bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Sound Intensity to the Measurement of Aeroacoustic Noise Sources in Flow
Authors: Donavan Paul R.
Published: June 2023

In the late 1970's and early 1980's, Jing-Yau Chung along with Joseph Pope published several external General Motors reports on the then novel measurement of sound intensity (SI) using the two-microphone, cross-spectral method. Application of this measurement method was then extended
to sound intensity measurements in flow. Through component wind tunnel measurements, it was determined that the intensity of noise sources could be accurately measured up to a level of 15 dB below the sound pressure level generated by flow noise on microphones. An initial application of this
method was to the identification of noise sources alongside rolling truck tires. It was then extended to the measurement of the aerodynamic noise generated by protrusions added to automotive vehicle designs. These included items such as outside rearview mirrors, windshield wipers, A-pillar
offsets, grille whistles, roof racks, underbodies, and fixed-mast radio antennas. Many of these could be applied on the early full-size clay models or other mock-ups as well as actual vehicles. An application of sound intensity was the development of the straked antenna design leading to a
GM Defensive Patent and its now universal application to virtually all vehicles with simple fixed-mast antennas. The development of this design is highlighted along with the background on the application of sound intensity to measurements in air flow.
Numerical simulation of on-road wind conditions for interior wind noise of passenger vehicles
Authors: Moron Philippe , Wu Long , Powell Robert , Senthooran Sivapalan
Published: June 2023

Traditionally vehicles are designed for wind noise under ideal steady wind conditions. But, passenger comfort is affected by high modulation of cabin noise while cruising in traffic due to variations of instantaneous wind speed and direction from driving through large-scale turbulence.
In consequence, designing a vehicle for the best performance in a low-turbulence wind tunnel may lead to issues during on-road conditions. To predict the interior noise corresponding to on-road turbulence, a simulation approach is proposed combining an upstream turbulence flow simulation with
an SEA vehicle model. This work is an extension of existing well validated procedures for steady wind conditions. Time-segmented transient loads on panels and steady-state structural acoustics transfer functions are combined, producing interior noise results for a series of overlapping time
segments. This interior noise prediction, as a function of time, captures the modulation of wind noise results, which are then visualized using a spectrogram, plotting sound pressure level indicated by color as a function of time and frequency bands. Audio signals are also created from the
interior noise results, allowing detailed signal analysis from this simulation. This capability enables designers to reduce wind noise modulation in time caused by on-road turbulence, improving speech intelligibility and passenger comfort.
HVAC Noise Prediction Using Lighthill Wave Method
Authors: George Binoj K. , Garikipati Nagababu , Doroudian Mark , Horne Kevin , Voonna Kiran , Erbig Lars
Published: June 2023

Automotive Heating Ventilation and Air Conditioning (HVAC) system is an essential component in providing thermal comfort to the cabin occupants. The HVAC noise which is typically not the main noise source in ICE vehicles, is considered to be one of the dominant sources in the electric
vehicle (EVs) cabin interiors. As air is delivered through ducts and registers into the cabin, it will create an air-rush/broadband noise and in addition to that, any sharp edges or gaps in flow path can generate monotone/tonal noise. Noise emanating from the HVAC system can be reduced by
optimizing the airflow path by the use of virtual analysis during the development stage. This paper mainly focuses on predicting the noise from the HVAC ducts and registers. In this study, Noise simulations were carried out with Ducts and Registers. An FVM based 3-Dimensional (3D) CFD solver
was used for flow as well as acoustic simulation. Large Eddy Simulation (LES) was used for flow field generation and noise characteristics were studied using Lighthill Wave method which is a hybrid aeroacoustic approach that can provide results with a quick turnaround time and low computational
power. The frequency response of the aeroacoustic noise from the ducts and registers were predicted using the simulations and the models were compared in terms of Overall Average Sound Pressure Level (OASPL). The simulated spectra exhibit good correlation with the test data.
Do Beef Production Conferences Affect Beef Producers' Perceptions of Applied Research and Extension Programs?
Authors: Nelson Mark , Llewellyn Donald
Published: June 2023

Decreased visibility and awareness of what Washington State University (WSU) was doing for the beef industry was a critical issue raised by beef industry leaders and WSU faculty. Statewide conferences have been used to distribute information to beef producers. However, these conferences require large commitments of labor, time, and financial resources, and it was not known whether they are effective given that so much information is easily obtained electronically. Therefore, we surveyed beef producers at WSU Beef Production Conferences in 2014 and 2016. Recommendations for improving translation of information include maintaining beef conferences, publishing more articles in beef trade magazines, and increasing information on WSU Internet sites. Applying similar activities elsewhere and with other agricultural producer audiences may prove useful.
Word Cloud Analysis of Early Adopter No-Till Farmer Interviews
Authors: Jemison John , Welcomer Stephanie , Kersbergen Richard , Majewski Carl
Published: June 2023

We interviewed early adopter no-till farmers in the New England region to assess why they changed tillage practices and what the perceived advantages and disadvantages of doing so were. We then generated word clouds from answers to key interview questions to convey the farmers' experiences. Most of these innovators were influenced to convert to no-till by the success of other "exemplary" farmers. Advantages noted included reductions in production time and fuel use. The greatest perceived disadvantage was pest management issues caused by cover crop residues. Yield losses were not mentioned, and many of the farmers experienced increased yields. Our findings suggest that Extension staff can increase adoption of new production techniques by identifying and conveying experiences of key farmer leaders.
Food Preservation: Using Technology-Based Tools to Reach Diverse Audiences
Authors: Johnson Tonya , Case Patty , Hyde Glenda , Kershaw Nancy , Kraemer Lauren
Published: June 2023

