bluuebunny/crossref_metadata_2025 huggingface dataset:
Study to find out about various risk factors responsible for repeat acute exacerbation of COPD, which cause readmission within 90 days after admission in hospital due to acute exacerbation of COPD
Authors: Parihar Sandeep kumar , Bharty Sanjay Kumar , Patel Brij Bihari , Patel Vikas , Prakash Brahma , Jain Avinash
Published: September 2023

Background: Approximately 3.2 million global deaths occur each year due to chronic obstructive pulmonary disease (COPD), in which exacerbations of COPD remain a prevailing cause. Exacerbations requiring hospitalization are associated with high mortality, and mortality risk is increased with higher exacerbation frequencies.
Aims and Objectives: This study aimed to prospectively identify the risk factors of COPD that cause readmission within 90 days after admission to the hospital due to acute exacerbations of COPD.
Materials and Methods: An observational study conducted at the School of Pulmonary Excellence, NSCB Medical College, Jabalpur, from the duration of March 2021 to August 2022 with a sample size of 140 estimated through 56% prevalence of readmission rate in available literature. Study participants, including all patients, were readmitted within 90 days after admission due to acute exacerbation of COPD (post-bronchodilator FEV1/FVC <0.70). Data analysis was performed using IBM software SPSS 22.0 and statistical association with the confidence interval of 95% and P<0.05.
Results: The majority of COPD cases were male (84%) and belonged to the 50–60 years of age group. There was a statistically significant (P=0.001) association between grades of dyspnea and readmission cases. Dyspnea among readmission patients was found to be 100%. The prevalence of CAT score >10 was 64% and <10 is 36% among readmission patients the association was highly significant and more exacerbation leads to more readmission.
Conclusion: In the study, various clinical parameters were found statistically significant between the admission and readmission groups. These parameters were CAT score, previous hospitalization history, previous exacerbation history, SpO2, dyspnea grading, and co-morbidities. The lung function test was difficult to do due to many of readmitted patients were not in a condition to do spirometry.
Agenesis of gallbladder-series of four cases - why it is difficult to diagnose preoperatively?
Authors: Biswarup Bose  , Abhimanyu Basu  , Subhadip Sarkar
Published: September 2023

Agenesis of gallbladder (AGB) is a rare clinical entity first reported by Bergman in 1702. The incidence is about in 10–65 cases/1,00,000 population. It is seen in 1/6th cases of biliary atresia. It is of unknown etiology and is believed to be due to abnormal embryonic development. Nearly 70% cases are sporadic. AGB may be associated with other congenital abnormalities including the biliary system. The majority (nearly 50%) of the patients are symptomatic with misinterpreted signs and symptoms of cholecystitis and lands up to unnecessary surgery. Our series of four cases have male: female ratio of 3:1. Two of the cases underwent laparoscopic surgery. Among the other two, one had biliary pancreatitis due to primary calculous in the common bile duct (CBD) with upstream dilation. Other cases had chronic pancreatitis with dilated pancreatic duct and a proximal calculous close to ampulla causing proximal dilation of CBD. Two operated cases were postoperatively diagnosed by magnetic resonance cholangiopancreatography (MRCP) and the non-operated patients were also diagnosed by MRCP. Symptomatic AGB is often wrongly interpreted as cholecystitis with cystic duct obstruction or as sclero-atrophic gallbladder, therefore leading to pointless surgical interventions. In case of false-positive ultrasonography (USG) of AGB, it has been suggested that either a loop of gas-containing bowel located in the gallbladder fossa or periportal tissue and subhepatic peritoneal folds impersonate a contracted gallbladder containing gallstones. When USG reveals such reports or in cases of non-visualization in other imaging modalities, the need of additional preoperative imaging investigation must be in the surgeon’s mind such as MRCP to avoid surgery which is not at all required.
Clinical profile of newly diagnosed leprosy patients with special references to deformities and disabilities
Authors: Chhakchhuak Laldinthari , Chhakchhuak Lalbiakdiki , Rongpi Rajesh , Lalromawii  , George Sandhya , Balasubramaniyan Pradeep
Published: September 2023

Background: After leprosy was declared eliminated as a public health problem in India on December 2005, the focus has shifted to the prevention of disability and deformities. This indirectly measures the effectiveness of health education and awareness.
Aims and Objectives: This study was conducted to assess the clinical profile and different patterns of disabilities and deformities among newly diagnosed leprosy patients.
Materials and Methods: A cross-sectional study was conducted for a period of 1 year on newly diagnosed leprosy patients attending a tertiary care hospital in Kerala. 32 patients included in the study were examined and disabilities observed were graded using WHO disability grading system. The variables are mentioned as numbers and percentages.
Results: 50% of the subjects had different grades of deformity/disability (6.25% had Grade 1 disability while 43.75% had Grade 2 disability). The mean duration of disease in patients with and without deformities was 44.19 and 20.5 months, respectively, which was statistically significant (P=0.025). A positive family history of Hansen’s disease was present among 5 (15.63%) patients. The different disability/deformity observed were ulcers, scars, muscle weakness, and redness of eyes. Feet were the most commonly affected site.
Conclusion: Proper health education and awareness activities that will promote early recognition of symptoms and reporting are crucial to decrease deformities.
Role of Wilms’ tumor 1 in diagnosis and grading of astrocytomas
Authors: John Emmanuel Raju S  , Nalini B  , Rajesh Muderla , Nagavelly Bhavani
Published: September 2023

