bluuebunny/crossref_metadata_2025 huggingface dataset:
HIGHLY SENSITIVE LABEL-FREE ELECTROCHEMICAL DETECTION OF HEAT SHOCK PROTEIN WITH LOW-COST SCREEN-PRINTED ELECTRODES
Authors: DOĞAN GUZEL Fatma , AKCAKOCA Iremnur , GHORBANPOOR Hamed , NOROUZ DİZAJİ Araz , ÖZTÜRK Yasin , BLAİR Ewen , KOCAGOZ Tanıl , CORRİGAN Damion , AVCI Hüseyin
Published: December 2021

Heat shock proteins are produced when the organisms are exposed to various environmental stress conditions such as temperature, light, toxins. It is a known fact that in bacteria, which has the HSP gene, antibiotics can trigger the expression of the heat shock protein. However, the response of heat shock protein genes to antibiotics has not been fully clarified in the literature yet, studies are still ongoing. In this study, a novel way for the detection heat shock protein65 was investigated using the electrochemical impedance spectroscopy due to its sensitivity, selectivity, low cost. To do so, heat shock protein65 probe and target were designed and the hybridization behavior of the probe with designed target was studied upon the binding onto screen-printed electrodes. Cyclic voltammetry was performed to analyze surface characterization of secreen printed electrodes and the performance of the screen printed electrodes was tested using electrocehimcal impedance spectroscopy by measuring changes in the charge transfer resistance upon hybridization. Based on obtained results, the designed heat shock protein65 probe was confirmed and an appropriate increase in charge transfer resistance values compliance to the literature proved that the electrochemical impedance spectroscopy can be effectively used to detect heast shock protein65 probe label-free. Results presented here can lead to development of antibiotic susceptibility assay based on the heat shock protein genes in future.
Lo sviluppo del controllo accentrato di costituzionalità in America latina e il suo ruolo nelle moderne democrazie: verso la costruzione di uno jus commune del diritto processuale costituzionale?
Authors: Rolla Giancarlo
Published: December 2021

Cien años después de la entrada en vigor de la Constitución austríaca en 1920, esta obra tiene por objeto, en primer lugar, poner de relieve tanto la novedad que representa la justicia constitucional, en comparación con las formas anteriores de control de la constitucionalidad, como las transformaciones que ha experimentado el «modelo» austríaco durante su circulación en Europa y en América Latina. Posteriormente, se examina con mayor profundidad el papel diferente que desempeñan los tribunales constitucionales tanto en las fases posteriores a una ruptura constitucional o durante una transición democrática como en los períodos de democracia «madura». En ambos contextos se intenta poner de relieve las técnicas interpretativas utilizadas por los tribunales constitucionales para armonizar los valores constitucionales con la sociedad y dialogar con los demás poderes del Estado. Por último, se subraya la creciente participación de los jueces constitucionales en la resolución de cuestiones de importancia política e institucional.
Editorial: Expanding the Digital Economy
Authors: Campbell Leith H.
Published: December 2021

This editorial comes in two parts: some remarks on barriers to the further expansion of the digital economy; and a brief introduction to the papers in this issue.
The bioinformatic identification of proteins with varying levels of post-translational modifications in experimental ischemic stroke in mice
Authors: Skvortsov V.S. , Ivanova Ya.O. , Voronina A.I.
Published: December 2021

The experimental data obtained by Simats A. et al. (Molecular and Cellular Proteomics, 2020, 19(12), 1921-1936) was analysed using a bioinformatic approach. Original experimental results available in the ProteomeXchange database were obtained using a comprehensive multidomain approach to identify potential blood biomarkers in ischemic stroke in mice. The identification of peptides with post-translational modification (PTM) was performed by us using the raw data (accession code PXD016538). Only phosphorylation and deamination were considered as PTMs. Different combinations of data sets (ischemic tissue with intact tissue, ischemic tissue with control taken from mice after sham surgery, etc.) were compared both in terms of the ratio of abundance for the modified peptide to the unmodified variant and in terms of absolute values of abundance. The most likely change in precisely PTM levels was shown for 27 proteins, which include dynamin, glycogen phosphorylase and 70 kDa heat shock protein.
Predicting the risk of tumor progression in patients with early stages of adenocarcinoma and squamous cell lung carcinoma based on laboratory parameters
Authors: Tahanovich A.D. , Kauhanka N.N. , Prohorova V.I. , Murashka D.I. , Gotko O.V.
Published: December 2021

