bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Knee Arthroplasty in Hemodialysis Patients: Routine or Complex Surgery?
Authors: Tsed Aleksander N. , Mushtin Nikita E. , Dulaev Aleksander K. , Schmeljew Anton V.
Published: November 2023

Background. Chronic hemodialysis significantly increases the risks associated with knee replacement. Among the late complications of knee arthroplasty in hemodialysis patients, deep periprosthetic joint infection (PJI) and aseptic loosening are more frequent. The frequency of revision interventions in patients with end-stage kidney disease (ESKD) is substantially higher compared to patients with normal kidney function.
The aim of the study — based on the perioperative parameters and midterm outcomes to justify the primary knee replacement in chronic hemodialysis patients as complex case of arthroplasty.
Methods. A retrospective randomized single-center cohort study was conducted, including 62 patients with various forms of knee osteoarthritis. Patients were divided into two groups: Group 1 — 29 (46.8%) patients with end-stage renal disease (ESRD) undergoing dialysis, Group 2 — 33 (53.2%) patients without kidney pathology. The average follow-up period in both groups was 3.7 years (min — 1, max — 6). The following parameters were assessed: patient age, length of hospital stay, morphocortical index, body mass index (BMI), duration of hemodialysis, functional assessment of the knee joint using the KSS Function Score and Forgotten Joint Score-12 (FJS-12), radiological results on the KRESS, and the frequency of various complications.
Results. In Group 1, patients had significantly lower BMI compared to Group 2. Length of hospital stay in Group 1 were 1.7 times longer. According to the KSS Function Score, no significant differences were observed between the groups in the first 36 months after the operation. However, by the 4th year of follow-up, average KSS Function Score in Group 1 decreased to 77.3 points, which was due to infectious complications. The FJS-12 showed worse scores in Group 2, averaging 68.7 points. After more than three years post-operation, no statistically significant differences were observed between the groups, which was associated with an increase in the number of complications in Group 1. Results on the KRESS after 43 months did not differ between the groups and averaged 4.8 points. Group 1 had more orthopedic complications and cases of PJI, accounting for 7 out of 37.
Conclusion. Age and constitutional characteristics of patients undergoing hemodialysis significantly differ from the normal population. The frequency of complications in Group 1 was 23.5%. These patients require the implantation of more constrained implant components and modular systems. Therefore, primary knee replacement in hemodialysis patients can be classified as a complex case of arthroplasty.
Prospects for the pharmacological validation of the use of platelets as a “peripheral model” of neurons
Authors: Urakov Aleksandr L. , Nikitina Irina L. , Klen Elena E. , Wang Yi , Samorodov Aleksandr V.
Published: November 2023

Depressive disorders often occur in patients with cardiovascular pathologies and are a predictor of the development of thrombotic events, such as myocardial infarction, acute ischemic cerebrovascular accident, and pulmonary embolism. These are believed to be caused by the structural and biochemical relationship between platelets and brain neurons, which allows us to consider platelets as a marker of central nervous system (CNS) pathologies. This review aimed to assess the relationship between the hemostasis system and the development of depressive disorders using platelets as a “peripheral model” of neurons and evaluate the effectiveness of drugs for the treatment of depression. The study was conducted in accordance with the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic literature search was conducted using PubMed, Cochrane, and CINAHL databases from 2018 to 2023, according to the following keywords: “hemostasis,” “acute cerebrovascular accident,” “depression,” “depressive disorders,” “platelets,” “cardiovascular diseases.” The data obtained indicate both a clinical link between depressive disorders and vascular events and the commonality of platelets and CNS cells because of the commonality of the following proteins: transporters and receptors of serotonin or 5-hydroxytryptamine, amyloid precursor protein, and brain neurotrophic factor, which were previously considered specific neural proteins. In addition, a relationship exists between hemostasis dynamics and drug therapy for depression. In this review, changes in hemostasis in terms of platelet activation in patients with depression and vascular disease were critically analyzed. The literature presents diverse mechanisms of platelet induction, which require further study. A rational study of the pathways of platelet activation in patients with depressive disorders will provide a comprehensive understanding of the molecular mechanisms underlying the relationship between hemostasis and depression in various vascular pathologies. Platelet activation in patients with depression and the dynamics of changes in hemostasis parameters during the treatment of depressive disorders allow us to consider hemostasis as a peripheral marker of the CNS and pharmacotherapy.
SAVAŞ EDEBİYATI VE MEHMET NUREDDİN SEMİN İN ŞİİRLERİNDE SAVAŞ KARŞITLIĞI
Authors: YILDIZ Hatice
Published: November 2023

