bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatiotemporal variation in groundwater level within the Manas River Basin, Northwest China: Relative impacts of natural and human factors
Authors: Wu Yage , Yang Guang , Tian Lijun , Gu Xinchen , Li Xiaolong , He Xinlin , Xue Lianqing , Li Pengfei , Xiao Senyuan
Published: May 2021

The Manas River Basin (MRB), Northwest China, is an arid basin dependent on irrigation for agriculture, and human activities are believed to be the primary factor affecting the groundwater level fluctuations in this basin. Such fluctuations can have a significant adverse impact on the social economy, agricultural development, and natural environment of that region. This raises concerns regarding the sustainability of groundwater use. In this study, we used ArcGIS spatial interpolation and contrast coefficient variance analysis to analyse groundwater level, land-use change, and water resource consumption patterns from 2012 to 2019 in the plains of the MRB. The aim was to determine the main factors influencing the groundwater level and to provide a scientific basis for the rational development, utilisation, and management of water resources in this area. During the study period, the groundwater level decreased, increased, and then fluctuated with a gradually slowing downward trend; the decline ranged from −17.82 to −11.67 m during 2012–2019. Within a given year, groundwater levels declined from March/April to August/September, then rose from August/September to March/April, within a range of 0.29–19.05 m. Primary factors influencing the groundwater level included human activities (e.g., changes in land use, river regulation, irrigation, and groundwater exploitation) and natural causes (e.g., climate and weather anomalies). Human activities were the primary factors affecting groundwater level, especially land-use change and water resource consumption. These results provide a theoretical basis for the rational exploitation of groundwater and the optimisation of water resource management in this region.
Evaluation of the mixing quality of high-viscosity yield stress fluids in a tubular reactor
Authors: Xie Le , He Guangwen , Yu Bin , Yan Shaowei
Published: May 2021

In this study, the mixing quality of high-viscosity yield stress fluid (Carbopol aqueous solution) under laminar and turbulent flow regimes was evaluated through a numerical experimental study. A three-dimensional computational fluid dynamics large-eddy simulation (CFD-LES) model was employed to capture large-scale vortex structures. The proposed CFD model was validated by the experimental data in terms of mean velocity profiles and velocity-time history. Thereafter, the CFD model was applied to simulate the residence time distribution using the tracking technique: tracer pulse method and step method. In addition, the non-ideal flow phenomena caused by molecular diffusion and eddy diffusion were evaluated. The effects of the rheological properties on the mixing performance were also investigated. The presented results can provide useful guidance to enhance mass transfer in reactors with high-viscosity fluids.
Comparison between flexible AC transmission systems (FACTs) and filters regarding renewable energy systems harmonics mitigation
Authors: Hamdy Mohamed , Abdelaziz Almoataz Y. , Ray Papia , Attia Mahmoud A.
Published: May 2021

Renewable energy growing is considered one of the main sources of the system harmonics. Thus, in this paper, Total Harmonic Distortion (THD) is reduced by using flexible AC transmission systems (FACTs). Static Compensator (STATCOM) and Static Synchronous Series Compensator (SSSC) are used and compared against basic harmonics filter. Cases studied are as follows: First, the system is studied without any harmonic limitation. Then each type of the chosen two types of (FACTs) is connected to the system. Finally, the harmonics filter is used as a reference to verify the (FACTs) effectiveness. MATLAB/SIMULINK is the tool to examine and simulate the system.
A fundamental measure of treatment effect heterogeneity
Authors: Levy Jonathan , van der Laan Mark , Hubbard Alan , Pirracchio Romain
Published: May 2021

The stratum-specific treatment effect function is a random variable giving the average treatment effect (ATE) for a randomly drawn stratum of potential confounders a clinician may use to assign treatment. In addition to the ATE, the variance of the stratum-specific treatment effect function is fundamental in determining the heterogeneity of treatment effect values. We offer a non-parametric plug-in estimator, the targeted maximum likelihood estimator (TMLE) and the cross-validated TMLE (CV-TMLE), to simultaneously estimate both the average and variance of the stratum-specific treatment effect function. The CV-TMLE is preferable because it guarantees asymptotic efficiency under two conditions without needing entropy conditions on the initial fits of the outcome model and treatment mechanism, as required by TMLE. Particularly, in circumstances where data adaptive fitting methods are very important to eliminate bias but hold no guarantee of satisfying the entropy condition, we show that the CV-TMLE sampling distributions maintain normality with a lower mean squared error than TMLE. In addition to verifying the theoretical properties of TMLE and CV-TMLE through simulations, we highlight some of the challenges in estimating the variance of the treatment effect, which lack double robustness and might be biased if the true variance is small and sample size insufficient.
Sino-Japanese Interaction via Chinese Junks in the Edo Period
Authors: Akira Matsuura
Published: May 2021

To maintain its policy of national isolation during the Edo period, Japan restricted contact with the outside world to Dutch merchant ships and Chinese junks at the Japanese port of Nagasaki. Sino-Japanese interaction consisted not only of trade in goods, but also of cultural and scholarly exchanges. This paper will examine how this unofficial trade affected both Japan and China from a cultural perspective.
One-pot solvothermal synthesis and characterization of highly stable nickel nanoparticles
Authors: Jaji Nuru-Deen , Othman Muhammad Bisyrul Hafi , Lee Hooi Ling , Hussin Mohd Hazwan , Hui David
Published: May 2021

