bluuebunny/crossref_metadata_2025 huggingface dataset:
TRABALHO COMO PRINCÍPIO EDUCATIVO E PESQUISA COMO PRINCÍPIO PEDAGÓGICO NAS OFICINAS DE INTEGRAÇÃO DO ENSINO MÉDIO INTEGRADO
Authors: Pasqualli Roberta , Machado da Silva Fabio , Gomes da Silva Vitor , Popov Zambiasi Bazzi Oberderfer Lara
Published: December 2021

Considera que a integração curricular caracteriza-se como um dos pilares para a desfragmentação do ensino, para a materialização da interdisciplinaridade e para a formação integral do estudante. Nesta direção, o objetivo deste texto é apresentar a relação teoria-prática dos docentes do currículo integrado objetivando, também, difundir práticas interdisciplinares em temas diversos no contexto escolar. Foi produzido por meio da pesquisa bibliográfica, análise documental e observações das práticas de docentes do currículo integrado. Tal modo de abordagem se assenta como pesquisa exploratória e descritiva, por meio de abordagem qualitativa e dialética, seguindo os movimentos e contradições próprios dos espaços educativos. Como resultados, destaca-se que o currículo integrado emerge como lugar profícuo de busca por um ensino menos tradicionalista e mais coletivo, menos enfadonho e mais ativo, um ensino que valorize o caráter dialógico do ato de ensinar, sempre associado ao aprender e ao pesquisar.
CENÁRIOS DA EDUCAÇÃO BRASILEIRA NO CONTEXTO DA PANDEMIA DA COVID-19: REVISÃO SISTEMÁTICA DE LITERATURA
Authors: Mendes Netto Cristiane , Rangel Teixeira Karine Keily , Reis Fernandes de Souza Maria Celeste , Bernardes Faria Campos Renata
Published: December 2021

Este artigo apresenta resultados de um estudo cujo objetivo foi mapear e analisar artigos acadêmicos brasileiros sobre a educação no contexto da COVID–19, visando contribuir para a compreensão da complexidade envolvida neste cenário educacional. Por meio de uma revisão sistemática de literatura realizada no Portal de Periódicos da Capes e SciELO, vinte e sete publicações foram selecionadas e estudadas, utilizando-se a “análise de conteúdo” (BARDIN, 2011), por meio da análise temática. Dentre os resultados, tem-se a caracterização e a discussão dessas publicações, bem como a análise em três categorias identificadas: acesso à educação, ensino e aprendizagem por meios digitais e trabalho docente. Como conclusão, considera-se que é preciso o fortalecimento de debates, discussões e estudos acerca das consequências, desafios e possíveis avanços nos processos de ensino e aprendizagem vivenciados.
POSSIBILIDADES DE COMO TRABALHAR AS PRÁTICAS DE LINGUAGEM EM SALA DE AULA
Authors: Rosa Souza Moisés José , Arena Dagoberto Buim
Published: December 2021

A linguagem está presente em todas as ações humanas. Ao longo da história, ela vem possibilitando ao homem se comunicar, apreender conhecimentos já construídos, interagir com o outro e seus discursos e criar enunciados, orais ou escritos, presentes na sociedade. Este artigo trata da linguagem e de como ensiná-la consoante à Filosofia da Linguagem. Com as contribuições teóricas de Volóchinov (2013, 2017) e Bakhtin (1997, 2016), principalmente, e pela experiência docente dos autores, o texto discute como efetivar um trabalho em sala de aula com a linguagem de modo que o processo atue na formação linguística, individual e social dos alunos envolvidos. Conclui-se que, pela natureza dinâmica, social e histórica da linguagem, entendida como fenômeno criado pela necessidade humana, o ensino deve privilegiar as práticas de linguagem, a partir da apreensão e construção de enunciados verbais presentes no cotidiano que traduzem e moldam a realidade, propiciando aos alunos agirem socialmente.
Multiple cranial nerve involvement as a presentation of primary central nervous system lymphoma: A case-based review
Authors: Modi Tanvi , Verma Mitusha , Patkar Deepak
Published: December 2021

Central nervous system (CNS) lymphoma is of two types: primary and secondary (more common). Primary CNS lymphoma usually presents as parenchymal lesions having characteristic imaging findings and may be associated with leptomeningeal involvement. Involvement of multiple cranial nerves as the initial manifestation of primary CNS lymphoma with the development of typical parenchymal lesions on follow-up is a rare entity. This nerve involvement is termed as neurolymphomatosis. We present the magnetic resonance imaging features of five patients presenting with neurolymphomatosis due to non-Hodgkin's lymphoma.
A true mimicker to plasmacytoma clinically, radiologically, and pathologically – A rare case report
Authors: Ashly Shino , Thomas Anu , Vadakkedam Sajeev
Published: December 2021

Lympho plasmacytoma is distinct type of diffuse large B cell lymphoma predominantly seen in HIV-positive patients. The diagnosis of lympho plasmacytoma could be a challenge due to its overlapping characterizes with those of myeloma and lymphoma. We report a case of a 50-year-old man who initially presented with a painful solitary destructive lesion at the second lumbar vertebra. Clinico-pathological findings were consistent with a solitary plasmacytoma, and he was treated with definitive radiotherapy. Eight months after completing radiotherapy, he was found to have similar lesions at D4 vertebral body, multiple ribs, and pelvis. Subsequent biopsy confirmed lympho plasmacytoma. Because of its rarity and heterogeneous presentations, lympho plasmacytoma could easily be overlooked clinically and pathologically in immunocompetent patients. The diagnosis of lympho plasmacytoma should be considered when there is coexpression of myeloma and lymphoma immune markers.
Risk factors associated with malignant transformation of astrocytoma: Competing risk regression analysis
Authors: Tunthanathip Thara , Sangkhathat Surasak , Kanjanapradit Kanet
Published: December 2021

