bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural Mechanisms of Mindful Disengagement from Worry
Authors: Westbrook Ceci , Dutcher Janine , Kusmierski Susan , Creswell J. David , Akpan Essang , Hallion Lauren S.
Published: May 2022

Uncontrollable worry is a hallmark of generalized anxiety disorder and a transdiagnostic feature of psychopathology. Mindfulness-based strategies show promise for treating worry, but neural mechanisms of mindful disengagement remain incompletely characterized. We recruited 40 participants with clinically significant worry to undergo fMRI while engaging in real-time, idiographic worry and instructed disengagement using two mindfulness strategies (focused attention; acceptance) and one comparison strategy (suppression). Hypotheses were preregistered and partially supported. All disengagement strategies downregulated default mode and upregulated frontoparietal and salience networks. Focused attention was most effective for promoting disengagement and elicited decreased activity in cognitive control and sensorimotor regions. Successful disengagement was associated with increased activity in rostrolateral prefrontal cortex and functional connectivity between posterior cingulate and primary somatosensory cortex. Findings support the role of cognitive control and somatosensory networks in disengagement from worry and suggest common and distinct mechanisms of disengagement, with focused attention a particularly promising strategy.
The hidden methodological implications of working memory and math anxiety: A review
Authors: Baxendale Alex , Roberts-Tyler Emily , Mari-Beffa Palome
Published: May 2022

Math anxiety impacts millions of lives on a daily basis which results in reduced STEM outputs throughout society. Research into the anxiety is often conflicted and fails to truly acknowledge methodological impact which contributes sizeable errors in data interpretation that has already infiltrated the literature. This review collates and describe trends in math anxiety research to discuss the damaging implications of methodological choice, with results exploring increased math anxiety in females but without performance deficits, and the lack of attention to adolescent and the elderly populations. Most importantly results demonstrate a striking difference in reports of impaired working memory depending on the task used, which serves as the basis for a number of conflicting arguments occurring within the field. Overall this review provides a concise overview of the literature and presents several suggestions for the improvement of future research.
Governance, Democracy and Inclusion in the Perspective of Nepal
Authors: Rai Parbat Kumar
Published: May 2022

Proportional representation is more effective in terms of inclusive governance. The constitution of Nepal, adopted in 2015, has largely implemented it. Quotas are reserved in different sector of the state. Despite this, various factions within Nepali society are still in movement in different form. There are two genuine questions in this context. Are the constitutional provisions appropriate? What are the challenges in the paths of inclusive governance? The objectives of this paper are to examine Nepal’s existing practices of inclusion in the governing process, and the challenges of inclusive democracy from a Nepali perspective. The descriptive research design was adopted in this paper. Secondary sources were used to acquire the information. In addition, the KSL comprehensive guideline was followed to prepare this paper. The conclusion of this paper is that the country faces numerous challenges in implementing inclusive governance, like the movement of concerning republicanism, secularism, federalism and inclusion. Nevertheless, federalism, republicanism, secularism and inclusions are crucial requirements for sustainable peace. Obviously, the PR model of representation in each state organ ensures that all sections are represented.
Theme: Geopolitical Turbulence in South Asian Politics: What Nepal can learn from Afghanistan Crisis?
Authors: Tripathi Dhananjay , Adhikari Khaganath , Tao Li , Ghufran Nasreen
Published: May 2022

No Abstract available.
Cadaver as the first silent medical teacher: Exploring bioethical perceptions of department of anatomy
Authors: Surajit Kundu  , Anil R Sherke  , Richa Gurudiwan
Published: May 2022

Background: Department of Anatomy with its time honored and integral essence, human cadaveric dissection has been trying to serve the medical profession since the inception of medicine. Every human cadaver who goes under the knife of medical student during anatomical dissection deserves special treatment and utmost respect. But unfortunately, probably the hidden curriculum of bioethical sentiments of the body donor and the human cadaver have been noted to become extinct from medical profession, until recently with the introduction of the new competency based medical education in India.
Aims and Objectives: The present study attempts to dig out the noble practices followed in various medical schools to ensure the human cadaver gets the rightful respect and dignity. Our literature review reflects the practice of students’ conduct and habits on the 1st day of dissection. We emphasize guidelines that may be sincerely recommended to medical schools to ensure respectful humanity and honor towards the human cadavers.
Materials and Methods: The psycho-social attitudes of MBBS students has been attempted to learn by distributing questionnaire to the 2019 batch MBBS students (n=60) of Late Shri Lakhiram Agrawal Memorial Government Medical College Raigarh (CG) during the foundation course (first 1 month of 1st year curriculum) and on their first encounter with the cadaver.
Results: About 95.4% and 57.5% of students showed positive and negative perceptions. The religious beliefs and emotional attachments with the cadaver were noted to be as 23.33% and 76.11%, respectively. The sentiments included cognitive, affective, moral, and behavioral.
Conclusion: The article attempts to focus the noble endeavor of the Cadaver as the first silent medical teacher who wishes to enlighten the pure minds of medical students with knowledge and empathy to be shown towards the patients. Based on the emotional observations made from the medical students on their first encounter with the cadaver, the present study anastomoses science and humanity with care, compassion, and dignity.
Nasal basal cell carcinoma in xeroderma pigmentosum - diagnosis, workup, management, and reconstruction
Authors: Sanket D Vakharia  , Parag Watve  , Gautam Purohit
Published: May 2022

