bluuebunny/crossref_metadata_2025 huggingface dataset:
Infantile parkinsonism-dystonia, type 1 (case report)
Authors: Kuzenkova Lyudmila M. , Pak Lale A. , Kondakova Olga B. , Lyalina Anastasia A. , Tsygankova Polina G. , Kanivets Ilya V. , Grebenkin Dmitry I. , Lapshina Natalia V.
Published: December 2020

Infantile parkinsonism-dystonia, type 1 (DTDS) (OMIM 613135) is a rare inherited autosomal recessive disease that manifests in infancy. The development of the disease is caused by a homozygous or compound-heterozygous mutation in theSLC6A3gene (OMIM 126455), which encodes a dopamine Transporter localized on the short arm of chromosome 5 (5p15). The main pathogenetic mechanism of the disease is the loss of the function of the main dopamine transporter at the presynaptic level, which leads to a decrease in the reuptake of dopamine in the synaptic cleft, depletion of presynaptic dopamine reserves, and an increase in the amount of extraneuronal dopamine. Currently, there are 20 cases of this disease in children in the world. The main clinical manifestations of DTDS are various hyperkinesis patterns (dystonia, chorea, athetosis, etc.), followed by hypokinesia and rigidity, developing against the background of axial hypotension. Difficulties in differential diagnosis lead to the fact that many patients are observed for years with erroneous clinical diagnoses, including cerebral palsy, regularly receiving rehabilitation treatment without clinical effect. The mentioned above explains the need for clinicians to be aware of a rare disease DTDS, which will avoid diagnostic errors, prescribe adequate therapy promptly, and thereby significantly improve the quality of life of patients and their families. The article contains an overview of the etiological, pathogenetic, epidemiological, diagnostic, and therapeutic aspects of DTDS. For the first time in Russia, there is reported a clinical case of this rare disease, which presents the own experience with DTDS patient.
Clinical experience of replacing enzyme replacement therapy in a patient with mucopolysaccharidosis type II
Authors: Kuzenkova Lyudmila M. , Podkletnova Tatyana V. , Pak Lale A. , Ereshko Oksana A.
Published: December 2020

Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is an inherited chronic progressive lysosomal disease associated with recessive X-linked inheritance. MPS II is classified as an orphan disease and occurs at a rate of 1.3 per 100,000 white boys. Hunter syndrome is the most common type of mucopolysaccharidosis, accounting for about 50% of MPS types. The diseases pathogenesis is based on a violation of the stepwise cleavage of glycosaminoglycans (GAG) heparansulfate and dermatansulfate caused by a deficiency of the iduronate-2-sulfatase enzyme encoded by theIDSgene. The existing deficiency or complete absence of iduronate-2-sulfatase leads to a violation of the final stage of glycosaminoglycan catabolism and the accumulation heparansulfate and dermatansulfate in all organs and tissues. Currently, there are two drugs registered in the Russian Federation for pathogenetic enzyme replacement therapy of MPS: idursulfase and idursulfase beta. This refers to the expansion of the therapeutic options for Hunter syndrome patients in the event of severe adverse events. It allows choosing the treatment regimen that will be optimal for the patient and will significantly improve the quality of life. In this article, the authors share their own experience of changing enzyme replacement therapy in an MPS II child patient.
Ueber Blasengonorrhoe
Authors: Wertheim Е.
Published: December 2020

Gyon and his school are known to have denied bladder gonorrhea. They looked at the disease of the last post gonorrhoe am nor on specific cystitis, but argued that the inflammation, localized in the orificium internum urethrae and its immediate circumference, leads only to functional disorder: tenesmus, frequent urination. Only in rare cases, they said, does purulent cystitis occur as a secondary infection caused by Bacil. coli, or streptococci, because gonococci in the urine have not been proven.
Wendung oder hohe Zange
Authors: Khazan S. Yu.
Published: December 2020

The author has come to the conviction that turning on one's feet does not at all have all the advantages ascribed to it by Simpson and others.
Zur vaginalen Totalexstirpation des Uterus und der Ahnexewegen schwerer chronischer Erkrankung derselben
Authors: Leopold G.
Published: December 2020

As a result of the above reason, L. had the uterus and appendages removed through the sleeve 57 times over a period of ten years. Twenty cases are cited; the other 37 have been printed elsewhere.
Zur Behandlung von Ovarialtumoren in Schwangerschaft, Geburt, und Wochenbtt
Authors: Hohl А. L.
Published: December 2020

According to the title, the author cites 5 cases from the clinic of prof. Fehling and comes to familiar, repeatedly published, conclusions.
Drei und dreissig vaginale Uterusexstirpationen nach Péan-Richelot
Authors: Schramm I.
Published: December 2020

The French method of using tweezers for sleeve extirpation of the uterus with labor paves its way. Not only in Germany, but even among the compatriots of the founders of this method, there are quite a few authors who assert that this method of operation is non-surgical and technically primitive.
The benefits or harms of systemic corticosteroids for community-acquired pneumonia in adults: аn overview of reviews
Authors: Efimov Nikolay V. , Sayfullin RUSAL F. , Shunkov Victor B.
Published: December 2020

