bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Sustainability in Halal Supply Chain
Authors: Ghalih Muhammad , Chang Chia-Hua
Published: August 2024

This chapter explores the role of sustainability in HSC and offers a framework for aligning these chains with Environmental, Social, and Governance (ESG) criteria and Sustainable Development Goals (SDGs). It emphasizes the importance of environmentally friendly, socially responsible, and ethically governed practices in HSC. The chapter introduces ESG criteria and explains their relevance to halal supply chain management, highlighting the need to incorporate these criteria into supply chain strategies. It also discusses how HSC can contribute to achieving SDGs by adopting sustainable practices, such as responsible sourcing of halal ingredients, green logistics, and socially responsible production practices. Case studies highlight successful implementation of sustainable practices in HSC, while also addressing challenges and opportunities, including regulatory issues and possibilities for innovation and collaboration. The chapter concludes with recommendations for practitioners and policymakers to enhance sustainability in HSC, along with suggestions for future research directions.
Sustainable Architecture in India
Authors: Thakur Anusha
Published: August 2024

As the Indian cities skylines an upward architectural trajectory, the country stands on the precipice of a revolutionary era. In the ever-evolving field of design, engineering, and construction, specialists creating environments that represent modern values, need to be abreast with both the present as well as past trends. The green wave widening across the infrastructure industry bolsters state-of-art innovativeness in technology and design. The amalgamation of environmental consciousness and parametric designs has completely revolutionized the sustainability paradigms. Increasing concepts of net-zero buildings are gaining traction, with an emphasis on the designing of structures generating energy as per consumption. Sustainability is becoming the fundamental consideration in each stage of the architectural process. Creating buildings that minimize environmental negativity and bolsters positivity is the need of the hour. The chapter examines the trends shaping the future of the industry with the amalgamation of innovativeness and conventional design elements in the dynamic and rich field of Indian architecture. It further contemplates the different real use cases exemplifying the ways sustainable designs owe the capability to shift toward the benefit of the communities and the environment.
Influência da concentração de substrato na síntese simultânea de Proteases e Amiloglicosidase em cultivo submerso de Aspergillus awamori NRRL 3112 com pré-sacarificado de amido de milho
Authors: Rosa Climaco Leticia , Roder Celise , Olivo José Eduardo
Published: August 2024

O presente estudo avaliou a influência que a concentração inicial de substrato teve no cultivo submerso de Aspergillus awamori NRRL 3112, para a síntese de amiloglicosidase e protease, com o amido de milho pré-sacarificado. Realizaram-se dois ensaios, analisando, entre outros, as taxas de bioconversão. Os resultados indicaram que o ensaio realizado com maior concentração inicial de substrato apresentou melhor desempenho, com valores como Y(AMG/S) e Y(PTS/S) de 33,43 e 294,64 U/g respectivamente.
High-Quality SiC Crystal Growth by Temperature Gradient Control at Initial Growth Stage
Authors: Lee Chae Young , Lee Seung Jun , Park Jong Hwi , Choi Jung Woo , Kim Jung Gyu , Ku Kap Ryeol , Na Jun Hyuck , Kang Min Kyu , Lee Won Jae
Published: August 2024

A modified process condition has been proposed for the growth of high-quality 6-inch 4H-SiC single crystal. Temperature gradient (dT[°C] = Tbottom-Tupper) was controlled by changing coil position in order to investigate the effect of the temperature gradient on the SiC crystal quality. SiC ingot surface and etch pit density (EPD) of etched SiC wafer were investigated according to different dT conditions at the initial stage of SiC crystal growth. The surface of SiC crystal ingots grown with different dT for 10h were observed by OM and etched SiC wafers were prepared from SiC crystal ingots after main growth step for 100h. Different dT conditions in the initial growth stage resulted in dramatically different surface images and the crystal quality evaluated by EPD.
Cost-Effective Hydrothermal Synthesis of Luminescent Carbon Dots from Date Palm Midrib
Authors: Hassan Omnia Hussny , Saad Ahmed Sayed , Ghali Mohsen
Published: August 2024

Nanocarbon synthesis from diverse sources has garnered significant attention, with a particular focus on materials derived from biomass. Carbon dots (CDs), due to their water solubility, low toxicity, and biocompatibility, have emerged as promising candidates for a wide range of applications. In recent years, CDs have found utility in several applications such as bioimaging, drug delivery, and biosensors. In this study, we present an eco-friendly, straightforward, and cost-effective technique for the synthesis of carbon dots through a hydrothermal reaction, utilizing peeled date palm midribs as the source material. High-resolution transmission electron microscopy, X-ray diffraction, UV-visible absorption spectroscopy, photoluminescence analysis, Fourier-transform infrared spectroscopy, and zeta potential measurements services to investigate the synthesized carbon dots' morphology, crystal and structure, and optical properties. The results show that the carbon dots had a size distribution ranging from 2.5 to 6 nm, and a crystallographic interplanar distance of 0.23 nm corresponding to the graphitic structure. When excited at a wavelength of 340 nm, the synthesized dots exhibited a prominent bluish emission at 420 nm, highlighting their potential for use in optical and biological applications. This work underscores the feasibility of harnessing sustainable biomass sources, such as date palm midribs, for the green synthesis of carbon dots with desirable properties, opening up new avenues for their utilization in cutting-edge technologies.
Regularities of Martensitic Transformations in New Medium-Entropy Single Crystals of CoNiAlFe Alloys
Authors: Eftifeeva Anna Sergeevna , Fatkullin Ilya , Tagiltsev Anton , Panchenko E.Yu. , Anikeev Sergey G. , Chumlyakov Yuriy
Published: August 2024