Background: Malignant transformation (MT) of low-grade astrocytoma (LGA) triggers a poor prognosis in benign tumors. Currently, factors associated with MT of LGA have been inconclusive. The present study aims to explore the risk factors predicting LGA progressively differentiation to malignant astrocytoma. Materials and Methods: The study design was a retrospective cohort study of medical record reviews of patients with LGA. Using the Fire and Grey method, the competing risk regression analysis was performed to identify factors associated with MT, using both univariate and multivariable analyses. Hence, the survival curves of the cumulative incidence of MT of each covariate were constructed following the final model. Results: Ninety patients with LGA were included in the analysis, and MT was observed in 14.4% of cases in the present study. For MT, 53.8% of patients with MT transformed to glioblastoma, while 46.2% differentiated to anaplastic astrocytoma. Factors associated with MT included supratentorial tumor (subdistribution hazard ratio [SHR] 4.54, 95% CI 1.08–19.10), midline shift >1 cm (SHR 8.25, 95% CI 2.18–31.21), nontotal resection as follows: Subtotal resection (SHR 5.35, 95% CI 1.07–26.82), partial resection (SHR 10.90, 95% CI 3.13–37.90), and biopsy (SHR 11.10, 95% CI 2.88–42.52). Conclusion: MT in patients with LGA significantly changed the natural history of the disease to an unfavorable prognosis. Analysis of patients' clinical characteristics from the present study identified supratentorial LGA, a midline shift more than 1 cm, and extent of resection as risk factors associated with MT. The more extent of resection would significantly help to decrease tumor burden and MT. In addition, future molecular research efforts are warranted to explain the pathogenesis of MT.
Microsurgical anatomy of middle cerebral artery in Northwest Indian Population: A cadaveric brain dissection study
Authors: Srinivasa Rakshith , Shwetha Kedia , Pravin Salunke , Daisy Saini , Eilene Basu , Mathuriya Suresh , Sareeshkumar Krishnakutty
Published: December 2021

Background: Microsurgical anatomy of the Middle Cerebral Artery (MCA) of the Northwest Indian population has not been described to date. A study of cadaveric brains will add to the existing knowledge of brain vessels. Objective: To study and compare the microsurgical anatomy of MCA in Northwest Indian Population with that of the available literature. Methods and Material: 15 Formalin Fixed Cadaveric brains, that is 30 vessels from its origin from Internal Cerebral Artery to M5 segment with respect to diameter, length and branching pattern were studied under high magnification (operating microscope) and the data compared with literature. Results: The main trunk of MCA was 16±3 mm long with no significant differences between both sides. Its outer diameter was 3±0.1 mm. Among the early branches 58% were destined to the temporal lobe. Distance between the origin of the early branch from MCA origin was 4±2mm on the right side and 4.5±2.5 mm on the left side. The most consistent perforating branch group was the intermediate group. The pattern of branching of the main trunk was bifurcation (73%), single trunk (10%) and trifurcation (10%). Within the bifurcation group, inferior trunk dominance was seen in 50%. Amongst the cortical branches diameter of the angular artery was largest and the temporo-polar was smallest. No significant difference in the data as compared to literature. Conclusions: The knowledge of anatomy of MCA and its variations are important for neurosurgical residents' training and neurosurgeons dealing with MCA aneurysm management or bypass surgeries.
Cerebrospinal fluid hypovolemia: A case report of a red herring
Authors: ONeill Brannan , Yaghi Nasser , Shahin Maryam , Sanusi Olabisi , Cetas Justin , Dogan Aclan
Published: December 2021

Mild intracranial hypotension can lead to classically recognizable symptoms such as positional headaches, nausea, vomiting, and occasionally blurred vision. Less commonly, severe cerebrospinal fluid (CSF) hypovolemia can lead to a life-threatening condition that mimics intracranial hypertension, including transtentorial herniation and subsequent rapid neurologic decline. In this report we present a unique case of severe intracranial hypotension from a thoracic tumor resection that led to symptoms initially mistaken for intracranial hypertension, however ultimately correctly diagnosed as severe CSF hypovolemia that improved with dural repair. Additionally, we describe a rare angiography finding associated with CSF hypovolemia, kinking of the basilar artery. Here we report a 47-year-old female with neurofibromatosis Type 2 found to have a T3 intradural extramedullary tumor. She initially presented with urinary incontinence and gait/balance difficulty. She underwent thoracic laminectomies at T3 and T4 for the excision of the lesion. She was discharged on postoperative day 4. On postoperative day 9, she was noted to have nausea, vomiting, and decreased consciousness. Head computed tomography (CT) demonstrated acute downward herniation. She was transferred to our institution from a community facility obtunded and was intubated for airway protection. She was placed in the Trendelenburg position with immediate improvement, and declined every time her head was raised. Angiogram showed significant kinking of her basilar artery. A CT myelogram revealed a CSF leak from her recent thoracic surgery. She underwent exploration of her thoracic wound, and a ventral durotomy was repaired. Following this, she began to tolerate the head of bed elevations and recovered back to her neurologic baseline. A postoperative head CT angiography obtained before discharge showed improvement of her basilar kink. Mild intracranial hypotension is a common finding in patients who undergo procedures that enter the CSF space. Severe intracranial hypotension can easily be missed diagnosed as the signs on the exam are similar to patients with signs of intracranial hypertension. It is of paramount importance that the clinician recognizes brain sag, as the treatment algorithms are vastly different from that of intracranial hypertension leading to transtentorial herniation.
Facial fractures: Independent prediction of neurosurgical intervention
Authors: Lucke-Wold Brandon , Pierre Kevin , Aghili-Mehrizi Sina , Murad Gregory
Published: December 2021