Background: The problem of reducing mortality in patients with community-acquired pneumonia remains extremely important despite the progress in the development of antibiotics. There is a certain consensus on the etiological treatment of typical and atypical variants of the disease, however, the efficacy of corticosteroids as a means of pathogenetic therapy for many years has remained a subject of discussion, in spite of the large number of studies conducted and several dozen reviews of them.
The aim of our study is to summarize more than one systematic review of randomized controlled trials to assess the evidence for the effect of adjuvant systemic CS in adults with CAP on mortality, symptom dynamics, risk of complications, and harmful side effects.
Methods: From July to September 2020, we searched for systematic reviews in the PubMed, Embase, CENTRAL databases in accordance with the recommendations of the Cochrane Guidelines for Systematic Reviews 6 version up to 2020. The methodological level of the selected reviews was assessed using the АMSTAR-2 form.
Results: 12 systematic reviews were selected that were performed in different countries from 2012 to 2018, covering 24 clinical trials with 2,791 participants. Comparison and generalization of review data confirms that additional prescription of CS led to a decrease in mortality in severe CAP, and with any severity of CAP - to a decrease in the risk of treatment failure in the first 57 days from its onset, acceleration of the onset of signs of clinical improvement, and a decrease in the risk of development respiratory failure and transfer to artificial lung ventilation, reducing the length of hospital stay and treatment in the intensive care unit. Short courses of steroid therapy did not increase the risk of harmful plug events, with the exception of hyperglycemia, which was easily controlled.
Our analysis has also shown that there is a feasibility of bridging the gap between existing regulations and the evidence base for current systematic reviews of RCTs on the use of CS in CAP.
Search for the optimal mass profile of neuropeptides for the implementation of antihypoxic and activating actions
Authors: Shustov Evgeny B. , Ivkin Dmitry Y. , Ivkina Arina S. , Kim Alexey E. , Lublin Stanislav L. , Nesterov Maxim S.
Published: December 2020

In this study, the dependence of the pharmacological effects of neurotropic peptides of natural and synthetic origin on their structure was studied in laboratory rats. First, the study of the relative molecular profiles of peptide complexes was carried out using HPLC (gel-penetrating chromatography) with an internal standard. Then peptide complexes were administered to animals rectal and verified their biological activity on two independent models antihypoxic activity (method of altitude the lift timing of the animal's life at a critical height) and the model of assessment of physical performance (time of forced swim test of animals with a load of 10% of the body weight to failure). The obtained data on biological activity (increase) were compared with the features of the structure of peptides. To assess the effect of drug doses on their activity, a single-factor analysis of variance was performed.

It has been shown that antihypoxic activity and performance stimulation are more or less inherent in all the studied peptide preparations, and are dose-dependent and related to the features of the molecular mass distribution of peptide components. It was also found that the specific antihypoxic activity of peptide preparations from brain tissues is associated with components having a mass range from 5 to 10 kDa. The optimal proportions of the peptide components for the implementation of biological activity by mass ranges were determined.

In addition, the chromatographic characteristics (molecular weight distribution over mass ranges) of natural neuropeptide complexes can be used to predict the severity of their biological effects.
ANTIPSYCHOTICS: FROM THE FIRST TO THE THIRD GENERATION
Authors: Petrova Nataliia N. , Sofronov Alexander G.
Published: December 2020

The review is devoted to comparative analysis of antipsychotics of three generations. When writing the review, a systematic search in the databases PubMed, Medline, Elsevier was carried out, a simple filter for keywords was used. Pharmacological and clinical issues of antipsychotic therapy were considered, the mechanisms of action of antipsychotics of different generations were revealed. Current trends in the development of approaches to the therapy of schizophrenia and the concept of atypicality of antipsychotics were discussed. A comparative analysis of indications for use, tolerance (safety of use) and efficacy of various antipsychotic drugs with an emphasis on the effect on negative (primary, persistent) symptoms has been conducted. The hypothesis underlying new approaches to the therapy of schizophrenia, based on the effect on dopamine autoreceptors, consisting of a high density of D2 and low density of D3 receptors, has been presented. It has been shown that antipsychotics of the third generation open up new possibilities in the therapy of psychosis within the framework of a personalized approach in psychiatry with the achievement of functional recovery of patients. The characteristics of the drugs representatives of the third generation of antipsychotics aripiprazole and cariprazine were given. The uniqueness of cariprazine as the only drug that inhibits D3 receptors in vitro, as well as in vivo in patients with schizophrenia was emphasized. The data of evidence-based studies of the effectiveness of cariprazine in the treatment of negative, including predominant negative symptoms were presented.
ADEL FEDOROVNA HAMMERMANN (1888-1978)
Authors: Narkevich Igor A. , Luganin Vladimir G. , Bespalova Nina V. , Zvyagin Yuri Y. , Perelygin Vladimir V.
Published: December 2020

Thanks to Nina Vladimirovna Bespalova for the active support of the present essay. She cherishes the memory of her grandmother Adele Fedorovna Hammermann all her life, a scientist who opened the way for women to the scientific community of Russian pharmacists. A.F. Hammermann became one of the leading specialists in pharmacognosy, the founder of the school for the study of Tibetan traditional medicine in Russia.
For almost half a century, Adel Fedorovna's life was inextricably linked with the present Saint Petersburg State Chemical and Pharmaceutical University. Here she first studied, and then taught and headed the Department of Pharmacognosy.
A.F. Hammermann has become one of those dedicated scientists that the Russian pharmaceutical school is proud of, and generations of university students have learned from her unique scientific heritage.
In the essay, based on materials from the home archive and the memoirs of teachers who at different times worked at the Department of Pharmacognosy of the University, we managed to describe the main milestones in the life path and scientific achievements of Adele Fedorovna Hammermann.
In the future, the authors of the essay hope to collect additional materials about this amazing woman and publish them in a separate edition.
Clinical pharmacology of pyrroxane (proroxane)
Authors: Shabanov Petr D.
Published: December 2020

