bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of cardiotocography in predicting perinatal outcomes in women presenting with reduced perception of fetal movements at term: an observational study
Authors: M. Bhuvaneshwari K. , N. Rekha
Published: December 2023

Background: Reduced perception of fetal movement by mother is a common reason for self referral for assessment by healthcare providers affecting 5-15% of pregnancy. It allows early identification of fetuses at risk of adverse outcome. Non stress test (NST) or Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum fetal surveillance. Hence, this study was conducted to evaluate the role of NST/CTG in predicting perinatal outcomes in women presenting with reduced perception of fetal movements.
Methods: A prospective observational study was conducted on 110 term pregnant women presenting with reduced perception of fetal movements. NST/CTG was done as a preliminary test in them and the results were analyzed statistically.
Results: Total 60% women had reactive CTG, 17.3% had suspicious CTG and 22.7% had pathological CTG at the time of presentation. Out of 66 women who had reactive NST, 34 women were discharged after observation for 24 hours to follow up. About 58.15% women had one or more risk factors associated with pregnancy in our study. Pathological/ suspicious CTG was more commonly associated with adverse perinatal outcomes like presence of MSAF, low APGAR score at 1 minute and 5 minutes, neonatal distress, need for neonatal resuscitation and NICU admission with statistical significance. However, all babies had good outcome in our study.
Conclusions: Early approach, timely intervention could reduce associated complications and improve perinatal outcome in all these cases.
A retrospective analysis of obstetric hysterectomy in a tertiary center over one year
Authors: Khandkar Sharvari A. , Jain Mahima
Published: December 2023

Background: Obstetric hysterectomy is a lifesaving procedure in a setting of life-threatening obstetrical hemorrhage. There is and increasing need of obstetric hysterectomy due to rising cases of caesarean sections and morbidly adherent placenta. We aimed to study the incidence, indications and fetomaternal outcome of obstetric hysterectomy. Various risk factors are discussed which may be helpful in reducing maternal and neonatal morbidity.
Methods: A one year hospital based retrospective study involving detailed medical records of patients who underwent obstetric hysterectomy between 1st April 2022 and 31st march 2023.
Results: The overall incidence of obstetric hysterectomy was 0.2% in this study with majority of patients in the 20-25-year age group, and patients who were 2nd and 3rd para comprised of the maximum number. The indication identified in this study were morbidly adherent placenta followed by atonic PPH and caesarean scar ectopic. The major risk factors noted were previous LSCS in 60% and morbidly adherent placenta in 53.3% patients. Of the 15 patients, 60% underwent total while 40% underwent subtotal hysterectomy. ICU admission, fever and coagulopathy were the leading post op complications. There was one case of maternal death noted and one case each of intrauterine death and perinatal mortality.
Conclusions: Obstetric hysterectomy is the last resort to intractable bleeding and hence an important lifesaving procedure. The feto-maternal outcome depends on timely decision, surgical techniques and stringent post op monitoring of these patients.
A comprehensive review of 53 gynae surgeries on the versius robotic system in a tertiary care hospital
Authors: Manchanda Rahul , Mirza Hera , Iqbal Mona , Bhardwaj Vinay
Published: December 2023

Background: Robotic-assisted surgery has attained widespread acceptance within clinical practice, emerging as the definitive standard for various medical indications. Within the realm of Gynae surgery, there has been a notable upsurge in the utilization of robotic and laparoscopic techniques. The Versius robotic system, developed by CMR Surgical, has demonstrated its efficacy on a global scale since its introduction in 2018, marking a significant stride in the landscape of robotic-assisted surgery. This review article was dedicated to providing an impartial assessment of robotic technology, elucidating our insights gleaned from 53 gynaecological surgeries conducted with the Versius robotic system.
Methods: A meticulous examination of 53 cases was undertaken, wherein average operative time, estimated blood loss, postoperative hospital stay, Intraoperative and postoperative complications, and conversion rates were subjected to retrospective scrutiny.
Results: The study conducted at a Tertiary care hospital involved the analysis of 53 gynecological cases using the Versius system. Results indicate the feasibility, efficiency, and patient-friendly nature of the Versius system, with notable advantages such as reduced hospital stay and smoother manipulation of tissues.
Conclusions: We acknowledge the ongoing evolutionary trajectory of robotic surgery and it is evident that its merit has already been substantiated by the endorsement of numerous medical practitioners and patients worldwide. The Versius robotic system stands as a revolutionary force within the healthcare paradigm, distinguished not only by its favorability among medical professionals but also by its patient-friendly attributes. In the realm of minimally invasive gynecologic surgery, robot-assisted surgery emerges as a compelling alternative.
Determination of the early initiation of breast feeding in low-middle income country: a systematic review
Authors: Rahmawati
Published: December 2023

