bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ROLE OF UKRAINIAN MASS MEDIA IN FORMING ATTITUDE OF SOCIETY TOWARDS UKRAINIAN WOMEN IN THE ARMY AND AT WAR
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, GRABOVSKA Iryna , NALYVAIKO Larysa ,   National Academy of Law Sciences of Ukraine, Kharkiv, Ukraine, TALKO Tetiana ,   Oles‘ Honchar Dnipro National University, Dnipro, Ukraine
Published: October 2024

The authors of the article analyze the role and significance of the mass media in highlighting the contribution of Ukrainian women to the fight against the Russian aggressor, overcoming gender stereotypes regarding women military servicemen of the Armed Forces of Ukraine in the mass consciousness of Ukrainian society, and in general, the specifics of the reflection of this process in the mass media of Ukraine. The article notes that with the beginning of Russia’s full-scale invasion of the territory of the independent Ukrainian state, significant changes took place in the Ukrainian mass media regarding the perception and representation of female military personnel in the Ukrainian army. If before the full-scale invasion of the Russian invaders into the territory of Ukraine there were differences in the assessment of the positive role of women in the Armed Forces, today women in the Ukrainian army are perceived as a positive phenomenon. The defenders of the people and the country against a dangerous enemy are the pride of Ukraine. Media materials reflect the real attitude of the warring society towards its women defenders and are an indicator of the process of overcoming a number of gender stereotypes that were inherent in Ukrainian society in the previous years before Russia’s open aggression against Ukraine. In particular, stereotypes about the inability of women to perform military tasks on an equal footing with men, the unsuitability of women to participate in war in general, the weakness of the female sex, etc. The article concludes about the active movement of Ukrainians towards the equality and equality of women and men in the army, including through overcoming gender stereotypes. The authors pay attention to specific examples and features of coverage of Ukrainian women's participation in hostilities through mass media; the connection of gender transformations in the Armed Forces of Ukraine with the principles of NATO is traced. The article makes a forecast regarding the mandatory/optional conscription of Ukrainian women into the army.
MODERN RUSSIAN-UKRAINIAN WAR IN THE MIRROR OF GEOPHILOSOPHICAL REFLECTION
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, DODONOV Roman
Published: October 2024

The article is devoted to understanding the nature of modern wars from the standpoint of geophilosophical methodology. Based on the research of O. Bazaluk, V. Mandragelya, N. Masciandaro, B. Woodard, T. Webb, K. Gulson, and others, it outlines the contours of the geophilosophical paradigm, where geographic space and psychospace are distinguished. War and peace are interpreted in geophilosophy as a continuous and non-linear interaction between psispaces, which on the surface of the Earth are manifested in the endless change of the boundaries of the loci of civilization. It is proven that in modern wars it is not enough to just capture the enemy's territory and resources. It is necessary to destroy his psyspace, which has an extraterritorial status. The world of spiritual values of the victim is sacralised, displaced into virtual space, where it is mobilized to resist the aggressor. Victory in the war of the 21st century is actually impossible because, in the information age, the war is primarily between ideas and values. The variant of partisan war is analyzed, which, according to K. Schmitt's "Partisan Theory", is a struggle not of elites, but of the people themselves for their existence. This figure of the "Ukrainian partisan" is well known to historians. For almost a decade after the end of the Second World War, OUN-UPA fighters waged their own war on their lands. They could not help but understand that they had very little chance of defeating the Soviet juggernaut, but they consciously sacrificed themselves, refusing to recognize other people's values. In the case of the modern Russian-Ukrainian war, not only the territory of Ukraine was under attack, but its valuable and meaningful core. The world of Ukrainian culture, the Ukrainian language, and Ukrainian history form the basis of the Ukrainian psyche. The role of Ukrainian studies as an ideological weapon in the modern war is emphasized. Ukrainian studies is a form of self-awareness of the nation, its awareness of its interests, and therefore an important step for the selfreproduction of Ukrainianness, through "Ukrainian love" and "Ukrainian creation".
Influence of Windowing and Overlapping on Kurtosis Value of Non-Gaussian IFFT Signals Generated by Shaker Controllers
Authors: Steinwolf Alexander
Published: October 2024

This paper concerns random vibration testing on electrodynamic shakers, which is specified by prescribing the power spectral density (PSD) of the generated excitation and its kurtosis if the latter needs to be higher or lower than that provided by the PSD simulation on its own. A special procedure of windowing and overlapping considered in this paper is performed by shaker controllers based on inverse fast Fourier transform (IFFT) in order to suppress discontinuities at data block boundaries and to introduce randomness into the initially generated periodic IFFT signal. The windowing operation is the same as in random signal analysis, but, combined with the overlapping, it affects the initial kurtosis value of the generated data blocks. This kurtosis transformation is discussed, and the relationship between input and output kurtosis values is proved to be linear. A precise algebraic equation for the output kurtosis has been derived for the Hann window function with various overlapping numbers. Numerical examples of signal time histories with high kurtosis after windowing and overlapping are demonstrated.
Digital Inequality and its Overcoming as a Guarantee of Equal Access to Education in the Russian Federation
Authors: Pibaeva E. A.
Published: October 2024

