bluuebunny/crossref_metadata_2025 huggingface dataset:
State Paternalism: from Science to Scientometrics
Authors:   Institute of Economics, Russian Academy of Sciences, Rubinstein Alexander Ya. ,   State Institute of Art Sciences
Published: September 2021

The article presents the results of the study of public opinion in the context of science reforming. The adoption of the Law on the Russian Academy of Sciences has in fact liquidated academic freedoms and consolidated state interference into scientific life by simultaneously escalating the use of Scientometrics. Respondents' assessments of the use of Scientometric indicators and journal rankings indicate that most economists do not trust the Scientometric tools. Based on the results of a sociological survey of the community of economists in 2020, the article concludes that there is a "managerial failure" of the paternalistic state. An analysis of the Scientometric indicators used in Scopus is also presented, including three well-known metrics: CiteScore", SNIP, and SCImago (SJR). In addition to the description of the sample of journals and the scale of monitoring, the author presents the criterion of ranking the journals MWR and the algorithm of its definition in comparison with the SJR indicator in Scopus. The final part of the paper discusses the econometric model based on the hypothesis that there are links between the ranking of journals, obtained on the basis of a sociological survey of economists, and the estimates of the "usefulness" of the introduction of relevant Scientometric indicators by the same respondents. The calculations performed have confirmed the formulated hypothesis and allowed to quantitatively measure the impact of the respondents' attitude to Scientometric indicators on the value of private ratings reflecting the Scientific level of the journal, the public prestige of the journal and Interest in the journal publications.
Empirical Analysis of Opportunism Based on Data on University Students of Different Courses
Authors:   National Research University Higher School of Economics, Rozmainsky Ivan V. , Shegay Vilina R. ,   National Research University Higher School of Economics
Published: September 2021

The article is devoted to the New Institutional analysis of the factors of opportunism among students of different courses. The analysis is based on a survey in which 231 students from the Higher School of Economics and other Russian universities took part from February to May 2021. Econometric modeling is based on Latent class analysis, which allows the identification of unobservable groups based on the observed categorical variables presented. One of the main findings of the research is that fourth year students are less prone to opportunism than first, second and third year students. This can be explained by the higher opportunity costs of cheating among fourth year students and their greater independence, primarily financial. In addition, students who are motivated primarily to obtain knowledge (mastery) show a lesser inclination towards opportunism compared with students whose main motive is the degree (performance). Furthermore, a higher level of rationality, both in a general sense and in relation to budget planning, is reflected in a greater tendency to dishonest behavior. Finally, more honest behavior outside the university is combined with more dishonest academic behavior. The latter can be explained by the fact that it is psychologically more difficult to commit an immoral act in relation to a loved one than to do so in an academic environment, when you deceive a not personally familiar person and not even a specific person. Thus, on the basis of the analysis carried out, it can be understood under what conditions the student environment will be characterized by a higher propensity for opportunism and, accordingly, a lower rate of human capital accumulation.
Narrative Institutional Analysis and The National Innovation System in Russia
Authors:   Southern Federal University, Shiriaev Igor M. , Kurysheva Anna A. ,   Southern Federal University, Volchik Vyacheslav V. ,   Southern Federal University
Published: September 2021

The paper deals with the widespread narratives describing the institutions specific to Russia’s innovation system. Narrative economics provides an interdisciplinary research perspective, due to its focus on qualitative data that were ignored by the conventional economics for a long time. We emphasize that narrative analysis is rooted in the methodological framework of original institutional economics. Literature review using the PRISMA method did not identified any examples of applying narrative analysis to institutional studied of Russia’s innovation system. The empirical data for this paper involve popular narratives contained in 43 rating media sources extracted from a Russian information analysis agency Integrum. The sources were selected using the real-time media monitoring and analysis system Medialogia. The study covered the period from January 1, 2010 to July 1, 2021. Content analysis of the core ideas extracted from scholarly publications and media sources allowed to identify common narratives on institutional arrangement of Russia’s innovation system, that impede commercialization of innovations. However, conflicting approaches are provided by the literature to deal with related problem situations. The viral spread of popular narratives that affect the actors of Russia’s innovation system is illustrated by one of the typical narratives about the Russian innovation system. The research implications can be useful for developing a strategy for state innovation policy. Improved methodology for assessing virality of narratives and their power, as well as the empirical testing of proposed hypotheses remain the subject for future research.
Gender Aspects of Reproduction of Professional Dynasties in Medicine
Authors:   Southern Federal University, Klimenko Lyudmila V. , Posukhova Oxana Yu. ,   Southern Federal University
Published: September 2021

