bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study Assessing the Correlation of Atherogenic Index of Plasma with Severity of Coronary Artery Disease by Modified Gensini Score in Postmenopausal Women
Authors: Parvathareddy Krishna Mala Konda Reddy , Pabba Anish , Nagula Praveen , Motkar Ankith Reddy , Suneetha K , Ravi Srinivas , Syed Imamuddin
Published: July 2024

ABSTRACT

Introduction:

The latest area of interest in lipids is small dense low-density lipoprotein cholesterol (sdLDL-C). They are highly atherogenic. There is no effective way of estimating them convetionally. Atherogenic index of plasma (AIP) reflects the level of sdLDL-C. The postmenopausal women have increased likelihood for coronary artery disease (CAD). In this study, the correlation between AIP and severity of CAD in postmenopausal women was assessed.

Materials and Methods:

A total of 448 postmenopausal women with chest pain were screened, of which 252 had a provisional diagnosis of CAD. Of them, 148 patients satisfying inclusion criteria were enrolled. Routine investigations, electrocardiogram, echocardiography, and coronary angiogram (CAG) were performed. Modified Gensini score (mGS) was used for severity of CAD. Chi-square test and Spearman correlation were used to analyze the correlation.

Results:

The mean age was 57 ± 8.3 years. The most common presentation was STEMI (32.4%), followed by unstable angina (28.4%). Patients already on statin therapy were 26.4%. Hypertension (HTN) was the most common risk factor (38.5%), followed by diabetes with HTN (23%). The mean AIP and mGS score were 0.23 ± 0.16 and 99.66 ± 65.61, respectively. Higher AIP values were seen in patients with higher mGS. Patients on statins and with normal lipid parameters showed higher mGS and AIP. There was a positive correlation of AIP with diabetes, HTN, Vitamin-D deficiency, C-reactive protein, body mass index, waist-circumference, waist-hip ratio, and waist-height ratio.

Conclusion:

AIP is a novel indicator and a strong marker for predicting the severity of CAD in postmenopausal women. In postmenopausal women with recurrent CAD and on statin therapy previously, AIP levels were high, implying that they need further management.
Sports activities as an integrative approach to overcome stigma associated with HIV/AIDS
Authors: Goyal Atul Kumar , Saini Jyoti
Published: July 2024

Background:

Traditional methods of HIV/AIDS awareness are failed to achieve significant participation from the community because young adults hesitate to participate in such activities due to the stigma associated with the disease.

Objective:

We proposed that if HIV/AIDS awareness programs are conducted integratively with sports activities, it may result in significant participation from the community, which in turn helps in overcoming the stigma associated with the disease.

Methods:

We conducted a literature review of various studies highlighting the role of sports activities in spreading HIV/AIDS awareness. We also conducted a pilot study by taking bicycle run activity to analyze its role in spreading HIV/AIDS awareness.

Results:

We found only five studies in which sports activities have been used to overcome stigma associated with HIV/AIDS. Football or soccer is the primary sports activity adopted to overcome HIV/AIDS stigma among school and college students. In our pilot trial, when we used the bicycle run as a means to overcome HIV/AIDS stigma, significant participation from the community was achieved.

Conclusions:

Sports activities can convey the message of HIV/AIDS awareness in a much more effective way compared to traditional methods. We recommended that the government should integrate HIV/AIDS awareness programs with sports activities to overcome stigma associated with the disease.
Cystica indeterminata – A novel intriguing pelvic pathology in a 9-year-old girl
Authors: Pal Kamalesh , El Bahtimi Reem , Pal Aniket , Pal Ankita
Published: July 2024

Intra-abdominal cystic lesions are commonly associated with visceral locations such as renal, hepatic, pancreatic, ovarian/adnexal, and mesenteric. Rarely, nonvisceral locations such as retroperitoneum, free intra-peritoneum, prevertebral space, and pelvis harbor cystic lesions. In almost all these lesions, radiology, histopathology, immunostaining, and serology markers are able to assign a definite origin and pathogenesis. Very rarely a clear diagnosis is not possible, and these lesions have been designated as “indeterminate” lesions. We report the first case of “cystica indeterminata” with completely obscure origin and histopathogenesis in a 9-year-old female child. Clinical, radiological, seromarkers, histopathology, related differentials, and pathogenesis have been discussed. We hypothesize that aborted organogenesis or acquired degenerative/involutory changes may lead to such indeterminate lesions.
Rheumatic diseases in the elderly: Challenges and management
Authors: Agarwal Avarna , Padhan Prasanta
Published: July 2024

The elderly demographic is seeing a gradual rise as a proportion of the overall global population, whilst also experiencing high rates of musculoskeletal issues, requiring specialized care. The management of rheumatic diseases in the elderly presents unique challenges due to the complex interplay among physiological changes, cognitive decline, and altered immune responses. Such conditions can be categorized into those progressing from earlier life stages (such as rheumatoid arthritis, systemic lupus erythematosus, spondyloarthritis, and gout) and those predominantly emerging in old age (such as polymyalgia rheumatica, giant cell arteritis, osteoarthritis, crystal arthropathies, and osteoporosis), each with distinct characteristics and management needs. These diseases often present atypically with nonspecific symptoms and altered serological markers, complicating diagnosis and management due to increased toxicity risks and comorbidities. Comprehensive, multidisciplinary care that includes cardiovascular health monitoring, bone density maintenance, gastrointestinal tolerance management, infection prevention, and mental health support are essential to improve outcomes and quality of life for elderly patients with rheumatic diseases.
Effect of Vitamin C on Blood Glucose Levels, Glycosylated Hemoglobin, and Serum Lipid Profile in Patients with Type 2 Diabetes Mellitus: A Prospective Study
Authors: Mukadam Fehmi M. , Gawali Ujwala P. , Pore Shraddha M.
Published: July 2024

Background:

Vitamin C reduces oxidative stress as well as prevents nonenzymatic glycosylation of proteins because of its structural similarity to glucose. This prospective study was conducted to investigate the impact of vitamin C supplementation on glycemic control and serum lipid profile in newly diagnosed patients with type 2 diabetes mellitus (T2DM).