Non-small cell carcinoma (NSCLC) prevails in the structure of the incidence of lung cancer. In patients with I stage NSCLC, only 60-70% overcome the 5-year survival barrier, and at II stage it decreases to 35-40%. The reason for such a high mortality rate is almost always a relapse of the disease. The main histological forms of NSCLC — adenocarcinoma (AC) and squamous cell carcinoma (SCLC) — differ in the course, protocols and effectiveness of the treatment. Comparative survival data for AK and PCLC are controversial, and reliable biomarkers for determining the risk of tumor progression are lacking. In thus study we have investigated the possibility of using laboratory parameters characterizing the level of some blood proteins involved in carcinogenesis in patients with early stages of AC and SCLC to determine the risk of disease progression. We retrospectively analyzed the duration of the relapse-free period after surgical treatment for one year in 1250 patients (816 with stages I and II of adenocarcinoma, G1-3 and 434 with early stages of SCLC, G1-3). In 81 patients with AC and 36 — with SCLC (stages I-II, G1-3) the level of CYFRA 21-1 and SCC by electrochemiluminescent method, chemokines CXCL5, CXCL8, TPA, pyruvate kinase M2, HIF-1α and hyaluronic acid by enzyme immunoassay, receptors CXCR1, CXCR2, CD44v6 by flow cytometry were determined. Using the Kaplan-Meier graphical analysis, groups of low (stage I G1-2 + stage II G1) and high (stage I G3 + stage II G2-3) risk of tumor progression were identified. In the case of the one-year survival rate of patients with AC was higher than with SCLC. In patients with AC and a high risk of tumor recurrence, compared with a low one, the level of CYFRA 21-1, the mean intensity of fluorescence (MFI) of the CXCR1 receptor in granulocytes, and the relative content of the CXCR2 receptor in lymphocytes were higher. In the case of rapid progression of SCLC in patients, the relative content of the CXCR2 receptor in lymphocytes, the proportion of monocytes equipped with the CD44v6 receptor, and the SCC level were higher than with slow progression. Regression equations, including combinations of the above parameters (threshold value for AC — 0,512, for SCLC — 0,409, sensitivity — 91,9% and 90,0%, specificity — 90,0% and 87,5%, respectively), allow to predict the probability of tumor recurrence.
Organ Transportation Thermoelectric Cooling System Design and Application
Authors: Taspınar Yavuz Selim , Işık Prof. Dr. Hakan
Published: December 2021

Thermoelectric modules are used in medical devices, air conditioners, refrigeration cabinets, measuring devices, etc. widely used in the fields. Application areas of thermoelectric modules and efforts to increase efficiency are in continuous development. In this study, an organ transport device with the thermoelectric cooling feature, which can be used in the medical field, was designed and performed and performance analyzes were made. An animal kidney measuring 5x6x10 cm was placed in the designed and realized system, and performance analyzes of the system were made at ambient temperatures of 25ºC, 30ºC, 35ºC, 40ºC. Each experiment was repeated five times and the average was taken. It was seen that the system, whose performance analyzes were carried out at different temperatures, was usable. The system's small size, less weight and low cost compared to conventional cooling systems are among the important advantages of the system. It is possible to say that with the further development of the implemented system, larger organs can be cooled and transported and further studies can be carried out in this direction.
Classification of left and right hand motor imagery EEG signals by using deep neural networks
Authors: Korhan Nuri , Abilzade Leyla , Ölmez Taner , Ölmez Zümray Dokur
Published: December 2021

The brain-computer interface (BCI) is one of the most promising technologies that allows us to establish a relationship between brain and devices. In this study, three-channel EEG signals collected from nine subjects performing two motor imagery tasks are classified using two different deep neural network (DNN) based approaches called framework 1 (FW1) and framework 2 (FW2). The proposed frameworks were evaluated using BCI Competition IV-IIb dataset. In FW1, the raw EEG data is directly presented to the deep neural network without performing any pre-processing. In FW2, the EEG data is first filtered with five band pass filters with fifth order (Butterworth), then the common spatial patterns (CSP) method, which introduces additional pseudo channels, is applied to the filtered signals. Two experiments were conducted for each framework. In the first experiment, a unique DNN is trained for each subject, and in the second experiment only one DNN is trained with the combination of training sets of all subjects. The performance of the two experiments are then compared in terms of average accuracy. According to the simulation results, we did not observe a significant difference between the average classification accuracies obtained with the first and the second experiments. Therefore, we concluded that, by the use of DNNs we do not need to train several subject-specific networks which requires high computational loads. On the other hand, we observed that the average classification performance significantly improves by the filtering and extracting features with CSP pre-processes.
A comparison of machine learning algorithms for forecasting solar irradiance in Eskişehir, Turkey
Authors: Ayko Ozan , Bozkurt Keser Sinem
Published: December 2021

This work compares the efficiency of 45 different machine learning (ML) algorithms to provide a comprehensive and most accurate model for global horizontal solar irradiance (GHSI) prediction in Eskişehir, Turkey. The dataset is provided by NASA Prediction of Worldwide Energy Resource (POWER) as satellite data that involves some characteristic weather condition variables such as temperature, precipitation, humidity etc. over 35 years. Some ML algorithms such as Extra Trees, LightGBM, HistGB, Random Forest (RF), Bagging and Decision Tree exhibit better performance among the others with commonly used statistical evaluation metrics in literature such as coefficient of determination (R²), root mean squared error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). In addition, Extra Tress regression slightly outperformed the rest of ensemble learning methods with R² of 0.99, RMSE of 8.05, MAE of 5.67, MAPE of 4%. Finally, the outcome demonstrates that the ML algorithms belonging to ensemble learning family achieved great results in GHSI prediction at specific location.
Role of transaminases, CRP and LDH in COVID-19 patients with and without respiratory failure during the disease outbreak
Authors: Magro Bianca , Tacelli Matteo , Pasulo Luisa , De Giorgio Massimo , Leonardi Filippo , Grazia Lucà , Gaffuri Giovanna , Triolo Michela , Mangia Giampaolo , Nobile Domenico , Rizzi Marco , Marco Fabiano , Cosentini Roberto , Gianatti Andrea , Fagiuoli Stefano
Published: December 2021

