bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten years risk assessment of cardiovascular events among adult population visiting urban health and training centre of a tertiary care institution, Farrukhabad, Uttar Pradesh, India
Authors: Alam M. N. , Khatoon Shagufta
Published: September 2021

Background: Cardiovascular diseases (CVDs) are the number one cause of death globally, four out of five CVDs deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age. In view of above background study conducted with the aim and objective to determine Ten years risk assessment of cardiovascular events (myocardial infarction or stroke) among adult population visiting UHTC of a tertiary care Institution, Farrukhabad, UP, India.Methods: A cross-sectional study was conducted using World Health organisation (WHO)/International Society of Hypertension (ISH) tool at urban health and training centre (UHTC) of a tertiary care institution at Farrukhabad, UP from August 2017 to January 2018.  Sample size was 400 (n=4pq/l2). Ethical clearance was obtained from institutional ethical committee and written informed consent obtained from the participants. Data analysed using SPSS Software. Chi-square test used to observe level of significance at p<0.05.Results: Majority (69.5%) have less than 10% risk for CVD whereas 10.5% have 10-20% risk, 8% people have 20-30% risk, 6.25% have 30-40% risk and 5.75% people have ≥ 40% risk. Majority (58.75%) belong to young adult. About 7.75% people were diabetic and 11.25% were smoker. Concerning serum cholesterol, 49% had 5 mmol/l, 42% had 4 mmol/l, 0.75% had ≥8 mmol/l. Statistically significant association observed between socio-economic status (SES) and cardiovascular event when chi-square is 95.344, and p<0.00001.Conclusions: About 1/3 population have risk above 10%. Mostly middle-income group are on risk.
Impact of adenoidectomy on middle ear function in children between 5-12 years of age with chronic adenoiditis
Authors: Agaman G. , Poduval Jayita D.
Published: September 2021

Background: Otitis media with effusion (OME) is an inflammatory disorder of the middle ear that is characterised by the presence of endotympanic fluid without any sign or symptom of acute ear infection, which may lead to hearing loss or long-term sequelae and have a negative impact on speech development and behaviour. Aim of the study was to determine the influence of adenoidectomy on middle ear function in children with chronic adenoiditis and to correlate degree of adenoid hypertrophy with middle ear function.

Methods: This cross-sectional study comprised 50 cases, who were 5-12 years of either sex presenting to ear, nose and throat outpatient department (ENT OPD) with grade 3, 4 adenoid hypertrophy. After detailed history and clinical examination, investigations such as pure tone audiogram, impedance audiometry, X-ray nasopharynx and diagnostic nasal endoscopy were carried out to confirm the diagnosis. All patients were posted for adenoidectomy by curettage. They were followed up at 1st, 3rd and 6th month for pure tone audiometry and impedance was done at 6th month of surgery.  

Results: In this study, maximum number (82%) of cases belonged to more than 7 years age group. On otoscopy, dull, amber coloured tympanic membranes ™ was the most common finding in 78% of cases. 66% had adenoid hypertrophy grade three and 34% had adenoid hypertrophy grade four. Mean audiometry findings at preoperative, and one month and 3 months post-op intervals are 24.2, 13.28 and 12.2, and the p value is less than 0.0001, which is statistically significant.

Conclusions: It may be concluded, that adenoidectomy completely eliminates the effusion in the middle ear cavity and exhibits significant postoperative hearing improvement.
Multidetector computed tomography imaging of squamous cell carcinoma of buccal mucosa
Authors: Sankhe Ashwini , Rahatekar Neha , Mankar Diksha
Published: September 2021

This study aims at describing the role of multidetector computed tomography (MDCT) and CT imaging findings in evaluation of squamous cell carcinoma of buccal mucosa and its staging. Retrospective study of 40 patients who underwent MDCT and were histopathogically proven case of squamous cell carcinoma (SCC) of buccal mucosa patients were included in the study. Plain, arterial, venous phase and puff cheek CT cuts were taken from base of skull till clavicle. The imaging findings in squamous cell carcinoma (SCC) of the oral cavity allow the radiologist to accurately determine the extent and staging of disease thereby help clinicians plan appropriate treatment. 40 such patients were done in which majority of them are male patients-27 as compared to female patients-13. Among these 40 patients, 20 patients had stage IVB cancer, 13 patients had stage IVA, 5 patients had stage II and 2 patients had stage I cancer. No patient included in our study had stage III.  Patients’ recovery will depend on how early the cancer is found and staging gives an idea of patients’ possible outcomes. MDCT is non-invasive and cost-effective investigation which helps in evaluating squamous cell carcinoma of buccal mucosa and determines its stage of buccal cancer and guide the therapy accordingly.
Thyroglossal cyst in elderly: a rare cause of inspiratory stridor
Authors: Agrawal Animesh , Baisakhiya Nitish , Sharma Harshita
Published: September 2021

