bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective study of intraoperative and post-operative complications during laparoscopic cholecystectomy among patients presenting with acute calculous cholecystitis
Authors: Rajat Kumar  , Chandrakala  , Ritu Kumari Saxena  , Shirale Vaishali
Published: February 2023

Background: Acute cholecystitis was initially thought to be a contraindication for laparoscopic cholecystectomy. Now, as the experience is increasing, laparoscopic surgeons are gradually undertaking laparoscopic cholecystectomy as the preferred procedure even in an acute setting. Early surgery in acute presentation has better surgical outcome with lesser and cheaper hospital stay and predictive of better quality of life as compared to delayed treatment.
Aims and Objectives: The objectives of this study were to study the perioperative complications during early laparoscopic cholecystectomy.
Materials and Methods: One hundred and five patients with acute calculus cholecystitis visiting Fortis Escorts Hospital, Faridabad from June 2017 to November 2018 were studied. All patients underwent laparoscopic cholecystectomy and subsequently compared for the following intraoperative parameters: Presence of adhesions, calot’s anatomy, need for decompression of gallbladder, difficulty in dissecting the gallbladder from liver bed, retrieval of gallbladder, time taken to complete surgery, need of placement of drain, and need for conversion to open cholecystectomy. Complications studied were massive bleed, bile spillage during dissection, stone spillage, duodenal injury, and common bile duct [CBD] injury.
Results: Decompression of the acute inflamed gallbladder facilitates laparoscopic cholecystectomy in acute cholecystitis with low conversion rate of 2.86%. Bleeding, CBD injury and duodenal injury are uncommon complications but major factors for conversion.
Conclusion: Most common reasons for difficulty in laparoscopic cholecystectomy for acute cholecystitis were found to be adhesions in Calot’s triangle and adhesion of gallbladder with surrounding structures (duodenum/transverse colon).
Correlation between post-operative electrolyte changes to perioperative factors in Bipolar TURP
Authors: Anurag Dubey  , Shivendra Singh Tiwari  , Kumar Santhosh , Paul Devaraj Vinent
Published: February 2023

Background: Transurethral resection of the prostate (TURP) is one of the best available treatments for benign hypertrophy of the prostate. Many of the complications in TURP are associated with the absorption of irrigation fluid. In BIPOLAR TURP, normal saline is used as an irrigant which is more physiological.
Aims and Objectives: Our aim of the study is to evaluate the correlation between post-operative electrolyte changes to perioperative factors in bipolar TURP.
Materials and Methods: One hundred and ten patients enrolled in this study who were admitted to Meenakshi Mission Hospital, Madurai, Tamil Nadu, India.
Results: Mean age of the participants was 65.68 (±8.50) years with a median of 66 years. mean hemoglobin drop was 1.21 (±1.36) g/dl. The mean serum sodium drop was 1.55 (±3.01) mEq/L. The mean serum potassium change was 0.06 (±0.74) mEq/L. There was a significant positive association between operative time and serum sodium drop (P<0.001). There was no significant correlation between any of the other parameters prostate size, resection time, resected volume were noted, and post-operative electrolyte April 2019–March 2021. Patient pre-operative changes and hemoglobin drop is observed. Correlation is assessed with Spearman Rho.
Conclusion: Our study concluded that as operative time increases sodium drop and hemoglobin drop significantly increases. Resected and pre-operative prostatic volumes do not affect electrolyte and hemoglobin levels.
Comparison of post-operative acidemia after intraoperative administration of balanced crystalloid plasma – Lyte A® vis-a-vis 0.9% sodium chloride in gastrointestinal surgery at a tertiary care hospital in Eastern India
Authors: Das Arindam Kumar , Roy Sankar , Gharami Bidyutbikas , Biswas Arunava , Bhattachariya Dipasri
Published: February 2023

Background: Fluid therapy is the most challenging and debatable aspect of perioperative care. Choice of administrating intravenous fluid perioperative period varies considerably among anesthesiologist.
Aims and Objectives: The aims of this study were to compare the effects of intraoperative administration of balanced crystalloid solution (Plasma-Lyte A®) and 0.9% sodium chloride (NaCl) on acid–base balance in the post-operative period on patients undergoing gastro intestinal surgery at a tertiary care hospital.
Materials and Methods: A prospective, randomized, comparative, and observational study was conducted on 80 patients of either sex aged 18–60 years with ASA-l and ASA-II who underwent gastrointestinal surgery which was at first randomly allocated to two equal groups of 40 each. Group 1 received Plasma-Lyte A® as the sole crystalloid and Group 2 received 0.9% NaCl. Intraoperative crystalloid infusion volumes, urinary output, blood loss, and blood transfusion volumes were recorded on hourly basis. Electrolytes (Na+, K+) and arterial blood gases were measured after induction of anesthesia and then every hour in the intraoperative period and at the 1st, 6th, and 12th hour of post-operative period.
Results: The demographic data with respect to age, sex, and type of surgery were comparable among the two groups with no significant difference (P>0.05). Intraoperative and post-operative fluid transfusion and blood transfusion were also comparable with no significant difference. On intergroup comparison, serum Na+ conc. of both the groups was comparable and no difference shown at the time of induction, but after 12 hours following operation, there was a significant increase in Group 2 (P<0.05). There was no significant difference in serum K+ concentration in both the groups except at 6-hour postoperatively, there was an increase in K+ concentration in Group 1 (P<0.05). Serum Cl- concentration at post-operative 1st, 6th, and 12th hour interval very significantly increased in Group 2 (P<0.001). A significant decrease in pH (P<0.05) observed in 0.9% NaCl group in comparison to Plasma-Lyte® group when the duration of surgery increased to more than 120 minutes.
Conclusion: Plasma-Lyte A® and 0.9% NaCl can be used safely during gastrointestinal surgery as the sole crystalloid. However, chance of developing hyperchloremic metabolic acidosis is more with 0.9% NaCl than Plasma-Lyte A® in prolonged surgery exceeding 2 hours.
Different presentations of hydatid cyst and its management – A prospective and observational study in a tertiary care hospital in Kolkata
Authors: Amit Kumar Samanta  , Arup Jyoti Rout  , Eashin Gazi  , Tushar Kanti Saha
Published: February 2023

