bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of ultrasound-guided tru-cut needle pleural biopsy in the diagnosis of unexplained exudative pleural effusion compared to medical thoracoscopy
Authors: Elaraby Mostafa B. , Elsharkawy Ahmed M. , Attia Ghada A. , Ganna Salwa A.
Published: October 2024

Background

Ultrasound-guided needle biopsy (USGNB) allows for precise and immediate viewing of pleural lesions, effusions, and needle placement without ionizing radiation. This study aimed to assess the efficacy of US-guided tru-cut needle pleural biopsy in diagnosing unexplained exudative pleural effusion compared to medical thoracoscopy (MT), focusing on safety, accuracy, time, and cost of the treatment.

Patients and methods

This observational cross-sectional research was conducted on 40 patients over 18 years old, of both sexes, with unexplained exudative pleural effusion. The patients were randomly separated into two equal groups. The girst group is USGNB and the second group is MT.

Results

Group II exhibited substantially greater costs, sedation levels, procedure duration, biopsy site discomfort, surgical emphysema, lung expansion failure, and psychological distress compared to group I (P<0.05). There was no notable disparity between the two groups regarding radiological detection of pleural effusion, pleural fluid properties, procedural observations, histological results, and diagnostic effectiveness. The duration of hospitalization was considerably shorter in group I compared to group II, assessed from the day of the operation to the day of release (P=0.001).

Conclusion

USGNB is an important tool in the diagnosis of pleural effusion after failure of pleural fluid analysis, which is performed by a chest physician is an accurate, safer, lower in cost, and shorter in duration with fewer complications compared with MT.
Cardiopulmonary exercise testing in patients with obstructive sleep apnea
Authors: El Sokkary Raafat T.I. , Azzoz Ahmed M. , Abd Elhamied Asmaa G.
Published: October 2024

Background

The cardiopulmonary exercise testing (CPET) is a noninvasive process aiming to evaluate the respiratory and cardiovascular system during exercise.

Aim

To study the effect of obstructive sleep apnea (OSA) on cardiovascular system and exercise capacity and to correlate the severity of OSA with CPET parameters.

Patients and methods

Fifty patients (30 males and 20 females) were enrolled in this study, diagnosed as OSA based on polysomnography (apnea–hypopnea index ≥5). All patients were given a thorough medical history, a thorough physical examination, an arterial blood gas analysis before and after exercise, a pulmonary-function test, polysomnography, and a CPET.

Results

Patients with mild/moderate OSA had significantly higher oxygen consumption (VO2) at peak (ml/min) and predicted value. Predicted VO2/kg was significantly higher among patients with mild/moderate OSA. Also, patients with mild/moderate OSA had significantly higher LT. Out of enrolled patients, three (6%), 15 (30%), and 32 (64%) patients had mild, moderate, and severe exercise impairment, respectively. Majority (90%) of the patients with severe OSA had severe exercise impairment, while majority (70%) of those with mild/moderate OSA had moderate exercise impairment.

Conclusions

OSA causes exercise impairment, which has a positive correlation with the severity of the disease.
The outcome of coronavirus disease 2019 in hospitalized patients with diabetes mellitus at Assiut University Hospital
Authors: Khalaf Mohammad G.A. , El-Sokkary Raafat T.I. , Eskander Martina S.L. , Azzouz Ahmed M.
Published: October 2024

Rationale

The chronic nature of diabetes renders it a risk factor for lower respiratory tract infections, adversely impacting patient prognosis.

Objective

This study aimed to investigate the influence of diabetes on the outcomes of coronavirus disease 2019 (COVID-19) patients.

Patients and methods

This prospective cohort study enrolled 160 patients admitted and diagnosed with COVID-19. Patients were categorized according to glycated hemoglobin level into two groups: diabetic and nondiabetics (80 patients each). The COVID-19 severity index was calculated for all patients. Follow-up of their in-hospital stay and incidence of complications was documented.

Results

It was found that diabetic patients had a significantly higher percentage of severe COVID-19 cases (83.8 vs. 61.3%) [odds ratio (OR)=1.89, 95% confidence interval (CI)=1.02–3.48]. The diabetic group had higher rates of ICU admission (OR=2.21, 95% CI=1.06–4.57), invasive mechanical ventilation (OR=3.75, 95% CI=1.321–10.803), and mortality (HR=1.69, 95% CI=1.132-2.514) compared with nondiabetic patients (33.8 vs. 18.8%, 20 vs. 6%, and 41.5 vs. 21.2%, respectively). From the nondiabetic group, 68.4% of prediabetic patients had hyperglycemia requiring insulin treatment during their hospital stay versus 31.6% of normoglycemic patients.

Conclusion

Diabetes mellitus is associated with more severe manifestations of the disease, increased complications, ICU admissions, ventilatory requirements, and mortality rates compared to nondiabetic individuals. COVID-19 is associated with poor glycemic control.
Study of malnutrition in patients with idiopathic pulmonary fibrosis
Authors: Dayem Aya A. , Knany Esraa R. , Ruby Dina
Published: October 2024

Background

Although the interest in Idiopathic Pulmonary Fibrosis (IPF) has increased in recent years due to the appearance of new therapies however the interest has focused on pulmonary involvement with little concern for systemic manifestations such as the nutritional status abnormalities. Thus, our study assessed the malnutrition prevalence in patients with IPF and the best indicators for the assessment of malnutrition among them.