WHO recommends Early Initiation of Breastfeeding (EIBF), which means direct breastfeeding to newborns within the first hour of life. However, nowadays, EIBF is not often carried out by mothers, which increases the risk of infant death. This review investigates studies that identify factors associated with EIBF practices. We conducted a systematic review to answer the aforementioned aims. Factors associated, mother-child, and early initiation breastfeeding were used as initial keywords, which were further developed using Medical Subject Headings. Four databases, including Sciencedirect, pubmed, Cochrane, and wiley online library were searched for potential articles. We also searched the references in addition to the main search. We included 12 articles in this review. Type of delivery assisted and mode of delivery were the most influence factors associated to EIBF. Other factors that are frequently showed up in analysis of studies included such as ANC/PNC visits, households wealth, place of residence, and birth order. Addressing the EIBF problem requires multi-sectoral and complex repair efforts. The results of this review show promising problem mapping to initiate a transformation. The type of delivery assisted and the mode of delivery were the most influential factors, in addition to other factors such as ANC/PNC visits, household wealth, place of residence, and birth order. Therefore, health workers must be aware of and communicate with clients regarding the urgent need for early breastfeeding.
A rare case of nulliparous prolapse at term
Authors: Phool Divya , Kaur Khushpreet , Pandove Arti , Jindal Ruchi
Published: December 2023

Uterovaginal prolapse complicating pregnancy is an extremely rare event. Obstetricians should be familiar with the condition as early recognition and close follow up is essential in order to avoid possible fetomaternal risks.  Its incidence is higher in women of advanced age and parity. This case report presents a rare occurrence of prolapse in nulliparous woman. In the present case report, we describe a case of a 24 year-old nulliparous female who experienced sudden uterine prolapse at 38 weeks of gestation without labor. She was delivered by cesarean section in view of primi with breech. Following delivery, the prolapse promptly improved and did not recur.
Comparison of the radiographic and functional outcome in pediatric orthopaedic patients with Gartland type II supracondylar fracture treated by operative versus non operative management
Authors: Espiritu Wesson Pious A. , Legaspi Juan Alejandro
Published: December 2023

Background: The non-operative method of closed reduction and application of long arm posterior splint and the operative method of closed reduction and percutaneous pinning are both putative management for Gartland II supracondylar fracture. The purpose of this study is to compare which method is superior in the management of this type of fracture thru the comparison of the radiographic as well as the functional outcome.
Methods: This study includes 51 pediatric patients undergoing supracondylar fracture treatment. The enrolled participants were randomly allocated to one of the two groups to receive either non operative or operative treatment. Radiographic and functional outcome was assessed post treatment.
Results: The operative group exhibited significant superiority versus the non operative group as reflected by the results of the post-treatment radiographs utilizing the anterior humeral line while the Baumann’s angle showed no significant difference between the two groups. Moreover, the operative group demonstrated a better Mayo elbow performance score total per follow up, only in the first 3 months but showed no significant difference thereafter.
Conclusions: We therefore conclude that non operative and operative management are both effective treatment for Gartland II supracondylar fracture. The operative group showed significant superiority with results of the anterior humeral line falling mostly at the central one-third of the capitellum. The operative group manifested a better Mayo elbow performance score total only during the first 3 months of follow up.
Suprascapular nerve block in shoulder dislocation
Authors: Madeira Sofia A. S. , Alves Marcelo P. T. , Nunes Catia F. C. , Rocha Maria Ines S. , Cabaço João D. P.
Published: December 2023

Background: The suprascapular nerve is the main sensitive nerve of the shoulder. In 1973, the suprascapular nerve block was applied in the reduction of a series of cases of acute shoulder dislocations using mepivacaine. Barber described a method using anatomic landmarks to locate and block the suprascapular nerve.
Methods: This study was approved by our Institutional Review Board and all patients signed an informed consent. We performed a prospective longitudinal study, characterized by a consecutive series of first episode of traumatic shoulder dislocation in patients over 18 years old. From July 2020 to April 2022, 50 cases were included in our study. All patients had their pain evaluated before the blockage, during the reduction and after the reduction. We used the Barber method for the blockage and the Spaso maneuver for reduction.
Results: From the 50 cases, 29 were males (58%). The mean age was 58,7 years. 47 cases were anterior dislocations, 2 cases posterior dislocations and one case of luxatio erecta. The mean initial VAS was 7.5 points (minimal 4, maximum 10). The main score during the reduction maneuver was 2 points (0-5) and the main score after reduction was 0,4 (0-3). In only one case, reduction was not successful after 3 attempts, and reduction was performed under sedation.
Conclusions: The suprascapular nerve block by Barber’s method proves to be a secure, effective and simple procedure to aid the shoulder dislocation reduction in the emergency room, without the need of any imaging resources.
A prospective and observational study to assess the efficacy of pregabalin versus Gabapentin in relieving early post operative neuropathic pain with respect to clinical and functional outcomes in patients undergoing open lumbar discectomy surgery
Authors: Garg Rohit N. , Vaje Shweta , Patil Hrishikesh , Bajaj Sanket
Published: December 2023

