bluuebunny/crossref_metadata_2025 huggingface dataset:
Paroxysmal tonic upgaze in a child with SCN8A‐related encephalopathy∗
Authors: Solazzi Roberta , Castellotti Barbara , Canafoglia Laura , Messina Giuliana , Magri Stefania , Freri Elena , Ragona Francesca , Franceschetti Silvana , Di Francesco Jacopo C. , Gellera Cinzia , Granata Tiziana
Published: July 2021

Pathogenic variants in the SCN8A gene have been associated with a broad phenotypic spectrum, ranging from benign familial infantile seizures to severe, early‐onset developmental and epileptic encephalopathy. This spectrum also includes an “intermediate phenotype” characterized by different degrees of cognitive disability, mild neurological impairment, and therapeutically manageable epilepsy. We report on a child harbouring a de novo, novel SCN8A deletion, whose clinical picture is consistent with an SCN8A‐related “intermediate phenotype”. This patient's peculiar feature is the occurrence of paroxysmal tonic upgaze (PTU), a non‐epileptic disorder consisting of sustained conjugate upward deviation of the eyes, with neck flexion, and downbeat saccades. PTU has been described in otherwise healthy children, as well as in a few genetic syndromes, but has never been observed in SCN8A‐related phenotypes. This report, therefore, adds a new symptom to the spectrum of movement disorders associated with SCN8A‐related developmental and epileptic encephalopathy. In this short communication, we provide video‐EEG documentation of PTU and seizures, and discuss the challenging differential diagnosis between the two symptoms.
Musicogenic epilepsy with ictal asystole: a video‐EEG case report
Authors: Benoit Jeanne , Martin Florence , Thomas Pierre
Published: July 2021

Musicogenic seizures and ictal asystole are two rare features mainly encountered in temporal lobe epilepsy. We present the first case of musicogenic epilepsy with ictal asystole in a patient with right temporal lobe epilepsy, confirmed by video‐EEG. The pathophysiological mechanism of both conditions remains uncertain. These two features appeared after many years of epilepsy in our patient, and although this association might be coincidental, common mechanisms could be involved, including remodelling of neural connections or seizure propagation to a singular zone. This case also highlights the need for precise electroclinical assessment of seizures that change clinically over time, particularly when falls occur after a certain period of latency, suggesting cardiac consequences of the seizures.
The relationship between the mechanism of injury and mandibular fractures
Authors: Abdoola Irshaad , Bouckaert Michael MR , Munzhelele Irene , Ibrahim Muniera , Mchenga James M
Published: July 2021

This prospective study describes the mechanism of injury, patient demographics and clinical presentation of 100 consecutive patients encountered in the patient population served by the Department of Maxillofacial and Oral Surgery at the Sefako Makgatho Health Sciences University. To determine the demographics, presentation and mechanism of injury of patients presenting with mandibular fractures in the patient population served by Sefako Makgatho Health Sciences University. Seventy percent of mandibular fractures were secondary to assault. Although this was high in comparison to other studies, it was similar to studies performed in London and other regions of South Africa. Mandibular fractures resulting from MVA (motor vehicle accidents), falls and sports were found to be less than the norm. The high percentage of mandibular fractures due to assault concurs with similar studies previously conducted in South Africa. With some variables similar to international trends, while others are not; certain salient results highlight the need for interventional campaigns.
Çocukların Oynadığı Dijital Oyunlara İlişkin Dijital Ebeveynlerinin Farkındalıkları Üzerine Bir İnceleme
Authors: BİRİCİK Zeynep
Published: July 2021

Yeni bir çağın ebeveynleri olarak dijital ebeveynlik, geçmiş kuşakların anne baba rollerinden oldukça farklılık içermektedir. Bu dijital çağın getirmiş olduğu kültürel kodları bilmek ve çocuklarla onların konuştuğu dili konuşmak ve en az onlar kadar bu teknolojiye aşina olmak belki de bu yolda atılacak olan önemli adımlardan ilki olacaktır. Bu çalışmada Erzurum ilindeki ilköğretim öğrencilerinin dijital oyun oynama eğilimleri karşısında ebeveynlerinin tutumlarının incelenmesi amaçlanmaktadır. Çalışma tarama modelinde yürütülmüş olup veri toplama aracı olarak demografik bilgileri, dijital oyun oynama eğilimlerini ölçen, çocuklarda oluşan dijital oyun kültürünü ve ebeveyn farkındalığını ortaya koymak adına araştırmacı tarafından geliştirilen bir yarı yapılandırılmış mülakat formu kullanılmıştır. Sosyoekonomik seviyeleri göz önünde bulundurularak düşük, orta ve yüksek olmak üzere üç okuldan 15 öğrenci olmak üzere toplamda 45 öğrencinin 90 ebeveyni ile görüşme planlanmıştır. Görüşmede; çocukların hangi dijital oyun oynadıkları, günlük ne kadar süre oynadıkları, çevrimiçi ya da çevrimdışı mı oynadıkları, hangi dijital araçla oynadıkları, oyunların zarar ve tehlikelerine karşı çocuklarını uyarıp uyarmadıkları ebeveynlerine sorularak dijital oyunlara ilişkin farkındalıkları incelenmiştir. Ebeveynlerin genel olarak çocuklarının oynamış oldukları dijital oyunlar hakkında yüzeysel bilgilere sahip oldukları, dijital oyunlardan dolayı çocuklarının karşılaşacağı riskler ve tehlikelerden çoğunlukla haberdar olmadıkları sonucuna ulaşılmıştır.
Çocuklara Yönelik Televizyon Reklamcılığında Ebeveyn Algılarının Tutum ve Arabuluculukları Üzerine Etkisi: Kocaeli (Gölcük)’de Bir Araştırma
Authors: TALİH AKKAYA Duygu , ÖZHAN Şeniz
Published: July 2021