Materials and Methods:

Adult patients attending the outpatient department of a tertiary care hospital, diagnosed with T2DM within the last 3 months, with fasting blood glucose (FBG) levels exceeding 126 mg/dL, were randomly assigned to either control group (n = 98) or study group (n = 102). The study group received oral vitamin C (1 g/day) in addition to metformin 500 mg twice daily, while the control group received metformin 500 mg twice daily alone. Baseline characteristics, including age, gender, and comorbidities, were recorded. The parameters FBG, postprandial blood glucose (PPBG), glycosylated hemoglobin (HbA1c), and serum lipid profile were measured at baseline and at the 12th week.

Results:

Both the control and study groups experienced significant reductions in FBG, PPBG, and HbA1c levels after 12 weeks. However, the study group exhibited greater improvements, with FBG decreasing by 22.42 ± 2.7 mg/dL (P < 0.05), PPBG decreasing by 33.25 ± 4.9 mg/dL (P < 0.05), and HbA1c decreasing by 1.33 ± 0.3 g% (P < 0.05). Additionally, both groups demonstrated significant improvements in serum lipid profile parameters, with the study group showing more significant improvements in high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol levels compared to the control group.

Conclusion:

Vitamin C supplementation as an adjuvant therapy with metformin for 12 weeks produces beneficial effects in T2DM patients, including improved glycemic control and significant improvement in the lipid profile.
Diabetes and Stroke—A Focused Review
Authors: Menon Bindu , Syed Rizwana , Yadav Praveen Kumar , Menon Medha
Published: July 2024

Globally, diabetes mellitus (DM) and stroke are two common chronic illnesses that have a substantial impact on rates of morbidity and mortality. There is significant evidence linking diabetes to an increased risk of stroke in terms of incidence, severity, and mortality. This extensive review looks at shared risk factors, underlying pathophysiological mechanisms, epidemiological trends, and evidence-based therapy approaches to give a thorough analysis of the causal relationship between diabetes mellitus and stroke. Studies using epidemiological data regularly show that people with diabetes have a higher incidence of stroke than people without the disease. Furthermore, diabetes is linked to a less favorable outcome following a stroke, as well as an elevated chance of stroke recurrence. Determining the pathophysiological pathways that connect diabetes and stroke is essential to understanding their relationship. Key pathophysiological processes associated with these disorders include endothelial dysfunction, inflammation, oxidative stress, hyperglycemia, and dyslipidemia. Due to microvascular complications, these mechanisms raise the risk of hemorrhagic stroke and predispose diabetics to an increased risk of ischemic stroke by creating a prothrombotic and atherosclerotic milieu. Diabetes and stroke are linked due to shared risk factors like smoking, obesity, dyslipidemia, hypertension, and poor glycemic control. Lifestyle changes, blood pressure control, lipid-lowering therapy, antiplatelet medicines, and a nutritious diet are essential for stroke risk reduction. Reducing the risk of stroke in people with diabetes requires the implementation of management techniques that focus on both diabetes control and stroke prevention. Optimizing results and lowering the frequency of stroke-related complications in diabetics requires multidisciplinary care. The intricate interactions between diabetes mellitus and stroke are highlighted in this review’s conclusion, which also highlights the value of patient education, risk factor treatment, the effect of antidiabetic therapy on stroke, and integrated care in lowering the incidence of stroke in people with diabetes.
Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
Authors: Hau Koo Thai , Mafauzy Mohamed , Bin Leong Xue
Published: July 2024

Type 2 diabetes mellitus (T2DM) significantly increases the risk of cardiovascular diseases. Despite advances in glycemic control, managing cardiovascular risk remains a critical challenge. This systematic review aims to assess and compare the cardiovascular outcomes associated with three classes of antidiabetic medications: sulfonylureas, Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with T2DM. A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed, Embase, Cochrane Library, and Google Scholar, were searched for relevant studies published between 2019 and 2023. Inclusion criteria were adults (≥18 years) with T2DM, studies assessing cardiovascular outcomes with the specified medications, randomized controlled trials, observational studies, or meta-analyses. Two independent reviewers performed data extraction and risk of bias assessments. From the initial 1,543 records, 12 studies were included involving 61,534 patients. As a result, GLP-1 RAs demonstrated favorable cardiovascular safety and efficacy, particularly in reducing major adverse cardiovascular events and all-cause mortality. DPP-4 inhibitors were associated with neutral cardiovascular outcomes but indicated an elevated risk of cardiac failure in some studies. In recent studies, sulfonylureas, previously associated with cardiovascular concerns, showed no consistent evidence of increased cardiovascular risk. These findings highlight the importance of personalized treatment strategies to optimize cardiovascular outcomes in patients with T2DM.
A Retrospective Analysis of Postpartum Adherence to Follow-up in High-risk Obstetric Patients in Primary Care
Authors: Corral Guilherme , Harb Crystel , Lodhra Zara , Turner Amanda , Parker Erin , Thackeray Bridget , Van De Putte Nichole
Published: July 2024

Background and Objectives:

Texas is a state with a well-documented statistical rate of the nation’s highest maternal mortality rates. Maternal mortality has a multiplicity of risk factors including gestational complications, not limited to diabetes mellitus, hypertension, and preeclampsia. The high-risk obstetrics (HROB) initiative was created at CommuniCare Health Centers in San Antonio, TX, to provide resources to obstetric (OB) patients identified as high risk for perinatal and postpartum complications. The goal of this analysis is to assess the consistency with which HROB patients enrolled present to the first and second OB postpartum follow-up visits and subsequently family medicine follow-up visits.