Xeroderma pigmentosum (XP) is genetic autosomal recessive disorder with photosensitivity on exposure to sun and also presents with various malignancies such as squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. A 22-year-old female visited our outpatient clinic with 18 months history of pigmented nodule on her nose. She was diagnosed with XP since she was 2 years old. Physical examination revealed a waxy, blackish-brown nodule on her nose. Incisional biopsy was performed. The histological findings revealed multiple, palisaded basophilic tumor masses surrounded by prominent infiltrating lymphocytes confirming our clinical diagnosis. She was advised sun protection with the use of protective clothing and glasses. XP leads to chances of various malignancies. Early diagnosis, proper clinical examination, histopathological examination for the diagnosis of condition is must to come to proper diagnosis. Instructions to the patients to take proper protection from sun and wearing protective clothing must be given.
Assessment of carcinoembryonic antigen as a prognostic marker in ovarian malignancies treated in a rural hospital of West Bengal
Authors: Chakrabarti Phalguni , Layek Krishnendu , Bandyopadhyay Debasmita , Chakraborty Sanghamitra , Hasan Ayesha , Sarkar Pinaki
Published: May 2022

Background: Ovarian neoplasms are the second most common cause of gynecological malignancy both worldwide as well as in India. Innocuous clinical presentation and late diagnosis contribute to the mortality toll of this neoplasm. Thus, early diagnosis remains the cornerstone to increase the survival rate of ovarian neoplasms. Though, cancer antigen 125 (CA-125) is a time-tested marker for ovarian neoplasm diagnosis yet its increment in benign gynecological conditions questions its own diagnostic specificity. Carcinoembryonic antigen (CEA), the conventional marker for colorectal cancer detection, is found to be associated with epithelial ovarian cancer.
Aims and Objectives: This study was aimed to find the efficacy of CEA along with CA-125 in the early detection of ovarian neoplasm and predicting the outcome.
Materials and Methods: This hospital-based longitudinal study was conducted in the Biochemistry department of Bankura Sammilani Medical College. Established cases of ovarian neoplasm were recruited as study population using pre-defined inclusion and exclusion criteria. Serum CEA and CA-125 were estimated at the time of diagnosis, 6 weeks, 6 months, and 12 months after surgery.
Results: There was no significant difference between the median concentration of CEA among the four phases of treatment. Serum CEA was positively correlated to CA-125 during all phases of treatment (Ρ=0.653, P=0.000). The binary logistic regression revealed that CEA (odds ratio=1.2, 0.83–1.69) had higher chances to be associated with ovarian stages associated with cancers beyond Stage IC. CEA had a lower sensitivity and specificity in comparison to CA-125.
Conclusion: This study suggested CEA, a theranostic marker, can supplement the present biochemical diagnostic modalities to improve diagnostic and prognostic efficacy cost-effectively.
Comparison of clinical efficacy of intrathecal ropivacaine versus ropivacaine with dexmedetomidine in patient posted for infraumbilical surgeries under spinal anesthesia
Authors: Yadav Isha , Aggarwal Ankita , Lakhanpal Mahima , Nirvan Himanshu
Published: May 2022

Background: Data related to clinical efficacy of intrathecal dexmedetomidine as an adjuvant to isobaric ropivacaine in spinal anesthesia were found to be inadequate, but the efficacy of newer molecules as an adjuvant is investigated constantly. Considering the favorable profile of dexmedetomidine, it could have a potential role as an adjuvant to ropivacaine.
Aims and Objectives: The aim of the study was to evaluate the benefits of adding intrathecal dexmedetomidine as an adjunctive along with ropivacaine. The aim of the study was to assess and compare the safety and efficacy, post-operative analgesia, complications, duration of analgesia, and time of rescue analgesia for intrathecal ropivacaine versus a combination of intrathecal ropivacaine with dexmedetomidine.
Materials and Methods: An observational study was carried out in 80 patients of either sex between 25 and 60 years of age, ASA Grade 1 and 2, undergoing elective abdominal, and lower limb surgeries. Subjects selected as per set inclusion/exclusion criteria and divided into two groups for spinal anesthesia. Group A: 3 ml of intrathecal 0.75% isobaric ropivacaine with 0.5 ml of normal saline. Group B: 3 ml of intrathecal 0.75% isobaric ropivacaine with 5 mcg preservative free dexmedetomidine in 0.5 ml of normal saline. Vital parameters were noted at 0 min, 1 min, 2 min, 5 min, 10 min, and thereafter every 15 min, till the surgery continued. Onset and the time for maximum sensory blockade were assessed and VAS scoring was done every 10 min till 30 min and thereafter every 15 min. The duration of effective analgesia was recorded along with the duration of sensory regression to S1, and time for administration of rescue analgesia was noted.
Results: The combination of ropivacaine with dexmedetomidine was statistically found to be efficacious when compared to ropivacaine alone, as evidenced by statistically significant differences (P<0.05) in VAS scores at 80, 180, and 360 min and duration of regression to S1 level. The differences in time for rescue analgesia were also statistically significant (P<0.05), further proving the advantage for longer lasting analgesia without any additional adverse effects.
Conclusion: 5 mcg dexmedetomidine is an attractive alternative as an adjuvant to spinal ropivacaine in surgical procedures, as opposed to ropivacaine alone, without any additional adverse effects.
A prospective, randomized clinical study for evaluation of pregabalin for post-operative analgesia in infraumbilical surgeries
Authors: Bhalavi Mona , Uikey Kishore , Bhalavi Seema , Tripathi Sonali
Published: May 2022