Thyroglossal cyst is the most common congenital anterior neck swelling in childhood. Commonly present as painless swelling in the 2nd decade of life but the cases are reported in the elderly age group also. It represents the persistent epithelial tract from the foramen cecum to the thyroid gland. Clinically can be diagnosed and can be differentiated with other mid-line swelling by movement with the protusion of tongue. It is usually related to the hyoid bone and may be supra-hyoid, infra-hyoid, lower part of the midline or rarely lingual in position. Ultrasonography is the investigation of choice for this cystic condition. It is safe, economical and easily available investigation among all the radiological study. MRI is helpful to diagnose cervical extension and lingual cyst. Inspite of close relation to the laryngeal structure it rarely present as laryngeal mass and causes stridor or sleep apnea as in our case. Classic Sistrunk procedure is the treatment of choice for the condition. Endoscopic CO2 Laser is useful in situation where only intraoral cyst present without cervical extension. Marsupialization is reserved for lingual cyst especially in Neonate. We are reporting this case which was present in the elderly and reported with long standing anterior neck swelling with inspiratory stridor on lying down position.
Retrospective study on fatal road traffic accident in Aizawl, Mizoram during 2014-2018
Authors: Keisham Supriya , Nandeibam Pabitramala , Pradipkumar Singh Kh. , Vanlalchhuanga George , Nabachandra H.
Published: September 2021

A traffic collision, also called a motor vehicle collision, car accident, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or any stationary obstruction, such as a tree, pole or building. Traffic collisions often result in injury, disability, death and damage to property as well as financial cost to both the society & individuals involved.
A prospective study of medicolegal autopsies to establish profile of burn deaths
Authors: Umbare R. B. , Bansude M. E. , Kadavkar S. M. , Dode C. R.
Published: September 2021

Burns injuries have been a one of the major cause of concern since prehistoric time to the present era of modern medicine. Burn is considered to be the commonest cause of unnatural death in India.Burns are injuries produced by application of dry heat such as flame, radiant heat or some heated solid substance like metal or glass to the body. Dry heat, application of hot bodies, licking by flames resulting in simple burns causes local injury to the body. Moist heat leading to scalds, corrosive poisons resulting in corrosive burns. Electric spark, discharges, flashes and lightning leads to electric burns.Present study aim to know the magnitude of burn deaths in the region of southern marathwada region. Two years prospective study was conducted at Government Medical College Latur. Study of medico legal autopsies to establish the profile of burn deaths was carried out. In the present study, it is found that burns are commonly found in female (72.04%) than in females. Housewives (43.52%) were common victims followed by works (9.80%). Most of the incidences took place in morning hours (45.53%). Most common place of incidence was house (83%). Kerosene (57.63%) was the most common accelerant used to cause burn. If percentage of burn increases, the survival period decreases and vice versa. Most common alleged manner of death was accident (53, 6%).
Comparison of dental caries and periodontal disease with dermatoglyphic patterns and salivary p
Authors: Aruna D. , Prasanth T.
Published: September 2021

Dermatoglyphic patterns are dermal ridge configurations present on the fingers, palm, toes and soles of human which are valuable in the diagnosis of many diseases associated with genetic disorders. Although the aetiology of dental caries and periodontal diseases is multi-factorial, we hypothesize that they may have genetic predisposition. We also evaluated its association with environmental factors like salivary pto assess any possible correlation.

This study aims to Compare Dental caries (DC) and chronic generalized periodontitis (CGP) with Dermatoglyphic patterns and salivary p.

One hundred patients were divided into group I (40 DC patients), group II (40 CGP patients) and group III includes 20 healthy controls. DMFT (decayed missing filled teeth) index (> 5) from group I, Russell’s periodontal index (2-5) from group II patients were taken. Finger print patterns by ink method and salivary p by p strips were recorded from all the groups and analysed with descriptive analysis.

Group I showed more incidence of whorl patterns at lower salivary p than Group II and III which was statistically significant (p<0.05). Group II showed more incidence of ulnar loop patterns at slightly lower p than Group I & III which was statistically significant (p<0.05).

The present study showed DC seen in people with more number of whorl patterns and periodontal disease with more ulnar loop patterns at lower salivary P. Larger scale studies are warranted to confirm our findings before applying dermatoglyphics to predict an individual prone to develop DC and periodontal disease in clinical practice.
An autopsy study of suicidal hanging
Authors: Rao Dinesh
Published: September 2021

Hanging is the most preferred method of Suicide. Individuals are known to use different Ligature material and suspend completely or partially. hence, it is important to understand the Parameters involved in it. Large number of Suicidal death are reported.

To Understand Suicidal Hanging by studying different parameters involved in it like Ligature Material, Type of Knot. Sex and Age Group, involved, kind of Suspension and Position of knot.

A total of 634 cases were studied . Crime scene examination was done only in those cases where their were Suspicion on the Suspension Deaths. Rest of the cases the crime scene photographs and investigating officer records were the inputs. Only Suicidal Hanging were Considered for the Study.

Suicidal Hanging contributed to 6.5% of the Total Cases. The Ropes[27%%] and Stole [36%]Contributed to the Most Preferred Ligature Material and Shoe Lace contribute[0.5%] to the least preferred Material for Self Suspension. Complete Suspension was observed in 62% of cases. The Majority of the Victims were Females contributing to 62% of the Deaths. The Major Age Group[50.76%] Involved was between 21-30years and the Uneffected Age group were those in the Extremes of Life i.e 1-10 and 61-70years. A Slip Knot was used on 97.73% of suspensions. In 78% of Suspension the Position of the Knot was situated over the [Typical Hanging]Nape of Neck. Married Victims Contributed to 37.45% of cases.

