bluuebunny/crossref_metadata_2025 huggingface dataset:
Dental Anxiety Among 4-7-Year-Old Children Measured by Hand Gestures
Authors: Dave Bhavna Haresh , Thaker Bhriti Aditya , Inderchand Bhavana
Published: August 2023

Introduction:

Dental Anxiety (DA) can have a serious impact on daily life and is a significant barrier for seeking and receiving dental care. Hence, our aim is to develop new scale for the assessment of DA in children between 4 and 7 years.

Methodology:

Visual analouge scale(VAS) and Dave's hand gesture scales were laminated on A2 size paper, which was shown to 60 participants before the procedure, immediately after the procedure and ½ h postprocedure and the participants were asked to show the score on the laminated sheet without the presence of any of the parent/guardian.

Result:

Descriptive analysis of all the explanatory and outcome parameters was performed. Friedman's test was used to compare the mean anxiety rating scores of both rating scales. Pearson correlation test was accustomed to correlate the anxiety rating scores. Chi-square test was used to compare the preference/liking of the different anxiety rating scales. The level of significance was set at P < 0.05. The results were statistically significant the new scale was in accordance with VAS.

Conclusion:

Dave's hand gesture scale is a reliable and valid measure of child's DA.
Effect of Yoga and Naturopathy in a Patient with Uterine Fibroid
Authors: Deepa Y. , Aruchunan Mooventhan , Akshaya Mini T. , Akila A.
Published: August 2023

Uterine fibroids (UFs) are common in women during their reproductive age. A 40-year-old married woman was diagnosed with UF and underwent conventional treatment in March 2019. Her symptoms began with dysmenorrhea associated with bloating of the abdomen. Initially, she visited a private hospital, underwent ultrasonogram (USG) of the pelvis in a private diagnostic center, and the report suggests the presence of bulky uterus with fibroid and features of adenomyosis. Her physician advised to undergo a surgery, but she refused and thus visited our hospital. The patient underwent yoga and naturopathy intervention for the period of 11 days. The results of the study showed a reduction in the UF size from 27 mm × 22 mm to 22 mm × 18 mm in the 11 days of yoga and naturopathy intervention. Although the results are encouraging, it may vary because of a single case study. Hence, further well-planned clinical studies are suggested with a large sample size to validate our results.
Swabhava Vipratipatti Adhyaya of Sushruta Sutra Sthana - An Explorative Study
Authors: Mamidi Prasad , Gupta Kshama
Published: August 2023

Sushruta Samhitais an ancientAyurvedictreatise predominantly focused on surgery.Maharshi Sushrutais considered as the father of Indian surgery.Arishtha Vijnana(concepts related to prognosis) has been documented in the chapters 28–33 ofSutra Sthana(section that deals with basic principles ofAyurveda).Swabhava Vipratipatti Adhyaya(SVA) is the 32ndchapter ofSushruta Sutra Sthana(SSS). Various pathological signs and symptoms, which denote fatal consequences, have been documented within seven verses in this chapter. Works are scarce onArishtha Vijnanamentioned in SSS, and further, exploration is required. The aim of the present study is to explore the prognostic potential of the contents of SVA with the help of contemporary prognostic literature. Various pathological features having poor prognoses such as hypo- and hyper-pigmentation, hypo- and hypertonia, hypo- and hyperthermia, atrophy, hypertrophy, dystrophy, discoloration, sclerosis, ankylosis, dislocations, prolapse, abnormal involuntary movements, “-malacia,” “-megaly,” “micro- and macro-,” anhidrosis and hyperhidrosis, exophthalmos and enophthalmos, ptosis, neuromuscular disorders, lower motor neuron syndromes, autoimmune disorders with systemic manifestations, immunodeficiency syndromes, anorexia, cachexia, sarcopenia, carcinomas, dysfunctional tear syndrome, marasmic kwashiorkor, lymphedema, voice disorders (aphonia, hypophonia, dysphonia, etc.), dacrystic seizures, gastric outlet obstruction, epileptic drop attacks, priapism with cervical cord lesions, Tourette syndrome-plus, trichotillomania, and terminal lucidity can be seen in SVA chapter. The contents of SVA chapter of SSS seem to have prognostic importance, and the present study paves the way for the development of new hypotheses for future testing.
A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation
Authors: Xue Xiajuan , Jian Chao , Fang Yicong , Luo Lixiong , Guo Yinzong , Ling Bijuan , Cai Mingzhi
Published: August 2023

Objective:

The objective is to investigate if laparoscopic-dominant abdominoperineal resection (LDAPR) with individualised levator ani resection inhibits local recurrence (LR) and prolongs survival as compared to laparoscopic abdominoperineal resection (APR).

Materials and Methods:

Rectal cancer surgery cases were retrospectively identified from September 2014 to December 2019. LDAPR-treated group (55 patients) and the APR-treated group (71 patients) were included in the study. The operation time, circumferential resection margin (CRM), intraoperative tumor surgery (ITP), post-operative complications, the 2-year overall survival (OS) and LR were compared in the two groups.

Results:

The CRM and ITP were significantly reduced in the LDAPR as compared to the APR group (3.6% vs. 16.9%, t = 5.522, P = 0.019; 3.6% vs. 14.1%, t = 3.926, P = 0.048). In terms of post-operative complications, the incidence of urinary retention in LDAPR was significantly reduced than the APR group (10.9% vs. 25.4%, χ
2 = 4.139, P = 0.041). Similarly, perineal pain at 6 months or 1 year after surgery was significantly down-regulated in LDAPR than in the APR group (72.7% vs. 88.7%, χ
2 = 5.320, P = 0.021; 18.2% vs. 43.2%, χ
2 = 8.288, P = 0.004). However, there was no statistically significant difference in the post-operative complications between the LDAPR and APR groups. Finally, LDAPR led to a significantly improved 2-year OS and a reduced LR compared to APR.