Background: Post-operative neuropathic pain is one of the most dreadful complications following lumbar spine surgeries. Owing to the similarities in the pathophysiological and biochemical mechanisms underlying epilepsy and neuropathic pain, many anti-epileptic drugs (AEDs) like pregabalin and gabapentin are being used in the treatment of post-operative neuropathic pain.
Methods: This prospective and observational study included a total of 60 patients out of 261 patients undergoing lumbar discectomy surgery, who postoperatively had neuropathic pain as diagnosed with LANSS score; and were randomly divided into pregabalin (n=30) and gabapentin (n=30) supplementation groups, and the efficacy was compared with respect to visual analog scale (VAS) score (clinically) and Oswestry disability index (ODI) score (functionally) at pre-operative and post-operative follow-ups; and also, total analgesia consumed.
Results: No statistical differences were observed between any of the demographic variables and surgical levels operated upon between the two groups. Both the groups showed significant improvements in clinical (VAS) and functional (ODI) outcome as compared to pre-operative status. Leeds assessment of neuropathic symptoms and signs scale (LANSS) score was significantly increased in both the groups postoperatively till the 3rdmonthfollow-up, after which there was a significant decrease in the score. The Pregabalin group showed significant (p<0.05) improvement in VAS and ODI scores at the post operative 1st, 3rd, and 6th month, as compared to the gabapentin group; however, at other follow-ups the difference was insignificant. Total analgesia consumed was significantly higher in the gabapentin group.
Conclusions: Our study concluded that both pregabalin and gabapentin are highly effective in the treatment of early post-operative neuropathic pain; showing encouraging clinical and functional improvements. Pregabalin had significantly better outcomes on short-term follow-ups; however, on longer follow-ups, both had similar beneficial outcomes. Pregabalin supplementation showed a significant analgesia-sparing effect as compared to gabapentin.
Management of adhesive capsulitis of shoulder joint with arthroscopic release vs. manipulation under anaesthesia: a comparative study
Authors: Vikranth P. Sai , Shravani G. , Reddy Surendranath , Deepak J. , Varenya N. Vamshi
Published: December 2023

Background: Shoulder stiffness is a manifestation of various pathologies or clinical scenarios variously described as scapula humeral periarthritis, frozen shoulder and adhesive capsulitis. Frozen shoulder is characterized by significant restriction of active and passive motion of the shoulder that occurs due to unknown factors. Adhesive capsulitis causes contracted, thickened joint capsule that seemed to be drawn tightly around the humeral head with a relative absence of synovial fluid and chronic inflammatory changes within the subsynovial layer of the capsule. In this study we did a comparison of 30 patients treated with arthroscopic release and manipulation under anesthesia.
Methods: There were 30 patients in this study with 15 patients in each group of different age groups. All the patients were studied for a period of one year between July 2021 to July 2022. The functional outcomes were assessed using dash scoring system.
Results: in this study of 30 patients with different age groups followed for 12 months and assessed by DASH scoring system. We had excellent results in arthroscopic group with postop dash score standard deviation is 5.87.
Conclusions: The arthroscopic capsular release of shoulder joint in adhesive capsulitis was found to have a better functional outcome as compared to the manipulation of shoulder joint under anaesthesia. Currently no treatment protocols are universally effective which needs more and more research and developments for proper treatment strategies. Morbidity with this condition has caused significant loss both economically and psychologically.
Teriparatide therapy in joint replacement surgery: mitigating complications and improving patient outcomes in osteoarthritis
Authors: Chaudhari Yogesh
Published: December 2023

Background: Teriparatide, a synthetic form of parathyroid hormone, has gained significant recognition as an effective treatment for osteoporosis. Its ability to stimulate bone formation and improve bone mineral density has made it a valuable therapeutic option in managing this prevalent skeletal disorder. However, its safety and potential benefits in preventing bone mineral density (BMD) loss after joint replacement surgery and post-surgical complications have yet to be extensively investigated.
Methods: This retrospective study included 32 patients who received teriparatide following joint replacement surgery for osteoarthritis. The analysis focused on assessing teriparatide’s effectiveness in any reductions in post-surgical complications and adverse events, if any.
Results: No teriparatide-related adverse events and post-surgical complications were reported during the follow-ups and the entire study duration.
Conclusions: Teriparatide demonstrated effectiveness in joint replacement patients. Further research is needed to explore long-term benefits and effects on implant longevity.
Femoropatellar alterations in knees with chronic anterior cruciate ligament injuries: a radiographic analysis
Authors: Arora Ekjot S. , Sharma B. P. , Das Narottam , Mohindra Mukul , Shaina Sandeep
Published: December 2023

Background: The objective of this study was to correlate the occurrence of patellofemoral malalignment in a chronic anterior cruciate ligament (ACL) deficient knee using common radiological parameters.
Methods: A case-control study was conducted on 35 adult patients with previously diagnosed unilateral chronic ACL injury. The injured knee was considered as the case, while the contralateral normal knee served as the control. Radiological parameters including the Caton-Deschamps patellar height index, Merchant patellar congruence angle, and Laurin lateral patellar tilt angle were measured on X-rays obtained from both normal and ACL injured knees. A comparative analysis was performed between the two groups.
Results: The Caton-Deschamps patellar height index had a mean value of 0.95±0.05 in the ACL-deficient knee. The Merchant patellar congruence angle showed mean values of 12.66±0.84 degrees in the ACL injured knee, while the Laurin lateral patellar tilt angle was 8.06±1.41 degrees in knees with ACL failure. These results indicate lower patellar height, greater lateral displacement of the patella, and increased lateral patellar tilt in knees with chronic ACL tears, thereby affecting the patellofemoral joint.
Conclusions: Chronic ACL tears are associated with patellofemoral malalignment, characterized by decreased patellar height, increased lateral displacement of the patella, and greater lateral patellar tilt, thus impacting the patellofemoral joint.
A case of a rare hibernoma tumour and a brief literature review
Authors: Gauci Kristen , Debono Fabian , Gauci Fiona , Panzavecchia Francesca
Published: December 2023

