bluuebunny/crossref_metadata_2025 huggingface dataset:
Application-Specific Discriminant Analysis of Cardiac Anomalies Using Shift-Invariant Wavelet Transform
Authors: Singh Ritu , Rajpal Navin , Mehta Rajesh
Published: April 2021

Automatic arrhythmia detection in electrocardiogram (ECG) using supervised learning has gained significant considerations in recent years. This paper projects the performance analysis of classifiers such as support vector machine (SVM), extreme learning machine (ELM), and k-nearest neighbor (KNN) with efficient time utilization showing multi-classification for specific medical application. The wavelet double decomposition is used to show the shift-invariant use of dual-tree complex wavelet transform for noise filtering and beat segmentation is done to extract 130 informative samples. Further, the linear discriminant analysis is applied to dimensionally reduce and elite the 12 most relevant features for classifying normal and four abnormal beats collected from MIT/BIH ECG database. The proposed executed system distinguishes SVM, ELM, and KNN with percentage accuracy of 99.8, 97, and 99.8 having classifier testing time as 0.0081s, 0.0031s, and 0.0234s, respectively. The simulated experimental outcomes in comparison with existing work yields adequate accuracy, and computational time.
Artificial Bee Colony Optimized Deep Neural Network Model for Handling Imbalanced Stroke Data
Authors: Dev Ajay , Malik Sanjay Kumar
Published: April 2021

The healthcare domain gets wide attention among the research community due to incremental data growth, advanced diagnostic tools, medical imaging processes, and many more. Enormous healthcare data is generated through diagnostic tool and medical imaging process, but handling of these data is a tough task due to its nature. A large number of machine learning techniques are presented for handling the healthcare data and right diagnosis of disease. However, the accuracy is one of primary concerns regarding the disease diagnosis. Hence, this study explores the applicability of deep neural network (DNN) technique for handling the imbalance of healthcare data. An artificial bee colony technique is adopted to determine the relevant features of stroke disease called ABC-FS-optimized DNN. The performance of proposed ABC-FS-optimized DNN model is evaluated using accuracy, precision, and recall parameters and compared with state of art existing techniques. The simulation results showed that proposed model obtains 87.09%, 84.28%, and 85.72% accuracy, precision, and recall rates, respectively.
Applying Big Data Analytics in Higher Education
Authors: Alkhalil Adel , Abdallah Magdy Abd Elrahman , Alogali Azizah , Aljaloud Abdulaziz
Published: April 2021

Higher education systems (HES) have become increasingly absorbed in applying big data analytics due to competition as well as economic pressures. Many studies have been conducted that applied big data analytics in HES; however, a systematic review (SR) of the research is scarce. In this paper, the authors conducted a systematic mapping study to address this deficiency. The qualitative and quantitative analysis of the mapping study resulted in highlighting the research progression over the last decade, and identification of three major themes, 12 subthemes, 10 motivation factors, 10 major challenges, three categories of tools and support techniques, and 16 models for applying big data analytics in higher education. This result contributes to the ongoing research on applying big data analytics in HES. It provides a better understanding of the level of contribution to research as well as identifies gaps for future research direction.
University Library Services and Student Academic Performance
Authors: Tubulingane Booysen Sabeho
Published: April 2021

In many countries, university libraries are required to demonstrate quantitatively their value to their institutions. Consequently, many universities spend a large part of their institutional budgets on acquiring new library books, paying for high online journal subscription fees, and recruiting library staff. However, few studies have been conducted to evaluate the contribution of the university libraries to the students' success. Thus, this study, which applied a quantitative survey methodology to quantify the contribution of a Namibian university library to student academic performance, was conducted. The study determined the contribution of the university library services to students' academic performance. Additionally, the study established a relationship between students' library service satisfaction and academic performance. Analysis of library user satisfaction, student age, and gender were also examined.
A Knowledge Approach for the Library Sciences
Authors: Randles Theodore J. , Richardson Sarah , Miller Allison Li
Published: April 2021

Like chemistry's table of elements, the knowledge spectrum organizes a large amount of information about knowledge, dividing intelligent behavior into its essential cognitive elements. This paper describes a way to catalog, measure, and analyze organization knowledge requirements and knowledge resources through inheritance of knowledge spectrum properties. Business process knowledge requirements trees and employee knowledge profiles would be created to permit knowledge requirements fulfillment analyses.
Lixus algirus L. (Coleoptera: Curculionidae): biology, population fluctuation, infestation as affected by varieties, location, and planting dates in Morocco
Authors: Ait Taadaouit N. , El Fakhouri K. , Sabraoui A. , Rohi L. , El Bouhssini M.
Published: April 2021