Over the past 15 years, there has been a resurgence of public interest in home food preservation as well as development of new ways to access information. Ensuring that Extension educators and consumers have ready access to research-based information is essential to keeping food safe. This article describes how to disseminate information on safe home food preservation using a robust menu of technology-based tools. Extension educators are encouraged to use such an approach with their educational programs to continue to reach diverse audiences and stay relevant in this age of information technology while reducing death and illness associated with improperly preserved foods.
Prens Sabahaddin’in Görüşlerinin Liberalizm Bağlamında Değerlendirilmesi
Authors: AKGÜN Muhammed Raşit
Published: June 2023

Bu makalede, Prens Sabahaddin’in görüşlerini ortaya koymak ve bunların liberalizm bağlamında değerlendirilmesi hedeflenmiştir. Öncelikle Prens Sabahaddin’in hayatı, eserleri ve siyasî faaliyetleri, görüşlerinin anlaşılmasında önem taşıdığı için kısaca incelenmiştir. Sabahaddin Bey, etkilenmiş bulunduğu Le Play ekolü ve “Science Sociale” (İlm-i İçtimâ) anlayışını, Osmanlı İmparatorluğu’nun problemleri çerçevesinde yeniden yorumlamıştır. Bu bağlamda toplumun yapısına, ekonomik sisteme, idarî yapıya ve eğitim sistemine dair çeşitli görüşler ileri sürmüştür. Onun fikirleri, liberalizmden dolaylı olarak tesir görmüş olan Demolins ve de Tourville gibi yazarlardan beslenmiştir. Bu sebeple fikirlerinde sıklıkla liberal öğelere rastlanmıştır. Prens Sabahaddin’in düşünceleri, eserleri ve faaliyetleriyle, Türk siyasî hayatında liberal ve adem-i merkeziyetçi kanadın gelişiminde önemli katkıda bulunduğu neticesine varılmıştır.
A Study on Recyclability of AlSi7Mg0.3 Machining Waste
Authors: GÖKELMA Mertol , ÖNEN TÜZGEL Rabia , KAYA A. Yiğit , ÖZAYDİN Onur
Published: June 2023

Aluminium products are widely used in the automotive industry. One of the important aluminium products in the automotive is wheel production. Turkish wheel production is expected to reach 360000 tons in 2025. The wheels are produced by Low-Pressure Die Casting at the first stage and the machining process in CNC machines is used to create the final form. A significant amount of machining waste (swarf, turnings, and chips) is created during the machining and the importance of secondary aluminium has been increasing due to environmental and economic concerns. This study focuses on the recycling of AlSi7Mg0.3 cast alloy machining waste. The turnings were sorted into two size fractions and remelted separately under a salt flux in a resistance heating furnace. Two different salt mixtures with different melting points and different salt factors were studied in this work. Metal yield and coagulation yield after remelting were discussed.
An Interactive Medium to Introduce Sasando Traditional Music Using Multimedia Development Life Cycle Method
Authors: Nadeak Salam Irianto , Ali Yusmar , Suryadi Djaka
Published: June 2023

ActionScript-based programming is one of the software which includes applications that teachers widely use to create interactive learning media in the world of education. ActionScript-based programming technology is a type of graphic animation software that can create a graphic object that can be animated without using other supporting software. At present, there are many educational circles to expedite the process of learning activities, especially for students. Interactive learning media is one means of delivering subject matter that is very important to apply today. In implementing student learning at school, it is necessary to present a practical and theoretical learning system which is the main point in helping to develop student competence. One form of culture in Indonesia is the traditional musical instrument Sasando. Sasando belongs to the chordophone instrument because it is played by picking it. The form of Sasando itself is in the form of a guitar, violin or harp. The central part of the Sasando is in the form of a long bamboo tube. In the middle, rounded from top to bottom, there is a wedge to stretch the strings. Developing interactive learning media requires a software development method; one of the development methods used is the MDLC (Multimedia Development Life Cycle) method. Making the MDLC has five stages: Concept, Design, Material Collecting, Assembly, and Testing
Studi Kontekstualisasi tentang Perjumpaan Aluk Sola Pemali dengan Kitab Suci Kristen dalam Merajut Keharmonisan bagi Masyarakat Sillanan
Authors: Tumanan Yohanis Luni , Timu Jovier
Published: June 2023

The aims of this study is to gain an in-depth comprehension of the teachings of Aluk Sola Pemali among Aluk Todolo adherents, and to facilitate a theological dialogue based on scriptural interpretation aimed at fostering harmony. This study employs a method that is qualitative and descriptive in nature, which involves both an analysis of relevant literature and conducting field research. To create harmony within the Sillanan society, field research was conducted by means of in-depth interviews to ascertain the meaning of Aluk sola Pemali, which was then compared with the teachings of the Scriptures. The research findings indicate that the encounter between Aluk sola Pemali and the Scriptures shares a common core teaching. In Aluk sola Pemali, the emphasis is on the way of life by Tintiri Buntu as a guiding principle, while in the Scriptures, rules and regulations are contained within the Law of Moses and the Law of Christ, serving as a way of life with a similar core teaching to Aluk sola Pemali. The particularistic differences between the two represent a beauty that needs to be embraced with an attitude of tolerance in weaving harmony.
Pengaruh Pengaruh Faktor Internal dan Eksternal Terhadap Return Saham Perusahaan Sektor Pertambangan yang Terdaftar di ISSI
Authors: Azid Abdul , Hermawan Dadang , Tripuspitorini Fifi Afiyanti , Purbayati Radia
Published: June 2023

