Methods: Prospective hospital based observational study. The study was conducted in the In-patient department, Department of General medicine at KMCT Medical college, Manassery, Kozhikode, Kerala, India. This study was conducted in 170 Diabetic patients above 18 years of age with symptoms of UTI with significant pyuria who were admitted under department of General Medicine, KMCT medical college, Kerala, who satisfied the inclusion criteria and gave consent for study. study consisted a total of 170subjects. Simple Random sampling method. Results: Fever was the most common clinical presentation followed by dysuria. E. coli was the most commonly isolated organism followed by Klebsiella. Most of the organisms were sensitive to Amikacin. Antibiotic resistance and Pyelonephritis were higher in patients with poor glycaemic control. The most common ultrasonographic abnormality was prostatomegaly. Conclusion: Patients with poor glycaemic control are at high risk of resistant UTI and Pyelonephritis. Good glycaemic control with routine monitoring of HbA1C is mandatory in diabetic patients to prevent UTI and to avoid its complications. E. coli was the most common organism isolated followed by Klebsiella. Most of the organisms were sensitive to Amikacin. Hence, Amikacin can be recommended as empirical antibiotic forDiabetic patients who are admitted with UTI.
A Prospective Study on Clinical and Laboratory Predictive Markers of Dengue Fever in Children in Tertiary Care Hospital
Authors: Dr. Sakeena Bano  , Dr. Shabasu Laxman Deepu  , Dr. Kuttuboina Venkatesh  , Dr. Neerugatti Banerji  , Dr. Sareena Bano
Published: April 2024

Background: Dengue fever is the world's fastest-spreading mosquitoborne viral disease, with a 30-fold increase in global incidence over the last five decades. It is a major public health concern throughout the world's tropical and subtropical regions. 1 Dengue is classified into Dengue +/- warning signs and severe dengue, which includes Dengue shock syndrome, Respiratory distress syndrome, Dengue hemorrhagic fever, and organ failure, according to WHO 2012 guidelines. Material & Methods : Study Design: Prospective Hospital based observational study. Study area: Department of Paediatrics, Siddhartha Medical College, Vijayawada, Andhra Pradesh. Study Period: 1 year. Study population: All children under the age of 13 years who had acute onset high grade fever and were Nonstructural antigen protein 1 [NS1] and/or Immunoglobulin M [IgM] positive were admitted to the paediatric ward. Sample size: study consisted a total of 150 cases. Sampling method: Purposive sampling technique on consecutive cases. The following laboratory test cut-off values are defined: leucopenia (white blood cell count < 4000/mm3), thrombocytopenia (platelet count < 150 103/mm3). Prolonged activated partial thromboplastin time (APTT) (> 38 sec), elevated serum aminotransferase levels (AST or ALT >39 U/L), and low C-reactive protein (CRP) (20 mg/L). The study compared clinical and laboratory parameters in dengue fever, dengue fever with warning signs, and severe dengue. Result: Several laboratory parameters were measured as predictors of laboratory- confirmed dengue infections. The positive predictive value of WBC was 80.6%, and NPV of 50% to differentiate the severity of three dengue groups. Whereas, PPV of platelet count was 90.8%, and NPV of platelet count was 50% to differentiate the severity of dengue groups. Conclusion: Our research discovered that a combination of commonly used blood tests, such as a white blood cell count, platelet count, liver function tests, and CRP and coagulation profiles, can help detect laboratory-confirmed dengue infection. These clinical and laboratory findings could be used as predictive markers to improve the early detection and severity of dengue infection.
Fine Needle Aspiration Cytology of Lymphnodes: A Hospital Based study in a Tertiary Health Care Center in Southern Odisha
Authors: Dr Kalyani Hazra  , Dr Pranati Pradhan  , Dr Subrat Burma
Published: April 2024

Introduction: FNAC is widely accepted the most accurate sensitive, specific, cost-effective minimally invasive OPD technique to establish the basic diagnostic information not only to relieve the anxiety of the patients but also to provide materials for microbial culture, and decrease unnecessary surgery from the visibly accessible superficial masses. It also distinguishes a benign from a malignant entity that can obtain tissue for immuno-phenotyping & molecular studies and obtain cellular & genetic material for storage also useful for staging and follow up including response to treatment in patients with known malignancies. Our study was conducted on 796 Outpatients including all age groups & sexes presenting with palpable enlarged lymph nodes not only for early diagnosis & treatment but also to reveal the burden of various categories of diseases in tribal areas where our institution is situated. Material & methods: FNAC was performed under aseptic precaution using a 22 to 24 Gauge needle attached to a 20CC disposable syringe. The aspirated material after smearing was treated with 95% ethyl alcohol for fixation and stained with H& E and Papanicolaou stain & air-dried smears are stained with Leishman stain. Modified Z-N stain was done wherever necessary followed by diagnosis based on clinic cytomorphological features. Result: Out of 796 cases the most common cause of lymphadenopathy in our study was found to be Tubercular lymphadenitis with 360 (45.22%) cases, the second most frequent entity was reactive lymphadenitis in 277(34.79%) cases followed by metastatic lesions in 47 (5.90%) cases and lymphoma 17 (2.13%) cases. Conclusion: FNAC is a simple, safe, reliable, and inexpensive method for early detection of various non-neoplastic (lymphadenitis) & neoplastic lesions (lymphoma & metastatic carcinoma) of enlarged lymph nodes which helped diagnose approximately 99% of cases.
Comprative Study of two Different Microscopic Techniqes and Fungal Culture for Isolation of Dermatophytes
Authors: Dr. Nidhi Sharma  , Mrs. Hirdesh Kumari Gupta  , Dr Prashant Harit
Published: April 2024

Introduction: Fungal infections are very common in man. They are assuming greater significance both in developed & developing countries due to advent of immunosuppressive drugs & disease hot & humid climate in tropical & subtropical countries like India makes dermatophytosis or ringworm a very common superficial fungal skin infection. Dermatophytosis is caused by dermatophytes, a group of keratinophilic fungi that require long incubation period to grow. The clinical presentation, though very typical of ringworm infection, is very often confused with other skin disorder particularly due to rampant application of broad – spectrum steroid containing skin ointments and cream leading to further misdiagnosis and mismanagement. Materials and Methods: Cross sectional lab based investigational study was conducted and skin, hair, nail sample from 110 clinically suspected cases of dermatophytosis were taken from OPD of district hospital of central India and were screened by direct microscopicexamination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mount. 10% potassium hydroxide (KOH) with 40% Dimethyl sulphoxide mount (DMSO) mixed in equal proportion. Results: Direct microscopy using KOH mount is simple, rapid and easy method to visualize fungal elements. Many modification have been evolved to increase the specificity & sensitivity of KOH microscopy results like use of 5% glycerol, addition of 36% DMSO, and addition of parker’s blue(4) in this study we compered the results of conventional KOH mount and a modified technique (40%KOH with DMSO)(5). When doing direct microscopic. Conclusion: The modified KOH with DMSO mount had allowed fastest and better visualization of fungal elements at 10 minutes instead of routine 30 minutes.