Review of literature and own studies on the pharmacology and clinical pharmacology of the domestic -adrenergic blocker pyrroxan (INN: proroxane). The drug was developed in the 1970s at the Institute of Toxicology of the USSR Ministry of Health (Leningrad). Expectations from -blockers created during this period (phenoxybenzamine, phentolamine, tropafen, fepracet, dihydrogenated ergot alkaloids) were high, especially in terms of the treatment of hypertensive and ischemic conditions, however, only few drugs from this group were used in clinical practice for these purposes (prazosin, doxazosin and some others). For pyrroxan, this direction was not the main one, and it was positioned as a means of treating diencephalic disorders like vegetative crises, where the drug immediately gained popularity, and this direction of use was clearly fixed to it. In the same period, the anti-alcohol and anti-drug action of -adrenergic blockers was found, since both in the experiment and in the clinic they demonstrated the suppression of alcohol (drug) motivation and a decrease in alcohol and drug consumption. Thelatter served as an impetus to the use of pyrroxane mainly in psychiatry, narcology and, to a lesser extent, in neurology, and recently the drug has been positioned almost exclusively for use in these areas of medicine. Thearticle analyzes the current clinical use of pyrroxane.
Preoperative antibiotic prophylaxis of odontogenic maxillary sinusitis, as a result of the formed oroantral joint
Authors: Maksimova Nalaliya V. , Dulov Filipp V. , Tkachuk Maksim F.
Published: December 2020

The article describes clinical research methods as an assessment of the effectiveness of preoperative antibiotic prophylaxis in operations on the alveolar process of the upper jaw.

Methods.70 patients underwent a tooth extraction operation, complicated by perforation of the Schneider membrane in the period 2018-2019. These patients are conditionally divided into two homologous groups (body weight, gender, age, information from the medical history). Group I (34 patients) is scheduled to prescribe antimicrobial agents as preoperative antibiotic prophylaxis. In group II (36 patients), standard seven-day antibiotic therapy was performed.

Results.Infectious and inflammatory complications in group 1 occurred in 5.4% of cases, in group 2 in 6.2% of cases, the difference in the occurrence of infectious and inflammatory complications was 1.2%.
Possibilities of in vivo validation of a model of experimental osteoporosis
Authors: Bairamov Alekber A. , Mamina Nailya Sh. , Karonova Tatiana L. , Shabanov Petr D.
Published: December 2020

In this work, the possibilities ofin vivovalidation of an experimental model of osteoporosis are analyzed. Themodel is based on the application of biochemical methodsforanalyzing predictors of osteoporosis inbloodserum,andtheirinformative value in the comparativeanalysis of the assessment of the degree of osteoporosisbasedoninstrumental studies of autopsy of bone tissue usingatomicabsorption spectroscopy and x-ray densitometry.
Ahıska Türklerinin Bazı Halk İnanışları (Geçiş Dönemleri ve Bazı Hayvanlar) (Denizli Örneği)
Authors: EŞMELİ İsmet , ETHEM Mürsel
Published: December 2020