The number of female health workers is predominant in the current health care system. However, in terms of the distribution of power and authority, career trajectories, and the culture of relationships, medicine still remains gender-related to men. Reproduction processes of the professional structure of medicine, in which professional dynasties occupy a special place, is also marked by gender differences. Thus, the article addresses the gender specificities of the institutional reproduction of medical dynasties in modern Russia. Based on in-depth interviews with twenty representatives of multigenerational families of doctors from ten cities, gender scenarios for the transmission of professional positions and the gender specificity of using the social and symbolic capital of the dynasty in the context of their reproduction are analyzed. According to the empirical research findings, the dynastic model of marital status transfer maintains and reproduces gender inequality in the medical profession. There is low gender sensitivity in doctors’ dynasties, where women are more likely to be passive or under family pressure to pursue educational and work tracks. The choice of professional specialization is conditioned by gender stereotypes. Career and professional opportunities of women doctors are limited by an imbalance between work and home responsibilities. Dynasty social and symbolic capital investment strategies are less resourceful for women in clinical practice and more effective in academic medicine. The deconstruction of the traditional gender display in the profession is proceeding at a slow pace, while medical dynasties continue to rather reproduce the inequality and male ethics of the medical profession.
Regional Development Corporations: Foreign Experience and Russian Practice
Authors:   Central Aerohydrodynamic Institute, Gousev Alexandr B. , Yurevich Maksim A. ,   Financial University under the Government of the Russian Federation
Published: September 2021

The article is focused on the chronology and classification of territorial development agencies (corporations) as an instrument of state regional policy. The paper shows the threat of transformation of the potentially constructive role of corporations into a negative plane. The example of Poland illustrates the EUʼs intervention in the countryʼs internal affairs through regional development corporations as contact points. In Kazakhstan, the first wave of social and entrepreneurial corporations, which were created in 2006–2007 on an extraterritorial basis, caused an internal conflict between the elites, which led to the reformatting of this institution and its subordination to the existing system of regional management (“one district – one region”). The pluralism of approaches to the formation of a network of regional development corporations (“bottom-up” – “top-down”, monoterritoriality – extraterritoriality, etc.) provides opportunities for managerial experimentation, the results of which in the territory of the Russian Federation were expressed in the mass of economic and managerial structures at the federal and regional levels. At the same time, the macroeconomic success of their joint activities remains unclear. For the Russian Federation, the model of consolidation and development of the internal economic space on the basis of corporations of macroregions representing a set of neighboring subjects of the Russian Federation and historically having economic ties of varying degrees of breadth and strength seems appropriate. The model under consideration is based on a new institution of state ownership (macroregion ownership), which allows solving the problems of economic integration of territories by building extraterritorial production and economic complexes.
Paris Was Not Built in a Day… Three-Dimensional Puzzles and Architectural Blocks as a Universal Tool Supporting the Process of Aesthetic Education
Authors: Kasprzak Marta
Published: September 2021

This article proposes the use of knowledge of space studies in the school educational practice. It allows for implementation of obligatory content and skills indicated in the core curriculum for general education. Shaping the spatial imagination and aesthetic sensitivity is accompanied by the development of both social and manual skills, while the construction of miniature buildings by students is a convenient starting point for a discussion on social and cultural changes.
Climate Change Impact on Vegetation Dynamics in Tensift Region, Morocco
Authors:   the Department of Geology, Laboratory of Applied Geology, Geomatics and Environment, Faculty of Sciences Ben M’sik, Hassan II University, Casablanca, Morocco, Akensous Y. , Al Sabri A. , Al-Akad S. , Hakdaoui M.
Published: September 2021

Tensift region is known by an arid and semi-arid climate. The city of Marrakech, experience an important temporal variability in rainfall and an increasing trend of temperature during the last five decades. However, the evolution of rainfall is more contrasted by a downward trend in Marrakech, it is also distinguished by alarming clues of global warming, like the number of hot days and heat waves. This paper evaluates the effect of climate change on Vegetation cover (evaluated by NDVI) in the Tensift region, Morocco. Temperature, rainfall data, and vegetation cover were used in this analysis. The effect of climate change on vegetation was studied using a linear regression analysis method, to explore the relationship between vegetation dynamics and climate factors (the trend of vegetation dynamics for the years between 1973 -2019). Analysis of annual data, for the temperature and vegetation cover shows a low regression coefficient value of 0.3057 and, rainfall and vegetation cover analysis show regression coefficient value of 0.7024. Monthly periods analysis showed that the most important period is the one between December and May where the regression coefficient value is 0.6568. In more details the period between March and May shows regression coefficient value of 0.4685, the period between December and February shows regression coefficient value of 0.434, the period between September and November shows regression coefficient value of 0.0734. The study reveals that, rainfall is significantly related with vegetation cover, especially the period between December and May, more than the temperature does in Tensift region.
A Study on Use of Mathematical Programs for Design of Electronic Circuits in Cybernetic-Physical Learning Environment
Authors:   the Department of Physics and Electronics, Hansraj College, University of Delhi, Delhi-110007, India, Soni Namrata Dewan , Bhola Jyoti , Bhatnagar Mona
Published: September 2021