Methods:

The patients were enrolled in this initiative based on a criterion for being considered high risk for obstetrical complications including hypertensive disease, preeclampsia, eclampsia, and diabetes mellitus. One hundred ninety-two patient charts were reviewed and 180 were included in this retrospective analysis.

Results:

A multivariate analysis revealed that an adjusted odds ratio for postpartum follow-up among HROB patients was 1.65 (95% confidence interval = 0.71–3.83). A positive trend was observed for HROB patients’ OB postpartum follow-up visits, whereas a negative trend was observed for family medicine postpartum follow-up visits.

Conclusion:

Prevention strategies aimed at reducing postpartum loss to follow-up identified in this study could promote better health outcomes among HROB patients in San Antonio, TX.
Diagnosis of Body Fluids Using a Combined Approach of Cytomorphology in Routinely Stained Smears and Cell Blocks: A Boon for Primary Health Care in this Era of Molecular Medicine!
Authors: Mandal Aindrila , Ayub Arshad , Mukherjee Mala , Sinha Ranwir Kumar , Kumar Nikhil , Lakra Prima Shuchita , Roy Asitava Deb
Published: July 2024

Accurate diagnosis of cells as reactive or malignant mesothelial cells in body fluids is a common problem. The limited sensitivity of cytodiagnosis in effusions primarily results from unclear morphological details of cells, cell overcrowding or overlapping, cell loss, and changes caused by diverse laboratory processing techniques. Numerous studies have observed that despite meticulous preparation, cytological assessments of fluid through smears often leave substantial unexplored residue, potentially harboring valuable diagnostic information. The unexplored residue can be easily and pragmatically assessed using the cell block method, where it is embedded in paraffin and examined alongside routine smears. Cell blocks prove especially beneficial when conventional cytological smear methods fall short in providing accurate diagnoses, as seen in cases such as reactive mesothelial cells, or when findings are ambiguous, as in occasional well-differentiated adenocarcinoma. The present study reviews the usefulness and benefits of cell block method in cyto-diagnosis of body fluids and highlight the importance of ancillary techniques such as immunohistochemistry (IHC) in improving the sensitivity of diagnosis. It was observed that isolated use of conventional smear misses the diagnosis when there is cell overcrowding, low cellularity, and deranged morphology. Hence, with the application of a simple cell block technique with or without ancillary techniques such as IHC, we can provide a quality report for better patient outcome even at the level of primary health care.
Acquired Spur-Like Bony Growth Over the Previous Fibulectomy Site Following the Management of Both Bone Leg Fracture Nonunion: A Case Report
Authors: Dharmshaktu Ganesh Singh , Dharmshaktu Ishwar Singh , Yadav Krishna Dev Singh
Published: July 2024

Exophytic bony outgrowths have many differential diagnoses, with osteochondroma being the most common. The de novo development of a well-defined bony growth over the location of a previous surgery is a rare occurrence. Here, we describe a case of gradual development of a small bony exophytic lesion over the fibula diaphysis as a delayed complication of the previous fibulectomy. The index surgical procedure of fibulectomy was coupled with bone grafting at the tibial nonunion site following failed conservative management of the tibia fracture. The tibia fracture eventually united after the bone graft procedure. However, there was a gradual development of the aforementioned bony outgrowth noted in serial radiographs at the site of the previous fibulectomy. The growing lesion was also palpable on deep palpation over the corresponding site, and the excision of the lesion revealed a solid bony mass. Histopathology showed the lesion to be composed of mature bony tissue without any evidence of a cartilage cap. No recurrence or complication was noted in the fourteen-month follow-up. The diagnosis of an acquired exostosis was established based on clinical, radiological, and histopathological evaluation.
Arthroscopic Ankle Arthrodesis in Post-Traumatic Ankle Arthritis with Compromised Soft Tissue: A Case Report
Authors: Regmi Anil , Meena Pradeep Kumar , Niraula Bishwa Bandhu , Aditya K.S. , Bansal Shivam , Maheshwari Vikas K. , Karn Rahul , Bondarde Parshwanath Ajit Kumar
Published: July 2024

Introduction:

The most common surgical treatment for end-stage ankle arthritis remains ankle arthrodesis. Dealing with the site of an incision in the ankle with poor soft tissue condition poses a challenge. The procedure of choice in cases of poor soft tissue condition around the ankle following an open ankle fracture remains questionable. This report presents a case of post-traumatic ankle arthritis with compromised soft tissue status. The patient was managed with arthroscopic ankle arthrodesis, taking into account the condition of the soft tissue.

Case Report:

A 25-year-old presented with advanced arthritis in the right ankle and compromised soft tissue condition. Arthroscopic ankle arthrodesis was performed, taking into account the poor soft tissue condition, where the soft tissue healing after the incision is expected to be poor, and sutures of the arthroscopic portal site were removed at the two-week follow-up, after adequate healing of the surgical site.

Conclusion:

Arthroscopic ankle arthrodesis is a preferred procedure for post-traumatic ankle arthritis with compromised soft tissue. However, in cases of ankle arthritis associated with gross deformity requiring ankle arthrodesis and additional deformity correction, open ankle arthrodesis may be superior to arthroscopic ankle arthrodesis.
Transosseous Suture Fixation in Quadriceps Rupture: A Surgical Technique and a Case Report
Authors: Regmi Anil , Niraula Bishwa Bandhu , Aditya K. S. , Maheshwari Vikas , Jayakrishnan Pranav , Meena Pradeep Kumar , Karn Rahul , Bondarde Parshwanath
Published: July 2024

Background:

An important goal of surgical treatment of the quadriceps or patellar tendons is to provide sufficient strength for performing range-of-motion exercises soon after surgery. A popular treatment for repair of acute quadriceps tendon rupture is to insert sutures through patellar bone tunnels, which yields good to excellent results in most cases.

