bluuebunny/crossref_metadata_2025 huggingface dataset:
The learning curve for transurethral enucleation with bipolar energy for benign prostate hyperplasia: a single-surgeon experience of 494 patients
Authors: Song Byeongdo , Song Sang Hun , Jeong Seong Jin
Published: December 2023

This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy (TUEB) for benign prostatic hyperplasia. The study involved 494 consecutive patients who underwent TUEB for benign prostatic hyperplasia from August 2018 to March 2022 by one surgeon (SJJ, Seoul National University Bundang Hospital, Seongnam, Korea). The patients were followed up at 1 week, 1 month, 3 months, and 6 months postoperatively. To evaluate the learning curve of TUEB, perioperative parameters including the enucleation ratio (enucleated tissue weight/transitional zone volume), TUEB efficiency (enucleated tissue weight/operation time), and enucleation efficiency (enucleated tissue weight/enucleation time) were analyzed. Functional outcomes and postoperative complications were also assessed, including the International Prostate Symptom Score (IPSS), IPSS quality-of-life (QoL) score, and uroflowmetry outcomes. The patients’ median age was 72 (interquartile range [IQR]: 66–78) years, and the estimated prostate volume and transitional zone volume were 63.0 (IQR: 46.0–90.6) ml and 37.1 (IQR: 24.0–60.0) ml, respectively. The enucleation ratio, TUEB efficiency, and enucleation efficiency were 0.60 (IQR: 0.46–0.54) g ml−1, 0.33 (IQR: 0.22–0.46) g min−1, and 0.50 (IQR: 0.35–0.72) g min−1, respectively, plateauing after 70 cases. The functional outcomes, including total IPSS, IPSS QoL score, and uroflowmetry outcomes, significantly improved at 6 months after TUEB (all P < 0.05), but without significant differences over the learning curve. Sixty-five (13.2%) patients developed complications after TUEB, 21.5% of whom experienced major complications (Clavien–Dindo grade ≥3). The rate of major complications declined as the number of TUEB cases increased (P = 0.013). Our results suggest that the efficiency of TUEB stabilized within 70 procedures.
Prevalence of Tactile Hallucination of Phone Vibration among Individuals Aged 18–22 Years
Authors: Mali Tanisha Sunil , Yadav Trupti
Published: December 2023

Background:

Overuse of phones can lead to physiological health hazards. The repeated use of vibration mode leads to fake perception of device being vibrating when it is not. Tactile hallucination of phone vibration is a prevalent phenomenon among young individuals. Theories explaining the possibility of the phenomenon are proven through researchers.

Design:

The study was a cross-sectional survey in design.

Participants:

Two hundred and four individuals responded to the questionnaire.

Material and Methods:

An electronic survey consisting of 12 questions based on demographic, mobile usage hours, and frequency of phantom vibrations experienced. An online questionnaire was used for the study. It is known as the Phantom Vibration Scale or phantom vibration questionnaire which was taken from an article (reference 9). The questionnaire was formed on Google Forms application and was circulated on WhatsApp in the form of a link through a smartphone. It consisted of 11 questions. The questions were brief and are easy to understand as it is supposed to cover a large population. The population selected was healthy without any neurological or psychological problem. The questionnaire consisted of questions on the duration of phone usage in a day, to know the risk of tactile hallucination in them. It had questions on whether they experience tactile hallucinations and information about its frequency and intensity.

Results:

Two hundred and four responses were received, out of that 68% experienced tactile hallucinations. Those who experienced hallucinations, were further observed for different characteristics presented. Nearly 88% possessed a smartphone for more than a year. Respondents were asked about the phone usage hours and the majority used it for 3–5 h daily. Social media are a known addiction of phone and the survey showed that 55% of the respondents used phones to scroll social media. The next factor which is vibration mode of the phone was used by 17% of the people always. About 29% used it for most of the time. About the placement, while carrying of phone, it showed that 69% always carried phone in their jean front pocket. Furthermore, 42% of the participants found those vibrations to be bothersome. Nearly 21% had the hallucinations so severe that they felt it when the phone was switched off.

Conclusions:

More than half of the people on this planet carry smartphone and most use it on vibration mode. Even if one-third of them experience hallucinations, a planned treatment is required for this.
Substance Abuse: A Public Health Concern
Authors: Amin Ulfat , Malla Adil Mudasir , Amin Ishrat , Jan Roohi
Published: December 2023

The context and purpose of the study. Substance abuse is a serious public health concern that affects the millions of people worldwide. It refers to the harmful or hazardous use of psychoactive substances, including drugs and alcohol, that can lead to various health problems, such as addiction, mental health disorders, and physical illness. Alcohol, nicotine, and other illicit drugs are frequently used in excess in substance use disorders, which can impair social, academic, and professional functioning. Cannabis, sedatives, hypnotics, anxiolytics, inhalants, opioids, hallucinogens, and stimulants are the most abused drugs. Throughout human history, substance abuse has been a complex public health issue. The two main approaches frequently used to address the issue of substance abuse are risk factors and treatment modalities. They relate to the various fields of genetic inheritance, physiology, cognitive science, parents, social development, and cultural structures. One of the main issues with public health in today’s culture is drug misuse. Recently, there has been an upsurge in the prevalence of drug usage, especially opioid abuse, worldwide and in Kashmir. This review paper points to a complicated interplay between various variables that affect teenage drug usage. It also describes the different risk factors leading to substance abuse and the various behavioral therapies for substance use disorders that may enhance patient results. As a result, intensive effort across all the levels of domains will be needed to create programmes that prevent teenage substance misuse.
Experiences and Perspectives of Student Nurses Toward Volunteerism during Health Emergencies: A Systematic Review
Authors: Prashar Pradeepti , Sharma Dinesh Kumar , Mohinder Bandana , Kumari Santosh
Published: December 2023