Background: Wilms’ tumor 1 (WT1) mutation has recently been detected in gliomas. Growing data indicate that WT1 mutation plays a causal role in gliomagenesis and is overexpressed in most glioblastomas. Emerging immunotherapy targeting WT1 has shown to be effective in resistant glioblastomas in clinical trials. WT1 expression and its potential utility in various grades of astrocytomas is still unclear and needs further elucidation. The evaluation of WT1 can be done by molecular or immunohistochemical methods. As immunohistochemistry is easier with wider routine use, immunoexpression of this biomarker was studied.
Aims and Objectives: This study aimed to evaluate WT1 immunoexpression across different histological grades of astrocytomas and differentiate low-grade astrocytomas from reactive astrogliosis.
Materials and Methods: This was an observational prospective study on 54 cases of astrocytomas.
Results: In the present study a total of 54 cases have been diagnosed as astrocytomas. Grade IV was the most common (31%) followed by grade II (44%). WT1 score correlated with histological tumor grades (P<0.001) with a higher score in a higher grade. It was also observed that different tumor grades depicted two distinct expression patterns. WT1 score and pattern were valuable in differentiating high- and low-grade astrocytomas.
Conclusion: This study supports the oncogenic role of WT1 in astrocytomas. WT1 was found to be valuable in distinguishing different grades of astrocytomas. The scoring and distinctive patterns of WT1 can aid in distinguishing high-grade and low-grade astrocytomas. However, one needs to be careful in pilocytic astrocytomas in which there is a mixed expression. WT1, therefore, appears to be an attractive immunohistochemistry (IHC) marker to be used concomitantly with other IHC markers in astrocytomas. In addition, the frequent expression of WT1 in astrocytomas supports its promising role in immunotherapy and its potential to guide patient selection for targeted immunotherapy.
Position of oral cephalosporins and its fixed-dose combinations in the guideline recommendations for the management of community-acquired infections
Authors: Mala Kaneria  , Ilambarathi M  , Singh Vishal , Varun N  , Rashmi Hegde  , Praveen Kamble  , Krunal Dalal
Published: September 2023

Community-acquired infections (CAIs) represent a major burden for health-care system. This directly aids the emergence of antibiotic-resistant organisms. India is not immune to it. This review assessed the current guideline recommendations for the usage of oral cephalosporins in the management of common CAIs. The researchers conducted iterative searches in PubMed, SCOPUS, and Google Scholar for published articles using various keywords. The search was conducted in November 2022 and considered articles published till date. Different CAIs are caused by similar organisms, susceptible to first-line antibiotics such as penicillin and cephalosporins. Most of the guidelines recommend the use of oral cephalosporins for the management of the commonly prevalent CAIs. These antibiotics however should be used as a monotherapy and not as fixed-dose combinations (FDCs), as FDCs with oral cephalosporins lack scientific basis and may be detrimental. For burden of CAIs intensified by anti-microbial resistance, guidelines are useful for the management of CAIs to educate the prescribers and preserve currently available antibiotics.
A prospective study of post-operative surgical site infections after open gastrointestinal surgeries
Authors: Tekam Vijay Kumar , Singh Priyanka , Bhandari Utkarsh , Rathore Ashok Kumar , Rathore Akshara
Published: September 2023

Background: Surgical site infections (SSIs) are infections of the tissues, organs, or spaces exposed by surgeons while performing an invasive procedure. SSI is one of the most common healthcare-associated infections, but its importance as a health-care priority is not fully understood, and limited work has been published defining the role of surgeons in SSIs.
Aims and Objectives: In the present study, we assess the burden of SSI after gastrointestinal (GI) surgery in a tertiary care hospital in the Central India.
Materials and Methods: The present study was conducted on patients admitted to Gandhi Medical College-affiliated Hamidia Hospital, Bhopal, in the General Surgery Department. The study included 207 patients who underwent emergency/routine GI surgeries between September 2020 and April 2022. Patient characteristics and laboratory data were recorded on a pre-designed form, and all patients were evaluated postoperatively for soakage along with culture and antibiotic testing.
Results: The overall incidence of SSI was 42.51% and its distributions between emergency and routine surgeries were 22.7% and 19.8%, respectively. SSI was predominant in male patients. White blood cell level was significantly associated between emergency and routine surgeries, while Hb level, serum protein level, and the time required for surgery were insignificant. SSI under contaminated dirty wounds was prevalent in both emergency and routine surgeries. Klebsiella was the most commonly isolated organism, followed by Escherichia coli. The commonly susceptible antibiotics have been found to be meropenem, pipzo, amikacin, and imipenem. Commonly resistant antibiotics were amoxiclav, ceftriaxone, linezolid, and doxycycline.
Conclusion: This paper presents the incidence of SSI in the hospital setting of Central India and the factors that may contribute to the high incidence of SSI. Further research needs to be done to better understand how specific risk factors are responsible for post-operative wound infections in open GI surgery.
Clinical profile and 30-day outcome of patients with acute coronary syndrome
Authors: Dutta Sumi , Naruttam Sonowal  , Mech Kaberi , Malakar Alokjyoti , Gara Himavathy Kodandarao , Vanamali Dharma Rao
Published: September 2023