Patients and methods

This work was conducted on 110 stable IPF patients who attended the outpatient clinic of Ain Shams University Hospitals from October 2020 to July 2021. Data about the detailed history and nutritional assessment was collected.

Results

22.7% and 20.9% were malnourished according to the definition of fat-free mass index (FFMI) and body mass index (BMI), respectively. Most malnourished patients according to low FFMI were female; not using PPI was a significant independent predictors of malnutrition. There was a statistically significant relation between low FFMI and low serum albumin, hemoglobin, and oxygen saturation. Our findings also revealed that measuring BMI and being less than or equal to 22.1 kg/m2 and mid-arm circumference (MAC) less than or equal 28.5 cm is significantly related to low free fat mass index (malnutrition) and increases that risk by 31.63 folds.

Conclusion

Nearly one-quarter of IPF patients were malnourished and it was found that measuring BMI less than or equal to 22.1 kg/m2 together with MAC less than or equal to 28.5 cm can predict low FFMI and that can be used in our clinical approach.
The role of pulmonary rehabilitation in improving lung functions in patients with ankylosing spondylitis
Authors: Ahmed Nehal M. , Galal Ahmed M. M. , El Helow Mohammed R. , Ahmed Sahar F. , Salama Sherihan M.
Published: October 2024

Background

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by axial and peripheral entheseal inflammation and new bone production(1).

The development of syndesmophytes, enthesophytes, and spinal fusion along the course of the disease is linked to chronic pain, functional impairment, and disability(2).

Fibrosis of the upper lobes of the lungs (interstitial lung disease) and chest wall abnormalities are two of the emerging forms of pulmonary involvement in AS. (3).

Pulmonary rehabilitation is a multifaceted program of education, counselling, breathing exercises, and other modalities that can increase the patient’s independence and ease of functioning(4).

Aim

To estimate the role of pulmonary rehabilitation in enhancing lung function in AS individuals in relation to disease activity, clinical, and functional parameters.

Patients and methods

This study was an interventional study: single-arm group (prospective randomized clinical study). Thirty people (30) participated in that study from those presented to Physical Medicine, Rheumatology and Rehabilitation inpatient and outpatient clinic at Ain Shams University hospitals, diagnosed as radiographic axial spondyloarthropathy (SPA) from 02/2022 to 12/2022. All patients underwent pulmonary rehabilitation program and were exposed to a detailed history, clinical, and pulmonary function testing. Disease activity was evaluated by Ankylosing Spondylitis Disease Activity Score C-reactive protein (ASDAS-CRP), Valuation of function by using Bath Ankylosing Spondylitis Functional index (BASFI), 6-Minute walk test (6MWT), the Modified Borg Dyspnoea Scale (MBS), and Timed Up and Go (TUG) test. All function and clinical scores were done at baseline and repeated after completing pulmonary rehabilitation program.

Result

The mean age of patients was 36.57 ± 7.83 years (23–45 years), with a median disease duration of (5 (3–9) years). In total, there were 19 out of the studied patients with restrictive pattern. With comparison between pre- and postintervention of pulmonary rehabilitation, there was a significant statistical difference in all, disease activity (ASDAS and BASFI) and functional (MBS, TUG, and 6MWT) parameters (P <0.001), except for occiput to the wall. Regarding pulmonary function tests, including forced vital capacity (FVC), expiratory volume in one second (FEV1), and peaked expiratory flow (PEF), there was a statistically significant change at baseline and at the end of exercise (P <0.001).

Conclusion

Improved respiratory function and disease activity and overall functional activity are possible outcomes of pulmonary rehabilitation programs in combination with other rehabilitation interventions.
Validity of a new weaning index of discontinuation from mechanical ventilation in intensive care unit
Authors: Kamal Eman Sabry , Al- Rahman Salem Gamal Abd , Dwedar Ibrahim Aly , El Embaby Dalia Abd Elsattar
Published: October 2024

Background

Failure to wean from mechanical ventilation (MV) is a frequent problem in the intensive care unit (ICU) setting. Herein, we investigate a new WI measured at the initial spontaneous breathing trial (SBT) in order to predict successful liberation from MV in mechanically ventilated ICU cases.

Patients and methods

This prospective cross-sectional study consisted of two phases; Phase I was designed to create a new WI from the criteria of 60 mechanically ventilated patients, while Phase II aimed to assess the accuracy of that index in another 40 patients.

Results

The incidence of failed weaning was 33.3% in phase I, and 35% in phase II. Multivariate regression analysis was done for phase I variables, and the following equation was created; (((Cough strength×0.743)–1.927)×0.05+((PaCO2 (mmHg)×-0.126)+6.786)×0.08+((mean airway pressure (CmH2O)×-1.304)+14.119)×0.193+((PaO2/FIO2 × 0.268)-58.555)×0.328+((rapid shallow breathing index×-0.485)+24.406)×0.353). Using a cut-off value of >0.69 and Applying this index in phase II, it showed a mean value of -1.43 and 4.67 in the failure and success groups, respectively (P<0.001). This new WI with cut-off value (>0.69) had 88.5% sensitivity, 57.1% specificity, and a 77.5% accuracy to predict the success of weaning from MV.

