bluuebunny/crossref_metadata_2025 huggingface dataset:
Aprendizaje basado en proyectos: la perspectiva del alumnado en aprendizaje semipresencial y totalmente en línea
Authors: Hernández-Arvizu Berenice Florian , Guzmán-Cedillo Yunuen Ixchel , Lima Villeda Diana Natalia
Published: June 2023

El objetivo de este estudio es identificar los significados atribuidos por estudiantes universitarios de psicología a la estrategia docente de Aprendizaje Basado en Proyectos (ABP), en relación con las actividades implicadas, el esfuerzo requerido y el aprendizaje adquirido en un entorno semipresencial previo a la pandemia COVID-19 y el sustitutivo de aprendizaje completamente a distancia implementado durante el confinamiento. El estudio utiliza una metodología cualitativa-fenomenológica para examinar la experiencia de los participantes en ambas modalidades. Los datos se obtuvieron a partir del discurso de 130 estudiantes universitarios de psicología: 67 semipresenciales y 63 a distancia. El análisis consistió en una codificación temática basada en un libro de categorías y subcategorías emergentes. Los resultados muestran que los estudiantes de ambas modalidades aprendieron una serie de contenidos, destrezas, conocimientos y habilidades diferentes a través de su proyecto. Se requiere más investigación para examinar el impacto de la modalidad de aprendizaje y la experiencia del docente de ABP.
Habilidades sociais, suporte familiar e clima escolar em estudantes do sexto ano
Authors: Penna-de-Carvalho Aline , Coimbra Susana , Gato Jorge , Leme Vanessa
Published: June 2023

Fundamentando na teoria bioecológica e da resiliência, o objetivo deste estudo foi analisar em que medida a percepção de um conjunto de fatores de proteção (habilidades sociais, suporte familiar e clima escolar) difere conforme as características sociodemográficas como sexo e reprovação escolar de alunos do 6º ano. Os dados foram coletados em uma amostra de 448 alunos de escolas públicas do estado do Rio de Janeiro usando a Versão Breve do Inventário de Habilidades Sociais para Adolescentes, a Escala da Percepção Infantil dos Suportes do Ambiente Familiar, o Questionário de Clima Escolar e o Questionário sociodemográfico. Os principais resultados da análise estatística indicaram diferenças no autocontrole e abordagem afetiva entre meninos e meninas, e que os estudantes sem experiência escolar de reprovação reportaram mais suporte familiar afetivo. Os achados do estudo apresentam implicações relevantes para futuras investigações e para programas educacionais destinados a adolescentes.
Imagen, ansiedad y actitudes ante la muerte antes del COVID-19 y tres años después: Un estudio con adolescentes
Authors: Campos Alfredo , López-Pérez Esther
Published: June 2023

Los trastornos de ansiedad y la depresión han aumentado como consecuencia de la COVID-19. El objetivo de este estudio es examinar la influencia de la pandemia y el género en las imágenes de la muerte, la ansiedad ante la muerte y las actitudes hacia la muerte en un grupo de adolescentes de secundaria. Un mes antes del comienzo de la pandemia, se entregaron pruebas que medían las imágenes de la muerte, la ansiedad ante la muerte y las actitudes hacia la muerte a 195 participantes, y 134 participantes realizaron las mismas pruebas tres años después, justo tras el final de la pandemia. La comparación de las puntuaciones antes y después de la pandemia no muestra diferencias significativas en las imágenes de la muerte o la ansiedad ante la muerte entre ambas. Después de la pandemia, los participantes mostraron una mayor Aceptación de Aproximación (AA) y Aceptación Neutral (NA), mientras que las mujeres experimentaron más Miedo a la Muerte (FD) y una mayor Aceptación de Escape (EA) que los hombres. Los resultados se explican teniendo en cuenta los momentos en que se realizaron las pruebas, así como las características de los participantes.
Factores determinantes de la adopción del m-commerce en consumidores de Tijuana
Authors: Cruz Estrada Isaac , Miranda Zavala Ana María
Published: June 2023

En la investigación se identificaron los factores que determinan la adopción del m-commerce en consumidores de la ciudad de Tijuana, Baja California. En la metodología se revisó literatura relacionada con el comportamiento del consumidor online y componentes de la adopción de este comercio. En la fase cuantitativa se aplicó un cuestionario a 600 usuarios frecuentes del m-commerce, residentes de Tijuana. En los resultados se confirmaron tres componentes principales para su adopción: 1) eficiencia del proceso de compra, seguridad y comunicación asertiva con el usuario; 2) diseño web intuitivo y amigable; 3) acompañamiento durante y después de la compra, y actualización del sitio móvil. Los usuarios del m-commerce están en constante evolución y reaccionan con mayor intensidad considerando las nuevas oportunidades presentes en Internet.
Forgiveness-Hope Relationships Considering the Risk of Depression: Samples from Public School Students in A Religious Country
Authors: Rahmandani Amalia , Amaranggani Anindhita Parasdyapawitra
Published: June 2023

