bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARISON OF DEXMEDETOMIDINE AND MIDAZOLAM-FENTANYL COMBINATION FOR TYMPANOPLASTY UNDER MONITORED ANAESTHESIA CARE
Authors: Azatshatru Shivankar , Dandona Sanjul
Published: December 2020

Objective- To compare the sedation, analgesia, hemodynamics effects, surgeon satisfaction and quality of surgical field provided by dexmedetomidine with combination of midazolam and fentanyl.
Methods- 100 patients of ASA I or II posted for tympanoplasty were divided into two groups of 50 patients each. Group D received Dexmedetomidine 1 μg/kg intravenously over 10 minutes loading and 0.2 μg/kg/h intravenously maintenance dose. Group MF received intravenously 0.03 mg/kg midazolam plus 1 μg/kg fentanyl over 10 minutes loading dose and normal saline 0.2 ml/kg/h intravenously as maintenance. Heart rate (HR), Mean Arterial Pressure (MAP), Respiratory Rate (RR), level of Sedation and degree of Analgesia were assessed intraoperatively. Surgeon satisfaction with the operative field and quality of sedation was inquired post-operatively with assessment of Pulse Rate (PR), Mean Arterial Pressure (MAP), Respiratory Rate (RR), sedation and duration of analgesia.
Results- Dexmedetomidine showed statistically significant decrease in heart rate and mean arterial pressure, better sedation and analgesia intraoperatively needing lesser rescue doses for sedation and analgesia and better surgeon satisfaction and longer duration of analgesia postoperatively. The adverse effects were bradycardia and hypotension with dexmedetomidine and nausea with midazolam-fentanyl.
Conclusion- Dexmedetomidine is better than a combination of midazolam-fentanyl for sedation and analgesia for tympanoplasty surgery under monitored anaesthesia care which provides optimal hemodynamic profile, better sedation, analgesia, surgeon satisfaction and minimal adverse effects.
STUDY ON CARDIAC MANIFESTATIONS AND ELECTROCARDIOGRAPHIC CHANGES IN SNAKE ENVENOMATION.
Authors: Gangula Aravind Reddy. , Manasa M
Published: December 2020

Snake bite is an occupational disease of farmers, plantation workers herdsmen, fishermen, snake workers and other food producers.It is therefore a medical problem that has significant implications for the nutritional and Economy of the countries. Snake envenomation is a common presentation in rural tertiary hospitals . The clinical profile of snake envenomation has been well established. However data on Electrocardiographic changes in snake envenomation particularly patients presenting to SouthIndian rural tertiary hospital are scant
Aims and objectives: To study on the cardiac manifestations and electrocardiographic findings of patients with snake envenomation.
Place of study : Department of General medicine,kamineni Institute of Medical sciences, Narketpally. Duration of study- sep 2018 to sep 2020.
Study design – Cross sectional study.
Sample size – 60.
The clinical profile of snake envenomation is varied, in its severity and type of species, hence the ECG may be cheap and simple tool to detect warning signs early to initiate timely and appropriate management .
TREATMENT OUTCOMES OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR URINARY CALCULI
Authors: P Nirmal K , G Manoj Kumar , R Sunil , Ganapath Aravind S
Published: December 2020

ESWL is considered as a standard treatment for renal calculi less than 20 mms, but the outcome of this therapy depends on different factors including stone composition, stone location, pelvicalyceal anatomy and stone size. This study was conducted to assess the treatment outcomes of patients undergoing ESWL for renal calculi and the factors influencing it. This was a descriptive study conducted in the Department of Urology, Government Medical College,Thiruvananthapuram. The study period was one year and 150 patients were enrolled. Overall success rate of ESWL in our study was 76.7%. Regarding the treatment outcomes our study concluded that the overall success rate of ESWL is 76.7%. But factors like lower calyceal location, skin to stone distance >10 cm, density > 950 HU and size >1.5 cms are associated with failure of fragmentation by ESWL.
COST ANALYSIS OF DISEASE MODIFYING ANTI RHEUMATIC DRUGS: THE INDIAN SCENARIO
Authors: Ansari Zarrin , Nerlekar Sharmada , Karia Sagar , Pawar Sudhir
Published: December 2020

Background: Rheumatoid arthritis is a chronic, autoimmune and inflammatory disease affecting the joints and cartilages, eventually leading towards deformity and resultant disability. Today’s rheumatologists have an armamentarium of Disease Modifying Anti Rheumatic Drugs (DMARDs) to choose from. The chronicity of the disease, resultant deformities and reduced work capacity adds to the socioeconomic burden of the disease. This study aims to compare the costs of various brands of DMARDs (both biological and non-biological agents), so as the give the readers an idea about the cost range and variation present amongst the available DMARDs.
Materials and Methods: Current Index of Medical Specialties (CIMS India) application was accessed in the month of August 2020 to note the cost of various brands of DMARDs. The information was tabulated. The cost difference and percentage cost variation was calculated and compared.
Results:The maximum number of brands was available for methotrexate amongst the biological as well as non-biological agents. Least and highest percentage cost variation was observed for 2.5 mg strength of methotrexate and 100 mg of cyclosporine, respectively. In general, biologicals had fewer brands in the market as the cost was considerably higher than the non-biological agents.
Conclusion:There is a wide variation amongst the costs of various DMARDs. This has its own advantages. Conscious choice of economical brands can profoundly effect the socioeconomic burden of rheumatoid arthritis management.
ELECTROCARDIOGRAPHIC CHANGES IN PATIENTS OF ACUTE ISCHEMIC STROKE IN RURAL TERTIARY CARE HOSPITAL
Authors: Kumar S. Sathish , Kanni Y.S.
Published: December 2020