Conclusion:

LDAPR reduces CMR, ITP and LR and simplified the perineum operation, subsequently protecting the pelvic autonomic nerves. Compared to the conventional APR, LDAPR is a promising procedure worth adopting for rectal cancer treatment.
Laparoscopic management of ovarian cysts during pregnancy under urgent situations
Authors: Tabatabaei Fatemeh , Hosseini Seyedeh Tala Nabipour , Hajiyar Reza
Published: August 2023

Background:

Majority of adnexal masses are incidental findings during pregnancy and resolve spontaneously. They may complicate pregnancy due to haemorrhage, cyst rupture and ovarian torsion. Laparoscopy is the preferred surgical intervention owing to shorter operative time, quicker recovery and lower post-operative pain. However, safety and feasibility of laparoscopic surgery in the management of ovarian cysts in pregnant women is challenging especially at advanced gestational ages and in urgent situations.

Methods:

In this retrospective study, a total of 48 cases of urgent laparoscopic surgeries were evaluated in the first and second trimesters of pregnancy between March 2018 and March 2021 in Al-Zahra Hospital, Tabriz, Iran.

Results:

The operations were ended in all patients successfully. The mean operation time was 45 min. There were no foetal maternal complications. All pregnancies had been terminated after 37 weeks of gestation. Oophorectomy had been performed in six patients and six other patients needed blood transfusion. Ovarian torsion was the most common reason for emergency surgery and mature teratoma was the most commonly reported pathology. Tocolytic therapy was required in six patients, and all of the patients were prescribed 50 mg of injectable progesterone twice daily for 10 days after surgery. The mean intra-abdominal pressure was equal to 15 mmHg and the mean end-expiratory carbon dioxide (CO2) pressure was 36 mmHg. Intravenous paracetamol was used to relieve post-operative pain. The mean hospitalisation time was 1.63 days.

Conclusion:

Most of the ovarian cysts can be managed laparoscopically with ensured safety and lower morbidity even in emergency situations at advanced gestational ages.
Long-term outcomes of vulvar or vaginal cancer patients undergoing laparoendoscopic single-site inguinal lymphadenectomy
Authors: Xu Jing-Yun , Yu Tian-Xiang , Guan Xiao-Ming , Ding Bo , Ren Mu-Lan , Shen Yang
Published: August 2023

Introduction:

Laparoendoscopic single-site inguinal lymphadenectomy (LESS-IL), a minimally invasive technique, has been reported in patients with vulvar or vaginal cancer regarding its safety and feasibility. However, the long-term outcomes, especially oncologic outcomes, are still lacking. We aimed to evaluate the long-term outcomes of LESS-IL to confirm its safety further.

Patients and Methods:

Data were prospectively collected from patients with vulvar or vaginal cancer who underwent LESS-IL at our institution between July 2018 and June 2021. The patients were followed up for at least 12 months. All procedures were performed according to treatment standards. Short- and long-term complications and oncologic outcomes were analysed.

Results:

A total of 16 patients undergoing 28 LESS-IL procedures were identified, amongst whom 4 underwent unilateral LESS-IL. The median numbers of excised groin lymph nodes were 9.0 (6.5–11.8) and 10.5 (8.3–12.0) in each left and right groin, respectively. Short-term complications occurred in 4 (25%) patients, including 18.7% lymphocele and 6.3% wound infection. Long-term complications regarding lower-limb lymphoedema appeared in 6 (37.5%) patients. Most short- and long-term complications were Clavien–Dindo 1 or 2, accounting for 90% of all post-operative issues. After a median follow-up of 27 (21.3–35.8) months, only 1 (6.3%) patient had isolated inguinal recurrence at 13 months postoperatively. No local or distant recurrence occurred.

Conclusion:

Our results suggest that LESS-IL is associated with little incidence of complications and promising oncologic outcomes, further demonstrating the safety and feasibility of the LESS-IL technique in patients requiring IL.
MIS for enucleation of leiomyoma of the oesophagus-strategic approach and experience of 19 cases
Authors: Rege Sameer Ashok , Dalvi Abhay N. , Churiwala Jayati Jagdish
Published: August 2023

Introduction:

Leiomyoma of the oesophagus, although rare, is the most common benign tumour to occur in the organ. Surgical approaches have evolved over time from an open thoracotomy or laparotomy to video-assisted thoracoscopic or laparoscopic and now robotic enucleation. We report a series of 19 cases of leiomyoma of the middle- and lower-third oesophagus treated by minimally invasive surgery.

Patients and Methods:

A retrospective analysis of 19 cases operated at a single tertiary care centre in India was performed. After the diagnosis of a benign oesophageal neoplasm on computed tomography (CT) and endosonography, laparoscopic transhiatal enucleation of the tumour for lower third (n = 16) and right-sided video-assisted thoracoscopic excision for middle-third tumours (n = 3) were performed. Dor fundoplication was done after the excision of leiomyomas from the lower oesophagus.

Results:

The most common symptom at presentation was retrosternal burning in lower oesophageal tumours, while tumours in the middle third of the oesophagus were asymptomatic and incidentally detected. The size of the tumour ranged from 3 cm to 8 cm in the largest dimension on contrast-enhanced CT scan. The mean operative time was 93 min ranging from 61 to 137 min. The average blood loss was 53 ml. No patient had an iatrogenic oesophageal mucosal injury. There were no conversions to open surgery or major complications including post-operative leak or death. Post-operative recovery was uneventful.