This study aims to examine the influence of the company's internal factors consisting of return on equity (ROE), Debt to Equiy Ratio (DER), and firm size (Firm Size) as well as external factors consisting of inflation, exchange rates, and Gross Domestic Product (GDP) on stock returns of mining sector companies listed on the Indonesian Sharia Stock Index (ISSI) for the 2016–2020 period. The data used is secondary data for the 2016-2020 period sourced from the Indonesia Stock Exchange (IDX), Bank Indonesia (BI), and the Central Statistics Agency (BPS). Samples were taken using a purpose sampling technique in order to obtain 13 companies that became the research sample. The data analysis technique used is multiple linear regression analysis using Eviews 12. The results show that simultaneously ROE, DER, firm size, inflation, exchange rate, and GDP have an effect on stock returns. while partially ROE, DER, firm size and exchange rate have no effect on stock returns. Inflation and GDP have a negative and significant effect on stock returns.
Analisis Pengaruh CAR, NPF, BOPO, dan FDR terhadap ROA (Studi Kasus PT. Bank Muamalat Indonesia Tbk.)
Authors: Zikri Shafanissa Aulia , Tamara Destian Arshad Darulmalshah , Mai Muhamad Umar , Nurdin Ade Ali
Published: June 2023

This research is motivated by the existence of problems at Bank Muamalat Indonesia (BMI) over the last few years involving its ability to earn profits, and by looking at the prolonged decline in ROA over the last eight years which shows that BMI as the first Islamic bank in Indonesia has a low ability to generate profits. This study aims to determine the impact of CAR, NPF, BOPO, and FDR on ROA in a BMI case study from 2014 to 2021. Related data to the research issues were collected using literature research methods. The collected data was analyzed using multiple linear regression methods using statistical data processin application tools. The results of this research are the variables CAR, NPF, BOPO, and FDR simultaneously have a significant effect on ROA, partially CAR and FDR have a significant positive effect on ROA, BOPO has a significant negative effect on ROA, and NPF has no significant effect on ROA.
Analisis Pengaruh Faktor Internal dan Faktor Eksternal terhadap Kinerja Reksa Dana Pendapatan Tetap Syariah
Authors: Rizki Ikhsan Maulana , Danisworo Dimas Sumitra , Djuwarsa Tjetjep , Mauluddi Hasbi Assidiki
Published: June 2023

Sharia fixed income mutual funds are the topic raised by the author because they are mutual funds with the lure of stable returns to investors. Fixed-income mutual funds are one of the biggest contributors to returns to investors,but decreased in 2020. Based on this phenomenon, this final project aims to find out what can affect the performance of Islamic fixed income mutual funds. There are five variables that can be taken based on previous research and classified into internal factors (Mutual fund age, Mutual fund size) and external factors (Inflation, Rupiah exchange rate, and interest rates) to then be tested for their effect on the performance of Islamic fixed income mutual funds as affected variable. The performance of Islamic fixed income mutual funds is measured using the Sharpe method. The sample used in this study were 10 investment manager companies that issued sharia fixed income mutual fund products in the 2016-2020 period and were selected through the Purposive Sampling Technique. The research method used is quantitative-descriptive with a path analysis model. This research is expected to provide information for readers related to sharia fixed income fund
Pengaruh Faktor Fundamental terhadap Return Saham Perusahaan Kategori Jakarta Islamic Index di Bursa Efek Indonesia
Authors: Febrianti Putri Deliana , Hermawan Dadang , Syarief Mochamad Edman , Amailiya Lya
Published: June 2023

This study aims to investigate the impact of the fundamental elements of the company as seen through financial ratios, including the Current Ratio (CR), Return on Equity (ROE), Debt to Equity Ratio (DER), Earnings Per Share (EPS), Price Earning Ratio (PER), and macroeconomic variables Inflation and BI Rate on stock returns of companies in the Jakarta Islamic Index category on the Indonesia Stock Exchange in the period 2015-2020. Panel data regression analysis is the data analysis method employed, while E-Views 9 is the data analysis tool. According to the study's findings, the Jakarta Islamic Index's stock returns are significantly and negatively impacted by the BI Rate. Meanwhile the Jakarta Islamic Index's stock returns are not significantly impacted by CR, DER, ROE, EPS PER, or inflation.
Keputusan Menjadi Nasabah Bank Syariah: Peran Literasi Keuangan Syariah, Kepercayaan, dan Citra Bank Syariah
Authors: Setiawan Setiawan
Published: June 2023

Islamic banks in Indonesia have existed in Indonesia for three decades. However, until now the development is not very significant. Even though Muslims are the majority population in Indonesia. The purpose of this study was to investigate how three factors - Islamic financial literacy, trust in Islamic banks, and the image of Islamic banks - impact the decision to become a customer of Islamic banks. The research employed a quantitative approach and explanatory research to collect primary data from 200 respondents with diverse backgrounds through questionnaires. The study found that a higher level of Islamic financial literacy can motivate individuals to choose Islamic banks as customers. This finding highlights the importance of enhancing public awareness and understanding of Islamic finance. Additionally, the trust and image of Islamic banks were identified as critical factors affecting customers' decisions. Therefore, it is vital for Islamic banks to maintain high levels of professionalism to sustain customer trust and present a positive image.
اختبار مستوى المعرفة الرياضية للطلبة عن الإصابات الرياضية
Authors: م. د واثق مدلل عبيد
Published: June 2023

اتاحة الفرصة للطلبة للمرحلتين الثالثة والرابعة في كليتي التربية الرياضية في جامعة بغداد والمستنصرية لابداء مستوى المعرفة الرياضية بالاصابات الرياضية وبالاسلوب المفضل لديهم له الاثر الكبير في تعزيز و زيادة الممارسة الرياضية.