The different Parameters of Suicidal Hanging are necessary to understand the Suicidal Nature of Hanging.
Retos y oportunidades para la reactivación productiva de la provincia de San Juan
Authors: Fernandini Puga Manuel , Castello Romina , Demichelis Francisco
Published: September 2021

En las condiciones de crisis actual como consecuencia de la pandemia de la COVID-19, la implementación de programas que promuevan el acceso a financiamiento resulta clave para la reactivación de las economías regionales. Esta publicación presenta los principales desafíos y oportunidades identificados para contribuir a la recuperación de la producción de la provincia de San Juan y apoyar la sostenibilidad de las micro, pequeñas y medianas empresas (mipyme) como sostén del empleo en la provincia.
Pilgrimage to the Holy Land and Religious Diplomacy of USSR during the Cold War
Authors: Gerasimova Victoria
Published: September 2021

The paper deals with the issue of organization of pilgrimage trips of representatives of the Russian Orthodox Church of the Moscow Patriarchate to the Holy Land (Israel and Jordan) during the Cold War Era. The author argues that a number of foreign policy factors (primarily the struggle for Russian property and the tension of Soviet-Israeli relations) led to the opening of the opportunity to make Orthodox pilgrimage trips from the USSR to the Holy Land. The paper provides evidence that the Soviet government considered the possibility of regular dispatch of groups of Soviet pilgrims from among the “clergy and laity” already in 1956, whereas in reality the first group went only in 1964. Archpriest Mikhail Zernov's project on the restoration of pilgrimage trips from the USSR to the Holy Land that has not been analyzed before is introduced into academic circulation. The author examines the specifics of the composition of the pilgrim groups, and a description of pilgrims' activities, as well as the perception of the role of pilgrims by Soviet officials. The author comes to the conclusion that the establishment of the practice of sending pilgrim groups through the ROC MP became one of the USSR's foreign policy instruments in the Middle East, which provided an alternative to traditional diplomacy.
Secret Operations of the Soviet Security Services against the Jehovah’s Witnesses in Ukraine (1949—1955)
Authors: Vagramenko Tatiana
Published: September 2021

This article reconstructs the history of one KGB operation against the Jehovah’s Witnesses in Ukraine, launched by the Ukrainian security services in 1951. The operation aimed to infiltrate the Jehovah’s Witness underground organization in Ukraine and to organize a Witness country committee as a covert operation. The plan was designed such that the Soviet security service became the head of the Jehovah’s Witnesses organization, and the headquarters of the official Watch Tower Bible and Tract Society became a channel in their counter-intelligence operations. This article tells about the failures and unexpected side-effects of the secret operation caused by internal conflicts within the Soviet politics of religion. Paradoxically, in the context of a disintegrated Witness underground network, caused by the post-war deportations and mass arrests, severed communication channels with the Watch Tower Society and the absence of religious literature, the Soviet security service became an alternative communication channel between the faith communities and a source of religious reproduction (including the source of the production of Watch Tower literature). This study dwells upon historical materials from recently opened SBU (former KGB) archives in Ukraine.
Miracula s. Willehadi: Prospects for Studying “Unreliable” Sources
Authors: Arnautova Yulia
Published: September 2021

The article deals with the heuristic potential of early medieval collections of saints' miracles (libri miraculorum, miracula) which are rarely studied in anthropologically oriented historiography, because they are literary fiction and, unlike the 12—17th century miracula, cannot serve as sources for studying folk piety or everyday life. Using the example of St. Willehadi's miracles (Miracula s. Willehadi, 860—865) by Bishop Ansgar of Bremen, the article analyzes the possibility of involving texts considered “unreliable” in terms of the facts described in them, within the framework of the cognitive theory of communication. The approach to the miraculous text as a message containing meaning-generating representations, which have a distinctly expressed communicative intent, allows to reassess its content, which in traditional studies is usually devalued as “hagiographic topics”, and to establish the pragmatic function of the text (causa scribendi), which is not always limited to the proof of the sanctity of the hero.
Design and Implementation of an Integrated Central Heating Information Monitoring System for Smart Cities
Authors: Shen Xiaogai
Published: September 2021

Establishing and optimizing an integrated central heating information monitoring and energy conservation system can not only help reduce the waste of resources, but also allow us to identify and solve the instability and safety problems in the heating process, and thus this system is of certain research value. Existing automated heating equipment fail to truly monitor and regulate heating due to various reasons like the lack of comprehensive parameter measurement and serious hydraulic imbalance of the system. To this end, this paper studies the design and implementation of an integrated central heating information monitoring system for smart cities. First, the big data of central heating temperature monitoring in smart cities was reconstructed, and then three different central heating regulation modes were introduced. The experimental results verified the effectiveness of the proposed algorithm. With an example of central heating monitoring shown, the energy efficiency analysis results regarding the energy conservation optimization of the system were given.
Analytical and Experimental Investigation of a Plate Fin Heat Exchanger at Cryogenics Temperature
Authors: Gupta Ajay K. , Kumar Manoj , Sahoo Ranjit K. , Sarangi Sunil K.
Published: September 2021