High stable nickel nanoparticles (NiNPs) have been successfully synthesized from nickel chloride as the precursor through a simple one-pot solvothermal process. A systematic investigation of the reaction parameters, namely, effects of reaction temperature, pH of precursor solution, the concentration of reactants, and reaction time on the formation of NiNPs, was carried out to obtain the optimal values for the synthesis. The optimum reaction temperature, pH, NiCl2·6H2O concentration, and reaction time are 190°C, pH 9, 0.1 M, and 24 h. The characteristic peaks of NiNPs have been confirmed by the Fourier transformer infra-red and surface plasmon resonance, with the presence of –OH stretching bands at 3,593 and 603 cm−1 (interaction with Ni and NiO) and λ
max 265 nm, respectively. The X-ray diffraction and transmission electron microscope demonstrated the particle size of about 24 nm (by Scherrer) and 49 nm (Image-J), respectively, with the face center cubic phase. The synthesized NiNPs showed good stability, where the degradation of NiNPs was completed at 800°C with more than 97% residue as depicted by the thermogravimetry analysis. The synthesized NiNPs can be used as fillers to enhance the thermal, mechanical, and electrical properties of polymeric materials.
Vapor bubble induced electric current generation
Authors: Li Wenzhuo , Zhang Wanying , Zhou Lingye , Shen Qingchen , Jiang Modi , Fu Benwei , Tao Peng , Song Chengyi , Wu Jianbo , Deng Tao , Shang Wen
Published: May 2021

Contact electrification (CE) has been utilized in various energy conversion systems in recent years. This work presents a constant electric energy output that was generated based on the CE at the water–metal interface. When a grounded Pt mesh is placed in water that is heated to boil, a continuous flow of electrons between the Pt mesh and the ground is generated. A possible mechanism for the generation of such electric current is based on the CE between the surface of the Pt mesh and water molecules. The local high-pressure thin liquid film regions between vapor bubbles and surface of Pt mesh promote this CE process. The constant water evaporation and bubble detachment enable the continuous electric current output. In this work, the impact of the heating temperature and the bias voltages on the generation of the current was also studied. This work provides an alternative approach to generate unidirectional current on the basis of CE at the water–metal interface, and it also offers new insights in the design of CE-based systems for the generation of electricity.
Nervonic acid amends motor disorder in a mouse model of Parkinson’s disease
Authors: Hu Dandong , Cui Yujuan , Zhang Ji
Published: May 2021

Objectives

Parkinson’s disease (PD) is a kind of common neurodegenerative disease in the world. Previous studies have proved that nervonic acid (NA), extracted from Xanthoceras sorbifolia Bunge, has the potentials of neuroprotection. However, the effect of NA on the PD remained unknown. This study was designed to investigate the NA’s potential function and relative mechanism on motor disorder.

Methods

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was used for producing parkinsonism motor disorder on male C57BL/6 mice. Toxicity experiments and behavioral assay were performed to evaluate the effect of NA. Besides, the expression levels of tyrosine hydroxylase and α-synuclein, as well as striatal dopamine (DA), serotonin, and their metabolites were explored through immunoblotting and chromatography after NA treatment in vivo.

Results

We found that NA could alleviate the MPTP-induced behavioral deficits dose-dependently. Moreover, NA has no toxic effects on the mouse liver and kidney. Of note, we found that NA significantly reduced the impact of MPTP impairment and striatal DA, serotonin, and metabolites were remained unaffected. In addition, tyrosine hydroxylase was upregulated while α-synuclein being downregulated and the oxidative stress was partially repressed evidenced by the upregulation of superoxide dismutase and glutathione activity after NA treatment.

Conclusion

Our findings unveil NA’s potential for protecting motor system against motor disorder in the PD mouse model without any side effects, indicating NA as an alternative strategy for PD symptom remission.
One-pot synthesis of 1-(benzothiazolylamino)aryl methyl-2-naphthols and 3-benzothiazolyl 2,3-dihydroquinazolinones using a magnetically recoverable core–shell nanocomposite as catalyst
Authors: Mardani Yousef , Karimi-Jaberi Zahed , Soltanian Fard Mohammad Jaafar
Published: May 2021

Nano-magnetite-supported sulfated polyethylene glycol (Fe3O4@PEG-SO3H) was prepared, characterized and utilized as a magnetically recoverable heterogeneous catalyst for the one-pot, three-component reaction of 2-aminobenzothiazole, aldehydes and 2-naphthol/isatoic anhydride resulting in efficient formation of 1-(benzothiazolylamino)arylmethyl-2-naphthol or dihydroquinazolinones derivatives. The significant features of this method include green conditions, operational simplicity, minimizing production of chemical waste, shorter reaction times and good to high yields. In addition, the nanocatalyst can easily be separated from the reaction mixture by application of a magnetic field and reused without significant deterioration in its catalytic activity.
Virtual Connectomic Datasets in Alzheimer’s Disease and Aging Using Whole-Brain Network Dynamics Modelling
Authors: Arbabyazd Lucas , Shen Kelly , Wang Zheng , Hofmann-Apitius Martin , Ritter Petra , McIntosh Anthony R. , Battaglia Demian , Jirsa Viktor
Published: May 2021