 لذلك هدفت الدراسة الحالية الى التعرف على مستوى المعرفة الرياضية لطلبة المرحلتين وبالتالي التعرف على الفروق في المعرفة على وفق متغيري المرحلة (الثالث والرابع) عليه كان من الضروري بناء اختبار معرفي للطلبة وممارسي الانشطة الرياضية فهو الأداة الرئيسة للبحث الحالي، ولتحقيق الأهداف عمد الباحث بتطبيق الأداة باستعمال المنهج الوصفي على عينة مكونة من (357) طالب وطالبة للعام الدراسي (2012-2013), اشتمل الاختبار على (100) عبارة باستخدام خمسة بدائل اجابة (تنطبق علي دائما, تنطبق علي غالبا ,تنطبق علي أحيانا, تنطبق علي نادرا,  لا تنطبق علي أبدا ) موزعة على تسعة ابعاد ،  وبعد العديد من الاجراءات  الميدانية المتمثلة في بناء الاختبار والتأكد من صلاحيته ، وأجراء التجربة الرئيسة (تطبيق الاختبار) ، ومعالجة البيانات باستعمال الوسائل الإحصائية المناسبة لمعالجة النتائج ، توصل الباحث إلى النتائج الآتية : إن طلبة المرحلتين  يتمتعون بمستوى منخفض من المعرفة الرياضية عن الاصابات الرياضية  وعدم وجود اختلاف في المعرفة لدى عينة البحث على وفق متغيري (ابعاد المقياس والمرحلتين) . اشتمل الاختبار في صورته النهائية على (43)عبارة محققا معامل صدق بلغت ( 92. 0) ومعامل ثبات بلغت (0.82) وقد اسفرت النتائج الى بناء اختبار مستوى المعرفة الرياضية للطلبة عن الاصابات الرياضية .
CLINICAL PROFILE AND OUTCOME OF NEONATAL PNEUMOTHORAX IN TERTIARY CARE CENTRE IN CENTRAL INDIA.
Authors: Ramakrishnan Pallavi , Josh Manojkumar
Published: June 2023

Neonatal pneumothorax is a life-threatening emergency situation. Respiratory distress syndrome, meconium aspiration, birth trauma or positive pressure ventilation may cause pneumothorax in neonates. It may manifest as respiratory distress, hypoxemia or respiratory failure depending upon severity of pneumothorax and eventually may cause compromise of cardiac function. Early radiological diagnosis by chest radiograph, point of care Ultrasonography, emergency needle thoracocentesis and supportive care may improve the outcome of pneumothorax. In this case report, we present a case of a full-term new born baby who required positive pressure ventilation with Ambu-Mask, who developed severe respiratory distress in immediate postnatal period after resuscitation. Early diagnosis of pneumothorax with chest radiograph and ultrasonography was done. Pneumothorax lead to cardiac function compromise which necessitated emergency needle thoracocentesis. Intercostal drainage tube was placed and secured for denitive resolution. Hence, patient was stabilized because of timely diagnosis and expeditious intervention.
ANAESTHETIC MANAGEMENT OF INTRAOPERATIVE IATROGENIC TRACHEAL TEAR
Authors: B.P Thrupthi , Nitin Gadre Vaijayanti
Published: June 2023

Intraoperative tracheal injury is rare but life threatening complication. High degree of suspicion is essential to identify these cases and early intervention is associated with better outcome[1]. We report a case of a intraoperative tracheal injury who was managed conservatively with protective lung ventilation in a patient undergoing transhiatal esophagectomy for carcinoma esophagus
HISTOPATHOLOGICAL STUDY OF NEOPLASTIC LESIONS OF BREAST: AT A TERTIARY CARE CENTRE.
Authors: Humera Begum Baig , K Shere Sunita. , R Joshi Anil.
Published: June 2023

Background: Female breast is one of the commonest sites of neoplasm in the human body. In India, breast cancer is the most common cancer among women in many regions. Histopathology plays an important role in management of breast diseases. To study gross and Objectives: microscopic characters of the Neoplastic Breast lesions, classify them according to WHO classication and to determine the distribution according to age and gender. The observational study was conducted in the Department of Pa Materials and Methods: thology, GMC Aurangabad from October 2020 to September 2022. All the patients presenting with Breast Lump were included in the study. Total 420 cases studied. Observation and Results: Out of 420 cases, most cases 331(78.8%) were malignant, 88 cases (20.95%) were benign and only 1 case (0.24%) was borderline. Majority 273 cases (82.42%) were found to be Invasive Breast carcinoma- Not Otherwise Specied (IBC NOS). Histopathology is Conclusion: gold standard for the diagnosis, staging and predicting the prognosis in breast lesions
FACIAL BASAL CELL CARCINOMA- CLINICAL VARIANTS, MANAGEMENT AND CLINICAL OUTCOME EXPERIENCE AT OUR CENTRE
Authors: G Prabha Amritha , Aizaz Khan Mohd , Kumar BR Kiran , Shankar Bharat , Varma Sudhir , Ganesh MS , S Narayan Geeta , J Thyagaraj
Published: June 2023