Özellikle tüketim toplumlarında kilit bir role sahip olan çocuklar için televizyon, hızla gelişen iletişim teknolojilerine rağmen vazgeçilmez bir kitle iletişim aracı olmaya devam etmektedir. Çocuklar televizyon içeriklerinin önemli bir kısmını oluşturan reklamlara çok fazla maruz kalmakta ve özellikle kendilerine yönelik reklamlardan etkilenmektedirler. Ebeveynlerin bu etkilere ilişkin algıları ise, çocuklara yönelik televizyon reklamları ile ilgili tutum ve davranışları üzerinde belirleyici olmaktadır. Bu araştırmanın amacı, ebeveynlerin çocuklara yönelik televizyon reklamlarına ilişkin algılarının tutumları ve arabuluculukları üzerindeki etkilerinin incelenmesidir. Bu amaç doğrultusunda öncelikle çocuklara yönelik televizyon reklamlarının onlar üzerindeki etkileri, ebeveynlerin söz konusu reklamlara yönelik algıları, tutumları ve ebeveyn arabuluculuğu ile ilgili literatür taraması yapılmıştır. Uygulama bölümünde ise ebeveynlerin çocuklara yönelik televizyon reklamlarına ilişkin algılarının tutumları ve arabuluculuklarına etkisinin incelenmesi amacıyla hazırlanan anket ebeveynler tarafından cevaplandırılmış, 247 ebeveynin cevapları sonucunda elde edilen veriler yapısal eşitlik modeli ile analiz edilmiş ve yorumlanmıştır. Elde edilen sonuçlara göre çocuklara yönelik televizyon reklamlarının etkilerine yönelik olumsuz algıya sahip olan ebeveynlerin söz konusu reklamlara ilişkin olumsuz tutumları olduğu ve çocuklarının televizyon izleme içeriği ve süresi üzerinde kontrol uyguladığı, reklamların bilgi verici olduğuna dair algıların ise ebeveynlerin çocuklarıyla reklam içeriği hakkında konuşmaları üzerinde olumlu yönde etkisi olduğu bulunmuştur. Ayrıca ebeveynlerin çocuklara yönelik televizyon reklamlarına ilişkin tutumlarının çocuklarıyla reklam içeriği hakkında konuşmaları üzerinde olumsuz yönde etkisi olduğu sonucuna varılmıştır.
GSM Operatörü Markalarının Sosyal Sorumluluk Çalışmaları: Kurumsal Web Sayfaları Üzerine Bir Analiz
Authors: SİLSÜPÜR Özer
Published: July 2021

Markalar sosyal sorumluluk çalışmalarıyla toplumsal sorunlara dikkat çekmek, bu sorunlara çözümler üretmek, insanların hayatlarına dokunmak ve böylece toplumla yakınlaşmaktadırlar. Markalar, gönüllülük esasıyla gerçekleştirdikleri sosyal sorumluluk çalışmalarını, önemli bir iletişim aracı olan kurumsal web sitelerinde paylaşmakta ve hedef kitleleri bilgilendirmektedirler. Markalar web sayfaları sayesinde, hedef kitlelerle hem hızlı hem de aracısız ve doğrudan iletişim kurabilmekte, bunun sonucunda oluşacak güvenle de marka imajlarına olumlu katkı sağlamaktadırlar. Bu bağlamda çalışmada, Türkiye’de ürün ve/veya hizmetleriyle faaliyet gösteren Turkcell, Vodafone ve Türk Telekom GSM operatörü markalarının sosyal sorumluluk mesajlarını kurumsal web sayfaları üzerinden değerlendirmek amaçlanmış ve bu doğrultuda markaların kurumsal web sayfaları içerik analizi yöntemiyle 19.02.2021-05.03.2021 tarihleri arasında incelenmiştir. Araştırmanın sonucunda, üç markanın da web sayfalarında sosyal sorumluluk mesajlarına yer verdiği görülmüştür. Turkcell sosyal sorumluluk mesajlarını “sponsorluk” linki içinde paylaşırken, Vodafone ve Türk Telekom’un sosyal sorumluluk linkleri olduğu tespit edilmiştir. Markaların en çok çevre, eğitim ve toplum alanlarında sosyal sorumluluk mesajı paylaştığı; turizm, kültür-sanat, spor alanlarında ise hiçbir sosyal sorumluluk faaliyetlerinde bulunmadıkları saptanmıştır. GSM operatörleri mesajlarını en çok metin aracılığıyla, daha sonra görsel ve yazılı materyal ve görsel ve işitsel materyal kullanarak paylaştıkları belirlenmiştir. GSM operatörleri içinde marka değeri açısından ikinci olan Turkcell’in en fazla sosyal sorumluluk çalışması gerçekleştirdiği tespit edilmiştir.
Destek Olmak Veya Ol(a)Mamak: Marka Aktivizmi Bağlamında Bir Değerlendirme
Authors: AYDINLIOĞLU Ömer , SUSUR Mert
Published: July 2021