BACKGROUND:
Stroke is the major cause of mortality and morbidity worldwide. In cerebrovascular accidents ischemic strokes are more common than hemorrhagic strokes. Electrocardiographic (ECG) changes are common in acute ischemic strokes. These ECG changes mimics myocardial ischemia. The main aim of this study is to study electrocardiographic changes that occur in acute ischemic stroke.
METHODS:
Seventy patients with acute ischemic stroke were included in the study. For all patients CT/MRI brain was done to confirm the diagnosis. A 12 lead ECG was taken for all patients at the time of admission.
RESULTS:
Out of seventy patients 44 patients were males (62.9%) and 26 (37.1%) patients were females. The mean age in our study was 60.35±10.21 years. 91.42% of patients have ECG changes and 8.57% have normal ECG. The most common ECG change observed is T wave inversion (38.57%) followed by ST segment changes (25.71%). some patients have more than one ECG change.
CONCLUSION:
This study shows the importance of ECG in the workup of acute ischemic stroke. ECG changes are common during acute stroke even in the absence of underlying cardiac pathology. so, clinicians should be aware of these changes while treating the patients. These ECG changes have some prognostic importance
A CLINICAL AND ANALYTICAL STUDY OF CORRELATION BETWEEN DRY EYE SYNDROME AND REFRACTIVE ERROR IN YOUNG ADULT PATIENTS ATTENDING OPHTHALMOLOGY DEPARTMENT, MBS HOSPITAL KOTA.
Authors: Singh Jaishree , Jat Parneet , Meena Ashok
Published: December 2020

Objectives:- This study aims to add new information about the DES in young adult by examining the correlation between dry eye syndrome and refractive errors.
Methods: In this cross sectional study, a total of 200 participants in the age range of 18 to 35 years and who were free of ocular surface disease, were taken from the patients attending outpatient Department of Ophthalmology, MBS Hospital Kota. Refraction was defined by the spherical equivalent (SE) as the following: 74 emmetropic eyes (±0.50 SE), 76 myopic eyes (≤−0.75 SE), and 50 hyperopic eyes (≥+0.75SE). All participants underwent full ophthalmic examinations assessing their refractive status and dryness level including tear film break up time, Rose Bengal staining and schirmer test.
Results: Prevalence of dry eye syndrome was 25.5% in this age group. In our study the prevalence of dry eye was 22.97%, 31.57%, and 20.00% in emmetropes, myopes, and hypermetropes, respectively (p value =0.28) and compared to emmetropes , prevalence of dry eye was higher in those with refractive errors (22.97% and 26.98% respectively). Mean Tear breakup time in seconds showed shorter time in eyes of myopic and hyperopic individuals compared to emmetropia. Mean Rose Bengal staining score showed less in emmetropic individuals compared to myopic and hyperopic.
Conclusion: The current results succeeded to demonstrate a correlation between refractive errors and dryness level.
Assessment of Efficacy of Dexmedetomidine and Fentanyl in Combination with Propofol for Ease of Laryngeal Mask Airway Insertion and Haemodynamic Stability
Authors: O Kankudte Akshay , Lawhale Sunil S
Published: December 2020

Background: Laryngeal mask airway (LMA) insertion requires anesthesia and suppression of airway reflexes. In search of an optimal drug, we compared dexmedetomidine and fentanyl, in combination with Propofol for ease of LMA insertion and haemodynamic stability. Method: Total 120 patients belonging to ASA status I & II posted for elective surgery were randomly divided into 2 equal groups. Both the groups received I.V glycopyrrolate 4μg/kg prior to receiving the study drugs. Group D received dexmedetomidine I.V 1μg/kg diluted in 10cc NS over 10min while group F received fentanyl I.V 2μg/kg diluted in 10cc NS over 10min. Induction was done with IV Propofol 2mg/kg in both the groups. After 90 sec, LMA insertion (no 3 for females and no.4 for males) was done by the consultant anaesthesiologist blinded to the technique. Results: Jaw opening, ease of LMA insertion, requirement of additional Propofol was clinically insignificant and comparable between two groups. Cough though seen more in fentanyl group, (p=0.042) while the incidence of bradycardia was more with dexmedetomidine group. Between the two groups, the change in blood pressure from baseline to 30sec after induction and upto 10min after LMA insertion was statistically insignificant. Within the individual groups, the changes in the blood pressure reached statistical significance. These changes did not reach a clinical significance and required no additional medication. Conclusion: Either dexmedetomidine or fentanyl when used along with propofol provides comparable conditions for the ease of LMA insertion with stable haemodynamic parameters in pre-hydrated, healthy and young patients.
EFFECT OF WHEY ON THE QUANTITATIVE CHANGE IN RESERVE FOOD OF THE GERMINATING SEEDS
Authors: Kiran Prabha
Published: December 2020

The percent starch in the germinating paddy seed was found gradually less faster due to treatment with whey than the control. Percent protein from germinating lentil seed was found to be gradually reduced with faster rate due to treatment with whey than the control. There appeared increase in soluble sugars in the endosperm of paddy during germination both in treated and control seeds. Also it was found that there is increase in total free amino acid in the cotyledons of lentils due to the treatment of whey. The decline in the amount of total soluble sugars in the endosperm of paddy after 3rd day of germination and in the cotyledon of lentil after 2nd day points out that soluble carbohydrates are more rapidly transferred to the embryo in lentil than to the paddy. Also decline in the amount of total free amino acid was observed in the endosperm of paddy after 3rd day while same on the 3rd day in lentil indicates the speed of the transfers of amino acid to the growing embryo. The unequal or varying speed might be due to the nature of seed as they belong to two unrelated group of plants.
A STUDY ON ASSOCIATION BETWEEN WORKRELATED FACTORS AND HYPERTENSION AMONG BUS DRIVERS IN TAMILNADU – A CROSS-SECTIONAL STUDY
Authors: S Imtiaz Ahmed , Govindrajan PK , Felix Felix
Published: December 2020