Background: Basal cell carcinoma (BCC) is the most common type of skin cancer and it constitutes more than three quarters of skin cancers of the
face. Any lesion in the face above the line joining the tragus and the angle of mouth are considered as high risk lesions for recurrence. The gold
standard surgical treatment is Mohs micrographic surgery (MMS) or surgical excision with intraoperative histological and margin assessment.
Radiation therapy (RT) has always played an essential role in the management of BCC. To retrospectively analyse the presentation, risk Aim:
factors, most common histopathology variant, margin status, ap reconstruction, need for adjuvant RT and recurrence of BCC in the face in a
tertiary centre. Methods: Retrospective analysis of 16 cases of BCC over the face treated at out centre was done from 2018 to 2020.All were BCC
above the line joining tragus to angle of mandible. All cases presented bet Results: ween the age 34 to 67, mean age of 54. Of the total 16 cases, 12
were males and 4 females. 12 cases were primary and 4 were recurrent operated outside. All lesions excised with 2-4mm margin and reconstructed
with local faciocutaneous aps in rst setting. All aps healed well with no complictaions except for 2 which had minor wound breakdown. Post op
Radiation given in 5 cases (4 recurrent and 1 primary). All patient had acceptable cosmesis after the completion of treatment. All patients were
followed up for 2 years. In our experience high risk BCC in the face can be excised wit Conclusion: h negative margins using intraoperative frozen
section and ap reconstruction can be done in rst setting only. Those that are recurrent and with high risk features , adjuvant therapy has to be
given
SCREENING THE TODDLERS BORN PRETERM FOR RISK OF NEURODEVELOPMENTAL DELAY
Authors: Sampathi Venkatesh
Published: June 2023

The present study aimed at identifying the proportion of preterm toddlers at risk of NDD who attended a tertiary care hospital using a screening tool ASQ 3 and comparing the risk of NDD among moderate to late preterm, very preterm and extreme preterms. The present Materials and Method: study was conducted in the Paediatric OPD of a tertiary care hospital. The study calculated the risk of neurodevelopmental delay among toddlers born preterm using a validated Marathi-translated version of ASQ 3.The ASQ 3 was completed by parents, mainly the mothers. The study included 111 preterm toddlers with chronological ages ranging from 12 to 24 months, with a mean of 17.63 ± 3.73 months and a male-to-female ratio 0f 1.4 :1. The toddlers under the black zone are considered at high risk of NDD and referred to the Child Development and Guidance Clinic for further evaluation. Overall, 22 (19.8%) preterm toddlers failed ASQ, with single-domain failure Results: (63.63%) being the most common, followed by 2-domain (22.72%) failure. Among those 22, more than two third (77.2%) failed in the gross motor domain, followed by 31.8% in ne motor, 22.7% in personal-social, and 13.63% each in communication and problem-solving. Additionally, 39 (35.13%) toddlers were in the grey zone, with 25.64% in ne motor, 20.51% each in the domain of communication, problem-solving and personal-social and 12.82 % in the gross motor domain. A decrease in gestational age was associated with a statistically signicant increase in the risk of NDD. the multivariate analysis identied the chronological age of ≤ 18 months, being underweight and receipt of mechanical ventilation during the neonatal period as independent risk factors for being at risk of NDD. ASQ is a reliable screening tool that can be e Conclusion: asily used in pediatric ofce practice
A LITERATURE REVIEW OF RADIOLOGICAL FINDINGS TO GUIDE THE DIAGNOSIS OF GALLBLADDER ADENOMYOMATOSIS.
Authors: Singh Aparajita , S. Goel K. , Talukdar Ramendranath , Tiwari Pawan
Published: June 2023

Background: Gallbladder adenomyomatosis (GA) is a benign gallbladder entity discovered as an asymptomatic gallbladder mass. Since gallbladder cancer is in the differential diagnosis for gallbladder masses, the ability to differentiate benign disease avoids a more extensive oncologic resection. This study sought to review imaging modalities used to diagnose GA. Methods: PubMed and SciVerse Scopus were systematically searched using the terms: “gallbladder adenomyomatosis” and “gallbladder imaging” for articles published between January 2000 and January 2015. Results:Atotal of 14 articles were reviewed in this analysis. Contemporary series report the use of ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI) in GAimaging. Ultrasound detection of Rokitansky-Aschoff sinuses, visualized as small cystic spaces with associated “comet-tail” or “twinkling” artifact, is pathognomonic for GA. A “Pearl-Necklace” sign of small connected sinuses on MRI or “Rosary” sign on CT are additional characteristics that may assist in establishing a diagnosis. Conclusion: Ultrasound is the most commonly used tool to investigate GA. If not diagnostic, CT or MRI are effective in attempting to differentiate a benign or malignant cholecystic mass. Characteristic signs should lead the surgeon to perform a laparoscopic cholecystectomy in symptomatic patients or manage non-operatively in asymptomatic patients
A STUDY OF ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC CHANGES IN PATIENTS OF CHRONIC KIDNEY DISEASE
Authors: Ladhani Samridhi
Published: June 2023