At the present stage of society’s development, the introduction of digital tools is obvious in many spheres of life, in particular in the field of education, which causes the widespread need for high information and digital literacy of students and teachers of various educational organizations. The COVID‑19 pandemic required serious adjustments to the educational process around the world, as educational organizations had to rebuild the learning process and transfer it to an online environment. In turn, that led to the inability of many to receive education at the level of a conventional off-line education. The paper raises the problem of digital inequality in Russian education. The author highlights the most important aspects of such inequality, concerning material and technical support, skills and abilities of participants in the educational process, content of the educational process in the context of digitalization, and suggests ways to overcome them. The paper analyzes the provisions of the national project «Education,» the national program «Digital Economy of the Russian Federation,» as well as the provisions of federal projects. Based on the analysis, the author concludes that the advantages of digitalization in the educational sphere are used unequally.
FİRMALARIN SERMAYE YAPISI KARARLARININ YATIRIM KARLILIĞINA ETKİSİ: BIST ÖRNEĞİ
Authors: Kurtaran Çelik Melike
Published: October 2024

Bu çalışmanın amacı firmaların sermaye yapıları ile karlılık oranları arasındaki ilişkiyi, diğer bir ifadeyle firmaların sermaye yapısı kararlarının karlılık düzeylerine etkisini incelemektir. Analize, Borsa İstanbul'da İmalat Sanayi sektöründe yer alan firmalar dahil edilmiştir. Çalışma kapsamına alınan firmalar tüm örnekleme ilaveten aktif büyüklüklerine göre büyük ve küçük ölçekli firmalar olarak iki grupta incelenmiştir. 2011-2015 arasındaki 5 yıllık dönemi kapsayan analiz sonuçlarına göre firmaların sermaye yapıları içerisinde daha fazla özkaynak kullanmaları hem aktif hem özsermaye karlılık oranlarını olumlu şekilde etkilemektedir. Konuya borcun vade yapısı açısından bakıldığında kısa vadeli borçların aktiflere oranı arttıkça karlılıklar da artmaktadır. Ayrıca yabancı kaynak içerisinde uzun vadeli finansal borç kullanmalarının karlılıklarını yine olumlu yönde etkilediği görülmüştür. Firma ölçeğinin ise karlılık düzeylerinde herhangi bir farklılık oluşturmadığı tespit edilmiştir.
ПРОБЛЕМЫ КВАЛИФИКАЦИИ ДИСТРИБЬЮТОРСКОГО ДОГОВОРА КАК ВИД ТОРГОВОЙ ДЕЯТЕЛЬНОСТИ В РОССИЙСКОМ ПРАВЕ
Authors: А.И. Муромцев
Published: October 2024

В статье рассматриваются проблемы, связанные с определением правовой квалификации дистрибьюторского договора, места дистрибьюторского договора в качестве самостоятельного вида договора, выделением его среди непоименованных договоров. В современной экономической среде проблемы квалификации дистрибьюторского договора остаются актуальными, поскольку отсутствие правового регулирования дистрибьюторского договора создает правовую неопределенность в правовом статусе участников дистрибьюторской деятельности, препятствует развитию торговых отношений между участниками рынка, является причиной конфликтов интересов и негативных последствий для субъектов дистрибьюторских отношений, вызывает правовые споры. Изучение проблемы квалификации дистрибьюторского договора в российском праве обусловлено необходимостью разработки четкого правового регулирования данного гражданско-правового договора с целью устранения коллизий в гражданском праве, обеспечения единообразия судебной практики, защиты прав сторон соглашения, улучшения договорной и правоприменительной практики.

The current article examines the issues related to defining the legal qualification of distribution agreement, determines the place of the distribution agreement as an independent type of contract, and highlights it among unnamed contracts. In the modern economic environment, the problems of qualification of the distribution agreement remain relevant. The absence of legal regulation of the distribution agreement creates legal uncertainty in the legal status of the distribution activity parties, hinders the development of trade relations between market participants, causes conflicts of interest and negative consequences for the entities of distributorship relations, causes legal disputes. The study of qualification problem of distribution agreement in Russian law results from the need to develop a clear legal regulation of this civil-legal contract in order to eliminate conflicts of civil law, ensure uniformity of judicial practice, protect the rights of parties of agreement, improve contractual and enforcement practices.
Antibiogram profile and phenotypic characteristics of clinical isolates of Staphylococcus aureus at Ayder Referral Hospital, Tigray, Ethiopia
Authors: Gebremariam Teklay , Eguale Tadesse , Belay Tesfaye , Abula Teferra , Engidawork Ephrem
Published: October 2024