This study aimed to describe forgiveness-hope relationships among normal adolescents and those at high risk of depression in Indonesia, which is considered a religious country. This study involved 713 adolescents from a state vocational school in Semarang, obtained purposively in both sample groups (Male=64.1%; nHigh Risk=42; nNormal=671). Measurements used the DASS-Depression, Forgiveness Scale, and State Hope Scale.  Data distributions supported non-parametric tests. Statistical analysis particularly used Spearman's rho correlation.  Additional analyses used descriptive statistics and Mann-Whitney U. The study resulted in a significant positive correlation in each sample group; the correlation coefficient was greater in the high risk sample. When the correlation in the normal sample was significant for each sex, the correlation in the male high-risk sample was not significant alone. Specifically, both sexes of the high-risk sample received benefits on their pathways but not agency subscale. Among all the forgiveness dimensions in the high-risk sample, only forgiveness of situation contributed to hope. The results indicate that forgiveness may encourage better hope in more depressed adolescents, especially female adolescents. Targeting forgiveness of situations is the primary thing for depressive adolescents, thus encouraging efforts to find coping strategies regardless of their capacity. Further examination using experimental methods can be suggested.
Prevalence of musculoskeletal disorders in elderly population in a rural community of Bangladesh
Authors: Hasan Moinul , Miah Sarker Md. Zilan , Ahmed Md. Shamim , Islam Md. Tanvir
Published: June 2023

Background: Musculoskeletal disorders are a leading source of physical impairment in elderly, and the frequency of these disorders is anticipated to increase rapidly as the population ages. In Bangladesh, musculoskeletal disorders among the elderly are on the rise, causing them immense misery. The aim of this study to find out prevalence of musculoskeletal disorder in this age group in a rural community of Bangladesh.
Methods: A descriptive cross-sectional study was conducted over the period of one year from April 2017 to March 2018 in a few villages of Mokshedpur union of Dohar Upazila in Dhaka district of individuals with 60 and above. Modified COPCORD (Community Oriented Program for Control of Rheumatic Disorders) questionnaire was used to detect positive respondents.
Results: The prevalence of musculoskeletal pain was 52.10%. Prevalence was higher in women, 113 (56.6%) than men, 85 (43.4%). Most of the patient belongs to age group 60-69 (79.3%). Higher prevalence rates were observed in housewife (42%), retired person (24%) and cultivators (17%). Most of the individual had no smoking habit, 145 (73.2) and 42.9% are daily smokeless tobacco users. Lower back pain (42.4%) and knee pain (37.4%) were prevalent among the study group. Non-specific low back pain (28.8%) and osteoarthritis in the knee (26.3%) were prevalent among the study group. Among all the disorder, female is prevalent than male.
Conclusions: Musculoskeletal disorders are common causes of morbidity and disability in rural communities of Bangladesh. Women are affected more frequently than men. Mechanical disorders are more common than inflammatory arthropathies.
Spectrum of acute kidney injury in patients of tropical acute febrile illness in a tertiary hospital
Authors: Badge Rohit P. , Babu V. Suresh , Rathore Vinay
Published: June 2023

Background: Tropical acute febrile illnesses (TAFI) such as malaria, typhoid, leptospirosis, dengue are major causes of AKI in the tropics. The spectrum of AKI due to TAFI in developing countries like India is still underestimated. Hence, we conducted a study to know the spectrum of AKI in patients of TAFI.
Methods: The prospective study was conducted in Yashoda hospital, Secunderabad a tertiary care hospital in India from April 2019 to March 2020. AKI was defined as per KDIGO. The clinical history, physical examination and laboratory investigations were recorded in a standard proforma.
Results: Hundred patients suffering from TAFI were admitted during the study period. Mean age of the study population was 43.12±14.33 years. Twenty-six (60.5%) were males. Most common presenting feature was fever (100%), chills (81.4%) and vomiting (67.4%). The most common cause of TAFI was dengue (n=49, 49%), leptospirosis (n=20, 20%), followed by malaria (n=10, 10%), scrub typhus (n=10, 10%) and undifferentiated fever (n=6, 6%). 43 patients (43%) had AKI as per KDIGO definition. 23 patients (53.5%) had stage 1, 11 (25.6%) had stage 2 and 9 (20.9%) had stage 3 AKI. RRT was required in 16.3% of patients. Dengue and leptospirosis were the most common causes for requirement of RRT. SLED was the most common modality of dialysis. Mortality was observed in 6.98% patients and Dengue was the most common cause of mortality.
Conclusions: AKI is common in tropical acute febrile illness. However, RRT was required only in 16.3% and mortality was observed in 6.98% patients.
Clinical approach: hypokalemia paralysis periodic with type 2 diabetes mellitus and insulin
Authors: Wibawa I. Dewa Gede Amara Putra , Dewi Anak Agung Istri Sri Kumala
Published: June 2023

Hypokalemic paralysis periodic (HypoKPP) also known as familial hypokalemic periodic paralysis (FHPP) or primary FHPP is rare case characterized by periodic muscle weakness and estimated prevalence of around 1 in 100.000. Insulin is a treatment for diabetes that also decreases blood potassium levels, therefore, it is necessary to further investigate the causes of hypokalemia. This will be the topic of further discussion if there is a correlation with FHPP. A 32-years-old Indonesian woman with diabetic who has symptoms indicate HypoKPP, and her twin-sister suffered same symptoms is suspected of having FHPP. FHPP is difficult to diagnose due to genetic, other causal factors that must be eliminated, and uncommon references.
Diagnosed with primary adrenal insufficiency? search adrenoleukodystrophy-two brothers presented with similar phenotype
Authors: Nur-E-Jannat Syeda , Ahmed Dewan Saifuddin
Published: June 2023

