bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Sentinel-1, Sentinel-2, and Landsat-8 data in the early recognition of irrigated areas in central Italy
Authors: Vergni Lorenzo , Vinci Alessandra , Todisco Francesca , Santaga Francesco Saverio , Vizzari Marco
Published: December 2021

This study evaluated the effectiveness of various remote sensing (RS) data (Sentinel-1, Sentinel-2, and Landsat 8) in the early recognition of irrigated areas in a densely cultivated area of central Italy. The study was based on crop data collected on more than 2000 plots in 2016 and 2017, characterized by quite different climatic conditions. The different RS data sources were used both alone and combined and with precipitation to define corresponding random forest (RF) classifiers whose overall accuracy (OA) was assessed by gradually increasing the number of available features from the beginning of the irrigation season. All tested RF classifiers reach stable OAs (OA 0.9) after 7-8 weeks from the start of the irrigation season. The performance of the radar indexes slightly improves when used in combination with precipitation data, but three weeks of features are required to obtain OA above 80%. The optical indices alone (Sentinel-2 and Landsat 8) reach OA ≈85% in the first week of observation. However, they are ineffective in cloudy conditions or when rainfed and irrigated fields have similar vigour. The most effective and robust indices are those based on combined sources (radar, optical, and meteorological), allowing OAs of about 92% and 96% at the beginning and in the middle of the irrigation season, respectively.
Invasive neuroendocrine tumor of the kidney: a case report
Authors: Olweny Ephrem O , Hsieh Michael H , Buckley Jill C , McAninch Jack W
Published: December 2021

Neuroendocrine tumors (NETs) involve the genitourinary system in less than 1% of cases, with primary renal carcinoids comprising only 19% of reported genitourinary NETs (56 cases worldwide). We report a case of a renal NET presenting as a large renal mass with extensive local invasion, requiring definitive radical en bloc resection via a thoracoabdominal approach.
Primary mediastinal giant cell tumor
Authors: Goldberg Judd , Azizad Shameen , Bandovic Jela , Khan Arfa
Published: December 2021

Giant cell tumor of soft tissue is a rare tumor first described by Salm and Sissons in 1972 as being a distinct entity. 1 Histologically, it is composed of multinucleated giant cells dispersed among mononuclear cells, and is indistinguishable from its bone equivalent. 2 The majority of these tumors have been reported to occur in the lower extremity. 2 , 3 We describe a case of giant cell tumor of soft tissue within the posterior mediastinum. The only other report of a primary mediastinal giant cell tumor of soft tissue in the English literature was published by Fu et al. in 2002, in which they described two patients with posterior mediastinal masses. 4
Intracystic papillary carcinoma of the breast in a 21-year old premenopausal Nigerian woman: a case report
Authors: Umanah Ivy N , Okpongette Akpan S
Published: December 2021

We report the case of a 21-year-old Nigerian woman who presented to us with features of intracystic papillary carcinoma, a rare form of breast cancer usually seen in postmenopausal women in their sixth to eighth decades of life. To the best of our knowledge, there has been only one other case report of this lesion occurring in women in their second decade of life.

Physical examination showed a well-defined mass, 54 mm in diameter, in the upper proximal quadrant of the right breast close to the areola, histologically composed of monotypic epithelial cells disposed in solid, cystic, and papillary patterns. A diagnosis of intracystic papillary carcinoma was made because of the presence of intracystic arborization of the fibrovascular stroma, a monotonous cell population, the presence of mitoses, and the lack of myoepithelial cells determined by immunohistochemistry using calponin and p63 stains. Estrogen receptor status was positive while progesterone status and HER-2-neu receptor status were negative.

The patient has survived for 12 months without any sign of recurrence after the last surgical resection of the tumor.
Metastasizing pleomorphic adenoma presenting as an asymptomatic kidney tumor twenty-nine years after parotidectomy – urological viewpoint and overview of the literature to date
Authors: Ebbing Jan , Blind Carolin , Stein Harald , Miller Kurt , Loddenkemper Christoph
Published: December 2021

Pleomorphic adenomas (benign mixed tumors) are the most common tumors of glandular origin in the head and neck and are one of the few benign neoplasms that can undergo malignant transformation. 1 Mixed tumors that are seemingly benign at the microscopic level but metastasize have been termed metastasizing mixed tumors (MZMTs). The entity of metastasizing benign mixed tumors has been reported since the early 1940s, with up to approximately 50 cases described in the literature to date. Despite their bland morphologic appearance, MZMTs have been associated with an overall mortality rate of about 20–40%. We report the case of a MZMT of the kidney almost 30 years after lateral parotidectomy owing to the same tumor entity. For benign mixed tumors, we are unaware of more than two other cases of metastasis to the kidney that have been published, whereas metastases to the bone, lung, and lymph nodes are more common. Parotidectomy is widely accepted as the first choice of treatment, 13 but once metastases have occurred the therapeutic strategy is uncertain with surgery being the only curative option in cases with resectable disease. This case report provides information about the rare event of metastatic disease to the kidney and points out therapeutic strategies. However, in view of the general lack of adequate information in the literature, the best therapy for systemic disease still remains unresolved.
A case of primary mucosa-associated lymphoid tissue lymphoma of the prostate
Authors: Koga Noriko , Noguchi Masanori , Moriya Fukuko , Ohshima Kouichi , Yoshitake Nobuyuki , Matsuoka Kei
Published: December 2021

