bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of upper-cross syndrome in college going students-a cross sectional study
Authors: P. V. Chithra , Vishwanath Sneha
Published: December 2022

Background: Upper cross syndrome is becoming more prevalent in today’s population. Upper crossed syndrome refers to overactive and underactive muscles group in the neck and shoulder girdle. Our aim in this study is to check the tightness and weakness of shoulder and scapular muscles.Methods: 100 adults with age group between 18-23 years were randomly selected for the study. All the students were selected based on inclusion and exclusion criteria. Tightness for pectoralis major, trapezius weakness and neck disability index (NDI) was measured. Data was analysed using SPSS version 20. Mean and SD was analyzed. Frequency was assessed with percentage.Results: Frequency of tightness of pectoralis major was 8% and weakness of trapezius was 59% respectively. NDI values with mean values 36.66 (30.89) was measured.Conclusions: Upper cross syndrome is found to be prevalent in college going students.
Systematic review and meta-analysis of biomarker proinflammation of depression in traumatic brain injury
Authors: Ate Andisty , Wariki Windy , Warouw Finny , Pertiwi Junita Maja
Published: December 2022

Depression is one of the long-term complications of traumatic brain injury (TBI) associated with the inflammatory process. This study aims to analyze the role of proinflammatory biomarkers on depression due to TBI and determine the types of proinflammatory biomarkers of depression in TBI. This systematic review and meta-analysis used the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol with the population, intervention, comparison, outcome method. The selected research articles consisted of 4 cohort studies and 2 cross-sectional studies. Participants were all participants who experienced TBI without any previous infectious disease and neurobehavior disorders. Article searches are limited to the last 10 years using digital libraries including Pubmed, Science Direct, Wiley, Google Scholar. Assessment of the risk of bias using the ROBINS-1 tool, research quality using the GradePro application, and meta-analysis using review manager software 5.4.1. The results of a meta-analysis of proinflammatory biomarkers of depression using 2 cross-sectional studies showed a risk of bias and a moderate level of certainty. The most common types of proinflammatory biomarkers are IL-6, TNF-α, and IL-10. These proinflammatory biomarkers are markers of depression in TBI and have an effect on depression in TBI, especially in recurrent TBI and high post-traumatic stress disorder with depression accompanied by an increase in the concentration value of these biomarkers. Increased proinflammatory biomarkers IL-6, TNF-α, and IL-10 were found in depression with TBI. This proinflammatory biomarker has a significant relationship so that it can be used as a marker of depression in TBI.
Topical corticosteroid therapy: clobetasol propionate 0.025%
Authors: Syed Waseem Y. , Ranade Minal A. , Agarwal Anshu , Kumar Pankaj , Mehta Surjit S. , Deexith Yeluri V. R. L. M. , Jain Devendra , Saini Nirmal K. , Patil Sanjeev S. , Talavia Parag A.
Published: December 2022

Topical corticosteroids have been the cornerstone of treatment over the last six decades for various dermatoses characterized by dry, scaly, crusted, or erythematous skin as well as those associated with inflammation and pruritus. The potency of a topical steroid depends on the specific molecule, the amount of drug reaching the target, absorption through the skin (0.25%–3%), and the formulation. Clobetasol propionate (CP) 0.025% cream formulation is a potent, fifth-generation topical corticosteroid. It is approved by the United States Food and Drug Administration to be applied twice daily for the treatment of moderate-to–severe psoriasis in adults. This case series covers the clinical experience of various dermatologists, including their expert opinion on the safety and efficacy of ImpoyzTM (CP) cream 0.025% in different skin disorders.
Rare benign tumour at an unusual site-angiomyoma of the ear: a case report and literature review
Authors: Reddy Sridhar , Gonuru Vinod Kumar , Ravipati Sri Vishnupriya
Published: December 2022

The objective was to demonstrate the occurrence of the rare benign tumour angiomyoma or angioleiomyoma in the ear canal. Angiomyoma, known as vascular leiomyoma or angioleiomyoma, is a benign tumour of smooth muscle arising from the muscular wall of veins and comprises less than 5% of all benign smooth muscle tumours. Peak incidence is observed in the fourth to sixth decades with the site of predilection being the subcutaneous tissue in the lower limbs, followed by the upper limbs. This is in contrast to our present case, where the angiomyoma was found in the ear canal which is very rare. A 60-year-old female, an otherwise healthy patient presented with fullness in the left ear. Excision of the swelling was done without any complications.
A huge right staghorn renal calculi: a case report of inevitable open surgery
Authors: Ali S. K. Sekendar , Chatterjee Aritra , Mukhopadhyay Narendra Nath
Published: December 2022

Staghorn renal calculi in a developing country, very often associated with insidious growth, late presentation, complication & recurrence, present an economic burden to the patient & challenge to the treating surgeon. A 70 years old male patient presented to the surgery dept. of our medical college with chief complaints of intermittent pain in right side of abdomen since 4 years, with increased frequency for last 5 days & radiating to back, non-radiating to groin, had h/o intermittent low grade fever and 3-4 times hematuria. Right sided pyelolithotomy done and a huge staghorn calculi that is extending into renal calyces is removed. Post operatively patient uneventful. In the last few decades, with improvement in endourological surgery, the indications for open surgery in stone diseases have become rare, although open surgery still has a role in selected cases such as complex stone burden, renal anatomic complications.
Post-operative rehabilitation of displaced-proximal radius fracture: a case study
Authors: Sharma Ridham , Sikka Gitanjali , Majok Aarti
Published: December 2022