The paper discusses how volunteerism, especially among nursing students, helps solve health crises. The study emphasizes community preparedness and volunteers’ unique role in supporting healthcare professionals during crises. Volunteers seek out opportunities to help, unlike emergency responders. Nursing students, a major employment source, are shown to be capable of first aid and emotional support. The COVID-19 pandemic highlights the unprecedented need for volunteers. Research shows that nursing students worldwide are willing to help in health emergencies. Professional ethics, humanity, and learning motivate. Self-care issues, system support issues, and psychological impacts are obstacles. The study uses a mixed-methods technique and the PRISMA framework to examine nursing students’ health crisis volunteering experiences, goals, and perceptions. The data show volunteer nursing students’ pleasures and problems. Although volunteering is rewarding, worries about self-care, family well-being, and psychological effects arise. Emotional stress, burnout, compassion fatigue, anxiety, sleep difficulties, guilt, and a lack of support affect nursing students’ mental health. Witnessing and experiencing health emergencies can cause emotional stress, highlighting the need for personalized solutions. The report recommends cash incentives, extensive training, and explicit protocols to increase student volunteering. Nursing students can safely volunteer in high-stress situations by recognizing and addressing the mental health risks and providing support and tools. The article recommends a holistic approach to volunteerism that recognizes its benefits and promotes the mental health and well-being of motivated nursing students. Nursing students helping in health emergencies need sufficient training, psychological support, and self-care to protect their mental health, according to the study. Providing support, shifting schedules, and understanding the emotional toll of employment are vital. Nursing schools should include emergency response training to prepare students for pandemic leadership.
A Phenomenological Study to Explore the Lived Experience of Patient Living with Mental Illness
Authors: Jyothi S. Veera , Lokhande Rajeshree , Thomas Chris
Published: December 2023

Background:

A broad understanding of patient’s mental health problem is important to deliver effective and patient-centered mental health interventions. Patients with mental illness feel frustrated when they will not be listened by the health professional. People living with mental illness have different problems which are unheard by the society because of various stereotypes regarding mental illness.

Objective:

The objective of this study was to describe the experience of the patient living with mental illness.

Methodology:

The research approach used was qualitative and the research design was hermeneutic phenomenological design. With the help of purposive sampling technique, the data were collected from 20 patients through the interview technique.

Results:

The study results were described into three emergent themes such as patient’s perception about the cause of their mental illness, patient’s experience of their symptoms, and patient’s understanding of their positive and negative experiences of their treatment.

Conclusion:

The study indicated that mentally ill persons experience many changes in their lives but manage to develop coping skills. Patients had both positive and negative experiences while living with mental illness. The experience of stigma and discrimination, dependence on prescribe medication and its related side effects, loss, and fear, all contributed to the hazy reality of living with mental illness.
Mental Images of Nurses with and without Patient with COVID-19: A Metaphor Study
Authors: Moran Müjde , Özdemir Firdevs Ebru , Yazgi Demir Zahide Gül , Yilmaz Mualla
Published: December 2023

Introduction:

The purpose of this study is to determine the perceptions of nurses who had COVID-19 disease and recovered and who were not sick through metaphors.

Materials and Methods:

This study was carried out with 50 nurses who were recovered from COVID-19 disease and 50 nurses who were not sick during the pandemic process who were working as nurses in a university hospital 3 months after the first wave of pandemics started in Turkey. The study is the qualitative research, which is as data collection technique, metaphors were used. The data collection form consists of six questions containing personal information and one metaphor question. The metaphors developed by nurses regarding the “COVID-19 disease” and the common features of these metaphors were tried to be determined. The content analysis was made.

Results:

It was determined that the answers given by the nurses were total of 75 metaphors in seven categories. It was determined that all of the metaphorical perceptions of the nurses regarding the “COVID-19 disease” were negative metaphoric perceptions, and the meanings of the metaphors that were seen as positive metaphors such as marriage, friend, life partner, love, hope under the emotions main theme, and relationship/moods sub-theme were negative when the content was examined.

Conclusion:

The results show that the metaphors expressed by the nurses include pessimism and negativity. This study reflects the ideas of nurses working with all their strength during the COVID-19 pandemic and puts forth the psychological state of nurses.
A case study on recurrent giant cell tumor of distal end radius
Authors: Rathore Pankaj , Garg Sahil
Published: December 2023

Background:

Based on location distal end radius is the second most common for giant cell tumors (GCTs) followed by the knee. Like at any other location, they are treated with extended curettage or resection but reports of recurrence are increasingly coming up. In this study, we aim to treat the recurrent distal end radius GCTs and their outcome after Index surgeries.