Conclusion:

The transhiatal approach to lower oesophageal leiomyomas is strategic to avoid complications of thoracoscopy, minimally invasive, cost-effective as compared to robotic surgery, suitable for adequate exposure and safe in the hands of an experienced laparoscopic surgeon.
Retroperitoneal approach for robot living donor nephrectomy: A step-by-step description of technical nuances
Authors: Shaikh Forqan Babu , Ganpule Arvind P.
Published: August 2023

Open, pure or hand-assisted laparoscopic, natural orifice transluminal endoscopic surgical (NOTES) and robotic approaches (Transperitoneal or retroperitoneal) are the described approaches for living donor nephrectomy. We describe the procedural steps of a robotic living donor nephrectomy (RLDN) retroperitoneal (RRLDN) technique using a da Vinci X surgical system and three robotic arms. This is the first reported case with the retroperitoneal robotic approach. The procedure in brief is as follows. First, with the patient placed in full flank position, the camera port is placed at the level of the Petit’s triangle apex. Retroperitoneal space is created by turning the index finger in a 180° movement through this port and a gloves balloon. The second 8mm port was inserted, 8 cm far from the first port, The peritoneum is reflected medially and downward off of the transversus abdominis muscle laparoscopically, respectively along the anterior and posterior axillary line; 3-5 cm caudally to the last one, a 12 mm AirSeal® assistant port is placed in the same manner. Only then, the port is placed under direct vision. The robotic ports placement will result in a caudally convex arc. This technique, due to the extensive use of the surgeon index, implies fast access to the retroperitoneum, protects the underlying anatomical structures from damage, and, due to the trocar positioning along an arc, lowers the arm conflict risk.
Effect of combination of Curcuma longa with Emblica officinalis in females with polycystic ovarian syndrome: An open-label, randomized active-controlled, exploratory clinical study
Authors: Gupte Poonam A , Khade Kalyani N , Wagh Girija N , Deshmukh Chaya S , Pandit Vijaya A , Bhalerao Supriya S
Published: August 2023

Introduction:

Polycystic ovarian syndrome (PCOS) is the commonest cause of infertility due to anovulation. The combination of Curcuma longa (CL) and Emblica officinalis (EO) is known to ameliorate diabetes and, thereby, may resurrect PCOS. The present study aimed to evaluate the effect of this combination prepared by two different methods, independently and with metformin (Met), compared with Met in PCOS on glycaemic control, inflammation, adipokines, and anthropometry.

Aim:

The aim of the study was to evaluate the effect of the combination of CL and EO, prepared by two different methods, independently and with Met, compared with Met in PCOS.

Materials and Methods:

PCOS women aged 18–35 years were selected through Rotterdam criteria from a tertiary care teaching hospital setting post-Ethics Committee permission. They were randomized to five groups (eight per group); combination of CL and EO prepared by traditional method (TF- Traditional Formulation), standardized extraction method (PNAE- Pharmanza Nisha Amalaki Extract), standard control Metformin (M­et) and their combinations, TF + Met and PNAE + Met for 90 days. Fasting glucose, insulin, lipid profile, reproductive hormones (luteinizing hormone [LH], follicle-stimulating hormone [FSH], and free testosterone), inflammatory markers (tumor necrosis factor-alpha [TNF-α], interleukin [IL]-6), and adipokines (leptin and adiponectin) were done at baseline and day 90, whereas anthropometry was done monthly.

Results:

Of 48 randomized women, 37 completed the study. TF and Met groups demonstrated higher weight decrease, whereas TF + Met significantly decreased waist circumference. Blood glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) decreased in all groups except glucose in TF + Met and HOMA-IR in the Met group. Only PNAE decreased free testosterone. TNF-α increased while leptin decreased in all groups. Both TF and PNAE, with Met reduced IL 6, significantly only in PNAE + Met group. Similarly, both TF and PNAE, with Met reduced LH/FSH ratio and significantly increased adiponectin. Two females, each, conceived in TF and PNAE, whereas one was in PNAE + Met group. No adverse events were reported.

Conclusion:

Both botanical formulations, TF and PNAE, were comparable to Met. The standardized extracts formulation PNAE seems more promising due to administration ease, smaller dose, and consistent bioactives.
Preparation, nutritional and glycemic properties of multigrain instant “adai” mix
Authors: Shobana Shanmugam , Gayathri Rajagopal , Sangavi Gopalakrishnan , Kavitha Vasudevan , Gayathri Nagamuthu , Anjana Ranjit Mohan , Sudha Vasudevan , Mohan Viswanathan
Published: August 2023

Background and Objectives:

“Adai” is a traditional South Indian breakfast prepared using the wet ground batter of white rice and pulses. Convenience foods are gaining popularity and owing to the increasing prevalence of noncommunicable diseases such as diabetes, there is a need for food products with lower glycemic index (GI). The current study aimed to develop an instant adai mix using brown rice, millets, pulses, and spices.

Materials and Methods:

The instant adai mix was prepared by blending pulverized brown rice, sorghum, and pulses (green gram, horse gram, decorticated and split red gram, black gram, and chickpea) along with roasted cumin, red chilies, and salt. The nutritional composition of the instant adai mix was analyzed, and GI of “adai” was evaluated in healthy human volunteers using International organization for standardization protocol.

Results:

The instant adai mix was rich in whole grains (48%) and pulses (45%). Nutritional profiling of the instant adai mix revealed that it is rich in protein and dietary fiber. One hundred grams of instant adai mix fulfill 27.8% of protein and 29.6% of dietary fiber requirements of recommended dietary allowance of adult male. Likewise, 100 g of instant adai mix fulfill 34.9% of protein requirements of the estimated average requirement of an adult male. The “adai” prepared from the instant mix exhibited medium GI (65.1).

