bluuebunny/crossref_metadata_2025 huggingface dataset:
ChatGPT: How Closely Should We Be Watching?
Authors: Meagher Timothy
Published: December 2023

ChatGPT is about to make major inroads into clinical medicine. This article discusses the pros and cons of its use.
The Transition of Women Warriors From the Military to Civilian Life
Authors:   , King-Lee Saundra Louise , Rasmussen Harriette
Published: December 2023

Women veterans, also referred to as woman warriors, depart the military and find their experience to successfully transition a challenge. Transitions take time, beginning with the initial reintegration steps with family and friends, minimizing tensions to find employment, managing one's health, plus avoiding homelessness or suicide. This study utilized an interpretative phenomenological analysis approach to explore the lived experiences of women warriors as they transitioned back to civilian life after military service and make meaning of their experience. Women from five military branches that included Army, Navy, Marine, Air Force, Coast Guard, and Reserve Components explored their transition experience. Schlossberg's transition theory served as the conceptual framework for this study. The overarching questions that guided this research were: 1. How do women warriors, either from active duty or reserve components, who have transitioned to civilian sectors, describe the essence and meaning of their lived experiences? 2. How do women warriors transitioning from active military service or reserve components describe their lived experience seeking employment? 3. How do women warriors describe their experiences with military, veterans, and non-profit institutions dedicated to assisting with transitional programs? 4. How do women warriors describe their outcomes from the overall experience of transitioning? Keywords: women, warrior, veteran, transition, Schlossberg
Carpathian Cultural Migration and Its Impact on the European Ethnogenesis of the Inhabitants of Podhale and the Tatra Mountains
Authors: Maksymowicz-Mróz Natalia
Published: December 2023

The article presents the existing concepts of the ethnogenesis of the Podhale Highlanders, which seems interesting in the context of the current fashion among Highlanders for their Wallachian origin. Until now, in the literature on the subject, the view of the European origin has not been so strongly discussed. The methods adopted by the researcher include the analysis of historical studies of 19th-century researchers, as well as contemporary ethnographic materials. The material is supplemented by a pilot survey on awareness of the bonds of the Highlanders of Podhale with the inhabitants of the Carpathians.
Open Access at the Main Library of the Maria Curie-Skłodowska University in Lublin – in the Light of Own Research Results
Authors: Babicz Anna , Gryz Agnieszka
Published: December 2023

The article presents the changes that have taken place in the Main Library of the Maria Curie-Skłodowska in Lublin, resulting from the introduction of open access to some of the col- lections. Its main goal was to indicate the problems and benefits resulting from modernization of the existing solutions related to the way of using library collections. The rules of classification of the Library of Congress and process of its implementation in the Main Library of the UMCS were discussed. The case study method and comparative analysis were used to achieve the set goals. The paper presents the results of user satisfaction surveys regarding the use of the open access zone. The conclusions were based on surveys conducted among the Library users (students and employees of Lublin universities). The information obtained during the survey showed streng- ths and weaknesses in the functioning and organization of the open access zone at the Library.
Academic Achievement of Foreign Language Undergraduate Students during Pandemic Times
Authors: Sánchez-Sánchez Gabriel , Encabo-Fernández Eduardo
Published: December 2023

This research article aims to show the academic achievement in the form of marks of students of the third year’s subject ‘Teaching and Learning English’ located in the Degree in Primary Education (Faculty of Education, Universidad de Murcia, Spain). Our corpus of participants has five different groups (including the bilingual group) with a total number of n=1496 students with an average per academic year of n=374 students whose marks have been analysed comparing four different academic years. Taking into account the subject programme, the performance of the students during the normal year, during the lockdown, in the blended learning yeart (face-to-face and online) and in the return-to-normal year have been analysed. The results show that in both the lockdown and the blended learning year the performance is higher than in the other academic years, which leads us to question whether the pandemic really influenced the assessment and teaching conditions of the subject.
Breathing Enlightenment and Necessary Change into English Language Programs with Creative Writing
Authors: Randolph Patrick T.
Published: December 2023

Employing a number of crucial discoveries in neuroscience and drawing from years of valuable teaching experience, I show that creative writing is the most effective and natural kind of writing to help English language learners (ELLs) develop their writing skills. Based on over 25 years of language teaching experience, I argue that creative writing helps students find their unique writing style and voice, nurtures confidence in the craft, creates a genuine relationship with the skill, and successfully articulates their feelings and thoughts to a desired audience. Core writing problems for ELLs are addressed and creative writing is suggested as a powerful solution to many of these issues. A very successful creative writing workshop developed at an American Intensive English Program is offered to illustrate how essential the various genres of creative writing are for ELLs. This creative writing program developed the ELLs’ writing skills significantly more than any of the traditional kinds of academic writing activities or assignments. In most cases, the ELLs improved 30% to 45% on their writing exit exams after completing the creative writing program. The exit exam results for the academic writing course were considerably lower when compared to the creative writing program results. The article concludes by showing how discoveries in neuroscience and cognitive psychology support the use of creative writing over other forms of writing used in Academic English Programs and Intensive English Programs.
Students’ Diaries as a Source of Knowledge about Their Everyday Education and Private Lives During the COVID-19 Pandemic
Authors: Garbula Joanna Maria
Published: December 2023