BACKGROUND: Sars-Cov-2 pneumonia is a pandemic disease with high morbidity and mortality. In literature transaminases, CRP and LDH were frequently found abnormal but their role has not been clarified. OBJECTIVES: Aim of this retrospective study is to explore the role of transaminases, CRP and LDH on short-term prognosis of hospitalized COVID-19 patients. METHODS: patients admitted in hospital for COVID-19 were consecutively recruited. Primary endpoint: evaluate role of transaminases, CRP and LDH on disease progression (DP). Secondary endpoints: find possible risk factors for (1) mortality and (2) CPAP ventilation at day 7. We also analyzed patients without respiratory failure at admission, also a subgroup of patients with liver disease. RESULTS: 342 patients were included. Median age of patients was 64 years (IQR 55-74), and 35.1% (n=120) was female. At multivariate analysis moderate ALT elevation at Day 1 (p=0.001, OR 2,42, CI95% 1.23-4,73) and CRP at Day 7 (p=0.001, OR 1, CI95% 1-1,1) were predictors of DP; LDH at admission (p=0.05, OR 1, CI95% 1.23-1,1) and moderate AST elevation at day 7 (p=0.04, OR 4,5, CI95% 1.05-19,4) were predictors of CPAP at day 7. At multivariate analysis age (p<0,001, OR 1,12, CI95% 1-1,2) and sex (p=0.01, OR 14, CI95% 1,7-116,7) were predictors of death. Mortality rate of patients with liver disease was 25%(n=3/12). CONCLUSIONS: Moderate ALT elevation at day 1 and moderate AST elevation at day 7 were respectively, predictors of DP and CPAP at day 7. For patients without respiratory failure, transaminases are not significative for anyone of our outcomes. Age, sex and CRP at day 1 are death risk factors.
COVID 19 Severity Correlation between Inflammatory Markers and High Resolution Computerised Tomography
Authors: Parrey Ashaq , Aijaz Abir , Ismail Mohd , Sadaqat Mir , Koka Manzoor , Ahmad Basharat , Bhat Hilal , Amin Yasmeen
Published: December 2021

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The outbreak of SARS-CoV-2 was considered to have originally started via a zoonotic transmission associated with the seafood market in Wuhan, China. Later it was recognized that human to human transmission played a major role in the subsequent outbreak. The Inflammatory responses caused by viral replication of SARS-CoV-2 with cellular destruction can recruit macrophages and monocytes and lead to the release of cytokines and chemokines.These inflammatory markers then attract immune cells and activate immune responses, leading to cytokine storms .Many such inflammatory markers have been attributed to determine the severity of SARS-CoV-2 disease and mortality associated with it. The Inflammatory markers such as serum ferritin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and interleukin-6 (IL-6) have been reported to be significantly associated with the high risks of the development of severe COVID-19 disease.
Maternal serum CA-125 repeated measurement during pregnancy and how to use as a prognostic factor of first trimester pregnancy outcome
Authors: Badr Nasreen S. , El Mallah Samira Y. , El Mahdy Magda I. , Ahmad Hanaa F.
Published: December 2021

Background: The aim of this study was to estimate the prognostic efficacy of repeated measurement of maternal serum CA125 in first trimester threatened miscarriage.Methods: Prospective case control study was conducted in the outpatient clinic. 100 pregnant women were divided into 50 women with normal course of pregnancy, and the other 50 were subdivided into 25 pregnant women with lower abdominal pain without vaginal bleeding and 25 presented with minimal vaginal bleeding. Repeated measuring of serum CA125 was done for each case on the 5th, 10th weeks of gestation.Results: Findings of this study suggested the possibility of using serum CA-125 for determining the prognosis of first trimester threatened miscarriage with cut-off value of CA125 38.25 U/ml on the 5th week of gestation and 53 U/ml on the 10th week of gestation in patients presented with pain only but in patients presented with minimal vaginal bleeding the cut-off value of CA125 on the 5th week of gestation become 45.6 U/ml and 68 U/ml on the 10th week of gestation.Conclusions: CA125, on its own, can discriminate between continued and non-continued pregnancy.
Intermittent auscultation in obstetric practice in tertiary health facilities in Nigeria. Are we doing it correctly?
Authors: Kinikanwo Green , Abbey Mkpe , Ela George M.
Published: December 2021