We report a case of primary mucosa-associated lymphoid tissue (MALT) lymphoma of the prostate. A 67-year-old man presented with urinary obstruction and an elevated prostate-specific antigen (PSA) level. A physical examination revealed mild prostate enlargement and no lymphadenopathy. A needle biopsy and immunohistochemical studies of the prostate were performed, which revealed marginal zone B-cell MALT-type lymphoma. A bone marrow aspiration and biopsy did not show involvement by lymphoma. Magnetic resonance imaging (MRI) of the abdomen and the pelvis revealed no lymphadenopathy or ascites. There was no involvement of other sites by lymphoma. The patient was diagnosed and staged as extranodal marginal zone B-cell MALT-type lymphoma of the prostate, low grade and stage I. The patient received external beam radiation therapy to the prostate with a total dose of 3600cGy in 22 fractions, and became free of disease within the following 15 months.
Primary NK/T cell lymphoma nasal type of the stomach with skin involvement: a case report
Authors: Kobold Sebastian , Merz Hartmut , Tiemann Markus , Mahuad Carolina , Bokemeyer Carsten , Koop Irmtraut , Fiedler Walter
Published: December 2021

Since nasal NK/T cell lymphoma and NK/T cell lymphoma nasal type are rare diseases, gastric involvement has seldom been seen. We report a unique case of a patient with a primary NK/T cell lymphoma nasal type of the stomach with skin involvement. The patient had no history of malignant diseases and was diagnosed with hematemesis and intense bleeding from his gastric primary site. Shortly after this event, exanthemic skin lesions appeared with concordant histology to the primary site. Despite chemotherapy, the patient died one month after the first symptomatic appearance of disease.
Splenic non-Hodgkin's lymphoma without organomegaly: occult presentation with fatal course and post-mortem diagnosis
Authors: Gollard Russell P , Garcia Diana
Published: December 2021

Splenic lymphoma without splenomegaly is uncommon. We report the case of a 68-year-old female who presented with fulminant B symptoms and thrombocytopenia, only to be found to have micronodular large B-cell lymphoma of the spleen post-mortem. Diagnosis of this rare entity remains difficult and overall prognosis is poor.
Neuroprotective Effect of Electroacupuncture Against Acute Ischemic Stroke via PI3K-Akt-mTOR Pathway-Mediated Autophagy
Authors: Yovitania Velika , Fu Qin-Hui , Pei Jian , Zhou Hua
Published: December 2021

Acupuncture has been used to treat ischemic stroke, and mounting evidence demonstrates the neuroprotective and autophagy-mediated actions of electroacupuncture (EA). This review summarizes the evidence that EA affects different stages of autophagy, its neuroprotective action, and effects of different acupoints in treating ischemic stroke. Systematic searches were conducted on English and Chinese databases (MEDLINE, Elsevier, ScienceDirect, Cochrane Library, and China National Knowledge Infrastructure). Studies published up until February 2021 were considered for inclusion, and a final of fifty articles were included in this review. There is evidence that acupuncture promotes neuroprotection by modulating autophagy, and the treatment effectiveness is related to the acupoint selection and timing of treatment administration.
Bisulfite Treatment of CG-Rich Track of Trinucleotide Repeat Expansion Disorder
Authors: Joz Abbasalian Zahra , Khanahmad Hossein , Tabatabaiefar Mohammad Amin
Published: December 2021

Background:

Trinucleotide repeat (TNR) expansion is a kind of mutation with instability in the number of microsatellite repeats. This nature of mutation leads to the different kinds of neurological and neuromuscular disorders; among them, fragile-X syndrome is the main cause of intellectual disability in which the increasing number of CGG TNR in 5' untranslated region is the main reason for epigenetic silencing of Fragile X mental retardation 1 gene. The aim of this study is to decrease the CG content of the candidate region to facilitate amplification by conventional polymerase chain reaction (PCR). Bisulfite treatment of the genomic DNA results in conversion of unmethylated cytosine to uridine and may overcome the diagnostic pitfalls.

Materials and Methods:

The whole blood DNA was extracted and bisulfite treated. Then any simplification in PCR process of desire sequence were assayed through following conventional PCR using specifically designed primers for converted sequence. Bisulfite-treated PCR product of a nearby sequence confirmed our results as a conversion control.

Results:

Both the control and the candidate sequences undergoing bisulfite treatment were successfully amplified by PCR.

Conclusions:

Decreasing the GC content of the sequence by bisulfite treating could be a new approach to overcome difficulties in amplifying GC-rich sequences.
Evaluation Avocado Soybean Unsaponifiables Loaded in Poly (lactic-co-glycolic) Acid/Avocado Soybean Unsaponifiables-Fibrin Nanoparticles Scaffold (New Delivery System) is an Effective Factor for Tissue Engineering
Authors: Gorji Mona , Zargar Kharazi Anoosheh , Setayeshmehr Mohsen , Ghasemi Nazem , Soleimani Mitra , Hashemibeni Batool
Published: December 2021

Background:

Growth factors and chemical stimulants have key role in cartilage tissue engineering, but these agents have unfavorable effects on cells. Avocado soybean unsaponifiables (ASU) has chondroprotective and anti-inflammatory effects. In this study, fibrin2nanoparticles (FNP)/ASU, as a new delivery system, with stem cells applied for cartilage tissue engineering in poly (lactic-co-glycolic) acid (PLGA) scaffold.