Proximal radial fractures typically occur after a fall on the outstretched hand. Elbow trauma is usually followed by post-traumatic elbow stiffness, which has been recognized as a major cause of functional impairment. A stiff elbow restricts patient’s ability to position hand in space required, for desired use of the upper extremities during activity of daily living. The goal of rehabilitation, post-traumatic elbow stiffness is to restore functional arc of motion. The patient treatment should be designed depending on the severity, type and time course of the arthrofibrosis. Since, there is no universally recognized treatment algorithm, treatment must be personalized/customized and stipulated through a shared decision-making process with each patient. Fourty four-year female was diagnosed with post – operative elbow stiffness following a displaced proximal one-third of radius fracture (right side). The patient had decreased muscle strength and limited shoulder, elbow and wrist range of motion, hypersensitivity around the scar and wrist and elbow pain. Progressive multi-treatment rehabilitation approach was given to the patient. Physical therapy intervention improved range of motion, strength, decreased hypersensitivity and pain of the patient as well as aided in quick recovery from stiff elbow.
Silent lupus nephritis: a case report
Authors: Saxena Sumanyu , Quaiser Saif , Rakesh Nikunj , Varshney Shivam
Published: December 2022

Systemic lupus erythematosus (SLE) is a multiorgan acquired autoimmune disease. The clinical picture can vary greatly. Lupus nephritis (LN), which affects about 50% of SLE patients, is associated with high morbidity and death. While renal histologic alterations are evident in almost all patients with SLE, clinical renal involvement only affects 40% to 75% of those individuals. Because of this, some patients who have nephritis on their renal biopsy may not actually have clinical kidney disease (silent nephritis). In this article, we discuss a case of silent lupus nephritis (SLN) with respect to clinical presentation, laboratory findings, diagnosis and outcome.
A retrospective study among patients undergoing laparoscopic cholecystectomy: intraoperative and postoperative complications
Authors: Rahman Anharur , Rahman Motiur , Uddin M. Saief , Taher Abu , Masum Mohammad Golam
Published: December 2022

Background: Laparoscopic cholecystectomy is a popular method to treat gallbladder diseases. But adopting laparoscopic cholecystectomy in a treatment of gallbladder diseases like symptomatic cholelithiasis or cholecystitis introduced a new spectrum of associated intraoperative and postoperative complications. The aim of this study was to assess the intraoperative and postoperative complications of patients undergoing laparoscopic cholecystectomy.Methods: This retrospective study was conducted in department of surgery of Lab Aid Hospital, Dhanmondi Central Hospital, and Ad Din Barrister Rafiqul Hospital, Dhaka, Bangladesh, during the period from December 2019 to December 2021 among 100 patients undergoing laparoscopic cholecystectomy. The intraoperative and postoperative complications were collected from the record book of the patients for this study with consent from the patients and guardians. This study was approved by the Institutional Review Board of Lab Aid Hospital and Ad Din Barrister Rafiqul Hospital, Dhaka.Results: Majority of the study people (30%) were in the age group of 52-60 years. Mean age of the study people was 50.6 years (SD±8.1 years). Majority of the study people (59%) ware female. Mean BMI of the study people was 23.33±2.26 kg/m2. Among the study people, 21% study people had smoking habit, 19% had diabetes, and 11% had hypertension. Mean operation time was 50.25±4.75 minutes. For the indications for laparoscopic cholecystectomy, most of the study people (56%) had symptomatic gallstones. The commonest intraoperative complication was trocar site bleeding (8%). The commonest postoperative complication was surgical site infection (5%).Conclusions: Although there were few intraoperative and postoperative complications, laparoscopic cholecystectomy has a low rate of mortality and morbidity making this operation a safe procedure with favourable results.
The clinical and radiological outcome of uncemented primary total hip arthroplasty in case of AVN of femoral head in middle age group
Authors: Rashid M. Mamunur , Masud M. Hasan , Alam M. Jahangir , Islam M. Sieful , Hasan M. Zahid , Hossain M. Zakir , Ferdoushi Naima , Das Bipul , Hussain Raquib
Published: December 2022