Devletlerin diplomatik yollardan çözemedikleri sorunları, silah ve şiddet aracılığıyla çözmeye çalıştıklarında çıkan savaşlar, toplumların hayatında büyük etkiler yaratır. Yıkım, göç, yokluk gibi pek çok sorunun ortaya çıktığı savaş dönemlerinde insani değerler altüst olurken, insan hayatı da kolay bir şekilde harcanır. Savaşlar tarih, sosyoloji gibi beşerî bilimlerin konusu olduğu gibi, insanlar üzerinde bıraktığı derin izlerle edebiyata da mal olur. Savaş dönemini ve sonrasını, cepheyi ve cephe gerisini anlatan eserlerden oluşan savaş edebiyatı, kadim zamanlardan itibaren insanların ortaya koyduğu sözlü ve yazılı bütün edebiyat ürünlerinde konu edilir. Bununla birlikte savaş edebiyatı kavramı, sınırları ve kapsamı bakımından farklı şekilde değerlendirilir. İlgili eserler, yazıldıkları zamana, değindikleri konulara ve işlevlerine göre cephe edebiyatı, cephe gerisi edebiyatı, savaş sonrası edebiyatı gibi çeşitli başlıklar altında incelenir. Tarihin çeşitli safhalarında ferdî veya millî kahramanlıkları, zafer ve yenilgileri işleyen savaş konulu edebî metinler, zaman zaman propaganda maksatlı olarak da kullanılır. Böylece savaşa çağrılan fertler, belirli bir düşmanın karşısında zafere ulaşmak gayesiyle birleştirilir. 20. yüzyılda kitlesel boyut kazanan savaşlar, savaş edebiyatında yeni bir yaklaşımı doğurur. Savaşın romantize edildiği kahramanlık temalı eserlerin yerini adı meçhul sıradan askerlerin bireysel dramları, acıları alır. Bu da savaş karşıtı bir söylemin giderek gelişmesini sağlar. Türk edebiyatı da başlangıcından itibaren savaş edebiyatına dâhil edilebilecek metinler bakımından zengindir. Destanlar, halk hikâyeleri, saz şiirleri, türküler ve divan edebiyatı türlerinin yanı sıra Tanzimat sonrası Türk edebiyatı da savaş edebiyatının çeşitli örnekleriyle doludur. Osmanlı Devleti’nin 18. ve 19. yüzyıllarda ardı arkası kesilmeyen savaşları edebiyat dünyasını da hareketlendirir. 20. yüzyılda da önce Balkan Savaşları sonra da devletin parçalanmasıyla sonuçlanacak I. Dünya Savaşı, edebiyatta da çok geçmeden karşılık bulur. Yönetim tarafından teşvik edilen propaganda edebiyatının yanında lirik ve hamasi eserlerin de bulunduğu bir savaş edebiyatı külliyatı oluşur. Bu külliyatın büyük bir kısmını ise şiirler meydana getirir. Savaş edebiyatı kapsamında değerlendirilebilecek olan savaş karşıtı söylem ise sansürün de etkisiyle fazla gelişmez. Yine de başta Tevfik Fikret olmak üzere savaşa muhalefet eden isimler bulunur. Bunlardan biri de Mehmet Nureddin Semin’dir. Yazdığı kimi şiirlerde savaşın yıkıcılığından ve insanlığın barış içinde yaşaması imkânından bahseder. Bu çalışmada Mehmet Nureddin Semin’in söz konusu şiirleri incelenecektir. Böylece savaş edebiyatı içinde göz ardı edilen bir tema olan savaş karşıtlığı hususu, bu örneklerle öne çıkarılacaktır.
An Analysis of Cybersecurity Subject and Vilanets Learning Media Towards Vocational School Students’ Digital Skills
Authors: Santyadiputra Gede Saindra , Kustono Djoko
Published: November 2023

Digital skills are crucial to accessing jobs, business opportunities, and information. The vocational school is vital in fulfilling Human Resources (HR) and future workforce candidates. Therefore, subject and learning media are needed to accommodate students' digital skills. The analysis methods are Strength, Weakness, Opportunity, and Threat (SWOT) and Systematic Literature Review (SLR). Cybersecurity is a desirable talent area of the future and is one of the digital skills competency areas. The results map the alignment of the scope of the Cybersecurity subject material and Vilanets learning media. These results can be used as a reference for the digital skills of students in vocational schools.
JSinAja: Javascript Programming Learning Application (React JS, React Native, Node JS) Mobile Based Using Problem Based Learning Method
Authors: Smaragdina Azhar Ahmad , Nur Susilowati Risky Cantika , Ahmadi Rizky , Andriansyah Yudo Dendy , Md Yunos Jailani bin
Published: November 2023

This article describes the design of a mobile-based learning application for JavaScript programming using React JS, React Native, and Node JS. This application aims to provide an interactive and engaging learning experience for beginners and advanced JavaScript programming users. This application is designed to cover the basics of JavaScript programming, such as syntax, data types, control structures, functions, and objects. This application also covers more advanced topics, such as asynchronous, functional, and object-oriented programming. The application uses the React JS library for web interfaces, React Native for mobile application development, and Node JS for the backend. The app's user-friendly design has a simple and intuitive interface that guides users through the learning process. This application is also equipped with features such as materials, tutorial videos, and discussions to help users apply their knowledge and test their abilities. In the future, this application is designed to be developed further by adding new modules and features. The app also includes user feedback and analytics to improve the learning experience continuously. This application uses one of the software development methods, namely the waterfall development method, which is based on a structured and sequential sequence of stages. Hopefully, this application will provide a valuable resource for anyone interested in learning JavaScript programming, from beginners to advanced users
Study on Effect of 3D Printing Parameters on Surface Roughness and Tensile Strength Using Analysis of Variance
Authors: Fadillah Faqih , Suryanto Heru , Suprayitno Suprayitno
Published: November 2023