Introduction: Chronic kidney disease is dened as the presence of kidney damage or an estimated glomerular ltration rate less than 60 ml/min/1.73 mt2, persisting for 3 months or more, irrespective of the cause. It is a state of progressive loss of kidney function ultimately resulting in the need for renal replacement therapy . A cardiovascular mortality that is 15 to 30 times greater than the age-adjusted cardiovascular mortality in the general population affects roughly 50% of people with ESRD. Therefore this study was undertaken for assessing electrocardiographic and echocardiographic ndings in CKD patients. Method: In this study 50 pts of chronic kidney disease as per KDIGO criteria were enrolled over a period of six months (Jan-June 2022).All relevant data were recorded and analyzed. Results: Among 50 pts, 26 percent of the patients each belonged to the age group of 61 to 70 years. 62 percent of the CKD patients were males while the remaining were females. While assessing the ECGndings among CKD patients, LVH and arrythmias were seen in 52 percent and 44 percent of the patients. While assessing the correlation of ECGndings with CKD severity grading, it was seen that ECG variables were signicantly deteriorate with increasing severity of CKD grading. While analysing ECHO ndings among CKD patients, abnormal ndings were seen in 88 percent of the patients . While assessing the correlation of ECHO ndings with CKD severity grading, it was seen that ECHO variables were signicantly deteriorate with increasing severity of CKD grading. Conclusion : LVH, LAE were very common ECG and ECHO abnormalities in CKD patients. Cardiac disorders are highly prevalent in patients with progressive CKD. All CKD patients must be evaluated for cardiac co-morbidities, since it might help to establish adequate treatment that may potentially improve patient's prognosis.
TRAUMATIC LATERAL TRANSLATIONAL INJURY OF THE LUMBAR SPINE-A RARE CASE REPORT
Authors: Mazumder Pankaj , Umesh Singh Takhelmayum , Dhanda Mohit , Sharma Bramhacharimayum Shashikanta , E Vengadasalabadhy
Published: June 2023

Introduction- Traumatic lateral translational injury of the lumbar spine is a rare lesion and frequently noted in patients with multiple traumatic injuries. We report a case of traumatic L4-L5 lateral translational inj Case Presentation- ury of the lumbar spine, in which successful decompression, reduction and xation with posterior instrumentation showed satisfactory outcome. Surgical reduction and xation Conclusion: should be attempted irrespective of the severity of the initial neurological decit. We recommend early decompression, reduction and xation with posterior instrumentation to achieve neurological recovery and stability of the spine
COMPARISION OF DIFFERENT DOSES OF CLONIDINE ADDED TO INTRATHECAL BUPIVACAINE IN ORTHOPEDICS SURGERY
Authors: Bhardwaj Harsh , Shukla Chetan , Gocher Kiran , Naraniya Anjali
Published: June 2023

Background: Intrathecal Clonidine is a very safe nonopioid adjuvant to local anaesthetics to prolong the duration of analgesia without any major side effects. Objective: The purpose of the present study is to evaluate the “ COMPARISION OF DIFFERENT DOSES OF CLONIDINE ADDED TO INTRATHECAL BUPIVACAINE IN ORTHOPEDICS SURGERY” Material &Method: ATotal of 60 aduit patients scheduled to undergo lower limb sugeries were ramdonly allocated into either of two group of 30 pateints. Group A: Bupivacaine heavy (0.5%) 2.5ml +30mcg Clonidine, total volume 2.8 ml Group B: Bupivacaine heavy (0.5%) 2.5ml +45mcg Clonidine, total volume 2.8 ml Onset & duration of sensory blockage, Degree of motor blockage, Degree of sedation, Intraoparative heamodynamics. Side effect or any other complication were noted. Result: The mean time of onset of sensory & motor block was less in higher dose added to bupivacaine . The Duration of sensory blockage was signicantly prolonged in Group B 367.26±36.60 min as compared to Group A 200.13±15.70 min . The Duration of motor blockage was signicantly prolonged in Group B 227.86± 22.49min as compared to Group A 176±12.91 min. Conclusions: The addition of intrathecal clonidine 30mcg to small dose of bupivacaine increased the spread , duration of analgesia, & produced effective spinal anesthesia with stable heamodynamis.
STUDY OF MICROALBUMINURIAAND ALBUMIN - CREATININE RATIO IN TYPE 2 DIABETES MELLITUS AND THEIR CORRELATION WITH GFR AND OTHER BIOCHEMICAL PARAMETERS
Authors: Kumar Nimish , Kumar Ashok , Mahesh Nalluri
Published: June 2023

Diabetes mellitus (DM) is one of the primary risk factors for developing renal impairment globally. The development of microalbuminuria has been considered to be one of the rst clinical signs of a classic course of diabetic nephropathy, which leads to macroalbuminuria and then to progressive loss of glomerular ltration rate (GFR) and eventually end-stage renal disease. Both type 1 and type 2 DM may lead to chronic complication of diabetic nephropathy (DN). The development of microalbuminuria has been considered to be one of the rst clinical signs of a classic course of diabetic nephropathy, which leads to macroalbuminuria and then to progressive loss of glomerular ltration rate (GFR) and eventually end-stage renal disease. Persistent macroalbuminuria predicts loss of kidney function and, more importantly, interventions that reduce macroalbuminuria also slow the loss of glomerular ltration rate. this prospective observational study was designed in an attempt to evaluate the relationship between microalbuminuria, albumin-creatinine ratio with other biochemical parameters in type 2 DM and to examine whether this relation differs from that of non-diabet
A RARE CASE REPORT: CAESAREAN SCAR ECTOPIC PREGNANCY - MEDICAL MANAGEMENT.
Authors: Naaz Farha , Raval Ravi
Published: June 2023