X-linked adrenoleukodystrophy (X-ALD) is a genetic disease with a variety of phenotypic expression. This is the first case report of X-AMN/ALD in two brothers in Bangladesh confirmed by raised VLCFA. Our index patient of 19 years presented on 2014 with adrenal insufficiency, after one year developed progressive spastic paraparesis along with cognitive declination and behavioral abnormality. His only brother was clinically asymptomatic at presentation with Addison’s disease and extensor planter reflexes. After three years of follow up, index patient became bed bound with slurred speech, urinary urge incontinence and his brother developed spastic paraparesis with cognitive impairment. None had gonadal impairment. Follow up MRI after three years revealed lesion in brainstem in both along with atrophy of thoracic segment of spinal cord in index patient and cerebellum, internal capsule involvement in his brother. Both were of pure AMN variety but due to presence of cognitive impairment and behavioral abnormality they can be categorized as cerebral variety of AMN. On 2023, our index patient is still surviving with major functional disability and his brother died on 2019, 5 years of initial diagnosis.
Bezoars: diagnosis, management, and potential complications in patients with psychiatric disorders
Authors: Cisneros Arias Francisco De Jesús , Espinal Campa Kassandra Janeth , Espinal Campa Alondra Yaneli , Beltran Serrano Erick , Diarte Vega Hector Aurelio
Published: June 2023

Word "bezoar" comes from Persian "pâdzahr," which means "antidote," since, in ancient times, it was believed that bezoar could cure and nullify effects of all poisons. In medical context, bezoar is the term used for conglomerates of undigested material that accumulate in de gastrointestinal tract. Case of 60-year-old female patient with repeated episodes of intestinal obstruction associated with digestive tract bleeding. She presented to emergency department with severe abdominal pain and intolerance to oral route. Computed tomography identified hypodense image suggestive of a oreign body in the small bowel  lumen. During laparotomy, stone-like mass of approximately 3×5 cm was found at level of jejuno-ileal junction, 80 cm from Treitz ligament, with presence of an intestinal flange that conditions rotation of the intestinal loop on its axis. Intestinal obstruction due to bezoar is uncommon in adult patients, and symptoms are usually non-specific. It requires a high index of suspicion and effective screening for trichotillomania. In such cases, imaging studies such as tomography help to establish the diagnosis.
A case of Guillain-Barre syndrome presenting at third trimester of pregnancy complicated with pre-eclampsia and acute kidney injury
Authors: Yadiyal Muralidhara , Shetty Bhushan C. , M. S. Shashank
Published: June 2023

Guillain-Barre syndrome (GBS) is immune mediated injury of the peripheral nerves. This condition can affect any individuals with some trigger. Here the disease affected the lady in her last trimester of pregnancy which was complicated with pre-eclampsia and acute kidney injury. Later she recovered by multimodal treatment approach, with a prolonged intensive care unit stay. Currently she and her baby are stable with frequent follow up. This case highlights the fact that GBS can affect any trimester of pregnancy and her pregnancy could be a trigger. Further, treatment approach involves multiple specialties including internal medicine, nephrologist, neurologist, physiotherapist and psychiatrist.
A typical presentation of a rare complication of cholelithiasis: Bouveret syndrome
Authors: Sultana Sadaf , Pimplawar Yayati
Published: June 2023

Bouveret syndrome (BS) is an exceptionally rare variant of gallstone ileus, specified by gastric outlet obstruction resulting from migration of a large gallstone through the bilio-enteric fistula and is impacted in the pylorus or duodenum. We present an atypical case of BS. A 60-year old male came in Era’s Lucknow medical college who had undergone multiple diagnostic procedures (x-ray kidney ureter bladder, ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopy) (MRCP) for his unusual presentation of right lower abdominal pain without any signs or symptoms of gastric outlet obstruction (nausea or vomiting). Initial attempts of endoscopic retrieval of stone with extracorporeal lithotripsy were performed as first-line treatment which had failed, therefore a successful surgical extraction of stone by enterolithotomy was attempted without cholecystectomy.
Awareness of the Saudi community toward multiple sclerosis in Al-Madinah Al- Munawarrah, Saudi Arabia
Authors: Alnefaie Zayed , Alamri Ghudai Hatem , Aljarboua Ghadi Bassam , Alnakhli Fatimah Mohammed , Abubaker Jana Jamil , Alhazmi Lajeen Faisal , Alsadi Rajaa M-Measar
Published: June 2023

Background: Multiple sclerosis (MS) is an inflammatory neurodegenerative disease affecting the central nervous system (CNS); pathophysiological concepts revealed that exposure to some infectious agents during childhood and genetics involvement played a role. Data reported that females were more affected by MS than males due to genetic predisposition. Recent epidemiological data indicated a higher prevalence of MS in the Arabian Gulf region, with increasing incidence in the Kingdom of Saudi Arabia (KSA). Knowledge about MS shall aid in better management, diagnosis and treatment. This study aimed to assess the level of awareness about MS among participants in Al Madinah Al Munawarrah, KSA.
Methods: This was a cross-sectional non-interventional observational survey questionnaire among 381 participants in Al Madinah.
Results: The majority of participants were female aged more than 20 years old and high graded; 66.4% of the participants reported good awareness about MS, and 68% reported that MS impact the central nervous system, causing more illness among females aged between 20-39 years. Regarding the risk factors towards MS, Family history of MS and personal history of autoimmune diseases were on top of the list among the participants in relation to risk factors MS, with 43.3% and 38.1%, respectively.
Conclusions: In summary, our study shed light on the lack of knowledge about MS among the adult population in Al Madinah AL Munawarrah, KSA. A better understanding of MS shall contribute towards better diagnosing and management.
Effect of non-surgical periodontal therapy on saliva levels of paraoxonase-1 in healthy and periodontitis subjects: a clinico-biochemical study
Authors: Koregol Arati C. , Kalburgi Nagaraj B. , Sulakod Kavya , Puladas Hannahson , Patil Kavita
Published: June 2023