Background: Staphylococcus aureus is a notorious pathogen known for its ability to form biofilms, contributing to a spectrum of infections ranging from minor skin abscesses to life-threatening bloodstream infections. The biofilm-forming capability of S. aureus complicates treatment and contributes to resistance to antimicrobial agents. This study investigates the antimicrobial susceptibility profiles and biofilm-forming capacities of clinical isolates of S. aureus.
Methods: A total of 118 clinical isolates of S. aureus were collected and subjected to antimicrobial susceptibility testing using the disk diffusion method against a panel of 17 antibiotics. Biofilm formation was assessed quantitatively using the tissue culture plate (TCP) method, which categorizes biofilm production into strong, moderate, or weak/non-based on optical density measurements.
Results: The results revealed a high resistance rate to ampicillin (71%), while resistance to linezolid was observed in only 2.54% of isolates. Notably, 49.15% of the isolates were identified as methicillin-resistant S. aureus (MRSA). Among the isolates, 64.4% were biofilm producers, with 64.5% of these being strong biofilm formers and 9.2% classified as weak biofilm formers. A significant correlation was found between antimicrobial resistance and biofilm formation, with 43 (74%) of the MRSA isolates being strong biofilm formers. This association underscores the challenge posed by biofilm-associated resistance in S. aureus infections.
Conclusions: Strategies to combat biofilm-associated infections, including development of novel antimicrobial agents and biofilm-disrupting compounds, are urgently needed to mitigate the public health impact of S. aureus infections.
Outcome of pars plana vitrectomy versus scleral buckling in the treatment of rhegmatogenous retinal detachment
Authors: Saifulla-Hel-Azam M. , Nabil Abrar Ahmed , Das Goutam , Muhammad Sayem Sha , Najnin Mosfica , Sultana Nahid
Published: October 2024

Background: Variety of surgical techniques are available to treat RRD. So, it is very difficult to choose the option. Objectives were to assess and compare the surgical outcome which includes retinal re-attachment rate, functional success rate and post-operative complications between pars plana vitrectomy (PPV) and scleral buckling (SB) in the treatment of rhegmatogenous retinal detachment (RRD).
Methods: This prospective observational study was conducted on 60 (sixty) eyes of 60 (sixty) patients with RRD in vitreo-retina department, at NIO and H. Subjects were divided into SB group (n=30) and PPV group (n=30). Ophthalmological data were included pre-operative and post-operative visual acuity, refractive status of the eye, intra ocular pressure, presence and extent of RRD, number and location of retinal breaks, presence of proliferative vitreoretinopathy, status of macula and peripheral retinal degenerations.
Results: Among 60 patients, majority (30% and 36.7%) were in the age between 41-50 years in PPV and SB group respectively. In both groups, males were predominant. Majority breaks were in total 25 (41.7%) eyes in superotemporal quadrant. Subtotal RRD was highest, in 19 (31.7%) eyes in total. Retinal anatomical re-attachment was achieved in total 55 (91.7%) eyes; among them 27 (90.0%) eyes in PPV group and 28 (93.3%) eyes in SB group.
Conclusions: Scleral buckling surgery may be taken as a unique option for uncomplicated rhegmatogenous retinal detachment surgery, as it is non-invasive and not accompanies with high incidence of post-operative cataract formation.
Coverage survey of mass drug administration for trachoma control in Taura district of Jigawa State Northern Nigeria
Authors: Idris Abdullahi , Ibrahim Umar Farouq , Garba Habib Saudat , Duke Roseline
Published: October 2024

Background: Trachoma is one of the neglected tropical diseases earmarked for elimination as a public health problem by 2030. Active trachoma-trachomatous inflammation-follicular (TF) is controlled through mass drug administration (MDA) with antibiotics where prevalence of TF exceeds 5% in children 1-9 years, with aim to achieve at least 80% coverage recommended by WHO. This study aimed to evaluate population-based MDA coverage for trachoma in Taura local government area, Jigawa state and compared it with administrative coverage to ascertain the effectiveness MDA programs.
Methods: A cross-sectional survey using ‘30×7’ cluster random sampling (CRS) technique was carried out in 202 randomly selected households of 30 clusters of Taura local government area of Jigawa state. Administrative coverage was compared with the surveyed coverage rates.
Results: The 1,047 persons received treatment during the MDA, giving a crude surveyed coverage of 69.7% (95% CI 67.4-72.0%). Nine hundred and 34 (89.2%) of those who received the antibiotics reported actual consumption, hence effective coverage of 62.2% (95% CI 59.7-64.8%) and coverage-compliance gap of 7.5%. The administrative coverage was 76.3%. Coverage was significantly higher in adults >15 years (p=0.005), female gender (p=0.043), higher literacy (p≤0.0001), and households’ participation in previous MDA (p≤0.0001).
Conclusions: The findings of this survey were lower than the WHO-recommended coverage rate, thereby posing a threat to the trachoma elimination target. If the MDA programme is to succeed, there is need to explore all factors that are likely to have a potential for increasing MDA coverage of antibiotics for trachoma control in the district.
Role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as markers of disease activity in systemic lupus erythematosus patients with or without renal involvement
Authors: Hossen Sheikh Imran , Saha Jyoti Vaskar , Rana Muhammad Saiful Ahsan , Jannat Gul , Aminul Islam M. , Nazrul Islam M.
Published: October 2024

