bluuebunny/crossref_metadata_2025 huggingface dataset:
RECOGNITION OF A LANDSCAPE TECHNO-SPHERE AS A NEW GEOSPHERE
Authors: Lavryk О. , Tsymbaliuk V. , Poshtaruk L.
Published: March 2023

The second half of XX century – the beginning of XXI century are characterized by  the  active development of a global ecological crisis, which  is  described  by  a  critical  state  of  the  environment and excessive  anthropogenization  of  a geographical  sphere. The  changes  which  lead  to  the formation of absolutely new techno-genic landscapes occur at very fast rates in current geo-spheres. The purpose of the work is to substantiate the recognition of a new geo-sphere – a landscape techno- sphere – based on the previous experience and our field research. The main tasks of the research are to analyze specific features and properties of a landscape techno-sphere; to identify its upper and lower borders; to study a structural organization of all options of a landscape sphere with available techno-substances; to characterize briefly the main stages of the development of a techno- sphere.

The research of a landscape techno-sphere is a complicated process and it is based on the use of classical and innovative methodological principles of contemporary geography. A parallel application of three scientific paradigms is the foundation: system, model and ecological. They do not contradict each other; they rather compliment the studying of the interaction between nature and engineering. A system approach allows considering a techno-sphere as a complicated system of a lower taxonomic range of a landscape sphere and a geographical sphere. The following generally accepted scientific methods are used in the paper: analysis, synthesis, comparison, generalization, systematization, induction and deductions.

The article substantiates the existence of a new geosphere – the landscape techno-sphere, which is formed by the planetary set of landscape-technical systems. it is noted that it does not have a continuous distribution, but is constantly increasing in size and gradually goes beyond the landscape. The specific features and properties of the landscape techno-sphere are analyzed in detail. Taking into account the criterion of the presence of a zone of direct contract of three blocks of landscape-technical systems (managerial, technical and natural), the upper and lower limits of the landscape techno-sphere are identified. The structure of all variants of the landscape sphere in the presence of technological substances is considered. The main periods of development of the landscape techno-sphere are briefly described. It is concluded that man will never be able to control landscape-technical systems on a planetary scale. However, applying the methods and principles of engineering landscape research, it is possible to achieve optimal interaction of the three blocks of landscape-technical systems and to extend their functional suitability.
Hígado graso no alcohólico y consumo de fructosa: revisión y actualización de la evidencia
Authors: Gobea Alcoba Anabella , Crespi Maria Florencia
Published: March 2023

El hígado graso no alcohólico (HGNA) es actualmente una de las principales causas de enfermedad hepática crónica. Se define como la presencia de esteatosis en ausencia de otras causas de enfermedad hepática crónica y su prevalencia aumenta en todo el mundo. Se ha sugerido que existe una relación causal entre el aumento de la prevalencia de HGNA y la ingesta de edulcorantes nutritivos, en particular de fructosa. El objetivo general de esta revisión es describir la asociación entre el hígado graso no alcohólico y la fructosa en humanos. 
Se realizó una búsqueda de artículos científicos con palabras clave. Los resultados de esta revisión describen que el consumo de fructosa se ha incrementado en las últimas décadas, principalmente a partir de la ingesta de sacarosa y jarabe de maíz de alta fructosa (JMAF), edulcorante de uso común en la industria alimentaria. El consumo crónico de fructosa promueve una serie de mecanismos que aumentan la lipogénesis hepática. Esta tasa de síntesis supera la tasa catabólica de oxidación de ácidos grasos y la capacidad de exportación como VLDL, que contribuye de manera importante a los lípidos intrahepáticos en el HGNA. 
El manejo inicial del HGNA implica, principalmente, recomendaciones de alimentación como disminución del consumo de azúcares libres, patrón de dieta mediterránea y cambios del estilo de vida para lograr la pérdida de peso; sin embargo, la evidencia es limitada y se necesitan grandes estudios prospectivos y ensayos controlados que evalúen la relación entre la fructosa y el HGNA.
Sarcopenia en pediatría, un nuevo panorama: revisión narrativa
Authors: Romero Arias Sergio David , Guio Gómez Yulia Daniela , Forero Ballesteros Luis Carlos , Bahamon Ávila Marta Patricia
Published: March 2023

Introducción: la sarcopenia es una condición clínica que se caracteriza por una reducción de la fuerza y la masa muscular. El diagnóstico de la sarcopenia en edades tempranas se asocia con un mayor riesgo de padecer enfermedades metabólicas desde la niñez, lo que impacta negativamente en la vida adulta; sin embargo, el estudio de esta patología en la población pediátrica aún es limitado. Esta revisión narrativa tiene como objetivo analizar y describir la información disponible acerca de la sarcopenia en pediatría y las patologías a las que se asocia con mayor frecuencia.
Métodos: se hizo una revisión de la literatura en las bases de datos Embase, PubMed, Google Scholar y Science. Cada autor de la revisión consultó una de las bases de datos y usó las palabras clave sarcopenia, población pediátrica y el algoritmo de búsqueda: “Sarcopenia” AND “pediatric” NOT “adults”.
Resultados: la investigación indica que la presencia de la sarcopenia y las condiciones, como la hepatopatía crónica, la obesidad, la patología oncológica y la enfermedad inflamatoria intestinal, pueden asociarse con peores desenlaces, como aumento de la mortalidad, falla terapéutica y mayor riesgo de intervención quirúrgica.
Conclusión: lo hallado en la revisión demuestra la necesidad de establecer una definición y evaluación específica de la sarcopenia en la edad pediátrica. Se necesita mayor investigación de la sarcopenia en la población pediátrica.
Sarcopenia y envejecimiento saludable: reporte de caso
Authors: Calvo Higuera Isabel , Gomez Carrillo Andrea
Published: March 2023