Ahıska Türkleri, günümüzde Gürcistan’da bulunan Ahıska bölgesine X-XI. yüzyılla-rında yerleşen Türk boylarından biridir. Onlar, yerleştikleri bölgeye nispetle Ahıska Türk-leri veya Meshet Türkleri olarak da bilinmektedir. Ahıska Türkleri, yaşadıkları bölge Os-manlı hâkimiyetinden çıktıktan sonra zorlu bir süreç yaşamışlardır. Bir daha dönmelerine izin verilmeyecek şekilde yurtlarından sürgün edilmeleri, Ahıskalı Türklerin tarihinde dönüm noktası olmuştur. Ahıska Türkleri, II. Dünya Savaşından sonra Stalin döneminde farklı bölgelere sürgün edilmişlerdir. Ahıska Türkleri sürgündeyken tüm zorluklara rağmen kimliklerini ve kimliklerini oluşturan unsurları muhafaza etmişlerdir. Böylece, sürgün edildikleri bölgelerde kimliklerini kaybetmemişlerdir. Ahıska Türkleri, diğer Türk toplu-luklarının inanışlarıyla örtüşen ve kimliklerinin bir parçası olan halk inanışlarına ayrı bir önem vermişlerdir. Ahıska bölgesinden farklı ülkelere sürgün edildikten uzun yıllar sonra Ahıska Türkleri, Türkiye’nin farklı bölgelerine yerleşmişlerdir. Denizli, Ahıska Türklerinin yoğun olarak yerleştiği yerlerdendir. Ancak, Ahıska Türkleri Türkiye kamuoyu tarafından yeterince bilinmemektedir. Bu çalışmamızda, Denizli’deki Ahıska Türklerinin kimliklerini koruyup devam ettirmelerinde önemli bir yere sahip olan bazı halk inanışlarını ve bu ina-nışlara ait uygulamalarını hem dini kökleri hem de toplumsal işlevleri bakımından incele-dik. Ancak çalışmamızın konusunu, Denizli’de yaşayan Ahıska Türklerinin geçiş dönemleri ve bazı hayvanlarla ilgili inanış ve uygulamalarıyla sınırlandırdık. İlgili halk inanışlarını ve uygulamalarını incelerken bizzat Denizli’de ikamet eden Ahıska Türklerinin kendile-rinden elde ettiğimiz bilgiler, çalışmamızın şekillenmesinde belirleyici olmuştur. Son ola-rak, birebir görüşmelerimizden elde ettiğimiz bilgileri ilahiyat ve dinler tarihi açısından ele aldık. Sonra bu inanışların ve uygulamalarının toplumdaki durumuyla ilgili bazı tespit-lerde bulunduk. Bu çalışmamız, Ahıska Türklerinin çektiği zorlukları ve bu zorlukların üstesinden gelmede halk inanışlarının ne tür bir işleve sahip olduğunu ortaya koyması ve ulaşılan bilgilerin İlahiyat ve Dinler Tarihi bilimi açısından değerlendirilmesi bakımından önem taşımaktadır. Ayrıca bu çalışma, Türkiye kamuoyunda Ahıska Türkleri hakkında bir farkındalık oluşmasına ve Ahıska Türklerinin kültürünün tanınmasına bir nebze de olsa katkı sunmaktadır.
Performance Analysis Of DSDV, AOMDV and ZRP Routing Protocols Application Simulation In Pekanbaru Vehicular Ad Hoc Network (VANET)
Authors: Safrianti Ery , Sari Linna Oktaviana , Saputri Fitriani
Published: December 2020

The increase in the number of vehicles without the development of driving safety technology, tends to create adverse impacts on society, such as a rise in casualties due to road accidents. Therefore, vehicles need information on the condition of the surrounding traffic environment to provide driver with safety. One of the methods used to obtain prompt information between vehicles that move dynamically is communication technology such as Vehicular Ad hoc Network (VANET). VANET has network characteristics that change rapidly due to the highly dynamic node movement. Therefore, it is necessary to choose the right routing protocol for optimal data transmission. In this study, the DSDV (Destination Sequenced Distance Vector), AOMDV (Ad-hoc on Demand Multipath Distance Vector), and ZRP (Zone Routing Protocol) routing protocols were tested using 3 field data scenarios. The first scenario is a variation of the number of nodes 100, 250, 600, and 700 nodes. The second scenario is a variation of the transmission ranges of 250m, 500m, and 1km. The third scenario is the variation of node speeds of 10 km/hour, 20 km/hour, 30 km/hour, 40 km/hour, and 50 km/hour in Pekanbaru city of Riau province. This research was carried out using the simulation method along with the QoS (Quality of Service) performance testing parameters comprising packet delivery ratio, end to end delay, throughput, collision rate, and packet loss. Out of the three scenarios tested, AOMDV is the best routing protocol to be implemented because it outperforms the other two protocol evaluated in all designated scenarios in the paper. Meanwhile, DSDV and ZRP are superior in end to end delay and routing overhead parameters, respectively.
CREATIVE MEDIA WORKERS AS REPRESENTATIVES TO ACTUALIZE THE TAGLINE OF “INDEPENDENT DAN TRUSTED”
Authors: Robin Patricia
Published: December 2020

Mass media workers have a good ability to convey ideas to be enjoyed by a wide and heterogeneous audience. Their talents and interests are not arbitrary. They have taken special education in college and graduated with a related bachelor's degree. However, their intellectual abilities are not accompanied by the ability to appreciate and reward themselves, which should deserve a decent income or a comfortable working environment. In the name of capitalism which was finally realized in the form of alienation, they carried out the work with great pride even though it was apparent. This study uses qualitative research methods by collecting data through interviews of one of the televisions workers. Based on the research results, it is clearly illustrated how the mass media workers consider that completely devoting themselves to companies that have provided opportunities and income is something that is worth doing. Moreover, there is special pride when they are able to contribute in providing education and information to the wider community. This confirms false awareness that arises from a mass media worker.

 

Kata Kunci: Buruh Kreatif Media massa, Ekonomi Politik Media, Kapitalisme, Alienasi
PODCASTER’S AWAL MINGGU COMMUNICATION STRATEGY IN CREATING PODCAST CONTENT ON THE SPOTIFY
Authors: Sundari Gina - , Purba Veny
Published: December 2020

Podcasts are now developing and much averred by millennials. The ease in producing podcasts makes people participate in making podcasts, so anyone can become a podcaster. The most widely used digital platform to listen to podcasts today is the Spotify platform. The purpose of this research is to find out how the communication strategy used by podcaster’s in creating podcast content on the Spotify digital platform. This research uses a qualitative approach with a case study method, and data collected from in-depth interviews and observations. The case study was conducted on the Podcast Awal Minggu. The analytical theory used in this study of Harold D. Laswell's communication theory and new media's theory. The results of this study are communication strategies used by the podcaster’s Awal Minggu : (1) consistent (2) conducting promotions using social media assets that are owned by the right hat and topic or can be called social climbing (3) collaboration is also carried out so that get followers. Collaboration is an important element for stealing followers.
COVID-19'da gastrointestinal semptomlar ile hastalığın seyri ve prognozu arasında bir ilişki var mı? Tek merkezli pilot çalışma
Authors: AVCI Enver , ARDAHANLI İsa , ÖZTAŞ Erkin , DİŞİBEYAZ Selçuk
Published: December 2020