Materials and Methods:

FNP/ASU prepared by freeze milling and freeze drying. NFP/ASU was characterized by dynamic light scattering (DLS). PLGA-NFP/ASU scaffold was fabricated and assessed by scanning electron microscope (SEM). Human adipose-derived stem cells (hADSCs) were seeded on scaffold and induced for chondrogenesis. After 14 days, cell viability and gene/protein expression evaluated.

Results:

The results of DLS and SEM indicated that nanoparticles had high quality. The expression of type II collagen and SOX9 and aggrecan (ACAN) genes in differentiated cells in the presence of ASU was significantly increased compared with the control group (P and lt; 0.01), on the other hand, type I collagen expression was significantly decreased and western blot confirmed it.

Conclusions:

This study indicated FNP/ASU loaded in PLGA scaffold has excellent effect on chondrogenic differentiation of hADSCs and tissue engineering.
The Comparison of Levetiracetam and Piracetam Effectiveness on Breath-Holding Spells in Children
Authors: Ghazavi Mohammad Reza , Salehi Mohammad Mehdi , Nasiri Jafar , Yaghini Omid , Mansouri Vahid , Hoseini Neda
Published: December 2021

Background:

We aimed to compare the effectiveness of Levetiracetam and Piracetam on the severity and frequency of spells in children with severe breath-holding spells (BHS), i.e. bening, paroxysmal, and nonepileptic events that are common in early childhood.

Materials and Methods:

This study is a randomized controlled clinical trial in 71 children from 6 months to 6 years of age with BHS. They were randomly assigned to the two study groups (Levetiracetam and Piracetam group). The frequency and severity of BHS and the response to treatment were recorded on monthly visits during our 3 months follow-up.

Results:

There was a significant decline in the average number of frequency of spells before and after 3 months of treatment in each group in this study. Levetiracetam had significant effects on the average incidence of the loss of consciousness and seizure-like movements in our study, while Piracetam had no significant effect on the loss of consciousness. Our result showed better response in the Levetiracetam group (88.9% partial or complete response after treatment) compared with the Piracetam group (77.1% partial or complete response after treatment); however, it was not significant. It seems that Levetiracetam had better effect than Piracetam in some aspects in the treatment of BHS.

Conclusions:

Both Piracetam and Levetiracetam are safe and had significant effects on the frequency of BHS in our study, however, levetiracetam showed superior effects on the severity of BHS.
Prevalence and Risk Factors of Posterior Reversible Encephalopathy Syndrome in Isfahan, Iran
Authors: Ansari Behnaz , Saadatnia Mohammad
Published: December 2021

Background:

Posterior reversible encephalopathy syndrome (PRES) is a rare clinical-radiological syndrome characterized by such symptoms as headaches, altered consciousness, blurred vision, seizure, and focal neurological deficits. We herein present well-documented PRES cases and discuss the risk factors and characteristic imaging patterns of this syndrome.

Materials and Methods:

We prospectively examined 31 patients with PRES in Alzahra Hospital, Isfahan, Iran, and compared the underlying diseases of PRES in terms of their clinical features and cranial magnetic resonance imaging (MRI) findings.

Results:

The most common underlying disease was hypertension (90.3%), followed by systemic lupus erythematosus (32.3%), preeclampsia (25.8%), chronic renal failure (22.6%), and rheumatoid arthritis (22.6%). Interestingly, we also reported heroin abuse as a possible risk factor for PRES (9.7%). The most frequent clinical signs were headaches (54.8%), seizure (54.8%), and blurred vision (35.5%). The most frequent lesions on cranial MRI were in the parieto-occipital area (87.1%), followed by the cerebellum (19.4%) and the frontal lobe (12.9%). Other abnormalities on MRI were less common. In addition, 16.1% of the study population had vasospasm on magnetic resonance arteriography (MRA). Clinical recovery was followed by radiological resolution in all the patients.

Conclusions:

The clinical presentation is nonspecific, most patients present with a combination of symptoms, particularly headaches and seizure. MRI is crucial for the diagnosis of PRES, and MRA is useful in that it can identify associated vasospasm. Timely diagnosis and treatment are required to avoid a devastating outcome.
Evaluating the Effect of Parkinson's Disease on Jitter and Shimmer Speech Features
Authors: Azadi Hamid , Akbarzadeh-T. Mohammad-R. , Shoeibi Ali , Kobravi Hamid Reza
Published: December 2021

Background:

Parkinson's disease (PD) is a neurological disorder caused by decreasing dopamine in the brain. Speech is one of the first functions that are disrupted. Accordingly, speech features are a promising indicator in PD diagnosis for telemedicine applications. The purpose of this study is to investigate the impact of Parkinson's disease on a minimal set of Jitter and Shimmer voice indicators and studying the difference between male and female speech features in noisy/noiseless environments.

Materials and Methods:

Our data includes 47 samples from nursing homes and neurology clinics, with 23 patients and 24 healthy individuals. The optimal feature for each category is studied separately for the men's and women's samples. The focus here is on the phonation in which the vowel/a/is expressed by the participants. The main features, including Jitter and Shimmer perturbations, are extracted. To find an optimal pair under both noisy and noiseless circumstance, we use the Relief feature selection strategy.

Results:

This research shows that the Jitter feature for men and women with Parkinson's is 21 and 33.4, respectively. While the Shimmer feature is 0.1 and 0.06. In addition, by using these two features alone, we reach a correct diagnosis rate of 79% and 81% for noisy and noiseless states, respectively.