Introducción: el envejecimiento saludable es el proceso de fomentar y mantener la capacidad funcional que permite el bienestar en la vejez. La sarcopenia es un síndrome clínico, el cual inicia en la tercera década de la vida y se acelera con el transcurso de los años, este se acompaña de un deterioro físico, fragilidad, discapacidad y dependencia de los demás; por otro lado, también afecta la adaptación metabólica al estrés y a la enfermedad. 
Caso clínico: se presenta el caso clínico de una paciente con diagnóstico de síndrome de intestino irritable y sarcopenia secundaria a la ingesta insuficiente de energía y proteína, así como al bajo rendimiento físico por disminución de la fuerza muscular. Se reporta evolución de la mejoría de la sintomatología gastrointestinal y de la composición corporal durante las primeras tres intervenciones. 
Conclusiones: la intervención nutricional temprana y oportuna permitió el alcance de los requerimientos calórico-proteicos y se presentó una mejora de la composición corporal, fuerza muscular y rendimiento físico.
Why Students Aren’t Learning What They Need for a Productive Life
Authors: Ross-Larson Bruce
Published: March 2023

The RISE program is a seven-year research effort that seeks to understand what features make education systems coherent and effective in their context and how the complex dynamics within a system allow policies to be successful. RISE had research teams in seven countries: Ethiopia, India, Indonesia, Nigeria, Pakistan, Tanzania, and Vietnam. It also commissioned research by education specialists in Chile, Egypt, Kenya, Peru, and South Africa. Those researchers tested ideas about how the determinants of learning lie more in the realm of politics and particularly in the interests of elites. They focused on how the political conditions have (or have not) put learning at the center of education systems (mostly not) while understanding the challenges of doing so. Each country team produced a detailed study pursuing answers to two central research questions: Did the country prioritize learning over access, and if so, during what periods? What role did politics play in the key decisions and how? The full studies detail their analytical frameworks, their data, and sources (generally interviews, government internal documents and reports, and other local and international publications), and the power of their assessments, given their caveats and limitations. Country summaries extract from the full studies how leadership, governance, teaching, and societal engagement are pertinent to student outcomes (see the next page). This synthesis, in line with Levy 2022, draws on the country summaries to detail the salience of goals of national leaders, alliances of stakeholders, missions of education bureaucracies, and expectations of society.
Should Communities Be Managing, Governing or Supporting Schools? A Review Essay on the System Conditions under Which Different Forms of Community Voice Can Improve Student Learning
Authors: Silberstein Jason
Published: March 2023

There are many different potential roles that parents and communities can play within education systems. This essay reviews the different ways that parents and communities can exercise their individual and collective voice within local schools. It develops a typology to distinguish between three different forms of voice, and explores the enabling conditions in the wider system that each form of voice requires to improve student learning outcomes. The dominant form of voice in many current education systems is “school management”, which is commonly exercised through school management committees. The essay diagnoses how other parts of the system – the state, the bureaucracy, and teachers - have constrained school committees into playing a limited “school management” role. Because they are generally granted circumscribed responsibilities related to the day-to-day running of the school, school management committees have failed to make consistent, significant improvements to either school accountability or student learning. “School governance” is an alternative, stronger form of voice. “School governance” entails giving parents and community members greater latitude to determine the kind of education offered in local schools, somewhat analogous to how a board sets a vision and is owed justifications against results for major decisions made by an organization’s management. This would necessitate giving school governing bodies greater responsibility over setting the curriculum and choosing school leadership. Furthermore, since parents do not always or necessarily prioritize student learning from among other competing educational goals, focusing “school governance” on learning would also require strengthening the central state’s capacity to fulfill key responsibilities such as setting and measuring progress against learning standards. “School governance” would therefore face steep political and implementation challenges, and would have to be accompanied by parallel, government-led reform to other parts of the education system. The system conditions for parents and communities to play an effective “school governance” role are exacting. “School support” is a more modest but potentially more workable form of voice in many current systems. Where “school management” and “school governance” ask parents and communities to hold local schools accountable, the “school support” paradigm emphasizes actions that individual parents and community members can take in collaboration with teachers to directly support children’s learning. However, there are many cases where more parent and community involvement is not necessarily better. Parents and community members need specific, structured opportunities that complement good teaching in the classroom for “school support” to translate into improved learning outcomes.
Sex buyers’ attitudes: A study of Toronto’s online "Escort Review Board"
Authors: Leung Rock , Gray-Beerman Mikhaela
Published: March 2023