Large neuroimaging datasets, including information about structural connectivity (SC) and functional connectivity (FC), play an increasingly important role in clinical research, where they guide the design of algorithms for automated stratification, diagnosis or prediction. A major obstacle is, however, the problem of missing features [e.g., lack of concurrent DTI SC and resting-state functional magnetic resonance imaging (rsfMRI) FC measurements for many of the subjects]. We propose here to address the missing connectivity features problem by introducing strategies based on computational whole-brain network modeling. Using two datasets, the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset and a healthy aging dataset, for proof-of-concept, we demonstrate the feasibility of virtual data completion (i.e., inferring “virtual FC” from empirical SC or “virtual SC” from empirical FC), by using self-consistent simulations of linear and nonlinear brain network models. Furthermore, by performing machine learning classification (to separate age classes or control from patient subjects), we show that algorithms trained on virtual connectomes achieve discrimination performance comparable to when trained on actual empirical data; similarly, algorithms trained on virtual connectomes can be used to successfully classify novel empirical connectomes. Completion algorithms can be combined and reiterated to generate realistic surrogate connectivity matrices in arbitrarily large number, opening the way to the generation of virtual connectomic datasets with network connectivity information comparable to the one of the original data.
Application of silane-treated tea waste powder as a potential filler for natural rubber composites
Authors: Hayeemasae Nabil , Ismail Hanafi
Published: May 2021

The aim of this work was to develop sustainable composites based on natural rubber (NR) and tea waste (TW) composites. The main concern was the compatibility mismatch between NR and TW. The presence of polar groups in the TW contributes to the weak interaction between relatively hydrophobic NR and TW. Therefore, silane coupling agent was introduced to enhance the properties of the composites. Treating the TW by silane coupling agent greatly influenced the overall properties of the composites. It speeded up the curing process due to its ability to reduce possible adsorption of accelerator by TW. Better interaction between TW and rubber matrix was clearly observed as evidenced by the maximum torque (MH) and tensile properties of the composites. Such findings can be verified by the Qf/Qg values, indicating better rubber-filler interaction when silane was used. Moreover, scanning electron microscope (SEM) images also provided some evidence related to the tensile properties observed. It can be concluded that the new composite based on NR and TW was successfully prepared with the contribution of a silane coupling agent.
Fungicidal properties of the medium from SCOBY microorganism cultivation in saturated wood against Coniophora puteana fungus
Authors: Betlej Izabela , Andres Bogusław , Szadkowska Dominika , Krajewski Kryzysztof J. , Ościłowska Aleksandra
Published: May 2021

Effects were assessed for the post-culture liquid medium originating from the cultivation of microorganisms that are present in the ecosystem called symbiotic consortium bacteria and yeast (SCOBY). The effectiveness of protecting Scotch pine wood samples against decomposition caused by the fungus Coniophora puteana was evaluated. The obtained results confirmed that impregnation of wood with post-culture medium reduces the possibility of decomposition of this wood by the test fungus. The potential biocidal effect of the post-culture medium from SCOBY was attributed to the presence the substances of a potential fungicidal nature, which were synthesized in the culture medium during metabolic processes occurring in the culture. The obtained results encourage further studies on the potential use of metabolites obtained from SCOBY breeding to protect wood against biodegradation.
Síndrome de deleção 6q
Authors: Menezes Ananda Larise Colares , Benzaquem Denise Corrêa , Carvalho Natalia Dayane Moura , Prazeres Vania Mesquita Gadelha , Fantin Cleiton
Published: May 2021

Objetivos: Síndrome da deleção 6q é considerada uma anomalia cromossômica rara. Assim, nosso objetivo foi relatar um caso de um menino com essa síndrome, em Manaus/Amazonas.Descrição do caso: Menino com quatro anos de idade que apresenta atraso do crescimento e do desenvolvimento neuropsicomotor, dificuldades de ganho de peso e anormalidades na retina. A análise citogenética do paciente revelou cariótipo com 46, XY, del(6)(q25-qter).Conclusões: Este relato demonstrou a importância das análises citogenéticas para o diagnóstico preciso das anomalias congênitas, pois auxiliam no encaminhamento de tratamentos adequados aos pacientes e na ampliação de conhecimento científico relacionado a essa deleção.
Prevalência de depressão e fatores associados em idosos atendidos na Atenção Primária à Saúde em região metropolitana do Distrito Federal
Authors: Ferreira Fernanda Guedes , Gomes Lucy de Oliveira , Grangeiro Adriano Filipe Barreto , Cintra Thais Reggiani , De Mello Juan Luca Menezes , Magalhães Priscila Rejane de Moraes , Cunha Cristina da Silva
Published: May 2021