Yaşanan toplumsal, çevresel, ekonomik ve politik olaylar bağlamında markaların farkındalık yaratmak ve destek vermek amacıyla eyleme geçmeleri olarak tanımlanan marka aktivizmi kavramı son yıllarda sıklıkla karşımıza çıkmaktadır. Yaşanan teknolojik gelişmeler ve sosyal medya platformlarının kullanımıyla birlikte marka aktivizmi hareketleri çoğunlukla dijital ortamlarda meydana gelmektedir. Tüketiciler, son yıllarda markalardan daha duyarlı olmalarını beklerken, tutarsız davranışlar sergileyen, yanlış eylemlerde bulunan veya aksi yönde bir algıya sebep olan markaları boykot etmektedir. Marka aktivizmi kavramı çerçevesinde vaka (durum) analizi tekniğiyle ele alınacak olan bu çalışmanın amacı, marka aktivizmi bağlamında örnekleme dahil edilen Nike, Starbucks ve Netflix gibi küresel markaların #blacklivesmatter akımına yapmış oldukları desteği ve bu desteğin tüketici kanadındaki yansımalarını masaya yatırmak ve değerlendirmektir. Amaçsal örneklem yöntemiyle seçilen ve #blacklivesmatter hashtagi kullanılarak aktivizm hareketlerinde bulunan Nike, Starbucks ve Netflix markalarına ait vakalar çalışmanın örneklemini oluşturmaktadır. Markalar aktivizm hareketlerinde bulunmadan önce tüketicinin bu yöndeki tepkisini ön görebilmelidir. Çalışma sonucunda, marka aktivizmi hareketlerinde bulunurken kuruluşların aktivist eylem ile tutarlı davranış sergilemelerinin, şüphe uyandıracak davranışlardan kaçınmalarının ve başka bir amaç ile hareketlere dahil olmamalarının çok büyük önem arz ettiği görülmektedir.
Retro Pazarlama Perspektifinden Tadım Kuruyemiş Markası İle İlgili Reklamın Göstergebilimsel Analiz Yöntemi İle İncelenmesi
Authors: TOKSARI Murat , AYDAR Amine Feyzanur
Published: July 2021

Günümüzün rekabet dünyasında tüketicilerin zihinlerinde marka algısı oluşturmak isteyen her işletmenin, marka ile tüketici arasında güçlü bağ oluşturacak stratejiler geliştirmesi oldukça önemlidir. Markaların birbirini taklit ettiği, abartılı reklamların oldukça bol olduğu, verilmek istenen mesajdan çok tüketicileri eğlendirmeye yönelik reklamların çoğaldığı ve tüketici alışkanlıklarının değiştiği günümüz dünyasında doğru mesajı vermek çok önemlidir. Bu nedenlerle tüketiciler üzerinde duygusal bir etki bırakmak, geçmiş zevk alışkanlıklarından bazılarını hatırlatmak ve bunları markayla harmanlamak ve medya araçlarıyla sunmak, işletmeler için retro pazarlama kavramlarının önemini artırmıştır. Bu bağlamda işletmeler, tüketicilerin subliminal algılarında duygusal yoğunluğa sebebiyet veren mesaj içeriklerine yönelmişler ve retro pazarlamaya ağırlık veren stratejiler geliştirmişlerdir.
Bu araştırma retro pazarlama kavramını betimlemeyi, markaların retro pazarlama uygulamasını kullanarak oluşturduğu reklam filmlerinde tüketicilerine ne gibi mesajlar vermek istediklerini ve retro pazarlama kavramının tüketicilerin zihninde neleri hatırlattığını ortaya koymayı amaçlamaktadır. Bu amaçla yapılan çalışmada, Tadım kuruyemiş markasının dünyada ve Türkiye'de popülaritesi her geçen gün artan Youtube üzerinden yayınlanan ‘Türkiye'nin En Büyük Sosyal Ağı’ adlı reklam filmi göstergebilimsel yöntemle analiz edilmiştir.
Factors affecting obesity in preadolescents: the case of Cappadocia
Authors: KOÇ Elif Tuba , ÇALIŞKAN Zehra , ERDEM Emine
Published: July 2021

Purpose: This cross-sectional study was conducted to determine the risk factors which affect obesity in preadolescents.

Materials and Methods: The sample of the study consisted of 500 preadolescents (girls: n=271, boys: n=229) attended in 18 secondary schools in the Cappadocia region of Turkey, and their parents. Data were collected using a questionnaire, the body weight, height, and waist circumference of the preadolescents were measured; the body mass index (BMI) and the waist-to-height ratio were calculated.

Results: Of preadolescents; 14.4% were obese, 11.4% were overweight, 35.2% had abdominal obesity, and 27% had likehood of being at high metabolic and cardiovascular risk based on their waist/height ratio. According to the results of binary multiple logistic regression analysis (the backward stepwise procedure), the presence of an obese person in the family (boys), mother's educational level (girls), leisure time activities (girls), and an increase in eating according to mood (girls) were revealed as significant predictors of being overweight/obese, adjusted for age. Satisfied with current body weight and mother’s BMI were the strongest variable to be associated with overweight/obese for both genders.

Conclusion: For early diagnosis and prevention of obesity in childhood, it is recommended to perform height-weight monitoring of students regularly, monitor risky children more frequently, provide training and consultancy for students and parents regarding balanced diets and physical activity, and provide the school-family cooperation.
Evaluation of the oral dental health status of the Romani community in Turkey
Authors: KOÇAK Elif , ALKAYA Bahar
Published: July 2021

Purpose: This study was conducted to determine the oral and dental health levels of individuals of a specific ethnic origin (Romani) living in Turkey and investigate its effects on quality of life.

Materials and Methods: The study was carried out in Adana (Yüreğir) between October 2018 and July 2019. Data were collected from 183 Romani individuals using face-to-face interview technique, an introductory information form, a form evaluating oral hygiene habits, and the Oral Health Impact Profile (OHIP) -14 scale. The number of dental caries, the number of missing teeth, and periodontal health levels, halitosis, and toothbrushing habits were evaluated by performing intraoral examinations of the participants.

Results: The OHIP-14 score of the individuals participating in the study showed a statistically significant change according to the number of missing teeth, the number of dental caries teeth, and brushing habits. Accordingly, the OHIP-14 score was observed higher in individuals with extracted teeth and decay in teeth. No statistically significant correlation was found between periodontal parameters and OHIP-14 scores.