Background: Acute coronary syndrome (ACS) accounts for a quarter of all-cause mortality, with substantial loss of productivity and socio-economic implications. Analyses of the clinical presentation, age- and gender-specific differences, and mortality pattern are decisive in determining the clinical outcome of a patient.
Aims and Objectives: The primary objective was to determine the in-hospital and 30th day outcomes in patients with ACS. The secondary objectives were to study cardiometabolic risk factors, the clinical presentation, and the clinical course of the patients with ACS during hospitalization.
Materials and Methods: The present study was conducted for 1-year duration involving 110 patients diagnosed with ACS. The patients’ data pertaining to socio-demographic information, clinical features, details of hospitalization, and treatment modalities were collected. The outcomes based on mortality and major adverse cardiovascular events (MACE) were evaluated in two phases: (a) in-hospital and (b) at the 30th day from the date of hospitalization.
Results: Out of 110 patients hospitalized with a diagnosis of ACS, the majority were male (71.82%), and their mean age was 58.45±9.18 years. Hypertension, obesity, smoking, and family history of ACS were reported by 40%, 30%, 30%, and 27.27% of patients, respectively. Chest pain was the commonest symptom, followed by sweating and radiating pain. The mean duration of hospitalization was 6.345±2.46 days. ST-segment elevation myocardial infarction (STEMI) was the commonest type of ACS, with a predominance of anterior wall myocardial infarction (MI). The mean door-to-needle time was 43.53±7.75 min, and 29.1% of patients underwent thrombolysis. During hospitalization, improvement and MACE were observed in 73.64% and 26.36% of patients, respectively. 30-day outcome MACE was significantly higher among STEMI patients. Mortality was significantly higher in patients with <30% left ventricular ejection fraction (LVEF), both during hospitalization and after 30 days.
Conclusion: The present study revealed that the mean age of presentation was 58.45±9.18 years. Anterior wall MI was the commonest pattern of STEMI. Thus, the type of MACE and mortality were significantly higher among patients with either LVEF <30% or STEMI. Thus, type and severity of ACS, along with clinical presentation, existing risk factors, and access to medical care, play a determining role in the clinical outcome of a patient.
Diagnostic utility of Risk of Malignancy Index in differentiation of benign from malignant ovarian masses
Authors: Ankita Kumari  , Vani Aditya  , Shaila Mitra  , Harish Chandra Tiwari
Published: September 2023

Background: Women with adnexal masses still pose a diagnostic dilemma and require efficient triaging. The Risk of Malignancy Index (RMI) is an algorithm used for differentiation of malignant from benign ovarian masses.
Aims and Objectives: The present study aimed to evaluate the four indices RMI 1, RMI 2, RMI 3, and RMI 4 to discriminate a malignant ovarian tumor from a benign one.
Materials and Methods: This cross-sectional study was carried out at a tertiary care hospital of Eastern Uttar Pradesh, India, in 312 patients with ovarian masses. RMI scores were calculated based on pre-operative cancer antigen-125 levels, ultrasonography, and menopausal status followed by post-operative histopathology, taken as gold standard. Using cutoff points of RMI indices, the sensitivity, specificity, positive predictive value, and negative predictive value of RMI were assessed.
Results: Out of total 312 patients, 68 (21.8%) had malignant disease and 244 (78.2%) had benign pathology. All indices presented a significantly better performance in detecting malignancy than the use of a single parameter. Each of the RMIs had a different optimal threshold; however, using a threshold of 250, RMI 1, RMI 2, RMI 3, and RMI 4 had a sensitivity and specificity of 64.7%, 70.5%, 64.7%, and 65.2% and 93.4%, 83.6%, 90.2%, and 91.4%, respectively.
Conclusion: The RMI is a simple, composite tool that at lower values can reliably predict benign nature of adnexal tumors. However, at values above the cutoff points, it is helpful for appropriate surgical planning and averts radical surgeries in women of reproductive age group.
Management and outcome of unknown patients with head injury in tertiary health-care center
Authors: Nikhil Khantal  , Vivek Kumar Kankane  , Avinash Sharma
Published: September 2023

Background: Patients who are admitted to government hospitals without any personal, family, or identification details are categorized as unknown patients or unidentified patients or destitute patients. Managing unknown patients pose unique challenges in developing countries, particularly in India, where there are significant medicolegal issues, humanitarian concerns, and treatment and rehabilitation challenges.
Aims and Objectives: Our study aims to investigate the demographic characteristics and outcomes of unidentified patients in our health-care facility and to evaluate the quality of care provided to them with the intention of enhancing it.
Materials and Methods: It is a prospective study conducted in the Department of Neurosurgery, Jayarogya Hospital, Gajra Raja Medical College, Gwalior, India, which is a tertiary care center. The study was conducted for a duration of 2 years between April 2021 and March 2023 in which 50 patients of traumatic brain injury (TBI) whose identity was unknown at the time of admission were analyzed.
Results: Out of the 50 TBI patients with unknown identities, 21 patients survived while 29 patients died as a result of their injuries. Among the 38 patients who were managed conservatively, 17 patients survived while 21 patients died. Of the 12 patients who underwent surgery, 4 survived while 8 patients died. The stable patients who were transferred to other departments were discharged to their homes.
Conclusion: Our study highlights the high mortality risk associated with unknown TBI patients. Due to the lack of crucial details about the traumatic event and the absence of a family support system, managing these patients are more challenging, and relevant health information is often unavailable. Improvements in identifying unknown victims are necessary, and resources must be allocated to address this challenging situation properly.
Awareness, acceptance, and hesitancy about COVID-19 vaccine among residents of urban and rural health training center field practice area of a medical college at Kolkata: A cross-sectional survey
Authors: Sain Sonali , Chattopadhyay Amitabha , Haldar Dibakar
Published: September 2023