Objetivo: verificar a prevalência de depressão e as variáveis sociodemográficas e clínicas associadas a esse transtorno nos idosos atendidos na Atenção Primária à Saúde (APS) em região metropolitana do Distrito Federal.Métodos: estudo transversal realizado entre janeiro e agosto de 2018, com idosos atendidos na Unidade Básica de Saúde da Granja do Torto, em Brasília, DF. Foi aplicado instrumento versando sobre variáveis sociodemográficas, comportamentais e clínicas. Para a avaliação dos sintomas depressivos, foi utilizada a Escala de Depressão Geriátrica, versão reduzida (EDG-15). Na análise dos dados, foi realizada a estatística descritiva e a aplicação do teste qui-quadrado para associação das variáveis categóricas, com nível de significância de 5% (p≤ 0,05).Resultados: a amostra constituiu-se de 70 idosos. Foi encontrada prevalência de 41,4% de sintomas depressivos nos idosos estudados, 35,7% com indicativo de depressão leve e 5,7% de depressão grave. No grupo com sintomas depressivos, houve predomínio do sexo feminino, idade entre 70 a 79 anos, casados, católicos, analfabetos, aposentados, de baixa renda e com duas ou mais pessoas com grau de parentesco vivendo na mesma residência. Foi identificado, no grupo com depressão, associação significativa com escolaridade (p=0,05), nível de instrução (p=0,04), renda mensal (p=0,006), condições clínicas como osteoporose (p=0,02) e artrite/artrose (p=0,03), quedas (p=0,03) e uso de antidepressivos (p=0,02), sendo, nessa classe, escitalopram o mais utilizado (p=0,004).Conclusão: foi evidenciada alta prevalência de depressão entre os idosos da APS da região metropolitana do Distrito Federal do sexo feminino com idades entre 70 e 79 anos. Variáveis como escolaridade, nível de instrução, renda mensal, osteoporose, artrite/artrose, quedas e uso de antidepressivos apresentaram diferenças estatisticamente significativas naqueles com depressão. Assim, é fundamental o rastreio precoce dos sintomas depressivos, mais precisão no diagnóstico e no tratamento desse transtorno, com intervenções não farmacológicas e farmacológicas, executadas por equipe multidisciplinar especializada, capacitada para assistir aos idosos da rede de APS, evitando os efeitos deletérios na qualidade de vida dos indivíduos desse grupo.
Role of nurses in a field hospital aimed at patients with Covid-19
Authors: Conz Claudete Aparecida , Braga Vanessa Augusta Souza , Reis Heliandra Holanda , Silva Soélen , Jesus Maria Cristina Pinto de , Merighi Miriam Aparecida Barbosa
Published: May 2021

ABSTRACT Objective: To understand the role of nurses in field hospitals aimed at patients with Covid-19. Methods: Qualitative research based on Alfred Schütz’s social phenomenology. Twenty nurses working in São Paulo were interviewed between May and June 2020. The testimonies were organized and analyzed based on the theoretical-methodological and thematic framework. Results: The following categories emerged: “Nurses’ challenges in field hospital care”, “Visibility of nursing in the Covid-19 pandemic scenario” and “Covid-19 post-pandemic professional valorization”. Final considerations: The reflection on the results that emerged in this study may contribute to support improvements in training, working conditions and valuing nurses, considering the importance of this professional category in the scope of health services. New investigations may increase knowledge in the area, providing subsidies for professional role in this and other health situations that require nursing intensity and excellence.
Decontamination protocol of the macroalga Bostrychia binderi Harvey (Rhodophyta) for unialgal cultures and laboratory studies
Authors: Borburema Henrique Douglas dos Santos , Barbosa Êmille Natane de Araújo , Miranda George Emmanuel Cavalcanti de
Published: May 2021

ABSTRACT This study aimed to test the effectiveness of physical and chemical procedures for surface decontamination of Bostrychia binderi Harvey. For this, thalli were washed and immersed in chemical solutions (5% liquid detergent, 1% povidone iodine and 0.2% sodium hypochlorite) at different times and combinations. After treatments the thalli were cultivated in laboratory to verify possible negative effects caused by the procedures to alga. Contaminating organisms in the algal culture medium were quantified at the end of cultivation. Washing, spraying, removal of macrofauna individuals with tweezers, thalli immersion in 5% liquid detergent for 60 seconds, after in 0.2% sodium hypochlorite for 2 minutes were effective procedures to eliminate all contaminants analyzed. Thalli immersion in 1% povidone iodine did not affect negatively the thalli growth, whereas immersion in 0.2% sodium hypochlorite for 5 minutes affected. For establishment of Bostrychia unialgal cultures we recommend the protocol proposed in this study.
Esplanade metro station in Kolkata, India: from concept to optimisation
Authors: Dewanjee Biswanath , Dutta Suman , Kar Debjyoti
Published: May 2021

Kolkata’s Line 2 metro is a major urban infrastructure project in India. Due for completion in 2022, it will connect the cities of Howrah and Kolkata by tunnelling through soft clayey subsoil under the Ganges and one of the world’s oldest and most congested urban areas. This paper describes the concept design of the new part of Esplanade station, one of the key interchanges on the project. It then explains how the configuration of the proposed four-level underground structure was optimised from a structural aspect, especially the depth and thickness of diaphragm walls.
Die Religion der Péceler Kultur
Authors: Makkai János
Published: May 2021

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RELATIONSHIP BETWEEN ACADEMIC SELF-EFFICACY AND COGNITIVE LOAD FOR STUDENTS IN DISTANCE LEARNING
Authors: Griskevica Inguna , Iltners Martins
Published: May 2021

The COVID-19 global pandemic has forced the education process worldwide to change its form to distance learning. This empirical study contributes to recently limited knowledge about the remote learning process. The study aimed to determine how academic self-efficacy is related to subjective cognitive load to predict achievement results in different forms of distance learning. The research method used was a quasi-experimental pilot study. The research questions were: (1) What is the relationship between academic self-efficacy, subjective cognitive load, and achievement results in teacher-directed distance learning? (2) What is the relationship between academic self-efficacy, subjective cognitive load, and achievement in student-directed distance learning? (3) What is the difference between teacher-directed and student self-directed distance learning settings regarding relationships between academic self-efficacy, subjective cognitive load, and achievement results? The measurement of academic self-efficacy and subjective cognitive load in the context of task assessment results were compared in different distance learning settings in two independent groups of 9th graders. The results suggest a significant relationship between subjective cognitive load and achievement results in student self-directed but non-significant between all variables in teacher-directed distance learning settings. In contrast, settings themselves demonstrated no influence on any measured factors.
Modernization of Prosecutorial Research Methods to Ensure the Rule of Law in the Budgetary Sphere
Authors: Lebedeva Anna E.
Published: May 2021