On 20 March 2020, the Polish authorities announced the outbreak of the COVID-19 pandemic, caused by SARS-CoV-2. The announcement of the state of pandemic completely changed our lives. Healthy people were locked at home, entry to forests was forbidden, online school and work became mandatory and face masks and hand sanitizers became a necessity. The “battle” for vaccines was started. As for the people infected with the virus, in addition to transforming wards on hospitals to ones dedicated to COVID-19 patients, additional beds were arranged, for example, on stadiums. The number of deaths rose sharply, to around 200,000 in the years 2020–2021. At the moment, COVID-19 progresses from the pandemic stage to endemic one, which means that it will become a part of our lives. The experiences gained during that time are rooted in every person. Thus, it is worth looking at diaries written by the students of pre-school and early school pedagogics (uniform studies leading to a master’s degree, at the University of Warmia and Mazury, UWM in Olsztyn), in which they described their entanglement in the difficult pandemic reality, in the years 2020–2021, in the context of their education and private lives. It is worth emphasizing the importance of the source of information, apart from the problems raised. In this study, this is a source created, constructed over several months in a reality different from normal. The diaries uncover/reveal the meanings which the pedagogics students assigned to the pandemic reality.
Can You Hear Me Now? The Potential of Trauma-Informed and Resilience-Oriented Music Therapy in the Context of Foster Care
Authors: Konieczna-Nowak Ludwika
Published: December 2023

The main reasons for placing a child in foster care system in Poland is neglect and abuse, experienced in their family environments. These conditions might result in trauma, which strongly influences functioning of these young people. Currently, concepts like trauma-informed and resilience-oriented practice receive more and more attention both in the practitioners and researchers, in search of the framework of care-services and therapies. The current paper explores these approaches and connects them to music therapy. It provides with rationale on potential of this form of therapy in the context of work within foster care system with young people. The case vignettes illustrate the theoretical considerations.
How Do Young Children Verbalise What They See and Know about the World?
Authors: Kuszak Kinga
Published: December 2023

This is a review article. It characterizes the early stage of language development based on chosen literature. The author describes how children start to use verbal symbols and how speech becomes a tool in the process of thought. The article consists of two parts. The first shows the connection between language, speech, thought and creating terms. The second describes the development of understanding language symbols process and giving meaning by children up to about 16 months old.
US Congress and Policy of Sanctions
Authors: Timofeev I.
Published: December 2023

U.S. Congress plays an increasing role in the American policy of economic sanctions. Although the President and the Administration retain a significant power in national foreign policy, including the use of sanctions, Congress affects political agenda, promotes its own design of sanctions and keeps an eye on their implementation and further upgrade. Emergence of sanctions in the pubic laws, initiated and passed by Congress, usually makes their revocation hardly possible and keeps them for a long term. Such an institutional role of Congress raises a number of research questions. What are the key target priorities for Congress in terms of sanctions policy? Do these priorities overlap with the ones of the Administration? Are there any partisan splits on sanctions or sanctions policy is rather a matter of bipartisan consensus? What instruments of sanctions does Congress prefer? What share of bills finally turns into public laws and what is a connection of bills success to partisan affiliation or priorities concerned? To deal with these questions, the article reflects an analysis of 539 Congressional bills on sanctions, introduced in the House of Representatives and the Senate in 2019-2023. The database of bills includes such variables as targets of sanctions, political triggers of proposed restrictions, list of measures proposed, partisan affiliation of sponsors and cosponsors, etc. Results demonstrate the overlapping of priorities of Congress and Administration, though Congress attempts to constrain Administration on a number of issues, such as Iranian Nuclear Deal. There are specific partisan priorities. Republicans are proactive on sanctioning China, Iran and Afghanistan. Democrats are exploring new areas of sanctions use, such as climate, ecology, minorities’ rights, etc. Still, most of the bills have a bipartisan composition of sponsors and cosponsors. Most of successful bills, which turned into laws, are of bipartisan nature. Congressional bills imply the use of universal instruments of targeted sanctions such as asset blocking, visa bans or trade restrictions. However, country-specific measures, like suspension of particular military cooperation programs, are also on the radars of Congress. China and Russia a key priorities for Congress in terms of sanctions.
Political Crisis and Right-Wing Populism
Authors: Samarskaia L.
Published: December 2023

The Israeli democratic system is facing a serious crisis. After five rounds of parliamentary elections within three and a half years, Benjamin Netanyahu was able to forge a relatively strong coalition in late 2022. The political instability, however, did not end and instead morphed into widespread protests against the new cabinet seeking to pass a judicial reform. The meltdown is accompanied by incessant populist rhetoric stemming from Israeli right-wing parties which formed the coalition. Populism is inherent in a great number of countries around the globe. Israel is no exception in this regard. The phenomenon has been gradually taking a central place in its political arena since the 1970s. Currently, most major Israeli parties have certain populist elements in their rhetoric. This is in many ways a consequence of the heterogeneity of Israeli society and a plethora of its intersectoral contradictions. They have constituted an integral part of the state from its inception only to grow deeper. The unresolved Israeli-Palestinian conflict is an additional contributing factor. Right-wing populist parties possess a lot of traits that resemble similar movements in other countries, but at the same time are defined by their own specific features. In particular, they often combine inclusionary and exclusionary populism. By “us” these movements imply mainly the Jews and counterpose themselves to the Arab population in the country, as well as non-Jewish migrants. They also prioritize the Jewish character of the state over the democratic one, though without denying the importance of democratic structures. Concurrently, right-wing populist actors envisage their implementation in a different way. Even if they are not the reason for the parliamentary crisis in Israel, they still exacerbate it instigating further escalation in already considerable intersectoral tensions and narrowing opportunities for dialogue with other political actors.
Assessment of Heavy Metal Content and Consumption Risks At Selected Paddy Field in Malaysia: A Review
Authors: Yin Chew Jia , Hee Cheng Wan , Shing Wong Ling , Hock Ong Ghim , Subramaniam Geetha , Barasarathi Jayanthi
Published: December 2023