Background: Hydatid disease of liver is quite common disease in Eastern India, though not very frequently reported. The diagnosis of hydatid cyst is often difficult because of its initial modes of presentation.
Aims and Objectives: The objectives of the present study were to evaluate the different clinical presentation, surgical management options, and complications if any after operation in a tertiary care center.
Materials and Methods: This prospective study was conducted with 30 patients (Male 17 and Female 13 with a mean age of 41.23 years) who were diagnosed of having hydatid cyst of liver.
Results: The presenting symptoms that were found pain abdomen (22 cases), abdominal lump/mass (16 cases), cholangitis (five cases), jaundice (two cases), constitutional (anorexia, nausea, and malaise two cases), and fever (18 cases). Deroofing and omentoplasty and wound drainage (12 cases), partial pericystectomy (nine cases), pericystic-cystectomy (six cases), marsupialization (two cases), and one case was managed nonoperatively. Post-operative complications were – biliary fistula (two cases), post-operative cholangitis (two cases), surgical site infections (two cases), and retained cyst (one case).
Conclusion: A high index of suspicion is always recommended when an adult patient comes with pain abdomen and abdominal mass. Different surgical methods, for example, deroofing and omentoplasty with wound drainage, partial pericystectomy, and pericystic-cystectomy can be applied. To establish the definite surgical management, many more randomized and controlled studies are needed.
Spectrum of histopathological patterns of breast lesions in a tertiary care hospital
Authors: Akinapally Mrudula  , Mohd Imran Ali  , Swathi Samalla  , Rajarikam Nagarjuna Chary
Published: February 2023

Background: Breast lesions are areas of abnormal breast tissue. It is estimated that 20% of women develop breast lesions. Breast lesions are either benign or malignant. Breast carcinomas are the most common cause of deaths in women accounting for 10.6% deaths in India, 6.9% deaths per year globally.
Aims and Objectives: To study various histopathological patterns of breast lesions in women admitted in Government General Hospital.
Materials and Methods: It is a prospective study in the department of pathology, Government General Hospital, Nizamabad, from December 2020 to July 2022. Grossing was done and details noted, tissue bits were processed and sections were stained with conventional H and E Staining.
Results: Out of 70 cases of breast lesions, 55 (78.5%) are benign breast lesions and 15 (21.5%) are malignant breast lesions. Fibroadenoma is the most common breast lesion accounting for 33 cases, that is, 60 %, followed by fibrocystic diseases (21.8%). Infiltrating ductal carcinoma of No Special Type is the most common malignant breast lesion accounting for 10 cases, that is, 66.6%. Among invasive breast carcinomas, the majority of cases are Grade II (69%).
Conclusion: Study of histopathological patterns of breast lesions plays an important role in diagnosis, treatment, and prognosis of breast lesions. This study highlighted incidence and pathological characteristics of a wide range of breast lesions.
Varied, unprecedented dermatologic manifestations of hypovitaminosis D –A case series
Authors: Sarkar Amit , Bandyopadhyay Rajat , Bhowmik Kalyan Kumar , Chakrabarti Arpan , Mukhopadhyay Neelakash , Paul Arnab
Published: February 2023

Vitamin D deficiency is endemic in India. Hypovitaminosis D not only results in musculoskeletal disorders but also affects extraskeletal systems. In this article, we describe three interesting patients suffering from hypovitaminosis D with dermatologic manifestations of erythema nodosum, heel fissures, and palmar hyperhidrosis. All the three cases responded well to treatment with vitamin D. Similar cases have not been reported earlier.
Bone mineral density in patients with chronic spinal cord injury: An observational study
Authors: Ratnakar Lal , Laisram Nonica , Banoth Kiran , Badhal Suman , Dhiman Nitish
Published: February 2023