This paper deals with the martensitic transformation and functional properties in the quenched single crystals of the Co35Ni35Al28Fe2 medium-entropy alloy, oriented along the [001]B2-direction. The microstructure and chemical composition of the single crystals have been studied in detail using transmission and scanning electron microscopy. The {111}L10 martensite twins up to 10-20 nm width and γ/γ′-phase precipitations larger than 100 μm are detected. The thermoelastic B2-L10 martensitic transformation upon stress-free cooling/heating in single crystals of Co35Ni35Al28Fe2 alloy is characterized by the accumulation of elastic energy, which is the driving force of the reverse martensitic transformation, and the low dissipation energy. The reverse transformation starts at lower temperatures than the forward transformation Ms>As. The regularities of the stress-induced B2-L10 martensitic transformation change due to an increase in the contribution of the dissipated energy and Msσ<Asσ. There is shape memory effect with the reversible strain (3.2±0.3)% and high temperature superelasticity with the reversible strain (3.3±0.3)% in the temperature range from 323 K to ≥548 K in the [001]B2-oriented single crystals. These crystals withstand stress up to 1200 MPa in compression without destruction.
Influence of the Size Distribution of the SiC Powder Source on the Shape of the Crystal Growth Interface during PVT Growth of 4H-SiC Boules
Authors: Schultheiß Jana , Ihle Jonas , Usseglio Nanot Sandro , Bonanomi Simone , Callejo Munoz David , Hammer René , Wellmann Peter J.
Published: August 2024

We compared the evolution of three different SiC sources during standard PVT growth runs. The evolution of the growing crystal and the morphological changes in the SiC source were visualized using in-situ X-ray visualization. Computer simulation was used to calculate the temperature field distributions. It is found that the densification and shrinkage of the SiC source material during the growth process can affect the growth conditions in such a way that the convexity of the growth interface is increased in an unfavorable manner. While unfavorable growth conditions can be related to thermal properties due to less favorable SiC powder evolution, predicting such behavior is a rather complex task that still relies on the support of experimental methods.
Enhancing Diabetic Retinopathy Detection Accuracy with Convolutional Neural Networks
Authors: Kumari H. M. L. S. , Walgampaya C. K.
Published: August 2024

Diabetic Retinopathy (DR) has emerged as a major illness that makes diabetic patients blind worldwide. If this disease is not treated promptly, it can progress to permanent blindness. Having the ability to identify people with DR rapidly will be beneficial for both medical professionals and researchers. In the current situation, manually analysing each minute nerve cell from fundus pictures is extremely time-consuming for clinicians. This paper not only concentrates on diabetic retinopathy detection but also on the analysis of DR progression in the given fundus image, which is performed with the help of data augmentation, Convolutional Neural network and transfer learning algorithms. Deep learning models DenseNet121, DenseNet169, DenseNet201, Resnet50, and InceptionV3 models are used on the Diabetic Retinopathy dataset in Kaggle and APTOS. Five DR stages, which are no DR, mild DR, moderate DR, severe DR and proliferate DR, are handled in this work. The fundus images of the eye are used as input to the model. The most robust model in the evaluations, DenseNet201, achieved an accuracy of approximately 98.56% for the APTOS dataset and 97.14% for the Diabetic Retinopathy dataset in Kaggle. These results were obtained using 5-fold stratified cross-validation and hyperparameter tuning, for detecting retinopathy and assessing its stage.
Effect of Different Irrigation Levels on Yield Attributes of Black Pepper (Piper nigrum L.)
Authors: Priyadarshana R .W. I. B. , Subasinghe H. M. P. A. , Ranawana S. R. W. M. C. J. K. , V H. M. S. K.
Published: August 2024

The growth of black pepper cultivations in Sri Lanka has been restricted to the Wet Zone of Sri Lanka due to lack of sufficient soil water in the Dry Zone as well as in certain parts of the Intermediate Zone. Therefore, identification of optimum irrigation level to get a higher yield of black pepper is vital as such information is limited. A pot experiment was conducted under protected environmental conditions to determine the effect of different irrigation levels on yield attributes of black pepper. Weekly irrigation was administered to three-year-old MB-12 vines at three different levels (8, 4, and 2 L vine-1 week-1; 8 L vine-1 week-1 represents near field capacity) with 3 replicates each. The experiment design was Completely Randomized Design (CRD). Black pepper vines provided with an irrigation level of 8 L vine-1 week-1, recorded significantly higher (P<0.05) mean values for yield attributes such as dry weight of berries of 10 spikes (40.5 g), spike length (11.76 cm), number of spikes per vine (81), number of berries per spike (87.4), and spike filling percentage (88.9%). In conclusion, irrigation level near field capacity (8 L vine-1) is preferable to get a greater yield from black pepper. Further studies are suggested at the field level before making a solid recommendation.
Impact of microlearning on academic performance of students in higher education: A systematic review and meta-analysis
Authors: Senandheera V.V. , Muthukumarana C.K. , Ediriweera D.S. , Rupasinghe T.P.
Published: August 2024