Conclusion:

The PD effects on the speech features can be accurately identified. Evaluating the extracted features suggests that the absolute value of the selected feature in men with PD is higher than for healthy ones. Whereas, in the case of women, this is the opposite.
Evaluation of the expressed miR-129 and miR-549a in patients with multiple sclerosis
Authors: Montazeri Mina , Eskandari Nahid , Mansouri Reza
Published: December 2021

Background:

The expression of microRNAs (miRNAs) as circulating biomarkers has been underlined in multiple sclerosis (MS) in the last decade. Due to the presence of a possible relationship between expressed miRNAs and heterogeneous appearances of the pathological processes in MS, the present study attempts to evaluate the expression of miR-129 and miR-549a in patients with MS in comparison with healthy control (HC) group.

Materials and Methods:

Peripheral blood mononuclear cells were separated from fifty patients with MS (subtypes including relapsing–remitting MS and secondary progressive MS) in the Kashani Hospital, Isfahan, Iran, and fifty people as HC group. After RNA extraction and complementary DNA synthesis, the expression of miR-129 and miR-549a was evaluated in patients with MS in comparison with the HC group using a quantitative real-time polymerase chain reaction assay. The data were analyzed using the Kolmogorov–Smirnov and Mann–Whitney tests. Spearman's correlation coefficient was used to examine the relationship between miR-129 and miR-549a with age.

Results:

The results showed that the expression of miR-129 and miR-549a was not significant in patients with MS in comparison with the HC group. Furthermore, the relationship between such miRNAs and age and gender was not significant.

Conclusion:

We suggest the expression of miR-129 and miR-549a as circulating miRNAs in peripheral blood mononuclear cells could not be considered a biomarker for diagnosis and Para clinical.
A Very Rare Association of Fuchs Heterochromic Uveitis and Ectropion Uvea in Usher Syndrome
Authors: Rezaei Leila , Ahmadyani Rashed
Published: December 2021

Usher syndrome is a heterogeneous genetic disease that is the most common cause of hereditary blindness–deafness. This syndrome is the most prevalent syndrome associated with retinitis pigmentosa. A 25-year-old man referred to us with hearing loss and vision diminution since childhood which has gradually worsened. Visual acuity of both eyes was 20/100. Slit lamp examination of the left eye revealed endothelial stellate keratic precipitates, mild anterior chamber reaction, iris heterochromia, ectropion of uvea, and mild posterior subcapsular cataract. There were also no crypts and abnormal vessels in the left eye iris. His intraocular pressure was 14 mmHg in the right eye and 18 mmHg in the left one. Funduscopy demonstrated waxy pallor optic nerve, marked arterial narrowing, and retinal bone spicule pigment formation in both eyes. We report for the first time a very rare association between Usher syndrome, Fuchs heterochromic uveitis (FHU), and ectropion uvea. To our knowledge, no association has been reported between ectropion uvea, FHU, and Usher syndrome.
Comparative Study of the Prophylactic Effects of Intravenous Injection of Dexmedetomidine, Ondansetron, and Pethidine on Postoperative Shivering of Abdominal Surgery under General Anesthesia
Authors: Jabalameli Mitra , Nazemroaya Behzad , Heydari Mahsa
Published: December 2021

Background:

postoperative shivering is a common complication of various surgical, so far no acceptable theory has been presented on the prevention of it. The aim of this study was to compare the effect of intravenous injection of dexmedetomidine, ondansetron, and pethidine on postoperative shivering among patients under abdominal surgery.

Materials and Methods:

In a double-blind clinical trial study, 128 patients undergoing abdominal surgery were selected and randomly divided into four groups of 32. In the 4 groups, 0.5 μg/kg dexmedetomidine, 0.5 mg/kg pethidine, 0.1 mg/kg ondansetron, and the same volume of normal saline were injected intravenously when anesthetics were discontinued and the incidence and severity of postoperative shivering were determined and compared in four groups.

Results:

The incidence of postoperative shivering was 12.5% in the dexmedetomidine group, 31.3% in the ondansetron group, 31.3% in the pethidine group, and 50% in the control group (P = 0.015). The mean of shivering severity in the four groups was 1.33 ± 0.5, 0.17 ± 0.8, 1.09 ± 0.4, and 1.13 ± 0.39, and the difference between the four groups was significant (P = 0.005).

Conclusion:

The use of all three drugs of dexmedetomidine, ondansetron, and pethidine is effective in decreasing the incidence of postoperative shivering, but the use of dexmedetomidine is associated with less postoperative shivering, better hemodynamic stability, and fewer other postoperative complications.
Strengthening home-based postnatal care of rural area of two districts of Haryana using mobile phone technology
Authors: Sharma Bharti , Raina Ankit , Kumar Vijay , Mohanty Premananda N. , Sharma Minakshi , Gupta Amit
Published: December 2021

Introduction:

Home-based postnatal care (HBPNC) plays an important role in improving the survival of mothers and newborns by complementing facility-based care. In India, HBPNC was initiated in 2011 under National Rural Health Mission, but the coverage and quality of postnatal care still remain a challenge. In the present study, we describe the methodology used in strengthening the existing HBPNC by utilizing mobile phone technology.