Background: In systemic inflammation, white blood cells show neutrophilia and lymphopenia. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging as key markers for systemic inflammation. This study aims to evaluate NLR and PLR as markers of disease activity in systemic lupus erythematosus (SLE) patients with or without renal involvement.
Methods: A cross-sectional study was conducted at Dhaka medical college and hospital (DMCH), national institute of kidney disease and urology (NIKDU), and Bangabandhu Sheikh Mujib medical university (BSMMU). It included 90 newly diagnosed SLE patients (with or without renal involvement) and 30 age- and sex-matched healthy controls. Patients were divided into two groups: active disease SLE disease activity index (SLEDAI score ≥8) and inactive disease (SLEDAI score <8). Data were analyzed using SPSS version 26.
Results: Results showed that both NLR and PLR were significantly higher in SLE patients compared to controls (both p<0.001) and were elevated in active disease (both p<0.001). NLR levels were higher in patients with renal involvement (p<0.05). NLR and PLR positively correlated with SLEDAI score, anti-dsDNA, and ESR, and negatively with C3 and C4. NLR differed significantly across lupus nephritis classes and correlated positively with activity index, while PLR did not. For predicting disease activity in SLE with renal involvement, NLR and PLR cut-off values were 2.41 (80% sensitivity, 51.1% specificity) and 178.4 (80% sensitivity, 57.8% specificity), respectively. For SLE without renal involvement, NLR was 2.23 (71.1% sensitivity, 52.02% specificity) and PLR was 159.6 (75.6% sensitivity, 73.3% specificity).
Conclusions: NLR and PLR are promising biomarkers for managing SLE patients, irrespective of renal involvement.
Study of incidence and factors associated with postoperative pulmonary complications in patients undergoing abdominal surgery
Authors: Ashraf Nashrah , Zargar Owais U. , Albina Ayat , Ahmed Showkat
Published: October 2024

Background: Postoperative pulmonary complications are an important cause of increased morbidity and mortality in surgical patients. These complications affect the normal respiratory functions and there are limited studies regarding the contributing factors. The aim of this study was to identify incidence and factors associated with postoperative pulmonary complications in patients undergoing abdominal surgery.
Methods: A prospective cross-sectional study was conducted at SKIMS Hospital, Soura. Sample size of 290 patients using systematic random sampling was taken. Variables included sociodemographic, surgical, and anaesthetic factors. Postoperative follow up was done for 7 days. Any respiratory problems were recorded. Both bivariate and multivariate logistic regressions were used for analysis. A p value of <0.05 was considered statistically significant.
Results: About 32% of the participants that underwent abdominal surgery developed postoperative pulmonary complications. Age >65 years, duration of surgery >3 hours, preoperative oxygen saturation <94%, and postoperative serum albumin level <3.5 g/dl (p value <0.001) were associated with postoperative pulmonary complications significantly.
Conclusions: The incidence of postoperative pulmonary complications after abdominal surgeries was high. Age >65 years, duration of surgery >3 hours, preoperative SpO2% <94%, cigarette smoking, and postoperative serum albumin level <3.5 g/dl were factors strongly associated with postoperative pulmonary complications.
Gynecologic radiology in fertility treatment: assessing tubal patency and ovarian reserve
Authors: Islam Ali Haider M. Tohurul , Mostafa Syeda Nazlee , Lovely Nur A. Atia
Published: October 2024

Background: A tubal patency test is a medical procedure that can help determine if a woman is having trouble conceiving due to blocked fallopian tubes. Fallopian tubal pathology is a primary risk factor for female infertility. Ovarian reserve is the number of healthy eggs in a woman's ovaries, and it’s a measure of the ability to have children. This study aimed to assess tubal patency and ovarian reserve in fertility treatment.
Methods: In a retrospective cohort study, 75 women aged 18-40, treated from January to December 2023, were included. Fallopian tube patency was tested using hysterosalpingography, hysterosalpingo-contrast sonography, or laparoscopic chromopertubation.
Results: Of 75 women, 19 (25.5%) were found to have at least one blocked fallopian tube. Unilateral blockage was more common than bilateral blockage, occurring in 12 out of the 19 cases (63.2%) compared to 7 out of 19 cases (36.8%). Mainly, blockages occurred near the opening of the fallopian tubes 86.2%. After adjusting for other factors, the presence of hydrosalpinx (odds ratio, OR, 13.323, 95% confidence interval, CI: 2.679-66.253, p=0.002) and myomas (OR 2.108, 95%CI: 1.008-4.409; p=0.048) were statistically significant factors associated with fallopian tube blockage.
Conclusions: Gynecologic radiology is still of major relevance in fertility evaluation. The presence of uterine myomas and hydrosalpinges significantly increases the risk.
Association between exercise capacity and health markers in adolescents
Authors: Mani Chandra , Ghildiyal Archna , Singh Shraddha , Mittal Anupam , Ansari Aaqib Husain
Published: October 2024

Background: Adolescent physical fitness is a crucial determinant of current and future health, influencing susceptibility to chronic diseases such as cardiovascular conditions and diabetes. The American Heart Association highlights cardiorespiratory endurance as a vital health metric, emphasizing the need for regular physical activity to mitigate long-term health risks.
Methods: A cross-sectional observational study was conducted from 24 March 2023 to 20 March 2024 in the Lucknow city, India. Total 411 adolescents recruited from local school camps and adolescent clinics. Participants underwent a series of assessments, including the 6-minute walk test (6-MWT) to evaluate functional capacity and endurance, body fat analysis using the body stat 1500 MDD machine, and anthropometric measurements. Tabulated data were statistically analysed to find any relationships between BMI, body fat composition, and physical performance.
Results: The study revealed significant correlations between BMI and body fat percentage (p<0.0001) and between BMI and body fat in kilograms (p<0.0001). Increased body fat percentage and fat mass was associated with higher BMI. The mean distance covered in the 6-MWT was 918.85 meters, with significant variability across gender. Body composition metrics indicated that higher BMI categories were associated with increased fat-free mass (p<0.0001).
Conclusions: This study underscores the critical need for targeted interventions to address physical inactivity and obesity in adolescents. By improving physical fitness and body composition, it is possible to mitigate health risks and promote better long-term health outcomes.
Which one is the best-comparison of three treatment modalities in membranous glomerulonephropathy?
Authors: Khan Mohammed Fahad , Reji Sherin M. , Raju Nijin Samuel , Siddini Vishwanath , Babu Kishore , Augustine Rohan , Jangamani Ravi , Shetty Shilpa , Prakash G. K. , Rampure Sanjay , Ballal Sudarshan
Published: October 2024