Conclusion:

The instant “adai” mix was found to be nutritionally superior, and the adai prepared from the mix showed a medium GI. It can be a healthy option compared with instant mixes containing refined grains such as white rice. More formulation trials are needed to prepare an adai mix to achieve a low GI. Reformulation of traditional foods with nutritious ingredients and achieving a lower GI can expand the healthier food choices for this vulnerable population who are at risk for type 2 diabetes.
Structural and Functional Changes after Standard Percutaneous Nephrolithotomy
Authors: Saswade Kalpesh , Darsan Lal , Pillai Biju S. , Moorthy H. Krishna
Published: August 2023

Introduction:

The surgical treatment of kidney stones more than 2 cm in size has been vastly simplified with the popularisation of percutaneous nephrolithotomy (PCNL) since the 1980s. However, technological revolution has witnessed miniaturisation of endoscopic instruments claiming more advantages over the usage of conventional instruments. However, the cost of smaller instruments and the higher expertise needed while using these miniature instruments have forced many surgeons to persist with the conventional procedures.

Aims and Objectives:

This study was intended to evaluate the structural and functional changes occurring in the kidneys after performing standard PCNL.

Materials and Methods:

Standard PCNL was done in 92 patients with renal stones of more than 2 cm using 25 Fr adult nephroscope. Pre-operative estimated glomerular filtration rate (eGFR) was calculated a day before the procedure and compared with post-operative eGFR estimated at 3 months. Structural changes occurring after PCNL were studied using USG renal morphometry and scarring at 3 months and compared these observations with pre-operative findings.

Results:

It was observed that the mean eGFR post-operative was 84.48 ± 32.18 ml/min (at 3 months) versus 77.61 ± 30.15 ml/min preoperatively (P < 0.05). The mean change of renal parenchymal thickness on post-operative USG versus pre-operative USG was insignificant (2.19 ± 0.32 cm vs. 2.22 ± 0.34 cm). There was no correlation between age and gender for change in eGFR. A mild positive correlation (correlation coefficient [r] = 0.065) was found between eGFR change and stone burden. Sixteen patients out of 92 were found to have renal scarring (>10% decrease in parenchymal thickness).

Conclusions:

We conclude that standard PCNL could be performed in indicated patients without apprehensions about functional loss or structural damage due to the procedure.
Catamenial haemothorax
Authors: Lukumanul Hakeem K. J. , Abraham Atul , Najeeb P. K.
Published: August 2023

Catamenial haemothorax (CH) is a rare manifestation of thoracic endometriosis (TE) syndrome. It is commonly seen associated with pelvic endometriosis in nulliparous reproductive-age women. Most cases are minor and self-limiting. We present an uncommon case of a 22-year-old woman with TE causing massive CH.
Arterial pH, Bicarbonate Levels and Base Deficit as Predictors of Morbidity and Mortality in Acute Pancreatitis
Authors: Jojo Joicy Els , Prabhu Satish G , Paul Vergis , Jayan MG
Published: August 2023

Background:

Although multiple criteria are available for prognosis and determination of severity of acute pancreatitis (AP), there is a need to identify better predictors of developing complications. Arterial pH is a component of the APACHE-II scoring system, commonly used in AP.

Aim:

The aim of this article is to study the diagnostic accuracy of arterial pH, bicarbonate levels and base deficit in predicting morbidity and mortality in AP.

Materials and Methods:

A cross-sectional study (agreement analysis) was performed on inpatients with AP in a tertiary hospital. One hundred and forty patients based on clinical, biochemical and radiological findings were included in this study. Patients with AP following trauma/surgical intervention, tumours of pancreas and patients with age ≤18 years were excluded all categorical variables were summarised using frequency and percentage. All quantitative variables were summarised using mean and standard deviation sensitivity, specificity, positive predictive value and negative predictive value were estimated. Statistical analysis was performed using EZ R software.

Results:

All participants who required ventilatory support, haemodialysis or blood product transfusion had a pH of <7.35. 12/13 (92.3%) of patients who were on haemodynamic supports had bicarbonate levels <22mmol/L. Those who required respiratory support had bicarbonate level <22 mmol/L and base deficit <–4 mmol/L. 11/13 (84.6%) who required haemodynamic supports had base deficit <–4 mmol/L. All 5 of the 140 (3.57%) participants who expired had an arterial pH <7.35, bicarbonate level <22 mmol/L and base deficit <–4 mmol/L.

Conclusion:

In patients with AP, low arterial pH, low bicarbonate levels and high base deficit at presentation predict an adverse outcome with a higher frequency of organ failure and mortality.
Comparison of Surgical Outcomes in Laser Haemorrhoidectomy and Stapler Haemorrhoidopexy for Grade II and III Haemorrhoids – A Prospective Cohort Study
Authors: Akshay Viswanath U. V. , Kuruvilla Rojan , Sajan P. , George Amal , Thomas Jinto Augustine
Published: August 2023

Background:

Haemorrhoids often necessitate surgical intervention. Laser haemorrhoidectomy and stapler haemorrhoidopexy are two alternative techniques that may be employed for the resolution of symptoms.

Aim:

The current study aims to compare the two modalities of treatment in terms of post-operative pain, post-operative complications and recurrence at 6 months.