Background: The appropriate treatment of avascular necrosis (AVN) of the femoral head has become a serious problem around the world, particularly in adult instances. Objective was to evaluate the clinical and radiological outcome of uncemented primary total hip arthroplasty in case of AVN of femoral head in terms of pain relief, functional capacity, range of motion, absence of deformity, radiological assessment and comparing pre-operative and post-operative functional status.Methods: This was a prospective observational study of 44 hips of 37 patients at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh.Results: Here, majority (70%) belong to 30-35 years age group, and 75% were male. The affected site of arthroplasty among patients where highest (51.35%) patients had been affected on right side and right side number of hip was (40.42%). Among all, 30 patients underwent unilateral total hip replacement (THR), 7 patients who were affected bilaterally underwent staged bilateral THR at an interval of 6-12 weeks. According to the position of the acetabular component, anteverted in 70% patients, retroverted in 0% patients, neutral in 25% patient, <35º inclined in 0% patients, 35º-50º inclined in 65% patients, and >50º inclined in 20% patients at follow-up cases. Based on modified Harris hip score (HHS), 92% cases rated this treatment as excellent.Conclusions: Uncemented total hip arthroplasty in individuals, who have arthritis of the hip joint secondary to AVN, provides satisfactory clinical and radiographic outcome. Though the procedure is not free of complications, the overall functional and clinical outcome had shown excellent result.
Laparoscopic feeding jejunostomy using T-tube-technique and analysis of outcomes
Authors: G. Raj Nihedan K. , Ramasamy Villalan , S. Padmanabhan , S. Karthikeyan , S. Balamurali
Published: December 2022

Background: Enteral nutrition is of paramount importance in management of upper gastrointestinal tract malignancies. Although various access routes for enteral nutrition are available, feeding jejunostomy tube is preferred to other methods. Since minimally invasive techniques have many advantages, we decided to perform it during staging laparoscopy.Methods: The medical records of all patients who underwent laparoscopic feeding jejunostomy between October 2019 and September 2021, in the department of surgical gastroenterology, Madurai medical college were retrospectively reviewed. Patient demographics, ECOG performance status, types of malignancy, indications for feeding jejunostomy, operative time, time to start feeds, length of hospital stay and complications were analysed.Results: 75 patients underwent laparoscopic feeding jejunostomies (51 men and 24 women), with a mean age of 51.6±11.7 years, using this method. ECOG performance status was between 0-2. Mean operating time was 83±8.8 minutes. Mean length of hospital stay was 3.5 days. There was no conversion, however one patient required reoperation for peritubal leak.Conclusions: Feeding jejunostomy can be accomplished by a total laparoscopic technique using intracorporeal suturing. The technique we propose is relatively simple, reproducible, cost effective and can be widely adopted.
Comparison of Amritsar scoring system using quantitative contrast enhanced ultrafast magnetic resonance mammography and diffusion technique with conventional Kaiser scoring system
Authors: Kapoor Atul , Kapur Aprajita , Sidhu Bholla Singh , Singh Paramjit , Brar Navjot , Singh Jasdeep
Published: December 2022

Background: Magnetic resonance imaging (MRI) mammography has been recommended as a problem solving tool in patients with breast lump for which newer imaging protocols like abbreviated, ultrafast MRI and diffusion MRI are now available. For interpretation lexicons like BIRADS and Kaiser score system are available but there is a scope for improvement of results and need for newer lexicons.Methods: Retrospective study of 175 patients of breast lump who had MRI mammography was done. The lesions were labelled as malignant by Kaiser score system (KSS) and a newer scoring system “Amritsar score system” (AMSS). Final diagnoses was confirmed by histological examination with hormone and Her2neu receptor studies. Statistical analysis was done for correlation, sensitivity, specificity and accuracy along with area under curves and the results compared.Results: Study comprised 32/175 patients with malignant nodules. Mean age of 47.2 (range: 44.2-49.6) years with mean nodule size of 2.2 cm (range 1.8-5.5 cm). ADC and Ktrans, Kep, TTE, MS and IAUC60 showed high correlation with size of malignant nodule. Sensitivity of detection was 87.4%, 87.5%, 88.6%, 71.8% and 80% respectively for ADC, Ktrans, Kep, TTE, MS and IAUC60 while specificities were 94, 88.7, 88.7% 90% and 90% respectively. The sensitivity, specificity and accuracy for KSS and AMSS were 62.5%, 88.9%, 72% and 96.5%, 90% and 94% respectively.Conclusions: AMSS is more accurate than KSS and improves the sensitivity and specificity of cancer detection.  Ktrans and ADC imaging parameters not only show high sensitivity for cancer detection but also have a good correlation with the size and nuclear grade to be used as imaging biomarkers.
Prospective study of predictive factors for conversion of laparoscopic cholecystectomy to open surgery
Authors: Shah Unnati , Sukhlecha Akhilesh
Published: December 2022

Background:  Gallstone diseases are a common gastrointestinal illness in the general population that frequently requires hospitalization with a prevalence of around 11% to 36% The goal of this study was to determine the conversion rate and identify the factors responsible for the conversion of laparoscopic cholecystectomy (LC) to open cholecystectomy (OC).This study intends to evaluate the causes of conversion from LC to OC and to establish the efficacy and safety of the procedure. Methods: This case series was conducted in the department of general surgery at Gujarat Adani institute of medical science, Bhuj, Gujarat from October 2018 to July 2020. Patients more than 18 years of age presenting with OPD with symptomatic gallstones and patients with acalculous cholecystitis were included in the study. Patients with dilated CBD (>8 mm in diameter), jaundice, gallbladder malignancy, and perforated gallbladder were excluded. Results: A total of 100 patients were included in the study; 68 were females and 32 were males. Eleven (11%) patients were converted to OC. The most common cause of conversion was dense adhesions followed by obscure anatomy at Calot's triangle. Other common causes were bleeding, bile leakage, visceral injuries, and instrument failure Conclusions: Most common cause of conversion from LC to OC was dense adhesions causing obscure anatomy at Calot's triangle followed by bleeding and CBD injury.
A prospective study on vertical mattress suture and subcuticular suture skin closure techniques in inguinal hernia repair cases
Authors: R. Saranya , S. Padma , K. Manoj S.
Published: December 2022