Hibernomas refer to benign tumours of immature adipose tissue known a brown fat. They are most commonly found in areas where brown adipose tissue is still present in adulthood such as the shoulder, back, neck, best, arm and abdomen. This case study describes a 60 year old male who presented with a growing 15 mm lump in the right forearm. On examination, tenderness in the area surrounding the mass was elicited. A magnetic resonance image of the right forearm was performed which reported a large intramuscular lipomatous tumour within the brachioradialis muscle, in close relation to the neuromuscular bundle. Surgical excision was performed successfully. Histology was consistent with a diagnosis of a hibernoma tumour. The patient healed well with no evidence of infection or recurrence on follow up.
Neck fluid extravasation in shoulder arthroscopic surgery-a life-threatening complication: a report of two cases
Authors: Sousa Diogo A. , Reis João , Guimarães André , L. Lopes António
Published: December 2023

Fluid extravasation in shoulder arthroscopy may lead to life-threatening consequences, such as airway compromise. These cases are rare and few were reported in the literature. Clinical cases of 2 female patients submitted to shoulder arthroscopy for a rotator cuff tear repair, complicated with fluid extravasation that led to trachea compression and need for intensive care unit (ICU) admission with postponed extubation. Neither patients showed any sequelae in the follow-up period. Report of these rare complications, with detailed and reproducible information, is vital for their comprehension and future elaboration of surveillance and treatment guidelines.
A rare location of the rare tumour-chondromyxoid fibroma of calcaneum
Authors: Rajpurohit Narendrasinh , Shariff Fardeen
Published: December 2023

Chondromyxoid fibroma (CMF) primary location is the long tubular bones of the lower extremity followed by foot and knee. This benign cartilaginous tumor of bone is the rarest reported neoplasm of cartilaginous origin. This mass can mimic other benign and malignant bone tumors owing to its variable histologic features. We report a case of CMF of the calcaneum with varying presentations.  Pathologic examination is difficult but can be used to differentiate this lesion from more serious conditions. A quick and accurate diagnosis of CMF can prevent unnecessary treatment that could be harmful to the patient.
How to manage blocked intramedullary canal while reaming during hip arthroplasty
Authors: Bansal Harish , Jajoriya Laxmi Narayan , Verma Aditya
Published: December 2023

Blockage of femoral canal while doing hemiarthroplasty is rare finding. Before inserting the femoral stem trial we should manage this blockage adequately to prevent iatrogenic fracture. Herein, we present a case of fracture neck of femur right in a 79-year-old male who presented with history of right hip pain and later was diagnosed with neck of femur fracture subcapital type that was treated with cementless hemiarthroplasty. In conclusion, if the canal is blocked, start with small diameter (K-wire), then insert guide wire and then reaming over it to open the blocked canal, do not hammer directly to prevent iatrogenic fracture. Go sequentially to open the blockage. First open the marrow then insert trial stem.
Non-ossifying fibroma of distal tibia: case report
Authors: H. R. Girish , Mittal Prabhat , M. Aravind
Published: December 2023

Non-ossifying fibroma is a benign fibrohistiocytic lesion most commonly seen in the metaphyseal region in children. It usually doesn’t present with any symptoms. As the bone grows and undergoes remodeling, the lesion tends to vanish and get substituted with healthy bone. Nonetheless, the lesion can debilitate the affected bone, leading to a potential fracture. Here, we report a case of non-ossifying fibroma in the metaphyseal region of the tibia in a 13-year female. The patient presented with complaints of pain in the left leg for 5 months and underwent radiological investigation showing a well-defined, multi-loculated, expansile, radiolucent, lytic lesion with a thin sclerotic margin in the meta-diaphyseal region of the distal tibia, for which extended bone curettage with bone grafting was performed. The sample was sent for histopathological examination, which showed bony trabeculae with bits of tumor composed of spindle cells with elongated nuclei and scant cytoplasm, arranged in a storiform pattern along with many scattered multinucleate giant cells and foamy histiocytes suggestive of non-ossifying fibroma. Post operatively, non-weight bearing mobilization was advised for 4 weeks. Most non-ossifying fibromas were diagnosed in childhood to late adolescence, found incidentally, and clinically asymptomatic. Most distal tibial non-ossifying fibromas (NOFs) tend to transpire at a specific anatomical site located at the far end of the interosseous membrane. The prognosis for NOFs is typically excellent with a low risk of recurrence.
End of life care in neurologically ill patients – An Indian perspective
Authors: Nidhal Mohamed
Published: December 2023

End of life care is a critical aspect of healthcare that aims to provide comfort, dignity, and support to patients with life-limiting illnesses, including neurologically ill patients. Neurological diseases such as Alzheimer's disease, Parkinson's disease, Amyotrophic lateral sclerosis (ALS), and brain tumors can profoundly impact a patient's quality of life and pose unique challenges in end-of-life decision-making and care provision. This article explores the importance of end of life care in neurologically ill patients and outlines key considerations for healthcare providers, patients, their families and mentions on the training for healthcare professionals available in India.
A study of stages and supplementary issues of Parkinson\'s in Parkinson disease and movement disorders
Authors: Raju V Rama , Lavanya N , Premchand P
Published: December 2023

: Indorsing (endorsing or encouraging) participation plus autonomy (PA) within the people has been tinted or emphasized as an definitive goal-of-rehabilitation for subjects with constant disorders and/or diseases by the World Health Organization (WHO), yet there are insufficient studies concentrating over the “PA” within the subjects through the Parkinson disease (PD). Thus, we present this study objectives to clarify/explain (explicate) the degree of “PA “within the Palasioses’ve the psychosomatic also developmental(behavioral) causes linked through it.