Background: Preemptive analgesia is about the administration of an analgesic agent before the initiation of noxious stimulus, aiming of preventing sensitization of the neural system to successive stimulus that could intensify pain perception. Pregabalin is derivative of gabapentinoid which exhibits analgesic properties.
Aims and Objectives: This clinical study designed to evaluate the effectiveness of pregabalin for post-operative analgesia in infraumbilical surgeries.
Materials and Methods: This prospective clinical study was conducted in a medical college hospital of central India after obtaining approval from institutional ethics committee and informed written consent from the selected patients over the period of 1 year. A total of 60 patients between the ages of 20 and 40 years of ASA Grade I/II were randomly assigned into two groups (n=30, each) using an online randomization tool. Patients in Group P received oral Pregabalin 150 mg and Group D received oral Diazepam 10 mg, 1 h before induction of anesthesia. Both the groups uniformly received Tablet Paracetamol 1 gm, 2 h after completion of surgery. Patients experiencing pain with visual analogue scale (VAS) score ≥3, were injected Inj. Tramadol 100 mg, as rescue analgesia. Outcome variables such as need for rescue analgesia, sedation, VAS score, and other adverse events were noted at time intervals of 2, 4, 6, 12, and 24 h.
Results: The mean VAS scores in patients of Group P were significantly lower than Group D (P<0.0001), over 24 h of post-operative period. In Group P, rescue analgesic Inj. Tramadol was given after 12.33±3.47 h as compared to 3.47±8.19 h in Group D (P<0.0001) with total need of 133.56±49.27 mg and 210.73±63.35 mg over 24 h in patients of Groups P and D, respectively (P<0.0001).
Conclusion: Pregabalin 150 mg in pre-operative period provides superior post-operative analgesia and considerably reduces need of rescue analgesia postoperatively.
Reliability of Typhidot-M in diagnosis of typhoid fever in children
Authors: Nithya M  , Jamdade Shrikant , Kannan N  , Mitra Nibedita
Published: May 2022

Background: Typhoid fever continues to be endemic and a major cause of mortality and morbidity in the developing countries. Many times, it presents a diagnostic challenge to treating physicians due to overlapping clinical features with other common causes of acute fever. A rapid and reliable laboratory test would be of great help to clinicians for early diagnosis and appropriate treatment of typhoid fever.
Aims and Objectives: The present study was conducted to assess the reliability of Typhidot-M in diagnosis of typhoid fever.
Materials and Methods: A total of 203 children with clinical features consistent with typhoid fever were enrolled in the study. Blood culture, Typhidot-M, and Widal test were performed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for Typhidot-M and Widal test in comparison with blood culture as reference standard.
Results: Out of 203 patients, 30 (14.8%) were blood culture positive. One hundred and six patients were Typhidot-M positive and 97 were negative. Typhidot-M had a sensitivity of 93.3%, specificity of 54.9%, and PPV and NPV of 26.4% and 97.9%, respectively.
Conclusion: Typhidot-M is a sensitive test for early diagnosis of typhoid fever. However due to low specificity, positive results should be correlated with clinical picture and other possible diagnoses.
Evaluation of normal distribution of palpebral fissure among the medical and paramedical students of Eastern Nepal
Authors: Surendra Kumar Sah  , Deepak Chaudhary  , Subrato Ghosh  , Amit Kumar Shah
Published: May 2022

Background: The palpebral fissure (PF) is the space between the upper and lower eyelids when the eye is open. The bilateral orbital region which is located in the face acts as one of the important determinants in the perception of facial attractiveness, youthfulness, and health conditions of the individuals. The PF dimensions may get altered in cases of facial deformities and road traffic traumas.
Aims and Objectives: The aim of this study was to analyze the mode of distribution of PF dimensions in medical and paramedical students in correlation with gender.
Materials and Methods: The study was a cross-sectional study conducted in the duration of August 2021–November 2021 including the sample of 300 medical and paramedical students in an equal number of male and female of age group 16–22 years from Nobel Medical College Teaching Hospital, Biratnagar, Nepal. We measured the dimensions of PF during the normal gaze. The data analysis was done using the SPSS version 16.
Results: The mean length of PF (LPF) in males and females was 23.24 mm and 22.72 mm, respectively. The mean height of PF (HPF) in male and female was 8.52 mm and 8.60 mm, respectively. The difference between males and females LPF and HPF was significant(<0.05). The mean PF index (PFI) in male and female subjects was, respectively, 37.20 and 38.68 which were statistically significant.
Conclusion: It was found that the LPF and HPF were more in males and PFI was slightly more in females than the male which confirmsthe sexual dimorphism. The data obtained will be helpful in the esthetic consideration of the student’spersonality as well.
A descriptive study of complications following vaginal surgeries for genital prolapse
Authors: RL Jayavani , S Kalaranjini , Muthalu Arunkumar , Latha Chaturvedula  , Habeebullah Syed
Published: May 2022