Conclusion

We developed a new WI using formula including (semiquantitative Cough strength, PCO2 gradient mean airway pressure, PO2/FIO2 ratio, Rapid shallow breathing index) with accepted sensitivity and moderate specificity for predicting successful weaning from MV in ICU patients. Its use should be encouraged in the ICU setting, especially by less experienced ICU physicians.
Acute Limb Ischemia Secondary to Thrombosis in Persistent Sciatic Artery: A Case Report and Review of Management Strategies
Authors: Vikraman V. G. , Elancherathan K , Kumar Ashok , Rajkumar T.
Published: October 2024

Persistent sciatic artery (PSA) is a rare vascular anomaly with potential for significant vascular complications. We present a case of a 39-year-old male with acute limb ischemia secondary to thrombosis in a PSA, highlighting the challenges in diagnosis and management. Despite the absence of aneurysmal formation, the patient presented with severe pain and absent distal pulses, prompting urgent intervention. Computed tomography angiography revealed thrombosis extending into the left common iliac artery. Catheter-directed thrombolysis (CDT) was successfully performed, resulting in complete resolution of the thrombus and restoration of limb perfusion. The patient experienced symptomatic relief postoperatively and regained ambulatory function. This case underscores the importance of considering PSA in the differential diagnosis of acute limb ischemia and highlights CDT as an effective treatment modality. Further research is needed to optimize the management of acute limb ischemia associated with PSA and to evaluate long-term outcomes.
Efficacy and Safety of Radiofrequency Ablation and Trendelenburg Procedure for Varicose Vein Treatment in a Tertiary Care Hospital
Authors: Thulasikumar Rathnaganpathi , Gogineni Mahesh , Ravichandran Manoj Prabakar , Gunasekaran Marun Raj , Subrammaniyan SR
Published: October 2024

Context:

Varicose veins have been conventionally treated by Trendelenburg procedure, which includes below-knee phlebotomies, juxta-femoral flush ligation of saphenous veins, and below-knee vein stripping. However, radiofrequency ablation (RFA) therapy, a less invasive method that uses high-frequency alternating current to cause thermal damage to the venous tissue, has become increasingly popular due to its reduced adverse effects. This study aimed to compare these two methods regarding early ambulation, return to work, postoperative pain severity, recovery time, and complication rates.

Aims:

To compare the effectiveness and safety of open procedure compared to endovenous ablation.

Settings and Designs:

An analytical cross-sectional study was prospectively conducted at Saveetha Medical College in Chennai.

Subjects and Methods:

This analytical cross-sectional study, conducted prospectively from May 2020 to May 2023, involved 100 individuals diagnosed with varicose veins. Participants were followed up at 3-, 6-, and 12-month intervals. The study was carried out at Saveetha Medical College in Chennai. Fifty patients were treated using the Trendelenburg method (Group I), while 50 patients received RFA (Group II). The data on early ambulation, return to work, postoperative pain severity, recovery time, and complication rates were collected and analyzed using the Epi Info 7 version.

Results:

Group I did not show any significant complications, such as bleeding, hematoma, or inflammation, compared to Group II. Notably, in Group II, there was an earlier hospital discharge, faster return to daily activities and work, and faster patient mobilization.

Conclusions:

This study concludes RFA, compared to the Trendelenburg method, has early ambulation, early return to work, reduced postoperative pain, swift recovery, and fewer complications. Consequently, we recommend RFA as their primary surgical option for patients with varicose veins in the lower limbs.
Pediatric Limb Ischemia: Our Experience from a Tertiary Hospital in Oman
Authors: Al Hinai Meerah , Al Kindi Ibrahim , Stephen Edwin , Al Wahaibi Khalifa
Published: October 2024

Introduction:

Pediatric acute limb ischemia (PALI) is a consequence of sudden loss of blood flow to an extremity that can progress to irreversible ischemia if not promptly treated. This may unfortunately result in life-changing consequences which include limb loss, limb length discrepancy, emotional trauma, and or financial stress. Due to the rarity of this condition, and the lack of high-quality evidence, treatment strategies have largely been anecdotal or extrapolated from treatment of the adult patient. The article is a guide to improve overall functional outcomes and reduce morbidity of PALI.

Methods:

The authors retrospectively analysed patient data on the electronic patient record of the hospital between January 2021 and December 2023. The patients with PALI were divided into three broad categories: iatrogenic arterial injury managed with the best medical management, managed surgically; iatrogenic deep vein injury/thrombosis, and trauma.

Results:

A total of 13 patients were referred during the study period. 9 were male. 8 cases were line related, 2 trauma and 3 acute deep vein thrombosis [DVT]. Two patients succumbed prior to intervention. Eight patients were managed with best medical therapy, two surgically and one by endovascular means.

Conclusion:

Since experience worldwide is limited with PALI, we decided to share our experience and a propose comprehensive algorithm for the management of PALI emphasizing a multi-disciplinary team approach that we follow at our hospital. Early and decisive involvement of vascular surgeons, hematologists, intervention radiologists, and pediatric intensive care physicians is necessary to achieve the most favorable outcomes.
Synchronous off-pump Coronary Bypass and Extra-anatomic Thoracic Aortobifemoral Graft Using Anterolateral Thoracotomy Single-center Experience
Authors: Shah Apurva , Shah Kesha , Dixit Sunil , Mittal Sourabh
Published: October 2024

Background:

Aortoiliac occlusive disease can coexist with coronary artery disease in many instances leading to the dilemma of which problem to address first as for these patients with multiple comorbidities and high surgical risk, it is critical to decrease the overall physiologic burden of surgery when possible. Furthermore, with severe or complete occlusion of vascular supply to lower limbs, it proves beneficial to avoid two-stage surgeries because of the high risk of irreversible ischemia necessitating amputation.