Fused deposition modeling of 3D printing is the process of making workpieces or parts by adding filaments to each layer. Some indicators of a high-quality product of 3D printing are the precisions dimensions, the surface roughness, and tensile strength. This research aims to find the parameters most affecting surface roughness and tensile strength. The research design used an experimental method with input parameters: (1) print speed (15-35 mm/s), (2) print temperature (200-210°C), (3) layer height (0.1 – 0.3 mm), (4) infill line directions (0-90°), and dependent variables were surface roughness and tensile strength. The data distribution used the L9 orthogonal array, and the statistic analysis used ANOVA. Material uses nanographite-reinforced polylactic acid (PLA) filament. The results indicate that print parameters that significantly affect surface roughness are layer height and infill line directions. The best surface roughness on the layer height parameter is 0.1 mm, and the infill line directions parameter is 90°. Based on ANOVA analysis, print speed, print temperature, and layer height do not significantly affect tensile strength, but infill line directions significantly affect tensile strength. The best tensile strength on infill line directions is 90°. The best average tensile strength with nanographite-reinforced PLA filament is 38.56 N/mm2, with 35 m/s print speed, 205 °C print temperature, 0.1 mm layer height, and 90° infill line direction parameter. The best average surface roughness with nanographite-reinforced PLA filament is 0.66 µm, with 35 m/s print speed, 205 °C print temperature, 0.1 mm layer height, and 90° infill line direction parameter.
Maximum Marginal Relevance and Vector Space Model for Summarizing Students' Final Project Abstracts
Authors: Gunawan Gunawan , Fitria Fitria , Setiawan Esther Irawati , Fujisawa Kimiya
Published: November 2023

Automatic summarization is reducing a text document with a computer program to create a summary that retains the essential parts of the original document. Automatic summarization is necessary to deal with information overload, and the amount of data is increasing. A summary is needed to get the contents of the article briefly. A summary is an effective way to present extended information in a concise form of the main contents of an article, and the aim is to tell the reader the essence of a central idea. The simple concept of a summary is to take an essential part of the entire contents of the article. Which then presents it back in summary form. The steps in this research will start with the user selecting or searching for text documents that will be summarized with keywords in the abstract as a query. The proposed approach performs text preprocessing for documents: sentence breaking, case folding, word tokenizing, filtering, and stemming. The results of the preprocessed text are weighted by term frequency-inverse document frequency (tf-idf), then weighted for query relevance using the vector space model and sentence similarity using cosine similarity. The next stage is maximum marginal relevance for sentence extraction. The proposed approach provides comprehensive summarization compared with another approach. The test results are compared with manual summaries, which produce an average precision of 88%, recall of 61%, and f-measure of 70%.
Long-Term Traffic Prediction Based on Stacked GCN Model
Authors: Karim Atkia Akila , Nower Naushin
Published: November 2023

With the recent surge in road traffic within major cities, the need for both short and long-term traffic flow forecasting has become paramount for city authorities. Previous research efforts have predominantly focused on short-term traffic flow estimations for specific road segments and paths. However, applications of paramount importance, such as traffic management and schedule routing planning, demand a deep understanding of long-term traffic flow predictions. However, due to the intricate interplay of underlying factors, there exists a scarcity of studies dedicated to long-term traffic prediction. Previous research has also highlighted the challenge of lower accuracy in long-term predictions owing to error propagation within the model. This model effectively combines Graph Convolutional Network (GCN) capacity to extract spatial characteristics from the road network with the stacked GCN aptitude for capturing temporal context. Our developed model is subsequently employed for traffic flow forecasting within urban road networks. We rigorously compare our method against baseline techniques using two real-world datasets. Our approach significantly reduces prediction errors by 40% to 60% compared to other methods. The experimental results underscore our model's ability to uncover spatiotemporal dependencies within traffic data and its superior predictive performance over baseline models using real-world traffic datasets.
Multivariate Analysis Approach to Factor-Affected Tuberculosis Disease
Authors: Gultom Zuli Agustina , Siregar Farid Akbar , Tanjung Mahardika Abdi Prawira , Hazidar Al-Hamidy
Published: November 2023

Tuberculosis is a disease caused by infection with the mycobacterium tuberculosis complex. Tuberculosis attack organ besides the lung, such as the pleura, lining of the brain, lining of the heart, lymph gland, bones, joint, skin, intestines, kidney, urinary tract, and genital. This disease is found in densely populated settlements with poor sanitation, lack of ventilation and sunlight and lack of rest. Moreover, the factors that will be analyzed in this research are Population Density (X1), Number of HIV/AIDS (X2), number of toddlers who experience nutrition (X3), Number of toddlers who experience BCG immunization (X4), number of toddlers who get exclusive breastfeeding (X5), Total families with PHBS (X6), number of residents with healthy homes (X7), number of families with clean water facilities (X8), number of families with ownership of latrine sanitation (X9), number of families with have landfills (X10), number of families have management waste place (X11), number of elementary education facilities (X12), Number of junior school education facilities (X13), Number of senior school education facilities (X14), Number of institutions fostered by neighborhood health (X15), Number of Posyandu (X16), Number Life Expectancy (X17), Literacy Rate (X18), Human Development Index (X19), Number of Tuberculosis sufferers (X20). This research aims to analyze what variables influence each other on the prevalence rate of tuberculosis in the city of Surabaya. The method used in this research is a multivariate analysis using factor analysis, cluster analysis, biplot analysis and discriminant analysis. This discriminant analysis determines accuracy by calculating the value (1-APER). The resulting research the Number of HIV/AIDS, number of residents with healthy homes, and Number of families with ownership of Sanitation (latrine, landfills, waste management) have a high correlation with the spread of tuberculosis in Surabaya. Meanwhile, areas with a high rate of tuberculosis are Tambaksari, Wonokromo, Sawahan, and Semampir.  The classification analysis accuracy level was 90.32% and the accuracy of the resulting model or discriminant function was very high. So that discriminant analysis can be used for predicting the accuracy of tuberculosis prevalence rates.
EEG Classification while Listening to Murottal Al-Quran and Classical Music using Random Forest Method
Authors: Sumarti Heni , Septiani Fahira , Sudarmanto Agus , Caesarendra Wahyu , Edison Rizki Edmi
Published: November 2023