Many recognize that people who buy sexual services create a demand for services that can lead to exploitation and harms to individuals and communities involved, but little research in the Canadian context has been published to understand these buyers. The present research sought to understand the attitudes of people who buy sex towards people who provide sex services by analyzing comments posted by Toronto Escort Review Board members between April 1 and October 31, 2021. A set of 15 comments were randomly selected for each of 6 searchable characteristics: “young” (age), “spinner” (body type), “ebony” (race), “trans” (gender), “submissive” (disposition), and “greek” (activity). This research reveals an attitude of consumerism in people who buy sex that leverages online communities 1) to select almost any type of person for a sexual experience and 2) get the support of fellow members to help them pursue a desired sexual experience. However, analyzed comments also suggest that members who buy sex generally ignore, consciously or unconsciously, possible exploitation or the impact on the welfare of the individual in the short and long term. Ongoing collaborations between Canadian law makers, the criminal justice system, and health and education sectors are needed to reduce the demand in sex services. This research shows there is much more work to do to confront the consumeristic views of people who provide sex services held by people who buy sex and combat online cultures that promote the exploitation of others.
Manual de atendimento pré-hospitalar para vítimas por arma de fogo
Authors: Carapeba Gabriel de Oliveira Lima , Silvestre Rodrigo Tadeu Rodrigues , Choji Cristiano Hayoshi , Ferro Rodrigo Sala , Rigolim Priscila Buosi Rodrigues , Filgueiras Iêda Maria Cavalli de Aguiar , Rocha Rodrigo Itocazo , Hasimoto Fabio Nishida , Maia Filho Enio Rodrigues , Molina Lina Maria Moreno , Vilela Julio Cesar Rodrigues , Camargo Milena Colonhese , Coércio Ricardo Luis , Disaró Luís Nelson , Ramos Ives Minosso de Almeida , Carvalho Vicente , Mohriak André , Bearare Sandro Christovam , Biasoli Eder , Archer Cleber Batistti , Feder Valdenir
Published: March 2023

Inicialmente registro a minha satisfação em apresentar a 2ª edição do Manual de atendimento pré-hospitalar para vítimas por arma de fogo. Essa obra foi escrita pelos autores: Gabriel de Oliveira Lima Carapeba, Rodrigo Tadeu Rodrigues Silvestre, Cristiano Hayoshi Choji, Rodrigo Sala Ferro, Priscila Buosi Rodrigues Rigolim, Iêda Maria Cavalli de Aguiar Filgueiras, Rodrigo Itocazo Rocha, Fabio Nishida Hasimoto, Enio Rodrigues Maia Filho, Lina Maria Moreno Molina, Julio Cesar Rodrigues Vilela, Milena Colonhese Camargo, Ricardo Luis Coércio, Luís Nelson Disaró, Ives Minosso de Almeida Ramos, Vicente Carvalho, André Mohriak, Sandro Christovam Bearare, Eder Biasoli, Cleber Batistti Archer e Valdenir Feder. São profissionais das mais diversas áreas, que emprestaram os seus saberes, experiências e técnicas sobre o estudo do APH, propiciando que os seus conhecimentos possam transcender e alcançar o público, de modo a treinar as pessoas para que efetivamente o APH seja aplicado no salvamento de vidas. O manual fornece conhecimento sobre procedimentos técnicos que devem ser prestados no local da emergência, bem como durante o translado da vítima, de modo a manter a sua vida estável e evitar o agravamento das lesões sofridas, para que no centro médico seja possível prestar o serviço de referência. Reconhecer uma situação de emergência, com a sua gravidade e saber prestar os cuidados imediatos necessários, certamente é salvar vidas. As ilustrações constantes na obra e as explicações são ferramentas fundamentais para o aprendizado e elucidam com clareza os procedimentos necessários. Os assuntos foram apresentados a partir de um sumário que é fiel a um desenvolvimento importante para o processo de ensino aprendizagem. Parabéns a todos os profissionais comprometidos com o salvamento de vidas.
Medicina e segurança pública: atendimento pré-hospitalar multiprofissional as vítimas de acidente de trânsito
Authors: Pereira Nathan Gabriel Patussi Linares
Published: March 2023

A Medicina exige conhecimentos teóricos e práticos não apenas ligados a ciência de Hipócrates, mas também sobre a segurança do cidadão. A presente publicação – Medicina e Segurança Pública: atendimento pré-hospitalar multiprofissional as vítimas de acidente de trânsito – tem como objetivo fornecer um material de consulta tanto para médicos como para profissionais de Segurança Pública e acadêmicos. Exporemos alguns dos principais assuntos de estudo e aplicação do Atendimento Pré-Hospitalar multiprofissional, envolvendo civis, bombeiros, enfermeiros, paramédicos, policiais e médicos. Além disso, a idealização deste livro tem como base o fornecimento do conhecimento a respeito da relação entre os direitos e deveres do médico e profissionais de Segurança Pública na manutenção da sobrevida de vítimas de acidente de trânsito, cenário ainda recorrente e preocupante em nosso país. Bem como aumentar o acervo da literatura nacional a respeito da abordagem no primeiro atendimento.
Perbandingan Filsafat Pendidikan Islam dan Filsafat Pendidikan Barat
Authors: Nuthpaturahman Nuthpaturahman
Published: March 2023

Pemikiran mendalam tentang permasalahan terkait pendidikan memiliki tujuan yang mulia yakni memperbaiki tatanan pendidikan hingga ke akar-akarnya hingga tercapai pembentukan manusia bermanfaat bagi diri sendiri, orang lain, dan lingkungannya. Catatan sejarah dalam filsafat barat semula pendidikan seluruhnya diserahkan kepada gereja yang pada perkembangannya memunculkan pemikiran dengan mengedepankan sikap proaktif yang memisahkan antara sain dan agama, hingga muncul para filsof barat dengan pemikirannya bahwa segala sesuatu yang terjadi di dunia ini adalah gerak materi yang berimplikasi bahwa dunia pendidikan adalah gerak pikiran di otak dari hasil dari peristiwa di dunia fisik. Sedang pada pemikiran Islam bahwa pendidikan berakar dari Alquran dan Hadist yang menyatukan serta mendamaikan antara sain dan agama, menjadikan nilai-nilai agama sebagai landasan dalam pengembangan ilmu pengetahuan guna mencapai puncak fitrahnya sebagai manusia hingga tercapai kebahagiaan, ketenangan, kedamaian dan keselamatan di dunia akhirat. 
Persekongkolan Tender Non Sub Kontrak dalam Perspektif Hukum Persaingan Usaha
Authors: Ikromi Eka Putri Fauzia , Chumida Zahry Vandawati , Wulandari Sinar Aju
Published: March 2023