The laboratory work holds a great importance for an undergraduate student of science. And during COVID -19 pandemic, when the theory classes were moved online, migrating practical classes to online mode turned out to be a challenging task. This article aims to study the use of mathematical programs as an extensive methodological approach to enhance the learning of electronic circuit designing at undergraduate level. The students were given a task of designing a well-known oscillator circuit using a mathematical program written in open source application Scilab. The values of all the components needed to design an oscillator were calculated. The circuit was then designed practically for various frequencies using the theoretically obtained component values. The obtained output frequency of oscillator circuit was within 5% variation to the theoretically obtained one. In this article, the authors captured the experience of 500 undergraduate science students studying at various colleges of University of Delhi, India via a valid online questionnaire circulated through different platforms. The response of the students was gauged and it could be inferred that mathematical programs are working as a decent replacement during these demanding times and can be used as an add-on, once the physical labs start operating back to normalcy.
Flipped Classroom with Challenge-Based Learning Model on an Online Streaming Ecosystem to Develop Coping Skills in Cyberbullying
Authors:   the Department of Information Technology, Faculty of Industry and Technology, Rajamangala University of Technology Rattanakosin Wang Klai Kangwon Campus, Thailand, Pornpongtechavanich Phisit , Eumbunnapong Kawitsara , Piriyasurawong Pallop
Published: September 2021

The purposes of this research were: 1) to synthesize documents and international research on designing flipped classroom with challenge-based learning model on an online streaming ecosystem to develop coping skills in cyberbullying; 2) to design a flipped classroom with challenge-based learning model on an online streaming ecosystem to develop coping skills in cyberbullying; (3) to assess the suitability of the flipped classroom with challenge-based learning model on an online streaming ecosystem to develop coping skills in cyberbullying. Ten experts were selected using a specific selection: they had more than five years of relevant experience in the field with expertise in educational technology and information technology. The assessment ensures the suitability of the flipped classroom model with eco-challenging, for online learning to improve cyber bullying coping skills. The results showed that 41 international papers and research studies were synthesized, which concluded that there were eight factors that contribute to cyberbullying. The factors used for online streaming consisted of eight elements. The cyberbullying skills development process used a flipped classroom model and challenging learning to form a new learning model. When the components were completed, they were designed and evaluated. It was found that the flipped classroom with online learning ecosystem improves cyber bullying skills. It is highly suitable for developing cyberbullying prevention skills.
Blended Learning Approach in Graduate Studies: A Bibliometric Analysis from 1997-2021
Authors:   Ghazali Shafie Graduate School of Government, School of International Studies & Research Institute for Indonesia, Thailand, and Singapore (UUM-ITS), Universiti Utara Malaysia, Malaysia, Omar Rusdi , Kaliappen Narentheren , Khamis Kamarul Azman , Sulisworo Dwi
Published: September 2021

Research on the blended learning approach in graduate studies has started since 1997. Thereafter, researchers in various subject areas have widely investigated the term blended learning. This paper thus seeks to analyze scientific literature, especially for graduate studies, published on the blended approach. All the literature published about blended approach in graduate studies was gathered using the Scopus database. The data was analyzed using Microsoft Excel. Standard bibliometric analysis was used to create the growth of publications and the citation analysis. A total of 801 documents were found based on the search results. Since 2004, the growth rate of literature on blended learning in graduate studies has accelerated radically. Journal articles and conference papers accounted for most of the publications, which were mostly written in English and Spanish. Most of the studies were conducted in the fields of social science and computer science. E-learning, online learning, collaborative learning and flipped classroom were among the most frequently used keywords. Most of the blended learning research in graduate studies was carried out in the United Kingdom, Australia, and the United States. This paper presents the literature's evolution in the blended learning approach in graduate studies and identifies current research interest and the potential future research direction.
Digitalization and Decolonizing Education: A Qualitative Study of University of South Africa (UNISA) Leadership
Authors:   Thabo Mbeki African School for Public and International Affairs, University of South Africa, South Africa, Msila Vuyisile
Published: September 2021

The COVID-19 pandemic that shook the world in 2020 forced all educational institutions to search for new ways of teaching and learning. Furthermore, education institutions such as the University of South Africa (UNISA), like all other universities, found themselves with a huge task of promoting digitalization. As a traditional distance education institution, UNISA had to refine digitalization in a time of decolonization in the Global South. This case study examined the role of educational managers in sustaining effective digitalization. Eight UNISA managers were selected and interviewed to understand how they perceived the role of digital leaders. Furthermore, the study sought to understand why it is critical that managers should be in the forefront of digitalization. The study found that at present in Africa it is critical for digitalization to be combined with decolonization. Additionally, when digitalization and decolonization are implemented simultaneously, they become vehicles for social justice and democracy. This then means that education can be a tool for liberation and achievement where the digital divide is minimized. When implemented well, education institutions become institutions with access for success. The conclusions show that a set strategy based on a new vision for a university will harness digital leadership. The participants also mentioned strategic documents at the university; on the one hand are the Five Pillars of Change whilst on the other are the Eight Dimensions of Transformation. Furthermore, the participants claimed that their institution was on the road to success whilst building UNISA as an institution “Towards the African University that builds futures.”
Footprint of Export-Related GHG Emissions from Latin America and the Caribbean
Authors: Li Kun
Published: September 2021