This study is aimed to classify the brain activity of adolescents associated with audio stimuli; murottal Al-Quran and classical music.  The raw data were filtered using Independent Component Analisys (ICA) and followed by band-pass filter in Python on the Google Colab Extraction was processed with Power Spectral Density (PSD) and the Random Forest Method in Weka Machine Learning was used for classification.  The research results showed the same results between the two types of stimulation, namely the order of brain waves from highest to lowest were delta, alpha, theta and beta. The average brain waves of teenagers when given murottal al-Quran stimulation were 45.32% delta, 31.60% alpha, 17.02 theta and 6.05% beta. Meanwhile, the average brain waves of teenagers when given classical music stimulation were 46.54% delta, 28.64% alpha, 19.21% theta and 5.50% beta. Classification is obtained with the best value that frequently appears (mode) from the prediction results for each sample using random forest methods. The accuracy, precision, and recall of classifying adolescent brain waves when given murottal and classical music stimuli using the Random Forest method with cross-validation technique (optimum at k-fold=5) were 65.38%, 76.92%, and 70.00%, respectively.  The results of this study show that stimulation using murottal al-Quran and classical music effectively improves adolescent relaxation conditions.
Recurrent Session Approach to Generative Association Rule based Recommendation
Authors: Armanda Tubagus Arief , Wardhani Ire Puspa , Akhriza Tubagus M. , Admira Tubagus M. Adrie
Published: November 2023

This article introduces a generative association rule (AR)-based recommendation system (RS) using a recurrent neural network approach implemented when a user searches for an item in a browsing session. It is proposed to overcome the limitations of the traditional AR-based RS which implements query-based sessions that are not adaptive to input series, thus failing to generate recommendations.  The dataset used is accurate retail transaction data from online stores in Europe. The contribution of the proposed method is a next-item prediction model using LSTM, but what is trained to develop the model is an associative rule string, not a string of items in a purchase transaction. The proposed model predicts the next item generatively, while the traditional method discriminatively. As a result, for an array of items that the user has viewed in a browsing session, the model can always recommend the following items when traditional methods cannot.  In addition, the results of user-centered validation of several metrics show that although the level of accuracy (similarity) of recommended products and products seen by users is only 20%, other metrics reach above 70%, such as novelty, diversity, attractiveness and enjoyability.
The study of thyroid dysfunction in patients with abnormal uterine bleeding
Authors: Nekkanti Dhanusha , S. Vasantha Kumar
Published: November 2023

Background: Abnormal uterine bleeding (AUB) is the most common gynecological condition observed during many women's reproductive period. AUB affects the quality of life, causing distress. Most of the cases are undiagnosed or not properly diagnosed. Multiple reasons are causing AUB, one of them is thyroid dysfunction. Nowadays, thyroid testing is readily available, which helps in diagnosis and better management of AUB.
Methods: A prospective observational study was conducted with 124 AUB cases using simple random sampling after approval from the ethics committee.
Results: Total thyroid dysfunction was noted in 32.26% of cases, and 70.16% were multiparous. About 34.1% of cases of menorrhagia and 54.2% of cases of oligomenorrhea had thyroid abnormalities.
Conclusions: For appropriate management of AUB, testing of thyroid levels is necessary.
Quantification of proteinuria by urine protein creatinine ratio in a single void urine in pre-eclamptic women and its correlation with 24 hours urinary protein
Authors: Saxena Rashmi , Sharma Manisha , Ranjan Rajeev
Published: November 2023

Background: Proteinuria is a major indicator of hypertensive disorders of pregnancy. Though 24 hr urinary protein is considered to be the gold standard for evaluation of proteinuria in preeclampsia but its collection is time consuming, cumbersome and needs admission of the patient. The role of spot UPCR in random sample proposed as an alternative
Method: A observational cross-sectional study was conducted from 2020 to 2021 on 78 antenatal women of gestational age >20 weeks meeting the inclusion and exclusion criteria were enrolled into this study. Data was compared by using Pearson correlation coefficient (r). ROC curve was plotted for spot UPCR value for detecting significant proteinuria (>300 mg/24 hr).
Result: The quantification of proteinuria by spot UPCR strongly correlated with 24hr urinary protein. The p=0.001. There was a positive correlation of 24hr urine protein (mg/24 hr) with spot UPCR urine sample which was significant statistically (r=0.997, p<0.05) ROC curve analysis of Spot UPCR for proteinuria (>300 mg/24 hr) after the 20 weeks gestation. The spot UPCR showed significant large area under the curve (AUC) on the ROC curve. There is positive correlation between 24 hr urinary protein (>300 mg/24 hr) and spot UPCR in patients of pre-eclampsia
Conclusions: From our study we concluded that spot urinary protein creatinine ratio has a significant linear correlation with 24 hr urinary protein in pre-eclampsia.
Study of fetomaternal outcome in HIV positive pregnant female at a tertiary health center in South Gujarat
Authors: Chauhan Jigisha , Agarwal Shraddha , Kansal Riya , Patel Zarana , Patel Krunal
Published: November 2023