Giriş ve Amaç: Pandemi yapan ve çok fazla ölüm nedeni olan COVID-19 genelde solunumsal semptomlarla prezente olsa da bazen bu semptomlara gastrointestinal semptomlar da eşlik etmektedir. Çalışmamızda COVID-19 hastalarında gastrointestinal semptomların sıklığını ve prognozla ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: 11 Mart 2020-30 Nisan 2020 tarihleri arasında Bilecik Devlet Hastanesine başvuran ve real time polimeraz zincir reaksiyonu ile tanısı konulan 110 hastanın demografik, radyolojik, laboratuvar ve klinik açıdan analizi yapıldı. Bulgular: Hastaneye başvuru esnasında 13 (%11.8) hastada bir veya daha fazla gastrointestinal semptom vardı. Biyokimyasal parametrelerden D-dimer ve fibrinojen artışıyla gastrointestinal semptomlar arasında belirgin ilişki vardı (p
Crosslinking and Fulguration in the Treatment of Acanthamoebic Keratitis
Authors: Trufanov S. V. , Zaitsev A. V. , Shakhbazyan N. P.
Published: December 2020

Purpose: to study the combined Photo-Activated Chromophore for Keratitis — Corneal Cross-Linking (PACK-CXL) in combination with fulguration of the infiltration zone in the treatment of medically refractive acanthamoebic keratitis.

Patients and methods. The study included 9 patients (10 eyes) with medically refractive acanthamoebic keratitis. The diagnosis was confirmed by confocal microscopy data from a microbiological study of scraping of corneal tissue from the lesion site with Romanovsky-Giemsa stain. All patients underwent combined surgical treatment of PACK-CXL with pre-fulguration. Optical coherence tomography (OCT) of the anterior segment of the eye was also performed using an RTVue-100 apparatus (Optovue USA), determination of visual acuity, photographing before and after surgery.

Results. In 6 cases (60 %), a positive effect was noted, relief of the symptoms of the disease and the formation of turbidity within a month after the procedure, as well as an increase in the maximum corrected visual acuity. According in vivo confocal microscopy, 6 months after the intervention, no signs of infection were detected. In 4 cases, the therapeutic effect was absent. Subsequently, 3 patients (3 eyes) underwent therapeutic keratoplasty. In one eye, the infectious process was stopped medically for 6 months.

Conclusion. The combined PACK-CXL method together with fulguration can be effective and safe in the treatment of medically refractive acanthamoebic keratitis, allowing keratoplasty to be performed with an optical goal if necessary, after stopping the infection process in a distant period.
A THEORETICAL INVESTIGATION ON THE EVAPORATIVE HEAT TRANSFER OF CO2 IN SMOOTH AND MICROFIN TUBE
Authors: ALATAŞ Pınar , ÖZKAN Derya Burcu
Published: December 2020

Nowadays, global environmental events such as thinning of the ozone layer and climate changes are increasing. These types of events are not only affecting all creatures living on the Earth, but also decreasing the quality of life. For this reason, natural refrigerants which are not harmful to environment, have been preferred in cooling systems. In this study, heat transfer coefficient of CO2 was investigated during the evaporation process in smooth tube and designed microfin tube. Features of the tube used in evaporator of these cooling systems directly affect to the heat transfer coefficient. The geometric parameters of the microfin tubes are an outer diameter of 9.52 mm, number of fins 50, apex angle of 38°, helix angle of 20° and fin height of 0.12 mm. Theoretical model was created on MATLAB environment. The heat transfer coefficient was investigated based on vapor quality. When theoretical results obtained for microfin tube were compared with experimental results, 6% approach was seen. A theoretical model was created for smooth and microfin tube by selecting heat flux as 10 kw/m^2 and mass flux as 380 kg/m2s and heat transfer coefficients in different evaporation temperatures were compared based on vapor quality. It has been concluded that heat transfer coefficients of microfin tube at 5°C, 0°C and -8°C were 52%, 44% and 34% higher than that of smooth tube, respectively.
A clinical study of hypertensive emergencies
Authors: Konuganti Sridhar Reddy , Swamy Narsimha
Published: December 2020

Background: Hypertensive crisis is characterized by high blood pressure that is highly likely to cause pressure against the arterial walls causing chronic cardiovascular diseases. It has caused higher mortality and morbidity rates in both adults and children in equal measures. Hypertensive emergency is scientifically believed to cause several vital organ failures. The current study aims to critically evaluate hypertensive emergencies and the spectrum of end-organ damage due to risk factors of hypertensive emergencies.Methods: This prospective study was conducted on 150 patients with a severe arterial blood pressure of >180/120 mmHg) admitted at Area hospital, Zaheerabad. The doctors performed a detailed medical and clinical examination on the patients to assess organ damage. 120 patients met the hypertensive emergency (HTN-E), while 30 patients met the hypertensive urgency (HTN-U).Results: Patients who reported signs of HTN-E were older adults who are more sedentary, highly intensive smokers, and non-adherent to all forms of hypertensive medications that those with HTN-U. Most of the HTC-U patients had a known history of hypertension than HTC-E. There is about 2% prevalence of hypertensive crisis while admitted at the ICU.Conclusions: Early assessment of the level of organ damage is key in regulating severe complications of hypertension.
Outcome of treatment with modified Ponseti technique in atypical congenital talipes equinovarus
Authors: Gupta Sanjeev , Bhutt Farooq , Kumar Manoj , Ahmad Maneer
Published: December 2020