Plate-fin heat exchangers provide a broad range of applications in many cryogenic industries for liquefaction and separation of gasses because of their excellent technical advantages such as high effectiveness, compact size, etc. Correlations are available for the design of a plate-fin heat exchanger, but experimental investigations are few at cryogenic temperature. In the present study, a cryogenic heat exchanger test setup has been designed and fabricated to investigate the performance of plate-fin heat exchanger at cryogenic temperature. Major parameters (Colburn factor, Friction factor, etc.) that affect the performance of plate-fin heat exchangers are provided concisely. The effect of mass flow rate and inlet temperature on the effectiveness and pressure drop of the heat exchanger are investigated. It is observed that with an increase in mass flow rate effectiveness and pressure drop increases. The present setup emphasis the systematic procedure to perform the experiment based on cryogenic operating conditions and represent its uncertainties level.
The Capability to Make Ice from Sunlight Utilizing a New Absorption Unit of Nano-Coated Ammonia/Calcium Chloride
Authors: Al-Dabbas Mohammed Awwad Ali
Published: September 2021

In southern Jordan, the ice machine was designed, produced, operated, and fully examined at Mutah University, a unique Nano-coated ammonium/calcium chloride absorption sun unit. Analytical and experimental assessments on the use of ammonia/calcium chloride absorption unit ice produced. The new study has decreased energy emission by the Nano ice-making company while enhancing Nano's ice machine's nuclear power compared to standard solar chiller absorption that is not used in the current research. Our case was the world's first research to examine the effect of a nanoparticle combination of paint on an absorption cooling system used to make ice by the sunlight. The result of the test was quite encouraging. The combination of paint and nanofluid particle materials has boosted the accessibility to sun-based cooling processes and their capability to make ice of absorption. In addition, 0.6 was found to be a pretty good COP for the ammonia/calcium chloride solar system of absorption.
Construction and Optimization of a Thermo-economic Cost Analysis Model for the Complex Energy Network
Authors: Zhang Meng , Wang Xutong
Published: September 2021

Improving the energy use efficiency of the energy system is of great significance to the development of the national energy economy and the improvement of the national economic competitiveness. The existing domestic research on thermo-economic costs is insufficient. For example, there is no research on the allocation of thermo-economic costs and on the complex energy network with multiple energy outputs. Therefore, this paper reconstructs and optimizes the thermo-economic cost analysis model for the complex energy network. First, the thermo-economic cost model for each sub-network and that for each energy output of the complex energy network were established, and the structure block diagram of the distributed thermo-economic cost allocation model for the complex energy network was given. Then, a local-global decomposition optimization method was proposed for the complex energy network to achieve the thermo-economic optimization of the complex energy network. The experimental results proved the effectiveness of the proposed algorithm.
Rheological Properties of Xanthan Gum and Polyacrylamide Mixture in Inorganic Salt Solutions
Authors: Liu Huanan , Wu Jinghua , Zhang Yichen , Wang Wei , Chen Yanan , Lang Qiuling , Gao Xiaolong , Song Jianshan , Pei Xiangjun
Published: September 2021

PAM is a good flocculant, and XG is a good tackifier. When the two solutions are mixed, the PAM/XG mixed solution has good viscosity and can be used as a foam stabilizer in foam drilling fluids, and it can also be used as a coupling agent for sand-fixation serous fluid. When metal cations enter the PAM/XG system, it will destroy the overall rheology and stability of the PAM/XG system. This article uses the DV3T-LV rheometer to test the rheology of different types of PAM (HPAM/CPAM/AMPAM/NPAM) and XG mixed solutions,and get the optimal test ratio. Then add various metal cations (Na+, K+, Ca2+, Mg2+) to the mixed solutions of HPAM/XG, CPAM/XG, AmPAM/XG, NPAM/XG respectively. We know divalent metal cations have greater impacts on the shear stress of the PAM/XG composite system, which is likely to cause its shear dilution. Finally, through mechanism analysis, it is concluded that it provides a good preliminary foundation for the research of foam drilling fluid and sand-fixation serous when the metal ion destroys the molecular structure of the PAM/XG composite system.
Characterization of a Closed Loop Pulsating Heat Pipe Using Ethanol with Different Angles
Authors: Ahmed Israa S. , Abd Hussain S. , Al Jubori Ayad M.
Published: September 2021

In low-temperature difference, a closed-loop pulsating heat pipe (CLPHP) can be used as a cooling device due to its capability to transfer heat. The thermal performance of the CLPHP is affected by the working fluids. In this work, the effects of some operating parameters such as using ethanol as working fluid with 0.5 filling ratio, orientation, and power inputs are offered based on experimental study. Where the CLPHP was constructed and tested to achieve a better vision into the effect of orientation of 0°, 15°, 30°, 45°, and 90°, and power input of 50 W, 115 W, 215 W, and 450 W on the heat transfer characteristics and the thermal performance. The results indicated that the minimum thermal resistance can be reached at 0.1585 (℃/W) with an orientation of 90° and a power input of 450 W. The results revealed that the inclination angles and power inputs had considerable influence on the enhancement of the thermal performance of the CLPHP. For the low boiling temperature of the working fluid, the power input is more favorable because of fast startup compared with a high power input that leads to some difficulties like the dry-out phenomenon.
The Church and Ecumenism in the Thought of John Henry Newman
Authors: Scerri Hector
Published: September 2021

This article explores the development of Newman’s thought on the Church, throughout different phases of his long life. The article focuses, among other themes, on the nature of the Church, the important introduction to his Via Media (1877), the charismatic dimension of the ekklesia, and the respective roles of the pope, the bishops and the laity, in particular what the latter can contribute to the whole People of God. The article also seeks to delve into the question whether one can talk about ecumenism in the writings of the influential nineteenth-century English man of letters and opinion leader. The conclusion offers some final considerations on what Newman underwent during his long and meandering journey with regard to some basic tenets of his ecclesiology.
Последние времена этого мира в богословской мысли преподобного Иустина Поповича
Authors: Sashko Sashko
Published: September 2021