Background: Prenatal identification of HIV infected women is crucial for delivery and optimal care to both mother and fetus. Prevention of parent-to-child transmission has been the major tool to identify HIV-infected pregnant women by voluntary counselling and testing for HIV and provide antiretroviral drug prophylaxis to them during delivery and then to their newborn infants. Aim and objective was to study the fetomaternal outcome of HIV Positive antenatal patients.
Methods: This was simple descriptive study which was conducted between January 2017 to June 2019 with 18 months follow-up suggestive of 40 patients were having HIV positive among 9015 deliveries. Thorough examination, investigations and treatment given according to NACO guidelines and fetomaternal outcome were noted in all cases.
Results: In present study, prevalence of HIV Positive pregnant women was 0.44%. Out of 40 patients, 5 patients were diagnosed with TB. 55% cases were diagnosed with HIV during ANC examination. 22 (55%) patients were having CD4 count >500 and 1 (2.5%) patient having low CD4 count <200. 32 (80%) patients delivered vaginally and 8 (20%) underwent LSCS. 8 (20%) of babies were admitted to NICU, 3 expired and 37 babies tested negative, 3 losses to follow-up and 34 tested negatives at 18months.
Conclusions: Mother-to-child transmission is the predominant way children become infected with human immunodeficiency virus worldwide. Good antenatal care and multidisciplinary approach to HIV-infected women can have good pregnancy outcome and early prophylaxis to the baby leads to decreased incidence of disease in the community.
COVID-19 infection-associated coagulopathy and its association with adverse outcomes in Indian gravidas: a prospective analysis
Authors: Singh Soumya P. , Singh Preeti , Gaonkar Rohini
Published: November 2023

Background: Objective of the study was the determination of trends of coagulation parameters and association between pregnant women with COVID-19 infection with adverse outcomes.
Methods: Design of the study was a prospective observational study. The study was conducted at the Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi. A total of 142 pregnant women with confirmed COVID-19 infection were recruited and studied prospectively between May 2020 and April 2021. Trends of coagulation parameters were compared in groups divided based on the adverse outcomes. 11 patients had adverse outcomes which included ICU admission or mortality. There were no adverse outcomes in the remaining 131 patients.
Results: The comparison of trends of coagulation parameters in both groups was studied. D-dimer and INR values were significantly higher, while fibrinogen level was significantly lower in COVID-19 subjects with adverse maternal outcomes than in those in which adverse maternal outcomes were not present (p<0.05). No significant difference was observed in other coagulation parameters like APTT.
Conclusions: Universal screening of coagulation parameters of all pregnant women with COVID-19 can be considered because of the association of adverse maternal outcomes with deranged D dimer and fibrinogen in our study.
Venous thromboembolism after major gynecological cancer surgery: an analysis of cause and effect from the experience of a tertiary referral oncologic centre
Authors: Ray M. D. , N. Premanand , Rajan Saroj , Rai Romey
Published: November 2023

Background: Patients undergoing extensive gynecological oncologic surgeries are at greater risk for developing deep vein thrombosis and pulmonary embolism than other oncological procedures. The anatomical confinement of vessels, lymphatics, and other structures in the restrictive pelvic space is contributory. We aimed to establish the etiopathogenesis of venous thromboembolism (VTE) with our practical experience.
Methods: We present our experience from a tertiary referral oncologic centre in north India in patients with ovarian cancer undergoing cytoreductive surgery (CRS) with or without HIPEC, with a focus on the incidence and etiopathogenesis of deep venous thromboembolism (DVT), including anatomical barriers, restricted movement during surgical dissection, risk stratification and preventive measures.
Results: Of 250 patients who underwent cytoreductive surgery (CRS) for ovarian cancer, 124 additionally underwent hyperthermic intraperitoneal chemotherapy (HIPEC). 20 (8%) patients were diagnosed with DVT within 30 days of surgery, and 3 (1.2%) were detected after 30 days. It is the most common significant postoperative morbidity.
Conclusions: DVT is the most common postoperative complication in patients undergoing CRS+HIPEC for carcinoma ovary. Anatomical confinement, closed dependant spaces and more significant surgical trauma to pelvic vessels and lymphatics may be the leading cause. Detailed knowledge of anatomy and careful surgical dissection may prevent the development of DVT.
The pain is not from the uterus: a rare complication of ovarian cyst during term labour
Authors: M. Adzlan Fadzlin
Published: November 2023