As the Malaysian population grows, there is a high demand for rice, the main staple food in this region. This has caused the overuse of agrochemicals that contain heavy metals and the utilization of contaminated groundwater to increase paddy yield, posing a risk to humans. This study reviewed the accumulated heavy metals in paddy fields of Malaysia's Selangor, Kedah and Sabah states and further calculated the consumption risks of rice grains from the selected areas. The study revealed that paddy soil in Ranau Valley (Sabah), Kota Marudu (Sabah) and Tanjung Karang (Selangor) showed presences of Cu and Cd in high concentration, respectively, creating higher potential to be uptake by paddy roots. These findings also revealed that Ranau Valley (Sabah) paddy grains contained high Cu and Cd concentrations, while Sabak Bernam (Selangor) contained high Pb concentrations. Further, a higher Cd concentration was reported from the Ranau Valley (Sabah), while the higher Pb concentrations were reported from the samples collected from Sabak Bernam (Selangor), Tanjung Karang (Selangor) and Kubang Pasu (Kedah). Based on the health risk indices calculation in this study, carcinogenic and non-carcinogenic health risks in all study areas except in Kubang Pasu (Kedah) and Langkawi (Kedah) are likely to occur due to Cu mining activities, ultrabasic soil contamination, utilization of contaminated groundwater and rock phosphate fertilizer and vehicular emission. Regular assessment of heavy metal content and consumption risks of paddy is essential to ensure the paddy field is free from contamination and will help protect the ecosystem and human health.
Work Place Self-Management by Academic Cum Clinical Physiotherapist – A Case Study
Authors: Ramalingam Vinodhkumar , Jain Mythri , Suganthirababu Prathap , Alagesan Jagatheesan , Balakrishnan Pradeep , Duraimurugan Prathibha , Balarathna  , Hussain Mohammed , Shing Wong Ling
Published: December 2023

One of the main issues in industrialized nations is work-related musculoskeletal disorders (WMSD), which are linked to demanding and repetitive work environments. Repetitive actions and work without leisure can lead to musculoskeletal problems. To prevent this occurrence, promoting healthy lifestyle self-care management is essential. The main objective of this case study was to assess the risk of work-related musculoskeletal disorders in professional physiotherapist and their workplace self-management. Case Description: a case of a 39-year-old male assistant professor cum clinical practitioner with 12 years of experience in the profession, who engages in using the computer for 6 hours a day for his academic and clinical documentation purposes, was assessed in the workstation. He complains of neck and shoulder pain after engaging in front of the computer for more than one hour, which he manages during the routine practice. He manages his pain by doing simple exercises like chin tuck-in and shoulder bracing by taking a short break every hour while working on a computer. Musculoskeletal-related pain was analyzed using the VAS score (visual analogue scale), and the level of the risks was analyzed using the rapid entire body assessment (REBA) scale. The case study showed that professional physiotherapists have a high risk of MSDs due to their engagement in multiple tasks and less attention to body posture. Regular exercise in the workstation and ergonomic workplace awareness would prevent the occurrence of work-related MSD.
SUSTENTABILIDADE EM ESTABELECIMENTOS PRODUTORES DE REFEIÇÕES NA REGIÃO NOROESTE PAULISTA
Authors: Gonçalves de Campos Pivetta Rebeca , Neumann Spinelli Mônica Glória , Carvalheiro Guerra Matias Andrea
Published: December 2023

Faced with new demands, human beings need to adapt their lives to available conditions, such as time, financial resources, places to eat, among other aspects. The present work had as objective to analyze the sustainability in Food Services (FS) in the Northwest region of São Paulo. A cross-sectional study was carried out using a convenience sample composed of twelve meal producers in the northwest region of São Paulo, generated from visits to norms and checklists related to social and environmental sustainability. It was observed that 75% (n = 9) of the improved perform selective collection of solid waste and separate disposable disposables that can be recycled and that 75% declared the need to hire new employees during the pandemic due to the increase in the delivery service, modality found in all food services and, to this end, 41.7% use expanded polystyrene (styrofoam), 33.3% use paper and 25% use cardboard for packaging. The use of products from family farming was not verified, probably due to the incompatibility between the planning of restaurant menus, high demand from FS and diversity of supply, in addition to the logistical issue of delivery for the full performance of the components. The present study concluded that the disposal of organic waste promoted compost production; as packaging for the selective collection of solid waste, together with the destination of the dissipated oil, the most effective form of disposal and most regulations make use of “styrofoam”, which is the main type of packaging used for delivery
ESTUDO COMPARATIVO DA QUALIDADE HIGIÊNICO-SANITÁRIA DA ÁGUA DE CONSUMO HUMANO EM DUAS COMUNIDADES NO VALE DO PARAÍBA, SP
Authors: Alves Sabrina Coelho , De Monteiro Ribeiro de Camargo Vanessa , Amorim Edvaldo Gonçalves de , De Aquino Silva Maria Regina
Published: December 2023