Background: Pelvic organ prolapse is the descent of the pelvic organs into the vagina accompanied by urinary, bowel, and sexual. Many types of surgeries are done to fix the organ prolapse.
Aims and Objectives: This study aims to study the intra-operative and immediate post-operative complications in patients undergoing surgery for genital prolapse. The study also aims to follow the patients for a period of 1 year evaluate the possible morbidity during the period and also assess the factors which contribute to this morbidity.
Materials and Methods: The present study was conducted in a tertiary care hospital in Puducherry among 121 patients who were admitted in the department of obstetrics and gynecology for genital prolapse. It was intended to study the intraoperative, early post-operative, and long-term complications among these patients who underwent vaginal surgeries for genital prolapse.
Results: Ward Mayo’s operation was done in the age group of 45–50 years and Manchester repair was done in the age group of 30–35 years. Patients who underwent Ward Mayo’s procedure had a parity of 3.5. Nearly 25% of patients had a parity of 25. There was a significant difference in operating time when surgeries were done by consultants when compared to senior residents (P=0.002) but there was no significant difference in blood loss (P=0.070). A significant increase in blood loss and operating time was noted when vaginal hysterectomy was combined with both anterior and posterior repair. In cases of complications, it was prolonged. Backache (4.95%, 4.13%, and 4.13) and psychological problems (4.13%. 6.61%, and 6.61%) after 6 weeks, 6 months, and 1 year, respectively, were common long-term complications that could be attributed to decreased awareness among our women.
Conclusion: It is concluded from the study that vaginal surgeries for genital prolapse have lesser complications both intra-operatively and during the post-operative period. The patient’s characteristics such as age, parity, other illnesses, and surgical details such as choice of the operation, experience of the surgeon, additional procedures performed, blood loss, and antibiotic usage influence the morbidities associated with the surgery.
Development and validation of an in-house handheld ELISA kit to detect glycosylated hemoglobin in human whole blood
Authors: Pyadala Nagababu , Prudhvi Chand M  , Ravi Kumar BN  , Manno N Konyak  , Ratna Giri Polvarapu
Published: May 2022

Background: Diabetes mellitus (DM) is known as one the oldest disease known to a human being and it is defined as a group of metabolic disorders characterized by the presence of hyperglycemia.
Aims and Objectives: The present study describes the development and evaluation of a cost-effective and straightforward in-house handheld enzyme-linked immunosorbent assay (ELISA) kit for the determination of HbA1c in human whole blood of diabetic patients and is suitable for resource-poor settings.
Materials and Methods: A total of 1056 specimens were collected for assay validation purposes. To check the proficiency of our diagnostic strategy, we compared our test results with high-performance liquid chromatography (HPLC) and a commercially available ELISA kit for HbA1c. The Institutional Ethical Committee approved this study (IEC). SPSS 16 statistical software analyzed all the data. The correlation regression was done to compare the assay. The level of significance of this study was P<0.001.
Results: The sensitivity, specificity, and efficiency of the inhouse HbA1c ELISA kit range from 98.8%, 100%, and 99.24%.
Conclusion: The newly developed in-house handheld HbA1c ELISA test kit is not only cost-effective, accurate, and straightforward but also gives good correlation with optimized methods such as HPLC and commercially available techniques in deciding the glycemic status of patients. Therefore, highly recommended for use in resource-poor settings in the management and diagnosis of DM.
Role of diagnostic laparoscopy in suspected abdominal tuberculosis
Authors: Gupta Ashwani , Prasad Nikhil , Shirale Vaishali , Dubey Neha , Dubey Indu Bhushan
Published: May 2022

Background: The difficulty in confirming the diagnosis, morbidity and mortality associated with laparotomy in patients with abdominal Tuberculosis (TB) has generated interest in laparoscopy to obtain specimens for histological and microbiological assessment.
Aims and Objectives: Difficulty in sample procurement, paucibacillary load and non-specific clinical, biochemical, and radiological features makes early diagnosis difficult in abdominal TB. Diagnostic laparoscopy with peritoneal biopsy can provide rapid and correct diagnosis of abdominal TB and reduce significant morbidity and mortality.
Materials and Methods: Laparoscopy with umbilical port enabled direct inspection of peritoneum, intra-abdominal organs and facilitated obtaining biopsy specimens, cultures, and aspiration.
Results: Diagnostic laparoscopy has an important role not only in diagnosing abdominal TB, but also to rule out TB in certain cases. In our study, mesenteric lymphadenopathy was present in 85% of cases, tubercles in 63% and adhesions in 73%. An alternative diagnosis was established in 6 suspected abdominal TB patients (20%) who were microbiologically confirmed TB negative.
Conclusion: The study showed the feasibility of diagnostic laparoscopy in diagnosis of abdominal TB by sampling macroscopically visible pathological tissue with a low complication and conversion rate in most patients with suspected TB, and also providing an alternative diagnosis.
Effectiveness of in-house developed Sandwich ELISA for antigen detection of tubercular antigen in resource constraint setting
Authors: Agrawal Uditkumar , Agrawal Vaibhav , Agrawal Shikha , Patond Swapnil , Agrawal Sanjay
Published: May 2022