A case of primigravida with an ovarian torsion at 39 weeks of gestation is reported here. A Malay lady in her late 20s with a known case of ovarian cyst complained of sudden onset of severe pain during labour. Diagnosis of ovarian torsion was made and she underwent laparotomy cystectomy with emergency lower segment caesarean section in the same setting. Post-operative recovery was unremarkable. Histopathological examination confirmed mucinous cystadenoma.
Use of intramyometrial carbetocin in caesarean myomectomy to reduce hemorrhage
Authors: Yaliwal Rajasri G. , Lakshmi Shilpa , Biradar Aruna M. , Sangolli Laxmi S. , Bankapur Gauri
Published: November 2023

Traditionally myomectomy is avoided during caesarean delivery because of potential excessive blood loss. As the size increases, blood supply of leiomyomas also increases in pregnancy, and specifically at term due to the effect of human chorionic gonadotropin. Carbetocin is an oxytocin analog. It is long acting and is effective in preventing blood loss. It has been used in myomectomy to prevent blood loss in non-pregnant uterus. We present a case report where it is used intramyometrial route during caesarean section. A 30-year-old multigravida of 38 weeks period of gestation with previous caesarean section, presented in labor. Her recent ultra sound report showed single live intrauterine fetus of 35 weeks 3 days with a single posterior wall fibroid. The woman requested for myomectomy along with caesarean delivery as she had heavy menstrual bleeding caesarean section was done and myomectomy was planned along with the caesarean section. Intramyometrial carbetocin 100 mcg was used to prevent excessive blood loss. The patient had an uneventful post-operative period. Intramyometrial carbetocin is an effective method to reduce blood loss in myomectomy during caesarean delivery.
Characterizing dropped head syndrome across neurologic disorders, the hidden epidemic of dropped head syndrome
Authors: Gómez-Piña Juan José
Published: November 2023

Background: Dropped head syndrome (DHS) usually characterizes neuromuscular disorders, however, is present in other neurological disorders as Parkinson's disease. Despite being a syndrome seen in the clinic, it's uncommon reported in the literature.
Methods: This retrospective study reviewed electronic medical records of patients hospitalized with neurological disorders from 2018-2022 in a single center. Of 1359 charts screened, 134 patients were confirmed to have co-occurring DHS based on documented neck extensor weakness and an associated neurological condition. Strict inclusion criteria were applied to ensure all included patients had a confirmed neurological disorder and physical exam findings consistent with DHS.
Results: Of 1359 patients hospitalized with neurological disorders, only 134 (0.96%) had co-occurring DHS. The cohort included 69 females (ages 24-79 years) and 65 males (25-87 years). The most prevalent neurological diagnoses linked to DHS were Parkinson's disease, chronic inflammatory demyelinating polyneuropathy, and myasthenia gravis. Less common associations were multiple system atrophy and Alzheimer's disease. The observed DHS prevalence may underestimate the true rate, highlighting the need for enhanced awareness and assessment.
Conclusions: Despite a high prevalence of neurological disorders like Parkinson's disease, chronic inflammatory demyelinating polyneuropathy, and myasthenia gravis at our hospital, dropped head syndrome remained uncommon, affecting only 134 out of 1359 (0.96%) hospitalized neurological patients. DHS showed no sex predilection but predominantly affected older individuals, likely reflective of age-related sarcopenia. This study provides initial data on the prevalence of DHS across different neurologic conditions and underscores the need for early detection to enable timely surgical and nonsurgical interventions. Further research is warranted to elucidate the risk factors and optimal management strategies for this enigmatic condition.
The Indore population's morphometric study of the nutrient foramina of the dried radius
Authors: Singh Pawika , Modi Vimal , Singh Anand K. , Singh Nirmal R.
Published: November 2023

Background: Bone formation, growth and its vitality necessitates blood supply. Nutrient artery is the key source of blood supply to the long bone apart from the other important sources like periosteal, metaphyseal and epiphyseal arteries. Nutrient foramina allow nutrient artery. Typically, the direction of the nutrient foramina is towards the elbow joint in radius, away from its growing end. Knowledge of foramen index, number, direction and size of the nutrient foramina assists the surgeon to take and exact section of bone in case of bone resection and transplantation techniques. The aim of the present study is to determine the number, position, size direction of the nutrient foramina and the Foramen Index of the human dry radius bones.
Methods: In the present study, 100 radius bones of unknown age and sex were taken into consideration from the department of anatomy Index Medical College, Indore (MP), India.
Results: Most of the foramen was observed on the anterior surface of the bone. Nutrient foramina was found to be absent in 4 right sided and 3 left sided bones. The foramen index on right side was 34.92±4.97 cm whereas on the left side 34.79±4.43 cm. The nutrient foramen was directed towards the proximal end of radius in all the bones studied.
Conclusions: In the present study the average length of the bone and foramina of the size larger are more on the right side when compared to the left side. The foramina are located mostly in the middle third of the bone of the anterior surface. This study may add to the present statistical data available on foramen index number of foramen and their location in the population of Indore region, during recent orthopaedic techniques like bone resection and transplantation.
Pharmacoeconomic evaluations of ceftriaxone and cefixime in the surgery department in a tertiary care teaching hospital
Authors: Basattikoppalu Puttegowda Satish Kumar , Dahim Muhammed , Basaralu Nagarajappa Ravindra , Anakuzhikkara Thekkuveettiil Najna Bai
Published: November 2023