To quantify the growth in GHG emissions related to international trade, we build an extensive database for export-related production and transportation GHG emissions covering 189 countries and 10 sectors from 1990 to 2014. We employ this database to quantify the contribution of production and international transportation to total export-related GHG emissions from Latin America and the Caribbean and decompose growth in these to contributions of the increase in the regions trade flows, shifts in the composition of trade partners, changes in the traded product basket, and technological progress.
Transfer Learning Approach - An Efficient Method to Predict Rainfall Based on Ground-Based Cloud Images
Authors: Ambildhuke Geeta Mahadeo , Banik Barnali Gupta
Published: September 2021

Clouds play a vital role in climate prediction. Rainfall prediction also majorly depends on the status and types of clouds present in the sky. Therefore, cloud identification is the most exciting and vital topic in meteorology and attracts most researchers from other areas. This paper presents the transfer learning technique to predict the Rainfall based on ground-based Cloud images responsible for rains. It will predict the estimated Rainfall by identifying the type of cloud by taking cloud images as input. The cloud images in the dataset are divided into three categories(classes) labeled as no-rain to very low-rain, low to medium-rain, and medium to high Rain based on the associated Precipitation responsible for the appropriate Rainfall. This model will be most helpful to the farmers to manage their Irrigation by knowing the status of Rainfall before every irrigation cycle or can also be helpful to take decisions on the outdoor events by taking prior knowledge of Rain. The model is trained on three classes to predict the Rainfall and firstly experimented with CNN. To improve the performance, the experiment is carried out with some best-pretrained models VGG16, Inception-V3, and XCeption using transfer learning and, the results are compared to the regular CNN model. The transfer learning technique is outperformed to get good accuracy as the dataset is too small and presented the best possible results of the model. Google colab with GPU setting makes the task fast and efficient to get the appropriate results in time, and performance achieved by transfer learning is excellent and can fulfill real-time requirements.
Optimal Control Policy for a Two-Phase M/M/1 Unreliable Gated Queue under N-Policy with a Fuzzy Environment
Authors: Sama Hanumantha Rao , Vemuri Vasanta Kumar , Boppana Venkata Siva Nageswara Hari Prasad
Published: September 2021

The two-phase service models analyzed by several authors considered only the probabilistic nature of the queue parameters with fixed cost elements. But the queue parameters and cost elements will be in general are of both possibilistic and probabilistic in nature. Analyzing the performance of the queueing systems with fuzzy environment facilitates to investigate for the possibilistic interval estimates to the performance measures of a queueing system rather than point estimates. In this work, it is proposed to construct membership function of the fuzzy cost function to obtain confidence estimates for some performance measures of a controllable two-phase service single server Markovian gated queue with server startups and breakdowns under N-policy in which the queue parameters viz. arrival rate, startup rate, batch service rate, individual service rate, repair rate and cost elements are all defined as fuzzy numbers. Based on Zadeh’s extension principle and the α-cuts, a set of parametric nonlinear programming problems are developed to find the upper and lower bounds of the minimum total expected cost per unit time at the possibility level α. As the analytical solutions of the nonlinear programming problems developed for the proposed model are tedious, considering the system parameters and cost elements as trapezoidal fuzzy numbers, numerical results for the lower and upper bounds of the optimal threshold N* and the minimum total expected cost per unit time are computed using the nonlinear programming solver available in MATLAB.
Permissioned Healthcare Blockchain System for Securing the EHRs with Privacy Preservation
Authors: Rao Katru Rama , Naganjaneyulu Satuluri
Published: September 2021

Healthcare data is very sensitive as many healthcare organizations will be very reluctant to share health data. However, sharing the healthcare data is having many more uses for both the patients as well as the research institutions too. Moreover, the existing Electronic Healthcare Record (EHR) management system will be stored in the central database in the form of plaintext. Whenever the data needs to be accessed from the database, the users will be requesting the required EHRs. However, this mechanism possesses the several challenges such as single point of failure, takes more time for user identification, interoperability issues, data recoverability issues, lack of privacy and security. This paper mainly focuses on providing security for the healthcare data, which can be shared among the various health institutions. Authentication and authorization are provided by establishing multiple certification authorities on the permissioned healthcare blockchain network. In this proposed model data integrity is also achieved by the concept of hashing of the electronic health records rather than storing it directly onto the permissioned healthcare block chain network.
Anatomical Study of Variations of Cystic Artery and Contents of Calot’s Triangle in South Kerala - A Cross Sectional Study
Authors: Bhaskaran Leena Ammini
Published: September 2021