Background: Effective vaccination is a successful tool for controlling COVID-19 pandemic, along with other preventive measures. Both intention to get vaccinated and barrier to vaccination played important role in COVID vaccination drive.
Aims and Objectives: The present study was conducted to assess awareness, acceptance, and hesitancy about COVID-19 vaccine among the residents of rural and urban area and to assess the factors related to their attitude.
Materials and Methods: A descriptive cross-sectional survey was conducted among the adult residents of urban and rural area over 6 months. Total sample size was 400. Simple random sampling technique was adopted to recruit the study participants after obtaining informed verbal consent. This process was continued until the desired number of sample size was attained. Data were compiled after collection and analysis was done.
Results: Rural population had significantly higher knowledge of coronavirus and urban population knew prevention of coronavirus infection more. Correct knowledge of COVID vaccine availability was higher among rural people but higher knowledge of vaccine related information was among urban population. Sources of information were mainly from mass media. Vaccine acceptance was more among urban population, but apprehension was significantly higher among urban residents. Higher proportion of urban people was motivated significantly by the healthcare workers as well as self-motivated than their rural counterpart.
Conclusion: Targeted interventions could be developed for increasing awareness of disease and availability of COVID-19 vaccines. Population-based vaccination program can decline the trend of the pandemic in long term.
A clinical study of keratomycosis to compare the efficacy of topical 10% NaCl with 5% natamycin versus 5% natamycin alone as a treatment strategy
Authors: Jitendra Kumar  , Naveen Sirohi  , Apurva Jain
Published: September 2023

Background: Corneal blindness is a major public health problem worldwide and preventable cause of blindness in India. Corneal blindness is the second most common cause of blindness, after cataract, in developing countries.
Aims and Objectives: A clinical study of keratomycosis to compare the efficacy of topical 10% NaCl with 5% natamycin (Group A) versus topical 5% natamycin (Group B) alone as a treatment strategy.
Materials and Methods: This prospective, randomized, interventional, and comparative study with parallel design enrolled 100 cases diagnosed with unilateral keratomycosis and fulfilling the inclusion criteria, who presented to the outpatient department of Ophthalmology, Maharani Laxmi Bai Medical College and Hospital, Jhansi, Uttar Pradesh, between April 2021 and June 2022 (15 months).
Results: Maximum patients in both the study groups belonged to the age group of 41–50 years showed male preponderance and belonged to the low socioeconomic status. Maximum patients in both the study groups had shown total regression in 66 cases with 41 cases from Group A and 25 cases from Group B, respectively. Regression was not seen in 34 cases with 9 cases belonging to Group A and 25 cases belonging to Group B. Maximum patients in study Group A had shown ulcer regression in 3.56 average weeks duration, while it was in 4.50 average weeks duration in Group B.
Conclusion: This comparative and interventional study demonstrates that the study Group A receiving 10% sodium chloride solution with 5% natamycin helps in faster healing of corneal ulcer, rate of progression of ulcer is slowed down, and complications are less in comparison to Group B receiving 5% Natamycin alone owning to the anti-edema property of hypertonic saline. Hence, topical 10% NaCl solution can be used with 5% natamycin, as a cost-effective adjunct in the management of fungal keratitis.
Effect of treatment of Helicobacter pylori with combination antibiotic therapy on iron deficiency anemia in patient with H. pylori-associated gastritis
Authors: Prashant Tanaji Dond  , Rahul Deshpande  , Shailesh Patil  , Naresh Bhat
Published: September 2023

Background: The failure to identify a cause of iron deficiency in a substantial subset of patients with low iron stores raises the question of whether there are additional as of yet unexplained causes of iron depletion. Recently, there has been a growing body of evidence to suggest a relationship between Helicobacter pylori gastritis and iron deficiency anemia (IDA) in the absence of peptic ulcer disease.
Aims and Objectives: Therefore, the present study was undertaken to investigate the effect of treatment of H. pylori with combination antibiotic therapy on IDA in patient with H. pylori-associated gastritis.
Materials and Methods: The present study was carried out at a tertiary care hospital catering to a large population in south Solapur and nearby areas. The study was conducted for 2 years. All patients with IDA attending outpatient department and admitted to the hospital for 2 years, were included in the present study. All patients who have IDA according to the World Health Organization criteria, as a hemoglobin concentration <13 g/dL for men and <12 g/dL for women, a mean corpuscular volume (MCV) <75 fL and a serum ferritin level < 30 ng/mL, both in-patient and outpatient setting were evaluated with detail history, clinical examination, and investigation.
Results: Baseline hemoglobin (Hb) in group I is 8.99±1.23, while in group II 7.55±2.08.All the parameters are comparable in groups I and II except baseline Hb%. There is a significant increase in Hb, packed cell volume (PCV), MCV, mean corpuscular hemoglobin (MCH), and MCH concentration (MCHC) after 2 months of treatment with oral iron therapy. There is a significant increase in Hb, PCV, MCV, MCH, and MCHC after 2 months of treatment with oral iron and triple therapy for H. pylori.
Conclusion: Treatment of H. pylori infection was associated with more rapid and significant response to oral iron therapy in IDA as compared with the use of iron therapy alone.
Effectiveness of Tinospora cordifolia in comparison to tramadol for analgesic activity in albino rats
Authors: Syed Gulam Ahmed  , Suguna Sajja  , Bhuvaneswari Edavaluru  , Shravya Edavaluru  , Praneeth Reddy Onteddu
Published: September 2023