Poor sanitation is a risk factor for waterborne diseases (DVH), whose transmission is fecal-oral. Several diseases are aggravated by contact with unhealthy environments. According to Unicef, diarrhea, a waterborne disease, is the second leading cause of death in children under 5 years of age in the world. The Potability Ordinance of the Ministry of Health establishes that drinking water is potable in the absence of total and thermotolerant coliforms. The objective is to compare the hygienic-sanitary quality of drinking water in two communities in Vale do Paraíba/SP (the first, in Guaratinguetá; the second, in São José dos Campos), lacking in sanitation. In the first, 20 residential samples were collected and in the second, 17 samples (residential, mine and distribution truck). In the first, which has water treatment, no contamination was found; in the second, lacking this resource, there was contamination in 71% of the samples. In conclusion, the importance of water treatment is emphasized, which constitutes a protection factor for the population and, furthermore, the implementation of monitoring and control policies for in natura sewage discharges into the Paraíba do Sul river must be considered as necessary, as well as policies that minimize the socio-environmental vulnerability evidenced in communities such as those studied in this work
IMPLICAÇÕES MEDICAMENTOSAS A NÍVEL HEPÁTICO EM PACIENTES SUBMETIDOS A TRATAMENTO DA COVID-19
Authors: Ribeiro Elielson Antunes , Bellaver Emyr Hiago , Zancanaro Vilmair
Published: December 2023

The COVID-19 virus has brought to light a new illness that has raised several questions worldwide, one of which is related to the prophylaxis of the disease, i.e., which drugs can be used to treat the infected patient and what long-term side effects the patient may develop. The aim of the article is to analyze possible hepatic changes in patients undergoing COVID-19 prophylaxis in the ICU, identify the correlation with pharmacological choice, and evaluate long-term side effects. The research was conducted by analyzing electronic medical records of 101 patients undergoing COVID-19 prophylaxis in the ICU in 2020 and 2021. The main observed hepatic changes were in GGT and AST, with the most used medication in the COVID-19 cocktail being azithromycin, associated or not with hydroxychloroquine, ivermectin, or both. The research has some limitations, as it was conducted in only one hospital unit, and therefore, the results cannot be generalized to other regions. However, the significant findings highlight the importance of evaluating the long-term side effects of medications used in COVID-19 prophylaxis, especially in relation to the liver, and considering the correlation with pharmacological choice. This can help improve therapy and prevent serious complications in patients with COVID-19
Iron profile in sickle cell heterozygous children: A case control study
Authors: Nayak Himanshu , Majhi Subhash Chandra , Kiro Sameer , Murmu Mangal Charan , Murmu Pitambar , Meher Shitanshu Kumar , Panda Sanjukta
Published: December 2023

Iron deficiency is the most common nutritional deficiency worldwide & it is an important public health problem in developing countries like India. Normally chronic hemolytic anemia are iron loaded because of excessive breakdown of RBC & increased frequency of blood transfusion, but there is small or no transfusion on sickle cell trait. This study has been done to see the iron profile among sickle cell trait children in western Odisha.

To determine the iron profile in children with sickle cell trait & normal healthy controls & compare them.

This was a case control study that has been conducted over a period of two years. A total of 202 subjects were included in the study; 102 of them were sickle cell heterozygous & 100 of them were normal healthy controls. Iron deficiency anemia among sickle cell trait & healthy controls were screened using various clinical & laboratory criteria.

A total of 202(n=202) study populations comprising of 102 sickle cell trait & 100 normal study populations were screened. A little female preponderance (n=109, 54%) was observed in this study. Abnormalities in blood parameters like MCV, MCH, MCHC, Serum ferritin were found to be statistically significant (p<0.005). Others clinical features like pallor, picophagia, sore tongue, fatigue was also found to be statistically significant (p<0.005). Out of 202 study populations 17 out of 102 sickle cell trait cases & 16 out of 100 normal controls were found to have Iron deficiency anemia.

In this study it showed that there were many sickle cell trait patients who were actually iron deficient. These patients should be screened carefully to look for Iron deficiency anemia. Clinical parameters like pallor, fatigue, picophagia, sore tongue & others laboratories parameters like MCV, MCH, MCHC, Serum ferritin were helpful in diagnosing Iron deficiency anemia.
Contributing factors, complications and immediate outcome of birth asphyxia in a tertiary care centre in Assam
Authors: Das Himadri , Medhi Gautam , Devi Priyanki , Deka Bhanita , Barman Diganta , Bhoktiari Monalisa
Published: December 2023

: Birth asphyxia is defined by the World Health Organization as the failure to initiate and sustain breathing at birth. Etiological factors include maternal factors like hypertension, chorioamnionitis, diabetes, maternal pulmonary or cardiac disorders, placental factors like abnormal placentation, abruption, infarction, hydrops, uterine rupture, umbilical cord prolapse, entanglement, true knot, compression, abnormalities of blood vessels, fetal factors like anemia, cardiomyopathy, infections, hydrops, neonatal factors like cyanotic congenital heart disease, persistent pulmonary hypertension of the newborn, respiratory failure due to meconium aspiration syndrome, congenital pneumonia, pneumothorax etc.