Microlearning is an innovative pedagogy which is the process of learning through small-sized, well-planned learning units and short-term learning activities. The objective of this study was to conduct a systematic review and meta-analysis to evaluate the impact of microlearning compared to macro-learning on the academic performance of students enrolled in higher education. Studies conducted on microlearning in higher education, in which the academic performance in theoretical examinations following microlearning method was evaluated quantitatively and compared with macro-learning. Studies which were reported in English language were included in this review. Ten databases were searched including SCOPUS, EBSCOhost, Emerald, JSTOR, Taylor & Francis, PubMed (MEDLINE), Oxford University Press, ERIC, ACM and IEEE Xplore. The search retrieved 602 studies and 12 studies were included in the systematic review. Cochrane’s risk of bias tool was used for the risk of bias assessment of the included studies. Five studies were included in the meta-analysis which was conducted using the RevMan 5.4 software. Meta-analysis showed a higher academic performance in students learned using microlearning (n=344) compared to the students learned using macro-learning (n=310) (p = 0.03). The overall mean difference in academic performance in relation to post-test scores in theoretical examinations between microlearning and macro-learning groups was 12.6 (95% CI: 1.2 - 23.9). Microlearning has contributed to a substantial increase in academic performance among students in higher education compared to macro-learning. Microlearning can increase academic performance of students by reducing cognitive load, providing flexible learning environment, promoting self-directed learning and by providing timely feedback.
Powers of the Local Authorities at the Grassroots Level in the Process of Development Planning in Sri Lanka
Authors: Hemakumara G. P. T. S.
Published: August 2024

A development plan implanted at the grassroots level such as a city is one of the physical plans consisting of three sub-plans, i.e. National Physical Plan, Region Plans, and Town Plans. This paper focuses on the laws of the local authorities and their powerfulness in comparison to different agencies and central government arms recently set up to implement similar tasks. Authorities such as the Municipality Council have convinced powers to implement development planning for the betterment of society and to set up public comfort and conveniences through their enforcement and implementation together with its planning agency, the Urban Development Authority (UDA). The remaining local authorities such as in rural areas, are still vesting their powers through the Housing and Town Improvement Ordinance of 1915. This paper discusses the core planning powers of Local Authorities (LAs) and their importance to the general public as a law.
Women’s experiences with continuity for effective coordination during maternal and neonatal continuum in Kenya: An interpretive phenomenology
Authors: Wainaina Grace M. , Kaura Doreen K.
Published: August 2024

Background: Embracing women’s experiences in decision-making is imperative for continuity in effective coordination of maternal and neonatal health (MNH); women are the end users within the care ecosystem. Through women’s continuous feedback, skilled birth attendants (SBAs) and the healthcare system get to understand emerging issues based on their needs and preferences.Aim: The purpose of this article is to describe women’s experiences of continuity for effective coordination of care through the transitions in the MNH continuum in Kenya.Setting: The study was conducted in selected counties of Kenya based on birth rates per woman as follows: Wajir (7.8) Narok (6.0) Kirinyaga (2.3) and Nairobi (2.7) (1). The clients were interviewed concerning their experiences of the MNH continuum of care in English and Kiswahili.Methods: An interpretive hermeneutic phenomenological approach was used to construct the experiences of women of continuity during transitions in the MNH continuum for effective care coordination. Twelve participants were interviewed between January and April 2023. Atlas ti 22 software was used for data analysis.Results: Four women experiences were highlighted: Women unawareness of preconception care, use of prenatal care, labour, birthing and postpartum flow and the women’s view on the MNH continuum.Conclusion: The women reported their segmental and transitional experience of the MNH continuum as one that did not consistently meet their needs and preferences in order for them to fully agree that the continuum enhanced continuity for effective coordination. They felt that they experienced continuity in some segments while in some they did not.Contribution: The embrace of women’s experience of their needs and preferences through the MNH continuum (segments and transitional segments) through the lens of continuity for effective coordination is timely towards the improvement of maternal and neonatal care by 2030.
The composition of listed family firm boards in South Africa: Alignment to best practices and governance codes
Authors: Dos Santos Gabriela , Viviers Suzette , Venter Elmarie
Published: August 2024