The article discusses methods of post-classical scientific research used in Specialty 12.00.11. The author argues for the preservation of historical and legal, comparative-legal, and formal-dogmatic methods and constitutionally protected, rights-based methods in the study of prosecutorial activity in the public sector.
International Cooperation in Criminal Digital Finance Cases
Authors: Belyaeva Nina A.
Published: May 2021

The development and application of digital technologies in the areas of governance, economy, society, etc., along with the digitalization of public life, have all led to changes in the legal sphere. The creation of legal rules governing relations connected with the digitalization and transformation of law and legal phenomena and categories are also influenced by the digitization process. The most active development is in the sphere of digital finance. Such concepts as cryptocurrency, tokens, digital financial assets, and virtual money are increasingly taking on their own legal forms. Such new technologies carry risks, because they can be used for both legal and illegal purposes. Since digital technologies are used on the Internet, a completely new, virtual environment of relations has been formed, which is unaffected by the traditional tools of industry legislation. For this reason, at the international level, a regulatory framework is beginning to form for interaction in criminal proceedings that are the subjects or means of digital financial instruments. The difficulty lies in the fact that digital technologies, although essentially based on the same software solutions, face different legal regulations and conceptual contents in different states. The purpose of this article is to analyze the current criminal procedural aspects related to international cooperation in digital finance cases.
Features of the installation of a suprapubic cystostomy for laparoscopic treatment of patients with intraperitoneal bladder rupture
Authors: Shanava Gocha S. , Soroka Igor V. , Mosoyan Michail S.
Published: May 2021

INTRODUCTION: In closed intraperitoneal bladder trauma, an alternative to laparotomy is laparoscopy. The rupture is closed with endoscopic sutures, and the bladder is drained with a urethral catheter. In the literature, the issue of the placement of a trocar cystostomy during laparoscopic treatment of patients with intraperitoneal bladder ruptures requiring prolonged drainage is insufficiently covered.

PURPOSE OF THE STUDY: Determination of the optimal trocar cystostomy method during laparoscopic treatment of intraperitoneal bladder rupture.

MATERIALS AND METHODS: Trocar cystostomy was performed in 8 patients with intraperitoneal bladder ruptures, among whom 7 had concomitant diseases of the prostate gland, and 1 had urethral stricture. Trocar cystostomy during laparoscopic surgery was performed in three different ways. Results. In the first method, the rupture of the bladder was initially sutured. Then, through the urethral catheter, the bladder was filled with saline. A trocar cystostomy was inserted through the suprapubic region. The second method consisted in the installation of a trocar cystostomy under the control of a laparoscope even before the suturing of the bladder rupture. In the third method proposed by us (patent No. 2592023), a Foley-type catheter with a balloon capacity of at least 200 ml was inserted into the abdominal cavity through the laparoscopic port. A catheter was inserted from the abdomen through an intraperitoneal rupture into the bladder. Inside the bladder, the catheter balloon was filled with saline. Then, through the suprapubic region, the anterior abdominal wall, the bladder and the inflated balloon of the catheter were pierced layer by layer with a trocar. Another catheter was inserted through the trocar into the bladder. After removal of the catheter with a ruptured balloon, the intraperitoneal rupture of the bladder was sutured.

FINDINGS: According to the results of the study, the third method of inserting a trocar cystostomy turned out to be the most optimal and safe.
PROM and it’s maternal outcome: a retrospective study in a rural medical college of India
Authors: Sarkar Malay , Mondal Tanushree , Sarkar Manojit
Published: May 2021

Background: Premature rupture of membrane is the unconstrained break of layer before the beginning of  labor and can happen any gestational age even at 42 weeks of growth. Around 2-30 % of all pregnancy will encounter PROM and prompts 33% of preterm birth. The analysis of PROM is to a great extent clinical and is normally proposed by a history of watery vaginal discharge and affirmed on sterile speculum assessment. This examination was led to decide the occurrence, to discover the age, equality dispersion, gestational age dissemination, presentation of PROM and plan the line of the management.Methods: The cases selected in this study were those who had spontaneous rupture of membrane after 28 weeks of gestation but before the onset of labor pain. The study period was of one year from 1st January 2019 to 31st December 2019. The study was conducted in the labor room complex of Coochbehar Govt. Medical College and Hospital, WB India. The patients were admitted in the labor room through emergency. All datas were collected from labor room log book.Results: Total no. of deliveries were 10900 and total no of PROM were 545.Incidence of PROM is 5% in the present study. Maximum no of cases were in the age group between 20-29yr (63%). PROM mainly occurs in primigravida (50.45%). And low rupture of membrane was 91.8%. Cephalic is the commonest presentation (85%) in PROM and the incidence of caesarean section is 24.95%.Conclusions: PROM is the obstetric emergency and once the PROM is diagnosed it is important to weigh the risk of PROM and prematurity and make the right choice of conservative management and active management. If there is chance of maternal morbidity pregnancy should be terminated considering the maternal wellbeing first and then that of the fetus.
Gigantic vulvar masses: a case series of benign large vulvar tumors
Authors: Bringas Lorie Ann H. , Billod Jimmy A.
Published: May 2021