Учение о последних временах этого мира преподобного Иустина Поповича концентрируется прежде всего вокруг знаков, возвещающих конец света, к которым относится проповедь Евангелия всем народам, обращение Израиля ко Христу, появление Антихриста, космическая катастрофа, а также небесное знамение креста накануне Второго Пришествия Спасителя. По мнению преподобного Иустина, наиболее трагическим моментом в конце этого мира будет появление Антихриста, в котором все зло достигнет своего апогею. Исходя от Священного Писания, а также трудов Отцов Церкви, архимандрит Иустин рассуждает о воскрешении человеческого тела, а также об анакефалаиосисе всего тварного под главою Христом, кода лишь Бог «будет все во всем» (1 Кор. 15,28). Для архимандрита Иустина самым большим даром Воскресшего Богочеловка естеству человеческому является бессмертие тела и материи.
EXPLORING THE CYC CIS-TEM: A LITERATURE REVIEW OF QUEER AND TRANS TOPICS IN CHILD AND YOUTH CARE
Authors: Walker Mattie
Published: September 2021

Although Child and Youth Care (CYC) sees itself as a field that embraces diversity and complexity, there is a notable lack of discussion of sexual and gender diversity: queer and trans topics are rarely taken up across CYC research, practice, and pedagogy. Through a systematic literature review of articles published between 2010 and early 2020 in six journals with a focus on CYC practice, research, and theory, this article assesses how queer, trans, Two-Spirit, and nonbinary identities and topics are being discussed in the current CYC literature and reveals a conspicuous absence of publication on these topics. In a 10-year period, across six CYC publications comprising over 4000 published articles, only 36 articles focused on queer and LGBT issues (by covering both sexual and gender diversity) and, of those, only eight articles specifically focused on gender diversity or trans topics. No articles were found within any of the reviewed publications that specifically focused on Two-Spirit identities or topics and only one article mentioned nonbinary identities. Through exploring how and where queer and trans, Two-Spirit, and nonbinary identities and topics are being discussed, this review asks how we as a CYC field might begin to make space for these topics within our field and practice, in order to work towards social change that shifts our field and challenges the cis-heteronormative CYC system.
MOVING QUEER VISIBILITIES INTO IDENTITY-SUSTAINING PRACTICES IN CYC: TOWARD QUEER(ED) FUTURES
Authors: Longoria A.
Published: September 2021

This essay aims at connecting child and youth care (CYC) to U.S. teacher education, educator pathways, and schooling in the United States. Further, this essay addresses Wolfgang Vachon’s call to push the boundaries of CYC, specifically in queering the field. I offer ways U.S. teacher education contexts and practices might be considered as guidance in supporting queer identities in CYC. I posit that there is a corporeal pedagogy that queer CYC practitioners enact that is effected beyond simple visibilities, and that they sustain their own identities and survival in CYC spaces through this practice. I also offer a testimonio of my practice as an out genderqueer, Chinese Mexican teacher educator who works in U.S. field-based teacher training and after-school CYC spaces. Further, I argue for critical engagement with curricula and field work in our training programs and make a call for training programs to support CYC practitioners in sustaining their queer identities. Finally, I argue for a need to continue to archive — and perhaps rescue — the practices and collective memories of queer CYC practitioners in order to advance a meaningful sustaining of queer identities in CYC.
Innovation, reflection, and future directions: An introduction to the special issue on Indigenous language revitalization
Authors: Chew Kari A. B. , McIvor Onowa
Published: September 2021

Introduction
Cuantificación del efecto de obstrucciones en el área transversal de un túnel de viento sobre los resultados de la calibración de anemómetros
Authors: Madolet Pinto Carolina , Granados Avellaneda Edison Gerardo , García Sanchez Carlos Eduardo
Published: September 2021

Los instrumentos utilizados para cuantificar magnitudes físicas requieren de calibraciones periódicas, para garantizar la fiabilidad y precisión de sus mediciones. Uno de los métodos de calibración de anemómetros más utilizados consiste en la comparación directa de las lecturas obtenidas por el anemómetro que se desea calibrar y por un instrumento patrón, al exponer ambos instrumentos a un gas a la misma velocidad en el interior de un túnel de viento. La presencia del anemómetro que está siendo calibrado supone una obstrucción que puede distorsionar el perfil de velocidad al interior del túnel de viento. La presente investigación tuvo como objetivo estudiar y modelar el efecto de las obstrucciones causadas por los anemómetros bajo prueba sobre los perfiles de velocidad al interior del túnel de viento WSL 20, de la Corporación CDT de Gas, y así evaluar su influencia sobre los procesos de calibración de instrumentos. Se concluye que el tamaño del anemómetro bajo prueba tiene efecto sobre la velocidad de gas registrada por el instrumento patrón. Los resultados muestran que el tubo de Pitot tipo L no causa una distorsión significativa en el perfil de velocidad, mientras que anemómetros rotativos de diferentes dimensiones ocasionan incrementos en la velocidad registrada por el patrón que varían entre 2,5 % y 5,6 %. Se evidencia la importancia de considerar el efecto de las obstrucciones al interior del túnel de viento y de cuantificar el sesgo que ocasionan, para evitar que este hecho se convierta en un error sistemático dentro del proceso de calibración.
Comparison of Two Muscle Relaxants for Tracheal Intubation in Patients Undergoing Surgery at Goa Medical College and Hospital
Authors: Deulker Anisha , Pai Rohini Bhat , Kamat Shaila , Dias Eufemia
Published: September 2021