Purpose: As elsewhere in the world, family firms (FFs) play a critical role in the South African economy. There is, however, scant research on how, if at all, listed South African FFs differ from their non-family counterparts concerning board composition and independence. The purpose of this study was to address this knowledge gap by investigating director and chair independence, chair-chief executive officer (CEO) role duality, board race and gender diversity, as well as board rotation at FFs listed on the Johannesburg Stock Exchange (JSE) over the period 2006 to 2022. The study was informed by the agency, socioemotional wealth, and stewardship theories.Design/methodology/approach: Data were collected on 753 directors who served on the boards of 37 JSE-listed FFs. Data sources included Bloomberg and the FFs’ integrated reports and websites. Data were analysed by examining trends in the considered variables over time.Findings/results: While family involvement at board level remained relatively constant, considerably fewer family members served as board chairs and CEOs towards the end of the research period. Board independence increased significantly over the research period.Practical implications: Shareholder activists’ requests for improved board governance of JSE-listed FFs seem justified. Activists should, however, also consider the benefits of family stewardship when evaluating director and chair independence in these firms. This study also identifies practical implications for nomination committees and investor education.Originality/value: The use of multiple theoretical lenses provides a balanced view of board governance at JSE-listed FFs. The study contributes to the scant body of knowledge on board composition and independence in listed FFs in South Africa, which will enable future FF research.
Does integrated talent management foster competitive advantage in higher education institutions?
Authors: Abiwu Lawrence , Martins Isabel
Published: August 2024

Orientation: Today, industries and academic institutions across different continents, including those in South Africa, compete for the same talent, which presents the most valuable asset of an organisation. The surge in talent rivalry means that employers need to adopt strategies to distinguish themselves from their rivals.Research purpose: The aim of this study was to develop a conceptual model to better understand how talent management (TM) creates value for higher education institutions.Motivation for the study: Talent management research is primarily built around an exclusive approach to TM, yet how it works in practice and is implemented, conceived and developed in higher education, remains unclear. Hence, this study is needed to understand how integrated TM fosters competitive advantage in higher education institutions.Research approach/design and method: A quantitative research method was, by means of a questionnaire. Primary data were collected from 265 academics across three universities in South Africa. The data were analysed using the Statistical Package for the Social Sciences and Analysis of Moment Structures.Main findings: The results revealed that integrated TM practices (i.e. talent attraction, development and retention) positively contributed to sustainable competitive advantage of higher education institutions.Practical/managerial implications: The study provides a better understanding of the role of integrated TM in improving competitive advantage. Also, the study will help shape the policy-making process on TM in higher education institutions.Contribution/value-add: This study adds value to TM literature by designing a conceptual model for higher education institutions to achieve sustainable competitive advantage.
Validity of focal laser photocoagulation followed by a single intravitreal ranibizumab injection for retinal artery macroaneurysm
Authors: Ewais Wael A. , Ali Lamia S. , Nossair Ashraf A.
Published: August 2024

Background

To evaluate safety and efficacy of dual focal laser (DFL) followed by a single intravitreal ranibizumab injection for exudative retinal artery macroaneurysms (RAM).

Methods

Retrospective review of records of eyes with RAM; treated between February 2012 and November 2020; was done, to collect and analyze the following data: Treatment details, features of RAM, associated retinal disease, best-corrected visual acuity (BCVA), central macular thickness (CMT), signs of RAM involution, and possible complications. We enrolled cases that had been treated by Direct and perilesional focal laser, followed by a single intravitreal ranibizumab injection a few days later, and had been followed-up for at least 6 months. Outcome measures included: change in BCVA, change in CMT, and complications.

Results

14 patients were enrolled. All cases were isolated RAM (without other retinal disease) with macular edema±hard exudates (100%). 12 cases (85.7%) were exudative, and 2 cases (14.3%) also had a hemorrhagic component (mixed type). Hemorrhagic macroaneurysms without exudation were not included in the study. RAM was fusiform in 12 cases (85.7%) and saccular in 2 cases (14.3%). RAM involved the upper temporal arcade in 10 cases (71.4%) and the lower temporal arcade in 4 cases (28.6%). RAM involved second order arteries in 10 cases (71.4%) and third order arteries in 4 cases (28.6%). Logarithm of the minimum angle of resolution (LogMAR) BCVA improved from an initial 0.71±0.35 to 0.27±0.26 at final follow-up. CMT was reduced from 417±82 μ to 285±31 μ at final follow-up. The mean interval between laser and ranibizumab injection was 3.2±2.9 days. The mean follow-up duration was 8.0±2.6 months. Involution/thrombosis- fibrosis of RAM was induced in all cases (100%).

Conclusion

Combined dual focal laser coagulation and single intravitreal ranibizumab injection for RAM are safe and effective, and may eliminate the need for repeated intravitreal injections. Isolated exudative macroaneurysms may be suitable for this combined approach.
Studying the effect of intrastromal anti-vascular endothelial growth factor injections on corneal neovascularization using optical coherence tomography angiography
Authors: Ahmed Ayoub Hussein Mohamed Sherif , Mousa Amr Saleh , Hamdi Momen Mahmoud , Mousa Rasha Mohamed , Awad-Allah Mo'mena Ahmad A.
Published: August 2024

Purpose

To evaluate the effect of intrastromal injection of anti-vascular endothelial growth factor (Anti-VEGF) on corneal neovascularization using spectral domain Optical coherence tomography angiography imaging (OCTA).