Methodology:

It was a hospital-based prospective cohort study done in the department of general surgery at a tertiary care centre. Patients were included if they were symptomatic with Grade II or III haemorrhoids in ano and underwent surgery in the same institute. Patients were excluded if they were <18 years of age, had co-existing anorectal diseases (perianal fistula, anal fissure or abscess), had a previous history of anorectal surgery or open haemorrhoidectomy, had a history of recurrent haemorrhoids, had regular use of medications such as analgesics or immunosuppressants, had a history of neurologic deficit or chronic pain syndrome, was unfit for surgery or anaesthesia, or if they were pregnant. Post-operative pain was evaluated using visual analogue scale.

Results:

Seventy-two patients were included in the study, and no one was lost to follow-up. The mean age was 51.8 (13.9) years and ranged from 22 to 77 years. Majority were males (80.6%). Post-operative pain was lower in the laser group at all time points. Surgical complications were slightly lower in the stapler group. Recurrence at 6 months of follow-up was noted in only one patient belonging to the stapler group.

Conclusion:

Laser haemorrhoidectomy has significantly lower post-operative pain, but stapler haemorrhoidopexy had lesser post-operative complications, though not statistically significant. Both surgical techniques have low recurrent rates.
Laparoscopic Submucosal Appendectomy for Complicated Appendicitis
Authors: John Jimmy C. , Srinivas I. C. , Arjunith PK
Published: August 2023

Background:

Complicated appendicitis with delayed presentations is difficult to manage surgically due to dense adhesions and distorted anatomy. Submucosal appendectomy could be an option in these cases.

Materials and Methods:

Out of 789 laparoscopic appendectomies, 239 were complicated cases. In 79 of these cases, no plane could be established between the appendix and adjacent bowel. Hence, the mucosa was identified by blunt dissection through the wall of intact appendix or through the perforation site and the mucosal tube was pulled out, and then dissected out fully from the tip and up to the base by blunt dissection, leaving behind the muscular wall. The base was then ligated and divided distally. Post-operatively, the patients were managed with ERAS protocol.

Results:

Out of 79 cases, 56 were male. Age ranged from 14 to 55 years. Forty-six cases were perforated, and 33 had mass formation. Submucosal appendectomy was done in all. There were no intra-operative complications. The average operating time was 56 min. In 68 cases, oral feeds were tolerated early, 11 cases suffered from prolonged ileus and one case had post-operative faecal leak, which settled on conservative management for 10 days. The average post-operative hospital stay was 3–5 days. Follow-up ranged from 2 months to 2 years. Three cases required re-admission, reported occasional abdominal pain, which on clinical evaluation and imaging showed no residual collection or stump appendicitis. Two cases presented with residual abscesses, which were managed with image-guided tube drainage.

Conclusions:

Submucosal appendectomy minimises bowel injury, avoids the need for conversion, and is a safe option for difficult cases during laparoscopy and also an alternative for the Ochsner–Sherren regimen.
Enterocutaneous Fistula in Thigh
Authors: Dinu M. K. , Sugeeth E.
Published: August 2023

Enterocutaneous fistula is a condition with a mortality rate as high as 10% in recent reports. Hence, early detection is important. This is a case report of a 53-year-old male with a rare presentation of an enterocutaneous fistula as a thigh abscess.
A Rare Case of Right Thyroid Hemiagenesis Associated with Papillary Carcinoma in Remnant Lobe
Authors: George Amal , Rajan P. , Akshay Viswanath, U. V. , Augustine Jinto Thomas , George Tony
Published: August 2023

Thyroid hemiagenesis is a rare congenital abnormality, in which one thyroid lobe fails to develop. The associated diseases in the remaining thyroid lobe include benign multinodular goiter, adenoma, hyperthyroidism, chronic thyroiditis and rarely carcinoma. The most common pathology involved in thyroid hemiagenesis is hyperthyroidism. The presence of carcinoma in a patient with hemiagenesis is quite rare and very few cases are reported in the world literature.
Submandibular Pleomorphic Adenoma in a Male
Authors: Guguloth Mohan Nayak , Kuchana Sai Kiran , Suvvari Tarun Kumar , Gopu Anthony Reddy , Mamidi Shanteja Reddy , Mittal Rahul Jagdishchandra
Published: August 2023

Pleomorphic adenoma (PA) of the submandibular gland is a very unusual neoplasm and comprises only 8%–10% of all benign tumours, most commonly affecting females between 30 and 50 years of age. In this case report, we described a case of a 36-year-old male patient who presented with swelling in the left neck region for 5 years, associated with dull aching pain and increased salivation. The ultrasonography and plain computed tomography (CT) of the neck revealed iso-hypointense lesions arising from the left submandibular gland. Fine needle aspiration cytology of the swelling revealed sheets and clusters of cells with an eccentric nucleus in the chondromyxoid and haemorrhagic background, and a probable diagnosis of PA was made based on Milan's scoring system. The patient underwent an excision of the gland. Post-operative biopsy showed islands of mesenchymal and epithelial components with intervening fibrous tissue and areas of haemorrhage, confirming the diagnosis of submandibular PA.
Disparities in ethnicity and metabolic disease burden in referrals to nephrology
Authors: Chua Yan Ting , Leo Cheang Han , Chua Horng Ruey , Wong Weng Kin , Chan Gek Cher , Vathsala Anantharaman , Gan Ye Lu Mavis , Teo Boon Wee
Published: August 2023

Introduction

The profile of patients referred from primary to tertiary nephrology care is unclear. Ethnic Malay patients have the highest incidence and prevalence of kidney failure in Singapore. We hypothesised that there is a Malay predominance among patients referred to nephrology due to a higher burden of metabolic disease in this ethnic group.

Methods

This is a retrospective observational cohort study. From 2014 to 2018, a coordinator and physician triaged patients referred from primary care, and determined co-management and assignment to nephrology clinics. Key disease parameters were collated on triage and analysed.