The stem borer, Lixus algirus L. (Coleoptera: Curculionidae) is the major insect pest of faba bean in the Mediterranean region. This study investigates the field biology and fluctuation of L. algirus at Douyet research Station in Morocco during two cropping seasons 2014-2015 and 2015-2016 using two local faba bean varieties. The influence of sowing dates and varieties on the damage caused by L. algirus was investigated over different locations and seasons using a split-plot design. The overwintering adults appear in the field from February by feeding over the leaves of faba bean plants. Eggs are laid from Mid-February through late April and mostly during March. The egg peak ranged from 0.75 to 1.1 eggs per plant. The number of larvae increases during March and peaked in April. The larval peaks ranged between 0.45 to 1.5 larvae per plant. The larval development takes an average of 42 days. Pupation lasts about 21 days within stems. Adults emerged in early June. Life cycle duration was 80 days. One generation of L. algirus was recorded on faba bean varieties in Morocco. The mean number of eggs showed a positive correlation with total rainfall. The number of pupae and relative humidity was negatively correlated. Peach and almond leaves were the most preferred by the newely emerged L. algirus adult during the summer and early autumn period. Planting dates did not affect L. algirus infestation levels over all varieties tested and locations.
The Relevance of Blepharoptosis in Diagnostic Suspicion of Myopathies
Authors: Papadopoulos Constantinos , Papadimas George K
Published: April 2021

Blepharoptosis (ptosis) is classified, based on etiology, into mechanical, cerebral, neurogenic, neuromuscular, myogenic, and due to miscellaneous causes. Primary myopathic diseases are rare causes of blepharoptosis and many patients with myogenic ptosis undergo a series of extensive investigations before a myopathy is being considered. In this study, we report four patients with different myopathic disorders who had blepharoptosis as a presenting symptom of their disease. Moreover, we highlight frequent diagnostic errors and difficulties in patients with myopathies who present blepharoptosis. Lack of clear cut aggravation of symptoms by fatigue and response to cholinesterase inhibitors treatment, the association of proximal, distal or extraocular muscle weakness, and positive family history or evidence of a multi systemic disorder should prompt evaluation of an underlying myopathy.
KetaDex
Authors: Sangeetha R P , Bharadwaj Suparna
Published: April 2021

Background: The anaesthetic mandate for a combination of electrocorticography (ECoG) and subcortical motor evoked potential mapping (SCMEPM) substantially differs from that required for each of these monitors in isolation. There is no current consensus defining the anaesthetic management for intraoperative multimodal monitoring combining these two modalities. Case description: We report our experience of anaesthetising a drug resistant epileptic patient for craniotomy and resection of his frontal gliotic lesion. We propose a novel anaesthetic technique to cater to the multiple goals of this surgery like optimal neuromonitoring under adequate depth of anaesthesia. We used balanced anaesthesia technique. Continuous intravenous (IV) infusions of Inj. Dexmedetomidine of 1.5 mcg/kg/hour and Inj. Ketamine at 0.5mg/kg/hour were used to supplement inhalational anaesthetic titrated to a MAC up to 0.5. Neuromuscular blockade was avoided after the initial tracheal intubation dose. Conclusion: To the best of our knowledge, this is the first case reporting the safety and efficacy of balanced anaesthetic technique for concurrent ECoG and SCMEPM. Successful intraoperative ECoG and SCMEPM monitoring with absent intraoperative awareness confirmed the safety of our anaesthetic technique. Through this, a composite of patient safety, surgeon satisfaction and adequate intraoperative monitoring could be achieved.
Patient Attitudes toward Neurosurgery in Low- and Middle-Income Countries
Authors: Kanmounye Ulrick S. , Nguembu Stéphane , Djiofack Dylan , Zolo Yvan , Tétinou Franklin , Ghomsi Nathalie , Figuim Bello , Esene Ignatius
Published: April 2021

Background:

Low- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs.

Objective:

As we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery.

Methods and Material:

PubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized.

Results:

Six of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient.

Conclusions:

There are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors.
Is Elective Neurosurgery Justified During COVID-19 Pandemic?
Authors: Arimappamagan Arivazhagan , Vilanilam George , Pandey Paritosh
Published: April 2021

Background:

As the world faces a new viral pandemic, which has spread very rapidly, initial response from most countries was to suspend nonemergent health services so that available resources can be diverted to handle the large numbers of patients with COVID-19 infection. Many societies issued guidelines to suspend or postpone nonemergent surgeries.

Methods:

We reviewed the emerging evidence regarding the impact of COVID-19 infection in neurosurgery and the postponement of elective surgeries.

Results and Observations:

COVID-19 infection poses serious threat in hospitals in the form of cross-infection, hospital staff falling sick, with potential risk to overwhelm or paralyze the healthcare. In addition, we have come to realize the significant perioperative morbidity and mortality secondary to active COVID-19 infection. All these strongly favor suspension of elective neurosurgical services. However, these have to be weighed against the fallout due to prolonged postponement of neurosurgical treatment for conditions, which can progress and cause neurological deterioration.

Conclusion:

This article discusses the contemporary published literature regarding the perioperative risk of COVID-19 infection, impact of postponed surgeries, challenges, risk assessment and guidelines for elective neurosurgery at this point of time.
Recurrent Neurocysticercosis
Authors: Kaur Khush Preet , Garg Ajay , Sebastian Leve Joseph Devaranjan , Bhatia Rohit , Singh Mamta Bhushan , Srivastava Achal , Tripathi Manjari , Padma M V
Published: April 2021

Background:

Solitary cysticercus granuloma (SCG) appearing as a single ring-enhancing lesion (SREL) is the most frequently encountered imaging finding in patients of neurocysticercosis (NCC) in India and during follow-up, most of SCGs resolve with or without calcifications. Recurrent SCG have been rarely reported.