Context: Over half of patients with facial fractures have associated traumatic brain injury (TBI). Based on force dynamic cadaveric studies, Lefort type 2 and 3 fractures are associated with severe injury. Correlation to neurosurgical intervention is not well characterized. Aims: This study characterizes fracture pattern types in patients requiring neurosurgical intervention and assesses whether this is different from those not requiring intervention. Settings and Design: Retrospective data were collected from the trauma registry from 2010 to 2019. Subjects and Methods: Patients over 18, with confirmed facial fracture, reported TBI, available neuroimaging, and hospital admission were included. Statistical Analysis Used: Retrospective Contingency Analysis with Fraction of Total Comparison was used with Chi-square analysis for demographic and injury characteristic data. Results: One thousand and one patients required no neurosurgical intervention and 171 required intervention. The intervention group had a significantly greater number of patients with Glasgow Coma Scale (GCS) <8 compared to the nonintervention group. Subset analysis revealed a twofold increase in Lefort type 2 fractures and notable increase in Lefort type 3 and panfacial fractures in the intervention group. Patients requiring craniectomy, craniotomy, or burr holes were much more likely to have Lefort type 2 or 3 fractures compared to those only requiring external ventricular drains or intracranial pressure monitoring. Subset analysis accounting for GCS supported these results. Conclusions: Lefort type 2 and type 3 fractures are significantly associated with requiring neurosurgical intervention. An improved algorithm for managing these patients has been proposed in the discussion. Ongoing work will focus on validating and refining the algorithm to improve patient care.
Fibromuscular dysplasia: A rare case with multiple vascular beds involvement
Authors: Yiek Siew-Hong
Published: December 2021

Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, and non-atherosclerotic vascular disease of small- to medium-sized arteries. It can be occurred in almost all arteries and most commonly involving cervicocranial and renal arteries. FMD is commonly present as renovascular hypertension and affecting most young ladies. However, this case demonstrates a casuistically rare form of multiple arterial beds involvement at different sites, i.e. vertebral, coronary, hepatic, and lumbar arteries, with the conjunction of both bilateral renal and cervicocranial arteries.
Rolandic cortex morphology: Magnetic resonance imaging-based three-dimensional cerebral reconstruction study and intraoperative usefulness
Authors: Bunyaratavej Krishnapundha , Wangsawatwong Piyanat
Published: December 2021

Background: During brain surgery, the neurosurgeon must be able to identify and avoid injury to the Rolandic cortex. However, when only a small part of the cortex is exposed, it may be difficult to identify the Rolandic cortex with certainty. Despite various advanced methods to identify it, visual recognition remains an important backup for neurosurgeons. The aim of the study was to find any specific morphology pattern that may help to identify the Rolandic cortex intraoperatively. Materials and Methods: Magnetic resonance imaging of the brain from patients with various conditions was used to create the three-dimensional cerebral reconstruction images. A total of 216 patients with 371 intact hemispheres were included. Each image was inspected to note the morphology of the Rolandic cortex and the suprasylvian cortex. In addition, other two evaluators exclusively inspected the morphology of the suprasylvian cortex. Their observation results were compared to find the agreements. Results: A number of distinctive morphology patterns have been identified at the Rolandic cortex and the suprasylvian cortex including a genu, or a knob at the upper precentral gyrus (pre-CG), an angulation of the lower postcentral gyrus (post-CG), a strip for pars opercularis, a rectangle for the lower pre-CG, and a triangle for the lower post-CG. Combined total and partial agreement of the suprasylvian cortex morphology pattern ranged 60.4%–85.2%. Conclusion: The authors have demonstrated the distinctive morphology of the Rolandic cortex and the suprasylvian cortex. This information can provide visual guidance to identify the Rolandic cortex particularly during surgery with limited exposure.
Anterior approach to the cervical spine: Elegance lies in its simplicity
Authors: Arumalla Kirit , Bansal Hanish , Jadeja Jigarsingh , Batish Aman , Deora Harsh , Tripathi Manjul , Mohindra Sandeep , Behari Sanjay
Published: December 2021