Background: Spinal cord injury (SCI) is accompanied by loss of bone mass caused by accelerated bone remodeling, with bone resorption exceeding bone formation which causes net bone loss. The significance of osteoporosis after SCI is that it results in skeletal fragility and an increased risk of fractures. Complications from fractures lead to an increase not only in the associated morbidity and mortality, but also in the health-care costs that they generate.
Aims and Objectives: The objective of the study was to evaluate bone mineral density (BMD) in patients with SCI in Indian population and to determine the effects of the neurological level, severity of injury, and mobility status on BMD.
Materials and Methods: This study was a prospective and observational study conducted on 52 chronic SCI patients. After detailed history and examination, patients were assessed using American spinal injury association impairment scale following which BMD was assessed by Dual Energy X-ray Absorptiometry Scan. Correlation between the T score and neurological level, severity of injury and mobility status was assessed. P<0.05 was considered statistically significant.
Results: Out of 52 patients included, 41 were having complete SCI and 35 were non-ambulatory. T score was significantly (P<0.001) lower in lumbar spine and both femur in complete SCI patients. The T score was indicative of increased osteoporosis in non-ambulatory patients. BMD did not differ significantly (P<0.059) in patients with relation to various neurological levels.
Conclusion: From this study, we conclude that osteoporosis is commonly present in patients with complete SCI and non-ambulatory was more affected. Early mobilization of these patients reduces the development of osteoporosis.
Comparative study of internal fixation of diaphyseal fractures of both bones of the forearm in adults between intramedullary nailing and plate osteosynthesis
Authors: Biswas Atin , Sabui Kanchan Kumar , Basu Anindya , Mandal Prasun
Published: February 2023

Background: Diaphyseal forearm fracture is one of the most commonly encountered fractures of the upper extremity. The literatures comparing the outcome of plate fixation and intramedullary nailing in adults are scarce and therefore the consensus on superiority of one over the other is lacking. This study was undertaken to compare the outcome of these operative techniques in adults with diaphyseal fracture of both bone forearm.
Aims and Objectives: This study was undertaken to compare the outcome of plate fixation and intramedullary nailing in adults with diaphyseal fracture of both bone forearm.
Materials and Methods: Patients of 18–70 years of age, with diaphyseal fractures of both bones of the forearm of <21 days old, were recruited. Patients were randomly allocated to two treatment groups: intramedullary nailing and plate osteosynthesis. Patients were followed up at 4th week, 12th week, and 24th week post-operative period. Functional outcome was measured at the end of 24th week based on the Clinical and Radiological parameters by Anderson et al., Score, Grace-Eversman Score, and Disabilities of the Arm, Shoulder and Hand (DASH) Score.
Results: This study comprised of 40 cases (n=40) who completed the follow-up period of 24 weeks. Most of the patients treated with plate (80%) demonstrated excellent outcome as per Anderson et al., score while the outcome was unsatisfactory in 50% of those treated with nails. About 90% of the patients of plate group had excellent result in contrast to 50% in case of nail group following Grace Eversman criteria. Considering DASH score, the former group showed mostly excellent (40%) and good (45%) outcome while the latter exhibited mostly fair (55%) and good (30%) result.
Conclusion: It may be stated that plate osteosynthesis is a better option in the treatment of diaphyseal fracture of both bones forearm in adults.
Comparative study of midazolam and fentanyl for the prevention of etomidate-induced myoclonus
Authors: Rasool Sophiya , Gupta Radha , Prakash Sukriti
Published: February 2023

Background: Etomidate is one of the popular rapidly acting inducing agents with cardio-stable profile but associated with side effects such as myoclonus. Myoclonus can lead to regurgitation, prolapse of vitreous in open globe or many other complications.
Aims and Objectives: The objectives are as follows: To compare the efficacy of Fentanyl and midazolam for prevention of Etomidate induced myoclonus. To study the hemodynamic parameters and side effects of midazolam and fentanyl in patients with myoclonus after etomidate injection.
Materials and Methods: Eighty patients scheduled for elective surgeries under general anesthesia were randomly allotted into two groups of 40 patients each. Group F – fentanyl 1 μg/kg and Group M – midazolam 0.03 mg/kg were administered as pre-treatment before induction by Etomidate. After injection of Etomidate, incidence of myoclonus was observed along with the change in hemodynamic parameters (heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP]). Comparison of hemodynamic parameters between 2 groups was done at pre-treatment, 1 min and 2 min after induction and 1 min after intubation.
Results: Both fentanyl and midazolam reduced the incidence of myoclonus. However, fentanyl was more effective in decreasing incidence as well severity of myoclonus. Fentanyl was associated with more stable hemodynamic parameters such as HR, SBP, DBP, and MAP 1 min after intubation (P<0.05). In both the groups, there was no increased incidence of PONV.
Conclusion: Fentanyl 1 μg/kg or midazolam 0.03 mg/kg can reduce etomidate induced myoclonus. However, fentanyl was more effective in decreasing incidence as well severity of myoclonus and was associated with stable hemodynamic parameters as compared to midazolam.
Assessment of depression, anxiety, stress, and cognitive parameters in medical students: A pilot study
Authors: Shomi Anand  , Kirti Hemwani  , Sonu Ajmani  , Sai Sailesh Kumar Goothy  , Anita Choudhary
Published: February 2023