Background: Intermittent auscultation (IA) was the main method of foetal monitoring in Nigeria, with the pinard stethoscope more in use than the hand-held Doppler. Aim of the study to produce a guideline on IA, conduct an audit on its use and to give a recommendation for future practice. Methods: A mixed-method design-observational-descriptive, review and an audit carried out in tertiary centres in Rivers State, Nigeria. The WHO 2018, FIGO 2015 and other guidelines on IA were reviewed. Good practice points were extracted from the literatures and used to produce a guideline. 17 review criteria for the audit were chosen from the guideline and used to test 150 doctors, midwives and nurses. Data were analysed with Epi. info 2020. Results: A guideline on IA was created. Out of the 150 participants, correct answers to the questions were given as follows: foetal movements over the preceding 24 hours before IA,  determination of  foetal lie, assessment of presentation and position before IA and identification of point of application of foetal stethoscope on maternal abdomen by 121 (80.67%), 17 (11.33%) and 34 (22.67%) respectively; frequency of IA in the antenatal period, duration of IA and maternal pulse palpation during IA for 13-98 (8.67-65.33%), 121 (80%) and 0 (0%) respectively; in labour, questions on timing of IA, ruling out hypoxia in early labour,  determination of the baseline FHR  and recording of the findings on IA for 61-130 (40.67-86.67%); interval and duration of IA and management of abnormal findings in the antenatal period and in labour, interval and duration of IA at 2-18 (1.33-12%).Conclusions: The performance of IA by obstetric practitioners was poor; that may account for some of the wrong management plan in the antenatal and intra-partum periods. A quarterly or yearly drills on IA were therefore recommended.
Non-disabled and disabled women sexual health comparison
Authors: Pitkēviča Ieva , Rostoka Zane , Saulīte Gabriela , Rezeberga Dace , Briedīte Ieva
Published: December 2021

Background: Disabled women constitute approximately 16% of all women in Europe. Regardless of disability level women are interested in maintaining sexual activity. The study aim was to compare, understand if there are sexual health disparities between disabled women and non-disabled women.Methods: A cross-sectional study was conducted in non-governmental associations and the general practitioner's office in Latvia from November 2018 to January 2019. Data were collected from self-filled questionnaires of 34 DW and 34 NDW.Results: The mean age of NDW was 32 years and 43 years for DW. 73.5% of DW and 41.2% of NDW were partially satisfied with their sex life, p=0.009. 47.1% of DW and 32.4% of NDW admitted having an irregular sex life, p=0.002. 58.8% of NDW and 29.4% of DW had last sexual intercourse within 6 days period, p=0.011. 67.6% NDW and 20.6% DW thought their sex life will improve in future, p=0.001. 70.6% of DW was interested in maintaining sexual relations as well as 91.2% of NDW. 20.6% of DW was interested in maintaining sexual relationships but less than before disability. 29.4% of respondents from both groups noted that the level of disability or other health disorders had little impact on their sexual health. 8.8% of disabled women and 2.9% of non-disabled women had severe symptoms of depression.Conclusions: The study demonstrated that NDW had regular sex life and were more satisfied with it than DW. Regardless of the state of health women were interested in maintaining sexual activity.
Medical management versus surgical management in fibroid uterus
Authors: Kurude Vilas Namdev , Mutyapwar Sneha Shekharreddy
Published: December 2021

Background: Uterine fibroids (leiomyomas) are most common tumours of the uterine smooth muscles, appear to increase in incidence with age during reproductive years, with a peak in incidence between 35 to 40 years. Signs and symptoms of uterine fibroids include heavy or prolonged menstrual bleeding, pain and pregnancy complications. Current management strategies mainly involve surgical interventions, but choice of treatment is guided by patient’s age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy.Methods: It is the prospective observational study conducted in inpatients of department of OBGY at tertiary care hospital, admitted during the period of June 2019 to May 2021. Outcome measured in terms of relief of symptoms, decrease in size of fibroid, requiring subsequent surgery, quality of life, blood transfusion requirements, length of stay in hospital, successful pregnanciesResults: Of patients treated with ulipristal, 78.57% had improved quality of life, in patients treated with leuprolide, 57.14% showed improved quality of life, with mifepristone 80% patients showed improved quality of life and with LNG 100% patients responded to it. All patients treated surgically, showed relief of symptoms.Conclusions: Medical line of management is best for patients in younger age group, small size fibroid, desire for future fertility. Uterus sparing option like myomectomy is done in patients not responding to medical line of management and desire for future fertility. Hysterectomy is definitive line of management for patients with fibroid uterus.
Concurrent cytologic and colposcopic evaluation of symptomatic cervical erosion
Authors: Goel Shreya , Lal Prabha
Published: December 2021

Background: Cervical cancer is amongst the leading causes of deaths due to cancer in developing countries. Moreover, preinvasive lesions of the cervix have a long latency period for conversion into malignancy and are also detectable by screening techniques. Hence, colposcopy in addition to cytology should be carried out wherever facility is available to ensure early detection and timely management.Methods: Simultaneous cytology and colposcopy was done for 80 women with symptomatic cervical erosion followed by a colposcopic directed biopsy in women with MRCI >3. Finally, correlation between cytology, colposcopy and histopathological results was done.Results: 65/80 women were biopsied. 12/80 women had MRCI >6 amongst which 10/80 were confirmed to have a high grade lesion on histopathology. 13/80 had lesser abnormalities (ASCUS and LSIL) amongst which 3/80 had CIN1 on histopathology. Only 2/80 had HSIL on cytology as compared to 8/80 on histopathology that had CIN 2/3. Lastly, only 1/80 had SCC on cytology compared to 2/80 on histopathology. The sensitivity, specificity, PPV and NPV of cytology and colposcopy for diagnosing cervical dysplasia was 46.1%, 83.5%, 35.2%, 88.8% and 84.6%, 86.5%, 55%, 96.6% respectively making colposcopy a better screening tool than cytology for evaluating cervical malignancy.Conclusions: Colposcopic examination should ideally be carried out in all women with symptomatic cervical erosion in addition to cytology. Moreover, suspicious areas should be biopsied even if cytology is normal to exclude malignancy.
Assessment of patient satisfaction after levonorgestral containing intrauterine system insertion in women with abnormal uterine bleeding
Authors: Dave Anupama , Sinha Kirti , Gupta Nidhi
Published: December 2021