Background: Salivary antioxidants play main roles in the defensive mechanism of saliva against free radicals. Prevalence of inflammatory conditions like periodontitis associated with several pathogeneses, knowing the defensive mechanism of salivary antioxidant against free radicals can provide helpful strategies in diagnosis and evaluation of these conditions. The aim of this study was evaluation of the paraoxonase (PON1) levels of saliva in healthy and periodontitis subjects.
Methods: In this clinico-biochemical study 30 patients diagnosed with periodontitis and 30 healthy controls aged between 18 to 60 years, 30 patients were recalled after non-surgical periodontal therapy were selected. Three millilitres (3 ml) of whole unstimulated saliva sample were collected. PON-1 level were determined by a commercially available enzyme-linked immunosorbent assay (ELISA) kit.
Results: The results showed a statistically significant difference in the salivary PON1 levels in pre (66.6600%) and post (89.3200%) treatment samples (p value <0.001). The saliva level of PON1 was improved compared to post treatment. There was an improvement in the clinical parameters, and seen a statistically significant difference with p=0.001.
Conclusions: The reduction in the saliva levels of paraoxonase in periodontitis patients has led to a variation leading to increased ROS and therefore periodontal breakdown. The variation in salivary paraoxonase levels before and after treatment can be taken as an indicator of success of periodontal therapy.
Influence of socio-demographic and environmental factors on child mortality in India
Authors: Panda Snigdha , Sarangi Pravat Kumar
Published: June 2023

Background: According to National Family Health Survey (NFHS) report (round 5), under five child mortality rate is 42 per 1000 live births which is far behind the sustainable development goal and National Health Policy, 2017. This research work aims to investigate the socio-demographic and environmental risk factors associated with child mortality between age 0-59 months in India.
Methods: To analyse the objective of this study secondary data of NFHS round 5 are used. NFHS is a large scale, multi-rounds survey conducted by ministry of Health and Family Welfare (MoHFW) with the collaboration of International Institute for Population Sciences (IIPS), Mumbai. Cox regression model is used for the statistical analysis and the data analysis work is carried out using R software.
Results: The research found that mortality rate is higher among mother’s age less than 20 years and mother’s having no education. In rural areas mortality rate is high compared to urban residence. Birth order of child more than 6 has 2.0966 times higher risk to die and the male child is more likely die than the female. Children born to family having richest wealth index (HR=0.6550, CI: 0.5856-0.7327) has the least mortality rate. Use of polluting cooking fuel and unimproved sanitation facility increase death risk on under-five mortality 1.1334 times and 1.0905 times respectively.
Conclusions: The study found a strong influence of socio-demographic and environmental factors on child mortality under the age of five.
Epidemiological correlates of depression in females at an infertility clinic of government medical hospital- a cross sectional study
Authors: Ukey Ujwala Uttamrao , Wadhva Sharma Sarita
Published: June 2023

Background: Infertility affects lives of millions of people worldwide which includes the couples themselves as well as extends further to their families, wider communities also. Moreover, in contrast to the usual belief, the problem is faced by men and women both. Infertility-related stress adversely affects all dimensions of health, quality of life of the couples and relationship with family.
Methods: This cross sectional study was carried out in the outpatient department (OPD) of obstetrics and gynecology during a period of two months (August and September 2022). The study subjects comprised of women in the age group of 18-45 years. Data was collected using interview techniques by a pre designed questionnaire. Statistical analysis was carried out nu epi info software.
Results: A total sample of 113 was covered in the present study. The mean age of the study subjects was 28.38 years, range being 21 to 37 year. Depression of varying levels was detected in 76 (67.25%) of the study participants. However, 32 (32.75%) females were normal without any detection of depression. Mild depression was observed in 15 (13.27%), moderate in 62 (49.56%) and remaining 5 (4.42%) had severe depression.
Conclusions: Depression of a varying level of severity is common occurrence in the women attending infertility clinic. Though role of socio demographic factors is not statistically proven in relation to depression in the study, their role cannot be denied.
Epidemiological analysis of dengue’s one-year laboratory data in a tertiary care center in Western India
Authors: Adrejiya Parth M. , Barve Sonia , Nanda Sandeep
Published: June 2023