Background: As there is an increase in mental health issues among medical students, it is mandatory to assess their mental health status. In our earlier studies, we observed differences in the scores of depression, anxiety, and stress between male and female students.
Aims and Objectives: The present study was undertaken to assess depression, anxiety, stress, and cognitive parameters in male and female medical students.
Materials and Methods: A total of 100 medical students’ males (n=50) and females (n=50) were part of the study after obtaining voluntary, written informed consent. The required sample size for the study was 97 with a 95% of confidence level, 10% of margin of error, and 50% of the population proportion. This means 97 or more measurements/surveys are needed to have a confidence level of 95% that the real value is within ±10% of the measured/surveyed value. Depression, anxiety, and stress were assessed using the DASS 21 questionnaire. Spatial and verbal memory test was administered to assess the cognitive functions.
Results: The depression scores were significantly higher (P<0.0001) in females when compared with males. Anxiety scores were significantly higher in females when compared with males (P<0.0001). Stress scores were significantly higher (P<0.0001) in females when compared with males. Spatial (P<0.0001) and verbal (P=0.0141) memory was significantly higher in females when compared with males.
Conclusion: There were significantly higher levels of depression, anxiety, and stress scores in female students when compared with males. Further, spatial and verbal memory was also higher in females. There is a strong need for further detailed studies in this area and for adopting adequate management methods to manage negative psychological emotions in females.
Idiopathic sudden sensorineural hearing loss – A 12-month review
Authors: Ali Malikka  , Joe Jacob Kandoth  , John Mathai
Published: February 2023

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a condition which is difficult to define and treat. Sensorineural hearing loss being a situation where rehabilitation therapy with hearing aids is the only treatment option, ISSNHL is an exception which can be treated medically if identified early enough.
Aims and Objectives: The aim of the study was (i) to calculate the recovery of hearing and other symptoms in patients diagnosed of ISSNHL treated with medical management as per institutional protocol and (ii) to determine the association between recovery with medical management and factors such as time of presentation and comorbidities in patients with ISSNHL.
Materials and Methods: In the Department of ENT, MCH, Kottayam, a protocol for the management of ISSNHL was worked out as per guidelines from standard otology textbooks. All patients with suspected ISSNHL were admitted. Hearing assessment was done using pure tone audiometry during inpatient care and on discharge of the patient. Patients were discharged after completion of the treatment and followed up for a period of at least 6 months.
Results: The inference of our study is that cases who presented early in the first 24–48 h of onset of symptoms have maximum chance of recovery irrespective of associated comorbidities.
Conclusion: The study highlights the fact that ISSNHL is and should be considered as a medical emergency.
Knowledge, attitude, and practices of adolescent school girls regarding menstrual hygiene in Lucknow district
Authors: Ruby Khatoon  , Shahzeb Ansari  , Syed Abid Asghar  , Beena Sachan  , Zeashan H Zaidi  , Sharique Ahmad
Published: February 2023

Background: Girls’ adolescence has been recognized as a unique period that occurs as they cross the threshold from childhood to adulthood. Menstruation is typically viewed in Indian society as unclean. A negative attitude about this condition has been perpetuated by efforts to isolate and restrict menstruation females in the household. Numerous investigations have discovered restrictions in daily activities. On the other hand, maintaining good cleanliness habits during menstruation is important for reproductive health since it reduces vulnerability to infections of the reproductive tract.
Aims and Objectives: The aim of the study was to assess knowledge and attitude about menstrual health among adolescent girls in rural and urban schools in Lucknow district and to find out practices of menstrual hygiene among them.
Materials and Methods: The study unit consists of 410 teenage school-going females who live in both urban and rural regions of the Lucknow district. There was a multi-stage random sampling. A pre-developed and pre-tested interview schedule was employed toobtain data. Participants were questioned about their personal cleanliness, which need to be covered in the academic program.
Results: Four hundred and ten adolescent girls who were enrolled in school participated in the study. The majority of girls in this survey (52.8%) are between the ages of 17 and 19. 87.6% of the girls reported being ignorant of menstruation before menarche. While 41.6% of the girls were unaware of the organ from which bleeding originates, around 68.2% of the girls believed that the primary reason of menstruation is physiological and unrelated to any sickness. At the age of 10–13 years, 42.60% of the girls reached menarche. The majority of participants (60.80%) gave accurate responses to the question about the typical menstrual cycle’s average length. Only 35.27% of the girls were aware of the proper menarche age. Of them, 65.50% were aware of the issues with their reproductive health.
Conclusion: Lack of education among mothers and other female family members may contribute to girls’ lack of knowledge and awareness of menstruation. Misinformation, pre-conceptions, limitations, and a lack of knowledge around menstruation come in many different forms. As a result, when the entire family is familiar with the phenomena of menstruation, age-old prohibitions, conventional preconceptions, incorrect ideas, and negative attitudes may be successfully erased.
Effect of yoga practice on cognitive functions among the patients of depression
Authors: Nitu Kumari  , Ishwar Dayal Gupta  , Dheeraj Jeph  , Anuradha Yadav  , Kavita Yadav  , Namit Garg  , Sai Sailesh Kumar Goothy  , Anita Choudhary
Published: February 2023