Conclusion: Within the limitation of the study; It is thought that oral-dental health knowledge levels and oral hygiene habits should be increased in Romani individuals.
Estilos de aprendizaje en educación superior: lecturas desde un programa de ciencias empresariales en una universidad pública
Authors: Avendaño-Castro William Rodrigo , Luna-Pereira Henry Orlando , Gamboa-Suárez Audin Aloiso
Published: July 2021

El presente artículo muestra los resultados de un estudio que pretendió analizar las diferencias en los estilos de aprendizaje entre estudiantes de programas de Ciencias Empresariales de jornada diurna y nocturna de una universidad pública. Para ello, se empleó un estudio cuantitativo no experimental-transversal de nivel descriptivo y diseño de campo. Se aplicó el cuestionario de Honey-Alonso sobre Estilos de Aprendizaje (CHAEA) a una muestra de 129 sujetos. Los resultados evidencian una inclinación moderada en los estilos teórico, activo y pragmático en ambos grupos y una no preferencia por el estilo reflexivo.
Características de los ambientes de aprendizaje enriquecidos con TIC para la comprensión lectora en el ciclo de la Educación Básica
Authors: Pérez-Benítez Wilman E. , Ricardo Barreto Carmen Tulia
Published: July 2021

Los bajos resultados de los estudiantes de educación básica en Lenguaje en las pruebas nacionales e internacionales, sus consecuencias negativas en la movilidad y permanencia en la educación superior y en el desarrollo socioeconómico regional, demandan que desde las escuelas se implementen estrategias para fortalecer la comprensión lectora con apoyo de las TIC. El objetivo del artículo es indagar sobre las características de los ambientes de aprendizaje que integran las TIC para favorecer la comprensión lectora y el papel que deben jugar los docentes en su implementación. Se consultaron bases de datos, libros y documentos digitales con los criterios: comprensión lectora, integración de la TIC, y ambientes de aprendizaje, y los términos: lectura crítica, tecnologías digitales, entornos de aprendizaje, en inglés y en español, entre 2014 y 2021, de los cuales se analizaron 72 que cumplieron con el propósito de la revisión y 31 parcialmente. Se concluye con la identificación de los recursos TIC que se integran a los procesos pedagógicos para favorecer la comprensión lectora, las características del entorno que se pueden incorporar en el diseño de los ambientes de aprendizaje y los roles que debe asumir el docente para su implementación en el ciclo de la educación media.
Significance of Epigenetics in Sars-CoV-2 Infection and Proposed Epi-Drugs for Covid-19
Authors: Chaturvedi Pragya , Singh Sudhanshu
Published: July 2021

We frequently come in contact with animal viruses through the food which we eat, the pets which we have, and our connections with nature. The enormous majority of viruses which enter our bodies pass inoffensively through our physiological systems or eradicate by our immune systems. However, on rare circumstances, a human-encounters by a virus which begins to replicate itself, accomplishing its entire lifecycle within human cells and intensifying themselves into a large number. Replication of an animal virus inside the human body is the key instant in the zoonotic process. SARS CoV-2 is one of these viruses which cause COVID-19 disease. To enter the target cell SARS-CoV-2 uses angiotensinconverting enzyme 2 (ACE2) and the cellular protease transmembrane protease serine 2 (TMPRSS2). Genome stability and maintenance of cellular equilibrium are the main parameters influenced by epigenetically regulated chromatin structure. Implication of regulation by epigenetic machinery has also been found in the physiopathology of the virus infection. By varying the function of gene locus. such regulation links genotype and phenotype without changing the original DNA sequences. However antiviral drugs have been used to treat various viral diseases since long, epi-drugs are now proposed to treat these diseases due to the epigenetic implications found in these infections. Epi-drugs are small agents that are able to reverse some epigenetic changes. This review is aimed to find implication of epigenetics in infection caused due SARS C0V-2 and if there is any epi-drugs approach possible to treat this infection.
An analysis of the risks of COVID-19 exposure to hospital employees at a private hospital in Yogyakarta, Indonesia
Authors: Khairunnisa Qanita , Rosa Elsye Maria , Pribadi Firman , Ulfa Maria
Published: July 2021

Background: The healthcare workers provide the services to reduce morbidity and mortality rates. However, they are also exposed directly to the patients. WHO reports that 88% of health workers were infected with COVID-19 while working in hospitals, and 17% got exposure from communities. This study analyzes the overview of risk exposure to COVID-19 and risk factors of COVID-19 exposure to hospital employees at a private hospital in Yogyakarta during the COVID-19 pandemic.Methods: This study employs a quantitative approach with a cross-sectional design study. The data collecting is using an online questionnaire to assess the risk of COVID-19 exposure toward healthcare workers. Results: From 101 employees who participated to be the respondent, 13 employees had been diagnosed with COVID-19 during work in the COVID-19 pandemic. There was a significant difference between IPC compliance with the incidence of COVID-19 (p=0.046). Meanwhile, there were no significant differences between comorbidity (p=0.205) and duration of work (p=0.125) with the incidence number of COVID-19. Based on the ANOVA analysis, there was no significant difference between; IPC compliance, comorbidity, and duration of work with the incidence number of COVID-19 (p=0.092). Conclusion: The risk of healthcare workers exposed to COVID-19 could be through various factors within and outside the hospital. Compliance with IPC, comorbidities, and duration of work only affect as much as 6.4% of the incidence of COVID-19 among hospital employees.
Satisfaction with teaching and learning quality among undergraduate pharmacy students in a Nigerian university
Authors: Onah Paul Otor , Abdulateef Siyaka , Abdulmalik Ahmed
Published: July 2021