Objectives:

The aim of our study is to report the incidence of recurrent SCG in a cohort of patients with SCG and postulate the hypothesis.

Materials and methods:

This retrospective study included 278 patients with SCG meeting the criteria of NCC. Their medical records and imaging studies were analyzed.

Results:

Out of 278 patients, 119 patients with SCG meeting the criteria of NCC with follow-up imaging were included. 15 (12.61%) had recurrent NCC and 104 (87.4%) patients did not have any recurrence during a median follow-up of 14.23 months (range; 0.24 - 113.3) and 25.26 months (range; 3.09- 98.11) respectively. Out of 15 recurrent NCC cases, ten patients had documented imaging resolution or partial regression of previous lesion followed by occurrence of new SCG in the same location, three patients had change in morphology of lesion from solitary discrete REL to solitary conglomerate REL secondary to development of new cysticercus granuloma adjacent to old lesion patients had recurrent lesions adjacent to previous lesion and two patients had new SCG in different locations following regression of old SCGs.

Conclusion:

Recurrent SCGs are not uncommon in NCC and recurrence is more likely to occur at the site of initial infection and therefore may be mistaken for persistent infection or other granulomatous lesions.
Management Dilemma in A Rare Case of Bilateral Temporo-Insular Glioma
Authors: Meena Rajesh , Doddamani Ramesh S , Chipde Harshad , Agrawal Deepak , Mahajan Swati , Chandra P S
Published: April 2021

Multicentric gliomas are uncommon pathological entities, although well described in the literature. The aim of this study was to highlight the management issues in a rare case of multicentric glioma occurring in a bilateral temporo-insular region. A 35-year-old farmer with no comorbid illness presented with a history of progressively increasing holocranial headaches, intermittent episodes of vomiting, and memory disturbances from the last 3 months. Radiological findings were suggestive of multicentric glioma involving bilateral temporo-insular regions. Patient underwent tumor decompression first on the left side followed by the right side. Postoperative course was uneventful. Management of multicentric gliomas is challenging.
Efficacy of Silicone Conduit in the Rat Sciatic Nerve Repair Model
Authors: Singh Suyash , Srivastava Arun Kumar , Baranwal Atul K , Bhatnagar Ankur , Das Kuntal Kanti , Jaiswal Sushila , Behari Sanjay
Published: April 2021

Background:

A lot of options have been tried for bridging the two ends of the injured nerves. Researchers have used decellularized nerve grafts, artificial materials and even nerve growth factors to augment functional recovery. These materials are either costly or inaccessible in developing world.

Objective:

The study aimed to evaluate the efficacy of the silicone conduit in a rat sciatic nerve injury model.

Materials and Methods:

24 healthy Sprague–Dawley (SD) rats (250-300 grams; 8-10 weeks) were used and right sciatic nerve was exposed; transected and re-anastomosed by two different methods in 16 rats. In control group, n = 8 (Group I) the sciatic nerve was untouched; Group II (reverse nerve anastomosis, n = 8): 1-centimeter of nerve was cut and re-anastomosed by using 10-0 monofilament suture; Group III (silicone conduit, n = 8) 1-centimeter nerve segment was cut, replaced by silicone conduit and supplemented by fibrin glue]. Evaluation of nerve recovery was done functionally (pain threshold and sciatic functional index) over 3 months and histologically and electron microscopically.

Results:

Functional results showed a trend of clinical improvement in Group III and II but recovery was poor and never reached up to normal. Histopathological and electron microscopic results showed an incomplete axonal regeneration in Groups II and III. Psychological analyses showed that no outwards signs of stress were present and none of the rats showed paw biting and teeth chattering.

Conclusion:

The silicone conduit graft may be an economical and effective alternative to presently available interposition grafts, however for short segments only.
PGT or ICSI? The impression of NGS-based PGT outcomes in nonmosaic Klinefelter syndrome
Authors: Tong Jing , Zhao Xiao-Ming , Wan An-Ran , Zhang Ting
Published: April 2021

This retrospective study demonstrates the clinical outcomes of patients with nonmosaic Klinefelter’s syndrome (KS) who underwent preimplantation genetic testing (PGT) with frozen-thawed testicular spermatozoa. Microdissection testicular sperm extraction (micro-TESE) was performed for sperm retrieval. Next-generation sequencing (NGS) was conducted for embryo analysis. A total of 18 couples aged ≤35 years were included, and 22 oocyte retrieval cycles were completed. Euploidy was detected in 29 of 45 (64.4%) embryos. Additionally, the numbers of aneuploid and mosaic embryos detected were 8 (17.8%) and 8 (17.8%), respectively, regardless of a lack of sex chromosome abnormalities. Finally, 13 couples with euploid embryos completed 14 frozen embryo transfer (FET) cycles. Ten couples had clinical pregnancies, and 6 of them had already delivered 5 healthy babies and 1 monozygotic twin. There were also 4 ongoing pregnancies and 2 biochemical pregnancies, but no early pregnancy loss was reported. Based on our results, we speculate that for KS patients, when sperm can be obtained by micro-TESE, the cryopreservation strategy makes the ovarian stimulation procedure more favorable for female partners. The paternal genetic risk of sex chromosome abnormalities in their offspring is extremely low in men with KS. In addition to PGT, the intracytoplasmic sperm injection (ICSI) procedure is comparably effective but more economical for young nonmosaic KS couples. ICSI should be offered as an option for such couples, but monitoring by prenatal genetic diagnosis is recommended.
Ophthalmological findings in movement disorders
Authors: Mehta Sahil , Takkar Aastha , Ray Sucharita , Lal Vivek
Published: April 2021