Patients and methods

This is a pilot study that was conducted on 10 eyes of 10 patients with corneal neovascularization who were planned for keratoplasty or after keratoplasty. Intrastromal injection of 5 mg/0.2 ml [2.5%] bevacizumab using a 30 Gauge needle was performed. OCTA was done 48 h before the injection, 1 week and 1 month after the injection. OCTA images were compared to evaluate the effect of Anti-VEGF on corneal neovascularization.

Results

Comparing the OCTA pictures with the preoperative period, at 1 week period, 9 cases have shown decreased corneal neovascularization, with only 1 case that has not changed and seemed to be unresponsive to the single injection of Anti-VEGF. At 1 month period, 8 cases re-vascularized again but none of them reached the preoperative level, 1 case had decreased vascularization (completely disappeared) and 1 case remained the same with no change.

Conclusion

A single injection of bevacizumab has a temporal effect on corneal neovascularization. No local or systemic complications have been noted. OCTA was able to visualize vessels in 3-D image, even under vascularized corneal scars. OCTA was able to recognize subtle changes in corneal neovascularization that were not visible by slit lamp.
Awareness of childhood visual impairment
Authors: Zaki Rania G.E. , Elshinawy Reham F. , Naguib Karim M.
Published: August 2024

Aim of the study

The aim was to evaluate the level of awareness among parents and caregivers of visually impaired children.

Methods

This was a prospective cross-sectional study that was conducted on parents/caregivers of visually disabled children to assess their realization of visual impairment through a structured questionnaire.

Results

The respondents included 604 parents/caregivers of visually impaired children. The results revealed that 48% were mothers, 82.1% were college graduates, 26.4% were aware of the availability of visual impairment rehabilitation, 66.9% believed that early detection of the child visual impairment was family’s responsibility, and 57.1% thought that the environment plays a key role in forming these children’s personality. Overall, 93.4% agreed that the family’s culture and social awareness play a key role in avoiding psychological burden, 91.9% agreed that the proper awareness campaigns have a significant role in mitigation of the children’s psychological burden, and 91.9% agreed that these programs could have a positive effect of the children’s educational career. The primary source of information was through the ophthalmology clinic, as reported by 45.6% of participants. In addition, 84.9% believed that these children should join regular schools, and 96.2% agreed that providers of educational services should be trained. Moreover, 51.7% were aware of the presence of special schools for these children. Furthermore, 51.5% believed that with the help of the family and environment, children with visual impairment could adapt in the society, and 65.2% agreed that these children could lead an independent life.

Conclusion

Raising public awareness particularly among families about the childhood visual impairment is crucial to foster understanding and acceptance of children with visual impairment, so that they can face challenges, interact with community, adapt to their surrounding environment, and lead an independent life.
Frequency of class 1 human leukocyte antigen allele subtypes in Egyptian patients with idiopathic uveitis
Authors: Bahgat Dina M.R. , Gad Alaa A. , Kosmass Walid R. , Fadel Mariam R. , Abdelraouf Fatma H.
Published: August 2024

Bacground

Idiopathic uveitis is the most common uveitis type and is viewed as an inconclusive diagnosis for patients as well as physicians. Human leukocyte antigen (HLA) typing helps in understanding the pathogenesis of several diseases. Limited knowledge is known regarding the association of HLA with idiopathic uveitis.

Aim

This was a cross-sectional observational case–control study evaluating HLA-A and HLA-B allelic and phenotypic frequencies in patients with idiopathic uveitis.

Patients and methods

HLA-A and HLA-B molecular typing by PCR-sequence-specific oligonucleotide probes and LIRAS interpretation software was performed for 60 patients with idiopathic uveitis and 60 controls recruited from Kasr Al-Ainy Hospitals, Cairo University.

Results

Anterior uveitis pattern was the most common (55%), followed by pan-uveitis (35%) and posterior uveitis (10%). Overall, 40% of patients had bilateral uveitis, whereas 60% had unilateral uveitis. A total of 23 HLA-A and 43 HLA-B variant alleles were detected. HLA-A*09 and HLA-A*10 allele and phenotype frequencies were significantly higher in the patient group (P=0.023 and 0.034, and P=0.013 and 0.029, respectively). HLA-B*07 allele and phenotype frequencies were significantly higher in the control group (P=0.007 and 0.006, respectively). HLA-B*27 and HLA-B*05 were detected in 8.3 and 26.7%, respectively, with no significant difference.