Material & Methods:

The study was conducted in the rural population of two districts of Haryana in collaboration with the National Health Mission Haryana and Survival for Women and Children (SWACH) foundation. The Accredited Social Health Activists (ASHAs) in the study area were provided a mobile phone and training related to the use of mobile technology, their roles, responsibility, and the information to be shared through phone and its purpose.

Results:

Along with providing home-based post-partum care, a total of 120,654 births (from May 2015 to August 2019) with detailed outcomes of pregnancy have been reported to SWACH. Population-based birth defect surveillance, stillbirth surveillance, and investigation of neonatal deaths are being done successfully using the same platform. Deaths are also being investigated by verbal autopsy. Age- and stage-specific participatory learning groups for action have been created on mobile phones for pregnant women, postnatal mothers to provide support, and interactive education to improve the maternal, newborn, and child health.

Conclusion:

It is feasible to strengthen the existing HBPNC with mobile phone technology to improve maternal and child health further. Vital events can be captured on an ongoing basis through ASHA as a key informant.
Prevalence and determinants of spacing contraceptive use among rural married women of Jammu, India
Authors: Khuda Priyanka , Gupta Nand Lal , Palaka Nishikanth , Kaur Gurjeet
Published: December 2021

Introduction:

Promotion of family planning, especially the use of contraceptive methods is essential to secure the well-being and development of society. Despite rise in the temporary contraceptive usage over the years, the implementation of the spacing method has been indicated lower in rural as compared to the urban areas of India. This study aims to find out the prevalence and determinants of current use of spacing contraceptives among married rural women of Jammu district, Jammu and Kashmir.

Material and Methods:

A community-based, cross-sectional study was conducted from January to June 2018 among married rural women. The survey was conducted house to house, and data were collected with the help of a questionnaire and BG Prasad Scale. Multi-stage sampling procedure was adopted to select the participants. Bivariate and multivariable logistic regression model was fitted to identify the factors associated with the current use of spacing contraceptive methods.

Results:

The current use of spacing contraceptive among married women was found to be 16.4%. The male condom was the most used method (55.7%) as well as most preferred contraceptive (46.8%). Lack of knowledge was reported as the main reason for not using contraceptive method. The current use of spacing contraceptive method was significantly higher among the upper socioeconomic status (adjusted odds ratio (AOR) 2.37(1.06–5.29), women with higher education (AOR) 5.04 (0.68–37.18), living in nuclear family (AOR 1.90; CI: 1.01–3.60), with 2 or more surviving children (AOR) 2.45 (1.27–4.73), and living near health center (AOR) 1.69 (0.91–3.14).

Conclusion:

Effective targeted programs along with conduction of more field researches that give scientific information should be implemented to achieve the desired goal of contraceptive usage in the rural area among married couples.
Smart phone usage pattern and associated insomnia among undergraduate students of a Medical College in Chengalpattu district, Tamil Nadu
Authors: Mani Geetha , Elavarasan Karthikeyan , Norman Prasan , Dhandapani Thirunaaukarasu
Published: December 2021

Introduction:

With increased integration of technology into medical education, smart phones have become an indispensable tool. Excess exposure to smart phones and its inadvertent use result in adverse health consequences, both physical and psychological. This study was planned to assess smart phone usage pattern and prevalence of smart phone addiction among undergraduate medical students and to identify association between smart phone usage and insomnia.

Material and Methods:

A descriptive, cross-sectional study was conducted among undergraduate students of a medical college in Chengalpattu, Tamil Nadu, during January and February 2020. A total of 221 students from first, second, and third year MBBS participated. A Google Form with informed consent, smart phone usage practices, Smartphone Addiction Scale-Short Version (SAS-SV), and Athens Insomnia Scale (AIS) was used as study tool. Data were summarized as percentages, mean, and standard deviation and appropriate statistical tests of significance applied using SPSS software.

Results:

Approximately half the students (49.3%) used smart phones for up to 3 h daily. Online videos (37.5%) and social media (34.9%) were the most common applications used; 39.4% skipped night-time sleep to use smart phone. The prevalence of smart phone addiction and insomnia was 23.5% and 30%, respectively. Gender, duration of use, time spent in online chats, and Internet search were significantly associated with insomnia; 51.9% of those with smart phone addiction reported insomnia (P < 0.05).

Conclusion:

The prevalence of smart phone addiction and associated insomnia are high among medical students. With evolving need for technology in medical education, it is imperative that students are sensitized to rational use of smart phones.
Perceptions of medical students regarding medical profession
Authors: Priyanka  , Goel Manish Kumar , Rasania Sanjeev Kumar
Published: December 2021

Introduction:

Medical students enter this profession with a set of perceptions toward the practice of medicine. The study of these factors becomes important as it may provide an insight into the perceptions of doctors toward medical profession to maintain a high standard of professionalism among medical practitioners.

Material & Methods:

This study was conducted by the department of community medicine of a premier medical institute of Delhi and involved the analysis of 457 feedback forms filled by medical students about their perceptions regarding medical profession at the time of entry and at the end of graduation. The responses were read several times and categorized into similar thematic areas.

Results:

At the time of choosing profession, 74.8% mentioned the reasons as, its respectable status in the society, 71.8% mentioned their interest to serve people, 26.9% the possibility of huge financial earning, and 21.2% the ease of getting employment. At the end of graduation, 312 (68.3%) considered ease of getting a job and 251 (54.9%) high paying capacity. The proportion of participants mentioning the profession to be prestigious and respectful (50.1%) and intention to serve people (51.2%) considerably declined. Regarding the reasons for change, majority (74.6%) mentioned stress, 66.7% felt it less rewarding, and 54.2% mentioned difficulty to maintain work-life balance.