Background: The atypical congenital talipes equinovarus (CTEV) patients tend to have a different clinical foot presentation with small great toe, deep transverse crease of sole, tender swollen dorsum of foot and rigid equinus.Methods: This study was conducted in GMC Jammu to evaluate efficacy of modified Ponseti technique in atypical CTEV patients. It was a prospective study and the patient data was collected during OPD visits of patients from August, 2018 to June, 2020. Twenty-one patients were diagnosed as atypical CTEV and were managed with modification of conventional Ponseti technique and percutaneous release of achilles tendon was done in all patients. Three patients were lost to follow-up. Hence, the final number of study participants was 18 (n=18).Results: With modified Ponseti technique, functional correction was achieved in all the patients in our study. The average number of casts required was 8 (range; 5-10). At final follow-up visit, all feet are functionally corrected. Only one case of relapse was seen.Conclusions: Early diagnosis and treatment with modified Ponseti technique is an effective and easy method of treatment in atypical CTEV.
Cataract surgery and intraocular pressure: perspective from the developing world
Authors: Bali Shaveta , Nawaz Shah , Mehdi Manzoor
Published: December 2020

Background: Cataract surgery has an IOP lowering effect. Aim of the study was to analyses and evaluate the effect of cataract surgery [phacoemulsification] for senile cataract on IOP.Methods: This prospective observational study was carried out at two private specialized ophthalmology centers at India over a period of one year from Jan 2015 to Dec 2015. Cataract surgery (phacoemulsification) was performed on single eye of all the test subjects presenting to the out-patient departments with senile cataract without any comorbidity. Preoperative intraocular pressure (IOP) readings were noted and then compared to the post-operative IOP readings. All the data was collected and analyzed.Results: Cataract surgery reduced the IOP by a mean of 1.6 mmHg. Eyes with a higher preoperative IOP had a much greater IOP reduction post cataract surgery. Patients having a shorter axial length had more IOP reduction after cataract surgery with a mean value of 2.4 mmHg, which was statistically significant with a p value of 0.02. Older patients had a greater decrease in IOP after cataract surgery and it was noted that the relationship between IOP and increasing age was statistically significant having a p value of 0.001.Conclusions: Cataract surgery (phacoemulsification) has a significant IOP lowering effect and it is more in eyes having higher pre-operative IOP, shallower anterior chamber and those of the elderly.
Etiologies of zygomatic bone fracture at a tertiary care hospital of South Punjab, Pakistan
Authors: Khan Usman Qadir , Shaikh Qaimuddin , Rana Zahoor Ahmed , Shabnum Shazia , Ambreen Nadia , Nazir Saadia
Published: December 2020

Background: Fracture of the zygomatic bone is a frequent maxillofacial trauma, due to its distinction which influences it to bear the brunt of facial trauma but its pattern seems to vary geographically. This study was planned to find out etiologies of zygomatic bone fracture at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive observational study was conducted at The Department of Oral and Dental Surgery, Shaikh zayed Medical College Hospital Rahim Yar Khan, Pakistan, from July December 2017. A total of 114 patients with isolated tripod zygomatic bone fracture were enrolled. Demographic characteristics of the patients along with etiologies of zygomatic bone fracture were recorded.Results: Out of a total of 114 patients having zygomatic bone fractures, there were 85 (74.6%) male. Majority of the patients, 58 (50.9%) were aged between 21 to 30 years, 78 (68.4%) belonged to rural areas, 42 (36.8%) laborers while socio-economic class of 66 (57.9%) patients was recorded to be middle income. Road traffic accidents were the commonest, seen among 48 (42.1%) patients followed by inter-personal violence and falls, noted among 26 (22.8%) and 17 (14.9%) patients respectively.Conclusions: Zygomatic bone fractures were most commonly seen among male gender and young age groups. Road traffic accidents and inter-personal violence were the most commonly noted etiologies in the present study.
An audit on usage of fresh frozen plasma in a tertiary care hospital in north western part of India
Authors: Yadav Anshika , Tiwari Priyanka , Sheemar Akhil K.
Published: December 2020