Results

A total of 6,017 patients were studied. The mean age of patients was 64 ± 16 years. They comprised 57% men; 67% were Chinese and 22% were Malay. The proportion of Malay patients is higher than the proportion of Malays in the general population (13.4%) and they were more likely than other ethnicities to have ≥3 comorbidities, including diabetes mellitus, hypertension, hyperlipidaemia, coronary artery disease and stroke (70% vs. 57%, P < 0.001). Malay and Indian patients had poorer control of diabetes mellitus compared to other ethnicities (glycated haemoglobin 7.8% vs. 7.4%, P < 0.001). Higher proportion of Malay patients compared to other ethnicities had worse kidney function with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 on presentation (28% vs. 24%, P = 0.003). More ethnic Malay, Indian and younger patients missed appointments.

Conclusion

A disproportionately large number of Malay patients are referred for kidney disease. These patients have higher metabolic disease burden, tend to miss appointments and are referred at lower eGFR. Reasons underpinning these associations should be identified to facilitate efforts for targeting this at-risk population, ensuring kidney health for all.
Effective finite generation for $[\mathrm{ IA}_n,\mathrm{ IA}_n]$ and the Johnson kernel
Authors: Ershov Mikhail , Franz Daniel
Published: August 2023

Let

\mathrm{ IA}_n

denote the group of

\mathrm{ IA}

-automorphisms of a free group of rank

n

, and let

\mathcal I_n^b

denote the Torelli subgroup of the mapping class group of an orientable surface of genus

n

with

b

boundary components,

b=0,1

. In 1935, Magnus proved that

\mathrm{ IA}_n

is finitely generated for all

n

, and in 1983, Johnson proved that

\mathcal I_n^b

is finitely generated for

n\geq 3

. It was recently shown that for each

k\in{\mathbb N}

, the

k

-th terms of the lower central series

\gamma_k \mathrm{ IA}_n

and

\gamma_k\mathcal I_n^b

are finitely generated when

n\gg k

; however, no information about finite generating sets was known for

k>1

. The main goal of this paper is to construct an explicit finite generating set for

\gamma_2 \mathrm{ IA}_n = [\mathrm{ IA}_n,\mathrm{ IA}_n]

and almost explicit finite generating sets for

\gamma_2\mathcal I_n^b

and the Johnson kernel, which contains

\gamma_2\mathcal I_n^b

as a finite index subgroup.
Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial
Authors: Lambrecht Nathalie J. , Müller-Hauser Anna A. , Sobhan Shafinaz , Schmidt Wolf-Peter , Huda Tarique Md. Nurul , Waid Jillian L. , Wendt Amanda S. , Kader Abdul , Gabrysch Sabine
Published: August 2023

Diarrhea and respiratory illness are leading causes of mortality and morbidity among young children. We assessed the impact of a homestead food production intervention on diarrhea and acute respiratory infection (ARI) in children in Bangladesh, secondary outcomes of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial. The trial enrolled 2,705 married women and their children 3 years or younger in 96 rural settlements (geographic clusters) in Sylhet Division, Bangladesh. The intervention promoted home gardening and poultry rearing alongside child nutrition and health counseling over 3 years (2015–2018). An 8-month food hygiene behavior change component using emotional drivers was delivered beginning in mid-2017. Caregiver-reported diarrhea and symptoms of ARI in the week preceding the survey were recorded every 2 months. We analyzed 32,460 observations of 3,276 children over 4 years and found that 3.9% of children had diarrhea and 3.4% had an ARI in the prior 7 days. There was no overall effect of the intervention on 7-day diarrhea period prevalence (odds ratio [OR], 0.92; 95% CI, 0.71–1.19), diarrhea point prevalence (OR, 1.03; 95% CI, 0.78–1.36), or 7-day ARI period prevalence (OR, 1.18; 95% CI, 0.88–1.60). There was no impact on diarrhea severity or differences in health-seeking behaviors. Our findings suggest that this homestead food production program was insufficient to reduce morbidity symptoms among children in a rural setting. More comprehensive water, sanitation, and hygiene measures, and behavioral recommendations may be needed to achieve impacts on child health.
A Patient Diagnosed with Li-Campeau Syndrome and Biotinidase Deficiency
Authors: Arslan Müjgan , Özbaş Halil , Karakoç Şeyma , Karataş Menekşe Rüveyda
Published: August 2023

Biotinidase (BTD) enzyme deficiency is a congenital metabolic disorder with autosomal recessive inheritance. Main symptoms in its deficiency are nervous system and skin manifestations. A 15-month-old patient who was diagnosed with Li-Campeau syndrome, was also diagnosed with BTD deficiency and his clinic rapidly improved with biotin treatment. With the awareness of different clinical presentations of BTD deficiency, patients presenting with clinical symptoms raising the suspicion of this disorder must be evaluated for enzyme activity and genetic analysis must be planned. It is of great importance to keep in mind the possibility of this rare but treatable neurometabolic disorder, even in countries with neonatal screening programme and include it in differential diagnoses in order to prevent irreversible symptoms.
The Relationship of Mother’s Perception With Breast Milk Exclusive at Pomalaa Health Center
Authors: Muliani Muliani , Rosjidi Cholik Harun , Abadi Ellyani , Uksim Muhammad
Published: August 2023