Introduction: Since the landmark publication by Smith and Robinson, approaches to the cervical spine anteriorly have undergone many modifications and even additions. Nevertheless, at its core, the anterior approach remains an elegant and efficient approach to deal with majority of cervical spine pathologies including the degenerative cervical spine. Methodology: For this review, we searched for all major cases series and randomized control trials of anterior cervical approaches using the PubMed databases. Articles having the details of clinical variables and outcomes were tabulated and analyzed. Results: A total of 9 case series for transoral, 7 case series for transmanubrial, 19 case series for anterior cervical discectomy and fusion (ACDF), 6 studies for ACDF versus posterior cervical foraminotomy, 37 case series for ACDF versus arthroplasty, and 7 studies for ACDF versus anterior cervical corpectomy and fusion have been included. The majority of the case series suggested that the anterior cervical procedures have good clinical outcomes. The upper cervical spine approached by the transoral route had good outcomes in ventral compressive pathologies, with morbidity of cerebrospinal fluid leak in 7% of patients. The midcervical spine approached by ACDF had better clinical outcomes equivalent to the majority of modifications even in multiple-level pathologies. The transsternal approach had provided greater access and stability to the cervicothoracic junction with minimal morbidity. Conclusion: The anterior cervical approach can address the majority of cervical pathologies. They provide adequate corridor from craniovertebral junction to T4 with minimal morbidity, thus providing a good clinical outcome.
Revisiting dandy–Walker malformation with associated neurofibromatosis
Authors: Shah Shreykumar , Gohil Jaypalsinh , Kesavapisharady Krishnakumar , Easwer Harihara
Published: December 2021

This report describes a very rare Dandy–Walker malformation (DWM) associated with neurofibromatosis (NF) and bony defect over torcula emphasizing the role of meticulous follow-up for asymptomatic DWM. The clinical aspects of an adolescent patient with undiagnosed DWM who was asymptomatic until the age of 14 years are being discussed. Computed tomography and magnetic resonance imaging were revealed DWM. To our knowledge, this is the first report from India that describes a patient who has been diagnosed with DWM with associated NF with bony defect over torcula creating a management dilemma.
Comparative analysis of long-term outcome of anterior reconstruction in thoracic tuberculosis by direct anterior approach versus posterior approach
Authors: Srivastava Sudhir , Gaddikeri Manojkumar , Raj Aditya , Bhosle Sunil , Naseem Atif , Amin Ankit , Agrawal Harsh
Published: December 2021

Study Design: Retrospective study. Aim: To retrospectively evaluate and compare the long-term outcome of anterior vertebral body reconstruction in tuberculosis (TB) of the dorsal spine by direct anterior-versus-posterior approach. Materials and Methods: A total of 127 patients operated by posterior approach, 118 by anterior for TB-thoracic spine with at least 1-year follow-up were included and retrospectively analyzed. Patients were assessed clinically, radiologically and data regarding age, sex, levels involved, surgical approach, operative time, blood loss, neurological recovery using Frankel grade, pre- and post-operative kyphosis, % correction of kyphosis, time for fusion, fusion grading using Bridwell criteria, % loss of correction, mobilization time and complications if any were collected, analyzed, compared in anterior-v/s-posterior approaches. Results: The mean age in anterior-approach was 36.03 and 39.83 years in posterior. Mean operative time in anterior-approach was 6.11 and 5 h in posterior. Mean blood loss of 1.6 L in anterior approach and 1.11 L in posterior. Mean preoperative kyphosis angle in posterior-approach was 34.803°and 11.286° (P < 0.001) at 3 months postopandtotal correction of 67.216%. Mean preoperative kyphosis angle in anterior-approach was 41.154° and 9.498° at 3 months postopandtotal correction of 77.467% (P < 0.001). Mean loss of correction at 1 year was 4.186°in posterior-approach and 6.184°in anterior. The mean time for fusion was 4.69 months in anterior-approach while 6.34 months in posterior as per Bridwell criteria. Meantime for mobilization in posterior-approach was 1.18 and 2.51 weeks in anterior. Significant improvement in neurology was seen in patients operated by either approach, slightly better in anterior. Complications were more in posterior-approach. Conclusions: Anterior-approach allows for thorough debridement, neural decompression, better anterior column reconstruction, and deformity correction under direct vision than posterior. Direct cord visualization while correcting kyphosis reduces the chances of neurological complications significantly. Both approaches have unique advantages and limitations. Though the posterior approach is easy to master, results shown by the anterior cannot be overseen. To conclude, better functional outcome and significantly better kyphosis correction are seen with anterior-approach, which are strong pointers favoring it.
Spinal intradural extramedullary capillary hemangioma with coexistent spinal edema and syringomyelia successfully treated by tumor removal and cervical laminoplasty
Authors: Takayama Motohiro , Maki Yoshinori
Published: December 2021

Capillary hemangioma (CH) is usually found in pediatric patients and is located in soft tissue of the neck or head. As uncommon location of CH, spinal intradural extramedullary space has been reported; however, coexistent spinal edema or syringomyelia with spinal intradural extramedullary CH seems rare manifestations on preoperative magnetic resonance imaging. Laminectomy and tumor resection have been often performed for spinal intradural extramedullary CH. An 83-year-old man was referred to our hospital, complaining of nocturia and motor weakness of the lower extremities. Magnetic resonance imaging revealed a mass at the level of T1, which was homogeneously enhanced on gadolinium-enhanced T1-weighted images. The lesion was accompanied by spinal edema and syringomyelia. An intradural extramedullary tumor was first considered. We thought that the coexistent spinal edema and syringomyelia could have been caused by spinal stenosis. Preoperative angiography revealed that the mass was fed by the radicular artery of C5–C6. To improve the clinical symptoms of the patient, tumor removal and cervical laminoplasty were performed. The spinal edema and syringomyelia regressed postoperatively. The histopathological diagnosis was CH. This is the first reported case of cervical intradural extramedullary CH with spinal edema and syringomyelia successfully treated by cervical laminoplasty and tumor removal.
Can apparent diffusion coefficient predict the grade, genotype, or proliferation index of oligodendrogliomas
Authors: Ali Laghari , Usman Khalid , Fatima Mubarak , Amna Alvi , Saeed Ali , Qadeer Shaikh , Shahzad Shamim , Ather Enam
Published: December 2021