Materials and Methods:

This case report was done in the year 2022–2023 on a patient with recurrent distal end radius GCT of age of 30 years. Recurrence had occurred after curettage and even after resection as index surgery. The recurrent lesion was treated with resection, excisional biopsy, fibula strut grafting, and wrist arthrodesis. The follow-up period was 12 months.

Results:

In various studies, when the patients with joint preservation were treated with curettage and those with resection of soft tissue recurrences were done with salvage of joint had better functional outcomes with a mean musculoskeletal tumor society (MSTS) score. In our case with arthrodesis using fibular strut grafting had a low MSTS score. The overall functional outcome was satisfactory.

Conclusions:

We conclude that local recurrence of GCT after curettage in long bones if contained within the bone and/or extending into the soft tissue, can be successfully treated with further more extensive surgery in an attempt to obtain wide margins with minimal risk of increased morbidity. It does increase some morbidity but there is significant gain with respect to the cure of the disease.
A Study on Birth Preparedness and Complication Readiness among Women Attending Antenatal Clinics in a Rural Area of Hooghly District, West Bengal
Authors: Shree Nidhi , Dutt Debasish , Dasgupta Aparajita , Paul Bobby , Bandyopadhyay Lina , Ghosh Pritam , Maurya Neelam , Pyrbot Foulisa
Published: December 2023

ABSTRACT

Background:

Globally, more than 40% of pregnant women experience acute obstetric problems and a large burden of it is shared by India. Birth Preparedness and Complication Readiness (BPCR) strategy is used to addresses these problems by encouraging women and communities to effectively plan for births, deal with birth emergencies.

Objective:

This study was conducted to assess the status of birth preparedness and complication readiness and to find out the factors associated with inadequate BPCR among pregnant woman in a rural area of West Bengal.

Methodology:

Institution based, observational study with cross-sectional design was conducted from January 2019 to September 2020 among pregnant women, attending antenatal care clinics in Singur block, Hooghly district West Bengal. Sample size was 272. Participants were chosen by systematic random sampling. Response rate was 94.5% (257). Data were collected using a predesigned pretested schedule and analyzed using Microsoft Excel version 2016 and SPSS version 16.0.

Results:

Overall, 60.3% mothers had inadequate BPCR. 66.1% mothers had poor BPCR knowledge and 72.8% mothers had poor BPCR practice. In multivariable logistic regression model, the odds of maternal morbidity [AOR = 2.03 (1.14 –3.62), P value = 0.16], ≤4 No. of ANC visits [AOR = 10.96 (4.82–22.9), P value = 0.001], first trimester USG [OR = 12.53 (5.8–24.5), P value = 0.001] showed significance with inadequate BPCR.

Conclusion:

Glimpse of BPCR is seen in government programmes like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK). Yet a big void exists among Indian pregnant women’s knowledge and practice of BPCR. Thus, there is a need to include BPCR in health care system to improve outcomes for pregnant women.
Camel Bite in an 11-year-old Child: A Case Report from Northwestern Nigeria
Authors: Sanni Usman A. , Lawal Taslim O. , Ile-Ogedengbe Bruno O. , Olayemi Lukman A.
Published: December 2023

ABSTRACT

Background:

Globally, animal bites are a major source of morbidity and mortality. However, camel bites are relatively rare in the medical literature. Whenever such bites occur, adults are mainly affected. Cases are exceedingly rare in children. We report a case of a camel bite in a male child.

Case Presentation:

The patient was an 11-year-old boy who presented to the Emergency Department of our facility 10 h after being bitten on his cheeks by a camel. The injury occurred while the patient was trying to feed the camel that strongly gripped the patient’s face between its jaws leading to multiple facial injuries. He was co-managed by the pediatric and maxillofacial teams. He did well and was discharged home after 10 days of admission.

Conclusion:

Camels are potential causes of serious injuries for children in this part of the country. Efforts should be made to prevent such injuries, which have the potential of being infected with tetanus and rabies in addition to disrupting school attendance. Public education about the proper and compassionate handling of domestic animals should be carried out.
Fine Needle Aspiration Cytology of Thyroid Lesions Using Bethesda Classification and Histopathological Correlation
Authors: Doley Ponkhi , Chikkannaiah Panduranga , Venkataramanappa Srinivasamurthy
Published: December 2023

ABSTRACT

Background:

To keep uniformity and to achieve standardization of thyroid cytopathology reporting National Cancer Institute proposed six tier diagnostic classification system named The Bethesda system for reporting thyroid cytopathology (TBSRTC) that represents a major step toward standardization, reproducibility, and ultimately improved clinical significance, usefulness, and predictive value of thyroid Fine-needle aspiration cytology (FNAC). The guidelines were formulated in 2007 and revised in 2017.

Material and Methods:

The present study was performed at between January 2015 and June 2019, on thyroid FNA classifying them according to TBSRTC. Cytology and histopathology correlation were done where ever available. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of TBSRTC were calculated considering histopathology as gold standard. The malignancy risk for each category was calculated and the result was tabulated.