BACKGROUND Cystic artery originates from right hepatic artery which is a branch of hepatic artery proper of coeliac trunk from abdominal aorta. Variations in the origin and course of cystic artery were observed in this study. Contents of Calot’s triangle were also studied. Knowledge of normal anatomy, variations of the biliary apparatus and the arterial supply to the gallbladder is important for surgeon. METHODS Descriptive cross-sectional study was done from April 2008 to January 2010 in 180 adult specimens and 50 foetal specimens in the Departments of Anatomy, Forensic Medicine and Pathology in Government Medical College, Thiruvananthapuram. The abdominal wall was incised and hepatobiliary region was identified and dissected. The gallbladder and coeliac trunk were identified. Cystic artery and Calot’s triangle were studied. RESULTS More than 90 percent of the cystic artery originates from the right hepatic artery in both sexes. Cystic artery originated from left hepatic artery in 4 cases, common hepatic artery in 5 cases and from middle hepatic artery in 1 case. The cystic artery within Calot’s triangle was observed in 41 %. Right hepatic artery was content in 29.9 %. Both the arteries were content in 19 %. Cystic artery and accessory hepatic duct were content of Calot’s triangle in 2.2 %. Double cystic artery was content of the triangle in 1 cadaver. Artery or duct was seen outside the Calot’s triangle in 16 cadavers. CONCLUSIONS It is important for surgeons to know the variations of cystic artery and Calot’s triangle during surgical interventions of the hepato biliary region. “Cystic artery syndrome” is a condition where cystic artery is seen winding around cystic duct although it originates from right hepatic artery. Knowledge of these variations is important for surgeons and helps in better surgical outcome. KEYWORDS Cystic Artery, Calot’s Triangle, Right Hepatic, Gall Bladder, Coeliac Trunk
Evaluation of Renal Microvascular Damage by Measuring Microalbuminuria in Non-Alcoholic Fatty Liver Disease – A Study from Punjab, India
Authors: Bansal Ankush , Sikri Tejinder , Nayyar Satya Bhushan
Published: September 2021

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by obesity, dyslipidaemia, insulin resistance and diabetes mellitus (DM). NAFLD represents another component of metabolic syndrome. NAFLD and metabolic syndrome are associated with increased risk of atherosclerosis. METHODS In the present comparative cross-sectional study, 100 cases with incidental NAFLD and 100 healthy controls were subjected to detailed history, physical examination including body-mass index (BMI) and biochemical investigations including renal function tests (RFT), lipid profile and liver function tests (LFT). Microalbuminuria was measured in these subjects to evaluate microvascular renal damage. Subjects with alcoholic liver disease, chronic viral hepatitis, renal disease, etc were excluded. RESULTS The mean urine albumin creatinine ratio (UACR) in cases and controls was 35.81 ± 27.81 and 7.88 ± 0.78 respectively. The mean UACR in grade 1 fatty liver was 16.31 ± 5.45, in grade 2 fatty liver was 28.64 ± 12.91, and 72.8 ± 27.10 in grade 3 fatty liver and they were compared with each other and were found to be statistically significant with P value = 0.001. CONCLUSIONS The present study showed highly significant (P < 0.001) correlation between microalbuminuria and NAFLD. There was a positive correlation which progresses with increased grades of NAFLD. This correlation points towards a positive relationship between increased renal microvascular damage and progression to chronic kidney disease (CKD) in patients with NAFLD. The occurrence of NAFLD is increasing mainly due to increasing obesity and metabolic syndrome. The clinical implications of these findings for patient care are the detection of NAFLD by routine ultrasonography (USG) especially in obese people and urine analysis for microalbuminuria in these persons. This will help the clinician in determining cardiovascular risks and risk of CKD in these apparently healthy persons. KEYWORDS NAFLD, CKD, Albuminuria
A Prospective Study of Clinical Outcomes in Laryngopharyngeal Reflux Diseases Following Treatment with Proton Pump Inhibitors in a Tertiary Care Hospital in Kerala
Authors: George Binu Raju , P.V Ajayan , Samad Saify
Published: September 2021

BACKGROUND Laryngopharyngeal reflux (LPR) is found to be a common disease encountered in Otolaryngology practice. LPR presents clinically with symptoms of laryngeal irritation, frequent throat clearing, cough, and hoarseness of voice. The main diagnostic methods currently used are Fiber-optic laryngoscopy and in some centers pH monitoring. Proton pump inhibitors (PPIs) are used and found to be cost-effective and useful for the treatment of LPR. The main objective of this study was to study the effectiveness of PPIs in alleviating the symptoms assessed using Reflux Symptom Index (RSI) score and Reflux Finding Scores (RFS). METHODS A prospective study was carried out on 100 patients attending the ENT OPD of Government Medical College and Hospital, Thrissur, Kerala. Patients were evaluated for improvement in symptoms of Laryngopharyngeal reflux disease following use of proton pump inhibitors, using Reflux symptom index and Reflux finding scores using 70 degree / flexible nasopharyngolaryngoscopy. Patients with clinical findings of LPRD with RSI score > 13 and RFS score > 7 were given a standard treatment protocol followed in our ENT department using Tab. Pantoprazole 40 mg twice daily before food and the treatment response was assessed by proper follow up at 6 weeks and 12 weeks. On each follow up visit, improvement in RSI and RFS scores with Proton pump inhibitor therapy was assessed. Data collected was then tabulated and analysed. RESULTS The study was conducted in 100 patients, 59 % of whom were females and 41 % males. Mean RSI score changed from 18.9 at the beginning to 14.5 at 6 weeks of treatment and 9.0 at 12 weeks of treatment with Proton pump inhibitor. Mean RFS score changed from 10.7 at the beginning to 8.7 at 6 weeks of treatment and to 5.9 at 12 weeks of treatment. Comparison of mean Reflux Symptom Index and mean Reflux Finding Scores before and after treatment revealed improvement and the result was statistically significant (p value < 0.001). CONCLUSIONS The use of RSI and RFS scores in the assessment of PPIs at fixed intervals is cost effective and avoids time consuming and cost intensive examinations. These scores also help in early diagnosis and long term follow up of LPR patient. Fixed time interval PPI treatment significantly improved RSI and RFS scores in LPR patients. The mean RSI score changed from 18.9 at the beginning of treatment to 14.5 at 6 weeks after treatment (p value < 0.001) and 9.0 after 12 weeks of treatment; (p value < 0.001) The mean RFS score changed from 10.7 at the beginning of treatment to 8.7 at 6 weeks after treatment (p value < 0.001) and 5.9 after 12 weeks of treatment; (p value < 0.001). KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score
Changing Trend in COVID 19 Pandemic, Orthopaedic Care, and Arthroplasty - A Prospective Study Conducted in Indira Gandhi Institute of Medical Sciences, an Apex Tertiary Centre of Bihar
Authors: Bhadani Janki Sharan , Ahmed Wasim , Kashyap Nishant , Kumar Indrajeet , Kumar Santosh , Kumar Rahul , Kumar Ashutosh
Published: September 2021