BACKGROUND Cisatracurium and atracurium are intermediate acting muscle relaxants which do not depend on renal or hepatic metabolism for elimination since they undergo Hofmann elimination. Despite the advantages of cisatracurium such as minimal effects on the cardiovascular system, no accumulative effects, no metabolite toxicity, and metabolic product has no neuromuscular blocking effects, due to slow onset and unsatisfactory intubating conditions, the use of cisatracurium is limited compared with those seen with equipotent doses of other neuromuscular blocking agents. This study was undertaken to find onset time and intubating conditions with 3 × ED95 doses of atracurium versus cisatracurium. METHODS ASA grade 1 or 2 patients, (N = 220) were randomly allocated into 2 groups to receive equipotent doses of either atracurium or cisatracurium. Intubating conditions were assessed using Cooper et al scale and neuromuscular monitoring done using TOF Watch SX. Haemodynamic responses and any adverse effects were noted. RESULTS The onset time was 167.36 ± 75.41 seconds (2.78 ± 1.25 minutes) in atracurium group whereas in cisatracurium group, onset time was 249.26 ± 75.90 seconds (4.15 ± 1.26) and the difference was statistically significant with p value of < 0.001. The difference in intubating conditions between the groups was statistically insignificant. However, atracurium produced a higher incidence of clinically acceptable conditions (excellent in 94.4 %) than cisatracurium (excellent in 87.3 %). The incidence of adverse effects such as erythema, flushing and bronchospasm was greater in Atracurium group though hypotension was observed in both groups. CONCLUSIONS Onset time and intubating conditions are significantly better with equipotent doses of atracurium compared to cisatracurium. But atracurium is associated with higher incidence of adverse effects such as erythema, flushing and bronchospasm, though the potential of cisatracurium to cause anaphylactoid reactions cannot be ignored. KEYWORDS Cisatracurium, Atracurium, Muscle Relaxants, Neuromuscular Blocking Agents, Erythema, Flushing, Bronchospasm, Hypotension, Anaphylactoid Reactions
Role of MRI in the Diagnosis and Pre-Operative Classification of Perianal and Anal Fistulas - A Cross-Sectional Study, Southern Rajasthan
Authors: Jat Hari Ram , Patel Neel , Barath Sitaram , Yadav Pooja
Published: September 2021

BACKGROUND Perianal fistulas account for a substantial discomfort and morbidity to the patient thus affecting productive man hours and quality of life. Accurate pre-operative assessment of course of the primary fistulous track and secondary extension or abscesses is required for successful surgical management of anal fistulas. The purpose of this study was to diagnose and classify pre-operative perianal fistulas. METHODS This is a cross-sectional study at Department of Radiodiagnosis in a tertiary level hospital of southern Rajasthan from November 2018 to November 2020. The study included a total of 50 patients referred to department of radiology for magnetic resonance imaging (MRI). Statistical analysis was done using chi square test and student t test. RESULTS Out of these patients, 56 % were having secondary tract on MRI, 12 % patients were having abscess and 4 % were having horseshoe abscess on MRI. The commonest type of ano-rectal fistula encountered in the study was Grade -II seen in 32 %. CONCLUSIONS MRI is a highly accurate, rapid and non-invasive tool in pre-operative evaluation of the perianal and anal fistulas. MRI evaluation and classification of perianal fistulae has a high degree of diagnostic accuracy. The use of MRI for the diagnosis and classification of perianal fistula can provide reliable information which has both pre-operative and prognostic value. St James University Hospital classification, which is an MR imaging-based grading system for perianal fistula is very useful for effective radiological-surgical communication thus contributing to improved patient care and reduced rate of recurrence. KEYWORDS MR Fistulogram, Perianal Fistula, Anal Fistula, Fistula Classification, Fistulography
Guillain Barre Syndrome in Pregnancy - A Rare Case
Authors: Patil Madhuri , Wankhede Trupti
Published: September 2021