Background: This retrospective study explores the efficacy of Modified Ponticelli, Rituximab and Tacrolimus in treating membranous nephropathy, focusing on remission rates.
Methods: This retrospective study analyzed 41 membranous nephropathy cases treated with Modified Ponticelli, Rituximab, or Tacrolimus. Statistical analyses included Kruskal-Wallis and Chi-Square tests to evaluate treatment responses, renal markers and remission outcomes, providing comprehensive insights into treatment efficacy.
Results: Modified Ponticelli demonstrated substantial reductions in proteinuria (-88.20%) and favorable increases in albumin (15.80%), outperforming Rituximab and Tacrolimus. Significant differences (p=0.0014) in remission outcomes underscore Modified Ponticelli's efficacy, with the highest complete remission rate (26.7%) and notable partial remission rate (73.3%). Rituximab (Complete 0%, Partial 46.2%) and Tacrolimus (Complete 15.4%, Partial 30.8%) exhibited lower rates.
Conclusions: In conclusion, Modified Ponticelli demonstrates superior efficacy in achieving both complete and partial remission in membranous nephropathy patients.
Male breast cancer: a case series and review of literature
Authors: Choudhary M. Amir , Syed Ameenuddin Ali , Syed Obaid
Published: October 2024

Male breast cancer (MBC) is a rare condition, representing about 0.5-1% of all breast cancer cases, while recent trends indicate a gradual increase in incidence. This study seeks to examine the clinical and pathological features of MBC patients. This study also sheds light on demographics factors and family history association with the disease. It also identifies various risk factors associated with disease and reviews its surgical management. We conducted a retrospective analysis of six MBC patients treated at the department of general surgery at Indian institute of medical science and research (IIMSR), Jalna, from May 2022 to September 2024. Data were collected on demographics, clinical history, local examination findings, family history, disease stage, histopathological findings and immunohistochemistry (IHC). The findings revealed a median age of 51.5 years at diagnosis. Four patients presented with right breast involvement, while two had left breast involvement. Diagnosis was confirmed with ultrasound (USG) and fine needle aspiration cytology. Four patients had skin involvement while five had clinically palpable axillary lymphadenopathy. Modified radical mastectomy (MRM) was the surgical procedure done in all six cases. Our study also emphasizes early diagnosis to improve outcomes by educational efforts focusing on promoting self-examinations and screening for high-risk populations.
Pylephlebitis secondary to a gangrenous appendicitis a forgotten complication: a case report and review of the literature
Authors: Medellin Rito J. , Silva Jesus A.
Published: October 2024

Pylephlebitis is an uncommon condition which can complicate intrabdominal sepsis of any etiology. A 22-year-old male with 2 weeks of epigastric and right upper quadrant pain with associated fever, chills, nausea, vomiting, hyperbilirubinemia and leukocytosis in blood test documented. An acute cholangitis was the first diagnosis. Abdominal ultrasound described multiple abscesses and gallbladder wall thickening. CT scan revealed a case of acute appendicitis complicated with a thrombosis of the portal vein. Diagnostic laparoscopy was performed, observing an inflammatory process in the right lower quadrant, cholecystectomy with cholangiography was done with no complications, and then appendicectomy was performed. Broad-spectrum antibiotic and anticoagulation treatment led to full recovery. Follow-up after 12 months showed a full recovery and no signs of thrombosis in the serial CT scans for follow-up. Pylephlebitis can present as a clinical cholangitis-like scenario with hyperbilirubinemia with liver abscess formation. CT scan seems to be the most sensitive diagnostic test because it can identify the underlying infection foci, it also can show the extension of the thrombosis and other complications like liver abscesses. Surgical removal of the source of infection and adequate antibiotic treatment adjusted by culture should be initiated promptly. Anticoagulant treatment should be considered in the case of poor clinical outcome or thrombosis progression. Pylephlebitis should suspected in the case of poor clinical outcome of intrabdominal infections, a properly diagnosis with imaging tests and multimodal management can reduce the morbidity and mortality, and also short- and long-term complications of this pathology.
Bouveret's syndrome: an uncommon cause of intestinal obstruction skulls
Authors: Torres Ordaz David Eduardo , Grande Ramirez Cesar Ivan , Lozano Leonel , Castro Rodriguez Mayra Cristina , Colin Macias Ilse Mariel , Diego Pérez Montes José Ignacio
Published: October 2024

Bouveret's syndrome is an uncommon cause of small bowel obstruction; it is a rare complication of chronic calculous cholecystitis leading to cholecystoenteric fistula, where gallstones pass through to the gastrointestinal tract leading to mechanical bowel obstruction. To perform a literature review of the medical-surgical management of Bouvaret's syndrome. 61-year-old female, attended general surgery consultation with data of intestinal occlusion, with tomographic findings of biliary calculus in terminal ileum performing exploratory laparatomy with enterotomy with calculus extraction. Bouvaret's syndrome is diagnosed by clinical and radiological studies. Surgical management is necessary due to the list of complications if left untreated.
Neuropsychiatric lupus: report of an interesting case with challenges in diagnosis and management
Authors: Sharma Divij , Patel Varsha , Jagannath Preethi , Pandya Darshan , Sharma Saksham
Published: October 2024