Results:

In the present study, total of 1248 cytology cases of thyroid were studied, out of them 1% were non diagnostic, 91.3% were benign, 1.5% were atypical lesions of undetermined significance (AUS). About 4% were follicular neoplasm (FN), 0.4 was suspicious for malignancy (SM), and 1.8% were malignant. A total of 179 cases were available for cytology and histopathology correlation and risk of malignancy (ROM) was calculated. No histopathology cases were available in category I for correlation, ROM was 4.7% in benign category, 46.2% in AUS category, 50% in SFN/FN, 100% in SM, and 85.7% in malignant category. TBSRTC showed sensitivity of 66.7%, specificity of 90.9%, PPV of 64.8%, NPV of 91.5%, and accuracy of 86.03%.

Conclusion:

TBSRTC improves perceptions of diagnostic terminology between cytopathologists and clinicians, prevent over diagnosis and helps in better patient management approaches. It should be included in all FNAC of thyroid reporting system.
Introduction of Team-Based Learning Strategy for Teaching Medicine to Undergraduate Medical Students in a North Indian Medical College
Authors: Mohan Charu , Nair Bindu T. , Rath Deepak
Published: December 2023

ABSTRACT

Background:

Newer methods of teaching which are student centered and using “active learning” techniques are being explored with a broader goal of application of knowledge than only acquisition of knowledge. This study is an effort to explore the use of one such active instructional strategy – team-based learning (TBL) to promote better education.

Materials and Methods:

The project was carried out in the Department of Medicine, Army College of Medical Sciences, New Delhi. Participants included the 2nd year MBBS students of 2015 Batch. One week prior to the study, the students were sensitized and were divided into seven teams. The first step was preclass preparation (learning resources for guidance given by the faculty), followed by Individual Readiness Assurance Test (IRAT) by MCQs. The final step was discussion of these questions as a team and scoring in the Group Readiness Assurance Test (GRAT). At the end of session, the students were given a feedback questionnaire to obtain their perceptions, attitudes, and acceptance of the TBL method.

Results:

A total of 56 MBBS students participated in the study. The scores obtained by GRAT were significantly better compared to IRAT. Furthermore, 83% of students reported that solving real-life clinical scenario questions helped more in retention of knowledge than by didactic lectures. TBL classes were acceptable and desired by 67.9% for future. However, 71.4% preferred the mixed method of both didactic lectures and TBL sessions.

Conclusion:

The study concluded that TBL is viewed favorably by medical students. It encouraged active participation of the students in group discussions resulting in improved performance in the class. However, a combination of traditional didactic lectures and TBL was preferred to didactic lectures or TBL alone by the students.
Comparison of Median Weight, Height and Body Mass Index of School Going Children of Western Maharashtra with International Growth References
Authors: Tyagi Shikha , Singh Yaduvir , Hiremath Ravishekar N. , Chourey Niraj , Ghodke Sandhya
Published: December 2023

ABSTRACT

Background:

Since School going children are our future working and productive population, it is of utmost importance that we constantly monitor the growth and nutrition of these children during their growth period.

Objectives:

This study was carried out with an objective to measure height, weight, and BMI of school going children of 6-15 years age group and comparing with WHO and CDC standards.

Materials and Methods:

This was a cross sectional point prevalence study among children in the age group of 6-15 years studying in schools of western Maharashtra. Two sections were randomly chosen form classes I to X and all the children in these classes were included in the study. A total of 2276 children in these age groups were thus studied. Ethical committee clearance and approval from schools were taken. Informed consent was obtained from parents. Data was collected through pretested predefined questionnaire and anthropometric measurements were done using standardized techniques. These were than compared with WHO MGRS and CDC standards were used.

Results:

Out of 2276 children, 56.23% were boys and 43.76% were girls. 18.5% had fathers belonging to class A occupational status, 31% belonging to class B occupational status and 50.5% belong to class C occupational status. 86.1% had mother who were homemakers. 40.55% had fathers who were graduates or beyond. The median weight of boys and girls of present study was less than the WHO and CDC standards till 10 years of age, thereafter it was more than the CDC standards. The median height of boys and girls in present study in all the age groups was more than WHO as well as CDC standards. The median height of girls was less than the boys for all age groups. Median BMI of boys and girls was less than WHO till 9 years and CDC standards till 10 years of age, thereafter it was more than both the standards till 13 years. The median BMI of girls was less than the boys till 9 years of age, thereafter it was more than the boys.

Conclusion:

The median weight, height and BMI of school going children of Western Maharashtra differed from that of WHO and CDC Standards. In-depth research to be regularly carried out to monitor the growth of children and proactive nutrition improvement measures need to be taken to maintain the growth standards of school going children.
Cancer Related Cognitive Impairment in Breast Cancer Survivors: A Case - Control Study of Karnataka, India
Authors: Venugopal Vaishali C. , Latha K. C. , Kishor M. , Arunkumar Mohan , Venugopal Vinitha , Balasubramanian S.
Published: December 2023

ABSTRACT

Background:

Breast cancer patients report difficulties with concentration, multi-tasking, and memory. Cognitive dysfunction can impact the quality of life by affecting activities of daily living, treatment compliance, interpersonal relationships, and profession.

Aims:

The objective of this study was to evaluate and compare the cognitive functions and psychological complications in breast cancer patients with a control population.