: To study the contributing factors, complications and immediate outcome of birth asphyxia in a tertiary care centre in Assam.

: It was a prospective observational study carried out in NICU, Gauhati Medical College & Hospital, Guwahati, Assam. The study included clinical profile of 200 cases of birth asphyxia admitted to the above center during period of one year starting from 1st of August 2021 to 31 July 2022.

: In our study, out of 200 neonates, 102(51%) were male and 98(49%) were female. 161 cases (80.5%) were term.115 mothers (57.5% were primigravida and 85 mothers (42.5%) were multigravida. Various antenatal contributing factors were found to be meconium stained liquor (68%), anemia (57%), pregnancy induced hypertension (15%), prolonged labor (28.5%), fever(5%), antepartum haemorrhage (5.5%), chorioamnionitis (5%).Various complications of birth asphyxia observed in the study were hyperbilirubinemia 76 cases (38%), hypocalcemia 46 cases (23%), shock 31 cases (15.5%), DIC(13%), meconium aspiration syndrome 24 cases (12%), hypoglycemia 15 cases(7.5%),sepsis 13 cases (6.5%), apnea 14 cases (7%), Necrotising Enterocolitis 6 cases (3%), AKI 120 cases (60%) and the total mortality percentage was 26%.

: Birth asphyxia is a leading cause of mortality among the newborn. The contributing factors needs to be addressed at the earliest to decrease the mortality and morbidity due to birth asphyxia.
Histopathology of endometrium in women presenting with abnormal uterine bleeding in Vindhya region
Authors: Tiwari Medha Singh , Agrawal Priyanka , Sutrakar S.K , Singh Santosh , Khatik Neha
Published: December 2023

: Any alteration in frequency, flow duration/blood loss amount of menstruation is known as Abnormal uterine bleeding/AUB. Almost 30% of all patient attending gynaecology OPD are for AUB. This study was conducted in Vindhya region to study endometrial histopathology amongst women complaining of abnormal bleeding pattern

: This retrospective study was conducted on 200 women presenting with AUB who undergone endometrial biopsy or hysterectomy in the Obstetrics and Gynaecology Department and sent to Histopathology section of Pathology department, SSMC, Rewa (MP) from Jan 2020 to June 2021. The formalin fixed specimens were received grossing done, followed by processing and then staining with H& E stain, followed by microscopy. Data & history was taken from the patient herself and attenders.

: AUB was observed in all age groups. Menorrhagia (105 patients, 52.5%) was commonest bleeding pattern observed in cases of AUB, followed by Metrorrhagia (54 patients, 27%). In our study Proliferative endometrium (71 patients,35.5%) was most common histopathological diagnosis found, followed by Non-Atypical endometrial Hyperplasia (45 patients, 22.5%), Secretory phase (20 patients,10%), DPE (20 patients,10%), Atrophic endometrium (12 patients,6%), Exogenous hormone (pill endometrium 10 patients, 5%), Benign Adenomatous polyp (9 patients, 4.5%), Atypical endometrial Hyperplasia (5 patients, 2.5%), chronic endometritis (5 patients, 2.5%), Endometrial carcinoma (3 patients, 1.5%).

Variable Histopathological findings are found in endometrial biopsy and curettage done in AUB patient. This study emphasizes the significance of endometrial biopsy and its histopathological diagnosis for proper patient management.
Comparison of central corneal thickness and endothelial cell count among diabetic retinopathy and non-diabetic cases
Authors: Chaudhury Pranati , Misra Anita , Puthal Niranjan , Sahoo Sasmita , Jena Bichismita , Panda Rajesh
Published: December 2023

: Diabetes is associated with alterations in the structure and functions of corneal endothelial cells. Current research has been carried out to compare the central corneal thickness and endothelial cell density in patients with diabetic retinopathy (DR) and non-diabetic (ND) individuals.

: A Cross Sectional comparative research was carried out in a tertiary eye care hospital, over the period of two years from April 2021 to March 2023. Among 160 study participants, 80 cases with diabetic retinopathy (DR) and 80 non-diabetic (ND) cases as age matched control have been selected. Thorough Ophthalmic assessment was done. We have included only retinopathy cases as they have longer duration of diabetis and poorer metabolic control, for better comparison of the endothelium parameters with non-diabetics. Specular microscopy has been done in all cases for endothelial cell count evaluation and thickness of cornea has been estimated by Pachymeter. Statistical analysis was carried out by students‘t’ test by comparing the variables between two groups.

: P-value was not significant for the mean age and sex distribution in the two groups. Mean endothelial cell density was lesser (2512.12±260.23cells/mm2) in DR than in ND group (2699.10±95.68cells/mm2). Mean central corneal thickness was greater (522.65±36.56μm) in DR than in ND group (486.50±18.67μm) (P<0.05). Also, the Co-efficient of variation percentage was more whereas the percentage of hexagonality was found to be statistically less in DR than ND group.