Background: Aedes aegypti and Aedes albopictus are the primary effective vectors for the dengue virus in India. The disease is conveyed through the bite of infected mosquitoes of the Aedes species and is the most quickly expanding vector-borne viral disease globally, putting an increasing number of locations at risk.
Methods: We looked at the laboratory surveillance data and reported the percentage of dengue cases that were confirmed in the lab by month, location (urban vs. rural), and individual (age vs. gender) factors.
Results: The maximum no. of suspected cases as well as found positive were in the monsoon and post-monsoon period from July to November. The dengue suspected cases were significantly more in the adult age group than in the pediatric age group. More cases were seen in urban areas than the rural areas.
Conclusions: Serology confirmed positive dengue cases were maximum in the adult group residing in an urban area in the period of monsoon and post-monsoon period from July to November.
Data analysis of malnutrition in India: a review of numerous factors
Authors: Chakravorty Sukanya , Manisha
Published: June 2023

Malnutrition is one of the most critical areas which needs government focus as it plays a crucial role in a country's economic and social development. In recent times, India is proving to be one of the fastest-growing countries in the South Asian region. Malnutrition and hunger rate is reduced to achieve The United Nation's second Sustainable Development Goal, Zero Hunger, to end world hunger by 2030. However, some states of India still serve as home to a more significant number of stunted and underweight children, especially in Bihar and Meghalaya, respectively. (NFHS-5) The current paper focuses on data analysis of malnutrition in India including several factors based on the qualitative research method. A systematic study was done to collect data by reviewing thousands of national- international journals and reports of 3rd, 4th and 5th NFHS and Globally hunger index of India, and WHO report on malnutrition in India. The government of India took the step of launching Poshan Abhiyan in 2017, which needs to be more focused on ruler areas of India.
Adolescent health problems and strategies to improve them
Authors: Dara Sanjeeta , Arora Smriti
Published: June 2023

Adolescent as any person between ages 10 and 19. It is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. The data about important adolescent’s health issues in different areas are limited. Hence detailed investigation and reports on adolescent’s health issues is the need of the hour. To achieve wholesome adolescent health, we need to have a multidimensional approach covering all the adolescent health problems with special emphasis on mental health, behavior change communication towards healthy lifestyle and positive social environment to acquire life skills. Availability of good quality care and healthcare workers trained to deal with adolescents is critical for delivering effective health interventions. Providing health care to adolescents presents a dual challenge: the treatment of immediate health problems, and the opportunity through health promotion and disease prevention, to influence health habits, lifestyle choices, and health status in adulthood because health behaviors originating in adolescence may well have long term health consequences.
Volar plating of isolated ulna shaft fractures
Authors: K. Avinash C. , D. Keshava Murthy , V. Goutham D. , G. Sachin H.
Published: June 2023

Background: Dorsal plating for ulna shaft fracture is a common practice. But this is associated with hardware prominence on the dorsal subcutaneous border of ulna necessitating implant removal on later days. Volar surface of ulna is flat similar to radius volar surface with good muscle cover reducing the problem of hardware prominence. So, we wanted to study the outcome of volar plating of ulnar shaft fractures. 
Methods: Ten patients satisfying our inclusion criteria underwent volar plating using volar approach between FCU and ECU and 3.5 DCP was placed on flat volar surface of ulnar shaft under thick muscle cover of FCU and FDP.
Results: Out of 10 patients, 7 were acute fractures, 2 were neglected non unions and 1was non-union with implant insitu. Bone graft was used in non-union cases. All fractures united at 6-9 month post op without any complications.
Conclusions: Isolated ulnar shaft fractures are common orthopaedic injuries. Displaced fractures require stabilization with dynamic compression plate (DCP). Application of implant on its volar aspect in distal 2/3rd fractures is easy due to flat surface and avoids complications related to hard ware prominence and subsequent need for implant removal.
Functional outcome of patients with lumbar intervertebral disc herniation treated by minimally invasive microdiscectomy
Authors: Kumar Krishan , Singh Harpal , Dattu Vijay , Khosla Vaibhav , Mittal Mandeep
Published: June 2023

Background: The disorder lumbosacral radiculopathy affects the function of one or more lumbosacral nerve roots. The aim of this research is to understand the clinical and epidemiological features of patients diagnosed with disc herniation and treated at our facility using minimally invasive microdisectomy.
Methods: From August 2021 to August 2022, we conducted a prospective research in the Department of Orthopedics at a tertiary care hospital in Pathankot. During the study period, all patients over the age of 18 who presented with complaints of leg or back pain, or other neurological symptoms supported by Magnetic Resonance Imaging (MRI) suggestive of disc herniation, were included. All patients were operated using a minimally invasive micro lumbar discectomy method.
Results: The majority of patients had less than 100 mL of blood loss (75%) and 72% underwent surgery in less than an hour. Only one patient had an intraoperative cerebrospinal fluid leak and no patient had post-operative infection. It was observed that 81% were admitted for 5 to 8 days. Immediately post-operatively, we observed that 50% had good outcome on MacNab score and 9% had excellent functional outcome. At the final outcome at 6 months, 44% had good functional outcome and 47% had an excellent functional outcome. At the final outcome at 6 months, 44% had good and 50% had excellent functional outcomes.
Conclusions: The findings of our study can aid us in budgeting and infrastructure planning for disc herniation patients. Long-term clinical outcomes in these individuals should be the focus of future study.
A comparative prospective study of platelet rich plasma versus corticosteroid injection in chronic plantar fasciitis
Authors: Singh Vikas , Assat R. P. , Singhal Anushrey , Silayach Rakesh
Published: June 2023