Background and Objective
Hypertension is a Leading cause of Morbidity and Mortality in developing nations. This study aims to Find the Association between Work related risk factors and Hypertension among transport Bus Drivers
Method
This study was a Cross Sectional Study carried out in Bus Depot and Bus Stand, Chidambaram, in Cuddalore district of Tamilnadu. The approximate prevalence of HTN among Adults in Tamilnadu was 31.5% (5). The estimated sample size for the study was 205. The Study tool included were Risk factor questionnaire and Physical measurement of Height, Weight and Blood pressure.
Results
Study showed significant Association between work-related factors or variables with Hypertension. Factors like Duration of Service in Present Job, Bus route travelling, Number of Hours at work, Family history of Hypertension are significantly associated with rise in Blood Pressure
Conclusion
Strong Association between work related factors like Service duration, travelling bus route, Duration of work hours, Shift duties and Hypertension was noted. Study recommends need for Periodic screening and follow up for Early diagnosis and treatment compliance. Lifestyle modifications and Periodic shift in duty patterns is also needed for the benefit of Bus drivers
MULTIPLEX PCR BASED SINGLE NUCLEOTIDE POLYMORPHISMS ANALYSIS OF HBS POINT MUTATION
Authors: Patel Jignisha S , Naik Jignaben P , Italia Yazdi M
Published: December 2020

Introduction: Sickle hemoglobin (HbS), an autosomal recessive hemoglobinopathy cause of Sickle cell disease (SCD), is widely sprayed around the globe affecting millions of people . SCD results from single nucleotide polymorphism (SNP) or point mutation causing amino acid substitution from Glutamic acid to Valine leads to sickled shape red blood cells. SNPs can be well studied by using allele-specific amplification (ASA) technique.
Aims & Objective: To develop a simple, rapid, easy and accurate genotyping method for SNP analysis of SCD.
Materials and methods: By performing different tests, a well characterized sample panel of 150 different types of samples was prepared. From this sample panel DNA was extracted and used for SNP-genotyping of SCD. Specific primers were used for performing monoplex PCR amplification of wild type allele (HbAA) and mutant allele (HbSS) were performed individually. By using the same primers multiplex PCR assay was experimented.
Results and conclusion: This is a simple and low cost molecular method for the detection of point mutation and useful tool for the diagnosis of SCD. The entire analysis can be performed in one reaction mixture, which results in higher speed, higher accuracy, and the need for smaller samples. This technique might be of great value for genotyping of homozygous sickle cell patients (SS) and heterozygous sickle cell trait (AS). But we found one discrepancy with double heterozygous (sickle β-thalassaemia) samples. We were not able to differentiate sickle cell carrier state (AS) from the double heterozygous like sickle β-thalassaemia state. So we conclude that for simultaneous detection of thalassaemia along with sickle cell requires addition of more primers specific for thalassaemia mutation. In addition to this when two bands, one for wild type allele and second for mutant allele appears, care must be taken to conclude whether the person is a sickle cell carrier (AS) or having double heterozygous (sickle β-thalassaemia) like condition.
FAMILIAL DYSKERATOTIC COMEDONES – A RARE CASE REPORT
Authors: S Sudheer Kumar , KR Ram Kumar , V Chenchaiah , P Venkata Ramana
Published: December 2020

Familial dyskeratotic comedones (FDC) is a rare autosomal dominant inherited condition, characterized by widespread, symmetrically scattered, comedone-like, hyperkeratotic papules, which are cosmetically unappealing. Lesions show a predilection to involve the trunk, arms and face and appear around puberty. The lesions are usually asymptomatic and worsen gradually with time. Histology shows invagination of the epidermis with a lamellar keratinous plug and focal evidence of dyskeratosis. This condition is generally refractory to therapy. We report here a case with this rare disorder.
WEARING FACE MASKS FOR COVID-19 PANDEMIC: FROM MEDICAL TRADITION TO COMMUNITY PRACTICE
Authors: Singh Neha , Jain Kamlesh , Jain Shilpa
Published: December 2020

Different forms of face coverings used by the public, like masks, gamchas, shields etc., are now widely recommended as source control during the COVID-19 pandemic. Significant debates about the general community use of face masks for guard against coronavirus disease 2019 (COVID-19) stemmed from differing views expressed by health authorities. We believe that the stigmatization and misconceptions about the use of face masks may delay the containment of the COVID-19 pandemic. The leading narrative driving policy, has observed face coverings as a medical intervention and evaluated its efficiency from an infection control perspective. We recommend that public officials and governments strongly encourage extensive use of face masks in public including the use of appropriate regulation. Face masks should not only measure as medical tools but as a community practice to reduce transmission of respiratory infections such as COVID-19.
COMPARATIVE STUDY OF INGUINAL HERNIA REPAIR WITH PLACEMENT OF MESH ANTERIOR AND POSTERIOR TO FASCIA TRANSVERSALIS IN CASES OF UNILATERAL INGUINAL HERNIA
Authors: Mukherjee Angshuman , Maulik Dhrubajyoti
Published: December 2020

Background: Since inception hernia surgery evolved a lot and achieved the gold standard of Lichtenstein hernioplasty. Chronic post-surgical inguinal pain and mesh related wound complications are still issues of concern for surgeons. To minimize these problems different modifications are being evaluated worldwide.
OBJECTIVE: To compare the incidence of post-surgical chronic inguinal pain duration of surgery between two different techniques of mesh placement, one is placing the mesh anterior to Fascia Transversalis and other is placing the mesh posterior to Fascia Transversalis.
STUDY DESIGN: Randomized superiority trial done among patients selected from opd and divided in two groups undergone hernioplasty by two different techniques of mesh placement.
MATERIALS AND METHODS: Each group of patients contained fifty patients of 18 to 65 years of age with unilateral inguinal hernia. Duration of surgery recorded and post-surgical chronic inguinal pain evaluated at 2 weeks 2 months 4 months and 6 months after surgery.
CONCLUSION: The study showed that placement of mesh posterior to fascia tranversalis gave better result than placing it anterior to FT in respect of post operative chronic pain but with a longer operative duration.
EARLIEST SYMPTOM & SIGN FOR WHICH HYPOTHYROIDISM IS SUSPECTED
Authors: Noronha Dotton Denis , Shetty Sneha B , Shetty Balachandra A
Published: December 2020