NPSLE, an array of neurological and psychiatric symptoms within systemic lupus erythematosus (SLE), poses diagnostic challenges due to negative serology and absence of systemic signs. We present a 54-year-old woman with anemia, musculoskeletal pain, recurrent pleural effusion, and erratic behavior. Despite delayed identification, extensive testing finally revealed NPSLE. This case underscores the difficulty in linking diverse symptoms to SLE, resulting in delayed treatment initiation and adverse outcomes upon presentation.
Limb salvage in a lower extremity with no venous circulation: free muscle sparring latissimus dorsi cross-leg flap - a case report
Authors: Rendón-Medina Marco Aurelio , Rendón-Pimentel Marco Antonio , Vargas-Rocha Manuel , Hanson-Viana Erik , Montes-Munguia Mariana , Herndandez-Ordoñez Rubén
Published: October 2024

Lower extremity trauma is prevalent in Mexico, with tibial fractures in about 15% of cases and wounds in 37%. Reconstruction, particularly with severe crush injuries, is challenging due to the risk of complete devascularization. The Gustilo-Anderson classification is essential for evaluating injury severity and vascular risks, and advanced planning is critical for severe cases. A 49-year-old male with systemic hypertension sustained blunt and crush trauma to the left leg. Initially managed with external fixation without fracture reduction, the patient was later referred to our centre. Angio tomography revealed a severe Gustilo-Anderson IIIB tibial fracture with diminished vascular flow and no detectable veins. We performed two interventions, ultimately utilizing a free latissimus dorsi flap to achieve successful coverage. In complex cases with limited recipient vessels, comprehensive diagnostic methods such as angiography and ultrasound are crucial. These tools provide vital information for precise surgical planning and improve patient outcomes.
Moderately differentiated invasive squamous cell carcinoma of the upper left maxillary: case report and literature review
Authors: Serrano Erik Beltrán , Leal C. Miguel Angel , Bermudez R. Judith del Rosario , Rosas O. Pricilla Iliana , Santana H. Ricardo , Vázquez S. Víctor Adrián
Published: October 2024

Squamous cell carcinoma, also known as squamous cell cancer, is the most common oral cavity cancer. Tobacco and alcohol are two of the most significant risk factors associated with this type of cancer development. This article presents a case report for a moderately differentiated invasive squamous cell carcinoma of the upper left maxilla patient, who underwent surgical management with partial left maxillectomy and temporary maxillary obturator placement. Diagnosis was made through histopathological studies. We describe the surgical approach aiming for its complete eradication (R0), function preservation and restoration, and patient reintegration into daily life while enabling adjuvant treatment.
Symptomatic presentation of spontaneous pneumomediastinum in a young girl: a case report
Authors: Choubey Abhinav , Choubey Shivani
Published: October 2024

Spontaneous pneumomediastinum (SPM) is a rare and typically benign condition that involves the presence of air in the mediastinum without an obvious cause, such as trauma or surgery. It most commonly affects adolescents and young adults, with a male predominance. This case report discusses a 14-year-old girl presenting with pleuritic chest pain and persistent cough, initially misdiagnosed as asthma exacerbation or lower respiratory tract infection. Despite multiple treatments, her symptoms persisted, and a high-resolution computed tomography (HRCT) scan eventually revealed pneumomediastinum. The patient was treated conservatively with analgesics and rest, and she experienced a complete resolution of symptoms within ten days. A review of the literature reveals that SPM is often self-limiting, with conservative management sufficient in most cases. While the condition mimics more serious diseases such as pneumothorax and pulmonary embolism, accurate diagnosis through imaging is key to avoiding unnecessary interventions. This report underscores the importance of considering SPM in young patients presenting with chest pain and respiratory symptoms, especially when they do not respond to standard treatments for more common conditions.
Can full thickness skin grafting be a cost effective alternative to dermal substitutes for keloid management? A case report
Authors: Gadgil Shreyas , Mula Rohit Babu , Yenuganti Sreechand
Published: October 2024

Keloids are always challenging to manage due to their high chances of recurrence and poorly understood pathophysiology. Various modalities have been described, to be used either alone or in combination. We opted to look for a cost effective solution, that was along the lines of the research done by Nguyen et al using a reconstruction that provides for a dermal component while avoiding a second procedure. Here, we present the management of a helical rim keloid by complete excision and reconstruction with a full-thickness skin graft to create a neo-dermis at the site of the defect. A 28 year old lady of Indian ethnicity presented with a mass lesion over right ear lobe since about one year, approximately measuring 6×2 cm. It was associated with occasional pruritis and there was a history of trauma to ear lobe about 1-2 months before noticing the lesion. On examination, a single, firm, well- circumscribed, non-tender mass was noted extending over the posterior and superior aspect of the helix of right ear. After routine preoperative evaluation, the patient was taken up for elective surgery where the keloid was excised with de-epithelization of 2mm margin and a full thickness skin graft harvested from the groin of size 3×2 cm was used to cover the defect. Postoperatively, the patient had an uneventful recovery and good cosmetic outcome was achieved. We found this to be an economically feasible and aesthetically superior alternative to reconstruction using a dermal substitute.
Orbital cellulitis after infiltration anaesthesia for sling surgery in a case of congenital ptosis: a case report
Authors: Dwivedi Kshama , Singh Vibha , Sachan Shubhi , Katiyar Divya
Published: October 2024