Conclusion

HLA-A*09 and HLA-A*10 alleles were statistically significantly higher in patients with idiopathic uveitis. HLA-B*07 might be a protective allele against disease development. Larger cohort needs to be tested to validate these findings. Routine HLA typing and proper follow-up for primarily diagnosed idiopathic uveitis is recommended as it might reveal secondary causes for uveitis, especially in patients with positive HLA-B*27 and HLA-B*05.
Procrastinating necessary evolution awaiting a calamity: The journey post the morcellation saga
Authors: Trivedi Soumil Prakash , Trivedi Prakash Harikant , Trivedi Aditi Soumil , Kar Kaustav , Kar Malvika Tiwari
Published: August 2024

This review article highlights the need for the timely adoption of various containment devices for tissue retrieval of large specimens, especially myomas and large uteri, irrespective of the minimally invasive surgical route or modality used for debulking, principally focusing on morcellation. This article aims to share the feasibility and safety profile of laparoscopic contained power morcellation and also to provide a basic comparative overview of various other tissue retrieval techniques currently employed. The authors share their technical experience of nearly 3000 cases of laparoscopic contained in-bag morcellation of fibroids or large uteri, which required debulking for retrieval and also the possible limitations. The authors found this technique viable, safe, and effective in reducing potential hazards of uncontained morcellation such as parasitic fibroids, leiomyomatosis peritonei and also reducing possible up-staging of cancers, but believe there is a pivotal role of preoperative diagnostic differentiation of any malignant conditions, which may be lacking in some cancers such as leiomyosarcoma. In conclusion, the authors urge to make this necessary evolution in tissue retrieval techniques rather than procrastinating for other multiple calamities to strike again.
Learning curves in robotic surgery: A retrospective analysis
Authors: Padte Kedar , Padte Jayashri , Pawar Uddhav , Gadkar Jyoti , Patil Shailaja
Published: August 2024

Purpose:

The purpose of this study was to outline the surgical outcomes associated with learning curves before and after achieving proficiency in the first 150 robot-assisted hysterectomies in an individual surgeon.

Methods:

We retrospectively analyzed the outcomes of patients who underwent robotic hysterectomy between February 2021 and August 2023. All perioperative details of each procedure were meticulously recorded by qualified personnel using standardized case report forms. The collected data included various parameters, namely, age, body mass index (BMI), obstetric and medical histories, and operative characteristics.

Results:

The mean patient age at the time of surgery was 49.8 years, and the mean BMI was 28.5. The mean total operative time was 98.6 min, the mean total docking time (DT) was 13.3 min, and the mean console time (CT) was 33.5 min. The mean estimated blood loss was 66.1 mL and the mean specimen weight was 281.1 g. Most patients were discharged 2.62 days after surgery. The analysis of patients by the learning curve showed that the operation, DT, and CT were significantly longer in patients treated before the surgeon achieved proficiency versus those treated after.

Conclusion:

Robot-assisted hysterectomies performed in the later phases of the surgeon’s learning curve showed significant decreases in operative, DT, and CT. Surgical proficiency, as measured by operative time, was attained in 50–60 cases.
An unusual case of neuroendocrine tumor
Authors: Raj Mala , Dalal Sharayu Parth , Palaniappan Rajashree
Published: August 2024

Introduction:

Neuroendocrine tumour is defined as tumour arising in specialised cells called neuroendocrine cells who show traits of nerve cells and hormone producing cells. These slow growing tumours are more common in adult female than in males or children and often present with vague symptoms. This report highlights unusual case of NET diagnosed incidentally intraoperatively.

Clinical Case:

A 46 yrs. old P2L2, menstruating women was referred with complaints of mild lower abdomen pain for 3 months. Since patient was symptomatic and USG inconclusive, MRI pelvis was done which revealed a well marginated thin-walled lesion in left paracentral presacral area suggestive of Para-ovarian or Haemorrhagic cyst. Patient posted for laparoscopy in view of adnexal cyst and intraoperative findings revealed normal uterus, bilateral tubes, and ovaries with no evidence of para-ovarian cyst. On examining lateral pelvic wall, a paracentral mass lateral to left uterosacral ligament was noted, excised, and retrieved in toto. Histopathology and immunohistochemical analysis suggestive of well differentiated Neuroendocrine tumour of WHO GRADE 2. Primary was noted in anterolateral wall of mid-rectum and colonoscopic biopsy confirmed the diagnosis followed by which low anterior resection of rectum was performed. Patient was followed for postoperative recovery and discharged.

Conclusion:

According to literature there is often a delay of average 52 months before patient reaches its correct diagnosis. High index of suspicion remains a key to clench diagnosis in such cases.
Factors Determining Risk of Contralateral Lower Limb Amputations in Unilateral Dysvascular Transfemoral and Transtibial Amputees
Authors: Muthusamy Ambikaveni , Thirunavukkarasu P. , Rajakumar A. , Chitrarasu K. , Kamakshi R. M. , Premalatha K. , Guna A.
Published: August 2024

Background:

This study deals with the factors influencing contralateral lower limb amputations among unilateral dysvascular transfemoral and transtibial amputees.

Aim:

(1) Early identification of risk factors responsible for amputations in contralateral lower limb. (2) To determine the preventive measures of the concerned risk factors. (3) The aim of this study was to determine the risk factors associated with, contralateral amputation in patients with chronic limb threatening ischaemia (CLTI).