Background: Sutures are used to keep tissues in place until enough healing has taken place to produce endogenous wound strength. The method of closure should be quick, simple, affordable, and successful while maximizing the cosmetic of the wound and patient outcomes. So, this study was an attempt to compare subcuticular and vertical mattress suture techniques in inguinal hernia repair. Methods: A prospective study was carried out among patients posted for inguinal hernia repair. The wound closure of the first 25 patients was done using a subcuticular suture and another by classical vertical mattress suture. Duration required for wound closure, complications, postoperative pain and cosmesis were assessed and analyzed using descriptive and inferential statistics. Results: The duration required for wound closure was higher in the subcuticular suture compared with the classical vertical mattress suture. There was no significant difference in post-operative pain, wound complications and wound cosmesis in both groups. Conclusions: Among cases with inguinal hernia repair there was no superiority in subcuticular and classical vertical mattress sutures from the patient side.
Colorectal cancer in a young adult: a case report of a rare phenomenon allowing early diagnosis and treatment
Authors: Micallef Jess , Muhlmann Mark
Published: December 2022

Despite the incidence and mortality of colorectal cancer in patients over the age of 50 years decreasing, in patients under the age of 50 it is increasing. Here we report a rare case of colocolic intussusception in a young adult male that allowed early diagnosis and treatment of colorectal adenocarcinoma.
A rare primary thyroid mixed germ cell tumour: a case report
Authors: R. W. Suriza W. A. , I. Junaidi A. , M. Helmi N. , H. Imi Sairi A.
Published: December 2022

Germ cell tumours mostly occur in the gonads. Extragonadal site is rare and mainly located in the mediastinum, retroperitoneum and pineal gland. Germ cell tumour that occurs in the thyroid gland is extremely rare. We present our first description of a patient with a mixed germ cell tumour located primarily in the thyroid gland. A 35 years old gentleman presented with two months history of thyroid swelling associated with compressive symptoms. His neck ultrasound showed multinodular goiter with suspicious nodule (TR4) and FNAC revealed highly suggestive of a malignant lesion. Subsequently, the thyroid mass progressively enlarged in size causing acute upper airway obstruction that made him collapsed at Emergency Department. Core biopsy of TR4 thyroid nodule suggestive of malignant lesion which could be mixed germ cell tumour or poorly differentiated carcinoma. Abnormal laboratory tests showed a high concentration of LDH, Alpha fetoprotein and beta-HCG. He underwent emergency total thyroidectomy, debulking and tracheostomy. Histopathology reported the mass composed of mixed non-seminomatous germ cell tumour with area of necrosis (30%), primarily immature elements (80%), yolk sac tumour (15%) and embryonal carcinoma (5%). He was scheduled for chemotherapy post operatively however he succumbed to the illness due to advanced tumour and sepsis.
Cavernous haemangioma of right nasal cavity: a case report
Authors: Roslle Nabihah , Khalid Mohamad Azizul Fitri , Paiman Noorasmaliza M. , Hamizan Aneeza Khairiyah Wan
Published: December 2022

Hemangiomas are common, benign tumors which arise from the proliferation of endothelial cells surrounding blood-filled cavities. Cavernous hemangioma of the nasal cavity is a rare clinical entity but it should be considered in the differential diagnosis of the nasopharyngeal mass and in cases with epistaxis. This lesion is usually found on the lateral wall of nasal cavity and are more common in elderly with no sex preponderance. We present a case of cavernous hemangioma arising from the sphenopalatine area in a 54-year-old female. The tumour was successfully excised by trans-nasal endoscopic approach with pre-operative surgical embolization.
Caecal endometriosis causing colo-colic intussusception: a rare cause of bowel obstruction
Authors: Thangamani P. , Kumar K. Senthil , Sivan M. , Sushmitha S. P.
Published: December 2022

Intussusception refers to telescoping of a segment of bowel into adjacent bowel. Only 5% occurs in adults. Causes include neoplasm and inflammatory causes. Caecal endometriosis causing colo colic intussusception is extremely rare condition. A 45-year-old menstruating female presented with complaints of diffuse abdominal pain with vomiting for 10 days. No history of menstrual abnormalities. P/A-mass of 8×5 cm was palpable in right lumbar and umbilical region with mild tenderness. Cect abdomen-colo colic intussusception involving ascending colon and right 2/3rd of transverse colon with no obvious lead point. Patient was taken up for emergency laparotomy and it revealed 1) Intussusception of caecum into ascending colon extending upto hepatic flexure, 2) Multiple black colored nodules over lateral pelvic wall, small bowel, omentum, mesentery, ascending sigmoid colon, 3) Anterior surface of rectum was found to be adherent to posterior surface of uterus and pouch of Douglas inaccessible, 4) Multiple nodes were identified within mesentery. Laparotomy proceeded and gentle manual reduction of intussusceptum was done and growth palpable within caecum, suspecting the growth to be malignant right hemicolectomy with ileocolic end to side anastomosis done. Post operative period uneventful, HPE-endometriosis caecum. Intussusception in adult is rare entity and endometrial mass in caecum acting as lead point has been infrequently reported. Clinical and radiological investigations are of little help in diagnosing endometriosis. Hence, high clinical suspicion is required in patients with previous history of endometriosis.
An unusual and rare presentation of mature cystic teratoma in a post menopausal woman
Authors: Quraishi Abdul H. , Jena Sanjib K. , Umare Girish , Borkar Sushrut
Published: December 2022