Background: The Plantar fasciitis is a common reason for heel pain which manifests as pain at medial process of calcaneal tuberosity. Patients are mostly diagnosed clinically on the basis of history. Conservative treatment in the form of stretching, non-steroidal anti-inflammatories, night splinting, ice packs, strapping, orthosis, and shoe modifications have been in use traditionally. Recently, the use of injectables like corticosteroids and platelet rich plasma (PRPs) has increased. This study aims at comparing the clinic-radiological outcomes of the two injectables in the treatment of chronic plantar fasciitis.
Methods: This was a Prospective, Comparative, Randomized, Hospital-based clinical case study conducted in the Department of Orthopaedics, Sawai Man Singh Medical College, Jaipur, Rajasthan. 60 patients of chronic plantar fasciitis were taken and divided randomly into group A (PRP) and group B (corticosteroids) and the results were assessed based on the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the plantar fascia thickness.
Results: Mean VAS in Group A decreased from 8.07 before injection to 2.9 after injection and in Group B decreased from before 8.33 injection to 3.13 after injection, at the final follow-up. Mean AOFAS score improved from 54.06 to 90.60 and from 54.86 to 75.13 in the respective groups at the 6-months follow-up. Plantar fascia thickness (as measured using ultrasonography) decreased from 5.77 to 3.32 and from 5.6 to 3.73 in the respective groups. The improvements observed were statistically significant.
Conclusions: Local injection of platelet rich plasma is an effective treatment option for chronic plantar fasciitis when compared with steroid injection with long lasting beneficial effects.
Use of fibular graft in Masquelet technique in osteomyelitis of long bones-a novel modification in the technique
Authors: Kharat Aniket , Aher Deepak
Published: June 2023

Background: Improper treatment of acute osteomyelitis mostly leads to chronic osteomyelitis. In the year 2000, Alain C. Masquelet described the Induced membrane technique for the first time. In this study, we aimed to determine the clinical efficiency of the Masquelet technique for bone loss due to osteomyelitis in the long bones.
Methods: This study was conducted at our tertiary care centre Shri Vasantrao Naik medical college and hospital, Yavatmal between August 2016 and September 2020. Masquelet technique with some modification was performed in all cases.
Results: In first stage, the defects were filled with antibiotic-loaded polymethyl methacrylate (PMMA) cement after radical debridement. In second stage after 6 to 8 weeks we used a combination of fibular strut graft with iliac cancellous graft. X-rays were taken before second stage and after 3 months, 6 months and 1 year to see for the union. The study included 10 patients, with 6 males and 4 females with mean age of 34 years (20 to 54). The mean duration of bone infection was 4 months (range: 3-5 months). All patients had an average follow-up period of 16 months (range, 12-24 months). Radiographic evidence of bone union was seen in 6 months (3 to 9 months) infection was not seen in any case.
Conclusions: This modified Masquelet is an effective method for the treatment of chronic osteomyelitis of the long bones.
Clinical outcomes of anterior cruciate ligament reconstruction using loop cruciate ligament fixation system
Authors: Shah Darshan , Balochiya Sanjay , Balochiya Nirav , Chaudhary Arini
Published: June 2023

Background: Anterior cruciate ligament (ACL) injuries cause knee instability and are associated with articular degeneration. ACL reconstruction is considered the primary treatment option for most cases. The study aimed to observe the clinical outcomes of ACL reconstruction using a Loop cruciate ligament fixation system.
Methods: This retrospective, multi-center study enrolled 187 patients who underwent arthroscopic ACL reconstruction using the LoopLoc CL fixation system and SlideRope Adjustable Loop (ArthroTEC, MJ Surgical, Ahmedabad, India). Among 187 patients, 179 received the targeted device for ACL reconstruction in the knee, seven received it for acromioclavicular joint fixation in the shoulder, and one received it for stabilization and repair in the foot/ankle. The patients were evaluated preoperatively, intraoperatively, and postoperatively at 1-month, 3-month, 12-month, 2-year, and 5-year follow-up periods. The evaluation was based on the international knee documented committee score (IKDC), visual analog scale score (VAS), Lysholm score, and knee injury and osteoarthritis outcome score (KOOS). The patient enrollment was conducted retrospectively, but the follow-up was planned to be carried out prospectively.
Results: The study found a significant improvement in the clinical outcomes with a low failure and complication rate among the patients. The mean deviation of patients with knee implantation showing IKDC score from baseline to 5-year was 17.58±2.56 to 91.48±3.05 (p<0.0001), while the VAS, Lysholm score, and KOOS also showed significant improvement. The study suggests that loop cruciate ligament may be a promising option for ACL reconstruction.
Conclusions: The study suggests that loop cruciate ligament may be a promising option for ACL reconstruction.
The outcome of transforaminal epidural steroidal injection in patients with lumbar canal stenosis: a study of 49 patients
Authors: Phunde Rajendra , Somani Vasav , Bava Surendar Singh , Jaiswal Nishant , Gupta Rajan
Published: June 2023