Persekongkolan non subkontrak kerap kali terjadi pada setiap proses pengadaan barang atau jasa, persekongkolan tersebut umumnya bisa terjadi dalam tiga jenis yaitu horizontal, vertikal, dan gabungan vertikal dengan horizontal. Penyedia tertentu telah menjalin hubungan transaksional pada oknum panitia tender untuk melakukan pengkondisian proses tender. Dalam hal ini penyedia tertentu menciptakan persaingan semu. Bahwa dengan kondisi demikian ini, sangat dirasa perlu pembahasan terkait Kedudukan tender yang terindikasi persekongkolan tender non sub kontrak pengadaan barang, dan akibat hukum atas persekongkolan tender non sub kontrak pengadaan barang. Penelitian hukum normatif berupa produk perilaku hukum. Penelitian yang dilakukan berfokus pada inventarisasi hukum positif. Penetapan jenis pekerjaan utama dan pekerjaan non utma oleh PPK akan berakibat pada penentuan subkontrak, Dengan ditentukannya jenis pekerjaan dan subkontrak, setiap perbuatan yang secara sengaja dan terang-terangan melanggar ketentuan hukum makan dapat dinyatakan sebagai perbuatan melawan hukum, khusunya panitia dan para penyedia barang dan jasa dalam proses tender. UKPBJ dapat melaporkan segala bentuk indikasi perbuatan peresekongkolan tender non subkontrak kepada KPPU untuk kemudian diproses secara pidana.
Institutional environment for ensuring the sustainable development of the Russian fisheries complex and the growth of trade with the EAEU countries
Authors: Dusaeva E. M. , Kurmanova A. H. , Mukhambetov S. Z.
Published: March 2023

The purpose of the work is to study the institutional environment that ensures the sustainable development of the Russian fisheries complex and the changes that contribute to the intensification of fish and seafood trade between the EAEU countries

The methods used: monographic, statistical, scientific abstraction, logical analysis allowed us to explore the theoretical foundations of the creation of institutions and changes in the institutional environment under the influence of external factors.

Novelty: the methodological aspects of the formation of the institutional environment have been clarified and the systematization of institutional changes aimed at ensuring the sustainable development of the Russian fisheries complex and increasing the volume of fish and seafood trade with the EAEU countries has been carried out on the basis of the Technical Regulation “On the Safety of Fish and Fish Products No. (EAEU TR 040/2016), which provides for appropriate requirements for the safety and quality of products.

Practical significance: High-level use of the potential of the Russian fisheries complex and increasing the efficiency of control of trade operations with the EAEU countries in the digital environment, minimizing risks and transaction costs caused by changes in the institutional environment to ensure mutually beneficial trade in fish and seafood.
Modeling the Investment Policy of a Fishing Firm: The Case of Russian Fisheries in the Baltic Sea
Authors: Mnatsakanyan A. G. , Tomkovich A. V. , Kharin A. G.
Published: March 2023

The purpose of the paper is to improve the methodology of fisheries management by expanding the set of factors for investment decisions.

Materials and methods. Our work is a further development of the bioeconomic approach, which is based on the interdependence of natural and produced capital in fisheries. Author's solutions are based on methods of analysis and synthesis, and use the modeling of economic processes in fisheries.

Results. The paper describes a theoretical model for making investment decisions. This model is used to analyze the investment policy of the firm. The key modeling parameters used are: stock of fish resources, catch size, capital and investment. Our study showed that for this fishery, the main factor in deciding on the optimal level of investment is the ratio of the unit values of existing assets and investments.

Practical significance. Although the proposed modified model is preliminary and has a number of limitations, empirical testing allows us to draw conclusions about the possibility of using it to develop optimal production and investment decisions for a fishing company and about the advisability of continuing work in this direction.
Brief results of research on scallops off the northern Kuril Islands in autumn 2022
Authors: Botnev D. A.
Published: March 2023

The purpose of the work: to collect materials for assessing the state and dynamics of scallop stocks in the North Kuril zone, to study the spatial structure of settlements, to monitor the dynamics, distribution and composition of commercial catches in 2022.

Materials and Methods: The work was carried out on a specialized rowing vessel “Vladimir Nikora” performed 210 dredging in the area limited by coordinates 49°20'N 49°30'N. and 154°57'E154°53'E at depths of 79-170 meters. The data collection tool is an industrial scallop dredge with a working width of 3.7 m (scallop dredge 1.04 / 3.74 m). The material type of the scallop dredge bag is kapron. The length of the dredging was 0.4-0.5 miles. The research covered the water area of 23 square meters. miles. Biological analysis was carried out for 5 thousand specimens of chlamy scallops. The biological state of hydrobionts was studied according to the methods generally accepted in fisheries research. For comparability of data on the distribution of hydrobionts, the catchability coefficient of the scallop dredge was used equal to 1. The linear dimensions of the scallops were measured with an accuracy of 1 mm.