Material and Method:

Hence, we attempted single-stage combined coronary artery bypass grafting with thoraco-bifemoral bypass grafting through left anterolateral thoracotomy in five cases.

Results:

In all 5 cases we got successful results with no major complications.

Conclusion:

Thus, CABG with thoracofemoral bypass grafting in single surgery can prove to be good alternative for patients with concomitant PVD (peripheral vascular disease) with CAD (coronary artery disease).
New Classification of Inferior Phrenic Artery Variations Correlated with Computed Tomography Angiography: Clinical Significance
Authors: Kumar Suresh D , Rajkumar R Vivil Vidya , Anish N , Ethiraj Dillibabu
Published: October 2024

Background and Aim:

A comprehensive understanding of the variations in the inferior phrenic artery (IPA) origin is essential for various interventional and surgical procedures utilized in treating conditions such as hepatocellular carcinoma, hemoptysis, trauma, iatrogenic injuries, and organ transplantations. In this study, we analyzed 1008 computed tomography angiography (CTA) cases and correlated the findings with the newly proposed classification of IPA variations of our study.

Materials and Methods:

Retrospectively evaluating IPA variations in 1040 cases, excluding 32 subjects, this study collected patient data from the hospital’s picture archiving and communication system. The analysis focused on IPA origins, including connections to the celiac artery, left gastric artery, and renal arteries. The inclusion criteria comprised routine CTA of the upper abdomen, with exclusion criteria excluding major vascular pathologies, upper abdominal surgeries, and motion artifacts.

Results:

An evaluation of 1008 CTA studies revealed the prevalence of IPA variations, leading to a new classification system grounded in embryology. IPA was categorized into four main types and respective subtypes: Type I (41.8%), Type II (41.4%), Type III (3.3%), and Type IV (7.2%), with detailed breakdowns of subtypes within each category.

Conclusion:

While recognizing the significant clinical importance of IPA variations, this study addresses the scarcity of comprehensive research on the topic. By presenting a various IPA variations, this research aims to simplify the identification and reporting of these variations for improved clinical practice.
Diagnostic Imaging Vs. Pathoanatomical Diagnosis in Low Back Pain: A Change in Approach: A Case Study
Authors: Semwal Bhini , Joshi Sudip J. , Kumar Deepak
Published: October 2024

Abstract

Back pain is an unpleasant and disturbing experience in everyone’s life and is a common lifetime health disorder. Involvement of many spinal structures can be the cause of low back pain (LBP), which can lead to difficulty in identifying and diagnosing the cause precisely. There is uncertainty about the optimal approach and a wide variation in patient care, which has led to different beliefs that conservative management is effective and radiological investigation is unnecessary and vice versa. Systemic reviews have concluded that only 1% of the individual coming to primary care needs diagnostic imaging for serious pathology, and this will save individuals from labeling their diseases and not adding up psychological factors. This may also limit the overdiagnosis and over treatment approach. Retrolisthesis, one of the causative factors for LBP, is not common. Very few studies have been documented for physical therapy rehabilitation in retrolisthesis, and so far no new protocol emerged in chronic cases. People suffering usually have anxiety, depression, and reduced quality of life. Apprehension of pain with avoidance of physical activity leads to secondary structural changes and recurrence of back pain. Physical therapy tailored to stretch and strengthening exercises is the most evidence-based treatment for retrolisthesis. This case report presents a unique case of the retrolisthesis which was not responding to conventional treatment of exercises and interestingly got dramatic results with a change in approach. This will give new dimensions to contemporary practice.
Pre-Requisites for Novice Researchers to Conduct Clinical Research
Authors: Rath Padmalya , Jana Shib Narayan , Nayak Chaturbhuja , Saraswat Kruiti
Published: October 2024

Clinical research or medical research is an important and emerging research field which intends to produce the latest knowledge about healthcare, interventions, complications, etc. A clinical trial should be well-designed, planned, and executed. This article aims at guiding the researchers, especially the novice ones, to conduct clinical research methodologically. The key points essential for the researchers to undertake research projects are mentioned in this paper. This paper will be a practical, user-friendly manual for medical professionals, that is, physicians, nurses, study coordinators, and investigators, especially the new entrants in the respective fields, to carry out clinical trials. It presents the approach and guidance in a step-by-step way for conducting any clinical or medical research in an efficient way. The data obtained therefrom will be acceptable to the profession, and the acceptance of research findings by the scientific world will be increased.
All-inside Technique versus Conventional Full-tunnel Reconstruction for Anterior Cruciate Ligament Tears of the Knee: A Systematic Review and Meta-analysis
Authors: Banerjee Sumit , Gupta Akshat , Roy Sanchit , Jain Chirag , Elhence Abhay
Published: October 2024

Introduction:

There is a paucity of evidence in literature regarding the efficacy of all-inside anterior cruciate ligament reconstruction (AIACLR) vis-à-vis the traditionally used full-tunnel (FT) technique. The primary aim of this review, thus, was to shed light on this discrepancy and determine which of the two methods had more optimum results.