Ocular manifestations form an important clinical component of several movement disorders. Both hypokinetic and hyperkinetic movement disorders can involve the eye. Ophthalmological manifestations can arise due to dysfunction at the level of retina, optic nerves, oculomotor system, or subcortical or visual cortex. Ophthalmological findings help in differentiating various movement disorders and give a clue about their severity. These follow or may precede the diagnosis of movement disorders. Basal ganglia and its various nuclei especially substantia nigra pars reticulata play an important role in the genesis of eye movements through its connections with the superior colliculus. Eye movement abnormalities using quantitative recording techniques are now being considered as noninvasive biomarkers not only for the diagnosis but also to track the progression of disease as well as to study the effects of therapies in various movement disorders. Moreover, there is ample evidence of presence of retinal degeneration in various neurodegenerative diseases evaluated using optical coherence tomography. Various patterns of retinal thinning have been described in different movement disorders and have been found to have a correlation with the stage and severity of the disorder. In this review, we discuss ophthalmological findings of common hypokinetic and hyperkinetic movement disorders.
A reversible lentiform nucleus T1 hyperintensity in hypoglycemic chorea
Authors: Chouksey Dinesh , Rathi Pankaj , Goyal Nitisha , Sodani Ajoy K.
Published: April 2021

Acute to subacute onset chorea is commonly due to stroke, metabolic, post-infectious, and autoimmune disorders. Chorea in diabetes (DM) patient is mostly due to hyperglycemia, and few cases were reported due to hypoglycemia. The mechanism at the cellular level is still evolving. The MRI changes in diabetic chorea patients are variably reported. It is important to discuss our patient with hypoglycemic hemichorea because of unique features like low BMI, recently diagnosed DM on sulphonylurea with a history of hypoglycemic episodes, and acute left hemichorea that was controlled with neuroleptics, and her MRI brain showed reversible lentiform nucleus T1 hyperintensity without diffusion restriction and blooming on SWI.
Huntington’s disease
Authors: Raju Srinivas , Kukkle Prashanth
Published: April 2021

Understanding of Huntington’s disease (HD) has been evolving since its early descriptions from nineteenth century. Significant breakthroughs into HD pathophysiology and therapeutic targets have been seen in last 50 years. Most of the publications in relation to HD are from European and American continents, indicating geographical higher prevalence. HD in India has been reported since early 1950s in the form of case reports and series, with exception of varying references in ancient Indian literature as “Tandavaroga.” In this review, we have amalgamated the various Indian publications on HD till date.
Occupational Burnout in Pre-Hospital Emergency Personnel in Iran
Authors: Sahebi Ali , Golitaleb Mohamad , Jahangiri Katayoun
Published: April 2021

Background:

Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of this study was to determine the frequency and intensity of occupational burnout among pre-hospital emergency staff in Iran.

Materials and Methods:

This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data resources included Scientific Information Database (SID), Magiran, Islamic World Science Citation Center (ISC), Irandoc, PubMed, Scopus, Web of Science, and Google Scholar.

Results:

Initially, 178 articles were extracted, and then 13 articles were finally analyzed. Overall,2034 pre-hospital emergency personnel were examined. Mean of occupational burnout in term of frequency, respectively for emotional exhaustion (16.78, 95% CI = 8.89-24.67, I2 = 62.30%, p = 0.004), depersonalization (11.57, 95% CI = 6.97-16.18, I2 = 68.50%, p = 0.001) and the lack of personal accomplishment (16.11, 95% CI = 8.60 -23.62, I2 = 74.70%, p = 0 <001) were determined. Also, in term of intensity, respectively for emotional exhaustion (17.90, 95% CI = 8.24-27.57, I2 = 64.80, p = 0.004), depersonalization (11.20, 95% CI = 6.80-16.22, I2 = 49.60%, p = 0.044) and the lack of personal accomplishment (23.45, 95% CI = 13.41 -33.49, I2 = 84.80%, p = 0 <001) were determined.

Conclusions:

According to findings, depersonalization and lack of personal accomplishment had moderate and high-level, respectively. Therefore, it is necessary health policymakers pay special attention to identifying and resolving the causes of occupational burnout in this population.
Cold Therapy and Respiratory Relaxation Exercise on Pain and Anxiety Related to Chest Tube Removal
Authors: Sajedi-Monfared Zahra , Rooddehghan Zahra , Haghani Hamid , Bakhshandeh Ali Reza , Monfared Laya Sajedi
Published: April 2021

Background:

Current strategies to control pain and anxiety of chest tube removal are not efficacious. The aim of this study is to determine the effects of cold therapy and respiratory relaxation exercise on pain and anxiety of chest tube removal.