The practical significance of the research: to provide commercial and biological information materials on the total allowable catches of scallops in the North Kuril.
In memory of Kamil A. Bekyashev
Authors: Kolonchin K. V. , Glubokovsky M. K. , Bekyashev D. K. , Glubokov A. I. , Galstyan G. G. , Vaniyan S. K.
Published: March 2023

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EFFECTIVENESS OF KAGOSHIMA-DVT SCORE IN DIAGNOSING DVT IN PATIENTS PRE-OPERATIVELY
Authors: Shabana Shaik , Gouthami Bammidi
Published: March 2023

Acute DVT is a major cause of morbidity and mortality in the hospitalized patient, particularly in the
surgical patient. The triad of venous stasis, endothelial injury, and hypercoagulable state, rst posited by
Virchow in 1856, has held true more than a century and a half later. This was a hospital-based prospective study conducted at
KIMS, Amalapuram between September 2020 and June 2022.The Kagoshima-DVT score was used to diagnose DVT by
assigning 2 points for D-dimer ≥1.5 g/ml,1 point each for female sex, age ≥60 years, prolonged immobility, ongoing
glucocorticoid therapy, and cancer with high risk of DVT. They were categorised into three groups as low risk (score 0-2),
intermediate risk (3-4) and high risk (≥5) Whole leg ultrasonography was performed on them.
KNOWLEDGE, ATTITUDE AND PRACTICE ABOUT DANDRUFF AND SEBORRHEIC DERMATITIS AMONG MEDICAL STUDENTS
Authors: H M Mallikarjuna , P Manjunatha
Published: March 2023

Background: Seborrheic dermatitis is a common inammatory skin disease clinically characterized by
erythematous, scaly patches on sebaceous gland–rich sites. Seborrheic Dermatitis (SD) and Dandruff
are continuous spectrum of same disease. Dandruff is restricted to scalp, involves itchy, aking skin without visible
inammation. Objectives: This study aimed to assess knowledge, attitude and practice(KAP) about Dandruff and Seborrheic
dermatitis among Medical students. Materials and Methods: This was a cross-sectional, descriptive study conducted among
Medical students at a tertiary care centre, using a questionnaire, from May 2022 To August 2022. Scoring was done for each
questionnaire and, levels of Knowledge, attitude and practice were classied into Poor, Inadequate and Good. Results:
Questionnaire was completed and submitted by 400 medical students. Majority of the participants(84%) had experienced
Dandruff. 82.5% participants felt that the conditions cause Embarrassment. Only 40% respondents believed that Dandruff and
Seborrheic Dermatitis were continuous spectrum of same disease. Scratching(96.5%), Emotional Stress(49.5%)
,Winter(49.75%) and Western diet(51%) were believed to aggravate SD. 33.25% students were not aware of conditions'
treatment . For treatment, 46.25% Individuals preferred Home Remedies, 33% visited doctor. Antifungal shampoos(68%),
Topical keratolytics(11.5%) and Topical corticosteroids(10.75%) were preferred for Treatment . Good levels of Knowledge,
Attitude and Practice was seen in only 24.5%, 39.25% and 34.25% participants respectively. Conclusion: Majority of the
participants lacked good levels of Knowledge, Attitude and Practice, suggesting the need for implementation of additional
education about very common conditions like Dandruff and Seborrheic Dermatitis in medical curriculum
THE ANALGESIC EFFICACY OF TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK VERSUS EPIDURAL ANALGESIA IN LAPAROSCOPIC LOWER ABDOMINAL SURGERIES IN ADULTS: A CASE STUDY
Authors: Ahmed Mufassir , Wanchoo Aditi , Devi Aradhana , Har Archana
Published: March 2023

Background: The aim of the study was to compare the analgesic efcacy of epidural analgesia and
transversus abdominis plane (TAP) block in laparoscopic lower abdominal surgeries for postoperative
pain management. Over time, TAP block has gained popularity, however its superiority versus epidural analgesia is still
debatable. Methods: 120 patients undergoing lower abdominal surgeries under general anaesthesia were randomly allocated
into two groups, to postoperatively receive lumbar epidural analgesia (Group E) or USG guided TAP block (Group T). Group E
received 0.125% bupivacaine (20ml) as a single shot postoperative analgesic via lumbar epidural catheter Group T received
0.125% bupivacaine (20ml) as a single shot postoperative analgesic via USG guided TAP block Pain at rest, Numeric Rating
Scale (NRS) and rst request for rescue analgesia (Inj. Paracetamol 20mg/kg IV) were recorded
A RARE ENTITY OF BILATERAL MEDIAL MEDULLARY SYNDROME IN SLE
Authors: Prathyusha Reddy P. , Sreeja B. , Ravinder Reddy K
Published: March 2023

Medial medullary syndrome is a rare type of ischemic stroke
and represents <1% of posterior circulation strokes, in which
bilateral infarcts are even rare and can rarely occur in young
patients. It usually presents with quadriplegia, dysarthria ,
dysphagia , impaired sensations. SLE is chronic systemic
autoimmune disease often effects young women and is
characterized by multisystem involvement. It has eightfold
higher risk of stroke, but it rarely occurs as initial
manifestation of disease. The CNS involvement in SLE leads
to increased rates of mortality, morbidity and disability.
Cerebrovascular disease may be attributed to disease, as
manifestation of Neuropsychiatric SLE
STUDY OF EPIDEMIOLOGICAL FEATURES, MICROBIOLOGICAL DIAGNOSIS AND TREATMENT OUTCOME OF INFECTIVE KERATITIS
Authors: Kumar Ravinder , Kumar Vaibhav , Kadam Dhruvika , Bairwa Pushpendra
Published: March 2023