The number of exclusive breastfeeding globally, although there has been an increase, this number has not increased significantly. One of the factors that influence exclusive breastfeeding is the value or attitude of the mother. The purpose of this study was to determine the relationship between mother's perception and exclusive breastfeeding at the Pomalaa Health Center. This research was carried out at the Pomalaa Health Center in June 2022 involving a sample of 51 respondents. The sampling technique used is the Saturated Sampling technique. Data collection used a research instrument in the form of a questionnaire. Data were analyzed using the chi-square test with the help of a computer. The results showed that 21 people (41.2%) gave exclusive breastfeeding and 30 people (58.8%) did not and 25 people (49%) had good perceptions and 26 people (51 %) who had poor perceptions and there was a relationship between mothers' perceptions of exclusive breastfeeding in the working area of the Pomalaa Health Center based on a ρ value of 0.001 (<0.05). It is recommended that mothers add insight regarding the benefits of exclusive breastfeeding for both children and mothers
HUBUNGAN DUKUNGAN SUAMI DENGAN KESIAPAN WANITA DALAM MENGHADAPI MASA MENOPAUSE DI GAMPONG CEURIH
Authors: Riza Nelva
Published: August 2023

Untuk meningkatkan kesiapan Wanita dalam menghadapi masa menopause dibutuhkan dukungan suami yang baik. Berdasarkan hasil survei pendahuluan di gampong ceurih didapatkan bahwa dukungan suami dalam menghadapi wanita yang menopause kurang baik. Sehingga dalam menghadapi masa menopause banyak Wanita yang tidak siap dalam menghadapinya baik secara fisik, psikologis dan spiritual. Penelitian bertujuan untuk mengetahui hubungan dukungan suami dengan kesiapan wanita dalam menghadapi masa menopause. Metode penelitian yaitu Survey Analitik dengan cara Cross Sectional. sampel adalah ibu menopause yang berusia 45-59 tahun, tinggal bersama suami sebanyak 78 orang, Alat ukur menggunakan kuesioner dengan teknik pengambilan sampel Purposive Sampling. Data yang dikumpulkan diolah dan dianalisis menggunakan Chi Square. Hasil penelitian menunjukkan terdapat hubungan dukungan suami (p=0,001) dengan kesiapan wanita dalam menghadapi masa menopause. Disarankan meningkatkan pelaksanaan penyuluhan Kesehatan reproduksi terutama tentang menopause kepada masyarakat.
PERSEPSI MAHASISWA PENDIDIKAN PROFESI NERS TERHADAP CLINICAL INSTRUCTUR (CI) DENGAN PENCAPAIAN KOMPETENSI PRAKTIK KLINIK DI RSUD dr. ZAINOEL ABIDIN
Authors: Hasnawati
Published: August 2023

Mahasiswa profesi keperawatan melaksanakan dua tahap pendidikan keperawatan yaitu pendidikan akademik dan pendidikan profesi. Pendidikan profesi dapat dilalui dengan proses pembelajaran klinik untuk mengaplikasikan teori ke dalam situasi klinik secara nyata. Pembelajaran klinik dapat dikatakan berhasil jika mahasiswa dapat mencapai kompetensi kliniknya. dalam pencapaian kompetensi praktik klinik mahasiswa dapat dipengaruhi beberapa faktor. Berdasarkan hasil survey awal pada tanggal 15 maret 2022 yang dilakukan di RSUD dr.Zainoel Abidin provinsi Aceh diperoleh data Sebanyak 739 Mahasiswa pendidikan profesi ners yang menjalani praktik klinik dari tahun 2021-2022, terdapat rata-rata data mahasiswa Ners yang praktek perbulan di RSUD dr.Zainoel Abidin Provinsi Aceh sebanyak 130 Mahasiswa. Tujuan Untuk mengetahui persepsi mahasiswa pendidikan profesi ners terhadap  kompetensi, profesional, komunikasi  Clinical Instructur dengan pencapaian kompetensi praktik klinik. Metode penelitian Jenis penelitian yang digunakan dalam penelitian ini adalah kuantitatif, Menggunakan pendekatan korelasional dengan jumlah sampel 98 Orang. Adapun cara pengumpulan data yag digunakan dengan cara meyebarkan kuesioner. Hasil penelitian ini  adalah Ada hubungan Kompetensi clinical instruktur (CI) Dengan Pencapaian Kompetensi  praktik klinik dengan nilai P value 0, 000 = Ha diterima. Ada hubungan Profesional clinical instruktur (CI) Dengan Pencapaian Kompetensi  praktik klinik dengan nilai P value 0,000 = Ha diterima. Ada hubungan komunikasi clinical instruktur (CI) Dengan Pencapaian Kompetensi  praktik klinik dengan nilai P value 0.000 = Ha diterima. Kesimpulan Dan Saran dapat dijadikan Sebagai masukan atau penambahan wawasan, iformasi dan referensi yang nantinya dapat dipraktikan sendiri oleh mahasiswa mengenai persepsi mahasiswa pendidikan profesi ners terhadap Clinical Instructur dengan pencapaian kompetensi praktik klinik.
WHY DO STUDENTS PREFER YOUTUBE-BASED ASSIGNMENT? A MIXED METHODS ANALYSIS OF ASSIGNMENT FORM
Authors: Saputra Indra , Hayatunnufus  , Yeni Putri Elviza
Published: August 2023

This research is motivated by the condition of not maximizing assignment activities in learning in higher education. The purpose of this study was to analyze the tendency of student choices towards Youtube-based assignment formats or essay-based assignments. This research is a comparative research with mixed methods method. The respondents of this study were Cosmetology and Beauty students of Universitas Negeri Padang. The results of the study described 87.5% of respondents choosing the YouTube-based assignment format for reasons related to freedom of space to express ideas and imagination, increased motivation and novelty of the assignment concept, increased understanding, challenges, and flexibility of assignment access. 2.5% of respondents chose the essay-based assignment format due to limited skills and supporting tools in terms of video editing. Furthermore, 10% of respondents chose a combination of Youtube-based assignments and essays for the reasons of excellence of each assignment format.