Background: Genetic subsets of oligodendrogliomas (OD) have distinct chromosomal and biophysical profiles. Pretherapeutic tumor grade and genotype analysis is a challenging aspect of management, with 1p/19q codeletion status and grade of oligodendroglioma among the most important considerations for clinical decision making. Methodology: Seventy-three patients with histopathological diagnosis of oligodendroglioma were selected, and their preoperative 1.5T magnetic resonance imaging (MRI) scans were reviewed through parameters including diffusion weighted image, susceptibility-weighted imaging, and apparent diffusion coefficient (ADC). These images were correlated with patients' histopathological and chromosomal testing. Tumor border irregularity, homogeneity, contrast enhancement, and other MRI characteristics were also studied. For analysis, descriptive statistics were generated, and normality was evaluated for ADC value, age, and Ki-67 tumor proliferation index. Objectives: The study aimed to determine the correlation of ADC with Ki-67, grade, and 1p/19q co-deletion in oligodendroglioma at a tertiary care hospital within a low-middle income country. Results: Ki-67 tumor proliferation index was high in 33 tumors. It was found to be statistically significant (P = 0.048) with respect to ADC, showing that 1p/19q co-deleted tumors have a difference in their Ki-67 index. Ki-67 also showed a significant relationship (P < 0.05) with grade of OD. However, there was no statistically significant relationship between 1p19q chromosomal co-deletion and ADC. Linear regression was carried out as the data set was continuous. Univariate analysis showed no significant result with all P values above 0.10. Conclusion: Mean ADC is a viable tool to predict Ki-67 and assist prognostic clinical decisions. However, mean ADC alone cannot predict 1p/19q codeletion and tumor grades in OD. Further supplementation with other radiological modalities may provide greater yield and positive results.
Patient satisfaction with implant removal after stabilization using percutaneous pedicle screws for traumatic thoracolumbar fracture
Authors: Sasagawa Takeshi , Takagi Yasutaka , Hayashi Hiroyuki , Nanpo Kazuhiro
Published: December 2021

Context: There are no reports of patient satisfaction with implant removal after stabilization using percutaneous pedicle screws (PPS) for traumatic thoracolumbar fracture (TTF). Aims: The aim of this study was to investigate patient satisfaction with implant removal after stabilization using PPS for TTF. Settings and Design: A retrospective study. Subjects and Methods: The present study included data from 24 patients who underwent posterior stabilization using PPS for single-level TTF following implant removal. The degree of patient satisfaction was evaluated using a questionnaire. We investigated residuary back pain, using the numerical rating scale (NRS) and Oswestry disability index (ODI), and types of occupation. Patients were divided into groups of those with residuary back pain (Group P) and those without (Group N). We evaluated local kyphosis and disc degeneration after implant removal. We investigated whether residuary back pain or types of occupation affect patient satisfaction. Statistical Analysis Used: All statistical analyses were conducted using IBM SPSS statistics. Results: Patients were “extremely satisfied” in 13 cases (54%), “moderately satisfied” in eight cases (33%), and “neither” in three cases (13%). No patients answered “moderately dissatisfied” or “extremely dissatisfied.” The mean scores on the NRS and ODI in Group P were 1.8 ± 0.9 and 13.2 ± 9.3, respectively. Patient satisfaction, disc degeneration, and local kyphosis were not significantly different between Group P and Group N. Patient satisfaction was not significantly different between the hard and light workgroups. Conclusions: Patient satisfaction with implant removal was high regardless of whether persistent back pain existed and did not depend on the type of occupation.
Symptomatic postsurgical lumbar pseudomeningocele treated by ultrasound-guided epidural blood patch application
Authors: Kavishwar Rohit , Shetty Ajoy , Subramanian Balavenkata , Rajasekaran Shanmuganathan
Published: December 2021

Postsurgical pseudomeningoceles are extradural collections of cerebrospinal fluid (CSF) that results following an intraoperative dural breach. Although usually asymptomatic and self-subsiding, they may present with symptoms of postural headache, blurred vision, diplopia, photophobia, back pain, radiculopathy, and vomiting. Most of the cases recover with conservative measures such as bed rest, hydration, and pressure dressings. Symptomatic patients usually require surgical re-exploration and direct open repair of the durotomy. We report the case of a 48-year-old female who presented with lumbar pseudomeningocele following lumbar microdiscectomy treated by Ultrasound-guided (USG)-guided epidural blood patch application. She had globular swelling at the surgical site, postural headache, and left lower-limb radicular pain with normal neurology. Her magnetic resonance imaging (MRI) showed a left L4 laminar defect with pseudomeningocoele (measuring 5.5 cm × 4.2 cm × 4 cm) with intraspinal communication. USG was used to guide the aspiration of CSF from pseudomeningocele and to apply the epidural blood patch one level above and at the level of laminectomy. Postoperatively, she had marked improvement in her symptoms. At 1-year follow-up, she was completely symptom free and full resolution of pseudomeningocele was seen on 1-year follow-up MRI. This case is being reported to highlight the use of USG-guided epidural blood patch for the treatment of postoperative lumbar pseudomeningocele.
Evaluation of thyromental height test in prediction of difficult airway in obese surgical patients: An observational study
Authors: Ahmed Abeer M. , Zaky Monica N. , El-Mekawy Nevan M. , Ollaek Mohamed A. , Sami Wael M. , Mohamed Dina M.
Published: December 2021

Background and Aims:

Thyromental height test (TMHT) has revealed good potentials for predicting difficult laryngoscopy view (DLV) in non-obese patients, but its accuracy in obese patients is not evident. This study aimed to assess the validity of TMHT as a predictor of DLV in obese surgical patients.