Background: Decline in the cognitive functions is commonly observed in patients suffering with depression. Practicing yoga was reported to improve cognitive functions as well as manages depression.
Aims and Objectives: The present study was undertaken to observe the effect of yoga practice on cognitive functions among the patients of depression.
Materials and Methods: A total of 64 patients suffering with depression were recruited after obtaining written informed consent. Participants were randomly assigned to the interventional and control groups with 32 participants in each group. Digit span test (DST) was used to assess the cognitive functions of the participants at the baseline, after 1 month, and after 3 months of intervention. Yoga practice was administered as an adjunctive therapy to the interventional group for 3 months of period. No intervention was administered to the control group. Unpaired Student’s “t”-test and repeated measure ANOVA test were applied and P<0.05 was considered as statistically significant.
Results: The forward, backward, and total DST scores were not significantly different between the interventional and control groups at the baseline as well as after 1 month. Whereas, a statistically significant improvement after 3 months of yoga intervention in the forward (P<0.001), backward (P<0.05), and total (P<0.001) DST scores was observed when the interventional group was compared with the control group. A statistically significant improvement was observed in the interventional group even after 1 month of yoga practice in forward (P<0.001) and total (P<0.05) DST scores, while in backward DST scores, statistically significant improvement was observed after 3 months.
Conclusion: The study results support improvement in the cognitive functions followed by yoga practice in patients suffering from depression within a short period of time. The study recommends the implication of yoga practice as an adjunctive therapy in the management of depression.
Evaluation of perfusion index as an objective indicator of successful interscalene block
Authors: Pardeep Kumar  , Arora Vandna , Akanksha Khatri  , Suresh Kumar Singhal  , Shikha Madan
Published: February 2023

Background: Interscalene nerve blocks are commonly performed for surgeries of the upper limb. Assessment methods for evaluation of blocks are conventional and subjective.
Aims and Objectives: The aim of the study was to evaluate perfusion index (PI) as an objective indicator for assessing successful ultrasound guided interscalene block.
Materials and Methods: This prospective, observational study included adult patients undergoing upper limb surgery (humerus and shoulder) under USG guided interscalene nerve block. PI was recorded at baseline (before LA administration), at every 2 min till 10 min, and then every 5 min till 30 min after the block in both the arms. The PI values were compared between the blocked and unblocked arms at all observed time points. PI ratio was calculated as the ratio between PI at 15 min after block and the baseline PI.
Results: The PI increased significantly in the blocked limb after local anesthetic injection and there was a statistically significant difference in PI values between the blocked and unblocked arms at all-time points. Both PI and PI ratio at 15 min after injection showed a sensitivity and specificity of 100% for block success at cutoff values of 3.2 and 2.04, respectively.
Conclusion: PI maybe used as an objective indicator of successful interscalene nerve block. PI >3.2 and PI ratio >2.04 at 15 min are accurate predictors for block success.
A rare case series of bilateral pneumothorax among adult COVID-19 patients reported at a tertiary care hospital in Mizoram, India
Authors: Sailo Lalnuntluanga , Ralte Wendy L , Varte Zorinsangi , Sailo Lalnunmawii , Zodinpuia Micky , Khiangte Zorinpuii , Anusuya Ganesh Shanmugasundaram
Published: February 2023

Apart from routine symptoms such as fever, cough, sore throat, myalgia, and dyspnea in severe form of Coronavirus Disease-2019 (COVID-19) infection, very rarely patients can develop worsening of dyspnea due to bilateral pneumothorax. The present case series is about five adult patients, of age ranging from 39 to 57 years, who developed bilateral pneumothorax during their stay in the hospital. All the cases were reported between May 2021 and October 2021 and were tested positive for COVID-19 by reverse transcriptase polymerase chain reaction. Out of five adults, three patients were males and were two females. All the patients were assessed with quick sequential organ failure assessment (q SOFA) score on admission and then monitored by SOFA Score. On admission, baseline contrast enhanced computer tomography chest was done for three patients, and chest radiography for one patient all showing features of moderate to severe COVID-19 pneumoniae. One patient with q SOFA Score of 3 on admission required immediate invasive mechanical ventilatory support with ultrasonogram chest immediately performed showing bilateral pneumothorax. Patients were started on remdesivir, dexamethasone, low molecular weight heparin or unfractionated heparin, tocilizumab, and antibiotics. Subsequently, during the course of stay in the hospital, rest of the four patients developed symptoms of pneumothorax and emergency bedside chest ultrasonography showed the typical barcode or stratosphere sign confirming bilateral pneumothorax. All the patients were managed with bilateral chest intercostal water seal drainage intercostal drain tube and invasive mechanical ventilation. Fraction of Inspired Oxygen (FIO2), and other ventilatory settings were adjusted depending on daily arterial blood gas findings. Attempts to wean off from ventilatory support and extubation were successful for two patients, whereas three patients did not survive. In this case series, we will be presenting about those five cases of bilateral pneumothorax in COVID-19 patients reported at a tertiary care hospital in Mizoram, India.
Evaluation of laparoscopic versus open sacrocolpopexy for vaginal vault prolapse – A study from a tertiary care center
Authors: Senthilkumar Poovathai  , Rajkumar Ramakrishnan  , Rajasekar Sundaram  , Sammohit Gulakavarapu  , Gopu Rakesh Vamsi  , Shravankumar Savadatti
Published: February 2023