Methods:

PubMed and Cochrane Library databases were systematically searched by two independent reviewers. Selection criteria were laid down as per the patient, intervention, control, and outcome (PICO) format. All included studies were checked for quality and methodological strength using well-defined risk-of-bias assessment tools. Techniques were compared with respect to their graft and tunnel dimensions, functional outcome scores, and complication rates. Data analysis was carried out using the RevMan 5.3® software.

Results:

A total of 12 articles (six randomized control trials or randomized clinical trials and six prospective/retrospective cohort studies) with 880 knees were included in this study. In most instances of AIACLR, a short and thick quadrupled semitendinosus graft was used for reconstruction. Suspensory fixation devices alone or in combination with interference screws were used for graft fixation. The two techniques were comparable in terms of their functional outcomes, with a slightly lower graft failure rate with AIACLR.

Conclusion:

The AI technique provides a safe and reliable alternative to conventional ACLR in terms of comparable functional results, reduced postoperative pain, and lower graft failure rates. However, more comparative trials with long-term follow-ups are needed before a definitive statement can be put forward.
Orthopedic Applications of Single-photon Emission Computed Tomography/Computed Tomography in Identifying Pain Generators in the Pre- and Post-operative Patient
Authors: Theobald George O. , Foley Robert , Scattergood Sean , Redman Stewart , Graham Richard , Little David , Kulshrestha Randeep
Published: October 2024

Postoperative and benign bone pathologies can sometimes be difficult to elicit on purely anatomical-based imaging. Single-photon emission computed tomography-computed tomography (SPECT-CT) is an established modality with emerging applications in the musculoskeletal field that combines cross-sectional structural imaging with the metabolic data. It is thought to offer certain clinical advantages to conventional imaging modalities as it can be sensitive to conditions before they appear as a structural abnormality. The aim of this pictorial review is to demonstrate the musculoskeletal applications of SPECT/CT in the pre- and post-operative orthopedic patient. The evidence for the musculoskeletal application of SPECT/CT is reviewed in various pre- and post-operative patients focusing on the advantages and disadvantages of this imaging modality alongside conventional imaging. Alongside this we present a series of musculoskeletal SPECT/CT cases in postoperative spinal and extremity joints identifying such pathologies as loosening, pseudoarthroses and prosthetic joint infection. We also include cases on the nonoperative joint identifying pain generators for targeted therapy. This review has shown that SPECT/CT can be a useful adjunct alongside other conventional imaging modalities in identifying musculoskeletal pain generators in the postoperative patient. It is especially useful in situations where anatomical imaging modalities alone provide insufficient diagnostic information or lack of symptomatic improvement. SPECT/CT is therefore likely to remain an complimentary investigative tool for unidentified musculoskeletal pain or for postoperative patients with metalwork in
situ.
Clinicoradiological and Arthroscopic Correlation of Meniscal Injuries
Authors: Date Jay Yashavant , Bhalerao Nitin , Chaughule Chandrasen , Tanpure Sanket
Published: October 2024

Background:

Menisci in knee joint serve very important functions of distributing joint stresses and stabilizing the joint. Meniscus tears are on the rise because of increased sports participation. Along with detailed history taking, the physical examination and special investigations such as magnetic resonance imaging (MRI) are required to diagnose meniscal injuries. A diagnostic arthroscopy is considered as the gold standard. Owing to heavy work duties, overdependence on MRI without due clinical examination is on the rise. The aim of our study was to correlate the findings of clinically diagnosed meniscal tears with its radiological and arthroscopic findings and to find out the reliability of clinical examination and MRI in meniscal injuries considering arthroscopy as the gold standard.

Materials and Methods:

It was a prospective, longitudinal study performed over 12 months. All patients fulfilling inclusion criteria underwent clinical examination and MRI scan; the data obtained were evaluated and correlated with arthroscopic findings. Using necessary equations sensitivity, specificity and accuracy were calculated.

Results:

The clinical examination showed sensitivity, specificity, and accuracy of 75%, 90.62%, and 83.33%, respectively, when correlated with arthroscopy. MRI scan showed sensitivity, specificity, and accuracy of 82.86%, 92%, and 86.67%, respectively, when correlated with arthroscopy.

Conclusion:

MRI and clinical examination are comparably sensitive, specific, and accurate for diagnosing meniscal injuries with a subtle preference toward MRI. Author recommends a thorough clinical examination should suffice, but having a MRI scan beforehand is always beneficial in the absence of other concerns to do MRI.
The Association between the Duration of Anterior Cruciate Ligament Rupture-reconstruction with Meniscal Lesions and Knee Functional Outcomes
Authors: Khorasani Ahmad Ghoochani , Afshar Cyrus , Aghili SeyedHadi , Ranjbar Mehri Farhang , Golshaninejad Amirhossein
Published: October 2024

Background:

Given the controversial correlation between the duration of anterior cruciate ligament (ACL) rupture-reconstruction and knee functional outcomes reported in previous studies, this study aimed to investigate the correlation between the duration of ACL rupture-reconstruction with knee meniscal lesions and functional outcomes.