Materials and Methods:

A parallel single-blind clinical trial study was conducted in Imam Khomeini Hospital, Iran, on 120 patients. Participants were randomized into 4 groups of 30. Numeric Rating Scale was used to assess pain and anxiety. One-way ANOVA test and Fisher's exact test were used to analyze demographic data. The Kruskal–Wallis test was used to compare the severity of pain and anxiety between groups; the Friedman and Mann–Whitney test were used to compare the severity of pain and anxiety within groups with a significance level of 0.05.

Results:

Pain intensity was weak before chest tube removal and there was no significant difference in basal pain. Pain immediately after chest tube removal was significantly higher than other times in each group (χ
2 = 57.16, χ
2 = 63.70, χ2 = 46.49, χ
2 = 59.04, df = 3, p < 0.001). There was no significant difference in pain score immediately (p = 0.052) and 15 min (p = 0.329) after Echest tube removal in experimental groups compared to the control group. No significant difference was found between control and experimental groups in anxiety score immediately (p = 0.995) and 15 min (p = 0.976) before chest tube removal.

Conclusions:

Mentioned methods were not effective in reducing pain and anxiety. It is suggested to investigate effects of different methods of removing chest tubes and applying cold with a larger sample size.
The Effect of Nursing Interventions Based on Burns Wean Assessment Program on Successful Weaning from Mechanical Ventilation
Authors: Sepahyar Maryam , Molavynejad Shahram , Adineh Mohammad , Savaie Mohsen , Maraghi Elham
Published: April 2021

Background:

The effective design and implementation of the nursing interventions to evaluate the patients' readiness for ventilator weaning will reduce their connection time to the ventilator and the complications of their connection to it. This study was conducted to examine the effect of nursing interventions based on the Burns Wean Assessment Program (BWAP) on successful weaning from Mechanical Ventilation (MV).

Materials and Methods:

In this clinical trial, 70 patients undergoing MV in the Intensive Care Units (ICUs) of Golestan Hospital (Ahvaz, Iran) in 2018 were randomly assigned to intervention and control groups. The nursing interventions designed based on BWAP were implemented on the patients in the intervention group, who were later weaned from the device according to this program. The recorded data included demographic information, BWAP score, vital signs, and laboratory values, which were analyzed using the Pearson correlation coefficient, Chi-Square, Fisher, and Mann-Whitney U tests.

Results:

There was a statistically significant and inverse correlation between the BWAP score and the MV duration such that a high BWAP score was associated with a shorter MV time (p = 0.041). Also, the mean number of re-intubation (p = 0.001) and the number of re-connection to the ventilator in the intervention group were significantly lower (p = 0.005).

Conclusions:

The results showed that nurses' assessment of patient's readiness for weaning from MV based on this tool and designed nursing care reduced the duration of MV, re-intubation, and re-connection.
A Comparative Study of Ultrasound-Guided Transversus Abdominis Plane Block with Local Anesthetic Infiltration in Inguinal Hernia Repair
Authors: Amir Syed Hussain , Chitra Kumari , Ali Qazi Ehsan , Jha Prabhash Chandra , Saquib Md. Chandra
Published: April 2021

Background:

Transversus abdominis plane (TAP) block is a relatively newer block that provides analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall.

Aims:

To determine the effectiveness of the TAP block over wound infiltration for hernia repair.

Settings and Design:

Randomized, double-blinded, prospective study in an academic teaching hospital.

Methods:

Sixty patients were divided into two groups of 30 each. In Group T, patients received ultrasound-guided TAP block for inguinal hernia repair whereas in Group I, local anesthetic infiltration at the wound site was done. Primary outcome measure was pain relief as assessed by a numeric rating scale (NRS) whereas secondary outcome measures were duration (from the time at which TAP block or local anesthetic infiltration is given to the time at which patient first requests for rescue analgesic) of post-operative analgesia, patient satisfaction score, and complications, if any.

Results:

Mean NRS score at 0hr for a group I was 0.88±0.74 and for group T was 0.68±0.70 with a p-value of 0.28 and the mean NRS score at 24hr for the group I was 4.47±0.66 and for group T was 4.54±0.62 with a p-value of 0.68 but at 2hr, 6hr and 12hr, the NRS was significantly more in group I (p < 0.05). Mean time of 1st analgesic request in group I was 403.73 minutes as compared to group T where it was 711.33 mins (P<0.001). The post-operative nausea and vomiting (PONV) and sedation in group I was significantly more than group T.

Conclusion:

Ultrasound-guided TAP block provides better postoperative analgesia both in quality and duration. TAP block reduces the opioid demand and opioid-related side effects like sedation and postoperative nausea vomiting and thus, improves overall patient satisfaction.
Bone cancer pain
Authors: Hernández-Porras B. Carolina , Plancarte Ricardo , Andrade Juan Miguel , Koyyalagunta Dhanalakshmi
Published: April 2021