Study Design:

Cross-sectional study, 45 patients with unilateral transfemoral and transtibial amputees due to diabetes and peripheral arterial disease (PAD) were recruited for this study.

Materials and Methods:

Analysis of risk factors by ankle-brachial index (ABI), Claudication Pain Scale.

Results:

Unilateral transfemoral and transtibial amputees due to diabetic foot syndrome and PAD are at 2–4 times increased risk for contralateral lower-limb amputations.

Conclusions:

Risk of anticipated contralateral limb amputation is high based on ABI and Claudication Pain Scale. All patients, but particularly those at increased risk, should undergo close surveillance and counselling to help prevent subsequent amputations in their contralateral lower extremity.
Footwear Modification in Patients with Peripheral Neuropathy by Use of Three-dimensional Force Plate
Authors: Saha Swati , Kumar Sanyal , Kumar Anjani , Pandey Sanjay Kumar
Published: August 2024

Background:

Peripheral neuropathy is the most common chronic complication of both type 1 and type 2 diabetes, with an estimated lifetime prevalence exceeding 50%. Loss of cutaneous sensory information from the foot sole is reported to be a critical factor contributing to walking instability, poor balance and falls, in people with diabetic peripheral neuropathy (DPN). Although there is a very little evidence in the literature on the effectiveness of microcellular rubber insoles, they may offer a new rehabilitative approach, which promotes self-management by the user, to improve balance and walking, and reduce the risk of falling, in adults with diabetes and this study aims to find out the effectiveness of microcellular rubber insoles in peripheral neuropathy.

Materials and Methods:

This was a prospective observational study. A total of 30 patients with DPN, fulfilling the inclusion criteria, were selected for the study. All of the participants were clinically tested for the presence of neuropathy and evaluated by the force platform, after which they were advised to wear micro cellular rubber insole footwear (which was made in institutional set up as per patient’s foot size) for a period of 4 weeks. At the end of the stipulated period, the participants were again evaluated on the same parameters in the force platform.

Results:

After 4 weeks of intervention, there was a significant improvement in the postural stability as evidenced by a decrease in the mean of anterior–posterior sway (7.1225 ± 0.7102/5.7972 ± 0.6901) (P < 0.0001). Mean mediolateral sway also shows an improvement (4.9570 ± 0.5106/3.9639 ± 0.5749) (P < 0.0001). Similarly, improvements shown in mean sway area (368.4048 ± 58.9558/313.8788 ± 57.5957) (P = 0.0040) and sway velocity (23.2842 ± 2.1151/21.8840 ± 1.8419) (P < 0.0001). The step length, however, did not show any statistically significant improvement (0.6474 ± 0.0524/0.6333 ± 0.0597) (P = 0.2820). There was a significant reduction in the vertical component of the ground reaction force post-use of the insole (737.4333 ± 73.1577/659.3667 ± 82.7937) (P < 0.0001) with a reduction of 13% mean value.

Conclusion:

This study demonstrates that neuropathy deteriorates postural balance and gait; the present evidence provides insight indicating that footwear interventions do significantly alter static balance performance in the neuropathy population. Footwear interventions seem to have the capacity to alter underlying strategies controlling static and dynamic movement patterns through a combination of mechanical and sensorimotor mechanisms, for which in-depth investigation of neurophysiologic responses to footwear interventions is necessary to help confirm any sensorimotor adaptations.
A Comparative Study of the Efficacy of Ultrasound Therapy against Intra-articular Corticosteroid Injection in Adhesive Capsulitis: A Randomised Open-label Study
Authors: Sannyashi Puja
Published: August 2024

Introduction:

Adhesive capsulitis is idiopathic, progressive, painful, and restricted active and passive shoulder range of motion in patients with normal radiographs. Adhesive capsulitis can be effectively treated by ultrasound therapy, exercise, and intra-articular steroids.

Objective:

To see the efficacy of ultrasound therapy and intraarticular corticosteroid injection in adhesive capsulitis. And compare the efficacy of ultrasound therapy and intra-articular corticosteroid injection.

Materials and Methods: Study Design:

A comparative study.

Setting:

Tertiary care center. Time period:from October 2019 to September 2020.

Participants:

80 patients who attended the Physical Medicine and Rehabilitation department during the study period, met the inclusion criteria.

Intervention:

Patients were randomly assigned to the intra-articular corticosteroid injection (Group A) and ultrasound therapy treatment (Group B).

Main Outcome Measures:

Parameters such as the Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI) and range of motion with goniometry. The examination was performed at the 1st visit (0 week) and then 4th, 8th and 12th weeks.

Results:

At the end of the study, a statistically significant improvement was obtained in all clinical parameters: VAS (P < 0.001), SPADI (P < 0.001) and goniometry (P < 0.001) in both Group A (the intra-articular corticosteroid injection) and Group B (ultrasound therapy treatment). While in combination with therapeutic exercises, the greatest pain improvement was seen in the local corticosteroid injection group, the ultrasound therapy group also showed significant and comparable improvement.