Methods:

105 patients, aged 18–60 years, with body mass index (BMI) >30 kg/m2, scheduled for elective surgeries under general anaesthesia with an endotracheal tube inserted using conventional laryngoscope were included. Airway was assessed with TMHT, modified Mallampati test (MMT), neck circumference (NC) and NC/TMHT ratio. The DLV was defined as Cormack–Lehane grade ≥3. The primary endpoint was the validity of TMHT as a predictor of DLV. The secondary endpoints were to compare the accuracy of TMHT with that of the NC, MMT and NC/TMHT ratio as predictors of the difficult airway.

Results:

The BMI was 43.7 ± 6.6 kg/m2. The DLV cases were 23/105 (21.9%). The MMT, TMHT and NC/TMHT ratio had the best predictive ability of DLV with areas under receiver operating characteristic curve of 0.91, 0.92 and 0.80; at cut-off values >2, <47 mm and >7.9, respectively. MMT and TMHT were the only predictors of DLV by multivariate analysis.

Conclusion:

In obese surgical patients, TMHT is an excellent predictor of DLV when the cut-off value is <47 mm.
Impact of Altmetrics in evaluation of scientific journals, research outputs and scientists’ careers: Views of editors of high impact anaesthesia, critical care and pain medicine journals
Authors: Fassoulaki Argyro , Staikou Chryssoula , Micha Georgia
Published: December 2021

Background and Aims:

Altmetrics represent the attention of an article drawn from social and mainstream media. The aim of this survey was to investigate the views of editors of high-impact journals on the Altmetric Attention Score (AAS), the number derived from an automated algorithm including a weighted count of mainstream news and social media sources.

Methods:

A questionnaire related to the AAS was sent to the editors of high-impact journals, namely Anaesthesia, Critical Care Medicine (CCM) and Pain Medicine (PM). Eleven questions were related to the possible benefits and flaws of Altmetrics.

Results:

Of the 1,381 editors asked, 126 answered. The overall answers showed that 76% of the editors were familiar with Altmetrics, 28% knew how AAS is calculated, 12% believed that AAS should replace traditional bibliometrics, 34% favoured AAS for journal ranking, 40% believed that AAS should be used to assess an article, 44% felt that AAS should be included in researchers’ curriculum vitae and 22% felt that it should be considered for grants. Sixty-two percent of editors believed that AAS is vulnerable to manipulations, 60% proposed improvement and 16% abandonment. Positive answers were similar across the fields, except for journal ranking. Fifty-four percent of editors of the CCM journals favoured journal ranking using AAS versus 28% and 26% editors of anaesthesia and PM journals (P= 0.025 andP= 0.006, respectively).

Conclusion:

A high percentage of editors believed that AAS should be used to assess scholarly output and that it should be included in the researchers’ curriculum vitae. Sixty percent of responders supported the improvement of AAS.
Regional anaesthesia practices in India: A nationwide survey
Authors: Ramachandran Srinivasan , Malhotra Naveen , Velayudhan Savitri , Bajwa Sukhminder Jit Singh , Joshi Muralidhar , Mehdiratta Lalit , Hiremath Vishwanath R.
Published: December 2021

Background and Aims:

There are no surveys documenting the existing regional anaesthesia (RA) practices in our country. This nationwide survey aims to record the existing RA practices, identify any lacunae that might exist and project the future direction of evolution.

Methods:

This online survey consisting of 31 questions was sent to all members of the Indian Society of Anaesthesiologists and addressed participants’ demographic features, central neuraxial block and peripheral nerve block practices, drug selection, RA training and safety measures. The data were analysed using Statistical Package for the Social Sciences version 24.0. All categorical variables were expressed as frequencies and percentages.

Results:

A total of 2141 responses were received, with participants distributed across the country. Forty-two per cent of the respondents reported that more than 60% of surgeries were performed under RA. Most of the participants use ‘traditional’ test dose for epidural space confirmation. Fifty participants (2.4%) use ultrasound for neuraxial space identification. Twenty per cent of the participants use a checklist for monitoring post-operative epidural analgesia. 6.7% have undergone specialised training in RA. Around 3.5% of the respondents have performed a wrong-side block. 31.4% of the respondents store intralipid in the operating room.

Conclusion:

The current survey highlights the prevailing practices, various deficiencies in monitoring and the need for RA training programmes. The data accrued can serve as a baseline for future comparison.
Evaluation of the use of the channeled King Vision video laryngoscope in improving glottic visualisation in patients with limited glottic view with the Macintosh laryngoscope: A prospective observational study
Authors: Choudhary Jaya , Barai Arijit Kumar , Das Sandip , Mukherjee Nirjhar
Published: December 2021

Background and Aims:

The role of King Vision videolaryngoscope (KVL) is well known in the anticipated difficult airway. However, its performance in patients with unanticipated restricted view of the glottis has never been investigated. The aim of this study was to evaluate the performance of KVL in patients with limited glottic view (POGO score <50%).

Methods:

Eighty-five patients fulfilling the inclusion criteria were included in this study. Laryngoscopy was performed in each patient with Macintosh blade followed by the channeled KVL. The laryngeal view obtained with each device was recorded using POGO score and Cormack--Lehane (CL) grade. After that, endotracheal intubation was attempted with the KVL. The haemodynamic parameters, the time taken for endotracheal tube placement and intubation, failure to intubate, modified intubation difficulty score and airway complications were also recorded.