: Subjects were inducted as of the neurology of a tertiary care hospital and city neuro research center by applying ease sampling for this type of research study design. A survey casing or layering the societal-demographic, illness-linked typical, Bharat version of impact over the involvement and participation autonomy (“IPA”) survey, and other rating scales including H and Y staging system plus all time UPDRS considering the UK brain bank criteria were employed. A statistical multi latent-variate stepwise linear regression analysis-technique was applied to decide the features/ (factors) which influences IPA.

: Regression showed UPDRS-stage III, β=0.34, p<0.001, chi-square, with 2 degree of freedom, highly significant had very good correlation by IPA, followed by drive (i.e., tenacity) as the second robust feature β=-0.24, p< 0.001. Also, H and Y score β=0.18, p< 0.001, plus accessibility-of- community sustain β=-0.11, p =0.001 were great factors.

: Standard echelon of PA amid Parkinson`s was middle (worse). Their bodily function, `psychological-resilience` plus `social-support` were the best factors coupled through PA amongst Parkinson`s. Thus the results yield significant insights in to Parkinson`s `PA` which aid clinicians for determining/predicting early-risks of limited PA amid Parkinson`s, executing involvement to endorse, to advance-PA and lastly to complete the decisive therapeutic-treatment.
A comparative evaluation of microsurgical excision of olfactory groove meningioma through unilateral (pterional) vs Bilateral (Bifrontal-transbasal) approach
Authors: Singh Deepak Kumar , Mishra Vineet Kumar , Chand Vipin Kumar , Singh Neha , Gupta Amit
Published: December 2023

Surgical management of olfactory groove meningiomas poses significant challenges. Common microsurgical approaches often result in delayed exposure of neurovascular structures. In contrast, the pterional approach offers the advantage of early dissection of the posterior neurovascular complex.

Olfactory groove meningiomas constitute 4 to 13% of all meningiomas. Surgery is the primary treatment, but the recommended extent and types of approaches vary. We conducted a retrospective review of our olfactory groove meningioma series treated with microsurgery via standard unilateral or bilateral approaches.

Patient records from our department (RMLIMS, LUCKNOW) were reviewed, encompassing cases treated with unilateral or bilateral approaches. Thirty patients who underwent olfactory groove meningioma removal were included, and clinical data, radiological findings, surgical treatment, and clinical outcomes were retrospectively analyzed.

A total of 30 craniotomies were performed, with 16 employing unilateral pterional approaches and 14 using bilateral transbasal approaches. Overall, gross total tumor resection was achieved in 27 cases. Postoperative complications included edema (in three patients) and hematoma (in three patients).

The unilateral (pterional) approach emerges as an excellent solution for olfactory groove meningioma treatment, offering early visualization of the posterior neurovascular complex. Additionally, it enables frontal sinus preservation and minimizes excessive brain retraction.
Survival and analysis of patients with various central nervous tumors who received post-operative radiation therapy: A retrospective study
Authors: Bhandari Virendra , Singhal Saloni , Lodi Ashar , Kumar Amresh
Published: December 2023

Central Nervous Tumors constitute 3% of cancer cases worldwide. The incidence of CNS tumors in India ranges from 5-10 per 100,000 population, ranking 14 among all other tumors and accounting for 2% of all malignancies.

The five most frequent tumors are astrocytoma (47.3%), Medulloblastoma (11.4%), craniopharyngioma (9.7%), ependymal tumors (4.8%), and nerve sheath tumors (4.1%). The tumor spectrum varies among different ages and sexes. The medical records of 238 patients were evaluated, out of which only 102 were fit for the study as per the inclusion and exclusion criteria.

The 3-year median overall survival (OS) of 8 years and Progression Free Survival (PFS) of 7 years, while the 5-year median OS of 9 years and PFS of 7 years is recorded. Glioblastoma (GBM) is the most aggressive out of all histologies, with a 2-year survival of 31% and a median OS of 8 months, as per our study. We got some good results with brainstem glioma as well, with a 2-year survival of 40% and a median OS of 18 months.

The survival in CNS tumours has improved widely with adjuvant concurrent chemotherapy with temozolamide along with radiation postoperatively and then adjuvant for 6months to 1 year and it was also seen that more complete the tumour resection done, the better was the survival seen.
Diagnostic concordance in consultation liaison psychiatry – Referring physicians to psychiatrists
Authors: Benerji Therissa , Bodepudi Sarath , Cherukuri Gayathri Devi , Kodali Madhavi , Parvathaneni Krishna Mohan
Published: December 2023

Psychiatric co-morbidity in patients with physical illness is known to influence the course and outcome of both conditions. Consultation liaison psychiatry [CLP] can be regarded as an essential service between psychiatry and other medical specialties. Efficient communication between different levels of care is known to have an impact on the quality of health care.

To study the patterns of referrals to the department of psychiatry and diagnostic concordance between referring physicians to CL-Psychiatrist.