Patients and Methods:

This retrospective cohort study was conducted on 221 patients with ACL rupture who underwent ACL reconstruction at a referral hospital in Tehran, Iran, from April 2021 to May 2023. Demographic characteristics and data about the duration of ACL rupture reconstruction were collected using the patients’ clinical documents. The status of knee meniscal lesions had been evaluated using magnetic resonance imaging report or operation note. After that, knee functional outcomes had been assed using Osteoarthritis Outcome Score scale. The correlation between the duration of ACL rupture-reconstruction with knee meniscal lesions and functional outcomes was evaluated using the multivariate regression test.

Results:

Most patients were male, with a mean age of 28.38 ± 7.33 years. The correlation between the duration of ACL rupture-reconstruction and knee meniscal lesions was statistically significant (P = 0.026); however, the correlation between the duration of ACL rupture-reconstruction with the KOOS questionnaire scale score and all its dimensions as a scale for assessing knee outcomes was not significant (P > 0.05).

Conclusion:

Although early ACL reconstruction is accompanied by reduced knee meniscal lesions, this cannot improve knee functional outcomes.
Mid-term Clinical Outcomes after Reversed Shoulder Arthroplasty are Comparable between Older Patients with Rheumatoid Arthritis and those with Osteoarthritis
Authors: Mochizuki Takeshi , Yano Koichiro , Ikari Katsunori , Okazaki Ken
Published: October 2024

Background:

To investigate the clinical outcomes of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA), using patient-reported outcome (PRO) measures, and compare the finding to those in patients with osteoarthritis (OA).

Materials and Methods:

The study included 24 patients (11 with RA and 13 with OA) who underwent primary RSA with a minimum of 2 years of follow-up. Clinical data, including range of motion (ROM; flexion, abduction, external rotation, and internal rotation) and PRO measures (Shoulder36 questionnaire and disability/symptom scale in Quick Disability of the Arm, Shoulder, and Hand [QuickDASH-DS]), were assessed.

Results:

ROM, Shoulder36 scores (except sports ability scores), and QuickDASH-DS in the RA group, and ROM (expect internal rotation), Shoulder36 scores (except general health scores), and QuickDASH-DS scores in the OA group were significantly improved at follow-up than the preoperative state. At follow-up, there was no significant difference found in any of the variables between the RA and OA groups (flexion: 116.4° vs. 133.1°, P = 0.102; abduction: 100.5° vs. 120.8°, P = 0.159; pain score in Shoulder36: 1.8 vs. 2.1, P = 0.397; ROM score in Shoulder36: 2.1 vs. 2.1, P = 0.578; muscle strength in Shoulder36: 1.8 vs. 1.9, P = 0.680; QuickDASH-DS score: 48.1 vs. 32.7, P = 0.059).

Conclusion:

The mid-term clinical results after RSA were comparable between patients with RA and those with OA. RSA can be considered the surgical treatment of shoulder in both patients with RA and those with OA.
Criticism Towards the Ruler: Illustrations From the Letter of the Law and the Practice of the Polish Constitutional State
Authors: Tarnowska Anna , Gałędek Michał
Published: October 2024

The publication is devoted to several examples of the practice of criticism of the Head of State and executive power in Polish history. The authors have chosen three moments of interest: the first one is the first decade of the “Congress” Polish Kingdom established in 1815, and the second refers to the Second Polish Republic in the period after the coup d’État by Józef Piłsudski in 1926. Finally, the authors refer to some practical aspects of criticism of the authority in the public space in recent times, also recalling the high-profile criminal trial that reached the highest instance – the Supreme Court in 2023. In these examples, the authors focus on aspects of the permissibility of criticism, its specific forms and the reaction of the executive in the early history of the constitutional state and camouflaged criticism of power respectively, through the interwar liberal model of protection of freedom of speech and of the press, which failed in the face of authoritarian changes and the political will to protect the good name of one particular individual; after the death of Piłsudski, the lack of adequate legal protection post mortem was finally “remedied” by a particular repressive law. The last section of the discussion refers to the contemporary Polish state of law, and here the focus is on the faces of criticism and the forms of its suppression. In particular, attention was paid to the problem of the extensive use of means used by the police against criticism particularly unpleasant to the power camp (up to the bizarre action with the hiring of a jib) and the question of maintaining specific protection of the Head of State against defamation in the Criminal Code.
Diagrama do patrocínio com Naming Rights:
Authors: Covaleski Rogério Luiz , De Castro Paloma
Published: October 2024

O investimento em Naming Rights no âmbito do esporte tem aumentado no Brasil, ainda que o país não figure entre os principais mercados que concedem a marcas, mediante investimento, a possibilidade de associarem seus nomes a arenas, clubes e competições. Este estudo busca compreender como o “direito de nomear” se relaciona com o patrocínio esportivo, e pretende contribuir para a construção de uma perspectiva nacional que aborde tal ação de patrocínioassociada à Comunicação e ao Esporte. Para isso, por meio de revisão de literatura, pesquisa exploratória e entrevistas em profundidade, objetiva determinar as possíveis modalidades de Naming Rights e suas interrelações com o patrocínio esportivo. Como contributo da pesquisa, é proposto um diagrama de patrocínio que situa o Naming Rights como alternativa de promoção marcária às patrocinadoras e de adoção como incremento de receita pelos entes esportivos.
A esquerda e o golpe de 1964
Authors: Archila da Costa Francisco Otavio
Published: October 2024