Results:

There was a statistically significant improvement in the POGO scores with the use of KVL: 20 (0,40) vs 90 (40,100) (P< 0.001). The frequency of CL grade I and II increased from 63% with conventional laryngoscopy to 100% with the KVL. Although the time taken to obtain the best glottic view was significantly longer with the KVL as compared to the Macintosh blade (P< 0.001), the first attempt success rate was 97.65%.

Conclusion:

Channeled KVL when used by experienced operators provides superior laryngeal view as compared to Macintosh laryngoscope in patients with restricted glottic view (POGO score <50%) without any major airway complications.
Recurrent gastrointestinal bleeding in a patient with Heyde syndrome with elevated factor VIII levels
Authors: Al-Radaideh Omar , Farouji Iyad , Abed Hossam , Shaaban Hamid
Published: December 2021

Heyde syndrome is the association between gastrointestinal (GI) bleeding from intestinal angiodysplasia (IA) and aortic stenosis (AS). Although the course of disease progression that links AS and GI bleeding has not been determined, overlaps among AS, intestinal dysplasia, and acquired von Willebrand's syndrome is thought to result in GI bleeding. Proper repair of the aortic valve can result in significant improvement of GI bleeding and its recurrence. Herein, we are reporting this rare case, in which a patient with moderate AS on echocardiogram presents with recurrent GI bleeding from multiple IA in the setting of elevated factor VIII levels, to propose a theory that angiodysplasia could potentially develop due to intermittent, recurrent low-grade obstruction of submucosal veins at the level of the muscularis propria secondary to venous thrombosis related to elevated factor VIII levels.
Evaluation and analysis of new design traditional handloom performance in reducing work musculoskeletal disorders among Sarong Samarinda female weavers
Authors: Ramdan Iwan Muhamad , Candra Krishna Purnawan
Published: December 2021

Background:

Work musculoskeletal disorder (WMSDs) are occupational health problems whose prevalence is still high in various countries. Ergonomic interventions are the most successful approach to reducing WMSDs. This study evaluated the effect of redesign traditional handloom on the work posture and musculoskeletal disorders of Samarinda Sarong traditional weavers.

Methods:

The quasi-experiment has been carried out on 40 traditional weavers from February to September 2019 in Samarinda, Indonesia. The weaver using the new design handloom then evaluated its impact on work posture and WMSDs in the first 3 months and the second 3 months. Work posture was assessed using Rapid Upper Limb Assessment (RULA). WMSDs were assessed using a Nordic Body Map questionnaire. Data were analyzed using Friedman and Dunn's test.

Results:

The RULA score decreased from 7 to 3 and 2, while the WMSD risk at “very high” level decreased from 12.5% to 7.5% and 2.5% and the WMSD at “high” risk level decreased from 87.5% to 10.0% and 5.0% following the introducing of the new design traditional handloom at 3 and 6 months, respectively.

Conclusions:

The new design of the traditional handloom on Sarong Samarinda female weavers has succeeded in improving work posture and reducing WMSDs.
Statin therapy associated with decreased neuronal injury measured by serum S100β levels in patients with acute ischemic stroke
Authors: Al-Kuraishy Hayder M. , Al-Gareeb Ali I. , Naji Marwa Thaier
Published: December 2021

Background:

Acute ischemic strokes (AIS) are a common cause of morbidity, mortality, and disability. The serum biomarker S100β correlates with poor neurological outcomes in the setting of AIS. This study describes the impact of statin treatment on S100β levels following AIS.

Methods:

This was a prospective case–control study of AIS patients compared to healthy controls. Patients were stratified into three groups: (1) AIS patients on statin therapy, (2) AIS patients not on statin therapy, and (3) healthy controls. Demographics, clinical parameters, stroke risk scores (SRS), and S100β levels were recorded for all patients.

Results:

Blood pressure, lipids, and SRS scores were higher in stroke versus control patients (all P < 0.05), and lower in Group I versus II (all P < 0.05). S100β levels were higher in stroke versus nonstroke patients (P = 0.001), and lower in Group I versus II (P = 0.001). Furthermore, patients on atorvastatin showed greater S100β reductions than those on rosuvastatin therapy (P = 0.01).

Conclusion:

In acute stroke patients, statins therapy correlated with reductions in the neuronal injury biomarker S100β, with greater reductions observed for atorvastatin than rosuvastatin therapy.
The burden and characteristics of nosocomial infections in an intensive care unit
Authors: Karn Manisha , Bhargava Dipak , Dhungel Binod , Banjara Megha Raj , Rijal Komal Raj , Ghimire Prakash
Published: December 2021

Background:

Patients at intensive care units (ICUs) are vulnerable to acquiring nosocomial infections. The main objective of this study was to explore and characterize the burden of nosocomial infections from an ICU of National Medical College and Teaching Hospital (NMCTH), Birgunj, Nepal.

Methods:

A prospective hospital-based study was conducted between April and December 2018 at NMCTH, Birgunj, Province 2, of Nepal. A total of 374 specimens including clinical specimens (n = 190) from patients admitted in an ICU and animate and inanimate environmental samples (n = 184) from the ICU were collected. Collected specimens were cultured in specific microbiological media, and microbial isolates were identified and subjected to antibiotic susceptibility test.