Settings and Design:

This study was conducted in the outpatient department of Bharath Hospital and Institute of Oncology, Mysore, where the cases were recruited. The study participants were 110 female breast cancer patients and 100 noncancer healthy females as controls.

Materials and Methods:

Demographic details of the participants were collected through a questionnaire. Clinical data were obtained from clinical records. Tools used were Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) to evaluate cognitive functions, depression, and anxiety, respectively.

Statistical Analysis:

The various findings were analyzed using mean, frequency, Pearson’s correlation, and two-sample t-test.

Results:

Mild cognitive impairment was observed in 88% of the cancer patients, and more than 95% were under severe anxiety and depression. There is a highly significant difference in all three tests (MoCA Test, HAM-D test, HAM-A test) with a P < 0.001.

Conclusion:

Breast cancer patients show statistically significant cognitive deficits as compared to noncancer individuals.
A Rare Case of Disseminated Histoplasmosis Presenting with Hemophagocytic Lymphohistiocytosis
Authors: Agarwal Kriti , Yadav Meghna , Tewari Vanmalini
Published: December 2023

ABSTRACT

Hemophagocytic lymphohistiocytosis (HLH) encompasses a wide spectrum of causes, characterized by excessive immune system activation and release of a cascade of inflammatory markers. HLH can be familial or primary and secondary, secondary being more common. Secondary HLH holds primary concern as it involves treatable causes and hence timely diagnosis and appropriate treatment are of utmost importance in patient care. Our case report is of a 34-year-old immunocompetent male with a history of fever of 5 days duration along with breathlessness, myalgia, and cough at the onset, but the symptoms kept deteriorating over a period of 1.5 months. Due to the wide range of clinical presentations and overlap of symptoms, an array of differentials was considered, however prioritizing an infectious cause led to our final diagnosis in this case. The patient succumbed to the disease.
Impact of Cochlear Implants (CIs) in Prelingual Deaf Children: A Synthesis of Available Evidences
Authors: Begam Nazia , Bashar MD. Abu
Published: December 2023

ABSTRACT

Background:

Profound hearing loss during childhood impacts the normal development of auditory and speech perception and language skills. Cochlear implants (CIs) have revolutionized the scenario of rehabilitation of profoundly deaf individuals, particularly the prelingual deaf. A prelingual deaf is congenitally deaf or has hearing loss before speech development.

Objective:

To perform a scoping review of available evidence for assessing the effects of CIs in prelingual deaf children on their auditory and speech perception and language development.

Materials and Methods:

A scoping review of research studies assessing the effects of CIs in prelingually deaf children was carried out in June 2022 using major databases such as PubMed, Medline, Scopus, and Web of Science using appropriate keywords. To be included in the review, the studies were required to be full-text articles in the English language only, and the studies on adult populations were excluded. All the relevant studies found to be suitable for inclusion were classified under three subheadings: “Impact on Auditory perception,” “Impact on Speech perception and/or development,” and “Impact on “Language development.”

Conclusion:

CIs are a highly effective intervention in the treatment and rehabilitation of prelingually deaf children, although complex due to the interaction of variables that affect the implanted child’s performance. The factors found to influence it are the child’s age at the time of implantation, time of hearing sensorial deprivation, duration of use of a cochlear implant, and type of speech codification strategy used. More well-designed longitudinal studies with greater follow-up periods post-implantation are required to better understand the implantation complexity and its impact on prelingual deaf children.
Role of Hyperbaric Oxygen Therapy in Severe Posterior Reversible Encephalopathy Syndrome
Authors: Parashar Samiksha , Malviya Deepak , Rai Sujeet , Gupta Ravi
Published: December 2023

ABSTRACT

Once considered to be reversible on the elimination of potential triggers, it is now known that severe form of posterior reversible encephalopathy syndrome (PRES) is associated with long-term morbidity and mortality. A 28-year-old female with severe PRES failed to show reversibility of symptoms with conservative management. Along with standard intensive care unit care, she was then given hyperbaric oxygen therapy (HBOT) for 7 days, 2 sessions per day, each session at 2 atm for 90 min. Baseline coma recovery score (CRS) was 0, when the diagnosis of severe PRES was made. At day 7 before start of HBOT, CRS-0 was 4. At the 1st, 5th, and 7th day of HBOT, CRS-1/5/7 was 5/12/19, respectively. She made significant recovery and discharged 18 days from admission. HBOT may reduce morbidity and mortality associated with severe PRES and might prove to be a treatment option allowing faster recovery.
Effect of deferasirox on renal function in thalassemic children
Authors: Talukder Dite , Selimuzzaman Mohammad , Rasha Tarannum Khondaker
Published: December 2023

Background:

Iron-chelating therapy causes improvement in the life expectancy of thalassemic patients. Deferasirox (DFX) is an oral iron chelator with an established dose-dependent efficacy, though alteration of renal function has been observed in many studies. In the present study, we evaluated the effect of treatment with DFX on renal function.