Introduction; Keratitis is an inammations of the cornea and Microbial keratitis is a most common type.
Potentially sight threatening ocular infection are known to be the second most signicant cause of
monocular blindness rated after cataract in some developing nations in particular. The aetiology of microbial keratitis varies
signicantly from country to country. Objective; To determine the epidemiological features, microbiological diagnosis and
treatment outcome of infective keratitis. Methods: This hospital based prospective study conducted on 75 patients with clinical
diagnosis of corneal ulceration at ophthalmology department, RNT Medical College and Hospital Udaipur, over a period of 18
months. Result: majority of cases were from 41-60age group and most common factor was ocular vegetative trauma.
Microorganisms were isolated from 75.86% of the 58 corneas that were cultured. culture proven bacterial keratitis. 58 patients
taken for the laboratory investigation by smears and culture. Pure bacterial growth was present in 21(36.2%) pure fungal growth
was present in 19 (32.8%) mixed growth was present in 4 (6.9%), 14(24.1% were not showing any culture growth. Out of 75, 19
(25.33%) were viral keratitis
RECURRENT GIANT CELL TUMOUR OF 5TH METATARSAL- A RARE CASE
Authors: Bahadur Gurung Yam , Kumar Pandey Ashish , Mishra Dipendra
Published: March 2023

Giant cell tumour (GCT) is one of the common benign tumours found in young adults. But small tubular
bones are an uncommon site. Very few cases of GCT occurring in the metatarsal have been mentioned in
literature. Recurrent GCTs in the foot are even rarer. We are reporting a case of recurrent GCT of 5th metatarsal of left foot in a 24
years female. She presented with pain and swelling of the lateral aspect of left foot for 3 months. She was initially treated with
tumour excision, curettage and bone cement spacer placement and after tumour recurrence she underwent 5th ray amputation
and is symptom free till last follow-up.
CLINICO-EPIDEMIOLOGICAL PROFILE OF SNAKE BITE CASES AT A TERTIARY CARE HOSPITAL- A RECORD BASED RETROSPECTIVE STUDY
Authors: M.C Rekha , T.K Aswathy , G.V Anikethana
Published: March 2023

Snake bite is a common medical emergency in developing countries with temperate and tropical climates
in which population subsist on agriculture and shing, which are major source of employment. A record
based retrospective study was conducted at a tertiary care hospital to know the clinico epidemiological prole of snake bite
cases. Datas of 226 patients admitted with alleged history of snake bite in the past year was obtained and analysed for
demographic and clinical features. It was observed that most number of snake bite cases presented during monsoon (36.2%)
and Viper was the most common poisonous snake (46.9%) causing snake bite. This study concluded that Many of the patients
did not have a proper idea about rst aids to be practised. Thus proper knowledge about the snakes and their toxicity and the
primary measures to be adopted prior to medical care may improve the outcome of snakebite admissions
“EVALUATION OF THROMBOLYSIS IN ACUTE ST ELEVATION MYOCARDIAL INFARCTION IN SIR T. HOSPITAL, BHAVNAGAR.”
Authors: Nayi Falguni , Sharma Jatin , Hadiyel Ila
Published: March 2023

INTRODUCTION: Acute ST elevation myocardial infarction (STEMI) occurs most commonly when
thrombus formation causes occlusion of a major coronary vessel. Thrombolytic therapy is a signicant
advancement in the treatment of STEMI. Clinical trials have established the safety and efcacy of thrombolytic therapy in
STEMI when administered within 12 hours of the onset of symptoms; the earlier it is administered, the greater the benet.
METHODOLOGY: A Cross-sectional observational study was carried out at Sir T. Hospital, Bhavnagar. 100 Acute STEMI (ST
elevation myocardial infarction) patients admitted in ICCU during august 2021 to July 2022 after taking informed written consent
were subjected to detailed history and complete physical examination and data collected was noted in a predesigned
Performa. Among 100 patients, majority of the cases were in age group of 51 to 60 yrs RESULTS: . Male patients are
predominantly affected than female patients. IV Streptokinase thrombolytic therapy in acute STEMI pa CONCLUSION: tients
within golden hours improved the reperfusion of myocardium and also associated with reduction of adverse events and
decreased mortality.
A STUDY OF POST DURAL PUNCTURE HEADACHE AFTER USING FINE GAUGE SPINAL NEEDLE IN SUBARACHNOID BLOCK
Authors: Srivastava Mehul , Das Arpita , Apoorva Nigam Kshitiz
Published: March 2023