In 2012, the International Agency for Research on Cancer reported 14.1 million new cancer cases, 8.2 million cancer deaths, and 32.6 million people living with cancer. Cancer pain not only causes significant suffering but also contributes to a decreased quality of life, functional status, and greatly increases health-care costs. The bones are a common site for metastases, especially tumors involving breast, lung, prostate, and kidneys. This can lead to significant pain, pathological fractures, compression of the spinal cord, poor quality of life, and increased mortality. Pathophysiology of cancer-induced bone pain is complex and has neuropathic and nociceptive characteristics. The aim of the treatment of bone metastases is palliating painful symptoms and preventing progression of skeletal-related events. A multimodal approach including various cancer therapies, analgesic and adjuvant agents, and interventional modalities should be used. This review focuses on the pathophysiology of bone cancer pain and pharmacological and non-pharmacological modalities that reduce bone cancer pain.
Molecular dynamics simulation of Fe-NO2 At-alpha mangostin as radiopharmaceutical model for detection of fatty acid synthase in cancer
Authors: Rosilawati N. Elly , Yusuf Muhamad , Kartamihardja Achmad Hussein S. , Samsuddin Shaharum , Muchtaridi Muchtaridi
Published: April 2021

α-mangostin is a xanthone compound isolated from mangosteen pericarp. It is known as an anticancer through induction of apoptotic process by inhibiting fatty acid synthase (FAS) receptor. α-mangostin is a potentially useful ligand for diagnostic purposes in the form of complexes with a radionuclide such as68Gallium (68Ga). Unfortunately, α-mangostin could not be directly labeled with radionuclides. In order to be labeled, a chelator such as 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA), a derivative (NO2At), is required. The aim of this study was to find out the interaction of Fe-NO2At-α-mangostin complex compound against FAS receptor using molecular dynamics software. Both the metals have similar chemical characteristics. The results showed a strong interaction between Fe-NO2At-α-mangostin complex compound and FAS receptor. The molecular dynamic showed the complex compound Fe-NO2At-α-mangostin in FAS-KS which produced a bond-free energy values (ΔG) of − 96.7 kcal/mol, forming hydrogen bonds with amino acid residues Glu 115 and Ser 114. The model of molecular dynamic result could be used as a model for the production of 68Ga-α-mangostin in radiopharmaceutical.
Retrospective and prospective monitoring in post COVID-19 complications and an approach for vigilance in Post-recovery period
Authors: Rao Devulapalli S , Nomier Yousra A. , Ahmed Rayan A. , Noureldeen Amal N.
Published: April 2021

COVID-19 is a Severe acute respiratory syndrome (SARS-CoV-2). It threatened the whole world and considered as pandemic recently, emergencies and quarantine has been declared all over the world. Many published reviews and research articles, discussed analysis, symptoms, diagnosis, and possible ways of treatments. However, nowadays, more focus is inclined on recovered patients and the possible events faced by these patients in postrecovery period. Specialists, medical care workers are looking for unmistakable approaches to defend their life later on. It is important to have a full background on their physical and psychological status after their recovery with certain guidelines to follow-up. There is more concern, care for family and society as they might suffer from stress, depression, and stigmatization from society. Awareness programs and counseling should be recommended to bring the recovered patients to their normalcy. Surveys and cohort studies will be helpful for prognosis of the disease as well as to be ready to face the second stage of COVID-19. This article will focus on recovered COVID-19 patients, their complications, precautionary methods, and post care.
Bioactivities of Karanda (Carissa carandas Linn.) fruit extracts for novel cosmeceutical applications
Authors: Khuanekkaphan Monsicha , Khobjai Warachate , Noysang Chanai , Wisidsri Nakuntwalai , Thungmungmee Suradwadee
Published: April 2021

The aim of this research was to determine the total phenolic content (TPC), antioxidation, antiaging, and antibacterial activities of Carissa carandas Linn., and aims at the novel plant sources which is utilized for their cosmeceutical applications. The two conditions (fresh and dried) and three stages (unripe, ripe, and fully ripe) of C. carandas were extracted by ethanolic maceration. Folin–Ciocalteu assay was used for determining the TPC. 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays were used for estimating antioxidant activity. The inhibitory tyrosinase activities were measured using the modified dopachrome assay. Antiaging was evaluated by inhibition of collagenase and elastase, and antibacterial activities. The result of six extracts from C. carandas showed that the highest phenolic content and elastase inhibition of the fresh fruit in fully ripe stage were 100.31 ± 2.64 mg GAE/g extract and 14.11% ± 0.95%, respectively. The fresh fruit in the unripe stage showed that the strongest percentage of DPPH IC50 and collagenase inhibitory activity were 29.11 ± 0.23 μg/mL and 85.94% ± 2.21%, respectively. The ethanolic extract of unripe dried fruit exhibited the highest antioxidant activity in the of ABTS assay, with an IC50 of 0.17 ± 0.01 μg/mL. The MBC displayed the dried fruit ripe stage anti Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus strains were 25.0, 25.0, and 16.25 mg/mL, respectively. The fresh fruit in the ripe stage showed that the strongest inhibition tyrosinase was 93.88% ± 5.64%. The conclusion of this research indicates that the fresh fruit of C. carandas fruit extracts has high potential as a novel cosmeceuticals’ applications to antiaging and skin whitening. The dried fruit in ripe stage extract has the most effective ingredient for antiacne products.
Comparison of Anthropometric and Metabolic Parameters between Normal and Deficient Vitamin D Polycystic Ovarian Syndrome Women
Authors: Bahadur Anupama , Mundhra Rajlaxmi , Kashibhatla Jyotshna , Verma Neha , Rajput Rashmi , Bahurupi Yogesh
Published: April 2021

Objective:

To compare the anthropometric and metabolic parameters between normal and deficient Vitamin D PCOS women.