Conclusions:

Both intra-articular corticosteroid injection and ultrasound therapy were effective in adhesive capsulitis treatment. Thus, ultrasound therapy can be an alternative treatment for adhesive capsulitis, particularly in patients who do not accept injections.
Depression, anxiety, and stress among private shopkeepers after COVID-19 pandemic: A cross-sectional study from Mohali, India
Authors: Goyal Ekram , Malhotra Nidhi , Kumar Ajay , Puria Alka , Chaudhury Suprakash , Saldanha Daniel
Published: August 2024

Background:

The COVID-19 pandemic affected almost all sections of society. The economy of the country collapsed and it affected the economic situation of the common man. Private shopkeepers also suffered as they could not open their shops. The current study was an effort to assess the psychological status of these people.

Aim:

To assess depression, anxiety, and stress levels among private shopkeepers in Mohali after the COVID-19 pandemic who were previously mentally healthy.

Materials and Methods:

This observational, cross-sectional study was conducted on 500 consenting private shopkeepers from 10 different topographically scattered markets of Mohali. Written informed consent was obtained. Ethical clearance was sorted by the institutional ethics committee. Sociodemographic data were recorded on sociodemographic proforma. Depression Anxiety Stress Scale -21 (DASS-21) was employed to assess depression, anxiety, and stress. The data obtained was statistically analyzed.

Results:

A total of 34.2% of shopkeepers had depression, 31.4% had anxiety, and 44.80% had stress. Out of which street vendors had more depression (6.60%), anxiety (6.80%), and stress (7.40%) compared to other shopkeepers. Depression (36.07%), anxiety (32.61%), and stress (46.87%) were comparatively more among shopkeepers who had incurred financial loss compared to those who had received gain. Shopkeepers who had their shops closed were suffering from depression (35.42%), anxiety (33.26%), and stress (46.65%) comparatively more than individuals who had their shops open. A total of 59.75%, 51.57%, and 72.96% of shopkeepers whose products expired during the pandemic were suffering from depression, anxiety, and stress respectively.

Conclusion:

Depression, anxiety, and stress are high in private shopkeepers after the pandemic. Mental health services should be more accessible, affordable, and available during a pandemic and its aftermath. The economy of the country should be strengthened after the pandemic keeping in interest the economic needs of the common man.
Health technology assessment in mental health services
Authors: Javadekar Narendra , Javadekar Archana , Thakur Deepa
Published: August 2024

Mental illnesses have a significant impact on the lives of people not only because of their morbidity but also because of their noticeable impact on economic wellbeing. Out-of-pocket expenditure for mental healthcare services is significant in India and may even lead to impoverishment of the families. The present paper states that Health Technology Assessment (HTA) is necessary for mental healthcare primarily because of its rising cost and competing interests in government decisions and prioritization. HTA does a systematic evaluation of the consequences of using health technology. HTA will provide information to decision makers to develop and implement safer, cost-effective, and efficient policies at the individual and government levels. Appropriate guidance regarding the cost-effectiveness of mental health interventions will help to serve the purpose of providing transparent reports in the context of limited budgets.
Assessment of depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during COVID-19 crisis
Authors: Soumya A V , Dhamija Sana , Davis Supriya , Samudra Madhura , Pooja V , Gupta Nishtha , Khan Aslam , Chaudhari Bhushan , Chaudhury Suprakash , Saldanha Daniel
Published: August 2024

Background:

During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems.

Aim:

To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis.

Materials and Methods:

Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience.

Results:

A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers.

Conclusion:

During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.
Prevalence of psychiatric comorbidities and cognitive dysfunction among chronic kidney disease patients in a general hospital
Authors: Singh Hartwinder , Nath Shubranshu , Singh Ranveer
Published: August 2024

Background:

Chronic kidney disease (CKD) presents a profound clinical challenge, not only affecting physical health but also significantly impacting mental well-being. The complex interplay between CKD and psychiatric morbidities remains understudied.

Aim:

To address the existing gap by investigating the prevalence and patterns of psychiatric morbidity and cognitive dysfunction among CKD patients.

Materials and Methods:

This study adopted a cross-sectional and hospital-based study design. It included 72 patients diagnosed with CKD who fulfilled the inclusion and exclusion criteria. Structured clinical interviews, validated assessment tools (GHQ-12, HAD-S, AUDIT, Addenbrooke’s Cognitive Examination-III), and a proforma gathered data on socio-demographic factors, illness severity, treatment history, and psychiatric history.

Results:

70.1% of participants exhibited psychological distress, indicating a high prevalence of psychiatric morbidity. Anxiety disorders were prevalent, affecting 58.1% of participants, while depression affected 32.3% (12.9% mild, 20.8% moderate, 4.8% severe). Cognitive impairment varied with CKD severity, with Stage 3 showing better scores than Stage 4, and hemodialysis patients exhibiting the most significant decline.

Conclusion:

This study underscores the substantial burden of psychiatric morbidity and cognitive dysfunction in CKD patients within a general hospital setting. Early identification and integrated interventions in mental health care are crucial for improving CKD patient outcomes and well-being.