The present study was a cross-sectional study conducted in the Department of Psychiatry of a tertiary care hospital. All the patients referred to the Psychiatry department for 4 months were taken after excluding referrals sent for disability assessment. Socio-demographic details, source of referral, reason for referral, and the psychiatric diagnosis by both the referring doctor and CL-psychiatrist were recorded. Statistical analysis was done using SPSS 25.0 software and kappa value was used to estimate the diagnostic concordance.

In the sample of 100 referrals studied, the mean age of the sample was 40.96±13.42 years. The majority of the cases referred were inpatients (61%), from the department of general medicine and allied branches (85%), (General medicine -55, Neurology- 21). The most common diagnosis was alcohol dependence syndrome 24 (24%), followed by depression (18%) and phobic anxiety (18%).

The concordance of the diagnosis between the referral and the psychiatry team was in perfect agreement (κ=0.81- 1.00) for paranoid schizophrenia, bipolar affective disorder, delirium, dissociative disorder, delusional disorder, and alcohol dependence syndrome. Very low concordance was observed in diagnosing obsessive-compulsive disorder (k=0) and adjustment disorder (k=0).

The overall diagnostic concordance was poor for adjustment disorder, OCD, and vascular dementia, and good for paranoid schizophrenia, delirium, dissociative disorder, delusional disorder, and BPAD.
Dichotomous interpretations and a stroke of luck: A case of silent cerebral hemorrhage
Authors: Paul Ankan , Tripathi Utkarsh K , Kaur Simranjit , Chakladar Abhishek , Alphonse Alexander M.
Published: December 2023

“Silent Cerebral Hemorrhage” in a young alcohol-dependent individual can pose a significant challenge to the treating physician. The neuroimaging and clinical presentation maybe dichotomous to a critical extent.

Our aim was to explore the scientific understanding of “Silent Cerebral Hemorrhage” and share the wisdom gathered about the diagnosis and management of this rare entity.

A 32-year-old male presented with fever and episodes of vomiting alongwith urinary incontinence, in the backdrop of heavy alcohol abuse. Detailed neurological assessment revealed no abnormal findings. MMSE indicated towards no significant cognitive deficits. On MRI, an extensive intracerebral hemorrhage was observed.

The I.C.H. score was 2/6 and the FUNC score was 8/11; which was in stark contrast to NIH Stroke Scale score of 0/42.

Blood-panel showed deranged liver enzymes. Patient was managed conservatively. Irritability was controlled using Haloperidol. Prophylactic antiepileptics were also started.

Upon follow-up, patient showed drastic improvement. Patient was started on Acamprosate for maintenance of abstinence.

Through this case report we have tried to highlight that “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.

“In this case, the absence of neurological deficits was indeed a stroke of luck for the patient.”

: “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. Hence, we should be vigilant about it in our clinical practice. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.
The flexibility of Islamic law in the Ganjur tradition in Lamongan, Indonesia
Authors: Khoiroh Muflikhatul , Syakur Abd Syakur
Published: December 2023

This article demonstrates the flexibility of Islamic family law in the Ganjur tradition in Lamongan, Indonesia, considered unique for allowing women to propose to men. Despite its uniqueness, the Ganjur tradition carries important moral teachings in the context of realizing humanistic and egalitarian family relations. This study is a legal-sociological study using a grounded research model to find evidence of the flexibility of Islamic law in determining the status of the law of the Ganjur tradition. The data required include the history of Ganjur, Ganjur practice, and people's views on Ganjur, which were explored through interviews with twenty informants and Focus Group Discussions (FGDs) with three traditional leaders, three religious leaders, and five traditional actors. To evaluate the data, the maqāṣid syarī'ah approach was utilized. The results indicate that the Ganjur tradition stems from the legend of Panji Laras and Panji Liris (male figures), who received a proposal from Andansari and Andanwangi (female figures). The act of proposing to a man (ngganjur) is considered a source of glory for a woman. Meanwhile, being proposed to by a woman (diganjur) denotes that a man is respected as a companion to his wife rather than dominated by her. The wedding ceremony is fully financed and organized by the woman's family. Following the event, the couple resides with the woman’s family for an indefinite period, until they have acquired sufficient resources to establish their own independent household. The husband and wife hold equal ownership of the family unit and collaboratively manage the household; the wife is not subordinate nor a complement to the husband (koncowingkeng). This study found that Islamic law’s flexibility could uphold the legitimacy of the Ganjur tradition with accurately proposed sharia.
The influence of service quality on sustainable competitive advantage in Kurdistan Iraq hotels: Perspective from hotel managers
Authors: Ahmad Mohammed Abdul-Aziz , Jais Juraifa
Published: December 2023

In today's ever-evolving and highly competitive market, hotels across the globe face numerous challenges. Among these, a key challenge is providing and consistently maintaining an excellent quality of service. As customer expectations rise, businesses in the hospitality industry are under pressure and must learn how to develop resilient strategies. These strategies are imperative if they wish to maintain a sustainable competitive advantage (SCA) amidst the intense competition they face daily. Interestingly, past studies often assumed the factors that predict competitive advantage, often disregarding the substantial impact of service quality (SQ). This error may incur significant costs. Therefore, to remain and become more competitive, logistic service providers (LSPs) should deeply understand the salient factors that contribute to building up their competitive advantage. They must also recognize the pivotal role of SQ and grasp its profound effect on SCA. The present research uniquely aims to assess the intricate relationship between SQ and SCA, particularly concerning hotel managers. Through this study, 152 sampled questionnaires were diligently obtained from hotel managers in the vibrant Kurdistan region of Iraq. These responses were thoroughly analyzed. Notably, the results demonstrated that all SQ dimensions, with the exception of assurance, were significant for ensuring the overall SCA of hotels. This groundbreaking study is the first of its kind to be conducted in this region. Ultimately, the valuable outcome of this study will guide and assist hotel managers in meticulously focusing on and enhancing their SQ levels, especially in the Kurdistan region.
Enhancement structure probiotic yoghurt made from whole milk powder by psyllium husk
Authors: Darwish Alzahraa Mohamed
Published: December 2023