J. Leonard Corning1 a neurologist of New York was the rst one to give recorded but accidental spinal
anesthesia in 1885 when he pierced the dura while experimenting with cocaine on spinal nerves of a dog.
According to International headache society the criteria dened for Post Dural Puncture Headache (PDPH) includes a
headache that develops in less than seven days after a spinal puncture, occurs or worsens in less than fteen minutes after
assuming upright position and improves in less than thirty minutes after assuming recumbent position with at least one of the
following associate (neck stiffness, tinnitus, hypacusia, photophobia and nausea). The headache usually resolves within
fourteen days after spinal puncture. In the present study we analyzed the incidence of post spinal headache after using narrow
gauge atraumatic needles irrespective of administrator's status. We also analyzed to relate the skill of administration to the
incidence of headache. Majority of the patients 1094 (88.58%) included in this study were between the ages of 20 to 60 years,
while 63 (5.11%) were below 20 years and 78 (6.31%) were above 60 years of age. Of the 1235 patients included in the study
429(34.74%) patients were male and 806(65.26%) were females. Of the 1235 patients 515 females underwent surgery for
obstetric reasons mostly L.S.C.S and rest underwent non obstetric surgeries. Overall PDPH rate observed in 1235 cases was
2.8% i.e. 35 patients had PDPH after using ne gauge spinal needle. Out of these 35 patients who reported having PDPH; in
21 patients (60%) was administered spinal anesthesia using 26G needle and 14 patients were given spinal block with 25G
needle. The incidence of PDPH seems higher with 26G needle as most of the patients in our institution receives spinal
anesthesia using 26G needle. . Of the 35 cases included reporting having PDPH, trauma occurred in only 6 cases i.e. 17.14%
and in rest of the cases LP was atraumatic. 23 out of 35 (65.71%) patients lumbar puncture was done in rst pass in single
interspace only, in 5 patients (14.28%) more than one attempt was required but attempts were taken in single interspace with
single skin puncture only, in 3 patients (8.57%) more than one attempt accompanied by one skin puncture in one interspace only
and lastly in 4 patients (11.42%) multiple attempts in multiple spaces was done. Thus above observations clearly establishes
that PDPH occurred more frequently in female in the age group of 20-40 years and majority of them underwent obstetric surgery.
RETROSPECTIVE STUDY OF CASTLEMAN DISEASE IN A TERTIARY CARE HOSPITAL
Authors: Ramya Sindhura T. , Anjana Priyanka A. , Vahini G. , Rajendra Prasad J.
Published: March 2023

Introduction: Castleman Disease (CD) is a rare, heterogeneous group of lymphoproliferative disorders.
Unicentric Castleman Disease (UCCD) is a localized disease, with little or no systemic symptoms. It may
be an incidental radiological nding or detected while investigating for a symptomatic lymph node mass. Surgery is the
primary treatment and has good long-term prognosis. Multicentric Castleman Disease (MCCD) is a more serious systemic
condition, often associated with constitutional symptoms. There are various types of multicentric CD including HHV8-
associated, idiopathic and a subset of cases that arise in association with POEMS syndrome. Therapy is required for most
patients with multicentric CD. As evidenced, the designation Castleman disease encompasses a heterogeneous group of
diseases of varied pathogenesis and require different therapies. To have an accountant of occurrence Aim: of CD in a tertiary
care centre and to study the clinical and histopathological features and categorize them as unicentric and multicentric tumors.
Objective: To determine the frequency and pattern of CD. This study is a retrospective analysis of 8 Materials And Methods:
cases of Castleman disease over a period of 12 years from June 2010 to June 2022. All cases were uni Results: centric. One case
was locally extensive. The clinical symptoms were related mostly to compression effects. 7 cases were of Hyaline vascular type
and one was Plasma cell variant. CD is misdiagnosed due to absence of specic clinical symptoms. It s Conclusion: hould be
included in differential diagnosis when evaluating lymph node hyperplasia. The progression from chronic antigen stimulation
to reactive lymphoid hyperplasia and then to overt lymphoid neoplasia can be illustrated by the Castleman disease
MATERNAL AND FETAL OUTCOME OF DENGUE FEVER IN PREGNANCY: AN OBSERVATIONAL STUDY
Authors: S Divya Louis J , Saleem Shemini , A M Reshma , Gurudas Girija
Published: March 2023

Dengue is a mosquito-transmitted viral infection, which is a threat to health services. Concern regarding
pregnant women becoming infected with dengue is on rise. They seem to be more likely present with
severe forms of infection. During the epidemic in our region we found out that only few studies has mentioned the association of
dengue with oligohydramnios. Also association of low birth weight is due to shorter period of gestation and not due to growth
restriction. With this background, we conducted the study using two groups, group I with dengue fever and group II
uncomplicated. Dengue infection resulted in premature birth, low birth weight, fetal distress, neonatal ICU admissions. Severe
thrombocytopenia was one of the striking features, which had led to multiple platelet transfusions. ICU admissions and
coagulation abnormalities were very high in dengue complicated group. Oligohydramnios seen during dengue fever was
transient and had no impact on pregnancy on follow up. Fetal distress was the major indication for emergency C-Section.
Patients, who reported late, had more complications and prolonged hospital stay. This increased the burden on our health
services. So our recommendations are early diagnosis, hydration and symptomatic treatment. Our study results will be used to
create awareness among the antenatal patients, during antenatal classes and stressing on the morbidity of the disease,
because always prevention is better than cure
SALIVA AS A DIAGNOSTIC TOOL-A REVIEW
Authors: S.G. Denesh P. , Devadharshini C. , Swamy R M Aravindh , Saravanan Thalaimalai
Published: March 2023

Early perseverance of disease plays the important part of treatment planning and prognosis which
reduces the severity of disease progression. This scrutiny explains the saliva as a fascinating diagnostic
tool for routine examination of identifying the oral and systemic disease in its early stage. On upper hand, saliva includes
uncluttering and non-invasive method with trouble free method of collecting the sample with low-cost storage. Whole saliva
may be used for diagnosis of systemic and oral disease because it contains serum constituents which serve as accurate
biomarkers for the diagnosis of disease. Saliva samples are easy to store and ship as it doesn't clot similar to blood. Saliva
present in the oral cavity not only maintains the health of oral cavity but plays an important role in diagnosis of communicable
and non-communicable disease. No need for trained medical staff, Multiple samples can be obtained easily, Collection and
screening can be done at home Minimal risks of cross-contamination, more economical sampling, shipping and storage
compared to serum, requires less manipulation during diagnostic procedures compared to serum, Commercial availability of
screening assays. All these characteristics make saliva an appealing diagnostic candidate for the detection and monitoring of
several biomarkers in infants, children, adults and uncooperative patients.
COMPARISON OF AVERAGE VOLUME ASSURED PRESSURE SUPPORT (AVAPS) AND BILEVEL POSITIVE AIRWAY PRESSURE (BIPAP) MODES IN THE MANAGEMENT OF COPD PATIENTS WITH ACUTE HYPERCAPNIC RESPIRATORY FAILURE
Authors: Shreya Reddy G. , Ramesh Kumar K. , Kranthi Randev G. , Ahmed Sara
Published: March 2023