Background: Pain and pyrexia are the warning signals, primarily protective in nature, that cause discomfort and suffering and may even be unbearable and incapacitating. The modern drugs (such as opioids, NSAIDs, and corticosteroids) currently used for the management of pain, fever, and inflammatory conditions, present with many known adverse effects. Tinospora cordifolia known as Giloe or guduchi, widely used in folk medicine due to its property to cure several diseases.
Aims and Objectives: The present study was undertaken to explore the analgesic activity of water-soluble extract of T. cordifolia in albino rats in experimentally induced pain.
Materials and Methods: The present study was done in the Department of Pharmacology, Gandhi Medical College, Secunderabad. Albino rats were used to study the analgesic activity of T. cordifolia aqueous extract at the dose of 300 mg/kg and 1 g/kg and tramadol 50 mg/kg per orally. Eddy’s hot plate was used for the antinociceptive study.
Results: In Eddy’s hot plate, an increase in reaction time was observed with peak effect at 90 min. Results were close to the standard drug tramadol.
Conclusion: Aqueous extract of T. cordifolia was effective in model of pain suggesting its possible action by central and peripheral mechanisms, and in higher doses, it was found to be effective like that of tramadol.
Assessment of macular thickness following cataract surgery in diabetic patients
Authors: Apurva H Suthar
Published: September 2023

Background: Cataracts and diabetes very commonly coexist. While the results of cataract extraction (CE) procedure are astounding, patients with diabetes may have more unfortunate visual outcomes in comparison to their counterparts.
Aims and Objectives: This study is planned to see the frequency of development of macular oedema (ME) in diabetic patients as compared to non-diabetics and also to see the progression of ME after cataract surgery.
Materials and Methods: This prospective comparative study enrolled 100 diabetics and 100 non-diabetics undergoing cataract surgery fulfilling inclusion criteria. Complete ocular examination was done for both the groups preoperatively and postoperatively at 1 week, 1 month, and 3 months including central macular thickness evaluation using optical coherence tomography (OCT).
Results: Improvement in visual acuity was observed in both the group but, non-diabetics achieved better visual acuity in comparison to diabetics. A significant increase in mean central foveal thickness (CFT) in diabetics and in non-diabetics post 1 month of surgery was observed; however, at 3 month, the difference was not significant. All the patients with mild, moderate, and severe non-proliferative diabetic retinopathy (NPDR) showed increment in the CFT from the baseline value but none of the patient of mild NPDR grade presented with new development of clinically significant macular edema on OCT.
Conclusion: Cataract surgery causes a significant increase in macular thickness post 1 month of surgery in both diabetic and non-diabetics. Cataract surgery did not lead to the progression of stages of DR, although patients with all the three grades of DR showed increment in CFT from the baseline reference value.
Gestational diabetes: The epicenter of feto-maternal crisis
Authors: Ruby Dhar  , Arun Kumar  , Subhradip Karmakar
Published: September 2023

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The rising trend in obesity and overweight globally poses a serious risk for developing GDM, more among South Asian population. The occurrence of perinatal complications seems to parallel with incidence of GDM contributing significantly to adverse pregnancy outcome. The matter of fact is that diabetes just do not affect the mothers only, but also the new-born, predisposing them to various neonatal adverse outcomes, including metabolic and cardiac disorders, and respiratory distress, as wells as neurologic impairment compromising with metal development. Further, low birth weights, macrosomia, and infections are some of the most commonly occurring outcomes of GDM, the severity of which parallels with maternal blood glucose levels and age. Further, there are higher risk of hypoglycemia among the new born of hyperglycemia diabetic mothers.
The numbers are soaring high, more in developing nations, with India almost topping the list with currently, over 80 million women worldwide who are affected by GDM and pregestational diabetes mellitus. How exactly GDM affects the developing fetus is still not precisely known. Animal studies using rodent models indicated glucose mediated oxidative stress, leading to excess apoptosis in the target organs as wells production of other reactive oxygen and nitrogen species. Further, an activation of unfolded protein response leading to endoplasmic reticulum stress seems to contribute to the pathogenesis of hyperglycemia. However, what is assuring is that risk mitigation against this detrimental effect can be adopted. This involves risk assessment of pregnant females at the first prenatal visit with special focus on comorbidities such as overweight with/and obesity, glycosuria, and family history and hence should be recommended for blood glucose testing (between 24 and 28 weeks of gestation). With the prevalence of GDM reported to range from 3.8% in Kashmir 17.9% in Tamil Nadu, the stakes are high. It is also clear that India has a very high prevalence of GDM by all global standards. Rational steps to tackle this problem at the early and effectively will decide its long-term consequences on maternal and child health.
Editorial Vol.5(2)
Authors: Saud Mohan Singh
Published: September 2023