Psyllium husk is a bioactive source that provides health benefits and is new best possible use in the dairy industry as a texture enhancer for its hydrochloride properties. The current study focuses on the optimization of a suitable amount of psyllium husk powder (PHP) with whole milk powder (WMP) to produce bioactive probiotic yoghurt and keep it stable during the storage period. The different levels of PHP (0, 0.5, 1.0, and 1.5 % w/w) with WMP were used to prepare the bioactive probiotic yoghurt as a functional food. We made four different mixtures and tested them for their chemical makeup (pH, titratable acidity, moisture, total solids, ash, fat, and protein), colour (L*, a*, b*, and C*), ability to hold water (WHC), and how they tasted after 1, 7, and 14 days at 5°C. The PHP probiotic yoghurt showed a significant decrease (p < 0.05) in pH, protein, and fat. While titratable acidity and ash contents were increased compared with the control. Also, the texture profile, like adhesive and hardiness, had better flow properties and more WHC than the control. Additionally, the color parameter showed an increase in a*, b*, and C* values and a decrease in the L* value. The sensory evaluators preferred the 1% PHP samples. The current study found that samples fortified with 1% PHP improved the physicochemical, texture, and sensory properties of probiotic yoghurt and maintained probiotic yoghurt structure during storage compared with the control. Probiotic yoghurt prepared from PHP has provided new dairy industrial applications.
Design and fabrication of a system to capture ambient CO2
Authors: Khan Sagir , Navalgund Lokeshwari , Joshi Keshava , Kumar Abhishek
Published: December 2023

Introduction:In the coming decades, addressing climate change necessitates substantial Carbon dioxide (CO2) emission reductions. Carbon capture and  storage are vital for achieving these goals. Beyond industrial emissions, Direct Air Capture (DAC) extracts CO2 from the atmosphere, complementing point source capture and enabling the reduction of atmospheric CO2 concentrations. Our research confirms the thermodynamic feasibility of DAC with Potassium hydroxide (KOH) solution, taking into account energy and performance considerations.
Materials and methods: To assess DAC's potential, we built a 1.2 m contactor prototype measuring CO2 absorption from the air. Operating at 100 pa with an air speed of 1.75 m/s in a cross-flow regime, we used KOH and NaOH solutions as capture mediums, implementing duty cycles for absorbent pumping and exhaust fan operation.
Results: Our findings revealed that transitioning to intermittent operation can dramatically reduce overall energy costs by 70%. We explored various absorbent concentrations for both KOH and NaOH solutions, examining their impact. Operating temperatures ranged from 14°C to 33°C, providing insights into temperature's pivotal role in DAC performance.
Conclusion: This study showcases the viability of DAC with a KOH solution, particularly highlighting the significant energy savings achieved through intermittent operation. These findings emphasise DAC's role as a vital tool in our collective efforts to combat climate change.
Finding New VEGFR2 Inhibitors Using Support Vector Machine Classification Model
Authors: Arabi Nooshin , Torabi Mohammad Reza , Fassihi Afshin , Ghasemi Fahimeh
Published: December 2023

Introduction: In our current era, the prevalence of cancer and its associated mortality rates have become a pressing concern. As such, finding effective methods for treating cancer has become a matter of significant importance. Abnormal angiogenesis is one of the common characteristics of different types of cancer. So far, the inhibition of vascular endothelial growth factor receptor 2 signaling pathway has received much attention due to its pro-angiogenic role. Therefore, finding reliable computational models to identify inhibitors can be effective in reducing time and cost. The purpose of this study was to use the support vector machine method to classify compounds into two inhibitory and non-inhibitory groups.
Methods: In order to implement the machine learning model, the ligands studied in this research were extracted from the https://www.bindingdb.org database and after passing the necessary pre-processing, some filter-based and embedded feature selection methods were used.  After extracting the descriptors from the data, using the feature selection algorithm based on correlation, the dimensions of the data have been reduced in order to avoid overfitting the model. The classification task utilized a support vector machine model, employing various kernels such as Radial Basis Function (RBF), Polynomial, Sigmoid, and Linear.
Results: The implementation of the support vector machine model with the RBF kernel along with the feature selection method based on correlation has resulted in a higher accuracy of 82.4% (P=0.008) compared to other feature selection methods used in this study.
Conclusion: Observations indicate that the correlation-based feature selection method is more accurate than other methods used in this study.
Zorunlu Öğretimde Eğitimsel Etkililik ve Anne-Babaların Yaptığı Eğitim Yatırımlarının Verimliliği
Authors: YILDIRIM Kamil
Published: December 2023