Materials and Methods:

All women with polycystic ovary syndrome (PCOS) women were analyzed over a period of eighteen months from- May 2016 to October 2017. The study participants were divided into two groups as per 25(OH)D level. Those with 25(OH)D level <20 ng/ml (Vitamin D deficient) were taken group I and those having 25(OH)D level ≥ 20 ng/ml i.e., sufficient vitamin D levels were group II. We measured anthropometric measurements and metabolic parameters like lipid profile, fasting insulin, fasting blood sugars and HOMA-IR.

Results:

Eighty-five women were evaluated during the time period. The mean age of the study sample was 23.34 ± 4.587. Almost 40 % (n=34) of the study sample were vitamin D deficient and more than half of PCOS women (n=51) had sufficient vitamin D levels. Out of 85 women analyzed in this study, 48.23% were obese (Group I: 52.9% and 45.1% in group II). The vitamin D deficient group was comparable with the sufficient group in terms of anthropometric and biochemical parameters, except fasting serum insulin levels, which was infact lower in the vitamin D deficient group as compared to vitamin D sufficient group. None of the parameter showed any significant correlation with vitamin D.

Conclusion:

Hypovitaminosis is a common occurrence in PCOS women, necessitating the need for screening to prevent future adverse outcome. Further large-scale trials need to be done.
A Rare Differential Diagnosis of Gluteal Mass
Authors: Jayabal Pandiaraja , Arumugam Shalini
Published: April 2021

Fat necrosis is an inflammatory process of fat folloing an insult to the adipose tissue. It is more common in the body region here there is high adipose tissue. It can present ith cellulitis, skin necrosis, discharging ounds, and mass. Carcinoma is one of the differential diagnoses of fat necrosis. Our case is presented ith a gluteal mass hich as diagnosed as a hydatid cyst, based on the imaging. Sometimes, imaging fails to identify traumatic fat necrosis, particularly if it is associated ith a capsule ith multiple fat lobules. Postoperative history confirms the encapsulated type of fat necrosis ith fat lobules. Encapsulated traumatic fat necrosis should be considered one of the differential diagnoses of hydatid cyst.
Unusual Clinical Accompaniment of Inflammatory Thyroiditis Preceding Hypothyroidism in Radiotherapy of Head-And-Neck Cancer
Authors: Yadaraju Vijaya Aditya , Narayan Aditya , Kandipalli Shilpa , Adusumalli Praveen , Sinha Sweta , Venkata Satya Prabhakar Rao Vatturi
Published: April 2021

The authors report an unusual clinical phenomenon of head-and-neck radiotherapy-induced thyroiditis presenting with clinical features of hyperthyroidism on immediate clinical follow-up with raised thyroid hormone levels. Conventional technetium thyroid scan showed a discordantly absent thyroid gland uptake instead of expected thyroid avidity in hyperthyroidism. The thyroid gland subsequently reverting to normal uptake in the postrecovery stage confirmed the thyroiditis nature, with prior radiation to the neck being the possible inciting factor.
Dosimetric Analysis and Acute Toxicity Comparison of Bone Marrow Sparing Intensity-Modulated Radiation Therapy versus Three-Dimensional Conformal Therapy with Concurrent Chemotherapy for the Treatment of Cervical Carcinoma
Authors: Bora Ghritashee , Kalita Apurba Kumar , Bhattacharyya Mouchumee , Singh Moirangthem Nara , Medhi Partha Pratim , Sharma Shashi Bhushan , Bansal Shashank , Paul Moumita
Published: April 2021

Background:

The aim of the study was to compare the dosimetry and acute toxicities of bone marrow sparing intensity-modulated radiation therapy (BMS-IMRT) and three-dimensional conformal radiation techniques (3DCRT) in locally advanced cervical cancer.

Materials and Methods:

This is a hospital-based prospective randomized study and histologically proven locally advanced cervical carcinoma patients were selected for the analysis. A total of thirty patients were equally allocated in the two treatment arms: BMS-IMRT and 3DCRT. External beam radiation therapy was delivered to a dose of 50 Gy/25# followed by high dose rate brachytherapy along with concurrent chemotherapy. The target volumes and the organs at risks were delineated. The BM comprised pelvic BM (PBM); lumbosacral BM (LSBM); ilium BM (IBM) and Ischium, Pubis and Pelvic femora together constituting lower PBM (LPBM).

Results:

BMS-IMRT was superior to the 3DCRT arm in reducing the dose to the PBM, small bowel, rectum, and bladder. On comparison of the BM dose volume histogram, the P value was significant (BMS IMRT vs. 3DCRT) in the higher dose range (30 and 40 Gy) for the IBM, LPBM, and whole pelvis BM. However, the difference in the low-dose irradiation (10 and 20 Gy) region was not significant. Furthermore, in the LSBM region, BMS IMRT was superior at all dose levels with no significant P value. Acute toxicities were higher in the 3DCRT arm.