BACKGROUND The novel corona virus pandemic has a profound impact on health services throughout the world, which reflected the changing guidelines of different health societies in different time zones. We tried first to ensure the safety of our patients and surgical staff. Patient care priorities based on strict evidence-based management of a particular case and also COVID-19-adjusted governmentimposed restriction during the crisis. We aim to study postoperative complication after arthroplasty and readmission rate and compared the same with the prepandemic era. We also address our strategies, concerns, and regulatory barriers due to government-imposed lockdown, during initial surge of pandemic and also when restrictions were lifted. This study is unique in the way that there is no such study from Bihar, a state of developing country with scarcity of specialized health services. METHODS In this prospective study done in Indira Gandhi Institute Of Medical Sciences, Patna, Bihar between 1st December 2019 to 31st January 2021 (14 months duration). We have selected a subset of those patient who were admitted for primary arthroplasty of hip during the pandemic after lock down, and compared those with patient those underwent similar operative management before the lockdown period. RESULTS There was no significant difference in postoperative complication and readmission rate when compared with the pre-pandemic era. CONCLUSIONS There is no significant increase in risks of patient as well as operating surgeon before the pandemic and during the pandemic when the elective operative procedure (arthroplasty) was allowed. Communication, precautions, and proper preoperative planning remain essential part of management at each step of treatment. By following above mentioned standard operative procedure (SOP) chances of getting infection of COVID-19 is negligible from operative work. KEYWORDS COVID 19, SARS-CoV-2, Arthroplasty, Orthopaedics
Association of CD4 Counts with Cardiovascular Dysfunction among HIV/AIDS Patients - A Hospital Based Study in North Karnataka
Authors: Devru Nandini , Lakshetty Swetha Rajshekhar , Katageri Anand
Published: September 2021

BACKGROUND Globally the number of people living with human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) has been rising steadily since 2011 nearing more than 33 million whereas in developing countries like India it is 2.4 million with a prevalence of 0.3%. The purpose of this study was to assess the association of CD4 counts with cardiovascular dysfunction among HIV/AIDS patients. METHODS This was a hospital-based study conducted at the Vijayanagara Institute of Medical Sciences, Bellary. Convenience sampling was used and patients admitted to the wards of the internal medicine as well as those attending anti-retroviral therapy (ART) centre out-patient department (OPD) were included in the study. A total of 200 cases of seropositivity of HIV patient diagnosed by Elisa technique were assessed after obtaining informed consent. Clinical profile and laboratory investigations were carried out on the patients such as CD4 counts and analyzed with various cardiac dysfunction. RESULTS Commonest affected with HIV infection were young male (26 – 40 years) 77.5 % followed by young female 60 % Commonest symptoms were fever, cough 82 % each and breathlessness 44 %. Commonest clinical findings were pallor 80 %, pedal oedema 68 %, and lymphadenopathy 32 %. 26 % of patients had electrocardiography (ECG) abnormalities with commonest being sinus tachycardia 18 %, low voltage complex 4 %, IHD (ischemic heart disease) 2 %, LVH (left ventricular failure) 2 %. 34 % had chest x-ray abnormalities such as cardiomegaly 14 %, pleural effusion 12 % and PTB (pulmonary tuberculosis) 2 %. Abnormal CD4 counts were noted in 94 % of patients, with 12 % having very low CD4 counts that is less than 50. Statistically significant pericardial effusion was noted with low CD4 counts on 2D ECHO cardiography. CONCLUSIONS The study concludes that decrease in CD4 count is statistically associated with increased pericardial effusion among HIV/AIDS patients. KEYWORDS CD4 Counts, HIV/AIDS Patients, Cardiovascular Dysfunction, Pericardial Effusion
Evaluation of ER, PR, HER2 / neu Receptor Status in Breast Cancer - A Cross Sectional Study from Manipur
Authors: Zimik Themthingla , Laiphrakpam Angelica , Longjam Deepa , L Sushila Devi
Published: September 2021