Background: Pharmacoeconomics involves the analysis of the cost of drug therapy in the health systems which will play a significant role in drug product selection for formulary, comparison of alternative therapies pricing a product and evaluating a drug product and expected quality of life improvement. Objective were to assess pharmacoeconomic evaluation and cost minimization analysis of ceftriaxone and cefixime in the surgery department in a tertiary care teaching hospital.
Methods: This prospective observational study conducts to pharmacoeconomic evaluation of ceftriaxone and cefixime. It analyses the number of available brands and generic drugs and performs a cost-minimization analysis for these drugs used in the surgery department.
Results: The study includes a total of 173 patients, among them 68 patients (39%) were using ceftriaxone, 39 patients (23%) were using cefixime and 66 patients (38%) were using ceftriaxone and cefixime (IV-PO) for various surgery cases. Monocef (₹121.04; $1.04 per day) was the most commonly used ceftriaxone brand, while Gramocef (₹114; $1.38 per day) least and Xone (₹112; $1.38 per day) were the cheapest options. The mean ceftriaxone cost for a vial is 56.67±10.04 and the tablet is 113.33±20.08 per day. Cost minimization analysis shows that most prescribed drugs were costlier than least prescribed drugs. Taxim-O (₹107.72; $1.30 per strip) was the most prescribed cefixime brand and the least Tanfix ($ 1.3: ₹107 per strip). The mean of cefixime cost per strip is 107.6±0.28; $1.31 and per day 21.51±0.05; $ 0.26. There is no major cost difference or price variation in cefixime brands (0.69%).
Conclusions: The cheaper drugs should be prescribed to patients rather than the costlier and it should be the duty of healthcare professionals to consider the pharmacoeconomic value of drugs while prescribing the medications.
Clinical prognostication of out-of-hospital cardiac arrest: insight from a prospective observational study using the shockable, witnessed, age and pH score
Authors: K. J. Jasmine , Rajeev P. C. , V. Abraham Siju , Varghese Salish
Published: November 2023

Background: Cardiac arrest remains a leading cause of mortality and morbidity worldwide. Though there are many prognostic tools, the importance of predicting prognosis of out of hospital cardiac arrest in the emergency department (ED) using SWAP (Shockable, witnessed, age and pH) score has not been studied extensively.
Methods: We conducted a hospital-based prospective observational study in Kerala, India, focusing on patients who arrived at the ED after experiencing out-of-hospital cardiac arrest (OHCA). For patients who met the inclusion criteria, (all patients who came to ED with OHCA with age more than 18 years) we calculated the SWAP score using historical information and venous blood gas sample analysis. Patients who achieved return of spontaneous circulation (ROSC) were closely monitored, and post-cardiac arrest care was initiated. Patients who achieved sustained ROSC were admitted, and at time of discharge, follow-up was conducted using cerebral performance category (CPC) score.
Results: The SWAP score was computed for patients who experienced OHCA. The analysis revealed that patients with favorable outcomes (CPC 1 and 2) had an average SWAP score of 1, while patients with unfavorable outcomes (CPC 3, 4, 5) had an average SWAP score of 1.55. Among the total of 116 patients, 7 individuals (6.03%) survived with positive neurological outcomes (CPC 1 and 2), while 109 patients (93.96%) experienced poor neurological outcomes (CPC 3, 4, 5, and mortality).
Conclusions: Patients who had a high SWAP score had a reduced likelihood of survival and sustained ROSC. Conversely, patients with a SWAP score below 2 had a higher probability of experiencing a ROSC and surviving.
Analysis of Barthel index and care giver strain index in stroke patients in tertiary care hospital in South India
Authors: Pai Hrishikesh S. , Kannan B. , Jebasingh Y. Kingsly , Raj A. Thomas Edwin , Das Soumyakanti
Published: November 2023

Background: Stroke patients have high rate of mortality and morbidity and survivors suffer from physical, cognitive and emotional issues. Quality of life of stroke survivors depends on severity of disability. These disability or morbidities not only affect stroke survivors but also has impact on physical and psychological wellbeing of caregivers providing support for daily routine. Aim of this study is to analyse the dependency using Barthel Index in stroke patients and care giver strain (CSI) among caregivers.
Methods: A cross sectional descriptive study in a tertiary care hospital in South India. Study duration of 5 months. 150 Patients admitted for stroke meeting the inclusion criteria were included for the study. Caregiver was interviewed after Informed consent and briefing of purpose of study. Berthel index and modified care giver strain index questionnaire was filled by interviewer with caregiver. Findings were described in simple descriptive manner. Statistical package for the social sciences (SPSS) version 24 was used for statistical analysis.
Results: Of 150 patients male 64% female 36%. Care giver strain score of <7 (40%), 8-14 (42%), >14 (18%). Sleep deprivation 68%, physical strain 85%, family adjustment problems 32%, work adjustment problems 67%, financial strain 76%, emotional adjustment problems 33%, personal plans problems 44%, upsetting behavior problems 44%. Only 17% termed it as inconvenient, 24% completely overwhelmed, 29% confining. Barthel index of >80 able to live independently (13%), 61-80 minimally dependent (32%), 41-60 partially dependent (26%), 21-40 very dependent (13%), <20 total dependency (16%).
Conclusions: In stroke care caregiver strain is high when patient is dependent for routine activities. This includes physical as well as psychological strain. There is need to develop strategic home based or community based programs to reduce caregiver stress and improve their quality of life.
Cardiac beriberi and malnutrition: rare complication of paracoccidioidomycosis
Authors: Belda Walter , Carvalho Caroline H. C. , Franciozi Amithis B. , Urresta Carlos G. S. , Lee Tiffany Y. H. , Nico Marcello M. S.
Published: November 2023