Not available.
Abuse and Harassment of Female Journalists in Karnali
Authors: Joshi Keshabi Kumari
Published: September 2023

This study explores the experiences of abuse and harassment faced by female journalists in the Karnali Province. In the base of concurrent research design, mixed method was adopted in this study. For quantitative method, questionnaire was developed and online survey was conducted for data collection. For that 60 respondents were selected. Like that, for qualitative study, focus group discussion and semi-structured interviews were performed. Where 3 senior female journalists were selected for the interview and 10 victims were selected for focus group discussion. This study set up within the theoretical framework of objectification and spiral of silence. Results reveal that patriarchal societal norms contribute to the objectification of female journalists, leading to a high prevalence of abuse that is often not reported due to ineffective laws, discrimination, shame, economic vulnerability, and lack of political access. The result also shows that female journalists often lack self-confidence and may bear the harassment silently or try to hide it due to the fear of social boycott. It highlights the issues of unequal wages, lack of credit for their work, and exploitation by senior journalists.
Resistance against Necropolitics: A Study of Shaila Abdullah’s Saffron Dreams
Authors: Bhatta Sita Ram
Published: September 2023

This paper examines the exercise of necropower by the Americans on the South Asians, especially the Muslims, in the aftermath of 9/11. The purpose of the study is to expose how the Americans (ab)used their social and political power on the lives of the Muslim migrants, making it difficult for them to exist in the host land, that is, the US. For this purpose the study analyzes the narrative data from Sheila Abdullah’s Saffron Dreams (2009). In the novel, the pregnant protagonist Arissa Illahi suffers racial hatred and discrimination while she was undergoing the trauma of losing her husband in the Twin Tower attack of 9/11. Drawing upon the concept of necropolitics by Achille Mbembe, the study discusses how the so-called advanced society of the USA is limited to parochialism of White supremacy. The paper focuses on how the events of ‘September 11’ resulted in the cultural clash between the West and the Muslim world, and how the fighters of the so-called War on Terror were exacerbating the terror through their conduct of Islamophobia. It concludes with a note that one can survive being committed to and taking help of art and creation in spite of social vulnerability.
Analysis of Entrepreneurial Activities for Promoting Organic Products in Karnali Province
Authors: Rokaya Ammar Bahadur , Pandey Akhilesh Chandra
Published: September 2023

Organic products not only provide numerous health benefits but also contribute to environmental sustainability. The entrepreneurial skills needed for the promotion of organic products in the Karnali province of Nepal can contribute significantly to the regional economy. But it requires a comprehensive policy framework to support and encourage the growth of this sector. The purpose of this study is to explore the current status of entrepreneurial activities to produce and promote organic products in the Karnali province and identify the challenges faced by entrepreneurs in this sector. The study is based on qualitative methods, including in-depth interviews with leading entrepreneurs, government authorities, and experts by using quota and convenience sampling techniques, and a review of relevant literature. This study finds the effective strategies for promoting entrepreneurship in the organic products sector in the Karnali province of Nepal. By analyzing the current state of organic agriculture and entrepreneurship development in the region, the study provides the recommendations for policymakers to support the growth of entrepreneurs in this sector. The findings suggest for the implications for the local community and the environment, as promoting organic agriculture with positive effects. Overall, this study seeks to contribute to the development of policies that promote entrepreneurship and sustainable development in the Karnali province.
Impact of Talent Management on Organizational Performance in Nepalese Non-government Organizations
Authors: Rijal Rheet , Rijal Chandra Prasad
Published: September 2023

This study opted for a positivist perspective-based deductive approach to determine the impact of talent management on organizational performance in Nepalese non-government organizations. The causal_comparative research design was used to determine the intensity and magnitude of the relationship between the selected constructs of the inquiry. To collect the primary data, an email survey was administered using referral sampling that generated a ‘sufficient’ sample size of 404 with complete responses by respondents of various demographic backgrounds. For the data analyses, descriptive and inferential analyses were used. The key findings of the study using the structural equation model revealed that attraction, selection, and retention were the drivers of improving organizational performance in the chosen context. However, talent development had no significant influence on organizational performance.
NUMERICAL INVESTIGATION OF FORCED CONVECTION HEAT TRANSFER ON INLINE CYLINDERS IMMERSED IN A POROUS MEDIA
Authors: Khudhair Enas , Khudhur Dhamyaa
Published: September 2023