Conclusion:

There was a change in students' perceptions at the end of graduation as compared to the time of entry. Their focus shifted from being in a respectful profession and serving community to getting jobs and earning money.
Assessment of quality of life and its determinants among the elderly residing in a rural area of Faridabad
Authors: Gupta Ekta , Goswami Shweta , Aggarwal Vaishali , Singh Mitasha , Agarwalla Rashmi
Published: December 2021

Introduction:

Population aging as a result of demographic transition has brought into focus issues pertaining to health status of elderly. We aimed to assess different domains of quality of life (QoL) and its determinants among the elderly population of a rural area of Faridabad.

Material & Methods:

A community-based cross-sectional study was carried out among 300 elderly people aged 60 years and above from October 2018 to January 2019 in village Pali of Faridabad, Haryana. The World Health Organization QOL-BREF scale was used for the assessment of QoL.

Results:

The study included 44% males with a mean age of 67.1 ± 7 years. The mean QOL score was highest in psychological domain (63.26 ± 18.48), followed by environmental domain (62.64 ± 16.23), physical domain (60.58 ± 19.24), and lowest in social domain (59.33 ± 17.81).

Conclusion:

Physical domain of QoL was significantly better in nondiseased elderly, while social domain was not significantly affected by morbidities or health-seeking behavior. Overall, QoL was fair to good. Determinants of good QoL included social as well as economic characteristics such as higher education, sex, and the absence of chronic disorders.
Whether COVID-19 has waterborne transmission too?
Authors: Kumar Chandra Mohan , Chowdhry Bhabesh Kant , Singh Shweta
Published: December 2021

SARS CoV-2 and COVID-19 have hogged the headlines for almost 18 months and over the last 2 months, it has occupied the mind space of entire India. Its second wave has not only sent shock waves across the nation but has created ripples across oceans too. There has been intense debate over how it went spiralling up in such a manner that India is is reporting large number of cases daily as well as deaths. One of most hotly debated topics is “Whether it is being transmitted through contaminated water too?” There is enough evidence that the virus sheds in feces and that the virus sheds in feces, sewage, sewer lines, waste water, and sewage treatment plants as well as effluents of plants. The important factor is that about two-third of sewer is not treated. On top of that, countries such as India do not have universal access to safe drinking water and practice of open defecation is still prevalent. In such a scenario, likelihood of waterborne transmission cannot be ruled out.
Novel infectious causes of acute pancreatitis
Authors: Gaba Saurabh , Gupta Monica , Gaba Ruchi , Lehl Sarabmeet Singh
Published: December 2021

Acute pancreatitis can result from a variety of infections. The causative pathogens have been well established to be certain viruses and parasites. However, certain infections fail to find mention in standard literature and have been overlooked due to the trivial number of cases of pancreatitis that result from them. Among these are influenza, leptospirosis, acute viral hepatitis, and certain tropical infections such as dengue, chikungunya, scrub typhus, malaria, and typhoid. In this narrative review, we have conducted a literature search on PubMed and EMBASE databases for cases of pancreatitis occurring in these diseases and compiled the data. Most of these infections are prevalent in the developing world, and consequently, more cases are reported from these regions. The pathogenesis, predictors of outcome, and the response to antimicrobial therapy have not been studied extensively. The actual incidence is probably higher than what is reported, and this subject deserves more attention.
The Safety and Efficacy of Hip Arthroscopy Performed using a Novel Knotless Suture Anchor
Authors: Turcotte Justin , Kelly McKayla , Petre Benjamin M.
Published: December 2021

Introduction:

Hip arthroscopy is commonly performed for patients with from femoroacetabular impingement (FAI); however, this procedure is technically difficult due to the anatomy of the hip joint and surrounding tissue. The purpose of this study was to evaluate the complication rates of hip arthroscopy procedures for FAI performed using the MICRORAPTOR Knotless Suture Anchor system.

Materials and Methods:

Retrospective review of consecutive patients undergoing hip arthroscopy for FAI was conducted. All patients underwent labral repair or reconstruction using the MICRORAPTOR Knotless suture anchor. The primary endpoint was any intraoperative or postoperative complication. Descriptive and inferential statistics were performed to assess the patient characteristics and outcomes.

Results:

Forty-three hip arthroscopies in 42 patients were reviewed at an average of 9 months (standard deviation 4 months) postoperatively; 36 (85.7%) were reviewed at over 6 months postoperatively. At presentation, 90.7% of patients demonstrated a positive anterior impingement sign, 86.0% demonstrated a positive posterior impingement sign, and the median pain numeric rating scale (NRS) was 7.0 ± 4.0 on a scale of 0–10. Four surgeries (9.3%) were revision hip arthroscopies, whereas the remaining 39 (90.7%) were primary labral repairs or reconstructions. Overall, the complications occurred in two (4.6%) cases. The median postoperative pain NRS was reduced from 7.0 ± 4.0 preoperatively to 2.0 ± 6.0 postoperatively (P = 0.003).