Among DR patients, endothelial cell density was significantly reduced and central corneal thickness considerably raised when compared with ND. Our results also suggest that poor metabolic control and advanced Diabetic Retinopathy are risk factors for developing keratopathy.
Quality of life in children aged 5- 14 years with beta thalessemia major
Authors: Ganguly Sristi , Jena Ipsita , Soren Narendranath
Published: December 2023

With recent advances for a chronic disease like thalassemia, where lifelong management is required, the quality of life, not just survival gains important. Owing to high burden of thalassemia in Odisha, this study analyses the quality of life in pediatric beta thalassemia major and the factors influencing the same.

This was a hospital based cross-sectional study done in a tertiary care hospital, Cuttack during September 2019 to January 2020. Children aged 5-14 years, diagnosed with beta-thalassemia major with regular blood transfusion, were subjected to modified SF-36 questionnaire to assess the quality of life in total and domains- General health , Physical health , Social activities , Limitation of activities, Educational , Psychological and Family aspect. Score above 50 considered as good. Data analysed using SPSS 18.0.Statistical significance was assessed by ANOVA and Chi-square test.

Among 200 cases studied, majority (70.5%) had poor score, with mean being 49.19+6.53. In terms of domain, family aspect led (62.0+ 15.60), followed by limitation of activities(58.25+27.69), psychological aspect (51.75+ 12.47), physical health (50.85+14.60), educational aspect (41.92+ 19.294), general health (41.40+12.32) and social aspect was 38.17+ 24.20.

A significant association was noted between good quality of life and male gender (p-0.004), mother’s occupation (p-0.013), number of children (p-0.001), higher serum ferritin level (p<0.05) and blood transfusion frequency (p-0.015) in the study population.

Considering the poor quality of life in children with thalassemia major, there is urgent need to focus on holistic approach towards management incorporating educational, emotional and physical rehabilitation, to ensure their productivity in the society.
Clinical profile, management and outcomes of pseudoexfoliation syndrome with glaucoma in a tertiary eye care hospital
Authors: Misra Anita , Chaudhury Pranati , Subudhi Priyambada , Puthal Niranjan , Panda Rajesh , Gupta Rupa
Published: December 2023

To study the clinical profile, management and outcomes of pseudoexfoliation (PXF) syndrome with glaucoma in a tertiary eye care hospital.

This is a prospective hospital based interventional study over a period of two years from January 2020 to December 2022. 300 eyes of 150 cases aged between forty to ninety years, visiting OPD and diagnosed with PXF syndrome with glaucoma were enrolled in the current study. Cases with other causes of glaucoma, ocular trauma or surgery, cases who were lost on follow-up were excluded.

In our study, 67% eyes with PXF syndrome were non-glaucomatous and 33% (300 eyes) were glaucomatous which was taken as the study population. PXF syndrome cases having glaucoma showed 43 % of PXF glaucoma, 27% primary open angle glaucoma, 18 % primary angle closure glaucoma and 12 % normal tension glaucoma respectively. Bilateral glaucoma was seen in 83% .Mean Intra ocular Pressure (IOP) of the cases was found to be 18.28 ± 3.48 mmHg. Surgical intervention was done in 20% with surgical complications reported among 16.7 % eyes. Mean IOP after 1 month and 12 month of surgery was 16.8 mmHg and 14.6 mmHg respectively.Greater prevalence rate was found with age greater than 60 yrs, mean being 64 yrs and there was no gender predilection.

We observed a greater incidence of PXF syndrome with glaucoma in our region and a positive statistical correlation with increasing age, poor mydriasis and progressive glaucomatous optic neuropathy unresponsive to medical management.Rate of surgical complications was very high.Hence, Ophthalmologists must emphasize on screening and meticulous preoperative examination of PXF to avoid intraoperative complications in these cases.
Cytomorphological study of pap smear and its efficacy to detect various cervical lesions
Authors: Jain Rashmi , Singh Nikita , Sanjuna D , Tripathi Lokesh , Jain Ankit
Published: December 2023

: Cervical lesions require screening for early diagnosis to differentiate between non-neoplastic and neoplastic lesions of cervix. The present research aimed to evaluate the prevalence of various cervical lesions and detect the efficacy as a screening test of pap smear for early diagnosis of cervical lesions.

: The current retrospective study was conducted in the Department of Pathology, SSMC, Rewa, M.P. Total 658 cervical pap smears were retrieved, re-examined and re-classified according to the revised Bethesda system for reporting of cervical cytology, 2014. Out of 658 pap smears, 234 biopsies were available, which were re-examined histopathologically and correlation was done with their corresponding cytological findings.

: Out of 658 pap smears, negative for intraepithelial lesion or malignancy (NILM) was found in 74.47% smears, while the prevalence of epithelial cell abnormalities (ECA) was 24.32%. Amongst ECA, most common (11.86%) cervical lesion was low-grade squamous intraepithelial lesion (LSIL). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the diagnosis of pre-invasive and invasive cervical lesions was found 70.54%, 81.9%, 82.72%, 69.35% and 75.6% respectively.