Background: Abnormal uterine bleeding is a common gynecological complaint affecting 10-30% of reproductive-aged women and it can result from different causes which adversely affects the woman’s quality of life, necessitating its appropriate and adequate management. Among all the pharmacological and surgical management options of AUB. LNG-IUS is emerging as a safer and effective treatment option of AUB. However apprehension about discomfort associated with the use of intrauterine device leads to its untimely removal. Aim of current study was to conduct a prospective qualitative study to observe the level of patient satisfaction with the use of LNG-IUS in patients with abnormal uterine bleeding.Methods: This study was conducted in the department of obstetrics and gynecology, MGM medical college and M.Y. Group of Hospitals, Indore from March 2017- March 2018. Follow up was done at 1, 3, 6 months.Results: In our study, majority of the women (90%) had improvement in their abnormal uterine bleeding along with significant increase in mean hemoglobin level from7.30+1.29 gm%  to 8.71+1.27 gm% at the end of six months. 86.66% of these patients were very satisfied with the use of LNG IUS,Conclusions: LNG-IUS is an effective device for medical management of AUB and it should be used as the first line therapy for the same. It should always be considered before surgical interventions. It yields promising result in terms of patient satisfaction.
Case series on mullerian anomalies incidence during caesarean section over one year period
Authors: Jain Mukta , Vijaywargiya Komal , Ruia Aayushi
Published: December 2021

Congenital uterine anomalies occur due to abnormal fusion of Mullerian duct during embryonic life. It is associated with high incidences of reproductive failures and adverse obstetrical outcomes. It may be associated with malpresentation, preterm labour or recurrent pregnancy losses. The association of congenital anomalies and early pregnancy loss has been well established but its adverse effect on late pregnancy in form of malpresentation, preterm deliveries has not yet been elaborated. Hence, this case series aimed to summarize the incidence and perinatal outcome of pregnancy in women with congenital uterine anomalies undergoing cesarean section. This was a case series which was conducted on women who underwent cesarean section at P. C. Sethi hospital, Indore between time period of October 2020 to September 2021. Out of total 1835 cesarean undergoing patients, 12 patients were found to have uterine anomalies. Out of 12 patients, 9 (75%) patients were associated with malpresentation, 4 (33.3%) patients had preterm delivery and 6 (50%) patients had low birth weight babies. Hence it can be said that women with congenital uterine anomalies were at higher incidence of malpresentation and preterm deliveries. Presence of congenital uterine anomalies were associated with adverse obstetrical outcome. This knowledge warrants the need for a larger case control study to extrapolate these findings to the general population and also to recommend the need for universal prenatal screening for uterine anomalies to improve the obstetrical and perinatal outcome in patients with uterine anomalies.
A case report of heterotopic pregnancy
Authors: R. Keerathana , S. Sundar Narayanan
Published: December 2021

Heterotopic pregnancy is the presence of both intrauterine and extrauterine (ectopic) implantation as described by Reece in 1983 and is extremely rare. It accounts for 1 per 30000, in natural cycles and 9 per 10000, in assisted reproduction cycles. The aim of this report is to introduce this case as it poses a challenge to diagnosis due to its complex clinical and laboratory findings. A primigravida aged 30 at 6 weeks period of gestation, reported with minimal bleeding per vaginum. On performing a physical examination her vitals were stable and no significant findings were noted except for an enlarged uterus corresponding to 6 weeks with posterior forniceal fullness. Her beta-hCG was 23765 IU/ml and ultrasound showed a live intrauterine gestation with left adnexal mass- likely ectopic gestational sac. Laparoscopy showed a left tubal pregnancy and salpingectomy was done. The postoperative period was uneventful and she was discharged with a single live intrauterine gestation of 6-7 weeks. She carried on with her pregnancy and delivered a healthy baby at term. The diagnosis is possible only in cases when there is a high index of suspicion by the treating clinician. The adnexa must be inspected carefully in the confirmatory ultrasound. The early timely diagnosis gives a good maternal outcome and hence crucial in the management.
A rare case report of psoas abscess in pregnancy in a tertiary centre
Authors: Chavan Niranjan N. , Ammara Umme , Dias Zaneta , Boob Manan
Published: December 2021

A psoas abscess in pregnancy is a relatively uncommon condition with nonspecific signs and symptoms. It may lead to serious complications if not diagnosed and treated promptly. Although spinal tuberculosis affects nearly half of skeletal tuberculosis patients, psoas abscess develops in only 5% of spinal tuberculosis cases. A clinical history and examination are used to make a diagnosis, which is then confirmed by microbiology and radiological findings. Here is an interesting case report on psoas abscess in pregnancy managed by pigtail catheter insertion and drainage.
Profiling cervical ripening for induction of labour with Foley’s balloon catheter in Ebonyi state, Nigeria: a randomized controlled trial
Authors: Adiele Nnabugwu Alfred , Mgbafulu Christian C. , Ikeotuonye Arinze Chidiebere , Anikwe Christian Chidebe , Adebayo Joshua Adeniyi , Adiele Nkemjika Miriam , Nwigboji Wilson Ndukwe , Olaleye Ayodele Adegbite , Nwafor Amuchechukwu Veronica , Lawani Lucky Osaheni
Published: December 2021

Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bishop Score significantly reduced in the 60 ml group (10.8 hours±2.99) as against 12.7 hours±10.0 in 30ml group (p=0.038). Mean duration of active phase of labour was significantly reduced in 60 ml group (5.6 hours±2.4) as against 8.4 hours±3.2 in 30 ml group (p=0.010). Caesarean delivery rate was significantly reduced in the 60 ml groups (p=0.027).Conclusions: The use of 60 ml inflated Foley’s balloon catheter when compared with 30mls to ripen the cervix effectively reduced the duration to favourable Bishop Score, duration of the active phase of labour and the rate of Caesarean sections.
Morbidity, mortality and clinico-laboratory profile of COVID-19 related illness in children: a retrospective observational study from a tertiary care centre in India
Authors: Patra Bijoy , Nimesh Manju , Kaur Parasdeep , Patil Sumantha , Gupta Hema , Jilowa Saria , Bahl Dheeraj
Published: December 2021

Background: As India is poised for a third wave of SARS Co-V2 infection with a large unvaccinated pediatric population, it becomes imperative and pertinent for a study to find out its demographic, clinico-laboratory profile, and outcome in children with COVID-19 disease and its related illness.Methods: This is a retrospective observational study undertaken for Children and Adolescent admitted in the department of pediatrics of a teaching and tertiary care referral hospital, Delhi.Results: The median age of admitted children with COVID-19 disease was 11 years with an interquartile range 3 to 16 years. The median duration of hospital stay was 10 days (mean: 18±14 days). Mortality was 9/62 (14%). Recovery in non-severe (asymptomatic, mild, moderate) was 41/41 (100%), and in severe and critical illness including MISC was 42.8% (9/21). Mortality in severe and critical patients managed in SARI and COVID ward was 44% (8/18). Death among MISC patient in PICU was 33% (1/3). Difference in CRP rise was significant in severe and non-severe group of COVID-19 (p=0.017).Conclusions: Even though the morbidity and mortality associated with COVID-19 infection and related illness seems to be miniscule, the infection causes significant illness in the subgroup of children who requires hospitalization and can be fatal in those with comorbidity.
P16 expression and clinicopathological features of oral and oropharyngeal squamous cell carcinoma
Authors: Raphael Rosemary , V. Priya P. , K. Anju C. , S. Sankar
Published: December 2021

Background: There is an epidemiological shift in head and neck squamous cell carcinoma (HNSCC) attributable to HPV infection. HPV positive HNSCC has unique biology, risk factors, clinicopathological characteristics and outcome. There is a large variation in the published prevalence of HPV-related HNSCCs in India ranging from 7 to 78.7%. This study aims to find the P16 expression in the oral cavity and oropharyngeal SCC, thereby prevalence of HPV in our setting and to define the clinicopathological characteristics of HPV positive tumours in our setting.Methods: 210 specimens of primary Oral squamous cell carcinoma (OSCC) and Oropharyngeal Squamous cell carcinoma (OPSCC) were included. Immunohistochemistry was done using monoclonal mouse p16 antibody. Clinical details of each case were collected. Analysis was done using SPSS software and the association of P16 and clinicopathological variables were calculated using Fishers exact test.Results: P16 positive expression is observed only in 1/122 (0.82%) of OSCC and 8/88 (9%) of OPSCC. P16 positivity showed significant association with Grade of tumor (p= 0.008) and histological variant of SCC (p=0.00). 77.7% of P16 positive tumours are Grade 2 and 66.6% of Basaloid SCC was P16 positive. There is no significant association between p16 expression and other variables (subsite, age, gender, alcoholism, smoking, betel chewing and stage).Conclusions: P16 positivity was higher in oropharyngeal than in oral cancer. However, the HPV positivity rates are lower than other parts of India.
Medication compliance in schizophrenic out patients with psychoactive substance use co-morbidity: a cross-sectional study
Authors: Ahlawat Saurabh , Aggarwal Vikrant , Kumar Rakesh
Published: December 2021

Background: Medication adherence is an important issue in the treatment and management of persons with psychiatric disorders including schizophrenia. Apart from side effects and inefficient outcomes of psychiatric medications, substance abuse also complicates the adherence pattern to the prescribed medications. Present study was designed to estimate the magnitude of medication non-adherence and its correlates in patients with schizophrenia having co-morbid psychoactive substance use.Method: The 60 schizophrenic patients with active substance use were taken from OPD of institute of mental health and hospital, Agra. Positive and negative syndrome scale (PANSS), alcohol, smoking and substance involvement screening test (ASSIST), medication adherence rating scale (MARS) and Morisky 8-item medication adherence questionnaire (MMAQ-8) were used to gather relevant clinical data along with a proforma for recording socio-demographic characteristics.Results: The results revealed an alarming level of medication adherence. The 91.7% sample (55 patients) met the criteria for medication non-adherence. Majority of the patients were using alcohol (58.3%) and cannabis (51.7%). Conclusions: Given the high rate of medication non-compliance it is suggested that specific intervention aimed at compliance to prescribed medication is needed in this population.
Perception of medical interns and residents about specialty of microbiology and the role of microbiologists during COVID-19 pandemic
Authors: Khan Imran Ahmed , Singh Amresh Kumar , Zaman Kamran , Shrivastava D. K.
Published: December 2021