Conclusion:

The MICRORAPTOR Knotless suture anchor appears to be safe for use in patients undergoing hip arthroscopy for FAI.
Sural Flap Effectiveness in Exposed Lower Extremity Fractures
Authors: Romero Fernando , Gonzalez Juan Carlos , Reyes Carlos Raul , Ardebol Javier
Published: December 2021

Background:

In a Guatemalan public hospital, 3710 fractures were diagnosed in 2016, of which 723 corresponded to the tibia. Of these tibial fractures, approximately 15% were exposed. Skin coverage in exposed fractures has always been a challenge for the attending physician. In the case of the lower limb, there is the option of making a sural flap.

Objectives:

To determine the effectiveness of the sural flaps when utilizing this technique as a treatment for exposed fractures in the lower limb in adult patients.

Methods:

A prospective observational descriptive study, the evaluated patients and patient files as primary and secondary sources, respectively, and control with observational variables. The sample consisted of 24 patients who got 3 follow-up appointments at 5 days, 2 weeks, and a year.

Results:

The results manifested effectiveness of 95.8%. The area most affected was the lateral malleolus. Additionally, comorbidities, schooling, and gender showed no influence on the effectiveness of the flap.

Conclusion:

The effectiveness of the sural flap technique in exposed fractures was 95.8%.

Recommendations:

Physicians ought to consider using the sural flap as the treatment of choice for skin coverage defects localized in the distal and middle third regardless of the leg and cause of the defect.
Management of Quadrilateral Plate Fractures
Authors: Verma Shilp , Agrawal Alok Chandra , Choudhary Ranjeet , Venishetty Nagaraju
Published: December 2021

Acetabular fractures are result of mostly high velocity injury with an incidence of 3/100,000/year. However in elderly patent low energy trauma also result in acetabulum fracture due to osteoporosis. Most of acetabular fracture commonly combined with quadrilateral plate fractures. Till date there is no standard classification system for quadrilateral plate fracture of acetabulum is published which can be utilized for accurately studying the fracture pattern and planning for the surgical approach with management. Initially acetabulum fracture was managed conservatively with traction for at least 6 weeks which results in aggravation of secondary symptoms such as pressure sore, DVT, post traumatic arthritis, loss of muscle strength and endurance. Aim of acetabulum fracture fixation are to allow early mobilization, restoring joint congruity, pain relive and reducing the risk of post traumatic arthritis. An internet search of MEDLINE and PMC using the search term 'acetabular fracture', 'quadrilateral plate fracture' and central hip dislocation in English language was performed on 1st march 2021. Papers specific with quadrilateral plate fracture were only included in the study and we found variety of technique available for displaced quadrilateral plate fractures, such as cerclage wire-plate composite, pelvic brim long screws, various combinations of spring plates (T-shaped plate, L-shaped plate, infrapectineal plate, H-plate, and multidirectional titanium fixator. In this review article we studied different treatment modalities and techniques used over several decades for management of quadrilateral fracture with their outcome.
Multifocal Skeletal Tuberculosis in Nonimmunocompromised Patient
Authors: Karuppal Raju , Sreedhar Sreehari , Kasim Asif
Published: December 2021

Tuberculosis (TB) of the musculoskeletal system is not an uncommon clinical condition. Multifocal osseous involvement is often rare and difficult to recognize. Because of the diverse and atypical clinical manifestations, it is easily misdiagnosed in many situations. The present study reports a case of multifocal skeletal TB masquerading as septic arthritis of the interphalangeal joint of the thumb. Because of the high prevalence of TB in developing countries, chronic osteoarticular infective lesions are to be considered as TB unless proved otherwise. The importance of clinical suspicion, systematic investigation, and the role of a biopsy in the diagnosis of skeletal TB is emphasized in this study.
Is Intramedullary K-wire Fixation Still Indicated in Treatment Midshaft Clavicle Fractures without Comminution?
Authors: Maaty Medhat Tawfik
Published: December 2021

Background:

Middle third clavicle fractures consist of up to 85% of clavicle fractures. Intramedullary (IM) fixation devices can be accomplished with less soft tissue dissection, more cosmetic incisions, and they may permit callus formation due to the relative stability with a different complication profile from plate fixation.

Patients and Methods:

Between July 2013 and November 2015, 25 patients presented by fracture midshaft clavicle without comminution were treated at our institution by minimal invasive retrograde IM k-wires.

Results:

The fractures union ranged from 12 to 16 weeks both clinically and radiologically. The results were excellent in 21 patients (84%) and good in 3 patients (12%). One (4%) had a poor result. All patients returned to their preinjury activities and jobs or sports activities.

Conclusions:

Surgical treatment of midshaft clavicle fracture without comminution through minimal invasive retrograde IM k-wire fixation improved the results and compared favorably with other techniques.
A Combined Anomaly Comprising Triple Muscular Variations - An Aberrant Flexor Indicis Profundus Lateralis Associated with Gantzer's Muscle and Flexor Indicis Profundus
Authors: Somanath Deepa , Ramalingam Sudha , Jayanthi S
Published: December 2021

Aberrations in the deep wrist flexors are frequently documented. These varied muscles might account for anterior interosseous nerve compression syndrome. The present study describes a case with three variations in the deep flexor of wrist comprising two separate small muscle bellies with their tendons and a higher level cleavage of the lateral tendon of flexor digitorum profundus muscle. Such a triple anomaly is a rare occurrence that has to be borne in mind by hand surgeons in case of nerve entrapment syndromes.
Free Fibular Graft Augmentation in Delayed Fixation of Fracture Neck of Femur in Young Adults
Authors: Thejaswi S. G. , Sagar B. G. , Kumar P. C. Sunil
Published: December 2021

Introduction:

This clinical study was conducted to assess the long-term follow-up results of using free fibular graft to augment fracture fixation with cannulated cancellous screw (CCS) or dynamic hip screw (DHS) as a treatment option for femoral neck fractures in young adults who presented after 24 h of injury but within 3 weeks.