Conclusion:

Thus, BMS-IMRT resulted in significant reduction of dose to the PBM. This can help in reducing the hematologic toxicities associated with pelvic radiation.
Вариационный метод для эллиптических систем с разрывными нелинейностями
Authors: Pavlenko Vyacheslav Nikolaevich , Potapov Dmitriy Konstantinovich
Published: April 2021

Изучается система из двух эллиптических уравнений с разрывными нелинейностями и однородными граничными условиями Дирихле. Вариационным методом получены теоремы существования сильных и полуправильных решений. Сильное решение называется полуправильным, если мера множества, на котором значения решения являются точками разрыва нелинейности по фазовой переменной, равна нулю. Выделены классы нелинейностей, для которых выполняются условия доказанных теорем. Вариационный подход в настоящей работе базируется на понятии квазипотенциального оператора, в отличие от традиционного, где используется обобщенный градиент Кларка.
Библиография: 22 названия.
Adequacy or otherwise of cemetery space for sustainable human body disposal in Benin city, Nigeria
Authors: Ibhadode C.A.E. , Dirisu A.R. , Akhimien F.O.
Published: April 2021

The adequacy or otherwise of cemetery space in Benin City was assessed in 2014, based on population projected from the 2006 census figures. The area of each cemetery was determined by running a Global Positioning System (GPS) traverse round each, which gave a total of 11.979 Ha. At a rate of 0.5 Ha of cemetery space to 1000 population, for 50 years, 702.749 Ha would be required for cemetery in Benin City. Results have shown that of these, only 1.68% is available for the teeming population of the city which comprised the three major Local Government Areas (LGAs). It is therefore recommended that cemeteries be established in new sites in each LGA, should reflect the population trends in order to achieve sustainable human body disposal in the city.Key Words:  Death, Global Positioning System, Inhabitants, Population, Sites
Contamination levels of domestic water sources in Maiduguri Metropolis, Borno State, Northeast, Nigeria
Authors: Jimme M.A. , Bukar W.M. , Monguno A.K.
Published: April 2021

The study examines the levels of contamination of domestic water sources in Maiduguri Metropolis area of Borno State based on their physicochemical and bacteriological properties.  It was informed by the global concern on good drinking water quality which is an indicator of development level; hence the focus on domestic water sources to ascertain safety as water from unhygienic sources pose serious health challenges. The study dwelt on physicochemical and bacteriological parameters believed to have health implications. Experimental design was adopted, where water samples derived from four different sources i.e. from treated surface water, deep boreholes, wash boreholes and harvested rainwater were tested in the laboratory for  pH, total dissolved solids (TDS), total hardness (TH), aluminium (Al), arsenic (As), cadmium (Cd), chromium (Cr), cupper (Cu), cyanide (Cn), lead (Pb), fluoride (Fl) and nitrate (NO3). Also tested were faecal coliform (E. coli) and total coliform counts in the samples. The results showed that levels of physicochemical parameters are within the acceptable limit of WHO mostly in samples from deep boreholes and treated surface water sources. Samples from wash boreholes and harvested rainwater show escalated levels of some of the physicochemical parameters. The two sources also did not yield zero E. coli count. The study concludes that water from wash boreholes and harvested rainwater sources potent health risk. Thorough epidemiological study to determine health implications of drinking water from wash boreholes and harvested rainwater in the study area was offered as recommendation.Keywords: Domestic Water, Contamination, Boreholes, Diseases
Bone Marrow and Peripheral Blood Cells Toxicity of a Single 2.0 Gy Cobalt60 Ionizing Radiation: An Animal Model
Authors: Akeem Shittu , Lukman Olatunbosun , Eltahir Khalil , Fatai Olalere , Abiola Babatunde , Khadijat Omokanye
Published: April 2021

BACKGROUND: Bone marrow is extremely vulnerable to damage caused by radiation therapy. Hence, bone marrow suppression is an important side effect of radiotherapy. Effective use of radiotherapy is therefore compromised by radiation-related injuries.MATERIAL AND METHODS: Six Guinea-pigs were recruited for the study of which three were subjected to total body irradiation with Co60 while the other three served as controls. Bone marrow and peripheral blood samples were collected before and at days 9, 14 and 21, post irradiation. Manual and automated counts were performed for bone marrow nucleated cells and peripheral blood cells respectively.RESULTS: Declining bone marrow cellularity was evident immediately post irradiation. Mean ± SD of marrow cell counted per mm3 were 121,924±281, 87,603±772, 121,367±375 and122,750±1000 pre-irradiation and days 9, 14 and 21, postirradiation (p-values 0.10, 0.27 and 0.29 respectively). Significant drops in counts were noticed on day 9 post-irradiation for all red cell parameters (p-values <0.05), for Total White Blood Cell Count and Neutrophil count (p-values <0.05) and also on days 14 and 21 for Lymphocytes (p-values <0.05) and on day 21 for Eosinophil/Basophil/Monocytes (p-value <0.05). A significant drop in platelets counts was also noticed on day 9 (p-value <0.05) which significantly increased above pre-irradiation value on day 21.CONCLUSION: Total body irrradiation with Co60 significantly affects the bone marrow with maximum reductions in marrow nucleated cells and peripheral blood cells counts on day 9 post irradiation.