It is rare to encounter benign forms of mature cystic teratoma in elderly women. It has been reported that the risk of malignant transformation is doubled in patients with mature cystic teratoma aged over 50 years. We reported a case of a 52-year-old woman with a large pelvic mass. The imaging and operative findings have been described. The diagnosis was confirmed on histopathology as mature cystic teratoma.
Delayed presentation of traumatic sigmoid perforation accompanied by ileal devascularization due to mesentric tear in a patient with blunt abdominal trauma-a case report
Authors: Khan Nida , Tayade Sandip , Gvalani Anil Kumar , Pednekar Jayant , Kumar Ashwanth , Ansari Adeel
Published: December 2022

Isolated colonic injuries are unusual following blunt abdominal trauma, and often have a delayed presentation. Associated or isolated mesentric injuries of small bowel although more frequent than the former, tend to present late as well. Due to the atypical presentation, these injuries are often missed and lead to significant morbidity and mortality. We present a case of blunt abdominal trauma that presented 7 days after primary injury with fecal peritonitis leading to septic shock. Patient had a sigmoid perforation with associated mesentric tear, devascularising its corresponding bowel. Patient underwent exploratory laprotomy. A resection of perforated sigmoid colon with descending-sigmoid anastomosis along with resection of devascularised ileum and double barrel stoma were performed. Patient required intensive care in the early perioperative period. He recovered well and was discharged on post operative day 10.
Dengue fever: A global threat to human beings
Authors: Shah Ashok Kumar , Wadhwa Alisha , Tyagi Bhawna , Mudgal Mukul
Published: December 2022

The RNA virus of the Flaviviridae family, which causes the acute viral sickness known as dengue, is transmitted by Aedes mosquitoes. Asymptomatic fever to terrifying consequences including hemorrhagic fever and shock may be the presenting symptoms. The most typical symptoms include acute-onset high fever, muscle and joint pain, myalgia, cutaneous rash, hemorrhagic episodes, and circulatory shock. Even though oral symptoms are rarely the main presenting symptom of dengue infection, this can happen in some situations. To reduce mortality, an early and precise diagnosis is essential. Despite the fact that dengue virus infections are normally self-limiting, dengue infection has become a public health concern in tropical and subtropical regions. Infections with the dengue virus, their various clinical symptoms, diagnosis, differential diagnosis, and prevention are the important concern of this paper.
Applications of biosensors - A short review
Authors: Manish Abhinav
Published: December 2022

Enzyme-based, tissue-based, immunosensors, DNA biosensors, thermal and piezoelectric biosensors are explored here, revealing applications in medical fields to distinguish between natural and man-made substances. Some industries have implemented the use of biosensors, such as the food industry. Biosensors are used in metabolic engineering to enable in vivo monitoring of cell metabolism, in order to obtain accurate glucose concentrations, in fermentation industries and in saccharification processes to control its quality and safety. Biosensors and their role in medicine, including early detection of human interleukin 10, which causes heart disease, and rapid detection of human papillomavirus (HPV). It's an important aspect. Fluorescent biosensors play an important role in drug discovery and cancer diagnosis. Biosensing applications are widely used to find missing links in metabolic processes. Basically, biosensors serve as inexpensive and highly efficient devices for these purposes in addition to other routine applications.
Association of Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in breast cancer patients of Bihar: Case-control study
Authors: Verma Tanu , Lal Rohit , Kumar Manish , Kumar Uday , Shahi S. K.
Published: December 2022

Breast cancer (BC) is the most frequent cancer in women globally and the main cause of cancer-related mortality. MTHFR C677T is a functional polymorphism in the genes encoding a one-carbon metabolism enzyme that affect folate metabolism and may be associated with breast cancer susceptibility.

We have conducted a case-control study taking 100 cases of diagnosed breast cancer and 100 healthy control. PCR-RFLP technique was used to detect the genotype of C677T polymorphism in the study population.

About 35% of cases had normal genotype(C677C), 49% had the genotype C677T & rest 16% had the genotype T677T for MTHFR. Among control the frequency of C677C genotype was 55% C677T was 40% & T677T was 5%. C677T & T677T MTHFR genotype were more common in case as compared to control [χ2 (2, N = 200) = 11.12, p = 0.004]. T allele frequency was significantly higher in case (40%) as compared to control (5%) [χ2 (1, N = 400) = 10.91, p = 0.001]. Cases with MTHFR 677TT genotype had a significantly higher risk of BC than 677CC individual [OR=1.64 (1.03 to 2.10)] and increasing T-allele was significant in BC [OR=1.07 (0.71 to 1.33)] (P for trend = 0.04).