Objective:

We report the case of quadriceps tendon rupture in a young male, his radiological findings, intervention received, and the review of relevant literature as well as outcomes.

Case Presentation:

A 29-year-old obese man presented with a 10-day-old quadriceps rupture, which was repaired with transosseous patellar fixation. A 6-month follow-up revealed a satisfactory clinical and functional outcome.

Discussion and Conclusion:

Repair of acute quadriceps tendon tear repair by passing sutures through patellar bone tunnels is a popular and successful technique to preserve the knee extensor mechanism and to provide sufficient strength for range-of-motion exercises.
Management Outcome of an Open Intertrochanteric with Associated Neck of Femur Fracture: A Rare Case Series
Authors: Kaganur Raghavendra , Regmi Anil , Paul Nirvin , Niraula Bishwa Bandhu , Sarkar Bhaskar , Azam Quamar , Khan Moin , Maheshwari Vikas
Published: July 2024

Introduction:

Intertrochanteric hip fractures are rare in young adults due to numerous soft tissue around the bone in the proximal femur. These fractures present a significant challenge for orthopedic surgeons in managing soft tissues, fracture reduction, fixation, and maximizing functional outcomes. Treatment of such injuries aims to prevent infection and achieve stable fixation and fracture union while reducing pain.

Objective:

This paper aims to present the series of open proximal femur fractures successfully managed with delayed intramedullary fixation, with a satisfactory functional and radiological outcome.

Materials and Methods:

Patients with an open proximal femoral fracture from Jan 2021 to Jan 2023 were evaluated retrospectively. Primary debridement was done at the earliest, and once the wound healed around 10–14 days later, definitive internal fixation by cephalo-medullary nailing was done. Patients were followed regularly at monthly intervals for 3 months, then every third month till the last follow-up at the end of 1 year to assess functional and radiological outcomes.

Results:

Three male patients with a mean age of 36 years with AO type 31A2.3 fracture were presented at a mean duration of 4 h, where primary debridement was done at a mean interval of 3.67 h from presentation, and the mean duration of definitive fixation was noted to be 12 days. Fracture union was noted at a mean interval of 26 weeks. There was no evidence of osteonecrosis of the femoral head after union. At the final follow-up, all patients had a VAS of 2/10 and a mean HHS of 82.6.

Conclusion:

In open intertrochanteric with the neck of femur fractures, delayed cephalomedullary fixation after aggressive primary debridement and after soft tissue recovery helps to decrease the risk of infection and provides the advantage of early mobilization and favorable functional and radiological outcomes.
Socioeconomic Impact of Injury-Related Amputations In Terms of Disability-Adjusted Life Year: Observational Study from a level-1 Trauma Center in Hilly Terrain
Authors: Yadav Arvind Kumar , Regmi Anil , Sarkar Bhaskar , Kumar Ajay , Uniyal Madhur , Azam MD Quamar
Published: July 2024

Background:

Trauma has been attributed as a major cause of amputation in developing countries. It has considerable effects on the emotional and psychological states of individuals. In this study, we used disability-adjusted life years (DALY) and SF-12 score to analyze the impact of amputation on disability status and wellbeing of patients undergoing amputation. Our hypothesis was that victims of traumatic amputation, often being from the younger age groups, may exhibit specific patterns in these indicators.

Materials and Methods:

The study was conducted between June 2020 and May 2022 at a level-1 trauma center. Data were collected retrospectively from the hospital records and by telephonic conversation with patients. Patients who underwent amputation due to accidental causes were included in the study. DALY and SF-12 scores were calculated at 1-year follow-up.

Results:

The total number of amputations performed during the specified period was 161. After considering the exclusion criteria, 104 patients were included for data analysis. The mean age of patients was 38.26 ± 17.9 years. The mean of DALY among amputation cases as a result of accidents was 9.16 ± 4.9. The mean SF-12 score was 79.6 ± 7.1.

Conclusion:

Amputation due to accidents including road traffic injury results in considerable loss of years with disability (DALY), as most of the cases belong to the productive age group. It also has adverse effects on physical as well as mental aspects of health. Hence, holistic preventive and rehabilitative measures are the need of the hour.
Malaysian newspaper coverage of the 2012 and 2016 Olympic Games
Authors: Cheong Jadeera Phaik Geok , Chew Elsa , Razman Rizal , Khoo Selina
Published: July 2024

Background:

The Olympic Games, as a major global sporting event, have received extensive media coverage. However, there is no published study on the media coverage of Malaysian newspapers in the Games.

Aims and Objectives:

The purpose of this study was to analyze and compare the newspaper coverage of the 2012 and 2016 Olympic Games across four English-language Malaysian newspapers.

Methodology:

The primary objective of this research is to scrutinize all articles and photographs published from the opening day to the closing ceremony of the Olympic Games. Various factors considered in the analysis include the frequency of coverage, total number of articles and photographs, size of articles and photographs, nationality, gender representation, and article placement. The sample for this study includes Malay Mail, New Straits Times, The Sun, and The Star. Data collection involved gathering articles and photographs published during the specified time frame of the Olympic Games. The collected data were then analyzed using quantitative methods to determine trends and patterns in newspaper coverage. This study utilized a summative content analysis method to determine and compare the frequency, amount, and size of newspaper coverage.