Background: Around 26% of World’s tuberculosis (TB) cases are in India. In resource constrained settings, it is difficult to use diagnostic tests such as nucleic acid amplification technique and mycobacterial culture due to their complexity and expensiveness. Developing an assay using polyclonal antibody may help to solve this problem.
Aims and Objectives: On the basis of this, we worked to detect tubercular antigen by developing Sandwich ELISA from the serum of TB patients.
Materials and Methods: For this study, 50 cases, 50 disease controls, and 30 healthy control subjects were taken. Commercially available reagents were used for the development of Sandwich ELISA. The data were statistically analyzed with the help of software SPSS version 16.0.
Results: Our effectively developed test had 82% area under the ROC curve. About 81% (n=35) patients of pulmonary TB cases with non-HIV infection detected by our Sandwich ELISA and 57% cases with the coinfection of HIV-TB. Developed test had 70.91% positive predictive value and 75.56% negative predictive value.
Conclusion: We successfully developed Sandwich ELISA for tubercular antigen detection and to increase the specificity of the Sandwich ELISA, as per the WHO guidelines, further work is needed for the detection of tubercular antigen.
Assessment of adverse events following first dose of COVISHIELD in healthcare workers of a tertiary care hospital in western Uttar Pradesh: A prospective observational study
Authors: Shivangna Singh  , Suchi Jain  , Bushra Hasan Khan  , Gautam Vivek , Mayank Batola
Published: May 2022

Background: COVID‑19 pandemic is a great health challenge around the world. Immunization appears best preventive strategy where monitoring the safety of COVID-19 vaccines is immensely important as limited safety data available on them.
Aims and Objectives: This study was conducted to perform safety surveillance and causality assessment of adverse events following immunization (AEFI) with COVID-19 vaccine.
Materials and Methods: This prospective observational study was conducted on healthcare workers who received their first dose of COVISHIELD during first phase of COVID-19 vaccination in January–February 2021 at F.H. Medical College and Hospital, Tundla, Firozabad. Approval for the study was taken from institutional ethical committee. The details of AEFIs were collected and duly noted in standard AEFI case reporting form of Ministry Of Health And Family Welfare, Immunization Division, Govt. of India and reported to District Immunization Officer. Causality assessment was done in accordance with protocol of the World Health Organization.
Results: Out of 419 vaccinees, 210 had developed AEFIs, and 527 AEFIs were reported considering the fact that one recipient could have experienced multiple AEFIs. Majority AEFIs were related to general disorders and administration site conditions (67.35%), where fever (28.46%), chills (16.69%),and pain at injection site (15.75%) were more common, followed by musculoskeletal and connective tissue disorders (19.55%) where myalgia (18.03%) was more commonly reported. Out of 527 AEFIs reported, majority (524, 99.43%) showed consistent causal association to immunization and 3 (0.57%) AEFIs showed inconsistent association. AEFIs classified as consistent causal association (524) mostly were vaccine product related reactions (520, 99.23%) and rest (4, 0.76%) were immunization anxiety related reactions. Severity assessment of AEFIs was done using Modified Hartwig and Siegel Severity Scale, out of total 527 AEFIs reported 60.9% were of mild severity and rest 39.1% were categorized as moderate severity.
Conclusion: As adverse events post-vaccination with COVISHIELD were mild to moderate in severity and lasted for a short duration, the inconvenience caused by these AEFIs outweigh the protection offered by the vaccination against COVID-19.
A study on clinico-radiological profile, risk factors, and management of mucormycosis during COVID pandemic in Rewa, (M.P.)
Authors: Indurkar Pallavi , Asati Aashutosh , Siddiqui Yasmeen , Nayak Shubhangi , Indurkar Manoj
Published: May 2022

Background: Second wave of coronavirus disease 2019 (Covid-19) pandemic has been particularly devastating in India. COVID-19 and mucormycosis (also known as black fungus) are causing comorbid conditions to worsen the extent of infection and mortality rates especially in India. Mucormycosis can involve nose, sinuses, orbit, central nervous system, lung (pulmonary), gastrointestinal tract any many other organs, but rhino orbital cerebral mucormycosis is the most common variety seen. Rapidity of dissemination of mucormycosis is an extraordinary phenomenon and a delay in the diagnosis could be fatal.
Aims and Objectives: The objective of this study is to document the clinical features, radiological extent, risk factors, management,and outcome of mucormycosis.
Materials and Methods: The study was retrospective observational study. Eighty-two mucormycosis patients admitted in SGMH Rewa were selected as study subjects. Data regarding clinical features, radiological extent, associated risk factors, comorbidities, management during hospital stay, and outcome of mucormycosis patients were collected on excel sheet and analyzed using appropriate statistical tests.
Results: In our study, majority of the patients were unvaccinated (88%). Most common presenting complaint was nasal congestion with or without discharge in 78% patients followed by Facial swelling, visual disturbances, facial weakness, dental pain, etc. On CT or magnetic resonance imaging examination, all cases of mucormycosis had maxillary sinus (100%) involvement, followed by ethmoid (82%) and sphenoid (78%) sinuses. Diabetes mellitus was most common comorbidity seen in 52% cases. About 83% cases had history of receiving high dose steroid intravenously during management of COVID illness. Among study cases 72% patients have taken oxygen supplementation for more than 72 h, for COVID-19 pneumonia before hospitalization for mucormycosis. Therapy of Liposomal Amphotericin B and Oral Triazole (predominantly oral Posaconazole) was the most common medical treatment offered to all patients with COVID associated mucorpatient. Functional endoscopic sinus surgery was done on 93% cases followed by Modified Denker’s procedure was done in 12% cases.
Conclusion: In our study, mucormycosis appears to be associated with COVID-19, diabetes, and use of corticosteroids. Full vaccination with COVID-19 vaccines, judicious use of corticosteroids in patients with COVID-19 and strict control of blood glucose level along with timely and proper management is highly recommended to reduce the incidence of fatal mucormycosis.
Study of APACHE II score and National Institutes of Health Stroke Scale as prognostic indicators in cerebrovascular accidents patients admitted in a tertiary care center, Rewa
Authors: Thakur Saritesh Kumar , Indurkar Pallavi , Malviya Dinesh Kumar , Indurkar Manoj
Published: May 2022