Background: Lumbar canal stenosis is a disease of advanced age, commonly seen in individuals >60 years of age. The disease begins with neurogenic claudication and is progressively associated with weakness in the lower limbs. Often, these patients also have radiculopathy, which may be due to a contribution of foraminal stenosis and facet arthropathy.
Methods: This research has been conducted on a sample of patients presenting to our tertiary care center with lumbar canal stenosis to evaluate the outcome of transforaminal epidural steroidal injection and to determine the therapeutic response of the patient in response to the epidural steroidal injection. A sample of 49 patients presenting with neurogenic claudication of 6 weeks duration (minimum) in correspondence with MRI finding suggestive of lumbar canal stenosis were chosen after obtaining informed consent for the procedure transforaminal epidural steroidal injection under fluoroscopy. Pre- and post-NRS scores were recorded at 2 instances.
Results: The mean and standard deviation of pre-procedural and immediate post-procedural NRS scores were found to be 7.02±1.62 and 3.12±1.2 respectively. The mean and standard deviation of the 1-month post-procedure NRS was found to be 3.27±1.56. Considering successful treatment as more than 50% reduction in the NRS score at 1 month when compared to the pre-treatment NRS score, the successful outcome of the study was 63.26%.
Conclusions: In our study, we have evaluated the effect of TEFSI in patients with lumbar canal stenosis presenting with neurogenic claudication and radiculopathy. Our study assessed pre-procedure, immediate post-procedure, and 1-month post-procedure NRS score following TEFSI. NRS score was assessed based on a questionnaire. The reduction of NRS score was equally seen in all patients irrespective of age, sex, and complaints.
A rare presentation site for osteochondroma scapula and pelvis, intramembranous ossifying bones of axial skeleton: case series
Authors: Pawar Eknath D. , Patel Ravi
Published: June 2023

Osteochondroma is the most common primary bone tumour comprising over 33% of benign bone tumours. The formation of osteochondroma occurs because of exophytic protuberance on the surface of growing bones. The most common sites for osteochondroma are the distal femur, proximal tibia, and proximal humerus. We are presenting a case series of three patients with rare presentation sites of osteochondroma, scapula and pelvis. Osteochondroma is primarily disease of appendicular skeleton but we are reporting it in axial skeleton. Radiographic findings include fluffy cartilaginous outgrowth arising from the external surface of a long tubular bone that may be pedunculated or sessile. Osteochondromas usually develop in bones that develop by enchondral ossification and rarely develop in bones developing by intramembranous ossification like pelvis. These tumours are usually asymptomatic but can cause pubic visceral compression or neurovascular compromise by compressing external and internal iliac vessels and lumbosacral pluxes. Scapular osteochondroma can cause compression or neurovascular compromise in thoracic cavity and axillary vessels and brachial pluxes. Treatment with surgical excision gives consistent results and relief of pain.
Current scenario and challenges for bone retrieval for allograft use in North India
Authors: Tejwani Mohit K. , Meena Ram K. , Arya Kartik , Bhat Rohith G. , Chauhan Lokendra S. , Singh Ramandeep
Published: June 2023

Bone grafts are the second most common tissue transplanted. With advances in the treatment of musculoskeletal tumors, limb salvage surgery, with its concomitant demand for bone graft, has increased significantly. This study aims to evaluate current scenario for bone donation in north India. This study was done in bone bank, Government Medical College, Kota, Rajasthan. Inclusion and exclusion criteria of bone donors were followed as per the APASTB standards of tissue banking. Bone was retrieved from deceased donor and live donors after proper consent and counselling in this institute during period 01 January 2021 to 31 January 2022. During the period of study bones were retrieved from 26 donors – 24 live donors and 2 cadavers. Out of 24 live donors 20 were femoral head, 2 tibia and fibula and 2 hemi-radius and hemi-ulna. All donors were between 28-71-year age group and mean age was 56 years. 18 males and 8 females participated in study. There is huge difference between demand and supply of bone allograft in this region of country. There is lack of initiative from government for encouraging people to donate bone along with other organ and tissue donations. Lack of infrastructure for to and fro transport of bone retrieval from deceased and live donors to storage unit results in loss of bone samples. Less trained personnel and sufficiently low coordination between various institutes. Concerns of family members and misconceptions to be addressed properly to reduce morbidity burden in society.
Management of severely comminuted fracture patella: a case report
Authors: Kumar Jayant , Kerketta Abhay H. , Rahul Kumar , Niraj Nishant Kumar
Published: June 2023

Fracture patella is a breach in the extensor mechanism of the knee and needs to be fixed. Comminuted fractures of patella are a challenge given the difficulty in restoring the extensor mechanism. Introduction: Treatment options have evolved over the years from sacrifice to salvage i.e., from total or partial patellectomy to patellar preserving surgery. The challenge remains to fix the fragments optimally and also to have a tailor-made physiotherapy and rehabilitation program for the patient to provide a satisfactory functional outcome. A 14-year-old female presented to the casualty with a history of domestic fall, injuring her right knee. X-ray was done which revealed a comminuted fracture of right patella, classified as 34C3 OA/OTA classification. Salvage procedure for severely comminuted patella fracture has a successful functional outcome following a stable fixation of fragment.
Intralesional extended curettage with fibular strut for the treatment of large peritrochanteric cyst: a case report and review of literature
Authors: Munde Kishor B. , Venugopal Adarsh , Jadhav Yash
Published: June 2023