: The current study showed that pap smear cytology is able to detect various cervical lesions with a diagnostic accuracy of 75.6%. So, women belonging to reproductive or postmenopausal age-group should be routinely screened for cervical lesions by non-invasive pap smear method. Conclusively, early diagnosis of cervical lesions is possible, thus reducing the incidence of invasive cervical carcinoma.
Clinical profile and comparison of renal insufficiency in obese and non-obese hypertensive patients: A cross-sectional comparative study
Authors: Kothari Saurabh , Shetty Varun , Bhori Mustansir
Published: December 2023

Renal failure can stem from various conditions, and detecting biomarkers associated with obesity-related disorders is crucial for early identification of the risk of renal failure and timely intervention in obese individuals. Though different studies have depicted a relationship between obesity, metabolic abnormalities and cardiovascular outcomes but there is scarcity of evidence in the Indian population as there are no published data comparing this condition in hypertensive patients with or without excess BMI. Thus, we designed a prospective study to determine the prevalence of renal insufficiency in a tertiary care hospital by correlating various socio demographic and clinical risk factors.

A total of 100 subjects were enrolled in the study as per the inclusion and exclusion criteria. We conducted a clinical and biochemical profiling to evaluate renal insufficiency in subjects.

: The mean duration of HTN in obese hypertensive patients were 7.50 ± 3.86 years and in non-obese hypertensive patients it was 7.22 ± 4.09 years. The mean systolic blood pressure recorded in obese and non-obese patients was 136.36 ± 12.17 and 138 ± 14.64 mm Hg respectively. Prevalence of renal insufficiency in obese and non-obese patients was found 30% and 20% respectively.

We can conclude on the basis of obtained results, hypertension is one of the major risk factors in the development of renal insufficiencies, and the presence of obesity may further increase its prevalence rate of kidney diseases.
Clinical profile of multi-drug reisitance tuberculosis in adults
Authors: V Latha , T M Tanveer Ahmed , G Shyamala
Published: December 2023

on 24 march 1884 etiological agent of tuberculosis was discovered by German doctor Dr. Robert Koch, this discovery led to variety of medical applications in diagnosis and management of pulmonary TB. Among many infectious disease prevalent in India, drug resistant TB is one among the important public health problem. There are many factor which influence occurrences of the drug resistant TB, our study conducted mainly to understand those factors which influences the drug resistant TB i.e clinical profile of drug resistant TB in tertiary hospital VIMS, Ballari.

The prospective study was conducted in patients admitted in medical college hospitals affiliated to Vijayanagar Institute of Medical Sciences, Ballari over a period of 2 years from November 2016 to October 2018. All patients with sputum AFB and X-ray suggestive of tuberculosis were sent to CBNAAT (Cartridge-based nucleic acid amplification test) for detection of drug resistance. Clinical and radiological characteristics, and risk factors were recorded and further analysis was made.

Out of 150 patients with pulmonary tuberculosis 28 of them were detected with drug resistance tuberculosis. Out of 28 drug resistance tuberculosis patients all 28 patients had resistance to isoniazid and rifampicin (MDR-TB). During the study period, among the drug resistant tuberculosis patients the maximum patients belonged to age group 35 to 48yrs of age and males (n=24, 85.7%) outnumbered females (n=4, 14.3%). Fever (n=26, 92.9%) was common symptom. And next common symptom was cough (n=25, 89.2%), loss of appetite, shortness of breath, hemoptysis, loss of weight, chest pain and wheezing. HIV (39.2%) was the common comorbidities among the study patients, followed by diabetes mellitus (35.7%), HTN (35.7%) and COPD (28.5%). About 71.5% of the cases were smokers and 64.3% had history of alcohol consumption and 14.2% were tobacco chewers in this study. About 57.1 % (n=16) were taken ATT previously and not completed treatment and 4 of them were relapse case.

This study had shown that, drug resistance tuberculosis is more common than a rare entity and also shows that drug residence is associated with HIV and drug defaulter. Appropriate adherence with ATT and early diagnosis is main determinant in drug resistance TB.
Sars-cov-2 and denv co-infection: Diagnostic challenge and curse on overloaded health care system
Authors: Tiwari Suman , Sarwat Tarana , Kakru Dalip K
Published: December 2023

Co-infection with dengue is posing a diagnostic challenge in dengue-endemic countries because of similar clinical symptoms & laboratory findings between COVID 19 and Dengue infection. This co-infection is a warning for dengue endemic regions to face the challenge of differentiating and managing two disease entities together as both show serological cross reactivity which can mislead the timely diagnosis and treatment and is associated with increased mortality. And if timely diagnosis is not made, it will spread the virus to other people as timely isolation will not be done.

: Present study aimed to determine the prevalence of COVID-19 & dengue co-infection in a tertiary care centre and to compare the laboratory findings among patients of COVID-19, dengue and co-infection cases.

: This cross-sectional study was conducted in the Department of Microbiology, SMSR, Sharda Hospital and University.

: This cross-sectional study was done on COVID-19 positive patients and dengue positive patients over the period of four months. Nasopharyngeal/ oropharyngeal swabs were subjected to RT-PCR for COVID-19 infection and serum samples of the patients were used for performing rapid card test for dengue infection.

: The statistical analysis was performed with SPSS Software (Statistical Package for Social Sciences) and presented in form of tables and graphs. P<0.05 was considered as statistically significant.