In the present study, forced convection heat transfer on eight inline cylinders immersed in a 10 × 10 × 30 cm packed bed of porous medium is numerically explored with a range of Reynolds numbers from 1100 to 2250. The airflow passes through eight cylinders with an inline arrangement, each having a diameter of 15 mm and a length of 10 cm, immersed in a horizontal porous channel at a constant heat flux of 2000W/m2. The commercial program ANSYS Fluent R.19 simulates the changes in pressure drop and temperature distribution by changing the Reynolds number and porosity. The dimensions of each porous pack are 10x10 cm in cross-section, 5 cm in length, and 5 cm in spacing from the next porous pack. The porosity values are (0.4001, 0.39112, and 0.3822). The general shape of all temperature contours shows that the high porosity near the cylinder wall enhances heat transfer from the heated cylinder surface. After that, the air temperature gradually decreases when going away from the cylinder surface. It can also be seen that the pressure drop decreases as particle diameter increases.
APPLICATIONS AND CHALLENGES OF THE REVERSE OSMOSIS MEMBRANE PROCESS: A REVIEW
Authors: Mohammed Hiba A. , Sachit Dawood E. , Al-Furaiji Mustafa
Published: September 2023

Reverse osmosis is one of the most prevalent methods of generating potable water owing to its low power usage, excellent rates of contaminant removal, simple design, large output capacity, and much cheaper initial and maintenance costs than comparable alternatives. In this review, the most important published research related to the reverse osmosis process was reviewed. It was found that the majority of reported studies were related to using the reverse osmosis process for water desalination and wastewater treatment. Research has proven that the reverse osmosis process is a very effective method for desalinating water and treating industrial effluent containing heavy metals, organics, and other pollutants. Fouling was found to be one of the greatest obstacles encountered by the reverse osmosis method in water treatment, which raises operating costs due to the need for frequent cleaning, reduces the membrane's lifespan, and reduces the permeate flux. In general, microfiltration/ultrafiltration pretreatment and backwashing were among the most effective strategies suggested by researchers to reduce fouling and ensure the longevity and proper operation of the system.
Teaching Evidence-Based Medicine and Non-conventional (Alternative) Therapies in Portuguese Veterinary Schools—A Curricular Assessment
Authors: Magalhães-Sant’Ana Manuel , Rodrigues Isilda , Costa Daniel , Stilwell George , Franco Nuno Henrique
Published: September 2023

Applying evidence-based veterinary medicine (EBVM) is considered a Day One competence for veterinary graduates. Furthermore, the increasing interest in the use of complementary and alternative (non-conventional) veterinary therapies (NCTs) must be grounded on EBVM principles. Few studies have mapped the teaching of EBVM and of NCTs and assessed their content. This study analyses the official curricula of six (out of eight) Portuguese veterinary schools in terms of EBVM and NCTs, using the self-evaluation documents submitted to the National Agency for Assessment and Accreditation of Higher Education (A3ES) (2014–2015). Results show that, with few exceptions, veterinary education in Portugal follows a traditional, clinically-driven approach to evidence, with concepts taught mostly from an empirical and experiential perspective instead of a systematic one. Core EBVM topics, such as placebo effect, methodological validity, PICO, cognitive bias, and systematic review are either absent or insufficiently covered. Moreover, the teaching of NCTs was found in three out of the six curricular programs, namely acupuncture, phytotherapy, homeopathy, traditional Chinese medicine, aromatherapy, Bach flower remedies, ayurveda, energetic healing (reiki), and massage. We found no evidence that these therapies are being taught under the principles of EBVM. Taken together, these results highlight the need for more explicit and targeted teaching of EBVM-related topics, namely regarding the critical appraisal of scientific literature and the integration of best evidence into clinical decision-making. Results can also be useful to inform the accreditation process by the A3ES and by education quality assurance agencies in other jurisdictions.
QUANTITATIVE ESTIMATES OF DIRECT PYROGENIC CARBON EMISSIONS IN FORESTS OF RUSSIA ACCORDING TO REMOTE MONITORING DATA 2021
Authors:   Center for Forest Ecology and Productivity Russian Academy of Sciences, Ershov D.V. , Sochilova E.N.
Published: September 2023

This paper presents the statistics of direct wildfire carbon emission estimates during the wildfires of 2021 on forest lands of Russia using long-term satellite data. In 2021, the area affected by forest wildfires was 9.3 million ha, while carbon emissions amounted to 66.4 MtC. Said values are almost two points higher than the long-term average values. A comparison of similar indicators for twenty years allowed us to conclude that said year was anomalous with respect to the entire time series, similar to the wildfire seasons of 2003 and 2012. A period or interval for recurrence of three anomalous wildfire seasons is nine years. The reason for the recurrence of anomalous wildfire seasons is yet to be found. At the same time, the forest areas affected by wildfires, and direct carbon and other greenhouse gas emissions in anomalous wildfire years decreased from 127.2 MtC (3.7 times) in 2003 to 83.8 MtC (2.4 times) in 2012, and to 66.4 MtC (1.9 times) in 2021.
Remote sensing data from Space for road image recognition in the forestry
Authors:   Center for Forest Ecology and Productivity Russian Academy of Sciences, Podolskaia E.S.
Published: September 2023