Background: Every blood Component carries inherent risk of adverse transfusion reactions and transmission of transfusion transmitted disease (TTD). The adverse transfusion reactions are unpredictable and makes transfusion services puzzled, FFP being the most common one, it is therefore necessary that appropriate and rational use of FFP is done to make transfusion safer in terms of patient safety. The objective of the study was to assess the utilisation of FFP in a tertiary care Hospital.Methods: We conducted a retrospective study on 256 patient who received FFP transfusion at our tertiary care hospital over a period of 6 months .The usage was classified as appropriate or inappropriate based on the guidelines for FFP usage by British committee for standards in haematology, 2004 and college of American pathologist, 1994.Results: There were 256 patients in the study period who received 1370 units of FFP transfusions. The male: Female ratio was 162 M & 94 F. Most of the patients belonged to Gastroenterology Department (41.75%) followed by CTVS (15.32%). 29.48% of FFP transfusions were reclassified as inappropriate either due to Lack of indication or inappropriate doses.Conclusions: The study emphasize on the need to incurate rational use of blood components which is FFP in present case for evolving safe transfusion practices in the country. This study highlights no adherence to guidelines among clinicians which is mainly due to lack of knowledge of appropriate usage.
Etiological study of urinary bladder carcinoma in patients presenting to tertiary care centre
Authors: Bhangu Gurpreet Singh , Singh Ripudaman , Bansal Darpan , Bajwa Balcharan S.
Published: December 2020

Background: Urothelial carcinoma is the most common invasive cancer of the urinary tract. Lately, there has been an increased incidence of urothelial neoplasia due to exposure to a wide range of potentially carcinogenic substances. Studies of involved factors led to the concept of existence of a so-called malignization terrain, which claims that individual genetic predisposition and chronic exposure to carcinogens act synergistically leading to the appearance of urothelial carcinomas of the bladder. Aim of the research was to find out the common etiological factors of bladder cancer in this part of India.Methods: The study included 100 patients of bladder carcinoma reporting to Sri Guru Ram Das Hospital, Amritsar from March 2018 to December 2019. A detailed history was taken to have the insight of various etiological factors of the disease. The data was entered in Microsoft excel spreadsheet and analysis was done using statistical package for social sciences (SPSS) version 21.0.Results: The most common blood group associated with CA UB was A +ve (39%) followed by B +ve (29%). 89% of the cases of CA UB were non-smokers predominantly attributed to type of patients coming to our tertiary care institute which are from a rural background (73%) and are mostly Sikhs (80%) and Sikhs are traditionally non-smokers. 80% were farmers by occupation who have exposure to pesticides, insecticides, weedicides and herbicides routinely.Conclusion: In our study majority of the patients turned out to be non-smokers and A +ve blood group in contrast to the strong predilection of smoking and bladder cancer.
Comparison of efficacy of mirabegron and darifenacin in overactive bladder- a prospective study
Authors: Bhangu Gurpreet Singh , Kaur Kamal Preet , Bansal Darpan , Bansal Ritansh
Published: December 2020

Background: Overactive bladder (OAB) is under reported yet distressing symptoms which can be managed effectively by the drugs available. Aim was to study and compare the efficacy of two drugs, mirabegron and darifenacin in controlling the symptoms of overactive bladder.Methods: This prospective study included a total of 120 cases of overactive bladder reported at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar from January 2018 to December 2019. This comparative study was done by giving Mirabegron to first five patients and next five patients were given darifenacin up to 120 patients. The drug treatment with once daily administration of 25 mg mirabegron and 7.5 mg of darifenacin was given for a total of 12 weeks. The signs and symptoms were noted at the beginning of the therapy and then follow up was done at 4, 8, 10 and 12 weeks.Results: Total 54 out of 60 patients (90%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of increased frequency of micturition. 53 of 60 pateints (88.33%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of decreased average voiding volume. 28 of 60 pateints (46.67 %) on miragaberon showed nocturia as compared to 25 of 60 patients (41.67%) on darifenacin.Conclusions: It has been concluded that both mirabegron as well as darifenacin are highly efficacious newer treatment options for the management of OAB. Our study found Darifenacin to be relatively more efficacious in the treatment of OAB at a lesser dose and statistically significant differences were observed between the two drugs.
Mini percutaneous nephrolithotomy. How good it is - a single centre experience
Authors: Qadri Syed Javid F. , Ahmed Mufti Mahmood , Khanday Zafar S. , Leharwaal Asim
Published: December 2020

Background: Percutaneous nephrolithotomy (PCNL) is one of the 1st line treatment options for managing renal stones. Miniaturization of this technique has been developed to decrease the morbidity of this technique without compromising the results. Mini PCNL (mPCNL) involves the use of small calibre sheath and nephroscope to tackle renal stones of small to moderate size. The aim of this study is to present the efficacy and technical advantages of mPCNL in managing renal stones.Methods: This was a retrospective single centre study of mPCNL in managing renal stones. Results: From July 2015 to July 2020 192 mPCNL procedures were done at our centre in 175 patients. The median number of stones was 1(1-3) and the average size of calculus was 18.5 mm (6-35) mm. Mean operative time in our study was 46 (35-92) minutes. Fever developed in 15 (7.8%) patients which was managed by parenteral antibiotics, none of our patients required ICU admission. Haemothorax developed in 2 (1%) patients and both of them were managed by tube thoracostomy. We achieved complete clearance in 183 (95.3%) cases. In 9 (4.7%) patients residual calculi were manged by flexible ureteroscopy at 1 month.  Conclusions: mPCNL is an effective procedure for management of patients with renal stones with the advantages of less blood loss, short hospital stay and excellent stone clearance rate.
Cholelithiasis and its relation to body mass index and waist to hip ratio: an observational study
Authors: Bansal Darpan , Rattan Anuj , Bhangu Gurpreet Singh , Singh Rupinder
Published: December 2020