C677T of MTHFR gene has a strong correlation with breast cancer in the studied population and can be used as a prognostic marker for the development of breast cancer.
Evaluation of Dyslipidemia with HbA1c levels in Diabetes Mellitus
Authors: Malathi R. D. , Fatima Aliya , Ahmed Mohd Iqbal
Published: December 2022

Diabetes is a metabolic disease which has hyperglycaemia resulting from defects in insulin secretion or action. HbA1C is one of the most reliable test used for estimation of glycaemic index. Diabetes is often accompanied by undiagnosed dyslipidaemia, characterized by increased triglyceride level, decreased high-density lipoprotein levels and increase in low-density lipoprotein (LDL) particles. Diabetes is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD). The purpose of this study was to correlate lipid parameters with different levels of HbA1c to assess dyslipidaemia with diabetic status.

An observational study was conducted in biochemistry laboratory at Gandhi Hospital, Telangana.

After informed consent, 5ml of venous blood sample was collected in plain tube and EDTA tube from diabetic and apparently non diabetic patients. Estimation of serum triglycerides was done by glycerol phosphate oxidase peroxidase, serum cholesterol by cholesterol oxidase method, serum HDL by direct clearance method in Beckmann Coulter AU 500 and HbA1c was estimated by high performance liquid chromatography in Bio-Rad D10.

A total of 90 samples were divided into 3 groups according to their HbA1c results. Group 1 with HbA1c less than 5.6, Group 2 with HbA1c 5.6-7 and Group 3 with HbA1c more than 7.

The present study showed no variation in the lipid profile in Group1 with HbA1c < 5.6. In Group 2 with HbA1c between 5.6-7, there was significant increase in LDL cholesterol. In Group 3 with HbA1c >7 there was marked increase in LDL, serum triglyceride. Hence we can conclude that dyslipidemia is increased in poor glycemic control and evaluation of HbA1c may also be used as a predictor of dyslipidaemia in diabetics.
Four hundred IU vs One thousand IU of vitamin D supplementation in first episode of nephrotic syndrome
Authors: Lekhwani Seema , Vaswani Narain Das , Kumar Sudeep , Kamboj Pradeep
Published: December 2022

Use of steroids in nephrotic children may lead to changes in bone mineral density and osteoporosis eventually affecting growth on a long term basis. We compared the proportionate changes in bone mineral content (BMC) and density(BMD), Vitamin D levels, Serum Calcium, phosphate and alkaline phosphatase levels in nephrotic children with the aim of giving high Vs low vitamin D doses (1000 IU Vs 400 IU) to two groups; group 1 (n=20) vs group 2 (n=20) respectively. The median BMC in group 1 increased from 11.53±3.48 g to 11.61±3.54 g after 1000 IU Vitamin D supplement and was statistically significant. However group 2 showed insignificant increases in BMC from 11.24±2.71 g to 11.25±2.67 g following 400IU Vitamin D. The change in BMD observed in group 1 from a mean of 0.426 to 0.429g/cm2 whereas in group 2 with 400 IU of vitamin D it didn’t show any significant change. The median vitamin D increased significantly in both groups; from 16.62±7.20 ng/ml to 27.45±6.47 ng/ml in group 1 while in group 2 from 18.72±8.07 ng/ml to 26.18±7.61 ng/ml which was statistically significant. The serum calcium levels normalized irrespective of 1000 IU or 400 IU of vitamin D supplementation. Changes in serum phosphate levels (decline from initial) were statistically significant however the changes in serum ALP were insignificant. We concluded that children supplemented with 1000 IU /day of vitamin D had better osteoprotection as compared to the other group.
Angiotensin II type I receptor gene polymorphism in essential hypertensive and normotensive subjects
Authors: Sharma Hariom , Patel Sapna , Sharma Shreyansh , Rao Drashti , Dholakia Jagruti , Baraiya Hina
Published: December 2022

Hypertension is a polygenic disorder that involves a complex interplay of genetic and environmental factors. Genes that influence the renin–angiotensin–aldosterone system (RAAS) appear to be particularly important among the many potential candidate components of EHT. The RAAS system plays an important role in BP regulation by maintaining vascular tone and renal hemodynamics. Most of these are mediated via the activation of the angiotensin II type 1 receptor (AT1R). Untreated hypertension increases the risk of developing cardiovascular diseases such as stroke, myocardial infarction, ischemic heart disease, and, target organ damage. A polymorphism in the 3’ untranslated region of the AT1R gene has been described with either an adenine (A) or a cytosine (C) base (A/C transversion) at the 1166 position that is associated with increased blood pressure.

A total of 170 hypertensive patients and 170 normal subjects were included in the present study. Genomic DNA was isolated from peripheral blood leukocytes, amplified with PCR, and separated with gel electrophoresis to determine the AT1R genotype. On electrophoresis, the genotypes A/A-359 bp, A/C-220+139 bp, and C/C-220, 139, and 359 bp were identified.