Background: Stroke is the 2nd largest cause of mortality world over. In the intensive care unit (ICU), severity scales are crucial adjuncts of treatment for anticipating patient outcomes, comparing quality of care, and stratification for clinical studies. They are an important aspect of making better health-care judgments and identifying people with unusual outcomes. This study was conducted to assess and compare Acute Physiology and Chronic Health Evaluation II (APACHE II) score and National Institutes of Health Stroke Scale (NIHSS) score as predictors of mortality in cerebrovascular accident (CVA) patients admitted in medical intensive care unit (ICU) of tertiary care center, Rewa.
Aims and Objectives: To evaluate APACHE II score, NIHSS score and APACHE II + NIHSS score as a predictor of short term mortality in CVA patients.
Materials and Methods: This was a cross-sectional, analytical study conducted in the Department of Medicine, Sanjay Gandhi Memorial Hospital, associated with Shyam Shah Medical College, Rewa (M.P), between January 2020 and June 2021. The APACHE II score, NIHSS score, and APACHE II+NIHSS scores were calculated for each patient on day of admission and patients were followed up for a maximum period of 7 days. The area under receiver operating characteristic (ROC) curve was used to measure the ability of these scoring systems to forecast the prognosis, to find the best dividing value.
Results: Out of 154 patients of CVA, 102 were male and 52 were female. In both sexes, the highest frequency of CVA was seen in those over 55 years of age. The mean age of the participants in the study was 62.70±12.62 years while it was 61.98±12.83 years for males and 64.13±12.19 years for females. The mean APACHE II score in death group was 29.45±10.095, mean NIHSS score in death group was 32.45±6.486, and the mean of both scores combined in death group was 61.91±14.017 and the mean of APACHE II score in survival group was 12.92±6.478, mean NIHSS score in survival group was 14.09±8.099, and the mean of both scores combined in survival group was 27.76±14.090. The APACHE II score had an area under the curve (AUC) of 0.919 which is slightly more than the NIHSS score which had the AUC of 0.913 and the sum of the two scores had the highest area under the ROC curve which is 0.947. According to Youden’s index, the dividing value for the APACHE II score is 21, the NIHSS score is 22, and APACHE II+NIHSS score was 42.
Conclusions: Application of APACHE II and NIHSS scores provides an objective method to decide prognosis and plan management of CVA patients. It also helps in deciding whether the patient needs to manage in neurology ward or ICU depending on the dividing value. Both the scores have good ability to predict the short-term prognosis of CVA patients and the combination of these two can provide an even better measure of mortality.
Diagnostic hysterolaparoscopy: An important tool in evaluation of female infertility, in beneficiaries of ESI scheme in Eastern India
Authors: Nita Singh  , Kaushik Datta Pramanik  , Manisha Bajaj  , Roy Rajib
Published: May 2022

Background: The WHO estimates that 60–80 million couples worldwide suffer from infertility and the overall prevalence of the primary infertility in India is 3.9–16.8%. As usual tests and examinations are unable to appreciate majority of pelvic pathology in infertile women, diagnostic laparoscopy has become an essential part of infertility evaluation. Diagnostic laparohysteroscopy (DHL) gives the opportunity to directly visualize and manipulate pelvic organs which allow accurate diagnosis and give an option to treat at the samesitting.
Aims and Objectives: The aims of this study were to detect pelvic organ abnormalities by diagnostic hysteroscopy and laparoscopy in the evaluation of female infertility in a tertiary care hospital.
Materials and Methods: This cross-sectional observational study recruited 50 patients who attended the infertility clinic during 1 year period as per inclusion and exclusion criteria. Those with male factor and endocrine abnormality were excluded from the study. The patients having abnormal hystero-salpingography (HSG) findings and those who in spite of having normal HSG finding, did not conceive even after three cycles of ovulation induction, underwent DHL.
Results: Out of the 50 patients, 35 (70%) suffering from the primary and 15 (30%) suffering from the secondary infertility. The mean age of the study population was 29.5±5.3 years. Most of the cases presented with 3–6 years of infertility. The most common reported laparoscopic abnormality was ovarian in 58% cases, followed by 56% of pelvic and peritoneal abnormalities, 44% tubal factor abnormality, 36% having endometriosis at different stages, and 30% having uterine abnormality.
Conclusions: Hystero -laparoscopy has good diagnostic accuracy in evaluating pelvic pathologies. The combination of hysteroscopy with laparoscopy done in a single setting improves the detection rate of abnormalities of uterus, fallopian tubes, ovaries, and pelvic peritoneum.
Clinical sub typing of newly detected type 2 diabetics on the basis of pancreatic beta cell function and degree of insulin resistance and their clinical characterization
Authors: Saha Avijit
Published: May 2022