Benign vulvar masses are uncommon condition of the lower genital tract. To date, there is no recognized classification for benign tumors. Most of the vulvar tumors show no symptoms, unless large enough to be noted on self-examination. Presented are 3 cases of large vulvar masses. The first case is a Bartholin’s gland cyst in 56 years old, G5P4 (4014) with a 5-year history of gradually enlarging mass characterized as fleshy, approximately 16x14x12 cm, soft, non-tender located in the medial portion of the left labia majora. Grossly, the specimen consists of a unilocular cyst filled with serous fluid and had a smooth glistening inner capsule wall. The second case is a cellular angiofibroma in 61 years old, G0, who developed a fleshy mass, approximately 13x18x15 cm, soft, non-tender, attached to the left labia majora via a pedicle, which developed for 10 years. The specimen is described as an irregular mass with well circumscribed nodules with soft to rubbery, flesh cut surface. The third case is lipoblastoma-like tumor of the vulva in 31 years old, G2P2 (2002), who had a fleshy hypopigmented mass, approximately 15x12x10 cm, pendulous, soft, smooth, non-tender in the right inferolateral labia majora, which grew for 8 years. The specimen is characterized as an irregular mass partially overlain by skin with cut sections showing cream fatty lobulated surfaces. Benign vulvar masses may present similarly to one another hence careful and detailed assessment should be done. Histologic evaluation is critical in establishing an accurate diagnosis due to the fact that multiple diagnoses may have similar gross characteristics. Management is based on type and size of mass and symptomatology of patient.
Advanced leiomyosarcoma of the uterus: a case report and literature review
Authors: Ottun Tawaqualit A. , Kuye Taiwo O. , Adegboyega Olukayode A. , Olalere Folasade D. H. , Akinbami Omobolanle , Oduyoye Oladunni Yusuf , Salami Morenikeji M. , Rabiu Kabiru , Adewunmi Adeniyi A.
Published: May 2021

Uterine leiomyosarcoma is a rare malignancy accounting for 1-2% of uterine malignancies with an annual incidence of 0.5-7 per 100,000 women. It occurs mostly between the 5th to 7th decades of life hence found more among postmenopausal women.  The aetiology is mostly unknown however, in 0.2% of cases, it originates from sarcomatous degeneration in a pre-existing benign uterine fibroid. Leiomyosarcoma can be mistaken for uterine leiomyoma also known as the uterine fibroid.  It is an aggressive tumour that has a poor prognosis, with or without treatment. This case report aimed to report and discuss the occurrence of leiomyosarcoma as a differential diagnosis of abnormal uterine bleeding in this environment among other conditions. This will bring to the fore awareness among gynaecologists, pathologists, radiologists and oncologists that leiomyosarcoma of the uterus, though rare, should be considered in cases of menorrhagia with suspected uterine fibroid to avoid mistaking it for a diagnosis of uterine fibroid/leiomyoma. It is, therefore, imperative to consider leiomyosarcoma in a pre-menopausal and perimenopausal women diagnosed of abnormal uterine bleeding with symptomatic uterine fibroid. MRI serves as a good tool in differentiating the two pathologies.
A case of hepatocellular carcinoma recurring during pregnancy
Authors: Sarsar Saloua , Chatbi Zaineb , Taheri Hafsa , Saadi Hanane , Mimoni Ahmed
Published: May 2021

The hepatocellular carcinoma is more common in African and Asian countries with an incidence in women at around 5.5/10,000. Hepatocellular carcinoma is an aggressive tumour, with high recurrence rates, reaching around 50%. Hepatocellular carcinoma is rare in pregnant women. In the English literature, we have found only one case of hepatocellular carcinoma recurrence during pregnancy that was described in a 39 years old patient with the recurrence occurring during her second pregnancy. In our work, we describe the second case of pregnancy complicated by recurrent, advanced and inoperable hepatocellular carcinoma. We also present a literature review about management challenges and the importance of multi-disciplinary care in pregnant women with hepatocellular carcinoma.
Predictors of hepatatis B prevention and awareness among barbers in Gwer West Local Government area, Benue state, Nigeria
Authors: Gabriel Ogbeyi Ofikwu , Joseph Jenewari Atiye , Francis Ogbeyi Aba , Tolulope Afolaranmi O. , Paul Aba John , Emmanuel Ikpom Terhemba
Published: May 2021

Background: The rapid increase in the prevalence of hepatitis B virus infection is an important public health issue worldwide. Millions of the general population is at an increased risk of being infected but they lack the awareness and preventive measures against this infection. This study was carried out among barbers in Naka, Gwer West Local Government area of Benue state, to determine the predictors of awareness and preventive measures against hepatitis B.  Methods: A cross sectional descriptive study involving all barbers in Naka were carried out. Structured interviewer administered questionnaires were used in collecting data from the respondents. Data were analyzed using statistical Package for Social Science (SPSS) version 23.0. Adjusted odds ratio and 95% confidence interval were used as point and interval estimates on the logistic model while a p value of ≤0.05 was considered statistically significant.Results: The total number of respondents in this study was 57. The mean age of the respondents was 25.9±2.10.  Majority (92.2%) of the respondents had heard of hepatitis B, 48.9% were able to identify the cause of the disease as virus. Majority of the respondents (78.7%) identified vaccination as a preventive measure against hepatitis B. On vaccination, more than half (51.1%) had been vaccinated against hepatitis B. Vaccination and information significantly affect prevention and awareness p=0.015 and 0.001 respectively.Conclusions: Awareness of hepatitis B was high in this study but awareness about causes and clinical presentations were low. There is need for proper health education programmes to improve their knowledge about hepatitis B and its prevention.
Undergraduate teaching in COVID-19 pandemic: an experience at tertiary care centre
Authors: Bhagyalakshmi A. , Uma Prasad
Published: May 2021