Orbital cellulitis has been reported as a complication of various ophthalmic surgeries. But to the best of our knowledge this is first case of orbital cellulitis following sling surgery. It was an observational study. An eight-year-old male, developed orbital cellulitis after ptosis surgery. He presented to us after one week with fever, periorbital swelling, chemosis and restricted ocular movement. He was successfully managed without any sequelae. Early suspicion and prompt management are the key to successful management of orbital cellulitis following ophthalmic surgeries.
Non-surgical management of bilateral condylar fracture with application of customized 3D printed hypomochlion splint a case report
Authors: Chakravarthy Chitra , Babu Chethan , Karthik Aaron , Patil Ravi S. , Bijja Sushmitha
Published: October 2024

Posttraumatic malocclusion is one of the most serious complications of condylar fracture responsible for mandibular functional impairment. Depending on the severity, it is imperative to resolve this complication through the surgical or nonsurgical mode of treatment. This report presents a scenario of a 21-year-old male patient with post-traumatic occlusal derangement due to the fracture of the bilateral condylar process and left parasymphysis mandible. The treatment protocol combined an open reduction and internal fixation for parasymphysis mandibular fracture and a closed approach using customized 3D printed hypomochlion splint and intermaxillary fixation in moderately displaced bilateral condylar fracture. No postoperative complication espied in a month follow-up period. Outcome in this case is, hypomochlion splint is effective in treating the post-traumatic occlusal discrepancy with the added advantage of accuracy of 3D printed splints that did not require intraoral manipulation and had better patient compliance.
From hurdles to high performance: overcoming day-to-day challenges for successful clinical trials at sites
Authors: Gangurde Nutan , Bagde Deepak
Published: October 2024

Randomized clinical trials are fundamental in testing new drugs, medical devices and treatment protocols. They help to determine the efficacy and safety of new treatments, leading to medical innovations that can significantly improve treatment outcomes. Clinical trial sites are the engines that drive medical advancements, but they face numerous challenges in their day-to-day operations and impact the study outcome as well as data quality. Continuous improvement through research and innovation ensures that clinical trials are conducted more effectively, leading to better healthcare advancements and patient outcomes. Execution of clinical trial at the hospital site is a critical task and associated with the new challenges every day which may include patient recruitment, retention and compliance to the data collection. GCP compliance is a soul of clinical research and difficult task to comply with. GCP is a harmonized guideline accepted by most of the countries all across the globe.
Association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County, Kenya
Authors: Jama Abdiwahit A. , Mutisya Redempta K. , Njuguna Christine W. , Matoke Vincent O. , Okenyoru Douglas S.
Published: October 2024

Background: Menstruation is the recurrent peeling of the uterine lining that occurs monthly on girls and women of the reproductive age. Many adolescent girls in African countries have poor knowledge regarding menstruation and this is even worse among menstruating girls with disabilities who are faced with a greater challenge as they require private and specific sanitation facilities. The study focused on establishing the association between attitude and menstrual hygiene management practices among adolescent girls with disabilities in selected schools in Wajir County.
Methods: A descriptive cross-sectional design was adopted. Census method was used to select respondents where 101 were interviewed. Pretested questionnaires were used to collect data. All necessary research approvals from relevant institutions were obtained as well as consent and assent sought from respondents and guardians where applicable. Data was managed using SPSS version 22.0 software.
Results: Most 88.1% of the respondents did not practice menstrual hygiene management. Further results revealed that 98.9% of those who had negative attitude had not practiced menstrual hygiene management. There was a significant statistical association between nature of attitude and practice of MHM (χ2=11.009, p*=0.029).
Conclusions: About 9 out of 10 adolescents with disabilities in Wajir County did not practice menstrual hygiene management. The nature of attitude towards menstrual hygiene management was significantly associated with practice. The study recommended provision of free sanitary pads by relevant stakeholders to all girls who are living with disabilities and provision of enough washrooms to address privacy issues.
Prevalence and pattern of self-medication with antibiotics among residents of Abia State, Southeastern Nigeria: a call for action
Authors: Amuzie Chidinma I. , Onyeonoro Ugochukwu U. , Nwamoh Uche N. , Ukegbu Andrew , Kalu Kalu U. , Izuka Michael O.
Published: October 2024