Background: Insulin resistance is a major cause for developing type 2 diabetes but is not synonymous with the type 2 diabetes. Pancreatic beta cell dysfunction probably needs to be sets in for clinical occurrence of type 2 diabetes. So knowledge regarding residual beta cell function and degree of insulin resistance is essential.
Aims and Objectives: The objectives are as follows: (1) To estimate degree of insulin resistance (HOMA-IR) and pancreatic beta cell functional capacity (HOMA-B %) among newly detected Type 2 diabetics and (2) to identify different clinical phenotypic presentations of type 2 diabetes on the basis of these parameters.
Materials and Methods: This present study was conducted in newly diagnosed type 2 diabeticpatients. After obtaining informed consent, anthropometric and clinical examination was carried out in all patients. Venous blood samples were drawn for fasting plasma glucose,c-peptide,fasting insulin level,HbA1c,lipid profile, etc.HOMA-IR and HOMA-B% were calculated with HOMA 2 calculator.
Results: A total 100 newly diagnosed type 2 diabetic patients were studied. About 71% pt of study population had HOMA-B% value below 50% and half of study population had significant amount of insulin resistance. Three distinct clinical phenotypes had identified. Insulin resistance predominant group (30%), beta cell dysfunction predominant group (45%), and both abnormalities coexist group (25%).
Conclusion: By the time of diagnosis of Type 2 diabetes, more than two-third study population had <50% residual beta cell function left and more than half had significant degree of insulin resistance. Hence,this functional assessment needs to be done for appropriate antidiabetic drug selection and for identification of different clinical phenotypes.
The mean attributable health care costs associated with hepatitis B virus in Ontario, Canada: A matched cohort study
Authors: Nanwa Natasha , Kwong Jeffrey C , Feld Jordan J , Fangyun Wu C , Sander Beate
Published: May 2022

BACKGROUND: No Canadian studies examined the economic impact of hepatitis B virus (HBV) using population-based, patient-level data. We determined attributable costs associated with HBV from a health care payer perspective. METHODS: We conducted an incidence-based, matched cohort, cost-of-illness study. We identified infected subjects (positive HBV surface antigen, DNA, or e-antigen) between 2004 and 2014, using health administrative data. The index date was the first positive specimen. The cohort was organized into three groups: no HBV-related complications, HBV-related complications before index date, and HBV-related complications post-index date. To evaluate costs (2017 Canadian dollars), we adopted the phase-of-care approach defining six phases. Mean attributable costs were determined by evaluating mean differences between matched pairs. Hard match variables were sex, age group, index year, rurality, neighbourhood income quintile, comorbidities, and immigrant status. Costs were combined with crude survival data to calculate 1-, 5-, and 10-year costs. RESULTS: We identified 41,469 infected subjects with a mean age of 44.2 years. The majority were males (54.7%), immigrants (58.4%), and residents of major urban centres (96.8%). Eight percent had HBV-related complications before index date and 11.5% had them post index date. Across groups, mean attributable costs ranged from CAD $27–$19 for pre-diagnosis, CAD $167–$1,062 for initial care, CAD $53–$407 for continuing care, CAD $1,033 for HBV-related complications, CAD $304 for continuing care for complications, and CAD $2,552–$4,281 for final care. Mean cumulative 1-, 5-, and 10-year costs ranged between CAD $253–$3,067, $3,067–$20,349, and $6,128–$38,968, respectively. CONCLUSIONS: HBV is associated with long-term economic burden. These results support decision-making on HBV prevention and monitoring strategies.
Evaluación del lenguaje en preescolar: desarrollo y validación de una rúbrica
Authors: García Aldaco Seiri Adilene , Pedroza Zúñiga Luis Horacio
Published: May 2022

El artículo presenta el resultado de una investigación cuyo objetivo fue el desarrollo y la obtención de evidencias de validez de un instrumento de evaluación de lenguaje para alumnos de preescolar. El estudio metodológico de evaluación educativa se dividió en dos fases: el diseño del instrumento, basado en las directrices de estándares internacionales para la elaboración de instrumentos de medición, y el logro de evidencias de validez de contenido a través del juicio de expertos y evidencias de validez fundamentadas en la estructura interna mediante análisis factorial exploratorio. Se obtuvo una rúbrica alineada al currículo y administrada por las educadoras que permite valorar el desempeño de niños y niñas, tanto en lenguaje oral como escrito, para fines formativos y de monitoreo de tendencias. La rúbrica mostró alta confiabilidad y una estructura unidimensional, y se recabaron evidencias de validez que respaldan su contenido. Las características del instrumento lo hacen valioso para su uso en la educación preescolar mexicana.
Mapping the Roles of Nutrition and Dietetics Professionals in Sustainable Food Systems and Exploring Opportunities for Strategic Collaboration
Authors: Goodridge Lindsay , Carlsson Liesel , Callaghan Edith G.
Published: May 2022

Current food systems drive environmental damage, social injustices, and undermine health, and these challenges are complex and seemingly intractable. Collaboration is required to transition to more sustainable food systems (SFS). Registered Dietitians and Nutritionists (RDs) are an under-leveraged and well-positioned group to contribute to addressing food systems challenges because of their locations in the system and their existing skillsets. Drawing on research with dietitians, this perspective paper presents both a theoretical proposal as well as collective expertise in supporting sustainable development of the global food system. It highlights where RDs work in food systems with the aim to reveal multiple points of entry where RDs can and do contribute to SFS across food systems, approaches to apply, as well as opportunities for collaboration within and beyond the profession. Educational and societal barriers exist that prevent systematic RD engagement; however, examples of established work provide models to follow.
Food Environment and Youth Intake May Influence Uptake of Gluten-Free Food Guide Recommendations in Celiac Disease
Authors: Cyrkot Samantha , Gidrewicz Dominica , Anders Sven , Marcon Margaret , Turner Justine M. , Mager Diana R.
Published: May 2022