Background: COVID-19 outbreak has taught us to opt for technologies, which have not been used before. There is lot of information available on the internet for learning, but undergraduate students of medicine need continuous guidance. The best platform would be live online teaching which includes student centred learning and observing appropriate COVID-19 social distancing. Aims and objectives of the study was to highlight various positive and negative impacts of COVID-19 on medical education.Methods: The students included in the study are from second MBBS with total number of 200. Time table was planned and everyday two live lectures across their subjects of study were taken. The classes were carried out using the Cisco Webex software. The students were able to ask questions and cleared doubts during and at the end of each class. The feedback of the session was collected by structured format and observations recorded.Results: In the present study the advantages of online classes based on student observations were: learning at ease, flexible environment, no delay in classes, and no peer distraction. In the present study the disadvantages were: eyes are getting strained, network issues, concentrate for long time, disturbances at home and no practical knowledge. In the present study, improvements and suggestions offered were to provide recorded videos or power point presentation, case based discussions, assignments and revision classes to be increased.Conclusions: The present study had several limitations. The study was conducted during the first phase of the COVID-19 pandemic at a Government Institute where most students belong to middle class. Despite these limitations, we believe the study provides relevant insights into the challenges facing online medical education in a time of healthcare crisis.
Correlation of platelet count/splenic diameter ratio for the diagnosis of esophageal varices in patients of cirrhosis of liver
Authors: Mandar Waghralkar , Vijay Somannavar
Published: May 2021

Background: In patients with cirrhosis, endoscopic screening for esophageal varices is currently recommended as a gold standard tool at the time of diagnosis of cirrhosis and to institute prophylactic measures in patients with large esophageal varices. Newer methods have been proposed as alternatives to conventional endoscopy for the non-invasive or minimally invasive diagnosis of esophageal varices.Methods: This one year observational study was done in the Department of Medicine at Dr. Prabhakar Kore Hospital MRC Belagavi. A total of 70 patients with cirrhosis of liver were included in the study. Relevant clinical examination, laboratory workup like complete blood count, liver function test, ultrasound abdomen and all patients underwent screening upper gastrointestinal endoscopy. Platelet count to spleen diameter ratio was calculated for all patients.Results: 54 (77.14%) had varices. Males predominated with 64 (91%). Majority patients ranged in between 31-50 years. Evidence of esophageal varices was more common with cirrhosis secondary to alcoholism as compared to hepatitis B virus (HBV) and hepatitis C virus (HCV). The child Pugh score, platelet count, spleen size, platelet count/spleen diameter ratio in patients with varices was significantly different from patients without varices. Platelet count spleen diameter ratio cutoff value of 909 was obtained with sensitivity of 77% and specificity of 79%. The positive predictive value was 88% and negative predictive value was 62%.Conclusions: The platelet count to spleen diameter ratio may be useful inexpensive tool for diagnosing esophageal varices in liver cirrhosis noninvasively when endoscopy facilities are not available.
A study of the prevalence of gonadal dysfunction and its association with increasing disease severity in patients diagnosed with chronic kidney disease at a tertiary care center in Kolkata, West Bengal
Authors: Parasher Anant , Ranjan Kunal , Munjal Vanshika
Published: May 2021

Background: Hypergonadotropic hypogonadism is a well described hormonal derangement associated with chronic kidney disease, also known as uremic hypogonadism. The objective of this study was to assess the prevalence of gonadal dysfunction associated with chronic kidney disease and to study the co-relation of gonadal dysfunction with disease severity.Methods: In this cross-sectional observational study, 50 patients with diagnosed chronic kidney disease were included during the one-year period from May 2015 to April 2016. The clinical and biochemical parameters related to gonadal dysfunction were evaluated in these cases.Results: Out of the 28 male CKD patients, 19 (68%) patients had Serum Testosterone values less than 90 ng/dl, 18 (64%) patients had a serum leutinizing hormone (LH) level greater than 9 mIU/ml and 19 (68%) patients had a serum follicle stimulating hormone (FSH) level greater than 13 mIU/ml. Out of 22 female CKD patients, 14 (64%) patients had serum estradiol value less than 50 pg/ml, 12 (54%) patients had Serum LH level greater than 80 mIU/ml and 20 (91%) patients had a S. FSH level greater than 26 mIU/ml. Out of a total of 50 patients in this study, 34 patients showed evidence of gonadal dysfunction, the majority of them belonging to stage 5 CKD.Conclusions: Out of the 34 patients showing gonadal dysfunction, 5 (15%) patients were in stage 3 CKD, 11 (32%) patient were in stage 4 CKD and 18 (53%) were in stage 5 CKD. It may be proposed that gonadal dysfunction is very common in CKD patients and the frequency of sexual dysfunction increases as the renal function deteriorates.
Atypical symptoms with typical signs in a patient with Propionibacterium acnes related mitral valve endocarditis
Authors: Hameed Rashid , Irrum Noshine , Saxena Pankaj , Musameh Muntaser D.
Published: May 2021