“A ofensiva feroz da extrema direita põe em risco o futuro da democracia e dos valores civilizatórios”. O alerta é do professor e escritor Dênis de Moraes, em entrevista sobre o atual momento das esquerdas no Brasil, impactado pela perda das ruas e de uma parte da juventude para as forças conservadoras.
Characteristics and Outcomes of Patients Admitted to a Tertiary Pediatric Intensive Care Unit in Western Black Sea Region of Turkey
Authors: Metin Hamdi , Seçkin Akın , Sevinç Eylem
Published: October 2024

Background
While the mortality rate in paediatric intensive care units (PICU) is as low as 2.39% in developed countries, this rate is much higher in developing countries.
Objective
To evaluate the demographic and clinical characteristics of patients admitted to a tertiary pediatric intensive care unit (PICU) in Karabuk, Western Black Sea Region of Turkey.
Methods
88 critically ill children who were admitted to the PICU between June 2023 and June 2024 were retrospectively analyzed. It were evaluated age, gender, presence of chronic disease, reason for admission to the PICU, length of stay in both the intensive care unit and hospital stay, need and duration of high-flow nasal cannula (HFNC), need and duration of invasive mechanical ventilation, type of nutrition, need for inotropic drugs, the glasgow coma scale (GCS), nutrition, pretransport pediatric risk of mortality (PRISM) score and mortality rates.

Results
Forty-three (48.9%) of these patients were female. The median age of the patients was 4.5 years [1.0-12.75]. According to the intensive care unit hospitalisation diagnoses, 37 (42.0%) of the patients had respiratory distress at the highest rate.It was observed that 24 (27.3%) of the patients had a chronic disease. Mechanical ventilation support was required in 19.3% of patients admitted to PICU, and the mean duration of mechanical ventilation was 10.0 [1.5-50.0] days. Moreover, 38.6% of patients required high-flow nasal cannula oxygen therapy. Among patients hospitalized in PICU, the median length of stay in the intensive care unit was 4.0 [2.0-6.0] days and the median length of hospitalization was 7.0 [4.0-13.0] days. GCS score was found to be significantly lower in the group with mortality (p= 0.004). PRISM scores of patients with mortality were found to be statistically significantly higher (p
Daratumumab-Based Therapeutic Approaches and Clinical Outcomes in Multiple Myeloma and other Plasma Cell Dyscrasias: Insights from a Nationwide Real-World Chart Review Study
Authors: Tso Allison C. Y. , Chng Wee Joo , Goh Yeow Tee , Ooi Melissa G , Chen Yunxin , Nagarajan Chandramouli , Tan Daryl , Acharyya Sanchalika , Ong Kiat Hoe
Published: October 2024

Singapore leads Southeast Asia in the routine use of daratumumab for multiple myeloma and other plasma cell dyscrasias. This retrospective review analyzed 112 patients who received daratumumab between 2012 and 2020. Tolerability, and efficacy based on prior lines (PL) of therapy, cytogenetic risk group, and the presence of renal impairment were presented. Infusion-related reactions occurred in 26.8% of patients. Grades 1 and 2 hematological and non-hematological adverse events were observed in 14.3% and 33.9% of patients, respectively. After a median follow-up of 16.9 months, there was no significant difference in overall response rates (ORR) (86% versus 76.3%, p = 0.082) or depth of response (≥ complete response (CR), 35.1% versus 28.9%, p = 0.469) between myeloma patients with and without renal dysfunction. Newly diagnosed and relapsed/refractory patients had an ORR of 92% and 76.3%, and a ≥ VGPR (very good partial response) rate of 80% and 55.3%, respectively. Median progression-free survival (PFS) was better for patients with 0/1 PL compared to ≥ 2 PLs (19.8 versus 6.2 months, p < 0.001), with a deeper response (≥ CR, 38.5% versus 16.7%, p = 0.033). Forty-six and a half percentage of patients had high-risk FISH abnormalities, and those with 0/1 PL had a significantly better ORR than those with ≥ 2 PLs (83.3% vsersus 47.1%, p = 0.022), achieving an ORR similar to that of the general cohort (80.2%, p = 0.905). In conclusion, positioning daratumumab in earlier lines of therapy leads to better outcomes and may mitigate the impact of high-risk FISH abnormalities.
The Rise and Fall of Chanda Kochhar: Icici’s Governance Breakdown and its Linkage to SDG 5, 8 and 16
Authors: Verma Meenakshi , Verma Anuj , Patil Prachita , Pillai Rajani , Mandala Gangu Naidu , Bansod Saket
Published: October 2024

Objectives: The primary objective of this paper is to explore how corporate governance failures can disrupt progress toward SDGs by eroding organizational commitment and sustainability.
Theoretical Framework : This paper has adopted “The Stewardship Theory” model to align with the Corporate Governance practices at ICICI Bank and thereby highlight the flaws in the system.
 
Method: Chanda Kochhar began her career at ICICI Bank in 1984 as a Management Trainee. After navigating through a fierce succession battle, she rose to the level of Managing Director in 2009. She became the first woman in Indian history to lead a mighty bank, succeeding the group Chairman K.V. Kamath. She was the face of Women Empowerment in India till one fine day when she was accused of corporate misconduct and quid pro quo for her involvement in questionable deals between her husband and Venugopal Dhoot, which were brought to light by whistle-blower Arvind Gupta, prompting an investigation.
 