Background: Post hysterectomy vault prolapse is a progressive herniation of the vaginal vault through the urogenital diaphragm and commonly leads to per vaginal bulge. Surgically, vault prolapse is corrected by sacrocolpopexy which can be done both as an open abdominal surgery and as a laparoscopic repair.
Aims and Objectives: This study was performed to compare the therapeutic efficacies of laparoscopic and abdominal sacrocolpopexy.
Materials and Methods: This study includes 50 cases of vault prolapsed who underwent hysterectomy previously, admitted in our institution and operated during January 2021–June 2022 for a period of 18 months with both open abdominal and laparoscopic sacrocolpopexy. We compared the basic characteristics, duration of surgery, post-operative stay, post-operative complications, and patient satisfaction between open and laparoscopic groups.
Results: No significant difference was observed between the characteristics of the patients in the abdominal-approach group and the laparoscopic-approach group. The laparoscopic-approach group had a lower intraoperative estimated blood loss (187.8 vs. 90.3 mL, P<0.001) and a shorter operative time (148.0 vs. 115.3 min, P<0.001) than the abdominal-approach group. The complication rates of the two groups were not significantly different.
Conclusion: Our Study is favorable for the use of laparoscopic approach over open abdominal surgery for treating cases of vault prolapse for sacrocolpopexy. The less invasive method leads to less blood loss and a shorter operative time than an open approach.
Outcome and complications of percutaneous nephrolithotomy for renal stones – Our institutional experience
Authors: Rajkumar Ramakrishnan  , Senthil Kumar Poovathai  , Rajasekar Sundaram  , Gopu Rakesh Vamsi  , Sammohit Gulakavarapu  , Vinayak Sangreshi
Published: February 2023

Background: Percutaneous nephrolithotomy (PCNL) is the preferred treatment of choice for renal calculi. PCNL has evolved remarkably since the eighties when it was first described. PCNL is the treatment of choice for renal stones ≥2 cm.
Aims and Objectives: Our aim is to observe the various surgical outcomes of different types of PCNL.
Materials and Methods: It is an observational study conducted in our institute a total of 160 pts of renal stone disease who presented to the outpatient department were included in the study. All patients underwent PCNL either in supine or prone position. The parameters such as stone free rate, body mass index (BMI), stone size, operative time, length of stay (LOS), in hospital, and complications were observed.
Results: There were no significant differences in stone size between supine and prone PCNL patients. The supine group had a higher mean BMI, shorter mean surgical time, shorter mean LOS, and higher stone free rate. Prone PCNL patients had a higher rate of overall complications.
Conclusion: PCNL is one of the best modalities for renal stones management, with supine and modified supine PCNL demonstrating better results in obese patients, and may be considered by all surgeons performing PCNLs.
A study on the prevalence of retinopathy in newly diagnosed Type 2 diabetes mellitus in a tertiary care center of Tamil Nadu
Authors: G Prakash , M Kumar Raja , N Kalaisezhian , T Yoganandh , Vasanthakumar JA  , Nivedhapriya P
Published: February 2023

Background: Type 2 diabetes mellitus (Type 2 DM) is one of the leading risk factors for cardiovascular diseases. Although the awareness of the need for screening and treatment for Type-2 DM is widely prevalent, the awareness of complications arising out of it is not widespread. This article highlights the occurrence of diabetic retinopathy (DR) among newly detected diabetic patients.
Aims and Objectives: The aim of the study was to study the prevalence of DR in patients who are diagnosed as having Type 2 diabetes mellitus for the first time.
Materials and Methods: The present study involved 501 newly diagnosed Type 2 DM patients. Their history was recorded and the investigations done included haemoglobin (Hb), glycated Hb percent (HbA1c), fasting blood sugar, and post-prandial blood sugar. These patients underwent fundus examination through direct ophthalmoscope and slitlamp examination.
Results: Out of the 501 patients in the study, 59.5% (298) had good knowledge about diabetes, but only 3.8% knew about retinopathy. A total of 71.5% of patients did not have periodic eye examination; the most common barrier identified was lack of awareness about the necessity for this (58.5%), 5.6% among the total population had an eye disease. Mild non-proliferative DR (NPDR) was found among 10 females and it was observed in eight males. Moderate NPDR was identified in three males and two females and while no severe cases were reported among the men, two were noted among the women.
Conclusion: The study highlights the prevalence of retinopathy in newly diagnosed Type 2 DM population in tertiary care center hospital in Salem district. The study also highlights the importance of detection of Type 2 DM before the occurrence of complications which arise due to diabetes and screening for microvascular complications is necessary at the time of diagnosis of DM and periodically.
Heat and moisture exchanger filter as a substitute for T-piece device - A novel approach
Authors: Vaithialingam Balaji , Arun BG
Published: February 2023

Letter to Editor
Performance of garden pea (Pisum sativum L.) genotypes for growth and yield characters at Dailekh, Karnali Province, Nepal
Authors: Luitel Binod Prasad , Bhandari Bishnu Bahadur
Published: February 2023