Infective endocarditis (IE) is a serious medical condition associated with an increase in morbidity and mortality if not treated promptly and adequately. The clinical outcome depends on the early diagnosis and aggressiveness of the causative organism. Patients usually present with typical features suggestive of Infective endocarditis but in some circumstances the presentations are atypical, and if not diagnosed and treated, may lead to serious consequences. We present a case of atypical presentations of infective endocarditis caused by Propionibacterium acnes organism with no classical features of endocarditis and had symptoms suggestive of urinary tract infection. The diagnosis of IE can be very difficult in patients with atypical clinical presentation, particularly caused by low-pathogenicity organisms. Appropriate clinical assessment and high level of suspicious especially in the patients with previous history of infective endocarditis or having prosthetic valves in situ is crucial.
Premalignant lesions of the oral cavity: current perspectives
Authors: Swain Santosh Kumar
Published: May 2021

Premalignant lesions of the oral cavity are also called as potentially malignant disorders. The common premalignant lesions of the oral cavity include leukoplakia, oral submucous fibrosis (OSMF) and oral erythroplakia. These lesions have a very high malignant transformation rate. The exact etiological factors for development of the premalignant lesions of the oral cavity are not fully understood till date. Use of tobacco, alcohol drinking, chewing betel quid containing areca nut and solar rays are important etiological factors for resulting the premalignant lesions of the oral cavity. Early diagnosis is an important step for preventing the malignant transformations of these lesions and can be also life-saving. There are several treatment options including conservative to surgical for eliminating the premalignant lesions of the oral cavity. The aim of this study was to discuss the details of epidemiology, etiopathology, clinical presentations, diagnosis and current treatment of the premalignant lesions of the oral cavity.
Impact of alcohol on gastric mucosa in a population with high prevalence of Helicobacter pylori
Authors: Nawahir Sultan , Kurian George , Alexander Thomas , Kurian Susy
Published: May 2021

Background: The purpose of the study was to see whether chronic alcohol abuse had any effect on the gastric mucosa in a population already affected by a high prevalence of Helicobacter pylori.Methods: 35 males with a history of chronic alcohol abuse were compared with 35 males who were abstinent or social drinkers. All subjects had complaints of dyspepsia. All subjects underwent endoscopy and targeted biopsies were taken from three specific sites in the stomach, namely body, antrum and incisura. Biopsies were studied to look for changes of atrophic gastritis and intestinal metaplasia. The presence or absences of H. pylori on the tissue biopsy were also recorded.Results: Atrophic gastritis were only assessable in 24 alcoholic patients and 21 non-alcoholic patients due to the inadequacy of the depth of the biopsy. AG were found to be equally distributed in both the groups. 23 (64.9%) patients in the alcoholic group and 19(54.5%) in the control group had AG (OR-1.54, p=0.47). Intestinal metaplasia was seen in 10 (28.5%) alcoholic group and 12 (34.2) in the control group (OR-0.65, p=0.45). Of the 42 subjects detected to have AG, 16 (38.1%) had IM. However, IM were always associated with AG. In addition, H. pylori were not seen to be different in the two groups. H. pylori were positive in 18 (51.4%) alcoholic and14 (40%) non-alcoholic patients (p=0.33).Conclusions: Chronic alcohol abuse doesn’t appear to have any major impact on the gastric mucosa in terms of producing premalignant lesions such as atrophic gastritis or intestinal metaplasia or enhancing the prevalence of H. pylori.
Clinical profile and outcomes of patients with acute pancreatitis and correlation with severity index from a tertiary care centre in South India-retrospective analysis
Authors: Nawahir Sultan , S. Babu Kumar , Naik Bala Kasi , Parthasarathy Ealai Athmarao
Published: May 2021

Background: Acute pancreatitis is an inflammatory condition of the pancreas having a varied clinical presentation. It is one of the commonest causes of abdominal pain requiring hospital admission. This retrospective study aims to describe the clinical profile and outcomes of patients with acute pancreatitis and its correlation with severity index.Methods: All patients admitted with a diagnosis of acute pancreatitis to medical gastroenterology department between January 2018 to December 2020 were included in this retrospective study.Results: A total of 61 subjects were included in the final analysis. The mean age was 41.64, the ranged between 19 to 88 years. Among the study population, 53 (86.89%) were male and 8 (13.11%) were female. Among the people 43 (70.49%) were alcoholics, 22 (36.07%) were smokers, 11(18.03%) had systemic hypertension and 5 (8.20%) participants had type 2 diabetic mellitus. The mean CTSI was 2.15±2.82, the mean Balthazar was 3.43±2.4 and the mean procalcitonin was 2.52±9.28. The mean Lipase was 7822. There was a weak positive correlation between CTSI and CRP (rs value: 0.147, p=0.260). There was a weak negative correlation between Balthazar and CRP (rs value:-0.067, p=0.606).Conclusions: Among the study population, 87% of the patients were males. 70% of the population were alcoholics. Mean serum lipase was 7822. There was a weak positive correlation between CTSI and CRP (rs value: 0.147, p=0.260). There was a weak negative correlation between Balthazar and CRP (rs value:-0.067, p=0.606).