In hypertensive patients, the CC genotype was present in 21.18 percent (n = 36) as compared to 11.76 percent (n = 20) in non-hypertensive patients. In this study AT1R CC homozygote was significantly associated with hypertension (p = 0.019). The odds ratio related to the association of the prevalence of the CC genotype with hypertension was 2.014 (95% CI: 1.112–3.650).

: From the present study, it is concluded that AT1R gene polymorphism is associated with hypertension, and with the CC genotype, the risk of hypertension increases in comparison to AC and AA. A allele is not significantly associated with hypertension, but the recessive and co-dominant modes of inheritance of allele C (CC) and its co-dominant mode (AC) are a genetic predisposition to hypertension.
Assessment of Lab request forms: How do our clinicians communicate with Laboratory?
Authors: Trivedi Dhiraj J
Published: December 2022

Central clinical laboratory is an important division in the health care setup. Laboratory results help clinical decisions, follow up care and ensure patient safety. Laboratory request Form [LRF] is an important medium between the patient, a treating clinician and Laboratory. A meticulously filled LRF is important for patient care. Providing accurate and complete information in LRF is the doctor's responsibility. Erroneous LRF will have an impact on the quality of laboratory results. Present study evaluates the degree of completeness and correctness of quality indicators on laboratory request forms [LRF] to examine preanalytical standards of laboratory services.

This study is a single center, prospective, cross sectional, descriptive type conducted at a 650 bed teaching hospital from Gujarat. In the span of a six months study period, 3735 [20% of total] LRFs were selected by simple random sampling method from the total LRF received at OPD blood collection center. They were analyzed for patient, clinician and sample identifier quality indicators along with completeness and correctness. Qualitative information was converted to quantitative by using two point scale, 0 score for incomplete information and 1 score for complete information.

Among patient identifier quality indicators name, age, gender and location were filled in more than 75% forms whereas, very poorly filled 2% provisional diagnosis and 42% MRD number. Clinician identifier quality indicator was attended to in less than 50% forms. Time and date of request were absent on 100% forms. Sample identifier quality indicator shows 97% forms with the nature of the sample and 92% having investigation requests. Test requests on one third forms were invalid and inappropriate. 38% forms were incomplete and inappropriate whereas 46% forms had error in filling one or other data indicators.

Appropriately filled LRF communicates well with the Central clinical laboratory. It will help in providing quality reports in time and benefit clinicians to manage quality care for patients. Hand written, poorly legible, inappropriately abbreviated, erroneous LRF are misleading and may compromise laboratory service and patient safety. Training and change in attitude towards LRF writing is required to maintain the standard of the health care system.
MODELAGEM DO NÚMERO DE FERIDOS E DE ACIDENTES DE TRÂNSITO NAS RODOVIAS FEDERAIS PARA O TRIÊNIO 2021-2023
Authors: Silva Leonardo Junio Borges da , Gonçalves Jussiane Nader
Published: December 2022

Os eventos relacionados aos acidentes de trânsito representam parcela importante das despesas hospitalares do Sistema Único de Saúde do Brasil. Dentre as causas externas de morbidade, no período de 2015-2020, estes eventos representaram 18,02% das internações e 20,22% do valor gasto com internações na rede pública hospitalar. No âmbito das rodovias federais, a Polícia Rodoviária Federal desenvolve campanhas educativas para sensibilização dos usuários com a finalidade de reduzir o número de acidentes de trânsito. Com base nos dados abertos de acidentes de trânsito no período de 2015 a 2020, disponibilizados no site da Polícia Rodoviária Federal, buscou-se neste trabalho, com aplicação de Modelos Lineares Generalizados, estabelecer uma modelagem para estimação do número de feridos e de acidentes nas rodovias federais para o triênio 2021-2023. Os resultados apontam para redução do número de feridos e acidentes, o que valida as ações desenvolvidas pela Polícia Rodoviária Federal, contudo, revelam uma tendência de crescimento na relação de feridos por acidente, o que deveria ser considerado no planejamento de futuras ações. Os resultados deste trabalho abrem caminho para a estimação e otimização dos diversos recursos empregados nas campanhas educativas da Polícia Rodoviária Federal para um trânsito mais seguro, com vistas à contínua redução do número de feridos e de acidentes nas rodovias federais.
Lei de cotas: Percepção da pessoa com deficiência em relação à inclusão no mercado de trabalho
Authors: Nogueira Bianca Dos Santos
Published: December 2022