Background: The thyroid hormone maintains the level of metabolism in the tissues that is optimal for their normal function. Traditional symptoms of hypothyroidism have been well known to medical practiioners. Yet hypothyroidism often remains undetected Aims and Objectives: To study the first symptom and sign that helps to diagnose hypothyroid state
Materials and MethodsThe study design is cross-sectional: all patients, regardless of results of physical examination, underwent the reference standard test (thyroid hormone assays) at the same point of time. All screened patients in the age group of 14 and above are considered for the study Results: Dry skin and cold sensitive skin were found to be the most common symptom amongst 100 subjects out of which 18% of the population had each of these symptoms being the first symptom that helped in diagnosing hypothyroid state. The most common physical sign out of 100 subjects was found to be delayed relaxation of ankle jerk, out of which 30% of the subjects had their first clinical sign being delayed ankle jerk that helped to diagnose hypothyroid state.
The next more common physical sign out of 100 subjects was found to be bradykinesia/slow movements, out of which 22% of the subjects were diagnosed hypothyroid state considering it being the first sign. Conclusion The most common symptom noted in symptom profile of hypothyroidism was dry skin and cold sensitivity, which was seen in 68% respectively,of which 18% of the cases were diagnosed hypothyroidism through these symptom. The most common feature noted in clinical profile of hypothyroidism was delayed relaxation of ankle jerk, which was seen in 92% of which 30% of the cases were diagnosed hypothyroidism through this clinical sign. The traditional symptoms, clinical examination and signs are valuable and more efficacious when deciding which patients to be tested for hypothyroidism
OSMOTIC DEMYELINATION SYNDROME WITH KETOSIS AND WITHOUT ELECTROLYTE
IMBALANCE, A RARE COMPLICATION OF JUVENILE DIABETES MELLITUS.
Authors: Saman Ravi Kumar , Gafoor J. Abdul , Radharani Radharani , Suresh B. , Harinath D.
Published: December 2020

Central pontine myelinolysis (CPM) is rarely reported in paediatric patients with diabetes. We report this case of a 10-year-old female with new onset diabetes. Patient presented with flaccid quadriparesis and bilateral lower motor neuron facial nerve palsy with associated history of difficulty on swallowing. MRI Brain showing central pontine myelinolysis (CPM) and bilateral parietal lobe edema. On biochemical examination blood glucose level 418mg/dl, urine ketone bodies insulin, patients condition improved. After ten days coarse of subcutaneous insulin twice a day HbA1c level was 7.1and mean plasma glucose level was 175mg/dl. MRI BRAIN shows significant improvement in CPM after 22 days compared to previous MRI scan and more improvement after 50 days with subcutaneous insulin twice a day. Though CPM is very rare with poor outcome.in our case prognosis of patient is good. And it will help us to plan a better protocol in future for CPM patient with diabetes.
A CROSS-SECTIONAL STUDY ON MEDICATION ADHERENCE AND HYPERTENSION
Authors: Jeyakumar Anaiappan , Deivasigamani Kuberan , P Praveena
Published: December 2020

BACKGROUND:
Advocates are exposed to long hours of stressful hectic work schedules and they struggle to cope up with life. This work pressure may predispose to non-communicable disease particularly hypertension. Considering above issues, a study was conducted among this target group. This part of the main study deals with the known hypertensive advocates in the study population and their adherence to anti-hypertensive medications.The objective is to evaluate the medication adherence among known hypertensive advocates practising in Madurai city
METHODS:
A cross-sectional study was conducted in a sample 300 practising advocates satisfying the study criteria at Madurai district court for a period of 1 year by simple random sampling method. Among the 300 samples, 56 were known hypertensives. This current study is carried out in 56 known hypertensive advocates to evaluate the level of medication adherence to anti hypertensives using the pre tested structured medication adherence questionnaire and scoring.
RESULTS:
Among 56 known hypertensive participants, a majority of the known hypertensives, 39(69.6%) adhere to anti-hypertensive medications and remaining 17(30.4%) had no proper adherence to anti-hypertensive medication
CONCLUSION:
Hypertension being a preventable and treatable disease can be reduced by following the healthy dietary practice and adherence to medications. Health education and motivation by health care professionals to the target group improves the effectiveness of the pharmacotherapy. Advocates being educated group should aim at consistent, sustain, regular health seeking effort to attain optimal medication adherence
ASSESSMENT OF BREAST CANCER INCIDENCE IN PATIENTS WITH MASTALGIA AND ROUTINE SCREENING
Authors: Akela Ankur , Kumari Rinku
Published: December 2020

About 70% of the women experiences breast pain once in their life time1. Mastalgia is described as tension, discomfort, and ache in breast1. The prevalence of cancer in patients manifesting with breast pain is reported to be 0.3-2% 2. As breast cancer awareness increases, the concern that breast pain may indicate malignancy contributes to the tendency of breast pain to be the most common breast symptom and leads to a woman consulting a breast surgeon3. Breast pain is categorized broadly in to two types; cyclical and non-cyclical breast pain. Cyclical mastalgia is a unilateral or bilateral pattern of pain or tenderness, frequently associated with swelling that reduces with the menstrual cycle. Noncyclic mastalgia tends to be unilateral and is more local than cyclical breast pain. The location of the pain can usually be localized. Typically, most women who had non cyclic mastalgia are in the fourth or fifth decade of life at the time of diagnosis.
AN ANALYSIS OF DEATHS FROM RURAL AND URBAN AREAS OF ANANTHAPURAMU DISTRICT DUE TO INTENTIONAL AND UNINTENTIONAL POISONING
Authors: Poluru Vishnu Vardhan , Kishore Kathi Aswani , Parigala Brahmaji Master
Published: December 2020