 

AbstrakPenelitian ini dilatarbelakangi oleh kondisi belum maksimalnya kegiatan penugasan dalam pembelajaran di perguruan tinggi. Tujuan penelitian ini adalah untuk menganalisis feasibility of Youtube-based assessment format as well as analyzing kecenderungan pilihan mahasiswa terhadap format penugasan berbasis Youtube atau penugasan berbasis esai. Penelitian ini merupakan penelitian komparatif dengan metode mixed methods. Pengumpulan data penelitian menggunakan angket dan juga wawancara terstruktur. Analisis data menggunakan analisis kuantitatif deskriptif dan juga kualitatif deskriptif. Responden penelitian ini adalah mahasiswi Tata Rias dan Kecantikan Univeritas Negeri Padang. Hasil penelitian mendeskripsikan 87,5% responden memilih format penugasan berbasis Youtube dengan alasan terkait kebebasan ruang untuk menuangkan ide dan imajinasi, peningkatan motivasi dan kebaruan konsep penugasan, peningkatan pemahaman, tantangan, dan fleksibilitas akses penugasan. 2,5% responden memilih format penugasan berbasis esai dengan alasan keterbatasan skill dan perangkat pendukung dalam hal editing video. Selanjutnya, 10% responden memilih kombinasi penugasan berbasis Youtube dan esai dengan alasan keunggulan dari masing-masing format penugasan.
Philosophical inquiry in a culturally diverse, faith-based community
Authors: Adusei-Asante Kwadwo , Bland Kaz , Kirkham Nin , Nelson Douglas , Tarrant Stella
Published: August 2023

This paper reports on collaborative research undertaken with the African Australian Christian Impact Centre (CIC) in Perth, Western Australia. It is part of a larger university philosophy outreach program in which the researchers seek to create opportunities for those on the educational and social margins, and young people, to engage in ‘doing philosophy’, and to learn from them about their experiences. We were interested to evaluate whether the collaborative philosophical inquiry methods we use in our university teaching could be beneficial outside of a formal educational setting, for members of the culturally diverse, faith-based community of CIC. In this multi-method evaluative study, we examined the extent to which participation in a series of Community of Inquiry (CoI) sessions improved or did not improve participants’ self-assessment of: (1) their competence and confidence in communicating with others in different contexts; (2) their competence and confidence as a ‘thinker’; and (3) their social competence and confidence. Our findings on ‘communication’ are discussed in this paper. The facilitated philosophical discussions led to insights about ‘speaking out’ and ‘listening’, particularly with respect to participants’ experiences of cultural and generational differences. We suggest that participation in CoI in a faith-based community setting has the potential to significantly increase confidence in communication skills, and lead to greater intergenerational, intercultural, and intercommunity sensitivity.
Safety Assessment: Outcome of the assessment of lacto-N-fucopentaose I (LNFP-l) and 2'-fucosyllactose (2'-FL) as a novel food
Authors: Risk Assessment FSA Regulated Products
Published: August 2023

An application was submitted to the Food Standards Agency (FSA) and Food Standards Scotland (FSS) in March 2021 from Glycom A/S, Denmark (“the applicant”) for the authorisation of a mixture of lacto-N-fucopentaose I (LNFP-l) and 2'-fucosyllactose (2'-FL) as a novel food. The novel food is a mixture of LNFP-l and 2'-FL which is intended to be used as a source of human identical milk oligosaccharides. LNFP-l/2'-FL is manufactured by microbial fermentation using a genetically modified strain of Escherichia coli K-12, and then refined to yield the purified novel food. This new application is seeking to use the novel food within the following food categories: dairy products and analogues, bakery wares, foods for special groups, beverages, and also as a food supplement. Food supplements are not intended to be used if other foods with added LNFP-l/2’-FL or breast milk are consumed the same day. To support the FSA and FSS in their evaluation of the application, the Advisory Committee on Novel Foods and Processes (ACNFP) were asked to review the safety dossier and supplementary information provided by the applicant. The Committee concluded that the applicant had provided sufficient information to assure the novel food, LNFP-l/2’-FL, was safe under the proposed conditions of use. The anticipated intake levels and the proposed use in foods and food supplements was not considered to be nutritionally disadvantageous and does not mislead consumers. The views of the ACNFP have been taken into account in this safety assessment which represents the opinion of the FSA and FSS on LNFP-l/2’-FL.
Safety Assessment: Outcome of the assessment of 3-fucosyllactose (3-FL) as a novel food
Authors: Risk Assessment FSA Regulated Products
Published: August 2023

The novel food is 3-FL which is intended to be used as a source of human identical milk oligosaccharides. 3-FL is manufactured by microbial fermentation using a genetically modified strain of Escherichia coli K-12, and then refined to yield the purified novel food. This new application is seeking to use the novel food within the food following categories: dairy products and analogues, bakery wares, foods for special groups, beverages, and also as a food supplement. Food supplements are not intended to be used if other foods with added 3-FL or breast milk are consumed the same day. To support the FSA and FSS in their evaluation of the application, the Advisory Committee on Novel Foods and Processes (ACNFP) were asked to review the safety dossier and supplementary information provided by the applicant. The Committee concluded that the applicant had provided sufficient information to assure the novel food, 3-FL, was safe under the proposed conditions of use. The anticipated intake levels and the proposed use in foods and food supplements was not considered to be nutritionally disadvantageous and does not mislead consumers. The views of the ACNFP have been taken into account in the regulatory assessment which represents the opinion of the FSA and FSS.