BACKGROUND Breast cancer is the most common cancer in women worldwide and has surpassed cervical cancer in India. As a result of regular mammography screening programs and public awareness, early-stage breast cancer with better prognosis has occurred. Immunohistochemistry (IHC) is now a common practice in tumour evaluation which are of importance in diagnosis as well as for deciding the treatment and of prediction of prognosis in breast cancer. The present study was undertaken in view of correlating the histopathology of the tumour and IHC profile with respect to oestrogen receptor (ER), progesterone receptor (PR) and HER2 / neu. METHODS The study is a cross-sectional prospective analysis of patients with primary carcinoma of breast who are undergoing surgery over a period of 2 years from September 2017 to August 2019. All specimens were processed and stained with haematoxylin and eosin and immunohistochemistry was done for oestrogen and progesterone receptors and HER 2neu. RESULTS A total of 20 cases of breast carcinoma specimens were studied, whose age ranged from 24 - 72 years of age. All the 20 cases occurred in females. Infiltrating duct carcinoma was the most histological subtype noted in this study comprising 85 % (17 / 20) of cases. In the study 50 % (10/20) of the cases showed ER / PR positivity with negative HER2 / neu while 15 % (3/15) of cases were negative for ER / PR and HER2 / neu and only one case showed positivity for all three markers. 10 cases (50 %) had lymph node metastases in this study. CONCLUSIONS Breast cancer is the most commonly diagnosed malignancy in Indian women and is also the leading cause of cancer death in women worldwide. Assessment of receptor (ER, PR and HER – 2 / neu) status along with histopathological grading and staging will guide the clinicians to impart a correct treatment protocols to the patients. It will also be of great help in assessing the prognosis. KEYWORDS Breast Cancer, Histopathology, Immunohistochemistry
Comparison between Invasive and Non-Invasive Blood Pressure Monitoring in High-Risk Prolonged Surgeries in a Medical College of Assam
Authors: Dutta Utpal , B Mahin Aboobacker , Bora Rituparna
Published: September 2021

BACKGROUND Blood pressure monitoring in intraoperative period is one of the basic parameters in haemodynamic monitoring. This guides an anaesthesiologist to maintain an optimal condition between the patient’s stress condition and the depth of anaesthesia. Blood pressure can be measured either invasively or non-invasively in patients undergoing surgery. Invasive measurement from an arterial line is the preferred method even though there may be calibration errors, movement artefacts and over or under damping. The gold standard in cases of high-risk prolonged surgery is continuous monitoring of blood pressure by means of invasive blood pressure (IBP) measurement. The purpose of this study was to compare the non-invasive and invasive blood pressure monitoring in patients undergoing high risk surgeries METHODS After getting institutional ethical committee (H) clearance, study was conducted on 40 patients undergoing high-risk prolonged surgeries. Non-invasive blood pressures (NIBP) were recorded by oscillometric method before intubation, after intubation, half an hour after intubation and one hour after intubation. Simultaneously invasive blood pressure monitoring was done by establishing radial artery line. Bland-Altman plot was used to compare the blood pressure measurement by the non-invasive and invasive method. RESULTS Systolic blood pressure readings using non-invasive blood pressure monitoring was overestimated, diastolic and mean arterial pressure (MAP) readings using noninvasive blood pressure monitoring was underestimated in all instances. In all time points non-invasive blood pressure showed a good correlation with invasive blood pressure. CONCLUSIONS The study revealed that there is statistically significant difference between noninvasive and invasive blood pressure readings. We recommend invasive blood pressure monitoring in high-risk surgeries and critically ill patients, although a large-scale study is required to arrive at a conclusion. KEYWORDS Non-invasive Blood Pressure, Invasive Blood Pressure, Bland-Altman Analysis, High Risk Surgery
Study of Calcium, Magnesium and Phosphorus Levels among Hypothyroid Patients in Trichy, Tamil Nadu
Authors: M Rasheed Khan , A.G Thivyah Prabha , K Siva Kumar
Published: September 2021