Background: Antibiotic self-medication occurs worldwide, and it is a major driver of antibiotic misuse and antimicrobial resistance. In developing countries like Nigeria, antibiotics are frequently sold as over-the-counter medications. There is a need to explore this pattern, aiding stakeholders in informed decision-making. We assessed the prevalence and pattern of antibiotic self-medication among the residents of Abia State.
Methods: A cross-sectional study was conducted among eligible adults in the State with respondents selected using the multistage sampling technique. An interviewer-administered questionnaire was used to obtain information from the respondents. Data analysis was done using SPSS version 26 and the level of significance was set at 5%.
Results: A total of 1,491 respondents were surveyed. The mean age was 34.7±13.1 years and females constituted 55.7%. The overall prevalence of antibiotic self-medication was 46.5% (95%CI: 43.9-49.1). The majority of the respondents took self-medication for cough (48.6%) and ampicillin/cloxacillin was the major antibiotic used (30.1%). The reason for antibiotic self-medication mostly reported was the perception of minor illness (62.7%). Most (52.4%) of the respondents got the antibiotics from pharmacies without prescriptions. The predictors of antibiotic self-medication included residence (aOR=2.44, 95% CI: 1.12-5.30), retention of previous prescriptions (aOR=10.98, 95% CI: 4.40-27.47), storage of leftover antibiotics (aOR=4.13, 95% CI: 1.79-9.54) and perceived susceptibility of antibiotic self-medication (aOR=4.96, 95% CI: 1.71-14.39).
Conclusions: Close to half of the residents practiced antibiotic self-medication with its pattern identified. We recommend tailored strategies including appropriate health education and enforcement of regulatory policies to promote community antibiotic stewardship.
Perception of parents on barriers and facilitators of treatment outcomes among children and adolescents attending psychotherapy services in a primary health care centre in Belize
Authors: Oladeji Olusola , Simmons Juliet , Baitwabusa Angella Edith , Augustine Jeffan
Published: October 2024

Background: The study assessed the perception of parents on barriers and facilitators treatment outcomes among children and adolescents attending psychotherapy services in a primary health care centre.
Methods: A cross sectional descriptive study using both quantitative and qualitative methods. The quantitative method used retrospective review of records of 65 children and adolescent clients who accessed psychotherapy services between January 2022 and December 2023 at Port Loyola Health Centre in Belize city.  The qualitative method used in-depth interviews of twenty parents of the patients randomly selected from the clinic registers. Univariate and bivariate analyses was used for the quantitative data while thematic analysis was used for the qualitative data.
Results: 25 (38.5%) of the patients completed their treatment and 34 (52.3%) dropped out, with half dropped out after the first visit. The identified parental perceived barriers and facilitators are organized into four main themes. The first theme was related to knowledge and understanding of mental health problems by the parents which showed that respondents had good knowledge about mental health problems. The second theme identified attitudes towards treatment as a major factor to completion of treatment. The third theme was related to structural factors like transportation cost and parents’ work schedule identified as key barriers. The fourth theme was related to inconvenient appointment time and lack of flexibility in the scheduling of appointment at the clinic.
Conclusions: The study highlights key areas of interventions to minimize barriers to completion of treatment among children accessing mental health services.
Utilization patterns of Chiranjeevi Swasthya Bima Yojana in Rajasthan during financial year 2023 to 2024: a cross-sectional study at a tertiary care hospital
Authors: Singh Shalini , Rathore Monika , Raj Ankit
Published: October 2024

Background: Publicly funded health insurance (PFHI) is considered a key policy tool to provide financial protection to households seeking healthcare. The state government of Rajasthan has launched Mukhya Mantri Chiranjeevi Swasthya Bima Yojana (CSBY), with a cover of 25,00,000 INR per family per year, that makes it one of the largest PFHI in world by cost-coverage. However, there is an evidence-gap on utilization patterns and consequent need of higher-rate packages in state-PFHIs. A study was designed with the objective to describe the utilization pattern of CSBY in Rajasthan.
Methods: The cross-sectional study was conducted at Sawai Man Singh Hospital in Jaipur, the highest public tertiary care institute of Rajasthan. The data on CSBY hospitalisations was collected from Chiranjeevi portal for financial year 2023-2024. Summary statistics were used to describe the variables such as age and gender of beneficiaries and medical specialities and cost details of packages utilised.
Results: The mean age of patients was 45.9 (±20.0) years and 62.1% were males. The top specialty by volume of admission was general medicine (14.2%) and by cumulative cost of packages utilized was cardiology (22.0%). The median cost of packages utilized per hospitalization was 12,200 INR. 96.8% of beneficiaries utilized the services at a cumulative cost of up to 1 lakh INR and only 0.01% patients utilized more than 5 lakh INR.
Conclusions: The study found higher utilisation of highly-specialised services over broad-specialties and an underutilisation of higher-rate packages, demonstrating a gap in perceived need of higher-rate packages in the state.
A study on association between respiratory morbidity and type of work, duration of work among unorganized sector workers in Tamil Nadu
Authors: Manivannan Tamilamudhan , Ayyappan Chitra
Published: October 2024

Background: In Tamil Nadu around 70 lakh workers including construction workers were enrolled in the e-SHRAM portal as of 31st March 2022. Occupation related respiratory disease occurs due to inhalation of dust in working place and this depends on the duration and type of work. This study aimed to find the association of respiratory morbidity with type of work and duration of work among workers in unorganized sectors in Tamil Nadu.
Methods: Cross sectional study conducted among adult workers in unorganized sectors in randomly selected districts of Tamil Nadu.
Results: The risk for respiratory morbidity was higher among quarry workers (AOR=9.489 with p value <0.001). The risk for restrictive lung disease among workers with a duration of work <5 years was more (OR=1.76 with 95% CI (1.14 - 2.71)).
Conclusions: The risk for respiratory morbidity was high among occupations with dust exposure. This study shows that restrictive lung disease occurs within 5 years of work, hence periodic screening should be advocated from the early days of joining the workplace.