Background: There is increased incidence of gall stones and its variable presentations in India is a great need for a study which can provide information regarding risk factors associated with the formation of gallstones, prevalence of disease, clinical presentations and outcome of cholelithiasis. So present study done to find a relationship between body mass index (BMI) and waist to hip ratio (WHR) with cholelithiasis.Methods: The observational study was conducted in tertiary care center of SGRD Amritsar comprised of 100 patients diagnosed with pain abdomen by cholelithiasis and control comprised of 100 patients with any other cause of pain abdomen. All patients were evaluated for BMI and waist to hip ratio. BMI was calculated according to the standard formula (Quetelet’s index). The WHR was measured according to WHO protocol. Statistical tests were applied as quantitative variables were compared using unpaired t-test/Mann-Whitney test (when the data sets were not normally distributed) between the two groups. Qualitative variables were compared using chi-Square test /Fisher’s exact test.Results: A significant association of formation of gall bladder stones in female gender in comparison to their male counterpart and increased chances of formation of gall bladder stones in the patients having higher BMI and higher WHR.Conclusion: Female gender and obesity is associated with increased risk of cholelithiasis.
Knowledge and attitude of law, medicine, and mass-communication students towards deceased organ donation
Authors: Paneru Pragya , Budhathoki Shyam S. , Uprety Samyog , Yadav Birendra K. , Mulmi Rashmi , Sharma Ikshya
Published: December 2020

Background: With the global increase in the incidence organ failure and subsequent advancement in the medical technology, organ transplantation is growing as the best choice of treatment among the patients with various kinds of organ failure. However, the rate of deceased organ donation is relatively low in South-East Asia regions, including Nepal. This has created a mismatch between the demand and supply of organs for transplantation. World Health Organization encourages organ transplantation from a deceased organ donor as there is no risk to the donor. Thus, this paper aimed to assess knowledge and attitude of literate group specifically towards deceased organ donation.Methods: This was a cross-sectional study conducted among 299 students selected conveniently from medicine, law, and mass communication streams from 9 different colleges (3 colleges from each stream) of Kathmandu. Data was collected through a self-administered questionnaire. Knowledge level was classified into three different categories based on obtained scores and attitude was analyzed based on five-point Likert scale.Results: Almost half (48.8%) of the respondents while only 7% had high level of knowledge on the organ donation and transplantation. Similarly, 95% of the people had positive attitude towards organ donation. However, there was a weak correlation between knowledge and attitude of the respondents. None of the respondents carried an organ donation card.Conclusions: There is a need to plan robust strategies to educate people on organ donation so that they can make pragmatic decisions to register their names for deceased organ donation.
Prevalence of renal failure patients with three-weekly standardized dialysis session at university teaching hospital of Butare
Authors: Ndayisenga Leonard , Nsanzabera Charles , Hitimana Eugene
Published: December 2020

Background: Dialysis is a treatment of choice to alleviate severe complications of end-stage renal disease. Renal failure is the most prevalent worldwide among diabetic, hypertensive, and where infective diseases are frequent. The study aimed to assess the prevalence of patients having three standard dialysis sessions weekly at University Teaching hospital of Butare dialysis centre from June 2013 to June 2014.Methods: A descriptive cross-sectional study used routine hospital data from university teaching hospital of Butare dialysis unit and its size were 110 patients who fulfilled the study inclusion criteria. Secondary data were collected using a checklist with different variables like age, sex, profession, health insurances, acute renal failure, chronic renal failure, diabetes mellitus, hypertension, glomerular disease sepsis, severe dehydration, frequency of dialysis per week and outcomes like renal recovery, death, stopping treatment and being referred. Data were analysed using SPSS software.Results: The findings showed that 40.9% of patients received three or above dialysis sessions per week and 59.1% of patients received less than three sessions per week.Conclusions: The study concluded on inadequacy dialysis treatment and recommended further studies to explore more about this inadequacy.
Knowledge of family planning and contraceptive use among indigenous women in Dinajpur, Bangladesh: a cross-sectional study
Authors: Majumder U. K. , Khan M. Salauddin
Published: December 2020

Background: Knowledge of family planning (KFP) and contraceptive use play a vital role in controlling the level of fertility. The association between indigenous women's KFP and contraceptive use was badly found in inadequate studies. This study aimed to determine the factors that connect contraceptives use as well as gathering KFP of indigenous women.Methods: This study was carried out among purposively selected six Upazilas of Dinajpur district, where most of the indigenous peoples live. About 223 respondents were randomly selected for data collection by using a structured questionnaire. Univariate and bivariate analyses were used to describe the individual variables, and to find the associations among the variables. Binary logistic regression analysis was applied to determine the effects of selected socio-demographic factors on KFP and contraceptive use. Results: The results acknowledged that contraceptive use was found higher among school attended women (69%) and women (75%) of service holder husbands. Women who were involved in higher working status also use more contraceptives and are concerned about KFP. Pill and injections were more used among modern methods. Location, school attendance, educational and occupational status of the respondent and their husbands were found to be significantly associated with KFP and use of contraception among indigenous women.Conclusions: KFP and contraceptive use among women defined a gap was identified. By creating educational and employment opportunities for women to be enhanced the KFP and contraceptive use. Also, the socio-demographic factors needed to be taken into consideration in formulating policies and implementing programs among women.