Simple bone cysts are benign bone lesions commonly found in children and adolescents. They are usually asymptomatic and are incidentally detected on imaging studies. However, in rare cases, simple bone cysts can grow to a large size and cause symptoms such as pain and functional limitations. We present a case report of a large peritrochanteric simple bone cyst in an adolescent male who presented with hip pain and difficulty in walking. The diagnosis was confirmed by radiographic findings and histopathological examination of the cyst. The patient was managed with curettage and auto allo bone grafting with fibular strut and supplementary plate fixation. Patient had a favourable outcome with complete resolution of symptoms at 18-month follow-up. Our case report highlights the need of fixation for large simple bone cyst in proximal femur region along with curettage and bone grafting.
‘Beyond broken bones’: the hidden impact of depression on orthopaedic patients-the silent struggle
Authors: Ganesh Arjun , Kumar M. Mohan
Published: June 2023

The recognition of the interplay between physical and mental health is of increasing importance in the management of orthopaedic patients. Orthopaedic patients not only encounter physical impairments but also mental health complications such as anxiety and depression. While orthopaedic surgeons traditionally focus on the physical aspects of patients' recovery, recent studies have highlighted the significant impact of psychological factors on functional outcomes and quality of life; thus, necessitating a comprehensive treatment approach.
‘From bones to burnout, delving beyond the scalpel’: prioritizing surgeon wellness for optimal patient outcomes
Authors: Ganesh Arjun , Kumar M. Mohan
Published: June 2023

Orthopaedic surgeons face significant challenges in balancing their demanding professional responsibilities with their personal lives, which can often lead to burnout and poor well-being. Orthopaedic surgeons face a variety of multifaceted stressors which lead to burnout and have significant impacts on their well-being and the quality of patient care. Here, we present an overview of relevant literature and provide evidence-based recommendations for a comprehensive multidisciplinary approach to implement strategies to mitigate their effects.
Efficacy and safety for the combination of lutein, vitamin C, zeaxanthin, zinc, copper, and vitamin E in Indian patients of age-related macular degeneration - Post marketing surveillance study
Authors: Pawaskar Lalit , Sharma Amit , Kiran Mayuresh
Published: June 2023

Age-related macular degeneration (AMD) is an ocular disease of complex nature which reduces the quality of life of the patient. Objectives behind the conduct of this study was to evaluate the efficacy as well as safety for the combination of Lutein, Vitamin C, Zeaxanthin, Zinc, Copper and Vitamin E in patients of AMD.

For the study 660 patients were recruited and 627 patients completed the study throughout India at 44 clinical trial sites. The study duration was of 90 days and efficacy and safety assessment was made on day 45 (visit 2) and day 90 (visit 3). Efficacy assessment was made by 2 efficacy assessment parameters including, “vision related quality of life (VRQOL)” and “vision Impairment score” obtained using “Vision Impairment Questionnaire”. Safety assessment was made by adverse events reported by the patients.

At baseline visit, the mean VRQOL score of all the patients completed the study was 5.733 which was increased to 6.682 on visit 2 and 7.476 on visit 3 where, percentage increase was of 16.550% and 30.403% respectively on visit 2 and 3 as compared to baseline. At baseline visit, the vision impairment score was 21.389 reduced to 17.352 on day 45 and further reduced to 14.135 on day 90.

Fixed dose combination of Vitamin C 250mg, Zinc 40mg, Lutein 5mg, Zeaxanthin 1mg, Copper 1mg and Vitamin E 200 IU per capsule was found efficacious and safe for the medical management of AMD in Indian patients.
Study of changes in choroidal thickness with severity of diabetic retinopathy and diabetic macular edema in type 2 diabetic patients
Authors: Pandey Rajshree , Jaiswal Ram Kumar , Yadav Ram Yash Singh
Published: June 2023

: Diabetic retinopathy (DR) is one of the long-term microvascular complications of Diabetes mellitus. Chronic hyperglycemia cause microvascular abnormalities to both retina and choroid. Optical coherence tomography (OCT) is a non-invasive fundus imaging modality, which plays a vital role in revealing the pathogenesis and development of retinal–choroidal diseases.

This prospective observational study included 128 eyes of 64 subjects diagnosed with type 2 diabetes and out of 128 eyes, 113 (88%) eyes were found to have DR. Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on OCT.

Mean age in the study group was 53.71 ± 9.37 years (45–70 years). Out of 113 eyes, 19 (17%) eyes were diagnosed as mild NPDR, 21 (19%) eyes had moderate NPDR, 36 (31%) eyes had severe NPDR and 37 (33%) eyes had PDR. The average SFCT in MILD NPDR was 310 ± 14.70 μm at 95% CI (1.86), MODERATE NPDR was 316 ± 17.97 μm at 95% CI (2.70), SEVERE NPDR was 326.02 ± 14.05 μm at 95% CI (4.59) and PDR was 298.55 ± 18.75μm at 95% CI. (1.41). The presence of DME significantly affects average SFCT. It was observed that choroidal thickness tends to increase as the severity DR with DME progress.

The average SFCT was thicker in patients with increase in severity of DR, and then SFCT decreased in patients with PDR. As the severity of NPDR increased from mild to moderate to severe NPDR, there was increase in sub foveal choroidal thickness. (p<0.05). PDR showed decrease in sub foveal choroidal thickness in comparison to NPDR which is highly statistically significant. p=0.01 (p<0.05). The presence of DME significantly affects average SFCT (p<0.05). It was observed that choroidal thickness tends to increase as the severity DR with DME progress. Thus, Choroidal thickness measurement can help in assessment of DR pathogenesis.