Results and Discussion: After preliminary hitches, the Central Bureau of Investigation thoroughly investigated this matter and found Chanda Kochhar guilty. This breakdown greatly impacted ICICI and had larger implications for achieving sustainability development goals (SDGs), predominantly those related to strong institutions & ethical leadership SDG 16, gender equality SDG 5 and decent work and economic growth SDG 8.
 
Research Implications: It was brought to light by an autonomous investigation that ICICI Banks’ CEO had failed to adhere to the set rules, regulations, and policies of the bank. In fact, she had dishonored the bank’s norms. This episode demonstrates how corporate governance failures can disrupt progress toward SDGs by eroding organizational commitment and sustainability.
Procedural Justice in Practice: A Comprehensive Study of its During the Implementation of the Criminal and Civil Procedure in the Basic Court of Gjilan and its Branches
Authors: Agushi Arben , Lutfiu Nuredin , Halabaku Agon
Published: October 2024

Propose: This study aims to analyze the implementation of the core principles of procedural justice Understanding, Neutrality, Respect, and Voice in the Basic Court of Gjilan and its branches.
 
Method: The perceptions and experiences of individuals involved in judicial processes will be evaluated through statistical, qualitative and quantitative methods, structured questionnaires, interviews, direct observation of court sessions (including communication, physical and emotional behavior of judicial staff), and analysis of audio/video recordings and official documentation, such as court decisions and communications.
 
Results: The study will assess the level of dignity and respect experienced by individuals, investigate opportunities to voice opinions and concerns, evaluate the perceived neutrality of decision-makers, and assess their trustworthiness.
Lecturers' Perspectives on Disability and Inclusion in Afghan Higher Education Institutions: A Study Toward Achieving the Sustainable Development Goals
Authors: Naeemy Mohammad Idrees , Yoneda Hiroki
Published: October 2024

Objective: This study investigates lecturers' insights into disability and inclusive practices within Afghan Higher Education Institutions (HEIs), exploring the challenges and accommodations provided to students with disabilities (SwDs) in alignment with Sustainable Development Goal 4 (SDG 4), which promotes inclusive and equitable education.
 
Theoretical Framework: The study is grounded in the concepts of inclusive education and disability studies. The study draws on the medical and social models of disability to analyze how faculty members perceive and implement inclusive practices. The social model aligns with SDG 4’s emphasis on removing societal barriers to provide equal educational opportunities.
 
Method: This qualitative study uses semi-structured interviews with 27 faculty members from six Afghan HEIs. Purposeful sampling was used to select participants with knowledge of inclusive education. Data were collected through face-to-face and virtual interviews, transcribed, translated, and analyzed using thematic analysis.
 
Results and Discussion: Lecturers demonstrate willingness to support SwDs, but barriers such as inadequate infrastructure, limited faculty training, and societal attitudes persist. The findings highlight that current practices are predominantly shaped by the medical model, limiting inclusivity. Targeted faculty development and institutional reforms are needed to align practices with SDG 4.
 
Research Implications: This research offers critical insights for improving inclusive education in Afghanistan and other low-resource settings, informing policymaking and development of disability support services to achieve SDG 4.
 
Originality/Value: This study is among the first to explore faculty perspectives on inclusive education in Afghan HEIs, providing recommendations for developing inclusive frameworks in conflict-affected and resource-limited contexts.
The Reality Of Employing Artificial Intelligence Applications and its Challenges in Teaching People with Learning Disabilities from the Point Of View of Teachers (SDG'S)
Authors: Najadat Munjed M. , Obeidat Khaled Ahmad
Published: October 2024

Purpose: This study aims to investigate the reality of employing artificial intelligence applications and its challenges in teaching children with learning Disabilities from the point of view of teachers and specialists in Amman- Jordan schools.
 
Theoretical Reference: The study is grounded employing artificial intelligence applications and its challenges in teaching children with learning Disabilities from the point of view of teachers and theories of learning disabilities.
 
 Method: The descriptive analytical approach was followed,  The researcher prepared a study A self-designed measure of employing artificial intelligence applications  in the education of children with learning Disabilities  from the point of view of teachers and the challenges they face was administered to special education teachers in capital Amman city, Jordan, focusing on their.   The questionnaire underwent validity and reliability assessments to ensure its appropriateness for the study. Statistical analyses, including means, standard deviations, and t-tests, were employed to analyze the data. 
 
Results and Conclusion: The   study results found that learning disabilities teachers demonstrated a medium  level of knowledge regarding reality of hiring teachers with learning Disabilities for artificial intelligence applications. However, while the results indicated that the challenges facing teachers came with a high degree.
 
Implications of Research: The findings suggest a need for targeted professional development and support for special education teachers to enhance their effectiveness employing artificial intelligence applications  in teaching children with learning Disabilities  . Policymakers and educational leaders could use these insights to develop comprehensive strategies and resources that empower teachers and promote a safer learning environment for all students.
 
Originality/Value: The research contributes to understanding the use AI applications for children with learning disabilities. It raises awareness among officials about artificial intelligence applications and accessibility for these children with learning disabilities.