BACKGROUND: Pesticides poisoning is most common in developing countries, whereas psychiatric medications top the list in developed countries. In this study, an analysis of deaths due to poisoning is done with respect to age, gender, nature of poisoning, type of poison, and socioeconomic status to propose some precautions to prevent deaths. MATERIAL AND METHODS: The present study is conducted after collecting details of 75 cases of intentional and unintentional poisoning who were brought to the Department of Forensic Medicine, Government Medical College, Ananthapuramu for medicolegal autopsy. Children were excluded from the study due to insufficient data. RESULTS: Total of 75 cases are selected to conduct the study. Organophosphorus poisoning tops the list. Most of the cases are suicidal in nature. Lower class people and males are involved mostly. CONCLUSION: Poisoning in India is a socio-economic problem. Regulation of sale of poisons cannot not prevent the incidence of cases. Hence a holistic approach is necessary to uplift society as a whole by solving the problems of poverty, unemployment, industrial development, adequate health care, suitable and sufficient education, etc.
A STUDY ON THE SOURCES AND CONSEQUENCES OF STRESS DUE TO COVID-19 PANDEMIC WITH SPECIAL REFERENCE TO TAMIL NADU
Authors: Anbugeetha D. , Nandhini B.
Published: December 2020

The mortality due to the COVID-19 pandemic is shooting up across the world in an apprehensive speed. People try to detach themselves from the current reality and turn towards something which gives them a brief relief. They try to find solace in snacks, TV shows, etc. However, the pandemic is actually a truth. This truth creates a negative feeling. All around words such as “lockdown; stay home, stay safe; wash your hands; wear a mask; maintain social distancing” is been heard continually. People have developed fear of death; fear of social security and fear of financial security.
Covid19 and the associated lock down have brought about a strong emotional trauma to men, women and children across the globe. This creates stress among people. This empirical paper aims to identify the sources of stress occurred due to this pandemic and tries to suggest a few sustainable practices to manage stress.
IMMEDIATE EFFECT OF MYOFASCIAL RELEASE V/S POSITIONAL RELEASE TECHNIQUE ON LEVATOR SCAPULAE TRIGGER POINTS IN YOUNG ADULTS
Authors: Noor Ahmed , Sanghvi Mansi , Khan Sarfraj
Published: December 2020

Context : Myofascial release is the gentle manual application of sustained pressure to release fascial restriction. One of the cervical spine pain healing methods is Trigger point therapy with positional release method. Aim: To compare the efficacy of Immediate Effect of Myofascial Release and Positional Release techniques on levator scapulae trigger points in young adults. Method and material: Study involved 30 subjects that were divided into 2 groups. Group A (n=15) Myofascial Release technique and Group B (n=15)Positional Release technique. Results: The data was analysed using statistical method of paired’t’-test between the pre and post interventional study of pain and range of motion. Result showed statistically significant improvement (p<0.05) and visible difference in the post intervention. Discussion and conclusion: From the present study we conclude that Myofascial release is more efficient in reducing pain whereas Positional Release Technique is more efficient in increasing the cervical ROM , both Active lateral flexion and Cervical rotation.
AMYGDALECTOMY AND SCHIZOPHRENIA: A CASE PERSPECTIVE
Authors: D.B. Sail , N.M. Thorat , P.V. Phutane
Published: December 2020

Introduction:
In the past century patients with mental illnesses were treated by invasive brain surgeries which clinically resulted in a variable degree of effectiveness. We report a case of stereotactic amygdalectomy performed in a case of schizophrenia which later required medical management due to failure of the surgical procedure.
Case:
A 24 years old unmarried male with a past history of psychiatric illness was brought and admitted for behavioural disturbances. He recently had undergone bilateral amygdalectomy for his illness. A detailed history and mental status examination revealed diagnosis of schizophrenia. He was treated with ECTs and Clozapine on which he showed marked improvement without any side effects.
Conclusion:
In patients of schizophrenia psychosurgery shall be an option only after an adequate trial of pharmacotherapy and other treatment modalities.
Security Safety and Organizational Standard Compliance in Cyber Physical Systems
Authors: Bicaku Ani , Schmittner Christoph , Rottmann Patrick , Tauber Markus , Delsing Jerker
Published: December 2020

In Industry 4.0 independent entities should interoperate to allow flexible and customized production. To assure the parties that individual components are secured to inter-operate, we investigate automated standard compliance. The standard compliance is defined based on given sets of security and safety requirements for which measurable indicator points are derived. Those reflect configurations of systems recommended by security, safety or process management relevant standards and guidelines, which help to demonstrate the state of compliance. We propose in this paper an approach to automate such an assessment when components are inter-operating with each other by using a monitoring and standard compliance verification framework. The framework will assure the parties that services or devices within their organizations operate in a secure and standard compliant way, without compromising the underlying infrastructure.
An OFDMA-based Hybrid MAC Protocol for IEEE 802.11ax
Authors: Islam Gazi Zahirul , Kashem Mohammod Abul
Published: December 2020