To know the efcasy of AVAPS Modes of non invasive
ventilation in management of COPD patients with type 2
Respiratory failure.To compare improvement in clinical
parameters, biochemical parameters, patient tolerance
between AVAPS and Conventional BIPAPA mode of ventilation
“TO ASSESS FETO-MATERNAL CIRCULATION BY DOPPLER STUDY IN WOMEN WITH THIRD TRIMESTER AND ITS CO RELATION WITH FETO-MATERNAL OUTCOMES.”
Authors: Parmar Zarna , Nakum Kanaklata
Published: March 2023

INTRODUCTION : Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity
throughout the world, accounting for 24% of all maternal deaths in India. 1,2 In developed countries, it
accounts for 7-10% of perinatal mortality and 20% in developing countries. Early detection of preeclampsia may allow for
vigilant antenatal surveillance and timely foetal delivery to avoid serious complications. The aim of the study was to determine
and compare the diagnostic performance of Doppler sonography of fetal middle cerebral artery (MCA) and umbilical artery
(UA) in prediction of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR) and severe PE.
METHODOLOGY: 100 pre-eclampsia patients were taken in study at Sir T. General Hospital, Bhavnagar from January 2021 to
July 2022. The various measures of central tendencies and graphical representations were used to analyse the data. RESULTS:
Majority of patients were in the age group of 26-30 years. Maximum incidence was seen with primigravida (65%).Out of all
patients maximum patients delivered normally (67%). Patients delivered low birth weight babies were around 38%. Umbilical
Artery Doppler parameters such as abnormal S/D ratio,Elevated Resistivity index, and elevated Pulsatility Index were found as
(78.72%), (80.85%) and (87.23%) in Adverse Outcome event which is statistically signicant compared to Good
outcome(p<0.0001). Middle cerebral artery Doppler parameters such as abnormal S/D ratio, Elevated Resistivity index, and
elevated Pulsatility Index are found as (25.53%),(76.59%) and (72.34%) in Adverse Outcome event which is statistically
signicant compared to Good outcome(p<0.0001). In addition, Cerebro Placental Ratio have found signicantly high
abnormality (89.36%) of neonates in adverse group. CONCLUSION: The Doppler technology is helpful in repetitive
noninvasive haemodynamic monitoring of pregnancy. In an obstetric patient population with a high prevalence of
complications like preeclampsia, the Doppler indices from the fetal circulation can reliably predict adverse perinatal
outcomes. Thus the appropriate timing of delivery is to be made before these changes occur. However, the Doppler study of
multiple vessels helps predict adverse outcomes , manage high-risk pregnancies complicated by preeclampsia
TAKOTSUBO CARDIOMYOPATHY IN POSTPARTUM- A CASE REPORT
Authors: Satyaprasanna Kumari Tadicherla , Dasari Srineeth , Ravinder Reddy K.
Published: March 2023

A 22-year-old female after a twin vaginal delivery presented with shortness of breath grade 2-4 NYHA,
grade 3 bilateral pedal edema and basal crepitations is diagnosed to have Takotsubo cardiomyopathy. A
young age of 22 years is uncommon for this disease and stressor might be twin vaginal delivery in this case. However, patient
showed signicant improvement within a week and showed complete recovery within 2 months.
ROLE OF COMPUTED TOMOGRAPHY IN EVALUATION OF MEDIASTINAL MASSES
Authors: Bhausaheb Patil Shubham , M. Kadam Mahesh
Published: March 2023

Mediastinal masses span a wide histopathological and radiological spectrum, comprising of tumours
(benign to extremely malignant), cysts, and lymph node masses. Present study was conducted to assess
utility of CT scan in distinguishing between the different types of mediastinal masses, to illustrate diagnostic CT features and its
association with histopathology ndings.30 cases referred to the radiodiagnosis department with clinically suspected
mediastinal masses at Vilasrao Deshmukh Government Medical College and Hospital, Latur were included over a one-year
period (Feb 2021-Jan 2022). Majority cases were males (76.7%), with 31-45 years' age group being commonest (33.33%). In our
study, anterior mediastinum was the most commonly involved compartment (n=17, 56.7%), followed by posterior mediastinum
(n=7, 23.3%) and middle as well as superior mediastiunum (n=3, 13.3%) each.In the study, thymoma (n=5,29.4%) ,Ca.
Esophagus(n=2,66.66%), Schwannoma (n=3,42.8%) and Ca Thyroid (n=2,66.66%) were the most common mediastinal
masses in the anterior,middle, posterior and superior mediastinal compartments respectively. Majority masses were welldened (70%), hypodense (86.7%) showing moderate (86.7%) and heterogenous contrast-enhancement (83.3%). All lesions
were soft tissue attenuating. However, other attenuations like Calcication (33.3%), Fluid (26.7%) and Fat (10%) were also
seen.were also seen.In 93.4% cases, CT diagnosis matched with histopathology. MDCT scan plays a substantial role in the
evaluation of mediastinal pathology, regarding diagnosis, distribution pattern and mass effect on adjacent structures