Results:

The findings indicate a decline in overall coverage from 3,009 articles in 2012 to 2,783 articles in 2016. Additionally, there was a decrease in the size of news articles, from 33,422.823 square inches in 2012 to 30,670.271 square inches in 2016. However, the size of photographs increased substantially in 2016 compared to 2012, rising from 24,349.514 square inches to 40,254.556 square inches. Most of the coverage was concentrated on the sports pages, with only 14% of articles in 2012 and 4% in 2016 featured on the front page. In terms of gender representation, males were prominently featured over females in both 2012 and 2016. Additionally, there was a higher prevalence of articles and photographs showcasing foreign nationals compared to Malaysians in both years.

Conclusion:

The study reveals significant differences in the newspaper coverage of the Olympic Games between 2012 and 2016 in Malaysian newspapers. These findings provide valuable insights into the media portrayal of the Olympics and contribute to a better understanding of the role of newspapers in shaping public perception of sporting events. To our knowledge, this is the first data on Malaysian newspaper coverage of the Olympics. Most articles were published in the sports sections, and the average size of articles and photos was larger compared to other countries. There were more articles featuring male subjects than female subjects, with males receiving more coverage overall. Additionally, there was more coverage of foreign athletes compared to Malaysians. Future research could explore the bias in reporting gender and nationality in Malaysian English-language newspapers.
Overcoming the challenges of cataract blindness in Nigeria: An action plan for ophthalmologists
Authors: Ayorinde Olutoke O. , Olusanya Bolutife A. , Bekibele Charles O.
Published: July 2024

Purpose:

The purpose of this study was to explore the eye care provider factors responsible for low cataract surgical rates (CSRs) in Nigeria and to develop an action plan to boost the CSR.

Methods:

This was a cross-sectional survey of ophthalmologists practicing in Nigeria. An online questionnaire was distributed via E-mail and social media platforms to respondents. Data collected included sociodemographic characteristics, type, and location of the eye hospital where respondents practiced, cataract surgeries performed monthly, frequency and type of outreach activities by the eye hospitals, barriers to uptake of cataract surgery at the hospitals, and suggestions on measures to overcome such barriers. Statistical analysis was done using IBM-SPSS version 20, and the level of significance was P < 0.05.

Results:

A total of 201 ophthalmologists responded to the survey. Majority (88.0%) were practicing in university or government hospitals while only 8 (4.0%) were working in mission hospitals. The average monthly cataract surgeries performed per hospital ranged from 0 to 600, with a median of 30 surgeries. Mission hospitals were more likely to perform ≥50 cataract surgeries per month compared to other hospitals (P = 0.003). Majority (75.1%) of hospitals organized outreach activities to identify cataract patients. Higher frequency of outreach activities (P = 0.028) and combining surgery with screening (P = 0.036) were associated with a higher likelihood that the cataract patients that were identified received surgery.

Conclusion:

The conduct of frequent outreach activities in which eye screening and cataract surgery are combined should boost CSRs and reduce the burden of cataract blindness in Nigeria.
Prevalence of elevated blood pressure and hypertension and its associated factors among children attending high schools in a rural panchayath of Kerala
Authors: Elipparakkal Najla , Ouseph Jose
Published: July 2024

CONTEXT:

Hypertension (HTN) in childhood and adolescence causes premature atherosclerosis and early cardiovascular disease. Although asymptomatic, they may have target organ damage. In 2017, the American Academy of Pediatrics updated the Clinical Practice Guideline for screening and managing high blood pressure (BP) in children and adolescents. However, no published studies from India have utilized this updated criterion for pediatric HTN. The coronavirus disease of 2019 (COVID-19) pandemic forced many children to spend long hours indoors, with increased exposure to digital devices and decreased physical activity. Hence, this study was done to assess the prevalence of HTN among children and to find associated risk factors.

AIMS:

This study aimed to determine the prevalence of elevated BP and HTN among children attending high schools of a rural panchayath in Kerala, to evaluate the anthropometric and epidemiological factors associated with elevated BP among them, and to find the prevalence of obesity among these children.

SETTINGS AND DESIGN:

This is a school-based cross-sectional study conducted among students attending high schools in Ambalappuzha North panchayat of Alappuzha, Kerala.

MATERIALS AND METHODS:

The study was conducted over 9 months from November 2022 to July 2023. Consent was requested from parents of all children (N = 847) studying in high schools. Children who provided assent and met the inclusion–exclusion criteria were enrolled (N = 576). Data were collected using a pre-validated semi-structured questionnaire. Children were interviewed about their lifestyle, including physical activity, sleep, diet, and exposure to smoking. Height and weight were recorded, and body mass index (BMI) was calculated. BP was measured using a digital oscillometric apparatus (OMRON HEM 7143T1A).

STATISTICAL ANALYSIS USED:

Data were analyzed using Statistical Package for the Social Sciences version 16 software.

RESULTS:

The study population comprised 345 boys and 231 girls. Elevated BP affected 12.3%, while stage I HTN affected 0.7% of the screened children. Additionally, 16% of the screened children were overweight, 8% were obese, and 7.5% were undernourished. The prevalence of abnormal BP (elevated BP + HTN) was 10.3% among children with normal BMI, 18.47% among overweight. and 26.08% among obese children.

CONCLUSIONS:

Elevated BP, HTN, obesity, and overweight are prevalent among adolescent children in Ambalappuzha North Panchayath, a rural coastal area. High BMI correlates with elevated BP and HTN and should be the focus of interventions.
Comparison of two dosage regimens of iron in preterm infants for the prevention of iron deficiency: A prospective interventional study
Authors: Asha S. , Anand M.R. , Remesh Preetha , Vishnu Mohan P.T.
Published: July 2024

BACKGROUND:

The majority of infants born <32 weeks of gestation develop anemia. The cause depends on multiple factors, most common being iron deficiency. Iron being a major nutrient, its deficiency may lead to irreversible neurodevelopment and cognitive impairment and overdose lead to neurodegeneration and gastrointestinal intolerance. Although the need for iron and outcome of iron deficiencies has been studied much, valid studies pertaining dosage for prevention of iron deficiency in preterm infants are insufficient.