Fourteen garden pea genotypes (13 improved genotypes and 1 was standard released variety) were evaluated for their morpho-agronomic characters, powdery mildew (PM) disease resistant, and yield performance. The genotypes were evaluated in randomized complete block design with three replications at Horticulture Research Station (HRS), Dailekh in 2018 and 2019. The results revealed that genotypes were significantly (P<0.01) different for pod length (cm), pod diameter (mm), green pod plant-1 (no.), green pod weight plant-1 (g), seed pod-1 (no.), dry pod plant-1 (no.), dry seed weight plant-1 (g), hundred seed weight (g) and seed yield (mt ha-1) except days to 50% flowering, plant height (cm) and branch/plant (no.). Green pod weight was significantly (P<0.01) higher in genotypes HRSDGP-11-18-10 (233.1 g plant-1) and HRSDGP-11-18-1 (224.1 g plant-1) than Sikkim Local (198.3 g/plant). Genotypes HRSDGP-11-18-10, HRSDGP-11-18-13 and HRSDGP-11-18-1 showed moderate resistant (3.0) reaction to PM disease. Green pod weight plant-1 showed significant (P<0.01) positive correlation with seed number/plant (r=0.74**), dry pod number/plant (r=0.52**), dry seed weight (r=0.58**) and seed yield (r=0.57**). Genotypes HRSDGP-11-18-10, HRSDGP-11-18-1 and HRSDGP-11-18-13 showed 32.3%, 20.5% and 2.9% seed yield advantage over the standard variety, Sikkim Local. Based on this result, HRSDGP-11-18-10, HRSDGP-11-18-1 and HRSDGP-11-18-13 are selected as high yielding and PM resistant genotypes which can be used for commercial production as well as breeding lines for garden pea improvement program.
Detection of superior rice genotypes through evaluating growth and yield parameters
Authors: Poudel Ankita , Chaudhary (Dhami) Manila Singh , Adhikari Anup , Shrestha Jiban
Published: February 2023

Rice (Oryza sativa L.) is the first staple crop in terms of area coverage for cultivation and production in Nepal. In rice breeding programs, developing superior genotypes depends on the evaluation of growth and yield parameters. Thus, to detect some of the primary superior genotypes, we evaluated the growth and yield parameters of 24 genotypes of rice in Rampur, Chitwan, Nepal. The rice varieties were planted in an alpha lattice design with three replications. The traits, such as plant height, number of tillers, number of effective tillers, length of panicles, number of panicles per square meter, and grain yield, were found to be highly significant (p=0.05). Sabitri (4.8 t ha-1) and Makwanpur-1 (4.4 t ha-1) were the two rice genotypes that yielded the most. Plant height, panicle length, and grains per panicle showed positive and significant (p=0.05) correlations with grain yield, showing potential genotypes for higher yield. We concluded that, among all 24 genotypes examined, the most promising varieties from a growth and yield perspective were Sabitri and Makwanpur-1.
Effect of calcium chloride and floral preservatives in the vase life of gerbera cut flower
Authors: Timalsina Sumitra , Poudel Puspa Raj , Acharya Anil Kumar , Pathak Rukmagat , Pun Umed Kumar
Published: February 2023

Postharvest loss of cut flower at all the stakeholders in Nepal before reaching consumer is about 20-25% in Nepal. The major problem in gerbera for its vase life is stem or scape bending. This study was aimed to assess the effect of calcium chloride and different floral preservatives in the vase life and to evaluate the quality of different varieties of gerbera cut flower. The study was conducted in a completely randomized design in the controlled lab of Central Agricultural Laboratory located at Hariharbhawan, Lalitpur at 17±2 ˚C temperature, 55 ± 2% relative humidity (RH) and 100 lux light. The study revealed that among two varieties, Rosalin, a light pink variety of gerbera was found to be better with prolonged vase life. Rosalin showed the longest vase life (14.05 days) with higher solution uptake (13.97 mL) and recorded minimum stem bending (43.8˚) on 15th day of vase life. Among ten different vase solutions, 4% sucrose + 1% calcium chloride (18.25 days), 4% sucrose + 0.5% calcium chloride (16.58 days) and 0.5% calcium chloride (16.25 days) were found the most effective vase solutions to prolong the vase life of gerbera cut flower as compared to control (7.67 days). Vase life solution of 4% sucrose + 1% calcium chloride is a potential commercial preservative solution to improve the keeping quality and vase life of cut gerbera. To conclude, calcium treatment along with a carbohydrate in a vase solution improves the vase life of gerbera cut flower.
Rice demand and production projections for 2050: Opportunities for achieving self-sufficiency in Nepal
Authors: Timsina Krishna Prasad , Gauchan Devendra , Gairhe Samaya , Subedi Sushil Raj , Pokhrel Bhanu Bhakta , Upadhyay Santosh , Joshi Krishna Dev , Pandey Sunita , Shrestha Jiban
Published: February 2023