Esta pesquisa teve por objetivo observar qual a percepção que as Pessoas com deficiência (PCD) tem em relação à Lei 8.213/91 (Lei de cotas) para a inclusão no mercado de trabalho. A pesquisa caracteriza-se como exploratória e descritiva e a abordagem do problema se classifica como quantitativa com enfoque qualitativo A coleta de dados foi feita por meio de um questionário, enviado pelo Google Formulários, dividido em dois blocos de questões. O primeiro bloco focou em obter informações sobre o perfil dos participantes da pesquisa, e o segundo avaliou o conhecimento e perspectiva das pessoas com deficiência em relação à Lei de Cotas e leis específicas que regulamentam os direitos ocupacionais/laborais desse grupo de trabalhadores. A pesquisa foi aplicada a 82 pessoas que se dispuseram a participar e compõem o banco de dados da Fundação Centro Integrado de Apoio ao Portador de Deficiência (FUNAD). Os dados obtidos foram organizados e apresentados por intermédio de tabelas e gráficos, avaliados por meio de estatística simples, e os dados qualitativos foram averiguados por meio da análise de conteúdo sob a perspectiva de Bardin (2011). Os resultados demonstram que os efeitos da Lei sobre a inclusão das pessoas com deficiência no mercado de trabalho dividiram as opiniões dos respondentes pois, ao passo que traz oportunidades e facilita a entrada e o envolvimento dos mesmos nas atividades trabalhistas, ela também não resolve o principal problema, que é a desigualdade perante os demais indivíduos. Além disso, seria necessária uma maior fiscalização para evitar que as empresas não somente cumpram com a obrigatoriedade do oferecimento de vagas, mas que finalizem as contratações.
A Little Fifteen
Authors: Man Tomasz
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
What Is Art?
Authors: Begay Les
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
My Answer to “What Is Art? Horizons of the Creator and Recipient”
Authors: Trojanowska Tamara
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
What Is Art?
Authors: Corby James
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
How Do Nonhuman Animals Make Art? Art as a Practice of Interspecies Questioning
Authors: Cull Ó Maoilearca Laura
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
What Is Art: The Viewer’s Horizon
Authors: Derdziuk Andrzej
Published: December 2022

The presented statement is part of the volume it covers a variety of responses from people who interact with art in different ways. The aim is to suggest to the participant of the contemporary world a new, personal perspective to rethink what is this area of our world that we label with art; thoughts with and without theoretical suggestions - reflections by the creators and reflections by the audience, teaching humility and uniqueness, perhaps - forming a fresh perspective on art.
Worship as Cognition, Intentionality and Freedom
Authors: DÜZGÜN Şaban Ali
Published: December 2022

Worship/ibādah is commonly defined as the innermost capability of cognizing of all rational beings of the existence of God and the sense of gratitude towards Him. The oft-quoted verse from the Qur’ān, Chapter al-Dhāriyāt, verse 56, is interpreted to this cause: “And tell them that I have not created the invisible beings and men to any end other than that they may (know and) worship me.” The intuitive knowledge requires them with conscious willingness to know His reality and conform their own existence to that of God. Analyzing worshipping act is to analyze the worshipper and his nature; so, it is necessary to engage in such a detailed probe of the composition of the human being as it is vital to our goal of showing how the personality of a human being is satisfied with the worshipping act. Therefore, analysis of human being as a worshipper brings us face-to-face such terms as intentionality (niyah), cognition (ma‘rifah) and freedom (hurriyah). Through his intentionality, human beings transcend the natural causal nexuses they are part of. We know that as part of nature and causal nexuses human beings have always been called to ponder about the created beings (how the sky is exalted, how celestial bodies are manifested as ornament, etc.), all of which are intended to affect his ‘will’ and orient it to this cause. Cognition, intentionality/willingness and freedom give the deepest meaning to what the Qur’ān describes as worship/ibādah, which is designed as an instrument for the inner development of the worshipper, who by the act of conscious/intentional self-surrender to the all-pervading Creative Will of God encounters with numinous One. Symbols in the worshipping act and the meaning every single act conveys during worship always remove the tension of this encounter, a phenomenological tide. Through this encounter, a worshipper transforms himself/herself into an ethical agent. The conditions that are necessary before, during and after prayer are intended to meet this essential end. The Qur’ānic verse, “Surely Prayer forbids indecency and evil” as post-condition of prayer is a call to create an ethical subject. And perseverance in prayer will turn this ethical subject into a subjected ethical subject which means ethical codes and norms willy-nilly arises from him. Al-amr bi’l ma’rūf and al-nahy ‘an al-munkar/enjoining the doing of what is right and avoiding doing of what is wrong is not but the manifestation of this exposed subject (determined or oriented subject), which means ethical behaviors necessarily become an indispensable part of him. Worship is a demand for recognition. It is a transpersonal act, aiming to satisfy the desire of finite being to transcend its finiteness. But at the end of worshipping act not unification, on the contrary a total clarification of the limits and borders between the two becomes much more evident.
Phase frequency characteristics evaluation for E-class devices output circuits
Authors: Baranov Alexander V.
Published: December 2022

Based on the unitarity of the E-class device circuit [S]-matrix, the phase frequency characteristics are estimated for the output circuit at any harmonic of the fundamental frequency. Formulas are derived for approximate phase frequency characteristics of an E-class device model with a switch that operates in two states corresponding to either zero or infinite active resistances. Using the example of the presented phase-frequency characteristics of the E-class power amplifier layout, the validity of the formulas obtained is confirmed. Taking into account the conclusions drawn from the formulas, recommendations are formulated for making additions to the well-known methods of designing E-class devices. These techniques can be supplemented by the introduction of parameter settings of the elements of the output circuits, for which the established estimated values of the phase frequency characteristics of the output circuit on harmonics are most respected with the maximum possible number of them.