Background: There is increasing acceptance that learning environment has significant impact on academic performance. Learning and teaching experiences influence satisfaction and perception of quality. Pharmacy education in Nigeria is evolving rapidly with new emphasis on acquisition of cognitive skills that upon graduation students can effectively implement pharmaceutical care. The evaluation of satisfaction can be used as a measure of quality and feedback system of teaching and learning experiences of students. The purpose of this study is to assess satisfaction with teaching and learning and their determinants.Methods: This was a cross sectional survey study involving third to fifth year pharmacy students. The educational service quality instrument was used to elicit response on items related to satisfaction. The 37-item questionnaire was administered on consenting students to elicit responses on a five-point Likert scale. The data was analyzed using descriptive statistics and one way ANOVA with post Hoc test. Factor analysis using principal component analysis and varimax rotation was used to identify items that have the most impact on satisfaction. P≤0.05 was considered statistically significantResults: Majority of students have less than average satisfaction across six domains of the instrument, though significant differences exist between lower and higher-level students in areas of administration and expertise (p<0.01). Several studies reported contrasting results some of which have comparable results with this study. Satisfaction and its determinants vary widely so emphasis should be in areas that produce the greatest impact on academic performanceConclusions: Satisfaction with quality of learning is generally low and there is need for institutions leadership to improve learning environment for students.
Assessment of the iliolumbar artery: its structural variations and applied aspect
Authors: Upadhayay Parul , Hansdak Ranjeeta , Agarwal Sneh
Published: July 2021

Background: The Iliolumbar artery normally arises from the posterior division of Internal iliac artery. The main artery and its two branches supply the iliacus and lumbar region and other vital structures in that area. However, various studies conducted depict the differences in the pattern of its origin and course. Thus, the goal of this study was to discover the various origins of the iliolumbar artery, as well as its relationships with other surgically significant anatomical structures; the importance of which can prevent any intraoperative hemorrhages during surgery.Methods: The study was conducted in Department of Anatomy Lady Hardinge Medical College between 2019-2021. Pelvis of 12 formalin fixed adult cadavers (8 females, 4 males) were dissected to observe the iliolumbar artery. Its origin, caliber and course were measured using a digital vernier caliper. The relationship of iliolumbar artery was established with obturator nerve, lumbosacral trunk and sympathetic chain.Results: Iliolumbar artery was originating from trunk of internal iliac artery in 70.83% cases in which the mean distance of origin and mean caliber was more on right side. In the remaining 29.17% cases where the Iliolumbar artery was arising from posterior division of internal iliac artery, the mean distance of origin and mean caliber was higher on left side. The truncal origin of iliolumbar artery was predominant in females.Conclusions: The variant origin of the iliolumbar artery and its clinic-anatomical relationships have been highlighted to reduce iatrogenic artery trauma during surgery.
A clinico-haematological study of hereditary hemoglobinopathies: a tertiary care centre experience
Authors: Atla Bhagyalakshmi , Botta Venkata Satya Kartheek , Balakrishnan Padmapriya , Lalam Neelima , Argi Anuradha , Natukula Kirmani
Published: July 2021

Background: Hemoglobinopathies are the cause of concern in India for not only its effect on the quality of life in patients but also for their inheritance patterns. Tribal population of Visakhapatnam district has a high chance of inheriting hemoglobinopathies due to their culture of consanguineous marriage. Aim and objectives of current study were to know the distribution of various abnormal haemoglobins in cases with clinical suspicion of hemoglobinopathies.Methods: This hospital-based observational study was conducted for a period of 10 months in the department of pathology, Andhra Medical College, Visakhapatnam. A total of 151 cases with suspected hemoglobinopathies, their parents, and siblings were screened for the presence of hemoglobinopathies. 3ml of venous blood was collected to perform complete blood count, peripheral smear, reticulocyte count, sickling test and High Performance liquid chromatography (HPLC).Results: In the present study, out of 151 cases, 55 cases (36.42%) were adults, and 96 cases (63.57%) cases were children. 67cases (44.37%) were asymptomatic and 84 (55.62%) were symptomatic. The most common symptom of subjects are fever (23 cases, 27.38%) and dyspnoea (22 cases, 26.19%). 85 cases (56.29%) had normal HPLC, and 66 cases (43.70%) had abnormal hemoglobin variants. The most common hemoglobinopathy detected by HPLC was sickle cell trait (36 cases, 23.84%) followed by homozygous sickle cell anemia 15 (9.93%). Other hemoglobinopathies detected were beta-thalassemia trait; 8 cases (5.29%) and compound heterozygous sickle beta-thalassemia 3 cases (1.98%).Conclusions: Endemic areas for hemoglobinopathies has to be screened with HPLC along with complete hemogram in suspicious cases for the better diagnosis and management of the condition.
Prevalence of ABO-Rh positive blood groups in relation to hypertension and type 2 diabetes mellitus among the male urban population of Deoghar, Jharkhand: a cross sectional study
Authors: Gogoi Heemanshu Shekhar , Shankar Om , Dhenwal Mukul
Published: July 2021