Two types of MAC mechanisms i.e., random access and reservation could be adopted for OFDMA-based wireless LANs. Reservation-based MAC is more appropriate than random access MAC for connection-oriented applications as connectionoriented applications provide strict requirements of traffic demands. On the other hand, random access mechanism is a preferred choice for bursty traffic i.e., data packets which have no fixed pattern and rate. As OFDMA-based wireless networks promise to support heterogeneous applications, researchers assume that applications with and without traffic specifications will coexist. Eventually, OFDMA-based wireless LAN will deploy hybrid MAC mechanisms inheriting traits from random access and reservation. In this article, we design a new MAC protocol which employs one kind of hybrid mechanism that will provide high throughput of data as well as maintains improved fair access policy to the medium among the terminals. The protocol works in two steps, where at step 1 sub-channels are approximately evenly distributed to the terminals and at step 2 terminals within in a subchannel will contend for medium randomly if the total number of terminals of the system is larger than the number of sub-channels. The details of the protocol is illustrated in the paper and we analyze the performance of our OFDMA-based multi-channel hybrid protocol using comprehensive computer simulations. Simulation results validate that our proposed protocol is more robust than the conventional CSMA/CA protocol in terms of throughput, collision reduction and fair access. In addition, the theoretical analysis of the saturation throughput of the protocol is also evaluated using an existing comprehensive model.
R3D3: A Doubly Opportunistic Data Structure for Compressing and Indexing Massive Data
Authors: Nagy Máté , Tapolcai János , Rétvári Gábor
Published: December 2020

Opportunistic data structures are used extensively in big data practice to break down the massive storage space requirements of processing large volumes of information. A data structure is called (singly) opportunistic if it takes advantage of the redundancy in the input in order to store it in iformationtheoretically minimum space. Yet, efficient data processing requires a separate index alongside the data, whose size often substantially exceeds that of the compressed information. In this paper, we introduce doubly opportunistic data structures to not only attain best possible compression on the input data but also on the index. We present R3D3 that encodes a bitvector of length n and Shannon entropy H0 to nH0 bits and the accompanying index to nH0(1/2 + O(log C/C)) bits, thus attaining provably minimum space (up to small error terms) on both the data and the index, and supports a rich set of queries to arbitrary position in the compressed bitvector in O(C) time when C = o(log n). Our R3D3 prototype attains several times space reduction beyond known compression techniques on a wide range of synthetic and real data sets, while it supports operations on the compressed data at comparable speed.
Pilgrims and Missionaries of Social Peace: Geneva and Pontigny as Sites of Scandinavian Internationalism in Late Interwar Europe
Authors: Mørkved Hellenes Andreas
Published: December 2020

This article investigates two interlinked sites of Scandinavian socialist internationalism in continental Europe: the Nordic folk high school in Geneva and the humanistic centre created by French philosopher Paul Desjardins in Pontigny. Locating and situating these two nodes on the cultural-political map of late interwar Europe allows for a study of how actors from the popular movements in Denmark, Norway and Sweden mobilised educational ideals and practices to internationalise the experience of Scandinavian social democracy. The analysis shows how the transnational activities of the Nordic folk high school’s study course opened up new spaces for Scandinavian internationalism. In this way, the article argues, the school represented an experiment in internationalism from below where Nordism was deployed as a cultural strategy to create international understanding for working-class Scandinavians; and created new arenas for Nordic encounters with French political and intellectual milieus that admired Scandinavian democracy and social peace.
Territórios indígenas no Brasil: aspectos jurídicos e socioculturais.
Authors: Arruda Rinaldo
Published: December 2020

Description:The article describes the lands of the indigenous in Brasil, in particular their legal and socio-cultural aspects.
Historia, organización y evolución de la población yanomami.
Authors: Lizot Jacques
Published: December 2020

Lizot’s paper is Spanish language version of article published in L’Homme. Revue d’Anthropologie, T. XXIV. No 2. pp. 5-40. Avril-juin 1984
Desarrollo del movimiento femenino en el Ecuador hasta los años 1980.
Authors: Śniadecka-Kotarska Magdalena
Published: December 2020

Short description:

The article is based on series of ethnographic interviews with Ecuadorian women that took place between 1997 and 2001. The informants where asked about their opinions on the development of the women’s rights movement. The accounts by the informants were used to present a historical overview from the female perspective. It relates with developments of the 40’s, 60’s, 70’s and 80’s. In 1989 significant new law changes toward equal rights of women were introduced, but it is suggested that they failed to introduce truly equal treatment as a common practice.
Retardo na chegada da pessoa com acidente vascular cerebral a um serviço hospitalar de referência
Authors: de Castro Brandão Paloma , Oliveira Antunes Ferraz Mariana , e Silva Sampaio Elieusa
Published: December 2020

Objetivos: Analisar fatores que retardam o atendimento dos pacientes na fase aguda do Acidente Vascular Cerebral em um hospital público de referência. Métodos: Estudo de corte transversal, realizado na cidade de Salvador/Bahia com 50 pacientes através de dados em prontuários e por entrevista semiestruturada. Os dados foram analisados através do programa SPSS versão 21, utilizado o Qui-quadrado para as variáveis do tempo, com ní­vel de significância de 5%. Resultados: Evidenciou-se média de idade de 61,2 ± 13 anos, predominando o sexo masculino. A maioria dos pacientes não realizou trombólise devido a fatores de atraso como: utilização de carro próprio, não ter um familiar presente na hora do evento, chegada ao hospital fora da janela terapêutica e procura por outros serviços anteriormente. Conclusão: Diversos fatores retardam o atendimento ao paciente com Acidente Vascular Cerebral. Desta maneira, observa-se a necessidade de melhorias no atendimento associada í  difusão de informações í  população.
Assistência de enfermagem aos pacientes portadores de alzheimer: uma revisão integrativa
Authors: Piccineli Zanchettin Silva Sabrina , Bernardo Allison Vinicius , Lima Noronha Lô Caroline , Verdeli Teodoro Campeiro Giovana , Rocha dos Santos Lucas
Published: December 2020