Rice is a major food, contributing 67% of cereal consumption in Nepal. It is playing a substantial role in food and nutritional security. Rice production is not sufficient to meet domestic consumption, so its import has been increasing. This study aims to explore whether Nepal can be self-sufficient in rice production in the current context of increasing rice demand and changing climate. We assessed the degree to which Nepal can be self-sufficient in rice production by the years 2030, 2040, and 2050, evaluating 12 different scenarios of demand driven by production, population growth, income, and climate change effect. We used compound growth rate estimation for analyzing the growth of rice production and population growth over time. Auto-regressive regression model was used to analyze the relationship of rice import and demand with domestic production, income, and population. A significant (p=0.000) positive impact of income on the import of rice was estimated, whereas significantly (p=0.000) higher impact of production on demand was estimated compared to income. Based on current rice productivity growth of 1.47% and population growth of 1.3% per year over three decades, the country will not achieve self-sufficiency until 2050.The situation would be further worsened in climate change scenarios. However, integrating the population growth rate of the last decade (0.57% per annum) with two productivity growth rate scenarios (current and (ii) 5% annual increment), the country can be self-sufficient by 2040. Based on different scenarios, the estimated demand can be met by increasing current productivity by at least 27–43% by 2030 and 42–85% by 2050. The study identified major gaps and opportunities in the rice production systems of Nepal and provided evidence-based solutions to meet the future demands in the context of increasing population and income, declining land availability, and high vulnerability to climate change.
The Psychomotor Development of Children Attending Forest Kindergartens in Poland
Authors: Christ Magdalena
Published: February 2023

The article focuses on the topic of psychomotor development of children attending forest kindergartens. Other authors’ research findings, showing the influence of nature on the functioning of children, were presented as a background and a reference point to the results of my own research. The research carried out in the Czech Republic and Germany, whose results indicate the development of children from local forest kindergartens, are presented in greater detail. The central part of the article is the presentation of the resultsof own research concerning the psychomotor development of children attending forest kindergartens in Poland. The research demonstrates that children who attend the said forest kindergartens vary in terms of their psychomotor development, however, in most cases their development does not deviate from the indicative norm. Therefore, forest kindergartens create conditions for children’s proper psychomotor development.
DEVELOPING FOREIGN LANGUAGE LEXICAL COMPETENCE AMONG FUTURE SPECIALISTS
Authors:   Бердянський державний педагогічний університет, HERASYMENKO Y.
Published: February 2023

The article is dedicated to the topical issue of developing foreign language communicative competence, which consists of phonetic, lexical, grammatical, reading and writing competencies among future specialists. Based on the statement that achieving a high level of professional foreign language competence is impossible without the formation of a particular profile of foreign language lexical competence among students in written and oral communication, the main emphasis was made precisely on developing lexical competence. The research has outlined the structure of foreign language lexical competence. It consists of: 1) lexical knowledge that students acquire during the mastering of a foreign language lexical system, namely semantic connections, oral and written forms of words, their relative value, rules of word formation, distinctive or similar features with the corresponding lexical unit (LU) of native language, etc.; 2) lexical skills to intuitively correctly create, implement and understand foreign language LU based on speech lexical connections between graphic and spoken forms of words; 3) speech and language experience, which ensures storage, categorization, and acquisition of skills for working with available information (its understanding and reinterpretation), which students receive while learning a foreign language, as well as building the patterns of using foreign words in their minds; 4) ways of carrying out cognitive activities that are realized during communication and depend on the knowledge of LU and their semantic meanings, as well as lexical skills that a student acquires during classroom and individual activities. The development of foreign language lexical competence occurs in two stages. At the introductory stage, students gain knowledge of the lexical structure of a foreign language and the rules by which it is used. At the automation stage, students develop and improve the skills of working with new lexical units at «word-phrase-sentence» and «monologue-dialogue-text» levels. In addition, the current work has presented effective methods and tools for developing foreign language lexical competence: online flashcards and interactive work with them; associative maps; LU visualization; use of YouTube; joining the online thematic groups; implementation of interactive dictionaries while reading texts online; passive work with LU – associograms, grouping LU by categories, search for semantic connections, etc. Key words: foreign language lexical competence, lexical units, oral communication, written communication, lexical knowledge, lexical skills.
PECULIARITIES OF PROJECT MANAGEMENT IN THE CONTEXT OF SOFTWARE ENGINEERING
Authors:   Бердянський державний педагогічний університет, GORBATIUK I.
Published: February 2023

The article is related to the problem of training future bachelors in software engineering for project management activities, which is caused by ensuring the quality and reliability of the software product and the insufficient level of preparation of young IT specialists for actual practice. The research method was the issue of theoretical justification of project management in software engineering. Based on the analysis of legal documents, psychological and pedagogical literature, and scientific research, the main concepts of the study were determined, such as: «project» and «project management». Thus, the project is characterized as a completed cycle of productive activity aimed at obtaining an objective new or subjective new result. The presence of uncertainties and the uniqueness of each project require specialists who will be engaged in its management. Emphasis is placed on understanding project management as a process of using knowledge, skills, tools, and techniques in project activities to achieve project requirements. The Waterfall’s methodology project phases were compared with the project phases proposed by the Project Management Institute in its books, based on which some features of project management in the context of software engineering were formed. The component of project management is singled out as «adjustment of project constraints: in a particular budget, resources, risks, delays, quality», which corresponds to the design phase of the project. The main program requirements for high-quality project management in support engineering have been established: understanding of the domain area of the project; knowledge of the programming language, technology stack, processes, and methodologies; project activity skills, characterized by the urgency of execution, concise lines, and quick results; the ability to adjust design constraints. Key words: project management, software engineering, waterfall.