Caesarean section scar ectopic pregnancy (SEP) is a rarest form of ectopic pregnancy. If not diagnosed and adequately treated in early pregnancy leads to considerable maternal morbidity and mortality. With the increasing rate of caesarean section there is a substantial increase in this condition with better understanding of this disease. Caesarean scar ectopic is the implantation of a gestational sac in the myometrium and brous tissues at the site of a previous uterine scar (mostly cesarean section scar). We describe the presentation, workup including radiology studies and management of a caesarean scar ectopic pregnancy in a 23 yrs. old gravida 4 para1 living 1 with 2 abortions with previous one caesarean section. The mean gestational age at the time of diagnosis was 7w 5d. The majority of the women presented with either pain or bleeding, but few cases were asymptomatic and were diagnosed with scar ectopic pregnancy during routine obstetric ultrasonography. We were successful in treating this rare form of ectopic pregnancy without any maternal morbidity and with medical management.
STUDY OF COAGULATION PROFILE IN PREECLAMPSIA.
Authors: Jakate Pratiksha , Joshi Anil , Deore Ankita
Published: June 2023

Background: Preeclampsia is multisystem disorder unique to pregnant women after 20 weeks of gestation. It is one of the most common causes of increased mortality, morbidity both in mother and in the fetus. We have undertaken this study to assess coagulation prole of preeclampsia for early detection of complications and to reduce maternal and fetal mortality and morbidity. Methodology: This was a facility based prospective observational study conducted at pathology department of tertiary care hospital. Atotal of 90 pre-eclampsia patients were recruited in the study. All clinically conrmed patients with pre-eclampsia were evaluated by history, clinical examination and platelet count, bleeding time, clotting time, PT, a PTT and D Dimer investigations. Results: Mean age, gestational age and gravida did not differ signicantly according to severity (p>0.05) while systolic & diastolic blood pressure was signicantly more among cases with mild and severe preeclampsia. There was signicant thrombocytopenia, bleeding time, clotting time, PT, aPTT were prolonged and D Dimer was raised in severe preeclampsia group (p<0.05). Conclusion: From this study we conclude that with routine screening of platelet count, bleeding time, clotting time, PT, a PTT and D Dimer, coagulation disorders of preeclampsia and eclampsia can be detected.
CORROBORATING TESTICULAR WORK UP FOR ISCHEMIAAND SUSPECTED TORSION [TWIST] SCORE IN THE EVALUATION OF TESTICULAR TORSION IN PATIENTS PRESENTING WITH ACUTE SCROTUM: A STUDY FROM A TERTIARY CARE CENTRE IN CENTRAL INDIA
Authors: Mishra Arun , Gupta Apoorv , Harchandani Rohit , Kela Manoj
Published: June 2023

Objective: To study the testicular workup for ischemia and suspected torsion (TWIST) score for evaluation of patients presenting with acute scrotum. Method:An observational study was done amongst the patients presenting with acute scrotum of the emergency department of a tertiary care hospital. The scoring system , as described by Barbosa, et al, consisted of testicular swelling(2), hard testicle(2), absent cremastric reex(1), nausea/vomiting(1), high riding testis(1). Along the entire duration of the study the same standard of resources were used in terms of radiological investigations and the surgery performed. Results: In the testicular torsion group, the mean TWIST score was 5.4 ranging from 4 to 7 while in the non torsion group it was 2.81 ranging from 2 to 6. In the testicular torsion group the no. of patients belonging to low, intermediate and high risk was 0, 2 and 8, respectively, while the number of patients without testicular torsion was 5, 5 and 1 in low, intermediate and high risk groups respectively. Conclusion: The testicular workup for ischemia and suspected torsion (TWIST) score can be used a tool for evaluation of patients presenting with acute scrotum. The score has a high positive predictive value for testicular torsion
COMPARISON OF ONDANSETRON AND ONDANSETRON PLUS DEXAMETHASONE FOR PREVENTING POSTOPERATIVE NAUSEAAND VOMITING IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Bende Komal , Parchandekar Mukund
Published: June 2023

Background and Aims: Postoperative nausea and vomiting (PONV), the most common and distressing symptoms experienced by patients after laparoscopic cholecystectomy often need prophylactic antiemetic therapy. Multimodal prophylactic antiemetic therapy is found to be more effective than any single antiemetic drug. The primary objective of the study was to compare efcacy of ondansetron and ondansetron plus dexamethasone for preventing PONV in patients undergoing laparoscopic cholecystectomy. Material and Methods:Aprospective, randomized, comparative, double blinded study was carried out on 60 ASA Grade I and II patients of either sex aging 26-60 years undergoing laparoscopic cholecystectomy under general anaesthesia. Patients were divided into 2 groups of 30 each by systemic randomization method. Group O: received Ondansetron 4 mg IV, and Group OD: received Ondansetron 4 mg plus Dexamethasone 8mg IV, 10 min before induction of anaesthesia. PONV was assessed immediately after surgery and at 30-min intervals for 2 hours in the recovery room and then in the ward at 6, 12 and 24 hours postsurgery. The occurrence of nausea and vomiting was evaluated on a 3-point ordinal scale. 0 = no nausea or vomiting, 1 = nausea only, 2 = retching and / or vomiting. The primary end point was a “complete response”, dened as no episode of PONV during the rst 24 hrs after recovery from anaesthesia. Failure of prophylaxis was considered as a need for rescue antiemetic. Results: 13 (43.33%) and 22 (73.33%) patients from Group O and Group OD respectively had complete response (p=0.018). 17 (56.66%) patients in Group O and 8 (26.66%) patients in Group OD, who had episode of PONV, 12 and 5 patients respectively needed rescue antiemetic (p>0.05). The duration of hospital stay was longer in Group O than Group OD (p<0.05). Conclusion: In patients undergoing laparoscopic cholecystectomy, prevention of postoperative nausea and vomiting is better with combination of ondansetron plus dexamethasone than ondansetron alone.
QSIRS SCORE IN PREDICTION OF MORTALITY IN PATIENTS WITH SEPSIS: A PROSPECTIVE STUDY
Authors: T N Diwakar , Nayana Nayana , Beguru Subramanya Preetham
Published: June 2023