Materials and Methods:

This quasi-experimental study was done in the Thalassemia Center of Bangladesh Shishu Hospital and Institute from June 2019 to July 2021, where 50 thalassemia major and E-β thalassemia children aged 2–18 years old were included. Blood urea nitrogen (BUN), serum creatinine, spot urinary protein creatinine ratio, spot urinary calcium creatinine ratio, and estimated glomerular filtration rate (eGFR) were measured. If renal functions were normal, DFX was started at a dose of 25 mg/kg/day. After 6 months of DFX treatment, the abovementioned investigations were repeated and analysis was done. The study variables were analyzed by paired t-test. P value <0.05 was considered significant.

Results:

The mean age of the thalassemic children was 5.21 ± 1.72 years. Before treatment, mean serum creatinine was 39.78 ± 3.12 μmol/L, and after 6 months, serum creatinine was increased but not statistically significant. The mean value was 40.50 ± 3.39 μmol/L after 6 months (P value 0.071). There was no significant change of BUN. Initially, the mean BUN was 3.39 ± 0.76 mmol/L, and 6 months after treatment, it was 3.45 ± 0.70 mmol/L. Initially, the spot urinary protein creatinine ratio was 0.12 ± 0.04, and after 6 months, the mean value was 0.43 ± 0.24. it was significantly increased (P value <0.001). Initially, the spot urinary calcium creatinine ratio was 0.068 ± 0.043, and after treatment, it was significantly raised. The mean value was 0.191 ± 0.168 (P value <0.001). After 6 months of treatment with DFX, 35 patients developed mild proteinuria, and eight patients developed hypercalciuria. There was no significant change of eGFR before and after treatment.

Conclusions:

In this study, we got significant proteinuria and hypercalciuria but nonsignificant changes in serum creatinine, BUN, and eGFR.
A rare cause of anemia and hepatosplenomegaly-marble bone disease
Authors: Hassan Md. Nazmul , Akter Lucky , Islam Nazrul , Sultana Jakia , Fazal Abul , Mostofa Md. Golam
Published: December 2023

Marble bone disease (“osteopetrosis”) is a rare, heritable disorder of the skeleton due to a defective function of the osteoclasts and characterized by increased bone density on radiographs. It is an uncommon disease with an unknown etiology. The presentation and severity of osteopetrotic conditions vary greatly, from neonatal onset with potentially fatal complications such as bone marrow failure (e.g., classic or “malignant” or autosomal recessive osteopetrosis) to the incidental discovery of osteopetrosis on radiographs (e.g., osteopoikilosis), susceptibility to infections, growth failure, and generalized osteosclerosis. If left untreated most of the cases of infantile form osteopetrosis die as a result of bone marrow suppression in the first decade of life. Normocytic anemia is caused either by hypoproliferation of hemopoietic tissue or increased destruction of red cells. Osteopetrosis is a rare cause of anemia. We are presenting here an unusual case that was diagnosed clinically and radiologically as malignant infantile osteopetrosis and was referred to us for the evaluation of anemia and hepatosplenomegaly.
Clinical features and outcomes of renal disease in children with COVID-19: A single-center retrospective study
Authors: Sharmim Mst. Shanjida , Begum Afroza , Roy Ranjit Ranjan , Uddin Golam Muin , Huque Syed Saimul , Jesmin Tahmina , Al Mamun Abdullah , Alam Mohammad Rashidul
Published: December 2023

Background:

The clinical spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic course to severe illness. Children have accounted 1%–5% of diagnosed cases so far. This study aimed to observe the clinical features and outcomes of renal disease in children with COVID-19.

Materials and Methods:

This retrospective study was conducted in the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from November 2021 to April 2022. The data were collected from 24 COVID-19-positive children under 18 years old with preexisting renal disease admitted in BSMMU from March 2020 to September 2021.

Results:

The mean age of the participants was 8.7 (±4.4) years. Among them, preexisting renal diseases were mainly nephrotic syndrome (50%), chronic kidney diseases (29%), and lupus nephritis (8%). Among the participants, 58% of patients became reverse transcription- polymerase chain reaction negative within 14 days, and the mean duration of hospital stay was 14.5 (±5.9) days. Most frequently presented clinical features were fever (75%), cough (71%), respiratory distress (54%), proteinuria (71%), hematuria (21%), diarrhea and acute kidney injury (17%), rapidly progressive glomerulonephritis (4%), heart failure (33%), and decreased saturation of peripheral oxygen ≤90% in 58% of cases. Mean white blood cell count was 8773.9 (±5178.1)/mm3, raised serum creatinine 62.5%. Pneumonia in chest X-ray was present in 50% of cases. Children getting more immunosuppressive drugs, especially those who got rituximab, had milder symptoms. Overall case-fatality rate was 25% with the highest rate in chronic kidney disease (CKD) patients.