Background: The speciality of microbiology is closely associated with keeping people healthy and disease free by accurate diagnosis of infectious diseases. In spite of this, awareness about the speciality seems to be scarce. In the present scenario, public perception about microbiology has been changed a lot. The SARS-CoV-2 pandemic has highlighted the crucial role of microbiologists in the health care system. The aim of this survey was to determine the perceptions of medical interns and residents regarding the specialty of microbiology and the role of microbiologists in maintaining and promoting health of people.Methods: On-line survey using google form to identify perception of medical interns and residents about the speciality of microbiology.Results: A total 298 valid responses were obtained response rate 26.02% from the participants among them 167 (56.0%) were male and 131 (44.0%) females. Though, the attitude of medical interns and residents were found positive for the speciality of microbiology, they even recognize the importance of medical microbiology in their future role as medical practitioners, but only few (3.48%) wished to opt it as their career.Conclusions: The risks and responsibilities of a microbiologist involved in managing patients seldom get due acknowledgement. Adequate measures need to be taken to enlighten the authorities about microbiology and various responsibilities of microbiologists. The health care providers and medical teachers needed to appreciate the perception of young medical students regarding current and future trends in specialty choice and take concrete steps to meet the unmet need of health care.
Guillain-Barré syndrome associated with COVID- 19 vaccination: a case report
Authors: John Vinod , Koshy Jiya Thankam , Gladson Nikhil , Wills Vimod K.
Published: December 2021

Several reports and studies are being conducted to this day based on the safety profile of COVID-19 vaccines. COVID-19 vaccination inducing GBS is a rare adverse effect and is likely to be causal. Though, there are reports concerning the relation between coronavirus infections and GBS, the pathogenic mechanism and relevant factors behind COVID-19 vaccines inducing GBS are still not being corroborated so far. Guillain-Barre syndrome is the principal cause of acute flaccid paralysis with a prevalence rate of 2 in 100, 000 people per year. We illustrate a 55 years old female patient who presented with acute onset paraesthesia and progressive weakness of bilateral lower limbs and gait imbalance of 5 days duration to the Hospital during the first week of September. Her symptoms occurred within 2 weeks of the first dose of the ChAdOx1-n-CoV-19 (Covishield) vaccine proving a major possibility of vaccine-induced neurological adverse effect as she didn't have any likely significant history of illness or allergies in the past rather than type 2 diabetes mellitus. This report aims to highlight the incidence and to ruminate upon this matter while evaluating any GBS cases in the current eras of the COVID-19 pandemic and vaccination.
Suicide by unusual methods: a rare case of complex suicide
Authors: Sarma Bedanta , M. Senthil Kumaran , S. Arun Kumar , Dash Shreemanta Kumar
Published: December 2021

Genital Self-Mutilation (GSM) is usually associated with mental illness. It is considered as the most brutal form of self-harm. Many cases of such self-harm have been described by various authors in different times. However, its existence in absence of any mental illness and using it as a method of suicide is a matter of question. Although, some cases are reported; its incidence is very low. Its association with complex suicide is even much lower. Usually, in complex suicide, the victim chooses some methods which are less painful. Such a complicated case of complex suicide was brought to the tertiary care center of Dibrugarh, Assam for post mortem examination. The deceased, a 36 years old male was brought with history of cutting his external genitalia followed by hanging. The case has been described in this paper with relevant review literature.
Phenytoin-induced rhabdomyolysis
Authors: Çokal Burcu G. , Guler Selda K. , Guneş Nalan
Published: December 2021

Rhabdomyolysis is a potentially life-threatening syndrome that can develop from a variety of causes. The most common causes are muscle injury, alcohol abuse, drugs, toxins and increased muscular activity. Phenytoin is one of the drugs that rarely cause rhabdomyolysis. We present the case of a man who developed rhabdomyolysis following phenytoin treatment.
A review on tools for measuring activity limitation in diabetic peripheral neuropathy
Authors: Boovaragasamy Chithra , Gnanasabai Gnanamani , Kumar Mohan
Published: December 2021

The burden of diabetic peripheral neuropathy (DPN) ranges from 10.5% to 32.2% and up to half of the diabetic patients will eventually develop neuropathy in the course of their disease. The present paper reviews the existing tools and measures for assessing activity limitation as a result of DPN; using a not exhaustive search strategy, limited to PubMed. The tools available for the assessment of activity limitation as a consequence of DPN are based on International Classification of Functioning, Disability and Health (ICF) and are equally effective. The researcher must make the choice based on cultural validation and specific study objectives. Researchers should select a set of tools and procedures that are appropriate for study purposes, study settings and strive to use them consistently.
Thyroid cytology during the COVID-19 pandemic: a single centre experience
Authors: Kulahci Ozgur , Tas Zeynel Abidin
Published: December 2021