Guillain-Barre syndrome is an immune mediated acute demyelinating polyradiculopathy, linked to various infectious agent. GBS has a very low incidence during pregnancy, estimated population incidence ranged from 0.62 to 2.66 cases per 100,000 person-years across all age groups.1 It is usually preceded by a bacterial or viral infection. Infections like CMV, EB, HIV-1, Hepatitis virus and campylobacter jejuni has been implicated as etiologic agents. Most common infectious agent associated with GBS is campylobacter jejuni.2 GBS classically presents with pain, numbness, paraesthesia, or weakness of the limbs, areflexia. Ascending paralysis with weakness beginning in the feet and migrating towards the trunk is the most typical symptoms. Life threatening complications particularly occurs if there is involvement of respiratory muscles. Increased incidence of respiratory complications is mostly due to gravid uterus. However, GBS is more common in the third trimester and the first 2 weeks of postpartum. 3 GBS is known to worsen in postpartum period due to an increase in delayed type IV of hypersensitivity response. Delayed diagnosis is common in pregnancy or immediate postpartum period because the initial nonspecific symptoms may mimic changes in pregnancy. GBS in pregnancy associated with high maternal mortality. A third of pregnant women required ventilator support with a mortality rate of 13 %.4 Diagnosis is based on the clinical presentation, laboratory and electrophysical investigations. Nerve conduction studies and EMG show an evolving multifocal demyelinating polyneuropathy. Management of GBS in pregnancy is a multidisciplinary approach. IVIG injection in high dose or plasmapheresis is beneficial if given within 1 to 2 weeks of motor syndrome.3 Maternal GBS is not an indication for caesarean section and operative delivery should be reserved for obstetrics indications only. A 25 years old, primigravida patient was relatively alright 9 days back, when she started complaining of weakness in right hand it was acute in onset and progressing gradually with time. The next day patient started having difficulty in standing up. On 29 / 07 / 2019 she was unable to move all four limbs. Patient was taken to private hospital where she was investigated. Her NCV was suggestive of severe acute onset polyneuropathy. She received IVIG at private hospital where her tracheostomy was done. She was brought by relatives to Indira Gandhi Government Medical College, Nagpur on 04 / 08 / 2019. On examination her general condition was not satisfactory, afebrile, pulse rate was 120/min, BP was 110 / 80 mm Hg, RBS 186 mg %. On CNS examination she was conscious oriented with time, place and person, bilateral planters absent, DTR absent, Power in all four limbs was zero.
A Comparative Study of Oral Atenolol and Oral Clonidine as Premedication for Hypotensive Anaesthesia in Patients Undergoing Functional Endoscopic Sinus Surgery under General Anaesthesia - A Randomized, Double Blinded Study in a Tertiary Care Hospital, Tirupati
Authors: K Mydhili , K.G Sreehari , Y Vijayakumari , T.V.L. Tanuja
Published: September 2021

BACKGROUND Bleeding during functional endoscopy sinus surgery (FESS) remains a main consideration. Even a small amount of blood may disturb the endoscopic view, increasing the likelihood of complications. So, we decided to compare the effects of clonidine and atenolol as oral premedication for hypotensive anaesthesia in patients undergoing FESS under general anaesthesia. The purpose of this study was to analyse and compare the efficacy of oral atenolol versus oral clonidine as premedication under general anaesthesia for induced hypotension in patients undergoing a functional endoscopic sinus surgery. METHODS The study included total 100 patients of age (18 – 60 years) [American Society of Anaesthesiologists (ASA grade I and II)] who were randomly divided into two groups of 50 each. Group - A (n = 50), a non-labelled clonidine tablet PO was given to the patients in the clonidine group in the dose of 2 mcg/kg at 7 pm the day before surgery and 4 mcg/kg two hours before surgery. Group - B (n = 50), a non-labelled atenolol 25 mg tablet was given PO to the patients in the atenolol group at 7 pm the day before surgery and also 2 hours before surgery. Induction and maintenance of general anaesthesia was performed by the same standard protocol for both groups. Hemodynamic effects [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), quality of surgical field, intraoperative complications, and post anaesthetic discharge score system (PADSS)] were recorded and statistically analysed. RESULTS The hemodynamic stability and good quality surgical field was obtained in both the groups. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. CONCLUSIONS We conclude that both oral clonidine and atenolol premedication provides superior and predictable perioperative hemodynamic control, reduces the requirement of hypotensive agents, and produces acceptable recovery characteristics. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. KEYWORDS Atenolol, Clonidine, Functional Endoscopic Sinus Surgery (FESS)
Use of Low Dose Olanzapine for the Control of Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy in a Rural Medical College in Etawah District, Uttar Pradesh, India
Authors: Mittal Kailash Kumar , Mendiratta Parveen , Bala Nishu
Published: September 2021

BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) is a frequent and feared adverse effect of cancer chemotherapy. International guidelines recommend combinations of 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, dexamethasone, and/or neurokinin-1 (NK1) receptor antagonists for the control of CINV in patients receiving highly emetogenic chemotherapy (HEC) as a part of their treatment. Even though, nausea in delayed period is less controlled and poses a major concern for these patients. METHODS This open label, prospective study was conducted in a rural medical college in Etawah District in Uttar Pradesh, India from November 2017 to November 2018 over a period of 1 year to observe the efficacy of low dose (5 mg OD) olanzapine in combination with standard anti-emetic regimen for the prevention of CINV. Olanzapine is a food and drug administration (FDA) approved antipsychotic drug that has anti-emetic activity and has shown to improve CINV. Low dose olanzapine along with a standard combination of ondansetron, dexamethasone and aprepitant was given to patients receiving highly emetogenic chemotherapy (Cisplatin >70 mg/m2 or doxorubicin-cyclophosphamide combination). CINV was assessed using common toxicity criteria of adverse events (CTCAE) version 5.0. RESULTS Complete response to nausea was observed in 90.90 %, 60.60 % and 54.54 % in acute, delayed and overall period respectively. Complete response to vomiting was observed in 96.96 %, 69.69 % and 66.66 % in acute, delayed and overall period respectively. Complete response to Grade-2 (or above) nausea was observed in 96.96 %, 93.93 % and 90.90 % in acute, delayed and overall period, respectively. Daytime Grade -3 somnolence which was seen in 2/33 patients (6.06 %) was attributable to olanzapine. Patients receiving olanzapine were more likely to have complete response of nausea and emesis in the early, late, and overall assessment periods especially of higher grade (G2 and G3). CONCLUSIONS The authors concluded that low dose olanzapine 5 mg OD combined with an NK1- receptor antagonist, a 5-HT3–receptor antagonist, and dexamethasone is safe and efficacious in the prevention of CINV in patients receiving HEC. KEYWORDS Olanzapine, Low Dose, CINV, HEC
Prevalence of Hyponatremia in Neurosurgical Patients in South India – An Institution-Based Observational Study
Authors: Sheikh Surumi Makkat Mukkil , Chandran Neetha Thattaparambil , Karthik Asish , Hameed Irfana , Chulliparambil Sunanda
Published: September 2021