Conclusion:

Children with preexisting renal disease got affected slightly at a higher percentage than the normal child, and those who got immunosuppressive therapy, especially rituximab, had milder symptoms. Children with CKD had fatal outcomes.
Is Medical Student Well-being Related to the Overall “Happiness” of a Country?
Authors: Hallett Florence , Patel Sunil , Molodynski Andrew , Bhugra Dinesh
Published: December 2023

Previous research has repeatedly shown poor mental health, high rates of substance misuse, and burnout in medical students across many countries. The annual World Happiness Report provides insight into how “happy” countries are and how happiness is measured. Our review aims to identify whether whole population “happiness” across different countries correlates with data looking specifically at burnout in medical students. We found a moderate negative correlation between medical student burnout (disengagement type) and population average life evaluations. There appears, therefore, to be some association between rates of medical student burnout in a country and the overall population average life evaluations. The overall happiness of a country obviously reflects on the whole population, but medical students are, especially under pressure and subject to unusual stressors. In this study, we note various factors which may need further exploration in future studies.
Hersch Lauterpacht and language in the international law of treaty interpretation
Authors: Nolte Georg
Published: December 2023

The contribution addresses a lesser-known chapter in the history of the rules on the interpretation of treaties: the role played by Hersch Lauterpacht as Rapporteur at the Institut de Droit International on the topic of treaty interpretation. The work of the Institut on this topic was situated within the general effort to progressively develop and codify the rules of international law, a movement itself inspired by the idea of codification that unfolded during the nineteenth century mainly in continental Europe. After the Second World War, Lauterpacht initiated the study of the topic of treaty interpretation both at the Institut and at the International Law Commission (ILC). As Rapporteur at the Institut, Lauterpacht provoked a remarkable controversy by proposing to place the emphasis, in the process of interpretation, on the travaux préparatoires rather than on the text of the treaty. Although the 1956 resolution of the Institut did not follow Lauterpacht in this respect, the work of the Institut nevertheless proved to be a catalytic event leading towards the integrative conception of the rules of interpretation which the ILC developed in the 1960s while preparing the Vienna Convention on the Law of Treaties. The Lauterpacht episode also marked a change of focus with regard to the addressees of the rules of treaty interpretation from intergovernmental interaction towards judicial decision-making.
The concept of an international legal concept
Authors: Linderfalk Ulf
Published: December 2023

International lawyers refer to concepts such as ‘State immunity’, ‘the high seas’, ‘jus cogens’ and many others as genre-specific – as ‘concepts of international law’. This practice presupposes a definition that can help to distinguish concepts of international law from other concepts used by participants in international legal discourse. This article draws attention to the great complexity of this issue. It starts from the assumption that all genre-specific concepts have an importance for the structuring and development of the branch of activity to which they are said to belong. It arrives at the conclusion that there is in fact not just one way of defining a concept of international law, but several. These definitions are inextricably tied to different conceptions of law. The article argues that it is important that international lawyers openly acknowledge this relationship between different theories of law and different conceptions of an international legal concept. Doing so will enhance the rationality of legal communication and the productivity of international legal discourse.
Multilingualism, translation and international law: four myths
Authors: Mowbray Jacqueline
Published: December 2023

Translators and interpreters allow international law and its institutions to operate in a multilingual world. However, the legal literature analysing how international law and institutions understand the role of translators, and the significance of translators’ work to the practice of international law, is still developing. This article contributes to this emerging body of work by analysing the discourse of international law on translation, interpretation and multilingualism. It identifies four key assumptions about translation and its role in the multilingual international legal order which repeatedly appear in the discourse of international law. Drawing on insights from other disciplines, including socio-linguistics and translation studies, it demonstrates ways in which these assumptions may be flawed, and explores the significance of this for the operation of international law. Ultimately, it argues that these ‘four myths’ skew the operation of international law in ways that empower some at the expense of others and call into question whether international law is truly ‘international’.
Interpretation and translation in atrocity trials: insights from the Khmer Rouge Tribunal
Authors: Killean Rachel , Grey Rosemary
Published: December 2023

This article draws attention to some of the ways the Extraordinary Chambers in the Courts of Cambodia’s (ECCC) proceedings have been shaped by the process of translation, interpretation and vernacularisation. In doing so, it seeks to add a novel case study to a growing literature that exposes the central role of language professionals in the operation of international courts and tribunals. The article highlights challenges that arose at the ECCC around the interpretation, translation and vernacularisation of legal concepts, using the examples of ‘genocide’ and ‘reparation’ to demonstrate how a focus on linguistic translation can obscure the more substantial vernacularisation work involved in rendering legal concepts legible. It then explores the challenges raised by victims’ and witnesses’ use of euphemism, interrogating different approaches towards translating and interpreting euphemism in the context of a criminal trial. Finally, it explores victims’ and witnesses’ use of Khmer Rouge jargon, and the challenges that posed for Khmer language professionals born after the fall of the regime. Drawing from these examples, the article emphasises the need for international criminal institutions to take the process of translation seriously, to understand it as significantly more than a technical linguistic exercise, and to give thought to the additional resources, training and expertise that might be needed to ensure accuracy both in the courtroom and when communicating concepts and processes outside the courtroom. This extends both to the training and resources that interpreters and translators might need, and the cultural awareness and sensitivity that legal practitioners might need in order to engage with victims and witnesses across language barriers.
In other words: the strategic use of Nasa Indigenous language in legal settings
Authors: Silva Nina Bries , Montenegro Esteban Díaz
Published: December 2023