O Alzheimer se caracteriza como uma demência neurodegenerativa, fatal e incurável, acometendo, principalmente os idosos. Objetivo: Evidenciar o estado da arte acerca da assistência de enfermagem ao portador de Alzheimer. Método: Trata-se de uma revisão integrativa da literatura acerca da Assistência de Enfermagem ao portador de Alzheimer, nos anos de 2016 a 2020, dentro das seguintes bases de dados: SciELO e LILACS, utilizando como estratégia de busca os descritores combinados com operadores booleanos "enfermagem" and "Alzheimer". Resultados: A amostra do estudo foi composta por sete artigos, evidenciando o papel do enfermeiro, junto ao cuidador e com o portador da Doença de Alzheimer, além de mostrar necessárias ações de promoção da saúde e prevenção de agravos. Conclusão: A doença de Alzheimer se configura como um desafio para a sociedade contemporânea, sendo que a Enfermagem tem papel fundamental no cuidado ao portador e ao cuidador.
Epidemiologia da violência sexual infanto-juvenil no municí­pio de São Paulo
Authors: Da Silva Oliveira Yasmin , Rodrigues da Silva Denise , Mundim Pombo Ana Paula , Ferreira Moura Roudom
Published: December 2020

Objetivo: Descrever o perfil epidemiológico da violência sexual em crianças e adolescentes residentes do municí­pio de São Paulo. Métodos: Trata-se de um estudo descritivo. Foram utilizados dados secundários, oriundos do Sistema de Informação de Agravos de Notificação no perí­odo de janeiro de 2015 a dezembro de 2017. Resultados: Para o perí­odo foram notificados 2.884 casos de violência sexual envolvendo crianças e adolescentes. Houve evolução do número de casos notificados entre os anos (2015–401; 2016–1049 e 2017 - 1434). A faixa etária com a maior estimativa de risco para violência sexual foi de 5 a 9 anos. A prevalência dos casos ocorreu no sexo feminino (81,1%) e na raça negra (47,2%). Em relação aos agressores prevaleceu os amigos/conhecidos (20,9%) e os pais (16,8%). Conclusão: Evidenciou-se o agravo temporal e evolutivo da violência sexual í  saúde de crianças e adolescentes e observou-se desigualdades no ciclo de vida, gênero e raça.
Primary aldosteronism – the expanding spectrum of unsolved practical issues
Authors: Łebek-Szatańska Agnieszka , Papierska Lucyna
Published: December 2020

Primary aldosteronism is the most frequent cause of hormonal hypertension. Recent findings support the concept of continuous spectrum of autonomous aldosterone secretion with mild or subclinical forms being even more common than was suspected. Assumptions emerge that a considerable number of low-renin hypertensives might actually have aldosterone overproduction. However, the awareness of the disease and its consequences is still unsatisfactory. Nowadays experts are still trying to manage some unanswered questions and on-going debate on who should be screened for primary aldosteronism and how to do so.
Growth hormone, somatomedins and cancer risk
Authors: Kozakowski Jarosław , Dudek Piotr , Zgliczyński Wojciech
Published: December 2020

Growth hormone (GH) promotes growth and development in children and is the meaningful co-regulator of the metabolism in adulthood. GH may act directly, through its receptor (GHR), as well as via mediators – insulin-like growth factors: IGF-1, i.e. somatomedin C and IGF-2. Moreover, GH and two growth factors are involved in the mechanisms of cell proliferation, differentiation and survival, hence their oncogenic potential is propounded. Indeed, GH, somatomedins and their receptors are found abundantly in normal and cancer cells in several tissues. It has been shown in animal and human trials that polymorphisms and mutations that increase signal transmission from the GH and IGF-1 receptor are associated with more frequent tumors development and reduce life expectancy. Numerous epidemiological studies have confirmed a clear relationship between GH/IGF-1 level in circulation and a cancer-dependent morbidity and mortality. It dictates caution in case of treatment with use of growth hormone. Such replacement therapy is recommended in cases of GH deficiency. In the common opinion of scientific societies such treatment is generally safe, although in some cases unambiguous opinion in this field cannot be determined yet. On the other hand, on the basis of available evidence, GH cannot be recommended for use by the healthy elderly (ani-aging medicine), bearing in mind that GH decline with age may represent a beneficial adaptation to ageing. Understanding the molecular mechanisms by which GH and GH-dependent growth factors affect cell metabolism and proliferation will allow to use them in oncology in the future.
Proposta de uma nova metodologia para calibração de rugosidades em redes com diferentes materiais
Authors: Lopes de Sousa David , de Araújo Bezerra Alessandro , Holanda de Castro Marco Aurélio
Published: December 2020

A calibração de redes de distribuição de água é uma importante ferramenta para a obtenção de modelos computacionais que representem melhor a rede instalada. Neste trabalho foi desenvolvida uma nova rotina, que adapta o Método do Gradiente Hidráulico Alternativo (MIGHA), utilizado na calibração do fator de atrito e no cálculo da rugosidade absoluta, tornando mais uniformes os resultados obtidos para esse parâmetro nas tubulações que possuem o mesmo material. Além disso, foram testadas diferentes funções objetivo com o intuito de descobrir qual é a mais indicada para o método. Os resultados obtidos sugerem que a nova rotina de uniformização melhora consideravelmente as calibrações, retornando excelentes resultados, mesmo utilizando apenas 25% dos nós com pressões conhecidas. As diferentes funções objetivo testadas não influenciaram significativamente nos resultados.
Palavras-chave: Calibração. Rugosidade absoluta. Rotina de uniformização. Funções objetivo.
电厂分散控制系统改造工程关键技术分析
Authors: 伟 胡
Published: December 2020