Anne-babaların çocuklarının eğitimi için yaptıkları harcamalar ulusal ve uluslararası düzeyde artma eğilimindedir. Bu harcamaların eğitimsel açıdan verimliliği hakkında bir araştırma boşluğu problemi bulunmaktadır. Problem doğrultusunda zorunlu örgün öğretim okullarında eğitimsel etkililik, anne-babaların yaptığı eğitim yatırımları ve teknik eğitimsel verimlilik düzeyleri incelenmiştir. Katılımcılar, 2022 Nisan-Haziran döneminde Aksaray İl Merkezinde zorunlu örgün öğretim kademesindeki okullarda çocuğu öğrenim gören toplam 335 anne-babadan oluşmaktadır. Betimsel desendeki bu çalışmada, katılımcılara, kolay ulaşılabilir ve kartopu örneklemeyle erişilmiştir. Araştırmacı tarafından geliştirilen veri toplama aracıyla toplanan veriler, tanımlayıcı istatistikler, çapraz tablo ve veri zarflama analizi kullanılarak incelenmiştir. Katılımcılar, araştırmanın gerçekleştirildiği dönemde aylık ortalama 1278 TL eğitim yatırımı yapmaktadır. Zorunlu örgün öğretim okullarında eğitimin kısmen etkili olduğu ve etkisizlik azaldığında verimliliğin arttığı sonucuna ulaşılmıştır. Verimliliği artırabilmek için etkisizlik sorunu azaltılmalıdır. Öğrencilerin bütünsel gelişimini sağlayacak şekilde kamu eğitim yatırımlarını kullanabilecek politika ve stratejilere ihtiyaç duyulmaktadır.
Analyst herding – whether, why, and when? Two new tests for herding detection in target forecast prices
Authors: Ghimire Binam , Reveley Callum , Shanaev Savva , Panta Humnath
Published: December 2023

This study proposes two novel tests for security analyst herding based on binomial correlation and forecast error volatility scaling and applies it to investigate herding patterns in analyst target prices in 2008-2020 in the UK. Analysts robustly herd in their valuations, with results consistent across years, sectors, in panel fixed effect, quantile, instrumental variable regressions, and when controlled for optimism and conservatism. Herding becomes prominent for stocks followed by at least five analysts and towards the long sides of Fama-French sorts, reinforcing its non-spurious and behavioral nature. Analyst herd more strongly subject to low volatility and uncertainty.
Córka na wydaniu. Zakres autonomii kobiety w procesie doboru matrymonialnego w Polsce międzywojennej i współczesnej
Authors: Przybył Iwona
Published: December 2023

Celem opracowania jest zilustrowanie, w jaki sposób reguły doboru matrymonialnego są wzmacniane przez szereg ograniczeń kulturowych na przykładzie zmieniającego się zakresu autonomii kobiety-córki. Podstawą analiz są materiały zastane, tj. publikacje z zakresu historii rodziny oraz badania własne autorki. Artykuł przedstawia społecznie określane zasady wyboru partnera małżeńskiego, a także wzorce obowiązujące na rynku małżeńskim wśród chłopów i inteligencji w Polsce międzywojennej oraz współcześnie. Wskazuje się tu przede wszystkim na wpływ porządku społecznego i wynikającego z niego statusu kobiety-córki na przebieg procesu doboru matrymonialnego (zarówno w aspekcie selekcji partnerów jak i prawidłowości przebiegu znajomości) oraz na kultywowaną obyczajowość przedmałżeńską. Sposób legitymizacji narzeczeństwa i małżeństwa, a co za tym idzie zakres autonomii kobiety, ściśle i niezmiennie wiąże ze statusem społecznym i statusem w rodzinie – bez względu na poddany w opracowaniu analizie okres historyczny. Tylko te kobiety, które są całkowicie niezależne ekonomicznie i mieszkaniowo od rodziny pochodzenia, mogą pozwolić sobie na autorską stylizację
przebiegu znajomości przedślubnej oraz ceremonii ślubno-weselnej.
Nowa żelazna kurtyna czy nowe średniowiecze? Ruchy antyaborcyjne, antygender i anty-LGBT+ w Polsce i innych krajach Europy Środkowo-Wschodniej
Authors: Desperak Iza
Published: December 2023

Artykuł poświęcony jest nowemu podziałowi Europy, który wyznaczony jest przez sprzeciw przeciwko równości płci, kwestii LGBT+ oraz prawom reprodukcyjnym i seksualnym. Analizuję w nim trzy główne wymiary transformacji dotyczące seksualności i intymności w Europie Środkowej i Wschodniej. Pierwszy to ruchy antyaborcyjne oraz antyaborcyjne polityki, jak niemal zupełny zakaz aborcji w Polsce, strefy bez aborcji na Białorusi czy tygodnie bez aborcji w niektórych rejonach Rosji, zestawione z liberalizacją prawa aborcyjnego w Rumunii. Drugi wymiar analizy dotyczy ruchu anty-gender. Kolejnym zjawiskiem poddanym analizie są kwestie LGBT+ i oficjalna homofobia, skutkująca polityką dyskryminacji, jak tak zwany „zakaz
propagandy homoseksualnej”, część polityki wymierzonej w „gej-Europę”. W artykule staram się
ukazać rolę ukrytych aktorów stojących za dyskryminującymi politykami i propagandą, odnoszącymi się do tych trzech obszarów.