BACKGROUND Mineral metabolism is frequently disturbed in thyroid dysfunctions. Among thyroid dysfunctions, hypothyroidism is one of the most common form resulting from the deficiency of thyroid hormones. Studies done on serum calcium, phosphorus and magnesium in hypothyroid patients earlier have conflicting results. Hence the present study has been undertaken to study the levels of serum calcium, phosphorus, and magnesium among hypothyroid patients and analyse their correlation with thyroid stimulating hormone (TSH). METHODS The case control study was conducted in the Department of Biochemistry in Trichy SRM Medical College Hospital and Research Centre for a period of 6 months from 2017 January to July 2017. The study was undertaken involving 50 hypothyroid cases and 50 healthy volunteers as controls after proper ethical clearance and informed consent of all the study subjects. Serum calcium, phosphorus and magnesium were measured along with tri-iodothyronine (FT3), tetra-iodothyronine (FT4) and TSH among all study subjects. Statistical analysis of data was done using statistical package for social sciences (SPSS) software. RESULTS The mean value of serum total calcium and total magnesium was lower among hypothyroid cases and phosphorus value was increased as compared to controls. (P < 0.001) Statistically significant negative correlation was observed between serum calcium, magnesium and TSH among hypothyroid cases. Statistically significant positive correlation was observed between serum phosphorus and TSH among hypothyroid cases. CONCLUSIONS Among hypothyroid patients the values of serum calcium, magnesium and phosphorus is significantly altered. Thyroid disorders have an important role in bone and mineral metabolism. Thus, monitoring of these minerals among hypothyroid patients in regular follow up may effectively improve the clinical manifestations in them. Hence, monitoring of mineral status of the hypothyroid patients on follow-up will be of benefit to the patients. KEYWORDS Hypothyroidism, Calcium, Phosphorus, Magnesium, Minerals
Variations in Serum Vitamin B12 Levels among Metformin Receiving and Non-Receiving Type 2 Diabetes Mellitus Patients - A Case Control Study in a Tertiary Care Hospital in Puducherry
Authors: Kannan Priyadharshini , Rajendran Sivaa , Nanda Sunil Kumar , Natarajan Vasanthi
Published: September 2021

BACKGROUND Metformin is considered as a cornerstone in the treatment of diabetes and is the most frequently prescribed first line therapy for individuals with T2DM. Metformin use in type 2 diabetes mellitus has shown to cause vitamin B12 (B12) deficiency. Besides these, B12 deficiency related neuropathy may mimic and/or aggravate the underlying diabetic neuropathy. Furthermore, there have been lack of consensus regarding the universal routine screening of serum B12 levels among metformin users with T2DM, and similar studies from India are also limited. So, we wanted to study the relationship between metformin use and serum B12 in T2DM patients. METHODS The study included a total of 104 subjects of which 52 are T2DM affected individuals who are only on metformin therapy for at least 3 months, served as cases and 52 are newly diagnosed T2DM age and sex matched individuals yet to be medically treated, served as controls. Their blood samples were collected to estimate vitamin B12 and other parameters. RESULTS The median B12 levels in cases 213.5 pg/mL (IQR 136.25-301.0) were found to be significantly lower (P < 0.05) when compared to median levels of controls 240 pg/mL (IQR 214-303.25). B12 levels also showed a significant fall in their levels with increasing duration of T2DM. CONCLUSIONS Metformin induced vitamin B12 deficiency plays a major role in developing life risks in T2DM patients. Routine screening and supplementation of B12 may be required in T2DM patients KEYWORDS Metformin, Type 2 Diabetes Mellitus, Vitamin B12
A Prospective Study on Post-Operative Complications Following Thyroid Surgery Conducted in a Tertiary Care Hospital in Tirupati
Authors: Nagamuneiah Sadhu , Prakash Gandikota Venkata , P Sabitha , Periyasamy Karthik , Madduri Sanjay Raj Kumar Reddy , U Jagadeeshwar
Published: September 2021

BACKGROUND Thyroidectomy is a surgical procedure which is commonly performed by surgeons worldwide, but the outcome and complication rates were mainly dependent on the surgeon’s skill and experience, indication and the extent of surgery and the number of thyroid surgeries performed at that particular centre. The aim of this study was to assess the frequency of the postoperative complications after thyroid surgery in Sri Venkateswara Ramnaraian Ruiya Government General Hospital, Tirupati. METHODS A prospective study conducted on 100 patients with thyroid swelling who attended the Sri Venkateshwara Ramnaraian Ruya Government General Hospital, Tirupati. Patient age, sex, rural/urban origin, history, diagnosis, type of surgery, laboratory investigation such as complete blood, serum calcium, thyroid function test, us culture and sensitivity test in wound infections and indirect laryngoscopy for all pre-operative patients and postoperative voice change patients. Outcomes recorded as a complication of thyroid surgery within one week. RESULTS Totally 100 patients were enrolled in the study. Thyroid enlargement was more common in females (F: M =5.6:1) presenting in 3rd and 4th decades mostly with the mean age and standard deviation were 42.92 years and 13.097 years respectively. Total thyroidectomy was the most common procedure performed (44 %) followed by hemithyroidectomy (31 %), subtotal thyroidectomies (29 %) and near total thyroidectomy (5 %). On histopathological examination most common finding was multinodular goiter (54 %) followed by nodular goiter (33 %) and malignancies (10 %). The overall postoperative complication rate was 47 %. The most common postoperative complications after thyroidectomies were seroma formation in wound complication (27 %), followed by hypocalcemia (11 %), recurrent laryngeal nerve (RLN) injury (3 %), and surgical site infection (2 %). Majority of these complications were found to be associated with total thyroidectomy, female population, and in patients with age more than 30 years. CONCLUSIONS Seroma formation in wound complication is the commonest post thyroidectomy complication. Female gender, old age, and extensive thyroid surgery were associated with increased complication rate. KEYWORDS Post-Operative Complications, Thyroid Surgery