A gluten-free (GF) food guide for children and youth (4–18 years) living with celiac disease (CD) has been developed and extensively evaluated by stakeholders, including registered dietitians. A case study analysis was conducted on data from 16 households of youth with CD to examine how factors related to parental food literacy, the home food environment, and food purchasing patterns may influence food guide uptake by Canadian youth with CD and their families. Households were of higher socioeconomic status, parents had good food literacy, and the home food availability of fruits, vegetables and GF grains was diverse. However, households also had a diverse supply of convenience foods and snack options. Youth reported consuming a larger proportion of these foods (>35% dietary intake) and had suboptimal diet quality. Dietary intake of fruits and vegetables were below GF plate model recommendations by over 30%. Despite limited economical barriers, good parental food literacy, and diverse food availability, meeting fruit and vegetable recommendations based on the pediatric GF food guide remains a major challenge. Findings inform that effective strategies and healthy public policies to support the uptake of GF food guide recommendations are needed to improve the health outcomes of youth with CD.
Залишкові риси слов’янської племінної організації в українській мові
Authors: Царук О. В.
Published: May 2022

Розглянуто питання походження української мови, що залишається одним із найактуальніших в українському мовознавстві. Здійснено компаративний аналіз української мови з іншими слов’янськими й визначено найважливіші чинники, що повинні враховуватися в дослідженні слов’янської племінної організації в українській мові.
Про надійність критеріїв генеалогічної класифікації слов’янських мов (методологічні засади курсу історії української мови у вузі)
Authors: Царук О. М.
Published: May 2022

Розглянуто питання про вихідні принципи порівняльного аналізу слов'янських мов, враховуючи значні традиційно-історичні та політичні нашарування. Розкрито критерії генеалогічної класифікації слов’янських мов, що є методологічними засадами курсу історії української мови у закладі вищої освіти.
Забезпечення валідності й надійності тестів протягом життєвого циклу
Authors: Жулаєва Вікторія Олександрівна
Published: May 2022

Стаття присвячена проблемам валідності й надійності тестових питань і відповідей, з якими стикається автор при створенні тесту для контролю знань за інформаційно-комунікативних технологій. Життєвий цикл тестових завдань розглядається від початку й до кінця на прикладі втіленої інформаційної системи
Интерполяционные сплайны в задачах цифровой обработки сигналов
Authors: Шелевицкий Игорь Владимирович
Published: May 2022

Статья посвящена использованию интерполяционных сплайнов в цифровой обработке сигналов. Основная идея состоит в управ лении погрешностью приближения путем синтеза базисных сплайнов с учетом априорной информации о частотных свой ствах сигнала, при этом особое внимание уделено эффективнос ти расчетов. Большинству инженеров известны в основном кубические сплай ны минимального дефекта (с двумя непрерывными производны ми) и их применение в системах компьютерной графики. В циф ровой обработке сигналов сплайны ассоциируются с вейвлета ми, где в качестве вейвлетов также используют алгебраические В сплайны. При этом основным способом адаптации сплайнов к сигналу является изменение масштаба базисных сплайнов. Од нако возможности сплайнов значительно шире, так же как и их разнообразие. Изложенное позволяет оценить и использовать это многообразие на практике. Многочисленные практические вычислительные схемы и примеры дают возможность без привлечения дополнительных материалов опробовать предложенные решения. Основными инструментами для работы являются пакеты Mathcad, MATLAB, Simulink. Эффек тивный вычислительный аппарат позволяет получать экономные алгоритмы и аппаратные решения в сочетании с прозрачностью и простотой идей. Преимущества сплайнов проявляются в полной мере в тех случаях, когда обрабатываемые гладкие сигналы имеют сложную форму. Относительным признаком этого является нали чие более 6–8 экстремумов на фрагменте обработки.
Глобальне прогнозування: біосферний аспект
Authors: Завізєна Наталія Станіславівна , Моісеєнко Наталя Володимирівна , Семеріков Сергій Олексійович
Published: May 2022

Кінець XX сторіччя характеризується прискореним розвитком науково-технічного прогресу, ростом соціальної напруги, різким демографічним вибухом, погіршенням стану навколишнього середовища. Дійсно, наша планета ніколи раніше не піддавалась таким фізичним та політичним навантаженням, які вона зазнає у наш час - людина ніколи раніше не брала з природи стільки данини і не опинялась настільки уразливою перед міццю, яку сама ж створила. Яким буде людство через 100 років? Чи зможе людина своїм розумом та волею врятувати себе саму та нашу планету від навислих над нею загроз?
Некоторые математические модели вспышек численности в популяциях организмов
Authors: Соловйов Володимир Миколайович , Теплицький Ілля Олександрович , Шанда Л. В. , Иванченко Е. А. , Завизена Наталья Станиславовна , Семеріков Сергій Олексійович
Published: May 2022

Популяционные вспышки характеризуются быстрым изменением в плотности популяции более чем на несколько порядков величины. Вспышки бывают у небольшого числа видов: например, у некоторых насекомых, являющихся переносчиками чумы, и грызунов. Популяционные вспышки часто вызывают серьезные экологические и экономические проблемы.