Background: Sepsis is a medical emergency contributing to 1 in 5 deaths worldwide . Both QSOFA score and SIRS criteria are widely used to predict the risk of sepsis and death. But QSOFA score and SIRS criteria has its own limitations. 2022 surviving sepsis guidelines recommend against using QSOFA as a single screening tool. In this study we aim to determine accuracy of predicting mortality with combined SIRS and QS OF Ascore : QSIRS and to compare it with SIRS and Q SOFA. Methodology: It was a prospective observational study. 100 patients with sepsis were included. On admission QSOFA, SIRS, QSIRS were calculated of all patients. Any score of 2 or more was deemed to be a positive score. In hospital mortality was considered as Outcome measure. Receiver Operating Characteristic analyses were performed to determine the Area Under the Curve, along with sensitivity and specicity of various scores were calculated. Results: Out of 100 patients studied 61% was male and 39% were female. Mean age of study participants was 55.7 years. Most common cause of sepsis was pneumonia (43%) followed by urinary tract infections (19 %). 33 deaths were recorded out of 100 patients (33%). In our study we found that QSIRS had the highest sensitivity of (96.96%) in compared to QSOFA(71.6%) and SIRS (84.8%). But the specicity of the QSIRS was low (22.3%). QSOFAhad the highest specicity of 71.6 %, followed by SIRS- 47.7%. AUC in ROC for QSIRS (O.711) was higher compared to QSOFA (0.697), and SIRS (0.588). Conclusion: Our study suggests that QSIRS score is most accurate in predicting mortality in patients with sepsis than SIRS or QSOFAalone. Combinations of QSOFAand SIRS could improve the predictive value for in hospital mortality for patients with sepsis.
AN OBSERVATIONAL STUDY OF CARDIOVASCULAR STRESS RESPONSE TO LARYNGOSCOPY WITH MCCOY, MACINTOSH, MILLER LARYNGOSCOPE BLADE FOR INTRAOPERATIVE ANAESTHESIA IN ADULT ELECTIVE SURGERIES
Authors: Sunil Navale Snehal , Nandkishor Rathi Priyanka , Pore Shobha , Kulkarni Samiksha
Published: June 2023

Background: The most commonly used equipment to aid endotracheal intubation is a laryngoscope, and the procedure performed is known as laryngoscopy, which leads to profound cardiovascular effects. The process of laryngoscopy causes the release of catecholamines, thereby leading to marked pressor responses and tachycardia. The process of laryngoscopy can be made easier by the use of various types of laryngoscopic blades. This study was conducted to observe cardiovascular stress response to the laryngoscopy with McCoy, Macintosh, Miller laryngoscope blades for anaesthesia in adult elective surgeries. Material: This study was conducted in 51 patients in age group 18-60 years of both sexes, posted for elective surgeries under general anaesthesia in surgery and gynaecology operation theatre. In this study, 51 patients were randomly allocated into three groups each of 17 patients Grope 1 (McCoy Laryngoscope), Group 2 (Macintosh Laryngoscope), Group 3 (Miller Laryngoscope). There Results: was no signicant difference in age and gender distribution between three groups. There was no signicant difference in sex distribution between three groups. There was a signicant difference in mean heart rate between different groups from 2 to 5 mins. There was a signicant difference in mean SBP and DBP comparison between different groups from 1 to 5 mins. It is least with McCoy, most with Miller and in between with Macintosh. There was a signicant difference in Glottic view Distribution between three groups. Glottic visualisation is best with Miller blade. There was a signicant difference in Ease of Intubation Distribution between different groups. So tracheal intubation is easier with McCoy blade as compared with Macintosh and Miller blade. There was no signicant difference in Side Effects Distribution between different groups. Conclusion: It is concluded that the cardiovascular stress response (increased heart rate, blood pressure and mean arterial pressure) to laryngoscopy is least with McCoy laryngoscope and most with Miller laryngoscope and in-between with Macintosh laryngoscope.
A STUDY OF CLINICAL AND IMAGING FEATURES OF REFRACTORY EPILEPSY IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL
Authors: Reddy Sudarshan , Vineela Vineela , Sreelekha K. , Sree Ranga lakshmi G. , Archana B.
Published: June 2023

Background & objectives Epilepsy is a chronic noncommunicable disease of the brain that affects people of all ages. It is estimated that 70% of people living with epilepsy could live seizure free if properly diagnosed and treated. The exact magnitude of medically intractable epilepsy in India is unknown. The factors that determine the outcome of epilepsy are age of onset and the type of seizure. The aim of our study was to identify the causes of refractory epilepsy To identify the clinical and imaging features i Objectives: n refractoriness. To determine the importance of early and proper evaluation of seizures in refractory epilepsy. It was an observational study Methods: in patients of refractory epilepsy. After taking informed consent, detailed history was taken and examination was done. 105 Patie Results: nts with refractory epilepsy were included in the study. Majority were between 21-30 years age group. 44% of the patients had the onset of seizures below 10 years. Focal seizure type (68 patients) was the most frequent type. Status epilepticus was found in 41.9% of the patients. Engel's seizure score showed the association of high seizure score with RE. The most common cause for refractoriness was found to be congenital anomalie Interpretation & Conclusions: s in children and calcication in adults.