Background: Hypertension is the subsequent elevation of the systemic arterial pressure to a level that places the patients at increased risk for target organ damage. Type 2 diabetes mellitus is characterised by the common phenotype of hyperglycemia due to genetic and metabolic defects in insulin action and/or secretion.Methods: This study was performed to evaluate the prevalence of ABO-Rh positive blood groups among the male hypertensive and type 2 diabetic urban population of Deoghar. It was a cross-sectional population based study. 356 hypertensive and 425 type 2 diabetic male subjects were selected based on inclusion and exclusion criteria. Their basal blood pressures were determined using palpatory and auscultatory method. The random blood glucose levels of the subjects were estimated and their blood groups were also determined using slide haemagglutination technique.Results: Among the hypertensive subjects ‘O’ Rh positive was the most prevalent (41%), followed by ‘B’ Rh positive (34%), ‘A’ Rh positive (17%) and lastly ‘AB’ Rh positive blood group (8%). Again, among the type 2 diabetic subjects ‘B’ Rh positive was most prevalent (45%), followed by ‘O’ Rh positive (36%), ‘A’ Rh positive (12%) and finally ‘AB’ Rh positive blood group (7%).Conclusions: This study concludes that ‘B’ Rh positive and ‘O’ Rh positive blood groups are more prevalent as compared to other ABO-Rh positive blood groups among the male hypertensive and type 2 diabetic urban population of Deoghar. Thus, the persons belonging to these two blood groups should take adequate precautions since their childhood against these co-morbidities as they are more prone to develop them.
A clinico-epidemiological profile of Parkinson’s disease patients attending the tertiary care hospital of hilly state of North India: a hospital based cross-sectional study
Authors: Bamon Amethyst , Raina Rajiv , Sharma Sudhir , Chauhan Nidhi
Published: July 2021

Background: Parkinson's disease (PD) is a neurodegenerative disorder, with male preponderance. It is associated with both motor and non-motor symptoms, which affect quality of life in elderly people. Due to paucity of studies on its epidemiology and prevalence, this disease needs assiduity and further exploration.Methods: A hospital based cross-sectional study was conducted in the tertiary care hospital, among 45 patients diagnosed with PD.Results: The mean age of the participants was 61.17±12.30 years, with male to female ratio was 2:1. The average age of onset of PD was 57.4±12.30 years. Tremor was the most common initial symptom (68.88%) followed by rigidity (20%) and bradykinesia. Most of the patients (86.66%) had progressive symptoms, and 69% had unilateral involvement of limbs.Conclusions: The profile of patients with PD in Himachal Pradesh is similar to that from other populations in India and other developing countries. However, the dearth of studies and data pertaining to PD, invigorate the need to explore this neurodegenerative disorder to comprehend its clinic-epidemiological profile in our state.
Evaluation of post-operative complications associated with tobacco use in thoracic surgery patients
Authors: Degirmenci Mehmet , Kus Celal
Published: July 2021

Background: Tobacco can make thoracic diseases more complicated by affecting their respiratory functions. Smoking causes many diseases that require surgical treatment and affects surgical results. The aim of the study was to determine the relationship between tobacco use and post-operative complications in thoracic surgery patients and contribute to public health.Methods: In this study, 754 patients were evaluated retrospectively. Patient characteristics and tobacco use habits of the patients were determined. Postoperative complications, admission to the intensive therapy unit, intubation, death, and length of stay in hospital were defined as surgical outcomes. These results were compared and analyzed with tobacco use.Results: The patients consisted of 536 (71.1%) men and 218 (28.9%) women. Tobacco use was more common in men (X2=223.216, p<0.001) and younger ages (X2=45.342, p<0.001). Complications occurred in 96 patients, 76 (79.2%) of whom used tobacco. Tobacco use (p<0.001, OR=3.547), ASA score (p=0.029, OR=2.004), major surgeries (p<0.001, OR=4.458), and minimally invasive surgeries (p=0.027, OR=2.323) are associated with complications. Length of hospital stay is related to the amount of tobacco (p<0.001, OR=3.706), size of surgery (p<0.001, OR=14.797), over 65 years (p<0.001, OR=2.635), and infectious diseases (p=0.039, OR=1.939).Conclusions: Tobacco use is related to poor outcomes in thoracic surgery patients, and it is a severe health problem, especially at young ages. Tobacco control programs should be supported to prevent the effects of tobacco use on thoracic diseases and postoperative complications.
Management of solid organ injury in patient of blunt abdominal trauma
Authors: Baldiwala Aafrin S. , Lad Vipul C.
Published: July 2021

Background: In this ongoing era of 21st century, trauma is the leading cause of death in individuals between age 1 and 44. In trauma, also road traffic accidents (RTAs) are the major cause of death. Blunt abdominal trauma is a frequent emergency and is associated with significant morbidity and mortality.Methods: A prospective analysis of 50 patients of blunt abdominal trauma admitted in SMIMER hospital Surat within a span of 12 months was done. Unstable patients with initial resuscitation underwent focused assessment sonography for trauma (FAST). Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen.Results: Most of the patients in our study were in the age group of 21-45 years with M:F ratio of 4:1. RTAs (62%) was the most common mechanism of injury. Spleen (38%) was the commonest organ injured and the most common surgery performed was splenectomy. In total non-operative management (NOM) was done in 58% of cases and surgical management was done in 42% of cases.Conclusions: Appropriate patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in management of blunt abdominal trauma. To conclude, initial resuscitation measures and correct diagnosis forms the most vital part of blunt abdominal trauma management.
Comparison of anterior and posterior surgical approaches in multi-level cervical spondylotic myelopathy
Authors: Balakrishnan Paruvakkattil Kunjan , Abraham Tinu R. , John Ajax
Published: July 2021