OBJECTIVE:

To compare two dosage regimens of iron for the prevention of iron deficiency among preterm infants born <32 weeks at 6 weeks of chronological age.

MATERIALS AND METHODS:

A prospective interventional study performed in a level III neonatal intensive care unit. A total of 64 infants with <32 weeks of gestation were studied, were classified into two grouped, and initiated with iron at two different doses (2 and 4 mg/kg/day). The preintervention and postintervention hemoglobin and serum ferritin were compared at 6 weeks of chronological age.

RESULTS:

Of the 32 babies with iron initiated at 2 mg/kg/day, 21 babies had low hemoglobin level and 11 babies had normal hemoglobin level, and 10 babies had low ferritin level and 22 babies had normal ferritin level.

Of the 32 babies with iron at 4 mg/kg/day, all babies had normal hemoglobin and ferritin levels.

Conclusion:

The incidence of anemia is lower in the infants receiving iron at 4 mg/kg/day compared with infants receiving iron at 2 mg/kg/day.
OPIN-ITP: Optimized Physics Informed Network with Trimmed Score Regression Based Insider Threats Prediction in Cloud Computing
Authors: Gayathri B.
Published: July 2024

INTRODUCTION: Insider threats are a major issue for cyber security. In contrast to external attackers, insiders have more privileges and authorized access to data and resources, which can cause an organization great harm. To completely understand an insider's activities throughout the organization, a more sophisticated method is needed.
OBJECTIVES: Based on an organization's login activity, this study proposes a novel conceptual method for insider threat detection. Behavioural activities such as HTTP, Email and Login details are collected to create a dataset which is further processed for pre-processing using data transformation and Trimmed Score Regression (TSR).
METHODS: These pre-data are given to the feature extraction process using Deep Feature Synthesis (DFS) extraction. The extracted data are fed to Physics Informed Neural Networks (PINN) for insider threat detection.
RESULTS: The prediction process of PINN was improved through optimally choosing parameters such as learning rate and weight using Hunter-prey Optimization (HPO). The proposed model offers 68% detection rate, 98.4% accuracy, 5% FDR, 95% F1_score and 0.7005 sec execution time.
CONCLUSION: Observed outcomes are compared to other traditional approaches of validation. The contrast with traditional approaches shows that the proposed model provides better outcomes than in traditional models and is therefore a good fit for real-time threat prediction.
К вопросу о допустимости мирового соглашения в публично-правовых спорах
Authors: Семенов К.Е.
Published: July 2024

НАСТОЯЩАЯ СТАТЬЯ ПОСВЯЩЕНА ПРОБЛЕМАТИКЕ ЗАКЛЮЧЕНИЯ МИРОВОГО СОГЛАШЕНИЯ ПО ДЕЛАМ ПУБЛИЧНО-ПРАВОВОГО ХАРАКТЕРА. НА ОБСУЖДЕНИЕ СТАВЯТСЯ ДВА ВОПРОСА: (1) О ПУБЛИЧНЫХ СПОРАХ, ПО КОТОРЫМ В СИЛУ ИХ ПРИРОДЫ В ПРИНЦИПЕ МОГУТ БЫТЬ ЗАКЛЮЧЕНЫ МИРОВЫЕ СОГЛАШЕНИЯ, И (2) О ЗАКРЕПЛЕНИИ ПОЛНОМОЧИЙ АДМИНИСТРАТИВНЫХ ОРГАНОВ НА ЗАКЛЮЧЕНИЕ МИРОВЫХ СОГЛАШЕНИЙ. АВТОР ПРИХОДИТ К ВЫВОДУ, ЧТО ДОПУСКАЕТСЯ ЗАКЛЮЧЕНИЕ МИРОВЫХ СОГЛАШЕНИЙ ПО ДЕЛАМ ОБ ОСПАРИВАНИИ НЕНОРМАТИВНЫХ ПРАВОВЫХ АКТОВ, ВЗЫСКАНИИ ОБЯЗАТЕЛЬНЫХ ПЛАТЕЖЕЙ И САНКЦИЙ И ДЕЛАМ ОБ АДМИНИСТРАТИВНЫХ ПРАВОНАРУШЕНИЯХ, А ПОЛНОМОЧИЯ НА ЗАКЛЮЧЕНИЕ МИРОВЫХ СОГЛАШЕНИЙ У АДМИНИСТРАТИВНЫХ ОРГАНОВ ИМЕЮТСЯ В СИЛУ ПОЛОЖЕНИЙ АПК РФ, ПОЭТОМУ НЕТ НЕОБХОДИМОСТИ В СПЕЦИАЛЬНОМ УКАЗАНИИ НА ЭТО В МАТЕРИАЛЬНОМ ЗАКОНОДАТЕЛЬСТВЕ. КРОМЕ ТОГО, АВТОРОМ ПРЕДЛАГАЕТСЯ АЛЬТЕРНАТИВНАЯ РЕДАКЦИЯ СТ. 190 «ПРИМИРЕНИЕ СТОРОН ПО СПОРАМ, ВОЗНИКАЮЩИМ ИЗ АДМИНИСТРАТИВНЫХ И ИНЫХ ПУБЛИЧНЫХ ПРАВООТНОШЕНИЙ» АПК РФ.
Reconstruction of Half of the Forehead Traumatic Defect with Single Rotation Flap and Hemi-Brow Transposition in a Resource Constrained Setting: A Case Report
Authors: Maduba Charles Chidiebele , Nnadozie Ugochukwu Uzodimma
Published: July 2024