Out of 45 cases with COVID-19 & DENV co-infection, age group 40-70yrs constitute 62.2% of cases. 24.4% (11 patients) out of 45 co-infection patients showed leucopenia. 62.2% (28 patients) out of 45 co-infection patients showed lymphopenia. 64.4% (29 patients) out of 45 co-infection patients showed increased levels of D-Dimer. 48.9% (22 patients) out of 45 co-infection cases developed thrombocytopenia.

: In dengue-endemic regions like India overlapping out-breaks of dengue & COVID-19 infection, poses a challenge for accurate diagnosis & treatment because of similarities in clinical symptoms and laboratory findings.
Knowledge and practice of masks during COVID-19 among non-teaching staff in a tertiary health care Centre, India
Authors: Kushwaha Poonam , Pundhir Ashish , Gahlot Anju , Singh Lakshmi
Published: December 2023

The novel coronavirus (COVID-19) pandemic has infected millions worldwide. Preventive interventions are beneficial to mitigate transmission, containment of the disease, and stop the resurgence of another wave of the pandemic.

A cross-sectional study was done among non-teaching staff, aged 18 years or above willing to voluntarily participate to assess knowledge and practice of face masks during the COVID-19 pandemic in a tertiary health care center. we also addressed the need for the use of face masks even after the vaccination is done.

Subjects demonstrated good knowledge about transmission and practice of preventive measures for COVID-19. Among those, who were always (100%) using masks, marital status, education, and occupation had a significant association with the frequency of use of masks. While those, who were mostly (>50%) using masks, marital status, and education were significant determinants of the frequency of use of masks.

The study highlighted the importance of knowledge and appropriate practice of the use of masks, which can help policymakers to predict success & make necessary modifications based on it, to stop transmission and fluctuation in the declining phase of covid-19 pandemic.
Study of thyroid functions in transfusion dependent thalassemia patients of pediatric age group with reference to serum ferritin level in a tertiary care centre
Authors: Nayak Bibhu Prasad , Murmu Mangal Charan , Panda Swarupa , Mohapatra Tanuja , Singh Bipsa
Published: December 2023

Hypothyroidism is one of the most common endocrine complication in transfusion dependent thalassemia patients. Its prevalence and severity is variable and the natural history is poorly described. The frequency of hypothyroidism in Beta Thalassemia Major (BTM) children ranges from 6 to 30%.

To determine the levels of serum TSH and FT4 in patients with transfusion-dependent thalassemia (TDT), as well as their relationship to the degree of iron excess indicated by serum ferritin levels.

This observational descriptive study was undertaken on 200 patients (5 to15 yrs of age) in the department of Pediatrics in SCB Medical College, Cuttack, Odisha, India from to after obtaining clearance from institutional ethical committee.

Out of total 200 TDT children, 141(70.50%) were euthyroid and 59(29.50%) were hypothyroid. Among hypothyroid children, 9(4.5%) had overt hypothyroidism and 50(25%) children had subclinical hypothyroidism. In children <10 years of age group there was a positive correlation between serum ferritin and rise in serum TSH (p < 0.05, r= .553). The rise in serum ferritin was statistically not significant with fall in serum FT4 (p < 0.05, r= .122). In children >10 years of age group, there was positive correlation between serum TSH and serum ferritin (p < 0.05,r=.845). There was an inverse relation between rise in serum ferritin and fall in serum FT4 (p < 0.05, r= -.406).

Hypothyroidism was associated in significant number of transfusion dependent thalassemia patients. Adequate iron chelation therapy to keep serum ferritin level within normal limit and early detection of hypothyroidism preferably below 10 years of age will prevent hypothyroidism and its complications in transfusion dependent thalassemia.
Drug utilization study in acute febrile illnesses in a tertiary care hospital of central India
Authors: Quazi Shadma Hafizuddin , Siddiqui Riyaz , Shende Tanaji R , Mahajan Harshal , Dashputra Amruta Vishwas
Published: December 2023

Acute febrile illness (AFI) can be caused by various aetiologies. Different antimicrobials are available to be used depending on the cause. Also, there are interpersonal variations in the prescription of these antimicrobials. Antibiotic stewardship programs frequently employ antibiotic policies to reduce the needless use of drugs and improve management. As a result, the purpose of this study is to examine current patterns in the use of antibiotics in patients with acute febrile illness.

It is an observational study based on records that were conducted at a tertiary care hospital. 300 patient case files with acute febrile illnesses were admitted to the Department of Medicine after analysing numerous etiologies for antibiotic usage. Antibiotics for different aetiologies of febrile sickness were noted in a case record form. Data collected were analysed for proportion to find the prescription pattern of antimicrobials.

Respiratory tract infections, especially upper respiratory tract infections (URTI) (26.6%) are frequent clinical diseases for which antibiotics were administered followed by acute gastroenteritis (16%), urinary tract infection (UTI) (12.3%) and lower respiratory tract infection (LRTI) (9.6%), dengue fever (9%) & viral fever (8.3%). Ceftriaxone (20%) was one of the most frequently prescribed antibiotics and Piperacillin+ Tazobactum (16.25%) was followed by Amoxycillin + clavulanic acid (10.5%), Clarithromycin (8.5%), Cefuroxime (7.25%).

According to our analysis, respiratory tract infections and gastrointestinal infections were the two conditions for which antibiotics were most frequently administered. Third-generation cephalosporins, particularly ceftriaxone and cefixime, were the most frequently used antibiotics.