BACKGROUND Hyponatremia is the most frequently encountered electrolyte abnormality in hospitalized patients, especially those with neurological injury. Acute onset hyponatremia is common in patients with any type of cerebral insult including traumatic brain injury (TBI), subarachnoid haemorrhage (SAH) and brain tumours. Also seen as a complication of intracranial procedures, contributing to increased morbidity and mortality. Early diagnosis and effective management can reduce mortality associated with this condition. This study was done to estimate the prevalence of hyponatremia in neurosurgical patients in our institution. METHODS This is an observational study that analysed the adult patients admitted to the neuro intensive care unit (ICU) after having undergone the neurosurgical procedure from January 2019 to July 2019. A structured questionnaire was used for data collection. The prevalence of hyponatremia was calculated with preoperative serum sodium levels in the study population. RESULTS In this study with 61 patients undergoing neurosurgical procedures, the prevalence of hyponatremia was 34.4 %. The majority of patients for surgery comes between 41 to 50 years. 57.4 % cases were with traumatic brain injury, 11.5 % cases were with sub arachnoid haemorrhage and 31.1 % were with intracranial tumour. 26 % of hyponatremia patients belonged to mild grade while 8 % to moderate grade. 62.5 % of patients above 70 years, 44.4 % of patients between 51 to 60 years and 40 % of patients between 61 and 70 years presented with mild hyponatremia. 37.5 % of patients above 70 years and 10 % of patients between 61 and 70 years presented with moderate hyponatremia. CONCLUSIONS Our study showed an increased prevalence of hyponatremia in neurosurgical patients which demand effective approaches for an accurate and timely diagnosis of this electrolyte disorder. Hyponatremia frequently occurs in patients with TBI, SAH and intracranial tumours. It is also essential to differentiate between syndrome of inappropriate antidiuretic hormone (SIADH) and cerebral salt wasting syndrome (CSW) as the treatment modalities are entirely different for these two entities. Early detection, close monitoring, etiological evaluation and prompt treatment based on aetiology can reduce the complications and improve patient’s outcomes. KEYWORDS Electrolyte Abnormality; Brain Injury, Morbidity
A Comparative Study between Bedside Index for Severity in Acute Pancreatitis (BISAP) and Acute Physiology and Chronic Health Evaluation (APACHE-II) Scoring System in Assessing the Severity of Acute Pancreatitis at Bangalore Medical College and Research Institute, Bangalore, India
Authors: Theerthegowda Akhila Nallur , Umashankar Pavithra , Iyer Nagashri Suresh
Published: September 2021

BACKGROUND Acute pancreatitis (AP) is an inflammatory disease of the pancreas, that results from intrapancreatic activation, release, and digestion of the organ by its own enzymes. The diagnosis of acute pancreatitis can be made when a patient presents with threefold elevated serum levels of amylase or lipase, abdominal pain and vomiting. In this study, we wanted to assess the severity of acute pancreatitis by using BISAP (Bedside index for severity in acute pancreatitis) and APACHE-II (Acute physiology and chronic health evaluation) scoring systems and compare the accuracy of BISAP scores with APACHE-II scores. METHODS A prospective study including 201 patients was conducted from April 2018 to March 2020 in Victoria Hospital, affiliated to BMCRI. RESULTS Among 201 AP patients, 129 were found to have mild acute pancreatitis (MAP), 72 were of severe acute pancreatitis (SAP), 192 survival cases, and 9 death cases. The larger the rating score, the higher the proportion of severe pancreatitis and mortality risk. Two kinds of scoring criteria; BISAP score points and Apache II score points compared in patients with MAP and SAP, In Apache II score to predict severity of organ failure, the sensitivity, specificity, positive predictive value, negative predictive value was 84.72 %, 93.02 %, 87.14 %, 91.60 % and area under the curve was 0.958 (P < 0.0001). In BISAP, the sensitivity, specificity, positive predictive value, negative predictive value was 90.28 %, 80.62 %, 72.22 %, 93.69 % and area under the curve was 0.917 (P < 0.0001). CONCLUSIONS Ability of APACHE II score prediction of AP in severity of organ failure and mortality are stronger than BISAP score, But APACHE II scoring system indicators were cumbersome, complicated assessment. BISAP scoring system is simple, economical, rapid and reliable, and it can effectively predict the severity and mortality of acute pancreatitis, and can be used as a preliminary screening method in accurate risk stratification and initiation of management accordingly at community health care, secondary health care and tertiary health care Hospitals. KEYWORDS Pancreatitis, Severity, Prediction, APACHE II and BISAP