Forehead reconstruction is very challenging due to limited availability of matching skin for coverage. This is even more challenging in acute traumatic events characterized by gross contamination, presence of open wounds and injury to surrounding tissues. The use of loco-regional flap option may be the only available resort where facility and expertise for free flaps are not adequate. We present a 50 year old lady that had traumatic avulsion of slightly over half of the forehead with an extension wound to the ipsi-lateral temporal region following road traffic accident. There were crushing of ipsi-lateral eye and periosteal stripping of the underlying bone. She had an immediate flap cover after resuscitation using a single rotation scalp flap based on the ipsi-lateral occipital, posterior auricular and superficial temporal arteries. The adjoining temporal region wound was covered with split-thickness skin graft. She had excellent flap survival and satisfactory graft take. We observed that this flap could be successfully used in the setting of trauma to transfer a like for skin in the setting of trauma. This is especially useful in resource constrained setting where free tissue transfer is still insufficiently used.

Keywords: Periosteal stripping, Rotational scalp flap reconstruction, Traumatic forehead avulsion
Creer en el mundo con el cristal actual-virtual, entre la ontología y los estudios de cine de Gilles Deleuze
Authors: Ferreyra Julián
Published: July 2024

Este artículo hace foco en el problema de la pérdida de la creencia del mundo, que Gilles Deleuze plantea en sus estudios sobre cine, a partir de uno de los temas ontológicos más perdurables en toda su obra: el par conceptual actual-virtual. Para ello, ponemos en relación la forma en la cual estos conceptos son expuestos y problematizados en Diferencia y repetición y cómo reaparecen en La imagen-movimiento (señalada por Deleuze como de carácter actual) y La imagen-tiempo (marcada por su virtualidad). A partir de este prisma, presentamos una perspectiva en el debate de los estudios deleuzianos sobre la relación actual-virtual, que cuestiona tanto la prioridad virtual como la relación de mediación entre los planos (sea en su versión clásica o sofisticada), para volcarnos a un vínculo de coalescencia para cuya conceptualización aunamos los recursos teóricos del cristal del tiempo con los del envolvimiento de la Idea y la intensidad. En esa coalescencia es posible comprender de qué manera el plano virtual, lejos de emplazarnos fuera del mundo, nos permite según Deleuze volver a creer en él.
¿Quién cuida el jardín?: Cuidado humanizador de los cimientos individuales y sociales ante el impacto de las tecnologías digitales
Authors: Peñarrubia Carrión Juan-Pablo
Published: July 2024

En el dominio del cuidado y la tecnología se realizan principalmente investigaciones sobre la aplicación de la tecnología al cuidado en campos o afectados específicos. En este artículo se aborda una perspectiva diferente analizando algunos efectos colaterales de las tecnologías digitales que debilitan elementos considerados sistémicos a nivel individual y social como: la privacidad y la autonomía personal; la función social de los medios de comunicación; la dinámica social deliberativa; la necesidad de orientar la regulación de las tecnologías digitales al impacto personal y social; la capacidad de atención y reflexión de las personas.
Se propone el nuevo ámbito del cuidado de los cimientos sistémicos individuales y sociales ante el impacto de las tecnologías digitales con objeto de preservar su esencia humanizadora y la sostenibilidad de la sociedad abierta democrática que conocemos.
MANAGEMENT OF SIDHMA KUSTA: A CASE STUDY.
Authors: Patil Naveenkumar , H G Yogesh
Published: July 2024

Psoriasis is an immune mediated disease with an unclear cause that is characterised by inflammation caused by Dysfunction of the immune system. Psoriatic plaque shows epidermic hyperplasia. Erythrodermic psoriasis is an acute condition in which almost all body surface is inflamed. This study is to show better management through ayurvedic treatment. In this case, a 35-year-old male patient diagnosed with erythrodermic psoriasis all over body predominantly on hands which is accompanied by erythema, dry, thin scaly lesions and itching. The condi-tion managed by Snehana(oleation), Pitta rechana(purgation), internal medicines, external application with Taila which is given according to avasthanusara(stage wise).
Observation and results: The outcome is positive, significant in terms of reduction of erythema, itching, scales, dryness and healing of lesions produced noticeable improvement. Ayurvedic principles provide great im-provement in signs and symptoms and increase the quality of life in the treatment of psoriasis.
ASSIMILATED EVALUATION OF PLANT GROWTH-PROMOTING RHIZOBACTERIA ON SEED-BORNE MYCOFLORA AND SEED VIGOUR ASSOCIATED WITH COMMERCIAL VARIETIES OF WHEAT (TRITICUM AESTIVUM L.)
Authors: Sharif Shama
Published: July 2024

Among all cereal crops, wheat is the most important staple food globally and in Pakistan. In this study, two parameters, mainly the effect of PGPR inoculation on seed germination, emergence and overall seed vigour under different temperature conditions and wheat associated seed-borne mycoflora in 10 commercial wheat cultivars, were investigated. A temperature of 20 °C was found to be more effective than 15 °C and 25 °C, which showed maximum seed germination and seed vigour. Ojala 2016 and Johar 2016 were found to have 100% germination percentage at 20 °C in seeds inoculated with a dual bacterial inoculum. Ojala 2016 in dual inoculation (PGPR 2) experiment had maximum shoot and root length (5.67cm and 8.07cm). Seed-borne mycoflora associated with 10 varieties of wheat were examined through the blotter paper method and agar plate method. Eleven fungal species were isolated and identified from seeds. Fungal species were identified using microscopic identification techniques. Agar plate method was found to be most efficient for fungal isolation. Fungal incidence was higher in unsterilized seeds than sterilized seeds. Most frequently occurring fungal species were Penicillium (46%, 43%) and Aspergillus niger (40%, 56%) in sterilized and unsterilized treatments of blotter paper. In agar plate method, Penicillium (76%, 76%) and A. niger (70%, 83%) were frequently occurring species. Sahar 2008 and Aas 2011 showed maximum contamination among all ten varieties of wheat. This experiment concluded that PGPR have the potential to boost plant growth and enhance the vigour of seed germination.
Pengaruh Terapi Musik Terhadap Penurunan Kecemasan: Tinjauan Literatur
Authors: Naibaho Amelia Elisabeth , Fadhila Filza , Daulay Wardiyah
Published: July 2024