Background: In our study, thyroid fine-needle aspiration biopsy (FNAB) data in the same calendar period of 1 year before and after the COVID-19 pandemic were compared.Methods: Thyroid FNAB data for the same calendar period of 1 year before and after the COVID-19 pandemic were included in the study. The patients were grouped according to age, gender and thyroid FNABs according to the Bethesda system for reporting thyroid cytopathology, and the data of both groups were compared considering the diagnoses of the patients who underwent thyroid surgery afterwards.Results: In the post-pandemic period, the number of thyroid FNABs and the number of patients over the age of 40 decreased (all p<0.001). In the post-pandemic period, the rates of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm or suspicious for a follicular neoplasm (FN/SFN), suspicious for malignancy, and malignant cytology increased despite the decrease in the number of patients (p=0.001). Furthermore, the malignant tumour rate was 1.4% before the pandemic in patients who underwent surgical thyroidectomy and/or lobectomy; this rate was 3.5% in the post-pandemic period (p=0.045).Conclusions: We found an increase in the percentage of AUS/FLUS, FN/SFN, suspicious for malignancy, and malignant cases during the period when there were restrictions, such as pandemics, and the sampling was reduced. This finding is valuable in terms of detecting an increased malignancy rate by performing less thyroid FNAB by carefully determining the indications for thyroid aspiration biopsy regarding the latest guidelines.
Functional outcome assessment for surgical decompression of cervical spondylotic myelopathy
Authors: Abraham Tinu Ravi , John Ajax , Balakrishnan P. K. , Jose Tom
Published: December 2021

Background: Cervical spondylotic myelopathy (CSM) is one of the most common dysfunctions of spinal cord occurs due to degenerative changes in cervical spine disc and facet joints. It is a form of progressive spine disease including herniated disc and spinal cord stenosis which manifests as changes in gait, skilled hand movements, muscle strength, bladder dysfunction etc. Recent studies and trials have established that surgical decompression of cervical spinal is a cost-effective treatment modality which provide satisfactory functional recovery. This study aimed at the functional outcome of surgical decompression of CSM.Methods: The prospective study of 100 cases of cervical myelopathy for which decompressive surgery was done from August 2020 to August 2021. Results were analysed according to Nuricks and modified Japanese orthopedic association scoring system (MJOA).Results: Seventy one males and 29 females were included in this study with average age was 53 and average hospital stay was 3.55 days. Average pre-op Nurick score was 1.93, while score after 6 months and 1year were 1.44 and 1.15respectively. Average pre-op MJOA score was 13.63, while score after 6 months and 1 year were 14.58 and 15.74 respectively.Conclusions: The functional results of decompressive surgeries for cervical myelopathy are satisfactory. Both anterior and posterior approaches are recommended for multiple cervical myelopathy with comparable outcomes. DM and age was observed as the independent predictor for functional outcome, while, gender and level of disease got less significant predictive value.
Clinical outcome of appendectomy: laparoscopic vs open technique
Authors: Rather Jan M. , Manzoor Sobia , Shah Mubashir
Published: December 2021

Background: Acute appendicitis is a common abdominal surgical emergency. Appendectomy has been proven to be the standard care for the treatment of acute appendicitis. Objective of the study was to compare laparoscopic and open appendectomy in terms of clinical outcome and complication rates.Methods: This was a single centric, retrospective study conducted at SKIMS, Soura from May 2018 to April 2021. Open and laparoscopic appendectomy patients were compared in terms of operative times, conversion rate, complication rates and duration of hospital stay.Results: Total 120 patients were included in this study with 40 in laparoscopic group while 80 patients in the open group. Increased operative time in laparoscopic group (p=0.033) and longer duration of hospital stay (p=0.021) with open group while as comparable complication rate in both procedures were observed. Higher rates of intra-abdominal collection in laparoscopic group as compared to open groupConclusions: Both laparoscopic and open appendectomy procedures can be performed routinely for acute appendicitis without the additional risks of complications.
D-dimer as a safe, convenient and easily available biomarker, when combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic disease in axilla and reduce false negative results
Authors: Dharamsi Karan , Deherkar Juthikaa , Agarwal Ankita , Ketkar Mrunal
Published: December 2021

Background: Breast cancer is frequently associated with activation of the hemostatic system and the extent of this activation correlates with a more advanced tumor stage. D-dimer is a biomarker that indicates the activation of hemostasis and fibrinolysis.Methods: This is a prospective, observational, analytical study in which we compare plasma D-dimer levels among three groups’ i.e., healthy subjects, benign patients and breast cancer patients. We have also evaluated plasma D-dimer levels in patients with lymphadenopathy and in those patients who did not have palpable lymph nodes. Plasma D-dimer levels were further characterized based on TNM classification in breast cancer patients where quantitative D-dimer levels were correlated with clinical stage grouping.Results: Through our study we have observed that D-dimer level is inexpensive and a convenient method for diagnosis and prognosis of breast cancer. We have used a control group so as to evaluate a more accurate result. Comparison between benign and malignant lesions was made and we have achieved a significant p value, which proved our study positive for raised D-dimer levels in cancer breast.Conclusions: D-dimer proves to be a safe, convenient and easily available biomarker which can be combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic disease in axilla and reduce false negative results. Plasma D-dimer level was positively correlated with clinical stage of solid cancers.