Background: Cervical spondylotic myelopathy (CSM) is one of the most common dysfunctions of spinal cord which occurs due to degenerative changes in cervical spine disc and facet joints. The management of multilevel spondylotic myelopathy is always controversial. The posterior approaches are always preferable in multiple level spondylosis. But according to newer studies, anterior approaches have similar results. Aim of the study was to compare the efficacy of posterior and anterior approaches in multilevel cervical myelopathy.Methods: This study includes all patients with multilevel cervical spondylotic myelopathy who have undergone decompression surgery with fusion. Detailed preoperative and post-operative assessment was done according to modified Japanese Orthopedic Association scoring system.Results: Eighty eight patients of CSM surgical cases were selected for this study and 29 cases of multi-level CSM were observed. And they were randomly selected for anterior and posterior approaches. Sixteen cases anterior approach was done either ACDF or Corpectomy with fusion. Mean age of study was 51.63 years with 64 males and 24 females. The spinal cord level at which most surgeries did was C5/6, 62 cases. While at level C4/5, it was 49 and at level C3/4 and C6/7, it was 35 and 36 respectively.Conclusions: Both anterior approach and posterior approaches were associated with betterment in postoperative neurological function for multilevel CSM. And there is no significant advantage in doing anterior approach in multilevel CSM.
Extra-pelvic endometriosis presenting as recurrent hepatic cyst: case report and literature review
Authors: Mushtaq Ruqia , Ameer Aqsa , Hanif Muhammad , Rauf Fatima
Published: July 2021

Hepatic endometriosis is a very rare form of endometriosis first described by Rokitansky in 1986. To our knowledge, 42 cases of hepatic endometriosis have been reported in the literature till date. The condition offers a diagnostic challenge owing to its variable presentation on imaging and the need for histological and immunohistochemical evidence for a definite diagnosis. We hereby present the 43rd case of ectopic endometrium in the liver of a 30 years old, multiparous female who presented with fever and pain in the right hypochondrium. Radiological imaging suggested a cystic lesion which was managed laparoscopically. Histopathology and immunohistochemistry findings came out to be consistent with endometriosis. The case highlighted the importance of considering endometriosis as a differential in all women irrespective of age and previous history of endometriosis.
Post road traffic accident one-month old, extra-large heel defect coverage by delayed reverse sural artery flap: an interesting case report
Authors: Gupta Madhusoodan , Varshney Deepti , Biswkarma Vishal K.
Published: July 2021

Post road traffic accident (RTA) complete heel avulsion injury is not very common, but once it happened, it is very challenging to plastic and reconstructive surgeon to reconstruct the total heal avulsion defect. There is paucity of soft tissue in the region of foot, ankle and lower one third of leg. Although the micro vascular free flap reconstruction is gold standard for reconstruction of large heel defect but not feasible most of the time. Reverse sural artery flap (RSAF) is a workhorse flap for reconstruction of heel and lower 1/3rd leg defect. Here we reported a case of 28 years old young man, who had road traffic accident and sustained complete right heel avulsion injury with calcaneal and right tibia bone fracture. Patient was presented to author one month later after the injury with extra-large infective right heel defect size 15×12 cm with k-wires in exposed calcaneal bone. Patient’s surgery was done in two stages. Delayed RSAF survived completely and well settled in our case.
Adenocarcinoma ileum: a rare cause of ileal stricture mimicking intestinal tuberculosis: a case report and literature review
Authors: Aggarwal Manisha , Manchikanti Dinesh , Kundaikar Janitta , Thomas Shaji , Arsia Ashish , Pusuluri Rahul , Meena Kusum , Kumar Sanjay
Published: July 2021

One of the commonest causes of small intestinal obstruction in India is tuberculosis. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement, and the most common abnormality is short-segment strictures. We report a patient who presented with small intestinal obstruction due to a solitary ileal stricture, but turned out to be a rare condition that can mimic intestinal tuberculosis. A 60-years-old man, with recurrent episodes of pain abdomen for 1 year, presented to our surgical emergency with evidence of small intestinal obstruction. A CT scan revealed a short segment stricture (2.7 cm) in mid ileal loop with luminal narrowing and marked proximal dilation of proximal ileal loops with a few sub centimetric mesenteric lymph nodes. On laparotomy with a suspected diagnosis of intestinal tuberculosis, it turned to be an adenocarcinoma of the ileum- a rare condition that can mimic intestinal tuberculosis. One of the commonest causes of small intestinal obstruction in India is abdominal tuberculosis. However, all cases of small intestinal obstruction are not tuberculosis. Adenocarcinoma of ileum is a very rare entity. This case report shows that a surgeon should have a high index of suspicion in an elderly patient presenting with small intestinal obstruction, with CT demonstrating isolated short-segment small bowel thickening, as it could be a presentation of obstructing type adenocarcinoma of the small intestine.
Crohn’s disease triggering ileoileal intussusception in an adult
Authors: Gnanadev Praveen , . Mukund , Taluru Hariprasad Ramachandra Naidu , Krishnappa Rohit , Hiremath Vinayak , Damodaran Geethu , . Suhas
Published: July 2021

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (intussusceptum) into an immediately adjacent distal bowel (intussuscipiens), causing venous congestion, edema, and blood supply reduction. Adult intussusception is a rare entity which can be with or without lead-point. Cases without lead-point frequently occurs in children or adults with celiac disease and Crohn’s disease and with lead point is caused by an underlying neoplasm, benign or malignant frequently presenting with bowel obstruction and acute abdomen. A 41-years-old male presented to our outpatient clinic with a history of recurrent abdominal pain. The clinical presentation and CT scan findings led to the diagnosis of ileoileal intussusception. Subsequently he underwent laparotomy which revealed an ileal intussusception, which was investigated and was found to be of Crohn’s etiology.
Splenic abscess presenting as a case of pneumoperitoneum: a rare presentation
Authors: Raju T. R. S. Prudhvi , Paruthy Shivani B. , Mohan Sajith K. , Wani Dawood I. , Bajwa Jaspreet S. , Anand Arun , Singh Kashinath , Das Anirban , Siwach Rajguru
Published: July 2021