Kecemasan merupakan suatu keadaan yang dapat diakibatkan oleh beberapa faktor, baik internal maupun eksternal. Kecemasan dapat berdapak negatif bagi individu. Kecemasan dapat ditangani dengan beberapa terapi salah satunya ialah terapi musik. Terapi musik berperan dalam pelepasan perasaan individu pada masalah emosional, memunculkan suasana hati yang positif, membantu pemecahan masalah, dan memperbaiki konflik pribadi. Penelitian ini dilakukan dengan menggunakan metode Literature Review. Pencarian literatur dilakukan terkait dengan Pengaruh Terapi Musik Terhadap Penurunan Kecemasan berikut : Science Direct, Google Schoolar, dan PubMed. Pencarian terkait judul dibatasi rentang waktu  dari tahun 2019-2023. Pada dasarnya, musik dapat bersifat preventif dalam usaha penyembuhan terhadap penderita yang mengalami sosial emosional maupun mental intelegensi serta sebagai intervensi non-farmakologi bagi perawat dalam merawat pasien agar tidak terlalu cemas.
Woolly hair generalizado: caso clínico e revisão da literatura
Authors: Lustosa Leticia de Melo , Martins Beatriz Mendonça , Junqueira Laura Magalhães , Alvarenga Ana Luísa Narciso Caetano
Published: July 2024

Introdução: O cabelo lanoso é um distúrbio inato incomum do esqueleto do couro cabeludo caracterizado por ser excessivamente ondulado, com amplitude média de até 0,5 centímetro, taxa de crescimento habitual, porém com etapa anágena incompleta, resultando em cabelos mais curtos. Pode ser classificado em quatro tipos e pode aparecer como sinal de uma comorbidade sistêmica, reconhecido como síndrome do cabelo lanoso ou não: cabelo lanoso não sindrômico.  Se difere das madeixas crespas dos negros, pois geralmente se fundem. Objetivo: Este artigo objetiva uma revisão da literatura médica acerca do tema Woolly hair generalizado e seus tratamentos, disponíveis a pacientes,  Materiais e métodos: Síndrome de Woolly Hair Generalizado, e devido à raridade do caso, que foi submetido e revisão de literatura nas bases de dados PubMed, Medline e Scopus, Scielo, Anais de dermatologia. Resultados e discussão: Apesar de ter sido descrita primariamente em uma família europeia, em 1907; atualmente, a população japonesa é a que mais se relaciona aos casos dessa comorbidade, seja como alteração genética autossômica recessiva ou dominante e principalmente quando se trata de genes com variantes heterozigóticas compostas. Considerações finais: De acordo com estudos e pesquisas, não há terapêuticas eficientes para o tratamento da comorbidade citada; no entanto, existem narrativas que defendem a ideia de que Minoxidil tópico auxilie na hipotricose.
Alopecia Areata: revisão e atualização
Authors: Albuquerque Lara Prata Silva , Leal Luiza Mousquer , Gelinski Anelisy , Cadore João Pedro , Camara Joao Pedro Carrijo Cunha
Published: July 2024

Introdução: Alopecia areata é uma doença crônica imunomediada que atinge os folículos capilares anágenos e causando queda de cabelo sem cicatrizes, podendo afetar não apenas o couro cabeludo, mas, também, qualquer área com cabelo no corpo como sobrancelhas, cílios e extremidades. Esta condição pode ser dividida em três categorias: alopecia areata irregular, forma mais comum, AA totalis - (perda completa de cabelo no couro cabeludo) e AA universalis (perda completa de cabelo no couro cabeludo e no corpo). Objetivo: Por ser um tema em constante atualização e novas pesquisas relacionadas, torna-se necessária revisão e atualização constante em relação a Alopecia Areata, principalmente em sua etiopatogenia e tratamento, tópicos mais estudados atualmente. Materiais e métodos: Para a elaboração deste artigo de revisão, foram consultados artigos científicos e artigos de revisão publicados e referenciados na Medline/PubMED, entre 2023-2024, listando a atualizações e revisões sobre a alopecia areata. A pesquisa dos artigos foi realizada, genericamente, com a filtragem Alopecia Areata. Resultados e discussão: A alopecia areata é uma doença de etiologia multifatorial e fisiopatologia complexa, requerendo grande atenção para seu quadro clínico variável e prognóstico reservado e individual. O tratamento deve respeitar a evolução da doença de cada paciente, assim como sua resposta terapêutica e psicossocial, visando sempre a redução dos danos sistêmicos e socioeconômicos. Considerações Finais: As formas simples e localizadas dessa patologia podem ser autolimitadas ou respondem a tratamento com corticoides tópicos ou injetados localmente mediante a procedimentos denominados de infiltrações. Já quando abordamos formas mais graves da doença, temos um difícil tratamento e um prognóstico mais reservado, sendo o uso de imunoterapia tópica uma grande ferramenta para o tratamento, com bons resultados.