Paper presents an overview of history and current research state on the use of remote sensing data from space to recognize roads for the regional projects in the forestry. We reviewed the principles of road detection on the optical satellite imagery. Group of direct recognition features used in combinations such as brightness and texture, geometry and brightness. Three research directions with examples were identified: visual roads recognition, use of special software and libraries for developers, and neural networks. For the road network detection we have described methods and software, type and spatial resolution of imagery. Road image recognition based on the optical survey from the open and commercial sources, machine learning methods and neural networks. Up-to-date tasks of road recognition are the following: evaluation of road surface condition, modeling of existing roads location, designing and building new roads, roads seasonality. A functional summary of MapFlow plugin for road recognition in Open Source QGIS is given. Paper is a part of regional forestry transport modeling project to access the forest fires and forest resources by ground means.
DYNAMICS OF FOREST VEGETATION DESTRUCTIOS IN THE AREA ADJAICENT TO THE COPPER MINE IN THE SVERDLOVSK REGION
Authors:   “Denezhkin Kamen’” Russian Federal Nature Preserve, Kvashnina A.E. , Vozmitel F.K. , Khamedov V.A. ,   Siberian State University of Geosystems and Technologies,   Saint-Petersburg State University of Aerospace Instrumentation
Published: September 2023

The study represents spatial and temporal analysis of the consequences of water pollution leading to vegetation destruction, caused by uncontrolled underspoil drain from a copper mine in the north of the Sverdlovsk region, based on GIS methods and satellite remote sensing data. Based on a 1:25 000 topography map DEM with filled sinks we built a flow accumulation model a watershed map. Examining the satellite imagery of the area dated from 2009 to 2023 we have noticed a distinct pattern of the vegetation destruction along the riverbeds located in the affected watersheds. Our ground observations and drone images have confirmed that the dead forest plots are located in the areas of flow accumulation, in the terrain depressions. The total area of forests affected by the uncontrolled underspoil drain from the copper mine gradually grows and has reaches 1140 ha.
ANALISIS LAPORAN KEUANGAN SEBAGAI DASAR DALAM PENILAIAN KINERJA KEUANGAN SPBU SAYATI 34-40251
Authors: Anggraena Mira , Anggraeni Meri , Rosalina Resmi Ranti
Published: September 2023

The purpose of thus study is to identify changes in the company's financial condition and operating performance over several periods, provide management insights and projections regarding the growth and decline of the company's financial condition in the future. This research method uses descriptive quantitative method. Four significant figures are used when analyzing the financial statements of the Sayati gas station 34-40251: liquidity ratio, solvency ratio, profitability ratio and activity ratio. Based on our research and analysis of the financial statements for the period 2017 to 2020, the financial performance of the Sayati 34-40251 gas station is liquid and stable because it can fulfill all its obligations, can earn income from all its activities, can use company resources efficiently despite a decline in financial performance. in 2020 due to the spread of Covid 19, but this did not have a negative impact on business operations.

Keywords : Ratio Liquidity, Ratio Solvability, Ratio Profitabilitas, Ratio Activity, Financial Report
Pengaruh Pajak Hotel, Pajak Restoran Dan Pajak Parkir Terhadap Pendapatan Asli Daerah Deli Serdang, Sumatera Utara Periode 2019-2021
Authors: Gurusinga Latersia Br , Sari Thevanni Tri Puspita
Published: September 2023

This study aims to examine and analyze the effect of hotel tax, restaurant tax and parking tax on local revenue of Deli Serdang, North Sumatra for the 2019-2021 period. The Regional Government of Deli Serdang has lost a lot of Local Original Revenue (PAD) during the current Covid-19 pandemic. This research was conducted in Deli Serdang, North Sumatra for the 2019-2021 period. Researchers obtained research data by entering the site https://bapenda.deliserdangkab.go.id/website/web. The population of this study is hotel tax, restaurant tax, parking tax and local revenue of Deli Serdang, North Sumatra for the 2019-2021 period. The research sample is 3 x 12 data so that 36 data. Data collection techniques are secondary data using documentation techniques. The data analysis technique of this research uses multiple linear regression. The results of this study partially and simultaneously have no effect on Hotel Tax, Restaurant Tax and Parking Tax on Regional Original Revenue of Deli Serdang, North Sumatra for the 2019-2021 period.

Keywords: Hotel Tax, Restaurant Tax, Parking Tax, Local Own Revenue
Strategi Dan Rencana Implementasi CRM Dalam Menghadapi Preferensi Pelanggan Perusahaan Farmasi Di Indonesia
Authors: Padmasari Catharina Cita , Windasari Nila Armelia
Published: September 2023

Customer Relationship Management in pharmaceutical industry is used to manage and maintain relationship with customers, most importantly healthcare professionals (HCP). Reassessing and improving customer engagement in light of the environment's shifting dynamics will inevitably lead to better access for patients as the final consumers of pharmaceuticals.  Initially, covid-19 pandemic social restrictions created new engagement model that depended solely on digital engagement. However, covid-19 instances are declining, and pandemic recovery is accelerating. There are shifting engagement dynamic to be hybrid engagement in Indonesia HCP as well. This opportunity enables pharmaceutical companies to understand HCP’s current preferences. This research aims to build CRM Engagement Strategy with understanding the customer’s perspectives and moderated with internal stakeholders' capabilities and external forces during post-pandemic recovery using case-study approach. The primary research found that pharmaceutical companies have enabled hybrid model that aligns with flexible preferences of HCP that combine face-to-face and digital interactions that address data privacy concerns of HCPs. The result of this research is importance of building CRM arrangement strategy in light of post-pandemic HCP’s preferences.

Keywords : customer relationship management; pharmaceutical companies; post-pandemic recovery