Methodology:

A prospective study was conducted on the patients of femoral neck fractures managed with multiple cancellous screws or DHS with fibular graft. Patients aged between 15 and 50 years and having Garden Type III or IV fracture with duration of injury >3 weeks were included in the study. They were assessed for radiological outcome and functional outcome using modified Harris hip score.

Results:

Twenty-two cases were operated between day 2 and day 21 after sustaining injury. The mean time of union was 3.4 months. Nineteen fractures united uneventfully. Two fractures went in for nonunion and one developed avascular necrosis (AVN) of the femoral head. According to Harris hip score, 14 patients scored “excellent,” three patients scored “good,” three scored “fair,” and “poor” score was recorded in two patients.

Conclusions:

Delay in surgery as a contributing factor for the development of complications in fracture neck of femur cannot be ruled out with the present literature available. Using a free fibular graft as an adjunct to implant construct helps in reducing the rates of nonunion and AVN. However, this cannot be a substitute for proper surgical precision that is required in the treatment of fracture neck of femur. Further prospective studies involving large sample size are required.
Effect of Mckenzie Method on Pain and Function in Patients with Cervicogenic Headache
Authors: Saini Seema , Pamnani Vinita , Palekar Tushar J.
Published: December 2021

Background:

Individuals with cervicogenic headache (CGH) go through problems in activity of daily living, limitedsocial involvement, and emotional distress. CGH patients score the “worse” in the physical function category when compared to migraine patients.

Aims:

The aim was to study the effect of McKenzie complemented with conventional treatment on cervical rotation and headache in patients with CGH.

Settings and Design:

This was an experimental study design and systematic sampling method was used to collect data. The study setting was an Smt. Kashibai Navale General Hospital, Physiotherapy Outpatient Department, Pune, India.

Methodology:

Thirty subjects were selected with CGH which fulfills the criteria given by the CGH International Study Group. They were divided into two groups of 15 each. One group was given conventional treatment and the other was given conventional combined with McKenzie Method. Flexion–rotation test (FRT), Visual Analog Scale, Neck Disability Index (NDI), and Headache Disability Index were used as outcome measures.

Statistical Analysis Used:

T-test was applied to see the difference in pre and post values for all variables in both the groups. All data were analyzed using the Statistical Package for the Social Sciences 21 with level of significance for all statistical tests set at P ≤ 0.05.

Results:

The results showed that FRT has a statistically significant difference in both the groups. Headache disability showed a significant improvement in both the groups with statistically significant difference P < 0.05, the improvement being greater in the experimental group than in the conventional group.

Conclusion:

This study showed that when the McKenzie method is complemented with the conventional treatment, it shows better improvement in function of the cervical dysfunctions that cause CGH and reduce the intensity of headache.
Outcome of Arthroscopic Rotator Cuff Repair after 4 Years of Evaluation
Authors: Das Subhendu , Sarkar Partha Sarathi , Santra Sabyasachi , Keshkar Sanjay
Published: December 2021

Background:

Shoulder pain is a common musculoskeletal complaint in the general population, mostly in the elderly. Among them, the rotator cuff problems are found to be most common causes. The treatment of rotator cuff pathology has progressed from open repair, first described by Codman in 1911 to arthroscopy assisted “mini open” techniques, to all arthroscopic repair techniques, first reported by Johnson who used metal staples while E.M. Wolf pioneered the first completely arthroscopic repair using suture anchors in 1990. The purpose of this study is to evaluate the functional outcome following all arthroscopic repairs of full-thickness rotator cuff tears with suture anchors.

Materials and Methods:

A prospective study was done for 24 shoulders in 24 patients treated for full-thickness rotator cuff tear by all-arthroscopic repair between February 2014 and September 2015 and followed until May 2018. The results were evaluated using the University of California at Los Angeles (UCLA) shoulder scoring system. Patients younger than 18 and over 80 and also those with bony lesion were excluded from the study as were those which might have confounded the outcome were excluded.

Results:

Among the 24 patients, the UCLA clinical scores were excellent in 12 patients, good in 9 patients, fair in 2 patients, and poor in 1 patient. The average UCLA score was 31.84.

Conclusion:

All-arthroscopic repair is an excellent treatment option for full-thickness rotator cuff tears, although with a steep learning curve.
Tuberculous Osteomyelitis of Proximal Fibula
Authors: Jain Gunjar , Mahmood Asjad
Published: December 2021

Tubercular involvement of the proximal fibula is very rare. We present a case of tuberculosis of proximal fibula in an immunocompetent young female. She was diagnosed clinically as a case of cellulitis. Radiological investigations including magnetic resonance imaging revealed a destructive lesion in her right proximal fibula. Finally, by fine-needle aspiration cytology and GeneXpert polymerase chain reaction, a diagnosis of tuberculous osteomyelitis of proximal fibula was established. She was managed nonoperatively with multidrug antitubercular chemotherapy. A high index of suspicion is required to make a diagnosis of musculoskeletal tuberculosis of such rare site in early stages.