Pneumoperitoneum is more pathognomonic of ruptured hollow viscera which requires urgent surgical intervention. But uncommon surgical entities may present with pneumoperitoneum. Splenic abscess is a relatively rare medical condition that results from bacteraemia. Pneumoperitoneum in a ruptured splenic abscess is very uncommon and is often misdiagnosed as a perforation. Spontaneous rupture of splenic abscess is a life-threatening emergency mandating early surgical intervention. We report a case of ruptured splenic abscess which presented with peritonitis and pneumoperitoneum, managed successfully by splenectomy.
Counselling-in-continuum-modern solution to ‘Google’ patients?
Authors: Bahl Ina , Khanna Sanat Kumar
Published: July 2021

Aim of the study was to highlight the benefits, barriers and methodology pertaining to effective patient counselling. The modern-day patient is well informed and well aware of patient rights. The need of the hour is to implement management plans jointly agreed upon based on both scientific evidence and patient preference by proper patient counselling. The process of counselling represents a well-founded intervention made of a quality interaction between the counsellor and the patient. Effective communication is advantageous for both healthcare professionals in the form of a comprehensive medico legal document, as well as for the patient as it tends to allay fear of treatment, dissipate misconceptions garnered from half-baked knowledge off the internet, cementing a bond of trust between the two. Counselling forms should carry information pertaining to the details regarding the patient’s disease, treatment options, pros and cons with aids in the form of pictures, models and videos. Ample time should be spent on the patient’s doubts, without the use of medical jargons. Barriers to effective communication include physical, psychological, administrative or time conflicts. Upliftment from the quick sands of barriers to patient communication requires the introduction of a curriculum laying emphasis on sound communication skills right from the undergraduate stage. Furthermore, internet can be used to aid counselling in the form of legit informative portals wherein patients are able to gather correct information about their disease and prognosis as is the case with online healthcare communities.
Manejo sostenible del suelo y el agua en los sistemas productivos de papa de Cundinamarca y Boyacá
Authors: Quintero Murillo Carlos
Published: July 2021

En julio de 2010, el programa de Ingeniería Ambiental de la Universidad El Bosque y la empresa Syngenta S.A. formalizaron un convenio para adelantar un proyecto de recuperación y conservación de tierras erosionadas en varios cultivos de papa de quince municipios de Cundinamarca y Boyacá. En el siguiente texto el profesor Carlos Quintero Murillo, el investigador que está a la cabeza de este proyecto, se refiere a algunos antecedentes del mismo, a los propósitos que lo guían y a los resultados obtenidos hasta ahora.
La industria discográfica en la era digital
Authors: Arango Archila Fabián
Published: July 2021

Con la masificación de internet y el extraordinario crecimiento de portales musicales como Youtube, Spotify o Deezer, la casas disqueras se enfrentan hoy a la mayor crisis de su historia, pues, ante la caída de sus ventas, se han visto obligadas a reconsiderar los viejos formatos de distribución de sus productos (el disco de vinilo, el disco compacto, el DVD, etc.). En el siguiente artículo el profesor Fabián Eduardo Arango reflexiona sobre los retos y las posibilidades que esta situación inédita le plantea a la industria musical.
La Universidad y la biología han sido mi proyecto de vida
Authors: Santafé Millán Clara
Published: July 2021

Hojas de El Bosque habló con Clara Santafé Millán, directora y fundadora del Programa de Biología de la Universidad El Bosque, acerca de los logros que ha tenido dicho programa, el cual, con tan sólo catorce años de creación, se ha consolidado como uno de los más innovadores del país.
Mitigating Sodinokibi Ransomware Attack on Cloud Network Using Software-Defined Networking (SDN)
Authors: Umar Rusydi , Riadi Imam , Kusuma Ridho Surya
Published: July 2021

Sodinokibi Ransomware virus becomes a severe threat by targeting data encryption on a server, and this virus infection continues to spread to encrypt data on other computers. This study aims to mitigate by experiment with building a prevention system through computer network management. The mitigation process is carried out through static, dynamic, and Software-Defined Networking (SDN) analysis to prevent the impact of attacks through programmatic network management. SDN consists of two main components in its implementation, the Ryu controller and Open Virtual Switch (OVS). Result testing mitigation system on infected networks by crippling TCP internet protocol access can reduce virus spread by 17.13% and suppress Sodinokibi traffic logs by up to 73.97%. Based on the percentage data, SDN-based mitigation in this study is per the objectives to make it possible to mitigate Ransomware attacks on computer network traffic.
Could Primary Tumor Resection Improve Survival in Metastatic Breast Cancer?
Authors: Aparecida Dias de Oliveira Rafaela , Aparecida Dias de Oliveira Lyvia , Davoli Abella Goulart Marília , Faustino Linhares Maria Clara
Published: July 2021

Introduction: In advanced breast cancer, local treatment is considered palliative. However, although there are some polemic opinions about the surgical treatment, some of the latest studies have emphasized that in advanced cases primary tumor resection (PTR) is related to better outcomes. This review aims to evaluate how resection of the original tumor impacts women with metastatic breast cancer, considering the most recent studies about this subject. Methods: The search was performed in MEDLINE, Scopus, PMC, Current Contents and Wiley Online Library databases; 23 articles - from 2016 to 2019 - were selected and 11 were included in this review. As inclusion criteria were considered: studies presenting outcomes about resection of the primary tumor, comparison between chemotherapy/ hormone therapy/ targeted cancer therapies and surgical intervention, studies published from 2016 to 2019 and available in English, Spanish or Portuguese. We excluded those which did not approach PTR, did not present outcomes of interest (progression-free survival comparison between PTR and systemic therapy) or only discussed systemic therapy, as well as those published before 2016. Results: It was reported in 6 studies that progression-free survival is better on those who underwent surgery. PTR was also related to longer median overall survival in women submitted to surgery, up to 16 months higher when compared to the ones who were not. Enhanced survival even pertained to surgical groups regardless of tumor size.  Conclusion: Based in the analysis, PTR in metastatic breast cancer can be related to higher overall survival.