After 56 years of internal armed conflict, Colombia undertook a transitional justice process and established the Special Jurisdiction for Peace (SJP or JEP in Spanish) as the court in charge of resolving cases related to the conflict. In 2018, the JEP opened a case to investigate gross violations committed against the Nasa Indigenous people and their ancestral territory during armed conflict. In the proceedings before the JEP, Nasa authorities and lawyers, most of whom are fluent in Spanish, have been purposely using linguistic constructions in Nasa Yuwe, their native language. This article explores the purpose behind this linguistic practice and its potential implication for the JEP and international law. Through critical discourse analysis and socio-linguistic analysis of legal documents, the article outlines different strategic uses of language by an ethnic minority, such as the Nasa, to strengthen and broaden their rights.
Revision of the Legend of Master Manole in Romanian Feminist Discourse after 1989
Authors: Bartosiewicz-Nikolaev Olga
Published: December 2023

The paper focuses on the ideological shift after 1989 that determined the nature of the debates over the role of Ana, the female character of the Legend of Master Manole, and her sacrifice. Until 1989, her perspective was widely ignored because the canonical interpretation of the ballad emphasized the male perspective of Manole and his sacrifice for the act of creation. After 1989, the feminist discourse argued that the symbolic structures perpetuated by this myth were reinforced in Romania by the communist regime. The main aim of the article is thus to present how the newly formed feminist critique employed one of the canonical Romanian texts to show the functioning of the model of a self-sacrificing woman in the social imaginary.
Management practice of the Sheko cattle breed in Ethiopia: A review
Authors: Aleme Melkam , Mengistu Gezahegn
Published: December 2023

The great diversity of agroecological conditions and production systems present in Ethiopia contributes to the country’s large livestock population and makes it suitable for various forms of livestock production. The Ethiopian livestock sector provides significant economic and social benefits at household levels and to the national economy. Ethiopia has 32 recognized indigenous cattle breeds, of which the Sheko is a known trypano-tolerant breed found in the southwest of the country. However, in recent times, the Sheko population has been declining mainly due to interbreeding with local Zebu cattle and to a shift in the production system. This paper aims to review and illustrate the current status and management practices of the Sheko cattle breed towards conserving and improving the breed, and the production system. The feed resources in the Sheko home area are natural pasture and crop residues, with limited utilization of cultivated improved forage. Husbandry practices such as feeding, watering, housing and veterinary services are priority areas where improvements are needed. Enhancing the conservation and improvement of the breed would greatly benefit from the active improvement of various stakeholders, including governmental policymakers and non-governmental organizations. Therefore giving special attention to enhancing the management systems in the breed’s home area is crucial. This involves the direct engagement of research centres, extension workers; and higher learning institutions in proximity to the area all aimed at the conservation and improvement of the Sheko cattle breed.
Bitlis Çayı Havzası’nda Çığ Oluşumuna Duyarlı Alanların Coğrafi Bilgi Sistemleri ile Tespit Edilmesi
Authors: İrcan Mustafa Recep , Duman Neşe
Published: December 2023

Çığ, eğimli ve bitki örtüsünden yoksun arazilerde biriken kar tabakasının iç ve dış etkilere bağlı olarak bir yüzey boyunca kayması olarak tanımlanmaktadır. Türkiye’de yaşanan çığ olaylarının büyük bir kısmı, yüksek ve eğimli arazilerinin yer aldığı, ülkenin doğu ve kuzeydoğu kesimlerinde etkili olmaktadır. Bu çalışmada Van Gölü Havzası’nın güneybatısında yer alan Bitlis Çayı Havzası’nın çığ duyarlılık durumunun tespit edilmesi amaçlanmıştır. Havzası’nın çığ duyarlılık durumu, arazi gözlemleri, uydu görüntüleri ve Coğrafi Bilgi Sistemleri (CBS) tabanında uygulanan analizlerle yorumlanıp açıklanmaya çalışılmıştır. CBS tabanlı analizde ArcGIS for Desktop 10.x yazılımı kullanılmıştır. İlgili yazılımda yükselti, bakı, eğim, yamaç şekli (eğriselliği) ve arazi kullanımı gibi bir takım coğrafi parametreler ağırlıklı çakıştırma (Weighted Overlay) aracı kullanılarak analiz edilmiştir. Elde edilen bulgulara göre havzanın %47’si orta; %34,1’i düşük; %18,2’si yüksek; %0,6’sı çok yüksek; %0,1’i çok düşük çığ duyarlılığına sahiptir. Havzada çığ duyarlılığının düşük olduğu alanlar Baykan ilçe merkezi ve güneyindeki eğimin ve yükselti değerlerinin düşük olduğu alanları oluştururken, duyarlılığın yüksek olduğu alanlar Bitlis İlçe merkezi ve çevresindeki alanlar ile Baykan ilçe merkezine kadar olan yüksek ve eğimli alanları oluşturmaktadır. Yapılan analiz ve gözlemler sonucunda havzada çığa duyarlı birçok alanın varlığı tespit edilmiştir. Bu konuda yapılacak en önemli adım havzada risk odaklı stratejiler benimsenerek yaşanan/yaşanacak doğa olayının afet boyutuna dönüşmesine engel olmaktır. Risk odaklı benimsenecek koruyucu tedbirler ve planlamalar sahanın çığ gibi çeşitli doğa olaylarından etkilenme riskini en aza indirecektir.