电厂生产实践中控制系统发挥着重要的作用，所以在实践中需要对控制系统的具体应用进行分析与讨论。就目前的分析来看，在电厂的工作实践中，分散控制系统的应用比较普遍，不过随着生产要求的提高，分散控制技术水准有所提升，所以要基于实际需求进行分散控制系统的改造。论文分析和探讨了电厂分散控制系统改造工程的关键技术，旨在为实践工作提供帮助与指导。
建筑施工企业工程项目成本核算探讨
Authors: 迎宾 李
Published: December 2020

论文对建筑施工企业工程项目成本核算的主要作用进行阐述，从缺少完备的工程项目成本核算机制、缺少完备的工程项目成本核算机制、工程项目成本核算意识普遍偏低三个方面，对当前建筑施工企业工程项目成本核算存在的主要问题进行解析，并以此为依据，提出加强建筑施工企业工程项目成本核算要点的有效措施。
施工管理经验观浅谈
Authors: 斌 朱 , 发钧 林
Published: December 2020

施工管理是目前房屋建筑等工程施工过程中必须常抓不懈的一项重要工作，工程中不重视施工现场的施工管理，就会使整个项目处于停滞不前的状态，各项工作都无法有序的开展。为确保工程安全、质量、进度目标的顺利进行及每年度预定目标的顺利实现，现将本人多年进行施工管理的经验做了总结和归纳，以期对施工项目管理起到很好地促进作用。
当前建筑电气安装工作现状及优化策略剖析
Authors: 健 王
Published: December 2020

电气安装是建筑工程建设中的关键工作，不仅会对建筑的整体使用功能产生影响，而且也关系到人们的用电安全，因此应该予以重视。电气安装工作涉及的内容较多，其具有较强的专业性，因此必须明确工作要点，避免出现严重的问题。论文对当前建筑电气安装现状进行分析，探索建筑电气安装工作的优化策略。
试论建筑节能工程建设监理策略
Authors: 伟男 高
Published: December 2020

目的：为研究在建筑节能工程建筑中的监控与管理策略，针对工程建设中的不足之处加以改善以实施更好地监控及管理，完善监理策略。方法：通过对某一小区正准备进行的建筑节能工程建设进行完整的监控与管理，包括施工前的准备、施工时的过程监控、确保工程的安全、施工后的质量验收、施工后的废物利用等，同时通过对比采用建筑节能工程建设后的整体建设成本及污染方面与之前比较。结果：对建筑节能工程建设的监理是重要的，对工程中的存在的问题提出相应的策略解决方法，可更好的实现工程建设成果，能在一定程度上控制施工成本，提高经济效益，同时通过废物利用可减少对环境的污染，符合中国的环保宗旨。
PENGARUH FINANCIAL LEVERAGE TERHADAP INITIAL RETURN PADA PERUSAHAAN YANG MELAKUKAN INITIAL PUBLIC OFFERING DI BURSA EFEK
Authors: Mahaitin H Sinaga
Published: December 2020

Penelitian ini bertujuan untuk menguji dan memberikan bukti empiris tentang pengaruh financial leverage terhadap initial return pada perusahaan yang melakukan Initial Public Offering (IPO) di Bursa Efek Indonesia. Variabel dependen yang disajikan dalam penelitian ini adalah initial return, sedangkan variabel independennya adalah financial leverage. Populasi penelitian ini dilakukan berdasarkan data sekunder dari laporan keuangan perusahaan yang melakukan IPO di Bursa Efek Indonesia selama periode 2015 - 2019, yaitu sebanyak 115 perusahaan. Sumber data  diperoleh dari situs www.idx.co.id, www.e-bursa.com, www.sahamok.com. Pemilihan objek penelitian dalam penelitian ini dilakukan dengan metode purposive sampling, yaitu objek penelitian yang dipilih dari populasi berdasarkan kriteria tertentu sebanyak 84 perusahaan. Teknik analisis data yang dipergunakan dalam penelitian ini adalah analisis deskriptif kualitatif dan analisis deskriptif kuantitatif yang meliputi uji asumsi klasik, analisis regresi linear sederhana, dan uji hipotesis yang dilakukan dengan bantuan software statistik SPSS 20. Hasil penelitian menunjukkan, bahwa financial leverage tidak berpengaruh dan tidak signifikan terhadap initial return pada perusahaan yang melakukan IPO di Bursa Efek Indonesia periode 2009-2013. Hal itu dapat dilihat dari: 1) Hasil analisis regresi linear sederhana, yaitu LN_IR = -2,027 – 0,260 LN_FL + ε. 2).Hasil analisis koefisien korelasi, yaitu nilai R sebesar 0,169 yang artinya terdapat hubungan yang sangat lemah antara kedua variabel. 3) Hasil analisis koefisien determinasi yaitu nilai R2 sebesar 0,029, yang artinya initial return dapat dijelaskan oleh variabel financial leverage sebesar 2,9%, sedangkan sisanya  sebesar 97,1 % dipengaruhi oleh variabel lain yang tidak dibahas dalam penelitian ini. 4) Hasil uji t dalam penelitian ini diperoleh thitung < ttabel (1,555 < 1,989) atau sig. > 0,05 (0,124 > 0,05), maka H0 diterima. Hasil penelitian ini menyimpulkan, bahwa  financial leverage tidak berpengaruh dan tidak signifikan terhadap initial return pada perusahaan yang melakukan Initial Public Offering (IPO) di Bursa Efek Indonesia periode 2009-2013. Oleh karena itu, sebaiknya perlu melakukan penelitian terhadap faktor-faktor informasi keuangan dan non keuangan lainnya sebagai variabel yang dianggap mempengaruhi initial return, kemudian menggunakan objek penelitian yang lebih banyak dengan menambah periode tahun penelitian, sehingga hasil penelitian akan lebih valid