Paracoccidioidomycosis is an endemic systemic mycosis that predominates in southern Mexico, parts of Central America, and South America. It is caused by a dimorphic fungus and is generally acquired through the lungs, from where it disseminates. Paracoccidioidomycosis has different clinical manifestations that require differentiation with tuberculosis, Hodgkin disease, several systemic and subcutaneous mycoses, and squamous cell carcinoma. Radiologic abnormalities in the lung fields may be seen. Mucous membrane lesions occasionally occur. The diagnosis is confirmed by finding yeast-like elements of P. brasiliensis in microscopic examinations of wet preparations of specimens submitted for mycologic studies. The occurrence of malnutrition and particularly beri beri conditions concomitant with paracoccidioidomycosis is uncommon. We report a case of a patient of low socio-economic status, without  permanent employment , possibly carrying out work as a bricklayer or working on small farms during the harvest season, with a five-year history of oral cavity lesions, which resulted  in difficulty eating  and  thus weight loss. A diagnosis of paracoccidioidomycosis was made through direct microscopy examination, culture and multisystem involvement was confirmed through imaging tests, including dilatation and dysfunction of the right ventricle. The hypothesis of Cardiac Beri-Beri related to thiamine deficiency was raised. The treatment was carried out with thiamine supplementation and liposomal amphotericin B, with excellent clinical evolution of the patient. This case highlights the importance of early recognition of paracoccidioidomycosis in its early stages and the adoption of proactive measures in the search for possible organic complications caused by nutritional deficiencies in prolonged cases.
Pervasiveness of metabolic syndrome and cardiovascular disease in tribal/rural population of India: a review
Authors: Nagwanshi Aayushi , Chakma Tapas , Nag Shikha , Singh Kritika , Kavishwar Arvind , Verma Pranshi , Shrivastava Suyesh
Published: November 2023

Diseases classified as non-communicable diseases (NCDs) are those that are often caused by unhealthy behaviors rather than by infection or by contact with others. One of the main NCDs causing many fatalities is cardiovascular disease (CVD). Recent research has shown that the prevalence of metabolic syndrome (Mets) associated CVDs among tribal populations is increasing in rapid pace. In this review, we have included studies investigating the components of Mets and the relationships between Mets and CVDs. From the assessment of studies, we may predict a significant association between Mets and CVDs as a whole. Our evaluation of these studies revealed that carrying at least three Mets risk components, like hyperglycemia, obesity, dyslipidemia, and high blood pressure, significantly enhances the risk of CVDs. Undernutrition, smoking, and a low intake of fruits and vegetables in the Indian tribal population are the main risk factors for managing Mets associated CVDs. Furthermore, various studies have also shown that Mets may be influenced by genetic and environmental factors. Finally, healthy habits such as a balanced diet and frequent exercise should be introduced from a young age in individuals, to prevent Mets progression. In order to combat the Mets associated CVDs, functionally upgraded primary health centers and special IECs (Information, education and communication) programs may play a beneficial role. Furthermore, strengthening public healthcare systems and focusing on prevention, early identification, and treatment using medical and social interventions can be of immense help in managing the metabolic risk factors that can lead to CVDs.
Spectrum of neurosurgical operative interventions at the regional centre for neurosurgery UDUTH Sokoto: a 5 years review
Authors: Lasseini Ali , Koko Aliyu M. , Isa Ashafa B. , Ladan Aliyu , Ladan Hali , Abdullateef Abdulhakeem
Published: November 2023

Background: Neurosurgical operative interventions are aimed for the diagnosis and treatment of diseases of the central and peripheral nervous systems. The spectrum of these interventions ranges from cranial, spinal and peripheral interventions, and could also be elective or emergency based on the urgency of the intervention. Data on the spectrum of neurosurgical operative interventions are limited in our environment. The aim of the study is to describe the epidemiological profile, diagnoses and pattern of neurosurgical operative interventions at our center.
Methods: This is a retrospective study analyzing the demographic profile, clinical diagnoses and operative interventions of neurosurgical patients managed at our center over a period of 5 years, from January 2014 to December 2018.
Results: A total of 784 patients had operative interventions during the study period. Five hundred and twenty (520) patients were males representing 66.3%; paediatric patients accounted for 487 patients (62.1%). Majority of the patients (518 patients: 66.1%) had elective interventions. The commonest indication for neurosurgical intervention during the study period was Neurotrauma (235 patients: 30%), followed by hydrocephalus (218 patients: 27.8%) and then neurooncology (137 patients: 17.5%). Ventriculoperitoneal shunt (218 patients: 27.8%), excision and repair of myelomeningocoele (107 patients: 13.6%) and debridement/elevation for open head injury/ elevation of depressed skull fracture (85 patients: 10.8%) were the commonest operative interventions during study period.
Conclusions: Although Ventriculoperitoneal shunt and excision and repair of myelomeningocoele were the commonest operative neurosurgical intervention during the study period, neurotrauma cases constituted the commonest indications for operative surgical intervention.