Results:

Altogether, 374 specimens (190 clinical specimens and 184 nonclinical) of an ICU were analyzed. Out of 190 clinical specimens, 51% (97/190) showed bacterial growth. Isolated bacteria were Staphylococcus aureus (33%; 32/97), Escherichia coli (20.6%; 20/97), Klebsiella spp. (15.5%; 15/97), Pseudomonas spp. (11.3%; 11/97), and Acinetobacter spp. (11.3%; 11/97). Out of 184 nonclinical specimens, 51.6% (95/184) of the samples showed microbial growth. Among the isolates, Klebsiella spp. predominated (30.6%; 26/85) the growth, followed by S. aureus (22.4%; 19/85), Acinetobacter spp. (21.2%; 18/85), and Pseudomonas spp. (17.6%; 15/85). Among all clinical and nonclinical isolates, 61.9% (60/97) of the clinical specimens and 65.9% (56/85) of the nonclinical specimens showed multidrug resistance (MDR).

Conclusion:

Two-thirds of the specimens from both clinical and nonclinical specimens showed MDR. Urgent actions are required to address the augmented rate of nosocomial infections and MDR bacteria among ICUs in Nepal.
Oral health status of hearing and speech-impaired schoolchildren in Erode district, Tamil Nadu – A cross-sectional study
Authors: Kalaivani S. , Shavi Girish R. , Shanmugam Shankar , Sanga Ranganath , Gunasekaran Lalithambigai , Rahila C.
Published: December 2021

Background:

Children with hearing and speech impairment are one of the important groups deprived of good oral health due to communication barriers. The chance of acquiring minimal information can significantly affect their personal as well as oral health.

Aim:

The present study was conducted to assess the oral health status among hearing and speech-impaired children in Erode.

Materials and Methods:

This cross-sectional descriptive study was conducted among hearing and speech-impaired children aged 7–14 years attending special schools at Erode, Tamil Nadu. A structured questionnaire written in vernacular language (Tamil) was used to obtain information on demographic details and oral hygiene practices. Then, oral examination was carried out and findings were recorded in the WHO Oral Health Assessment Form for Children, 2013. Descriptive statistics and Chi-square test were used for statistical analysis.

Results:

A total of 75 children were examined including 46 males (61%) and 29 females (39%). The common dental diseases found in the children were dental caries (65%) and gingival bleeding (47%). Most of the children (76%) required prompt treatment. Intervention urgency is higher among those children who have not visited a dentist before.

Conclusion:

The present study population has extensive dental treatment needs owing to communication difficulties and underutilization of dental care. The dental professionals along with the school authorities and voluntary agencies should reorganize the preventive as well as curative dental services so as to benefit the hearing and speech-impaired children.
Essay on the prospects for the use of decorative perennials of the spontaneous flora of the local landscape Feofaniya
Authors: Matiashuk Raisa , Gubar Liubov , Pirko Inna
Published: December 2021

The taxonomic and ecological structure of an artificial set of species of spontaneous flora of the local landscape Feofaniya, distinguished by decorative features, is presented. Decorative perennials, with the exception of aquatic and coastal ones, number 147 species. They are considered taking into account the adaptive characteristics, as a potentially basic component of the regional assortment of ornamental plants for landscaping. In terms of taxonomic composition, the species belong to 100 genera from 38 families. A significant part of perennials is rare in ornamental gardening. Among the studied perennials, the rare fraction includes 13 species with international (four species), state (seven species), or regional (six species) conservation status. According to the results of bioecological analysis, the predominance of mesophytic (76 %), heliophytic (44 %), mesotrophic (82 %), and neutrophilic (65 %) species is shown. When considering the ecological affiliation, the studied species are united into 15 principal ecomorphological groups. The use of plants represented in such groups as the main assortment in the landscaping of the corresponding ecotopes is a prerequisite for the stability and durability of such artificial communities as flower arrangements. The proposed assortment ensures the creation of modern low-cost flower arrangements, as well as the preservation of the biodiversity of the local flora by expanding the cultigen range of these species.
Media Coverage of Injury Prevalence in Tennis: a Content Analysis of Selected Online Newspapers
Authors: Hassan Isyaku , Musa Rabiu Muazu , Azmi Mohd Nazri Latiff , Abdullah Mohamad Razali , Abdullah Ahmad Taufik Hidayah
Published: December 2021

The health benefits of tennis have been well-described. However, like many other sports, playing tennis places athletes at risk of injury with a lot of physical and psychological effects. Thus, research has indicated the need for systematic studies to design useful strategies for the prevention and treatment of tennis-related injuries. Therefore, via a media-based analysis, this study aims to identify the most commonly reported tennis-related injuries and determine the extent of their news coverage in selected Nigerian online newspapers. Vanguard, Punch, The Nation, The Sun, and ThisDay were selected based on their popularity and online readership. A total of 113 tennis-related news articles were gathered via an internet-based search and subjected to content analysis. The articles were collected from January 2015 until December 2020 using “tennis” and “injury” as keywords. The findings showed that tennis-related injuries occur more often in lower extremities than upper extremities. Also, knee injury, hip injury, and elbow injury were the most commonly reported tennis-related injuries in the selected newspapers. Interestingly, these findings concur with previous clinical research on tennis-related injuries. Further analysis revealed that the selected newspapers paid much attention to tennis-related injuries. However, very few news stories reported official responses to tennis injuries. It was envisaged that this study could provide valuable insights on how to discover more efficient data for tennis injury analysis.